• 대한이식학회지
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• 제28권3호
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• pp.160-164
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• 2014

Background: In solid organ transplantation patients, complications of cholelithiasis may run a fulminant course, resulting in high morbidity and mortality under immunosuppression and may even result in rejection. Here, we reviewed medical records of 66 patients in order to determine the outcome of management approach for asymptomatic gallstones in renal transplantation patients. Methods: We retrospectively reviewed clinical courses of 66 cases of renal transplantation performed between 2000 and 2012 at Kosin University Gospel Hospital. Results: Among 66 cases, eight had gallstones before transplantation. Three of these cases had undergone previous cholecystectomy for symptomatic gallstones, one had a simultaneous laparoscopic cholecystectomy and renal transplantation, and four were observed by regular abdominal ultrasonography. One patient was found to have cholangitis, and endoscopic retrograde biliary drainage was performed, resulting in alleviation of symptoms. Among 58 cases without preoperative gallstones, three developed gallstones after transplantation. One patient had cholecystitis, and the symptoms subsided after conservative treatment. Conclusions: For patients with asymptomatic gallstones who are awaiting renal transplantation, expectant management should be considered.

• 대한한방내과학회지
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• 제44권4호
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• pp.803-813
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• 2023

Objective: This case report outlines an investigation into the efficacy of Korean medicine treatment in a patient who presented with acute cholangitis accompanying common bile duct stones. The patient underwent percutaneous transhepatic gallbladder drainage and subsequently experienced resolution of the common bile duct stones. Methods: The patient was treated with Shihosogan-tang, general acupuncture, ear acupuncture, moxibustion, and cupping therapy. Changes in symptoms were evaluated using a self-reported numerical rating scale (NRS) score and a visual analog scale (VAS) score each morning. Laboratory tests were conducted to examine serum amylase, serum lipase, and liver function. Results: After 29 days, the NRS scores for indigestion and fatigue and the VAS score for abdominal pain all decreased. Additionally, the laboratory test results showed improvement. Discussion: The results suggest that Korean medicine could be effective in treating symptoms of acute cholangitis. However, further research is necessary.

• Tuberculosis and Respiratory Diseases
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• 제63권4호
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• pp.378-381
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• 2007

Tsutsugamushi disease (Scrub typhus) is an acute, febrile illness caused by Orientia tsutsugamushi, which is transmitted to humans through chigger bites. Leptospirosis, a febrile disease caused by various pathogenic Leptospira, and is acquired by exposure to contaminated water and soil. Both diseases have been the most common acute febrile diseases in the autumn in Korea for many years. Concomitant leptospirosis and scrub typhus is quite rare. We report a case of a coinfection with leptospirosis and scrub typhus in a 51-year-old male who presented with fever, abdominal pain and acute dyspnea. The patient was diagnosed with as acalculous cholecystitis, acute respiratory distress syndrome, and septic shock caused by the infection. This is the first case report of a coinfection with leptospirosis and scrub typhus in Korea.

• 한국미생물학회:학술대회논문집
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• 한국미생물학회 2001년도 추계학술대회
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• pp.77-81
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• 2001

Enterocytozoon bieneusi는 특히 AIDS환자에게 치명적인 질병을 초래하는 세균과 원충 중간단계의 병원체로서 현재 $30\~50\%$의 발생률오 AIDS환자로부터 가장 많이 발생되는 병원체로 알려져 있다. 하지만 이 병원체는 1980년 후반에서야 비로서 학계의 주목을 받기 시작했으며 환자에게 심한 만성설사, 기력 쇠진, 악성 영양 결핍 등을 주 임상증상으로 하고 있다. 이렇게 다양하고 심각한 질병을 일으킴에도 불구하고 현재까지 이 병원체에 대한 연구가 미흡하였다. 현재 이 병원체에 대한 가장 중요한 연구 중 연구 중 하나는 이 병원체에 대한 AIDS환자로의 전파 경로이다. 최근 여러 각도의 동물야외 조사 및 실험동물을 이용한 연구를 토대로 AIDS환자에 대한 이 병원체의 전파가능성은 감염동물에서부터 전파가 가장 중요한 경로가 될 거라 보고되고 있다.

• 동의신경정신과학회지
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• 제14권1호
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• pp.133-139
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• 2003

본 증례는 약물부작용으로 인한 이차성 파킨슨 중에서 설(舌), 하악(下顎), 수부(手部)에 진전(震顫)증상이 나타난 환자를 풍담(風痰)으로 인한 진전(震顫)증상으로 보고 척담탕(滌痰湯)을 투여하고, 합곡(合谷), 태충(太衝), 중완(中脘), 풍륭(豊隆), 염천(廉泉), 족삼리(足三里), 양릉천(陽陵泉), 풍지(風池), 백회(百會) 위주의 침(鍼)치료를 병행하여 치료한 결과, 빠른 증상회복을 보였던 예이다. 이런 결과는 약물부작용으로 인한 이차성 파킨슨증을 치료하는 기초적 자료가 될 것이며, 약물회피요법을 단독으로 시행하는 경우와 한의학적 치료를 병행하는 경우의 치료효과에 대한 비교분석을 포함하여 향후 객관적이고 지속적인 연구가 필요하 리라 사료된다.

• 대한한의학방제학회지
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• 제12권2호
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• pp.203-211
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• 2004

Hypochondriac pain include pain in one or both side costa portion and lateral abdomen. There are different kinds of flank-related disease such as Hepatitis, cholecystitis, pleuritis, intercostal nerve pain and so on. Hypochondriac pain due to Phlegm Retention arises from pathological abnormal activities. In oriental medicine, Retention of Phlegm and Fluid is a morbid condition due to fluid retention in the stomach and intestines, and Gungha-tang used to treat the disease diagnosed as Retention of Phlegm and Fluid. So, we decided to apply Gungha-tang-gamibang to a patient who suffered from hypochondriac pain diagnosed as Retention of Phlegm and Fluid. Therefore the patient treated with Gungha-tang-gamibang and improved in consciousness symptoms, so we report it for the better treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권5호
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• pp.430-438
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• 2020

Purpose: We investigated the clinical features and factors affecting the choice of treatment modality and the course of pediatric gallstone (GS) disease. Methods: We retrospectively analyzed the medical records of 65 patients diagnosed with GS using imaging studies between January 2009 and December 2017 were included. Results: This study included 65 patients (33 boys and 32 girls; mean age, 8.5±5.3 years; range, 0.2-18 years) who primarily presented with abdominal pain (34%), jaundice (18%), and vomiting (8%). Idiopathic GS occurred in 36 patients (55.4%). The risk factors for GS included antibiotic use, obesity, hemolytic disease, and chemotherapy in 8 (12.3%), 7 (10.8%), 6 (9.2%), and 4 patients (6.2%), respectively. We observed multiple stones (including sandy stones) in 31 patients (47.7%), a single stone in 17 (26.2%), and several stones in 17 (26.2%). GS with a diameter of <5 mm occurred in 45 patients (69.2%). Comorbidities included hepatitis, choledocholithiasis, cholecystitis, and acute pancreatitis in 20 (30.8%), 11 (16.9%), 11 (16.9%), and 4 patients (6.2%), respectively. Ursodeoxycholic acid (UDCA) was administered to 54 patients (83.1%), leading to stone dissolution in 22 patients (33.8%) within 6 months. Cholecystectomy was performed in 18 patients (27.7%) (mean age, 11.9±5.1 years). Most patients treated surgically had multiple stones (83%) and stones measuring <5 mm in size (89%), and 66.7% of patients had cholesterol stones. Conclusion: Cholecystectomy is feasible in patients with small-sized or large numbers of GS and those with persistent abdominal pain and/or jaundice. UDCA administration with close follow-up is recommended in patients with uncomplicated GS.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3903-3909
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• 2016

Purpose: To evaluate the expression of Her2/neu and Ki-67 in benign and malignant gallbladder lesions, and to establish correlations with clinico-pathologic parameters. Materials and Methods: A retrospective analysis was conducted on formalin fixed paraffin embedded (FFPE) benign (n=25) and malignant gallbladder (n=25) tissue samples. Hematoxylin and eosin stained slides of each case were reviewed for: type of malignancy (whether adenocarcinoma, squamous cell carcinoma, or any other type), grade (well, moderate, and poor), depth of invasion, pre-neoplastic changes in adjacent mucosal epithelium like metaplasia and dysplasia. Immunohistochemistry for Her 2 neu and Ki-67 was performed and data analysis was conducted using SPSS 17 software. Chi-square test was used to compare categorical/dichotomous variables. P value of ${\leq}0.05$ was considered significant. Results: The difference of Her 2 neu expression and Ki67 index between benign and malignant groups was found to be statistically significant. Her2/neu positivity did not have any significant correlation with various clinicopathological parameters other than liver involvement. 5 cases of gallbladder cancer showed both Her2/neu and Ki67 positivity. Ten cases were Ki67 positive but Her2/neu negative while one case was Her2/neu positive but Ki67 negative. Conclusions: The present study demonstrated overexpression of Her2/neu and Ki67 in gallbladder cancer. A trend of decreasing Her2/neu expression with increasing grade of tumor was observed. Furthermore, greater Ki67 positivity was found in cases with lymph node metastasis and distant metastasis. Future studies with a larger number of patients will be required to precisely define the correlation of Her2/neu expression and Ki67 positivity with clinicopathological parameters. The results however are encouraging and suggest evaluation of Her2/neu as a candidate for targeted therapy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권1호
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• pp.47-55
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• 2000

Purpose: The aim of this research is to examine the abnormal liver function complicated with Kawasaki disease (KD) and to analyze its clinical characteristics and complications. Methods: Ninty eight cases were diagnosed as having KD, among which thirty four cases had abnormal alanine aminotransferase (ALT) (>30 IU/L). These abnormal ALT cases were evaluated in terms of age and sex distribution, major symptoms, complications, laboratory and histopathologic findings. Results: Male to female ratio was 2.4:1 and most patients (91.2%) were under 5 years of age. Cervical lymphadenopathy was observed in 3 cases (8.8%); and recurred cases were two (5.8%). Average fever duration was 8 days; average length of hospitalization was 9 days; and average recovery period was 13 days. Immediately after admission, positive CRP was observed in 31 cases (91.2%), leukocytosis (> $10,000/mm^3$) in 26 cases (76.0%), thrombocytosis (> $450,000/mm^3$) in 7 cases (20.6%), and anemia (<10 gm/dl) in 7 cases (20.6%), respectively. GB hydrops or cholecystitis were noted in 3 cases (8.8%), abnormal ECG finding in 1 case (2.9%), coronary dilatation or aneurysm in 2 cases (5.9%). Liver biopsy was done in four cases and revealed mild infiltration of lymphocytes on the portal area and mild bile duct proliferations. Conclusion: The abnormal liver function was noted in 34.7% of KD patients, and subsided all within one month. But the liver function test should be checked closely in patients of the abnormal liver function test complicated with KD despite of its good prognosis.

• 대한한의학회지
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• 제17권2호
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• pp.214-226
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• 1996

In an attempt to evaluate the effect of high and low concentration of Injinsaryungsan and high and low concentration of Sosihotang on cholestatic liver injery induced by $ANIT({\alpha}-naphthylisothiocyanate)$, biochemical changes in serum transaminase(GOT, GPT), alkaline phosphate, lactate dehydrogenase, total cholesterol, triglyceride, total-bilirubine were studied and the following results were obtained. 1. High concentration of Injinsaryungsan(2.2g／Kg) inhibited significantly the activity increases of GOT, GPT, ALP, LDH, TC, TG, T-Bilirubine induced by $ANIT({\alpha}-naphthylisothiocyanate)$. 2. Low concentration of Injinsaryungsan(1.1g／Kg) inhibited the activity increases of ALP, LDH, TC, TG with statistical significance, while inhibited the activity increase of GOT ,but with no statistical significance. 3. High concentration of Sosihotang(2.4g／Kg) inhibited the activity increases of LDH, TG, TC with statistical significance while inhibited the activity increases of GOT, GPT, ALP, T-bilirubine with no significance. 4. Low concentration of Sosihotang(1.2g／Kg) inhibited the activity increase of TG, while inhibited the activity increase of ALP, TC with no statistical sig-nificance, but didn't inhibite the activity increases of GOT, GPT, LDH, T-Bil. These results suggest that Injinsaryungsan has more significant effect on the liver injury induced by $ANIT({\alpha}-naphthylisothiocyanate)$ compared with Sosihotang and so can be applicable clinically to virus hepatitis and cholestatic liver injury. Further study will be required to evaluate the effect of Sosibotang on cholangitis and cholecystitis.