• Title/Summary/Keyword: Acute liver injury

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Surgical Treatment of Thoracic Injuries Combined with Abdominal Injuries (복부 손상을 동반한 흉부손상 환자의 외과적 치료)

  • Jeong, Seong-Un;Kim, Byeong-Jun;Lee, Seong-Gwang
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.842-846
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    • 1995
  • Recently, the trauma patients have been markedly increasing due to the vast increase of traffic accident, industrial disaster, incidental accident and violence. The authors have analysed of 22 patients of thoracic injuries combined with abdominal injuries and summarized as follows. The ratio of male to female was 3.4:1 and their age distribution was from 5 years to 68 years and mean age was 34.4 years. The etiologies of injury were traffic accident, stab wound, fall down and violence. Associated injuries were fractures, bowel perforation, kidney rupture, head injury, liver laceration, spleen rupture and so forth. The modes of treatment were closed thoracostomy, repair of diaphragm, ruptured bowel repair, explo-thoracotomy, splenectomy, hepatic lobectomy in this order of frequency. The postoperative complications were atelectasis, wound infection, pneumonia, empyema, acute renal failure, respiratory failure and bleeding. The mortality rate was 13.6% [3/22 and the causes of death were respiratory failure 1 case, acute renal failure 1 case and hypovolemic shock 1 case.

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A Nuclear Medicine Study on the Effect of High Energy Gamma Irradiation on Rabbit Liver (고(高)에너지 방사선(放射線) 조사(照射)가 가토(家兎) 간장(肝臟)에 미치는 영향(影響)에 관(關)한 핵의학적(核醫學的) 연구(硏究))

  • Lee, Joon-Il;Min, Bong-Hee
    • Journal of radiological science and technology
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    • v.12 no.1
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    • pp.3-16
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    • 1989
  • In order to investigate the in vivo effect of $^{60}Co$ radiation on rabbit liver, the uptake ratio and regional excretory value in hepatocytes and Kupffer cells were estimated during acute and chronic hepatic injuries. The left lobe of liver was irradiated at 15 Gy or 30 Gy with a single dose and subsequent changes were analysed with a seial nuclear medicine imaging by using $^{99m}Tc-phytate,\;^{99m}Tc-DISIDA\;and\;^{99m}Tc-HSA$ and resulting data were computerized. The degree of hepatic damage, duration of the injury, and recovery pattern after the irradation were in agreement with the findings of other investigations. However, out values were more quantitative evacuation than those of other publications. Recovery of decreased uptake of $^{99m}Tc-phytate$ was delayed approximately $2{\sim}3$ days later than that of $^{99m}Tc-DISIDA$. In acute radiation induced injury, the results demonstrated that the recovery of Kupffer cells was delayed more than that of hepatocytes. This discrepancy was considered due to the differences in repair activities between these cell types. The decreased of regional excretory value in irradiated area was found to be dose-dependent but had no corelation with regional uptakes of DISIDA and phytate. The decreased of regional excretory value observed in non-irradiated region suggested that irradiated liver might induce an indirect effect.

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Use of a Postoperative Hepatic Arterial Embolization in Patients with Postoperative Bleeding due to Severe Hepatic Injuries (외상성 대량 간 손상 환자에서 수술 후 간 동맥 색전술의 유용성)

  • Cha, Soo Hyun;Jung, Yong Sik;Won, Jae Hwan;Kim, Wook Whan;Wang, Hee Jung;Kim, Myung Wook;Lee, Kug Jong
    • Journal of Trauma and Injury
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    • v.19 no.1
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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.

Allopurinol Decreases Liver Damage Induced by Dermal Scald Burn Injury (피부 화상으로 유도된 간 손상에서 Allopurinol의 효과)

  • Cho, Hyun-Gug;Yoon, Chong-Guk;Park, Won-Hark
    • Applied Microscopy
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    • v.31 no.1
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    • pp.37-47
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    • 2001
  • In order to investigate a pathogenesis of liver damage induced by skin burn, thermal injury was induced by scald burn on entirely dorsal surface in rats (total burn surface area $20\sim25\%$) except for inhalated injury. At 5 and 24 h after scald burn, biochemical assay and morphological changes in serum and liver tissue were examined. Skin burn increased liver weight (% of body weight, p<0.05) and the activity of serum aniline amino-transferase (ALT, p<0.05), in addition, the activity of xanthine oxidase (XO), an enzyme of oxygen free radical generating system, was elevated (p<0.01) in serum, but not in skin and in liver. Postburn treatment of allopurinol intraperitoneally decreased liver weight, serum ALT activity and serum XO activity. Scald burn induced ultrastructurally swelling of endoplasmic reticulum, ribosome detachment, accumulation of lipid, dilatation of bile canaliculi and intercellular space, neutrophil infiltration, activation of Kupffer's cells and degeneration of hepatocytic microvilli. Futhermore , thermal injury decreased not only the protein concentration in plasma but also the number of intravascular leukocytes, that indicates induction of edema formation with protein exudation and inflammation by neutrophil infiltration into the internal organs. However allopurinol injection after burn inhibited post burn ultrastructural changes. These data suggest that acute dermal scald burn injury leads to liver damage, that is related to elevation of xanthine oxidase activity in serum. Xanthine oxidase may be a key role in the pathogenesis of liver damage induced by skin burn.

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Protective effect of ultrasonication-processed ginseng berry extract on the D-galactosamine/lipopolysaccharide-induced liver injury model in rats

  • Nam, Yoonjin;Bae, Jinhyung;Jeong, Ji Hoon;Ko, Sung Kwon;Sohn, Uy Dong
    • Journal of Ginseng Research
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    • v.42 no.4
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    • pp.540-548
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    • 2018
  • Background: Acute hepatic failure is a life-threatening critical condition associated with rapid deterioration of liver function and liver transplantation. Several studies have shown that Panax ginseng Mayer has antidiabetic and hepatoprotective effects. However, the hepatoprotective effect of ginseng berry is still unveiled. In this study, we evaluated the hepatoprotective effects of ultrasonication-processed ginseng berry extract (UGBE) on acute hepatic failure model in rats. Methods: Ginseng berry extract (GBE) was ultrasonically processed. The GBE, silymarin, and UGBE were orally administered to male Sprague-Dawley rats for 4 wk. Twenty-four h after the last administration, rats were challenged with D-galactosamine (D-GalN)/lipopolysaccharide (LPS). Results: After ultrasonication, the component ratio of ginsenosides Rg2, Rg3, Rh1, Rh4, Rk1, Rk3, and F4 in GBE had been elevated. Administration of UGBE significantly increased the survival rate of D-GalN/LPS-challenged rats. Pretreatment with UGBE significantly decreased serum alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels in D-GalN/LPS-challenged rats in a dose-dependent manner. The levels of enzymatic markers for oxidative stress (superoxide dismutase, glutathione peroxidase, catalase, and glutathione) were increased by UGBE treatment in a dose-dependent manner. Tumor necrosis factor alphalevel, inducible nitric oxide synthase activities, and nitric oxide productions were reduced by UGBE treatment. In addition, hemeoxygenase-1 levels in liver were also significantly increased in the UGBE-treated group. The protein expression of toll-like receptor 4 was decreased by UGBE administration. Hematoxylin and eosin staining results also supported the results of this study showing normal appearance of liver histopathology in the UGBE-treated group. Conclusion: UGBE showed a great hepatoprotective effect on D-GalN/LPS-challenged rats via the toll-like receptor 4 signaling pathway.

Clinical Report about the Efficacy of Herbal Medicine in Comparison with Western Medication Mixed for an Acute Liver Injured CVA Patient (급성 간손상을 동반한 CVA환자에서 한약, 양약 복합투여 시와 한약 단독 투여 시의 간기능 개선 효과에 관한 증례 보고)

  • Lee, Yeon-Kyoung;Shin, Yoo-Jeong;Cho, Dong-Heu;Shin, Oh-Chul;Kang, Suk-Pong;Park, Chi-Sang
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.2
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    • pp.502-506
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    • 2008
  • This patient has been acute hepatic injured three times(2005.11.14-11.30, 2006.2.25-3.8, 2006.3.21-4.10) while he hadn't taken herb medicine or anything special. During these periods, his liver function tests showed a sharp elevation of AST, ALT and ALP level. The 1st period by western medication and herb medicine mixed and the 2nd, the 3rd by herb medicine only, he'd been treated. Each of it got significant results in short haul. It maybe means that herb medicine is not dangerous even for the acute hepatic injured person, moreover it can be more effective in comparison with western treatment.

Efficacy of Transcatheter Arterial Embolization with N-Butyl Cyanoacrylate in Acute Bleeding Patient (급성 출혈 환자에서 N-Butyl Cyanoacrylate를 이용한 경도관 동맥색전술의 유용성)

  • Jae, Hwan Jun;Kim, Sang Youn;Lee, Eui Jung;Lee, Whal;Suh, Gil Joon
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.112-118
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    • 2005
  • Background: N-Butyl Cyanoacrylate (NBCA) is a liquid embolic material that can be useful for transcatheter arterial embolization (TAE) of acute bleeding especially in patients with coagulopathy, because it does not depend on coagulation for its therapeutic effect. The aims of this study were to evaluate the clinical efficacy and safety of TAE with NBCA in acute bleeding patients. Methods: Between August 2003 and September 2004, TAE using NBCA for acute bleeding was performed in 23 patients (16 men, 7 women; mean age, 56.5years). The causes of bleeding were gastric ulcer (n=5), postoperative bleeding (n=4), post-biopsy bleeding (n=3), postpartum bleeding (n=3), duodenal ulcer (n=2), angiodysplasia (n=2), gastric lymphoma (n=1), iatrogenic injury (n=1), CMV gastritis (n=1), stab injury of the liver (n=1). TAE was performed using 1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure-related complication and clinical outcomes were evaluated. Results: The angiographic and clinical success rate was 100% and 91.3% (21/23), respectively. There was no serious ischemic complication. Recurrent bleeding occurred in 2 patients (8.7%) and they were managed with successful second TAE (n=1) and endoscopic treatment (n=1). Nine patients (39.1%) had coagulopathy at the time of TAE and clinical success rate in this group of patients was 88.9% (8/9). Conclusions: TAE with NBCA is highly effective and safe treatment modality for acute bleeding patients, especially when the patient has a coagulopathy.

A Case of Acute Renal Failure Associated with Non-fulminant Acute Hepatitis A (비전격성 급성 A형 간염 환자에서의 급성 신부전의 병발 1예)

  • Na, Ji-Hoon;Park, Jong-Won;Park, Kyu-Hwan;Oh, Myong-Jin;Choi, Yun-Jung;Park, Jung-Min;Chang, Woo-Jin
    • Journal of Yeungnam Medical Science
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    • v.27 no.2
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    • pp.127-132
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    • 2010
  • Acute hepatitis A is a generally self-limiting disease of the liver. Acute renal failure is rare in patients with acute non-fulminant hepatitis A Acute tubular necrosis is the most common form of renal injury found in such patients. The 215 years old male patient visited our hospital with complaint of general weakness, fatigue, nausea, vomiting and myalgia. He was diagnosed with acute renal failure associated with acute non-fulminant hepatitis A We report here on a case of acute renal failure associated with non-fulminant hepatitis A, and we include a review of the literature.

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The pharmacological role of Ginsenoside Rg3 in liver diseases: A review on molecular mechanisms

  • Wenhong Wang;Ke Li;Weihua Xiao
    • Journal of Ginseng Research
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    • v.48 no.2
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    • pp.129-139
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    • 2024
  • Liver diseases are a significant global health burden and are among the most common diseases. Ginssennoside Rg3 (Rg3), which is one of the most abundant ginsenosides, has been found to have significant preventive and therapeutic effects against various types of diseases with minimal side effects. Numerous studies have demonstrated the significant preventive and therapeutic effects of Rg3 on various liver diseases such as viral hepatitis, acute liver injury, nonalcoholic liver diseases (NAFLD), liver fibrosis and hepatocellular carcinoma (HCC). The underlying molecular mechanism behind these effects is attributed to apoptosis, autophagy, antioxidant, anti-inflammatory activities, and the regulation of multiple signaling pathways. This review provides a comprehensive description of the potential molecular mechanisms of Rg3 in the development of liver diseases. The article focuses on the regulation of apoptosis, oxidative stress, autophagy, inflammation, and other related factors. Additionally, the review discusses combination therapy and liver targeting strategy, which can accelerate the translation of Rg3 from bench to bedside. Overall, this article serves as a valuable reference for researchers and clinicians alike.

Clinical evaluation of chest trauma (흉부손상의 임상적 고찰)

  • 김영호
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.414-421
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    • 1982
  • 200 patients admitted to the Chest Surgery Department of Jeonbug National University Hospital from January, 1974 to December, 1981 were analyzed clinically. The ratio of male to female was 7: 1, which showed male predominance. Distribution of patients according to age disclosed that over half [62%] of the patients was social age between 20 and 49 years. The most common cause of chest trauma was traffic accident [39%], and the next were stab wound, fall down [17.5%], and hit [8.5%] in decreasing order. Common lesions due to chest trauma were as follows; rib fracture [51%], hemopneumothorax, hemothorax, and pneumothorax in decreasing number. The most common cause of rib fracture was traffic accident [50%] and the associated organ injuries were long bone fracture, head injury, spine and pelvic bone fracture, spleen rupture, and liver laceration. Hemothorax, pneumothorax, and hemopneumothorax were treated with insertion of thoracic catheter in 90 cases, pure thoracentesis in 11 cases, and emergency thoracotomy in 11 cases. In flail chest, 6 patients were treated by intramedullary insertion of Kirschner`s wire and the results were good. The incidence of complication was 17%, including atelectasis [11 cases], pyothorax, fibrothorax, pneumonia, and acute respiratory failure. Four patients were died [2%], and the causes were acute respiratory failure in 2 cases, spinal cord injury in one case and head injury in one case.

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