• Title/Summary/Keyword: hepatobiliary function

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Evaluation and Prediction of Post-Hepatectomy Liver Failure Using Imaging Techniques: Value of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging

  • Keitaro Sofue;Ryuji Shimada;Eisuke Ueshima;Shohei Komatsu;Takeru Yamaguchi;Shinji Yabe;Yoshiko Ueno;Masatoshi Hori;Takamichi Murakami
    • Korean Journal of Radiology
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    • v.25 no.1
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    • pp.24-32
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    • 2024
  • Despite improvements in operative techniques and perioperative care, post-hepatectomy liver failure (PHLF) remains the most serious cause of morbidity and mortality after surgery, and several risk factors have been identified to predict PHLF. Although volumetric assessment using imaging contributes to surgical simulation by estimating the function of future liver remnants in predicting PHLF, liver function is assumed to be homogeneous throughout the liver. The combination of volumetric and functional analyses may be more useful for an accurate evaluation of liver function and prediction of PHLF than only volumetric analysis. Gadoxetic acid is a hepatocyte-specific magnetic resonance (MR) contrast agent that is taken up by hepatocytes via the OATP1 transporter after intravenous administration. Gadoxetic acid-enhanced MR imaging (MRI) offers information regarding both global and regional functions, leading to a more precise evaluation even in cases with heterogeneous liver function. Various indices, including signal intensity-based methods and MR relaxometry, have been proposed for the estimation of liver function and prediction of PHLF using gadoxetic acid-enhanced MRI. Recent developments in MR techniques, including high-resolution hepatobiliary phase images using deep learning image reconstruction and whole-liver T1 map acquisition, have enabled a more detailed and accurate estimation of liver function in gadoxetic acid-enhanced MRI.

A Case of Thickened Gallbladder Wall and Pneumonia in a Child with Infectious Mononucleosis (담낭염과 폐렴을 동반한 전염성 단핵구증 1례)

  • Kim, Hyun Soo;Kim, Hyung Suk;Shin, Young Kyoo;Eun, Baik Lin;Park, Sang Hee;Cha, Sang Hoon
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.167-173
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    • 1997
  • Acute infectious mononucleosis, caused by Epstein-Barr virus(EBV), is a self limited lymphoproliferative illness that is common in adolescents and young adults. It shows many complications in multiple organ systems, but the hepatobiliary and the respiratory complication is uncommon. We report a case with thickened gallbladder wall and pneumonia as complications of acute infectious mononucleosis in a child. Also the related literature were reviewed. A 4 year old boy presented with a history of high fever, cough, and abdominal distension for 20days. Physical Examination revealed audible crackles in whole lung field and gross hepatomegaly. Chest X-ray showed pneumonia and liver function tests were abnormal. Ultrasonography and computed tomography revealed a thickened gallbladder wall and hepatosplenomegaly. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serologic tests. The patients's fever subsided 6 weeks later and pneumonia was recovered around this time. Liver function tests returned near normal 2 months later and ultrasonography of gallbladder was normal at this time.

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Study on Liver Function Test and Liver Disorders under the Ultrasonography for each of the Sasang Constitutional Types (사상체질별 간기능 검사 및 초음파상의 간질환에 대한 연구)

  • Kim, Min-Ji;Bae, Hyo-Sang;Park, Seong-Sik
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.3
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    • pp.195-207
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    • 2013
  • Objectives This study aimed to examine differences in the hepatic function disorders and prevalence rates of liver diseases in accordance with the Sasang constitutional type, and to analyze whether Sasang constitution is a significant risk factor for fatty liver. Methods A total of 1211 patients who underwent health check-up at the Ilsan Hospital of Dongguk University and had their physical constitutions diagnosed by a specialist in Sasang constitutional medicine from October 31, 2011 to September 28, 2012 were used as the subjects of this study. Presence of hepatobiliary diseases was analyzed from the results of the hepatic function test, lipid test and viral hepatitis infection marker test in the biochemistry tests, and abdominal ultrasonography. Results & Conclusion Subjects of the study were composed of 691 males and 520 females and, in terms of Sasang constitution distribution, 550 Taeeumin, 343 Soeumin and 318 Soyangin. As the results of analysis of prevalence rates in accordance with Sasang constitutions, significant differences were observed in the prevalence rates of abnormal groups in the cases of AST, ALT, GGT, Triglyceride, HDL-cholesterol and LDL-cholesterol, and all of their prevalence rates were in the descending order of Taeeumin, Soyangin and Soeumin. Soeumin displayed significantly higher positive rate for HBs Ab in comparison to Taeeumin and Soyangin. In the results of abdominal ultrasonography, the prevalence rates of fatty liver displayed significant differences and were in the descending order of Taeeumin, Soyangin and Soeumin. And as the result of logistic regression analysis in order to find the risk factors of fatty liver, the Sasang constitution was found to be a significant risk factor for fatty liver. The odds ratio of Taeeumin in fatty liver was found to be 1.634 higher than Soeumin and 1.773 higher than Soyangin

A Randomized, Double-Blind, Placebo-Controlled Trial of Early Ursodeoxycholic Acid Administration for Prevention of Total Parenteral Nutrition-Induced Hepatobiliary Complications (총정맥영양법의 간담도 합병증에 대한 Ursodeoxycholic Acid 조기투여의 이중맹검 위약대조군 연구)

  • Choe, Yon-Ho;Beck, Nam-Sun;Kim, Ji-Hee;Lee, Suk-Hyang;Park, Tae-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.174-180
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    • 2002
  • Purpose: Ursodeoxycholic acid (UDCA) is known to decrease hepatic injury by promoting the biliary secretion of retained toxic endogenous bile acids in hepatobiliary diseases complicated by total parenteral nutrition (TPN). However, most studies have focused on treatment for complications after TPN. We investigated the preventive role of early administration of UDCA in TPN-induced hepatobiliary complications by a randomized, double-blind, placebo-controlled trial. Methods: Between May 2000 and May 2002, thirteen patients, who were given TPN more than 10 days in the hospital, were assigned randomly to two groups. One was the case group (7 patients) who were given UDCA simultaneously with TPN regimen, and the other, the control group (6 patients) who were given placebo. Their age ranged from 1 day to 13 years. They were affected with diseases impossible for enteral nutrition, such as prematurity, cerebral palsy, chronic diarrhea, anorexia nervosa, pancreatitis, and cyclic vomiting. The duration of TPN ranged from 10 to 70 days. Hematologic parameters including liver function test were measured at regular intervals, and the duration, composition, administration rate, total calorie of TPN were recorded. The serum levels of total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase were compared between groups after cessation of the study. Results: The autoregressive coefficient of the control group was 0.4419 (p=0.0651) in bilirubin, -0.0431 (p=0.7923) in AST, 0.2398 (p=0.2416) in ALT, and 0.2459 (p=0.1922) in alkaline phosphatase by mixed procedure model when the parameters were referred to the case group. Conclusion: The serum level of total bilirubin did not increase in comparison with that of the control group, but statistically insignificant, when both TPN and UDCA were administered simultaneously from the beginning.

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A Case of Neonatal Lupus Erythematosus and Retrospectively Diagnosed with Asymtomatic Maternal Lupus Erythematosus (다형 홍반으로 발현한 신생아 루푸스와 역진단된 산모 루푸스 1례)

  • Han, Ji-Yeon;Yoon, Jung-Min;Kim, June-Bum;Lim, Jae-Woo;Lee, Young-Hyuk;Ko, Kyong-Og
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.391-394
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    • 2011
  • Neonatal lupus erythematosus (NLE) is a rare disease characterized by typical clinical features and the transplacental passage of maternal autoantibodies, particularly anti-SSA/Ro. The major clinical manifestations are cutaneous lupus lesions, congenital heart block, hematological disorders, and hepatobiliary diseases. We report a case of NLE presenting with multiple round and oval target-like erythematous skin lesions and abnormal liver function, born to a clinically asymptomatic mother whose diagnosis was made retrospectively only after her newborn's diagnosis. Both the infant and the mother were positive for the anti-SSA/Ro and anti-SSB/La antibodies.

Effect of Analytical Method on the Pharmacokinetic Evaluation of Bromosulfophthalein: Comparison of HPLC and UV Spectroscopy Method (Bromosulfophthalein의 체내동태 평가에 미치는 분석법의 영향: HPLC 법과 UV 흡광광도법의 비교)

  • Oh, Ju-Hee;Cha, You-Kyoung;Lee, Young-Joo
    • Journal of Pharmaceutical Investigation
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    • v.38 no.6
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    • pp.399-403
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    • 2008
  • The aim of this study was to evaluate the difference of analytical methods for the pharmacokinetic study of bromosulfophthalein (BSP), an indicator of hepatobiliary function. The plasma and bile concentrations of BSP after intravenous administration were measured according to custom UV spectroscopy and HPLC, respectively. Plasma concentration of BSP measured by UV spectroscopy was similar to that measured by HPLC. There was no significant difference in the distribution volume, total body clearance, area under the curve and mean residence time of BSP between different analytical method groups. However, bile concentration of BSP measured by UV spectroscopy was overestimated compared with concentration measured by HPLC method. Biliary clearance of BSP obtained from UV spectroscopy method was almost 3 times higher than that obtained from HPLC method. Thus, a feasibility of UV spectroscopy method for high throughput pharmacokinetic evaluation of BSP was limited to the study based on the plasma concentration of BSP, not bile concentration.

Toll-Like Receptor-Mediated Free Radical Generation in Clonorchis sinensis Excretory-Secretory Product-Treated Cholangiocarcinoma Cells

  • Bahk, Young Yil;Pak, Jhang Ho
    • Parasites, Hosts and Diseases
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    • v.54 no.5
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    • pp.679-684
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    • 2016
  • Clonorchiasis, caused by direct contact with Clonorchis sinensis worms and their excretory-secretory products (ESPs), is associated with chronic inflammation, malignant changes in bile ducts, and even cholangiocarcinogenesis. Our previous report revealed that intracellular free radicals enzymatically generated by C. sinensis ESPs cause NF-${\kappa}B$-mediated inflammation in human cholangiocarcinoma cells (HuCCT1). Therefore, the present study was conducted to examine the role of upstream Toll-like receptors (TLRs) on the initial host innate immune responses to infection. We found that treatment of HuCCT1 cells with native ESPs induced changes in TLR mRNA levels in a time-dependent manner, concomitant with the generation of free radicals. ESP-mediated free radical generation was markedly attenuated by preincubation of the cells with TLR1-4-neutralizing antibodies, indicating that at least TLR1 through 4 participate in stimulation of the host innate immune responses. These findings indicate that free radicals triggered by ESPs are critically involved in TLR signal transduction. Continuous signaling by this pathway may function in initiating C. sinensis infection-associated inflammation cascades, a detrimental event leading to progression to more severe hepatobiliary diseases.

The Roles of Kupffer Cells in Hepatic Dysfunction Induced by Ischemia/Reperfusion in Rats

  • Jung Joo-Yeon;Lee Sun-Mee
    • Archives of Pharmacal Research
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    • v.28 no.12
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    • pp.1386-1391
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    • 2005
  • This study examined the role of Kupffer cells in altering the hepatic secretory and microsomal function during ischemia and reperfusion (ls/Rp). Rats were subjected to 60 min of hepatic ischemia, followed by 1 and 5 h of reperfusion. Gadolinium chloride ($GdCl_{3}$, 7.5 mg/kg body weight, intravenously) was used to inactivate the Kupffer cells 1 day prior to ischemia. Is/Rp markedly increased the serum aminotransferase level and the extent of lipid peroxidation. $GdCl_{3}$ significantly attenuated these increases. Is/Rp markedly decreased the bile. flow and cholate output, and $GdCl_{3}$ restored their secretion. The cytochrome P450 content was decreased by Is/Rp. However, these decreases were not prevented by $GdCl_{3}$. The aminopyrine N-demethylase activity was decreased by Is/Rp, while the aniline p-hydroxylase activity was increased. $GdCl_{3}$ prevented the increase in the aniline p-hydroxylase activity. Overall, Is/Rp diminishes the hepatic secretory and microsomal drug-metabolizing functions, and Kupffer cells are involved in this hepatobiliary dysfunction.

Cytokine Production in Cholangiocarcinoma Cells in Response to Clonorchis sinensis Excretory-Secretory Products and Their Putative Protein Components

  • Pak, Jhang Ho;Lee, Ji-Yun;Jeon, Bo Young;Dai, Fuhong;Yoo, Won Gi;Hong, Sung-Jong
    • Parasites, Hosts and Diseases
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    • v.57 no.4
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    • pp.379-387
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    • 2019
  • Clonorchis sinensis is a carcinogenic human liver fluke that promotes hepatic inflammatory environments via direct contact or through their excretory-secretory products (ESPs), subsequently leading to cholangitis, periductal fibrosis, liver cirrhosis, and even cholangiocarcinoma (CCA). This study was conducted to examine the host inflammatory responses to C. sinensis ESPs and their putative protein components selected from C. sinensis expressed sequenced tag (EST) pool databases, including $TGF-{\beta}$ receptor interacting protein 1(CsTRIP1), legumain (CsLeg), and growth factor binding protein 2 (CsGrb2). Treatment of CCA cells (HuCCT1) with the ESPs or bacterial recombinant C. sinensis proteins differentially promoted the secretion of proinflammatory cytokines ($IL-1{\beta}$, IL-6, and $TNF-{\alpha}$) as well as anti-inflammatory cytokines (IL-10, $TGF-{\beta}1$, and $TGF-{\beta}2$) in a time-dependent manner. In particular, recombinant C. sinensis protein treatment resulted in increase (at maximum) of ~7-fold in $TGF-{\beta}1$, ~30-fold in $TGF-{\beta}2$, and ~3-fold in $TNF-{\alpha}$ compared with the increase produced by ESPs, indicating that CsTrip1, CsLeg, and CsGrb2 function as strong inducers for secretion of these cytokines in host cells. These results suggest that C. sinensis ESPs contribute to the immunopathological response in host cells, leading to clonorchiasis-associated hepatobiliary abnormalities of greater severity.

Gut microbiota-generated metabolites: missing puzzles to hosts' health, diseases, and aging

  • Yan Zhang;Shibo Wei;Hang Zhang;Yunju Jo;Jong-Sun Kang;Ki-Tae Ha;Jongkil Joo;Hyun Joo Lee;Dongryeol Ryu
    • BMB Reports
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    • v.57 no.5
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    • pp.207-215
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    • 2024
  • The gut microbiota, an intricate community of bacteria residing in the gastrointestinal system, assumes a pivotal role in various physiological processes. Beyond its function in food breakdown and nutrient absorption, gut microbiota exerts a profound influence on immune and metabolic modulation by producing diverse gut microbiota-generated metabolites (GMGMs). These small molecules hold potential to impact host health via multiple pathways, which exhibit remarkable diversity, and have gained increasing attention in recent studies. Here, we elucidate the intricate implications and significant impacts of four specific metabolites, Urolithin A (UA), equol, Trimethylamine N-oxide (TMAO), and imidazole propionate, in shaping human health. Meanwhile, we also look into the advanced research on GMGMs, which demonstrate promising curative effects and hold great potential for further clinical therapies. Notably, the emergence of positive outcomes from clinical trials involving GMGMs, typified by UA, emphasizes their promising prospects in the pursuit of improved health and longevity. Collectively, the multifaceted impacts of GMGMs present intriguing avenues for future research and therapeutic interventions.