The Korean journal of hepatology最新文献

{"title":"Drug rash with eosinophilia and systemic symptoms syndrome following cholestatic hepatitis A: a case report.","authors":"Jihyun An,&nbsp;Joo Ho Lee,&nbsp;Hyojeong Lee,&nbsp;Eunsil Yu,&nbsp;Dan Bi Lee,&nbsp;Ju Hyun Shim,&nbsp;Sunyoung Yoon,&nbsp;Yumi Lee,&nbsp;Soeun Park,&nbsp;Han Chu Lee","doi":"10.3350/kjhep.2012.18.1.84","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.84","url":null,"abstract":"<p><p>Hepatitis A virus (HAV) infections occur predominantly in children, and are usually self-limiting. However, 75-95% of the infections in adults are symptomatic (mostly with jaundice), with the illness symptoms usually persisting for a few weeks. Atypical manifestations include relapsing hepatitis, prolonged cholestasis, and complications involving renal injury. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, drug-induced hypersensitivity reaction characterized by skin rash, fever, lymph-node enlargement, and internal organ involvement. We describe a 22-year-old male who presented with acute kidney injury and was diagnosed with prolonged cholestatic hepatitis A. The patient also developed DRESS syndrome due to antibiotic and/or antiviral treatment. To our knowledge, this is the first report of histopathologically confirmed DRESS syndrome due to antibiotic and/or antiviral treatment following HAV infection with cholestatic features and renal injury.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"84-8"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/95/kjhep-18-84.PMC3326989.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30580487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent trends in the treatment of chronic hepatitis C.","authors":"Dae Won Jun, Won Young Tak, Si Hyun Bae, Youn Jae Lee","doi":"10.3350/kjhep.2012.18.1.22","DOIUrl":"10.3350/kjhep.2012.18.1.22","url":null,"abstract":"<p><p>Pegylated interferon and ribavirin combination therapy is accepted as the standard antiviral treatment for chronic hepatitis C regardless of HCV genotype. This combination therapy achieves higher response rates than previous therapy, but, nevertheless, a large proportion of patients suffer from treatment failure or adverse events. Recent clinical studies of viral kinetics during antiviral treatment have led to the introduction of response-guided therapy, the concept of 'customized therapy depending on viral response', which focuses on modulation of the treatment period depending on the viral response to create a sustained viral response without unnecessary medication and costs. New upcoming direct-acting antivirals (DAAs) maximize response rate, and triple therapy including DAAs along with pegylated interferon and ribavirin combination therapy could soon be the standard therapy. In this article, we reviewed the factors affecting treatment, response guided treatment, retreatment after failure of standard treatment, management of adverse events during treatment, and new treatment options.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"22-8"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/bb/kjhep-18-22.PMC3326995.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30582178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients.","authors":"Yun Jung Kim,&nbsp;Byoung Kuk Jang,&nbsp;Eun Soo Kim,&nbsp;Kyung Sik Park,&nbsp;Kwang Bum Cho,&nbsp;Woo Jin Chung,&nbsp;Jae Seok Hwang","doi":"10.3350/kjhep.2012.18.1.41","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.41","url":null,"abstract":"<p><strong>Background/aims: </strong>The treatment for chronic hepatitis C (CHC) is removal of the virus in order to prevent progression to liver cirrhosis and hepatocellular carcinoma (HCC). Few data have been presented regarding the clinical significance of changes in the alanine aminotransferase (ALT) level in this context. We analyzed the patterns of changes in ALT level and investigated the relationship between the rapid normalization of ALT and sustained virologic response (SVR) after combined treatment with peginterferon and ribavirin.</p><p><strong>Methods: </strong>CHC patients (n=370) were classified into four groups according to the initial ALT level and subsequent changes: (1) initially abnormal ALT level and sustained abnormal ALT level during treatment, (2) initially abnormal ALT level but achievement of ALT normalization, (3) initially normal ALT level and variable ALT abnormality during treatment, and (4) initially normal ALT level and sustained normalization of ALT level during treatment. We subdivided groups 1 and 2 into those with patterns of decreased and normalization of ALT, with or without rapid normalization. We checked the end-treatment response (ETR) and SVR rates in each group and the factors associated with SVR, including patterns of changes in ALT level.</p><p><strong>Results: </strong>A total of 168 patients completed the therapy (age=54.34±10.64 years [mean±SD], 95 males [56.5%], genotype 1:82 [48.8%]). SVR was achieved in 115 (68.45%) of the completely treated patients. The SVR rate was significantly lower in group 1 than in group 2 (37.8 vs. 81.6%, P<0.001), and significantly higher in the rapid normalization group than in the group without rapid normalization (78.5% vs. 41.2%, P<0.001). Multiple logistic regression analysis revealed that age (odds ratio [OR]=0.94, 95% confidence interval [CI]=0.91-0.98, P=0.005), viral genotype (OR=2.76, 95% CI=1.20-6.38, P=0.017), and initial hepatitis C virus RNA titer (OR=0.28, 95% CI=0.10-0.75, P=0.012) were identified as independent significant predictive factors for SVR.</p><p><strong>Conclusions: </strong>The SVR rate is significantly associated with normalization, and especially rapid normalization of ALT. Rapid normalization of ALT by 4 weeks after treatment might be a useful response factor that is readily available in clinical practice, and especially for genotype 1 patients.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"41-7"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fc/91/kjhep-18-41.PMC3326992.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30582182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of isolated metastatic hepatocellular carcinoma arising from the pelvic bone.","authors":"Kyu Sik Jung,&nbsp;Kyeong Hye Park,&nbsp;Young Eun Chon,&nbsp;Sa Ra Lee,&nbsp;Young Nyun Park,&nbsp;Do Yun Lee,&nbsp;Jin Sil Seong,&nbsp;Jun Yong Park","doi":"10.3350/kjhep.2012.18.1.89","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.89","url":null,"abstract":"<p><p>Reports of metastatic hepatocellular carcinoma (HCC) without a primary liver tumor are rare. Here we present a case of isolated HCC that had metastasized to the pelvic bone without a primary focus. A 73-year-old man presented with severe back and right-leg pain. Radiological examinations, including computed tomography (CT) and magnetic resonance imaging (MRI), revealed a huge mass on the pelvic bone (13×10 cm). He underwent an incisional biopsy, and the results of the subsequent histological examination were consistent with metastatic hepatocellular carcinoma. The tumor cells were positive for cytokeratin (AE1/AE3), hepatocyte paraffin 1, and glypican-3, and negative for CD56, chromogranin A, and synaptophysin on immunohistochemical staining. Examination of the liver by CT, MRI, positron-emission tomography scan, and angiography produced no evidence of a primary tumor. Radiotherapy and transarterial chemoembolization were performed on the pelvic bone, followed by systemic chemotherapy. These combination treatments resulted in tumor regression with necrotic changes. However, multiple lung metastases developed 1 year after the treatment, and the patient was treated with additional systemic chemotherapy.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"89-93"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/26/kjhep-18-89.PMC3326999.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30580488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of alanine aminotransferase dynamics on predicting sustained virological response in chronic hepatitis C virus infection.","authors":"Tae Yeob Kim","doi":"10.3350/kjhep.2012.18.1.29","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.29","url":null,"abstract":"See Article on Page 41 The sustained virological response (SVR) of the combination of both pegylated interferon alfa (PegIFN) and ribavirin (RBV) in patients with chronic hepatitis C virus (HCV) infection is heterogeneous. 1 The therapeutic approach has been more individualized to obtain the better outcomes of patients with chronic HCV infection, and clinicians need to know the factors for predicting SVR. 2 The viral factors are","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"29-31"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/14/kjhep-18-29.PMC3326988.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30582180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-expression patterns of Notch1, Snail, and p53 in grade III hepatocellular carcinoma with postoperative recurrence: a preliminary study.","authors":"Sun Kyung Jang,&nbsp;Gi Hong Choi,&nbsp;Junjeong Choi,&nbsp;Xiaoyuan Quan,&nbsp;Jeong Won Jang,&nbsp;Bo Hyun Kim,&nbsp;Guhung Jung,&nbsp;Young Min Park","doi":"10.3350/kjhep.2012.18.1.63","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.63","url":null,"abstract":"<p><strong>Background/aims: </strong>We aimed to determine the association between the co-expression patterns of Notch1, Snail, and p53 proteins (NSP) and the postoperative prognosis of hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>The immunoblot data for molecular expression (147 HCC/corresponding non-HCC tissues and 15 dysplastic nodules) and the sequencing data for p53 mutations (110 HCCs) were obtained from our previous study. Data analyses were restricted to cases with HCC differentiation grade III (n=47), due to its high p53 mutation rate.</p><p><strong>Results: </strong>Nineteen of the 47 patients (40.4%) -comprising 12 in the liver and 7 in distant organs-had relapsed at 1-2 years after surgery. There was no relationship between p53 mutation and postoperative recurrence in the grade III HCCs. Seven (87.5%) of the eight relapsed cases with Notch1, Snail, and p53 (wild) co-expression experienced recurrence only within the liver, and all tumors were smaller than 5 cm in diameter. Extrahepatic relapse occurred mostly in HCC patients with tumors larger than 5 cm in diameter, without any deviation in the NSP pattern.</p><p><strong>Conclusions: </strong>The results of this preliminary study suggest that the co-expression of Notch1, Snail, and p53 (wild) is not inferior to the patterns with p53 mutation as an indicator of postoperative recurrence of grade III HCC.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"63-74"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/87/kjhep-18-63.PMC3326987.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30582185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ciliated hepatic foregut cyst.","authors":"Jae Do Yang,&nbsp;Woo Sung Moon","doi":"10.3350/kjhep.2012.18.1.98","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.98","url":null,"abstract":"Ciliated hepatic foregut cyst (CHFC) is a rare developmental disorder of the liver. Diagnoses of CHFC has become frequent during the past two decades due to technological progress and increased use of various imaging modalities.1 Clinically and radiologically, this lesion can be difficult to distinguish from the other cystic neoplasms of the liver. In this issue, we present a case of CHFC and discuss the typical histopathologic findings.","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"98-100"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8a/03/kjhep-18-98.PMC3327000.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30580489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body iron, serum ferritin, and nonalcoholic fatty liver disease.","authors":"Jae-Jun Shim","doi":"10.3350/kjhep.2012.18.1.105","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.105","url":null,"abstract":"Serum ferritin is an independent predictor of histologic severity and advanced fibrosis in patients with nonalcoholic fatty liver disease. \u0000 \u0000Kris V. Kowdley, Patricia Belt, Laura A Wilson, Matthew M. Yeh, Brent A. Neuschwander-Tetri, Naga Chalasani, Arun J. Sanyal, and James E. Nelson; for the NASH Clinical Research Network. Hepatology 2012;55:77-85. \u0000 \u0000Nonalcoholic fatty liver disease (NAFLD) is now recognized as a major cause of chronic liver diseases, including liver cirrhosis and hepatocellular carcinoma (HCC) in Western countries.1,2 Like alcoholic liver disease, NAFLD covers a wide spectrum of disorders from simple steatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis. Approximately 30% of the US population and 20% of the Korean population have NAFLD.1,3 \u0000 \u0000Just as all heavy drinkers do not progress to cirrhosis and HCC, nor do all patients with nonalcoholic steatosis progress. In addition to its high prevalence, one of the challenges facing hepatologists is the diagnosis and risk stratification of NAFLD. There is no proven serologic marker to confirm the disease, which is diagnosed by excluding a history of alcohol consumption and other causes of liver disease using various serologic tests; sometimes a liver biopsy is needed. Moreover, after the diagnosis, it is not clear who will progress to cirrhosis or HCC. Central obesity is a well-known risk factor and hyperglycemia, diabetes, and age are associated with advanced fibrosis.1,4 However, to evaluate the risk of disease progression, a liver biopsy is essential. Recently non-invasive methods to distinguish between simple steatosis and significant fibrosis have been introduced. Serological tests have been investigated, including α2-macroglobulin, apolipoprotein A-I, hyaluronic acid, the platelet count, bilirubin, and gamma-glutamyl transpeptidase.2 Direct and indirect inflammation mediators such as interleukin-6 (IL-6), CC-chemokine ligand 2, and N-glycans gave positive results, but further studies are needed to determine whether these have diagnostic roles.2 An apoptosis product, cytokeratin- 18 (CK-18) fragments, was also associated with NASH or fibrosis.5 \u0000 \u0000Recently, hepatic iron overload and its correlation with chronic liver disease have been considered.6,7 With recent progress in understanding iron metabolism in patients with hereditary hemochromatosis at the molecular level, accumulating evidence suggests a link between altered iron metabolism and NAFLD. In the last decade, many studies have found a relationship between hepatic iron and NASH or its progress.8-11 \u0000 \u0000Iron (ferrum in Latin), atomic number 26, is the most common element on Earth. It is essential in most living organisms. Iron binds to cofactors in hemes, myoglobin, cytochrome P450, and catalases. When body iron accumulates, it promotes oxidative free-radical reactions, which have harmful effects. In hereditary hemochromatosis, accumulated iron in the liver, heart, and pancreas leads to cirrhosis, heart failure","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"105-7"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/49/kjhep-18-105.PMC3326993.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30580492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision and update on clinical practice guideline for liver cirrhosis.","authors":"Ki Tae Suk, Soon Koo Baik, Jung Hwan Yoon, Jae Youn Cheong, Yong Han Paik, Chang Hyeong Lee, Young Seok Kim, Jin Woo Lee, Dong Joon Kim, Sung Won Cho, Seong Gyu Hwang, Joo Hyun Sohn, Moon Young Kim, Young Bae Kim, Jae Geun Kim, Yong Kyun Cho, Moon Seok Choi, Hyung Joon Kim, Hyun Woong Lee, Seung Up Kim, Ja Kyung Kim, Jin Young Choi, Dae Won Jun, Won Young Tak, Byung Seok Lee, Byoung Kuk Jang, Woo Jin Chung, Hong Soo Kim, Jae Young Jang, Soung Won Jeong, Sang Gyune Kim, Oh Sang Kwon, Young Kul Jung, Won Hyeok Choe, June Sung Lee, In Hee Kim, Jae Jun Shim, Gab Jin Cheon, Si Hyun Bae, Yeon Seok Seo, Dae Hee Choi, Se Jin Jang","doi":"10.3350/kjhep.2012.18.1.1","DOIUrl":"10.3350/kjhep.2012.18.1.1","url":null,"abstract":"","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"1-21"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/15/kjhep-18-1.PMC3326994.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30582179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of emphysematous hepatitis with spontaneous pneumoperitoneum in a patient with hilar cholangiocarcinoma.","authors":"Jung Ho Kim,&nbsp;Eul Sik Jung,&nbsp;Seok Hoo Jeong,&nbsp;Ju Seung Kim,&nbsp;Yang Suh Ku,&nbsp;Ki Baik Hahm,&nbsp;Ju Hyun Kim,&nbsp;Yeon Suk Kim","doi":"10.3350/kjhep.2012.18.1.94","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.94","url":null,"abstract":"<p><p>An 80-year-old woman with hilar cholangiocarcinoma was hospitalized due to sudden-onset abdominal pain. Computed tomography revealed hepatic necrosis accompanied with emphysematous change in the superior segment of the right liver (S7/S8), implying spontaneous rupture, based on the presence of perihepatic free air. Although urgent percutaneous drainage was performed, neither pus nor fluids were drained. These findings suggest emphysematous hepatitis with a hepatic mass. Despite the application of intensive care, the patient's condition deteriorated rapidly, and she died 3 days after admission to hospital. Liver gas has been reported in some clinical diseases (e.g., liver abscess) to be caused by gas-forming organisms; however, emphysematous hepatitis simulating emphysematous pyelonephritis is very rare. The case reported here was of fatal emphysematous hepatitis in a patient with hilar cholangiocarcinoma.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"94-7"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/c0/kjhep-18-94.PMC3326990.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30580490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}