• 대한의용생체공학회:의공학회지
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• 제20권2호
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• pp.173-182
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• 1999

조영 증강제를 이용한 나선식 CT는 간 질환을 진단하는데 있어 중요한 역할을 하고있음에도 불구하고 진단의 효율을 최적화하는 프로토콜은 명확하게 알려져 있지 않다. 따라서 나선식 CT에서의 간암-간 대조 곡선을 모의 실험(simulation) 하여 다양한 요소들이 시간-조영 곡선에 어떻게 영향을 미치는지 파악하고, 또한 CT 검사 전에 모의 실험을 하여 이론적으로 최적의 스캔을 할 수 있도록 하기 위하여 약동학(pharmacokinetics)에 기초한 compartment model을 구성하였다. 간암, 간, 대동맥 및 간문맥 등을 각 구획(compartment)으로 설정하여 각 구획에서의 미분방정식을 얻은 후 적분하여 Hounsfield unfit 값을 조영제 주입 후 시간의 함수로 얻었으며 각 구획의 시간-조영 곡선을 출력하였다. 구현한 프로그램에서는 간암의 크기 및 종양 혈관의 분포 등과 같은 간암의 성질, 간경화의 정도에 따른 간 혈관 공급의 양상 및 조영제의 부피, 농도, 주입 속도 등의 조영제 주입 방법, 환자의 몸무게, 키 등의 환자의 신체 계수, 그리고 심박출량 등의 환자의 혈역학적 계수 등을 입력 받아 간암을 비롯한 각 구획의 시간-조영 곡선 및 간-간암 대조 곡선을 출력할 수 있도록 하였다. 모델링을 통해 얻은 조영 증강 곡선은 같은 환경하에서 얻은 24명의 환자 데이터와 비교하여 유사한 결과를 얻을 수 있었으며, 조영 증강제 주입 방법의 변화가 간암-간 대조 곡선에 미치는 영향을 비교할 수 있었다.

• 한국간담췌외과학회지
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• 제26권4호
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• pp.386-394
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• 2022

Splenic artery steal syndrome (SASS) is a cause of graft hypoperfusion leading to the development of biliary tract complications, graft failure, and in some cases to retransplantation. Its management is still controversial since there is no universal consensus about its prophylaxis and consequently treatment. We present a case of SASS that occurred 48 hours after orthotopic liver transplantation (OLTx) in a 56-year-old male patient with alcoholic cirrhosis and severe portal hypertension, and who was successfully treated by splenic artery embolization. A literature search was performed using the PubMed database, and a total of 22 studies including 4,789 patients who underwent OLTx were relevant to this review. A prophylactic treatment was performed in 260 cases (6.2%) through splenic artery ligation in 98 patients (37.7%) and splenic artery banding in 102 (39.2%). In the patients who did not receive prophylaxis, SASS occurred after OLTx in 266 (5.5%) and was mainly treated by splenic artery embolization (78.9%). Splenic artery ligation and splenectomies were performed, respectively, in 6 and 20 patients (2.3% and 7.5%). The higher rate of complications registered was represented by biliary tract complications (9.7% in patients who received prophylaxis and 11.6% in patients who developed SASS), portal vein thrombosis (respectively, 7.3% and 6.9%), splenectomy (4.8% and 20.9%), and death from sepsis (4.8% and 30.2%). Whenever possible, prevention is the best way to approach SASS, considering all the potential damage arising from an arterial graft hypoperfusion. Where clinical conditions do not permit prophylaxis, an accurate risk assessment and postoperative monitoring are mandatory.

• 대한핵의학회지
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• 제28권3호
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• pp.350-356
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• 1994

Purpose : Hepatic arterial perfusion scintigraphy with Tc-99m-macroggregated albumin (HAPS) study was carried out in 16 patients with hepatocellular carcinoma(HCC) and in six patients without liver tumor to evaluate HAPS findings of hepatocellular carcinoma and usefullness of HAPS. Materials and Methods : HAPS with planar and SPECT study were performed in 22 patients after conventional hepatic or celiac arteriography. For HAPS study, 4-5 mCi of MAA mixed with 2ml of saline was injected into proper hepatic artery or its distal branches at the rate of approximately 1ml/sec. We analysed 21 HCCs over 2cm in diameter(average diameter; 6.4cm) and 17 of 21 HCCs were over 4cm in diameter(Table 1). CT, sonography and angiography were performed within two week in all 16 patients and liver scan was performed in 12 patients. Results : Three different pattern of tumor perfusion were observed in 16 patients with HCC (Table 2). 1) diffuse increased perfusion in 16 of 21(76%)(Fig. 1) 2) increased peripheral perfusion in 4 of 21(19%) (Fig. 2) 3) diffuse decreased perfusion in 1 of 21 (5%) Arteriovenous shunt indicated by lung uptake of MAA were observed in 9 of 16(56%)(Fig. 4). In contrast, angiography demonstrates arteriovenous shunt in 2 of 16(13%). There was no accumulation of radioactivity on RBC-blood pool scan in all six patients with HCC examined (Fig. 1). Conclusion : HAPS is useful study in evaluation of perfusion pattern or vascularity of HCC and in detection of arteriovenous shunt.

• 대한약리학회지
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• 제23권1호
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• pp.15-23
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• 1987

만성 간문맥 고혈압에 동반하는 내장 충혈에 대한 발생 기전을 규명하기 위하여 고양이의 간문맥을 결찰하고 그 경과에 따라 비 -간 교감 신경성 반사 흥분의 변동과 동시에 순환 역동학적 변동을 관찰하였다. 1. 대조 고양이 (Sham 수술군)에서 비동맥을 통하여 capsaicin, bradykinin 및 vasopressin을 주사 하였을 매에는 전신 동맥압의 반사 흥분뿐만 아니라 비정맥압의 상승을 초래하였다. 그러나 심박동수는 변화가 없었다. 동시에 비장(비-비 반사) 및 간장 (비 -간 반사)에서 교감 신경의 만사 흥분을 일으켰다. 2. Capsaicin을 간 표면에 도포하였을 때는 간 신경 흥분 (간-간 반사)과 등시에 승압 반사를 유발시켰다. 3. 문맥 결찰 후에는 비정맥압은 시간 경과에 따라 증가 하였고 이에 동반하여 전신 동맥압은 감소하였다. 그러나 승압반사 항진은 제2일에 현저하게 야기되었고 그후 대조치로 회복되었다. 비-비 또는 비-간 교감 신경 반사 흥분은 제8일에 현저히 감약되었다. 4. 이상의 성적을 종합하면 비장 및 간장에 분포하는 교감 신경 반사 흥분은 동일한 중추 지배에 의하여 조절되고, 간문맥 결찰 후 내장 반사 흥분의 감소는 내장 충혈의 발생과 밀접한 관련이 있을 것으로 사료되었다.

• 약학회지
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• 제44권1호
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• pp.71-79
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• 2000

Curcumin, the yellow pigment in turmeric, curry and mustard, has anti-inflammatory and anti-carcinogenic activities. In this study; we investigated the hypocholesterolemic and anti-atherogenic effect of curcumin in rabbits. Hypercholesterolemia was induced by feeding high cholesterol diet to male rabbits for 30 days, and the animals were then fed high cholesterol diet containing 0.1% (w/w) or 0.5% (w/w) curcumin for additional 30 days. Supplementation of 0.l% curcumin tended to lower serum total cholesterol and low density lipoprotein (LDL)-cholesterol levels and inhibit serum lipid peroxidation. In the 0.5% curcumin-supplemented group, serum total cholesterol was significantly lowered by 11.7%, LDL-cholesterol by 12.8% and lipid peroxidation by 47.9% compared to the control group. Hepatic cholesterol and triglyceride contents were also significantly lowered by 50.6% and 37.4%, respectively compared to the control group. Lipid staining of the arteries isolated from the curcumin-treated rabbits showed that curcumin significantly decreased formation of fatty streaks and atheromatous plaques on the intima of the arteries. These results demonstrated that curcumin lowered serum cholesterol concentration, hepatic cholesterol and triglyceride contents, and accumulation of cholesterol in the artery These cholesterol lowering effects of curcumin, together with its anti-oxidative and anti-inflammatory activities, may play some important roles in preventing atherosclerosis.

• Clinical and Experimental Pediatrics
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• 제48권6호
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• pp.660-664
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• 2005

저자들은 신생아 시기에 심부전 증세를 보인 간내 혈관내피종 환아에서 내과적 치료와 간동맥 색전술 후 호전을 보이지 않아 간좌엽 절제술을 시행하여 치료한 1례를 경험하였기에 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제32권1호
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• pp.38-41
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• 2015

Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.

• Nutritional Sciences
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• 제6권2호
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• pp.100-105
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• 2003

Small dense LDL(LDL III) is emerging as a major risk factor for coronary artery disease. LDL III generation is associated with high triglyceride concentration, high hepatic lipase activity, and high cholesterol ester transfer protein (CETP) levels. CETP polymorphisms have been reported to be associated with coronary artery disease. In this study, we investigated the relationship between CETP polymorphism and LDL III generation. VLDL1, VLDL2, IDL and LDL subfractions were measured in 87 normal healthy Korean subjects who had been SNP genotyped for Taq1B, I405v and A629C. We found no differences in LDL subfractions and lipoprotein composition between homozygotes for Taq1B2B2, and those for Taq1B1B1 and Taq1B1B2. There were no differences in LDL subfractions and lipoprotein composition between homozygotes for 629AA, and those for 629AC and -629CC. However, homozygotes for 405VV had a significantly lower LDL III concentration and proportion than those for 405II and 405IV. We concluded that, among the Taq1B, I405V and A629C polymorphisms, only the 1405V polymorphism was associated with the concentration and proportion of LDL III.

• 한국콘텐츠학회논문지
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• 제15권9호
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• pp.411-417
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• 2015

Liver CT 검사에서 간세포암과 간혈관종의 구별은 악성종양과 양성종양을 구별하여 치료방법을 결정하는 것에 있어서 중요한 검사 방법 중 하나이다. 현재 사용되는 방법은 전문의의 주관적인 해석에 의해 판독이 이루어지고 있으며, 추가적인 해석을 위해 본 연구에서는 객관적인 방법을 제시하고자 한다. 조영제 주입 후 검사시간은 조영주입전기(Pre), 동맥기(35sec), 문맥기(70sec), 지연기(180sec)로 하였다. 조영증강패턴변화(Enhancement Pattern) 에서 간세포암의 일반적인 패턴변화는 26.6% 로 관찰 되었다. 간혈관종의 일반적인 패턴변화는 16.6%로 관찰 되었다. 간세포암과 간혈관종의 HU(Hounsfield unit)값 변화를 관찰하기 위해 각각의 시간별 평균값과 표준편차를 확인한 결과 Lesion부위의 artery-portal차이가 가장 큰 것으로 나타났다. (간세포암 $19.76{\pm}23.52$, 간혈관종 $60.23{\pm}29.43$). 간세포암 에서 76.6%, 간혈관종 에서 80.0%가 일치하게 나타났다. 본 연구를 통해 HCC와 HH의 객관적 분석 지표로 HU값 을 제안하고 분석방법을 임상에 사용 한다면 진단에 도움을 줄 것이다.

• Journal of Genetic Medicine
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• 제18권2호
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• pp.142-146
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• 2021

Alagille syndrome (AGS) is a rare autosomal dominant inherited disorder, with major clinical manifestations of bile duct paucity, cholestasis, cardiovascular anomaly, ophthalmic abnormalities, butterfly vertebrae, and dysmorphic facial appearance. It is caused by heterozygous mutations in JAG1 or NOTCH of the Notch signaling pathway presenting with variable phenotypic penetrance and involving multiple organ systems. The following case report describes a unique case of a 16-year-old female with AGS who presented with the primary complaint of renovascular hypertension. She had a medical history of ventricular septal defect and polycystic ovary syndrome. The patient had a dysmorphic facial appearance including frontal bossing, bulbous tip of the nose, a pointed chin with prognathism, and deeply set eyes with mild hypertelorism. Stenoocclusive changes of both renal arteries, celiac artery, lower part of the abdominal aorta, and left intracranial artery, along with absence of the left internal carotid artery were found on examination. Whole exome sequencing was performed and revealed a pathologic mutation of JAG1, leading to the diagnosis of AGS. Reverse phenotyping detected butterfly vertebrae and normal structure and function of the liver and gallbladder. While the representative symptom of AGS in most scenarios is a hepatic problem, in this case, the presenting clinical features were the vascular anomalies. Clinical manifestations of AGS are diverse, and this case demonstrates that renovascular hypertension might be in some cases a presenting symptom of AGS.