• The Journal of Korean Medicine
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• v.32 no.4
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• pp.149-158
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• 2011

Object: Any medication can have the risk of liver damage. To prevent this risk, liver function tests should be monitored carefully during every course of medication. This paper is a psoriasis case report on liver damage related to Scutellaria Radix medication. Shown by this case, herbal medicine has the possibility of liver damage, too. Therefore it should be carefully used under the direction of Oriental Medical Doctors who specialize in it. The purpose of this case report is to suggest this, and that more cases of liver damage related to herbal medicine should be reported. Methods: To monitor the medication's effect on the liver, liver function was evaluated during medications. Reflotron plus was used to evaluate AST and ALT by analyzing peripheral blood. Results: By this test, a case was identified as liver damage caused by a medication including Scutellaria Radix. Conclusion: This case suggests that Scutellaria Radix medication caused liver damage in a certain patient. Therefore, to prevent liver damage related to Scutellaria Radix, doctors should monitor patient's liver function regularly.

• The Korean Journal of Nuclear Medicine
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• v.16 no.1
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• pp.49-54
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• 1982

For this study, the authors obtained and examined anterior views of the liver and spleen in two different positions, upright and supine, of 39 normal subjects and 20 patients with hepaticpathology by means of $^{99m}Tc-colloid$ and gamma camera. This examination confirms the following findings. In general, it is shown, left lobe of the liver in upright position becomes longer in height than in supine position, while the distance between lateral margin of the liver and that of the spleen becomes father in with in supine position than in upright position. The upper margin of liver moves more downward in upright position than in supine. It is noticeable that as for 5 cases with severe chronic liver disease, there is minimal alteration of the liver shape between in two positions. The comparison of the both positions for the better liver scan shows the following finding. Prominent caudate and/or left lobe are marked in the upright position in 16 cases out of the total 59, while none is found in the supine. The false cold area in lower part of the liver disappears in 7 cases in the upright position, while only one shows the disappeance of the false cold area in the supine. Left liver margin due to close contact of spleen is blurred in 3 cases in the upright position. In total 23 cases out of 59 support that the upright position is better for the liver scan, while only 4 cases support the supine position is better. These findings support two assumptions. One is that upright view can bo expected more improved resoluton than supine view for liver scan. Second is that minimal change of the liver shape in both views indicate the serious abnormality in the liver.

• Journal of Nutrition and Health
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• v.32 no.6
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• pp.628-636
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• 1999

There is a marked increase in geriatric disease, especially liver disease, due to the continuous increase in alcohol and fat consumption. Since the fatty liver, induced by alcohol or fat, is basically from abnormalities in the lipid metabolism, it is possible that fatty acid binding protein(FABP) which is related to the fatty acid metabolism may also be abnormal in these livers. FABP is a small molecular weight protein family present in cytosol in high concentration. It has been proposed as a fatty acid transfer protein and as a binding protein responsible for controlling intracellular free fatty acid concentration. In this research, we have examined the relationship between liver FABP and fatty liver induced by alcohol or high cholesterol diet. Rats were fed one of either semipurified liquid diets; control diet containing 65% carbohydrate, 20% protein, and 15% fat or high cholesterol diet containing 1%(w/w) cholesterol or alcohol diet containing 37% of alcohol instead of carbohydrate. After 5 weeks of feeding period, all rats received commercial chow diet for 5 weeks to examine recovery effect. Liver and blood samples were collected at 0, 1, 3, 5 and 10 weeks to analyze lipid compositions. FABP was purified from liver cytosol and injected to rabbit to obtain antiserum. Liver FABP amount was determined by SDS-PAGE and western blotting methods. Fatty acid binding capacity was determined by binding of 14Cpalmitate with the delipidated liver cytosol. Consumption of alcohol increased serum cholesterol, triglyceride concentration and decreased HDL-cholesterol concentration after 5 weeks. Serum apolipoprotein B concentration increased after 3 weeks and LDL-cholesterol and apolipoprotein A concentration changed after 1 week. Liver cholesterol and triglyceride concentration increased after 3 weeks. Consumption of high cholesterol diet changed liver and serum lipid composition after 3 weeks. Swiching to normal diet for 5 weeks did not normalize most of lipid composition in serum and liver except serum and liver except serum cholesterol, triglyceride and liver cholesterol. Liver cytosol FABP content and the fatty acid binding capacity decreased dramatically after 1 week with alcohol consumption. This results indicate that FABP content changes before the changes before the changes of blood or liver lipid composition, suggesting changes of FABP may cause development of the fatty liver induced by alcohol and can be used as an index of detecting a early development of fatty liver.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6155-6160
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• 2014

Background: This study was conducted to investigate whether apparent diffusion coefficient (ADC) measurements by dividing the liver into left and right hepatic lobes may be utilized to improve the accuracy of differential diagnosis of benign and malignant focal liver lesions. Materials and Methods: A total of 269 consecutive patients with 429 focal liver lesions were examined by 3-T magnetic resonance imaging that included diffusion-weighted imaging. For 58 patients with focal liver lesions of the same etiology in left and right hepatic lobes, ADCs of normal liver parenchyma and focal liver lesions were calculated and compared using the paired t-test. For all 269 patients, ADC cutoffs for focal liver lesions and diagnostic accuracy in the left hepatic lobe, right hepatic lobe and whole liver were evaluated by receiver operating characteristic curve analysis. Results: For the group of 58 patients, mean ADCs of normal liver parenchyma and focal liver lesions in the left hepatic lobe were significantly higher than those in the right hepatic lobe. For differentiating malignant lesions from benign lesions in all patients, the sensitivity and specificity were 92.6% and 92.0% in the left hepatic lobe, 94.4% and 94.4% in the right hepatic lobe, and 90.4% and 94.7% in the whole liver, respectively. The area under the curve of the right hepatic lobe, but not the left hepatic lobe, was higher than that of the whole liver. Conclusions: ADCs of normal liver parenchyma and focal liver lesions in the left hepatic lobe were significantly higher than those in the right hepatic lobe. Optimal ADC cutoff for focal liver lesions in the right hepatic lobe, but not in the left hepatic lobe, had higher diagnostic accuracy compared with that in the whole liver.

• Journal of the Korean Society of Food Science and Nutrition
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• v.20 no.6
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• pp.527-537
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• 1991

To evaluate an effect of liver xanthine oxidase on the induction of liver damage, carbon tetrachloride (CCl4) was intraperitoneally injected twice at 0.1ml/100g body weight to the rate fed a low (LP)or high protein diet(HP) while the control group fed LP or HP received only olive oil. The changing rate of liver xanthine oxidas activity was compared with that of a free radical generating enzyme, liver aniline hydroxylase and a scavenging enzyme, glutathions S-transferase activity between the rate fed a LP and those fed HP, and the two groups treated with CCl4. Concomitantly, the degree of liver damage which could be considered as the paramete for CCl4 metabolism in case of CCl4-intoxicated animal was observed in the present experimental conditions and the effect of allopurinol, xanthine oxidase inhibitor, on the CCl4-toxicity of rate liver was alos demostrated. On the other hand, the comparative effect of actinomycin D on the liver and serum xanthine oxidase of CCl4-treated rats fed HP with that of those fed LP and the kinetics of purifed liver enzyme from the liver of CCl4-treated rats fed HP was also compared with that of those fed LP to clarify the differences of xanthine oxidase activity between two groups. The increasing rate of liver weigth/body wt, serum levels of ALT and the decreasing rate of hepatic ALT activity and protein contents to each control group were higher in CCl4-treated rats fed HP than those fed LP. Under the animal models as indentified by the present data herein, the liver xanthine oxidase activity was higher in CCl4-treated rats fed HP than those fed LP, and the control group fed HP also showed the much higher activity xanthine oxidase than that fed LP, whereas there were no differences in the activity of hepatic aniline hydroxylase and glutathions S-transferase between the two group treated with CCl4. Although the hepatic aniline hydroxylase activity was somewhat higher in the rats fed HP than those fed LP, the increasing rate of liver xanthine oxidase to the rats fed LP was higher in those fed HP than that of liver aniline hydroxylase. The degree of liver damage identified such as liver weight and serum ALT activity was less in the CCl4-treated rats pretreated with allopurinol. These results suggest that even a system at which xanthine oxidase acts as well as the drug metabolizing enzyme may influence the acelatin of CCl4 metabolism. In addition, the purified liver xanthine oxidase from CCl4-treated rats fed HP showed decreased Km value when compared to its control group. The Km value of liver xanthine oxidase of CCl4-treated rats fed LP showed a similar Km value with its control group. Furthermore, the decreasing rate of liver and serum xanthine oxidase acitivity in CCl4-treated rats pretreated with actinomycin D to the CCl4-treated rats was higher in rats fed HP than in those fed LP. These results suggest that the inductino of xanthine oxidase in CCl4-treated rats fed HP may be greater than in those fed LP.

• Korean Journal of Radiology
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• v.24 no.5
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• pp.465-475
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• 2023

Objective: To evaluate the feasibility of ultrasound shear wave elastography (SWE) for predicting hepatic fibrosis and native liver outcomes in patients with biliary atresia. Materials and Methods: This prospective study included 33 consecutive patients with biliary atresia (median age, 8 weeks [interquartile range, 6-10 weeks]; male:female ratio, 15:18) from Severance Children's Hospital between May 2019 and February 2022. Preoperative (within 1 week from surgery) and immediate postoperative (on postoperative days [PODs] 3, 5, and 7) ultrasonographic findings were obtained and analyzed, including the SWE of the liver and spleen. Hepatic fibrosis, according to the METAVIR score at the time of Kasai portoenterostomy and native liver outcomes during postsurgical follow-up, were compared and correlated with imaging and laboratory findings. Poor outcomes were defined as intractable cholangitis or liver transplantation. The diagnostic performance of SWE in predicting METAVIR F3-F4 and poor hepatic outcomes was analyzed using receiver operating characteristic (ROC) analyses. Results: All patients were analyzed without exclusion. Perioperative advanced hepatic fibrosis (F3-F4) was associated with older age and higher preoperative direct bilirubin and SWE values in the liver and spleen. Preoperative liver SWE showed a ROC area of 0.806 and 63.6% (7/11) sensitivity and 86.4% (19/22) specificity at a cutoff of 17.5 kPa for diagnosing F3-F4. The poor outcome group included five patients with intractable cholangitis and three undergoing liver transplantation who showed high postoperative liver SWE values. Liver SWE on PODs 3-7 showed ROC areas of 0.783-0.891 for predicting poor outcomes, and a cutoff value of 10.3 kPa for SWE on POD 3 had 100% (8/8) sensitivity and 73.9% (17/23) specificity. Conclusion: Preoperative liver SWE can predict advanced hepatic fibrosis, and immediate postoperative liver SWE can predict poor native liver outcomes in patients with biliary atresia.

• Korean Journal of Radiology
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• v.21 no.8
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• pp.987-997
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• 2020

Objective: Measurement of the liver and spleen volumes has clinical implications. Although computed tomography (CT) volumetry is considered to be the most reliable noninvasive method for liver and spleen volume measurement, it has limited application in clinical practice due to its time-consuming segmentation process. We aimed to develop and validate a deep learning algorithm (DLA) for fully automated liver and spleen segmentation using portal venous phase CT images in various liver conditions. Materials and Methods: A DLA for liver and spleen segmentation was trained using a development dataset of portal venous CT images from 813 patients. Performance of the DLA was evaluated in two separate test datasets: dataset-1 which included 150 CT examinations in patients with various liver conditions (i.e., healthy liver, fatty liver, chronic liver disease, cirrhosis, and post-hepatectomy) and dataset-2 which included 50 pairs of CT examinations performed at ours and other institutions. The performance of the DLA was evaluated using the dice similarity score (DSS) for segmentation and Bland-Altman 95% limits of agreement (LOA) for measurement of the volumetric indices, which was compared with that of ground truth manual segmentation. Results: In test dataset-1, the DLA achieved a mean DSS of 0.973 and 0.974 for liver and spleen segmentation, respectively, with no significant difference in DSS across different liver conditions (p = 0.60 and 0.26 for the liver and spleen, respectively). For the measurement of volumetric indices, the Bland-Altman 95% LOA was -0.17 ± 3.07% for liver volume and -0.56 ± 3.78% for spleen volume. In test dataset-2, DLA performance using CT images obtained at outside institutions and our institution was comparable for liver (DSS, 0.982 vs. 0.983; p = 0.28) and spleen (DSS, 0.969 vs. 0.968; p = 0.41) segmentation. Conclusion: The DLA enabled highly accurate segmentation and volume measurement of the liver and spleen using portal venous phase CT images of patients with various liver conditions.

• Journal of International Society for Simulation Surgery
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• v.1 no.1
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• pp.37-40
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• 2014

Purpose For living donor liver transplantation, liver segmentation is difficult due to the variability of its shape across patients and similarity of the density of neighbor organs such as heart, stomach, kidney, and spleen. In this paper, we propose an automatic segmentation of the liver using multi-planar anatomy and deformable surface model in portal phase of abdominal contrast-enhanced CT images. Method Our method is composed of four main steps. First, the optimal liver volume is extracted by positional information of pelvis and rib and by separating lungs and heart from CT images. Second, anisotropic diffusing filtering and adaptive thresholding are used to segment the initial liver volume. Third, morphological opening and connected component labeling are applied to multiple planes for removing neighbor organs. Finally, deformable surface model and probability summation map are performed to refine a posterior liver surface and missing left robe in previous step. Results All experimental datasets were acquired on ten living donors using a SIEMENS CT system. Each image had a matrix size of $512{\times}512$ pixels with in-plane resolutions ranging from 0.54 to 0.70 mm. The slice spacing was 2.0 mm and the number of images per scan ranged from 136 to 229. For accuracy evaluation, the average symmetric surface distance (ASD) and the volume overlap error (VE) between automatic segmentation and manual segmentation by two radiologists are calculated. The ASD was $0.26{\pm}0.12mm$ for manual1 versus automatic and $0.24{\pm}0.09mm$ for manual2 versus automatic while that of inter-radiologists was $0.23{\pm}0.05mm$. The VE was $0.86{\pm}0.45%$ for manual1 versus automatic and $0.73{\pm}0.33%$ for manaual2 versus automatic while that of inter-radiologist was $0.76{\pm}0.21%$. Conclusion Our method can be used for the liver volumetry for the pre-surgery planning of living donor liver transplantation.

• The Journal of Internal Korean Medicine
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• v.26 no.4
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• pp.836-843
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• 2005

Objective : Liver cirrhosis is a disease of the liver in which normal cells are replated by scar tissue. Chronic liver disease and liver cirrhosis are the foutth ranked causes of death in Korea. However, clinical data on liver cirrhosis is not accumulated in oriental medicine. Therefore, clinical characteristics of 33 liver patients admitted to Hana Oriental Hospital from May 2004 to May 2005 were studied. Methods : Clinical characteristics of liver cirrhosis, such sex, age, causes, Child-Pugh class, chief complain, abdomen ultrasonography, disease duration, past history, blood test and urinalysis were reviewed. Results : The results of this study were as follows: 1 The distribution of sex and age in our study is similar to already reported statistics. 2. Hepatitis B and alcohol are the major factors to cause the liver cirrhosis. Diabetes and hypertention contribute more to cause than they have in previous histories. 3. Major symptoms are following: fatigue 87.9%, ascites 84.8%, jaundice 78.8%, leg edema 72.7%, dyspepsia 45.5%. 4. Most liver cirrhosis patients have pancytopenia. Standard Deviation accentuates the big differences between total bilirubin and serum amonia. 5. In urinalysis, Urobilinogen 19 patients (57.6%), bilirubin 12 patients (36.4%), blood 15 patients (45.5%) are positive. 11 cases of 15 in blood positive results scored $3{\sim}4+$. Contusions : In oriental medicine, it will be necessary to research and develop oriental medical therapies for liver disease including liver cirrhosis.

• 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.