In the past 10 years, the standard treatment for chronic hepatitis C has been pegylated interferon and ribavirin for 24 to 48 weeks, based on genotype. Until now, fixed schedule therapy for chronic hepatitis C infection is the standard treatment in most countries. Response-guided therapy (RGT) is an emerging concept in which treatment decisions are based on how the virus responds to treatment. RGT has not been accepted into practice guidelines in all countries. The RGT approach takes into account both viral and host factors. RGT allows clinicians to provide a shorter duration of treatment, sparing patients of ongoing side effects and medical costs. We review several new treatment guidelines on new direct protease inhibitors. In late 2011, telaprevir and boceprevir were approved for treating chronic hepatitis C. Nowadays, the strategy for hepatitis C genotype 1 has been revolutionized by these two drugs. Other new direct acting antiviral agents have increased the sustained viral response significantly in chronic hepatitis genotype 1 patients in several recent clinical trials. In the future, Hepatitis C treatment will be personalized according to early viral response and baseline viral load. An interferon-free regimen will also be available for chronic hepatitis C.
Antiviral Agents ; Appointments and Schedules ; Genotype ; Hepatitis C ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Interferons ; Oligopeptides ; Proline ; Protease Inhibitors ; Ribavirin ; Viral Load ; Viruses

Hepatocellular carcinoma (HCC) is one of the most common life-threatening cancers worldwide. Recently, many patients with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) have progressed to HCC even in the absence of cirrhosis. As the morbidity of metabolic syndrome increases, the proportion of HCC associated with NAFLD is expected to increase gradually. A new mechanism for the development of HCC in NAFLD has been identified; Diabetes mellitus, insulin resistance, obesity, lipotoxicity, gut dysbiosis are risk factors. Inflammatory cytokines such as adipokines, leptin, tumor necrosis factor-α, interlukin-8, nuclear factor-κB constitute dysplasia-carcinoma sequence. At the time of diagnosis, NAFLD/NASH related HCC tend to progress to larger and in advanced tumor-node-metastasis stages compared to viral hepatitis related HCC. But there are no guidelines for early detection of NAFLD-related HCC. So, it is essential to study the screening program for the early detection of NAFLD-related HCC and precise methods for NAFLD.
Adipokines ; Carcinoma, Hepatocellular* ; Cytokines ; Diabetes Mellitus ; Diagnosis ; Dysbiosis ; Fatty Liver ; Fibrosis ; Hepatitis ; Humans ; Insulin Resistance ; Leptin ; Mass Screening ; Metabolic Syndrome X ; Necrosis ; Non-alcoholic Fatty Liver Disease* ; Obesity ; Risk Factors

No abstract available.

We report herein a case of subcutaneous granuloma pyogenicum developed on the fourth interdigital space of right foot of 36-year-old housewife. Histopathological findings showed characteristic lobular capillary hemangioma. The subcutaneous nodule had a thick fibrous capsule and were composed of multiple, confluent cellular, angiomatous lobules separated by loose fibrous tissue. Most lobules contained round, oval or angular capillaries, lined by proliferated prominant endothelial cells projecting into the lumina of the vessels. Clinically, the lesion was a tender subcutaneous nodule with macerated surface aind soft corn or traumatic epidermal cyst were considered in the differential diagnoses.
Adult ; Capillaries ; Diagnosis, Differential ; Endothelial Cells ; Epidermal Cyst ; Foot ; Granuloma* ; Granuloma, Pyogenic* ; Humans ; Zea mays

Causalgiform pain was produced in adult rats(Sprague-Dawley) by the tight ligation of L5 and L6 spinal nerves. To verify the causalgiform pain, we tested spontaneous pain behavior', withdrawal sensitivity to the innocuous mechanical stimulation of Von Frey hair 2.35gm(mechanical allodynia); and withdrawal frequency to the cold stimulation of acetone (cold allodynia). The natural duration of causalgiform pain (control group, N=11) and the change of pain by surgical sympathectomy (sympathectomy group, N=9) was observed. The results were as follows 1) Mechanical allodynia(57.8%) and cold allodynia(63.2%) was induced on the postoperative 7th day. 2) Causalgiform pain was continued for 3 to 5 weeks in the control group. 3) Mechanical allodynia and cold allodynia was reduced significantly (P<0.05) after surgical sympathectomy in the sympathectomy group.
Acetone ; Adult ; Animals ; Hair ; Humans ; Hyperalgesia ; Ligation* ; Rats* ; Spinal Nerves* ; Sympathectomy

Prevalence of non-alcoholic fatty liver disease (NAFLD) is about 20-25% in Korean adults population. Obesity is strongly associated with NAFLD and the prevention of obesity is a major public issue. Unfortunately, pharmacological treatment of obesity and NAFLD remains uncertain. Only weight loss by dietary changes been shown to lead to histological improvement in fatty liver. So the nutrition therapy is a cornerstone of treatment for NAFLD. Epidemiologic studies show that saturated fat, trans-fatty acid, carbohydrate, and simple sugar have strong correlation with intrahepatic fat accumulation. But, true associations with specific nutrients still remain unclear. Recently, fructose consumption has been rising in many countries and several epidemiologic studies show that fructose consumption has strong correlation with metabolic diseases. The consumption of excessively added sugar in the pathogenesis of steatohepatitis has received attention. Most clinicians agree with lifestyle modification are effective in histologic improvement. Total energy intake restriction is the most important action to reduce intrahepatic fat accumulation. Macronutrient composition may also have correlation with the development of NAFLD. To reduce the incidence of NAFLD, public statements on optimal dietary education program have been issused. Various specific dietary programs are suggested. Among them low fat diet and low carbohydrate diet are suggested in patients with NAFLD. However, there is no ideal diet to obtain the histological improvement in NAFLD. Further randomised controlled studies about specific diet are needed to determine the long-term benefit and histological improvement by ideal diet. Tailoring diet therapy to a patient's lifestyle is more important than universal specific dietary program.
*Diet ; Diet, Carbohydrate-Restricted ; Diet, Fat-Restricted ; Dietary Proteins/metabolism ; Energy Intake ; Fatty Acids, Monounsaturated/metabolism ; Fatty Liver/diet therapy/epidemiology/*etiology ; Humans