• 제목/요약/키워드: Liver failure

검색결과 318건 처리시간 0.022초

진행된 원발성 간암 환자에서 방사선 치료 및 온열 요법에 따른 간 기능의 변화 (Biochemical Changes of Liver Function in Patients with Hepatocellular Carcinoma Following Radiotherapy and Hyperthermia)

  • 오영택;성진실;신현수;김귀언
    • Radiation Oncology Journal
    • /
    • 제11권1호
    • /
    • pp.109-117
    • /
    • 1993
  • To analyze biochemical changes of liver function following combined radiotherapy and hyperthermia, we reviewed retrospectively 37 patients with hepatocellular carcinoma treated with radiotherapy and hyperthermia between July 1988 and December 1990 at Department of Radiation Oncology, Yonsei University College of Medicine. Mean age was 52.7 years and male to female ratio was 11:1. The patients were classified as follows; to A and B group by Child's classification, to M and L group by irradiated volume, and subclassified into BM, BL, AM and AL group according to the combination of Child's classification and irradiated volume. Radiation dose to the primary tumor was 3060 cGy with daily 180 cGy, 5 fraction per week using 10 MV or 4 MV linear accelerator. Hyperthermia (Thermotron RF-8) was performed more than 4 times in all patients. Biochemical parameters including albumin (Alb), total bilirubin (T. Bil), aspartate aminotransferase (AST or SGOT), alanine aminotransferase (ALT or SGPT), and alkaline phosphatase (ALP) were regularly followed from 1 week before the treatment to 3 months after the treatment. The results are summerized as follows; 1) In all the patient, mean ALP level peaked at 1 month, decreased at 2 months, slightly increased at 3 months after the treatment. Mean SGOT and SGPT levels peaked at 1 month after the treatment. Mean T. Bil level increased continuously and highest at 3 months after the treatment. Mean Alb level did not show significant changes.; 2) Mean ALP level retured to normal level at 3 month after the treatment in A but increased in B group and the differences were statistically significant (p<0.01). Mean SGOT and SGPT levels peaked 1 month in A and 2 months after the treatment in B group. All the biochemical parameters did not show significant difference between M and L group. Mean ALP level increased at 3 months after the treatment in BM and BL groups and decreased in AM and AL groups. Mean SGOT level increased at 3 months after the treatment in BL groups.; 3) Hepatic failure occurred within 3 months after the treatment in 4 patients, all of whom were in BL group. It is suggested that pre-treatment liver function and irradiated volume influence biochemical changes of liver in patients with hepatocellular carcinoma following combined radiotherapy and hyperthermia, and this treatment modality appears generally to be safe but might cause hepatic failure particularly in patient with poor liver function and large treatment volume.

  • PDF

감초 물 추출물 및 Glycyrrhizin이 인체 간 Microsome에서 Cytochrome P450 약물대사효소에 미치는 영향 (Inhibitory Effect of Licorice Ethanol Extracts and Glycyrrhizin on Cytochrome P450 Drug-Metabolizing Enzymes in Human Liver Microsomes)

  • 박종훈;박지영;주영승
    • 대한예방한의학회지
    • /
    • 제7권2호
    • /
    • pp.65-74
    • /
    • 2003
  • Objective : The aim of present study is to evaluate the inhibitory potential of licorice extract and glycyrrhizin on cytochrome P450(CYP) in human liver microsomes. Methods : Using human liver microsomes, water extract of licorice and glycyrrhizin as an inhibitor were co-incubated with each probe drug representing selective CYP isoform activity. We measured relative metabolic activity in incubation condition compared to that with no extract of licorice using HPLC system. Results : Both water extracts of licorice and glycyrrhizin showed inhibitory effect on CYP-catalyzed reactions. CYP2C19 $(IC_{50}=126.7{\mu}g/ml)$ is most potently inhibited by water extract than other tested CYP isoforms$(IC_{50}>450{\mu}g/ml)$, but glycyrrhizin exhibited potent inhibition on CYP1A2$(IC_{50}=106.9{\mu}g/ml)$ followed by CYP2C9 and CYP2D6. Conclusion: These results indicate that water extract of licorice and glycyrrhizin have inhibitory potential on CYP-catalyzed reaction in human liver microsomes. But the mechanism of inhibition was slightly different between them Water extract of licorice mainly inhibited CYP2C19, and glycyrrhizin primarily inhibited CYP1A2. The inhibition by water extract of licorice and glycyrrhizin on CYP isoforms may cause drug interaction with co-administered drug leading to toxicity or treatment failure.

  • PDF

뇌사자 간이식 후 발생한 하대정맥 협착: 위양성과의 감별점 (Inferior Vena Cava Stenosis Following Orthotopic Liver Transplantation: Differentiating Points from False Positives)

  • 최연수;김진혁;전웅배;장주연;김태언;류화성
    • 대한영상의학회지
    • /
    • 제84권3호
    • /
    • pp.713-718
    • /
    • 2023
  • 뇌사자 간이식은 말기 간질환 환자에서 최우선치료로 시행되고 있다. 간이식 후 가성동맥류 형성, 동맥 혈전증 및 협착, 정맥의 협착 및 폐색 등 다양한 초기 또는 후기 혈관 합병증이 발생할 수 있으며, 이는 이식 실패를 야기할 수 있다. 이러한 합병증을 빨리 발견하고 적절한 치료를 하는 것이 이식 성공을 달성하고 재이식을 방지하기 위해 중요하다. 이 증례 보고에서는 컴퓨터단층촬영 및 디지털감산 혈관조영술 영상 소견과 협착 부위 전후의 압력차 측정을 통해 뇌사자 간이식 후 발생한 하대정맥 협착 환자에서 즉각적인 인터벤션이 필요한 감별점을 제시하고자 한다.

Safety and efficacy of early corticosteroid withdrawal in liver transplant recipients: A randomized controlled trial

  • Jongman Kim;Jae-Won Joh;Kwang-Woong Lee;Dong Lak Choi;Hee-Jung Wang
    • 한국간담췌외과학회지
    • /
    • 제28권2호
    • /
    • pp.238-247
    • /
    • 2024
  • Backgrounds/Aims: Prolonged use of steroids after liver transplantation (LT) significantly increases the risk of diabetes or cardiovascular disease, which can adversely affect patient outcomes. Our study evaluated the effectiveness and safety of early steroid withdrawal within the first year following LT. Methods: This study was conducted as an open-label, multicenter, randomized controlled trial. Liver transplant recipients were randomly assigned to one of the following two groups: Group 1, in which steroids were withdrawn two weeks posttransplantation, and Group 2, in which steroids were withdrawn three months posttransplantation. This study included participants aged 20 to 70 years who were scheduled to undergo a single-organ liver transplant from a living or deceased donor at one of the four participating centers. Results: Between November 2012 and August 2020, 115 patients were selected and randomized into two groups, with 60 in Group 1 and 55 in Group 2. The incidence of new-onset diabetes after transplantation (NODAT) was notably higher in Group 1 (32.4%) than in Group 2 (10.0%) in the per-protocol set. Although biopsy-proven acute rejection, graft failure, and mortality did not occur, the median tacrolimus trough level/dose/weight in Group 1 exceeded that in Group 2. No significant differences in safety parameters, such as infection and recurrence of hepatocellular carcinoma, were observed between the two groups. Conclusions: The present study did not find a significant reduction in the incidence of NODAT in the early steroid withdrawal group. Our study suggests that steroid withdrawal three months posttransplantation is a standard and safe immunosuppressive strategy for LT patients.

외상성 횡격막 손상 치험 11례 (Traumatic diaphragmatic injuries: Report of 11 cases)

  • 이영;장일성;김인구;배진선;손기섭
    • Journal of Chest Surgery
    • /
    • 제9권2호
    • /
    • pp.323-327
    • /
    • 1976
  • Eleven cases of traumatic diaphragmatic injuries were treated at the department of Surgery from Jan. 1972 to Nov. 1976 were reviewed in this study. 1. Sex ratio of the observed patients was 10 : 1 showing definitely high incidence male patients. 2. The age distribution in this series ranged from 4 to 49 years of age, and average age was 26 years age. 3. Seven cases were received blunt injury on lower chest and upper abdomen, three cases were stabbed by knife and gunshot injury case was on case 4. Six cases were diagnosed and treated early post-traumatic stage within 24 hours, three cases were repaired within I0 days, and the last case was repaired after 5 years post-trauma. 5. The operative mortality was 10% (1/10), the cause of death was liver failure, after right lobectomy of the liver for traumatic liver rupture.

  • PDF

Prevalence and Clinical Manifestations of Malaria in Aligarh, India

  • Asma, Umm-E;Taufiq, Farha;Khan, Wajihullah
    • Parasites, Hosts and Diseases
    • /
    • 제52권6호
    • /
    • pp.621-629
    • /
    • 2014
  • Malaria is one of the most widespread infectious diseases of tropical countries with an estimated 207 million cases globally. In India, there are endemic pockets of this disease, including Aligarh. Hundreds of Plasmodium falciparum and P. vivax cases with severe pathological conditions are recorded every year in this district. The aim of this study is to find out changes in liver enzymes and kidney markers. Specific diagnosis for P. falciparum and P. vivax was made by microscopic examination of Giemsa stained slides. Clinical symptoms were observed in both of these infections. Liver enzymes, such as AST, ALT, and ALP, and kidney function markers, such as creatinine and urea, were estimated by standard biochemical techniques. In Aligarh district, P. vivax, P. falciparum, and mixed infections were 64%, 34%, and 2%, respectively. In case of P. falciparum infection, the incidences of anemia, splenomegaly, renal failure, jaundice, and neurological sequelae were higher compared to those in P. vivax infection. Recrudescence and relapse rates were 18% and 20% in P. falciparum and P. vivax infections, respectively. Liver dysfunctions and renal failures were more common in P. falciparum patients, particularly in elderly patients. Artesunate derivatives must, therefore, be introduced for the treatment of P. falciparum as they resist to chloroquine as well as sulfadoxine-pyrimethamine combinations.

Furfural 어류급성독성 및 조직병리에 관한 연구 (Studies on the Acute Toxicity and Histological Changes in Fish Exposed to Furrural)

  • 이철우;최성수;최필선;이상협;이길철;박광식
    • Environmental Analysis Health and Toxicology
    • /
    • 제12권3_4호
    • /
    • pp.55-59
    • /
    • 1997
  • Furfural, an organic solvent, is widely used as synthetic component material in producing chemical products. However, furfural has been reported that it shows strong toxicities to human being showing intense stimulus to skin, eyes, mucous membrane and nerve system. It is also known to cause anemia, liver cirrhosis, kidney failure and genetic toxicity in the human being working in the exposed area. LD$_{50}$ of furfural for peritoneal injected mouse has been known around 20mg/kg, but the acute toxicity on aquatic organisms such as fish, daphnid or algae are not well known, compared to those on rodents. In this experiment, we studied on the fish toxicity of furfural using Japanese Medaka (Orvzias latipes) and Common Carp (Cvprinus carpio). We also observed histological changes in the fish organs. The LC$_{50}$ were 12. Smg/L in Japanese Medaka and 21.8 mg/L in Common Carp, respectively. When Common Carps were exposed to 120mg/L of furfural concentration for 30 minutes, blood congestion in gills and lysis of secondary lamella were shown. Though the muscle of caudal fin was not completely eroded, its epidermic cells were shown to be necrotic in various parts. Tissue atrophy and cell necrosis were also shown in the liver of Common Carps exposed to furfural. From these results, furfural seems to cause histological damages on liver, an internal organ as well as on external organs such as gills and fins eventhough the fish were exposed for a short-term.

  • PDF

바이러스성 간질환 치료약 (Drugs for the Treatment of Viral Hepatitis)

  • 김충섭
    • 약학회지
    • /
    • 제57권1호
    • /
    • pp.43-54
    • /
    • 2013
  • Viral hepatitis is the inflammation of liver cells caused by viruses, and still one of the major health-care problems worldwide. A number of viruses to cause hepatitis are type A, B, C, D, E or G. Among these viruses leading to hepatitis, B and C are more troublesome being more prone to chronic illness which can cause the potentially fatal conditions of hepatocellular carcinoma (HCC) and/or liver failure. If immediate treatment is not initiated, liver transplant is the only option left. Over the past few decades there has been remarkable progress in diagnose and monitor all hepatitis virus infections for treatment and prevention. Nonetheless, important challenges remain to develop more effective and safe vaccines for prevention as well as antiviral agents to reduce viremia/viral load by inhibiting viral replication. The development and evaluation of antiviral agents through carefully designed clinical trials over the last 25 years has heralded a new dawn in the treatment of patients chronically infected with the hepatitis B and C viruses, but not so for the D virus. The introduction of Direct Acting Antivirals (DDAs) for the treatment of HBV carriers has permitted the long term use of these compounds for the continuous suppression of viral replication. This review aims to summarize the current status and development approaches of antiviral drugs for the treatment of viral hepatitis and future perspectives.

흉막액의 임상적 고찰 (Clinical Evaluation of Pleural Effusion -Report of Cases-)

  • 이정희;임진수
    • Journal of Chest Surgery
    • /
    • 제26권5호
    • /
    • pp.384-389
    • /
    • 1993
  • A clinical analysis of pleural effusion was done on 100 patients who were between 5 and 67 years old. The etiologic diagnosis of pleural effusion at the time of discharge were pulmonary tuberculosis in 38 cases[38%],pneumonia in 20 cases[20%],lung carcinoma in 16 cases[16%],liver cirrosis in 9 cases[9%],congestive heart failure in 4 cases[4%],nephrosis in 3 cases[3%],Meig,s syndrom in 3 cases[3%].liver abscess 2 cases[2%],pancreatitis in 1 cases[1%] and other metastatic malignancy in 4 cases[4%]. Their chief complaints was chest pain in 89 cases[89%],dyspnea in 74 cases[74%],coughing in 46 cases[46%], fever in 13 cases[13%],weakness in 12 cases[12%] and dizziness in 11 cases[11%].

  • PDF

지역약국 방문 성인 환자의 Acetaminophen 사용 현황 평가 (The Evaluation of Acetaminophen Use for Adult Patients at Community Pharmacies in Korea)

  • 이유정
    • 약학회지
    • /
    • 제54권3호
    • /
    • pp.174-179
    • /
    • 2010
  • Acetaminophen is one of the most commonly used over-the-counter medication in Korea. It is a safe and effective medication for the treatment of mild to moderate pain or fever when used in therapeutic doses. However, acetaminophen overdose is a frequent cause of acute liver failure. The purpose of this study was to evaluate the acetaminophen use for adult patients at community pharmacies in Korea. This study was a 11-questionnaire survey conducted from December 15, 2009 to January 5, 2010. Of the 204 respondents, 117 (57.4%) had used acetaminophen products within 6 months. Only 20 (9.8%) reported having knowledge about the daily maximum doses of acetaminophen, and 3 out of 20 knew it correctly. Only 10 (4.9%) reported having knowledge about the potentialtoxicity of acetaminophen overdose, and 7 out of 10 knew that acetaminophen overdose could cause liver toxicity. The results of this study indicates a need for pharmacists to educate patients regarding the appropriate doses and potential toxicities of acetaminophen.