• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.120-124
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• 2001

Sclerosing cholangitis is a chronic cholestatic disease characterized by inflammation and obliterative fibrosis of the bile ducts, leading to biliary cirrhosis and ultimately to liver failure. In children, sclerosing cholangitis is known to be associated with Langerhans cell histiocytosis, as well as with congenital immunodeficiencies and cystic fibrosis. Secondary sclerosing cholangitis is suspected in Langerhans cell histiocytosis with chronic cholestasis, liver dysfunction and portal hypertension. Unlike primary sclerosing cholangitis, the cholangitis associated Langerhans cell histiocytosis is destructive in nature and progresses more rapidly to biliary cirrhosis, therefore uniformly the prognosis is poor. In this setting, liver transplantation should be considered early in children with sclerosing cholangitis complicating Langerhans cell histiocytosis before end-stage liver failure and variceal bleeding. We experienced a case of secondary sclerosing cholangitis in Langerhans cell histiocytosis in a 2-year-old boy. We report this case with brief review of the related literatures.

• Applied Microscopy
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• v.15 no.1
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• pp.101-111
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• 1985

A study was undertaken to observe the distribution and ultrastructure of the sensory papillae of the liver and lung flukes which was obtained from experimentally infected rats and dogs. For this study, the rats were artificially infected with metacercariae isolated from Pseudorasbora parve, and the dogs were artificially infected with metacercariae isolated from Cambaroides similis. The liver flukes (Clonorchis sinensis) were collected from the bile ducts of the rats which were autopsied 5 weeks later since infection. The lung flukes (Paragonimus westermani) were collected from the lung of the dogs which were autopsied 3 months later since infection. With the collected worms, ultrastructure of sensory papillae was studied by means of a scanning and transmission electron microscope. The liver flukes were compared with the lung flukes. The results of the observation are as follows. 1. The sensory papillae of the liver flukes was classified into 3 types and most of sensory papillae were distributed on the oral sucker. 2. The sensory papillae of the lung flukes were distinguished 8 types. The sensory papilla type VIII was specifically distributed on the oral sucker and type I, II were distributed on the tegumental surface of the worm. The sensory papillae of the lung flukes were mostly observed between oral sucker and ventral sucker of the worm excusively 3. The sensory papillae of the liver flukes were distributed around the sucker while those of the lung flukes were developed between spine. 4. The sensory papillae were formed by many tegumental ridge in the liver flukes while was made of many small sensory papillae in the lung flukes. 5. The sensory cilia were observed between tegumental ridges in the sensory papilla of the liver flukes and also in lung flukes. And they are alike in that respect. 6. The sensory papillae were not developed in the posterior part of the liver and lung flukes but mostly nerve endings were formed in the tegumental syncytium, and it was connected with neuropile.

• Journal of Clinical Nutrition
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• v.10 no.2
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• pp.38-44
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• 2018

Purpose: Parenteral nutrition (PN) is known to provide therapeutic beneficial improvements in malnourished patients for whom enteral nutrition is not feasible. The objective of this study was to investigate the current clinical characteristics and utilization of PN in Korea. Methods: We analyzed the Health Insurance Review Agency National Inpatients Sample database from 2014 to 2016, which included 13% of all hospitalized patients in Korea. Adult patients aged 20 years or older and receiving premixed multi-chamber bag containing PN were included for this study. Patient characteristics, admission type, primary diagnosis, and hospital demographics were evaluated. SAS version 9.4 was used for data analysis. Results: From 2014 to 2016, 149,504 patients received premixed PN, with 226,281 PN prescriptions being written. The mean patient age was 65.0 years, and 81,876 patients (54.8%) were male. Premixed 3-chamber bag and 2-chamber bag PN solutions were utilized in 131,808 (88.2%) and 32,033 (21.4%) patients, respectively. The number of patients hospitalized through the emergency department were 70,693 (47.3%), whereas 43,125 patients (28.8%) were administered PN in intensive care units. In the adult PN patients, the highest primary diagnosis was malignant neoplasm of the stomach (8,911, 6.0%), followed by organism unspecified pneumonia (7,008, 4.7%), and gastroenteritis and colitis of unspecified origin (6,381, 4.3%). Overall, 34% of adult PN patients were diagnosed with malignancies, the most common being neoplasm of the stomach (17.7%), neoplasm of bronchus/lung (11.2%), neoplasm of colon (11.1%), and neoplasm of liver/intrahepatic bile ducts (10.0%). PN solutions were most frequently administered in the metropolitan area (55.0%) and in hospitals with more than 1,000 beds (23.6%). Conclusion: PN was commonly administered in older patients, with primary diagnosis of malignancy in a significant number of cases. This study is the first large-scale description of PN-prescribing patterns in real-world clinical practice in South Korea.

• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.966-978
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• 2022

Jaundice in children have various etiologies. Among them, physiological jaundice is a very common disease observed in more than half of full-term neonates. When jaundice persists or develops after 2 weeks of age, the total/direct bilirubin is measured in consideration of the possibility of cholestasis. In case of cholestasis, imaging studies differentiate biliary atresia and other disorders of the extrahepatic bile ducts. In this review, we briefly presented the major differential diseases of cholestasis in children and introduced diagnostic imaging techniques, including normal findings.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.2
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• pp.172-179
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• 2023

Backgrounds/Aims: Cancer stigma (CS), a self-inflicted sense of hopelessness, has been identified as a major factor affecting cancer patients' outcomes. However, few studies have investigated the CS-related outcomes in hepatobiliary and pancreatic (HBP) cancer. Thus, the aim of this study was to investigate effects of CS on quality of life (QoL) of HBP cancer. Methods: From 2017 to 2018, 73 patients who underwent curative surgery for HBP tumor at a single intuitive were enrolled prospectively. The QoL was measured using the European Organization for Research and Treatment of Cancer QoL score, and CS was evaluated in three categories, "impossibility of recovery," "cancer stereotypes," and "social discrimination." the stigma was defined by higher scores of attitudes compared with the median value. Results: The stigma group showed a lower QoL (-17.67, 95% confidence interval [CI]: -26.75 to 8.60, p < 0.001) than the no stigma group. Similarly, most function and symptoms of the stigma group showed worse results than the no stigma group. The difference in function scores between the two groups according to CS was highest in cognitive function (-21.20, 95% CI: -30.36 to 12.04, p < 0.001). Fatigue showed the largest difference between the two groups at 22.84 (95% CI: 12.88-32.07, p < 0.001) and was the most severe symptom in stigma group. Conclusions: CS was an important negative factor affecting the QoL, function, and symptoms of HBP cancer patients. Therefore, appropriate management of CS is crucial for improved postoperative QoL.

• Clinical Endoscopy
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• v.57 no.2
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• pp.226-236
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• 2024

Background/Aims: This study aimed to compare the safety of the double-guidewire technique (DGT) with that of the conventional single-guidewire technique (SGT) in real-world situations. Methods: A total of 240 patients with naïve papilla who underwent endoscopic retrograde cholangiopancreatography (ERCP) at Daegu Catholic University Medical Center between January 2021 and December 2021 were included. The primary outcome was the rate of post-ERCP pancreatitis (PEP) in the SGT and DGT groups. Results: A total of 163 patients (67.9%) belonged to the SGT group, and 77 (32.1%) belonged to the DGT group. The rates of successful biliary cannulation were 95.7% and 83.1% in the SGT and DGT groups, respectively (p=0.002). In the study group, PEP occurred in 14 patients (5.8%). The PEP rates were not significantly different between the SGT and DGT groups (4.3% vs. 9.1%, p=0.150). In the multivariate analysis, the age of <50 years (odds ratio [OR], 9.305; 95% confidence interval [CI], 1.367-63.358; p=0.023) and hyperlipidemia (OR, 7.384; 95% CI, 1.103-49.424; p=0.039) were significant risk factors for PEP in the DGT group. Conclusions: DGT did not increase the PEP rate in patients with naïve papilla. In addition, the age of <50 years and hyperlipidemia were significant risk factors for PEP in the DGT group.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4597-4606
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• 2012

Cholangiocarcinoma (CCA) is an uncommon adenocarcinoma which arises from the epithelial cells of the bile ducts. The aim of the study was to investigate the cytotoxicity, toxicity, and anticancer activity of a crude ethanolic extract of ginger (Zingiber officinale Roscoe) against CCA. Cytotoxic activity against a CCA cell line (CL-6) was assessed by calcein-AM and Hoechst 33342 assays and anti-oxidant activity was evaluated using the DPPH assay. Investigation of apoptotic activity was performed by DNA fragmentation assay and induction of genes that may be involved in the resistance of CCA to anticancer drugs (MDR1, MRP1, MRP2, and MRP3) was examined by real-time PCR. To investigate anti-CCA activity in vivo, a total of 80 OV and nitrosamine (OV/DMN)-induced CCA hamsters were fed with the ginger extract at doses of 1000, 3000, and 5000 mg/kg body weight daily or every alternate day for 30 days. Control groups consisting of 10 hamsters for each group were fed with 5-fluorouracil (positive control) or distilled water (untreated control). Median $IC_{50}$ (concentration that inhibits cell growth by 50%) values for cytotoxicity and anti-oxidant activities of the crude ethanolic extract of ginger were 10.95, 53.15, and $27.86{\mu}g/ml$, respectively. More than ten DNA fragments were visualized and up to 7-9 fold up-regulation of MDR1 and MRP3 genes was observed following exposure to the ethanolic extract of ginger. Acute and subacute toxicity tests indicated absence of any significant toxicity at the maximum dose of 5,000 mg/kg body weight given by intragastric gavage. The survival time and survival rate of the CCA-bearing hamsters were significantly prolonged compared to the control group (median of 54 vs 17 weeks). Results from these in vitro and in vivo studies thus indicate promising anticancer activity of the crude ethanolic extract of ginger against CCA with the absence of any significant toxicity. Moreover, MDR1 and MRP3 may be involved in conferring resistance of CCA to the ginger extract.

• Parasites, Hosts and Diseases
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• v.23 no.1
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• pp.95-101
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• 1985

Fascioliasis in cattle is one of the most common and very serious trematode diseases in Korea. In the present study, the enzyme linked immunosorbent assay (ELISA) was applied in the diagnosis of fascioliasis using antigen of Fasciela hepatica, perokidase of conjugate anti-cattle Is G and orthophenylenediamine as a substrate by micro-method technique of Volley et at. (1976b) and MacLaren (1978) with a slight modification. Results obtained from the present study are as follows. 1. In assay for optimal dilution of stock antigen, the antigen (protein contents; 0. Bmgymz) was diluted from 1150 to 1/600 with carbonate buffer (pH 9.6), and then absorbance values were measured with 1/100 diluted sera. The regression equations between the OD values of ELISA and dilution of antigen were log Y: -0.181-0.00127X in infected sera, and log Y: -0.578-0. 000879X in normal sera. The significantly higher (p<0.05) OD value was observed in the former. 2. In assay for optimal dilution of sera, the sera were diluted from 1125 to 1/400 with in PBSJ Tween 20 (pH 7.4), and absorbance values were measured with 1/200 diluted antigen. The regression equation between the OD values of ELISA and dilution of sera were log Y: -0.1540-0.0007238X in infected sera and log Y: -0.4834-0.00116X in normal sera. The former was higher than the latter (p<0.05). 3. In the 27 cases of negative intradermal test, OD values of the ELISA are $0.447{\pm}0.144$, the 95% confidence interval (Mean+2 H SD) of the values was 0.735, and there was no case over the values. Therefore, the sensitivity of the antigen to diagnose fascioliasis was 100% in the negative case. The OD value 0.7 which is designed as a criterion (detection level of positive one) is useful for the performance of the ELISA in fascioliasis. 4. According to the OD value of criterion in the regression equations, the optimal dilutions of stock antigen and serum were 1/250 and 1/100, respectively. 5. In the 58 cases of fascioliasis from which the adult could be found in the bile ducts, the OD value was $0.846{\pm}0.224$. The 75% (44 cattle) among them had higher value with compared to the criterion, and the 60% (20 cattle) of the cases of proliferative cholangitis of 33 cattle which had been infected previousely with Fasciola sp. is higher than the criterion. 6. Prevalence of fascioliasis was 43.4% in the application of the ELISA to 272 cattle which were reared in Jeonbug district.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1097-1102
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• 2016

Background: Liver fluke infection with Opisthorchis viverrini and its associated cholangiocarcinoma constitute a serious problem in Thailand. Healthy behavior can decrease infection, therefore, the investigation of knowledge, attitude, and practice is need required in high risk areas. Objective: This study aimed to investigate the behavior and perceptions regarding liver fluke. Materials and Methods: A cross-sectional descriptive study was conducted in Chum Phuang district of Nakhon Ratchasima province, Thailand during July to November 2015. A total 80 participants who had screened with verbal screening test, stool examination, and ultrasonography, were purposive selected and completed a pre-designed questionnaire (Kruder-Richardon-20=0.80, Cronbach's alpha coefficient=0.82 and 0.79). T-test, ANOVA, and Pearson correlation test were used for analyzed data. Results: The results reveal that O. viverrini infection was 1.25%, and 3 patients had a dilated bile ducts. The participants had a high knowledge, attitude, and practice regarding liver fluke. The education, occupation, and income, were statistical significant to attitude regarding liver fluke. Nurses and television were the main sources of information regarding liver fluke, with statistical significance(p-value <0.05). Knowledge was significantly associated with attitude and practice (p-value<0.05). Conclusions: Participants had good behavior regarding liver fluke. Improvement of knowledge and attitude is influenced to practical change regarding this carcinogenic fluke. In addition, nurse and television are the main information resources for key success in increasing people perception for disease prevention and control in this area.

• Tuberculosis and Respiratory Diseases
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• v.56 no.2
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• pp.216-220
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• 2004

Because a cavitary pulmonary metastasis is rare, it may not be readily identified. However, various types of cancers can metastasize to the lung in the form of cavities. We report a case of a multiple cavitary metastases to the lung from a cholangiocarcinoma in a 60-year-old man. He complained of generalized weakness and a poor oral intake for 2 months. The plain chest radiography and the chest computed tomography showed multiple small thick-walled cavities and nodules the both lungs. A bronchoscopic examination revealed a focal irregularly elevated surface of the mucosa at the orifice of the superior segment of the right lower lobe and the biopsy demonstrated an infiltrative metastatic adenocarcinoma. The abdomen-pelvis computed tomography showed an ill-marginated and irregularly low-dense area in the right lobe of the liver and a diffuse dilatation of the peripheral intrahepatic bile ducts. The esophagogastroscopy and colonoscopy showed no abnormal findings. It was concluded that the cholangiocarcinoma of the liver metastasized to the lung in the form of cavities. Thereafter, the patient underwent six cycles of the systemic chemotherapy with gemcitabine and cisplatin, and the follow-up imaging studies showed a partial response.