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대한간학회> Clinical and Molecular Hepatology(대한간학회지)

Clinical and Molecular Hepatology(대한간학회지) update

Clinical and Molecular Hepatology (CMH)

  • : 대한간학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCI,SCOPUS
  • : 연속간행물
  • : 계간
  • : 2287-2728
  • : 2287-285x
  • : 대한간학회지()→Korean Journal of Hepatology(2004~)→대한간학회지(2012~)

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수록범위 : 1권1호(1995)~27권2호(2021) |수록논문 수 : 4,715
Clinical and Molecular Hepatology(대한간학회지)
27권2호(2021년 04월) 수록논문
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KCI등재 SCI SCOPUS

1Evaluation and management of extrahepatic manifestations of nonalcoholic fatty liver disease

저자 : Karn Wijarnpreecha , Elizabeth S. Aby , Aijaz Ahmed , Donghee Kim

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 2호 발행 연도 : 2021 페이지 : pp. 221-235 (15 pages)

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Nonalcoholic fatty liver disease (NAFLD) is a multisystemic disease and a rapidly growing cause of chronic liver disease in children and adults worldwide. Diagnosis and management of extrahepatic manifestations of NAFLD, including cardiovascular disease (CVD), type 2 diabetes mellitus, metabolic syndrome, chronic kidney disease, obstructive sleep apnea, polycystic ovarian syndrome, hypothyroidism, psoriasis, and extrahepatic malignancy are crucial for the treatment of patients with NAFLD. The leading cause of death in NAFLD is primarily from CVD, followed by liver-related mortality, extrahepatic cancer, liver cancer, and diabetes-related mortality. Therefore, clinicians need to identify high-risk patients earlier in the disease course and be aware of the extrahepatic manifestations of NAFLD to improve liver disease outcomes. In this review, we focus on the monitoring and management of the extrahepatic manifestations of NAFLD. (Clin Mol Hepatol 2021;27:221-235)

KCI등재 SCI SCOPUS

2Optimizing the management of intermediate-stage hepatocellular carcinoma: Current trends and prospects

저자 : Takuji Torimura , Hideki Iwamoto

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 2호 발행 연도 : 2021 페이지 : pp. 236-245 (10 pages)

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Hepatocellular carcinoma (HCC) is usually accompanied by chronic liver damage, which sometimes influences the selection of HCC treatment. The Barcelona Clinic Liver Cancer (BCLC) staging system, which was first introduced in 1999, is the most commonly used worldwide. Although the intermediate-stage (BCLC stage B) includes the largest number and heterogeneous HCC patients, the recommended treatment option is transarterial chemoembolization (TACE) only. However, recent progress in radical treatments such as hepatic resection, liver transplantation, radiation therapy, and percutaneous therapy has made it possible to treat selected patients with BCLC stage B HCC. Radical treatments are expected to prolong survival time. To-date, TACE has also progressed. In addition to conventional TACE, balloon-occluded TACE and drug-eluting beads TACE are available. These new modalities of TACE will improve therapeutic efficacy and reduce adverse events. One of the most serious concerns of TACE is that repeated TACE reduces the treatment effect and induces liver function impairment. The decision on when TACE should be interrupted is complex. Many molecular targeted agents are now available, and immune checkpoint inhibitors will soon be available for HCC patients with Child- Pugh class A worldwide. Under these circumstances, in patients with TACE unsuitability, switching to molecular targeted agents before deterioration of liver function might improve the prognosis compared to repeated TACE. We should pay attention to stop TACE in TACE-unsuitable HCC patients as it can induce the deterioration of liver function. (Clin Mol Hepatol 2021;27:236-245)

KCI등재 SCI SCOPUS

3Current and future strategies for the treatment of chronic hepatitis C

저자 : Omar Alshuwaykh , Paul Y. Kwo

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 2호 발행 연도 : 2021 페이지 : pp. 246-256 (11 pages)

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Chronic hepatitis C infection is a major cause of liver disease and hepatocellular carcinoma worldwide. While hepatitis C has been treated for decades with some success, the introduction of direct acting antiviral agents has revolutionized the treatment of hepatitis C with finite, highly effective, well-tolerated therapy and there are few populations that cannot be successfully treated now or are complicated to manage. The World Health Organization has released elimination targets in an effort to eliminate viral hepatitis and reduce dramatically the morbidity and mortality caused by both viral hepatitis. While hepatitis C is straightforward to treat, it remains problematic to eliminate on a global scale. Diagnosis of hepatitis C remains the major gap in the cascade of care and numerous screening strategies will be required to reduce this gap. While historically, treatment of hepatitis C has been centralized, decentralized approaches will be required to diagnose, evaluate, and link to care the large population of individuals worldwide with hepatitis C across low-, middle-, and high-income countries. With the introduction of multiple pangenotypic treatment options and reduced cost for these therapies, assessment and treatment for those with hepatitis C has been simplified and made more accessible worldwide. There are multiple populations for whom care models are being developed and refined, including those when inject drugs, those who are incarcerated, those who present with sexually transmitted disease including the men who have sex with men population, amongst many others. While a vaccine for hepatitis C remains elusive these efforts continue. Multiple successful elimination efforts have been reported. (Clin Mol Hepatol 2021;27:246-256)

KCI등재 SCI SCOPUS

4From nonalcoholic fatty liver disease to metabolic-associated fatty liver disease: Big wave or ripple?

저자 : Seong Hee Kang , Yuri Cho , Soung Won Jeong , Seung Up Kim , Jin-woo Lee

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 2호 발행 연도 : 2021 페이지 : pp. 257-269 (13 pages)

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There is some dissatisfaction with the term “nonalcoholic fatty liver disease (NAFLD),” which overemphasizes alcohol and underemphasizes the importance of metabolic risk factors in this disease. Recently, a consensus recommended “metabolic (dysfunction)-associated fatty liver disease (MAFLD)” as a more appropriate term to describe fatty liver diseases (FLD) associated with metabolic dysfunction. During the definition change from NAFLD to MAFLD, subjects with FLD and metabolic abnormalities, together with other etiologies of liver diseases such as alcohol, virus, or medication who have been excluded from the NAFLD criteria, were added to the MAFLD criteria, while subjects with FLD but without metabolic abnormality, who have been included in the NAFLD criteria, were excluded from the MAFLD criteria. This means that there is an emphasis on the metabolic dysfunction in MAFLD which may underestimate the prognostic value of hepatic steatosis itself, whereas the MAFLD criteria might better identify subjects who are at a higher risk of hepatic or cardiovascular outcomes. However, non-metabolic risk NAFLD subjects who are excluded from the MAFLD criteria are missed from the diagnosis, and their potential risk can be the cause of future diseases. Although huge controversies remain, this review focused on summarizing recent studies that compared the clinical and prognostic characteristics between subjects with NAFLD and MAFLD. (Clin Mol Hepatol 2021;27:257-269)

KCI등재 SCI SCOPUS

5A need for patient-centered care in managing patients with liver cirrhosis

저자 : Eileen L. Yoon

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 2호 발행 연도 : 2021 페이지 : pp. 270-272 (3 pages)

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KCI등재 SCI SCOPUS

6Negligible risk of hepatocellular carcinoma in chronic hepatitis B patients in immune-tolerant phase: Myth or fact

저자 : Terry Cheuk-fung Yip , Grace Lai-hung Wong , Vincent Wai-sun Wong

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 2호 발행 연도 : 2021 페이지 : pp. 273-277 (5 pages)

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KCI등재 SCI SCOPUS

7Biopsy or cytology for diagnosing hepatic focal lesions?

저자 : Haeryoung Kim

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 2호 발행 연도 : 2021 페이지 : pp. 278-280 (3 pages)

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KCI등재 SCI SCOPUS

8Another oral antiviral treatment, but still far away from hepatitis B virus cure

저자 : Tai-chung Tseng

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 2호 발행 연도 : 2021 페이지 : pp. 281-282 (2 pages)

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KCI등재 SCI SCOPUS

9Association between new-onset liver cirrhosis and suicide risk in South Korea: A nationwide cohort study

저자 : Suk-yong Jang , Woo Sun Rou , Seok Hyun Kim , Byung Seok Lee , Hyuk Soo Eun

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 2호 발행 연도 : 2021 페이지 : pp. 283-294 (12 pages)

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Background/Aims: Current evidence suggests that liver cirrhosis (LC) causes severe psychological stress and depression, which are risk factors for suicide. Although previous studies reported the association between LC and suicidal thoughts, little is known of its effect on suicidal deaths. Therefore, this study was undertaken to investigate the effect of new-onset LC on suicide.
Methods: From the National Health Insurance Service-National Sample Cohort of South Korea, 5,809 incident LC patients and 11,618 risk-set controls matched by propensity score were selected for follow-up. The incidence rate of suicide was estimated using a generalized estimating equation with a Poisson distribution. Effect size was presented as a hazard ratio (HR) using Cox's proportional hazards model.
Results: The incidence rate of suicide was 143.3 cases per 100,000 person years (95% confidence interval [CI], 100.2-205.1) among the LC cohort. The LC patients were 2.37 times more likely to commit suicide compared with matched controls (HR, 2.37; 95% CI, 1.44-3.88). Increased suicide risk was evident within the first 2 years of the follow-up period (HR, 2.59; 95% CI, 1.20-5.60) and among the 18-49-year-old age group (HR, 3.72; 95% CI, 1.45-9.56).
Conclusions: Our study found increased risk of suicide in patients with new onset LC, especially during the early period following diagnosis and in younger patients. To decrease this suicide risk, a regular and continuous social support system is required. (Clin Mol Hepatol 2021;27:283-294)

KCI등재 SCI SCOPUS

10Negligible risks of hepatocellular carcinoma during biomarker-defined immune-tolerant phase for patients with chronic hepatitis B

저자 : Mi Young Jeon , Beom Kyung Kim , Jae Seung Lee , Hye Won Lee , Jun Yong Park , Do Young Kim , Sang Hoon Ahn , Kwang-hyub Han , Seung Up Kim

발행기관 : 대한간학회 간행물 : Clinical and Molecular Hepatology(대한간학회지) 27권 2호 발행 연도 : 2021 페이지 : pp. 295-304 (10 pages)

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Background/Aims: The immune-tolerant (IT) phase of chronic hepatitis B (CHB) patients is not generally indicative of antiviral therapy (AVT). We assessed and compared the risk of hepatocellular carcinoma (HCC) during the IT-phase stringently defined by a low fibrosis-4 (FIB-4) index, compared to that in patients undergoing AVT.
Methods: Among 125 untreated patients that were hepatitis B e-antigen positive, hepatitis B virus-DNA >20,000 IU/mL, with normal alanine aminotransferase level from 2012 to 2018, those with a FIB-4 index of <1.45 were classified into the IT-group. The cumulative probability of HCC was estimated using Kaplan-Meier analysis. All patients were assessed until HCC development (intention-to-treat [ITT] analysis), whereas those suspected of experiencing CHB phase switch were assessed using the per-protocol (PP) and censored at the time of phase switch.
Results: The cumulative probability of HCC at 1-, 3-, and 5-years among the IT-group was zero, compared to AVT-treated patients with FIB-4 indices <1.45 during the same period: 0.2%, 0.6%, and 1.4%, respectively (P=0.264 for ITT and P=0.533 for PP). Among the initially screened 125 untreated patients, those with a FIB-4 index of ≥1.45 had a higher risk of HCC compared to the IT-group (P=0.005). Furthermore, among AVT-treated patients, those with a FIB-4 index of ≥1.45 had a higher risk of HCC compared to their counterpart (P<0.001).
Conclusions: The risk of HCC was negligible in the IT-group stringently defined by a low FIB-4 index. However, given that a higher HCC risk exists among untreated patients with higher FIB-4, appropriate criteria for AVT should be established. (Clin Mol Hepatol 2021;27:295-304)

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