• Food Science of Animal Resources
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• v.41 no.2
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• pp.343-352
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• 2021

The objective of this study was to evaluate the effects of Lactobacillus acidophilus ATCC 43121 and L. fermentum MF27 on biochemical indices in the serum, cholesterol metabolism in the liver and mucin expression in the gallbladder in lithogenic diet (LD)-induced C57BL/6J mice to determine the preventive effects of lactobacilli on gallstone formation. By the end of 4 wk of the experimental period, mice fed on a LD with high-fat and high-cholesterol exhibited higher levels of total and low-density lipoprotein cholesterol in the serum compared to mice fed on control diet or LD with L. acidophilus ATCC 43121 (LD+P1; p<0.05). Cholesterol-lowering effects observed in the LD+P1 and LD with L. fermentum MF27 (LD+P2) groups were associated with reduced expression of 3-hydroxy-3-methylglutaryl coenzyme A reductase in the liver compared to the LD group (p<0.05). Furthermore, expression of the gel-forming mucin, including MUC5AB and MUC5B, was suppressed in the LD+P1 and LD+P2 groups compared to the LD group (p<0.05). Therefore, steady intake of both L. acidophilus ATCC 43121 and L. fermentum MF27 may have the ability to prevent the formation of cholesterol gallstones in LD-induced C57BL/6J mice.

• Proceedings of the Korean Society of Near Infrared Spectroscopy Conference
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• 2001.06a
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• pp.4106-4106
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• 2001

A method to discriminate human gallstones by nea. infrared(NIR) spectrometry using a soft independent modeling of class analogy (SIMCA) has been studied. The fifty NIR spectra of gallstones in the wavenumber range from 4500 to 10,000 cm$\^$-1/ were measured. The forty samples were classified to three classes, cholesterol stone, calcium bilirubinate stone and calcium carbonate stone according to the contents of major components in each gallstone. The training set which contained objects of the different known class was constructed using forty NIR spectra and the test set was made with ten different gallstone spectra. The number of important principal components(PCs) to describe the class was determined by cross validation in order to improve the decision criterion of the SIMCA for the training set. The score plots of the class training set whose objects belong to the other classes were inspected. The critical distance of each class was computed using both the Euclidean distance and the Mahalanobis distance at a proper level of significance(${\alpha}$). Two methods were compared with respect to classification and their robustness towards the number of PCs selected to describe different classes.

• Journal of radiological science and technology
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• v.21 no.2
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• pp.31-35
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• 1998

Gallstone diseases appear frequently in surgical patients. One of the etiolic factors in the formation of cholesterol gallstones is the supersaturation of bile with cholesterol. The bile stasis in the gallbladder may also play a role in the formation of cholesterol gallstones by supplying the proper condition to nucleation of cholesterol crystal. Author evaluated gallbladder empting in response to fat meal by ultrasonography in 12 patients with gallstones and normal control group of 12 healthy subjects. Of the 12 patients with gallstones, six had radiolucent stones and the rest of them had radioopaque stones. Additionally, author evaluated gallbladder contraction in both cholesterol gallstones and pigment gallstones. The gallbladder was significantly contracted in control group by the fat meal but not by water. The contraction of gallbladder by fat meal with gallstone patients was significantly decreased compared with those in control group. The time of maximum contraction was 30 minutes in patients with gallstones. At 30 minutes, the gallbladder contraction was more significantly decreased in patients with radiolucent stones than in those with radioopaque stones. In conclusion, the more significant decrease of gallbladder contraction in patients with radiolucent stones may be interpretated as the possible factor of pathologenesis for the formation of the cholesterol stone.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3447-3453
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• 2016

Background: Gall bladder cancer (GBC) is highly fatal disease with poor prognosis, with a 5 year survival rate of <10%. It is relatively rare cancer worldwide; however it is the sixth cancer and second most common gastrointestinal tract cancer in Nepalese women. The study focused on associations of certain demographic, lifestyle, dietary, and reproductive factors with gall bladder cancer. Materials and Methods: We conducted a hospital-based matched case control study on newly diagnosed cases of primary GBC at BP Koirala Institute of Health Sciences and BP Koirala Memorial Cancer Hospital. Controls were healthy non-GBC relatives of cancer patients, matched for age, sex and marital status (in case of females) with cases at a ratio of 1:2. Data were collected between April 2012-April 2013 by semi structured interview from both cases and controls. Analyses were carried out with SPSS. Conditional logistic regression was used to find odds ratios and 95% confidence intervals for bivariate and multivariate analysis. Results: A total of 50 cases and 100 controls were enrolled in this study. On bivariate analysis, factors found to be significantly associated with gallbladder cancer were illiteracy (OR=3.29, CI=1.06-10.2), history of gallstone disease (OR=27.6, CI=6.57, 115.6), current smoker (OR=2.42, CI=1.005-5.86), early menarche <13 years (OR=2.64, CI=1.09-6.44), high parity more than 3 (OR=3.12, CI=1.25,7.72), and use of mustard oil (OR=3.63, CI=1.40, 9.40). A significant protective effect was seen with high consumption of fruits at least once a week (OR=0.101, CI=0.03-0.35). On multivariate analysis, history of gallstone disease, early menarche, current smoker and high consumption of fruits persisted as significant factors. Conclusions: History of gallstone disease, cigarette smoking and early menarche were associated with increased risk of gallbladder cancer while high consumption of fruits was found to have a protective effect.

• Journal of the Korea Society of Computer and Information
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• v.27 no.3
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• pp.119-126
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• 2022

The reported risk factors for gallstone disease (GD) are old age, female sex, obesity, metabolic syndrome and migrants. Many younger adults tend to live in Jeju City, where transportations are convenient and commercial activities are active. Whereas, older people tend to live in Seogwipo City, because they engaged in fisheries and agriculture. Rates of migrants and old age could affect the prevalence of GD among residents in two regions. Therefore, the purpose of this study was to compare the GD prevalence and analyze risk factors affecting GD including residencies. A total of 13,050 subjects who visited a single health medical check-up center on Jeju Island between 2012 and 2019 were included. We performed univariate and multivariate analysis to identify risk factors for GD. The prevalence of GD among residents were 5.7% in Jeju City and 5.8% in Seogwipo City, respectively. Multivariate analysis revealed that age (P=0.008), body mass index (P=0.044), high-density lipoprotein cholesterol (P=0.006) and gamma-glutamyl transferase (P=0.013) were independent factors affecting GD. The old age, mean higher body mass index, gamma-glutamyl transferase and mean lower high-density lipoprotein cholesterol were independent risk factors affecting GD. However, residencies did not affect the prevalence of GD.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1281-1283
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• 2014

Background: Gallbladder cancer (GBC) is a rare malignancy characterized by high invasiveness and poor survival. In a nation-wide cancer survey, the age-standardized incidence rate of GBC was the highest in Jeju Island compared to 15 other provinces in Korea. The purpose of this study was to compare the clinical outcomes of GBC according to the nature of diagnosis, that is, incidental versus non-incidental. Materials and Methods: Consecutive patients who were newly diagnosed with GBC at the Digestive Disease Center and Department of Internal Medicine, Cheju Halla General Hospital, between November 2008 and November 2011, were enrolled and divided into 2 groups: incidental gallbladder cancer (IGBC) and non-incidental gallbladder cancer (NIGBC). Clinical outcomes were retrospectively compared between the two groups. Results: Seventy-nine patients were enrolled and analyzed in our study. Thirty-three (41.8%) and 46 (58.2%) were identified as IGBC and NIGBC, respectively. The proportions of patients with gallstone disease, gallbladder polyp, and cholecystectomy were significantly different between the two groups. Additionally, the median survival rate was significantly higher for patients with IGBC than for those with NIGBC (11.4, 95% confidence interval, 5.6-13.7 vs 4.0, 95% confidence interval 3.03-5.96 months; p=0.01) during a median follow-up period of 5.7 months. Conclusions: Patients with IGBC showed better clinical prognosis than those with NIGBC. Therefore, patients with gallstone disease or gallbladder polyps, major predictive risk factors for IGBC, should undergo advanced work-up for chelecystectomy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8451-8454
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• 2016

Background: Gallbladder cancer (GBC) is a rare but highly invasive malignancy characterized by poor survival. In a national cancer survey, the age-standardized incidence rate of GBC was highest in Jeju Island among the 15 provinces in South Korea. The aim of this descriptive epidemiological study was to suggest the modifiable risk factors for this rare malignant disease in Jeju Island by performing an age-sex-matched case-control study. Materials and Methods: The case group included patients diagnosed with GBC at the Department of Internal Medicine of Cheju Halla General Hospital, Jeju, South Korea, within the 5-year study period. The control group consisted of age-sex-matched subjects selected from among the participants of the health promotion center at the same institute and in the same period. We compared 78 case-control pairs in terms of clinical variables such as histories of hypertension, diabetes, vascular occlusive disorders, alcohol and smoking consumption, obesity, and combined polypoid lesions of the gallbladder (PLG) or gallstone diseases (GSDs). Results: Among the relevant risk factors, alcohol consumption, parity ${\geq}2$, PLG, and GSDs were significant risk factors in the univariate analysis. PLG (p < 0.01; OR, 51.1; 95% confidence interval [CI], 2.98-875.3) and GSD (p < 0.01; OR, 54.9; 95% CI, 3.00-1001.8) were associated risk factors of GBC in the multivariate analysis with the conditional logistic regression model. However, we failed to find any correlation between obesity and GBC. We also found a negative correlation between alcohol consumption history and GBC in the multivariate analysis (p < 0.01; OR, 0.06; 95% CI, 0.01-0.31). Conclusions: These results suggest that combined PLG and GSDs are strongly associated with the GBC in Jeju Island and mild to moderate alcohol consumption may negatively correlate with GBC risk.

• The Journal of Internal Korean Medicine
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• v.42 no.3
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• pp.431-436
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• 2021

Objectives: This study aims to determine whether Korean medicine improves epigastric symptoms of biliary dyskinesia without unfavorable side effects. Methods: A 37-year-old woman who had chronic dyspepsia with intermittent back pain had gallstone-like sludge identified on ultrasound scan. We administered Saenggan-tang and used ultrasound examination to observe the changes in symptoms such as dyspepsia, the occurrence of back pain, and gallbladder contraction. Results: After 2 months of taking Saenggan-tang, symptoms such as dyspepsia, abdominal pain, headache, and back pain improved. In addition, biliary motility improvement was evaluated by ultrasonography. Moreover, there was no occurrence of any side effects. Conclusion: This study suggests that Korean medicine might be effective for managing biliary dyskinesia.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.3
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• pp.277-286
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• 2023

Backgrounds/Aims: To study histopathological changes in gall bladder mucosa in cholelithiasis patients, and analyse their relation to the number and size of gallstones. These findings were evaluated in the context of age distribution of the study population. Methods: One hundred cases of cholecystectomy were part of the study, which was conducted in collaboration with the pathology department. The time period of the study was January 2020 to June 2021. Results: Maximum cases had multiple stones (69.0%), while one third cases (31.0%) had solitary stones. While initial univariate analysis showed age (odds ratio [OR], 6.882; p = 0.043), gallstone number (OR, 9.1; p = 0.050), gallstone size (OR, 17.111; p = 0.013), and duration of symptom (OR, 34.125; p = 0.001) to be significant risk factors associated with gallbladder carcinoma, multivariate analysis found none of these variables to be significant. However, conditional multivariate analysis for the duration of symptom (p = 0.008; OR, 21.118) yielded significant p-value. With histopathological diagnoses, 5% of cases had gallbladder cancer. Conclusions: This study shed light on the rising incidence of cholelithiasis in the young population and the high rate of gallbladder carcinoma in Punjab, India. Although gall stone characteristics (size, number) and patient age appeared to be significant risk factors when their individual relation with gallbladder carcinoma was studied, multivariate analysis, could not prove that. Conditional multivariate analysis showed the duration of symptom to be the only significant risk factor associated with gallbladder carcinoma. Further research with larger sample size is needed to study the rising incidence of gallbladder carcinoma, and the risk factors associated with it.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.366-371
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• 2023

Backgrounds/Aims: Biliary surgery in patients with extrahepatic portal vein obstruction with portal cavernoma (PC) is technically challenging, and associated with the risk of bleeding. Therefore, prior portal vein decompression is usually recommended before definitive biliary surgery. Only a few studies have so far reported the safety of isolated laparoscopic cholecystectomy. We aimed to evaluate our experience of laparoscopic cholecystectomy in patients with PC without prior portal decompression. Methods: Prospectively maintained data for patients with PC who underwent laparoscopic cholecystectomy for symptomatic gallstone disease without portal decompression were analyzed. Clinical features, imaging, intraoperative factors, conversion rate, complications of surgery, and long-term outcomes were assessed. Results: Sixteen patients underwent cholecystectomy without portal decompression from 2012 to 2021, of which interventions 14 were laparoscopic cholecystectomies. One patient required conversion (7.1%) to open surgery. Jaundice was present in 5 patients (35.7%), and underwent endoscopic stone clearance before surgery. Median intraoperative blood loss, operative time, and hospital stay were 100 mL (20-400 mL), 105 min (60-220 min), and 2 days (1-7 days), respectively. Blood transfusion was required in two patients (14.2%). Prior endoscopic or percutaneous intervention was associated with significant blood loss and prolonged intraoperative time. Conclusions: In centers with experience, prior portal decompression can be avoided in patients with PC requiring isolated cholecystectomy to treat gallstones or their complications. Laparoscopic surgery is safe and feasible for these patients, and gives excellent outcomes in the selected group.