Alcoholism ; complications ; China ; Congresses as Topic ; Fatty Liver ; epidemiology ; etiology ; Hepatitis, Viral, Human ; complications ; Humans ; Metabolic Syndrome ; complications ; Risk Factors

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cause of Death ; Child ; Cross Infection ; epidemiology ; Female ; Hepatitis, Viral, Human ; complications ; Humans ; Liver Cirrhosis ; complications ; Male ; Middle Aged ; Peritonitis ; complications ; epidemiology ; Pneumonia ; complications ; epidemiology

OBJECTIVETo study the nosocomial fungal infections in the patient with severe hepatitis and analyze of risk factor.

METHODSAll 115 severe hepatitis with fungal infections inpatients was studied prospectively.

RESULTSWe identified 115 cases with fungal infections, the mean age of patients was 37.2+/-21.5 years, male: 49 cases, female 66 cases. Infection of abdominal cavity accounted for 40.9%, infectious rate in respiratory tract and digestive tract were 26.9%, 21.8%, respectively. Candida albicans accounted for 67.6%. Use of broad-spectrum antibiotic and corticosteroids, neutropenia, severity of liver disease, improper medical manipulations as significant risk factors for fungal infection. Death rate of study group and control group was 59.1%, 34.8%, respectively (x2=36.0). In multivariate analysis, neutropenia, disseminated infection and severity of liver diseases were independent prognostic factors.

CONCLUSIONIdentification of risk factors and predictors of a poor outcome in patients with severe hepatitis with fungal infections, it suggested that implications in prophylaxis of fungal infection, early diagnosis and appropriate therapy would be important for these patients.

Adult ; Candidiasis ; diagnosis ; epidemiology ; China ; epidemiology ; Cross Infection ; complications ; epidemiology ; Female ; Hepatitis, Viral, Human ; complications ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Mycoses ; epidemiology ; microbiology ; Prospective Studies ; Risk Factors ; Severity of Illness Index

BACKGROUND/AIMS: The aim of this study was to describe the types and causes of liver disease in patients from a single community hospital in Korea between April 2005 and May 2010. METHODS: A cohort of patients who visited the liver clinic of the hospital during the aforementioned time period were consecutively enrolled (n=6,307). Consistent diagnostic criteria for each liver disease were set by a single, experienced hepatologist, and the diagnosis of all of the enrolled patients was confirmed by retrospective review of their medical records. RESULTS: Among the 6,307 patients, 528 (8.4%) were classified as acute hepatitis, 3,957 (62.7%) as chronic hepatitis, 767 (12.2%) as liver cirrhosis, 509 (8.1%) as primary liver cancer, and 546 (8.7%) as a benign liver mass or other diseases. The etiologies in the acute hepatitis group in decreasing order of prevalence were hepatitis A (44.3%), toxic hepatitis (32.4%), other hepatitis viruses (13.8%), and cryptogenic hepatitis (9.1%). In the chronic hepatitis group, 51.2% of cases were attributed to viral hepatitis, 33.3% to nonalcoholic fatty liver disease, and 13.0% to alcoholic liver disease (ALD). Of the cirrhoses, 73.4% were attributable to viral causes and 18.1% to alcohol. Of the hepatocellular carcinoma cases, 86.6% were attributed to viral hepatitis and 11.6% to ALD. Among the benign tumors, hemangioma comprised 52.2% and cystic liver disease comprised 33.7%. CONCLUSIONS: Knowledge of the current status of the type and cause of liver disease in Korea may be valuable as a basis for evaluating changing trends in liver disease in that country.
Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking/adverse effects ; Carcinoma, Hepatocellular/epidemiology/etiology/pathology ; Chronic Disease ; Cohort Studies ; Fatty Liver/epidemiology ; Female ; Hepatitis/epidemiology ; Hepatitis, Viral, Human/complications/epidemiology ; Humans ; Liver Cirrhosis/epidemiology/etiology ; Liver Diseases/*diagnosis/epidemiology ; Liver Diseases, Alcoholic/complications/epidemiology ; Liver Neoplasms/epidemiology/etiology/pathology ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Young Adult

OBJECTIVESTo analyze the factors related to prognosis of hepatitis failure and to determine the factors which significantly affect it, and to build a scoring system for assessment of the prognosis of hepatitis failure and also to examine its efficacy for clinical use.

METHODSClinical data from 301 patients were analyzed retrospectively. The correlated degree between those single factors and prognosis of hepatitis failure was explored by logistic regression analysis. Independent risk factors of prognosis and those correlated coefficients, which were from logistic regression analysis, were used to build a scoring system. This system was used in analyzing the clinical data of 275 patients to examine its efficacy of the prognostic assessment.

RESULTSThe factors that significantly affected the prognosis of hepatitis failure included age, clinical typing, hepatic coma, total bilirubin, and others (P < 0.01). Some factors, including PTA, blood urea, sodium and hepatic coma, were independent risk factors of prognosis. The scoring system built gave different scores between the effective treatment group and ineffective treatment group with statistical significance (P < 0.01). When the score was less than 40, the probability of a recovery was 76.9%; when the score was 40 to 80, the probability of a recovery was only 12.5%. When the score was more than 80, the probability of a recovery dropped to 0%.

CONCLUSIONSThe factors, including PTA, blood urea and sodium and hepatic coma, are important in building a scoring system to assess the prognosis of hepatitis failure. The scoring system we built is very effective in evaluating the prognosis of hepatitis failure.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; epidemiology ; Evaluation Studies as Topic ; Factor Analysis, Statistical ; Female ; Hepatitis, Viral, Human ; complications ; epidemiology ; Humans ; Liver Cirrhosis ; epidemiology ; etiology ; Liver Failure ; epidemiology ; etiology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors

Alcoholism ; complications ; Antiviral Agents ; therapeutic use ; Fatty Liver ; diagnosis ; epidemiology ; etiology ; therapy ; Hepatitis, Viral, Human ; complications ; diagnosis ; drug therapy ; Humans ; Insulin Resistance ; Interferons ; therapeutic use ; Obesity ; complications ; Risk Factors

In order to evaluate the familial clustering of hepatitis B virus(HBV) and hepatitis C virus(HCV) infections and to elucidate the possible routes of HCV transmission among Korean adults with chronic liver disease, 137 household contacts of 51 chronic carriers of HBsAg and 111 household contacts of 38 controls, and 181 household contacts of 96 anti-HCV positives and 102 household contacts of 76 anti-HCV negatives were tested from July 1990 to March 1994. Of 71 non-vaccinated household contacts of HBsAg carriers, 10 gave positive result for HBsAg(14.1%), but none of the household contacts of the controls were positive for HBsAg(p< 0.05). Familial clustering of HBV infection was found, when the offspring of carriers and controls were compared. A significantly higher percentage of the offspring of carriers were positive for HBV infection(54.6% vs 15.4%, p< 0.05) with OR of 6.6(95% Cl; 1.3-34.5). No evidence of familial clustering of HCV infection was found with 2.2%(4/181) anti-HCV positivity among the household contacts of index cases, similar to 1.0%(1/102) among those of controls. History of acute hepatitis(OR 3.2), transfusion(OR 3.2), and acupuncture(OR 2.5) were associated with an increased risk of HCV infection. In conclusion, HBV has strong familial clustering whereas HCV does not in Korea.
Acupuncture Therapy/adverse effects ; Adolescent ; Adult ; Aged ; Biological Markers ; Blood Transfusion/adverse effects ; Carrier State ; Child ; Child, Preschool ; Cluster Analysis ; Comorbidity ; Comparative Study ; Contact Tracing ; *Family Health ; Female ; Hepatitis B/*epidemiology/prevention & control/transmission/virology ; Hepatitis B Antibodies/blood ; Hepatitis B Core Antigens/blood ; Hepatitis B Surface Antigens/blood ; Hepatitis C/*epidemiology/prevention & control/transmission/virology ; Human ; Infant ; Korea/epidemiology ; Male ; Middle Age ; Postoperative Complications/epidemiology ; Prevalence ; Risk Factors ; Seroepidemiologic Studies ; Sexually Transmitted Diseases/epidemiology ; Support, Non-U.S. Gov't ; Viral Hepatitis Vaccines

Alcoholism ; complications ; China ; Congresses as Topic ; Fatty Liver ; diagnosis ; etiology ; prevention & control ; Fatty Liver, Alcoholic ; epidemiology ; etiology ; prevention & control ; Hepatitis, Viral, Human ; etiology ; prevention & control ; Humans ; Metabolic Syndrome ; Risk Factors

OBJECTIVETo analyze the prognostic factors for patients with acute-on-chronic liver failure, and to build a scoring system for assessment of the prognosis of liver failure.

METHODS480 patients with acute-on-chronic liver failure in our hospital from January 2006 to June 2008 were enrolled in this study. The patients were divided into improved group and deteriorated group. The clinical data were analyzed by using chi square test, independent-Samples T Test and Binary logistic regression.

RESULTSThe factors that significantly affected the prognosis of Acute-on-chronic Liver Failure included age, hepatitis or liver cirrhosis, Staging, Hyponatremias, alpha-fetoprotein (AFP), the prothrombin time activity (PTA), total bilirubin (TBil), creatinine (Cr), albumin (ALB) and Hepatic encephalopathy, ascites, alimentary tract hemorrhage (P less than 0.05, P less than 0.01). PTA, Hyponatremias, hepatitis or liver cirrhosis, Hepatic encephalopathy and alimentary tract hemorrhage were independent risk factors of prognosis.

CONCLUSIONPTA, Hyponatremias, hepatitis or liver cirrhosis, Hepatic encephalopathy and alimentary tract hemorrhage are important to build a scoring system to assess the prognosis of Acute-on-chronic Liver Failure and may be useful to guide clinical treatment.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers ; blood ; Child ; Child, Preschool ; Chronic Disease ; Female ; Hepatic Encephalopathy ; complications ; Hepatitis, Viral, Human ; complications ; epidemiology ; Humans ; Hyponatremia ; complications ; Infant ; Liver Failure, Acute ; blood ; etiology ; pathology ; Logistic Models ; Male ; Middle Aged ; Prognosis ; Prothrombin Time ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Young Adult

Alcohol Drinking ; adverse effects ; Hepatitis, Viral, Human ; complications ; diagnostic imaging ; pathology ; Hepatocytes ; pathology ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Cirrhosis, Alcoholic ; diagnostic imaging ; etiology ; pathology ; Liver Diseases, Alcoholic ; diagnostic imaging ; etiology ; pathology ; Liver Neoplasms ; epidemiology ; etiology ; pathology ; Prognosis ; Radiography ; Risk Factors