• Title, Summary, Keyword: hepatic encephalopathy

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An operation for the correction of Membranous obstruction of Inferior Vena Cava using Total Circulatory Arrest (전혈류 정지술을 이용한 하공정맥 폐색증의 교정수술)

  • Kim, Jhin-gook;Na, Myung-Hoon;An, Hyuk
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.20 no.4
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    • pp.773-779
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    • 1987
  • MOVC is an uncommon disease which can be corrected by surgical method if early detected. A case of a 34-year-old male with MOVC is reported. Operation was done on cardiopulmonary bypass with circulatory arrest under moderate hypothermia. The incision was done both on the RA extending to level of suprahepatic IVC and on the IVC just proximal to the right renal vein. And then, thrombectomy and membranectomy under the direct visualization was done. Total circulatory arrest was used intermittently in order to get good visual field and for preventing blood loss. The Postop. course was good except one episode of hepatic encephalopathy which was persisted for 12 hours and then controlled by conservative measures.

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A Case of Hyperacute Liver Failure from Mushroom Intoxication in a Child Treated with Penicillin (페니실린으로 완치한 버섯 중독에 의한 소아 급성 간부전 1예)

  • Kwak, Byung-Ok;Bae, Sun-Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.210-213
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    • 2008
  • Hyperacute liver failure from mushroom intoxication in children is rare and has a low survival rate. We report a case of hyperacute liver failure from mushroom intoxication in a 29-month-old boy. The patient ingested a mushroom about three days prior to presentation. He was admitted to the hospital with vomiting, abdominal pain, seizures, and hematemesis. During the hospitalization the patient developed hepatic encephalopathy (stage IV-a), and a coagulopathy. He recovered fully with specific medication, Penicillin GK and N-acetylcysteine.

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Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury

  • Chhavi, Nanda;Zutshi, Kiran;Singh, Niranjan Kumar;Awasthi, Ashish;Goel, Amit
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.3
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    • pp.162-169
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    • 2014
  • Purpose: To study temporal pattern of serum liver enzymes levels in newborns with hepatic injury associated with birth asphyxia (BA). Methods: Singleton term newborns with BA and ${\leq}72$ hours of age admitted to neonatal intensive care unit were prospectively enrolled. Term newborns with physiological jaundice and without BA were studied as controls. Serum liver enzymes were measured at <24 hours, 24-72 hours, and at 6-12 days of age for cases and at 1-6 days of age for controls. BA was defined by 1 minute Apgar score <7 or delayed or absent cry with hypoxic ischemic encephalopathy. BA-associated liver injury was defined as serum alanine aminotransferase (ALT) elevation beyond +2 standard deviation (ALT > +2 SD) above the mean of control subjects at any of the three time points. Results: Sixty controls and 62 cases were enrolled. Thirty-five cases (56%) developed BA-associated liver injury (ALT>81 IU/L). They had higher serum levels of ALT, aspartate aminotransferase, lactate dehydrogenase than the control infants, with peak at 24-72 hours. In controls, serum liver enzyme levels were significantly higher in appropriate-for-date (AFD) babies than small-for-date (SFD) babies. Serum enzyme pattern and extent of elevation were comparable between SFD and AFD babies. Degree of serum liver enzyme elevation had no relationship with severity of hypoxic encephalopathy. Conclusion: Serum liver enzyme elevation is common in BA; it peaks at 24-72 hours followed by a sharp decline by 6-12 days of age. Pattern and extent of enzyme elevation are comparable between SFD and AFD babies.

Delayed Continuous Venovenous Hemodiafiltration in Chronic Lithium Intoxication (만성 리튬 중독환자의 지연성 정정맥 혈액 투석여과 사례)

  • Kim, Tae Su;Cha, Yong Sung;Kim, Hyun;Kim, Oh Hyun;Cha, Kyoung Chul;Lee, Kang Hyun;Hwang, Sung Oh
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.1
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    • pp.28-30
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    • 2013
  • A 66-year-old male with chronic alcoholism presented with tremor, gait disturbance, memory impairment, insomnia, decreased appetite, and confusion. The patient had been taking lithium daily for treatment of bipolar disorder. Brain CT showed no specific abnormality, and serum lithium and ammonia levels were 3.63 mEq/L (therapeutic range, 0.6~1.2 mEq/L) and $85{\mu}g/dL$ (reference range: $19{\sim}54{\mu}g/dL$), respectively. Therefore, the initial differential diagnosis included chronic lithium intoxication, hepatic encephalopathy, Wernicke encephalopathy, or alcohol withdrawal syndrome. Even with the provision of adequate hydration, the patient's neurologic status did not show improvement, so that lactulose enema, thiamine replacement, and continuous venovenous hemodiafiltration (CVVHDF) were started on the third admission day. By the fifth admission day he had made a rapid neurologic recovery, and was discharged on the 20th admission day. Therefore, CVVHDF might be a treatment for patients with chronic lithium intoxication, because, even if serum lithium concentration is normal, lithium concentration in the brain may be different from that of the serum.

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The Characteristics and Outcomes of Abernethy Syndrome in Korean Children: A Single Center Study

  • Kim, Eun Sil;Lee, Ki Wuk;Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.1
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    • pp.80-85
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    • 2019
  • Purpose: Abernethy malformation is a rare condition, which was first described in 1793 as a congenital extrahepatic porto-systemic shunt (CEPS) directing splanchnic blood flow into the inferior vena cava. Eighty cases have been published so far that reported CEPS, while in Korea, very few cases have been reported. Through this study, we present 6 cases of patients diagnosed with CEPS at Samsung Medical Center and compare these with other such cases published in France and China. Methods: We reviewed clinical, laboratory, and imaging data of 6 children with CEPS in our pediatric clinic between 2004 and 2017. Results: A total of 6 children with CEPS was included in this study, namely, one with type 1a, two with type 1b, and three with type 2 CEPS. The most common presenting symptom was gastrointestinal bleeding (50.0%). Therapeutic interventions included shunting vessel ligation (16.7%) in type 2 CEPS and liver transplantation (16.7%) in type 2 CEPS patient with suddenly developed hepatic encephalopathy. Conclusion: There is no consensus guideline for the optimal management of patients with CEPS. Large-sample studies regarding CEPS are needed to evaluate the characteristics of patients with CEPS and determine the treatment guideline for CEPS.

Liver Cirrhosis of Korean Native Goat in Korea : A Case Report (산양의 Liver cirrhosis 발생보고)

  • 민병만;박경애;김환균;조용성;김성열;구찬희;정운익;김홍집
    • Korean Journal of Veterinary Service
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    • v.16 no.1
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    • pp.57-64
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    • 1993
  • This survey was performed to report rare outbreak of liver cirrhosis in Korean native goat (KNG) which was died of Yangpyeong's goat farm on Feb. 1992. The examination for the KNG was carried out by clinical signs, necropsy and various lab-oratory test including parasitic, bacterial and histological test. The KNG looked jaundice, ascite, hemorrhage of lumen, abomasum and intestine, and brownish smooth cirrhotic liver at necropsy. Histological examination for liver revealed considerable proliferation of connective tissue and piecemeal necrosis which was caused by chronic active inflammation in interlobules and intralobules. There were atrophic micro and macro nodules which were sur-rounded by connective tissue. The lobular structure lack almost all central vein. The portal areas appearred proliferation of bile ducts, blood vessels and connective tissues. These connective tissue infiltrated heavily with plasma cells, Iymphocytes and histocytes. Histological examination for brain proved to be hepatic encephalopathy by virture of congestion and edema in cerebral medullary. From these results were demonstrated miked nodular, active, postnecrotic liver cirrhosis.

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Effect of Dietary Protein on the Serum Xanthine Oxidase Activity in Methanethiol-treated Rats (식이성 단백질 함량이 Methanethiol 투여한 흰쥐의 혈청 Xanthine Oxidase 활성에 미치는 영향)

  • 윤종국;전태원;임영숙
    • Journal of Environmental Health Sciences
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    • v.19 no.1
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    • pp.66-70
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    • 1993
  • Introduction : Methanethiol is a toxicant that is a byproduct in the industrial process (oil refinery), and it is produced in vivo from methionine via transamination in case of its overintake. And it also can be generated by the action of mucosal thiol Smethyltransferase on hydrogen sulfite which is formed by anaerobic bacteria in the intestinal tract. The toxicity of methanethiol has often been suggested as one of endogenous factors involved in the pathogenesis of hepatic encephalopathy. Furthermore, methanethiol could cause the membrane damage and inhibition of some membrane protective enzymes.

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Chelation of Thallium (III) in Rats Using Combined Deferasirox and Deferiprone Therapy

  • Salehi, Samie;Saljooghi, Amir Sh.;Badiee, Somayeh;Moqadam, Mojtaba Mashmool
    • Toxicological Research
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    • v.33 no.4
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    • pp.299-304
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    • 2017
  • Thallium and its compounds are a class of highly toxic chemicals that cause wide-ranging symptoms such as gastrointestinal disturbances; polyneuritis; encephalopathy; tachycardia; skin eruptions; hepatic, renal, cardiac, and neurological toxicities; and have mutagenic and genotoxic effects. The present research aimed to evaluate the efficacy of the chelating agents deferasirox (DFX) and deferiprone (L1) in reducing serum and tissue thallium levels after the administration of thallium (III), according to two different dosing regimens, to several groups of Wistar rats for 60 days. It was hypothesized that the two chelators might be more efficient as a combined therapy than as monotherapies in removing thallium (III) from the rats' organs. The chelators were administered orally as either single or combined therapies for a period of 14 days. Serum and tissue thallium (III) and iron concentrations were determined by flame atomic absorption spectroscopy. Serum and tissue thallium (III) levels were significantly reduced by combined therapy with DFX and L1. Additionally, iron concentrations returned to normal levels and symptoms of toxicity decreased.

Simultaneous chylothorax and chylous ascites (암죽가슴증 및 암죽복수의 동시발생)

  • Jang, Tae Soo;Jeong, In Beom;Cho, Do Yeun;Kang, Sung Ju;Kwon, Oh Jung
    • Yeungnam University Journal of Medicine
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    • v.34 no.2
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    • pp.265-269
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    • 2017
  • Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.

A Case of Reye Syndrome Following Treatment of Kawasaki Disease with Aspirin (가와사키병 치료를 위한 아스피린 사용 후 발생한 라이 증후군 1예)

  • Lee, Joon Kee;Kang, Ji Eun;Choi, Eun Hwa;Choi, Jung Yun
    • Pediatric Infection and Vaccine
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    • v.19 no.2
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    • pp.79-83
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    • 2012
  • Reye syndrome is a rapidly progressive encephalopathy with hepatic dysfunction, which often begins several days after apparent recovery from a viral illness, especially varicella or influenza A or B. Salicylate use was identified as a major precipitating factor for the development of Reye syndrome. With the recommendation to avoid use of salicylates in children, Reye syndrome has virtually disappeared in recent years. We report a case of Reye syndrome in a 5-month-old infant who had been treated with intravenous immunoglobulin and aspirin under the diagnosis of Kawasaki disease, and showed symptoms of sudden onset of irritability, rigidity, decreased activity, vomiting, poor appetite, lethargy, liver dysfunction without jaundice, coagulopathy, and hyperammonemia.

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