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Query: UMLS:C0001339 (acute pancreatitis)
 10,593 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A specific and sensitive radioimmunoassay (R.I.A.) has been developed which makes possible the determination of serum or plasma trypsin concentrations despite the presence of trypsin inhibitors, which have invaldiated previously available enzymatic techniques. The assay was most precise at about 300 microng trypsin standard Ag5 per litre of serum, a value comparable with the mean in 76 healthy volunteers (273 microng/1) and in 20 hospital patients with non-pancreatic disease (266 microng/1). Markedly raised concentrations (970-6500 microng/1) were found in all 14 patients with acute pancreatitis and in 8 patients with chronic renal failure (580-1360 microng/1). Abnormal concentrations were found in 11 of 16 patients (69%) with pancreatic cancer (8 high, 3 low) and in 15 of 23 patients (65%) with chronic pancreatitis (3 high, 12 low). Patients with jaundice had normal or marginally lower than normal concentrations unless pancreatic disease or common-duct gallstones were present.
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PMID:Diagnostic importance of changes in circulating concentrations of immunoreactive trypsin. 6 50

The ratio of renal clearance of immunoreactive trypsin relative to renal clearance of creatinine was measured in 71 subjects including 27 controls and patients with cancer of pancreas, chronic pancreatitis, and acute pancreatitis. The upper limit of the control range was 4.1 x 10(-5) (mean + 2SD). 6 of 9 patients (67%) with acute pancreatitis had raised values. All 18 patients with chronic pancreatitis had values within the control range. In contrast, all 17 patients with carcinoma of pancreas had raised clearance ratios. The test may therefore prove valuable in distinguishing between chronic pancreatitis and cancer of pancreas.
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PMID:Urinary immunoreactive trypsin excretion: a non-invasive screening test for pancreatic cancer. 9 Sep 69

125 patients were subjected to computer tomography on account of suspected pancreatic disease. 48 patients were operated on--the computer tomography (CT) diagnosis was confirmed in 85.5% of the cases. Acute pancreatitis can be detected by CT if it is accompanied by an appropriate enlargement of the organ. Chronic pancreatitis can be recognized by deformations of the organ, calcifications or formation of pseudocysts. Pancreatic carcinoma is recognizable when it is larger than 3 cm accompanied by a change in the shape of the organ or if infiltration of neighboring structures has occurred. Computer tomography offers patients a safe, non-invasive method of performing follow-up examinations at short intervals.
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PMID:[Computer tomography on the pancreas. A diagnostic extension from the surgical aspect (author's transl)]. 11 64

Twenty three patients with acute pancreatitis were studied to assess the serum alpha 1-antitrypsin levels as well as the total trypsin-inhibitor capacity. These parameters were found to be normal or increased, which is not the case with patients with chronic pancreatitis. The value of protease-inhibitor treatment in acute pancreatitis is doubted.
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PMID:Alpha 1-antitrypsin and total trypsin-inhibitor capacity in acute pancreatitis. 11 90

Ultrasonic examination of the pancreas is rendered difficult by the echogenic characteristics of the organ, by its depth, by the overlying gas, and by bony structures and anatomic variations. The reintroduction of gray-scale imaging promises to simplify the technique and expand its usefulness. The 75Se-/-selenomethionine scan is a reliable test when performed after effective pancreatic stimulation with a scintillation camera that permits the angulation required to separate pancreas from liver. Gallium-67-citrate may be important for both mapping inflammatory processes and imaging some tumors. Retrograde pancreatography has developed into a rather reliable and sensitive method of visualizing pancreatic duct abnormalities. Angiography remains the most reliable technique for finding small lesions, while computerized axial tomography appears a promising modality in the near future. In acute pancreatitis, gallium scanning may find a place alongside plain films, GI series, and echography. Chronic pancreatitis appears best studied by pancreatography, possibly with selenomethionine scanning as a function study and echography to find associated mass lesions. Pseudocysts are most easily located by ultrasound examination. Screening for pancreatic carcinoma is done most effectively with selenomethionine scanning when the index of suspicion is low and with pancreatography or arteriography when it is high. Echography is useful for localization for aspiration biopsy and for sequential evaluation of therapeutic response. Islet-cell tumors are best found by angiographic studies.
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PMID:Ultrasonic and radionuclide scanning in pancreatic disease. 17 26

The abnormalities of the humoral immune phenomena in pancreatitis may be summarized on the grounds of published evidence and of the present results as follows: 1. Circulating anti-pancreas antibodies are present in acute pancreatitis as also after its cure, and in chronic pancreatitis. 2. The appearance of soluble immune complexes in pathological amounts was demonstrated in the sera of the patients by radiobioassay in acute pancreatitis of identified aetiology 3 to 4 weeks after onset. On the evidence of follow-up studies over 1 to 8 months the immune complexes were found to persist at increased levels after complete cure of acute pancreatitis. Soluble immune complexes were demonstrable in pathological amounts in the cases of chronic pancreatitis as well. 3. In acute pancreatitis the total serum complement titres decline fast and after a few weeks persistent hypocomplementaemia develops in a number of cases. 4. The possible role of circulating soluble immune complexes and of the complement system in pancreatitis is discussed, and it is suggested on the grounds of the present data that acute pancreatitis is associated with a specific and nonspecific immune sensitization, still demonstrable in a number of cases after a few months.
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PMID:Abnormalities in humoral and cellular immune activity in pancreatitis. I. Study of the humoral immune system. 31 Nov 32

Exocrine pancreatic function was determined by oral administration of N-benzoyl-L-tyrosyl-p-aminobenzoic acid (peptic-PABA-test) in 120 controls, 74 patients with chronic pancreatitis, 35 patients with acute pancreatitis 2--6 weeks after recovery, 201 patients with a variety of gastro-intestinal diseases and in 10 patients with anorexia nervosa. In the control group, 70% +/- 18% of the oral administered dose of PABA was found within 6 hours in the urine. In contrast the group of chronic pancreatic patients excreted only 40% +/- 13% over the same period. "False negative" PABA excretion was found in 11 (9%) of the 120 persons with no pancreas disease. "False positive" PABA excretion was found in 13 (17,5%) of the 74 patients with chronic pancreatitis. The test was not influenced by age or sex. After stomach resection or cholecystectomy and in patients with ulcus duodeni, chronic hepatitis, functional diarrhea, Crohn's disease, colitis ulcerosa and acute pancreatitis 2--6 weeks after recovery the peptide-PABA-test was not distored. Diminished PABA excretion was encountered in some patients with toxic liver disease, inflammatory disease of the small intensine like M. Whipple, celiac disease and unspecific enteritis and in a few patients with cholelithiasis. Low PABA excretion was found in early all patients with partial small intestinal resection, terminal liver cirrhosis or liver metastasis with ascites and in all patients with anorexia nervosa.
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PMID:[The specificity of peptide-PABA-test (author's transl)]. 31 33

By the use of [11C]methionine and positron computed tomography (PCT), images of the pancreas were obtained in 32 patients. The injection of between 10 and 20 mCi of this product enables four to six transverse sections to be obtained. Seventeen of the patients studied had no exocrine pancreatic disease, and in all these cases the pancreas was clearly visible. In four cases of pancreatic carcinoma and one of retroperitoneal tumor, there were abnormalities visible. In five cases of chronic pancreatitis, no pancreatic uptake was observed. In a sixth case, concentration was visible, but only in the head of the pancreas. One case of acute pancreatitis, which showed no concentration during the acute phase, returned to normal after recovery. When visible, the pancreas was easily located and distinguishable from the intestinal image, except in two cases that were uninterpretable for technical reasons. No false positive or negative was observed, but a differential diagnosis between cancer and pancreatitis was impossible.
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PMID:[11C]methionine pancreatic scanning with positron emission computed tomography. 31 98

The authors have employed external drainage of the pancreatic duct in 96 patients. Pancreaticostomy was performed with prophylactic and therapeutic purposes. Prophylactic pancreaticostomy after the Doubilet technic was accomplished in all cases of papillosphincteroplasty. In case of evident stenosis of the pancreatic duct ostimum (6 patients) papillosphinctero-wirsungoplasty with external drainage of the duct was performed. In acute pancreatitis pancreaticostomy would contribute to prompt normalization of pancreatic enzymes and subsidence of the inflammatory process. In chronic pancreatitis with involvement of the duct system along with papillosphinctero-wirsungoplasty and transpapillary drainage of the pancreatic duct terminal portion also cystodigestive and pancreaticodigestive anastomoses were constructed with external transanastomosis transenteric (after the Folker technic) drainage of the cyst cavity of pancreatic duct.
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PMID:[Practical use of external drainage of the pancreatic duct]. 32 5

The diagnosis of both acute and chronic pancreatitis continues to be a challenge despite the development of new techniques and the refinement of old methods. The problem is best approached by the application of a combination of tests which can provide a reasonable degree of sensitivity and specificity applicable to the different forms of pancreatitis. In acute pancreatitis an elevation of serum amylase and amylase/creatinine clearance ratio is diagnostically useful. In chronic pancreatitis, several tests are needed to enhance the diagnostic yield, and such tests can include the secretin-pancreozymin test, ERCP, fecal fat measurement, Lundh test meal, and the administration of the synthetic peptide BZ-Ty-PABA.
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PMID:Laboratory aids in the diagnosis of pancreatitis. 34 Aug 13


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