Prediction of the risk of developing hepatocellular carcinoma in health screening examinees: a Korean cohort study.

BACKGROUND: Almost all Koreans are covered by mandatory national health insurance and are required to undergo health screening at least once every 2 years. We aimed to develop a machine learning model to predict the risk of developing hepatocellular carcinoma (HCC) based on the screening results and insurance claim data. METHODS: The National Health Insurance Service-National Health Screening database was used for this study (NHIS-2020-2-146). Our study cohort consisted of 417,346 health screening examinees between 2004 and 2007 without cancer history, which was split into training and test cohorts by the examination date, before or after 2005. Robust predictors were selected using Cox proportional hazard regression with 1000 different bootstrapped datasets. Random forest and extreme gradient boosting algorithms were used to develop a prediction model for the 9-year risk of HCC development after screening. After optimizing a prediction model via cross validation in the training cohort, the model was validated in the test cohort. RESULTS: Of the total examinees, 0.5% (1799/331,694) and 0.4% (390/85,652) in the training cohort and the test cohort were diagnosed with HCC, respectively. Of the selected predictors, older age, male sex, obesity, abnormal liver function tests, the family history of chronic liver disease, and underlying chronic liver disease, chronic hepatitis virus or human immunodeficiency virus infection, and diabetes mellitus were associated with increased risk, whereas higher income, elevated total cholesterol, and underlying dyslipidemia or schizophrenic/delusional disorders were associated with decreased risk of HCC development (p < 0.001). In the test, our model showed good discrimination and calibration. The C-index, AUC, and Brier skill score were 0.857, 0.873, and 0.078, respectively. CONCLUSIONS: Machine learning-based model could be used to predict the risk of HCC development based on the health screening examination results and claim data.

Prediction of organic pollutant removal using Corynebacterium glutamicum fermentation waste.

The disposal of bio-waste (e.g., Corynebacterium glutamicum) produced by the fermentation industry is a serious problem and has a negative impact on economic returns. Some fermentation waste can be recycled as livestock feed, but much cannot be used. Therefore, other recycling methods must be developed to increase its applications, for example, as an environmentally friendly adsorbent for the removal or recovery of chemicals. To broaden its application as an adsorbent, we carried out comprehensive experimental and theoretical analysis. From the experiments, adsorption affinity values between C. glutamicum and micropollutants were measured, and, based on the experimental values, we developed a predictive model. The experimental results reveal that the degree of adsorption is dependent on the structural properties of the micropollutants. In particular, the adsorbent has remarkable adsorption ability toward cations, whereas anionic and neutral compounds interact weakly with the adsorbent. In addition, we found that adsorption is affected by the sodium chloride concentration. Briefly, an increase in salt concentration increases the adsorption of anions, whereas the opposite behavior is observed for cations. In contrast, the adsorption of neutral compounds was not affected by the presence of salt. The modeling studies revealed that a linear free energy relationship model can be used to predict the adsorption affinity. Based on the developed model, we found that hydrogen-bond basicity, anionic coulombic interactions, and molecular volume are the main contributing factors to the adsorption model. However, to achieve the best predictability (a coefficient of determination (R2) of 0.902), additional parameters, such as the dipolarity/polarizability and dispersive interaction, should be included. This indicates that adsorption is a product of complex interactions.

Effect of Annealing Temperature on Morphology and Electrical Property of Hydrothermally-Grown ZnO Nanorods/p-Si Heterojunction Diodes.

In this study, ZnO nanorods (NRs) were synthesized using the hydrothermal method, and the effects of annealing temperature (150 °C-600 °C) on morphology, crystallinity, defects states of the NRs, and electrical property of the n-type ZnO NRs/p-type Si heterojunction diodes were investigated. No appreciable changes in the morphology and crystal structure of the ZnO NRs were observed with increasing annealing temperature up to 450 °C. As the temperature increased to 600 °C, the average length and diameter of the NRs decreased due to the partial melting and sintering in the NRs. From the X-ray photoelectron spectroscopy (XPS) results, the concentration of internal oxygen vacancies decreased with increasing annealing temperature to 450 °C due to thermal diffusion of oxygen vacancies to the surface. The electrical conductivity of the NRs increased to 450 °C, which was attributed to the increased crystallinity and low defects concentration (oxygen vacancy) in the NRs. Conversely, the electrical conductivity degraded at 600 °C due to the decreased effective contact area.

Facet Control of Subunits in Anatase TiO2 Mesocrystal by Diethanolamine for Enhanced Photocatalytic Activity.

Controllable TiO2 architectures with different facets play a key role in the adjustment of the surface area and charge recombination efficiency in photocatalysts. In this study, we synthesized anatase TiO2 mesocrystals with diethanolamine (DEA, 0-5 mM) as a nontoxic capping agent to control the facet of subunits using hydrothermal method, and determine the effect of DEA on subunits, by-products, and consequent photocatalytic performance of TiO2 mesocrystals. The pure TiO2 was spindle-like shaped mesocrystal having bipyramidal subunits with high portion of {101} facets. As DEA concentration was increased, the percentage of {001} exposed facet of subunits increased, but the number of subunits was gradually reduced. When a large amount of DEA (≥3 mM) was added, TiO2 exhibited single crystals rather than mesocrystal, probably because the long chain of DEA interfered with the oriented attachment of subunits. The photocatalytic activity of the TiO2 improved at 0.5 mM of DEA due to low charge recombination rate by increasing {001} facet. On the other hand, subsequent deterioration with further increase of DEA was attributed to the increased by-products and reduced the number of subunits despite the increase in specific surface area. These results imply that charge separation efficiency, rather than specific surface area, is highly responsible for the photocatalytic activity of TiO2.

Do hospital characteristics influence Cesarean delivery? Analysis of National Health Insurance claim data.

Background: The rates of Cesarean delivery in South Korea are high among the Organization for Economic Cooperation and Development countries. We analyzed the relationship between hospital characteristics, in particular hospital volume and market competition and Cesarean delivery. Methods: We used data from National Health Insurance claims (n = 53 591) at 51 hospitals to analyze the relationship between hospital characteristics and Cesarean delivery between 2010 and 2013. We performed logistic regression analysis using generalized estimating equations models that included both inpatient and hospital variables to examine factors associated with Cesarean delivery. Results: Among 53 591 hospitalization cases, 14 425 (26.9%) patients underwent Cesarean delivery. Hospital volumes for deliveries were inversely associated with Cesarean delivery (per increases 100 deliveries = OR 0.896, 95% CI 0.887-0.905). Market competition had inverse relationship with Cesarean delivery (per increase in 10 Hirschmann-Herfindal index points; OR 0.982, 95% CI 0.979-0.985). Conclusions: Our findings suggest that hospital characteristics affect Cesarean delivery. These situations might be caused by maintaining profit with regard to survival or competition, and protecting themselves against unexpected delivery risks. Therefore, based on our findings, health policy makers must make an effort to implement effective strategies for the optimal management of excessive Cesarean rates in South Korea.

Association between chronic disease and catastrophic health expenditure in Korea.

BACKGROUND: The prevalence and economic burden of chronic diseases are increasing worldwide. Nevertheless, little information is available on catastrophic health expenditures (CHE) associated with chronic diseases in Korea. This study explored the burden of household out-of-pocket health expenditures among the Korean population for different chronic diseases. METHODS: This study was conducted utilizing data collected from the 7,006 households that participated in the Korea Health Panel Survey (KHPS) in 2008. The effect of CHE in relation to type of chronic disease was assessed via multiple logistic regression analysis. RESULTS: Roughly 3.5% of the participating households experienced CHE. As opposed to households headed by females and middle-aged individuals (40-59 years), those of low economic status, elderly households, and households with a member who suffered from a chronic disease were more likely to experience CHE. According to type of chronic condition, households with a member who suffered from cerebrovascular disease, diabetes, or chronic kidney disease were at a significantly higher risk of experiencing CHE. CONCLUSION: Although Korea has greatly expanded its health insurance coverage, financial protection against CHE remains a concern. Policy-makers need to focus on expanding benefits according to the economic burden of individual chronic conditions.

Evolutionary kinetics of graphene formation on copper.

It has been claimed that graphene growth on copper by chemical vapor deposition is dominated by crystallization from the surface initially supersaturated with carbon adatoms, which implies that the growth is independent of hydrocarbon addition after the nucleation phase. Here, we present an alternative growth model based on our observations that oppose this claim. Our Gompertzian sigmoidal growth kinetics and secondary nucleation behavior support the postulate that the growth can be controlled by adsorption-desorption dynamics and the dispersive kinetic processes of catalytic dissociation and dehydrogenation of carbon precursors on copper.

Low-bias active control of terahertz waves by coupling large-area CVD graphene to a terahertz metamaterial.

We propose an hybrid graphene/metamaterial device based on terahertz electronic split-ring resonators directly evaporated on top of a large-area single-layer CVD graphene. Room temperature time-domain spectroscopy measurements in the frequency range from 250 GHz to 2.75 THz show that the presence of the graphene strongly changes the THz metamaterial transmittance on the whole frequency range. The graphene gating allows active control of such interaction, showing a modulation depth of 11.5% with an applied bias of 10.6 V. Analytical modeling of the device provides a very good qualitative and quantitative agreement with the measured device behavior. The presented system shows potential as a THz modulator and can be relevant for strong light-matter coupling experiments.

Simulation of a Multistaggered Baffle Scrubber to Enhance the Efficiency of Simultaneous Desulfurization and Denitrification.

In this study, we conduct simulation research on simultaneous desulfurization and denitrification in a multistaggered baffle spray scrubber. By employing two-phase flow simulations within the Euler-Lagrange framework and calculating the gas-liquid mass transfer rate with user-defined functions, we comprehensively analyzed the effects of various operational parameters. Initially, we validated our simulation model by comparing the simulation results with experimental data. Under conditions of a 0.2 mm droplet diameter, a liquid-to-gas ratio (L/G) of 12 L/m3, and a gas flow rate of 5 CMM using a full cone nozzle, the simulation indicated a desulfurization efficiency of 99.90 versus 99.84% obtained experimentally and a denitrification efficiency of 92.01 versus 90.67% obtained experimentally. This comparison confirmed the reliability of the simulation model. Our findings indicate that a droplet size of 2 mm is optimal, enhancing the desulfurization efficiency from 99.90 to 99.98% and the denitrification efficiency from 92.01 to 99.76%. However, when the droplet size exceeds 2 mm, efficiencies marginally decrease. Increasing the liquid-to-gas ratio to 16 L/m3 further improves desulfurization and denitrification efficiencies to 99.98 and 99.80%, respectively. In contrast, higher inlet flue gas flow rates reduce these efficiencies, with a decline observed from 100% to as low as 93.90% for denitrification with 2 mm droplets. Additionally, the use of a swirl cone nozzle, compared to full or hollow cone nozzles, better disperses droplets, enhancing the gas-liquid contact and achieving efficiencies of 99.99% for desulfurization and 99.81% for denitrification with 2 mm droplets. These insights are valuable for optimizing operational conditions in industrial-scale spray scrubbers, significantly contributing to mitigating the environmental impacts of industrial emissions.

Primary hepatic mucosa-associated lymphoid tissue lymphoma mimicking hepatocellular carcinoma in a patient with chronic hepatitis B: a case report.

Primary hepatic lymphoma is a rare disease, and primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma accounts for only 0.3% of all primary hepatic lymphomas. Herein, we report a case of primary hepatic MALT lymphoma in a male patient in his mid-40 s with chronic hepatitis B infection. The patient visited our department for further examination of a hepatic nodule initially visualized through abdominal pelvic computed tomography (CT). Based on imaging studies and elevated levels of tumor markers, the tumor was suspected to be hepatocellular carcinoma. A laparoscopic inferior sectionectomy (segment 5 and 6) was performed, and immunohistochemical staining revealed that the tumor was positive for CD20, B-cell lymphoma 2, pan-cytokeratin (CK), and CK19 markers. Pathological findings revealed it to be a primary hepatic MALT lymphoma. After surgery, bone marrow biopsies and fluorodeoxyglucose-positron emission tomography integrated with CT scanning confirmed that there was no other involvement. The patient did not receive chemotherapy, and there was no recurrence during the 24-month follow-up period. Hepatocellular carcinoma is the most common malignancy in patients with chronic hepatitis B, but rare tumors such as primary MALT lymphoma can also occur, so a careful approach is required for their differentiation.

Organic acid-based linear free energy relationship models for green leaching of strategic metals from spent lithium-ion batteries and improvement of leaching performance.

Water-soluble organic acids (e.g., acetic acid, acrylic acid, and ascorbic acid), as green leachants, have been applied to leach strategic metals (Ni, Li, Mn, and Co) from spent lithium-ion batteries (LIBs). Organic acid-based linear free energy relationship models were developed and simulated to predict the feasibility of the leaching efficiency for each of the strategic metals based on in silico calculated descriptors. The developed models, with accuracy (R2) of 0.747-0.831, reveal that hydrogen bond acidity of organic acids promotes the leaching efficiency, whereas molecular volume or excess molar refraction inhibits the efficiency. Furthermore, toxicity (lethal dose 50%) of organic acids was discussed along with the predicted leaching efficiency to explore more green and efficient organic acids. Considering both toxicity and leaching efficiency, citric acid was selected as a green and efficient leachant. To more improve the leaching performance (rate and efficiency) of citric acid, glucose as a green reductant and microwave treatment were additionally applied. Under the selected conditions, the leaching efficiencies after 1 h for Ni, Li, Mn, and Co were enhanced up to 98.3%, 99.1%, 98.7%, and 97.7%, respectively.

Simple, green organic acid-based hydrometallurgy for waste-to-energy storage devices: Recovery of NiMnCoC2O4 as an electrode material for pseudocapacitor from spent LiNiMnCoO2 batteries.

A simple, green approach to recover NiMnCoC2O4 as an electrode material for high-performance pseudocapacitors from spent LiNiMnCoO2 (NMC) batteries is proposed. Four strategic metals (Li, Ni, Co, and Mn) were leached from spent NMC batteries using several organic acids as model green leachants. Among the various candidates of green leaching agents, 2 M citric acid and 5 wt% glucose were selected as the leachant and reductant, respectively. Microwave irradiation was conducted during the leaching step to maximize the performance of the leaching rate and efficiency. The leaching efficiencies within 0.5 h for Ni(II), Li(I), Mn(II), and Co(II) were 90.7 ± 1.6%, 98.3 ± 2.4%, 94.9 ± 4.3%, and 95.6 ± 1.4%, respectively, and were thus as efficient as using aqua regia leaching. After the leaching process, divalent metal ions, that is, Ni(II), Co(II), and Mn(II), were immediately separated at room temperature using oxalic acid. The recovered samples were not further treated and used directly for energy storage applications. The recovered NiMnCoC2O4⋅nH2O has been demonstrated as a promising electrode for pseudocapacitors, providing a specific capacitance of 1641 F/g, good rate-retention capability (80% of low-current capacitance), and good cycle stability over 4000 charge-discharge cycles.

Evaluation of Utility of the Cement Solidification Process of Waste Ion Exchange Resin.

The present study aimed to evaluate the utility of the cement solidification process for stably disposing of waste ion exchange resin generated during the treatment of radioactive wastewater. The cement solidification process using the in-drum mixing system was selected to be used for the solidification process of waste ion exchange resins. The disposal safety of waste forms was evaluated according to the waste acceptance criteria (WAC) applicable to domestic waste disposal sites, and the tests were conducted for six test items provided in the WAC. A total of 15 representative samples were collected from the waste-form drums produced using the optimum operating conditions, and their structural stability for disposal considerations was evaluated. In addition, the leaching index of the samples was 11.05, 10.12, 8.39 for Co, Sr, and Cs, respectively, and it was found to exceed 6, the leaching index standard of WAC. The results confirmed that cement waste forms including waste ion exchange resins produced through this process were considered to be conforming to the requirements for disposal safety.

23-Hydroxytormentic acid and niga-ichgoside f1 isolated from Rubus coreanus attenuate cisplatin-induced cytotoxicity by reducing oxidative stress in renal epithelial LLC-PK1 cells.

The unripe fruits of Rubus coreanus (Rosaceae) are used in traditional Chinese medicine to relieve kidney dysfunction. In the present study, we evaluated the protective effects of the triterpenoid glycoside niga-ichigoside F1 (NIF1) and of its aglycone 23-hydroxytormentic acid (23-HTA) isolated from the unripe fruits of Rubus coreanus (Rosaceae) against cisplatin-induced cytotoxicity in renal epithelial LLC-PK1 cells. Pretreating LLC-PK1 cells with 23-HTA or NIF1 was found to prevent cisplatin-induced cytotoxicity and apoptosis. In addition, 23-HTA or NIF1 pretreatment significantly improved the changes associated with cisplatin toxicity by increasing levels of glutathione (GSH) and decreasing levels of malondialdehyde (MDA) and reactive oxygen species (ROS). The activity of antioxidant enzymes including catalase (CAT) and superoxide dismutase (SOD) was significantly lower in cisplatin-treated LL-PK1 cells, and 23-HTA or NIF1 treatment notably increased the these enzyme activity and protein and mRNA levels of CAT and manganese SOD (MnSOD). Moreover, cisplatin caused a significant decrease in nuclear levels of nuclear factor erythroid 2-related factor 2 (Nrf2) and pretreatment with 23-HTA or NIF1 significantly suppressed the cisplatin-induced translocation of Nrf2 in LLC-PK1 cells. Taken together, these results suggest that 23-HTA ameliorates cisplatin-induced toxicity via modulation of antioxidant enzymes through activation of Nrf2 in LLC-PK1 cells.

The ameliorative effect of 23-hydroxytormentic acid isolated from Rubus coreanus on cisplatin-induced nephrotoxicity in rats.

Previously, the authors demonstrated that the triterpenoid glycoside niga-ichigoside F1 (NIF1) and its aglycone 23-hydroxytormentic acid (23-HTA) isolated from the unripe fruits of Rubus coreanus (Rosaceae) ameliorate cisplatin-induced toxicity in renal epithelial LLC-PK1 cells. In the present study, the nephroprotective effects of NIF1 and 23-HTA were investigated in Sprague-Dawley rats with acute renal injury induced by a single intraperitoneal (i.p.) injection of cisplatin (7 mg/kg). Pretreatment with 23-HTA (10 mg/kg/d, per os (p.o.)) significantly reduced cisplatin-induced elevations in blood urea nitrogen (BUN) and serum creatinine level, whereas NIF1 (10 mg/kg, p.o.) slightly reduced these levels. In addition, pretreatment with 23-HTA prevented cisplatin-induced hydroxyl radical generation, malondialdehyde (MDA) production, glutathione (GSH) depletion, and cisplatin-induced changes in the activities of oxidant and antioxidant enzymes in rat renal tissues. In addition, histopathological examinations showed that 23-HTA pretreatment reduced cisplatin-induced acute tubular necrosis and histological changes. In contrast, NIF1 was found to have a slight or no influence on cisplatin-induced oxidative enzymes and acute tubular necrosis. Taken together, these results suggest that protective effect of 23-HTA pretreatment on cisplatin-induced renal damage is associated with the attenuation of oxidative stress and the preservation of antioxidant enzymes.

Self-coagulating polyelectrolyte complexes for target-tunable adsorption and separation of metal ions.

Metal-containing wastes in aquatic environments lead to public health hazards and valuable resource lose. Metal-bearing wastewater must be treated to remove heavy metals or recover precious metals. To achieve these, target-tunable adsorbents that bind cationic and anionic metal species were developed through facile polyelectrolyte complexation using polyethylenimine (PEI) and polyacrylic acid (PAA). Utilizing the properties of the two polyelectrolytes and pKa variabilities, stable tunable adsorbents were fabricated in water without additional solvents. The homogenous complex adsorbents were strategically synthesized via dissolution in 0.1 M NaOH and drop-wise addition of 1 M HCl, followed by crosslinking with glutaraldehyde. Consequently, the adsorbents in alternating weight ratios of 4:1 and 1:4 (PEI:PAA) exhibited good tunability and adsorption properties. The maximum single metal adsorption capacities were 1609.7 ± 49.6 and 558.6 ± 9.67 mg/g for gold and cadmium, respectively. The pseudo-second-order model fitted the kinetics data more appropriately and was recognized as the rate controlling step. In a binary mixture, gold selectivity was observed to be influenced by adsorption-reduction mechanism, which was elucidated by XRD and XPS. Moreover, the adsorbents demonstrated NO3- sequestration properties, a feat deemed important for environmental remediation of nitrate ions. Finally, sequential separation was achieved with ethylenediaminetetraacetic acid (EDTA) and acidified thiourea.

Effectiveness of Hepatocellular Carcinoma Surveillance and an Optimal Surveillance Interval: Nationwide Cohort of Korea.

PURPOSE: To assess associations between surveillance intervals in a national hepatocellular carcinoma (HCC) surveillance program and receiving curative treatment and mortality using nationwide cohort data for Korea. MATERIALS AND METHODS: Using the National Health Insurance Service Database of Korea, we retrospectively identified 3201852 patients, the target population of the national HCC surveillance program, between 2008 and 2017. After exclusion, a total of 64674 HCC patients were divided based on surveillance intervals: never screened, ≤6 months (6M), 7-12 months (1Y), 13-24 months (2Y), and 25-36 months (3Y). Associations for surveillance interval with the chance to receive curative therapy and all-cause mortality were analyzed. RESULTS: The 6M group (51.9%) received curative therapy more often than the other groups (1Y, 48.3%; 2Y, 43.8%; 3Y, 41.3%; never screened, 34.5%). Odds ratio for receiving curative therapy among the other surveillance interval groups (1Y, 0.87; 2Y, 0.76; 3Y, 0.77; never screened, 0.57; p<0.001) were significantly lower than that of the 6M group. The hazard ratios (HRs) of all-cause mortality were 1.07, 1.14, and 1.37 for 2Y, 3Y, and never screened groups. The HR for the 1Y group (0.96; p=0.092) was not significantly different, and it was lower (0.91; p<0.001) than that of the 6M group after adjustment for lead-time bias. Curative therapy was associated with survival benefits (HR, 0.26; p<0.001). CONCLUSION: HCC surveillance, especially at a surveillance interval of 6 months, increases the chance to receive curative therapy.

Polyethyleneimine impregnated alginate capsule as a high capacity sorbent for the recovery of monovalent and trivalent gold.

For the first time, a polyethyleneimine-impregnated alginate capsule (PEIIAC) with a high adsorption capacity is developed for the recovery of monovalent and trivalent gold from an acidic solution. The strategy results in a new type of adsorbent, polyethyleneimine impregnated alginate capsule (PEIIAC) with a core-shell structure having a large number of amine groups as cationic binding site, facilitating maximum uptake of anionic auric chloride. The maximum uptake of PEIIAC was 3078 and 929 mg/g for Au (III) and Au (I), respectively, are recordable compared to other reported adsorbents to date. The as-prepared material was executed to check the sorption efficacy for Au (III) and Au (I) in the pH range of 1-12. With an increment in pH, the uptake capacity for Au (III) increased, while the uptake capacity for Au (I) decreased. The FTIR, XRD, and XPS studies revealed that the gold adsorption mechanism includes ionic interactions and reduction, wherein the amine, hydroxyl, and carboxyl groups are involved. The capsule showed a higher adsorption efficiency than other reported sorbents, making the material applicable in acidic solutions for the recovery of Au (I) and Au (III).

Biogenic formation and growth of uraninite (UO2).

Biogenic UO2 (uraninite) nanocrystals may be formed as a product of a microbial reduction process in uranium-enriched environments near the Earth's surface. We investigated the size, nanometer-scale structure, and aggregation state of UO2 formed by iron-reducing bacterium, Shewanella putrefaciens CN32, from a uranium-rich solution. Characterization of biogenic UO2 precipitates by high-resolution transmission electron microscopy (HRTEM) revealed that the UO2 nanoparticles formed were highly aggregated by organic polymers. Nearly all of the nanocrystals were networked in more or less 100 nm diameter spherical aggregates that displayed some concentric UO2 accumulation with heterogeneity. Interestingly, pure UO2 nanocrystals were piled on one another at several positions via UO2-UO2 interactions, which seem to be intimately related to a specific step in the process of growing large single crystals. In the process, calcium that was easily complexed with aqueous uranium(VI) appeared not to be combined with bioreduced uranium(IV), probably due to its lower binding energy. However, when phosphate was added to the system, calcium was found to be easily associated with uranium(IV), forming a new uranium phase, ningyoite. These results will extend the limited knowledge of microbial uraniferous mineralization and may provide new insights into the fate of aqueous uranium complexes.

Toll-like receptor polymorphisms are not associated with liver cirrhosis in hepatitis B virus infected Korean patients.

BACKGROUND/AIMS: Hepatitis B virus (HBV) induces inflammatory signaling leading to progressive liver damage. Polymorphisms of the toll-like receptor (TLR) 2 (Arg677Trp, Arg753Gln) and TLR4 (Asp299Gly, Thr399Ile) genes, which are important components of innate immunity against viral infection, have recently been described. We evaluated the association between TLR2 and TLR4 polymorphisms and the development of liver cirrhosis in Koreans with chronic HBV infection. METHODOLOGY: This study enrolled 456 Koreans with chronic HBV infection between December 2004 and October 2007; 242 with chronic hepatitis B (group I) and 214 with liver cirrhosis (group II). TLR2 and TLR4 polymorphisms were determined using direct sequencing. RESULTS: Mean age differed significantly between groups (group I, 34.8 +/- 11.4 years; group II 51.0 +/- 8.9 years; p < 0.001), whereas the proportion of males (80.2% vs. 73.4%, respectively; p = 0.085) and hepatitis B e antigen-positive patients (40.7% vs. 43.6%, respectively; p = 0.575) did not. The serum alanine aminotransferase level was significantly higher in group I (87.9 +/- 138.5 IU/L) than in group II (56.6 +/- 70.7 IU/L, p = 0.003). However, the TLR2 Arg677Trp and Arg753Gln and TLR4 Asp299Gly and Thr399Ile mutant alleles were not detected in any patients. CONCLUSIONS: The TLR2 Arg677Trp, Arg753Gln and TLR4 Asp299Gly, Thr399Ile mutant alleles were not detected in any patient, suggesting that they are very rare in the Korean population. Our results do not permit any conclusion regarding their role in the development of liver cirrhosis.