• 대한의생명과학회지
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• 제10권1호
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• pp.35-42
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• 2004

Liver and serum $\beta$-D-mannosidase activities were determined in ethanol intoxicated rats with extrahepatic cholestasis induced by common bile duct ligation (CBD) to manifest the biochemical background of alcohol drinking hazard under the hepatobiliary disease. Liver $\beta$-D-mannosidase activity and its Vmax value in CBD ligated rats with chronic ethanol intoxication were found to be significantly decreased than that in CBD ligation alone. However, the difference of Km value on above hepatic enzyme was not found between the experimental groups. On the other hand, serum $\beta$-D-mannosidase activity in CBD ligated rats with chronic ethanol intoxication was increased more than that in CBD ligation alone. These results indicate that the biosynthesis of the hepatic $\beta$-D-mannosidase decreases and the serum $\beta$-D-mannosidase activity increases in cholestasis combined with chronic ehtanol intoxication, reflecting damage of aggravated hapatocytic membrane. Accordingly, the resulting data supported the fact that alcoholic drinks were enzymologically harmful to the hepatobiliary disease.

• 약학회지
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• 제41권5호
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• pp.622-628
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• 1997

Hepatic cirrhosis is a common response to chronic liver injury from many causes and is one of the most common cause of all deaths. This study was carried out to compare experimental hepatic cirrhosis in rats to understand this disease and to apply for the pharmacokinetics in disease state. Following three kinds of experimental models were induced; 1) Bile duct ligation/scission (BDL/S), 2) N, N-dimethylnitrosamine(DMN), 3) Carbon tetrachloride. The hepatic cirrhosis was characterized by examing the liver/body weight ratio, serum biochemical values, hydroxyproline content in liver and histopathological lesions in cirrhotic rat liver. The results are as follows : (1) In BDL/S, the liver was enlarged to 250% of normal liver. In contrast the liver was shrinked to 48% and 78% of the normal liver in DMN and carbon tetrachloride, respectively. (2) In carbon tetrachloride and BDL/S, the serum ALT, AST, ALP and total bilirubin levels were significantly increased to 200~300% of normal level, while ALT and total bilirubin levels were significantly increased in DMN group. (3) Hydroxyproline content in cirrhotic rat liver was significantly 200~500% higher than that of normal liver. (4) Nodular formation with fibrosis was observed in BDL/S, DMN, carbon tetrachloride induced cirrhotic rat liver.

• Clinical Endoscopy
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• 제56권1호
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• pp.92-99
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• 2023

Background/Aims: There are few studies assessed the efficacy and mortality of endoscopic retrograde cholangiopancreatography (ERCP) for the removal of common bile duct (CBD) stones in the elderly aged ≥90 years. We aimed to assess the safety and efficacy of endoscopic removal of CBD stones in nonagenarians. Methods: We retrospectively reviewed ERCP reports for CBD stone removal. The endoscopic and therapeutic outcomes were collected. The length of stay (LOS), the total number of adverse events, and mortality rate were compared between groups. Results: A total of 125 nonagenarians were compared with 1,370 controls (65-89 years old individuals). The mean LOS for nonagenarians was significantly higher than in controls (13.6 days vs. 6.5 days). Completed intended treatment was similar in the nonagenarians and controls (89.8% and 89.5%, respectively). The overall complication rate did not differ between the groups. However, nonagenarians had a higher incidence of post-ERCP pneumonia (3.9%). None of the nonagenarians were readmitted to the hospital within 7 days. Four nonagenarians (3.2%) and 25 (1.8%) controls died within 30 days. Conclusions: Advanced age alone did not affect the decision to perform the procedure. However, prompt diagnosis and treatment of post-ERCP pneumonia in nonagenarians could improve the outcomes and reduce mortality.

• Journal of Magnetics
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• 제17권2호
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• pp.138-144
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• 2012

3-dimensional magnetic resonance cholangiopancreatography (MRCP) images reconstructed using the maximum intensity projection technique were analyzed qualitatively in patients diagnosed with pancreatobiliary diseases to determine their diagnostic utility. Single shot fast spin echo (SSFSE), fast spin echo (FSE) and 3-dimensional reconstructive images were acquired from 20 patients diagnosed histologically with pancreatobiliary diseases using a 3.0T MR scanner. According to qualitative analysis, the fast spin echo images and 3-dimensional reconstructed images of the hepatic duct, gall bladder and common bile duct had a higher signal to noise ratio (SNR) than the single shot fast spin echo images. Fast spin echo images and 3-dimensional reconstructed images did not show any differences. The contrast to noise ratio of the hepatic duct, gallbladder and common bile duct on the fast spin echo images and 3-dimensional reconstructed images was higher than that of the single shot fast spin echo images. The fast spin echo images and 3-dimensional reconstructed images showed similar quality.

• 한국간담췌외과학회지
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• 제27권3호
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• pp.322-327
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• 2023

Situs inversus totalis (SIT) is a rare condition in which cardiac and abdominal organs are inverted from their normal left-sided orientation. Mirizzi syndrome, characterized by the obstruction of the common hepatic duct or the common bile duct by gallstone, is a rare condition. Mirizzi syndrome co-occurrence in SIT patients is rare. Gallbladder in sinistroposition is extremely uncommon in SIT patients. We report a known case of diabetes, ventricular septal defect with transposition of the great arteries in a 32-year-old female who presented with jaundice, cholangitis, chills, and fever that had lasted for 10 days. She was confirmed to have SIT with type III Mirizzi syndrome following a series of diagnostic procedures. Primarily, endoscopic retrograde cholangiopancreatography along with common bile duct stenting was performed to initially reduce cholangitis. After an eight-week follow-up after the reduction of cholangitis, surgery was conducted. Mirror-imaged ports were used for the laparoscopic procedure, and the surgeon was on the patient's right side rather than the usual left side. The patient was discharged from the hospital following two days of uneventful healing.

• 대한영상의학회지
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• 제85권3호
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• pp.581-595
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• 2024

목적 본 연구는 담낭절제술 후 보상적 총담관 확장의 빈도와 정도를 조사하고, 담낭절제술과 common bile duct (이하 CBD) 확장 사이의 시간을 평가하고, 폐쇄성 CBD 확장을 암시하는 잠재적으로 유용한 CT 소견을 식별하는 것을 목표로 한다. 대상과 방법 2009년에서 2011년 사이에 단일 센터에서 담낭절제술 전후에 여러 차례 CT 스캔을 받은 담도 폐쇄가 없는 121명의 환자를 대상으로 한 후향적 연구를 진행하였다. 또한 담낭절제술 후 CBD 결석 또는 팽대부 종양으로 인해 초기에 연구에서 제외되었던 11명의 환자의 임상 및 CT 소견을 조사하여 폐쇄성 및 비폐쇄성 CBD 확장의 특징을 확인하였다. 결과 121명의 환자의 평균(표준편차) 단축 최대 CBD 직경은 담낭절제술 전 축면에서 5.6(± 1.9) mm였지만 담낭절제술 후 7.9 (± 2.6) mm로 증가했다(p < 0.001). 담낭절제술 전 축성 CBD 직경이 8 mm 미만인 106명의 환자 중 39명(36.8%)이 담낭절제술 후 ≥ 8 mm의 CBD 확장을 보였다. 장기(> 2년) 연속 추적 CT 스캔을 받은 17명의 환자 중 6명(35.3%)은 결국 모두 담낭 절제술 후 2년 이내에 축성 CBD 직경이 유의미하게(> 1.5배) 증가한 것으로 나타났다. 폐색 또는 관련 증상이 없는 121명의 환자 중 단 1명(0.1%)만이 담낭 절제술 후 intrahepatic duct (이하 IHD) 확장 > 3 mm를 보였던 반면, CBD 폐쇄가 있는 11명의 환자 모두 복통과 비정상 검사실 지수가 있었고 81.8% (9/11)가 IHD 및 CBD의 상당한 확장을 보였다. 결론 보상적 비폐쇄성 CBD 확장은 일반적으로 폐쇄성 확장과 비슷한 정도로 담낭절제술 후에 발생한다. 그러나 담낭절제술 후 담관 폐색과 관련 증상이 있거나, 의미 있는 IHD 확장 또는 2-3년 후 추가적인 CBD 확장이 발생하는 경우 CBD 폐쇄를 의심해야 한다.

• 대한약리학회지
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• 제18권1호
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• pp.43-54
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• 1982

Bile formation is a complex process comprised of three separate physiologic mechanism operating at two anatomical sites. At present time, it was known that at least two processes are responsible for total canalicular secretion at the bile canaliculus. One of the processes is bile salt-dependent secretion (BSDS) hypothesis that the active transport of bile salts from plasma to bile provided a primary stimulus for bile formation: the osmotic effect of actively transported bile acid was responsible for the movement of water and ions into bile. The other process is bile salt-independent secretion (ESIS), which is unrelated to bile salt secretion at the canaliculus and which may involve the active transport of sodium. The third process for bile formation involves the biliary ductal epithelium. Secretin-stimulated bile characteristically contained bicarbonate in high concentration. Therefor, it was suggested that secretin stimulated water and bicarbonate secretion from the biliary ductules. One the other hand, it was found that a large amounts of cAMP was present in canine bile but no apparent relationship between bile salt secretion and cAMP content in dog bile. However, bile flow studies in human have demonstrated that secretin and glucagon increase bile cAMP secretion as does secretin in baboons. Secretin increases baboon bile duct mucosal cAMP levels in addition to bile CAMP levels suggesting that in that species secretin-stimulated bile flow may be cAMP mediated. It has been postulated that glucagon and theophylline which increase the bile salt-independent secretion in dogs might act through an increased in liver cAMP content. In a few studies, the possible role of cAMP on bile formation has teen tested by administration of an exogenous derivative of cAMP, dibutyryl cAMP. In the rat, DB cAMP did not modify bile flow, but injection of DB cAMP in the dog promoted an increase in the bile salt-independent secretion. Because of these contradictory results, this study was carried out to examine the relationship between cyclic nucleotides and bile flow due to various bile salts as well as secretin or theophylline. Experiments were performed in rabbits with anesthesia produced by the injection of seconal(30 mg/kg). Rabbits had the cystic duct ligated and the proximal end of the divided common duct cannulated with an appropriately sized polyethylene catheter. A similar catheter was placed into the inferior vena cava for administration of drugs. Bile was collected for determination of cyclic nucleotides and total cholate in 15 min. intervals for a few hours. The results are summerized as followings. 1) Administrations of taurocholic acid or chenodeoxycholic acid increased significantly the concentrations of cAMP and cGMP in bile of rabbits. 2) Concentration of cAMP in bile during the continuous infusion of ursodeoxycholic acid, was remarkedly increased in accordance with the increase of bile flow, while on the contrary concentration of cGMP in bile was decreased significantly. 3) Dehydrocholic acid and deoxycholic acid significantly increased bile flow, total cholate output and cyclic nucleotides in bile. 4) Only cAMP concentration in bile was significantly increased from control value by secretin, while theophylline increased cAMP as well as cGMP in rabbit bile. 5) In addition, the administration of secretin to taurocholic acid-stimulated bile flow increased cAMP while theophylline produced the increases of cAMP and cGMP in bile. 6) The administration of insulin to taurocholic acid-stimulated bile flow decreased cAMP concentration, while on the contrary cGMP was remarkedly increased in rabbit bile.

• Biomolecules & Therapeutics
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• 제31권6호
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• pp.674-681
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• 2023

Bile pigment, bilirubin, and biliverdin concentrations may change as a results of biliary tract cancer (BTC) altering the mechanisms of radical oxidation and heme breakdown. We explored whether changes in bile pigment components could help distinguish BTC from benign biliary illness by evaluating alterations in patients with BTC. We collected bile fluid from 15 patients with a common bile duct stone (CBD group) and 63 individuals with BTC (BTC group). We examined the bile fluid's bilirubin, biliverdin reductase (BVR), heme oxygenase (HO-1), and bacterial taxonomic abundance. Serum bilirubin levels had no impact on the amounts of bile HO-1, BVR, or bilirubin. In comparison to the control group, the BTC group had considerably higher amounts of HO-1, BVR, and bilirubin in the bile. The areas under the curve for the receiver operating characteristic curve analyses of the BVR and HO-1 were 0.832 (p<0.001) and 0.891 (p<0.001), respectively. Firmicutes was the most prevalent phylum in both CBD and BTC, according to a taxonomic abundance analysis, however the Firmicutes/Bacteroidetes ratio was substantially greater in the BTC group than in the CBD group. The findings of this study showed that, regardless of the existence of obstructive jaundice, biliary carcinogenesis impacts heme degradation and bile pigmentation, and that the bile pigment components HO-1, BVR, and bilirubin in bile fluid have a diagnostic significance in BTC. In tissue biopsies for the diagnosis of BTC, particularly for distinguishing BTC from benign biliary strictures, bile pigment components can be used as additional biomarkers.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권3호
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• pp.170-177
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• 2014

Purpose: Choledochal cyst is a cystic dilatation of common bile duct. Although the etiology is presently uncertain, anomalous pancreaticobiliary ductal union (APBDU) is thought to be a major etiology of choledochal cyst. In this study, we analyzed the clinical and anatomical characteristics and pathologies of patients diagnosed with choledochal cyst in a single institute for 25 years. Methods: A total of 113 patients, diagnosed with choledochal cyst and who received an operation in Severance Children's Hospital from January 1988 to May 2013, were included. Medical records were reviewed, including clinical and demographic data, surgical procedures. Abdominal ultrasonography, magnetic resonance cholangiopancreatography, and intraoperative cholangiography were used as diagnostic tools for evaluation and classification of choledochal cyst and the presence of anomalous pancreaticobiliary ductal union. Todani's classification, and relationship between APBDU and surgical pathology. Results: Among 113 patients, 77 patients (68.1%) presented symptoms such as hepatitis, pancreatitis and/or cholecystitis. Eighty three patients (73.5%) had APBDU, and 94 patients (83.2%) showed inflammatory pathologic changes. APBDU, pathologic inflammation, and serological abnormalities such as hepatitis or pancreatitis showed a statistically significant correlation to one another. Conclusion: APBDU is thought to be one of the etiologic factors of choledochal cyst. It is related to the inflammatory changes in bile duct that can lead to the cystic dilatation.

• 대한수의학회지
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• 제23권1호
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• pp.25-35
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• 1983

In order to assess the diagnostic aid of serum gammaglutamyl transpeptidase values in hepatitis, obstructive jaundice and pancreatitis, four groups of 14 health dogs were subjected to the gastric intubatin of $CCl_4$(1.5ml/kg of body weight), the ligation of common bile duct, the ligation of pancreatic ducts and the injection of chloroform(0.2ml/kg of body weight) in the parenchyma of the pancreas. Some serum enzymes serum glutamic pyruvic transaminase(SGPT), serum glutamic oxalacetic transaminase(SGOT), total bilirubin, amylase and lipase known to be indicative of hepatic and pancreatic diseases were monitored. In comparision of these enzymes, gamma-glutamyl transpeptidase(GGTP) valuers were determined in these dogs before and after the experimental procedures. The results were summarized as follows: 1. In $CCl_4$ intoxication gorup, there were no significant changes in serum GGTP activities(mean: 6.0~14.6 IU/L). 2. In bile duct ligation group, serum GGTP activities shelved marked increases, beginning at postsurgical day 1 and rose the highest mean value(342.7 IU/L) on day 12. Then the activities never approached to the base-line values. 3. After the ligation of pancreatic ducts and the injection of chloroform in the pancreas, serum GGTP activities did not rise throughout the experiment. 4. SGPT:GGTP ratio did not increase in bile duct ligation group, but increase markedly in $ccl_4$ intoxication group. 5. The results indicated that serum GGTP values or SGPT:GGTP ratio could provide valuable indicators for differential diagnosis between hepatobiliary obstruction and hepatocellular disease.