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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
박한규 (가톨릭대학교 의학부 방사선과학교실)
저널정보
대한영상의학회 대한방사선의학회지 대한방사선의학회지 제16권 제2호
발행연도
1980.1
수록면
499 - 538 (40page)

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초록· 키워드

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Oral cholecystographi si a reliable and the most popular clinical examination . The examination is not suitabel for morphological study of the gallbladder but also efficient in diagnosing a calculous cholecystitis, and cystic duct syndrome and some ill defined functional disorders. For the functional evaluation of the gallbladder fat meal stimulation has been used traditionally. Recently, however, potent cholecystagogues called cholecystokinin(CCK) and curuletide were introduced in the radiological examination of the gallbladder stimulating acute interest in research of acalculous cholecystitis and cystic duct syndrome. The present study has been undertaken to test both experimentally and clinically the cholecystokinetic effects of CCK and ceruletide. In addition , the study has been designed to test if pharmacological constriction of the Od야 sphincter with morphine in animal and prostigmine in human subjects promotes visualization of the common bile duct and handhopefully th common hepatic duct. Seven(7) mongrel dogs weighing 10kg were anesthesized with Pentothal sodium(20mg/kg body wt) in the evening allowed to swallow 2 of lopanoic acid (Teiepaque) per os. Twelve hours later in the next morning dogs were radiographed their upper abdomen in LAO. Upon confirming optimal opacification of the GB 0.03$\mu\textrm{g}$.kg of CCK was injected intravenously to each of the 7 mongrel dogs for the test of contraction rate and contraction time of the gallbladder. The same test was repeated after injecting 10 mg/dog of morphine to constrict the Oddi sphincter .Theclinical materials consisted of 30 normal human subjects and 60 patients with biliary symptoms and signs. Those with abnormal upper gastrointestinal series and abnormal function tests of the pancreas were excluded from the materials. We injected the same amount of CCK and studied the contraction rate and time with an emphasis on acalculous cholecystitis and cystic duct syndrome and some ill-defined functional disorder. In addition, based on the results of animal experiments, we made an attempt to enhance the visualization of the biliary tree by injecting prostigmine and ceruletide in human subjects. The results were as follows : 1. The initial contraction of the gallbladder after intravenous CCK occurred between 1 and 2 minutes in dog. The mean maximum contraction of the gallbladder after intravenous CCK was 37.6$\pm$12.6% and occurred between 10 and 15 minutes indog. The visualization of extraheptic bile ducts were enhanced after intravenous CCK added by morphine in 5 out of 7 dogs. 2. The mean maximum contraction of the gallbladder after intravenous CCK was 38.8$\pm$23.7% in normal human controls and 29.5$\pm$18.4% in patients group, respectively. The difference was not significant statistically. A local spasm of the gallbladder after intravenous CCK was noted in 23% of patients group but none of normal controls . The difference was significant statistically (p<0.05). Positive symptomatic response such as right upper quadrant and epigastric pain and cramps after intravenous CCK occurred in 33% of patients group but none of normalcontrals . Local spasms and symptomatic response after intravenous CCK are helpful for correct diagnos of pathologic gallbladder which is visualized normally. 3. The cystic duct and common bile duct were visualized after CCK in 73 and 78% , respectively, in controls and 69 and 74% , respectively, in patient. In 2 of 69 patients, definite hepatic duct reflux occurred. 4. The visualization of extrahepatic bile ducts was enhancement after intramuscular ceruletide added by prostigmine in 5 our of 10 normal human subjects.

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