• Title/Summary/Keyword: liver fibrosis(cirrhosis)

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The study on Oriental and Western medical of Liver cirrhosis(Fibrosis) pathological system (알코올성 간경변(肝硬變)(섬유화(纖維化))의 병변(病變) 기전(機轉)에 대한 동서의학적(東西醫學的) 고찰(考察))

  • Han, Sung soo;Son, Chang Gyu
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.379-386
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    • 2000
  • 1. There two parts of alcohol's metabolic system the first one is alcoholdehydrogenase(ADH), and second is microsomal ethanol oxidizing system(MEOS). 2. Alcoholic cirrhosis(fibrosis) leads from cytotoxin, malnutrition, and immunue reaction. 3. In the Oriental medical point of view alcohol has strong heat and toxin, which can cause judal, ju-ka, ju-beack, ju-juck, and ko-chang in other words these means that it can cause hepatasis, fatty liver, fibrosis, and liver cirrhosis. 4. About the Liver cirrhosis(fibrosis) pathological system, in the oriental medical point of view, it effects the liver, kidney and spleen which causes Uy-heulGin-guk(瘀血 積), seup-yeul ne-oun(濕熱內蘊), and in the long term it can cause kansinyumhu(肝腎陰虛), kanbeyumhu(肝脾陰虛). Because of the expand of alcohol liver disease, in the future there must be more studies about these disease in Oriental medicine point of view.

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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.

The Screening of Antioxidant and Antifibrotic Effect from Water Extracts of Herbs(LH) in Biliary Liver Fibrosis (Cirrhosis) Induced Rsts (간섬유화(경화)를 유도한 실험동물에서 생약 추출물(LH)의 항산화와 항섬유화 효과 검색)

  • 임진아;김기영
    • YAKHAK HOEJI
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    • v.46 no.2
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    • pp.129-136
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    • 2002
  • The pathogenesis of cholestatic liver injury as well as the modulation of hepatic fibrogenesis is causally associated with involvement of reactive oxygen species (ROS) and free radical reactions. In this study, we investigated whether dried extracts of oriental medicine (LH) have antioxidant and antifibrotic effect under the biliary liver fibrosis (cirrhosis) c ondition. The female Sprague-Dawley rats were divided in six groups (Normal, N-LH, op-2, op-4, opLH-2, opLH-4) and were observed in 2 weeks or 4 weeks. For this purpose the rats were operated by bile duct ligation/scission (BDL/S), which induced to liver fibrosis and cirrhosis. After surgery, the prepared LH was administered p.o. 2 mι/day/rat in 2 weeks or 4 weeks for opLH groups. During the observation period, jaundices appeared in eyes, ears and tail of all BDL/S operated rats. And at the time of sacrifice, cholestasis was observed in proximal bile duct, especially the color of bile juice and urine in opLH-4 group showed more clear than op-2, op-4 and opLH-2 group. The value of clinical parameters and product of lipid peroxidation (MDA) in sera and the hydroxyproline (hyp) content in liver tissue were significantly increased in all liver fibrosis (cirrhosis) developed rats (p<0.001~0.05). Among the clinical parameters of sera, value of BUN, ALP in opLH-4 group showed significantly lower than in op-4 group (p<0.05, p<0.001). The content of hyp in opLH-2, opLH-4 group (478.0 $\pm$ 134.3 $\mu\textrm{g}$/g 897.5 $\pm$ 118.2 $\mu\textrm{g}$/g) showed lower than in op-2, op-4 group (528.9 $\pm$ 220.7 $\mu\textrm{g}$/g, 1023.8 $\pm$ 277.1 $\mu\textrm{g}$/g) and then the value of MDA in opLH-4 was also significantly reduced to 59.4% of that in op-4 group (p<0.001). The histological change (bile duct proliferation, fibrosis, collagen bundle) was similarly observed in op-2 group and in opLH-2 group, but the weak fibrosis and bile duct proliferation were observed in opLH-4 group compared with in op-4 group. Our data indicate that the 4 weeks treatment with LH extract suppressed lipid peroxidation and inhibited fibrotic (cirrhosis) process, and experimental cholestatic liver disease is associated with increased lipid peroxidation in BDL/S operated rats. Hence we concluded that the measurement of MDA and hyp can be useful monitor for the screening of antioxidant and antifibrotic effect in experimental liver fibrosis (cirrhosis), and LH has been shown to have hepatoprotective effect, antifibrotic effect and antioxidant effect.

The Extracts from Natural Product Complex (DW) Suppress Lipid reroxidation and Inhibit Liver Fibrosis (Cirrhosis) in Rats (실험동물에서 복합천연물(DW)의 지질 과산화 억제와 간섬유화 저해 효과 검색)

  • 정재열;임진아;박선영;서의석;제갈승주;김기영
    • YAKHAK HOEJI
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    • v.45 no.5
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    • pp.513-521
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    • 2001
  • The chronic cholestasis induce to biliary liver fibrosis (cirrhosis) and the increased products of ROS(reactive oxygen species) cause to the liver damage. In this study ; the antioxidant and antifibrotic effect of dried extracts of oriental medicine (DW) was investigated under the liver fibrotic (cirrhotic) condition. The female Sprague-Dawley rats were divided in 5 groups (Normal, Op-2, Op-4, OpDW-2, OpDW-4). Except for normal group, the rats were induced to biliary liver fibrosis (cirrhosis) by the operation of bile duct ligation/scission (BDU/S) and were observed in 2 weeks or 4 weeks. And the prepared DW was treated p.o.2 ml/day/rats in 2 weeks or 4 weeks for OpDW groups. At the time of sacrifice, the liver, kidney, spleen were weighed and the ratio of organ weight/body weight was calculated. The MDA, the hyp and biochemical parameters (GOT GTP, ALP, t-bili) were measured in sera and liver tissue of rats. The biochemical change was observed on liver tissue. In the result, the hepatomegaly and spleenomegaly appeared in all BDL/S operated rats, and significantly lower liver weight was observed in OpDW-4 group compared with in Op-4 group (p<0.05). The level of clinical parameters in sera of all liver fibrosis (cirrhosis) developed rats was higher than in normal group. Especial1y, the value of GOT in OpDW-2 group and ALP in OpDW-4 group showed significantly lower than in Op-2 group and Op-4 group (p<0.01, p<0.005). The content of hyp in all operation groups was significantly higher than in normal group (p<0.05∼<0.005), and showed significantly lower value in the OpDW-4 group than in Op-4 group (p<0.05). The product of lipid peroxidationUDA) increased significantly under the fibrotic(cirrhotic) condition (p<0.05∼ <0.005), and the MDA value in OpDW-4 group decreased significantly in Op-4 group (p<0.005). The histological change (bile duct proliferation, fibrosis, collagen bundle) was similarly observed in Op-2 group and in OpDW-2 group, but the weak fibrosis and bile duct proliferation were observed in OpDW-4 group compared with in Op-4 group. In conclusion, lipid peroxidation and severe liver damage were activated by bile duct obstruction, and the measurement of MDA and hap can be useful monitor for the screening of antioxidant and antifibrotic effect in experimental liver fibrosis (cirrhosis). The 4 weeks treatment with DW extracts suppressed lipid peroxidation and inhibited fibrotic (cirrhotic) process in BDL/S operated rats.

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Evaluation of Stage of Liver Fibrosis by Ultrasonography : Based on Pathologic Results of Biopsy (초음파검사를 통한 간 섬유화 병기단계 평가 : 조직검사결과 기준으로)

  • An, Hyun;Lee, Hyo-Yeong;Im, In Chul
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.547-555
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    • 2019
  • The purpose of this study was to evaluate the usefulness of routine liver ultrasonography on the basis of the scoring system according to the morphological parameters of liver ultrasound images and the histopathological results of liver biopsy. The morphological parameters of the liver through ultrasonography were divided into liver surface, liver edge and liver parenchyma. Pathologic results of liver biopsy were classified as mild fibrosis(F1), significant fibrosis(F2), severe fibrosis(F3), and cirrhosis(F4). In conclusion, routine ultrasound examination showed a sensitive predictive factor for fibrosis with mild fibrosis (F1) to severe fibrosis (F3) were liver edge>liver parenchyma>liver surface. However, the predictive factors for detecting cirrhosis (F4) were liver parenchyma>liver surface>liver edge. The use of three variable combinations rather than individual variables in routine ultrasonography may be useful in evaluating the degree and progress of liver fibrosis.

Consideration of Cut-off Value for Fibrosis Serum Marker by Liver Fibrosis Stage in Chronic Hepatitis C Patients (만성 C형간염 환자에서 간섬유화 등급별 혈청표지자들의 Cut-off값에 대한 고찰)

  • Nam, Ji-Hee;Kim, Jung-Hoon
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.539-546
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    • 2019
  • Liver biopsy is invasive and it is a risk of complications. Nevertheless, liver biopsy is gold standard for predicting liver fibrosis. To compensate for these shortcomings, in this study, the liver fibrosis stage was divided using Fibroscan(R) in 200 chronic hepatitis C patients. And, the usefulness and cut-off values of fibrosis index based on four factors(FIB-4), AST to platelet ratio index(APRI) and AST/ALT ratio(AAR) calculated as serum tests were investigated by analyzing ROC curve. As a result, using FIB-4 and APRI rather than AAR is appropriate for evaluation of liver fibrosis. And using APRI to predict significant Fibrosis(F2) and FIB-4 is considered useful for predicting cirrhosis(F4). By applying the advantages of the serum based liver fibrosis marker, which are convenient and repeatable, liver fibrosis follow-up term can be reduced, and furthermore, the prevalence of liver cirrhosis and hepatocellular carcinoma(HCC) can be reduced.

A Study on the Expression of Thymosin-β4 and c-Myc mRNA in the Model of liver cirrhosis with fibrosis (섬유화 진행 간경변 조직 모델에서 Thymosin β4와 C-myc mRNA 융합 발현 연구)

  • Kim, Jean-Soo;Park, Un-Kyu
    • Journal of the Korea Convergence Society
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    • v.10 no.6
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    • pp.65-71
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    • 2019
  • The propose of this study has been conducted to examine expression of c-Myc and Thymosin-${\beta}4$ in liver cirrhosis model from liver fibrosis and For the method of study, the experiment was conducted in 2 groups; liver cirrhosis model experiment group due to liver fibrosis and control group with distilled water. This study outcome showed that liver cirrhosis model experiment group had significantly higher expression of c-Myc and Thymosin-${\beta}4$. with changes to hepatic tissue of special staining and electron microscopy. In conclusion, in clinical tests regarding liver function, molecular evaluation of c-Myc and Thymosin-${\beta}4$ and their expression along with serological change and histological assessment can be utilized as a reference for diagnosing liver disease for prevention and diagnosis of the disease, Based on this research in the future, we will carry out an in-depth study by adding the types of experimental groups and related genes.

Diagnostic Performance of Spin-Echo Echo-Planar Imaging Magnetic Resonance Elastography in 3T System for Noninvasive Assessment of Hepatic Fibrosis

  • Se Woo Kim;Jeong Min Lee;Sungeun Park;Ijin Joo;Jeong Hee Yoon;Won Chang;Haeryoung Kim
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.180-188
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    • 2022
  • Objective: To validate the performance of 3T spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) for staging hepatic fibrosis in a large population, using surgical specimens as the reference standard. Materials and Methods: This retrospective study initially included 310 adults (155 undergoing hepatic resection and 155 undergoing donor hepatectomy) with histopathologic results from surgical liver specimens. They underwent 3T SE-EPI MRE ≤ 3 months prior to surgery. Demographic findings, underlying liver disease, and hepatic fibrosis pathologic stage according to METAVIR were recorded. Liver stiffness (LS) was measured by two radiologists, and inter-reader reproducibility was evaluated using the intraclass correlation coefficient (ICC). The mean LS of each fibrosis stage (F0-F4) was calculated in total and for each etiologic subgroup. Comparisons among subgroups were performed using the Kruskal-Wallis test and Conover post-hoc test. The cutoff values for fibrosis staging were estimated using receiver operating characteristic (ROC) curve analysis. Results: Inter-reader reproducibility was excellent (ICC, 0.98; 95% confidence interval, 0.97-0.99). The mean LS values were 1.91, 2.41, 3.24, and 5.41 kPa in F0-F1 (n = 171), F2 (n = 26), F3 (n = 38), and F4 (n = 72), respectively. The discriminating cutoff values for diagnosing ≥ F2, ≥ F3, and F4 were 2.18, 2.71, and 3.15 kPa, respectively, with the ROC curve areas of 0.97-0.98 (sensitivity 91.2%-95.9%, specificity 90.7%-99.0%). The mean LS was significantly higher in patients with cirrhosis (F4) of nonviral causes, such as primary biliary cirrhosis (9.56 kPa) and alcoholic liver disease (7.17 kPa) than in those with hepatitis B or C cirrhosis (4.28 and 4.92 kPa, respectively). There were no statistically significant differences in LS among the different etiologic subgroups in the F0-F3 stages. Conclusion: The 3T SE-EPI MRE demonstrated high interobserver reproducibility, and our criteria for staging hepatic fibrosis showed high diagnostic performance. LS was significantly higher in patients with non-viral cirrhosis than in those with viral cirrhosis.

The Screening of Hepatic Functional Improvement, Liver Protection and Antifibrotic Effect from Dried Extracts of Concha Cipangopaludinae in Rats (랫드에서 전라 추출물의 간기능 개선, 간보호 및 항섬유화 효과 검색)

  • Kim Hee Seok;Kim Jin Sook;Kim Ki young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.1
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    • pp.118-122
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    • 2003
  • Oxidative stress and its consequent lipid peroxidation exert harmful effects, which have been currently involved in the generation of carbon tetrachloride (CCl₄)-induced fibrosis(cirrhosis). In this study, it was investigated whether dried extract of 田螺(Concha Cipangopaludinae; CC) has liver functional improvement, antioxidative and antifibrotic effect in rats those were induced liver fibrosis by CCl₄ administration. The female Sprague-Dawley rats were divided into 3 groups(Normal, AC, AC-CC) and were observed in 6 weeks. Except for normal group, liver fibrosis(cirrhosis) in rats were developed by CCl₄ administration(0.8 ㎖/rat/week). And the rats were treated with prepared CC(p. o. 2 ㎖/day/rat). At the time of sacrifice, the liver, kidney and spleen were weighed and the ratio of organ weight/body weight was calculated. The MDA, hyp and biochemical parameters(AST, ALT, ALP, t-bili) were measured in sera and liver tissue of rats. The strong yellow color of urine was observed in all CCl₄-treated group compared with normal group, but jaundice didn't appear in CCl₄-treated group. The mortality of CCl₄-treated group is very low(<13%) during 6 weeks of observation time. The ratio of liver/body as well as the weight of liver in CCl₄-treated rats significantly increased compared with that in normal group(p<0.001). The level of clinical parameters in sera of all liver fibrosis(cirrhosis) developed rats were significantly higher than that of normal group(p<0.001-0.05). Especially the value of BUN, ALP, t-bilirubin in AC-CC group showed 20.9%, 19.6%, 47.9% lower than that in AC group. The content of hyp in CCl₄-treated rats was significantly higher than normal group(p<0.001~<0.05), and showed 12.2% lower value in the AC-CC group than AC group(p<0.05). The production of lipid peroxidation(MDA) in sera and liver tissue significantly increased under the fibrotic(cirrhotic) condition(p<0.001~<0.05). Especially the MDA value of AC-CC group in sera significantly 46.5% decreased compared with that of AC group(p<0.05), and the MDA value of AC-CC in liver tissue showed 21.4% lower than that of AC group. Concha Cipangopaludinae can be improved hepatic function, and maybe have effect of liver protection, antioxidation and antifibrosis.

Noninvasive diagnosis of pediatric nonalcoholic fatty liver disease

  • Yang, Hye Ran
    • Clinical and Experimental Pediatrics
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    • v.56 no.2
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    • pp.45-51
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    • 2013
  • Because nonalcoholic steatohepatitis can progress towards cirrhosis even in children, early detection of hepatic fibrosis and accurate diagnosis of nonalcoholic fatty liver disease (NAFLD) are important. Although liver biopsy is regarded as the gold standard of diagnosis, its clinical application is somewhat limited in children due to its invasiveness. Noninvasive diagnostic methods, including imaging studies, biomarkers of inflammation, oxidative stress, hepatic apoptosis, hepatic fibrosis, and noninvasive hepatic fibrosis scores have recently been developed for diagnosing the spectrum of NAFLD, particularly the severity of hepatic fibrosis. Although data and validation are still lacking for these noninvasive modalities in the pediatric population, these methods may be applicable for pediatric NAFLD. Therefore, noninvasive imaging studies, biomarkers, and hepatic fibrosis scoring systems may be useful in the detection of hepatic steatosis and the prediction of hepatic fibrosis, even in children with NAFLD.