• Title/Summary/Keyword: 췌장

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당뇨병 치료의 미래 - 인슐린 펌프의 미래

  • Kim, Jae-Hyeon
    • The Monthly Diabetes
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    • s.286
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    • pp.16-22
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    • 2013
  • 인슐린 펌프는 첨단이라는 단어가 붙으며 당뇨병 환자들이나 의료인들에게 모든 것이 알아서 해결되는 인공췌장(artificial pancreas)으로 잘못 오인되기도 하지만 앞으로 가까운 장래에 좀 더 완벽하게 첨단 인공췌장의 역할이 기대되는 분야이기도 하다. 본 장에서는 최근에 이루어진 첨단 인슐린 펌프들로 1) 연속혈당 측정기와 결합형 펌프 (glucose sensor-augmented insulin pump), 2) 인슐린 주입 알고리듬 (artificial pancreas software)이 탑재된 인공췌장형 펌프 연구들을 소개하고 앞으로 해결해야 할 과제와 전망에 대해서 알아보고자 한다.

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A Case of Obstructive Jaundice Secondary to Traumatic Pancreatitis Treated with Percutaneous Transhepatic Biliary Drainage (경피경간담도배액술로 치료한 외상 급성 췌장염에 의한 폐쇄 황달)

  • Park, Ji-Sook;Baek, Jong-Geun;Yeom, Jung-Sook;Park, Eun-Sil;Seo, Ji-Hyun;Lim, Jea-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang;Shin, Tae-Beom
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.204-209
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    • 2010
  • Isolated pancreatic trauma and secondary obstructive jaundice in the pediatric population is unusual. Biliary tract obstruction can be a major cause of acute pancreatitis. We report a case of obstructive jaundice secondary to isolated traumatic acute pancreatitis in a previously healthy 32-month-old girl. In our case, secondary obstructive jaundice aggravated the pancreatic inflammation and was successfully treated with percutaneous transhepatic biliary drainage (PTBD).

Hereditary Pancreatitis - Report of a Kindred - (유전성 췌장염 - 1가계보고 -)

  • Kim, Hyoung-Ran;Chung, Jae-Hee;Song, Young-Tack;Yoon, Won-Jae;Ryu, Ji-Kon;Kim, Yong-Tae
    • Advances in pediatric surgery
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    • v.12 no.1
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    • pp.24-31
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    • 2006
  • Hereditary pancreatitis (HP) appears as an autosomal dominant trait. If the patient has (1) more than 2 affected relatives in different generations and (2) no known etiological factors such as alcohol or gallstones, or has R122H or N29I mutation in the cationic trypsinogen (CT) gene, the diagnosis of HP can be applied. Risk of pancreatic cancer is estimated to be 53-fold higher than in a general population after the age of 50 years. We report a kindredof HP, involving three of its family together; two siblings (14 years old, 13 years old) and cousin (26 years old). The patient had complicating chronic pancreatitis and pancreatic stone, and was treated with amodified Puestow-Gillesby procedure. Her sisters showed chronic pancreatitis. Her cousin underwent a drainage procedure of the pancreatic duct for chronic pancreatitis during the high school period. All the three members showed the R122H mutation of the CT gene.

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Ultrasonographic Resistive Index of the Cranial Pancreaticoduodenal Artery in Normal Conscious Dogs (정상견에서 전방 췌장십이장 동맥의 초음파학적 혈관 저항지수)

  • Eom, Ki-Dong;Lee, Hae-oon;Seong, Yun-sang;Lee, Jeong-min;Lee, Jong-won;Oh, Tae-ho
    • Journal of Veterinary Clinics
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    • v.20 no.3
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    • pp.274-277
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    • 2003
  • The purpose of this study was to determine the range of resistive index(RI) of the cranial pancreaticoduodenal artery(cPDA) in the normal dog's and to assess the possibility of clinical application of RI for diagnosing a pancreatitis. Five patients with acute pancreatitis and 17 healthy adult beagle dogs were used. Duplex color Doppler ultrasonographic examination was performed by using a real-time scanner with 11-MHz linear-array transducer. The dogs were restrained in dorsal recumbency without the use of chemical agent. The mean RI of the normal pancreas(0.63$\pm$0.04) was significantly(t = 5.79, p = 0.001) different from acute pancreatitis dog(0.75$\pm$0.04). Duplex color Doppler ultrasonography was an useful technique for detecting and measuring RI of the cPDA. The evaluation of RI of the cPDA may be a valuable supportive diagnostic procedure for evaluating the pancreatitis or suspected in dogs.

Regulatory T Cells Promote Pancreatic Islet Function and Viability via TGF-β1 in vitro and in vivo (조절 T 세포 유래 TGF-β1에 의한 췌장섬세포의 기능 및 활성 증가)

  • Choi, Bongkum;Kim, Sa-Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.3
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    • pp.304-312
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    • 2018
  • Regulatory T cells (Treg), known as immune-suppressors, may help modulate the immune response. In this study, we investigated the effect of Treg-derived $TGF-{\beta}1$ on pancreatic islet cell function in vitro and in vivo. One hundred eighty IEQ (islet equivalents) of pancreatic islets, the marginal amount to regulate blood glucose level after syngeneic islet transplantation in mouse type 1 diabetes (T1D) model, were co-cultured with $4{\times}10^6$ Treg cells for 48 hours. The changes in $TGF-{\beta}1$, interleukin-6 (IL-6), and insulin secretion levels were measured and analyzed among the Treg-only group, the islet-only group, and the Treg/islet co-cultured group. In the Treg/islet co-cultured group, IL-6 and insulin secretion levels were increased (P<0.0005, P<0.005) and islet viability was improved (P<0.005) compared with the islet-only group. Furthermore, after transplantation, the co-cultured islets regulated blood glucose levels efficiently in the T1D mouse model. These data suggest that Treg could improve islet functions and viability via the $TGF-{\beta}1$ secretion pathway (P<0.05~0.005), thus the use of Treg in islet transplantation should be explored further.

Immunohistochemical study of the pancreatic endocrine cells in the ICR mice (ICR 마우스 췌장 내분비세포에 대한 면역조직화학적 연구)

  • Ku, Sae-kwang;Lee, Hyeung-sik;Lee, Jae-hyun
    • Korean Journal of Veterinary Research
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    • v.42 no.1
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    • pp.21-28
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    • 2002
  • The regional distribution and relative frequency of the pancreatic endocrine cells in the ICR mouse were studied by immunohistochemical (PAP) method using four types of specific antisera against insulin, glucagon, somatostatin and human pancreatic polypeptide (PP). The pancreas of mice could be divided into three portions; pancreatic islets, exocrine and pancreatic ducts. Pancreatic islets, furthermore, were subdivided into three regions (central, mantle and peripheral region) according to their located types of immunoreactive cells. In the pancreatic islet portions, insulin-immunoreactive cells were located in the central and mantle regions but most of somatostatin-, glucagon- and PP-immunoreactive cells were detected in the mantle and peripheral regions with various frequencies. In addition, PP-immunoreactive cells were also found in the central regions of pancreatic islets of ICR mouse. In the exocrine portions, all four types of immunoreactive cells were demonstrated in the ICR mouse. In the pancreatic duct portions, insulin- and glucagon-immunoreactive cells were situated in the epithelial lining of ICR mouse with a few and rare frequencies, respectively. In addition, rare PP-immunoreactive cells were also demonstrated in the subepithelial regions of the pancreatic duct. However, no somatostatin-immunoreactive cells were demonstrated.

Pancreatic trauma with acute hemorrhage successfully treated surgically after Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) and angioembolization (Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)와 혈관색전술 후 수술적 치료로 호전된 급성 출혈을 동반한 외상성 췌장 손상)

  • Kang, Wu Seong;Park, Chan Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.1
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    • pp.371-375
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    • 2019
  • The role of resuscitative endovascular balloon occlusion of the aorta (REBOA) in hemodynamically unstable pancreatic trauma is unclear. We report here a case of traumatic pancreatic bleeding controlled with REBOA and angioembolization of the splenic artery before surgery. A 65-year old man experienced blunt trauma upon falling from a height of 20 m. Computed tomography (CT) revealed distal pancreatic trauma (grade III) and contrast extravasation around the splenic artery. Shortly after CT, his systolic blood pressure was 60 mmHg and REBOA was performed for hemodynamic stability. His systolic pressure increased to 130 mmHg after balloon inflation and angioembolization of the splenic artery was performed. On angiography, no further arterial bleeding was identified and the balloon was removed. Subsequently, the patient underwent emergent laparotomy with distal pancreatectomy. There was no active bleeding during surgery and distal main pancreatic duct injury was identified. After surgery, the patient recovered without complication. In this case, hemodynamically unstable hemorrhagic pancreatic trauma was treated effectively and safely with distal pancreatectomy after REBOA with angioembolization.

Exocrine Pancreatic Secretion in Response to Electrical Stimulation of Reticular Formation in Mesencephalone in Rats (흰쥐에서 중뇌망상체의 전기자극이 췌장액 분비에 미치는 영향)

  • Park, Hyoung-Jin;Lee, Yun-Lyul;Kwon, Hyeok-Yil;Shin, Won-Im
    • The Korean Journal of Physiology
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    • v.20 no.1
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    • pp.1-7
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    • 1986
  • It has been well documented that the peripheral autonomic nervous system plays an important role in exocrine pancreatic secretion. However, the role of the central nervous system in pancreatic function is still obscure even though the central nervous system has been known to control gastrointestinal functions through the autonomic nervous system. Since the reticular formation in the mesencephalone seems to integrate the autonomic function, the present study was undertaken to investigate a possible influence of the reticular formation upon the exocrine pancreatic secretion. Twenty·two albino rats fasted for 24 hours were anesthetized by intraperitoneal injection of urethane in a dose of 1 g/kg, The pancreatic duct was cannulated to collect pancreatic juice and bile juice was diverted to the jejunum. The gastroduodenal junction was ligated to Prevent passage of gastic juice into the duodenum. A pair of electrodes were bilaterally inserted in the reticualr formation of the mesencephalone with aid of a stereotaxic apparatus. When the volume of pancreatic juice secreted for 10 min became constant, the reticular formation was electrically stimulated for 10 min. Parameters of the electical stimulation was 1.3V, 40 Hz and 2 msec. When the pancreatic secretion returned to the level before the electrical stimulation, cervical vagotomy (11 rats) or administration of propranolol (11 rats) in a dose of 0.1 mg/kg through the jugular vein was carried out. Ten minutes after the treatment, the electrical stimulation of the reticular formation was repeated. The brain was fixed by perfusion of 10% formaline solution through the heart, and then placement of the electrode tip was examined histologically. Protein concentration and amylase activity in samples of Pancreatic secretion were measured. The electrical stimulation of the reticular formation significantly increased in volume $({\mu}l/10\;min)$, Protein output $({\mu}g/10\;min)$ and amylase output (U/10 min) in the pancreatic secretion. The stimulatroy effects were not affected by the cervical vagotomy but completely abolished by propranolol. Meantime, it was also observed that both vagotomy and propranolol significantly reduced the pancreatic secretory function. These results indicate that the reticular formation in the mesencephalone may exert a stimulatory effect upon the Pancreatic secretory function not through the vagus nerve but through the sympathetic pathway in anesthetized rats.

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[6]-Gingerol Attenuates Autophagy and Increases Activities of Antioxidative Defense Enzymes in Mice with Cerulein-induced Acute Pancreatitis (Cerulein 유도 급성췌장염 마우스모델에서 자가분해 조절과 항산화 활성에 미치는 [6]-gingerol의 영향)

  • Kim, Sung Ok;Choi, Yung Hyun
    • Journal of Life Science
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    • v.23 no.10
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    • pp.1280-1287
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    • 2013
  • The current study investigated the effects of [6]-gingerol, a ginger phytochemical, on the expression of autophagy-related genes and the activation of antioxidative enzymes in the pancreas of mice with cerulein-induced acute pancreatitis. The following were studied: pancreatic edema, ${\alpha}$-amylase activity in serum, expression of autophagy genes, activities of antioxidative defense enzymes, such as superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and the production of lipid peroxidation (LPO). The results revealed that cerulein-induced edema in the pancreas and ${\alpha}$-amylase activity in the cerulein group significantly increased compared with that of the control. However, that of the [6]-gingerol pretreated group was significantly decreased compared with that of the cerulein-alone injected group (positive control). There was no significant difference compared with that of control. The expression of autophagy-related proteins, including Beclin-1 and cleaved microtubule-associated protein 1 light chain 3, were significantly increased in the positive control but significantly decreased in the [6]-gingerol-pretreated group. Furthermore, the activities of SOD and GSH-Px in the positive control were decreased compared with those of the control. However, those of the [6]-gingerol pretreated group were significantly increased compared with those of the cerulein-alone group. The mRNA levels and antioxidant enzyme activities were similar. The production of LPO in the cerulein with and without [6]-gingerol groups was increased by 133.1% and 26.3%, respectively, compared with that of the control, whereas that of the [6]-gingerol-pretreated group was significantly decreased by 48.5% compared with that of the positive control. Therefore, [6]-gingerol may be a strong candidate in reducing autophagy and LPO production and in enhancing antioxidative enzyme activities to help prevent acute and chronic pancreatitis.

Perilesional Steatosis in Ectopic Pancreas Mimicking Exogastric Mass : A Case Report (주변부 지방침윤으로 인해 외위장 종괴로 보이는 이소성 췌장: 증례 보고)

  • Nam, Mi Yeon;Kim, Mi Young;Kim, Yeo Ju;Suh, Chang Hae;Choi, Suk Jin;Cho, Jae Sung
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.154-157
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    • 2013
  • We report an unusual case of ectopic pancreas that appeared on radiologic images as a lobulated, submucosal mass enclosed by fat component in the gastric lower body. Although, ectopic pancreas including fat component is extremely rare, in the setting of gastric submucosal mass with containing perilesional fat, these findings should be considered in ectopic pancreas as part of the differential diagnosis.