• Title/Summary/Keyword: liver disorder

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Cerebrovascular Events in Pediatric Inflammatory Bowel Disease: A Review of Published Cases

  • Rohani, Pejman;Taraghikhah, Nazanin;Nasehi, Mohammad Mehdi;Alimadadi, Hosein;Aghdaei, Hamid Assadzadeh
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.3
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    • pp.180-193
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    • 2022
  • Pediatric inflammatory bowel disease (PIBD) is a multisystem disorder characterized by intestinal and extraintestinal manifestations and complications. Cerebrovascular events (CVE) are rare extraintestinal complications in patients with PIBD. Statistics show that 3.3% patients with PIBD and 1.3-6.4% adult patients with inflammatory bowel disease (IBD) experience CVE during the course of the disease. Therefore, this study aimed to review the records of children with IBD who developed CVE during the course of the disease. We retrospectively reviewed 62 cases of PIBD complicated by CVE. The mean patient age at the time of thrombotic events was 12.48±4.13 years. The incidence of ulcerative colitis was significantly higher than that of Crohn's disease (43 [70.5%] vs. 13 [21.3%] patients). Most patients (87.93%) were in the active phase of IBD at the time of CVE. The mean time interval between the onset of IBD and CVE was 20.84 weeks. Overall, 11 (26.83%) patients showed neurological symptoms of CVE at disease onset. The most frequent symptom on admission was persistent and severe headaches (67.85%). The most common site of cerebral venous thrombosis was the transverse sinuses (n=23, 53.48%). The right middle cerebral artery (n=3, 33.34%) was the predominant site of cerebral arterial infarction. Overall, 41 (69.49%) patients who were mostly administered unfractionated heparin or low-molecular-weight heparin (56.09%) recovered completely. Patients with IBD are at a risk of thromboembolism. CVE may be the most common type of thromboembolism. Based on these findings, the most common risk factor for CVE is IBD flares. In patients with CVE, anticoagulant therapy with heparin, followed by warfarin, is necessary.

Posttransplantation lymphoproliferative disorder after pediatric solid organ transplantation: experiences of 20 years in a single center

  • Jeong, Hyung Joo;Ahn, Yo Han;Park, Eujin;Choi, Youngrok;Yi, Nam-Joon;Ko, Jae Sung;Min, Sang Il;Ha, Jong Won;Ha, Il-Soo;Cheong, Hae Il;Kang, Hee Gyung
    • Clinical and Experimental Pediatrics
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    • v.60 no.3
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    • pp.86-93
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    • 2017
  • Purpose: To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children. Methods: We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital. Results: Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed as having PTLD over the last 2 decades (4.8% for LT and 2.9% for KT). PTLD usually presented with fever or gastrointestinal symptoms in a median period of 7 months after SOT. Eight cases had malignant lesions, and all the patients except one had evidence of Epstein-Barr virus (EBV) involvement, assessed by using in situ hybridization of tumor tissue or EBV viral load quantitation of blood. Remission was achieved in all patients with reduction of immunosuppression and/or rituximab therapy or chemotherapy, although 1 patient had allograft kidney loss and another died from complications of chemotherapy. The first case of PTLD was encountered after the introduction of tacrolimus for pediatric SOT in 2003. The recent increase in PTLD incidence in KT coincided with modification of clinical practice since 2012 to increase the tacrolimus trough level. Conclusion: While the outcome was favorable in that all patients achieved complete remission, some patients still had allograft loss or mortality. To prevent PTLD and improve its outcome, monitoring for EBV infection is essential, which would lead to appropriate modification of immunosuppression and enhanced surveillance for PTLD.

The Effect of Garlic and Medicinal Plants Extracts on the Liver Function and Lipid Metabolism of Rats Administered with Alcohol (마늘과 한약재 추출물의 혼합급이가 알코올 투여에 의한 간기능 및 지질대사에 미치는 영향)

  • Lee, Soo-Jung;Kang, Min-Jung;Shin, Jung-Hye;Kim, Jeong-Gyun;Kang, Shin-Kwon;Sung, Nak-Ju
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.5
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    • pp.561-568
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    • 2009
  • To investigate the effects of garlic and medicinal plants extracts (GP) on liver function and lipid metabolism of rat administered with ethanol chronically, Sprague-Dawly male rats were fed with a basial diet (Normal), a basial diet plus ethanol (Control, 10 mL of 20% ethanol/kg b.w/day), a control diet plus 0.5% garlic and 1.0% medicinal plants extracts (GP-I), and a control diet plus 1.0% garlic and medicinal plants extracts (GP-II) for 4 weeks. Blood glucose in GP group was significantly decreased, but not significantly different between GP-I and GP-II group. Albumin content of serum was significantly increased in GP groups, while total lipid, cholesterol and triglyceride of serum were significantly decreased in GP group. Total cholesterol and triglyceride were not significantly different between GP-I and GP-II group. LDL-cholesterol in blood was decreased to 58% in GP-I group and 73% in GP-II group compared to the control group, it's contents were the lowest amounts among the normal, control and experimented groups. Lipid levels in liver of rat administered with alcohol were decreased in GP group and significantly different in GP-II group. GOT and r-GTP activities were significantly higher in control than normal group, while GPT and ALP activities were not significant in groups administered with alcohol. Activities of GOT, GPT and r-GTP were significantly lower in GP group than control group, while ALP activity was not significant in all groups. TBARS contents were not significant in serum, but it's contents in liver were significantly decreased in GP groups than control group. DPPH radical scavenging ability in serum and liver was significantly increased in GP groups. These results indicate that garlic and medicinal plants extracts were effective in improving and protecting liver disorder induced from long-term alcohol consumption.

Regulation of ANKRD9 expression by lipid metabolic perturbations

  • Wang, Xiaofei;Newkirk, Robert F.;Carre, Wilfrid;Ghose, Purnima;Igobudia, Barry;Townsel, James G.;Cogburn, Larry A.
    • BMB Reports
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    • v.42 no.9
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    • pp.568-573
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    • 2009
  • Fatty acid oxidation (FAO) defects cause abnormal lipid accumulation in various tissues, which provides an opportunity to uncover novel genes that are involved in lipid metabolism. During a gene expression study in the riboflavin deficient induced FAO disorder in the chicken, we discovered the dramatic increase in mRNA levels of an uncharacterized gene, ANKRD9. No functions have been ascribed to ANKRD9 and its orthologs, although their sequences are well conserved among vertebrates. To provide insight into the function of ANKRD9, the expression of ANKRD9 mRNA in lipidperturbed paradigms was examined. The hepatic mRNA level of ANKRD9 was repressed by thyroid hormone ($T_3$) and fasting, elevated by re-feeding upon fasting. However, ANKRD9 mRNA level is reduced in response to apoptosis. Transient transfection assay with green fluorescent protein tagged- ANKRD9 showed that this protein is localized within the cytoplasm. These findings point to the possibility that ANKRD9 is involved in intracellular lipid accumulation.

A Clinical Study on 4 Cases of Tremor Patients with Acupuncture Treatment (침(針)과 한약(韓藥) 치료(治療)를 통한 진전 환자 4례(例)에 대한 증례보고)

  • Shin, Hyun-Kwon;Kong, Hyun-Woo;Park, Se-Jin;Seo, Joo-Hui;Kim, Joo-Won
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.2
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    • pp.267-276
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    • 2005
  • Tremor is a rhythmic, involuntary muscular contraction characterized by oscillations(to-and-fro movements) of a part of the body. The most common of all involuntary movements, tremor can affect various body parts such as the hands, head, facial structures, vocal cords, trunk, and legs; most tremors, however, occur in the hands. Tremor often accompanies neurological disorders associated with aging. Although the disorder is not life-threatening, it can be responsible for functional disability and social embarrassment. The clinical study was carried out the 4 patients with tremor who were treated in Dong Seo Medical Center from 1 January 2005 to 31 August. The results were summarized as follows. Tremor has relation to liver according to Jangbu theory. So we performed acupuncture treatment(Ganseonggyeok) and Herbal medication on tremor. After our treatments, tremor and some other symptoms were improved.

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Randomized Clinical Controlled Trials of a Herb Remedies in Korea - Systematic Review (한약을 이용한 한국에서의 무작위 임상시험 개괄적 검토)

  • Oh, Rai-Young;Seol, In-Chan;Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.31 no.4
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    • pp.1-8
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    • 2010
  • Objective: The study aimed to review all randomized controlled clinical trials (RCTs) performed in Korea with herbal medicine, to produce further useful information for herbal-drug development. Methods: All papers reporting RCT with herbal drugs were collected via public database of Korea Science and Technology Integration Services, and various Oriental medicine journals. Then, the clinical question, herbal medicine, result, RCT design, and its conductor were analyzed. Results: A total of 20 RCTs were finally selected, and most of them were performed after 2003. The main subjects of RCT were related to heart and blood circulation, dermatitis, respiration disorder, Sasang constitution, or psychiatric disorders. Eight RCTs were done with a single herb while 12 RCTs were with multiple herbal formulae. In particular, three RCTs for atopic dermatitis with three formulae showed positive results. The quality of RCT was considered as better than average. Conclusions: This study revealed the current status of RCT using herbal drugs. This result would provide helpful information for research and drug development using traditional herbal medicine.

Case Report of Parkinson's Disease Diagnosed as Deficiency of Qi and Blood(氣血兩虛) (기혈양허로 변증한 파킨슨병 환자 증례 보고)

  • Kim, Young-Eun;Kim, Il-Wha;Lee, Jae-Hwa;Lee, Seoung-Geun;Lee, Key-Sang
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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    • pp.901-908
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    • 2009
  • Parkinson's disease is a slowly progressive degenerative disorder of the central nervous system. It is characterized by tremor when muscles are at rest, increased muscle tone, slowness of voluntary movements, and difficulty maintaining balance. In oriental medicine, these symptoms are diagnosed as yin(陰)-deficiency of liver and kidney, deficiency of qi(氣) and blood, retention of phlegm(痰), qi-stagnation and blood stasis. In this case, we diagnosed patients as deficiency of qi(氣) and blood type according to symptoms and treated by herbs that strengthen yang and benefiting yin for two weeks, while maintaining existing parkinson's western medication. After treatment, clinical symptoms were improved, while UPDRS (Unified Parkinson's Disease Rating Scale) score was decreased. These cases suggest that oriental medicine therapy maybe effective in the treatment of Parkinson's disease.

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Vitamin D dependent rickets type I

  • Kim, Chan-Jong
    • Clinical and Experimental Pediatrics
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    • v.54 no.2
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    • pp.51-54
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    • 2011
  • Vitamin D is present in two forms, ergocalciferol (vitamin $D_2$) produced by plants and cholecalciferol (vitamin $D_3$) produced by animal tissues or by the action of ultraviolet light on 7-dehydrocholesterol in human skin. Both forms of vitamin D are biologically inactive pro-hormones that must undergo sequential hydroxylations in the liver and the kidney before they can bind to and activate the vitamin D receptor. The hormonally active form of vitamin D, 1,25-dihydroxyvitamin D3 $[1,25(OH)_2D]$, plays an essential role in calcium and phosphate metabolism, bone growth, and cellular differentiation. Renal synthesis of $1,25(OH)_2D$ from its endogenous precursor, 25-hydroxyvitamin D (25OHD), is the rate-limiting and is catalyzed by the $1{\alpha}$-hydroxylase. Vitamin D dependent rickets type I (VDDR-I), also referred to as vitamin D $1{\alpha}$-hydroxylase deficiency or pseudovitamin D deficiency rickets, is an autosomal recessive disorder characterized clinically by hypotonia, muscle weakness, growth failure, hypocalcemic seizures in early infancy, and radiographic findings of rickets. Characteristic laboratory features are hypocalcemia, increased serum concentrations of parathyroid hormone (PTH), and low or undetectable serum concentrations of $1,25(OH)_2D$ despite normal or increased concentrations of 25OHD. Recent advances have showed in the cloning of the human $1{\alpha}$-hydroxylase and revealed mutations in its gene that cause VDDR-I. This review presents the biology of vitamin D, and $1{\alpha}$-hydroxylase mutations with clinical findings.

Pharmacokinetics of Acebutolol and Diacetolol After Oral Administration of Acebutolol in Rabbits with Folate-Induced Renal Failure (신장장애 가토에서 경구투여시 아세부토롤과 활성대사체인 디아세토롤의 약물동태)

  • Choi, Jun-Shik;Lee, Jin-Hwan
    • Journal of Pharmaceutical Investigation
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    • v.31 no.3
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    • pp.161-165
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    • 2001
  • Acebutolol (ABT) is almost absorbed after oral administration, but its bioavailability is reduced because of considerable first-pass metabolism in the gastrointestine and liver. The purpose of this study was to report the pharmacokinetic changes of ABT and its metabolite, diacetolol (DAT) after oral administration of acebutolol to control rabbits and rabbits with mild and severe folate-induced renal failure (FIRRs). Both of the area under the plasma concentration-time curve $(AUC^0_{\infty})$ of ABT and DAT were significantly increased in mild (p<0.05) and severe FIRRs (p<0.01), but the $AUC^0_{\infty}$ of DAT was more influenced than that of ABT in severe rabbits. There was a good correlation between serum creatinine and both of $AUC^0_{\infty}$ of ABT and DAT. The elimination half-life of ABT and DAT was significantly prolonged in mild (p<0.05) and severe (p<0.01) FIRRs, but the half-life of DAT was more influenced than that of ABT in severe FIRRs. The results suggest that the dosage of acebutolol should be adjusted according to the degree of renal disorder on the base of the serum creatinine concentration.

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Study on Clinical Diseases of Blood Stasis Pattern (어혈증(瘀血證)의 임상 질환 범위에 대한 고찰)

  • Park, Mi Sun;Kim, Yeong Mok
    • Herbal Formula Science
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    • v.21 no.1
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    • pp.1-15
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    • 2013
  • Objectives : This article is a study on to which categories of modern diseases blood stasis patterns are assigned and the meaning of blood stasis interpreted with perspectives of Korean Medicine and modern medicine. Methods : We reviewed "Neijing", "Shanghanlun", "Yilingaicuo", "Xuezhenglun" and other books and modern clinical papers related with blood stasis. Results : 1. Blood stasis patterns are related with disorders of hemorrheology, hemodynamics, platelet function, microcirculation, microelements and endothelial damage. 2. From the types of syndrome differentiation, diverse diseases classified in type of qi deficiency with blood stasis and type of blood stasis due to qi stagnation are reported, which reflects qi and blood are closely connected. And many diseases are classified in type of kidney deficiency with blood stasis, which has something in common with chronic diseases can achieve effect from treatment considering blood stasis. 3. Diseases related with kidney involve menopausal disorder, mazoplasia, prostatitis, erectile dysfunction, chronic nephritis, renal calculus, osteoporosis and bursitis. Diseases related with heart involve coronary artery disease, arrhythmia and cerebral thrombosis. Diseases related with spleen involve gastritis, colonitis and digestive organ ulcer. Diseases related with liver involve hepatitis, hyperthyroidism and stroke. Diseases related with lung involve neurodermatitis, bronchitis and paranasal sinusitis. Conclusions : Blood stasis pattern which is one of the areas to draw medicine's attention has broad clinical application.