• Journal of Digestive Cancer Research
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• v.3 no.1
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• pp.42-44
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• 2015

Anomalous union of the pancreaticobiliary duct (AUPBD) has been shown to predispose to carcinomas of the biliary tract (bile duct and gallbladder) and pancreatic cancer because of chronic recurrent inflammatory reaction due to pancreatic or bile juice refluxes. However, pancreatic duct would be less affected by the bile because of the relatively higher intraductal pressure of the pancreatic duct. We report a case of metachronous pancreatic cancer in AUPBD patient without choledochal cyst who underwent cholecystectomy because of gallbladder cancer.

• Journal of Digestive Cancer Research
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• v.4 no.2
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• pp.83-87
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• 2016

Till now, two distinct epithelial lesions, dysplasia and adenoma, are currently recognized as premalignant stages of gallbladder (GB) carcinogenesis. In these two carcinogenesis pathways, GB stones and polyps are regarded as one of the most important risk factors of GB carcinoma respectively. Although there still remain controversies for the indication of prophylactic cholecystectomy for GB stones and polyps due to lack of high-level evidence, the present review demonstrated that patients who have GB stones with more than 3 cm size, chronic typhoid carriers, porcelain GB, or anomalous pancreaticobiliary ductal union and patients with more than 1 cm sized GB polyp would be recommended prophylactic cholecystectomy.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3903-3909
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• 2016

Purpose: To evaluate the expression of Her2/neu and Ki-67 in benign and malignant gallbladder lesions, and to establish correlations with clinico-pathologic parameters. Materials and Methods: A retrospective analysis was conducted on formalin fixed paraffin embedded (FFPE) benign (n=25) and malignant gallbladder (n=25) tissue samples. Hematoxylin and eosin stained slides of each case were reviewed for: type of malignancy (whether adenocarcinoma, squamous cell carcinoma, or any other type), grade (well, moderate, and poor), depth of invasion, pre-neoplastic changes in adjacent mucosal epithelium like metaplasia and dysplasia. Immunohistochemistry for Her 2 neu and Ki-67 was performed and data analysis was conducted using SPSS 17 software. Chi-square test was used to compare categorical/dichotomous variables. P value of ${\leq}0.05$ was considered significant. Results: The difference of Her 2 neu expression and Ki67 index between benign and malignant groups was found to be statistically significant. Her2/neu positivity did not have any significant correlation with various clinicopathological parameters other than liver involvement. 5 cases of gallbladder cancer showed both Her2/neu and Ki67 positivity. Ten cases were Ki67 positive but Her2/neu negative while one case was Her2/neu positive but Ki67 negative. Conclusions: The present study demonstrated overexpression of Her2/neu and Ki67 in gallbladder cancer. A trend of decreasing Her2/neu expression with increasing grade of tumor was observed. Furthermore, greater Ki67 positivity was found in cases with lymph node metastasis and distant metastasis. Future studies with a larger number of patients will be required to precisely define the correlation of Her2/neu expression and Ki67 positivity with clinicopathological parameters. The results however are encouraging and suggest evaluation of Her2/neu as a candidate for targeted therapy.

• The Journal of Internal Korean Medicine
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• v.19 no.1
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• pp.318-328
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• 1998

The aqua-acupuncture blended with liquid medicine and acupuncture is known to be effective in treating various medical disorders. This study used gallbladders of bear (WoongDam, WD, Ursus arctos Linne) and pig(JeoDam, JD, Sus scrofa domestica Brisson) plus the stones from the ox gallbladder(WooHwang, WH, Bos taurus var, domesticus Gmelin) to produce the liquid medicine. For the acupuncture, acupoint of ST -36 which is located one finger breadth from the anterior crest of the tibia was selected. There were a couple of purposes in this experiment. First, the relationship between aqua-acupuncture and gastric activity was scrutinized. Secondly, the possibility of pig gallbladder as an alternative organ to bear gallbladder for making liquid medicine was evaluated. Thirdly, different injection concentration ratio of liquid medicine was tried to figure out the optimal dosage for the aqua-acupuncture. The data of the present results indicated that the mixtures of WD + WH and JD + WH have a similar hypotonic effect on the stomach. These findings illustrated that aqua-acupuncture or hydroacupuncture showed inhibitory effect on the stomach in addition to its well-known prophylactic value. Also the possible alternative medical organ of pig gallbladder was checked out since two mixtures illustrated very similar trends in suppressing the gastric activity. The injection concentration ratio was not very different between two mixtures in terms of gastric motility except a couple of ratio. In conclusion, the aqua-acupuncture is a promising way to control the gastric activity for better medical purposes and the gallbladder of pig was assessed as a prospective one for making a liquid medicine.

• The Journal of Internal Korean Medicine
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• v.43 no.3
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• pp.477-484
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• 2022

Objective: The purpose of this study was to report the improvement effect of symptoms of integrative cancer treatment (ICT) on recurrent gallbladder cancer patients. Methods: A 73-year-old patient with recurrent gallbladder cancer visited the Daejeon Korean Medicine Hospital of Daejeon University East West Cancer Center (EWCC) on February 2022. After the diagnosis of gallbladder cancer, the patient underwent cholecystectomy and relapsed during follow-up. After the operation, the cancer recurred during follow-up, and after radiation treatment, she had been receiving ICT since February 2022. The clinical outcomes were measured by X-ray, computed tomography (CT), laboratory findings, including tumor markers (CEA, CA19-9), and numeric rating scales (NRS). Results: After treatment, abdominal pain was relieved from NRS 5 to 2, and abdominal circumference decreased from 74.5 to 67. During and after treatment, we found neither hepatotoxicity nor nephrotoxicity in the laboratory findings. Conclusion: This case study suggests that ICT may improve symptoms in patients with gallbladder cancer.

• Applied Microscopy
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• v.22 no.2
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• pp.15-29
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• 1992

The gallbladder is known to have the function of the storage and the concentration of the bile produced by the liver. This function is carried out by the removal of water and inorganic electrolytes. Extrahepatic cholestasis or the impairment of excretion of the bile leads to the distension and loss of the function of the gallbladder. The purpose of this study was to examine the ultrastructural characteristics of the normal gallbladder epithelial cells, and their structural changes induced by the ligation of common bile duct of the rabbit. Common bile duct ligation was performed under ether anesthesia. The rabbits were sacrificed on the 1st, 3rd, 5th, 7th and 14th day, respectively after operations. The tissue blocks of the gallbladder were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde prior to fixation in 1% osmium tetroxide, and embedded in the araldite mixture, and observed with JEM 100 CX-II electron microscope. The results were as follows: 1. The normal gallbladder epithelium of adult rabbit demonstrated two cell types, the ordinary epthelial cell and the dark cell. The dark cells have electron dense cytoplasm, and were found much infrequently, whereas ordinary epthelial cells were found quite numerous. 2. The ordinary epthelial cells of normal gallbladder were provided with the regular microvilli at the free surface and the images of pinocytotic activities in the apical cytoplasm, and exhibit highly convoluted lateral surfaces with elaborated microfolds. These figures of the cells suggest that they are resorptive in functional activity. 3. In the early stages (1st, 3rd, 5th day groups) following the ligation, the apical cytoplasm of some cells is protruding from the free surface and lost their microvilli. Numerous mucous granules filled in the apical and supranuclear cytoplasm compactly. 4. In the late stages (7th, 14th day groups) following the ligation, many light cells containing mumerous mucous granules are seen, between the ordinary epthelial cells. Mucous granules are fused each other, and are discharged into the lumen from the apical cytoplasm. The lateral membranes are straight or undulating without any interdigitations. From the above results, it was concluded that in the cholestasis induced by the common bile duct ligation, there is a tendency for the mucosal epithelium of the rabbit gallbladder to have secretory rather than an absorptive function.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.2
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• pp.386-393
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• 2016

The incidence of gallbladder polyps are increasing due to the extended use of ultrasonography. Although there are various reports on the risk of gallbladder polyps, there are few studies of the relationships among the presence of metabolic syndrome including serum biochemistry, lifestyle and the development of gallbladder polyps. The aim of this study was to determine association of the presence of metabolic syndrome, including serum biochemistry, with the development of gallbladder polyps in the Korean population. Among the health examination examinees, 596 people, who underwent abdominal ultrasonography from January, 2013 to December 2013, were included in this study. Physical measurements also taken, such as height, weight, blood pressure, waist measurement, and BMI. The general characteristics including age, sex, smoking, and drinking as the related factors were checked. At the same time, various blood tests were performed and the fasting blood sugar was analyzed through blood-gathering to determine the presence of metabolic syndrome. Regarding the factors associated with gallbladder polyps, the results showed that being male, smoking, non-drinking were significantly high. In addition, testing positive for HBsAg and an increasing BMI was apparently higher the group with metabolic syndrome than the non-metabolic syndrome group. The highest predictive factors for gallbladder polyps was being male (1.8 times), followed by metabolic syndrome (2.3 times) and testing positive for HBsAg (2.6 times).

• Journal of Korean Traditional Oncology
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• v.21 no.1
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• pp.27-33
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• 2016

Background : This case is to report a gallbladder cancer patient treated with Korean Medicine who could not receive conventional cancer therapies such as operation and chemotherapy due to her underlying diseases, old age and poor performance. Method and Results : An eighty-year-old female patient was diagnosed with stage IV gallbladder cancer on Feb. 2014 and she already had hypertension, diabetes and Parkinsonism. Comprehensive Korean Medicine (KM) treatments instead of operation and chemotherapy were administrated due to her poor condition and old age. KM treatments were done focused on improving symptoms and quality of life combined with best supportive care. During KM treatments her abdominal pain was generally managed and she survived for 22 months. Conclusion : Further studies should be performed in the future to clarify the survival benefit and symptom management of comprehensive KM treatments.

• Proceedings of the Korean Society of Computer Information Conference
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• 2020.07a
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• pp.151-154
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• 2020

Metabolic syndrome (MS) is increasing as obesity increases in Korea. In this study, we investigated the relationship between MS and gallbladder polyp (GBP). We examined 9,861 subjects who visited a single health-screening center in Jeju between January 2009 and December 2019. MS was defined according to the revised National Cholesterol Education Program criteria. Multiple logistic regression analysis was performed after adjusting for age to evaluate the association between the components of MS and GBP. The estimated rates of MS and GBP among subjects were 28.5% and 4.8%, respectively. Multivariate analysis suggested that MS (odds ratio[OR] 1.405, P=0.006) was the only independent factor affecting GBP. In our study sample, MS was correlated with GBP. The prevalence of gallbladder polyp increased with an increase in the risk factors indicating MS.

• Molecules and Cells
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• v.24 no.3
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• pp.364-371
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• 2007

The tumor suppressor gene Ras association domain family 1A (RASSF1A) is highly methylated in a wide range of human sporadic tumors. The current study investigated the hypermethylation of RASSF1A, the expression of RASSF1A protein, and the correlation between these and the clinicopathological features of gallbladder (GB) cancer in Korean patients. Formalin-fixed, paraffin-embedded tumors and non-neoplastic GB tissues (22 carcinomas, 8 adenomas, 26 normal epithelia) were collected from patients who had undergone surgical resection. The methylation status of two regions of the RASSF1A CpG island was determined by methylation-specific PCR (MSP), and the expression of RASSF1A protein was examined by immunohistochemistry using tissue microarrays. The K-RAS mutation was analyzed by direct sequencing. Methylation of the RASSF1A promoter (region 1) was detected in 22.7% (5/22) of carcinomas, 12.5% (1/8) of adenomas, and 0% (0/26) of normal gallbladder epithelia (P = 0.025). Methylation of the first exon (region 2) was found in 36.4% (8/22) of carcinomas, 25.0% (2/8) of adenomas, and 8.0% (2/26) of normal gallbladder epithelia (P = 0.038). K-RAS mutations were present in 4.5% (1/22) of carcinomas and 25% (2/8) of adenomas. RASSF1A methylaton was not associated with clinicopathological factors or K-ras mutation. Reduction or loss of RASSF1A expression was observed in most methylated adenocarcinomas. Three RASSF1A-expressing human biliary tract cancer cell lines examined contained unmethylated promoters and exons 1. These results suggest that downregulation of RASSF1A expression by DNA hypermethylation may be involved in GB carcinogenesis.