• Title/Summary/Keyword: Bile duct

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Clinicopathological Significance of Osteopontin in Cholangiocarcinoma Cases

  • Laohaviroj, Marut;Chamgramol, Yaovalux;Pairojkul, Chawalit;Mulvenna, Jason;Sripa, Banchob
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.201-205
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    • 2016
  • Cholangiocarcinoma (CCA) is generally a rare primary liver tumor of the bile duct with extremely poor clinical outcomes due to late diagnosis. Osteopontin (OPN) is the most abundant expressed gene in intrahepatic CCA and its involvement in tumor aggressiveness suggests it could be a useful prognostic biomarker. However, the prognostic significance of OPN expression in CCA is still controversial. We therefore immunohistochemically studied OPN expression in 354 resected CCAs and correlated the results with patient clinicopathological parameters. OPN expression was separately scored according to the percentage of cancer cells or degree of stromal tissue staining and classified as low (score 0-1) and high (score 2-3). OPN expression in CCA cells was found in 177 out of 354 patients (56.5%), whereas stroma was positive in 185 out of 354 patients (52.3%). Univariate analysis with several of the aforementioned parameters revealed that stromal but not cancer cell OPN expression was significantly associated with tumor size, tumor direct invasion into normal liver parenchyma, regional lymph node metastasis and higher staging. The combination of cancer cell and stromal OPN expression demonstrated a positive trend for linkage with lymph node metastasis. Multivariate analysis identified gender, the presence of lymphatic permeation and lymph node metastasis, but not OPN expression, as independent prognostic factors. This study confirms the presence of stromal OPN expression in tumor aggressiveness but not survival in CCA patients.

Implementation of Health Behavior Education Concerning Liver Flukes among Village Health Volunteers in an Epidemic Area of Thailand

  • Kaewpitoon, Soraya J;Rujirakul, Ratana;Wakkuwattapong, Parichart;Matrakool, Likit;Tongtawee, Taweesak;Norkaew, Jun;Kujapun, Jirawoot;Kampangsri, Wilas;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1713-1716
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    • 2016
  • Background: Liver fluke infection is associated with cholangiocarcinoma; the bile duct cancer found frequently in the northeast and north of Thailand. Prevention and control particularly requires health education and behavior change. Objective: This study aimed to improve health behavior among village health volunteers (VHV) regarding liver fluke exposure in an epidemic area. Materials and Methods: A quasi-experimental study was performed during July 2015 to January 2016 in Sang Kha district of Surin province, Thailand. A total of 67 VHVs underwent a health education program (HEP) and data were collected on knowledge, attitude, and practice (KAP) before and after participation for HEP 3 months with a pre-designed questionnaire. The Students paired T-test was used for comparisons of mean KAP levels before/after the intervention. Results: The results revealed that knowledge (P-value=0.004), attitude (P-value=0.004), and practice level (P-value=0.000) were significantly improved after participation in the HBP. Attitude was significantly associated with knowledge (r=0.266, p<0.05), and practice (r=0.348, p<0.01). Conclusions: The implementation of health education among VHVs is feasible and increases their KAP. This improvement should have potential in liver fluke prevention and control in local communities in rural Thailand.

A Case of Moyamoya Disease in a Child with Alagille Syndrome (Alagille 증후군 환아에서 발생한 Moyamoya병 1례)

  • Lim, Mi Rang;Lee, So Yaun;Kim, Deok Soo;Kim, Kyung Mo;Ko, Tae Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.86-90
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    • 2003
  • Alagille syndrome is a autosomal dominant disorder characterized by intrahepatic bile duct paucity and resultant chronic cholestasis in combination with cardiac(mainly peripheral pulmonary stenosis), skeletal, ocular, and facial abnormalities. In addition to the pulmonary stenosis, in large series, anecdotal reports of vascular lesions have concerned the renal artery, aorta, hepatic artery, carotid artery, celiac artery or subclavian artery. Theses diffuse vascular abnormalities, which appear to be a feature of Alagille syndrome, suggest Notch signaling pathway defects affect angiogenesis. The associations of Alagille syndrome with moyamoya disease, the chronic cerebrovascular occlusive disease, were reported and suggested as additional evidence of vasculopathy of Alagille syndrome. We report another 25 month-old Alagille syndrome girl who presented with acute left hemiparesis and was diagnosed with moyamoya disease through the cerebral angiographic study.

Changes of Liver Function In Korean Black Goats Dosed wit Carbon Tetrachloride and 1-naphthylisothiocyanate (한국흑염소에 있어서 사염화탄소와 1-naphthylisothiocyanate 투여시의 간기능 변화)

  • Im Jung-Sik;Choi Hee-In
    • Journal of Veterinary Clinics
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    • v.7 no.1
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    • pp.381-390
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    • 1990
  • In order to study the effects of administration of carbon tetrachloride(CCI$_4$) and 1-naphthylisothiocyanate(ANIT) on the liver of Korean black goats, some liver function tests and liver biopsy were done on 4 Korean black goats dosed with CCI$_4$(0.4m1/kg of body weight) in-traruminally and 4 Korean black goats dosed with ANIT(400mg/kg of body weight) by stomach tube. BSP Tl/2 and serum total bilirubin concentration in goats dosed with CCI$_4$ were increased gradually, reached to maximum value on 2nd and 1st day, respectively, and then began to decrease in normal range, gradually. In goats dosed with ANIT, BSP Tl/2 and serum total bilirubin concentration were increased rapidly, reached to maximum value on 0.5 and 1st day, respectively, and then returned to normal ragne, rapidly. Serum SDH, AST and GGT activities in goats dosed with CCI$_4$ were increased rapidly and reached to maximum value on 3rd, 1st and 2nd day, respectively. Thereafter, the serum enzyme activities began to decrease in normal range gradually. In goats dosed with ANIT, however, serum SDH, AST and GGT activities were not changed. The histopathologic changes in goats dosed with CCI$_4$ were lipidosis and centrilobular nee-rosis of the hepatic parenchyma. In goats dosed with ANIT, hyperplasia of bile duct epithelium was noticeable, but pathologic changes in liver parenchyma were not noticed. Conclusively, in Korean black goats dosed with CCI$_4$, main finding was necrosis of hepatic parenchyma. In Korean black goats dosed with ANIT, main finding was cholestasis.

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Human Infections with Liver and Minute Intestinal Flukes in Guangxi, China: Analysis by DNA Sequencing, Ultrasonography, and Immunoaffinity Chromatography

  • Jeon, Hyeong-Kyu;Lee, Dongmin;Park, Hansol;Min, Duk-Young;Rim, Han-Jong;Zhang, Hongman;Yang, Yichao;Li, Xueming;Eom, Keeseon S.
    • Parasites, Hosts and Diseases
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    • v.50 no.4
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    • pp.391-394
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    • 2012
  • The prevalence of liver and intestinal fluke infections was determined by surveying inhabitants of Hengxuan, Fusui, and Shanglin villages which were known to be endemic for liver flukes in Guangxi, China in May 2010. A total of 718 people were examined for helminth eggs by the Kato-Katz thick smear technique, ultrasonography, immunoaffinity chromatography, and DNA sequencing. The overall egg positive rate was found to be 59.6% (28.0-70.6%) that included mixed infections with liver and intestinal flukes. Cases showing higher than 20,000 eggs per gram of feces (EPG) were detected between 1.3% and 16.2%. Ultrasonographic findings exhibited overall 28.2% (72 of 255 cases) dilatation rate of the intrahepatic bile duct. Clonorchis sinensis infection was detected serologically in 88.3% (38 of 43 cases) among C. sinensis egg positive subjects by the immunoaffinity chromatography using a specific antigen for C. sinensis. For differential diagnosis of the liver and intestinal flukes, more precise PCR and nucleotide sequencing for copro-DNA were performed for 46 egg positive cases. Mixed infections with C. sinensis and Metagonimus yokogawai were detected in 8 of 46 egg positive cases, whereas 29 specimens were positive for Haplorchis taichui. Ultrasonographic findings and immunoaffinity chromatography results showed usefulness, even in a limited way, in figuring out of the liver fluke endemicity.

Canine distemper outbreak in a zoo (동물원에서 집단 발생한 개 디스템퍼 감염증)

  • Hur, Kwon;Bae, Ji-Seon;Choi, Jae-Hoon;Shin, Nam-Sik;Lee, Ki-Whan;Kwon, Soo-Wahn;Kim, Dae-Yong
    • Korean Journal of Veterinary Pathology
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    • v.2 no.2
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    • pp.139-145
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    • 1998
  • A total of 5 animals including 3 raccoons, 1 badger, and 1 fennec fox kept in outdoor exhibits at the Everland Zoological Gardens showed depression, anorexia, dyspnea, serous oculonasal discharge, diarrhea, and convulsions. All the affected animals died within 10 days after the onset of clinical signs. This outbreak lasted about 4 months. On necropsy, major gross lesions were confined to the lungs. Red to grey sublobular to lobular consolidations with various sized tan to reddish spots were observed in the lungs. Histopathologically, the pulmonary lesions were characterized by acute to subacute bronchointerstitial pneumonia with secondary bacterial or adenoviral infections. Intracytoplasmic eosinophilic inclusion bodies compatible with canine distemper virus (CDV) were found in the lung, urinary bladder, kidney, intrahepatic bile duct, stomach, small and large intestines. Multifocal areas of severe demyelination and accumulation of gitter cells or nonsuppurative inflammation were seen in the brains of 2 raccoons. CDV -specific antigens were demonstrated in the lung sections on immunofluorescent assay. The present report describes an outbreak of CDV infection in a zoo and indicates the range of susceptible zoo animal species.

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[ $^{99m}Tc-DISIDA$ ] Cholescintigraphy in the Evaluation of Neonatal Jaundice: The Usefulness of Hepatic Uptake in Differential Diagnosis (신생아 황달에서 $^{99m}Tc-DISIDA$ 간담도 스캔: 감별진단에서 간 섭취율의 유용성)

  • Park, Byung-Ran;Ji, Joo-Yun;Kim, Se-Jong
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.492-496
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    • 1995
  • To evaluate the usefulness of hepatic uptake in neonatal jaundice, Tc-99m-DISIDA cholescintigraphy was reviewed for 13 infants with prolonged mired jaundice and no demonstrable excretion into bowel,even after 24hr. Five patients proved to have biliary atresia. The remainder had neonatal hepatitis. There was no distinct differentiation of the hepatic uptake of tracer at 5 and 10 minutes between biliary atresia and neonatal hepatitis. The consideration of hepatic uptake rate of the tracer is not useful in differentiating neonatal hepatitis from biliary atresia.

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Abdominal Inflammatory Myofibroblastic Tumor in Children (소아에서 발생한 복강내 염증성 근섬유모세포종의 임상적 고찰)

  • Kim, Hyun-Young;Moon, Suk-Bae;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.153-163
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    • 2008
  • Inflammatory myofibroblastic tumor (IMT) is a rare reactive lesion characterized by the feature of myofibroblasts and a mixed inflammatory infiltrate that rarely undergoes malignant transformation. Extrapulmonary IMTs in children have been described involving the mesentery, omentum, retroperitoneum, abdominal soft tissues, liver, bladder, mediastinum, head and neck, extremity, appendix, and kidney. Medical records of children treated with abdominal IMT between 1985 and 2005 were reviewed retrospectively. Seven children were treated for IMT with the mean age of 3 y 2 m (range, 1 y 1 m to 14 y). Tumors were located in transverse mesocolon (n=2), omentum (n=1), porta hepatis (n=2), complex site (antrum, duodenum, common bile duct, porta hepatis) (n=2). The symptoms included abdominal mass, fever, jaundice, abdominal pain and anemia. The masses were excised totally in transverse mesocolon, omentum IMT and there is no evidence of recurrence (follow-up periods: 6 y 8 m, 8 y 9 m, 4 y 10 m). In porta hepatis IMT, liver transplantations were performed and there is no evidence of recurrence (follow period: 6 y 8 m, 8 y 7 m). In one case of complex site IMT, partial excision of mass was performed and he still survived with no change of the residual tumor during follow-up period. The other one of complex site IMT denied further treatment after the biopsy. In conclusion, complete surgical excision including liver transplantation and close follow-up are mandatory for the abdominal IMT in child.

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Exocrine Pancreatic Secretion in Response to Electrical Stimulation of Dorsal Raphe Nucleus in Rats (흰쥐에서 배측 봉선핵의 전기자극이 췌장의 외분비기능에 미치는 영향)

  • Suh, Sang-Won;Park, Hyoung-Jin
    • The Korean Journal of Physiology
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    • v.24 no.2
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    • pp.403-411
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    • 1990
  • The present investigation was performed to see a possible influence of the dorsal raphe nucleus (DRN) on pancreatic exocrine secretion in anesthetized rats since the DRN had been known to exert a regulatory mechanism on sympathetic activity which was known to be very important for pancreatic exocrine secretion, particularly in rats. Twenty-nine Sprague-Dawley rats fasted for 24 hours were anesthetized by i.p. injection of 1 g/kg of urethane. The pancreatic duct was cannulated to collect pancreatic juice while bile juice was diverted into the jejunum. The duodenopyloric junction was tightly ligated. After surgery for collection of pancreatic exocrine secretion and recording of carotid blood pressure, a coaxial electrode was stereotaxically inserted in the DRN with a guide of a brain atlas. And then, electrical stimulus of biphasic square wave with 2 v, 2 msec, 40 Hz was applied on the electrode for 10 minutes. Pancreatic volume flow and protein output secreted in 10 min were measured. Either bilateral cervical vagotomy or spinal cord transection at the level of $C4{\sim}C5$ was performed 20 min prior to stimulation of the DRN. 1) Electrical stimulation of the DRN resulted in significant (p<0.05) increase in pancreatic volume flow and protein output. These stimulatory effects were not affected by cervical vagotomy but completely abolished by cervical cord transection. 2) Electrical stimulation of the DRN also resulted in significant (p<0.05) rise of blood pressure of the carotid artery. The hypertensive effect was not affected by cervical vagotomy but completely abolished by cervical cord transection. The results strongly suggest that the DRN, a part of the central serotonergic system, could exert a stimulatory influence on pancreatic exocrine secretion by increasing the sympathetic activity in anesthetized rats.

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Effects of Excretory/Secretory Products from Clonorchis sinensis and the Carcinogen Dimethylnitrosamine on the Proliferation and Cell Cycle Modulation of Human Epithelial HEK293T Cells

  • Kim, Eun-Min;Kim, June-Sung;Choi, Min-Ho;Hong, Sung-Tae;Bae, Young-Mee
    • Parasites, Hosts and Diseases
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    • v.46 no.3
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    • pp.127-132
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    • 2008
  • Clonorchis sinensis is one of the most prevalent parasitic helminths in Korea. Although cholangiocarcinoma can be induced by C. sinensis infection, the underlying mechanism is not clearly understood. To assess the role of C. sinensis infection in carcinogenesis, an in vitro system was established using the human epithelial cell line HEK293T. In cells exposed to the excretory/secretory products (ESP) of C. sinensis and the carcinogen dimethylnitrosamine (DMN), cellular proliferation and the proportion of cells in the G2/M phase increased. Moreover, the expression of the cell cycle proteins E2F1, p-pRb, and cyclin B was dramatically increased when ESP and DMN were added together. Similarly, the transcription factor E2F1 showed its highest level of activity when ESP and DMN were added simultaneously. These findings indicate that DMN and ESP synergistically affect the regulation of cell cycle-related proteins. Our results suggest that exposure to C. sinensis and a small amount of a carcinogen such as DMN can promote carcinogenesis in the bile duct epithelium via uncontrolled cellular proliferation and the upregulation of cell cycle-related proteins.