Clinical and Molecular Hepatology

"Jong Eun Yeon"

Original Articles

Impacts of muscle mass dynamics on prognosis of outpatients with cirrhosis: Tae Hyung Kim, Young Kul Jung, Hyung Joon Yim, Joo Won Baik, Sun Young Yim, Young-Sun Lee, Yeon Seok Seo, Ji Hoon Kim, Jong Eun Yeon, Kwan Soo Byun; Clin Mol Hepatol 2022;28(4):876-889.
Published online September 19, 2022; DOI: https://doi.org/10.3350/cmh.2022.0231

Background/Aims
Sarcopenia negatively affects the prognosis of cirrhotic patients, but clinical implications of changes in muscle mass remain unclear. We aimed to elucidate its role in the prognosis of outpatients with cirrhosis.
Methods
Patients with cirrhosis who underwent annual abdominal computed tomography (CT) for hepatocellular carcinoma surveillance were included in the prospective cohort. The L3 skeletal muscle index (SMI) was adopted as a proxy for the amount of skeletal muscle, and the rate of SMI change between inclusion and after 1 year (ΔSMI/yr%) was calculated.
Result
s: In total, 595 patients underwent a second CT after 1 year. Among them, 109 and 64 patients had sarcopenia and Child-Pugh class B/C decompensation at inclusion, which changed to 103 and 45 at the 1-year follow-up, respectively. During a median follow-up of 30.1 months after 1 year, 86 patients had at least one cirrhosis complication, and 18 died or received liver transplantation. In the development of cirrhosis complications, ΔSMI/yr% was independently associated, even after adjusting for the Child-Pugh and model for end stage liver disease (MELD)-Na scores. In addition, ΔSMI/yr% showed a good predictive performance for the development of cirrhosis complications within 6 months after 1-year follow-up in all subgroups, with a cut-off of -2.62 (sensitivity, 83.9%; specificity, 74.5%) in the overall population. SMI at 1-year and Child-Pugh score were independent factors associated with survival. In addition, changes in sarcopenia status significantly stratified survival.
Conclusion
ΔSMI/yr% was a good predictor of the development of cirrhosis complications in outpatients with cirrhosis, independent of Child-Pugh and MELD scores.

Citations

Citations to this article as recorded by

Impact of year-to-year changes in skeletal muscle mass on the prediction of long-term survival in patients with liver cirrhosis
Fulian Zhao, Ruojing Wang, Chengbin Zhu, Chang Zhang, Tianzhi Ni, Qijuan Zang, Yali Feng, Mengmeng Zhang, Li Zhu, Yage Zhu, Juan Du, Zhe Jiao, Chenxia Li, Taotao Yan, Yingli He, Yuchao Wu, Yingren Zhao, Yuan Yang
Nutrition.2026; 142: 112982. CrossRef
Effect of adipose-related parameters on mortality in patients with liver cirrhosis: a meta-analysis
Zhang Wen, Shuyue Tuo, Qiuju Ran, Jia Yuan, Yong Li, Ying Zhang, Danyan Chang, Chan Li, Shejiao Dai, Jinhai Wang, Xinxing Tantai
Annals of Medicine.2025;[Epub] CrossRef
Assessment of Sarcopenia in Patients with Liver Cirrhosis—A Literature Review
Dorotea Bozic, Bisera Mamic, Iva Peric, Ivona Bozic, Ivan Zaja, Tomislav Ivanovic, Ana Gugic Ratkovic, Ivica Grgurevic
Nutrients.2025; 17(16): 2589. CrossRef
Predictive performance of distinct skeletal muscle index cut-offs-defined sarcopenia for long-term mortality in decompensated cirrhosis: A prospective observational study
Chao Sun, Han Wang, Ziyi Yang, Huanli Jiao
European Journal of Radiology.2025; 192: 112396. CrossRef
Proton Beam Therapy Provides Longer Survival and Preserves Muscle Mass in Hepatocellular Carcinoma Compared to TACE+RFA
Takuto Nosaka, Ryotaro Sugata, Yosuke Murata, Yu Akazawa, Tomoko Tanaka, Kazuto Takahashi, Tatsushi Naito, Masahiro Ohtani, Kenji Takata, Tetsuya Tsujikawa, Yoshitaka Sato, Yoshikazu Maeda, Hiroyasu Tamamura, Yasunari Nakamoto
Cancers.2025; 17(17): 2849. CrossRef
Prevalence of and associated factors for sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis
Shuyue Tuo, Yee Hui Yeo, Rachel Chang, Zhang Wen, Qiuju Ran, Longbao Yang, Qing Fan, Junxiu Kang, Jiaojiao Si, Yi Liu, Haitao Shi, Yong Li, Jia Yuan, Na Liu, Shejiao Dai, Xiaoyan Guo, Jinhai Wang, Fanpu Ji, Xinxing Tantai
Clinical Nutrition.2024; 43(1): 84. CrossRef
Correlation between sarcopenia and cirrhosis: a meta-analysis
Yifan Cui, Mingming Zhang, Jing Guo, Jin Jin, Haijiao Wang, Xinran Wang
Frontiers in Nutrition.2024;[Epub] CrossRef
Sarcopenia increases mortality risk in liver transplantation: a systematic review and meta-analysis
Konstantinos PROKOPIDIS, Marco AFFRONTI, Giuseppe D. TESTA, Andrea UNGAR, Emanuele CEREDA, Lee SMITH, Francesco PEGREFFI, Mario BARBAGALLO, Nicola VERONESE
Panminerva Medica.2024;[Epub] CrossRef
Sarcopenia evaluated by EASL/AASLD computed tomography-based criteria predicts mortality in patients with cirrhosis: A systematic review and meta-analysis
Elton Dajti, Susana G. Rodrigues, Federica Perazza, Luigi Colecchia, Giovanni Marasco, Matteo Renzulli, Giovanni Barbara, Francesco Azzaroli, Annalisa Berzigotti, Antonio Colecchia, Federico Ravaioli
JHEP Reports.2024; 6(8): 101113. CrossRef
Appendicular Skeletal Muscle Mass to Visceral Fat Area Ratio Predicts Hepatic Morbidities
Eugene Han, Yong-ho Lee, Sang Hoon Ahn, Bong-Soo Cha, Seung Up Kim, Byung-Wan Lee
Gut and Liver.2024; 18(3): 509. CrossRef
Alcohol-associated liver disease increases the risk of muscle loss and mortality in patients with cirrhosis
Tatsunori Hanai, Kayoko Nishimura, Shinji Unome, Takao Miwa, Yuki Nakahata, Kenji Imai, Atsushi Suetsugu, Koji Takai, Masahito Shimizu
Journal of Gastroenterology.2024; 59(10): 932. CrossRef
Muscle mass dynamics is independently associated with long-term liver-related mortality in patients with cirrhosis
Jiarui Zheng, Shuo Yang, Wenhui Ren, Juan Zhong, Xin Liu, Rui Han, Tingyang Wei, Changjie Tie, Yuteng Yang, Chengwu Hong, Bo Feng, Rui Huang
Heliyon.2024; 10(15): e35354. CrossRef
Accelerated muscle mass estimation from CT images through transfer learning
Seunghan Yoon, Tae Hyung Kim, Young Kul Jung, Younghoon Kim
BMC Medical Imaging.2024;[Epub] CrossRef
Psoas muscle index in sarcopenia following transjugular intrahepatic portosystemic shunt: A multicenter, retrospective study
Tongqiang Li, Ze Wang, Yang Liu, Liguo Dai, Xiaoli Zhu, Jiacheng Liu, Qikun Guo, Weijie Luo, Yaowei Bai, Wei Luo, Menglan Chu, Duiping Feng, Bin Xiong
Portal Hypertension & Cirrhosis.2024; 3(4): 173. CrossRef
Correspondence on Letter regarding “Impacts of muscle mass dynamics on prognosis of outpatients with cirrhosis”
Tae Hyung Kim, Young Kul Jung, Hyung Joon Yim
Clinical and Molecular Hepatology.2023; 29(1): 173. CrossRef
Letter regarding “Impacts of muscle mass dynamics on prognosis of outpatients with cirrhosis”
Do Seon Song, U Im Chang, Jin Mo Yang
Clinical and Molecular Hepatology.2023; 29(1): 165. CrossRef
Interaction between sarcopenia and nonalcoholic fatty liver disease
Sae Kyung Joo, Won Kim
Clinical and Molecular Hepatology.2023; 29(Suppl): S68. CrossRef
MAFLD might be better in identifying subjects with sarcopenia or cardiovascular risk than NAFLD: A nationwide study
Eugene Han, Ho Soo Chun, Yong‐ho Lee, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Byung‐Wan Lee, Eun Seok Kang, Bong‐Soo Cha, Sang Hoon Ahn, Seung Up Kim
Journal of Gastroenterology and Hepatology.2023; 38(9): 1598. CrossRef
Sarcopenia in cirrhosis: Prospects for therapy targeted to gut microbiota
Roman Maslennikov, Aliya Alieva, Elena Poluektova, Yury Zharikov, Andrey Suslov, Yana Letyagina, Ekaterina Vasileva, Anna Levshina, Evgenii Kozlov, Vladimir Ivashkin
World Journal of Gastroenterology.2023; 29(27): 4236. CrossRef
Pretransplant Functional Status Predicts Postoperative Morbidity and Mortality after Liver Transplantation in Patients with Cirrhosis
Myung Ji Goh, Jihye Kim, Won Hyuk Chang, Dong Hyun Sinn, Geum-Yeon Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik, Jong Man Kim, Wonseok Kang
Gut and Liver.2023; 17(5): 786. CrossRef

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Artificial intelligence, epidemiology, methodology, or others

Serum milk fat globule-EGF factor 8 protein as a potential biomarker for metabolic syndrome: Han Ah Lee, Jihwan Lim, Hyung Joon Joo, Young-Sun Lee, Young Kul Jung, Ji Hoon Kim, Hyunggin An, Hyung Joon Yim, Yoon Tae Jeen, Jong Eun Yeon, Do-Sun Lim, Kwan Soo Byun, Yeon Seok Seo; Clin Mol Hepatol 2021;27(3):463-473.
Published online February 15, 2021; DOI: https://doi.org/10.3350/cmh.2020.0351

Background/Aims
Useful biomarkers for metabolic syndrome have been insufficient. We investigated the performance of serum milk fat globule-EGF factor-8 (MFG-E8), the key mediator of inflammatory pathway, in diagnosis of metabolic syndrome.
Methods
Subjects aged between 30 and 64 years were prospectively enrolled in the Seoul Metabolic Syndrome cohort. Serum MFG-E8 levels were measured at baseline.
Result
s: A total of 556 subjects were included, comprising 279 women (50.2%) and 277 men (49.8%). Metabolic syndrome was diagnosed in 236 subjects (42.4%), and the mean MFG-E8 level of subjects with metabolic syndrome was significantly higher than that of subjects without metabolic syndrome (P<0.001). MFG-E8 level was significantly correlated with all metabolic syndrome components and pulse wave velocity (all P<0.05). Subjects were categorized into two groups according to the best MFG-E8 cut-off value as follows: group 1, MFG-E8 level <4,745.1 pg/mL (n=401, 72.1%); and group 2, MFG-E8 level ≥4,745.1 (n=155, 27.9%). At baseline, metabolic syndrome in group 2 was significantly more prevalent than in group 1 (63.9% vs. 34.2%, P<0.001). During median follow-up of 17 months, metabolic syndrome developed in 122 (38.1%) subjects among 320 subjects without it at baseline. The incidence of metabolic syndrome in group 2 was significantly higher than that in group 1 (55.4% vs. 34.5%, P=0.003). On multivariate analysis, MFG-E8 level ≥4,745.1 pg/mL was an independent predictor for diagnosis and development of metabolic syndrome after adjusting other factors (all P<0.05).
Conclusions
Serum MFG-E8 level is a potent biomarker for the screening and prediction of metabolic syndrome.

Citations

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Dan Li, Wang Rongchun, Weihong Lu, Ying Ma
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Volodymyr P. Tryndyak, Rose A. Willett, Zhuolin Song, Kostiantyn Dreval, Jennifer M. Hughes Hanks, Mark I. Avigan, Fred A. Wright, Frederick A. Beland, Ivan Rusyn, Igor P. Pogribny
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Elevated circulating HHIP levels in patients with metabolic syndrome
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Editorial

Viral hepatitis

Does the old-fashioned sofosbuvir plus ribavirin treatment in genotype 2 chronic hepatitis C patients still works for Koreans?: Jong Eun Yeon; Clin Mol Hepatol 2018;24(3):294-296.
Published online September 11, 2018; DOI: https://doi.org/10.3350/cmh.2018.1009

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Real-Life Effectiveness and Safety of Glecaprevir/Pibrentasvir for Korean Patients with Chronic Hepatitis C at a Single Institution
Young Joo Park, Hyun Young Woo, Jeong Heo, Sang Gyu Park, Young Mi Hong, Ki Tae Yoon, Dong Uk Kim, Gwang Ha Kim, Hyung Hoi Kim, Geun Am Song, Mong Cho
Gut and Liver.2021; 15(3): 440. CrossRef
Critical View on the Usage of Ribavirin in Already Existing Psychostimulant-Use Disorder
Branka Petković, Srđan Kesić, Vesna Pešić
Current Pharmaceutical Design.2020; 26(4): 466. CrossRef

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Review

Viral hepatitis

Recent update of the 2017 Korean Association for the Study of the Liver (KASL) treatment guidelines of chronic hepatitis C: Comparison of guidelines from other continents, 2017 AASLD/IDSA and 2016 EASL: Jong Eun Yeon; Clin Mol Hepatol 2018;24(3):278-293.
Published online May 2, 2018; DOI: https://doi.org/10.3350/cmh.2018.1002

Abstract
PDF

The paradigm for the treatment of chronic hepatitis C (CHC) has been changed due to the development of direct acting antivirals (DAAs) of hepatitis C virus (HCV). The high sustained virologic response rate and ease of administration makes the DAAs approach ideal to contribute to the complete eradication of HCV. Currently, treatment options for individual patients vary depending on the genotype or subtype of HCV, presence or absence of liver cirrhosis, previous experience of antiviral treatment or resistance associated substitutions. Because of drug avalilability, cost-effectiveness, preference, compliance and greater possibility of desirable effects and presumed patient-important outcomes may vary between countries, treatment options for individual patients are different. The review focuses on the comparing the current treatment options for CHC in other continents with the 2017 Korea Association for the Study of the Liver guidelines.

Citations

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Consideration of ledipasvir/sofosbuvir as an alternative to glecaprevir/pibrentasvir based upon on-treatment FIB-4 changes and sustained virologic response at 12 weeks in hepatitis C genotype 1 and 2 infections: A propensity score-matched study
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Medicine.2025; 104(47): e46079. CrossRef
Evaluating long-term outcomes of direct-acting antiviral therapy in chronic hepatitis C: A retrospective study
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Chronic Hepatitis C Infection Treated with Direct-Acting Antiviral Agents and Occurrence/Recurrence of Hepatocellular Carcinoma: Does It Still Matter?
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Characterization of Incident Hepatitis C Virus Infection among People Living with HIV in a HIV Clinic in Korea
BumSik Chin, Yeonjae Kim, Gayeon Kim, Jaehyun Jeon, Min-Kyung Kim, Jae Yoon Jeong, Hyeokchoon Kwon, Seongwoo Nam
Infection & Chemotherapy.2024; 56(4): 544. CrossRef
Efficacy and safety of glecaprevir/pibrentasvir treatment in Koreans with chronic hepatitis C: A retrospective study
Byung Soo Kwan, Sung Min Kong, Sang Goon Shim, Kwang Min Kim, Gil Jong Yu, Jae Jin Lee, Jin Dong Kim
Arab Journal of Gastroenterology.2023; 24(2): 104. CrossRef
Real-life experience of ledipasvir and sofosbuvir for HCV infected Korean patients: a multicenter cohort study
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Real-world Effectiveness and Safety of Direct-acting Antiviral Agents in Patients with Chronic Hepatitis C Genotype 2 Infection: Korean Multicenter Study
Yeo Wool Kang, Yang Hyun Baek, Sung Wook Lee, Sung-Jae Park, Jun Sik Yoon, Ki Tae Yoon, Youngmi Hong, Nae-Yun Heo, Kwang Il Seo, Sang Soo Lee, Hyun Chin Cho, Jung Woo Shin
Journal of Korean Medical Science.2021;[Epub] CrossRef
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Jeong Heo, Yoon Jun Kim, Jin-Woo Lee, Ji Hoon Kim, Young-Suk Lim, Kwang-Hyub Han, Sook-Hyang Jeong, Mong Cho, Ki Tae Yoon, Si Hyun Bae, Eric D. Crown, Linda M. Fredrick, Negar Niki Alami, Armen Asatryan, Do Hyun Kim, Seung Woon Paik, Youn-Jae Lee
Gut and Liver.2021; 15(6): 895. CrossRef
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Pil Soo Sung, Eui-Cheol Shin
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Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals
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Comparison of the Clinical Characteristics and Outcomes between Leprosy-Affected Persons in Sorokdo and the General Population Affected by Chronic Hepatitis C in Korea
Young-Hwan Ahn, Hyungcheol Park, Myeon Jae Lee, Dong Hyun Kim, Sung Bum Cho, Eunae Cho, Chung Hwan Jun, Sung Kyu Choi
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Original Article

Liver fibrosis, cirrhosis, and portal hypertension

Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis: Dae Hoe Gu, Moon Young Kim, Yeon Seok Seo, Sang Gyune Kim, Han Ah Lee, Tae Hyung Kim, Young Kul Jung, Altay Kandemir, Ji Hoon Kim, Hyunggin An, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun, Soon Ho Um; Clin Mol Hepatol 2018;24(3):319-330.
Published online April 30, 2018; DOI: https://doi.org/10.3350/cmh.2017.0077

Abstract
PDF

Background/Aims
The most widely used method for diagnosing sarcopenia is the skeletal muscle index (SMI). Several studies have suggested that psoas muscle thickness per height (PMTH) is also effective for detecting sarcopenia and predicting prognosis in patients with cirrhosis. The aim of this study was to evaluate the optimal cutoff values of PMTH for detecting sarcopenia in cirrhotic patients.
Methods
All cirrhotic patients who underwent abdominal computed tomography (CT) scan including L3 and umbilical levels for measuring SMI and transverse psoas muscle thickness, respectively, were included. Two definitions of sarcopenia were used: (1) sex-specific cutoffs of SMI (≤52.4 cm² /m² in men and ≤38.5 cm² /m² in women) for SMI-sarcopenia and (2) cutoff of PMTH (<16.8 mm/m) for PMTH-sarcopenia.
Result
s: Six hundred fifty-three patients were included. The average age was 53.6 ± 10.2 years, and 499 patients (76.4%) were men. PMTH correlated well with SMI in both men and women (P<0.001). Two hundred forty-one (36.9%) patients met the criteria for SMI-sarcopenia. The best PMTH cutoff values for predicting SMI-sarcopenia were 17.3 mm/m in men and 10.4 mm/m in women, and these were defined as sex-specific cutoffs of PMTH (SsPMTH). The previously published cutoff of PMTH was defined as sex-nonspecific cutoff of PMTH (SnPMTH). Two hundred thirty (35.2%) patients were diagnosed with SsPMTH-sarcopenia, and 280 (44.4%) patients were diagnosed with SnPMTH-sarcopenia. On a multivariate Cox regression analysis, SsPMTH-sarcopenia (hazard ratio [HR], 1.944; 95% confidence interval [CI], 1.144–3.304; P=0.014) was significantly associated with mortality, while SnPMTH-sarcopenia was not (HR, 1.446; 95% CI, 0.861–2.431; P=0.164).
Conclusions
PMTH was well correlated with SMI in cirrhotic patients. SsPMTH-sarcopenia was an independent predictor of mortality in these patients and more accurately predicted mortality compared to SnPMTH-sarcopenia.

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Case Report

Hepatic neoplasm

Complete response of advanced hepatocellular carcinoma to sorafenib : another case and a comprehensive review: Tae Suk Kim, Ji Hoon Kim, Baek hui Kim, Young-Sun Lee, Yang Jae Yoo, Seong Hee Kang, Sang-June Suh, Young Kul Jung, Yeon Seok Seo, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun; Clin Mol Hepatol 2017;23(4):340-346.
Published online June 20, 2017; DOI: https://doi.org/10.3350/cmh.2016.0070

Abstract
PDF

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 hypervascular/portal-washout mass in the right lobe and invasion in the right portal vein. Twelve weeks after beginning sorafenib therapy, the AFP level was normalized and a CT scan showed a prominent decrease in the hepatic mass and a significant decrease in the volume of portal vein thrombosis (PVT). The patient received a right liver hemihepatectomy after 12 months. No viable tumor cells were found in the resected specimen, and there was no thrombotic obstruction of the portal vein. Twelve months later the patient showed no clinical evidence of HCC recurrence. This is the first case of CR in HCC treatment following sorafenib with histologically confirmed HCVrelated HCC without LC evidence, HCC with PVT, and a follow-up of longer than 12 months. This case seems to be an extremely unusual clinical outcome in advanced HCC.

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Dung Thi Nguyen, Duong Hoang Nguyen, Van Thi Hong Nguyen
Journal of International Medical Research.2023;[Epub] CrossRef
Automatic prediction of hepatic arterial infusion chemotherapy response in advanced hepatocellular carcinoma with deep learning radiomic nomogram
Ziming Xu, Chao An, Feng Shi, He Ren, Yuze Li, Song Chen, Jiaqi Dou, Yajie Wang, Shaozhen Yan, Jie Lu, Huijun Chen
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Junichi Arita, Akihiko Ichida, Rihito Nagata, Yuichiro Mihara, Yoshikuni Kawaguchi, Takeaki Ishizawa, Nobuhisa Akamatsu, Junichi Kaneko, Kiyoshi Hasegawa
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Kuo-Wei Huang, Pei-Chang Lee, Yee Chao, Chien-Wei Su, I-Cheng Lee, Keng-Hsin Lan, Chi-Jen Chu, Yi-Ping Hung, San-Chi Chen, Ming-Chih Hou, Yi-Hsiang Huang
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Dashuai Yang, Yang Su, Fangrui Zhao, Chen Chen, Kailiang Zhao, Xiangyun Xiong, Youming Ding
Frontiers in Oncology.2022;[Epub] CrossRef
Lenvatinib is independently associated with the reduced risk of progressive disease when compared with sorafenib in patients with advanced hepatocellular carcinoma
Soojin Kim, Kyung Hyun Kim, Beom Kyung Kim, Jun Yong Park, Sang Hoon Ahn, Do Young Kim, Seung Up Kim
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Outcomes of reduction hepatectomy combined with postoperative multidisciplinary therapy for advanced hepatocellular carcinoma
Yoh Asahi, Toshiya Kamiyama, Tatsuhiko Kakisaka, Tatsuya Orimo, Shingo Shimada, Akihisa Nagatsu, Takeshi Aiyama, Yuzuru Sakamoto, Hirofumi Kamachi, Akinobu Taketomi
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Tetsushi MIZUTANI, Mizuo HASHIMOTO, Hiroaki USUI, Tomoki KOBAYASHI, Motonobu NISHIMURA, Kenji SAKAGUCHI
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2021; 82(3): 635. CrossRef
Modeling Hepatocellular Carcinoma Cells Dynamics by Serological and Imaging Biomarkers to Explain the Different Responses to Sorafenib and Regorafenib
Piero Colombatto, Coskun Ozer Demirtas, Gabriele Ricco, Luigi Civitano, Piero Boraschi, Paola Scalise, Daniela Cavallone, Filippo Oliveri, Veronica Romagnoli, Patrizia Bleve, Barbara Coco, Antonio Salvati, Lucio Urbani, Ferruccio Bonino, Maurizia Rossana
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Akane Kurosugi, Tetsuhiro Chiba, Terunao Iwanaga, Hidemi Unozawa, Takafumi Sakuma, Naoto Fujita, Kengo Kanayama, Hiroaki Kanzaki, Keisuke Koroki, Kazufumi Kobayashi, Soichiro Kiyono, Ryo Nakagawa, Naoya Kanogawa, Masato Nakamura, Takayuki Kondo, Tomoko Sa
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Alessandra Bertacco, Alessandro Vitale, Claudia Mescoli, Umberto Cillo
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Original Articles

Liver fibrosis, cirrhosis, and portal hypertension

Cyanoacrylate injection versus band ligation for bleeding from cardiac varices along the lesser curvature of the stomach: Sang Jung Park, Yong Kwon Kim, Yeon Seok Seo, Seung Woon Park, Han Ah Lee, Tae Hyung Kim, Sang Jun Suh, Young Kul Jung, Ji Hoon Kim, Hyunggin An, Hyung Joon Yim, Jae Young Jang, Jong Eun Yeon, Kwan Soo Byun; Clin Mol Hepatol 2016;22(4):487-494.
Published online December 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0050

Abstract
PDF

Background/Aims
Practice guidelines recommend endoscopic band ligation (EBL) and endoscopic variceal obturation (EVO) for bleeding from esophageal varices and fundal varices, respectively. However, the optimal treatment for bleeding from cardiac varices along the lesser curvature of the stomach (GOV1) remains undefined. This retrospective study compared the efficacy between EBL and EVO for bleeding from GOV1.
Methods
Patients treated by EBL or EVO via cyanoacrylate injection for bleeding from GOV1 were enrolled. Patients diagnosed with hepatocellular carcinoma or treated with endoscopic injection sclerotherapy were excluded.
Result
s: The study included 91 patients treated for bleeding from GOV1. The mean age was 56.3±10.9 years (mean±SD), and 78 of them (85.7%) were men. Overall, 51 and 40 patients were treated with EBL and EVO, respectively. A trend for a higher hemostasis rate was noted in the EVO group (100%) than in the EBL group (82.6%, P=0.078). Varices rebled in 15 patients during follow-up. The rebleeding rate was significantly higher in the EBL group than in the EVO group (P=0.004). During follow-up, 13 patients died (11 in the EBL group and 2 in the EVO group); the survival rate was marginally significant between two groups (P=0.050). The rebleeding-free survival rate was significantly higher in the EVO group than in the EBL group (P=0.001).
Conclusions
Compared to EBL, EVO offered significantly lower rebleeding rates, significantly higher rebleeding-free survival rates, and a trend for higher hemostasis and survival rates. EVO appears to be the better therapeutic option for bleeding from GOV1.

Citations

Citations to this article as recorded by

Endoscopic management of acute esophagogastric variceal bleeding: recent advances
Xinhui Li, Jing Wang, Qun Li, Wenbo Li, Xingshun Qi, Xiaofeng Liu
Therapeutic Advances in Gastroenterology.2026;[Epub] CrossRef
Short-term efficacy and safety of endoscopic injection of low dose of sclerotherapy and cyanoacrylate injection for type GOV1 gastric varices combined with endoscopic variceal ligation for esophageal varices
Tingting Zhang, Chuangyang Xin, Xueyun Guo, Sihai Chen, Xuelian Zheng, Wen Xu, Dongjing Zhang, Biming Li, Ye Chen, Xuan Zhu, Anjiang Wang
Surgical Endoscopy.2025; 39(1): 280. CrossRef
Emergency Plug-Assisted Retrograde Transvenous Obliteration for Active Bleeding from Ruptured Gastric Varices
Eunbyeol Ko, Jeongyeon Kim, Dong Il Gwon, Hee Ho Chu, Gun Ha Kim, Gi-Young Ko
Journal of Vascular and Interventional Radiology.2025; 36(6): 994. CrossRef
A randomized controlled trial comparing large-volume band ligator and cyanoacrylate injection in the endoscopic management of actively bleeding gastric varices
Ding Shi, Guojing Xu, Weijin Pan
Scientific Reports.2025;[Epub] CrossRef
Evaluation of the efficacy and safety of endoscopic band ligation in the treatment of bleeding from mild to moderate gastric varices type 1
Yue Deng, Ya Jiang, Tong Jiang, Ling Chen, Hai-Jun Mou, Bi-Guang Tuo, Guo-Qing Shi
World Journal of Gastroenterology.2024; 30(5): 440. CrossRef
Gastric variceal obstruction improves the efficacy of endoscopic management of esophageal variceal bleeding in GOV type I
Xiaoquan Huang, Detong Zou, Huishan Wang, Wei Chen, Lili Zhang, Feng Li, Lili Ma, Chunqing Zhang, Ying Chen, Shiyao Chen
Endoscopy International Open.2024; 12(08): E940. CrossRef
Aluminum phosphate gel reduces early rebleeding in cirrhotic patients with gastric variceal bleeding treated with histoacryl injection therapy
Hao-Tian Zeng, Zhu-Liang Zhang, Xi-Min Lin, Min-Si Peng, Li-Sheng Wang, Zheng-Lei Xu
World Journal of Gastrointestinal Endoscopy.2023; 15(3): 153. CrossRef
A case report of an endoscopic approach to life‐threatening cecal variceal hemorrhage
Kirsty E MacFarlane, Nicholas J Fischer
JGH Open.2022; 6(4): 277. CrossRef
Endoscopic variceal obturation and retrograde transvenous obliteration for acute gastric cardiofundal variceal bleeding in liver cirrhosis
Han Ah Lee, Jungwon Kwak, Sung Bum Cho, Young-Sun Lee, Young Kul Jung, Ji Hoon Kim, Seung Up Kim, Hyonggin An, Hyung Joon Yim, Jong Eun Yeon, Yeon Seok Seo
BMC Gastroenterology.2022;[Epub] CrossRef
Diagnosis and Management of Esophageal and Gastric Variceal Bleeding: Focused on 2019 KASL Clinical Practice Guidelines for Liver Cirrhosis
Min Kyung Park, Yun Bin Lee
The Korean Journal of Gastroenterology.2021; 78(3): 152. CrossRef
Endoscopic Removal of Inflated Transected Sengstaken–Blakemore Tube Using Endoscopic Scissors
Jun Ho Lee, Eu-Kwon Hwang, Chanmesa Doeun, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Clinical Endoscopy.2019; 52(2): 182. CrossRef
Prevention and management of gastroesophageal varices
Yeon Seok Seo
Clinical and Molecular Hepatology.2018; 24(1): 20. CrossRef
The Choice of Interventional Treatment of Gastric Variceal Hemorrhage: What Is Better?
Moon Young Kim
Gut and Liver.2018; 12(6): 611. CrossRef
Endoscopic Therapy for Variceal Bleeding: from Patient Preparation to Available Techniques and Rescue Therapies
Philippe Sultanik, Dominique Thabut
Current Hepatology Reports.2017; 16(4): 398. CrossRef

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Viral hepatitis

Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B: Han Ah Lee, Yeon Seok Seo, Seung Woon Park, Sang Jung Park, Tae Hyung Kim, Sang Jun Suh, Young Kul Jung, Ji Hoon Kim, Hyunggin An, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun, Soon Ho Um; Clin Mol Hepatol 2016;22(3):382-389.
Published online September 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0047

Abstract
PDF

Background/Aims
Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV) off-treatment response.
Methods
This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg) at baseline, 56.8%; HBV DNA level, 6.8±1.3 log10 IU/mL) treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal.
Result
s: After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076–4.706; P=0.031). When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log₁₀ IU/mL (n=5), while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log₁₀ IU/mL (n=11) and >3 log₁₀ IU/mL (n=28), respectively.
Conclusions
The off-treatment HBsAg level is closely related to clinical relapse after treatment cessation. A serum HBsAg level of <2 log₁₀ IU/mL is an excellent predictor of a sustained off-treatment response in CHB patients who have received ETV for a sufficient duration.

Citations

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Takehisa Watanabe, Sanae Hayashi, Yasuhito Tanaka
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Arthrospira Enhances Seroclearance in Patients with Chronic Hepatitis B Receiving Nucleos(t)ide Analogue through Modulation of TNF-α/IFN-γ Profile
Sheng-Jie Shiue, Chao-Ling Cheng, Han-Shiang Shiue, Chun-Nan Chen, Sheng-Wei Cheng, Li-Wei Wu, Ganbolor Jargalsaikhan, Tze-Sian Chan, Hsin-Yi Lin, Ming-Shun Wu
Nutrients.2022; 14(14): 2790. CrossRef
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Niraj James Shah, Mark M Aloysius, Neil Rohit Sharma, Kumar Pallav
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Samuel Anthony Lachlan Hall, Sara Vogrin, Olivia Wawryk, Gareth S Burns, Kumar Visvanathan, Vijaya Sundararajan, Alexander Thompson
Gut.2021; : gutjnl-2020-323979. CrossRef
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Niraj James Shah, Mark M Aloysius, Neil Rohit Sharma, Kumar Pallav
World Journal of Gastrointestinal Pharmacology and Therapeutics.2021; 12(4): 56. CrossRef
Risks and Benefits of Discontinuation of Nucleos(t)ide Analogue Treatment: A Treatment Concept for Patients With HBeAg‐Negative Chronic Hepatitis B
Florian van Bömmel, Thomas Berg
Hepatology Communications.2021; 5(10): 1632. CrossRef
Improving the Prediction of Relapse After Nucleos(t)ide Analogue Discontinuation in Patients With Chronic Hepatitis B
Do Seon Song, Jeong Won Jang, Sun Hong Yoo, Jung Hyun Kwon, Soon Woo Nam, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon
Clinical Infectious Diseases.2021; 73(4): e892. CrossRef
Emerging Diagnostic Tools to Decide When to Discontinue Nucleos(t)ide Analogues in Chronic Hepatitis B
Margarita Papatheodoridi, George Papatheodoridis
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The Yin and the Yang of Treatment for Chronic Hepatitis B—When to Start, When to Stop Nucleos(t)ide Analogue Therapy
Samuel Hall, Jessica Howell, Kumar Visvanathan, Alexander Thompson
Viruses.2020; 12(9): 934. CrossRef
Comparison of clinical practice guidelines for the management of chronic hepatitis B: When to start, when to change, and when to stop
Hyung Joon Yim, Ji Hoon Kim, Jun Yong Park, Eileen L. Yoon, Hana Park, Jung Hyun Kwon, Dong Hyun Sinn, Sae Hwan Lee, Jeong-Hoon Lee, Hyun Woong Lee
Clinical and Molecular Hepatology.2020; 26(4): 411. CrossRef
Efficacy of 104-week Telbivudine-based optimization strategy in patients with HBeAg-negative chronic hepatitis B virus infections
Weiqiang Gan, Jianguo Li, Chunlan Zhang, Xuefu Chen, Chaoshuang Lin, Zhiliang Gao
BMC Infectious Diseases.2020;[Epub] CrossRef
Immunological biomarkers as indicators for outcome after discontinuation of nucleos(t)ide analogue therapy in patients with HBeAg‐negative chronic hepatitis B
Hariklia Kranidioti, Spilios Manolakopoulos, George Kontos, Michael S. Breen, Anastasia Kourikou, Melanie Deutsch, Maria Ester Quesada‐Del‐Bosque, Rocio T. Martinez‐Nunez, Mohammed M. Naiyer, Christopher H. Woelk, Tilman Sanchez‐Elsner, Emilia Hadziyannis
Journal of Viral Hepatitis.2019; 26(6): 697. CrossRef
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New Biomarkers of Chronic Hepatitis B
Lung-Yi Mak, Wai-Kay Seto, James Fung, Man-Fung Yuen
Gut and Liver.2019; 13(6): 589. CrossRef
Stopping long‐term treatment with nucleos(t)ide analogues is a favourable option for selected patients with HBeAg‐negative chronic hepatitis B
Florian van Bömmel, Thomas Berg
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An expert consensus for the management of chronic hepatitis B in Asian Americans
M. J. Tong, C. Q. Pan, S.‐H. B. Han, D. S.‐K. Lu, S. Raman, K.‐Q. Hu, J. K. Lim, H. W. Hann, A. D. Min
Alimentary Pharmacology & Therapeutics.2018; 47(8): 1181. CrossRef

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Case Report

Hepatic neoplasm

A case of necrotizing pancreatitis subsequent to transcatheter arterial chemoembolization in a patient with hepatocellular carcinoma: Song-I Bae, Jong Eun Yeon, Jong Mee Lee, Ji Hoon Kim, Hyun Jung Lee, Sun Jae Lee, Sang Jun Suh, Eileen L. Yoon, Hae Rim Kim, Kwan Soo Byun, Tae-Seok Seo; Korean J Hepatol 2012;18(3):321-325.
Published online September 25, 2012; DOI: https://doi.org/10.3350/cmh.2012.18.3.321

Abstract
PDF

Necrotizing pancreatitis is one of the rare complications of transcatheter arterial chemoembolization (TACE). Necrotizing pancreatitis after TACE may result from the development of ischemia caused by regurgitation of embolic materials into the vessels supplying the pancreas. We report a case of post-TACE necrotizing pancreatitis with abscess formation in a patient with hepatocellular carcinoma. The patient had suffered hepatic artery injury due to repetitive TACE; during his 25th TACE procedure he had submitted to selective catheterization of the feeding vessel from the dorsal pancreatic artery with a cytotoxic agent and Gelfoam particles. The patient complained of abdominal pain after the TACE procedure, and a CT scan led to a diagnosis of necrotizing pancreatitis with abscess formation. The pancreatic abscess progressed despite general management of the pancreatitis, including antibiotics. Percutaneous catheter drainage was performed, and the symptoms of the patient improved.

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Malkhaz Mizandari, Tamta Azrumelashvili, Nino Toria, Nino Nanava, Ia Pantsulaia, Nino Kikodze, Nona Janikashvili, Tinatin Chikovani
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Serkan Öcal, Nuretdin Suna, Digdem Özer Etik, Fatih Boyvat, Haldun Selcuk
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Xiao Jing Wang, Navtej Buttar, Andrew C. Storm
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Pancreas lipiodol embolism induced acute necrotizing pancreatitis following transcatheter arterial chemoembolization for hepatocellular carcinoma
Youwen Tan, Jianhui Sheng, Huiying Tan, Jianzhong Mao
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Sai Pavan Chintalapati, Arpan Patel, Hari Conjeevaram
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Takashi Yamaguchi, Toshihito Seki, Atsushi Komemushi, Kanehiko Suwa, Rinako Tsuda, Ryosuke Inokuchi, Miki Murata, Michiko Yuki, Yoko Harima, Kazuichi Okazaki
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66 Download
Crossref

Original Article

Virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis B patients: Young Kul Jung, Jong Eun Yeon, Kwang Gyun Lee, Eun Seok Jung, Jeong Han Kim, Ji Hoon Kim, Yeon Seok Seo, Hyung Joon Yim, Sun Ho Um, Ho Sang Ryu, Kwan Soo Byun; Korean J Hepatol 2011;17(4):261-267.
Published online December 26, 2011; DOI: https://doi.org/10.3350/kjhep.2011.17.4.261

Abstract
PDF

Background/Aims

We investigated the durability of the biochemical and virologic responses after adefovir (ADV) discontinuation in lamivudine-resistant (LMV-R) chronic hepatitis B (CHB) patients, and the outcomes of ADV discontinuation compared to that of ADV maintenance.

Methods

The indication for ADV treatment cessation was an undetectable level of hepatitis B virus (HBV) DNA documented on two occasions at least 6 months apart. All patients received additional ADV for at least 12 months after the confirmation of undetectable HBV DNA (Cobas TaqMan PCR assay, <70 copies/mL). Of 36 patients who had a sufficient ADV therapeutic effect, 19 discontinued ADV treatment, while the others maintained it. A virologic rebound was arbitrarily defined as the redetection of HBV DNA at a level higher than 10⁵ copies/mL.

Results

In the ADV discontinuation group, ADV treatment and additional therapy were administered for medians of 33 months (range, 12-47 months) and 18 months, respectively. The patients were followed for a median of 12 months (range, 3-30 months) after ADV cessation. During that period, 18 of 19 patients (95%) experienced viral relapse. Viral rebound was observed in six patients (32%). However, 12 of 18 patients (67%) exhibited serum HBV DNA levels of less than 10⁵ copies/mL. Biochemical relapses were observed in four of the six patients with viral rebound. In the ADV maintenance group, patients were treated for a median of 53 months (range, 31-85 months), and 9 patients (53%) experienced viral breakthrough.

Conclusions

During short-term follow-up after ADV discontinuation, most patients (95%) exhibited viral relapse, whereas and viral breakthrough occurred in about half of patients (53%) maintained on ADV therapy. Therefore, the durability of virologic response after ADV discontinuation in LMV-R patients was unsatisfactory. In addition, and viral breakthrough was not infrequent in the ADV continuation group.

Citations

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Systematic review: Clinical outcomes of discontinuation of oral antivirals in hepatitis B-related liver cirrhosis
Yuhao Yao, Jiaxin Zhang, Xiaoke Li, Xiaobin Zao, Xu Cao, Guang Chen, Yong'an Ye
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Issam Tout, Pietro Lampertico, Thomas Berg, Tarik Asselah
Antiviral Research.2021; 185: 104992. CrossRef
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Apichat Kaewdech, Pimsiri Sripongpun
World Journal of Hepatology.2021; 13(9): 1042. CrossRef
Risks and Benefits of Discontinuation of Nucleos(t)ide Analogue Treatment: A Treatment Concept for Patients With HBeAg‐Negative Chronic Hepatitis B
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Stopping long‐term treatment with nucleos(t)ide analogues is a favourable option for selected patients with HBeAg‐negative chronic hepatitis B
Florian van Bömmel, Thomas Berg
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Why not to stop antiviral treatment in patients with chronic hepatitis B
Sebastián Marciano, Adrián Gadano
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