• Title/Summary/Keyword: 급성 췌장염

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The Predcitors of the Development of Acute Respiratory Distress Syndrome in the Patients with Acute Pancreatitis (급성 췌장염으로 내과계 중환자실에 입원한 환자들의 급성호흡곤란 증후군 발생에 연관된 인자에 관한 연구)

  • Yoo, Mi-Ran;Koh, Youn-Suck;Lim, Chae-Man;Lee, Moon-Gyu;Lee, Hong-Jae;Lee, Moo-Song;An, Jong-Jun;Lee, Sung-Koo;Kim, Myung-Hwan;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.861-870
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    • 1997
  • Background : Though acute respiratory distress(ARDS) often occurs in the early stage of severe acute pancreatitis and significantly contributed to the mortality of the condition, the characteristics of the group who develops ARDS in the patients with acute pancreatitis have not been fully found. The objective of this investigation was to identify predictable factors which distinguish a group who would develop ARDS in the patients with acute pancreatitis. Method : A retrospective analysis of 94 cases in 86 patients who were admitted the Medical Intensive Care Unit with acute pancreatitis was done. ARDS were developed in 13 cases among them (13.8%). The possible clinical factors related to the development were analyzed using univariate analysis and $x^2$-test. Results : The risk of ARDS development was increased in the patients with abonormal findings of chest X-ray at admission compared to the patients with normal chest X-ray (p<0.05). The risk was also increased according to the sevecrity index score in abdominal computed tomography at the time of admission (p<0.05). The higher APACHE III score of the first day of admission, the more risk increment of ARDS development was observed (p<0.01). Patients with more than one points of Murray's lung injury score showed higher risk of ARDS compared to the patients with 0 points of that. The patients with sepsis and the patients with more than three organ dysfunction at admission had 3.5 times and 23.3 times higher risk of the development of ARDS compared to the patients without sepsis and without organ failure in each (p<0.05, p<0.01). Conclusion : The risk of ARDS development would be higher in the acute pancreatitis patients with abnormal chest X-ray, higher CT severity index, higher APACHE III or Murray's lung injury score, accompanying sepsis, and more than three organ failure at admission.

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A case of hereditary pancreatitis with a N29I mutation in the cationic trypsinogen gene (Cationic Trypsinogen N29I 유전자 변이에 의한 유전 췌장염 1례)

  • Shin, Jee Youn;Oh, Dae Sung;Rheu, Jeong Min;Shim, Jeong Ok;Park, Ji Sook;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1111-1115
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    • 2006
  • Hereditary pancreatitis is an autosomal dominant disease characterized by recurrent episodes of pancreatitis, often beginning in childhood, with a positive family history involving at least two other affected family members with no known other precipitating factors. Most forms of hereditary pancreatitis are caused by one of two common mutations, i.e., R122H in exon 3 and N29I in exon 2 of the cationic trypsinogen (CT) (PRSS1) gene, located on chromosome 7. The authors describe the case of a 15-year-old boy who had suffered from recurrent attacks of pancreatitis since age three. His mother and grandmother had chronic pancreatitis and diabetes mellitus. Mutation analysis was performed on the family due to the suspicion of hereditary pancreatitis. The CT gene was analyzed in DNA samples extracted from the peripheral blood of three family members, the mother, the proband, and the proband's sister. Two members of the family, the mother and the proband, were found to have a N29I mutation in the CT gene. The authors document the first family with hereditary pancreatitis associated with the N29I mutation in Korea.

A Case of Isoniazid Induced Acute Pancreatitis (Isoniazid에 의해 유발된 급성 췌장염 1예)

  • Chung, Byung Ha;Nam, Hae Seong;Kwon, Jung Hyun;Im, So Hi;Park, Sun Hee;Kim, Jin Woo;Kim, Seung Joon;Lee, Sook Young;Kim, Young Kyoon;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.4
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    • pp.411-414
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    • 2004
  • Isoniazid is a first-line drug in the treatment of tuberculosis. A variety of adverse reactions of isoniazid have been reported. These include hepatitis, peripheral neuropathy, skin rashes, neurologic disturbances and hematologic alterations. Among these, acute pancreatitis due to isoniazid is very rare. We report a case of acute pancreatitis due to isoniazid confirmed by rechallenge test with review of some literatures.

Isolated Splenic Vein Thrombosis Associated with Acute Pancreatitis (급성 췌장염에 동반된 고립성 비정맥 혈전증 1예)

  • Song, Hyang-Soon;Yang, Noo-Ri;Jin, So-Hee;Choi, Kyeong-Dan;Jang, Young-Taek
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.221-225
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    • 2009
  • Pancreatic disease is the most frequent cause of isolated splenic vein thrombosis. Splenic vein thrombosis causes a localized form of portal hypertension known as sinistral or left-sided portal hypertension. Splenic vein thrombosis may be complicated by the formation of gastric varices, with the potential of massive upper gastrointestinal bleeding. Whereas splenectomy is considered to be the treatment of choice for symptomatic splenic vein thrombosis, the role of splenectomy in the patient with asymptomatic splenic vein thrombosis remains controversial. We report a rare case of acute pancreatitis complicated by isolated asymptomatic splenic vein thrombosis. Recognition of this disease entity is important because the risk of secondary variceal bleeding, while uncommon, can be life-threatening.

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An Update on Hypertriglyceridemia-Induced Acute Pancreatitis (고중성지방혈증 급성췌장염의 최신 지견)

  • Kim, Hong Ja
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.518-524
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    • 2018
  • Hypertriglyceridemia a major cause of acute pancreatitis, accounting for up to 10% of all cases. The pathophysiological mechanism of hypertriglyceridemia-induced acute pancreatitis (HTGP) is presumed to involve the hydrolysis of triglycerides by pancreatic lipase resulting in an excess of free fatty acids and elevated chylomicrons, which are thought to increase plasma viscosity and induce ischemia and inflammation in pancreatic tissue. Although the clinical course of HTGP is similar to other forms of acute pancreatitis, the clinical severity and associated complications are significantly higher in patients with HTGP. Therefore, an accurate diagnosis is essential for treatment and prevention of disease recurrence. At present, there are no approved guidelines for the management of HTGP. Different treatment modalities such as apheresis/plasmapheresis, insulin, heparin, fibric acids, and omega-3 fatty acids have been successfully implemented to reduce serum triglycerides. Following acute phase management, lifestyle modifications including dietary adjustments and drug therapy are important for the long-term management of HTGP and the prevention of relapse. Additional studies are required to produce generalized and efficient treatment guidelines for HTGP.

생활습관병 예방 프로젝트 4 실천 List - 규칙적으로 천천히 오래~오래

  • Kim, Eun-Gyeong
    • 건강소식
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    • v.37 no.2
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    • pp.14-15
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    • 2013
  • 과식과 폭식은 건강의 적이다. 소화불량, 역류성 식도염, 복통, 복부팽만감, 설사 등 위장 장애를 일으킬 뿐만 아니라 급성장염이나 드물지만 급성췌장염 등의 심각한 병으로까지 발전할 수 있기 때문이다. 현대인들의 만병의 근원인 비만의 원인이 되기도 한다. 특히 설과 같은 명절기간엔 평소보다 튀김이나 전, 잡채 등과 같은 기름기와 지방이 많은 음식을 더 많이 섭취하기 때문에 각별한 주의가 필요하다. 건강한 설을 보낼 수 있는 식습관에 대해 알아보자.

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A Case of Autoimmune Chronic Pancreatitis in a Child (자가면역성 만성 췌장염으로 진단된 소아 1예)

  • Choi, In-Young;Jin, So-Hee;Choi, Kyung-Dan;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.215-220
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    • 2007
  • We present a case of autoimmune chronic pancreatitis in a previously healthy child without any history of autoimmune disease. A 12-year-old boy was admitted to the hospital with abdominal pain. The serum amylase, lipase, and IgG levels were elevated and autoantibodies (antinuclear antibody, antineutrophil antibody) were detected. An abdominal CT (computed tomographic) scan revealed diffuse enlargement of the pancreas. ERCP (endoscopic retrograde cholangiopancreaticography) demonstrated an irregular stricture of the main pancreatic duct in the pancreas tail. After two years of oral steroid and immunosuppressive drug therapy, the clinical, laboratory and radiological findings were improved. The patient has been symptom-free for 18 months after the discontinuation of medication.

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Acute Pancreatitis Associated with Varicella Infection in an Immunocompetent Child (정상 면역기능을 가진 소아에서 수두 감염 후에 발생한 급성 췌장염 1예)

  • Oh, Ki-Won;Kim, Joon-Sung;Kim, Ja-Hyeong;Park, Sang-Kyu;Jeong, Jin-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.75-79
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    • 2008
  • Blunt trauma, drugs, infection, congenital anomalies of the pancreaticobiliary system, and multisystem diseases are the main causes of acute pancreatitis in children. Various viruses can cause acute pancreatitis, but varicella-induced pancreatitis is unusual and generally observed in adults or immunocompromised patients. We report a rare case of acute pancreatitis associated with varicella-zoster virus infection in a 6-year-old immunocompetent girl. The patient initially presented complaining of severe abdominal pain and repetitive vomiting. The patient had multiple cutaneous crusts that has been caused by preceding varicella infection and had elevated values of serum amylase and lipase. Abdominal ultrasonography demonstrated swelling of the pancreas and pancreatic duct dilatation, findings which were compatible with acute pancreatitis. The patient's clinical and laboratory abnormalities were completely normalized through conservative treatment consisting of fasting, total parenteral nutrition, and analgesic therapy.

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Recurrent Acute Pancreatitis Associated with Sphincter of Oddi Dysfunction in a Child (오디 괄약근 기능 이상으로 인한 소아의 재발 급성 췌장염 1예)

  • Choi, Byung-Ho;Park, Sun-Min;Kim, Ho-Gak;Kim, Jung-Mi;Hong, Suk-Jin;Kim, Jung-Ok;Cho, Min-Hyun;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.193-197
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    • 2008
  • Recent studies suggest that sphincter of Oddi dysfunction (SOD) is one of the possible causes of unexplained recurrent acute pancreatitis in children. A 14-year-old boy who had suffered from idiopathic recurrent acute pancreatitis was diagnosed with SOD. Abdominal ultrasonography, computerized tomography, and magnetic resonance cholangiopancreatography revealed no evidence of stone, tumor, or pancreatic ductal anomaly. Endoscopic retrograde cholangiopancreatography (ERCP) and sphincter of Oddi manometry (SOM) revealed elevated basal pressure and tachyoddia consistent with SOD. Hence, an endoscopic pancreatic sphincterotomy was performed. We report a case of recurrent acute pancreatitis associated with SOD in a child. ERCP and SOM may be considered in patients with multiple unexplained attacks of pancreatic pain and negative abdominal imaging.

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Effects of Trypsin Inhibitors on Oleic acid Induced Acute Pancreatitis in Dogs (개에서 Oleic acid로 유발시킨 급성췌장염에 대한 Trypsin inhibitor의 투여효과)

  • 윤영민;최희인;조명행
    • Biomolecules & Therapeutics
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    • v.5 no.2
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    • pp.158-164
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    • 1997
  • To investigate the effects of trypsin inhibitors, aprotinin and urinary trypsin inhibitor (UTI), on the cute pancreatitis, this study was carried out in dogs of acute pancreatitis induced by oleic acid (0.28 mg/kg). Administration with aprotinin and UTI seemed to have a therapeutic effect on the clinical sign, ultrasonographic finding, histopathologic finding. But in amylase and lipase activity, there were no significant differences among three groups.

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