• 제목/요약/키워드: Cirrhosis

검색결과 625건 처리시간 0.029초

당뇨병과 간성뇌증이 동반된 간경변증 1례 (Case Report of Liver Cirrhosis with Diabetes Mellitus and Hepatic Encephalopathy)

  • 나란희;이정욱;한덕진;방창호;장석오;최지혜;김강산
    • 동의생리병리학회지
    • /
    • 제23권4호
    • /
    • pp.919-924
    • /
    • 2009
  • The liver is one of the principal organs involved in glucose metabolism. Diabetes mellitus(DM) commonly develops in patients with liver cirrhosis as a result of hepatocyte dysfunction. Hepatic encephalopathy(HE) is a major neuropsychiatric complication of liver cirrhosis. HE develops frequently in advanced stage of liver cirrhosis due to portal hypertension. We experienced a case of liver cirrhosis with DM and HE in 67 years old male patient. The patient's symptoms were lethargy, general malaise, asterixis, dizziness, and heavy headedness. Hwangryunjihwang-tang, Saengkankunbi-tang, Injinchija-tang and Injinho-tang were prescribed to the patient. Finally, the symptoms had been improved, however significant change was not observed from serum ammonia, fasting blood sugar and postparandial blood sugar. So we hope that this case report will be helpful in treating patient of liver cirrhosis.

Combined Effect of Granulocyte-Colony-Stimulating Factor-Induced Bone Marrow-Derived Stem Cells and Red Ginseng in Patients with Decompensated Liver Cirrhosis (Combined Effect of G-CSF and Red Ginseng in Liver Cirrhosis)

  • Kim, Hyun Hee;Kim, Seung Mo;Kim, Kyung Soon;Kwak, Min A;Kim, Sang Gyung;Kim, Byung Seok;Lee, Chang Hyeong
    • 대한한의학회지
    • /
    • 제37권4호
    • /
    • pp.36-44
    • /
    • 2016
  • Objectives: Granulocyte-colony-stimulating factor (G-CSF) mobilized bone marrow (BM)-derived hematopoietic stem cells could contribute to improvement of liver function. In addition, liver fibrosis can reportedly be prevented by the Rg 1 component of red ginseng. This study investigated the combined effect of G-CSF and red ginseng on decompensated liver cirrhosis. Methods: Four patients with decompensated liver cirrhosis were injected with G-CSF to proliferate BM stem cells for 4 days ($5{\mu}g/kg$ bid subcutaneously) and followed-up for 3 months. The patients also received red ginseng for 4 days (2 tablets tid per os). We analyzed Child-Pugh scores, Model for End-Stage Liver Disease (MELD) scores and cirrhotic complications. Results: All patients showed marked increases in White blood cell (WBC) and CD34+ cells in the peripheral blood, with a peak time of 4 days after G-CSF injection. Spleen size also increased after G-CSF injection, but not severely. At end of the study, 2 patients showed improvement in Child-Pugh scores, hepatic encephalopathy, and refractory ascites. During the clinical trial period, none of the 4 patients showed any other adverse events or deterioration of liver function. Conclusions: We conclude that G-CSF/red ginseng combination therapy is relatively effective in improving liver function and major complications of decompensated liver cirrhosis without adverse effects. Further clinical trials are warranted to assess the clinical effects of G-CSF for decompensated liver cirrhosis.

Presence of Sarcopenia and Its Rate of Change Are Independently Associated with Long-term Mortality in Patients with Liver Cirrhosis

  • Jeong, Jae Yoon;Lim, Sanghyeok;Sohn, Joo Hyun;Lee, Jae Gon;Jun, Dae Won;Kim, Yongsoo
    • Journal of Korean Medical Science
    • /
    • 제33권50호
    • /
    • pp.299.1-299.13
    • /
    • 2018
  • Background: Sarcopenia is associated with a poor prognosis in patients with liver cirrhosis. However, it is not known whether the rate of skeletal muscle depletion is also associated with a poor prognosis. We investigated the prognostic impact of the rate of skeletal muscle depletion in patients with liver cirrhosis. Methods: We included retrospectively all patients with liver cirrhosis who underwent both multiple computed tomography scans and hepatic venous pressure gradient (HVPG) measurements. Results: A total of 131 patients with liver cirrhosis were enrolled. The mean age of the patients was 53.7 years and alcoholic liver disease was the most common cause (61.8%). Sixty-four patients (48.9%) were diagnosed with sarcopenia. The median changes in skeletal muscle area per year (${\Delta}SMA/y$) were -0.89%. During a median follow-up period of 46.2 months (range, 3.4-87.6), 45 patients (34.4%) died. In multivariate analyses, age, Child-Pugh score, HVPG, presence of sarcopenia and ${\Delta}SMA/y$ were independently associated with mortality. Cumulative mortality was significantly higher in patients with ${\Delta}SMA/y$ < -2.4% than those with ${\Delta}SMA/y{\geq}-2.4%$ (log-rank test, P < 0.001). Conclusion: Both the presence and rate of change of sarcopenia are independently associated with long-term mortality in patients with liver cirrhosis.

컴퓨터단층영상에서 TIA를 이용한 간경화의 컴퓨터보조진단 (Computer-Aided Diagnosis for Liver Cirrhosis using Texture features Information Analysis in Computed Tomography)

  • 김창수;고성진;강세식;김정훈;김동현;최석윤
    • 한국콘텐츠학회논문지
    • /
    • 제12권4호
    • /
    • pp.358-366
    • /
    • 2012
  • 간경화(liver cirrhosis)는 섬유조직의 증식과 재생성 결절 형성의 형태학적인 변화로 2차적으로 간내혈관의 변형 및 간기능의 저하가 나타나는 질병이며, 정맥류, 복수와 부종, 간성뇌증, 간암 등의 합병증 동반을 미연에 방지하는 것이 간경변증 진단 및 치료에 핵심이다. 일반적으로 간 컴퓨터단층영상이 간경변의 진단 및 병기를 결정하는 방법으로 사용한다. 그러므로 본 연구에서는 간경화의 자동 인식을 위하여 PCA와 TIA 알고리즘을 이용한 특징추출을 통하여 간경변의 자동 검출능력을 알아보고, 각 알고리즘간의 성능을 비교하였다. 실험은 학습영상과 테스트영상으로 구분한다. 고유영상을 생성시키기 위한 학습영상으로 정상영상이 사용되고, 테스트영상으로는 간경화영상이 사용된다. 간 CT 영상에서 간의 질병 부위를 균등하게 ROI 설정하고, $50{\times}50$ 픽셀 크기로 영상을 저장하여 실험하였다. 실험결과로 PCA는 간경화 검출율이 35%로 질병 인식으로 부적합하며, TIA 알고리즘의 AGL, TM, MU, EN는 100% 질병 인식력을 나타내어 간경화 자동 진단 인식으로 가능했다. 또한 결과를 임상에 적용하여 간경변의 컴퓨터보조진단으로 활용한다면 영상의학과 의사에게 업무 부담을 줄이고, 일차적 간경변의 스크리닝 도구로서 활용이 가능할 것이다. 그리고 TIA 알고리즘을 활용한 자동진단은 질병 진단의 전단계로서 예비판독의 정보를 제공하며 간경변의 조기 진단 및 예방이 가능다고 판단된다.

알코올과 간질환 (Alcohol and Liver disease)

  • 박병채
    • 생명과학회지
    • /
    • 제5권3호
    • /
    • pp.145-150
    • /
    • 1995
  • Alcoholic liver disease is defined by the development of three types of liver damage following chronic heavy alcohol consumption, namely, alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis, The clinical features and laboratory tests often do not distinguish among these types of liver injuries. In addition, a considerable number of the patients who have clinical and laboratory features compatible with alcoholic liver disease are diagnosed on liver biopsy to have chronic viral hepatitis or other lesion. Because of these factors, liver biopsy is frequently needed to arrive a definite diagnosis of the disease, its activity, and its chronicity. Fatty liver is usually a benign and reverible condition that disappears on abstinence from alcohol. However, alcoholic hepatitis is usually regarded as a precursor of cirrhosis. The principle factors in the development of alcoholic hepatitis and cirrhosis are the quantity and length of ingestion of alcohol. women are much more susceptible than men to hepatic injuries. Since only 10 - 20% of alcoholics develop cirrhosis, however, it is conceivable that other factors, either genetic, environmental, or nutritional may contribute in the genesis of liver injuries. The most important factor in the treatment of alcoholic liver disease is prolonzed abstinence from alcohol, since abstinence by itself improves clinical status and survival, Nutritional support in patients with nutritional deficiency, and specific drug therapies such as corticosteroid or anabolic steroids for hospitaliged patients with severe alcoholic hepatitis also play an important role in devreasing morbidity and improving survival. Liver transplantation is a newer treatment modality in the patients with advanced cirrhosis, not responsible to medical treatment.

  • PDF

청간건비탕가미방(淸肝健脾湯加味方)으로 복수(腹水)를 동반한 알코올성 간경변(肝硬變) 환자(患者) 치험 1례 (Chunggangunbi-tang-gamibang's Effect on Alcoholic Liver Cirrhosis with Ascites)

  • 정은우;조윤성;김현식;김소연;이상관
    • 대한한의학방제학회지
    • /
    • 제15권2호
    • /
    • pp.161-169
    • /
    • 2007
  • We applied Chunggangunbi-tang-gamibang to a 64 year-old male patient who had alcoholic liver cirrhosis with ascites. Chunggangunbi-tang-gamibang has been used to treat alcoholic liver disease and because of its beneficial effects. The patient with the disease expected several symptoms induced by Alcoholic liver cirrhosis, and we diagnosised differentiation of symptoms, using Chunggangunbi-tang-gamibang while removing dampness through diuresis and invigorating the spleen. After medication we could find remarkable effects on clinical symptoms, blood test results and abdomen ultrasonographic images. From this case, it is thought that using Chunggangunbi-tang-gamibang is very effective to improve the symptom of alcoholic liver cirrhosis with ascites.

  • PDF

Massive bleeding from a rectal Dieulafoy lesion in a patient with alcoholic cirrhosis

  • Choi, Young Hoon;Eun, Jong Ryeol;Han, Jae Ho;Lim, Hyun;Shin, Jung A;Lee, Gun Hwa;Lee, Seung Hee
    • Journal of Yeungnam Medical Science
    • /
    • 제34권1호
    • /
    • pp.88-90
    • /
    • 2017
  • Although Dieulafoy lesion can occur in any part of the gastrointestinal tract, its occurrence in the rectum is rare. Rectal Dieulafoy lesions have been associated with advanced age, renal failure, burns, liver transplantation and cirrhosis. Here, we report on a case of massive bleeding from a rectal Dieulafoy lesion after lung decortication surgery in a 57-year-old male patient with alcoholic cirrhosis. Although rare, a rectal Dieulafoy lesion should be included in the differential diagnosis of massive lower gastrointestinal bleeding in a patient with cirrhosis.

Effect of Hepatic Cirrhosis on the Pharmacokinetics of Theophylline in Rats

  • Nam, Bang-Hyun;Sohn, Dong-Hwan;Ko, Geonil;Kim, Jae-Baek
    • Archives of Pharmacal Research
    • /
    • 제20권4호
    • /
    • pp.318-323
    • /
    • 1997
  • The experimental hepatic cirrhosis was induced either by bile duct ligation (BDL) or by pretreatment with dimethyinitrosamine (DMNA). The pharmacokinetics of theophylline were studied after a single intravenous or a single oral administration. Using the ultrafiltration method, protein-drug binding experiments were also carried out. The bilirubin level was several-fold increased by BDL, but not by DMNA treatment. The albumin content was decreased in both cirrhotic groups. The total clearance (Clt, ml/kg/hr) of theophylline in both hepatic cirrhosis groups significantly decreased and the terminal half-life $(t_{1/2})$ in the cirrhotic rats was increased about two-fold after intravenous and oral administration. The volume of distribution at steady state (Vdss, ml/kg) was increased slightly in the cirrhotic groups. Protein binding in BDL $(8.67{\pm}4.85%)$ decreased about four-folds, but in DMNA $(73.00{\pm}9.85%)$ similar result war observed as compared with the control. Increased free fraction of theophylline did not increase the volume of distribution in BDL. Therefore decreased total body clearance of theophylline was mainly due to decreased intrinsic clearance of theophylline in the liver. The absolute bioavailability of theophylline in these experiments was between 63.8 and 72.8%(66.1% in BDL, 63.8% in Sham operated and Control, 72.8% in DMNA). These results suggest that in the experimental hepatic cirrhosis model, administration route does not affect the disposition of theophylline.

  • PDF

태음조위탕가미방(太陰調胃湯加味方)으로 복수를 동반한 간경변 환자 치험 1례 (A Case report of ascites in Liver cirrhosis treated with Taeumjowetang-gamibang)

  • 김정철;이해연;박정한;이재준;이유경;한동윤;조현석
    • 대한한방내과학회지
    • /
    • 제25권3호
    • /
    • pp.625-632
    • /
    • 2004
  • Liver cirrhosis is a disease of the liver in which normal cells are replaced by scar tissue. This condition results in the failure of the liver to perform many of its usual functions. Liver cirrhosis include acsites, jaundice, portal hypertension, varices etc. This report is about one case of ascites with liver cirrhosis. In this case, we administrated Taeumjowetang-gamibang was administered and acupuncture was done in treatment of ascites and its symptoms. After administration of Taeumjowetang-gamibang medication, clinical symptoms and prominently improved and ascites dwindled to nothing. This reports suggests Taeumjowetang-gamibang has desirable effected on ascites.

  • PDF

간경변증 환자의 식이이행과 영양상태 및 질병상태와의 관계 (Relationships among Dietary Compliance, Nutritional Status and Stages of Disease in Patients with Liver Cirrhosis)

  • 윤미정;민혜숙
    • 근관절건강학회지
    • /
    • 제22권3호
    • /
    • pp.219-227
    • /
    • 2015
  • Purpose: The purpose of this study was to investigate the degree of dietary compliance, nutritional status, and stages of disease in patients with liver cirrhosis and to identify the relationships among those variables. Methods: This study used a cross-sectional design and conducted a survey of 100 patients who were treated at D-university hospital in Busan. For data analysis, descriptive statistics and Pearson's correlation coefficients were performed using SPSS/WINdow 20.0 program. Results: The mean score of dietary compliance was 3.50 in the a 5-point scale. Stage of disease was significantly correlated with dietary compliance (r=.20, p=.048), and protein as one of nutritional status (r=-.44, p<.001). Conclusion: These findings suggest that dietary compliance of patients with liver cirrhosis can have an influence on prognosis of disease. Therefore, patients should be encouraged to improve dietary compliance from the early stage of liver cirrhosis.