BACKGROUND/AIMS: Oxidative stress is known to play a role in the pathogenesis of a certain liver diseases such as alcoholic liver disease, metal storage disease, and ischemia/reperfusion injury. Recently oxidative stress(lipid peroxidation) has also been implicated in hepatic fibrosis, which is now regarded as a common response to chronic liver injury regardless of its nature. Development of fibrosis and cirrhosis are the major complications of chronic hepatitits B. So we aimed to detect lipid peroxidation in chronic hepatitis B and to investigate its potential role in the pathophysiology of the disease. METHODS: The subjects were histologically-proven 56 patients, including fatty liver(FL, n=8), healthy HBsAg carrier(n=6), chronic persistent hepatitis(CPH, n=8), mild chronic active hepatitis(CAH-m, n=10), severe CAH(CAH-s, n=16), and liver cirrhosis(LC, n=8). All patients were serologically HBsAg-positive except those with FL. Lipid peroxidation was detected in serum and liver specimen with TBARS(thiobarbituric acid-reacting substances) assay. Western blot and immunohistochemical stain of liver specimen were also performed, using polyclonal antibody against malondialdehyde (MDA). RESULTS: 1. There were no significant differences in serum TBARS levels among groups(p= 0.24). 2. The mean tissue TBARS level(nmol/g) was significantly higher in CAH-s group(175.4+ 41.5) than in other groups(FL 54.0+ 6.4, Carrier 51.1+ 15.9, CPH 63.9+ 2.9, CAH-m 68.9+ 7.9, LC 22.6+ 5.1) (p<0.05). 3. Tissue TBARS levels correlated with serum ALT levels(r=0.5934, p<0.05). 4. Western blot showed MDA bands only in CAH-s group. 5. Immunohistochemistry showed a strong MDA stain around portal and periportal area in CAH-s group, but weak or no stain in other groups. CONCLUSIONS: This study shows that lipid peroxidation can be detected in situ and commonly occurs in severe chronic hepatitis B. Oxidative stress may be related to active necroinflammatory change of the liver and contribute to the progression of the disease in chronic hepatitis B.
Blotting, Western ; Fibrosis ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic ; Humans ; Immunohistochemistry ; Lipid Peroxidation* ; Liver Diseases* ; Liver Diseases, Alcoholic ; Liver* ; Malondialdehyde ; Oxidative Stress ; Thiobarbituric Acid Reactive Substances

BACKGROUND/AIMS: The most effective method of improving survival in patients with HCC is early diagnosis and curative hepatic resection. However, longterm survival after curative resection remains low because of high recurrence rate after resection. The purpose of the study is to assess the prognosis and the efficacy of the various treatment modalities on recurrent HCC after curative resection. METHODS: The clinical records of 50 patients with recurrent HCC were reviewed retrospectively who underwent curative surgery in Yonsei University, Severance Hospital from Jan. 1987 through Oct. 1994. The cummulative recurrent rate after resection, the response rate of treatment after resection, the median progression free survival and the survival after recurrence according to the treatment modalities were evaluated. RESULTS: The cummulative recurrent rate after resection was 3.9% at 3 month, 8.3% at 6 month, 14.1% at 12 month, 21.5% at 24 month, 23.4% at 36 month and 24.4% at 60 month. The response rate of treatment after recurrence was 23.7% (9 patients). The median progression free survival of the patient with reoperation and hepatic embolization was 13.9 months, that of conservative treatment group was 6.8 months and that of no treatment group was 4 months(p = 0.004). The survival after recurrence of HCC was 19.7 months in reoperation and hepatic embolization group, 11.4 months in multimodality group, 16.9 months in conservative treatment group and 8.4 months in no treatment group(p=0.0998). CONCLUSION: Reoperation and hepatic embolization for HCC after curative resection was effective in improving progression free survival, but overall survival were not significantly different according to the treatment modalities. This results proposed that reoperation and hepatic embolization for recurrent HCC after curative resection improve progression free survival.
Carcinoma, Hepatocellular* ; Disease-Free Survival ; Early Diagnosis ; Humans ; Prognosis* ; Recurrence ; Reoperation ; Retrospective Studies

Several anticancer chemotherapeutic agents (5-fluorouracil, adriamycin and cisplatinum) and desferrioxamine, an iron chelator, were tested with regard to cytotoxicity and to the combined effect on radiation induced cell killing using two human hepatoma cell lines (HepG2 and PLC/PRF/5). Survival fractions were measured by quantitative colorimetric assay (MTT assay) and dose-response curves were plotted. MTT assay could be successfully used in the assessment of radiosensitivity in addition to chemosensitivity, because a good linear relationship between optical densities and cell numbers was observed and cells approached exponential growth for the first 7 days of culture when 5 x 10(3) or less cells were inoculated per well in our study. Steepness of the final slope (D0), width of the shoulder (D0) and the extrapolation number (n) of radiation survival curves were 1061.72 rad, 226.43 rad and 1.25 respectively in HepG2 and 1091.38 rad, 268.42 rad and 1.29 respectively in PLC/PRF/5. After combining anticancer chemotherapeutic agents and desferrioxamine with radiation, the widths of the shoulders were decreased whereas sensitizer enhancement ratios were increased as the concentration of drugs increased in both cell lines. These results suggest that neither anticancer chemotherapeutic agents nor desferrioxamine enhance cell killing induced by radiation alone, but suggested the possibility that they inhibit the repair of radiation damage.
Antineoplastic Agents/*pharmacology ; Carcinoma, Hepatocellular/*drug therapy/*radiotherapy ; Deferoxamine/*pharmacology ; Human ; Liver Neoplasms/*drug therapy/*radiotherapy ; Support, Non-U.S. Gov't ; Tumor Cells, Cultured/drug effects/radiation effects

Asymptomatic chronic HBsAg carriers with normal liver function tests are, in general regarded as having no liver pathology. Most of the histologic findings in asymptomatic chronic carriers have been reported from areas with low incidence of Hepatitis B virus (HBV) infection, such as North America and Western Europe. It is well known that there are many differences in HBV infection between low and high endemic areas, but there have been few reports on the histologic findings of asymptomatic chronic HBsAg carriers from endemic areas. The present study was undertaken in Korea which is one of the endemic areas for HBV infection and was designed to assess the prevalence of chronic liver disease by peritoneoscopic liver biopsy among asymptomatic chronic HBsAg carriers and to make a basis for the follow-up of asymptomatic chronic HBsAg carriers according to the results obtained. One hundred and ten asymptomatic HBsAg-positive carriers with normal liver function tests and no hepatomegaly were included in the study. Final diagnosis by peritoneoscopic liver biopsy revealed that of the 110 asymptomatic carriers only 27 (24.5%) had a histologically normal liver, while 51 (46.4%) had chronic liver diseases, and the remaining 32 (29.1%) had nonspecific histologic abnormalities (nonspecific reactive changes in 18 cases, cholestasis in 6 cases, and fatty change in 8 cases). Of the 51 patients with chronic liver diseases, 3 had liver cirrhosis, 4 chronic active hepatitis with cirrhosis, 11 chronic active hepatitis and 33 chronic persistent hepatitis. The frequency of liver cirrhosis and chronic active hepatitis with cirrhosis was significantly high in the over 30 years of age group (12.1%) than in the under 30 years of age group (0%; p = 0.011 by Fisher's exact test). In conclusion, 46.4% of the Korean asymptomatic chronic HBsAg carriers with normal liver function tests and no hepatomegaly had chronic liver disease. This finding contrasted with reports from low incidence areas of HBV infection. Our results suggest that in endemic areas, a liver biopsy should be considered to assess the status of liver disease in asymptomatic chronic HBsAg carriers even if liver function tests are normal and hepatomegaly is absent, and the result can be used as a basis for the follow-up of each asymptomatic chronic HBsAg carriers.
Adolescent ; Adult ; Biopsy ; Carrier State/*pathology ; Chronic Disease ; Female ; Hepatitis B/*pathology/physiopathology ; Hepatitis B Surface Antigens/*analysis ; Human ; Laparoscopy ; Liver/*pathology/physiopathology ; Male ; Middle Age

No abstract available.
Hemangiosarcoma*

Peliosis hepatis is characterized by the presence in the liver of blood-filled cavities, which may or may not be lined with sinusoidal cells. The individual cysts or cavities usually do not exceed several centimeters in diameter. The cysts are typically continuous with adjacent, more normal sinusoids, and they sometimes can be seen in continuity with hepatic venous tributaries. The lesion is usually diagnosed by gross or microscopic examination. When suspected, it can be diagnosed by percutaneous liver biopsy. In the past, peliosis hepatis is primarily associated with wasting diseases, such as tuberculosis, malignancy, and chronic suppurative infection. However, recently peliosis hepatis is seen most commonly in association with the administration of anabolic steroids or HIV infection. We report a case of peliosis hepatis that is diagnosed by peritoneoscopic live biopsy and not associated with known disease.
Biopsy* ; HIV Infections ; Laparoscopy ; Liver* ; Peliosis Hepatis* ; Steroids ; Tuberculosis ; Wasting Syndrome

Endoscopic injection therapy using various different agents(ethanol, polidocanol, epinephrine with and without hypertonic saline, etc.) is considered as the least expensive and effective technique to obtain hemostasis in peptic ulcer bleeding, however most of these agents induce tissue necrosis or degeneration. Theoretically the injection of fibrin glue in peptic ulcer bleeding may be safer than that of other agents, however, to date, there have been no data from randomized clinical trials on the comparison of the efficacies between these agents. To compare the hemostatic efficacy between FG[Beriplast P, Behring, Germany] and HSE[3% saline and epinephrine(1: 10,000)], we conducted a prospective, randomized, clinical trial among one hundred twenty-seven patients with peptic ulcer bleeding from March, 1992 to December, 1993 and in whom a visible vessel or active bleeding was identified.
Epinephrine* ; Fibrin Tissue Adhesive* ; Fibrin* ; Hemorrhage* ; Hemostasis ; Humans ; Necrosis ; Peptic Ulcer* ; Prospective Studies*

BACKGROUND AND OBJECTIVES: Several hypotheses have been proposed in the etiopathogenesis of otitis media with effusion (OME). The bacterial or fungal infection may also play a major role in the pathogenesis of OME. To investigate the relationship between bacteria and fungi as pathogens in OME and to analyze the incidence, the authors evaluated the pathogens of OME using polymerase chain reaction (PCR) technique, which is known to be more sensitive and specific than conventional bacterial and fungal culture. SUBJECTS AND METHOD: Twenty-three children (thirty ears), who were diagnosed with OME and had underwent ventilation tube insertion, were evaluated in the department of ORL-HNS, University Hospital, from May 2006 to March 2007. The middle ear effusion, obtained during the procedure, was evaluated for the identification of bacteria and fungi by PCR. RESULTS: Among 30 ears, viable pathogenic bacteria were detected in 20 ears (66.6%) and fungi in 13 ears (43.3%). The bacterial pathogens included Haemophilus influenzae (13 ears), followed by Streptococcus pneumonize (6 ears). The fungi detected from PCR were Candida albicans (4 ears-30.8%), Aspergillus niger (2 ears-15.4%) and Paecilomyces lilacinus (2 ears-15.4%). Additional pathogens include Basidiomycete yeast, Saccharamycete sp., Eurotium rubrum, Dothioraceae sp. and Stemphylium solani. Detection of fungal DNA was more common in patients with cleft palate and in recurrent cases with statistical significance. CONCLUSION: The use of PCR of middle ear effusion is effective for the detection of pathogens in patients with OME. While bacteria were thought to be the causative pathogen, this study suggests the etiological role of fungi in the pathogenesis of OME. However, the relationship between fungi and OME requires further studies.
Aspergillus niger ; Bacteria ; Basidiomycota ; Candida albicans ; Child ; Cleft Palate ; DNA, Fungal ; Ear ; Eurotium ; Fungi ; Haemophilus influenzae ; Humans ; Incidence ; Otitis ; Otitis Media ; Otitis Media with Effusion ; Paecilomyces ; Polymerase Chain Reaction ; Streptococcus ; Ventilation ; Yeasts

BACKGROUND: Oxidative stress possiby contributes to the development of diabetic nephropathy. Glutathione S-transferases (GSTs) can work as one of endogenous antioxidants to protect cells from oxidative stress. The activity of GSTM1 or GSTT1 are determined genetically. The homologous deletion of the gene (null genotype) which reduced the GSTM1/T1 activity, may be associated with diabetic nephropathy development in diabetic patients. METHODS: We examined 94 patients with diabetic nephropathy and 102 patients without diabetic nephropathy in Korean type 2 diabetic patients. We used multiplex polymerase chain reaction (PCR) to analyze polymorphisms of two endogenous antioxidant genes, GSTM1 and GSTT1. RESULTS: The two patients groups were well matched with regard to age, body mass index, duration of diabetes and HbA1c. GSTM1 null genotype was observed in 50% of patients with nephropathy versus 51% of patients without nephropathy. GSTT1 null genotype was observed in 48.9% of patients with nephropathy versus 51% of patients without nephropathy. No association between homozygous deletion of GSTM1 or GSTT1 and development of diabetic nephropathy in diabetic patients. CONCLUSION: This study is the first to investigate the association of GSTM1/TT1 gene polymorphism which development of diabetic nephropathy in Korean type 2 diabetic patients. The present result suggest that GSTM1/TT1 null genotype does not contribute to the development of diabetic nephropathy in Korean type 2 diabetic patients.
Antioxidants ; Body Mass Index ; Diabetic Nephropathies* ; Genotype ; Glutathione Transferase ; Glutathione* ; Humans ; Multiplex Polymerase Chain Reaction ; Oxidative Stress ; Polymorphism, Genetic*

There is no dispute on that the ear evaluation should be done continuously for cleft palate patients. But, there is a controversy about interrelation between otitis media and clinical factors. Therefore, we have analyzed the relationship between the prevalence of otitis media and several prospective clinical factors. In this study, 96 cleft palate patients(191 hearing ears with one atresia) were examined to evaluate middle ear function by tympanometry. In all cases, middle ear evaluation was performed before subsequent palatoplasty and then, the middle ear evaluation was performed again in 145 ears, at an average of 5.7 months after the procedure. The prevalence before palatoplasty in cleft palate patients shows that otitis media with effusion is present in 60 percent, and otopathologic feature tends to decrease with age. The prevalence of otitis media in submucous cleft palate was lower than that in incomplete or complete cleft palate patients, and the types of cleft palate seems statistically not related to any incidence of otitis media. There was statistical reduction in the prevalence of otitis media after palatoplasty. Our research indicates that the prevalence of otitis media in cleft palate patients was reduced by increased age and palatoplasty. Otological check up should be done continuously for the cleft palate patients.
Acoustic Impedance Tests* ; Cleft Palate* ; Dissent and Disputes ; Ear ; Ear, Middle* ; Hearing ; Humans ; Incidence ; Otitis Media ; Otitis Media with Effusion ; Prevalence* ; Prospective Studies