• Journal of Oriental Physiology
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• v.14 no.2 s.20
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• pp.23-41
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• 1999

The disease of cholelith is common world widely. As life expectancy gets extended and life environment and dietary life change, increased to gallstone in Korea. On the case that elimination surgery is inapplicable and for the aged patients. recently the dissolution therapy of cholelith is studied world widely. From the view of oriental medicine, the causes of gallstone, treatment methods and the effects of therapy are as follows ; 1. The attack of gallstone is by the stagnation and disturbance of qi in the body. 2. The causes of gallstone are classified into three types. 1).The type of stagnation of qi. 2).The type of damp-heat. 3).The type of noxious heat. 3. The treatment effect is high in the damp-heat type. 4. Medical treatment of gallstone, considering the function of the intestines, are lithodialysis and removol of gallstone, soothing the liver and regulating the cerculation of qi, clearing away heat and elininating dampness. 5. The dissolution therapy of gallstone effected to the size within the diameter of 1.5cm 6. Through the oriental medicine therapy, besides excretion and dissolution of gallstone, the interval extention and elimination of spasm, the prevention of relapse and aftere effect are to be expected. The study which can improve the treatment rate of cholelith through the combination therapy of oriental and western is needed and deep study on oriental medicine diagnostic and classification according to the observation based on symptoms is necessary.

• Korean Journal of Community Nutrition
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• v.13 no.2
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• pp.288-297
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• 2008

It has been reported frequently that clinical features of gallstone disease in Korean were similarly changing to those of Occidentals. This changing was thought to be due to Westernized lifestyle and dietary patterns in Korean. The purpose of this study was to investigate the nutritional risk factor among patients with gallstone. The subjects of this study were 90 gallstone group with biliary stone as confirmed by cholecystectomy and 111 control group with no biliary stone as confirmed by ultrasonography adjusted according to age and gender. Anthropometric indices and biomarkers were measured and dietary habit as well as nutrient consumption pattern were investigated using a structured checklist of health-related eating behavior and a semi-quantitative food frequency questionnaire. The mean age was higher in GG (gallbladder stone patient group) than CG (control group). The average BMI and WHR (waisthip ratio) tended to be higher than those in CG. WC (waist circumference) and WHR of women in GG were significantly higher than in CG. GG had lower levels in TC (p < 0.01), LDL-C (p < 0.05), and HDL-C (p < 0.05), but higher FBG levels (p < 0.001). GG tended to be associated with lower physical activity and more frequent consumption of meat, meats with high fat and high sugar content food. The consumption levels of fiber (p < 0.05), vitamin C (p < 0.05), calcium (p < 0.01) in GG were significantly lower than in CG. These findings showed that the association with incidence of gallbladder stone and anthrophometric indices and dietary consumption patterns. Further study may be necessary to elucidate the dietary risk factors in the changing patterns of gallstone disease.

• Korean Journal of Community Nutrition
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• v.12 no.6
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• pp.826-837
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• 2007

Gallstone composition has changed over the past decades in the Korean with a prominent increase in the prevalence of cholesterol gallstone. This trend is possibly due to the westernization of dietary habits. The purpose of this study was descriptive of GB patient's health related eating behaviors and nutrient consumption patterns. One hundred and six gallstone patients who have had cholecystitis surgery enrolled in this study. Anthropomertic indices, such as height, weight, waist circumference, and hip circumference were measured and calculated BMI and WHR. As the biomarker, TC, TG, LDL-C, HDL-C, FBG level and SBP/DBP were measured and analyzed the relationship with GB stone formation. The structured checklist of health related eating behavior and the semiquantitative food frequency questionnaire after pre-test was used in the face to face interview study. The mean age was $54.9{\pm}13.3$ and gallstone disease was more frequent in the fifties and sixties. Mean BMI was $24.3{\pm}2.8$ in males, and $23.4{\pm}3.9$ in females, the average of waist circumference was $91.1{\pm}7.0cm$ in males and females were $85.4{\pm}9.6cm$. The WHR of men and women was $0.93{\pm}0.0,\;0.90{\pm}0.1$, respectively. The obesity and overweight trend was observed in gallstone patients. The mean blood sugar was researched at $114.5{\pm}35.0mg/dL$. And the ratio of both symptoms DM and gallstone was 26.4%. The rate of dramatic eating repast was significantly higher in the females (p<0.01). Males tended to more frequently consume meat, of high fat content meats and greasy food consumption when eating out. The CPF ratio was 57:16.5:26.5. There was a significant positive correlation between WC and energy (r=0.252, p<0.05), carbohydrate (r=0.255, p<0.05) and niacin (r=0.227, p<0.05). In addition, carbohydrate were significantly correlatied with TC (r=0.230, p<0.05). BMI appeared positive in correlation of protein (r=0.201, p<0.05) and fat (r=0.205, p<0.05). These findings provide a little association that dietary habits are related with cholesterol gallstone formation.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.14 no.1
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• pp.42-47
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• 2014

Gaucher disease is a multisystemic disorder arising from a deficient activity of the lysosomal enzyme glucocerebrosidase, which leads to accumulation of glycosylceraide and other glycolipids in the regiculoendothelial system. The characteristics of Gaucher disease are anemia, thrombocytopenia, hepatosplenomegaly, and skeletal disease. Enzyme replacement therapy (ERT) has been proven to prevent progressive manifestations of Gaucher disease and effective in improving anemia, thrombocytopenia, bone markers and biomarkers. However, some patient needs still remain unmet because of the inaccessibility of certain sites including brain, bone and various organs. ERT could not Improve the irreversible lesion such as liver fibrosis, hepatopulmonary syndrome, and necrosis or infarction of bone and other organs. Adult patients with Gaucher disease should be screened for longterm complication such as bone disease, pulmonary hypertension, gallstone, and cancer, especially in patients with splenectomy. Parkinsonism and polyneuropathy was also reported among patients with type 1 Gaucher disease, but ERT does not improve neurological function. We need to review the benefits and unmet needs of ERT in Gaucher disease.

• 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.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.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.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.197-202
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• 1990

Mechanical obstruction of the common hepatic duct includes the following causes ; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the "syndrome del conducto hepatico" in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mirizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a varient of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of $38^{\circ}C$, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/$cm^2$;albumin 2.6g/dl(normal 3.9-5.1) ; SGOT 183u/L(normal 0-50) ; SGPT167u/L(normal 0-65) ; bilirubin, 8.2mg/dl(normal 0-1) with the direct bilirubin, 4.4mg/dl(normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction(Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5613-5617
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• 2012

Gallbladder carcinoma (GBC) is the commonest cancer of the biliary tree and the most frequent cause of death from biliary malignancies. The incidence of GBC shows prominent geographic, age, race, and gender-related differences and is 4-7 times higher in patients with gallstones. This prompted us to study the clinicopathological aspects of the disease and the incidence of gallstones in gallbladder carcinoma patients, in this part of India. In this, combined retrospective (Jan 2004-March 2010) and prospective study (April 2010-Dec 2011) of eight years, 198 patients of gallbladder carcinoma (50 males and 148 females), (range 28-82 years; mean 55 years) were studied. Most of the patients were poor and presented with abdominal pain and mass, with abnormal lab parameters. Gallstones were present in 86% of patients. Surgical exploration was performed in 130, with gallbladder resection in 60 (including 7 incidental GBC). Adenocarcinoma (87.7%) was the commonest histological type. The study indicates that GBC is common in our scenario. It is a disease of elderly females, has a strong association with gallstones and every cholecystectomy specimen should be examined histopathologically.