• Title/Summary/Keyword: 혈액 담즙증

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Cholelithiasis Complicated with Biliary Sludge and Urolithiasis in a Dog (개의 담낭 슬러지와 요 결석증을 동반한 담석증)

  • Lee, Seung-Gon;Kim, Dong-Gun;Lee, Joon-Seok;Kwak, Ho-Hyun;Nam, Hyun-Sook;Woo, Heung-Myong;Park, In-Chul;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.325-328
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    • 2006
  • A 10-year-old intact female Miniature Schnauzer dog was referred with the primary complaint of persistent anorexia, remittent fever, vomiting and abdominal pain. Hemogram suggested a chronic inflammatory disease. Serum biochemistry showed moderate hepatobiliary cellular damage with severe cholestasis. Abdominal radiography and ultrasonography revealed hepatomegaly, choleliths and sludges in gall bladder and small stones in urinary bladder. Based on diagnostic findings, the case was diagnosed as cholelithiasis complicated with biliary sludge and urolithiais. Using cholecystectomy and cystectomy, choleliths and uroliths were removed from gall bladder and urinary bladder, respectively. The clinical condition was dramatically improved after surgery.

Infectious Cholecystitis and Concurrent Endocarditis in a Dog: Rare but Important Association (개에서 감염성 담낭염과 동시 발병한 감염성 심내막염 1례)

  • Jung, Joohyun;Choi, Mincheol
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.338-342
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    • 2015
  • A 12-year-old castrated male miniature Schnauzer had anorexia, vomiting, lethargy, and fever for four days. The dog had leukocytosis, thrombocytopenia, hypoglycemia, hypoalbuminemia, hyperbilirubinemia, increased hepatic enzymes on hematologic and biochemical examinations. On abdominal ultrasonographs, there was an enlarged gallbladder with hyperechoic irregular wall thickening. Echocardiography showed vegetative change and regurgitation of aortic and mitral valves. E.coli was identified through ultrasound guided percutaneous cholecystocentesis and bile culture. Bacterial cholecystitis and concurrent endocarditis were diagnosed. The dog was recovered from sepsis with antibacterial and aggressive supportive therapy.

Arterio-Biliary Fistula as a Rare Life-Threatening Complication of Transjugular Intrahepatic Portosystemic Shunt: A Case Report (경경정맥 간내 문맥 정맥 단락술 후 드물게 발생하는 동맥-담관루: 증례 보고)

  • Ji Su Ko;Lyo Min Kwon;Han Myun Kim;Min-Jeong Kim;Hong Il Ha;Ji Won Park;Ji Young Woo
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.705-711
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    • 2022
  • A 46-year-old male with alcoholic liver cirrhosis underwent a transjugular intrahepatic portosystemic shunt (TIPS) for refractory ascites. On the 9th day after the procedure, he presented with melena and decreasing hemoglobin levels. Hemobilia due to fistula formation between the right intrahepatic bile duct and right hepatic artery was suspected on computed tomography. Angiography revealed a fistula of the small branches of the hepatic segmental arteries, and right intrahepatic bile duct was confirmed; embolization was successfully performed with a coil for the eighth segmental hepatic artery, a glue-lipiodol mixture for the fifth segmental hepatic artery, and gelfoam slurry for the right anterior hepatic artery. However, 2 days after embolization, the patient died owing to aggravated disseminated intravascular coagulopathy. When gastrointestinal bleeding occurs after TIPS, careful evaluation is immediately required, and hemobilia should be considered.

A Case of Neonatal Intrahepatic Cholestasis Caused by Citrin Deficiency (NICCD) Confirmed by SLC25A13 Mutation

  • Son, Yeong-Bae;Jang, Ju-Yeong;Park, Hyeong-Du;Lee, Su-Yeon
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.2
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    • pp.186-190
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    • 2014
  • Citrullinemia type 2 (citrin deficiency) is an autosomal recessive inborn error metabolism, caused by the SLC25A13 gene mutation. Citrin deficiency is associated with two clinical phenotype; neonatal-onset type II citrullinemia (CTLN2), also known as neonatal intraphepatic cholestasis caused by citrin deficiency (NICCD) and adult-onset CTLN2. Clinical manifestations of NICCD include poor growth, intrahepatic cholestasis, liver dysfunction and increased plasma citrulline, methionine, threonine, arginine. The molecular diagnosis could be confirmed by SLC25A13 gene mutation analysis. A 3-month-old male infant with persistent jaundice was referred for evaluation. Newborn screening was normal at birth. Mild elevation of serum ammonia and AST/ALT were observed. Plasma amino acid analysis showed significantly elevated citrulline, methionine, threonine. DNA sequence analysis of the SLC25A13 gene revealed two compound heterozygous mutations, c.[852_855del]($p.Met285Profs^*2$) and [1180+1G>A]. We suggest that NICCD should be considered as one of the cause of in infants with cholestatic jaundice, although the newborn screening was normal.

A Case of Portosystemic Shunt in a Domestic Shorthair Cat (한국 집고양이의 문맥전신션트 한 증례)

  • Cho, Eunkwang;Jeong, Ye Chan;Choi, Ul Soo
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.316-318
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    • 2014
  • A 3-year-old castrated male domestic shorthair cat was presented with a chief complaint of sudden onset of intermittent seizures occurring five times a day. Physical examination revealed the copper colored iris and loss of menace response at both eyes. Abnormalities of blood works and serum chemistry revealed mild erythrocytosis, severe microcytosis, and threefold increase in ALT activity. Additional liver function tests results were increased bile acid and $NH_3$ concentration. Radiographic study revealed multifocal nodules of the liver and an extrahepatic shunt was noted by ultraonography, which was confirmed by computed tomography as multiple extrahepatic shunts. The cat was scheduled for surgery applying an ameloid ring to occlude the shunt gradually. Diazepam and lactulose were instituted to the patient. However, clinical signs worsened despite medical management with shortened interval of seizures and the patient died due to cardiac arrest.

Pre- and post-paturition rumen volatile fatty acid composition and blood chemistry in ketotic and non-ketotic dairy cows (케톤증(症) 및 비(非)케톤증(症) 빈유우간(牝乳牛間)의 출산전후시(出産前後時) 제1위내(第1胃內) 휘발성지방산(揮發性脂肪酸)과 혈액화학치(血液化學値)의 변화(變化) 비교관찰(比較觀察))

  • Hamakawa, Masaaki;Shohji, Hiroshisa;Sakai, Takeo;Lee, Won-chang
    • Korean Journal of Veterinary Research
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    • v.35 no.4
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    • pp.823-831
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    • 1995
  • The composition of rumen volatile fatty acids(VFA) and the blood chemistry were investigated in 5 clinically health dairy cows(Group I) reared on dairy farms and in 5 cows with post-parturition(POP) primary ketosis(Group II). The determinations were performed on days 5 to 7 pre-parturition(PRP), immediately POP, and on days 5, 10, 15, 20 and 25 POP. In both groups, the total VFA levels gradually increased starting from day 5 POP, but the levels were lower in Group II than in Group I. With regard to POP. changes in the composition of VFA, Group II occasionally showed lower levels of acetic acid and caproic acid than did Group I. Blood glucose levels decreased POP in both groups. In contrast, blood levels of ketone bodies and 3-hydroxybutyric acid were increased POP, but there was no statistically by significant difference between the groups. The aspartate aminotransferase level was transiently increased immediately POP in both groups, and the increase was more marked in Group II than in Group I. Both groups showed a tendency for total cholesterol, free cholesterol, ester cholesterol, phospholipid, and total bile acid to be increased POP, but there was no statistically significant difference between the groups. Clinically healthy dairy cows also showed POP changes in the composition of VFA and blood similar to those in dairy cows with ketosis, suggesting that even apparently healthy cows are at risk of subclinical ketosis POP.

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The Exon 2 Deletion of the COMMD1 Causing Copper Toxicosis in Bedlington Terriers in Korea (한국 베들링턴 테리어에서 구리중독증을 유발하는 COMMD1 유전자의 exon 2 결손변이)

  • Kim, Yun-Gi;Kim, So-Yeon;Yun, Young-Min
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.1-4
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    • 2015
  • This study was performed to survey prevalence of Copper metabolism domain containing 1 (COMMD1) mutation using molecular diagnostic method in a population of Bedlington terriers in Korea. COMMD1 gene (formerly MURR1) functions as a regulator of sodium transport and copper metabolism. The deletion of exon 2 of the COMMD1 gene causes copper toxicosis in Bedlington terriers. Bedlington terriers with this autosomal recessive disorder were shown to have the elevated liver copper levels due to genetic derangement in the biliary copper excretion pathway. DNA samples were extracted from whole blood collected from 257 Bedlington terriers (109 males, 148 females) of pet dog clubs in Korea. A multiplex PCR was carried out to detect of exon 2 deletion of COMMD1 gene. In this study, it was possible to know the existence and prevalence of exon 2 deletion of COMMD1 in Bedlington terriers in Korea. Of the 257 samples, 131 (51%) were wild type homozygous for the normal COMMD1 gene, 108 (42%) were heterozygous, having both normal and mutated copy of the COMMD1 gene. The eighteen (7%) were mutant type homozygous. The results of genetic analysis could help establish proper management strategy and selective breeding program to prevent COMMD1 mutation in Bedlington terriers in Korea.

Effect of Ginseng Saponin on LDL Receptor Biosynthesis (인삼사포닌의 저밀도지질단백질(LDL)수용체에 미치는 영향)

  • Joo Chung No;Lee Hee Bong;Lee Yong Woo;Kang In Chul
    • Proceedings of the Ginseng society Conference
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    • 1988.08a
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    • pp.47-54
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    • 1988
  • Cholesterol a component of all eucaryotic plasma membranes. is essential for the growth and viability of cells in higher organisms. However. too much cholesterol can be lethal because of atherosclerosis resulting from the deposition of cholesterol ester plaques. It was attempted in this study to understand the preventive effect of ginseng saponin. one of the major components of the roots of Panax ginseng C.A. Meyer. against hypercholesterolemia induced by high cholesterol diet. $^{125}I-LDL$ was injected intravenously to rabbits and rats. which were fed a high cholesterol diet with and/or without ginseng saponin for 12 days. The disappearance of the radioactivity occurred faster in the test group than the control. The effect of saponin fraction from Panax ginseng C.A. Meyer and the purified ginsenosilks. $Rb_1,\;Rb_2,\;Re\;and\;Rg_1,$ on LDL receptor biosynthesis in high cholesterol fed rat has been investigated. Analysis of LDL receptors from various organs such as liver. kidney. adrenal cortex and testis showed that the population of LDL receptors of test group significantly higher than that of the control. It was also found that liver homogenate containing ginsenosides $(10^{-3}-10^{-4}\%)$ stimulated the biosynthesis of bile acid form cholesterol. From the above results. it seemed that ginsenosides lower the cholesterol level by stimulating cholesterol metabolism. which result in the suppression of the inhibitory action of cholesterol on LDL receptor biosynthesis.

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Sudden Unexpected Death in Infancy (Analysis of 34 Cases Including 13 Autopsies) (영아 돌연사에 대한 고찰 (13 부검례를 포함한 34례 분석))

  • Moon, Yeo Ok;Choi, Hee Kyoung;Her, Jeoung-A;Shin, Woo Jong;Kim, Myoung-A;Lee, Seong Yong;Jang, Seong Hee;Dong, Eun Sil;Kim, Chong Jae;Ahn, Young Min;Chi, Je Geun
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1065-1074
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    • 2002
  • Purpose : The purpose of this study is to analyze the epidemiologic characteristics of sudden unexpected death in infancy and to evaluate the importance of postmortem autopsy. Methods : We reviewed, retrospectively, medical records of 34 infants admitted to Kangnam General Hospital from January 1987 to December 2001 because of sudden unexpected death. We investigated the cause of death through medical history, death scene examination, autopsy findings, acylcarnitine and organic acid analysis. Results : Among the total 34 infants, 18 were male(52.9%) and 16 were female(47.1%). Thirty infants(88%) were below the six months of age. Winter was the most affected season(38.2%). Eighteen infants(52.9%) died between 6 and 12AM. The prone sleeping position was observed more frequently than the supine position at death; nine cases in the prone position, six cases in the supine position. The cause of death of 23 cases could not be found by only history and death scene examination. Autopsy was done in 13 cases. Seven cases of them were thought to be SIDS. In six cases, we explained the cause of death with autosy findings. They were an endocardial fibroelastosis, a nesidioblastosis, a subdural hematoma, a bronchopneumonia and two fatty changes of liver. Metabolic screening tests performed in three cases to rule out metabolic disorder since 2000 were all normal. Conclusion : We concluded that autopsy and metabolic screening test should be performed to find out the cause of death in sudden unexpected death in infancy.

Therapeutic Efficacy of Cefotaxime as an Empirical Antibiotic on Ascending Cholangitis after Kasai Operation for Biliary Atresia (Kasai 수술 후 발생한 상행성 담관염에서 경험적 항생제로서 Cefotaxime 치료의 적정성에 대한 평가)

  • Kim, Dong Ho;Lee, Byong Sop;Kim, Yun Kyung;Ko, Jae Sung;Lee, Hoan Jong;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.473-481
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    • 2002
  • Purpose : Ascending cholangitis is the most common complication after Kasai operations. The aim of this study is to evaluate the therapeutic efficacy of cefotaxime as an empirical antibiotic on ascending cholangitis after Kasai operations. Methods : Thirty-nine episodes of cholangitis in twenty-nine children who underwent Kasai operations at Seoul National University Children's Hospital from January 1991 to December 2000 were included in this study. Empirical cefotaxime treatments were divided into three groups : cefotaxime and amikacin treatment group(CA group), cefotaxime and gentamicin treatment group(CG group) and cefotaxime treatment group(C group). A diagnosis of cholangitis was made on the basis of unexplained fever(>$38^{\circ}C$) and either development of acholic stool or elevation of serum total bilirubin (>1.5 mg/dL). Therapeutic efficacy was judged by elimination of fever up to 72 hours, 120 hours, and 168 hours after antibiotic treatment. Results : There were therapeutic responses in 51%(20/39) up to 72 hours after antibiotic treatment : 54%(13/24) in CA group, 43%(3/7) in CG group and 50%(4/8) in C group. There were therapeutic responses in 69%(27/39) up to 120 hours, in 79%(31/39) up to 168 hours and in 82%(32/39) up to 2 weeks. There were no differences in therapeutic efficacy among the three regimens. In 12 of 39 episodes, the etiologic pathogens including Escherichia coli and enterococcus were cultured from the blood. Conclusion : Cefotaxime can be tried as an initial antibiotic in Korean children with ascending cholangitis after Kasai operation prior to the identification of microorganism on culture. However, further evaluation of pathogen and its resistant strain to cefotaxime should be done.