• Title, Summary, Keyword: hepatic encephalopathy

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Hepatic Encephalopathy in Captive Scimitar-Horned Oryxs (Oryx dammah) (동물원 흰오릭스에서 발생한 간성뇌증 3례)

  • Kim, Kyoo-Tae;Lee, Seung-Hun;Kwak, Dongmi
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.385-388
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    • 2015
  • Three cases of hepatic encephalopathy were diagnosed in scimitar-horned oryxs housed at a zoo. Administration of amino acid and ornithine-aspartate fluid therapy via an intravenous injection decreased serum levels of ammonia and liver enzymes in cases 1 and 2. Further, additional oral ingestion of non-absorbable disaccharide lactulose to eliminate intestinal nitrogenous products enabled recovery of two oryxs. However, in case 3, the serum levels of ammonia and liver enzymes increased even after treatment, and the oryx died. Necropsy revealed cecum and colon compaction due to stiff dried feces, and this condition could have an adverse effect on increased blood ammonia levels that may have caused mortality. Overconsumption of pellets may have been the primary cause of hepatic encephalopathy. Thus, a fiber rich diet with decreased amount of pellets is needed to prevent hepatic encephalopathy, since the normal diet of scimitar-horned oryxs is rich in fiber.

3 Cases of Hepatic Encephalopathy (간성뇌증환자 3례에 대한 임상보고)

  • Ahn, Jung-Jo;Lim, Seung-Min;Cho, Hyun-Kyung;Kim, Yong-Jin;Yu, Ho-Ryong;Kim, Yun-Sik;Seol, In-Chan;Choi, Young
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.743-747
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    • 2001
  • Hepatic encephalopathy is caused by disorders affecting the liver. The exact cause of the disorder is unknown. It occurs changes in mental state, consciousness, behavior, personality and changes in mood include forgetfulness, confusion, disorientation, delirium, dementia, decreased alertness, daytime sleepiness, decreased responsiveness, progressive stupor, coma. As 3 admission patients into oriental hospital of daejeon university include 2 cases of cerebral infarction, 1 case of liver cirrhosis, we found those are all hepatic encephalopathy. But until the diagnosis is made, we have many mistakes to find correct. Among the mistackes, specialy mixed thing is to compare hepatic encephalopathy and cerebral infarction. So, we report these cases with a brief review of related literatures.

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Brief Review of the Revised Korean Association for the Study of the Liver Clinical Practice Guidelines for Liver Cirrhosis: Varices, Hepatic Encephalopathy and Related Complications (2019 개정 대한간학회 간경변증 진료 가이드라인 소개: 정맥류, 간성뇌증 및 관련 합병증)

  • Jang, Eun Sun
    • The Korean Journal of Gastroenterology
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    • v.74 no.5
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    • pp.274-280
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    • 2019
  • Liver cirrhosis patients are suffering from many complications, which are directly related to a poor prognosis. Although there have been many recent advances in diagnosis and treatment for varix and hepatic encephalopathy in cirrhotic patients, the standard practice for these conditions should consider the different medical resources and etiology of these liver diseases among various countries. The Korean Association for the Study of the Liver published in 2005 a clinical practice guideline for the treatment of cirrhosis complications, and this year, they revised the guideline for treating gastroesophageal varices and hepatic encephalopathy. This review summarizes the revised practice guideline and emphasizes the updated recommendation.

Clinical Study on Hepatic Encephalopathy (간성뇌병증 환자의 증례 1례)

  • Kim, Do-Gyoung;Jeong, Hyun-Yun;Lee, Jae-Wook;Shin, Yoon-Ri;Sin, Cheol-Kyung;Kim, Kyung-Min;Kim, Young-Kyun;Lee, Yong-Tae;Kwon, Jung-Nam
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.4
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    • pp.702-706
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    • 2010
  • The clinical manifestation of Hepatic encephalopathy is personality change, vacant behavior, lethargy, flapping tremor, muscle twitching, noisy, abusive, violent, coma. The purpose of this clinical study was done to report the improvement of hepatic encephalopathy after oriental medical treatment (herb-med, acupuncture, moxibustion). We applied Ukieum-ja and Sopungsungi-won to patient who had liver cirrhosis and hepatic encephalopathy. We examined the Change of CBC, LFT and Clinical Manifestation to evaluate the effectiveness of oriental medical treatment. We observed that oriental medical complex treatment decreased symtoms and improved general condition of a patient. So we report this clinical study to be helpful in treating patients of hepatic encephalopathy.

Hepatoprotective effect of sodium hydrosulfide on hepatic encephalopathy in rats

  • Kwon, Kyoung Wan;Nam, Yoonjin;Choi, Won Seok;Kim, Tae Wook;Kim, Geon Min;Sohn, Uy Dong
    • The Korean Journal of Physiology and Pharmacology
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    • v.23 no.4
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    • pp.263-270
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    • 2019
  • Hydrogen sulfide is well-known to exhibit anti-inflammatory and cytoprotective activities, and also has protective effects in the liver. This study aimed to examine the protective effect of hydrogen sulfide in rats with hepatic encephalopathy, which was induced by mild bile duct ligation. In this rat model, bile ducts were mildly ligated for 26 days. Rats were treated for the final 5 days with sodium hydrosulfide (NaHS). NaHS ($25{\mu}mol/kg$), 0.5% sodium carboxymethyl cellulose, or silymarin (100 mg/kg) was administered intraperitoneally once per day for 5 consecutive days. Mild bile duct ligation caused hepatotoxicity and inflammation in rats. Intraperitoneal NaHS administration reduced levels of aspartate aminotransferase and alanine aminotransferase, which are indicators of liver disease, compared to levels in the control mild bile duct ligation group. Levels of ammonia, a major causative factor of hepatic encephalopathy, were also significantly decreased. Malondialdehyde, myeloperoxidase, catalase, and tumor necrosis factor-${\alpha}$ levels were measured to confirm antioxidative and anti-inflammatory effects. N-Methyl-D-aspartic acid (NMDA) receptors with neurotoxic activity were assessed for subunit NMDA receptor subtype 2B. Based on these data, NaHS is suggested to exhibit hepatoprotective effects and guard against neurotoxicity through antioxidant and anti-inflammatory actions.

The Pallidal Index in Patients with Acute-on-Chronic Liver Disease: Is It a Predictor of Severe Hepatic Encephalopathy?

  • Lee, Dong Hyun;Lee, Hui Joong;Hahm, Myong Hun
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.125-130
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    • 2017
  • Purpose: To evaluate the clinical significance of T1 high signal intensity on the globus pallidus as a predictor of severe hepatic encephalopathy in patients with acute-on-chronic liver failure (ACLF), which is a distinct syndrome characterized by multi-organ dysfunction including cerebral failure. Materials and Methods: From January 2002 to April 2014, we retrospectively reviewed the magnetic resonance imaging (MRI) findings and clinical and magnetic resonance (MR) features of 74 consecutive patients (44 men and 30 women; mean age, 59.5 years) with liver cirrhosis. The chronic liver failure-sequential organ failure assessment score was used to diagnose ACLF. The pallidal index (PI), calculated by dividing the mean signal intensity of the globus pallidus by that of the subcortical frontal white matter were compared according to ACLF. The PI was compared with the Model for End-Stage Liver Disease (MELD) score in predicting the development of ACLF. Results: Fifteen patients who were diagnosed with ACLF had higher hepatic encephalopathy grades (initial, P = 0.024; follow-up, P = 0.002), MELD scores (P < 0.001), and PI (P = 0.048). In the ACLF group, the mean PI in patients with cerebral failure was significantly higher than that in the patients without cerebral failure (1.33 vs. 1.20, P = 0.039). In patients with ACLF, the area under the curve (AUC) for PI was 0.680 (95% confidence intervals [CI], 0.52-0.85), which was significantly lower than that for the MELD score (AUC, 0.88; 95% CI, 0.77-0.99) (P = 0.04). Conclusion: The PI can be an ancillary biomarker for predicting the development of ACLF and severe hepatic encephalopathy.

Sarcopenia: Ammonia metabolism and hepatic encephalopathy

  • Jindal, Ankur;Jagdish, Rakesh Kumar
    • Clinical and Molecular Hepatology
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    • v.25 no.3
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    • pp.270-279
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    • 2019
  • Sarcopenia (loss of muscle mass and/or strength) frequently complicates liver cirrhosis and adversely affects the quality of life; cirrhosis related liver decompensation and significantly decreases wait-list and post-liver transplantation survival. The main therapeutic strategies to improve or reverse sarcopenia include dietary interventions (supplemental calorie and protein intake), increased physical activity (supervised resistance and endurance exercises), hormonal therapy (testosterone), and ammonia lowering agents (L-ornithine L-aspartate, branch chain amino acids) as well as mechanistic approaches that target underlying molecular and metabolic abnormalities. Besides other factors, hyperammonemia has recently gained attention and increase sarcopenia by various mechanisms including increased expression of myostatin, increased phosphorylation of eukaryotic initiation factor 2a, cataplerosis of α ketoglutarate, mitochondrial dysfunction, increased reactive oxygen species that decrease protein synthesis and increased autophagy-mediated proteolysis. Sarcopenia contributes to frailty and increases the risk of minimal and overt hepatic encephalopathy.

Hepatic Encephalopathy in a Dog (개의 간성 뇌증)

  • 반현정;황철용;김종민;윤화영;윤정희;오태호;한홍율
    • Journal of Veterinary Clinics
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    • v.18 no.3
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    • pp.293-296
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    • 2001
  • Hepatic encephalophthy was diagnosed with serum chemistry, abdominal radiography and ultrasonography in a 2.6kg, 4 year-old maltese dog showing signs of hypersalivation, involutary spasm of facial muscles, ataxia, behavior abnormalities like dullness, sleep disorder, restlessness. In serum chemistry, the level of alanine transferase and aspartate trasferase was mildly elevated, ammonia was severely increased. On abdominal radio-graphs, the size of liver was mildly decreased. In ultrasonographic examination, diffuse lesion with hyperechoic change and decreased vasculature were seen in the hepatic region. But vascular abnormalities of liver were not observed. Drug and dietary therapy were undertaken and severities of clinical sign were alleviated.

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Oculogyric Crisis Due to Metronidazole Toxic Encephalopathy (메트로니다졸 독성 뇌병증으로 인한 안구운동발작)

  • Lee, Sang-Woo;Kim, Hyeongseok;Heo, Deokhyun;Park, Jeong-Ho
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.322-324
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    • 2018
  • Oculogyric crisis is an acute dystonia involving ocular muscles characterized by sustained conjugate upward or lateral deviation of the eyes. Metronidazole is a commonly used antimicrobial agent in treatment of anaerobic infections. However, its long-term use can cause toxic encephalopathy particularly in patients with hepatic dysfunction. Here, we describe a case of oculogyric crisis as a presenting manifestation of metronidazole-induced encephalopathy.

The High Expressed Serum Soluble Neural Cell Adhesion Molecule, a High Risk Factor Indicating Hepatic Encephalopathy in Hepatocelular Carcinoma Patients

  • Liu, Tian-Hua;Guo, Kun;Liu, Ri-Qiang;Zhang, Shu;Huang, Zhuo-Hui;Liu, Yin-Kun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3131-3135
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    • 2015
  • Objective: To investigate whether the expression of serum soluble neural cell adhesion molecule (sNCAM) is associated with hepatic encephalopathy (HE) in hepatocelular carcinoma (HCC) patients. Materials and Methods: The Oncomine Cancer Microarray database was used to determine the clinical relevance of NCAM expression in different kinds of human cancers. Sera from 75 HCC cases enrolled in this study were assessed for expression of sNCAM by enzyme linked immunosorbent assay (ELISA). Results: Dependent on the Oncomine Cancer Microarray database analysis, NCAM was down regulated in 10 different kinds of cancer, like bladder cancer, brain and central nervous system cancer, while up-regulated in lung cancer, uterine corpus leiomyoma and sarcoma, compared to normal groups. Puzzlingly, NCAM expression demonstrated no significant difference between normal and HCC groups. However, we found by quantitative ELISA that the level of sNCAM in sera from HCC patients with HE ($347.4{\pm}151.9ng/ml$) was significantly more up-regulated than that in HCC patients without HE ($260.3{\pm}104.2ng/ml$), the p-value being 0.008. sNCAM may be an important risk factor of HE in HCC patients, the correlation coefficients was 0.278 (P<0.05) on rank correlation analysis. Conclusions: This study highlights that up-regulated level of serum sNCAM is associated with HE in HCC patients and suggests that the high expression can be used as an indicator.