임형준 교수

In the past, liver cirrhosis was considered an irreversible phenomenon. However, many experimental data have provided evidence of the reversibility of liver fibrosis. Moreover, multiple clinical studies have also shown regression of fibrosis and reversal of cirrhosis on repeated biopsy samples. As various etiologies are associated with liver fibrosis via integrated signaling pathways, a comprehensive understanding of the pathobiology of hepatic fibrogenesis is critical for improving clinical out

Background/Aims: Although early recognition and treatment with effective antibiotics have lead to improvements in the prognosis of patients with spontaneous bacterial peritonitis (SBP), it remains to be a serious complication in cirrhotic patients. This study was designed to evaluate the clinical manifestations and prognosis of patients with liver cirrhosis and SBP in Korea. Methods: This was a multicenter retrospective study examining 157 episodes of SBP in 145 patients with cirrhosis. SBP was

The prognostic role of aberrant serum miRNA expression for predicting response to sorafenib treatment in advanced hepatocellular carcinoma (HCC) patients has not been well characterized. We aimed to identify specific serum miRNAs that are associated with positive radiologic responses or improved survival in sorafenib-treated HCC patients. miR-18a, miR-21, miR-139-5p, miR-221, miR-224, and miR-10b-3p, were selected for analysis. Serum samples from 24 patients with advanced stage HCC and 25 patien

Background/Aims: α-Fetoprotein (AFP) is the biomarkermost widely used to detect hepatocellular carcinoma (HCC),despite its suboptimal diagnostic accuracy. Glypican-3 (GPC3)and osteopontin (OPN) are secreted glycoproteins that are reportedlyassociated with tumorigenesis and metastasis. Thisstudy was conducted to evaluate the clinical utility of usingplasma GPC3 and OPN as diagnostic biomarkers for HCC. Methods: We measured the plasma levels of GPC3 and OPNin 120 HCC and 40 chronic liver disease (

Background/Aims: Sorafenib is the first approved systemic treatment for advanced hepatocellular carcinoma (HCC). However, its clinical utility is limited, especially in Asian countries. Several reports have suggested the survival benefits of hepatic arterial infusion chemotherapy (HAIC) for advanced HCC with main portal vein tumor thrombosis (PVTT). This study aimed to compare the efficacy of sorafenib-based therapy with that of HAIC-based therapy for advanced HCC with main PVTT. Methods: Advanc

The purpose of this study was to characterize the clinical features of acute hepatitis A in Seoul and Gyeonggi province during the recent 2 years. Methods: We reviewed the medical records of 222 patients who were diagnosed as acute hepatitis A between August 2005 and March 2007 at the Konkuk University Hospital and Korea University, Ansan Hospital. The clinical manifestation, serological tests, and image findings were analyzed. Results: Median age of the patients was 28.1 years and the age group

Background/Aims: We aimed to evaluate the effi cacy and safety of peginterferon plus ribavirin for chronic hepatitis C (CHC) patients under real life setting in Korea. Methods: We retrospectively analyzed the medical records of 758 CHC patients treated with peginterferon plus ribavirin between 2000 and 2008 from 14 university hospitals in the Gyeonggi-Incheon area in Korea. Results: Hepatitis C virus (HCV) genotype 1 was detected in 61.2% of patients, while genotype 2was detected in 35.5%. Basel

The purpose of this prospective study was to verify and compare the strengths of various blood markers and fibrosis models in predicting significant liver fibrosis. One hundred fifty-eight patients with chronic liver disease who underwent liver biopsy were enrolled. The mean age was 41 yr and male patients accounted for 70.2%. The common causes of liver disease were hepatitis B (67.7%) and C (16.5%) and fatty liver (9.5%). Stages of liver fibrosis (F0-4) were assessed according to the Batts and

목적: 우리 나라 H. pylori 제균 요법의 1차 제균 치료제인 proton pump inhibitor와 amoxicillin, clarithromycin을 병합하는 삼제 요법은 초창기에는 90% 이상의 제균율을 보이는 유용한 치료법이었으나, 이후 연구 결과들은 제균율이 이에 미치지 못하는 결과를 보였다. 이에 대해 최근 11년간의 H. pylori가 증명된 환자들을 대상으로 1차 및 2차 치료의 제균율 변화 추이 그리고 제균 치료에 영향을 주는 요인들을 분석하고자 하였다. 방법: 고려대학교 안산병원에서 1997년 1월부터 2007년 12월까지 상부위장관 내시경검사를 통해 H. pylori 감염이 확인된 후 1차 삼제 요법으로 제균 치료를 시행받은 환자를 대상으로 후향 연구를 하였다. 추적이 가능하였던 환자들은 치료 종료 2주 이내에 치료 순응도와 부작용 발생 여부에 대한 질문에 답하였고, 치료 종료 후 최소 4주 이상 경과한 후 상부위장관 내시경검사를 통한 조직검사 및 신속요소

Since sorafenib was introduced in 2007 for treating advanced hepatocellular carcinoma (HCC), 15 patients have achieved a complete response (CR) in advanced HCC. However, only four of these reports can be regarded as real CRs involving adequate assessments including imaging, serum tumor markers, and histologic examinations of completely resected specimens. A 54-year-old man with hepatitis C virus (HCV)-related liver cirrhosis (LC) presented to our unit. A CT scan demonstrated a 3.8-cm arterial hy

Background/Aims: In patients with liver cirrhosis, drugs acting on the central nervous system can lead to hepatic encephalopathy and the effects may be prolonged. Recently, misuse of propofol has been reported and the associated risk of death have become an issue. Propofol is commonly used during sedative endoscopy;therefore, its safety in high-risk groups must be further investigated. We performed a pilot study of the safety and efficacy of propofol during endoscopy in Korean patients with cirr

The hepatitis B virus (HBV) polymerase gene has overlapping reading frames with surface genes, which allows to alter the amino acid codon of the surface genes. In adefovir (ADV) treated chronic hepatitis B patients carrying rtA181T/rtA181V mutations,overlap with surface gene mutations such as sW172stop/sL173F has been reported. However, the clinical consequences of such surface mutations have not been determined. The aim of this study was to determine the surface gene sequence in ADV-resistant p

The aim of this study was to investigate the clinical characteristics of acute hepatitis A during a recent outbreak in Korea. Data of patients diagnosed with acute hepatitis A from 2007 to 2009 were collected from 21 tertiary hospitals retrospectively. Their demographic, clinical, and serological characteristics and their clinical outcomes were analyzed. A total of 4,218 patients (mean age 33.3 yr) were included. The median duration of admission was 9 days. The mean of the highest ALT level was

An accumulation of pigment deposits on mucosa, called melanosis or pseudomelanosis,of the small bowel is observed infrequently during endoscopic examination. We describe 6 cases of small bowel pseudomelanosis; the possible etiology of which was chronic iron intake. We observed numerous brown spots in duodenum, jejunum, and terminal ileum during upper and lower endoscopy. Interestingly, all patients have been taking oral iron for several years. Histology showed pigment depositions within macropha

Duodenal diverticula are detected in up to 27% of patients undergoing uppergastrointestinal tract evaluation with periampullary diverticula (PAD) being the mostcommon type. Although PAD usually do not cause symptoms, it can serve as a source ofobstructive jaundice even when choledocholithiasis or tumor is not present. This duodenaldiverticulum obstructive jaundice syndrome is called Lemmel’s syndrome. An 81-yr-oldwoman came to the emergency room with obstructive jaundice and cholangitis. Abdomin