• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.2
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• pp.83-90
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• 2008

Organophosphate (OP) pesticides are the most common source of human toxicity globally, causing high mortality and morbidity despite the availability of atropine as a specific antidote and oximes to reactivate acetylcholinesterase. The primary toxicity mechanism is inhibition of acetylcholinesterase (AchE), resulting in accumulation of the neurotransmitter, acetylcholine, and abnormal stimulation of acetylcholine receptors. Thus, the symptoms (muscarinic, nicotinic, and central nervous system) result from cholinergic overactivity because of AchE inhibition. OP can also cause rhabdomyolysis, pancreatitis, parotitis, and hepatitis. OP therapy includes decontamination, supportive therapy, and the use of specific antidotes such as atropine and oximes. However, there has been a paucity of controlled trials in humans. Here we evaluated the literature for advances in therapeutic strategies for acute OP poisoning over the last 10 years.

• Korean Journal of Veterinary Research
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• v.47 no.3
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• pp.341-347
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• 2007

Pancreatic pseudocyst is one of the most common pancreatic mass lesions developed following acute or chronic pancreatitis. Two dogs were presented with nonspecific clinical signs such as abdominal pain, vomiting and depression and diagnosed as pancreatic pseudocysts through percutaneous ultrasound-guided aspiration. Pancreatic pseudocyst may contain pancreatic juice, so leads the deteriorate state of patient through pertinent inflammation and autodigestion of pancreas. In this study, the clinical signs and pancreatic lesion were improved after aspiration. Percutaneous ultrasound-guided aspiration can provide the diagnostic information through cytology and lipase and amylase concentration, and be selected as the first choice for treatment.

• Mycobiology
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• v.45 no.4
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• pp.426-429
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• 2017

A yeast-like organism was isolated from a urine sample of a 6-year-old neutered male miniature poodle dog with urinary tract infection, diabetes ketoacidosis, and acute pancreatitis. We identified the yeast-like organism to be Candida glabrata and found that this fungus was highly resistant to azole antifungal drugs. To understand the mechanism of azole resistance in this isolate, the sequences and expression levels of the genes involved in drug resistance were analyzed. The results of our analysis showed that increased drug efflux, mediated by overexpression of ATP transporter genes CDR1 and PDH1, is the main cause of azole resistance of the C. glabrata isolated here.

• Tuberculosis and Respiratory Diseases
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• v.76 no.5
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• pp.240-244
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• 2014

Pancreaticothoracic fistula is a rare complication of acute or chronic alcoholic pancreatitis. It may present with various symptoms, like dyspnea, abdominal pain, cough, chest pain, fever, back pain, hemoptysis, fatigue, or orthopnea. Pancreaticothoracic fistula can be detected by magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), or computed tomography. MRCP has high sensitivity and fewer side effects, and thus it has recently been recommended as the first choice for the detection of pancreaticothoracic fistula. On the other hand, ERCP enables the detection and treatment of pancreaticothoracic fistula and allows for stent insertion; for this reason it is a commonly used modality in pancreaticothoracic fistula cases. Herein, the authors describe a case of pancreaticothoracic fistula detected by ERCP and MRCP that manifested only respiratory symptoms, namely hemoptysis and pneumothorax without abdominal pain, which commonly accompanies pancreatitis.

• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.254-259
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• 2017

Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia- disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.

• Advances in pediatric surgery
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• v.6 no.2
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• pp.143-148
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• 2000

Pseudoaneurysm of the splenic artery may arise from a vascular erosion by a surrounding inflammatory processes in acute and chronic pancreatitis. Rupture of the pseudoaneurysm may threaten the patient's life. Conservative management for massive hemorrhage may cause 100 percent mortality and even with prompt therapy there is a high mortality. Preoperative detection of bleeding source is desirable because of the difficult identification of the bleeding site at laparotomy. Angiographic identification and embolization of the hemorrhagic vessels in selected cases may obviate the risk of urgent surgery. The authors have recently managed a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography confirmed the diagnosis. We managed this child successfully with the urgent transcatheter arterial embolization followed by elective surgery.

• Clinical Endoscopy
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• v.57 no.1
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• pp.105-111
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• 2024

Background/Aims: The pancreatic pseudocyst (PP) is a type of fluid collection that typically develops as a delayed complication of acute pancreatitis. Drainage is indicated for symptomatic patients and/or associated complications, such as infection and bleeding. Drainage modalities include percutaneous, endoscopic, laparoscopic, and open drainage. This study aimed to assess trends in the utilization of different drainage modalities for treating PP from 2016 to 2020. The trends in mortality, mean length of hospital stay, and mean hospitalization costs were also assessed. Methods: The National Inpatient Sample database was used to obtain data. The variables were generated using International Classification of Diseases-10 diagnostic and procedural codes. Results: Endoscopic drainage was the most commonly used drainage modality in 2018-2020, with an increasing trend over time (385 procedures in 2018 to 515 in 2020; p=0.003). This is associated with a decrease in the use of other drainage modalities. A decrease in the hospitalization cost for PP requiring drainage was also noted (29,318 United States dollar [USD] in 2016 to 18,087 USD in 2020, p<0.001). Conclusions: Endoscopic drainage is becoming the most commonly used modality for the treatment of PP in hospitals located in the US. This new trend is associated with decreasing hospitalization costs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.98-103
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• 2014

Purpose: Gallbladder (GB) wall thickening can be found in various conditions unrelated to intrinsic GB disease. We investigated the predisposing etiologies and the outcome of acalculous GB wall thickening in children. Methods: We retrospectively analyzed 67 children with acalculous GB wall thickening who had visited our institute from June 2010 to June 2013. GB wall thickening was defined as a GB wall diameter > 3.5 mm on abdominal ultrasound examination or computed tomography. Underlying diseases associated with GB wall thickening, treatment, and outcomes were studied. Results: There were 36 boys and 31 girls (mean age, $8.5{\pm}4.8years$ [range, 7 months-16 years]). Systemic infection in 24 patients (35.8%), acute hepatitis in 18 (26.9%), systemic disease in 11 (16.4%), hemophagocytic lymphohistiocytosis in 4 (6.0%), acute pancreatitis in 3 (4.5%), and specific liver disease in 3 (4.5%) predisposed patients to GB wall thickening. Systemic infections were caused by bacteria in 10 patients (41.7%), viruses in 5 patients (20.8%), and fungi in 2 patients (8.3%). Systemic diseases observed were systemic lupus erythematosus in 2, drug-induced hypersensitivity in 2, congestive heart failure in 2, renal disorder in 2. Sixty-one patients (91.0%) received symptomatic treatments or treatment for underlying diseases. Five patients (7.5%) died from underlying diseases. Cholecystectomy was performed in 3 patients during treatment of the underlying disease. Conclusion: A wide range of extracholecystic conditions cause diffuse GB wall thickening that resolves spontaneously or with treatment of underlying diseases. Surgical treatments should be avoided if there are no definite clinical manifestations of cholecystitis.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.2
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• pp.203-213
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• 2024

Backgrounds/Aims: The standard treatment for acute cholecystitis, biliary pancreatitis and intractable biliary colics ("hot gallbladder") is emergency laparoscopic cholecystectomy (LC). This paper aims to identify the prognostic factors and create statistical models to predict the outcomes of emergency LC for "hot gallbladder." Methods: A prospective observational cohort study was conducted on 466 patients having an emergency LC in 17 months. Primary endpoint was "suboptimal treatment," defined as the use of escape strategies due to the impossibility to complete the LC. Secondary endpoints were postoperative morbidity and length of postoperative stay. Results: About 10% of patients had a "suboptimal treatment" predicted by age and low albumin. Postop morbidity was 17.2%, predicted by age, admission day, and male sex. Postoperative length of stay was correlated to age, low albumin, and delayed surgery. Conclusions: Several predictive prognostic factors were found to be related to poor emergency LC outcomes. These can be useful in the decision-making process and to inform patients of risks and benefits of an emergency vs. delayed LC for hot gallbladder.

• Korean Journal of Veterinary Research
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• v.43 no.2
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• pp.311-314
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• 2003

Pacheco's disease (PD) is a highly contagious, acute disease of psittacines caused by a herpesvirus. Five 56-day-old dead parakeets (Neophema bourkii) were submitted to the National. Veterinary Research & Quarantine Service for diagnosis. At necropsy, principle lesions were seen in the pancreas, which were hard, whitish, nodular and atrophic resulting in distortion of the duodenal loop. Histologically, lymphocytic pancreatitis with eosinophilic intranuclear inclusions syncytium-formed acinar epithelium was prominent. In the brain, marked focal gliosis and perivascular lymphocytic cuffing were observed. On the electron microscopy examination, various forms of viral particles were found in both the nucleus and cytoplasm of acinar epithelium of pancreas, identified as a herpesvirus. These results were suggested that the cases were diagnosed as PD in the parrakeet.