• 제목/요약/키워드: bilirubin

검색결과 614건 처리시간 0.034초

근로자 건강진단시 간기능 이상자의 정밀검사항목 개선을 위한 조사연구 (A Baseline Study on the Choice of Optimal Screening Test Items among Workers with Abnormal Liver Function Tests on Workers' Periodic Health Examination)

  • 정해관;임현술;김규회
    • Journal of Preventive Medicine and Public Health
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    • 제27권4호
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    • pp.747-761
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    • 1994
  • Workers' periodic health examination is the main tools used to manage the health problems of most workers in Korea. The most common health problem found in workers' periodic health examination is liver disorder. Liver disorder is also one of the most common health problems in general population and one of the leading causes of mortality in adult population. Regulation proposed by government (No. 207, Ministry of Labor, 1992) defines the criteria for selection of workers with the liver dysfunction for further evaluative examination and the examination items used for diagnosis of the workers with liver dysfunction. This study was designed to evaluate the proficiency of each examination items presently defined in Regulation and propose the optimal examination items for detection of the liver disorders found by workers' periodic health examination. Study subjects are 186 workers with abnormal liver function tests in screening examination of workers' periodic health examination. Questionnaire survey including past history of liver disorder, drinking history, height and weight was done. Physical examination by physician, routine test items defined by Regulation (SGOT, SGPT, $\gamma$-GTP, protein, albumin, total and direct bilirubin, alkaline phosphatase, $\alpha$-feto protein, HBsAg and anti-HBs), anti-HCV antibody test and liver ultrasonography were done. Results are as follows; 1. Result of evaluative examination utilizing only the items defined in Regulation was; There were 75 workers with suspected live. disorder(40.3%), 63 with no liver dysfunction (33.9%), 13 with suspected hepatitis B(7.0%), 10 workers with hepatitis B(5.4%), 10 workers with hepatitis B carrier state(5.4%), 10 with alcoholic liver disorders(5.4%), 5 with fatty liver(2.7%). When alternative diagnostic criteria applying additional examination items (drinking history, body mass index, anti-HCV antibody and ultrasonography) diagnosability of liver disorder was increased. When all four items were included, final results were; 23 workers (17.8%) with hepatitis B (10 carriers, 13 suspects and 10 hepatitis B), 10 (5.4%) with hepatitis C(4 carriers, 5 suspects and 1 hepatitis C), 13(7.0%) with alcoholic liver disorder, 45(24.2%) with fatty liver (40 suspects, 5 fatty liver), 410%) with suspected liver disorders and 44 (23.7%) with normal liver. 2. Of examination items defined by Regulation, only SGOT, SGPT, $\gamma$-GTP and HBsAg were significantly different in abnormal rate and mean value, and all other laboratory findings did not showed significant difference between two groups. Drinking history, body mass index and anti-HCV antibody test which are the items that authors included in this study, also showed significant difference between two groups. Utilization of body mass index (BMI) for abnormal liver function group in diagnosis of fatty liver had high specificity (97.6%) but sensitivity (22.3%) was low. Therefore we suggest that SGOT, SGPT, $\gamma$-GTP, HBsAg, alcohol drinking history, BMI and anti-HCV Ab were useful for diagnosis of liver disorders among worker's periodic health examination.

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Initial clinical outcomes of proton beam radiotherapy for hepatocellular carcinoma

  • Yu, Jeong Il;Yoo, Gyu Sang;Cho, Sungkoo;Jung, Sang Hoon;Han, Youngyih;Park, Seyjoon;Lee, Boram;Kang, Wonseok;Sinn, Dong Hyun;Paik, Yong-Han;Gwak, Geum-Youn;Choi, Moon Seok;Lee, Joon Hyeok;Koh, Kwang Cheol;Paik, Seung Woon;Park, Hee Chul
    • Radiation Oncology Journal
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    • 제36권1호
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    • pp.25-34
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    • 2018
  • Purpose: This study aimed to evaluate the initial outcomes of proton beam therapy (PBT) for hepatocellular carcinoma (HCC) in terms of tumor response and safety. Materials and Methods: HCC patients who were not indicated for standard curative local modalities and who were treated with PBT at Samsung Medical Center from January 2016 to February 2017 were enrolled. Toxicity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Tumor response was evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST). Results: A total of 101 HCC patients treated with PBT were included. Patients were treated with an equivalent dose of $62-92GyE_{10}$. Liver function status was not significantly affected after PBT. Greater than 80% of patients had Child-Pugh class A and albumin-bilirubin (ALBI) grade 1 up to 3-months after PBT. Of 78 patients followed for three months after PBT, infield complete and partial responses were achieved in 54 (69.2%) and 14 (17.9%) patients, respectively. Conclusion: PBT treatment of HCC patients showed a favorable infield complete response rate of 69.2% with acceptable acute toxicity. An additional follow-up study of these patients will be conducted.

Ethylene glycol 중독견의 임상병리학적 소견 (Clinico-pathological findings of experimental ethylene glycol poisoning in dogs)

  • 성은주;이현범
    • 대한수의학회지
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    • 제37권4호
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    • pp.883-897
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    • 1997
  • Present study was undertaken in order to find out the most significant laboratory test for the early diagnosis of ethylene glycol poisoning in dogs. Seven dogs weighing from 5.0kg to 19.3kg were administered orally 6ml or l0ml of ethylene glycol per kilogram of body weight. In addition to clinical observations, blood samples were taken from the jugular vein on 0, 1, 3, 6, 12, 24 and 48 hours or until death after the adminisration and examined for the hematological, blood chemical, venous blood gas and electrolyte changes. Urine samples were simultaneously taken and examined for pH, protein, glucose and calcium oxalate crystals in the sediments. The results were as follows : 1. All dogs showed marked hypothermia in addition to the characteristic signs of ethylene glycol poisoning until death. 2. No significant hematological changes were observable after the administration of ethylene glycol except the secondary dehydration and stress leukogram. 3. Chemical values related to the liver function(serum glutamic pyruvic transaminase, total serum protein, serum albumin, serum total bilirubin) showed no significant changes during the experimental period in all dogs. 4. Chemical values related to the renal function(BUN and creatinine) showed significant(p<0.0l, p<0.001) increase from 24 hours to death in all dogs. 5. All dogs showed significant(p<0.01, p<0.001) decrease in blood pH from 3 hours to death after the ethylene glycol administration. 6. All dogs showed significant(p<0.05, p<0.01, p<0.001) increaes in anion gap from 1 hour to death after the ethylene glycol administration. 7. All dogs showed significant(p<0.05, p<0.01) decrease in urine pH from 1 hour to 6 hours after the administration of ethylene glycol. 8. Characteristic envelope form of calcium oxalate crystals were found in the urinary sediment from 6 hours after the administration of ethylene glycol in all dogs. 9. Histologically calcium oxalate crystals were found in the renal rubles in all dogs. 10. From these results, it may be concluded that the examinations of urinary sediments for the calcium oxalate crystals, blood or urinary pH and blood anion gap are most reliable tests for the early diagnosis of ethylene glycol poisoning in dogs.

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체외순환기 인터루킨-6의 생성과 염증반응간의 상관관계에 관한 연구 (Relationship Between Interleukin-6 Production and Inflammatory Response during Cardiopulmonary Bypass)

  • 박광훈;최석철;한일용;최국렬;최강주;조광현
    • Journal of Chest Surgery
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    • 제33권5호
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    • pp.407-418
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    • 2000
  • Background: With open heart surgery(OHS), it has been recognized that many postoperative complications and postperfusion syndrome are associated with the activations of complements and leulocytes. Recently, some investigators also demonstrated that interlukin-6(IL-6) linked highly with postperfusion syndrome. The puropose of this study was to investigate the sequential changes of the IL-6 and to clarify each IL-6 relationship to the complements(C3, C4) and inflammatory response following cardiopulmonary bypass(CPB). Material and Method: To determine serum levels of IL-6, complements, leukocytes, and biochemistric markers of liver and renal function, blood samples were taken from th radial artery in 30 adult patients undergoing OHS with CPB. Result: Serum IL-6 levels incrased significantly at 10 minutes after CPB-on(CPB-10) in comparison with the control levels and reached the peak at CPB-off(p<0.05). Serum complement levels declined rapidly at CPB-10 and remained at the lower levels during CPB(p<0.01). Sequential changes of IL-6 levels had positive correlations with the changes of total leukocytes and neutrophil fractions(p<0.05), but had negative correlations with lymphocyte fractions(p<0.05). Changes of C3 related postively to monocyte fractions(p<0.05). Postoperative levels of total protein and albumin, decreased significantly in comparison with the control levels(p<0.01), while the postoperative levels of AST(aspartate transaminase) and bilirubin increased (p<0.01). At CPB-off, IL-6 levels had negative correlations with total protein and albumin levels(r=-0.60, -0.47 respectively, p<0.05), whereas C3 levels had positive correlations with albumin levels(r=0.40, p<0.05). IL-6 levels, as well as neutrophil fractions, had positive correlations with aortic clamp time(ACT) and total bypass time(TBT) (IL-6; r=0.82, 0.79 respectively, neutrophil fractions; r=0.50, 0.56 respectively, p<0.05), wheres lymphocyte frations and albumin levels had negative correlations whith ACT and TBT(lymphocyte fractions; r=-0.52, -0.58 respectively, albumin; r=-0.58, -0.55 respectively, p<0.05). Conclusion: These data showed that elevated production of serum IL-6 during CPB may play a pivotal role in systemic inflammatory responses and prologed CPB period may be assosiated with more sever postperfusion syndromes.

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Antitumor effect of Careya arborea against Ehrlich ascites carcinoma with reference to lipid peroxidation and enzymatic and non enzymatic antioxidant system in Swiss albino mice

  • Kumar, R Sambath;Sivakumar, T;Senthil, V;Murthy, N Venkateswara;Balasubramaniam, V;Sabi, R Kanaga;Sundram, R. Shanmuga;Perumal, P;Mazumder, U K;Gupta, M
    • Advances in Traditional Medicine
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    • 제8권2호
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    • pp.154-163
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    • 2008
  • The methanol extract of stem barks of Careya arborea Roxb. (MECA) (Family- Myrtaceae) was evaluated for antitumor activity and antioxidant status against Ehrlich's Ascites Carcinoma (EAC) bearing Swiss albino mice. After 24 h of tumor inoculation the MECA was administered at the doses of 50, 100 and 200 mg/kg body weight/mice/day for 14 days. After the last dose and 18 h fasting mice were sacrificed. The effect of MECA on the growth of transplantable murine tumor, life span of EAC bearing hosts, hematological profiles, serum and liver biochemical parameters were estimated. The MECA showed significant (P < 0.01) decrease in ascites volume, packed cell volume and viable cell count and prolonged the life span of EAC tumor bearing mice. Hematological profiles reverted to more or less normal levels in extract treated mice. The MECA also produced protective effect by decreasing the activity of serum enzymes, bilirubin and increase the protein and uric acid levels. MECA significantly (P < 0.05) decreased the levels of lipid peroxidation, while significantly (P < 0.05) increased the levels of glutathione content, vitamin C, vitamin E, superoxide dismutase and catalase CAT. The results indicate that MECA exhibited significant antitumor and antioxidant activity in EAC bearing mice.

신생아 집중치료실 퇴원아의 청성뇌간반응(ABR) 결과에 미치는 위험인자 및 경과 (Auditory brainstem response (ABR) results in NICU graduates)

  • 최희정;이태호;오기원;김행미
    • Clinical and Experimental Pediatrics
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    • 제49권12호
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    • pp.1301-1307
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    • 2006
  • 목 적 : 신생아기의 청력 소실은 그 빈도가 높으며 조기 발견 및 조기 치료가 예후를 결정하는데 중요하다. 신생아 집중치료실에 입원했던 신생아들은 일반 신생아에 비해 청력 소실의 빈도가 더 높은 것으로 알려지고 있다. 이에 저자들은 신생아 집중치료실에 입원했던 신생아를 대상으로 청력 소실의 발생 빈도와 위험 인자 및 청력 소실의 양상을 조사하기 위해 이 연구를 시행하였다. 방 법 : 2002년 7월부터 2005년 6월까지 3년간 경북대학교병원 신생아 집중치료실에 입원한 환아를 대상으로 ABR 검사를 시행하여 이들의 청력 소실 정도와 이와 관련된 임상 소견을 조사하고 추적 관찰을 시행하였다. 결 과 : 연구 기간 동안 ABR 검사를 받은 환아는 474명으로 총 입원아의 54.0%였고, 검사를 받은 신생아의 13.5%인 64명이 ABR 검사에 이상 소견을 보였다. 이들 64명의 귀 128례의 청력 소실의 양상은 편측 정상이 37례(28.9%)이고 경증, 중등도, 중증 및 초중증 청력 소실이 각각 43례(33.6%), 36례(28.1%), 2례(1.6%) 및 10례(7.8%)로 중증 이상의 청력 소실 빈도는 9.5%였다. 미숙아, 저출생 체중아 및 극소 저출생 체중아, 신생아 가사, 두부 안면 기형 및 amikacin의 15일 이상 사용이 ABR 비정상군에서 유의하게 많았다(P<0.05). 고빌리루빈혈증 환아에서 최고 빌리루빈 수치, 광선치료의 기간과 교환수혈의 시행 여부 모두 ABR 정상군과 비정상군 사이에 유의한 차이를 보이지 않았다. ABR 비정상군 중 15명에서 생후 $8.8{\pm}4.4$개월에 시행한 추적 ABR 검사는 80.0%에서 호전 혹은 정상화되었다. 결 론 : 신생아 집중치료실에 입원했던 신생아는 청력 소실의 위험이 높으므로 이에 대한 체계적이고 효과적인 청력 평가와 관리가 필요하다.

청심연자탕 복용에 따른 생체 징후, 혈액 검사, 기능 검사 결과의 변화 (Changes in Results of Vital Signs, Blood Tests, and Functional Tests after Taking Cheongsimyeonja-tang)

  • 조재현;배고은;서희정;최진용;심소현;한창우;김소연;최준용;박성하;윤영주;이인;권정남;이시우;홍진우
    • 대한한방내과학회지
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    • 제38권6호
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    • pp.971-979
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    • 2017
  • Objectives: The aim of this study was to analyze the effects of Cheongsimyeonja-tang on the human body. Methods: This was a retrospective study, conducted using electronic medical records (EMR). Appropriate clinical cases were identified and databased through EMR. Changes of vital signs, blood tests, and functional tests before and after taking Cheongsimyeonja-tang were determined. Results: There were several significant changes after taking Cheongsimyeonja-tang. Hemoglobin, total blood proteins, and total bilirubin were increased. Eosinophil, aspartate aminotransferase, total cholesterol, and low-density lipoprotein cholesterol were decreased. Conclusions: Cheonseomyeonja-tang had significant effects, including improvement of blood cell count (increase of red blood cells and hemoglobin), improvement of blood lipid level (decrease of total cholesterol and LDL-cholesterol), and blood pressure control (reduction of systolic blood pressure).

원발성 간암의 방사선치료및 온열요법의 병용치료 효과 (Therapeutic Effect of Combined Radiotherapy and Hyperthermia in Primary Hepatocellular Carcinoma)

  • 강기문;최일봉;계철승;최병옥;정수미;김인아;한성태;선희식;정규원;신경섭
    • Radiation Oncology Journal
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    • 제12권2호
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    • pp.191-199
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    • 1994
  • Purpose : This study was undertaken to show the clinical results of combined radiotherapy and hyperthermia in primary hepatoma Materials and Methods : Between December 1989 and March 1993, 50 patients with hepatomas were treated by combined radiotherapy and hyperthermia. Among them, we analyzed retrospectively 33 patients who received the complete course of treatment. The ages of the patients ranged from 36 to 75(mean age: 55.5 years). Twenty-six patients ($78.8\%$) were men, and 7 ($21.2\%$ were women. According to Child's classification, nine patients ($27.3{\%}$) were A group, 9 ($27.3\%$) were B group, 15 ($45.4\%$) were C group. Radiation therapy was done by a 6 MV and 15 MV linear accelerator. Patients were treated with daily fractions of 150-180 cCy to doses of 2550 cGy -4950 cGy (median : 3000 cGy). Local hyperthermia was done by 8 MHZ RF capacitive heating device (Cancermia. Green Cross Co., Korea), 50-60 min/session, 1-2 sessions/wk, and 8.5 sessions (median number)/patient. We analyzed the prognostic factors including age, sex, tumor type, Child's classification, $\alpha$-fetoprotein, liver cirrhosis, ascites, portal vein invasion, esophageal varix, number of hyperthermia, chemotherapy, total bilirubin level, Karnofsky perfomance status. Results : The overall 1-year survival was $24.2\%$, with a mean survival of 10months. Of 33 patients, tumor regression (PR+MR) was seen in $30.4\%$, no response was seen in $52.2\%,\;17.4\%$ patient was progressed. In patients who had tumor regression, the overall 1-year survival was $42.1\%$ with a mean survival of 14 months. Factors influencing the survival were sex (p=0.05), tumor type (p=0.0248), Child's classification (p=0.0001), liver cirrhosis (p=0.0108), ascites (p=0.0009), and Karnofsky perfomance status (p=0.0028). Complications developed in 28 patients, including 18 hot pain,5 fat necrosis, 3 transient fever, 2 nausea and vomiting. Conclusion : In this study, the results suggests that combined radiotherauy and hyperthermia may improve the survival rate of hepatoma.

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Acute and 28-Day Subacute Toxicity Studies of Hexane Extracts of the Roots of Lithospermum erythrorhizon in Sprague-Dawley Rats

  • Han, Chung-Tack;Kim, Myoung-Jun;Moon, Seol-Hee;Jeon, Yu-Rim;Hwang, Jae-Sik;Nam, Chunja;Park, Chong-Woo;Lee, Sun-Ho;Na, Jae-Bum;Park, Chan-Sung;Park, Hee-Won;Lee, Jung-Min;Jang, Ho-Song;Park, Sun-Hee;Han, Kyoung-Goo;Choi, Young Whan;Lee, Hye-Yeong;Kang, Jong-Koo
    • Toxicological Research
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    • 제31권4호
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    • pp.403-414
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    • 2015
  • Lithospermum erythrorhizon has long been used as a traditional oriental medicine. In this study, the acute and 28-day subacute oral dose toxicity studies of hexane extracts of the roots of L. erythrorhizon (LEH) were performed in Sprague-Dawley rats. In the acute toxicity study, LEH was administered once orally to 5 male and 5 female rats at dose levels of 500, 1,000, and 2,000 mg/kg. Mortality, clinical signs, and body weight changes were monitored for 14 days. Salivation, soft stool, soiled perineal region, compound-colored stool, chromaturia and a decrease in body weight were observed in the extract-treated groups, and no deaths occurred during the study. Therefore, the approximate lethal dose (ALD) of LEH in male and female rats was higher than 2,000 mg/kg. In the subacute toxicity study, LEH was administered orally to male and female rats for 28 days at dose levels of 25, 100, and 400 mg/kg/day. There was no LEH-related toxic effect in the body weight, food consumption, ophthalmology, hematology, clinical chemistry and organ weights. Compound-colored (black) stool, chromaturia and increased protein, ketone bodies, bilirubin and occult blood in urine were observed in the male and female rats treated with the test substance. In addition, the necropsy revealed dark red discoloration of the kidneys, and the histopathological examination showed presence of red brown pigment or increased hyaline droplets in the renal tubules of the renal cortex. However, there were no test substance-related toxic effects in the hematology and clinical chemistry, and no morphological changes were observed in the histopathological examination of the kidneys. Therefore, it was determined that there was no significant toxicity because the changes observed were caused by the intrinsic color of the test substance. These results suggest that the no-observed-adverse-effect Level (NOAEL) of LEH is greater than 400 mg/kg/day in both sexes.

흉수가 있는 환아에서 저알부민혈증의 정도에 따른 임상 양상의 차이 (Difference of Clinical Features according to Hypoalbuminemia in the Children with Pleural Effusion)

  • 성민정;박희주
    • Clinical and Experimental Pediatrics
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    • 제48권5호
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    • pp.523-526
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    • 2005
  • 목 적 : 흉수가 있는 환아에서 저알부민혈증의 중등도에 따른 임상 경과의 차이점을 알아보고자 하였다. 방 법 : 1999년 8월부터 2004년 8월까지 부산대학교병원에 입원 당시 흉수가 있었던 환아 96명 중 감염이 원인 질환인 환아 79명을 혈청 알부민 수치에 따라 두 군으로 나누었다(1군 : ${\leq}2.5g/dL$, 2군 : >2.5 g/dL). 각 환자의 연령, 성별, 혈청 알부민 수치를 포함한 기본 혈액 검사, 흉부 방사선 촬영 결과와 각 군에서 환아의 치료 방법 및 예후를 의무 기록을 바탕으로 후향적으로 조사하였다. 결 과 : 79명 중 남아 48명, 여아 31명이었고, 평균 나이는 3.9세 이었다. 각 군에서 기본 혈액 검사는 차이가 없었고, 원인이 되었던 질환은 폐렴 58례, 농흉 12례, 폐 결핵 8례, 심낭염과 폐렴이 동반된 환아는 1례이었다. 각 군별로 입원 기간은 1군이 더 긴 것으로 나왔고, 항생제나 항결핵제 사용만으로 회복된 환아는 1군에서 4례, 2군에서 26례로 각 군별 환자 비율에 유의한 차이를 나타냈다(P=0.004). 항생제 사용하면서 흉관 삽입을 한 경우는 1군에서 14례, 2군에서 26례로 각 군별 환자 비율에 차이가 없었다. 그리고 인공 호흡기 치료가 필요하였던 경우가 1군에서 8례, 2군에서 1례로 분포되어 있었고, 통계학적으로 유의한 차이를 보였다(P=0.000). 결 론 : Starling 법칙에 따라 모세혈관의 정수압의 상승과 삼투압의 감소가 흉수를 일으킨다고 알려져 있지만 뚜렷한 체액의 저류 없이 저알부민혈증을 가진 경우도 드물게 흉수를 일으킬 수 있다. 그리고 혈청 알부민 수치가 낮을수록 인공 호흡기 치료를 하거나 사망하는 경우와 같은 치명적인 결과를 초래할 가능성이 높다.