• Title/Summary/Keyword: biliary excretion

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A Case Report of Alcoholic Liver Disease with Jaundice and Eating Disorder (황달과 섭식장애를 주소증으로 하는 알코올성 간질환 환자 치험 1례)

  • Ji You Beag;Dae Sung Jung;Jae Ryong Bae
    • Journal of Korean Medical Ki-Gong Academy
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    • v.23 no.1
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    • pp.30-43
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    • 2024
  • Objective : The purpose of this study is to report a case of treating alcoholic liver disease patients with jaundice and eating disorder through Korean Medicine treatment. Methods : The patient was administered with additional Gagampyeongwi-san and Sinseonbulchuidan for 30 days. For acupuncture, the colonic reducing method (大腸勝格, LI-) and spleen tonifying method (脾正格, SP+) of hand acupuncture were applied. 內關 (PC6), 公孫 (SP4), 三陰交 (SP6), and 足三里 (ST36) were basically collected, and additional 率谷 (GB8), 合谷 (LI4), and 百會 (GV20) were additionally drained and collected by body acupuncture. During the inpatient treatment period, three liver function tests were performed. Results : AST and ALT were restored to the normal range, and γ-GTP and CPK were also reduced, indicating that alcoholic hepatitis was greatly recovered. Total bilirubin and direct bilirubin were also recovered close to normal, and it was predictable that the liver excretion capacity due to hepatocellular damage was also restored, and the findings of biliary obstruction were alleviated close to normal values. When looking at the rise of eGFR along with BUN and uric acid, it seems that kidney function was recovered and improved. Conclusions : Through the combination treatment of Korean Medicine and fluid treatment, it was effective in recovering jaundice and eating disorder for alcoholic liver disease.

The Synthesis and MR Properties of New Macromolecular MR Contrast Agent (새로운 거대분자 MR 조영제의 합성 및 MR 특성에 관한 연구)

  • 장용민;장영환;황문정;박현정;전경녀;이종민;배경수;강봉석
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.1
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    • pp.35-40
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    • 2002
  • Purpose : To evaluate the NMR relaxation properties and imaging characteristics of tissue-specificity for a newly developed macromolecular MR agent. Materials and methods : Phthalocyanine (PC) was chelated with paramagnetic ion, Mn.2.01g (5.2 mmol) of Phthalocyanine was mixed with 0.37g (1.4 mmol) of Mn chloride at $310^{\circ}C$ for 36 hours and then purified by chromatography (CHC13/CH3OH 98/2 v/v, Rf, 0.76) to obtain 1.04g (46%) of MnPC (molecular weight= 2000d). The $T1}T2$ relaxivity of MnPC was measured in 1.5T(64 MHz) MR using 0.1 mM MnPC. The MR image characteristics of MnPC was evaluated using spin-echo (TR/TE=500/14 msec) and gradient-echo (FLASH) (TR/TE=80/4 msec, flip angle=60) techniques in 1.57 MR scanner. The images of rabbit liver were obtained every 10 minutes up to 4 hours. To study the effect of concentration on image, 20 mM, 50 mM, 100 mM of MnPC were tested. Results : The relaxivities of MnPC at 1.5T(64MHz) were Rl=7.28 $mM^{-1}S^{-1},{\;}R2=55.56mM^{-1}S^{-1}$. Compared to the values of Gd-DTPA (Rl[=4.8 $mM^{-1}S^{-1})$], R2[=5.2 $mM^{-1}S^{-1}])$]), both T1/T2 relaxivities of MnPC were higher than those of Gd-DTPA. For both of SE and FLASH techniques, the contrast enhancement reached maximum at 10 minutes after bolus injection and the enhancement continued for more than 2 hours. When compared with small molecular weight liver agents such as Gd-EOB-DTPA, Gd-BOPTA and MnDPDP, MnPC was characterized by more prolonged enhancement time. The time course of MR images also revealed biliary excretion of MnPC. Conclusion : We developed a new macromolecular MR agent, MnPC. The relaxivities of MnPC were higher than those of small molecular weight Gd-chelate. Hepatic uptake and biliary excretion of MnPC suggests that this agent is a new liver-specific MR agent.

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Distribution of the fungicide hexaconazole in internal organs of carp (Cyprinus carpio L.) (살균제 hexaconazole의 잉어(Cyprinus carpio L.) 장기 중 분포)

  • Lee, Eun-Young;Park, In-Young;Kim, Byung-Seok;Park, Yeon-Ki;You, Oh-Jong;Park, Kyung-Hun;Kim, Kyun;Kyung, Kee-Sung
    • The Korean Journal of Pesticide Science
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    • v.11 no.4
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    • pp.217-221
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    • 2007
  • In order to elucidate the behavior of the fungicide hexaconazole (1-(6-chloro-3-pyrldyhnethyl)N-nitroimidazolidin-2-ylideneamine) in carp (Cyprinus carpio L.), carps were exposed to [$^{14}C$]hexaconazole at a predicted environmental concentration (PEC) of 0.32 mg $L^{-1}$ for 4 days under static conditions. Hexaconazole in water was absorbed into carps to reach the maximum concentration 2 days after exposure. The amounts of the [$^{14}C$]hexaconazole and its metabolites absorbed in gall were much higher than those in the other organs and especially those in gall 2 days after exposure were 25 and 67 times higher than those in liver and kidney, respectively, strongly suggesting that biliary excretion involving enterohepatic recirculation could be an import route for the elimination of hexaconazole absorbed in carps.

The Exon 2 Deletion of the COMMD1 Causing Copper Toxicosis in Bedlington Terriers in Korea (한국 베들링턴 테리어에서 구리중독증을 유발하는 COMMD1 유전자의 exon 2 결손변이)

  • Kim, Yun-Gi;Kim, So-Yeon;Yun, Young-Min
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.1-4
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    • 2015
  • This study was performed to survey prevalence of Copper metabolism domain containing 1 (COMMD1) mutation using molecular diagnostic method in a population of Bedlington terriers in Korea. COMMD1 gene (formerly MURR1) functions as a regulator of sodium transport and copper metabolism. The deletion of exon 2 of the COMMD1 gene causes copper toxicosis in Bedlington terriers. Bedlington terriers with this autosomal recessive disorder were shown to have the elevated liver copper levels due to genetic derangement in the biliary copper excretion pathway. DNA samples were extracted from whole blood collected from 257 Bedlington terriers (109 males, 148 females) of pet dog clubs in Korea. A multiplex PCR was carried out to detect of exon 2 deletion of COMMD1 gene. In this study, it was possible to know the existence and prevalence of exon 2 deletion of COMMD1 in Bedlington terriers in Korea. Of the 257 samples, 131 (51%) were wild type homozygous for the normal COMMD1 gene, 108 (42%) were heterozygous, having both normal and mutated copy of the COMMD1 gene. The eighteen (7%) were mutant type homozygous. The results of genetic analysis could help establish proper management strategy and selective breeding program to prevent COMMD1 mutation in Bedlington terriers in Korea.

Scintigraphic Features of Choledochal Cyst Using Technetium-99m-DISIDA Hepatobiliary Scan (총담관낭종의 $^{99m}Tc$-DISIDA 간담도 스캔)

  • Choi, Chung-Il;Kim, Jeong-Gyun;Bae, Sun-Kun;Kwak, Dong-Suk;Chung, Byung-Cheon;Lee, Jae-Tae;Lee, Kyu-Bo;Zeon, Seok-Kil;Lee, Hyung-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.71-80
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    • 1993
  • In order to evaluate the scintigraphic features of choledochal cyst and these diagnostic value, authors investigated the findings of fourteen patients with choledochal cyst undergone hepatobiliary scan with $^{99m}Tc$-DISIDA before surgery. Five cases demonstrated the decreased hepatic uptake at 5-minute image of which four cases revealed severe jaundice. Seven cases demonstrated visualization of the cystic dilated common bile duct within 1 hour after injection. Two cases showed the cyst activity between 1 and 12 hours, but the cyst activity was not visible in five cases. Nonvisualization of the gall bladder was noted in ten cases, while four cases demonstrated visualization of the gall bladder within 1 hour. The time of visualization of gut activity was variably delayed. The intestinal activity was found in three cases within 1 hour and appeared in three cases between 1 and 2 hours and eight cases showed no visible gut activity. In four cases, intrahepatic ductal prominence was visible on the scintigram. Seven cases showed early and persistent accumulation of tracer in the common bile duct. Three cases showed persistent photon-deficient area in the gall bladder region. Two cases showed early photon-deficient area around gall bladder region with progressive accumulation of tracer in the same region. Two cases showed no evidence of activity in the biliary tract but noted late excretion into the small intestine. We concluded that hepatobiliary scan using $^{99m}Tc$-DISIDA is a noninvasive test useful in the evaluation and the diagnosis of choledochal cyst.

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Behavior of the herbicide metolachlor in carps (제초제 metolachlor의 잉어체내 행적)

  • Kyung, Kee-Sung;Kim, Jin-Wha;Lee, Byung-Moo;Oh, Byung-Youl;Jeong, Young-Ho;Lee, Jae-Koo
    • The Korean Journal of Pesticide Science
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    • v.3 no.2
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    • pp.54-59
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    • 1999
  • In order to investigate the behavior of the herbicide metolachlor [2-chloro-6'-ethyl-N-(2-methoxy-1-methylethyl)aceto-O-toluidide] in fish, carps (Cyprinus carpio L.) were exposed to the herbicide at $LC_{10}$(1.93 mg/L) for 4 days. Metolachlor dissolved in water was absorbed rapidly into carps to mark the maximum concentration 6 hours after exposure. The amounts of the $^{14}C$-metolachlor and its metabolites absorbed in gall were much higher than those in the other parts, strongly suggesting that biliary excretion involving enterohepatic recirculation could be an important route for the elimination of metolachlor. The $^{14}C$-radioactivity distributed into aqueous phase fraction in test water and in carp extract was increased in time-dependent manner. Extraction rate of $^{14}C$ absorbed in carp tissues was decreased remarkably up to 6 hours after exposure, suggesting that the possible polar metabolites of metolachlor were transformed into the conjugates to form non-extractable bound residues.

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Some Observations on the Organelles Participating in the Biliary Excretion in the Hepatocyte of the Biligrafin Injected Mouse (Biligrafin 투여 마우스 간세포의 미세구조적 및 세포화학적 연구)

  • Kim, Hyang;Shin, Young-Chul
    • Applied Microscopy
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    • v.23 no.2
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    • pp.53-77
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    • 1993
  • In this study, an attempt was made to investigate the probable organelles participating in the secretion of biligrafin. The animals (ICR male mice, 25-30gm) were divided into normal control and 6 biligrafin injected groups to which 30% biligrafin (0.006ml/gm b.w.) were injected at 10, 20, 40, 80, 160 and 320 min prior to the sampling. The mice of each group were perfused through the heart with ice-cold 2.5% glutaraldehyde buffered with 0.1M Na-cacodylate (pH. 7.4) under the Na-pentobarbital (Nembtal 0.0015mg/gm b.w.) anesthesia and liver tissues were taken from each group. Some specimens were immersed 1 hr in the same solution used in the perfusion. After an overnight rinse in 0.1M Na-cacodylate buffer containing 10% DMSO and 7.6% sucrose, $75{\mu}m$ fronzen sections were made for cytochemical study. The sections were incubated in thiamin pyrophosphatase (TPPase) and inosine diphosphatase (ID Pase) media for 70 min at $37^{\circ}C$ respectively and acid phosphatase (AcPase) medium for 40 min at $37^{\circ}C$. They were postfixed in 1 % $OsO_4$ for 1 hr. The other specimens were immersed for 8 hrs in the fixative consisting of 2.5% glutaraldehyde and 3.0% paraformaldehyde buffered with Na-cacodylate (pH. 7.4). All of the osmificated specimens were processed for electron microscopy. In both normal and biligrafin injected groups, endoplasmic reticulum (ER), vacuoles, Golgi apparatus and lysosomes were seen in the vicinity of bile canaliculus. In the biligrafin injected groups, however, the Golgi apparatus appeared to be decreased and ER and vacuoles were dilated and increased. The rough endoplasmic reticulum (RER) having a few attached ribosomes appeared to be the round saccule, especially at 20 min after biligrafin injection. Smooth endoplasmic reticulum (SER) seemed to be formed by the detachment of ribosomes at the cisternal end of RER. The cistern of SER showed saccules which probably budded off to form the vacuole. The vacuoles were devoid of visible centents. This finding seemed to be in agreement with the biochemical property of the bile constituents. The fusion between the vacuoles and bile canaliculus were frequently seen in the groups injected with biligrafin. The lysosome did not show any changes in the biligrafin injected groups. Accumulation of some material and lipid droplets were seen at the 40 and 80 min after biligrafin injection, especially at the latter. At 160 and 320 min after biligrafin injections, however, they were decreased successively while the RER stack, free ribosomes and polysomes were increased. Although the reactive products of TPPase and IDPase were observed in the ER saccules and vesicles of the normal control and biligrafin injected groups, the fusion between the bile canaliculus and saccules or vesicles could easily be seen in the latter. The AcPase activity, however, was observed in the cistern at the maturing face of Golgi apparatus and lysosomes in both normal and biligrafin groups. The results suggest that the biligrafin is excreted via the vesicles, vacuoles or sacoules probably derived from the SER without the participation of Golgi apparatus and lysosomes, and the excess amount of material is stored as inclusions during the repairing of the organelles being overactive.

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Total Bilirubin Level as a Predictor of Suboptimal Image Quality of the Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI in Patients with Extrahepatic Bile Duct Cancer

  • Jeong Ah Hwang;Ji Hye Min;Seong Hyun Kim;Seo-Youn Choi;Ji Eun Lee;Ji Yoon Moon
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.389-401
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    • 2022
  • Objective: This study aimed to determine a factor for predicting suboptimal image quality of the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI in patients with extrahepatic bile duct (EHD) cancer before MRI examination. Materials and Methods: We retrospectively evaluated 259 patients (mean age ± standard deviation: 68.0 ± 8.3 years; 162 male and 97 female) with EHD cancer who underwent gadoxetic acid-enhanced MRI between 2011 and 2017. Patients were divided into a primary analysis set (n = 184) and a validation set (n = 75) based on the diagnosis date of January 2014. Two reviewers assigned the functional liver imaging score (FLIS) to reflect the HBP image quality. The FLIS consists of the sum of three HBP features, each scored on a 0-2 scale: liver parenchymal enhancement, biliary excretion, and signal intensity of the portal vein. Patients were classified into low-FLIS (0-3) or high-FLIS (4-6) groups. Multivariable analysis was performed to determine a predictor of low FLIS using serum biochemical and imaging parameters of cholestasis severity. The optimal cutoff value for predicting low FLIS was obtained using receiver operating characteristic analysis, and validation was performed. Results: Of the 259 patients, 140 (54.0%) and 119 (46.0%) were classified into the low-FLIS and high-FLIS groups, respectively. In the primary analysis set, total bilirubin was an independent factor associated with low FLIS (adjusted odds ratio per 1-mg/dL increase, 1.62; 95% confidence interval [CI], 1.32-1.98). The optimal cutoff value of total bilirubin for predicting low FLIS was 2.1 mg/dL with a sensitivity of 95.1% (95% CI: 88.9-98.4) and a specificity of 89.0% (95% CI: 80.2-94.9). In the validation set, the total bilirubin cutoff showed a sensitivity of 92.1% (95% CI: 78.6-98.3) and a specificity of 83.8% (95% CI: 68.0-93.8). Conclusion: Serum total bilirubin before acquisition of gadoxetic acid-enhanced MRI may help predict suboptimal HBP image quality in patients with EHD cancer.

The Comparative Imaging Study on Mn-phthalocyanine and Mangafodipir trisodium in Experimental VX2 Animal Model (실험적으로 유발시킨 VX2 동물모델에서의 Mn-phthalocyanine과 Mangafodipir trisodium의 비교영상)

  • Park Hyun-Jeong;Ko Sung-Min;Kim Yong-Sun;Chang Yongmin
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.1
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    • pp.32-41
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    • 2004
  • Purpose : To measure the NMR relaxation properties of MnPC, to observe the characteristics of liver enhancement patterns on MR images in experimentally implanted rabbit VX2 tumor model, and to estimate the possibility of tissue specific contrast agent for MnPC in comparison with the hepatobiliary agent. Materials and Methods : Phthalocyanine (PC) was chelated with paramagnetic ions, manganese (Mn). 2.01 g (5.2 mmol) of phthalocyanine was mixed with 0.37 g (1.4 nlmol) of Mn chloride at $310^{\circ}C$ for 36 hours and then purified by chromatography ($CHCl_3:\;CH_3OH=98:2$, volume ratio) to obtain 1.04 g $(46\%)$ of MnPC (molecular weight = 2000 daltons). The T1/T2 relaxivity (R1/R2) for MnPC were determined at a 1.5 T (64 MHz) MR spectrometer. VX2 tumor model was experimentally implanted in the liver parenchyma of rabbits. All MR studies were performed on 1.5 T. The human extremity radio frequency coil of a bird cage type was employed. MR images were acquired at 17 to 24 days after VX2 carcinoma implantation.4 mmol/kg MnPC and 0.01 mmol/kg Mn-DPDP were injected via the ear vein of rabbits. T1-weighted images were obtained with spin-echo (TR/TE=516/14 msec) and fast multiplanar spoiled gradient recalled (TR/TE : 80/4 msec, $60^{\circ}$ flip angle) pulse sequence. Fast spin-echo (TR/TE=1200/85 msec) was used to obtain the T2-weighted images. Results : The value of T1/T2 relaxivity (R1/R2) of MnPC was $7.28\;mM^{-1}S^{-1}$ and $55.56\;mM^{-1}S^{-1}$ respectively at 1.5 T (64 MHz). Because the T2 relaxivity of MnPC that bonded strongly, covalently manganese with phthalocyanine was very high, the signal intensity of liver parenchyma was decreased on postcontrast T2-weighted images and we could easily distinguish the VX2 carcinoma within the liver parenchyma. When MnPC was administrated intravenously, the tumor margin delineation was more remarkable than Mn-DPDP-enhanced images. The enhancement of liver parenchyma with MnPC persisted at relatively high levels over at least one hour after injection of the contrast agents. Conclusion : The hepatic uptake and biliary excretion of MnPC, which are similar to Mn-DPDP, suggest that this agent is a new liver-specific agent. Also, MnPC seems to be used as a dual contrast agent (T1 and T2) with high T2 relaxivity. However, it is warranted that MnPC needs further investigation as a potential contrast agent for MR imaging of the liver. That is, further characterizations of MnPC are needed in vivo and in vitro before clinical trials. The diagnostic potential of MnPC will also have to be examined more in the animal models of additional types.

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