• Title/Summary/Keyword: Common duct

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Use of Omega-3 Polyunsaturated Fatty Acids to Treat Inspissated Bile Syndrome: A Case Report

  • Jun, Woo Young;Cho, Min Jeng;Han, Hye Seung;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.4
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    • pp.286-290
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    • 2016
  • Inspissated bile syndrome (IBS) is a rare condition in which thick intraluminal bile, including bile plugs, sludge, or stones, blocks the extrahepatic bile ducts in an infant. A 5-week-old female infant was admitted for evaluation of jaundice and acholic stool. Diagnostic tests, including ultrasound sonography, magnetic resonance cholangiopancreatography, and a hepatobiliary scan, were not conclusive. Although the diagnosis was unclear, the clinical and laboratory findings improved gradually on administration of urodeoxycholic acid and lipid emulsion containing omega-3 polyunsaturated fatty acids (PUFAs) for 3 weeks. However, a liver biopsy was suggestive of biliary atresia. This finding forced us to perform intraoperative cholangiography, which revealed a patent common bile duct with impacted thick bile. We performed normal saline irrigation and the symptom was improved, the final diagnosis was IBS. Thus, we herein report that IBS can be treated with omega-3 PUFAs as an alternative to surgical intervention.

Experimental and Analytical Study on the Bus Duct System for the Prediction of Temperature Variations Due To the Fluctuation of Load

  • Thirumurugaveerakumar, S.;Sakthivel, M.;Valarmathi, S.
    • Journal of Electrical Engineering and Technology
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    • v.9 no.6
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    • pp.2036-2041
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    • 2014
  • In this paper, a thermal model is developed for the bus bar system to predict the temperature variation during the transient time period and to calculate both the steady-state and transient electrical current carrying capacity (ampacity) of bus bar. The bus bar system installed in the power house of Kumaraguru College of Technology, Coimbatore has been considered. Temperature variation predicted in the modelling is validated by observing the current and steady state temperatures in different feeders of the bus bar. Magnetic field of the extreme phases R and B induces more current in the middle phase Y. Hence, the steady state temperature in the phase Y is greater than other two phases. The transient capabilities of the bus bar are illustrated by calculating the variations in the bus bar temperature when it is subjected to a step change in current during the peak hours due to increase in hostel utilities and facilities (5.30 pm to 10.30 pm). The physical and geometrical properties of the bus bar and temperature variation in the bus bar are used to estimate the thermal time constants for common bus bar cross-sections. An analytical expression for the time constant of the bus bar is derived.

The Effect of Botulinum Toxin on an Iatrogenic Sialo-Cutaneous Fistula

  • Hong, Seung Eun;Kwon, Jung Woo;Kang, So Ra;Park, Bo Young
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.237-239
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    • 2016
  • A sialo-cutaneous fistula is a communication between the skin and a salivary gland or duct discharging saliva. Trauma and iatrogenic complications are the most common causes of this condition. Treatments include aspiration, compression, and the administration of systemic anticholinergics; however, their effects are transient and unsatisfactory in most cases. We had a case of a patient who developed an iatrogenic sialo-cutaneous fistula after wide excision of squamous cell carcinoma in the parotid region that was not treated with conventional management, but instead completely resolved with the injection of botulinum toxin. Based on our experience, we recommend the injection of botulinum toxin into the salivary glands, especially the parotid gland, as a conservative treatment option for sialo-cutaneous fistula.

Scan Manifestation and Trace-Dose Radiogold Clearance Rates in Obstructive Jaundice (폐쇄성(閉鎖性) 황달의 진단에 관한 핵의학적(核醫學的) 고찰)

  • Kim, Dong-Jip;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.3 no.2
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    • pp.49-54
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    • 1969
  • The present study has been undertaken to analyze scan manifestations in obstructive jaundice. Scan changes were cprrelated with the duration of jaundice. In addition, clearance rates of trace dose of colloidal radiogold were assessed in each case. The materials were consisted of 19 cases with surgically and/or histopathlogically verified obstructive jaundice from various causes including common duct stone, empyema of the gall bladder and carcinoma of the pancreas head etc. Blood clearance rates of colloidal $^{198}Au$ were determined after the injection of 8 uCi by simple geometrical drawing of recorded strip charts. Scan was performed following additional injection of the same radiogold. In 16 out of 19 cases, the scan revealed rather typical "arborifrom" mottlings around the porta hepatis. The intensity and appearance of such mottlings on the scan was related with the duration of jaundice and level of serum bilirubin and alkaline phosphatase. The blood clearance rates remained to be within normal range in 74 percent of the patients. In the remaining 26 percent, clearance rates ranged between 4.1 and 6 minutes. It is concluded that the association of "arboriform" mottlings and normal or mildly delayed clearance rates in the patients with jaundice is characteristic of obstructive changes in the biliary system.

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A Case of Recurrent Liver Abscess Due to Choledochoduodenal Fistula (재발하는 간농양에서 총담관-십이지장 누공의 내시경적 치료 1예)

  • Hur, Jun Ho;Choi, Sun Taek;Sohn, Min Su;Lee, Ji Eun;Chung, In Hee;Ki, Sung Ho
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.39-42
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    • 2013
  • Cholelithiasis, duodenal ulcer, duodenal perforation and tumor invasion may lead to choledochoduodenal fistula (CDF). CDF often has no specific symptoms and may be incidentally detected in an upper gastrointestinal radiographic study or endoscopy; but in some cases, it may be accompanied by recurrent cholangitis and liver abscess. In this paper, a case of recurrent liver abscess caused by CDF is reported. A 62-year-old female was admitted to the authors' hospital because of right upper quadrant pain and fever. The abdominal computed tomography showed a liver abscess in the right lobe. A duodenal fistulous orifice was detected with endoscopy, and a contrast was injected through the duodenal orifice using a catheter under fluoroscopy. The injection of the contrast revealed a fistulous track between the duodenal bulb and the common hepatic duct. In fistulas complicated by recurrent liver abscess, surgery or medical management may be needed. The CDF in this case study was treated via endoscopic clipping.

Mitomycin-C in Endoscopic Dacryocystorhinostomy (비내누낭비강문합술에서 Mitomycin-C의 효과)

  • 김명원;이종환;김은석;이상철;장백암;변영자
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.188-192
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    • 1998
  • Background and Objectives: The most common cause of the failure of endoscopic dacryocystorhinostomy is closure of the osteotomy site due to granulation or adhesion. We used mitomycin-C, an antineoplastic antibiotic agent, soaking over the osteotomy site to suppress fibrous proliferation and scar formation during the endoscopic dacryocystorhinostomy. Materials and Methods : A total of 20 Patients diagnosed with nasolacrimal duct obstruction were assigned randomly to either a mitomycin-C group or a control group. Endoscopic dacryocystochinostnmy has been used in both groups. In the mitomycin-C group, a piece of merocel soaked with 0.2 mg/ml mitomycin-C was applied to the osteotomy site and then after 30 minutes was removed. Results : All patients in the mitomycin-C group remained symptom free after removal of their silicone tube (100% success), and there were two patients in the control group who had recurrent epiphora (67% success). In the mitomycin-C group, the average surface area of the osteotomy at the end of the sixth postoperative month was 4.1 $\textrm{mm}^2$, whereas that of the control group was 2.5 $\textrm{mm}^2$. Neither serious systemic nor local toxicity were noted in the mitomycin-C group. Conclusion : Intraoperative mitomycin-C may possibly improve success rates over the endoscopic dacryocystorhinostomy procedure.

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A case series on nonpuerperal mastitis and breast abscess (비수유기 유선염 및 유방농양 환자 증례 보고)

  • Lee, Jong-Deok;Ryu, Sung-Won;Choi, Chang-Min
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.2
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    • pp.295-304
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    • 2006
  • Inflammatory conditions of the breast are uncommon and may be encountered in the puerperal and nonpuerperal setting. Nonpuerperal mastitis is less common and usually presents with inflammation and chronic abscess formation in the periareolar and peripheral region. These abscess have a high rate of recurrence and are often associated with an underlying disease state, such as diabetes, steroid treatment, trauma or other kinds of a deficient immune system. The diagnosis is suggested by the history of sudden onset and the presense of swelling, tenderness, heat, erythema, and in the case of abscess, fluctuation. Ultrasound can also be useful. Treatment consists of antibiotic administration or incision and drainage of the abscess and, in cases of retroareolar abscess, resection of entire underlying duct system. Recently, we have gotten good result from treating two cases of nonpuerperal mastitis and breast abscess which had treatment of antibiotics and drainage three times but recurred. After taking gamijipaesan(加味芷貝散) and acupuncture treatment, they have recovered and haven't recurred in 8 months. So it proves that herb medication and acupuncture are effective on nonpuerperal chronic mastitis and breast abscess.

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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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Robustness Improvement and Assessment of EARSM k-ω Model for Complex Turbulent Flows

  • Zhang, Qiang;Li, Dian;Xia, ZhenFeng;Yang, Yong
    • International Journal of Aerospace System Engineering
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    • v.2 no.2
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    • pp.67-72
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    • 2015
  • The main concern of this study is to integrate the EARSM into an industrial RANS solver in conjunction with the $k-{\omega}$ model, as proposed by Hellsten (EARSMKO2005). In order to improve the robustness, particular limiters are introduced to turbulent conservative variables, and a suitable full-approximation storage (FAS) multi-grid (MG) strategy is designed to incorporate turbulence model equations. The present limiters and MG strategy improve both robustness and efficiency significantly but without degenerating accuracy. Two discretization approachs for velocity gradient on cell interfaces are implemented and compared with each other. Numerical results of a three-dimensional supersonic square duct flow show that the proper discretization of velocity gradient improves the accuracy essentially. To assess the capability of the resulting EARSM $k-{\omega}$ model to predict complex engineering flow, the case of Common Research Model (CRM, Wing-Body) is performed. All the numerical results demonstrate that the resulting model performs well and is comparable to the standard two-equation models such as SST $k-{\omega}$ model in terms of computational effort, thus it is suitable for industrial applications.

Pharmacological treatment options for acne (여드름의 약물치료요법)

  • Park, Kui Young
    • Journal of the Korean Medical Association
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    • v.61 no.11
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    • pp.680-686
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    • 2018
  • Acne vulgaris is a very common condition affecting up of about 80% to 90% of adolescents. The patients with acne have been shown to be adversely impacted by the effect of acne on their quality of life. Four factors are believed to play a key role in the development of acne lesions: excess sebum production, disturbed keratinization within the follicle, colonization of the pilosebaceous duct by Propionibacterium acnes, and the release of inflammatory mediators into the skin. Consequently, the target for acne therapy is these well-known pathogenic factors responsible for this disease state. Topical retinoids correct abnormal keratinization, but it should be applied cautiously because of irritation. Benzoyl peroxide is an effective bactericidal agent against P. acnes. Main topical antibiotics are erythromycin and clindamycin. Fixed combination topical products with retinoids, benzoyl peroxide and antibiotics have been introduced. Use of systemic antibiotics, including tetracyclines and macrolides rapidly improves inflammatory acne lesions. Oral isotretinoin is effective against all of the main pathogenic features of acne but is contraindicated in pregnant women and has been associated with cheilitis and dry skin. Hormonal therapy has been found to improve acne in some selective patients and should be considered for appropriate candidates. This review will present the general aspects of the pharmacological treatments for acne.