• Clinical and Experimental Pediatrics
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• 제49권7호
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• pp.737-744
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• 2006

Purpose : To assess the usefulness of $^{99m}Tc-DISIDA$ scanning in the early evaluation of neonatal cholestasis and to verify the diagnostic value of this test in the differential diagnosis of biliary atresia. Methods : DISIDA scannings were performed and analyzed in 87 children(58 males and 29 females; age, 18-139 days, mean, 59.1 days) with neonatal cholestasis. Five groups according to the final diagnosis and the results of DISIDA scanning were analyzed by scatter plots using the parameters of age and the level of liver function tests(direct bilirubin, AST, ALT, ALP, GGT). The diagnostic sensitivity, specificity and accuracy of DISIDA scanning in the diagnosis of biliary atresia were compared between a higher bilirubin group and a lower bilirubin group(direct bilirubin level >5 mg/dL vs. <5 mg/dL) decided by the pattern of scatter plots. Results : DISIDA scannings in the diagnosis of biliary atresia were analyzed by high sensitivity(100 percent, 16/16) but lower specificity(70.4 percent, 50/71) and accuracy(75.9 percent, 66/87). False positivity(29.6 percent, 21/71) was higher in patients with a higher direct bilirubin level(42.5 percent for >5 mg/dL vs. 9.7 percent for <5 mg/dL, P<0.01). The age and the level of liver function tests(AST, ALT, ALP, GGT) analyzed by scatter plots revealed neither diagnostic value in predicting final diagnosis nor estimated the accuracy rate of DISIDA scanning in the evaluation of neonatal cholestasis. Conclusion : We suggest that DISIDA scannings should not be routinely used in evaluating neonatal cholestasis with elevated direct bilirubin level(>5 mg/dL), especially if it delays early diagnosis and surgical intervention.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제8권2호
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• pp.177-193
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• 2005

Purpose: To identify genes specifically expressed in biliary atresia, we compared the patterns of gene expression between biliary atresia and neonatal hepatitis syndrome using cDNA microarray analysis. Methods: Liver tissues were taken from livers of 11 patients (7 patients with biliary atresia and four with neonatal hepatitis) with neonatal cholestasis by needle biopsy. Normal control could be obtained from donor liver tissue during living-related liver transplantation. Total RNA was extracted from each samples and reversely transcribed to make cDNA. Then fluorescent cDNA were pooled and hybridized to the clones on the microarray. Fluorescence intensities at the immobilized targets were measured. Utilizing cDNA arrays of 4.7 K human genes, gene expression profiles were analyzed. Results: Among 4,700 microarray clones, 17 cDNA clones were significantly over-expressed in all 11 patients with neonatal cholestasis, while 20 clones were significantly decreased. Genome-wide expression analysis was carried out in livers obtained at the time of diagnosis. We could identify 49 genes, in which there showed differential expression between biliary atresia and neonatal hepatitis syndrome. Conclusion: This study shows the pattern of differentially expressed genes in biliary atresia and neonatal hepatitis syndrome. We believe that this study can contribute to the understanding of pathogenesis of neonatal cholestasis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제5권1호
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• pp.51-61
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• 2002

Purpose: The most common causes of neonatal cholestasis are neonatal hepatitis (NH) and extrahepatic biliary atresia (EHBA). Since neonatal cholestasis presents with variable expression of same pathologic process and has similar clinical, biochemical, and histologic features between EHBA and idiopathic neonatal hepatitis (NH), differential diagnosis is often difficult. We reviewed the differences of clinical characteristics and laboratory data to find out any correlation between the results of $Tc^{99m}$ DISIDA scan and presence of acholic stool. Methods: Between June 1993 and January 2001, total 29 infants younger than 4 month-old underwent $Tc^{99m}$ DISIDA scan. Their biochemical tests and clinical course were reviewed retrospectively. Results: Patients who had negative intestinal activity on $Tc^{99m}$ DISIDA scan showed acholic stool and revealed higher serum direct bilirubin and urine bilirubin level. 18.2% of patients with acholic stool showed intestinal activity on $Tc^{99m}$ DISIDA scan and 81.8% of them did not. All the patients without acholic stool showed positive intestinal activity on $Tc^{99m}$ DISIDA scan. The result of $Tc^{99m}$ DISIDA scan and the presence of acholic stool showed high negative correlation (r :-0.858). Patients with acholic stool and negative intestinal activity on $Tc^{99m}$ DISIDA scan showed higher serum total bilirubin level. Patients without acholic stool and positive intestinal activity on $Tc^{99m}$ DISIDA scan showed higher serum level of ALT. Conclusion: Patients with acholic stool and negative intestinal activity showed high correlation, but 18.2% of patients with acholic stool showed positive intestinal activity. So operative cholangiogram or transcutaneous liver biopsy should be performed for confirmation.

• Journal of the Korean Society of Radiology
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• 제81권5호
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• pp.1216-1221
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• 2020

Neoadjuvant concurrent chemoradiotherapy has been increasingly used to obtain secondary resectability for locally advanced pancreatic cancers. Although most patients require biliary decompression, only a few studies have investigated the safety of biliary stenting with chemoradiotherapy. Herein, we report a rare case of delayed hemorrhage of the hepatic artery caused by biliary stenting after chemoradiotherapy. The serial follow-up CT demonstrated that the biliary stent was approaching the right hepatic artery and eventually caused acute angulation and indentation. Diagnostic catheter angiography revealed contrast extravasation at the right hepatic artery, and endovascular embolization was performed. This report highlights the relevance of anatomical deformation after chemoradiotherapy, which can result in fatal complications. Indentation of the hepatic artery caused by biliary stents should be recognized as a warning sign of vascular injury.

• Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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• 한국지하수토양환경학회 2003년도 총회 및 춘계학술발표회
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• pp.55-58
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• 2003

제주도 동부지역에 위치한 심부관측정(해수면 하 60m 이상 착정) 11개소를 대상으로 2001 년 11월부터 2002년 10월까지 1년간 담.염수 경계면의 분포와 변화에 대하여 조사를 실시하였다. 담.염수 경계면의 두께는 대체로 해안에서 내륙 쪽으로 향함에 따라 두터워지는 경향을 나타냈고, 해안에서 6~6.kmm 이상 지역에는 담.염수 경계면을 갖는 기저지하수체가 발달하지 않는 것으로 조사되었다. 또한, 담.염수 경계면은 조석의 영향에 의해 1일 동안 최대 8.1m, 최소 0.14m의 변화를 나타냈으며, 계절에 따라서는 최대 33.2m, 최소 2m의 수축 및 확장을 일으키는 것으로 조사되었다. 조석과 계절에 따른 담.염수 경계면의 수축과 확장의 폭은 조사대상 관측정의 위치, 지하지질, 강우량 등의 여러 가지 요인에 의해 좌우되고 있는 것으로 해석되었다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권1호
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• pp.59-64
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• 1999

Purpose: The aims of this study are to measure the serum levels of fat soluble vitamins (vitamin A and D) from bile duct ligated rats, and to evaluate the effect of oral bile acids administration to facilitate absorption of fat soluble vitamins. Methods: We measured serum ALT, total bilirubin, vitamin A, and vitamin D of Sprague-Dawley rats 1 week before and 4 weeks after experimental bile duct ligation. Rats were consisted with 3 groups. Group 2 had been fed bile acids and group 3 ursodeoxycholic acid after operation for 4 weeks. Multi-vitamin was given to all groups. Results: 1) Base line (mean value before duct ligation): ALT 74.2 IU, total bilirubin 0.26 mg/dL; vitamin D 13.01 ng/mL vitamin A $0.87\;{\mu}g/mL$, total bile acids $25.16\;{\mu}mol/L$. 2) Four weeks after ligation: ALT 100.7 IU, total bilirubin 2.58 mg/dL; vitamin D 7.89 ng/mL vitamin A $1.37{\mu}g/mL$, total bile acids $278.22\;{\mu}mol/L$. 3) 4 weeks after ligation, each group (group 1, group 2 and group 3) showed vitamin D (7.62, 8.10 and 7.99) ng/mL, vitamin A (1.68, 1.06 and 1.33) ${\mu}g/mL$, total bile acids (233.17, 345.80 and 268.57) ${\mu}mol/L$, which were statistically not significant. Conclusion: Serum level of vitamin A is increased after bile duct ligation although vitamin D is decreased. Oral administration of bile acids does not affect the serum levels of vitamin A and D in bile duct ligated rats.

• Journal of the Korean Society of Radiology
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• 제83권5호
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• pp.1003-1013
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• 2022

Biliary atresia is an unknown etiology of extrahepatic bile duct obstruction with a 'fibrous ductal remnant,' which represents the obliterated ductal remnant in the porta hepatis. The sonographic 'triangular cord' (TC) sign has been reported to indicate a fibrous ductal remnant in the porta hepatis. In this review, we discuss the correlations among surgicopathological and sonographic findings of the porta hepatis and the definition, objective criteria, diagnostic accuracy, and differential diagnosis of the TC sign in biliary atresia.

• The Magazine of the Society of Air-Conditioning and Refrigerating Engineers of Korea
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• 제32권7호
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• pp.41-44
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• 2003

실내의 냉난방부하와 필요환기량을 동시에 처리하던 기존의 전공기 공조시스템과 달리 냉난방과 환기를 분리하여 개별적으로 담당하는 외기전담시스템에 관하여 소개한다.

• Applied Microscopy
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• 제28권1호
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• pp.73-82
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• 1998

To elucidate how microfilaments and vesicles participate in bile formation, the pericanalicular cytoplasms were observed in the liver of rats treated with taurocholic acid by deep etching with rapid freezing, and copmpared them with the findings on convensional thin sections. The microfilaments were identified around the bile canaliculi in the forms of core filaments of microvilli, filaments of pericanalicular web running in parallel to the border of bile canaliculi, and filaments on the junctional complex. In taurocholic acid-treated rats, microfilaments could be visualized around the bile canaliculi and along their borders. The microfilaments appeared to be installed to link to both the canalicular membrane and vesicles. Such specialized microfilaments are considered to participate in the translocation of vesicles in the pericanalicular cytoplasm. From the evidence, it is assumed that the microfilament induces the vesicles to transport and fuse to bile canalicull into which bile acids is secreted by exocytosis.

• Radiation Oncology Journal
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• 제29권2호
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• pp.121-126
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• 2011

The author reports a bile duct cancer patient whose stent shifted significantly from right to left over the course of radiotherapy. The 80-year-old female patient had a short stature with thoracic kyphosis and mutiple spinal compression fractures. She was also emaciated and very lean. By comparing the weekly scanned computed tomography images, the author found her stent to have shifted by more than 4 cm from right to left over the course of external beam radiotherapy. The results of this case study suggest that for a very lean and emaciated kyphotic bile duct cancer patient, the possibility of large interfractional movement of the bile duct or stent during radiotherapy should be considered.