• Advances in pediatric surgery
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• v.2 no.2
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• pp.143-147
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• 1996

Spontaneous perforation of the bile duct in children is a very rare disorder. We experienced a 6 year-old girl with spontaneous perforation of the right hepatic duct. The patient was initially misdiagnosed as hepatitis because of elevation of liver enzyme and then as appendicitis because of fluid collection in the pelvic cavity demonstrated by ultrasonogram. A laparoscopic exploration was done and no abnormal findings were detected except bile-stained ascites. Peritoneal drainage was performed and the patients seemed to improve clinically. Abdominal pain, distention and high fever developed after removal of the drains. DISIDA scan showed a possible of bile leak into the peritoneal cavity. ERCP demonstrated free spill of dye from the right hepatic duct. At laparotomy, the leak was seen in the anterior wall of the right hepatic duct 2cm above the junction of the cystic duct and common hepatic duct. The perforation was linear in shape and 0.8cm in size. The patient underwent cholecystectomy, primary closure of the perforation and T-tube choedochostomy. We could not identify the cause of the perforation; however, the T-tube cholangiography taken on the 42nd postoperative day showed a little more dilatation of the proximal common bile duct compared with the cholangiography taken on the 14th day. Long-term follow-up of the patient will be necessary because of the possibility for further change of the duct.

• CELLMED
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• v.4 no.3
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• pp.18.1-18.5
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• 2014

Leea asiatica (L.) Ridsdale, a folk medicinal plant is used by the ethnic people of North East India for the treatment of hepatic disorder. In this study, we have investigated the hepatoprotective and antioxidant activity of L. asiatica leaves against acetaminophen induced hepatotoxicity. Methanol extract of L. asiatica (150 and 300 mg/kg/day, p.o.) were administered to rats for three consecutive days followed by single acetaminophen (3000 mg/kg, p.o.) administration on $3^{rd}$ day. After 48 h of acetaminophen administration animals were sacrificed and biochemical estimation of serum, in vivo antioxidant activity using liver tissue were carried out. High levels of serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase, serum alkaline phosphatase, total bilirubin, direct bilirubin, total cholesterol and triglycerides were observed in disease control group, which found near to normal in extract treated groups. Higher dose exhibited significant hepatoprotective activity against acetaminophen induced toxicity. Level of superoxide dismutase, catalase, glutathione peroxidase in liver tissue, and reduced glutathione in liver and blood were also significantly increased in extract (300 mg/kg) treated animals compare to disease control group. In this study we found that leaves of L. asiatica exhibited potent hepatoprotective activity against acetaminophen induced hepatic damage in experimental animals which justify the folklore claim, and the possible mechanism of this activity may be due to strong antioxidant activities of extract.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.202-208
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• 2015

Progressive familial intrahepatic cholestasis type 3 (PFIC3) is an autosomal recessive disorder of cholestasis of hepatocellular origin, typically seen in infancy or childhood caused by a defect in the ABCB4 located on chromosome 7. Here we report on an older patient, aged 15, who presented with biochemical testing that led to an initial consideration of a diagnosis of Wilson disease (WD) resulting in a delayed diagnosis of PFIC3. Diagnosis of PFIC3 was later confirmed by molecular studies that identified novel mutations in the ABCB4 gene. Cholestasis due to PFIC3 can cause elevated hepatic copper and increased urine copper excretion that overlap with current diagnostic criteria for WD. Molecular diagnostics are very useful for establishing the diagnosis of PFIC3. Ursodeoxycholic acid ameliorates cholestasis in PFIC3, and may help mediate a reduction in hepatic copper content in response to treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.263-268
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• 2005

Erythropoietic protoporphyria is a genetic disorder due to a deficiency of ferrochelatase resulting in excessive accumulation and excretion of protoporphyrin. The predominant clinical feature is photosensitivity. Severe hepatic failure occurs in a small percentage of patients, and neurological symptoms are very rare. We report a case of erythropoietic protoporphyria associated with severe hepatic dysfunction and neurological symptoms. A 9-year-old girl presented with severe abdominal pain, nausea, weakness and pain of extremities, and urinary retention. Ultrasonogram and abdominal CT scanning revealed a diffuse infiltrated and enlarged liver. Liver biopsy showed deposition of dense dark brown pigment within the bile, hepatocytes and Kupffer cells. Plus, dense dark brown deposits gave a red birefringent under polarize light. Porphyrin studies demonstrated markedly elevated serum free erythrocyte protoporphyrin. This girl was diagnosed as erythropoietic protoporphyria with severe liver dysfunction and neurological symptoms.

• The Journal of Internal Korean Medicine
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• v.36 no.4
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• pp.470-477
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• 2015

Objectives: Given current vaccinations against the hepatitis B virus and changes in dietary lifestyles, the status of liver disorders, especially in the younger population, is different than it was in the past. This study aimed to discover the prevalence of the HBsAg positive and abnormal hepatic enzyme among college students.Methods: The study analyzed the medical examinations of 2,646 college students that were performed at Semyung University from March to September 2013.Results: A total of 11 out of 2,646 students (0.4%) showed as positive for the hepatitis B antigen, while 23.8% of students had the serum HBs antibody. A total of 212 students (8.0%) showed abnormally elevated serum levels of ALT, with significant differences between men and women. The prevalence of the abnormal serum ALT and its average value significantly increased according to an increase of BMI score, especially in male students.Conclusions: This study showed the importance of obesity as a causative factor in liver disorders, especially in the young generation. This finding will be useful for the development of therapeutics using Korean medicine in the future.

• The Korean Journal of Physiology and Pharmacology
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• v.28 no.1
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• pp.31-38
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• 2024

As in type 1 diabetes, the loss of pancreatic β-cells leads to insulin deficiency and the subsequent development of hyperglycemia. Exercise has been proposed as a viable remedy for hyperglycemia. Lithium, which has been used as a treatment for bipolar disorder, has also been shown to improve glucose homeostasis under the conditions of obesity and type 2 diabetes by enhancing the effects of exercise on the skeletal muscles. In this study, we demonstrated that unlike in obesity and type 2 diabetic conditions, under the condition of insulin-deficient type 1 diabetes, lithium administration attenuated pancreatic a-cell mass without altering insulin-secreting β-cell mass, implying a selective impact on glucagon production. Additionally, we also documented that lithium downregulated the hepatic gluconeogenic program by decreasing G6Pase protein levels and upregulating AMPK activity. These findings suggest that lithium's effect on glucose metabolism in type 1 diabetes is mediated through a different mechanism than those associated with exercise-induced metabolic changes in the muscle. Therefore, our research presents the novel therapeutic potential of lithium in the treatment of type 1 diabetes, which can be utilized along with insulin and independently of exercise.

• Parasites, Hosts and Diseases
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• v.49 no.4
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• pp.413-418
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• 2011

Human alveolar echinococcosis (AE), a hepatic disorder that resembles liver cancer, is a highly aggressive and lethal zoonotic infection caused by the larval stage of the fox tapeworm, Echinococcus multilocularis. E. multilocularis is widely distributed in the northern hemisphere; the disease-endemic area stretches from north America through Europe to central and east Asia, including northern parts of Japan, but it has not been reported in Korea. Herein, we represent a first case of AE in Korea. A 41-year-old woman was found to have a large liver mass on routine medical examination. The excised mass showed multinodular, necrotic, and spongiform appearance with small irregular pseudocystic spaces. Microscopically, the mass was composed of chronic granulomatous inflammation with extensive coagulation necrosis and parasite-like structure, which was revealed as parasitic vesicles and laminated layer delineated by periodic acid-Schiff (PAS) stain. Clinical and histologic features were consistent with AE. After 8 years, a new liver mass and multiple metastatic pulmonary nodules were found and the recurred mass showed similar histologic features to the initial mass. She had never visited endemic areas of AE, and thus the exact infection route is unclear.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.23 no.2
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• pp.8-14
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• 2023

The hepatic glycogen storage disease type 0 (GSD type 0) is an autosomal recessive disorder caused by a deficiency of hepatic glycogen synthase encoded by the glycogen synthase 2 (GYS2) gene, leading to abnormal synthesis glycogen. The clinical findings of GSD type 0 are hyperketotic hypoglycemia at fasting state and accompanying postprandial hyperglycemia and hyperlactatemia. GSD type 0 has only been reported in a very small number so far, and the diagnosis is likely to be missed because symptoms are mild, severe hypoglycemia is rare or asymptomatic, or symptoms gradually disappear with age. Essential management strategies include feeding high-protein meals to stimulate gluconeogenesis, frequent meals to prevent hypoglycemia during the day and feeding complex carbohydrates such as uncooked cornstarch to slowly release glucose during nignt. GSD type 0 has a good prognosis, with appropriate treatment, normal growth can be achieved and no complications occur. Significant hypoglycemia occurs less common in adulthood, but ongoing dietary management may be necessary.

• The Journal of Internal Korean Medicine
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• v.21 no.1
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• pp.100-107
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• 2000

Objective : To investigate the effects of Artemisiae Capillaris Fructus on liver injury induced $CCl_4$. Method : Carbon tetrachloride-induced hepatic injury in $CCl_4$,-treated rats caused changes in the glutamic oxaloacetic transaminase(GOT), glutamic pyruvic transaminase(GPT) and alkaline phosphatase(ALP) activities in the serum. Result : The Methanol extract of the Artemisiae Capillaris Fructus was found to protect the rats against such changes significantly. Protective activities were shown to be present in ether-soluble and buthanol-soluble fractions prepared from the above methanol extract. Conclusion : we have examined the detoxyfying effect, one of several medicinal effects of Artemisiae Capillaris Fructus. on liver disorder experimentally induced by $CCl_4$. as an animal model of liver disorder.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.2
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• pp.153-166
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• 2013

Yang deficiency pattern is a representative syndrome differentiation. This article is a study on to which categories of modern diseases yang deficiency is assigned by reference to modern clinical papers and the meaning of yang deficiency interpreted with a perspective of Korean Medicine and a modern perspective. Yang deficiency, yang qi deficiency, lack of yang qi and yang qi debilitation are the words found in "Nei Ching" and yang qi can be interpreted as something to warm, drive and arouse. Zhangzhongjing considered recovery or loss of Yang as the key to life in "Shanghanlun". Danxi proposed "Yang being liable to hyperactivity, Yin being insufficient" and emphasized pathological ministerial fire of Yang exuberance rather than physiological ministerial fire of Yang deficiency. Zhangjingyue proposed "Yang not being in excess, Yin being often deficient" and understood growth and decline of yin qi are all led by yang qi and put emphasis on true yin in addition to yang qi. Diseases of yang deficiency pattern are related with decline of metabolic level, hypofunction of internal secretion, disorder of immune function, disorder of automatic nerve system, sympathetic nerve inhibition, metabolic disorder of microelements, increase of cGMP, change of microcirculation, low speed of blood stream, kidney malfunction. Diseases related with kidney are sterility, polycystic ovary syndrome, spinal stenosis, edema, renal failure, IgA nephropathy, erectile dysfunction, nephritis, prostatitis, benign prostatic hyperplasia, decrease of adrenal cortical hormone by nephrotic syndrome, myelodysplastic syndrome. Disease related with heart are heart failure, arrhythmia, cardiomyopathy, atherosclerosis heart disease, hypertension, hyperlipidemia, pulmonary heart disease. Diseases related with spleen are irritable bowel syndrome, ulcerative colitis. Diseases related with liver are hypothyroidism, liver cirrhosis ascites, hepatitis B, chronic hepatitis, hepatic diabetes. Diseases related with lung are allergic rhinitis, cough variant asthma, bronchial asthma, pulmonary emphysema. And diabetes mellitus, metabolic syndrome, aplastic anemia, headache, encephalatrophy, Alzheimer's disease are also related with yang deficiency.