• Journal of Trauma and Injury
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• v.23 no.2
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• pp.151-156
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• 2010

Purpose: The liver is the second most common organ injured by blunt abdominal trauma. The purpose of this study was to determine the utility of liver transaminase in screening blunt abdominal trauma patients for traumatic liver injury. Methods: We retrospectively reviewed the medical records of 231 patients who sustained blunt trauma and were at risk for traumatic liver injury between June 2009 and August 2010. All of them underwent a focused assessment with sonography for trauma (FAST) and abdominal computed tomography (CT). Based on the diagnosis of abdominal CT, patients were divided into two groups: group I with liver injury and group II without liver injury. We compared the two groups and calculated the sensitivity, the specificity and the predictive values of serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT) by using multiple cutoff values. Results: Of 231 patients with no abdominal free fluid in the FAST, 33 had traumatic liver injury on abdominal CT. The mean AST and ALT levels in group I (311.6 IU/L and 228.1 IU/L, respectively) were significantly higher than the values in group II (48.4 IU/L and 35.6 IU/L, respectively). The cutoff to distinguish liver injury is 60 IU/L for AST and 58 IU/L for ALT, with 93.8% sensitivity and 79.8% specificity for AST, and 90.6% sensitivity and 87.4% specificity for ALT. Conclusion: We recommend that all patient with suspected blunt abdominal trauma be evaluated using serum liver transaminase as a screening test for liver injury even though no abdominal free fluid is shown on the FAST. If AST > 60 IU/L and/or ALT > 58 IU/L, abdominal CT was useful to confirm liver injury in this study.

• Korean Journal of Clinical Pharmacy
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• v.24 no.3
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• pp.213-218
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• 2014

Objectives: The aim of this study was to identify the causal relationship between use of levocetrizine or cetrizine, and liver injury, by comparing frequency and pattern of hepatotoxicity in levocetrizine or cetrizine prescribed patients. Methods: This is a retrospective observational study, using data retrieved from electronic medical record system. Among 1164 patients prescribed levocetrizine or cetrizine during study period (Jul, 2009 - Jun, 2010) at Seoul National University Hospital, 543 patients with more than 4- time liver function test (LFT) results were included in final analysis. Liver injury was defined as greater than 3 times elevated level of alanine aminotransferase or 2 times elevated level of alkaline phosphatase or total bilirubin, compared to upper limit of normal, in patient with normal liver function at baseline. The frequency and pattern of liver injury were assessed. Results: Incidence of liver injury in patients prescribed with levotcetrizine or cetrizine were 1.48% and 2.94%, respectively. With few exceptions, most injuries were shown to be hepatocellular type. Rapid recovery was observed after drug cessation and long term use tends to be associated with incidence of liver injury. In patient with digestive system disorder, rate of liver injury was significantly higher (p=0.011). Conclusion: The result of this study implies potential need of liver toxicity monitoring, especially in patients taking long term levecetrizine or cetrizine or in patient with digestive system disorder. However, prospective large scale observational study is needed to confirm liver injury associated with the use of levocetirizine or cetirizine.

• Herbal Formula Science
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• v.9 no.1
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• pp.375-385
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• 2001

Objectives : This study was carried out to research the protective effects of Sagunja-Tang(SA) through in vivo experiments, and tried to investigate the relation between oxidation of liver tissues and deficiency of Qi. Methods : Acute liver injury which initiated from free radical induced by $CCl_4$, were applied to mice and metabolic data were obtained. In order to measure the degree of liver injury, serum level of alanine aminotransferase(AST), aspartate aminotransferase(ALT), creatinine, blood urea nitrogen(BUN), total protein(TP) and glucose were measured. Lipid peroxidation of liver slice was examined by measuring malondialdehyde(MDA), a product of lipid peroxidation. Results : SA had protective effects on $CCl_4$ induced acute liver injury by decreasing serum level of ALT. Kidney injury was induced by injection of $CCl_4$ too, and SA protected kidney injury by decreasing serum level of creatinine and BUN. Conclusions : Through this study, we found that SA have healing effects on liver and kidney injury of $CCl_4$ induced oxidative stress that is similar to deficiency of Qi. And further studies have to be followed to certify the mechanisms.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.242-247
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• 2009

Purpose: Trauma is an important cause of death in children. In particular, the liver is the second most commonly organ injured by blunt abdominal trauma. Treatment of patients with liver injury is has changed, and non-operative treatment is the major treatment method at present. In this study, we reviewed traumatic liver injury in pediatric patients. Methods: Seventy-seven patients younger than 16 years of age with traumatic liver injury were assessed for 10 years from July 1999 to June 2009 at Wonju Christian hospital. Records of the patients were reviewed retrospectively. Demographic and clinical data were analyzed. Results: The median age was 6 years, and the male-to-female ratio was 1.2 : 1. The most common injury grade was grade I. The majority of injuries were caused by was traffic accidents, and the second most common cause of injuries was falls. Twenty-four patients had liver injuries alone, and the most common accopaning injury was a lung injury. The average hospital stay was 20.7 days, and the average ICU stay was 4.8 days. Four patients died (5.2%). There were 6 patients with under 10 points on the Glasgow coma scale (GCS). Among these patients, three died. All mortality cases had over 16 points on the Injury Severity Score (ISS). Two patients were treated surgically, one of whom died. Of the 75 patients with non-operative management, three died due to associated injuries. Conclusion: Most pediatric patients with liver injury have good results with non-operative management. Associated injuries and hemodynamic instability are predictive of patient outcome, and those with isolated liver injuries can be successfully managed non-operatively.

• Toxicological Research
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• v.32 no.2
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• pp.133-140
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• 2016

Sulfasalzine is a widely administered drug against inflammatory-based disorders in human. However several cases of liver injury are associated with its administration. There is no stabilized safe protective agent against sulfasalazine-induced liver injury. Current investigation was designed to evaluate if N-acetylcysteine (NAC) and dithioteritol (DTT) as thiol reducing agents and/or vitamins C and E as antioxidants have any protective effects against sulfasalazine-induced hepatic injury in an ex vivo model of isolated rat liver. Rat liver was canulated and perfused via portal vein in a closed recirculating system. Different concentrations of sulfasalazine and/or thiol reductants and antioxidants were administered and markers of organ injury were monitored at different time intervals. It was found that 5 mM of sulfasalazine caused marked liver injury as judged by rise in liver perfusate level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) (p < 0.05). A significant amount of lipid peroxidation and hepatic glutathione depletion were detected in drug-treated livers, accompanied with significant histopathological changes of the organ. Administration of NAC ($500{\mu}M$), DTT (${400\mu}M$), Vitamin C ($200{\mu}M$), or vitamin E ($200{\mu}M$) significantly alleviated sulfasalazine-induced hepatic injury in isolated perfused rat liver. The data obtained from current investigation indicate potential therapeutic properties of thiol reductants and antioxidants against sulfasalazine-induced liver injury.

• Herbal Formula Science
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• v.22 no.1
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• pp.193-200
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• 2014

Objective : The purpose of this study is to report that patient diagnosed as drug-induced liver injury treated with herbal and western medicine improve liver function test. Methods : We treated the patient diagnosed as drug-induced liver injury caused by antibiotics with Hepatotonics and Cheonggan-tang Gagam(淸肝湯加減). Then, We followed up the result of liver function test. After the result of liver function test improved, we diagnosed the patient with Korean medical methods, and evaluated the symptom of Cerebral infarction and liver function test treating the patient with Jihwangumja (地黃飮子). Result : After our treatment, Liver function test and symptoms of Cerebral infarction result improved. Conclusion : Use of Western medicine with herbal medicine can improved liver function test of drug-induced liver injury effectively and herbal medicine do not disturb the liver function.

• Biomedical Science Letters
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• v.7 no.1
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• pp.47-51
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• 2001

To investigate an effect of the topical toluene application to .at skin on the liver injury, toluene (35 mg/$cm^2$) was sequentially applied for 3 or 5 days to rat skin and then the animals were sacrificed. 5 day toluene-treated rats showed the slight increase of live. weight per body weight(%) compared with control. Serum levels of xanthine oxidase and alanine aminotransferase activity were significantly increased both in 3 days and 5 days toluene-treated animals compared with control. In the histopathological findings, cytoplasmic degeneration of hepatocytes around the central vein was noted in the liver of rats applied with toluene to the skin. These results indicate toluene application to rat skin feds to somewhat slight liver injury. On the other hand, the hepatic benzylalcohol or aldehyde dehydrogenase activities were significantly decreased by toluene application to rat skin. In conclusion, the liver min was induced by toluene application to rat skin, and it can be hypothesized that accumulation of benzaldehyde in liver cell may be responsible for liver injury.

• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.207-211
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• 2004

Recently a case of liver injury from ingestion of Taeyeumjowi-tang containing Ma-huang(Ephedra sinica stapf) arose. The patient, a 30 year-old woman, was diagnosed with asthenia and anorexia after 6 weeks of ingesting Taeyeumjowi-tang containing Ma-huang(Ephedra sinica stapf) as a treatment for her obesity. Tests showed elevated levels of serum transaminase(ALT 903 IU/L, AST 716 IU/L), alkaline phosphatase (229 IU/L), total bilirubin (1.4 mg/dl). Other possible causes of liver injury were excluded by laboratory test and medical history, so the liver injury was taken to be drug-induced. Saenggangeonbi-tang was administered. After 2 weeks of treatment with this medication, the clinical symptoms and liver function improved. This case is reported with a call for further accumulation of objective data on drug-induced liver injury, and to bring more attention to the relative levels of safety and toxicity of herbal medicines.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1035-1042
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• 2019

Background: Herbal medication is widely used in the Korean Medicine Hospital, and drug-induced liver injury (DILI) in Korea has increased proportionally. Herb-induced liver injury now accounts for approximately 40% of cases of hepatotoxicity in Korea, according to research data. Currently, however, the component responsible for the toxicity is usually unknown or can only be suspected. Objective: To study the hepatotoxicity of Cheongsimyeonja-tang in DILI. Methods: A retrospective review was conducted of 82 inpatients between April 2010 and March 2017 with suspected drug-induced liver injury (n=5). The standard criteria (RUCAM scale) for drug-induced liver injury (DILI) were applied. The electronic medical records (EMRs) were retrospectively reviewed to identify the relevant database. Aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin (T. Bili) were analyzed in blood samples before and after the administration of Cheongsimyeonja-tang. Results: Five cases out of 82 patients had a criterion-referenced probable (RUCAM) score ranging from 6 to 8 points DILI. However, statistical analysis of the liver function parameters results of the 82 patients did not show a statistically meaningful elevation after taking Cheongsimyeonja-tang. Conclusions: These data suggest a relationship between Cheongsimyeonja-tang and DILI. More studies are needed to validate these observations and to explore their implications.

• The Journal of Internal Korean Medicine
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• v.21 no.2
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• pp.267-274
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• 2000

Objectives : In order to investigate the curative effect of Daesihotang-sosunggitang-gagambang on the liver injury of rats induced by $CCl_4$ and d-galactosamine. Methods : All animals were divided into 5 groups, those were normal group(untreated), control group(administrated with 0.9% Saline solution), sample I group(65mg/kg administrated), sample II group(130mg/kg administrated), positive control group(administrated with 200mg/kg silymarine). After the liver injury of rats induced by ccl4 and d-galactosamine, and cheked the serum transaminase(GOT, GPT) alkaline phosphatase(ALP), lactic dehydrogenase(LDH) for enzyme activities and triglyceride, total cholesterol amounts for serum component were measured. Result : The inhibitory effects on the serum GOT, GPT, LDH, ALP activities, serum total cholesterol content level in liver injury of rats induced by ccl4 were noted in both sample I group and sample II group. The inhibitory effects on the serum GPT, LDH activities and serum total cholesterol content level in liver injury of rats induced by d-galactosamine were noted in both sample I group and sample II group. The inhivitory effects on the serum GOT activities and triglyceride content level in liver injury of rats induced d-galactosamine were noted in sample I group, but it is not recognizable statistically. In sample II, they were noted. Conclusions : Deesihotang-sosoonggitang-gagambang has treatment effect against liver injury in rats induced by ccl4 and d-galactosamine. So it is required to study about the actions of mutual relation of medicines and path-mechanism by experiment.