• Journal of Trauma and Injury
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• 제25권4호
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• pp.217-222
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• 2012

Purpose: Diaphragmatic rupture following trauma is often an associated and missed injury. This report is about our experience with treating traumatic diaphragmatic rupture (TDR). Methods: From January 2007 to September 2012, 18 patients who had a diaphragmatic rupture due to blunt trauma or penetrating injury underwent an operation for diaphragmatic rupture at our hospital. We retrospectively reviewed their medical records, including demographic factors, initial vital signs, associated injuries, interval between trauma and diagnosis, injured side of the diaphragm, diagnostic tools, surgical method or approaches, operative time, herniated organs, complications, and mortality. Results: The average age of the patients was 43 years, and 16 patients were male. Causes of trauma included motor vehicle crashes (n=7), falls (n=7), and stab wounds (n=5). The TDR was right-sided in 6 patients and left-sided in 12. The diagnosis was made by using a chest X-ray (n=3), and thorax or upper abdominal computed tomography (n=15). Ten(10) patients were diagnosed within 12 hours. A thoracotomy was performed in 8 patients, a video-assisted thoracoscopic surgery in 4 patients, a laparotomy in 3 patients, and a sternotomy in one patient. Herniated organs were the omentum (n=11), stomach (n=8), spleen and colon (n=6), and liver (n=6). Eighteen diaphragmatic injuries were repaired primarily. Seven patients underwent ventilator care, and two of them had pneumonia and acute respiratory distress syndrome. There were no operative mortalities. Conclusion: Early diagnosis and surgical treatment determine the successful management of TDR with or without the herniation of abdominal organs. The surgical approach to TDR is chosen based on accompanying organ injuries and the injured side.

• Biomolecules & Therapeutics
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• 제31권1호
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• pp.97-107
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• 2023

Aristolochic acid (AA), extracted from Aristolochiaceae plants, plays an essential role in traditional herbal medicines and is used for different diseases. However, AA has been found to be nephrotoxic and is known to cause aristolochic acid nephropathy (AAN). AA-induced acute kidney injury (AKI) is a syndrome in AAN with a high morbidity that manifests mitochondrial damage as a key part of its pathological progression. Melatonin primarily serves as a mitochondria-targeted antioxidant. However, its mitochondrial protective role in AA-induced AKI is barely reported. In this study, mice were administrated 2.5 mg/kg AA to induce AKI. Melatonin reduced the increase in Upro and Scr and attenuated the necrosis and atrophy of renal proximal tubules in mice exposed to AA. Melatonin suppressed ROS generation, MDA levels and iNOS expression and increased SOD activities in vivo and in vitro. Intriguingly, the in vivo study revealed that melatonin decreased mitochondrial fragmentation in renal proximal tubular cells and increased ATP levels in kidney tissues in response to AA. In vitro, melatonin restored the mitochondrial membrane potential (MMP) in NRK-52E and HK-2 cells and led to an elevation in ATP levels. Confocal immunofluorescence data showed that puncta containing Mito-tracker and GFP-LC3A/B were reduced, thereby impeding the mitophagy of tubular epithelial cells. Furthermore, melatonin decreased LC3A/B-II expression and increased p62 expression. The apoptosis of tubular epithelial cells induced by AA was decreased. Therefore, our findings revealed that melatonin could prevent AA-induced AKI by attenuating mitochondrial damage, which may provide a potential therapeutic method for renal AA toxicity.

• 대한한방부인과학회지
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• 제36권4호
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• pp.40-48
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• 2023

Objectives: The purpose of this study is to investigate safety of postpartum herbal medicine by assessing the effect of taking herbal medicine of postpartum period on liver function. Methods: A retrospective chart review was conducted on 167 mothers who underwent liver function tests (LFT) within 3 months before and after childbirth among mothers who gave birth at ○○ Hospital between January 1, 2016 and May 31, 2018. Mothers with abnormally elevated LFT during pregnancy were excluded. Among 167 women, 6 women are herbal-medicine-group took herbal medicine for 5-6 weeks during postpartum period, and 161 patients are general -group who did not take herbal medicine. LFT Variation of Subjects before and after childbirth were compared between the two groups. And subjects who had elevated liver levels above the normal range after delivery were classified separately, the characteristics and causes of changes in liver levels were analyzed, and the presence or absence of drug-induced liver damage was confirmed. Results: Among a total of 167 subjects, there were 5 women in the herbal-medicine-group and 150 women in the general-group who had changes in liver values within the normal range after childbirth. Aspartate transaminase (AST) change before and after childbirth in the herbal-medicine-group was 3.40±1.82, and AST change in the general-group was 2.92±8.59, showing no significant difference between the two groups (p=0.901). Increase of Alanine transaminase (ALT) before and after childbirth in the herbal-medicine-group was 5.60±3.65, and ALT change in the general-group was 8.01±11.81, showing no significant difference between the two groups (p=0.651). There were 12 subjects who had elevated AST, ALT above the normal range after delivery, including 1 in the herbal-medicine-group and 11 in the normal mothers group. Valuation of 1 Subject of the herbal-medicine-group before and after delivery was 17 IU/L of AST and 52 IU/L of ALT. Because results of AST, ALT is under the standard to diagnose to liver damage, she was observed without any treatment. However the cause of AST, ALT elevation was not found in the chart, she was receiving treatment for diabetes and hyperlipidemia. The general-group had an average increase of AST 35.64±22.67 IU/L and ALT 53.00±26.80 IU/L. As a result of analyzing the cause, there were direct causes such as autoimmune hepatitis, chronic hepatitis B, and acute pyelonephritis. Abnormal elevations in liver levels were also found in mothers with hypothyroidism, diabetes, and fever of unknown cause, although they were not direct causes. Conclusions: To investigate the safety of taking herbal medicines, we assess the variation in AST and ALT within 3 months before and after delivery in the herbal-medicine-group and general-group. There was no significant difference between two groups.

• 대한수의학회지
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• 제51권4호
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• pp.259-265
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• 2011

Several compounds and extracts isolated from a brown alga, Ishige (I.) okamurae, exhibit anti-oxidant and anti-inflammatory effects. The present study investigated whether the ethyl acetate (EtOAc) fraction of I. okamurae (EFIO) could ameliorate carbon tetrachloride ($CCl_{4}$)-induced hepatotoxicity in rats. Sprague-Dawley rats were intraperitoneally (i.p.) administered with EFIO at 10 or 50 mg/kg per day for 2 consecutive days before $CCl_{4}$ injection (3.3 mL/kg, i.p.). Twenty four hours later, the rats were anesthesized with diethyl ether and dissected. Pretreatment with EFIO significantly reduced the increased serum levels of alanine aminotransferase and aspartate aminotransferase in $CCl_{4}$-treated rats. Pretreatment with EFIO also significantly inhibited the reduced activities of superoxide dismutase and catalase in the $CCl_{4}$-injured liver. Histopathological evaluations showed that hemorrhage, hepatocyte necrosis, inflammatory cell infiltration, and fatty degeneration induced by $CCl_{4}$ treatment were ameliorated by the administration of EFIO. Additionally, liver immunohistochemical analyses revealed the marked reduction in ED1-positive monocyte-like macrophages in EFIO-pretreated rats given $CCl_{4}$. These results suggest that EFIO ameliorates $CCl_{4}$-induced liver injury, possibly through the inhibition of oxidative stress.

• Tuberculosis and Respiratory Diseases
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• 제51권2호
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• pp.161-165
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• 2001

저자 등은 다량의 흉막유출로 반대측 폐의 일부 허탈과 폐부종을 보이는 만성 간질환 환자의 호흡곤란의 경감을 위하여 시행한 흉강천자 후 발생한 양측성 재팽창성 폐부종(reexpansion pulmonary edema)과 이로 인한 급성호흡곤란증후군을 경험하고 이를 문헌고찰과 함께 보고하는 바이다.

• Parasites, Hosts and Diseases
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• 제51권6호
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• pp.695-701
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• 2013

Opisthorchis viverrini infection causes inflammation and liver injury leading to periductal fibrosis. Little is known about the pathological alterations in bile canaliculi in opisthorchiasis. This study aimed to investigate bile canalicular alterations in O. viverrini-infected hamsters and to examine the chemopreventive effects of curcumin on such changes. Hamsters were infected with O. viverrini and one group of animals was fed with 1% dietary curcumin supplement. Animals were examined during the acute infection phase, days 21 and 30 post-infection (PI) and chronic infection phase (day 90 PI). Scanning electron microscopy revealed that in the infected group fed with a normal diet, bile canaliculi became slightly tortuous by 30 day PI and more tortuous at day 90 PI. Transmission electron microscopy showed a reduction in microvilli density of canaliculi starting at day 30 PI, with a marked loss of microvilli at day 90 PI. These ultrastructral changes were slightly seen at day 21 PI, which was similar to that found in infected animals fed with 1% curcumin-supplemented diet. Notably, curcumin treatment prevented the reduction of microvilli density, reduced the dilation of bile canaliculi, and decreased the tortuosity of the bile canaliculi relative to non-infected animals on a normal diet at days 30 and 90 PI. These results suggest that curcumin reduces alteration of bile canaliculi and may be a promising agent to prevent the onset of bile duct abnormalities induced by O. viverrini infection.

• 한국수산과학회지
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• 제47권3호
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• pp.204-210
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• 2014

The brown alga Saccharina japonica is consumed as a foodstuff in many countries. Carbon tetrachloride ($CCl_4$) is a potent hepatotoxin that is used to assess hepatotoxicity in animal models. This study assessed the protective effect of S. japonica extract (SJE) on $CCl_4$-induced acute liver injury in rats. Experimental rats were divided into the following three groups: control, $CCl_4$, and $CCl_4$+SJE; the latter two groups were given 150 or 300 mg SJE/kg orally for 10 days. Three hours after the final treatment, all rats-except for those in the control group-were administered intraperitoneal injections of $CCl_4$. One day later, blood and liver samples were collected for evaluation biomarker of levels. Aspartate transaminase (APT; GPT) and alanine aminotransferase (ALT; GOT) levels were markedly lower in the $CCl_4$+SJE group than the $CCl_4$ group. The hepatic superoxide dismutase (SOD) activity of the $CCl_4$+SJE group was significantly lower than that of the $CCl_4$ group. In comparison, glutathione S-transferase (GSH) and catalase (CAT) levels were significantly higher in the $CCl_4$+SJE group. Western blotting revealed that SJE attenuated the $CCl_4$-induced EGFR and MAPK activity in the liver. Thus, we conclude that SJE protects against $CCl_4$-induced hepatotoxicity.

• 대한한의학방제학회지
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• 제11권1호
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• pp.129-149
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• 2003

Liver is an important target of the toxicity of drugs, xenobiotics and oxidative stress. Acetaminophen pverdose causes acute liver injury in both humans and animals. This study was performed to observe the effect of sachunwhan and its component groups on recovery of hepatoxicity in acetaminophen treated rats. The experimental group was divided into 4 groups: sachungwhan(SC), samultang group(SC-1: 當歸, 川芎), chungyul group(SC-2: 龍膽草, 大黃, 梔子), and haepyo group(SC-3:羌活, 防風). Under the same condition Normal group was fed basal diet and water; Control group was injected acetaminophen and fed basal diet for 2 weeks; Experimental groups were injected acetaminophen and fed each extracts for 2 weeks respectively. The results were obtained as follows: 1. In the study on antioxidative defense system in vivo, SC reduced the amount of lipid peroxide in both serum and liver and showed activity on antioxidative enzymes such as catalase, glutathion. Other groups had effect only on glutathion. 2. In the study on hepatotoxicity(GOT, GPT, ${\gamma}$-GTP, ALP, LDH, Bilirubin), SC had a significant effect on recovery of hepatoxicity in acetaminophen treated rats. Other groups had no effect except SC-1 having effect on ${\gamma}$-GTP. As results shown, only Sachungwhan(SC) has significant effects on recovery of hepatoxicity and antioxidative defense system in vivo. These results suggest that Sachungwhan(SC) made antioxidative defense system active and it seemed to be very important to its effect on recovery of hepatoxicity. In the other hand, Component groups had no effect on recoverv of hepatoxicity and antioxidative defense system in vivo. This was thought that component drugs' cooperative synergy effect would be important to Sachungwhan(SC)'s effects mentioned in this paper.

• Journal of Ginseng Research
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• 제43권1호
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• pp.10-19
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• 2019

Background: Frequent overdose of paracetamol (APAP) has become the major cause of acute liver injury. The present study was designed to evaluate the potential protective effects of ginsenoside Rk1 on APAP-induced hepatotoxicity and investigate the underlying mechanisms for the first time. Methods: Mice were treated with Rk1 (10 mg/kg or 20 mg/kg) by oral gavage once per d for 7 d. On the 7th d, allmice treated with 250mg/kg APAP exhibited severeliverinjury after 24 h, and hepatotoxicitywas assessed. Results: Our results showed that pretreatment with Rk1 significantly decreased the levels of serum alanine aminotransferase, aspartate aminotransferase, tumor necrosis factor, and interleukin-$1{\beta}$ compared with the APAP group. Meanwhile, hepatic antioxidants, including superoxide dismutase and glutathione, were elevated compared with the APAP group. In contrast, a significant decrease in levels of the lipid peroxidation product malondialdehyde was observed in the ginsenoside Rk1-treated group compared with the APAP group. These effects were associated with a significant increase of cytochrome P450 E1 and 4-hydroxynonenal levels in liver tissues. Moreover, ginsenoside Rk1 supplementation suppressed activation of apoptotic pathways by increasing Bcl-2 and decreasing Bax protein expression levels, which was shown using western blotting analysis. Histopathological observation also revealed that ginsenoside Rk1 pretreatment significantly reversed APAP-induced necrosis and inflammatory infiltration in liver tissues. Biological indicators of nitrative stress, such as 3-nitrotyrosine, were also inhibited after pretreatment with Rk1 compared with the APAP group. Conclusion: The results clearly suggest that the underlying molecular mechanisms in the hepatoprotection of ginsenoside Rk1 in APAP-induced hepatotoxicity may be due to its antioxidation, antiapoptosis, anti-inflammation, and antinitrative effects.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.12-17
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• 2011

Purpose: A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments. Methods: From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment. Results: The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality. Conclusion: In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.