• Title/Summary/Keyword: pancreatic duct

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A Case of Autoimmune Chronic Pancreatitis in a Child (자가면역성 만성 췌장염으로 진단된 소아 1예)

  • Choi, In-Young;Jin, So-Hee;Choi, Kyung-Dan;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.215-220
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    • 2007
  • We present a case of autoimmune chronic pancreatitis in a previously healthy child without any history of autoimmune disease. A 12-year-old boy was admitted to the hospital with abdominal pain. The serum amylase, lipase, and IgG levels were elevated and autoantibodies (antinuclear antibody, antineutrophil antibody) were detected. An abdominal CT (computed tomographic) scan revealed diffuse enlargement of the pancreas. ERCP (endoscopic retrograde cholangiopancreaticography) demonstrated an irregular stricture of the main pancreatic duct in the pancreas tail. After two years of oral steroid and immunosuppressive drug therapy, the clinical, laboratory and radiological findings were improved. The patient has been symptom-free for 18 months after the discontinuation of medication.

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Highlights for the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting (2019 미국 임상종양학회 두경부암 하이라이트)

  • Lee, Yun-Gyoo
    • Korean Journal of Head & Neck Oncology
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    • v.35 no.2
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    • pp.1-10
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    • 2019
  • The 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, which took place May 31-June 4 in Chicago, drew more than 32,000 oncology specialists from around the world. The theme of 2019 ASCO conference was "Caring for Every Patient, Learning from Every Patient". Among the topics of interest covered were new approaches to surmount limited access to cancer care and the latest advances in targeted therapies for pancreatic, prostate cancers and soft tissue sarcomas. In the field of head and neck cancer, 8 oral abstracts and 75 poster abstracts were presented at this meeting. In this review, we are going to summarize the eight studies that have been presented orally. The topics are recurrent and/or metastatic head and neck squamous cell carcinoma for two abstracts (#6000, #6002), salivary duct carcinoma for one abstract (#6001), locally advanced nasopharyngeal carcinoma for two abstracts (#6003, #6004), oropharyngeal carcinoma for two abstracts (#6006, #6008), and oral cavity cancer for one abstract (#6007).

Differentiation of Adenomyoma from Localized Adenocarcinoma of the Ampulla of Vater Using Multidetector CT (다중 검출 전산화단층촬영 영상에서 바터 팽대부의 샘근종과 국소적 샘암종의 감별)

  • Yeongtae Park;Jisun Lee;Yook Kim;Bum Sang Cho;Kil Sun Park;Chang Gok Woo
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.393-405
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    • 2021
  • Purpose To determine the multidetector CT (MDCT) findings that differentiate adenomyoma of the ampulla of Vater (AOV) from localized adenocarcinoma of the AOV. Materials and Methods Sixteen and 30 patients with adenomyoma and localized adenocarcinoma of the AOV, respectively, were evaluated using MDCT. We analyzed the size and attenuation value and presence of uniform enhancement of the lesions, diameters of the extrahepatic bile duct (EHD) and main pancreatic duct, presence of regional lymph node enlargement, and laboratory findings. We determined the independent findings for differentiating adenomyoma from localized adenocarcinoma of the AOV using multivariate analysis. Results The size of the lesion and diameter of the EHD were significantly smaller for adenomyoma than those for localized adenocarcinoma of the AOV (all p < 0.001). In multivariate analyses, a lesion size of ≤ 1.3 cm, an EHD diameter of ≤ 1.3 cm, and an alanine transaminase level of ≤ 31 IU/L significantly differentiated adenomyoma from localized adenocarcinoma of the AOV. When all of these three findings were met, the specificity for adenomyoma of the AOV was 93.3%. Conclusion MDCT imaging may facilitate the differential diagnosis of adenomyoma and localized adenocarcinoma of the AOV based on the size of the lesion and diameter of the EHD.

A Study on the Radiographic Diagnosis of Caroli's Disease (카롤리병의 방사선학적 진단에 대한 고찰)

  • Yeo-jin Hong;Min-a Kim;Soo-bin Kim;Jin-joo Song;Kyoung-hoon Jang;Min-cheol Jeon;Man-Seok Han
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.385-392
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    • 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.

Pi Class of Glutathione Transferase is the Major Form of Detoxifying Enzyme in the Human Epithelial Tissues and Saliva (인체상피조직 및 타액내 해독효소로서의 glutathione transferase Pi)

  • 박상철;곽상순;서희명;김옥경;정윤미;최경호;김우호
    • Environmental Mutagens and Carcinogens
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    • v.11 no.2
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    • pp.148-160
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    • 1991
  • Localization of isoenzyme of glutathione transferase Pi class was compared in different human tissues by immunohistochemical analysis. Strong enrich-ment of GST-Pi in the epithelial tissues was observed in the granular layer of skin, nipple and esophagus which are vulnerable to exogenous chemicals and in the duct epithelium such as pancreatic, biliary, salibvary, renal tubules as well as in the steroid biosynthesis organs such as theca and granulosa of ovary, leydig cell of testis and zona reticularis of adrenal glands.

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Acute Pancreatitis Associated with Varicella Infection in an Immunocompetent Child (정상 면역기능을 가진 소아에서 수두 감염 후에 발생한 급성 췌장염 1예)

  • Oh, Ki-Won;Kim, Joon-Sung;Kim, Ja-Hyeong;Park, Sang-Kyu;Jeong, Jin-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.75-79
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    • 2008
  • Blunt trauma, drugs, infection, congenital anomalies of the pancreaticobiliary system, and multisystem diseases are the main causes of acute pancreatitis in children. Various viruses can cause acute pancreatitis, but varicella-induced pancreatitis is unusual and generally observed in adults or immunocompromised patients. We report a rare case of acute pancreatitis associated with varicella-zoster virus infection in a 6-year-old immunocompetent girl. The patient initially presented complaining of severe abdominal pain and repetitive vomiting. The patient had multiple cutaneous crusts that has been caused by preceding varicella infection and had elevated values of serum amylase and lipase. Abdominal ultrasonography demonstrated swelling of the pancreas and pancreatic duct dilatation, findings which were compatible with acute pancreatitis. The patient's clinical and laboratory abnormalities were completely normalized through conservative treatment consisting of fasting, total parenteral nutrition, and analgesic therapy.

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Histopathological Study and Expression of Beta-Catenin in Congenital Choledochal Cyst in a Tertiary Care Pediatric Referral Center in South India

  • Rashmi Tresa Philpose;Abdul Aleem Mohammed;Ashrith Reddy Gowni
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.1
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    • pp.62-70
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    • 2024
  • Purpose: Choledochal cysts are congenital anomalies that occur as localized cystic or fusiform dilatations of the biliary tree. Reflux and stasis of pancreatic enzymes in the biliary duct may relate to the development of intestinal metaplasia which might be an important factor related to the carcinogenesis of choledochal cyst, thus the expression of beta-catenin in the metaplastic epithelium might be associated with malignant transformation of choledochal cyst epithelium. Methods: This study was conducted at a tertiary care pediatric center between October 2014 and March 2017. Forty patients were evaluated for epithelial lining, mural ulceration, fibrosis, inflammation, and metaplasia. Results: Out of 40, 12 cases (30.0%) were the infantile age group and 28 cases (70.0%) were in the classic pediatric group. Ulceration was classified as grade 0 (14 cases, 35.0%), grade 1 (17 cases, 42.5%), or grade 2 (nine cases, 22.5%). Inflammation was classified as grade 0 (2 cases, 5.0%), grade 1 (26 cases, 65.0%), or grade 2 (12 cases, 30.0%). Fibrosis was classified as grade 0 (five cases, 12.5%), grade 1 (11 cases, 27.5%), grade 2 (17 cases, 42.5%), or grade 3 (seven cases, 17.5%). Metaplasia was noted in five (12.5%) out of 40 cases. All choledochal cysts with metaplasia showed beta-catenin nuclear positivity on immunohistochemistry and were followed up. Conclusion: This study emphasizes the importance of detailed histopathological examination and documentation of metaplastic changes. Metaplasia was associated with beta-catenin nuclear positivity. These findings suggest a potential role for beta-catenin as a marker of metaplastic changes in choledochal cysts.

A New Health Care Policy in Korea Part 2: Expansion of Coverage by National Health Insurance on the Abdominal Ultrasound and MRI (새로운 건강보험 보장성 강화 대책 2부: 복부 초음파 및 MRI 급여 확대)

  • Min Jae Jang;Seong Jin Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1069-1082
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    • 2020
  • Coverage by National Health Insurance (NHI) was expanded in the abdominal imaging area as follows: upper abdominal ultrasound on April 1, 2018, lower abdominal ultrasound on February 1, 2019, and abdominal MRI on November 1, 2019. Many patients can benefit from the expansion of NHI coverage. Newly included diseases for NHI coverage includes liver cirrhosis, gallbladder polyps, hepatic adenoma/dysplastic nodules, pancreatic cysts, autoimmune pancreatitis and bile duct stone disease. However, the expansion of coverage made each examination more complex, including indications, follow-up strategy, the number of examination per patients, the standard images to be acquired, and the standard forms of the radiological report. Therefore, more careful consideration is mandatory when an abdominal imaging examination is prescribed and conducted.

Clinical Analysis of Traumatic Pancreatic Injury (개복 수술로 확인된 외상성 췌장 손상 환자에 대한 임상적 고찰)

  • HwangBo, Seon-Mi;Kwon, Young-Bong;Yun, Kyung-Jin;Kwon, Hyung-Jun;Chun, Jae-Min;Kim, Sang-Geol;Park, Jin-Young;Hwang, Yun-Jin;Yun, Young-Gook
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.68-74
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    • 2011
  • Purpose: Although pancreas injury is rare in abdominal trauma, it poses a challenge to the surgeon because its clinical features are not prominent and the presence of main duct injury cannot be easily identified by imaging studies. Furthermore, severe pancreas injuries require a distal pancreatectomy or a pancreaticoduodnectomy which are associated considerable morbidity and mortality. We reviewed the clinical features of and outcomes for patients with pancreas injury. Methods: For 10 years from Jan. 2001 to Dec. 2010, thirty-four patients were diagnosed as having pancreas injury by using an explo-laparotomy. Patients successfully treated by non-operative management were excluded. Patients were divided into early (n=18) and delayed surgery groups (n=11) based on an interval of 24hours between injury and surgery. The clinical features of and the outcomes for the patients in both groups were compared. Results: Males were more commonly injured (82.4% vs.17.6%). The mean age was 37.2 years. The injury mechanisms included vehicle accidents (62.9%, 22/34), assaults (20%, 7/34), and falls (11.4%, 3/34). The head and neck of the pancreas was most commonly injured, followed by the body and the tail (16, 12, and 6 cases).Of the 34 patients, 26 (76.5%) patients had accompanying injuries. Grade 1 and 2 occurred in 14 (5 and 9) patients, and grade 3, 4, and 5 occurred in 20 (16, 3, and 1) patients. The early and delayed surgery groups showed no difference in surgical outcomes. Two patients with grade 3 in the early surgery group died after surgery,one due to massive hemorrhage and the other due to septic shock. Of the five patients initially managed non-operatively, three developed peripancreatic necrosis and two developed pseudocyst. All five patients were successfully cured by surgery. Conclusion: All cases of pancreas injury in this study involved blunt injury, and accompanying injury to major vessels or the bowel was the major cause of mortality. Surgery delayed for longer than 24 hours after was not associated with adverse outcomes.

Light and Scanning Electron Microscopy of Tetragomphius procyonis (Ancylostomatoidea) from Wild Badger (한국산 야생 오소리에서 분리한 오소리구충 (Tetragomphius procyonis)의 광학 및 주사전자현미경 소견)

  • Son, Hwa-Young;Oh, Yoon-Hee;Kim, Hyeon-Cheol;Park, Bae-Keun
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.379-385
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    • 2009
  • Tetragomphius procyonis Baylis & Daubney, 1923 were obtained from the pancreatic duct of a naturally infected Eurasian badger, Meles meles, which was submitted to animal hospital for parasitic diagnosis from Gyeryongsan National Park in Korea. The hookworms were examined by light and scanning electron microscope. The length of body measured male 15.0-18.8 mm, female 21.5-25.5 mm, respectively. In both sex, the ventral cutting plates of oral margin are much reduced and elongated latero-dorsally, the dorsal cutting plate is located long follow doral margin of the oral opening. The buccal capsule is cup-shaped and thicken with four cusped tooth at its base. The copulatory bursa has elongated ventral lobes and their large rays are parallel, while the dorsal lobe with its supporting rays is slightly split in two. The slender spicules are filariform and very long (8.7-9.3 mm), and their tips are fused together. The hookworm has following characters: dorsal cone on the both sex, gubernaculum on the male and terminal spine on the female tail absent; vulva is opening in the juction of the fourths and fifths of the body; dorsal ray with two long stems. The eggs from the uterus are 16 cell stages and those from the rectal feces, 32 cell stages. The size of eggs is 77.48-83.45 ${\times}$ 50.75-63.38 ${\mu}m$.