• Title/Summary/Keyword: Cerebral

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Functional MR Imaging Using BOLD Technique in Patients with Brain Tumors (뇌종양 환자에서 BOLD 기법을 이용한 기능적 자기공명영상)

  • Kim Jeong;Yim Nam-Yeol;Shin Sang-Soo;Lim Hyo-Soon;Yoon Woong;Chung Tae-Woong;Jeong Yong-Yeon;Jeong Gwang-Woo;Park Jin-Gyoon;Kang Heoung-Keun;Jung Shin;Kang Sam-Suk;Seo Jeong-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.2
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    • pp.124-131
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    • 2003
  • Purpose : To reveal clinical usefulness of functional MRI (fMRI) using sensorymotor and language stimuli for demonstrating anatomic relationship between sensorimotor or language cortices and lesions in the planning of brain tumor surgery. Materials and Methods : This study included 12 right-handed patients with brain tumors in or around sensorimotor or language cortices. Eleven patients were evaluated with primary motor and sensory stimuli. Of these patients, six patients were also evaluated with language stimuli. One patient was evaluated with language stimuli only. For fMR imaging, a 1.5T scanner was used and the EPI BOLD technique was employed. For postprocessing image, the SPM99 program and a program made by our department was utilized. We evaluated whether sensorimotor and language stimuli activate sensorimotor and language cortices. And also, clinical efficacy of revealing anatomic relationship between cerebral cortices and lesions for planning neurosurgical operation were evaluated. Finally, we compared post-operative neurologic function with pre-operative neurologic function in same patients. Results : The fMRI examination was successful in identifying the functional cortices and depicting anatomic relationship between functional cortices and lesions in all patients. In nine patients of 11 patients with identified sensorimotor cortices, postoperative grade of manual motor test was not changed, compared with preoperative grade. Whereas postoperative improved than preoperative grade in one patient of remaining two patients, postoperative aggravated than preoperative grade in the other. This result was due to atherosclerotic lacunar infarction, regardless of tumor resection. Postoperative deficit of language function was not found in seven patients with identified language cortices. Conclusion : fMRI could be a helpful method for determining the best approach to neurosurgical treatment in patients with brain tumors in or around sensorimotor or language cortices.

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Effects of Head Acupuncture Versus Upper and Lower Limbs Acupuncture on Signal Activation of Blood Oxygen Level Dependent(BOLD) fMRI on the Brain and Somatosensory Cortex (두침과 상하지 침자극이 뇌와 뇌의 체성감각피질에 미치는 영향에 대한 fMRI Study)

  • Park, Jung-Mi;Gwak, Ja-Young;Cho, Seung-Yeon;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Jang, Geon-Ho;Bang, Jae-Seung
    • Journal of Acupuncture Research
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    • v.25 no.5
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    • pp.151-165
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    • 2008
  • Objectives : To evaluate the effects of Head Acupuncture versus Upper and Lower Limbs Acupuncture on signal activation of Blood Oxygen Level Dependent(BOLD) fMRI on the Brain and Somatosensory Cortex. Subjects and Methods : 10 healthy normal right-handed female volunteer were recruited. The average age of the 10 subjects was 30 years old. The BOLD functional MRI(fMRI) signal characteristics were determined during tactile stimulation was conducted by rubbing 4 acu-points in the right upper and lower limbs($LI_1$, $LI_{10}$, $LV_3$, $ST_{36}$). After stimulation of Head Acupuncture in Sishencong($HN_1$), $GB_{18}$, $GB_9$, $TH_{20}$ of Left versus Upper and Lower Limbs Acupuncture($LI_1$, $LI_{10}$, $LV_3$, $ST_{36}$ of Right) and took off needles. Then the BOLD fMRI signal characteristics were determined at the same manner. Results : 1. When touched with cotton buds(sensory stimulation), left Parietal Lobe, Post-central Gyrus, primary somatosensory cortex(BA 1, 2, 3), and primary motor cortex(BA 4) were mainly activated. When $ST_{36}$ was stimulated, Frontal Lobe, Parietal Lobe, Cerebellum, and Posterior Lobe as well as Inter-Hemispheric displaying a variety of regions. 2. In signal activation before and after Head Acupuncture reaction, it showed signal activation after removing the acupuncture needle and right Somatosensory Association Cortex, Postcentral Gyrus, and Parietal Lobe were more activated. 3. In reactions of before and after Upper and Lower Limb Acupuncture, it also showed signal activation after removing the acupuncture needle and bilateral Occipital Lobe, Lingual Gyrus, visual association cortex, and Cerebellum were activated. 4. After acupuncture stimulation, In Upper and Lower Limb Acupuncture Group, left frontal Lobe, Precentral Gyrus and Bilateral parietal lobe, Postcentral Gyrus and Primary Somatosensory Cortex(BA 2) were activated. In Head Acupuncture Group, which has most similar activation regions, but especially right Pre-Post central Gyrus, Primary Somatosensory Cortex(BA 3), Primary Motor Cortex, frontal Lobe and Parietal Lobe were activated. Conclusions : When sensory stimulation was done with cotton buds on four acup-points($LI_1$, $LI_{10}4, $LV_3$, $ST_{36}$), while bilaterally activated, contralateral sense was more dominant. It showed consistency with cerebral cortex function. When $ST_{36}$ was stimulated Frontal Lobe, Parietal Lobe, Cerebellum, Posterior Lobe as well as Inter-Hemispheric were stimulated. In Head Acupuncture, it showed more contralateral activation after acupuncture. In Upper and Lower Limb Acupuncture, it showed typically contralateral activation and deactivation of limbic system after acupuncture stimulation. Therefore, there were different fMRI BOLD signal activation reaction before and after Head Acupuncture vs Upper and Lower Limb Acupuncture which might be thought to be caused by acu-points' sensitivity and different sensory receptor to response acupuncture stimulation.

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Effects of Ginseng and Its Saponins on Experimental Amnesia in Mice and on Cell Cultures of Neurons (인삼 및 인삼 사포닌이 쥐의 건망증 및 신경세포배양에 미치는 영향)

  • Saito Hiroshi;Nishiyama Nobuyoshi;Iwai Akihiko;Kawajiri Shinichi;Himi Toshiyuki;Sakai Toshimi;Fukunaka Chizu
    • Proceedings of the Ginseng society Conference
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    • 1988.08a
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    • pp.92-98
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    • 1988
  • The present study was performed to find the effects of ginseng and its saponins. which is written in Chung Yao Ta Tsu Tien as anti-amnesia in its chief indication. on experimental amnesia in mice. In the step through test. ginsenoside $Rb_1\;(GRb_1)\;and\;GRg_1$ facilitated the registration of memory and antagonized the electroconvulsive shock (ECS)-induced inhibition of the retention of memory. Moreover. $GRg_1$ antagonized the EtOH-induced inhibition of the retrieval of memory. In the step down test. $GRb_1\;GRb_2\;and\;GRg_1$ antagonized the ECS-induced inhibition of the retention of memory. Moreover. $GRg_1$ antagonized the EtOH-induced inhibition of the retrieval of memory and facilitated the acquisition of short term memory. In the shuttle hox and lever press tests. they have no effects on acquisition and retrieval of memory. except $GRb_1\;GRb_1$ depressed the retrieval of conditioned avoidance response in the shuttle box test. After the end of four tests. the effects of these orally administered drugs on sedative. analgesic. antipyretic and anticonvulsant actions. and on spontaneous and exploratory movements were tested in doses of less than 500mg/kg. but they had none of these effects. Present study may indicate that $GRg_1$ had effects on the retrieval of memory and on the acquisition process of learning response. The recent research on the role of NGF for the survival. regeneration and regulation of brain in adult animals. indicated the importance of NGF on dementia and amnesia. During our research on the specificity of the neurite out growth induced by NGF. we found that the effect of NGF was potentiated by $GRb_1$ in organ cultures of chick embryonic dorsal root ganglia. Then. the effect of $GRb_1$ on neuronal cell survivalin cell culture system was studied. $GRb_1$ potentiated the NGF-mediated increase of neurofilaments in cell cultures of chick embryonic sensory and sympathetic neurons. NGF with $GRb_1$ also showed a tendency to increase the number of surviving neurons of rat embryonic cerebral cortex. NGF increased choline acetyl transferase activity in cell cultures of rat embryonic septum area neurons. but $GRb_1$ did not potentiate NGF activity in cell cultures of rat embryonic septum area neurons. Present study may indicate that $GRb_1$ plays an important role for the survival or regeneration of neurons in the brain.

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Causes of Sensori-Neural Hearing Impairment in Korean Children (감음신경성난청(感音神經性難聽)의 원인(原因)에 관(關)하여)

  • Rhee, Kyu-Shik;Kim, Young-Soon;Kwon, Do-Ha;Kim, Joo-Ho;Kwon, Yo-Han;Rhee, Tae-Yung;Paik, Choon-Ki;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.55-64
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    • 1976
  • This paper presents the results of a survey for the causes of sensori-neural hearing impairment in Korea, The subjects were 1,676 children of total 2,928 enrolled in 16 Deaf Schools; two schools in each area of Seoul, Busan, Kyoungbook, Kyoungnam, Kyounggi and Chunbug, and each one in Chungnam, Chungbug, Chunnam and Jaeju. The data were collected by questionaire with 28 items distributed to their parents. The filling in the check lists were performed by their class teachers, interviewer, for 18 months from September, 1975 to february, 1976. The questionable or missed problems were reaffirmed. The results obtained were as follows. Most of the reasons, 78.5% were acquired characters that could be developed during pregnant period, the time of delivery and the time of after birth. The pure hereditary reasons except the cases complexed with one or two were only 11.3%. Those who could not be defined with any reasons were 10.2%. Among the acquired causes, 5.8% of total subjects were developed for pregnancy: 3.3%, during delivery; and 69.7%, after birth. In the pregnant period, the drug intoxications were 2.4% of total subjects, several diseases such as influenja, bleeding, surgical operation, venereal diseases and rubella etc. were about one percent, and the accompanied with some symptoms of pregnancy intoxication and traumatic events were 2.4%, During time, the cases with delayed rhythmical pain were 16 persons, the immaturities were 11, the asphyxial cases were nine, the errors of forceps delivery were seven, the cases of low body weight inspite of full term were four, the cases with cesarian section were three, the head injuries were two, and the accompanied with three kinds of above reasons were three. During after birth, the cases with acute communicable diseases were 35.4% of total subjects, the fever unknown origin were 16.1%, the chronic otitis media were 3.7%, the meningitis were 3.5%, the gastric and nutritional diseases were 3.5%, the drug intoxications were 4.8%, the blood diseases were 0.3% and the other causes were 2.2%. Here by acute communicable diseases, some importants were measle, 10.1% of total subjects; meningitis, 7.3%; convulsion with some reasons, 4.9%; poliomyelitis. 3.2%; encephalitis, 2.4%; and mumps, rubella, pertusis, scarlet fever, and small pox were somewhat played a role in. Among 59 cases with train diseases, 53 were concussion by the accidents, such as traffic and falling or sliping down etc., the cerebral paralysis and hydrocephalus were two, respectively. And the blood diseases were severe newjaundice in all five cases. If we were summarized with the above mentioned, most of the hearing impairments were introduced by the combined reasons with familial or hereditary factors and the acquired, than by a simple disease. Among the congenital or hereditary hearing impairments classified to now a day, we suppose that the many cases with the acquired causes during pregnancy, delivery and after birth were complexed. Subsequently, the maternal and child health should be more and more developed in our country, also.

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Principle and Recent Advances of Neuroactivation Study (신경 활성화 연구의 원리와 최근 동향)

  • Kang, Eun-Joo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.172-180
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    • 2007
  • Among the nuclear medicine imaging methods available today, $H_2^{15}O-PET$ is most widely used by cognitive neuroscientists to examine regional brain function via the measurement of regional cerebral blood flow (rCBF). The short half-life of the radioactively labeled probe, $^{15}O$, often allows repeated measures from the same subjects in many different task conditions. $H_2^{15}O-$ PET, however, has technical limitations relative to other methods of functional neuroimaging, e.g., fMRI, including relatively poor time and spatial resolutions, and, frequently, insufficient statistical power for analysis of individual subjects. However, recent technical developments, such as the 3-D acquisition method provide relatively good image quality with a smaller radioactive dosage, which in turn results in more PET scans from each individual, thus providing sufficient statistical power for the analysis of individual subject's data. Furthermore, the noise free scanner environment $H_2^{15}O$ PET, along with discrete acquisition of data for each task condition, are important advantages of PET over other functional imaging methods regarding studying state-dependent changes in brain activity. This review presents both the limitations and advantages of $^{15}O-PET$, and outlines the design of efficient PET protocols, using examples of recent PET studies both in the normal healthy population, and in the clinical population.

Influences of Histamine on Permeability across Blood-brain Barrier (혈액-뇌장벽 투과성에 대한 히스타민의 영향)

  • Kim, Kee-Jin;Shin, Dong-Hoon
    • The Korean Journal of Physiology
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    • v.2 no.2
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    • pp.33-43
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    • 1968
  • Histamine, 0.5 mg as histamine base in 4 ml of normal saline solution, was injected into rabbits anesthetized with nembutal and the mean blood pressure was kept in the range of $52{\sim}80\;mmHg$ for over one hour by supplemental additions. Following the injection of the test substances, 300 mg of urea and 200 mg of antipyrine intravenously, serial blood samples were obtained from the femoral artery and the internal jugular vein at $0.5{\sim}3$ minutes interval. The decreasing patterns in the concentrations of arterial and venous blood plasma samples were compared with each other. The ratio of the concentration of brain tissue to that of the final arterial plasma was also studied. By these measures the degrees of penetration of the test substances in the brain in the control and in the histamine treated rabbits were observed. The concentrations of antipyrine and urea in the arterial blood plasma were decreasing exponentially with respect to the time elapsed. The venous concentrations were anticipated to increase initially and to cross the arterial concentration curve in the point of equlibrium between the plasma and the tissue. On the contrary to the expectation venous concentration also revealed the decreasing tendency similar to that of arterial plasma. The similarity between these two curves, arterial and venous, would be atributable to the fact that the cerebral blood flow rate was large enough and the rising phase in the venous concentration curve was instantly over before serial blood samples were taken. Inspite of some similarity in the decreasing tedency in both concentration curves there were appreciable discrepancies between the arterial and venous plasma which would reflect the situation far from the equlibria among several compartments in the brain. Changes in plasma potassium levels caused by the injection of histamine or bleeding were observed, too. Using 8 rabbits as the control and 12 rabbits for the histamine treated group following results were obtained: 1. Both of the concentration curves, arterial and venous, declined rapidly at_first and slowly later on and approached same equilibrium concentration with the passage of time after a single injection. The time at which attained the same concentration was $2.0{\pm}0.54\;min.$ in the control and $4.3{\pm}1.92\;min.$ in the histamine treated group with respect to antipyrine. On the other hand in the case of urea they were $2.4{\pm}0.59\;min.$ in the control and $4.4{\pm}1.31\;min.$ in the histamine group, respectively. In the histamine treated group enlarged spaces for distribution of test substances were postulated. 2. The concentration of antipyrine in the brain tissue water revealed no significant differences between the control and experimental groups, showing $212{\pm}40.2\;mg/l$ in the control and $206{\pm}64.1\;mg/l$ in the histamine treated group. On the other hand urea revealed higher value in the histamine treated group than in the control, showing an enhanced penetration of urea into the tissue after injection of histamine. Urea concentration in the brain water was $32.3{\pm}3.36\;mg%$ in the control and $39.2{\pm}4.25\;mg%$ in the histamine treated group. 3. The distribution ratio of antipyrine in the brain tissue was very close to unity in the histamine treated animals as well as in the control. 4. The average of the distribution ratio of urea in the control animals was 0.77 and it showed the presence of blood-brain barrier with regard to urea. However in the histamine treated animals the distribution ratios climbed up to 0.86 and they were closer to unity than in the control animals. Out of 12 cases 5 were greater than 0.9 and 8 exceeded 0.85. It appeared that histamine enhanced the penetration of urea through the barrier. 5. Histamine injection and or hemorrhage caused an elevation of the concentration of potassium in plasma. In the event that histamine and hemorrhage were applied together the elevation of potassium exceed the elevation seen at the histamine alone. There was no evidence that the leakage of potassium from the brain tissue was dominant in comparison with the general leakage from the whole body.

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Relationship of Risk Factors and Incidence to Size, Number and Location of Unruptured Intracranial Aneurysm (비파열 동맥류의 크기, 개수, 위치에 따른 위험요인과 발생빈도의 상관관계)

  • Choi, Pahn Kyu;Kang, Hyun Goo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.240-247
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    • 2017
  • The increased investigation of the cerebral arteries with magnetic resonance angiography has resulted in an increase in the identification of unruptured intracranial aneurysms (UIAs). Knowledge of the distribution and factors associated with UIAs might be helpful for understanding the pathological mechanism of unruptured aneurysms. This study examined patients who visited a health care center and had a health examination from January 2007 to December 2016. Subjects who underwent magnetic resonance angiography with a health examination at the Health Screening were enrolled in this study. The incidence and risk factors of UIAs (age, sex, hypertension, diabetes mellitus, smoking, alcohol, and coronary artery disease) were investigated by comparing the size (more than 3 mm vs. less than 3 mm) and multiple aneurysm (single vs. multiple aneurysms). The frequency of aneurysm according to the site was also analyzed. Among the 187166 subjects, who received a health examination, 18954 underwent magnetic resonance angiography. Of them, 367 (1.93%) had UIAs. A comparison of the size of more than 3 mm and less than 3 mm showed that the mean age of the more than 3 mm group of patients was significantly higher than the other size groups (more than 3 mm $57.16{\pm}8.47$ vs. less than 3 mm $55.12{\pm}8.19$; p=0.07). High-density lipoprotein was significantly higher in the more than 3 mm group than in the less than 3 mm($55.95{\pm}16.03$ vs. less than 3 mm $50.85{\pm}13.65$; p=0.007). Hypertension was significantly higher in the multiple aneurysm group (single 153 in 399 (38.3%) VS multiple 19 in 35 (54.3%); p=0.065). An aneurysm of less than 3 mm in size was frequent in the distal internal carotid artery (34.3%) and MCA-bifurcation (16.4%) (p=0.003). Aneurysms of more than 3 mm were frequent in the distal internal carotid artery (43.4%) and MCA-bifurcation (13.4%), and anterior communicating artery (13.4%) (p=0.003). The difference in size and single or multiple aneurysm revealed other risk factors. These risk factors suggest that degenerative and hemodynamic disorders may lead to the presence of aneurysms.

Clinical Result of Aortic Arch Replacement using Antegrade Brain Perfusion Via Right Axillary Artery (우액와동맥을 통한 순행성 뇌관류법을 이용한 대동맥궁 치환의 임상성적)

  • Kim, Dong-Jin;Na, Yong-Jun;Jeong, Dong-Seop;Kim, Kyung-Hwan
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.25-31
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    • 2007
  • Background: Cerebral protection is one of the most important procedures during aortic arch surgery. We can minimize neurological complications through short period of total circulatory arrest and resuming of brain perfusion. We evaluated 11 patients who underwent arch replacement using antegrade brain perfusion via right axillary artery. Material and Method: Between July 2004 and July 2006, 11 patients (male 9, female 2) underwent aortic arch replacement with antegrade brain perfusion via right axillary artery. Preoperative diagnosis was listed; 5 type A aortic dissections (5/11, 45.5%), 5 aortic aneurysms (5/11, 45,5%) and 1 type A IMH (intramural hematoma, 1/11, 9%). The mean age at the time of operation was $60.3{\pm}12.8$ years. For antegrade brain perfusion, we performed right axillary artery cannulation in all patients. Retrograde brain perfusion was used briefly during total circulatory arrest. Result: The mean total circulatory arrest time was $31.1{\pm}16.9$ minutes and the mean retrograde brain perfusion time was $21{\pm}17.8$ minutes. Mean antegrade brain perfusion time was $77.9{\pm}17.5\;(43{\sim}101)$ minutes. We had neither operative mortality nor permanent neurological complications. Conclusion: By means of antegrade brain perfusion via right axillary artery, that could lead to decrease circulatory arrest time and minimize damages to severely atheromatous arch vessels, we can expect to reduce neurological complications after aortic arch replacement. Further investigation with iarge patient populations will be required.

The Efficiency of Radiation Therapy in the Treatment of Intracranial Oligodendrogliomas : Factors Influencing the Prognosis (뇌내 희돌기교종의 방사선치료 성적 및 예후인자)

  • Yoon Sei Chul;Kay Chul Seung;Chung Su Mi;Ryu Mi Ryung;Kim Yeon Shil;Hong Yong Kil;Kim Moon Chan;Kang Joon Ki
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.193-198
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    • 2002
  • Purpose : Oligodendrogliomas (ODG) are a rare, slow growing, tumor in the brain, which can be cured by complete surgical resection, but as yet it is not known if postoperative adjuvant radiation therapy (RT) is essential, We analyzed the treatment results of patients with irradiated ODG to investigate the efficacy of RT in terms of survival rates and other influencing prognostic factors. Methods and Materials : Between March 1983 and December 1997, 42 patients with ODG were treated with RT at our hospital. The RT was peformed dally at a dose of $1.8\~2.0\;Gy$, at 5 fractions per week, to a total dose of between 39.6 Gy and 64.8 Gy (mean 53.3 Gy). The ages of the patients ranged between 5 and 62 years, with a median age of 39 years. The mean follow-up period was 63.4 months (8-152 months). The Kaplan-Meier method was used to assess the survival, and 5 year survival rates (5-YSR). Log rank tests and Cox regression analyses were used to define the significance of prognostic factors. Results : The majority of ODG in this study were located in the cerebral hemisphere $(83.3\%)$. ODG are slightly more common in men than women, and commonly occurs in middle age, between the 3rd and 4th decades. It has been recommended that RT is commenced within 4 weeks following surgery (5-YSR; $86\%\;vs.\;49\%;\;p<0.03$). Histologically well differentiated, as opposed to poorly differentiated, tumors were found to have a more favorable prognosis (p<0.02). The actuarial 5-YSR was $65.3\%$ (median survival 90 months). 5-YSR for the various extents of surgical excision, followed by external RT, was superior to that of biopsy only followed by external RT $(69.9\%\;vs.\;25.6\%,\;p<0.01)$. Tumor size and location, overall elapsed irradiation days, age, sex, whole brain irradiation as a course of treatment and chemotherapy, had no influence on the 5-YSR (p>0.05). Conclusion : A local involved field irradiation with conventional fractionation, commencing within 4 weeks following surgical excision of the tumor, was beneficial for the 5-YSR, but a total radiation dose exceeding 60 Gy did not improve the 5-YSR.

A Randomized, Double-Blind, Placebo-Controlled Trial of Early Ursodeoxycholic Acid Administration for Prevention of Total Parenteral Nutrition-Induced Hepatobiliary Complications (총정맥영양법의 간담도 합병증에 대한 Ursodeoxycholic Acid 조기투여의 이중맹검 위약대조군 연구)

  • Choe, Yon-Ho;Beck, Nam-Sun;Kim, Ji-Hee;Lee, Suk-Hyang;Park, Tae-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.174-180
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    • 2002
  • Purpose: Ursodeoxycholic acid (UDCA) is known to decrease hepatic injury by promoting the biliary secretion of retained toxic endogenous bile acids in hepatobiliary diseases complicated by total parenteral nutrition (TPN). However, most studies have focused on treatment for complications after TPN. We investigated the preventive role of early administration of UDCA in TPN-induced hepatobiliary complications by a randomized, double-blind, placebo-controlled trial. Methods: Between May 2000 and May 2002, thirteen patients, who were given TPN more than 10 days in the hospital, were assigned randomly to two groups. One was the case group (7 patients) who were given UDCA simultaneously with TPN regimen, and the other, the control group (6 patients) who were given placebo. Their age ranged from 1 day to 13 years. They were affected with diseases impossible for enteral nutrition, such as prematurity, cerebral palsy, chronic diarrhea, anorexia nervosa, pancreatitis, and cyclic vomiting. The duration of TPN ranged from 10 to 70 days. Hematologic parameters including liver function test were measured at regular intervals, and the duration, composition, administration rate, total calorie of TPN were recorded. The serum levels of total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase were compared between groups after cessation of the study. Results: The autoregressive coefficient of the control group was 0.4419 (p=0.0651) in bilirubin, -0.0431 (p=0.7923) in AST, 0.2398 (p=0.2416) in ALT, and 0.2459 (p=0.1922) in alkaline phosphatase by mixed procedure model when the parameters were referred to the case group. Conclusion: The serum level of total bilirubin did not increase in comparison with that of the control group, but statistically insignificant, when both TPN and UDCA were administered simultaneously from the beginning.

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