• Title/Summary/Keyword: Hepatic cirrhosis

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Dynamic Study on the Hepatobiliary Diseases with Combination of $^{131}I$-Rose bengal and $^{198}Au$-Colloid Scintiphotography (간담도질환(肝膽道疾患)의 Scintiphotography 상(像)에 있어서 $^{131}I$-Rose bengal 및 $^{198}Au$-colloid의 섭취(攝取)와 배설(排泄)에 관(關)한 역동학적(力動學的) 연구(硏究))

  • Rhee, Yong-Kook
    • The Korean Journal of Nuclear Medicine
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    • v.5 no.1
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    • pp.49-64
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    • 1971
  • The radioactive $^{131}I$-rose bengal serial scintiphotography was performed in 62 patients with the hepatobiliary diseases and in 20 normal subjects. This approach permitted visualization of the hepatic uptake of $^{131}I$-rose bengal from the circulation and its excretion into the biliary trees and the intestines. In some of these patients, gallbladder function was examined, using eggs as a gallbladder constrictor. The time of maximum hepatic uptake was well correlated to the conventional biochemical liver function tests. In addition to $^{131}I$-rose bengal scintiphotography, $^{198}Au$-colloid scintiphotography was also performed to make comparison of these two tests. The results obtained were as follows: 1. In normal subjects, the maximum hepatic uptake of $^{131}I$-rose bengal occurred at $23{\pm}2.9$ minutes, the initial hepatic excretion at $34{\pm}5.1$ minutes, the visualization of the gallbladder at $29{\pm}5.7$ minutes and the intestinal visualization at $54{\pm}25.8$ minutes. The radioactivity in the gallbladder decreased to $10.7{\pm}5.0%$ one hour after the ingestion of eggs. 2. In the patients with cirrhosis of the liver, there was a delayed and decreased hepatic uptake. The maximun hepatic upake occurred at $43{\pm}12.9$ minutes. The differences in the results of uptake between the cirrhotic and the normal group were statistically significant. The initial hepatic excretion occurred at $60{\pm}18.5$ minutes and had tendency of delaying compared with the normal controls. The gallbladder was visualized in 13 of 16 cases (81%) and its visualization occurred at $49{\pm}14.6$ minutes with a tendency to be delayed compared with the normal controls. The intestinal visualization occurred at $63{\pm}15.8$ minutes and its delaying tendency was somewhat more prominent. 3. In patients with hepatitis, the maximum hepatic uptake occurred at $59{\pm}21.4$ minutes and was significantly delayed. The initial hepatic excretion occurred at $82{\pm}34.3$ minutes and the results revealed a delaying tendency. The gallbladder was visualized in 15 of 20 cases (75%) at $57{\pm}18.7$ minutes, which was significantly delayed. The Intestinal visualization was noted in all cases with marked delay. 4. In patients with obstructive jaundice, the maximum hepatic uptake was noted at $83{\pm}14.7$ minutes, showing the most significant delay. The hepatic excretion into biliary trees and intestines was not entirely noted in all cases except the only one case with gallbladder visualization. 5. In patients with cholelithiasis, the maximum hepatic upake and the initial hepatic excretion were slightly delayed with mean times of $39{\pm}11.2\;and\;48{\pm}17.1$ minutes respectively. The visualization of the gallbladder was demonstrated in 10 of 17 cases (59%) and occurred at $52{\pm}25.6$ minutes with a slight delay. The intestinal visualization occurred at $67{\pm}47.7$ minutes and was slightly delayed. $^{131}I$-rose bengal in the gallbladder remained high, $49.3{\pm}21.3%$, which suggested quantitatively decreased power of gallbladder constriction. 6. The time of the maximum hepetic uptake was correlated well to BSP retention and serum alkaline phosphatase ativity. However, the maximum hepatic uptake had no definite correlation with serum albumin, serum globulin, TTT, serum cholesterol, SGPT or SGOT. 7. In the diagnosis of the hepatobiliary diseases with jaundice, $^{131}I$-rose bengel serial scintiphotography has proved to be more useful than $^{198}Au$-colloid scintiphotography. With these results, it could be justified that $^{131}I$-rose bengal scintiphotography is an excellent diagnostic aid for dynamic hepatobiliary function studies in the clinical practice.

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Arterio-Biliary Fistula as a Rare Life-Threatening Complication of Transjugular Intrahepatic Portosystemic Shunt: A Case Report (경경정맥 간내 문맥 정맥 단락술 후 드물게 발생하는 동맥-담관루: 증례 보고)

  • Ji Su Ko;Lyo Min Kwon;Han Myun Kim;Min-Jeong Kim;Hong Il Ha;Ji Won Park;Ji Young Woo
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.705-711
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    • 2022
  • A 46-year-old male with alcoholic liver cirrhosis underwent a transjugular intrahepatic portosystemic shunt (TIPS) for refractory ascites. On the 9th day after the procedure, he presented with melena and decreasing hemoglobin levels. Hemobilia due to fistula formation between the right intrahepatic bile duct and right hepatic artery was suspected on computed tomography. Angiography revealed a fistula of the small branches of the hepatic segmental arteries, and right intrahepatic bile duct was confirmed; embolization was successfully performed with a coil for the eighth segmental hepatic artery, a glue-lipiodol mixture for the fifth segmental hepatic artery, and gelfoam slurry for the right anterior hepatic artery. However, 2 days after embolization, the patient died owing to aggravated disseminated intravascular coagulopathy. When gastrointestinal bleeding occurs after TIPS, careful evaluation is immediately required, and hemobilia should be considered.

Protective Effects of near nile Juice Against Carbon Tetrachloride-Induced Acute Hepatotoxicity in ICR Mice (웅담이 CCl4로 유발된 mouse의 간 손상에 미치는 영향)

  • Kim, Hyun-Do;Lee, Kyu-Jae;Park, Seong-Kyu;Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.8 no.3
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    • pp.31-38
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    • 2005
  • Objectives : This study was aimed at investigating liver protection mechanism of bear bile juice (Fel Ursi)by inducing liver toxicity through $CCl_4$ in mice and evaluated histological and serological findings. Methods : Experiment groups was categorized into untreated normal group, $CCl_4$ treated control group, and orally administered bear bile juice experiment group. At the termination of experiment, gross examination of the liver as well as histological findings, and Total protein, Albumin, Total bilirubin, Direct bilirubin SGOT, SGPT, and ALP contents in the serum were evaluated. Results : 1. For gross examination and histological findings, $CCI_4$ treated control group showed destroyed lobular structure, increased fibrosis, as well as hepatic cirrhosis. For the group treated with bear bile juice, the lobular structure suffered less damage, and showed lower level of fibrosis and liver cirrhosis compared to the control group. 2. For serum analysis, Total protein and Albumin were significantly increased in the bear bile juice experiment group than the control group. Total bilirubin and Direct bilirubin didn't show significant differences between the two groups. SOOT, SGPT, and ALP were significantly decreased in the normal and bear bile juice experiment groups compared to the control group. Conclusion : Taken together, bear bile juice can be effectively used for recovering the liver functions and further researches must be conducted to verify the efficacies of bear bile juice.

Protective Effects of Moschus Against Carbon Tetrachloride-Induced Acute Hepatotoxicity in ICR Mice (사향이 CCl4로 유발된 mouse의 간 손상에 미치는 영향)

  • Park, Jae-Seuk;Kim, Seung-Wook;Lee, Kyu-Jae;Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.9 no.1
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    • pp.45-52
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    • 2006
  • Objectives : This study was aimed at investigating liver protection mechanism of Moschus by inducing liver toxicity through $CCl_4$ in mice and evaluated histological and serological findings. Methods : Experiment groups was categorized into untreated normal group, $CCl_4$ treated control group, and orally administered Moschus experiment group. At the termination of experiment, gross examination of the liver as well as histological findings, and Total protein, Total bilirubin, Direct bilirubin SGOT, SGPT, and ALP contents in the serum were evaluated. Results : 1. For gross examination and histological findings, $CCl_4$ treated control group showed destroyed lobular structure, increased fibrosis, as well as hepatic cirrhosis. For the group treated with Moschus, the lobular structure suffered less damage, and showed lower level of fibrosis and liver cirrhosis compared to the control group. 2. For serum analysis, Total protein were significantly increased in the Moschus experiment group than the control group. 3. Total bilirubin didn't show significant differences between the two groups. but direct bilirubin was significantly increased in the Moschus experiment group than the control group. 4. SGOT, SGPT, were significantly decreased in the normal and Moschus experiment groups compared to the control group. 5. ALP was significantly decreased in the normal group compared to the control group, but Moschus experiment group didn't show significant differences compared to the control group. Conclusion : Taken together, Moschus can be effectively used for recovering the liver functions and further researches must be conducted to verify the efficacies of Moschus bile juice.

Anti-Oxidative Effects of Rubus coreanum Miquel Extract on Hepatic Injury Induced by Lipopolysaccharide (복분자 추출물이 Lipopolysaccharide로 유도된 간 손상에 대한 항산화 효과)

  • Kim, In-Deok;Kang, Kum-Suk;Kwon, Ryun-Hee;Ha, Bae-Jin
    • Toxicological Research
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    • v.23 no.4
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    • pp.347-352
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    • 2007
  • The protective effects of Rubus coreanum Miquel (RCM) extract against LPS-induced hepatotoxicity were studied in rats. Squrague-Dawley rats were intraperitoneally administered the RCM at 100 mg/kg per day for three weeks. Then single dose of LPS (5 mg/kg) was injected into rats. Four hours later, they were anesthesized with ether and dissected. We examined the levels of glutamate oxaloacetate transaminase (AST), glutamate pyruvate transaminase (ALT), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) in sera, superoxide dismutase (SOD) in mitochondrial fraction and catalase (CAT), glutathione peroxidase (GPx) in liver homogenate. LPS-treatment markedly increased the levels of AST, ALT, ALP, LDH and significantly decreased those of SOD, CAT and GPx. But RCM-pretreatment decreased the levels of AST, ALT, ALP and LDH by 57.9%, 37.4%, 62% and 69% respectively and increased those of SOD, CAT and GPx by 82.9%, 64.2% and 96.7% respectively. Subsequently, the protective effects of RCM was evaluated through histopathological examination of liver tissue. The LPS treatment increased the state of necrosis and cirrhosis surrounding the central veins (CV) and sinusoid, but RCM-treatment decreased the state of necrosis and cirrhosis in the liver tissue. These results demonstrated that protective effects of RCM against LPS-induced hepatotoxicity.

A study on the knowledge and awareness of some health-related and health-unrelated majors about Hepatitis B (일부 보건과 비보건계열 대학생의 B형 간염에 대한 지식과 인식에 관한 조사 연구)

  • Jung, Gi-Ok;Kim, Ju-Yeong
    • Journal of Korean society of Dental Hygiene
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    • v.9 no.2
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    • pp.125-136
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    • 2009
  • The purpose of this study was to investigate the recognition of the infection routes, symptoms and treatments of HBV by students of health-related departments so as to help students learn correct knowledge about hepatitis B and provide the basic data for establishment of oral health policies to prevent hepatitis B and improve the quality of infection management. For the subjects of this study, 666 students of health-related departments and other departments of universities in Daegu City, Gyeongbuk Province were arbitrarily chosen and given a questionnaire. Then the questionnaires collected between October 1st and 31st, 2007 were analyzed. Major findings from this study are summarized below. 1. Regarding general characteristics of the subjects, 311 were students of health-related departments and 355 were students of other departments. 55.9% of the health-related department students and 49.0% of the other department students received immunization against hepatitis. 36.0% of the health-related department students and 31.6% of the other department students had antibodies. 2. Regarding the recognition of the infection routes of HBV, the right answer "Infected through placenta" was chosen by more juniors(94.4%), sophomores(93.8%) and freshmen(74.1%) of health-related departments than other students in this order (P<0.05). The answer "Infected through sexual intercourse" was chosen by the highest percentage(75.0%) of juniors followed by freshmen(69.2%) and sophomores(31.9%) (P<0.05). 3. The percentages of health-related department students who knew that "HBV can develop into hepatic cirrhosis or liver cirrhosis were the highest among juniors(88.9%), freshmen(87.7%) and sophomores(68.8%) in this order(P<0.05). Among the other department students, the percentages of right answers to the question "Acute HBV infection shows jaundice" were the highest among juniors(75.0%), sophomores(74.8%) and freshmen(58.7%)(P<0.05).

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Therapeutic Effects of Korean Red Ginseng Extract in Egyptian Patients with Chronic Liver Diseases

  • Abdel-Wahhab, Mosaad A.;Gamil, Khaled;El-Kady, Ahmed A.;El-Nekeety, Aziza A.;Naguib, Khayria M.
    • Journal of Ginseng Research
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    • v.35 no.1
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    • pp.69-79
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    • 2011
  • Hepatocellular carcinoma (HCC) is the fi fth most common malignancy in the world and complicates liver cirrhosis related to hepatitis C virus (HCV) in many cases. We evaluated the therapeutic effect of Korean red ginseng extract (KGE) in patients with chronic liver diseases. Thirty male and female patients with HCC and another thirty with liver cirrhosis were included. Each category was divided into two groups; the first was used as control group, and received medical therapy only and the second group received the medical therapy supplemented with KGE capsules. The treated group with HCC received three KGE capsules/day (900 mg) while the treated group with HCV received two KGE capsules/day (600 mg) for 11 weeks along with their medical therapy. All patients were subjected to clinical examination and laboratory investigations, including liver function tests (at baseline, after 6 weeks of treatment and at the end of the study) and abdominal ultrasonography. Patients showing focal hepatic lesions were subjected to triphasic spiral abdominal computerized tomography and alpha-fetoprotein (AFP). HCV RNA was determined quantitatively by Roche for patients in the HCV group. Results showed that the medical therapy alone failed to normalize the liver enzymes or decrease the virus concentration. KGE administration induced a significant improvement in liver function tests, decreased the tumor marker (AFP) levels, and decreased the viral titers in HCV patients. Thus, KGE demonstrated powerful therapeutic effects against HCV and liver cancer.

Anemia of Chronic Liver Diseases (만성(慢性) 간질환(肝疾患)의 빈혈상(貧血像))

  • Shin, Hyun-Chung;Lee, Jhung-Sang;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.5 no.2
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    • pp.41-56
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    • 1971
  • The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseass were studied by various methods. Only patients without previous blood loss were included: 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and $T_{50}Cr$. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

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Systematic exploration of therapeutic effects and key mechanisms of Panax ginseng using network-based approaches

  • Young Woo Kim;Seon Been Bak;Yu Rim Song;Chang-Eop Kim;Won-Yung Lee
    • Journal of Ginseng Research
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    • v.48 no.4
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    • pp.373-383
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    • 2024
  • Background: Network pharmacology has emerged as a powerful tool to understand the therapeutic effects and mechanisms of natural products. However, there is a lack of comprehensive evaluations of network-based approaches for natural products on identifying therapeutic effects and key mechanisms. Purpose: We systematically explore the capabilities of network-based approaches on natural products, using Panax ginseng as a case study. P. ginseng is a widely used herb with a variety of therapeutic benefits, but its active ingredients and mechanisms of action on chronic diseases are not yet fully understood. Methods: Our study compiled and constructed a network focusing on P. ginseng by collecting and integrating data on ingredients, protein targets, and known indications. We then evaluated the performance of different network-based methods for summarizing known and unknown disease associations. The predicted results were validated in the hepatic stellate cell model. Results: We find that our multiscale interaction-based approach achieved an AUROC of 0.697 and an AUPR of 0.026, which outperforms other network-based approaches. As a case study, we further tested the ability of multiscale interactome-based approaches to identify active ingredients and their plausible mechanisms for breast cancer and liver cirrhosis. We also validated the beneficial effects of unreported and top-predicted ingredients, in cases of liver cirrhosis and gastrointestinal neoplasms. Conclusion: our study provides a promising framework to systematically explore the therapeutic effects and key mechanisms of natural products, and highlights the potential of network-based approaches in natural product research.

Hypoxemia In Liver Cirrhosis And Intrapulmonary Shunt Determination Using Tc-99m-MAA Whole Body Scan (간경화 환자에서의 저산소혈증과 Tc-99m-MAA 주사를 이용한 폐내단락 측정)

  • Lee, Kye-Young;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.504-512
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    • 1994
  • Background: It is well known that severe hypoxemia is often associated with liver cirrhosis without preexisting cardiac or pulmonary diseases. Pulmonary vascular impairments, more specifically, intrapulmonary shunting have been considered as a major mechanism. Intrapulmonary shunting arises from pulmonary vascular dilatation at the precapillary level or direct arteriovenous communication and has relationship with the characteristic skin findings of spider angioma. However, these results are mainly from Western countries where alcoholic and primary biliary cirrhosis are dominant cuases of cirrhosis. It is uncertain that the same is true in viral hepatitiss associated liver cirrhosis, which is dominant causes of liver cirrhosis in Korea. We investigated the incidences of hypoxemia and orthodeoxia in Korean cirrhotic patients dominantly composed of postnecrotic cirrhosis and the significance of intrapulmonary shunting as the suggested mechanism of hypoxemia, Method: We performed the arterial blood gas analysis separately both at the supine and errect position in 48 stable cirrhotic patients without the evidences of severe complications such as ascites, variceal bleeding, and hepatic coma. According to the results of arterial blood gas analysis, all patients were divided into hypoxemic and normoxemic group. In each group, pulmonary function test and Tc-99m-MAA whole body scan were performed. The shunting fraction was calculated based on the fact that the sum of cerebral and bilateral renal blood flow is 32% of the systemic blood flow. Results: The hypoxemia of $PaO_2$ less than 80 mmHg was observed in 9 patients(18.8%) and Orthodeoxia more than 10 mmHg was observed in 8 patients(16.7%). But there was no patient with significant hypoxemia of $PaO_2$ less than 60 mmHg. $PaO_2$ was significantly decreased in the patients with spider angioma than the pathients without spider angioma and showed no correlation with the serologic type and severities of liver function test findings. Any parameters of pulmonary function test did not demonstrate the difference between normoxemic and hypoxemic group. But hypoxemic group showed significantly increased shunt fraction of $11.4{\pm}4.1%$ than normoxemic group of $4.1{\pm}2.0%$ (p<0.05). Conclusions: Hypoxemia is not infrequently observed complication in liver cirrhosis and intrapulmonary shunting is suggested to p1ay a major ro1e in the development of hypxemia. But there was no great likelihood of clinically significant hypoxemia in our domestic cirrhotic patients predominantly composed of postnecrotic type.

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