• Clinical Endoscopy
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• v.56 no.2
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• pp.155-163
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• 2023

Malignant hilar biliary obstruction (MHO), an aggressive perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment for biliary malignancies. However, the majority of patients with MHO cannot undergo surgery on presentation because of an advanced inoperable state or a poor performance state due to old age or comorbid diseases. Therefore, palliative biliary drainage is mandatory to improve symptomatic jaundice and the quality of life. Among the drainage methods, endoscopic biliary drainage is the current standard for palliation of unresectable advanced MHO. In addition, combined with endoscopic drainage, additional local ablation therapies, such as photodynamic therapy or radiofrequency ablation (RFA), have been introduced to prolong stent patency and survival. Currently, RFA is commonly used as palliative therapy, even for advanced MHO. This literature review summarizes recent studies on RFA for advanced MHO.

• Clinical Endoscopy
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• v.56 no.2
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• pp.135-142
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• 2023

Endoscopic biliary drainage strategies for managing unresectable malignant hilar biliary obstruction differ in terms of stent type, drainage area, and deployment method. However, the optimal endoscopic drainage strategy remains unclear. Uncovered self-expandable metal stents (SEMS) are the preferred type because of their higher functional success rate, longer time to recurrent biliary obstruction (RBO), and fewer cases of reintervention than plastic stents (PS). Other PS subtypes and covered SEMS, which feature a longer time to RBO than PS, can be removed during reintervention for RBO. Bilateral SEMS placement is associated with a longer time to RBO and a longer survival time than unilateral SEMS placement. Unilateral drainage is acceptable if a drainage volume of greater than 50% of the total liver volume can be achieved. In terms of deployment method, no differences were observed in clinical outcomes between side-by-side (SBS) and stent-in-stent deployment. Simultaneous SBS boasts a shorter procedure time and higher technical success rate than sequential SBS. This review of previous studies aimed to clarify the optimal endoscopic biliary drainage strategy for unresectable malignant hilar biliary obstruction.

• Korean Journal of Agricultural Science
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• v.13 no.2
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• pp.311-317
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• 1986

On 11-year-old female mixed-breed dog with chief complaints of existence of abdominal enlargement and anorexia was referred to the veterynary teaching hospital of Chungnam National University. The dog was diagnosed into cholangiocarcinoma by the result of the histopathological observation. The results observed are summarized as follows: The clinical signs were abdominal enlargement, anorexia, dyspnea and depression. There were marked increase in serum glutamic pyruvic transaminase(GPT), serum glutamic oxaloacetic transaminase(GOT), lactic dehydrogenase(LDH) and blood urea nitrogen(BUN). Serum total protein and albumin were slightly below normal. In gross finding, the liver was enlarged and friable with numerous white, cauliflower-like nodules over the surface and composed on cysts from 3 to 4 cm in diameter. The cystic lesions contained a yellow gelatinous material. Anatomically, this neoplasm was classified as intrahepatic bile duct carcinoma. Histologically, this neoplasm was combined tubular carcinoma with bile duct cystadenocarcinoma. The former were characterized by tubular structures lined by anaplastic cuboidal or columnar cells with diffuse fibrous stroma, and the latter by multiple cystic structures lined by simple and stratified cuboidal or columnar cells.

• Korean Journal of Veterinary Research
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• v.39 no.3
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• pp.593-601
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• 1999

This study was designed to evaluate the effect of cyclophosphamide(CY) on diethylnitrosamine(DEN)-induced hepatic tumors in rats. Thirty five male or female Sprague Dawley rats were continiously given water containing 0.01% DEN for 10 weeks and then were given with CY 25mg/rat/day in water for 3, 5, 7 or 9 days. The livers of rats were removed and fixed in 10% buffered neutral formalin. he appearances of positive cells by immunohistochemical methods using proliferating cell nuclear antigen (PCNA) antibody, p53 antibody and apoptotic kit were investigated. The livers of rats given with CY were grossly brilliant, red-brown color, flexible, and thin border, and stainability of the liver cells were restored microscopically, and the vaccuolated and degenerated regions were differentiated from restored regions. These restored findings also were advanced in control group because of no DEN treatment but tended to be less avanced. In immunohistochemistry, positive cells to PCNA antibody appeared more numerous in control groups than that of CY treated groups. Appearance of positive cells in CY-treated group for 7 days and for 9 days were more numerous than those of CY-treated groups for 3 days and for 5 days, respectively. So these findings suggested that CY suppressed cell proliferations and effects of these action were decreased with CY-treated days. The numbers of positive cells to PCNA antibody were more prominent in hepatocellular carcinoma regions and cholangiocarcinoma regions, and then were ranked as order of large liver cell regions and normal liver cell regions. Also the numbers of the positive cells by apoptotic kit tended to be higher in hepatocellular carcinoma regions and cholangiocarcinoma regions but not uniformly in order in all regions and were much less numbers than those of PCNA positive cells. So immunohistochemical methods using PCNA antibody together than using apoptotic kit alone when anti-carcinogen experiments. Rats with positive cells by p53 antibody were 11 of 15 rats(73.4%) in control groups and 12 of 18 rats(66.7%) in CY treated group, respectively. These positive cells appeared focally in early vacuole-occurring regions and were very low in numbers.

• Biomolecules & Therapeutics
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• v.25 no.5
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• pp.482-489
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• 2017

Individual differences in drug responses are associated with genetic and epigenetic variability of pharmacogene expression. We aimed to identify the relevant miRNAs which regulate pharmacogenes associated with drug responses. The miRNA and mRNA expression profiles derived from data for normal and solid tumor tissues in The Cancer Genome Atlas (TCGA) Research Network. Predicted miRNAs targeted to pharmacogenes were identified using publicly available databases. A total of 95 pharmacogenes were selected from cholangiocarcinoma and colon adenocarcinoma, as well as kidney renal clear cell, liver hepatocellular, and lung squamous cell carcinomas. Through the integration analyses of miRNA and mRNA, 35 miRNAs were found to negatively correlate with mRNA expression levels of 16 pharmacogenes in normal bile duct, liver, colon, and lung tissues (p<0.05). Additionally, 36 miRNAs were related to differential expression of 32 pharmacogene mRNAs in those normal and tumorigenic tissues (p<0.05). These results indicate that changes in expression levels of miRNAs targeted to pharmacogenes in normal and tumor tissues may play a role in determining individual variations in drug response.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1589-1593
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• 2016

Opisthorchis viverrini (OV) liver flukes are common parasites found in central and southern Laos and constitute a major public health problem in the country. Laos people continue to have the habit of extensively consuming raw or half-cooked fish which are intermediate hosts. This study aimed to determine the prevalence and factors associated with OV infection in the population of Thakek district, Khammouane Province. This cross-sectional analytic study covered 237 subjects who filled out structured questionnaires. Fecal examination for OV infection was performed by Kato's thick smear method. Data analysis was carried out using STATA Version 10.0. Multiple logistic regression was applied. The results showed that the infection rate of OV was 54.8%. Factors associated with OV infections were gender, a habit of defecation in fields and raw fish (goi bplaa dip) consumption. Opisthorchiasis and associated cholangiocarcinoma development thus appear to remain as important concerns in Laos.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.7039-7043
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• 2013

A liver fluke, Opisthorchis viverrrini (OV), is the major cause of the high incidence of cholangiocarcinoma in North-eastern Thailand. The prevalence of OV infection remains high in various parts of the country, especially in wetland rural areas where a large proportion of the community work in agriculture and continue the traditional practice of eating raw or uncooked cyprinoid fish products. The national control program seems to have had little impact in many of these areas, and it has been difficult to make precise assessments of the overall effectiveness of the program. Therefore there is a need for a community-based approach to prevent infection with the parasite, ideally involving as many players as possible. Here we document an attempt to assess the best means to prevention on the basis of a community intervention in three villages in north-east Thailand, with participation of representatives of Health Promotion Hospitals of the Ministry of Public Health with dedicated staff, but also school teachers, independent government sponsored village health volunteers, and housewives responsible for cooking and diet selection. An action plan was followed, allowing detailed discussions of practical proposals, their introduction and then repeated reflection and further proposals at the individual village level.

• The Journal of Internal Korean Medicine
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• v.19 no.1
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• pp.73-81
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• 1998

This study was performed on the basis of clinical consideration about patient who has hepatoma, cholangiocarcinoma and pancreatic cancer. Cancer has gradually increased morbidity and mortality all over the world including Korea. Western medicine has treated with surgical therapy, chemotherapy, radiotherapy and immunotherapy, but has not obtained outstanding results and has a difficulty due to side effects by those therapies. In this study, we recognized that symptom including pain by cancer are rapidly decreased with oriental medicine treatment. Oriental medicine treatment is applied throughly on the basis of the oriental medicine principle and the prescrptions were used Bulwhankumjunggisan(不換金正氣散), Sojukbaekchulsan(消積白朮散) Banhabackchulchunmatang(半夏白朮天麻湯). The communitial effect of those prescriptions are invigorating the spreen and benefiting vital energy(健脾益氣), supporting healthy energy to eliminate evils(扶正祛邪) and those treatments are corresponed with traditional oriental treatment principle. Also we can know this patient has a little improvement in the general test including biochemistry, blood test, urine analysis and etc. in spite of outstanding improvement of patient's symptom on administration of oriental medicine. According to the above results, though we has not got satisfaction in getting rid of cancer completely on administration of oriental medicine, it is helpful in decreasing symptoms including pain by cancer and in improving quality of life of patient and in improving quality of patient life.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3489-3493
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• 2012

Hepatocellular carcinoma (HCC), the most common primary hepatic tumor, is highly prevalent in the Asia-Pacific region, including Thailand. Many genetic and epigenetic alterations in HCC have been elucidated. The aim of this study was to determine whether aberrant methylation of the suppressor of cytokine signaling 1 gene (SOCS1) occurs in HCCs. Methylation specific-PCR assays were performed to identify the methylation status of SOCS1 in 29 tumors and their corresponding normal liver tissues. An abnormal methylation status was detected in 17 (59%), with a higher prevalence of aberrant SOCS1 methylation significantly correlating with HCC treated without chemotherapy (OR=0.04, 95%CI=0.01-0.31; P=0.001). This study suggests that epigenetic aberrant SOCS1 methylation may be a predictive marker for HCC patients.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3399-3402
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• 2012

A liver fluke, Opisthorchis viverrrini (OV), is the major cause of the high incidence of cholangiocarcinoma in Thailand. The prevalence of OV infection remains high in various parts of the country, especially in Northeast Thailand and particularly in wetland rural areas where a large proportion of the community work in agriculture and continue the traditional practice of eating raw or uncooked cyprinoid fish products. The national control program seems to have had little impact in many of these areas, and it has been difficult to make precise assessments of the overall effectiveness of the program. This paper is the first report of prospective research project designed to monitor the impact of the national control program in rural communities located in a northeastern province and at high risk of OV infection. The participants in this initial survey were 1,569 villagers, aged 20-65 years, living in two subdistricts of Yasothon Province. Stool examinations showed that 38.68% were infected with OV. Males were slightly more likely to be infected than females, but the difference was not statistically significant. Infection was found to be positively associated with age in both males and females. The preliminary data indicate that the population selected for study is suitable for the purpose of the monitoring project.