• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.59-63
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• 2016

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe drug-induced hypersensitivity syndrome characterized by hematological abnormalities and multiorgan involvement. Liver involvement is the most common visceral manifestation. However, renal failure has been rarely described. The common culprit drugs are anticonvulsants and allopurinol. We experienced a patient with DRESS syndrome with acute interstitial nephritis caused by concomitant administration of quinolone and non-steroidal anti-inflammatory drugs (NSAIDs). A 41-year-old man presented with a diffuse erythematous rash and fever which developed after administration of quinolone and NSAIDs for a month due to prostatitis. He was diagnosed with DRESS syndrome. Skin rash, fever, eosinophilia, and elevations of liver enzymes improved with conservative treatment and discontinuation of the causative drugs. However, deterioration of his renal function occurred on day 8 of admission. The levels of blood urea nitrogen and serum creatinine increased and oliguria, proteinuria and urinary eosinophils were observed. Ultrasonography showed diffuse renal enlargement. The clinical features were compatible with acute interstitial nephritis. Despite intravenous rehydration and diuretics, renal function did not improve. After hemodialysis, his renal function recovered completely within 2 weeks without administration of systemic corticosteroid.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.59-66
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• 2006

Purpose: Acute liver failure after massive partial hepatectomy is critical condition with high mortality. To prevent postoperative liver failure from being induced by a massive partial hepatectomy, many doctors do a minimal resection on the single lobe of the liver that might cause postoperative bleeding from the remaining ruptured parenchyma. The objective of this study was to assess clinical experience with postoperative hepatic arterial embolization to control bleeding from the remaining ruptured liver during the postoperative period. Methods: This retrospective 4-year study was conducted from May 2002 to April 2006 and included consecutive patients who had sustained massive hepatic injuries and who had undergone a laparotomy, followed by postoperative hepatic arterial angiographic embolization to control bleeding. Data on the injury characteristics, the operative treatment and embolization, and the amount of transfused packed red cells (PRBC) were gathered and analyzed. In addition, data on the overall complications and survival rate were collected and analyzed. Results: Every case showed severe liver injury, higher liver injury scaling grade IV. Only ten cases involved a ruptured bilateral liver lobe. A lobectomy was done in 6 cases, a left lobectomy was done in 3 cases, and a primary suture closure of the liver was done in 2 cases. Suture closure was also done on the remaining ruptured liver parenchyma in cases of lobectomies. The postoperative hepatic arterial embolizations were done by using the super-selection technique. There were some cases of arterio-venous malformations and anomalous vessel branches. The average amount of transfused PRBC during 24 hours after embolization was $2.36{\pm}1.75$, which statistically significantly lower than that before embolization. Among the 11 cases, 9 patients survived, and 2 died. There was no specific complications induced by the embolization. Conclusion: In cases of postoperative bleeding in severe hepatic injury, if there is still a large amount of bleeding, postoperative hepatic arterial embolization might be a good therapeutic option.

• Toxicological Research
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• 제24권4호
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• pp.281-287
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• 2008

Impairment of hepatic metabolism of sulfur-containing amino acids has been known to be linked with induction of liver injury. We determined the early changes in the transsulfuration reactions in liver of rats challenged with a toxic dose of $CCl_4$ (2 mmol/kg, ip). Both hepatic methionine concentration and methionine adenosyltransferase activity were increased, but S-adenosylmethionine level did not change. Hepatic cysteine was increased significantly from 4 h after $CCl_4$ treatment. Glutathione (GSH) concentration in liver was elevated in $4{\sim}8$ h and then returned to normal in accordance with the changes in glutamate cysteine ligase activity. Cysteine dioxygenase activity and hypotaurine concentration were also elevated from 4 h after the treatment. However, plasma GSH concentration was increased progressively, reaching a level at least several fold greater than normal in 24 h. ${\gamma}$-Glutamyltransferase activity in kidney or liver was not altered by $CCl_4$, suggesting that the increase in plasma GSH could not be attributed to a failure of GSH cycling. The results indicate that acute liver injury induced by $CCl_4$ is accompanied with extensive alterations in the metabolomics of sulfurcontaining amino acids and related substances. The major metabolites and products of the transsulfuration pathway, including methionine, cysteine, hypotaurine, and GSH, are all increased in liver and plasma. The physiological significance of the change in the metabolomics of sulfur-containing substances and its role in the induction of liver injury need to be explored in future studies.

• 대한한의학방제학회지
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• 제17권2호
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• pp.123-132
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• 2009

Acetaminophen (AP) is widely used as an over-the-counter analgesic and antipyretic drug. AP-induced hepatotoxicity is a common consequence of AP overdose and may lead to acute liver failure. In this study, we investigated the liver damage in mice using single dose (300 mg/kg) of AP and the possible protective effects of administration (50-200 mg/kg body weight) of Joo-Juk on acetaminophen-induced liver damage in mice. The alanine aminotransferase (ALT), and aspartate aminotransferase (AST) activities were determined in the plasma of mice. The effect of Joo-Juk on lipid peroxidation product thiobarbituric reacting substances (TBARS) and some antioxidant enzymes superoxide dismutase (SOD), catalase, d-aminolevulinate dehydratase ($\sigma$-ALA-D) activities, and gluthathione peroxidase (GPx), were also evaluated in the mouse liver homogenate. AP caused liver damage as evident by statistically significant increased in plasma activities of AST and ALT. There were statistically significant losses in the activities of SOD, catalase, $\sigma$-ALA-D, and GPx and an increase in TBARS in the liver of AP-treated group compared with the control group. However, Joo-Juk was able to counteract these effects. These results suggest that Joo-juk can act as hepato-protectant against AP toxicity and is a good candidate for further evaluation as an effective chemotherapeutic agent.

• Journal of Digestive Cancer Research
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• 제2권1호
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• pp.28-31
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• 2014

췌장암은 예후가 매우 불량한 암으로 gemcitabine을 근간으로 하는 항암화학요법이 진행성 췌장암에 대한 표준치료이지만, 이러한 일차 항암화학요법에 반응이 없을 경우의 이차 항암화학요법에 대해서는 아직까지 정립된 것이 없는 상태이다. FOLFIRINOX 병합용법은 최근 여러 연구에서 일차 항암화학요법으로서의 치료 효과가 보고되고 있고, gemcitabine 항암화학요법에 반응이 없는 진행성 췌장암에 대한 이차 항암화학요법으로도 시도되어 양호한 치료 효과가 보고되고 있다. 저자들은 gemcitabine을 근간으로 하는 병합요법에 대해 반응이 없는 진행성 췌장암 환자에 대한 이차 항암화학요법으로 FOLFIRINOX 병합요법을 시행하여 완전 관해를 획득한 증례를 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제24권2호
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• pp.190-196
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• 1991

Clinical experience of 48 acute pericarditis with effusion was reviewed and presented. There were 28 male and 20 female patients ranging from 3 years to 77 years old. Malignant effusion; Twenty patients had underlying malignancy. These etiologies were lung ca[8 patients, 40%], breast ca[7 patients 35%], lymphoma[2 patients, 10%], esophageal ca[1 patients, 5%], stomach ca[1 patient, 5%], ovarian ca[1 patient, 5%]. Uremic effusion; 15 patients with renal failure required surgical intervention. Traumatic effusion; 7 patients had traumatic pericarditis. These etiologies were stab wound [5 patients, 71.4%] and aspiration[2 patients, 28.6%]. Pyogenic effusion: 6 patients had pyogenic pericarditis. These etiologies were empyema thoracis[3 patients, 50%], liver abscess[2 patients, 33.3%], pneumonia[1 patient, 16.7%]. The patients were treated by pericardiocentesis, subxiphoid tube drainage, pericardiectomy: 4 of them underwent pericardiocentesis; 37, subxiphoid tube drainage; 5, pericardiectomy. We conclude that subxiphoid tube pericardial drainage was effective for treatment of pericardial effusion.

• The Korean Journal of Physiology and Pharmacology
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• 제20권1호
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• pp.15-23
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• 2016

Acetaminophen (APAP) overdose is one of the most common causes of acute liver failure. The study aimed to investigate the protective effect of carnosic acid (CA) on APAP-induced acute hepatotoxicity and its underlying mechanism in mice. To induce hepatotoxicity, APAP solution (400 mg/kg) was administered into mice by intraperitoneal injection. Histological analysis revealed that CA treatment significantly ameliorated APAP-induced hepatic necrosis. The levels of both alanine aminotransferase (ALT) and aspartate transaminase (AST) in serum were reduced by CA treatment. Moreover, CA treatment significantly inhibited APAP-induced hepatocytes necrosis and lactate dehydrogenase (LDH) releasing. Western blot analysis showed that CA abrogated APAP-induced cleaved caspase-3, Bax and phosphorylated JNK protein expression. Further results showed that CA treatment markedly inhibited APAP-induced pro-inflammatory cytokines TNF-${\alpha}$, IL-$1{\beta}$, IL-6 and MCP-1 mRNA expression and the levels of phosphorylated $I{\kappa}B{\alpha}$ and p65 protein in the liver. In addition, CA treatment reduced APAP- induced hepatic malondialdehyde (MDA) contents and reactive oxygen species (ROS) accumulation. Conversely, hepatic glutathione (GSH) level was increased by administration of CA in APAP-treated mice. Mechanistically, CA facilitated Nrf2 translocation into nuclear through blocking the interaction between Nrf2 and Keap1, which, in turn, upregulated anti-oxidant genes mRNA expression. Taken together, our results indicate that CA facilitates Nrf2 nuclear translocation, causing induction of Nrf2-dependent genes, which contributes to protection from acetaminophen hepatotoxicity.

• Archives of Pharmacal Research
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• 제28권1호
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• pp.81-86
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• 2005

The hepatoprotective effects of chalcone derivatives were evaluated in D-galactosamine/lipopolysaccharide (D-GaIN/LPS)-induced fulminant hepatic failure in mouse. Thirteen chalcone derivatives were synthesized for study and their hepatoprotective effects were evaluated by assessing aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in serum. Chalcone preparations were injected into mice at 12 hand 1 h before intraperitoneal injection of D-GaIN/LPS. After abdominal administration, changes in AST and ALT between the control and treated groups were observed. Ten of the synthesized chalcone derivatives exhibited inhibitory effects on D-GaIN/LPS-induced levels of AST and ALT in mice. Compounds 2, 3, 8, 9, and 12 markedly reduced serum AST and ALT at 8 h, inhibited hepatocyte necrosis and showed significant hepatoprotective activities. The activity of compound 3 was compared with the bifendate (DDB) through oral administration. Compound 3 showed much higher inhibitory effects than bifendate for decreasing AST and ALT activity. The results indicate that compound 3 has strong hepatoprotective activity through suppression of tumor necrosis factor­alpha (TNF-alpha) preduction, reduction of the histological change in the liver, and attenuated of hepatocyte apoptosis confirmed by DNA fragmentation assay.

• 대한의생명과학회지
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• 제7권4호
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• pp.211-216
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• 2001

This studs was carried out to evaluate KBrO$_3$-induced acute toxicity by clinical pathological parameters in rats. Fourty rats were divided into 4 groups including normal group and three KBrO$_3$-treated groups with doses of 200, 300, and 400 mg/kg, p. o., respectively. Creatinine and BUN were increased remarkably by KBrO$_3$ at 400 mg/kg, respectively (p<0.05, p<0.01). Phosphorus content increased two times the control at 400 mg/kg (p<0.05). Osmolarity was increased, whereas $CO_2$ content showed decrease at 400 mg/kg, respectively (p<0.01, p<0.05). Histopathological findings also showed dose-dependent renal failure. On the other hand, AST was increased three times the control at 400 mg/kg (p<0.01). WBC was increased by KBrO$_3$ depending on the dosage. Platelet was decreased at 200 mg/kg, whereas it was increased at 400 mg/kg (p<0.05). The results above suggest that clinical pathological parameters could be used as indices for the evaluation of KBrO$_3$-induced acute toxic reponse occuring in not only kidney but other organs including liver, when the dosage is as high as 400 mg/kg.

• KSBB Journal
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• 제16권1호
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• pp.24-29
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• 2001

급성 간부전 환자나 간이식 대기 상태의 환자의 생명을 간이 재생되거나 간 이식때 까지 연장시키기 위하여 생인공간이 많이 연구되고 있다. 본 연구에서는 적당한 cell opening을 가지는 폴리우레탄 폼을 15% NCO-prepolymer를 이용하여 직접 제조하였으며 이를 직경 3~4 mm 크기의 정육면체로 절단하여 충진형 반응기를 제조하였다. 분리된 일차간세포를 원심분리 방법을 이용하여 PUF 1 $cm^3$ 당 5.5$\pm$1.1$\times$$10^6$개의 세포를 접종하였으며 일주일간 관류 배양하면서 생인공간으로서의 성능을 측정하였다. 접종된 간세포는 구상체를 형성하였고 안정된 암모니아 제거능력과 요소 분비율을 나타내었다. 알부민 분비율은 배양 4일 이후 감소하는 경향을 보였다. 이상의 결과를 볼 때 PUF 충진형 간세포 반응기는 생인공간으로 개발되기에 충분한 가능성을 가진 것으로 판단된다.