No abstract available.
Aged ; Amiodarone/*adverse effects/therapeutic use ; Anti-Arrhythmia Agents/*adverse effects/therapeutic use ; Hepatitis, Alcoholic/diagnosis/etiology ; Hepatitis, Chronic, Drug-Induced/*diagnosis/etiology/pathology ; Humans ; Male

OBJECTIVETo estimate the correlations between functional MRI (fMRI) parameters and the severity of chronic liver lesions of hepatitis B patients.

METHODS47 hepatitis B patients [6 with chronic hepatitis, 41 with cirrhosis (14 with Child-Pugh class A cirrhosis; 12 with class B cirrhosis; and 15 with class C cirrhosis)] and 10 normal volunteers, referred for measurements of apparent diffusion coefficient (ADC) values of the liver, perfusion imaging parameters, portal flow parameters and serum markers of hepatic fibrosis were included in the study. Diffusion-weighted imaging (DWI) with different b values and b value remainder was performed. Time to peak (TP), maximum slope of increase (MSI) and distribution volume (DV) were measured with dynamic contrast material-enhanced MR imaging. Portal velocity and portal flow with phase contrast (PC) were measured. The patients' serum hepatic fibrosis markers, including hyaluronic acid (HA), type-III-procollagen (PC III), laminin (LN) and type-IV-collagen (C IV), were measured and analyzed together with the fMRI results.

RESULTS(1) The mean ADC3 in Child A, B, C cirrhosis patients was significantly lower than that in the controls (P < 0.05 in Child A, and P < 0.05 in Child B). (2) There was a significant increase of time to peak and a decrease of maximum slope of increase (P < 0.01) in the Child A, B, C patients than in the normal controls. (3) There was a significant decrease in portal velocity in cirrhotic patients as compared to that of the controls and chronic hepatitis patients (P < 0.01). (4) The mean HA in Child A, B, C cirrhosis patients was significantly higher than that in chronic hepatitis patients and in the controls (P < 0.01); The mean LN in Child A, B, C cirrhosis was also significantly higher than that in chronic hepatitis patients and in normal controls (P < 0.01); The mean PC III in Child A, B, C cirrhosis was significantly higher than that in the normal controls (P < 0.01).

CONCLUSIONfMRI parameters can reflect some changes of the livers, therefore fMRI parameters are of value in clinical diagnosis and treatment of chronic hepatitis B patients.

Adult ; Aged ; Female ; Hepatitis B ; complications ; Hepatitis B, Chronic ; diagnosis ; pathology ; Humans ; Liver Cirrhosis ; diagnosis ; etiology ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged

Hepatitis A is generally known as a mild, self-limiting disease of the liver, but in rare instances it can progress to fulminant hepatitis, which may require liver transplantation for recovery. Such cases are known to be related to old age and underlying liver disease. We report four cases of hepatitis A in which patients presented with fulminant hepatitis and acute renal failure and underwent liver transplantation. The following common features were observed in our cases: (1) occurrence in relatively old age (> or =39 years old), (2) association with acute renal failure, (3) presence of hepatomegaly, and (4) microscopic features of submassive hepatic necrosis.
Adult ; Age Factors ; Female ; Hepatitis/complications/*diagnosis/therapy ; Hepatitis A/complications/*diagnosis ; Hepatomegaly/diagnosis/etiology ; Humans ; Kidney Failure, Acute/complications/*diagnosis ; Liver/pathology ; Liver Cirrhosis/diagnosis/etiology ; *Liver Transplantation ; Male ; Tomography, X-Ray Computed

Biomarkers ; blood ; Diagnostic Techniques, Digestive System ; Elasticity ; Hepatitis C, Chronic ; complications ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; etiology

Facial nerve palsy due to temporal bone metastasis of hepatocellular carcinoma (HCC) has rarely been reported. We experienced a rare case of temporal bone metastasis of HCC that initially presented as facial nerve palsy and was diagnosed by surgical biopsy. This patient also discovered for the first time that he had chronic hepatitis B and C infections due to this facial nerve palsy. Radiation therapy greatly relieved the facial pain and facial nerve palsy. This report suggests that hepatologists should consider metastatic HCC as a rare but possible cause of new-onset cranial neuropathy in patients with chronic viral hepatitis.
Carcinoma, Hepatocellular/complications/*pathology ; Facial Nerve Diseases/diagnosis/etiology ; Facial Pain/etiology ; Facial Paralysis/diagnosis/etiology ; Hepatitis B, Chronic/diagnosis ; Hepatitis C, Chronic/diagnosis ; Humans ; Immunohistochemistry ; Liver Neoplasms/complications/*pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Skull Neoplasms/*diagnosis/pathology/secondary ; Tomography, X-Ray Computed

BACKGROUND/AIMS: We compared the accuracy and usefulness of clinical diagnostic criteria for hepatocellular carcinoma in a hepatitis B virus (HBV)-endemic area. METHODS: We reviewed the medical records of 355 patients who had undergone liver resection or biopsy at our institution between January 2008 and December 2009. These patients were reevaluated using four noninvasive diagnostic criteria for hepatocellular carcinoma proposed by the European Association for the Study of the Liver (EASL), the American Association for the Study of Liver Diseases (AASLD), the Korean Liver Cancer Study Group and the National Cancer Center (KLCSG/NCC), and National Comprehensive Cancer Network (NCCN) guidelines. RESULTS: The overall sensitivity was highest using the KLCSG/NCC criteria (79.8%), followed by the AASLD (51.5%), EASL (38.4%), and NCCN (10.1%; P<0.001) criteria, whereas the specificity (84.5-98.3%) and positive predictive value (96.2-98.3%) were similar for all of the criteria. The KLCSG/NCC criteria had an acceptable false-positive rate and the highest sensitivity among all of the patients, including those positive for HBsAg, those without liver cancer, and those with a tumor of at least 2 cm. CONCLUSIONS: The KLCSG/NCC and AASLD criteria exhibited the highest sensitivity, and all four guidelines had a high specificity among all of the patients. Based on the sensitivity and false-positive rate, the KLCSG/NCC criteria was the most useful in the majority of patients. Inclusion of HBV infection in the clinical diagnostic criteria for hepatocellular carcinoma would be reasonable and may lead to an improvement in the sensitivity, with acceptable false-positive rates, in HBV-endemic areas.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/*diagnosis/etiology/pathology ; Female ; Hepatitis B/complications/*diagnosis/epidemiology ; Hepatitis B Surface Antigens/blood ; Hepatitis C/diagnosis/epidemiology ; Humans ; Liver/pathology ; Liver Neoplasms/*diagnosis/etiology/pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Practice Guidelines as Topic ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed ; Young Adult ; alpha-Fetoproteins/analysis

Dubin-Johnson syndrome is a rare clinical entity. It shows intermittent symptoms such as chronic or intermittent jaundice, abdominal pain, weakness, nausea, vomiting, anorexia and diarrhea. Symptoms are precipitated or aggravated by pregnancy, alcoholism, surgical procedures and intercurrent disease. Chronic idiopathic jaundice is typical of Dubin-Johnson syndrome and its prognosis is good. We describe a case of prolonged cholestasis for more than 10 months caused by acute A viral hepatitis in a patient with Dubin-Johnson syndrome. It is a first report of cholestasis complicated by acute A viral hepatitis in a patient with Dubin-Johnson syndrome.
Acute Disease ; Adult ; Bilirubin/blood ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis/*diagnosis/etiology ; Hepatitis A/complications/*diagnosis ; Humans ; Jaundice, Chronic Idiopathic/complications/*diagnosis ; Liver/pathology ; Male ; Tomography, X-Ray Computed

Sweet's syndrome (SS), also known as acute febrile neutrophilic dermatosis, is characterized by the sudden onset of painful erythematous skin lesions together with fever and neutrophilia. SS can be associated with several disorders, such as malignancy, autoimmune disease, and infections. However, SS associated with liver cirrhosis is uncommon. We report a case of SS in a patient who was diagnosed with liver cirrhosis caused by chronic hepatitis B.
Hepatitis B, Chronic/complications/*diagnosis ; Humans ; Liver Cirrhosis/*diagnosis/etiology ; Male ; Middle Aged ; Neutrophils/immunology/pathology ; Skin Diseases/*diagnosis/pathology ; Sweet Syndrome/*diagnosis/pathology ; Tomography Scanners, X-Ray Computed

Brain ; pathology ; Globus Pallidus ; pathology ; Hepatitis B, Chronic ; complications ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Cord Diseases ; diagnosis ; etiology

Acute hepatitis A is currently outbreaking in Korea. Although prognosis of acute hepatitis A is generally favorable, a minority of patients are accompanied by fatal complications. Severe cholestasis is one of the important causes of prolonged hospitalization in patients with acute hepatitis A. In such cases, higher chances of additional complications and increased medical costs are inevitable. We report three cases of severely cholestatic hepatitis A, who showed favorable responses to oral corticosteroids. Thirty milligram of prednisolone was initiated and tapered according to the responses. Rapid improvement was observed in all cases without side effects. We suggest that corticosteroid administration can be useful in hepatitis A patients with severe cholestasis who do not show improvement by conservative managements. Clinical trial will be needed to evaluate effectiveness of corticosteroids in these patients.
Acute Disease ; Administration, Oral ; Adult ; Anti-Inflammatory Agents/administration & dosage/*therapeutic use ; Cholestasis/*drug therapy/etiology/pathology ; Hepatitis A/*complications/diagnosis ; Humans ; Liver/pathology ; Male ; Predni