• The Journal of Internal Korean Medicine
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• v.36 no.2
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• pp.105-121
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• 2015

Objectives: This study investigated the effects of Gagam-daewhang mangcho-tang (GDM) and its components on cerulein-induced acute pancreatitis (AP) in mice Methods: The AP mouse model was induced by intra-peritoneal injection of cerulein (50 μg/kg) at hourly intervals for 6 times. The experimental drug was administrated intraperitoneally 1 hour prior to the first injection of cerulein. Mice were sacrificed at 6 hours after the last injection of cerulein. Blood samples were taken to determine serum amylase level. The pancreas and lungs were rapidly removed for histochemical examination and myeloperoxidase (MPO) assays. Results: Administration of modified GDM significantly reduced the ratio of pancreas/body weight, level of serum amylase, neutrophil infiltration, and histological damage of the pancreas and lung. In a test of the components of GDM, the Salvia miltiorrhiza (SM) group showed a significant suppression of the severity of AP. In an experiment testing the concentration of SM, the 150 mg/kg SM group showed significant attenuation of the severity of AP. Conclusions: Modified GDM and a SM water extract could attenuate AP and AP-associated lung injury via suppression of digestive enzyme secretion and MPO activity.

• The Journal of Internal Korean Medicine
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• v.34 no.3
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• pp.298-311
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• 2013

Objectives : In this study, we aimed to investigate the effect of Eunhoebanchong-san (EBS) on caerulein-induced acute pancreatitis (AP) by detecting oxidative stress markers and performing histopathological examination. Methods : Thirty adult male Sprague-Dawley rats were divided into five groups as follows: normal (NOR), caerulein-induced (CON), caerulein+EBS (130 mg/kg, EA), caerulein+EBS (260 mg/kg, EB) and caerulein+EBS (520 mg/kg, EC) groups. Pancreatic tissues of rats from all groups were removed for apoptosis, and light, and electron microscopic examination. Blood of rats from all groups was obtained for oxidative stress markers and pathological examination. Pancreatic oxidative stress markers were evaluated by the measurements of serum amylase, and interleukin-6 (IL-6) levels were determined spectrophotometrically. Results : The ratio of pancreas/body weight increased significantly in the CON compared with the NOR, but decreased significantly in the EA, the EB, the EC groups compared with the CON. Caerulein administration resulted in a significant increase in amylase, but EBS reduced the levels of these enzymes. Interleukin-6 (IL-6) levels increased significantly in CON compared with NOR, but reduced in EA, EB, and EC group at 24 hrs. In the observations of optical microscopy and electron microscopy, the experimental groups showed significant decreases in pancreatic tissue inflammation, edema, vacuolization, necrosis compared to the control group. Altogether, this indicates EBS is potentially capable of limiting pancreatic damage produced during AP by restoring the fine structure of acinar cells and tissue. Conclusions : We concluded that EBS may have beneficial effects in the treatment of caerulein-induced AP.

• The Korea Journal of Herbology
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• v.27 no.5
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• pp.9-14
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• 2012

Objective : We investigated the effect of Poncirus trifoliata and Citrus aurantium extract in mice with cerulein-induced acute pancreatitis (AP) model. Methods : AP was induced via intraperitoneal injection of cerulein (50 ${\mu}g/kg$) given every hour for 6h. Poncirus trifoliata (PT: 200 or 400 mg/kg) and Citrus aurantium (CA: 200 or 400 mg/kg) extract were injected 1 h before in mice with cerulein-induced AP. Mice were sacrificed at 6 h after last injection of cerulein. Blood samples were taken to determine serum amylase and lipase levels. The pancreas and lungs were rapidly removed for morphological examination, myeloperoxidase assay. Results : PT pre-treatment significantly protected the pancreas and lung damages and reduced the MPO activity and serum amylase in cerulein-induced AP. However, CA pre-treatment did not significantly protected the pancreas and lung inflammation in cerulein-induced AP. Conclusion : These results suggest that PT but not CA could protect the cerulein-induced AP. Conclusion : These results suggest that PT but not CA could protect the cerulein-induced AP.

• The Korea Journal of Herbology
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• v.37 no.4
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• pp.1-8
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• 2022

Objectives : Dioscorea batas Decaisne (DB) has been known to be good for the digestive system on Eastern Asia. However, the protective effect of DB on acute pancreatitis (AP) has not been studied. In this study, we tried to investigate the protective effect of DB water extract on caerulein-induced AP. Methods : To measure the protective effect of DB on AP, Mice were injected with cholecystokinin analogue caerulein (50 ㎍/kg) hourly for 6 times. DB water extract (200 or 400 mg/kg) or saline (control group) was administered orally 1 h before the first injection of caerulein. The mice were sacrificed at 6 h after the last injection of caerulein. The pancreas tissues and serum samples were immediately taken for further analysis. Results : Administration of DB water extract showed the inhibitory effect on the increase of pancreas weight/body weight ratio, pancreatic histological damage. And the rise of serum lipase level was significantly reduced in DB water extract treatment group during AP in mice. However administration of DB water extract did not show significant reduction in serum amylase level. Also, mRNA levels of pro-inflammatory cytokines Interleukin (IL)-6 and Tumor necrosis factor (TNF)-𝛼 but not IL-1𝛽 were inhibited by administration of DB water extract. Conclusions : Taken together, we found that administration of DB water extract ameliorates the severity of caerulein-induced AP, which suggests the potential to be an effective treatment on AP.

• The Korea Journal of Herbology
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• v.33 no.2
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• pp.45-52
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• 2018

Objectives : Smilacis Glabrae Rhizoma (SGR) has been used in traditional medicine for treating diseases related to inflammation and cancer. However, the protective effect of SGR has not been reported in the study of acute pancreatitis (AP). Therefore, this study was performed to evaluate the protective effects of SGR water extract on cerulein-induced AP. Methods : AP was induced by intraperitoneal injection of supramaximal concentrations of stable cholecystokinin analogue cerulein ($50{\mu}g/kg$) 6 times at intervals of one hour in mice. SGR water extract (0.01, 0.05, or 0.1 g/kg) was administrated intraperitoneally 1 h prior to the first injection of cerulein. The mice were sacrificed at 6 h after the final injection of cerulein. Pancreas and lung were rapidly removed for histochemical examination and myeloperoxidase (MPO) assay. In addition, polymerase chain reaction (PCR) was performed to examine mRNA levels of proinflammatory cytokines such as interleukin(IL)-6, $IL-1{\beta}$ and Tumor necrosis $factor(TNF)-{\alpha}$. Results : Administration of SGR water extract significantly inhibited pancreatic weight to body weight ratio. In addition, SGR treatment inhibited the histological damages and increase of MPO activity in both pancreas and lung during AP. Also, mRNA levels of IL-6 but not $IL-1{\beta}$and $TNF-{\alpha}$ were inhibited by SGR water extract against AP. Conclusion : Our results revealed that pre-treatment of SGR water extract reduces the severity of cerulein-induced AP. Therefore, this study suggest that SGR could be used as a drug or agent to prevent AP.

• BMB Reports
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• v.45 no.7
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• pp.402-407
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• 2012

Nardostachys jatamansi (NJ) belonging to the Valerianaceae family has been used as a remedy for gastrointestinal inflammatory diseases for decades. However, the potential for NJ to ameliorate alcoholic chronic pancreatitis (ACP) is unknown. The aim of this study was to examine the inhibitory effects of NJ on ACP. C57black/6 mice received ethanol injections intraperitoneally for 3 weeks against a background of cerulein-induced acute pancreatitis. During ACP, NJ was ad libitum administrated orally with water. After 3 weeks of treatment, the pancreas was harvested for histological examination. NJ treatment increased the pancreatic acinar cell survival (confirmed by amylase level testing) and reduced collagen deposition and pancreatic stellate cell (PSC) activation. In addition, NJ treatment reduced the activation but not death of PSC. In conclusion, our results suggest that NJ attenuated ACP through the inhibition of PSC activation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.3
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• pp.304-309
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• 2020

An 18-year-old woman with annular pancreas and duodenal duplication presented with recurrent acute pancreatitis and underwent a resection of duodenal duplication. However, the patient experienced recurrent abdominal pain after resection. Abdominal computed tomography and magnetic resonance imaging showed a dilatation of the peripheral pancreatic duct and stenosis and malformation of both the Wirsung's and Santorini's duct due to multiple stones. The modified puestow procedure was performed. The main pancreatic ducts in the body and tail were opened, and the intrapancreatic common bile duct was preserved. A Roux-en-Y pancreatico-jejunostomy was performed for reconstructing the pancreaticobiliary system after removing the ductal protein plug. The patient experienced no abdominal pain, no significant elevation of the serum amylase and lipase levels, and no stone formation during the 2 years of follow-up. This procedure is considered to be beneficial for pediatric patients with chronic pancreatitis due to annular pancreas and duodenal duplication.

• Clinical Endoscopy
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• v.55 no.5
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• pp.665-673
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• 2022

Background/Aims: In patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), calcineurin activates zymogen, which results in pancreatitis. In this study, we aimed to determine the efficacy of tacrolimus, a calcineurin inhibitor, in preventing post-ERCP pancreatitis (PEP). Methods: This was a prospective pilot study in which patients who underwent ERCP received tacrolimus (4 mg in two divided doses); this was the Tac group. A contemporaneous cohort of patients was included as a control group. All patients were followed-up for PEP. PEP was characterized by worsening abdominal pain with an acute onset, elevated pancreatic enzymes, and a duration of hospital stay of more than 48 hours. Serum tacrolimus levels were measured immediately before the procedure in the Tac group. Results: There were no differences in the baseline characteristics between the Tac group (n=48) and the control group (n=51). Only four out of 48 patients (8.3%) had PEP in the Tac group compared to eight out of 51 patients (15.7%) who had PEP in the control group. The mean trough tacrolimus level in patients who developed PEP was significantly lower (p<0.05). Conclusions: Oral tacrolimus at a cumulative dose of 4 mg safely prevents PEP. Further randomized controlled studies are warranted to establish the role of tacrolimus in this context.

• Journal of the Korean Burn Society
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• v.22 no.1
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• pp.10-14
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• 2019

Purpose: To find progression and prognosis of pancreatitis developed in massive burn patients through retrospective analysis. Methods: A retrospective study was conducted on 32 patients with abnormal increase of serum lipase level among 2523 acute burn patients admitted to our burn center from January 1, 2017 to June 30, 2018. Pancreatitis in this study was defined as a serum lipase concentration level that is higher than 180 IU/L which is three times more than the normal level (less than 60 IU/L). In this study, a retrospective analysis was performed on patients with serum lipase level higher than 300 IU/L to better understand causality of burns and pancreatitis. Results: 32 patients (1.27%) had serum lipase level higher than 180 IU/L among 2523 acute burn subjects. And 13 patients (0.52%) of these 32 patients had serum lipase level elevated more than 300 IU/L. The study indicated serum lipase level was increased around 7 days after the injury. It returned to normal level early as after 1 to 2 weeks and late as after 4 to 6 weeks of injury. The serum amylase level was increased as similar modality as to the serum lipase level increase. The serum bilirubin, AST, ALT, LD, and GGT were also observed to be elevated when serum lipase was more than 1000 IU/L. Conclusion: The pancreatitis developed in burn patients are mostly as mild symptom. It could due to the ischemic injury and can easily be treated by a temporary fasting, TPN, and Gabexate intravenous injection.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1436-1447
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• 2020

Purpose To investigate the clinical and CT features at admission to predict the progression to necrotizing pancreatitis (NP) in patients initially diagnosed with interstitial edematous pancreatitis (IEP). Materials and Methods Patients with IEP who underwent contrast-enhanced CT at admission and follow-up CT (< 14 days) were included (n = 178). Two radiologists performed a consensus review of follow-up CT scans and diagnosed the type of acute pancreatitis as IEP or NP. Laboratory findings at admission were recorded. Clinical, CT, and laboratory findings were compared between the IEP-IEP group and IEP-NP group using the chi-square test and the t-test. Multivariate analysis was also performed. Results There were 112 and 66 patients in the IEP-IEP and the IEP-NP groups, respectively. The proportion of patients with alcohol etiology was significantly larger in the IEP-NP group. Among the CT findings, the presence of peripancreatic fluid and heterogeneous parenchymal enhancement were more frequently observed in the IEP-NP group. Among the laboratory variables, serum C-reactive protein levels and white blood cell counts were significantly higher in the IEP-NP group. Multivariate analysis revealed that the presence of peripancreatic fluid and heterogeneous parenchymal enhancement were significant findings distinguishing the two groups. Conclusion CT findings, such as the presence of peripancreatic fluid and heterogeneous pancreatic parenchymal enhancement, may be helpful in predicting the progression to NP in patients initially diagnosed with IEP.