Alcoholic liver disease is a major cause of liver disease that results in significant morbidity and mortality in Korea. Abstinence isthe most important strategy to prevent disease progression. Corticosteroids improve the one-month survival in patients with severealcoholic hepatitis, but it was not effective on long-term survival. An N-acetylcysteine treatment combined with corticosteroidsmay provide a short-term survival benefit than corticosteroids alone. Pentoxifylline is unlikely to affect short-termsurvival. Hence, studies on new therapies, such as granulocyte colony-stimulating factor and fecal microbiota transplantation, areongoing. This paper briefly reviews the current knowledge of the medical treatment of alcoholic liver disease.

BACKGROUND: The changes of the composition in the T-lymphocyte are important as an immunological abnormality in the pathogenesis of tuberculosis. Previously, the second type of TCR dimer(gamma delta T lymphocyte) that did not express CD4 or CD8 molecules was found. In other reports the presence of this type of lymphocytes was increased in the initial stage of tuberculous infections. METHOD: To determine whether there are some differences in the T-lymphocyte subsets in the peripheral blood or pleural effusion among the forty-nine patients were examined T-lymphocyte subset analysis(CD4+T-cell,CD8+ T-cell,gamma delta T-lymphocytes) with anti-Leu4, anti-Leu3a, anti-Leu2a, anti HLA-DR and anti-TCR-gammadelta-1(Becton & Dickinson Co.). RESULTS: The average age of the patients was 50 years old(17-81year). There were 33 males and 16 female patients. patiensts with tuberculosis are 30cases(tuberculous pleurisy 15), lung cancer 12cases(malignant effusion 9) and pneumonia 7cases(parapneumonic effusion 6cases) In T lymphocyte subsets of pleural effusion, helper T lymphocyte(54.6 + 13.8 %) of tuberculous pleurisy was higher than that(36.2 + 25.3 %) of non-tuberculous pleurisy(p= 0.04). The peripheral blood gammadelta T-lymphocytes in tuberculousis was insignificantly higher than non-tuberculous patients(p= 0.24). The peripheral blood gammadelta T-lymphocytes and pleural gammadelta T-lymphocytes in tuberculous pleurisy was insignificantly higher than in non-tuberculous pleurisy(p= 0.16, p= 0.12). CONCLUSION: The percentage of gammadelta T lymphocytes among the total T-lymphocytes is not significantly increased in the peripheral blood or pleural effusion of the pleural tuberculosis. gammadelta T lymphocytes is less useful as a diagnostic method of pleural tuberculosis.
Female ; HLA-DR Antigens ; Humans ; Lung Neoplasms ; Lymphocytes ; Male ; Pleural Effusion ; Pleurisy ; Pneumonia ; T-Lymphocyte Subsets ; T-Lymphocytes* ; Tuberculosis ; Tuberculosis, Pleural*

Sorafenib is the standard treatment for advanced hepatocellular carcinoma according to the Barcelona Clinic Liver Cancer staging system. However, because of its unsatisfactory efficacy, adverse effects, and high cost, the use of sorafenib is limited, and other treatment modalities are required. Recent studies reported that treatment modalities other than sorafenib, such as hepatic arterial infusion chemotherapy and transarterial radioembolization, showed comparable or better response rates and survival rates than sorafenib. In this review, treatment modalities that could be used as alternatives to sorafenib will be discussed.
Carcinoma, Hepatocellular* ; Drug Therapy ; Humans ; Liver Neoplasms ; Survival Rate

Hepatocellular carcinoma (HCC) is the third most common cause of cancer deaths in the world. There have been many advances in the diagnosis of HCC during the last ten years, especially in the imaging techniques. The Korean Liver cancer study group (KLCSG), European Association for the Study of the Liver (EASL), American Association for the Study of Liver disease (AASLD), and Asian-Pacific Association for the Study of Liver (APASL) have made and changed the HCC guidelines with the advances in the imaging techniques and according to the results of the researches on HCC. We reviewed the changes of the imaging guidelines in HCC diagnosis according to the advances in the imaging techniques. Further studies will be necessary to resolve the controversies in the diagnosis of HCC smaller than 1 cm in size.
Carcinoma, Hepatocellular/complications/*diagnosis/pathology ; Hepatitis B/complications ; Hepatitis C/complications ; Humans ; Liver Cirrhosis/complications ; Liver Neoplasms/complications/*diagnosis/pathology ; Magnetic Resonance Imaging ; *Practice Guidelines as Topic ; Risk Factors ; alpha-Fetoproteins/analysis

No abstract available.
Mucocele*

Spontaneous bacterial peritonitis (SBP) is defined as bacterial infections that occur in patients with cirrhosis and ascites without any significant intraperitoneal infection, accounting for approximately 10–30% of bacterial infections in hospitalized patients. SBP develops in patients with liver cirrhosis because bacterial translocations are increased by changes in the intestinal bacteria and mucosal barriers. In addition, the decreased host immune response cannot remove the bacteria and their products. The most common cause of SBP is Gram-negative bacteria, such as Escherichia coli and Klebsiella species, and infections by Gram-positive bacteria are increasing. SBP is diagnosed by the presence of >250 polymorphonuclear leukocyte/mm³ in ascites after paracentesis. If SBP is diagnosed, empirical antibiotic therapy should be started immediately. Empirical antibiotic treatment should distinguish between community acquired infections and nosocomial infections. Cirrhotic patients with gastrointestinal bleeding or low ascitic protein concentrations should consider primary prevention and those who recover from SBP should consider secondary prevention. This review describes the pathophysiology, diagnosis, treatment, and prevention of SBP.
Ascites ; Bacteria ; Bacterial Infections ; Community-Acquired Infections ; Cross Infection ; Diagnosis ; Escherichia coli ; Fibrosis ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Hemorrhage ; Humans ; Klebsiella ; Liver Cirrhosis ; Paracentesis ; Peritonitis* ; Primary Prevention ; Secondary Prevention

Abdominal ultrasound examinations are performed by many gastroenterologists in clinical practice, but abdominal ultrasound education has not been included in internal medicine resident or gastroenterology fellowship training courses. Abdominal ultrasound education was established as an essential part of the resident training program in 2017, and since then interest in ultrasound has increased. An educational accreditation system for trainers of ultrasonography in the internal medicine field was developed in 2018, but accredited ultrasound trainers and equipment and space for ultrasound education are lacking. This article describes how to revitalize ultrasound education program for resident and fellowship training.
Accreditation ; Education ; Fellowships and Scholarships ; Gastroenterology ; Internal Medicine ; Ultrasonography

BACKGROUND: Acute pulmonary injury by paraquat are caused by multiple mechanisms including direct injury with oxygen free radicals and several mediators released from inflammatory cells. In order to clarify whether vitamin E could reduce tissue damages induced by intraperitoneal administaration of paraquat and to investigate the pathogenetic mechanisms of paraquat-induced pulmonary injury, vitamin E as a free radical scavenger was administered. METHODS: Rats were divided into three groups (group 1: control, group 2 : paraquat treated group, group 3 : paraquat and vitamin E treated group). Animals were sacrificed on day 1, day 2, day 3, and day 8 after the administration of saline, paraquat, or paraquat/vitamin E. RESULTS: Treatment with vitamin E decreased the death rate of rats treated with paraquat. Comparing with control group (1.37 x 106/ml), mean total cell counts recovered from the lavage fluid from animals treated with paraquat (1.65 x 106/ml) were increased(p=0.06). Magnitudes of increament of the total cell counts on the Day 8 in the vitamin E treated group were smaller than those of the animals treated with paraquat alone. The neutrophils began to appear in significant amounts in the lavage fluid on Day 8 after the administration of paraquat(37.0 + 12.7%). A significant decreasing neutrophil concentration at Day 8 was observed in the paraquat/vitamin E treated group(20.6 + 13.4 %). Histologically the degree of pulmonary fibrosis was most prominent in the paraquat treated group while diffuse alveolar damage was continuously observed in the paraquat/vitamin E treated group and extensive interstitial lymphocytic infiltration was seen in the paraquat/vitamin E treated group. The paraquat/vitamin E treated group showed the less histologic changes. CONCLUISON: In this study vitamin E acting as a scavenger of neutrophil-derived free radicals and suppressant of lipid peroxidation, seemed to be the effective antioxidant in the inhibition of paraquat-induced pulmonary injury.
Acute Lung Injury ; Animals ; Bronchoalveolar Lavage ; Cell Count ; Free Radicals ; Lipid Peroxidation ; Lung Injury ; Mortality ; Neutrophils ; Oxygen ; Paraquat* ; Pulmonary Fibrosis ; Rats* ; Therapeutic Irrigation ; Vitamin E* ; Vitamins*