• 제목/요약/키워드: Liver failure

검색결과 318건 처리시간 0.021초

유전성 대사 질환 동물 모델에서의 줄기 세포 치료 (Stem cell therapy in animal models of inherited metabolic diseases)

  • 최동호;이동환;정성철
    • 대한유전성대사질환학회지
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    • 제5권1호
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    • pp.116-125
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    • 2005
  • Orthotopic liver transplantation is the treatment of choice for inherited metabolic diseases. However, the supply of donor organs is limiting and therefore many patients cannot benefit from this therapy. In contrast, hepatocytes can be isolated from a single donor liver. They can be transplanted into several recipients, and this procedure may help overcome the shortage of donor livers. A great deal of work with animal models indicates that hepatocytes transplanted into the liver or spleen can survive, function, and participate in the normal regenerative process. Recent clinical studies suggest that hepatocyte transplantation may be useful for bridging patients to whole organ transplantation and for providing metabolic support during liver failure and for replacing whole organ transplantation in certain inherited metabolic diseases. Nowadays, hepatocytes from various stem cells have been regarded as an another cell source for treatment of inherited metabolic diseases. Although cell therapy using stem cells for inherited metabolic disease patient has been accepted only as an experimental trial yet, hepatocytes from stem cells can solve a lot of obstacles in the treatment of inherited metabolic diseases.

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소아 복부둔상에 의한 간장손상의 치료 (Management of Liver Injuries Following Blunt Abdominal Trauma in Children)

  • 박진영;장수일
    • Advances in pediatric surgery
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    • 제3권1호
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    • pp.32-40
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    • 1997
  • A clinical review was done of 31 children with blunt liver injury who were admitted to the Department of Surgery, Kyungpook National University Hospital between 1981 and 1990. Seventeen of the 31 children required laparotomy(11 primary repairs, 4 lobectomies, 2 segmentectomies). There were two deaths after laparotomy, one due to associated severe head injury and another due to multiorgan failure. The remaining 14 children, who were hemodynamically stable after initial resuscitation and who did not have signs of other associated intraabdominal injuries, were managed by nonoperative treatment. Patients were observed in a pediatric intensive care unit for at least 48 hours with repeated abdominal clinical evaluations, laboratory studies, and monitoring of vital signs. The hospital courses in all cases were uneventful and there were no late complication. A follow-up computed tomography of 7 patients showed resolution of the injury in all. The authors believe that, for children with blunt liver injuries, nonoperative management is safe and appropriate if carried out under careful continuous surgical observation in a pediatric intensive care unit.

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Necroptosis Is a Mechanism of Death in Mouse Induced Hepatocyte-Like Cells Reprogrammed from Mouse Embryonic Fibroblasts

  • Lee, Yun-Suk;Park, Kyung-Mee;Yu, Lina;Kwak, Ho-Hyun;Na, Hee-Jun;Kang, Kyung-Sun;Woo, Heung-Myong
    • Molecules and Cells
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    • 제41권7호
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    • pp.639-645
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    • 2018
  • Liver transplantation is recommended for patients with liver failure, but liver donors are limited. This necessitates the development of artificial livers, and hepatocytes are necessary to develop such artificial livers. Although induced hepatocyte-like cells are used in artificial livers, the characteristics of mouse induced hepatocyte-like cells (miHeps) reprogrammed with embryonic fibroblasts have not yet been clarified. Therefore, this study investigated the mechanisms underlying the survival, function, and death of miHeps. miHeps showed decreased cell viability, increased cytotoxicity, decreased hepatic function, and albumin and urea secretion at passage 14. Addition of necrostatin-1 (NEC-1) to miHeps inhibited necrosome formation and reactive oxygen species generation and increased cell survival. However, NEC-1 did not affect the hepatic function of miHeps. These results provide a basis for development of artificial livers using hepatocytes.

비전격성 급성 A형 간염 환자에서의 급성 신부전의 병발 1예 (A Case of Acute Renal Failure Associated with Non-fulminant Acute Hepatitis A)

  • 나지훈;박종원;박규환;오명진;최윤정;박정민;장우진
    • Journal of Yeungnam Medical Science
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    • 제27권2호
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    • pp.127-132
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    • 2010
  • Acute hepatitis A is a generally self-limiting disease of the liver. Acute renal failure is rare in patients with acute non-fulminant hepatitis A Acute tubular necrosis is the most common form of renal injury found in such patients. The 215 years old male patient visited our hospital with complaint of general weakness, fatigue, nausea, vomiting and myalgia. He was diagnosed with acute renal failure associated with acute non-fulminant hepatitis A We report here on a case of acute renal failure associated with non-fulminant hepatitis A, and we include a review of the literature.

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폐외증상을 동반한 호흡기세포융합바이러스 감염 1예 (Respiratory Syncytial Virus Infection Complicated by Extrapulmonary Manifestations)

  • 정재호;김윤겸;최희정
    • Pediatric Infection and Vaccine
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    • 제24권3호
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    • pp.188-192
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    • 2017
  • 호흡기세포융합바이러스는 소아 하기도 감염의 주된 원인으로 대부분의 양호한 경과를 보이지만, 일부에서는 호흡부전과 같은 심한 경과를 보이기도 한다. 이러한 심한 호흡기세포융합바이러스 감염에는 드물지 않게 폐외증상이 동반될 수 있다. 저자들은 기계 환기를 필요로 하는 하기도 감염과 함께 급성 심근염, 전격성 간 기능부전을 보인 심한 호흡기세포융합바이러스 감염을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

어린 백서에서 패혈증으로 유발된 다발성 장기 부전증의 특성 (Characteristics of Multiple Organ Failure in Baby Rats)

  • 유수영;노광수;정진형;김일호;고용택
    • Advances in pediatric surgery
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    • 제6권1호
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    • pp.10-18
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    • 2000
  • Multisystem organ failure resulting from gram negative bacterial sepsis is associated with high morbidity and mortality in surgical neonates. There are differences in the clinical characteristics of organ failure in neonates and adults. The purpose of this study is to identify the differences and determine the order of organ failure between baby rats and adult rats after induction of gram negative sepsis. Fifty baby rats less than 30-day-old and another 50 adult rats more than 2-month-old were divided into control group (G1) and experimental group (G2). The G1 consisted of 10 baby- and 10 adult-rats, and the G2 consisted of 40 babies and 40 adults. E. coli ($10^8/mL$ per 100g of body weight) were injected into the peritoneal cavity in G2 and same amount of saline was injected in G 1. Blood samples were obtained before injection, 24 hour, 48 hour, 72 hour and after death. WEC, platelet, $PaO_2$, $PaCO_2$, total bilirubin, BUN, creatinine, albumin and abdominal wall thickness were measured to evaluate the sequence of organ failure. The mortality was 55.0 % in G2-babies and 32.5 % in G2-adults. In baby rats, microvascular, hematologic and renal failure appeared within 24 hours after injection and pulmonary failure followed. Pulmonary, renal and liver failure developed within 24-48 hours in adult rats; however, microvascular failure did not appear until they were moribund. Thrombocytopenia, hypoalbuminemia, increased BUN and generalized edema was the earlist sign of sepsis in baby rats.

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Hereditary Tyrosinemia Type I 환아의 NTBC 치료 경험 (Hereditary Tyrosinemia Type I)

  • 강현영;김숙자;송웅주;장미영
    • 대한유전성대사질환학회지
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    • 제4권1호
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    • pp.13-17
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    • 2004
  • 저자들은 생후 28일된 발열, 간종대, 출혈성 경향, 구토, 잦은 보챔, 전신의 황달 증상을 보이던 환아를 MS-MS 이용한 신생아 대사 이상 검사와 혈중 아미노산 분석, 뇨중 유기산 분석을 통하여 hereditary tyrosinemia type I으로 진단하였다. 저 페닐알라닌/타이로신 식이와 NTBC 사용으로 국내 첫 타이로신혈증 I 치료 성공례를 경험하였다.

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신생아 대사이상 선별검사 이상으로 진단된 I형 타이로신혈증 (A Case with Tyrosinemia Type I Detected by Neonatal Screening Test)

  • 손영배;이해상;이장훈;황진순
    • 대한유전성대사질환학회지
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    • 제12권2호
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    • pp.99-103
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    • 2012
  • I형 타이로신혈증은 타이로신의 분해 과정 중 최종단계에 관여하는 효소인 fumarylacetoacetate hydrolase(FAH)의 결핍에 의한 대사 이상질환이다. 급성 I형 타이로신혈증은 치명적인 간부전이나 혈액응고장애와 같은 급성 임상증상이 나타난 이후에는 예후가 불량하였으나 최근에는 신생아 대사이상 선별검사를 통해 조기 진단이 가능해졌고 2-(2-nitro-4-trifluoro-methylbenzyol)-1,3 cyclohexanedione nitisinone (NTBC) 약물 치료로 타이로신혈증의 치료 성적이 향상됨에 따라 신생아 대사이사 선별검사를 통한 조기 진단과 조기 치료가 더욱 중요해졌다고 할 수 있다. 이에 저자들은 심각한 출혈이나 간부전과 같은 급성 이상 증상이 나타나기 전 신생아 대사이상 선별검사로 조기 진단 및 조기 중재적 치료로 양호한 경과를 보이고 있는 I형 타이로신혈증 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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초음파영상을 이용한 간탄력도 검사의 유용성 (The Usefulness of Liver Fibroscan Test Using Ultrasound Image)

  • 안현;이진수;임인철;양성희
    • 한국방사선학회논문지
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    • 제11권4호
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    • pp.205-212
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    • 2017
  • 만성간질환(Chronic diffuse hepatopathy)의 진단은 간경화, 간부전, 간암으로 인한 사망률과 유병율을 감소시키는 중요한 임상과제 중 하나이다. 이에 본 연구에서는 초음파진단 영상을 바탕으로 간탄력도검사(Fibroscan)를 통해 지방간, 만성간질환을 예측할 수 있는 기준을 알아보고자 하였다. 280명의 환자를 대상으로 혈청학적 검사, 간탄력도 검사 측정값(kPa)을 분석하였으며 ROC 곡선분석을 이용하여 지방간 및 만성간질환을 예측을 위한 간탄력도 측정값의 cut-off value를 결정하였다. 혈청학적 검사에서 Bililubin, PT(prothrombin time)은 질병예측에 관련성이 없었으며(p=0.243, p=0.115), 혈당과 중성지방수치는 지방간에서 의미 있는 차이를 보이며 높게 나타났다(p<0.05). 간탄력도 측정값은 정상 대조군, 지방간, 만성간질환 순으로 높게 측정되었으며 만성간질환 예측을 위한 cut-off value는 10.3 kPa(AUC 0.98, Sensitivity 94.94%, Specificity 94.93%)로 결정하였다. 따라서 정량적인 평가로 만성간질환 환자의 진단에 일차적인 도구로 활용될 것으로 사료된다.

Cilostazol Decreases Ethanol-Mediated TNFalpha Expression in RAW264.7 Murine Macrophage and in Liver from Binge Drinking Mice

  • Lee, Youn-Ju;Eun, Jong-Ryeol
    • The Korean Journal of Physiology and Pharmacology
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    • 제16권2호
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    • pp.131-138
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    • 2012
  • Alcoholic hepatitis is a leading cause of liver failure in which the increased production of tumor necrosis factor ${\alpha}$ (TNF${\alpha}$) plays a critical role in progression of alcoholic liver disease. In the present study, we investigated the effects of cilostazol, a selective inhibitor of type III phosphodiesterase on ethanol-mediated TNF${\alpha}$ production in vitro and $in$ $vivo$, and the effect of cilostazol was compared with that of pentoxifylline, which is currently used in clinical trial. RAW264.7 murine macrophages were pretreated with ethanol in the presence or absence of cilostazol then, stimulated with lipopolysacchride (LPS). Cilostazol significantly suppressed the level of LPS-stimulated TNF${\alpha}$ mRNA and protein with a similar degree to that by pentoxifylline. Cilostazol increased the basal AMP- activated protein kinase (AMPK) activity as well as normalized the decreased AMPK by LPS. AICAR, an AMPK activator and db-cAMP also significantly decreased TNF${\alpha}$ production in RAW264.7 cells, but cilostazol did not affect the levels of intracellular cAMP and reactive oxygen species (ROS) production. The $in$ $vivo$ effect of cilostazol was examined using ethanol binge drinking (6 g/kg) mice model. TNF${\alpha}$ mRNA and protein decreased in liver from ethanol gavaged mice compared to that from control mice. Pretreatment of mice with cilostazol or pentoxifylline further reduced the TNF${\alpha}$ production in liver. These results demonstrated that cilostazol effectively decrease the ethanol-mediated TNF${\alpha}$ production both in murine macrophage and in liver from binge drinking mice and AMPK may be responsible for the inhibition of TNF${\alpha}$ production by cilostazol.