• Journal of Yeungnam Medical Science
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• 제25권2호
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• pp.165-170
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• 2008

The incidence of hepatocellular carcinoma presenting as obstructive jaundice is 0.7~9%. The mechanisms of obstructive jaundice include bile duct invasion by tumor, tumor thrombi, blood clots, direct bile duct compression by tumor, and intraductal tumor growth. We report a rare case of hepatocellular carcinoma with intraductal growth. A 46-year-old woman was admitted due to colicky right upper abdominal pain and jaundice for 4 days. Computed tomography showed dilatation of the left intrahepatic duct, and endoscopic retrograde cholangiography showed a filling defect in the left main intrahepatic duct. We performed a left lobectomy with a Roux-en-Y hepaticojejunostomy. The tumor was diagnosed as a hepatocellular carcinoma with intraductal growth.

• 대한한의학회지
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• 제34권4호
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• pp.46-55
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• 2013

Objectives: Classifying the pattern of jaundice during diagnosis will significantly improve the outcome of common KM interventions. This study aimed at determining an objective index for accurately diagnosing heat and dampness KM patterns in patients with jaundice. Methods: We systematically reviewed laboratory findings from case reports published in the scientific literature of Korean medicine. Cases were classified as following either the heat or dampness pattern. Biochemical indices were compared using a Bayesian factor (BF) analysis and standard t-tests. Results: The laboratory findings of 32 patients were evaluated. The heat pattern was observed in 17 patients and the dampness pattern in 15. No significant differences were observed between the 2 groups in terms of white blood cell count (BF=1.659); hemoglobin concentration (BF=2.627); platelet count (BF=1.019); or levels of direct bilirubin (BF=1.453), aspartate aminotransferase (BF=1.226), alanine aminotransferase (BF=1.340), alkaline phosphatase (BF=2.344), or gamma-glutamyl transpeptidase (BF=2.782). However, total bilirubin levels were significantly higher in the dampness pattern group (BF=0.854, P-value=0.070). Conclusions: Patients with high total bilirubin levels may predominantly follow the dampness pattern, while those with low levels may predominantly follow the heat pattern. These results are expected to be useful for the development of timely and efficient KM treatments as well as new integrative therapeutic approaches for jaundice. However, further studies are essential to fully validate the utility of total bilirubin as a biomarker for differentiating between heat and dampness patterns.

• Radiation Oncology Journal
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• 제8권1호
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• pp.79-84
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• 1990

1984년부터 1988년까지 인제대학교 의과대학 치료방사선과에서 전이성 암에의해 발생한 악성 폐쇄성 황달환자 13명을 대상으로 간문을 포함하는 국소방사선치료를 시행하였다. 총 3명의 환자중 추적가능한 7명은 표준 방사선 조사야에 2.6주에서 6주 동안에 걸쳐 $2600\~5480$cGy의 방사선 조사를 받았으며 이중 5명은 완전관해, 1명은 부분 관해를 보여주었다. 전체 13명의 환자에서의 평균 생존기간은 3개월 이었으며 7명의 추적가능한 환자에서는 10.5개월이었다. 완전 관해를 보인 환자 5명중 2명은 황달의 재발없이 1년 이상의 생존기간을 보여주었다. 따라서 간문의 전이성 암으로 인해 발생한 악성 폐쇄성 황달 환자에 있어서 간문을 포함하는 조사야의 국소적 방사선 치료는 황달 해소와 증상완화에 많은 도움을 줄 수 있는 것으로 생각된다.

• 사상체질의학회지
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• 제17권2호
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• pp.85-91
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• 2005

1. Objectives The Purpose of this article is to find out the change of Dong-Mu's concepts about Soeumin Hwangdal(jaundice;황달(黃疸)) 2. Methods This study Was researched as bibliographically with Dong-Mu's writings such as ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ written in 1894('GaboBon'), ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ published in 1901('Sinch ukBon') 3. Results and Conclusions I) The conception of Soewnin Hwangdal(jaundice, 황달(黃疸)) is a syndrome of indigestion, which needs releasing excessive through the method of decending the interior yin. 2) In the course of Taeum syndrome(태음병(太陰炳)), Soeuwnin Hangdal(jaundice황달(黃疸)) locate beetwen Miman (bloating, 비만(?滿)) and Bujong(edema, 부종(浮腫)) on the point of view of Healthy Energy. 3)In ?SinchukBon? , Soewnin interior disease is divided two syndromes. The one is the syndrome that has diarrhea as major symptom, and the another is the syndrome that has bloating as major symptom 4) In ?SinchukBon? , Dong-Mu suggested that diuresis is an important treatment of the syndrome which has bloating as major symptom.

• Clinical and Experimental Pediatrics
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• 제49권12호
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• pp.1296-1300
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• 2006

목 적 : 신생아 황달은 신생아기에 가장 흔한 질환으로 핵황달 및 사망까지의 심각한 후유증을 유발할 수 있기 때문에 신속하고 정확한 빌리루빈 농도의 측정과 치료가 중요하다. 따라서 신생아 황달의 진단에서 빌리루빈 측정법 중 경피적 빌리루빈 측정기의 개발로 신생아 황달의 선별법으로 사용되고 있다. 그러나 광선치료 동안에 경피적 빌리루빈 측정기의 유용성이 연구되지 않아 이에 저자들은 광선치료 동안에 측정하는 신체의 부위별 TcB와 PB의 상관관계를 조사해서 경피적 빌리루빈 측정기의 유용성을 알아보고자 본 연구를 시행하였다. 방 법 : 2005년 6월부터 8월까지 제일병원 신생아실에서 광선치료를 받는 황달의 임상적 위험성(미숙아, Rh및 ABO 부적합증, 간손상 등 다른 합병증)이 없는 신생아 90명을 대상으로 경피적 빌리루빈 측정기인 JM-103을 사용하여 광선치료 시작전 이마와 흉골 중앙부에 opaque patch을 붙이고 광선치료 동안에 opaque patch 부위와 바로 인접한 부위에서 TcB를 측정하였다. TcB 측정시 각각 3회씩 측정하여 평균치를 TcB로 하였으며, 경피적 빌리루빈 측정기로 측정한 시각으로부터 30분 이내에 발뒤꿈치를 천자하여 PB를 측정하여 측정 부위간 TcB와 PB의 상관관계를 비교 관찰하였다. 결 과 : 대상에 포함된 신생아는 황달의 임상적 위험성(미숙아, Rh 및 ABO 부적합증, 간손상 등 다른 합병증)이 없는 신생아를 대상으로 하였고 신생아의 평균 재태주령은 $38.6{\pm}1.3$주였고 평균 출생 체중은 $3,207.0{\pm}472.1g$이었고 광선치료 시작 시기는 평균 $4.9{\pm}0.9$일이고 평균 광선치료 기간은 $1.3{\pm}0.6$일이었다. 대상 신생아의 광선치료 시작전 PB와 patch 붙인 흉골 부위의 TcB, patch 붙인 이마 부위의 TcB, 흉골 부위의 TcB, 이마 부위의 TcB 결과는 각 부위간에 유의한 상관관계를 보였다. 광선치료 동안에 각 측정부위별(TcB-UF, TcB-UC, TcB-PF, TcB-PC)와 PB는 의미있는 상관관계를 나타내었고 opaque patch를 붙인 부위가 인접한 부위보다 PB와 의미 있는 상관관계를 나타내었으며 TcB-PC가 TcB-PF보다 더욱 더 PB와 의미 있는 상관관계를 나타내었으며 일치도가 높았다. 결 론 : 본 연구의 결과로 경피적 빌리루빈 측정기는 신생아 황달의 선별검사 방법뿐 아니라 광선치료 동안에도 추적검사 측정법으로 사용하기에 적절하다고 생각되며 사용하는 기관에서 자기고유의 회귀직선을 작성하여 사용한다면, 신생아의 몸에 침해를 가하지 않고 편리하고 신속하게 신생아 과빌리루빈혈증 진단과 추적검사에 유용하게 사용될 수 있으리라 생각된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup2호
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• pp.35-43
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• 2008

Jaundice is common in breast-fed infants. Any infant noted to be jaundiced at 2 weeks of age need to be evaluated for cholestasis with measurement of total and direct serum bilirubin. The most common causes of cholestatic jaundice in infants are biliary atresia and neonatal hepatitis. Genetic causes of the neonatal hepatitis syndrome are increasingly recognized and idiopathic neonatal hepatitis is decreasing. Cholestasis should be investigated using a structured protocol. Early detection and timely, accurate diagnosis is important for successful treatment and a favorable prognosis. In particular, a Kasai portoenterostomy for biliary atresia has the best outcome if performed before the infant is 8 weeks of age. The management of cholestasis is mainly supportive, including nutritional support and alleviation of symptoms to improve the quality of life. Specific treatments are available for some causes of neonatal hepatitis syndrome and should be started as soon as possible. For decompensated liver disease, liver transplantation yields a better outcome.

• Clinical and Experimental Pediatrics
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• 제55권2호
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• pp.58-62
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• 2012

Carnitine (${\beta}$-hydroxy-${\gamma}$-trimethylaminobutyric acid) is involved in the transport of long-chain fatty acids into the mitochondrial matrix and the removal of potentially toxic acylcarnitine esters. Transient carnitine transport defect is a rare condition in newborns reported in 1/90,000 live births. In this paper, we describe a case of transient carnitine transport defect found in a premature baby who had prolonged cholestatic jaundice and poor weight gain, and who responded dramatically to oral carnitine supplementation.

• 대한수의학회지
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• 제51권1호
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• pp.55-58
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• 2011

Two 4-day-old Thoroughbred foals with acute clinical signs of depression, elevated pulse and respiratory rates, anemia, and jaundice were referred to the equine hospital of Korea Racing Authority. The foals were seemingly normal at birth, but showed clinical signs such as abnormal behavior, jaundice and anemia suddenly after ingestion of the mare's colostrum, followed by death at 4 days after birth. According to the results of the hematology, serum chemistry analysis, jaundice foal agglutination test, and blood groups test, the foals were diagnosed as neonatal isoerythrolysis (NI) caused by the mare's antibodies. These results suggested that the pregnant mares have a potential for NI.

• 대한방사선협회지
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• 제29권1호
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• pp.31-34
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• 2003

Purpose : To evaluate technical feasibility and clinical usefulness of CT fluoroscopy (CTF) guided PTBD immediately after CT scanning in ER Patients with obstructive jaundice. Materials and Method : ER patients diagnose4 as obstructive jaundice through cl

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.55-57
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• 2017

A 64-year-old man was admitted due to jaundice for 2 weeks. Radiologic findings revealed biliary stricture at the hepatic hilum with intrahepatic duct dilation suggesting Bismuth type IV Klatskin tumor. Jaundice improved spontaneously several days after hospitalization. Surgical treatment was considered but he only wanted to observe without specific treatment. Ten months later, he was re-admitted due to the recurrence of jaundice. Computed tomography (CT) showed no significant difference compared to previous results. Serum cancer antigen 19-9 and Immunoglobulin G4 were normal. Endoscopic forcep biopsy during endoscopic retrograde cholagiopancreatography (ERCP) revealed chronic inflammation. After steroid use under possible diagnosis of IgG4 related cholangiopathy, biliary stricture improved slightly. Four years later, he was hospitalized with the occurrence of acute cholangitis. Endoscopic retrograde biliary drainage was performed following endobiliary forcep biopsy. Pathology revealed well-differentiated adenocarcinoma at this time. Combined chemotherapy based on gemcitabine and cisplatin was performed. Six months later, CT revealed partial response.