• 제목/요약/키워드: Hepatic vein

검색결과 143건 처리시간 0.022초

반충손상 기전에 의한 간문맥손상에 대한 증례 보고 (Contrecoup Injury associated with Fatal Portal Vein Bleeding: A Case Report)

  • 유중현;박성준;이승화;정환훈
    • 대한영상의학회지
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    • 제82권6호
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    • pp.1594-1599
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    • 2021
  • 64세 남성이 2미터 높이에서 낙상한 이후 심한 우측 옆구리 통증으로 내원하였다. 시행한 조영증강 전산화단층촬영에서 우측 혈흉과 다수의 우측 갈비뼈 골절 및 우측 장골의 골절 소견이 있었다. 또한 간 주변에 혈종이 있었으나, 간실질 외상 소견은 보이지 않았다. 먼저 시행된 수술 중, 간문에서 지혈되지 않는 지속적인 출혈이 관찰되었다. 이에 대한 진단을 위해 인터벤션 시술이 시행되었고, 최초 간동맥조영술에서는 출혈 소견이 보이지 않았다. 이어서 시행한 조영증강 전산화단층촬영에서 좌측 복부의 조영제혈관바깥유출이 보였는데, 이는, 경피경간문맥조영술에서 좌측 문맥의 출혈로 확인되었다. 이 지점에 접착제 색전술을 시행했으나, 환자는 끝내 사망하였다. 이 증례를 통해 복부 외상환자 평가에서 간동맥조영술이 정상이라도 간문맥 손상의 가능성을 고려해야 한다는 것과 복부에서도 반충손상기전에 의한 손상이 가능하다는 것을 확인하였다.

Effect of Uranyl Nitrate-Induced Acute Renal Failure on the Pharmacokinetics of Sulfobromophthalein in Rats

  • Park, Gun-Hwa;Shim, Chang-Koo
    • Archives of Pharmacal Research
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    • 제13권3호
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    • pp.233-239
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    • 1990
  • The efect of acute renal failure (ARF) on the pharmacokinetics o sulfobromophthalein (BSP) was investigated in order to elucidate if renal failure modifies the hepatic metabolism of drugs. ARF was induced by intravenous (iv) injection of uranyl nitrate (UN) to rats (5 mg/kg) five days before the experiment. Area under the plasma concentration-time curve (AUC)of BSP after portal vein (pv) injection increased by 2-fold and total body clearance ($CL_1$) decreased one half (p <0.01) in UN-induced ARF (UN-ARF) rate compared to the control rats. But the plasma disappearance of BSP after iv injection did not differ significantly between control and UN-ARF rats. Since BSP is excreted via the liver, $CL_1$ represented the approximate hepatic clearance of BSP. Therefore, the decrease in $CL_1$ represented the approximate hepatic clearance of BSP. Therefore, the decrease in $CL_1$ represents a decrease in hepatic intrinsic clearance ($CL_{int}$) for BSP since plasma free fraction ($f_p$) of BSP was not affected by UN-ARF. The content of hepatic cytoplasmic Y-protein, which catalyzes BSP-glutathione conjugation and limits the trasfer of BSP from blood to bile, increased significantly (p < 0.01), however its binding activity (BA) for BSP was decreased significantly (p <0.01) by UN-ARF. The decrease in $CL_{int}$might have some correlation with the changed characteristics of hepatic Y-protein, specifically its decreased BA for BSP.

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Hypereosinophilic Syndrome: CT Findings in Patients with Hepatic Lobar or Segmental Involvement

  • Jae Hoon Lim;Won Jae Lee;Dong Ho Lee;Kyung Jin Nam
    • Korean Journal of Radiology
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    • 제1권2호
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    • pp.98-103
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    • 2000
  • Objective: The purpose of this study was to describe the CT findings of hepatic hypereosinophilic syndrome in which hepatic lobes or segments were involved. Materials and Methods: Seven patients with hypereosinophilic syndrome with hepatic lobar or segmental involvement were included in our study. In all seven, diagnosis was based on liver biopsy and the results of corticosteroid treatment. CT findings were retrospectively reviewed by three radiologists, who reached a consensus. Biopsy specimens were examined, with special reference to portal and periportal inflammation. Results: CT demonstrated well-defined, homogeneous or heterogeneous low attenuation with a straight margin limited to a hepatic lobe (n = 2), segments (n = 3), or subsegments (n = 2), particularly during the portal phase. Where there was subsegmental involvement, lesions were multiple, ovoid or wedge-shaped, and showed low attenuation. In two patients with lobar or segmental involvement, segmental portal vein narrowing was observed. Histopathologic examination disclosed eosinophilic infiltration in the periportal area, sinusoids and central veins, as well as portal phlebitis. Conclusion: Hypereosinophilic syndrome may involve the presence of hepatic lobar, segmental, or subsegmental low-attenuated lesions, as seen on CT images. Their presence may be related to damage of the liver parenchyma and to portal phlebitis.

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거대 간 종괴와 심방 중격 결손을 동반한 Abernethy 기형 2형 1예 (A Case of Congenital Extra Hepatic Portocaval Shunt (Abernethy Malformation Type 2) with a very Large Liver Mass and an Atrial Septal Defect)

  • 이해정;이지현;허준;강이석;이흥재;서연림;유소영;최연호
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제11권1호
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    • pp.56-59
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    • 2008
  • 저자들은 간의 거대 종괴와 심방 중격 결손으로 수술을 받았던 환아에서 복부 CT와 간 조직 검사를 통해 확인된 Abernethy 기형 2형 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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비글견의 간 CT 혈관조영상에서의 Iopamidol과 Iopromide, Iohexol 조명제의 비교실험 (A Comparison of Iopamidol with Iopromide and Iohexol Contrast Media in Hepatic CT Angiography in Beagle Dogs)

  • 정유철;임창윤;김경민;이성옥;정주현;장진화;오선경;송경진;윤정희;최민철
    • 한국임상수의학회지
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    • 제23권2호
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    • pp.129-132
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    • 2006
  • The purpose of this paper was to compare the clinical efficacy of iopamidol and iopromide, iohexol nonionic contrast media in terms of their image quality in Beagle dogs with hepatic CT angiography and their application in veterinary clinics. With 9 Beagle dogs, contrast media of iopamidol (pamiray-$300^(R)$) and iopromide (ultravist-$300^(R)$, iohexol (omnipaque-$300^(R)$) were induced intravenously (600 mg I/kg, BW) and CT angiography was done under general anesthesia. CT scan included scout, pre-contrast and cine examinations. During CT angiography, peak HU (Hounsfield unit) and peak time were examined on each site (ROI; region of interest) of the aorta, caudal vena cava, potral vein and liver parenchyma. Any side effects were also examined. After experiments, it was found that there were no significant changes of HU and maximal enhancing time of each ROIs of aorta, caudal vena cava, portal vein and liver parenchyma between these contrast media. And any side effects were not noted. So it is concluded that iopamidol has similiar contrast enhancement like as iopromide and iohexol in hepatic angiography and and it is thought to be useful for evaluation of the abdominal organs by CT scan in veterinary clinics.

갑자기 간성뇌증이 발생한 선천성 간내 문맥정맥단락 환자의 코일 색전술 치료: 증례 보고 (Treating Sudden Onset Hepatic Encephalopathy with Coil Embolization in a Patient with a Congenital Intrahepatic Portosystemic Venous Shunt: A Case Report)

  • 최연수;김진혁;전웅배;장주연;김태언;류화성
    • 대한영상의학회지
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    • 제83권6호
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    • pp.1426-1431
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    • 2022
  • 간내 문맥정맥단락은 간문맥-대정맥 또는 간문맥-간정맥이 연결되어 있는 드문 혈관 질환이다. 간내 문맥정맥단락은 주로 무증상을 보이며, 다른 질환으로 영상 검사를 하였을 때 우연히 발견될 수 있다. 하지만 단락양이 많거나 증상이 있는 경우 단락 색전술을 고려하여야 한다. 저자들은 선천성 간내 문맥정맥단락 환자에서 갑자기 간성뇌증이 발생하여 이를 경간 코일 색전술로 치료한 증례를 보고하고자 한다.

대정맥 폐쇄증에 대한 인조혈관 대치술[치험 3예] (Replacement Operation for Occlusion of Great Vein with Dacron Prosthesis: 3 Cases Report)

  • 이정호;김병열;유회성
    • Journal of Chest Surgery
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    • 제14권3호
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    • pp.274-279
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    • 1981
  • We performed three replacement operations of great venous obstruction with Dacron prosthesis from July, 1980 to Nov. 1980. Summary of 3 cases as belows: 1) Inferior vena cava obstruction . 43 years old male was admitted because of abdominal distension and marked superficial collateral circulation on chest and abdomen. Inferior vena cavogram showed complete obstruction of I. V .C. just below hepatic vein. Bypass operation was done between Rt atrium '||'&'||' I. V.C. (just above renal vein) with Woven Dacron prosthesis (22mm in Diameter) under ex tracorporeal ci rculation. 2) Superior vena cava obstruction . 21 years old male was admitted because of facial edema and irritative cough. Well circumscribed lobulated mass was located at ant. superior mediastinum and extended to Rt. thorax in chest P-A view. Woven Dacron prosthesis (10mm in Diameter) was replaced at involved S.V.C. segment after Rt. upper '||'&'||' middle lobectomy with tumor resection. 3) Common iliac vein obstruction (Lt) . 64 years old female was admitted because of generalized edema and tenderness of Lt. lower extremity. Venography of Lt leg showed complete obstruction of common iliac vein. Woven Dacron prosthesis (10mm in Diameter) was replaced at obstruction site.eplaced at obstruction site.

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Rat에 있어서 Phenobarbital이 유기음이온성 의약품의 간클리어란스에 미치는 영향 - Indocyanine Green의 체내동태를 중심으로 - (Influence of Phenobarbital on the Hepatic Clearance of Organic Anionic Drugs in Rats - On the Basis of Pharmacokinetics of Indocyanine Green -)

  • 이용복;신상철;고익배
    • 한국임상약학회지
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    • 제3권1호
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    • pp.31-43
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    • 1993
  • The influence of phenobarbital(PB) pretreatment(75mg/kg/day, Lp. for 4 days) on the hepatic clearance of indocyanine green(ICG) as a model compound of organic anionic drugs was investigated in rats in order to elucidate the relative contributions of change in the hepatic blood flow versus increase in the hepatic intrinsic activity to remove ICG due to PB pretreatment. ICG(1mg/kg) was injected single bolus via femoral or portal vein to the control and the PB-pretreated rats. The initial hepatic uptake clearance$(V_{d.c.}K_{12})$ obtained from plasma concentration-time data was increased by $38.4\% in the PB-pretreated rats, which may be due to the increased hepatic blood flow by PB pretreatment. Using a pharmacokinetic approach, hepatic blood flows were estimated of 67.5ml/min/kg in control rats and 91.9ml/min/kg in PB-pretreated rats. They were in good agreement with other's blood flow estimates observed experimentally. It may be concluded that the $38\%$ increased initial hepatic uptake clearance of ICG was due to the $36\%$ increased hepatic blood flow with phenobarbital, and that the increased hepatic blood flow and the activated hepatic intrinsic clearance with phenobarbital contributed to $49\%\;and\;51\%$ of the increased systemic clearance of ICG, respectively.

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MDCT 영상에서 간 체적 계산을 위한 4 점 이용 간 분할 방법 (Liver Cut Method Using 4 Points for Hepatic Volumerty at MDCT Image)

  • 서정주;조백환;박종원
    • 대한전자공학회논문지SP
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    • 제47권1호
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    • pp.17-24
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    • 2010
  • 본 논문은 생체간이식 전에 복부 MDCT(Multi-Detector Computed Tomography) 영상에서 이식편의 체적(the volume of right and left liver lobe)을 정확하게 계산하기 위하여 좌간과 우간을 나누는 방법을 제안하였다. 간이 추출된 영상에 해부학적인 좌간과 우간을 나누는 4점(하대정맥(Inferior Vena Cava)를 반으로 나눌 수 있는 중심점, 담낭와와 가까운 중간정맥(Middle Hepatic Vein)의 끝부분 한 점, 좌우문맥(Portal Vein) 분지부에서 한 점, 담낭와(gallbladder fossa)를 좌우로 나눌 수 있는 중심점)을 선택한다. 선택된 4점을 기준으로 좌간과 우간을 나누고 체적과 간 전체에 대한 좌우간의 비율을 계산한다. 계산된 체적의 정확성을 입증하기 위해 방사선과 의사가 수동으로 처리하여 계산한 체적과 함께 수술 중 획득한 실측무게와 비교하였다. 그리고 4점을 선택한 후 좌우간을 분할하여 체적을 계산하는 시간을 측정하여 수술실에서 실시간으로 처리 가능한 지의 여부를 확인하였다. 본 연구는 간이식에 참여하는 기증자와 수혜자의 안전을 보장하기 위하여 진행되었다.