• Title/Summary/Keyword: liver disorder

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Differential Diagnosis of Acute Liver Failure in Children: A Systematic Review

  • Berardi, Giuliana;Tuckfield, Lynnia;DelVecchio, Michael T.;Aronoff, Stephen
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.6
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    • pp.501-510
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    • 2020
  • Purpose: To develop a probability-based differential diagnosis for pediatric acute liver failure (PALF) based on age and socioeconomic status of the country of origin. Methods: Comprehensive literature search using PubMed, EMBASE, and SCOPUS databases was performed. Children 0-22 years of age who met PALF registry criteria were included. Articles included >10 children, and could not be a case report, review article, or editorial. No language filter was utilized, but an English abstract was required. Etiology of PALF, age of child, and country of origin was extracted from included articles. Results: 32 full text articles were reviewed in detail; 2,982 children were included. The top diagnosis of PALF in developed countries was acetaminophen toxicity (9.24%; 95% CredI 7.99-10.6), whereas in developing countries it was Hepatitis A (28.9%; 95% CredI 26.3-31.7). In developed countries, the leading diagnosis of PALF in children aged <1 year was metabolic disorder (17.2%; 95% CredI 10.3-25.5), whereas in developing countries it was unspecified infection (39.3%; CredI 27.6-51.8). In developed countries, the leading diagnosis in children aged >1 year was Non-A-B-C Hepatitis (8.18%; CredI 5.28-11.7), whereas in developing countries it was Hepatitis A (32.4%; CredI 28.6-36.3). Conclusion: The leading causes of PALF in children aged 0-22 years differ depending on the age and developmental status of their country of origin, suggesting that these factors must be considered in the evaluation of children with PALF.

A Clinical Report of Traumatic Cervical Stenosis Patient with Half Length Paralysis and Sensory Disorder (편마비와 감각장애를 주소로 하는 외상성 경추관 협착 환자 1례에 대한 임상적 고찰)

  • Ryu Hyung Cheon;Lee Kyung Hwan;Kim Bang Qui;Choi Chang Won;Lee Young Soo;Kim Jong Seok;Kim Hee Chul
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.1
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    • pp.279-284
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    • 2004
  • Excluding an operation remedy about an example of Traumatic Cervical Stenosis patient, by doing pattern identification such as blood stagnation in hospitalization for the early days and such as the stagnation of Oi for the middle days and such as Eum deficiency of liver and kidney for the last. We have done treatment by being based on method of therapy to promote blood flow to remove blood stasis and to promote the normal flow of Oi and to nourish the liver and the kidney. In result, we had remarkable conclusion and considered that we had to treat a patient like that appropriately by distinguishing & making a diagnosis correctly from now on. If we apply clinically by thinking of Oriental Medicine through more example of symptoms, we have considered that it will serve as a momentum that we can sympathize with the excellency of Oriental Medicine. In the future, we have considered that have to be necessary to make more researches and reports upon it.

The Inhibitory Effects of So-yangin Biman-bang on the Obese-Mice Induced by High-Fat Diet (소양인(少陽人) 비만방(肥滿方)이 생쥐의 비만 억제에 미치는 영향)

  • Park, In-Sun;Yoon, Il-Ji
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.2
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    • pp.35-50
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    • 2010
  • Objectives : In order to investigate the effects of So-yangin Biman-bang(here in after referred to BM) on the obese gene and obese inhibitory, C57BL/6 mice were distinctively induced by high fat diet. Methods : C57BL/6 mice were divided into four groups(normal, high fat diet with control, high fat diet with Reductil(here in after referred to RDT), high fat diet with BM extract) and have been fed for 8 weeks. Through observing the process, the weight change of the adipocytes in body and liver, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, glucose, leptin change in the serum, the expression of ${\beta}3AR$ and leptin gene in 3T3-L1 cell and primary adipocyte cell. Results : The following results have been found in this study. 1. Losing weight have significantly been shown. 2. The weight change of the body adipocyte and liver have been decreased but no significance has been found. 3. With close observation on the change of blood, HDL-cholesterol has positively been increased in numbers but the level of glucose, LDL-cholesterol, triglyceride have distinctively been decreased. 4. The manifestation of ${\beta}3AR$ in 3T3-L1 cell and primary adipocyte cell have shown a definite increase in numbers but the manifestation of leptin has shown certain decrease in its amount. Conclusions : As results of this, So-yangin Biman-bang is thought to be effective in metabolic syndrom and lipid metabolism disorder that can possibly be occurred by obesity control and treatment. The clinical research will be needed in order to apply to So-yangin constitution in the future.

A study for diagnosis and pattern identification of Hwa-Byung (화병의 진단 및 변증유형에 관한 연구)

  • Lee, Hui-Young;Park, Jong-Hoon;Whang, Wei-Wan;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.1
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    • pp.1-17
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    • 2005
  • Objective : This empirical research is performed to recognize diagnostic concept, pattern identification, and clinical features of Hwa-byung. In other words, the aims of this research are to examine the differences of the diagnosis between Hwa-Byung and the other psychiatric disorders, and to find out pattern identification, and clinical characteristics of Hwa-Byung for prescriptions of this syndrome. Method : In the experiment, there were participated 30 patients who were met for our criterions according to HBDIS (Hwa-Byung Diagnostic interview Schedule). These patients were diagnosed as Axis1 according to criterions of DSM-IV with administering SCID-I. OMS-prime was utilized for finding out pattern identification of oriental medicine. Symptom Check List-90-Revision(SCL-90-R), Hemilton rating Scale for Depression(HRSD), Heart Rate Variability(HRV), and Digital Infrared Thermographic imaging(D.I.T.I.) were also utilized to discover clinical characteristics of Hwa-Byung Patients. Results : 1. Regarding Sex-ratio, male subjects were 3(10%), and female subjects are 27(90%). The age of subjects ranged from 22 year old to 75 $(51.87{\pm}11.04;\:Mean{\pm}SD)$ 2. In the results of diagnosis on the basis of DSM-IV, the 17(56.67%) patients were MOD (Major Depressive Disorder), the 5(16.67%) patients were USD (Undifferentiated Somatoform Disorder), the 4(13.33%) patients were Dysthymic Disorder, the 3(10%) patients were GAD (Generalized Anxiety Disorder), and the 1(3.33%) was Panic Disorder. Two of the patients who diagnosed as MOD were diagnosed as Panic Disorder too, and one of them was diagnosed as Pain Disorder too. 3. Regarding pattern identification, Hwa-Byung is positively correlated to deficiency of Heart(心). and then to stagnancy of Liver-Gall bladder. Hwa-Byung is correlated deficiency symptom-complex rather than excessiveness symptom-complex. That is also correlated positively to Pathological heat and fire. 4. In SCL90-R, the mean of PSDI was $(75.3{\pm}10.7;\:Mean{\pm}SD)$. The each mean of the other 11 factors was distributed between50-70. 5. The mean of HRSD was $(17.9{\pm}5.6;\:Mean{\pm}SD)$ in the entire subject's group. Then the group of MDD was $20.9{\pm}4.4$ and the group of USD was $12.0{\pm}4.8$ 6. In the results of HRV. the mean of TP is $972.4{\pm}1174(Mean{\pm}SD)$, this is lower than normal range 1000-200. The other factors were within normal range. Then, there were no significant differences between them (p<0.05). 7. The temperatures of each acupoint have significant differences between HNl(印堂) and PC6(內關), between CV17(顫中) and PC6(內關), between HN1(印堂) and CV8(神闕), between CV17(顫中) and CV8(神闕) in comparison with the average of body temperature in the use of D.I.T.I. (p<0.01) 8. In the analysis of correlation between SCL-90-R, HRSD, HRV. and D.I.T.I. there were no significant results. According to results that the correlation was analyzed with only the MDD group as subjects, there was negative correlation between RMSSD of HRV and HRSD, between LF of HRV and PDSIof SCL-90-R, and between LF/HF of HRV and ANX, PSY, and PDSI of SCL-90-R. Conclusion : In the observation of clinical features of 30 cases of Hwa-Byung patients by using diverse structured tests, there could make diverse diagnosis as depressive disorder, anxiety disorder, and Somatoform Disorder. Particularly. MDD was highly distributed. Considering oriental medicine's pattern identification of Hwa-Byung, this syndrome is related strongly to Heart, and there were demonstrated deficiency symptom-complex, and Pathological heat and fire. One of the limits of this study is lack of control subject's group, therefore, in the future study, it requires reexamination through a comparative research with these data to complete this study.

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Syphacia obvelata: A New Hope to Induction of Intestinal Immunological Tolerance in C57BL/6 Mice

  • Taghipour, Niloofar;Mosaffa, Nariman;Rostami-Nejad, Mohammad;Homayoni, Mohamad Mohsen;Mortaz, Esmaeil;Aghdaei, Hamid Asadzadeh;Zali, Mohammad Reza
    • Parasites, Hosts and Diseases
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    • v.55 no.4
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    • pp.439-444
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    • 2017
  • The ability of nematodes to manipulate the immune system of their host towards a Th2 and T regulatory responses has been proposed to suppress the inflammatory response. Clinical trials have proposed a useful effect of helminth infections on improvement of inflammatory disorders. In this study, we investigated the immunomodulatory effect of Syphacia obvelata infection to induce intestinal tolerance in C57BL/6 mice. Mice were infected through the cagemates with self-infected BALB/c mice. Four weeks post-infection, expression levels of $IFN-{\gamma}$, $TNF-{\alpha}$, IL-17, and IL-10 were assessed in the supernatant of mesenteric lymph node (MLN) culture. $Foxp3^+Treg$ were measured in MLN cells by flow cytometry. In the S. obvelata-infected group, the percentage of Tregs ($5.2{\pm}0.4$) was significantly higher than the control ($3.6{\pm}0.5$) (P<0.05). The levels of IL-10 ($55.3{\pm}2.2$ vs $35.2{\pm}3.2$), IL-17 ($52.9{\pm}3.8$ vs $41{\pm}1.8$), $IFN-{\gamma}$ ($44.8{\pm}4.8$ vs $22.3{\pm}2.3$) and $TNF-{\alpha}$ ($71.1{\pm}5.8$ vs $60.1{\pm}3.3$) were significantly increased in infected mice compared to the control group (P<0.05). The above results showed the potential effects of S. obvelata to induce intestinal tolerance. Therefore, it seems that S. obvelata may increase the immunological suppressive function in the intestinal tract.

A Randomized, Double-blind, Placebo-controlled Study to the efficacy and Safety of NMED-01 and NMED-02 in Mild Alcoholic Liver Subjects (NMED-01과 NMED-02의 간기능 개선에 대한 인체 효능 평가)

  • Park, Sangwoug;Kwon, Yongbeom;Kim, Ki Tae;Shin, Seon Mi;Leem, Kang-Hyun;Ko, Heung;Song, MiKyung;Jung, Yoon Chul;Kim, Hocheol;Park, Juyeon
    • The Korea Journal of Herbology
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    • v.28 no.6
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    • pp.31-38
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    • 2013
  • Objectives : The purpose of this study was to determine whether NMED-01 or NMED-02 improves laboratory test results in participants with liver function disorder. Methods : This is a randomized, placebo-controlled trial in which participants, treating physicians and data management staff were blinded to treatment group. The study was conducted at Semyung university oriental medicine hospital in Jecheon where participants with high level of serum ${\gamma}$-GTP (60-350 U/L) were enrolled. The intervention consisted of three times daily ingestion of either two capsules of placebo, NMED-01 (NeuMed. co. ltd., Seoul), or NMED-02 (NeuMed. co. ltd., Seoul) for twelve weeks. To evaluate the efficacy and safety of NMED-01 and NMED-02, we primarily evaluated the degree of decrement of serum ${\gamma}$-GPT level among three groups. Secondarily the decrement of serum ALT, AST, and triglyceride level in each group were also evaluated. Adverse effects were monitored during the twelve weeks treatment. Results : The change of ${\gamma}$-GTP level of NMED-01 group was lower than that of placebo group at the end of 12-week administration ($28.1{\pm}38.7U/L$ vs. $9.3{\pm}27.0U/L$, p=0.046). Other variables including AST, ALT, and triglyceride level were not significantly reduced. The decrement of ${\gamma}$-GPT, AST, ALT, and triglyceride level of NMED-02 group was not significant. There were no significant adverse effects or toxicities during treatment period. Conclusions : Participants receiving NMED-01 had improvement in laboratory test results. Despite a modest sample size, our results suggest that NMED-01 are safe and may be potentially effective in improving liver function. However, NMED-02 have lack of a detectable effect in this study.

A Case of Idiopathic Congenital Neonatal Cholestasis in a Patient with Down Syndrome

  • Huh, Tae-Eon;Do, Hyun Jeong;Park, Ji Sook;Yeom, Jung Sook;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;Park, Chan-Hoo;Woo, Hyang Ok;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.2
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    • pp.117-121
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    • 2012
  • Down syndrome is a rare cause of neonatal cholestasis. Neonatal cholestasis in a patient with Down syndrome is usually associated with severe liver diseases, such as neonatal hemochromatosis, myeloproliferative disorder and intrahepatic bile duct paucity. We experienced a case of idiopathic neonatal cholestasis in a patient with Down syndrome, which resolved spontaneously.

A Case of Rotor's Syndrome (로터 증후군(Rotor's syndrome) 1례)

  • Kim, Sung Soo;Park, Jae Ock;Koh, Eun Suk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.243-247
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    • 2004
  • Rotor's syndrome is a hereditary disorder characterized by predominantly conjugated hyperbilirubinemia with normal hepatic histology. It resembles Dubin-Johnson syndrome but the main differences are no dark brown pigmentation in the hepatic cells and visualization of the gallbladder in oral cholangiography. We experienced a 14 year-old male patient who had icteric sclerae and predominantly conjugated hyperbilirubinemia when he was hospitalized for varicocelectomy. His liver biopsy specimen showed no dark brown pigmentation and any other pathologic abnormalities in the hepatic cells. Hepatobiliary scan shows no evidence of obstructive lesions. His urinary excretion of total coproporphyrin was markedly increased.

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A Study on The Side Effects and Toxicity of Herbal Medicine (한약과 민간약물의 독성 및 부작용에 대한 고찰)

  • Park, Byung-Wook;Hea, Gum-Jeong;Ko, Heung;Lee, Eun
    • The Journal of Internal Korean Medicine
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    • v.23 no.2
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    • pp.222-227
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    • 2002
  • Although there are a few reports concerning the side effects and toxicity of herbal medicines, there has not yet been any report concerning their causes, mechanisms or prevention. We investigated the internal reports concerning the side effects and toxicity of herbal medicines. In the findings, liver disorder (hepatic injury) was found in 7 cases, kidney disorders (nephropathy) were found in 12 cases, heart disorders were found in 4 cases and mineral-caused diseases were found in 2 cases. Besides, we found the major cause of the side effects and toxicity was drug abuse, such as over-dosage and long term medication. So, we hope this report brings more attention to the safety and toxicity of herbal medicines.

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Hepatoprotective and Hypolipidemic Activity of Plantaginis Herba Extracts in Diabetic Model (당뇨성 모델에서 차전초의 간보호 및 지질개선효과)

  • Yoon, Soo-Hong;Ha, Hun
    • Environmental Analysis Health and Toxicology
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    • v.16 no.3
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    • pp.127-131
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    • 2001
  • The antihepatic and hypolipidemic activities and total lipid levels of water extract of Plantaginis Herba, used for respiratory and renal disorder in folk medicine, were evaluated in streptozotocin-induced diabetic rats. Diabetes was induced by a single injection of streptozotocin (50 mg/kg, i.p.). Water extract of Plantaginis Herba recovered enzyme activities such as GOT, GPT, ALP and LDH increased by streptozotocin (STZ) treatment. This crude drug also suppressed the enhanced production of lipid in hyperglycemia. These results strongly suggest that Plantaginis Herba be a promising liver-protective and hypolipidemic agent.

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