• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.1
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• pp.285-290
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• 2007

A liver is responsible for drug metabolism in a body. 10% of all medicine side effects lead to liver injury. Herb medicine is not an exception to this rule but all Herb medicines do not lead to liver injury absolutely. As for two times of occurrence of the drug induced liver injury during treatment of a CVA patient, we gave him Herb medicines in conjunction with Western medicines and Western medicines alone for each case. We meet with the result that giving the patient Herb medicines in conjunction with Western medicines reduces the duration of decreasing AST, ALT level as compared with giving him Western medicines alone. So we are now reporting the result.

• Journal of Yeungnam Medical Science
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• v.37 no.1
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• pp.2-12
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• 2020

Drug-induced liver injury (DILI), including herbal and dietary supplement hepatotoxicity, is often passed lightly; however, it can lead to the requirement of a liver transplant or may even cause death because of liver failure. Recently, the American College of Gastroenterology, Chinese Society of Hepatology and European Association for the Study of the Liver guidelines for the diagnosis and treatment of DILI have been established, and they will be helpful for guiding clinical treatment decisions. Roussel Uclaf Causality Assessment Method scoring is the most commonly used method to diagnose DILI; however, it has some limitations, such as poor validity and reproducibility. Recently, studies on new biomarkers have been actively carried out, which will help diagnose DILI and predict the prognosis of DILI. It is expected that the development of new therapies such as autophagy inducers and various other technologies of the fourth industrial revolution will be applicable to DILI research.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.3
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• pp.183-189
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• 2016

A 84 year old male patient with amyotrophic lateral sclerosis (ALS) was treated by Jeungsonbaekchulsan and Gakbyeongyeonsu-tang for ten days. In the course of treatments, this patient was evaluated with Roussel Uclaf Casusality Assessment Method (RUCAM), showing results of drug induced liver injury. Herb medicine was immediately discontinued, followed by therapeutic laser treatments once a day for one week combined with 2 weeks of GODEX$^{(R)}$ administration. Transaminase results were lowered and changes in blood test results were time-effective changes. Therapeutic laser therapy could be considered effective on drug induced liver injury with further studies.

• The Journal of Korean Medicine
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• v.32 no.6
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• pp.112-116
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• 2011

Objectives: To inform the clinical features of drug-induced liver injury (DILI), and study traditional Korean medicine (TKM)-based strategies or therapeutics. Methods: A female patient with hepatitis after long term use of medication for cold symptoms was treated with Oriental therapies, after which the clinical outcome was evaluated by serum biochemical parameters and ultrasonography. Results: Clinical and biochemical levels were fluctuating during administration of cold medicine, but the patient completely recovered her health with herbal medicines. Conclusion: This case report would provide information about a typical DILI by western medicine followed by treatment with traditional Korean medicine.

• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.531-541
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• 2020

From January 2014 to December 2016, 38 out of 153 inpatients admitted to the Korean Medicine Hospital for more than one month underwent follow-up blood tests to evaluate their liver function levels, and one drug-induced liver injury (DILI) patient was observed. 1. At the time of admission, six (15.8%) of the 38 patients had abnormal alanine aminotransferase (ALT) levels and five of them recovered after hospitalization. 2. At follow-up, two (5.3%) patients had a Council for International Organizations of Medical Science (CIOMS)-based liver injury. One was identified as a liver injury accompanied by pneumonia, and one was judged as a liver injury caused by the drug. 3. The patient had a suspected DILI and completely recovered after 13 days while discontinuing the herbal medication and by using Sanggangunbi-tang (生肝健脾湯).

• Biomolecules & Therapeutics
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• v.8 no.2
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• pp.119-124
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• 2000

We hypothesized that the extent of hypoxic injury would be involved in reduction of oxygen delivery to the tissue. Livers isolated from 18 hr-fasted rats were subjected to $N_2$-induced hypoxia or low flow hypoxia. Livers were perfused with nitrogen/carbon dioxide gas for 45min or perfused with normoxic Krebs-Henseleit bicarbonate buffer (KHBB) at low flow rates around 1 ml/g liver/min far 45min, which caused cells to become hypoxic because of insufficient delivery of oxygen. When normal flow rates(4 ml/g liver/min) of KHBB (pH 7.4, 37$^{\circ}C$, oxygen/carbon dioxide gas) were restored for 30min reoxygenation injury occurred. Lactate dehydrogenase release gradually increased in $N_2$-induced hypoxia, whereas it rapidly increased in low flow hypoxia. Total glutathione in liver tissue was not changed but oxidized glutathione markedly increased after hypoxia and reoxygenation, expecially in $N_2$-induced hypoxia. Similarly, lipid peroxidation in liver tissue significantly increased after hypoxia and reoxygenation in low flow hypoxia. Hepatic drug metabolizing functions (phase I, II) were suppressed during hypoxia, especially in $N_2$-induced hypoxia but improved by reoxygenation in both models. Our findings suggest that hypoxia results in abnormalities in drug metabolizing function caused by oxidative stress and that this injury is dependent on hypoxic conditions.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.539-544
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• 2004

Herbal medicine has been used in the Eastern world for 2,000 years, and is beneficial for numerous diseases. There have been reports pertaining to the safety of herbal medicine, but there have been few reports about herbal medicine induced liver injury in Eastern or Western medicine. Most are descriptions of hepatotoxicity of certain toxic herbs. We experienced one case of drug induced liver injury in the treatment of cerebral infarction with Chungsim Yeonja-tang. Although the patient had not used medication and Chungsim Yeonja-tang has no toxic herbs in it. patient's ALP, AST, ALT, GGT was twice elevated after 20 days on medication. This was diagnosed as drug induced liver injury, possibly due to incorrect diagnosis of Sasang constitution. So no herbal medicine was given for seven days. Then Gagam Saeng Gan-tang was given. Gagam Saeng Gan-tang have been used to treat hepatic disease and have been known to have beneficial effects. After 25 days on medication, the clinical symptoms and liver function improved. So, this case is presented to bring more attention to the toxicity of herbal medicines.

• Advances in Traditional Medicine
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• v.7 no.3
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• pp.311-320
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• 2007

The present study was designed to estimate the protective effect of (-) epigallocatechin gallate (EGCG) on ethanol-induced liver injury in rats. Chronic ethanol administration (6 g/kg/day ${\times}$ 60 days) caused liver damage that was manifested by the elevation of markers of liver dysfunction - aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, bilirubin and ${\gamma}$-glutamyl transferase in plasma and reduction in liver glycogen. The activities of alcohol metabolizing enzymes such as alcohol dehydrogenase and aldehyde dehydrogenase were found to be altered in alcohol-treated group. Ethanol administration resulted in the induction of cytochrome p450 and cytochrome-$b_{5}$ activities and reduction of cytochrome-c reductase and glutathione-S-transferase, a phase II drug metabolizing enzyme. Further, ethanol reduced the viability of isolated hepatocytes (ex vivo) as assessed by trypan blue exclusion test and induced hepatocyte apoptosis as assessed by propidium iodide staining. Treatment of alcoholic rats with EGCG restored the levels of markers of liver injury and mitigated the alterations in alcohol metabolizing and drug metabolizing enzymes and cyt-c-reductase. Increased hepatocyte viability and reduced apoptotic nuclei were observed in alcohol + EGCG-treated rats. These findings suggest that EGCG acts as a hepatoprotective agent against alcoholic liver injury.

• YAKHAK HOEJI
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• v.59 no.5
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• pp.201-206
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• 2015

The aim of the present study was to optimize in vitro method for the prediction of drug-induced liver injury using human liver microsomes (HLM). Cytotoxicity test of cyclophosphamide and acetaminophen in HepG2 cells cultured with HLM showed that the newly established condition using 0.375 mg/ml HLM for 24 hr incubation was comparable or more sensitive than the previously established condition using 0.75 mg/ml HLM for 12 hr incubation. Although the cytotoxic effect of troglitazone was completely attenuated by 0.75 mg/ml HLM, it was augmented by 0.375 mg/ml HLM in the presence of the NADPH-generating system. The cytotoxic effect of chlormezanone, a withdrawn drug due to hepatotoxicity in human, was increased by HLM in the presence of the NADPH-generating system. In contrast, the cytotoxic effect of methapyrilene, a withdrawn drug due to hepatotoxicity in rats, was decreased by HLM in the presence of the NADPH-generating system. The present study suggests that the optimized in vitro method using HLM can be useful for the prediction of drug-induced hepatotoxicity.

• Korean Journal of Clinical Pharmacy
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• v.24 no.3
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• pp.213-218
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• 2014

Objectives: The aim of this study was to identify the causal relationship between use of levocetrizine or cetrizine, and liver injury, by comparing frequency and pattern of hepatotoxicity in levocetrizine or cetrizine prescribed patients. Methods: This is a retrospective observational study, using data retrieved from electronic medical record system. Among 1164 patients prescribed levocetrizine or cetrizine during study period (Jul, 2009 - Jun, 2010) at Seoul National University Hospital, 543 patients with more than 4- time liver function test (LFT) results were included in final analysis. Liver injury was defined as greater than 3 times elevated level of alanine aminotransferase or 2 times elevated level of alkaline phosphatase or total bilirubin, compared to upper limit of normal, in patient with normal liver function at baseline. The frequency and pattern of liver injury were assessed. Results: Incidence of liver injury in patients prescribed with levotcetrizine or cetrizine were 1.48% and 2.94%, respectively. With few exceptions, most injuries were shown to be hepatocellular type. Rapid recovery was observed after drug cessation and long term use tends to be associated with incidence of liver injury. In patient with digestive system disorder, rate of liver injury was significantly higher (p=0.011). Conclusion: The result of this study implies potential need of liver toxicity monitoring, especially in patients taking long term levecetrizine or cetrizine or in patient with digestive system disorder. However, prospective large scale observational study is needed to confirm liver injury associated with the use of levocetirizine or cetirizine.