• 대한미생물학회지
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• 제20권1호
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• pp.35-44
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• 1985

Isolation and identification of anaerobic bacteria from blood cultures are still technically demanding procedures. Recently, with the use of gas liquid chromatography, the accuracy of identification is much improved. However, there has never been a satisfactory data analysis on anaerobic bacteremia in Korea. The authors evaluated both the clinical and the bacteriological data of 129 anaerobic bacteremias found at the Yonsei Medical Center during the period of 1973 to 1984. The most frequently isolated anaerobic bacteria were Bacteroides (52.7%), among which the major species was B. fragilis (38.7%). Incidence of anaerobic bacteremia by sex was 57% in male and 43% in female. Mortality was higg in groups below 1-year old and above 50-year old. The cause of death seemed closely correlated with the patient's age, general condition and the severity of the underlying disease. Various neoplasms were the most common (20%) underlying diseases predisposing the anaerobic bacteremia. Biliary tract was considered the most frequent route of infection in anaerobic bacteremia. The frequent clinical signs in anaerobic bacteremia were fever (65%), followed by liver function abnormality (29%), jaundice (20%) and hypotention(18%). When analysis of positive rate of blood culture was made on the patients from whom 4 cultures were done within 24 hours, it was found that 33% of the samples were positive. Isolation rate of anaerobic bacteria in thioglycollate medium was 83.8%, while it was 44% in Tryptic soy broth. Among the anaerobic bacteremia, 25.4% were polymicrobial infections with aerobic bacteria (92.5%), such as E. coli(33.3%). From these studies, it is concluded that B. fragilis is the most important causative organism in anaerobic bacteremia, with high fatality, particularly in those who have underlying diseases. The ports of entry are mainly biliary, gastrointestinal and female genital tract. Fever is the most frequent clinical sign. Single blood culture is not sufficient to detect all anaerobic bacteremia, therefore more cultures with optimal time interval are needed. The incidence of polymicrobial infection in anaerobic bacteremia is higher than that in overall bacteremia.

• Clinical and Experimental Pediatrics
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• 제48권1호
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• pp.104-107
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• 2005

저자들은 20개월 유아에서 복통이나 담즙정체 등의 특이 증상이 동반되지 않으면서도 간, 비장종대를 동반하고 간 조직검사에서 간경화가 있었으나, 종괴제거 수술 후 간기능검사 뿐 아니라 간, 비장 종대가 급격하게 해결된 총수담관낭을 경험하였다. 총수담관낭을 조기에 발견하여 적절하게 제거하는 것이 간기능 검사의 호전 뿐 아니라 조직학적으로 입증된 간경화를 호전시키는 데에도 중요함을 시사한다고 하겠다.

• 대한한의학회지
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• 제29권4호
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• pp.30-38
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• 2008

Objectives: The main goals of cancer treatment are improvement of quality of life and survival prolongation. There is a limitation to prolonging the survival time in hepatobiliary and pancreatic cancer. The purpose of this study was to evaluate the quality of life of hepatobiliary and pancreatic cancer patients who visited for traditional Korean cancer treatment. Methods: We evaluated the quality of life of 23 hepatobiliary and pancreatic cancer patients who visited for oriental medicine treatment at East-West Neo Medical Center from June to October of 2007. FACT-G (Functional Assessment Cancer Therapy-General), used in this study, is a scale for evaluation of QOL confirmed validity and reliability, popularly used in many countries to evaluate QOL of cancer patients. Results: The average age of enrolled patients was 57. There were 10 hepatocellular carcinoma patients, 7 pancreatic cancer patients, 6 biliary tract cancer patients. Twenty one patients were in stage IV and 20 patients had distant metastases. By Sasang constitution, Taeumin were 7, Soyangin were 8, and Soeumuin were 8. The baselines of FACT-G score in the first visit were from 34.33 to 85, and the mean score was 67.3. The mean score of FACT-G in hepatocellular carcinoma patients was 67.5, that of pancreatic cancer patients was 62.5, and that of biliary tract cancer patients was 71. Conclusions: This study is valuable as an initial QOL study of hepatobiliary and pancreatic cancer patients who visited an oriental medical clinic. We believe that consistent studies will be necessary to demonstrate oriental treatment-related quality of life with hepatobiliary and pancreatic cancer.

• Journal of Preventive Medicine and Public Health
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• 제49권3호
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• pp.143-152
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• 2016

Objectives: Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented. Methods: We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise. Results: A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer. Conclusions: The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women.

• 한국간담췌외과학회지
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• 제26권4호
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• pp.407-411
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• 2022

Mesenchymal hamartoma of the liver (MHL) is a rare benign tumor that often presents in early childhood, and it rarely occurs in adulthood. Aberrant development of the portal tract is a known cause of MHL. Although limited information is available on the natural course of MHL, malignant transformation has been reported in a few cases. Here, we report a case of a 26-year-old female with intrahepatic cholangiocarcinoma secondary to unresected MHL. The patient underwent resection of the hepatic mass, which was diagnosed as MHL at 2 years of age, due to an increase in mass size and a suspicion of malignant transformation during work-up. Histopathology confirmed intrahepatic adenosquamous carcinoma in the background of MHL, with a T2N0M0 pathological stage (stage II). The surgical margin was free from tumor cells. The patient fully recovered postoperatively and started receiving adjuvant chemotherapy. Previous case reports have only reported about the development of undifferentiated embryonal sarcoma or angiosarcoma as malignant transformation of MHL. Cases of other malignancies have not been published; however, it is difficult to rule out the occurrence of various malignancies related to the portal tract when considering the pathogenesis of the disease. To the best of our knowledge, this is the first case report of adenocarcinoma of bile duct origin secondary to MHL. This case report suggests that aggressive surgical management should be considered after the initial diagnosis of MHL.

• 대한영상의학회지
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• 제84권6호
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• pp.1350-1360
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• 2023

목적 악성 담관 폐쇄 환자에서 경피경간 담도 배액술을 시행할 때 유증상 이탈을 유발하는 예측 인자에 대해 연구를 진행하고자 한다. 대상과 방법 2010년 1월부터 2015년 2월까지 572명의 악성 담관 폐쇄 환자에서 시행한 733건의 경피경간 담도 배액술을 대상으로 후향적 연구를 시행하였다. 카테터의 거치 기간, 접근 위치, 카테터 팁의 위치, 삽입 각도, 피그테일 루프의 유무, 도관 직경을 평가하였다. 결과 추적관찰 기간 동안 157명의 환자에서 224건(30.56%)의 도관 이탈이 발생하였다. 그중 146건(19.92%)가 유증상 도관 이탈이었다. 배액관 이탈 발생까지의 기간은 평균 30일(범위: 1-159일)이었다. 유증상 도관 이탈은 배액관의 교체(137명) 또는 담관 스텐트 삽입(9명)을 통해 치료하였다. 남성(교차비: 1.636, 95% 신뢰구간: 1.131-2.367, p = 0.009), 우측 접근(교차비: 1.567, 95% 신뢰구간: 1.080-2.274, p = 0.018), 도관 삽입 각도 증가(교차비: 1.015, 95% 신뢰구간: 1.005-1.026, p = 0.005), 불완전 피그테일 루프(교차비: 1.672, 95% 신뢰구간: 1.098-2.545, p = 0.016)가 독립적인 경피경간 담도 배액술 도관 유증상 이탈의 예측 인자였다. 결론 유증상 이탈을 유발하는 예측인자에는 남성, 우측 접근, 도관 삽입 각도 증가, 불완전 피그테일 루프가 있다.

• 대한방사선기술학회지:방사선기술과학
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• 제20권1호
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• pp.43-49
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• 1997

Purpose of this paper is to extend help for clinical application in balloon cholangiography on patients who have undergone endoscopic sphincterotomy, impacted stones of intrahepatic duct, and missed bile duct because of other diseases in operating endoscopic retrograde cholangiopancreatography. This study was done for the patients who had clinical signs of biliary diseases from January to December In 1996. We studied 45 patients who had endoscopic sphincterotomy, re-examination after interventional treatment of the endoscopic retrograde cholangiopancreatography, and uncertain diagnosis due to common bile duct and intrahepatic duct those are not filled with contrast media. Balloon cholangiography was performed in case of uncertain diagnosis while operating endoscopic retrograde cholangiopancreatography. First of all, we insert balloon catheter Into the working channel of treatment jejunofiberscope and remove treatment Jejunofiberscope after ballooning, and lastly take biliary tract X-ray after Injection and changing position of patient. The results of this study were as follows. (1) In classification of diseases, stones of gall bladder, those of common bile duct, and those of intrahepatic duct were 30 cases, fistula was 1 case. (2) In total cases of 45, only diagnosis were 25 cases, interventional treatment were 20 cases. (3) In case of interventional treatment, endoscopic sphincterotomy and endoscopic nasobiliary drainage, and stone removal were about the same, 7, 7, 6 respectively. Balloon cholangiography will be useful to prevent patients from having repeated and unnecessary studies for the cases above explained. It is considered that this study will be useful for clinical application in terms of reducing medical expenses, pain while examination, and consultation hours.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.294-298
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• 2021

Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제13권2호
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• pp.204-209
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• 2010

소아에서 외상 급성 췌장염은 드물기는 하지만 주로 자전거 손잡이에 의한 복부 둔상으로 발생할 수 있다. 치료는 손상의 정도에 따라 개별화되며, 저자들에 따라 치료 방법에 차이를 보이지만 대부분 췌장 도관의 손상과 위치에 따라 결정된다. 외상 급성 췌장염의 합병증으로 췌장 거짓낭이 주로 발생하지만 저자들은 췌장염의 보존적 치료 경과 중 원위부 총담관의 협착과 담즙찌꺼기에 의한 담도 폐쇄를 경험하였고 경피경간담도 배액술로 성공적으로 치료하였기에 보고하는 바이다.

• 한국임상수의학회지
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• 제31권6호
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• pp.531-534
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• 2014

3년령의 암컷 사냥견이 구토, 호흡곤란, 식욕부진을 주증으로 내원 하였다. 환자는 내원 2주 전 멧돼지에 받힌 병력이 있었다. 환자는 방사선사진상 횡격막 탈장 소견, 초음파 검사상 확장된 담도계가 확인되었다. 탐색적 개복술 시 오른쪽 횡격막의 손상이 확인되었고 흉강내에서 일부 간엽과 소장분절, 확장된 담도계를 확인하였다. 수술적 처치로 흉강내 위치하는 복강 장기들을 환원시키고 횡격막 탈장 교정술을 실시하였으며 이후 임상증상, 방사선사진과 초음파 검사 소견은 모두 정상적인 수준으로 회복되었다. 이를 토대로 횡격막 탈장에 의해 속발된 간외담도계폐색으로 진단하였다. 본 증례는 횡격막 탈장에 의해 속발된 간외담도계폐색이 발생한 증례 보고이다.