• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.115-122
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• 2023

Hepatic ischemia-reperfusion injury is a major complication of liver transplantation, trauma, and shock. This pathological condition can lead to graft dysfunction and rejection in the field of liver transplantation and clinical hepatic dysfunction with increased mortality. Although the pathological mechanisms of hepatic ischemia-reperfusion injury are very complex, and several intermediators and cells are involved in this phenomenon, oxidative stress and inflammatory responses are the key processes that aggravate hepatic injury. This review summarizes the current understanding of oxidative stress and inflammatory responses and, in that respect, addresses the therapeutic approaches to attenuate hepatic ischemia-reperfusion injury.

• The Journal of Internal Korean Medicine
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• v.21 no.5
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• pp.869-872
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• 2000

Although there are a few reports concerning the hepatic injury of herbal medicine in western medicine, there is no reports concerning the hepatic injury of herbal medicine in oriental medicine. We experienced one case of the hepatic injury suggested toxic hepatitis (drug induced hepatitis) in the treatment of oriental medicine for cerebral infarction. We make a reports for the progress of treatment. One patient of Rt hemiparesis diagnosed cerebral infarction in Brain MRI was administered Taeumin Yuldahanso-tang, treated with physical therapy and improved in the state of Rt hemiparesis(Gr 2/3,4). In the course of treatment, the patient intermittently complained of general weakness, dizziness, pericephalic discomfort(頭不淸), nausea, both leg weakness so we changed Taeumin Yuldahanso-tang to Soyangin Dokwhaljiwhang-tang. Alter that, the patient complained of general weakness, abdominal discomfort, heat and fever($38.4^{\circ}C$). We recognized the elevated total bilirubin(1.7mg/dl), serum transaminase(AST534U/L ALT720U/L), serum gammg glutamyl transpepridase (GGT106mg/dl) and Alk phosphatase124U/L. In the abdominal ultrasonogram there is hepatomegaly (16.5cm). We supposed hepatic injury suggested toxic hepatitis(induced hepatitis) of herbal medicine. After we administered Saeng gan gunbi-tang for 2days and Alk phosphatase and GGT inadequately was elevated. After that, we stopped administering medicine and the serum transaminase, total bilirubin, serum gamma glutamyl transpeptidase and Alk phosphatase level was decreased. In the abdominal ultrasonogram there was no signal. In the case, we supposed that the changing Sasang constitution and Sasang herbal medicine may induce hepatic injury. We are suggesting the necessity of a test for the hepatic injury of herbal medicine.

• The Korea Journal of Herbology
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• v.30 no.1
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• pp.51-57
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• 2015

Objectives : The effect of pear extract with Daekumeumjagami and vitamin C medication(PDV) on alcohol metabolism and hepatic injury was assessed following hepatic injury induced by alcohol in mice. Methods : The model of alcoholic hepatic injury was established by orally administration with 3 g/kg 25% alcohol in mice. PDV was orally administrated once a day for 5 days. Mice were randomly divided into 5 groups : normal group, control group, and PDV groups (PDV-A, PDV-B and PDV-C). The activities of aspartate amino transferase (AST) and alanine amino transferase (ALT) and alcohol dehydrogenase (ADH) in serum, superoxide dismutase (SOD) and catalase in liver were determined after alcohol exposure. Results : Compared with control group, treatment with PDV-B and PDV-C significantly elevated activities of ADH. Moreover, the index of hepatic injury in serum was significantly decreased by treatment with PDV-B and PDV-C in ALT activity and PDV-C in AST activity. Additionally, enhanced catalase activities in liver was found in PDV-C treated mice after exposure to alcohol. Also, WBC in blood was significantly lower by treatment with PDV-B and PDV-C. Conclusions : This study suggests that PDV treatment could enhance alcohol metabolism, and prevent hepatic injury after alcoholic hepatic injury and that this effect is likely related to its modulation on the alcohol metabolizing and antioxidant enzymes.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2022.09a
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• pp.114-114
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• 2022

Excessive endogenous endotoxin, especially lipopolysaccharide (LPS) reflux from gastrointestinal (GI) tract to the liver tissue is one of the most serious reasons of severe and acute liver injury which is mainly mediated by Kupffer cell activations. However, there is no clear molecular clues to explain the exact pathophysiological mechanism and effective drugs available till nowadays. We aimed to comprehend the pathophysiological features of LPS-induced liver injury and evaluate the efficacies of potential therapeutic drug, Ga-mi-Yuk-Mi-Jihwang-Tang (GYM), which is composed of herbal plants. GYM remarkably caused to normalize hepatic inflammation and oxidations against LPS-induced liver injury by evidence of serum liver enzymes, histopathological analysis, both hepatic protein and gene expression levels of pro-inflammatory cytokines, nitric oxide levels, and hepatic tissue levels of reactive oxygen species (ROS) levels, malondialdehyde (MDA), and 4-hydroxyneoneal, respectively. To assess molecular events in the hepatic tissue, we further found hepatic Sirtuin6 (Sirt6) levels were considerably depleted by LPS injection with aberrant alterations of Nrf2/HO-1 signaling pathways, whereas administration with GYM notably exerted to normalize these abnormalities. Our results exhibited that GYM would be one of target drug to diminish hepatic inflammation as well as oxidative stress by regulation of hepatic Sirt6 levels.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.164-168
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• 2007

This study was performed to establish the recovery effect of So Si Ho Tang on hepatic injury in dogs. Clinically healthy eight dogs (1-3 yrs old, 3-5 kg) were divided into control group (n=3) and experimental group (50 mg/kg, n=5). Hepatic injury was induced by administration of $CCl_4$ in all groups. Control group was received no treatment after hepatic injury and experimental group was orally administered with So Si Ho Tang at a dose of 50 mg/kg. The change of serum ALT and AST activities was examined before hepatic injury and on day 0, day 5 and day 12 after administration of So Si Ho Tang. Histopathologic examinations were performed on day 12. As a result, significant changes in serum ALT were found on day 5(p<0.05) and day 12(p<0.05), compared with those of control group, respectively. In addition, significant change in serum AST was found on day 1 (p<0.05) and day 5 (p<0.05), compared with those of control group, respectively. In histopathologic examination, mild hemorrhage and fatty degeneration and vacuolization were observed in experimental group in contrast to those of control group. Accordingly, it was suggested that administration of So Si Ho Tang was effective for hepatic injury induced by $CCl_4$ in dogs.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.231-234
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• 2017

Extrahepatic bile duct injury is commonly associated with hepatic, duodenal, or pancreatic injuries, and isolated extrahepatic bile duct injury is rare. We report a patient who presented with an isolated extrahepatic bile duct injury after blunt trauma. A 50-year-old man was referred to our hospital after having suffered a fall down injury. His laboratory findings showed hyperbiliribinemia with elevated aspartate aminotransferase and alanine aminotransferase level. Initial abdominal computed tomography (CT) showed a mild degree of hemoperitoneum without evidence of abdominal solid organ injury. On the 3rd day of hospitalization, the patient complained of dyspnea and severe abdominal discomfort. Follow-up abdominal CT showed no significant interval change. Owing to the patient's condition, Emergency laparotomy revealed a large amount of bile-containing fluid collection and about 1 cm in size laceration on the left lateral side of the common hepatic duct. Primary repair of the injured bile duct with T-tube insertion was performed On postoperative day (POD) 30, endoscopic retrograde cholangiopancreatography showed minimal bile leakage and endoscopic sphincteroplasty and endoscopic retrograde biliary drainage were performed. On POD 61, the T-tube was removed and the patient was discharged.

• Journal of Trauma and Injury
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• v.29 no.2
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• pp.47-50
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• 2016

Transcatheter arterial embolization (TAE) for blunt hepatic injury in children is not common and is especially rare after damage control surgery (DCS). We report a successful TAE after DCS on a child for massive bleeding from the left hepatic artery due to a motor vehicle accident. The car (a sport utility vehicle) ran over the chest and abdomen of a 4-year-old boy. On arrival, initial vital signs were as follows: blood pressure, 70/40 mmHg; heart rate, 149/min; temperature, $36.7^{\circ}C$; respiratory rate, 38/min. After resuscitation, computed tomography was done, and a suspicious contrast leakage from a branch of the left hepatic artery and a spleen injury (grade V) were found. TAE was performed successfully after DCS for a liver injury.

• Biomolecules & Therapeutics
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• v.32 no.3
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• pp.341-348
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• 2024

Endoplasmic reticulum (ER) stress plays a crucial role in liver diseases, affecting various types of hepatic cells. While studies have focused on the link between ER stress and hepatocytes as well as hepatic stellate cells (HSCs), the precise involvement of hepatic macrophages in ER stress-induced liver injury remains poorly understood. Here, we examined the effects of ER stress on hepatic macrophages and their role in liver injury. Acute ER stress led to the accumulation and activation of hepatic macrophages, which preceded hepatocyte apoptosis. Notably, macrophage depletion mitigated liver injury induced by ER stress, underscoring their detrimental role. Mechanistic studies revealed that ER stress stimulates macrophages predominantly via the PERK signaling pathway, regardless of its canonical substrate ATF4. hnRNPA1 has been identified as a crucial mediator of PERK-driven macrophage activation, as the overexpression of hnRNPA1 effectively reduced ER stress and suppressed pro-inflammatory activation. We observed that hnRNPA1 interacts with mRNAs that encode UPR-related proteins, indicating its role in the regulation of ER stress response in macrophages. These findings illuminate the cell type-specific responses to ER stress and the significance of hepatic macrophages in ER stress-induced liver injury. Collectively, the PERK-hnRNPA1 axis has been discovered as a molecular mechanism for macrophage activation, presenting prospective therapeutic targets for inflammatory hepatic diseases such as acute liver injury.

• CELLMED
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• v.3 no.2
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• pp.15.1-15.5
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• 2013

Previous reports showed that Compound Astragalus and Salvia miltiorrhiza extract (CASE), which was mainly composed of astragalosides, astragalus polysaccharide and salvianolic acids, inhibited hepatic fibrosis by mediating transforming growth factor-${\beta}$ (TGF-${\beta}$)/Smad signaling. Our aim was to examine the effects of CASE on D-galactosamine (D-GalN) treated liver injury in mice and carbon tetrachloride ($CCl_4$)-induced liver fibrosis in rats. CASE was administered to mice with D-GalN-induced liver injury and to rats with $CCl_4$-induced liver fibrosis, respectively. Liver injury was routinely evaluated by relative liver weight, serum levels of ALT, AST, hyaluronic acid (HA), hepatic malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, hydroxyproline (HYP) and histopathologic changes. Treatment of mice with CASE (60, 120, and 240 mg/kg, ig) significantly lowered ALT, relative liver weight, and MDA levels when compared with D-GalN treated mice. CASE (120, 240 mg/kg) significantly lowered ALT, AST, HA, HYP, and MDA levels against $CCl_4$ treated rats. Decreased SOD level was reversed with CASE treatment. Upon histopathological examination, CASE treatment had significantly inhibitory effect on the progression of hepatic fibrosis in rats. These results indicate that CASE might be effective in treatment and prevention of acute and chronic hepatic injury due to its antioxidant activity.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.211-214
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• 2015

The primary and secondary survey was designed to identify all of a patient's injuries and prioritize their management. However 15 to 22.3% of patient with missed injuries had clinically significant missed injuries. To reduce missed injury, special attention should be focused on patients with severe anatomical injury or obtunded. Victims of blunt trauma commonly had multiple system involvement. Some reports indicate that inexperience, breakdown of estalished protocol, clinical error, and restriction of imaging studies may be responsible for presence of missed injury. The best way of reducing clinical significant of missed injuries was repeated clinical assessment. Here we report a case of severe blunt hepatic injury patient and pericardial injury that was missed in primary and secondary survey. After damage control surgery of hepatic injury, she remained hemodynamically unstable. Further investigation found cardiac tamponade during intensive care. This was managed by pericardial window operation through previous abdominal incision and abdominal wound closure was performed.