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표승일 ( Seung Il Pyo ),이한주 ( Han Chu Lee ),서동대 ( Dong Dae Seo ),신정우 ( Jung Woo Shin ),류수형 ( Soo Hyung Ryu ),박영환 ( Young Hwan Park ),정영화 ( Young Hwa Chung ),이영상 ( Yung Sang Lee ),유은실 ( Eun Sil Yu ),서동진 ( 대한내과학회 2003 대한내과학회지 Vol.64 No.1
목적 : 자가 면역성 간질환에는 AIH, PBC, 중복 증후군, AIC, PSC 등이 있으며, 면역학적 기전에 의해서 발생한다고 알려졌고, 약물 치료로 호전되는 경우가 많아 임상적 중요성을 갖는다. 저자 등은 한국인에서 자가 면역성 간질환들의 임상 양상 및 치료에 대한 반응을 알아보고, 질환들 간에 임상양상, 생화학적지표, 혈청학적 지표 및 조직소견을 비교해보고자 본 연구를 시행하였다. 방법 : 1990년 1월부터 2001년 3월까지 서울아산병원에서, Background : Autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), primary biliary cirrhosis (PBC), and autoimmune cholangiopathy (AIC) are major classes of liver diseases currently considered autoimmune. We investigated the clinical, biochemi
증례 : 급성 췌장염 환자에서 복강동맥 협착과 동반하여 발생한 비장경색의 1예
김진건 ( Jin Gun Kim ),임동혁 ( Dong Hyuck Lim ),한봉준 ( Bong Jun Han ),표승일 ( Seung Il Pyo ),이숭환 ( Soong Hwan Lee ),김인숙 ( In Sook Kim ),전의용 ( Eui Yong Jeon ) 대한내과학회 2006 대한내과학회지 Vol.71 No.2
비장경색이 급성 췌장염의 합병증으로 발생된 보고는 드물며, 아직까지 복강동맥 협착과 연관되어 비장경색이 발생된 보고는 없다. 췌장염에서 비장 경색의 발생은 비장 혈관의 혈전에 의한 폐색에 의한 것으로 알려졌다. 그러나 급성 췌장염(특히 두부) 환자에서 비장색을 동반한 경우 가능한 원인으로 복강동맥 협착을 고려해 봐야 할 것이다. 본 증례에서 비장경색의 기전으로 협착후방 확장부의 혈전 형성, 혹은 췌장 두부 동맥으로부터 비장 동맥으로의 비정상적 역류에 의한 것으로 생각된다. 저자들은 급성 췌장염의 병력을 가진 환자에서 혈관조영 술상 발견된 무증상 복강동맥 협착이 비장경색과 연관 되는 1예를 경험하였기에 보고하는 바이다. Prevalence of splenic infarction developed during acute pancreatitis is extremely rare. However, we recently experienced a case of 42-year-old woman who developed splenic infarction during acute alcoholic pancreatitis. There were sustained subjective symptoms and no resolution of image despite of conservative management, so we performed angiography to confirm whether vascular lesion existed or not. We found the significant celiac artery stenosis due to compression by median arcuate ligament and no visible thrombus. We report an unusual case of splenic infarction developed during acute recurrent pancreatitis possibly related with celiac artery stenosis.(Korean J Med 71:198-202, 2006)
서동대(Dong Dae Seo),이윤정(Yun Jung Lee),박일권(Il Gwon Park),이현주(Hyun Ju Lee),박성제(Seong Je Park),표승일(Seung Il Pyo),윤길숙(Kil Sook Yun),서동완(Dong Wan Seo),이성구(Sung Koo Lee),김명환(Myung Hwan Kim),김기락(Ki Rhack Kim) 대한소화기학회 2001 대한소화기학회지 Vol.37 No.5
Endometriosis is defined as the presence of endometrial tissue outside the uterus. We experienced 51-year-old woman with symptom of epigastric pain and sign of a palpable mass on the left quadrant abdomen. A cystic mass in the tail area of the pancreas was found on CT scan and was removed surgically. It was a cystic mass originated from the mesentery and separated from the pancreas. It was diagnosed as endometrial cyst histopathologically. (Korean J Gastroenterol 2001;37:389-391)
각종 췌장질환에서 Somatostatin Analogue 사용 경험
김현영,김명환,박현주,이성구,서동완,민영일,신영록,이석수,전병민,표승일,유교상 대한소화기학회 2000 대한소화기학회지 Vol.35 No.6
Background/Aims: Octreotide, long-acting analogue of somatostatin, has been used for symptomatic carcinoid syndrome and vasoactive intestinal peptide-producing tumors. In pancreatic diseases, however, the effect of octreotide has not been settled yet. The aim of this study was to evaluate the effect of octreotide in various pancreatic diseases which did not respond to conventional medical treatment. Methods: We reviewed retrospectively the medical records of 28 patients who were admitted at the Asan Medical Center from January 1997 to June 1999. Their diseases were pancreatic fistula (n=9), pancreatic pseudocysts (n=17), and pancreatic ascites (n=2). Octreotide was administered subcutaneously at a dose of 0.1 mg every 12 hours. Results: In the cases of pancreatic fistulas, the mean output of baseline fistula was 289 cc/day. This was decreased to 178 cc/day on the first day of octreotide therapy and to 49 cc/day on the seventh day. Five (56%) patients eventually closed their fistulas. In the cases of pancreatic pseudocysts, 11 (65%) cases had showed complete resolution of pseudocysts. The remaining 6 cases which showed no improvement were treated operatively. In the cases of pancreatic ascites, the two patients (100%) were successfully treated with octreotide. Conclusions: Octreotide seems to be a safe and useful alternative therapy in patients with pancreatic fistulas, pseudocysts or ascites who do not respond to conventional medical management. Further detailed study may be necessary for the establishment of the role of octreotide in the treatment of various pancreatic diseases.
Somatostatin Analogue(Octreotide)치료가 유효했던 췌장성 복수 1예
신정현,김명환,정성희,이성구,서동완,민영일,김선영,유교상,박은택,임병철,나비석,표승일 대한소화기학회 2000 대한소화기학회지 Vol.35 No.4
Pancreatic ascites has the characteristics of highly proteinaceous, amylase-rich intraperitoneal fluid. It usually occurs as a result of rupture of a pseudocyst or disruption of main pancreatic duct during the course of acute or chronic pancreatitis. It can be managed by traditional conservative methods including fasting, total parenteral nutrition and ascites tapping or surgical interventions. Recently, several cases of treating pancreatic ascites with somatostatin analogue (octreotide) successfully have been reported. We experienced a patient with chronic pancreatitis and pancreatic ascites, who was successfully treated by somatostatin analogue (octreotide).