• Title/Summary/Keyword: Acute-on-chronic liver disease

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A Study on the Measurement of Intrapulmonary Shunt in Liver Diseases by the Nucleotide Method (핵의학적 방법에 의한 간질환자(肝疾患者)의 폐장내 단락양 측정에 관한 연구)

  • Yun, Sung-Chul;Ahn, Jae-Hee;Choi, Soo-Bong
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.2
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    • pp.199-205
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    • 1987
  • The fact there are increase of intrapulmonary arterioveneous shunt amount in the liver cirrhosis patient has been known since 1950. And the method of shunt amount calculation by radionuclide method using $^{99m}Tc-MAA$ was introduced in the middle of 1970. We measured intrapulmonary shunt amount by means of perfusion lung scan using $^{99m}Tc-MAA$ in the various type of liver diseases especially in chronic liver diseases and acute liver disease. The results were as followed. 1) The amount of arteriovenous intrapulmonary shunt in the total case of liver disease was $9.3{\pm}3.9%$, and that of in the control group was $4.6{\pm}2.1%$. 2) The amount of arteriovenous intrapulmonary shunt in the chronic liver disease was $10.8{\pm}4.4%$, and that of in the acute liver disease was $7.2{\pm}2.8%$. We observed significant differences between normal control group and liver disease group, and between chronic liver disease group and acute liver disease group in the amount of shunt by the nucleolide method.

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A method of background noise removal of Raman spectra for classification of liver disease (간 질병 분류를 위한 라만 스펙트럼의 배경 잡음 제거 방법)

  • Park, Aaron;Baek, Sung-June
    • Smart Media Journal
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    • v.2 no.2
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    • pp.33-38
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    • 2013
  • In this paper, we investigated baseline estimation methods for remove background noise using Raman spectra from acute alcohol liver injury and acute ethanol-induced chronic liver fibrosis. Far the baseline estimation, we applied first derivative, linear programming and rolling ball method. Optimal input parameter of each method were determined by the training rate of MAP (maximum a posteriori probability) classifier. According to the experimental results, classification results baseline estimation with the rolling ball algorithm gave about 89.4%, which is very promising results for classification of acute alcohol liver injury and acute ethanol-induced chronic liver fibrosis. From these results, to determined the appropriate methods and parameters of baseline estimation impact on classification performance was confirmed.

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Protective Effects of SAPP, a Novel Herbal Complex, in Acute Hepatotoxic Mouse Model

  • Lee, Geum Seon;Lee, Ki Man;Kim, Seung Hyun;Jeong, Nam-Joo;Kim, Young-Jung;Jung, Ju-Young;Kang, Tae Jin
    • Natural Product Sciences
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    • v.19 no.2
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    • pp.173-178
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    • 2013
  • The protective effect of SAPP, an extract from a novel herbal complex, on acute liver injury was investigated using mouse animal model in this study. The content of total phenol in SAPP was increased at dose dependent manner. Consistent with the content of total phenol, SAPP showed the significant anti-oxidative effects on 1, 1-diphenyl-2-picrylhydrazyl (DPPH) method. Acute liver injury was induced by D-galactosamine (D-GalN) in mouse. Treatment with SAPP significantly reduced the level of alanine transaminase (ALT) and aspartate transaminase (AST) in serum. Histological observation revealed that whereas D-GalN treated mouse showed vacuolization of hepatocytes, sinusoidal dilation and congestion, loss of cell boundaries and ballooning degeneration, loss of architecture and cell necrosis, treatment with SAPP improved D-GalN-induced liver injury. These results suggest that SAPP shows protective effects against D-GalN-induced hepatotoxicity in vivo acute mouse model.

Favorable effect of corticosteroids in treating acute-on-chronic liver failure underlying chronic hepatitis B

  • Kim, Hyeji;Kwon, Jung Hyun;Kim, Yong Hee;Nam, Soon Woo;Lee, Jong Yul;Jang, Jeong Won
    • Clinical and Molecular Hepatology
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    • v.24 no.4
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    • pp.430-435
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    • 2018
  • Acute-on-chronic liver failure (ACLF) occurs in the presence of a chronic liver disease or cirrhosis, and often results from exacerbation of chronic hepatitis B (CHB). The efficacy of corticosteroid treatment in ACLF patients with underlying CHB remains unclear. We report the case of a 50-year-old woman who experienced ACLF due to CHB exacerbation and was treated with a combination of corticosteroids and nucleot(s)ide analogue (NUC). The patient showed rapid decompensation due to CHB exacerbation. Three months of antiviral therapy produced no improvement in liver function. Combination therapy with corticosteroids and NUC was started, which did result in improvement of liver function. This case shows that the combined therapy of corticosteroids and NUC can be effective in treating ACLF due to CHB exacerbation.

The Pallidal Index in Patients with Acute-on-Chronic Liver Disease: Is It a Predictor of Severe Hepatic Encephalopathy?

  • Lee, Dong Hyun;Lee, Hui Joong;Hahm, Myong Hun
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.125-130
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    • 2017
  • Purpose: To evaluate the clinical significance of T1 high signal intensity on the globus pallidus as a predictor of severe hepatic encephalopathy in patients with acute-on-chronic liver failure (ACLF), which is a distinct syndrome characterized by multi-organ dysfunction including cerebral failure. Materials and Methods: From January 2002 to April 2014, we retrospectively reviewed the magnetic resonance imaging (MRI) findings and clinical and magnetic resonance (MR) features of 74 consecutive patients (44 men and 30 women; mean age, 59.5 years) with liver cirrhosis. The chronic liver failure-sequential organ failure assessment score was used to diagnose ACLF. The pallidal index (PI), calculated by dividing the mean signal intensity of the globus pallidus by that of the subcortical frontal white matter were compared according to ACLF. The PI was compared with the Model for End-Stage Liver Disease (MELD) score in predicting the development of ACLF. Results: Fifteen patients who were diagnosed with ACLF had higher hepatic encephalopathy grades (initial, P = 0.024; follow-up, P = 0.002), MELD scores (P < 0.001), and PI (P = 0.048). In the ACLF group, the mean PI in patients with cerebral failure was significantly higher than that in the patients without cerebral failure (1.33 vs. 1.20, P = 0.039). In patients with ACLF, the area under the curve (AUC) for PI was 0.680 (95% confidence intervals [CI], 0.52-0.85), which was significantly lower than that for the MELD score (AUC, 0.88; 95% CI, 0.77-0.99) (P = 0.04). Conclusion: The PI can be an ancillary biomarker for predicting the development of ACLF and severe hepatic encephalopathy.

Hepatic encephalopathy on magnetic resonance imaging and its uncertain differential diagnoses: a narrative review

  • Chun Geun Lim;Myong Hun Hahm;Hui Joong Lee
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.136-145
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    • 2023
  • Hepatic encephalopathy (HE) is a severe neuropsychiatric abnormality in patients with either acute or chronic liver failure. Typical brain magnetic resonance imaging findings of HE are bilateral basal ganglia high signal intensities due to manganese deposition in chronic liver disease and hyperintensity in T2, fluid-attenuated inversion recovery, or diffusion-weighted imaging (DWI) with hemispheric white matter changes including the corticospinal tract. Low values on apparent diffusion coefficient mapping of the affected area on DWI, indicating cytotoxic edema, can be observed in acute HE. However, neuropsychological impairment in HE ranges from mild deficits in psychomotor abilities affecting quality of life to stupor or coma with higher grades of hepatic dysfunction. In particular, the long-lasting compensatory mechanisms for the altered metabolism in chronic liver disease make HE imaging results variable. Therefore, the clinical relevance of imaging findings is uncertain and differentiating HE from other metabolic diseases can be difficult. The recent introduction of concepts such as "acute-on-chronic liver failure (ACLF)," a new clinical entity, has led to a change in the clinical view of HE. Accordingly, there is a need to establish a corresponding concept in the field of neuroimaging diagnosis. Herein, we review HE from a historical and etiological perspective to increase understanding of brain imaging and help establish an imaging approach for advanced new concepts such as ACLF. The purpose of this manuscript is to provide an understanding of HE by reviewing neuroimaging findings based on pathological and clinical concepts of HE, thereby assisting in neuroimaging interpretation.

A Clinical Study on the Effects of Saenggan-tang (생간탕(生肝湯)의 효능(效能)에 관(關)한 임상적(臨床的) 연구(硏究))

  • Lee, Bo-Hyeong;Kim, Deok-Ho;U, Hong-Jeong;Kim, Byeong-Un
    • The Journal of Internal Korean Medicine
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    • v.11 no.1
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    • pp.29-40
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    • 1990
  • In order to study the effect on liver diseases, Saenggan-tang has been applied to 26 patients of chronic hepatitis, 9 patients of liver cirrhosis, 5 patients of acute hepatitis, 8 patients of alcoholic liver diseases, 1 patient of hepatoma total 49 patients visiting the first internal medicine department of the hospital of Oriental Medicine, Kyung Hee University. The Saenggan-tang was taken every 4 weeks (ecept acute hepatitis every 2 weeks). 1. Saenggan-tang had decrease on activity of SGOTF SGPT, with the passage of time, 4, 8, and 12 weeks, showing statistically significant effect. 2. Saenggan-tang revealed sharp decrease on levels of total bilirubin and alkaline phosphatase no showing significance in relation to a few cases 3. Serum protein total and albumin levels were in normal limit before or after Saenggan-tang treatment 4. Triglyceride level was lowered remarkably after Saenggan-tang treatment, showing significance in alcoholic liver disease group whereas no significance in chornic hepatitis Judging from above results, it is proved that Saenggan-tang has curative effect of liver diseases such as acute, chronic hepatitis, liver cirrhosis, alcobolic liver diseases and so on.

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Application of MAP and MLP Classifier on Raman Spectral Data for Classification of Liver Disease (라만 스펙트럼에서 간 질병 분류를 위한 MAP과 MLP 적용 연구)

  • Park, Aa-Ron;Baek, Seong-Joon;Yang, Bing-Xin;Na, Seung-You
    • The Journal of the Korea Contents Association
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    • v.9 no.2
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    • pp.432-438
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    • 2009
  • In this paper, we evaluated the performance of the automatic classifier applied for the discrimination of acute alcoholic liver injury and chronic liver fibrosis. The classifier uses the discriminant peaks of the preprocessed Raman spectrum as a feature set. In preprocessing step, we subtract baseline and apply Savitzky-Golay smoothing filter which is known to be useful at preserving peaks. After identifying discriminant peaks from the spectra, we carried out the classification experiments using MAP and neural networks. According to the experimental results, the classifier shows the promising results to diagnosis alcoholic liver injury and chronic liver fibrosis. Classification results over 80% means that the peaks used as a feature set is useful for diagnosing liver disease.

Automated Clinical best Result Analysis System - Application to liver function test - (퍼지이론을 이용한 임상검사 자동분석에 관한 연구 - 간기능검사 결과 자동분석시스템 -)

  • 차은종;이태수
    • Journal of Biomedical Engineering Research
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    • v.14 no.4
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    • pp.341-348
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    • 1993
  • Automated system to analyze liver function test results is presented based on fuzzy logic knowledge. Clinician's knowledge and experience was first expressed in linguistic terms fol- lowed by conversion to numerical values to create membership functions of disease possibility for each test item and liver disease. Membership functions were then compensated for different relative importances of test items. Liver diseases considered were acute viral hepatitis (AVH), chronic persistent hepatitis(CPH), chronic active hepatitis(CAH), and liver cirrhosis(LC), Liver function test results of alanine aminotransferase(ALT), aspartate amino- transferase(AST) , glutamate dehydrogenase(GDH), ornithine carbamyltransferase(OCT) , ALT/AST, and 10* GDH/ALT in 218 patients were analyzed by the present system, welch resulted in 80% accuracy. AVH and CAH showed the highest 93 % and the lowest 58% ac- curacies, respectively, which was similar to the clinician's expectation. The simple mathemat- ical formulation of the present system would enable an easy implementation in commercial analysis instruments. Also, the identical fuzzy logic can be applied to similar diagnostic envi- ronments in general.

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Hepatoprotective Effect of Alnus japonica and Portulaca oleracea Complex on Alcohol-induced Liver Injury Mice Models by Anti-oxidation Activity

  • Dong ki Hong;Soodong Park;Jooyun Kim;Jaejung Shim;Junglyoul Lee
    • Korean Journal of Plant Resources
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    • v.36 no.3
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    • pp.198-206
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    • 2023
  • The effectiveness of the extracts of Alnus japonica and Portulaca oleracea, which are effective in improving alcohol-induced liver damage, was confirmed using acute and chronic alcoholic liver injury animal models. In the acute alcoholic liver injury model, dieting Alnus japonica and Portulaca oleracea complex (ALPOC) at a dose of 50 mg/kg showed no significant change in liver or body weight, while measured plasma ALT activity to be deficient (28.12 U/ml) compared to the alcohol intake group (42.5 U/ml), and confirmed that restored it to an average level. It showed an improvement of 34.9% compared to the alcohol intake group. AST activity confirmed that it showed a very effective liver protection activity by showing a gain of 12.6%. The chronic alcoholic liver damage animal model demonstrated that ALT showed an improvement effect of 25%, and AST showed an effect similar to that of the positive control group, Hovenia extract. In addition, through H&E staining analysis, observed that the ALPOC improved the necrosis and bleeding of the liver. And the ALPOC group showed intense antioxidant activity of 127% or more compared to the alcohol intake group, and this was confirmed to have a very high activity, which is more than 20% higher than that of the hovenia fruit extract.