• Pediatric Infection and Vaccine
• /
• v.4 no.1
• /
• pp.167-173
• /
• 1997

Acute infectious mononucleosis, caused by Epstein-Barr virus(EBV), is a self limited lymphoproliferative illness that is common in adolescents and young adults. It shows many complications in multiple organ systems, but the hepatobiliary and the respiratory complication is uncommon. We report a case with thickened gallbladder wall and pneumonia as complications of acute infectious mononucleosis in a child. Also the related literature were reviewed. A 4 year old boy presented with a history of high fever, cough, and abdominal distension for 20days. Physical Examination revealed audible crackles in whole lung field and gross hepatomegaly. Chest X-ray showed pneumonia and liver function tests were abnormal. Ultrasonography and computed tomography revealed a thickened gallbladder wall and hepatosplenomegaly. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serologic tests. The patients's fever subsided 6 weeks later and pneumonia was recovered around this time. Liver function tests returned near normal 2 months later and ultrasonography of gallbladder was normal at this time.

• Journal of Preventive Medicine and Public Health
• /
• v.30 no.1 s.56
• /
• pp.103-128
• /
• 1997

The object of this study is to evaluate the possibility of chemical-induced liver disorder among workers exposed to various chemicals and to classify the the liver function abnormalities by causes and to analyse the risk factors for each liver disorders. A cross-sectional study including questionnaire survey, physical examination, laboratory tests and ultrasonography of liver was conducted on 1,126 workers, 459 workers in a coal chemical plant(company A) and 667 workers in an insulation material manufacturing factory(company B). An industrial hygienist reviewed the chemicals used in both companies and evaluated the work environments to classify the workers by chemical exposure semiquantitatively. The results are as follows: 1. Of 459 workers in company A, 83 workers(18.1%) are classified as nonexposed, group 163(35,5%) as short-term exposure group, 155(33.8%) as intermediately exposed group and 58(12.6%) as long-term exposed group bared on the mean daily exposure to hepatotoxic chemicals evaluated by an industrial hygienist. Of 667 workers in company B, 484(72.6%) workers were classified as nonexposed and 183(35.5%) as exposed group. 2. Workers with SGOT level higher than 40 IU/l were (10.0%) in company A and 77(11.5%) in company 3, and those with SGPT level higher than 35 IU/l were 118(25.7%) in company A and 198(29.7%) in company B. The differences were not significant between companies and between exposure groups(p>0.05). Workers with $\gamma-GT$ level higher than 62 IU/l were 29(6.3%) in company A and 77(11.5%) in company B (p<0.01). The difference between exposure groups was not significant(p>0.05) within companies. Workers with liver function abnormalities(defined as SGOT higher than 40 IU/l or SGPT higher than 35 IU/l) were 338(30.0%) among 1,126 workers. Of 338 workers with live. function abnormalities 139(12.3%) had fatty liver by ultrasonography, 79(7.0%) had alcoholic liver(defined as workers with liver function abnormalities with weekly alcohol consumption greater than 280 g for more than 5 years), 54(4.8%) had hepatitis B, 12(1.1%) had hepatitis C and the other 114(33.7%) was not otherwise classified. Prevalences of alcoholic liver and fatty liver were significantly lower in company A(prevalence ratio 0.24 for alcoholic liver, p<0.001, prevalence ratio 0.76 for fatty liver, p<0.05) but prevalences of liver disorders between exposure groups within companies were not significant(p>0.05). 3. Summary prevalence ratios(SPR) of live. function abnormalities, fatty live. and other liver disorders, adjusted by age and company were not significantly higher in exposed group in any chemicals(p>0.05) but in some chemicals, SPRs were significantly lower. 4. On simple analysis of risk factors for liver function abnormalities, prevalence odds ratio(POR) of those with age between 30 and 39 was 1.54(p<0.01) and those with age ever 40 was 1.51(p<0.01). POR of those with histories of liver disorders and general anesthesia was 1.77(p<0.001) and 4.02 for those with overweight and 6.23 for those with obesity, defined by body mass index(p<0.001). 5. On logistic regression analysis, risk factors of liver function abnormality were fatty liver(POR 2.92 for grade 1, 12.15 for grade 2), presence of hepatitis B surface antigen(POR 3.62) and obesity(POR 5.38 for overweight and 16.52 for obesity). Presence of hepatitis B surface antigen(POR 0.18) was the only preventive facto. of fatty live. Company(POR 0.30) and obesity(POR 2.49 for overweight, 4.52 for obesity) were related to the alcoholic live. Obesity(POR 2.94 for overweight) was the only significant risk factor of hepatitis B and there was no significant risk factor for liver function abnormality not otherwise classified. It is concluded that the evidence of liver disorder related with chemical exposure is not evident in these factories. It is also postulated that fatty liver and alcoholic liver is most common causes of liver function abnormalities among workers and effort for weight control and improvement of life style should be done.

• The Korean Journal of Nuclear Medicine
• /
• v.24 no.1
• /
• pp.119-123
• /
• 1990

Unexpected renal abnormality can be detected on bone scan using Tc-99m-MDP. The purpose of the study is to evaluate the diagnostic significance of diffusely increased bliateral renal uptake on bone scarf. 1,500 boor scan were reviewed and 43 scans which showed diffusely increased bliateral renal uptake were selected for analysis. Laboratory findings for renal and liver function tests including routine urinalysis were reviewed in 43 patients. 26 of 43 case showed abnormality in urinalysis and renal function stud 20 of 43 cases showed abnormal liver function study and 3 of these cases were diagnosed as hepatorenal syndrome later. 13 of those 20 cases had liver cirrhosis with or without hepatoma. 12 of 43 cases showed abnormality both in renal and liver function studies. 2 of 43 cases showed diffusely increased bilateral renal uptake after chemotherapy for cancer but not on previous scans before chemotherapy. 2 of 43 cases showed hypercalcemia and 8 of 43 cases had multifocal bone uptake due to metastasis or benign bone lesion. but the latter showed no hypercalcemia at all. There was no significant correlatrion between increased renal uptake and MDP uptake in soft tissue other than kidneys. This study raised the possibility that the impaired liver and/or renal function may result in diffuse increase of bliateral renal uptake of MDP of unknown mechaninsm. It seems to need further study on this correlation.

• The Korean Journal of Nuclear Medicine
• /
• v.4 no.2
• /
• pp.41-53
• /
• 1970

Although the radioisotope liver scan has primarily been of use in the detection of the intra-hepatic space occupying lesions, there has been an increasing awareness of its use in evaluation of liver function. In this study, the degree of hepatomegaly, changes in shape and mottling radiodensity on each lobe and splenic visualization in the liver scans done with colloidal radiogold were numerically expressed as scores under the arbitrary standard in 210 patients with liver cirrhosis. The clinical value of this scoring system was studied with special regards to the correlation between the radiogold hepatic uptake half time and conventional liver function tests. Following were the results; 1) The normal scan appeared in 6.7% of 210 patients with liver cirrhosis. 2) The colloidal radiogold hepatic uptake half time was abnormally and progressively prolonged in parallel to severity of hepatocellular dysfunction. The mean hepatic uptake half time in cirrhosis showing normal scan was $2.76{\pm}0.73$ minutes. 3) The scoring system was well correlated with the serum albumin and globulin levels, A/G ratio and BSP retention. There was some correlative tendency in alkaline phosphatase activity. 4) There was no correlation with the thymol turbidity test, cholesterol levels, transaminase activities and bilirubin levels. 5) The spleen was visualized in 38.6% of total patients with liver cirrhosis. Excluding normal scans in liver cirrhosis, the spleen was visualized in 41.3%. 6) The scoring system appears to confirm the clinical diagnosis and to give a reliable estimate of the degree of hepatocellular dysfunction in patients with liver cirrhosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.27 no.4
• /
• pp.215-223
• /
• 2024

Purpose: Patients who receive frequent blood transfusions are at an elevated risk of developing hepatic fibrosis due to iron overload in the liver. In this study, we evaluated the effectiveness of transient elastography (TE) (FibroScan^®) for assessing liver fibrosis in patients with pediatric cancer. Methods: We enrolled 106 consecutive cases of acute leukemia in individuals under 21 years of age. The participants were followed for 2 years. Based on their serum ferritin (SF) levels, the patients were divided into two groups: group 1 (SF≥300 ng/mL) and group 2 (SF<300 ng/mL). A liver FibroScan^® was performed, and a p-value of less than 0.05 was considered statistically significant. Results: Among the various parameters in the liver function test (LFT), alkaline phosphatase was significantly higher in a subgroup of patients aged 5-8 years in group 2 compared to those in group 1. The indices of liver fibrosis determined by TE, including the FibroScan score, controlled attenuation parameter score, steatosis percentage, and meta-analysis of histological data in viral hepatitis score, as well as indirect serum markers of liver fibrosis such as the aminotransferase (AST)/alanine aminotransferase (ALT) ratio, Fibrosis 4 score, and AST to platelet ratio index, did not differ significantly between the two groups. The association between the TE results and LFT parameters was only significant for ALT. Conclusion: Transfusion-associated iron overload does not have a significant correlation with severe liver fibrosis. FibroScan^® is not a sensitive tool for detecting early stages of fibrosis in survivors of pediatric leukemia.

• Journal of Society of Preventive Korean Medicine
• /
• v.11 no.2
• /
• pp.23-39
• /
• 2007

Objectives : The aim of this study was to evaluate effects of herbal medicine and other associated factors for abnormal liver function tests(especially total bilirubin, AST, ALT, and ${\gamma}GT$) levels in outpatients at an oriental medical clinic. Methods : A cross-sectional study based on clinical records was conducted on 1,871 patients at one Oriental medical clinic in Seoul, Korea. 504 patients received a liver function tests for screening and 497 patients ranging from the age of 4 to 74 were chosen for the study. Patients with basal liver disease or DM were excluded during the screening process. Patients were classified into case(abnormal) and control(normal) groups by normal liver function test references. Results and Conclusions : In this study, 33.0% of the patients were females, and 67.0% were males. The mean age was $34.7{\pm}11.9$ years old. The mean total protein value was $6.78{\pm}0.66g/dL$(male $6.79{\pm}0.61$, female $6.76{\pm}0.76$), albumin $3.89{\pm}0.50g/dL$(male $3.94{\pm}0.47$, female $3.81{\pm}0.54$), total bilirubin $0.51{\pm}0.35mg/dL$(male $0.54{\pm}0.39$, female $0.45{\pm}0.23$), AST $23.31{\pm}18.22U/L$(male $26.37{\pm}20.73$, female $17.09{\pm}8.72$), ALT $33.49{\pm}36.36U/L$(male $40.56{\pm}41.77$, female $19.13{\pm}12.64$), LDH $258.07{\pm}74.84mg/dL$(male $263.68{\pm}73.77$, female $246.70{\pm}75.92$), and ${\gamma}GT$ $39.64{\pm}59.16U/L$(male $50.15{\pm}69.43$, female $17.83{\pm}8.36$). The percentage of abnormal total bilirubin levels(>1.0) in these patients was 2.6%, abnormal AST levels(>39m, >29f) 8.5%, ALT levels(>47m, >32f) 18.8%, and ${\gamma}GT$ (>50m, >40f) 19.9%.

• Journal of radiological science and technology
• /
• v.16 no.2
• /
• pp.87-94
• /
• 1993

In order to investigate radiation effects on the liver, functional changes of liver were analyzed after irradiation. Doses of 10 Gy, 15 Gy and 20 Gy were exposed partially to the liver of male rats(Sprague-Dawley) with X-ray(4MV linear accelerator) at room temperature. On 1, 2, 4 and 8 weeks after irradiation, liver tissues and sera of the animals were compared with those of unirradiated animal by liver function tests. Enzyme activities in sera such as alanine aminotransferase, aspartate aminotransferase, malondialdehyde. The content of malondialdehyde in the activities of many enzymes including alanine aminotransferase, aspartate aminotransferase in sera were increased slightly with increasing exposure dose in all experiments and the activities of these enzymes increased markedly in 20 Gy irradiated groups. From these above results, functional changes of the liver were induced in all irradiated groups. Damaged liver was recovered along with time collapse after irradiation to the doses of 10 Gy and 15 Gy while no recovery was deteced within 8 weeks after irradiation to 20 Gy. These results suggest that careful attention must be paid to liver not to be included in exposure field in radiation therapy.

• The Korean Journal of Nuclear Medicine
• /
• v.16 no.2
• /
• pp.71-80
• /
• 1982

In the present communication, the results will be reported on a clinical study of how well scintigraphic visualization of the hepatobiliary elements and several commonly used clinical liver function tests correlate each other in various diseases oft hepatobiliary system. The demonstrability of the biliary tract, gallbladder (GB) and duodenum was rather closely paralleled to serum bilirubin level and less closely to alkaline phosphatase and rather poorly to SGOT and SGPT. The biliary tree could not be visualized scintigraphically when bilirubin exceeded 10.5mg/dl. The usefulness of Tc-99m EHIDA [N-(2,6-diethylacetanilido) iminodiacetic acid, made by Amersham, England] hepatobiliary scintigraphy (Tc EHIDA HBS) in settling diagnostic controversy and ambiguity raised by oral cholecystography, intravenous cholangiography and ultrasonography in many hepatobiliary diseases is well known. The purpose of this investigation was to semiquantitatively evaluate the scintigraphic demonstrability of the hepatobiliary tract, GB and duodenum following intravenous injection of Tc-99m EHIDA in normal subjects and in patients with a disturbed liver function from various hepatobiliary diseases. The hepatobiliary scintigraphy was performed in 10 normal subjects and 39 patients with various hepatobiliary diseases (Table 1) at the Dept. of Radiology, St. Mary's Hospital Catholic Medical College, Seoul, Korea during 2 years period from September 1979. Scintigraphic examination was started at end of 3 minutes after intravenous injection of Tc-99m EHIDA in the amount of $50{\mu}Ci/kg$ and was continued until after 30 minutes at 5 minutes interval. The imaging was usually terminated when the tracer could be seen in the duodenum. Late scintigrams were obatained at 1 1/2, 3, 4 and 6 hours when reeded. Scintigrams were analyzed in terms of promptness and clarity of visualization of the biliary tree, GB and duodenum and demonstrability of these anatomical landmarks was correlated with the values of liver function tests. The demonstrability of the common hepatic duct, common bile duct, GB and duodenum was closely paralleled to the level of serum bilirubin when it is less than 10.5 mg/dl as shown in figure 1. However when the bilirubin exceeded 10.5 mg/dl the time of visualization between protracted reaching a flat curve or plateau around 10.5 mg/dl. The biliary tract could not be visualized when the bilirubin was higher than 10.5 mg/dl. The correlability between scintigraphic demonstration and serum alkaline phosphatase was less strong and between scintigraphic demonstration and SGOT and SGPT was rather poor. The present clinical study confirmed the usefulness and limitation of Tc-99m EHIDA hepatobiliary scintigraphy in visulizing and diagnosing the biliary system and duodenum when radiogrpahy and ultrasonography failed to provide useful informations. Scintigraphy was very helpful in the diagnosis of neonatal hepatitis, biliary atresia, cholecystitis and extrahepatic biliary obstruction. The hepatobiliary system and duodenum were visualized when serum bilirubin level was less than 10.5 mg/dl, SGOT 135 units, SGPT 114 units and alkaline phosphatase 52.2 KAU.

• The Korean Journal of Nuclear Medicine
• /
• v.3 no.1
• /
• pp.1-12
• /
• 1969

Liver functions in diffuse parenchymal liver disease such as cirrhosis of the liver depend largely on the effective hepatic blood flow rather than on the individual cell functions. Clinical methods of measuring the hepatic blood flow were developed recently by the application of colloidal disappearance rate. In order to correlate the radiogold disappearance rate to conventional biochemical liver function tests, 21 normal subjects and 80 cases of cirrhosis of the liver were studied with both methods. The results are summarized as following: 1. The validity of external counting method to measure the blood disappearance rate of colloidal radiogold was confirmed by in vitro counting of the serial blood samples. 2. The blood disappearance rate of collidal radiogold was essentially the same. as the liver uptake rate of colloidal radiogold in normal and cirrhotic subjects with various degrees of functional disturbance. And it seemed there was no serious extrahepatic removal of the colloidal radiogold. 3. The disappearance rate of colloidal radiogold was not significantly changed by the posture change, but was enhanced by ingestion of 500 ml of water. 4. The disappearance rate of colloidal radiogold was not influenced by single dose of Telepaque, while BSP retention was increased after Telepaque. 5. The mean disappearance half time of colloidal radiogold in normal subjects was $2.49{\pm}0.391$(S.D.) minutes. The mean normal disappearance rate constant (K value) was $0.285{\pm}0.0428$(S.D.)/minute. 6. The colloidal radiogold disappearance half time was abnormally prolonged (over 3.2 min.) in $87.7{\pm}3.68$(S.D.) % of cirrhotic subjects. 7. In patients of liver cirrhosis the blood disappearance rate of colloidal radiogold correlated well to serum albumin and globulin levels and BSP retention which were considered to reflect functions of hepatic parenchymal cells. There was, however, no correlation between colloidal disappearance rate and thymol turbidity test, serum glutamic pyruvic transaminase, and serm alkaline phosphatase activities. The latters were considered to be associated with the activity of liver disease.

• Research in Community and Public Health Nursing
• /
• v.19 no.2
• /
• pp.234-246
• /
• 2008

Purpose: This study was performed in order to examine the effects of an smoking cessation counselling program for smoking cessation success. Method: Among a total of 468 persons who had ceased from smoking for 6-months and had visited the smoking cessation clinic of a public health center from January 2nd to December 31th in 2006, 61 in all who had a negative reaction in the urine nicotine check were selected for this study. Collected data were expiratory CO concentration, BMI, blood pressure, liver function, and lipid metabolism. These data were analyzed by descriptive statistics, repeated measured ANOVA and paired t-test with the SPSS/PC(Version 12.0) program. Result: There were significant changes in expiratory CO concentration, SBP, DBP, AST, ALT, and TG, but not in BMI, $\gamma$-GTP, TC, HDL-C, and LDL-C. Conclusion: This study showed that smoking cessation through a smoking cessation counselling program has partially positive effects for smoking cessation success. The results of this study show that the smoking cessation counselling program at the smoking cessation clinic of a public health center should be continued for smoking cessation success.