• Title/Summary/Keyword: 간내담석

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A case of biliary ascariasis accompanied by cholelithiasis (담석증을 동반한 담도회충증 1례)

  • 최민호;박인애
    • Parasites, Hosts and Diseases
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    • v.31 no.1
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    • pp.71-74
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    • 1993
  • A 43-year-old Korean woman with billary ascariasis accompanied by cholellthiasis is reported. Her chief complaints were abdominal pain, nausea, and vomiting. She had the past history of several attacks of abdominal pain in her childhood. ciliary stones were recovered from the left hepatic duct after cholecystectomy, which contained degenerated cuticle or body wall, and numerous eggs of Ascaris lumbriooides. It is strongly suggested that the ciliary stones were formed from the dead Ascmis worm(s). This is a rare case of biliary ascariasis during the recent 5 years in Korea.

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$^{99m}Tc-DISIDA$ Hepatobiliary Scintigraphic Study in Symptomatic Patients after Various Biliary Surgeries: Regional Emphasis of Recurrent Pyogenic Cholangitis and Intrahepatic Duct Stones (담도계 수술후 증상이 재발한 환자에서의 $^{99m}Tc-DISIDA$ Hepatobiliary Scintigraphy: 재발 농양성 간담도염과 간내 담석 발생빈도의 지역적인 특성을 고려한 연구)

  • Yum, H.Y.;Park, Y.H.;Suh, J.K.;Lee, S.D.;Choi, K.H.
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.2
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    • pp.19-38
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    • 1986
  • 54 patients who had symptoms after biliary operation were studied by $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy for evaluation of clinical utility, with regional emphasis of recurrent pyogenic cholangitis (RPC) and intrahepatic stones. As expected, the most common disease was recurrent pyogenic cholangitis regardless of surgical anastomosis, 58% and next frequent disease was clonorhis sinensis infestation, 26%, stenosis of ampula vater 8%, and chronic hepatitis 4% (20% of patients had hepatitis but they showed clinically and scintigraphically dominallt combined disease feature). 87% of recurrent pyogenic cholangitis was associated with stones in intra or/and extrahepatic ducts and only 11.4% of RPC was found to be associated with Cs-infestation. The scintigraphic diagnosis of RPC was 81.6% and 78.6% of stones was detected by indirect visualization of scintigraphy findings and 71.7% of Cs-infestation was detected by scintigraphy. The characteristic bile flow pattern were described.

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A Clinical Report on 1Case of the Jaundice Caused by the Hepatic Resection to Eliminate Intra Hepatic Duct Stone (간내담석으로 간부분절제 수술 후 발생한 황달의 치험 1례에 관한 고찰)

  • Choi, Seo-Hyoung;Sim, Min;Sim, Yun-Seub;Choi, Young-Gyoo
    • The Journal of Internal Korean Medicine
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    • v.26 no.3
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    • pp.634-640
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    • 2005
  • Objective : This study was designed to investigate the effects of herbal medicine on jaundice caused by hepatic resection. Methods : This study was carried out on one patient with jaundice ensued by hepatic resection. The patient was admitted on October 25th, and treated until November 13th, 2004, using acupuncture and herbal medicine(Hepacure-I and Ex.Sosiho-tang.) Result : After 18 days, clinical symptoms had improved. Results of total bilirubin, ALP, GGT tests and urinalysis also showed improvement. Conclusions : These result support a role for this combination of acupunture and herbal medicine in treatment of chronic liver disease.

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99mTc-DISIDA HEPATOBILIARY SCINTIGRAM IN EVALUATION OF CLONORCHIS SINENSIS INFESTATION IN ENDEMIC REGION (간흡충증 간염에서의 $^{99m}Tc-DISIDA$ 간담도스캔)

  • Yum, Ha-Yong
    • The Korean Journal of Nuclear Medicine
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    • v.19 no.2
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    • pp.25-41
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    • 1985
  • 간흡충증은 한국 및 동남아세아에 널리 분포되어 있는 중요한 풍토병의 하나로서 진단은 전통적으로 분변검사에 의존하여 오고 있다. 최근 들어 담관내 간흡충 및 이의 합병증의 진단을 위해 ERCP 및 contrast cholangiogram등이 시도되었으나 실제에 이용하기에는 많은 제약이 있다 하겠다. 저자는 간흡충증에 있어서 최근 소개된 $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy의 진단적 의의를 규명하고자 1982년부터 1983년까지 고신의대 부속 복음병원에서 검진한 간흡충증 환자 90명을 대상으로 하여 $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy와 formalin-ether 원침법에 의한 분변검사를 시행하였다. $^{99m}Tc-DISIDA$ scintigram소견은 간내 담관 bile flow 및 총수담관 bile flow defect, 그리고 간세포기능의 정도에 따라 자료를 분석하였고 그외 합병증의 진단은 병록 기록, 수술 소견, ERCP 등에 의존하여 결론을 얻었다. $^{99m}Tc-DISIDA$ scintigraphy는 특이한 양상의 bile flow dynamics를 나타내었으며 간내 주담관의 intermittent irregular focal bile flow defect 및 tile flow stasis를 나타내고 말초담관의 bile flow defect는 경미하고 60분 내에 담관 bile flow activity의 완전한 배설을 나타내는 경우를 mild pattern, 간내 담관의 심한 irregular bile flow dynamics 및 간내담관의 심한 irregularity (담관내벽의 심한 불규칙성), 총수담관, 간내 주담관 및 말초 담관까지 심하게 irregular bile flow stasis를 나타내며 bile flow activity의 완전 베설이 $60\sim90$분사이 혹은 90분이상까지 인지된 경우를 moderate-severe pattern으로 분류하였다. 1) 분변검사상 간흡충증은 95검사중 70검사(환자 86명중 67명)에서 양성을 보여 분변 충난검사의 양성율은 73.7%였고 음성율은 26.3%였다. 2) $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy는 90명중 70명에서 특이한 Cs-bile flow양성을 보였으며 양성율은 77.8%였으며 음성율은 22.2%였다. 3) $^{99m}Tc-DISIDA$ hepatobiliary scintigram양성율을 나타낸 환자 70명중 11명은 mild pattern, 59명은 moderate-severe pattern을 나타냈으며 그중 21명은 여러가지 간세포 기능 및 담관에 영향을 미치는 질환과 합병했지만 특이한 Cs-bile flow pattern을 dominent하게 나타내었으며 합병된 여러 질환들도 bile flow pattern상 인지 할 수 있었다. 4) $^{99m}Tc-DISIDA$ hepatobiliary scintigram 음성율을 나타낸 환자 20명중 8명은 만성간염, 5명은 간경변증, 3명은 재발성 농양성담관염(recurrent pyogenic cholangitis)과 간내담도의 stricture 및 담관담석증이 합병되었으며 scintigram상 합병증의 pattern을 나타냈고 4명에서는 low CBD obstruction을 나타내었으며 후에 CBD stone, CBD carcinoma, gall bladder Ca.의 porta hepatis 전이 및 clonorchis worms의 cluster에 의한 obstruction이 operation 및 ERCP로서 진단 되었다. 5) $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy pattern은 현재의 자각증상과 관계된 dominent disease를 나타내었으며, 공간 점유병소도 multiple project images를 시행하므로서 쉽게 발견할 수 있었다. 이와 같이 간흡충증에 있어서 $^{99m}Tc-DISIDA$ hepatobiliary scintigram은 환자의 자각증상과 관계된 질환을 규명하는 데 필요한 정보를 얻었을 수 있었으며 간내담관의 damage정도를 규명하는데 필요한 procedure임이 판명되었다.

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Simultaneous Determination of Cholesterol, Bile Acids and Sterols in Human Bile Juices and Gallstones Using GC/MS (GC/MS에 의한 담석과 담즙내의 Cholesterol, Bile Acids 및 Sterols의 동시 Profiling)

  • Yang, Yoon Jung;Lee, Seon Hwa;Kim, Hyun Joo;Chung, Bong Chul
    • Journal of the Korean Chemical Society
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    • v.42 no.3
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    • pp.266-276
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    • 1998
  • Cholesterol supersaturation in bile, which causes gallstone formation, is the result of low bile acid secretion or high cholesterol secretion. The quantitative analysis of cholesterol, bile acids and sterols which are precursors of cholesterol have been used to examine the changes in bile component. We described a simple, sensitive and reproducible method for simultaneous determination of cholesterol, five bile acids and seven sterols in human bile juices and gallstones by capillary column gas chromatography-mass spectrometry (GC/MS). Clinical samples were hydrolyzed by alcoholic KOH, extracted twice (pH 14 and 1) and derivatized to trimethylsilyl (TMS) ether with $MSTFA/NH_4I$ (N-methyl-N-trimethylsilyltrifluoroacetamide/ammonium iodide) mixture in order to be detected on the GC/MS. The good quality control data were obtained through within-a-day and day-to-day test (RSD values were 1.72-13.79, 0.68-14.10, respectively) and the recovery range of them was 73.56-96. 95 Using this method, biliary and gallstone compositions in the patients with intrahepatic stones were analyzed. The amounts and its relative distribution of cholesterol, bile acids and sterols showed different pattern in bile juices and gallstones.

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