• 한국간담췌외과학회지
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• 제27권3호
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• pp.241-250
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• 2023

Helicobacter pylori is a gram-negative pathogen commonly associated with peptic ulcer disease and gastric cancer. H. pylori infection has also been reported in cholelithiasis, cholecystitis, gallbladder polyps, and biliary tract cancers. However, the association between H. pylori and gallbladder and biliary tract pathologies remains unclear due to the paucity of literature. In response to the current literature gap, we aim to review and provide an updated summary of the association between H. pylori with gallbladder and biliary tract diseases and its impact on their clinical management. Relevant peer-reviewed studies were retrieved from Medline, PubMed, Embase, and Cochrane databases. We found that H. pylori infection was associated with cholelithiasis, chronic cholecystitis, biliary tract cancer, primary sclerosing cholangitis, and primary biliary cholangitis but not with gallbladder polyps. While causal links have been reported, prospective longitudinal studies are required to conclude the association between H. pylori and gallbladder pathologies. Clinicians should be aware of the implications that H. pylori infection has on the management of these diseases.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1963-1969
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• 2012

Objectives: Recent data show that the metabolic syndrome may play a role in several cancers, but the etiology for biliary tract cancer is incompletely defined. The present aim was to evaluate risk factors for biliary tract cancer in China. Methods: A case-control study in which cases were biliary tract cancer patients referred to Peking Union Medical College Hospital (PUMCH). Controls were randomly selected from an existing database of healthy individuals at the Health Screening Center of PUMCH. Data on the metabolic syndrome, liver diseases, family history, and history of diabetes and hypertension were collected by retrospective review of the patients' records and health examination reports or by interview. Results: A total of 281 patients (102 intrahepatic cholangiocarcinoma (ICC), 86 extrahepatic cholangiocarcinoma (ECC) and 93 gallbladder carcinoma (GC)) and 835 age- and sex-matched controls were enrolled. $HBsAg^+/anti-HBc^+$ (P=0.002), history of diabetes (P=0.000), cholelithiasis (P=0.000), TC (P=0.003), and HDL (P=0.000) were significantly related to ICC. Cholelithiasis (P=0.000), Tri (P=0.001), LDL (P=0.000), diabetes (P=0.000), Apo A (P=0.000) and Apo B (P=0.012) were significantly associated with ECC. Diabetes (P=0.017), cholelithiasis (P=0.000) and Apo A (P=0.000) were strongly inversely correlated with GC. Conclusion: Cholelithiasis, HBV infection and metabolic symptoms may be potential risk factors for the development of biliary tract cancer.

• 대한의생명과학회지
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• 제19권3호
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• pp.280-283
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• 2013

Leuconostoc spp. is intrinsically resistant against vancomycin and rarely causes the infection in immunocompromised patients. In this report, we describe a fatal case of Leuconostoc lactis bacteremia in a patient with biliary tract stent insertion to resolve the biliary tract obstruction by multiple pseudocysts in the pancreatic head region. Leuconostic lactis isolated from the blood of the patients was confirmed by 16S rRNA sequencing and this isolate was susceptible against most antibiotics, including levofloxacin, penicillin, erythromycin and cefotaxime except vancomycin. The septic shock and multi-organ failure was abruptly progressed due to delayed use of adequate antibiotic. Using vancomycin as the empirical antibiotics in a bacteremic patient by Gram positive cocci, the treatment failures by the isolates with intrinsic resistance against vancomycin have to be considered. In addition, the prompt and accurate identification of Leuconostoc spp. are very important to select the adequate antibiotics.

• 대한간호학회지
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• 제1권1호
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• pp.95-102
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• 1970

Ascariasis symptoms penetrated into biliary tract are reported to be found much more in Korea than in foreign countries. And the present writer believes there are also many cases of biliary tract symptoms that are actually experienced but that are not reported. As a result of experiencing and nursing twenty cases of ascariasis symptoms of biliary tract, the present writer has got several conclusions, and reports them together with reference to sundry records. (1) The penetrating rate of ascariasis in male versus female was 1 to 1.5. Consequently the rate of female was higher than that of male. The highest age of the case was 67, the lowest 19, and the average age was 45.2. (2) As to symptoms, right upper quadrant abdomen pain and fat diet intolerance were the largest in number. By laboratory findings there were depressive pain on right upper quadrant abdomen in all the cases. (3) As to the location of ascariasis, choledochus occupied the largest part, and the longer illness history was, the more cases coexisting with calculus were found. (4) As to operative method, cholecystectomy and choledochotomy weres the largest in number, and choledochotomy T-tube was inserted in all cases. As to complication after operation, there were operative wound infection, excoriation through bile juice issue, etc. There were three cases of re-penetration of ascariasis and only one case of reoperation.

• 대한미생물학회지
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• 제20권1호
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• pp.35-44
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• 1985

Isolation and identification of anaerobic bacteria from blood cultures are still technically demanding procedures. Recently, with the use of gas liquid chromatography, the accuracy of identification is much improved. However, there has never been a satisfactory data analysis on anaerobic bacteremia in Korea. The authors evaluated both the clinical and the bacteriological data of 129 anaerobic bacteremias found at the Yonsei Medical Center during the period of 1973 to 1984. The most frequently isolated anaerobic bacteria were Bacteroides (52.7%), among which the major species was B. fragilis (38.7%). Incidence of anaerobic bacteremia by sex was 57% in male and 43% in female. Mortality was higg in groups below 1-year old and above 50-year old. The cause of death seemed closely correlated with the patient's age, general condition and the severity of the underlying disease. Various neoplasms were the most common (20%) underlying diseases predisposing the anaerobic bacteremia. Biliary tract was considered the most frequent route of infection in anaerobic bacteremia. The frequent clinical signs in anaerobic bacteremia were fever (65%), followed by liver function abnormality (29%), jaundice (20%) and hypotention(18%). When analysis of positive rate of blood culture was made on the patients from whom 4 cultures were done within 24 hours, it was found that 33% of the samples were positive. Isolation rate of anaerobic bacteria in thioglycollate medium was 83.8%, while it was 44% in Tryptic soy broth. Among the anaerobic bacteremia, 25.4% were polymicrobial infections with aerobic bacteria (92.5%), such as E. coli(33.3%). From these studies, it is concluded that B. fragilis is the most important causative organism in anaerobic bacteremia, with high fatality, particularly in those who have underlying diseases. The ports of entry are mainly biliary, gastrointestinal and female genital tract. Fever is the most frequent clinical sign. Single blood culture is not sufficient to detect all anaerobic bacteremia, therefore more cultures with optimal time interval are needed. The incidence of polymicrobial infection in anaerobic bacteremia is higher than that in overall bacteremia.

• Journal of Yeungnam Medical Science
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• 제7권1호
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• pp.165-171
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• 1990

영남대학교 의과대학 외과학교실에서는 1989년 11월에 한국에서 발병한 간흡충병의 여섯번째 증례로, 특히 간내 담관에 발생한 첫 증례를 우측 간엽 절제술 및 담낭 적출술로 좋은 결과를 얻었으며, 간내 담관에 발생한 경우에는 간암과의 구별이 요구되어야 한다는 점을 상기 시키면서 증례보고와 더불어 문헌적 고찰을 하였다.

• Advances in pediatric surgery
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• 제2권1호
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• pp.17-25
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• 1996

Acute pancreatitis(AP) in children is not common but can be associated with severe morbidity rates and its diagnosis is often delayed. Thus, reported mortality rates range from 0 to 78%. We have treated 26 patients with AP from 5 to 17 years of age over the past 17 years. We are intended to assess the relevance of the prognostic criteria used to assess severity of adult AP and to review the etiology, clilical presentation, diagnosis, and management of AP in children. The authors retrospectively reviewed 26 children with AP managed in Kyung Hee University Hospital from 1978 to 1995. Among 26 patients with AP, male were 12, and female were 14. And the mean age of patients was 11.8 years. In 9(34.6%), no definitive cause was identified. Common causes of AP were trauma(23.1%) and biliary tract disease(23.1%). Other etiologies were viral infection(15.4%) and post ERCP(3.8%). The presenting features were abdominal pain(92.3%), vomiting(61.5%), fever(19.2%), submandibular pain(11.5%), and abdominal mass(7.6%). Back pain was rare(3.8%). Abdominal ultrasonographic findings were abnormal in 10 of 16 patients(62.5%) and abdominal CT findings were abnormal for 9 of 9 patients(100%). Seventeen patients(65.3%) were managed conservatively, and nine patients(34.6%) required surgical treatment. There was no mortality. To evaluate the severity of disease, we used the Imrie prognostic criteria used to assess the severity in adult AP. The number of positive criteria was correlated to the duration of hospitalization(r2=0.91) but statistically insignificant(p>0.05). But, the number of positive criteria was correlated to the operative incidence(r2=0.93) and statistically significant(p<0.05). The common causes of AP in children were unknown origin(34.6%), trauma(23.1%), and biliary tract disease(23.1%). Ultrasonography and computed tomography were useful imaging tools of AP in children. The Imrie criteria used to evaluate the severity in adult AP were suspected to be valuable to assess the severity of AP in children.

• Journal of Yeungnam Medical Science
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• 제23권2호
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• pp.171-181
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• 2006

간흡충은 담도계를 침범하여 황달, 담도염 및 담도계암 등의 합병증을 유발하는 기생충으로 예방과 치료가 가능함에도 불구하고 감염의 빈도가 줄지 않고 있다. 한편 간흡충에 감염이 되더라도 증상이 없이 발견되기도 한다. 평균 3.3%의 감염률을 보였으며, 대상 환자 1,063명의 남녀 성비는 3.6：1로 남자가 높았으며, 남녀 모두 40~60대에서 가장 높은 빈도를 차지하였다. 내원 당시 환자들은 증상이 없는 경우가 76.5%로 가장 많았으며, 증상 중에는 우상복부 동통이 전체의 7.6%, 상복부 동통이 7.2%를 차지하였다. ALP는 85.2%에서, GGT는 56.0%에서 정상범위를 보였으며 그리고 호산구수의 증가는 전체의 66.1%를 차지하였다. 복부초음파 소견은 정상적인 경우가 전체의 46.5 %, 지방간은 22.9% 그리고 coarse parenchymal echogenicity는 7.0%를 차지하였으며 ERCP 검사에서는 전체의 32.5%에서 말단부의 담도 확장 소견을 보였다. 간흡충과 동반된 간담도계 질환으로는 지방간이 21.0%로 가장 높은 빈도를 차지했고, 다음으로 담낭 결석이 4.7%로 빈도가 높았으며, 또한 담도계의 종양은 전체 환자의 3.5%를 차지하였다. 간흡충증은 여전히 우리나라에서 빈번히 발견되고 있으며 자각증상이 없이 우연히 발견되는 경우가 많다. 증상이 없더라도 민물고기 생식을 한 적이 있거나, 간검사의 이상, 호산구수 상승 또는 영상학적 검사에서 기생충의 감염이 의심되는 경우에는 간흡충증의 가능성을 염두에 두어야 한다.

• Archives of Pharmacal Research
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• 제28권2호
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• pp.203-208
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• 2005

Scoparone is a major component of the shoot of Artemisia capillaris (Compositae), which has been used for the treatment of hepatitis and biliary tract infection in oriental countries. In the present study we observed that, scorparone exhibited no cytotoxic effect in unstimulated macrophages, but reduced the release of nitric oxide (NO) and prostaglandin $E_2\;(PGE_2)$ upon stimulation by IFN-${\gamma}$/LPS or LPS. The inhibitory effects were found to be in conjuction with the suppression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in IFN-${\gamma}$/LPS stimulated RAW 264.7 cells. Moreover, scoparone also attenuated the production of tumor necrosis factor (TNF)-${\alpha}$, interleukin (IL)-$1{\beta}$ and IL-6 in LPS-stimulated RAW264.7 cells. These results suggest that scoparone decreases the production of the inflammatory mediators such as NO and $PGE_2$ in macrophages by inhibiting iNOS and COX-2 expression.

• Tuberculosis and Respiratory Diseases
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• 제65권2호
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• pp.131-136
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• 2008

담즙흉은 담도 또는 담낭과 흉강 사이에 형성된 누공을 통해 담즙이 흉강으로 누출되어 흉수의 형태로 관찰되는 흉막염의 일종으로, 주로 흉강-복부 외상과 관련된 매우 드문 합병증이며 그동안 국내에는 담즙흉에 대한 문헌보고가 없었다. 이에 저자들은 최근 외상 후 흉막성 흉통과 호흡곤란을 호소하였고 담도결석 제거를 위한 경피경간담도내시경술 이후에 흉수가 발생한 환자에서 담즙흉으로 진단된 환자 1예를 경험하였기에 보고한다.