Biomedical subjects

Jae Woo Kim

Publications and source records attributed to Jae Woo Kim.

At least 19 recordsLinked to original sources

PubMed2006

Stable stem cell commitment to the adipocyte lineage by inhibition of DNA methylation: role of the BMP-4 gene.

Previous studies showed that exposure of C3H10T1/2 stem cells to bone morphogenetic protein-4 (BMP-4) produced cells that convert into adipocytes at high frequency when treated with differentiation inducers. In the present investigation, an independent approach shows that BMP-4 is required for stable commitment of pluripotent stem cells to the adipocyte lineage. Exposure of proliferating 10T1/2 stem cells to 5-azacytidine, a potent DNA methylation inhibitor, gave rise to a subpopulation of cells that can be cloned and that have the capacity to undergo conversion into adipocytes upon treatment with terminal differentiation inducers. Detailed studies performed with a cloned committed subline, the A33 line, verified stable adipocyte lineage determination in the absence of exogenous BMP-4. Remarkably, this cell line expresses and secretes BMP-4 during proliferation in the same time window that exogenous BMP-4 must be added to naïve 10T1/2 cells to induce maximal adipocyte commitment. Furthermore, exposure of A33 cells to noggin, a naturally occurring BMP-4-binding antagonist, during this critical time window blocks subsequent differentiation. The role of BMP-4 in adipocyte lineage commitment is further strengthened by gene expression profiling of proliferating 10T1/2 stem cells and A33 preadipocytes. These findings revealed changes in the molecular circuitry, specifically coordinated changes in the expression of members of the BMP-4 signaling pathway, that distinguish A33 preadipocytes from uncommitted parental 10T1/2 stem cells. Together, these studies provide compelling evidence for the participation of BMP-4 in adipocyte lineage determination.

Adipocytes↗

PubMed2006

A retrospective cohort study of Parkinson's disease in Korean shipbuilders.

OBJECTIVE: We performed a retrospective cohort study in South Korea to clarify the role of occupational exposure, especially to welding, in the etiology of Parkinson's disease (PD). METHODS: We constructed a database of subjects classified into an exposure group (blue-collar workers) and a non-exposure group (white-collar workers) in two shipbuilding companies. Jobs of blue-collar workers were categorized into the first group of welding, the second group of fitting, grinding and finishing, cutting, and the other group. To determine new cases of PD during the follow-up period (1992-2003), we used the physician billing claims database of the National Health Insurance Corporation. For the detected PD patients in the physician billing claims database, a neurologist in our research team confirmed the appropriateness of each diagnosis by reviewing medical charts. Based on the review, we confirmed the numbers of new cases of PD and calculated the relative risk (RR) and the 95% confidence intervals (CI) by Cox regression analysis. RESULTS: In a backward selection procedure, 'age' was a significant independent variable but exposure was not. Furthermore, the RR in welders (high exposure group) was also insignificant and less than that in others (very low exposure group). CONCLUSION: This longitudinal study of shipbuilding workers supports our previous case-control studies suggesting that exposure to manganese does not increase the risk of PD.

Age of Onset↗

PubMed2006

Use of microsatellite markers to detect quantitative trait loci in Yorkshire pigs.

To identify genetic markers associated with economic traits in pigs, 157 microsatellite markers were examined in Yorkshire pigs. Thirty eight female Yorkshire pigs were initially examined and six of them were selected as progenitors; half were more than 1.5 standard deviations (SD) above the mean for average daily gain (ADG) and backfat thickness (BFT), and the remaining half were more than 1.5 SD below the mean. These pigs were then mated to male Duroc pigs, and 200 F2 pig offspring were examined for the association of specific alleles with ADG and BFT. To confirm the specific markers identified in the initial analysis, associations of significant markers with economic traits were further examined in 228 additional performance-tested purebred pigs. Twenty-five microsatellite markers were significantly associated with either ADG or BFT, and among these, 17 were associated with both traits. The markers with the highest association to ADG were also associated with BFT. Our study reveals that specific markers could be used to predict economic significance, and confirms several quantitative trait loci (QTL) identified in previous studies. However, further analysis with more closely-spaced microsatellite markers is required to refine predictive values for economic traits and positions of QTL that are reliable for actual phenotypic prediction.

Alleles↗

PubMed2006

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction.

BACKGROUND: Cholecystitis related to metal stent placement is a morbid event. OBJECTIVE: This study evaluated the risk factors of cholecystitis after metal stenting for malignant biliary obstruction. PATIENTS: Between December 1997 and April 2003, 155 patients who were treated with a metal stent for malignant biliary obstruction were retrospectively enrolled. MAIN OUTCOME MEASUREMENTS: The incidence and characteristics of patients with cholecystitis were evaluated and compared with those of patients without cholecystitis. Patient characteristics and tumor or procedure-related data were recorded for the following variables: sex, age, tumor and stent length, stent type (covered vs uncovered), cholangitis before ERCP, degree of gallbladder filling with contrast medium during ERCP, primary disease type (Klatskin vs others), presence of gallbladder stones, and the relationship of the cystic duct orifice to the location of the tumor (across vs others). RESULTS: There were 15 (9.7%) patients diagnosed with cholecystitis after metal stent insertion. The onset of cholecystitis was on average 4.6 days (range 1 to 26) after the procedure. We found that an obstruction across the cystic duct orifice by tumor (P < .01, odds ratio 12.7) and the presence of gallbladder stone (P = .01, odds ratio 6.6) were positively related to the cholecystitis after metal stent insertion. LIMITATIONS: The limitations of the study were the use of multiple types of stents and the retrospective design. CONCLUSIONS: This study demonstrated that an obstruction across the cystic duct by tumor and the presence of gallbladder stone were risk factors for the development of cholecystitis after metal stent placement.

Adult↗

PubMed2006

Comparison of the efficacy of rabeprazole 10 mg and omeprazole 20 mg for the healing rapidity of peptic ulcer diseases.

AIM: Rabeprazole has been known to inhibit H(+)/K(+)-ATPase more rapidly than omeprazole, the prototype proton pump inhibitor (PPI). The aim of this study was to demonstrate equivalence between low-dose rabeprazole 10 mg and omeprazole 20 mg for the healing rapidity of active peptic ulcer and for improvement of symptoms. Also, the effect of CYP2C19 genotypes on ulcer healing rapidity was investigated. METHODS: A total of 112 patients with active peptic ulcer were randomized to receive either rabeprazole 10 mg q.d. or omeprazole 20 mg q.d. for 6 weeks. The remaining ratios (%) and complete healing of the ulcer were determined by endoscopy at 1 week and 6 weeks of treatment. The severity of ulcer pain was also investigated during treatment. CYP2C19 genotype was determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. RESULTS: The remaining ratio of peptic ulcers after 1 week and the complete healing rate after 6 weeks in the rabeprazole versus omeprazole group were 45.5% versus 50.3% (P = 0.475) and 80.6% versus 87.0% (P = 0.423), respectively. CYP2C19 genotypes had no effect on the remaining ratio of peptic ulcers after 1 week and the healing rate of peptic ulcers after 6 weeks in both groups. The proportions of patients with symptom improvement or resolution were comparable between the two groups. CONCLUSION: Low-dose rabeprazole 10 mg has a similar efficacy for the healing rapidity of active peptic ulcer disease and symptom improvement compared with standard-dose omeprazole 20 mg.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed2006

Recent variceal bleeding: Doppler US hepatic vein waveform in assessment of severity of portal hypertension and vasoactive drug response.

PURPOSE: To prospectively evaluate both the correlation between abnormal Doppler ultrasonography (US) hepatic vein waveforms and the hepatic venous pressure gradient (HVPG) and the response to drug treatment in patients with cirrhosis. MATERIALS AND METHODS: Ethics committee approval and informed consent of patients and control subjects were obtained. In 78 patients with cirrhosis (70 men, eight women; mean age, 49.4 years +/- 9.7 [standard deviation]) and a history of variceal bleeding, both the hepatic vein waveform--as measured with Doppler US--and the HVPG were measured, and the relationship between them was analyzed. Hepatic vein Doppler waveforms were classified as triphasic, biphasic, or monophasic. Severe portal hypertension was defined as an HVPG of more than 15 mm Hg. In a subgroup of 21 patients, changes in hepatic vein waveform and HVPG were evaluated after intravenous administration of 2 mg of terlipressin. Statistical analyses were performed with Spearman rank correlation, logistic regression analysis, and cross tabulation. RESULTS: Abnormal hepatic vein waveforms were seen in 72 patients (92%). Forty-four patients (56%) had biphasic waveforms, 28 (36%) had monophasic waveforms, and six (8%) had triphasic waveforms. A positive correlation was found between the extent of abnormalities in hepatic vein waveforms and the increase in HVPG (P < .05). Monophasic waveforms were associated with severe portal hypertension, with a sensitivity of 74% and a specificity of 95%. Twenty patients in the terlipressin subgroup had abnormal baseline waveforms; the baseline waveform improved in 18 patients in association with the HVPG reduction after injection of terlipressin. CONCLUSION: Doppler US hepatic vein waveform assessment is useful in the noninvasive evaluation of the severity of portal hypertension and the response to vasoactive drugs in patients with portal hypertension and variceal bleeding.

Antihypertensive Agents↗

PubMed2006

[Modulation of colon cancer cell invasiveness induced by deoxycholic acid].

BACKGROUND/AIMS: Deoxycholic acid (DCA), a secondary bile acid, has been implicated to promote colon cancer growth and progression. However, its molecular mechanisms are largely unknown. In this study, we investigated the effects of DCA on proliferation, migration, and invasiveness of colon cancer cells (HT-29). METHODS: HT-29 cells were incubated with either medium (control) only or DCA for 24-48 hours. Time courses of RT-PCR for vascular endothelial growth factor (VEGF) and hypoxia-inducible factor (HIF)-1alpha mRNA expression, Western blotting for VEGF and matrix metalloproteinase (MMP)-9, zymography for MMP-9 activation, and wound-migration assay were determined after various concentrations of DCA (0-80 microM) treatment. Moreover, these experiments were reassessed after pretreatments (2-6 hours) with specific inhibitors of various signal pathways. RESULTS: DCA enhanced HIF-1alpha mRNA expression, VEGF mRNA and VEGF protein expression, MMP-9 protein expression/activation, and cell migration ability in a dose-related manner. DCA-induced VEGF protein expression was inhibited by pretreatment with NS-398 (COX-2 inhibitor), PDTC (NF-kappaB inhibitor), or tauroursodeoxycholic acid (TUDC). DCA-induced cell migration ability was inhibited by pretreatment of GF109203X, a protein kinase C inhibitor. DCA-induced MMP-9 protein expression/activation was inhibited by pretreatment with SB203580, U0126, or PDTC. CONCLUSIONS: DCA significantly upregulates invasive and angiogenic potentials of human colon cancer cells through multiple signal transduction pathways.

Cell Movement↗

PubMed2006

[A case of percutaneous endoscopic gastrostomy in a patient with liver cirrhosis accompanied by both esophageal and gastric varices].

Malnutrition in patients with liver disease is common. Consequently, percutaneous endoscopic gastrostomy may be needed for the correction of malnutrition. Percutaneous endoscopic gastrostomy is rarely performed in patients with liver cirrhosis because of the presence of varices and coagulation abnormalities. However, if careful insertion technique along with thorough clinical assessment is undertaken, percutaneous endoscopic gastrostomy may be successfully performed in patients with liver cirrhosis. Here, we report successful application of percutaneous endoscopic gastrostomy in a patient with liver cirrhosis accompanied by both gastric and esophageal varices.

Aged↗

PubMed2006

[Effect of endoscopic sclerotherapy using N-butyl-2-cyanoacrylate in patients with gastric variceal bleeding].

BACKGROUND/AIMS: Gastric variceal bleeding is a severe complication of cirrhosis, and it has a high mortality rate. This study was conducted to evaluate the efficacy of n-butyl-2-cyanoacrylate injection therapy for patients suffering with gastric variceal bleeding. METHODS: A total of 86 patients diagnosed with gastric variceal bleeding underwent endoscopic n-butyl-2-cyanoacrylate (Histoacryl) injection therapy at our department between April, 2002 and July, 2005, with a mean follow-up period of 44 weeks (range: 2 to 136 weeks). The initial hemostasis rate and the rebleeding rate of endoscopic sclerotherapy were analyzed. Also, the cumulative survival rate was analyzed according to the status of hepatocellular carcinoma and hyponatremia, the MELD score, the Child-Pugh score and the amount of injected Histoacryl. RESULTS: The initial hemostasis rate of Histoacryl injection therapy was 93% and the 1 month rebleeding rate was 16.1%. The total number of session for treating the initial hemostasis was 1.2+/-0.4 and the total volume of Histoacryl was 2.7+/-1.2 mL. The cumulative rebleeding-free rates for the patients treated by the Histoacryl injection method at 1 month, 12 months and 34 months period were 95.1%, 83.2% and 74%, respectively. The cumulative survival rates were 78.3% at 1 month, 61.9% at 12 months and 54.6% at 34 months, respectively. No thromboembolic phenomenon occurred. According to the Cox's proportional hazards analysis, only the MELD score (<15) was an independent predicting factor for survival of the patients with gastric variceal bleeding. CONCLUSIONS: Endoscopic sclerotherapy using n-butyl-2-cyanoacrylate was a safe and effective hemostatic method for patients with gastric variceal bleeding. Also, the MELD score (<15) contributed to predicting survival of the patients with gastric variceal bleeding.

Adult↗

PubMed2005

Multigeneration reproductive and developmental toxicity study of bar gene inserted into genetically modified potato on rats.

Each specific protein has an individual gene encoding it, and a foreign gene introduced to a plant can be used to synthesize a new protein. The identification of potential reproductive and developmental toxicity from novel proteins produced by genetically modified (GM) crops is a difficult task. A science-based risk assessment is needed in order to use GM crops as a conventional foodstuff. In this study, the specific characteristics of GM food and low-level chronic exposure were examined using a five-generation animal study. In each generation, rats were fed a solid pellet containing 5% GM potato and non-GM potato for 10 wk prior to mating in order to assess the potential reproductive and developmental toxic effects. In the multigeneration animal study, there were no GM potato-related changes in body weight, food consumption, reproductive performance, and organ weight. Polymerase chain reaction (PCR) was carried out using extracted genomic DNA to examine the possibility of gene persistence in the organ tissues after a long-term exposure to low levels of GM feed. In each generation, the gene responsible for bar was not found in any of the reproductive organs of the GM potato-treated male and female rats, and the litter-related indexes did not show any genetically modified organism (GMO)-related changes. The results suggest that genetically modified crops have no adverse effects on the multigeneration reproductive-developmental ability.

Animals↗

PubMed2005

Occupations and Parkinson's disease: a multi-center case-control study in South Korea.

OBJECTIVE: We performed a hospital based case-control study in South Korea (1) to clarify the role of occupational exposure, and especially manganese (Mn) exposure in the etiology of Parkinson's disease (PD) and (2) to discover the association between any occupations and PD. METHODS: We selected two groups, PD patient group (N1) and controls (N2). Three hundred sixty-seven consecutive outpatients with PD (177 men, 190 women) and 309 controls were interviewed about life style, past history, family history, education level, and occupational history etc. We employed a range of industrial categories as defined by section (the most broad category) and division (sub-category) of the Korea Standard Industry Code (KSIC) Manual. Along with KSIC, we also used the Korea Standard Classification of Occupations (KSCO) as proxies of occupational exposure. The odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for age, sex, smoking status, and education level are presented. RESULTS: As regarding the exposure to hazardous materials, especially Mn, more subjects in the control group than the PD patient group have worked in the occupations with potential exposure to Mn (P < 0.001). Ever having worked in 'agriculture, hunting, and forestry' section of industry was positively associated with PD (OR 1.88), and 'agriculture production crops (OR 1.96)' division of industry was positively associated with PD. On the other hand, ever having worked in the 'manufacturing (OR 0.56)', 'transportation (OR 0.28)' section of industry, and 'transporting (OR 0.20)' division of industry were negatively associated with PD. 'Drivers (OR 0.13)' division of occupation also was negatively associated with PD. CONCLUSIONS: To our knowledge, this is the first case-control studies to find an inverse relationship between 'transporting' or 'technicians like machinery engineers' as his/her longest job and PD risk. Because of this unexpected finding, our work should be replicated in various populations.

Adult↗

PubMed2005

Effectiveness of walking exercise as a bowel preparation for colonoscopy: a randomized controlled trial.

OBJECTIVES: This prospective study was conducted to assess the effect of walking exercise on bowel cleansing before colonoscopy and to define a patient subgroup that would benefit from walking exercise. METHODS: A total of 383 outpatients were randomized into two groups (G1 [n = 196]; walking exercise, G2 [n = 187]; nonexercise). Those randomized to G1 were instructed to drink 250 mL of polyethylene glycol (PEG) solution and then walk at least for 5 min at intervals of 10 min whereas those randomized to G2 were instructed to drink and then take rest in a waiting room until the entire 2.5-3 L volume was consumed. The amount of walking exercise in both groups was estimated using a step counter. A single endoscopist estimated the efficacy of cleansing in a single-blinded manner. Patient's demographics, various parameters related to bowel preparation, and the degree of patients discomfort caused by the walking exercise were assessed. RESULTS: The number of step counts taken was significantly different for the two groups (p < 0.001). The degree of bowel cleansing in the G1 (n = 189) and G2 (n = 177) groups was significantly different (p < 0.01). However, the groups were similar in terms of all other data collected. By univariate analysis, walking exercise was especially beneficial to a subgroup of nonobese patients of age <65 yr, without history of abdominal surgery. Also, multivariate logistic regression analysis demonstrated that nonexercise (OR = 0.49; 95% CI = 0.31-0.79) was an independent risk factor for poor bowel cleansing. Most walking patients (97.3%) considered walking exercise more comfortable than taking the polyethylene glycol solution. CONCLUSION: The walking exercise was found to improve colonoscopic bowel cleansing without significant patient discomfort.

Adult↗

PubMed2005

Ascorbic acid enhances nitric oxide production in trabecular meshwork cells.

PURPOSE: This study investigated the role of ascorbic acid on the production of nitric oxide (NO) in the trabecular meshwork (TM) cells. METHODS: After primarily cultured human TM cells were exposed to 1, 10, and 100 microM of L-ascorbic acid (LAA), with or without co-administration of 1 mM sodium nitroprusside or 100 microM hydrogen peroxide for 48 hr, cellular survival and NO production were measured with MTT and Griess assay, respectively. RESULTS: LAA significantly potentiated NO production in a dose-dependent manner (p<0.05) without affecting cell viability. LAA increased cell viability after hydrogen peroxide-induced oxidative stress in a dose-dependent manner. LAA enhanced NO production in TM cells and showed a cytoprotective effect against hydrogen peroxide-induced oxidative stress. CONCLUSIONS: LAA might be involved in the regulation of trabecular outflow by enhancing NO production in TM cells.

Ascorbic Acid↗

PubMed2005

Predictive factors of recurrent bleeding in Mallory-Weiss syndrome.

BACKGROUND/AIMS: Although the majority of patients with Mallory-Weiss syndrome (MWS) have a benign course, MWS patients with recurrent bleeding have an unfavorable outcome and require intensive care. Therefore, this study was carried out to identify the risk factors for recurrent bleeding in MWS patients. METHODS: The medical records of patients with MWS between January 1999 and December 2003, were reviewed retrospectively. Demographics, initial clinical and laboratory parameters, and endoscopic findings of the patients with and without recurrent bleeding were compared and the potential risk factors predicting recurrent bleeding in MWS were evaluated. RESULTS: A total of one hundred and fifty-nine patients (22 women, 137 men, mean age 48.1 years old) were enrolled in the study. Recurrent bleeding was observed in 17 patients (10.7%). Those patients with recurrent bleeding showed higher frequency for the presence of shock at initial manifestation, combined liver cirrhosis and endoscopic findings of active bleeding, lower hemoglobin level and platelet count, higher amount of transfusions and epinephrine-mixed fluid injections, and longer hospital stay than those patients without recurrent bleeding. Significant risk factors predicting the recurrent bleeding in MWS were the presence of shock at initial manifestation (OR 3.71, 95% CI 1.07-14.90) and the evidence of active bleeding on endoscopic examination (OR 9.89, 95% CI 1.88-51.98) on multivariate analysis. CONCLUSIONS: Intensive care with close monitoring is required for the patients with shock on initial manifestation or with evidence of active bleeding on endoscopic examinations since these are independent risk factors predicting the recurrent bleeding in MWS patients.

Female↗

PubMed2004

Adipocyte determination- and differentiation-dependent factor 1/sterol regulatory element-binding protein 1c regulates mouse adiponectin expression.

Adiponectin is exclusively expressed in differentiated adipocytes and plays an important role in regulating energy homeostasis, including the glucose and lipid metabolism associated with increased insulin sensitivity. However, the control of adiponectin gene expression in adipocytes is poorly understood. We show here that levels of adiponectin mRNA and protein are reduced in the white adipose tissue of ob/ob and db/db mice and that there is a concomitant reduction of the adipocyte determination- and differentiation-dependent factor 1 (ADD1)/sterol regulatory element-binding protein 1c (SREBP1c) transcription factor. To determine whether ADD1/SREBP1c regulates adiponectin gene expression, we isolated and characterized the mouse adiponectin promoter. Analysis of the adiponectin promoter revealed putative binding sites for the adipogenic transcription factors ADD1/SREBP1c, peroxisomal proliferator-activated receptor gamma and CCAAT enhancer-binding proteins. DNase I footprinting and chromatin immunoprecipitation analyses revealed that ADD1/SREBP1c binds in vitro and in vivo to the proximal promoter containing sterol regulatory element (SRE) motifs. A luciferase reporter containing the promoter was transactivated by ADD1/SREBP1c, and introduction of SRE mutations into the construct abolished transactivation. Adenoviral overexpression of ADD1/SREBP1c also elevated adiponectin mRNA and protein levels in 3T3-L1 adipocytes. Furthermore, insulin stimulated adiponectin mRNA expression in adipocytes and augmented transactivation of the adiponectin promoter by ADD1/SREBP1c. Taken together, these data indicate that ADD1/SREBP1c controls adiponectin gene expression in differentiated adipocytes.

3T3-L1 Cells↗

PubMed2004

Statin reduces the platelet P-selectin expression in atherosclerotic ischemic stroke.

Recently, it has been demonstrated that 3-hydroxy-3-methylglutaryl coenzyme A (HMG Co-A) reductase inhibitor or statin can regulate the thrombogenesis beyond its lipid lowering effect. In this study, we investigated the beneficial effect of statin to reduce the platelet P-selectin expression in atherosclerotic ischemic stroke. Thirty-two (28 men, 4 women; mean age 59.8 +/- 9.6 years) patients with atherosclerotic ischemic stroke were assigned to receive simvastatin 20 mg per day for 12 weeks and discontinued for another 12 weeks. Then, administration of simvastatin was discontinued for the following 12 weeks. Using whole blood flow cytometry, we evaluated the change of platelet P-selectin expression of all the patients after the 12-weeks use and the 12-weeks discontinuance of simvastatin. The platelet P-selectin expression was significant reduced after treatment of simvastatin 20 mg for 12 weeks (p < 0.001). However, the effect of statin to reduce platelet P-selectin expression disappeared after 12 weeks of cessation of statin. In addition, the P-selectin changes induced by statin were independent of the changes of the LDL cholesterol (r = -0.311, p = 0.386). This study demonstrated that the use of statin might be a helpful add-on therapy to regulate the platelet related thrombogenesis in atherosclerotic ischemic stroke.

Aged↗

PubMed2004

Increased platelet CD63 and P-selectin expression persist in atherosclerotic ischemic stroke.

Platelet activation is an important process in the pathogenesis of atherothrombosis. However, the serial changes of platelet activation in atherosclerotic ischemic stroke have not been determined. In this study, we measured serially platelet expression of CD63 and P-selectin and platelet aggregability to ADP and collagen. Measurements were made 24 and 72 h and 7 and 90 days after the ischemic event in 29 patients with atherosclerotic ischemic stroke. Platelet aggregability was significantly decreased after 72 h compared to that at 24 h of stroke onset. However, platelet CD63 and P-selectin expression remained high even 90 days after the events. These findings suggest that platelet hyperactivation in atherosclerotic ischemic stroke may be sustained for a considerable period.

Adenosine Diphosphate↗

PubMed2004

Relationship of hemodynamic indices and prognosis in patients with liver cirrhosis.

BACKGROUND: Hyperdynamic circulation due to reduced peripheral vascular resistance and increased cardiac output, and the development of portal hypertension are the hemodynamic changes observed in patients with liver cirrhosis. Such hemodynamic abnormalities appear in patients with late stage liver cirrhosis. Therefore, hemodynamic indices, which represent hyperdynamic circulation and portal hypertension, are significant for the prognosis of patients with liver cirrhosis. The aim of this study was to determine the hemodynamic indices associated with the prognosis of patients with liver cirrhosis. METHODS: A total of 103 patients diagnosed with liver cirrhosis between December 1999 and June 2003, with a mean follow-up period of 73 weeks, ranging from 7 to 168 weeks, were recruited. Using Child-Pugh classification, the mean arterial pressure, heart rate and hepatic venous pressure gradient (HVPG) were measured. The indices of Doppler ultrasonography, including the portal and splenic venous flows, and the resistance of the hepatic, splenic, and renal arteries were also measured using the arterial pulsatility index (PI). The prognostic values of these indices were determined by their comparison with the patient survivals. RESULTS: Significant hemodynamic indices for a bad prognosis were high HVPG (> or = 15 mmHg) and renal arterial PI (> or = 1.14)(p<0.05). A Child-Pugh score > or = 10 was important for a poor prognosis (p<0.05). CONCLUSION: Severe portal hypertension (HVPG > or = 15 mmHg) and high renal arterial resistance (PI +/- 1.14) were valuable hemodynamic indices for the prognosis of patients with liver cirrhosis. Therefore, it was concluded that the measurement of these hemodynamic indices, in addition to the Child-Pugh classification, is helpful in the prognosis of patients with liver cirrhosis.

Female↗