• Clinical and Experimental Pediatrics
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• 제56권11호
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• pp.500-504
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• 2013

Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

• Korean Journal of Radiology
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• 제2권4호
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• pp.204-209
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• 2001

Objective: To determine the feasibility of transcaval transjugular intrahepatic portosystemic shunt (TIPS) in patients with occluded previous TIPS. Materials and Methods: Between February 1996 and December 2000 we performed five transcaval TIPS procedures in four patients with recurrent gastric cardiac variceal bleeding. All four had occluded TIPS, which was between the hepatic and portal vein. The interval between initial TIPS placement and revisional procedures with transcaval TIPS varied between three and 31 months; one patient underwent transcaval TIPS twice, with a 31-month interval. After revision of the occluded shunt failed, direct cavoportal puncture at the retrohepatic segment of the IVC was attempted. Results: Transcaval TIPS placement was technically successful in all cases. In three, tractography revealed slight leakage of contrast materials into hepatic subcapsular or subdiaphragmatic pericaval space. There was no evidence of propagation of extravasated contrast materials through the retroperitoneal space or spillage into the peritoneal space. After the tract was dilated by a bare stent, no patient experienced trans-stent bleeding and no serious procedure-related complications occurred. After successful shunt creation, variceal bleeding ceased in all patients. Conclusion: Transcaval TIPS placement is an effective and safe alternative treatment in patients with occluded previous TIPS and no hepatic veins suitable for new TIPS.

• Asian-Australasian Journal of Animal Sciences
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• 제18권9호
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• pp.1255-1261
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• 2005

The objective of this study was to evaluate the net flux response of nitrogen compounds (alpha-amino N, ammonia N, urea N, essential amino acids) across the portal-drained viscera (PDV), liver and total splanchnic tissues of mature wethers to increasing level of dietary fishmeal (FM) supplementation. Four wethers (average body weight, 64 kg) with chronic indwelling catheters into the portal, hepatic and mesenteric veins and the abdominal aorta were used in a 4${\times}$4 Latin square design. A basal diet consisting of 0.7 hay and 0.3 concentrate was fed twice daily with a fixed amount at 1.4 times maintenance energy (1.3 kg/day on a dry matter basis). The supplementation proportion of FM as treatment was 0, 0.03, 0.06 and 0.09 to the amount of the basal diet to contain 119, 137, 154 and 170 g crude protein per kg dietary dry matter, respectively. Blood flows through PDV and liver did not differ (p>0.05) among the treatments. Both net PDV release and hepatic uptake of alpha amino acid N increased linearly (p<0.05) in response to increased dietary FM, which resulted in similar total splanchnic release of alpha-amino N among the treatments. Similarly, increased dietary FM increased net PDV absorption and hepatic removal of ammonia N linearly (p<0.05). Hepatic synthesis and total splanchnic release of urea N increased linearly (p<0.01) with increased dietary FM, but PDV uptake of urea N did not respond to increased dietary FM. Linear regression equations between the increases in FM N intake and PDV net flux indicated that 0.34 and 0.30 of FM N was absorbed in the form of alpha-amino N and ammonia N, respectively. The results demonstrated that FM supplementation provides more alpha-amino N than ammonia N to the liver, but the alpha-amino acid N absorption is less than the expected metabolizable protein N from FM supplementation.

• 한국콘텐츠학회논문지
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• 제10권9호
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• pp.259-266
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• 2010

고해상도 엑스선 영상장치인 마이크로 CT를 이용, 흰쥐 간의 전체적인 문맥상과 각 간엽(lobe)의 미세혈관구조를 관찰하여 4개 분절 간엽의 구조를 영상화 하였고, 단축면상의 데이터를 3D영상으로 재구성한 미세혈관 구조의 입체적인 영상을 획득할 수 있는 마이크로 CT에 대한 유용성을 알아보고자 하였다. 5마리의 간 중에서 손상이 가장 적은 1개의 간을 4 개의 분절 간엽으로 각각 절단하여 문맥의 미세구조를 이차원으로 구성하였으며, MIP기법을 이용하여 간 문맥 전체 미세혈관의 3D영상을 얻었으며, 각 간엽의 미세혈관은 6분지까지 관찰할 수 있었다. 6 분지까지의 크기를 측정한 결과 평균치는 1 branch : $0.51mm{\pm}0.08$, 2 branch : $0.32mm{\pm}0.12$, 3 branch : $0.23mm{\pm}0.11$, 4 branch : $0.19 mm{\pm}0.08$, 5 branch : $0.13mm{\pm}0.06$, 6 branch : $70.5{\mu}m{\pm}14.1$ 로 측정되었다. 본 연구의 실험 결과에서 획득한 3차원의 입체 영상과 미세혈관 구조의 발견은 향후 고해상력의 영상을 얻을 수 있는 마이크로 CT가 많이 이용될 수 있을 것으로 기대된다.

• Asian-Australasian Journal of Animal Sciences
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• 제22권3호
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• pp.371-377
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• 2009

The objectives of the present study were to investigate the effects of different dietary ratios of whole-crop corn silage and alfalfa hay on nitrogen (N) digestion, duodenal flow and metabolism across the portal-drained viscera (PDV) of growing beef steers, and to elucidate their relationships. Four steers (236${\pm}$7 kg BW) fitted with duodenal cannulae and chronic indwelling catheters into the portal and mesenteric veins and abdominal aorta were used in a 4${\times}$4 Latin square design. Animals were fed (at 12-h intervals) the 4 diets consisting of whole-crop corn silage (C) and alfalfa hay (A) in 80:20 (C8A2), 60:40 (C6A4), 40:60 (C4A6) and 20:80 (C2A8) ratios of which dietary crude protein (CP) was 10.5, 12.0, 13.5 and 15.0% of dry matter (DM), respectively. Feeding level was restricted to 95% of ad libitum intake to measure N digestion, blood flow and net flux of N across the PDV. Digestibility of DM and neutral detergent fiber and digestible energy intake linearly increased as the ratio of alfalfa hay increased. The N intake, duodenal flow and intestinal disappearance increased linearly with increasing alfalfa hay. Arterial and portal concentrations of ${\alpha}$-amino N showed a quadratic response to increasing levels of alfalfa hay and were the highest in steers fed the C6A4 diet. The net PDV release of ${\alpha}$-amino N and ammonia N increased linearly with increasing alfalfa hay, but urea N uptake by PDV did not differ among diets. As a percentage of apparently digested N in the total gut, net PDV release of ${\alpha}$-amino N linearly decreased from 66 to 48% with increasing alfalfa hay. Conversely, net PDV recovery of ${\alpha}$-amino N to intestinal N disappearance varied with increasing alfalfa hay accounting for 49, 50, 58 and 61% on C8A2, C6A4, C4A6 and C2A8 diets, respectively. Net PDV uptake of urea N, relative to apparently digested N, linearly decreased from 81 to 25% as alfalfa hay increased from 20 to 80% of DM intake. Considering PDV uptake of urea N, microbial efficiency and conversion of total tract digested N to PDV ${\alpha}$-amino N net supply, a diet consisting of 80% whole-crop corn silage and 20% alfalfa hay (10.5% CP) was the best, while considering the quantities of intestinal N disappearance and ${\alpha}$-amino N absorption, a diet of 20% whole-crop corn silage and 80% alfalfa hay (15% CP) would be preferred. The proportion of ${\alpha}$-amino N recovered by PDV relative to the intestinal N disappearance may vary with energy intake level of mixed forage diets.

• Parasites, Hosts and Diseases
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• 제51권4호
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• pp.475-477
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• 2013

Although alveolar echinococcosis (AE) can cause a serious disease with high mortality and morbidity similar to malign neoplasms. A 62-year-old woman admitted to a hospital located in Sivas, Turkey, with the complaints of fatigue and right upper abdominal pain. On contrast abdominal CT, a $54{\times}70{\times}45$ mm sized cystic lesion was detected in the left lobe of the liver that was seen to extend to the posterior mediastinum and invade the diaphragm, esophagus, and pericardium. The cystic lesion was seen to be occluding the inferior vena cava and left hepatic vein at the level where the hepatic veins poured into the inferior vena cava. Bilateral pleural effusion was also detected. We discussed this secondary Budd-Chiari Syndrome (BCS) case, resulting from the AE occlusion of the left hepatic vein and inferior vena cava, in light of the information in literature.

• 대한의생명과학회지
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• 제8권2호
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• pp.89-93
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• 2002

To investigate the postmortem changes in hepatic cell membrane, the rats were sacrificed with cervical dislocation and kept in an incubator at $25^{\circ}C$, 70% of humidity for 12 hours. The biochemical experiments in postmortem were done at 2, 4, 8 and 12 hours. The degree of rigor mortis and algor mortis were increased with the time during 12 hours. The contents of hepatic malondialdehyde were rapidly increased ai 2 hours, and gradually decreased afterward. In histological findings, after 8 hours, the clotted blood was seen in central vein and sinusoids, and especially portal veins were dilated a1though the structure of hepatic lobules was preserved well. Furthermore, both in the histochemical and enzymatic examinations, membrane bounding alkaline phosphatase activities were gradually decreased with the time. In conclusion, the activity of membrane bounding alkaline phosphatase was linearly decreased with time in the early postmortem period and so it might be referred to the possibility fur the estimation of death time in the early postmortem period.

• 한국임상수의학회지
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• 제26권1호
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• pp.86-90
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• 2009

An intact female, 5-year old, Shihtzu, weighing 3.2 kg with a history of depression, hypersalivation, dullness, and ataxia for 3 days was referred. Radiographic findings included microhepatica, bilateral renal calculi, and a cystic calculus. Ultrasonography showed microhepatica, decreased visibility of portal veins in the liver, bilateral renal calculi, a cystic calculus, and an abnormal tortuous dilated vessel in the craniodorsal abdomen. A single congenital extrahepatic portoazygous shunt was confirmed through operative mesenteric portography. The patient received surgery using an ameroid constrictor ring and recovered well.

• 대한수의학회지
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• 제7권2호
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• pp.46-50
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• 1967

The pathologic studies on the cottonseed meal poisoning in chicken were performed by feeding a diet containing 50 per cent cottonseed meal. The results obtained are summarized as follows: The specific effect of cottonseed meal on chicken was apparently limited to the parenchymatous tissue and blood vessels, where its major pathologic manifestations were degenerative changes in acute cases fed for a period of 7 days, while necrosis of portal and central veins of liver and consequent perivascular hemorrhage and coagulative necrosis of liver and intra-glomerular hemorrhage were characteristic lesions in chronic cases fed for a period 20, 40 and 60 days. In addition, specific cottonseed pigment cells were observed in small number in villus of small intestine in acute cases and in large number in villus, liver and spleen in chronic cases.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.248-251
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• 2013

Introduction: A post-traumatic mesenteric arteriovenous fistula (AVF) is extremely rare. Case Report: A previously healthy 26-year-old male was injured with an abdominal stab wound. Computed tomography (CT) showed liver injury, pancreas injury and a retropancreatic hematoma. We performed the hemostasis of the bleeding due to the liver injury, a distal pancreatectomy with splenectomy and evacuation of the retropancreatic hematoma. On the 5th postoperative day, an abdominal bruit and thrill was detected. CT and angiography showed an AVF between the superior mesenteric artery (SMA) and the inferior mesenteric vein with early enhancement of the portal vein (PV). The point of the AVF was about 4 cm from the SMA's orifice. After an emergent laparotomy and inframesocolic approach, the isolation of the SMA was performed by dissection and ligation of adjacent mesenteric tissues which was about 6 cm length from the nearby SMA orifice, preserving the major side branches of the SMA, because the exact point of the AVF could not be identified despite the shunt flow in the PV being audible during an intraoperative hand-held Doppler-shift measurement. After that, the shunt flow could not be detected by using an intraoperative hand-held Doppler-shift measuring device. CT two and a half months later showed no AVF. There were no major complications during a 19-month follow-up period. Conclusion: Early management of a post-traumatic mesenteric AVF is essential to avoid complications such as hemorrhage, congestive heart failure and portal hypertension.