• Journal of Digestive Cancer Research
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• 제2권1호
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• pp.32-36
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• 2014

We report a patient with combined hepatocellular-cholangiocarcinoma confined in the common hepatic duct and scirrhous type of hepatocellular carcinoma in the caudate lobe of liver simultaneously. The patient was a 55-yearsold Korean man with hepatitis B virus (HBV) carrier who was referred from a local hospital due to detected liver mass on abdominal computed tomography (CT). He has presented jaundice and weight loss for the previous 3 weeks. Laboratory examination showed AST/ALT elevation and hyperbilirubinemia. HBsAg was positive. The tumor marker study showed elevated AFP and DCP, not CEA and CA 19-9. Abdominal CT disclosed an about 2.1×0.9 cm sized soft tissue density in hilum with both intrahepatic duct (IHD) dilatations and an about 3×2.1 cm sized arterial enhancing lesion at segment 8 of the liver. Patient received 15 cycles of Gemcitabine/Cisplantin chemotherapy from February 27, 2013 to December 31, 2013. Caudate lobectomy of liver, segmental resection of bile duct and Roux-en-Y hepaticojejunostomy was performed on February 10, 2014. The final pathologic report showed double primary liver cancer, combined hepatocellular-cholangiocarcinoma in common hepatic bile duct and scirrhous type of hepatocellular carcinoma in segment 1 of the liver. This is a very unusual case in which combined hepatocellular-cholangiocarcinoma confined in the large bile duct and two rare hepatic cancers coexisted.

• 한국임상수의학회지
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• 제40권6호
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• pp.452-456
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• 2023

This report presents two rare cases of gallbladder rupture in dogs with small gallbladders that did not result in bile leakage and their subsequent surgical treatment. The report includes a 5-year-old spayed female Chihuahua weighing 3.5 kg and a 9-year-old castrated male Poodle weighing 5.3 kg. Both dogs had elevated liver enzyme levels on blood chemistry. However, only the second dog (2) (Poodle) presented with hyperbilirubinemia and jaundice, whereas the first dog (Chihuahua (1)) did not display any specific clinical signs. Diagnostic imaging revealed a small gallbladder in both dogs, and the dogs were diagnosed with cholecystolithiasis (1) and extrahepatic biliary tract obstruction (2). No bile leakage-related abdominal effusion was observed. Gallbladder rupture and adhesion to the adjacent tissues were confirmed during cholecystectomy.

• Clinical and Experimental Pediatrics
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• 제60권12호
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• pp.385-389
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• 2017

Purpose: This study aimed to assess whether different anesthetic techniques and oxytocin use applied during delivery affect transcutaneous bilirubin levels during the first 24 hours in neonates. Methods: A total of 1,044 neonates delivered by either caesarian section (C/S) or normal vaginal delivery (NVD) were included in the study. They were classified into 5 groups as follows: group 1: born by C/S using general anesthesia, group 2: C/S using spinal anaesthesia, group 3: C/S using general anesthesia after failed spinal block, group 4: by NVD without anesthesia, and group 5: oxytocin-induced vaginal delivery without anesthesia. Transcutaneous total bilirubin levels (TBLs) were measured during the first 24 hours and on the fifth and eighth days of life and the levels in different groups were compared. Results: The TBLs were significantly higher in neonates delivered by C/S using general anesthesia rather than spinal anesthesia (P<0.001), and both groups had higher levels than those born by NVD without anesthesia ($P{\leq}0.001$). However, the group receiving general anesthesia after failed spinal block was found to have the highest bilirubin level. Moreover, TBLs were significantly higher with the use of oxytocin ($P{\leq}0.001$). Conclusions: C/S and general anesthesia adversely affect the bilirubin levels in neonates, and the use of oxytocin during vaginal delivery also increases TBLs in neonates.

• Clinical and Experimental Pediatrics
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• 제46권7호
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• pp.718-721
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• 2003

저자들은 신생아 용혈성 질환을 일으킨 아기를 분만한 산모와 신생아에서 $anti-Jk^b$를 동정하여 진단하였으며, 이에 대해 그 임상경과를 문헌고찰과 함께 보고하는 바이다. 따라서, 생후 24시간이내 신생아 황달이 있는 경우 군소 혈액형 부적합증에 의한 신생아 용혈성 질환을 감별하여야 하며, 불규칙항체 선별 검사나 불규칙항체 동정 검사를 통하여 항체를 규명하고, 광선요법이나 교환수혈 등을 실시하여 핵황달 예방에 주의함과 동시에 지연성 빈혈이 없는지 지속적인 관찰이 필요할 것으로 사료된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.114-123
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• 2017

Purpose: The goal of this study was the early diagnosis of ABCB11 spectrum liver disorders, especially those focused on benign recurrent intrahepatic cholestasis and progressive familial intrahepatic cholestasis. Methods: Fifty patients presenting neonatal cholestasis were evaluated to identify underlying etiologies. Genetic analysis was performed on patients suspected to have syndromic diseases or ABCB11 spectrum liver disorders. Two families with proven ABCB11 spectrum liver disorders were subjected to genetic analyses to confirm the diagnosis and were provided genetic counseling. Whole exome sequencing and Sanger sequencing were performed on the patients and the family members. Results: Idiopathic or viral hepatitis was diagnosed in 34%, metabolic disease in 20%, total parenteral nutrition induced cholestasis in 16%, extrahepatic biliary atresia in 14%, genetic disease in 10%, neonatal lupus in 2%, congenital syphilis in 2%, and choledochal cyst in 2% of the patients. The patient with progressive familial intrahepatic cholestasis had novel heterozygous mutations of ABCB11 c.11C>G (p.Ser4*) and c.1543A>G (p.Asn515Asp). The patient with benign recurrent intrahepatic cholestasis had homozygous mutations of ABCB11 c.1331T>C (p.Val444Ala) and heterozygous, c.3084A>G (p.Ala1028Ala). Genetic confirmation of ABCB11 spectrum liver disorder led to early liver transplantation in the progressive familial intrahepatic cholestasis patient. In addition, the atypically severe benign recurrent intrahepatic cholestasis patient was able to avoid unnecessary liver transplantation after genetic analysis. Conclusion: ABCB11 spectrum liver disorders can be clinically indistinguishable as they share similar characteristics related to acute episodes. A comprehensive genetic analysis will facilitate optimal diagnosis and treatment.

• 대한유전성대사질환학회지
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• 제4권1호
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• pp.13-17
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• 2004

저자들은 생후 28일된 발열, 간종대, 출혈성 경향, 구토, 잦은 보챔, 전신의 황달 증상을 보이던 환아를 MS-MS 이용한 신생아 대사 이상 검사와 혈중 아미노산 분석, 뇨중 유기산 분석을 통하여 hereditary tyrosinemia type I으로 진단하였다. 저 페닐알라닌/타이로신 식이와 NTBC 사용으로 국내 첫 타이로신혈증 I 치료 성공례를 경험하였다.

• 한국임상수의학회지
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• 제31권1호
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• pp.57-60
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• 2014

6개월령의 한국토종단모고양이가 발열, 빈호흡, 식욕부진, 체중감소로 내원하였다. 고양이는 10일 전 Fellocel$^{(R)}$ 백신을 접종받은 이후 증상을 보였다. 신체검사 결과 공막의 황달과 호흡곤란을 호소했다. 혈액혈구검사와 혈액화학검사에서 빈혈, 혈소판감소증, 백혈구증가증, 고빌리루빈혈증이 관찰되었다. 혈액도말 검사와 기타 검사를 통해 심한 용혈을 확인할 수 있었고 고양이 용혈성 빈혈을 감별진단 하기위해 Erhlichia, Hemobartonella, FeLV, FIV, Anaplasma PCR 검사를 의뢰하였다. PCR 검사 결과 Mycoplasma haemofelis 특이 208 bp의 양성밴드가 확인되었고, 다른 질병은 음성으로 진단되었다. 고양이는 4주 동안 Doxycycline을 사용하였고 급성기 1주 동안에는 prednisolone을 같이 사용하였다. 임상증상은 약물투여 4일째부터 호전되기 시작하였고 이후 PCR 재검을 통해 완치를 확인하였다. 이것은 M. haemofelis 감염 고양이의 진단을 확인하고 완치한 국내 첫 증례이다.

• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.21-24
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• 2013

Hemolytic disease in a newborn that causes early jaundice is common. It is often due to the Rh (D) and ABO incompatibility, but rarely due to unexpected antibodies. Among these unexpected antibodies, the anti-$Di^a$Dia antibody rarely occurs. The anti-$Di^a$ antibody was observed in the serum and red-cell eluate of an infant, and in the serum of his mother. The frequency of the appearance of the $Di^a$ antigen in the Korean population is estimated to be 6.4-14.5%. This paper reports a case of hemolytic disease in a newborn associated with the anti-$Di^a$ antibody. A full-term male infant was transferred to the authors' hospital due to hyperbilirubinemia the day after his birth. The laboratory data indicated a hemoglobin value of 11.6 g/dL, a reticulocyte count of 10.6%, a total bilirubin count of 14.4 mg/dL, a direct bilirubin count of 0.6 mg/dL, and a positive result in the direct Coombs' test. Due to the identification of an irregular antibody from the maternal serum, an anti-$Di^a$ antibody was detected, which was also found in the eluate made from the infant's blood. The infant had been treated with phototherapy and intravenous immunoglobulin since the second day after his birth and was discharged due to an improved condition without exchange transfusion. Therefore, in cases of iso-immune hemolytic disease in a newborn within 24 hours from birth who had a negative result in an antibody screening test, the conduct of an anti-$Di^a$ antibody identification test is recommended due to the suspicion of an anti-$Di^a$ antigen, followed by early administration of intravenous immunoglobulin.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3155-3160
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• 2016

Background: L-asparaginase (ASNase) is commonly used in the treatment of acute lymphoblastic leukemia (ALL) and natural killer (NK)/T-cell lymphoma. This study was designed to describe the incidence of toxicity associated with ASNase in Asian adults. Secondary objectives were to investigate the management and impact of toxicity on subsequent ASNase use, and to compare the actual management against current recommendations. Materials and Methods: In this retrospective, multi-center, observational study, Asian patients ${\geq}18$ years old who received ${\geq}1$ dose of the native E. coli ASNase from 2008 to 2013 were included. Patients were excluded if they did not receive ASNase. Endpoints of this study were development of specific toxicities, whether ASNase was discontinued or re-challenged, and developmentg of recurrent toxicity. All data analyses were performed using SPSS version 20.0. Results: A total of 56 patients were analyzed. Mean (${\pm}SD$) age was 36.2 (${\pm}15.2$) years old, with 62.5% being males, 55.4% with ALL and 28.6% with NK/T-cell lymphoma. Hypersensitivity (12.5%) was associated with the highest incidence of toxicity (6 out of 7 patients had Grade 3 and 4 toxicity), followed by 10.7% for hepatic transaminitis, 3.6% for non-CNS thrombosis and 1.8% each for hyperbilirubinemia and pancreatitis. Hypersensitivity recurred in the 3 patients who were re-challenged with E. coli ASNase. Conclusions: ASNase is associated with a wide range of toxicities, with hypersensitivity being the most commonly observed among Asian adult patients.

• 한국임상수의학회지
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• 제23권2호
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• pp.197-201
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• 2006

A 2-year-old female mongrel dog was referred to the Veterinary Medical Center of Chungbuk National University due to anorexia, depression and weight loss after the administration of exogenous estrogen for contraception in the local hospital. Although the dog was medicated with antibiotics and fluid for two weeks in the local hospital, there was a deterioration in the patient's general condition. Therefore the dog was referred to our Veterinary Medical Center. Hematological and biochemical analysis showed non-regenerative anemia, thrombocytopenia, severely immature leukocytosis, hyperbilirubinemia, hyperglycemia and elevated serum alkaline phosphatase, gamma-glutamyltransferase, and lactate dehydrogenase. Abdominal ultrasonography showed double line of gallbladder and irregular hypertrophic wall of uterus. On the basis of these examination's results and history taking, final diagnosis was exogenous estrogen-induced myelotoxicosis with cholecystitis and endometritis. The symptomatic therapy for estrogen toxicosis was performed for 26 days after the final diagnosis. However, the symptom had no response to therapy except endometritis and anemia. On day 135 after administration of estrogen, platelet and neutrophil count were normalized, but monocytic leukocytosis was occurred.