• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.27 no.3
• /
• pp.241-250
• /
• 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
• /
• v.13 no.5
• /
• pp.1963-1969
• /
• 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.

• Biomedical Science Letters
• /
• v.19 no.3
• /
• pp.280-283
• /
• 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.

• Journal of Korean Academy of Nursing
• /
• v.1 no.1
• /
• pp.95-102
• /
• 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.

• The Journal of the Korean Society for Microbiology
• /
• v.20 no.1
• /
• pp.35-44
• /
• 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
• /
• v.7 no.1
• /
• pp.165-171
• /
• 1990

Human Fasciola hepatica infection is a rare entity involving infestation of the liver and biliary tree with adult flukes. which can result in hepatitis. cirrhos is and biliary tract inflammation. obstruction and lithiasis. The patient had the typical diagnostic tetrad of fever. eosinophilic leukocytos is. tender hepatomegaly and fluke ova in the stools. Theatment consistes of Emetine hydrochloride administration for hepatic involvement and common bile duct exploration for removal of flukes. with cholecystectomy for associated cholelithiasis. The combination of medical and surgical therapy cal be expected to produce an arrest of this infection. The removed liver revealed eggs of the fasciols species in the intrahepatic bile duct. The clinical history. pathological findings and treatment of this case were described.

• Advances in pediatric surgery
• /
• v.2 no.1
• /
• pp.17-25
• /
• 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
• /
• v.23 no.2
• /
• pp.171-181
• /
• 2006

Background: $Clonorchis$ $sinensis$ is an important human parasite that is usually found in the biliary tract. It is widely distributed in East Asia in Taiwan, Japan, China and Korea. About 2 million people are estimated to be infected with $C.$ $sinensis$ in Korea. This study was conducted to evaluate the state of infestation and clinical aspects of $C.$ $sinensis$. Material and Methods: We evaluate 1,063 patients with clonorchiasis retrospectively at Yeungnam University Hospital and Health Promotion Center from January 2001 to December 2003. All patients were diagnosed by a positive stool test for $C.$ $sinensis$ eggs. Clinical features, laboratory data and imaging studies were evaluated. Results: The ratio between affected males and females was 3.6 : 1. The highest infection rate was noted in the 40-60 age groups regardless of sex. The infection rate of $C.$ $sinensis$ among the residents of urban areas was higher than in rural areas. There were 813 (76.5%) patients who were asymptomatic. Common symptoms included right upper abdominal pain in 7.6% and epigastric pain in 7.2%. For the laboratory studies, serum ALP and GGT levels were within normal limits in 85.2% and 56.0% respectively. Peripheral eosinophilia was noted in 66.1% of cases. Of the 83 cases undergoing ERCP, 27 cases (32.5%) showed peripheral dilatation of the intrahepatic duct. Conclusion: This study suggests that $C.$ $sinensis$ infection is still endemic even in rural areas of Korea and that asymptomatic infections are common. Further work should be focused on the early diagnosis and treatment of patients with subclinical infection.

• Archives of Pharmacal Research
• /
• v.28 no.2
• /
• pp.203-208
• /
• 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
• /
• v.65 no.2
• /
• pp.131-136
• /
• 2008

Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.