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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Urinary amylase activity (UAA) is used for diagnosis of rejection in bladder-drained pancreas grafts. Unfortunately, most rejection episodes occur after the patient has been discharged. In those cases, an early diagnosis is often difficult, and a method for home UAA monitoring is needed. We have developed a method that can be used for this purpose. The method, based on Kodak dry-film technology, is shown to have good response to the wide range of UAA seen in these patients compared with responses to standard laboratory kinetic methods. The analysis (performed by the patient) involves 1) collecting urine for 24 h in a 4-L container, 2) diluting the urine with tap water to a total urine of 4 L, and 3) placing a drop of this dilution onto a slide. The slide is read by a handheld spectrophotometer that displays the UAA in secreted units per hour. The reliability of this system has been tested for wide changes of urine pH, volume of the drop applied to the slide, and tap water from different sources. Temperature coefficients have been determined to correct changes in ambient temperatures. The final handheld prototype is being developed based on these preliminary studies. This device could be of benefit for the early diagnosis of rejection episodes in recipients of bladder-drained pancreas grafts after hospital discharge.
Diabetes 1989 Jan
PMID:Method for home monitoring of urinary amylase after pancreas transplantation. 246 99

We have recently reported successful 72-h preservation of the canine pancreas with a new cold-storage solution developed at the University of Wisconsin (UW solution). Over 10 mo, we performed 11 combined pancreas-kidney and 4 isolated-pancreas transplants with this solution. In situ cooling of the donor pancreas was performed with 1000 ml of UW solution followed by ex vivo perfusion with an additional 250-500 ml. Graft preservation times ranged from 3 to 19 h (mean 10.2 h). Pancreas transplants were vascularized whole-organ grafts with pancreaticoduodenocystostomy. Early graft function was excellent as assessed by immediate insulin independence, high urinary amylase and low serum amylase levels, and a technetium perfusion index indicating good pancreatic blood flow. There were no episodes of primary nonfunction, graft pancreatitis, or vascular thrombosis. Actuarial patient and graft survival at 1 mo was 92.9%. We conclude that UW solution provides excellent early graft function for up to 19 h of cold storage. Based on previously reported data on its efficacy in liver and kidney preservation, UW solution seems ideally suited as a universal intra-aortic flush and cold-storage solution.
Diabetes 1989 Jan
PMID:Use of UW solution in pancreas transplantation. 246

On the basis of 26 combined pancreas-kidney transplants we questioned whether both organs undergo rejection simultaneously. Reliable diagnosis of pancreas-graft rejection was made possible by monitoring exocrine graft function, including quantitative measurements of pancreatic juice, its amylase content, and pancreatic juice cytology. In addition, diagnosis of pancreas rejection was based on regular flow studies, daily urinary neopterin excretion, and a retrospective analysis of the clinical course. Clinical symptoms, blood chemistry, and, primarily, histology were used to assess rejection of the kidney allograft. In 18 cases the kidney and pancreas were rejected together; in 8 cases the kidney or the pancreas was rejected. Although both organs were rejected at the same time in most cases, either organ can be rejected alone. Thus, the kidney cannot be used to monitor the pancreas allograft in every case.
Diabetes 1989 Jan
PMID:Rejection of kidney and pancreas after pancreas-kidney transplantation. 246 1

Both adrenalectomy and chemically induced diabetes mellitus cause a marked decrease of pancreatic amylase synthesis in rats. Diabetes is further associated with alterations of cholecystokinin (CCK)-stimulated enzyme secretion. Using isolated pancreatic acini prepared from adrenalectomized male rats, we investigated the effects of adrenalectomy on pancreatic enzyme secretion. CCK8-stimulated amylase secretion showed a typical biphasic dose-response curve in acini from both adrenalectomized and sham-operated animals with similar basal secretions, similar sensitivities to various CCK8 concentrations, but a statistically significant elevation of maximal amylase secretion after adrenalectomy. Receptor-binding studies with 125I-BH-CCK8 revealed an increase of binding to the high-affinity part of the CCK receptor in adrenalectomized rats. While carbachol-stimulated secretion showed no changes in maximal secretion rates, it did show a decrease in sensitivity in adrenalectomized animals with a statistically significant shift to the right of the dose-response curves. Competitive inhibition curves with 3H-N-methylscopolamine and carbachol as the competitive receptor agonist showed no differences in receptor binding between controls and adrenalectomized rats. We propose that complex alterations in hormone/neurotransmitter-stimulated pancreatic enzyme secretion are found in glucocorticoid depletion, explainable via a postreceptor defect in carbachol-stimulated secretion. The functional and binding data with regard to CCK are more difficult to explain.
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PMID:Influence of adrenalectomy on pancreatic enzyme secretion. 246 11

To determine the cause of hyperglycemia appearing after pancreas transplantation in type I diabetic recipients, we performed 65 oral glucose tolerance tests with serum insulin and C-peptide determinations in 32 patients with pancreas grafts functioning two or more months following transplantation. We correlated these results with estimates of graft size obtained by magnetic resonance imaging (MRI) and values of urinary amylase as a measure of pancreatic exocrine function. A total of 33 studies were obtained in 20 patients at times of normal glucose tolerance, and normal ranges for serum insulin and C-peptide levels were established; 32 studies in 17 patients during periods of glucose intolerance revealed values of serum insulin and C-peptide that were within the normal range, though the time to peak values was delayed to 2 hr, characteristic of type II diabetes. Only 3 of 17 patients examined by MRI had significant pancreatic allograft atrophy. These patients also had low urinary amylase excretion, and the only values for serum C-peptide that were below the normal range. The other 14 hyperglycemic patients had normalized pancreas grafts, normal urinary amylase excretion, and normal values for serum insulin and C-peptide. In our experience, then, in 76% of patients with hyperglycemia more than 2 months following pancreas transplantation, the cause was appearance of type II diabetes rather than destruction of the allograft with recurrence of type I diabetes. This observation has important implications for the definition of pancreas allograft failure and for the management of pancreas allograft recipients with hyperglycemia.
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PMID:Appearance of type II diabetes mellitus in type I diabetic recipients of pancreas allografts. 246 91

The effect of the alpha-glucosidase inhibitor acarbose on pancreatic exocrine and endocrine function was studied using the isolated perfused pancreata prepared from rats fed a normal (control diet) or an acarbose-containing sucrose- (ACS diet) or glucose-supplemented diet (ACG diet) for 10 days. Pancreatic amylase and insulin contents in rats fed the ACS diet were significantly decreased compared with those in rats with the control diet. Rats fed the ACG diet, however, had normal enzyme and hormone contents. Basal and cerulein-stimulated flow rates of pancreatic juice in rats with the ACS or ACG diet were similar to those in rats fed the control diet, suggesting that the pancreata from rats treated with acarbose have normal sensitivity and responsiveness to cerulein. On the other hand, cerulein-stimulated amylase output was significantly decreased in rats with the ACS diet, but was normal in rats with the ACG diet. Insulin secretion to both glucose and cerulein stimulation in rats fed the ACS diet was reduced by approximately 55% compared with the control rats. On the other hand, rats fed the ACG diet showed normal insulin secretion to glucose stimulation, although the insulin response to cerulein stimulation was reduced by 30%. These results suggest that the addition of acarbose to the sucrose-rich diet decreases the secretory responsiveness of amylase to cerulein stimulation and that of insulin to both glucose and cerulein stimulation. All these alterations, except the sensitivity of B cells to cerulein, can be normalized by replacing sucrose with glucose.
Diabetes Res Clin Pract 1988 Oct 14
PMID:Effect of alpha-glucosidase inhibitor on exocrine and endocrine pancreatic function in rats fed a high-carbohydrate diet consisting of sucrose or glucose. 246 25

Exocrine pancreatic function was studied by fecal chymotrypsin test in three groups of diabetic patients seen in southern India. Exocrine pancreatic insufficiency, as shown by low fecal chymotrypsin levels, was seen in 87.5% of patients with fibrocalculous pancreatic diabetes (FCPD), in 23.5% of insulin-dependent diabetes mellitus patients, and in 4.5% of non-insulin-dependent diabetes mellitus patients. There was no correlation between fecal chymotrypsin levels and serum amylase, serum lipase, age, body mass index, duration of diabetes, fasting plasma glucose, or glycosylated hemoglobin levels. The fecal chymotrypsin test is a useful additional investigation for the diagnosis of FCPD found in tropical countries.
Diabetes Care 1989 Feb
PMID:Exocrine pancreatic function in tropical fibrocalculous pancreatic diabetes. 246 88

The pancreatic lipase and trypsin activities in streptozotocin-induced diabetic rats were determined as well as the relative levels of mRNA coding for these proteins. It was found that after development of diabetes, the activities of pancreatic lipase and trypsin were significantly increased by 105% and 52%, respectively, accompanied by an increase in the levels of lipase and trypsinogen mRNA by 98% and 49%, respectively, while amylase activity and its mRNA were significantly decreased. The alteration of lipase, trypsin, and amylase activities and their mRNA in diabetic rats were all normalized by replacement of insulin. It is concluded that in the diabetic situation, the pretranslational control for pancreatic lipase and trypsinogen is stimulated, resulting in high levels of these enzymes in the diabetic rat.
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PMID:Increase in pancreatic lipase and trypsin activity and their mRNA levels in streptozotocin-induced diabetic rats. 247 68

Both adrenalectomy and chemically induced diabetes mellitus cause a marked decrease of pancreatic amylase activity in rats, but it is unknown whether these effects are the result of a direct or indirect mechanism. The synthesis of various pancreatic enzymes has been studied in isolated pancreatic acini from sham-operated, castrated, and adrenalectomized animals as well as in animals that have been both adrenalectomized and castrated. Protein synthesis was measured by pulse labeling of acini with [35S]methionine followed by either trichloroacetic acid precipitation of total protein and counting or by SDS-PAGE and autoradiography, and additionally by in vitro translation of extracted pancreatic RNA using rabbit reticulocytes. Adrenalectomy resulted in a 70% reduction of amylase activity per milligram of acinar protein as a result of a decrease in amylase synthesis. This reduction in amylase synthesis is a consequence of a decrease in the amount of mRNA coding for amylase. After adrenalectomy, plasma concentrations of the following were reduced compared to controls: corticosterone to 0.45%, insulin to 11%, and glucose to approximately 66%. Addition of glucose to the drinking water caused an increase in insulin and plasma glucose, but this was not followed by an increase in amylase activity. We postulate that corticosterone directly regulates amylase synthesis in the rat pancreas.
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PMID:Role of glucocorticosteroids in the regulation of pancreatic amylase synthesis. 247 63

The effects of streptozotocin-induced diabetes on the function and pattern of innervation of the rat parotid gland were investigated. An in vitro preparation was used to measure amylase release and immunohistochemistry was used to examine the innervation of the gland. Basal amylase release and the response to field stimulation were reduced in diabetic animals. In the presence of atropine or a propranolol/phentolamine mixture both control and diabetic responses were attenuated. When all 3 antagonists were present the response to field stimulation (non-adrenergic, non-cholinergic [NANC] response) was about 30% of maximal in untreated rats but virtually abolished in diabetic animals. Substance P (SP), vasoactive intestinal polypeptide (VIP) and neuropeptide Y (NPY) all stimulated amylase release in untreated rats. However, in diabetic rats the responses to all 3 peptides were reduced. No differences in staining were observed between control and diabetic rats with antisera to tyrosine hydroxylase, substance P. VIP or calcitonin gene-related peptide. In contrast there was a marked reduction in NPY-like immunoreactivity in the acinar tissue of diabetic rats. These data suggest that the diabetic rats had a failure of NANC transmission which appears to be due to a reduced NPY innervation and a lack of responsiveness to peptidergic (SP, VIP and NPY) agonists.
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PMID:The effects of streptozotocin-induced diabetes on the peptidergic innervation and function of the rat parotid gland. 247 75


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