• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제9권1호
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• pp.108-113
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• 2006

윌슨병에서 용혈성 빈혈과 전격성 간부전이 동반되면 혈장교환술이나 간이식이 필수적이다. 저자들은 간염과 용혈위기가 동반된 전격성 윌슨병 환아에서 혈장교환술을 계속하였으나 호전을 보이지 않아 교환수혈을 시행한 결과 용혈위기를 극복하였다. 현재까지 약물치료와 혈장교환술에 뒤이은 간이식이 일차 치료로 되어 있지만, 전격성 간부전이 응급으로 간이식을 해야 할 만큼 심하지 않은 경우에는 혈장교환술후 교환수혈을 시도할 수 있을 것으로 생각한다.

• Tuberculosis and Respiratory Diseases
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• 제63권5호
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• pp.435-439
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• 2007

PZA에 의한 독성 간염은 약 2% 정도 보고되고 있으나 전격성 간염으로 진행하여 사망하는 경우는 드물게 보고되고 있다. 본 증례에서는 항결핵제에 의해 중증 독성 간염을 보였다가 회복된 후 저용량의 PZA을 재투여 하고 전격성 간염으로 진행하는 양상을 보였다. 이번 사례를 통해 저용량의 PZA를 투약시 전격성 간부전으로 진행하는 경우를 경험했고 항결핵제 투여시 면밀한 관찰이 필요하고 항결핵 약제 투여시 신중을 기울여야겠다.

• 대한임상독성학회지
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• 제2권2호
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• pp.133-136
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• 2004

Phalloides syndrome has usually occurred after incidental mushroom ingestion. It is sometimes difficult to differentiate toxic mushrooms from edible ones, especially in lay person because of their morphological similarities. In Korea, Amanita virosa and Amanita subjunquillea have been reported as a cause of fulminant hepatic failure in mushroom poisoning (phalloides syndrome). We report a case of phalloides syndrome who came to death with fulminant hepatic failure even though we planned liver transplantation and used T-PLS(R) (Twin Pulse Life Support) for hemodynamic support while waiting for the donor.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2008년도 추계학술대회A
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• pp.1419-1426
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• 2008

Fulminant hepatic failure is a clinical syndrome associated with a high mortality rate. Orthotopic liver transplantation is the only clinically proven effective treatment for patients with end-stage liver disease who do not respond to medical management. A major limitation of this treatment modality is the scarcity of donor organs available, resulting in patients dying while waiting for a donor liver. An extracorporeal bioartificial liver (BAL) device containing viable hepatocytes has the potential to provide temporary hepatic support to liver failure patients, serving as a bridge to transplantation while awaiting a suitable donor. In some patients, providing temporary hepatic support may be sufficient to allow adequate regeneration of the host liver, thereby eliminating the need for a liver transplant. Although the BAL device is a promising technology for the treatment of liver failure, there are several technical challenges that must be overcome in order to develop systems with sufficient processing capacity and of manageable size. In this overview, the authors describe the critical issues involved in developing a BAL device. They also discuss their experiences in hepatocyte culture optimization within the context of a microchannel flat-plate BAL device.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup2호
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• pp.50-58
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• 2008

급성 간부전은 여러 분야의 전문가 및 이식 센터의 협조가 필요한 질환으로 급성 간염을 보이는 모든 환자에서 급성 간부전으로 진행할 가능성에 대해 고려하여야 한다. 소아에서 급성 간부전은 원인 미상인 경우가 가장 흔하며, 영아기에는 대사성 간질환도 염두에 두어야 한다. 급성 간부전의 예후는 간이식이 도입된 이후 획기적으로 향상되었으나, 간성 뇌증, 혈액응고 장애, 감염, 신부전 등 주요 합병증에 대한 치료는 여전히 예후를 좌우하는 중요한 부분이며, 여기에 더하여 간이식의 여부 및 시기에 대한 결정이 소아과 의사의 중요한 역할 중 하나가 되었다. 원인이 밝혀진 경우에는 예후 예측에 도움이 되고, 원인에 대한 치료를 시도해볼 수 있으나 소아 환자는 원인 미상인 경우가 많아 예후 예측이 어렵고, 주 사망 원인인 간성 뇌증에 대한 평가가 어려워 특히 세심한 모니터가 필요하다.

• Pediatric Infection and Vaccine
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• 제24권3호
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• pp.188-192
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• 2017

호흡기세포융합바이러스는 소아 하기도 감염의 주된 원인으로 대부분의 양호한 경과를 보이지만, 일부에서는 호흡부전과 같은 심한 경과를 보이기도 한다. 이러한 심한 호흡기세포융합바이러스 감염에는 드물지 않게 폐외증상이 동반될 수 있다. 저자들은 기계 환기를 필요로 하는 하기도 감염과 함께 급성 심근염, 전격성 간 기능부전을 보인 심한 호흡기세포융합바이러스 감염을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Archives of Pharmacal Research
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• 제28권1호
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• pp.81-86
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• 2005

The hepatoprotective effects of chalcone derivatives were evaluated in D-galactosamine/lipopolysaccharide (D-GaIN/LPS)-induced fulminant hepatic failure in mouse. Thirteen chalcone derivatives were synthesized for study and their hepatoprotective effects were evaluated by assessing aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in serum. Chalcone preparations were injected into mice at 12 hand 1 h before intraperitoneal injection of D-GaIN/LPS. After abdominal administration, changes in AST and ALT between the control and treated groups were observed. Ten of the synthesized chalcone derivatives exhibited inhibitory effects on D-GaIN/LPS-induced levels of AST and ALT in mice. Compounds 2, 3, 8, 9, and 12 markedly reduced serum AST and ALT at 8 h, inhibited hepatocyte necrosis and showed significant hepatoprotective activities. The activity of compound 3 was compared with the bifendate (DDB) through oral administration. Compound 3 showed much higher inhibitory effects than bifendate for decreasing AST and ALT activity. The results indicate that compound 3 has strong hepatoprotective activity through suppression of tumor necrosis factor­alpha (TNF-alpha) preduction, reduction of the histological change in the liver, and attenuated of hepatocyte apoptosis confirmed by DNA fragmentation assay.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권2호
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• pp.121-127
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• 2015

Purpose: To evaluate clinical and laboratory profile of Wilson's disease (WD) in children. Methods: This cross sectional study was conducted at Bangabandhu Sheikh Mujib Medical University Hospital. Bangladesh, over a period of 3 years. One hundred consecutive children of WD between 3 to 18 years of age were evaluated. Results: Mean age was $8.5{\pm}1.5years$. Male female ratio was 2:1. Ninety-one percent of patients were Muslim and 9% Hindu. A total of 53% cases of hepatic WD presented between 5 to 10 years of age and most of the neurologic WD manifested in 10-15 years age group. Sixty-nine children presented only with hepatic manifestations, 6 only with neurological manifestations, 14 with both hepatic and neurological manifestation, 10 children was asymptomatic and 1 patient presented with psychiatric features. WD presented as chronic liver disease (CLD) in 42%, CLD with portal hypertension in 34%, acute hepatitis in 20% and fulminant hepatic failure in 4% cases. Stigmata of CLD were found in 18% patients. Keiser-Fleischser ring was found in 76% total patients. Elevated serum transaminase was found in 85% cases, prolonged prothrombin time in 59% cases and hypoalbuminaemia in 53% cases. A total of 73% patients had low serum ceruloplasmin, basal urinary copper of >$100{\mu}g/day$ was found in 81% cases and urinary copper following penicillamine challenge of >$1,200{\mu}g/day$ was found in 92% cases. Conclusion: Majority of studied WD children presented with hepatic manifestation of which 76% presented with CLD. Any child presented with jaundice after the age of 3 years should be investigated for WD.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2003년도 생물공학의 동향(XIII)
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• pp.305-306
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• 2003

To treat fulminant hepatic failure (FHF) patients, various extracorporeal bioartificial liver (BAL) systems have been developed. Several requirements should be met for the development of BAL systems: hepatocytes should be cultured in a sufficiently high density; their metabolic functions should be of a sufficiently high level and duration; and the BAL systems module should permit scaling-up and aseptic handling. Several investigators have found that freshly isolated primary hepatocytes can be cultured into three dimensional, tightly packed, freely suspended, multicellular aggregates, or spheroids. These specialized cell structures exhibited enhanced liver specific functions and a prolonged differentiated state compared to cells maintained in a monolayer culture. Cells in spheroids appear to mimic the morphology and ultrastructure of the in vivo liver lobule. The ability of hepatocytes to organize into three-dimensional structures was hypothesized to contribute to their enhanced liver-specific activities. In this study, the ammonia removal rate and urea secretion rate of pig hepatocytes spheroids encapsulated in Ca-alginate bead were determined. A packed-bed bioreactor with encapsulated pig hepatocytes was devised as BAL support system. The efficacy of the system was evaluated in vitro.

• 대한의용생체공학회:의공학회지
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• 제19권3호
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• pp.215-224
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• 1998

본 논문은 급성 간 부전 환자나 간이식 대기상태에 있는 환자에 이용하기 위한 체외 간 보조장치를 개발하기 위한 기초 실험에 관한 것이다. 밀도 33kg/m, 평균 직경 500um, 60-70%의 window를 가진 폴리우레탄 폼을 15% NCO-프리폴리머로 제조하였다. 폴리우레탄 폼에 접종된 간세포는 3일 후에 거의 모두 100-150um 크기의 구상체를 형성하였다. BSA 코팅을 한 폴리우레탄 폼은 BSA로 코팅하지 않은 폴리우레탄 폼보다 간세포 구상체 형성 시간이 더 짧았다. 폴리우레탄 폼에 형성된 간세포 구상체의 간 기능을 증명하기 위하여 암모니아 제거율과 요소 및 알부민 분비율을 측정하였다. 폴리우레탄 폼은 간세포 구상체 배양에 적합하며, 폴리우레탄 폼 내에서의 간세포 구상체 배양은 체외 간 보조장치로의 개발 가능성이 높다.