Clinical Characteristics of Acute Toxic Liver Injury / 대한간학회지

BACKGROUND/AIMS: Recently, acute toxic liver injury has been reported to be the most common cause of acute hepatitis. The frequency and clinical manifestations of acute toxic liver injury was evaluated. METHODS: The medical records of 68 patients demonstrating clinically significant acute toxic liver injury were retrospectively reviewed. Patients with mild biochemical abnormalities were excluded. RESULTS: The annual percentage of toxic liver injury ranged from 50% to 90% among acute hepatitis groups. Among the causes, prescribed drugs (group D) accounted for 55%, herbs or plant products (group H) for 42% and both accounted for 3%. Antibiotics and anti-inflammatory drugs were the most common agents (78%) among group D. The mean age of the patients was 43 and 70% of patients were female. Of the population, common symptoms were jaundice, weakness, fatigue, and nausea. Initial ALT and AST levels were 847 +/- 879 and 664 +/- 625 IU/L, and initial total bilirubin was 7.5 +/- 8.1 mg/dL. Acute toxic liver injury occurred after a mean of 32 days after first exposure. Liver injury resolved within a mean of 32 days. Hepatocellular, mixed, and cholestatic type was 45.2%, 32.3%, 22.5%, respectively. CONCLUSIONS: Recently, acute toxic liver injury has been the most common cause of acute hepatitis in Korea. Prescribed drugs and herbs or plant products are equally important etiologic agents of toxic liver injury. However, etiologic difference may not affect clinical courses or outcomes. A nationwide investigation of the hepatotoxicity of drugs, herbs or other plant products is required.

A Case of Primary Gastric Choriocarcinoma / 대한소화기내시경학회지

Extragonadal choriocarcinoma arising in the stomach of a 53-year-old male is presented. The tumor was diagnosed as choriocarcinorna of the stomach by histologic examination and immunohistologic method of biopsy specimens. The tumor showed the multiple metastases to the lung and liver. The level of human chorionic gonadotropin was significantly increased in the serum. The patient died of hepatic failure at the 26th hospital day.

A Case of Hepatoid Adenocarcinoma of Stomach / 대한소화기내시경학회지

A 54-year old woman was received subtotal gastrectomy. Gastroscbpy showed Bormann type III tumor located in the antrum, incisura angularis and body. Preoperative serum AFP was 1910ng/mL. Endoscopic biopsy revealed adenocarcinoma, but after subtotal gastrectomy, the tumor contained histologic features resembling hepatocellular carcinoma with lymphatic invasion and venous invasion. So we reported it as a hepatoid adenocarcinoma.