• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권1호
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• pp.63-67
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• 2000

목 적: 신생아 담즙정체증의 흔한 원인중 하나인 담도폐쇄증의 진단에 많이 이용되고 있는 Tc-99m DISIDA간담도 주사의 진단적 의의에 대하여 알아보고자 하였다. 방 법: 1995년 1월부터 1999년 8월까지 4년 8개월 동안 서울 중앙병원 소아과와 소아외과에서 신생아담즙정체증으로 Tc-99m DISIDA간담도 주사를 시행한 60명의 환자를 대상으로 그 결과를 분석하였다. 결 과: 전체 60명의 환자 중에서 담도폐쇄증으로 14례(23%), 신생아 간염으로 33례(55%), 간내 담도형성부전증으로 9례(15%), 경정맥 고영양법으로 인한 황달로 4례(7%)가 진단되었다. Tc-99m DISIDA 간담도주사의 민감도는 100%를 보였고 특이도는 80%였다. 결 론: Tc-99m DISIDA 간담도주사에서 장관내 방사능이 관찰되면 담도폐쇄증을 진단에서 제외할 수 있지만 관찰되지 않을 경우에는 경피간침생검이나 시험적 개복술 등의 적극적인 진단방법을 고려해야 할 것으로 생각된다.

• Investigative Magnetic Resonance Imaging
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• 제5권1호
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• pp.49-56
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• 2001

목적 자기공명 담관췌장조영술(MR Cholangiopancreatography, 이하 MRCP)에서 음성 경구 조영제로 사용한 초상자성 산화철 (Superparamagnetic iron oxide, SPIO) 제제의 유용성을 영상 질의 향상 효과를 통하여 알아보고자 하였다. 대상 및 방법: 임상소견, 이학적 검사 및 초음파 검사에서 담도와 췌장질환이 의심되었던 48명의 환자와 자원자 6명을 대상으로 하였다 음성 경구 조영제로 사용한 SPIO 제재의 적정 농도의 선택을 위해 정주용 SPIO제재 0.5ml, 0.75m1, 1 ml, 1.5 ml 및 2ml을 500m1 물에 희석시켜 가상 실험을 통하여 72강조영상에서 물의 신호강도가 완전히 소실되는 최소농도를 산출하였다. MRCP영상은 1.57를 이용하여 지방억제 HASTE (half-courier acquisition single-shot turbo spin echo) 와 터보스핀에코(Turbo spin echo) 기법을 이용하여 얻었다. 조영 후 영상은 음성 경구 조영제 300m1를 경구 섭취하고 10분 후에 얻었고, 조영 전 후 영상을 최대 신호 투영법으로 재구성하였다. 영상 분석은 조영 전 영상에 비교하여 위 십이지장내의 액체의 고신호강도에 따른 총수담판 및 췌관의 묘출의 방해 정도 및 진단의 향상 정도를 두 명의 방사선과 의사가 합의하여 정성적으로 분석하였다. 결과: 가상 실험에서, 22.4 ugFe/ml 농도의 혼합액 (Feridex I ml 용액을 자유수 500m1에 희석하여 만든 농도)에서의 신호강도 소실 백분율의 증가가 가장 현저한 변화를 보였다. 영상분석에서는, 조영 후 영상이 조영 전 영상에 비해 영상의 질이 향상되었다. 또한 환자의 25% (12/48)에서 조영 전 영상에 비하여 더 정화한 진단을 가능하게 하였다. 결론. MRCP영상 획득 시 음성 경구 조명제로서 사용된 초상자성 산화철 (SPIO) 제재는 영상질의 향상시켜 담도 및 췌장질환을 평가하는데 유용할 것으로 사료된다.

• 대한핵의학회지
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• 제16권2호
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• pp.71-80
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• 1982

In the present communication, the results will be reported on a clinical study of how well scintigraphic visualization of the hepatobiliary elements and several commonly used clinical liver function tests correlate each other in various diseases oft hepatobiliary system. The demonstrability of the biliary tract, gallbladder (GB) and duodenum was rather closely paralleled to serum bilirubin level and less closely to alkaline phosphatase and rather poorly to SGOT and SGPT. The biliary tree could not be visualized scintigraphically when bilirubin exceeded 10.5mg/dl. The usefulness of Tc-99m EHIDA [N-(2,6-diethylacetanilido) iminodiacetic acid, made by Amersham, England] hepatobiliary scintigraphy (Tc EHIDA HBS) in settling diagnostic controversy and ambiguity raised by oral cholecystography, intravenous cholangiography and ultrasonography in many hepatobiliary diseases is well known. The purpose of this investigation was to semiquantitatively evaluate the scintigraphic demonstrability of the hepatobiliary tract, GB and duodenum following intravenous injection of Tc-99m EHIDA in normal subjects and in patients with a disturbed liver function from various hepatobiliary diseases. The hepatobiliary scintigraphy was performed in 10 normal subjects and 39 patients with various hepatobiliary diseases (Table 1) at the Dept. of Radiology, St. Mary's Hospital Catholic Medical College, Seoul, Korea during 2 years period from September 1979. Scintigraphic examination was started at end of 3 minutes after intravenous injection of Tc-99m EHIDA in the amount of $50{\mu}Ci/kg$ and was continued until after 30 minutes at 5 minutes interval. The imaging was usually terminated when the tracer could be seen in the duodenum. Late scintigrams were obatained at 1 1/2, 3, 4 and 6 hours when reeded. Scintigrams were analyzed in terms of promptness and clarity of visualization of the biliary tree, GB and duodenum and demonstrability of these anatomical landmarks was correlated with the values of liver function tests. The demonstrability of the common hepatic duct, common bile duct, GB and duodenum was closely paralleled to the level of serum bilirubin when it is less than 10.5 mg/dl as shown in figure 1. However when the bilirubin exceeded 10.5 mg/dl the time of visualization between protracted reaching a flat curve or plateau around 10.5 mg/dl. The biliary tract could not be visualized when the bilirubin was higher than 10.5 mg/dl. The correlability between scintigraphic demonstration and serum alkaline phosphatase was less strong and between scintigraphic demonstration and SGOT and SGPT was rather poor. The present clinical study confirmed the usefulness and limitation of Tc-99m EHIDA hepatobiliary scintigraphy in visulizing and diagnosing the biliary system and duodenum when radiogrpahy and ultrasonography failed to provide useful informations. Scintigraphy was very helpful in the diagnosis of neonatal hepatitis, biliary atresia, cholecystitis and extrahepatic biliary obstruction. The hepatobiliary system and duodenum were visualized when serum bilirubin level was less than 10.5 mg/dl, SGOT 135 units, SGPT 114 units and alkaline phosphatase 52.2 KAU.

• 대한영상의학회지
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• 제82권2호
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• pp.393-405
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• 2021

목적 다중 검출 전산화단층촬영(multidetector CT; 이하 MDCT) 영상에서 바터 팽대부의 샘근종과 국소 샘암종을 감별할 수 있는 영상 소견을 알아보고자 하였다. 대상과 방법 MDCT 영상을 이용하여 바터 팽대부의 샘근종이 있는 16명의 환자와 국소 샘암종이 있는 30명의 환자를 평가하였다. 우리는 병변의 크기와 감쇠정도, 병변의 균일한 조영 증강의 여부, 간외담관과 주췌관의 직경, 국소 림프절 종대 유무를 측정하였고, 혈액검사 결과도 분석하였다. 바터 팽대부의 국소 샘암종과 비교하여 샘근종을 시사하는 독립적 소견을 확인하기 위해 다변량 분석을 수행하였다. 결과 병변의 크기와 간외담관의 직경은 샘근종에서 국소 샘암종군보다 유의하게 작았다(all p < 0.001). 다변량 분석에서 병변의 크기가 1.3 cm보다 작은 것, 간외담관의 작경이 1.3 cm 보다 작은 것, alanine transaminase level이 31보다 낮은 소견은 바터 팽대부의 국소 샘암종과 비교하여 샘근종을 시사하는 통계적으로 의미 있는 독립적 소견으로 나타났다. 이러한 세 소견을 모두 만족하는 경우 바터 팽대부에 생긴 샘근종의 진단적 특이도는 93.3%였다. 결론 MDCT 영상에서 병변의 크기와 간외담관의 직경을 측정하여 바터 팽대부의 샘근종과 국소 샘암종의 감별에 도움을 받을 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1737-1742
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• 2015

Background: Mitochondrial DNA (mtDNA) mutations have been shown to be associated with cancer. This study explored whether mtDNA mutations enhance cholangiocarcinoma (CCA) development in individuals. Materials and Methods: The whole mitochondrial genome sequences of 25 CCA patient tissues were determined and compared to those of white blood cells from the corresponding individuals and 12 healthy controls. The mitochondrial genome was amplified using primers from Mitoseq and compared with the Cambridge Reference Sequence. Results: A total of 161 mutations were identified in CCA tissues and the corresponding white blood cells, indicating germline origins. Sixty-five (40%) were new. Nine mutations, representing those most frequently observed in CCA were tested on the larger cohort of 60 CCA patients and 55 controls. Similar occurrence frequencies were observed in both groups. Conclusions: While the correspondence between the cancer and mitochondrial genome mutation was low, it is of interest to explore the functions of the missense mutations in a larger cohort, given the possibility of targeting mitochondria for cancer markers and therapy in the future.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.228-231
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• 2012

Bronchobiliary fistula (BBF), defined as an abnormal communication between the biliary duct and bronchial trees, is a very rare condition. Bilioptysis is a pathognomonic finding for BBF. We studied a 58-year-old man, who had a BBF complicated by liver biloma that occurred after radiofrequency ablation. The diagnosis was confirmed by the presence of bile-stained sputum and an Endoscopic Retrograde Cholangio-Pancreatography. BBF was treated successfully by endoscopic sphincterotomy and biliary drainage with insertion of a double pig-tail plastic stent into the biloma. We suggest that the optimal choice of treatment modality for BBF depends on the natural course of the underlying disease, and the status of the biliary stricture.

• 대한수의학회지
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• 제36권2호
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• pp.417-428
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• 1996

In order to know the toxic effect and carcinogenic activity in rats and mice fed with juice of Korean native Petasites japonicus Maxim of its pellet(4% or 8%) which were dried, milled and mixed with basal diet, the investigations were carried out by macroscopy and histopathology. Macroscopically, although remarkable changes were not observed in the liver of mice, there were slight to moderate swelling of rat livers in the whole groups at 12 to 14 weeks after feeding and milky spots in rats fed with its juice and 8% pelleted Petasites japonicus Maxim diet and a normal diet for 1 week alternatively for 14 weeks. Moreover, moderate to severe swelling and milk spots were recognized in livers of all rats fed with its juice and 8% pellet or 8% pelleted Petasites japonicus Maxim for 16 weeks. But, in cases of rats fed with its juice and 4% pellet or 4% pelleted Petasites japonicus Maxim, only swelling of livers was recognized moderately or severely. Histopathologically, major lesions were found in livers of both rats and mice. There were congestion, hemorrhage, fatty change, focal necrosis, megalocytosis and hyperplasia of endothelial cell in livers of mice and rats, the additional lesions such as proliferation of bile duct and nodular regeneration with diffuse regenerating cells were seen in livers of rats. In addition, preneoplastic lesions, the areas of milky spots macroscopically, were observed in livers of rats fed with Petasites japonicus Maxim for 14 to 16 weeks. In a few cases, haemangioendothelial sarcoma in livers was detected in rats fed with Petasites japonicus Maxim for 16 weeks. Petasites japonicus maxim growing naturally in Korea seem to exhibit toxic effect especially in liver and it contained a causative agent of primary liver tumors.

• 한국미생물학회:학술대회논문집
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• 한국미생물학회 2001년도 추계학술대회
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• pp.77-81
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• 2001

Enterocytozoon bieneusi는 특히 AIDS환자에게 치명적인 질병을 초래하는 세균과 원충 중간단계의 병원체로서 현재 $30\~50\%$의 발생률오 AIDS환자로부터 가장 많이 발생되는 병원체로 알려져 있다. 하지만 이 병원체는 1980년 후반에서야 비로서 학계의 주목을 받기 시작했으며 환자에게 심한 만성설사, 기력 쇠진, 악성 영양 결핍 등을 주 임상증상으로 하고 있다. 이렇게 다양하고 심각한 질병을 일으킴에도 불구하고 현재까지 이 병원체에 대한 연구가 미흡하였다. 현재 이 병원체에 대한 가장 중요한 연구 중 연구 중 하나는 이 병원체에 대한 AIDS환자로의 전파 경로이다. 최근 여러 각도의 동물야외 조사 및 실험동물을 이용한 연구를 토대로 AIDS환자에 대한 이 병원체의 전파가능성은 감염동물에서부터 전파가 가장 중요한 경로가 될 거라 보고되고 있다.

• Advances in pediatric surgery
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• 제10권1호
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• pp.17-21
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• 2004

Improvement in prenatal ultrasonography is leading to diagnose choledochal cyst before birth and before onset of classical symptom more frequently. But, there is a controversy about optimal timing for Cyst excision of prenatally diagnosed asymptomatic choledochal cyst. To identify the most appropriate timing for surgery in prenatally diagnosed choledochal Cysts, we analyzed 6 patients who had operation for choledochal cysts within 30days after birth at the division of Pediatric Surgery, Samsung Medical Center and Inha University School of Medicine, from June 1995 to June 2002. Males were four and females 2, the mean age at operation was 11.2 days, and the median age 8.0 days. The range of gestational ages of the antenatal diagnosis of bile duct dilatation was 24 weeks to 32 weeks, mean was 38.3 weeks, and mean birth weight was 3,298.3 g. After birth, abdominal ultrasonography, hepatobiliary scintigraphy, and magnetic resonance cholangiopancratography (MRCP) were performed. Mean age at operation was 11.2 days. All patients had the cyst excision and Rouxen-Y hepaticojejunostomy. Immediate postoperative complication was not found. During the median follow-up period of 41 months, one patient was admitted due to cholangitis, and the other due to variceal bleeding. Early operative treatment of asymptomatic newborn is safe and effective to prevent developing complications later in life.

• Toxicological Research
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• 제19권2호
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• pp.105-114
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• 2003

TO evaluate an effect of cyclohexane treatment on the degree of liver damage, rats were induced liver damage with 10 or 17 times $CCl_4$ injection (0.1 m1/100 g body wt., 50% $CCl_4$ dis-solved in olive oil) at intervals of every other day. Cyclohexane (1.56 g/kg body wt., i.p.) was administrated to the animals at 48 hours after the last pretreatment of $CCl_4$ . Rats were sacrificed at 4 hours after injection of cyclohexane. On the basis of histopathological findings, liver weight/body weight (LW/ BW, %), activities of serum alanine aminotransferase (ALT), xanthine oxidase (XO) and akaline phosphatase (ALP), and contents of liver protein and manlondialdehyde (MDA), $CCl_4$ -pretreatment induced liver damage. And $CCl_4$ 17 times treated group showed more severe liver damage than $CCl_4$ 10 times treated group. Administration of one dose of cyclohexane to $CCl_4$ 10 times treated animals resulted in the enhanced liver damage; liver necrosis with proliferation of fibroblast and bile duct abnormality, and increase in hepatic MDA content and the activities of serum ALP and ALT, But the enhanced liver damage was not found in $CCl_4$ 17 times treated animals. Serum cyclohexanone concentrations at 4 or 8 hours after injection of cyclohexane were higher in all liver damaged groups than normal group and were somewhat higher In $CCl_4$ 17 times treated animals than $CCl_4$ 10 times treated ones. Among the oxygen free radical metabolizing enzymes, hepatic cytochrome P45O dependent aniline hydroxylase (CYPdAH) activity in cyclohexane metabolizing enzyme system was meaningfully increased by the injection of cyclohexane to the liver damaged rats, with increased Vmax and high affinity to aniline. LW/BW (%) and activities of serum XO and ALT were more significantly increased in liver damaged groups than normal group by administration of cyclohexanone. In conclusion, it is assumed that an enhancement of liver damage by injection of one dose of cyclohexane to liver damaged animals might be caused by oxygen free radicals and cyclohexanone.