• Title/Summary/Keyword: 담낭담석

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Prevalence and Risk Factors of Gallstones in Adult Health Screening Population (건강한 성인의 담석 유병률과 위험인자)

  • Lee, Mi-Hwa;Kwon, Duck-Moon;Cho, Pyong-Kon
    • Journal of radiological science and technology
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    • v.37 no.4
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    • pp.287-294
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    • 2014
  • Gallstone is the most common disease of the biliary system. Korean has experienced an increase in the percentage of cholesterol gallstones. The major risk factors associated with cholesterol gallstones are age, gender as well as obesity. This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. The study population consisted of 2,484 males and 2,212 females who visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. Classified as underweight, normal weight or overweight using the population of obese according to the body mass index, and classified according to mood diagnosis of diabetes presented by the American Diabetes Association. Fasting blood glucose and number of liver function, the divided the control group by referring to the normal liver function values used herein. The geological map, I was classified as NCEP APT III. A showed of total 148 people were found to have gallstones. The prevalence of sex among 148 patients (3.15%) 84 men (1.79%) and 64 women 1.36%) which shows significantly there is little difference. 1.84% 40 years and below, 3.38% 40's showed age prevalence was 4.66% in 50's and above. In addition, Total-cholesterol was at the most in 52 people, LDL-cholesterol in 398 people, Triglyceride in 36 people, HDL-cholesterol in 19 people. The abnormal group, was created from the total-cholesterol categories from a physical examination of a subject that has been found to be gallstones in the gallbladder. A result of conducting the univariate analysis shows the prevalence of gallstones, a correlation that is meaningful. The logistic regression analysis of multiple ages was chosen to show risk factors age independent cholelithiasis. In spite of the conclusion, gallstones are not displayed in relation to the metabolic syndrome but in order to clarify this, not only the subject of a health examination is needed but, a further study of the general public when possible.

A Case of Gallbladder Stones Associated with Anti-E Antibody Hemolytic Disease in a Neonate (신생아에서 담석을 동반한 Anti-E 항체에 의한 동종 면역성 용혈성 질환 1례)

  • Lee, Hyo-Jin;Hong, Seung-Soo;Sim, Yun-Hee;Kim, Eun-Ryoung
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.190-195
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    • 2008
  • Cholelithiasis is rarely recognized in children, especially in infants. Hemolytic disorders, long-term total parenteral nutrition (TPN), congenital anomalies of the biliary tree leading to stasis of bile flow, congenital IgA-deficiency, furosemide treatment, and prolonged fasting have been reported as predisposing factors for cholelithiasis in childhood. Hemolytic disease of the newborn due to anti-E has rarely been reported as a risk factor for cholelithiasis. We report a case of gallbladder stones in a neonate associated with anti-E antibody hemolytic disease.

A Study on the Efficiency of Hand-Knee Position in GB Stone Ultrasonography (담낭결석 초음파검사에서 Hand-Knee position의 효율성에 관한 연구)

  • Park, Soung-Ock;Do, Yun-Su
    • Journal of radiological science and technology
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    • v.29 no.4
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    • pp.267-274
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    • 2006
  • The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.

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A Case of Cholecystotomy in a Dog with Cholelithiasis (개에서 담석제거를 위한 담낭절개술의 일례)

  • 구자민;황재민;김현희;이원익;손우진
    • Journal of Veterinary Clinics
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    • v.18 no.4
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    • pp.455-458
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    • 2001
  • A twelve-month old female, shih-tzu, was presented to diagnose a hind limb ataxia to the Animal Teaching Hospital, Gyeongsang National University. Even though a variety of physical and neurological examination was performed, the cause of the ataxia was not understood. In serum analysis, an elevated levels of ALT, $\gamma$-GTP and LDH were found. A gallstone was subsequently observed at the right 9 and 10th intercostal region on ultrasonography and radiography. Cholelithiasis was diagnosed, and then cholecystotomy was undertaken. No complications were occurred after the operation. The gallstone removed by cholecystotomy was composed of calcium, carbonate and oxalate, identified by a black pigment gallstone.

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The Study on the Gallbladder Empting in Patients with Gallstones (담석증 환자의 담낭수축능에 관한 연구)

  • Yoon, Han-Sik
    • Journal of radiological science and technology
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    • v.21 no.2
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    • pp.31-35
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    • 1998
  • Gallstone diseases appear frequently in surgical patients. One of the etiolic factors in the formation of cholesterol gallstones is the supersaturation of bile with cholesterol. The bile stasis in the gallbladder may also play a role in the formation of cholesterol gallstones by supplying the proper condition to nucleation of cholesterol crystal. Author evaluated gallbladder empting in response to fat meal by ultrasonography in 12 patients with gallstones and normal control group of 12 healthy subjects. Of the 12 patients with gallstones, six had radiolucent stones and the rest of them had radioopaque stones. Additionally, author evaluated gallbladder contraction in both cholesterol gallstones and pigment gallstones. The gallbladder was significantly contracted in control group by the fat meal but not by water. The contraction of gallbladder by fat meal with gallstone patients was significantly decreased compared with those in control group. The time of maximum contraction was 30 minutes in patients with gallstones. At 30 minutes, the gallbladder contraction was more significantly decreased in patients with radiolucent stones than in those with radioopaque stones. In conclusion, the more significant decrease of gallbladder contraction in patients with radiolucent stones may be interpretated as the possible factor of pathologenesis for the formation of the cholesterol stone.

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Management of Asymptomatic Gallstones in Renal Transplantation

  • Lee, Ru Da;Youn, Seok Hwa;Shin, Dong Hoon
    • Korean Journal of Transplantation
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    • v.28 no.3
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    • pp.160-164
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    • 2014
  • Background: In solid organ transplantation patients, complications of cholelithiasis may run a fulminant course, resulting in high morbidity and mortality under immunosuppression and may even result in rejection. Here, we reviewed medical records of 66 patients in order to determine the outcome of management approach for asymptomatic gallstones in renal transplantation patients. Methods: We retrospectively reviewed clinical courses of 66 cases of renal transplantation performed between 2000 and 2012 at Kosin University Gospel Hospital. Results: Among 66 cases, eight had gallstones before transplantation. Three of these cases had undergone previous cholecystectomy for symptomatic gallstones, one had a simultaneous laparoscopic cholecystectomy and renal transplantation, and four were observed by regular abdominal ultrasonography. One patient was found to have cholangitis, and endoscopic retrograde biliary drainage was performed, resulting in alleviation of symptoms. Among 58 cases without preoperative gallstones, three developed gallstones after transplantation. One patient had cholecystitis, and the symptoms subsided after conservative treatment. Conclusions: For patients with asymptomatic gallstones who are awaiting renal transplantation, expectant management should be considered.

Evaluation of Usefulness of SPIO (Superparamagnetic iron oxide) Contrast Agent in MRCP (Magnetic resonance cholangiopancreatography) (자기공명 담도췌장조영술에서의 SPIO 조영제의 유용성 평가)

  • Hong, In-Sik;Lee, Hae-Kak;Cho, Jae-Hwan;Kim, Hyeon-Ju;Jang, Hyun-Cheol;Park, Cheol-Soo;Lee, Sun-Yeob;Goo, Eun-Hoe;Dong, Kyung-Rae;Cho, Moo-Seong
    • Journal of the Korean Society of Radiology
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    • v.5 no.3
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    • pp.143-148
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    • 2011
  • The purpose of this study was to examine the usefulness of SPIO contrast agent in Magnetic Resonance Cholangiopancreatography (MRCP) by performing a quantitative comparative analysis in patients undergoing MRCP for gallbladder stones with and without oral injection of SPIO (Superparamagnetic iron oxide) contrast agent. The subjects were 36 patients undergoing MRCP for suspected gallbladder stones between January 2009 and February 2010 and they were divided into halves to compare the two groups of with and without SPIO agent. For each subject in both the injected and non-injected group, T2-weighted images on a 1.5T MR scanner were obtained, using both the breath-holding and respiratory-triggered methods, respectively. The following regions were measured; for breath-hold T2-weighted images, the measurement regions were located at the central part of the gallbladder, and the areas 15 mm away from its center, toward the front and back, respectively, which were chosen to include surrounding tissues, while for respiratory-triggered T2-weighted images, at the central part of the gallbladder, and segment 5 and 6 of liver. In a quantitative analysis, average signal to noise ratio (SNR) in each of regions of interest (ROI) for each group were calculated and then average contrast to noise ratio (CNR) in each of ROI were obtained by using the SNR in the gallbladder as the basis to compare and analyze the values between the two groups. The CNR were higher for the injected group in those regions.

Gallbadder Dynamics Before and After Extracorporeal Shock Wave Lithotripsy (체외충격파 담석 쇄석술 전후의 담낭운동성의 변화)

  • Lee, Myung-Hae;Suk, Jae-Dong;Moon, Dae-Hyuk;Kim, Myung-Hwan;Min, Young-Il
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.53-60
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    • 1991
  • Extracorporeal shock wave lithotripsy (ESWL) with adjunctive oral litholytic therapy has proven to be a useful treatment in selected patients with gallbladder stones. To study the effect of ESWL on gallbladder dynamics, $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy was done for 25 patients with symptomatic gallstones and 10 normal controls. Of these 25 patients, 15 were treated with ESWL and adjunctive oral litholytic agents (ESWL group) and 10 were treated only with oral litholytic agents (UDCA group). After overnight fast and gallbladder visualization on a routine hepatobiliary scintigraphy with 7mCi of $^{99m}Tc-DISIDA$, subjects were given fatty meal and imaged with a gamma camera interfaced to a computer (1 frame/minute for 70 minutes). A gallbladder time-activity curve was generated and latent period (LP), ejection period (EP), ejection fraction (EF) and ejection rate (ER) were calculated. ESWL group were studied before, 1day after and 2weeks after ESWL, and WDCA group were studied before and 2weeks after starting oral medication. Mean basal EF was significantly reduced in patients but other parameters were not reduced. In ESWL group, mean EF and mean ER at lday after ESWL were reduced. In 3 of them, gallbladder was not visualized at all. Two weeks after ESWL, however, all parameters were recoverd to basal level. In UDCA group, all parameters were not changed significantly during medication. We can conclude that ESWL has such immediate adverse effect on gallbladder dynamics as reducing contractility and nonvisualization of gallbladder but it has no long-term effect.

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Extraction Method of Significant Clinical Tests Based on Data Discretization and Rough Set Approximation Techniques: Application to Differential Diagnosis of Cholecystitis and Cholelithiasis Diseases (데이터 이산화와 러프 근사화 기술에 기반한 중요 임상검사항목의 추출방법: 담낭 및 담석증 질환의 감별진단에의 응용)

  • Son, Chang-Sik;Kim, Min-Soo;Seo, Suk-Tae;Cho, Yun-Kyeong;Kim, Yoon-Nyun
    • Journal of Biomedical Engineering Research
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    • v.32 no.2
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    • pp.134-143
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    • 2011
  • The selection of meaningful clinical tests and its reference values from a high-dimensional clinical data with imbalanced class distribution, one class is represented by a large number of examples while the other is represented by only a few, is an important issue for differential diagnosis between similar diseases, but difficult. For this purpose, this study introduces methods based on the concepts of both discernibility matrix and function in rough set theory (RST) with two discretization approaches, equal width and frequency discretization. Here these discretization approaches are used to define the reference values for clinical tests, and the discernibility matrix and function are used to extract a subset of significant clinical tests from the translated nominal attribute values. To show its applicability in the differential diagnosis problem, we have applied it to extract the significant clinical tests and its reference values between normal (N = 351) and abnormal group (N = 101) with either cholecystitis or cholelithiasis disease. In addition, we investigated not only the selected significant clinical tests and the variations of its reference values, but also the average predictive accuracies on four evaluation criteria, i.e., accuracy, sensitivity, specificity, and geometric mean, during l0-fold cross validation. From the experimental results, we confirmed that two discretization approaches based rough set approximation methods with relative frequency give better results than those with absolute frequency, in the evaluation criteria (i.e., average geometric mean). Thus it shows that the prediction model using relative frequency can be used effectively in classification and prediction problems of the clinical data with imbalanced class distribution.