• Title/Summary/Keyword: liver cirrhosis

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Dynamics and Liver Disease Specific Aspects of Quality of Life Among Patients with Chronic Liver Disease in Yunnan, China

  • Che, Yan-Hua;You, Jing;Chongsuvivatwong, Virasakdi;Li, Li;Sriplung, Hucha;Yan, Yuan-Zhi;Ma, Si-Jia;Zhang, Xiaoli;Shen, Ting;Chen, He-Min;Rao, Shao-Feng;Zhang, Ru-Yi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.4765-4771
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    • 2014
  • Background: Patients with chronic liver diseases (CLD) may have compromised health related quality of life (HRQoL). Hepatitis B virus (HBV) infection has long been the leading cause of CLD including liver cancer and cirrhosis. Knowledge on different symptom profiles of CLD should help in development of comprehensive treatment and patient care plans. Objective: To access the facets of HRQoL in chronic liver diseases throughout their spectrum of severity. Materials and Methods: A cross-sectional study was conducted in the First Affiliated Hospital of Kunming Medical University in Yunnan Province of China. Both out- and inpatients undergoing treatment protocols for different HBV related liver disease states were consecutively collected from December 2012 to June 2013. ANOVA was used to compare the mean scores of EQ-5D and chronic liver disease questionnaire (CLDQ) among 5 disease groups. The relationship between demographic variables predicting global CLDQ scores and the domains of CLDQ was analysed. Results: A total of 1040 patients including 520 without complications, 91 with compensated cirrhosis, 198 with decompensated cirrhosis, 131 with HCC and 100 with liver failure were recruited. All domains of CLDQ, the means of EQ-5D value and EQ VAS exhibited significant decline with worsening of disease severity from uncomplicated HBV to liver failure. The multivariate regression demonstrated the reduction of mean scores of CLDQ domain at advanced stage. Patients with liver failure and HCC had more HRQoL impairment than other disease states. No effect of patient gender was found. Patient age was associated with 'fatigue' and 'worry' domains (p=0.006; p=0.004) but not with other domains and global scores of CLDQ and ED-5D. Conclusions: The HRQoL in chronic hepatitis B patients is greatly affected by disease states. Care for HBV-related diseases should consider not only the outcomes of treatment strategies but also improvement in patient wellbeing.

Correlation of Major Scan Findings and Esophageal Varices in Liver Cirrhosis (간경변증에 있어서의 주요 간주사 소견과 식도정맥류와의 상관성에 관하여)

  • Ahn, J.S.;Bahk, Y.W.;Lim, J.I.
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.1
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    • pp.37-42
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    • 1970
  • In an endeavor to help understand some typical scan findings and portal hemodynamics in liver cirrhosis, several commonly occurring scan changes and esophageal varices as demonstrated by esophagram were correlated one another from quantitative and qualitative stand points. Clinical materials consisted of 34 patients with proven diagnosis of liver cirrhosis and esophageal varices. Liver scan was performed with colloidal 198-Au and the changes in the size and internal architecture of the liver, splenic uptake and splenomegaly were graded and scored by repeated double-blind readings. The variceal changes on esophagrams were also graded according to the classification of Shanks and Kerley following modification. Of 34 patients, 91% showed definite reduction in liver volume (shrinkage) constituting the most frequent scan change. The splenic uptake and splenomegaly were noted in 73.5 and 79.4%, respectively. The present study revealed no positive correlation between the graded scan findings including shrinkage of the liver, splenic uptake or splenomegaly and severity of variceal changes of the esophagus. Exceptionally, however, apparently paradoxical correlation was noted between the severity of mottlings and varices. Thus, in the majority (73.5%) of patients mottlings were either absent or mild. This interesting observation is in favor of the view held by Christie et al. who consider the mottlings to be not faithful expression of actual scarring of the cirrhotic liver. This also would indicate that variceal changes are to be the results of intrahepatic arteriovenous shunting of blood with hypervolemic load to the portal system rather than simple hypertension secondary to fibrosis and shrinkage.

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Quantitation of Hepatic and Extrahepatic $^{99m}Tc-Tin$ Colloid Uptake in the Hepatocellular Diseases (간세포성 질환에서의 간 및 간외 $^{99m}Tc-Tin$ Colloid 섭취의 정량분석)

  • Park, Young-Ha;Kim, Choon-Yul;Kim, Sung-Hoon;Park, Seog-Hee;Park, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.1
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    • pp.9-16
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    • 1987
  • It is well-known that hepatic scintigraphv have been found to be less sensitive and specific in the detection of the diffuse hepatocellular diseases than that of the space-occupying lesions. To obtain the higher diagnostic specificity and sensitivity, we, using the computer quantitation, have attempted to analyze hepatic and extrahepatic $^{99m}Tc-tin$ colloid uptake patterns in various diffuse hepatocellular diseases retrospectively. The studied groups consisted of 116 cases of normal, 67 cases of acute hepatitis, 112 cases of chronic hepatitis, 61 cases of liver cirrhosis, 47 cases of fatty liver, 12 cases of hepatoma and 9 cases of metastasis, making total 424 cases. Scintigraphic imagings were obtained in the anterior, right lateral and posterior projections using high-resolution collimation, and simultaneously these gamma data were acquisited into the computer system. Both large region of interest (ROI) using light pen and ROI computer program were placed over right lobe, left lobe of liver, spleen and cardiac blood pool. Total counts in ROI were divided by the number of pixels in the ROI, and mean count rate per pixels calculated. Mean right-lobe counts were divded by mean-left lobe counts to determine right-to-left hepatic lobe ratio and mean spleen counts were divided by mean liver counts to determine spleen to liver ratio. The results were as follows. 1) Of 424 cases, 292 were male and 132 were female. The majority of age distribution was in $30\sim49$ (54.5%). 2) Inter-observer between two independant operators and inter-method between drawing by light-pen and ROI computer program variations were not significant. 3) The uptake count values (per pixel) determined at each area in normal group were $106.53{\pm}18.35$ in right lobe, $79.00{\pm}13.82$ in left lobe, $17.52{\pm}8.31$ in spleen and $8.09{\pm}3.43$ in cardiac blood pool. 4) In liver cirrhosis, right lobe uptake was decreased but spleen and cardiac blood pool uptakes were increased (p<0.01). 5) Right-to-left hepatic lobe uptake ratio was $1.37{\pm}0.24$ in normal group and significantly low in chronic hepatitis, liver cirrhosis and fatty liver, and more or less low in acute hepatitis. 6) Spleen-to-right hepatic lobe uptake ratio was $0.17{\pm}0.09$ in normal group and high in chronic hepatitis and liver cirrhosis. 7) The computer-quantitation of hepatic and extrahepatic uptake patterns thought to be sensitive and useful method in the interpretation of liver scintigram.

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Hepatic Cavernous Hemangioma in Cirrhotic Liver: Imaging Findings

  • Jeong-Sik Yu;Ki Whang Kim;Mi-Suk Park;Sang-Wook Yoon
    • Korean Journal of Radiology
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    • v.1 no.4
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    • pp.185-190
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    • 2000
  • Objective: To document the imaging findings of hepatic cavernous hemangioma detected in cirrhotic liver. Materials and Methods: The imaging findings of 14 hepatic cavernous hemangiomas in ten patients with liver cirrhosis were retrospectively analyzed. A diagnosis of hepatic cavernous hemangioma was based on the findings of two or more of the following imaging studies: MR, including contrast-enhanced dynamic imaging (n = 10), dynamic CT (n = 4), hepatic arteriography (n = 9), and US (n = 10). Results: The mean size of the 14 hepatic hemangiomas was 0.9 (range, 0.5-1.5) cm in the longest dimension. In 11 of these (79%), contrast-enhanced dynamic CT and MR imaging showed rapid contrast enhancement of the entire lesion during the early phase, and hepatic arteriography revealed globular enhancement and rapid filling-in. On contrast-enhanced MR images, three lesions (21%) showed partial enhancement until the 5-min delayed phases. US indicated that while three slowly enhancing lesions were homogeneously hyperechoic, 9 (82%) of 11 showing rapid enhancement were not delineated. Conclusion: The majority of hepatic cavernous hemangiomas detected in cirrhotic liver are small in size, and in many, hepatic arteriography and/or contrast-enhanced dynamic CT and MR imaging demonstrates rapid enhancement. US, however, fails to distinguish a lesion of this kind from its cirrhotic background.

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The Study on Concentration of Serum Selenium in Patients with Hepatoma (간암환자의 혈청내 셀레늄 농도에 관한 연구)

  • 신원식
    • Journal of Nutrition and Health
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    • v.24 no.6
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    • pp.506-515
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    • 1991
  • Serum concentration of selenium were measured ; Studying 36 patients with Hepatoma. 19 with Hepatitis 15 with Liver cirrhosis and 67 Normal control to discover the correlation between serum selenum and cancer. And it have tested also the serum protein and albumin to compare the nutrition status by researching the same persons above The results of those two experiments are as follow : 1) The mean of each group of patients resulting from mearsuing the serum protein content showing 6.91$\pm$0.10g/dl in the patients with hepatoma 7.05$\pm$0.17g/dl in the ones with hepatitis 6.42$\pm$0.13g/dl in the ones with liver cirrhosis and 7.46$\pm$0.06g/dl in the normal control is all being within the normal range such as 6.0-0.8(g/dl) while the distribution is revealin 10.5%, 13.3% in the patients with hepatitis and liver cirrhosis which are below the normal range and 47.2%, 96.9%, 80.0% in the low range of normal one ; therefore in could see that patientsw compared with normal control are in low level in the serum protein content 2) The mean based on the consquence of serum albumin measurement is 3.74$\pm$0.11g/dl. 4.26$\pm$0.13g/dl 4.73$\pm$0.06g/dl in the patients with hepatoma hepatits and normal control which are in between the normal range such as 3.5-5.5(g/dl) except the patients with liver cirrhosis(3/05$\pm$0.12g/dl) while the distribution of the patients with hepatoma an liver cirrhosis is showing 27.8% 73.3% which are below the normal one and 55.5%, 52.6% and 26.7% in the patients with hepatoma hepatits and liver cirrhosis which are in the low area of normal range ; as a result It could find that patients. compared with the normal control are in low level in serum albumin measurement. 3) The mean consulting the serum concentration is 430.86$\pm$26.06$\mu\textrm{g}$/1, 192.37$\pm$18.15$\mu\textrm{g}$/1 186.73$\pm$23.99$\mu\textrm{g}$/1, 196.94$\pm$8.94$\mu\textrm{g}$/1 in the patients with hepatoma hepatitis liver cirrhosis and noramal control ; it shows 2.19 times increasing of serum selenium concentra-tion in the patients with hepatoma 'compared with the normal control and patients with hepatoma spread out at a still higher range in serum selenium concentration test. 4) The serum selenium concentration is not quite dependent on sexes and doesn't show any correlation with age, serum protein, serum albumin. The nutrition status of patients, rested on the results of those experiments, stays in low level, which is caused by that they are in low stage of serum protein and serum albu¬min. In serum selenium concentration, patients with hepatitis and liver cirrhosis, specially, show the condition as good as normal control's; while patients with hepatoma are indicating a significant increasing compared with the three groups, which can be reasoned into that there is a possibility for the patients to take selenium and chemotherapy or radiation treatment, and have high serum selenium concentration by poor excreting of seleno methionine, which is caused by low serum protein content And another thing can be reasoned is that the difference in origination mechanism hetween korean and western people. As a result, It showed that the correlation between serum selenium and seses, age, serum protein, and serum albumin neither exists nor affects on each other.

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Effect of Propranolol on Portal Vein Pressure in Patients with Chronic Liver Disease: Evaluation by Perrectal Portal Scintigraphy (만성 간질환에서 Propranolol의 문맥압 감소 효과: 경직장 문맥 신티그라피를 이용한 평가)

  • Rho, Young-Ho;Han, Shin;Kim, Hak-Su;Yoon, Su-Jin;Kim, Yun-Kwon;Kim, So-Yon;Kim, Yeong-Jung;Cho, Min-Koo;Park, Byong-Yik;Lee, Gwon-Jun
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.388-397
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    • 1999
  • Purpose: Propranolol is known to decrease portal pressure by reducing blood flow of portal vein. Perrectal portal scintigraphy with Tc-99m pertechnetate has been introduced to evaluate the portal circulation and early diagnosis of liver cirrhosis. We evaluated the effects of propranolol on portal circulation by using per-rectal portal scintigraphy. Materials and Methods: We analyzed the portal hemodynamics by per-rectal portal scintigraphy in 51 patients with liver cirrhosis, 10 chronic hepatitis and 10 normal subjects. 38 patients with cirrhosis underwent per-rectal portal scintigraphy before and after propranolol medication. Perrectal portal scintigraphy was performed after per-rectal administration of 370 MBq of Tc-99m pertechnetate. The shunt index was calculated as the ratio, expressed as a percentage of heart radioactivity to the sum of heart and liver radioactivity during the first 30 seconds. Results: The shunt index in 40 patients with cirrhosis ($59.8{\pm}27.2%$) was significantly higher than that of normal control ($5.0{\pm}1.2%$. p<0.01) and chronic hepatitis ($11.4{\pm}3.5%$, p<0.01). Shunt index was significantly different according to Child's classification and the degree of esophageal varix (p<0.01). After propranolol medication, shunt index was significantly decreased from $59.9{\pm}27.3%$ to $51.3{\pm}15.3%$ (p<0.01) in 38 patients with liver cirrhosis. There was no significant difference of the amount of shunt index reduction after propranolol according to Childs' classification and the degree of esophgageal varix. Conclusion : The effect of propranolol on portal circulation was demonstrated as decreasing shunt index on per-rectal portal scintigraphy in patients with liver cirrhosis. Per-rectal portal scintigraphy may be useful to evaluate the portal circulation and to predict the effect of propranolol in patients with liver cirrhosis.

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The Antifibrotic Effects of Polysaccharides Extracted from Garnoderma lucidum on the Experimental Hepatic Cirrhosis (영지로부터 추출한 다당체의 실험적 간경화에 대한 섬유화 억제효과)

  • Park, Eun-Jeon;Kim, Ki-Young;Kim, Jae-Baek;Kim, Soo-Woong;Lee, Seung-Yong;Sohn, Dong-Hwan
    • YAKHAK HOEJI
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    • v.38 no.3
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    • pp.338-344
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    • 1994
  • This study was carried out to investigate the antifibrotic effects of polysaccharides extracted from Garnoderma lucidum. The biliary cirrhosis was induced by bile duct ligation/scission (BDL/S) in rats. BDL/S rats were dosed 5 mg/rat/day orally for 4 weeks after the operation. Antifibrotic effects were evaluated by serum biochemical values, serum procollagen type III peptide (PIIINP) levels, liver hydroxyproline contents, and light microscopical histology. The results obtained were as follows; 1) PIIINP levels in sera of treated BDL/S group were lowered to 50% of those of untreated BDL/S group. 2) Hydroxyproline contents in the liver of treated BDL/S group were also reduced to 83% of those of untreated BDL/S rats. 3) The hepatic damage such as hepatocellular necrosis, inflammation, bile duct proliferation and fibrosis was less severe in the livers of treated rats. These results suggest polysaccharides extracted from Garnoderma lucidum to be a promising agent for the inhibition of hepatic cirrhosis(fibrosis).

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