BACKGROUND/AIMS: In HCC with low AFP. we have to use repeated imaging study to evaluate residual viable rumor or recurrence after TACE ( transarterial chemoembolization). We performed the study to know that sICAM-1 in HCC can be a tumor marker of diagnosis and has cor relation with tumor size or clinical staging. The results were compared with PIVKA- , an another tumor marker of HCC. METHODS: Previously untreat ed 39 pat ients with HCC were evaluated. Serum sICAM- 1, AFP and PIVKA-II were measured by EIA, immunoradiometric assay and EIA, respectively. Tumor size were meas ured by abdominal CT and angiogr aphy. RESULTS: Range of sICAM- 1 levels with HCC patients were 189.0 to 983.6 ng/ mL, and mean value was 668.3+- 254.4 ng/ mL. Thirty four of the 39 patients (87.2%) with HCC showed sICAM- 1 levels higher than 306.4 ng/ mL (mean of 131 healt hy controls + 2SD level). Range of PIVKA-II level with HCC patients were 25.3 to 2,779.3mAU/nL, and mean value was 1,340.1+-1,091.1mAU/mL. seven of the 39 patients(94.9%) with HCC showde PIVKA-II levels higher than 40mAU/mL. Range of AFP levels with HCC patients were 4.2 to 57,520ng/mL, and mean value was 4,215.6+-10,807.2ng/mL. 10 patients (26%) showed AFP lower than 20ng/mL, and 17 patients(44%) were AFP lower than 100ng/mL. All of the 17 patients with alphaFP lower than 100ng/mL had s ICAM-1 levels more than reference range (mean of 131 healt hy cont r ols + 2 SD level), and PIVKA-II levels also more than reference range. Positive correlation was observed between PIVKA-II level and tumor size in 18 patients without vascular invasion. Accor ding t o HCC clinical staging, 10 patients (25.6%) belonged clinical stage II. 5 pat ients (12.8%) III, 24 pat ients (61.5%) IV. Both of PIVKA-II and sICAM-1 levels of stage showed significantly higher than stage II. PIVKA-II showed more positive correlation with tumor size and clinical stage than sICAM- 1. No correlation was found between AFP and sICAM-1, and positive correlation was AFP and PIVKA-II. CONCLUSION: In HCC patients with low AFP, sICAM-1 and PIVKA-II correlated with tumor size and clinical stage. sICAM-1 and PIVKA-II may be a useful marker of diagnosis. So, we need to further study to evaluate whether sICAM- 1 and PIVKA-II can be used as a marker of disease progression or prognosis.
Carcinoma, Hepatocellular* ; Diagnosis ; Disease Progression ; Humans ; Immunoradiometric Assay ; Intercellular Adhesion Molecule-1* ; Prognosis ; Recurrence ; Reference Values ; Tomography, X-Ray Computed

Fascioliasis is a zoonotic disease caused by Fasciola hepatica, a liver fluke, for which human acts as an accidental host. Fascioliasis, while common in some tropical countries, is rare in Korea. Endoscopie retrograde cholangiopancreatography(ERCP) has been described in only a very few cases as a useful technique for the diagnosis of fascioliasis. We report a case of fascioliasis diagnosed by ERCP, after endoscopic sphinchterotomy adult worms were removed by Dormia basket.
Adult ; Biliary Tract* ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Fasciola hepatica ; Fascioliasis* ; Humans ; Korea ; Pancreas* ; Sphincterotomy, Endoscopic ; Zoonoses

BACKGROUND/AIMS: Recent studies, have examined the expression of adhesion molecules in liver inflammation, and the existence of soluble ICAM 1 in serum could be proved by ELISA. We maeasured s-ICAM 1 in patients with acute and ehronic liver disease to see the level of s-ICAM 1 can reflect degree of necroinflammation or progress of disease. METHOD: Serum levels of soluble forms of intercellular adhesion molecule 1(sIGAM 1) in 78 patients with acute and chronic liver disease including acute hepatitis B, CAH, C.'PH, post-necrotic and alcoholic liver cirrhosis, hepatoceliular carcinoma, toxic hepatitis were measured by enzyme-linked immunosorbent assays. RESULTS: 1) ICAM 1 semm levels in acute and chronic liver disease including acute hepatitis B(709.6+/-321.7 ng/L, p<0.001), C:AH(582.2+/-312.4 ng/L, p<0.001), CPH(357,8+/-135.0 ngL, p<0.044), postnecrotic livercirrhosis(716.2+/-348.0 ng/L, p<0.0001), alcoholic liver cirrhosis(763.3+/-48l.5 ng/L, p<0.009). Hepatocellular carcinoma(728.2+/-329.0 ng/L, p<0.002), toxic hepatitis(817.3+/-324.4 ng/l, p<0.0001) were signiticantly higher than that of healthy controLs(234.5+/-67.5 ng/L).2) In comparison with CPH we found significantly increased ICAM- 1 serum levels in CAH.(p=0.027) A significant correlation was found between the ICAM-1 serum level and the histologically graded inflammatory activity in CAH. 3) No correlation was found be1ween the ICAM l serum level aml the Child- Pugh classification in liver cirrhosis. 4) In comparison with chronic hepatitis we found signitcantly increased 1CAM 1 serum levels in liver cirrhosis(p = 0.001) , and in hepatocellular carcinoma(p = 0.0001). CONCLUSION: Soluble ICAM I serum level correlated well with ongoing necrointlammatory activity in acute and chronic hepatitis and also slCAM 1 can reflect disease severity in various chronic 1iver disease groups.
Alcoholics ; Classification ; Drug-Induced Liver Injury ; Enzyme-Linked Immunosorbent Assay ; Hepatitis ; Hepatitis B ; Hepatitis, Chronic ; Humans ; Inflammation ; Intercellular Adhesion Molecule-1 ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic ; Liver Diseases* ; Liver*

The effects of styrene on the induction of cytochrome P-450s (P450), (P4501A1/2, P4502B1/2 and P4502El) and activities of other related enzymes were investigated in the male Sprague Dawley rats which were treated with styrene 500 (S1), 1,000 (S2) 1,500 (S3) mg/kg in olive oil intraperitoneally once a day for two days and sacrificed for the preparation of liver microsomes after 24 hrs. 1. The contents of total protein and P450 in the microsomes derived from the styrene treated groups were slightly higher than those from the control group except those from the 53 group (1,500 mg styrene/kg body weight) . The decreases in microsomal protein contents was prominent in the S3 (p<0.05), but the P450 contents was increased significantly in the S2 (p<0.05). 2. The activities of NADPH-P450 and NADH b5 reductase in hepatic microsomes derived from the treated groups were significantly increased in the treated groups(p<0.05). 3. The activities of PROD were also prominently increased with the treatment of styrene except in 53 group, but the activity of EROD was decreased by styrene treatment. The activities of pNPH in the styrene treated groups were higher than that of the control group (p<0.05). 5. Western blotting with monoclonal antibodies against P4502B1/2 isozymes showed the presence of P4502B1/2 in hepatic microsomes from the rats treated with styrene, and the increase in the densities of immunoblots were corelated with the dosages of styrene. The blot densities against P4501A1/2 and P4502El were slightly increased in the styrene treated groups compared with the control group. These results suggested that styrene could primarily induce P4502B1/2 as major and P4501A1/2 and P4502El in minor forms for the metabolism of styrene in rats.
Animals ; Antibodies, Monoclonal ; Blotting, Western ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2B1 ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Humans ; Isoenzymes ; Male ; Metabolism ; Microsomes ; Microsomes, Liver ; NAD ; Olea ; Oxidoreductases ; Rats* ; Rats, Sprague-Dawley ; Styrene*

The effects of styrene on the induction of cytochrome P-450s (P450), (P4501A1/2, P4502B1/2 and P4502El) and activities of other related enzymes were investigated in the male Sprague Dawley rats which were treated with styrene 500 (S1), 1,000 (S2) 1,500 (S3) mg/kg in olive oil intraperitoneally once a day for two days and sacrificed for the preparation of liver microsomes after 24 hrs. 1. The contents of total protein and P450 in the microsomes derived from the styrene treated groups were slightly higher than those from the control group except those from the 53 group (1,500 mg styrene/kg body weight) . The decreases in microsomal protein contents was prominent in the S3 (p<0.05), but the P450 contents was increased significantly in the S2 (p<0.05). 2. The activities of NADPH-P450 and NADH b5 reductase in hepatic microsomes derived from the treated groups were significantly increased in the treated groups(p<0.05). 3. The activities of PROD were also prominently increased with the treatment of styrene except in 53 group, but the activity of EROD was decreased by styrene treatment. The activities of pNPH in the styrene treated groups were higher than that of the control group (p<0.05). 5. Western blotting with monoclonal antibodies against P4502B1/2 isozymes showed the presence of P4502B1/2 in hepatic microsomes from the rats treated with styrene, and the increase in the densities of immunoblots were corelated with the dosages of styrene. The blot densities against P4501A1/2 and P4502El were slightly increased in the styrene treated groups compared with the control group. These results suggested that styrene could primarily induce P4502B1/2 as major and P4501A1/2 and P4502El in minor forms for the metabolism of styrene in rats.
Animals ; Antibodies, Monoclonal ; Blotting, Western ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 CYP2B1 ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Humans ; Isoenzymes ; Male ; Metabolism ; Microsomes ; Microsomes, Liver ; NAD ; Olea ; Oxidoreductases ; Rats* ; Rats, Sprague-Dawley ; Styrene*

No abstract available.
Alcoholics* ; Humans ; Liver Cirrhosis* ; Liver*

Symptomatic hepatic cysts are infrequently seen. A 82-year-old woman was admitted because of growing abdominal mass and pain. On admission, the mass was palpated on right upper quadrant of the abdomen. Ultrasonography and computed tomography disclosed a huge cystic lesion of the liver. It measured 22.5 x 19.0 x 18.0 cm and had a thick wall that was irregular. Because of the patient's symptoms and the radiologic findings, the decision was made to aspirate the cyst percutaneously under fluoroscopic guidance. Percutaneous drainage yielded approximately 3300 cc of yellow brownish fluid. A cytologic evaluation of the fluid was negative for malignant cells, and a fluid analysis was described as predominantly inflammatory in nature. Cultures revealed a growth of Klebsiella oxytoca. After drainage of the cystic fluid, we instilled contrast medium. No communication between the cyst and bile ducts was seen. Seven days later, the patient was discharged. Four months after treatment, no reaccumulated fluid was observed by ultrasonography. Ten months after treatment, the patient is healthy without abdominal discomfort. We report a case of the infected huge hepatic cyst successfully treated with fluoroscopic-uided percutaneous drainage.
Abdomen ; Aged, 80 and over ; Bile Ducts ; Drainage* ; Female ; Humans ; Klebsiella oxytoca ; Liver ; Ultrasonography

Alendronate sodium (Fosamax(R)) is an aminophosphonate used in treatment of postmenopausal osteoporosis by inhibition of osteoclastic activity. Esophageal ulcers related to alendronate use have been reported at the rate of 2~6%. However, there have been no reports of esophagitis or esophageal ulcer by alendronate in Korea. We present a case of esophageal ulcer caused by alendronate. The patient presented with retrosternal pain and severe odynophagia for a few days. Esophagogastroduodenoscopy revealed multiple deep ulcers at the esophagus. Her symptoms resolved completely after stopping alendronate. A follow-up esophagogastroduodenoscopy 6 weeks later revealed complete healing of the ulcers.
Alendronate* ; Endoscopy, Digestive System ; Esophagitis ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Korea ; Osteoclasts ; Osteoporosis, Postmenopausal ; Ulcer*

Gastric MALT lymphoma usually presents with various endoscopic morphologic characteristics. The majority of the endoscopic findings of low-grade gastric MALT lymphoma reveal multiple and superficial erosions or ulceration with mucosal nodularity, but high-grade gastric MALT lymphomas show ulceroinfiltrative and fungating lesion. However, low-grade gastric MALT lymphoma that presents as advanced gastric cancer is very rare. We experienced a case of low-grade gastric MALT lymphoma with perigastric lymph node infiltration; it presented as advanced gastric cancer, and it was treated with H. pylori eradication and CHOP chemotherapy. So we report on this case along with a review of related literatures.
Drug Therapy ; Lymph Nodes ; Lymphoma, B-Cell, Marginal Zone* ; Stomach Neoplasms* ; Ulcer

Acute gastric anisakiasis is caused by gastric mucosal penetration from an Anisakis larvae. It occurs with those who ingest raw or inadequately cooked saltwater fish or squid containing anisakis. The clinical symptoms are severe abdominal pain, nausea, vomiting, diarrhea, and so on. A case of acute gastric Anisakiasis with massive hematemesis was presented. Initial endoscopic examination revealed an edematous or raised erosive lesion with a small blood clot-covered vessel in the fundus which was thought to be a stigmata of recent bleeding. The lesion was treated with an epinephrine-hypertonic saline injection, electrocoagulation, and an ethanol injection. A follow-up gastroscopy revealed an artificial coagulation-induced ulcer at the previous bleeding site. At the ulcer margin, a whitish linear worm was found with half of its body penetrating the gastric mucosa. The worm was removed using biopsy forceps and the patient was subsequently placed on a soft diet. The next day however, hematemesis recurred. Gastroscopic band ligation of the vessel was performed with a cessation of bleeding. Three weeks later, a gastroscopy determined that the ulcer had completely healed.
Abdominal Pain ; Anisakiasis* ; Anisakis ; Biopsy ; Christianity ; Decapodiformes ; Diarrhea ; Diet ; Electrocoagulation ; Endoscopy ; Ethanol ; Follow-Up Studies ; Gastric Mucosa ; Gastroscopy ; Hematemesis* ; Hemorrhage ; Humans ; Larva ; Ligation ; Nausea ; Surgical Instruments ; Ulcer ; Vomiting