• Title/Summary/Keyword: jaundice

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Diagnostic Significance of the Blood Disappearance Rate of $^{131}I$-Rose Bengal and of $^{198}Au$ colloid in Hepatobiliary Diseases (간담도질환(肝膽道疾患)에 있어서 $^{131}I$-Rose Bengal 및 $^{198}Au$ 교질(膠質)의 혈중소실율(血中消失率)의 진단적(診斷的) 의의(意義)에 관(關)한 연구(硏究))

  • Chun, Young-Kyoon;Koh, Chang-Soon;Hahn, Shim-Suk
    • The Korean Journal of Nuclear Medicine
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    • v.5 no.2
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    • pp.7-18
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    • 1971
  • The liver function test was performed by means of two radioisotope tracer techniques in 20 normal subjects and in 63 patients with hepatobiliary diseases. The blood disappearance rates of $^{131}I$-rose bengal and of $^{198}Au$ colloid were determined by external counting method. The hepatocellular function and the hepatic blood flow were estimated from the observed data and the results were compared with those of the conventional liver function tests. The results obtained were as follows: 1. The mean blood disappearance half time of $^{131}I$-rose bengal was $6.6{\pm}0.63$ minutes in normal control, $17.7{\pm}6.93$ in cirrhosis of the liver, $16.6{\pm}4.80$ in acute hepatitis, and $14.7{\pm}3.46$ in obstructive jaundice. It was markedly prolonged in the hepatobiliary diseases as compared with the normal control, but there was no significant difference among the hepatobiliary diseases. 2. The mean blood disappearance half time of $^{198}Au$ colloid was $4.0{\pm}0.66$ minutes in normal control, $9.8{\pm}3.42$ in cirrhosis of the liver, $4.4{\pm}0.82$ in acute hepatitis, and $5.0{\pm}1.42$ in obstructive jaundice. The difference between cirrhosis of the liver and normal control Was statistically significant. However, there was no definite difference among acute hepatitis, obstructive jaundice, and normal control. The mean blood disappearance rate constant (K value) was $0.177{\pm}0.028/minute$ in normal control. In cirrhosis of the liver, it was markedly decreased which was suggestive of the reduced hepatic blood flow. 3. The ratio of $^{131}I$-rose bengal blood disappearance half time to $^{198}Au$ colloid disappearance half time was $1.68{\pm}0.20$ in normal control, $1.82{\pm}0.31$ in cirrhosis of the liver, $3.80{\pm}0.82$ in acute hepatitis, and $3.01{\pm}0.54$ in obstructive jaundice. The ratios in acute hepatitis and obstructive jaundice were remarkably higher than those in normal control and cirrhosis of the liver. 4. There was a significant correlation between the blood disappearance half time of $^{131}I$-rose bengal and that of $^{198}Au$ colloid in cirrhosis of the liver. 5. In cirrhosis of the liver, the blood disappearance half times of $^{131}I$-rose bengal and of $^{198}Au$ colloid were inversely correlated to the serum albumin level. In acute hepatitis, there was a good positive correlation between the blood disappearance half time of $^{131}I$-rose bengal and the serum transaminase activities. In obstructive jaundice, the blood disappearance half time of $^{131}I$-rose bengal was correlated to the serum bilirubin level.

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A Case with Subdural Hemorrhage as the First Symptom of Extrahepatic Biliary Atresia (경막하 출혈에 의하여 발견된 선천성 담도폐색증 치험 1예)

  • Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.63-67
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    • 1995
  • Although bleeding was reported before as the first symptom in a few cases of biliary atresia, this association is not generally known. We treated 115-day-old female with extrahepatic biliary atresia presented with subdural hemorrhage rather than with prolonged jaundice. Four years after craniectomy and Kasai's hepatic portojejunostomy, she looks happy without jaundice nor brain damage sequela even though she had recent episode of esophageal variceal bleeding.

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Analysis of Different Ways of Drainage for Obstructive Jaundice Caused by Hilar Cholangiocarcinoma

  • Xu, Chuan;Lv, Peng-Hua;Huang, Xin-En;Wang, Shu-Xiang;Sun, Ling;Wang, Fu-An
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5617-5620
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    • 2014
  • Objective: To evaluate the prognosis of different ways of drainage for patients with obstructive jaundice caused by hilar cholangiocarcinoma. Materials and Methods: During the period of January 2006- March 2012, percutaneous transhepatic catheter drainage (PTCD)/ percutaneous transhepatic biliary stenting (PTBS) were performed for 89 patients. According to percutaneous transhepatic cholangiography (PTC), external drainage was selected if the region of obstruction could not be passed by guide wire or a metallic stent was inserted if it could. External drainage was the first choice if infection was diagnosed before the procedure, and a metallic stent was inserted in one week after the infection was under control. Selection by new infections, the degree of bilirubin decrease, the change of ALT, the time of recurrence of obstruction, and the survival time of patients as the parameters was conducted to evaluate the methods of different interventional treatments regarding prognosis of patients with hilar obstruction caused by hilar cholangiocarcinoma. Results: PTCD was conducted in 6 patients and PTBS in 7 (p<0.05). Reduction of bilirubin levels and ALT levels was obvious after the procedures (p<0.05). The average survival time with PTCD was 161 days and with PTBS was 243 days (p<0.05). Conclusions: With both drainage procedures for obstructive jaundice caused by hilar cholangiocarcinoma improvement in liver function was obvious. PTBS was found to be better than PTCD for prolonging the patient survival.

Clinical Study of the Jaundice Patient with Toxic Hepatitis and Liver Failure (독성 간염과 간부전 소견을 보이는 황달환자 치험례)

  • Lee Seung-Eon;Yun Jong-Min;Park Sae-Wook;Lee Min-Goo;Son Ji-Woo;Lee Sun-Woo;Cha Suk;Kim Kang-San;Kim Yong-Jeong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.6
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    • pp.1710-1714
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    • 2005
  • This study was designed to report the clinical effects of oriental medical therapy on a patient of jaundice with a toxic hepatitis and liver failure. Herbal medication, acupuncture and cupping therapy were applied to the patient for 18 weeks. Symptoms were checked repeatedly, and clinicopathologic test(such as total bilirubin, direct bilirubin, AST, ALT ect.) were done to evaluate improvement. After 18 weeks treatment with oriental medical therapy, most symptoms disappeared or improved. Clinicopathologic examinations showed improvement. The above results that oriental medical therapy is beneficial for the patient with jaundice.

[ $^{99m}Tc-DISIDA$ ] Cholescintigraphy in the Evaluation of Neonatal Jaundice: The Usefulness of Hepatic Uptake in Differential Diagnosis (신생아 황달에서 $^{99m}Tc-DISIDA$ 간담도 스캔: 감별진단에서 간 섭취율의 유용성)

  • Park, Byung-Ran;Ji, Joo-Yun;Kim, Se-Jong
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.492-496
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    • 1995
  • To evaluate the usefulness of hepatic uptake in neonatal jaundice, Tc-99m-DISIDA cholescintigraphy was reviewed for 13 infants with prolonged mired jaundice and no demonstrable excretion into bowel,even after 24hr. Five patients proved to have biliary atresia. The remainder had neonatal hepatitis. There was no distinct differentiation of the hepatic uptake of tracer at 5 and 10 minutes between biliary atresia and neonatal hepatitis. The consideration of hepatic uptake rate of the tracer is not useful in differentiating neonatal hepatitis from biliary atresia.

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Jaundice in Cultured Eel (Anguilla japonica) (양식 뱀장어 (Anguilla japonica)의 황달에 관하여)

  • KIM, Dae-Hyun;PARK, Sung-Woo
    • Journal of Fisheries and Marine Sciences Education
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    • v.28 no.6
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    • pp.1573-1580
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    • 2016
  • The disease occurred in cultured eel (Anguilla japonica) in a recirculatory culture system without any separated filtration apparatus. As the pond had a high level of nitrite with $60mg/{\ell}$, 1% NaCl was added to reduce nitrite toxicity to eel. The first outbreak was observed a week after the NaCl treatment and continued for 10 days. Accumulated mortality was about 0.2-0.5%. Affected fish ranged from 150-350 g were usually anorexic and exhibited yellow colour in the skin of the abdominal region and at the base of pectoral fins, as well as in the eyes. In a few individuals with severe symptoms, the lateral skin was also yellowish. The spleen, kidney, muscle and gall bladder were yellowish and the liver was pale-yellow colour but green on the posterior part. The gall bladder was shrunken without bile. Some abnormal erythrocytes such as "tear drop" cells (dacrocyte) were observed in peripheral blood smears stained with May-Grunwald Giemsa. Hematocrit values and hemoglobin contents in the jaundiced eel were significantly lower compared with apparently heathy eel. Severe haemosiderosis accompanied by erythrophagocytosis was found in the kidney and spleen. Haemosiderin deposits were observed in macrophages of the haematopoietic tissue of the kidney and in the splenocytes. But no significant alterations were found in the hepatic cells. In this study we report the first outbreak of jaundice in cultured eel in Korea. Pathological and hematological investigations suggested that severe hemolysis may resulted in jaundice in eel although the cause of hemolytic jaundice was not identified in this study.

Novel Mutations in the CPT1A Gene Identified in the Patient Presenting Jaundice as the First Manifestation of Carnitine Palmitoyltransferase 1A Deficiency

  • Choi, Jong Sub;Yoo, Hyeoh Won;Lee, Kyung Jae;Ko, Jung Min;Moon, Jin Soo;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.1
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    • pp.76-81
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    • 2016
  • Carnitine palmitoyltransferase 1A (CPT1A) is an enzyme functioning in mitochondrial fatty acid oxidation (FAO) of the liver. Patients with CPT1A deficiency have impaired mitochondrial FAO and display hypoketotic hypoglycemia and hepatic encephalopathy as typical manifestations. In this report, we present a case of CPT1A deficiency presenting jaundice as the first manifestation. A 1.9 years old boy showed jaundice and elevated levels of free and total carnitine were observed. From direct sequencing analysis of CPT1A, two novel mutations, c.1163+1G>A and c.1393G>A (p.Gly465Arg), were identified. At the age of 2.2 years, hypoglycemia, tachycardia, and altered mental status developed just after cranioplasty for craniosynostosis. High glucose infusion rate was required for recovery of his vital signs and mentality. Diet rich in high carbohydrate, low fat and inclusion of medium chain triglyceride oil resulted in improvement in cholestatic hepatitis and since then the boy has shown normal growth velocity and developmental milestones to date.

Analysis of Cholangitis Rates with Extended Perioperative Antibiotics and Adjuvant Corticosteroids in Biliary Atresia

  • Goh, Lynette;Phua, Kong Boo;Low, Yee;Chiang, Li Wei;Yong, Chen;Chiou, Fang Kuan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.4
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    • pp.366-376
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    • 2021
  • Purpose: There is no consensus regarding adjuvant therapies following Kasai portoenterostomy (KP) for biliary atresia (BA). This study aimed to analyze the effect of extended perioperative intravenous antibiotics (PI-Abx) and adjuvant corticosteroid on cholangitis and jaundice clearance rates in the 3 years post-KP in children with BA. Methods: Data of patients who underwent KP between 1999-2018 at a single center were retrospectively analyzed. Group A (1999-2010) received PI-Abx for 5 days, Group B (2010-2012) received PI-Abx for 5 days plus low-dose prednisolone (2 mg/kg), and Group C (2012-2017) received PI-Abx for 14 days plus high-dose prednisolone (5 mg/kg). Results: Fifty-four patients were included with groups A, B, and C comprising 25, 9, and 20 patients, respectively. The number of episodes of cholangitis was 1.0, 1.6, and 1.3 per patient (p=NS) within the first year and 1.8, 2.3, and 1.7 (p=NS) over 3 years in Groups A, B, and C, respectively. The jaundice clearance rate at 6 months was 52%, 78%, and 50% (p=NS), and the 3-year native liver survival (NLS) rate was 76%, 100%, and 80% (p=NS) in Groups A, B, and C, respectively. A near-significant association was observed between the incidence of cholangitis within the first year and decompensated liver cirrhosis/death at 3 years post KP (p=0.09). Persistence of jaundice at 6 months was significantly associated with decompensated cirrhosis/death at 3 years (p<0.001). Conclusion: The extended duration of PI-Abx and adjuvant corticosteroids was not associated with improved rates of cholangitis, jaundice clearance, or NLS in patients with BA.

Painless Jaundice Caused by Clonorchis sinensis Infection: A Case Report

  • Hao, Yuhua;Bao, Wanguo;Jin, Meishan;Li, Yuxiang;Wang, Feng
    • Parasites, Hosts and Diseases
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    • v.54 no.3
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    • pp.323-327
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    • 2016
  • A man with only yellowing of the skin and eye sclera was diagnosed with clonorchiasis, which rarely manifested jaundice as the initial symptom. However, because of a lack of evidence for a diagnostic gold standard, the time until definitive diagnosis was more than a week. The diagnostic process relied on inquiring about the patient's history, including the place of residence, dietary habits, and symptoms, as well as on serological findings, an imaging examination, and pathological findings. MRCP and CT results showed mild dilatation of intrahepatic ducts and increased periductal echogenicity. The eggs were ultimately found in stool by water sedimentation method after the negative report through direct smear. DNA sequencing of PCR production of the eggs demonstrated 98-100% homology with ITS2 of Clonorchis sinensis. After anti-parasite medical treatment, the patient's symptoms were gradually relieved. Throughout the diagnostic procedure, besides routine examinations, the sedimentation method or concentration method could be used as a sensitive way for both light and heavy C. sinensis infection in the definite diagnosis.

A Tae-Eumin Exterior-Cold-Disease by the Cold in the Esophagus's Case Study of Diagnosed as Acute Hepatitis A (급성 A형간염으로 진단받은 태음인(太陰人) 위완수한표한병(胃脘受寒表寒病) 환자(患者) 치험(治驗)1례(例))

  • Choi, Eun-Joo;Song, Hak-Soo;Yoon, Woo-Young;Yoo, Jun-Sang
    • Journal of Sasang Constitutional Medicine
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    • v.21 no.3
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    • pp.216-222
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    • 2009
  • 1. Objectives: This case study described a process of the patient diagnosed as acute hepatitis A treated by medication based on the Sasang Constitutional Medicine and acupuctural theraphy and obtained improved effects about several symptoms. 2. Methods: We diagnosed the male patient with acute hepatitis A as Tae-Eumin Exterior-Cold-Disease by the Cold in the Esophagus, and administered Mahwangbalpyo-tang and Handayeolso-tang according to clinical progress. And we evaluated the results by liver function test(LFT; AST, ALT, $\gamma$-GTP ), total bilirubin level and the visual analog scale(VAS) of symptoms. 3. Results and Conclusion: Almost symptoms (except for jaundice) at the time of admission were disappeared, and also jaundice (estimated by color of scleras and color of urine) was alleviated. Also level of AST, ALT, $\gamma$-GTP and total bilirubin decreased in laboratory test. We obtained positive effects to the therapy but we considered necessities of further comparative studies with control group.

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