• Title/Summary/Keyword: Acute liver failure

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A Case of Acute Hepatic Failure due to Acetaminophen Overdose Treated with Molecular Adsorbents Recirculating System$^{(R)}$ (Acetaminophen 중독에 의한 급성 간 부전 환자에서 Molecular Adsorbents Recirculating System$^{(R)}$을 이용한 치험 1례)

  • Yang, Byung Keun;You, Je Sung;Joo, Young Seon;Chung, Sung Phil;Lee, Hahn Schick
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.1
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    • pp.31-34
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    • 2014
  • We report on a patient who developed acute hepatic failure despite intravenous N-acetyl cysteine therapy who was treated with the Molecular Adsorbents Recirculating System (MARS). She presented 20 hours after the ingestion of 13 g of acetaminophen. The MARS is based on albumin dialysis principle which can be applied for patients with acute poisoning from drugs that have high protein-binding capacity because of its ability to selectively remove from circulation protein-bound toxins. The clinical toxicologist should be consider this technology when treating patients with hepatic failure following acetaminophen poisoning.

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Effect of Uranyl Nitrate-Induced Acute Renal Failure on the Pharmacokinetics of Sulfobromophthalein in Rats

  • Park, Gun-Hwa;Shim, Chang-Koo
    • Archives of Pharmacal Research
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    • v.13 no.3
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    • pp.233-239
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    • 1990
  • The efect of acute renal failure (ARF) on the pharmacokinetics o sulfobromophthalein (BSP) was investigated in order to elucidate if renal failure modifies the hepatic metabolism of drugs. ARF was induced by intravenous (iv) injection of uranyl nitrate (UN) to rats (5 mg/kg) five days before the experiment. Area under the plasma concentration-time curve (AUC)of BSP after portal vein (pv) injection increased by 2-fold and total body clearance ($CL_1$) decreased one half (p <0.01) in UN-induced ARF (UN-ARF) rate compared to the control rats. But the plasma disappearance of BSP after iv injection did not differ significantly between control and UN-ARF rats. Since BSP is excreted via the liver, $CL_1$ represented the approximate hepatic clearance of BSP. Therefore, the decrease in $CL_1$ represented the approximate hepatic clearance of BSP. Therefore, the decrease in $CL_1$ represents a decrease in hepatic intrinsic clearance ($CL_{int}$) for BSP since plasma free fraction ($f_p$) of BSP was not affected by UN-ARF. The content of hepatic cytoplasmic Y-protein, which catalyzes BSP-glutathione conjugation and limits the trasfer of BSP from blood to bile, increased significantly (p < 0.01), however its binding activity (BA) for BSP was decreased significantly (p <0.01) by UN-ARF. The decrease in $CL_{int}$might have some correlation with the changed characteristics of hepatic Y-protein, specifically its decreased BA for BSP.

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A case of ARDS Overlooked Tsutstugamushi Disease that Presented as Simple Cutaneous Lesions (단순 피부병변으로 간과되어 급성 호흡곤란 증후군으로 진행된 쯔쯔가무시병 1예)

  • Ryu, Ki Hyun;Kim, Ki Hong;Kim, Hong Dai;Son, Ji Woong;Na, Moon Jun;Choi, Eugene
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.4
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    • pp.389-393
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    • 2006
  • Tsutstugamushi disease is a major febrile disease that generally occurs in the fall in Korea with hemorrhagic fever with renal syndrome and leptospirosis. This disease is often accompanied by interstitial pneumonia, acute renal failure and liver failure. The causative agent, namely Orientia tsutsugamushi, is transmitted to humans through the bite of a laval trombiculid mite, which is commonly known as a chigger. A 78 year old man was admitted in October 2004 with intractable fever and a drowsy mentality. Two weeks earlier, he visited a private clinic complaining of a simple skin rash. He was treated with antihistamine and steroid, but his symptoms were aggravated and he was referred to our hospital. His physical examination and laboratory findings showed a septic shock status. The maculopapular rash had spread over his face, chest, abdomen and extremities. Eschar was observed in lower back area but it was too difficult to distinguish it from other skin rashes. His chest X-ray appeared as diffuse nodular patchy consolidations in the bilateral lung parenchyme. He was treated with a mechanical ventilator and doxycycline under th suspicion of Tsutstugamushi disease. However, he suffered multiorgan failure accompanied by acute respiratory distress syndrome, acute renal failure and acute hepatitis. He was treated in the intensive care unit for approximately 12 weeks and his general condition was recovered.

Tumour Lysis Syndrome: Implications for Cancer Therapy

  • Mika, Denish;Ahmad, Sabrina;Guruvayoorappan, C.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3555-3560
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    • 2012
  • The tumour lysis syndrome (TLS) is a group of metabolic abnormalities caused by rapid and unexpected release of cellular components into the circulation as a result of massive destruction of rapidly proliferating malignant cells. It usually develops in patients with hematologic malignancies like acute lymphoid leukemia, non-Hodgkin and Burkitt's lymphoma after initiation of chemotherapy or may, rarely, occur spontaneously. Though TLS is seldom observed in relation to solid tumours, there have been reports of connections with examples such as lung, liver, breast, gastric carcinomas. The clinical manifestations of TLS include hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. These indications if untreated lead to life-threatening complications such as acute renal failure, cardiac arrhythmias, seizures, and eventually death due to multiorgan failure. Therefore early detection of TLS is of vital importance. This can be accomplished by identification of high risk patients, implementation of suitable prophylactic measures andmonitoring of the electrolyte levels in patients undergoing chemotherapy.

Severe Diarrhea-induced Acute Kidney Injury and Its Consequence in an Elderly

  • Chang-Gue Son
    • The Journal of Korean Medicine
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    • v.44 no.4
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    • pp.163-169
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    • 2023
  • Methods: This study presents a comprehensive case study of an elderly male diagnosed with acute kidney injury (AKI) resulting from severe dehydration, supported by an extended follow-up with laboratory findings. Results: An 83-year-old male patient experienced severe diarrhea overnight, leading to hospitalization due to symptoms of dehydration and hypotension. His laboratory results displayed a typical AKI pattern, including a significant increase in creatinine levels (5.19 mg/dL) and the presence of hyperkalemia and hyponatremia. Following general treatments, including the administration of an herbal drug (Bulhwangeumjeonggi-san), the estimated glomerular filtration rate (eGFR) improved from 10 ml/min (Stage 5) to 34 ml/min (Stage 3) within five days when he was discharged. Although subsequent eGFR tests, conducted one and two months later as an outpatient, revealed an improvement of 42 ml/min, the patient still experienced mild chronic dysfunction as a consequence. Conclusion: This study presents a noteworthy case of acute kidney injury attributed to severe dehydration, emphasizing the importance of medical awareness regarding diarrhea-induced kidney function impairment, especially in the elderly population.

APPLICATION OF THREE DIMENSIONAL CULTURE OF ADULT RAT HAPATOCYTES IN POLYURETHANE FOAM PORES FOR AN ARTIFICIAL LIVER SUPPORT SYSTEM

  • Funatsu, K.;Matsushita, T.;Ijima, H.;Iwahashi, T.
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.137-144
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    • 1994
  • Spherical multicellular aggregates of adult rat hepatocytes (spheroid) which have tissue like structure, were formed and immobilized in the pores of polyurethane foam (PUF) which was used as a culture substratum. These hepatocyte/spheroids, about 100 $\mu\textrm{m}$ in diameter, have maintained higher differentiated functions than those of hepatocyte/monolayer for about 3 weeks in serum-free medium. Then, we designed a prototype module of an artificial liver support system using a PUF/spheroid packed-bed, in which hepatocyte/spheroids were immobilized at high density. The urea synthesis activity of the artificial liver was maintained at least 10 days in 100% rat blood plasma. We start examining the performance of hybrid artificial liver in an ex vivo extracorporeal experiment with an acute hepatic failure rat.

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Infantile Hepatic Hemangioma: Avoiding Unnecessary Invasive Procedures

  • Ernst, Lukas;Grabhorn, Enke;Brinkert, Florian;Reinshagen, Konrad;Konigs, Ingo;Trah, Julian
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.1
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    • pp.72-78
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    • 2020
  • Infantile hepatic hemangioma, the most common vascular tumor of the liver in infancy, can occur with acute postnatal liver and congestive heart failure. Nevertheless, its course is often benign, and many children can be diagnosed and treated without surgical intervention. The distinction from malignant diseases is not always easy and it not clear whether invasive procedures for diagnosis and therapy should be performed. Here we report our experiences in our Center for Pediatric Liver Disease and postulate that large studies are needed to avoid unnecessary invasive procedures for these patients in the future.

Application of Extracorporeal Membranous Oxygenation in Trauma Patient with Possible Transfusion Related Acute Lung Injury (TRALI) (수혈 관련 급성 폐손상이 동반된 외상환자에서 체외막 산화기의 적용 경험)

  • Lee, Dae-Sang;Park, Chi-Min
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.34-38
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    • 2015
  • The case of a patient with a transfusion-related acute lung injury (TRALI) to whom extracorporeal membrane oxygenation (ECMO) had been applied is reported. A 55-year-old male injured with liver laceration (grade 3) without chest injury after car accident. He received lots of blood transfusion and underwent damage control abdominal surgery. In the immediate postoperative period, he suffered from severe hypoxia and respiratory acidosis despite of vigorous management such as 100% oxygen with mechanical ventilation, high PEEP and muscle relaxant. Finally, ECMO was applied to the patients as a last resort. Aggressive treatment with ECMO improved the oxygenation and reduced the acidosis. Unfortunately, the patient died of liver failure and infection. TRALI is a part of acute respiratory distress syndrome (ARDS). The use of ECMO for TRALI induced severe hypoxemia might be a useful option for providing time to allow the injured lung to recover.

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Studies on the Acute Toxicity and Histological Changes in Fish Exposed to Furrural (Furfural 어류급성독성 및 조직병리에 관한 연구)

  • 이철우;최성수;최필선;이상협;이길철;박광식
    • Environmental Analysis Health and Toxicology
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    • v.12 no.3_4
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    • pp.55-59
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    • 1997
  • Furfural, an organic solvent, is widely used as synthetic component material in producing chemical products. However, furfural has been reported that it shows strong toxicities to human being showing intense stimulus to skin, eyes, mucous membrane and nerve system. It is also known to cause anemia, liver cirrhosis, kidney failure and genetic toxicity in the human being working in the exposed area. LD$_{50}$ of furfural for peritoneal injected mouse has been known around 20mg/kg, but the acute toxicity on aquatic organisms such as fish, daphnid or algae are not well known, compared to those on rodents. In this experiment, we studied on the fish toxicity of furfural using Japanese Medaka (Orvzias latipes) and Common Carp (Cvprinus carpio). We also observed histological changes in the fish organs. The LC$_{50}$ were 12. Smg/L in Japanese Medaka and 21.8 mg/L in Common Carp, respectively. When Common Carps were exposed to 120mg/L of furfural concentration for 30 minutes, blood congestion in gills and lysis of secondary lamella were shown. Though the muscle of caudal fin was not completely eroded, its epidermic cells were shown to be necrotic in various parts. Tissue atrophy and cell necrosis were also shown in the liver of Common Carps exposed to furfural. From these results, furfural seems to cause histological damages on liver, an internal organ as well as on external organs such as gills and fins eventhough the fish were exposed for a short-term.

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Effect of A Combined Prescription on Liver Injury of Rats by $CCl_4$ (사역산합평위산가인진택사방(四逆散合平胃散加茵蔯澤瀉方)이 $CCl_4$에 의한 흰쥐의 간(肝) 손상에 미치는 영향)

  • Kim, Hyung-Woo;Kim, Sung-Wook;Yun, Yeo-Choong;Cho, Su-In
    • The Korea Journal of Herbology
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    • v.21 no.3
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    • pp.69-74
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    • 2006
  • Objectives : This study was undertaken to determine if a combined(SPe) has a protective effect against functional failure induced by $CCl_4$ in rat liver. Methods : Acute liver injury which initiated from free radical induced by $CCl_4$, were applied to rats and data were obtained. Liver injury was estimated by measuring aspartate aminotransferase(AST) and alanine aminotransferase(ALT) activity in serum. Lipid peroxidation was examined by measuring malondialdehyde, a product of lipid peroxidation. GSH activities in liver tissues were also measured. Results : When rats were treated intraperitoneally with $CCl_4$, serum AST and ALT were increased compared with the control, which was significantly inhibited by pretreatment of SPe. SPe also prevented reduction in GSH induced by $CCl_4$. Conclusion : Above results suggest that SPe exerts protective effect against $CCl_4$ by its antioxidant action in liver tissues. Thus, SPe may be used in prevention and treatment of drug-induced liver cell injury. However, the precise mechanisms of SPe protection remain to be determined.

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