• Title/Summary/Keyword: 담도계

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Jejunal Migration of the Stent-Graft Used for Common Hepatic Artery Pseudoaneurysm (총간동맥 가성동맥류의 치료로 삽입한 스텐트 그라프트의 공장으로의 위치 이동)

  • Jiwon Kim;Byung-Hee Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.189-193
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    • 2022
  • Hemorrhage after pancreaticobiliary surgery is an infrequent but fatal complication. It is primarily caused by rupture of the pseudoaneurysm, and treatment options include endovascular coil embolization or endovascular stent-graft placement. Herein, we report a case of migration of an arterial stent-graft that was placed in the common hepatic artery to treat pseudoaneurysm after pylorus-preserving pancreaticoduodenectomy. The stent-graft migrated to the jejunum and was eventually excreted from the body.

The Role of Radiotherapy for Carcinomas of the Gall Bladder and Extrahepatic Biliary Duct: Retrospective Analysis (담낭 및 간외담도계 악성종양의 방사선치료결과)

  • Jeong Hyeon Ju;Lee Hyun Ju;Yang Kwang Mo;Suh Hyun Suk;Kim Re Hwe;Kim Sung Rok;Kim Hong Ryong
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.43-49
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    • 1998
  • Purpose : Carcinomas arising in the gall bladder(GB) or extrahepatic biliary ducts are uncommon and generally have a poor prognosis. The overall 5-year survival rates are less than $10\%$. Early experiences with the external radiation therapy demonstrated a good palliation with occasional long-term survival. The present report describes our experience over the past decade with irradiation of primary carcinomas of the gallbladder and extrahepatic biliary duct. Materials and Methods : From Feb. 1984 to Nov. 1995, thirty-three patients with carcinoma of the GB and extrahepatic biliary duct were treated with external beam radiotherapy with curative intent at our institution. All patients were treated with 4-MV linear accelerator and radiation dose ranged from 31.44Gy to 54.87Gy(median 44.25Gy), and three Patients received additional intraluminal brachytherapy(range, 25Gy to 30Gy). Twenty-seven Patients received postoperative radiation. Among 27 patients, Sixteen patients underwent radical operation with curative aim and the rest of the patients either had bypass surgery or biopsy alone. In seventeen patients, adjuvant chemotherapy was used and eleven patients were treated with 5-FU, mitomycin and leucovorin. Results : Median follow up period was 8.5 months(range 2-97 months). The overall 2-year and 5-year survival rates in all patients were $29.9\%$ and $13.3\%$ respectively. In patients with GB and extrahepatic biliary duct carcinomas, the 2-year survival rates were $34.5\%$ and $27.8\%$ respectively. Patients who underwent radical operation showed better 2-year survival rates than those who underwent palliative operation($43.8\%\;vs.\;20.7\%$), albeit statistically insignificant(p>0.05). The 2-year survival rates in Stage I and II were higher than in Stage III and IV with statistical significance(p<0.05). Patients with good performance status in the beginning showed significantly better survival rates than those with worse status(p<0.05). The 2-year survival rates in combined chemotherapy group and radiation group were $40.5\%$ and $22.0\%$ respectively. There was no statistical differences in two groups (p>0.05). Conclusion : The survival of patients with relatively lower stage and/or initial good performance was significantly superior to that of others. We found an statistically insignificant trend toward better survival in patients with radical operation and/or chemotherapy, More radical treatment strategies, such as total resection with intensive radiation and/or chemotherapy may offer a better chance for cure in selective patients with carcinoma of gall bladder and extrahepatic biliary ducts.

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A Study for the Gallbladder Stone on the Dietary Factors (식이요인에 따른 담석형성에 관한 연구)

  • Sim, Hyun-Sun;Jung, Hong-Ryang
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.391-397
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    • 2007
  • Background/Aims : Gallbladder(GB) stone is the most common disease in the biliary system, and the incidence is gradually increasing in Korea. This change may include rapidly proceeding urbanization and changing food factor. We performed this study to investigate related GB stones and contraction of GB as dietary factors. Methods : We investigated 129 subjects(mean age : 47 years). GB stone group is 9 subjects(M: 2, F: 7) in Namyangju-si. Control group without GB stone is 18 subjects(M: 6, F: 12) in Wi-do island. For subjects without GB stone, diabetes mellitus decide 4(M: 2, F: 2) and then each after eat flesh and meat of estimated by experimental group ejection fraction rate(%). Results : Ejection fraction rate of GB were different between meat and fishes intake. When ate the meat in experiment for hypothetical verification, when become ejection fraction rate of meal GB 210 minutes, was the highest and when ate fish, the ejection fraction rate of GB was the highest in meal 120 minutes. Conclusions : After meats intaking the bile inside the GB is stagnant long and the GB stone is formed. We studied the results GB motility may important play a role on GB stone formation.

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Gastric Reflux on Routine Tc-99m DISIDA Hepatobiliary Scintigraphy (Tc-99m DISIDA 간담도 Scintigraphy상 우연히 발견된 위장역류의 임상적 의의)

  • Lee, Kang-Wook;Lee, Heon-Young
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.3
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    • pp.313-318
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    • 1995
  • Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid delivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISIDA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows : 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenoscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

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담도계 회충증의 간호와 임상적 고찰

  • 김은덕
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.95-102
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    • 1970
  • Ascariasis symptoms penetrated into biliary tract are reported to be found much more in Korea than in foreign countries. And the present writer believes there are also many cases of biliary tract symptoms that are actually experienced but that are not reported. As a result of experiencing and nursing twenty cases of ascariasis symptoms of biliary tract, the present writer has got several conclusions, and reports them together with reference to sundry records. (1) The penetrating rate of ascariasis in male versus female was 1 to 1.5. Consequently the rate of female was higher than that of male. The highest age of the case was 67, the lowest 19, and the average age was 45.2. (2) As to symptoms, right upper quadrant abdomen pain and fat diet intolerance were the largest in number. By laboratory findings there were depressive pain on right upper quadrant abdomen in all the cases. (3) As to the location of ascariasis, choledochus occupied the largest part, and the longer illness history was, the more cases coexisting with calculus were found. (4) As to operative method, cholecystectomy and choledochotomy weres the largest in number, and choledochotomy T-tube was inserted in all cases. As to complication after operation, there were operative wound infection, excoriation through bile juice issue, etc. There were three cases of re-penetration of ascariasis and only one case of reoperation.

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Usefulness of Brushing Cytology in the Diagnosis of the Patients with the Stricture of Biliary Tree (담도계 협착 환자의 진단에 솔질 세포검사의 유용성)

  • Park, Mi-Ok
    • The Korean Journal of Cytopathology
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    • v.11 no.1
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    • pp.11-18
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    • 2000
  • Pancreaticobiliary tract strictures are frequent Indications for endoscopic retrograde cholangiopancreatography(ERCP). We have investigated the brushing cytology in order to determine its efficacy for diagnosis of pancreaticobiliary malisnancies. Brushing cytology during ERCP was evaluated in 56 patients with biliary tract stricture presenting to the Catholic Hospital of Taegu-Hyosung from April 1997 to August 1999. A comparison was made between the cytologic and histologic diagnoses on 32 cases from 30 patients. A diagnosis of malignancy was establishied in 78.1%, benign in 15.6%, and inadequate in 6.3% of the cases. Statistical data on cytologic diagnoses in strictures of the bile duct were as follows; specificity and sensitivity of blushing procedure was 100% & 83.3%, respectively: sensitivity of interpretation was 89.3%: with no false positive cases and 3 false negative cases: predictive value for malignancy was 100% & 100%, respectively: predictive value for benign was 28.6% & 40%,, respectively: overall diagnostic efficiency was 84.4%. It is concluded that brush cytology is a diagnostically reliable, highly specific technique for malignant lesions encounted at ERCP, although a negative result does not rule out the diagnosis of malignancy.

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Two adolescent cases of Fitz-Hugh-Curtis syndrome (청소년에서의 Fitz-Hugh-Curtis Syndrome 2례)

  • Kim, Ji Hye;Oh, Sung Hee
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.1038-1043
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    • 2009
  • Two adolescent cases of Fitz-Hugh-Curtis syndrome, which has not been previously reported in Korean girls, presenting with right upper-quadrant abdominal pain, nausea, vomiting, and fever are reported here. A careful and thorough inquiry into the sexual history of the first patient, which was not done upon admission, led to a careful reassessment of the dynamic abdominal computed tomography scan revealing hepatic capsular enhancement without evidence of gallbladder or liver disease. Both cases were diagnosed noninvasively and were treated successfully by medical intervention. A high index of suspicion of Fitz-Hugh-Curtis syndrome should be implemented in the differential diagnosis of right upper quadrant pain, particularly in sexually active girls, for a prompt diagnosis and rapid cure.

Clinical Application of $^{99m}Tc-DISIDA$ Scintigraphy with Nonvisualization of Biliary Excretion (담도계로 배설되지 않는 $^{99m}Tc-DISIDA$ 신티그램의 임상적 응용)

  • Moon, Tae-Yong;Kim, Yong-Ki;Kim, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.1
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    • pp.25-32
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    • 1987
  • Authors analysed biochemical studies and scintigraphic findings of obstructive jaundice and nonobstructive jaundice in 44 cases of $^{99m}Tc-DISIDA$ scintigraphy with nonvisualization of biliary excretion till 120 min or 240 min after injection of $^{99m}Tc-DISIDA$. Causative diseases of $^{99m}Tc-DISIDA$ scintigraphy with nonvisualization of biliary excretion were in order to choledocholithiasis (25%), hepatitis (25%), cholangiocarcinoma (14%), cholangitis (14%) and pancreas head tumor (11%). In obstructive jaundice, statistically significant findings were elevated alkaline phosphatase above 300 IU/L on biochemical study and single lobe enlargement of the liver, irregular radioisotope uptake of the liver and concave indentation of the gall bladder fossa of the liver on scintigraphy. In nonobstructive jaundice, statistically significant findings were persistent renal excretion of $^{99m}Tc-DISIDA$ and more increased uptake density of the heart than the liver on scintigraphy.

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Active Noise Control in Ductilike System using Adaptive Filtering (적응필터링에 의한 덕트계의 능동소음제어)

  • 이태연;김상명;송원식;오재응
    • Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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    • 1991.04a
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    • pp.17-22
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    • 1991
  • 최근 기계장치로부터 발생하는 소음을 감소시키는 새로운 방법으로서, 능동 적으로 소음을 제어하는 방법에 대한 연구가 활발히 진행되고 있다. 이것은 원하지 않는 소음을 그 신호의 역위상을 갖는 부가음을 이용하여 능동적으 로 감쇠시키는 방법으로서, 저주파수 대역에서 비효율적인 수동적인 방법인 소음기둥에 대한 대안으로 많은 학자들의 관심의 대상이 되어 왔다. 초기에 는 소음을 줄이기 위해 요구되는 여러가지 음향요소의 전달함수를 제어하는 데 대한 불가능성으로 인해 능동 소음제어에 대한 실질적인 발전이 지연되 어 왔으나 최근 마이크로 컴퓨터를 비롯한 전자공학의 발전으로 인해 적응 신호처리 분야가 등장하게 되었으며, 음향계의 소음을 원하는 수준까지 제어 하는 능동 소음제어의 실시간 구현이 가능하게 되었다. 그 중에서도 음이 1 차원적으로 전파한다고 볼 수 있는 길이가 긴 덕트구조물에서의 능동 소음 제어는 가장 기본적이며 현실적으로 자동차 배기계나 냉동.공조설비에 있어 서 실용적으로 적용할 수 있는 문제임 만큼 많은 연구가 이루어지고 있다. 이러한 능동 소음제어 방법을 음향계에 적용하였을 때, 부가적인 음을 발생 하는 제어용 스피커로 인해 입력마이크로폰으로의 음향궤환이 존재하고 이 에 따라 제어계가 불안정해질 수 있으며, 또한 변환기의 사용으로 인한 부가 적인 전달함수가 존재하므로 이에 대한 중요한 의미를 갖고 고려하여야 한 다. 본 연구에서는 적응 필터링 이론에 의한 소음원의 입력신호에 대한 최적 한 예측으로써 부가음을 발생시키고, 입력신호 및 제어된 출력신호간의 차인 오차를 최소화 시키도록 하는 오차적응제어법을 이용한 능동소음 제어 방법 을 제시하였다. 이와 아울러 제어계의 환경변화에 따른 파라메타의 변화에 적응적으로 응답이 가능해야 하는 적응 소음제어 시스템에서, 음향궤환과 함 께 필히 고려해야 하는 부가적인 전달함수의 영향을 고려한 능동 소음제어 에 대해 연구하였다. 경량화 추세에 따라 지반이나 케이싱이 경량이거나 유연하여 회전축과 동적으로 연성된 경우 회전축-베어링-지반으로 이루어진 2중구조의 회전축 계 동특성을 해석할 수 있는 프로그램을 개발하므로서 회전 기계류의 진동 전반에 걸친 문제점에 대한 그 원인과 현상을 명확히 분석하여 국내의 전기 계류의 보다 신뢰성있는 설계 및 제작자료를 확보하는데 기여할 수 있게 하 였다.존의 small molecular Gd-chelate에 비해 매우 큼을 알 수 있었다. MnPC는 간세포에 흡수된 후 담도계로 배출되는 간특이성 조영제임을 확인하였다. 장비 내에서 반복 시행한 평균값의 차이는 대체적으로 유의한 차이가 없었으나, 다른 장비에서 반복 시행한 장비간의 사이에는 유의한 차이가 있는 경우가 더 많았다. 따라서 , MRS 검사를 소뇌나 뇌교의 어떤 절환에 적용하기 전에 각 장비 마다 정상 기준치를 반드시 얻은 후에 이상여부를 판 정하는 것이 필수적이라고 생각된다.EX> 이상이 적절한 진단기준으로 생각되었다. $0.4{\;}\textrm{cm}^3$ 이상의 좌우 부피차를 보이는 모든 증례에서 육안적으로도 해마위축이 뚜렷이 나타났다. 결론 : MR영상을 이용한 해마의 부피측정은 해마경화증 환자의 진단에 있어 육안적인 MR 진단이 어려운 제한된 경우에만 실제적 도움을 줄 수 있는 보조적인 방법으로 생각된다.ofile whereas relaxivity at high field is not affected by τS. On the other hand, the change in τV does not affect low field profile but strongly in fluences on both inflection fie이 and the maximum relaxivity value. The results shows a fluences on both inflection field

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A Case of Nonspecific Interstitial Pneumonia in a Patient with Ulcerative Colitis (궤양성 대장염에 병발된 비특이적 간질성 폐렴 1예)

  • Noh, Young Wook;Baik, Eun Kyung;Ryu, Yon Ju;Kim, Seong-Eun;Lee, Jin Hwa;Sim, Sung Shin;Lee, Shi Nae;Chun, Eun Mi
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.56-61
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    • 2007
  • Pulmonary complications of ulcerative colitis are relatively uncommon and may present as a variety of disorders. Ulcerative colitis-related interstitial lung disease is extremely rare. There are a few case reports of nonspecific interstitial pneumonia in ulcerative colitis worldwide but none in Korea. We report a patient with ulcerative colitis related biopsy-proven nonspecific interstitial pneumonia, who responded to prednisolone (1 mg/kg) and mesalazine therapy.