• Asian Pacific Journal of Cancer Prevention
• /
• 제17권9호
• /
• pp.4363-4365
• /
• 2016

Background: The complex anatomy of the pancreaticobiliary duct was crucial in management of pancreatic and biliary tract disease. Materials and Methods: Fresh specimens of pancreas, common bile duct (CBD), and duodenum were obtained en bloc from autopsies of 160 patients. Results: Ninety-three male and 67 female patients were included. The length of the pancreas ranged from 9.8-20 cm (mean, 16.20 +/- 1.70 cm). The intrapancreatic portion of the CBD showed patterns of three types: most common (85.30%) was type A, in which the anterior surface of the common bile duct was totally covered, while its posterior surface was partially covered, by the pancreatic parenchyma. On dissection of the accessory duct of Santorini, the accessory duct was traceable to the duodenal wall in 67.6%. The anatomy of the Wirsung-choledochus confluence was grouped into five different types. The common channel was found in 75.60% and its length varied from just a common junction (so-called "V-type" anatomy) to 15 mm (Y-type-b). Separate papillae (so-called "II-type") were found in 15.3% of specimens. Conclusions: Several important points regarding the anatomy of the pancreaticobiliary junction and pancreatic ductal system were illustrated in this study.

• 대한핵의학회지
• /
• 제12권2호
• /
• pp.17-22
• /
• 1978

Carcinoembryonic antigen was initially known as tumor specific antigen and had a potential diagnostic value in the detection of digestive tract malignancies. However, subsequent studies showed CEA and CEA-like antigen present in benign disease, particullary in liver. We had collected sera from 58 patients who had liver scan and later were diagnosed clinically and histologically as liver disease. We estimated CEA values and correlations were made with liver function tests in liver cirrhosis cases. The results: 1) The raised plasma carcinoembryonic antigen level were found in 13 (68.4%) of 19 patients in liver cirrhosis, 5(27.8%) of 18 patients in hepatoma, 5(71. %) of 7 patients in chronic active hepatitis, all 3 patients in liver abscesses, 2(66.7%) of 3 patients in liver ablscesses, 2(66.7%) of 3 patients in obstructive biliary disease and none in each one patient of traumatic liver hematoma, subphrenic abscess and clonorchiasis. 2) There is no linear correlation between carcinoembryodic antigen level and liver function tests including serum bilirubin, alkaline phosphatase, SGOT and prothrombin time in liver cirrhosis patients.

• 대한핵의학회지
• /
• 제24권1호
• /
• pp.56-61
• /
• 1990

We evaluated 85 cases with atrophy of left lobe among 11,133 cases performed liver scan using $^{99m}Tc-phytate$ from January 1984 to January 1990 at Kyungpook National University Hospital in association with underlying causes and related conditions. Seventeen cases seemed to be due to biliary tract diseases, eg, cholelithiasis, cholangiocarcinoma, clonorchiasis and postcholecystectomy state. Fifteen cases were patients with primary and metastatic hepatic malignancies. One case had a history of hepatic irradiation. Thirty cases comprised acute hepatitis, chronic hepatitis, liver cirrhosis and fatty liver. However no causative abnormalities could be detected in 22 cases despite of meticulous diagnostic work-up.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제24권6호
• /
• pp.528-534
• /
• 2021

Purpose: Living-donor liver transplant emerged as an alternative treatment for end stage liver disease due to the lack of cadaveric organs availability that met the demand. In Portugal, pediatric living-donor liver transplant (P-LDLT) was initiated in 2001 in Portugal in order to compensate for the scarcity of cadaveric organs for such cases. The aim of this study was to retrospectively analyze the morbi-mortality of the 28 donors included in P-LDLT program performed at Coimbra's Pediatric Hospital (CHUC), a Portuguese reference center. Methods: We retrospectively collected pertinent donor data and stratified complications according to Clavien's scoring system. Results: In total, 28.6% (n=8) of the donors had surgical complications. According to Clavien-Dindo's classification, two donors had major complications (Clavien grade ≥3), four donors had grade 2 complications, and two donors had grade 1 complications. There were no P-LDLT-related mortalities in the present case series. The most common verified complications were biliary tract injuries and superficial incisional infections, which are consistent with the complications reported in worldwide series. Conclusion: These patients from CHUC shows that donor hepatectomy in P-LDLT is a safe procedure, with low morbidity and without mortality.

• 한국임상수의학회지
• /
• 제40권6호
• /
• pp.452-456
• /
• 2023

This report presents two rare cases of gallbladder rupture in dogs with small gallbladders that did not result in bile leakage and their subsequent surgical treatment. The report includes a 5-year-old spayed female Chihuahua weighing 3.5 kg and a 9-year-old castrated male Poodle weighing 5.3 kg. Both dogs had elevated liver enzyme levels on blood chemistry. However, only the second dog (2) (Poodle) presented with hyperbilirubinemia and jaundice, whereas the first dog (Chihuahua (1)) did not display any specific clinical signs. Diagnostic imaging revealed a small gallbladder in both dogs, and the dogs were diagnosed with cholecystolithiasis (1) and extrahepatic biliary tract obstruction (2). No bile leakage-related abdominal effusion was observed. Gallbladder rupture and adhesion to the adjacent tissues were confirmed during cholecystectomy.

• 대한세포병리학회지
• /
• 제3권1호
• /
• pp.1-11
• /
• 1992

췌-담도 및 배터 팽대부 주위의 암은 조기진단이 어려워 처음 발견시 질병이 상당히 진행되어 있어, 근치술은 물론 생검진단도 수행하기가 어려운 경우가 흔히 있다. 과거 이런 환자들의 진단 방법의 하나로 십이지장에서 담즙을 얻어 세포병리 검사가 시도 되었었으나, 이 경우 얻어진 담즙에 위액 및 췌액이 섞여 있어 변성을 쉽게 초래하고, 염증세포들이 많이 섞여 있을 뿐만 아니라 주위의 염증으로 비정형 세포변화를 초래하여 진단이 어려운 경우가 흔히 있었다. 최근 이런 환자들에 있어 수반되는 증상인 폐색성 황달의 완화와 방사선학적 진단을 위해 경피 경간 담도 조영술 및 담즙배출술이 시행되고 있는데, 이때 비교적 세포형태가 잘 유지된 담즙을 반복 채취하여 세포 병리검사가 시행된다. 저자들은 이 방법으로 얻어진 담즙의 세포 병리학적 진단 성적을 검토하여 다음과 같은 결과를 얻었다. 총 검체는 148명 환자의 275 검체로 이들의 세포 병리학적 진단은 선암 30예 (20.3%) 편평상피 세포암 1예 (0.75%), 전이성 소 세포암 1예 (0.7%), 선조성 비후 8예 (5.4%) 비정형 6예 (4.1 %), 간 흡충증 17예 (11.5), 양성 질환 57예 (38.5%)였고 28명 (18.9%)에서는 부적합 검체가 의뢰 되었었다. 그중 105명에서 의무기록의 확인이 가능하였는데 이들의 임상진단은 99명에서는 악성 질환 이었고 6명에서는 총 담관 결석과 협착과 같은 양성 질환 이었다. 담즙 세포 병리검사에서의 이들 악성 진단율은 23.2%이었다. 이들 악성 질환을 담도 유래의 종양과(1군)부근 림프절의 전이성암, 췌장암, 배터 팽대부 주위암 등의 외인성으로 담도를 압박하는 종양(2군)으로 나누어 보면 악성 진단율은 각각 37%와 11.6%로 현저한 차이가 있었다. 이들중 조직학적 진단이 가능 하였던 9예의 경우 세포 병리 진단율은 각각 50%(1군)와 20%(2군)로 역시 현저한 차이가 있었다 임상진단이 양성 질환 이었던 예들은 전예에서 세포 병리학적으로 양성으로 진단되어 담즙 세포 병리검사의 임상진단과의 일치율은 27.6%, 특이도는 100%이었다. 이상으로 이 담즙세포 검사의 악성 진단율은 그리높지 않으나, 경피 경간 담즙 배출술로 환자의 증상을 완화 시키면서 부수적으로 진단도 얻을 수 있는 유용한 방법이라 하겠고, 그중 담도유래의 종양군에서 외인성으로 담도를 압박하게 되는 종양군에 비해 현저히 높은 진단율을 보였다.

• Molecules and Cells
• /
• 제24권3호
• /
• pp.364-371
• /
• 2007

The tumor suppressor gene Ras association domain family 1A (RASSF1A) is highly methylated in a wide range of human sporadic tumors. The current study investigated the hypermethylation of RASSF1A, the expression of RASSF1A protein, and the correlation between these and the clinicopathological features of gallbladder (GB) cancer in Korean patients. Formalin-fixed, paraffin-embedded tumors and non-neoplastic GB tissues (22 carcinomas, 8 adenomas, 26 normal epithelia) were collected from patients who had undergone surgical resection. The methylation status of two regions of the RASSF1A CpG island was determined by methylation-specific PCR (MSP), and the expression of RASSF1A protein was examined by immunohistochemistry using tissue microarrays. The K-RAS mutation was analyzed by direct sequencing. Methylation of the RASSF1A promoter (region 1) was detected in 22.7% (5/22) of carcinomas, 12.5% (1/8) of adenomas, and 0% (0/26) of normal gallbladder epithelia (P = 0.025). Methylation of the first exon (region 2) was found in 36.4% (8/22) of carcinomas, 25.0% (2/8) of adenomas, and 8.0% (2/26) of normal gallbladder epithelia (P = 0.038). K-RAS mutations were present in 4.5% (1/22) of carcinomas and 25% (2/8) of adenomas. RASSF1A methylaton was not associated with clinicopathological factors or K-ras mutation. Reduction or loss of RASSF1A expression was observed in most methylated adenocarcinomas. Three RASSF1A-expressing human biliary tract cancer cell lines examined contained unmethylated promoters and exons 1. These results suggest that downregulation of RASSF1A expression by DNA hypermethylation may be involved in GB carcinogenesis.

• 대한핵의학회지
• /
• 제15권2호
• /
• pp.11-17
• /
• 1981

Cholescintigraphic studies with $^{99m}Tc-HIDA$(dimethyl iminodiacetic acid) were performed in 22 cases of normal subjects, 21 of acute cholecystitis, 12 of chronic cholecystitis and 12 others, with the results of, 1) In normal control group, liver and intrahepatic biliary tree, CBD and gall bladder, and G-I tract appeared at 10, 20 and 30 minutes after intravenous injection of $^{99m}Tc-HIDA$ respectively, 2) In acute cholecystitis, 20 among 21 cases showed non-visualization of gall bladder with the diagnostic accuracy, sensitivity and specificity of 93.2%, 95.2% and 100% respectively. 3) In chronic cholecystitis, 5 among 12 cases showed non-visualization of gall bladder and remained 7 among 12 cases showed poor contraction of gall bladder (4), delayed visualization of gall bladder (1) and normal findings (2). 4) In the other disease group, the 12 cases which initially suspected as acute cholecystitis, revealed normal scan findings to exclude the cystic duct obstruction easily, With the above results, this scintigraphic procedure was found very rapid, accurate and easily available method for the determining of the cystic duct patency.

• Biomolecules & Therapeutics
• /
• 제11권3호
• /
• pp.163-168
• /
• 2003

Pharmacokinetics of eupatilin (an active components of $Stillen^{\circledR}$, a new antigastritic agent) were investigated after both intravenous and oral administration at a dose of 30mg/kg to rats. After intravenous administration, the plasma concentrations of unchanged eupatilin declined rapidly with a mean terminal half-life of 0.101 h. Eupatilin was eliminated fast in rats; the total body clearance was 121 mL/min/kg. Eupatilin was mainly metabolized in rats; the percentage of intravenous dose of eupatilin excreted in 24 h urine and feces as unchanged eupatilin was only 2.5 and 0.919％, respectively. Eupatilin was mainly metabolized to form its glucuronide conjugate; after intravenous administration, 15.9 and 51.7％ of intravenous dose was excreted in 24 h urine and feces, respectively, as eupatilin plus its glucuronide. After oral administration, the absolute bioavailability was only 3.86％ based on $AUC_{0-24h}$ of eupatilin plus its glucuronide. Approximately 68.5％ of oral dose was not absorbed from the entire gastrointestinal tract. Therefore, it could be concluded that the superior effect of eupatilin in experimental animal models of gastric ulcer and inflammatory bowel disease after oral administration could be due to the local action of eupatilin. Further pharmacokinetic studies to elucidate the local action of eupatilin are required.

• Advances in pediatric surgery
• /
• 제11권1호
• /
• pp.19-26
• /
• 2005

Choledochal cysts have been associated with complications such as cholangitis, pancreatitis, and malignancy of the biliary tract. Recently, the incidence of choledochal cyst in neonate and young infant is increasing due to advances in diagnostic imaging. The aim of this study is to investigate the rationale of excision of choledochal cyst during the neonatal period. The clinical outcome and correlation between age at surgery and the degree of liver fibrosis were reviewed retrospectively. A total of 198 patients with choledochal cyst who were managed surgically between January 1985 and December 2000 at the Department of Surgery, Seoul National University Children's Hospital were included in this study. The overall outcome and the outcome of patients who were managed surgically during the neonatal period were compared. Correlation between age and the degree of liver fibrosis was evaluated by chi-square test and Pearson exact test. The mean age of the patients was 2 years 7 months (ranged from 5 days to 15 years). Mean postoperative follow-up period was 7 years 1 month (7 months to 20 years). The results are as follows. Twelve patients (6%) had postoperative complications, cholangitis (7), bleeding (4) and ileus (1). Eleven patients operated during the neonatal period had no postoperative complications. The positive correlation between age group and degree of liver fibrosis was statistically significant (chi-square: p=0.0165, Pearson exact test: p=0.019). The results support the rationale that excision of choledochal cyst can be performed safely without increasing morbidity in neonates.