• Title/Summary/Keyword: Bile Ducts

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$^{99m}Tc-DISIDA$ Hepatobiliary Scintigraphic Study in Symptomatic Patients after Various Biliary Surgeries: Regional Emphasis of Recurrent Pyogenic Cholangitis and Intrahepatic Duct Stones (담도계 수술후 증상이 재발한 환자에서의 $^{99m}Tc-DISIDA$ Hepatobiliary Scintigraphy: 재발 농양성 간담도염과 간내 담석 발생빈도의 지역적인 특성을 고려한 연구)

  • Yum, H.Y.;Park, Y.H.;Suh, J.K.;Lee, S.D.;Choi, K.H.
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.2
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    • pp.19-38
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    • 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.

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Diagnostic Utility of Tc-99m DISIDA Hepatobiliary Scintigraphy in the Diagnosis of Biliary Atresia (담도폐쇄증 진단에서 DISIDA 간담도주사의 진단적 의의)

  • Lee, Byeong-Seon;Choi, Bo-Hwa;Kim, Kyung-Mo;Kim, Jae-Seung;Moon, Dae-Hyeok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.63-67
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    • 2000
  • Purpose: Biliary atresia, one of the major causes of neonatal cholestais, is an idiopathic, serious disorder, affecting the newborn that results in complete obstruction of biliary tract. Successful reestablishment of bile flow is dependent on early surgical intervention, early diagnosis is imperative. The authors evaluate the utility of Tc-99m-labeled diisoprpyliminodiacetic acid (DISIDA) hepatobiliary scintigraphy in the diagnosis of biliary atresia. Methods: From January, 1995 to August, 1999, total 60 patients with neonatal cholestasis underwent Tc-99m DISIDA hepatobiliary scintigraphy at Asan Medical Center. Results: The undelying causes of neonatal cholestasis were biliary atresia in 14, neonatal hepatitis in 33, intrahepatic bile duct paucity in 9, and total parenteral nutrition induced cholestasis in 4. All patient with biliary atresia were interpreted correctely in DISIDA hepatobiliary scintigraphy, showing 100% sensitivity. Of the 46 patients with neonatal hepatitis and other causes, 37 patients had intestinal radioactivity showing 80% specificity. Conclusion: Visualization of DISIDA in the intestinal tract indicates patency of the biliary ducts and excludes the diagnosis of biliary atresia. But the absence of intestinal excretion on the DISIDA hepatobiliary scintigraphy dose not necessarily indicate biliary atresia.

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Arterial Tortuosity Syndrome in a Neonate

  • Kim, Kyung Min;Hur, Sun-Mi;Yoon, Ji Hong;Lee, Eun-Jung;Lee, Jae Young
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.49-52
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    • 2018
  • Arterial tortuosity syndrome (ATS) is a very rare autosomal recessive connective tissue disease characterized by generalized elongation and tortuosity of the medium- to large-sized arteries, and other systemic connective tissue manifestations. To date, this disease entity has not been reported in Korea. We report a case of ATS diagnosed in a neonate who presented with severe elongation and tortuosity of the aorta and its major branches, as well as the intracranial arteries. Additionally, the patient presented with a tortuous dilatation of the inferior vena cava, an aneurysmal dilatation of the extra-hepatic bile ducts, and an inguinal and sliding hiatal hernia. The diagnosis was confirmed using DNA sequencing analysis, and the patient demonstrated a compound heterozygosity for two novel mutations (c.738delG [p.Gln247Serfs*33] and c.362T>C [p.Ile121Thr]) in exon 2 of the SLC2A10 gene. Genetic analysis also confirmed that both parents were heterozygous carriers of the responsible mutations. Owing to such clinical manifestations, ATS is often misdiagnosed as other connective tissue diseases including Loeys-Dietz syndrome, Marfan syndrome, and Ehlers-Danlos syndrome. In patients presenting with a high index of suspicion, thorough clinical evaluation and screening for ATS including computed tomography or magnetic resonance angiography and target gene analysis are necessary for early diagnosis and management.

Platynosomum fastosum (Trematoda: Dicrocoeliidae) from Cats in Vietnam: Morphological Redescription and Molecular Phylogenetics

  • Nguyen, Hung Manh;Hoang, Hien Van;Ho, Loan Thi
    • Parasites, Hosts and Diseases
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    • v.55 no.1
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    • pp.39-45
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    • 2017
  • The present study was performed to reveal the morphological characteristics and molecular phylogenetic position of Platynosomum fastosum Kossack, 1910. A total 167 specimens of P. fastosum were collected in 8 (4.9%) out of 163 sets of gall-bladders and bile ducts of cats. The number of worms was 1-105 per infected cat. This species was characterized by having a long and slender body, slightly larger ventral sucker than the oral sucker, indistinct prepharynx, small pharynx, short esophagus, bifurcation midway between 2 suckers, and ceca extending to the posterior end of the body. The length of the partial sequences of ITS1 and 5.8S rDNA of P. fastosum were 990 bp, GC-rich. AT/GC ratio was 0.9, there were 9 polymorphic sites, and intraspecific variations ranged from 0.1% to 0.9%. Phylogenetic analyses by neighbor-joining phylogram inferred from ITS1 rDNA sequences revealed that the genetic distance between P. fastosum specimens ranged from 0.3 to 1.5% while the smallest interspecific distance among dicrocoeliid species was 20.9 %. The redescription and genetic characters of P. fastosum are taxonomically important to recognize future different species of the genus Platynosomum showing high intraspecific and morphological variability.

Opisthorchis viverrini Infection Activates the PI3K/AKT/PTEN and Wnt/β-catenin Signaling Pathways in a Cholangiocarcinogenesis Model

  • Yothaisong, Supak;Thanee, Malinee;Namwat, Nisana;Yongvanit, Puangrat;Boonmars, Thidarut;Puapairoj, Anucha;Loilome, Watcharin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10463-10468
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    • 2015
  • Opisthorchis viverrini (Ov) infection is the major etiological factor for cholangiocarcinoma (CCA), especially in northeast Thailand. We have previously reported significant involvement of PI3K/AKT/PTEN and $Wnt/{\beta}$-catenin in human CCA tissues. The present study, therefore, examined the expression and activation of PI3K/AKT/PTEN and $Wnt/{\beta}$-catenin signaling components during Ov-induced cholangiocarcinogenesis in a hamster animal model. Hamsters were divided into two groups; non-treated and Ov plus NDMA treated. The results of immunohistochemical staining showed an upregulation of PI3K/AKT signaling as determined by elevated expression of the $p85{\alpha}$-regulatory and $p110{\alpha}$-catalytic subunits of PI3K as well as increased expression and activation of AKT during cholangiocarcinogenesis. Interestingly, the staining intensity of activated AKT (p-AKT) increased in the apical regions of the bile ducts and strong staining was detected where the liver fluke resides. Moreover, PTEN, a negative regulator of PI3K/AKT, was suppressed by decreased expression and increased phosphorylation during cholangiocarcinogenesis. We also detected upregulation of $Wnt/{\beta}$-catenin signaling as determined by increased positive staining of Wnt3, Wnt3a, Wnt5a, Wnt7b and ${\beta}$-catenin, corresponded with the period of cholangiocarcinogenesis. Furthermore, nuclear staining of ${\beta}$-catenin was observed in CCA tissues. Our results suggest the liver fluke infection causes chronic inflammatory conditions which lead to upregulation of the PI3K/AKT and $Wnt/{\beta}$-catenin signaling pathways which may drive CCA carcinogenesis. These results provide useful information for drug development, prevention and treatment of CCA.

Contamination of Sediments and Histological Alterations in Barfin Plaice Pleuronectes pinnifasciatus from Amursky Bay(Peter the Great Bay, East Sea/Sea of Japan)

  • Vaschenko Marina A.;Syasina Iraida G.;Durkina Valentina B.;Zhadan Petr M.
    • Ocean and Polar Research
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    • v.25 no.1
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    • pp.31-40
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    • 2003
  • In August-September 2001, 15 samples of bottom sediments were collected in the inner, middle and open parts of Amursky Bay near Vladivostok, Russia, and barfin plaice Pleuronectes pinnifasciatus was sampled from the inner and the middle locations of the bay. In the sediments from all three sites elevated concentrations of several heavy metals, i.e. Zn ($102-115{\mu}/g$ dry weight), Ni $(70-73{\mu}g/g)$ and Cu $(27-35{\mu}g/g)$ were discovered. The contents of oil hydrocarbons were very close to or slightly higher than the maximal normal environmental background level, $100{\mu}g/g$ dry weight. The sediments contained negligible amounts of hexachlorocyclohexane, while DDT concentrations were quite high (1.7-16.3ng/g dry weight). Generally, there were no substantial differences in the pollution levels of the locations studied and our results resembled those reported for Amursky Bay in the 1990s. Surprisingly, in 2001 'fiesh' DDT comprised 70-85% of the total DDT content in sediment from all the locations studied. In fish liver total DDTs concentrations were 212.8 and 122.54 ng/g wet weight for the inner and the middle locations, respectively, and 'fresh' DDT comprised 35 and 64% of DDTs, respectively. These results provide evidence of recent input of DDT from an unknown source into the ecosystem of Amursky Bay. Histopathological changes revealed in the plaice liver (vacuolization of hepatocytes, coagulative necrosis of hepatocytes, inflammatory reaction, and necrosis of epithelial cells of bile ducts) are probably connected with an intensive metabolism of DDT in the fish organism. No histological and histomorphometric differences were found in the state of the interrenal tissue. Similar condition of the liver and the interrenal tissue in barfin plaice sampled from the inner and the middle locations of Amursky Bay may be explained by the absence of great differences in the pollution levels of these sites.

Development of Cholecystectomy Simulation for Laparoscopic Surgery Training (복강경수술 훈련용 담낭 절제술 시뮬레이션 개발)

  • Kim, Young-Jun;Roy, Frederick;Lee, Seung-Bin;Seo, Joon-Ho;Lee, Deuk-Hee;Park, Se-Hyung
    • Korean Journal of Computational Design and Engineering
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    • v.17 no.5
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    • pp.303-311
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    • 2012
  • Laparoscopic surgery is a surgical procedure which uses long laparoscopic instruments through tiny holes in abdomen while watching images from a laparoscopic camera through umbilicus. Laparoscopic surgeries have many advantages rather than open surgeries, however it is hard to learn the surgical skills for laparoscopic surgery. Recently, some virtual simulation systems for laparoscopic surgery are developed to train novice surgeons or resident surgeons. In this study, we introduce the techniques that we developed for laparoscopic surgical training simulator for cholecystectomy (gallbladder removal), which is one of the most frequently performed by laparoscopic surgery. The techniques for cholecystectomy simulation include modeling of human organs (liver, gallbladder, bile ducts, etc.), real-time deformable body calculation, realistic 3D visualization of surgical scene, high-fidelity haptic rendering and haptic device technology, and so on. We propose each simulation technique for the laparoscopic cholecystectomy procedures such as identifying cystic duct and cystic artery to clamp and cut, dissecting connective tissues between the gallbladder and liver. In this paper, we describe the techniques and discuss about the results of the proposed cholecystectomy simulation for laparoscopic surgical training.

The Effect of CYP Polymorphism on Resistance against Praziquantel in Clonorchis Sinensis-infected Patients

  • Kim, Chung-Hyeon;Choi, Min-Ho;Chae, Jong-Il;Shin, Eun-Hee;Hong, Sung-Tae
    • Molecular & Cellular Toxicology
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    • v.3 no.3
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    • pp.195-197
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    • 2007
  • Currently praziquantel is used for treatment of not only clonorchiasis but also other trematodes and cestodes. But cure rate of praziquantel is just 60-80% for most trematodes. It needs for the treatment-failed patients to have more drugs. The cause of failure of treatment is not studied. We just know that the blood level of praziquantel is severely different among the people. We guess that this factor may influence the results of treatment. In an endemic area of human clonorchiasis in Heilongjiang Providence, China, 78 subjects were selected for the study. Three doses of 25 mg/kg (total 75 mg/kg) of praziquantel were administered to 78 clonorchiasis patients. After three weeks of treatment, stool examination was undertaken once again to confirm the cured and uncured subjects. To analyze SNP (single nucleotide polymorphism) of CYP3A5 PS2-1, CYP3A5 PS2-2, and CYP3A5*6, PCR method was done with specifically designed primers. The mutation rates of all sites were not significant statistically. The number of subjects was too small, so we need more subjects and other delivery proteins of bile ducts (ex. MRP etc.) were also considered for effects of praziquantel. We analyzed, for the first time, the entire CYP3A5 gene in a French population, using a polymerase chain reaction- single strand conformational polymorphism (PCR-SSCP) strategy.

A Case of Secondary Sclerosing Cholangitis in Langerhans Cell Histiocytosis (랑게르한스세포 조직구증 환아에서 발생한 속발성 경화성 담관염 1례)

  • Kim, Ja-Hyung;Choi, Bo-Hwa;Kim, Kyung-Mo;Moon, Hyung-Nam
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.120-124
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    • 2001
  • Sclerosing cholangitis is a chronic cholestatic disease characterized by inflammation and obliterative fibrosis of the bile ducts, leading to biliary cirrhosis and ultimately to liver failure. In children, sclerosing cholangitis is known to be associated with Langerhans cell histiocytosis, as well as with congenital immunodeficiencies and cystic fibrosis. Secondary sclerosing cholangitis is suspected in Langerhans cell histiocytosis with chronic cholestasis, liver dysfunction and portal hypertension. Unlike primary sclerosing cholangitis, the cholangitis associated Langerhans cell histiocytosis is destructive in nature and progresses more rapidly to biliary cirrhosis, therefore uniformly the prognosis is poor. In this setting, liver transplantation should be considered early in children with sclerosing cholangitis complicating Langerhans cell histiocytosis before end-stage liver failure and variceal bleeding. We experienced a case of secondary sclerosing cholangitis in Langerhans cell histiocytosis in a 2-year-old boy. We report this case with brief review of the related literatures.

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Ultrastructure of the Sensory Papillae in the Liver and Lung Flukes (간과 폐에 기생하는 흡충류 감각유두의 미세구조)

  • Kim, S.J.
    • Applied Microscopy
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    • v.15 no.1
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    • pp.101-111
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    • 1985
  • A study was undertaken to observe the distribution and ultrastructure of the sensory papillae of the liver and lung flukes which was obtained from experimentally infected rats and dogs. For this study, the rats were artificially infected with metacercariae isolated from Pseudorasbora parve, and the dogs were artificially infected with metacercariae isolated from Cambaroides similis. The liver flukes (Clonorchis sinensis) were collected from the bile ducts of the rats which were autopsied 5 weeks later since infection. The lung flukes (Paragonimus westermani) were collected from the lung of the dogs which were autopsied 3 months later since infection. With the collected worms, ultrastructure of sensory papillae was studied by means of a scanning and transmission electron microscope. The liver flukes were compared with the lung flukes. The results of the observation are as follows. 1. The sensory papillae of the liver flukes was classified into 3 types and most of sensory papillae were distributed on the oral sucker. 2. The sensory papillae of the lung flukes were distinguished 8 types. The sensory papilla type VIII was specifically distributed on the oral sucker and type I, II were distributed on the tegumental surface of the worm. The sensory papillae of the lung flukes were mostly observed between oral sucker and ventral sucker of the worm excusively 3. The sensory papillae of the liver flukes were distributed around the sucker while those of the lung flukes were developed between spine. 4. The sensory papillae were formed by many tegumental ridge in the liver flukes while was made of many small sensory papillae in the lung flukes. 5. The sensory cilia were observed between tegumental ridges in the sensory papilla of the liver flukes and also in lung flukes. And they are alike in that respect. 6. The sensory papillae were not developed in the posterior part of the liver and lung flukes but mostly nerve endings were formed in the tegumental syncytium, and it was connected with neuropile.

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