Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021843 (bowel obstruction)
 9,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pancreatic enzyme extracts have been used for several decades to decrease maldigestion of macro- and micronutrients due to pancreatic insufficiency and to alleviate various abdominal symptoms, including the pain of alcohol-induced chronic pancreatitis and distal intestinal obstruction. Decreasing nutrient maldigestion and malabsorption in pancreatic insufficiency is of additional critical importance because improvement in nutritional status reduces morbidity and mortality. For example, pancreatic sufficient patients with cystic fibrosis (CF) demonstrate a slower decline in pulmonary function. In spite of the recognized importance of pancreatic enzymes, several problems exist with current preparations, and as newer enzyme preparations are marketed, proper evaluation becomes critical. There is a clear need to optimize the constituents of enzyme preparations, improve manufacturing processes, and find better sources of enzymes. Other issues that need addressing include standardization of the ratios of enzymes (lipase, amylase, protease) in these products; the stability of the enzymes at room temperature; the shelf life of the finished product; whether there are significant batch-to-batch differences; and the need for a USP reference standard.
Pancreas 1994 Jan
PMID:Enzyme therapy for pancreatic insufficiency: present status and future needs. 810 63

Duodenal adenocarcinoma remains the leading cause of cancer death in familial adenomatous polyposis patients following colectomy. Stratification based on Spigelman's criteria provides a means for determining therapy. Spigelman stage IV patients have been selected for pancreas-sparing duodenectomy. Twenty-one patients underwent resection between 1992 and 2004, with a mean age of 58 +/- 11 years. The mean time from colectomy to duodenectomy was 27 +/- 13 years. Invasive cancer was found in the distal duodenum in one patient. Operative time averaged 327 +/- 61 minutes with a mean blood loss of 503 +/- 266 ml. There was no mortality, and eight patients (38%) had 14 complications: six (29%) with delayed gastric emptying, four (19%) with biliary/pancreatic anastomotic leak, one with pancreatitis, and one with wound infection. There were two reoperations: one for delayed gastric emptying and one for an early biliary leak. Mean length of stay was 15 +/- 10 days. Two late complications occurred: a stomal ulcer and an intestinal obstruction at 48 and 24 months, respectively. Mean follow-up was 79 months (range, 3-152 months). Two patients developed polyps in the advanced jejunal limb and were endoscopically treated. Pancreas-sparing duodenectomy represents a definitive treatment for advanced duodenal polyposis and can obviate the need for pancreaticoduodenectomy.
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PMID:Pancreas-sparing duodenectomy is effective management for familial adenomatous polyposis. 1626 79

Pancreas transplantation with enteric drainage avoids the long-term urological complications of bladder drainage. Increasing use of this technique raises the possibility of complications from the enteric reconstruction. This report describes a patient five yr after left-sided pancreas transplant with Roux-en-Y enteric drainage, presenting with abdominal pain, leukocytosis and radiological evidence of bowel obstruction. Exploration revealed a volvulus of the Roux limb as it passed through the mesocolon, with necrosis of the allograft duodenum and marked congestion of the pancreas. This is the first report of pancreas graft loss due to this entity, which should be recognized as an unusual cause of abdominal pain after pancreas transplantation. Potential bowel complications related to the sigmoid mesentery in left-sided pancreas transplantation are additional reasons for right-sided placement of the pancreas allograft.
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PMID:Roux limb volvulus after pancreas transplantation: an unusual cause of pancreatic graft loss. 1919 16

The adrenalin index as used in this paper means the amount of adrenalin in milligrams per gram of gland. As in our hands the chemical colorimetric method has proved more accurate, these values rather than the physiological values will be given in the final analysis. The two adrenal glands in the same individual as a rule contain about the same amount of adrenalin per gram, but variations of 10 to 20 per cent. are not unusual. Normal dogs show an index which may vary from 1.2 to 1.8 milligrams. The dogs were killed by short ether anesthesia and bleeding from the carotid. Normal human beings, dying from trauma, rupture of aneurysm, etc., show an index of 0.35 to 0.50 of a milligram, when autopsy takes place a few hours after death. Deterioration of uncut glands or of a gland hash kept on ice in the dark is not rapid and rarely exceeds 10 per cent. in twenty-four hours. Acute intoxication in dogs shows a low adrenalin index, especially the intoxication associated with intestinal obstruction and the closed intestinal loop. Intravenous injection of the poison found in closed duodenal loops sufficient to cause fatal shock causes a great drop in the adrenalin index, at times to one fourth normal or even lower. After recovery from a sublethal toxic dose the adrenalin index may rise rapidly to a point considerably above normal. The same may hold for recovery after chloroform poisoning. Anesthesia by chloroform or ether causes a drop in the adrenalin index depending upon the length of anesthesia and probably in part on the depth of anesthesia. Liver poisons (chloroform, phosphorus, hydrazine) cause a drop in the adrenal index to a low level, perhaps one half normal in acute cases. Pancreas extirpation with prolonged glycosuria and death produces a great drop in the adrenalin index (cat). There is evidence that this may hold in some cases of human diabetes. In man disease of one adrenal (tuberculosis) may be associated with an adrenalin index of double the normal value in the intact adrenal. Pernicious anemia is the only disease so far found to present an abnormally high adrenalin index, and the single case shows an index at least twice normal. This is of interest especially in relation to the views recently put forward to indicate that the spleen and adrenal may be concerned in the lipoid metabolism which is thought to be profoundly disturbed in this disease. Secondary anemia due to repeated hemorrhage or the intoxication of cancer or tuberculosis causes a fall in the adrenalin index. Cachexia due to neoplasm or tuberculosis may cause a marked fall in the adrenalin index, perhaps to less than one half of normal. Acute infections (typhoid fever), septicemia, peritonitis, and similar conditions may be associated with a normal adrenalin index or one somewhat below normal. Diseases of the kidneys, heart, or blood vessels associated with elevated blood pressure show no constant variation in the adrenalin index, which may be normal or slightly subnormal.
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PMID:THE ADRENALIN INDEX OF THE SUPRARENAL GLANDS IN HEALTH AND DISEASE. 1986 91