• 대한영상의학회지
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• 제81권2호
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• pp.365-378
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• 2020

목적 본 연구는 gadoxetic acid 조영증강 간 자기공명영상에서 T1 이완시간이 만성간질환을 가진 환자에서 간섬유화의 발견과 병기설정에 유용한지 알아보고자 한다. 대상과 방법 국소간병변이 의심되는 103명 환자들이 간 자기공명영상과 Fibroscan을 시행하였다. Fibroscan은 간섬유화의 정도를 분류하는 참조표준검사로 사용되었다. T1 이완시간은 조영제 주입 전(preT1)과 주입 20분 후(postT1), 그리고 이들 간의 T1 이완시간 감소율(rrT1)을 3 테슬라 자기공명영상의 횡단 3D VIBE 시퀀스 하에 측정하였다. Receiver operating characteristic (이하 ROC) 분석을 통해 간섬유화 병기설정을 위한 최적의 cut-off 값이 결정되었다. 결과 METAVIR score (F0-F4)에 따른 간섬유화 병기가 증가함에 따라, preT1과 postT1은 증가하였고, rrT1은 감소하였다. PreT1의 F2와 F3 사이(F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, p < 0.05), postT1의 F3와 F4 사이(F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, p < 0.05), 그리고 rrT1의 F3와 F4사이(F3, 65.4 ± 7.7%; F4 57.3 ± 11.4%, p < 0.05)에서 통계적 유의미한 차이를 보였다. ROC 분석은 preT1과 postT1의 병용검사가 간섬유화 병기설정에 있어 가장 유용한 검사라는 것을 보여준다. 결론 preT1과 postT1은 간섬유화 병기가 증가함에 따라 증가하며, T1 mapping이 gadoxetic acid 조영증강 간 자기공명영상에서 간섬유화 병기설정에 있어 유용한 보조적 시퀀스로 사용될 수 있다.

• 보험의학회지
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• 제2권1호
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• pp.34-36
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• 1985

Korea is an endemic area of chronic hepatitis in the world. Liver cirrhosis and liver cell carcinoma, presumed to be related to such chronic hepatitis, are the major causes of death in this country. The purpose of this study is disclosing the sources of chronic hepatitis in Korea establishing its histologic characteristics, disclosing the patterns of progression in chronic hepatitis, delineating its prognosis and finally speculating its etiology. The study group was composed of 183 patients with biopsy-proven acute icteric viral hepaticis, 32 patients with biopsy- proven anicteric hepatitis and 260 patients with biopsy- proven chronic hepatitis. These patients submitted to long-term follow-up by means of liver needle biopsy and/or clinicolaboratory evaluation. The period of follow-up ranged from two months to 18 years. The histological features of the initial biopsy specimens of chronic hepatitis permitted a division of the cases cases into the following five types: Type I. Persisting portal hepatitis : so called persisting hepatitis 43 Type II. Chronic inactive hepatitis with incomplete strand septal fibrosis. This type has thin fibrotic septation in addition to Type I with portal sclerosis 38 Type III. Chronic active periportal hepatitis(CAPH) : so called aggressive hepatitis, characterized by marked piecemeal necrosis. This type has been subdivided further into three groups: AB and C on the basis of histologic features. A CAPH without cirrhosis 15 B CAPH with cirrhosis 99 C CAPH with diffuse acinus type parenchymal nodules; characterized by rosette-forming micronodules 21 Type IV. Subacute hepatic necrosis; characterized by multilobular and/or bridging necrosis. 14 Type V. Persisting lobular hepatitis; characterized by spotty necrosis, which looks very similar to acute viral hepatitis. Such histologic changes should be persisted for more than six months 30 In Korea the main source of chronic hepatitis is the anicteric type. Of the chronic hepatitis observed in the hospital, Type IIIb was the most frequent in its incidence and occasionally exhibited development of hepatocellular carcinoma, but the mortality was highest in Type IIIc during the period of follow-up. Histologic characteristics of these five types suggest a spectrum of chronic hepatitis in Korea from an early and mild stage to advanced and fatal cirrhosis, which is occasionally associated with primary hepatic cell carcinoma. It seems that Type IV can be followed by flare-up of various stages of acute and chronic hepatitis with HBsAg and that many cases of liver cirrhosis prevalent in Korea occur through such an active process of Type IV. The etiology is not established, but in Korea it is mainly related to HBsAg.

• Journal of Preventive Medicine and Public Health
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• 제54권6호
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• pp.412-421
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• 2021

Objectives: Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent metabolic disease. Muscle is known to influence NAFLD development. Therefore, this study aimed to determine the relationships among low muscle mass, NAFLD, and hepatic fibrosis using various definitions of low muscle mass and NAFLD diagnostic methods, including magnetic resonance imaging-based proton density fat fraction (MRI-PDFF). Methods: This cross-sectional study included 320 participants (107 males, 213 females) from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population cohort. Muscle mass was assessed using whole-body dual-energy X-ray absorptiometry and adjusted for the height squared, body weight, and body mass index (BMI). NAFLD was diagnosed using ultrasonography (US), MRI-PDFF, and the comprehensive NAFLD score (CNS). Hepatic fibrosis was assessed using magnetic resonance elastography. Multivariable logistic and linear regression analyses were performed to determine the aforementioned associations. Results: According to US, 183 participants (57.2%) had NAFLD. Muscle mass adjusted for body weight was associated with NAFLD diagnosed using US (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.70 to 5.31), MRI-PDFF (OR, 2.00; 95% CI, 1.13 to 3.53), and CNS (OR, 3.39; 95% CI, 1.73 to 6.65) and hepatic fibrosis (males: β=-0.070, p<0.01; females: β=-0.037, p<0.04). Muscle mass adjusted for BMI was associated with NAFLD diagnosed by US (OR, 1.71; 95% CI, 1.02 to 2.86) and CNS (OR, 1.95; 95% CI, 1.04 to 3.65), whereas muscle mass adjusted for height was not associated with NAFLD. Conclusions: Low muscle mass was associated with NAFLD and liver fibrosis; therefore, maintaining sufficient muscle mass is important to prevent NAFLD. A prospective study and additional consideration of muscle quality are needed to strengthen the findings regarding this association.

• Asian Pacific Journal of Cancer Prevention
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• 제15권9호
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• pp.3879-3884
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• 2014

Background: In chronic hepatitis B (CHB), the presence of hepatic steatosis (HS) seems to be associated with known host and viral factors which may influence the long-term prognosis of chronic hepatitis B (CHB), probably leading to cirrhosis and hepatocellular carcinoma (HCC). Different from chronic hepatitis C (CHC), factors associated with HS in CHB are not clearly explored. Materials and Methods: 160 CHB patients were divided into two groups depending on the results of liver biopsy. Group I consisted of 71 patients with confirmed steatosis. Group II comprised 89 patients without steatosis. The groups were compared in terms of basal characteristics, body mass index (BMI), liver enzymes (ALT, AST, ALP), serum fasting blood sugar (FBS) and lipids, hepatitis B e antigen (HBeAg), viral load, and histological findings. Results: In terms of host factors, male gender, older age, BMI, high serum FBS and lipid levels were associated with HS. On the other hand, ALT levels, the HAI scores of necroinflammation and stage of fibrosis did not associate with HS. On multivariate analysis, parameters of sex, BMI, cholesterol and FBS levels were independently associated with HS. Regarding viral factors, HBeAg negativity was significantly associated with HS (81.7%, p value 0.006), but not HBV DNA level (p value 0.520). Conclusions: HS in CHB appears to be unrelated to the status of HBV replication. However, fibrosis progression in CHB is related to variable host factors. HS may be enhanced through these factors in HBV chronic patients.

• 한방비만학회지
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• 제18권1호
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• pp.19-26
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• 2018

Objectives: Alcoholic fatty liver is a potentially pathologic condition which can progress to steatohepatitis, fibrosis, and cirrhosis. The objective of this study is to investigate the effects of Scutellaria Radix (SR) extract on the alcoholic fatty liver induced by long-term EtOH administration. Results: Male Sprague Dawley rats were used in this study. All animals were randomly divided into Normal group, treated with saline (n=10); EtOH group, treated with ethanol (n=10); EtOH+SR group, treated with ethanol+Scutellaria Radix extract (n=10). For oral administration of ethanol in EtOH and EtOH+SR group, the ethanol was dissolved in distilled water in concentrations of 25% (v/v). Throughout the experiment of 8 week, the rats were allowed free access to water and standard chow. Sample group were administrated by Scutellaria Radix extract daily for 8 weeks. Results: The levels of hepatic marker such as aspartate aminotransferase and alanine aminotransferase were altered. Histopathological changes such as ballooning, fatty and hydropic degeneration were reduced and the expression of tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) was significantly attenuated by Scutellaria Radix extract. Conclusions: These data suggest that Scutellaria Radix extract attenuated the alcoholic simple fatty liver by improving hepatic lipid metabolism via suppression of $TNF-{\alpha}$ protein. Scutellaria Radix could be effective in protecting the liver from alcoholic fatty liver.

• 한국독성학회:학술대회논문집
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• 한국독성학회 2002년도 Molecular and Cellular Response to Toxic Substances
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• pp.161-161
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• 2002

The abnormal accumulation of collagen is progressive and often results in impairment of liver function, i.e. liver cirrhosis. Collagen synthesis requires several posttranslational events. Prolyl 4-hydroxylase is the key enzyme in collagen synthesis that catalyzes the hydroxylation of peptide-bound proline residues to 4-hydroxyroline.(omitted)

• 대한한방내과학회지
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• 제31권2호
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• pp.346-355
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• 2010

Objectives : This study was performed in order to investigate the anti-fibrogenic effect of Acer tegmentosum Maxim. on r at hepatic stellate cell line T6. Materials and Methods : Hepatic stellate Cells (T6) were treated with various concentrations of distilled water Acer teg mentosum Maxim. extract for 24, 48, 72 hours. After the treatment, cell viability, proliferation, procollagen levels, mRNA of AS MA, MMP-2, collagen type 1a2 and IL-6 production were measured using MTT assay, BrdU assay, RT-PCR, procollagen typ e 1 C-peptide EIA kit and murine IL-6 ELISA development kit. Results : Cell viability of HSC-T6 decreased significantly in both 24 hours and 48 hours groups in a dose-dependant man ner. Proliferation of HSC also decreased in the same way. In the RT-PCR, mRNA expression of collagen type 1a2 and ASMA decreased in the groups which were treated with Acer tegmentosum Maxim. for 24 hours. The production of procollagen tended to decrease in a dose-dependant manner in the 24 hours treated group. IL-6 production increased under Acer tegmentosum trea tment in a dose-dependant manner in both 24 and 48 hours groups. Conclusion : These results show the possibility that Acer tegmentosum Maxim. can be an effective remedy for liver fibrosi s and liver cirrhosis.

• Toxicological Research
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• 제25권2호
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• pp.71-78
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• 2009

We investigated the pathogenesis of liver tissue damage during the lipid peroxidation and fibrogenesis with the observation of correlations between the parameters of collagen synthesis (and deposition) and lipid peroxidation in liver fibrosis (cirrhosis) rats. Rats were randomly divided into two groups, normal and $CCl_4$-thiopental sod. intoxicated group. And the one group was treated intragastrically with the mixture of $CCl_4$-thiopental sod. 3 times per week for 3 weeks. The liver tissue and sera were used for the measurement of hydroxyproline (HYP), malonedialdehyde (MDA) and superoxide dismutase (SOD). Biochemical parameters such as aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), total-bilirubin and blood urea nitrogen (BUN) were measured. Additionally, the expression of collagen ${\alpha}1$(III) and $\beta$-actin mRNA was observed by RTPCR. The histological change in liver tissue was also observed by Masson's trichrome and H&E staining. Correlation analysis was carried by Spearman's rho method. All biochemical parameters except total-bilirubin were significantly higher in the $CCl_4$-thiopental sod. treated group than that of the normal group (p < 0.01). In the $CCl_4$-thiopental sod. treated group, Hyp as a parameter of collagen synthesis (deposition) and MDA as a metabolite of lipid peroxidation, were significantly elevated by 1.98 and 2.11 times higher than that of the normal group (p < 0.001) respectively. The activity of SOD in the $CCl_4$-thiopental sod. treated group is decreased significantly by 44.8% (p < 0.001). And collagen ${\alpha}1$(III) mRNA was more expressed in the $CCl_4$-thiopental sod. treated group than that of the normal group. However, the expression of $\beta$-actin mRNA is showed similar in both of groups. A good correlation was observed between the content of hyp and MDA concentration (r = 0.70, n = 40) in the two groups. And the correlation between the levels of hyp and SOD (r = -0.71, n = 25) is also reliable. However, no correlation were observed between MDA concentration and SOD (r = -0.40, n = 25) in the two groups. Elevated levels of MDA in $CCl_4$-thiopental sod. treated rats indicated enhancement of lipid peroxidation, which is accompanied by a decrease in SOD activity. Moreover, we could confirm that the parameters of collagen synthesis (and deposition) is in good correlation with the metabolite of lipid peroxidation (MDA) and the lipid peroxidation antagonizing enzyme (SOD). Hence, we propose that (1) lipid peroxidation and collagen synthesis (and deposition) could be enhanced by intragastrically application of $CCl_4$-thiopental sod. during a short terms. And (2) the intoxication of $CCl_4$-thiopental sod. could be used for monitoring of lipid peroxidation and collagen synthesis (and deposition) for test of antioxidant and antifibrotic agent.

• 대한디지털의료영상학회논문지
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• 제14권1호
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• pp.21-29
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• 2012

The purpose of this study is to evaluate the mutual relations by measuring SNR from T2 weighted image and ADC values on the basis of the stiffness values from liver tissues. This study was conducted that total 37 people(23 of males and 11 of females) were taken the liver MRI examination and average age was $54.5{\pm}12.7$ years old. The equipment was MAGNETOM Skyra 3.0T (SIEMENS, Erlangen, Germany) and 32 channel body-array coil. The examination were conducted with HASTE T2 weighted image by axial plane, Spin-echo EPI (echo planner image) DWI (b-value = 800) and Magnetic resonance elastography. The ROIs (region of interest: 200-300 $mm^2$) were established on the basis of the first axial stiffness image corresponded 95% confidence interval from axial stiffness image and then were measured values. After drawing the grid lines, signals were measured SNR from T2 weighted image and ADC values on the same locations that were analysed other 3 planes respectively. The results were showed correlation (0.057) that were increased to SNR from T2 weighted image by increasing stiffness value that no significant difference statistically p = 0.003. Other results were showed correlations (-0.301) that were decreased to ADC values by increasing stiffness values that no significant difference statistically p = 0.088. In the 3.0T equipment, the results may be error in much the same fashion as the 1.5T from ADC values by evaluation of fibrosis stage. However, Magnetic resonance elastography would be useful method that is used to diagnose exactly liver fibrosis stages in the 3.0T.

• Journal of Yeungnam Medical Science
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• 제9권2호
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• pp.224-238
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• 1992

간 섬유화에서 fat-storing cell의 변화를 미세 구조학적 측면에서 관찰하고자, 사염화탄소를 mineral oil에 녹여 1 : 1로 회석한 후 Kg당 0.5 ml의 용량을 주 2회씩 12주간 흰쥐에 복강 주입하였다. 실험기간 동안 1주 간격으로 도살하고, 적출된 간조직을 광학현미경과 연역조직화학적 검사 및 전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 광학현미경적 소견상 소엽 중심주의 염증 반응 및 세포 침윤 현상은 사염화탄소 투여 후 1주부터 나타나서 4주 째 가장 심하였으며, 이시기에 desmin염색 반응 양성세포의 수도 증가되었다. 괴사 및 섬유화는 2주부터 나타나기 시작하여 6주부터 결절이 형성되기 시작하였고 괴사성 병변은 8주까지 지속되었다. 그러나 세포 침윤 정도는 감소되면서 desmin에 대한 반응성도 낮아졌고, 경변성 변화는 10주 이후부터 나타났다. 전자현미경적 소견상 fat-storing cell의 숫적 증가는 1주부터 관찰되었으며 지방적이 감소하고 rER이 팽창된 이행세포는 2주째 출현하여 4주에 가장 현저히 증가되었다. 섬유아세포는 3주부터 나타나기 시작하였는데, rER이 확장되었으며 지방적은 없거나 1-2개의 소적이 세포돌기에서 관찰되었다. 섬유화가 진행됨에 따라 이행세포 및 fat-storing cell은 감소하고 섬유아세포는 증가된 상태를 유지하였다. 이상의 결과로 보아 fat-storing cell은 간섬유화 과정에서 활성화되고 증식하여 형태학적으로 이행세포 및 섬유아세포로 전환함으로써, 정지상태에 있는 섬유아세포의 전구체로서 간섬유화에 중요한 역할을 하는 것으로 사료된다.