• The Korean Journal of Nuclear Medicine
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• v.16 no.2
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• pp.71-80
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• 1982

In the present communication, the results will be reported on a clinical study of how well scintigraphic visualization of the hepatobiliary elements and several commonly used clinical liver function tests correlate each other in various diseases oft hepatobiliary system. The demonstrability of the biliary tract, gallbladder (GB) and duodenum was rather closely paralleled to serum bilirubin level and less closely to alkaline phosphatase and rather poorly to SGOT and SGPT. The biliary tree could not be visualized scintigraphically when bilirubin exceeded 10.5mg/dl. The usefulness of Tc-99m EHIDA [N-(2,6-diethylacetanilido) iminodiacetic acid, made by Amersham, England] hepatobiliary scintigraphy (Tc EHIDA HBS) in settling diagnostic controversy and ambiguity raised by oral cholecystography, intravenous cholangiography and ultrasonography in many hepatobiliary diseases is well known. The purpose of this investigation was to semiquantitatively evaluate the scintigraphic demonstrability of the hepatobiliary tract, GB and duodenum following intravenous injection of Tc-99m EHIDA in normal subjects and in patients with a disturbed liver function from various hepatobiliary diseases. The hepatobiliary scintigraphy was performed in 10 normal subjects and 39 patients with various hepatobiliary diseases (Table 1) at the Dept. of Radiology, St. Mary's Hospital Catholic Medical College, Seoul, Korea during 2 years period from September 1979. Scintigraphic examination was started at end of 3 minutes after intravenous injection of Tc-99m EHIDA in the amount of $50{\mu}Ci/kg$ and was continued until after 30 minutes at 5 minutes interval. The imaging was usually terminated when the tracer could be seen in the duodenum. Late scintigrams were obatained at 1 1/2, 3, 4 and 6 hours when reeded. Scintigrams were analyzed in terms of promptness and clarity of visualization of the biliary tree, GB and duodenum and demonstrability of these anatomical landmarks was correlated with the values of liver function tests. The demonstrability of the common hepatic duct, common bile duct, GB and duodenum was closely paralleled to the level of serum bilirubin when it is less than 10.5 mg/dl as shown in figure 1. However when the bilirubin exceeded 10.5 mg/dl the time of visualization between protracted reaching a flat curve or plateau around 10.5 mg/dl. The biliary tract could not be visualized when the bilirubin was higher than 10.5 mg/dl. The correlability between scintigraphic demonstration and serum alkaline phosphatase was less strong and between scintigraphic demonstration and SGOT and SGPT was rather poor. The present clinical study confirmed the usefulness and limitation of Tc-99m EHIDA hepatobiliary scintigraphy in visulizing and diagnosing the biliary system and duodenum when radiogrpahy and ultrasonography failed to provide useful informations. Scintigraphy was very helpful in the diagnosis of neonatal hepatitis, biliary atresia, cholecystitis and extrahepatic biliary obstruction. The hepatobiliary system and duodenum were visualized when serum bilirubin level was less than 10.5 mg/dl, SGOT 135 units, SGPT 114 units and alkaline phosphatase 52.2 KAU.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2185-2190
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• 2013

Gallbladder carcinoma, the most frequent malignant neoplasm of the biliary tract system, has always been considered to feature late clinical presentation and diagnosis, limited treatment options and an extremely poor prognosis. In recent years, while the incidence of gallbladder cancer has appeared to be on the increase, the available treatment methods have not greatly improved survival of the affected patients. Thus, exploring new therapeutic targets for this devastating disease is an urgent matter at present. Epidemical studies have demonstrated that the incidence of gallbladder carcinoma exhibits a distinct gender bias, affecting females two to three times more than males, pointing to crucial roles of estrogen. It is well known that estrogen acts on target tissues by binding to estrogen receptors (ERs), which are mainly divided into three subtypes, $ER{\alpha}$, $ER{\beta}$ and $ER{\gamma}$. $ER{\alpha}$ and $ER{\beta}$ appear to have overlapping but also unique even opposite biological effects. As important pathogenic mediators, ERs have been considered to relate to several kinds of tumors. In gallbladder carcinoma tissue, ERs have been shown to be positively expressed, and ERs expression levels are associated with differentiation and prognosis of this cancer. Nevertheless, the exact mechanisms of estrogen inducing growth of gallbladder carcinoma remain poorly understood. On the base of the current investigations, we deduce that estrogen participates in promotion of gallbladder carcinoma by influencing the formation of gallstones, stimulating angiogenesis, and promoting abnormal proliferation. Since ERs mediate the carcinogenic actions of estrogen in gallbladder, and therapy targeting ERs may provide new directions for gallbladder carcinoma. Therefore, it should be stressed that ERs are potential therapeutic targets for gallbladder carcinoma.

• Journal of Veterinary Clinics
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• v.35 no.3
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• pp.100-102
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• 2018

A nine-year-old spayed female Turkish angora cat presented for evaluation of anorexia, lethargy, vomiting, ptyalism and jaundice. Based on clinical examinations including laboratory examinations, concurrent inflammatory condition of the biliary system, pancreas and intestines (triaditis) was suspected. The cat was under antibiotic and immune-suppressive therapy, but there was no response. Further examination revealed the possibility of malignant hepatobiliary tumor with pulmonary metastasis. The condition of the cat continued to deteriorate and the cat died 3 weeks after the diagnosis. This case demonstrates the clinical findings of triaditis combined with suspected malignant hepatobiliary tumor.

• Clinical Endoscopy
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• v.57 no.5
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• pp.628-636
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• 2024

Background/Aims: Advanced pancreatic and biliary tract cancers can invade the duodenum and cause duodenal hemorrhagic stenosis. This study aimed to evaluate the efficacy of covered self-expandable metal stents in the treatment of cancer-related duodenal hemorrhage with stenosis. Methods: Between January 2014 and December 2016, metal stents were placed in 51 patients with duodenal stenosis. Among these patients, a self-expandable covered metal stent was endoscopically placed in 10 patients with hemorrhagic duodenal stenosis caused by pancreatobiliary cancer progression. We retrospectively analyzed the therapeutic efficacy of the stents by evaluating the technical and clinical success rates based on successful stent placement, degree of oral intake, hemostasis, stent patency, and overall survival. Results: The technical and clinical success rates were 100%. All 10 patients achieved a gastric outlet obstruction scoring system score of three within two weeks after the procedure and had no recurrence of melena. The median stent patency duration and overall survival after stent placement were 52 days (range, 20-220 days) and 66.5 days (range, 31-220 days), respectively. Conclusions: Endoscopic placement of a covered metal stent for hemorrhagic duodenal stenosis associated with pancreatic or biliary tract cancer resulted in duodenal hemostasis, recanalization, and improved quality of life.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1149-1161
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• 2022

Purpose: This systematic review was conducted to evaluate the clinical effects of Injinho-tang on hyperbilirubinemia in hepatobiliary disorders. Methods: We searched for randomized controlled clinical trials that had administered Injinho-tang as an intervention in the following medical databases: Public/Publisher MEDLINE (PubMed), Excerpta Medica dataBASE (EMBASE), Cochrane library, Research Information Sharing Service (RISS), ScienceON, Oriental Medicine Advanced Searching Integrated System (OASIS), and China National Knowledge Infrastructure (CNKI). Among the retrieved studies, only trials that met the inclusion criteria were selected, and serum total bilirubin values were extracted and analyzed from the finally selected trials. Results: The serum total bilirubin values of 1,302 patients with various hepatobiliary diseases were synthesized through a meta-analysis, which confirmed a decrease in serum total bilirubin of 21.03 𝜇mol/L (95% CI -29.58~-12.49, p<0.01) in the group administered with Injinho-tang compared with the control group. Conclusions: Injinho-tang is effective in alleviating hyperbilirubinemia in hepatobiliary diseases when administered with conventional treatment. However, the potential risk of bias, high heterogeneity among the included trials, and differences in herbal composition are limitations of the results of this meta-analysis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.16-22
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• 2009

Purpose: To update the epidemiologic information of hepatobiliary diseases in pediatric inpatients using cross-sectional survey data throughout the Republic of Korea. Methods: Nationwide cross-sectional survey was obtained from the 85 residency training hospitals in Korea to gather the final diagnosis on discharge. The surveyed periods were from 2004 to 2006. All the reports regarding the diagnosis were based on ICD-10 system. In this study, we focused on hepatobiliary diseases. Results: A total of 826,896 cases with discharge data were collected, of which 4,151 (5.0%) hepatobiliary cases were identified; 2,385 cases (57.4%) of hepatobiliary disease were hepatitis, which was the most common hepatobiliary disease. Other diseases included congenital hepatobiliary diseases (524 cases [12.6%]) and biliary diseases (315 cases [7.6%]). The prevalence of hepatobiliary disease according to age differed. Biliary atresia was the most common hepatobiliary disease in the neonatal period, whereas the prevalence of hepatitis increased in adolescents. The total number of hepatobiliary operations was 416 cases. With the comparison of annual data, there was no definite difference in the total number of hepatobiliary cases. The average duration of hospital stay appeared to decrease gradually. Conclusion: In this study, we have summarized the recent epidemiology of hepatobiliary disorders in Korean children based on discharge data. Hepatobiliary disorders in pediatric inpatient units consisted of diverse disorders with a low prevalence, so multi-center approaches should be considered to enhance the clinical and public health outcomes. To improve this nationwide survey, a new data collecting system should be developed.

• Nuclear Engineering and Technology
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• v.37 no.4
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• pp.391-394
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• 2005

N-(3-bromo-2,4,6-trimethylacetanilide)iminodiacetic acid (BrTIDA) was synthesized using nitrilotriacetic anhydride prepared in situ, and lyophilized vials were prepared which contained 20 mg of BrTIDA and 0.4 mg of $SnCl_2$. To evaluate the clinical efficacy of the in-house prepared lyophilized kit, a technetium-99m complex of BrTIDA was prepared; its in vivo pharmacokinetic behavior was evaluated via animal studies to assess the hepatocytic function and the functional status of the cystic duct and the gallbladder. Serial static image scans of rabbits and the biodistribution in mice injected with $^{99m}Tc-BrTIDA$ revealed that none of the tissues except for the hepatobiliary system showed radioactivity concentrations, and a rapid clearance from the organs was observed. In conclusion, a lyophilized kit and its prepared $^{99m}Tc-BrTIDA$ can be applied as a hepatobiliary imaging agent for the evaluation of the functional status of the hepatocytes and the patency of the biliary duct.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4843-4845
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• 2012

Cancer is now a worldwide problem. Although we have obtained a deeper understanding of the disease with the help of the science and technology, we still cannot reach the essence of cancer. Based on the former theory of carcinogenic and researches, we submit a new theory called "Spatial -Temporal Biphasic Carcinogenesis" to explain its development from the viewpoints of time and space.

• Journal of the Korean Chemical Society
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• v.49 no.4
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• pp.370-376
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• 2005

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3747-3752
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• 2014

Background: Gallbladder carcinoma (GBC) is the most common carcinoma of the biliary system. Among its research models, orthotopic xenograft models, important research tools, have been rarely reported in the literature however. Aim: To explore establishment of an orthotopic xenograft model and to evaluate the advantage and disadvantage as compared with other models. Materials and Methods: Subcutaneous xenograft and orthotopic xenograft models of gallbladder carcinoma in nude mice were established and compared with human gallbladder carcinomas. Results: For the orthotopic xenograft model and clinical gallbladder carcinomas, the lymph node metastatic rates were 69.2% and 53.3% (p>0.05); ascites generation rates, 38.5% and 11.7%(p<0.05); liver invasive rates, 100% and 61.7%(p<0.05); and lymphatic vessel densities (LVD), $10.4{\pm}3.02$ and $8.77{\pm}2.92$ (p>0.05), respectively. In the subcutaneous xenograft model, no evidence of ascites generation, lymph node metastasis and liver metastasis were found, and its LVD was lower ($4.56{\pm}1.53$, p<0.05). Conclusions: Compared with the subcutaneous xenograft model, the orthotopic xenograft model better simulates clinical gallbladder carcinoma in terms of metastasis and invasion, which may be attributed to the difference in microenvironment and LVD.