• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권2호
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• pp.121-124
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• 2014

Omega (${\omega}$)-3 polyunsaturated fatty acids appear to be effective in preventing and treating parenteral nutrition-associated liver disease, and several mechanisms were proposed for this observation. An 8-week-old male infant with cholestasis and acholic stool was diagnosed non-syndromic intrahepatic interlobular bile duct paucity by open-wedge liver biopsy. Initially he was treated with usual supportive medical therapy, including ursodeoxycholic acid. However, the clinical status and laboratory tests did not improve. Omega (${\omega}$)-3 polyunsaturated fatty acids (initially intravenous administration and oral administration later), were started and his liver function, including aminotransferase level and bilirubin levels normalized, and the ivory stool color turned green. We report the possible effectiveness of ${\omega}$-3 polyunsaturated fatty acids as a potent choleretic agent for non-syndromic intrahepatic interlobular bile duct paucity, a very rare structural pediatric hepatic disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권2호
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• pp.222-226
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• 2000

Common bile duct stones are an unusual occurrence in children. Endoscopic retrograde cholangiopancreaticography and endoscopic papillary sphincterotomy are excellent tool for diagnosis and therapy. Bleeding after endoscopic papillary sphincterotomy occurs in approximately 0.5~12% of procedures. We experienced a case of common bile duct stone in 5-year-old boy. After endoscopic papillary sphincterotomy, the stone was passed. 5 days after the procedure bleeding occurred, but it was controlled spontaneously.

• Journal of Digestive Cancer Research
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• 제2권2호
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• pp.78-81
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• 2014

담관암은 예후가 불량한 암으로 전암성 병변의 병리, 임상적 특징, 예후 등의 이해가 중요할 것으로 생각된다. 관내 유두상 종양은 드문 질환으로 만성적인 담관의 염증이 동반되어 있는 환자에서 발생 위험이 증가하며 비교적 느리게 성장하고 덜 침습적인 특징이 있으나 악성 전환 가능성이 높은 질병이므로 첫 진단 시 조직학적으로 양성이라 하더라도 적극적인 치료를 고려하도록 권고하고 있다. 이에 질병의 자연경과에 대한 보고는 적어, 저자들은 치료없이 8년간 경과 관찰하여 담관암으로 진행한 담관내 유두상 종양 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Trauma and Injury
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• 제29권3호
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• pp.93-97
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• 2016

Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

• 한국간담췌외과학회지
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• 제26권4호
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• pp.325-332
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• 2022

Backgrounds/Aims: To analyze relationships of hepatic histopathological findings and bile microbiological profiles with perioperative outcomes and risk of late biliary stricture in individuals undergoing surgical bile duct injury (BDI) repair. Methods: A historical cohort study was carried out at a tertiary university hospital. Fifty-six individuals who underwent surgical BDI repair from 2014-2018 with a minimal follow-up of 24 months were enrolled. Liver biopsies were performed to analyze histopathology. Bile samples were collected during repair procedures. Hepatic histopathological findings and bile microbiological profiles were then correlated with perioperative and late outcomes through uni- and multi-variate analyses. Results: Forty-three individuals (76.8%) were females and average age was 47.2 ± 13.2 years; mean follow-up was 38.1 ± 18.6 months. The commonest histopathological finding was hepatic fibrosis (87.5%). Bile cultures were positive in 53.5%. The main surgical technique was Roux-en-Y hepaticojejunostomy (96.4%). Overall morbidity was 35.7%. In univariate analysis, liver fibrosis correlated with the duration of the operation (R = 0.3; p = 0.02). In multivariate analysis, fibrosis (R = 0.36; p = 0.02) and cholestasis (R = 0.34; p = 0.02) independently correlated with operative time. Strasberg classification independently correlated with estimated bleeding (R = 0.31; p = 0.049). The time elapsed between primary cholecystectomy and BDI repair correlated with hepatic fibrosis (R = 0.4; p = 0.01). Conclusions: Bacterial contamination of bile was observed in most cases. The degree of fibrosis and cholestasis correlated with operative time. The waiting time for definitive repair correlated with the severity of liver fibrosis.

• 한국독성학회:학술대회논문집
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• 한국독성학회 2002년도 Molecular and Cellular Response to Toxic Substances
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• pp.107-114
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• 2002

Cholestatic liver injury results from the accumulation of toxic bile salts within the liver. The aim of the present study was to understand the mechanism of bile salts-induced hepatocellular apoptosis in bile duct-ligated (BDL) rats, using Western blot and immunohistochemical analysis.(omitted)

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권1호
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• pp.65-69
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• 2008

담도 폐쇄증은 수술적 치료가 필요하며 알라질 증후군은 대증적 치료가 가능하기 때문에 이를 감별하는 것이 중요하다. 저자들은 신생아기에 선천성 심장질환과 함께 담즙 정체 소견이 있는 환아에게서 원인 질환을 진단하는 과정에서 수술적 담관조영술 통해 제2형 담도 폐쇄증인 간관 폐쇄를 동반한 알라질 증후군 1예를 경험하였기에 보고하는 바이다.

• Journal of Pharmaceutical Investigation
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• 제17권1호
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• pp.15-21
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• 1987

Effects of phenobarbital pretreatment on the pharmacokinetics of enterohepatic recirculating griseofulvin were investigated by comparing normal to bile duct cannulated rats and also the effects of enhanced endogeneous bile flow on the absorption of griseofulvin were studied by means of in situ recirculation method in phenobarbital-pretreated rats. Phenobarbital was administered orally for five days at the dose of 75 mg/kg/day. The influence of phenobarbital pretreatment on the absorption rate constant, area under the plasma concentration-time curve, maximum plasma concentration of orally administered griseofulvin was not found in bile duct cannulated rats. Decreased absorption clearance and apparent partition coefficient of griseofulvin in accordance with the amount of endogeneous bile juice seemed to be due to the decrease of thermodynamic activity of griseofulvin as bile forms the micelle with griseofulvin.

• 대한수의학회지
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• 제34권1호
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• pp.1-7
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• 1994

The distribution of the bile and hepatic ducts within the liver of 24 Korean native cattle were observed. Vinylite solution was injected into common bile ducts on 13 cases for cast preparation. The angiography was prepared in 11 cases which were injected 30% barium sulfate solution into the common bile ducts and then radiographed on X-ray apparatus. The results were summarized as follows; 1. The dorsal, intermediate and ventral ducts of left hepatic lobes, ducts of quadrate lobes, and ducts of papillary process were collected into left hepatic ducts. The dorsal and ventral ducts of right hepatic lobe, ducts of caudate process and papillary process were collected into right hepatic ducts. 2. The bile ducts in the left hepatic lobes were collected into dorsal, ventral and intermediate ducts of left hepatic lobes. The intermediate ducts of left hepatic lobes was absent in some cases(5 cases, 20.83%). 3. In some cases, the ventral ducts of right hepatic lobes were collected into right hepatic ducts directly. 4. The ducts of quadate lobes were collected into left hepatic ducts(8 cases, 33.33%), ventral ducts of left hepatic lobes(13 cases, 54.17%), and dorsal duct of left hepatic lobes, intermediate and ventral ducts of left hepatic lobe, common trunk collected into intermediate and ventral duct of left hepatic lobe and left hepatic duct(1 cases, 4.17%) respectively. 5. The ducts of papillary process were collected into left and right hepatic ducts(12 cases, 50%), left hepatic ducts only(11 cases, 45.83%) or right hepatic duct only(1 cases, 4.17%). 6. The average length of right hepatic ducts was 26.87(6-45.8)mm. The average length of left hepatic ducts was 56.68(6-127)mm. The length of gallbladder was 128.60(104-160)mm on the average. The breadth of gallbladder was 67.16(38.4-153.4)mm on the average. But there was a difference in the length and the breadth according to the quantity of bile. 7. The ramified angles of dorsal, intermediate and ventral ducts of left hepatic lobes, ducts of quadrate lobes, ducts of papillary processes and caudate processes, dorsal and ventral ducts of right hepatic lobes and cystic ducts were 130-170, 160-200, 190-250, 240-300, 90-140, 320-350, 30-100, 270-330 and 240-300 degrees respectively.

• 대한의생명과학회지
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• 제11권4호
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• pp.473-479
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• 2005

Possible mechanism of decreased catechol-O-methyltransferase (COMT) activity in cholestatic rat liver was studied. Hepatic and serum COMT activities were determined from the experimental rats with common bile duct ligation (CBDL). The Michaelis-Menten constants in this hepatic enzyme were also measured. The activities of cytosolic, mitochondrial and mircosomal COMT as well as their Vmax values were found to be decreased significantly in CBDL plus taurocholic acid (TCA) injected group than in the control group, such as CBDL alone groups. However, their Km values in the experimental groups did not vary. Serum COMT activity increased slightly in the CBDL plus TCA injected group than in the control group. The above results suggest that TCA represses biosynthesis of the COMT in the liver. The elevated activity of the serum COMT is believed to be caused by the increment of membrane permeability of hepatocytes upon TCA mediated liver cell necrosis.