• 제목/요약/키워드: Abnormal Liver Function

검색결과 134건 처리시간 0.028초

Short Bowel Syndrome as the Leading Cause of Intestinal Failure in Early Life: Some Insights into the Management

  • Goulet, Olivier;Nader, Elie Abi;Pigneur, Benedicte;Lambe, Cecile
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • 제22권4호
    • /
    • pp.303-329
    • /
    • 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.

일부 사무직 근로자와 생산직 근로자간의 일반건강진단 검사 결과의 차이 (Differences of Screening Test Results of Health Examination between Clerks and Laborers)

  • 박종원;신동훈;이미영;서석권
    • Journal of Preventive Medicine and Public Health
    • /
    • 제28권3호
    • /
    • pp.543-550
    • /
    • 1995
  • 이 연구는 대구시 소재 일개 검진기관에서 1992년도에 일반건강진단을 받은 근로자를 대상으로 하여 사무직 근로자와 생산직 근로자간의 차이가 선별검사 결과에서 있는지를 알기 위해 시행되었다. 대상자는 남자 6,597명과 여자 3,610명으로 총 10.2명이 선택되었다. 남녀별로 나누어 각 선별검사 항목별로 단일분석을 시행한 후 유의한 변수를 골라 지수 회귀분석을 이용하여 사무직종에 대한 생산직을 비교하였다. 청력검사 항목은 남녀 모두에서 사무직보다 생산직에서 이상률이 더 컸다. 혈구용적치와 고혈압 항목은 조정변수를 교정한 후에도 남녀모두 직종간의 차이가 없었다. 간기능과 요단백 항목은 남자에서 사무직의 이상률이 생산직보다 더 높은 것으로 나타났다. 시력항목은 여자에서만 직종간의 차이를 보였으며 사무직에서 시력교정의 필요성이 더 켰다. 이상의 결과는 사무직종과 생산직종간에 일반건강진단의 검사 결과에서 차이가 있으며 원인규명을 위한 연구가 필요함을 보여준다.

  • PDF

주단계(朱丹溪)의 "양유여음불족론(陽有餘陰不足論)"에 관한 연구(硏究) (A Study on Zhu dan Xi's "Theory on the Sufficiency of Yang and the Deficiency of Yin")

  • 양광열;정창현
    • 대한한의학원전학회지
    • /
    • 제20권2호
    • /
    • pp.147-174
    • /
    • 2007
  • "Theory on the Sufficiency of Yang and the Deficiency of Yin(陽有餘陰不足論)" mainly instituted as follows: The 'Yang Qi(陽氣)' of the heaven(天) has changed to 'Qi(氣)', and the 'Yin Qi(陰氣)' of the earth(地) has changed to 'Xue(血)', 'Qi(氣)' is always sufficient and 'Xue(血)' is always deficient. 'The Always Sufficient Qi(氣常有餘)' means 'the fire always exists(常有火)', and 'the fire(火)' is 'the premier fire(相火)'. 'The premier fire(相火)' is always in men's body and causes 'activities(動)' which is the core characteristic in men's life, and in other side it always has opportunities to be made symptoms by 'the abnormal activities of the premier fire(相火妄動)'. In 'the always deficient Xue(血常不足)' , 'Xue(血)' is the 'Yin Qi(陰氣)' of liver and kidneys[肝腎] which is attached by 'the premier fire(相火)', as it means 'Xue(血)' and 'Jing(精)'. He suggested that 'the premier fire(相火)' is the power of human life, but if 'the premier fire(相火)' is not based on 'Yin Qi(陰氣)', it can not fulfill its function. So he thought that the maintenance and fulfillment of 'Yin Qi(陰氣)' is very important. In conclusion, "Theory on the Sufficiency of Yang and the Deficiency of Yin(陽有餘陰不足論)" explains the basic character of men's life which 'Dong Duo Jing Shao(動多靜少)', so 'the premier fire(相火)' which control 'the activities(動)' is always being and 'Jing Xue(精血)' which control 'Jing(靜)' is always scare.

  • PDF

일부 비만아동 및 청소년에 대한 임상영양학적 조사연구 (Chinical and Nutritional Examination in Examination in Obese Children and Adolescents)

  • 안홍석
    • Journal of Nutrition and Health
    • /
    • 제27권1호
    • /
    • pp.79-89
    • /
    • 1994
  • The purpose of this study was to investigate the relationship between body fat and risk factors of chronic diseases in obese children and eventually to contribute to the prevention and treatment of childhood obesity. Anthropometric parameters such as height, weight, skinfold thickness, circumferences, body fat content were measured in 55 obese subjects of age 5-20. Blood pressure, serum components, daily food intakes were also considered. The average age of the subjects was 12.5$\pm$3.3yrs and the mean obesity index was 64.7$\pm$21.3%. The average percentage of body fat was 35.6$\pm$5.4% and the mean weight of lean body mass was 45.3$\pm$13.9kg. Mean total muscle weight of the subjects was estimated to be 34.11$\pm$1.3kg. The mean systolic and diastolic blood pressures of the obese were 134.8$\pm$15.8mmHg and 69.6$\pm$11.6mgHg respectively. The concentrations fo serum triglyceride, total cholersterol, HDL-cholesterol, LDL-cholesterol were estimated to be 246.0$\pm$136.4mg/dl, 257.0$\pm$54.3mg/dl, 48.2$\pm$13.1mg/dl and 158.9$\pm$53.5mg/이 respectively. The concentrations of serum GOT and GPT were 34.6$\pm$17.1U/L and 24.7$\pm$15.3U/L. The mean content of uric acid is serum was 6.2$\pm$1.9mg/dl. Of these 55 children, 82% has hyperlipidemia, 26% was abnormal liver function and 24% was hyperuricemia. One patient was diabetic. Eighty seven% of them have developed more than one complications.

  • PDF

골절을 동반한 다발성 외상 환자에서 발생한 비결석성 담낭염 (Acalculous Cholecystitis Following Multiple Trauma with Fractures)

  • 김기훈;경규혁;김진수;김관우;김운원;김지완
    • Journal of Trauma and Injury
    • /
    • 제25권4호
    • /
    • pp.203-208
    • /
    • 2012
  • Purpose: The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis. Methods: We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty- nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management Results: There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation. Conclusion: The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma.

한방병원 건강검진 수진자의 대사증후군 발생과 관련요인 연구 (Incidence and Related Factors of the Metabolic Syndrome in a Korean Medicine Hospital)

  • 최성환;안정조;조현경;유호룡;설인찬;김윤식
    • 동의생리병리학회지
    • /
    • 제25권3호
    • /
    • pp.563-572
    • /
    • 2011
  • The purpose of this study was to investigate incidence and related factors of the metabolic syndrome in a Korean medicine hospital. The 716 subjects were analyzed using biochemical data and survey who took medical examination in Daejeon Korean Medicine Hospital for general health check-up. This investigation was conducted from February in 2008 to July in 2010. The metabolic syndrome was diagnosed according to the definition by the NCEP ATP III. The abdominal obesity guidelines for waist circumference applied by the WHO Western Pacific Region, IASO and IOTF: The Asia-Pacific Perspective in 2000. Incidence of metabolic syndrome was 12% (14.6% in men, 8.2% in women). The groups that have two metabolic risk factors were 21.9% in men and 7.5% in women. The incidence increased with ageing. The mean of metabolic syndrome`s triglyceride was in hypertriglyceridemia, and that of their BMI in men was in primary obese and that of their AST, ALT, ${\gamma}$-GTP means were in abnormal liver function. Smokers in men have metabolic syndrome 10 times more than non-smokers in men. Exercisers that do the exercise once or twice a week in women have metabolic syndrome 0.2 times more than non-exerciser in women. Women that have family history of stroke, were associated with metabolic syndrome by $x^2$-test. Men that have family history of hypertension, have metabolic syndrome 4 times more than otherwise men. Men that have family history of diabetes mellitus, have metabolic syndrome 3 times more than otherwise men.

다용 한약처방 투여가 흰쥐의 신장기능에 미치는 영향 -십전대보탕, 보증익기탕, 오적산 및 육미지황탕을 중심으로- (Effects of High Frequency Herbal Medication Administrations on the Renal Functions in Rats -Focusing on Sipjeondaebotang, Bojunikgitang, Ojeoksan and Yukmijihwangtang-)

  • 신규원;이선동;박해모;전성진;변진석
    • 대한예방한의학회지
    • /
    • 제9권1호
    • /
    • pp.119-133
    • /
    • 2005
  • Traditional herbal medicine is widely used among the Korean people, and other eastern Asian countries employ similar therapies as well. In recent years, due to increasing interest in herbal medicines, many researches have been made on the toxicity and side effects of herbal medications. Through private and public media, there have been many opinions suggesting taking herbal medicines is very harmful, especially on the liver and kidney functions. This assertion has been mainly presented by the doctors that practice western medicine, But this assertion is never based on adequate knowledge of herbal medicine. This study aims to provide the evidences that taking herbal medicines is safe on the renal functions. Four frequently used herbal medications(Sipjeondaebotang, Bojungigitang, Ojeoksan, and Yukmijihwangtang) were used to test the toxicity of herbal medicine oh the lab animal model(SD-Rat). There is no significant difference in body weight and kidney weight after herbal medication for 1 month. In all experimental groups, no abnormal findings were observed in histological study, and lab renal function index(BUN, creatinine, uric acid). These results say that four herbal multi-used-medicines, when medicated, is safe from the renal toxicity in lab animal model.

  • PDF

Ceftriaxone과 연관된 소아의 담도 오니(biliary sludge) 1례 (A Case of Ceftriaxone Associated Biliary Sludge)

  • 윤재균;이현희;신영규;정지태;독고영창
    • Pediatric Infection and Vaccine
    • /
    • 제4권2호
    • /
    • pp.308-313
    • /
    • 1997
  • Ceftriaxone, an effective third generation cephalosporin with a wide range of antimicrobial activity, has become widely used by pediatricians for a variety of bacterial infections including meningitis. It has been associated with the development of sludge or stone in the gallbladder of some patients treated with this drug. Ceftriaxone associated biliary sludge has unusual acoustic characteristics and resembles gallstone. The sludge can cause symptoms such as cramping abdominal pain, and disappears after stopping ceftriaxone administration. Because of these seemingly confusing observations, it is important for the clinicians to recognize these findings that ceftriaxone treatment can cause. We report a case of ceftriaxone associated biliary sludge in Korean children. A 6-year-old girl who was treated for meningitis with ceftriaxone (100mg/kg/day) developed cramping upper abdominal pain from 5th hospital day. Physical examination, liver function tests and X-ray revealed no specific abnormal findings. But abdominal ultrasound revealed high amplitude echogenic sludge with prominent post-acoustic shadow in gallbladder and its diameter was 1.5cm. We stopped ceftriaxone administration and tried conservative care. Abdominal cramping pain subsided after 3 days of ceftriaxone removal. Second abdominal ultrasound confirmed the disappearance of sludge at 3 weeks later.

  • PDF

골수이형성증후군 환자의 한약을 사용한 치험 1례 (One Case of Myelodysplastic Syndrome Treated with Herbal Medicine)

  • 황조현;김어진;이주영;장은경;이장훈;김영철
    • 대한한방내과학회지
    • /
    • 제43권3호
    • /
    • pp.444-450
    • /
    • 2022
  • Objectives: The aim of this study was to identify the effects of herbal medicine on the clinical symptoms and abnormal blood tests of a patient with myelodysplastic syndrome. Methods: A 64-year-old woman diagnosed with myelodysplastic syndrome in 2020 was prescribed Bojungikgi-tang-gagambang from January 6, 2022 to June 22, 2022 to reduce bleeding tendency and frequent defecation and to improve laboratory findings, such as platelet count. We observed changes in the symptoms and improvement of laboratory findings after six months of treatment. Results: In this study, approximately six months of treatment with Bojungikgi-tang-gagambang showed considerable improvement in laboratory findings and clinical symptoms, especially frequent defecation, petechiae, and gum bleeding, compared to the baseline parameters of the first visit. Also, no adverse effects, such as liver injury or decreased kidney function, were observed during herbal medicine treatment. Conclusion: This study suggests the availability of herbal medicine as a therapeutic option for managing patients with myelodysplastic syndrome.

골수 검사상 양성 혈구 탐식 조직구가 나타난 소아의 임상적 고찰 (A Clinical Study of Children Who Showed Benign Hemophagocytic Histiocytes in Bone Marrow Examination)

  • 박진아;박주영;박지민;박샛별;김흥식;전동석
    • Clinical and Experimental Pediatrics
    • /
    • 제45권8호
    • /
    • pp.1007-1015
    • /
    • 2002
  • 목 적: 혈구 탐식 조직구 증식증은 양성 질환으로는 드물게 치명율이 높은 질환으로, 발열, 간비장 종대, 림프절 종대 등의 증상이 있고, 검사 소견에서 양성의 혈구 탐식 조직구가 나타난 경우 진단되나 치료가 혼란스러운 경우가 많다. 골수 검사상 양성의 혈구 탐식조직구가 나타난 예들의 임상적 특징을 분석하여 진단 및 치료 방향과 예후 판정에 도움이 되고자 이 연구를 시행하였다. 방 법 : 1995년 1월부터 2001년 11월까지 계명대학교 동산병원에서 골수 검사상 양성의 혈구 탐식 조직구가 나타난 환아 30례를 대상으로, 특징적 임상 증상, 진찰 소견, 혈액 검사 소견, 골수 검사 소견, 치료 방법과 예후에 대하여 임상 기록지를 후향적으로 분석하였다. 또한 골수 도말에서 혈구 탐식 조직구의 수에 따라 a few, some, many로 나누어 환아의 예후와 비교하였다. 결 과 : 골수 검사상 양성 혈구 탐식 조직구를 보인 예들을 분석한 결과 이들의 연령 분포는 2개월에서 15세로, 평균 연령은 5.6세였고, 남녀비는 2.3 : 1로 남아가 많았다. 입원 당시 증상으로는 발열이 가장 많았으며, 호흡기 증상, 위장관 증상 등의 순이었고, 평균 발열 기간은 19.5일이었으며, 진찰 소견은 간비종대, 피부 발진, 림프절 비대 순으로 많았다. 혈액 검사 소견상 백혈구 감소증이 23례(76.7%)로 가장 많았고, 혈소판 감소증이 16례(53.3%), 빈혈이 15례(50.0%), 간기능 검사 이상이 15례(50.0%)로 나타났다. 기저 질환으로 급성 림프구성 백혈병, 악성 림프종 등 면역 저하된 상태가 5례였고, 건강했던 경우가 25례 였으며, 관련 질환의 종류로는 패혈증, 폐렴, 전염성 단핵구증 등의 순이었고, 원인으로는 세균이 많았으며, 바이러스로는 EBV가 4례였고, candida가 1례였다. 골수 도말 소견상 세포 충실도가 정상이 25례(83.3%)였고, 5례(16.7%)에서 감소되어 있었으며, 혈구 탐식 조직구의 수에 따라 분류하였을 때, some이 15례(50.0%), many가 9례(30.0%), a few가 6례(20.0%)이었다. 치료는 보존 요법, 항생제와 항바이러스제, 항진균제, 면역 글로불린, steroid, etoposide, cyclosporine 등의 병용 요법을 시행하였다. 사망율은 30명 중 8명으로 26.7%였으며, 연령이 낮은 군과 혈구 탐식 조직구 수가 some 이상인 경우에 사망률이 높았다. 결 론 : 고열, 간비종대, 범혈구 감소증과 간기능 이상 등의 소견을 보이는 환아에서 조기에 골수 검사를 시행하여 혈구 탐식 조직구가 보일 때, 원인 치료 및 대증 요법과 함께 면역 화학 요법을 시행하는 것이 예후에 도움이 될 것으로 생각되며, 골수 소견과 예후와의 관계는 지속적인 연구 관찰이 필요할 것으로 사료된다.