• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권4호
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• pp.273-278
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• 2013

We present a case of a 7-year-old boy who had cholestasis after trimethoprim-sulfamethoxazole combination therapy. Liver biopsy was performed 36 days after the onset of jaundice because of no evidence of improving cholestasis. Liver histology revealed portal inflammation, bile plug, and biliary stasis around the central vein with the loss of the interlobular bile ducts. Immunohistochemical stains for cytokeratin 7 and 19 were negative. These findings were consistent with those of vanishing bile duct syndrome (VBDS). Chlestasis was progressively improved with dose increment of urosodeoxycholic acid from conventional to high dose. This is the first case report of trimethoprime-sulfamethoxazole associated VBDS in Korean children. The case suggests that differential diagnosis of VBDS should be considered in case of progressive cholestatic hepatitis with elevation of alkaline phosphatase and gamma-glutamyl transpeptidase after or during taking medicine to treat nonhepatobiliary diseases illness.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7195-7200
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• 2015

Background: Since seventeen employees of an offset printing company in Osaka, Japan developed cholangiocarcinoma it has become recognized as an occupational cancer. This study investigated the differences of clinical features between occupational cholangiocarcinoma and sporadic young-onset cholangiocarcinoma. Materials and Methods: Thirty-four young adults (<50 years old) with sporadic cholangiocarcinoma were extracted from the Rosai Hospital Group database (sporadic group) and their clinical features were compared with those of 17 patients with occupational cholangiocarcinoma (occupational group). Results: The 34 patients in the sporadic group were treated for cholangiocarcinoma at 16 different Rosai hospitals. There were significant differences of age (p<0.01), gender (p<0.01), abnormal laboratory tests (p<0.01), and tumor location (p<0.01) between the two groups. The percentage of patients with abnormal laboratory tests was significantly higher in the occupational group than in the sporadic group (p<0.001). Regional dilation of bile ducts, which is a characteristic of occupational cholangiocarcinoma, was not observed in the sporadic group. Conclusions: No cluster of cholangiocarcinoma cases was identified in the Rosai Hospital database. There were differences of clinical features between occupational and sporadic cholangiocarcinoma, which might be helpful for diagnosing occupational cholangiocarcinoma in the future.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.6991-6996
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• 2015

In the past decade, the incidence and mortality rates of cholangiocarcinoma (CCA) have been increasing worldwide. The relatively low responsiveness of CCA to conventional chemotherapy leads to poor overall survival. Recently, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL or Apo2L) has emerged as the most promising anti-cancer therapeutic agent since it is able to selectively induce apoptosis of tumor cells but not normal cells. In this study, we aimed to investigate the therapeutic effect of TRAIL in CCA cell lines (M213, M214 and KKU100) compared with the immortal biliary cell line, MMNK1, either alone or in combination with a subtoxic dose of 5-fluorouracil (5-FU). We found that recombinant human TRAIL (rhTRAIL) was a potential agent which significantly inhibited cell proliferation and mediated caspase activities (caspases 8, 9 and 3/7) and apoptosis of CCA cells. The combined treatment of rhTRAIL and 5-FU effectively enhanced inhibition of CCA cell growth with a smaller effect on MMNK1. Our finding suggests TRAIL to be a novel anti-cancer therapeutic agent and advantage of its combination with a conventional chemotherapeutic drug for effective treatment of CCA.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권2호
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• pp.284-288
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• 2004

영아에서 담관의 자연 천공은 매우 드물며 조기에 발견하여 치료하지 않으면 사망할 수 있는 질환이다. 출생 후 건강하던 영아가 복부팽만, 복수, 황달이 나타나면 의심하게 되며 대부분 수술적 담도 조영술을 시행하는 과정에서 진단된다. 저자들은 복부팽만, 황달, 무담즙변 증상이 있는 생후 4개월 된 소아에서 총담관의 자연천공 1례를 경험하여 문헌 고찰과 함께 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2361-2367
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• 2016

Since 1980, endoscopic ultrasound (EUS) has been used as an important tool for the evaluation of malignant diseases in hollow viscus and bilio-pancreas, as well as sub-epithelial tumors. The high-resolution capacity and low penetration depth of EUS make it possible to obtain highly detailed images of the gastrointestinal wall and immediate surroundings to a depth of 4-5 cm. Thus, over the past 35 years, EUS succeeded to modify management in significant number of cases and is now considered a gold standard tool for many gastrointestinal diseases, especially in the pancreatico-biliary tract, and adjuvant needle insertion now allows access to remote lesions that were difficult to reach in the past. With the growing spectrum of indications, tissue sampling for diagnostic purposes has become common. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in staging of upper gastrointestinal malignancies, especially esophageal, gastric and ampullary tumors.

• 대한한의진단학회지
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• 제19권3호
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• pp.159-171
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• 2015

Objectives: Lately, non alcoholic fatty liver patients are increasing rapidly and the average age of patients are getting younger. Non alcoholic fatty liver often represents asymptomatic and korean pattern diagnosis is difficult to implement without symptoms. This study aimed to analyze interrelationship between non alcoholic fatty liver disease and Injinho-tang. Methods The AHP is a systematic procedure for analyzing the elements of any problem hierarchically. Based on survey of expertise, as series of pairwise comparison judgements is performed to evaluate the various elements in the hierarchy. We are expected to use the AHP analysis that would apply to oriental doctor's diagnostic process analysis. Results and conclusion Non-alcoholic fatty liver disease induced complex causes of the metabolic syndrome. Injinho-tang has been widely used disease that causes jaundice and liver biliary disease. According to AHP analysis, LFT is the most important facor in choosing Injinho-tang on non alcoholic fatty liver disease. BMI and body composition by bioelectrical impedance analysis are the next important factors. Personal hot temper also gives a big impact on choicing Injinho-tang on non alcoholic fatty liver disease.

• The Korean Journal of Physiology and Pharmacology
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• 제2권2호
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• pp.261-269
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• 1998

Concomitant administration of a single acute dose of ethanol (4 g/kg) protected mice from the hepatocellular injury observed upon administration of a large dose of acetaminophen (400 mg/kg). This was evidenced by the normal histological appearances of liver sections and by the lowered serum aminotransferase activities in mice treated with ethanol and acetaminophen together. In the mice treated with acetaminophen alone, along with the hepatic necrosis, the hepatic microsomal aminopyrine N-demethylase activity was decreased. However, co-administration of ethanol prevented this acetaminophen dependent inhibition on the microsomal mixed function oxidase activity. Pharmacokinetic studies indicated that the concentration of un-metabolized drug in the blood was increased in the ethanol treated mice. Furthermore, upon co-administration of ethanol, although the biliary levels of acetaminophen metabolites (glucuronide, sulfate and cysteine conjugates) were decreased, the level of unmetabolized acetaminophen was increased. Our findings suggest that co-administration of an acute dose of ethanol reduces the degree of hepatocellular necrosis produced by a large dose of acetaminophen and this ethanol dependent protection is, in major part, afforded by suppression of the hepatic microsomal mixed function oxidase activity catalyzing the metabolic activation of acetaminophen.

• BMB Reports
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• 제49권11호
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• pp.590-597
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• 2016

Parasitic diseases remain an unarguable public health problem worldwide. Liver fluke Clonorchis sinensis is a high risk pathogenic parasitic helminth which is endemic predominantly in Asian countries, including Korea, China, Taiwan, Vietnam, and the far eastern parts of Russia, and is still actively transmitted. According to the earlier $8^{th}$ National Survey on the Prevalence of Intestinal Parasitic Infections in 2012, C. sinensis was revealed as the parasite with highest prevalence of 1.86% in general population among all parasite species surveyed in Korea. This fluke is now classified under one of the definite Group 1 human biological agents (carcinogens) by International Agency of Research on Cancer (IARC) along with two other parasites, Opisthorchis viverrini and Schistosoma haematobium. C. sinensis infestation is mainly linked to liver and biliary disorders, especially cholangiocarcinoma (CCA). For the purposes of this mini-review, we will only focus on C. sinensis and review pathogenesis and carcinogenesis of clonorchiasis, disease condition by C. sinensis infestation, and association between C. sinensis infestation and CCA. In this presentation, we briefly consider the current scientific status for progression of CCA by heavy C. sinensis infestation from the food-borne trematode and development of CCA.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1994년도 춘계학술대회 and 제3회 신약개발 연구발표회
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• pp.202-202
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• 1994

G009의 hepatic cirrhosis animal model중 bile duct ligation/scission (BDL/S) rat에서의 항섬유화 효과를 조사하였다. BDL/S 수술 후 4주간 투약군에는 G009 saline soln.(5mg/rat/day)을, 대조군에는 saline을 경구투여하였다. fibrosis가 최고에 달하는 4주후 rat를 도살하여, 혈청중 N-terminal procollagen type III peptide(PIIINP) level, 간 조직중 hydroxy proline content, serum biochemical value(ALT, AST, choleterol, total bilirubin, creatinine) 측정 및 간조직검사를 실시하였다. 그 결과 1) 혈청중 PIIINP의 경우, 투약군 BDL/S group(10.3ng/ml$\pm$2.2)이 대조군 (20.5ng/m1$\pm$3.9)에 비해 약 50%정도 유의성 있게 감소하였다(p<0,01). 2) 간 조직중 hydroxy proline치 측정 결과, 투약군 BDL/S group(471$\pm$160$\mu\textrm{g}$/g liver)이 대조군(566$\pm$42.9$\mu\textrm{g}$/g liver)에 비하여 약 13%정도 유의성있게 감소하였다(p<0.05). 3) 간조직검사 결과 투약군의 BDL/S op. group이 대조군보다 necrosis, inflammetion, bile duct proliferation, connective tissue 침착 등이 약화되었다. 위 실험을 종합한 결과 G009는 biliary cirrhosis model에서 antifibrotic effect가 있음이 사료된다.

• 한국임상약학회지
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• 제21권2호
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• pp.49-56
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• 2011

The family of bile acids belongs to a group of molecular species of acidic steroids with very peculiar biological characteristics. They are synthesized by the liver from cholesterol through several complementary pathways and secreted into small intestine for the participation in the digestion and absorption of fat. The bile acids are mostly confined to the territories of the so-called enterohepatic circulation, which includes the liver, the biliary tree, the intestine and the portal blood with which bile acids are returned to the liver. In patients with bile acid malabsorption, the amount of primary bile acids in the colon is increased compared to healthy controls. Although the increase in the secondary bile acids including deoxycholic acid, is reported to have the potency to affect tumorigenesis in gastrointestinal tracts, there is no firm evidence that clinically relevant concentrations of the bile acids induce cancer. The list of their physiological roles, as well as that of the pathological processes is long and still not complete. There is no doubt that many new concepts, pharmaceutical tools and pharmacological uses of bile acids and their derivatives will emerge in the near future.