• Title/Summary/Keyword: Portal Vein

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Radiographic and Ultrasonographic Diagnosis of Single Intrahepatic Portosystemic Shunt in a Dog (개의 단순 간내성 간문맥전신단락증의 영상진단학 및 치료 1예)

  • 전혜영;장동우
    • Journal of Veterinary Clinics
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    • v.20 no.4
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    • pp.508-515
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    • 2003
  • A 4-month-old 5.7 kg male Golden retriever with history of seizure, depression, lethargy and anorexia was referred to Veterinary Medical Teaching Hospital, Chungbuk National University. Hematologic examination revealed microcytosis and nonregenerative anemia. Serum chemical values showed increased serum ammonia (423 $\mu$mol/L), ALP (1101 U/L), r-GTP (13.9 U/L) and CPK (1454 U/L), and decreased total protein (4.9 g/dl) and BUN (1.6 mg/dl). Microhepatia was shown in survey abdominal radiographs. Color doppler ultrasonographic examination revealed dilated tortuous vein with turbulent flow within liver parenchyma. Intraoperative jejunoportography and intraoperative ultrasonography confirmed the location and size of single intrahepatic shunt vessel in the left medial liver lobe. Also, the anomalous vessel entering the caudal vena cava was identified beneath the diaphragm. The shunting vessel was ligated with using an Ameroid constrictor. General conditions, hematologic and serum chemical values resolved gradually after surgery. One month after surgery abdominal radiograph showed normal gastric axis and it was consistent whit the normal size liver. Normal echogenecity of liver and enlargement of portal vein were shown in ultrasonography. It is assumed that survey radiography and ultrasonography are useful for diagnosis of single intrahepatic shunt in a dog and especially jejunoportography vein portography and intraoperative ultrasonography are suitable for confirmation of the anatomic location and size of the shunting vessels.

A Study of Influencing Factors in the Effectiveness of Vascular and Hepatic Parenchyma Enhancement During Intravenous Injection of Contrast Medium (경정맥 조영제 주입시 혈관 및 간실질의 조영증강에 영향을 미치는 외부적 인자에 관한 연구)

  • Han Dong-Hyun;Chang Kun-Jo
    • Journal of The Korean Radiological Technologist Association
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    • v.30 no.1
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    • pp.131-142
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    • 2004
  • In this study, when intravenous contrast medium was injected in spiral CT study, the effects of injection volume, injection rate, injection mode, location and lumen of IV catheter on enhancement of contrast medium in aorta, portal vein and liver parenchym

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Hepatic Scintigraphic Findings of Budd-Chiari Syndrome due to Inferior Vena Caval Obstruction (하대정맥 폐색으로 인한 Budd-Chiari 증후군의 간신티그램 소견)

  • Kim, Sung-Hoon;Chung, Soo-Kyo;Byun, Jae-Young;Lee, Sung-Yong;Shinn, Kyung-Sub;Kim, Choon-Yul;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.1
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    • pp.47-53
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    • 1988
  • Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows : 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

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Diagnosis of Multiple Extrahepatic Portosystemic Shunt in Two Dogs (개의 다발성 간외성 간문맥전신단락증의 진단 2예)

  • Kim, Ju-Hyung;Han, Sung-Young;Chun, Hye-Young;Kim, Tae-Hun;Kang, Ji-Houn;Han, Tae-Sung;Na, Ki-Jeong;Yang, Mhan-Pyo;Kim, Gon-Hyung;Kang, Sang-Chul;Kim, Jae-Hoon;Chang, Dong-Woo
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.269-275
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    • 2007
  • Two dogs referred to Veterinary Medical Center, Chungbuk National University diagnosed as multiple extrahepatic portosystemic shunt were reported. The first dog was a 20-month-old, 8 kg, male Cocker spaniel with history of peritoneal effusion, diarrhea, anorexia and stunted growth. The second dog was a 3-year-old, 13.4 kg, male Jindo with a history of severe depression. Hematologic examination of first dog revealed mild microcytosis and nonregenerative anemia. All of 2 cases, serum chemical values showed increase of serum ammonia, ALP, r-GTP and glucose. In survey radiography, microhepatia was apparent. In the color Doppler ultrasonographic examination, the first dog revealed a dilated tortuous vein communicating with caudal vena cava was observed near the left kidney and the second dog revealed numerous shunting vessels ventral to L5 and L6. Transcolonic portal scintigraphy of the first dog confirmed the presence of portosystemic shunt. In intraoperative jejunoportography, the first dog showed single congenital extrahepatic portosystemic shunt and multiple acquired extrahepatic portosystemic shunts. The second dog showed multiple acquired extrahepatic portosystemic shunts. In these dogs, the presence of congenital and acquried portosystemic shunts and histopathologic findings were considered to represent a combination of multiple extrahepatic portosystemic shunts and noncirrhotic portal hypertension or portal vein hypoplasia.

Liver Cut Method Using 4 Points for Hepatic Volumerty at MDCT Image (MDCT 영상에서 간 체적 계산을 위한 4 점 이용 간 분할 방법)

  • Seo, Jeong-Joo;Cho, Baik-Hwan;Park, Jong-Won
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.47 no.1
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    • pp.17-24
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    • 2010
  • This paper proposed the method to separate a liver into left and right liver lobes for exact volumetry of the river graft at abdominal MDCT(Multi-Detector Computed Tomography) image before living donor liver transplantation. On the image of segmented liver, 4 points(the middle point of Inferior Vena Cava, a point of Middle Hepatic Vein, a point of Portal Vein, a middle point of gallbladder fossa) are selected. A liver is separated into left and right liver lobes on the basis of the 4 points. The volume and ratio of the river graft are estimated. The volume estimated using 4 points and the manual volume that radiologist processed and estimated are compared with the weight measured during surgery to support proof of the exact volumetry. After selection the 4 points, the time involved in separation a liver into left and right river lobe and volumetry of them is measured for confirmation that the algorithm can be used on real time during surgery. This study progressed to ensure donor's and recipient's safe who will undergo the liver transplantation.

Studies of Alterations in Spleno-Hepatic Reflex in Portal Hypertensive Cats (간문맥 고혈압 고양이에서 비-간 교감신경성 반사의 변동에 대한 연구)

  • Song, Hwan-Kyu;Rhim, Byung-Yong;Kim, Chi-Dae;Hong, Ki-Whan
    • The Korean Journal of Pharmacology
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    • v.23 no.1
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    • pp.15-23
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    • 1987
  • To elucidate the mechanism of splanchnic hyperemia associated with chronic portal hypertension, we have investigated the alteration in visceral reflexes in conjuction with circulatory hemodynamics in portal ligated portal hypertension in cats. When capsaicin, bradykinin and vasopressin were injected via splenic artery of sham cat, respectively, they caused not only reflex excitation of systemic arterial pressure, but also elevation of splenic venous pressure with unchanged heart rates. Simultaneously, they evoked the sympathetic efferent excitation of liver (spleno-hepatic reflex) as well as of spleen (spleno-splenic reflex). Similarly, capsaicin upon pledging on the liver surface evoked a significant increase in the pressor reflex with hepatic nerve excitation (hepato-hepatic reflex). After portal ligation, the splenic venous pressure was gradually elevated in association with decrease in systemic arterial pressure. However, the excitation of pressor reflex was enhanced on the and day, thereafter, being returned to the control, and the reflexly induced spleno-splenic, spleno-hepatic and hepato-hepatic sympathetic excitations were significantly diminished on the 8th day following portal vein ligation. In conclusion, it is suggested that sympathetic reflexes to spleen and liver are specifically intervened by the same central pathways and furthermore, the diminution of these viscero-visceral reflex excitations after portal ligation may be related to the intestinal hyperemia.

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Clinical Significance of Axin and β-catenin Protein Expression in Primary Hepatocellular Carcinomas

  • Guan, Cheng-Nong;Chen, Xin-Ming;Lou, Hai-Qing;Liao, Xiang-Hui;Chen, Bao-Ying;Zhang, Pei-Weng
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.677-681
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    • 2012
  • The aim of the present research was to investigate clinicopathologic correlations of immunohistochemically-demonstrated axin (axis inhibition) and ${\beta}$-catenin expression in primary hepatocellular carcinomas (HCCs), in comparison with paraneoplastic, cirrhotic and normal liver tissues. Variation in Axin expression across groups were significant (P < 0.01), correlating with alpha fetoprotein (AFP), HBsAg, cancer plugs in the portal vein, and clinical stage of HCCs(P < 0.05); however, there were no links with sex, age, and tumour size (P > 0.05). Differences in cell membrane ${\beta}$-catenin expression were also statistically significant (P < 0.01), again correlated with AFP, HBsAg, cancer plugs in the portal vein, and clinical stage in HCCs (P < 0.05) but not with sex, age, and tumour size (P > 0.05). Axin expression levels in tissues with reduced membrane ${\beta}$-catenin were low (P < 0.05), also being low with nuclear ${\beta}$-catenin expression (P < 0.05). Axin and ${\beta}$-catenin may play an important role in the genesis and progression of HCC via the Wnt signal transmission pathway. Simultaneous determination of axin, ${\beta}$-catenin, AFP, and HBsAg may be useful for early diagnosis, and metastatic and clinical staging of HCCs.

Roles of Fibroblast Growth Factor-inducible 14 in Hepatocellular Carcinoma

  • Li, Nan;Hu, Wen-Jun;Shi, Jie;Xue, Jie;Guo, Wei-Xing;Zhang, Yang;Guan, Dong-Xian;Liu, Shu-Peng;Cheng, Yu-Qiang;Wu, Meng-Chao;Xie, Dong;Liu, Shan-Rong;Cheng, Shu-Qun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3509-3514
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    • 2013
  • The prognostic value of the fibroblast growth factor-inducible 14 (Fn14) expression in hepatocellular carcinoma (HCC) is unknown. Real-time PCR (RT-PCR), western blot assays and immunohistochemistry analysis were here performed in order to compare Fn14 expressios in paired liver samples of HCC and normal liver tissue. Most of the tumor tissues expressed significantly higher levels of Fn14 compared to adjacent non-tumor tissues, with Fn14High accounting for 54.6% (142/260) of all patients. The Pearson ${\chi}^2$ test indicated that Fn14 expression was closely associated with serum alpha fetal protein (AFP) (P=0.002) and tumor number (p=0.019). Univariate and multivariate analyses revealed that along with tumor diameter and portal vein tumor thrombosis (PVTT ) type, Fn14 was an independent prognostic factor for both overall survival (OS) (HR=1.398, p=0.008) and recurrence (HR=1.541, p=0.001) rates. Fn14 overexpression HCC correlated with poor surgical outcome, and this molecule may be a candidate biomarker for prognosis as well as a target for therapy.

$^{67}Ga$ Scan of Primary Hepatocellular Carcinoma; Correlation with Angiography (원발성 간암의 $^{67}Ga$ Scan소견 ; 혈관조영술 소견과의 비교)

  • Kim, Myung-Joon;Yoo, Hyung-Sik;Lee, Jong-Tae;Suh, Jung-Ho;Park, Chang-Yun;Lee, Do-Yun
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.1
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    • pp.27-33
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    • 1989
  • The relationship between angiographic findings and those of $^{67}Ga$ scan was evaluated in 30 patients with primary hepatocellular carcinoma diagnosed by either pathological examination or laboratory, radiologic findings. Twenty-three cases revealed hot activities on $^{67}Ga$ scan and definite tumor stains on angiography. Main findings of $^{67}Ga$ scans of 7 cases were isoactivity in 5 and cold area in 2, 5 of which revealed faint or no tumor stain on angiography. Cold areas within the primary hepatocellular carcinoma were noted in 9 cases by $^{67}Ga$ scan. In 6 cases these were due to tumor necrosis. Remaining 3 cases had arterioportal shunt, portal vein thrombosis and one had necrosis as well. These results indicate that gallium uptake of primary hepatocellular carcinoma seems to be relatively correlated with tumor stains on angiography. It is well known that the necrotic portion of primary hepatocellular carcinoma does not uptake gallium and it's the main cause of cold areas on $^{67}Ga$ scan. And we suspect that the hemodynamic changes of primary hepatocellular carcinoma such as large arterioportal shunt, portal vein thromosis may cause the decreased activity on $^{67}Ga$ scan.

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Safety and Efficacy of Sequential Transcatheter Arterial Chemoembolization and Portal Vein Embolization prior to Major Hepatectomy for Patients with HCC

  • Xu, Chuan;Lv, Peng-Hua;Huang, Xin-En;Wang, Shu-Xiang;Sun, Ling;Wang, Fu-An;Wang, Li-Fu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.703-706
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    • 2014
  • Objective: To evaluate the safety and efficacy of sequential transcatheter arterial chemoembolization (TACE) and portal vein embolization (PVE) before major hepatectomy for patients with hepatocellur carcinoma (HCC). Methods: In this retrospective case-control study, data were collected from patients who underwent sequential TACE and PVE prior to major hemihepactectomy. Liver volumes were measured by computed tomography volumetry before TACE, and preoperation to assess degree of future remnant liver (FRL) hypertrophy and to check whether intro- or extrohepatic metastasis existed. Liver function was monitored by biochemistry after TACE, prior to and after major hepatectomy. Results: Mean average FRL volume increased 32.3-71.4% (mean 55.4%) compared with preoperative FRL volume. After TACE, liver enzymes were elevated, but returned to normal in four weeks. During PVE and resection, no patient had intro- or extrohepatic metastasis. Conclusion: Sequential TACE and PVE is an effective method to improve resection opportunity, expand the scope of surgical resection, and greatly reduce postoperative intra- and extrahepatic metastasis.