• Neonatal Medicine
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• v.17 no.1
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• pp.136-140
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• 2010

Galactosemia is a group of inherited enzyme deficiencies characterized by increase in the blood galactose levels. This condition may be associated with deficiencies of galactose-1-phosphate uridyl transferase, galactokinase, or uridine diphosphate galactose-4-epimerase. However, the elevated galactose identified by neonatal screening tests has several other possible etiologies, including hepatic hemangioendothelioma, hepatic hemangioma, and patent ductus venosus with hypoplasia of the portal vein. We report a 13-day-old Korean male with hepatic hemangioendothelioma, which was incidentally detected during the evaluation for suspected galactosemia. Laboratory studies revealed that mildly elevated levels of galactose, galactose-1-phosphate and alpha- fetoprotein, at the time of admission, were graduallydecreased to the normal range over the 6 months of observation. Ultrasonography showed a well-defined heterogeneous hypoechoic mass in the liver, and magnetic resonance imaging study showed multiple enhanced mass lesions, which was compatible with the diagnosis of a hepatic hemangioendothelioma. Thus, hepatic imaging, especially ultrasonography, should be performed if neonatal screening suggests galactosemia.

• Journal of Veterinary Clinics
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• v.22 no.3
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• pp.206-213
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• 2005

This experiment was conducted to find out the therapeutic effect of Artemisia capillaris extracts on hepatic damage in rats induced by carbon tetrachloride ($CCl_{4}$). In this experiment, 96 Sprague-Dawley rats were used as experimental groups, which were divided into 4 groups; control group(A), $CCl_{4}$-treated group(B), $CCl_{4}$+Artemisia extract-treated group(C) and $CCl_{4}$+silymarin-treated group(D). The B, C, D group were administrated single dose of $CCl_{4}$(2.5 ml/kg) to induce acute hepatic injury. C group was administrated with Artemisia capillaris extract(200 mg/kg/day) and D group treated with silymarin(50 mg/kg/day) for 7 days. Hematological, ultrasonographical, histological examinations and examination of antioxidant activity were also performed in all groups. AST and ALT activities of C group were significantly decreased compared with B group. The activities of AST and ALT in C and D groups returned to the normal range more rapidly than those of B group. In ultrasonographic examination, the echogenicity of liver in C group was significantly decreased compared with B group. Also C and D group had tended to recover faster than B group on liver histogram. Histologically, the percentage of degenerative regions and degenerative cell numbers in peri-central vein hepatic parenchyma of C and D group were significantly decreased compared with B group. In examination of lipid peroxidation, malondialdehyde of hepatic tissue in C group was decreased as compared with B group. In examination of antioxidant enzyme activity in liver, glutathione peroxidase and catalase activities were significantly increased compared with B group. As results of this study, it is thought that A. capillaris extract has therapeutic effects on hepatic injury induced by carbon tetrachloride, and has the similar therapeutic effects as silymarin in rats.

• Journal of Pharmaceutical Investigation
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• v.27 no.2
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• pp.109-117
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• 1997

In order to elucidate the effect of phenobarbital (PB) on the nonlinear pharmacokinetic behavior of naproxen (NAP), we compared the dose dependent hepatic intrinsic clearance, biliary excretion and protein binding of NAP in control rats to those in the PB-pretreated rats which were intraperitoneally pretreated with PB sodium (75 mg/kg) once a day for four days. NAP was injected via femoral (1.5 mg/kg) and portal(0.25, 0.5, 1.5, 15 and 30 mg/kg) vein to the control and PB-pretreated rats, respectively. And also, we measured the plasma free fraction of NAP with the equilibrium dialysis method and the biliary excreted total amounts of NAP in both rats. Plasma free fraction of NAP was decreased in lower concentration than $150\;{\mu}g/ml$ of NAP due to PB pretreatment. In higher concentration, however, plasma free fraction was increased. These in vitro results suggest that the total protein concentration was increased but the total binding capacity of NAP to protein was decreased by PB-pretreatment. The total plasma clearance and the hepatic intrinsic clearance of NAP had similar values in both groups, respectively. And, both clearances of NAP were significantly increased by PB-pretreatment. Even though the plasma free fractions of NAP in both groups were constantly remained within the concentration range according to the increase of administration dose, the hepatic intrinsic clearances of NAP were significantly increased in both groups with the increased dose. And, the biliary excreted total amounts of NAP were significantly increased by PB-pretreatment at the lower dose, but decreased at the higher dose. These in vivo results suggest that NAP represents the uncommon nonlinear pharmacokinetic behavior that the hepatic intrinsic clearance was enhanced with the increased dose, and that PB enhances further the hepatic intrinsic clearance of NAP with the increased dose due to its enzyme induction effect.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.2
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• pp.134-143
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• 2024

Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.3
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• pp.257-262
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• 2022

Backgrounds/Aims: Middle hepatic vein (MHV) is usually preserved as a part of the right or left hepatectomy in order preserve the venous outflow of remnant liver. The aim of this study was to evaluate if resection of MHV could influence post-resection outcomes of standard right or left hepatectomy. Methods: Patients who underwent standard right or left hepatectomy between January 2015 and December 2019 were included. Anatomical remnant liver volumes were measured retrospectively using the Hermes workstation (Hermes Medical Solutions AB, Stockholm, Sweden). Uni- and multi-variate analyses were performed to assess the difference in outcomes of those with preservation of MHV and those without preservation. Results: A total of 144 patients were included. Right hepatectomy was performed for 114 (79.2%) and left hepatectomy was performed for 30 (20.8%) patients. MHV was resected for 13 (9.0%) in addition to the standard right or left hepatectomy. Median remnant liver volume was significantly higher in the MHV resected group (p < 0.01). There was no significant difference in serum level of bilirubin, international normalized ratio, alanine aminotransferase, creatinine on postoperative day 1, 3, 5, or 10, ≥ grade IIIa complications (p = 0.44), or 90-day mortality (p = 0.41). On multivariable analysis, resection of the MHV did not influence the incidence of post hepatectomy liver failure (p = 0.52). Conclusions: Resection of the MHV at standard right or left hepatectomy did not have a negative impact on postoperative outcomes of patients with adequate remnant liver volume.

• Journal of Chest Surgery
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• v.26 no.12
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• pp.950-954
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• 1993

Two patients with chronic Budd-Chiari syndrome resulting from segmental obstruction of the inferior vena cava underwent operation. There were 1 man and 1 woman. The obstructed segment was directly visualized by a transthoracic, transdiaphragmatic, retroperitoneal approach. In these two cases, severe segmental obstruction of the inferior vena cava was observed just above the right hepatic vein. These patients underwent successful retrohepatic cavoatrial bypass with a polytetrafloroethylene [PTFE] graft [ 16mm plain and 16mm ringed graft ]. There were no operative mortality and postoperative complication. These patients have been followed up for 6months and 36months without evidence of re-obstruction. When there is a severe stricture of the IVC with hepatic veins draining freely into the obstructed segment of the IVC, a dorsal cavoatrial bypass with a PTFE graft, preferably ringed, is the method of choice.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.732-738
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• 1991

Membranous obstruction of the inferior vena cava[IVC] is a rare congenital anomaly that may present clinical features of Budd-Chiari syndrome caused by chronic obstruction of hepatic drain. We have experienced a case of IVC obstruction caused by hour-glass constriction and membrane in its center. Operative correction was accomplished using profound hypothermia [20%] and total circulatory arrest of 26 minutes. This technique permitted resection of membrane with direct vision and removal of thrombus of IVC and hepatic vein. After then constricted IVC was repaired with autologous pericardial patch. Total circulatory arrest was used intermittently for good visual field. Postoperative course was smooth and postoperative angiography showed unobstructed flow through the IVC in spite of slight constriction of cavoatrial junction and nearly complete disappearance of collateral vessels.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.3
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• pp.227-240
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• 2023

Hilar cholangiocarcinomas are highly aggressive malignancies. They are usually at an advanced stage at initial presentation. Surgical resection with negative margins is the standard of management. It provides the only chance of cure. Liver transplantation has increased the number of 'curative' procedures for cases previously considered to be unresectable. Meticulous and thorough preoperative planning is required to prevent fatal post-operative complications. Extended resection procedures, including hepatic trisectionectomy for Bismuth type IV tumors, hepatopancreaticoduodenectomy for tumors with extensive longitudinal spread, and combined vascular resection with reconstruction for tumors involving hepatic vascular structures, are challenging procedures with surgical indications expanded. Liver transplantation after the standardization of a neoadjuvant protocol described by the Mayo Clinic has increased the number of patients who can undergo operation.

• Journal of Acupuncture Research
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• v.23 no.6
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• pp.45-60
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• 2006

Objectives : This study was guided to estimate inhibitory effects against hepatic metastasis and activation of immunocytes by Carthami Semen Herbal Acupuncture. Methods : Colon26-L5 carcinoma cells were injected through hepatic portal vein to induce hepatic metastatic cancer. Changes in weight, morphology of the cancer were estimated and cytokine level was analyzed to produce immunological changes. Results: The experimental group was significantly decreased metastatic size and proliferation compared with the control group. Observing immunocytes from the spleen of experimental group T-lymphocytes were significantly increased. As compared with control group, the differentiation of total T cell, helper T cell, cytotoxic T cell, Macrophage and NK cell was increased. Measuring the level of cytokine $IFN-{\gamma}$ which stimulates Th 1 was significantly increased in splenocyte with Con A stimuli. $IFN-{\gamma}$ and IL-12 were significantly increased in peritoneal exudate macrophage with LPS stimuli. Conclusion : These findings strongly indicate Carthami Semen Herbal Acupuncture improves immunity to inhibit the growth of cancer and metastasis.

• Archives of Pharmacal Research
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• v.18 no.3
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• pp.141-145
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• 1995

Omeprazole, a proton pump inhibitor, was given intravenously (iv), orally (po), intraperitoneally (ip), hepatoportalvenously (pv), and intrarectally (ir) to rats at a dose of 72mg/kg in order to investigate the bioavailability of the drug, The extent of bioavailabilities of omeprazole administered through pv, ip, po, and ir routes were 88.5, 79.4, 40,8, and 38.7%, respectively. Pharmacokinetic analysis in this study and literatures (Regardh et al., 1985 : Watanabe et al., 1994) implied significant dose-dependency in hepatic first-pass metabolism, clearance and distribution, and acidic degradation in gastric fluid. The high bioavailability from the pv administration (88.5%) means that only 11.5% of dose was extracted by the first-pass metabolism through the liver at this dose (72 mg/kg). The low bioavailability from the oral administration (40.8%) in spite of minor hepatic first-pass extraction indicates low transport of the drug from GI lumen to portal vein. From the literature (Pilbrant and Cederberg, 1985), acidic degradation in gastric fluid was considered to be the major cause of the low transport. Thus, enteric coating of oral preparations would enhance the oral bioavailability substantially. The bioavailability of the drug from the rectal route, in which acidic degradation and hepatic first-pass metabolism may not occur, was low (38.7%) but comparable to that from the oral route (40.8 %) indicating poor transport across the rectal membrane. In this case, addition of an appropriate absorption enhancer would improve the bioavailability. Rectal route seems to be an possible alternative to the conventional oral route for omeprazole administration.