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Potentials of Chenpi on Metabolic Syndrome: A Review

  • Lee, Yoo-na;An, Yu-min;Kim, Jun-seok;Baek, Kyungmin
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.645-671
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    • 2021
  • Objectives: Metabolic Syndrome (MetS) is strongly related with central obesity, hypertriglyceridemia, low high-density lipoprotein-cholesterol (HDL-C), hyperglycemia, and hypertension. This study reviewed the potential of Chenpi in treatment of MetS through amelioration of co-related diseases, such as diabetes mellitus, hyperlipidemia, obesity, hepatic steatosis, and inflammation. Methods: Six electronic databases (Oriental Medicine Advanced Searching Integrated System (OASIS), Korean Traditional Knowledge Portal, Korea Institute of Oriental Medicine (KIOM), Research Information Sharing Service (RISS), PubMed, and Embase) were used to search for in vitro, in vivo, and clinical research that discusses the potential effects of Chenpi (Citrus unshiu Markovich, Citrus reticulata Blanco) on diabetes mellitus, hyperlipidemia, obesity, hepatic steatosis, and inflammation. Results: This review suggests the potential of Chenpi as a candidate for the treatment of metabolic syndrome through improvement of co-related diabetes, hyperlipidemia, obesity, hepatic steatosis, and inflammation. However, comparison of the results of each study was limited by a lack of quantification of the experimental materials.

Primary hepatic sarcoidosis presenting with cholestatic liver disease and mimicking primary biliary cholangitis: a case report

  • Park, Young Joo;Woo, Hyun Young;Kim, Moon Bum;Ahn, Jihyun;Heo, Jeong
    • Journal of Yeungnam Medical Science
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    • v.39 no.3
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    • pp.256-261
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    • 2022
  • Sarcoidosis often involves the liver. However, primary hepatic sarcoidosis confined to the liver without evidence of systemic involvement is rare. We report the case of a 37-year-old man with hepatic sarcoidosis who initially presented with elevated liver enzymes and suspicious cirrhotic nodules on computed tomography. The patient had cirrhosis but did not have portal hypertension. Based on the initial histopathologic finding of chronic granulomatous inflammation and the common clinical characteristics of sarcoidosis, he was initially diagnosed with primary biliary cholangitis, and his daily dosage of ursodeoxycholic acid was increased to 900 mg. After 14 months of treatment, his total serum bilirubin concentration was 10.9 mg/dL (upper normal limit, 1.2 mg/dL). Additionally, a transjugular liver biopsy revealed multiple noncaseating granulomas. He was diagnosed with primary hepatic sarcoidosis involving the lungs, heart, spleen, kidneys, and skin. Treatment with methylprednisolone was initiated. Two weeks later, he was started on azathioprine, and the dose of steroid was simultaneously reduced. These findings indicate the importance of including hepatic sarcoidosis as a possible diagnosis in patients with elevated liver enzymes or cryptogenic cirrhosis.

Computed Tomographic Features of Gallbladder Agenesis in a Golden Retriever

  • Yujung Lee;Dongjun Kim;Jeongin Choi;Youngwon Lee;Hojung Choi
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.43-48
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    • 2024
  • A two-year-old, intact female Golden Retriever had previously been diagnosed with a portosystemic shunt (PSS) during an ultrasonographic examination at a local animal hospital. The serum biochemistry revealed elevated liver enzymes and bile acid levels. The abdominal radiographic examination revealed mild serosal detail loss and microhepatica, while abdominal ultrasonography revealed mild ascites and high-velocity flow to the caudal vena cava (CVC) suspected as a PSS. The gallbladder was not observed within the hepatic parenchyma during ultrasonography. Computed tomography (CT) revealed an absent gallbladder and dilation of the common bile duct (CBD). Dilations of the gastroduodenal, splenic, colic and renal veins were also observed. A dilated left phrenico-abdominal vein that entered the CVC was previously misinterpreted as a PSS on the ultrasound examination. Based on the imaging examinations, the dog was diagnosed with congenital gallbladder agenesis associated CBD dilation.

The Analysis of Study Trends of Wild ginseng, Bovis Calculus, Ursi Fel, Moschus and The Study on Applied Possibility as Obesity medications (산삼, 우황, 웅담, 사향의 연구 동향 분석 및 비만 치료제로써의 응용 가능성 탐색 연구)

  • Kim, Min-Woo;Song, Yun-Kyung;Lim, Hyung-Ho
    • Journal of Korean Medicine for Obesity Research
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    • v.11 no.2
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    • pp.41-68
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    • 2011
  • Objectives: After organizing segmentations related to obesity from classics and each studies, we would like to examine the value of wild ginseng, bovis calculus, ursi fel and moschus as a obesity medicine. Methods: We found out 4 drugs which are wild ginseng, bovis calculus, ursi fel and moschus from the classics, such as "Shin-Nong-Bon-Cho-Kyung", "Myoung-Eui-Byul-Lok", "Bon-Cho-Gang-Mok", "Bon-Cho-Jong-Shin", "Bon-Cho-Bi-Yo", "Bon-Cho-Gu-Jin" and "Deuk-Bae-Bon-Cho", we searched websites such as RISS, Korean traditional knowledge portal, the society of Korean medicine for obesity research, Korean pharmacopuncture institute, the Korean academy of oriental rehabilitation medicine and Korean acupuncture & moxibustion society as well. Results: 1. We couldn't find the contents related to the efficacy of improving obesity through wild ginseng, bovis calculus, ursi fel and moschus from the classics. 2. Wild ginseng had a study dealing with the efficacy of anticancer, obesity, toxicity, immunity, sulfation, diabetes, plasma proteins, depression, hypertension, endometriosis and hair loss. Especially among 6 studies related to obesity, apart from the study that treated extract of wild ginseng directly to the cell or oral administration to the animals, also have studies that had an efficacy of improving obesity through injecting pharmacopuncture to acupuncture point and vein, etc. 3. Bovis calculus had a study about efficacy related to arthritis, liver, inflammation of cornea, obesity, anticancer, immunity, antacid, heart, lumbar pain, hypertension, toxicity, a digestive organ and sasang constitution, especially in case of obesity, had each studies about oral administration of complex prescription and about cell unit experiment of pharmacopuncture. 4. Ursi fel had a study about efficacy related to liver, arthritis, inflammation of cornea, immunity, obesity, anticancer, antacid, lumbar pain, digestive organ, toxicity, cell protection, skin ailment, etc. Especially in case of obesity, had each studies about oral administration of animal experiment and about cell unit experiment of pharmacopuncture. 5. Moschus had a study about efficacy related to liver, the central nervous system, arthritis, inflammation of cornea, immunity, obesity, anticancer, hypertension, heart, lumbar pain, etc. Especially in case of obesity, had one study about oral administration of complex prescription. Conclusion: Through the result of probability as a obesity medicine of wild ginseng, bovis calculus, ursi fel and moschus, we could identify the possibility of each drug as a obesity medicine. Also in the future, it is considered that studies about one or complex prescription and pharmacopuncture as a obesity medicine will be needed.

A Ultrasonic Diagnosis of Family Incidence Bilateral Adult Type Polycystic Kidney: Three Cases (가족발생(家族發生) 양측성(兩側性) 성인형(成人型) 다낭종신(多囊腫腎) 3례(例)의 초음파진단(超音波診斷) - 보험가입자(保險加入者)를 대상(對象)으로 -)

  • Moon, Soo-Hyung;Han, Hye-Jin;Kim, Kang-Seuck
    • The Journal of the Korean life insurance medical association
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    • v.2 no.1
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    • pp.218-232
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    • 1985
  • Congenital hereditary disease is in devided into Infantile type and Adult type, Adult type is hidden for many years and keeps normal renal function till middle age. Cyst is stimultaneously made in both sides and becomes lowered in renal function in 30's to 40's. Infantile type is generally born with the big kidneys, renal failure, undergrowth of intrahepatic bile duct. Both infantile and childhood type have ureteral dilatation and portal hypertension In infantile type, it is mostly developed into renal failure, but generally faces death as a result of hepatic disease. The reason of death is that an abnormal condition of recessive autosome affects the liver and kidneys. While the incidence of infantile type is rare as $0.017{\sim}0.07%$ and it is autosomal recessive heredity, Adult type can rarely exist in infantile period. Though it exists in middle period, 50% of patients can live for 2-4 years after the first symptom incidence and 25% can less than 2 years. It is hard to cure completely in medicine and surgery. Three difficulties in familial incidence are comparative decrease of the donor who have no affection on renal transplantation. For another consideration it is to show the family history for several generations. We, the Med. Dept. of Dae Han Kyouk Life Insurance Co. Ltd., used the ultrasonic apparatus in diagnosing the one case of adult type bilateral polycystic kidney and then doubted the family history. As a result of inspecting the family we experienced bilateral polycystic kidney from 3 persons out of 4 who can be inspected. The results are as follows: 1) We could confirm the polycystic kidney from 3 persons out of 4(75%). 2) Then when they came for check up, chief complaint was the pain in all 3 cases(100%). 3) Accompanying disease was hypertension in 2 cases(67%). 4) In early disease incidence, we couldn't observe the specific change in pathological opinion. 5) All 3 cases are not accompanied with cystic lesion in liver, spleen, pancreas.

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Bile Peritonitis due to Choledochal Cyst Perforation in Infants (총담관낭 환아에서의 담즙성 복막염)

  • Jung, Jae-Hee;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.4 no.2
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    • pp.156-162
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    • 1998
  • Choledochal cyst is rare in the western countries, but common in oriental countries. Complicatioins include ascending cholangitis, recurrent pancreatities, progressive biliary cirrhosis, portal hypertension, stone formation and later malignant transformation. Bile peritonitis secondary to rupture is one of the rarest complications, with an incidence of 1.8 % to 18 %. The anomalous arrangement of the pancreatobiliary ductal system with a long common channel may cause inflammation leading to perforation of the cyst. The authors found 4 cases (14.2 %) of bile peritonitis among 28 cases of choledochal cyst treated from Jan. 1983 to Jan. 1998. The patients ages ranged from 6 months to 3 years and three were female. The perforation sites were located on the common bile duct at its junction with the cystic duct in 2 cases, the distal cyst wall in 1 case and the left hepatic duct at its junction with cyst in 1 case. The types of choledochal cysts by Todani's classification were Type IVa in 3 cases and type I in 1 case. By the new Komi's classification utilizing operative cholangiogram there were 2 cases of Type Ia, 1 case of type IIb and 1 case of type III. One stage cyst excision and hepaticojejunostomy(Roux-en Y type) was done in 3 cases, and two staged operation in 1 case. All patients had an uneventful course postoperatively. The average day of discharge was 9.8th postoperatively. In conclusion, primary excision of the choledochal cyst and biliary reconstruction is a safe and effective treatment of ruptured choledochal cyst in infants.

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Secondary adrenal insufficiency caused by sorafenib administration in a patient with hepatocellular carcinoma

  • Jo, Soo Yeon;Ryu, Soo Hyung;Kim, Mi Young;Moon, Jeong Seop;Yoon, Won Jae;Kim, Jin Nam
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.155-158
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    • 2016
  • Sorafenib (Nexavar) has been regarded as a treatment for unresectable hepatocellular carcinoma (HCC), with side effects that include hand-foot skin reaction, diarrhea, rash, fatigue, hypertension, nausea, anorexia, weight loss, and alopecia. Thyroid disorder, such as endocrine side effect, has also been reported. However no case involving adrenal insufficiency has been reported. Here, we report a case of adrenal insufficiency which occurred after taking sorafenib in a patient with HCC. A 56-year-old man visited our hospital due to right upper quadrant abdominal pain and he was diagnosed as multiple disseminated and unresectable HCCs with portal vein invasion; therefore transarterial chemoembolization was performed and sorafenib administration was started. Two months later, he was admitted to the hospital complaining of severe fatigue. The laboratory results showed cortisol of <$0.2{\mu}g/dL$ and adrenocorticotropic hormone of <1.00 pg/mL. The patient had no history of taking steroids or herbal medications. Secondary adrenal insufficiency was diagnosed and prednisolone 10 mg per day was started immediately; as a result, fatigue remarkably improved. This may be the first report indicating a possible association between sorafenib and adrenal insufficiency and it implies that the possibility of adrenal insufficiency should be considered in patients taking sorafenib who complain of severe fatigue.

DENTAL MANAGEMENT OF THE PATIENT WITH BILIARY ATRESIA : A CASE REPORT (담도폐쇄증 환아의 치과치료 : 증례보고)

  • Baik, Byeong-Ju;Yang, Yeon-Mi;Lee, Seung-Ik;Kim, Jae-Gon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.1
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    • pp.70-76
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    • 2000
  • Congenital biliary atresia with progressive sclerosis of the intra- and extra-hepatic duct system occurs in 1 : 10,000 live births, and has a poor prognosis with an expected survival of less than 5 years. Etiology of biliary atresia is unclear, however, it is believed a genetic or developmental cause. The clinical characteristics include pronounced jaundice, hepatosplenomegaly, pruritus, steatorrhea, xanthomas, growth retardation, portal hypertension, bleedings, ascites and respiratory infections. Oral manifestations have seldom been reported in patients with biliary atresia, but there may be enamel hypoplasia, delayed tooth eruption, and green teeth. Early diagnosis and surgical intervention have decreased morbidity. returned growth and development to normal and improved the prognosis for survival. Authors report the clinical and radiologic characteristics, proper managements about two cases with biliary atresia.

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Estimation of the Arterial Fraction of Total Hepatic Flow from Radionuclide Angiogram Using $^{99m}Tc-DISIDA$ ($^{99m}Tc-DISIDA$를 이용한 간 혈류 중 동맥 분획의 측정)

  • Lee, Hae-Giu;Lim, Gye-Yeon;Yang, Il-Kwon;Kim, Hack-Hee;Lim, Jung-Ik;Bahk, Yong-Whee;Han, Sok-Won;Han, Nam-Ik;Lee, Young-Sok
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.2
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    • pp.200-206
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    • 1991
  • Arterial fraction of total hepatic blood flow was estimated by a new method, slope method, on radionuclid angiogram using $^{99m}Tc-DISIDA$ and was compared with that from $^{99m}Tc-Phytate$ radionuclide angiogram. This study included 11 of normal subjects, 37 of intermediate group with various liver diseases, and 25 patients with liver cirrhosis. We analyzed the datas with slope method from radionuclide angiograms and the results were compared with hepatic arterial fractions from uptake method, introduced by Lee et al. at 1986. The hepatic arterial fractions from radionuclide angiograms using $^{99m}Tc-DISIDA$ and $^{99m}Tc-Phytate$ were $0.32{\pm}0.09\;and\;0.31{\pm}0.11$ respectively in normal subjects, and $0.75{\pm}0.18\;and\;0.77{\pm}0.21$ respectively in patients with liver cirrhosis. The hepatic arterial fractions by the slope method was well correlated with those of the uptake method on $^{99m}Tc-DISIDA$ scan. There was high correlation between the hepatic arterial fractions from $^{99m}Tc-DISIDA$ and $^{99m}Tc-Phytate$ scans. Hepatic arterial fraction estimated by the slope method is a useful index for the diagnosis of liver cirrhosis and the evaluation of status of portal hypertension.

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Wilson's Disease in Bangladeshi Children: Analysis of 100 Cases

  • Rukunuzzaman, Md.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.2
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    • pp.121-127
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    • 2015
  • Purpose: To evaluate clinical and laboratory profile of Wilson's disease (WD) in children. Methods: This cross sectional study was conducted at Bangabandhu Sheikh Mujib Medical University Hospital. Bangladesh, over a period of 3 years. One hundred consecutive children of WD between 3 to 18 years of age were evaluated. Results: Mean age was $8.5{\pm}1.5years$. Male female ratio was 2:1. Ninety-one percent of patients were Muslim and 9% Hindu. A total of 53% cases of hepatic WD presented between 5 to 10 years of age and most of the neurologic WD manifested in 10-15 years age group. Sixty-nine children presented only with hepatic manifestations, 6 only with neurological manifestations, 14 with both hepatic and neurological manifestation, 10 children was asymptomatic and 1 patient presented with psychiatric features. WD presented as chronic liver disease (CLD) in 42%, CLD with portal hypertension in 34%, acute hepatitis in 20% and fulminant hepatic failure in 4% cases. Stigmata of CLD were found in 18% patients. Keiser-Fleischser ring was found in 76% total patients. Elevated serum transaminase was found in 85% cases, prolonged prothrombin time in 59% cases and hypoalbuminaemia in 53% cases. A total of 73% patients had low serum ceruloplasmin, basal urinary copper of >$100{\mu}g/day$ was found in 81% cases and urinary copper following penicillamine challenge of >$1,200{\mu}g/day$ was found in 92% cases. Conclusion: Majority of studied WD children presented with hepatic manifestation of which 76% presented with CLD. Any child presented with jaundice after the age of 3 years should be investigated for WD.