• Korean Journal of Veterinary Research
• /
• v.34 no.3
• /
• pp.549-557
• /
• 1994

This study was done to find the method of the extermination of Fasciola hepatica matacercariae. And the artificial infection was carried out with 30 metacercarae exposed to 5% ammonia water and not-exposed to 5% ammonia water. Serial determinations of live weight, red blood cell, hemoglobin, packed cell volume, and eosinophils were performed in rats at 7 days interval for 16 weeks after infection (WAI). Recovery of worm burden and microscopic findings of livr was performed in rats at 10 WAI. The results in this work were summarized as follows; 1. Fasciola spp metacercariae exposed to 5% ammonia water have lost their ability of infection. 2. In teh exposed group, the mean of worm recovered was 2.25 and the common bile duct was swelling up to 0.71cm in diameter. 3. The value of live weight was different in two groups as the not-exposed group and the exposed group were 321.28, 384.38 at 10 WAI, respectively. 4. In the not-exposed group, at 7 WAI, hemoglobin at 5 WAI and packed cell volume at 7 WAI wre minimally decreased to $5.84{\times}10^{-6}/mm^3$, 11.53g/dl and 43.2%, respectively. But those three values were slowly increased at 10 WAI. Rercent cosinophil was increased to 12.2% at 4 WAI and slightly decreased to 7.9% at 10 WAI. But there are no stastistical singnificance between the exposed group and the normal control group. 5. In histolgical findings in the not-exposed group, the dilated common bile ducts and intrahepatic bile ducts showed distinct hyperplasia of the epithelium. Lymphocytes and eosinophils were infilterated around the bile ducts. The hepatic cells and Kupffer cells showed swollen appearance.

• Journal of Yeungnam Medical Science
• /
• v.7 no.1
• /
• pp.165-171
• /
• 1990

Human Fasciola hepatica infection is a rare entity involving infestation of the liver and biliary tree with adult flukes. which can result in hepatitis. cirrhos is and biliary tract inflammation. obstruction and lithiasis. The patient had the typical diagnostic tetrad of fever. eosinophilic leukocytos is. tender hepatomegaly and fluke ova in the stools. Theatment consistes of Emetine hydrochloride administration for hepatic involvement and common bile duct exploration for removal of flukes. with cholecystectomy for associated cholelithiasis. The combination of medical and surgical therapy cal be expected to produce an arrest of this infection. The removed liver revealed eggs of the fasciols species in the intrahepatic bile duct. The clinical history. pathological findings and treatment of this case were described.

• Investigative Magnetic Resonance Imaging
• /
• v.6 no.2
• /
• pp.129-136
• /
• 2002

Purpose : To evaluate the usefulness of MRCP in the diagnosis of the variable causes of common bile duct(CBD) dilatation, except stone or tumor Materials and methods : Twenty-six patients(M:F=15:11, mean age; 62 years) with both MRCP and ERCP were included in this study. Dynamic MRCP(n=12) and contrast-enhanced MRI(n=10) of abdomen were also added. Dilatation of CBD, intrahepatic ducts and pancreatic duct was evaluated, including coexistence of intrahepatic ductal stone, pancreatic pseudocyst, and papillary or papillary edema. The criteria of CBD dilatation was over than 7mm(n= 21, without cholecystectomy) or 10 mm(n=5, with cholecystecto-my) in diameter on T2-weighted coronal image. Results : The mean diameter of CBD was 12.7mm without cholecystectomy(9-19 mm) and 13.0 mm with cholecystectomy(10-15mm), respectively(p 〉0.05). Cholangitis(n=11, 42.3%), chronic pancreatitis(n=8, 30.8%), stenosis of distal CBD(n= 6, 23.1%), periampullary diverticulum(n=3, 11.5%), stenosis of ampulla of Vater(n=2, 7.7%), dysfunction of sphincter of Oddi(n=2, 7.7%), acute focal pancreatitis in the pancreatic head(n=2, 7.7%), papillitis(n=1, 3.8%), pseudocyst in the pancre atic head(n = 1, 3.8%), and ascaris in CBD(n=1, 3.8%) were noted. Pancreatic duct dilatation(n=10, 38.5%) and duodenal diverticulum(n=3, 11.5%) were also seen on MRC P. On dynamic MRCP(12 patients), distal CBD was visualized in 2 patients(16.7%), which was not shown on routine MRCP. Only 1 patient(10.0%) showed papillitis with slightly enhancing papilla on contrast-enhanced MRI (10 patients). Conclusion : MRCP was thought to be helpful in the evaluation of the causes of CBD dilatation, not caused by stone or tumor, especially in the cases of stenosis of distal CBD and chronic pancreatitis, dysfunction of sphincter of Oddi on dynamic MRCP and cholangitis and pericholangitic abnormality on contrast-enhanced MRI.

• Advances in pediatric surgery
• /
• v.13 no.2
• /
• pp.135-143
• /
• 2007

Biliary atresia (BA) is an uncommon neonatal surgical disease that has a fatal outcome if not properly treated. The survival rates of the patients with native liver after Kasai's operation in countries outside Japan are not so good. We reviewed the results of 22 cases of biliary atresia treated in Kosin University Hospital between October 1987 and March 2001. There were 13 males and 9 females aged from 21 to 106 days (mean 52 days). There were 3 cases of Type I (13.6%), and 3 of Type II (13.6%), and 16 Type III (72.7%). The operative methods were resection of the common bile duct remnant and cyst followed by Roux-en-Y hepaticojejunostomy in 3 cases for Type I BA; Kasai I in 15 cases, Kasai II in 1 case, and Ueda's operation in 3 cases for Types II and III BA. There was no death within the first 30 days after operation. We were able to follow 21 of the 22 patients (95.4%) for more than 5 years. The actual 5 year survival rate (YSR) was 40.9%. One Type I case received a living-related liver transplantation at 6 years of age because of the multiple intrahepatic stones and liver cirrhosis. Five YSR after biliostomy group (Kasai II and Ueda op.) was 75 % (3/4) while that of Kasai I was 20% (3/15). One case had no bile duct in the resected fibrotic plaque on microscopic review and died 8 months after Kasai I operation, would have been a strong candidate for early liver transplantation. From the above result, our conclusions are as follows; (1) early liver transplantation should be considered for cases of no bile duct after pathologic examination of the resected specimen, (2) measures to prevent postoperative cholangitis and prevention of postoperative liver cirrhosis are needed, (3) liver transplantation program should be available for failed cases.

• BMB Reports
• /
• v.56 no.11
• /
• pp.600-605
• /
• 2023

Intrahepatic cholangiocarcinoma (ICC) is a bile duct cancer and a rare malignant tumor with a poor prognosis owing to the lack of an early diagnosis and resistance to conventional chemotherapy. A combination of gemcitabine and cisplatin is the typically attempted first-line treatment approach. However, the underlying mechanism of resistance to chemotherapy is poorly understood. We addressed this by studying dynamics in the human ICC SCK cell line. Here, we report that the regulation of glucose and glutamine metabolism was a key factor in overcoming cisplatin resistance in SCK cells. RNA sequencing analysis revealed a high enrichment cell cycle-related gene set score in cisplatin-resistant SCK (SCK-R) cells compared to parental SCK (SCK WT) cells. Cell cycle progression correlates with increased nutrient requirement and cancer proliferation or metastasis. Commonly, cancer cells are dependent upon glucose and glutamine availability for survival and proliferation. Indeed, we observed the increased expression of GLUT (glucose transporter), ASCT2 (glutamine transporter), and cancer progression markers in SCK-R cells. Thus, we inhibited enhanced metabolic reprogramming in SCK-R cells through nutrient starvation. SCK-R cells were sensitized to cisplatin, especially under glucose starvation. Glutaminase-1 (GLS1), which is a mitochondrial enzyme involved in tumorigenesis and progression in cancer cells, was upregulated in SCK-R cells. Targeting GLS1 with the GLS1 inhibitor CB-839 (telaglenastat) effectively reduced the expression of cancer progression markers. Taken together, our study results suggest that a combination of GLUT inhibition, which mimics glucose starvation, and GLS1 inhibition could be a therapeutic strategy to increase the chemosensitivity of ICC.

• Journal of the Korean Society of Radiology
• /
• v.17 no.3
• /
• pp.385-392
• /
• 2023

Caroli's disease is a fibrocystic liver disease. Autosomal recessive disorder is characterized by congenital multiple dilatation of the bile duct. Computerized tomography, magnetic resonance imaging, cholangiography and ultrasound are among the methods for diagnosing caroli disease. Computerized tomography is essential for detecting and distinguishing fibroplastic liver disease and is useful for determining intrahepatic bile duct dilatation. However, awareness of the possible side effects of using contrast mediums is necessary. A typical method of magnetic resonance cholangiography is used for magnetic resonance imaging. A non-invasive examination can reduce the pain of the patient, and the anatomical structure of the bile pancreatic duct and the presence or absence of lesions can be easily and quickly observed. Biliary contrast is an effective diagnostic method that can directly visualize various cystic dilatations throughout the enlarged bile duct. However, since this procedure is also an invasive procedure, it is recommended not for diagnosis but for treatment purposes. Ultrasonography can confirm similar findings to computerized tomography. The hepatic artery root is difficult to prove with conventional grayscale ultrasound. However, it is of clinical value in that it can not only describe dilated bile ducts with vascular roots in the tube but also easily identify color Doppler signals in the tube. With the development of video diagnostics, early diagnosis has become possible through computerized tomography, magnetic resonance imaging, cholangiography, and ultrasound. In order to further contribute to the development of video diagnostics so that long-term prognosis can be improved after treatment through early diagnosis, we examined what aspects of each test's caroli disease appear.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.5
• /
• pp.1995-1997
• /
• 2012

Background: Brain metastasis from cholangiocarcinoma (CCA) is a rare but fatal event. To the best of our knowledge, only few cases have been reported. Herein, we report the incident rate and a first case series of brain metastases from CCA. Methods: Between January 2006 and December 2010 5,164 patients were treated at Srinagarind hospital, Khon Kaen University; of those, 8 patients developed brain metastasis. Here we reviewed clinical data and survival times. Results: The incident rate of brain metastases from CCA was 0.15%. The median age of the patients was 60 years. Tumor subtypes were intrahepatic in 6 and hilar in 2 patients. All suffered from symptoms related to brain metastasis. Three patients were treated with whole-brain radiation therapy (WBRT), one of whom also underwent surgery. The median survival after the diagnosis of brain metastasis was 9.5 weeks (1-28 weeks). The longest survival observed in a patient in RPA class I with two brain lesions and received WBRT. Conclusion: This is a first case series of brain metastases from CCA with the incident rate of 0.15%. It is rare and associated with short survival time.

• Advances in pediatric surgery
• /
• v.8 no.2
• /
• pp.156-160
• /
• 2002

When jaundice persists for more than 14 days postnatally, the early diagnosis of surgical jaundice is important for the prognosis in extrahepatic biliary atresia after draining procedure. The role of diagnostic laparoscopy to differenctiate medical causes of jaundice from biliary atresia is evaluated in this report. Four patients with prolonged jaundice have been included in this study. When the gallbladder was not visualized we proceeded to laparotomy. In patients with enlarged gallbladder visualized at laparoscopy, laparoscopic guided cholangiogram was performed, and laparoscopic liver biopsy was done for those who had a patent biliary tree. Two patients had small atretic gallbladder and underwent a Kasai hepato-portoenterostomy. One patients showed a patent gallbladder and common bile duct with atresia of the common hepatic and intrahepatic ducts, and they underwent a Kasai hepatic-portoenterostomy. One patient showed an enlarged gallbladder and laparoscopic-guided cholangiogram were normal. Laparoscopic liver biopsy was performed. There were no complications. Laparoscopy with laparoscopic-guided cholangiogram may be a valuable method in accurate and earlier diagnosis in an infant with prolonged jaundice.

• Clinical Endoscopy
• /
• v.51 no.6
• /
• pp.596-599
• /
• 2018

An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. The stones located in the B2 segment were difficult to remove because the endoscope could not be inserted deeply into this segment due to the small size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioning the endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residual stones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases of PDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure.

• The Korean Journal of Nuclear Medicine
• /
• v.20 no.2
• /
• pp.19-38
• /
• 1986

54 patients who had symptoms after biliary operation were studied by $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy for evaluation of clinical utility, with regional emphasis of recurrent pyogenic cholangitis (RPC) and intrahepatic stones. As expected, the most common disease was recurrent pyogenic cholangitis regardless of surgical anastomosis, 58% and next frequent disease was clonorhis sinensis infestation, 26%, stenosis of ampula vater 8%, and chronic hepatitis 4% (20% of patients had hepatitis but they showed clinically and scintigraphically dominallt combined disease feature). 87% of recurrent pyogenic cholangitis was associated with stones in intra or/and extrahepatic ducts and only 11.4% of RPC was found to be associated with Cs-infestation. The scintigraphic diagnosis of RPC was 81.6% and 78.6% of stones was detected by indirect visualization of scintigraphy findings and 71.7% of Cs-infestation was detected by scintigraphy. The characteristic bile flow pattern were described.