• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.4
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• pp.407-411
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• 2022

Mesenchymal hamartoma of the liver (MHL) is a rare benign tumor that often presents in early childhood, and it rarely occurs in adulthood. Aberrant development of the portal tract is a known cause of MHL. Although limited information is available on the natural course of MHL, malignant transformation has been reported in a few cases. Here, we report a case of a 26-year-old female with intrahepatic cholangiocarcinoma secondary to unresected MHL. The patient underwent resection of the hepatic mass, which was diagnosed as MHL at 2 years of age, due to an increase in mass size and a suspicion of malignant transformation during work-up. Histopathology confirmed intrahepatic adenosquamous carcinoma in the background of MHL, with a T2N0M0 pathological stage (stage II). The surgical margin was free from tumor cells. The patient fully recovered postoperatively and started receiving adjuvant chemotherapy. Previous case reports have only reported about the development of undifferentiated embryonal sarcoma or angiosarcoma as malignant transformation of MHL. Cases of other malignancies have not been published; however, it is difficult to rule out the occurrence of various malignancies related to the portal tract when considering the pathogenesis of the disease. To the best of our knowledge, this is the first case report of adenocarcinoma of bile duct origin secondary to MHL. This case report suggests that aggressive surgical management should be considered after the initial diagnosis of MHL.

• Journal of Nutrition and Health
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• v.48 no.1
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• pp.1-8
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• 2015

Purpose: Anthocyanins from purple sweet potato (PSP) have been investigated in vitro and in animals and found to have a protective effect against oxidative hepatic damage. In this study, we investigated that aqueous extract of PSP can ameliorate the dysfunction of lipid metabolism in mice fed a high fat/cholesterol diet. Methods: Forty C57BL/6J mice were randomly divided into 5 groups (n = 8) and fed one of the following diets for 8 weeks; normal fat (NF) diet; high fat/cholesterol (HFC) diet; HFC with 1.25% PSP (HFPL) diet; HFC with 2.5% PSP (HFPM) diet; HFC with 5% PSP (HFPH) diet. Results: Non-alcoholic fatty liver was manifested in the HFC group by showing increased levels in plasma alanine aminotransferase (ALT) activity, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C), increased level of TC and presence of many large lipid droplets in the liver, and increased fat cell size in the HFC group compared with the NF group. However, administration of HFC induced a significant decrease in food intake, resulting in decrease in fat mass. Co-administration of PSP did not lead to reversal of body weight changes, ALT activity, and lipid levels in plasma and the liver, but suppressed excess enlargement of the fat cell size through increasing carnitine palmitoyltransferase-1 (CPT-1) gene expression in the liver. Accordingly, the number of fat droplets in the liver was reduced in PSP administered groups. Conclusion: Taken together, these results suggest that PSP may have a protective effect on the dysfunction of lipid metabolism. Conduct of further studies on the coordinated regulation of PSP for lipid metabolic homeostasis at the liver-adipose tissue axis is needed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5721-5727
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• 2014

Objectives: To evaluate the performance of clustering methods used in the prognostic assessment of categorical clinical data for hepatocellular carcinoma (HCC) patients in China, and establish a predictable prognostic nomogram for clinical decisions. Materials and Methods: A total of 332 newly diagnosed HCC patients treated with hepatic resection during 2006-2009 were enrolled. Patients were regularly followed up at outpatient clinics. Clustering methods including the Average linkage, k-modes, fuzzy k-modes, PAM, CLARA, protocluster, and ROCK were compared by Monte Carlo simulation, and the optimal method was applied to investigate the clustering pattern of the indices including platelet count, platelet/lymphocyte ratio (PLR) and serum aspartate aminotransferase activity/platelet count ratio index (APRI). Then the clustering variable, age group, tumor size, number of tumor and vascular invasion were studied in a multivariable Cox regression model. A prognostic nomogram was constructed for clinical decisions. Results: The ROCK was best in both the overlapping and non-overlapping cases performed to assess the prognostic value of platelet-based indices. Patients with categorical platelet-based indices significantly split across two clusters, and those with high values, had a high risk of HCC recurrence (hazard ratio [HR] 1.42, 95% CI 1.09-1.86; p<0.01). Tumor size, number of tumor and blood vessel invasion were also associated with high risk of HCC recurrence (all p< 0.01). The nomogram well predicted HCC patient survival at 3 and 5 years. Conclusions: A cluster of platelet-based indices combined with other clinical covariates could be used for prognosis evaluation in HCC.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.30 no.5
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• pp.823-833
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• 1997

To clarify the annual reproductive cycle of the banded catfish, Pseudobagrus fulvidraco (Richardson), the seasonal changes in histological aspect of gonad and liver were examined. The adult fish was raptured from the upper stream of Young-San river, Chunnam in each month from May 1992 to June 1993. Based on the annual changes in GSI (gonadosomatic index), HSI (hepatosomatic index), CF (condition factor) and histological aspects of the gonads, the annual reproductive cycle were classified into 5 periods as follows: 1) Growing phase (from April to early May): The value of GSI increased and the size of oocytes in perinucleolus stage in oocytes increased gradually. Spermatogonia were developed actively from the epithelial tissues of seminiferous tubules. 2) Maturing phase (from Hay to early June): GSI levels increased rapidly in both sex. Oocytes at various developmental stages were observed. Appearance of active spermatogenesis were observed. 3) Mature and spawning phase (from June to August): High values of GSI remained static and oocytes accumulated significant quantitis of yolk globules. 4) Degenerating phase (from September to November): GSI levels decreased and ovaries were filled mostly with oocytes at the perinucleolus stage. Hepatic cells accumulated significant amounts of lipid droplets. 5) Resting period (from December to March) : Low values of GSI were kept and the size of oocytes at the perinucleolus stage did not increase. Spermatogenesis was not observed.

• Korean Journal of Radiology
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• v.22 no.10
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• pp.1628-1639
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• 2021

Objective: Based on the Liver Imaging Reporting and Data System version 2018 (LI-RADS, v2018), this study aimed to analyze LR-5 diagnostic performance for hepatocellular carcinoma (HCC) when threshold growth as a major feature is replaced by a more HCC-specific ancillary feature, as well as the frequency of threshold growth in HCC and non-HCC malignancies and its association with tumor size. Materials and Methods: This retrospective study included treatment-naive patients who underwent gadoxetate disodium-enhanced MRIs for focal hepatic lesions and surgery between January 2009 and December 2016. The frequency of major and ancillary features was evaluated for HCC and non-HCC malignancies, and the LR-category was assessed. Ancillary features that were significantly more prevalent in HCC were then used to either replace threshold growth or were added as additional major features, and the diagnostic performance of the readjusted LR category was compared to the LI-RADS v2018. Results: A total of 1013 observations were analyzed. Unlike arterial phase hyperenhancement, washout, or enhancing capsule which were more prevalent in HCCs than in non-HCC malignancies (521/616 vs. 18/58, 489/616 vs. 19/58, and 181/616 vs. 5/58, respectively; p < 0.001), threshold growth was more prevalent in non-HCC malignancies than in HCCs (11/23 vs. 17/119; p < 0.001). The mean size of non-HCC malignancies showing threshold growth was significantly smaller than that of non-HCC malignancies without threshold growth (22.2 mm vs. 42.9 mm, p = 0.040). Similar results were found for HCCs; however, the difference was not significant (26.8 mm vs. 33.1 mm, p = 0.184). Additionally, Fat-in-nodule was more frequent in HCCs than in non-HCC malignancies (99/616 vs. 2/58, p = 0.010). When threshold growth and fat-in-nodule were considered as ancillary and major features, respectively, LR-5 sensitivity (73.2% vs. 73.9%, p = 0.289) and specificity (98.2% vs. 98.5%, p > 0.999) were comparable to the LI-RADS v2018. Conclusion: Threshold growth is not a significant diagnostic indicator of HCC and is more common in non-HCC malignancies. The diagnostic performance of LR-5 was comparable when threshold growth was recategorized as an ancillary feature and replaced by a more HCC-specific ancillary feature.

• Korean Journal of Radiology
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• v.21 no.4
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• pp.402-412
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• 2020

Objective: To evaluate the performance of predicting early recurrence using preoperative factors only in comparison with using both pre-/postoperative factors. Materials and Methods: We retrospectively reviewed 549 patients who had undergone curative resection for single hepatcellular carcinoma (HCC) within Milan criteria. Multivariable analysis was performed to identify pre-/postoperative high-risk factors of early recurrence after hepatic resection for HCC. Two prediction models for early HCC recurrence determined by stepwise variable selection methods based on Akaike information criterion were built, either based on preoperative factors alone or both pre-/postoperative factors. Area under the curve (AUC) for each receiver operating characteristic curve of the two models was calculated, and the two curves were compared for non-inferiority testing. The predictive models of early HCC recurrence were internally validated by bootstrap resampling method. Results: Multivariable analysis on preoperative factors alone identified aspartate aminotransferase/platelet ratio index (OR, 1.632; 95% CI, 1.056-2.522; p = 0.027), tumor size (OR, 1.025; 95% CI, 0.002-1.049; p = 0.031), arterial rim enhancement of the tumor (OR, 2.350; 95% CI, 1.297-4.260; p = 0.005), and presence of nonhypervascular hepatobiliary hypointense nodules (OR, 1.983; 95% CI, 1.049-3.750; p = 0.035) on gadoxetic acid-enhanced magnetic resonance imaging as significant factors. After adding postoperative histopathologic factors, presence of microvascular invasion (OR, 1.868; 95% CI, 1.155-3.022; p = 0.011) became an additional significant factor, while tumor size became insignificant (p = 0.119). Comparison of the AUCs of the two models showed that the prediction model built on preoperative factors alone was not inferior to that including both pre-/postoperative factors {AUC for preoperative factors only, 0.673 (95% confidence interval [CI], 0.623-0.723) vs. AUC after adding postoperative factors, 0.691 (95% CI, 0.639-0.744); p = 0.0013}. Bootstrap resampling method showed that both the models were valid. Conclusion: Risk stratification solely based on preoperative imaging and laboratory factors was not inferior to that based on postoperative histopathologic risk factors in predicting early recurrence after curative resection in within Milan criteria single HCC patients.

• Korean Journal of Radiology
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• v.22 no.7
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• pp.1066-1076
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• 2021

Objective: To evaluate the performance of the 2018 Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) Practice Guidelines (hereafter, PG) for the diagnosis of hepatocellular carcinoma (HCC) using gadoxetic acid-enhanced MRI, compared to the Liver Imaging-Reporting and Data System (LI-RADS) version 2018 (hereafter, v2018). Materials and Methods: From January 2013 to October 2015, treatment-naïve hepatic lesions (≥ 1 cm) on gadoxetic acid-enhanced MRI in consecutive patients with chronic hepatitis B or cirrhosis were retrospectively evaluated. For each lesion, three radiologists independently analyzed the imaging features and classified the lesions into categories according to the 2018 KLCA-NCC PG and LI-RADS v2018. The imaging features and categories were determined by consensus. Generalized estimating equation (GEE) models were used to compare the per-lesion diagnostic performance of the 2018 KLCA-NCC PG and LI-RADS v2018 using the consensus data. Results: In total, 422 lesions (234 HCCs, 45 non-HCC malignancies, and 143 benign lesions) from 387 patients (79% male; mean age, 59 years) were included. In all lesions, the definite HCC (2018 KLCA-NCC PG) had a higher sensitivity and lower specificity than LR-5 (LI-RADS v2018) (87.2% [204/234] vs. 80.8% [189/234], p < 0.001; 86.2% [162/188] vs. 91.0% [171/188], p = 0.002). However, in lesions of size ≥ 2 cm, the definite HCC had a higher sensitivity than the LR-5 (86.8% [164/189] vs. 82.0 (155/189), p = 0.002) without a reduction in the specificity (80.0% [48/60] vs. 83.3% [50/60], p = 0.15). In all lesions, the sensitivity and specificity of the definite/probable HCC (2018 KLCA-NCC PG) and LR-5/4 did not differ significantly (89.7% [210/234] vs. 91.5% [214/234], p = 0.204; 83.5% [157/188] vs. 79.3% [149/188], p = 0.071). Conclusion: For the diagnosis of HCC of size ≥ 2 cm, the definite HCC (2018 KLCA-NCC PG) had a higher sensitivity than LR-5, without a reduction in specificity. The definite/probable HCC (2018 KLCA-NCC PG) had a similar sensitivity and specificity to that those of the LR-5/4.

• Journal of Yeungnam Medical Science
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• v.17 no.1
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• pp.39-48
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• 2000

Background: There arc two theories in the development of colon cancer. One is the adenoma-carcinoma sequence theory and the other is the de novo cancer theory. Western countries believe in the adenoma-carcinoma sequence theory, however there are many recent reports from, Japan about cancers developing from small adenomas. Methods: The present study analyzed 408 polyps from 508 cases that were taken by colonoscopic polypectomy at the Department of internal Medicine, Yeungnam University Hospital. Results: The percentage of patients who had a polyp was 41.3% (210 cases out of 526 cases), and the peak incidence was noted in patients in their 50s and 60s, There was no difference between the sexes, but we noted significant increase in the incidence of polyps in patients over the age of thirty. We found 395 polyps below 1cm and 13 polyps above 1cm. Among 408 polyps, 5 cases were cancerous polyps and 3 cases showed polyp size of less than 1cm each. The first case was a polyp of 0.4cm in size with elevated mucosa at the ascending colon. The second was 0.5cm in size with round elevation and hyperemic mucosa in the rectum. The third was 0.6cm in size with tubular elevation at the hepatic flexure. Conclusions: Colon polyp is a common disease in Koreans, Even small polyps can have cancer tissue, which should be removed if discovered during colonoscopy. We believe that not all colon cancer originates in the manner described by the adenoma-carcinoma sequence theory. However further studies with a larger sample population arc needed to determine the exact role of colon polyps in the development of colon cancer.

• Herbal Formula Science
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• v.20 no.1
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• pp.67-80
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• 2012

Objectives : We investigated the effects of Ingecheonggeumdan(ICD) on body weight and examined whether blood lipid levels and visceral fat are inhibited by it in high fat diet-fed obese male mice. Methods : 8 weeks old, high fat diet-fed obese male mice were divided into 6 groups: C57BL/6N normal, control, ICD-1(150mg/kg), ICD-2(300mg/kg), ICD-3(600mg/kg) and orlistat(10mg/kg). After mice were treated with ICD and orlistat for 8 weeks, we measured body weight gain, food intake, feeding efficiency ratio, fat weight, plasma leptin and lipid levels. We also performed histological analysis for liver and fat on the mice. Results : Compared with controls, ICD and orlistat-treated mice had lower body weight gain and adipose tissue weight, the magnitudes of which were prominent in ICD-3. Compared with controls, ICD and orlistat-treated mice had lower blood leptin levels, the magnitude of which was prominent in ICD-3. Compared with controls, ICD and orlistat-treated mice had higher blood HDL-cholesterol and lower blood plasma LDL-cholesterol, free fatty acid and triglyceride levels, the magnitudes of which were prominent in ICD-3. Blood plasma AST and ALT concentrations were not changed by ICD and orlistat, indicating ICD and orlistat do not show any toxic effects. Consistent with their effects on body weight gain, the size of adipocytes and hepatic lipid accumulation were significantly decreased by ICD and orlistat. Conclusions : These results demonstrate that ICD and orlistat effectively reduce body weight gain, blood plasma LDL-cholesterol, free fatty acid and triglyceride levels and improves abdominal fat, the magnitudes of which were prominent in ICD-3.

• Journal of the East Asian Society of Dietary Life
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• v.25 no.3
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• pp.425-431
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• 2015

Estrogen deficiency is associated with increased body weight and fat mass, resulting in obesity-associated complications such as insulin resistance, cardiovascular disease, and type-2 diabetes. The present study was performed to investigate the effect of black rice (Oryza sativa L.) extracts (BRE) on body weight and fat mass in ovariectomized rats. Ovariectomized (or sham-operated) rats were randomly blocked into three groups (n=8~10 per group): sham operated group (S), ovariectomized control group (OVX), and ovariectomized group with BRE 30 mg/kg B.W. (BRE). High fat diet (fat calories 45%) was fed to all experimental rats for 12 weeks. Final body weight, weight gain, and body fat weight showed significant increases in the OVX group, whereas they were reduced by BRE supplementation. Serum TAG, T-chol level, and adipocyte size were not significantly different among the three groups. However, ovariectomy-induced hepatic steatosis was improved in BRE-treated group. Moreover, in the BRE group, serum leptin levels was significantly lower and fecal total lipid concentrations was significantly higher compared to the OVX group. The gathered data suggest that BRE is a potentially useful ingredient to protect against estrogen deficiency-related obesity and its related diseases.