• Investigative Magnetic Resonance Imaging
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• 제23권3호
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• pp.251-258
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• 2019

Purpose: To assess the feasibility of the use of spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) in livers of children and young adults. Materials and Methods: Patients (${\leq}20$ years old) who underwent 3T SE-EPI MRE were included retrospectively. Subjects were divided into three groups according to the purpose of the liver MRI: suspicion of fatty liver or focal fat deposition in the liver (FAT group), liver fibrosis after receiving a Kasai operation from biliary atresia (BA group), and hepatic iron deposition after receiving chemotherapy or transfusions (IRON group). Technical failure of MRE was defined when a stiffness map showed no pixel value with a confidence index higher than 95%, and the patients were divided as success and failure groups accordingly. Clinical findings including age, gender, weight, height, and body mass index and magnetic resonance imaging results including proton density fat fraction (PDFF), $T2^*$, and MRE values were assessed. Factors affecting failure of MRE were evaluated and the image quality in wave propagation image and stiffness map was evaluated using the appropriate scores. Results: Among total 240 patients (median 15 years, 211 patients in the FAT, 21 patients in the BA, and 8 patients in the IRON groups), technical failure was noted in six patients in the IRON group (6/8 patients, 75%), while there were no failures noted in the FAT and BA groups. These six patients had $T2^*$ values ranging from 0.9 to 3.8 ms. The image quality scores were not significantly different between the FAT and BA groups (P > 0.999), while the scores were significantly lower in the IRON group (P < 0.001). Conclusion: The 3T SE-EPI MRE in children and young adults had a high technical success rate. The technical failure was occurred in children with decreased $T2^*$ value (${\leq}3.8ms$) from iron deposition.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.303-329
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• 2019

Intestinal failure (IF) is the critical reduction of the gut mass or its function below the minimum needed to absorb nutrients and fluids required for adequate growth in children. Severe IF requires parenteral nutrition (PN). Pediatric IF is most commonly due to congenital or neonatal intestinal diseases or malformations divided into 3 groups: 1) reduced intestinal length and consequently reduced absorptive surface, such as in short bowel syndrome (SBS) or extensive aganglionosis; 2) abnormal development of the intestinal mucosa such as congenital diseases of enterocyte development; 3) extensive motility dysfunction such as chronic intestinal pseudo-obstruction syndromes. The leading cause of IF in childhood is the SBS. In clinical practice the degree of IF may be indirectly measured by the level of PN required for normal or catch up growth. Other indicators such as serum citrulline have not proven to be highly reliable prognostic factors in children. The last decades have allowed the development of highly sophisticated nutrient solutions consisting of optimal combinations of macronutrients and micronutrients as well as guidelines, promoting PN as a safe and efficient feeding technique. However, IF that requires long-term PN may be associated with various complications including infections, growth failure, metabolic disorders, and bone disease. IF Associated Liver Disease may be a limiting factor. However, changes in the global management of IF pediatric patients, especially since the setup of intestinal rehabilitation centres did change the prognosis thus limiting "nutritional failure" which is considered as a major indication for intestinal transplantation (ITx) or combined liver-ITx.

• 한국수의병리학회지
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• 제7권1호
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• pp.59-62
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• 2003

A two-year-old pointer dog showed a liver failure for long duration. By radiographic examination, barium or gas filled intestine was detected in the pericardium. Although liver function was bad, surgery was tried to repair hernia due to the poor prognosis. Intestine, omentum, and liver with gall bladder were dislocated in the pericadial sac by peritoneopericardial diaphragmatic hernia (PPDH). Intestine was easily removed from pericardial sac but omentum and liver were not because of strong adhesion to the pericardial sac. Postmortem examination was performed because the patient was died after surgery. Grossly, herniated liver whose right medial lobe was strongly adhered to the pericardial sac was severely congested with fibrin adhesion on the surface. Hypoplastic abnormally up-located heart had a fissure in the outside of lower right venticulum bordered apex and depressed large vessels including vena cava and aortic arch into the base of heart. It was suggested that formation of a fissure and depression of vessels might be due to the pressure of herniated organs. In the veterinary literature as far as we knew, PPDH associated with liver failure due to adhesion of liver to the pericardial sac has not been reported.

• Clinical and Experimental Pediatrics
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• 제48권6호
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• pp.660-664
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• 2005

저자들은 신생아 시기에 심부전 증세를 보인 간내 혈관내피종 환아에서 내과적 치료와 간동맥 색전술 후 호전을 보이지 않아 간좌엽 절제술을 시행하여 치료한 1례를 경험하였기에 보고하는 바이다.

• Clinical and Experimental Reproductive Medicine
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• 제40권1호
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• pp.38-41
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• 2013

Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the literature. However, there has never been a fruitful debate on this topic. The present manuscript tried to fill this gap. We reported a case of a 35-year-old nulliparous woman admitted to our obstetric emergency room for severe pre-eclampsia. She had been subjected to four cycles of controlled ovarian stimulation for intrauterine insemination. At 32 weeks of gestation, she developed severe pre-eclampsia, which led to HELLP syndrome complicated by fatal liver failure. The etiological link between ovarian stimulation and HELLP syndrome is intriguing. Further investigations are needed to understand whether repeated ovarian stimulation may represent a risk factor in pre-eclamptic patients.

• 대한한방내과학회지
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• 제13권1호
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• pp.167-180
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• 1992

This study has been carried out to investigate the cause and originative mechanism of vertigo by referring to 46 literatures. The results were as follows; 1. The 1st factors causing vertigo are exuberance of fire in the Liver (肝火偏亢). and ascending of Yang of Wind (風陽升動) resulting from thought excess (思慮太過) and melancholy (憂鬱). 2. The 2nd factors causing vertigo is a malnurtrient of the brain resulting from dispersion of the Liver function (肝血虛) and failure in ascending of the Clear Yang (淸陽不升) due to hemorrhage and so on. 3. The 3rd factors causing vertigo are failure in ascending to the Brain and deficiency of blood of the Liver (肝血虛) resulting from the injury of the essence of the Kidney (肝精虧損). 4. The 4th factors causing vertigo is a ascending of exogenous pathogenic factors (外邪) to the Brain on deficiency state. 5. The 1st factors causing vertigo are Stagnatum of clear Yang (淸陽不振) and pershing of Yang (亡陽) resulting from loss of water and damage of active thin body fluid (津氣虧損). 6. The obesity is beonged to excessiveness Symptom-Complex (實證) and the thin to deficiency Symptom-complex (虛證). 7. The vertigo is connective with the Live (肝), Spleen (脾) and the Kidney (腎), but among those, most intimative viscera is the Liver (肝).

• Journal of Yeungnam Medical Science
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• 제37권1호
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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.

• Korean Journal of Radiology
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• 제20권6호
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• pp.880-893
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• 2019

Objective: To assess the technical performance of two-dimensional shear wave elastography (2D-SWE) for measuring liver stiffness. Materials and Methods: The Ovid-MEDLINE and EMBASE databases were searched for studies reporting the technical performance of 2D-SWE, including concerns with technical failures, unreliable measurements, interobserver reliability, and/or intraobserver reliability, published until June 30, 2018. The pooled proportion of technical failure and unreliable measurements was calculated using meta-analytic pooling via the random-effects model and inverse variance method for calculating weights. Subgroup analyses were performed to explore potential causes of heterogeneity. The pooled intraclass correlation coefficients (ICCs) for interobserver and intraobserver reliability were calculated using the Hedges-Olkin method with Fisher's Z transformation of the correlation coefficient. Results: The search yielded 34 articles. From 20 2D-SWE studies including 6196 patients, the pooled proportion of technical failure was 2.3% (95% confidence interval [CI], 1.3-3.9%). The pooled proportion of unreliable measurements from 20 studies including 6961 patients was 7.5% (95% CI, 4.7-11.7%). In the subgroup analyses, studies conducting more than three measurements showed fewer unreliable measurements than did those with three measurements or less, but no intergroup difference was found in technical failure. The pooled ICCs for interobserver reliability (from 10 studies including 517 patients) and intraobserver reliability (from 7 studies including 679 patients) were 0.87 (95% CI, 0.82-0.90) and 0.93 (95% CI, 0.89-0.95), respectively, suggesting good to excellent reliability. Conclusion: 2D-SWE shows good technical performance for assessing liver stiffness, with high technical success and reliability. Future studies should establish the quality criteria and optimal number of measurements.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권4호
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• pp.344-348
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• 2001

Isoflurane and enflurane are currently used on orthognathic surgery in Korea. Since starting to use enflurane and isoflurane in orthognathic surgery, we have questioned their effect on liver function. Many studies have reported liver function after enflurane and isoflurane anesthesia. Although both enflurane and isoflurane are less hepatotoxic than halothane, some cases of liver dysfunction have been reported after enflurane and isoflurane anesthesia. And, we know that isoflurane is less hepatotoxic than its predecessors, enflurane. But, fulminant liver failure and necrosis were also reported after isoflurane anesthesia. The purpose of this study was to compare immediate liver function in healthy orthognathic surgical patients receiving enflurane or isoflurane anesthesia. To assess the effect of enflurane and isoflurane on liver function, we measured pre-and post-operative serum concentrations of aspartate aminotransferase(AST), and alanine aminotransferase(ALT), alkaline phosphatase(ALP), total bilirubin(Tbil).

• 대한본초학회지
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• 제21권3호
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• pp.69-74
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• 2006

Objectives : This study was undertaken to determine if a combined(SPe) has a protective effect against functional failure induced by $CCl_4$ in rat liver. Methods : Acute liver injury which initiated from free radical induced by $CCl_4$, were applied to rats and data were obtained. Liver injury was estimated by measuring aspartate aminotransferase(AST) and alanine aminotransferase(ALT) activity in serum. Lipid peroxidation was examined by measuring malondialdehyde, a product of lipid peroxidation. GSH activities in liver tissues were also measured. Results : When rats were treated intraperitoneally with $CCl_4$, serum AST and ALT were increased compared with the control, which was significantly inhibited by pretreatment of SPe. SPe also prevented reduction in GSH induced by $CCl_4$. Conclusion : Above results suggest that SPe exerts protective effect against $CCl_4$ by its antioxidant action in liver tissues. Thus, SPe may be used in prevention and treatment of drug-induced liver cell injury. However, the precise mechanisms of SPe protection remain to be determined.