• Advances in pediatric surgery
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• 제7권1호
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• pp.68-72
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• 2001

Prenatally diagnosed neuroblastomas have been reported in increasing numbers over the past several years. The vast majority are in favorable stages of the disease (stage I, II, IV-S). The authors experienced one case of stage IV-S neuroblastoma of the adrenal gland with liver metastasis, which regressed spontaneously after removal by adrenalectomy. This patient was noticed to have an abdominal mass at prenatal ultrasonography performed at 36weeks of gestation. This tumor was a neuroblastoma of the left adrenal gland with multiple liver metastases. Left adrenalectomy and liver biopsy were performed at 3 months of age. Thirty-eight months after surgery, an MRI demonstrated that the hepatic metastatic lesions had completely regressed without chemotherapy or radiation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권3호
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• pp.199-206
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• 2016

Purpose: To analyze the associations among the degrees of nonalcoholic fatty liver disease (NAFLD) by ultrasonography and metabolic syndrome, degrees of obesity in children, and degrees of parental obesity. Methods: A total of 198 children with obesity who visited a pediatric obesity clinic were prospectively enrolled in this study. The severity of NAFLD based on ultrasonography was classified into no, mild, moderate, or severe NAFLD group. The degree of obesity based on the percentage over standard weight for height per sex was classified into mild, moderate, or severe. Results: Of 132 patients evaluated for the degree of NAFLD and metabolic syndrome, the p-value of correlation between the two factors was 0.009. Therefore, metabolic syndrome might significantly affect the degree of NAFLD. Of 158 patients evaluated for the degree of NAFLD and the degree of obesity, the p-value of correlation between the two factors was 0.122. Of 154 patients evaluated for the degree of obesity and father's obesity, the p-value was 0.076. Of 159 patients evaluated for the degree of obesity and mother's obesity, the p-value was 0.000, indicating that mother's obesity could significantly affect the degree of obesity in children. Of 142 patients evaluated for the degree of obesity and metabolic syndrome, the p-value was 0.288. Conclusion: Metabolic syndrome might significantly affect the degree of nonalcoholic fatty liver in children. In addition, mother's obesity might be a significant factor that affects the degree of obesity in children.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3931-3936
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• 2015

Fatty liver disease (FLD) can be a precondition for other liver pathology including cholangiocarcinoma (CCA). Diabetes mellitus (DM) has been suggested in some studies to be a risk factor for FLD as well as cancers, including cholangiocellular carcinoma; however, there are currently very few studies on FLD in DM subjects, although the rate of FLD continues to increase annually. To determine the association between DM and FLD ultrasonographic data were analyzed from the Cholangiocarcinoma Screening and Care Program (CASCAP), in northeast Thailand. DM was reported by the subjects based on the CASCAP health questionnaire. Factors that were associated with FLD were determined by prevalence, odds ratio (ORs) and its 95% confidence intervals (CIs) using multiple logistic regression. There were 45,263 subjects with a mean age of 53.46 (${\pm}9.25$) years. FLD was found in 36.3% of DM subjects but only in 20.7% of non-DM subjects. The association between DM and FLD was adjusted for all other factors including gender, age, education level, relatives diagnosed with CCA, smoking, alcohol consumption, and hepatitis B and C. The risk of DM in subjects having FLD was highly significant compared with the non-DM subjects (OR 2.13; 95%CI: 1.92 to 2.35; p-value < 0.001). Thus DM is significantly associated with FLD which in turn may facilitate the development of several diseases including CCA. DM should be taken into consideration in future ultrasonic investigations of FLD and CCA.

• 한국콘텐츠학회논문지
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• 제8권10호
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• pp.217-223
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• 2008

성인형 다낭성 간질환(adult polycystic liver disease, PLD)은 양성 질환으로 매우 드물고 상염색체우성 다낭성 신장질환(autosomal dominant polycystic kideny disease, ADPKD)을 동반한다. 다낭성 간질환(PLD)은 간실질에 여러 개의 미만성 낭성질환을 특징으로 하는 상염색체우성 유전성 질환이다. 간과 관련된 중요한 증상 또는 합병증이 발생할 수 있으며 이로 인하여 복강경 또는 간을 절제하거나 또는 절제 없이 천공설치술을 포함하는 치료가 이루어지며 간이식도 할 수 있다. 본 고찰에서는 복부 불쾌감이 있는 성인형 다낭성 간질환을 경험하였기에 초음파 검사와 복부 CT 소견에 대해 참고 문헌과 함께 보고하고자 한다.

• Pediatric Infection and Vaccine
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• 제4권1호
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• pp.167-173
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• 1997

Acute infectious mononucleosis, caused by Epstein-Barr virus(EBV), is a self limited lymphoproliferative illness that is common in adolescents and young adults. It shows many complications in multiple organ systems, but the hepatobiliary and the respiratory complication is uncommon. We report a case with thickened gallbladder wall and pneumonia as complications of acute infectious mononucleosis in a child. Also the related literature were reviewed. A 4 year old boy presented with a history of high fever, cough, and abdominal distension for 20days. Physical Examination revealed audible crackles in whole lung field and gross hepatomegaly. Chest X-ray showed pneumonia and liver function tests were abnormal. Ultrasonography and computed tomography revealed a thickened gallbladder wall and hepatosplenomegaly. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serologic tests. The patients's fever subsided 6 weeks later and pneumonia was recovered around this time. Liver function tests returned near normal 2 months later and ultrasonography of gallbladder was normal at this time.

• 한국임상수의학회지
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• 제30권2호
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• pp.111-114
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• 2013

4살령의 중성화된 암컷 미니어쳐 핀셔가 3년 5개월 동안의 지속적인 간효소 수치 상승으로 본원으로 내원하였다. 간효소 수치의 지속적인 상승은 반복적인 혈액검사를 통해 확인하였으며, 간효소 수치 상승 원인에 대한 정확한 진단을 위하여 추가적인 검사가 진행 되었다. 복부초음파검사에서 복강내의 어느 단면에서도 담낭을 확인할 수 없었다. 복부초음파검사에서 담낭의 무형성을 의심하였으며 컴퓨터단층촬영을 통해 담낭 무형성을 확인하였다. 이 증례는 미니어쳐 핀셔에서 컴퓨터단층촬영을 이용하여 담낭 무형성을 진단한 첫번째 증례보고이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.4131-4136
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• 2016

Background: The population in northeast Thailand continues to present with hepatobiliary abnormalities, particularly periductal fibrosis (PDF) which is the result of chronic infection with liver fluke (Opisthorchis viverini; OV) and may lead to the development of cholangiocarcinoma (CCA). Although the prevalence of OV infection has been decreased due to a liver fluke control program over decades, the prevalence of PDF remains high. This study aimed to investigate demographic factors associated with PDF risk based on ultrasonography (US) screening. Materials and Methods: This cross-sectional study is part of the Cholangiocarcinoma Screening and Care Program (CASCAP), a prospective cohort study. Multiple logistic regression was used for data analysis. Results: In 55,246 subjects, the overall prevalence of PDF was 33.0% (95%CI: 32.6 - 33.4). Males (33.9 %) were at higher risk for developing PDF than females (32.2 %) (ORcrude = 0.93; 95%CI: 0.89 - 0.96; p-value < 0.001). Factors associated with an increased PDF risk, in addition to OV infection, included old age (${\geq}70$ years) (ORadj = 1.28, 95% CI: 1.14 - 1.44, p < 0.001) and hepatitis B infection (ORadj = 1.31, 95% CI: 1.11 - 1.55, p = 0.001). In contrast, number of praziquantel treatments (> 2 times) (ORadj = 0.54, 95% CI: 0.47 - 0.63, p < 0.001) and diabetes mellitus (ORadj = 0.57, 95% CI: 0.49 - 0.65, p < 0.001) were significantly associated with a decreased PDF risk. Conclusions: Future US screening should closely examine older people and hepatitis B subjects for the purpose of PDF surveillance among high risk groups for CCA. However, the results of inverse associations require further investigation in order to confirm our findings.

• 디지털융복합연구
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• 제12권3호
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• pp.345-352
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• 2014

지방간은 초음파검사에 의해 진단되는 임상적으로 흔한 간질환이다. 본 연구에서는 지방간과 대장암의 전구병변인 대장용종과의 연관성을 분석하여 지방간에 대한 보다 포괄적인 접근방법을 제시하고자 한다. 2012년부터 2013년 1년 동안 청주소재 소화기내과전문센터에서 복부초음파와 대장내시경검사를 동시에 시행한 만성간질환이나 대장질환이 없는 성인 348명을 대상으로 하였다. 지방간과 대장용종의 Chi-Square test에서 지방간이 있는 사람이 지방간이 없는 사람보다 유의미하게 용종이 많이 발생하였다(p<.001). 각 요인별 상관관계를 보았을 때 지방간과 대장용종간의 상관관계가 가장 높았다(p<.001). 다중회귀분석에서는 지방간(OR 3.80; 95% CI 1.93.-7.50), 공복 시 혈당(OR 2.51; 95% CI 1.12-5.62), 나이(OR 2.12; 95% CI 1.27-3.54) 이 대장용종의 발생에 유의미하게 작용하였다. 이상의 연구결과에서 초음파검사로 진단된 지방간이 대장용종의 발생에 있어 유의미한 영향력을 나타내어 지방간으로 진단되었을 때에는 대장내시경검사를 좀 더 적극적으로 고려해보는 것이 좋을 것이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제15권2호
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• pp.111-116
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• 2012

Toxic hepatitis is a rare but devastating disease in children. Herbs are widely used in oriental medicine to treat various symptoms in Korea, however, several herbs have been reported to induce liver injury. We report a case of toxic hepatitis induced by Hovenia dulcis in a 3-year-old boy. He complained of nausea, abdominal discomfort, and jaundice. The patient had consumed water boiled with hovenia dulcis for about 1 year prior to presentation. A diagnosis of toxic hepatitis was made based on his history, laboratory data, viral markers, ultrasonography, and biopsied liver tissue. We administered supportive management for acute fulminant hepatitis but his symptoms and liver function progressed. He was transferred to another hospital for further evaluation and consideration for liver transplantation. Because acute liver failure due to herbs or dietary supplement taken for a long time is often fetal, it is important to make early diagnosis and stop taking the drug as soon as drug induced liver injury is suspected.

• Journal of Gastric Cancer
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• 제11권1호
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• pp.64-68
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• 2011

A 54 year old man was referred to our hospital with gastric cancer. The patient had a history of splenectomy and a left nephrectomy as a result of a traffic accident 15 years earlier. The endoscopic findings were advanced gastric cancer at the lower body of the stomach. Abdominal ultrasonography (USG) and magnetic resonance imaging demonstrated a metastatic nodule in the S2 segment of the liver. Eventually, the clinical stage was determined to be cT2cN1cM1 and a radical distal gastrectomy, lateral segmentectomy of the liver were performed. The histopathology findings confirmed the diagnosis of intrahepatic splenosis, omental splenosis. Hepatic splenosis is not rare in patients with a history of splenic trauma or splenectomy. Nevertheless, this is the first report describing a patient with gastric cancer and intrahepatic splenosis that was misinterpreted as a liver metastatic nodule. Intra-operative USG guided fine needle aspiration should be considered to avoid unnecessary liver resections in patients with a suspicious hepatic metastasis.