• The Korean Journal of Nuclear Medicine
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• v.21 no.1
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• pp.17-24
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• 1987

Authors classified 161 cases of photon defects due to the gall bladder on hepatic parenchymal scintigraphy on $^{99m}Tc-phytate$ and $^{99m}Tc-DISIDA$ according to the position of the gall bladder, the pattern of photon defects and the hepatobiliary diseases. The results were as follows; 1) Conocordance of $^{99m}Tc-DISIDA$ and $^{99m}Tc-phytate$ hepatic parenchymal images in photon defect due to the gall bladder was 94% of 32 cases. 2) The frequency according to the position of the gall bladder was in order to 68% of the gall bladder of the lower margin of the liver, 30% of the intrahepatic gall bladder and 2% of the extrahepatic gall bladder, and the frequency of the photon defects due to the gall bladder was in order to 81% of the intrahepatic gall bladder, 71% of the gall bladder of the lower margin of the liver and 20% of the extrahepatic gall bladder. 3) The pattern of the photon defects due to the gall bladder was 47% of funnel shape in the intrahepatic gall bladder, 69% of semilunar shape in the gall bladder of the lower margin of the liver and 100% of semilunar shape in the extrahepatic gall bladder. 4) All of 9 cases of the intrahepatic gall bladder at the lateral area of the right lobe and the gall bladder of the lower margin of the liver at the right hepatic angle were associated with liver cirrhosis with the right lobe atrophy and the left lobe hypertrophy, 2 cases of the gall bladder of the lower margin of the liver at just-left side of the porta hepatis with hepatoma in the right lobe and 1 case of the intrahepatic gall bladder at the central portion of the right lobe with choledochal cyst.

• Journal of Microbiology and Biotechnology
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• v.10 no.6
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• pp.844-850
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• 2000

The specific binding and internalization of viral particles is an essential step for the successful infection of viral pathogens. In the case of the hepatitis B virus (HBV), virions bind to the host cell via the preS domain of the viral surface antigen and are subsequently internalized by endocytosis. HBV-preS specific receptors are primarily expressed on hepatocytes, however, viral DNA and proteins have also been detected in extrahepatic sites, suggsting that celluar recepators for HBV may also exist on extrahepatic cells. Recently, an EBV-transformed B-cell line was identified onto which the preS region binds in a receptor-ligand specific manner. In this study, this specific interaction was further characterized, and the binding region within the preS protein was locaized. Also the internalization after host cell attachment was visualized and analyzed by fluorescence-labeled HBV-preS1 proteins using confocal microscopy. Energy depletion by sodium azide treatment effectively inhibited the internalization of the membrane-bound preS1 ligands, thereby indicating an energy-dependent receptor-mediated endocytotic pathway. Accordingly, the interaction of HBV-pres! with this specific B-cell line may serve as an effective model for an infection pathway in extrahepatic cells.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.531-534
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• 2014

A 3-year-old intact mixed hunting dog was referred to Gyeongsang Animal Medical Center with the clinical signs of vomiting, dyspnea, anorexia. The dogs had traumatic history that wounded at abdominal wall during the wild boar hunting 2 week ago. The dogs was diagnosed as extrahepatic biliary tract obstruction (EHBO) secondary to traumatic hernia. Diagnosis was based on radiographic features of a diaphragmatic hernia on survey radiography, dilated bile duct in abdominal ultrasonography and complete recovery due to the return of displaced organs into the peritoneal cavity and repair of the diaphragmatic rent. Diagnostic imaging and surgical intervention may result in a favorable outcome in dog with post hepatic obstruction secondary to diaphragmatic hernia. This case emphasizes the strangulation of bile duct by diaphragmatic rupture could be the cause of EHBO.

• Molecules and Cells
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• v.40 no.5
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• pp.363-370
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• 2017

Extrahepatic cholangiocarcinoma (ECC), a malignant tumor of biliary origin, has a poor prognosis with limited treatment options. The KRAS oncogene is the most commonly mutated gene in ECC and one of the factors that predicts a poor prognosis and low survival rate. L1 cell adhesion molecule (L1CAM) is expressed in ECC cells and acts as an independent poor prognostic factor in predicting patient survival. In this study we investigate the functional significance of L1CAM in ECC cells with activating KRAS mutation. We selected an ECC cell line, EGI-1, with activating KRAS mutation, and then confirmed its expression of L1CAM by RT-PCR, western blot analysis, and flow cytometry. The suppression of L1CAM expression (using a specific lentivirus-delivered shRNA) significantly decreased the migratory and invasive properties of EGI-1 cells, without altering their proliferation or survival. Analyses of signaling effectors in L1CAM-depleted and control EGI-1 cells indicated that L1CAM suppression decreased the levels of both phosphorylated MKK4 and total MKK4, together with c-Jun N-terminal kinase (JNK) phosphorylation. Further, exposure to a JNK inhibitor (SP600125) decreased migration and invasion of EGI-1 cells. These results suggest that L1CAM promotes cellular migration and invasion via the induction of MKK4 expression, leading to JNK activation. Our study is the first to demonstrate a functional role for L1CAM in ECC carrying the activating KRAS mutation. Given that KRAS is the most commonly mutated oncogene in ECC, L1CAM may serve as an attractive therapeutic target for ECC cells with activating KRAS mutation.

• Korean Journal of Radiology
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• v.22 no.1
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• pp.41-62
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• 2021

Radiologic imaging is important for evaluating extrahepatic bile duct (EHD) cancers; it is used for staging tumors and evaluating the suitability of surgical resection, as surgery may be contraindicated in some cases regardless of tumor stage. However, the published general recommendations for EHD cancer and recommendations guided by the perspectives of radiologists are limited. The Korean Society of Abdominal Radiology (KSAR) study group for EHD cancer developed key questions and corresponding recommendations for the radiologic evaluation of EHD cancer and organized them into 4 sections: nomenclature and definition, imaging technique, cancer evaluation, and tumor response. A structured reporting form was also developed to allow the progressive accumulation of standardized data, which will facilitate multicenter studies and contribute more evidence for the development of recommendations.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.3
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• pp.307-312
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• 2023

Hepatic arterioportal fistulae are abnormal communications between the hepatic artery and portal vein. They are reported to be congenital or acquired secondary to trauma, iatrogenic procedures, hepatic cirrhosis, and hepatocellular carcinoma, but less likely to occur spontaneously. Extrahepatic portal venous obstruction (EHPVO) can lead to pre-hepatic portal hypertension. A spontaneous superimposed hepatic arterioportal fistula can lead to pre-sinusoidal portal hypertension, further exacerbating its physiology. This report describes a young woman with long-standing EHPVO presenting with repeated upper gastrointestinal variceal bleeding and symptomatic hypersplenism. Computed tomography scan demonstrated a cavernous transformation of the portal vein and a macroscopic hepatic arterioportal fistula between the left hepatic artery and portal vein collateral in the central liver. The hepatic arterioportal fistula was associated with a flow-related left hepatic artery aneurysm and a portal venous collateral aneurysm proximal and distal to the fistula, respectively. Endovascular coiling was performed for the hepatic arterioportal fistula, followed by proximal splenorenal shunt procedure. This case illustrates an uncommon association of a spontaneous hepatic arterioportal fistula with EHPVO and the utility of a combined endovascular and surgical approach for managing multifactorial non-cirrhotic portal hypertension in such patients.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.2
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• pp.151-157
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• 2023

Backgrounds/Aims: Cholangiocarcinoma (CCA) can be classified as intrahepatic CCA or extrahepatic CCA (eCCA). We intended to analyze and reports the survival outcomes for eCCA. Methods: Surveillance, epidemiology, and end results (SEER) registry, site recode C24.0, was used to select cases of eCCA from 2000 to 2018. Patients with incomplete data or ages <18 years were excluded. Results: Male (52.69%) and White race (77.99%) predominated. Compared with 2000-2006, survival increased in 2013 (adjusted hazard ratio [HRadj]: 0.68, 95% confidence interval [CI] 0.58-0.70; p < 0.01). Surgery with chemoradiotherapy (HRadj: 0.69, 95% CI 0.60-0.7; p < 0.01) and surgery with chemotherapy (HRadj: 0.72, 95% CI 0.62-0.83; p < 0.01) improved survival over surgery alone. Compared with surgery without lymph node (LN) removal, surgery of four or more regional LN reduced the risk of death by 58% (HRadj: 0.42, 95% CI 0.36-0.51; p < 0.01). Compared with patients without surgery, patients who underwent bile duct excision (HRadj: 0.82, 95% CI 0.72-0.94; p < 0.01), simple or extended lobectomy (HRadj: 0.85, 95% CI 0.75-0.95; p = 0.009), and hepatectomy (HRadj: 0.80, 95% CI 0.72-0.88; p < 0.01) significantly improved survival. Patients with distal CCA had a 17% higher survival than perihilar CCA (HRadj: 0.83, 95% CI 0.74-0.92; p < 0.01) and LN dissection was equally beneficial for both subgroups (p < 0.01). Conclusions: Surgery with chemoradiotherapy has a proven increase in the 5-year survival of the eCCA. LN resection, bile duct excision, lobectomy, and hepatectomy have better outcomes.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.488-493
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• 2012

Two Maltese (2-year-old, intact female and 4-month-old, intact female) and a Pekingese (10-year-old, intact male) dogs were referred due to vomiting, anorexia, head-pressing and hypersalivation. Physical examinations, complete blood count, serum chemical analysis, radiography, ultrasonography and computed tomography (CT) were evaluated. Laboratory findings in these dogs included high hepatic enzyme, serum bile acid and ammonia concentration. Microhepatia was found on abdominal radiographs in two dogs. The existence of portosystemic shunt was presented in abdominal ultrasonography. The shunt vessel was identified in all dogs by CT imaging. Based on three-dimensional CT reconstruction, the origin and termination of each shunt vessel were defined certainly. In consequence, each dog was diagnosed single extrahepatic portosystemic shunt. After diagnosis, surgical treatment was performed in all dogs. This case report describes clinical finding, imaging characteristics, and three-dimensional CT imaging of single extrahepatic portosystemic shunt cases.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.43-49
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• 1998

Purpose : Carcinomas arising in the gall bladder(GB) or extrahepatic biliary ducts are uncommon and generally have a poor prognosis. The overall 5-year survival rates are less than $10\%$. Early experiences with the external radiation therapy demonstrated a good palliation with occasional long-term survival. The present report describes our experience over the past decade with irradiation of primary carcinomas of the gallbladder and extrahepatic biliary duct. Materials and Methods : From Feb. 1984 to Nov. 1995, thirty-three patients with carcinoma of the GB and extrahepatic biliary duct were treated with external beam radiotherapy with curative intent at our institution. All patients were treated with 4-MV linear accelerator and radiation dose ranged from 31.44Gy to 54.87Gy(median 44.25Gy), and three Patients received additional intraluminal brachytherapy(range, 25Gy to 30Gy). Twenty-seven Patients received postoperative radiation. Among 27 patients, Sixteen patients underwent radical operation with curative aim and the rest of the patients either had bypass surgery or biopsy alone. In seventeen patients, adjuvant chemotherapy was used and eleven patients were treated with 5-FU, mitomycin and leucovorin. Results : Median follow up period was 8.5 months(range 2-97 months). The overall 2-year and 5-year survival rates in all patients were $29.9\%$ and $13.3\%$ respectively. In patients with GB and extrahepatic biliary duct carcinomas, the 2-year survival rates were $34.5\%$ and $27.8\%$ respectively. Patients who underwent radical operation showed better 2-year survival rates than those who underwent palliative operation($43.8\%\;vs.\;20.7\%$), albeit statistically insignificant(p>0.05). The 2-year survival rates in Stage I and II were higher than in Stage III and IV with statistical significance(p<0.05). Patients with good performance status in the beginning showed significantly better survival rates than those with worse status(p<0.05). The 2-year survival rates in combined chemotherapy group and radiation group were $40.5\%$ and $22.0\%$ respectively. There was no statistical differences in two groups (p>0.05). Conclusion : The survival of patients with relatively lower stage and/or initial good performance was significantly superior to that of others. We found an statistically insignificant trend toward better survival in patients with radical operation and/or chemotherapy, More radical treatment strategies, such as total resection with intensive radiation and/or chemotherapy may offer a better chance for cure in selective patients with carcinoma of gall bladder and extrahepatic biliary ducts.

• Parasites, Hosts and Diseases
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• v.30 no.4
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• pp.269-276
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• 1992