, Tae Hun Kim, Kwon Yoo, Ye Ji Han, Jeong Eun Choi, Ji Yoon Kim, Min-Sun Cho Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease that may progress to end stage liver cirrhosis. Benefits of ursodeoxycholic acid (UDCA) treatment has been investigated through large clinical studies. However, most of the studies were done in western countries and recent increase in prevalence of this relatively uncommon chronic liver disease draws attention in Korea. As early UDCA treatment effectively prevent the grave consequences of PBC progression, early diagnosis and lifelong management with UDCA is important. This study was designed to investigate the clinical features of PBC and response rates of UDCA treatments in Ewha Womans University Medical Center.
Clinical data of PBC patients diagnosed between 2001 and 2014 at Ewha Womans University Medical Center were analyzed retrospectively.
A total of 35 patients with mean follow-up duration of 42 months were enrolled. At the diagnosis, 72.7% of the patients were asymptomatic, 5.7% had decompensated liver cirrhosis. The mean serum alkaline phosphate (ALP) level was 2.65 times upper limit of normal. UDCA was prescribed in 91.4% of the patients (n=32), among which 77.4% exhibited biochemical responses defined as serum ALP less than 2 upper limit of normal at 6 months (Mayo criteria).
Most PBC patients were asymptomatic at the time of diagnosis and the average biochemical responses rate to UDCA treatment were ranged from 60.0% to 78.9% according to various response criteria. To elucidate the clinical features and courses of Korean PBC patients in detail, larger scale investigations and longer clinical follow up studies are warranted.
, Tae Hun Kim, Min Kyung Chung, Ji Young Chang, Soo Kyung Lim, Ko Eun Lee Eosinophilic gastroenteritis is a rare, benign condition, characterized by various gastrointestinal symptoms associated with eosinophilic infiltration of the wall of the any part of the digestive tract, most commonly the stomach and small intestine. Eosinophilic gastroenteritis is generally classified according to the involved layer of the gastrointestinal tract. Serosal type is the rarest form of eosinophilic gastroenteritis that is characteristically accompanied with eosinophilic ascites and responds well to steroid treatment. We have experienced a typical case of serosal type eosinophilic gastroenteritis in a women who complained of abdominal pain. She had peripheral eosinophilia, gastric and small bowel wall thickening with eosionophilic ascites. Her symptom relieved rapidly after starting corticosteroid treatment and she had long been in clinical remission after discontinuation of corticosteroid administration.
Citations
, Ki-Nam Shim, Hyoung Won Cho, Ju Young Choi, Shin A Lee, Min Jin Lee, Da Yeon Oh, Sun Hee Roh, Chung Hyun Tae, Seong-Eun Kim, Hye-Kyung Jung, Tae Hun Kim, Sung-Ae Jung, Sun Young Yi, Kwon Yoo, Il Hwan Moon Ingestion of corrosive substances can produce severe injury to the gastrointestinal tract and can even result in death in the acute phase. The extent and degree of damage depends on the type and amount of substances. There are occasional reports of severe contiguous injury to the esophagus and stomach caused by strong alkali ingestion in the acute phase. Usually the deaths occur within a couple of days due to multi-organ failure after ingestion of relatively much amount of agent for a suicidal attempt. But death due to late progression is very rare.
We have reported a case of 60-year-old female patient who was diagnosed as corrosive esophagitis after accidental ingestion of strong alkali. Initial endoscopic findings were compatible with IIa-IIa-0(according to Zargar's classification) in the esophagus, stomach and duodenum, respectively. After several weeks of supportive care, her subjective symptoms were much improved during she had been wating for the operation of colon interposition due to esophageal stricture. Metabolic acidosis and thrombocytopenia developed abruptly probably due to upper gastrointestinal tract necrosis and she died when 60 days had passed after the occurrence of initial esophageal injury.
Citations
, Jae Jung Park, Il Hwan Moon, Seo Woo Kim, Hyun Kyung Kim, Hyun Jung Oh, Go Heun Kim, Yoon Jung Choi, Hyun Mi Huh, Young Wook Roh, Tae Hun Kim, Kwon Yoo, Ji Yoon Bae, Dong Eun Song Mixed hepatocellular-cholangiocarcinoma accounts for about 1% of all hepatocellular carcinoma. In many cases, mixed hepatocellular-cholangiocarcinoma has been misdiagnosed as hepatocellular carcinoma or cholangiocarcinoma because of the indistinctive clinical course and radiologic findings. The clinical course and the pathologic characters are not known well, but it resembles the characteristics of hepatocellularcarcinoma rather than cholangiocarcinoma. So mixed hepatocellular-cholangiocarcinoma was classified as a kind of hepatocellular carcinoma. But the growth and dissemination rate is faster than that of hepatocellular carcinoma and the prognosis more poor. So the exact diagnosis is important. Authors experienced a patient who has the mixed hepatocellular-cholangiocarcinoma diagnosed by liver and neck node biopsy in patient who complain-ed abdominal discomfort and palpable mass, so we report the case.
Citations
, Tae Hun Kim, Kum Hei Ryu, So Yeon Lim, Ju Ho Lee, Shi Nae Lee Hepatoid adenocarcinoma was described by Ishikura in 1985 for the first time. It is a very rare variant of adenocarcinoma characterized by morphological and functional features of hepatocyte differentiation. It is most commonly presented as gastric adenocarcinoma with otherwise unexplained elevation of serum alpha-fetoprotein level. Most of the patients with gastric hepatoid adenocarcinoma were diagnosed in advanced stages having vascular invasion and/or extensive metastasis in liver or lymph nodes. Accordingly, the prognosis of hepatoid adenocarcinoma is dismal. We experienced a typical case of gastric hepatoid adenocarcinoma and described the clinical features.
Reactive oxygen species (ROS) such as hydrogen peroxide, superoxide anion and hydroky radicals are produced in various physiologic and pathologic conditions and involved in many cellular processes as proliferation, differentiation and apoptosis. Studies investigating the role of ROS in various cellular behaviors especially in proliferation and apoptosis have been widely conducted in many cell types but the role of ROS in nontransformed human hepatocyte differentiation has not been investigated yet. thus we were going to elucidate the roleof ROS on human hepatocyte differentiaiton using sodium butyrate (SB) induced hepatocyte differentiation model of our own establishment.
Intracellular ROS and apoptotic cell death were monitored by flowcytometry using peroxide sensitive probe (Dicholorofluorscein diacetate) and Annexin V/Propidium iodide, respectively. Urea nitrogen in culture media was measured by colorimetric methods. Ornithine transcarbamylase(OTC) and albumin trasncription was evaluated by RT-PCR.
Intracellular ROS production was increased by SB. SB induced urea production was significantly decreased with antioxidant treatment (p<0.05) and SB induced OTC and albumin transcription were also attenuated with antioxidant treatment. SB induced increase in apoptosiswas significantly inhibited by antioxidant treatment (p<0.05).
ROS produced during the process of sodium butyrate induced human hepatocyte differentiation auguments hepatoctye differentiation and apoptosis.
, Tae Hun Kim, Woon Sup Han Chronic HBV infection is the main cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma in Korea. Hepatic flbrosis progresses as the duration of HBV infection prolongs therefore more advanced histologic findings are anticipated in patients with perinatally acquired HBV infection than in patients of the same age who acquired HBV otherwise. We are going to investigate the histologic findings of young adult patients with chronic hepatitis B with respect to maternal HBsAg status, duration of HBV possession and senun HBeAg starus and ALf levels.
A total of 96 HBsAg positive young adult male patients who visited our hospital forliver biopsy were enrolled and their histologic findings were analysed according to the standardcriteria. The medical records of the patients were reviewed and supplementary information weretaken via telephone interviews.
Hepatic inflammatory scores and fibrosis stages were increased as the serum ALf level increased. Histologic findings showed no significant differences according to the duration of HBV infection, serostatus of HBeAg, the number of HBsAg positive cells and matemal senun HBsAg status.
In young adult patients with chronic hepatitis 3, the hepatic histologic findings were worsen as the serum ALf level increased and associated with neither the HBeAg status of the patient nor the matemal HBsAg status.
Pyogenic liver abscess is a potentially life-threatening disease with substantial mortality rate. With the recent advances in diagnostic modalities and new treatment strategies, the overall mortality of pyogenic liver abscess has been decreased significantly but stillhigh mortality rates are recorded in patients with old age, multiple abscesses, malignant biliary obstruction and inadequate drainage. Therefore pyogenic liver abscess remains a major clinical challenge. We are going to investigate the current clinical features of pyogenic liver abscess.
Medical records of those who admitted to the Ewha Womans University Mokdong Hospital since 1993 and diagnosed as having Pyogenic liver abscess were reviewed. A total of 88 pyogenic liver abscess patients was detected and their clinical presentation, bacteriologic etiologies, comorbidities and treatment results were investigated.
Fifty male and 38 female (1.3 :1) patients were enrolled and the mean age was 59years. The most common presenting symptom was fever/chill (77%) followed by abdominal pain(64%), nausea/vomiting (42%) and general weakness (41%). Diabetes mellitus was combined in 17% of the patients and most of pyogenic liver abscesses were induced by ascending biliary infection (43%) or unknown cause (52%). Leukocytosis was evident in 74% of the patients and elevated akaline phosphatase in 52%. Sixty five percent of the abscess cavities were located inright lobe of the liver and most of them were solitary (73%). Pus culture was more efficient than blood culture for the detection of causative microorganis and
Rapid diagnosis of pyogenic liver abscess can be done through a complete history taking, physical examination and a prompt imaging studies and aggressive application of percutaneous aspiration or drainage of the abscess cavity with the empirical antibiotic administration targetting gram-negative aerobe may contribute to the improvement of the mangement of pyogenic liver abscess.
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