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박찬복 ( Chan Bok Park ),문원 ( Won Moon ),최평락 ( Pyoung Rak Choi ),임동한 ( Dong Han Im ),신은경 ( Eun Kyung Shin ),김규종 ( Kyu Jong Kim ),박무인 ( Moo In Park ),박선자 ( Seun Ja Park ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.4
Pancreatitis has been occasionally associated with Crohn`s disease (CD). A definite etiology of pancreatitis can be identified in most patients, but a very small proportion remain idiopathic. We report a case of idiopathic pancreatitis resolved along with the clinical improvement of CD in a 25-year-old man. He presented with abdominal pain and diarrhea for 8 years. Ileocolonoscopy and enteroclysis showed multiple, longitudinal ulcers and strictures at the ileojejunum. The laboratory findings showed elevated serum amylase (951 IU/L) and lipase (326 IU/L) without positive autoantibodies. Esophagogastroduodenoscopy, enhanced pancreatic CT, and MRCP showed no abnormalities at ampulla of Vater, pancrease, and pancreaticobiliary duct. With the treatment with antibiotics, 5-aminosalicylic acid, steroid, and azathioprine, as a whole, decreasing pattern and intermittent fine coordinated fluctuation of the levels of amylase and lipase along with the decrease of Crohn`s disease activity index (CDAI) and the CRP levels were observed. Then, three months after the start of the treatment, normalization of the pancreatic enzymes was observed, and there was recurrent elevation of pancreatic engyme during 12 months maintenance therapy. This report supports the concept of an association between idiopathic pancreatitis and CD, based on a significant and close relation between the levels of serum amylase and lipase, and CDAI. (Korean J Gastroenterol 2009;53:251-256)
신부전을 동반한 낭창성 신염 환자에서 Mycophenolate Mofetil 사용 경험
박미정 ( Mi Jeong Park ),김현주 ( Hyun Ju Kim ),이화목 ( Hwa Mok Lee ),오준석 ( Joon Seok Oh ),황현철 ( Hyun Cheol Hwang ),임동한 ( Dong Han Im ),오혜주 ( Hoe Joo Oh ),박용기 ( Yong Ki Park ),신용훈 ( Yong Hun Shin ),김중경 ( Joon 대한신장학회 2006 Kidney Research and Clinical Practice Vol.25 No.4
신용훈 ( Yong Hun Sin ),김현주 ( Hyun Ju Kim ),이화목 ( Hwa Mok Lee ),오준석 ( Joon Seok Oh ),황현철 ( Hyun Cheol Hwang ),임동한 ( Dong Han Im ),김지환 ( Ji Hwan Kim ),박창수 ( Chang Soo Park ),박미정 ( Mi Jeong Park ),오혜주 ( Ho 대한내과학회 2005 대한내과학회지 Vol.69 No.4
목적 : 최근 신장이식에 있어 대기 수혜자수에 비해 공여자수가 현저히 부족함에 따라 부모-자식간 또는 형제-자매간의 이식 외에 부부간 또는 가능성 있는 비혈연간의 이식을 위한 노력들이 증가함에 따라 HLA 적합정도가 낮은 군간의 신이식 수술도 국내 여러 이식센터에서 시행되고 있으나 HLA 적합정도에 따른 이식신 및 수혜자의 임상성적은 각 이식센터에 따라 상이한 실정이다. 이에 저자들은 HLA 적합수가 0, 1, 2인 대상군을 HLA haploidentical 군과 임상 성적을 비교하여 HLA 적합수가 낮은 군의 신이식 후 성적을 예견하는 지침으로 활용키 위해 본 연구를 시행하였다. 방법 : 1984년 12월부터 2004년 3월까지 본원에서 3개월 이상 추적관찰된 HLA-A, B, DR 전체 6개 항원 중 HLA 적합수가 0, 1, 2인 군 89명과 HLA haploidentical 군 79명 간의 이식신 생존률, 급성거부반응의 빈도, 이식신 기능소실의 원인, 이식 후 1, 2, 3, 5년의 혈청 크레아티닌치 등을 후향 분석하였다. 결과 : HLA-A, B, DR 전체 6개 항원 중 HLA 적합수가 0, 1, 2인 군과 HLA haploidentical 군간의 이식신 생존률, 급성 거부반응의 빈도, 이식신 기능소실의 원인, 이식 후 1, 2, 3, 5년의 혈청 크레아티닌치의 차이는 없었다. 결론 : HLA 적합수가 0, 1, 2인 군과 HLA haploidentical 군간의 이식 후 임상성적이 유의한 차이가 없어 HLA 적합수가 0, 1, 2인 군의 신이식도 적극적으로 고려할 수 있을 것으로 보인다. Background : Poor HLA matched donors may become an additional organ source for renal transplantation. This study is conducted to predict the clinical outcomes of renal transplantation in a poor HLA matched group (0 or 1 or 2 HLA matching) by comparing them with those of HLA haploidentical group. Methods : This study compared a poor HLA matched group (N=89) with HLA haploidentical group (N=79) to analyze differences between two groups in graft survival, incidence of acute rejection, cause of graft failure, posttransplant serum creatinine at 1, 2, 3, 5 years. Total 168 cases, appeared in the medical records for more than six months in Bong-Saeng Hospital, from December, 1984 to March, 2004 were traced and identified as relevant cases for this study. Results : Allograft survival rate at 1, 3, 5, 10 years for poor HLA matched group and HLA haploidentical group were 100%, 98.6%, 95.4%, 72.5% and 100%, 100%, 96.1%, 86.2% (p=not significant) respectively. Acute rejection developed in 25.8% of poor HLA matched group versus 18.9% of HLA haploidentical group (p=not significant). The most common causes of graft failure in both groups were chronic rejection. Conclusions : It should be actively encouraged to consider renal transplantation in a poor HLA matched group as the results of this study support that the clinical outcomes of renal transplantation in a poor HLA matched group are equivalent to those of HLA haploidentical group.(Korean J Med 69:402-409, 2005)