• Title/Summary/Keyword: End stage liver disease

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Prevalence and Risk Factors of Fatty Liver among Industrial Male Workers (산업장 남성 근로자의 지방간 유병율 및 위험요인 연구)

  • Paek, Yun-Mi;Choi, Tae-In;Kim, Yun-Jeong;Choi, Eun-Ok
    • The Korean Journal of Rehabilitation Nursing
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    • v.10 no.2
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    • pp.141-146
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    • 2007
  • Purpose: This study was conducted to estimate the prevalence rate, and related factors,of fatty liver in male industrial workers. Method: Fatty liver was diagnosed using ultrasonography. The data for abdominal ultrasonography, BMI, smoking, alcohol drinking, exercise, liver enzymes, and lipid profiles were collected in 4,604 male who were examined with a health screening program in 2005. Prevalence rate and associated factors of fatty liver were analyzed using SPSS v. 12.0. Results: Overall prevalence of fatty liver was 34.1% and higher in the 30-39 year male group. Age, body mass index(BMI), hypertriglyceridemia, hypercholesterolemia, HDL cholesterol, r-GTP level were independently associated factors with presence of fatty liver in logistic regression analysis. Conclusion: The prevalence of fatty liver and tendency of associated factors were similar to those in the western world. To prevent development of this hepatic disorder, which may result in end-stage liver disease, risk factors such as obesity and dyslipidemia must be monitored and controlled within normal levels. The results of this study suggested maintenance of a healthy lifestyle, including diet, exercise, and behavioral change, as fundamental rehabilitation nursing implications.

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Nutritional Status of Liver Transplantation Recipients and Factors Influencing Nutritional Status (간 이식 수혜자의 영양 상태와 영향 요인)

  • Hwang, SinYoung;Choi-Kwon, Smi
    • Journal of Korean Academy of Nursing
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    • v.49 no.3
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    • pp.340-348
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    • 2019
  • Purpose: This study aimed to investigate the nutritional status of liver transplantation (LT) recipients and explore certain factors that influence nutritional status, including dietary patterns and physical activities. Methods: This was a cross-sectional, descriptive study. The subjects included 211 LT recipients at a medical center outpatient clinic located in Seoul, Korea. The nutritional status, dietary patterns, and physical activities of each subject were measured using the body mass index (BMI), Mini Dietary Assessment (MDA), and Global Physical Activity Questionnaire. Independent t-test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the data. Results: The percentages of living and deceased donor LTs were 81.0% and 19.0%, respectively. The mean BMIs pre- and post-LT were 23.88 and $23.16kg/m^2$, respectively, and the average MDA score was 36.55. More than 60.0% of the subjects had a moderate or high level of physical activity. In multivariate analysis, a higher BMI before LT (${\beta}=.72$, p<.001), a lower Model for End-stage Liver Disease (MELD) score (${\beta}=-.18$, p<.001), and being male (${\beta}=-.10$, p=.024) contributed to better nutritional status post-LT. Patients within six months of LT were less engaged in muscle exercises than those post six months of LT (p=.020). Conclusion: LT recipients in Korea have good nutritional status and a good level of physical activity. To improve recipients' post-LT nutritional status, the pre-LT nutritional status should be considered, particularly in those with a higher MELD score. In addition, physical activity including muscle-strengthening exercises should be encouraged from an earlier stage.

Measurements of the Hepatectomy Rate and Regeneration Rate Using Deep Learning in CT Scan of Living Donors (딥러닝을 이용한 CT 영상에서 생체 공여자의 간 절제율 및 재생률 측정)

  • Sae Byeol, Mun;Young Jae, Kim;Won-Suk, Lee;Kwang Gi, Kim
    • Journal of Biomedical Engineering Research
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    • v.43 no.6
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    • pp.434-440
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    • 2022
  • Liver transplantation is a critical used treatment method for patients with end-stage liver disease. The number of cases of living donor liver transplantation is increasing due to the imbalance in needs and supplies for brain-dead organ donation. As a result, the importance of the accuracy of the donor's suitability evaluation is also increasing rapidly. To measure the donor's liver volume accurately is the most important, that is absolutely necessary for the recipient's postoperative progress and the donor's safety. Therefore, we propose liver segmentation in abdominal CT images from pre-operation, POD 7, and POD 63 with a two-dimensional U-Net. In addition, we introduce an algorithm to measure the volume of the segmented liver and measure the hepatectomy rate and regeneration rate of pre-operation, POD 7, and POD 63. The performance for the learning model shows the best results in the images from pre-operation. Each dataset from pre-operation, POD 7, and POD 63 has the DSC of 94.55 ± 9.24%, 88.40 ± 18.01%, and 90.64 ± 14.35%. The mean of the measured liver volumes by trained model are 1423.44 ± 270.17 ml in pre-operation, 842.99 ± 190.95 ml in POD 7, and 1048.32 ± 201.02 ml in POD 63. The donor's hepatectomy rate is an average of 39.68 ± 13.06%, and the regeneration rate in POD 63 is an average of 14.78 ± 14.07%.

Cytokine-like Activity of Liver Type Fatty Acid Binding Protein (L-FABP) Inducing Inflammatory Cytokine Interleukin-6

  • Hyunwoo Kim;Gaae Gil;Siyoung Lee;Areum Kwak;Seunghyun Jo;Ensom Kim;Tam T. Nguyen;Sinae Kim;Hyunjhung Jhun;Somi Kim;Miyeon Kim;Youngmin Lee;Soohyun Kim
    • IMMUNE NETWORK
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    • v.16 no.5
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    • pp.296-304
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    • 2016
  • It has been reported that fatty acid binding proteins (FABPs) do not act only as intracellular mediators of lipid responses but also have extracellular functions. This study aimed to investigate whether extracellular liver type (L)-FABP has a biological activity and to determined serum L-FABP levels in patients with end-stage renal disease (ESRD). We isolated L-FABP complementary deoxyribonucleic acid (cDNA) from the Huh7 human hepatocarcinoma cell line and expressed the recombinant L-FABP protein in Escherichia coli. A549 lung carcinoma and THP-1 monocytic cells were stimulated with the human recombinant L-FABP. Human whole blood cells were also treated with the human recombinant L-FABP or interleukin (IL)-1α. IL-6 levels were measured in cell culture supernatants using IL-6 enzyme-linked immunosorbent assay (ELISA). Human recombinant L-FABP induced IL-6 in a dose-dependent manner in A549, THP-1 cells, and whole blood cells. The blood samples of healthy volunteers and patients with ESRD were taken after an overnight fast. The serum levels of L-FABP in healthy volunteers and ESRD patients were quantified with L-FABP ELISA. The values of L-FABP in patients with ESRD were significantly lower than those in the control group. Our results demonstrated the biological activity of L-FABP in human cells suggesting L-FABP can be a mediator of inflammation.

Experiences of Pregnancy and Childbirth in Women after Liver Transplantation (간이식 여성의 임신과 출산 경험)

  • Ha, Hea Seon;Lim, Kyung-Choon;Hong, Jung Ja;Kim, In Ok;Jeon, Mi Kyeong;Jeong, Jae Sim;Lee, Soon Haeng;Son, Haeng Mi;Yi, Myungsun;Lee, Sung Gyu
    • Korean Journal of Adult Nursing
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    • v.25 no.6
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    • pp.690-700
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    • 2013
  • Purpose: Liver transplantation (LT) is the best treatment for patients with end-stage liver disease and most patients with LT return to their normal life. However, pregnancy and childbirth for women with LT are less common, mainly because it is considered to be dangerous for their health. The purpose of this study was to describe how Korean women after LT experience their pregnancy and childbirth. Methods: This study was designed to explore the experiences of pregnancy and childbirth of women with LT. Data were collected by individual in-depth interviews with four women who were pregnant and gave birth following LT in 2009. All interviews were audio-taped and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results: Four themes emerged as a result of analysis: recovery of lost feminity and marriage; fulfilling roles through pregnancy; life-risking pregnancy; and perfect family achieved by childbirth. These themes describe in detail about challenges and concerns the women with LT faced for their pregnancy and childbirth as well as many emotionally touching experiences. Conclusion: The results of this study would support health professionals to be better prepared to help women with LT for pregnancy and childbirth by providing in-depth and insightful information.

Inferior Vena Cava Stenosis Following Orthotopic Liver Transplantation: Differentiating Points from False Positives (뇌사자 간이식 후 발생한 하대정맥 협착: 위양성과의 감별점)

  • Yeonsoo Choi;Jin Hyeok Kim;Ung Bae Jeon;Joo Yeon Jang;Tae Un Kim;Hwaseong Ryu
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.713-718
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    • 2023
  • Orthotopic liver transplantation has become the treatment of choice for patients with end-stage liver disease. Various early or delayed vascular complications, including arterial pseudoaneurysm, thrombosis, or stenosis, and venous stenosis or occlusion, may lead to graft failure. Early detection and prompt management of such complications are essential to achieve successful transplantation and prevent the need for retransplantation. This report presents differentiating points, using computed tomography and digital subtraction angiography findings and measurement of pressure gradient across the stenotic lesion, that require immediate intervention in patients with inferior vena cava stenosis after orthotopic liver transplantation.

Partial Pancreatectomy Using an Ultrasonic-Activated Scalpel in Two Spaniel Dogs with Canine Insulinoma

  • Park, Jiyoung;Lee, Hae-Beom;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.34 no.5
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    • pp.359-365
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    • 2017
  • Two spaniel dogs were presented with a history of lethargy, weakness, refractory hypoglycemia, and episodic seizure. A pancreatic mass on the distal end of the left limb was identified through screening tests including dualphase CT angiography in each patient. Canine insulinoma was suspected with low blood glucose, low fructosamine, and normal to high serum insulin levels. Exploratory laparotomies were performed, and partial pancreatectomy using an ultrasonic-activated scalpel was achieved without enzyme leakage or fistula formation after surgery. The lesions were definitively diagnosed as insulinoma via histopathologic examination. One dog has been doing well until POD 870 with medication; in the other dog, diffuse hepatic nodules noted during surgery were confirmed as a liver metastasis. This dog died at POD 45. This case report addresses the utility of the ultrasonic scalpel in partial pancreatectomy for the treatment of canine insulinoma and differences in prognosis according to disease stage.

Upregulation of Carbonyl Reductase 1 by Nrf2 as a Potential Therapeutic Intervention for Ischemia/Reperfusion Injury during Liver Transplantation

  • Kwon, Jae Hyun;Lee, Jooyoung;Kim, Jiye;Kirchner, Varvara A.;Jo, Yong Hwa;Miura, Takeshi;Kim, Nayoung;Song, Gi-Won;Hwang, Shin;Lee, Sung-Gyu;Yoon, Young-In;Tak, Eunyoung
    • Molecules and Cells
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    • v.42 no.9
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    • pp.672-685
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    • 2019
  • Currently, liver transplantation is the only available remedy for patients with end-stage liver disease. Conservation of transplanted liver graft is the most important issue as it directly related to patient survival. Carbonyl reductase 1 (CBR1) protects cells against oxidative stress and cell death by inactivating cellular membrane-derived lipid aldehydes. Ischemia-reperfusion (I/R) injury during living-donor liver transplantation is known to form reactive oxygen species. Thus, the objective of this study was to investigate whether CBR1 transcription might be increased during liver I/R injury and whether such increase might protect liver against I/R injury. Our results revealed that transcription factor Nrf2 could induce CBR1 transcription in liver of mice during I/R. Pre-treatment with sulforaphane, an activator of Nrf2, increased CBR1 expression, decreased liver enzymes such as aspartate aminotransferase and alanine transaminase, and reduced I/R-related pathological changes. Using oxygen-glucose deprivation and recovery model of human normal liver cell line, it was found that oxidative stress markers and lipid peroxidation products were significantly lowered in cells overexpressing CBR1. Conversely, CBR1 knockdown cells expressed elevated levels of oxidative stress proteins compared to the parental cell line. We also observed that Nrf2 and CBR1 were overexpressed during liver transplantation in clinical samples. These results suggest that CBR1 expression during liver I/R injury is regulated by transcription factor Nrf2. In addition, CBR1 can reduce free radicals and prevent lipid peroxidation. Taken together, CBR1 induction might be a therapeutic strategy for relieving liver I/R injury during liver transplantation.

A Case of Secondary Sclerosing Cholangitis in Langerhans Cell Histiocytosis (랑게르한스세포 조직구증 환아에서 발생한 속발성 경화성 담관염 1례)

  • Kim, Ja-Hyung;Choi, Bo-Hwa;Kim, Kyung-Mo;Moon, Hyung-Nam
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.120-124
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    • 2001
  • Sclerosing cholangitis is a chronic cholestatic disease characterized by inflammation and obliterative fibrosis of the bile ducts, leading to biliary cirrhosis and ultimately to liver failure. In children, sclerosing cholangitis is known to be associated with Langerhans cell histiocytosis, as well as with congenital immunodeficiencies and cystic fibrosis. Secondary sclerosing cholangitis is suspected in Langerhans cell histiocytosis with chronic cholestasis, liver dysfunction and portal hypertension. Unlike primary sclerosing cholangitis, the cholangitis associated Langerhans cell histiocytosis is destructive in nature and progresses more rapidly to biliary cirrhosis, therefore uniformly the prognosis is poor. In this setting, liver transplantation should be considered early in children with sclerosing cholangitis complicating Langerhans cell histiocytosis before end-stage liver failure and variceal bleeding. We experienced a case of secondary sclerosing cholangitis in Langerhans cell histiocytosis in a 2-year-old boy. We report this case with brief review of the related literatures.

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Drug Evaluation of Ursodeoxycholic Acid Use for Treatment of Cholestasis Associated with TPN Therapy in Neonate (신생아의 TPN 요법 시 발생되는 Cholestasis 치료를 위한 Ursodeoxycholic Acid의 약물사용 평가)

  • Lee, Jung-Ok;Song, Tae-Beom;Lee, Myung-Koo;Lim, Sung-Cil
    • YAKHAK HOEJI
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    • v.54 no.4
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    • pp.270-281
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    • 2010
  • Total parenteral nutrition (TPN) is necessary to neonates in neonatal intensive care unit (NICU) for survival and growth because of impossible of enteral feeding. Long-term TPN can be associated with a broad spectrum of hepatobiliary disorder, ranging from mild hepatic dysfunction to severe end-stage liver disease. Cholestasis developed most commonly in neonate, ursodeoxycholic acid (UDCA) is widely used in adult with cholestatic and non-cholestatic liver diseases but there have been limited data on the effects in neonate with PNAC. This study was performed retrospectively to review all medical histories of the total 30 neonates with was administrated UDCA for treatment to parenteral nutrition associated cholestasis (PNAC) at Chungbuk National University Hospital NICU from April 2002 to December 2008. UDCA was administrated at bilirubin is over 2 mg/dl. The criterias for drug evaluation were included hepatic biochemical marker such as direct bilirubin, total bilirubin, AST, ALT, ALP and GGT, TPN therapy period, cholestasis development period, UDCA treatment period, UDCA dosage and adverse effect. In the results, Post-UDCA treatment significant was decreased direct bilirubin, total bilirubin, AST and ALP (p<0.05), and was decreased GGT (p>0.05) and slightly was increased ALT (p>0.05). Reffective timect biDCA was appear at mean $10.5{\pm}1.3$ days, iDCA administration period was mean $64.4{\pm}5.9$ days, cholestasis period was mean $71.9{\pm}6.4$ days and UDCA dosage was mean $22.9{\pm}0.9$ mg/kg/day. Common adverse effects is diarrhea, 5 patients arised mild diarrhea but it possible also related with increased enteral feeding. In conclusion, iDCA can decrease direct bilirubin that major parameter t bcholestasis and oher hepatic biochemical makers. UDCA is effective on PNAC without any serious side effect and cost-effective. Although no greatly shortening cholestasis period, but can protect to develop into severe liver disease and other complication or death. Based on these result, UDCA is recommended for treatment of cholestasis at direct bilirubin is over 2 mg/dl.