The study of the epidemiology of toxic liver injury has been limited in Korea. The number of hospitalizations for toxic liver injury has been estimated to be 2,400 persons per year. About 30~40% of fulminant hepatitis was attributed to toxic hepatitis. The frequent causative agents of toxic hepatitis in Korea are herbal medicines (34~40%), folk remedies (23~34%), and prescribed medicines (24~55%). However, the most common agents causing severe liver injury including fulminant hepatitis are herbal medicine and folk remedies. Antituberculosis drugs and acetaminophen are two common causes of fulminant hepatitis among prescribed drugs. Alcohol is one of the leading causes of chronic liver disease in Korea. No nationwide study on the epidemiology of alcoholic liver disease (ALD) has been carried out, but 7~31% of cirrhosis has been reported to be alcoholic in a few single-center studies. Alcohol could be a risk factor for the development of hepatocellular carcinoma (HCC) in chronic viral hepatitis. Several studies have shown that alcohol increased the risk of HCC in liver cirrhosis with HBsAg or anti-HCV. Furthermore, alcoholic cirrhosis with occult hepatitis B virus infection increased the risk of HCC.
Drug-Induced Liver Injury/diagnosis/*epidemiology/etiology ; Humans ; Korea/epidemiology ; Liver Cirrhosis, Alcoholic/complications/epidemiology ; Liver Diseases, Alcoholic/complications/*epidemiology ; Liver Neoplasms/etiology ; Risk Factors

China ; epidemiology ; Female ; Humans ; Liver Diseases, Alcoholic ; epidemiology ; etiology ; Male ; Obesity ; complications ; Risk Factors ; Sex Factors

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

Adult ; Age Factors ; Alcoholism ; complications ; China ; epidemiology ; Fatty Liver ; epidemiology ; etiology ; Female ; Humans ; Liver Diseases, Alcoholic ; epidemiology ; etiology ; Male ; Middle Aged ; Prevalence ; Sex Factors

OBJECTIVETo analyze the pathohistological changes of the livers and the clinical features of patients with biliary tract complications after their orthotopic liver transplantations.

METHODSFrom Sept 1998 to June 2005 clinical and pathological data of 173 post-liver transplantation patients with biliary tract complications were analyzed.

RESULTSBiliary tract complications occurred within 3-2920 days after the transplantation operations. These complications occurred within 1-30 days, 31-90 days, 91-180 days, 180 days at rates of 49.71%, 17.92%, 4.62%, 27.74% respectively. The complications were of inflammatory nature in 171 cases, (72.25%), and of obstructive nature in 164 cases (27.74%). The main pathological changes were epithelium degeneration of interlobular bile ducts, inflammatory cell infiltration in portal areas, proliferation of interlobular bile ducts, fibrosis in portal areas, cholestasis in small bile ducts and hepatocytes.

CONCLUSIONMany of the biliary tract complications of post-liver transplantation in our cases were of inflammatory nature and they often occurred within 30 days after the surgery. Obstructive nature complications often occurred in 90 days after the surgery and the prognosis of these cases was much poorer. The pathological changes of live tissues shown in liver biopsies are important for prognostic evaluation, differential diagnosis and categorization of biliary tract complications.

Adolescent ; Adult ; Biliary Tract Diseases ; epidemiology ; etiology ; China ; epidemiology ; Cholangitis ; epidemiology ; etiology ; Female ; Gallstones ; epidemiology ; etiology ; Humans ; Liver Cirrhosis ; surgery ; Liver Neoplasms ; surgery ; Liver Transplantation ; adverse effects ; Male ; Middle Aged

BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD) has been characterized by a wide spectrum of liver damages that span from steatosis to cryptogenic liver cirrhosis and even to hepatocellular carcinoma (HCC). The aims of this study were to determine whether the prevalence of HCC arising from cryptogenic cirrhosis has increased during the last ten years and to characterize the clinical features of cryptogenic HCC in Korea. METHODS: A retrospective and hospital-based analysis of the clinical data was done in 1,145 HCC patients; group A (Jan. 1993-Dec. 1995), group B (Jan. 2000-Dec. 2002). The etiologies of HCC with liver cirrhosis in group A and group B were analyzed. The risk factors of NAFLD such as obesity, type 2 diabetes mellitus, hypertriglyceridemia and hypertension between cryptogenic HCC and HCC with well-defined etiologies were compared. RESULTS: The major leading causes of HCC in each group were hepatitis B virus infection, followed by alcohol, hepatitis C virus and cryptogenic. There was a significant increase in the proportion of cryptogenic HCC in group B (A: 2.3%, B: 5.4%, p<0.05). In the case of HCV, it was 5.3% in group A and 9.9% in group B (p<0.05). Although the prevalence of cyptogenic HCC was significantly increased at an interval of seven years apart, there was no significant difference in the proportions of risk factors of NAFLD between cryptogenic HCC group and well-defined etiology group. CONCLUSIONS: The prevalence of cryptogenic HCC was significantly increased in Korea during the last decade. Although statistically insignifcant, there was a trend toward the higher proportion of risk factors with NAFLD in patients with cryptogenic HCC. This suggests that increased proportion of risk factors associated for NAFLD may have contributed to the development of cryptogenic HCC.
Aged ; Carcinoma, Hepatocellular/*epidemiology/etiology ; English Abstract ; Fatty Liver/complications ; Female ; Hepatitis B/complications ; Hepatitis C/complications ; Humans ; Incidence ; Korea/epidemiology ; Liver Diseases, Alcoholic/complications ; Liver Neoplasms/*epidemiology/etiology ; Male ; Middle Aged

OBJECTIVETo study the relationship between nonalcoholic fatty liver disease (NAFLD) and the development of cardiovascular disease (CVD) in children with obesity.

METHODSTwo hundred and thirty-one obese children and 24 non-obese children as control were enrolled. Body mass index (BMI), serum triglyceride, blood pressure, liver function, and carotid artery intima-media thickness (IMT) were examined. The obese children were classified into two subgroups according to the diagnosis criteria: group 1 without liver disorder (OCWLD group, n=75) and group 2 with NAFLD (NAFLD group, n=156). The incidences of hyperlipidemia and hypertension, carotid artery intima-media thickness (IMT) and biochemical indicators were compared in the three groups.

RESULTSThe NAFLD group showed significantly greater carotid IMT (0.066+/-0.021 cm) than the OCWLD (0.060+/-0.011 cm) and control groups (0.037+/-0.007 cm) (P<0.05). The OCWLD group had also thicker IMT than the control group (P<0.05). The incidences of hyperlipidemia and hypertension were 39.7% and 40.4%, respectively in the NAFLD group, which were significantly higher than those in the OCWLD (22.7% and 29.3% respectively)and control groups (4.2% and 12.6% respectively) (P<0.05). The liner stepwise regression analysis showed that the IMT was positively correlated with BMI, NAFLD and ALT (adjusted R2=0.316, P<0.01).

CONCLUSIONSNAFLD may be not only an early marker but also an early state of CVD in obese children. Early diagnosis and treatment of NAFLD is crucial for the prevention of the occurrence and development of CVD.

Adolescent ; Adult ; Cardiovascular Diseases ; etiology ; Carotid Arteries ; pathology ; Child ; Fatty Liver ; complications ; Female ; Humans ; Hypertension ; epidemiology ; Male ; Obesity ; complications

INTRODUCTION: The aims of this study were to establish weight change, incidence of non-alcoholic fatty liver disease (NAFLD) and cardiovascular risk factors (CvRF) in liver transplant recipients (LTRs). METHODS: Eighty-three patients whose mean (standard deviation [SD]) age was 55.6 (8.4) years (median follow-up 73 months) and who underwent their first liver transplantation (LT) at Singapore General Hospital between February 2006 and March 2017 were included in the study. Anthropometric, clinical and demographic data were collected retrospectively from patients' medical records. Diabetes mellitus (DM), hyperlipidaemia and hypertension were regarded as CvRF. RESULTS: Compared to baseline, mean (SD) body weight decreased significantly at 1 month post-LT (60.8kg [11.9] versus 64.3kg [13.7], CONCLUSION CvRF increased significantly post-LT, and NAFLD occurred in 25.3% of LTRs. Body weight dropped drastically within the first month post-LT, which then returned to baseline level just before the end of first year. This novel finding suggests that nutritional intervention needs to be tailored and individualised, based on events and time from transplant. Although long-term obesity is a significant problem, aggressive oral or enteral nutritional supplements take precedence in the early and immediate post-LT period, while interventions targeted at metabolic syndrome become necessary after the first year.
Cardiovascular Diseases/etiology* ; Heart Disease Risk Factors ; Humans ; Liver Transplantation ; Middle Aged ; Retrospective Studies ; Risk Factors ; Singapore/epidemiology*

Adult ; Aged ; Alcohol Drinking ; adverse effects ; epidemiology ; Alcoholism ; complications ; pathology ; China ; epidemiology ; Female ; Humans ; Liver Cirrhosis, Alcoholic ; epidemiology ; etiology ; Liver Diseases, Alcoholic ; complications ; epidemiology ; Male ; Middle Aged ; Risk Factors

Malaria is one of the most widespread infectious diseases of tropical countries with an estimated 207 million cases globally. In India, there are endemic pockets of this disease, including Aligarh. Hundreds of Plasmodium falciparum and P. vivax cases with severe pathological conditions are recorded every year in this district. The aim of this study is to find out changes in liver enzymes and kidney markers. Specific diagnosis for P. falciparum and P. vivax was made by microscopic examination of Giemsa stained slides. Clinical symptoms were observed in both of these infections. Liver enzymes, such as AST, ALT, and ALP, and kidney function markers, such as creatinine and urea, were estimated by standard biochemical techniques. In Aligarh district, P. vivax, P. falciparum, and mixed infections were 64%, 34%, and 2%, respectively. In case of P. falciparum infection, the incidences of anemia, splenomegaly, renal failure, jaundice, and neurological sequelae were higher compared to those in P. vivax infection. Recrudescence and relapse rates were 18% and 20% in P. falciparum and P. vivax infections, respectively. Liver dysfunctions and renal failures were more common in P. falciparum patients, particularly in elderly patients. Artesunate derivatives must, therefore, be introduced for the treatment of P. falciparum as they resist to chloroquine as well as sulfadoxine-pyrimethamine combinations.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Clinical Laboratory Techniques ; Female ; Humans ; India/epidemiology ; Infant ; Infant, Newborn ; Kidney/physiopathology ; Kidney Diseases/epidemiology/etiology ; Kidney Function Tests ; Liver/physiopathology ; Liver Diseases/epidemiology/etiology ; Liver Function Tests ; Malaria, Falciparum/complications/*epidemiology/*pathology ; Malaria, Vivax/complications/*epidemiology/*pathology ; Male ; Middle Aged ; Prevalence ; Recurrence ; Young Adult