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Sample records for monolobar hepatobiliary fibropolycystic

  1. Fibropolycystic liver disease in children

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    Veigel, Myka Call [Kansas City University of Medicine and Biosciences, Kansas City, MO (United States); University of Missouri-Kansas City, St. Luke' s Hospital, Department of Radiology, Kansas City, MO (United States); Prescott-Focht, Julia; Zinati, Reza [University of Missouri-Kansas City, St. Luke' s Hospital, Department of Radiology, Kansas City, MO (United States); Rodriguez, Michael G. [University of Missouri-Kansas City School of Medicine, Kansas City, MO (United States); Shao, Lei [Children' s Mercy Hospitals and Clinics, Department of Pathology, Kansas City, MO (United States); Moore, Charlotte A.W.; Lowe, Lisa H. [University of Missouri-Kansas City, Department of Radiology, Kansas City, MO (United States); Children' s Mercy Hospitals and Clinics, Department of Radiology, Kansas City, MO (United States)

    2009-04-15

    Fibropolycystic liver diseases are a group of associated congenital disorders that present most often in childhood. These disorders include congenital hepatic fibrosis, biliary hamartomas, autosomal dominant polycystic liver disease, choledochal cysts and Caroli disease. We present a discussion and illustrations of the embryology, genetics, anatomy, pathology, imaging approach and key imaging features that distinguish fibropolycystic liver disease in children. The pathogenesis of these disorders is believed to be abnormal development of the embryonic ductal plates, which ultimately form the liver and biliary systems. An understanding of the abnormal embryogenesis helps to explain the characteristic imaging features of these disorders. (orig.)

  2. Monolobar Caroli's Disease in Left Lobe of the Liver: A Case Report

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    Cho, Han Il; Lee, Young Hwan; Jeon, Se Jeong; Roh, Byung Suk; Juhng, Seon Kwan [Wonkwang University Hospital, Iksan (Korea, Republic of)

    2010-06-15

    Caroli's disease is a rare congenital hepatobiliary disease characterized by multifocal segmental dilatation of the intrahepatic bile ducts and hepatic fibrosis that can cause bile duct stones, cholangitis, and cholangiocarcinoma. The disease may diffusely affect the liver or be localized to one lobe or segment. Less than 20% of all reported cases of Caroli's disease are the monolobar type. We report a case of Caroli's disease of the monolobar type, which was confined to segment 4a of the liver in a 30-year-old man. The disease was diagnosed by CT and Gd-EOB-DTPA enhanced MRI, and confirmed histopathologically after a hepatic lobectomy

  3. Hepatobiliary Intervention in Children

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    Franchi-Abella, Stéphanie [Le Centre Hospitalier Universitaire du Kremlin-Bicêtre (France); Cahill, Anne Marie; Barnacle, Alex M. [Great Ormond Street Hospital, Department of Radiology (United Kingdom); Pariente, Danièle [Le Centre Hospitalier Universitaire du Kremlin-Bicêtre (France); Roebuck, Derek J., E-mail: derek.roebuck@gosh.nhs.uk [Great Ormond Street Hospital, Department of Radiology (United Kingdom)

    2013-08-02

    Various vascular and nonvascular hepatobiliary interventional radiology techniques are now commonly performed in children’s hospitals. Although the procedures are broadly similar to interventional practice in adults, there are important differences in indications and technical aspects. This review describes the indications, techniques, and results of liver biopsy, hepatic and portal venous interventions and biliary interventions in children.

  4. Hepatobiliary and pancreatic ascariasis

    Science.gov (United States)

    Khuroo, Mohammad S; Rather, Ajaz A; Khuroo, Naira S; Khuroo, Mehnaaz S

    2016-01-01

    Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode, Ascaris lumbricoides, in to the biliary tract and pancreatic duct. Patients present with biliary colic, cholangitis, cholecystitis, hepatic abscesses and acute pancreatitis. Ascarides traverse the ducts repeatedly, get trapped and die, leading to formation of hepatolithiasis. HPA is ubiquitous in endemic regions and in Kashmir, one such region, HPA is the etiological factor for 36.7%, 23%, 14.5% and 12.5% of all biliary diseases, acute pancreatitis, liver abscesses and biliary lithiasis respectively. Ultrasonography is an excellent diagnostic tool in visualizing worms in gut lumen and ductal system. The rational treatment for HPA is to give appropriate treatment for clinical syndromes along with effective anthelmintic therapy. Endotherapy in HPA is indicated if patients continue to have symptoms on medical therapy or when worms do not move out of ductal lumen by 3 wk or die within the ducts. The worms can be removed from the ductal system in most of the patients and such patients get regression of symptoms of hepatobiliary and pancreatic disease. PMID:27672273

  5. Hepatobiliary and pancreatic ascariasis.

    Science.gov (United States)

    Khuroo, Mohammad S; Rather, Ajaz A; Khuroo, Naira S; Khuroo, Mehnaaz S

    2016-09-07

    Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode, Ascaris lumbricoides, in to the biliary tract and pancreatic duct. Patients present with biliary colic, cholangitis, cholecystitis, hepatic abscesses and acute pancreatitis. Ascarides traverse the ducts repeatedly, get trapped and die, leading to formation of hepatolithiasis. HPA is ubiquitous in endemic regions and in Kashmir, one such region, HPA is the etiological factor for 36.7%, 23%, 14.5% and 12.5% of all biliary diseases, acute pancreatitis, liver abscesses and biliary lithiasis respectively. Ultrasonography is an excellent diagnostic tool in visualizing worms in gut lumen and ductal system. The rational treatment for HPA is to give appropriate treatment for clinical syndromes along with effective anthelmintic therapy. Endotherapy in HPA is indicated if patients continue to have symptoms on medical therapy or when worms do not move out of ductal lumen by 3 wk or die within the ducts. The worms can be removed from the ductal system in most of the patients and such patients get regression of symptoms of hepatobiliary and pancreatic disease.

  6. Hepatobiliary imaging in gallstone ileus

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    Bocobo, G.R.; Slavin, J.D. Jr.; Rao, H.; Aseltine, D. Jr.; Spencer, R.P.

    1984-01-01

    Hepatobiliary imaging was performed in a woman who, at subsequent surgery, was found to have gallstone ileus due to a large gallstone obstructing the proximal jejunum. The triad of findings (failure of the radiopharmaceutical to pass beyond the point of obstruction, marked reflux into the stomach, and nonvisualization of the gallbladder) is nonspecific but, in the appropriate clinical setting, should suggest the possibility of gallstone ileus.

  7. Hepatobiliary cystadenoma: a rare pediatric tumor.

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    Tran, Sifrance; Berman, Loren; Wadhwani, Nitin R; Browne, Marybeth

    2013-08-01

    Hepatobiliary cystadenoma is a rare hepatic neoplasm that has been reported only 10 times in the pediatric population. Although considered a benign cystic tumor of the liver, hepatobiliary cystadenoma has a high risk of recurrence with incomplete excision and a potential risk for malignant degeneration. Complete tumor excision with negative margins is the mainstay in treatment. Unfortunately, due to the paucity of cases and its vague presentation, hepatobiliary cystadenoma is rarely diagnosed preoperatively. Therefore, in patients with hepatic cystic masses without a clear diagnosis, total resection of the lesion with negative margins is indicated to adequately evaluate for malignant potential and limit the risk of recurrence. We describe a 2-year-old girl with an asymptomatic abdominal mass that was found to be hepatobiliary cystadenoma. In addition, the pathogenic, histopathologic and clinical features of hepatobiliary cystadenoma are reviewed.

  8. Hepatobiliary

    Science.gov (United States)

    ... obtain the best quality images. If you are claustrophobic, you should inform the technologist before your exam begins. ... first few hours or days following the test. You should also drink plenty of water to help flush the radioactive material out of your body ...

  9. Complications in pediatric hepatobiliary surgery.

    Science.gov (United States)

    Grisotti, Gabriella; Cowles, Robert A

    2016-12-01

    This review highlights the complications and their risk factors encountered in pediatric hepatobiliary surgery, specifically in the context of pediatric hepatic resection, excision of choledochal cyst, and the Kasai hepatoportoenterostomy procedure for biliary atresia as well as other procedures potentially affecting the biliary tree. With the understanding that these are relatively rare procedures, case reports and small case series are included in addition to larger series when available. The review focuses on publications in English over the past 15 years. Complications included both surgery-specific pathology, such as biliary stricture after excision of choledochal cyst, and disease-specific entities, such as malnutrition in biliary atresia. This review may be useful when considering a particular procedure or in the discussion thereof with a patient and family. Additionally, it illuminates the need for additional work with larger patient databases to refine and expand our knowledge of these complications and precipitating risk factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. HEPATOBILIARY COMPLICATIONS OF PARENTERAL NUTRITION IN CHILDREN

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    R. F. Tepaev

    2013-01-01

    Full Text Available Parenteral nutrition allows adequately providing children’s bodies with amino acids, carbohydrates, fats and energy required to maintain the baseline energy level and correct the preceding nutritive deficiency. Long-term parenteral nutrition is associated with hepatobiliary complications of varying severity – from transitory complications to lethal ones, caused by cholestasis. The article presents modern data on diagnostics, prevention and treatment of hepatobiliary complications of parenteral nutrition in children.

  11. Hepatobiliary Imaging and Its Pitfalls

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    Mukhtar Alam Ansari

    2011-05-01

    Full Text Available Ultrasound is the initial imaging modality for the"nevaluation of acute right upper quadrant pain. It"npermits accurate diagnosis of acute cholecystitis and"nsuccessfully identifies multiple other causes of patient"nsymptomatology. Some of these processes lie outside"nthe hepatobiliary system and include renal infection"nand obstruction, pancreatitis and its sequelae, duodenal"nor colonic perforation or mass lesions, peritoneal"ntumor spread, adrenal hemorrhage, and even remote"nproblems, such as pneumonia. The limitations on US"ninclude incomplete imaging of the liver, most often at"nthe dome or beneath ribs on the surface, and incomplete"nvisualization of lesion boundaries, particularly"nwith some infections and tumors. For these clinical"nscenarios, contrast-enhanced CT is complementary to"nUS and should be encouraged. In the biliary tree, US"nhas limitations in situations in which the ducts are not"ndilated and sometimes with imaging the extrahepatic"nducts, especially distally. For these patients, CT or"nMR imaging (MRCP is especially useful. If one keeps"nthe clinical scenario in mind and always images a"npatient where the pain is located, US is a powerful and"neffective diagnostic method for evaluating acute right"nupper quadrant pain.

  12. Emergency surgeon-performed hepatobiliary ultrasonography.

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    Kell, M R; Aherne, N J; Coffey, C; Power, C P; Kirwan, W O; Redmond, H P

    2002-11-01

    Acute hepatobiliary pathology is a common general surgical emergency referral. Diagnosis requires imaging of the biliary tree by ultrasonography. The accuracy and impact of surgeon-performed ultrasonography (SUS) on the diagnosis of emergent hepatobiliary pathology was examined. A prospective study, over a 6-month period, enrolled all patients with symptoms or signs of acute hepatobiliary pathology. Patients provided informed consent and underwent both SUS and standard radiology-performed ultrasonography (RUS). SUS was performed using a 2-5-MHz broadband portable ultrasound probe by two surgeons trained in ultrasonography, and RUS using a 2-5-MHz fixed unit. SUS results were correlated with those of RUS and pathological diagnoses. Fifty-three consecutive patients underwent 106 ultrasonographic investigations. SUS agreed with RUS in 50 (94.3 per cent) of 53 patients. SUS accurately detected cholelithiasis in all but two cases and no patient was inaccurately diagnosed as having cholelithiasis at SUS (95.2 per cent sensitivity and 100 per cent specificity). As an overall complementary diagnostic tool SUS provided the correct diagnosis in 96.2 per cent of patients. Time to scan was significantly shorter following SUS (3.1 versus 12.0 h, P < 0.05). SUS provides a rapid and accurate diagnosis of emergency hepatobiliary pathology and may contribute to the emergency management of hepatobiliary disease.

  13. Emergency surgeon-performed hepatobiliary ultrasonography.

    LENUS (Irish Health Repository)

    Kell, M R

    2012-02-03

    BACKGROUND: Acute hepatobiliary pathology is a common general surgical emergency referral. Diagnosis requires imaging of the biliary tree by ultrasonography. The accuracy and impact of surgeon-performed ultrasonography (SUS) on the diagnosis of emergent hepatobiliary pathology was examined. METHODS: A prospective study, over a 6-month period, enrolled all patients with symptoms or signs of acute hepatobiliary pathology. Patients provided informed consent and underwent both SUS and standard radiology-performed ultrasonography (RUS). SUS was performed using a 2-5-MHz broadband portable ultrasound probe by two surgeons trained in ultrasonography, and RUS using a 2-5-MHz fixed unit. SUS results were correlated with those of RUS and pathological diagnoses. RESULTS: Fifty-three consecutive patients underwent 106 ultrasonographic investigations. SUS agreed with RUS in 50 (94.3 per cent) of 53 patients. SUS accurately detected cholelithiasis in all but two cases and no patient was inaccurately diagnosed as having cholelithiasis at SUS (95.2 per cent sensitivity and 100 per cent specificity). As an overall complementary diagnostic tool SUS provided the correct diagnosis in 96.2 per cent of patients. Time to scan was significantly shorter following SUS (3.1 versus 12.0 h, P < 0.05). CONCLUSION: SUS provides a rapid and accurate diagnosis of emergency hepatobiliary pathology and may contribute to the emergency management of hepatobiliary disease.

  14. Hepatobiliary tuberculosis in western India

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    Amarapurkar Deepak

    2008-04-01

    Full Text Available Tuberculous involvement of liver as a part of disseminated tuberculosis is seen in up to 50-80% cases, but localized hepatobiliary tuberculosis (HBTB is uncommonly described. During 6 years, a total of 280 consecutive patients with TB were evaluated prospectively for the presence and etiology of liver involvement. Cases with miliary TB or immunosuppression and cases receiving anti-tuberculosis drugs prior to presentation to our unit were excluded (38 cases. Details of clinical, biochemical and imaging findings and histology/microbiology were noted. Of 242 included cases, 38 patients (15.7%; age 38.1 ± 12.5 years; sex ratio 2.5:1 had HBTB, whereas 20 patients (9%; age 39.3 ± 16.3 years; sex ratio 2.1:1 had other liver diseases. Diagnosis of HBTB was based on caseating granuloma on histology (18/23 procedures, positive smear/culture for acid-fast bacilli (21/39 procedures and positive polymerase chain reaction for Mycobacterium tuberculosis (28/29 procedures when diagnostic procedures were guided by imaging results. Thirty-eight cases with HBTB were classified as follows [patients (n, (%]: (A hepatic TB [20 (52.6%]: (1 granulomatous hepatitis - 10 (26.3%, (2 liver abscesses or pseudotumors - 10 (26.3% and (3 calcified hepatic granuloma - 0 (0%; (B biliary TB [15 (39.4%]: (1 biliary strictures - 2 (5.2%, (2 gall bladder involvement - 1 (2.6% and (3 biliary obstruction due to lymph node masses - 12 (31.5%; (C mixed variety [3 (7.8%]: (1 simultaneous granulomatous hepatitis and biliary stricture - 1 (2.6% and (2 simultaneous lymph node involvement and calcified hepatic granuloma - 2 (5.2%. All the cases responded well to standard anti-tuberculosis therapy. HBTB forms an important subgroup in TB cases. It requires a combination of imaging, histological and microbiological procedures to define the diagnosis. HBTB responds well to treatment.

  15. Hepatobiliary Disorders in Celiac Disease: An Update

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    Kaushal K. Prasad

    2011-01-01

    Full Text Available This communication reviews recent literature and summarizes hepatobiliary abnormalities that may complicate the clinical course of celiac disease. A wide spectrum of hepatobiliary diseases has been described, including asymptomatic elevations of liver enzyme levels, nonspecific hepatitis, nonalcoholic fatty liver disease, and autoimmune and cholestatic liver disease. Moreover, in the majority of patients, liver enzyme levels will normalize on a gluten-free diet. In addition, celiac disease may be associated with rare hepatic complications, such as hepatic T-cell lymphoma. Because many celiac patients do not have overt gastrointestinal symptoms, a high index of suspicion is required. Simple methods of detecting celiac disease such as serum antibody tests help in the early identification of the disease, thus preventing serious complications of the disorder. The IgG DGP antibody test and IgA tTG antibody test used in combination are an excellent screening test for suspected cases of celiac disease.

  16. Sequential hepatobiliary scintigraphy using IDA derivatives

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    Michalova, K. (Karlova Univ., Prague (Czechoslovakia). Biofyzikalni Ustav)

    1983-04-21

    A brief characteristic is presented of new radiopharmaceuticals suitable for functional examination of the hepatobiliary system. The examination is a contribution to non-invasive imaging, especially suitable for the evaluation of bile duct obstruction in icteric diseases and for the diagnosis of acute cholecystitis. It does not replace sonography or computer tomography but it is a complementary examination which in combination with clinical information may be valuable for diagnosis.

  17. Functional hepatobiliary MR imaging in children

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    Tamrazi, Anobel; Vasanawala, Shreyas S. [Stanford University, Department of Radiology, Stanford, CA (United States)

    2011-10-15

    Clinical application efforts for the hepatocyte-specific MRI contrast agent gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) have mainly been directed toward detection and characterization of various hepatic masses in the adult population. Here we report our initial experience with Gd-EOB-DTPA for evaluating congenital and acquired hepatobiliary pathologies in the pediatric population. Twenty-one consecutive children receiving Gd-EOB-DTPA for functional hepatobiliary evaluation at our institution were retrospectively identified with IRB approval. The use of Gd-EOB-DTPA was classified in each case as definite, potential, or no clinical utility, focusing on the clinical value gained beyond traditional noncontrast fluid-sensitive MR cholangiopancreatography (FS-MRCP) and other imaging modalities. Definite added value of Gd-EOB-DTPA was found in 12 patients, with potential value in 4 patients, and no value in 5 patients. Benefit was seen in cases of iatrogenic and non-iatrogenic biliary strictures, perihepatic fluid collections for biliary leak, hepatobiliary dysfunction in the absence of hyperbilirubinemia, and in the functional exclusion of cystic duct occlusion that can be seen in acute cholecystitis. This is the first reported series of children with Gd-EOB-DTPA and this early work suggests potential pediatric applications. (orig.)

  18. Hepato-biliary clinical trials and their inclusion in the Cochrane Hepato-Biliary Group register and reviews

    DEFF Research Database (Denmark)

    Klingenberg, Sarah Louise; Nikolova, Dimitrinka; Alexakis, Nicholas

    2011-01-01

    The Cochrane Hepato-Biliary Group (CHBG) is one of the 52 collaborative review groups within The Cochrane Collaboration. The activities of the CHBG focus on collecting hepato-biliary randomized clinical trials (RCT) and controlled clinical trials (CCT), and including them in systematic reviews wi...

  19. [Role of Helicobacter species in hepatobiliary diseases]3

    DEFF Research Database (Denmark)

    Rasmussen, M.E.; Lauritsen, L.E.; Andersen, Leif Percival

    2008-01-01

    Helicobacter species have been found in extragastric tissues of humans and mice, and it has been shown that hepatic infection with H. hepaticus causes chronic hepatitis and hepatocellular carcinoma (HCC) in mice. 18 studies of humans with hepatobiliary diseases have been reviewed. In studies...... of patients with HCC the results imply a pathogen role of Helicobacter species. The same trend was not found in studies of humans with other hepatobiliary diseases. There is no evidence of the possible involvement of Helicobacter species in the development of diseases in the hepatobiliary system...

  20. The management of hepatobiliary cystadenomas: lessons learned.

    Science.gov (United States)

    Martel, Guillaume; Alsharif, Jamal; Aubin, Jean-Michel; Marginean, Celia; Mimeault, Richard; Fairfull-Smith, Robert J; Mohammad, Waleed M; Balaa, Fady K

    2013-08-01

    Mucinous cystic neoplasms of the liver (hepatobiliary cystadenomas) are rare neoplastic lesions. Such cysts are often incorrectly diagnosed and managed, and carry a risk of malignancy. The objective of this study was to review the surgical experience with these lesions over 15 years. A retrospective chart review identified consecutive patients undergoing surgery for liver cystadenomas from 1997-2011. Clinical data were collected and summarized. Thirteen patients (mean age 51 years, 12/13 females) with cysts 4.6-18.1 cm were identified. Most cysts were located in the left lobe/centrally (11/12) and had septations (8/13). Mural nodularity was infrequent (3/13). Nine patients had liver resection/enucleation, whereas four had unroofing. Frozen section analysis had a high false-negative rate (4/6). All patients had cystadenomas, of which two had foci of invasive carcinoma (cystadenocarcinoma) within mural nodules. There was no 90-day mortality. All but one patient (myocardial infarction) were alive at a median follow-up of 23.1 months. No patient with unroofing has developed malignancy to date. Non-invasive hepatobiliary cystadenomas present as large central/left-sided cysts in young or middle-aged women. Associated malignancy was relatively uncommon and found within mural nodules. Intra-operative frozen section analysis was ineffective at ruling out cystadenomas. Complete excision is recommended, but close follow-up might be considered in patients with a prohibitive technical or medical risk, in the absence of nodularity on high-quality imaging. © 2012 International Hepato-Pancreato-Biliary Association.

  1. Hepato-biliary clinical trials and their inclusion in the Cochrane Hepato-Biliary Group register and reviews

    DEFF Research Database (Denmark)

    Klingenberg, Sarah Louise; Nikolova, Dimitrinka; Alexakis, Nicholas

    2011-01-01

    The Cochrane Hepato-Biliary Group (CHBG) is one of the 52 collaborative review groups within The Cochrane Collaboration. The activities of the CHBG focus on collecting hepato-biliary randomized clinical trials (RCT) and controlled clinical trials (CCT), and including them in systematic reviews...... with meta-analyses of the trials. In this overview, we present the growth of The CHBG Controlled Trials Register, as well as the systematic reviews that have been produced since March 1996....

  2. Radiology illustrated. Hepatobiliary and pancreatic radiology

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byung Ihn (ed.) [Seoul National Univ. Hospital (Korea, Republic of). Dept. of Radiology

    2014-04-01

    Clear, practical guide to the diagnostic imaging of diseases of the liver, biliary tree, gallbladder, pancreas, and spleen. A wealth of carefully selected and categorized illustrations. Highlighted key points to facilitate rapid review. Aid to differential diagnosis. Radiology Illustrated: Hepatobiliary and Pancreatic Radiology is the first of two volumes that will serve as a clear, practical guide to the diagnostic imaging of abdominal diseases. This volume, devoted to diseases of the liver, biliary tree, gallbladder, pancreas, and spleen, covers congenital disorders, vascular diseases, benign and malignant tumors, and infectious conditions. Liver transplantation, evaluation of the therapeutic response of hepatocellular carcinoma, trauma, and post-treatment complications are also addressed. The book presents approximately 560 cases with more than 2100 carefully selected and categorized illustrations, along with key text messages and tables, that will allow the reader easily to recall the relevant images as an aid to differential diagnosis. At the end of each text message, key points are summarized to facilitate rapid review and learning. In addition, brief descriptions of each clinical problem are provided, followed by both common and uncommon case studies that illustrate the role of different imaging modalities, such as ultrasound, radiography, CT, and MRI.

  3. Hepatobiliary disease in children and adolescents with cystic fibrosis.

    Science.gov (United States)

    Nascimento, Fernanda de S; Sena, Nelson A; Ferreira, Tatiane da A; Marques, Cibele D F; Silva, Luciana R; Souza, Edna Lúcia S de

    2017-09-07

    The aims of the study were to determine the frequency of hepatobiliary disease in patients with CF and to describe the sociodemographic, clinical, and laboratory profile of these patients. This was a retrospective, descriptive, and analytical study of 55 patients diagnosed with CF fibrosis, aged between 3 months and 21 years, followed-up from January 2008 to June 2016 in a referral center. Medical records were consulted, including sociodemographic, clinical and laboratory data, including hepatobiliary alterations, imaging studies, genetic studies, liver biopsies, and upper digestive endoscopies. Hepatobiliary disease was diagnosed in 16.4% of the patients and occurred as an initial manifestation of CF in 55.6% of these cases. The diagnosis of hepatopathy occurred before or concomitantly with the diagnosis of CF in 88.9% of the children. All patients with hepatobiliary disease were considered non-white, with a predominance of females (77.8%) and median (IQR) of 54 (27-91) months. Compared with the group without hepatobiliary disease, children with liver disease had a higher frequency of severe mutations identified in the CFTR gene (77.8% vs. 39.6%, p=0.033) and severe pancreatic insufficiency (88.9% vs. 31.6%, p=0.007). The frequency of hepatobiliary disease was high, with a very early diagnosis of the disease and its complications in the studied series. A statistical association was observed between the occurrence of hepatobiliary disease and the presence of pancreatic insufficiency and severe mutations in the CFTR gene. It is emphasized that CF is an important differential diagnosis of liver diseases in childhood. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  4. Arterial blood gas anomaly in canine hepatobiliary disease.

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    Kaneko, Yasuyuki; Torisu, Shidow; Kobayashi, Takumi; Mizutani, Shinya; Tsuzuki, Nao; Sonoda, Hiroko; Ikeda, Masahiro; Naganobu, Kiyokazu

    2016-01-01

    Arterial blood gas analysis is an important diagnostic and monitoring tool for respiratory abnormalities. In human medicine, lung complications often occur as a result of liver disease. Although pulmonary complications of liver disease have not been reported in dogs, we have frequently encountered hypoxemia in dogs with liver disorders, especially extrahepatic biliary obstruction. In addition, respiratory disorders account for 20% of perioperative fatalities in dogs. Therefore, in this study, we evaluated the respiratory status in dogs with hepatobiliary disease by arterial blood gas analysis. PaO2 and PaCO2 were measured. Alveolar-arterial oxygen difference (AaDO2), the indicator of gas exchange efficiency, was calculated. Compared to healthy dogs (control group), hepatobiliary disease dogs had significantly lower PaO2 and higher AaDO2. Hypoxemia (PaO2 of ≤80 mmHg) was observed in 28/71 dogs with hepatobiliary disease. AaDO2 was higher (≥30 mmHg) than the control group range (11.6 to 26.4 mmHg) in 32/71 hepatobiliary disease dogs. By classifying type of hepatobiliary disease, dogs with extrahepatic biliary obstruction and chronic hepatitis showed significantly lower PaO2 and higher AaDO2 than in a control group. Dogs with chronic hepatitis also had significantly lower PaCO2. The present study shows that dogs with hepatobiliary disease have respiratory abnormalities more than healthy dogs. Preanesthetic or routine arterial blood gas analysis is likely beneficial to detect the respiratory abnormalities in dogs with hepatobiliary disease, especially extrahepatic biliary obstruction and chronic hepatitis.

  5. Use of Serum MicroRNAs as Biomarker for Hepatobiliary Diseases in Dogs

    NARCIS (Netherlands)

    Dirksen, K; Verzijl, T; Grinwis, G C; Favier, R P; Penning, L C; Burgener, I A; van der Laan, L J; Fieten, H; Spee, B

    2016-01-01

    BACKGROUND: Current biochemical indicators cannot discriminate between parenchymal, biliary, vascular, and neoplastic hepatobiliary diseases. MicroRNAs are promising new biomarkers for hepatobiliary disease in humans and dogs. OBJECTIVE: To measure serum concentrations of an established group of mic

  6. Use of Serum MicroRNAs as Biomarker for Hepatobiliary Diseases in Dogs

    NARCIS (Netherlands)

    Dirksen, K; Verzijl, T; Grinwis, G C; Favier, R P; Penning, L C; Burgener, I A; van der Laan, L J; Fieten, H; Spee, B

    2016-01-01

    BACKGROUND: Current biochemical indicators cannot discriminate between parenchymal, biliary, vascular, and neoplastic hepatobiliary diseases. MicroRNAs are promising new biomarkers for hepatobiliary disease in humans and dogs. OBJECTIVE: To measure serum concentrations of an established group of mic

  7. [Hepatobiliary diseases in Crohn disease and ulcerative colitis].

    Science.gov (United States)

    Kruis, W

    1987-02-01

    Hepatobiliary diseases are certainly not very frequent extraintestinal complications of chronic intestinal inflammatory diseases, however, they are an important prognostic factor. 2% of patients with ulcerative colitis develop liver cirrhosis but 10% of those die as a direct result of liver failure. Other associated severe hepatobiliary diseases include primary sclerosing cholangitis, carcinoma of the bile duct and amyloidosis. The present review attempts to divide the associated hepatobiliary diseases into three groups. 1. those that are the result of therapy. 2. those that are the result of the pathophysiological mechanisms of the underlying disease and 3. those of unknown etiological origin. This division might serve not only for a better understanding of the various mechanisms but should have some impact on therapeutic regimens.

  8. Etiology of the obstructive pattern in hepatobiliary imaging

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    Hughes, K.S.; Marrangoni, A.G.; Turbiner, E.

    1984-04-01

    The records of all patients undergoing hepatobiliary imaging with technetion radioisotopes at our hospital from January 1980 to March 1983 were reviewed and 29 scans met the criteria for a pattern consistent with complete biliary tract obstruction. Biliary tract obstruction (due to choledocholithiasis, primary or secondary carcinoma involving the common bile duct, and pancreatitis) was documented in 24 of these patients. However, the remaining five patients had a patent common bile duct, and the etiologic factor was intrahepatic cholestasis secondary to sepsis in four and peritonitis in one. A classification of altered biliary dynamics in hepatobiliary imaging, which is based on the classification of jaundice, is proposed.

  9. The enteric microbiome in hepatobiliary health and disease.

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    Tabibian, James H; Varghese, Cyril; LaRusso, Nicholas F; O'Hara, Steven P

    2016-04-01

    Increasing evidence points to the contribution of the intestinal microbiome as a potentially key determinant in the initiation and/or progression of hepatobiliary disease. While current understanding of this dynamic is incomplete, exciting insights are continually being made and more are expected given the developments in molecular and high-throughput omics techniques. In this brief review, we provide a practical and updated synopsis of the interaction of the intestinal microbiome with the liver and its downstream impact on the initiation, progression and complications of hepatobiliary disease.

  10. Accuracy of Hepatobiliary Scintigraphy after Liver Transplantation and Liver Resection

    Directory of Open Access Journals (Sweden)

    Manuel Eckenschwiller

    2016-01-01

    Full Text Available Background and Aims. Biliary complications are the most frequent complications after common liver surgeries. In this study, accuracy of hepatobiliary scintigraphy (HBS and impact of hyperbilirubinemia were evaluated. Methods. Between November 2007 and February 2016, 131 patients underwent hepatobiliary scintigraphy after having liver surgery. 39 patients with 42 scans after LTX (n=13 or hepatic resection (n=26 were evaluated in the study; 27 were male, with mean age 60 years. The subjects underwent hepatobiliary scintigraphy with Tc-99m labeled Mebrofenin. The results were compared to ERCP as gold standard performed within one month after HBS. We calculated sensitivity, specificity, PPV, and NPV. We compared LTX patients to patients with other liver surgeries. Furthermore the influence of hyperbilirubinemia on HBS scans was evaluated. Results. HBS always provided the correct diagnosis in cases of bile leak in the liver-resected group (14/14. Overall diagnostic accuracy was 76% (19/25 in this group and 54% (7/13 in the LTX group. False negative (FN diagnoses occurred more often among LTX patients (p=0.011. Hyperbilirubinemia (>5 mg/dL significantly influenced the excretion function of the liver, prolonging HBS’s time-activity-curve (p=0.001. Conclusions. Hepatobiliary scintigraphy is a reliable tool to detect biliary complications, but reduced accuracy must be considered after LTX.

  11. Radiological findings of intraparenchymal liver Ascaris (hepatobiliary ascariasis)

    Energy Technology Data Exchange (ETDEWEB)

    Akata, D.; Oezmen, M.N.; Kaya, A.; Akhan, O. [Dept. of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)

    1999-02-01

    Ascariasis is a well-known cause of acute cholangitis and cholecystitis; however, very rarely do worms penetrate and colonize the liver parenchyma. Here we present the unique radiological demonstration (US, CT and ERCP) of hepatobiliary ascariasis in which worm was first alive in the parenchyma of the liver and subsequently died and formed liver abscess. (orig.) (orig.) With 3 figs., 8 refs.

  12. Ultrasound Imaging of the Hepatobiliary System and Pancreas.

    Science.gov (United States)

    Larson, Martha Moon

    2016-05-01

    Ultrasound is an extremely valuable diagnostic modality for the diagnosis of hepatobiliary and pancreatic disease. Normal appearance and normal variations are important to understand to avoid misinterpretation. Although ultrasound can identify a lesion, cytology and histopathology are usually needed for a final diagnosis.

  13. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1995-06-15

    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  14. Robotic hepatobiliary surgery: update on the current status.

    Science.gov (United States)

    Carr, A D; Ali, M R; Khatri, V P

    2013-10-01

    An update on the current status of robotic hepatobiliary surgery based on a review of the available literature. A literature search was performed using the PubMed database with search phrases "robotic hepatectomy", "robotic liver resection", "robotic liver surgery", "robotic hepatobiliary surgery", and "robotic biliary reconstruction". We selected articles with high volume case series or case controlled series. As a result of our literature search we will focus on the 9 major articles on robotic liver resection (RLR) with 235 patients undergoing RLR for a total of 244 liver resections. In addition a brief update on robotic biliary reconstruction will also be presented based on the above articles and recent review articles. Indications for robotic liver resection included both benign (N.=72, 29.5%) and malignant disease (N.=172, 70.5%). The most common indication was colorectal liver metastasis (N.=87, 50.6%) and hepatocellular carcinoma (N.=57, 33%). The most common type of resection was subsegmental (N.=55, 22.5%), with a significant number of major hepatectomies (N.=80, 32.8%). Overall conversion rate was 7.8%, with majority converted to open (N.=18) and one converted to hand assisted. The overall complication rate was 11.8% (N.=29). No perioperative mortality was reported. Preliminary results show that robotic assisted laparoscopic hepatobiliary surgery has materialized as a new technique that combines the advantages of laparoscopy with the dissection, suturing and articulation of robotics. This more closely approximates open surgery. The preliminary data demonstrates that RLR can be applied in major hepatobiliary centers safely. Future comparative studies are needed to determine if this is of significant benefit over current open techniques.

  15. Hepatobiliary Tract and Pancreatic Disorders in Celiac Disease

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    1997-01-01

    Full Text Available A number of hepatobiliary tract and pancreatic disorders have been documented in patients with celiac disease. Some disorders have shared immunological or genetic factors, including chronic hepatitis, primary biliary cirrhosis and sclerosing cholangitis. Other hepatic or pancreatic pathological changes in celiac disease have been documented with severe malnutrition and malabsorption, including hepatic steatosis and pancreatic insufficiency, sometimes with pancreatic calcification. Finally, celiac disease may be associated with other very rare hepatic complications, such as hepatic T cell lymphoma.

  16. [The evaluation of chemoradiotherapy to unresectable hepatobiliary cancers].

    Science.gov (United States)

    Akita, Hirofumi; Yamada, Terumasa; Sasaki, Yo; Eguchi, Hidetoshi; Ohigashi, Hiroaki; Ishikawa, Osamu; Imaoka, Shingi

    2005-10-01

    Today, there are few effective treatment options to unresectable hepatobiliary cancers. We enforced chemoradiotherapy to 7 patients who had far advanced hilar cholangiocarcinomas or hepatobiliary cancers because they could not receive radical operations. Then, we examined the effectiveness of this therapy. The radiation method was a conformation radiotherapy to 5 patients and the combination of conformation radiotherapy and RALS to 2 patients irradiated once with the radiation of 2-3 Gy. The menu of chemotherapy was the combination of 5-FU (1,250 2,500 mg/week) and CDDP (10-50 mg/week) by intravenous infusion or injection to the hepatic artery in all patients. By this therapy, 6 out of 7 patients were able to live for one year or more, and the median survival time was 1.41 years (0.65-2.65). Only two patients were judged as clinical PR by computed tomography, but the value of the tumor marker after radiotherapy was 85.7% (6/7), a decrease of 1/3 or less before the treatment. As for side effects, nausea, vomit, and appetite loss were observed in some patients. However, they were not so severe and the treatment could be easily restarted. Though various examinations are necessary, the chemoradiotherapy is expected to be useful for unresectable hepatobiliary cancers.

  17. Funding, disease area, and internal validity of hepatobiliary randomized clinical trials

    DEFF Research Database (Denmark)

    Kjaergard, Lise Lotte; Gluud, Christian

    2002-01-01

    The aim of this study was to assess whether funding and the disease area are related to the internal validity of hepatobiliary randomized clinical trials.......The aim of this study was to assess whether funding and the disease area are related to the internal validity of hepatobiliary randomized clinical trials....

  18. Assessment of Future Remnant Liver Function Using Hepatobiliary Scintigraphy in Patients Undergoing Major Liver Resection

    NARCIS (Netherlands)

    de Graaf, W.; van Lienden, K.P.; Dinant, S.; Roelofs, J.J.T.H.; Busch, O.R.C.; Gouma, D.J.; Bennink, R.J.; van Gulik, T.M.

    2010-01-01

    Tc-99m-mebrofenin hepatobiliary scintigraphy (HBS) was used as a quantitative method to evaluate liver function. The aim of this study was to compare future remnant liver function assessed by Tc-99m-mebrofenin hepatobiliary scintigraphy with future remnant liver volume in the prediction of liver

  19. Pitfalls and Limitations of Radionuclide Hepatobiliary and Gastrointestinal System Imaging.

    Science.gov (United States)

    Low, Chen Sheng; Ahmed, Haseeb; Notghi, Alp

    2015-11-01

    Radionuclide imaging for the hepatobiliary and gastrointestinal system covers a wide range of different indications and imaging techniques. This wide variety allows the different functional assessments of both systems. Therefore, the understanding of each technique and its indications is essential. Cholescintigraphy is a well-established method in the assessment of acute and chronic cholecystitis. It also has a role in the detection of biliary atresia. The assessment of gastrointestinal transit is also well-established in radionuclide imaging for functional investigation of the gastrointestinal tract. Furthermore, detection of acute gastrointestinal bleeding with radionuclide imaging is also standard practice. This article aims to review the pitfalls and limitations in all of these areas.

  20. Hepatobiliary scintigraphy for early diagnosis of biliary atresia

    DEFF Research Database (Denmark)

    Brittain, Jane Maestri; Kvist, Nina; Johansen, Lars Søndergaard;

    2016-01-01

    INTRODUCTION: The aim of this study was to evaluate the validity of (99m)Technetium-trimethylbromo-iminodiacetic acid hepatobiliary scintigraphy (HS) for the diagnosis of biliary atresia (BA). METHODS: From January 2005 to December 2009, a total of 47 infants with conjugated hyperbilirubinaemia...... sensitivity and NPV prevent un-necessary surgery. Because of the low specificity of HS in diagnosing BA, it should be part of a multimodality imaging strategy when the result supports a clinical suspicion of BA. In cases with non-draining HS and normal GGTP blood levels, supplemental imaging modalities...

  1. Association between Helicobacter spp. infections and hepatobiliary malignancies: A review

    Science.gov (United States)

    Segura-López, Fany Karina; Güitrón-Cantú, Alfredo; Torres, Javier

    2015-01-01

    Hepatobiliary cancers are highly lethal cancers that comprise a spectrum of invasive carcinomas originating in the liver hepatocellular carcinoma, the bile ducts intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma, the gallbladder and the ampulla of Vater (collectively known as biliary tract cancers). These tumors account for approximately 13% of all annual cancer-related deaths worldwide and for 10%-20% of deaths from hepatobiliary malignancies. Cholangiocarcinoma (CCA) is a devastating disease that displays a poor survival rate for which few therapeutic options are available. Population genetics, geographical and environmental factors, cholelithiasis, obesity, parity, and endemic infection with liver flukes have been identified as risk factors that influence the development of biliary tract tumors. Other important factors affecting the carcinogenesis of these tumors include chronic inflammation, obstruction of the bile ducts, and impaired bile flow. It has been suggested that CCA is caused by infection with Helicobacter species, such as Helicobacter bilis and Helicobacter hepaticus, in a manner that is similar to the reported role of Helicobacter pylori in distal gastric cancer. Due to the difficulty in culturing these Helicobacter species, molecular methods, such as polymerase chain reaction and sequencing, or immunologic assays have become the methods of choice for diagnosis. However, clinical studies of benign or malignant biliary tract diseases revealed remarkable variability in the methods and the findings, and the use of uniform and validated techniques is needed. PMID:25663761

  2. Hepatobiliary Scan in Infantile Spontaneous Perforation of Common Bile Duct

    Energy Technology Data Exchange (ETDEWEB)

    Zeon, Seok Kil; Ryu, Jong Gul; Lee, Eun Young [Keimyung University School of Medicine, Taegu (Korea, Republic of); Lee, Jong Gil [Taegu Fatima Hospital, Taegu (Korea, Republic of)

    1996-03-15

    Spontaneous perforation of CBD in infant is a rare but fatal disease. We report a case of bile leakage from common bile duct in 11 months old girl with progressive abdominal distension and vomiting, preoperatively diagnosed by hepatobiliary scan with Tc-99m-DISIDA, which was confirmed by surgery. Operative cholangiogram showed a small perforation at the confluence of cystic duct and common bile duct with mild fusiform dilatation, and no definite abnormality in confluence of the common bile duct and pancreatic duct. Simple drainage of the free peritoneal bilous fluid and T-tube drainage were performed without any evidence of the complication. Patient was inevitable for 6 months OPD follow-up examination.

  3. Citation bias of hepato-biliary randomized clinical trials

    DEFF Research Database (Denmark)

    Kjaergard, Lise L; Gluud, Christian

    2002-01-01

    -1996. From each trial, we extracted the statistical significance of the primary study outcome (positive or negative), the disease area, and methodological quality (randomization and double blinding). The number of citations during two calendar years after publication was obtained from Science Citation Index......The objective of this study was to assess whether trials with a positive (i.e., statistically significant) outcome are cited more often than negative trials. We reviewed 530 randomized clinical trials on hepato-biliary diseases published in 11 English-language journals indexed in MEDLINE from 1985....... There was a significant positive association between a statistically significant study outcome and the citation frequency (beta, 0.55, 95% confidence interval, 0.39-0.72). The disease area and adequate generation of the allocation sequence were also significant predictors of the citation frequency. We concluded...

  4. Hepatobiliary and pancreatic ascariasis-sonographic pictorial essay on four pediatric cases with acute biliary colic.

    Science.gov (United States)

    Lynser, Donboklang; Marbaniang, Evarisalin

    2016-04-01

    Hepatobiliary and pancreatic ascariasis occur due to migration of the round worm ascaris lumbricoides through the bile duct orifice finally reaching the common bile duct, main pancreatic duct, intrahepatic ducts or gallbladder. These resulted in acute epigastric and right hypochondriac region colicky pain. Ultrasound is the investigation of choice in hepatobiliary ascariasis. We present here sonographic images on four pediatric patients with acute biliary colic.

  5. Changes in Hepatobiliary Enzyme Abnormality After the Great East Japan Earthquake: The Fukushima Health Management Survey.

    Science.gov (United States)

    Takahashi, Atsushi; Ohira, Tetsuya; Uemura, Mayu; Hosoya, Mitsuaki; Yasumura, Seiji; Hashimoto, Shigeatsu; Ohira, Hiromasa; Sakai, Akira; Ohtsuru, Akira; Satoh, Hiroaki; Kawasaki, Yukihiko; Suzuki, Hitoshi; Sugiura, Yoshihiro; Shishido, Hiroaki; Hayashi, Yoshimitsu; Takahashi, Hideto; Nakano, Hironori; Kobashi, Gen; Ozasa, Kotaro; Ohto, Hitoshi; Abe, Masafumi

    2017-04-06

    Although the incidence of hepatobiliary enzyme abnormality increased immediately after the Great East Japan Earthquake and subsequent Fukushima Daiichi Nuclear Power Plant accident, longer-term trends remain unclear. The aims of this study were to determine longer-term trends in hepatobiliary enzyme abnormality and to elucidate lifestyle factors associated with such changes among residents of a nuclear-disaster-affected area. This longitudinal survey enrolled 20,395 adults living in the vicinity of Fukushima Daiichi Nuclear Power Plant. Data were obtained from the records of annual health checkups of adults aged ≥40 years between 2011 and 2012. Follow-up examinations were conducted from June 2013 to March 2014. Associations were assessed between changes in hepatobiliary enzyme abnormality immediately and 3-4 years after the disaster and lifestyle factors. The overall prevalence of hepatobiliary enzyme abnormality significantly decreased over the study period, from 29.9% to 27.1%. Multivariate logistic regression analysis revealed significant associations between improved hepatobiliary enzyme abnormality and improvements in daily physical activity and frequency of breakfast consumption. The results suggest that improvements in daily physical activity and frequency of breakfast consumption significantly reduced the incidence of hepatobiliary enzyme abnormality 3-4 years after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant accident.

  6. The role of hepatobiliary scintigraphy and oral cholecystography in predicting the performance of laparoscopic cholecystectomy

    Energy Technology Data Exchange (ETDEWEB)

    Won, Kyoung Sook [Kangnung Hospital, Kangnung (Korea, Republic of); Ryu, Jin Sook; Moon, Dae Hyuk [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)] [and others

    1997-03-01

    Laparoscopic cholecystectomy can be performed safely in most patients with symptomatic cholelithiasis. Preoperative evaluation should assess the potential problems that affect the performance of laparoscopic cholecystectomy. Hepatobiliary scintigraphy or oral cholecystography can assess the gallbladder function and nonvisualization of gallbladder usually indicates acute or severe chronic cholecystitis. The purpose of this study was to evaluate the role of preoperative hepatobiliary scintigraphy or oral cholecystography in predicting the performance of laparoscopic cholecystectomy. The study group consists of 176 patients who underwent both hepatobiliary scintigraphy with Tc-99m DISIDA and oral choelcystography within one month before laparoscopic cholecystectomy. Nonvisualization of gallbladder was defined as persistent nonvisualization of gallbladder until 4 hours on hepatobiliary scintigraphy or 12 hours on oral cholecystography. Among 176 patients, gallbladder was not visualized in 38 patients on hepatobiliary scintigraphy and 41 patients on oral cholecystography. Concordance rate between hepatobiliary scintigraphy and oral cholecystography was 89.2%. The conversion rate to open cholocystectomy was significantly higher in patients with nonvisualization of gallbladder than in patients with gallbladder higher in patients with nonvisualization of gallbladder visualization (15.8% vs 2.9% on hepatobiliary scintigraphy, 12.2% vs 3.7% on oral cholecystography: p<0.01 and p<0.05 respectively). The operative complication rate was also significantly higher in patients with nonvisualization of gallbladder (13.2% vs 2.9% on hepatobiliary scintigraphy, 14.6% vs 2.2% on oral cholecystography : p<0.01 and p<0.001, respectively). Similarly, operation time was significantly prolonged in patients with nonvisualization of gallbladder (88.8{+-}41.9 min vs 62.5{+-}23.6 min on hepatobiliary scintigraphy : p<0.001, 89.4{+-}41.3 min vs 61.8{+-}22.8 min on oral cholecystography :p<0

  7. Chronic Opisthorchis viverrini infection and associated hepatobiliary disease is associated with iron loaded M2-like macrophages.

    Science.gov (United States)

    Bility, Moses T; Sripa, Banchob

    2014-12-01

    Chronic Opisthorchis viverrini-induced hepatobiliary disease is associated with significant leukocyte infiltration, including activated macrophages; however, the polarization of infiltrating macrophages remains to be fully characterized. In this study, we characterized macrophage polarization and phenotype in chronic O. viverrini-induced hepatobiliary disease in humans and hamsters using gene expression and histochemical analysis. Chronic O. viverrini infection and associated hepatobiliary diseases were associated with iron loaded M2-like macrophages in both humans and hamsters. This study provides suggestive evidence that iron loaded M2-like macrophages promote hepatobiliary disease in chronic O. viverrini infection.

  8. State of the art in robotic hepatobiliary surgery.

    Science.gov (United States)

    Milone, Luca; Daskalaki, Despoina; Fernandes, Eduardo; Damoli, Isacco; Giulianotti, Pier Cristoforo

    2013-12-01

    Hepatobiliary (HB) surgery is a challenging surgical subspecialty that requires highly specialized training and an adequate level of experience in order to be performed safely. As a result, minimally invasive HB surgery has been met with slower acceptance as compared to other subspecialties, with many surgeons in the field still reluctant to adopt the approach. Recently development of the robotic platform has provided a tool that can overcome many of the limitations of conventional laparoscopic HB surgery. Augmented dexterity enabled by the endowristed movements, software filtration of the surgeon's movements, and high-definition three-dimensional vision provided by the stereoscopic camera combine to allow steady and careful dissection of the liver hilum structures, as well as prompt and precise endosuturing in cases of intraoperative bleeding. These advantages have fostered many centers to widen the indications for minimally invasive HB and gastric surgery, with encouraging initial results. As one of the surgical groups that has performed the largest number of robot-assisted procedures worldwide, we provide a review of the state of the art in minimally invasive robot-assisted HB surgery.

  9. Use of health-related quality of life tools in hepatobiliary surgery

    Institute of Scientific and Technical Information of China (English)

    Muhammad Shaifque Sajid; Mawara Iftikhar; Jasmin Rimple; Mirza Khurrum Baig

    2008-01-01

    BACKGROUND:The objective of this article is to review the literature and discuss the various tools used in hepatobiliary surgery for the measurement of health related quality of life (HR-QOL) and highlight various outcome variables that affect the HR-QOL among patients with common hepatobiliary disorders. DATA SOURCES:We reviewed HR-QOL articles published in the last 20 years on different hepatobiliary curative or palliative procedures in all languages. RESULTS:HR-QOL is a questionnaire tool which is utilized to assess the changes in the health status of patients after a hepatobiliary intervention. These surveys are of increasingly importance, as health care providers are challenged to justify treatment approaches and rationale for any surgical intervention. These HR-QOL tools are very helpful for the evaluation of subjective outcome of common hepatobiliary procedures like gastrointestinal quality of life index (GIQLI) for cholecystectomy, functional assessment in cancer therapy (FACT) for liver resection, short form 36 (SF-36) for liver transplantation, and quality of life questionnaire for patients with pancreatic cancer (QLQ-PAN). CONCLUSIONS:Use of validated and reliable health instruments in hepatobiliary surgery is directed at measuring the impact in a reproducible and valid fashion. Curative or palliative procedures should be offered to the patients of hepatobiliary disorders after the assessment by HR-QOL tools. Because the impairments of function that may occur after different operations vary considerably, an operation-speciifc assessment of HR-QOL for each type of surgical procedure is becoming an essential principle to follow in a successful healthcare system.

  10. Hepatobiliary transport and metabolism of the methylmercury-glutathione complex

    Energy Technology Data Exchange (ETDEWEB)

    Dutczak, W.J.

    1994-12-31

    Biliary excretion, followed by fecal elimination, is a major route for the elimination of metals, including methylmercury; however, the mechanisms for the hepatobiliary transport and metabolism of these compounds have not been identified. The goal of this research was to characterize the mechanism by which methylmercury, a highly neurotoxic environmental contaminant, is transported across the canalicular membrane into bile and to investigate the fate of this metal within the biliary tree. Methylmercury is eliminated predominately through biliary excretion and undergoes extensive enterohepatic cycling. Because methylmercury is believed to be transported across the canalicular membrane into bile as a glutathione complex (CH{sub 3}Hg-SG), its fate may be similar to that of glutathione (GSH). GSH is transported into bile by an electrogenic, carrier mediated transport system, where it is catabolized by the luminal enzymes {gamma}-glutamyltransferase ({gamma}-GT) and dipeptidases yielding glutamate, cysteine, and glycine, and these products are then partially reabsorbed from the biliary tree. To investigate the mechanism by which CH{sub 3}Hg-SG is transported into bile, CH{sub 3}{sup 203}Hg-SG transport was characterized using liver plasma membrane vesicles derived from the canalicular domain of rat hepatocytes. CH{sub 3}Hg-SG uptake was independent of either ATP or a Na{sup +} gradient; however, uptake was stimulated by an induced electrical potential. CH{sub 3}Hg-SG transport was saturable with both high (K{sub m} = 11.9 {+-} 1.6 {mu}M) and low (K{sub m} = 1.47 {+-} 0.22 mM) affinity components. Uptake of this complex was inhibited by GSH and various GSH conjugates but not by GSSG, bile acids, amino acids, or p-glycoprotein substrates. Furthermore, GSH competitively inhibited and trans-stimulated CH{sub 3}Hg-SG uptake.

  11. Therapeutic endoscopic retrograde cholangiopancreatography and related modalities have many roles in hepatobiliary hydatid disease

    Institute of Scientific and Technical Information of China (English)

    Ersan (O)zaslan

    2006-01-01

    The authors report their experience about 8 cases of intrabiliary rupture of hepatobiliary hydatid disease, and add an algorithm for treatment. To our opinion, the use of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in the management of hepatobiliary hydatid disease was not stated properly in their proposed algorithm. According to the algorithm, the use of ERCP and related modalities was only stated in the case of postoperative biliary fistulae. We think that postoperative persistant fistula is not a sole indication, there are many indications for ERCP and related techniques namely sphincterotomy, extraction, nasobiliary drainage and stenting, in the treatment algorithm before or after surgery.

  12. Hepatobiliary cholesterol transport is not impaired in Abca1-null mice lacking HDL

    NARCIS (Netherlands)

    Groen, AK; Bloks, VW; Bandsma, RHJ; Ottenhoff, R; Chimini, G; Kuipers, F

    The ABC transporter ABCA1 regulates HDL levels and is considered to control the first step of reverse cholesterol transport from the periphery to the liver. To test this concept, we studied the effect of ABCA1 deficiency on hepatic metabolism and hepatobiliary flux of cholesterol in mice. Hepatic

  13. Robotics in hepatobiliary surgery-initial experience, first reported case series from India

    Directory of Open Access Journals (Sweden)

    S. Goja

    2017-01-01

    Conclusion: This initial series adds to existing data on the feasibility of robotic hepatobiliary cases with inherent advantages of minimal invasive surgery, however with limitation of availability and use of devices like cavitron ultrasonic surgical aspirator (CUSA and higher operative cost.

  14. Subtle to severe hepatobiliary morbidity in Opisthorchis viverrini endemic settings in southern Laos.

    Science.gov (United States)

    Ayé Soukhathammavong, Phonepasong; Rajpho, Virasack; Phongluxa, Khampheng; Vonghachack, Youthanavanh; Hattendorf, Jan; Hongvanthong, Bouasy; Rasaphon, Oroth; Sripa, Banchob; Akkhavong, Kongsap; Hatz, Christoph; Odermatt, Peter

    2015-01-01

    Evidence of severe hepatobiliary morbidity associated with Opisthorchis viverrini liver fluke infection including cholangiocarcinoma (CCA) is scarce in Laos although O. viverrini infection is highly prevalent. We assessed hepatobiliary morbidity using abdominal ultrasonography (US) in O. viverrini adult patients in Saravan province, Southern Laos. A random sample of 431 O. viverrini patients from 10 villages underwent abdominal US. Mild, moderate and markedly advanced periductal fibrosis was diagnosed in 7.0%, 66.5%, and 17.0% of patients, respectively. Normal liver parenchyma was seen in only 9.5% of patients. Presence of gall stones (13.2%), sludge (1.4%), gall wall thickening (1.2%), bile duct dilatation (1.6%), fatty liver (12.0%), kidney stones (8.6%) and cysts (7.9%) were diagnosed in considerable frequencies. In five patients (1.2%) hepatobiliary lesions suggesting CCA were diagnosed. Tumour markers, i.e. Interleukin-6, plasminogen activator inhibitor and carbohydrate antigen 19-9 were within normal range. The number of CCA suspected liver masses and hepatobiliary morbidity diagnosed among clinically asymptomatic adult patients in O. viverrini endemic area presents a major public health concern in Laos. However, definitive diagnosis of Opisthorchis-related severe sequelae including CCA is urgently needed to gauge the burden of this deadly disease in Laos.

  15. Anatomy of the Murine Hepatobiliary System: A Whole-Organ-Level Analysis Using a Transparency Method.

    Science.gov (United States)

    Higashiyama, Hiroki; Sumitomo, Hiroyuki; Ozawa, Aisa; Igarashi, Hitomi; Tsunekawa, Naoki; Kurohmaru, Masamichi; Kanai, Yoshiakira

    2016-02-01

    The biliary tract is a well-branched ductal structure that exhibits great variation in morphology among vertebrates. Its function is maintained by complex constructions of blood vessels, nerves, and smooth muscles, the so-called hepatobiliary system. Although the mouse (Mus musculus) has been used as a model organism for humans, the morphology of its hepatobiliary system has not been well documented at the topographical level, mostly because of its small size and complexity. To reconcile this, we conducted whole-mount anatomical descriptions of the murine extrahepatic biliary tracts with related blood vessels, nerves, and smooth muscles using a recently developed transparentizing method, CUBIC. Several major differences from humans were found in mice: (1) among the biliary arteries, the arteria gastrica sinistra accessoria was commonly found, which rarely appears in humans; (2) the sphincter muscle in the choledochoduodenal junction is unseparated from the duodenal muscle; (3) the pancreatic duct opens to the bile duct without any sphincter muscles because of its distance from the duodenum. This state is identical to a human congenital malformation, an anomalous arrangement of pancreaticobiliary ducts. However, other parts of the murine hepatobiliary system (such as the branching patterns of the biliary tract, blood vessels, and nerves) presented the same patterns as humans and other mammals topologically. Thus, the mouse is useful as an experimental model for studying the human hepatobiliary system.

  16. Cutaneous Metastases from Primary Hepatobiliary Tumors as the First Sign of Tumor Recurrence following Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Adam T. Hauch

    2014-01-01

    Full Text Available Cutaneous metastasis from hepatobiliary tumors is a rare event, especially following liver transplantation. We report our experience with two cases of cutaneous metastases from both hepatocellular carcinoma and mixed hepatocellular/cholangiocarcinoma following liver transplantation, along with a review of the literature.

  17. Coinfection with Helicobacter pylori and Opisthorchis viverrini Enhances the Severity of Hepatobiliary Abnormalities in Hamsters.

    Science.gov (United States)

    Dangtakot, Rungtiwa; Pinlaor, Somchai; Itthitaetrakool, Upsornsawan; Chaidee, Apisit; Chomvarin, Chariya; Sangka, Arunnee; Wilailuckana, Chotechana; Pinlaor, Porntip

    2017-04-01

    Persistent infection with Opisthorchis viverrini causes hepatobiliary abnormalities, predisposing infected individuals to cholangiocarcinoma (CCA). In addition, Helicobacter pylori is highly prevalent in most countries and is a possible risk factor for CCA; however, its role in enhancing hepatobiliary abnormality is unclear. Here, we investigated the effects of coinfection with H. pylori and O. viverrini on hepatobiliary abnormality. Hamsters were divided into four groups: (i) normal, (ii) H. pylori infected (HP), (iii) O. viverrini infected (OV), and (iv) O. viverrini and H. pylori infected (OV+HP). At 6 months postinfection, PCR and immunohistochemistry were used to test for the presence of H. pylori in the stomach, gallbladder, and liver. In the liver, H. pylori was detected in the following order: OV+HP, 5 of 8 (62.5%); HP, 2 of 5 (40%); OV, 2 of 8 (25%). H. pylori was not detected in normal (control) liver tissues. Coinfection induced the most severe hepatobiliary abnormalities, including periductal fibrosis, cholangitis, and bile duct hyperplasia, leading to a significantly decreased survival rate of experimental animals. The greatest thickness of periductal fibrosis was associated with a significant increase in fibrogenesis markers (expression of alpha smooth muscle actin and transforming growth factor beta). Quantitative reverse transcription-PCR revealed that the highest expression levels of genes for proinflammatory cytokines (interleukin-1 [IL-1], IL-6, and tumor necrosis factor alpha) were also observed in the OV+HP group. These results suggest that coinfection with H. pylori and O. viverrini increased the severity of hepatobiliary abnormalities to a greater extent than either single infection did.

  18. A FIVE-YEAR STUDY OF HEPATOBILIARY LESIONS IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Megha Sharma

    2016-06-01

    Full Text Available BACKGROUND The hepatobiliary system is composed of liver, biliary tree and gallbladder which occupy the right upper quadrant of the abdomen. The dominant primary diseases of the liver are viral hepatitis, alcoholic liver diseases, cirrhosis, NASH and hepatocellular carcinoma. Primary tumours as well as metastatic carcinomas flourish in hepatic environment. Disorders of the biliary tract affect a significant portion of the world population. Over 95% of biliary tract diseases are attributable to cholelithiasis (gall stones. Gall bladder stones can occur in any age group including infants and newborns. Benign lesions of gall bladder (most common being chronic cholecystitis are much more common than malignant lesions. AIM This study was carried out to study the various histopathological lesions of hepatobiliary system in Jammu and adjoining region. STUDY DESIGN This study is a prospective study conducted for a period of five years. MATERIAL & METHOD This study was done for a period of five years from 1 st Jan 2011 to 31 st Jan 2016 in the Department of Pathology, Govt. Medical College, Jammu and deals with lesions of hepatobiliary system including intrahepatic and extrahepatic biliary ducts, liver and gall bladder. RESULTS A total of 500 cases were studied of which gall bladder lesions constituted 350 cases (70%, 138 (27.6% cases were from liver (27.6%, whereas extrahepatic biliary system constituted 12 cases (2.4% only. In the present study, the overall prevalence of lesions of hepatobiliary system was observed to be higher in females i.e. 287 cases (57.4% as compared to males i.e. 213 cases (42.6%. Benign lesions were more common than malignant lesions. CONCLUSION The present study provides an insight into the varied lesions of hepatobiliary system in this region.

  19. Hepatobiliary Complications of Sickle Cell Disease among Children Admitted to Al Wahda Teaching Hospital, Aden, Yemen

    Science.gov (United States)

    Qhalib, Hana A.; Zain, Gamal H.

    2014-01-01

    Objectives: This study aimed to describe the pattern of hepatobiliary complications among patients with sickle cell disease (SCD) and to assess their correlation with age, gender and other risk factors. Methods: This cross-sectional study assessed 106 patients with SCD who were admitted to Al Wahda Teaching Hospital in Aden, Yemen, between January and June 2009. A full history, thorough examination, essential laboratory investigations (including a complete blood count, liver function test and viral markers test) and an abdominal ultrasound were performed on all patients. The clinicopathological characteristics of the hepatobiliary complications were analysed for their correlation to different risk factors such as age and gender. Results: It was found that 46.2% of the patients with SCD had hepatobiliary complications. Of these, 36.7% had viral hepatitis, 26.0% had cholecystitis and 20% had gallstones. A total of 60.4% of the affected patients were male. The mean levels of alanine aminotransferase (59.4 and 56.0 U/L) and aspartate transaminase (40.1 and 38.3 U/L) were significantly elevated in patients with viral hepatitis and cholecystitis, respectively. Hepatitis B virus surface antigen showed higher positivity (10.4%) than anti-hepatitis A and anti-hepatitis C antibodies. Hepatobiliary complications increased significantly with age and were notably higher among those who were often admitted to hospital and/or underwent frequent blood transfusions. Conclusion: This study suggests that hepatobiliary complications are common among SCD patients and the likelihood of developing such complications increases as patients age. Thus, regular clinical follow-ups, abdominal ultrasound studies and periodic liver function tests, as well as serological tests for viral hepatitis, are strongly recommended. These can help in the early detection of these complications and allow opportunities for their management and prevention. PMID:25364561

  20. Dumbbell Gallbladder Cholecystitis on Tc-99m Diisopropyliminodiacetic acid Hepatobiliary Imaging

    Science.gov (United States)

    Fakhri, Asif Ali; Rodrigue, Paul David; Hussain, Aun; Taiyebi, Abbas

    2017-01-01

    We present a case of a 79-year-old immunocompromised female admitted for abdominal pain and sepsis, who had an abdominal computed tomography (CT) showing distal gallbladder fundus wall thickening, pericholecystic edema, and a right posteroinferior hepatic abscess. Subsequent hepatobiliary scintigraphy with Tc-99m diisopropyliminodiacetic acid showed gallbladder filling of the proximal gallbladder fundus, yet no radiotracer filling of the distal gallbladder fundus. Further correlation with the initial CT showed a partial gallbladder stricture and a resultant altered morphology resembling a dumbbell-shaped gallbladder. Percutaneous cholangiogram also confirmed this dumbbell morphology. Nonfilling of radiotracer into the distal end of the dumbbell gallbladder correlating with CT findings of focal gallbladder inflammation indicated that there was a focal inflammation suggesting a distal dumbbell gallbladder cholecystitis. This case demonstrates a unique finding of focal inflammatory pathology involving an anatomic variant - the dumbbell-shaped gallbladder, and the challenges this anatomic variant presents in hepatobiliary scintigraphy image interpretation. PMID:28242983

  1. Postoperative follow-up studies in congenital dilatation of the common bile duct using hepatobiliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hirobe, Seiichi; Ishida, Haruo; Hayashi, Akira; Kamagata, Shoichiro; Fuchimoto, Yasufumi; Mizuno, Dai; Yano, Tsunehiro [Tokyo Metropolitan Kiyose Children`s Hospital (Japan); Ishii, Katsumi

    1995-03-01

    Follow-up studies in congenital dilatation of the common bile duct were done in 20 cases ranging 3 to 20 years after operation. Operative cholangiography had shown dilatation of the intrahepatic bile ducts in 15 patients (75%), of these, 7 patients had cystic dilatation. Five cases of these 7 patients showed prolonged stasis of the nuclide in the cystic dilated intrahepatic bile ducts by {sup 99m}Tc-PMT hepatobiliary scintigraphy in the follow-up studies even at 10 years after operation. But none of 20 cases had complication such as intrahepatic lithiasis, cholangitis, and liver dysfunction. Hepatobiliary scintigraphy could provide moderate anatomic and excellent functional information which were useful for these follow-up studies and careful follow-up should be done in the case of cystic dilatation of the intrahepatic bile ducts. (author).

  2. Management of hepatobiliary and pancreatic ascariasis in children of an endemic area.

    Science.gov (United States)

    Malik, Arshad Hussain; Saima, B D; Wani, M Y

    2006-02-01

    Ascariasis is the most common parasitic infestation in endemic areas and accounts for 50-60% of pediatric admissions in the surgical emergency department. Hepatobiliary and pancreatic ascariasis accounts for about 10% of such admissions. The present study was undertaken to evaluate the clinical features, investigations, and management of hepatobiliary and pancreatic ascariasis. The study was conducted in the endemic areas of Kashmir in northern India over a period of 3 years. During the study period (May 2001 to April 2004), 214 children with hepatobiliary and pancreatic ascariasis were admitted in the department. These children underwent complete clinical evaluation, investigation including ultrasound, and ERCP when required. Surgical intervention was done in patients who failed to settle with medical treatment. Ninety percent of our admissions were from rural areas and 86% of the children presented with pain in the right hypochondrium. Twenty-two percent of patients presented with cholangitis, whereas 39% of the children had mild icterus at presentation. Thirty-eight percent of the children had vomited worms during the episode of illness. Ultrasound was the diagnostic method of choice, which revealed the worms in the CBD in 80% of the patients, and in gall bladder in 16% of the children. Eight patients had worms in the main pancreatic duct while seven (4%) had multiple small liver abscesses. Serum alkaline phosphatase was raised in majority of children (80%). Twenty (9%) children were referred for ERCP. Medical treatment including endoscopic management was successful in 97% of the children. Seven (4%) children had to be operated upon due to complications of the disease. We conclude that the majority of the children with hepatobiliary and pancreatic ascariasis respond to conservative treatment, and surgical treatment is rarely needed.

  3. Increasing time delay from presentation until surgical referral for hepatobiliary malignancies

    Science.gov (United States)

    Croome, Kristopher P; Chudzinski, Robyn; Hanto, Douglas W

    2010-01-01

    Background Studies have shown that delayed treatment of several non-hepatobiliary (HB) malignancies is associated with adverse effects on disease progression and survival. Delayed treatment of HB malignancies has not been thoroughly investigated. Methods We performed a retrospective institutional review of patients referred to the Hepatobiliary Surgery Service at Beth Israel Deaconess Medical Center (BIDMC) for hepatobiliary malignancies from 2002 to 2008. Primary outcomes included the time delays (TD) in patient workup. Secondary outcomes were reasons for delay as well as disparities in TD based on demographic factors. Results Multivariate-adjusted linear regression showed a significant trend of increasing time from presentation until referral to a HB surgeon over the 7-year period (P = 0.001). There were no differences in TD by gender, age or education level. Multivariate-adjusted linear regression showed a significant trend of increasing number of imaging tests performed prior to referral [computerized tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and ultrasound and endoscopic ultrasound (US/EUS)] (P 30 days compared with those with a TD1 (TD from presentation until referral) <30 days (P = 0.042). Conclusions Delays were associated with an increase in imaging studies and delays adversely affect survival in resected patients. Referring physicians are encouraged to expedite the evaluation and early referral of all patients to an HB surgeon for evaluation and treatment. PMID:20961373

  4. Parameters Obtained by Hepatobiliary Scintigraphy Have Significant Correlation with Biochemical Factors Early After Liver Transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kansoul, H.A.; Axelsson, R.; Yamamoto, S.; Savicheva, I.; Aspelin, P.; Ericzon, B.G.; Gjertsen, H. [Div. of Transplantation Surgery and Div. of Radiology, Dept. of Clinical Science, Intervention, and Technology, Karolinska Inst., Karolinska Univ. Hospital, Stockholm (Sweden)

    2007-08-15

    Background: Early postoperative hepatobiliary scintigraphy after liver transplantation is performed worldwide, but data on its significance for graft function are currently limited. Purpose: To examine the correlation between the result of early postoperative hepatobiliary scintigraphy and pre- and postoperative biochemical parameters in liver transplantation (LTx) patients. Material and Methods: Six parameters of hepatobiliary scintigraphy using {sup 99m}Tc mebrofenin were statistically analyzed in 108 LTx patients: 1) half-life of the activity of elimination of mebrofenin from the blood; 2) total clearance of mebrofenin from the blood due to all possible routes; 3) half-life of the activity due to liver uptake; 4) clearance of mebrofenin from the blood due to liver uptake; 5) time to maximal uptake in the liver; and 6) the hepatic extraction fraction (HEF) and biochemical data. Analysis between patients with preoperative normal liver function, familial amyloid polyneuropathy (FAP), and end-stage liver disease (non-FAP) was also performed. Results: Univariate and multivariate analysis revealed that total bilirubin postoperative day 3 correlated with all three scintigraphic parameters, and peak aspartate aminotransferase and alanine aminotransferase correlated with HEF. The analysis between patients with FAP and non-FAP revealed no significant difference of scintigraphic data between the two groups. Conclusion: A significant correlation between early postoperative scintigraphic results and biochemical parameters was demonstrated.

  5. Bile acid signaling through farnesoid X and TGR5 receptors in hepatobiliary and intestinal diseases

    Institute of Scientific and Technical Information of China (English)

    Bojan Stanimirov; Karmen Stankovand Momir Mikov

    2015-01-01

    BACKGROUND: The well-known functions of bile acids (BAs) are the emulsification and absorption of lipophilic xenobiotics. However, the emerging evidences in the past decade showed that BAs act as signaling molecules that not only autoregulate their own metabolism and enterohepatic recirculation, but also as important regulators of integrative metabolism by ac-tivating nuclear and membrane-bound G protein-coupled re-ceptors. The present review was to get insight into the role of maintenance of BA homeostasis and BA signaling pathways in development and management of hepatobiliary and intestinal diseases. DATA SOURCES: Detailed and comprehensive search of PubMed and Scopus databases was carried out for original and review articles. RESULTS: Disturbances in BA homeostasis contribute to the development of several hepatobiliary and intestinal disorders, such as non-alcoholic fatty liver disease, liver cirrhosis, choles-terol gallstone disease, intestinal diseases and both hepatocel-lular and colorectal carcinoma. CONCLUSION: Further efforts made in order to advance the understanding of sophisticated BA signaling network may be promising in developing novel therapeutic strategies related not only to hepatobiliary and gastrointestinal but also sys-temic diseases.

  6. Preresection Obesity Increases the Risk of Hepatobiliary Complications in Short Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Alan N. Langnas

    2012-09-01

    Full Text Available Patients developing the short bowel syndrome (SBS are at risk for hepatobiliary disease, as are morbidly obese individuals. We hypothesized that morbidly obese SBS individuals would be at increased risk for developing hepatobiliary complications. We reviewed 79 patients with SBS, 53 patients with initial body mass index (BMI < 35 were controls. Twenty-six patients with initial BMI > 35 were the obese group. Obese patients were more likely to be weaned off parenteral nutrition (PN (58% vs. 21%. Pre-resection BMI was significantly lower in controls (26 vs. 41. BMI at 1, 2, and 5 years was decreased in controls but persistently increased in obese patients. Obese patients were more likely to undergo cholecystectomy prior to SBS (42% vs. 32% and after SBS (80% vs. 39%, p < 0.05. Fatty liver was more frequent in the obese group prior to SBS (23% vs. 0%, p < 0.05 but was similar to controls after SBS (23% vs. 15%. Fibrosis (8% vs. 13% and cirrhosis/portal hypertension (19% vs. 21% were similar in obese and control groups. Overall, end stage liver disease (ESLD was similar in obese and control groups (19% vs. 11% but was significantly higher in obese patients receiving PN (45% vs. 14%, p < 0.05. Obese patients developing SBS are at increased risk of developing hepatobiliary complications. ESLD was similar in the two groups overall but occurs more frequently in obese patients maintained on chronic PN.

  7. Radiation-Induced Liver Damage: Correlation of Histopathology with Hepatobiliary Magnetic Resonance Imaging, a Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Seidensticker, Max, E-mail: max.seidensticker@med.ovgu.de [Universitätsklinik Magdeburg, Klinik für Radiologie und Nuklearmedizin (Germany); Burak, Miroslaw [Pomeranian Medical University, Department of Diagnostic Imaging and Interventional Radiology (Poland); Kalinski, Thomas [Universitätsklinik Magdeburg, Institut für Pathologie (Germany); Garlipp, Benjamin [Universitätsklinik Magdeburg, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie (Germany); Koelble, Konrad [Philipps Universität Marburg, Fachbereich Medizin der, Abteilung für Neuropathologie (Germany); Wust, Peter [Charité Universitätsmedizin Berlin, Klinik für Radioonkologie und Strahlentherapie (Germany); Antweiler, Kai [Universitätsklinik Magdeburg, Institut für Biometrie und Medizinische Informatik (Germany); Seidensticker, Ricarda; Mohnike, Konrad; Pech, Maciej; Ricke, Jens [Universitätsklinik Magdeburg, Klinik für Radiologie und Nuklearmedizin (Germany)

    2015-02-15

    PurposeRadiotherapy of liver malignancies shows promising results (radioembolization, stereotactic irradiation, interstitial brachytherapy). Regardless of the route of application, a certain amount of nontumorous liver parenchyma will be collaterally damaged by radiation. The functional reserve may be significantly reduced with an impact on further treatment planning. Monitoring of radiation-induced liver damage by imaging is neither established nor validated. We performed an analysis to correlate the histopathological presence of radiation-induced liver damage with functional magnetic resonance imaging (MRI) utilizing hepatobiliary contrast media (Gd-BOPTA).MethodsPatients undergoing local high-dose-rate brachytherapy for whom a follow-up hepatobiliary MRI within 120 days after radiotherapy as well as an evaluable liver biopsy from radiation-exposed liver tissue within 7 days before MRI were retrospectively identified. Planning computed tomography (CT)/dosimetry was merged to the CT-documentation of the liver biopsy and to the MRI. Presence/absence of radiation-induced liver damage (histopathology) and Gd-BOPTA uptake (MRI) as well as the dose applied during brachytherapy at the site of tissue sampling was determined.ResultsFourteen biopsies from eight patients were evaluated. In all cases with histopathological evidence of radiation-induced liver damage (n = 11), no uptake of Gd-BOPTA was seen. In the remaining three, cases no radiation-induced liver damage but Gd-BOPTA uptake was seen. Presence of radiation-induced liver damage and absence of Gd-BOPTA uptake was correlated with a former high-dose exposition.ConclusionsAbsence of hepatobiliary MRI contrast media uptake in radiation-exposed liver parenchyma may indicate radiation-induced liver damage. Confirmatory studies are warranted.

  8. Histology atlas of the developing mouse hepatobiliary hemolymphatic vascular system with emphasis on embryonic days 11.5-18.5 and early postnatal development

    Science.gov (United States)

    A critical event in fetal development is the proper formation of the vascular system, of which the hepatobiliary system plays a pivotal role. This has lead pathologists and scientists to utilize transgenic mice to identify developmental disorders associated with the hepatobiliary vascular system. Va...

  9. Animal models of gastrointestinal and liver diseases. Animal models of cystic fibrosis: gastrointestinal, pancreatic, and hepatobiliary disease and pathophysiology.

    Science.gov (United States)

    Olivier, Alicia K; Gibson-Corley, Katherine N; Meyerholz, David K

    2015-03-15

    Multiple organ systems, including the gastrointestinal tract, pancreas, and hepatobiliary systems, are affected by cystic fibrosis (CF). Many of these changes begin early in life and are difficult to study in young CF patients. Recent development of novel CF animal models has expanded opportunities in the field to better understand CF pathogenesis and evaluate traditional and innovative therapeutics. In this review, we discuss manifestations of CF disease in gastrointestinal, pancreatic, and hepatobiliary systems of humans and animal models. We also compare the similarities and limitations of animal models and discuss future directions for modeling CF.

  10. Hepato-biliary late effects in survivors of childhood and adolescent cancer: a report from the Children's Oncology Group.

    Science.gov (United States)

    Castellino, Sharon; Muir, Andrew; Shah, Ami; Shope, Sheila; McMullen, Kevin; Ruble, Kathy; Barber, Ashley; Davidoff, Andrew; Hudson, Melissa M

    2010-05-01

    Curative therapy for childhood and adolescent cancer translates to 1 in 640 young adults being a survivor of cancer. Although acute hepato-biliary toxicity occurs commonly during pediatric cancer therapy, the impact of antineoplastic therapy on long-term liver health in childhood/adolescent cancer survivors is unknown. This article reviews the medical literature on late liver dysfunction following treatment for childhood/adolescent cancer. We also outline the Children's Oncology Group (COG) guidelines for screening and follow-up of hepato-biliary sequelae. As the population of survivors grow and age, vigilance for risks to hepatic health needs to continue based on specific exposures during curative cancer therapy.

  11. Monolobar Caroli’s disease with renal cysts: Case report

    Directory of Open Access Journals (Sweden)

    Shruti Thakur

    2014-03-01

    Full Text Available Caroli’s disease is autosomal recessive, non-obstructive dilatation of intrahepatic biliary ducts. The exact etiology is unclear. Two variants of Caroli’s disease are well known-simple; in which bile ducts are dilated without hepatic fibrosis and the second type which is associated with congenital hepatic fibrosis along with its sequelae, also known as Caroli’s syndrome. Simple Caroli’s disease without hepatic fibrosis is quite rare. The importance of recognizing this disease as a cause of biliary stasis is its frequent association with lithiasis, recurrent cholangitis, liver abscesses, cirrhosis and cholangiocarcinoma.

  12. Hepatobiliary scintigraphy in chronic intrahepatic cholestasis. Diagnosis of primary sclerosing cholangitis

    Energy Technology Data Exchange (ETDEWEB)

    Aburano, Tamio; Takayama, Teruhiko; Shuke, Noriyuki

    1987-05-01

    Primary sclerosing cholangitis (PSC) is a rare disease of unknown origin, leading to chronic intermittent cholestasis. Due to its low incidence, insidious clinical onset and varied clinical picture, the diagnosis is often delayed by years. PSC is sometimes diagnosed falsely as another disease of chronic intermittent cholestasis, primary biliary cirrhosis (PBC). In the present study, the hepatobiliary imaging with Tc-99m diethyl IDA was done in a total of 14 patients with chronic intermittent cholestasis including 3 patients with PSC and 11 patients with PBC, in order to decide its clinical usefulness as a noninvasive method for the differentiation between PSC and PBC. All three patients with PSC showed a typical pattern of radionuclide stasis within the area of intrahepatic and/or extrahepatic ductal system, representing the stenosis on endoscopic retrograde cholangiogram. On the other hand, none of 11 patients with PBC showed any radionuclide stasis within the area of intrahepatic and/or extrahepatic ductal system. This result suggests that the radionuclide hepatobiliary imaging may be a noninvasive method for investigating patients with chronic intermittent cholestasis, leading to earlier differentiation between PSC and PBC.

  13. GROWTH HORMONE LEVEL EVOLUTION IN CHILDREN WITH HEPATOBILIARY DISEASES, UNDERGOING LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    O. P. Shevchenko

    2012-01-01

    Full Text Available End stage liver disease is often associated with growth retardation in children with congenital and hereditary diseases of hepatobiliary system. The aim was to investigate the serum growth hormone level before and after liver transplantation in 52 children with congenital and hereditary diseases of hepatobiliary system. Data of our research work revealed increased serum level of growth hormone in children with liver cirrhosis (3,32 ± 7,7 ng/ml vs. 1,16 ± 1,46 ng/ml in healthy children, p = 0,01, which correlates with PELD score (r = 0,62, p < 0,001. In a month after liver transplantation growth hormone concentration decreases (p < 0,001 and in a year after transplantation it doesn’t differ from healthy children. There wasn’t revealed any interaction between serum growth hormone level and anthropometric parameters before liver transplantation, but in a year after there was significant correlation between growth hormone concentration and height (r = 0,79, p = 0,01. Investigation of growth hormone level in children with liver cirrhosis and its evolution after liver transplantation is of interest as objective criterion of recovery of physical development regulation and as an additional parameter, which cor- relates with severity of end-stage liver disease. 

  14. Elevated prevalence of Helicobacter species and virulence factors in opisthorchiasis and associated hepatobiliary disease

    Science.gov (United States)

    Deenonpoe, Raksawan; Mairiang, Eimorn; Mairiang, Pisaln; Pairojkul, Chawalit; Chamgramol, Yaovalux; Rinaldi, Gabriel; Loukas, Alex; Brindley, Paul J.; Sripa, Banchob

    2017-01-01

    Recent reports suggest that Opisthorchis viverrini serves as a reservoir of Helicobacter and implicate Helicobacter in pathogenesis of opisthorchiasis-associated cholangiocarcinoma (CCA). Here, 553 age-sex matched cases and controls, 293 and 260 positive and negative for liver fluke O. viverrini eggs, of residents in Northeastern Thailand were investigated for associations among infection with liver fluke, Helicobacter and hepatobiliary fibrosis. The prevalence of H. pylori infection was higher in O. viverrini-infected than uninfected participants. H. pylori bacterial load correlated positively with intensity of O. viverrini infection, and participants with opisthorchiasis exhibited higher frequency of virulent cagA-positive H. pylori than those free of fluke infection. Genotyping of cagA from feces of both infected and uninfected participants revealed that the AB genotype accounted for 78% and Western type 22%. Participants infected with O. viverrini exhibited higher prevalence of typical Western type (EPIYA ABC) and variant AB’C type (EPIYT B) CagA. Multivariate analyses among H. pylori virulence genes and severity of hepatobiliary disease revealed positive correlations between biliary periductal fibrosis during opisthorchiasis and CagA and CagA with CagA multimerization (CM) sequence-positive H. pylori. These findings support the hypothesis that H. pylori contributes to the pathogenesis of chronic opisthorchiasis and specifically to opisthorchiasis-associated CCA. PMID:28198451

  15. Interactions between Bacteria and Bile Salts in the Gastrointestinal and Hepatobiliary Tracts

    Directory of Open Access Journals (Sweden)

    Verónica Urdaneta

    2017-10-01

    Full Text Available Bile salts and bacteria have intricate relationships. The composition of the intestinal pool of bile salts is shaped by bacterial metabolism. In turn, bile salts play a role in intestinal homeostasis by controlling the size and the composition of the intestinal microbiota. As a consequence, alteration of the microbiome–bile salt homeostasis can play a role in hepatic and gastrointestinal pathological conditions. Intestinal bacteria use bile salts as environmental signals and in certain cases as nutrients and electron acceptors. However, bile salts are antibacterial compounds that disrupt bacterial membranes, denature proteins, chelate iron and calcium, cause oxidative damage to DNA, and control the expression of eukaryotic genes involved in host defense and immunity. Bacterial species adapted to the mammalian gut are able to endure the antibacterial activities of bile salts by multiple physiological adjustments that include remodeling of the cell envelope and activation of efflux systems and stress responses. Resistance to bile salts permits that certain bile-resistant pathogens can colonize the hepatobiliary tract, and an outstanding example is the chronic infection of the gall bladder by Salmonella enterica. A better understanding of the interactions between bacteria and bile salts may inspire novel therapeutic strategies for gastrointestinal and hepatobiliary diseases that involve microbiome alteration, as well as novel schemes against bacterial infections.

  16. Managing injuries of hepatic duct confluence variants after major hepatobiliary surgery: An algorithmic approach

    Institute of Scientific and Technical Information of China (English)

    Georgios Fragulidis; Athanasios Marinis; Andreas Polydorou; Christos Konstantinidis; Georgios Anastasopoulos; John Contis; Dionysios Voros; Vassilios Smyrniotis

    2008-01-01

    AIM:To investigate injuries of anatomy variants of hepatic duct confluence during hepatobiliary surgery and their impact on morbidity and mortality of these procedures. An algorithmic approach for the management of these injuries is proposed.METHODS: During a 6-year period 234 patients who had undergone major hepatobiliary surgery were retrospectively reviewed in order to study postoperative bile leakage. Diagnostic workup included endoscopic and magnetic retrograde cholangiopancreatography (E/MRCP), scintigraphy and fistulography.RESULTS: Thirty (12.8%) patients who developed postoperative bile leaks were identified. Endoscopic stenting and percutaneous drainage were successful in 23 patients with bile leaks from the liver cut surface.In the rest seven patients with injuries of hepatic duct confluence, biliary variations were recognized and a stepwise therapeutic approach was considered.Conservative management was successful only in 2 patients. Volume of the liver remnant and functional liver reserve as well as local sepsis were used as criteria for either resection of the corresponding liver segment or construction of a biliary-enteric anastomosis. Two deaths occurred in this group of patients with hepatic duct confluence variants (mortality rate 28.5%).CONCLUSION: Management of major biliary fistulae that are disconnected from the mainstream of the biliary tree and related to injury of variants of the hepatic duct confluence is extremely challenging. These patients have a grave prognosis and an early surgical procedure has to be considered.

  17. Function and regulation of ATP-binding cassette transport proteins involved in hepatobiliary transport (vol 12, pg 13, 2000)

    NARCIS (Netherlands)

    Hooiveld, GJEJ; van Montfoort, JE; Meijer, DKF; Muller, M

    2001-01-01

    Hepatobiliary transport of endogenous and exogenous compounds is mediated by the coordinated action of multiple transport systems present at the sinusoidal (basolateral) and canalicular (apical) membrane domains of hepatocytes. During the last few years many of these transporters have been cloned an

  18. Altered intestinal bile salt biotransformation in a cystic fibrosis (Cftr(-/-)) mouse model with hepato-biliary pathology

    NARCIS (Netherlands)

    Bodewes, Frank A. J. A.; van der Wulp, Mariette Y. M.; Beharry, Satti; Doktorova, Marcela; Havinga, Rick; Boverhof, Renze; Phillips, M. James; Durie, Peter R.; Verkade, Henkjan J.

    Background: Cftr(-/-tm1UC) mice develop progressive hepato-biliary pathology. We hypothesize that this liver pathology is related to alterations' in biliary bile hydrophobicity and bile salt metabolism in Cftr(-/-tm1Unc) mice. Methods: We determined bile production, biliary and fecal bile salt- and

  19. Prediagnostic selenium status and hepatobiliary cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort

    NARCIS (Netherlands)

    Hughes, David J.; Duarte-Salles, Talita; Hybsier, Sandra; Trichopoulou, Antonia; Stepien, Magdalena; Aleksandrova, Krasimira; Overvad, Kim; Tjønneland, Anne; Olsen, Anja; Affret, Aurélie; Fagherazzi, Guy; Boutron-Ruault, Marie Christine; Katzke, Verena; Kaaks, Rudolf; Boeing, Heiner; Bamia, Christina; Lagiou, Pagona; Peppa, Eleni; Palli, Domenico; Krogh, Vittorio; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Bueno de Mesquita, Hendrik Bastiaan|info:eu-repo/dai/nl/06929528X; Peeters, Petra H.|info:eu-repo/dai/nl/074099655; Engeset, Dagrun; Weiderpass, Elisabete; Lasheras, Cristina; Agudo, Antonio; Sánchez, Maria José; Navarro, Carmen; Ardanaz, Eva; Dorronsoro, Miren; Hemmingsson, Oskar; Wareham, Nicholas J.; Khaw, Kay Tee; Bradbury, Kathryn E.; Cross, Amanda J.; Gunter, Marc; Riboli, Elio; Romieu, Isabelle; Schomburg, Lutz; Jenab, Mazda

    2016-01-01

    Selenium status is suboptimal in many Europeans and may be a risk factor for the development of various cancers, including those of the liver and biliary tract. Objective: We wished to examine whether selenium status in advance of cancer onset is associated with hepatobiliary cancers in the EPIC (Eu

  20. Prediagnostic selenium status and hepatobiliary cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort

    NARCIS (Netherlands)

    Hughes, David J.; Duarte-Salles, Talita; Hybsier, Sandra; Trichopoulou, Antonia; Stepien, Magdalena; Aleksandrova, Krasimira; Overvad, Kim; Tjønneland, Anne; Olsen, Anja; Affret, Aurélie; Fagherazzi, Guy; Boutron-Ruault, Marie Christine; Katzke, Verena; Kaaks, Rudolf; Boeing, Heiner; Bamia, Christina; Lagiou, Pagona; Peppa, Eleni; Palli, Domenico; Krogh, Vittorio; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Bueno de Mesquita, Hendrik Bastiaan; Peeters, Petra H.; Engeset, Dagrun; Weiderpass, Elisabete; Lasheras, Cristina; Agudo, Antonio; Sánchez, Maria José; Navarro, Carmen; Ardanaz, Eva; Dorronsoro, Miren; Hemmingsson, Oskar; Wareham, Nicholas J.; Khaw, Kay Tee; Bradbury, Kathryn E.; Cross, Amanda J.; Gunter, Marc; Riboli, Elio; Romieu, Isabelle; Schomburg, Lutz; Jenab, Mazda

    2016-01-01

    Selenium status is suboptimal in many Europeans and may be a risk factor for the development of various cancers, including those of the liver and biliary tract. Objective: We wished to examine whether selenium status in advance of cancer onset is associated with hepatobiliary cancers in the EPIC (Eu

  1. Altered intestinal bile salt biotransformation in a cystic fibrosis (Cftr(-/-)) mouse model with hepato-biliary pathology

    NARCIS (Netherlands)

    Bodewes, Frank A. J. A.; van der Wulp, Mariette Y. M.; Beharry, Satti; Doktorova, Marcela; Havinga, Rick; Boverhof, Renze; Phillips, M. James; Durie, Peter R.; Verkade, Henkjan J.

    2015-01-01

    Background: Cftr(-/-tm1UC) mice develop progressive hepato-biliary pathology. We hypothesize that this liver pathology is related to alterations' in biliary bile hydrophobicity and bile salt metabolism in Cftr(-/-tm1Unc) mice. Methods: We determined bile production, biliary and fecal bile salt- and

  2. Histology atlas of the developing mouse hepatobiliary system with emphasis on embryonic days 9.5-18.5.

    Science.gov (United States)

    Crawford, Laura Wilding; Foley, Julie F; Elmore, Susan A

    2010-10-01

    Animal model phenotyping, in utero exposure toxicity studies, and investigation into causes of embryonic, fetal, or perinatal deaths have required pathologists to recognize and diagnose developmental disorders in spontaneous and engineered mouse models of disease. In mammals, the liver is the main site of hematopoiesis during fetal development, has endocrine and exocrine functions important for maintaining homeostasis in fetal and adult life; and performs other functions including waste detoxification, production and removal of glucose, glycogen storage, triglyceride and fatty acid processing, and serum protein production. Due to its role in many critical functions, alterations in the size, morphology, or function(s) of the liver often lead to embryonic lethality. Many publications and websites describe individual aspects of hepatobiliary development at defined stages. However, no single resource provides a detailed histological evaluation of H&E-stained sections of the developing murine liver and biliary systems using high-magnification and high-resolution color images. The work herein provides a histology atlas of hepatobiliary development between embryonic days 9.5-18.5. Although the focus of this work is normal hepatobiliary development, common defects in liver development are also described as a reference for pathologists who may be asked to phenotype mice with congenital, inherited, or treatment-related hepatobiliary defects. Authors' note: All digital images can be viewed online at https://niehsimagesepl-inc.com with the username "ToxPathLiver" and the password "embryolivers."

  3. Microproteinuria during Opisthorchis viverrini infection: a biomarker for advanced renal and hepatobiliary pathologies from chronic opisthorchiasis.

    Directory of Open Access Journals (Sweden)

    Prasert Saichua

    Full Text Available Approximately 680 million people are at risk of infection with Opisthorchis viverrini (OV and Clonorchis sinensis, with an estimated 10 million infected with OV in Southeast Asia alone. While opisthorchiasis is associated with hepatobiliary pathologies, such as advanced periductal fibrosis (APF and cholangiocarcinoma (CCA, animal models of OV infection show that immune-complex glomerulonephritis is an important renal pathology that develops simultaneously with hepatobiliary pathologies. A cardinal sign of immune-complex glomerulonephritis is the urinary excretion of immunoglobulin G (IgG (microproteinuria. In community-based studies in OV endemic areas along the Chi River in northeastern Thailand, we observed that over half of the participants had urine IgG against a crude OV antigen extract (OV antigen. We also observed that elevated levels of urine IgG to OV antigen were not associated with the intensity of OV infection, but were likely the result of immune-complex glomerulonephritis as seen in animal models of OV infection. Moreover, we observed that urine IgG to OV antigen was excreted at concentrations 21 times higher in individuals with APF and 158 times higher in individuals with CCA than controls. We also observed that elevated urine IgG to OV antigen could identify APF+ and CCA+ individuals from non-cases. Finally, individuals with urine IgG to OV antigen had a greater risk of APF as determined by Odds Ratios (OR = 6.69; 95%CI: 2.87, 15.58 and a greater risk of CCA (OR = 71.13; 95%CI: 15.13, 334.0 than individuals with no detectable level of urine IgG to OV antigen. Herein, we show for the first time the extensive burden of renal pathology in OV endemic areas and that a urine biomarker could serve to estimate risk for both renal and hepatobiliary pathologies during OV infection, i.e., serve as a "syndromic biomarker" of the advanced pathologies from opisthorchiasis.

  4. [Hepatobiliary fascioliasis and echinococcosis/hydatidosis in domestic animals in Haiti].

    Science.gov (United States)

    Blaise, J; Raccurt, C P

    2007-12-01

    In Haiti, hepatobiliary fascioliasis and hepatic hydatid cysts cause major economic losses among livestock. Surveys show high prevalence rates for bovine distomatosis caused by Fasciola hepatica (10.7% to 22.78%). Among small ruminants, the prevalence of distomatosis is low (sheep: 3.2%, goats: 0.9%) although Dicrocoelium dendriticum is found in 1.1% of sheep. Hepatic hydatidosis is more common among pigs (5.2%) and sheep (2.1%) than among goats (0.9%) and cattle (0.3%). In the case of dogs, 21% excrete egg-bearing segments in their faeces and 25% harbour Echinococcus granulosus in the small intestine. As a result of local dietary habits (consumption of raw cress), environmental pollution by animal faeces, poverty and poor standards of hygiene in Haiti, these flatworms pose serious health risks to the population, even though this is largely unknown at present.

  5. Identification of Helicobacter spp. in gastrointestinal tract, pancreas and hepatobiliary system of stray cats.

    Science.gov (United States)

    Shojaee Tabrizi, A; Derakhshandeh, A; Esfandiari, A; Ali Atashi, Z

    2015-01-01

    The aim of the present study was to determine the presence of Helicobacter species in different parts of gastrointestinal tract, hepatobiliary system and pancreas of stray cats. Six different sites at the level of genus, gastric (H. heilmannii and H. felis) and enterohepatic species of Helicobacter were investigated in six cats using species-specific primers by polymerase chain reaction (PCR). Interestingly, DNA of enterohepatic spp. was detected in 1/6 duodenum, 2/6 colon and 1/6 pancreas specimens. Results of sequencing revealed that all of these four positive samples belong to Helicobacter canis. While cats have not been considered as a potential zoonotic danger for non-pylori Helicobacter infections, the results of current study show prompt re-evaluation of that view. To the best of our knowledge, this is the first study about distribution of Helicobcater spp. in gastrointestinal tract of cats.

  6. Sporadic incidence of Fascioliasis detected during Hepatobiliary procedures: A study of 18 patients from Sulaimaniyah governorate

    Directory of Open Access Journals (Sweden)

    Hawramy Tahir Abdullah Hussein

    2012-12-01

    Full Text Available Abstract Background Fascioliasis is an often-neglected zoonotic disease and currently is an emerging infection in Iraq. Fascioliasis has two distinct phases, an acute phase, exhibiting the hepatic migratory stage of the fluke’s life cycle, and a chronic biliary phase manifested with the presence of the parasite in the bile ducts through hepatic tissue. The incidence of Fascioliasis in Sulaimaniyah governorate was unexpected observation. We believe that shedding light on this disease in our locality will increase our physician awareness and experience in early detection, treatment in order to avoid unnecessary surgeries. Findings We retrospectively evaluated this disease in terms of the demographic features, clinical presentations, and managements by reviewing the medical records of 18 patients, who were admitted to the Sulaimani Teaching Hospital and Kurdistan Centre for Gastroenterology and Hepatology. Patients were complained from hepatobiliary and/or upper gastrointestinal symptoms and diagnosed accidentally with Fascioliasis during hepatobiliary surgeries and ERCP by direct visualization of the flukes and stone analysis. Elevated liver enzymes, white blood cells count and eosinophilia were notable laboratory indices. The dilated CBD, gallstones, liver cysts and abscess were found common in radiological images. Fascioliasis diagnosed during conventional surgical CBD exploration and choledochodoudenostomy, open cholecystectomy, surgical drainage of liver abscess, ERCP and during gallstone analysis. Conclusion Fascioliasis is indeed an emerging disease in our locality, but it is often underestimated and ignored. We recommend the differential diagnosis of patients suffering from Rt. Hypochondrial pain, fever and eosinophilia. The watercress ingestion was a common factor in patient’s history.

  7. Extrahepatic collaterals and liver damage in embolotherapy for ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery

    Institute of Scientific and Technical Information of China (English)

    Yoshitsugu Tajima; Tamotsu Kuroki; Ryuji Tsutsumi; Ichiro Sakamoto; Masataka Uetani; Takashi Kanematsu

    2007-01-01

    AIM: To evaluate the effects of extrahepatic collaterals to the liver on liver damage and patient outcome after embolotherapy for the ruptured hepatic artery pseudoaneurysm following hepatobiliary pancreatic surgery.METHODS: We reviewed 9 patients who underwent transcatheter arterial embolization (TAE) for the ruptured hepatic artery pseudoaneurysm following major hepatobiliary pancreatic surgery between June 1992 and April 206. We paid special attention to the extrahepatic arterial collaterals to the liver which may affect post-TAE liver damage and patient outcome.RESULTS: The underlying diseases were all malignancies, and the surgical procedures included hepatopancreatoduodenectomy in 2 patients, hepatic resection with removal of the bile duct in 5, and pancreaticoduodenectomy in 2. A total of 11 pseudoaneurysm developed: 4in the common hepatic artery, 4 in the proper hepatic artery, and 3 in the right hepatic artery. Successful hemostasis was accomplished with the initial TAE in all patients, except for 1. Extrahepatic arterial pathways to the liver, including the right inferior phrenic artery, the jejunal branches, and the aberrant left hepatic artery,were identified in 8 of the 9 patients after the completion of TAE. The development of collaterals depended on the extent of liver mobilization during the hepatic resection,the postoperative period, the presence or absence of an aberrant left hepatic artery, and the concomitant arterial stenosis adjacent to the pseudoaneurysm. The liver tolerated TAE without significant consequences when at least one of the collaterals from the inferior phrenic artery or the aberrant left hepatic artery was present. One patient, however, with no extrahepatic collaterals died of liver failure due to total liver necrosis 9 d after TAE.CONCLUSION: When TAE is performed on ruptured hepatic artery pseudoaneurysm, reduced collateral pathways to the liver created by the primary surgical procedure and a short postoperative interval may

  8. Characteristic MR and CT imaging findings of hepatobiliary paragonimiasis and their pathologic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Chunyan; Hu, Yajun; Chen, Weixia [Dept of Radiology, West China Hospital of Sichuan Univ., Sichuan (China)], e-mail: wxchen25@126.com

    2012-06-15

    Background: Hepatobiliary paragonimiasis (HP) is not commonly encountered and may be confused with hepatobiliary tumors; however, computed tomography (CT) and magnetic resonance imaging (MRI) features of HP allow this entity to be distinguished from other diseases. Purpose: To present the CT and MRI findings in patients with HP and to describe some specific imaging findings along with their pathological correlations. Material and Methods: Imaging and clinical findings of 21 patients (9 boys/men and 12 girls/women; age range 3-67 years; mean age 40 years) who were diagnosed with HP were retrospectively evaluated. Among these patients, 16 underwent CT examination only, two had MR examination only, and three underwent both CT and MR. All patients underwent surgery, and the HP diagnosis was confirmed by the surgical and histopathologic results. Results: Chronic abdominal pain or back pain was reported by 14 patients, severe abdominal pain with acute onset was reported by one patient, and six patients were asymptomatic and were discovered incidentally. Peripheral eosinophilia was present in 14 patients (14/21, 66.7%), and abnormal liver function tests were found in 16 patients (16/21, 76.2%). Of the 19 patients who underwent CT imaging, 17 patients showed multiple mixed hypodense lesions or multiple cysts with inlaying septation with separate irregular rims or circular enhancement on post-contrast CT images. Tunnel-shaped micro abscesses and necrotic cavities were found in the lesions of 12 of those 17 patients. The other two patients showed smaller cystic masses. MRI showed faveolate T1 hypointense and T2 hyperintense areas in the liver parenchyma with rim or peripheral enhancement. Nodular or circular hyperintense materials were found scattered in the lesions on T1-weighted imaging. Conclusion: CT and MRI can reveal the radiological-pathological features of HP. Together with laboratory findings, MRI and CT findings may provide diagnostic clues, especially in endemic

  9. Hepatobiliary Clearance Prediction: Species Scaling From Monkey, Dog, and Rat, and In Vitro-In Vivo Extrapolation of Sandwich-Cultured Human Hepatocytes Using 17 Drugs.

    Science.gov (United States)

    Kimoto, Emi; Bi, Yi-An; Kosa, Rachel E; Tremaine, Larry M; Varma, Manthena V S

    2017-09-01

    Hepatobiliary elimination can be a major clearance pathway dictating the pharmacokinetics of drugs. Here, we first compared the dose eliminated in bile in preclinical species (monkey, dog, and rat) with that in human and further evaluated single-species scaling (SSS) to predict human hepatobiliary clearance. Six compounds dosed in bile duct-cannulated (BDC) monkeys showed biliary excretion comparable to human; and the SSS of hepatobiliary clearance with plasma fraction unbound correction yielded reasonable predictions (within 3-fold). Although dog SSS also showed reasonable predictions, rat overpredicted hepatobiliary clearance for 13 of 24 compounds. Second, we evaluated the translatability of in vitro sandwich-cultured human hepatocytes (SCHHs) to predict human hepatobiliary clearance for 17 drugs. For drugs with no significant active uptake in SCHH studies (i.e., with or without rifamycin SV), measured intrinsic biliary clearance was directly scalable with good predictability (absolute average fold error [AAFE] = 1.6). Drugs showing significant active uptake in SCHH, however, showed improved predictability when scaled based on extended clearance term (AAFE = 2.0), which incorporated sinusoidal uptake along with a global scaling factor for active uptake and the canalicular efflux clearance. In conclusion, SCHH is a useful tool to predict human hepatobiliary clearance, whereas BDC monkey model may provide further confidence in the prospective predictions. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  10. {sup 99m}Tc sestamibi imaging. Can it be a useful substitute for hepatobiliary scintigraphy in infantile jaundice?

    Energy Technology Data Exchange (ETDEWEB)

    Sadeghi, R.; Kakhki, V.R.D.; Zakavi, R. [Mashhad Univ. of Medical Sciences (Iran). Nuclear Medicine Dept.; Kianifar, H.R. [Mashhad Univ. of Medical Sciences (Iran). Paediatric Dept.; Ansari, K. [Tehran Univ. of Medical Sciences (Iran). Nuclear Medicine Dept.

    2009-07-01

    Hepatobiliary scintigraphy is an integral part in the diagnostic work-up of the neonatal cholestasis syndrome. However, less than optimal specificity is its major disadvantage. Differentiation between biliary atresia and neonatal hepatitis is nearly impossible in some cases with poor hepatocellular function. {sup 99m}Tc sestamibi (MIBI) is a cationic lipophilic agent which is a substrate of P-glycoprotein. This glycoprotein is normally expressed in biliary canalicular surfaces of hepatocytes. This property provides a hepatic excretory mechanism which is different from bilirubin excretion. In this study we evaluated the value of {sup 99m}Tc MIBI in differential diagnosis of neonatal cholestasis. 20 infants with a mean age of 2.41 months (range, 0.1-5 months) were included in the study. Ten infants turned out to have extrahepatic biliary atresia and the other ten had neonatal hepatitis. Hepatobiliary (with {sup 99m}Tc BrIDA) and {sup 99m}Tc MIBI scintigraphy were performed for all the patients. {sup 99m}Tc MIBI scintigraphy has shown bowel activity in all patients, including the patients with biliary atresia. Hepatobiliary scintigraphy revealed bowel activity only in five patients with neonatal hepatitis. Bowel visualization with {sup 99m}Tc MIBI may be seen in patients with biliary atresia and {sup 99m}Tc MIBI has limited value in differential diagnosis of neonatal cholestasis. (orig.)

  11. Hepatocellular carcinoma: clinical significance of signal heterogeneity in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fujita, Nobuhiro; Nishie, Akihiro; Asayama, Yoshiki; Ushijima, Yasuhiro; Moirta, Koichiro; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, Fukuoka (Japan); Kubo, Yuichiro; Aishima, Shinichi [Kyushu University, Department of Anatomic Pathology, Graduate School of Medical Sciences, Fukuoka (Japan); Takayama, Yukihisa [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Fukuoka (Japan); Shirabe, Ken [Kyushu University, Department of Surgery and Science, Graduate School of Medical Sciences, Fukuoka (Japan)

    2015-01-15

    To clarify the relationship between the biological behaviour of hepatocellular carcinomas (HCCs) and their signal intensity in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging with a special focus on the signal heterogeneity. A total of 68 patients with 70 pathologically proven HCCs were enrolled. On the basis of the signal intensity in the hepatobiliary phase, the lesions were classified into three groups: group 1, homogeneous hypointensity (n = 44); group 2, heterogeneous hyperintensity (n = 20); and group 3, homogeneous hyperintensity (n = 6). The clinicopathological findings were compared among the three groups. The tumour size and the serum level of protein induced by vitamin K absence or antagonist-II (PIVKA-II) were significantly higher in group 2 compared to group 1 (p = 0.0155, p = 0.0215, respectively) and compared to group 3 (p = 0.0330, p = 0.0220, respectively). The organic anion transporting polypeptide 8 (OATP8) expression in group 2 and group 3 was significantly higher than in group 1 (p < 0.0001, p < 0.0001, respectively). Group 2 showed a significantly lower disease-free survival rate compared to group 1 (p = 0.0125), and group 2 was an independent prognostic factor for disease-free survival (p = 0.0308). HCCs in the hepatobiliary phase that are heterogeneously hyperintense on gadoxetic acid-enhanced MR imaging have more malignant potential than other types of HCCs. (orig.)

  12. Bile leakage after living donor liver transplantation demonstrated with hepatobiliary scan using 9mTc-PMT.

    Science.gov (United States)

    Kanazawa, Akishige; Kubo, Shoji; Tanaka, Hiromu; Takemura, Shigekazu; Yamazaki, Keiichi; Hirohashi, Kazuhiro; Shiomi, Susumu

    2003-09-01

    Although it is recognized that hepatobiliary scan is of value in assessing postoperative complications of biliary surgery or cadaveric whole liver transplantation, there have been few reports regarding its usefulness following living donor liver transplantation. We performed living donor liver transplantation in a patient with biliary cirrhosis due to hepatolithiasis, using a right lobe graft from her sister. On the 15th postoperative day, bile discharge appeared from the operative wound. The leakage point could not be identified by computed tomography and cholangiography from the biliary drainage catheter. Hepatobiliary scan with Tc-99m Sn-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) demonstrated biliary extravasation from the left side of the anastomosis of the hepatico-jejunostomy, indicating biliary leakage from the anastomosis. Conservative therapy was continued because the radioisotope flowed smoothly into the reconstructed jejunum and the biliary drainage catheter, and the leakage was stopped on the 63th postoperative day. Hepatobiliary scan is useful in determining the therapeutic plan as well as detection of bile leakage and identification of leakage points after living donor liver transplantation.

  13. In vivo hepatic uptake inhibition study of Tc-99m-labeled hepatobiliary agents

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Meyoung Kon [National Institutes of Health, Bethesda (United States)

    1998-07-01

    We have previously reported that the hepatic uptake of Tc-99m-mercaptoacetyltriglycine (MAG3)-biocytin was not affected by coinjecting bilirubin in mice whereas the uptake of Tc-99m-diisopropyliminodiacetic acid (DISIDA) was inhibited (Kim et al. J Nucl Med, 38 : 50 p, 1997). The aim of this study was to investigate whether the hepatic uptake of Tc-99m-MAG3-biocytin or Tc-99m-DISIDA could be inhibited by biotin and biocytin. The Balb/c mice (female, 20g, n=5-8) were injected i.v. with the hepatobiliary agents alone (15-22 MBq/20-40 {mu}g) or together with inhibitors at two doses (14 and 28 mg/kg). For pharmacokinetic studies, images were acquired at 10-sec intervals for 20 min using a gamma camera equipped with a pin-hole collimator (d= 1 mm), starting immediately after intravenous injection. Pharmacokinetic parameters, peak liver/heart ratio (Rmax) and hepatic half clearance time (HCT), were calculated from liver and heart time-acitivity curves from regions-of-interest. Dynamic images showed rapid hepatic uptake inhibition was characterized by persistent high blood background. These qualitative scintigraphic findings were reflected in the pharmacokinetic parameters. Tc-99m-MAG3-biocytin without inhibitor coinjection showed Rmax of 9.3 and HCT of 383 sec. These parameters did not change significantly when bilirubin or biotin was coinjected, but did change significantly (P<0.05) for biocytin only at the higher dose: 52% decrease in HCT. In contrast, the parameters for Tc-99m-DISIDA (Rmax of 9.2 and HCT of 258 sec) were greatly affected (P<0.01) by biotin (79% decrease in Rman and 2-fold increase in HCT) even at 14 mg/kg concentration. We concluded that Tc-99m-MAG3-biocytin is less sensitive to inhibition by bilirubin, biotin, and biocytin than Tc-99m-DISIDA. Tc-99m-MAG3-biocytin appears to be a promising hepatobiliary imaging agent for hepatic function studies and may also be a useful tool to investigate the hepatic uptake mechanism of biotin derivatives in vivo.

  14. The usefulness of hepatobiliary scintigraphy in the diagnosis of complications after adult-to-adult living donor liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Moon, Dae Hyuk; Lee, Hee Kyung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea); Lee, Sung Gyu; Lee, Young Joo; Park, Kwang Min; Hwang, Shin [Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea)

    2002-04-01

    Living donor liver transplantation has become an accepted procedure to overcome the shortage of adult donor organs. The aim of this study was to evaluate the usefulness of hepatobiliary scintigraphy in the diagnosis of complications after adult-to-adult living donor liver transplantation. We analysed 82 hepatobiliary scintigraphy studies performed using technetium-99m DISIDA in 60 adult patients (44 males, 16 females) who had been transplanted with a living donor's hepatic lobe (right lobe, 32; left lobe, 28). Indications for hepatobiliary scintigraphy were abnormal symptoms and/or liver function tests (n=54) or suspected bile leak or biloma (n=28). Median interval between transplantation and scintigraphy was 69 days (9 days to 23 months). Scintigraphic findings were classified into hepatic parenchymal dysfunction, total biliary obstruction, segmental biliary obstruction, bile leak and normal graft. Scintigraphic findings were confirmed by liver biopsy in 17 cases, and by radiological and clinical follow-up in 65 cases. There were 29 events relating to biliary complications (six total biliary obstructions, eight segmental biliary obstructions and 15 bile leaks) and 19 relating to non-biliary complications (15 cases of rejection, two of infection and two of vascular compromise) in 38 patients. Hepatobiliary scintigraphy provided the correct diagnosis in all eight segmental and five of six total biliary obstructions, and in all 15 cases of bile leak. Of the 19 non-biliary complications, 16 showed parenchymal dysfunction regardless of the aetiology and three showed total biliary obstruction on scintigraphy. All but three of 34 normally functioning grafts were normal on scintigraphy. The diagnostic sensitivity and specificity of scintigraphy for biliary obstruction in the 54 patients with abnormal symptoms or liver function tests were 93% (100% for segmental, 83% for total) and 88% (35/40), respectively. The sensitivity and specificity were each 100% (15/15, 13

  15. Age dependence of spleen- and muscle-corrected hepatic signal enhancement on hepatobiliary phase gadoxetate MRI

    Energy Technology Data Exchange (ETDEWEB)

    Matoori, Simon [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Clinic St. Anna, Clinical Research Group, Lucerne (Switzerland); Froehlich, Johannes M. [Hirslanden Clinic St. Anna, Clinical Research Group, Lucerne (Switzerland); ETH Zurich, Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, Zurich (Switzerland); Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Breitenstein, Stefan [Cantonal Hospital Winterthur, Department of Surgery, Clinic for Visceral and Thoracic Surgery, Winterthur (Switzerland); Doert, Aleksis [Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Pozdniakova, Viktoria [Stavanger University Hospital, Department of Radiology, Stavanger (Norway); Koh, Dow-Mu [Royal Marsden Hospital, Department of Radiology, Surrey, England (United Kingdom); Gutzeit, Andreas [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Clinic St. Anna, Clinical Research Group, Lucerne (Switzerland); Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland)

    2016-06-15

    To identify correlations of signal enhancements (SE) and SE normalized to reference tissues of the spleen, kidney, liver, musculus erector spinae (MES) and ductus hepatocholedochus (DHC) on hepatobiliary phase gadoxetate-enhanced MRI with patient age in non-cirrhotic patients. A heterogeneous cohort of 131 patients with different clinical backgrounds underwent a standardized 3.0-T gadoxetate-enhanced liver MRI between November 2008 and June 2013. After exclusion of cirrhotic patients, a cohort of 75 patients with no diagnosed diffuse liver disease was selected. The ratio of signal intensity 20 min post- to pre-contrast administration (SE) in the spleen, kidney, liver, MES and DHC, and the SE of the kidney, liver and DHC normalized to the reference tissues spleen or MES were compared to patient age. Patient age was inversely correlated with the liver SE normalized to the spleen and MES SE (both p < 0.001) and proportionally with the SE of the spleen (p = 0.043), the MES (p = 0.030) and the kidney (p = 0.022). No significant correlations were observed for the DHC (p = 0.347) and liver SE (p = 0.606). The age dependence of hepatic SE normalized to the enhancement in the spleen and MES calls for a cautious interpretation of these quantification methods. (orig.)

  16. Hepato-biliary profile of potential candidate liver progenitor cells from healthy rat liver

    Institute of Scientific and Technical Information of China (English)

    Céric Maerckx; Isabelle Scheers; Tatiana Tondreau; David Campard; Omar Nyabi; Mustapha Najimi; Etienne Sokal

    2012-01-01

    AIM:To evaluate the presence of progenitor cells in healthy adult rat liver displaying the equivalent advanced hepatogenic profile as that obtained in humans.METHODS:Rat fibroblastic-like liver derived cells (rFLDC) were obtained from collagenase-isolated liver cell suspensions and characterized and their phenotype profile determined using flow cytometry,immunocyto-chemistry,reverse transcription polymerase chain reaction and functional assays.RESULTS:rFLDC exhibit fibroblastoid morphology,express mesenchymal (CD73,CD90,vimentin,α-smooth muscle actin),hepatocyte (UGT1A1,CK8) and biliary (CK19) markers.Moreover,these cells are able to store glycogen,and have glucose 6 phosphatase activity,but not UGT1A1 activity.Under the hepatogenic differentiation protocol,rFLDC display an up-regulation of hepatocyte markers expression (albumin,tryptophan 2,3-dioxygenase,G6Pase) correlated to a down-regulation of the expression of the biliary marker CK19.CONCLUSION:Advanced hepatic features observed in human liver progenitor cells could not be demonstrated in rFLDC.However,we demonstrated the presence of an original rodent hepato-biliary cell type.

  17. Statins alter the hepatobiliary transport of unconjugated and conjugated bilirubin in sandwich-cultured rat hepatocytes.

    Science.gov (United States)

    Szabó, Mónika; Veres, Zsuzsa; Bátai-Konczos, Attila; Kékesi, Orsolya; Kis, Emese; Szabó, Kitti; Jemnitz, Katalin

    2014-09-01

    Several studies have reported that statins occasionally cause impairment of liver functions characterized by elevated serum bilirubin levels, which might be due to altered function of the multidrug resistance-associated proteins (Mrp2/3). We aimed to study the modulation of the hepatobiliary transport of bilirubin by four statin derivatives, atorvastatin, fluvastatin, pravastatin, and rosuvastatin in sandwich-cultured rat hepatocytes. All statins except pravastatin significantly inhibited the uptake of bilirubin. The biliary efflux of bilirubin conjugates was increased by pravastatin and rosuvastatin concentration dependently. Rosuvastatin stimulated not only the Mrp2 mediated biliary, but the Mrp3 mediated sinusoidal elimination, resulting in decreased intracellular bilirubin accumulation. The significantly induced Mrp2/3 protein levels (ranging from 1.5 to 1.8-fold) accounted for the elevated efflux. Cell polarization, the formation of biliary network was also significantly increased by fluvastatin, pravastatin and rosuvastatin (151%, 216% and 275% of the control, respectively). The simultaneous inhibition of the uptake and the stimulation of the sinusoidal and canalicular elimination may explain, at least in part, the clinical observation of elevated serum bilirubin levels. In conclusion, our results suggest that in spite of the elevated serum bilirubin levels, the altered Mrp2 and Mrp3 functions by statins is probably not associated with hepatotoxic effects.

  18. Histology Atlas of the Developing Mouse Hepatobiliary Hemolymphatic Vascular System with Emphasis on Embryonic Days 11.5-18.5 and Early Postnatal Development.

    Science.gov (United States)

    Swartley, Olivia M; Foley, Julie F; Livingston, David P; Cullen, John M; Elmore, Susan A

    2016-07-01

    A critical event in embryo development is the proper formation of the vascular system, of which the hepatobiliary system plays a pivotal role. This has led researchers to use transgenic mice to identify the critical steps involved in developmental disorders associated with the hepatobiliary vascular system. Vascular development is dependent upon normal vasculogenesis, angiogenesis, and the transformation of vessels into their adult counterparts. Any alteration in vascular development has the potential to cause deformities or embryonic death. Numerous publications describe specific stages of vascular development relating to various organs, but a single resource detailing the stage-by-stage development of the vasculature pertaining to the hepatobiliary system has not been available. This comprehensive histology atlas provides hematoxylin & eosin and immunohistochemical-stained sections of the developing mouse blood and lymphatic vasculature with emphasis on the hepatobiliary system between embryonic days (E) 11.5-18.5 and the early postnatal period. Additionally, this atlas includes a 3-dimensional video representation of the E18.5 mouse venous vasculature. One of the most noteworthy findings of this atlas is the identification of the portal sinus within the mouse, which has been erroneously misinterpreted as the ductus venosus in previous publications. Although the primary purpose of this atlas is to identify normal hepatobiliary vascular development, potential embryonic abnormalities are also described. © The Author(s) 2016.

  19. Monitoring Hepatocyte Dysfunction and Biliary Complication After Liver Transplantation Using Quantitative Hepatobiliary Scintigraphy

    Science.gov (United States)

    Zou, Si-Juan; Chen, Dong; Li, Yan-Zhao; Du, Dun-Feng; Chen, Zhi-Shui; Zhu, Xiao-Hua

    2015-01-01

    Abstract The significance of hepatobiliary scintigraphy (HBS) for hepatic graft function assessment was established mostly on retrospective studies and was not widely recognized due to the lack of quantitative data and variation in accuracy. This prospective study was performed to investigate the effectiveness of quantitative HBS for assessing hepatocyte dysfunction and biliary complication in liver transplant recipients. In 57 recipients who had undergone orthotopic liver transplantation, a total of 67 dynamic 99mTc-EHIDA scans were performed and quantitative parameters including the hepatocyte extraction fraction (HEF), time to maximum hepatic radioactivity (Tmax), and time for peak activity to decrease by 50% (T1/2) were calculated. The scintigraphic results based on the 3 parameters were compared against the final diagnosis. A ROC curve analysis was carried out to identify the cutoff value of Tmax for diagnosis of biliary stricture. Correlation between the parameters of postoperative HBS and conventional biochemical liver function indices were also analyzed. Quantitative 99mTc-EHIDA HBS had an overall sensitivity of 94.12% (16/17), specificity of 93.33% (42/45), and diagnostic accuracy of 93.55% (58/62) for detecting hepatocyte dysfunction and biliary complication in liver transplant recipients. The recommended cutoff value of Tmax for diagnosis of post-transplant biliary stricture was set at 15.75 min with a sensitivity of 100.0% and a specificity of 94.0%. The scintigraphic parameters (HEF, Tmax) were statistically significantly associated with the conventional liver function parameters. Quantitative 99mTc-EHIDA HBS offers a noninvasive imaging modality with high sensitivity and specificity to diagnose hepatocyte dysfunction as well as distinguish between patients with or without biliary stricture following liver transplantation. Furthermore, HEF and Tmax values obtained from dynamic HBS show good correlation with conventional liver function parameters

  20. Analysis of bile in various hepatobiliary disease states: A pilot study

    Directory of Open Access Journals (Sweden)

    Ajay Verma

    2014-01-01

    Full Text Available Aim: Our study aims to find various enzymatic and biochemical components of bile and their clinical or prognostic correlation with regard to progression and severity of hepatobiliary diseases. Materials and Methods: It was a cross-sectional study where all the patients suffering from choledochal cyst (CDC, extrahepatic portal venous obstruction (EHPVO, and infantile obstructive cholangiopathy undergoing diagnostic preoperative cholangiogram; and patients with history of total parenteral nutrition (TPN undergoing surgery for some other condition were included in the study. Intraoperatively, bile was collected from the gallbladder and sent for estimation of amylase, lipase, sodium, potassium, calcium, chloride, bicarbonate, total bilirubin, pH, cholesterol, triglycerides, and total bile acid. Results: A total of 80 patients were included in the study (20 in each of the four disease-based groups. Amylase, lipase, and pH were significantly different among the patients of CDC when compared with the presence or absence of dilated intrahepatic biliary radicals. Similarly, amylase, lipase, and pH were also significantly different among the patients of EHPVO when compared with presence or absence of biliopathy. Levels of cholesterol and bile acid were significantly higher in patients who were evaluated after 1 year following TPN than those who were evaluated before 1 year. The patients of infantile cholangiopathy, who had history of fever, had significantly higher level of calcium. Conclusion: The components of bile show close correlation with various clinical and prognostic markers, there is a very close correlation between these parameters and the clinical severity, disease progression, and final outcome.

  1. Dose and batch-dependent hepatobiliary toxicity of 10 nm silver nanoparticles

    Directory of Open Access Journals (Sweden)

    Marcella De Maglie

    2015-07-01

    Full Text Available Silver nanoparticles (AgNPs are widely used because of their antimicrobial properties in medical devices and in a variety of consumer products. The extensive use of AgNPs raises concerns about their potential toxicity, although it is still difficult to draw definite conclusions about their toxicity based on published data. Our preliminary studies performed to compare the effect of the AgNPs size (10-40-100 nm on toxicity, demonstrated that the smallest AgNPs determine the most severe toxicological effects. In order to best investigate the impact of physicochemical characteristics of 10 nm AgNPs on toxicity, we compare three different batches of 10 nm AgNPs slightly different in size distribution (Batch A: 8.8±1.7 nm; Batch B: 9.4±1.7 nm; Batch C: 10.0±1.8 nm. Mice were intravenously treated with two doses (5 and 10 mg/kg of the 3 AgNPs. 24 hours after the treatment, mice were euthanized and underwent complete necropsy. Tissues were collected for histopathological examination and total silver content was determined in tissues by inductively coupled plasma mass spectrometry (ICP-MS. All batches induced severe hepatobiliary lesions, i.e. marked hepatocellular necrosis and massive hemorrhage of the gall bladder. The toxicity was dose-dependent and interestingly, the toxic effects were more severe in mice treated with batches A and B that contained smaller AgNPs. Since the total silver mass concentration was similar, the observed batch-dependent toxicity suggest that even subtle differences in size may contribute to relevant changes in the toxicological outcomes, confirming the fundamental involvement of physicochemical features with respect to toxicity.

  2. The imager replacing the pathologist in the diagnosis of hepatobiliary and pancreatic disease.

    Science.gov (United States)

    van Leeuwen, D J

    2001-02-01

    Advances in imaging technology, specifically cross-sectional imaging techniques (ultrasonography, computer tomography, magnetic resonance imaging), are dynamic and rapid. They have dramatically changed the management of hepatobiliary and pancreatic diseases. Although imaging is not identical to the traditional gold standard of a tissue diagnosis, it often obviates its need and provides a much better insight into clinically relevant pathology compared with a biopsy. However, this requires a thorough insight into the clinical and pathologic aspects of the disease, knowledge of limitations of imaging techniques, and insight in management implications. The clear identification of characteristic disease findings on imaging, such as a cirrhotic configuration of the liver or gallstones that match clinical findings, are most helpful. Imaging and tissue investigation often have a complementary role in patient management. Their yield is highest if they are part of a critical integration of clinical findings by a multidisciplinary team. The latter should help as much in identifying specific opportunities for treatment as preventing futile and potential harmful interventions. The contribution of imagers and pathologists to the management of patients will continue to be redefined in the new century. Noninvasive and virtual imaging will develop further. A specific and challenging role for the pathologists and clinical imagers in close cooperation with many other disciplines will be to identify sensitive molecular targets that can be used to provide noninvasive images that not only accurately provide a diagnosis, but also resolution of disease and response to specific therapy. Ann Diagn Pathol 5:57-66, 2001. Copyright 2001 by W.B. Saunders Company

  3. Helicobacter pylori and other Helicobacter species DNA in human bile samples from patients with various hepato-biliary diseases

    Institute of Scientific and Technical Information of China (English)

    Santosh K Tiwari; Aleem A Khan; Mohd Ibrahim; Mohd Aejaz Habeeb; C Ml Habibullah

    2006-01-01

    AIM: To investigate the presence of Helicobacter species by nested PCR of 16S rRNA genes followed by the presence of Helicobacter pylori (H pylori) 16S rRNA, ureA, cagA genes in bile obtained at endoscopic retrograde cholangio-pancreatography (ERCP) from 60Indian subjects.METHODS: Sixty bile samples were obtained from patients diagnosed with various hepato-biliary diseases and control subjects at ERCP. PCR analysis was carried out using primers for Helicobacter genus 16S rRNA gene and H pylori(16S rRNA, ureA and caaA) genes. Gastric Hpyloristatus was also assessed from biopsies obtained at endoscopy from patients with various hepato-biliary diseases and controls. The control group mainly consisted of subjects with gastric disorders. Sequencing analysis was performed to confirm that PCR products with 16S rRNA and cagA primers were derived from H pylori.RESULTS No Helicobacters were grown in culture from the bile samples. Helicobacter DNA was detected in bile of 96.7% and 6.6% of groups Ⅰ and Ⅱ respectively. Ten from group Ⅰ were positive for 16S rRNA and ureA and 9were positive for cagA gene. In contrast of the 2 from the control, 1 amplified with 16S rRNA, ureA and cagA primers used. The sequences of the 16S rRNA genes and cagA were 99% similar to Helicobacter pylori.CONCLUSION: Helicobacters are associated with the pathogenesis of various hepato-biliary disorders.

  4. Image-guided Treatment in the Hepatobiliary System: Role of Imaging in Treatment Planning and Posttreatment Evaluation.

    Science.gov (United States)

    Bajpai, Surabhi; Kambadakone, Avinash; Guimaraes, Alexander R; Arellano, Ronald S; Gervais, Debra A; Sahani, Dushyant

    2015-01-01

    In the past decade, image-guided targeted treatments such as percutaneous ablation, intra-arterial embolic therapies, and targeted radiation therapy have shown substantial promise in management of hepatobiliary malignancies. Imaging is integral to patient selection, treatment delivery, and assessment of treatment effectiveness. Preprocedural imaging is crucial and allows local tumor staging, evaluation of surrounding structures, and selection of suitable therapeutic options and strategies for treatment delivery. Postprocedural imaging is required to monitor therapeutic success, detect residual or recurrent disease, and identify procedure-related complications to guide appropriate future therapy. Technical innovations in cross-sectional imaging techniques such as computed tomography (CT) and magnetic resonance (MR) imaging, combined with advances in image postprocessing and new types of contrast agents, allow precise morphologic assessment and functional evaluation of hepatobiliary tumors. Advanced postprocessing techniques such as image fusion and volumetric assessment not only facilitate procedural planning and treatment delivery but also enhance posttreatment imaging surveillance. In addition, molecular imaging techniques such as fluorodeoxyglucose positron emission tomography (PET), PET/CT, and PET/MR imaging offer opportunities to evaluate various physiologic properties of tumors.

  5. STRUCTURAL AND METABOLIC CHARACTERISTICS OF COMPENSATORY-ADAPTIVE PROCESSES IN THE HEPATOBILIARY SYSTEM WITH ACETATE GASTRIC AND EXPOSURE TO PESTICIDES

    Directory of Open Access Journals (Sweden)

    M. A. Shakhnazarov

    2014-01-01

    Full Text Available Abstract. Aim. To study the structural and metabolic features of the hepatobiliary system for chronic oral exposure to pesticides in combination with acetate gastric ulcer. Methods. After playing acetate stomach ulcers spent histomorphologically and histoenzymatic research cryostatic and paraffin tissue sections of the liver of experimental and control animals. Set response to succinate dehydroge nase, lactate dehydrogenase, which is glitserofosfatdegidrogenazy, nicotineinduced  diaphorase, monoamine oxi dase, acid and alkaline phosphatase; determined the content of glycogen and RNA in the liver with subsequent com puter flow cytometric evaluation. Results. When injecting pesticides at 1 exposure limit values (ELV to animals there increase metabolic and protec tiveadaptive processes both in ulcer border zone and in remote fraction of the liver. Increasing doses of pesticides up to 50 ELV and above cause aggressive course of ulcer with penetration into the liver and development of second ary hepatitis, hepatosclerosis and dysfunction of the hepatobiliary system. Main conclusions. When combined pathology with gastric ulcers modeling (OkabePfeiffer and chronic oral expo sure of hexachlorocyclohexane, CuSO4, chlorophos pathomorphological changes in the liver are caused by both dose of pesticides and ulcers morphogenesis. The most toxic for the liver from the studied pesticides is hexachloro cyclohexane. 

  6. Levels of 8-OxodG Predict Hepatobiliary Pathology in Opisthorchis viverrini Endemic Settings in Thailand.

    Science.gov (United States)

    Saichua, Prasert; Yakovleva, Anna; Kamamia, Christine; Jariwala, Amar R; Sithithaworn, Jiraporn; Sripa, Banchob; Brindley, Paul J; Laha, Thewarach; Mairiang, Eimorn; Pairojkul, Chawalit; Khuntikeo, Narong; Mulvenna, Jason; Sithithaworn, Paiboon; Bethony, Jeffrey M

    2015-01-01

    Opisthorchis viverrini is distinct among helminth infections as it drives a chronic inflammatory response in the intrahepatic bile duct that progresses from advanced periductal fibrosis (APF) to cholangiocarcinoma (CCA). Extensive research shows that oxidative stress (OS) plays a critical role in the transition from chronic O. viverrini infection to CCA. OS also results in the excision of a modified DNA lesion (8-oxodG) into urine, the levels of which can be detected by immunoassay. Herein, we measured concentrations of urine 8-oxodG by immunoassay from the following four groups in the Khon Kaen Cancer Cohort study: (1) O. viverrini negative individuals, (2) O. viverrini positive individuals with no APF as determined by abdominal ultrasound, (3) O. viverrini positive individuals with APF as determined by abdominal ultrasound, and (4) O. viverrini induced cases of CCA. A logistic regression model was used to evaluate the utility of creatinine-adjusted urinary 8-oxodG among these groups, along with demographic, behavioral, and immunological risk factors. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive accuracy of urinary 8-oxodG for APF and CCA. Elevated concentrations of 8-oxodG in urine positively associated with APF and CCA in a strongly dose-dependent manner. Urinary 8-oxodG concentrations also accurately predicted whether an individual presented with APF or CCA compared to O. viverrini infected individuals without these pathologies. In conclusion, urinary 8-oxodG is a robust 'candidate' biomarker of the progression of APF and CCA from chronic opisthorchiasis, which is indicative of the critical role that OS plays in both of these advanced hepatobiliary pathologies. The findings also confirm our previous observations that severe liver pathology occurs early and asymptomatically in residents of O. viverrini endemic regions, where individuals are infected for years (often decades) with this food-borne pathogen. These

  7. Levels of 8-OxodG Predict Hepatobiliary Pathology in Opisthorchis viverrini Endemic Settings in Thailand.

    Directory of Open Access Journals (Sweden)

    Prasert Saichua

    Full Text Available Opisthorchis viverrini is distinct among helminth infections as it drives a chronic inflammatory response in the intrahepatic bile duct that progresses from advanced periductal fibrosis (APF to cholangiocarcinoma (CCA. Extensive research shows that oxidative stress (OS plays a critical role in the transition from chronic O. viverrini infection to CCA. OS also results in the excision of a modified DNA lesion (8-oxodG into urine, the levels of which can be detected by immunoassay. Herein, we measured concentrations of urine 8-oxodG by immunoassay from the following four groups in the Khon Kaen Cancer Cohort study: (1 O. viverrini negative individuals, (2 O. viverrini positive individuals with no APF as determined by abdominal ultrasound, (3 O. viverrini positive individuals with APF as determined by abdominal ultrasound, and (4 O. viverrini induced cases of CCA. A logistic regression model was used to evaluate the utility of creatinine-adjusted urinary 8-oxodG among these groups, along with demographic, behavioral, and immunological risk factors. Receiver operating characteristic (ROC curve analysis was used to evaluate the predictive accuracy of urinary 8-oxodG for APF and CCA. Elevated concentrations of 8-oxodG in urine positively associated with APF and CCA in a strongly dose-dependent manner. Urinary 8-oxodG concentrations also accurately predicted whether an individual presented with APF or CCA compared to O. viverrini infected individuals without these pathologies. In conclusion, urinary 8-oxodG is a robust 'candidate' biomarker of the progression of APF and CCA from chronic opisthorchiasis, which is indicative of the critical role that OS plays in both of these advanced hepatobiliary pathologies. The findings also confirm our previous observations that severe liver pathology occurs early and asymptomatically in residents of O. viverrini endemic regions, where individuals are infected for years (often decades with this food-borne pathogen

  8. Comparison of the dynamics of bile emptying by quantitative hepatobiliary scintigraphy before and after cholecystectomy in patients with uncomplicated gallstone disease

    DEFF Research Database (Denmark)

    Madácsy, L; Toftdahl, D B; Middelfart, H V

    1999-01-01

    of cholecystectomy on the bile flow has not yet been investigated. The goal of the current study was to examine the dynamics and normal variations of bile flow by quantitative hepatobiliary scintigraphy before and after cholecystectomy in a group of patients with uncomplicated gallstone disease. METHODS: Twenty...

  9. The Proper Scan Delay of the Hepatobiliary Phase of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging to Evaluate Small-Sized ({<=} 3 cm) Hepatocellular Carcinoma in Cirrhotic Liver

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Yong Yeon; Heo, Sook Hee; Kim, Jin Woong; Kang, Heoung Keun [Dept. of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun (Korea, Republic of); Lee, Ji Hyun; Shin, Sang Soo [Dept. of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2013-04-15

    To assess the optimal scan delay of hepatobiliary phase of gadoxetic acid (GA)-enhanced magnetic resonance (MR) imaging for small-sized ({<=} 3 cm) hepatocellular carcinomas (HCCs) in cirrhotic liver. There were 71 HCCs included in this study, derived from 53 patients with liver cirrhosis. Hepatobiliary phase MR imaging was obtained at 10, 15 and 20 mins after GA injection. For quantitative analysis, 2 radiologists calculated signal to noise ratio (SNR), enhancement ratio (ER) of the tumor and liver parenchyma and contrast-to-noise ratio (CNR) at 10 min, 15 min, and 20 min images, respectively. For qualitative analysis, 3 radiologists independently reviewed the 3 different phase about HCC possibilities using a 5-point scale. For each observer, the diagnostic accuracy of different hepatobiliary phases was compared using the area under the alternative free-response receiver operating characteristic curve (Az). In addition, sensitivity and specificity were compared. No significant differences in SNR, ER and CNR at 10 min, 15 min, and 20 min were found. The Az values for HCC possibility were not significantly different. Sensitivity and specificity were also not significantly different. Hepatobiliary phase MR imaging were obtained at 10 min, 15 min and 20 min yield comparable diagnostic information, so that the choice of scan delay can be adapted according to the clinical routine needs.

  10. Beyond current guidelines: reduction in minimum administered radiopharmaceutical activity with preserved diagnostic image quality in pediatric hepatobiliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fahey, Frederic; Markelewicz, Robert; Grant, Frederick; Drubach, Laura; Treves, S. Ted [Harvard Medical School, Division of Nuclear Medicine and Molecular Imaging, Boston Children' s Hospital, Boston, MA (United States); Harvard Medical School, Joint Program in Nuclear Medicine, Boston (United States); Zukotynski, Katherine [University of Toronto, Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto (Canada); Harvard Medical School, Joint Program in Nuclear Medicine, Boston (United States); Zurakowski, David [Boston Children' s Hospital, Departments of Anesthesia and Surgery, Boston (United States); Falone, Anthony; Vitello, Marie; Cao, Xinhua [Harvard Medical School, Division of Nuclear Medicine and Molecular Imaging, Boston Children' s Hospital, Boston, MA (United States); Vija, A.H.; Bhattacharya, Manojeet; Ding, Xinhong [Siemens Medical Solutions USA, Inc., Molecular Imaging, Malvern, PA (United States); Bar-Sever, Zvi [Schneider Children' s Medical Center, Petach Tikvah (Israel); Tel-Aviv University, Tel-Aviv (Israel); Gelfand, Michael [Cincinnati Children' s Hospital, Cincinnati, OH (United States)

    2014-12-15

    To determine if the minimum administered radiopharmaceutical activity for hepatobiliary scintigraphy can be reduced while preserving diagnostic image quality using enhanced planar processing (EPP). A total of 40 infants between 10 and 270 days old (body mass 2.2 - 6.5 kg) had hepatobiliary scintigraphy during the period 2004 - 2010 following the intravenous administration of either {sup 99m}Tc-mebrofenin (18 patients) or {sup 99m}Tc-disofenin (22 patients). Due to the small size of these patients, they all received the minimum administered activity of 18.5 MBq consistent with the North American Consensus Guidelines. Six nuclear medicine physicians subjectively graded the acceptability of the image quality for clinical interpretation using a four-point scale (not acceptable, fair, good, excellent). Each physician independently graded seven image sets including the original study (full activity) and simulated reduced activity studies using binomial subsampling (50 % of full activity, 25 % of full activity and activity reduced by weight), with and without EPP. For full-activity studies, 98 % were deemed acceptable by the six physicians for clinical interpretation. The percentages of acceptable 50 % reduced activity studies with and without EPP were not significantly different from the percentage of acceptable full-activity studies (P = 0.193 and P = 0.998, respectively). The percentage of acceptable 25 % reduced activity studies without EPP was significantly different from the percentage of acceptable full-activity studies (P < 0.001); however, this difference vanished when EPP was applied (P = 0.482). The activity reduced by weight ranged from 1.85 to 4.81 MBq (10 % to 26 % of full dose) and the percentages of acceptable studies with and without EPP were significantly different from the percentage of acceptable full-activity studies (P < 0.001 and P = 0.02, respectively). Clinically interpretable hepatobiliary scintigraphy images can be obtained in infants when the

  11. Ga-68-labeled tetrabromophthalein (Ga-68 BP-IDA) for positron imaging of hepatobiliary function: concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Schuhmacher, J.; Matys, R.; Hauser, H.; Clorius, J.H.; Maier-Borst, W.

    1983-07-01

    The chemical synthesis of an iminodiacetic-acid-substituted tetrabromo-o-cresolphthalein (BP-IDA), which complexes Ga-68 tightly is described. The liver uptake, bile excretion, and urinary excretion of the complex were examined in rats. Maximum liver uptake reached 60%, and 1-h cumulative bile excretion was 75% of injected dose. Urinary excretion in rats with ligated common bile duct remained below 1%. Competitive action of exogenous billirubin on hepatobiliary excretion of the Ga complex was less pronounced than that of bromosulfophthalein. The absolute activity determination of the positron emitter Ga-68, the high accumulation in the liver, the low urinary excretion, and the weak competition from exogeneous bilirubin are promising features of this radiopharmaceutical for the quantitative study of hepatobillary function.

  12. Hepatobiliary magnetic resonance imaging in patients with liver disease: correlation of liver enhancement with biochemical liver function tests.

    Science.gov (United States)

    Kukuk, Guido M; Schaefer, Stephanie G; Fimmers, Rolf; Hadizadeh, Dariusch R; Ezziddin, Samer; Spengler, Ulrich; Schild, Hans H; Willinek, Winfried A

    2014-10-01

    To evaluate hepatobiliary magnetic resonance imaging (MRI) using Gd-EOB-DTPA in relation to various liver function tests in patients with liver disorders. Fifty-one patients with liver disease underwent Gd-EOB-DTPA-enhanced liver MRI. Based on region-of-interest (ROI) analysis, liver signal intensity was calculated using the spleen as reference tissue. Liver-spleen contrast ratio (LSCR) and relative liver enhancement (RLE) were calculated. Serum levels of total bilirubin, gamma glutamyl transpeptidase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamate dehydrogenase (GLDH), lactate dehydrogenase (LDH), serum albumin level (AL), prothrombin time (PT), creatinine (CR) as well as international normalised ratio (INR) and model for end-stage liver disease (MELD) score were tested for correlation with LSCR and RLE. Pre-contrast LSCR values correlated with total bilirubin (r = -0.39; p = 0.005), GGT (r = -0.37; p = 0.009), AST (r = -0.38; p = 0.013), ALT (r = -0.29; p = 0.046), PT (r = 0.52; p function tests, suggesting that hepatobiliary MRI may serve as a valuable biomarker for liver function. The strongest correlation with liver enhancement was found for the MELD Score. • Relative enhancement (RLE) of Gd-EOB-DTPA is related to biochemical liver function tests. • Correlation of RLE with bilirubin, ALT, AST, GGT, INR and MELD Score is reverse. • The correlation of relative liver enhancement with prothrombin time is positive. • AST, ALT, GLDH, prothrombin time, INR and MELD Score correlate with pre-contrast liver-spleen contrast ratio. • Such biomarkers may help to evaluate liver function.

  13. Agreement between microscopic examination and bacterial culture of bile samples for detection of bactibilia in dogs and cats with hepatobiliary disease.

    Science.gov (United States)

    Pashmakova, Medora B; Piccione, Julie; Bishop, Micah A; Nelson, Whitney R; Lawhon, Sara D

    2017-05-01

    OBJECTIVE To evaluate the agreement between results of microscopic examination and bacterial culture of bile samples from dogs and cats with hepatobiliary disease for detection of bactibilia. DESIGN Cross-sectional study. ANIMALS 31 dogs and 21 cats with hepatobiliary disease for which subsequent microscopic examination and bacterial culture of bile samples was performed from 2004 through 2014. PROCEDURES Electronic medical records of included dogs and cats were reviewed to extract data regarding diagnosis, antimicrobials administered, and results of microscopic examination and bacterial culture of bile samples. Agreement between these 2 diagnostic tests was assessed by calculation of the Cohen κ value. RESULTS 17 (33%) dogs and cats had bactibilia identified by microscopic examination of bile samples, and 11 (21%) had bactibilia identified via bacterial culture. Agreement between these 2 tests was substantial (percentage agreement [positive and negative results], 85%; κ = 0.62; 95% confidence interval, 0.38 to 0.89) and improved to almost perfect when calculated for only animals that received no antimicrobials within 24 hours prior to sample collection (percentage agreement, 94%; κ = 0.84; 95% confidence interval, 0.61 to 1.00). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that agreement between microscopic examination and bacterial culture of bile samples for detection of bactibilia is optimized when dogs and cats are not receiving antimicrobials at the time of sample collection. Concurrent bacterial culture and microscopic examination of bile samples are recommended for all cats and dogs evaluated for hepatobiliary disease.

  14. EGFR分子靶向治疗肝胆肿瘤的研究进展%EGFR-targeted therapy for hepatobiliary cancers: recent progress

    Institute of Scientific and Technical Information of China (English)

    邢荣春

    2013-01-01

    随着对肝胆肿瘤研究的不断深入,针对癌细胞异常通路和靶点的药物已经取得了很大的进展.目前针对表皮生长因子受体(EGFR)分子靶向药物已广泛应用于肝胆肿瘤的治疗,相对于传统化疗药物其已显现出其独特的优势,但其长期应用易出现耐药.笔者就EGFR分子靶向治疗在肝胆肿瘤的中的临床应用及其耐药机制方面进行综述,以期能对临床治疗提供新的思路.%With the growth of research on hepatobiliary cancers,great progress has been achieved in the development of drugs targeting the abnormal pathways or molecules in cancer cells.At present,the drugs targeting the epidermal growth factor receptor (EGFR) has been widely used in hepatobiliary cancer therapy,and has exhibited unique advantages compared to traditional chemotherapy drugs,but may still give rise to drug resistance in long term use.This paper mainly addresses the clinical application of EGFR-targeted therapy in hepatobiliary cancers and the mechanisms of resistance,with the purpose of providing new insights for clinical practice.

  15. Comparative imaging of HIV-associated diseases of the hepatobiliary system in CT and cholangiography; Vergleichende Darstellung HIV-assoziierter Erkrankungen des hepatobiliaeren Systems in Computertomographie und Cholangiographie

    Energy Technology Data Exchange (ETDEWEB)

    Knollmann, F.D. [Strahlenklinik und Poliklinik, Klinikum Rudolf Virchow, Freie Universitaet Berlin (Germany); Adler, A. [Klinik fuer Innere Medizin mit Schwerpunkt Gastroenterologie, Zentrale Interdisziplinaere Endoskopie, Klinikum Rudolf Virchow, Freie Universitaet Berlin (Germany); Maeurer, J. [Strahlenklinik und Poliklinik, Klinikum Rudolf Virchow, Freie Universitaet Berlin (Germany); Gruenewald, T. [2. Innere Abteilung, Klinikum Rudolf Virchow, Freie Universitaet Berlin (Germany); Hintze, R.E. [Klinik fuer Innere Medizin mit Schwerpunkt Gastroenterologie, Zentrale Interdisziplinaere Endoskopie, Klinikum Rudolf Virchow, Freie Universitaet Berlin (Germany); Schedel, H. [Strahlenklinik und Poliklinik, Klinikum Rudolf Virchow, Freie Universitaet Berlin (Germany); Veltzke, W. [Klinik fuer Innere Medizin mit Schwerpunkt Gastroenterologie, Zentrale Interdisziplinaere Endoskopie, Klinikum Rudolf Virchow, Freie Universitaet Berlin (Germany)

    1995-07-01

    With the incidence of AIDS being on the rise, diagnostic work-up of hepatobiliary disease in these patients is of increasing interest. 57 X-ray cholangiograms and computed tomographic studies of 13 AIDS-patients with clinical signs of cholangitis were reviewed. Nine patients had abnormal cholangiographic findings. Computed tomography of 8 patients revealed hepatobiliary disease in six cases. Of three patients with cholangiograms reflecting bile duct dilatation of neoplastic aetiology, CT was required in two for definite diagnosis. Cholangiography is the method of choice for diagnosing AIDS-associated cholangitis, whereas computed tomography compres favourably in depicting neoplastic disease of the hepatobiliary system. Follow-up of AIDS-associated cholangitis usually delineates unchanged radiologic findings. (orig.) [Deutsch] Die Beteiligung des hepatobiliaeren Systems bei AIDS wurde in 57 roentgencholangiographischen und computertomographischen Untersuchungen an 13 Patienten retrospektiv analysiert. Bei 9 Patienten wurden im Cholangiogramm pathologische Gallengangveraenderungen gefunden. 6 von 8 durch CT untersuchte Patienten hatten Zeichen einer hepatobiliaeren Erkrankung. Bei 3 Patienten mit gallenstaubdingenden Tumoren war die definitive Diagnose in 2 Faellen erst durch CT zu stellen. Waehrend die Cholangiographie zur Sicherung einer AIDS-assoziierten Cholangitis das Verfahren der Wahl darstellt, ist zur Tumordiagnositk die Computertomographie ueberlegen. Cholangitische Gallengangsveraenderungen bleiben im Verlauf haeufig konstant. (orig.)

  16. Hepatobiliary magnetic resonance imaging in patients with liver disease: correlation of liver enhancement with biochemical liver function tests

    Energy Technology Data Exchange (ETDEWEB)

    Kukuk, Guido M.; Schaefer, Stephanie G.; Hadizadeh, Dariusch R.; Schild, Hans H.; Willinek, Winfried A. [University of Bonn, Department of Radiology, Bonn (Germany); Fimmers, Rolf [University of Bonn, Department of Medical Biometry, Informatics and Epidemiology, Bonn (Germany); Ezziddin, Samer [Department of Nuclear Medicine, Bonn (Germany); Spengler, Ulrich [Department of Internal Medicine I, Bonn (Germany)

    2014-10-15

    To evaluate hepatobiliary magnetic resonance imaging (MRI) using Gd-EOB-DTPA in relation to various liver function tests in patients with liver disorders. Fifty-one patients with liver disease underwent Gd-EOB-DTPA-enhanced liver MRI. Based on region-of-interest (ROI) analysis, liver signal intensity was calculated using the spleen as reference tissue. Liver-spleen contrast ratio (LSCR) and relative liver enhancement (RLE) were calculated. Serum levels of total bilirubin, gamma glutamyl transpeptidase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamate dehydrogenase (GLDH), lactate dehydrogenase (LDH), serum albumin level (AL), prothrombin time (PT), creatinine (CR) as well as international normalised ratio (INR) and model for end-stage liver disease (MELD) score were tested for correlation with LSCR and RLE. Pre-contrast LSCR values correlated with total bilirubin (r = -0.39; p = 0.005), GGT (r = -0.37; p = 0.009), AST (r = -0.38; p = 0.013), ALT (r = -0.29; p = 0.046), PT (r = 0.52; p < 0.001), GLDH (r = -0.55; p = 0.044), INR (r = -0.42; p = 0.003), and MELD Score (r = -0.53; p < 0.001). After administration of Gd-EOB-DTPA bilirubin (r = -0.45; p = 0.001), GGT (r = -0.40; p = 0.004), PT (r = 0.54; p < 0.001), AST (r = -0.46; p = 0.002), ALT (r = -0.31; p = 0.030), INR (r = -0.45; p = 0.001) and MELD Score (r = -0.56; p < 0.001) significantly correlated with LSCR. RLE correlated with bilirubin (r = -0.40; p = 0.004), AST (r = -0.38; p = 0.013), PT (r = 0.42; p = 0.003), GGT (r = -0.33; p = 0.020), INR (r = -0.36; p = 0.011) and MELD Score (r = -0.43; p = 0.003). Liver-spleen contrast ratio and relative liver enhancement using Gd-EOB-DTPA correlate with a number of routinely used biochemical liver function tests, suggesting that hepatobiliary MRI may serve as a valuable biomarker for liver function. The strongest correlation with liver enhancement was found for the MELD Score. (orig.)

  17. A Prototype Educational Model for Hepatobiliary Interventions: Unveiling the Role of Graphic Designers in Medical 3D Printing.

    Science.gov (United States)

    Javan, Ramin; Zeman, Merissa N

    2017-08-14

    In the context of medical three-dimensional (3D) printing, in addition to 3D reconstruction from cross-sectional imaging, graphic design plays a role in developing and/or enhancing 3D-printed models. A custom prototype modular 3D model of the liver was graphically designed depicting segmental anatomy of the parenchyma containing color-coded hepatic vasculature and biliary tree. Subsequently, 3D printing was performed using transparent resin for the surface of the liver and polyamide material to develop hollow internal structures that allow for passage of catheters and wires. A number of concepts were incorporated into the model. A representative mass with surrounding feeding arterial supply was embedded to demonstrate tumor embolization. A straight narrow hollow tract connecting the mass to the surface of the liver, displaying the path of a biopsy device's needle, and the concept of needle "throw" length was designed. A connection between the middle hepatic and right portal veins was created to demonstrate transjugular intrahepatic portosystemic shunt (TIPS) placement. A hollow amorphous structure representing an abscess was created to allow the demonstration of drainage catheter placement with the formation of pigtail tip. Percutaneous biliary drain and cholecystostomy tube placement were also represented. The skills of graphic designers may be utilized in creating highly customized 3D-printed models. A model was developed for the demonstration and simulation of multiple hepatobiliary interventions, for training purposes, patient counseling and consenting, and as a prototype for future development of a functioning interventional phantom.

  18. Circadian Clock Is Involved in Regulation of Hepatobiliary Transport Mediated by Multidrug Resistance-Associated Protein 2.

    Science.gov (United States)

    Oh, Ju-Hee; Lee, Joo Hyun; Han, Dong-Hee; Cho, Sehyung; Lee, Young-Joo

    2017-09-01

    There has been a growing interest in circadian regulation of the expression and function of drug transporters. In this study, we investigated circadian rhythm in the expression and function of multidrug resistance-associated protein 2 (Mrp2) in mouse liver and involvement of circadian clock in their regulations by using the circadian clock genes (period 1 and period 2) knockout mice. The mRNA and protein expression of Mrp2, P-glycoprotein, and breast cancer resistance protein was measured in the mouse liver at different times of the day. Circadian variation of hepatobiliary excretion of phenolsulfonphthalein, a model substrate of Mrp2, was also investigated in mice. Circadian oscillation of Mrp2 protein expression was clearly observed in the mouse liver with levels down at the light phase and up at the dark phase. The cumulative biliary excretion and biliary clearance of phenolsulfonphthalein from the liver to the bile was 2.37- and 1.74-fold greater in mice administered during the dark phase than in those administered during the light phase, respectively. The circadian oscillation in mRNA expression of Mrp2 disappeared in period 1 and period 2 double knockout mice. These results suggest that the expression and function of Mrp2 show the circadian rhythm, controlled by circadian clock genes. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  19. Hyperintense HCC on hepatobiliary phase images of gadoxetic acid-enhanced MRI: Correlation with clinical and pathological features

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young [Department of Radiology and Research Institute of Radiological Science, Yonsei University Severance Hospital, Seoul (Korea, Republic of); Kim, Myeong-Jin, E-mail: kimnex@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Yonsei University Severance Hospital, Seoul (Korea, Republic of); Kim, Kyung Ah; Jeong, Hyeon Tae [Department of Radiology and Research Institute of Radiological Science, Yonsei University Severance Hospital, Seoul (Korea, Republic of); Park, Young Nyun [Department of Pathology, Yonsei University Severance Hospital, Seoul (Korea, Republic of)

    2012-12-15

    Purpose: To retrospectively determine whether the hyperintense hepatocellular carcinomas (HCCs) seen on the hepatobiliary phase of gadoxetic acid-enhanced MR imaging (EOB-MRI) might have different histologic characteristics from usual hypointense HCCs. Materials and methods: Two hundred three surgically proven HCCs from 192 patients who underwent preoperative EOB-MRI were analyzed. The demographic and histologic characteristics of hyperintense HCCs were compared with usual hypointense HCCs by using the t-test or Fisher's exact test. Results: By visual assessment, 18 (8.8%) tumors were classified as hyperintense HCCs. Patients with hyperintense HCC were significantly (p < 0.05) older (60.1 vs. 55.2 years) than those with hypointense HCCs. Hyperintense HCCs showed significantly lower rate of microvascular invasion (27.8% vs. 53.5%) and significantly higher rate of peliosis (61.1% vs. 30.8%). Hyperintense HCCs were more frequently expanding type, and none showed infiltrative type or scirrhous histologic pattern. Conclusions: Hyperintense HCCs seem to have clinical and histologic features that might be related with more favorable outcomes.

  20. Altered intestinal bile salt biotransformation in a cystic fibrosis (Cftr-/-) mouse model with hepato-biliary pathology.

    Science.gov (United States)

    Bodewes, Frank A J A; van der Wulp, Mariëtte Y M; Beharry, Satti; Doktorova, Marcela; Havinga, Rick; Boverhof, Renze; James Phillips, M; Durie, Peter R; Verkade, Henkjan J

    2015-07-01

    Cftr(-/-tm1Unc) mice develop progressive hepato-biliary pathology. We hypothesize that this liver pathology is related to alterations in biliary bile hydrophobicity and bile salt metabolism in Cftr(-/-tm1Unc) mice. We determined bile production, biliary and fecal bile salt- and lipid compositions and fecal bacterial composition of C57BL/6J Cftr(-/-tm1Unc) and control mice. We found no differences between the total biliary bile salt or lipid concentrations of Cftr(-/-) and controls. Compared to controls, Cftr(-/-) mice had a ~30% higher bile production and a low bile hydrophobicity, related to a ~7 fold higher concentration of the choleretic and hydrophilic bile salt ursocholate. These findings coexisted with a significantly smaller quantity of fecal Bacteroides bacteria. Liver pathology in Cftr(-/-tm1Unc) is not related to increased bile hydrophobicity. Cftr(-/-) mice do however display a biliary phenotype characterized by increased bile production and decreased biliary hydrophobicity. Our findings suggest Cftr dependent, alterations in intestinal bacterial biotransformation of bile salts. Copyright © 2014. Published by Elsevier B.V.

  1. Identification of an Enterocytozoon bieneusi-like microsporidian parasite in simian-immunodeficiency-virus-inoculated macaques with hepatobiliary disease.

    Science.gov (United States)

    Mansfield, K G; Carville, A; Shvetz, D; MacKey, J; Tzipori, S; Lackner, A A

    1997-04-01

    Enterocytozoon bieneusi is a common opportunistic pathogen of human patients with acquired immune deficiency syndrome (AIDS) causing significant morbidity and mortality. In a retrospective analysis utilizing conventional histochemical techniques, in situ hybridization, polymerase chain reaction, and ultrastructural examination, we identified 18 simian-immunodeficiency-virus-infected macaques (16 Macaca mulatta, 1 M. nemestrina, and 1 M. cyclopis) with Enterocytozoon infection of the hepatobiliary system and small intestine. The organisms were readily identified in the bile ducts and gall bladder by special stains and by in situ hybridization using a probe directed against the small subunit ribosomal RNA of human origin E. bieneusi. Infection of the biliary system was associated with a nonsuppurative and proliferative cholecystitis and choledochitis. Hepatic involvement was characterized by bridging portal fibrosis and nodular hepatocellular regeneration accompanied by marked bile ductular and septal duct hyperplasia. Ultrastructurally, all developmental stages of the organism were found in direct contact with the host cell cytoplasm; spores and sporoblasts contained a double layer of polar tubes. Sequencing of a 607-bp segment of the small subunit ribosomal RNA revealed 97 and 100% identity to two clones of small subunit ribosomal RNA derived from E. bieneusi of human origin. Extensive morphological and genetic similarities between the simian and human enterocytozoons suggest that experimentally infected macaques may serve as a useful model of microsporidial infection in AIDS.

  2. Prediction of the histopathological grade of hepatocellular carcinoma using qualitative diffusion-weighted, dynamic, and hepatobiliary phase MRI

    Energy Technology Data Exchange (ETDEWEB)

    An, Chansik; Kim, Yeo-Eun; Chung, Woo-Suk; Chung, Yong Eun; Kim, Ki Whang [Yonsei University College of Medicine, Department of Diagnostic Radiology, Research Institute of Radiological Science, Severance Hospital, Seoul (Korea, Republic of); Park, Mi-Suk [Yonsei University College of Medicine, Department of Diagnostic Radiology, Research Institute of Radiological Science, Severance Hospital, Seoul (Korea, Republic of); Yonsei University College of Medicine, Institute of Gastroenterology, Seoul (Korea, Republic of); Yonsei University College of Medicine, Brain Korea 21 Project for Medical Science, Seoul (Korea, Republic of); Severance Hospital, Department of Diagnostic Radiology, Seoul (Korea, Republic of); Jeon, Hyae-Min [Yonsei University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Kim, Myeong-Jin [Yonsei University College of Medicine, Department of Diagnostic Radiology, Research Institute of Radiological Science, Severance Hospital, Seoul (Korea, Republic of); Yonsei University College of Medicine, Institute of Gastroenterology, Seoul (Korea, Republic of); Yonsei University College of Medicine, Brain Korea 21 Project for Medical Science, Seoul (Korea, Republic of)

    2012-08-15

    To investigate the effectiveness of qualitative diffusion-weighted imaging (DWI), subtraction of unenhanced from arterial phase images, and hepatobiliary phase (HBP) images in estimating the histopathological grade of hepatocellular carcinoma (HCC). We retrospectively reviewed gadoxetic acid-enhanced magnetic resonance images of 175 patients with 201 surgically resected HCCs. The signal intensity and its relationship with histopathological grade were assessed for each sequence and a combination of sequences. There was a tendency towards higher grades in tumours showing restricted diffusion on DWI (P < 0.001) or arterial enhancement on subtraction imaging (P <0.001), but not hepatocyte-defect on HBP images (P = 0.33). When lesions were divided into three groups based on combined findings on DWI and subtraction imaging, a linear trend was observed between group and grade (P < 0.001). The positive predictive value (PPV) of the combination of no restricted diffusion and no arterial enhancement in predicting well-differentiated HCC was 100%, higher than the PPV of individual findings on DWI (74%) or subtraction imaging (81%). DWI and subtraction imaging are helpful for predicting the histopathological grade of HCC, especially when the two sequences are considered together. (orig.)

  3. Prediagnostic selenium status and hepatobiliary cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort.

    Science.gov (United States)

    Hughes, David J; Duarte-Salles, Talita; Hybsier, Sandra; Trichopoulou, Antonia; Stepien, Magdalena; Aleksandrova, Krasimira; Overvad, Kim; Tjønneland, Anne; Olsen, Anja; Affret, Aurélie; Fagherazzi, Guy; Boutron-Ruault, Marie-Christine; Katzke, Verena; Kaaks, Rudolf; Boeing, Heiner; Bamia, Christina; Lagiou, Pagona; Peppa, Eleni; Palli, Domenico; Krogh, Vittorio; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Bueno-de-Mesquita, Hendrik Bastiaan; Peeters, Petra H; Engeset, Dagrun; Weiderpass, Elisabete; Lasheras, Cristina; Agudo, Antonio; Sánchez, Maria-José; Navarro, Carmen; Ardanaz, Eva; Dorronsoro, Miren; Hemmingsson, Oskar; Wareham, Nicholas J; Khaw, Kay-Tee; Bradbury, Kathryn E; Cross, Amanda J; Gunter, Marc; Riboli, Elio; Romieu, Isabelle; Schomburg, Lutz; Jenab, Mazda

    2016-08-01

    Selenium status is suboptimal in many Europeans and may be a risk factor for the development of various cancers, including those of the liver and biliary tract. We wished to examine whether selenium status in advance of cancer onset is associated with hepatobiliary cancers in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. We assessed prediagnostic selenium status by measuring serum concentrations of selenium and selenoprotein P (SePP; the major circulating selenium transfer protein) and examined the association with hepatocellular carcinoma (HCC; n = 121), gallbladder and biliary tract cancers (GBTCs; n = 100), and intrahepatic bile duct cancer (IHBC; n = 40) risk in a nested case-control design within the EPIC study. Selenium was measured by total reflection X-ray fluorescence, and SePP was determined by a colorimetric sandwich ELISA. Multivariable ORs and 95% CIs were calculated by using conditional logistic regression. HCC and GBTC cases, but not IHBC cases, showed significantly lower circulating selenium and SePP concentrations than their matched controls. Higher circulating selenium was associated with a significantly lower HCC risk (OR per 20-μg/L increase: 0.41; 95% CI: 0.23, 0.72) but not with the risk of GBTC or IHBC. Similarly, higher SePP concentrations were associated with lowered HCC risk only in both the categorical and continuous analyses (HCC: P-trend ≤ 0.0001; OR per 1.5-mg/L increase: 0.37; 95% CI: 0.21, 0.63). These findings from a large prospective cohort provide evidence that suboptimal selenium status in Europeans may be associated with an appreciably increased risk of HCC development. © 2016 American Society for Nutrition.

  4. Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Verloh, N.; Haimerl, M.; Schlabeck, M.; Schreyer, A.G.; Stroszczynski, C.; Fellner, C.; Wiggermann, P. [University Hospital Regensburg, Department of Radiology, Regensburg (Germany); Zeman, F. [University Hospital Regensburg, Center for Clinical Trials, Regensburg (Germany); Barreiros, A. [University Hospital Regensburg, Department of Gastroenterology, Regensburg (Germany); Loss, M. [University Hospital Regensburg, Department of Surgery, Regensburg (Germany)

    2014-05-15

    The purpose of this study was to evaluate the usefulness of Gd-EOB-DTPA-enhanced 3-T MRI to determine the hepatic functional reserve expressed by the model for end-stage liver disease (MELD) score. A total of 121 patients with normal liver function (NLF; MELD score ≤ 10) and 29 patients with impaired liver function (ILF; MELD score > 10) underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 min after contrast injection. Relative enhancement (RE) between plain signal intensity and contrast-enhanced signal intensity was calculated and was used to determine Gd-EOB-DTPA uptake into the liver parenchyma for patients with different MELD scores. RE differed significantly (p ≤ 0.001) between patients with NLF (87.2 ± 29.5 %) and patients with ILF (45.4 ± 26.5 %). The optimal cut-off value for RE to differentiate NLF from ILF was 47.7 % (AUC 0.87). This cut-off value showed a sensitivity of 82.8 % and a specificity of 92.7 % for the differentiation of the analysed groups. Gd-EOB-DTPA uptake in hepatocytes is strongly affected by liver function. Gd-EOB-DTPA-enhanced MRI and assessment of RE during the hepatobiliary phase (HBP) may serve as a useful image-based test in liver imaging for determining regional and global liver function. (orig.)

  5. Validity of the FACT Hepatobiliary (FACT-Hep) questionnaire for assessing disease-related symptoms and health-related quality of life in patients with metastatic pancreatic cancer.

    Science.gov (United States)

    Cella, David; Butt, Zeeshan; Kindler, Hedy Lee; Fuchs, Charles S; Bray, Sarah; Barlev, Arie; Oglesby, Alan

    2013-06-01

    Evaluate reliability and validity of the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire and its derivative FACT Hepatobiliary Symptom Indexes (FHSI-18 and FHSI-8) in people with metastatic pancreatic cancer. Self-reported questionnaire data from a randomized controlled Phase II study evaluating the efficacy and safety of conatumumab (AMG 655), ganitumab (AMG 479) or placebo combined with gemcitabine were evaluated. The following were assessed: internal consistency, using Cronbach's α; discriminant validity, comparing baseline patient-reported outcomes (PRO) scores across Eastern Cooperative Oncology Group (ECOG) performance status (PS) levels; and ability to detect change, comparing change from baseline PRO score at each cycle across PS and tumour response groups. The analysis included 96 patients. All scale scores demonstrated good internal consistency (Cronbach's α > 0.7) and discriminant validity. Baseline scores were significantly poorer among patients with PS = 1 versus patients with PS = 0 (e.g. difference in FACT-Hep total score -17.27; p FACT-Hep total score -24.29; p FACT-Hep total score -12.58; p = 0.004). Changes on the FHSI-18 and FHSI-8 scales were similar in magnitude whether ECOG improved or worsened. FACT-Hep detects change and is a reliable and valid instrument for measuring health-related quality of life in patients with metastatic pancreatic cancer.

  6. Specific serum IgG, but not IgA, antibody against purified Opisthorchis viverrini antigen associated with hepatobiliary disease and cholangiocarcinoma.

    Science.gov (United States)

    Pinlaor, Porntip; Pongsamart, Porntip; Hongsrichan, Nuttanan; Sangka, Arunnee; Srilunchang, Thitima; Mairiang, Eimorn; Sithithaworn, Paiboon; Pinlaor, Somchai

    2012-03-01

    Opisthorchiasis caused by Opisthorchis viverrini infection induces hepatobiliary disease (HBD)-associated cholangiocarcinoma (CCA) via a chronic inflammatory immune response. Here, we evaluated specific IgG and IgA antibodies against different fractions of O. viverrini antigen in residents from an endemic community in Northeast Thailand with varying hepatobiliary abnormalities. Crude somatic O. viverrini antigen was purified into three fractions (viz., P1, P2 and P3) by gel infiltration chromatography and these served as antigens for detection of fluke-specific IgG and IgA antibodies by enzyme-linked immunosorbent assay (ELISA). The results revealed fluke-specific IgG and IgA antibody levels-against these antigens from subjects with O. viverrini-positive HBD-higher than in subjects with O. viverrini-negative HBD. Interestingly, the rank of fluke-specific IgG (and not IgA) antibody levels against crude extract and P1 antigens was CCA>severe HBD>mild HBD>healthy individuals. Purified antigens reduced cross-reactivity with other parasites compared to the crude antigen. Multiple linear regression analysis showed that HBD status was significantly associated with the liver fluke-specific IgG antibody against purified antigens. These results suggest that purified O. viverrini-antigen improves serodiagnosis for the evaluation of opisthorchiasis-associated HBD, and may be useful in the screening of opisthorchiasis in subjects at risk of developing CCA.

  7. Clinical significance of parenchymal excretion delay of unilateral graft on hepatobiliary scintigraphy after dual grafts living donors liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Y. J.; Kim, J. S.; Lee, S. K.; Hwang, S.; Park, G. M.; Lee, Y. J.; Moon, D. H. [Asan Medical Center, Seoul (Korea, Republic of)

    2005-07-01

    Clinical significance of unilateral graft parenchymal excretion delay (UED) after dual grafts living donors liver transplantation (DLDLT) on hepatobiliary scintigraphy (HBS) may be different from that of liver transplantation with single graft considering the immune reaction and surgical techniques. The purpose of this study was to evaluate the clinical significance of UED after DLDLT. Clinicopathologic findings of 136 patients (48{+-}9 yrs; M/F=119/17) who underwent HBS using Tc-99m DISIDA after DLDLT were retrospectively evaluated. UED was considered when HBS showed delayed parenchymal excretion of unilateral graft with normal contralateral graft and HBS findings of UED were further classified into biliary obstructive (BO) or non-biliary obstructive (NBO) pattern according to biliary to enteric transit time. The etiology and outcome of UED were determined by clinical and pathologic findings. Of 136 patients, 18 showed UED (Rt/Lt=11/7) within 1 mo (1.6{+-}1.4 wk) after transplantation and 18 (Rt/Lt=6/12) after 1 mo (7.7{+-}5.0 mo). Of 18 patients with UED within 1 mo, 16 resulted from the early postoperative graft dysfunction (EGD) which showed NBO pattern in all but three (81%), and 2 resulted from biliary stenosis of anastomotic site. After 1 mo, 9 of 18 UED resulted from biliary stenosis and parenchymal dysfunction due to unknown but non-biliary etiology in 7, acute rejection in 1, and vascular insufficiency in 1. Four of 9 UED with biliary stenosis showed BO pattern on HBS and 6 of 9 UED with parenchymal dysfunction showed NBO pattern. UED due to EGD was spontaneously resolved and longterm outcome of the involved graft were not different from the contralateral normal graft. Most of unilateral graft parenchymal excretion delay within 1 mo after DLDLT showed NBO pattern on HBS and resulted from transient EGD without longterm prognostic value. UED after 1 mo resulted from variable etiology and needed further diagnostic work-up regardless of scintigraphic pattern.

  8. 肝胆外科术后腹腔感染的综合护理%Integrated nursing for abdominal infections after hepatobiliary surgery

    Institute of Scientific and Technical Information of China (English)

    程艳爽; 吕少诚; 徐明月; 高国强; 路辉; 张雯雯; 刘同友; 史宪杰

    2012-01-01

    OBJECTIVE To explore the integrated nursing of abdominal infection after hepatobiliary surgery. METHODS We retrospectively analyzed the clinical data of 51 patients with abdominal infections after hepatobiliary surgery between Jan 2009 and Dec 2011. All of the patients were treated by the method of the integrated nursing including unobstructed drainage, vacuum suction, and physiotherapy. RESULTS Of 51 patients with abdominal infections, were isolated, there were 35 case-times of single bacterial infectinos and 16 case-times of wixed infections and totally 61 strains of patnogens were isolated, among which the top three pathogens causing infections were 22 (32. 8%) strains of Enterococcus faecalis , 16 (23. 9%) strains of Escherichia coli, and 12 (17. 9%) strains of Enterococcus faecium ; After the integrated nursing for all the patients, forty-seven patients were cured with the effective rate of 92. 2 %, 4 cases were dead. CONCLUSION To adopt the integrated nursing for abdominal infections after hepatobiliary surgery can contribute to the control and treatment of the infections and decrease the mortality of the patients.%目的 探讨肝胆外科术后腹腔感染的综合护理方法.方法 回顾性分析2009年1月-2011年12月51例肝胆外科术后出现腹腔感染患者的临床资料,所有患者术后采用通畅引流、负压吸引、理疗等综合护理方法.结果 51例腹腔感染患者中送检标本培养阳性67例次,其中单一菌感染35例次,混合感染16例次;共检出病原菌67株,位居前3位的病原菌分别为粪肠球菌22株占32.8%、大肠埃希菌16株占23.9%、屎肠球菌12株占17.9%;所有患者经积极综合护理治疗后,47例治愈,治愈率为92.2%,4例死亡.结论 对肝胆外科术后腹腔感染的患者采用综合护理措施,有助于控制和治疗感染,降低患者的死亡率.

  9. Predictors of Toxicity Associated With Stereotactic Body Radiation Therapy to the Central Hepatobiliary Tract

    Energy Technology Data Exchange (ETDEWEB)

    Osmundson, Evan C.; Wu, Yufan; Luxton, Gary [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Bazan, Jose G. [Department of Radiation Oncology, The Ohio State University, Columbus, Ohio (United States); Koong, Albert C. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Chang, Daniel T., E-mail: dtchang@stanford.edu [Department of Radiation Oncology, Stanford University, Stanford, California (United States)

    2015-04-01

    Purpose: To identify dosimetric predictors of hepatobiliary (HB) toxicity associated with stereotactic body radiation therapy (SBRT) for liver tumors. Methods and Materials: We retrospectively reviewed 96 patients treated with SBRT for primary (53%) or metastatic (47%) liver tumors between March 2006 and November 2013. The central HB tract (cHBT) was defined by a 15-mm expansion of the portal vein from the splenic confluence to the first bifurcation of left and right portal veins. Patients were censored for toxicity upon local progression or additional liver-directed therapy. HB toxicities were graded according to Common Terminology Criteria for Adverse Events version 4.0. To compare different SBRT fractionations, doses were converted to biologically effective doses (BED) by using the standard linear quadratic model α/β = 10 (BED10). Results: Median follow-up was 12.7 months after SBRT. Median BED10 was 85.5 Gy (range: 37.5-151.2). The median number of fractions was 5 (range: 1-5), with 51 patients (53.1%) receiving 5 fractions and 29 patients (30.2%) receiving 3 fractions. In total, there were 23 (24.0%) grade 2+ and 18 (18.8%) grade 3+ HB toxicities. Nondosimetric factors predictive of grade 3+ HB toxicity included cholangiocarcinoma (CCA) histology (P<.0001), primary liver tumor (P=.0087), and biliary stent (P<.0001). Dosimetric parameters most predictive of grade 3+ HB toxicity were volume receiving above BED10 of 72 Gy (V{sub BED10}72) ≥ 21 cm{sup 3} (relative risk [RR]: 11.6, P<.0001), V{sub BED10}66 ≥ 24 cm{sup 3} (RR: 10.5, P<.0001), and mean BED10 (Dmean{sub BED10}) cHBT ≥14 Gy (RR: 9.2, P<.0001), with V{sub BED10}72 and V{sub BED10}66 corresponding to V40 and V37.7 for 5 fractions and V33.8 and V32.0 for 3 fractions, respectively. V{sub BED10}72 ≥ 21 cm{sup 3}, V{sub BED10}66 ≥ 24 cm{sup 3}, and Dmean{sub BED10} cHBT ≥14 Gy were consistently predictive of grade 3+ toxicity on multivariate analysis. Conclusions: V

  10. Utilização das hepatectomias centrais nas cirurgias hepatobiliares Use of central hepatectomies in the hepatobiliary surgeries

    Directory of Open Access Journals (Sweden)

    Fábio Luiz Waechter

    2000-12-01

    Full Text Available O tratamento das doenças hepatobiliares através de hepatectomias centrais tem sido um dos desafios técnicos mais importantes para a cirurgia neste final de século. Embora diversas técnicas tenham sido utilizadas nas últimas décadas, só recentemente estas têm sido executadas com segurança, diminuindo drasticamente as taxas de morbi-mortalidade, e com isso propiciando resultados favoráveis no tratamento das diferentes afecções hepáticas. Quer o figado apresente-se ou não com hepatopatia crônica, a integração de equipes multidisciplinares afeitas a este tipo de cirurgia e de patologia, permitiu que ressecções complexas fossem realizadas. Com o princípio de manter massa e função hepatocitária remanescente viáveis, o estudo morfológico e funcional do fígado no pré-operatório impõe que técnicas de transplante de segmentos hepáticos sejam freqüentemente utilizadas, seja na reconstrução vascular, seja na redução e conservação de massa hepática. Desta maneira, a ressecção de qualquer parte do fígado com o mínimo de utilização de derivados sangüíneos tem se mostrado factível através do conhecimento apurado da anatomia hepática e da utilização de ecografia transoperatória. Deste trabalho de revisão de diferentes técnicas de hepatectomias centrais são apresentadas, discutidas as indicações e detalhes cirúrgicos de cada uma delas.The treatment of hepatobiliary diseases by central hepatectomies has been one of the most important challenges in surgical technique at the end of this century. Although different techniques were used in the last decades, only recently they have been carried out safely, drastically reducing the morbidity and mortality rates, and thus providing favorable results in treating different hepatic diseases. Whether the liver does or not present chronic liver disease, the integration of related multiple-disciplinary teams in this type of surgery and disease has allowed complex

  11. Quantitative hepatobiliary scintigraphy and endoscopic sphincter of Oddi manometry in patients with suspected sphincter of Oddi dysfunction: assessment of flow-pressure relationship in the biliary tract

    DEFF Research Database (Denmark)

    Madácsy, L; Middelfart, H V; Matzen, Peter;

    2000-01-01

    OBJECTIVE: In the present study, the diagnostic efficacy of quantitative hepatobiliary scintigraphy (QHBS) was compared with that of endoscopic sphincter of Oddi (SO) manometry (ESOM) in patients with a suspected SO dysfunction (SOD) of biliary type II or III. METHODS: Twenty cholecystectomized...... patients with SOD biliary types II and III were investigated by QHBS and by ESOM. Twenty asymptomatic cholecystectomized patients served as controls for scintigraphy. ESOM was performed by applying the station pull-through method. Then SO basal pressure and phasic contraction characteristics were....... RESULTS: In patients with SOD and elevated SO basal pressure (> 40 mmHg), QHBS parameters, such as Tmax and T(1/2) calculated from regions of interest over the hepatic hilum and common bile duct, HDTT and DAT proved to be significantly increased compared to controls: 28.7 +/- 4.3 versus 21.1 +/- 4.6 min...

  12. An in vivo microdialysis measurement of harpagoside in rat blood and bile for predicting hepatobiliary excretion and its interaction with cyclosporin A and verapamil.

    Science.gov (United States)

    Wu, Qian; Wen, Xiao-Dong; Qi, Lian-Wen; Wang, Wei; Yi, Ling; Bi, Zhi-Ming; Li, Ping

    2009-03-15

    Harpagoside, a major bioactive iridoid glucoside in genus Scrophularia, has been widely used in clinical practice for the treatment of pain in the joints and lower back for its neuroprotective and anti-inflammation activities. To investigate the pharmacokinetics and hepatobiliary excretion, an in vivo microdialysis method coupled with high performance liquid chromatography was developed to monitor the concentration of harpagoside in blood and bile. The harpagoside bile-to-blood distribution ratio (AUC(bile)/AUC(blood)) up to 986.28+/-78.46 significantly decreased to 6.41+/-0.56 or 221.20+/-18.92 after co-administration of cyclosporin A or verapamil. The results indicated that harpagoside went through concentrative elimination from the bile which was probably regulated by P-glucoprotein, providing possible clinical trials of co-administration of transporter inhibitors to decrease drug efflux, thus to enhance the curative effects.

  13. A case report of localized hepatic sinusoidal dilatation: The diagnostic usefulness of the hepatobiliary phase of Gd-EOB-DTPA-enhanced magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kyung Min; Kim, Seong Hoon [Dept. of Radiology, Daegu Fatima Hospital, Daegu (Korea, Republic of)

    2015-09-15

    Hepatic sinusoidal dilatation (HSD) is a rare vascular disorder characterized by focal dilatation of the sinusoidal spaces in the liver. In most cases, it may be associated with venous outflow impairment. In addition, this histological change could occur in a number of systemic and hepatic conditions in the absence of hepatic venous obstruction. However, the pathogenesis has not yet been elucidated. To the best of our knowledge, imaging findings in a case of localized HSD without any additional medical disorder or oral contraceptive therapy have not been described previously in the literature written in English. Here, we describe imaging findings in a case of localized HSD mimicking a hepatic tumor, focusing on the useful findings on the gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced hepatobiliary phase MR image.

  14. Prognosis of small hepatocellular nodules detected only at the hepatobiliary phase of Gd-EOB-DTPA-enhanced MR imaging as hypointensity in cirrhosis or chronic hepatitis

    Energy Technology Data Exchange (ETDEWEB)

    Higaki, Atsushi; Ito, Katsuyoshi; Tamada, Tsutomu; Sone, Teruki; Kanki, Akihiko; Noda, Yasufumi; Yasokawa, Kazuya; Yamamoto, Akira [Kawasaki Medical School, Department of Radiology, Kurashiki City, Okayama (Japan)

    2014-10-15

    To evaluate the prognosis of ''strict'' high-risk nodules (small hepatocellular nodules detected only in the hepatobiliary phase of initial Gd-EOB-DTPA-enhanced MR examination) in patients with cirrhosis or chronic hepatitis. The study included thirty-three patients with 60 ''strict'' high-risk nodules showing hypointensity at the hepatobiliary phase that was undetectable at the vascular phase and other conventional sequences of initial Gd-EOB-DTPA-enhanced MR imaging. These nodules were observed on follow-up MR examinations until hypervascularity was detected. The potential predictive factors for hypervascular transformation were compared between two groups (group A showing hypervascular transformation, group B not showing hypervascularization). Ten (16.7 %) of 60 ''strict'' high-risk nodules showed hypervascular transformation during follow-up periods (group A). The growth rates of the nodules in group A (6.3 ± 4.5 mm/year) were significantly higher than those in group B (3.4 ± 7.2 mm/year) (p = 0.003). Additionally, the median observation period in group A (177.5 ± 189.5 day) was significantly shorter than in group B (419 ± 372.2 day) (p = 0.045). The other predictive factors were not significantly correlated with hypervascularization. Subsets of ''strict'' high-risk nodules showed hypervascular transformation during follow-up periods in association with increased growth rates, indicating that nodule growth rate is an important predictive factor for hypervascularization. (orig.)

  15. Correcting for respiratory motion in liver PET/MRI: preliminary evaluation of the utility of bellows and navigated hepatobiliary phase imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hope, Thomas A. [Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA (United States); Department of Radiology, San Francisco VA Medical Center, San Francisco, CA (United States); Verdin, Emily F. [Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA (United States); Bergsland, Emily K. [Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA (United States); Ohliger, Michael A. [Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA (United States); Department of Radiology, San Francisco General Hospital, San Francisco, CA (United States); Corvera, Carlos University; Nakakura, Eric K. [Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco, CA (United States)

    2015-09-18

    The purpose of this study was to evaluate the utility of bellows-based respiratory compensation and navigated hepatobiliary phase imaging to correct for respiratory motion in the setting of dedicated liver PET/MRI. Institutional review board approval and informed consent were obtained. Six patients with metastatic neuroendocrine tumor were imaged using Ga-68 DOTA-TOC PET/MRI. Whole body imaging and a dedicated 15-min liver PET acquisition was performed, in addition to navigated and breath-held hepatobiliary phase (HBP) MRI. Liver PET data was reconstructed three ways: the entire data set (liver PET), gated using respiratory bellows (RC-liver PET), and a non-gated data set reconstructed using the same amount of data used in the RC-liver PET (shortened liver PET). Liver lesions were evaluated using SUV{sub max}, SUV{sub peak}, SUV{sub mean}, and Vol{sub isocontour}. Additionally, the displacement of each lesion between the RC-liver PET images and the navigated and breath-held HBP images was calculated. Respiratory compensation resulted in a 43 % increase in SUVs compared to ungated data (liver vs RC-liver PET SUV{sub max} 26.0 vs 37.3, p < 0.001) and a 25 % increase compared to a non-gated reconstruction using the same amount of data (RC-liver vs shortened liver PET SUV{sub max} 26.0 vs 32.6, p < 0.001). Lesion displacement was minimized using navigated HBP MRI (1.3 ± 1.0 mm) compared to breath-held HBP MRI (23.3 ± 1.0 mm). Respiratory bellows can provide accurate respiratory compensation when imaging liver lesions using PET/MRI, and results in increased SUVs due to a combination of increased image noise and reduced respiratory blurring. Additionally, navigated HBP MRI accurately aligns with respiratory compensated PET data.

  16. The role of surgical clips in the evaluation of interfractional uncertainty for treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jin Suk; Kim, Dong Hyun; Kim, Won Taek; Kim, Yong Ho; Park, Dahl; Ki, Yong Kan [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of)

    2017-03-15

    To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip{sub p}, ≤2 cm) and 3 distal clips (clip{sub d}, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy.

  17. Progress in diagnosis and treatment of IgG4-related hepatobiliary diseases%lgC4相关肝胆疾病诊疗进展

    Institute of Scientific and Technical Information of China (English)

    李萍; 李永哲

    2014-01-01

    IgG4相关性疾病是一类以淋巴浆细胞性炎症为主,伴血清和组织中IgG4增多并累及多器官或组织的慢性进行性全身性炎性疾病,累及肝胆胰腺系统时称之为IgG4相关肝胆疾病。简述了IgG4相关自身免疫性胰腺炎、IgG4相关硬化性胆管炎、IgG4相关自身免疫性肝炎的临床表现和实验室检查等方面。准确识别IgG4相关肝胆疾病的各个实验室结果,并正确诊断此类疾病,有助于避免不必要的手术和错误的治疗。%IgG4-related diseases are a class of chronic,progressive,systemic inflammatory disorders that are characterized by lymphoplas-macytic inflammation,as well as elevated IgG4 levels in serum and tissue,and may involve multiple organs or tissues.When involving the pancreas,liver,and biliary tracts,they are called IgG4-related hepatobiliary diseases.IgG4-related autoimmune pancreatitis,IgG4-re-lated sclerosing cholangitis,and IgG4-associated autoimmune hepatitis are reviewed in terms of their clinical manifestations and laboratory findings.Accurate identification of the laboratory results for IgG4-related hepatobiliary diseases and correct diagnosis of these diseases help to avoid unnecessary surgery and wrong treatment.

  18. Magnetic resonance imaging of liver metastases: experimental comparison of anionic and conventional superparamagnetic iron oxide particles with a hepatobiliary contrast medium during dynamic and uptake phases.

    Science.gov (United States)

    Kaufels, Nicola; Korn, Ronny; Wagner, Susanne; Schink, Tania; Hamm, Bernd; Taupitz, Matthias; Schnorr, Jörg

    2008-07-01

    To assess the contrast-enhancing effects of citrate-coated superparamagnetic iron oxide particles (VSOP-C184) in a rat liver tumor model using dynamic and delayed magnetic resonance imaging in comparison to carboxydextran-coated particles (ferucarbotran) and a hepatobiliary contrast medium (gadobenate dimeglumine). A total of 32 male rats with liver tumors (CC-531 colorectal carcinoma) were examined at 1.5 T with a T1-weighted dynamic series (3D gradient echo sequence) and T1-weighted and T2*-weighted images (2D gradient echo sequences) before and 15 and 90 minutes after injection. VSOP-C184 was investigated at doses of 0.015, 0.045, and 0.06 mmol Fe/kg, ferucarbotran at 0.015 mmol Fe/kg, and gadobenate dimeglumine at 0.025, 0.05, and 0.1 mmol Gd/kg. Liver-tumor contrast-to-noise ratio (CNR) was calculated and statistically compared. T1-weighted dynamic images: VSOP-C184 has significantly higher CNR values at a dose of 0,015 mmol Fe/kg than ferucarbotran at the same dose (P = 0.001). VSOP-C184 produces a significantly higher CNR at a dose of 0.045 mmol Fe/kg than gadobenate dimeglumine at a dose of 0.05 mmol Gd/kg (P = 0.019). At a dose of 0.06 mmol Fe/kg, the CNR for VSOP-C184 is significantly lower than that of gadobenate dimeglumine (0.1 mmol Gd/kg) (P = 0.005).T2-weighted delayed images: CNR values of VSOP-C184 are similar to those of ferucarbotran and are significantly higher than those of gadobenate dimeglumine (P VSOP-C184 produces a high contrast comparable to that of a hepatobiliary contrast medium in addition to its contrast-enhancing effect in T2-weighted imaging.

  19. Hepatobiliary complications of inflammatory bowel disease%炎症性肠病肝胆并发症的研究进展

    Institute of Scientific and Technical Information of China (English)

    牛国超; 刘蕾; 张晓岚

    2012-01-01

    Inflammatory bowel disease (IBD) is a chronic idiopathic immune-mediated inflammatory disease of the gastrointestinal tract, including ulcerative colitis (UC) and Crohn's disease (CD). Extraintestinal manifestations (EIMs) are frequently encountered in IBD patients. Hepatobili-ary manifestations are common extraintestinal manifestations of IBD, including primary scle-rosing cholangitis (PSC), nonalcoholic fatty liver, cholelithiasis, primary biliary cirrhosis (PBC), small-duct PSC, IgG4-associated cholangitis (IAC), granulomatous hepatitis, amyloidosis, autoimmune hepatitis (AIH), PSC/AIH overlap syndrome, and portal vein thrombosis. In this paper, we describe the progress in understanding the hepatobiliary complications associated with IBD.%炎症性肠病(inflammatory bowel disease,IBD)包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn's disease,CD),是一种免疫介导的慢性特发性胃肠道炎症性疾病,常伴随有肠外表现(extraintestinal manifestations,EIMs),且涉及多个器官.肝胆系统病变是IBD常见的肠外表现,包括原发性硬化性胆管炎(primary sclerosing cholangitis,PSC)、非酒精性脂肪肝、胆石症、原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)、小胆管性PSC、IgG4相关性胆管炎(IgG4-associated cholangitis,IAC)、肉芽肿性肝炎、淀粉样变性、自身免疫性肝炎(autoimmune hepatitis,AIH)、PSC/AIH重叠综合征和门静脉血栓形成等.本综述从IBD相关的肝胆并发症方面简述了该领域的研究进展,以期能为认识IBD相关肝病的发病机制和临床治疗提供新的启示.

  20. Hepatobiliary function assessed by {sup 99m}Tc-mebrofenin cholescintigraphy in the evaluation of severity of steatosis in a rat model

    Energy Technology Data Exchange (ETDEWEB)

    Vetelaeinen, Reeta L.; Vliet, Arlene van; Gulik, Thomas M. van [Academic Medical Center, Department of Surgery, Amsterdam (Netherlands); Bennink, Roelof J.; Bruin, Kora de [Academic Medical Center, Department of Nuclear Medicine, Amsterdam (Netherlands)

    2006-10-15

    This study evaluated the utility of non-invasive assessment of hepatobiliary function by {sup 99m}Tc-mebrofenin cholescintigraphy in a rat model of diet-induced steatosis. Male Wistar rats (250-300 g) were fed a standard methionine- and choline-deficient (MCD) diet for up to 5 weeks, thereby inducing hepatic fat accumulation, progressive inflammation and fibrogenesis corresponding with clinical steatosis. {sup 99m}Tc-mebrofenin pinhole scintigraphy was used to evaluate the hepatocyte mebrofenin uptake rate, the time of maximum hepatic uptake (T{sub peak}) and the time required for peak activity to decrease by 50% (T{sub 1/2peak}). Scintigraphic parameters were correlated with biochemical and serological parameters and with liver histopathology. MCD diet induced mild steatosis after 1 week and severe steatosis with prominent inflammation after 5 weeks. T{sub peak}, T{sub 1/2peak} prolonged and the uptake rate decreased significantly, while the severity of steatosis increased (p<0.05). There was a strong, significant correlation between the severity of steatosis (histopathology, hepatic triglyceride content) and the {sup 99m}Tc-mebrofenin uptake rate (r {sup 2}=0.83, p<0.0001 and r {sup 2}=0.82, p<0.0001, respectively). In addition, the uptake rate correlated significantly with the increased inflammation (plasma and hepatic TNF-{alpha}, r {sup 2}=0.72, p<0.0001 and r {sup 2}=0.52, p=0.001, respectively). The correlation of the uptake rate with hepatocellular damage was weak (AST and ALT, r {sup 2}=0.29 and 0.32, respectively), but correlation with synthetic function was strong (prothrombin time, r {sup 2}=0.70, p<0.001). Hepatobiliary function assessed by {sup 99m}Tc-mebrofenin scintigraphy correlates with the extent and progression of steatosis. These results suggest a potential role for mebrofenin scintigraphy as a non-invasive functional follow-up method for disease progression in steatotic patients. (orig.)

  1. Independent and joint effect of type 2 diabetes and gastric and hepatobiliary diseases on risk of pancreatic cancer risk: 10-year follow-up of population-based cohort.

    Science.gov (United States)

    Lin, C-C; Chiang, J-H; Li, C-I; Hsieh, T-F; Liu, C-S; Lin, W-Y; Lee, Y-D; Li, T-C

    2014-11-25

    Type 2 diabetes mellitus, gastric and hepatobiliary comorbidities, and cancer share common risk factors: for example, tobacco, obesity, physical inactivity, high calorie intake, and metabolic disorders. Prior studies find type 2 diabetes and gastric and hepatobiliary comorbidities heightening risk of pancreatic cancer. Yet joint association of type 2 diabetes mellitus and gastric and hepatobiliary comorbidities on pancreatic cancer risk has not been assessed. This study rates independent/joint effects of type 2 diabetes as well as gastric and hepatobiliary comorbidity on pancreatic cancer risk for a retrospective population-based cohort of 166,850 type 2 diabetics identified in 1997-1998 and followed for 10-11 years, comparing their cancer incidence with that of 166,850 non-diabetics matched for age, gender, and locale. Time-dependent Cox's proportional hazards model evaluted joint association of type 2 diabetes and chronic conditions on pancreatic cancer risk. A total of 1178 subjects were newly diagnosed with pancreatic cancer during follow-up, with incidence rates of 0.49 per 1000 person-years in type 2 diabetes and 0.26 per 1000 person-years in the non-diabetics. We observed greater magnitude of hazard ratios (HRs) of pancreatic cancer for patients with type 2 diabetes along with acute alcoholic hepatitis, acute pancreatitis, cholecystitis, and gastric ulcer compared with patients without type 2 diabetes or counterpart comorbidity (HR: 1.36, 95% confidence interval (CI): 1.19-1.56; 1.74, 1.23-2.45; 9.18, 7.44-11.33; and 2.31, 1.98-2.70, respectively). Main effects of type 2 diabetes were all statistically with narrow 95% CI and remained similar across risk stratification with various comorbidities: range 1.59-1.80. Our study demonstrates that pre-existing type 2 diabetes, acute alcoholic hepatitis, acute pancreatitis, cholecystitis, and gastric ulcer independently or jointly predict subsequent pancreatic cancer risk. Clinicians must recognise burden of these

  2. Rare Type of Course and Distribution of an Additional Right Hepatic Artery: A Possible Source of Iatrogenic Injury During Hepato-biliary and Pancreatic Surgeries

    Directory of Open Access Journals (Sweden)

    Prakashchandra Shetty

    2017-07-01

    Full Text Available Celiac artery shows frequent variations in its branching pattern. Knowledge of its possible variations is useful in gastric, pancreatic and hepato-biliary surgeries. During our dissection classes, we observed a rare variation of the branching pattern of celiac trunk. It divided normally into its three branches; left gastric, splenic and common hepatic arteries. Left gastric and splenic arteries were normal in their course and distribution. The common hepatic artery trifurcated to give hepatic artery proper, gastroduodenal artery and an additional right hepatic artery. The branching pattern of hepatic artery proper and gastroduodenal arteries was normal. The additional right hepatic artery gave origin to a right gastric artery and a large pancreatic branch to the head of the pancreas. It coursed parallel to the bile duct, being on its right side, passed through the Calot’s triangle and entered the right lobe of liver through the fossa for gall bladder. In the Calot’s triangle, it gave a cystic branch to the gall bladder. We discuss the clinical importance of this rare variation in this paper.

  3. Bibliometric analysis of the Chinese Journal of Hepatobiliary Surgery%《中华肝胆外科杂志》文献计量分析

    Institute of Scientific and Technical Information of China (English)

    杨华

    2013-01-01

    Objective To identify the researchers' productivity,the citation states and the grant patterns of the Chinese Journal of Hepatobiliary Surgery through citation analysis.Methods Articles published in the Chinese Journal of Hepatobiliary Surgery between 2009 to 2012 were collected from the Chinese Science Citation Database.These articles were analyzed with statistics and bibliometrics.The indicators included cooperation degree,core authors,distribution of grant,authors' origin and citation states.Results Of the 1321 papers which were published by the journal during the study period,505 papers were cited 923 times.Of the 1111 first authors,957 (86.14%) published one paper only.There were 154 core authors (13.86% of first authors),and they published 364 papers (27.55%).There were 14 high-productivity institutes,which published 299 papers (22.63%).According to the geographical distribution,Beijing ranked first with 190 (14.38%) papers.The second was Shanghai with 156 (11.81%),the third was Jiangshu province with 134 (10.14%),the fourth was Zhejiang province with 132 (9.99%),and the fifth was Guangdong province with 101 (7.65 %) papers.1262 papers were completed by collaborate teams of more than one author.The cooperative rate was 95.53% and the cooperative degree was 4.67.361 papers were funded by 553 supporting foundations.Conclusions The authors of the Chinese Journal of Hepatobiliary Surgery were geographically widely distributed.Some were core authors with high-productivity.They were highly cited and with good cooperation degree.Beijing,Shanghai,Jiangshu,Zhejiang and Guangdong provinces play important roles in research on hepatobiliary surgery.%目的 从文献引证的角度透视《中华肝胆外科杂志》的作者发文和被引情况及基金论文情况.方法 利用统计学和文献计量学方法,统计分析《中国科学引文数据库》2009-2012年《中华肝胆外科杂志》论文,指标有论文合作度、核心作者、基

  4. Role of diffusion-weighted imaging, apparent diffusion coefficient and correlation with hepatobiliary phase findings in the differentiation of hepatocellular carcinoma from dysplastic nodules in cirrhotic liver.

    Science.gov (United States)

    Inchingolo, Riccardo; De Gaetano, Anna Maria; Curione, Davide; Ciresa, Marzia; Miele, Luca; Pompili, Maurizio; Vecchio, Fabio Maria; Giuliante, Felice; Bonomo, Lorenzo

    2015-04-01

    To investigate the utility of diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and the correlation with hepatobiliary phase (delayed phase imaging, DPI) findings in the differentiation of cirrhotic hepatocellular nodules. Forty-three patients with 53 pathology-proven nodules (29 hepatocellular carcinomas (HCCs), 13 high-grade (HGDNs) and 11 low-grade dysplastic nodules (LGDNs); mean size 2.17 cm, range 1-4 cm), who underwent liver MRI with DWI and DPI sequences, were retrospectively reviewed. Lesions were classified as hypointense, isointense, or hyperintense relative to the adjacent liver parenchyma. ADC of each nodule, of the surrounding parenchyma, and lesion-to-liver ratio were calculated. Hyperintensity versus iso/hypointensity on DWI, hypointensity versus iso/hyperintensity on DPI, and the mean lesion-to-liver ratio showed a statistically significant difference both between HCCs versus DNs and between "HCCs + HGDNs" versus LGDNs (p Correlation of DWI with DPI improves differential diagnosis of cirrhotic nodules. • Characterization of atypically enhancing lesions becomes more confident.

  5. Contribution of the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI to Dynamic MRI in the detection of hypovascular small ({<=}2 cm) HCC in cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Golfieri, Rita; Renzulli, Matteo; Lucidi, Vincenzo; Corcioni, Beniamino [University of Bologna, Radiology Unit, Department of Digestive Diseases and Internal Medicine, Sant' Orsola-Malpighi Hospital, Bologna (Italy); Trevisani, Franco [University of Bologna, Unit of Semeiotica, Department of Digestive Diseases and Internal Medicine, Sant' Orsola-Malpighi Hospital, Bologna (Italy); Bolondi, Luigi [University of Bologna, Unit of Internal Medicine, Department of Digestive Diseases and Internal Medicine, Sant' Orsola-Malpighi Hospital, Bologna (Italy)

    2011-06-15

    To prospectively assess the additional value of the hepatobiliary (HB) phase of Gd-EOB-DTPA-MRI in identifying and characterising small ({<=}2 cm) hepatocellular carcinomas (HCCs) undetermined in dynamic phases alone because of their atypical features, according to the AASLD criteria. 127 cirrhotic patients were evaluated with Gd-EOB-DTPA-MRI in two sets: unenhanced and dynamic phases; unenhanced, dynamic and HB phases. Sixty-two out of 215 nodules (29%) were atypical in 42 patients (33%). 62 atypical nodules were reported at histology: high-grade dysplastic nodules (HGDN)/early HCC (n = 20), low-grade DN (LGDN) (n = 21), regenerative nodules (n = 17) and nodular regenerative hyperplasia (n = 4). The sensitivity, specificity, accuracy, positive and negative predictive value (PPV, NPV) were increased by the addition of the HB phase: 88.4-99.4%, 88-95%, 88-98.5%, 97-99%, and 65-97.5%, respectively. Twenty atypical nodules were malignant (32%), 19 of which were characterised only during the HB phase. The HB phase is 11% more sensitive in the classification of HGDN/early HCC than dynamic MRI, with an added value of 32.5% in the NPV. The high incidence (33%) of atypical nodules and their frequent malignancy (32%) suggest the widespread employment of Gd-EOB-DTPA-MRI in the follow-up of small nodules ({<=}2 cm) in cirrhosis. (orig.)

  6. Imaging-based evaluation of liver function: comparison of {sup 99m}Tc-mebrofenin hepatobiliary scintigraphy and Gd-EOB-DTPA-enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Geisel, Dominik; Gebauer, Bernhard [Charite Campus Virchow-Klinikum, Department of Diagnostic and Interventional Radiology, Berlin (Germany); Luedemann, Lutz [Essen University Hospital, Department of Medical Physics, Essen (Germany); Froeling, Vera; Denecke, Timm [Charite Campus Virchow-Klinikum, Department of Diagnostic and Interventional Radiology, Berlin (Germany); Charite Campus Virchow-Klinikum, Department of Nuclear Medicine, Berlin (Germany); Malinowski, Maciej; Stockmann, Martin; Baron, Annekathrin; Seehofer, Daniel [Charite Campus Virchow-Klinikum, Department of General, Visceral and Thoracic Surgery, Berlin (Germany); Prasad, Vikas [Charite Campus Virchow-Klinikum, Department of Nuclear Medicine, Berlin (Germany)

    2015-05-01

    To compare Gd-EOB-enhanced MRI and {sup 99m}Tc-mebrofenin hepatobiliary scintigraphy (HBS) as imaging-based liver function tests for separate evaluation of right (RLL) and left liver lobe (LLL) function. Fourteen patients underwent Gd-EOB-enhanced MRI and {sup 99m}Tc-mebrofenin HBS after portal vein embolization within 24 h. Relative enhancement (RE) and hepatic uptake index (HUI) were determined from MRI; and T{sub max}, T{sub 1/2} and mebrofenin uptake were determined from HBS, all values separately for RLL and LLL. Mebrofenin uptake correlated significantly with HUI and RE for both liver lobes. There was strong correlation of mebrofenin uptake with HUI for RLL (r{sup 2} = 0.802, p = 0.001) and RE for LLL (r{sup 2} = 0.704, p = 0.005) and moderate correlation with HUI for LLL (r{sup 2} = 0.560, p = 0.037) and RE for RLL (r{sup 2} = 0.620, p = 0.018). Correlating the percentage share of RLL function derived from MRI (with HUI) with the percentage of RLL function derived from mebrofenin uptake revealed a strong correlation (r{sup 2} = 0.775, p = 0.002). Both RE and HUI correlate with mebrofenin uptake in HBS. The results suggest that Gd-EOB-enhanced MRI and {sup 99m}Tc-mebrofenin HBS may equally be used to separately determine right and left liver lobe function. (orig.)

  7. Tc-99m-BrIDA hepatobiliary (HIDA) scan has a low sensitivity for detecting biliary complications after orthotopic liver transplantation in patients with hyperbilirubinemia.

    Science.gov (United States)

    Hopkins, L Olivia; Feyssa, Eyob; Parsikia, Afshin; Khanmoradi, Kamran; Zaki, Radi; Campos, Stalin; Araya, Victor; Tran, Huyen; Ortiz, Jorge

    2011-12-01

    Tc-99m-BrIDA hepatobiliary scans are noninvasive tests for detecting biliary leaks and obstructions. However, there is low sensitivity and specificity in patients with hyperbilirubinemia. Biliary complications (BC) are the Achilles heel of orthotopic liver transplantation (OLT). We questioned whether hyperbilirubinemia in liver transplant recipients rendered HIDA scanning less dependable. HIDA findings were compared to endoscopic retrograde cholangiopancreatography, laparotomy, and clinical course. Results were categorized as follows: true positive (TP), true negative (TN), false positive (FP), false negative (FN), or nondiagnostic/inconclusive. We searched for variables associated with erroneous or nondiagnostic tests which we defined as all examinations determined to be FP, FN and/or nondiagnostic/inconclusive. Thirty-four patients underwent a HIDA scan. The sensitivity and specificity were 70 and 100%. The sensitivity of HIDA improved to 100% in patients with a total bilirubin (TB) 5 mg/dl. One FN had a TB <5 mg/dl, but was determined inconclusive due to the roux-en-Y. HIDA scans performed when the total bilirubin was <5 mg/dl had a high sensitivity and specificity for detecting biliary complications after OLT. However, when the total bilirubin exceeded 5 mg/dl, the specificity was still 100% but the numbers of nondiagnostic/inconclusive and FN exams were increased.

  8. LIVER ULTRASONOGRAPHY IN DOLPHINS: USE OF ULTRASONOGRAPHY TO ESTABLISH A TECHNIQUE FOR HEPATOBILIARY IMAGING AND TO EVALUATE METABOLIC DISEASE-ASSOCIATED LIVER CHANGES IN BOTTLENOSE DOLPHINS (TURSIOPS TRUNCATUS).

    Science.gov (United States)

    Seitz, Kelsey E; Smith, Cynthia R; Marks, Stanley L; Venn-Watson, Stephanie K; Ivančić, Marina

    2016-12-01

    The objective of this study was to establish a comprehensive technique for ultrasound examination of the dolphin hepatobiliary system and apply this technique to 30 dolphins to determine what, if any, sonographic changes are associated with blood-based indicators of metabolic syndrome (insulin greater than 14 μIU/ml or glucose greater than 112 mg/dl) and iron overload (transferrin saturation greater than 65%). A prospective study of individuals in a cross-sectional population with and without elevated postprandial insulin levels was performed. Twenty-nine bottlenose dolphins ( Tursiops truncatus ) in a managed collection were included in the final data analysis. An in-water ultrasound technique was developed that included detailed analysis of the liver and pancreas. Dolphins with hyperinsulinemia concentrations had larger livers compared with dolphins with nonelevated concentrations. Using stepwise, multivariate regression including blood-based indicators of metabolic syndrome in dolphins, glucose was the best predictor of and had a positive linear association with liver size (P = 0.007, R(2) = 0.24). Bottlenose dolphins are susceptible to metabolic syndrome and associated complications that affect the liver, including fatty liver disease and iron overload. This study facilitated the establishment of a technique for a rapid, diagnostic, and noninvasive ultrasonographic evaluation of the dolphin liver. In addition, the study identified ultrasound-detectable hepatic changes associated primarily with elevated glucose concentration in dolphins. Future investigations will strive to detail the pathophysiological mechanisms for these changes.

  9. 浅谈肝胆外科专业进修医师带教%Experience of Teaching Advanced-study Doctors in the Department of Hepatobiliary Surgery

    Institute of Scientific and Technical Information of China (English)

    杨美华; 岳海燕; 张宝华

    2012-01-01

    To discuss the clinical teaching experience for advanced - study doctors in department of Hepatobiliary surgery as the following ; to make understand of students fully; to strengthen pre - job training; to strengthen basic skill training; to carry out problem based learning and evidence - based medicine practice, to train good medical ethics and improve doctor - patient communication ability, to strengthen the assessment and management strictly.%探讨肝胆外科专科医院进修生的临床带教经验.结合长期的进修生培养工作,就教学医院进修生培养总结归纳以下经验:充分了解进修生的特点;加强岗前培训;加强三基培养;开展问题式教学,进行循证医学实践;培养良好的医德医风,提高医患沟通能力;加强考核,严格管理.

  10. Role of diffusion-weighted imaging, apparent diffusion coefficient and correlation with hepatobiliary phase findings in the differentiation of hepatocellular carcinoma from dysplastic nodules in cirrhotic liver

    Energy Technology Data Exchange (ETDEWEB)

    Inchingolo, Riccardo; De Gaetano, Anna Maria; Curione, Davide; Ciresa, Marzia; Bonomo, Lorenzo [Catholic University of the Sacred Heart, Department of Bioimaging and Radiological Sciences, Institute of Radiology, ' ' Agostino Gemelli' ' Hospital, Rome (Italy); Miele, Luca; Pompili, Maurizio [Catholic University of the Sacred Heart, Department of Internal Medicine, ' ' Agostino Gemelli' ' Hospital, Rome (Italy); Vecchio, Fabio Maria [Catholic University of the Sacred Heart, Department of Anatomo-Pathology, ' ' Agostino Gemelli' ' Hospital, Rome (Italy); Giuliante, Felice [Catholic University of the Sacred Heart, Department of Surgery, ' ' Agostino Gemelli' ' Hospital, Rome (Italy)

    2015-04-01

    To investigate the utility of diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and the correlation with hepatobiliary phase (delayed phase imaging, DPI) findings in the differentiation of cirrhotic hepatocellular nodules. Forty-three patients with 53 pathology-proven nodules (29 hepatocellular carcinomas (HCCs), 13 high-grade (HGDNs) and 11 low-grade dysplastic nodules (LGDNs); mean size 2.17 cm, range 1-4 cm), who underwent liver MRI with DWI and DPI sequences, were retrospectively reviewed. Lesions were classified as hypointense, isointense, or hyperintense relative to the adjacent liver parenchyma. ADC of each nodule, of the surrounding parenchyma, and lesion-to-liver ratio were calculated. Hyperintensity versus iso/hypointensity on DWI, hypointensity versus iso/hyperintensity on DPI, and the mean lesion-to-liver ratio showed a statistically significant difference both between HCCs versus DNs and between ''HCCs + HGDNs'' versus LGDNs (p < 0.05); sensitivity, specificity, and accuracy for the diagnosis of ''HCCs + HGDNs'' were 96.8 %, 100 %, 97.4 % respectively when combining hyperintensity on DWI and hypointensity on DPI, and 90.9 %, 81.0 %, 83.6 % respectively when lesion-to-liver ratio was <0.95. Hyperintensity on DWI, especially in association with hypointensity on DPI, and low lesion-to-liver ratios should raise the suspicion of HCC, or at least of HGDN, thus helping the characterization of atypically enhancing lesions. (orig.)

  11. Periportal lymphatic system on post-hepatobiliary phase Gd-EOB-DTPA-enhanced MR imaging in normal subjects and patients with chronic hepatitis C.

    Science.gov (United States)

    Yamada, Yasunari; Matsumoto, Shunro; Mori, Hiromu; Takaji, Ryo; Kiyonaga, Maki; Hijiya, Naoki; Tanoue, Rika; Tomonari, Kenichiro; Tanoue, Shuichi; Hongo, Norio; Ohta, Masayuki; Seike, Masataka; Inomata, Masafumi; Murakami, Kazunari; Moriyama, Masatsugu

    2017-04-25

    We sought to evaluate visualization of periportal lymphatics and lymph nodes (lymphatic system) on Gd-EOB-DTPA-enhanced magnetic resonance (MR) images using a fat-suppressed T2-weighted sequence with 3-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) at 3.0 T in normal subjects and patients with chronic hepatitis C. MR imaging was performed in 254 subjects between June 2013 and May 2016. After applying inclusion and exclusion criteria, the final population was 31 normal subjects and 34 patients with chronic hepatitis C. Images were acquired after the hepatobiliary phase following intravenous administration of Gd-EOB-DTPA, which causes signal loss in the bile ducts, to facilitate the visualization of the periportal lymphatic system. Two radiologists assessed the visualization of the periportal lymphatic system in 31 normal subjects. The axial dimensions of the main periportal lymphatic system in normal subjects were measured and compared with those of 34 patients with chronic hepatitis C using the Mann-Whitney U-test, and their correlation with a hepatic fibrosis marker, the Fibrosis-4 (FIB-4), was assessed using Spearman's rank correlation test. The periportal lymphatic system was detected as high signal intensity areas surrounding the portal vein up to the third branches by each reader in all normal subjects. The axial dimensions of the main periportal lymphatic system in patients with chronic hepatitis C were significantly larger than those in normal subjects (p system and the degree of hepatic fibrosis.

  12. Added value of smooth hypointense rim in the hepatobiliary phase of gadoxetic acid-enhanced MRI in identifying tumour capsule and diagnosing hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    An, Chansik; Han, Kyunghwa; Choi, Jin-Young; Park, Mi-Suk; Kim, Myeong-Jin [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Seoul (Korea, Republic of); Rhee, Hyungjin [Yonsei University College of Medicine, Department of Pathology, Brain Korea 21 PLUS Project for Medical Science, Integrated Genomic Research Center for Metabolic Regulation, Seoul (Korea, Republic of); Park, Young-Nyun [Yonsei University College of Medicine, Department of Pathology, Brain Korea 21 PLUS Project for Medical Science, Integrated Genomic Research Center for Metabolic Regulation, Seoul (Korea, Republic of); Yonsei University College of Medicine, Severance Biomedical Science Institute, Seoul (Korea, Republic of); Park, Sumi [National Health Insurance Service Ilsan Hospital, Department of Radiology, Goyang (Korea, Republic of)

    2017-06-15

    To examine the added value of considering smooth hypointense rim in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI as capsule appearance for diagnosing tumour capsules and hepatocellular carcinoma (HCC). A total of 377 hepatic lesions (330 HCCs, 35 non-HCC malignancies and 12 benign) were included from 345 patients who underwent resection after MRI between January 2008 and December 2011. Two radiologists assessed the presence or absence of conventional capsule appearance and smooth hypointense rim in the HBP, and categorized each hepatic lesion according to the Liver Imaging Reporting and Data System. Difference in diagnostic performance was evaluated using the generalized estimating equation method. For identifying capsule, the sensitivity and accuracy of HBP hypointense rim were significantly higher than those of conventional capsule appearance (81.5 % vs. 57.8 % and 76.1 % vs. 59.4 %, respectively; P < 0.001). For diagnosing HCC, the sensitivity and accuracy of LR-5 or LR-5 V were significantly higher when the HBP hypointense rim was also considered capsule appearance (83 % vs. 72.7 % and 84.1 % vs. 75.1 %, respectively; P < 0.001), with the same specificity (91.5 %). Regarding smooth hypointense rim in the HBP as capsule appearance could improve the detection of tumour capsule and the diagnosis of HCC. (orig.)

  13. 肝胆外科住院患者抗菌药物应用分析%Use of antibiotics among hospitalized patients of hepatobiliary surgery department

    Institute of Scientific and Technical Information of China (English)

    张洪卫; 李晓娜; 张天伟

    2015-01-01

    OBJECTIVE To investigate the rationality of use of antibiotics among the hospitalized patients of hepato‐biliary surgery department so as to provide guidance for the reasonable clinical use of antibiotics .METHODS The clinical data of 260 patients who were hospitalized the hepatobiliary surgery department from Jan 2010 to Oct 2013 were retrospectively analyzed ,and the rationality of use of antibiotics was observed .RESULTS Of the 260 pa‐tients ,242 cases used antibiotics ,with the utilization rate of antibiotics of 93 .08% .Among the 242 patients who used antibiotics ,about 8 categories ,22 types of antibiotics ,were involved ;the cephalosporins ,penicillins ,quino‐lones ,and imidazole nitrates were the most frequently used antibiotics ;the combination use of antibiotics was widespread ,there were 78 (32 .23% ) patients receiving two‐drug therapy ,67 (27 .69% ) patients receiving three‐drug therapy ,and 53 (21 .90% ) patients receiving more than three‐drug therapy ;the metronidazole plus cephalo‐sporins plus quinolones or aminoglycosides was the most frequently used three‐drug therapy .Only 43 of 260 pa‐tients underwent the detection of pathogens ,with the submission rate of 16 .54% .CONCLUSION The use of anti‐biotics among the hospitalized patients of hepatobiliary surgery department basically conforms to the principle of effectiveness and safety ,however ,unreasonable use of antibiotics remains among the minority of the patients , which should be paid high attention to .%目的:了解肝胆外科住院患者的抗菌药物应用及其合理性,为临床合理使用抗菌药物提供参考依据。方法回顾性分析医院2010年1月-2013年10月收治的260例肝胆外科住院患者临床资料,调查其抗菌药物的应用并分析其用药合理性。结果260例患者中有242例使用了抗菌药物,抗菌药物的使用率达93.08%;242例用药患者中所涉及的抗菌药物约8大类、22个品种;使用最多

  14. Clinical value of ultrasonography in hepatobiliary disease census in%超声在肝胆疾病普查中的临床价值

    Institute of Scientific and Technical Information of China (English)

    彭毅

    2014-01-01

    Objective to explore the clinical value of abdominal ultrasonography in hepatobiliary disease census in. Methods retrospective analysis of the clinical data of 1688 person times in 2013 June to 2013 december in our hospital medical center for health examination by abdominal ultrasonography in hepatobiliary organs. Results of 1688 lines of liver and gallbladder ultrasound census, 438 patients with positive, accounting for 25.95%. the pathology, spiral ct diagnosed 402 cases, diagnostic accuracy was 91.78%. Positive diagnosis in patients with primary liver cancer in 16 cases, 24 cases of liver hemangioma, 32 cases of liver cyst, fatty liver, 110 cases, 23 cases of cirrhosis of the liver, gallbladder in 5 cases, 10 cases of gallbladder polyp and gallbladder stones in 82 cases, 100 cases of cholecystitis. Conclusion application of ultrasound technology in the liver and gallbladder disease census, not only can detect no significant clinical symptoms of malignant lesions, can detect the fatty liver, cirrhosis of the liver, cholecystitis and gall bladder calculi many benign lesions, such as the liver and gallbladder disease in the diagnosis accuracy is high, and is an important non-invasive means in the early detection of disease.%目的:探讨腹部超声检查在肝胆疾病普查中的临床价值。方法回顾性分析了2013年6月~2013年12月在我院体检中心行健康体检中采用腹部超声检查肝胆脏器的1688人次的临床资料。结果本组1688人次行肝胆超声普查中,阳性患者438例,占25.95%。经病理、螺旋 ct 确诊402例,诊断准确率为91.78%。阳性确诊患者中原发性肝癌16例,肝血管瘤24例,肝囊肿32例,脂肪肝110例,肝硬化23例,胆囊癌5例,胆囊息肉10例,胆囊结石82例,胆囊炎100例。结论应用 B 超技术在肝胆疾病普查中,不仅能够检测出无明显临床症状的恶性病变,能够检测出脂肪肝、肝硬化、胆囊炎、胆囊结石等很多良

  15. Noninvasive diagnosis of hepatocellular carcinoma on gadoxetic acid-enhanced MRI: can hypointensity on the hepatobiliary phase be used as an alternative to washout?

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Ijin; Lee, Dong Ho; Jeon, Ju Hyeon [Seoul National University Hospital, Department of Radiology, 101 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, 103 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of); Lee, Jeong Min; Han, Joon Koo; Choi, Byung Ihn [Seoul National University Hospital, Department of Radiology, 101 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, 103 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, 103 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of)

    2015-10-15

    To determine which dynamic phase(s) of gadoxetic acid-enhanced MRI is most appropriate to assess ''washout'' in the noninvasive diagnosis of hepatocellular carcinoma (HCC) based on hemodynamic pattern. In this retrospective cohort study, 288 consecutive patients with chronic liver disease presented with 387 arterially enhancing nodules (292 HCCs, 95 non-HCCs) (≥1 cm) on gadoxetic acid-enhanced MRI. All HCCs were confirmed by histopathology or by their typical enhancement pattern on dynamic liver CT. MR imaging diagnosis of HCC was made using criteria of arterial enhancement and hypointensity relative to the surrounding parenchyma (1) on the portal-venous phase (PVP), (2) on the PVP and/or transitional phase (TP), or (3) on the PVP and/or TP, and/or hepatobiliary phase (HBP). For the noninvasive diagnosis of HCC, criterion 1 provided significantly higher specificity (97.9 %; 95 % confidence interval, 92.6 - 99.7 %) than criteria 2 (86.3 %; 77.7 - 92.5 %), or 3 (48.4 %; 38.0 - 58.9 %). Conversely, higher sensitivity was obtained with criterion 3 (93.8 %; 90.4 - 96.3 %) than with criterion 2 (86.6 %; 82.2 - 90.3 %) or 1 (70.9 %; 65.3 - 76.0 %). To make a sufficiently specific diagnosis of HCC using gadoxetic acid-enhanced MRI based on typical enhancement features, washout should be determined on the PVP alone rather than combined with hypointensity on the TP or HBP. (orig.)

  16. Effect of ethanol on hepatobiliary transport of cationic drugs. A study in the isolated perfused rat liver, rat hepatocytes and rat mitochondria

    Energy Technology Data Exchange (ETDEWEB)

    Steen, H.; Merema, M.; Meijer, D.K.F. (Department of Pharmacology and Therapeutics, University Centre for Pharmacy, Groningen State Univrsity, Groningen (Netherlands))

    1994-01-01

    The effect of ethanol on the hepatic uptake of various cationic drugs was studied in isolated perfused rat livers, isolated rat hepatocytes and isolated rat liver mitochondria. In isolated rat hepatocytes and in isolated perfused rat livers, the uptake of the model organic cation tri-n-butylmethylammonium was found to be markedly stimulated by ethanol in a concentration-dependent fashion. The uptake of tri-n-butylmethylammonium at 1 [mu]M was increased to 120% and 137% at 0.5% (v/v, (=87 mM)) and 1% (v/v, (=174 mM)) ethanol, respectively. At 25 [mu]M, tri-n-butylmethylamonium uptake was increased to 124% and 152% at 0.5% (v/v) and 1% (v/v) of ethanol, respectively. The uptake of the organic cations azidoprocainamide methoiodide, vecuronium, ORG 9426 and ORG 6368, the anionic compound taurocholate and the uncharge compound ouabain was not markedly increased at these ethanol concentrations. The mechanism of action of ethanol on the uptake of tri-n-butylmethylammonium was further studied. Competitive inhibitors for the type I organic cation uptake system, procainamide ethobromide and verapamil, almost completely blocked uptake of tri-n-butyl-methylammonium (1 [mu]M) in the presence of 1% (v/v) ethanol, indicating that carrier-mediated uptake is still involved and that additional passive diffusion is unlikely. Neither the plasma membrane potential nor the accumulation of the cation in mitochondria was altered after ethanol treatment, suggesting that potential driving forces for uptake and sequestration were not affected. The results of our study indicate that ethanol selectively stimulates the uptake of the aliphatic organic cation tri-n-butylmethylammonium rather than through generally alterated hepatobiliary transport processes. (EG) (28 refs.).

  17. Hepato-biliary effects of mucoviscidosis: use of Mebrofenine scintigraphy; Atteinte hepato-biliaire de la mucoviscidose: interet de la scintigraphie a la Mebrofenine

    Energy Technology Data Exchange (ETDEWEB)

    Perrin-Fayolle, O.; Morelec, I. [Medecine Nucleaire, C.H. Lyon-Sud, Lyon (France); Gilly, R. [Pediatrie, C.H. Lyon-Sud, Lyon (France); Roche, S.; Sappey-Marinier, D.; Briere, J.; Bonmartin, A. [Medecine Nucleaire, C.H. Lyon-Sud, Lyon (France); Bellon, G. [Pediatrie, C.H. Lyon-Sud, Lyon (France)

    1997-12-31

    The objective of this work is the scintigraphic profile of patients afflicted with mucoviscidosis with portal hypertension (PHT) and the questions whether there exists a criterion to characterized the first stage of fibrosis as well as whether exist in this stage lesions of hepato cellular insufficiency (HCI). The method of the work implied the study of the dynamics of 60 minutes after injecting 40 - 120 MBq of Mebrofenine in 18 patients, 9 presenting a certain PHT, and 9, signs of hepatobiliary affliction without genuine PHT. In the population with PHT, all patients presented a splenomegaly, a very heterogeneous fixation and a retention of the tracer in the intrahepatic-biliary tracts (IHBT) with augmentation of T{sub 1/2} in 5 cases; 8 presented a diminution of the hepatic extraction fraction (HEF), serving as control of HCI. In the population without PHT 2 patients are normal. In the other seven, the most frequently found anomalies are the accumulation of tracer in the IHBT (5/7) and the hepatic heterogeneity (4/7). HEF is low in one case. No dilatation was visible by echography. In conclusion, the accumulation in the IHBT (14 patients, 9 PHT and 5 non PHT) expresses the presence of a functional stasis without organic effects (no echographic dilatation), consequence of a obstruction of biliary ducts by mucus plugs due to dehydration of the bile. The HEF, labeller of HCI, is low in 8 PHT and in one non-PHT, hence tardy in the evolution of the disease, the portal cirrhosis occurring at more on less long term. This parameter can not be considered as a labeller of fibrosis, on the contrary, the accumulation of this tracer in the IHBT and the hepatic heterogeneity seems more interesting for an early detection and start of a preventive treatment

  18. Inhibition of P-glycoprotein and multidrug resistance-associated protein 2 regulates the hepatobiliary excretion and plasma exposure of thienorphine and its glucuronide conjugate

    Directory of Open Access Journals (Sweden)

    Ling-Lei Kong

    2016-08-01

    Full Text Available Thienorphine (TNP is a novel partial opioid agonist that has completed phase II clinical evaluation as a promising drug candidate for the treatment of opioid dependence. Previous studies have shown that TNP and its glucuronide conjugate (TNP-G undergo significant bile excretion. The purpose of this study was to investigate the roles of efflux transporters in regulating biliary excretion and plasma exposure of TNP and TNP-G. An ATPase assay suggested that TNP and TNP-G were substrates of P-gp and MRP2, respectively. The in vitro data from rat hepatocytes showed that bile excretion of TNP and TNP-G was regulated by the P-gp and MRP2 modulators. The accumulation of TNP and TNP-G in HepG2 cells significantly increased by the treatment of mdr1a or MRP2 siRNA for P-gp or MRP2 modulation. In intact rats, the bile excretion and pharmacokinetic profiles of TNP and TNP-G were remarkably changed with tariquidar and probenecid pretreatment, respectively. Tariquidar increased the Cmax and AUC0-t and decreased MRT and T1/2 of TNP, whereas probenecid decreased the plasma exposure of TNP-G and increased its T1/2. Knockdown P-gp and MRP2 function using siRNA significantly increased the plasma exposure of TNP and TNP-G and reduced their mean retention time in mice. These results indicated the important roles of P-gp and MRP2 in hepatobiliary excretion and plasma exposure of TNP and TNP-G. Inhibition of the efflux transporters may affect the pharmacokinetics of TNP and result in a drug-drug interaction between TNP and the concomitant transporter inhibitor or inducer in clinic.

  19. Hepatobiliary transit times of gadoxetate disodium (Primovist) for protocol optimization of comprehensive MR imaging of the biliary system-What is normal?

    Energy Technology Data Exchange (ETDEWEB)

    Ringe, Kristina I., E-mail: ringe.kristina@mh-hannover.de [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States); Hannover Medical School, Department of Radiology, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Husarik, Daniela B., E-mail: danielahusarik@yahoo.com [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States); Gupta, Rajan T., E-mail: rajan.gupta@duke.edu [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States); Boll, Daniel T., E-mail: daniel.boll@duke.edu [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States); Merkle, Elmar M., E-mail: elmar.merkle@duke.edu [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States)

    2011-08-15

    Objective: The purpose of this study was to determine transit times for excretion of Gd-EOB-DTPA into different segments of the hepatobiliary system in patients with normal liver function. Methods: This retrospective study was IRB approved with a waiver of consent granted. 61 patients (39 female, 22 male, mean age 52.5 years) with normal liver and renal function who underwent contrast enhanced hepatic MRI after injection of 10 mLGd-EOB-DTPA at 1.5 T and 3 T were included. Two readers evaluated all delayed images (3-20 min post contrast) for the presence of contrast agent in the intrahepatic bile ducts (IBD), the common bile duct (CBD), the gallbladder and the duodenum. A two-tailed, unpaired Student's t-test with p < 0.05 deemed significant was used to determine whether transit times were affected by patient gender, age or body mass index. Results: 20 min after contrast initiation, Gd-EOB-DTPA could be detected in the IBD and the CBD in all patients (100%); gallbladder reflux was visible in 53 (86.9%), duodenal excretion in 40 patients (65.5%), respectively. Mean transit times for contrast appearance in the various segments were as follows: IBD 12 min 13 s; CBD 12 min 27 s; gallbladder 13 min 32 s. Transit times were not significantly affected by patient gender, age or BMI. Conclusion: Within 20 min post contrast initiation, Gd-EOB-DTPA can be expected in the IBD and the CBD in patients with normal liver function. However, functional information about the sphincter Oddi complex can be ascertained only in about two thirds of these patients within this timeframe.

  20. Inhibition of P-Glycoprotein and Multidrug Resistance-Associated Protein 2 Regulates the Hepatobiliary Excretion and Plasma Exposure of Thienorphine and Its Glucuronide Conjugate

    Science.gov (United States)

    Kong, Ling-Lei; Shen, Guo-Lin; Wang, Zhi-Yuan; Zhuang, Xiao-Mei; Xiao, Wei-Bin; Yuan, Mei; Gong, Ze-Hui; Li, Hua

    2016-01-01

    Thienorphine (TNP) is a novel partial opioid agonist that has completed phase II clinical evaluation as a promising drug candidate for the treatment of opioid dependence. Previous studies have shown that TNP and its glucuronide conjugate (TNP-G) undergo significant bile excretion. The purpose of this study was to investigate the roles of efflux transporters in regulating biliary excretion and plasma exposure of TNP and TNP-G. An ATPase assay suggested that TNP and TNP-G were substrates of P-gp and MRP2, respectively. The in vitro data from rat hepatocytes showed that bile excretion of TNP and TNP-G was regulated by the P-gp and MRP2 modulators. The accumulation of TNP and TNP-G in HepG2 cells significantly increased by the treatment of mdr1a or MRP2 siRNA for P-gp or MRP2 modulation. In intact rats, the bile excretion, and pharmacokinetic profiles of TNP and TNP-G were remarkably changed with tariquidar and probenecid pretreatment, respectively. Tariquidar increased the Cmax and AUC0-t and decreased MRT and T1/2 of TNP, whereas probenecid decreased the plasma exposure of TNP-G and increased its T1/2. Knockdown P-gp and MRP2 function using siRNA significantly increased the plasma exposure of TNP and TNP-G and reduced their mean retention time in mice. These results indicated the important roles of P-gp and MRP2 in hepatobiliary excretion and plasma exposure of TNP and TNP-G. Inhibition of the efflux transporters may affect the pharmacokinetics of TNP and result in a drug-drug interaction between TNP and the concomitant transporter inhibitor or inducer in clinic. PMID:27555820

  1. (99m)Tc sulfur colloid and (99m)Tc mebrofenin hepatobiliary functional liver imaging in normal and diabetic rats.

    Science.gov (United States)

    Al-Saeedi, Fatma; Loutfi, Issa

    2011-01-01

    To use (99m)Tc sulfur colloid ((99m)Tc-SC) and (99m)Tc mebrofenin ((99m)Tc-BrIDA) to study liver function in normal and diabetic rats. Radionuclide imaging was performed on 2 groups of rats, using (99m)Tc-SC for one group and (99m)Tc-BrIDA for the other (20 rats per group) before and after induction of diabetes mellitus (DM) using streptozotocin administration (55 mg/kg i.p.). Dynamic acquisition was obtained for 1 h after the injection of 37 MBq of radiotracer. For the (99m)Tc-SC group, organ/tissue uptake was determined by drawing regions of interest (ROI) over the heart, liver, spleen and also the whole body (WB). The ratio of the ROI of each organ to the WB ROI was calculated. For (99m)Tc-BrIDA, ratios of cumulative count rates in liver, liver parenchyma, biliary tree and abdomen ROI to a WB ROI were also calculated. Statistical analysis was performed to compare the ratios of organ/tissue uptake to WB uptake before and after DM induction using the paired t test. (99m)Tc-SC uptake ratios (means ±SD) showed a lower liver-to-WB uptake ratio (0.75 ± 0.05) in the rats after DM induction compared to baseline (0.81 ± 0.06), while the cardiac blood pool showed higher uptake ratios in the rats after DM induction (p = 0.026). For (99m)Tc-BrIDA, there was no significant difference in radiotracer uptake ratios obtained from the rats before and after DM induction (p = 0.41). Using functional liver imaging, there was a statistically significant decrease in the liver phagocytic/reticuloendothelial system function after DM induction, as evidenced by decreased (99m)Tc-SC liver uptake and increased blood pool compared to prediabetes, while the hepatobiliary function remained unchanged after DM induction using (99m)Tc-BrIDA imaging. Copyright © 2011 S. Karger AG, Basel.

  2. Molecular aspects of hepatobiliary transport

    NARCIS (Netherlands)

    Muller, M; Jansen, PLM

    1997-01-01

    Generation of bile flow is a regulated, ATP-dependent process and depends on the coordinated action of a number of transporter proteins in the sinusoidal and canalicular domains of the hepatocyte. Dysfunction of any of these proteins leads to retention of substrates, with conjugated hyperbilirubinem

  3. HEPATOBILIARY ASCARIASIS COMPLICATED BY PANCREATITIS.

    Science.gov (United States)

    Azhar, Muhammad; Sheikh, Ali Sibtain Farooq; Khan, Asim; Mustafa, Saqib; Shah, Imran Ali; Hameed, Bilal

    2015-01-01

    Ascaris lumbricoides is the commonest organism causing soil-transmitted helminth infection. It is particularly common in poor sanitary conditions. Nevertheless, involvement of the gallbladder by Ascaris is a rare entity. A lady presented to us with long-standing history of vague abdominal symptoms suggesting dyspepsia. Ultrasound showed a tube like structure invading the biliary channels. Serum amylase was elevated and the patient was managed conservatively, as for acute pancreatitis. She improved clinically, but subsequent imaging with magnetic resonance cholangiopancreatography revealed worm in the gallbladder. Laparoscopic cholecystectomy was done and Ascaris lumbricoides was removed. Ascaris infestation is an important differential diagnosis of patients with upper abdominal symptoms and screening with stool examination and ultrasound is warranted in high-risk population.

  4. The Effect of Psychological Nursing Intervention Applied in the Department of Hepatobiliary Surgery%心理护理干预在肝胆外科中的效果应用

    Institute of Scientific and Technical Information of China (English)

    崔淑芹

    2015-01-01

    Objective To investigate the application of psychological nursing intervention in the department of hepatobiliary surgery,and to analyze the intervention on the recovery of patients with mental and physical effect. Methods 50 cases of patients accepted operation in department of hepatobiliary surgery in our hospital,who were divided into control group and experimental group randomly,the control group of 25 patients with routine nursing, test group of 25 patients with psychological nursing intervention based on routine nursing. Results In the test group,whether regulation of patients with postoperative complications of emotional or psychological anxiety,emotional control,compared with the control group had better effect(P<0.05). Conclusion Psychological nursing intervention on patients in the department of hepatobiliary surgery can effectively slow down the catheter cause discomfort and the incision pain,reduce the patient on the prognosis of the disease and drainage control situation concern.%目的:观察心理护理干预在肝胆外科中的应用,并分析干预对患者身心恢复的效果。方法选取我院50例接受肝胆外科手术的患者,随机将患者分为对照组和试验组,对照组25例患者采用常规护理方法,试验组25例患者在常规护理基础上进行心理护理干预,对两组的应用效果进行对比分析。结果试验组不论是对患者的术后并发症的情绪的调控,还是心理焦虑等情绪的调控,较之对照组都有较好的效果(P<0.05),具有统计学意义。结论心理护理干预对肝胆外科患者能有效减缓尿管导致的不适和切口疼痛,降低患者对疾病预后和引流管制情况的担心,患者接受度高,能更好地帮助患者身心康复。

  5. Application of single-site laparoscopic technique in Department of Hepatobiliary Surgery%单孔腹腔镜技术在肝胆外科的应用进展

    Institute of Scientific and Technical Information of China (English)

    卢攀; 张伟

    2016-01-01

    NOTES (natural orifi ce transluminal endoscopic surgery) has been developed rapidly because of its advantages such as less trauma, less pain, faster recovery and better cosmetic effect. This paper reviews the progress of single-site laparoscopic technique in Department of hepatobiliary surgery.%经自然腔道内镜手术NOTES(natural orifice transluminal endoscopic surgery),因其具有创伤小、痛苦轻、恢复快、美容效果好等优点而得以迅速发展。现就对单孔腹腔镜技术在肝胆外科中的应用进展进行综述。

  6. 硅胶半管切口引流在肝胆疾病开放手术切口中的应用%Silicone Half Tube Incision Drainage in Open Operation Incision in Hepatobiliary Disease

    Institute of Scientific and Technical Information of China (English)

    何清雄; 孔德平

    2015-01-01

    目的:探讨硅胶半管切口引流在肝胆疾病开放手术切口中的临床应用效果。方法回顾性总结我院收治的相关病例资料共计308例。结果158例应用硅胶半管切口内引流的患者有6例发生切口感染,切口感染率为3.8﹪;150例未应用硅胶半管切口内引流的患者有30例发生切口感染,切口感染率为20﹪,差异有统计学意义(<0.05)。结论硅胶半管切口引流在肝胆疾病开放手术切口中具有更优秀的临床效果。%Objective To explore the clinical application of silicone half tube incision drainage ef ect in hepatobiliary disease in open operation incision. Methods Retrospective analysis of our hospital were col ected a total of 308 cases of cor elation. Results 158 cases of application of silicone half tube incision drainage in patients with 6 cases of infection of incision, incision infection rate was 3.8﹪;150 patients without the use of silicone half tube incision drainage in patients with 30 cases of wound infection, wound infection rate of 20%, the dif erence was statistical y significant ( <0.05). Conclusion Silicone half pipe drainage has bet er clinical ef ect in hepatobiliary disease open operation incision.

  7. Gadoxetic acid-enhanced 3.0 T MRI for the evaluation of hepatic metastasis from colorectal cancer: Metastasis is not always seen as a “defect” on the hepatobiliary phase

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Aram, E-mail: arkim.rad@gmail.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Lee, Chang Hee, E-mail: chlee86@hanmail.net [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Kim, Baek Hui, E-mail: maelstrom@naver.com [Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Lee, Jongmee, E-mail: leejongmee@hanmail.net [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Choi, Jae Woong, E-mail: cooljay@korea.ac.kr [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Park, Yang Shin, E-mail: pys797979@naver.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Kim, Kyeong Ah, E-mail: kahkim@korea.ac.kr [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Park, Cheol Min, E-mail: chlee86@gmail.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of)

    2012-12-15

    Purpose: To determine specific imaging features of hepatic metastasis from colorectal cancer, focusing on the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI. Materials and methods: Over a 2-year period, 79 hepatic metastatic lesions were identified from 32 patients (22 men and 10 women) who proven colorectal cancer and underwent gadoxetic acid-enhanced 3.0 T MRI. Hepatic metastases were proven pathologically in 16 patients: by surgical liver resection (n = 14) and by US-guided biopsy (n = 2). The remaining 16 patients were considered to have hepatic metastasis based on imaging studies and clinical information. Two radiologists evaluated the imaging features of each MRI sequence, including high resolution T2WI, dynamic contrast enhancement study with hepatobiliary phase, and diffusion weighted image. We also compared SI of the lesions on T2WI and HBP. Results: T2WI showed homogeneous high SI (n = 25; 31.7%), target appearance (n = 3; 3.8%), reversed target appearance (n = 2; 2.6%), and heterogeneously high SI (n = 49; 62%). On HBP, homogeneous defect were seen in 22 lesions (27.9%), target appearance in five lesions (6.4%), reversed target appearance in two lesions (2.5%), and heterogeneous defect in 50 lesions (63.3%); including reticular (70%), partially globular (26%), and diffuse GGO-like (4%) patterns. According to the imaging features on HBP, the homogeneous defect and heterogeneous defect groups had a mean ADC value of 0.99 × 10{sup −3} and 1.07 × 10{sup −3} mm{sup 2}/s, respectively, without statistically significant difference. Conclusion: Hepatic metastasis from colorectal cancer usually showed as a heterogeneous defect on HBP and a heterogeneous high SI on T2WI. The generally accepted “true defect” was not a common finding in hepatic metastasis from colorectal cancer.

  8. The application of one-piece transparent ostomy bag in postoperation leakage of hepatobiliary surgery%一件式透明造口袋在肝胆外科术后渗漏中的应用

    Institute of Scientific and Technical Information of China (English)

    胡亚丽; 夏瑾; 王小梅

    2015-01-01

    目的:探讨一件式透明造口袋在肝胆外科手术后渗漏中的应用价值。方法将肝胆外科手术后腹部发生渗漏的患者随机分为实验组和对照组,实验组采用一件式透明造口袋收集渗出液,对照组采用无菌纱布吸收渗出液体的传统换药方式。对比两组渗漏处周围皮肤情况、渗漏液性状、渗漏量、换药频率、时间及成本。结果实验组渗漏处周围皮肤完好,渗漏出的液体计量准确,换药频次减少,换药成本降低。结论一件式透明造口袋应用于肝胆外科术后腹部渗漏护理能减少渗漏相关并发症,提高患者舒适度,节约医疗资源。%Objective To explore the value of one‐piece transparent ostomy bag in aspect of postoperative wound leakage of hepatobiliary diseases .Method The postoperative patients found with abdominal wound leakage were ran‐domly divided into experimental group and control group .At first ,in experimental group ,certain ostomy bags were used for collecting the effusion around the wound .On the contrary ,sterile gauze was utilized as a traditional method in the control group .In these two groups ,the sign of the skin around the abdominal wound and the cost for dressing change were recorded and then analyzed respectively .Result In experimental group ,the peripheral skin around the wound was intact .As we found ,this group also ended up with accurate measurements of the volume of the effusion , clear observations of the characteristics of the effusion ,decreased rates and low expense of dressing change .Conclu‐sion One‐piece transparent ostomy bags ought to be applied in hepatobiliary surgery to reduce postoperative leakage‐related complications ,enhance patient comfort ,and realize large savings of health care resources .

  9. Anesthesia of patients for hepatobiliary and gastrointestinal surgery with da Vinci S robotics%达芬奇机器人肝胆胃肠手术麻醉研究

    Institute of Scientific and Technical Information of China (English)

    隋波; 王维; 马涛; 李冠华; 袁建广; 马玉恒; 田雷; 周宁新; 米卫东

    2011-01-01

    目的 总结达芬奇机器人肝胆胃肠手术251例麻醉临床经验.方法 对2008年1月-2011年6月251例达芬奇机器人肝胆胃肠手术麻醉过程及麻醉并发症进行分析总结.结果 251例全程机器人手术麻醉,麻醉时间(456.5±92.4)min,手术时间(414.6±83.6)min,气腹时间(408.7±46.8)min,麻醉手术中血流动力学稳定,气腹时间多于180min者PaCO2比术前基线值明显增加(P<0.05),气腹时间多于360min者动脉血pH比术前基线值明显降低(P<0.05),9例中转开腹未列入本组统计.结论 达芬奇机器人腹部手术中患者血流动力学平稳,但气腹时间明显延长,易发生酸碱失衡.%Objective To summarize the clinical anesthesia experiences with 251 cases who underwent hepatobiliary and gastrointestinal surgery with da Vinci S robotics. Methods Anesthesia of 251 patients who underwent hepatobiliary and gastrointestinal surgery with da Vinci S robotics from January 2008 to June 2011 and its complications were analyzed and summarized. Results All patients were anesthetized and underwent surgery with robotics. The anesthesia time was 456.5 ± 92.4min, the operation time was 414.6 ± 83.6min, and the CO2 pneumoperitoneum time was 408.7 ± 46.8min. The hemodynamics of patients was stable during operation. The PaCO2 was significantly higher after 180min of pneumoperitoneum than before operation(P<0.05), while the pH was significantly lower after 360min of pneumoperitoneum than before operation(P<0.05). Nine cases were transferred for laparotomy. Conclusion The hemodynamics of patients is stable during anesthesia of patients for abdominal operation with da vinci S robotics. The time of CO2 pneumoperitoneum is significantly longer than other surgical procedures, and thus often leading to acid-base disturbance.

  10. 肝胆外科机器人手术医师培育模式的初步探讨%Exploring the new strategy of training and education for hepatobiliary robotic surgeons

    Institute of Scientific and Technical Information of China (English)

    陈耿; 杨占宇; 郑树国; 别平

    2012-01-01

    机器人外科是当前微创外科发展的重要方向,在我国尚处于起步阶段.机器人外科医师的培训与教育是一个亟待解决的难题.研究者在腹腔镜外科培训的基础上,吸收传统外科教育精髓,借鉴国外机器人外科培训教育成功经验,初步探索适合我国国情的肝胆外科机器人手术医师培训与教育方式,收到良好效果.%Robotic surgery is a major trend of mini-invasive surgery,which is still in its infancy in China.The training and education of robotic surgeons is a problem to be solved imperatively.In our clinical practice,we explored the new strategy of training and education for hepatobiliary robotic surgeons by assimilating the essence of traditional surgery education and by drawing lessons from the successful training of robotic surgery in foreign countries.Satisfactory teaching effect was obtaincd.

  11. 提高医学留学生肝胆外科教学质量的方法%Methods of improving the teaching quality of hepatobiliary surgery for international medical students

    Institute of Scientific and Technical Information of China (English)

    易滨; 邱应和; 魏勇鹏; 张永杰

    2012-01-01

    By relating to our practice of international student teaching, this paper discusses methods of improving teaching quality as follows to adapt to the needs of hepatobiliary surgery teaching: choosing proper teaching contents and methods, preparing tailor-made English teaching materials, improving teachers ' skills, enhancing leacher-student communications, adopting multiple teaching methods and multimedia materials, meeting personalized learning needs, and applying the regimen of class observation and evaluation by both teachers and students. Practice proves that these methods are helpful in improving the quality of teaching.%为适应医学留学生肝胆外科教学需要,结合留学生教学实践,从选定合适的教学内容与方法、编制专用的英文教材、提高教师技能并加强师生沟通、采用多种教学方法和教学媒体、满足个体化学习需求、开展听课评课制度等方面进行了探讨.实践表明,对提高教学质量有一定帮助.

  12. Nutritional risk screening in elderly inpatients with hepatobiliary diseases%老年肝胆外科住院患者的动态营养风险筛查

    Institute of Scientific and Technical Information of China (English)

    门吉芳; 唐大年; 李喆; 张丹静; 朱明炜; 李磊; 奚宇虹; 韦军民

    2010-01-01

    目的 调查老年肝胆外科住院患者营养风险、营养不足发生率以及营养支持应用状况.方法 采用定点连续抽样,对156例老年肝胆外科住院患者(≥65岁)入院后第2天早晨和住院2周或出院时进行营养风险筛查2002(NRS 2002)的动态描述性研究.结果 NRS 2002的适用率为96.8%(151/156).患者总的营养风险发生率为36.9%(57/156),营养不足发生率为26.2%(41/156).住院时间大于2周的患者营养风险和营养不足发生率分别为49.6%和36.7%,住院时间小于2周的患者营养风险和营养不足发生率分别为37.3%和21.4%,两者相比差异具有统计学意义(P<0.05).存在营养风险和无营养风险患者营养支持率分别为64.1%和17.4%.其中,接受大手术患者中有营养风险和无营养风险患者的营养支持率分别为87.9%和36.8%,接受中、小手术患者中有营养风险和无营养风险患者的营养支持率分别为41.3%和9.6%.结论 NRS 2002适用于老年肝胆外科住院患者的营养风险筛查.住院时间大于2周老年肝胆外科住院患者营养风险和营养不足发生率反而有所增加.临床营养支持在肝胆外科需要更加重视住院患者的营养问题,临床上存在肠外、肠内营养的不合理应用.%Objective To investigate the nutritional risk,malnutrition rate,and nutritional support in elderly inpafients with hepatobiliary diseases.Methods Totally 156 eldedy inpatients(≥65 years)with hepatobiliary diseases were consecutively enrolled.Nutritional Risk Screening 2002(NRS 2002)was applied to screen nutritional risks on the next morning after admission and two weeks after admission or on the discharge day.Results Of 156 enrolled patients,151 patients(96.8%)completed the NRS 2002 screening.The nutrition risk and malnutrition rate were 36.9%(57/156)and 26.2%(41/156),respectively.The nutrition risk and malnutrition rate were significantly higher in patients with a hospital stay longer than 2 weeks than

  13. Clinical analysis of bloodstream infections caused by Escherichia coli in elderly patients with hepatobiliary disease%老年肝胆疾病患者大肠埃希菌血流感染的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    王钱; 鲍春梅; 何卫平; 崔恩博; 张文瑾; 范振平; 曲芬

    2015-01-01

    Objective To investigate the clinical characteristics and drug resistance in elderly patients with hepatobiliary disease and blood-stream infections caused by Escherichia coli,and to provide a basis for clinical therapy.Methods A retrospective analysis was performed on the clinical characteristics and drug susceptibility of 57 elderly inpatients with hepatobiliary disease and bloodstream infections caused by Esch-erichia coli in our hospital from 2009 to 2012.Comparison of continuous data between the two groups was made by t test,and comparison of categorical data was made by chi -square test.Results The majority of patients had liver cirrhosis,and spontaneous bacterial peritonitis was the major infection source.A total of 57 strains of Escherichia coli were isolated from elderly patients with hepatobiliary disease,and 24 (42.1%)out of them were positive for extended -spectrum β-lactamase (ESBL).ESBL -positive strains had a significantly higher level of drug resistance than ESBL -negative strains (P 0.05).The case -fa-tality rate in patients with septic shock,hepatic encephalopathy,or acute kidney injury was significantly higher than that in patients with no com-plications (χ2 =9.541,7.622,9.733,respectively,P <0.05).Conclusion Elderly patients with hepatobiliary disease and bloodstream infections caused by ESBL -positive Escherichia coli had a high level of drug resistance and a poor prognosis for severe complications.Antibiotic therapy combined with prevention and control of severe complications should be taken as early as possible to reduce the case -fatality rate.%目的:分析老年肝胆疾病患者大肠埃希菌血流感染的临床特点及耐药性,为临床治疗提供依据。方法回顾性分析2009年-2012年于解放军三二医院住院的57例老年肝胆疾病患者血流感染大肠埃希菌的临床特点及药敏试验结果。计量资料组间比较采用 t 检验,计数资料组间比较采用χ2检验。结果57例老年肝

  14. Hypovascular hypointense nodules on hepatobiliary phase without T2 hyperintensity on gadoxetic acid-enhanced MR images in patients with chronic liver disease: long-term outcomes and risk factors for hypervascular transformation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Seek [Chonbuk National University Medical School and Hospital, Department of Radiology, Jeonju-si, Chonbuk (Korea, Republic of); Song, Ji Soo; Lee, Hyun Kyung; Han, Young Min [Chonbuk National University Medical School and Hospital, Department of Radiology, Jeonju-si, Chonbuk (Korea, Republic of); Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Research Institute of Clinical Medicine, Chonbuk (Korea, Republic of)

    2016-10-15

    To evaluate the long-term outcomes and imaging features associated with hypervascularization of hypovascular nodules that show T2 iso-/hypointensity and hypointensity on hepatobiliary phase (HBP) of gadoxetic acid-enhanced magnetic resonance (MR) images in patients with chronic liver disease. Sixty patients and 114 nodules, which were hypovascular and iso-/hypointense on T2-weighted images and hypointense on HBP of gadoxetic acid-enhanced MRI, were included. We evaluated the effect of baseline clinical features, baseline MR features and growth rate on subsequent hypervascularization. Twenty-seven nodules in 21 patients transformed to hypervascular hepatocellular carcinoma (HCC). Using multivariate Cox analysis, T1 hyperintensity (hazard ratio [HR] = 2.69, P = 0.021), previous history of HCC (HR = 2.64, P = 0.021), and initial nodule size (HR = 1.09, P = 0.046) were identified to be associated with hypervascularization. The growth rate of nodules was a more powerful determinant of subsequent hypervascularization than baseline clinical and MR features. At long-term follow-up after >3 years, only one nodule with T1 isointensity showed hypervascularization. Careful follow-up or diagnostic procedures, such as biopsy, should be considered for up to 3 years after detection of hypointense nodules on HBP with T1 hyperintensity or a higher growth rate. (orig.)

  15. PBL教学法在肝胆外科见习教学中的应用优势探讨%Discussion on the Application Advantages of PBL Teaching Method in Hepatobiliary Surgery Practice Teaching

    Institute of Scientific and Technical Information of China (English)

    孙运鹏; 单云峰; 吴欢欢; 张启瑜

    2013-01-01

    目的探讨PBL(Problem-based Learning, PBL)教学法在肝胆外科临床见习教学中的应用优势。方法随机抽取80名临床本科见习生,分为实验组(n=40)和对照组(n=40),实验组采用PBL教学法的教学方式,对照组采用传统讲授法,分析两组学生考试成绩并对两种教学方法进行综合评价。结果两组均无不及格的学生,实验组考试成绩平均分高于对照组(5.019,P=0.000);实验组87.5%的学生对PBL教学法感到满意,而对照组仅45%的学生对传统教学法感到满意;在综合评价中,实验组学生学习兴趣、团队协作能力、临床实践能力、分析解决问题能力较对照组学生有显著提高(P<0.05)。结论与传统教学法相比,PBL教学法在肝胆外科临床见习中的应用效果较效果更好,优势明显,更易被学生接受。%Objective To investigate the advantage of PBL (Problem-based Learning, PBL) pedagogy in hepatobiliary surgery clinical practice teaching. Methods Randomly selected 80 clinical undergraduate students, divided into experimental group (n = 40) and control group (n = 40), the experimental group using PBL teaching method and using the traditional lecture in the control group. To analyze exam results of two groups students and evaluaed the two teaching methods. Results There were no students who failed the test scores. The average scores of experimental group were higher than that in the control group (5.019, P = 0.000); 87.5% of the students in the experimental group were satisfied with the PBL teaching, while only 45% of the students in the control group of traditional pedagogy are satisfied. In the comprehensive evaluation of the experimental group students' interest in learning, teamwork, clinical practice skil s, analytical problem-solving skil s were higher than the control group students significantly (P<0.05). Conclusion compared to traditional teaching methods, PBL teaching in clinical training

  16. Hepatobiliary alterations in massive biliary ascariasis: histopathological aspects of an autopsy case Lesões hepatobiliares em ascaridíase biliar maciça: aspectos histopatológicos em um caso de autópsia

    Directory of Open Access Journals (Sweden)

    Luiz Carlos da Costa Gayotto

    1990-04-01

    Full Text Available Hepatobiliary alterations found in an autopsy case of massive Biliary Ascariasis, are reported on histological grounds. Severe cholangitis was the main finding, but other changes were also detected, such as pyloric and intestinal metaplasia, hyperplasia of the epithelial lining, with intraductal papillomas and adenomatous proliferation. Remnants of the worm were observed tightly adhered to the epithelium, forming microscopic intrahepatic calculi. Mucopolysaccharides, especially acid, showed to be strongly positive on the luminal border, and in proliferated glands around the ducts. The authors discuss the similarity between such findings and Oriental Cholangiohepatitis, and suggest that inflammation and the presence of the parasitic remnants are responsible for the hyperplastic and metaplastic changes, similarly with what occurs in chlonorchiasis, fascioliasis and schistosomiasis.Os autores apresentam os aspectos histopatológicos encontrados no fígado de um caso de autópsia de Ascaridíase Biliar maciça. A intensa colangite foi o aspecto predominante, mas outras lesões também foram encontradas, tais como metaplasia pilórica e intestinal, hiperplasia epitelial com papilomas intraductais, e por vezes padrão adenomatoso. Restos do helminto foram encontrados fortemente aderidos ao epitélio, sendo intensa a positividade de mucopolissacárides, principalmente ácidos, na borda luminal do epitélio ductal e em glândulas proliferadas ao redor dos ductos. Os autores discutem a semelhança da Ascaridíase Biliar com a Colangio Hepatite Oriental, e sugerem que o processo inflamatório e a presença de restos do verme são responsáveis pelas alterações hiperplásicas e metaplásicas, analogamente ao que ocorre na clonorquíase, fasciolíase e esquistossomose.

  17. Application of da Vinci surgical system in hepatobiliary and pancreatic surgery: a single center experience%“达芬奇”机器人在肝胆胰手术中的应用(单中心报道)

    Institute of Scientific and Technical Information of China (English)

    顾磊; 詹茜; 邓侠兴; 彭承宏; 沈柏用

    2013-01-01

    目的:总结“达芬奇”机器人手术系统在我中心进行肝胆胰手术的临床经验.方法:回顾性分析我科2010年3月至2013年3月间机器人肝胆胰手术124例临床资料和手术并发症的发生率.结果:肝脏手术组15例,中转开腹1例,中转腹腔镜手术1例,该组所有病人围手术期无并发症,无死亡病例.手术时间(199.6±110.5)min,术中出血(703.3±1 260.7)mL,术后住院(11.0±3.6)d.胆囊手术组7例,无中转开腹病人,并发症发生率14.3%,无死亡病例.手术时间(212.9±64.2) min,术中出血(257.1±127.2)mL,术后住院(6.8±2.5)d.胰腺手术组102例,其中良性病人中1例中转开腹,并发症发生率50.0%,无死亡病例;恶性病人中2例中转开腹,并发症发生率55.9%,1例死亡.胰十二指肠切除术31例,手术时间(450.4±102.1)min,术中出血(506.5±266.5)mL,术后住院(34.4±7.8)d;胰体尾切除术42例,手术时间(161.0±68.7)min,术中出血(278.0±331.5) mL,术后住院(20.9±10.9)d;胰腺中段切除术16例,手术时间(215.6±45.7) min,术中出血(145.6±118.4)mL,术后住院(22.7±8.0)d;Beger术7例,手术时间(284.2±35.8) min,术中出血(321.7±244.2)mL,术后住院(26.3±7.7)d;局部切除术6例,手术时间(116.7±37.2)min,术中出血(61.7±69.1)mL,术后住院(27.8±11.8)d.结论:“达芬奇”机器人系统可独立完成各类肝胆胰手术,安全可行,推动了微创外科领域的发展进程,尤其在复杂的肝胆胰手术方面,有效地补充传统的腹腔镜手术.但在机器人手术开展初期,应慎重选择胰腺手术病人.%Objective To summarize the clinical experience of robotic hepatobiliary and pancreatic surgery in our center.Methods da Vinci surgical system was applied to perform robotic hepatobiliary and pancreatic operations for 124 patients from Mar 2010 to Mar 2013.The intra-and post-operative data including morbidity were analyzed.Results The robotic hepatectomy was performed in 15 cases.One case was

  18. Establishment of a perinatal cytomegaiovirus (CMV) induced hepatobiliary system injury model in guinea pigs%豚鼠围产期巨细胞病毒感染肝胆损伤模型的建立

    Institute of Scientific and Technical Information of China (English)

    王玮; 郑珊

    2009-01-01

    Objective To establish a perinatal cytomegalovirus (CMV) induced hepatobiliary system injury model in guinea pigs. Methods Three experimental groups were designed as follows. (1) Prenatal group (Group P): Female guinea pigs on the 40th to 43rd gestational day were randomly allocated into 3 subgroups. Guinea pigs in group P1 and P2 accepted intraperitoneal injection of virus supernatant with the dose of 1 10 9 TCID per dam and saline respectively, while guinea pigs in group P3 served as blank control. Live-born pups were sacrificed within 24 hours, on day 10 or 20 after birth. Samples of livers, extrahepatic bile duct and blood were collected. Weight gain, clinical signs of hepa-tobiliary injury (I. E. , jaundice in non-fur-covered skin, acholic stools) and survival were recorded. (2) Neonatal group (Group N) : A subset of healthy pups accepted intraperitoneal injection of virus supernatant at the dose of 1 108 TCID per pup within 24 hours after birth. Samples were collected on day 10, 20, or 30 after birth. (3) Infantile Group (Group Ⅰ): Healthy pups were inoculated with a same dose of virus supernatant on day 10 after birth. Samples were harvested on day 10, 20 or 30 after inoculation. The level of total bilirubin (TB), direct bilirubin (DB), ALT and AST in blood samples was analyzed. Serial sections of the liver or extrahepatic bile duct fixed in formalin were stained with Hematoxylin and Eosin. Hybridization in situ was applied on frozen sections to detect the distribution of viral mRNA. Results Compared to those in the control group, TB, DB, ALT and AST levels in Pups infected prenatally were significantly higher within the first 10 days of life (P<0. 05), and de-creased to the normal level on 20th day of life. A few pups of P1 group got the signs of jaundice (ie. Acholic stools ), which were associated with increased TB and DB level. In the neonatal group, a higher AST level was observed on the 10th day post inoculation in pups but it returned to normal soon

  19. Hepatobiliary Fascioliasis: Clinical and Radiological Features

    Directory of Open Access Journals (Sweden)

    K Aghazade

    2007-08-01

    Full Text Available Fascioliasis is a worldwide but unevenly distributed zoonosis caused by the trematode Fasciola hepatica that infects do­mesti­cated herbivores. Fasciolosis also occurs accidentally in humans by ingestion of metacercaria-laden freshwater or water plants. Human infections are common in developing countries and are not rare in Europe. The clinical course has been con­ventionally described in two phases: an acute phase of hepatic parenchymal invasion of an immature worm larva (parenchy­mal phase and a stationary phase after residence in the bile duct and production of eggs (ductal phase. We report a 34 years old woman from Ilam, western Iran with hepatic disorder, RUQ pain, and jaundice. The diagnosis was made by sonography, CT scan and serologic studies. Serologic exam (ELISA was positive & CT findings were compatible with fascioliasis.

  20. Hepatobiliary and pancreatic disorders in celiac disease

    Institute of Scientific and Technical Information of China (English)

    Hugh James Freeman

    2006-01-01

    A variety of hepatic and biliary tract disorders may complicate the clinical course of celiac disease. Some of these have been hypothesized to share common genetic factors or have a common immunopathogenesis, such as primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune forms of hepatitis or cholangitis. Other hepatic changes in celiac disease may be associated with malnutrition resulting from impaired nutrient absorption,including hepatic steatosis. In addition, celiac disease may be associated with rare hepatic complications, suchas hepatic T-cell lymphoma. Finally, pancreatic exocrine function may be impaired in celiac disease and represent a cause of treatment failure.

  1. Isolation of epithelial cells with hepatobiliary phenotype.

    Science.gov (United States)

    Castorina, Sergio; Luca, Tonia; Torrisi, Antonella; Privitera, Giovanna; Panebianco, Mariangela

    2008-01-01

    The regenerative capacity of the liver after partial hepatectomy or chemical injury is well known. In human liver, the resident progenitor cells are called "hepatic progenitor cells" (HPCs) while the term "oval cells" should be discouraged in order to indicate the stem cell compartment. The aim of our study was first to analyse the cellular aspects of liver regeneration through differentiation in cholangiocytes and hepatocytes, and then to characterise resident progenitor cells, using "primary cultured hepatocytes" derived from healthy adult human livers. Human hepatocytes were isolated from fresh surgical specimens of patients who underwent hepatic resections in our Clinical Centre surgery operating room. Hepatic differentiation and function were analysed by immunocytochemistry techniques and the presence of liver epithelial cell populations within normal adult human liver, was demonstrated by immunohistochemistry analysis. These cells expanded in vitro and showed the capacity for self-renewal and multipotent differentiation. Human liver stem cells expressed several mesenchymal markers, such as CD44, but not haematopoietic stem cell markers. In addition, these cells expressed alpha-fetoprotein, albumin, CK7 and CK19, indicating a partial commitment to hepatic and biliary cells. Interestingly the expression of both hepatocytes and biliary markers in HPCs reflects the bipotential nature of the hepatic stem cells toward both the hepatic and biliary lineage. According to their immature and bipotential phenotype, hepatic epithelial cells might represent a pool of precursors in the healthy human adult liver.

  2. 消化科及肝胆外科护士对肝硬化相关知识及患者健康教育认识的调查%Cirrhosis-related knowledge and awareness of patients' health education in nurses from departments of gastroenterology and hepatobiliary surgery

    Institute of Scientific and Technical Information of China (English)

    张婕; 黄婷婷

    2011-01-01

    Objective To investigate the cirrhosis-related knowledge and awareness of patients' health education in nurses from departments of gastroenterology and hepatobiliary surgery in order to provide a better basis for carrying out health education. Methods Cirrhosis-related knowledge and awareness of patients' health education were investigated in 60 nurses from department of gastroenterology and 24 nurses from department of hepatobiliary surgery using questionnaires. Results The nurses had a moderate level in cirrhosis-related knowledge. The scores of cirrhosis-related knowledge were different in nurses with different professional titles and working hours(P<0.05). The majority of nurses were fully aware of health education, but they were not satisfied with the conditions for implementing health education. Conclusion Nurses in departments of gastroenterology and hepatobiliary surgery should improve their cirrhosis-related knowledge. At present, they have no sufficient time as well as health education and communication skills. Patients and their relatives do not fully understand and believe nurses. The publicity materials are insufficient in departments to carry out health education of patients.%目的 调查消化科及肝胆外科护士对肝硬化相关知识的掌握程度及对健康教育的认识,为更好的开展科室健康教育提供依据.方法 采用问卷调查法调杏本院消化科60名及肝胆外科24名护士对肝硬化相关知识的掌握程度及对健康教育的认识.结果 护士对肝硬化相关知识掌握的总体情况处于中等水平:不同职称、专科工作时间及科室的护士对肝硬化相关知识得分的差异具有统计学意义(P<0.05);绝大多数护士对健康教育有充分的认识,但普遍对健康教育的实施条件不满意.结论 消化科及肝胆外科护士对肝硬化相关知识有待提高,目前临床科室护士没有充足的时间和熟练的健康教育技能及沟通技巧,患者及家属

  3. Analysis of and countermeasures for stressors among nursing students in different periods of clinical practicum in hepatobiliary specialized hospital%肝胆专科医院护生不同实习阶段压力源的分析与对策

    Institute of Scientific and Technical Information of China (English)

    常艳琴; 王志红; 刘栋梅; 杨远

    2013-01-01

    目的:探索肝胆专科医院护生在不同实习阶段压力、压力源及对策.方法:采用自行设计的压力源量表,对2011年5月至2012年3月在我院实习的68名护生进行问卷调查.结果:肝胆专科医院护生实习早期排在首位的压力源为时间分配及工作量,实习中、后期则为病人护理;护生的压力在三个阶段均处于中度水平.结论:在实习早期,通过向护生传授时间管理方法,使带教计划透明化,缓解护生在时间及工作量分配方面压力;实习中、后期则可通过开展人文和心理教育、“一对一导师制”带教,缓解护生在病人护理方面压力.%Objective: To investigate the stressors and stress levels among nursing students in different periods of clinical practicum in hepatobiliary specialized hospital. Methods: From May, 2011 to March, 2012, 68 nursing students in Eastern Hepatobiliary Surgery Hospital were investigated by a self-developed questionnaire and stressor scale. Results: In the early stage, workload and time allocation were the primary stressors. However, in the middle and the late stage, the primary stressors for nursing students were both about patient care. The stress levels of nursing students were moderate in all the three practicum stages. Conclusion: In the early stage, nursing students should learn methods for time allocation with a clear teaching plan. For stressors about patient care, humanities and psychology education are needed.

  4. 鱼油脂肪乳在肝胆管恶性肿瘤术后病人肠外营养中的价值%The value of parenteral fish oil lipid emulsion supplementation in patients after surgical operation of hepatobiliary malignancy

    Institute of Scientific and Technical Information of China (English)

    杨婧; 郑启昌; 张进祥; 熊俊; 宋自芳; 胡青钢

    2009-01-01

    目的: 研究添加鱼油脂肪乳对肝胆管恶性肿瘤术后病人肝功能恢复和营养状况的评价. 方法: 肝胆管恶性肿瘤切除术后病人32例,随机分为对照组和研究组,两组病人均接受等氮、等热量PN支持,研究组加用鱼油脂肪乳.比较手术前后两组病人血清蛋白质、血糖、胆红素、转氨酶和碱性磷酸酶水平和感染并发症的发生率. 结果: 经术后连续7 d的治疗,研究组病人血清蛋白质和胆红素水平明显改善,与对照组比有显著性差异(P<0.05),感染并发症亦明显少于对照组. 结论: 肝胆管恶性肿瘤术后病人应用鱼油脂肪乳,有利于营养状况和肝功能的恢复.%Objective: The impact of parenteral fish oil lipid emulsion on liver function and nutritional status of malignant tumors of the liver and gallbladder patients. Methods: From December 2007 to A-pril 2008, 32 post-operative hepatobiliary cancer patients were randomly divided into control and study groups. Two groups were treated with isocaloric, isonitrogenic parenteral nutrition and the study group was added fish oil lipid emulsion. Comparison of plasma protein, glucose, jaundice index, transaminase, ALP and the rate of infection complications was made betweent the two groups. Results: The blood glucose, transaminase and ALP levels were not significantly different between the two groups. But the plasma proteins and bilirubin levels were improved significantly (P < 0.05) with reduced infection complication in the study group. Conclusion : Fish oil lipid emulsion is conducive to the recovery of post-operative liver and gallbladder cancer patients in live function and nutritional status.

  5. 预防肝胆外科手术患者尿路感染目标管理的应用研究%Application of target safety management for prevention of urinary tract infections in surgical patients of department of hepatobiliary surgery

    Institute of Scientific and Technical Information of China (English)

    朱俊青; 郭芳; 孙会凤; 陈虎; 赵冀安; 郑素芬

    2015-01-01

    OBJECTIVE To explore the effect of target safety management on prevention of urinary catheter-associ-ated urinary tract infections in the surgical patients of department of hepatobiliary surgery so as to provide data support for taking effective prevention measures .METHODS A total of 200 patients who were treated in the hospi-tal from Jan 2011 to Dec 2013 were enrolled in the study and randomly divided into the observation group and con-trol group ,with 100 cases in each group .The control group was treated with conventional intervention ,while the observation group was given the target safety management intervention ;the incidence of the catheter-associated u-rinary tract infections ,catheter indwelling time ,incidence of bacteriuria ,isolation rate of pathogenic bacteria , qualified rate of samples collection ,and rate of repeated intubation were observed and compared between the two groups .RESULTS The incidence of the infections was 2 .0% in the observation group ,lower than that of the con-trol group ;the incidence of bacteriuria was 3 .0% in the observation group ,lower than that of the control group , there was significant difference between the two groups (P< 0 .05) .The qualified rates of spot check of hand hy-giene ,air in the ward ,and object surfaces of the observation group were respectively 97 .0% ,94 .0% ,and 95 .0% ,higher than those of the control group ,there was significant difference between the two groups (P <0 .05) .The rate of repeated intubation of the observation group was 7 .0% ,lower than 18 .0% of the control group ;the catheter indwelling time of the observation group was (2 .11 ± 0 .47)days ,shorter than (2 .31 ± 0 .63) days of the control group ,and there was significant difference between the two groups (P< 0 .05) .CONCLUSION The implementation of the target safety management can remarkably reduce the incidence of the catheter -associated urinary tract infections in the surgical patients of department of hepatobiliary surgery

  6. A survey of pain and its influential factors in patients after operation of hepatobiliary surgery%肝胆外科择期手术患者术后痛感觉和痛情绪影响因素的研究

    Institute of Scientific and Technical Information of China (English)

    李乐之; 张慧琳; 梁敉宁

    2011-01-01

    目的 探讨肝胆外科择期手术患者术后疼痛及其影响因素.方法 采用一般资料调查表、状态-特质焦虑问卷(STAI)、疼痛视觉模拟量表(VAS)、领悟社会支持量表(PSSS)、艾森克人格问卷(EPQ)对120例肝胆外科择期手术的患者于术前及术后1周内测评.结果 患者术后2h疼痛水平最高(7.21±1.37)分,随着术后时间的延长而逐渐降低,但72h时仍处于中度水平(4.41±1.79)分.患者术前的状态焦虑(S-AI)平均得分高于常模(P<0.01);术前S-AI对患者术后(2~48 h)的疼痛有影响;术前S-AI与术后VAS(2h,12 h,24h,48h,72h)呈正相关(r=0.301,0.387,0.416,0.227,0.230).精神质人格特征对患者术后(12h,24h)的疼痛有影响;精神质维度与术后VAS(12h、1周)呈正相关(r=0.399、0.297).镇痛方法对患者术后(2h,48h)的疼痛有影响.PCIA组在术后2h、12h的疼痛分值低于对照组(P<0.05、P<0.01).社会支持对患者术后(48h)的疼痛有影响;PSSS得分与术后VAS(48 h、72h、1周)呈负相关(r=-0.160、-0.241、-0.276).年龄对患者术后(12h)的疼痛有影响;职业对患者术后(48 h)的疼痛有影响.结论 术前S-AI、精神质人格特征、不同镇痛方法、领悟社会支持、年龄、职业、手术时间对术后疼痛有影响.%Objective To investigate the pain level and its influential factors in patients after operation of hepatobiliary surgery. Methods 120 patients were evaluated with the demographic data, State Trait Anxiety Inventory Form (STAI) , Visual Analogue Scale (VAS) , Perceived Social Support Scale (PSSS) and Eysenck Personality Questionnaire (EPQ). Results The highest pain level was within 2h in patients after the operation,then decreased gradually,but its still in the moderate level until 72h after the operation;the pain scores of the PCIA group were lower than the control group ( 2h, 12h after the operation) (P < 0.05, (P < 0. 01 ). The preoperative state anxiety (S-AI) scores were higher than the

  7. Genetic cholestasis, causes and consequences for hepatobiliary transport

    NARCIS (Netherlands)

    Jansen, PLM; Sturm, E

    2003-01-01

    Bile salts take part in an efficient enterohepatic circulation in which most of the secreted bile salts are reclaimed by absorption in the terminal ileum. In the liver, the sodium-dependent taurocholate transporter at the basolateral ( sinusoidal) membrane and the bile salt export pump at the

  8. Natural heme oxygenase-1 inducers in hepatobiliary function

    Institute of Scientific and Technical Information of China (English)

    Giovanni Li Volti; Raul Abella; Alessandro Frigiola; Fabio Galvano; David Sacerdoti; Claudia Di Giacomo; Maria Luisa Barcellona; Antonio Scacco; Paolo Murabito; Antonio Biondi; Francesco Basile; Diego Gazzolo

    2008-01-01

    Many physiological effects of natural antioxidants, their extracts or their major active components, have been reported in recent decades. Most of these compounds are characterized by a phenolic structure, similar to that of a-tocopherol, and present antioxidant proper-ties that have been demonstrated both in vitro and in vivo. Polyphenols may increase the capacity of endog-enous antioxidant defences and modulate the cellular redox state. Changes in the cellular redox state may have wide-ranging consequences for cellular growth and differentiation. The majority of in vitro and in vivo studies conducted so far have attributed the protective effect of bioactive polyphenols to their chemical reac-tivity toward free radicals and their capacity to prevent the oxidation of important intracellular components. However, in recent years a possible novel aspect in the mode of action of these compounds has been sug-gested; that is, the ultimate stimulation of the heme oxygenase-1 (HO-1) pathway is likely to account for the established and powerful antioxidant/anti-inflam-matory properties of these polyphenols. The products of the HO-catalyzed reaction, particularly carbon mon-oxide (CO) and biliverdin/bilirubin have been shown to exert protective effects in several organs against oxidative and other noxious stimuli. In this context, it is interesting to note that induction of HO-1 expression by means of natural compounds contributes to protec-tion against liver damage in various experimental mod-els. The focus of this review is on the significance of targeted induction of HO-1 as a potential therapeutic strategy to protect the liver against various stressors in several pathological conditions.

  9. Accomplishments in 2007 in the Management of Hepatobiliary Cancers

    Science.gov (United States)

    Chan, Anthony T.C.; Kishi, Yoji; Chan, Stephen L.

    2008-01-01

    SUMMARY Hepatocellular CarcinomaOverview of the Disease IncidencePrognostic or Predictive FactorsCurrent Therapy Standards SurgeryLocoablative TreatmentSystemic TreatmentAccomplishments and Lack of Accomplishments TherapyMilan Criteria to Select Patients for Liver TransplantBiologic AgentsBiomarkersBasic ScienceWhat Needs To Be DoneFuture Directions Comments on ResearchObstacles to Progress Biliary Tract CancerOverview of the Disease IncidencePrognostic or Predictive FactorsCurrent Therapy StandardsAccomplishments and Lack of Accomplishments TherapyBiomarkersWhat Needs To Be DoneFuture Directions PMID:19352465

  10. Analysis of standardized hand-washing spectrum for the improvement of the hand-washing hygiene rate for hepatobiliary surgery medical staff%规范化外科洗手图谱对提高肝胆外科医护人员手卫生合格率的效果分析

    Institute of Scientific and Technical Information of China (English)

    刘平玉; 程月娥

    2015-01-01

    目的:探讨《规范化外科洗手图谱》对提高肝胆外科医护人员手卫生合格率的应用效果。方法根据中华人民共和国卫生部《消毒技术规范》和解放军总后勤部《医院感染管理技术规范》中对外科洗手程序、接台手术洗手、脱去手套后洗手的要求绘制《规范化外科洗手图谱》。纳入2011年1月至2013年10月参加手术的医护人员400名,按数字表法随机分为实验组与对照组,每组各200名。实验组人员按照规范化外科洗手图谱洗手,对照组人员采用传统教学法或凭经验洗手。结果实验组医护人员洗手程序合格率、手卫生合格率均高于对照组,细菌学检测阳性率、手术后患者医院感染发生率低于对照组,差异有统计学意义(P <0.01)。结论《规范化外科洗手图谱》可提高医护人员手卫生合格率,且简单、实用,值得推广。%Objective To investigate the effect of standardized hand-washing spectrum for the improvement of the hand-wash-ing hygiene rate for hepatobiliary surgery medical staff.Methods The standardized surgical hand-washing spectrum was developed in accordance with the requirements of pre-surgical hand-washing procedures,hand-washing of operation table distribution and hand-wash-ing after removing surgical gloves,as specified in《the Technical Standards for Disinfection》(the Ministry of Health of the People′s Re-public of China)and 《the Technical Standards for Nosocomial Infection Management》(the General Logistics Department of PLA).Four hundred surgical personnel involved in surgeries were enrolled for the study and were randomized into the experimental group and the control group,each consisting of 200 people.The surgical personnel in the experimental group washed their hands as required by the standardized hand-washing spectrum,and those in the control group washed their hands with conventional methods or by experience. Results The

  11. Feasibility of Using Real-time Cine-MRI for Treating Moving & Deforming Tumors

    Science.gov (United States)

    2012-12-05

    Pancreatic Cancer; Liver Cancer; Lung Cancer; Lung Cancer Non-Small Cell Cancer (NSCLC); Lung Cancer Small Cell Lung Cancer (SCLC); Hepatobiliary Cancers; Hepatobiliary Cancers Liver; Hepatobiliary Cancers Hepatocellular Carcinoma (Hepatoma); Hepatobiliary Cancers Gallbladder; Hepatobiliary Cancers Bile Duct

  12. Hepatobiliary fascioliasis with multiple aneurysms and active bleeding: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Young; Kim Jae Woon; Jang, Jae Cheon [Dept. of Radiology, College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2015-04-15

    A 52-year-old woman visited our institution with upper abdominal pain which had lasted for the past two days. Laboratory tests revealed mild leukocytosis, decreased serum hemoglobin, and peripheral blood eosinophilia. CT scans showed multiple ill-defined, hypodense lesions in the peripheral areas of both hepatic lobes and active bleeding with a subcapsular hematoma in the right hepatic lobe. Angiography also showed active bleeding in the right hepatic lobe with multiple aneurysms, so a transarterial coil embolization was performed to stop the bleeding. The endoscopic retrograde cholangiopancreatography revealed several moving flat flukes in the common bile duct, which were pathologically confirmed as Fasciola hepatica.

  13. Molecular changes in hepatobiliary function and injury after human liver transplantation

    NARCIS (Netherlands)

    Geuken, Wirtje

    2006-01-01

    De lever vervult een belangrijke rol in de stofwisseling van het lichaam. De lever betsaat uit diverse celtypen die elk hun eigen functie hebben. De hepatocyten zijn het meest frequent voorkomende celtype in de lever. Ongeveer 80% van de cellen in de lever zijn hepatocyten. Hepatocyten zijn gepolari

  14. [Usefulness of hepatobiliary scintigraphy in the follow-up of patients with biliary reconstruction].

    Science.gov (United States)

    Sánchez-Fernández, Patricio; Martínez-Ordaz, José Luis; Sánchez-Reyes, Karina; Ferat-Osorio, Eduardo

    2015-01-01

    Introducción: la importancia de casos de lesión de vía biliar no solo involucra el diagnóstico y el tratamiento oportuno, sino también el seguimiento a largo plazo por la posibilidad de complicaciones tardías y los aspectos médico-legales. La medicina nuclear ha desempeñado un papel importante en el diagnóstico de múltiples enfermedades hepatobiliares. Métodos: estudio observacional, retrospectivo, transversal y analítico. Revisión de pacientes con lesión de vía biliar y sometidos a reconstrucción bilio-digestiva y biopsia hepática en la cirugía. Seguimiento clínico, con laboratorio y colangiogamagrama. Resultados: de enero de 2001 a diciembre de 2009 se evaluaron cien pacientes, treinta y cinco hombres y sesenta y cinco mujeres con edad promedio de 38.8 años. Los tipos de lesión de acuerdo con la Clasificación de Strasberg fueron: Tipo E1 (13 %); Tipo E2 (17 %); Tipo E3 (38 %), y Tipo E4 (32 %). Todos los pacientes fueron sometidos a cirugía reconstructiva de la vía biliar, 84 con técnica de Hepp-Couinaud y 16 pacientes con técnica convencional de hepático-yeyuno anastomosis en Y de Roux. Por biopsia hepática, doce pacientes con inflamación, cuarenta nueve colestasis, diecinueve ductopenias y diecinueve fibrosis. Conclusiones: la colangiogamagrafía, es un estudio adecuado en el seguimiento al valorar la captación y eliminación, su mejor utilidad es en pacientes con resultado histopatológico de colestasis y ductopenia.

  15. Effects of honey as a scolicidal agent on the hepatobiliary system

    Institute of Scientific and Technical Information of China (English)

    Bulent Kilicoglu; Iskender Sayek; Kemal Kismet; Sibel Serin Kilicoglu; Serap Erel; Omur Gencay; Kadriye Sorkun; Esra Erdemli; Okan Akhan; Mehmet Ali Akkus

    2008-01-01

    AIM: To examine the effects of 10% diluted honey, which has been shown to be scolicidal, on the liver and biliary system and determine whether it could be used as a scolicidal agent in the presence of biliary-cystic communication.METHODS: Thirty Wistar-Albino rats were divided into two groups. Honey with 10% dilution in the study group and 0.9% saline (NaCI) in the control group were injected into the common bile ducts of rats through a 3-mm duodenotomy. The animals were sacrificed 6 mo after the procedure. Histopathological, biochemical, and radiological examinations were performed for evaluation of side effects.RESULTS: At the end of the sixth month, liver function tests were found to be normal in both groups. The tissue samples of liver and ductus choledochus of the honey group showed no histomorphologic difference from the control group. No stricture on the biliary tree was detected on the retrograde cholangiograms.CONCLUSION: According to these results, (we concluded that 10% diluted honey could be used as scolicidal agent safely in the presence of biliary-cystic communication.

  16. Recognizing Immunoglobulin G4-Related Overlap Syndromes in Patients with Pancreatic and Hepatobiliary Diseases

    Directory of Open Access Journals (Sweden)

    Aldo J Montano-Loza

    2008-01-01

    Full Text Available The first description of autoimmune pancreatitis and elevated serum immunoglobulin-G4 (IgG4 in 2001 heralded further reports of several related autoimmune diseases with raised IgG4 levels. It is now recognized that a spectrum of overlap syndromes associated with increased IgG4 and biopsy evidence of IgG4-producing plasma cells, which has now been convincingly linked with cholangitis, autoimmune hepatitis, Sjögren’s syndrome, nephritis and retroperitoneal fibrosis. Collectively, this disease cluster is referred to as IgG4-related systemic disease. The importance of making the correct diagnosis is underscored by the management of individuals with IgG4-related systemic disease. In the first instance, patients generally have a dramatic response to immunosuppressive therapy, whereas patients with other forms of cholangitis and pancreatitis do not. Also, surgical management of pancreatic malignancy can be avoided once the correct diagnosis of IgG4-related disease has been made. In the present review, an overview of the current information regarding the role of IgG4 and IgG4-positive cells affecting the biliary system, pancreas and liver is provided.

  17. Meta-analysis: antioxidant supplements for liver diseases - the Cochrane Hepato-Biliary Group

    DEFF Research Database (Denmark)

    Bjelakovic, Goran; Gluud, L L; Nikolova, D

    2010-01-01

    Several liver diseases have been associated with oxidative stress. Accordingly, antioxidants have been suggested as potential therapeutics for various liver diseases. The evidence supporting these suggestions is equivocal....

  18. Prospective association of liver function biomarkers with development of hepatobiliary cancers

    NARCIS (Netherlands)

    Stepien, Magdalena; Fedirko, Veronika; Duarte-Salles, Talita; Ferrari, Pietro; Freisling, Heinz; Trepo, Elisabeth; Trichopoulou, Antonia; Bamia, Christina; Weiderpass, Elisabete; Olsen, Anja; Tjønneland, Anne; Overvad, Kim; Boutron-Ruault, Marie Christine; Fagherazzi, Guy; Racine, Antoine; Kühn, Tilman; Kaaks, Rudolf; Aleksandrova, Krasimira; Boeing, Heiner; Lagiou, Pagona; Benetou, Vassiliki; Trichopoulos, Dimitrios; Palli, Domenico; Grioni, Sara; Tumino, Rosario; Naccarati, Alessio; Panico, Salvatore; Bueno-de-Mesquita, H. Bas; Peeters, Petra H.; Lund, Eiliv; Quirós, J. Ramón; Nápoles, Osmel Companioni; Sánchez, María José; Dorronsoro, Miren; Huerta, José María; Ardanaz, Eva; Ohlsson, Bodil; Sjöberg, Klas; Werner, Mårten; Nystrom, Hanna; Khaw, Kay Tee; Key, Timothy J.; Gunter, Marc; Cross, Amanda; Riboli, Elio; Romieu, Isabelle; Jenab, Mazda

    2016-01-01

    Introduction: Serum liver biomarkers (gamma-glutamyl transferase, GGT; alanine aminotransferase, ALT; aspartate aminotransferase, AST; alkaline phosphatase, ALP; total bilirubin) are used as indicators of liver disease, but there is currently little data on their prospective association with risk of

  19. Prevalence of hepatobiliary dysfunction in a regional group of patients with chronic inflammatory bowel disease

    DEFF Research Database (Denmark)

    Wewer, V; Gluud, C; Schlichting, P

    1991-01-01

    primary sclerosing cholangitis, of whom two were primarily diagnosed; one patient had cholangiocarcinoma also primarily diagnosed; and two patients were found to have alcoholic hepatic damage. Among the 125 patients with Crohn's disease, 38 (30%; 95% confidence limits, 23-38%) had at least 1 abnormal...

  20. Evolution of laparoscopic surgery in a high volume hepatobiliary unit: 150 consecutive pure laparoscopic hepatectomies.

    Science.gov (United States)

    López-Ben, Santiago; Ranea, Alejandro; Albiol, M Teresa; Falgueras, Laia; Castro, Ernesto; Casellas, Margarida; Codina-Barreras, Antoni; Figueras, Joan

    2017-05-01

    Compared to other surgical areas, laparoscopic liver resection (LLR) has not been widely implemented and currently less than 20% of hepatectomies are performed laparoscopically worldwide. The aim of our study was to evaluate the feasibility, and the ratio of implementation of LLR in our department. We analyzed a prospectively maintained database of 749 liver resections performed during the last 10-year period in a single centre. A total of 150 (20%) consecutive pure LLR were performed between 2005 and 2015. In 87% of patients the indication was the presence ofprimary or metastatic liver malignancy. We performed 30 major hepatectomies (20%) and (80%) were minor resections, performed in all liver segments. Twelve patients were operated twice and 2 patients underwent a third LLR. The proportion of LLR increased from 12% in 2011 to 62% in the last year. Conversion rate was 9%. Overall morbidity rate was 36% but only one third were classified as severe. The 90-day mortality rate was 1%. Median hospital stay was 4 days and the rate of readmissions was 6%. The implementation of LLR has been fast with morbidity and mortality comparable to other published series. In the last 2 years more than half of the hepatectomies are performed laparoscopically in our centre. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. [Hepatobiliary complications detected by ultrasonography in patients undergoing total parenteral nutrition].

    Science.gov (United States)

    Garassini, M E; Alvarado, M C

    1994-01-01

    We studied 8 adult patients who received total parenteral nutrition (TPN). An abdominal ultrasound and liver functions test were done weekly looking for biliary sludge, thickening of the gallbladder wall, changes en bile ducts and liver parenchyma. Seven patients developed biliary sludge at week four. We didn't detect changes in bile ducts neither in the gallbladder wall. Two patients had elevations of bilirubin, Alkaline phosphatase and aminotransferase during TPN. 3 patients developed mild liver steatosis detected by ultrasound during the third and sixth week of NPT. Our findings agree with other studies that describe the development of biliary sludge, gallbladder stones, liver steatosis and colestasis in patients receiving TPN. Once TPN is stopped and oral feeding is restarted this changes usually disappear.

  2. An Approach for Treating the Hepatobiliary Disease of Cystic Fibrosis by Somatic Gene Transfer

    Science.gov (United States)

    Yang, Yiping; Raper, Steven E.; Cohn, Jonathan A.; Engelhardt, John F.; Wilson, James M.

    1993-05-01

    Cystic fibrosis (CF) is an inherited disease of epithelial cell ion transport that is associated with pathology in multiple organ systems, including lung, pancreas, and liver. As treatment of the pulmonary manifestations of CF has improved, management of CF liver disease has become increasingly important in adult patients. This report describes an approach for treating CF liver disease by somatic gene transfer. In situ hybridization and immunocytochemistry analysis of rat liver sections indicated that the endogenous CFTR (cystic fibrosis transmembrane conductance regulator) gene is primarily expressed in the intrahepatic biliary epithelial cells. To specifically target recombinant genes to the biliary epithelium in vivo, recombinant adenoviruses expressing lacZ or human CFTR were infused retrograde into the biliary tract through the common bile duct. Conditions were established for achieving recombinant gene expression in virtually all cells of the intrahepatic bile ducts in vivo. Expression persisted in the smaller bile ducts for the duration of the experiment, which was 21 days. These studies suggest that it may be feasible to prevent CF liver disease by genetically reconstituting CFTR expression in the biliary tract, using an approach that is clinically feasible.

  3. Alteration of amino acid and biogenic amine metabolism in hepatobiliary cancers: Findings from a prospective cohort study.

    Science.gov (United States)

    Stepien, Magdalena; Duarte-Salles, Talita; Fedirko, Veronika; Floegel, Anne; Barupal, Dinesh Kumar; Rinaldi, Sabina; Achaintre, David; Assi, Nada; Tjønneland, Anne; Overvad, Kim; Bastide, Nadia; Boutron-Ruault, Marie-Christine; Severi, Gianluca; Kühn, Tilman; Kaaks, Rudolf; Aleksandrova, Krasimira; Boeing, Heiner; Trichopoulou, Antonia; Bamia, Christina; Lagiou, Pagona; Saieva, Calogero; Agnoli, Claudia; Panico, Salvatore; Tumino, Rosario; Naccarati, Alessio; Bueno-de-Mesquita, H B As; Peeters, Petra H; Weiderpass, Elisabete; Quirós, J Ramón; Agudo, Antonio; Sánchez, María-José; Dorronsoro, Miren; Gavrila, Diana; Barricarte, Aurelio; Ohlsson, Bodil; Sjöberg, Klas; Werner, Mårten; Sund, Malin; Wareham, Nick; Khaw, Kay-Tee; Travis, Ruth C; Schmidt, Julie A; Gunter, Marc; Cross, Amanda; Vineis, Paolo; Romieu, Isabelle; Scalbert, Augustin; Jenab, Mazda

    2016-01-15

    Perturbations in levels of amino acids (AA) and their derivatives are observed in hepatocellular carcinoma (HCC). Yet, it is unclear whether these alterations precede or are a consequence of the disease, nor whether they pertain to anatomically related cancers of the intrahepatic bile duct (IHBC), and gallbladder and extrahepatic biliary tract (GBTC). Circulating standard AA, biogenic amines and hexoses were measured (Biocrates AbsoluteIDQ-p180Kit) in a case-control study nested within a large prospective cohort (147 HCC, 43 IHBC and 134 GBTC cases). Liver function and hepatitis status biomarkers were determined separately. Multivariable conditional logistic regression was used to calculate odds ratios and 95% confidence intervals (OR; 95%CI) for log-transformed standardised (mean = 0, SD = 1) serum metabolite levels and relevant ratios in relation to HCC, IHBC or GBTC risk. Fourteen metabolites were significantly associated with HCC risk, of which seven metabolites and four ratios were the strongest predictors in continuous models. Leucine, lysine, glutamine and the ratio of branched chain to aromatic AA (Fischer's ratio) were inversely, while phenylalanine, tyrosine and their ratio, glutamate, glutamate/glutamine ratio, kynurenine and its ratio to tryptophan were positively associated with HCC risk. Confounding by hepatitis status and liver enzyme levels was observed. For the other cancers no significant associations were observed. In conclusion, imbalances of specific AA and biogenic amines may be involved in HCC development.

  4. Spindle-cell variant of primary cutaneous follicle center lymphoma spreading to the hepatobiliary tree, mimicking Klatskin tumor.

    Science.gov (United States)

    Rozati, Sima; Kerl, Katrin; Kempf, Werner; Tinguely, Marianne; Zimmermann, Dieter R; Dummer, Reinhard; Cozzio, Antonio

    2013-01-01

    Primary cutaneous follicle center lymphoma (pcFCL) is an indolent type of primary cutaneous B-cell lymphoma (pcBCL) rarely disseminating to other organs. PcBCL with spindle-cell morphology has been described as a rare variant of pcFCL but the prognosis data of this variant is sparse. We report a rare case of spindle-cell pcFCL with CD20(+), CD79a(+), CD3(+), Bcl-6(+), Mum-1(-) and CD10(-) tumor cells that infiltrated the hepatic hilum, mimicking a Klatskin tumor. On the basis of the sparse published data on spindle-cell morphology of pcBCL, this growth pattern should elicit awareness of an increased risk of systemic involvement in the otherwise indolent pcFCL.

  5. Alteration of amino acid and biogenic amine metabolism in hepatobiliary cancers : Findings from a prospective cohort study

    NARCIS (Netherlands)

    Stepien, Magdalena; Duarte-Salles, Talita; Fedirko, Veronika; Floegel, Anne; Barupal, Dinesh Kumar; Rinaldi, Sabina; Achaintre, David; Assi, Nada; Tjønneland, Anne; Overvad, Kim; Bastide, Nadia; Boutron-Ruault, Marie Christine; Severi, Gianluca; Kühn, Tilman; Kaaks, Rudolf; Aleksandrova, Krasimira; Boeing, Heiner; Trichopoulou, Antonia; Bamia, Christina; Lagiou, Pagona; Saieva, Calogero; Agnoli, Claudia; Panico, Salvatore; Tumino, Rosario; Naccarati, Alessio; Bueno-de-Mesquita, H. B.; Peeters, Petra H.; Weiderpass, Elisabete; Quirós, J. Ramón; Agudo, Antonio; Sánchez, María José; Dorronsoro, Miren; Gavrila, Diana; Barricarte, Aurelio; Ohlsson, Bodil; Sjöberg, Klas; Werner, Mårten; Sund, Malin; Wareham, Nick; Khaw, Kay Tee; Travis, Ruth C.; Schmidt, Julie A.; Gunter, Marc; Cross, Amanda; Vineis, Paolo; Romieu, Isabelle; Scalbert, Augustin; Jenab, Mazda

    2016-01-01

    Perturbations in levels of amino acids (AA) and their derivatives are observed in hepatocellular carcinoma (HCC). Yet, it is unclear whether these alterations precede or are a consequence of the disease, nor whether they pertain to anatomically related cancers of the intrahepatic bile duct (IHBC), a

  6. The stereoisomers quinine and quinidine exhibit a marked stereoselectivity in the inhibition of hepatobiliary transport of cardiac glycosides

    NARCIS (Netherlands)

    Hedman, A; Meijer, DKF

    1998-01-01

    Background / Aims: Certain basic (cationic) drugs are known to interact with the hepatic transport, and renal and/or biliary clearance of cardia glycosides. The mechanisms behind these interactions are not fully understood, In the present study our was to investigate the effects of the two diastereo

  7. Meta-analysis of propylthiouracil for alcoholic liver disease--a Cochrane Hepato-Biliary Group Review

    DEFF Research Database (Denmark)

    Rambaldi, A; Gluud, C

    2001-01-01

    The aim of this review was to determine the benefits and adverse effects of propylthiouracil for patients with alcoholic liver disease.......The aim of this review was to determine the benefits and adverse effects of propylthiouracil for patients with alcoholic liver disease....

  8. Rosuvastatin reduces plasma lipids by inhibiting VLDL production and enhancing hepatobiliary lipid excretion in ApoE*3-Leiden mice

    NARCIS (Netherlands)

    Delsing, DJM; Post, SM; Groenendijk, M; Solaas, K; van der Boom, H; van Duyvenvoorde, W; de Wit, ECM; Bloks, VW; Kuipers, F; Havekes, LM; Princen, HMG

    The present study was designed to investigate the lipid-lowering properties and mechanisms of action of a new HMG-CoA reductase inhibitor, rosuvastatin, in female ApoE*3-Leiden transgenic mice. Mice received a high fat/cholesterol (HFC) diet containing either rosuvastatin (0 [control], 0.00125%,

  9. The breast cancer resistance protein (BCRP/ABCG2) affects pharmacokinetics, hepatobiliary excretion, and milk secretion of the antibiotic nitrofurantoin

    NARCIS (Netherlands)

    Merino, G; Jonker, JW; Wagenaar, E; van Herwaarden, AE; Schinkel, AH

    2005-01-01

    Nitrofurantoin is a commonly used urinary tract antibiotic prescribed to lactating woman. It is actively transported into human and rat milk by an unknown mechanism. Our group has demonstrated an important role of the breast cancer resistance protein (BCRP/ABCG2) in the secretion of xenotoxins into

  10. Obstructive jaundice activates nitroxidergic neurons of the vago-vagal neural circuit that regulates the hepatobiliary system in rabbits.

    Science.gov (United States)

    Hu, Ming-E; Lin, Yung-Chang; Chang, Hung-Ming; Tyan, Yeu-Sheng; Lan, Chyn-Tair

    2012-01-01

    In this study, we investigated the expression of neuronal nitric oxide synthase (nNOS) and nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d), two specific enzymes for nitric oxide (NO) synthesis, in the development of liver fibrosis induced by chronic bile duct ligation (BDL) in the rabbit. We specifically studied the liver-innervated nitroxidergic neurons that originate in the nodose ganglion (NG), nucleus of the solitary tract (NTS) and dorsal motor vagal nucleus (DMV). Our data showed that BDL resulted in overexpression of NADPH-d/nNOS in the NG, NTS and DMV neurons. Using densitometric analysis, we found a significant increase in NADPH-d expression as a result of BDL in the NG, NTS and DMV (72.6, 79.4 and 57.4% increase, respectively). These findings were corroborated by serum biochemistry and hepatic histopathological examination, which were influenced by NADPH-d/nNOS-generated NO in the liver following BDL. Upregulation of NADPH-d/nNOS expression may have important implications, including (1) facilitation of extrahepatic biliary parasympathetic tone that promotes gallbladder emptying of excess stagnant bile; (2) relaxation of smooth muscles of bile canaliculi thus participating in the pathogenesis of cholestasis; (3) dilation of hepatic sinusoids to counter BDL-induced intrahepatic portal hypertension in which endothelia may be damaged, and (4) alterations in hepatic metabolism, such as glycogenesis, bile formation and secretion, and bilirubin clearance.

  11. Prevalence of renal and hepatobiliary disease, laboratory abnormalities, and potentially toxic medication exposures among persons with COPD

    Directory of Open Access Journals (Sweden)

    Mapel DW

    2013-03-01

    Full Text Available Douglas W Mapel,1 Jenõ P Marton21Lovelace Clinic Foundation, Albuquerque, New Mexico, NM, USA; 2Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USABackground: The purpose of this study was to describe the prevalence of renal and hepatic disease, related laboratory abnormalities, and potentially hepatotoxic and nephrotoxic medication use in a population-based cohort of persons with chronic obstructive pulmonary disease (COPD.Methods: This was a retrospective case-control cohort analysis of COPD patients enrolled in one regional health system for at least 12 months during a 36-month study period (n = 2284. Each COPD patient was matched by age and gender to up to three persons not diagnosed with COPD (n = 5959.Results: The mean age for cases and controls was 70.3 years, and 52.5% were women. The COPD cohort had significantly higher prevalences (cases/100 of acute, chronic, and unspecified renal failure as compared with controls (1.40 versus 0.59, 2.89 versus 0.79, and 1.09 versus 0.44, respectively. Among the cases, 31.3% had at least one renal or urinary tract diagnosis during the study period, as compared with 21.1% of controls. COPD cases also had more gallbladder disease (2.76 versus 1.63 and pancreatic disease (1.40 versus 0.60, but not hepatic disease. COPD patients were more likely to have at least one serum creatinine level (5.1 versus 2.1 or liver aspartate aminotransferase level (4.5 versus 2.7 that was more than twice the upper limit of normal. COPD patients had prescription fills for an average of 17.6 potentially nephrotoxic and 27.4 hepatotoxic drugs during the study period, as compared with 13.6 and 19.9 for the controls (P value for all comparisons < 0.01.Conclusion: COPD patients have a substantially increased prevalence of renal, gallbladder, and pancreatic diseases, as well as abnormal renal and hepatic laboratory values, but not diagnosed liver disease. COPD patients are also more likely to be prescribed medications with potentially toxic renal or hepatic side effects.Keywords: chronic obstructive pulmonary disease, kidney diseases, liver diseases, epidemiology, toxicology, health care utilization

  12. Experimental and clinical trials of new /sub 99m/Tc-labeled hepatobiliary agents. [Iminodiacetic acid derivatives

    Energy Technology Data Exchange (ETDEWEB)

    Wistow, B.W.; Subramanian, G.; Gagne, G.M.; Henderson, R.W.; McAfee, J.G.; Hall, R.C.; Grossman, Z.D.

    1978-09-01

    Several new derivatives of lidocaine were synthesized and used to examine the intra- and extrahepatic bile ducts and gallbladder. Diisopropyl-IDA exhibited approximately twice the bile concentration of /sup 131/I-rose bengal during the first hour after injection. P-butyl-IDA also concentrates moderately well in the bile and has the added advantage of very low excretion into the urine (2%). It seems more effective than the other IDA derivatives at high bilirubin levels.

  13. Diseases of the hepatobiliary system as a cause of acute abdomen; Erkrankungen des hepatobiliaeren Systems als Ursache des akuten Abdomens

    Energy Technology Data Exchange (ETDEWEB)

    Schima, W.; Eisenhuber-Stadler, E. [Krankenhaus Goettlicher Heiland, Abteilung fuer Radiologie und bildgebende Diagnostik, Wien (Austria); Koelblinger, C.; Kulinna-Cosentini, C.; Ba-Ssalamah, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2010-03-15

    Diseases of the liver and biliary system are common causes of acute abdominal pain and gallstone disease predisposes to cholecystitis and cholangiolithiasis. Sonography is the method of choice for the assessment of cholecystitis, whereas magnetic resonance cholangiopancreaticography (MRCP) is the standard technique to detect stones in the common bile duct. Multi-detector computed tomography (MDCT) is ideal for detection of associated complications, including abscess formation and gall stone ileus. Pyogenic, amebic and fungal liver abscesses are reliably diagnosed with MDCT which can also be used for interventional radiologic therapy of liver abscesses by percutaneous aspiration or drainage procedures. The second most common cause of liver rupture after blunt trauma is spontaneous rupture of hypervascular liver tumors (i.e., HCC, adenoma, angiosarcoma) and due to medical procedures. Multi-phase contrast-enhanced MDCT can reliably detect active bleeding to guide further therapy in these cases. (orig.) [German] Die Cholezystitis ist eine der haeufigsten Ursachen fuer ein akutes Abdomen. Waehrend die Sonographie die Methode der Wahl zum Nachweis einer Cholezystolithiasis und Cholezystitis ist, steht bei der Entwicklung von Komplikationen die Multidetektorcomputertomographie (MDCT) diagnostisch im Vordergrund. Die Magnetresonanzcholangiopankreatikographie (MRCP) hat einen hohen Stellenwert bei der Abklaerung der Cholangiolithiasis, v. a. bei der Differenzialdiagnose zu anderen Ursachen einer Cholestase. Die Diagnose bakterieller, Amoeben- oder fungaler Leberabszesse kann mittels Sonographie oder MDCT rasch gestellt werden, wobei diese Methoden auch fuer die interventionelle radiologische Therapie von Leberabszessen (Punktion oder Drainage) gut geeignet sind. Die mehrphasige, kontrastmittelverstaerkte MDCT ist die Methode der Wahl fuer den Nachweis von Leberinfarkten oder -rupturen, da bei diesen Erkrankungen bzw. Verletzungsfolgen die Darstellung der Lebergefaessversorgung bzw. der Funktionsfaehigkeit von entscheidender Bedeutung ist. (orig.)

  14. Experience of a single center with congenital hepatic fibrosis:A review of the literature

    Institute of Scientific and Technical Information of China (English)

    Ali; Shorbagi; Yusuf; Bayraktar

    2010-01-01

    Congenital hepatic fibrosis(CHF) is an autosomal recessive inherited malformation defined pathologically by a variable degree of periportal fibrosis and irregularly shaped proliferating bile ducts.It is one of the fibropolycystic diseases,which also include Caroli disease,autosomal dominant polycystic kidney disease,and autosomal recessive polycystic kidney disease. Clinically it is characterized by hepatic fibrosis,portal hypertension,and renal cystic disease.CHF is known to occur in association with a ran...

  15. [Caroli's syndrome. Report of a case beginning in childhood with favorable course].

    Science.gov (United States)

    Rivero, M J; Román, E; Cilleruelo, M L; Sánchez, F; Barrio, J

    2000-07-01

    Caroli's disease is a rare entity that is included in the fibropolycystic abnormalities of the bile ducts. Ultrasonographic patterns consist of evident dilatation of the bile ducts. Although it is thought to be a congenital disease, it usually presents in young adults and few cases have been reported in children. We present the case of a 10-year-old boy with Caroli's syndrome (Caroli's disease, congenital hepatic fibrosis and polycystic renal disease). Evolution was favorable.

  16. EFFECT OF ETHANOL ON HEPATOBILIARY TRANSPORT OF CATIONIC DRUGS - A STUDY IN THE ISOLATED-PERFUSED RAT-LIVER, RAT HEPATOCYTES AND RAT MITOCHONDRIA

    NARCIS (Netherlands)

    STEEN, H; MEIJER, DKF; Merema, M.T.

    1994-01-01

    The effect of ethanol on the hepatic uptake of various cationic drugs was studied in isolated perfused rat livers, isolated rat hepatocytes and isolated rat liver mitochondria. In isolated rat hepatocytes and in isolated perfused rat livers, the uptake of the model organic cation tri-n-butylmethylam

  17. Open, small-incision, or laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis: An overview of Cochrane Hepato-Biliary Group reviews (Review)

    NARCIS (Netherlands)

    Keus, F.; Gooszen, H.G.; Laarhoven, C.J.H.M. van

    2010-01-01

    BACKGROUND: Patients with symptomatic cholecystolithiasis are treated by three different techniques of cholecystectomy: open, small-incision, or laparoscopic. There is no overview on Cochrane systematic reviews on these three interventions. OBJECTIVES: To summarise Cochrane reviews that assess the e

  18. Hepatobiliary and intestinal clearance of amphiphilic cationic drugs in mice in which both mdr1a and mdr1b genes have been disrupted

    NARCIS (Netherlands)

    Smit, JW; Schinkel, AH; Weert, B; Meijer, DKF

    1998-01-01

    1 We have used mice with homozygously disrupted mdr1a and mdr1b genes (mdr1a/1b (-/-) mice) to study the role of the mdr1-type beta-glycoprotein (P-gp) in the elimination of cationic amphiphilic compounds from the body. These mice lack drug-transporting P-gps, but show no physiological abnormalities

  19. Complicaciones hepatobiliares asociadas a la Nutrición Parenteral Domiciliaria (NPD Home-based parenteral nutrition (HBPN-associated hepatobiliary complications

    Directory of Open Access Journals (Sweden)

    C. Martínez Faedo

    2011-06-01

    Full Text Available La Nutrición Parenteral Domiciliaria (NPD permite recuperar o mantener el estado nutricional de los pacientes con insuficiencia intestinal crónica que no pueden cubrir sus requerimientos nutricionales por vía digestiva. Es frecuente que a lo largo del tratamiento aparezcan alteraciones de la función hepática que, en los casos más graves y sobretodo en niños prematuros y de bajo peso, pueden condicionar un fallo hepático irreversible. La correcta composición de la bolsa de nutrición parenteral, evitando un excesivo aporte de energía, junto con el uso de nuevos tipos de emulsiones lipídicas (con menor contenido en ácidos grasos de la serie ω-6 y exentas de fitosteroles así como la utilización, aunque sea mínima, de la vía digestiva pueden contribuir a disminuir la aparición de la hepatopatía asociada a la NPD. Es imprescindible realizar controles periódicos clínicos y analíticos para detectar precozmente las alteraciones de la función hepática con objeto de realizar los cambios adecuados en el tratamiento y valorar la indicación de un posible trasplante intestinal antes de que el fallo hepático sea irreversible.Home-based parenteral nutrition (HBPN allows recovering or maintaining the nutritional status of patients with chronic intestinal failure that cannot afford their nutritional requirements through the digestive route. Frequently, liver function impairments develop along the treatment, which in the most severe cases, and especially in premature and low-weight infants, may lead to an irreversible liver failure. The proper composition of the parenteral nutrition bag, avoiding an excess of energy intake, together with the use of new types of lipid emulsions (with lower content in -6 fatty acids and voided of phytosterols as well as the use, although being minimal, of the enteral route, may contribute to a decrease in the occurrence of HBPN-associated liver disease. It is necessary to perform monthly clinical and biochemical checks to early detect liver function impairments in order to perform the appropriate changes in the treatment and assess the indication of a potential bowel transplant before the liver damage becomes irreversible.

  20. Quantitative hepatobiliary scintigraphy and endoscopic sphincter of Oddi manometry in patients with suspected sphincter of Oddi dysfunction: assessment of flow-pressure relationship in the biliary tract

    DEFF Research Database (Denmark)

    Madácsy, L; Middelfart, H V; Matzen, Peter;

    2000-01-01

    patients with SOD biliary types II and III were investigated by QHBS and by ESOM. Twenty asymptomatic cholecystectomized patients served as controls for scintigraphy. ESOM was performed by applying the station pull-through method. Then SO basal pressure and phasic contraction characteristics were...... patients with SOD, a statistically significant linear correlation was found between the SO basal pressure and the QHBS parameters. Although HDTT was the most sensitive scintigraphic parameter (89%), the combined sensitivity and specificity of Tmax and T(1/2) of the common bile duct reached 100...

  1. 血管学研究与肝胆外科的发展%Angiological Studies and the Progress of Hepatobiliary Surgery

    Institute of Scientific and Technical Information of China (English)

    黄志强

    2003-01-01

    @@ 凡是涉及一个脏器基本结构的研究,不论是大体的、显微镜的、分子的、基因水平或功能状态的研究,都属于临床外科中的基础研究范畴.解剖学研究虽然是外科临床基础研究中最古老的项目,但是随着新科技和临床外科学的发展,又从未间断地添加新的研究内容.例如当前的可视化人体的研究便是个突出的例子.肝、胆管血循环的研究在当代的胆道外科学和移植外科学中占有重要的位置, 而上世纪50年代初期的肝内管道解剖学研究,奠定了现代肝脏外科的基础.

  2. Is portal vein cavernous transformation a component of congenital hepatic fibrosis?

    Institute of Scientific and Technical Information of China (English)

    Ozlem Yonem; Yusuf Bayraktar

    2007-01-01

    Congenital hepatic fibrosis (CHF) is an autosomal recessive disorder that belongs to the family of fibropolycystic liver diseases. This family includes a spectrum of disorders which are usually found in combination with each other and are usually inherited.Clinically fibropolycystic diseases have three effects being present in different proportions, those of a space occupying lesion, of portal hypertension and of cholangitis. In most patients, the first manifestations of CHF are signs and symptoms related to portal hypertension such as splenomegaly and varices. Portal hypertension in these patients has been attributed to the hypoplasia or compression of the portal vein radicles in the fibrous bands. Cavernous transformation of the portal vein (CTPV) is a relatively rare condition resulting from extrahepatic portal vein obstruction with recanalization or collateral vein formation to bypass the obstruction. It has been found that patients with CHF having an accompanying CTPV have relatively large splenomegaly and suffers more frequent episodes of bleeding from esophageal varices. We believe that CTPV is a congenital component of CHF and also one of the important causative factors of portal hypertension in these patients.

  3. 模拟诊疗在八年制肝胆外科临床教学中的应用%Application of "Simulated Therapy" in hepatobiliary surgery clinical teaching for eight-year-pro grammed medical students

    Institute of Scientific and Technical Information of China (English)

    韩克强; 吴娅利; 黄小兵; 李靖; 梁平

    2009-01-01

    “模拟诊疗”是外科临床教学的重要辅助手段,是以“病例和问题”为中心的仿真教学法。其目的是去除学生初到外科学习的恐惧与不适,使学生学会针对不同病人如何进行采集病史、系统查体和全面分析病人资料,从而做出正确的诊断并选择合理的治疗方案,培养学生正规的临床思维能力和基本诊疗能力”。我科在2004级八年制学生临床教学中引入了“模拟诊疗”的教学方式,有效地提高了学生的临床思维和综合应用知识的能力,现报告如下。

  4. 肝胆外科全机器人辅助下肝脏切除术的护理管理%Nursing management of patients accepting pan-robot-assisted hepatectomy in hepatobiliary surgical department

    Institute of Scientific and Technical Information of China (English)

    银彩霞

    2010-01-01

    [目的]探讨肝胆外科全机器人辅助下肝脏切除术手术人员、设备的护理管理.[方法]对参与6例全机器人辅助下肝脏切除术的医护人员进行培训、手术期间加强责任制管理、手术室合理布局、加强设备维护和管理.[结果]6例病人均成功接受了全机器人辅助下右半肝脏切除术,无机械故障或其他原因导致的术式改变.无中转开腹,创伤小,术中出血明显减少.[结论]全机器人辅助下肝脏切除术提高了手术效率,有效、全面的护理管理是全机器人手术成功的重要保证.

  5. Revised criteria for classification of the etiologies of acute liver failure and late-onset hepatic failure in Japan: A report by the Intractable Hepato-biliary Diseases Study Group of Japan in 2015.

    Science.gov (United States)

    Mochida, Satoshi; Nakayama, Nobuaki; Ido, Akio; Takikawa, Yasuhiro; Yokosuka, Osamu; Sakaida, Isao; Moriwaki, Hisataka; Genda, Takuya; Takikawa, Hajime

    2016-03-01

    In 2011, the Intractable Liver Diseases Study Group of Japan, established novel diagnostic criteria for "acute liver failure ", and published the classification criteria for the etiologies of acute liver failure and late-onset hepatic failure (LOHF) in 2013. According to this classification, HBV carriers showing acute hepatitis exacerbation were divided into 3 subgroups; asymptomatic or inactive HBV carriers without drug exposure, asymptomatic or inactive HBV carriers developing HBV reactivation during and after immunosuppressive therapies and/or antineoplastic chemotherapies and those with previously resolved HBV infection showing iatrogenic HBV reactivation. In an annual nationwide survey in 2013, however, a patient with previously resolved HBV infection was enrolled, in whom LOHF developed as a result of HBV reactivation despite in the absence of immunosuppressive therapies and/or antineoplastic chemotherapies. Thus, the study group revised the classification criteria in 2015; HBV carriers developing acute hepatitis exacerbation were classified into asymptomatic or inactive HBV carriers and patients with previously resolved HBV infection, and both groups were further sub-classified into those receiving immunosuppressive therapies and/or antineoplastic chemotherapies and those without such drugs exposure.

  6. Contribution of the murine mdr1a P-glycoprotein to hepatobiliary and intestinal elimination of cationic drugs as measured in mice with an mdr1a gene disruption

    NARCIS (Netherlands)

    Smit, J.W; Schinkel, A.H; Muller, M; Weert, B; Meijer, D.K F

    1998-01-01

    In the mouse, both the mdr1a and the mdr1b gene encode drug-transporting P-glycoproteins, The mdr1a P-glycoprotein is expressed in epithelial cells of, among others, the liver and the intestine, Furthermore, the mdr1b gene product is found in the liver but is not detectable in the intestine, To esta

  7. Clinical Value of the Damage Control Operation Applied to the Hepatobiliary Surgery%损伤控制性手术在肝胆外科治疗中的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    祝建勇; 邱宝安; 郭晓东; 夏念信; 杨英祥; 刘鹏; 安阳; 吴印涛

    2015-01-01

    目的:损伤控制性手术(Damage Control Operation,DCO)是针对严重创伤患者进行阶段性修复的外科策略,本文通过观察DCO在肝胆外科治疗中的效果,探讨其临床应用价值,为肝胆外科手术治疗提供参考.方法:选取2012年2月-2013年3月我院收治的90例重症肝胆外伤患者的临床资料进行回顾性分析.将所选病例随机分为对照组和DCO组,每组45例.其中对照组实施常规手术治疗,DCO组实施损伤控制性手术进行治疗.对比两组患者的手术时间,术中出血量、死亡率、术后感染及并发症等.结果:DCO组手术时间为(62.59± 8.61) min,术中出血量为(306.48± 23.54) mL,死亡率为20%,术后感染率为8.89%,并发症的发生率为11.11%;对照组术时间为(90.35± 7.86) min,术中出血量为(600.32± 34.21) mL,死亡率为53.33%,术后感染率为24.44%,并发症的发生率为35.56%;DCO组患者的各项指标均优于对照组,差异显著且具有统计学意义(P<o.05).结论:在肝胆外科治疗中采用损伤控制性手术具有明显的临床效果,不但缩短了手术时间,减少出血量,降低死亡率,提高手术成功率,而且降低了术后并发症及感染的发生率,值得推广.

  8. H3K4 dimethylation in hepatocellular carcinoma is rare compared with other hepatobiliary and gastrointestinal carcinomas and correlates with expression of the methylase Ash2 and the demethylase LSD1.

    Science.gov (United States)

    Magerl, Christian; Ellinger, Jörg; Braunschweig, Till; Kremmer, Elisabeth; Koch, Lin Kristin; Höller, Tobias; Büttner, Reinhard; Lüscher, Bernhard; Gütgemann, Ines

    2010-02-01

    Methylation of core histones regulates chromatin structure and gene expression. Recent studies have demonstrated that these methylation patterns have prognostic value for some tumors. Therefore, we investigated dimethylation of histone H3 at lysine 4 (H3K4diMe) and H3K4 methylating (Ash2 complex) and demethylating enzymes (LSD1) in carcinomas of the hepatic and gastrointestinal tract. High levels of H3K4diMe were rarely observed in 15.7% of hepatocellular carcinoma (8/51) unlike other carcinomas including, in ascending order, cholangiocellular carcinoma/adenocarcinoma of the extrahepatic biliary tract, gastric carcinoma, pancreatic ductal adenocarcinoma, and neuroendocrine carcinoma (P carcinomas (38/45) and correlated directly with H3K4diMe modification (correlation coefficient r = 0.53) and LSD1 expression (r = 0.35). In contrast to other carcinomas, 65.9% (29/44) of hepatocellular carcinomas analyzed showed no LSD1 expression (P carcinomas without LSD1 expression appeared to be frequently Ash2 and H3K4diMe weak or negative (P = .004). In summary, high H3K4diMe expression is rare in hepatocellular carcinoma compared with other carcinomas (negative predictive value 92.3%), which may aid in the differential diagnosis. Lack of H3K4diMe is possibly due to complex epigenetic regulation involving Ash2 and LSD1.

  9. Evaluation of hepatic functional gain by hepato-biliary scintigraphy (HBS) after portal embolization; Evaluation du gain functionnel hepatique par la scintigraphie hepato-biliaire (SHB) apres embolisation portale

    Energy Technology Data Exchange (ETDEWEB)

    Zerbib, E.; Azoulay, D.; Wartski, M.; Castaing, D.; Bismuth, H. [Medecine Nucleaire CCML, 92350 Le Plessis-Robinson, CHB, Hopital Paul Brousse, 94804 Villejuif Cedex (France)

    1997-12-31

    The partial hepatic extirpation is an alternative therapeutics in malign tumors of liver. The post-surgery risk of hepato-cellular insufficiency (HCI) is important when the extracted volume is higher than 70 - 80% of the total volume of a non-cirrhotic liver. In this case, sometimes, a homolateral-to-tumor portal embolization (PE) was proposed in order to induce an atrophy of the embolized side and a compensating hypertrophy of the contralateral side. The HBS was proposed as a method for evaluated the functional gain after PE. Six patients have benefited by 2 HBS: one of them before PE, the others, 3 weeks after. The dynamic acquisition was achieved after intravenous injection of 300 MBq of {sup 99m}Tc - tBIDA, on a DST (SMV) camera equipped with HRBE collimators. The regions of interest (ROI) corresponding to right and left liver, were drawn on an anterior and posterior image of the `parenchymatous` time (the forth or fifth minute), allowing the calculation of the functional ratio by arithmetic mean. The gain of the functional ratio of healthy liver was in average of 7% (ranging from 1 to 13%). These results appear to be comparable with those from scanner in 5 cases but different in one case (functional gain without volumetric gain at scanner); this last patient was finally successfully operated. Totally, the surgery indication was posed in these 6 patients, one of whom, solely, on arguments of scintigraphic quantification. The HBS allows estimating the variations in functional ratios before and after PE. This is a supplementary tool in the evaluation of the feasibility of a major hepatectomy after PE

  10. Improving Goals of Care Discussion in Advanced Cancer Patients

    Science.gov (United States)

    2016-12-20

    Primary Stage IV Hepatobiliary; Esophageal; Colorectal Cancer; Glioblastoma; Cancer of Stomach; Cancer of Pancreas; Melanoma; Head or Neck Cancer; Stage III; Stage IV; Lung Cancers; Pancreatic Cancers

  11. Intestinal SR-BI does not impact cholesterol absorption or transintestinal cholesterol efflux in mice

    NARCIS (Netherlands)

    Bura, Kanwardeep S.; Lord, Caleb; Marshall, Stephanie; McDaniel, Allison; Thomas, Gwyn; Warrier, Manya; Zhang, Jun; Davis, Matthew A.; Sawyer, Janet K.; Shah, Ramesh; Wilson, Martha D.; Dikkers, Arne; Tietge, Uwe J. F.; Collet, Xavier; Rudel, Lawrence L.; Temel, Ryan E.; Brown, J. Mark

    2013-01-01

    Reverse cholesterol transport (RCT) can proceed through the classic hepatobiliary route or through the non-biliary transintestinal cholesterol efflux (TICE) pathway. Scavenger receptor class B type I (SR-BI) plays a critical role in the classic hepatobiliary route of RCT. However, the role of SR-BI

  12. Blood metabolic signatures of body mass index

    DEFF Research Database (Denmark)

    Carayol, Marion; Leitzmann, Michael F; Ferrari, Pietro

    2017-01-01

    Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: Metabolites were measured in blood from 392 men from the Oxford (UK) cohort (EPIC-Oxford) and in 327 control subjects who were part of a nested case-control study on hepatobiliary carcinomas (EPIC-Hepatobiliary). Measured metabolites...

  13. Collection of Biospecimen & Clinical Information in Patients w/ Gastrointestinal Cancers

    Science.gov (United States)

    2012-05-24

    Gastrointestinal Neoplasms; Gynecologic Cancers; Gynecologic Cancers Cervical Cancer; Gastric (Stomach) Cancer; Gastro-Esophageal(GE) Junction Cancer; Gastrointenstinal Stromal Tumor (GIST); Colon/Rectal Cancer; Colon/Rectal Cancer Colon Cancer; Colon/Rectal Cancer Rectal Cancer; Colon/Rectal Cancer Anal Cancer; Anal Cancer; Hepatobiliary Cancers; Hepatobiliary Cancers Liver; Pancreatic Cancer

  14. Tolerability and efficacy of gamma knife radiosurgery on hepatocellular carcinoma with portal vein tumor thrombosis

    Science.gov (United States)

    Lu, Xiao-Jie; Dong, Jing; Ji, Li-Juan; Xiao, Li-Xin; Ling, Chang-Quan; Zhou, Jun

    2016-01-01

    This is a retrospective study on the safety and efficacy of gamma knife radiosurgery (GKR) in treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Patients with confirmed HCC and PVTT were allocated into two groups based on the treatments they received (palliative or GKR). A total of 138 patients were included (74 in the palliative group, 64 in GKR group). No significant differences in baseline characteristics existed between the two groups. Treatment-related adverse events (AEs) were recorded and compared between groups. The majority of AEs were mild to moderate and subsided naturally or after medication. There was no AE-induced death. The influences of baseline characteristics and treatment options on patients' OS were analyzed. The median OS of patients in the palliative and GKR group were 3.0 months (95% CI: 2.719-3.281) and 6.1 months (95% CI: 4.706-7.494) respectively (p = 0.003). Multivariate analysis revealed that GKR treatment, performance status 0-1, Child A, smaller tumor diameter and monolobar distribution were significant favorable prognosticators. Subgroup analyses showed OS benefit of GKR regardless of PVTT location (main or branch of PVTT). In conclusion, GKR is well tolerated in selected HCC-PVTT patients and can confer OS benefit, which needs validation in future prospective studies. PMID:26473291

  15. Abstracts

    National Research Council Canada - National Science Library

    2016-01-01

    ... , Abduljaleel Al Alwan 1,2 , Abeer Ibrahim 4 , Hadi Kuriry 3 , Ali Albenmousa 6 1 Department of Hepatobiliary Sciences, Division of Hepatology, King Abdulaziz Medical City, National Guard Health Affairs, 2...

  16. New aspects in the clinical spectrum of neonatal lupus

    DEFF Research Database (Denmark)

    Laurinaviciene, Rasa; Christesen, Henrik Thybo; Bygum, Anette

    2012-01-01

    Neonatal lupus erythematosus (NLE) is a rare, passively acquired autoimmune disease, caused by maternal autoantibodies. Characteristic clinical features of NLE are transient rash and congenital heart block (CHB), but also hematological abnormalities and hepatobiliary dysfunction may occur...

  17. National Comprehensive Cancer Network

    Science.gov (United States)

    ... Nervous System Cancers Cervical Cancer Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Chronic Myeloid Leukemia Colon Cancer Dermatofibrosarcoma Protuberans Esophageal and Esophagogastric Junction Cancers Gastric Cancer Hairy Cell Leukemia Head and Neck Cancer Hepatobiliary Cancers Hodgkin ...

  18. Extraintestinal manifestations in Crohn's disease and ulcerative colitis

    DEFF Research Database (Denmark)

    Isene, Rune; Bernklev, Tomm; Høie, Ole

    2015-01-01

    BACKGROUND: In chronic inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]), symptoms from outside the gastrointestinal tract are frequently seen, and the joints, skin, eyes, and hepatobiliary area are the most usually affected sites (called extraintestinal...

  19. What's new in pain management?

    African Journals Online (AJOL)

    are pertinent to the clinical practice of anaesthesiologists is ... changes in renal or hepatobiliary laboratory parameters. ... South African registration has only been concluded for ... the osmotically controlled release oral delivery system.

  20. 77 FR 2738 - Center for Scientific Review; Notice of Closed Meetings

    Science.gov (United States)

    2012-01-19

    ...@csr.nih.gov . Name of Committee: Vascular and Hematology Integrated Review Group; Hypertension and... Systems Integrated Review Group; Hepatobiliary Pathophysiology Study Section. Date: February 13-14, 2012...

  1. DNA methylation of PTEN gene promoter region is not correlated ...

    African Journals Online (AJOL)

    Yomi

    2012-02-23

    Feb 23, 2012 ... Key words: PTEN, promoter methylation, bladder cancer. INTRODUCTION ... al., 2005), pancreatic cancer (Asano et al., 2004), thyroid cancer (Frisk et al., ..... papillary mucinous neoplasms of the pancreas. J. Hepatobiliary.

  2. Approach to biliary imaging amongst consultant and specialist registrars in gastroenterology in a national setting.

    LENUS (Irish Health Repository)

    Murray, T

    2010-12-01

    Radiological investigation plays an important role in the management of conditions affecting the hepatobiliary system. However, multiple imaging modalities exist and inappropriate requesting can lead to delays in diagnosis and subsequent treatment.

  3. Nutrition in Cystic Fibrosis: Macro- and Micronutrients

    NARCIS (Netherlands)

    Oudshoorn, Johanna Hermiena

    2006-01-01

    Cystic fibrosis (CF) is the most common life-threatening autosomal recessive inherited disease in Caucasians, and is characterized by progressive lung disease, pancreatic insufficiency, malnutrition, hepatobiliary disease and elevated sweat electrolyte levels. The increased survival of CF patients d

  4. Metal-responsive gene regulation and metal transport in Helicobacter species

    NARCIS (Netherlands)

    C. Belzer (Clara); J. Stoof (Jeroen); A.H.M. van Vliet (Arnoud)

    2007-01-01

    textabstractHelicobacter species are among the most successful colonizers of the mammalian gastrointestinal and hepatobiliary tract. Colonization is usually lifelong, indicating that Helicobacter species have evolved intricate mechanisms of dealing with stresses encountered during colonization of

  5. Drug: D06031 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D06031 Drug Technetium Tc 99m disofenin (USP) Diagnostic aid [hepatobiliary function determination]; Radioac...tive agent ATC code: V09DA01 Component of Hepatolite kit (TN) Anatomical Therapeuti

  6. Gallbladder radionuclide scan

    Science.gov (United States)

    ... ducts Cancer of the hepatobiliary system Gallbladder infection ( cholecystitis ) Gallstones Infection of the gallbladder, ducts, or liver ... Saunders; 2010:chap 65. Read More Acute Acute cholecystitis Bile Bile duct obstruction Cyst Gallstones Liver cancer - ...

  7. Cyclosporin versus tacrolimus as primary immunosuppressant after liver transplantation

    DEFF Research Database (Denmark)

    McAlister, V C; Haddad, E; Renouf, E

    2006-01-01

    A systematic review of randomized clinical trials (RCT) was undertaken to evaluate the beneficial and harmful effects of immunosuppression with cyclosporin versus tacrolimus for liver transplanted patients. MEDLINE, EMBASE, Cochrane Central and Hepato-Biliary Group Controlled Trials Registers were...

  8. Mutations of the CEP290 gene encoding a centrosomal protein cause Meckel-Gruber syndrome.

    NARCIS (Netherlands)

    Frank, V.; Hollander, A.I. den; Bruchle, N.O.; Zonneveld, M.N.; Nurnberg, G.; Becker, C.; Bois, G. Du; Kendziorra, H.; Roosing, S.; Senderek, J.; Nurnberg, P.; Cremers, F.P.M.; Zerres, K.; Bergmann, C.

    2008-01-01

    Meckel-Gruber syndrome (MKS) is an autosomal recessive, lethal multisystemic disorder characterized by meningooccipital encephalocele, cystic kidney dysplasia, hepatobiliary ductal plate malformation, and postaxial polydactyly. Recently, genes for MKS1 and MKS3 were identified, putting MKS on the

  9. Diagnostic performance of multidetector computed tomography in the evaluation of esoph

    Directory of Open Access Journals (Sweden)

    Tarek ELKammash

    2016-03-01

    Conclusion: MDCT is a fast, well tolerable, non-invasive procedure and accepted from most of the examined patients for evaluation and grading of EV, detection of other portosystemic collaterals and hepatobiliary pathologies.

  10. [Effect of 1-O-alkyl-glyceride ethers isolated from lipids of the squid Berrytteuthis magister liver on lipid metabolism and hematological parameters of rats with experimental dislipidemia].

    Science.gov (United States)

    Novgorodtseva, T P; Karaman, Iu K; Kas'ianov, S P; Vitkina, T I

    2009-01-01

    On the white Wistar rats with alimentary dyslipidemia investigated influence 1-O-alkyl-glycerides ethers (AGE), received by a method of hydrolysis 1-O-alkyl-diacylglycerides from lipids of the squid Berryteuthis magister liver, on a lipid metabolism, hepatobiliary functions of liver, antioxidant systems and parameters of blood. Are revealed antioxidant, antianemia and immunoactive properties of AGE. AGE raise a level of glucose and activity of enzymes hepatobiliary systems in blood, interfere the decrease of a cholesterol in blood.

  11. MR liver imaging with Gd-EOB-DTPA: a delay time of 10 minutes is sufficient for lesion characterisation

    Energy Technology Data Exchange (ETDEWEB)

    Kessel, C.S. van [University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands); University Medical Centre Utrecht, Department of Surgery, Utrecht (Netherlands); Veldhuis, W.B.; Bosch, M.A.A.J. van den; Leeuwen, M.S. van [University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands)

    2012-10-15

    To assess whether, in patients with normal liver function, a hepatobiliary delay time of 10 min after Gd-EOB-DTPA injection is sufficient for lesion characterisation. In 42 consecutive patients with suspected focal liver lesions, dynamic MRI was performed after intravenous Gd-EOB-DTPA, followed by hepatobiliary phases at 5, 10 and 20 min. The following items were assessed at each hepatobiliary phase: parenchymal enhancement, contrast agent excretion in bile ducts, lesion enhancement characteristics (hypo-, iso-, or hyperintensity, rim enhancement, central non-enhancement), and contrast- and signal-to-noise ratios, separately for hypo- and hyperintense lesions. Following enhancement, parenchymal signal intensity increased significantly up to 10 min (86.3%, P < 0.001), and subsequently stabilised (86.5% after 20 min, P = 0.223). Biliary contrast agent excretion was first observed in 2, 32 and 5 patients after 5, 10 and 20 min respectively. Hepatobiliary lesion enhancement characteristics observed after 5 min persisted during later hepatobiliary phases. CNR and SNR ratios increased significantly (P < 0.05) up to 10 min after enhancement without further increase at 20 min, in hypo- and hyperintense lesions. If lesion characterisation is the primary reason for performing MRI, a hepatobiliary delay time of 10 min after Gd-EOB-DTPA injection is sufficient in patients with normal liver function. (orig.)

  12. Water transport into bile and role in bile formation.

    Science.gov (United States)

    Calamita, Giuseppe; Ferri, Domenico; Gena, Patrizia; Liquori, Giuseppa E; Marinelli, Raúl A; Meyer, Giuliano; Portincasa, Piero; Svelto, Maria

    2005-06-01

    Formation of bile and generation of bile flow are driven by the active secretion of bile salts (BS), lipids and electrolytes into the canalicular and bile duct lumens followed by the osmotic movement of water. Although the transporting proteins involved in solute secretion have been cloned and their coordinated interplay defined both in health and disease, boosted by the discovery of the aquaporin water channels, only recently has considerable attention been addressed to the mechanism by which water, the major component of bile (> 95%), moves across the hepatobiliary epithelia. This review summarizes the novel acquisitions in liver membrane water transport and functional participation of aquaporin water channels in multiple aspects of hepatobiliary fluid balance. Emerging evidences suggesting involvement of aquaporins in the metabolic homeostasis of the hepatobiliary tract are also discussed.

  13. Gall bladder ascariasis

    Directory of Open Access Journals (Sweden)

    Ranendra Hajong

    2013-01-01

    Full Text Available Hepatobiliary ascariasis is commonly reported from highly endemic regions like India, Bangladesh, Latin America, parts of Middle East and Africa. In humans, the usual habitat of Ascaris lumbricoides is the small intestine. When the worm load is high, going as high as more than 1000 worms, then the worms tend to migrate away from the usual site. Patients with hepatobiliary ascariasis may present with biliary colic due to obstruction caused by the worms in the gall bladder, common bile duct or as a result of obstructive symptoms caused by calcified worms or lithiasis, which is commonly found in patients with hepatobiliary ascariasis. Acute pancreatitis may also be caused by ascariasis. Management usually is conservative if it is still alive or can be extracted by endoscopic retrograde cholangio-pancreatography or surgery.

  14. Atopic dermatitis severity in the patients with hepatobilliary pathology

    Directory of Open Access Journals (Sweden)

    T. V. Melnikova

    2014-01-01

    Full Text Available The aim of the research was to define severity of atopic dermatitis (AtD in the patients with hepatobiliary pathology. 221 patients with AtD were under investigation. 51 of them had associated biliary dyskinesia, 45 patients had chronic viral hepatitis (CVH without replecative kinesis, 65 patients had chronic viral hepatitis (CVH with replecative kinesis, and 50 patients had no hepatobiliary pathology. The results obtained showed marked effect of the hepato-biliary system pathology on the severity of the AtD pathology. The patients with biliary dyskinesia have a lichenoid kind of AtD and patients with deep-rooted viral hepatitis have an eczematous kind of AtD.

  15. A letter on ABCB4 from Iceland: On the highway to liver disease.

    Science.gov (United States)

    Lammert, F; Hochrath, K

    2015-12-01

    Large-scale whole-genome sequencing of the Icelandic population identified an association between several mutations of ABCB4 encoding the hepatobiliary phosphatiylcholine floppase with liver diseases and function in the general population. Whereas rare mutations of this transporter were known to cause progressive familial intrahepatic cholestasis, the genome-wide association studies in Iceland find the common ABCB4 variant c.711A>T to be a general risk factor for elevated aminotransferases and higher impact variants to be potential determinants of early-onset gallstone disease, cholestasis of pregnancy, liver cirrhosis, and hepatobiliary cancer.

  16. Detection of bile duct leaks using MR cholangiography with mangfodipir trisodium (Teslascan).

    Science.gov (United States)

    Vitellas, K M; El-Dieb, A; Vaswani, K; Bennett, W F; Fromkes, J; Steinberg, S; Bova, J G

    2001-01-01

    Mangafodipir trisodium (Teslascan), a hepatobiliary contrast agent, has the potential of providing functional biliary imaging similar to hepatobiliary scintigraphy. To our knowledge. the potential role of this biliary contrast agent in the detection of bile duct leaks has not been reported. In this case report, we report the first case of a bile duct leak diagnosed with enhanced MRI with mangafodipir trisodium in a patient following laparoscopic cholecystectomy. Our case illustrates that functional MR cholangiography images can be successfully acquired by using a post-mangafodipir fat-suppressed GRE technique and that bile duct leaks can be detected.

  17. Laparoscopic fenestration of multiple giant biliary mucinous cystadenomas of the liver

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Biliary cystadenomas of the liver are rare, cystic neoplasms of the biliary ductal system usually occur in middle aged women. We report a case of synchronous multiple huge biliary mucinous cystadenomas with unique features. This is, according to our knowledge, the first report in the literature about three synchronously occurring hepatobiliary cystadenomas. Cystadenomas have a strong tendency to recur, particularly following incomplete excision, and a potential of malignant transformation. A therapeutic re-evaluation may be necessary when the diagnosis of hepatobiliary cystadenoma is made after the operation and an open liver resection should be considered.

  18. ADENOSINE TRIPHOSPHATE-DEPENDENT COPPER TRANSPORT IN ISOLATED RAT-LIVER PLASMA-MEMBRANES

    NARCIS (Netherlands)

    INTVELD, G; VANDENBERG, GJ; MULLER, M; KUIPERS, F; VONK, RJ

    1995-01-01

    The process of hepatobiliary copper (Cu) secretion is still poorly understood: Cu secretion as a complex with glutathione and transport via a lysosomal pathway have been proposed. The recent cloning and sequencing of the gene for Wilson disease indicates that Cu transport in liver cells may be media

  19. 75 FR 32540 - Health Effects Not Associated With Exposure to Certain Herbicide Agents

    Science.gov (United States)

    2010-06-08

    ... herbicide exposure for three conditions (Parkinson's disease, ischemic heart disease, and b-cell leukemias... Parkinson's disease, ischemic heart disease, and b-cell leukemias, and VA published a proposed rule in the... small intestine and anus); hepatobiliary cancers (liver, gallbladder and bile ducts); pancreatic cancer...

  20. Excretion of biliary compounds during intrauterine life

    Science.gov (United States)

    Macias, Rocio IR; Marin, Jose JG; Serrano, Maria A

    2009-01-01

    In adults, the hepatobiliary system, together with the kidney, constitute the main routes for the elimination of several endogenous and xenobiotic compounds into bile and urine, respectively. However, during intrauterine life the biliary route of excretion for cholephilic compounds, such as bile acids and biliary pigments, is very poor. Although very early in pregnancy the fetal liver produces bile acids, bilirubin and biliverdin, these compounds cannot be efficiently eliminated by the fetal hepatobiliary system, owing to the immaturity of the excretory machinery in the fetal liver. Therefore, the potentially harmful accumulation of cholephilic compounds in the fetus is prevented by their elimination across the placenta. Owing to the presence of detoxifying enzymes and specific transport systems at different locations of the placental barrier, such as the endothelial cells of chorionic vessels and trophoblast cells, this organ plays an important role in the hepatobiliary-like function during intrauterine life. The relevance of this excretory function in normal fetal physiology is evident in situations where high concentrations of biliary compounds are accumulated in the mother. This may result in oxidative stress and apoptosis, mainly in the placenta and fetal liver, which might affect normal fetal development and challenge the fate of the pregnancy. The present article reviews current knowledge of the mechanisms underlying the hepatobiliary function of the fetal-placental unit and the repercussions of several pathological conditions on this tandem. PMID:19230042

  1. Patient Age, Sex, and Inflammatory Bowel Disease Phenotype Associate With Course of Primary Sclerosing Cholangitis

    NARCIS (Netherlands)

    Weismueller, Tobias J.; Trivedi, Palak J; Bergquist, Annika; Imam, Mohamad; Lenzen, Henrike; Ponsioen, Cyriel Y.; Holm, Kristian; Gotthardt, Daniel; Faerkkilae, Martti A.; Marschall, Hanns-Ulrich; Thorburn, Douglas; Weersma, Rinse K.; Fevery, Johan; Mueller, Tobias; Chazouilleres, Olivier; Schulze, Kornelius; Lazaridis, Konstantinos N.; Almer, Sven; Pereira, Stephen P.; Levy, Cynthia; Mason, Andrew L.; Naess, Sigrid; Bowlus, Christopher L.; Floreani, Annarosa; Halilbasic, Emina; Yimam, Kidist K.; Milkiewicz, Piotr; Beuers, Ulrich; Huynh, Dep K.; Pares, Albert; Manser, Christine N.; Dalekos, George N.; Eksteen, Bertus; Invernizzi, Pietro; Berg, Christoph P.; Kirchner, Gabi I.; Sarrazin, Christoph; Zimmer, Vincent; Fabris, Luca; Braun, Felix; Marzioni, Marco; Juran, Brian D.; Said, Karouk; Rupp, Christian; Jokelainen, Kalle; de Valle, Maria Benito; Saffioti, Francesca; Cheung, Angela; Trauner, Michael; Schramm, Christoph; Chapman, Roger W.; Karlsen, Tom H.; Schrumpf, Erik; Strassburg, Christian P.; Manns, Michael P.; Lindor, Keith D; Hirschfield, Gideon M.; Hansen, Bettina E.; Boberg, Kirsten M.

    BACKGROUND & AIMS: Primary sclerosing cholangitis (PSC) is an orphan hepatobiliary disorder associated with inflammatory bowel disease (IBD). We aimed to estimate the risk of disease progression based on distinct clinical phenotypes in a large international cohort of patients with PSC. METHODS: We

  2. Colonic perforations caused by migrated plastic biliary stents

    Energy Technology Data Exchange (ETDEWEB)

    Virgilio, Edoardo; Pascarella, Agauido; Scandavini, Chiara Maria; Frezza, Barbara; Bocchetti, Tommaso; Balducci, Genoveffa [Faculty of Medicine and Psychology ' Sapienza' , St. Andrea Hospital, Rome (Italy)

    2015-04-15

    Endoscopic insertion of plastic endoprostheses has become an integral part of the management of many benign and malignant diseases affecting the hepatobiliary and pancreatic system. Clogging and dislocation into the duodenum are the most frequently described complications following stent placement. Distal migration with or without perforation of the colon is an exceedingly rare phenomenon and the treatment is not well defined, as discussed below.

  3. Nuclear receptors : mediators and modifiers of inflammation-induced cholestasis

    NARCIS (Netherlands)

    Mulder, Jaap; Karpen, Saul J.; Tietge, Uwe J. F.; Kuipers, Folkert

    2009-01-01

    Inflammation-induced cholestasis (IIC) is a frequently occurring phenomenon. A central role in its pathogenesis is played by nuclear receptors (NRs). These ligand-activated transcription factors not only regulate basal expression of hepatobiliary transport systems, but also mediate adaptive response

  4. Effect of pirenzepine on gallbladder emptying in humans

    Energy Technology Data Exchange (ETDEWEB)

    Keshavarzian, A.; Fitzpatrick, M.L.; Anagnostides, A.; Chadwick, V.S.

    1986-11-01

    The effect of the selective antimuscarinic agent, pirenzepine, on gallbladder function was studied in six healthy volunteers, using /sup 99m/Tc HIDA (N-(2,6-diethylthenyl) carbamoylmethyl iminodiacetic acid) hepatobiliary scanning. Pirenzepine, in doses that inhibit gastric acid secretion, did not alter gallbladder emptying responses to sham feeding stimulation or to a test meal.

  5. Excretion of biliary compounds during intrauterine life

    Institute of Scientific and Technical Information of China (English)

    Rocio IR Macias; Jose JG Marin; Maria A Serrano

    2009-01-01

    In adults, the hepatobiliary system, together with thekidney, constitute the main routes for the eliminationof several endogenous and xenobiotic compounds intobile and urine, respectively. However, during intrauterinelife the biliary route of excretion for cholephiliccompounds, such as bile acids and biliary pigments, isvery poor. Although very early in pregnancy the fetal liver produces bile acids, bilirubin and biliverdin, these compounds cannot be efficiently eliminated by the fetal hepatobiliary system, owing to the immaturity of the excretory machinery in the fetal liver. Therefore, the potentially harmful accumulation of cholephilic compounds in the fetus is prevented by their elimination across the placenta. Owing to the presence of detoxifying enzymes and specific transport systems at different locations of the placental barrier, such as the endothelial cells of chorionic vessels and trophoblast cells, this organ plays an important role in the hepatobiliary-like function during intrauterine life. The relevance of this excretory function in normal fetal physiology is evident in situations where high concentrations of biliary compounds are accumulated in the mother. This may result in oxidative stress and apoptosis, mainly in the placenta and fetal liver, which might affect normal fetal development and challenge the fate of the pregnancy. The present article reviews current knowledge of the mechanisms underlying the hepatobiliary function of the fetal-placental unit and the repercussions of several pathological conditions on this tandem.

  6. Increased atherosclerosis in P2Y(13)/apolipoprotein E double-knockout mice : contribution of P2Y(13) to reverse cholesterol transport

    NARCIS (Netherlands)

    Lichtenstein, Laeticia; Serhan, Nizar; Espinosa-Delgado, Sara; Fabre, Aurelie; Annema, Wijtske; Tietge, Uwe J. F.; Robaye, Bernard; Boeynaems, Jean-Marie; Laffargue, Muriel; Perret, Bertrand; Martinez, Laurent O.

    2015-01-01

    Aims High-density lipoproteins (HDLs) protect against atherosclerosis mainly due to their function in hepatobiliary reverse cholesterol transport (RCT). This is a process whereby excess cholesterol from peripheral tissues is transported by HDL particles to the liver for further metabolism and

  7. Focal liver lesions detection and characterization: The advantages of gadoxetic acid-enhanced liver MRI

    Institute of Scientific and Technical Information of China (English)

    Stefano; Palmucci

    2014-01-01

    Since its clinical introduction, several studies in literature have investigated gadolinium ethoxybenzhyl diethylenetriaminepentaacetic acid or gadoxetic acid(Gd-EOB-DTPA) properties. Following contrast injection, it provides dynamic vascular phases(arterial, portal and equilibrium phases) and hepatobiliary phase, the latter due to its uptake by functional hepatocytes. The main advantages of Gd-EOB-DTPA of focal liver lesion detection and characterization are discussed in this paper. Namely, we focus on the possibility of distinguishing focal nodular hyperplasia(FNH) from hepatic adenoma(HA), the identification of early hepatocellular carcinoma(HCC) and the pre-operative assessment of metastasis in liver parenchyma. Regarding the differentiation between FNH and HA, adenoma typically appears hypointense in hepatobiliary phase, whereas FNH is isointense or hyperintense to the surrounding hepatic parenchyma. As for the identification of early HCCs, many papers recently published in literature have emphasized the contribution of hepatobiliary phase in the characterization of nodules without a typical hallmark of HCC. Atypical nodules(no hypervascularizaton observed on arterial phase and/or no hypovascular appearance on portal phase) with low signal intensity in the hepatobiliary phase, have a high probability of malignancy. Finally, regarding the evaluation of focal hepatic metastases, magnetic resonance pre-operative assessment using gadoxetic acid allows for more accurate diagnosis.

  8. Preparation and Preliminary Biological Evaluation of c-Gluc-Lys([Al18F]NOTA)-TOCA

    Institute of Scientific and Technical Information of China (English)

    GUO; Fei-hu; SHI; Cui-yan; WEN; Kai; LIANG; Ji-xin; DU; Jin

    2013-01-01

    18F labeled somatostatin analogues that bind to the somatostatin receptors(SSTR)on some tumor cells with high specific affinity hold great potential for diagnostic imaging.After glycosylationmodification,the pharmacokinetic properties of somatostatin analogues were significantly optimized,the hepatobiliary uptakes were reduced,and tumor-targeting were improved.In order to explore a novel PET

  9. The relationship between gallbladder dynamics and the migrating motor complex in fasting healthy subjects

    DEFF Research Database (Denmark)

    Qvist, N; Oster-Jørgensen, E; Rasmussen, L

    1988-01-01

    The relationship between gallbladder dynamics and the interdigestive migrating motor complex (MMC) was investigated in 10 healthy male volunteers by a hepatobiliary scintigraphy and gastroduodenal pressure recordings. Filling of the gallbladder commenced in late phase II or in phase III of the MM...

  10. Scintigraphic survey of liver grafts in acute phase: influence of choledoco-choledocian anastomosis realized in 13 cases with and in 13 other cases without Kehr drain. Surveillance scintigraphique des greffes du foie a la phase aigue: incidence de l'anastomose choledoco-choledocienne realisee dans 13 cas avec et dans 13 autres cas Sans drain de Kehr

    Energy Technology Data Exchange (ETDEWEB)

    Brunot, B.; Constantinesco, A.; Altieri, M. (Centre Hospitalier Universitaire, 67 - Strasbourg (France))

    1992-12-01

    This work shows that hepato-biliary scintigraphy is of great interest to keep track of patients just liver transplanted. This investigation is easy to realize without any constraint for the patient and provide data to detect principal complications of transplantation. 8 refs., 4 tabs.

  11. Tilfaeldigt fund af biliaer ascariasis

    DEFF Research Database (Denmark)

    Kristensen, Anders Donatsky; Achiam, Michael

    2010-01-01

    We describe a case of biliary ascariasis in a 27-year-old Philippine au-pair with recurrent upper abdominal pain. Hepatobiliary ascariasis is rarely seen in non-endemic areas. The diagnosis is important because severe complications can occur. If migrated into the biliary tree, it is recommended...

  12. Bile secretion of cadmium, silver, zinc and copper in the rat. Involvement of various transport systems.

    NARCIS (Netherlands)

    Havinga, R; Vonk, RJ; Kuipers, F

    1996-01-01

    In the present study we compared, in vivo in rats, the hepatobiliary transport of monovalent (silver:Ag) and divalent metals (zinc:Zn; cadmium:Cd) with that of copper (Cu). Cu can have two oxidation states in vivo, i.e. Cu(I) and Cu(II). Studies were performed in normal Wistar (NW) rats and mutant G

  13. Mortality and cancer risk related to primary sclerosing cholangitis in a Swedish population-based cohort

    NARCIS (Netherlands)

    de Valle, Maria Benito; Bjornsson, Einar; Lindkvist, Bjorn

    2012-01-01

    Background: Population-based studies on the epidemiology of primary sclerosing cholangitis (PSC) are sparse. Aims: To investigate mortality and risk of cancer, and to identify risk factors for hepatobiliary cancer and the combined end-point liver related death or liver transplantation (OLT) in a pop

  14. Direct intestinal cholesterol secretion contributes significantly to total fecal neutral sterol excretion in mice

    NARCIS (Netherlands)

    Van der Velde, Astrid E.; Vrins, Carlos L. J.; Van den Oever, Karin; Kunne, Cindy; Elferink, Ronald P. J. Oude; Kljipers, Folkert; Groen, Albert K.

    2007-01-01

    Background & Aims: Hepatobiliary secretion is generally believed to be an integral step in the pathway of cholesterol excretion from the body. Here we have investigated the validity of this paradigm in mice. Methods: Cholesterol balance was assessed by measuring intake, excretion, and biliary output

  15. Successful treatment of Ascites of hepatic origin in Dog

    Directory of Open Access Journals (Sweden)

    Pradhan M. S.

    2008-01-01

    Full Text Available Detailed clinico-pathological study of a Doberman pinsiner female, 8 years of age confirmed the ascites of hepatic origin. Administration of diuretic, liver tonic, antibiotics and hepatobiliary drug resulted in complete recovery. [Vet World 2008; 1(1.000: 23-23

  16. Pre-and postconditioning effects of metformin in rat donor livers

    NARCIS (Netherlands)

    Westerkamp, A.C.; De Jong, I.; Nijsten, M.W.; Leuvenink, H.G.D.; Touw, D.J.; Lisman, T.; Moshage, H.; Porte, R.J.

    2016-01-01

    Background: Pre- or reconditioning of donor livers can improve organ quality prior to transplantation. The aim of this study was to investigate whether metformin as pre- or reconditioning agent is able to reduce preservation injury in rat donor livers and improve hepatobiliary function during ex sit

  17. Pre-and postconditioning effects of metformin in rat donor livers

    NARCIS (Netherlands)

    Westerkamp, A.C.; De Jong, I.; Nijsten, M.W.; Leuvenink, H.G.D.; Touw, D.J.; Lisman, T.; Moshage, H.; Porte, R.J.

    2016-01-01

    Background: Pre- or reconditioning of donor livers can improve organ quality prior to transplantation. The aim of this study was to investigate whether metformin as pre- or reconditioning agent is able to reduce preservation injury in rat donor livers and improve hepatobiliary function during ex

  18. Ursodeoxycholic acid for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Gong, Y.; Huang, Z.B.; Christensen, Erik

    2008-01-01

    biliary cirrhosis against placebo or no intervention. SEARCH STRATEGY: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Central Register of Controlled Trials on The Cochrane Library, MEDLINE, EMBASE, SCI-EXPANDED, The Chinese Biomedical CD Database, LILACS...

  19. Mutations of the CEP290 gene encoding a centrosomal protein cause Meckel-Gruber syndrome.

    NARCIS (Netherlands)

    Frank, V.; Hollander, A.I. den; Bruchle, N.O.; Zonneveld, M.N.; Nurnberg, G.; Becker, C.; Bois, G. Du; Kendziorra, H.; Roosing, S.; Senderek, J.; Nurnberg, P.; Cremers, F.P.M.; Zerres, K.; Bergmann, C.

    2008-01-01

    Meckel-Gruber syndrome (MKS) is an autosomal recessive, lethal multisystemic disorder characterized by meningooccipital encephalocele, cystic kidney dysplasia, hepatobiliary ductal plate malformation, and postaxial polydactyly. Recently, genes for MKS1 and MKS3 were identified, putting MKS on the li

  20. 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) induce hepatic expression of the phospholipid translocase mdr2 in rats

    NARCIS (Netherlands)

    Hooiveld, GJEJ; Vos, TA; Scheffer, GL; Van Goor, H; Bloks, Vincent; Loot, AE; Meijer, DKF; Jansen, PLM; Kuipers, F; Muller, M

    1999-01-01

    Background & Aims: Biliary cholesterol secretion is coupled to that of phospholipids in a process controlled by mdr2 P-glycoprotein activity and bile salt secretion. Statins, the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, have been shown to affect hepatobiliary lipid secre

  1. The simultaneous use of 99m-Tc-HIDA scintigraphy and ultrasound in determination of gallbladder storage and emptying in the fasting state

    DEFF Research Database (Denmark)

    Qvist, Niels; Rafaelsen, Søren Rafael; Øster-Jørgensen, E.

    1991-01-01

    In eight healthy fasting young men simultaneous hepatobiliary scintigraphy and ultrasonography of the gallbladder was performed using intravenous infusion of 99m-Tc-HIA administered at a rate of 40 Mbq/h. Time-activity curves over the gallbladder and intestinal area were generated. Gallbladder vo...

  2. Hepatocellular carcinoma in cirrhotic patients: prospective comparison of US, CT and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Di Martino, Michele; De Filippis, Gianmaria; Geiger, Daniel; Del Monte, Maurizio; Lombardo, Concetta Valentina; Catalano, Carlo [University of Rome ' ' Sapienza' ' , Department of Radiological Sciences, Oncology and Anatomical Pathology, Rome (Italy); De Santis, Adriano; Corradini, Stefano Ginanni [University of Rome ' ' Sapienza' ' , Department of Clinical Medicine, Division of Gastroenterology, Rome (Italy); Rossi, Massimo; Mennini, Gianluca [University of Rome ' ' Sapienza' ' , Department of General Surgery, Division of Organ Transplantation, Rome (Italy)

    2013-04-15

    To prospectively compare the diagnostic performance of ultrasound (US), multidetector computed tomography (MDCT) and contrast-enhanced magnetic resonance imaging (MRI) in cirrhotic patients who were candidates for liver transplantation. One hundred and forty consecutive patients with 163 hepatocellular carcinoma (HCC) nodules underwent US, MRI and MDCT. Diagnosis of HCC was based on pathological findings or substantial growth at 12-month follow-up. Four different image datasets were evaluated: US, MDCT, MRI unenhanced and dynamic phases, MRI unenhanced dynamic and hepatobiliary phase. Diagnostic accuracy, sensitivity, specificity, PPV and NPV, with corresponding 95 % confidence intervals, were determined. Statistical analysis was performed for all lesions and for three lesion subgroups (<1 cm, 1-2 cm, >2 cm). Significantly higher diagnostic accuracy, sensitivity and NPV was achieved on dynamic + hepatobiliary phase MRI compared with US, MDCT and dynamic phase MRI alone. The specificity and PPV of US was significantly lower than that of MDCT, dynamic phase MRI and dynamic + hepatobiliary phase MRI. Similar results were obtained for all sub-group analyses, with particular benefit for the diagnosis of smaller lesions between 1 and 2 cm. Dynamic + hepatobiliary phase MRI improved detection and characterisation of HCC in cirrhotic patients. The greatest benefit is for diagnosing lesions between 1 and 2 cm. (orig.)

  3. Unusual biliary scan appearance in a child with a transplanted liver with hepatic arterial thrombosis: a case report.

    Science.gov (United States)

    Porn, U; Howman-Giles, R; Shun, A; Dorney, S; Uren, R

    2000-02-01

    A 5-year-old girl with biliary atresia and a subsequent Kasai procedure is described. She had clinical symptoms suggestive of rejection after a recent orthotopic liver transplant A hepatobiliary scan showed partial hepatic infarction and a biloma in the infarcted area.

  4. Haemorrhoids in Children: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Afra Karavelioglu

    2015-06-01

    Conclusions: We followed up one of the largest group for haemorrhoids in children. We performed laboratory examinations only for suspected hepatobiliary disorder. Patients did not have progressive illness during follow-up period. We believe that haemorrhoids disease in children can be followed up by routine control examinations, without detailed laboratory examinations. [J Contemp Med 2015; 5(2.000: 106-110

  5. Congenital hepatic fibrosis associated with von Recklinghausen's disease Fibrosis hepática congénita asociada a enfermedad de von Recklinghausen

    Directory of Open Access Journals (Sweden)

    O. A. Jorge

    2006-09-01

    Full Text Available Congenital hepatic fibrosis is characterized by a ductal plate malformation with duct-like structures and fibrosis. It manifests clinically with portal hypertension and may be associated with multiple congenital defects. We present the case of a 16-year-old male with splenomegaly, leukopenia and thrombocytopenia, esophageal varices, and a histopathological diagnosis of congenital hepatic fibrosis. He exhibits "café au lait' spots and "Lisch' nodules, with a diagnosis of von Recklinghausen's disease. Congenital hepatic fibrosis belongs to the so-called fibropolycystic diseases, in which there is a disordered interaction between cells and the extracellular matrix. Von Recklinghausen's disease affects tissues derived from the neural crest and its diagnosis is based on clinical criteria. It is associated with multiple diseases. We describe its association with congenital hepatic fibrosis for the first time.La fibrosis hepática congénita se origina como consecuencia de una malformación de la placa ductal con estructuras tipo ductales acompañadas de fibrosis. Se manifiesta con hipertensión portal y puede asociarse a múltiples defectos congénitos. Presentamos un varón de 16 años con esplenomegalia, leuco- y plaquetopenia, varices esofágicas y diagnóstico histopatológico de fibrosis hepática congénita. La exploración física mostraba la existencia de manchas de "café con leche' y nódulos de "Lisch' con diagnóstico de enfermedad de von Recklinghausen. La fibrosis hepática congénita forma parte de las enfermedades fibropoliquísticas donde existiría una alteración en la interacción entre las células y la matriz extracelular. La enfermedad de von Recklinghausen afecta a los tejidos derivados de la cresta neural y su diagnóstico se basa en criterios clínicos. Se asocia a múltiples patologías. Presentamos por primera vez su asociación con fibrosis hepática congénita.

  6. Apolipoprotein A-1 (apoA-1) deposition in, and release from, the enterocyte brush border

    DEFF Research Database (Denmark)

    Danielsen, E Michael; Hansen, Gert H; Rasmussen, Karina

    2012-01-01

    Transintestinal cholesterol efflux (TICE) has been proposed to represent a non-hepatobiliary route of cholesterol secretion directly "from blood to gut" and to play a physiologically significant role in excretion of neutral sterols, but so far little is known about the proteins involved in the pr......Transintestinal cholesterol efflux (TICE) has been proposed to represent a non-hepatobiliary route of cholesterol secretion directly "from blood to gut" and to play a physiologically significant role in excretion of neutral sterols, but so far little is known about the proteins involved...... transport (RCT), we propose that brush border-deposited apoA-1 in the small intestine acts in TICE by mediating cholesterol efflux into the gut lumen....

  7. Imaging of Drug-induced Complications in the Gastrointestinal System.

    Science.gov (United States)

    McGettigan, Melissa J; Menias, Christine O; Gao, Zhenqiang J; Mellnick, Vincent M; Hara, Amy K

    2016-01-01

    Drug-induced injury commonly affects the gastrointestinal and hepatobiliary systems because of the mechanisms of absorption and metabolism. In pill esophagitis, injury is frequently related to direct contact with the esophageal mucosa, resulting in small superficial ulcers in the mid esophagus. Nonsteroidal anti-inflammatory drugs can lead to gastrointestinal tract ulcers and small bowel mucosal diaphragms (thin weblike strictures). Injury to the pancreatic and hepatobiliary systems can manifest as pancreatitis, acute or chronic hepatitis, cholestasis, or steatosis and steatohepatitis (which may progress to cirrhosis). Various drugs may also insult the hepatic vasculature, resulting in Budd-Chiari and sinusoidal obstructive syndromes. Focal lesions such as hepatic adenomas may develop after use of oral contraceptives or anabolic steroids. Ultrasonography, computed tomography, and magnetic resonance imaging can aid in diagnosis of drug-induced injuries and often are necessary to exclude other causes.

  8. The influence of gallbladder function on the symptomatology in gallstone patients, and the outcome after cholecystectomy or expectancy

    DEFF Research Database (Denmark)

    Larsen, Thomas Kjaergaard; Qvist, Niels

    2007-01-01

    The purpose of this study was to examine whether gallbladder function as assessed by a hepatobiliary scintigraphy was related to the symptomatology in gallstone patients and to the outcome 1 year after either cholecystectomy or watchful waiting. The study included 100 patients with uncomplicated...... gallstone disease. Fifty-six patients had a functioning gallbladder and 44 had a nonfunctioning gallbladder. Patients with a nonfunctioning gallbladder had significantly more vomiting and received more pain-killing injections during pain attacks. Otherwise, there were no differences in pain patterns...... by a hepatobiliary scintigraphy was not related to the symptoms in gallstone patients, and was not related to the occurrence of symptoms after cholecystectomy or watchful waiting....

  9. Cystic fibrosis from the gastroenterologist's perspective.

    Science.gov (United States)

    Ooi, Chee Y; Durie, Peter R

    2016-03-01

    Cystic fibrosis is a life-limiting, recessive disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Increased survival outcomes and the multisystem nature of the disease, including the involvement of hepatobiliary and gastrointestinal tracts, now require the need for more extensive knowledge and expertise in cystic fibrosis among gastroenterologists. Manifestations are either a direct consequence of the primary defect in cystic fibrosis or a secondary complication of the disease or therapy. Adult patients with cystic fibrosis also have an increased risk of malignancy in the gastrointestinal and pancreatico-biliary tracts compared with the general population. Novel treatments that target the basic defects in the CFTR protein have emerged, but to date not much is known about their effects on the gastrointestinal and hepatobiliary systems. The introduction of such therapies has provided new opportunities for the application of intestinal endpoints in clinical trials and the understanding of underlying disease mechanisms that affect the gut in cystic fibrosis.

  10. Use of sofosbuvir-based direct-acting antiviral therapy for hepatitis C viral infection in patients with severe renal insufficiency.

    Science.gov (United States)

    Hundemer, Gregory L; Sise, Meghan E; Wisocky, Jessica; Ufere, Nneka; Friedman, Lawrence S; Corey, Kathleen E; Chung, Raymond T

    2015-01-01

    Sofosbuvir-based direct-acting antiviral therapy revolutionized the treatment of hepatitis C virus (HCV) infection. However, sofosbuvir use is not approved for patients with severe renal insufficiency (estimated glomerular filtration (eGFR) rate below 30 ml/min) or end-stage renal disease (ESRD) based on concerns raised during premarket animal testing over hepatobiliary and cardiovascular toxicity in this population. We report the first published data on use of sofosbuvir-based regimens in patients with severe renal insufficiency and ESRD, focusing on clinical efficacy and safety. Six patients were treated with full dose sofosbuvir; three received sofosbuvir and simeprevir, two received sofosbuvir and ribavirin, and one received sofosbuvir, ribavirin, and interferon. Three of the patients had cirrhosis. On-treatment viral suppression was 100% and sustained virological response (SVR) rate at 12 weeks was 67%. One patient had to discontinue antiviral therapy early due to side effects. No hepatobiliary or cardiovascular toxicity was reported.

  11. Liver Disorders in Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Victor Uko

    2012-01-01

    Full Text Available Disorders of the hepatobiliary system are relatively common extraintestinal manifestations of inflammatory bowel disease (IBD. These disorders are sometimes due to a shared pathogenesis with IBD as seen in primary sclerosing cholangitis (PSC and small-duct primary sclerosing cholangitis (small-duct PSC. There are also hepatobiliary manifestations such as cholelithiasis and portal vein thrombosis that occur due to the effects of chronic inflammation and the severity of bowel disease. Lastly, medications used in IBD such as sulfasalazine, thiopurines, and methotrexate can adversely affect the liver. It is important to be cognizant of these disorders as some do have serious long-term consequences. The management of these disorders often requires the expertise of multidisciplinary teams to achieve the best outcomes.

  12. Comparative evaluation of scintigraphy and upper gastrointestinal tract endoscopy for detection of duodenogastric reflux

    Energy Technology Data Exchange (ETDEWEB)

    Mittal, B.R.; Ibrarullah, Mohammad; Agarwal, D.K.; Maini, Atul; Ali, Wasif; Sikora, S.S.; Das, B.K. (Sanjay Gandhi Postgraduate Inst. of Medical Sciences (India))

    1994-08-01

    Duodenogastric reflux, the reflux of duodenal bile into stomach, when suspected clinically requires an objective evaluation for proper management. In this study hepatobiliary scintigraphy in 91 patients of different clinical conditions was evaluated for presence of duodenogastric reflux. Upper gastrointestinal endoscopy was also performed in 44 of these patients. On scintigraphy duodenogastric reflux was present in 26 (29%) of 91 patients. Upper gastrointestinal endoscopy revealed presence of refluxed bile in the stomach in 12 (27%) of 44 patients. In the same groups of patients scintigraphy detected reflux in 18 (41%) of 44 patients. This shows that hepatobiliary scintigraphy is superior to upper gastrointestinal endoscopy in detection of duodenogastric reflux and also has the advantage of being non-invasive and physiological. (author).

  13. Novel targets of miR-30, a microRNA required for biliary development [v1; ref status: indexed, http://f1000r.es/1so

    Directory of Open Access Journals (Sweden)

    Claire L. Le Guen

    2013-09-01

    Full Text Available MicroRNAs have been found to play a profound role in embryonic and post-natal development through their regulation of processes such as cell proliferation, differentiation, and morphogenesis. The microRNA-30 (miR-30 family is necessary for vertebrate hepatobiliary development; however, the mechanism through which miR-30 regulates these processes is not fully understood. Here, we identify genes directly regulated by miR-30 that have been characterized as key developmental factors. The targets were confirmed via a luciferase reporter assay, following exogenous over-expression of miR-30a and miR-30c2 in cultured cells. Five novel miR-30ac2 targets were identified using this approach, all of which play crucial roles in hepatobiliary development or are involved in hepatocellular carcinoma and cholangiocarcinoma.

  14. MRI Features of Hepatocellular Carcinoma Related to Biologic Behavior

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eun-Suk [Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720 (Korea, Republic of); Choi, Jin-Young [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of)

    2015-11-01

    Imaging studies including magnetic resonance imaging (MRI) play a crucial role in the diagnosis and staging of hepatocellular carcinoma (HCC). Several recent studies reveal a large number of MRI features related to the prognosis of HCC. In this review, we discuss various MRI features of HCC and their implications for the diagnosis and prognosis as imaging biomarkers. As a whole, the favorable MRI findings of HCC are small size, encapsulation, intralesional fat, high apparent diffusion coefficient (ADC) value, and smooth margins or hyperintensity on the hepatobiliary phase of gadoxetic acid-enhanced MRI. Unfavorable findings include large size, multifocality, low ADC value, non-smooth margins or hypointensity on hepatobiliary phase images. MRI findings are potential imaging biomarkers in patients with HCC.

  15. Extraintestinal manifestations of inflammatory bowel disease: epidemiology, diagnosis, and management

    DEFF Research Database (Denmark)

    Larsen, Signe; Bendtzen, Klaus; Nielsen, Ole Haagen

    2010-01-01

    , metabolic, dermatologic (mucocutaneous), ophthalmologic, hepatobiliary, hematologic, thromboembolic, urinary tract, pulmonary, and pancreatic extraintestinal manifestations related to IBD. Articles were identified through search of the PubMed and Embase databases, the Cochrane Library, and the web sites...... of the European Agency for the Evaluation of Medicinal Products (EMEA) and the US Food and Drug Administration (FDA) (cut-off date October 2009). The search terms 'Crohn's disease', 'inflammatory bowel disease', or 'ulcerative colitis' were combined with the terms 'adalimumab', 'anemia', 'arthritis...

  16. Biliary cryptococcosis in a child: MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Jyoti Das, Chandan; Hari, Smriti [All India Institute of Medical Science, Department of Radiology, New Delhi (India); Shyam Pangtey, Ghan [All India Institute of Medical Science, Department of Medicine, New Delhi (India); Hari, Pankaj [All India Institute of Medical Science, Department of Paediatrics, New Delhi (India); Kumar Das, Anup [All India Institute of Medical Science, Department of Pathology, New Delhi (India)

    2006-08-15

    Cryptococcosis is a systemic mycosis with a worldwide distribution. It frequently occurs in patients who are immunologically compromised or chronically ill. Clinical manifestations are usually confined to the central nervous system, lungs and skin. Involvement of the hepatobiliary system is very rare. We describe the MR imaging appearance of a rare case of disseminated cryptococcosis in an immunocompetent child in whom the clinical presentation was dominated by biliary and lymph nodal involvement. (orig.)

  17. Complications of the extrahepatic biliary surgery in companion animals.

    Science.gov (United States)

    Mehler, Stephen J

    2011-09-01

    Surgery of the biliary tract is demanding and is associated with several potentially life-threatening complications. Veterinarians face challenges in obtaining accurate diagnosis of biliary disease, surgical decision-making, surgical hemostasis and bile peritonitis. Intensive perioperative monitoring is required to achieve early recognition of common postoperative complications. Proper treatment and ideally, avoidance of surgical complications can be achieved by gaining a clear understanding physiology, anatomy, and the indications for hepatobiliary surgery.

  18. PERITONITIS DUE TO TRANSVERSE COLON PERFORATION: A RARE PRESENTATION

    Directory of Open Access Journals (Sweden)

    Vandana B.

    2015-08-01

    Full Text Available Abdominal tuberculosis is defined as infection of the peritoneum, hollow or solid abdominal organs with Mycobacterium tuberculi . TB can affect any part of the gastrointestinal (GI tract including anus, peritoneum and hepatobiliary system. The peritoneum and the ileocaecal region are the most likely sites of infection. The clinical manifestations of abdominal tuberculosis are nonspecific and mimic various GI disorders and cause delay in diagnosis and management. This pa thology has several complications, including free intestinal perforation.

  19. Bile duct hamar tomas-the von Meyenburg complex

    Institute of Scientific and Technical Information of China (English)

    Valdemir José Alegre Salles; Alexandre Marotta; Jorge Miguel Kather Netto; Manlio Basílio Speranzini; Marcos Roberto Martins

    2007-01-01

    Hamartomas of the bile duct (von Meyenburg complex) are benign neoplasms of the liver, constituted histologically cystic dilatations of the bile duct, encompassed by ifbrous stroma. We report a 42-year-old female patient with symptomatic cholecystitis, whose gross and ultrasonic appearance suggestive of multiple liver metastases. Magnetic resonance imaging and liver biopsy are the gold standards for diagnosis of this rare hepatobiliary condition.

  20. Fitz-Hugh-Curtis syndrome: abdominal pain in women of 26 years old Síndrome de Fitz-Hugh-Curtis: dolor abdominal en mujer de 26 años

    OpenAIRE

    Liseth Rivero-Sánchez; Elsa María López-Soriano; Luisa Guarner-Aguilar

    2011-01-01

    Fitz-Hugh-Curtis syndrome is an inflammation of the liver capsule as a complication of pelvic inflammatory disease, whose most common etiologic agent is the C. trachomatis. The acute phase of the Fitz-Hugh-Curtis syndrome may present itself with pain in right upper abdomen, commonly confused with other hepatobiliary and gastrointestinal tract diseases. Definitive diagnosis is now possible with non-invasive techniques such as ultrasound, computed tomography, as well as techniques to isolate th...

  1. The influence of a metal stent on the distribution of thermal energy during irreversible electroporation

    OpenAIRE

    Scheffer, Hester J.; Vogel, Jantien A.; Willemien van den Bos; Neal, Robert E; Krijn P. van Lienden; Besselink, Marc G.H.; van Gemert, Martin J. C.; van der Geld, Cees W. M.; Meijerink, Martijn R.; Klaessens, John H; Rudolf M Verdaasdonk

    2016-01-01

    Purpose Irreversible electroporation (IRE) uses short duration, high-voltage electrical pulses to induce cell death via nanoscale defects resulting from altered transmembrane potential. The technique is gaining interest for ablations in unresectable pancreatic and hepatobiliary cancer. Metal stents are often used for palliative biliary drainage in these patients, but are currently seen as an absolute contraindication for IRE due to the perceived risk of direct heating of the metal and its sur...

  2. The Opisthorchis viverrini genome provides insights into life in the bile duct

    OpenAIRE

    Neil D Young; Nagarajan, Niranjan; Lin, Suling Joyce; Korhonen, Pasi K.; Jex, Aaron R.; Ross S Hall; Safavi-Hemami, Helena; Kaewkong, Worasak; Bertrand, Denis; Gao, Song; Seet, Qihui; Wongkham, Sopit; Teh, Bin Tean; Wongkham, Chaisiri; Intapan, Pewpan Maleewong

    2014-01-01

    Opisthorchiasis is a neglected, tropical disease caused by the carcinogenic Asian liver fluke, Opisthorchis viverrini. This hepatobiliary disease is linked to malignant cancer (cholangiocarcinoma, CCA) and affects millions of people in Asia. No vaccine is available, and only one drug (praziquantel) is used against the parasite. Little is known about O. viverrini biology and the diseases that it causes. Here we characterize the draft genome (634.5 Mb) and transcriptomes of O. viverrini, elucid...

  3. EpCAM aptamer-functionalized polydopamine-coated mesoporous silica nanoparticles loaded with DM1 for targeted therapy in colorectal cancer

    OpenAIRE

    Li, Yang; Duo, Yanhong; Bao,Shiyun; He, Lisheng; Ling, Kai; Luo, Jinfeng; Zhang, Yue; Huang, Hao; Zhang,Han; Yu, Xiaofang

    2017-01-01

    Yang Li,1,* Yanhong Duo,2,3,* Shiyun Bao,1 Lisheng He,4 Kai Ling,5 Jinfeng Luo,4 Yue Zhang,1 Hao Huang,2 Han Zhang,2 Xiaofang Yu1 1Department of Hepatobiliary and Pancreas Surgery, Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, 2Shenzhen Engineering Laboratory of Phosphorene and Optoelectronics, Collaborative Innovation Center for Optoelectronic Science and Technology, Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education an...

  4. Acute pancreatitis due to ascariasis: a sonographic pictorial essay on four cases.

    Science.gov (United States)

    Lynser, Donboklang; Thangkhiew, R S; Laloo, Demitrost; Hek, M D; Marbaniang, Evarisalin; Tariang, Satisfy

    2016-06-01

    Ascariasis is the commonest helminthic disease to infect humans. Due to their wandering nature, the roundworms from the second part of the duodenum migrate through the biliary opening into the hepatobiliary and pancreatic ducts. Ascariasis is the most common parasitic cause of pancreatitis in endemic region. Pancreatitis can result due to pancreatic ascariasis, biliary ascariasis or both. Pancreatitis due to ascariasis can be severe and life-threatening. We present a pictorial essay of acute pancreatitis due to ascariasis on four cases.

  5. [Coincidental finding of biliary ascariasis].

    Science.gov (United States)

    Kristensen, Anders Donatsky; Achiam, Michael

    2010-04-19

    We describe a case of biliary ascariasis in a 27-year-old Philippine au-pair with recurrent upper abdominal pain. Hepatobiliary ascariasis is rarely seen in non-endemic areas. The diagnosis is important because severe complications can occur. If migrated into the biliary tree, it is recommended to perform endoscopic extraction combined with antihelmintic therapy. In severe cases, the recommendation is laparoscopic cholecystectomy and peroperative exploration of the common hepatic duct.

  6. Reverse cholesterol transport revisited

    Institute of Scientific and Technical Information of China (English)

    Astrid; E; van; der; Velde

    2010-01-01

    Reverse cholesterol transport was originally described as the high-density lipoprotein-mediated cholesterol flux from the periphery via the hepatobiliary tract to the intestinal lumen, leading to fecal excretion. Since the introduction of reverse cholesterol transport in the 1970s, this pathway has been intensively investigated. In this topic highlight, the classical reverse cholesterol transport concepts are discussed and the subject reverse cholesterol transport is revisited.

  7. From blood to gut: Direct secretion of cholesterol via transintestinal cholesterol efflux

    Institute of Scientific and Technical Information of China (English)

    Carlos; LJ; Vrins

    2010-01-01

    The reverse cholesterol transport pathway (RCT) is the focus of many cholesterol-lowering therapies. By way of this pathway, excess cholesterol is collected from peripheral tissues and delivered back to the liver and gastrointestinal tract for excretion from the body. For a long time this removal via the hepatobiliary secretion was considered to be the sole route involved in the RCT. However, observations from early studies in animals and humans already pointed towards the possibility of another route. In t...

  8. Targeting the hedgehog pathway for gallbladder cancer therapy?

    Science.gov (United States)

    Mittal, Balraj; Yadav, Saurabh

    2016-02-01

    Gallbladder carcinoma is a fatal malignancy of hepatobiliary tract that is generally diagnosed at advanced stages of cancer because of its asymptomatic nature. Advanced GBC tumors are unresectable with poor prognosis. Improvement in GBC patient care requires better understanding of the biological signaling pathways and application of newly discovered drugs for cancer therapy. Herein, we discuss the possibilities and challenges in targeting the hedgehog pathway in gallbladder cancer therapy based on recent developments in the area.

  9. Obstructive jaundice due to tuberculosis of distal CBD and periampullary region mimickcholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Sumantra Ray

    2012-01-01

    Full Text Available Abdominal tuberculosis (TB commonly affects the intestinal tract, lymph nodes, peritoneum, and solid organs in varying combinations. Hepatobiliary or pancreatic TB is rare and the preoperative diagnosis is difficult. Though rare, there have been a few citations of intrahepatic tuberculosis, but isolated bile duct tuberculosis is extremely rare. Here we report a case of obstructive jaundice which was initially thought to be due to lower-end cholangiocarcinoma but postoperatively it was found to be tuberculosis.

  10. Accessory hepatic lobe simulating a left hemidiaphragmatic tumor. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kuroiwa, Toshiro; Hirata, Hitoshi; Iwashita, Akinori; Yasumori, Kotaro; Mogami, Hiroshi; Teraoka, Hiroaki (Matsuyama Red Cross Hospital (Japan))

    1984-08-01

    A 72-year-old woman with a 20-year history of neuralgia was confirmed at surgery to have a tumor in the left hemidiaphragmatic region which was connected with the left lobe of the liver. Reassessment of radiological diagnosis after surgery revealed that hepatobiliary scintigraphy and computed tomography using left anterior oblique scanning are useful in differentiating the accessory hepatic lobe of the liver from a tumor and in confirming the diagnosis, respectively.

  11. [Hemobilia secondary to percutaneous hepatic biopsy. Report of a clinical case].

    Science.gov (United States)

    Vertemati, G; Russo, R; Semeraro, M V; Ballerini, A; Carzaniga, P L; Gatti, A

    1995-04-01

    The increasingly frequent use of invasive diagnostic and therapeutic procedures concerning the hepatobiliary system has led to a rise in the incidence of hemobilia as well as altering its etiological status. The authors report a clinical case of hemobilia secondary to percutaneous hepatic biopsy which was brought to their attention. This is followed by a short discussion of the etiopatogenesis and diagnostic and therapeutic strategies with special reference to the ratio between the advantages/limits of the methods now available.

  12. Fospropofol disodium injection for the sedation of patients undergoing colonoscopy

    OpenAIRE

    Levitzky, Benjamin E; Vargo, John J.

    2008-01-01

    Benjamin E Levitzky1, John J Vargo21Department of Gastroenterology and Hepatology, 2Section of Therapeutic and Hepatobiliary Endoscopy, Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio, USAAbstract: Sedation plays a central role in making colonoscopy tolerable for patients and feasible for the endoscopist to perform. The array of agents used for endoscopic sedation continues to evolve. Fospropofol (FP), a prodrug of propofol with a slower pharmacokin...

  13. Percutaneous liver biopsy.

    Science.gov (United States)

    Rustagi, Tarun; Newton, Eric; Kar, Premashish

    2010-01-01

    Percutaneous liver biopsy has been performed for more than 120 years, and remains an important diagnostic procedure for the management of hepatobiliary disorders. Modern biochemical, immunologic, and radiographic techniques have facilitated the diagnosis and management of liver diseases but have not made liver biopsy obsolete. This comprehensive review article will discuss the history of development of percutaneous liver biopsy, its indications, contraindications, complications and the various aspects of the biopsy procedure in detail.

  14. Diagnosis of clinically unsuspected gallbladder perforation in an obese patient, by Tc-99m IDA cholescintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Mesgarzadeh, M.; Haines, J.E.; Bobba, V.R.; Von Dollen, L.E.; Jarboe, G.; Krishnamurthy, G.T.

    1983-11-01

    A male Pickwickian syndrome patient was admitted to the hospital with sudden onset of abdominal pain. Physical examination was equivocal. Due to patient's ileus and morbid obesity (weight 450 lb), neither TCT scan nor ultrasound was possible. A Tc-99m PIPIDA hepatobiliary imaging study revealed intraperitoneal leakage of radioactive bile with collection of the activity in both abdominal gutters, indicating gallbladder rupture. Prompt surgery confirmed the diagnosis.

  15. Comparison of Dynamic and Liver-Specific Gadoxetic Acid Contrast-Enhanced MRI versus Apparent Diffusion Coefficients.

    Directory of Open Access Journals (Sweden)

    John N Morelli

    Full Text Available Hepatic lesions often present diagnostic connundrums with conventional MR techniques. Hepatobiliary phase contrast-enhanced imaging with gadoxetic acid can aid in the characterization of such lesions. However, quantitative measures describing late-phase enhancement must be assessed relative to their accuracy of hepatic lesion classification.To compare quantitative parameters in gadoxetic acid contrast-enhanced dynamic and hepatobiliary phase imaging versus apparent diffusion coefficients in hepatic lesion characterization.57 patients with focal hepatic lesions on gadoxetic acid MR were included. Lesion enhancement at standard post-contrast time points and in the hepatobiliary phase (HB; 15 and 25 minutes post-contrast was assessed via calculation of contrast (CR and enhancement ratios (ER. Apparent diffusion coefficient (ADC values were also obtained. Values for these parameters were compared among lesions and ROC analyses performed.HB enhancement was greatest with FNH and adenomas. HB ER parameters but not HB CR could distinguish HCC from benign entities (0.9 ER ROC AUC versus 0.5 CR ROC AUC. There was no statistically significant difference found between the 15 and 25 minutes HB time points in detection of any lesion (p>0.4. ADC values were statistically significantly higher with hemangiomas (p<0.05 without greater accuracy in lesion detection relative to HB phase parameters.Hepatobiliary phase gadoxetic acid contrast-enhanced MR characterizes focal hepatic lesions more accurately than ADC and conventional dynamic post-contrast time point enhancement parameters. ER values are generally superior to CR. No discernible benefit of 25 minute versus 15 minute delayed imaging is demonstrated.

  16. Liver and Biliary System

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    2011349 Expression of Raf kinase inhibitor protein and its significance in invasion and metastasis of hepatocellular carcinoma. WU Xiaohui(吴曉慧),et al.Dept Hepatobiliary Surg,4th Hosp,Hebei Med Univ,Shijiazhuang 050011.Abstract:Objective To investigate the expression of RKIP,p65 and pERK in hepatocellular carcinoma(HCC) and their correlation with invasion

  17. Phenolic profile of wild Achillea millefolium L. obtained by HPLC-DADESI/MS.

    OpenAIRE

    Dias, Maria Inês; Barros, Lillian; Dueñas, Montserrat; Carvalho, Ana Maria; Oliveira, M.B.P.P.; Santos-Buelga, Celestino; FERREIRA, ISABEL C.F.R.

    2013-01-01

    Achillea millefolium L., commonly known as yarrow, belongs to Asteraceae family and it is very common in mountain meadows, pathways, crop fields and homegardens. It is widely used in Europe as an herbal remedy to treat digestive problems, diabetes, hepato-biliary diseases and amenorrhea, being also consumed for its antitumor, antimicrobial, anti-inflammatory and antioxidant properties [1,2]. Some studies related A. millefolium medicinal properties to the presence of phenolic compo...

  18. Associated factors for a hyperechogenic pancreas on endoscopic ultrasound

    Institute of Scientific and Technical Information of China (English)

    Cheol; Woong; Choi; Gwang; Ha; Kim; Dae; Hwan; Kang; Hyung; Wook; Kim; Dong; Uk; Kim; Jeong; Heo; Geun; Am; Song; Do; Youn; Park; Suk; Kim

    2010-01-01

    AIM: To identify the associated risk factors for hyperechogenic pancreas (HP) which may be observed on endoscopic ultrasound (EUS) and to assess the relationship between HP and obesity. METHODS: From January 2007 to December 2007, we prospectively enrolled 524 consecutive adults who were scheduled to undergo EUS. Patients with a history of pancreatic disease or with hepatobiliary or advanced gastrointestinal cancer were excluded. Finally,284 patients were included in the analyses. We further analyzed the ri...

  19. Cryotherapy for hepatocellular carcinoma

    DEFF Research Database (Denmark)

    Awad, Tahany; Thorlund, Kristian; Gluud, Christian

    2009-01-01

    for the treatment of hepatocellular carcinoma. SEARCH STRATEGY: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and LILACS until June 2009. We identified further studies by searching...... national and topic-specific databases, bibliographies, conference abstracts, journals, and grey literature. Furthermore, we reviewed the reference lists and contacted the principal authors of the identified studies. SELECTION CRITERIA: Randomised clinical trials (irrespective of language or publication...

  20. Prevalensi Obesitas pada Anak Sekolah Dasar Negeri 060888 Medan Tahun 2015

    OpenAIRE

    Hartanto

    2016-01-01

    Introduction: Obesity and overweight is a metabolic disease which cause an excessive storage of body fat. Obesity seems increasingly found in children not only from the developed country, but also in children from developing country. Children with BMI percentile (P) ≥ 95 are classified as obesity. Obesity in children seems to be the risk factor of cardiovascular, endocrine, respiratory, ortophaedic, dan hepatobiliary system. Methods: The method used in this study is descriptive based study...

  1. Radioimmunoassay in the evaluation of pancreatic function in chronic pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Zubovskij, G.A.; Vasil' chenko, S.A. (Nauchno-Issledovatel' skij Inst. Rentgenologii i Radiologii, Moscow (USSR))

    1983-12-01

    Insular apparatus function in primary chronic and reactive pancreatitis associated with hepatobiliary pathology was studied in 178 patients by radioimmunoassay. Typical changes of insulin and C-peptide concentration in the presence of an intravenous glucose tolerance test are shown that make it possible to differentiate in combination with the trypsin concentration in the serum primary and reactive pancreatitis as well as exacerbation and remission stages of the disease.

  2. Septic liver - Clinical relevance of early inhomogeneous enhancement of the liver in patients with acute pyelonephritis

    Energy Technology Data Exchange (ETDEWEB)

    Han, Ga Jin; Lee, Nam Kyung; Kim, Suk [Dept. of Radiology, Biomedical Research Inst., Pusan National Univ. Hospital, Pusan National Univ. School of Medicine, Busan (Korea, Republic of)], e-mail: kimsuk@medimail.co.kr; Kim, Tae Un [Dept. of Radiology, Pusan National Univ. Yangsan Hospital, Pusan National Univ. School of Medicine, Yangsan (Korea, Republic of); Song, Sang Heon [Dept. of Internal Medicine, Biomedical Research Inst., Pusan National Univ. Hospital, Pusan National Univ. School of Medicine, Busan (Korea, Republic of); Kim, Hyun Sung; Jo, Hong Jae [Dept. of Surgery, Biomedical Research Inst., Pusan National Univ. Hospital, Pusan National Univ. School of Medicine, Busan (Korea, Republic of)

    2013-10-15

    Background: CT scans of patients with febrile illness occasionally show hepatobiliary changes, although infection does not originate in the hepatobiliary system. These findings may cause radiologists and clinicians to misrecognize hepatobiliary diseases and initiate an inappropriate treatment. Thus, it is important to recognize hepatobiliary CT findings in cases of extrahepatobiliary infectious disease. Purpose: To evaluate extrarenal CT manifestations in patients with acute pyelonephritis and to determine the correlation between these extrarenal CT findings and septic liver based on laboratory parameters of sepsis. Material and Methods: This study included 157 retrospectively identified patients with confirmed acute pyelonephritis based on CT imaging and urine test, and who had also undergone multi-phase dynamic contrast-enhanced CT scan. Two radiologists reviewed CT findings including early inhomogeneous enhancement of the liver, periportal low density and gallbladder edema, which were correlated with laboratory data including liver function enzymes, albumin, C-reactive protein, white blood cell count, and results of a blood culture by using the Fisher's exact test and Mann-Whitney U test. Results: Forty-six patients (29.3%) showed early inhomogeneous enhancement of the liver, which was associated with increased C-reactive protein (P < 0.001), a positive blood culture (P < 0.005), and decreased albumin level (P < 0.002). The periportal low density and gallbladder wall edema were noted in 15 patients (9.6%) and six patients (3.8%), respectively. These two CT findings were significantly associated with only decreased albumin level (P < 0.001 and P < 0.040). Conclusion: Early inhomogeneous enhancement of the liver in patients with acute pyelonephritis was significantly associated with increased CRP level, a positive blood culture and decreased albumin level, reflecting sepsis and sepsis-associated liver dysfunction, requiring rapid and appropriate intensive

  3. Does general surgery residency prepare surgeons for community practice in British Columbia?

    Science.gov (United States)

    Hwang, Hamish

    2009-06-01

    Preparing surgeons for clinical practice is a challenging task for postgraduate training programs across Canada. The purpose of this study was to examine whether a single surgeon entering practice was adequately prepared by comparing the type and volume of surgical procedures experienced in the last 3 years of training with that in the first year of clinical practice. During the last 3 years of general surgery training, I logged all procedures. In practice, the Medical Services Plan (MSP) of British Columbia tracks all procedures. Using MSP remittance reports, I compiled the procedures performed in my first year of practice. I totaled the number of procedures and broke them down into categories (general, colorectal, laparoscopic, endoscopic, hepatobiliary, oncologic, pediatric, thoracic, vascular and other). I then compared residency training with community practice. I logged a total of 1170 procedures in the last 3 years of residency. Of these, 452 were performed during community rotations. The procedures during residency could be broken down as follows: 392 general, 18 colorectal, 242 laparoscopic, 103 endoscopic, 85 hepatobiliary, 142 oncologic, 1 pediatric, 78 thoracic, 92 vascular and 17 other. I performed a total of 1440 procedures in the first year of practice. In practice the break down was 398 general, 15 colorectal, 101 laparoscopic, 654 endoscopic, 2 hepatobiliary, 77 oncologic, 10 pediatric, 0 thoracic, 70 vascular and 113 other. On the whole, residency provided excellent preparation for clinical practice based on my experience. Areas of potential improvement included endoscopy, pediatric surgery and "other," which comprised mostly hand surgery.

  4. Isolation, characterization and clinical evaluation of the gamma-glutamyltransferase associated with hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Izumi,Masaki

    1985-02-01

    Full Text Available Sera from 24 patients with hepatocellular carcinoma (HCC, 30 patients with hepatobiliary diseases other than HCC and 5 normal subjects were analyzed for gamma-glutamyltransferase (GGT isozymes. In ultracentrifugation, GGT I' was recovered in the non-lipoprotein fraction (the residue, together with GGTs I'', II', I and X. GGTs III to IX were recovered in lipoprotein fractions. GGTs in the lipoprotein fractions were removed beforehand by Affi-Gel Blue chromatography, leaving GGTs I', I'', II', I and X in the non-bound fraction, which was subjected to Con A-Sepharose chromatography. From the double affinity chromatography (DAC, GGTs I' and II' were recovered in the unbound fraction, and GGTs I, I'', II' and X in the bound fraction. GGT activities in the unbound fractions of sera from HCC patients were generally higher than those from patients with other benign hepatobiliary diseases. When the GGT activity of the unbound fractions in DAC was expressed as a percent of the sum of the unbound and bound activities (U/(U + B and 22% was set as the lower limit of positive values, 54% of the HCC cases had positive values, while none of the patients with hepatobiliary diseases other than HCC had positive values. The U/(U + B ratio of GGT in DAC appears to be a clinically useful test for screening HCC.

  5. Liver scintigraphy in veterinary medicine.

    Science.gov (United States)

    Morandi, Federica

    2014-01-01

    The most common veterinary application of liver scintigraphy is for the diagnosis of portosystemic shunts (PSSs). There has been a continual evolution of nuclear medicine techniques for diagnosis of PSS, starting in the early 1980s. Currently, transplenic portal scintigraphy using pertechnetate or (99m)Tc-mebrofenin is the technique of choice. This technique provides both anatomical and functional information about the nature of the PSS, with high sensitivity and specificity. Hepatobiliary scintigraphy has also been used in veterinary medicine for the evaluation of liver function and biliary patency. Hepatobiliary scintigraphy provides information about biliary patency that complements finding in ultrasound, which may not be able to differentiate between biliary ductal dilation from previous obstruction vs current obstruction. Hepatocellular function can also be determined by deconvolutional analysis of hepatic uptake or by measuring the clearance of the radiopharmaceutical from the plasma. Plasma clearance of the radiopharmaceutical can be directly measured from serial plasma samples, as in the horse, or by measuring changes in cardiac blood pool activity by region of interest analysis of images. The objective of this paper is to present a summary of the reported applications of hepatobiliary scintigraphy in veterinary medicine.

  6. Gd-EOB-DTPA enhanced MRI of the liver: Correlation of relative hepatic enhancement, relative renal enhancement, and liver to kidneys enhancement ratio with serum hepatic enzyme levels and eGFR

    Energy Technology Data Exchange (ETDEWEB)

    Talakic, Emina; Steiner, Jürgen; Kalmar, Peter; Lutfi, Andre [Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Quehenberger, Franz [Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036 Graz (Austria); Reiter, Ursula; Fuchsjäger, Michael [Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Schöllnast, Helmut, E-mail: helmut.schoellnast@medunigraz.at [Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036 Graz (Austria)

    2014-04-15

    Objectives: To assess the correlation of relative hepatic enhancement (RHE), relative renal enhancement (RRE) and liver to kidneys enhancement ratio (LKR) with serum hepatic enzyme levels and eGFR in Gd-EOB-DTPA enhanced MRI of the liver and to assess threshold levels for predicting enhancement of the liver parenchyma. Methods: Data of 75 patients who underwent Gd-EOB-DTPA enhanced MRI of the liver were collected. Images were obtained before contrast injection, during the early arterial phase, late arterial phase, venous phase, delayed phase, and hepatobiliary phase which was 20 min after Gd-EOB-DTPA administration. Signal intensity of the liver and the kidneys in all phases was defined using region-of-interest measurements for relative enhancement calculation. Serum hepatic enzyme levels and eGFR were available in all patients. Spearman correlation test was used to test the correlation of RHE, RRE and LKR with serum hepatic enzyme levels and eGFR. Results: In the hepatobiliary phase all serum hepatic enzymes were significantly correlated with RHE; total bilirubin (TBIL) and cholin esterase (CHE) showed strongest correlations. TBIL and CHE were significantly correlated with RRE in the arterial phases. TBIL and CHE were significantly correlated with LKR in the arterial phase and hepatobiliary phase. eGFR showed no correlation. Conclusions: In Gd-EOB-DTPA enhanced MRI, TBIL and CHE levels may predict RHE, RRE and LKR.

  7. Gadoxetic acid enhanced MRI for differentiation of FNH and HCA: a single centre experience

    Energy Technology Data Exchange (ETDEWEB)

    Grieser, Christian; Steffen, Ingo G.; Perez Fernandez, Carmen Maria; Hamm, Bernd; Denecke, Timm [Klinik fuer Radiologie, Campus Virchow-Klinikum, Charite - Universitaetsmedizin Berlin, Berlin (Germany); Kramme, Incken-Birthe; Blaeker, Hendrik; Kilic, Ergin [Institut fuer Pathologie, Campus Virchow-Klinikum, Charite - Universitaetsmedizin Berlin, Berlin (Germany); Seehofer, Daniel [Klinik fuer Allgemein, Viszeral- und Transplantationschirurgie, Campus Virchow-Klinikum, Charite - Universitaetsmedizin Berlin, Berlin (Germany); Schott, Eckart [Medizinische Klinik m.S. Hepatologie und Gastroenterologie, Campus Virchow-Klinikum, Charite - Universitaetsmedizin Berlin, Berlin (Germany)

    2014-06-15

    Evaluation of enhancement characteristics of histopathologically confirmed focal nodular hyperplasias (FNHs) and hepatocellular adenomas (HCAs) with gadoxetic acid-enhanced MRI. Sixty-eight patients with 115 histopathologically proven lesions (FNHs, n = 44; HCAs, n = 71) examined with gadoxetic acid-enhanced MRI were retrospectively enrolled (standard of reference: surgical resection, n = 53 patients (lesions: FNHs, n = 37; HCAs, n = 53); biopsy, n = 15 (lesions: FNHs, n = 7; HCAs, n = 18)). Two radiologists evaluated all MR images regarding morphological features as well as the vascular and hepatocyte-specific enhancement in consensus. For the hepatobiliary phase, relative enhancement of the lesions and lesion to liver enhancement were significantly lower for HCAs (mean, 48.7 (±48.4) % and 49.4 (±33.9) %) compared to FNHs (159.3 (±92.5) %; and 151.7 (±79) %; accuracy of 89 % and 90 %, respectively; P < 0.001). Visual strong uptake of FNHs vs. hypointensity of HCAs in the hepatobiliary phase resulted in an accuracy of 92 %. This parameter was superior to all other morphological and dynamic vascular criteria alone and in combination (accuracy, 54-85 %). For differentiation of FNHs and HCAs by means of MRI, gadoxetic acid uptake in the hepatobiliary phase was found to be superior to all other criteria alone and in combination. (orig.)

  8. Contrast-Enhanced Magnetic Resonance Cholangiography: Practical Tips and Clinical Indications for Biliary Disease Management.

    Science.gov (United States)

    Palmucci, Stefano; Roccasalva, Federica; Piccoli, Marina; Fuccio Sanzà, Giovanni; Foti, Pietro Valerio; Ragozzino, Alfonso; Milone, Pietro; Ettorre, Giovanni Carlo

    2017-01-01

    Since its introduction, MRCP has been improved over the years due to the introduction of several technical advances and innovations. It consists of a noninvasive method for biliary tree representation, based on heavily T2-weighted images. Conventionally, its protocol includes two-dimensional single-shot fast spin-echo images, acquired with thin sections or with multiple thick slabs. In recent years, three-dimensional T2-weighted fast-recovery fast spin-echo images have been added to the conventional protocol, increasing the possibility of biliary anatomy demonstration and leading to a significant benefit over conventional 2D imaging. A significant innovation has been reached with the introduction of hepatobiliary contrasts, represented by gadoxetic acid and gadobenate dimeglumine: they are excreted into the bile canaliculi, allowing the opacification of the biliary tree. Recently, 3D interpolated T1-weighted spoiled gradient echo images have been proposed for the evaluation of the biliary tree, obtaining images after hepatobiliary contrast agent administration. Thus, the acquisition of these excretory phases improves the diagnostic capability of conventional MRCP-based on T2 acquisitions. In this paper, technical features of contrast-enhanced magnetic resonance cholangiography are briefly discussed; main diagnostic tips of hepatobiliary phase are showed, emphasizing the benefit of enhanced cholangiography in comparison with conventional MRCP.

  9. Quantitative targeted bile acid profiling as new markers for DILI in a model of methapyrilene-induced liver injury in rats.

    Science.gov (United States)

    Slopianka, Markus; Herrmann, Anne; Pavkovic, Mira; Ellinger-Ziegelbauer, Heidrun; Ernst, Rainer; Mally, Angela; Keck, Matthias; Riefke, Bjoern

    2017-07-01

    Recently, bile acids (BAs) were reported as promising markers for drug-induced liver injury (DILI). BAs have been suggested to correlate with hepatocellular and hepatobiliary damage; however a clear connection of BA patterns with different types of DILI remains to be established. To investigate if BAs can improve the assessment of liver injury, 20 specific BAs were quantitatively profiled via LC-MS/MS in plasma and liver tissue in a model of methapyrilene-induced liver injury in rats. Methapyrilene, a known hepatotoxin was dosed daily over 14-days at doses of 30 and 80mg/kg, followed by a recovery phase of 10days. Conventional preclinical safety endpoints were related to BA perturbations and to hepatic gene expression profiling for a mechanistic interpretation of effects. Histopathological signs of hepatocellular and hepatobiliary damage with significant changes of clinical chemistry markers were accompanied by significantly increased levels of indivdual BAs in plasma and liver tissue. BA perturbations were already evident at the earliest time point after 30mg/kg treatment, and thereby indicating better sensitivity than clinical chemistry parameters. Furthermore, the latter markers suggested recovery of liver injury, whereas BA levels in plasma and liver remained significantly elevated during the recovery phase, in line with persistent histopathological findings of bile duct hyperplasia (BDH) and bile pigment deposition. Gene expression profiling revealed downregulation of genes involved in BA synthesis (AMACR, BAAT, ACOX2) and hepatocellular uptake (NTCP, OATs), and upregulation for efflux transporters (MRP2, MRP4), suggesting an adaptive hepatocellular protection mechanism against cytotoxic bile acid accumulation. In summary, our data suggests that specific BAs with high reliability such as cholic acid (CA) and chenodeoxycholic acid (CDCA) followed by glycocholic acid (GCA), taurocholic acid (TCA) and deoxycholic acid (DCA) can serve as additional biomarkers for

  10. Clinical study of distribution and drug resistance of pathogens in patients with severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    SU Mao-sheng; LIN Mao-hu; ZHAO Qing-hua; LIU Zhi-wei; HE Lei; JIA Ning

    2012-01-01

    Background Previous researches about necrotic pancreatic tissue infections are numerous,but the study on systemic infection related to the severe acute pancreatitis (SAP) treatment period is limited.This study aimed to investigate the distribution and drug resistance of pathogenic bacteria in patients who had hepatobiliary surgery for SAP during the past three years.Methods A retrospective study was conducted on the distribution,category and drug resistance of pathogenic bacteria in patients who had hepatobiliary surgery for SAP from 2008 to 2011.Results A total of 594 pathogenic bacteria samples were isolated.Among them 418 isolates (70.4%) were Gram bacteria negative,142 isolates (23.9%) were Gram bacteria positive,and 34 isolates (5.7%) were found fungi.The most common Gram negative bacteria were Escherichia coli (19.8%),and the dominant Gram positive pathogenic bacteria were Enterococcus faecium.The distribution of SAP-related infectious pathogens was mainly in peritoneal drainage fluid,sputum,bile,and wound secretions.Almost all the Gram negative pathogenic bacteria were sensitive to carbapenum.Extended-spectrum β-lactamases (ESBLs) producing strains were more resistant to penicillins and cephalosprins than the ESBLs non-producing strains.Staphylococcus was sensitive to vancomycin and linezolid.The drug resistance of meticillin-resistant staphylococcus (MRS) to commonly used antibiotics was higher than meticillin-sensitive streptococcus (MSS).Enterococcus sp.exhibited lower drug-resistance rates to vancomycin and linezolid.Conclusions Gram negative bacteria were the dominant SAP-related infection after hepatobiliary surgery.A high number of fungal infections were reported.Drug resistant rates were high.Rational use of antibiotics according to the site of infection,bacterial species and drug sensitivity,correctly executing the course of treatment and enhancing hand washing will contribute to therapy and prevention of SAP-related infection and decrease

  11. The EASTR Study: indications for transfusion and estimates of transfusion recipient numbers in hospitals supplied by the National Blood Service.

    Science.gov (United States)

    Wells, A W; Llewelyn, C A; Casbard, A; Johnson, A J; Amin, M; Ballard, S; Buck, J; Malfroy, M; Murphy, M F; Williamson, L M

    2009-12-01

    This study provides data on National Blood Service (NBS) red blood cell (RBC, n = 9142), platelet (PLT, n = 4232) and fresh frozen plasma (FFP, n = 3584) recipients independently sampled by monthly quota from 29 representative hospitals over 12 months in 2001-2002. Hospitals were stratified by size according to total yearly RBC issues. Transfusion indications were chosen from diagnostic and procedural codes, and recipients grouped into Epidemiology and Survival of Transfusion Recipients Case-mix Groups (E-CMGs). The main E-CMGs were digestive [19% of RBC recipients; including 5% gastrointestinal (GI) bleeds and 3% colorectal surgery], musculoskeletal (15%; 12% hip and knee replacement), haematology (13%) and obstetrics and gynaecology (10%). Renal failure, fractured neck of femur, cardiac artery by-pass grafting (CABG) and paediatrics, each accounted for 3-4% recipients. FFP recipients: the main E-CMGs were digestive (21% of FFP recipients; including 7% GI bleeds and 3% colorectal surgery), hepatobiliary (15%; 7% liver disease and 2% liver transplant), cardiac (12%) and paediatrics (9%) The renal, paediatrics, vascular and haematology E-CMGs each had 6-7% of recipients. PLT recipients: the main E-CMGs were haematology (27% of PLT recipients; including 9% lymphoma and 8% acute leukaemia), cardiac (17%), paediatrics (13%), hepatobiliary (10%) and digestive (9%). Back-weighting gave national estimates of 433 000 RBC, 57 500 FFP and 41 500 PLT recipients/year in England and North Wales, median age 69, 64 and 59 years, respectively. Digestive and hepatobiliary indications emerged as the top reason for transfusion in RBC and FFP recipients, and was also a frequent indication in PLT recipients.

  12. Biliary tract infections caused by Aeromonas species.

    Science.gov (United States)

    Chao, C M; Lai, C C; Tang, H J; Ko, W C; Hsueh, P-R

    2013-02-01

    This study investigated the clinical and microbiological characteristics of patients with Aeromonas infections of the biliary tract. Patients with bile cultures positive for Aeromonas species during the period July 2004 to December 2011 were identified from a computerized database of a hospital in Taiwan. Patients with Aeromonas infections of the biliary tract were further identified. During the study period, a total of 1,142 isolates of Aeromonas species were obtained from 750 patients. Of those patients, 91 (12.1 %) had Aeromonas infections of the biliary tract. The annual incidence (episodes per 10,000 patient-days) of biliary tract infections caused by all Aeromonas species was 0.31 in 2007, 0.12 in 2010, and 0.27 in 2011. A. hydrophila was the most common species isolated (n = 41, 45.1 %), followed by A. caviae (n = 30, 33.0 %), A. veronii biovar sobria (n = 15, 16.5 %), and A. veronii biovar veronii (n = 5, 5.5 %). The majority of patients (n = 77, 84.6 %) had polymicrobial infections. Hepatobiliary stones (n = 50, 54.9 %) and hepatobiliary cancer (n = 38, 41.8 %) were the most common underlying diseases, followed by diabetes mellitus (n = 29, 31.9 %) and liver cirrhosis (n = 7, 7.7 %). The in-hospital mortality rate was 8.8 %. Infection-related mortality was associated with underlying immunocompromised condition (p = 0.044) and use of mechanical ventilation (p = 0.004), but was not associated with inappropriate antibiotic usage or concomitant bacteremia (n = 8, 8.8 %). In conclusion, biliary tract infections caused by Aeromonas species are not uncommon and can develop in both immunocompromised and immunocompetent patients; however, patients with underlying hepatobiliary diseases are particularly susceptible to these infections.

  13. Does general surgery residency prepare surgeons for community practice in British Columbia?

    Science.gov (United States)

    Hwang, Hamish

    2009-01-01

    Background Preparing surgeons for clinical practice is a challenging task for postgraduate training programs across Canada. The purpose of this study was to examine whether a single surgeon entering practice was adequately prepared by comparing the type and volume of surgical procedures experienced in the last 3 years of training with that in the first year of clinical practice. Methods During the last 3 years of general surgery training, I logged all procedures. In practice, the Medical Services Plan (MSP) of British Columbia tracks all procedures. Using MSP remittance reports, I compiled the procedures performed in my first year of practice. I totaled the number of procedures and broke them down into categories (general, colorectal, laparoscopic, endoscopic, hepatobiliary, oncologic, pediatric, thoracic, vascular and other). I then compared residency training with community practice. Results I logged a total of 1170 procedures in the last 3 years of residency. Of these, 452 were performed during community rotations. The procedures during residency could be broken down as follows: 392 general, 18 colorectal, 242 laparoscopic, 103 endoscopic, 85 hepatobiliary, 142 oncologic, 1 pediatric, 78 thoracic, 92 vascular and 17 other. I performed a total of 1440 procedures in the first year of practice. In practice the break down was 398 general, 15 colorectal, 101 laparoscopic, 654 endoscopic, 2 hepatobiliary, 77 oncologic, 10 pediatric, 0 thoracic, 70 vascular and 113 other. Conclusion On the whole, residency provided excellent preparation for clinical practice based on my experience. Areas of potential improvement included endoscopy, pediatric surgery and “other,” which comprised mostly hand surgery. PMID:19503663

  14. Sclerosing cholangitis: cholescintigraphy with Tc-99m-labeled DISIDA

    Energy Technology Data Exchange (ETDEWEB)

    Ament, A.E.; Bick, R.J.; Miraldi, F.D.; Haaga, J.R.; Wiedenmann, S.D.

    1984-04-01

    Four patients with primary sclerosing cholangitis (PCS) were examined with the hepatobiliary agent Tc-99m-labeled DISIDA (diisopropylphenylcarbamoyl iminodiacetic acid), and the results correlated with those of invasive cholangiography. Cholescintigraphy is superior to cholangiography in cases of suspected PSC where there is nonfilling of biliary radicals due to high-grade stenosis. The finding of delayed hepatic parenchymal clearance can allow estimation of the degree of obstruction of the various branches of the major bile ducts. Cholescintigraphy offers a noninvasive method of investigating patients with suspected sclerosing chloangitis, leading to earlier diagnosis. Confirmation with invasive cholangiographic procedures is recommended.

  15. Cancer Risk and Surveillance in Primary Sclerosing Cholangitis.

    Science.gov (United States)

    Folseraas, Trine; Boberg, Kirsten Muri

    2016-02-01

    Primary sclerosing cholangitis (PSC) is a chronic, progressive disease characterized by inflammatory and fibrosing strictures of the biliary tree. PSC is associated with a high lifetime risk of hepatobiliary and colorectal cancers. The nature of the carcinogenic process in PSC is not well established. The lack of diagnostic methods for early detection and the limited therapeutic options for cholangiocarcinoma constitute a major challenge in the current handling of PSC patients. The article reviews the risk for cancer development in PSC and discusses surveillance strategies for PSC-associated cancers.

  16. El enfoque del paciente ictérico

    Directory of Open Access Journals (Sweden)

    Luis D Quesada

    2005-01-01

    Full Text Available Se presenta una revisión actualizada del metabolismo de la bilirrubina, las causas de la hiperbilirrubenemia, la clasificación implícita de las mismas y el abordaje del paciente con enfermedad hepatobiliar e ictericia según se maneja en nuestro medio en forma óptima de acuerdo a los recursos disponibles.We present an up-to-date review article on the metabolism of bilirrubin, the causes of hiperbilirrubinemia, a classification of these and the management of patients with hepatobiliary disease and jaundice, according to the guidelines we apply optimizing our resources in our hospital.

  17. Steerable real-time sonographically guided needle biopsy.

    Science.gov (United States)

    Buonocore, E; Skipper, G J

    1981-02-01

    A method for dynamic real-time ultrasonic guidance for percutaneous needle biopsy has been successful in obtaining cytologic and histologic specimens from abdominal masses. The system depends on a real-time ultrasonic transducer that has been rigidly attached to a laterally placed steerable needle holder. Using simple trigonometric functions, a chart has been derived that gives the exact angulation and needle length to produce quick, reliable, guided needle placements. Examples of successful renal, hepatobiliary, and retroperitoneal biopsies are presented. Advantages of this technique include speed, accuracy, low cost, three-dimensional format, and the omission of contrast media and radiation.

  18. An unusual case of fever and abdominal pain

    Directory of Open Access Journals (Sweden)

    Arundhati G Diwan

    2012-01-01

    Full Text Available Ascariasis is one of the commonest parasitic infestations in tropical countries. Main symptoms are pain in abdomen, weight loss, diarrhea and passage of worms in stool. If acute, it may present as intestinal obstruction, perforation, cholangitis, appendicitis and pancreatitis. The incidence of hepato-biliary ascariasis is probably underestimated. We report a case which presented to us with fever, abdominal pain and weight loss of a month′s duration, mimicking abdominal tuberculosis. On investigations, patient was found to have ascariasis of gall bladder, terminal ileum, caecum and appendix, causing simultaneous inflammation of all these structures.

  19. [Importance of preoperative and intraoperative imaging for operative strategies].

    Science.gov (United States)

    Nitschke, P; Bork, U; Plodeck, V; Podlesek, D; Sobottka, S B; Schackert, G; Weitz, J; Kirsch, M

    2016-03-01

    Recent advances in preoperative and postoperative imaging have an increasing influence on surgical decision-making and make more complex surgical interventions possible. This improves the possibilities for frequently occurring challenges and promoting improved functional and oncological outcome. This manuscript reviews the role of preoperative and intraoperative imaging in surgery. Various techniques are explained based on examples from hepatobiliary surgery and neurosurgery, in particular real-time procedures, such as the online use of augmented reality and in vivo fluorescence, as well as new and promising optical techniques including imaging of intrinsic signals and vibrational spectroscopy.

  20. Troubleshooting arterial-phase MR images of gadoxetate disodium-enhanced liver

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Ji Mi; Kim, So Yeon; Lee, Seung Soo; Kim, Kyoung Won [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Yeh, Benjamin M.; Wang, Z. Jane [Dept. of Radiologyand Biomedical Imaging, University of California San Francisco, San Francisco (United States); Wu, En Haw [Dept. of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University College of Medicine, Taoyuan (China); Zhao, Li Qin [Beijing Friendship Hospital, Capital Medical University, Beijing (China); Chang, Wei Chou [Tri-Service General Hospital and National Defense Medical Center, Taipei (China)

    2015-12-15

    Gadoxetate disodium is a widely used magnetic resonance (MR) contrast agent for liver MR imaging, and it provides both dynamic and hepatobiliary phase images. However, acquiring optimal arterial phase images at liver MR using gadoxetate disodium is more challenging than using conventional extracellular MR contrast agent because of the small volume administered, the gadolinium content of the agent, and the common occurrence of transient severe motion. In this article, we identify the challenges in obtaining high-quality arterial-phase images of gadoxetate disodium-enhanced liver MR imaging and present strategies for optimizing arterial-phase imaging based on the thorough review of recent research in this field.

  1. Etiological and clinicopathologic characteristics of intrahepatic cholangiocarcinoma in young patients

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To investigate the prevalence,risk factors,and clinicopathologic characteristics of intrahepatic cholangiocarcinoma(ICC)in young patients.METHODS:A retrospective analysis was performed in ICC patients referred to the Eastern Hepatobiliary Surgery Hospital in Shanghai,China.Among 317 consecutively enrolled patients,40 patients were aged ≤40 years(12.61%).We compared the risk factors and clinicopathologic characteristics of these patients(groupⅠ:n=40)with those aged>40 years(group Ⅱ:n=277).RESULTS:Group I...

  2. [Development of vibration-induced intrahepatic cholestasis in pilots and new ways of correcting these disorders].

    Science.gov (United States)

    Preobrazhenskiĭ, V N; Vasilenko, V V; Taianovskiĭ, V Iu

    1999-01-01

    Data of analysis of the role of vibration in the development of hepatobiliary pathology in helicopter pilots are reported. Vibration was found to drastically deteriorate colloid-osmotic qualities of the bile and increase the lithogenesis risk. Exposure to vibration over 10 and more years of the flying career may instigate cholelithiasis. Dynamic USI with functional testing for early diagnostics and correction with ursodeoxycholic acid (ursosan) of disorders in the colloid-osmotic properties of the bile and can be proposed as one of the methods to prevent cholelithiasis.

  3. Opisthorchiasis in Thailand: Review and current status

    Institute of Scientific and Technical Information of China (English)

    Natthawut Kaewpitoon; Soraya J Kaewpitoon; Prasit Pengsaa

    2008-01-01

    Opisthorchiasis caused by Opisthorchis viverrini (O.viverrini)remains a major public health problem in many parts of Southeast Asia including Thailand, Lao PDR,Vietnam and Cambodia. The infection is associated with a number of hepatobiliary diseases, including cholangitis,obstructive jaundice, hepatornegaly, cholecystitis, cholelithiasis and cholangiocarcinoma. The liver fluke infection was induced by eating raw or uncooked fish products that is the tradition and popular in the northeastern and northern region, particularly in rural areas of Thailand.Health education programs to prevent and control opisthorchiasis are still required in high-risk areas.

  4. Rings in the neonate.

    LENUS (Irish Health Repository)

    Hackett, C B

    2011-02-01

    Neonatal lupus erythematosus (NLE) is an uncommon disease of the neonate. It is believed to be caused by the transplacental passage of maternal autoantibodies to the ribonucleoproteins (Ro\\/SSA, La\\/SSB or rarely U RNP) as these are almost invariably present in NLE sera. The most common clinical manifestations include cutaneous lupus lesions and congenital complete heart block. Hepatobiliary and haematologic abnormalities are reported less frequently. We describe a patient with cutaneous NLE to illustrate and raise awareness of the characteristic annular eruption of this condition. We also emphasize the need for thorough investigation for concomitant organ involvement and for maternal education regarding risk in future pregnancies.

  5. Diagnosis und differential diagnosis of focal liver lesions using the hepatocyte-specific contrast agent Gd-EOB-DTPA; Diagnose und Differenzialdiagnose fokaler Leberlaesionen unter Verwendung von Gd-EOB-DTPA (Primovist)

    Energy Technology Data Exchange (ETDEWEB)

    Ringe, Kristina Imeen [Medizinische Hochschule Hannover (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

    2016-03-15

    The implementation of MR contrast agents significantly improves detection and characterization of focal liver lesions. This article is focusing on the hepatocyte-specific contrast agent Gd-EOB-DTPA, which has been available in Germany for liver MRI since 2004. In the introduction, the specific pharmacokinetic and -dynamic properties of this contrast agent are reviewed, and a workflow-optimized pulse sequence protocol for comprehensive hepatobiliary MRI in daily routine is presented. Afterwards, the appearance of the most common focal liver lesions is illustrated, including the differences to the use of extracellular contrast agents as well as a discussion of the most important differential diagnoses.

  6. Cholecystoenteric Fistule and Laparoscopic Repair

    Directory of Open Access Journals (Sweden)

    Temel Bulut

    2014-03-01

    Full Text Available Gallbladder stones are an endemic disease of hepatobiliary system.Whereas, cholecystoenteric fistules which develop by depending on gallbladder stone are rarely seen complications. A diagnosis is usually established during an operation. As is seen in our case too, in view of acute-stoned cholecystitis, laparoscopy has been carried out and a diagnosis of cholecystoduodenal fistule has been established during laparoscopy. Our case to whom laparoscopic duodenography and cholecystectomy has been applied is a rarely seen disease in literature. So, we aimed at sharing this information.

  7. Wandering biliary ascariasis with hepatic abscess in a postmenopausal woman.

    Science.gov (United States)

    Nahar, N; Khan, N; Islam, S M; Chakraborty, R K; Rima, S Z; Alam, M N; Roy, A S

    2014-10-01

    Hepatobiliary ascariasis is common in developing countries where there is a low standard of public health and hygiene. We are reporting a rare case of ascariasis which induced multiple liver abscesses in a post menopausal woman who presented with fever, anorexia, nausea, vomiting and mild hepatomegaly. Ultrasonography revealed biliary ascariasis with multiple hepatic abscesses. Laparoscopic drainage of hepatic abscesses was done and microscopic examination of drainage materials showed decorticated eggs of Ascaris Lumbricoides. The post operative recovery of the patient was uneventful. Ultrasonography is a reliable modality to diagnose and follow up of such cases.

  8. 十二指肠镜治疗胆道蛔虫病2021例

    Institute of Scientific and Technical Information of China (English)

    胡兵; 张丙印; 田伏洲; 黄大熔; 陶小红

    2002-01-01

    @@ 胆道蛔虫病是临床常见急腹症之一,因其临床常同时有胆道与胰腺症状,故又称胆胰性蛔虫病(hepatobiliary and pancreatic ascariasis,HPA).近年HPA发病率有所下降,但农村地区仍较高.我们从1981~2001年通过十二指肠镜镜下治疗HPA共2 021例,积累了较多的经验,现总结如下.

  9. Three Living Fasciola Hepatica in the Biliary Tract of a Woman

    Science.gov (United States)

    Niknam, Ramin; Kazemi, Mohammad Hassan; Mahmoudi, Laleh

    2015-01-01

    Fasciola hepatica (F. hepatica) as a foodborne trematode can occasionally cause hepatobiliary diseases. We report a 67-year-old woman who was referred to our center because of the diagnosis of cholangitis. She was a resident of mountainous area with the history of unsafe water and contaminated vegetables. Endoscopic retrograde cholangiopancreatography (ERCP) was performed as a diagnostic and therapeutic modality for her. Three living F. hepatica was removed from biliary tract with a basket via ERCP. Clinical and laboratory condition of the patient improved after therapy of antibiotics and triclabendazole. PMID:26379355

  10. Neonatal Bartter syndrome with cholelithiasis and hydrocephalus: Rare association.

    Science.gov (United States)

    Özdemir, Özmert Ma; Çıralı, Ceren; Yılmaz Ağladıoğlu, Sebahat; Evrengül, Havva; Tepeli, Emre; Ergin, Hacer

    2016-09-01

    Neonatal Bartter syndrome (NBS) is a rare autosomal recessive renal tubular disorder. This disease is characterized by hypokalemia, hypochloremia, and metabolic alkalosis that is often associated with failure to thrive and recurrent episodes of dehydration. The combination of BS and cholelithiasis in an infant is very rare. Herein, we report a premature male infant with NBS who developed cholelithiasis and hydrocephalus on clinical follow up. We recommend that periodic routine hepatobiliary ultrasonograpic screening for cholelithiasis should be performed in patients with NBS. © 2016 Japan Pediatric Society.

  11. POSSIBILITIES OF EARLY REHABILITATION OF PATIENTS WITH CHOLELITHIASIS AFTER ENDOSCOPIC CHOLECYSTECTOMY

    Directory of Open Access Journals (Sweden)

    S. I. Marsheva

    2013-01-01

    Full Text Available The aim of the clinical test was to develop a method for combined rehabilitation of patients after endoscopic cholecystectomy at the early stage with the use of magnetic-laser therapy, UHF therapy, and mineral waters.The analysis of obtained results has indicated that the combined rehabilitation of cholelithiasis patients after endoscopic cholecystectomy with the use of natural and и preformed physical factors favored the improvement of indices of functional activity of the hepatobiliary system, psychoemotional state, and adaptability of the organism, not causing their stress.

  12. Helicobacter canis colonization in sheep: a Zoonotic link.

    Science.gov (United States)

    Swennes, Alton G; Turk, Michelle L; Trowel, Elise M; Cullin, Cassandra; Shen, Zeli; Pang, Jassia; Petersson, Katherine H; Dewhirst, Floyd E; Fox, James G

    2014-02-01

    Helicobacter canis has been associated with hepatobiliary and gastrointestinal disease in dogs, cats, and humans. Infection has not been documented in other species. Sheep feces subjected to microaerobic culture. Isolates were characterized by genus-specific PCR, restriction fragment length polymorphism, biochemical profiling, and 16S rRNA sequence analysis. Helicobacter canis was isolated from sheep feces and confirmed by the above methods. These isolates are distinct from other sheep-origin enterohepatic Helicobacter species previously isolated. This study identifies sheep as H. canis reservoirs potentially important in zoonotic or foodborne transmission. © 2013 John Wiley & Sons Ltd.

  13. Gadolinium-based contrast agents in pediatric magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gale, Eric M.; Caravan, Peter [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, The Martinos Center for Biomedical Imaging, Boston, MA (United States); Rao, Anil G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); McDonald, Robert J. [College of Medicine, Mayo Clinic, Department of Radiology, Rochester, MN (United States); Winfeld, Matthew [University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Pediatric Radiology, Cincinnati, OH (United States); Gee, Michael S. [MassGeneral Hospital for Children, Harvard Medical School, Division of Pediatric Imaging, Department of Radiology, Boston, MA (United States)

    2017-05-15

    Gadolinium-based contrast agents can increase the accuracy and expediency of an MRI examination. However the benefits of a contrast-enhanced scan must be carefully weighed against the well-documented risks associated with administration of exogenous contrast media. The purpose of this review is to discuss commercially available gadolinium-based contrast agents (GBCAs) in the context of pediatric radiology. We discuss the chemistry, regulatory status, safety and clinical applications, with particular emphasis on imaging of the blood vessels, heart, hepatobiliary tree and central nervous system. We also discuss non-GBCA MRI contrast agents that are less frequently used or not commercially available. (orig.)

  14. Liver in systemic disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Potential causes of abnormal liver function tests include viral hepatitis, alcohol intake, nonalcoholic fatty liver disease, autoimmune liver diseases, hereditary diseases, hepatobiliary malignancies or infection, gallstones and drug-induced liver injury. Moreover, the liver may be involved in systemic diseases that mainly affect other organs. Therefore, in patients without etiology of liver injury by screening serology and diagnostic imaging, but who have systemic diseases, the abnormal liver function test results might be caused by the systemic disease. In most of these patients, the systemic disease should be treated primarily. However, some patients with systemic disease and severe liver injury or fulminant hepatic failure require intensive treatments of the liver.

  15. Adverse events after hepatitis A B combination vaccine.

    Science.gov (United States)

    Woo, Emily Jane; Miller, Nancy B; Ball, Robert

    2006-03-24

    In May 2001, the U.S. Food and Drug Administration (FDA) approved Hepatitis A Inactivated and Hepatitis B Recombinant Vaccine (HEPAB) for immunization of adults. From May 2001 to September 2003, the Vaccine Adverse Event Reporting System (VAERS) received 305 reports of adverse events after HEPAB. Many events were similar to those reported after the monovalent hepatitis A and B vaccines. Non-serious events included constitutional symptoms and local reactions. Serious events included neurologic, hepatobiliary, and dermatologic conditions, and detailed medical and epidemiological review did not suggest a clear pattern of evidence supporting a causal relationship with the vaccine, except for injection site reactions and some allergic reactions.

  16. Diffusion weighted MRI in intrahepatic bile duct adenoma arising from the cirrhotic liver

    Energy Technology Data Exchange (ETDEWEB)

    An, Chansik [Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Park, Sumi; Choi, Yoon Jung [National Health Insurance Corporation Ilsan Hospital, Goyang (Korea, Republic of)

    2013-10-15

    A 64-year-old male patient with liver cirrhosis underwent a CT study for hepatocellular carcinoma surveillance, which demonstrated a 1.4-cm hypervascular subcapsular tumor in the liver. On gadoxetic acid-enhanced MRI, the tumor showed brisk arterial enhancement and persistent hyperenhancement in the portal phase, but hypointensity in the hepatobiliary phase. On diffusion-weighted MRI, the tumor showed an apparent diffusion coefficient twofold greater than that of the background liver parenchyma, which suggested that the lesion was benign. The histologic diagnosis was intrahepatic bile duct adenoma with alcoholic liver cirrhosis.

  17. COMPARISON OF SERUM YST/ASAT, ALAT AND ALP LEVELS IN HEPATIC DISEASES

    Directory of Open Access Journals (Sweden)

    DR. M ZAHRAIE

    1987-06-01

    Full Text Available The purpose of this study was to determine a simple and sensitive test for clinical diagnosis of various hepatic diseases. Therefore y-glutamyltranspeptidase (Y** GT, aspartate aminotransferase (ASAT, alanine aminotr¬ansferase (ALAT and alkaline phosphatase (ALP levels were measured in 29 healthy adults and 88 sera with various liver diseases. Table I represents the results, according to which y-GT activity increases in all of studied patients, especially in alcoholic liver disease and hepatobiliary dysfunction (13, 5, 3,10, 4."nThe data suggest that in liver disease it is better to estimate y-GT level in serum prior to other related enzymes.

  18. Ursodeoxycholic acid treatment of vanishing bile duct syndromes

    Institute of Scientific and Technical Information of China (English)

    Thomas Pusl; Ulrich Beuers

    2006-01-01

    Vanishing bile duct syndromes (VBDS) are characterized by progressive loss of small intrahepatic ducts caused by a variety of different diseases leading to chronic cholestasis, cirrhosis, and premature death from liver failure. The majority of adult patients with VBDS suffer from primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC). Ursodeoxycholic acid (UDCA), a hydrophilic dihydroxy bile acid, is the only drug currently approved for the treatment of patients with PBC, and anticholestatic effects have been reported for several other cholestatic syndromes. Several potential mechanisms of action of UDCA have been proposed including stimulation of hepatobiliary secretion, inhibition of apoptosis and protection of cholangiocytes against toxic effects of hydrophobic bile acids.

  19. Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy.

    Science.gov (United States)

    Kayaalp, Cüneyt; Soyer, Vural; Ersan, Veysel; Aydın, Cemalettin; Karagül, Servet

    2016-01-01

    Congenital choledochal cysts are rare in adults. Due to the risk of developing cholangiocarcinoma, the current standard of care is complete excision of the cyst and reconstruction with hepaticojejunostomy. So far, more than 200 laparoscopic resections have been reported in adults, the majority being from Far Eastern countries over the last five years. Herein, the technique of laparoscopic type I choledochal cyst excision and hepaticojejunostomy is presented in a 37-year-old male with an accompanying video. The advantages of laparoscopic surgery are applicable for choledochal cyst excision as well. We believe that teamwork, expertise on intracorporeal suturing and hepatobiliary surgery are central issues for this operation.

  20. [Surgical managment of colorectal liver metastasis].

    Science.gov (United States)

    Prot, Thomas; Halkic, Nermin; Demartines, Nicolas

    2007-06-27

    Surgery offer the only curative treatment for colorectal hepatic metastasis. Nowadays, five-year survival increases up to 58% in selected cases, due to the improvement and combination of chemotherapy, surgery and ablative treatment like embolisation, radio-frequency or cryoablation. Surgery should be integrated in a multi disciplinary approach and initial work-up must take in account patient general conditions, tumor location, and possible extra hepatic extension. Thus, a surgical resection may be performed immediately or after preparation with chemotherapy or selective portal embolization. Management of liver metastasis should be carried out in oncological hepato-biliary centre.

  1. Hepatic manifestations of non-steroidal inflammatory bowel disease therapy

    Institute of Scientific and Technical Information of China (English)

    Robert; Hirten; Keith; Sultan; Ashby; Thomas; David; E; Bernstein

    2015-01-01

    Inflammatory bowel disease(IBD) is composed of Crohn’s disease and ulcerative colitis and is manifested by both bowel-related and extraintestinal manifestations. Recently the number of therapeutic options available to treat IBD has dramatically increased, with each new medication having its own mechanism of action and side effect profile. A complete understanding of the hepatotoxicity of these medications is important in order to distinguish these complications from the hepatic manifestations of IBD. This review seeks to evaluate the hepatobiliary complications of non-steroid based IBD medications and aide providers in the recognition and management of these side-effects.

  2. Radiofrequency ablation for incidentally identified primary intrahepatic cholangiocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Witold Zgodzinski; N.Joseph Espat

    2005-01-01

    Cholangiocarcinoma is the second most common primary hepato-biliary malignancy. The majority of patients with primary hepatic tumors are not suitable candidates for resection, due to advanced stage of the disease at presentation, anatomic limitations and medical comorbidities. At present, radiofrequency ablation (RFA) may offer an alternative, feasible and safe therapy for selected patients with hepatic tumors, who are not otherwise candidates for hepatic resection. Herein, we present the case of successful RFA in a patient with a solitary, primary intrahepatic cholangiocarcinoma. The patient remained free of disease 24 mo after the procedure, and is still followed up. This is the first report of RFA application inthe treatment of primary intrahepatic cholangiocarcinoma.

  3. Genetic Analysis of Digestive Physiology Using Fluorescent Phospholipid Reporters

    Science.gov (United States)

    Farber, Steven A.; Pack, Michael; Ho, Shiu-Ying; Johnson, Iain D.; Wagner, Daniel S.; Dosch, Roland; Mullins, Mary C.; Hendrickson, H. Stewart; Hendrickson, Elizabeth K.; Halpern, Marnie E.

    2001-05-01

    Zebrafish are a valuable model for mammalian lipid metabolism; larvae process lipids similarly through the intestine and hepatobiliary system and respond to drugs that block cholesterol synthesis in humans. After ingestion of fluorescently quenched phospholipids, endogenous lipase activity and rapid transport of cleavage products results in intense gall bladder fluorescence. Genetic screening identifies zebrafish mutants, such as fat free, that show normal digestive organ morphology but severely reduced phospholipid and cholesterol processing. Thus, fluorescent lipids provide a sensitive readout of lipid metabolism and are a powerful tool for identifying genes that mediate vertebrate digestive physiology.

  4. INSTRUCTIONS TO AUTHORS

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    GENERAL INFORMATION World Journal of Gastrointestinal Pathophysiology(World J Gastrointest Pathophysiol,WJGP,online ISSN 2150-5330,DOI:10.4291)is a peer-reviewed open access(OA)academic journal that aims to guide clinical practice and improve diagnostic and therapeutic skills of clinicians.Aim and scope WJGP is to report rapidly the most recent results in basic and clinical research on gastrointestinal pathophysiology,including all aspects of normal or abnormal function of the gastrointestinal tract,hepatobiliary system,and pancreas.WJGP specifically covers gro-

  5. The diagnostic efficacy of quantitative liver MR imaging with diffusion-weighted, SWI, and hepato-specific contrast-enhanced sequences in staging liver fibrosis - a multiparametric approach

    Energy Technology Data Exchange (ETDEWEB)

    Feier, Diana [Medical University of Vienna, General Hospital of Vienna (AKH), Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Emergency County Hospital, Department of Radiology, Cluj-Napoca (Romania); Balassy, Csilla; Bastati, Nina; Fragner, Romana; Ba-Ssalamah, Ahmed [Medical University of Vienna, General Hospital of Vienna (AKH), Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Wrba, Friedrich [Medical University of Vienna, General Hospital of Vienna (AKH), Department of Pathology, Vienna (Austria)

    2016-02-15

    To assess the diagnostic efficacy of multiparametric MRI using quantitative measurements of the apparent diffusion coefficient (ADC) of the liver parenchyma on diffusion-weighted imaging (DWI), signal intensity (SI) on susceptibility-weighted imaging (SWI), and gadoxetic acid-enhanced T1-weighted imaging during the hepatobiliary phase for the staging of liver fibrosis. Seventy-seven patients underwent a 3T MRI examination, including DWI/SWI sequences and gadoxetic acid-enhanced T1-weighted MRI. Liver fibrosis according to liver biopsy was staged using the Metavir fibrosis score: F0 (n = 21, 27.3 %); F1 (n = 7, 9.1 %); F2 (n = 8, 10.4 %); F3 (n = 12, 15.6 %); and F4 (n = 29, 37.7 %). SI of the liver was defined using region-of-interest measurements to calculate the ADC values, the relative enhancement (RE) in the hepatobiliary phase, and the liver-to-muscle ratio (LMR) measurements for SWI. The values of RE, LMR, and ADC measurements were statistically significantly different among the five fibrosis stages (p < 0.004). Combining the three parameters in a multiparametric approach, the AUC for detecting F1 stage or greater (≥ F1) was 94 %, for F2 or greater (≥F2) was 95 %, for F3 or greater (≥F3) was 90 %, and for stage F4 was 93 %. Multiparametric MRI is an efficient non-invasive diagnostic tool for the staging of liver fibrosis. (orig.)

  6. Scintigraphic imaging with {sup 99m}Tc- exorphin C in rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Ertay, T. [Department of Nuclear Medicine, Medical School, Dokuz Eyluel University, Inciralti (Turkey)]. E-mail: turkan.ertay@deu.edu.tr; Uenak, P. [Department of Nuclear Applications, Institute of Nuclear Sciences, Ege University, Bornova (Turkey); Tasci, C. [Department of Nuclear Medicine, Medical School, Dokuz Eyluel University, Inciralti (Turkey); Zihnioglu, F. [Department of Biochemistry, Faculty of Sciences, Ege University, Bornova, Izmir (Turkey); Durak, H. [Department of Nuclear Medicine, Medical School, Dokuz Eyluel University, Inciralti (Turkey)

    2005-06-01

    Exorphin C is a peptide with five amino acids [(Tyr-Pro-Ile-Ser-Leu) Trifluoroacetate salt] (Sigma) that has an affinity to opioid receptor-expressing tissues and tumors. Exorphin-C was labeled with {sup 99m}Tc using glucoheptonate (GH) as bifunctional chelating agent. Then, we investigated its radiopharmaceutical potential as opioid receptor-expressing tissue on rabbits. Quality controls were performed by ITLC, paper electrophoresis and HPLC. Labeling efficiency was higher than 98%. The compound was stable for at least 5 h at room temperature. Scintigraphic imaging with {sup 99m}Tc-GH-exorphin C ({sup 99m}Tc-GE) was performed on male Albino rabbits. Static images were obtained from anterior projection using a Camstar XR/T gamma camera at several time intervals. Although a significant amount of activity was seen in the brain, less activity was seen on receptor saturation studies at 30 min. Slight hepatobiliary excretion was seen, though the main excretion route was renal. After saturating, the receptor hepatobiliary excretion was not seen; the only excretion route was renal.

  7. Robotic liver surgery is the optimal approach as bridge to transplantation

    Science.gov (United States)

    Magistri, Paolo; Tarantino, Giuseppe; Ballarin, Roberto; Coratti, Andrea; Di Benedetto, Fabrizio

    2017-01-01

    The role of minimally invasive liver surgery as a bridge to transplantation is very promising but still underestimated. However, it should be noted that surgical approach for hepatocellular carcinomas (HCC) is not merely a technical or technological issue. Nowadays, the epidemiology of HCC is evolving due to the increasing role of non-alcoholic fatty-liver-disease, and the emerging concerns on direct-acting antivirals against hepatitis C virus in terms of HCC incidence. Therefore, a fully multidisciplinary study of the cirrhotic patient is currently more important than ever before, and the management of those patients should be reserved to tertiary referral hepatobiliary centers. In particular, minimally invasive approach to the liver showed several advantages compared to the classical open procedure, in terms of: (1) the small impact on abdominal wall; (2) the gentle manipulation on the liver; (3) the limited surgical trauma; and (4) the respect of venous shunts. Therefore, more direct indications should be outlined also in the Barcelona Clinic Liver Cancer model. We believe that treatment of HCC in cirrhotic patients should be reserved to tertiary referral hepatobiliary centers, that should offer patient-tailored approaches to the liver disease, in order to provide the best care for each case, according to the individual comorbidities, risk factors, and personal quality of life expectations. PMID:28217260

  8. Prevalence of clonorchiasis in patients with gastrointestinal disease: A Korean nationwide multicenter survey

    Institute of Scientific and Technical Information of China (English)

    Ho Gak Kim; Jimin Han; Myung-Hwan Kim; Kyu Hyun Cho; Sang Soo Lee; Im Hee Shin; Gwang Ha Kim; Jae Seon Kim; Jin Bong Kim; Tae Nyeun Kim; Tae Hyo Kim; Jae Woo Kim; Ji Kon Ryu; Yong Bum Yoon; Young-Soo Moon; Jong Ho Moon; Sung Jae Park; Chan Guk Park; Sung-Jo Bang; Chang Heon Yang; Kyo-Sang Yoo; Byung Moo Yoo; Kyu Taek Lee; Dong Ki Lee; Jae Bok Chung; Byung Seok Lee; Seung Ok Lee; Woo Jin Lee; Chang Min Cho; Young-Eun Joo; Gab Jin Cheon; Young Woo Choi

    2009-01-01

    AIM: To investigate prevalence of Clonorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea. METHODS: Consecutive patients who had been admitted to the Division of Gastroenterology with gastrointestinal symptoms were enrolled from March to April 2005. Of those who had been diagnosed with clonorchiasis, epidemiology and correlation between infection and hepatobiliary diseases were surveyed by questionnaire. RESULTS: Of 3080 patients with gastrointestinal diseases, 396 (12.9%) had clonorchiasis and 1140 patients (37.2%) had a history of eating raw freshwater fish. Of those with a history of raw freshwater fish ingestion, 238 (20.9%) patients had clonorchiasis. Cholangiocarcinoma was more prevalent in C. sinensis-infected patients than noninfected patients [34/396 (8.6%) vs 145/2684 (5.4%),P = 0.015]. Cholangiocarcinoma and clonorchiasis showed statistically significant positive cross-relation ( P = 0.008). Choledocholithiasis, cholecystolithiasis,cholangitis, hepatocellular carcinoma, and biliary pancreatitis did not correlate with clonorchiasis.CONCLUSION: Infection rate of clonorchiasis was still high in patients with gastrointestinal diseases in Korea, and has not decreased very much during the last two decades. Cholangiocarcinoma was related to clonorchiasis, which suggested an etiological role for the parasite.

  9. Sonographic Findings of Human Fascioliasis

    Directory of Open Access Journals (Sweden)

    F. Mansour Ghanaei

    2006-08-01

    Full Text Available Background/Objective: Ultrasonography is an imaging modality which is easy to use and less expensive than other imaging methods. It is becoming more widely available in regions of the world where Fasciola hepatica infestation is prevalent. In this report, we described the sonographic findings of hepatic lesions in patients with fascioliasis. Patients and Methods: In this cross-sectional study, 248 patients with confirmed hepatic fascioliasis from Guilan province who were referred by internists or infectious disease specialists to private sonographic offices were studied. Abdominal sonography was performed in supine and left decubitus positions using an Aloka 288 scanner and a 3.5 MHz transducer. Results: Out of 176 hepatobiliary involvement, the right lobe of liver and the periportal area with echoic or hypoechoic lesions, had the most involvement (45.2%. There were lesions in the gallbladder of 34 (13.7% and biliary tracts of 17 (7% patients. There was coincident in-volvement of both liver and biliary tracts in 13 (5.2% patients. Conclusion: Sonography is a useful method to confirm hepatobiliary lesions in human fascio-liasis and can facilitate the diagnosis of this condition, particularly in areas where it is endemic.

  10. Chronic pancreatitis in dogs: a retrospective study of clinical, clinicopathological, and histopathological findings in 61 cases.

    Science.gov (United States)

    Bostrom, Brier M; Xenoulis, Panagiotis G; Newman, Shelley J; Pool, Roy R; Fosgate, Geoffrey T; Steiner, Jörg M

    2013-01-01

    The objective of this study was to characterize the clinical, clinicopathological, and histopathological findings of dogs with chronic pancreatitis. The necropsy database at Texas A&M University was searched for reports of dogs with histological evidence of chronic pancreatitis defined as irreversible histologic changes of the pancreas (i.e. fibrosis or atrophy). A reference necropsy population of 100 randomly selected dogs was used for signalment and concurrent disease comparisons. Cases were categorized as clinical or incidental chronic pancreatitis based on the presence of vomiting, decreased appetite, or both vs. neither of these signs. All archived pancreas samples were scored histologically using a published scoring system. Sixty-one dogs with chronic pancreatitis were included. The most frequent clinical signs were lethargy, decreased appetite, vomiting, and diarrhea. Compared to the reference necropsy population, chronic pancreatitis cases were more likely to be older, neutered, of the non-sporting/toy breed group, and to have concurrent endocrine, hepatobiliary, or neurological disease. Clinical cases had significantly higher histological scores for pancreatic necrosis and peripancreatic fat necrosis, and were significantly more likely to have hepatobiliary or endocrine disease as well as increased liver enzyme activities, or elevated cholesterol and bilirubin concentrations. In conclusion, clinical disease resulting from chronic pancreatitis might be related to the presence of pancreatic necrosis and pancreatic fat necrosis. The signalment, presentation, and concurrent diseases of dogs with chronic pancreatitis are similar to those previously reported for dogs with acute pancreatitis.

  11. Genetic Cholestasis: Lessons from the Molecular Physiology of Bile Formation

    Directory of Open Access Journals (Sweden)

    Peter LM Jansen

    2000-01-01

    Full Text Available Progressive familial intrahepatic cholestasis (PFIC is a group of severe genetic cholestatic liver diseases of early life. PFIC types 1 and 2 are characterized by cholestasis and a low to normal serum gamma-glutamyltransferase (GGT activity, whereas in PFIC type 3, the serum GGT activity is elevated. PFIC types 1 and 2 occur due to mutations in loci at chromosome 18 and chromosome 2, respectively. The pathophysiology of PFIC type 1 is not well understood. PFIC types 2 and 3 are caused by transport defects in the liver affecting the hepatobiliary secretion of bile acids and phospholipids, respectively. Benign recurrent intrahepatic cholestasis (BRIC is linked to a mutation in the same familial intrahepatic cholestasis 1 locus at chromosome 18. Defects of bile acid synthesis may be difficult to differentiate from these transport defects.Intrahepatic cholestasis of pregnancy (ICP appears to be related to these cholestatic diseases. For example, heterozygosity in families with PFIC type 3 is associated with ICP, but ICP has also been reported in families with BRIC.In Dubin-Johnson syndrome there is no cholestasis; only the hepatobiliary transport of conjugated bilirubin is affected. This, therefore, is a mild disease, and patients have a normal lifespan.

  12. A new manganese-based oral contrast agent (CMC-001) for liver MRI. Pharmacological and pharmaceutical aspects

    Energy Technology Data Exchange (ETDEWEB)

    Joergensen, Jan Troest [Research and Development, CMC Contrast AB, Scion DTU, Lyngby (Denmark)], email: jtj@cmc-contrast.dk; Rief, Matthias; Wagner, Moritz [Dept. of Radiology, Charite - Universitaetsmedizin Berlin, Berlin (Germany); Brismar, Torkel B.; Albiin, Nils [Dept. of Radiology, Karolinska Inst., Karolinska Univ. Hospital, Stockholm (Sweden)

    2012-09-15

    Manganese is one of the most abundant metals on earth and is found as a component of more than 100 different minerals. Besides being an essential trace element in relation to the metabolic processes in the body, manganese is also a paramagnetic metal that possesses similar characteristics to gadolinium with regards to T1-weighted (T1-w) magnetic resonance imaging (MRI). Manganese, in the form of manganese (II) chloride tetrahydrate, is the active substance in a new targeted oral contrast agent, currently known as CMC-001, indicated for hepatobiliary MRI. Under physiological circumstances manganese is poorly absorbed from the intestine after oral intake, but by the use of specific absorption promoters, L-alanine and vitamin D3, it is possible to obtain a sufficiently high concentration in the liver in order to achieve a significant signal enhancing effect. In the liver manganese is exposed to a very high first-pass effect, up to 98 %, which prevents the metal from reaching the systemic circulation, thereby reducing the number of systemic side-effects. Manganese is one of the least toxic trace elements, and due to its favorable safety profile it may be an attractive alternative to gadolinium-based contrast agents for patients undergoing an MRI evaluation for liver metastases in the future. In this review the basic pharmacological and pharmaceutical aspects of this new targeted oral hepatobiliary specific contrast agent will be discussed.

  13. Recurrent Cholangitis by Biliary Stasis Due to Non-Obstructive Afferent Loop Syndrome After Pylorus-Preserving Pancreatoduodenectomy: Report of a Case

    Science.gov (United States)

    Sanada, Yukihiro; Yamada, Naoya; Taguchi, Masanobu; Morishima, Kazue; Kasahara, Naoya; Kaneda, Yuji; Miki, Atsushi; Ishiguro, Yasunao; Kurogochi, Akira; Endo, Kazuhiro; Koizumi, Masaru; Sasanuma, Hideki; Fujiwara, Takehito; Sakuma, Yasunaru; Shimizu, Atsushi; Hyodo, Masanobu; Sata, Naohiro; Yasuda, Yoshikazu

    2014-01-01

    We report a 71-year-old man who had undergone pylorus-preserving pancreatoduodenectomy (PPPD) using PPPD-IV reconstruction for cholangiocarcinoma. For 6 years thereafter, he had suffered recurrent cholangitis, and also a right liver abscess (S5/8), which required percutaneous drainage at 9 years after PPPD. At 16 years after PPPD, he had been admitted to the other hospital because of acute purulent cholangitis. Although medical treatment resolved the cholangitis, the patient was referred to our hospital because of dilatation of the intrahepatic biliary duct (B2). Peroral double-balloon enteroscopy revealed that the diameter of the hepaticojejunostomy anastomosis was 12 mm, and cholangiography detected intrahepatic stones. Lithotripsy was performed using a basket catheter. At 1 year after lithotripsy procedure, the patient is doing well. Hepatobiliary scintigraphy at 60 minutes after intravenous injection demonstrated that deposit of the tracer still remained in the upper afferent loop jejunum. Therefore, we considered that the recurrent cholangitis, liver abscess, and intrahepatic lithiasis have been caused by biliary stasis due to nonobstructive afferent loop syndrome. Biliary retention due to nonobstructive afferent loop syndrome may cause recurrent cholangitis or liver abscess after hepaticojejunostomy, and double-balloon enteroscopy and hepatobiliary scintigraphy are useful for the diagnosis of nonobstructive afferent loop syndrome. PMID:25058778

  14. Gadobenate-dimeglumine-enhanced magnetic resonance imaging for hepatic lesions in children

    Energy Technology Data Exchange (ETDEWEB)

    Chavhan, Govind B.; Mann, Erika [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Toronto (Canada); Kamath, Binita M. [The Hospital for Sick Children and University of Toronto, Division of Gastroenterology, Hepatology and Nutrition, Toronto (Canada); Babyn, Paul S. [Royal University Hospital, Department of Medical Imaging, Saskatoon (Canada)

    2014-10-15

    Magnetic resonance imaging enhanced by hepatocyte-specific contrast media has been found useful to characterize liver lesions in adults and children. To present our experience with gadobenate dimeglumine (Gd-BOPTA)-enhanced MRI for evaluation of focal liver lesions in children. We retrospectively reviewed gadobenate-dimeglumine-enhanced MR images obtained for evaluation of suspected hepatic lesions in 30 children. Signal characteristics on various sequences including 45- to 60-min hepatobiliary phase images were noted by two radiologists. Chart review identified relevant clinical details including history of cancer treatment, available pathology and stability of lesion size on follow-up imaging. Of the 30 children who had gadobenate-enhanced MRI, 26 showed focal lesions. Diagnoses in 26 children were focal nodular hyperplasia (FNH) in 15, hemangiomas in 3, regenerating nodules in 3, focal fatty infiltration in 2, indeterminate lesions in 3, and one patient each with adenomas, hepatoblastoma and metastasis. Two patients had multiple diagnoses. All FNH lesions (39), all regenerative nodules (19) and an indeterminate lesion were iso- or hyperintense on hepatobiliary-phase images while all other lesions (28) were hypointense to hepatic parenchyma. The average follow-up period was 21.7 months. Our experience with gadobenate-enhanced MRI indicates potential utility of gadobenate in the evaluation of pediatric hepatic lesions in differentiating FNH and regenerating nodules from other lesions. (orig.)

  15. Combination of Praziquantel and Aspirin Minimizes Liver Pathology of Hamster Opisthorchis viverrini Infection Associated Cholangiocarcinoma.

    Science.gov (United States)

    Sudsarn, Pakkayanee; Boonmars, Thidarut; Ruangjirachuporn, Wipaporn; Namwat, Nisana; Loilome, Watcharin; Sriraj, Pranee; Aukkanimart, Ratchadawan; Nadchanan, Wonkchalee; Jiraporn, Songsri

    2016-01-01

    Opisthorchiasis is one of the major risk factors for cholangiocarcinoma (CCA) in northeastern Thailand. An effective drug for killing this parasite is praziquantel. Recently, several reports have shown that with frequent use, praziquantel may itself be a CCA risk and can cause liver cell damage from an immunopathological response after parasite death. Aspirin has many properties including anti-inflammation and anti-cancer. Therefore, we use of aspirin (As) and praziquantel (Pz) to improve hepatobiliary system function in hamsters infected with Opisthorchis viverrini (OV) and or administered N-nitrosodimethylamine (ND). Livers of OVNDAsPz, appeared healthy macroscopically, suggesting slow progression of cholangiocarcinoma evident by extent of fibrosis and bile duct cell proliferation was less than OVND although aggregations of inflammatory cells remained. Proliferating cell nuclear antigen (PCNA), cytokeratin 19 (CK19), and cancer antigen (CA19-9) staining were strongly positive in OVND, but were only slight in OVNDAs. Moreover, OVNDAsPz, appeared a few inflammatory infiltrations, bile duct proliferation, fibrosis and CCA area than the OVNDAs group. Thirty seven point five percent of hamster in this group could not develop CCA. These findings suggest that using aspirin combination with praziquantel treatment can improve the hepatobiliary system after O. viverrini infection and reduce the risk of CCA.

  16. Gadoxetate Acid-Enhanced MR Imaging for HCC: A Review for Clinicians

    Directory of Open Access Journals (Sweden)

    Jendana Chanyaputhipong

    2011-01-01

    Full Text Available Hepatocellular carcinoma (HCC is increasingly being detected at an earlier stage, owing to the screening programs and regular imaging follow-up in high-risk populations. Small HCCs still pose diagnostic challenges on imaging due to decreased sensitivity and increased frequency of atypical features. Differentiating early HCC from premalignant or benign nodules is important as management differs and has implications on both the quality of life and the overall survival for the patients. Gadoxetate acid (Gd-EOB-DTPA, Primovist®, Bayer Schering Pharma is a relatively new, safe and well-tolerated liver-specific contrast agent for magnetic resonance (MR imaging of the liver that has combined perfusion- and hepatocyte-specific properties, allowing for the acquisition of both dynamic and hepatobiliary phase images. Its high biliary uptake and excretion improves lesion detection and characterization by increasing liver-to-lesion conspicuity in the added hepatobiliary phase imaging. To date, gadoxetate acid-enhanced MRI has been mostly shown to be superior to unenhanced MRI, computed tomography, and other types of contrast agents in the detection and characterization of liver lesions. This review article focuses on the evolving role of gadoxetate acid in the characterization of HCC, differentiating it from other mimickers of HCC.

  17. Acute Cholecystitis Detected by Serial Emergency Department Focused Right Upper Quadrant Ultrasound

    Directory of Open Access Journals (Sweden)

    David Bosch

    2016-06-01

    Full Text Available Acute cholecystitis is a common etiology of acute right upper quadrant pain in patients presenting to the emergency department (ED. The use of ED-focused right upper quadrant ultrasound (RUQ US is becoming more widely utilized to evaluate abdominal pain thought to be hepatobiliary in nature. We describe a case series of two patients with acute cholecystitis detected by serial ED-focused RUQ US. Case 1: A woman presented to the ED with epigastric pain of acute onset. She was initially found to have a mild leukocytosis and cholelithiasis detected by ED-focused RUQ US. Seventy-five minutes later, the patient had a repeat bedside ultrasound by the same sonographer that showed visual evidence of acute cholecystitis that was later confirmed by surgical pathology. She was treated operatively. Case 2: A man with known cholelithiasis presents to the ED with acute-onset RUQ pain. Initial RUQ ultrasound performed by the Department of Radiology (University of Colorado Hospital was equivocal, showing cholelithiasis with a mildly thickened wall and no pericholecystic fluid. A repeat ED-focused RUQ ultrasound 5 hours later showed increased wall thickness and pericholecystic fluid. The patient was subsequently taken for same-day cholecystectomy. This case series demonstrates the dynamic and progressive nature of acute cholecystitis detected by ED-focused RUQ US. It also highlights how serial bedside ultrasonography can reduce harm, appropriately triage patients with hepatobiliary disease and lead to reductions in overall morbidity.

  18. Comparison of Gd-Bz-TTDA, Gd-EOB-DTPA, and Gd-BOPTA for dynamic MR imaging of the liver in rat models.

    Science.gov (United States)

    Jaw, Twei-Shiun; Chen, Shih-Hsien; Wang, Yun-Ming; Hsu, Jui-Sheng; Kuo, Yu-Ting; Chiu, Yen-Yu; Tsai, Kun-Bow; Hsieh, Tsyh-Jyi; Liu, Gin-Chung

    2012-03-01

    To evaluate the competitive potential of a new lipophilic paramagnetic complex, Gd-Bz-TTDA [4-benzyl-3,6,10-tri (carboxymethyl)-3,6,10-triazado-decanedioic acid] compared with two other commercially available MR hepatobiliary contrast agents, gadobenate dimeglumine (Gd-BOPTA) and gadoxetic acid (Gd-EOB-DTPA), dynamic MR imaging studies were performed on normal and hepatocellular carcinoma (HCC) rat models using a 1.5-Tesla MR scanner. The results indicate that normal rats that were injected with 0.1 mmol/kg Gd-Bz-TTDA showed significantly more intense and persistent liver enhancement than those that were injected with the same dose of Gd-EOB-DTPA or Gd-BOPTA. All of these agents showed similar enhancement patterns in the implanted HCC. The liver-lesion contrast-to-noise ratios were higher and more persistent in rats that were injected with Gd-Bz-TTDA. These results indicate that Gd-Bz-TTDA is comparable with the commercially available hepatobiliary agents, Gd-EOB-DTPA and Gd-BOPTA, and can result in more intense and prolonged liver enhancement while still providing better liver-lesion discrimination. These results warrant further large-scale studies.

  19. Life-threatening hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy: report of a case

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    Wu Hurng-Sheng

    2010-07-01

    Full Text Available Abstract Background Hemobilia is a rare but lethal biliary tract complication. There are several causes of hemobilia which might be classified as traumatic or nontraumatic. Hemobilia caused by pseudoaneurysm might result from hepatobiliary surgery or percutaneous interventional hepatobiliary procedures. However, to our knowledge, there are no previous reports pertaining to hemobilia caused by hepatic pseudoaneurysm after T-tube choledochostomy. Case presentation A 65-year-old male was admitted to our hospital because of acute calculous cholecystitis and cholangitis. He underwent cholecystectomy, choledocholithotomy via a right upper quadrant laparotomy and a temporary T-tube choledochostomy was created. However, on the 19th day after operation, he suffered from sudden onset of hematemesis and massive fresh blood drainage from the T-tube choledochostomy. Imaging studies confirmed the diagnosis of pseudoaneurysm associated hemobilia. The probable association of T-tube choledochostomy with pseudoaneurysm and hemobilia is also demonstrated. He underwent emergent selective microcoils emobolization to occlude the feeding artery of the pseudoaneurysm. Conclusions Pseudoaneurysm associated hemobilia may occur after T-tube choledochostomy. This case also highlights the importance that hemobilia should be highly suspected in a patient presenting with jaundice, right upper quadrant abdominal pain and upper gastrointestinal bleeding after liver or biliary surgery.

  20. From the stomach to other organs: Helicobacter pylori and the liver

    Institute of Scientific and Technical Information of China (English)

    Marek; Waluga; Micha?; Kukla; Micha?; ?orniak; Agata; Bacik; Rafa?; Kotulski

    2015-01-01

    Many recent studies have examined the importance of Helicobacter pylori(H. pylori) infection in the pathogenesis of the diseases outside the stomach and explored the significance of this bacterium in the pathogenesis of some metabolic and cardiovascular diseases. Recent studies have provided evidence that H. pylori is also involved in the pathogenesis of some liver diseases. Many observations have proved that H. pylori infection is important in the development of insulin resistance, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, liver fibrosis and cirrhosis. The worsening of liver inflammation of different origins also occurs during H. pylori infection. Some studies have indicated that H. pylori infection induces autoimmunological diseases in the liver and biliary tract. The potential significance of this bacterium in carcinogenesis is unclear, but it is within the scope of interest of many studies. The proposed mechanisms through which H. pylori impacts the development of hepatobiliary diseases are complex and ambiguous. The importance of other Helicobacter species in the development of hepatobiliary diseases is also considered because they could lead to the development of inflammatory, fibrotic and necrotic injuries of the liver and, consequently, to hepatocellular carcinoma. However, many contrary viewpoints indicate that some evidence is not convincing, and further studies of the subject are needed. This review presents the current knowledge about the importance of H. pylori in the pathogenesis of liver and in biliary diseases.

  1. Downregulation of CYP3A and P-glycoprotein in the secondary inflammatory response of mice with dextran sulfate sodium-induced colitis and its contribution to cyclosporine A blood concentrations.

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    Kawauchi, Shoji; Nakamura, Tsutomu; Miki, Ikuya; Inoue, Jun; Hamaguchi, Tsuneo; Tanahashi, Toshihito; Mizuno, Shigeto

    2014-01-01

    CYP3A and P-glycoprotein (P-gp) play important roles in drug metabolism and excretion; however, their functions in pathological conditions remain unclear. Hepatobiliary abnormalities have been described in patients with ulcerative colitis, which may affect drug metabolism and excretion in the liver and small intestine. We examined the functions of CYP3A and P-gp in the liver and small intestine of mice with dextran sodium sulfate (DSS)-induced colitis. Up to day 7, inflammatory markers were significantly increased in the livers of DSS-treated mice, accompanied by decreased CYP3A. Additionally hepatobiliary transporters and Pregnane X receptor, which regulates the transcriptional activation of CYP3A, were reduced. Both CYP3A and P-gp were significantly decreased in the upper small intestine of DSS-treated mice on day 7. This was associated with the increased expression of inducible nitric oxide synthase, but not changes in nuclear receptor expression. On day 7 of DSS treatment, the concentrations of cyclosporine A (CsA), a substrate of both CYP3A and P-gp, were significantly higher than controls. These results indicated the existence of a second inflammatory response in the liver and upper small intestine of mice with DSS-induced colitis, and bioavailability of CsA was increased by the dysfunction of CYP3A and P-gp in these organs.

  2. The role of antimicrobial sutures in preventing surgical site infection.

    Science.gov (United States)

    Leaper, D; Wilson, P; Assadian, O; Edmiston, C; Kiernan, M; Miller, A; Bond-Smith, G; Yap, J

    2017-07-01

    INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient's pathway through both nosocomial and community care. METHODS This report is based on a meeting held at The Royal College of Surgeons of England on 21 July 2016. Using PubMed, members of the panel reviewed the current use of antiseptics and antimicrobial sutures in their specialties to prevent SSI. FINDINGS The group agreed that wider use of antiseptics in surgical practice may help in reducing reliance on antibiotics in infection prevention and control, especially in the perioperative period of open elective colorectal, hepatobiliary and cardiac operative procedures. The wider use of antiseptics includes preoperative showering, promotion of hand hygiene, (including the appropriate use of surgical gloves), preoperative skin preparation (including management of hair removal), antimicrobial sutures and the management of dehisced surgical wounds after infection. The meeting placed emphasis on the level I evidence that supports the use of antimicrobial sutures, particularly in surgical procedures after which the SSI rate is high (colorectal and hepatobiliary surgery) or when a SSI can be life threatening even when the rate of SSI is low (cardiac surgery).

  3. Changing patterns of traumatic bile duct injuries: a review of forty years experience

    Institute of Scientific and Technical Information of China (English)

    Zhi-Qiang Huang; Xiao-Qiang Huang

    2002-01-01

    AIM: To summarize the experiences of treating bile ductinjuries in 40 years of clinical practice.METHODS: Based on the experience of more than 40 yearsof clinical work, 122 cases including a series of 61 bile ductinjuries of the Southwest Hospital, Chongqing, and 42cases (1989-1997) and 19 cases (1998-2001) of the GeneralHospital of PLA, Beijing, cases were reviewed with specialreference to the pattern of injury. A series of cases of theliver and the biliary tract injuries following interventionaltherapy for hepatic tumors, most often hemangioma of theliver, were collected. Chinese medical literature from 1995 to1999 dealing with 2742 traumatic bile duct strictures werereviewed.RESULTS: There was a changing pattern of the bile ductinjury. Although most of the cases of bile duct injuriesresulted from open cholecystectomy. Other types of traumasuch as laparoscopic cholecystectomy (LC) and hepaticsurgery were increased in recent years. Moreover, serioushepato-biliary injuries following HAE using sclerotic agentssuch as sodium morrhuate and absolute ethanol for thetreatment of hepatic hemangiomas were encountered inrecent years. Experiences in how to avoid bile duct injuryand to treat traumatic biliary strictures were presented.CONCLUSION: Traumatic bile duct stricture is one of theserious complications of hepato-biliary surgery, itsprevalence seemed to be increased in recent years. Thepattern of bile duct injury was also changed and has becomemore complicated. Interventional therapy with sclerosingagents may cause serious hepatobiliary complications andshould be avoided.

  4. Imaging findings of biliary hamartomas

    Institute of Scientific and Technical Information of China (English)

    Rong-Qin Zheng; Bo Zhang; Masatoshi Kudo; Hirokazu Onda; Tatsuo Inoue

    2005-01-01

    AIM: To evaluate the imaging findings of biliary hamartomas (von Meyenburg complexes, VMCs) and discuss the differential diagnosis with other related diseases.METHODS: Imaging findings of biliary hamartomas on ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), MR cholangiopancreatography (MRCP)and hepatobiliary scintigraphy were retrospectively analyzed in six patients.RESULTS: On ultrasound images, five of the six cases showed multiple small hyper- and hypo-echoic lesions with comet-tail echoes, especially when magnified by US with the usage of zoom function. In all the six cases,multiple tiny hypodense lesions less than 10 mm in diameter were revealed as scattered throughout the liver with no enhancement on CT. These tiny lesions were demonstrated to be hyper- and hypo-intensity on T2- and TI-weighed images, respectively, in three patients who underwent MRI examinations. MRCP was performed in two patients, and clearly showed multiple tiny irregular- and round-shaped hyper-intensity lesions.MRCP and hepatobiliary scintigraphy showed normal appearances of intra- and extra-hepatic bile ducts in two and one patients, respectively.CONCLUSION: Imaging modalities are useful in the diagnosis and differential diagnosis of VMCs. A correct diagnosis might be obtained when typical imaging findings are present even without a histological confirmation.

  5. Comparison of different diagnostic methods in infants with Cholestasis

    Institute of Scientific and Technical Information of China (English)

    Seyed Mohsen Dehghani; Mahmood Haghighat; Mohammad Hadi Imanieh; Bita Geramizadeh

    2006-01-01

    AIM: To evaluate different methods in differentiating idiopathic neonatal hepatitis from biliary atresia.METHODS: Sixty-five infants with cholestatic jaundice and final diagnosis of idiopathic neonatal hepatitis and biliary atresia were studied prospectively from September 2003 to March 2006. A thorough history and physical examination were undertaken and the liver enzymes were examined. All cases underwent abdominal ultrasonography, hepatobiliary scintigraphy,and percutaneous liver biopsy. The accuracy, sensitivity,specificity and predictive values of these various methods were compared.RESULTS: There were 34 girls and 31 boys, among them 46 subjects had idiopathic neonatal hepatitis (age,61 ± 17 d) and 19 had biliary atresia (age, 64 ± 18 d).The mean age at onset of jaundice was significantly lower in cases of biliary atresia when compared to idiopathic neonatal hepatitis cases (9 ± 13 d vs 20 ± 21 d;P = 0.032). The diagnostic accuracy of different methods was as follows: liver biopsy, 96.9%; clinical evaluation,70.8%; ultrasonography, 69.2%; hepatobiliary scintigraphy, 58.5%; and liver enzymes, 50.8%.CONCLUSION: Our results indicate that clinical evaluation by an experienced pediatric hepatologist and a biopsy of the liver are considered as the most reliable methods to differentiate idiopathic neonatal hepatitis and biliary atresia.

  6. Extragastric manifestations of Helicobacter pylori infection:Possible role of bacterium in liver and pancreas diseases

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Helicobacter pylori (H. pylori ) is an ancient microorganismthat has co-evolved with humans for over 60000 years.This bacterium typically colonizes the human stomachand it is currently recognized as the most commoninfectious pathogen of the gastroduodenaltract. Althoughits chronic infection is associated with gastritis, pepticulcer, dysplasia, neoplasia, MALT lymphoma and gastricadenocarcinoma, it has been suggested the possibleassociation of H. pylori infection with several extragastriceffects including hepatobiliary and pancreatic diseases.Since a microorganism resemblingH. pylori was detectedin samples from patients with hepatobiliary disorders,several reports have been discussed the possible role ofbacteria in hepatic diseases as hepatocellular carcinoma,cirrhosis and hepatic encephalopathy, nonalcoholic fattyliver disease and fibrosis. Additionally, studies havereported the possible association between H. pyloriinfection and pancreatic diseases, especially becauseit has been suggested that this infection could changethe pancreatic physiology. Some of them have relateda possible association between the microorganismand pancreatic cancer. H. pylori infection has alsobeen suggested to play a role in the acute and chronicpancreatitis pathogenesis, autoimmune pancreatitis,diabetes mellitus and metabolic syndrome. Consideringthat association of H. pylori to liver and pancreas diseasesneeds further clarification, our work offers a review aboutthe results of some investigations related to the potentialpathogenicity of H. pylori in these extragastric diseases.

  7. Evaluation of bile reflux in HIDA images based on fluid mechanics.

    Science.gov (United States)

    Lo, Rong-Chin; Huang, Wen-Lin; Fan, Yu-Ming

    2015-05-01

    We propose a new method to help physicians assess, using a hepatobiliary iminodiacetic acid scan image, whether or not there is bile reflux into the stomach. The degree of bile reflux is an important index for clinical diagnosis of stomach diseases. The proposed method applies image-processing technology combined with a hydrodynamic model to determine the extent of bile reflux or whether the duodenum is also folded above the stomach. This condition in 2D dynamic images suggests that bile refluxes into the stomach, when endoscopy shows no bile reflux. In this study, we used optical flow to analyze images from Tc99m-diisopropyl iminodiacetic acid cholescintigraphy (Tc99m-DISIDA) to ascertain the direction and velocity of bile passing through the pylorus. In clinical diagnoses, single photon emission computed tomography (SPECT) is the main clinical tool for evaluating functional images of hepatobiliary metabolism. Computed tomography (CT) shows anatomical images of the external contours of the stomach, liver, and biliary extent. By exploiting the functional fusion of the two kinds of medical image, physicians can obtain a more accurate diagnosis. We accordingly reconstructed 3D images from SPECT and CT to help physicians choose which cross sections to fuse with software and to help them more accurately diagnose the extent and quantity of bile reflux.

  8. Intraoperative ultrasonography of liver, bile ducts and pancreas

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    Luciana Mendes de Oliveira Cerri

    Full Text Available The use of intraoperative ultrasonography (IOUS to evaluate liver, bile ducts and pancreatic disease, as compared to the results of preoperative ultrasonography and CT, is discussed. Forty-two patients who underwent abdominal surgery for suspected hepatobiliary and/or pancreatic disease were studied. The intraoperative study was carried out with a portable apparatus (Aloka 500, Japan, using 5.0 MHz and 7.5 MHz linear sterile transducers. The main indications for IOUS were the search for and/or evaluation of primary hepatic masses,hepatic abscesses or metastases, obstructive jaundice, or neuroendocrine tumors. In 15 cases (38.5 percent from the hepatobiliary group and in 7 cases (58.3 percent from the pancreatic group, a difference between preoperative and intraoperative findings was observed. The main difference was observed in relation to the number and size of hepatic and pancreatic lesions. The relationship between the lesions and the vascular structures was evaluated through IOUS. The method was also used to guide surgical procedures such as biopsies, the alcoholization of nodules, and the drainage of abscesses. IOUS plays an important role in detecting small hepatic and pancreatic nodules, in the assessment of anatomical relationships between the lesions and the vascular structures, and in the performance of interventionist procedures.

  9. [Influence of environmental enrichment on parameters of behavior in open field test in the rats born from females with chronic alcoholization].

    Science.gov (United States)

    Vakhnin, V A; Briukhin, G V

    2014-04-01

    The aim of this work was studying of morphology of a brain and the analysis of behavior at posterity of females of rats with a chronic alcoholic intoxication. As object of research were taken 60-day animals received from mothers with chronic alcoholic injury of hepatobiliary systems. During certain time (1.5 months) the part of animals grew in standard conditions, and another--in the "enriched" environment. The behavior analysis was spent in the open field test. Also was carried out research of a thickness of a cortex and a molecular layer of a forebrain. Work included three series of experiments. It is established, that the posterity of mothers with chronic injury of the hepatobiliary systems is characterized by the lowered motorial and research activity, increased by emotional reactivity that is accompanied by changes of structure of a cortex. The long finding of "alcoholic" animals in the "enriched" environment within 1.5 months promoted increasing of motorial and research activity, emotional reactance, change of structure of a cortex.

  10. A new manganese-based oral contrast agent (CMC-001) for liver MRI: pharmacological and pharmaceutical aspects.

    Science.gov (United States)

    Jørgensen, Jan Trøst; Rief, Matthias; Brismar, Torkel B; Wagner, Moritz; Albiin, Nils

    2012-09-01

    Manganese is one of the most abundant metals on earth and is found as a component of more than 100 different minerals. Besides being an essential trace element in relation to the metabolic processes in the body, manganese is also a paramagnetic metal that possesses similar characteristics to gadolinium with regards to T1-weighted (T1-w) magnetic resonance imaging (MRI). Manganese, in the form of manganese (II) chloride tetrahydrate, is the active substance in a new targeted oral contrast agent, currently known as CMC-001, indicated for hepatobiliary MRI. Under physiological circumstances manganese is poorly absorbed from the intestine after oral intake, but by the use of specific absorption promoters, L-alanine and vitamin D(3), it is possible to obtain a sufficiently high concentration in the liver in order to achieve a significant signal enhancing effect. In the liver manganese is exposed to a very high first-pass effect, up to 98%, which prevents the metal from reaching the systemic circulation, thereby reducing the number of systemic side-effects. Manganese is one of the least toxic trace elements, and due to its favorable safety profile it may be an attractive alternative to gadolinium-based contrast agents for patients undergoing an MRI evaluation for liver metastases in the future. In this review the basic pharmacological and pharmaceutical aspects of this new targeted oral hepatobiliary specific contrast agent will be discussed.

  11. ANTIBACTERIAL PROPERTIES OF PHARMACEUTICAL COMPOSITION OF HEPATOPROTECTORS

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    Aslanian MA

    2016-12-01

    Full Text Available Pathology problemof hepatobiliary system (HBS of contagious origin becomes relevant with the increase of disturbance and complications of lipid metabolism and bile pigments among young people. Leading role in prophylaxis and treatment in the context of this pathology belongs to antibacterialc hemotherapeutic agents. However, along with antimicrobial activity, numerous side effects can be observed during treatment with antibacterial agents. According to the recent study on hepatobiliary system (HBS, therapeutic effect can be seen only while using herbal medicine with choleretic action as well as their various compositions.Amountof medicine with the appropriate effect is insufficient, that is why the study was conducted towards finding effective combinations of plant substances of different groups for the purpose of creatingan effective medicine for treatment of hepatobiliary system (HBS of contagious origin. Aim of the work The purpose of study was to examine antibacterial properties of different combinations with flamin and lavender oil in combined medicine during the course of treatment of cholecystitis and cholangitis. Materials and methods. It the result of study 61 microbial strains were distinguished and identified from the pathological material taken from 53 patients with cholecystitis and cholangitis. All distinguished clinical microbial strains taken from the patients were tested for sensitivity to combined medicine in the form of tablets with flamin and lavender oil. Minimal inhibitory concentration for S. aureus АТСС 25923 amounted to 250-350 ug/ml, for E. coli АТСС 25922 - 350±50,0 ug/ml, for P. aeruginosa АТСС 27853 750±100,0 ug/ml, for Р. vulgaris АТСС 4636 - 850±100,0 ug/ml, minimal inhibitory concentration to the tablets № 2 та № 3 amounted to > 1000 мкг/мл. Minimal inhibitory concentration for B. subtilis АТСС 6633 amounted to 250±50,0 ug/ml, for C. albicans ATCC 885/653 300±50,0 ug

  12. Distinct prognostic values of alcohol dehydrogenase mRNA expression in pancreatic adenocarcinoma

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    Liao X

    2017-07-01

    Full Text Available Xiwen Liao,1,* Rui Huang,2,* Xiaoguang Liu,1,3 Chuangye Han,1 Long Yu,1,4 Shijun Wang,5 Na Sun,2 Bopei Li,6 Xin Ning,7 Tao Peng1 1Department of Hepatobiliary Surgery, 2Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 3Department of Hepatobiliary Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 4Department of Hepatobiliary and Pancreatic Surgery, 5Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 6Department of Gastrointestinal Surgery, 7Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China *These authors contributed equally to this work Background: Alcohol dehydrogenase (ADH isoenzymes have been reported as a potential diagnostic marker for pancreatic cancer, but their prognostic value in pancreatic cancer remains unclear. The aim of this investigation was to identify the prognostic value of ADH genes in human patients with pancreatic adenocarcinoma (PAAD.Materials and methods: An RNA sequencing dataset and corresponding survival profiles of PAAD were obtained from The Cancer Genome Atlas. Survival analysis and gene set enrichment analysis were used to investigate the prediction value and potential mechanism of ADH genes in PAAD prognosis.Results: Survival analysis of ADH genes suggests that a high expression of ADH1A (adjusted P=0.037, adjusted hazard ratio [HR] =0.627, 95% CI =0.404–0.972 and ADH6 (adjusted P=0.018, adjusted HR =0.588, 95% CI =0.378–0.914 were associated with a significantly decreased risk of death, while a high expression of ADH5 was associated with a significantly increased risk of death (adjusted P=0.043, adjusted HR =1.564, 95% CI =1.013–2.414. Joint effects analysis of three ADH gene prognostic markers suggests that the prognosis difference for any marker combination was more significant than that for any

  13. Pharmacokinetics, tissue distribution and excretion of a new photodynamic drug deuxemether.

    Science.gov (United States)

    Wang, Rui; Hao, Haiping; Wang, Guangji; Xie, Haitang; Xu, Meijuan; Wang, Wei; He, Hui; Li, Xiaoyu

    2008-03-28

    Deuxemether was a new photodynamic drug effective for many kinds of solid tumor therapy, which was mainly composed of 3-(or 8-)-(1-methoxyethyl)-8-(or 3-)-(1-hydroxyethyl)-deutero-porphyrin IX (MHD) and 3,8-di(1-methoxyethyl)-deuteroporphyrin IX (DMD). The aims of this study were to elucidate its pharmacokinetic characteristics, tissue distribution, plasma protein binding and excretion properties and underlying mechanisms of deuxemether in rats based on the simultaneous determination of MHD and DMD. The pharmacokinetic profiles of both MHD and DMD in rats after intravenous doses were linear and best fitted to a two compartment model, characterized with a rapid distribution phase (MHD: t(1/2)alpha, 0.09-0.14 h; DMD: t 1/2 alpha, 0.07-0.11h) and a relatively slow elimination phase (MHD: t 1/2 beta, 2.03-3.20 h; DMD: t 1/2 beta, 2.51-3.20 h). The tissue distributions of MHD and DMD in rats were rather limited as evidenced from their low distribution volume (0.75-1.70 L/kg) and the results of tissue distribution study. Protein binding of MHD and DMD were moderate (65.36-89.99% for MHD; 45.43-76.23% for DMD), independent of drug concentrations and similar between human and rat plasma over a concentration range of 0.50-50.0 microg/mL. Both MHD and DMD were predominantly (>74.1%) eliminated from rats as the parent drugs through the hepatobiliary systems and finally excreted into the feces. The multidrug resistance-associated proteins 2 (MRP2) inhibitors, bromosulfophthalein and probenecid, substantially inhibited the hepatobiliary elimination of MHD and DMD while the P-gp inhibitor digoxin had little effect, suggesting that MRP2 may contribute to the rapid and extensive hepatobiliary excretion of deuxemether. There were no significant differences between MHD and DMD for all pharmacokinetic characteristics studied. In conclusion, this study provided firstly the full pharmacokinetic characteristics and mechanisms of deuxemether, which would be helpful for its clinical

  14. Growth and development of a new subspecialty: pediatric hepatology.

    Science.gov (United States)

    Balistreri, William F

    2013-08-01

    Several major forces converged to catalyze the formal emergence of a body of knowledge and an organized focus on disorders of the liver in early life. Attendant to the development of a focused clinical subspecialty the pace of patient- and laboratory-based research in the field quickened in parallel to decipher the consequences of genetic or metabolic aberrations on immature liver structure and function. The key research observations that catalyzed the emergence and subsequent rapid growth of Pediatric Hepatology include: (1) an understanding of the dynamic events occurring during hepatobiliary development and the importance of these physiologic variables that occur during liver maturation; (2) the recognition of the unique nature of inherited and acquired liver diseases that affect infants and children-such as biliary atresia and Reye's syndrome; and (3) redefinition of the once obscure inherited intrahepatic cholestatic diseases of the liver, which, in turn, provided insight into normal and abnormal hepatobiliary physiology. The clinical advances were highlighted by the development of specific approaches to the diagnosis and management of liver disease in infants and children, including both liver transplantation and nontransplant treatment options. These seminal events led to the expansion of the workforce, creating a critical mass consisting of individuals with focused, specialized skills and techniques. In-depth expertise allowed more accurate diagnosis and highly effective treatment strategies for advanced hepatobiliary disease in children. The demand for pediatric clinicians with experience in advanced hepatology allowed sub-sub-specialization to flourish. Continued maturation of the field led to definition of hepatology-focused curricular elements and educational content for Pediatric Gastroenterology training programs, and subsequently the development of program requirements for those who wished to acquire additional training in Pediatric Hepatology. A

  15. Real time elastography endoscopic ultrasound (RTE-EUS), a comprehensive review

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    Dietrich, C.F., E-mail: christoph.dietrich@ckbm.de [Med. Klinik 2, Caritas-Krankenhaus Bad Mergentheim (Germany); Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova (Romania); Klinik für Innere Medizin, Krankenhaus Märkisch Oderland (Germany); Săftoiu, A.; Jenssen, C. [Med. Klinik 2, Caritas-Krankenhaus Bad Mergentheim (Germany); Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova (Romania); Klinik für Innere Medizin, Krankenhaus Märkisch Oderland (Germany)

    2014-03-15

    Real-time elastography (RTE) performed during endoscopic ultrasound (EUS) is a relatively new technique which allows the evaluation of tissue stiffness, with the intent of better characterising lesions during EUS examinations. The aim of this comprehensive review was to describe the technique of RTE-EUS, as well as the clinical applications, including the study of pancreatic lesions, but also hepatobiliary, gastrointestinal (GI) tract pathology (including anal canal), lymph nodes, adrenal glands, lung and mediastinum, as well as urogenital applications. One of the advantages of the RTE-EUS technique is especially the possibility to be used in various locations accessible from the GI tract. Future developments are also briefly discussed, as elastography is a tissue characterising technique that will certainly not replace biopsy, but will rather be an adjunct during EUS examinations, due to its ease of use and low cost.

  16. Correction of the functional condition of the bile excretory system in pathogenetic management of polymorbid patients with atherosclerosis

    Directory of Open Access Journals (Sweden)

    I. A. Gorbacheva

    2013-01-01

    Full Text Available The aim of the search was development of some methods for improvement of effectiveness of treatment of polymorbid patients with atherosclerosis and disordered bile outflow. Complex phytotherapy (phytocomplex «Hepar» with its hepatoprotective and choleratic effects was prescribed for 33 patients with atherosclerosis and hepatobiliary dysfunction (in addition to dietotherapy and choleratics. Administration of the balanced phytotherapy resulted in significant reduction of the cholesterol level associated with the decrease of the C-reactive protein index in the blood. These changes were followed by decrease of the blood lipids and protein substrates oxidation - the factors meaning suppression of the degree of oxidative stress and of inflammation in the body.

  17. Specific Features of Progression of the Parasitic Invasion, caused by Opisthorchis felineus, in Golden Hamsters.

    Science.gov (United States)

    Semenov, D E; Zhukova, N A; Tolstikova, T G; Sorokina, I V; Lushnikova, E L

    2016-08-01

    The influence of Opisthorchis felineus invasion on the development of pathological changes in the hepatobiliary system was studied in 120 golden hamsters in a long-term experiment (42 weeks) after single infection per os in the dose of 50 metacercariae per animal. The animals were sacrificed on weeks 4, 8, 12, 16, 28 and 42. Chronic experimental infestation with O. felineus triggered a cascade of morphogenetic processes in both extrahepatic and intrahepatic biliary systems. At the early stages of the experiment, polyps and strictures of bile ducts were formed in the lobar bile ducts; in portal tracts, hyperplasia and adenomatous transformation of the newly formed epithelial structures were observed. At the later stages, third-degree biliary intraepithelial neoplasia developed in the lobar bile ducts; in the intrahepatic bile ducts, increased epitheliocyte hyperplasia and invasive growth of cell cords were observed, that impaired tissue architectonics. Progressing cell atypia can be classified as cholangiocellular cancer.

  18. Artery to Cystic Duct: A Consistent Branch of Cystic Artery Seen in Laparoscopic Cholecystectomy

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    Arshad Rashid

    2015-01-01

    Full Text Available Uncontrolled arterial bleeding during laparoscopic cholecystectomy is a serious problem and may increase the risk of bile duct damage. Therefore, accurate identification of the anatomy of the cystic artery is very important. Cystic artery is notoriously known to have a highly variable branching pattern. We reviewed the anatomy of the cystic artery and its branch to cystic duct as seen through the video laparoscope. A single artery to cystic duct with the classical “H-configuration” was demonstrated in 161 (91.47% patients. This branch may cause troublesome bleeding during laparoscopic dissection in the hepatobiliary triangle. Careful identification of artery to cystic duct is helpful in the proper dissection of Calot’s triangle as it reduces the chances of hemorrhage and thus may also be helpful in prevention of extrahepatic biliary radical injuries.

  19. [Trans-intestinal cholesterol excretion (TICE): a new route for cholesterol excretion].

    Science.gov (United States)

    Blanchard, Claire; Moreau, François; Cariou, Bertrand; Le May, Cédric

    2014-10-01

    The small intestine plays a crucial role in dietary and biliary cholesterol absorption, as well as its lymphatic secretion as chylomicrons (lipoprotein exogenous way). Recently, a new metabolic pathway called TICE (trans-intestinal excretion of cholesterol) that plays a central role in cholesterol metabolism has emerged. TICE is an inducible way, complementary to the hepatobiliary pathway, allowing the elimination of the plasma cholesterol directly into the intestine lumen through the enterocytes. This pathway is poorly characterized but several molecular actors of TICE have been recently identified. Although it is a matter of debate, two independent studies suggest that TICE is involved in the anti-atherogenic reverse cholesterol transport pathway. Thus, TICE is an innovative drug target to reduce -cardiovascular diseases.

  20. Use of Omega-3 Polyunsaturated Fatty Acids to Treat Inspissated Bile Syndrome: A Case Report

    Science.gov (United States)

    Jun, Woo Young; Cho, Min Jeng; Han, Hye Seung

    2016-01-01

    Inspissated bile syndrome (IBS) is a rare condition in which thick intraluminal bile, including bile plugs, sludge, or stones, blocks the extrahepatic bile ducts in an infant. A 5-week-old female infant was admitted for evaluation of jaundice and acholic stool. Diagnostic tests, including ultrasound sonography, magnetic resonance cholangiopancreatography, and a hepatobiliary scan, were not conclusive. Although the diagnosis was unclear, the clinical and laboratory findings improved gradually on administration of urodeoxycholic acid and lipid emulsion containing omega-3 polyunsaturated fatty acids (PUFAs) for 3 weeks. However, a liver biopsy was suggestive of biliary atresia. This finding forced us to perform intraoperative cholangiography, which revealed a patent common bile duct with impacted thick bile. We performed normal saline irrigation and the symptom was improved, the final diagnosis was IBS. Thus, we herein report that IBS can be treated with omega-3 PUFAs as an alternative to surgical intervention. PMID:28090475

  1. The evolution of robotic general surgery.

    Science.gov (United States)

    Wilson, E B

    2009-01-01

    Surgical robotics in general surgery has a relatively short but very interesting evolution. Just as minimally invasive and laparoscopic techniques have radically changed general surgery and fractionated it into subspecialization, robotic technology is likely to repeat the process of fractionation even further. Though it appears that robotics is growing more quickly in other specialties, the changes digital platforms are causing in the general surgical arena are likely to permanently alter general surgery. This review examines the evolution of robotics in minimally invasive general surgery looking forward to a time where robotics platforms will be fundamental to elective general surgery. Learning curves and adoption techniques are explored. Foregut, hepatobiliary, endocrine, colorectal, and bariatric surgery will be examined as growth areas for robotics, as well as revealing the current uses of this technology.

  2. Antibody induction versus placebo, no induction, or another type of antibody induction for liver transplant recipients

    DEFF Research Database (Denmark)

    Penninga, Luit; Wettergren, André; Wilson, Colin H

    2014-01-01

    BACKGROUND: Liver transplantation is an established treatment option for end-stage liver failure. To date, no consensus has been reached on the use of immunosuppressive T-cell antibody induction for preventing rejection after liver transplantation. OBJECTIVES: To assess the benefits and harms...... of immunosuppressive T-cell specific antibody induction compared with placebo, no induction, or another type of T-cell specific antibody induction for prevention of acute rejection in liver transplant recipients. SEARCH METHODS: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane...... Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Science Citation Index Expanded, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) until September 2013. SELECTION CRITERIA: Randomised clinical trials assessing immunosuppression with T...

  3. Antibody induction versus corticosteroid induction for liver transplant recipients

    DEFF Research Database (Denmark)

    Penninga, Luit; Wettergren, André; Wilson, Colin H

    2014-01-01

    BACKGROUND: Liver transplantation is an established treatment option for end-stage liver failure. To date, no consensus has been reached on the use of immunosuppressive T-cell specific antibody induction compared with corticosteroid induction of immunosuppression after liver transplantation....... OBJECTIVES: To assess the benefits and harms of T-cell specific antibody induction versus corticosteroid induction for prevention of acute rejection in liver transplant recipients. SEARCH METHODS: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register...... of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Science Citation Index Expanded, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) on 30 September 2013 together with reference checking, citation searching, contact with trial authors and pharmaceutical companies...

  4. Transient elastography for diagnosis of stages of hepatic fibrosis and cirrhosis in people with alcoholic liver disease

    DEFF Research Database (Denmark)

    Pavlov, Chavdar S; Casazza, Giovanni; Nikolova, Dimitrinka

    2015-01-01

    fibrosis in people with liver diseases. Transient elastography is a non-invasive method for assessing and staging hepatic fibrosis. OBJECTIVES: To determine the diagnostic accuracy of transient elastography for diagnosis and staging hepatic fibrosis in people with alcoholic liver disease when compared...... with liver biopsy. To identify the optimal cut-off values for differentiating the five stages of hepatic fibrosis. SEARCH METHODS: The Cochrane Hepato-Biliary Group Controlled and Diagnostic Test Accuracy Studies Registers, The Cochrane Library, MEDLINE (OvidSP), EMBASE (OvidSP), and the Science Citation...... Index Expanded (last search August 2014). SELECTION CRITERIA: Diagnostic cohort and diagnostic case-control study designs that assessed hepatic fibrosis in participants with alcoholic liver disease with transient elastography and liver biopsy, irrespective of language or publication status. The study...

  5. Concepto actual y aspectos clínicos de la enfermedad de Crohn y la colitis ulcerosa

    Directory of Open Access Journals (Sweden)

    Luis Ortigosa

    2005-06-01

    Full Text Available Inflammatory Bowel Disease (IBD groups two clinic entities: Ulcerative colitis (UC and Crohn´s disease (CD. UC is defined as a diffuse colonic inflammation (affecting always to rectum, and may be extending (continuosly over proximal colon. The inflammatory process is located to the colonic mucosa and submucosa. CD may affect to one or several parts of the digestive tube, including a transmural inflammation, mainly on the terminal ileum, colon and perianal region. Damaged areas are mixed with normal areas, versus UC difuse inflammation. Both disorders may present digestive and extradigestive manifestations. These comprehend arthritis, mucocutaneous signs, hepatobiliary, nephrourologic, and ocular symptoms, mainly. Differential diagnosis between UC and CD is possible, with the help of a precise clinical record, laboratory findings, endoscopic, histopathologic and image techniques. Activity index disease is a very useful tool for managing IBD.

  6. Bacteremia Due to Arthrobacter creatinolyticus in an Elderly Diabetic Man with Acute Cholangitis.

    Science.gov (United States)

    Yamamoto, Kei; Hayakawa, Kayoko; Nagamatsu, Maki; Fujiya, Yoshihiro; Mawatari, Momoko; Kutsuna, Satoshi; Takeshita, Nozomi; Tamura, Saeko; Mezaki, Kazuhisa; Ohmagari, Norio

    2017-03-24

    An 87-year-old man with poorly controlled diabetic mellitus presented with fever, bedsores, and elevated hepatobiliary enzyme levels. He was diagnosed with bacteremia with acute cholangitis due to Arthrobacter species, which are Gram-positive, aerobic, catalase-positive, coryneform bacteria belonging to the family Microbacteriaceae. Doripenem and subsequencial sulbactam/ampicillin treatment were used for the acute cholangitis, and the bacteremia was treated with a 2-week course of vancomycin. The bacteremia was misidentified by the phenotyping assay (API Coryne test), but was identified as Arthrobacter creatinolyticus by 16S rRNA and matrix-assisted laser-desorption/ionization time-of-flight mass spectrometry. To our knowledge, this is the first report of a human case of A. creatinolyticus bacteremia.

  7. Primary biliary cystadenocarcinoma mimicking a complicated hydatid cyst.

    Science.gov (United States)

    Genç, V; Cakmak, A; Akbari, M; Orozakunov, E; Ersöz, S

    2010-01-01

    Cystadenocarcinoma of the liver is a rare neoplasm that originates from hepatobiliary epithelium. Primary location of this tumor is generally intrahepatic and most cases are in the right hepatic lobe. Herein we present a case of intrahepatic cystadenocarcinoma in a 53-year-old man who had been followed up for 8 years as hydatic cyst disease of the liver. He was admitted to our hospital with jaundice and loss of appetite. Ultrasound and computed tomography showed a cystic lesion that looked like type II cyst hidatic. Thereafter magnetic resonance imaging revealed a cystic lesion associated with biliary tree. On diagnostic laparotomy peritoneal infiltrations were observed and pathologic examination revealed a biliary cystadenocarcinoma and peritonitis carcinomatosa was diagnosed. Unfortunately correct diagnosis was extremely late and no curative management was possible.

  8. Management of intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Marschall, Hanns-Ulrich

    2015-01-01

    Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease during pregnancy, characterized by otherwise unexplained pruritus in late second and third trimester of pregnancy and elevated bile acids and/or transaminases. ICP is associated with an increased risk of adverse perinatal outcomes for the fetus and the later development of hepatobiliary disease for the mother. Bile acids should be monitored throughout pregnancy since fetal risk is increased at serum bile acids >40 µmol/l. Management of ICP consists of treatment with ursodeoxycholic acid, which reduces pruritus. Early elective delivery is common practice but should be performed on an individualized basis as long as strong evidence supporting this practice is lacking. Mothers should be followed-up for normalization of liver function tests 6-12 weeks after delivery. Future research in large-scale studies is needed to address the impact of ursodeoxycholic acid and early elective delivery on fetal outcome.

  9. Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems

    Science.gov (United States)

    Kondrackiene, Jurate; Kupcinskas, Limas

    2008-01-01

    Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder. Maternal effects of ICP are mild; however, there is a clear association between ICP and higher frequency of fetal distress, preterm delivery, and sudden intrauterine fetal death. The cause of ICP remains elusive, but there is evidence that mutations in genes encoding hepatobiliary transport proteins can predispose for the development of ICP. Recent data suggest that ursodeoxycholic acid is currently the most effective pharmacologic treatment, whereas obstetric management is still debated. Clinical trials are required to identify the most suitable monitoring modalities that can specifically predict poor perinatal outcome. This article aims to review current achievements and unsolved problems of ICP. PMID:18855975

  10. How to improve the early diagnosis of pancreatic cancer%如何提高胰腺癌的早期诊断率

    Institute of Scientific and Technical Information of China (English)

    张太平; 展翰翔; 赵玉沛

    2009-01-01

    Pancreatic cancer is highly malignant with a poor prognosis. The resectability and prognosis of early pancreatic cancer are much better than the advanced, so early diagnosis is crucial for saving patients' lives. Because the symptoms of pancreatic cancer are non-specific, most of the patients are misdiagnosed as gastrointestinal or hepatobiliary diseases. Early diagnosis rate of pancreatic cancer can be greatly improved by combined application of tumor marker detection, endoscopic ultrasound, computed tomography, positron emission tomo-graphy, and etc. Early screening of high-risk population has been advocated by the experts, and its value in early diagnosis of pancreatic cancer has been confirmed by relevant studies. The colaboration of multiple pancreatic surgery centers in conducting prospective studies and setting gnidlines for the pancreatic cancer diagnosis, and relevant fundamental reseaches should also be emphasized.

  11. The ABCG5/8 Cholesterol Transporter and Myocardial Infarction Versus Gallstone Disease

    DEFF Research Database (Denmark)

    Stender, Stefan; Frikke-Schmidt, Ruth; Nordestgaard, Børge G

    2014-01-01

    OBJECTIVES: The study sought to test the hypothesis that genetic variation in ABCG5/8, the transporter responsible for intestinal and hepatobiliary cholesterol efflux, may simultaneously influence plasma and biliary cholesterol levels, and hence risk of myocardial infarction (MI) and gallstone...... disease in opposite directions. BACKGROUND: High plasma levels of low-density lipoprotein (LDL) cholesterol are a causal risk factor for MI, whereas high levels of biliary cholesterol promote gallstone formation. METHODS: A total of 60,239 subjects from Copenhagen were included, including 5,647 with MI...... and 3,174 with symptomatic gallstone disease. Subjects were genotyped for 6 common, nonsynonymous and functional variants in ABCG5/8, and a combined weighted genotype score was calculated. RESULTS: Combined, weighted genotype scores were associated with stepwise decreases in LDL cholesterol of up to 5...

  12. Ectopic fascioliasis mimicking a colon tumor

    Institute of Scientific and Technical Information of China (English)

    Ozer Makay; Baris Gurcu; Cemil Caliskan; Deniz Nart; Muge Tuncyurek; Mustafa Korkut

    2007-01-01

    Fasciola hepatica, a leaf shaped trematode that is common in cattle, sheep and goats, is acquired by eating raw water plants like watercress or drinking water infected with the encysted form of the parasite.The varied clinical presentations of fascioliasis still make a high index of suspicion mandatory. Besides having a wide spectrum of hepatobiliary symptoms like obstructive jaundice, cholangitis and liver cirrhosis, the parasitic infection also has extrabiliary manifestations.Until recently, extrahepatic fascioliasis has been reported in the subcutaneous tissue, brain, lungs, epididymis,inguinal lymph nodes, stomach and the cecum. In this report, a strange manifestation of the fasciola infection in a site other than the liver, a colonic fascioliasis, is presented.

  13. Klatskin tumor: Diagnosis, preoperative evaluation and surgical considerations.

    Science.gov (United States)

    Molina, Víctor; Sampson, Jaime; Ferrer, Joana; Sanchez-Cabus, Santiago; Calatayud, David; Pavel, Mihai Calin; Fondevila, Constantino; Fuster, Jose; García-Valdecasas, Juan Carlos

    2015-11-01

    Hiliar cholangiocarcinoma is the most common type of cholangiocarcinoma, an represent around 10% of all hepatobiliary tumors. It is an aggressive malignancy, resectable in around 47% of the patients at diagnosis. Complete resection is the most effective and only potentially curative therapy, with a survival rate of less than 12 months in unresectable cases. Axial computerized tomography and magnetic resonance are the most useful image techniques to determine the surgical resectability. Clinically, jaundice and pruritus are the most common symptoms at diagnosis;preoperative biliary drainage is recommended using endoscopic retrograde cholangiography or percutaneous transhepatic cholangiography. Surgery using extended liver resections with an en bloc resection of the liver with vascular reconstruction is the technique with the highest survival. Complete resection with histologically negative resection margins (R0), nodal involvement and metastases are the most important prognostic factors.

  14. The curious case of a Klatskin tumor.

    Science.gov (United States)

    Njei, Basile; Konjeti, Venkata Rajesh; Sanchez, Harold

    2013-01-01

    Klatskin tumors are the most common type of cholangiocarcinomas. They are perihilar tumors usually found at the bifurcation of right and left hepatic ducts. The absence of early symptoms leads to the diagnosis of most Klatskin tumors at an advanced incurable stage. Despite emerging adjuvant treatment regimens, survival outcomes remain poor. Surgery is currently the standard of care and the only curative treatment modality available. In this manuscript, we share our experience with an asymptomatic patient with elevated liver enzymes, who was found to have a Klatskin tumor, extending into the left hepatic duct. The patient's diagnosis, management, and prognosis are discussed. The case highlights the importance of screening for hepato-biliary malignancies in elderly patients with abnormal liver function markers.

  15. The Immunogenetics of Autoimmune Cholestasis.

    Science.gov (United States)

    Trivedi, Palak J; Hirschfield, Gideon M

    2016-02-01

    The immune-mediated hepatobiliary diseases, primary biliary cirrhosis and primary sclerosing cholangitis are relatively rare, albeit and account for a significant amount of liver transplant activity and liver-related mortality globally. Precise disease mechanisms are yet to be described although a contributory role of genetic predisposition is firmly established. In addition to links with the major histocompatibility complex, a number of associations outside this region harbor additional loci which underscore the fundamental role of breaks in immune tolerance and mucosal immunogenicity in the pathogenesis of autoimmune biliary disease. We provide an overview of these key discoveries before discussing putative avenues of therapeutic exploitation based on existing findings. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Primary biliary cirrhosis and ulcerative colitis: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Wen-Bin Xiao; Yu-Lan Liu

    2003-01-01

    AIM: To summarize the characteristics of patients suffered from primary biliary cirrhosis associated with ulcerative colitis.METHODS: To report a new case and review the literature.RESULTS: There were 18 cases (including our case) of primary biliary cirrhosis complicated with ulcerative colitis reported in the literature. Compared with classical primary biliary cirrhosis, the patients were more often males and younger similar. The bowel lesions were usually mild with proctitis predominated. While ulcerative colitis was diagnosed before primary biliary cirrhosis in 13 cases, the presentation of primary biliary cirrhosis was earlier than that of ulcerative colitis in our new case reported here. The prevalence of primary biliary cirrhosis among patients of ulcerative colitis was almost 30 times higher than in general population.CONCLUSION: Association of primary biliary cirrhosis with ulcerative colitis is rare. It should be considered in the differential diagnosis of hepatobiliary disease in patients with ulcerative colitis, and vice versa.

  17. Laparoscopic cholecystectomy in a patient with situs inversus totalis

    Institute of Scientific and Technical Information of China (English)

    Unal Aydin; Omer Unalp; Pinar Yazici; Baris Gurcu; Murat Sozbilen; Ahmet Coker

    2006-01-01

    Currently, laparoscopic cholecystectomy is an undoubtfully optimal treatment of cholelithiasis. What about performing this procedure on a patient with situs inversus totalis and what are the difficulties of this operation for a right-handed surgeon? We presented a 35-year-old man with unknown situs inversus totalis who was admitted with epigastric pain and digestive problems. Ultrasonography and computed tomography of the abdomen confirmed the diagnosis of a gallstone.Besides, the liver and gallbladder were on the left side and the spleen was on the right. All systems were left-right reversal as mirror image in all diagnostic studies.Laparoscopic cholecystectomy was safely performed,despite of difficulties of situs inversus. The patient was discharged on postoperative day 1.It should be considered that existence of other anomalies may easily cause uninvited injuries. In the patients with situs inversus, laparoscopic cholecystectomy can be safely managed by an experienced surgeon through laparoscopy, and also hepatobiliary surgery.

  18. Hepatic S4a + S5 and bile duct resection for gallbladder carcinoma.

    Science.gov (United States)

    Miyazaki, Masaru; Shimizu, Hiroaki; Ohtsuka, Masayuki; Yoshidome, Hiroyuki; Kato, Atsushi; Yoshitomi, Hideyuki; Furukawa, Katsunori; Kimura, Fumio

    2012-05-01

    In the surgical treatment of gallbladder cancer, segment 4a + 5 hepatic resection and bile duct resection is usually recommended for T2 and/or T3 gallbladder cancer involving hepatic parenchyma without hepatic biliary confluence. This procedure does not affect liver function excessively, provided there is correct identification of hepatic S4a and S5, the most important aspect of this procedure. In this paper, the technique of hepatic S4a + 5 and bile duct resection is described in detail. This surgical procedure could be a useful option for the surgical treatment of the hepatobiliary pancreatic malignancies. Surgeons should therefore master the surgical techniques for this procedure.

  19. Non-absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis

    DEFF Research Database (Denmark)

    Gluud, Lise Lotte; Vilstrup, Hendrik; Morgan, Marsha Y

    2016-01-01

    BACKGROUND: Non-absorbable disaccharides (lactulose and lactitol) are recommended as first-line treatment for hepatic encephalopathy. The previous (second) version of this review included 10 randomised clinical trials (RCTs) evaluating non-absorbable disaccharides versus placebo/no intervention...... and eight RCTs evaluating lactulose versus lactitol for people with cirrhosis and hepatic encephalopathy. The review found no evidence to either support or refute the use of the non-absorbable disaccharides and no differences between lactulose versus lactitol. OBJECTIVES: To assess the beneficial...... and harmful effects of i) non-absorbable disaccharides versus placebo/no intervention and ii) lactulose versus lactitol in people with cirrhosis and hepatic encephalopathy. SEARCH METHODS: We carried out electronic searches of the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central...

  20. Strengthening the case that elevated levels of programmed death ligand 1 predict poor prognosis in hepatocellular carcinoma patients

    Directory of Open Access Journals (Sweden)

    Zhong J

    2016-12-01

    Full Text Available Jian-Hong Zhong,1,* Cheng-Piao Luo,2,* Chun-Yan Zhang,2 Le-Qun Li1 1Hepatobiliary Surgery Department, 2Experimental Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People’s Republic of China *These authors contributed equally to this work Abstract: Immunotherapy targeting programmed death receptor 1 and programmed death ligand 1 (PD-L1 has shown impressive antitumor efficacy in several solid cancers, including advanced hepatocellular carcinoma (HCC. Since response rates of various cancers to such immunotherapy appear to correlate with PD-L1 expression levels, several studies have examined whether PD-L1 expression correlates with HCC pathology and patient prognosis. In this paper, we analyzed the strength and limitations of a recent meta-analysis of associations of PD-L1 with HCC characteristics and patient prognosis. Keywords: hepatocellular carcinoma, programmed death ligand 1, hepatic resection, prognoses

  1. Acceptance and Commitment Therapy in Improving Well-Being in Patients With Stage III-IV Cancer and Their Partners

    Science.gov (United States)

    2017-09-21

    Malignant Female Reproductive System Neoplasm; Malignant Hepatobiliary Neoplasm; Partner; Stage III Breast Cancer; Stage III Cervical Cancer; Stage III Colorectal Cancer; Stage III Lung Cancer; Stage III Prostate Cancer; Stage III Skin Melanoma; Stage III Uterine Corpus Cancer; Stage IIIA Breast Cancer; Stage IIIA Cervical Cancer; Stage IIIA Colorectal Cancer; Stage IIIA Lung Carcinoma; Stage IIIA Skin Melanoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Breast Cancer; Stage IIIB Cervical Cancer; Stage IIIB Colorectal Cancer; Stage IIIB Lung Carcinoma; Stage IIIB Skin Melanoma; Stage IIIB Uterine Corpus Cancer; Stage IIIC Breast Cancer; Stage IIIC Colorectal Cancer; Stage IIIC Skin Melanoma; Stage IIIC Uterine Corpus Cancer; Stage IV Breast Cancer; Stage IV Cervical Cancer; Stage IV Colorectal Cancer; Stage IV Lung Cancer; Stage IV Prostate Cancer; Stage IV Skin Melanoma; Stage IV Uterine Corpus Cancer; Stage IVA Cervical Cancer; Stage IVA Colorectal Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Cervical Cancer; Stage IVB Colorectal Cancer; Stage IVB Uterine Corpus Cancer

  2. Biloma: An unusual complication in a patient with pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    Palak Jitendrakumar Trivedi; Prakash Gupta; Jane Phillips-Hughes; Anthony Ellis

    2009-01-01

    The term biloma describes an encapsulated collection of bile within the abdomen, usually secondary to bile duct disruption. The commonest causes reported in the literature are iatrogenic (secondary to hepatobiliary surgery), trauma or complications due to choledocholithiasis. A few cases have been reported as complications of cholangiocarcinoma or acute cholecystitis. We report the case of a 64-year-old man initially diagnosed with a non-obstructive malignancy of the pancreas, who developed a spontaneous intrahepatic biloma 8 mo later. This was identified following a 1-wk history of fever, rigors and icterus. The biloma was identified on computed tomography and subsequently drained under ultrasound guidance. Forty-eight hours later, a stent was inserted endoscopically into his common bile duct and he made an uneventful in-hospital recovery. We believe this is the first documented case of spontaneous intrahepatic biloma to occur secondary to pancreatic malignancy.

  3. Sensorineural Hearing Loss Associated with Kawasaki Disease

    Directory of Open Access Journals (Sweden)

    Hitoshi Tanimoto

    2014-04-01

    Full Text Available Kawasaki disease (KD is an acute systemic vasculitis of children characterized by fever, rash, conjunctival hyperemia, oropharyngeal erythema, edema and erythema of the hands and feet, and cervical adenopathy [1]. A variety of other features are also characteristics of this syndrome, including coronary artery aneurysms, urethritis, anterior uveitis, mild hepatobiliary dysfunction, and gallbladder hydrops. Coronary artery abnormalities, including aneurysms and ectasia, occur in approximately 20% of untreated patients [2]. Neurologic involvement is rare. Cranial nerve palsy, especially involving the seventh nerve, has been reported [3], as well as hemiparesis caused by cerebral thrombosis and infarction, and convulsions. Although about 30% of patients with acute KD in the United States have been reported to suffer mild sensorineural hearing loss (SNHL [4], only a few such cases have been reported in Japan. On the other hand, in both countries, a few cases of severe or profound SNHL in children who were in the acute phase of KD have been documented [5].

  4. Usefulness of endoscopic ultrasonography in hepatology

    Science.gov (United States)

    Bissonnette, Julien; Paquin, Sarto; Sahai, Anand V; Pomier-Layrargues, Gilles

    2011-01-01

    Endoscopic ultrasonography (EUS) is used to evaluate patients with hepatobiliary diseases. The technique is useful for the diagnosis of esogastric varices in selected cases of portal hypertension, and to evaluate the pathogenic role and prognostic value of the collateral circulation in patients with this condition. When coupled with the Doppler technique, EUS can be used to guide injection sclerotherapy and to verify the obliteration of varices (particularly fundal varices) after endoscopic treatment. Hemodynamic changes induced in the collateral circulation by vasoactive drugs can also be measured with Doppler-EUS. Fine-needle aspiration under EUS guidance is useful in the diagnosis of focal liver lesions and perihepatic adenopathy, and in the evaluation of biliary tract diseases. New indications can be developed in the future after adequate experimental validation. PMID:22059170

  5. Usefulness of Endoscopic Ultrasonography in Hepatology

    Directory of Open Access Journals (Sweden)

    Julien Bissonnette

    2011-01-01

    Full Text Available Endoscopic ultrasonography (EUS is used to evaluate patients with hepatobiliary diseases. The technique is useful for the diagnosis of esogastric varices in selected cases of portal hypertension, and to evaluate the pathogenic role and prognostic value of the collateral circulation in patients with this condition. When coupled with the Doppler technique, EUS can be used to guide injection sclerotherapy and to verify the obliteration of varices (particularly fundal varices after endoscopic treatment. Hemodynamic changes induced in the collateral circulation by vasoactive drugs can also be measured with Doppler-EUS. Fine-needle aspiration under EUS guidance is useful in the diagnosis of focal liver lesions and perihepatic adenopathy, and in the evaluation of biliary tract diseases. New indications can be developed in the future after adequate experimental validation.

  6. The Opisthorchis viverrini genome provides insights into life in the bile duct.

    Science.gov (United States)

    Young, Neil D; Nagarajan, Niranjan; Lin, Suling Joyce; Korhonen, Pasi K; Jex, Aaron R; Hall, Ross S; Safavi-Hemami, Helena; Kaewkong, Worasak; Bertrand, Denis; Gao, Song; Seet, Qihui; Wongkham, Sopit; Teh, Bin Tean; Wongkham, Chaisiri; Intapan, Pewpan Maleewong; Maleewong, Wanchai; Yang, Xinhua; Hu, Min; Wang, Zuo; Hofmann, Andreas; Sternberg, Paul W; Tan, Patrick; Wang, Jun; Gasser, Robin B

    2014-07-09

    Opisthorchiasis is a neglected, tropical disease caused by the carcinogenic Asian liver fluke, Opisthorchis viverrini. This hepatobiliary disease is linked to malignant cancer (cholangiocarcinoma, CCA) and affects millions of people in Asia. No vaccine is available, and only one drug (praziquantel) is used against the parasite. Little is known about O. viverrini biology and the diseases that it causes. Here we characterize the draft genome (634.5 Mb) and transcriptomes of O. viverrini, elucidate how this fluke survives in the hostile environment within the bile duct and show that metabolic pathways in the parasite are highly adapted to a lipid-rich diet from bile and/or cholangiocytes. We also provide additional evidence that O. viverrini and other flukes secrete proteins that directly modulate host cell proliferation. Our molecular resources now underpin profound explorations of opisthorchiasis/CCA and the design of new interventions.

  7. Opisthorchis viverrini:The carcinogenic human liver fluke

    Institute of Scientific and Technical Information of China (English)

    Natthawut Kaewpitoon; Soraya J Kaewpitoon; Prasit Pengsaa; Banchob Sripa

    2008-01-01

    Opisthorchiasis caused by Opisthorchis viverrini remains a major public health problem in many parts of Southeast Asia,including Thailand,Lao PDR,Vietnam and Cambodia.The infection is associated with a number of hepatobiliary diseases,including cholangitis,obstructive jaundice,hepatomegaly,cholecystitis and cholelithiasis.Multi-factorial etiology of cholangiocarcinoma,mechanical damage,parasite secretions,and immunopathology may enhance cholangiocarcinogenesis.Moreover,both experimental and epidemiological evidences strongly implicate liver fluke infection as the major risk factor in cholangiocarcinoma,cancer of the bile ducts.The liver fluke infection is induced by eating raw or uncooked fish products that is the tradition and popular in the northeastern and northern region,particularly in rural areas,of Thailand.The health education programs to prevent and control opisthorchiasis are still required in the high-risk areas.

  8. The zoonotic, fish-borne liver flukes Clonorchis sinensis, Opisthorchis felineus and Opisthorchis viverrini.

    Science.gov (United States)

    Petney, Trevor N; Andrews, Ross H; Saijuntha, Weerachai; Wenz-Mücke, Alexandra; Sithithaworn, Paiboon

    2013-11-01

    Clonorchis sinensis, Opisthorchis felineus and Opisthorchis viverrini are the three most important liver flukes involved in human health, infecting more than 45 million people worldwide. Both C. sinensis and O. viverrini, and possibly O. felineus, can induce human cholangiocarcinoma as well as inducing other hepatobiliary pathology. Although the life cycles of all three species are similar, only that of O. felineus in Europe remains predominantly zoonotic, while O. felineus in Asia and C. sinensis have a stronger mixture of zoonotic and anthroponotic components in their life cycles. Opisthorchis viverrini from the Mekong area of southeastern Asia is predominantly anthroponotic. Here we discuss the comparative epidemiology of these three taxa comparing in detail the use of first, second and final animal hosts, and consider the potential role of humans in spreading these pathogens. In addition we discuss the genetic structure of all three species in relation to potentially cryptic species complexes.

  9. Contrast Enhanced MRI in the Diagnosis of HCC

    Directory of Open Access Journals (Sweden)

    Eric Niendorf

    2015-09-01

    Full Text Available Hepatocellular carcinoma (HCC is the 6th most common cancer worldwide. Imaging plays a critical role in HCC screening and diagnosis. Initial screening of patients at risk for HCC is performed with ultrasound. Confirmation of HCC can then be obtained by Computed Tomography (CT or Magnetic Resonance Imaging (MRI, due to the relatively high specificity of both techniques. This article will focus on reviewing MRI techniques for imaging HCC, felt by many to be the exam of choice for HCC diagnosis. MRI relies heavily upon the use of gadolinium-based contrast agents and while primarily extracellular gadolinium-based contrast agents are used, there is an emerging role of hepatobiliary contrast agents in HCC imaging. The use of other non-contrast enhanced MRI techniques for assessing HCC will also be discussed and these MRI strategies will be reviewed in the context of the pathophysiology of HCC to help understand the MR imaging appearance of HCC.

  10. The use of endo-GIA vascular staplers in liver surgery and their potential benefit: a review.

    Science.gov (United States)

    Schemmer, Peter; Friess, Helmut; Dervenis, Christos; Schmidt, Jan; Weitz, Jürgen; Uhl, Waldemar; Büchler, Markus W

    2007-01-01

    Stapling devices have been introduced for safety and to reduce the overall operative time in many surgical procedures. In hepatobiliary surgery, i.e. liver resection, several types of staplers are in use. While transection of hepatic vessels with vascular staplers is well established, their use in dissecting hepatic parenchyma has only been assessed recently. Its advantages were especially a low rate of biliary complications (i.e., bile fistulas, bilioma) and reduced bleeding. As expected, the operative time was decreased dramatically while both the complication rate in general and the overall costs for stapler hepatectomy were comparable with other techniques used in high-volume centers. Thus, endo-GIA vascular staplers can be safely used to dissect the hepatic parenchyma in a routine clinical setting with low incidence of surgical complications.

  11. Cutaneous neonatal lupus with cutis marmorata telangiectatica congenita-like lesions.

    Science.gov (United States)

    Trevisan, Flávia; Cunha, Paulo Rowilson; Pinto, Clóvis Antonio Lopes; Cattete, Fernanda Gomes

    2013-01-01

    Neonatal lupus is a rare disease caused by the transplacental transfer of maternal autoantibodies to the foetus, characterized by transient clinical manifestations such as cutaneous, haematological, and hepatobiliary events or permanent such as congenital heart block. The typical cutaneous manifestations include erythematous, scaly, annular or arched lesions on the face, with slight central atrophy and photosensitivy, clinically and histologically similar to subacute cutaneous lupus. However, in some cases, the lesions may resemble those in cutis marmorata telangiectatica congenita, although this phenomenon is rare and only eight such cases have been reported to date. We report a case of cutaneous neonatal lupus with atypical lesions on the limbs, which had a reddish-purple marbled appearance, resembling the lesions in cutis marmorata telangiectatica congenita.

  12. Cutaneous neonatal lupus with cutis marmorata telangiectatica congenita-like lesions*

    Science.gov (United States)

    Trevisan, Flávia; Cunha, Paulo Rowilson; Pinto, Clóvis Antonio Lopes; Cattete, Fernanda Gomes

    2013-01-01

    Neonatal lupus is a rare disease caused by the transplacental transfer of maternal autoantibodies to the foetus, characterized by transient clinical manifestations such as cutaneous, haematological, and hepatobiliary events or permanent such as congenital heart block. The typical cutaneous manifestations include erythematous, scaly, annular or arched lesions on the face, with slight central atrophy and photosensitivy, clinically and histologically similar to subacute cutaneous lupus. However, in some cases, the lesions may resemble those in cutis marmorata telangiectatica congenita, although this phenomenon is rare and only eight such cases have been reported to date. We report a case of cutaneous neonatal lupus with atypical lesions on the limbs, which had a reddish-purple marbled appearance, resembling the lesions in cutis marmorata telangiectatica congenita. PMID:23793203

  13. Tumor diagnosis in the adult liver transplant candidate

    Energy Technology Data Exchange (ETDEWEB)

    Mahfouz, A.E. [Department of Radiology, Humboldt Univ. (Germany)]|[Department of Radiology, Cairo University Hospital, Cairo (Egypt); Vogl, T. [Department of Radiology, Humboldt Univ., Berlin (Germany).; Hamm, B. [Department of Radiology, Humboldt Univ. (Germany)

    1999-06-01

    Hepatic transplantation has emerged as a potentially curative treatment of certain malignant hepatic neoplasms such as hepatocellular carcinoma, bile duct carcinoma, fibrolamellar hepatocellular carcinoma, metastases from neuroendocrine tumors, and epithelioid hemangioendothelioma. In the early years of hepatic transplantation, there was great enthusiasm to cure patients with unresectable hepatobiliary malignancy. This early enthusiasm was tempered by the unfavorable outcome of transplantation in advanced cases of malignancy and the organ-donor shortage. Presently, patients have to be selected with predictable likelihood for long-term survival. Pre-transplantation imaging is indispensable for detection, characterization, staging, and surgical road-mapping before the procedure. The present article focuses on the role of imaging modalities in these different aspects of preoperative assessment. (orig.) With 12 figs., 2 tabs., 66 refs.

  14. Right Accessory Hepatic Artery Arising From Celiac Trunk-Case Report of a Variation that Must Be Looked for During Multiorgan Procurement.

    Science.gov (United States)

    Bastos-Neves, D; da Silva Alves, J A; Guedes Dias, L G; de Rezende, M B; Salvalaggio, P R

    2016-09-01

    Knowledge of the anatomy of the hepatic artery and its variations is important to hepatobiliary and liver transplant surgeons and interventional radiologists. We report a rare anatomic variation of liver hepatic arterial supply: a right accessory hepatic artery arising directly from the celiac trunk and observed at the time of multiorgan procurement. The anatomic variation described in this case occurs in up to 2% of cases and their knowledge is essential to avoid injuries during multiorgan procurement that could require multiple anastomoses or lead to inadvertent vessel injury. This variation is very rarely reported in the medical literature. We document successful deceased-donor liver transplantation with a graft that had an accessory right accessory hepatic artery from the celiac trunk.

  15. Parasitic disease of the liver and biliary tree

    Directory of Open Access Journals (Sweden)

    Mohamed Abdulrahman

    1997-01-01

    Full Text Available Several parasites infest liver or biliary tree, either during their maturation stages or as adult worms. Bile iry tree parasites may cause pancreatitis, cholecystitis, biliary tree obstruction, recurrent cholangitis, biliary tree strictures and some may lead to cholangiocarcinoma. This review discusses the hepatobiliary parasites, and shows our experience in diagnosis and management of these parasites. Ultrasonography of the liver is diagnostic in schistosomiasis, hydatid cysts, amebic liver abscess, ascariasis and other biliary tree parasites showing bile duct dilatation. Percutaneous aspiration under ultrasonography guidance of hydatid liver cysts or amebic abscess are effective measures in management. Endoscopic retrograde cholangiopancreatography (ERCP is safe and effective in diagnosis and management of biliary tree parasites.

  16. Late preterm birth is associated with short-term morbidity but not with adverse neurodevelopmental and physical outcomes at 1 year

    DEFF Research Database (Denmark)

    Hughes, Alice; Greisen, Gorm; Arce, Joan-Carles

    2014-01-01

    . The women were part of a clinical trial to investigate the tocolytic effect of the oxytocin antagonist barusiban. Babies born late preterm (34-36(+6) weeks) had a significantly increased risk of short-term morbidity (hepatobiliary disorders, respiratory disorders, metabolic disorders, nervous system......We compared the neonatal and infant outcomes at one year (Bayley mental and psychomotor development index, and physical growth) of babies who were (n = 63) or were not (n = 100) delivered prior to 37 weeks in women admitted in threatened late preterm labor (34-35(+6) weeks) with a cervix ≤15 mm...... disorders, infection; p born at term, but there were no significant differences in the neurodevelopmental and physical outcomes at one year (p > 0.05 for both one-year outcomes)....

  17. Portal vein embolization before major hepatectomy

    Institute of Scientific and Technical Information of China (English)

    Hai Liu; Yong Fu

    2005-01-01

    To discuss the rationale, techniques and the unsolved issues regarding preoperative portal vein embolization (PVE) before major hepatectomy. After a systematic search of Pubmed, we reviewed and retrieved literature related to PVE. Preoperative PVE is an approach that is gaining increasing acceptance in the preoperative treatment of selected patients prior to major hepatic resection. Induction of selective hypertrophy of the nondiseased portion of the liver with PVE in patients with either primary or secondary hepatobiliary, malignancy with small estimated future liver remnants (FLR) may result in fewer complications and shorter hospital stays following resection. Additionally, PVE performed in patients initially considered unsuitable for resection due to lack of sufficient remaining normal parenchyma may add to the pool of candidates for surgical treatment. The results suggest that PVE is recomm-endable in treating the cirrhotic patients before major liver resection.

  18. [Ways to improve efficiency of patient clinical examinations during early stage of cholelithiasis].

    Science.gov (United States)

    Khokhlacheva, N A; Suchkova, E V; Vakhrushev, Ia M

    2013-01-01

    The aim of the work was to improve the organization and conduct of clinical examination of patients with gallstone disease (GSD). An integrated study of 396 patients with different pathologies of the hepatobiliary system and the medical check-up for three years for 101 patients. Built logistic model to predict the likelihood of developing gallstone disease and developed a predictive scoring table it possible to distinguish patients at risk of developing gall stones. The result of follow-up of the proposed method was prevented economic losses due to the lack of need for a cholecystectomy, which is made up of one patient 6766.22 rubles., The entire group of 1,004,966.63 rubles. Obtained to diagnose cholelithiasis at an early stage dokamennoy. Developed a screening questionnaire, predictive scoring table, the scheme of follow-up also improves clinical examination of patients with cholelithiasis dokamennoy stage.

  19. Peginterferon plus ribavirin versus interferon plus ribavirin for chronic hepatitis C

    DEFF Research Database (Denmark)

    Hauser, Goran; Awad, Tahany; Brok, Jesper

    2014-01-01

    BACKGROUND: Pegylated interferon (peginterferon) plus ribavirin is the recommended treatment for patients with chronic hepatitis C, but systematic assessment of the effect of this treatment compared with interferon plus ribavirin is needed. OBJECTIVES: To systematically evaluate the benefits...... and harms of peginterferon plus ribavirin versus interferon plus ribavirin for patients with chronic hepatitis C. SEARCH METHODS: We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Science Citation Index......-Expanded, and LILACS. We also searched conference abstracts, journals, and grey literature. The last searches were conducted in September 2013. SELECTION CRITERIA: We included randomised clinical trials comparing peginterferon plus ribavirin versus interferon plus ribavirin with or without co-intervention(s) (e...

  20. Metabolic syndrome in chronic hepatitis C infection: does it still matter in the era of directly acting antiviral therapy?

    Directory of Open Access Journals (Sweden)

    Lim TR

    2014-12-01

    Full Text Available TR Lim Centre for Liver Research and NIHR Biomedical Research Unit in Liver Disease, University of Birmingham and Liver and Hepatobiliary Unit, Queen Elizabeth Hospital Birmingham, UK Abstract: Metabolic syndrome is prevalent in patients with hepatitis C virus (HCV infection. Given the pandemic spread of HCV infection and metabolic syndrome, the burden of their interaction is a major public health issue. The presence of metabolic syndrome accelerates the progression of liver disease in patients with HCV infection. New drug development in HCV has seen an unprecedented rise in the last year, which resulted in better efficacy, better tolerance, and a shorter treatment duration. This review describes the underlying mechanisms and clinical effects of metabolic syndrome in HCV infection, as well as their importance in the era of new directly acting antiviral therapy. Keywords: HCV, genotype 3, metabolic syndrome, steatosis, directly acting antiviral agents

  1. Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems

    Institute of Scientific and Technical Information of China (English)

    Jurate Kondrackiene; Limes Kupcinskas

    2008-01-01

    Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder. Maternal effects of ICP are mild; however, there is a clear association between ICP and higher frequency of fetal distress, preterm delivery, and sudden intrauterine fetal death. The cause of ICP remains elusive, but there is evidence that mutations in genes encoding hepatobiliary transport proteins can predispose for the development of ICP. Recent data suggest that ursodeoxycholic acid is currently the most effective pharmacologic treatment, whereas obstetric management is still debated. Clinical trials are required to identify the most suitable monitoring modalities that can specifically predict poor perinatal outcome. This article aims to review current achievements and unsolved problems of ICP.

  2. Syndrome of inappropriate antidiuretic hormone secretion concurrent with liver disease in a dog.

    Science.gov (United States)

    Kang, Min-Hee; Park, Hee-Myung

    2012-05-01

    A 5-year-old female Chihuahua was presented for acute collapse. Laboratory examinations showed markedly elevated levels of hepatobiliary enzymes. Empiric antibiotic therapy for bacterial infection of the liver was ineffective. The clinical signs worsened with the development of hyponatremia with hypoosmolality and elevated urine sodium levels. The dog was suspected of having acute cholangiohepatitis associated with an immune-mediated disease. Subsequently, it was diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) on the basis of the specific disease criteria. Further tests showed normal function of the adrenal and thyroid glands, and MRI and cerebrospinal fluid (CSF) analysis did not show any intracranial diseases. Immunosuppressive therapy and water restriction resolved the clinical signs and improved the SIADH in this dog. This case indicates that SIADH can occur concurrently with suspected immune-mediated liver disease in dogs.

  3. Fospropofol disodium injection for the sedation of patients undergoing colonoscopy

    Directory of Open Access Journals (Sweden)

    Benjamin E Levitzky

    2008-09-01

    Full Text Available Benjamin E Levitzky1, John J Vargo21Department of Gastroenterology and Hepatology, 2Section of Therapeutic and Hepatobiliary Endoscopy, Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio, USAAbstract: Sedation plays a central role in making colonoscopy tolerable for patients and feasible for the endoscopist to perform. The array of agents used for endoscopic sedation continues to evolve. Fospropofol (FP, a prodrug of propofol with a slower pharmacokinetic profi le, is currently under evaluation for use during endoscopic procedures. Preliminary data suggests that FP dosed at 6.5 mg/kg is well tolerated by most patients with perineal paresthesias being the most commonly experienced adverse effect. This article will examine the current literature on the use of FP for the sedation of patients undergoing colonoscopy, highlighting the pharmacokinetics, pharmacodynamics, risks, and common adverse events associated with the novel sedative/hypnotic.Keywords: fospropofol, Aquavan, propofol, sedation, colonoscopy

  4. Prospects and Challenges towards Sustainable Liver Fluke Control.

    Science.gov (United States)

    Sripa, Banchob; Echaubard, Pierre

    2017-10-01

    The liver fluke Opisthorchis viverrini (Ov) is endemic in Southeast Asia where more than 10 million people are estimated to be infected. The infection is associated with several hepatobiliary diseases, including cholangiocarcinoma (CCA). Northeast Thailand is a hotspot for Ov transmission, and, despite extensive public health prevention campaigns led by the government, the prevalence of Ov infection is still high. High infection rates result from cultural and ecological complexities where wet-rice agrarian habitats, centuries-old raw-food culture, and the parasite's complex biology combine to create an ideal transmission arena. Here we review the state of our knowledge regarding the social-ecological determinants underlying Ov transmission. We also describe an integrative research rationale for liver fluke control better aligned with sustainable health development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The level of plasma homocysteine in patients with non-alcoholic fatty liver disease in combination with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    V. F. Orlovskiy

    2015-06-01

    Full Text Available Non-alcoholic fatty liver disease (NAFLD is one of the major causes of chronic diseases of the hepatobiliary zone. Aim. In order to explore new pathogenetic factors of NAFLD examined the level of plasma homocysteine in 110 patients. Methods and results. Patients were divided into two groups - the isolated NAFLD and in combination with Diabetes mellitus type 2. Found a significant increase in homocysteine level in all patients with NAFLD compared with the control group. High homocysteine concentration was in patients with comorbidity. There was positive correlation between levels of homocysteine and lipid components and cytolytic syndrome in all patients. Conclusion. The data obtained allow us to consider homocysteine as one of the factors in the pathological changes development in the liver.

  6. Large mucinous biliary cystadenoma with "ovarian-like" stroma: A case report

    Institute of Scientific and Technical Information of China (English)

    Mircea Beuran; Mircea Dan Venter; Laura Dumitru

    2006-01-01

    Hepatobiliary cystadenomas are rare tumors that are difficult to diagnose preoperatively. They can reach large sizes that make them real intraoperative "surprises". A 63-year-old woman, presented with a symptomatic huge abdominal cystic mass, underwent complete resection of the mass with safety margins. Histopathological report revealed mucinous hepatic cystadenoma with "ovarianlike" stroma and areas of sclerohyalinization. The differential diagnosis of the large cystic tumors which occupy the right hemiabdomen must include the biliary cystadenoma; the complete resection of the tumor with safety margins avoids local recurrence, and therefore represents the optimal therapy because of the malignant potential of the disease. The postoperative follow-up includes abdominal ultrasound or CT scan and CA 19-9measurement.

  7. Liver and brain abscess caused by Aggregatibacter paraphrophilus in association with a large patent foramen ovale: a case report

    Directory of Open Access Journals (Sweden)

    Carmichael Andrew

    2010-02-01

    Full Text Available Abstract Introduction Aggregatibacter paraphrophilus (former name Haemophilus paraphrophilus is a normal commensal of the oral flora. It is a rare cause of hepatobiliary or intracerebral abscesses. Case presentation We report a case of a 53-year-old Caucasian man with a liver abscess and subsequent brain abscesses caused by Aggregatibacter paraphrophilus. The probable source of the infection was the oral flora of our patient following ingestion of a dental filling. The presence of a large patent foramen ovale was a predisposing factor for multifocal abscesses. Conclusion In this case report, we describe an unusual case of a patient with both liver and brain abscesses caused by an oral commensal Aggregatibacter paraphrophilus that can occasionally show significant pathogenic potential.

  8. Some Aspects of Protozoan Infections in Immunocompromised Patients: A Review

    Directory of Open Access Journals (Sweden)

    Ferreira Marcelo Simão

    2002-01-01

    Full Text Available Protozoa are among the most important pathogens that can cause infections in immunocompromised hosts. These microorganisms particularly infect individuals with impaired cellular immunity, such as those with hematological neoplasias, renal or heart transplant patients, patients using high doses of corticosteroids, and patients with acquired immunodeficiency syndrome. The protozoa that most frequently cause disease in immunocompromised patients are Toxoplasma gondii, Trypanosoma cruzi, different Leishmania species, and Cryptosporidium parvum; the first two species cause severe acute meningoencephalitis and acute myocarditis, Leishmania sp. causes mucocutaneous or visceral disease, and Cryptosporidium can lead to chronic diarrhea with hepatobiliary involvement. Various serological, parasitological, histological and molecular methods for the diagnosis of these infections are currently available and early institution of specific therapy for each of these organisms is a basic measure to reduce the morbidity and mortality associated with these infections.

  9. [Genomics and transcriptomics of the Chinese liver fluke Clonorchis sinensis (Opisthorchiidae, Trematoda)].

    Science.gov (United States)

    Chelomina, G N

    2017-01-01

    The review summarizes the results of first genomic and transcriptomic investigations of the liver fluke Clonorchis sinensis (Opisthorchiidae, Trematoda). The studies mark the dawn of the genomic era for opisthorchiids, which cause severe hepatobiliary diseases in humans and animals. Their results aided in understanding the molecular mechanisms of adaptation to parasitism, parasite survival in mammalian biliary tracts, and genome dynamics in the individual development and the development of parasite-host relationships. Special attention is paid to the achievements in studying the codon usage bias and the roles of mobile genetic elements (MGEs) and small interfering RNAs (siRNAs). Interspecific comparisons at the genomic and transcriptomic levels revealed molecular differences, which may contribute to understanding the specialized niches and physiological needs of the respective species. The studies in C. sinensis provide a basis for further basic and applied research in liver flukes and, in particular, the development of efficient means to prevent, diagnose, and treat clonorchiasis.

  10. Molecular Pathogenesis and Current Therapy in Intrahepatic Cholangiocarcinoma

    DEFF Research Database (Denmark)

    Høgdall, Dan Taksony Solyom; O'Rourke, Colm J; Taranta, Andrzej

    2016-01-01

    clinical strategies and patient outcome. This was achieved for other cancers, such as breast carcinoma, facilitated by the delineation of patient subsets and of precision therapies. In iCCA, many questions persevere as to the evolutionary process and cellular origin of the initial transforming event......, the context of tumor plasticity and the causative features driving the disease. Molecular profiling and pathological techniques have begun to underline persistent alterations that may trigger inherited drug resistance (a hallmark of hepatobiliary and pancreatic cancers), metastasis and disease recurrence....... In this review, we will focus on the key molecular achievements that are currently advancing the characterization and stratification of iCCA. We will discuss current clinical practice and how genomic achievements may advance diagnosis and therapy as well as ultimately improve patient outcome....

  11. Effect of Inhibition of Intestinal Cholesterol Absorption on the Prevention of Cholesterol Gallstone Formation.

    Science.gov (United States)

    Portincasa, Piero; Wang, David Q-H

    2017-01-01

    Cholesterol cholelithiasis is a multifactorial hepatobiliary disease. Interactions between genetic and environmental factors play a critical role in biliary cholesterol homeostasis and its imbalance enhances cholelithogenesis. In patients developing symptoms or complications of gallstone disease, laparoscopic cholecystectomy is recommended for treatment of gallstones. In a subgroup of patients with small, radiolucent pure cholesterol gallstones, the hydrophilic bile acid, ursodeoxycholic acid (UDCA) is still considered the only pharmacological therapy able to induce oral litholysis. Identifying novel and effective pharmacological therapies is being investigated. We propose that the specific intestinal Niemann-Pick C1-like 1 protein inhibitor ezetimibe is a potential agent for preventing gallstone formation by reducing bioavailability of intestine- derived cholesterol to the liver for biliary secretion and desaturating bile through the inhibition of intestinal absorption of cholesterol. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  12. Air Embolism after Endoscopic Retrograde Cholangiopancreatography in a Patient with Budd Chiari Syndrome

    Science.gov (United States)

    Wills-Sanin, Beatriz; Cárdenas, Yenny R.; Polanco, Lucas; Rivero, Oscar; Suarez, Sebastian; Buitrago, Andrés F.

    2014-01-01

    Endoscopic retrograde cholangiopancreatography is a procedure commonly used for the diagnosis and treatment of various pancreatic and biliary diseases. Air embolism is a rare complication, which may be associated with this procedure. This condition can be manifested as cardiopulmonary instability and/or neurological symptoms. Known risk factors include: sphincterotomy; application of air with high intramural pressure; anatomic abnormalities; and chronic hepatobiliary inflammation. It is important for the health-care staff, including anesthesiologists, interventional gastroenterologists, and critical care specialists, amongst others, to promptly recognize air embolism and to initiate therapy in a timely fashion, thus preventing potentially fatal outcomes. We submit a brief review of the literature and a case report of air embolism which occurred in the immediate postoperative stage of an endoscopic retrograde cholangiopancreatography, performed in a woman with a history of liver transplantation due to Budd Chiari syndrome and biliary stricture. PMID:25478242

  13. Preparation and biological evaluation of 99Tcm-labelled fatty acids

    Institute of Scientific and Technical Information of China (English)

    LIANG Jixin; HU Ji; CHEN Baojun; LUO Lianzhe; LI Hongyu; SHEN Langtao; LUO Zhifu

    2007-01-01

    The aim of the present work was to develop radiolabelling fatty acids based on 99Tcm carbonyl chemistry for heart imaging. Undecanoic acids functionalised with iminodiacetatic acid and cysteine were radiolabelled with [99Tcm (CO)3(H2O)3]+ intermediates, and their radiolabelling conditions were carefully studied. Biodistribution of 99Tcm (CO)3-CYST FAC11 and 99Tcm (CO)3-IDA FAC11 were observed in normal mice. The results showed that two 99Tcm-labelled compounds had similar profile in terms of high initial radioactivity uptake and rapid washout of radiotracers in the heart. 99Tcm (CO)3-IDA FAC11 was mainly excreted via hepatobiliary system in contrast to 99Tcm (CO)3-CYST FAC11, which was excreted from urinary system. It may be in part attributed to the more lipophilicity of 99Tcm (CO)3-IDA FAC11 than 99Tcm (CO)3-CYST FAC11.

  14. Classification and basic properties of contrast agents for magnetic resonance imaging.

    Science.gov (United States)

    Geraldes, Carlos F G C; Laurent, Sophie

    2009-01-01

    A comprehensive classification of contrast agents currently used or under development for magnetic resonance imaging (MRI) is presented. Agents based on small chelates, macromolecular systems, iron oxides and other nanosystems, as well as responsive, chemical exchange saturation transfer (CEST) and hyperpolarization agents are covered in order to discuss the various possibilities of using MRI as a molecular imaging technique. The classification includes composition, magnetic properties, biodistribution and imaging applications. Chemical compositions of various classes of MRI contrast agents are tabulated, and their magnetic status including diamagnetic, paramagnetic and superparamagnetic are outlined. Classification according to biodistribution covers all types of MRI contrast agents including, among others, extracellular, blood pool, polymeric, particulate, responsive, oral, and organ specific (hepatobiliary, RES, lymph nodes, bone marrow and brain). Various targeting strategies of molecular, macromolecular and particulate carriers are also illustrated.

  15. Transient heterogeneous enhancement on dual-phase helical CT of liver

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Tadashi; Hama, Hikaru; Oikawa, Hideki; Yamada, Takayuki; Abe, Hiroyuki; Saitoh, Haruo; Sakamoto, Kiyohiko [Tohoku Univ., Sendai (Japan). School of Medicine; Satoh, Akihiro

    1996-08-01

    Transient heterogeneous enhancement was seen on the arterial phase of dual-phase helical CT of the liver. The shape of the enhancement was appeared wedged or patchy. These phenomena without liver tumor were observed in 23 (2.3%) of 1012 patients with suspected hepatobiliary disease. Plain CT showed no attenuation difference in the liver. Twenty-two of these 23 cases were diagnosed as scarred liver, A-P shunt caused by liver biopsy, acute cholecystitis, liver abscess, liver cirrhosis, or advanced pancreas head cancer. The diagnosis of one case was uncertain. These phenomena were thought to be caused by a regional direct increase in hepatic arterial flow due to arterial-portal (A-P) shunt, or hypervascular tumor; or a compensatory increase in hepatic arterial flow as a result of decreased portal venous flow caused by tumor invasion or severe liver cirrhosis. (author)

  16. Nuclear Transport Modulation Reduces Hypercholesterolemia, Atherosclerosis, and Fatty Liver

    Science.gov (United States)

    Liu, Yan; Major, Amy S.; Zienkiewicz, Jozef; Gabriel, Curtis L.; Veach, Ruth Ann; Moore, Daniel J.; Collins, Robert D.; Hawiger, Jacek

    2013-01-01

    Background Elevated cholesterol and triglycerides in blood lead to atherosclerosis and fatty liver, contributing to rising cardiovascular and hepatobiliary morbidity and mortality worldwide. Methods and Results A cell‐penetrating nuclear transport modifier (NTM) reduced hyperlipidemia, atherosclerosis, and fatty liver in low‐density lipoprotein receptor‐deficient mice fed a Western diet. NTM treatment led to lower cholesterol and triglyceride levels in blood compared with control animals (36% and 53%, respectively; Ptriglyceride, and fatty acid synthesis. NTM‐modulated translocation of SREBPs to the nucleus was associated with attenuated transactivation of their cognate genes that contribute to hyperlipidemia. Conclusions Two‐pronged control of inflammation and dyslipidemia by modulating nuclear transport of their critical regulators offers a new approach to comprehensive amelioration of hyperlipidemia, atherosclerosis, fatty liver, and their potential complications. PMID:23563994

  17. Restorative treatment program with physical exercise of patients with dysfunction of the biliary tract.

    Directory of Open Access Journals (Sweden)

    Parhotik I.I.

    2011-06-01

    Full Text Available In the thesis there has been shown that biliary dyskinesia takes a leading position among hepatobiliary diseases. 54 women and 14 men aged between 19 and 64 years old, who suffered from hypo kinetic and hyper kinetic forms of dyskinesia, took part in the research. Based on the character of the functional disorders, it was defined that at hyper kinetic form of dyskinesia the best rehabilitation effects were achieved at the application of physical exercises promoting relaxation of the gallbladder, sphincter and biliary duct musculature combined with the stimulation of bile formation. It was proved that means and methods of motion therapy for patients with hyper kinetic dyskenisia had to be aimed at the restoration of the gallbladder till its full reduction. It was defined that application of different forms of therapeutic physical training considering the type of biliary dyskinesia promoted the improvement of the patients' clinical condition, motor and evacuator function of the biliary ducts.

  18. Magnetic Resonance Cholangiography with Mangafodipir Trisodium in Caroli's Disease with Pancreas Involvement

    Directory of Open Access Journals (Sweden)

    Simone Maurea

    2010-09-01

    Full Text Available Context Caroli’s disease is a rare congenital disorder first described by Caroli in 1958. This abnormality consists of non-obstructive, saccular or fusiform dilation of the intrahepatic bile ducts resulting in cystic lesions; similar abnormalities may also occur in the kidneys and pancreas. Case report We illustrate the role of enhanced mangafodipir trisodium magnetic resonance imaging in a patient with sporadic non-hereditary Caroli’s disease associated with pancreatic involvement in which mangafodipir trisodium magnetic resonance imaging characterized part of the cystic liver lesions as saccular dilations of the intrahepatic bile ducts of the left lobe, allowing diagnosis of the disease. Conclusion We strongly recommend hepatobiliary magnetic resonance imaging with mangafodipir trisodium in such patients.

  19. A multimedia CD-ROM tool to improve student understanding of bile salts and bilirubin metabolism: evaluation of its use in a medical hybrid PBL course.

    Science.gov (United States)

    Azer, Samy A

    2005-03-01

    Over the last 35 years our understanding of bile salts, bilirubin metabolism, and hepatobiliary transport has progressively increased. From 1965 to the end of 2002, 3,610 articles and review papers have been published on hepatobiliary and enterocyte transport of bile salts. However, there is a lack of information in the content of current textbooks about hepatobiliary physiology, bile salt transporters, bile formation, mechanisms underlying cholestasis, and drug-induced liver injury. The use of an integrated multimedia program on the liver covering these gaps in textbooks may be useful to student learning. This study aims to 1) assess student views on a multimedia CD-ROM ("The Liver") integrating basic and clinical sciences related to the liver, bile salts, and bilirubin metabolism, 2) assess the usefulness of problem-based learning (PBL) cases included in the multimedia CD-ROM, and 3) assess student learning before and after use of the multimedia CD-ROM. A total of 106 first-year medical students (27 with and 79 without a prior university degree) at the University of Melbourne participated in this study. Students were tested on the liver, bile salts, and bilirubin metabolism before and after using the multimedia CD-ROM. After completing the multimedia CD-ROM, each student filled out a 5-point Likert scale questionnaire evaluating the features of the program and its usefulness to their learning. Results show that the aims of the package were clear to participants, the contents were logically organized and clear, the key concepts were easy to identify, the contents were pitched to an appropriate level, and the package was interactive and encouraged participants to reflect on their learning. Students also agreed that the assessment tools used in the program and the feedback provided were meaningful and helpful to their learning. No differences were found when responses were compared on the basis of academic background, gender, citizenship, or first language of

  20. Pancreatic adenocarcinoma in type 2 progressive familial intrahepatic cholestasis

    Directory of Open Access Journals (Sweden)

    Green Richard M

    2010-03-01

    Full Text Available Abstract Background BSEP disease results from mutations in ABCB11, which encodes the bile salt export pump (BSEP. BSEP disease is associated with an increased risk of hepatobiliary cancer. Case Presentation A 36 year old woman with BSEP disease developed pancreatic adenocarcinoma at age 36. She had been treated with a biliary diversion at age 18. A 1.7 × 1.3 cm mass was detected in the pancreas on abdominal CT scan. A 2 cm mass lesion was found at the neck and proximal body of the pancreas. Pathology demonstrated a grade 2-3 adenocarcinoma with invasion into the peripancreatic fat. Conclusions Clinicians should be aware of the possibility of pancreatic adenocarcinoma in patients with BSEP disease.

  1. Spontaneous rupture of a type ⅣA choledochal cyst in a young adult during radiological imaging

    Institute of Scientific and Technical Information of China (English)

    Ekaterini Stipsanelli; Pipitsa Valsamaki; Spyridon Tsiouris; Angelika Arka; Georgios Papathanasiou; Nikolaos Ptohis; Stephanos Lahanis; Vassilios Papantoniou; Cherry Zerva

    2006-01-01

    A case of a 24-year-old male with jaundice and epigastric pain is reported. The patient underwent a thorough clinical, laboratory, and imaging investigation.Computerized tomography revealed a 9 cm×10 cm choledochal cyst. Magnetic resonance imaging and magnetic cholangiopancreatography were performed,during which he developed an "acute abdomen", with radiological evidence of biliary peritoneal leak. Urgent surgery revealed rupture of the distended malformed common bile duct. A peritoneal drain was instilled and a more definitive surgical procedure was accordingly scheduled. Hepatobiliary scintigraphy following surgery verified these findings, as well as confirmed the adequacy of the urgent surgery. A combination of radiological and nuclear medicine techniques substantially contributes to the diagnosis of choledochal cyst rupture and the adequacy of surgical intervention.

  2. Primary sclerosing cholangitis: Updates in diagnosis and therapy

    Institute of Scientific and Technical Information of China (English)

    Piero Portincasa; Michele Vacca; Antonio Moschetta; Michele Petruzzelli; Giuseppe Palasciano; Karel J. van Erpecum; Gerard P. van Berge-Henegouwen

    2005-01-01

    Primary sclerosing cholangitis (PSC) is a chronic cholestatic syndrome of unknown origin mostly found in males, and characterized by diffuse inflammation and fibrosis of both intra- and extra-hepatic bile ducts. So far, PSC is considered as an autoimmune hepatobiliary disease. In most cases the progression of PSC towards liver cirrhosis and liver failure is slow but irreversible, and liver transplantation is currently the only definitive treatment. In recent years,PSC has been an area of active research worldwide with great interest in etiology, pathogenesis, diagnosis, and therapeutic options such as hydrophilic ursodeoxycholic acid and immunosuppressive agent tacrolimus. Recent updates on clinical and therapeutic aspects of PSC are discussed in the present review.

  3. Safety profile of subjects treated to very low low-density lipoprotein cholesterol levels (JUPITER).

    Science.gov (United States)

    Everett, Brendan M; Mora, Samia; Glynn, Robert J; MacFadyen, Jean; Ridker, Paul M

    2014-12-01

    Recent US guidelines expand the indications for high-intensity statin therapy, yet data on the safety of attaining very low-density lipoprotein cholesterol (LDL-C) levels are scarce. Among 16,304 participants in the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) with on-treatment LDL-C levels, we identified 767 who did and 7,387 who did not achieve LDL-C JUPITER, achieving LDL-C levels <30 mg/dl with high-intensity statin therapy appeared to be generally well tolerated but associated with certain adverse events, including more physician-reported diabetes, hematuria, hepatobiliary disorders, and insomnia. These data may guide the monitoring of patients on intensive statin therapy and adverse events in trials of therapies that lead to very low LDL-C levels.

  4. Pyogenic liver abscess associated with large colonic tubulovillous adenoma

    Institute of Scientific and Technical Information of China (English)

    Hsueh-Chou Lai; Cho-Yu Chan; Cheng-Yuan Peng; Chih-Bin Chen; Wen-Hsin Huang

    2006-01-01

    Pyogenic liver abscesses usually occur in association with a variety of diseases. Rarely, liver abscess has been reported as the presenting manifestation of colonic tubulovillous adenoma. We report two cases of pyogenic liver abscess without hepatobiliary disease or other obvious etiologies except that one had a history of diabetes mellitus (DM). The pathogen in the patient with DM was Klebsiella pneumonia (KP). In both of the patients, ileus developed about two to three weeks after the diagnosis of liver abscess. Colonoscopy revealed large polypoid tumors with pathological findings of tubulovillous adenoma in both cases. Two lessons were learned from these two cases: (1) an underlying cause should be aggressively investigated in patients with cryptogenic liver abscess; (2) DM could be one of the etiologies but not necessarily the only cause of KP liver abscess.

  5. The "flying" bile duct: avulsion of the common bile duct in a plane crash survivor.

    LENUS (Irish Health Repository)

    Mohan, H

    2012-02-01

    Blunt trauma is an unusual cause of extrahepatic bile duct injury. This is a case of a 51-year-old gentleman who sustained a significant seatbelt injury in a plane crash. Laparotomy, performed due to persistent abdominal pain, revealed that the common bile duct (CBD) was completely avulsed from the duodenum. Following insertion of drains and transfer to a hepatobiliary centre, the devascularised CBD was excised and replaced with a roux-en-y hepaticojejunostomy. Necrotic tissue was debrided from the pancreatic head. A persistent bile leak developed from the sub-hepatic drain. Repeat laparotomy revealed a bile leak from small ducts on the liver surface. Ligation of the ducts and bioglue sealing of the area were successfully performed. Subsequent to this a pancreatic fistula developed from the main pancreatic duct, which has since resolved. This unusual case illustrates the need for prompt recognition and early repair to optimise outcomes in traumatic CBD injury.

  6. Hemoperitoneum secondar y to rupture of cystic ar ter y pseudoaneur ysm

    Institute of Scientific and Technical Information of China (English)

    Ali Ghoz; Ehab Kheir; Anil Kotru; Karim Halazun; David Kessel; Jai Patel J; J Peter A Lodge

    2007-01-01

    BACKGROUND:Spontaneous hemoperitoneum of hepato-biliary origin is commonly due to hemorrhage from a liver tumor. It is rarely caused by spontaneous rupture of aneurysm in visceral arteries. METHODS:We report an unusual case of hemoperitoneum caused by rupture of cystic artery pseudoaneurysm, and also outline the approach to its management through surgical and radiological methods. RESULTS:In our patient, the pseudoanurysm was initially treated with percutaneous thrombin injection. However this method of treatment failed after initial success. The pseudoanurysm was ifnally obliterated successfully using microcoil embolization. CONCLUSIONS: The mainstay of treatment of cystic artery pseudoaneurysm is cholecystectomy and ligation of the aneurysm. Recent publications showed success in using microcoil embolisation. In this case we also outline the use of percutaneous thrombin injection as a deifnitive treatment method and discuss its success or failure as a new method of treatment.

  7. Pediatric robotic surgery: A single-institutional review of the first 100 consecutive cases.

    Science.gov (United States)

    Meehan, John J; Sandler, Anthony

    2008-01-01

    Robotic surgery is a new technology which may expand the variety of operations a surgeon can perform with minimally invasive techniques. We present a retrospective review of our first 100 consecutive robotic cases in children. A three-arm robot was used with one camera arm and two instrument arms. Additional accessory ports were utilized as necessary. Two different attending surgeons performed the procedures. Twenty-four different types of procedures were completed using the robot. The majority of the procedures (89%) were abdominal procedures with 11% thoracic. No urology or cardiac procedures were performed. Age ranged from 1 day to 23 years with an average age of 8.4 years. Weight ranged from 2.2 to 103 kg with a median weight of 27.9 kg. Twenty-two patients were less than 10.0 kg. Examples of cases included gastrointestinal (GI) surgery, hepatobiliary, surgical oncology, and congenital anomalies. The overall majority of cases had never been performed minimally invasively by the authors. The overall intraoperative conversion rate to open surgery was 13%. One case (1%) was converted to thoracoscopic because of lack of domain for the articulating instruments. No conversions or complications occurred as a result of injuries from the robotic instruments. Interestingly, four abdominal cases were converted to open surgery due to equipment failures or injuries from standard laparoscopic instruments used through non-robotic accessory ports. Robotic surgery is safe and effective in children. An enormous variety of cases can be safely performed including complex cases in neonates and small children. Simple operations such as cholecystectomies have minimal advantages by using robotic technology but can serve as excellent teaching tools for residents and newcomers to this form of minimally invasive surgery (MIS). The technology is ideal for complex hepatobiliary cases and thoracic surgery, particularly solid chest masses.

  8. Analysis for phenotype of HNPCC in China

    Institute of Scientific and Technical Information of China (English)

    Yong-Mao Song; Shu Zheng

    2002-01-01

    AIM: The aims of this study were to identify theclinicopathological features of Chinese HNPCC families andto evaluate the value of criteria for suspected HNPCC(sHNPCC) in clinical diagnosis.METHODS: According to the follow-up records, 54 HNPCCfamilies (including 12 TCG-HNPCC families and 42 sHNPCCfamilies) were screened out from patients with colorectal cancers(CRCs), operated upon in 2nd Affiliated Hospital of ZhejiangUniversity from 1984 to 2001. Clinical data of probands andtumor spectrum in these families were listed and analyzed,RESULTS: (1) Mean age, proportion of colonic cancer, poorlydifferentiated cancer, multiple CRCs and Dukes′ A+B of theprobands in ICG-HNPCC and sHNPCC kindred were 39ys and47.5ys, 75 % and 62 %, 0 and 12.8 %, 16.7 % and 14.3 %,58.3 % and 81%,respectively. Compared with sporadiccolorectal cancers, probands from ICG-HNPCC and sHNPCCfamilies were obviously different at age of onset(P=0.025and 0.031), tumor location (P=0.001 and 0.000),differentiation(P=0.002 and 0.011) and development ofmultiple tumors (P=0.014 and 0.002). (2) A total of 178malignant neoplasms were found in 54 HNPCC families,including 139 colorectal cancers. Besides of colorectal cancer,extracolonic tumors occurred in stomach, endometrium,hepatobiliary system, and so on (8 gastric cancers, 6 endometrialcancers, 6 hepatobiliary system cancers and 19 others) canalso be seen in Chinese ICG-HNPCC and sHNPCC families.CONCLUSION: (1) Chinese HNPCC families have specificclinicopathological features, such as early onset, predilectionfor the involvement of colon, tendency of multiple CRCs,development of extracolonic tumors and well differentiation.(2) The criteria for suspected HNPCC is useful in clinicaldiagnosis and management of HNPCC.

  9. Nuclear medicine in tropical diseases

    Energy Technology Data Exchange (ETDEWEB)

    Braga, Francisco Jose Hossri Nogueira [Centro Oncologico da Regiao de Araraquara, SP (Brazil). Servico de Medicina Nuclear]. E-mail: fjbraga@dfm.ffclrp.usp.br

    2002-09-01

    Tropical diseases affect more people in the world than any other kind of disease, but scintigraphic data on that matter are not so frequent in the literature. Since the geographic regions where such diseases occur are normally very poor, scintillation cameras may not be available. We present a resumed summary of part of what has been done on this subject to-date. Leprosy affects circa 12 million people worldwide and has already been studied by means of the following scintigraphic exams: gallium-67, 99mTc-MDP or HMDP, 99mTc-colloid or Dextran, 99mTc-DTPA and 99mTc-WBC. Paracoccidioidomycosis is a deep mycosis and such cases may be evaluated by means of gallium-67, bone scintigraphy, lymphoscintigraphy, hepato-biliary, bone marrow and liver/spleen scintigraphies. Mycetoma is bone and soft tissue mycosis and gallium-67 and bone studies are very useful in the evaluation of such cases. Tuberculosis is the most well studied tropical disease and dozens of radiopharmaceuticals and techniques were described to evaluate such patients. Jorge Lobo disease is a rare mycosis that affects mainly indians from the Amazon region and gallium-67 was shown to accumulate in active disease. Neurocysticercosis is spread worldwide and brain SPECT (99mTc-ECD or 99mTc-HMPAO) is a very good tool for the functional evaluation of the disease. Patients suffering from cutaneous and mucous leishmaniasis may benefit from gallium-67 scintigraphy. Chagas disease may affect the heart and or the digestive tract and several scintigraphic exams may be helpful in the evaluation of such cases (gated blood pool, heart perfusions tests, pharyngeal transit tests, gastric emptying tests, intestinal transit tests, hepato-biliary scintigraphy, among others). Scintigraphy should be more largely used in the functional evaluation of organs and systems of patients affected y tropical diseases. It is a powerful tool to evaluate both the extent of disease and the efficacy of therapy. (author)

  10. Biodistribution and dosimetry in humans of two inverse agonists to image cannabinoid CB{sub 1} receptors using positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Terry, Garth E. [National Institute of Mental Health, Molecular Imaging Branch, Bethesda, MD (United States); Karolinska Institutet, Department of Clinical Neuroscience, Psychiatry Section, Stockholm (Sweden); Hirvonen, Jussi; Liow, Jeih-San; Seneca, Nicholas; Morse, Cheryl L.; Pike, Victor W.; Innis, Robert B. [National Institute of Mental Health, Molecular Imaging Branch, Bethesda, MD (United States); Tauscher, Johannes T.; Schaus, John M.; Phebus, Lee; Felder, Christian C. [Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN (United States); Halldin, Christer [Karolinska Institutet, Department of Clinical Neuroscience, Psychiatry Section, Stockholm (Sweden)

    2010-08-15

    Cannabinoid subtype 1 (CB{sub 1}) receptors are found in nearly every organ in the body, may be involved in several neuropsychiatric and metabolic disorders, and are therefore an active target for pharmacotherapy and biomarker development. We recently reported brain imaging of CB{sub 1} receptors with two PET radioligands: {sup 11}C-MePPEP and {sup 18}F-FMPEP-d{sub 2}. Here we describe the biodistribution and dosimetry estimates for these two radioligands. Seven healthy subjects (four men and three women) underwent whole-body PET scans for 120 min after injection with {sup 11}C-MePPEP. Another seven healthy subjects (two men and five women) underwent whole-body PET scans for 300 min after injection with {sup 18}F-FMPEP-d{sub 2}. Residence times were acquired from regions of interest drawn on tomographic images of visually identifiable organs for both radioligands and from radioactivity excreted in urine for {sup 18}F-FMPEP-d{sub 2}. The effective doses of {sup 11}C-MePPEP and {sup 18}F-FMPEP-d{sub 2} are 4.6 and 19.7 {mu}Sv/MBq, respectively. Both radioligands demonstrated high uptake of radioactivity in liver, lung, and brain shortly after injection and accumulated radioactivity in bone marrow towards the end of the scan. After injection of {sup 11}C-MePPEP, radioactivity apparently underwent hepatobiliary excretion only, while radioactivity from {sup 18}F-FMPEP-d{sub 2} showed both hepatobiliary and urinary excretion. {sup 11}C-MePPEP and {sup 18}F-FMPEP-d{sub 2} yield an effective dose similar to other PET radioligands labeled with either {sup 11}C or {sup 18}F. The high uptake in brain confirms the utility of these two radioligands to image CB{sub 1} receptors in brain, and both may also be useful to image CB{sub 1} receptors in the periphery. (orig.)

  11. Gallbladder Dynamics Before and After Extracorporeal Shock Wave Lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Hea; Suk, Jae Dong; Moon, Dae Hyuk; Kim, Myung Hwan; Min, Young Il [Asian Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    1991-03-15

    Extracorporeal shock wave lithotripsy (ESWI.) with adjunctive oral litholytic therapy has proven to be a useful treatment in selected patients with gallbladder stones. To study the effect of ESWL on gallbladder dynamics, {sup 99m}Tc-DISIDA hepatobiliary scintigraphy was done for 25 patients with symptomatic gallstones and 10 normal controls. Of these 25 patients, 15 were treated with ESWL and adjunctive oral litholytic agents (ESWL group) and 10 were treated only with oral litholytic agents (UDCA group). After overnight fast and gallbladder visualization on a routine hepatobiliary scintigraphy with 7 mCi of {sup 99m}Tc-DISIDA, subjects were given fatty meal and imaged with a gamma camera interfaced to a computer (I frame/minute for 70 minutes). A gallbladder time-activity curve was generated and latent period (LP), ejection period (EP), ejection fraction (EF) and ejection rate (ER) were calculated, ESWL group were studied before, l day after and 2 weeks after ESWL, and UDCA group were studied before and 2 weeks after starting oral medication Mean basal EF was significantly reduced in patients but other parameters were not reduced. In ESlVL group, mean EF and mean ER at 1 day after ESWL were reduced. In 3 of them, gallbladder was not visualized at all. Two weeks after ESWL, however, all parameters were recovered to basal level. In UDCA group, all parameters were not changed significantly during medication. We can conclude that ESWL has such immediate adverse effect on gallbladder dynamics as reducing contractility and nonvisualization of gallbladder but it has no long-term effect.

  12. Autoimmune hepatitis from the paediatric perspective.

    Science.gov (United States)

    Roberts, Eve A

    2011-11-01

    Autoimmune hepatitis (AIH) is an important entity within the broad spectrum of autoimmune hepatobiliary disease comprised of AIH, primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC). Since the 1960s, AIH has been investigated with extensive clinical research aimed at effective therapeutic intervention. It was one of the first liver diseases where treatment was demonstrated to prolong survival. AIH occurs in children, as well as in adults. Its clinical manifestations in children may differ from classic adult AIH. These differences have elucidated certain aspects of AIH and hepatobiliary disease in general. There are two major patterns of AIH: type 1, with anti-smooth muscle antibodies and type 2, with anti-liver/kidney microsomal antibodies. The second type of AIH was first identified in children and is more common in younger patients. AIH often presents as acute disease in children and also in adults: the nomenclature has dropped the allusion to chronicity. Some children who have sclerosing cholangitis present with clinical disease closely resembling AIH; this AIH-like PSC, termed autoimmune sclerosing cholangitis (ASC), is also found in adults. Children with AIH may have identifiable monogenic disorders of immune regulation such as autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED). Like adults with AIH, children with AIH usually respond very favourably to immunosuppressive treatment with corticosteroids ± azathioprine. True cures seem to be rare, although many children achieve a stable remission. Nonetheless children with AIH may develop cirrhosis and some require liver transplantation. Early diagnosis and improved treatment strategies may further improve the outlook for children with AIH.

  13. Portal Vein Embolization as an Oncosurgical Strategy Prior to Major Hepatic Resection: Anatomic, Surgical and Technical Considerations for Successful Outcomes

    Directory of Open Access Journals (Sweden)

    Sonia Tewani Orcutt

    2016-03-01

    Full Text Available Preoperative portal vein embolization (PVE is used to extend the indications for major hepatic resection, and it has become the standard of care for selected patients with hepatic malignancies treated at major hepatobiliary centers. To date, various techniques with different embolic materials have been used with similar results in the degree of liver hypertrophy. Regardless of the specific strategy used, both surgeons and interventional radiologists must be familiar with each other’s techniques to be able to create the optimal plan for each individual patient. Knowledge of the segmental anatomy of the liver is paramount to fully understand the liver segments that need to be embolized and resected. Understanding the portal vein anatomy and the branching variations, along with the techniques used to transect the portal vein during hepatic resection, is important because these variables can affect the PVE procedure and the eventual surgical resection. Comprehension of the advantages and disadvantages of approaches to the portal venous system and the various embolic materials used for PVE is essential to best tailor the procedures for each patient and to avoid complications. Before PVE, meticulous assessment of the portal vein branching anatomy is performed with cross-sectional imaging, and embolization strategies are developed based on the patient’s anatomy. The PVE procedure consists of several technical steps, and knowledge of these technical tips, potential complications and how to avoid the complications in each step is of great importance for safe and successful PVE, and ultimately successful hepatectomy. Because PVE is used as an adjunct to planned hepatic resection, priority must always be placed on safety, without compromising the integrity of the future liver remnant, and close collaboration between interventional radiologists and hepatobiliary surgeons is essential to achieve successful outcomes.

  14. Portal Vein Embolization as an Oncosurgical Strategy Prior to Major Hepatic Resection: Anatomic, Surgical, and Technical Considerations.

    Science.gov (United States)

    Orcutt, Sonia T; Kobayashi, Katsuhiro; Sultenfuss, Mark; Hailey, Brian S; Sparks, Anthony; Satpathy, Bighnesh; Anaya, Daniel A

    2016-01-01

    Preoperative portal vein embolization (PVE) is used to extend the indications for major hepatic resection, and it has become the standard of care for selected patients with hepatic malignancies treated at major hepatobiliary centers. To date, various techniques with different embolic materials have been used with similar results in the degree of liver hypertrophy. Regardless of the specific strategy used, both surgeons and interventional radiologists must be familiar with each other's techniques to be able to create the optimal plan for each individual patient. Knowledge of the segmental anatomy of the liver is paramount to fully understand the liver segments that need to be embolized and resected. Understanding the portal vein anatomy and the branching variations, along with the techniques used to transect the portal vein during hepatic resection, is important because these variables can affect the PVE procedure and the eventual surgical resection. Comprehension of the advantages and disadvantages of approaches to the portal venous system and the various embolic materials used for PVE is essential to best tailor the procedures for each patient and to avoid complications. Before PVE, meticulous assessment of the portal vein branching anatomy is performed with cross-sectional imaging, and embolization strategies are developed based on the patient's anatomy. The PVE procedure consists of several technical steps, and knowledge of these technical tips, potential complications, and how to avoid the complications in each step is of great importance for safe and successful PVE and ultimately successful hepatectomy. Because PVE is used as an adjunct to planned hepatic resection, priority must always be placed on safety, without compromising the integrity of the future liver remnant, and close collaboration between interventional radiologists and hepatobiliary surgeons is essential to achieve successful outcomes.

  15. MRI and (1)H MRS findings of hepatobilary changes and cholangiocarcinoma development in hamsters infected with Opisthorchis viverrini and treated with N-nitrosodimethylamine.

    Science.gov (United States)

    Hanpanich, Petcharakorn; Pinlaor, Somchai; Charoensuk, Lakhanawan; Yongvanit, Puangrat; Chamgramol, Yaovalux; Pairojkul, Chawalit; Mairiang, Eimorn

    2015-11-01

    3 T MRI and (1)H MRS were useful for quantitative investigation of the serial development of hepatobiliary changes in Opisthorchis viverrini infection in hamsters, and the differential diagnosis of cholangiocacinoma (CCA) development from bile duct changes and normal condition is unclear. In this study, we investigated the serial development of hepatobiliary changes and CCAgenesis in O. viverrini-infected and N-nitrosodimethylamine (NDMA) treated hamsters (ON group) using 3 T MRI and (1)H MRS and the results were compared with those either in the O. viverrini-infected group (OV group) and uninfected normal controls. In the ON group, CCAs were first found at 9 weeks post-infection, with sizes of ~2 mm. The typical MR signal characteristics of CCA were hypo- and occasionally isointensity signal on T1-weighted images, and mild-moderate to hyper-intensity signal on T2-weighted images compared to the liver parenchyma. T2-weighted images with fat suppression revealed dilatation of the intra- and extrahepatic bile ducts, and often defined the anatomical level of biliary obstruction, cystic lesions, liver abscesses, and CCA which was starting seen of these noticeable abnormalities at 5 weeks onwards. The results of fibrosis grading using MR images showed a positive correlation (r=0.90, P<0.038 by Spearman's rank correlation test) with those of the histopathological grading. In addition, 3.0 T (1)H MRS showed elevated choline and decreased lipids levels in the liver tissues of the ON group. In conclusion, MRI and (1)H MRS are useful for the quantitative investigation of the serial development of hepatobilary changes and CCA in hamsters, and are potentially useful as early diagnostic tools for CCA.

  16. Chronic Opisthorchis viverrini Infection Changes the Liver Microbiome and Promotes Helicobacter Growth

    Science.gov (United States)

    Itthitaetrakool, Upsornsawan; Pinlaor, Porntip; Pinlaor, Somchai; Chomvarin, Chariya; Dangtakot, Rungtiwa; Chaidee, Apisit; Wilailuckana, Chotechana; Sangka, Arunnee; Lulitanond, Aroonlug; Yongvanit, Puangrat

    2016-01-01

    Adults of Opisthorchis viverrini reside in the biliary system, inducing inflammation of bile ducts and cholangitis, leading to hepatobiliary disease (HBD) including cholangiocarcinoma. O. viverrini infection also has major implications for the bacterial community in bile ducts and liver. To investigate this in chronic O. viverrini infection (≥ 8 months p.i.), bacterial genomic DNA from livers of hamsters and from worms was investigated using culture techniques, PCR for Helicobacter spp. and high-throughput next-generation sequencing targeting the V3-V4 hypervariable regions of prokaryotic 16S rRNA gene. Of a total of 855,046 DNA sequence reads, 417,953 were useable after filtering. Metagenomic analyses assigned these to 93 operational taxonomic units (OTUs) consisting of 80 OTUs of bacteria, including 6 phyla and 42 genera. In the chronic O. viverrini-infected group, bacterial community composition and diversity were significantly increased compared to controls. Sequences of Fusobacterium spp. were the most common (13.81%), followed by Streptococcus luteciae (10.76%), Escherichia coli (10.18%), and Bifidobacterium spp. (0.58%). In addition, Helicobacter pylori (0.17% of sequences) was also identified in the liver of chronic O. viverrini infections, but not in normal liver. The presence of H. pylori was confirmed by PCR and by use of an antibody against bacterial antigen, supporting the metagenomics data. The identities of bacteria cultured for enrichment suggested that chronic O. viverrini infection changes the liver microbiome and promotes Helicobacter spp. growth. There may be synergy between O. viverrini and the liver microbiome in enhancing immune response-mediated hepatobiliary diseases. PMID:27806126

  17. Qualitative analysis of small (≤2 cm) regenerative nodules, dysplastic nodules and well-differentiated HCCs with gadoxetic acid MRI.

    Science.gov (United States)

    Di Martino, Michele; Anzidei, Michele; Zaccagna, Fulvio; Saba, Luca; Bosco, Sandro; Rossi, Massimo; Ginanni Corradini, Stefano; Catalano, Carlo

    2016-11-11

    The characterization of small lesions in cirrhotic patients is extremely difficult due to the overlap of imaging features among different entities in the step-way of the hepatocarcinogenesis. The aim of our study was to evaluate the role of gadoxetic-acid MRI in the differentiation of small (≤2 cm) well-differentiated hepatocellular carcinomas from regenerative and dysplastic nodules. Seventy-three cirrhotic patients, with 118 focal liver lesions (≤2 cm) were prospectively recruited. MRI examination was performed with a 3T magnet and the study protocol included T1 - and T2-weighted pre-contrast sequences and T1 -weighted gadoxetic-acid enhanced post-contrast sequences obtained during the arterial, venous, late dynamic and hepatobiliary phases. All lesions were pathologically confirmed. Two radiologists blinded to clinical and pathological information evaluated two imaging datasets; another radiologist analysed the signal intensity characteristics of each lesion. Sensitivity, specificity and diagnostic accuracy were considered for statistical analysis. Good agreement was reported between the two readers (κ 0.70). Both readers reported a significantly improved sensitivity (57.7 and 66.2 vs 74.6 and 83.1) and diagnostic accuracy (0.717 and 0.778 vs 0.843 and 0.901) with the adjunction of the hepatobiliary phase 57.7 vs 74.6 and 66.2 vs 83.1 (p ≤ 0.04). Gadoxetic-acid MRI is a reliable tool for the characterization of HCC and lesions at high risk to further develop.

  18. A feasibility study evaluating the relationship between dose and focal liver reaction in stereotactic ablative radiotherapy for liver cancer based on intensity change of Gd-EOB-DTPA-enhanced magnetic resonance images

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Sang Hoon; Yu, Jeong Il; Park, Hee Chul; Lim, Do Hoon; Han, Young Yih [Dept. of Radiation Oncology, amsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-03-15

    In order to evaluate the relationship between the dose to the liver parenchyma and focal liver reaction (FLR) after stereotactic ablative body radiotherapy (SABR), we suggest a novel method using a three-dimensional dose distribution and change in signal intensity of gadoxetate disodium-gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) hepatobiliary phase images. In our method, change of the signal intensity between the pretreatment and follow-up hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was calculated and then threshold dose (TD) for developing FLR was obtained from correlation of dose with the change of the signal intensity. For validation of the method, TDs for six patients, who had been treated for liver cancer with SABR with 45-60 Gy in 3 fractions, were calculated using the method, and we evaluated concordance between volume enclosed by isodose of TD by the method and volume identified as FLR by a physician. The dose to normal liver was correlated with change in signal intensity between pretreatment and follow-up MRI with a median R{sup 2} of 0.935 (range, 0.748 to 0.985). The median TD by the method was 23.5 Gy (range, 18.3 to 39.4 Gy). The median value of concordance was 84.5% (range, 44.7% to 95.9%). Our method is capable of providing a quantitative evaluation of the relationship between dose and intensity changes on follow-up MRI, as well as determining individual TD for developing FLR. We expect our method to provide better information about the individual relationship between dose and FLR in radiotherapy for liver cancer.

  19. Unique perception of clinical trials by Korean cancer patients

    Directory of Open Access Journals (Sweden)

    Lee Su Jin

    2012-12-01

    Full Text Available Abstract Background In the past few years, the number of clinical trials has increased rapidly in East Asia, especially for gastric and hepatobiliary cancer that are prevalent in Asian populations. However, the actual degree of understanding or perceptions of clinical trials by cancer patients in East Asian countries have seldom been studied. Methods Between July 1st and November 30th of 2011, we conducted a prospective study to survey cancer patients regarding their awareness of, and willingness to participate in, a clinical trial. Patients with gastrointestinal/hepatobiliary cancer who visited the Hematology-Oncology outpatient clinic at Samsung Medical Center (SMC were enrolled. A total of 21 questions were asked including four questions which used the Visual analogue scale (VAS score. Results In this survey study, 1,000 patients were asked to participate and 675 patients consented to participate (67.5%. The awareness of clinical trials was substantially higher in patients who had a higher level of education (pp=0.004, and had a higher economic status (p=0.001. However, the willingness to participate in a clinical trial was not affected by the level of education or economic status of patients. The most influential factors for patient willingness to participate were a physician recommendation (n=181, 26.8%, limited treatment options (n=178, 26.4%, and expectations of effectiveness of new anti-cancer drugs (n=142, 21.0%. Patients with previous experience in clinical trials had a greater willingness to participate in clinical trials compared to patients without previous experience (p Conclusions This large patient cohort survey study showed that Korean cancer patients are more aware of clinical trials, but awareness did not translate into willingness to participate.

  20. A prospective pilot study: Can the biliary tree be visualized in children younger than 3 months on Magnetic Resonance Cholangiopancreatography?

    Energy Technology Data Exchange (ETDEWEB)

    Siles, Pascale [La Timone Children' s Hospital, Department of Radiology, Marseille (France); Aschero, Audrey; Gorincour, Guillaume; Bourliere-Najean, Brigitte; Petit, Philippe [La Timone Children' s Hospital, Department of Pediatric Radiology, Marseille (France); Roquelaure, Bertrand [La Timone Children' s Hospital, Department of Pediatrics, Marseille (France); Delarue, Arnauld [La Timone Children' s Hospital, Department of Pediatric Surgery, Marseille (France)

    2014-09-15

    Magnetic resonance cholangiopancreatography (MRCP) could aid in the diagnosis of biliary atresia, a hepatic pathology with thin, irregular or interrupted biliary ducts. There is little published evidence of MRCP appearances in normal neonates and young infants. To assess the use of MR cholangiopancreatography in visualizing the biliary tree in neonates and infants younger than 3 months with no hepatobiliary disorder, and to assess this visibility in relationship to the child's age, weight, and sedation and fasting states. Between December 2008 and October 2010 our department performed MRI of the brain, orbits and face on 16 full-term neonates and infants. Each child was younger than 3 months (90 days) and without any hepatobiliary disorders. The children were scanned with a respiratory-gated 0.54 x 0.51 x 0.4-mm{sup 3} 3-D MRCP sequence. We used a reading grid to assess subjectively the visibility of the extrahepatic bile ducts along with extrahepatic bile duct confluence. The visibility of the extrahepatic bile duct confluence was assessed against age, weight, and sedation and fasting states. The extrahepatic bile duct confluence was seen in 10 children out of 16 (62.5%). In the neonate sub-group (corrected age younger than 30 days), the MRCP was technically workable and the extrahepatic bile duct confluence was seen in four cases out of eight (50%). This visualization was up to 75% in the subgroup older than 30 days. However, statistically there was no significant difference in visibility of the extrahepatic bile duct confluence in relationship to age, weight or MRCP performance conditions (feeding, fasting or sedation). The complete normal biliary system (extrahepatic bile duct confluence included) is not consistently visualized in infants younger than 3 months old on non-enhanced MRCP. Thus the use of MRCP to exclude a diagnosis of biliary atresia is compromised at optimal time of surgery. (orig.)

  1. Intestinal SR-BI does not impact cholesterol absorption or transintestinal cholesterol efflux in mice.

    Science.gov (United States)

    Bura, Kanwardeep S; Lord, Caleb; Marshall, Stephanie; McDaniel, Allison; Thomas, Gwyn; Warrier, Manya; Zhang, Jun; Davis, Matthew A; Sawyer, Janet K; Shah, Ramesh; Wilson, Martha D; Dikkers, Arne; Tietge, Uwe J F; Collet, Xavier; Rudel, Lawrence L; Temel, Ryan E; Brown, J Mark

    2013-06-01

    Reverse cholesterol transport (RCT) can proceed through the classic hepatobiliary route or through the nonbiliary transintestinal cholesterol efflux (TICE) pathway. Scavenger receptor class B type I (SR-BI) plays a critical role in the classic hepatobiliary route of RCT. However, the role of SR-BI in TICE has not been studied. To examine the role of intestinal SR-BI in TICE, sterol balance was measured in control mice and mice transgenically overexpressing SR-BI in the proximal small intestine (SR-BI(hApoCIII-ApoAIV-Tg)). SR-BI(hApoCIII-ApoAIV-Tg) mice had significantly lower plasma cholesterol levels compared with wild-type controls, yet SR-BI(hApoCIII-ApoAIV-Tg) mice had normal fractional cholesterol absorption and fecal neutral sterol excretion. Both in the absence or presence of ezetimibe, intestinal SR-BI overexpression had no impact on the amount of cholesterol excreted in the feces. To specifically study effects of intestinal SR-BI on TICE we crossed SR-BI(hApoCIII-ApoAIV-Tg) mice into a mouse model that preferentially utilized the TICE pathway for RCT (Niemann-Pick C1-like 1 liver transgenic), and likewise found no alterations in cholesterol absorption or fecal sterol excretion. Finally, mice lacking SR-BI in all tissues also exhibited normal cholesterol absorption and fecal cholesterol disposal. Collectively, these results suggest that SR-BI is not rate limiting for intestinal cholesterol absorption or for fecal neutral sterol loss through the TICE pathway.

  2. Lipopolysaccharide-induced biliary factors enhance invasion of Salmonella enteritidis in a rat model.

    Science.gov (United States)

    Islam, A F; Moss, N D; Dai, Y; Smith, M S; Collins, A M; Jackson, G D

    2000-01-01

    In this study, the role of the hepatobiliary system in the early pathogenesis of Salmonella enteritidis infection was investigated in a rat model. Intravenous (i.v.) challenge with lipopolysaccharide (LPS) has previously been shown to enhance the translocation of normal gut flora. We first confirmed that LPS can similarly promote the invasion of S. enteritidis. Oral infection of outbred Australian Albino Wistar rats with 10(6) to 10(7) CFU of S. enteritidis led to widespread tissue invasion after days. If animals were similarly challenged after intravenous administration of S. enteritidis LPS (3 to 900 microg/kg of body weight), significant invasion of the livers and mesenteric lymph nodes (MLN) occurred within 24 h, with invasion of the liver increasing in a dose-dependent fashion (P < 0.01). If bile was prevented from reaching the intestine by bile duct ligation or cannulation, bacterial invasion of the liver and MLN was almost totally abrogated (P < 0.001). As i.v. challenge with LPS could induce the delivery of inflammatory mediators into the bile, biliary tumor necrosis factor alpha (TNF-alpha) concentrations were measured by bioassay. Biliary concentrations of TNF-alpha rose shortly after LPS challenge, peaked with a mean concentration of 27.0 ng/ml at around 1 h postchallenge, and returned to baseline levels (3.1 ng/ml) after 2.5 h. Although TNF-alpha cannot be directly implicated in the invasion process, we conclude that the invasiveness of the enteric pathogen S. enteritidis is enhanced by the presence of LPS in the blood and that this enhanced invasion is at least in part a consequence of the delivery of inflammatory mediators to the gastrointestinal tract by the hepatobiliary system.

  3. Optimized detection and characterization of liver metastases. The role of current MRI contrast agents; Optimierte Detektion und Charakterisierung von Lebermetastasen. Leistungsvermoegen aktueller MRT-Kontrastmittel

    Energy Technology Data Exchange (ETDEWEB)

    Weinrich, J.M.; Well, L.; Bannas, P. [Universitaetsklinikum Hamburg-Eppendorf, Zentrum fuer Radiologie und Endoskopie, Klinik und Poliklinik fuer diagnostische und interventionelle Radiologie und Nuklearmedizin, Hamburg (Germany)

    2017-05-15

    Metastases are the most common malignant lesions of the liver. The presence of liver metastases is an important prognostic factor and is decisive for the further management, especially in patients with colorectal cancer. Detection and characterization of liver metastases as well as differentiation from benign lesions are of high importance and a daily challenge in clinical radiology. Contrast-enhanced magnetic resonance imaging (MRI) has the highest sensitivity in detecting liver metastases. The sensitivity of MRI has been further increased due to the development of liver-specific contrast agents. This article describes the role of extracellular and hepatobiliary contrast agents for the detection and characterization of liver metastases. Moreover, the current knowledge on safety, sequence optimization, transient severe dyspnea and the combination of hepatobiliary with intravascular contrast agents for liver imaging is discussed. (orig.) [German] Metastasen sind die haeufigsten malignen Leberlaesionen. Das Vorhandensein von Lebermetastasen ist entscheidend fuer die Prognose und weitere Therapieplanung von Tumorpatienten, insbesondere von Patienten mit kolorektalen Karzinomen. Die Detektion von Lebermetastasen sowie deren Unterscheidung von anderen Leberlaesionen sind daher von hoechster Bedeutung und stellen eine alltaegliche Herausforderung fuer den Radiologen dar. Die Bildgebung mit der hoechsten Sensitivitaet fuer die Detektion von Lebermetastasen stellt die dynamische kontrastmittelgestuetzte Magnetresonanztomographie (MRT) dar. Die bereits hohe Sensitivitaet der MRT wird durch den Einsatz leberspezifischer Kontrastmittel noch weiter gesteigert. Dieser Artikel beleuchtet die Rolle der aktuellen unspezifischen und leberspezifischen MRT-Kontrastmittel fuer die Detektion und Charakterisierung von Lebermetastasen. Weiterhin werden Erkenntnisse zur Sicherheit, Sequenzoptimierung, zu transienten Atemartefakten und zur Kombination von MRT-Kontrastmitteln fuer die

  4. Emergence of the Zoonotic Biliary Trematode Pseudamphistomum truncatum in Grey Seals (Halichoerus grypus) in the Baltic Sea

    Science.gov (United States)

    Bergman, Anders; Bignert, Anders; Höglund, Johan; Lundström, Karl; Strömberg, Annika; Bäcklin, Britt-Marie

    2016-01-01

    The biliary trematode Pseudamphistomum truncatum parasitizes a wide range of fish-eating mammals, including humans. Here we report the emergence of this parasite in grey seals (Halichoerus grypus) in the Baltic Sea. One hundred eighty-three of 1 554 grey seals (11.9%) examined from 2002–2013 had detectable hepatobiliary trematode infection. Parasite identification was confirmed as P. truncatum by sequencing the ITS2 region of a pool of five to 10 trematodes from each of ten seals collected off the coast of seven different Swedish counties. The proportion of seals parasitized by P. truncatum increased significantly over time and with increasing age of seals. Males were 3.1 times more likely to be parasitized than females and animals killed in fishery interactions were less likely to be parasitized than animals found dead or hunted. There was no significant difference in parasitism of seals examined from the Gulf of Bothnia versus those examined from the Baltic Proper. Although the majority of infections were mild, P. truncatum can cause severe hepatobiliary disease and resulted in liver failure in at least one seal. Because cyprinid fish are the second intermediate host for opisthorchiid trematodes, diets of grey seals from the Baltic Sea were analysed regarding presence of cyprinids. The proportion of gastrointestinal tracts containing cyprinid remains was ten times higher in seals examined from 2008 to 2013 (12.2%) than those examined from 2002 to 2007 (1.2%) and coincided with a general increase of trematode parasitism in the host population. The emergence and relatively common occurrence of P. truncatum in grey seals signals the presence of this parasite in the Baltic Sea ecosystem and demonstrates how aquatic mammals can serve as excellent sentinels of marine ecosystem change. Investigation of drivers behind P. truncatum emergence and infection risk for other mammals, including humans, is highly warranted. PMID:27755567

  5. Can the National Health Service Cancer Plan timeline be applied to colorectal hepatic metastases?

    LENUS (Irish Health Repository)

    Jones, Claire

    2012-02-01

    INTRODUCTION: The National Health Service (NHS) Cancer Plan guidelines recommend a maximum 2-week wait from referral to first appointment, and 2 months from referral to treatment for primary cancers. However, there are currently no guidelines available for metastatic disease. In the UK, nearly half of all colorectal cancer patients develop hepatic metastases. Timely, surgical resection offers the potential for cure. The aim of this study was to audit current practice for colorectal liver metastases in a regional hepatobiliary unit, and compare this to the NHS Cancer Plan standards for primary disease. PATIENTS AND METHODS: A retrospective review of the unit\\'s database was performed for all hepatic metastases referrals from January 2006 to December 2008. The dates of referral, first appointment, investigations and initiation of treatment, along with patient\\'s age and sex, were recorded on Microsoft Excel and analysed. Time was expressed as mean +\\/- SD in days. RESULTS: A total of 102 patients with hepatic metastases were identified. Five were excluded due to incomplete data. The average time from referral to first appointment was 10.6 +\\/- 9.4 days and the average time from referral to treatment was 38.5 +\\/- 28.6 days. Seventy-five (72.7%) had surgical intervention, of whom 37 also had chemotherapy. CONCLUSIONS: The data compare favourably to the NHS Cancer Plan guidelines for primary malignancy, demonstrating that a regional hepatobiliary unit is capable of delivering a service for colorectal liver metastases that adheres to the NHS Cancer Plan. Therefore, the NHS Cancer Plan can be applied to this cohort.

  6. Impact of liver cirrhosis on liver enhancement at Gd-EOB-DTPA enhanced MRI at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Verloh, N., E-mail: niklas.verloh@stud.uni-regensburg.de [Department of Radiology, University Hospital Regensburg, Regensburg (Germany); Haimerl, M.; Rennert, J.; Müller-Wille, R.; Nießen, C. [Department of Radiology, University Hospital Regensburg, Regensburg (Germany); Kirchner, G. [Department of Gastroenterology, University Hospital Regensburg, Regensburg (Germany); Scherer, M.N. [Department of Surgery, University Hospital Regensburg, Regensburg (Germany); Schreyer, A.G.; Stroszczynski, C.; Fellner, C.; Wiggermann, P. [Department of Radiology, University Hospital Regensburg, Regensburg (Germany)

    2013-10-01

    Purpose: The purpose of this study was to assess differences in enhancement effects of liver parenchyma between normal and cirrhotic livers on dynamic, Gd-EOB-DTPA enhanced MRI at 3 T. Materials and methods: 93 patients with normal (n = 54) and cirrhotic liver (n = 39; Child–Pugh class A, n = 18; B, n = 16; C, n = 5) underwent contrast-enhanced MRI with liver specific contrast media at 3 T. T1-weighted volume interpolated breath hold examination (VIBE) sequences with fat suppression were acquired before contrast injection, in the arterial phase (AP), in the late arterial phase (LAP), in the portal venous phase (PVP), and in the hepatobiliary phase (HBP) after 20 min. The relative enhancement (RE) of the signal intensity of the liver parenchyma was calculated for all phases. Results: Mean RE was significantly different among all evaluated groups in the hepatobiliary phase and with increasing severity of liver cirrhosis, a decreasing, but still significant reduction of RE could be shown. Phase depending changes of RE for each group were observed. In case of non-cirrhotic liver or Child–Pugh Score A cirrhosis mean RE showed a significant increase between AP, LAP, PVP and HBP. For Child–Pugh B + C cirrhosis RE increased until PVP, however, there was no change in case of B cirrhosis (p = 0.501) and significantly reduced in case of C cirrhosis (p = 0.043) during HBP. Conclusion: RE of liver parenchyma is negatively affected by increased severity of liver cirrhosis, therefore diagnostic value of HBP could be limited in case of Child Pugh B + C cirrhosis.

  7. Clinical manifestations and prognostic factors of Morganella morganii bacteremia.

    Science.gov (United States)

    Lin, T-Y; Chan, M-C; Yang, Y-S; Lee, Y; Yeh, K-M; Lin, J-C; Chang, F-Y

    2015-02-01

    Although Morganella morganii causes a variety of clinical infections, there are limited studies on M. morganii bacteremia after the year 2000. A total of 109 patients with M. morganii bacteremia at a medical center in Taiwan from 2003 to 2012 were studied. Among them, 30.3 % had polymicrobial bacteremia and 75.2 % had community-acquired infection. The most common underlying diseases were hypertension (62.4 %) and diabetes mellitus (38.5 %). The urinary tract (41.3 %) was the major portal of entry, followed by the hepatobiliary tract (27.5 %), skin and soft tissue (21.1 %), and primary bacteremia (10.1 %). Susceptibility testing of M. morganii isolates showed ubiquitous resistance to first-generation cephalosporins and ampicillin-clavulanate; resistance rates to gentamicin, piperacillin-tazobactam, and ciprofloxacin were 30.3 %, 1.8 %, and 10.1 %, respectively. Overall, the 14-day mortality was 14.7 %. Univariate analysis revealed that elevated blood urea nitrogen (BUN) values [p = 0.0137, odds ratio (OR) 5.26], intensive care unit (ICU) admission (p = 0.011, OR 4.4), and higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (p < 0.001, OR 1.62) were significantly associated with mortality. The APACHE II score remained the only significant risk factor for mortality in multivariate analysis (p = 0.0012, OR 1.55). In conclusion, M. morganii bacteremia patients were mostly elderly, with one or more comorbidities. Most of the patients had community-acquired infection via the urinary and hepatobiliary tracts. Furthermore, prognosis can be predicted according to disease severity measured by the APACHE II score.

  8. Variability in plasma concentration of cefotaxime in critically ill patients in an Intensive Care Unit of India and its pharmacodynamic outcome: A nonrandomized, prospective, open-label, analytical study

    Directory of Open Access Journals (Sweden)

    B Abhilash

    2016-01-01

    Full Text Available Background: Cefotaxime is a widely utilized cephalosporin in most intensive care units of India. However, no data are available about its pharmacokinetic/pharmacodynamic variability in critically ill patients of the Indian population. Aim: To investigate the variability in the plasma concentration and pharmacodynamic profile of intermittent dosing of cefotaxime in critically ill patients, according to their locus of infection and causative organism. Materials and Methods: Cefotaxime levels were determined using high-performance liquid chromatography by grouping patients according to their locus of infection as hepatobiliary, renal, pulmonary, and others. Patients with cefotaxime concentration below the minimum inhibitory concentration (MIC and 5 times below the MIC for the isolated organism were determined. Results: The difference in the plasma cefotaxime concentration between the hepatobiliary and the nonhepatobiliary groups was significant at 1 h (P = 0.02 following drug dosing, while the difference was significant between the renal and nonrenal group at 1 h (P = 0.001, 4 h (P = 0.009, and 8 h (P = 0.02 after drug dosing. The pulmonary group showed significantly (P < 0.05 lower plasma cefotaxime levels than the nonpulmonary group at all-time points. The cefotaxime levels were below the MIC and below 5 times the MIC for the isolated organism in 16.67% and 43.33% of the patients, respectively. Conclusion: The concentration of cefotaxime differs according to the locus of an infection in critically ill patients. Use of another class of antibiotic or shifting to continuous dosing of cefotaxime, for organisms having MIC values above 1 mg/L, is advisable due to the fear of resistance.

  9. Health-related quality of life evaluated by tumor node metastasis staging system in patients with hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Cui-Xia Qiao; Xiao-Feng Zhai; Chang-Quan Ling; Qing-Bo Lang; Hui-Juan Dong; Qun Liu; Mou-Duo Li

    2012-01-01

    AIM:To investigate and evaluate the change in healthrelated quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC).METHODS:A total of 140 patients diagnosed with HCC between June 2008 and April 2009 in our department were enrolled to this study.One hundred and thirty-five (96.5%) patients had liver cirrhosis secondary to hepatitis B virus (HBV) infection,73 (54.07%) of them being HBV DNA positive; the other etiologies of liver cirrhosis were alcoholic liver disease (1.4%),hepatitis C (1.4%)or cryptogenic (0.7%).All subjects were fully aware of their diagnosis and provided informed consent.HRQoL was assessed before treatment using the functional assessment of cancer therapy-hepatobiliary (FACTHep) questionnaire.Descriptive statistics were used to evaluate demographics and disease-specific characteristics of the patients.One-way analysis of variance and independent samples t tests were used to compare the overall FACT-Hep scores and clinically distinct TNM stages.Scores for all FACT-Hep items were analyzed by frequency analyses.The mean scores obtained from the FACT-Hep in different Child-Pugh classes were also evaluated.RESULTS:The mean FACT-Hep scores were reduced significantly from TNM Stage Ⅰ to Stage Ⅱ,Stage ⅢA,Stage ⅢB group (687 ± 39.69 vs 547 ± 42.57 vs 387 ± 51.24 vs 177 ± 71.44,P =0.001).Regarding the physical and emotional well-being subscales,scores decreased gradually from Stage Ⅰ to Stage ⅢB (P =0.002 vs Stage Ⅰ ; P =0.032 vs Stage Ⅱ; P =0.033 vs Stage ⅢA).Mean FACT-Hep scores varied by Child-Pugh class,especially in the subscales of physical well-being,functional well-being and the hepatobiliary cancer (P =0.001 vs Stage Ⅰ; P =0.036 vs Stage Ⅱ ; P =0.032 vs Stage ⅢA).For the social and family well-being subscale,only Stage ⅢB scores were significantly lower as compared with Stage Ⅰ scores (P =0.035).For the subscales of functional well-being and

  10. 胆固醇逆转运的新途径:胆固醇经肠道直接排出体外?%Novel Pathway for Reverse Cholesterol Transport: Directly Transintestinal Cholesterol Efflux?

    Institute of Scientific and Technical Information of China (English)

    司艳红; 商战平; 秦树存

    2011-01-01

    过多的胆固醇沉积在动脉壁对机体极为有害,可以引起动脉粥样硬化甚至心血管疾病.而胆固醇逆转运(reverse cholesterol transport,RCT)可以逆转此过程.传统的RCT是指胆固醇由外周组织转运回肝脏进行再循环或以胆汁酸的形式随粪便排出体外的过程,此过程受多种因子调控.近几年研究发现,胆固醇还可由血经过肠道直接分泌(transintestinal cholesterol efflux,TICE)通路随粪便排出体外,此过程对外界刺激更敏感.RCT已经成为防治动脉粥样硬化研究的新靶点,TICE有可能成为更有效的RCT调控通路.%The presence of excess cholesterol in cells, and in particular in macrophages in the arterial vessel wall, might be harmful. The accumulation of cholesterol in arteries can lead to atherosclerosis, and in turn, to other cardiovascular diseases. Reverse cholesterol transport ( RCT) can reverse this processing. By the pathway of classic RCT, excess cholesterol is collected from peripheral tissues and delivered back to the liver and hepatobiliary tract for excretion via the feces. This processing could be affected by many factors. For a long time this removal via the hepatobiliary secretion was considered to be the sole route involved in the RCT. In the last few years it has become evident that a nonbiliary cholesterol secretion pathway exists. That is the transintestinal cholesterol efflux ( TICE) pathway. Moreover, recent studies have shown that TICE is also sensitive to stimulation. Therefore, RCT, especially TICE, was seen as a suitable and approachable target for the development of drugs aimed at the prevention of atherosclerosis.

  11. Intrahepatic cholestasis of pregnancy and cancer, immune-mediated and cardiovascular diseases: A population-based cohort study.

    Science.gov (United States)

    Wikström Shemer, Elisabeth A; Stephansson, Olof; Thuresson, Marcus; Thorsell, Malin; Ludvigsson, Jonas F; Marschall, Hanns-Ulrich

    2015-08-01

    Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. It is associated with hepatobiliary diseases that might predispose to cancer and also with gestational diabetes and preeclampsia. In this study, we examined associations between ICP and cancer, and immune-mediated and cardiovascular diseases. By linking the Swedish Medical Birth Register and the Swedish Patient Register, we identified 11,388 women with ICP and 113,893 matched women without ICP who gave birth between 1973 and 2009. Diagnoses of cancer and immune-mediated and cardiovascular diseases both before and after delivery were obtained from the Patient Register. The main outcome measures were hazard ratios (HRs), calculated through Cox regression, for the indicated diseases after delivery. ICP was not associated with later overall cancer (HR 1.07, 95% confidence interval [CI] 0.94-1.21), but it was associated with later liver and biliary tree cancer (HR 3.61, 95% CI 1.68-7.77, and 2.62, 95% CI 1.26-5.46, respectively). ICP was also associated with later immune-mediated diseases (HR 1.28, 95% CI 1.19-1.38), and specifically diabetes mellitus (HR 1.47, 95% CI 1.26-1.72), thyroid disease (HR 1.30, 95% CI 1.14-1.47), psoriasis (HR 1.27, 95% CI 1.07-1.51), inflammatory polyarthropathies (HR 1.32, 95% CI 1.11-1.58) and Crohn's disease (HR 1.55, 95% CI 1.14-2.10), but not ulcerative colitis (HR 1.21, 95% CI 0.93-1.58). Women with ICP also had a small increased risk of later cardiovascular disease (HR 1.12, 95% CI 1.06-1.19). Women with ICP have increased risk of later hepatobiliary cancer and immune-mediated and cardiovascular diseases. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  12. Surgical treatment of double primary liver cancer

    Science.gov (United States)

    Li, Aijun; Ma, Senlin; Pawlik, Timothy; Wu, Bin; Yang, Xiaoyu; Cui, Longjiu; Wu, Mengchao

    2016-01-01

    Abstract Double primary liver cancer (DPLC) is a special type of clinical situation. As such, a detailed analysis of the surgical management and prognosis of patients with DPLC is lacking. The objective of the current study was to define the management and outcome of patients undergoing surgery for DPLC at a major hepatobiliary center. A total of 87 patients treated by surgical resection at the Eastern Hepatobiliary Surgery Hospital from January 1st, 2007 to October 31st, 2013 who had DPLC demonstrated by final pathological diagnosis were identified. Among these, 50 patients had complete clinical and prognostic data. Demographic and tumor characteristics as well as the prognosis were analyzed. The proportion of hepatitis B surface antigen (HBsAg) (+) and hepatitis B virus e antigen (HBeAg) (+), HBsAg (+), and HBeAg (−) hepatocirrhosis in all patients was 21.84%, 67.82%, and 63.22%, respectively. Incidental findings accounted for 58.62% of patients; among those who had symptoms, the main symptom was abdominal pain (31.03%). Nonanatomic wedge resection was the main operative approach (62.07%). Postoperatively, the main complications included seroperitoneum (11.49%), hypoproteinemia (10.34%), and pleural effusion (8.05%). Factors associated with disease-free survival (DFS) included intrahepatic cholangiocarcinoma (ICC) tumor size (P = 0.002) and use of postoperative prophylactic transcatheter arterial chemoembolization (TACE) treatment (P = 0.015). Meanwhile, hepatocellular carcinoma (HCC) size (P = 0.045), ICC size (P < 0.001), and liver function (including aspartate aminotransferase [P = 0.001] and r-glutamyl transferase [P < 0.001]) were associated with overall survival (OS). Hepatitis B virus (HBV)-related hepatitis or cirrhosis is also an important factor in the pathogenesis of DPLC and surgical treatment is safe for it with low complication rates. In addition, it is effective to prolong DFS that DPLC patients undergo postoperative

  13. Surgical treatment of double primary liver cancer: An observational study for a rare type of tumor.

    Science.gov (United States)

    Li, Aijun; Ma, Senlin; Pawlik, Timothy; Wu, Bin; Yang, Xiaoyu; Cui, Longjiu; Wu, Mengchao

    2016-08-01

    Double primary liver cancer (DPLC) is a special type of clinical situation. As such, a detailed analysis of the surgical management and prognosis of patients with DPLC is lacking. The objective of the current study was to define the management and outcome of patients undergoing surgery for DPLC at a major hepatobiliary center.A total of 87 patients treated by surgical resection at the Eastern Hepatobiliary Surgery Hospital from January 1st, 2007 to October 31st, 2013 who had DPLC demonstrated by final pathological diagnosis were identified. Among these, 50 patients had complete clinical and prognostic data. Demographic and tumor characteristics as well as the prognosis were analyzed.The proportion of hepatitis B surface antigen (HBsAg) (+) and hepatitis B virus e antigen (HBeAg) (+), HBsAg (+), and HBeAg (-) hepatocirrhosis in all patients was 21.84%, 67.82%, and 63.22%, respectively. Incidental findings accounted for 58.62% of patients; among those who had symptoms, the main symptom was abdominal pain (31.03%). Nonanatomic wedge resection was the main operative approach (62.07%). Postoperatively, the main complications included seroperitoneum (11.49%), hypoproteinemia (10.34%), and pleural effusion (8.05%). Factors associated with disease-free survival (DFS) included intrahepatic cholangiocarcinoma (ICC) tumor size (P = 0.002) and use of postoperative prophylactic transcatheter arterial chemoembolization (TACE) treatment (P = 0.015). Meanwhile, hepatocellular carcinoma (HCC) size (P = 0.045), ICC size (P < 0.001), and liver function (including aspartate aminotransferase [P = 0.001] and r-glutamyl transferase [P < 0.001]) were associated with overall survival (OS).Hepatitis B virus (HBV)-related hepatitis or cirrhosis is also an important factor in the pathogenesis of DPLC and surgical treatment is safe for it with low complication rates. In addition, it is effective to prolong DFS that DPLC patients undergo postoperative prophylactic TACE

  14. 肝胆患者外科手术后胃肠功能恢复护理分析

    Institute of Scientific and Technical Information of China (English)

    张红

    2014-01-01

    目的:比较肝胆外科患者手术后常规护理和综合护理方法对胃肠功能恢复的影响,从而探讨能显著促进患者术后胃肠功能恢复的护理方法。方法:收集我院2010年4月至2013年9月在我院进行外科手术的肝胆患者90例作为研究对象进行分析。按照临床和护理方法,分成观察组和对照组,每组45例。结果:通过两组比较,两组之间术后肠鸣音恢复时间、肛门首次排气时间、排便时间,,差异有统计学意义(P<0.05)。结论:采用围手术期综合护理方法能使肝胆外科手术患者胃肠功能恢复效果显著,值得广大临床医护工作者推广和应用。%Objective:To compare the effects of Department of hepatobiliary surgery patients after operation of routine nursing and comprehensive nursing methods on the recovery of gastrointestinal function, so as to explore the nursing methods can significantly promote the recovery of gastrointestinal function after sur-gery. Methods: in our hospital from 2010 April to 2013 September, surgical operation in our hospital from liver in 90 patients as the research object analysis. Ac-cording to the clinical and nursing method, divided into the observation group and the control group, 45 cases each group. Results:by comparing the two groups, two groups of postoperative recovery time of bowel sound, anal exhaust time, defecation time,, the difference was statistically significant (P<0. 05). Conclusion:the comprehensive nursing in the peri operation period of patients in Department of hepatobiliary surgery operation method can make the gastrointestinal function recovery effect is significant, worthy of clinical popularization and application of medical workers.

  15. A Randomized Study of Peginterferon Lambda-1a Compared to Peginterferon Alfa-2a in Combination with Ribavirin and Telaprevir in Patients with Genotype-1 Chronic Hepatitis C

    Science.gov (United States)

    Flisiak, Robert; Shiffman, Mitchell; Arenas, Juan; Cheinquer, Hugo; Nikitin, Igor; Dong, Yuping; Rana, Khurram; Srinivasan, Subasree

    2016-01-01

    Background A randomized, double-blind, multinational, phase 3 study was conducted comparing the efficacy and safety of peginterferon lambda-1a (Lambda)/ribavirin (RBV)/telaprevir (TVR) vs. peginterferon alfa-2a (Alfa)/RBV/TVR in patients with chronic hepatitis C virus (HCV) genotype-1 (GT-1) infection. Methods Patients (treatment-naïve or relapsers on prior Alfa/RBV treatment) were randomly assigned in a 2:1 ratio to receive Lambda/RBV/TVR or Alfa/RBV/TVR. Total duration of treatment was either 24 or 48 weeks (response-guided treatment), with TVR administered for the first 12 weeks. The primary endpoint was the proportion of patients who achieved a sustained virologic response at post treatment week 12 (SVR12), which was tested for noninferiority of Lambda/RBV/TVR. Results A total of 838 patients were enrolled, and 617 were treated; 411 and 206 patients received Lambda/RBV/TVR and Alfa/RBV/TVR, respectively. The majority of patients were treatment-naïve, with HCV GT-1b and a high baseline viral load (≥800,000 IU/mL). Less than 10% of patients had cirrhosis (Lambda, 7.5%; Alfa, 6.8%). Lambda/RBV/TVR did not meet the criterion for noninferiority (lower bound of the treatment difference interval was -12.3%); the SVR12 in all patients (modified intent-to-treat) was 76.2% in the Lambda arm and 82.0% in the Alfa arm. Overall, the frequency of adverse events in each arm was comparable (Lambda, 91.7%; Alfa, 97.1%). As expected based on the safety profile of the 2 interferons, there were more hepatobiliary events observed in the Lambda arm and more hematologic events in the Alfa arm. Conclusions In this comparison of Lambda/RBV/TVR and Alfa/RBV/TVR in patients who were treatment-naïve or had relapsed on prior Alfa/RBV treatment, Lambda failed to demonstrate noninferiority based on SVR12 results. Treatment with Lambda/RBV/TVR was associated with a higher incidence of relapse. More patients discontinued Lambda/RBV/TVR treatment during the first 4 weeks of study treatment

  16. Structure of viral hepatitis in infants

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    T.V. Sorokman

    2017-07-01

    Full Text Available Background. Many current studies are devoted to the study of hepatitis caused by viral infections, which are qualified as TORCH-infection. In infants TORCH-induced lesions prevail in the structure of viral hepatitis, the largest proportion is hepatitis of cytomegalovirus etiology. The purpose was to study the structure of viral hepatitis in infants. Materials and methods. The study included sixty-two children (mean age 1.8 ± 0.9 years born in 2007–2016 treated in Chernivtsi Regional Children’s Clinical Hospital. The comparison group consisted of 36 healthy children of the same age. The pathogens of viral hepatitis B, C, TORCH infections were verified by enzyme immunoassay and polymerase chain reaction. The results of the research were analyzed using computer package Statistica StatSoft Inc. and Excel XP for Windows for a personal computer. Results. The results of the analysis of the liver diseases structure in 62 young children, according to hospital statistics, determined that the overwhelming majority (38 children; 61.3 % had viral hepatitis (VH, the other 24 (38.7 % patients were divided by the etiological structure of liver damage as follows: 8 (12.9 % patients had prolonged conjunctive jaundice, 7 (11.3 % patients had congenital metabolic disorders, 9 (14.5 % patients had congenital hepatobiliary abnomalities. 16.6 % of young children had hepatitis B and C viruses. In 5.8 % of cases VH was caused by viruses of the TORCH group of infections. Conclusions. In the structure of hepatobiliary diseases in infants, viral hepatitis (68.4 % is on the first ranked place. Among the viral hepatitis in children in the first year of life, CMV-hepatitis (68.4 % is most common, in children over 1 year old chronic hepatitis B and C. Severe obstetrical anamnesis, violations of pregnancy, placental infection are rather significant in the group of children with viral hepatitis. The main clinical signs of CMV-hepatitis are prolonged jaundice, cholestasis

  17. Hypothermic perfusion with retrograde outflow during right hepatectomy is safe and feasible.

    Science.gov (United States)

    Reiniers, Megan J; Olthof, Pim B; van Golen, Rowan F; Heger, Michal; van Beek, Adriaan A; Meijer, Ben; Leen, René; van Kuilenburg, André B P; Mearadji, Banafsche; Bennink, Roelof J; Verheij, Joanne; van Gulik, Thomas M

    2017-07-01

    In situ hypothermic perfusion during liver resection performed under vascular inflow occlusion decreases hepatic ischemia-reperfusion injury, but technical limitations have restricted its widespread use. In situ hypothermic perfusion with retrograde outflow circumvents these impediments and thus could extend the applicability of in situ hypothermic perfusion. The safety and feasibility of in situ hypothermic perfusion with retrograde outflow were analyzed in selected patients undergoing right (extended) hepatectomy and compared to intermittent vascular inflow occlusion, the gold standard method, in this randomized pilot study. Patients were first screened for parenchymal liver disease (exclusion criteria: steatosis ≥30%, cirrhosis, or cholestasis). Study participants were randomized intraoperatively to undergo in situ hypothermic perfusion with retrograde outflow (n = 9) or intermittent vascular inflow occlusion (n = 9). The target liver core temperature during in situ hypothermic perfusion with retrograde outflow was 28°C. The primary end point was ischemia-reperfusion injury (expressed by peak postoperative transaminase levels). Secondary outcomes included functional liver regeneration (assessed by hepatobiliary scintigraphy) and clinical outcomes. Peak transaminase levels, total bilirubin, and the international normalized ratio were similar between both groups, although a trend toward more rapid normalization of bilirubin levels was noted for the in situ hypothermic perfusion with retrograde outflow group. Functional liver regeneration as evaluated by hepatobiliary scintigraphy was improved on postoperative day 3 fafter in situ hypothermic perfusion with retrograde outflow but not after intermittent vascular inflow occlusion. Furthermore, in situ hypothermic perfusion with retrograde outflow (requiring continuous ischemia) was comparable to intermittent vascular inflow occlusion for all clinical outcomes, including postoperative complications and hospital

  18. The Evaluation of Liver Function Using Liver-Specific MR Contrast Agents%MR特异性对比剂肝功能评价研究

    Institute of Scientific and Technical Information of China (English)

    冯汝静; 黄仲奎

    2013-01-01

    Objective To evaluate the application value of liver-specific contrast agents in evaluating liver function. Methods Thirty six patients with liver dysfunction underwent MRI enhanced examination using liver specific contrast a-gent,including Gd BOPTA in 28 cases and Gd EOB DTPA in 12 cases, as well as MR conventional raulti phase enhanced scan. The liver function were evaluated with the biliary display in the hepatobiliary excretion phase. Results According to the visibility score of biliary in the hepatobiliary excretion phase images, 33 patients' liver function can be classified as grade A (grade > 16 points) in 17 cases,grade B (6 to 15 points) in 10 cases,grade C (6 to 15 points)in 6 cases. The consistency of image grading and clinical Child-pugh grading for liver function were good in the 33 patients (K = 0. 570, P = 0. 000). Especially, excellent consistency was presented in 10 cases using Gd EOB DTPA agent (K = 0. 804, P = 0.000). Conclusion The liver function could be evaluated by the liver-specific contrast agent enhanced MR images.%目的 探讨MRI特异性对比剂对肝功能评价的应用价值.方法 选择2011年至2012年行肝脏MRI检查的33例肝功能障碍患者资料.行肝脏常规MRI平扫、肝脏MRI特异性对比剂[钆贝葡胺(Gd-BOPTA)26例,钆塞酸二钠(Gd-EOB-DTPA) 10例]增强,对肝胆排泄期的各级胆管显示情况进行5级评分,再根据各级胆管显示总评分进行肝功能MRI分级.结果 33例患者的肝功能MR分级与临床Child-Pugh分级一致性良好(K=0.570,P=o.ooo),其中10例Gd-EOB-DTPA增强肝功能MR分级与临床Child-Pugh分级吻合程度极佳(K=0.804,P=0.000).结论 观察肝脏MRI特异性对比剂增强肝胆排泄期的胆管显示情况,可以评价整个肝脏肝功能情况.

  19. AGE AND GENDER PECULIARITIES OF DEVELOPMENT OF GALLSTONE DISEASE

    Directory of Open Access Journals (Sweden)

    N. A. Hohlacheva

    2016-01-01

    Full Text Available Goal. Study of the role of risk factors in mechanized gall stone formation depending on sex and age of patients. Material and methods We examined 210 patients with stage I gallstone disease (GSD. In verification of diagnosis used an ultrasound study of the hepatobiliary system, multi-grade duodenal sounding with subsequent macroscopic, microscopic, chemical and physical examination of bile. In the portions “b” and “C” bile was determined the total concentration of bile acids, cholesterol, with the subsequent calculation it consists of cholesterol ratio. Estimation of surface tension of bile viscosity and bile. In the studied blood levels of total cholesterol, lipoproteins of very low density, lowdensity lipoproteins, high density lipoproteins, triglycerides, were determined the coefficient of atherogenicity. To assess the degree of accumulation of body fat was used the Quetelet index. Studied the relative risk of anamnestic risk factors of GSD. Results. The features of biliary lithogenesis based on gender and age of patients. High value PR for the gall stone formation are female gender — 3,16, Mature and elderly age (older than 50 of 3.67. In young women, gall-stone formation is mainly due to the increase of cholesterol level of bile, at the age of 50 years with a decline in zhelchnokamennaja pool, increased viscosity and surface tension of bile. The most important risk factors of cholecystolithiasis are also gender differences: if women is multiple pregnancies and (or childbirth (more than 3 — OR 4,62, overweight (BMI over 26 — OR is 4.57 and the violation of the principles of good nutrition (eating disorders, overeating or starvation, the use of large quantities of animal fats — OR 3,94, for men it’s physical inactivity — OR a 4.25, the increase in KA — PR 3.87 and burdened by GSD genetics — OR of 2.05. Conclusion. The data obtained can be used in the organization of dispensary work with patients with hepatobiliary

  20. The surgical experience of general surgery residents: an analysis of the applicability of the specialty program in General and Digestive Surgery.

    Science.gov (United States)

    Targarona Soler, Eduardo Ma; Jover Navalon, Jose Ma; Gutierrez Saiz, Javier; Turrado Rodríguez, Víctor; Parrilla Paricio, Pascual

    2015-03-01

    Residents in our country have achieved a homogenous surgical training by following a structured residency program. This is due to the existence of specific training programs for each specialty. The current program, approved in 2007, has a detailed list of procedures that a surgeon should have performed in order to complete training. The aim of this study is to analyze the applicability of the program with regard to the number of procedures performed during the residency period. A data collection form was designed that included the list of procedures from the program of the specialty; it was sent in April 2014 to all hospitals with accredited residency programs. In September 2014 the forms were analysed, and a general descriptive study was performed; a subanalysis according to the resident's sex and Autonomous region was also performed. The number of procedures performed according to the number of residents in the different centers was also analyzed. The survey was sent to 117 hospitals with accredited programs, which included 190 resident places. A total of 91 hospitals responded (53%). The training offered adapts in general to the specialty program. The total number of procedures performed in the different sub-areas, in laparoscopic and emergency surgery is correct or above the number recommended by the program, with the exception of esophageal-gastric and hepatobiliary surgery. The sub-analysis according to Autonomous region did not show any significant differences in the total number of procedures, however, there were significant differences in endocrine surgery (P=.001) and breast surgery (P=.042). A total of 55% of residents are female, with no significant differences in distribution in Autonomous regions. However, female surgeons operate more than their male counterparts during the residency period (512±226 vs. 625±244; P<.01). The number of residents in the hospital correlates with the number of procedures performed; the residents with more procedures