• 제목/요약/키워드: Liver failure

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Anti-Tumor Necrosis Factor Therapy in Intestinal Behçet's Disease

  • Park, Jihye;Cheon, Jae Hee
    • Gut and Liver
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    • 제12권6호
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    • pp.623-632
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    • 2018
  • Intestinal Behçet's disease is a rare, immune-mediated chronic intestinal inflammatory disease; therefore, clinical trials to optimize the management and treatment of patients are scarce. Moreover, intestinal Behçet's disease is difficult to treat and often requires surgery because of the failure of conventional medical treatment. Administration of anti-tumor necrosis factor-${\alpha}$, a potential therapeutic strategy, is currently under active clinical investigation, and evidence of its effectiveness for both intestinal Behçet's disease and inflammatory bowel diseases has been accumulating. Here, we review updated data on current experiences and outcomes after the administration of anti-tumor necrosis factor-${\alpha}$ for the treatment of intestinal Behçet's disease. In addition to infliximab and adalimumab, which are the most commonly used agents, we describe agents such as golimumab, etanercept, and certolizumab pegol, which have recently been shown to be effective in refractory intestinal Behçet's disease. This review also discusses safety issues associated with anti-tumor necrosis factor-${\alpha}$, including vulnerability to infections and malignancy.

당뇨병이 없는 뇌경색 환자에서 발생한 저혈당과 동반된 심정지 (Cardiac Arrest in Conjunction with Hypoglycemia in a Non-Diabetic Patient with Cerebral Infarction)

  • 고정민;이지용
    • 대한신경집중치료학회지
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    • 제11권2호
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    • pp.143-147
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    • 2018
  • Background: Hypoglycemia is uncommon in people without diabetes. There have been only a few reports of cardiac arrest in conjunction with hypoglycemia in non-diabetic patients. Case Report: A 66-year-old man visited the emergency room with dizziness. He was a chronic alcoholic. Laboratory test showed no evidence of diabetes mellitus. Brain magnetic resonance imaging revealed a left cerebellar infarction. Abdomen computed tomography demonstrated liver cirrhosis with minimal ascites. During his hospital stay, he consumed only a small amount of food because of nausea and headache. On hospital day 4, he had a cardiac arrest after two seizure episodes. His blood glucose was 10 mg/dL. The combination of liver cirrhosis, renal failure and poor oral intake was presumed to be the causes of the severe hypoglycemia. Conclusion: We report a rare case of cardiac arrest occurring in conjunction with severe hypoglycemia in a non-diabetic patient with cerebral infarction.

Effect of Previous Gastrectomy on the Performance of Postoperative Colonoscopy

  • Kim, Sunghwan;Choi, Jeongmin;Kim, Tae Han;Kong, Seong-Ho;Suh, Yun-Suhk;Im, Jong Pil;Lee, Hyuk-Joon;Kim, Sang Gyun;Jeong, Seung-Yong;Kim, Joo Sung;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • 제16권3호
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    • pp.167-176
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    • 2016
  • Purpose: The purpose of this study was to determine the effect of a prior gastrectomy on the difficulty of subsequent colonoscopy, and to identify the surgical factors related to difficult colonoscopies. Materials and Methods: Patients with a prior gastrectomy who had undergone a colonoscopy between 2011 and 2014 (n=482) were matched (1:6) to patients with no history of gastrectomy (n=2,892). Cecal insertion time, intubation failure, and bowel clearance score were compared between the gastrectomy and control groups, as was a newly generated comprehensive parameter for a difficult/incomplete colonoscopy (cecal intubation failure, cecal insertion time >12.9 minutes, or very poor bowel preparation scale). Surgical factors including surgical approach, extent of gastrectomy, extent of lymph node dissection, and reconstruction type, were analyzed to identify risk factors for colonoscopy performance. Results: A history of gastrectomy was associated with prolonged cecal insertion time ($8.7{\pm}6.4$ vs. $9.7{\pm}6.5$ minutes; P=0.002), an increased intubation failure rate (0.1% vs. 1.9%; P<0.001), and a poor bowel preparation rate (24.7 vs. 29.0; P=0.047). Age and total gastrectomy (vs. partial gastrectomy) were found to be independent risk factors for increased insertion time, which slowly increased throughout the postoperative duration (0.35 min/yr). Total gastrectomy was the only independent risk factor for the comprehensive parameter of difficult/incomplete colonoscopy. Conclusions: History of gastrectomy is related to difficult/incomplete colonoscopy performance, especially in cases of total gastrectomy. In any case, it may be that a pre-operative colonoscopy is desirable in selected patients scheduled for gastrectomy; however, it should be performed by an expert endoscopist each time.

심부전(心不全)의 원인(原因) 및 증후(症候)에 관(關)한 문헌적(文獻的) 고찰(考察) (The Oriental Medical Study To The Causes And Symptoms Of Heartfailure)

  • 김형규;조기호;이원철;김영석;배형섭;이경섭;구본홍
    • 대한한방내과학회지
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    • 제11권1호
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    • pp.61-75
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    • 1990
  • According to the research, the Estern and Western medical literatural records about the causes and symptoms of the heart failure, the results as follows are concluded. 1. The asthma, suceptibility to fright and severe palpitation are generally revealed from the left heart failure. The causes of it are belong to the Yang and Yeum deficiency which are mainly caused by primordial energy deficiency. 2. The symtoms of asthma which are derived from left heart failure are related to the gasping that contain dyspnea, asthma due to the accumulation of phlegm and severe palpitation and related to shortness of breath due to fluid retention (水喘) that make asthma. 3. In the right heart failure, the edema which is derived from the congestion of vein, is revealed as stoppage of main channel that is mainly caused by the Yang or the Yeum deficiency. 4. The edema which is caused by the right heart failure, is mainly related to the symptoms of Yeum type edema, also it is related to the five viscera-fluid, moreover to the heart-fluid (心水), lung-fluid (肺水) and liver-fluid (肝水). 5. In heart failure, the pathologic symptoms which are derived from the stoppage of blood circulation, are phlegm-retention disease (痰飮), diffuse fluid-retention syndrom (溢飮), fluid-retention syndrome characterized by dyspnea and edema (支飮).

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Toxicological Profiles of Poisonous, Edible, and Medicinal Mushrooms

  • Jo, Woo-Sik;Hossain, Md. Akil;Park, Seung-Chun
    • Mycobiology
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    • 제42권3호
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    • pp.215-220
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    • 2014
  • Mushrooms are a recognized component of the human diet, with versatile medicinal properties. Some mushrooms are popular worldwide for their nutritional and therapeutic properties. However, some species are dangerous because they cause toxicity. There are many reports explaining the medicinal and/or toxic effects of these fungal species. Cases of serious human poisoning generally caused by the improper identification of toxic mushroom species are reported every year. Different substances responsible for the fatal signs and symptoms of mushroom toxicity have been identified from various poisonous mushrooms. Toxicity studies of mushroom species have demonstrated that mushroom poisoning can cause adverse effects such as liver failure, bradycardia, chest pain, seizures, gastroenteritis, intestinal fibrosis, renal failure, erythromelalgia, and rhabdomyolysis. Correct categorization and better understanding are essential for the safe and healthy consumption of mushrooms as functional foods as well as for their medicinal use.

Phalloides 증후군에서 혈역학적 보조를 위해 T-PLS를 사용한 1례 (A Case of Phalloides Syndrome where T-PLS(R)was used for Hemodynamic Support)

  • 김성춘;김규석;서길준
    • 대한임상독성학회지
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    • 제2권2호
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    • pp.133-136
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    • 2004
  • Phalloides syndrome has usually occurred after incidental mushroom ingestion. It is sometimes difficult to differentiate toxic mushrooms from edible ones, especially in lay person because of their morphological similarities. In Korea, Amanita virosa and Amanita subjunquillea have been reported as a cause of fulminant hepatic failure in mushroom poisoning (phalloides syndrome). We report a case of phalloides syndrome who came to death with fulminant hepatic failure even though we planned liver transplantation and used T-PLS(R) (Twin Pulse Life Support) for hemodynamic support while waiting for the donor.

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Tumour Lysis Syndrome: Implications for Cancer Therapy

  • Mika, Denish;Ahmad, Sabrina;Guruvayoorappan, C.
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.3555-3560
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    • 2012
  • The tumour lysis syndrome (TLS) is a group of metabolic abnormalities caused by rapid and unexpected release of cellular components into the circulation as a result of massive destruction of rapidly proliferating malignant cells. It usually develops in patients with hematologic malignancies like acute lymphoid leukemia, non-Hodgkin and Burkitt's lymphoma after initiation of chemotherapy or may, rarely, occur spontaneously. Though TLS is seldom observed in relation to solid tumours, there have been reports of connections with examples such as lung, liver, breast, gastric carcinomas. The clinical manifestations of TLS include hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. These indications if untreated lead to life-threatening complications such as acute renal failure, cardiac arrhythmias, seizures, and eventually death due to multiorgan failure. Therefore early detection of TLS is of vital importance. This can be accomplished by identification of high risk patients, implementation of suitable prophylactic measures andmonitoring of the electrolyte levels in patients undergoing chemotherapy.

침도 침술시 부작용과 예방법에 관한 연구 (Clinical Characteristics of Poor Responders to Acupotomy and Safety Pretreatment Management)

  • 김성철
    • Journal of Acupuncture Research
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    • 제25권4호
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    • pp.117-125
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    • 2008
  • Objectives : Analyze according to types of event causing the adverse outcome due to acupotomy, and discuss problems and safety reqirements to using this therapy in Korea. Methods : Based upon the indication, contraindication, treatment procedures, clinical obsevations, acupotomy-related adverse outcome case reports, the factors of damaging event were classified. Results : The main factors of adverse outcome by acupotomy were anatomical ignorance, contamination of device or hospital staff, failure to notice preexisting disease(cardiovascular disease, hypertension, renal failure, hemophilia, chronic Liver Disease, etc.), unskilled treatment procedures(massive bleeding) and techniques(nerve injury, hepatic and splenic injury, Pneumothorax). Conclusions : It is mandatory to prepare adequate sterilie aseptic technique. The clinician should ensure understand genernal health state of patient and anatomical direction.

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용혈위기를 동반한 윌슨병에서 교환 수혈로 회복된 소아 1예 (Hemolytic Crisis Recovered by Exchange Transfusion in a Child with Fulminant Wilson's Disease)

  • 최희정;임해리;최병호
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제9권1호
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    • pp.108-113
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    • 2006
  • 윌슨병에서 용혈성 빈혈과 전격성 간부전이 동반되면 혈장교환술이나 간이식이 필수적이다. 저자들은 간염과 용혈위기가 동반된 전격성 윌슨병 환아에서 혈장교환술을 계속하였으나 호전을 보이지 않아 교환수혈을 시행한 결과 용혈위기를 극복하였다. 현재까지 약물치료와 혈장교환술에 뒤이은 간이식이 일차 치료로 되어 있지만, 전격성 간부전이 응급으로 간이식을 해야 할 만큼 심하지 않은 경우에는 혈장교환술후 교환수혈을 시도할 수 있을 것으로 생각한다.

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Role of Kupffer Cells in Alteration of Vasoregulatory Gene Expression in Hepatic Ischemia/Reperfusion

  • Kim, Yong-Hyuk;Kim, Sung-Ho;Lee, Sun-Mee
    • 대한약학회:학술대회논문집
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    • 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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    • pp.299.1-299.1
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    • 2002
  • Failure of the hepatic microcirculation is a major component of reperfusion injury in the liver. However. the vasoactive mediators involved in the regulation of sinusoidal flow during reperfusion following hepatic ischemia remain to be identified. We investigate the role of Kupffer cells in hepatic ischemia/reperfusion (l/R)-induced imbalance of vasoregulatory gene expression. Rats were subjected to 60 min hepatic ischemia, followed by 5 h of reperfusion. (omitted)

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