• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제18권3호
• /
• pp.180-186
• /
• 2015

Purpose: Bile duct dilatation is a relatively common sonographic finding; nevertheless, its clinical significance in children is controversial because little research has been done in the area. Therefore, we investigated the natural course and clinical significance of biliary duct dilatation in children. Methods: We performed a retrospective study of 181 children (range, 1-day-old to 17-year-old) in whom dilatation of the intrahepatic duct and/or common hepatic duct and/or common bile duct was detected by abdominal ultrasonography at the Severance Children's Hospital between November 2005 and March 2014. We reviewed and analyzed laboratory test results, clinical manifestations, and clinical course in these patients. Results: Pediatric patients (n=181) were enrolled in the study and divided into two groups. The first group included 59 subjects, without definitive cause of bile duct dilatation, who did not require treatment; the second group included 122 subjects, with definitive cause of bile duct dilatation or underlying biliary disease, who did require treatment. In the first group, 24 patients (40.7%) showed spontaneous resolution of bile duct dilatation, 20 patients (33.9%) showed no change, and 15 patients (25.4%) were lost to follow-up. In the second group, 31 patients were diagnosed with choledochal cysts, and 91 patients presented with biliary tract dilatations due to secondary causes, such as gallbladder or liver disease, post-operative complications, or malignancy. Conclusion: Biliary dilatation in pediatric patients without symptoms, and without laboratory and other sonographic abnormalities, showed a benign clinical course. No pathologic conditions were noted on follow-up ultrasonography.

• Korean Journal of Acupuncture
• /
• 제30권4호
• /
• pp.201-211
• /
• 2013

Objectives : The aim of this study is to summarize and compare acupuncture points used for dental disorder in the classics with those used in recent clinical trials. Methods : We searched the data for acupuncture points used and rationale of acupuncture in dentistry. Following two sources were searched: 1) seven Classics of traditional medicine and 2) clinical trials through Pubmed from January 2000 to March 2013 with no language restriction. Results : Dental pain was the most common disorder in the dentistry section of the Classics of traditional medicine. We found many similarities of acupuncture points used between literatures and clinical trials. From the meridian perspective, large intestine meridian(LI), stomach meridian(ST), triple energizer meridian(TE), and gallbladder meridian(GB) were frequently used in the Classics of traditional medicine and the clinical trials. From the acupuncture point perspective, acupuncture points were selected according to syndrome. The specific points such as five transport points, source points, and connecting points were also used. In the clinical trials, combination of acupuncture points usually consisted adjacent points and distant points. Among them, LI4 was used in all of the studies included in this review. Conclusions : For well-designed clinical trial, appropriate intervention is essential. To establish appropriate acupuncture treatment, we have to suggest reasoning for treatment based on literature and/or expert consensus. Our review only focused on pain relief in dentistry and had many limitations. Further studies based on the literatures such as the Classics of traditional medicine are required to ensure the rationale of acupuncture treatments in various dental disorders.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권3호
• /
• pp.1485-1488
• /
• 2016

Background: Chile is one of the countries with the highest prevalence of cholelithiasis worldwide, considering the Mapuche ethnicity as a risk factor for developing this pathology. Moreover, cholelithiasis is the main risk factor for developing gallbladder cancer, being the fifth cause of cancer death in Chile. The purpose of this study was to compare the frequency of cholelithiasis and biliary pathology among the population belonging to Rapanui ethnicity and non-Rapanui population living on Easter Island. Materials and Methods: In this retrospective case-control study, a total of 609 abdominal ultrasonographs performed consecutively in Hanga Roa Hospital during the period August 2012 to January 2015 were analyzed. Multiple logistic regression was used to obtain odds ratio (OR) and 95% confidence intervals (95% CI) of cholelithiasis and biliary pathology, adjusting for age, gender and referral diagnostic hypothesis. Results: In the Rapanui population the frequency for cholelithiasis and biliary pathology was 6.4% and 13%, meanwhile for the non-Rapanui population it was 13% and 22% respectively. Compared to the non-Rapanui Chilean population, the Rapanui ethnicity presented an OR of 0.53 (95% CI: 0.29-0.95) for cholelithiasis and OR of 0.52 (95% CI: 0.33-0.82) for biliary pathology. Conclusions: We found statistically significant ethnic differences in the frequency of cholelithiasis and biliary disease among the population of Rapanui and non-Rapanui ethnicity, so that this could be a protective factor for the development of biliary pathology, given the Chilean population context. Other studies including community population to determine the real prevalence of cholelithiasis and analyze the protective role of Rapanui ethnicity on this disease are necessary.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권11호
• /
• pp.6257-6260
• /
• 2013

Gallstone disease is a major surgical problem in many populations; it is probably related to diet, especially excessive consumption of meat. The objective of this study was to determine the chemical composition of gallstones and their association with neoplastic changes including cholangiocarcinomas in cholecystectomised patients. The chemical composition of gallstones from 40 patients (8 males and 32 females) was analyzed. This is a prospective study performed in Baquba teaching hospital in the period from 1/10/2012 to 1/1/2013 in which we collected the gallstones for the patients who underwent cholecystectomy, whether open or laparoscopic. The stones were classified according to their chemical composition as a mixed stones (MS), and examined using a stone analysis set (chemical qualitative method) for calcium, magnesium, phosphate, uric acid and oxalate which was used reagent for qualitative determination of main individual components of stones. The results of this study showed the highest incidence of gallstones in the age group 40-49 was 13 cases followed by 11, 8 and 4 cases for age groups 30-39, 50-59, 20-29 and 60 and above, respectively. The chemical analysis showed the majority of gallstones were mixed, 38 containing calcium followed by 37 cases with uric acid, 28 with magnesium, and 25 and 22 stones with oxalate and phosphate, respectively. Microscopically, we confirmed neoplastic changes (17.5%) as cholangiocarcinomas (CCCs) (7.55%) and dysplastic cells of carcinoma in situ in 4 (10%), 31 (77.5%) cases were chronic cholecystitis and 2 (5%) cases were acute cholecystitis with empyema out of bile duct disorders patients. In conclusion, majority of cases had mixed gallstones that involved five and four of inorganic chemicals of calcium, magnesium and phosphate, the highest incidence of gallstones in age group 40-49 years old was 13 cases, and neoplastic changes were confirmed (17.5%) including CCCs, (7.5%) and dysplastic cells of carcinoma in situ (10%), while 31 (77.5%) cases were chronic cholecystitis.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권14호
• /
• pp.5647-5654
• /
• 2015

Gall bladder cancer (GBC) is a gastro-intestinal cancer with high prevalence among north Indian women. Platelet derived growth factor-B (PDGFB) and human epidermal growth factor receptor-2 (HER2) may play roles in the etiology of GBC through the inflammation-hyperplasia-dysplasia-carcinoma pathway. To study the association of PDGFB and HER2 polymorphisms with risk of GBC, 200 cases and 300 controls were considered. PDGFB +286A>G and +1135A>C polymorphisms were investigated with an amplification refractory mutation system and the HER2 $Ile^{655}Val$ polymorphism by restriction fragment length polymorphism. Significant risk associations for PDGFB +286 GG (OR=5.25) and PDGFB +1135 CC (OR=3.19) genotypes were observed for GBC. Gender wise stratification revealed susceptibility for recessive models of PDGFB +1135A>C (OR=3.00) and HER2 $Ile^{655}Val$ (OR=2.52) polymorphisms among female GBC cases. GBC cases with gall stones were predisposed to homozygous +286 GG and +1135 CC genotypes. Significant risk associations were found for ACIle (OR=1.48), GAVal (OR=1.70), GAIle (OR=2.00) haplotypes with GBC cases and GCIle haplotype with female GBC cases (OR=10.37, P=<0.0001). Pair-wise linkage disequilibrium revealed negative associations among variant alleles. On multi-dimensional reduction analysis, a three factor model revealed significant gene-gene interaction for PDGFB +286A>G, PDGFB +1135A>C and HER2 Ile165Val SNPs with GBC. Protein-protein interaction showed significant association of PDGFB and HER2 with the epidermal growth factor receptor signaling pathway.

• 대한한의학원전학회지
• /
• 제22권3호
• /
• pp.107-131
• /
• 2009

After having comparison, the Bunchon-ga in nine books -"Chimguchwiyeong(鍼灸聚英)", "Nengmunjeonsudong-injihyeol(凌門傳授銅人指穴)", "Chimgumundae(針灸問對)", "Gyeongrakgo(經絡考)", "Gyeongrakhoepyeon(經絡匯編)", "Geumchimbijeon(金針秘傳)", "Jagusimbeop-yogyeol(刺灸心法要訣)", "Chimgubongwon(鍼灸逢源)" "Chimgusinseo(鍼灸神書)", and invested the difference based on "Chimguhak(鍼灸學)", "WHO standard acupuncture point location" I got some conclusion like below. Two kinds of Bunchon-ga are similar in "Chimguchwiyeong", "Nengmunjeonsudong-injihyeol", and also in "Gyeongrakgo(經絡考)", "Gyeongrakhoepyeon(經絡匯編)", and "Geumchimbijeon(金針秘傳)" Bunchon-ga of twelve meridian is different from their order - Stomach meridian(胃經), Bladder meridian(膀胱經), Kidney meridian(腎經), Triple Energizer meridian(三焦經), and Gallbladder meridian(膽經). In nine kinds of Bunchon-ga, missing acupuncture points(漏落穴) are generally located on the first line of Bladder meridian(膀胱經) - from Daejeo(大杼) to Baekhwansu(白環兪), and Pungsi(風市), Haegye(解谿), Yangsi(羊矢), Geummaek(急脈) are not appeared in them, Hyeopdang(脇堂), Michung(眉衝), Yanghyeol(陽穴) are recorded. There are some parts adapted different way of proportional bone chon - from Yanggok(陽谿) to Gokji(曲池) in Large Intestine meridian[大腸經], from Sanggu(商丘) to Umreungcheon(陰陵泉) in Spleen meridian[脾經], and from Oegwan(外關) to Sadok(四瀆) in Triple Energizer meridian[三焦經]. The acupuncture points explained by structure, there are many different finger chons between some books. Bunchon on breast and abdomen, is generally explained by vertical, horizontal finger chon based on Governor vessel[任脈], vertical explanations of each book have little difference opinions, but horizontal have many. Especially, the locations of Eunmum(殷門), Bukeuk(浮郄) and Wiyang(委陽) are extremely different from "Chimguhak(鍼灸學)", and "WHO standard acupuncture point locations".

• 대한한의학원전학회지
• /
• 제33권2호
• /
• pp.77-90
• /
• 2020

Objectives : To determine the meaning of 'yi(噫)' from verses containing the character in 『Huangdineijing』. Methods : First, examples of the usage of 'yi(噫)' in Huangdineijing were collected and analyzed, followed by examples from the other books of the time when 『Huangdineijing』 was written. Finally the term 'ai' which surfaced in a later period than Huangdineijing to refer to eructation was examined. Results & Conclusions : Based on analysis of the usage of 'yi(噫)' in the 『Huangdineijing』, out of a total of 20 cases, 14 cases could be categorized as referring to eructation, 4 cases were difficult to categorize as eructation, and 2 cases were indeterminable. At the time of publication of 『Huangdineijing』, the character 'yi(噫)' was generally used to refer to eructation when used in a medical context, while in non-medical contexts it referred to sigh, or groan. The appearance of 'ai(噯)' is predicted to be during the Song period, but its appearance did not take away the meaning of eructation from 'yi(噫)' and both were used. Based on the change of meaning of 'yi(噫)', we can determine the approximate time when certain contents of the 『Huangdineijing』 were constructed. In the case of '心爲噫[Heart makes 'yi(噫)']', we can understand it as the pectoral qi leaking through the throat manifesting as a sigh in order to relieve stagnation of the excessiveness of the Heart. In cases of deficiency, when the Stomach function is weak, the body is likely to let out a sigh. The term meaning sighing which is 'taixi(大息)' was understood as symptomatic of problems of the Gallbladder as well as the Heart.

• Radiation Oncology Journal
• /
• 제31권3호
• /
• pp.125-130
• /
• 2013

Purpose: We investigated the role of radiotherapy (RT) for pancreatobiliary neuroendocrine tumors (PB-NETs). Materials and Methods: We identified 9 patients with PB-NETs who received RT between January 2005 and March 2012. Of these 9 patients, 4 were diagnosed with NETs in the pancreas and 5 were diagnosed with NETs in the gallbladder. All patients received RT to the primary tumor or resection bed with a median total irradiation dose of 50.4 Gy, with or without chemotherapy. Results: The tumor response rate and tumor control rate in the RT field were 60% and 100 %, respectively. All 4 patients who underwent surgery had no evidence of disease in the RT field. Of the 5 patients who received RT to the primary gross tumor, 1 had complete response, 2 had partial response, and 2 had stable disease in the RT field. The median time to progression was 11 months. Of the 9 patients, four patients had no progression, and 5 patients had progression of disease (locoregional, 2; distant, 2; locoregional/distant, 1). Of the 4 patients without progression, 3 were treated with RT in adjuvant or neoadjuvant setting, and one received RT to primary tumor. One patient experienced radiation-induced duodenitis at 3 months after concurrent chemoradiation without treatment-related mortality. Conclusion: RT can yield local control for advanced PB-NETs. RT should be considered an essential part of multimodality treatment in management of advanced PB-NETs.

• 한국임상수의학회지
• /
• 제23권2호
• /
• pp.197-201
• /
• 2006

A 2-year-old female mongrel dog was referred to the Veterinary Medical Center of Chungbuk National University due to anorexia, depression and weight loss after the administration of exogenous estrogen for contraception in the local hospital. Although the dog was medicated with antibiotics and fluid for two weeks in the local hospital, there was a deterioration in the patient's general condition. Therefore the dog was referred to our Veterinary Medical Center. Hematological and biochemical analysis showed non-regenerative anemia, thrombocytopenia, severely immature leukocytosis, hyperbilirubinemia, hyperglycemia and elevated serum alkaline phosphatase, gamma-glutamyltransferase, and lactate dehydrogenase. Abdominal ultrasonography showed double line of gallbladder and irregular hypertrophic wall of uterus. On the basis of these examination's results and history taking, final diagnosis was exogenous estrogen-induced myelotoxicosis with cholecystitis and endometritis. The symptomatic therapy for estrogen toxicosis was performed for 26 days after the final diagnosis. However, the symptom had no response to therapy except endometritis and anemia. On day 135 after administration of estrogen, platelet and neutrophil count were normalized, but monocytic leukocytosis was occurred.

• 동의생리병리학회지
• /
• 제22권5호
• /
• pp.1071-1077
• /
• 2008

Hwa-byung is a form of psychogenic illness among people in Korea and is listed as a culture-bound syndrome of Korea in the DSM-IV. Despite increased clinical researches for Hwa-byung in the oriental medicine of Korea, there has been no agreement of pattern identification for Hwa-byung. The purpose of this study is to develop a standard instrument of pattern identification for Hwa-byung which will be applied to clinical research. The items and structure of the instrument were based on review of published literature. The advisor committee on this study was organized by 15 neuropsychiatry professors of 11 oriental medical colleges nationwide. The experts attended 2 consultation meetings and discussed developing the instrument. and we also took professional advices by e-mail. The results were as follows; First, we divided the symptoms and signs of Hwa-byung into five pattern identification - stagnation of liver Qi, flare-up of the liver fire, disharmony between heart and kidney, deficiency of both Qi and blood, malfunction of gallbladder due to phlegm stagnation. Second, we got the mean weights to each symptom of five pattern identification which had been scored on a 5-point scale - ranging from 0 to 4 by the 15 experts. Third, we made out the Korean instrument of the pattern identification for Hwa-byung. It was composed of 34 questions and decided on question-and-answer form. Though there are some limits in this study, the instrument of pattern identification for Hwa-byung is meaningful and expected to be applied to the subsequent research. And also, we hope to improve the instrument and make up for this study through various research and discussion.