• Title/Summary/Keyword: Bile duct dilatation

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A Choledochal Cyst Associated with Hemorrhagic Tendency and a Cerebral Hematoma -Report of a case and review of literature- (두강내 출혈 및 출혈성 경향을 동반한 선천성 담관 낭종 -1예 보고와 문헌보고-)

  • Park, Young-Bok;Lee, Myung-Wo;Kim, Hong-Jin;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.299-306
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    • 1985
  • Congenital dilatation of the common bile duct is relatively rare anomaly. Its pathogenesis has not been completely understood. Complications of the choledochal cyst are mainly suppurative cholangitis, liver cirrhosis, stone formation, malignant change, bile peritonitis due to spontaneous and traumatic rupture. We experienced one case of choledochal cyst associated with hemorrhagic tendency and a cerebral hematoma, which is extremely rare complication. The 3 monthes old male patient reported here was treated with complete excision of cyst and Roux-en-Y choledochojejunostomy after correction of bleeding tendency and removal of crebral hematoma. Postoperative course was relatively uneventful, 11 days after operation, the patient was discharged with full improvement.

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Abnormality of Reproduction and Organ Structure of the Pale Chub, Zacco platypus from Isa Stream (이사천에서 채집된 피라미, Zacco platypus의 생식과 기관계 구조 이상)

  • Jin Young-Guk;Shin Soon-Ho;Lee Jae-Bong;Lee Jae-Woo;An Cheul-Min;Lee Jung-Sick
    • Environmental Analysis Health and Toxicology
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    • v.21 no.1 s.52
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    • pp.35-43
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    • 2006
  • Reproduction and organ structure of the pale chub, Zacco platypus in Isa stream were investigated by means of histological methods. The results of the study confirmed reproductive abnormality and histopathological features in the pale chub. The gonadosomatic index (GSI) of the fish showed two peak in April and August. In summer season, GSI of the male was about two times of the female's GSI. Monthly variation of the gonadal development was very irregular. From the histological analysis of the organ structure, epidermal atrophy, necrosis and hyperplasia of pigment cell were observed in the skin. Epithelial layer lifting and clubbing of the lamella and bifurcation of the filament were observed in the gill. Also histological changes as congestion, cytoplasmic degeneration of hepatic cell, degeneration of bile duct, glomerular dilatation, degeneration of renal tubule and pycnosis of interstitial cell were identified in the liver and kidney, respectively.

AIDS-related Zoonotic Pathogen, Enterocytozoon bieneusi

  • Lee John Hwa
    • Proceedings of the Microbiological Society of Korea Conference
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    • 2001.11a
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    • pp.77-81
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    • 2001
  • Microsporidia in humans emerged with the AIDS epidemic. Enterocytozoon bieneusi is the most significant species' and causes chronic diarrhea, wasting, papillary stenosis, acaculous cholecystitis, bile duct dilatation and sclerosing cholangitis and is responsible for $30-50\%$ of all cases of in people with AIDS. Microsporidiosis has been reported in immunosuppressed, and in immunologically normal individuals. Variety of study has revealed the mode of transmission and possible reservoir of E. bieneusi. Its sites of infection suggest that transmission occurs by ingestion. Transmission has been speculated to occur via infected animals to human, person to person. There is evidence that E. bieneusi occurs in pigs, monkeys, and possibly other animals such as cattle, dogs, cats, llamas and rabbits. E. bieneusi from infected humans has been transmitted experimentally to macaques and to pigs. These observations reflect indirectly the zoonotic nature of E. bieneusi and indicate that cross species transmission is a real possibility. Meanwhile, In recent report, thirty-two percent of the pigs were found to be positive with rates higher over the summer months in US.

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Operative Management of the Prenatally Diagnosed Choledochal Cyst (산전 초음파에서 진단된 담도낭종의 수술적 치료)

  • Choi, Yun-Mee;Choi, Jae-Hyuck;Seo, Jeong-Meen;Lee, Suk-Koo
    • Advances in pediatric surgery
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    • v.10 no.1
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    • pp.17-21
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    • 2004
  • Improvement in prenatal ultrasonography is leading to diagnose choledochal cyst before birth and before onset of classical symptom more frequently. But, there is a controversy about optimal timing for Cyst excision of prenatally diagnosed asymptomatic choledochal cyst. To identify the most appropriate timing for surgery in prenatally diagnosed choledochal Cysts, we analyzed 6 patients who had operation for choledochal cysts within 30days after birth at the division of Pediatric Surgery, Samsung Medical Center and Inha University School of Medicine, from June 1995 to June 2002. Males were four and females 2, the mean age at operation was 11.2 days, and the median age 8.0 days. The range of gestational ages of the antenatal diagnosis of bile duct dilatation was 24 weeks to 32 weeks, mean was 38.3 weeks, and mean birth weight was 3,298.3 g. After birth, abdominal ultrasonography, hepatobiliary scintigraphy, and magnetic resonance cholangiopancratography (MRCP) were performed. Mean age at operation was 11.2 days. All patients had the cyst excision and Rouxen-Y hepaticojejunostomy. Immediate postoperative complication was not found. During the median follow-up period of 41 months, one patient was admitted due to cholangitis, and the other due to variceal bleeding. Early operative treatment of asymptomatic newborn is safe and effective to prevent developing complications later in life.

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Clinical and Histopathologic Findings on the Abnormal Liver Function Complicated with Kawasaki Disease (가와사끼 병에 합병된 간기능 이상소견에 대한 임상적 및 병리조직학적 소견)

  • Lee, Sung-Chul;Tchah, Hann;Na, Song-Yi;Kim, Hee-Sup;Park, Ho-Jin;Shin, Mi-Kyeong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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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.

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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.

Correlation of sonographic findings with histopathological changes of the bile ducts in rabbits infected with Clonorchis sinensis (간흡충에 감염된 토끼 담관의 초음파 소견과 조직병리학적 병변의 비교)

  • 홍성태;박기흠
    • Parasites, Hosts and Diseases
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    • v.32 no.4
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    • pp.223-230
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    • 1994
  • Clonorchiasis is an important parasitic disease of humans in Korea. The present study intended to compare sonographic findings with histopathological changes in experimental clonorchiasis. Eighteen New Zealand white rabbits were infected with metacercariae of Cknorchis sinensis, and examined 4, 10, and 22 weeks post-infection (PI). Four infected rabbits were treated with praziquantel 10 weeks PI and were examined 12 weeks after treatment. Sonography revealed mild to severe dilatation of the intrahepatic ducts (IHDD) and slightly increased periductal echoes in 12 out of 14 rabbits at 4 weeks PI, and all of the animals after 10 and 22 weeks PI and 12 weeks after treatment. The histopathological lesions were duct dilatation, mucosal hyperplasia, and periductal fibrosis, which progressed from 4 weeks to 22 weeks PI and even in treated rabbits. The dilated intrahepatic ducts over 1 mm diameter were detected by sonography. The present results indicate that sonographic findings are well correlated with histopathological lesions in rabbit clonorchiasis except for early phase of light burden of infection. The sonography has a limitation in discriminating residual sequelae of the ducts after praziquantel treatment.

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A Ultrasonic Diagnosis of Family Incidence Bilateral Adult Type Polycystic Kidney: Three Cases (가족발생(家族發生) 양측성(兩側性) 성인형(成人型) 다낭종신(多囊腫腎) 3례(例)의 초음파진단(超音波診斷) - 보험가입자(保險加入者)를 대상(對象)으로 -)

  • Moon, Soo-Hyung;Han, Hye-Jin;Kim, Kang-Seuck
    • The Journal of the Korean life insurance medical association
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    • v.2 no.1
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    • pp.218-232
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    • 1985
  • Congenital hereditary disease is in devided into Infantile type and Adult type, Adult type is hidden for many years and keeps normal renal function till middle age. Cyst is stimultaneously made in both sides and becomes lowered in renal function in 30's to 40's. Infantile type is generally born with the big kidneys, renal failure, undergrowth of intrahepatic bile duct. Both infantile and childhood type have ureteral dilatation and portal hypertension In infantile type, it is mostly developed into renal failure, but generally faces death as a result of hepatic disease. The reason of death is that an abnormal condition of recessive autosome affects the liver and kidneys. While the incidence of infantile type is rare as $0.017{\sim}0.07%$ and it is autosomal recessive heredity, Adult type can rarely exist in infantile period. Though it exists in middle period, 50% of patients can live for 2-4 years after the first symptom incidence and 25% can less than 2 years. It is hard to cure completely in medicine and surgery. Three difficulties in familial incidence are comparative decrease of the donor who have no affection on renal transplantation. For another consideration it is to show the family history for several generations. We, the Med. Dept. of Dae Han Kyouk Life Insurance Co. Ltd., used the ultrasonic apparatus in diagnosing the one case of adult type bilateral polycystic kidney and then doubted the family history. As a result of inspecting the family we experienced bilateral polycystic kidney from 3 persons out of 4 who can be inspected. The results are as follows: 1) We could confirm the polycystic kidney from 3 persons out of 4(75%). 2) Then when they came for check up, chief complaint was the pain in all 3 cases(100%). 3) Accompanying disease was hypertension in 2 cases(67%). 4) In early disease incidence, we couldn't observe the specific change in pathological opinion. 5) All 3 cases are not accompanied with cystic lesion in liver, spleen, pancreas.

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Final Report of China-Korea Collaborative Project of Control Strategies of Clonorchiasis in Heilongjiang Pilot Areas(2001-2004) (중국 흑룡강성 간흡충증 관리사업(2001-2004))

  • Ji, Zhuo;Li, Zhimin;Wang, Shuyu;Yuan, Ren;Ge, Tao;Yuan, Shang;Cui, Changyuan;Ge, Hongan;Feng, Zheng;Xu, Longqi;Hong, Sung-Tae;Choi, Min-Ho;Cho, Seung-Yull;Choi, Dong-Il;Hong, Kwang-Seon;Rim, Han-Jong;Lee, Soon-Hyung
    • Journal of Korea Association of Health Promotion
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    • v.3 no.1
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    • pp.72-83
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    • 2005
  • The present pilot project was executed to recommend a strategy of clonorchiasis control in China. The pilot area of this project was Zhaoyuan, Hailin, and Ningan, Heiloagjiang province. A baseline survey subjecting 4,865 residents in Heilongjiang confirmed Zhaoyuan asa high endemic area and Hailin and Ningan as moderate endemic areas. Six different control strategies were implemented in Zhaoyuan, two were in Hailin, and one was in Ningan. Including the baseline survey and project programs from 2000 to 2004, total 63,274subject-times were examined of their feces for Clonorchiseggs, 26,680 were treated, 10,082 were screened by ELISA, and 6,130 subjects were examined of their liver by sonography. The egg Positive rates in 6 villages of Zhaoyuan were as high as 44.8% 70,0%. Following the protocolof each strategy, the subjected residents were examined of their feces and treated with 25 mg/kg praziquantel, 3 times. Except the control group, all of the villages showed 72.8% to 92.0% reduction of their original egg Positive rates at Zhaoyuan. Mass treatments of all subjected residents in 2001 and 2003 reduced the egg rate from 68.8% to18.7% and 4 annual mass treatments reduced the rate from 44.8% in 2001 to 8.7% in 2004.Selective annual treatments of egg positive subjects reduced the egg rates from 50.8% in2001 to 13.8% in 2004 or from 70.0% in 2001 to 11.6% in 2004, and two treatments in a year reduced the rate from 57.6% in 2001 to 4.6% in 2004. According to repeated treatments, EPG counts decreased remarkably. In moderate endemic areas, the original egg rates were 22.6% and 28.3% in 2001 but were 1.7% and 1.1% after 2 or 3 selective treatments. The present findings of the chemotherapeutic control of clonorchiasis prove that repeated medication is important. The reduction is directly correlated with dose of praziquantel but not with mass or selective treatments. Chemotherapeutic control of reservoirhosts has little effect on reinfection of clonorchiasis because the field along the Songhua-jiang is too wide to be impacted. ELISA confirmed many serologically positive cases to Clonorchisantigen but only a few cases were positive to other antigens (Paragonimus, cysticercus, sparganum). The abdominal soaography visualized intrahepatic bile duct dilatation and periductal echo in 2,002 of 6,070 examined subjects. In addition to these examinations and treatment, health education supplemented tㅗe control activities. The present findings prove clonorchiasis is very widely prevalent and heavily endemic along the rivers in Heiloagjiang. The results suggest that group chemotherapy with praziquantel is effective to reduce endemicity of clonorchiasis. Mass treatment without individual fecal examination is recommended in heavy endemic areas where the egg rate is over 40% while one selective treatment is effective enough in moderate endemic areas.

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