• Title/Summary/Keyword: Gall stone

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An Opinion on Cholelithiasis by Ultrasonography in Life Insurance Medicine (초음파(超音波)를 이용(利用)한 담낭결석(膽囊結石)의 보험의학적(保險醫學的) 소견(所見))

  • Moon, Soo-Hyung;Kim, Soo-Hee;Kim, Kang-Seuck
    • The Journal of the Korean life insurance medical association
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    • v.2 no.1
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    • pp.182-194
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    • 1985
  • Cholelithiasis, one of the digestive, disease is one of the subject to have to be solved in the medical field because it is very important health problem in clinic and gives people much pain. The formulative process of gall stone is not certainly known yet, but an approach to the size, location, bile sludge of gall ston and the existence of pus is very contributive to the cure and prediction of the disease. As above, the early diagnosis of gall stone is very important. A few study on the possessing rate of gall stone in normal Korean Group is reported. But no report has submitted to the Korean Life Insurance Medical Association until now. We, the Medical Dept. of Dae Han Kyouk Life Insurance Co. Ltd., practiced ultrasonic examination for the recent 17 months and obtained 84 data of gall stone potency out of 4201 examples. We analyzed them on the basis of sex, age, gall stone incidence rate and the results are as follows; 1) The possessing rate of gall stone in female showed 1.22 times higher than in in male. 2) The older the medical examined group grow, the more the frequency of gall stone incidence increase regardless of sex. 3) Our report coincides with foreign one in sex and age, but in total gall stone incident frequency our country has 2%, which is much less than foreign one.

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Ability of Biochemical Parameters to Distinguish between Bile Duct Cancer and Gall Bladder Stones - A Case Control Study in a Tertiary Care Hospital of Pokhara Valley

  • Yadav, Shambhu Kumar;Mittal, Ankush;Sapkota, Kumar;Gupta, Satrudhan Prasad;Sathian, Brijesh
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.817-819
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    • 2013
  • Background: The present study was designed to comparatively assess alteration of biochemical parameters in bile duct cancer and gall stone disease. Materials and Methods: A hospital based case-control study was carried out in the Department of Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January 2010 and $31^{st}$ December 2012. The variables collected were age, gender, serum total cholesterol, total bilirubin, AST, ALT, serum alkaline phosphatase, albumin and hemoglobin. One way ANOVA was used to examine the statistical significance of differences between groups. A post-hoc LSD test was applied for the comparison of means of control versus case groups. A p-value of <0.05 (two-tailed) was considered significant. Results: The mean age of cases and controls was $53.2{\pm}21.2$ years. The levels of serum cholesterol were higher in cases of cancer $192.5{\pm}21.5$ mg/dl in comparison to stone cases $168.7{\pm}16.1$ mg/dl (p value: 0.0001). The total bilirubin showed the marked difference in cases of cancer $7.6{\pm}3.2$ mg/dl in comparison to stone cases $2.5{\pm}0.8$ mg/dl of bile duct. There was discernible divergence in values of alkaline phosphatase in cases of cancer $251.5{\pm}20.1$ IU/l when compared to stone cases $173.2{\pm}12.6$ IU/l of bile duct. In contrast, there was no apparent deviation in values of aspartate transaminases and alanine transaminases in cases of cancer $59.1{\pm}8.9$ IU/l and $105.5{\pm}26.5$ IU/l when compared to stone cases $56.9{\pm}7.9$ IU/l and $84.5{\pm}13.5$ IU/l respectively. Conclusions: LFT analysis for pre-operative assessment was a good predictive marker in setting apart bile duct cancer and gall bladder stone.

A Case of Epstein-Barr Virus Infection with Gall Bladder and Common Bile Duct Stones in an Otherwise Healthy Child

  • Park, Jong-Hyun;Noh, Jin-Chul;Park, Hyang-Mi;Jung, Yu-Soek;Park, Sei-Hyeog;Hong, H. Christian;Shin, Hye-Jung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.1
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    • pp.57-61
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    • 2012
  • Cholelithiasis and choledocholithiasis are uncommon pediatric diseases, although clinicians have seen them with increasing frequency in children in recent years. Moreover, no case of Epstein-Barr virus (EBV) infection with cholelithiasis and choledocholithiasis has been previously reported in the English literature. We report a pediatric patient with EBV infection, a gall bladder stone, and a common bile duct stone, may have had GB and CBD stones prior to her EBV infection, whom we successfully treated with antibiotics and laparoscopic cholecystectomy for cholecystitis.

Elevated Expression of Maspin mRNA as a Predictor of Survival in Stage II and III Gallbladder Cancer Cases

  • Baghel, Kavita;Kazmi, Hasan Raza;Raj, Saloni;Chandra, Abhijit;Srivastava, Rajeshwar Nath
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.343-347
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    • 2014
  • Background: Maspin expression is a potential prognostic factor for various malignancies but its relation with gallbladder cancer is unknown and needs to be investigated needs to be investigated. We therefore here focused on maspin mRNA expression in normal, gall stone disease and gallbladder cancer subjects, with particular attention to prognostic importance in individuals with malignancies. Materials and Methods: This study was carried out at the Department of Surgical Gastroenterology, King George's Medical University, Lucknow, India. Gallbladder samples from normal (n=25), gall stone disease (n=25) and cancer patients (n=38) were analysed for maspin mRNA expression by semi-quantitative reverse transcriptase PCR and quantitative real time PCR. Statistical analysis was carried out using the Students t test or ANOVA. Survival analysis was conducted according to the Kaplan-Meier method and correlations were assessed using the Pearson correlation method. p<0.05 was considered statistically significant. Results: Significant increase (p=0.028) in expression of maspin mRNA was observed in gallbladder cancer as compared to gall stone disease, whereas no expression was found in normal tissues. Significant correlation (Pearson's coefficient(r)=-0.798, p<0.0001) was observed between relative quantification of maspin mRNA and survival of cancer patients after surgery, with significantly shorter (p=0.002) survival in patients having relative quantification >1.5 as compared to those having relative quantification <1.5. Similarly, significant differences in patient survival for maspin mRNA expression was observed for stage II (p=0.025) and III (p=0.011) cancer. Conclusions: Higher expression of maspin mRNA in gallbladder cancer has prognostic significance for stage II and III cancer, which needs to be investigated further.

Association of Cytochrome-17 (MspA1) Gene Polymorphism with Risk of Gall Bladder Stones and Cancer in North India

  • Dwivedi, Shipra;Agrawal, Sarita;Singh, Shraddha;Madeshiya, Amit Kumar;Singh, Devendra;Mahdi, Abbas Ali;Chandra, Abhjeet
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5557-5563
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    • 2015
  • Background: Cholelithiasis is associated in 54%-98% of patients with carcinoma of the gallbladder, and a high incidence among females suggests a role of female hormones in the etiology of the disease. Cytochrome $P450C17{\alpha}$ (CYP-17) is a key enzyme involved in estrogen metabolism and polymorphisms in CYP-17 are associated with altered serum levels of estrogens. Thus, we investigated whether the CYP-17 MspA1 gene polymorphism might impact on risk of gall bladder cancers or gallstones, as well as to determine if this gene polymorphism might be linked with estrogen serum levels and lipid profile among the North Indian gall bladder cancer or gallstone patients. Materials and Methods: CYP-17 gene polymorphisms (MspA1) were genotyped with PCR-RFLP in cancer patients (n=96), stone patients (n=102), cancer + stone patients (n=52) and age/sex matched control subjects (n= 256). Lipid profile was estimated using a commercial kit and serum estrogen was measured using ELISA. Results: The majority of the patients in all groups were females. The lipid profile and estrogen level were significantly higher among the study as compared to control groups. The frequency of mutant allele A2 of CYP17 MspA1 gene polymorphism was higher among cancer (OR=5.13, 95% CI+3.10-8.51, p=0.0001), stone (OR=5.69, 95%CI=3.46-9.37, p=0.0001) and cancer + stone (OR=3.54, 95%CI=1.90-6.60, p=0.0001) when compared with the control group. However there was no significant association between genotypes of CYP17 MspA1 gene polymorphism and circulating serum level of estrogen and lipid profile. Conclusions: A higher frequency of mutant genotype A1A2 as well as mutant allele A2 of CYP-17 gene polymorphism is significantly associated with risk of gallbladder cancer and stones. Elevated levels of estrogen and an altered lipid profile can be used as predictors ofgall bladder stones and cancer in post menopausal females in India.

Gall formation on different age, habitat, and parasite position in Rhus javanica L. (붉나무의 수령, 서식지 및 기생위치에 따른 오배자 형성)

  • Jo, Hyeong-Chan;Han, Kwang-Soo;An, Eun-Yong
    • Korean Journal of Medicinal Crop Science
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    • v.8 no.4
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    • pp.304-311
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    • 2000
  • This study was conducted to investigate the ratio and number of the Rhus javanica gall formed by chinese sumac aphid, Scheleechtendalia chinensis, in several different conditions in which R. javanica lives. The density of 11 to 15-year-old R. javanica was more higher and the number of galls was also higher than 1 to 5- or over 16-year-old one at these sites. The formed gall according to four directions such as the East, West, South and North was founded the highest at the East and followed South, North, and West order. The formative rate of R. javanica gall did not differ in the mixture forest, and in the habitat having a heap of a little stone and mosses near a valley was better than in the site of road perimeter. Through an index of the gall diameter and the number of chinese sumac aphid, we evaluated the gall processing and development formed by the aphid. As the density of aphids increase, the size of the gall was also more plumped. The part of phyllotaxy of R. javanica gall in leaf and pinnate of was increased in the middle and upper part of terminal leaflet and leaflet was more occupied than wing. R. javanica which did not form a gall in natural environmental, formed gall by a artificial inoculation of S. chinensis. Some gall disappeared during a gall development from various environmental conditions.

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Case series of gallstone ileus with one- or two-stage surgery

  • Jun Sen Chuah;Jih Huei Tan;Kharlina Binti Khairudin;Louis Leong Liung Ling;Tuan Nur'Azmah Binti Tuan Mat
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.2
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    • pp.199-203
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    • 2022
  • Gallstone ileus is an uncommon cause of intestinal obstruction. It may present with typical symptoms of intestinal obstruction with or without biliary sepsis. Its management strategies vary depending on the patient and operative factors. Enterotomy and stone removal alone versus synchronous cholecystectomy and fistula disconnection at the same stage, often pose a debate among surgeons. The decision for operative strategies largely depends on the surgeon's experience, patient's physiology, and operative difficulties. As literature on gall stone ileus remains insufficient at a regional level, we report four cases of gallstone ileus managed with different approaches. Three patients were managed in a staged-manner, whereas one patient received a definitive procedure performed at index surgery. Clinical challenges and associated operative strategies are discussed. Findings of the current study were compared to those of the literature. The need for a definitive fistula disconnection and repair or cholecystectomy following stone removal in these patients was subsequently discussed.

Choledochocele containing a stone mistaken as a distal common bile duct stone (원위부 총담관 결석으로 오인된 결석을 동반한 총담관류 치료)

  • Kwak, Tae Young;Park, Chang Hwan;Eom, Seok Hyeon;Hwang, Hong Suk;Chung, Duk Won;Seo, Ji Young;Kim, Yeong Sung;Kwak, Dong Hyup
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.60-64
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    • 2015
  • A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors' hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.

Histopathological changes in gall bladder mucosa in relation to the number, and size of gallstones, and analysis of the findings in the context of age distribution of the patients: A perspective

  • Sanjeev Sharma;Bhupinder Singh Walia;Mandeep Randhawa;Arjun Sharma;Pankaj Dugg;Jiteshwar Singh Pannu
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.277-286
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    • 2023
  • Backgrounds/Aims: To study histopathological changes in gall bladder mucosa in cholelithiasis patients, and analyse their relation to the number and size of gallstones. These findings were evaluated in the context of age distribution of the study population. Methods: One hundred cases of cholecystectomy were part of the study, which was conducted in collaboration with the pathology department. The time period of the study was January 2020 to June 2021. Results: Maximum cases had multiple stones (69.0%), while one third cases (31.0%) had solitary stones. While initial univariate analysis showed age (odds ratio [OR], 6.882; p = 0.043), gallstone number (OR, 9.1; p = 0.050), gallstone size (OR, 17.111; p = 0.013), and duration of symptom (OR, 34.125; p = 0.001) to be significant risk factors associated with gallbladder carcinoma, multivariate analysis found none of these variables to be significant. However, conditional multivariate analysis for the duration of symptom (p = 0.008; OR, 21.118) yielded significant p-value. With histopathological diagnoses, 5% of cases had gallbladder cancer. Conclusions: This study shed light on the rising incidence of cholelithiasis in the young population and the high rate of gallbladder carcinoma in Punjab, India. Although gall stone characteristics (size, number) and patient age appeared to be significant risk factors when their individual relation with gallbladder carcinoma was studied, multivariate analysis, could not prove that. Conditional multivariate analysis showed the duration of symptom to be the only significant risk factor associated with gallbladder carcinoma. Further research with larger sample size is needed to study the rising incidence of gallbladder carcinoma, and the risk factors associated with it.

A Literary Study on Bezoar Bovis (우황에 대한 문헌적 고찰)

  • Park, Seong-Kyu;Park, Jae-Seuk;Baik, Seong-Il;Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.8 no.3
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    • pp.51-55
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    • 2005
  • Objectives: Literary investigation of existing data was conducted to verify effects of Bezoar Bovis and its herbal acupuncture, and determine quality management through component analysis. Results: Following results were obtained through literary investigation. 1. Bezoar Bovis is dried cystic stone from a cattle. Its characteristics are cool, no toxicity, and bitter taste. Known actions are: quells heat and detoxifies Fire Poison, extinguishes internal movement of Liver Wind and stops convulsion, vaporizes phlegm, and opens orifice. It is mainly used for treating tremor, stroke, delirium, sore throat, oral furuncle, boil, and others. 2. Bezoar Bovis is effective for eliminating liver toxicity, protecting against brain damage, and has anti-microbial activities. 3. Bezoar Bovis is mixed with bear gall bladder and deer musk to be used as herbal acupuncture, and this mixture is effective is invigorating liver functions as well as treating arthritis, headache, and etc. 4. Principal components of Bezoar Bovis are bilirubin-type pigments and cholic acids. The amount of bilirubin can be used as a standard to determine the quality of Bezoar Bovis.