Journal Detail Information

1

Cite

Share

N-utyl--yanoacrylate (Histoacryl) in the Treatment of Esophageal Variceal Bleeding: Comparison with Band Ligation.

Gyu Hyun LEE ; Yong Jun SHIN ; Young Yun KO ; Jun Ho KO ; Ho Dong KIM ; Byeong Moo YOO ; Kwang Jae LEE ; Young Soo KIM ; Ki Baik HAHM ; Jin Hong KIM ; Sung Won CHO

The Korean Journal of Hepatology.1999;5(4):306-313.

BACKGROUND/AIMS: Endoscopic sclerotherapy and band ligation have been well documented beneficial therapeutic options of esophageal variceal bleeding. But acute variceal bleeding is refractory to sclerotherapy in upto one-hird of patients, and rebleeding occurs in 30% to 50%. Recently alternative endoscopic modality, N-utyl--yanoacrylate (Histoacryl) injection is performed in intravariceal sclerotherapy but its efficacy and safty are not clearly established. We evaluated the efficacy of Histoacryl on esophageal variceal bleeding and compared with that of endoscopic band ligation in the present study. MATERIALS/METHODS: From March 1994 to March 1998, ninety seven patients with endoscopically documented esophageal variceal bleeding were enrolled. Histoacryl injection (Histoacryl group, n=33) or endoscopic band ligation (EVL group, n=64) was done for esophageal variceal bleeding. We evaluated the rebleeding rate and in-ospital mortality in both groups. RESULTS: Baseline characteristics were similar but active bleeding on first endoscopic session was significantly higher in Histoacryl group (Histoacryl group; 90.7%, EVL group; 26.6%, p=0.002). Successful hemostasis was done at 87.9% in Histoacryl group, 95.3% in EVL group (not significant). There were no significant differences on early rebleeding rate (18.2% vs 23.4%), late rebleeding rate (39.4% vs 37.5%) and in-ospital mortality (24.2% vs 15.6%) between Histoacryl group and EVL group. There were no technique-elated fatal complications at Histoacryl injection group. CONCLUSION: Therapeutic efficacy of Histoacryl injection was similar to the endoscopic band ligation in patients with esophageal varix bleeding in terms of hemostasis and rebleeding. Histoacryl is effective therapeutic option for esophageal variceal bleeding as well as gastric variceal bleeding.
Enbucrilate ; Esophageal and Gastric Varices* ; Hemorrhage ; Hemostasis ; Humans ; Ligation* ; Mortality ; Sclerotherapy

2

Cite

Share

Endoscopic Variceal Ligation plus Octreotide versus Variceal Ligation Alone for the Prevention of Early Rebleeding from Esophageal Varices.

Gyu Hyun LEE ; Sung Won CHO ; Heon Jong KIM ; Kwang Hyun KO ; Jun Ho KO ; Young Yun KO ; Ho Dong KIM ; Kwang Jae LEE ; Ki Baik HAHM ; Jin Hong KIM

The Korean Journal of Hepatology.1999;5(4):299-305.

BACKGROUND/AIMS: Endoscopic variceal ligation (EVL) has been effective modality for esophageal variceal bleeding, but recurrent bleeding occurs 20 to 40% of patients. So there has been an increased interest in the use of vasoactive drugs to lower portal hypertension and help control variceal bleeding before and after endoscopy. We investigated the efficacy of octreotide (OCT) infusion as an adjunct to EVL for preventing early rebleeding from varices. METHODS: From Jan. 1997 to Feb. 1999, fifty four patients with endoscopically documented esophageal variceal bleeding were included. The patients were randomly treated by EVL alone (EVL group, n=30) or EVL plus octreotide (EVL+OCT group, n=24). We evaluated the 5-ay and 6-eek rebleeding rate and 6-eek mortality. RESULTS: Baseline characteristics were similar in two group but hospital stay (p=0.028) and units of transfused blood (p=0.043) were significantly less in EVL+OCT group. There were no significant differences on 5-ay rebleeding rate (EVL group; 7%, EVL+OCT group; 0%) and 6-eek rebleeding rate (EVL group; 20%, EVL+OCT group; 4%). CONCLUSIONS: The combined therapy did not decrease early rebleeding and mortality, but it was superior to EVL alone in hospital course such as requirement of transfusion and duration of hospitalization.
Endoscopy ; Esophageal and Gastric Varices* ; Hemorrhage ; Hospitalization ; Humans ; Hypertension, Portal ; Length of Stay ; Ligation* ; Mortality ; Octreotide* ; Varicose Veins

3

Cite

Share

Sequence Analysis of 'a' Determinant in Two Patients with De Novo HBV Infection after Renal Transplantation.

Byung Hyun CHOE ; Kwang Hyub HAN ; Hyo Young CHUNG ; Yong Han PAIK ; Jung Il CHUNG ; Yoo Sun KIM ; Chae Yoon CHON ; Young Myoung MOON

The Korean Journal of Hepatology.1999;5(4):291-298.

BACKGROUND/AIMS: HBV infection can be seen after organ transplantation. The presence of anti-Bs in serum means protection from HBV infection. If amino acids were mutated in 'a' determinant which was a common antigenic epitope of HBsAg, escape from humoral immunity can occur. Recently, in chronic HBV infected patients who received liver transplantation but reinfected by HBV, many authors reported mutations in 'a' determinant sequence. However, in renal transplantation, there were few reports about HBV infection and 'a' determinant mutation after transplantation. Therefore, we studied the incidence of HBV reinfection after renal transplantation and also tried to analyze 'a' determinant sequence in those patients. METHODS: We reviewed HBsAg-egative patients who received renal transplantation in our hospital, but turned HBsAg positive after transplantation. We selected two patients who were anti-Bs positive before transplantation but turned HBsAg positive after transplantation, and analyzed 'a' determinant of amino acid sequence of these patients. RESULTS: Among 1682 patients who were HBsAg negative before transplantation, 21 patients were turned HBsAg positive after transplantation. Among them, 6 patients were anti-Bs positive before transplantation. Sequence analysis of the 'a' determinant amino acid in two patients whose HBsAg turned positive after transplantation revealed no evidence of mutation in comparison with previously reported subtype 'a' determinant sequences. CONCLUSION: In renal transplantation, HBV could be reinfected in patients who had been anti-Bs positive before transplantation even without mutation in 'a' determinant region.
Amino Acid Sequence ; Amino Acids ; Hepatitis B Surface Antigens ; Humans ; Immunity, Humoral ; Incidence ; Kidney Transplantation* ; Liver Transplantation ; Organ Transplantation ; Sequence Analysis* ; Transplants ; United Nations

4

Cite

Share

A Prospective Study of Therapeutic Effect of 6 Months Trial with Lamivudine in Patients with Chronic Viral Hepatitis B.

Chang Woo GHAM ; Soong Hwan LEE ; Seung Woo NAM ; Byung Joo ROH ; Dong Hoo LEE

The Korean Journal of Hepatology.1999;5(4):282-290.

BACKGROUND/AIMS: The purpose of this study was to evaluate the effectiveness of lamivudine treatment in patients with chronic liver disease caused by chronic infection of hepatitis B virus (HBV). METHODS: Thirty-ive patients with chronic infection of HBV were included in this study who were diagnosed at Hanyang University Hospital from January 1998 to January 1999. They received 150mg of lamivudine per oral once daily for 6 months with follow-p of liver function test, serum HBV DNA and serologic markers for hepatitis B virus every two months. Lamivudine was well tolerated. Eight patients underwent liver biopsies before entering the study and follow-p biopsies were done at 5 patients. RESULTS: Out of all 35 patients, chronic hepatitis patients histologically confirmed were 8, chronic hepatitis patients clinically diagnosed were 25 and liver cirrhosis patients clinically diagnosed were 2. The mean age was 35.7 years. Male-female ratio was 2.2:1. There was no hepatitis B surface antigen (HBsAg) negative seroconversion. The HBeAg loss rate was 26.9%(7/26) and HBeAg seroconversion rate was 10.7%(3/28) at the end of follow-p. Ten patients were anti-Be positive prior to treatment, 3 of them became anti-Be negative at the end of follow-p. Five patients underwent follow-p liver biopsies, in which histologic improvements were shown in 4 cases. Serum replicative HBV DNA by bDNA assay was decreased in all patients and HBV DNA was undetectable in 52.9%(9/17) at the end of treatment. Out of the 15 patients with abnormal alanine aminotransferase (ALT) levels at baseline, ALT level in 7 patients(46.7%) was normalized at treatment completion. Pretherapy ALT level was the only predictive factor for loss of HBeAg by stepwise logistic regression analysis(odds ratio : 1.0208) (95% Confidence Interval : 1.0023 ~ 1.0396) (p value=0.0271). CONCLUSIONS: Lamivudine induced sustained suppression of HBV replication during treatment in all patients. In treating patients with lamivudine, who had chronic liver disease due to chronic infection of HBV, the improvement of liver function test and suppression of viral replication appeared early and was sustained during the 6months treatment. This, in turn, may induce histological improvement as well. Pretherapy ALT level was the only predictive determinant for HBeAg loss during lamivudine therapy, and that should be kept in mind in selecting patients for treatment.
Alanine Transaminase ; Biopsy ; Branched DNA Signal Amplification Assay ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Lamivudine* ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Logistic Models ; Prospective Studies*

5

Cite

Share

Hepatic tuberculosis presenting as a large liver mass.

Yong Moon SHIN

The Korean Journal of Hepatology.2010;16(2):197-200. doi:10.3350/kjhep.2010.16.2.197

No abstract available.
Adult ; Diagnosis, Differential ; Humans ; Male ; Mycobacterium tuberculosis/genetics ; Polymerase Chain Reaction ; Tomography, X-Ray Computed ; Tuberculosis, Hepatic/*radiography/ultrasonography

6

Cite

Share

Infantile hemangioendothelioma with increased serum alpha-fetoprotein.

Jae Yeon SEOK ; Young Bae KIM

The Korean Journal of Hepatology.2010;16(2):192-196. doi:10.3350/kjhep.2010.16.2.192

No abstract available.
Female ; Hemangioendothelioma/metabolism/*pathology/surgery ; Humans ; Infant ; Interferon-alpha/therapeutic use ; Liver Neoplasms/metabolism/*pathology/surgery ; Tomography, X-Ray Computed ; alpha-Fetoproteins/*analysis

7

Cite

Share

Occurrence of diabetic ketoacidosis and autoimmune thyroiditis in a patient treated with pegylated interferon-alpha 2b and ribavirin for chronic hepatitis C.

Yun Nah LEE ; Soung Won JEONG ; Jae Hee LIM ; Yang Seon RYU ; Seong Ran JEON ; Sang Kyun KIM ; Jae Young JANG ; Young Seok KIM ; Boo Sung KIM ; Mi Oh ROH

The Korean Journal of Hepatology.2010;16(2):187-191. doi:10.3350/kjhep.2010.16.2.187

Combined pegylated interferon and ribavirin therapy for chronic hepatitis C infection cause a wide range of side effects, including flu-like syndrome, hematological abnormalities, cardiovascular symptoms, gastrointestinal symptoms, pulmonary dysfunction, depression, and retinopathy. Interferon-alpha has been shown to be related to the development of various autoimmune diseases, including systemic lupus erythematosus, rheumatoid arthritis, autoimmune thyroid disease, and type 1 diabetes mellitus (DM). Type 1 DM and thyroid disease respectively develop in 0.08~2.61% and 10~15% of patients treated with combined interferon-alpha and ribavirin for chronic hepatitis C. The coexistence of type 1 DM and autoimmune thyroiditis was rarely reported. We report a case of a 33-year-old female patient with chronic hepatitis C who simultaneously developed diabetic ketoacidosis and autoimmune thyroiditis after treatment with pegylated interferon-alpha 2b and ribavirin.
Adult ; Antiviral Agents/*adverse effects/therapeutic use ; Diabetic Ketoacidosis/drug therapy/*etiology ; Drug Therapy, Combination ; Female ; Hepatitis C, Chronic/*drug therapy ; Humans ; Insulin/therapeutic use ; Interferon Alfa-2b/*adverse effects/therapeutic use ; Polyethylene Glycols/*adverse effects/therapeutic use ; Ribavirin/*adverse effects/therapeutic use ; Thyroiditis, Autoimmune/drug therapy/*etiology ; Thyroxine/therapeutic use

8

Cite

Share

Toxic hepatitis associated with Polygoni multiflori.

Sang Hoon BAE ; Dong Hyun KIM ; Young Seok BAE ; Kwang Jae LEE ; Dong Wan KIM ; Jeoung Bin YOON ; Joon Ho HONG ; Sang Hyun KIM

The Korean Journal of Hepatology.2010;16(2):182-186. doi:10.3350/kjhep.2010.16.2.182

Toxic hepatitis has been reported as a major cause of acute hepatitis, but its potential induction by herbal remedies and/or health foods is usually neglected. We experienced a case of toxic hepatitis associated with Polygoni multiflori, a Chinese herb commonly known as Ho-Shou-Wu. A 54-year-old woman consumed Ho-Shou-Wu for 1 month, after which she experienced fatigue and overall weakness. A diagnosis of toxic hepatitis was made based on her clinical history, the findings for viral markers and other laboratory data, and ultrasonography. Her condition improved considerably after she stopped taking Ho-Shou-Wu. However, she resumed taking Ho-Shou-Wu immediately after discharge from hospital, which aggravated her symptoms and liver function. She was immediately readmitted and stopped taking Ho-Shou-Wu. Her relapse into hepatitis immediate after resuming consumption of the herb is strongly indicative of the validity of Koch's postulate in this case.
Drug-Induced Liver Injury/*diagnosis/pathology/ultrasonography ; Female ; Humans ; Middle Aged ; Plant Extracts/toxicity ; Polygonum/*toxicity

9

Cite

Share

Deficiencies in proteins C and S in a patient with idiopathic portal hypertension accompanied by portal vein thrombosis.

Sena HWANG ; Do Young KIM ; Minju KIM ; Young Eun CHON ; Hyun Jung LEE ; Young Nyun PARK ; Jun Yong PARK ; Sang Hoon AHN ; Kwang Hyub HAN ; Chae Yoon CHON

The Korean Journal of Hepatology.2010;16(2):176-181. doi:10.3350/kjhep.2010.16.2.176

Portal vein thrombosis (PVT) is an uncommon cause of presinusoidal portal hypertension. Among various hepatoportal disorders, noncirrhotic portal hypertension conditions such as idiopathic portal hypertension (IPH) are considered to have a close relation with PVT. PVT is known to have several predisposing conditions, including infection, malignancies, and coagulation disorders. There is growing interest and recognition that deficiencies in proteins C and S are associated with a hypercoagulable state. These deficiencies are regarded as key factors of systemic hypercoagulability and recurrent venous thromboembolism. We report the case of a 19-year-old male diagnosed as IPH with PVT and combined deficiencies in proteins C and S.
Humans ; Hypertension, Portal/complications/*diagnosis/pathology ; Male ; *Portal Vein ; Protein C Deficiency/*complications ; Protein S Deficiency/*complications ; Tomography, X-Ray Computed ; Venous Thrombosis/complications/*diagnosis/pathology ; Young Adult

10

Cite

Share

Could patients who underwent hepatic resection due to hepatocellular carcinoma with high alpha-fetoprotein be monitored for recurrence by alpha-fetoprotein level?.

Woo Young SHIN ; Kyung Suk SUH ; Taehoon KIM ; Young Min JEON ; Nam Joon YI ; Kuhn Uk LEE

The Korean Journal of Hepatology.2010;16(2):168-175. doi:10.3350/kjhep.2010.16.2.168

BACKGROUND/AIMS: The follow-up strategy after hepatectomy for hepatocellular carcinoma (HCC) usually depends on the experience of physician, resulting in frequent imaging studies, which leads to increased cost. Hence, we investigated the role of monitoring alpha-fetoprotein (AFP) levels after hepatectomy in patients with preoperative high AFP. METHODS: From January 2000 to December 2004, 66 patients who underwent curative hepatectomy due to HCC with preoperative AFP level >400 ng/mL were reviewed. Changes in AFP level after the operation were investigated. The recurrence was suspected in case of two consecutive increase of AFP over cut-off value. Cut-off value was determined by ROC curve. All patients were divided into 2 groups: patients who met the definition (Group S) and those who didn't (Group D). RESULTS: AFP level of 20 ng/ml was proposed as the cut-off value for diagnosis of recurrence by ROC curve. Thirty two patients who didn't have the AFP level decreased below 20 ng/ml after the resection had HCC recurred, whereas 16 out of 34 patients who had AFP decreased had tumor recurrence. The AFP level of patients without recurrence was kept below 20 ng/ml during the follow-up. The AFP level of 44 out of 48 recurred patients increased over 20 ng/ml upon recurrence. By definition, group D were 5 patients. In 4 patients of group D, the AFP level didn't increase above 20 ng/ml upon recurrence. These patients had HCC and they recurred 1 year after the surgery. CONCLUSIONS: In patients with preoperative AFP level >400 ng/ml, the AFP level tended to increase above 20 ng/ml at recurrence mostly within 1 year. Hence, we proposed that these patients could be monitored by only AFP until 1 year after surgery.
Adult ; Aged ; Carcinoma, Hepatocellular/mortality/radiography/*surgery ; Disease-Free Survival ; Female ; Hepatectomy ; Humans ; Liver Neoplasms/mortality/radiography/*surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local/mortality/radiography/*surgery ; ROC Curve ; alpha-Fetoproteins/*analysis

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share