1.Intraductal malignant tumors in the liver mimicking cholangiocarcinoma: Imaging features for differential diagnosis.
Ah Yeong KIM ; Woo Kyoung JEONG
Clinical and Molecular Hepatology 2016;22(1):192-197
No abstract available.
Adult
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Anterior Temporal Lobectomy
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Bile Duct Neoplasms/*diagnostic imaging/surgery
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*Bile Ducts, Intrahepatic/surgery
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Carcinoma, Hepatocellular/diagnostic imaging
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Cholangiocarcinoma/*diagnostic imaging/surgery
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Cholangiopancreatography, Magnetic Resonance
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Diagnosis, Differential
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Humans
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Liver/diagnostic imaging/metabolism
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Liver Neoplasms/diagnostic imaging
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Magnetic Resonance Imaging
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Male
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Middle Aged
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Tomography, X-Ray Computed
2.Liver metastasis of meningeal hemangiopericytoma: a study of 5 cases.
Regina C LO ; Arief A SURIAWINATA ; Brian P RUBIN
Clinical and Molecular Hepatology 2016;22(1):188-191
Mesenchymal tumors in the liver, whether primary or metastatic, are rare. Meningeal hemangiopericytoma (HPC) is characteristically associated with delayed metastasis and the liver is one of the most common sites. Despite its consistent histological features, a pathological diagnosis of HPC in the liver is sometimes not straightforward due to its rarity and usually remote medical history of the primary meningeal tumor. In this report, the clinicopathological features of 5 cases of metastatic HPC to the liver were reviewed and described.
Adult
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Female
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Hemangiopericytoma/*pathology
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Humans
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Liver/pathology
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Liver Neoplasms/*pathology/secondary
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Male
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Meningeal Neoplasms/*pathology
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Middle Aged
3.Regression of esophageal varices during entecavir treatment in patients with hepatitis-B-virus-related liver cirrhosis.
Hye Young JWA ; Yoo Kyung CHO ; Eun Kwang CHOI ; Heung Up KIM ; Hyun Joo SONG ; Soo Young NA ; Sun Jin BOO ; Seung Uk JEONG ; Bong Soo KIM ; Byoung Wook LEE ; Byung Cheol SONG
Clinical and Molecular Hepatology 2016;22(1):183-187
Recent studies suggest that liver cirrhosis is reversible after administering oral nucleos(t)ide analogue therapy to patients with hepatitis B virus (HBV) infection. However, few studies have addressed whether esophageal varices can regress after such therapy. We report a case of complete regression of esophageal varices during entecavir therapy in patients with HBV-related liver cirrhosis, suggesting that complications of liver cirrhosis such as esophageal varices can regress after the long-term suppression of HBV replication.
Abdomen/diagnostic imaging
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Antiviral Agents/*therapeutic use
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DNA, Viral/blood
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Esophageal and Gastric Varices/complications/prevention & control
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Guanine/*analogs & derivatives/therapeutic use
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Hepatitis B virus/genetics
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Hepatitis B, Chronic/complications/*drug therapy/virology
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Humans
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Liver Cirrhosis/*diagnosis/etiology
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Male
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Middle Aged
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Polymerase Chain Reaction
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Ultrasonography
4.Primary squamous cell carcinoma of the liver: a case report.
Tae Kyung YOO ; Byung Ik KIM ; Eun Na HAN ; Dong Hyung KIM ; Jung Hee YOO ; Seung Jae LEE ; Yong Kyun CHO ; Hong Joo KIM
Clinical and Molecular Hepatology 2016;22(1):177-182
Primary squamous cell carcinoma (SCC) of the liver is very rare, and few cases have been reported in Korea. Primary SCC of the liver is known to be associated with hepatic cysts and intrahepatic stones. A 71-year-old male was admitted to our hospital, and a abdominal computed tomography scan revealed a 10 × 6 cm mass in the liver. Analysis of a biopsy sample suggested SCC, and so our team performed a thorough workup to find the primary lesion, which was revealed hepatoma as a pure primary SCC of the liver with multiple distant metastases. The patient was treated with one cycle of radiotherapy, transferred to another hospital for hospice care, and then died 1 month after discharge.
Abdomen/diagnostic imaging
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Aged
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Carcinoma, Squamous Cell/*diagnosis/pathology/radiotherapy
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Humans
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Immunohistochemistry
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Keratins/metabolism
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Liver Neoplasms/*diagnosis/pathology/radiotherapy
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Male
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Palliative Care
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Positron-Emission Tomography
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Tomography, X-Ray Computed
5.Portal biliopathy treated with endoscopic biliary stenting.
Sung Jin JEON ; Jae Ki MIN ; So Young KWON ; Jun Hyun KIM ; Sun Young MOON ; Kang Hoon LEE ; Jeong Han KIM ; Won Hyeok CHOE ; Young Koog CHEON ; Tae Hyung KIM ; Hee Sun PARK
Clinical and Molecular Hepatology 2016;22(1):172-176
Portal biliopathy is defined as abnormalities in the extra- and intrahepatic ducts and gallbladder of patients with portal hypertension. This condition is associated with extrahepatic venous obstruction and dilatation of the venous plexus of the common bile duct, resulting in mural irregularities and compression of the biliary tree. Most patients with portal biliopathy remain asymptomatic, but approximately 10% of them advance to symptomatic abdominal pain, jaundice, and fever. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography are currently used as diagnostic tools because they are noninvasive and can be used to assess the regularity, length, and degree of bile duct narrowing. Management of portal biliopathy is aimed at biliary decompression and reducing the portal pressure. Portal biliopathy has rarely been reported in Korea. We present a symptomatic case of portal biliopathy that was complicated by cholangitis and successfully treated with biliary endoscopic procedures.
Abdomen/diagnostic imaging
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Cholangiopancreatography, Endoscopic Retrograde
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Cholestasis/*diagnosis
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Humans
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Hypertension, Portal/*diagnosis
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Male
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Middle Aged
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Portal Vein
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*Stents
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Tomography, X-Ray Computed
6.Acute pancreatitis associated with pegylated interferon-alpha-2a therapy in chronic hepatitis C.
Jong Wook CHOI ; June Sung LEE ; Woo Hyun PAIK ; Tae Jun SONG ; Jung Wook KIM ; Won Ki BAE ; Kyung Ah KIM ; Jung Gon KIM
Clinical and Molecular Hepatology 2016;22(1):168-171
Chronic hepatitis C virus (HCV) infection is a major cause of liver cirrhosis and hepatocellular carcinoma. Combination therapy of pegylated interferon-alpha (PEG-IFN-α) and ribavirin (RBV) is a current standard treatment for chronic HCV infection in Korea, which has considerable adverse effects. Acute pancreatitis is a rare complication of PEG-IFN-α administration. We report a case of a 62-year-old female who experienced acute pancreatitis after 4 weeks of PEG-IFN-α-2a and RBV combination therapy for chronic HCV infection. The main cause of the acute pancreatitis in this case was probably PEG-IFN-α rather than RBV for several reasons. A few cases have been reported in which acute pancreatitis occurred during treatment with PEG-IFN-α-2b. This is the first report of acute pancreatitis associated with PEG-IFN-α-2a in Korea.
Amylases/analysis
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Antiviral Agents/adverse effects/*therapeutic use
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Drug Therapy, Combination
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Female
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Hepatitis C, Chronic/diagnostic imaging/*drug therapy
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Humans
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Interferon-alpha/adverse effects/*therapeutic use
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Lipase/analysis
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Middle Aged
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Pancreatitis/*etiology
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Polyethylene Glycols/adverse effects/*therapeutic use
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Recombinant Proteins/adverse effects/therapeutic use
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Republic of Korea
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Ribavirin/therapeutic use
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Tomography, X-Ray Computed
7.Survival outcomes of hepatic resection compared with transarterial chemoembolization or sorafenib for hepatocellular carcinoma with portal vein tumor thrombosis.
Jung Min LEE ; Byoung Kuk JANG ; Yoo Jin LEE ; Wang Yong CHOI ; Sei Myong CHOI ; Woo Jin CHUNG ; Jae Seok HWANG ; Koo Jeong KANG ; Young Hwan KIM ; Anil Kumar CHAUHAN ; Soo Young PARK ; Won Young TAK ; Young Oh KWEON ; Byung Seok KIM ; Chang Hyeong LEE
Clinical and Molecular Hepatology 2016;22(1):160-167
BACKGROUND/AIMS: Treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remains controversial. We compared the outcomes of hepatic resection (HR), transarterial chemoembolization (TACE), and sorafenib therapy as treatments for HCC with PVTT. METHODS: Patients diagnosed as HCC with PVTT between January 2000 and December 2011 who received treatment with sorafenib, HR, or TACE were included. Patients with main PVTT, superior mesenteric vein tumor thrombosis, or Child-Turcotte-Pugh (CTP) class C were excluded. The records of 172 patients were analyzed retrospectively. HR, TACE, and sorafenib treatment were performed is 40, 80, and 52 patients respectively. PVTT was classified as either involving the segmental branch (type I) or extending to involve the right or left portal vein (type II). RESULTS: The median survival time was significantly longer in the HR group (19.9 months) than in the TACE and sorafenib groups (6.6 and 6.2 months, respectively; both p<0.001), and did not differ significantly between the latter two groups (p=0.698). Among patients with CTP class A, type I PVTT or unilobar-involved HCC, the median survival time was longer in the HR group than in the TACE and sorafenib groups (p=0.006). In univariate analyses, the initial treatment method, tumor size, PVTT type, involved lobe, CTP class, and presence of cirrhosis or ascites were correlated with overall survival. The significant prognostic factors for overall survival in Cox proportional-hazards regression analysis were initial treatment method (HR vs. TACE: hazard ratio=1.750, p=0.036; HR vs. sorafenib: hazard ratio=2.262, p=0.006), involved lobe (hazard ratio=1.705, p=0.008), PVTT type (hazard ratio=1.617, p=0.013), and CTP class (hazard ratio=1.712, p=0.012). CONCLUSIONS: Compared with TACE or sorafenib, HR may prolong the survival of patients with HCC in cases of CTP class A, type I PVTT or unilobar-involved HCC.
Adult
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Aged
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Antineoplastic Agents/*therapeutic use
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Carcinoma, Hepatocellular/complications/drug therapy/*therapy
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Chemoembolization, Therapeutic
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Combined Modality Therapy
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Female
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Follow-Up Studies
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Humans
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Liver Neoplasms/complications/drug therapy/*therapy
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Male
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Middle Aged
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Niacinamide/*analogs & derivatives/therapeutic use
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Phenylurea Compounds/*therapeutic use
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Portal Vein
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Proportional Hazards Models
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Retrospective Studies
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Severity of Illness Index
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Survival Rate
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Treatment Outcome
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Venous Thrombosis/*complications
8.Comparison of tenofovir plus lamivudine versus tenofovir monotherapy in patients with lamivudine-resistant chronic hepatitis B.
Chan Ho PARK ; Seok Won JUNG ; Jung Woo SHIN ; Mi Ae BAE ; Yoon Im LEE ; Yong Tae PARK ; Hwa Sik CHUNG ; Neung Hwa PARK
Clinical and Molecular Hepatology 2016;22(1):152-159
BACKGROUND/AIMS: Tenofovir disoproxil fumarate (TDF) exhibits similar antiviral efficacy against treatment-naïve and lamivudine (LAM)-resistant chronic hepatitis B (CHB). However, there are few clinical reports on the antiviral effects of TDF-LAM combination therapy compared to TDF monotherapy in patients with LAM-resistant CHB. METHODS: We investigated the antiviral efficacy of TDF monotherapy vs. TDF-LAM combination therapy in 103 patients with LAM-resistant CHB. RESULTS: The study subjects were treated with TDF alone (n=40) or TDF-LAM combination therapy (n=63) for ≥6 months. The patients had previously been treated with TDF-based rescue therapy for a median of 30.0 months (range, 8-36 months). A virologic response (VR) was achieved in 99 patients (96.1%): 95.0% (38/40) of patients in the TDF monotherapy group and 96.8% (61/63) of patients in the TDF-LAM combination therapy group. The VR rates were not significantly different between the TDF monotherapy and TDF-LAM combination therapy groups (88.9 vs. 87.3% at month 12, and 94.4 vs. 93.7% at month 24, log-rank p=0.652). Univariate and multivariate analyses revealed that none of the pretreatment factors were significantly associated with VR. CONCLUSIONS: TDF monotherapy was as effective as TDF-LAM combination therapy for maintaining viral suppression in the vast majority of patients with LAM-resistant CHB, which suggests that TDF add-on therapy with LAM is unnecessary.
Adult
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Aged
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Aged, 80 and over
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Antiviral Agents/pharmacology/*therapeutic use
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DNA, Viral/blood
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Drug Administration Schedule
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Drug Resistance, Viral/drug effects
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Drug Therapy, Combination
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Female
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Hepatitis B virus/genetics
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Hepatitis B, Chronic/*drug therapy
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Humans
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Kidney Function Tests
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Lamivudine/*therapeutic use
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Liver Function Tests
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Male
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Middle Aged
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Polymerase Chain Reaction
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Tenofovir/*therapeutic use
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Treatment Outcome
9.The serum vitamin D level is inversely correlated with nonalcoholic fatty liver disease.
Goh Eun CHUNG ; Donghee KIM ; Min Sun KWAK ; Jong In YANG ; Jeong Yoon YIM ; Seon Hee LIM ; Mustafa ITANI
Clinical and Molecular Hepatology 2016;22(1):146-151
BACKGROUND/AIMS: A low vitamin D level has been associated with metabolic syndrome and diabetes. However, an association between a low vitamin D level and nonalcoholic fatty liver disease (NAFLD) has not yet been definitively established. This study aimed to characterize the relationship between a vitamin D level and NAFLD in Korea. METHODS: A cross-sectional study involving 6,055 health check-up subjects was conducted. NAFLD was diagnosed on the basis of typical ultrasonographic findings and a history of alcohol consumption. RESULTS: The subjects were aged 51.7±10.3 years (mean±SD) and 54.7% were female. NAFLD showed a significant inverse correlation with the vitamin D level after adjusting for age and sex [odds ratio (OR)=0.85, 95% confidence interval (CI)=0.75-0.96]. The age- and sex-adjusted prevalence of NAFLD decreased steadily with increasing vitamin D level [OR=0.74, 95% CI=0.60-0.90, lowest quintile (≤14.4 ng/mL) vs highest quintile (≥28.9 ng/mL), p for trend <0.001]. Multivariate regression analysis after adjusting for other metabolic factors revealed that NAFLD showed a significant inverse correlation with both the vitamin D level (>20 ng/mL) [OR=0.86, 95% CI=0.75-0.99] and the quintiles of the vitamin D level in a dose-dependent manner (p for trend=0.001). CONCLUSIONS: The serum level of vitamin D, even when within the normal range, was found to be inversely correlated with NAFLD in a dose-dependent manner. Vitamin D was found to be inversely correlated with NAFLD independent of known metabolic risk factors. These findings suggest that vitamin D exerts protective effects against NAFLD.
Adult
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Aged
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Cross-Sectional Studies
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Female
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Humans
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Male
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Middle Aged
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Multivariate Analysis
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Non-alcoholic Fatty Liver Disease/blood/*diagnosis/diagnostic imaging
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Odds Ratio
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Regression Analysis
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Ultrasonography
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Vitamin D/*blood
10.Magnetization-tagged MRI is a simple method for predicting liver fibrosis.
Kyung Eun KIM ; Mi Suk PARK ; Sohae CHUNG ; Chansik AN ; Leon AXEL ; Rakhmonova Gulbahor ERGASHOVNA
Clinical and Molecular Hepatology 2016;22(1):140-145
BACKGROUND/AIMS: To assess the usefulness of magnetization-tagged magnetic resonance imaging (MRI) in quantifying cardiac-induced liver motion and deformation in order to predict liver fibrosis. METHODS: This retrospective study included 85 patients who underwent liver MRI including magnetization-tagged sequences from April 2010 to August 2010. Tagged images were acquired in three coronal and three sagittal planes encompassing both the liver and heart. A Gabor filter bank was used to measure the maximum value of displacement (MaxDisp) and the maximum and minimum values of principal strains (MaxP1 and MinP2, respectively). Patients were divided into three groups (no fibrosis, mild-to-moderate fibrosis, and significant fibrosis) based on their aspartate-aminotransferase-to-platelet ratio index (APRI) score. Group comparisons were made using ANOVA tests. RESULTS: The patients were divided into three groups according to APRI scores: no fibrosis (≤0.5; n=41), moderate fibrosis (0.5-1.5; n=23), and significant fibrosis (>1.5; n=21). The values of MaxDisp were 2.9±0.9 (mean±SD), 2.3±0.7, and 2.1±0.6 in the no fibrosis, moderate fibrosis, and significant fibrosis groups, respectively (P<0.001); the corresponding values of MaxP1 were 0.05±0.2, 0.04±0.02, and 0.03±0.01, respectively (P=0.002), while those of MinP2 were -0.07±0.02, -0.05±0.02, and -0.04±0.01, respectively (P<0.001). CONCLUSIONS: Tagged MRI to quantify cardiac-induced liver motion can be easily incorporated in routine liver MRI and may represent a helpful complementary tool in the diagnosis of early liver fibrosis.
Aged
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Aspartate Aminotransferases/analysis
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Blood Platelets/cytology
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Humans
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Liver Cirrhosis/*diagnostic imaging/metabolism/pathology
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*Magnetic Resonance Imaging
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Male
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Middle Aged
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Retrospective Studies
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Severity of Illness Index