• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.219-222
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• 2008

Crigler-Najjar syndrome is a rare inherited disease associated with unconjugated hyperbilirubinemia. It is inherited via an autosomal recessive pattern and is caused by mutation in one of the five exons of the bilirubin uridine-diphosphoglucuronate glucuronosyltransferase (UGT1A1) gene. The synthesis of inactive isoforms of bilirubin uridine-diphosphoglucuronate glucuronosyltransferase (B-UGT) results in unconjugated hyperbilirubinemia. A 13-year-old boy with jaundice for 4 months was admitted to our hospital. He had unconjugated hyperbilirubinemia with no evidence of infection, hemolysis, or structural abnormalities on abdominal ultrasonography or 99mTc-DISIDA scan. The authors identified a missense mutation of Tyr486Asp in the fifth exon of the UGT1A1 gene and diagnosed the patient with Crigler-Najjar syndrome type II. This is the first reported case of Crigler-Najjar syndrome in a Korean child, and it is also the first reported case of a genetic mutation leading to Crigler-Najjar syndrome in Korea.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.6
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• pp.1710-1714
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• 2005

This study was designed to report the clinical effects of oriental medical therapy on a patient of jaundice with a toxic hepatitis and liver failure. Herbal medication, acupuncture and cupping therapy were applied to the patient for 18 weeks. Symptoms were checked repeatedly, and clinicopathologic test(such as total bilirubin, direct bilirubin, AST, ALT ect.) were done to evaluate improvement. After 18 weeks treatment with oriental medical therapy, most symptoms disappeared or improved. Clinicopathologic examinations showed improvement. The above results that oriental medical therapy is beneficial for the patient with jaundice.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.6
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• pp.657-661
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• 2014

Gilbert's syndrome is one that shows a benign course with intermittent unconjugate hyperbilirubinemia without any evidence of hepatobiliary tract disease or hemolysis. It is often found in a health examination or blood laboratory test by chance. In particular, patients who are taking drugs, including herbal medicine should be careful for their medication due to the possibility of associations with changes in liver function because of drug metabolism, sometimes they have to quit the use of the medication for a certain period and often they should get an additional test. Two male patients increased serum total bilirubin level without other systemic symptoms in screening test for clinical herb medicine pharmacokinetics study. Therefor they was diagnosed with suspected Gilbert's syndrome. They had been calory deprivation test with 24 hours fasting state. They also performed liver function test and ultrasonogram for evaluation of hepatobiliary tract disease. Total serum bilirubin was markedly increased, especially unconjugate bilirubin level higher over the two times than base line after they had been calory deprivation for 24 hours, They was not found another abnormality all laboratory results and physical examination. This study is a report on two cases of hyperbilirubinemia, diagnosed as Gilbert's syndrome, which were found in the process of a clinical pharmacokinetic study of a decoction of medicinal herbs.

• Journal of Pharmaceutical Investigation
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• v.25 no.3
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• pp.193-204
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• 1995

In order to examine the effect of extrahepatic cholestasis induced by common bile duct ligation on the hepatic function, the pharmacokinetics of antipyrine and d-propranolol were investigated in rats. In addition, in an attempt to observe the degree of direct hepatic injury, light and electron microscopic observations and conventional pathologic test using serum were performed. Five days after common bile duct ligation, antipyrine(15 mg/kg) and d-propranolol(3 mg/kg) were intravenously administrated to the rats, respectively. The total clearances of antipyrine and d-propranolol were significantly(p<0.05) decreased. Because hepatic clearance of antipyrine poorly extracted by the liver and that of d-propranolol highly extracted by the liver are respectively dependent on the hepatic intrinsic clearance and the hepatic blood flow, it may be concluded that extrahepatic cholestasis following five days after common bile duct ligation decreased the hepatic intrinsic clearance and the hepatic blood flow. SGPT, SGOT, cholesterol, bilirubin(total bilirubin, direct bilirubin) and alkaline phosphatase were significantly increased(p<0.05). The proliferation of bile ducts was prominent, and degeneration and necrosis of hepatocytes were observed by light microscope. Also, ultrastructurally, bile canaliculi were containing the amorphous materials and losing microvilli, and SER and RER in hepatocytes were dilated and vacuolated.

• The Journal of Dong Guk Oriental Medicine
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• v.5
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• pp.1-13
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• 1996

This study was done in order to investigate the protective effects of A.G.R.(Angelicae gigantis Radix) aqua-acupuncture on acetaminophen induced liver damage in rats. The liver damage was induced by acetaminophen (500mg/kg) injection into the peritoneum. The A.G.R. aqua-acupuncture solution was injected into the corresponding loci to Ganshu($BL_{18}$) and Qimen($LR_{14}$) of human body and a blank locus of the root of tail on four consecutive times at 0, 3, 6, and 12 hours after acetaminophen injection. And the serum GOT, GPT, LDH, ALP activities, total bilirubin, direct bilirubin levels were measured in the rats. The serum GOT, GPT, LDH ALP activities and bilirubin level were decreased comparing with that of a control group in case of A.G.R. aqua-acupuncture treated group, specially Ganshu and Qimen aqua-acupuncture treated groups showed an obvious significant decrease.

• The Journal of Internal Korean Medicine
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• v.22 no.2
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• pp.251-256
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• 2001

In western medicine, there are some reports about herbal medicine induced hepatitis, but in oriental medicine, there are few reports about that. We experienced one case of drug acute cholestatic-hepatitis in the treatment of oriental medicine for HNP. We treated the patient with acupuncture, physical therapy and herb medicine. The patient's symptoms improved after two weeks of treatment. In the course of treatment, the patient intermittently complained of general weakness, nausea, yellowish urin, dyspepsia, and abdominal discomfort. We recognized that total bilirubin(7.2mg/dl), direct bilirubin(5.5mg/dl), serum transaminase(AST 360U/L, ALT 354U/L), alkaline phosphatase(16.6 K/A), urobilinogen(++) and bilirubin(++) were elevated. We diagnosed drug induced hepatitis. We stopped giving herb medicine and began giving Saeng gan gunbi-tang and Injin-oryung-san. Saeng gan gunbi-tang and Injin-oryung-san have been used to treat hepatic disease and have been known to have beneficial effects. After 3weeks on medication, the clinical symptoms and liver function improved. So, we report this case to bring more attention to the safety and toxicity of herbal medicine.

• Journal of Gastric Cancer
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• v.19 no.2
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• pp.183-192
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• 2019

Purpose: Due to adverse events, dose reduction or withdrawal of adjuvant chemotherapy is required for some patients. To identify the predictive factors for tolerability to postoperative adjuvant S-1 monotherapy in gastric cancer (GC) patients, we evaluated the predictive values of blood indicators. Materials and Methods: We analyzed 98 patients with pStage II/III GC who underwent postoperative adjuvant S-1 monotherapy. We retrospectively analyzed correlations between 14 parameters obtained from perioperative routine blood tests to assess their influence on the withdrawal of postoperative adjuvant S-1 monotherapy, within 6 months after discontinuation. Results: Postoperative adjuvant chemotherapy was discontinued in 21 patients (21.4%) within 6 months. Univariable analysis revealed that high preoperative albumin-bilirubin (ALBI) scores had the highest odds ratio (OR) for predicting the failure of adjuvant S-1 chemotherapy (OR, 6.47; 95% confidence interval [CI], 2.08-20.1; cutoff value, -2.696). The high ALBI group had a significantly shorter time to failure of postoperative adjuvant S-1monotherapy (hazard ratio, 3.48; 95% CI, 1.69-7.25; P=0.001). Multivariable analysis identified high preoperative ALBI score as an independent prognostic factor for tolerability (OR, 10.3; 95% CI, 2.33-45.8; P=0.002). Conclusions: Preoperative ALBI shows promise as an indicator associated with the tolerability of adjuvant S-1 monotherapy in patients with pStage II/III GC.

• Korean Chemical Engineering Research
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• v.59 no.3
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• pp.373-378
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• 2021

The study aimed to develop a high-power enzymatic electrode for a wearable fuel cell that generates electricity utilizing lactate present in a sweat as fuel. Anode was fabricated by immobilizing lactate oxidase (LOx) on flexible carbon paper. As the lactate concentration in the electrolyte solution increased, the amount of current generated by catalysis of lactate oxidase increased. The immobilized LOx generated 1.5-times greater oxidation current density in the presence of gold nanoparticles than carbon paper only. Bilirubin oxidase (BOD)-immobilized cathode generated a larger amount of reduction current in the electrolyte saturated with oxygen than purged with nitrogen. A fuel cell composed of two electrodes was fabricated and cell voltage was measured under different discharge current. At the discharge current density of 66.7 ㎂/cm², the cell voltage was 0.5±0.0 V leading to maximum cell power density of 33.8±2.5 ㎼/cm².

• Journal of Appropriate Technology
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• v.7 no.2
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• pp.206-210
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• 2021

Hyperbilirubinemia is the most common neonatal disease and is observed in about 80% of newborns worldwide in neonatal period within a week after birth. Untreated infant hyperbilirubinemia may lead to brain damage and even death, so it is very important to diagnose it quickly and accurately. In this study, a total bilirubin measurement system was developed that is portable and easy to use without pre-processing using a commercial smartphone. This system measures using the LED and camera of the smartphone without the need for additional devices, and because a small amount of blood is injected without pre-treatment, anyone can easily measure it in the field. In a comparative study with Cobas c111 results, accuracy meets CLIA guidelines with 94% (17/18) within ±0.4 mg/dL below 3 mg/dL and 98% within ±20% above 3 mg/dL (276/282). This system offers a simple, fast and accurate diagnosis for jaundice in infants and young children in low-resource settings.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.737-744
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• 2006

Purpose : To assess the usefulness of $^{99m}Tc-DISIDA$ scanning in the early evaluation of neonatal cholestasis and to verify the diagnostic value of this test in the differential diagnosis of biliary atresia. Methods : DISIDA scannings were performed and analyzed in 87 children(58 males and 29 females; age, 18-139 days, mean, 59.1 days) with neonatal cholestasis. Five groups according to the final diagnosis and the results of DISIDA scanning were analyzed by scatter plots using the parameters of age and the level of liver function tests(direct bilirubin, AST, ALT, ALP, GGT). The diagnostic sensitivity, specificity and accuracy of DISIDA scanning in the diagnosis of biliary atresia were compared between a higher bilirubin group and a lower bilirubin group(direct bilirubin level >5 mg/dL vs. <5 mg/dL) decided by the pattern of scatter plots. Results : DISIDA scannings in the diagnosis of biliary atresia were analyzed by high sensitivity(100 percent, 16/16) but lower specificity(70.4 percent, 50/71) and accuracy(75.9 percent, 66/87). False positivity(29.6 percent, 21/71) was higher in patients with a higher direct bilirubin level(42.5 percent for >5 mg/dL vs. 9.7 percent for <5 mg/dL, P<0.01). The age and the level of liver function tests(AST, ALT, ALP, GGT) analyzed by scatter plots revealed neither diagnostic value in predicting final diagnosis nor estimated the accuracy rate of DISIDA scanning in the evaluation of neonatal cholestasis. Conclusion : We suggest that DISIDA scannings should not be routinely used in evaluating neonatal cholestasis with elevated direct bilirubin level(>5 mg/dL), especially if it delays early diagnosis and surgical intervention.