• Title/Summary/Keyword: Gallbladder

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Clinical factors causing hyperbilirubinemia in patients with Kawasaki disease (가와사끼병에서 고빌리루빈혈증의 관련인자에 대한 임상적 고찰)

  • Moon, Kyung Hee;Kim, Ok Ran;Yu, Seung Taek;Hong, Myung Eun;Lee, Chang Woo;Choi, Du Young;Oh, Yeon Kyun;Kim, Jong Duk;Yoon, Hyang Suk
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.52-55
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    • 2007
  • Purpose : Hyperbilirubinemia, jaundice and gallbladder hydrops are unusual manifestations of Kawasaki disease (KD). In this case, abdominal pain, anorexia and abdominal distension may follow eventfully. We reviewed the clinical and laboratory data to investigate the causative factors of hyperbilirubinemia in patients with KD. Methods : Two-hundred eighty two children diagnosed and hospitalized with KD were identified by searching patients' charts. Cases were included in the study if diagnosed between January 1997 and December 2004. We reviewed clinical data, age, sex, duration from the onset of fever to admission and duration from start of treatment to defervescence. Clinical and laboratory data were compared between normal (A) and hyperbilirubinemia (B) groups. Results : Thirteen patients (4.6 percent) showed hyperbilirubinemia. In the hyperbilirubinemia group, age and initial ALT value were higher than group A (P=0.003, 0.018 respectively). Duration from the onset of fever to admission and age were relative risk factors in hyperbilirubinemia (P=0.007, 0.003 respectively) in patients with KD. Conclusion : Shorter duration from the onset of fever to admission and older age group were relative risk factors of hyperbilirubinemia in patients with KD.

A Study on Hemifacial spasm (안면경련의 침구치료에 대한 문헌적 고찰)

  • Cho, Hyun-Seok;Jang, Jun-Hyouk;Kim, Kyoun-Ho;Yoon, Jong-Hwa;Kim, Kap-Sung
    • The Journal of Dong Guk Oriental Medicine
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    • v.7 no.2
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    • pp.69-79
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    • 1999
  • Hemifacial spasm including blepharospasm is characterized by spontaneous clonic an d tonic muscle spasm on one side of the face with synkinesis. Though the etiology of hemifacial spasm is not entirely understood, generally there are two. One is nuclear hypothesis and the other is peripheral hypothesis. There are two ways of treatment of hemifacial spasm. One is internal medicine and the other is operative method. In oriental medicine, hemifacial spasm is very similar to diseases such as Anpojindo (眼胞振跳), Poryunjindo(胞輪振跳), or Aunido(眼眉跳) in symptoms. The diseases such as Anpojindo(眼胞振跳), Poryunjindo(胞輪振跳), Anmido(眼眉跳) is related to the function of liver(肝) and risk factors are regarded as Pung(風). The acupuncture therapy of hemifacial spasm is based on Liver meridian(LV), Gallbladder meridian(GB). And ear-acupuncture is recommended as a good method for hemifacial spasm.

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The Carcinogenic Liver Fluke Opisthorchis viverrini is a Reservoir for Species of Helicobacter

  • Deenonpoe, Raksawan;Chomvarin, Chariya;Pairojkul, Chawalit;Chamgramol, Yaowalux;Loukas, Alex;Brindley, Paul J;Sripa, Banchob
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1751-1758
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    • 2015
  • There has been a strong, positive correlation between opisthorchiasis-associated cholangiocarcinoma and infection with Helicobacter. Here a rodent model of human infection with Opisthorchis viverrini was utilized to further investigate relationships of apparent co-infections with O. viverrini and H. pylori. A total of 150 hamsters were assigned to five groups: i) Control hamsters not infected with O. viverrini; ii) O. viverrini-infected hamsters; iii) non-O. viverrini infected hamsters treated with antibiotics (ABx); iv) O. viverrini-infected hamsters treated with ABx; and v) O. viverrini-infected hamsters treated both with ABx and praziquantel (PZQ). Stomach, gallbladder, liver, colonic tissue, colorectal feces and O. viverrini worms were collected and the presence of species of Helicobacter determined by PCR-based approaches. In addition, O. viverrini worms were cultured in vitro with and without ABx for four weeks, after which the presence of Helicobacter spp. was determined. In situ localization of H. pylori and Helicobacter-like species was performed using a combination of histochemistry and immunohistochemistry. The prevalence of H. pylori infection in O. viverrini-infected hamsters was significantly higher than that of O. viverrini-uninfected hamsters ($p{\leq}0.001$). Interestingly, O. viverrini-infected hamsters treated with ABx and PZQ (to remove the flukes) had a significantly lower frequency of H. pylori than either O. viverr-iniinfected hamsters treated only with ABx or O. viverrini-infected hamsters, respectively ($p{\leq}0.001$). Quantitative RT-PCR strongly confirmed the correlation between intensity H. pylori infection and the presence of liver fluke infection. In vitro, H. pylori could be detected in the O. viverrini worms cultured with ABx over four weeks. In situ localization revealed H. pylori and other Helicobacter-like bacteria in worm gut. The findings indicate that the liver fluke O. viverrini in the biliary tree of the hamsters harbors H. pylori and Helicobacter-like bacteria. Accordingly, the association between O. viverrini and H. pylori may be an obligatory mutualism.

The Study on Acupuncture Operation Method of ${\ll}$Sang Han Lun(傷寒論)${\gg}$ Liu-Jing-Bian-Zheng(六經辯證) ((${\ll}$상한론(傷寒論)${\gg}$ 소양병(少陽病) 제강(提綱)의 침구학적(鍼灸學的) 분경(分經) 및 정증(定證)의 운용(運用) 방법(方法)에 관(關)한 연구(硏究))

  • Jo, Jeong-Sig;Lee, Jun-Beom;Hwang, Min-Seob;Yoon, Jong-Hwa
    • Journal of Acupuncture Research
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    • v.24 no.3
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    • pp.119-126
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    • 2007
  • Objectives: The following study was undertaken in order to seek the acupuncture operation method of ${\ll}$Sang Han Lun(傷寒論)${\gg}$ Liu-Jing-Bian-Zheng(六經辯證). Methods: Based on the documents quoted in ${\ll}$Sang Han Za Bing Lun ${\cdot}$ Xu Wen(傷寒雜病論 ${\cdot}$ 序文)${\gg}$ of "Zhang, Zhong-Jing(張仲景)", the relativity of the theory of Jing-Mai(經脈) and Liu-Jing-Bian-Zheng of convalescence, and from the Liu-Jing-Bing(六經病), the origin and implication that caused So-Yang-Bing(少陽病) to form was studied on the basis of acupuncture medicine publications and the commentary writing of ${\ll}$Sang Han Lun${\gg}$. Results: 1. ${\ll}$Sang Han Lun${\gg}$ Liu-Jing-Bian-Zheng has succeeded and was developed based on Liu-Jing-Fen-Zheng(六經分證) of ${\ll}$ Su Wen ${\cdot}$ Re Lun(素問 ${\cdot}$ 熱論)${\gg}$. In addition, the summary of Liu-Jing-Bing became the general principle of Fen-Jing(分經) and Ding-Zheng(定證) that may be applicable to Fenghan(風寒), Wenre(溫熱), Lili and Zabing(雜病). 2. Most commentators of $\ll$Sang Han Lun$\gg$ in the Song, Ming and Ching Dynasties of ${\ll}$Sang Han Lun${\gg}$interpreted the So-Yang-Bing in physiological and pathological aspects of Rong-Wei(榮衛) as the disease of the bladder meridian that oversees the skin of the human body. 3. From the Liu-Jing-Bing of ${\ll}$Sang Han Lun${\gg}$, the region of acupuncture treatment of So-Yang-Bing is treated with the needle from the point of view of bing-Zheng-Lun-Zhi(辯證論治) with the basis of the important region of acupuncture of the Triple Energizer meridian and Gallbladder of meridian.

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Rhei Rhizoma Mainly Blended Prescriptions According to the Fomula, Manipulation, Related Co-herb in Dongeuibogam (『동의보감(東醫寶鑑)』 중 대황(大黃)이 주약(主藥)으로 배오(配伍)된 방제(方劑)의 제형(劑形), 포제(?製), 약대구성(藥對構成)에 따른 활용(活用))

  • Joh, Hae-In;Kook, Yoon-Bum
    • Herbal Formula Science
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    • v.25 no.4
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    • pp.553-574
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    • 2017
  • The purpose of this study is to find out effects of prescriptions according to the formula, manipulation of Rhei Rhizoma, configuration. The following results were reached through investigations on the prescriptions using Rhei Rhizoma as a main component. Objectives : Analysis of prescriptions According to the formula : Liquid Extract Prescriptions were used widely on three parts to treat fever and damp heat in the interior organs. Powder Prescriptions were taken with hot water, thin porridge, tea etc. to treat damp heat, congestion of phlegm, acute episodes. Liquid Mixed Pill treat congestion of QI, damp heat, phlegm. Honey Mixed Pill treat accumulated fever, distension, acute excessive fever. Paste Pill treat blood stagnation, excessive toxic-fever, epidemic diseases. External Application treat inflammation by injury, swelling due to severe fever by internal damage. Methods : Analysis of prescriptions According to the manipulation of Rhei Rhizoma : Prescriptions including Liquor processed Rhei Rhizoma treat excessive toxic-fever, congestion of phlegm, blocking orifices on the upper side. Steamed Rhei Rhizoma strengthen effects of making evacuate and cooling of heat. Processed Rhei Rhizoma with vinegar strengthen effects of removing blood stagnation by activating blood movement, releasing gathering. Results : Analysis of prescriptions According to the Composition of Rhei Rhizoma : 41% of the total prescriptions were on the area of less than 20%. In case of lower groups show increased frequency of combination with Pharbitidis Semen, Persicae Semen, Scutellariae Radix and manipulation of baking, steaming, roasting. In case of higher groups show increased frequency of treating excess syndrome, critical illness, acute severe illness, and using proccesed Rhei Rhizoma with vinegar. Treatment of damp heat on the liver and gallbladder, disorder of the spleen and stomach is done mostly by prescriptions on the area of less than 30%. Conclusions : Rhei Rhizoma-Coptidis Rhizoma pair treat damp heat, heat toxins in blood, and Constipation caused by excessive heat. Rhei Rhizoma-Glycyrrhizae Radix pair relieve effects of Rhei Rhizoma passing blocked feces, removing the poison, activating blood movement, releasing gathering with the effects of Glycyrrhizae Radix relaxing tension by harmonizing Middle. Rhei Rhizoma-Magnoliae Cortex pair are used to treat damp heat in middle area, excessive heat in the stomach and intestine. Rhei Rhizoma-Pharbitidis Semen pair act on both blood system and QI system treating edema, damp, stagnation, heat toxins, feces. Rhei Rhizoma-Persicae Semen pair treat blood stagnation with fever on blood system.

Tc-99m EHIDA Scintigraphic Demonstrability of Biliary Elements and Liver Function Tests in Hepatobiliary Diseases (몇가지 간담도질환에서 간기능에 따른 Tc-99m EHIDA의 담도영상능)

  • Kim, Choon-Yul;Lee, Myung-Hee;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.2
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    • pp.71-80
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    • 1982
  • In the present communication, the results will be reported on a clinical study of how well scintigraphic visualization of the hepatobiliary elements and several commonly used clinical liver function tests correlate each other in various diseases oft hepatobiliary system. The demonstrability of the biliary tract, gallbladder (GB) and duodenum was rather closely paralleled to serum bilirubin level and less closely to alkaline phosphatase and rather poorly to SGOT and SGPT. The biliary tree could not be visualized scintigraphically when bilirubin exceeded 10.5mg/dl. The usefulness of Tc-99m EHIDA [N-(2,6-diethylacetanilido) iminodiacetic acid, made by Amersham, England] hepatobiliary scintigraphy (Tc EHIDA HBS) in settling diagnostic controversy and ambiguity raised by oral cholecystography, intravenous cholangiography and ultrasonography in many hepatobiliary diseases is well known. The purpose of this investigation was to semiquantitatively evaluate the scintigraphic demonstrability of the hepatobiliary tract, GB and duodenum following intravenous injection of Tc-99m EHIDA in normal subjects and in patients with a disturbed liver function from various hepatobiliary diseases. The hepatobiliary scintigraphy was performed in 10 normal subjects and 39 patients with various hepatobiliary diseases (Table 1) at the Dept. of Radiology, St. Mary's Hospital Catholic Medical College, Seoul, Korea during 2 years period from September 1979. Scintigraphic examination was started at end of 3 minutes after intravenous injection of Tc-99m EHIDA in the amount of $50{\mu}Ci/kg$ and was continued until after 30 minutes at 5 minutes interval. The imaging was usually terminated when the tracer could be seen in the duodenum. Late scintigrams were obatained at 1 1/2, 3, 4 and 6 hours when reeded. Scintigrams were analyzed in terms of promptness and clarity of visualization of the biliary tree, GB and duodenum and demonstrability of these anatomical landmarks was correlated with the values of liver function tests. The demonstrability of the common hepatic duct, common bile duct, GB and duodenum was closely paralleled to the level of serum bilirubin when it is less than 10.5 mg/dl as shown in figure 1. However when the bilirubin exceeded 10.5 mg/dl the time of visualization between protracted reaching a flat curve or plateau around 10.5 mg/dl. The biliary tract could not be visualized when the bilirubin was higher than 10.5 mg/dl. The correlability between scintigraphic demonstration and serum alkaline phosphatase was less strong and between scintigraphic demonstration and SGOT and SGPT was rather poor. The present clinical study confirmed the usefulness and limitation of Tc-99m EHIDA hepatobiliary scintigraphy in visulizing and diagnosing the biliary system and duodenum when radiogrpahy and ultrasonography failed to provide useful informations. Scintigraphy was very helpful in the diagnosis of neonatal hepatitis, biliary atresia, cholecystitis and extrahepatic biliary obstruction. The hepatobiliary system and duodenum were visualized when serum bilirubin level was less than 10.5 mg/dl, SGOT 135 units, SGPT 114 units and alkaline phosphatase 52.2 KAU.

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Synthesis Characterization and Biodistribution of $^{99m}Tc$-Ethyl-3-Isocyanobutyrate as a New Myocardial Perfusion Agent (새로운 심관관류 영상 화합물로서 $^{99m}Tc$-Ethyl-3-Isocyano-butyrate의 합성, 표지 및 체내동태에 대한 연구)

  • Lee, Myung-Chul;Cho, Jung-Hyuck;Lee, Dong-Soo;Lim, Sang-Moo;Oh, Seung-Joon;Chung, Soo-Wook;Lee, Kyung-Han;Jeong, Jae-Min;Chung, June-Key;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.223-232
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    • 1993
  • Technetium labeled isonitrile analogues are widely used as myocardial perfusion imaging agents. We synthesized and characterized a new isonitrile compound, ethyl 3-isocyanobutyrate(EIB). Proton and $^{13}C$ NMR spectroscopy and thin layer chromatography with a $C_{18}$ coat was performed. EIB was easily labeled with $^{99m}TcO_4^-$- with sodium dithionite. The labeling efficiency measured by RP-HPLC was over 95%. The labeled product was stable with dilution in normal saline and with prolonged incubation at room temperature. There was no formation of secondary products or free $^{99m}TcO_4^-$. In vivo kinetics study of $^{99m}Tc$ (I) labeled EIB in rabbits showed adequate myocardial uptake, good contrast against lung background, and relatively rapid liver clearance. The heart to lung ratio was over 2.5 and the heart to liver ratio was approximately from 0.4 to 5 at 60 minutes post injection. Hepatic clearance of $^{99m}Tc-MIBI$ was faster ($t_{1/2}$=6 minutes) than that of $^{99m}Tc-MIBI$. In vivo kinetics observed in dog was similar to that in rabbit but there was faster gallbladder filling, and thus lower liver background. SPECT imaging of the canine myocardium showed favorable imaging characteristics. However, biodistribution in mice demonstrated a myocardial % injected dose/organ of less than 0.1%. This was thought to be due to interspecies difference in plasma esterase activity. In human plasma, $^{99m}Tc$ ( I ) labeled EIB was stable for at least 2 hours, without production of secondary products by HPLC. We conclude that ethyl 3-isocyanobutyrate may be a potential new myocardial perfusion imaging agent and deserves further investigation as to its usefulness for clinical use.

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A Study of 'uplift yang-qi to raise sinking' efficacy in Radix Bupleuri (시호(柴胡)의 승약작용에 관한 연구)

  • Park, Pil-Sang;Kang, Ok-Hwa;Lee, Go-Hoon;Lee, Kye-Suk;Ko, Ho-Yeon;Kwon, Dong-Yeul
    • The Korea Journal of Herbology
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    • v.21 no.4
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    • pp.213-218
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    • 2006
  • Objectives : Radix Bupleuri is from the dried root of the herb of the Perennial herbaceous plant, Bulpleurum falcatum L. or Bulpleurum chinense DC. or Bulpleurum. scorzonerifolium Willd., family Umbelliferae. Medicinal Properties are bitter and pungent in flavor, slightly cold in nature and attributed to the liver and gallbladder meridians. Actions in modern Materia Medica are regulate the functional relation of internal organs to relieve fever, disperse the stagnated liver-qi and uplift yang-qi to raise sinking. The ‘uplift yang-qi to raise sinking’ efficacy, out of three efficacies (regulate the functional relation of internal organs to relieve fever, disperse the stagnated liver-qi and uplift yang-qi to raise sinking), has been disputed in the medical profession for a long period. Hereupon, this study ascertained the reason why it has been disputed. Methods : With respect to this medicinal herb, the efficacies of regulate the functional relation of internal organs to relieve fever, disperse the stagnated liver-qi and uplift yang-qi to raise sinking were described as to what was written in ‘Shen Nong's Herbal’ from Chin and Han dynasties until Jin and Yuan dynasties. Results : The beginning of Jin and Yuan dynasties, it began to deal with the ‘uplift yang-qi to raise sinking’ efficacy and so it has been carried on modern textbooks and medical books. The reason why it was added is that it was influenced by the theory of ‘Raise Sinking’ advocated by Zhang jieku who lived in the period of Jin and Yuan dynasties. Since then, the properties of ‘Radix Bupleuri’ have been wrongly known to the public. Additionally, ‘Radix Stellariae Seu Gypsophilae’, which was begun to be introduced from the Four Cities since the Five Dynasties, has been combined with the best stuffs of ‘Radix Bupleuri’ produced from Yin Zhou. Consequently, its original properties were remarkably disordered. Likewise, respective medical schools’ theories were changed by the influence of ‘Bulpleurum. scorzonerifolium Willd’ begun to be used since Tang dynasty. Conclusion : it is considered that the current ‘Raise Sinking’ efficacy of Radix Bupleuri is unreasonable to be applied to the efficacy of the whole Radix Bupleuri because it is limited to certain species.

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Cancer Mortality and Morbidity Based on Secondary Data Analysis of Health Among Residents Around Waegwan, Gyeongsangbuk-do, Korea (건강관련 2차 자료에 근거한 왜관 지역주민의 암 발생 현황)

  • Lee, Kwan;Lim, Hyun-Sul;Min, Young-Sun;Lee, Duk-Hee;Ju, Young-Su;Yang, Won-Ho;Cho, Yong-Sung;Kim, Geun-Bae
    • Journal of Environmental Health Sciences
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    • v.39 no.4
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    • pp.335-345
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    • 2013
  • Objectives: As the suspicion was raised that 'Agent Orange' was reclaimed 30 years ago at Camp Carol, located in Waegwan, Gyeongsangbuk-do, the government conducted an investigation of the influence of environmental and health effects around Camp Carol through a public-private joint investigation team. As part of the investigation of population health effects, this study was carried out in order to observe changes and regional differences in diseases, particularly cancer, by year. Methods: We authors conducted an analysis of secondary health data, such as cancer registration data, mortality data, and health insurance data. We drew an age standardized incidence ratio (SIR), death rate (SDR), mortality ratio (SMR), and health care utilization rate using these data. Results: For gastric cancer in women, and other cancers in men, a significant increase in incidence was observed compared to the control area. For biliary tract cancer, gallbladder cancer, and thyroid cancer in women, and prostate cancer in men, a significant decrease in incidence was observed compared to the control area. In the national statistical analysis of data, such as health insurance data and mortality data, we did not observe a significant increase at the Waegwan region compared to other regions. Conclusions: We must consider the limitations of this study. Because thirty years have passed from the time of the estimated landfill of 'Agent Orange', recent national statistical data may not reflect the past real situation. Therefore, the monitoring of secondary data for health effects at the municipal level should be carried out continuously.

Carcinoembryonic Antigen (CEA) in the Gallbladder Bile (b-CEA) of Gastric Carcinoma Patients with Long-term Follow up (위암 환자의 담즙 CEA 농도와 장기 생존율 및 간전이와의 연관성)

  • Baik Sang-Hyun;Kim Hyun Koo;Kang Min Soo;Shin Yeon Myung;Choi Kyung Hyun
    • Journal of Gastric Cancer
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    • v.4 no.1
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    • pp.1-6
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    • 2004
  • Purpose: Despite numorous reports on the relationship between the level of carcinoembryonic antigen (CEA) in gall bladder bile and liver metastasis in colorectal cancer, no similar studies have been carried out for gastric carcinomas. We, therefore, undertook the present study to establish the relationship between the gall bladder bile CEA and liver metastasis as well as the post-operative survival rate in gastric carcinoma patients with curative resections. Materials and Methods: In 373 gastric cancer patients (252 males, 121 females, age $21\∼76$ years) operated on at Kosin University Hospital between 1989 1996, the CEA concentration in the gall bladder bile was determined during the operation and the value was related to the rates of post-operative survival and liver metastasis during follow-up period. Results: The overall rate of patient survival decreased gradually with increase in TNM stage. The 13-year postoperative survival rates for stages Ia, Ib, II, IIIa, and IIIb were $95.7\%,\;92.5\%,\;79.9\%,\;50.9\%,\;and\;43.3\$, respectively, and the 10-year survival rate for stage IV was $22.6\%$. The patients with a high ($\geq$10 ng/ml) biliary CEA showed a significantly lower rate of survival than those with a low (<10 ng/ml) biliary CEA. The 13-year cumulative survival rate was $55.4\%$ for the high CEA group and $76.5\%$ for the low CEA group (P<0.01). Also, the patients with a high biliary CEA showed a significantly higher rate ($11.5\%$) of liver metastasis than those with a low biliary CEA ($1.9\%$) (P<0.000). In patients with TNM stages (I and II), the CEA level did not affect the post-operative survival rates ($95.4\%\;and87.7\%$ in the high and low CEA groups, P>0.10), but in those with high TNM stages (III and IV), the survival rate was significantly lower in the high CEA group ($25.9\%$) than in the low CEA group ($57.8\%$) (P<0.05). Conclusion: These result suggest that the gall bladder bile CEA level obtained in an advanced-staged gastric cancer operation may be used in predicting the post-operational survival rate and in sorting out patients with a high risk for cancer recurrence, especially in the liver area.

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