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Clinical Observation of Liver Scintigram (간(肝) Scintigram의 임상적(臨床的) 고찰(考察))

  • Moon, Sung-Soo;Oh, Kyoung-Sik;Kim, Yul-Za;Kim, Yong-Cheol;Lee, Chong-Suk;Lee, Hak-Choong
    • The Korean Journal of Nuclear Medicine
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    • v.14 no.2
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    • pp.19-27
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    • 1980
  • Although primary application of radioisotope scanning technics to the liver has been of use in the detection of the intra-hepatic space occupying lesion from the normal functioning liver parenchyme, there has been on increasing awareness of its use in evalution of Liver function. In this study, the diseases of the liver were classified into group A,B,C and D by the liver scanning findings, conventional liver function tests and clinical findings. Following were the results: 1. The colloidal radiogold liver scan appeared normal in the group A, also the albumin in serum, alkaline phosphatase activity and prothrombin time were within normal levels in this group. 2. In the group B, there were acute hepatitis 24(48%), chronic hepatitis 5(10%), toxic hepatitis 3(6%), subacute hepatic necrosis 3(6%), typhoid liver 4(8%), hepatic tuberculosis 2(4%), diabetes mellitus 3(6%) and others 3(6%). In this group, SGOT and SGPT were increased predominantly as compared with group A, and the liver scan showed small amount of mottling of activity and faintly visualized spleen. 3. In the group C, there were postnecrotic liver cirrhosis 30(60%), Laennec cirrhosis 10(20%), cardiac cirrhosis 1(2%), cholangiocarcinoma 1(2%), chronic active hepatitis 6(12%), hepatic milliary tuberculosis 1(2%) and gall bladder cancer 1(2%). In this group, the albumin in serum and prothrombin time were lowered significantly and the liver scan showed severe mottling of activity with extra-hepatic uptake in the spleen and bone marrow along the vertebral column. 4. In the group D, there were primary hepatoma 26(52%), hepatoma with liver cirrhosis 7(14%), metastatic liver cancer 5(10%), liver abscess 10(20%), multiple liver cyst 1(2%) and cystic duct adenoma 1(2%), In this group, the alkaline phosphatase activity was elevated with single or multiple intrahepatic space occupying lesion in the radiogold colloid liver scan.

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Analysis on Usefulness of Non-invasive Liver Fibrosis Evaluation Method according to the Liver Disease : Focused on Hepatitis C patients (간질환 종류에 따른 비침습적 간섬유화 평가법의 유용성 분석 : C형 간염 보균자 중심으로)

  • Nam, Ji-Hee;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.42 no.5
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    • pp.345-350
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    • 2019
  • Liver biopsy is the gold standard for diagnosing liver fibrosis, but it is invasive and has a risk for complications. For this reason, recently, study has been actively conducted on non-invasive liver fibrosis evaluation method. But, there is no established standard for the type of diffuse liver disease. Therefore, this study was suggest the usefulness and cut-off values of Fibroscan, FIB-4, APRI and AAR of patients with hepatitis C in Korea. According to the diagnosis, 240 people in hepatitis C are classified into fatty liver, chronic hepatitis, and liver cirrhosis. The statistical analysis was performed by ANOVA to verify difference between groups. The ROC curve was analyzed to determine the usefulness and practical cut-off value. As a result, for all diseases, the AUC value for Fibroscan was 0.8 over and the APRI was 0.7 over. Cut-off value of serum based liver fibrosis markers was increased in order of fatty liver, chronic hepatitis and liver cirrhosis. If Fibroscan and serological liver fibrosis markers are applied to predict liver fibrosis, it is expected that excessive liver biopsy can be reduced.

Factors Related Self-Care Behavior among Liver Cirrhosis Patients: Focusing on Disease Knowledge and Family Support (간경변증 환자의 자가간호 행동 관련 요인: 질병 지식과 가족지지를 중심으로)

  • Park, HaeJin;Shin, Yeonghee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.647-656
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    • 2017
  • This study examined the associations among the factors related to self-care behavior in patients with liver cirrhosis, focusing on disease knowledge and family support. The subjects were 120 liver cirrhosis patients recruited from the medical out-patient clinic of ageneral hospital in the U metropolitan city during the period of June-August, 2015. The data were analyzed with SPSS(Version 21) program. The results showed that the average scores of disease knowledge was $12.64{\pm}2.16$ out of 18; family support was $23.28{\pm}5.68$ out of 32; and self-care behavior was $35.66{\pm}8.67$ out of 60. The study subjects had moderate levels of disease knowledge and family support, but low levels of self-care behavior. The data showedthat self-care behavior was positively correlated with disease knowledge (r=0.675, p<0.001) and family support (r=0.804, p<0.001) of the subjects. The best predictors for self-care behavior were family support, disease knowledge, frequency of alcohol consumption per week, having liver cirrhosis patients among family or relatives, and educational level, which accounted for 69.7% of the variance. In conclusion, promoting the self-care behavior of liver cirrhosis patients should be planned based on a consideration of the patient's educational level, knowledge of their own disease, and family support.

Analysis of Image for Liver Disease using Blood Test in the Ultrasound Fibroscan (Fibroscan에서의 혈액검사를 이용한 간질환의 영상분석)

  • Lee, Jeong-Hyun;Kim, Dong-Hyun;Kim, Changsoo
    • The Journal of the Korea Contents Association
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    • v.15 no.8
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    • pp.389-396
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    • 2015
  • The liver fibrosis is a disease we often see in clinical medicine, and the persistence and repeatition of inflammation and necrosis of liver cells continue for several years, and it is proceeded to cirrhosis. So decrease of death rate and prevalence rate by complications of cirrhosis and hepatocellular carcinoma is main task of clinical medicine by protection of chronic liver ailment patients from proceeding to cirrhosis and hepatocellular carcinoma. So this study tried to represent the ultrasonic image, blood test, the relationship with liver stiffness of diffuse liver ailment patients as numbers. This study was performed with patients from whom the image was taken by ultrasonic and 141 people who were treated by fibroscan, the basic data for blood test was obtained from the test results at the time when ultrasonic image and liver fibroscan was performed. The statistical analysis was performed by One-way analysis of variance(ANOVA) to verify difference between groups. The value of liver stiffness was increased in the order of normal, chronic liver disease and cirrhosis. As a results, ALT and Albumin have no statistical difference between object groups, and there are statistical differences in the results of ultrasonic decoding at age, AST, ALP, Bilirubin, PLT, PT, and kPa, and they are statistically meaningful(p<0.005). And the value of liver stiffness of chronic liver ailment was presented only as over 12.5kPa in other study, but it was represented as numbers for quantitative diagnosis by presenting average kPa threshold value according to disease in this study. And by presenting relationship of diagnosed results, it is considered that it could be used as first tool to diagnose chronic liver ailment patients according to their disease.

The Clinical Evaluation of Hepatic Disease (간장질환의 임상에 대한 관찰)

  • Yang, Il-Sun;Cho, Chong-Sook
    • Journal of Nutrition and Health
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    • v.6 no.2
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    • pp.17-24
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    • 1973
  • The function of the liver is so complicated and important that various Hepatic diseases are occured due to functional retardation of liver. Above all, the incidence of Hepatitis and liver cirrhosis among Koreans has shown an increasing tendency recently. 113 cases of Hepatitis and 125 cases of liver cirrhosis which had been admitted, more than 10 days, to KOREA Hospital between November, 1968 and July,1972, were studied through clinic charts. (A) Hepatitis 1) of the 113 cases; 54 cases (47.7%) were Infectious hepatitis; 40 cases (35.4%) were chronic hepatitis 2) of the 113 cases ; 80 cases (70.8%) were male and 33 cases (29.2%) were female; the sex ratio was 2.4 : 1 The ages of the onset of the disease was as follows; 34 cases (30.1%) were among $30{\sim}40$. 3) Patients had abdominal pain (77.9%) anorexia (66.4 %) and general weakness(82.3%) as symptom and jaundice (94.7%) hepatomegaly (76.1%) as sign 4) 57 cases of all had complication 26 cases (45.6%) were parasite, 12 cases (21.1%) were diabeties mellitus. 5) 99 casea (87.6%) of all were improved and recovered. (B) Liver Cirrhosis 1) Etiologic factors are hepatitis (56cases) and alcoholics (28 cases). 2) of the 125 cases, 84 cases (67.2%) were male and 41 cases (32.8%) were female; the sex ratio was 2 : 1 The age of the onset of the disease was as follows; 47 cases (37.6%) were among 41-50. 3) Patients had symptoms: indigestion (64.8%), Abdominal pain (60%), general wenkness (35.2%) and signs; Hepatomegaly (61.6%) Ascites (59.2%), Jaundice(56.8%). 4) 107 cases of all had complications; Hepatic coma was 20 cases (18.7 %), Ascites was 16 cases (15.0%). 5) 69 cases (55.2%) were improved. (c) Treatment of Hepatitis and cirrhosis. 1) Absolutely (bed) rest. 2) A well-balanced diet adequate in calorie value, showed be given (High Carbohydrate, High Protein, High vitamin diet) if the patient's appetite is good and easily digested. 3) Drugs; (1) Vitamins (2) Digestants (3) Tranquize

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Liver-to-Spleen Volume Ratio Automatically Measured on CT Predicts Decompensation in Patients with B Viral Compensated Cirrhosis

  • Ji Hye Kwon;Seung Soo Lee;Jee Seok Yoon;Heung-Il Suk;Yu Sub Sung;Ho Sung Kim;Chul-min Lee;Kang Mo Kim;So Jung Lee;So Yeon Kim
    • Korean Journal of Radiology
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    • v.22 no.12
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    • pp.1985-1995
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    • 2021
  • Objective: Although the liver-to-spleen volume ratio (LSVR) based on CT reflects portal hypertension, its prognostic role in cirrhotic patients has not been proven. We evaluated the utility of LSVR, automatically measured from CT images using a deep learning algorithm, as a predictor of hepatic decompensation and transplantation-free survival in patients with hepatitis B viral (HBV)-compensated cirrhosis. Materials and Methods: A deep learning algorithm was used to measure the LSVR in a cohort of 1027 consecutive patients (mean age, 50.5 years; 675 male and 352 female) with HBV-compensated cirrhosis who underwent liver CT (2007-2010). Associations of LSVR with hepatic decompensation and transplantation-free survival were evaluated using multivariable Cox proportional hazards and competing risk analyses, accounting for either the Child-Pugh score (CPS) or Model for End Stage Liver Disease (MELD) score and other variables. The risk of the liver-related events was estimated using Kaplan-Meier analysis and the Aalen-Johansen estimator. Results: After adjustment for either CPS or MELD and other variables, LSVR was identified as a significant independent predictor of hepatic decompensation (hazard ratio for LSVR increase by 1, 0.71 and 0.68 for CPS and MELD models, respectively; p < 0.001) and transplantation-free survival (hazard ratio for LSVR increase by 1, 0.8 and 0.77, respectively; p < 0.001). Patients with an LSVR of < 2.9 (n = 381) had significantly higher 3-year risks of hepatic decompensation (16.7% vs. 2.5%, p < 0.001) and liver-related death or transplantation (10.0% vs. 1.1%, p < 0.001) than those with an LSVR ≥ 2.9 (n = 646). When patients were stratified according to CPS (Child-Pugh A vs. B-C) and MELD (< 10 vs. ≥ 10), an LSVR of < 2.9 was still associated with a higher risk of liver-related events than an LSVR of ≥ 2.9 for all Child-Pugh (p ≤ 0.045) and MELD (p ≤ 0.009) stratifications. Conclusion: The LSVR measured on CT can predict hepatic decompensation and transplantation-free survival in patients with HBV-compensated cirrhosis.

Massive bleeding from a rectal Dieulafoy lesion in a patient with alcoholic cirrhosis

  • Choi, Young Hoon;Eun, Jong Ryeol;Han, Jae Ho;Lim, Hyun;Shin, Jung A;Lee, Gun Hwa;Lee, Seung Hee
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.88-90
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    • 2017
  • Although Dieulafoy lesion can occur in any part of the gastrointestinal tract, its occurrence in the rectum is rare. Rectal Dieulafoy lesions have been associated with advanced age, renal failure, burns, liver transplantation and cirrhosis. Here, we report on a case of massive bleeding from a rectal Dieulafoy lesion after lung decortication surgery in a 57-year-old male patient with alcoholic cirrhosis. Although rare, a rectal Dieulafoy lesion should be included in the differential diagnosis of massive lower gastrointestinal bleeding in a patient with cirrhosis.

A Case Report of Alcohol-Associated Cirrhosis Treated with Cheongganhaeju-tang (알코올 간경변증 환자에 대한 청간해주탕 치험 1례)

  • Juyoung Lee;Eunkyung Lee;Minjeong Park;Youngchul Kim;Jang-Hoon Lee
    • The Journal of Internal Korean Medicine
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    • v.45 no.2
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    • pp.270-277
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    • 2024
  • Objectives: This study identified the effects of Korean medicine treatment on a patient with alcohol-associated cirrhosis. Methods: A 50-year-old male with alcohol-associated cirrhosis was treated with Cheongganhaeju-tang from 10 November 2023 to 18 January 2024 to reduce fatigue, dyspepsia, anorexia, and weight loss and to improve laboratory findings, such as liver enzymes. We observed changes in the patient's symptoms and laboratory findings during a treatment period of approximately 2 months. Results: With Cheongganhaeju-tang treatment, serum levels of liver enzymes remained stable, clinical symptoms improved, and alcohol cravings decreased. Conclusion: This case points to Cheongganhaeju-tang as a therapeutic option to manage alcohol-associated cirrhosis.

Investigation of the Prevalence of Cholelithiasis in Liver Cirrhosis Cases and Controls on Upper Abdominal Ultrasound Images (상복부 초음파 영상에서 간경변증 환자군과 대조군의 담석증 유병률 연구)

  • Cheong-Hyeon Jo;Yong-Gwon Kim;Se-Jong Yoo;Seok-Hwan Bae
    • Journal of radiological science and technology
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    • v.46 no.6
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    • pp.553-560
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    • 2023
  • This study aimed to understand the correlations of prevalence and relevant variables of cholelithiasis with a group of cirrhosis patients and a control group targeting the subjects who received the abdomen ultrasonography from K university hospital in Daejeon Metropolitan City from January 1st 2019 to December 31st. And the results are as follows. First, the group of cirrhosis patients showed relatively higher prevalence of cholelithiasis than the control group as ordinary people, which showed statistically significant differences. Second, in the control group, there were statistically significant differences in the occurrence of cholelithiasis with respect to age. Conversely, in the cirrhosis patient, there was no statistically significant association observed with age; nonetheless, age itself exhibited statistical significance. Third, according to sex, the prevalence was not statistically significant in both group of cirrhosis patients and control group. Fourth, in each degree and cause of subdivided cirrhosis, the correlation was only shown in each degree. In the results of this study, the cirrhosis patients showed high correlation with the incidence of cholelithiasis, and the control group showed the high correlation with the incidence of cholelithiasis according to age.

A Study on the Significance of the Colloidal Radiogold Disappearance Rate as a Simple Clinical Liver Function Test (임상간기능검사법(臨床肝機能檢査法)으로서의 교질형방사성금(膠質形放射性金)의 혈중소실율(血中消失率)의 의의(意義)에 관(關)한 연구(硏究))

  • Hong, Chang-Gi
    • The Korean Journal of Nuclear Medicine
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    • v.3 no.1
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    • pp.1-12
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    • 1969
  • Liver functions in diffuse parenchymal liver disease such as cirrhosis of the liver depend largely on the effective hepatic blood flow rather than on the individual cell functions. Clinical methods of measuring the hepatic blood flow were developed recently by the application of colloidal disappearance rate. In order to correlate the radiogold disappearance rate to conventional biochemical liver function tests, 21 normal subjects and 80 cases of cirrhosis of the liver were studied with both methods. The results are summarized as following: 1. The validity of external counting method to measure the blood disappearance rate of colloidal radiogold was confirmed by in vitro counting of the serial blood samples. 2. The blood disappearance rate of collidal radiogold was essentially the same. as the liver uptake rate of colloidal radiogold in normal and cirrhotic subjects with various degrees of functional disturbance. And it seemed there was no serious extrahepatic removal of the colloidal radiogold. 3. The disappearance rate of colloidal radiogold was not significantly changed by the posture change, but was enhanced by ingestion of 500 ml of water. 4. The disappearance rate of colloidal radiogold was not influenced by single dose of Telepaque, while BSP retention was increased after Telepaque. 5. The mean disappearance half time of colloidal radiogold in normal subjects was $2.49{\pm}0.391$(S.D.) minutes. The mean normal disappearance rate constant (K value) was $0.285{\pm}0.0428$(S.D.)/minute. 6. The colloidal radiogold disappearance half time was abnormally prolonged (over 3.2 min.) in $87.7{\pm}3.68$(S.D.) % of cirrhotic subjects. 7. In patients of liver cirrhosis the blood disappearance rate of colloidal radiogold correlated well to serum albumin and globulin levels and BSP retention which were considered to reflect functions of hepatic parenchymal cells. There was, however, no correlation between colloidal disappearance rate and thymol turbidity test, serum glutamic pyruvic transaminase, and serm alkaline phosphatase activities. The latters were considered to be associated with the activity of liver disease.

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