• 대한임상독성학회지
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• 제14권2호
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• pp.83-91
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• 2016

Purpose: This study was conducted to investigate the incidence, associated factors and clinical impact of hyperamylasemia in self-poisoning patients. Methods: This study was based on a toxicology case registry of patients treated from 2009 to 2013 at a tertiary care university hospital. We retrospectively investigated the demographics, clinical variables, laboratory variables and intoxicants. Hyperamylasemia was defined as an elevation in serum amylase level to above the upper normal limit within 24 hours after admission. We analyzed the predisposing factors and clinical outcomes of patients in the hyperamylasemia group. Results: Hyperamylasemia was identified in 49 (13.3%) of the 369 patients. Using multivariate logistic regression, the odds ratios for HA were 3.384 (95% confidence interval, 1.142-8.013, p=0.014), 3.261 (95% confidence interval, 1.163-9.143, p=0.025) and 0.351 (95% confidence interval, 0.154-0.802, p=0.013) for pesticides, multi-drug use and sedatives, respectively. In the hyperamylasemia group, the peak amylase levels during 72 hours were correlated with the peak lipase levels (r=0.469, p=0.002) and peak aspartate aminotransferase levels (r=0.352, p=0.013). Finally, none of these patients had confirmed acute pancreatitis. Conclusion: Hyperamylasemia occurred rarely in these self-poisoning patients, and pesticide and multi-drug use were independent predictors of hyperamylasemia. Peak amylase levels were correlated with the peak lipase and aspartate aminotransferase levels.

• Tuberculosis and Respiratory Diseases
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• 제44권3호
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• pp.661-668
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• 1997

종양세포에 의한 hyperamylasemia는 드물게 보고되고 있으며 주로 폐암에 의하고 조직형은 선암으로 보고되어 있다. 이때 생성되는 아밀라제는 타액형으로 췌장질환에 의한 것과는 구별이 되며 hyperamylasemia에 의한 임상적인 증상은 없다. 저자등은 소세포성 폐암으로 진단받은 54세 남자 환자에서 아밀라제 농도가 상승되어 있음을 발견하고, 임상경과 및 검사결과 아밀라제를 분비하는 소세포성 폐암으로 진단하고 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제59권6호
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• pp.674-678
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• 2005

원발성 폐암에서 아밀라제가 증가하는 기전은 정확히 밝혀져 있지 않으나 대부분 타액형이며, 조직학적으로 거의 대부분이 선암이었으며, 일부 소세포폐암에서 부종양증후군으로 고아밀라제 혈증을 동반한 경우가 보고되고 있으나, 편평상피세포 폐암과 동반된 예는 국내에서 보고된 바가 없어 이를 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제33권8호
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• pp.655-661
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• 2000

Backgound: This study was performed to evaluate the incidences, the risk factors, and the clinical course of the hyperamylasemia in patients who underwent open heart surgery under cardiopulmonary bypass. Material and Method: Thirty seven patients who underwent cardiopulmonary bypass were studied at Department of Thoracic & Cardiovascular Surgery, Yeungnam University Hospital, from July 1997 to June 1998. The thirty seven patients were divided into two groups, 13 patients in group I had normal serum amylase levels and 24 patients in group II had hyperamylasemia. Result: Mean serum amylase(IU/l) levels and 24 patients in group II had hyperamylasemia. Result: Mean serum amylase(IU/l) levels of gorup II showed 54.3$\pm$4.6, 78.0$\pm$9.2, 372.0$\pm$103.4, 460.5$\pm$80.4, 280.4$\pm$46.6, and 131.0$\pm$15.6, preoperative, immediate postoperative, at postoperative 1, 2, 3, and 7 days, respectively. In group II, serum amylase level of the postoperative day 2 was the highest and was significantly higher than that of the preoperative day(p<0.001). Serum amylase level started to decreased at postoperative day 3 and returned to the normal level at postoperative day 7. Significant clinical symtoms of overt pancreatitis were not shown in patients in group II. The following perioperative variable such as diagnosis, cardiopulmonary bypass time, aortic cross clamping time, mean systemic pressure during bypass, and administration of steroid were compared between groups. There were no significant differences between groups. In all patients, Serum amylase level of postoperative day 2 and aortic cross clamping time were correlated significantly(p=0.047). Conclusion: Serum amylase level after cardiopulmonary bypass could be elevated postoperatively and serum amylase level of POD 2 was considered to have significant correlation with aortic cross clamping time. Shortening of aortic cross clamping time will help in reducing the hyperamylsemia. In this study, although significant clinical symptoms and overt pancreatitis were not seen from hyperamylsemic patients, careful clinical observation of hyperamylasemia would be necessary.

• Clinical and Experimental Pediatrics
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• 제52권11호
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• pp.1283-1285
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• 2009

마크로아밀라아제혈증은 대개 혈중 아밀라아제 분자의 크기가 큰 양성 질환으로 1-2% 까지 보고된다. 마크로아밀라아제혈증에서는 아밀라아제가 면역 글로불린과 결합하여 고분자 복합체를 형성하여 소변을 통한 배출이 정상 혹은 저하되어 혈청 내 고아밀라아제혈증을 일으킨다. 소아에서는 매우 드문 질환이다. 본 저자들은 초기 급성 췌장염으로 오인된 4세 여아가 마크로아밀라아제혈증으로 진단되어 보고하는 바이다. 고아밀라아제혈증의 원인중 하나인 마크로아밀라아제혈증을 조기 진단하지 못하면 췌장질환과 감별을 위한 고 비용의 검사를 하게 되고 금식이나 정맥 영양과 같은 필요 없는 치료를 할 수 있다.

• 대한임상독성학회지
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• 제4권2호
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• pp.166-169
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• 2006

Poisonings caused by 'mad honey' are known to occur in response to grayanotoxins, which bind to sodium channels in the cell membrane, increasing membrane sodium permeability and preventing inactivation. Mild symptoms of mad honey intoxication are dizziness, weakness, hypersalivation, nausea, vomiting, and paresthesia. Severe intoxication, however, leads to serious cardiac manifestations such as atrioventricular block, dose-dependent hypotension, bradycardia, and respiratory depression. Atropine and vasoactive drugs improve symptoms of both bradycardia and respiratory rate depression. We report an unusual case of saliva-type hyperamylasemia in a mad honey poisoning patient who developed clinically significant bradycardia. She recovered fully within 3 days following atropine administration and medical treatment.

• Journal of Chest Surgery
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• 제28권1호
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• pp.1-6
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• 1995

• The Korean Journal of Physiology and Pharmacology
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• 제2권5호
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• pp.629-635
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• 1998

It has been suggested that oxygen free radicals are involved in the initiation process of acute pancreatitis, although its pathogenesis is not clear. This study evaluates the roles of oxygen radicals and the effects of small molecular antioxidants (rebamipide, N-acetyl-cysteine, allopurinol, ${\beta}-carotene)$ on the development of cerulein-induced acute pancreatitis. Acute edematous pancreatitis was induced by the intravenous infusion of cerulein at supramaximal dose of 10 ${\mu}g/kg/hour$ for 3.5 hours. The effects of antioxidants, rebamipide (100 mg/kg, i.p.), N-acetyl-cysteine (200 mg/kg, i.v.), allopurinol (20 mg/kg/hour), ${\beta}-carotene$ (50 mg/kg, i.p.), were examined. Cerulein administration resulted in a significant increase in serum amylase activity and pancreatic malondialdehyde (MDA), but not glutathione peroxidase (GSHpx). The glutathione (GSH) content in pancreatic tissue decreased dramatically. Pretreatment of N-acetyl-cysteine significantly decreased the cerulein-induced hyperamylasemia and maintained GSH content in pancreas, but MDA was slightly decreased. In addition, N-acetyl-cysteine ameliorated histological damage. Allopurinol and ${\beta}-carotene$ attenuated cerulein-induced hyperamylasemia, but histologically there was no difference from control. These results indicate that oxygen free radicals play an important role in the initiation of experimental acute pancreatitis. N-acetyl-cysteine is an effective antioxidant that ameliorates the cerulein-induced acute pancreatitis, and the possible therapeutic application of antioxidants against acute pancreatitis needs a further evaluation.

• Journal of Chest Surgery
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• 제28권10호
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• pp.892-899
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• 1995

Pancreatitis is a known complication of cardiac surgery with cardiopulmonary bypass. Although ischemia is believed to be a factor, the exact cause of pancreatitis after cardiopulmonary bypass remains unknown.We prospectively studied 67 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass for evaluation of the pancreatic injury after cardiopulmonary bypas. Serial measurement of amylase level in serum and urine was done postoperatively. Hyperamylasemia was detected in 15 patients[22.4% , of whom no patient had pancreatitis. There was no significant difference between serum amylase level and parameters such as cardiopulmonay bypass time, aortic cross clamp time, mean blood pressure, rectal temperature, flow rate, and use of circulatory arrest during cardiopulmonary bypass. Hyperamylasuria was detected in 8 patients[11.9% , and urine amylase level was elevated significantly in the groups with prolonged cardiopulmonary bypass, mean blood pressure more than 40mmHg, and rectal temperature more than 20 $^{\circ}$C. We recommend that serum amylase level and/or amylase-creatinine clearance ratio is measured for ealy detection and management of pancreatitis after cardiopulmonary bypass.

• 약학회지
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• 제46권3호
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• pp.192-196
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• 2002

To investigate the effect of intravenous ethanol administration on pancreatic exocrine secretion, we measured volume and protein amount in pancreatic juice and assayed amylase activity and phospholipase $A_2$ activity in pancreatic fragments and serum. Acute pancreatitis induced by obstruction of common bile-pancreatic duct (CBPD) and caerulein infusion (5 $\mu\textrm{g}$/kg/hr) showed typical characteristics, such as hyperamylasemia and pancreatic edema and increase of phospholipase $A_2$ activity in pancreatic fragments and serum. Intravenous ethanol infusion (50 mg/kg/hr) significantly stimulated pancreatic exocrine secretion, but such a stimulatory effect of ethanol disappeared at dose of 100 mg/kg/hr without typical symptoms of acute pancreatitis. In microscopic examination, there were no typical changes of edematous pancreatitis in ethanol administrated rats. These results suggest that acute ethanol administration has dual effect on exocrine pancreatic secretion: low dose of ethanol (50 mg/kg/hr) stimulates pancreatic exocrine secretion, whereas high dose of ethanol (100 mg/kg/hr) does not without typical changes of edematous pancreatitis.