Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This report describes a new monoclonal antibody (MAb) designated 47D10 which was produced by immunizing mice against a human lung adenocarcinoma line, A549. The MAb 47D10 reacts with a surface antigen found in 95% of adenocarcinomas of the pancreas as well as on high percentages of adenocarcinomas from colon, breast, lung, and bile duct. The antigen was not detected in normal pancreas, in pancreatitis, or in a variety of normal tissues with the exception of colon and mature granulocytes. Lymphocytes and erythrocytes were also negative. The binding of 47D10 to tumor cells was unaffected by treatment of cells with neuraminidase. Immunoprecipitation followed by polyacrylamide gel electrophoresis showed that 47D10 MAb recognized a group of glycoproteins ranging in molecular weight from 67,000-98,000 on A549 lung carcinoma cells. Pulse-chase labeling showed two precursor proteins with molecular weights of 69,000 and 67,000 which were processed to the larger polypeptides in 1.5 h. At least part of the carbohydrates associated with the 47D10 antigen was asparagine linked because the antigen was sensitive to endoglycosidases, and tunicamycin inhibited the biosynthesis of 47D10 antigen. The 47D10 antigen was expressed on the cell surface because it could be detected on live A549 cells by enzyme-linked immunosorbant assays as well as by immunofluorescent staining. Furthermore, 47D10 antigens on tumor cell lines and granulocytes were vectorially labeled with 125I. The antigen found on granulocytes showed a higher molecular weight of 150,000-180,000, which was digested by endoglycosidase F to polypeptides with molecular weights ranging from 23,000-27,000. In contrast, the degradation product of the A549 antigen was a Mr 39,000 polypeptide after treatment with endoglycosidase F. The immunochemical characteristics of 47D10 antigen suggest that it is distinct from other antigens associated with pancreatic tumors, such as carcinoembryonic antigen, 19-9, and Du-PAN-2. By virtue of its broad range of tumor cell reactivity and low activity on normal cells, the 47D10 MAb may represent an important immunological reagent for differential diagnosis, especially of pancreatic carcinoma.
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PMID:Tissue distribution, immunochemical characterization, and biosynthesis of 47D10, a tumor-associated surface glycoprotein. 353 19

Obliteration of the fat plane surrounding the superior mesenteric artery has been described as characteristic of pancreatic carcinoma. To determine the specificity of this and other computed tomography findings in the pancreas and peripancreatic region, scans of 86 patients were reviewed without clinical history. Diagnoses included pancreatitis (26 patients); pancreatic adenocarcinoma (14 patients); lymphoma (17 patients); metastatic nonpancreatic carcinoma (14 patients); and normal findings (15 patients). Confluent adenopathy could not be reliably differentiated from a pancreatic mass except when adenopathy separated the common bile duct from the duodenum. Retrocrural adenopathy was unusual with pancreatic carcinoma. The fat plane surrounding the superior mesenteric artery was obliterated with pancreatic carcinoma (36%), nonpancreatic carcinoma (29%), and lymphoma (24%), but not with pancreatitis, although perivascular edema was seen in 19%. Evaluation of the celiac axis was less rewarding. Obliteration of the superior mesenteric artery fat plane is a sign of malignancy, but it is not specific for pancreatic carcinoma. We propose that the superior mesenteric artery origin be considered within a paraaortic space, separate from the anterior pararenal space. This explains its characteristic lack of involvement by pancreatitis.
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PMID:The superior mesenteric artery fat plane: is obliteration pathognomonic of pancreatic carcinoma? 360 49

Pylorectomy and end-to-end gastroduodenostomy are surgical procedures that allow excision of abnormal pyloric tissue and provide improved gastric outflow. These techniques were used for the treatment of benign, malignant, and ulcerative conditions that were judged to be not adequately treatable with pyloromyotomies or pyloroplasties. End-to-end gastroduodenostomy was not much more difficult than a standard intestinal anastomosis; however, a thorough knowledge of the pyloric area anatomy was required to avoid serious surgical errors. In addition, gentle tissue manipulation and precise suture placement reduced the chance of iatrogenic pancreatitis, biliary obstruction, tissue ischemia, and/or suture line leakage. The results of surgery depended on the underlying disease process. Dogs with benign lesions such as chronic hypertrophic pyloric gastropathy responded favorably to treatment. Dogs with malignant disease and perforated ulcers had low long-term survival rate. Pyloric adenocarcinoma was not adequately treated with this method alone.
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PMID:Pylorectomy and gastroduodenostomy in the dog: technique and clinical results in 28 cases. 405 13

Real-time ultrasound imaging was employed at 122 operations for the complications of pancreatitis, adenocarcinoma, and islet cell tumors. Ultrasound was found to be useful in 69% of the operations for pancreatitis and 66% of the operations for tumor. Assistance was provided in diagnosis or definition of pathology. Help in diagnosis consisted in detecting conditions that were not found on preoperative testing or at exploration and excluding conditions that were suspected on the basis of previous diagnostic studies or findings at operation. Better definition of pathology was provided by precise localization of structures, assessment of their size and surrounding anatomy, and distinction of tissue features that helped to recognize their identity. Ultrasound was usually more helpful in defining pathology than in diagnosis. Ultrasound enabled early orientation to important landmarks, reduced the need for contrast x-ray studies, and yielded unique information about the etiology of abnormalities. Although ultrasound has a slow learning curve, we believe that its use during pancreatic operations can significantly aid the surgeon and we recommend its wider application in surgical practice.
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PMID:The role of imaging ultrasound during pancreatic surgery. 609 74

Ultrasound has proven invaluable in detecting and evaluating pancreatic pseudocysts, and it is now a standard test to rule out complications of pancreatitis. In reviewing the authors' experience with 122 patients treated surgically for a pancreatic pseudocyst, five patients were identified in whom an ultrasound demonstrated a pseudocyst that was associated with an unexpected cancer at the time of operation. A sixth patient, with a pseudocyst documented by ultrasound, died prior to surgery and was found at autopsy to have metastatic common bile duct carcinoma. There was little difference in presenting symptoms, age, frequency of alcoholism, or physical findings compared with patients with pseudocysts secondary to pancreatitis. In two patients, pseudocysts were found in the tail of the pancreas at operation, in addition to carcinoma. In the other three patients, no pseudocyst was found; however, a subcapsular splenic hematoma was present in one. Five patients had metastatic disease, three from pancreatic adenocarcinoma, one from islet cell carcinoma, and one from a common bile duct carcinoma. One patient with a pancreatic adenocarcinoma confined to the head underwent a Whipple procedure and has no evidence of disease 6 months later. Malignancy may cause or coexist with pancreatic pseudocysts. Ultrasound is often not helpful in distinguishing pseudocysts associated with malignancy from those associated with pancreatitis. Biopsy should be performed to rule out malignancy when operating for pancreatic pseudocysts.
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PMID:Carcinoma masquerading as a pancreatic pseudocyst on ultrasound. 620 50

Highly purified antibodies to two ubiquitous components of basement membrane, type IV collagen and laminin, were applied to both fresh-frozen and formalin-fixed tissue sections of a variety of invasive carcinomas, carcinomas in situ, and their "look-alike" benign counterparts. These included lesions of the breast (infiltrating ductal carcinoma, comedocarcinoma, and sclerosing adenosis); lesions of the skin (squamous cell carcinoma, Bowen's disease, and pseudoepitheliomatous hyperplasia); lesions of the pancreas (adenocarcinoma and pancreatitis); lesions of the prostate (adenocarcinoma and benign prostatic hyperplasia); and other epithelial lesions of the invasive, in situ, and benign category. By both immunofluorescence and immunoperoxidase techniques, benign and in situ lesions showed intact basement membranes with linear staining of type IV collagen and laminin. The majority of invasive carcinomas, in contrast, lacked immunoreactivity for both of these basement membrane components. In cases of in situ carcinoma with microinvasion, there was thinning, fragmentation, and disruption of the basement membrane in the foci of microinvasion but not elsewhere. Utilizing antibodies to type IV collagen and laminin aids in both understanding the pathophysiology of the invasive process and the recognition of its presence in tissue sections.
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PMID:Loss of basement membrane components by invasive tumors but not by their benign counterparts. 634 6

Nineteen patients with proven pancreatic disease and 50 control subjects were examined by magnetic resonance (MR) using a variety of spin echo and inversion recovery techniques. The MR results were then compared with CT scans. The normal pancreatic head, body, and tail were identified by MR in approximately 60% of patients. Pancreatic adenocarcinoma and retroperitoneal lymphoma were detected using morphologic criteria similar to those used in CT. Differentiating bowel from pancreas was difficult on MR in patients with little retroperitoneal fat, and tissue relaxation times were usually not helpful in differentiating adenocarcinoma or lymphoma from normal pancreatic tissue. However, MR intensity, T1, and T2 were useful in differentiating pancreatic islet cell tumors from normal pancreatic tissue. MR accurately identified retroperitoneal invasion, vascular involvement, and liver metastases. In pancreatitis, tissue T1 and T2 relaxation times were prolonged and complications such as ductal dilatation, pseudocyst, phlegmon, and ascites were identified. Small pancreatic calcifications were not detected by MR. Pancreatic iron overload was seen in patients with hemochromatosis. Although respiratory motion and spatial resolution are currently limiting factors, MR is a versatile and unique modality for the evaluation of pancreatic disease.
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PMID:Magnetic resonance and CT of the normal and diseased pancreas: a comparative study. 668 55

Computed tomography (CT) in the assessment of suspected pancreatic disease, although an excellent screening procedure, has certain shortcomings, such as a significant percentage of inaccurate studies, a low predictive value of the finding of a pancreatic mass, failure to detect small lesions, and inability to differentiate localized masses caused by pancreatitis from those caused by adenocarcinoma. Arteriography provides important additional information in patients with clinically suspected pancreatic lesions and positive findings on CT or other noninvasive screening studies in whom surgical resection is contemplated. This procedure helps determine the presence and resectability of adenocarcinoma and can also demonstrate lesions which may resemble pancreatic adenocarcinoma on CT but which, in reality, are nonmalignant or nonpancreatic or both. Arteriography should no longer be used as a screening procedure but should be performed whenever a potentially resectable pancreatic mass, either cystic or solid is suggested by CT.
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PMID:The changing role of pancreatic arteriography in the era of computed tomography. 738 12

Pancreatic cytomorphology based on Papanicolaou-stained smears has been studied extensively; however, studies on Diff-Quik-stained pancreatic smears are rather limited. Air-dried, Diff-Quik-stained smears lack crisp nuclear details, the cells are flattened on the slides, and the nuclei appear large and hyperchromatic. Between January 1988 and June 1992, 40 cases of intraoperative pancreatic fine needle aspirates were assessed by Diff-Quik stain. The objective of this study was to find practical clues applicable to the rapid and accurate assessment of Diff-Quik-stained pancreatic aspirates for intraoperative consultations. All cases were reviewed and correlated with histopathology. In particular, three cases that proved to be adenocarcinoma on subsequent frozen section but were not so diagnosed during intraoperative fine needle aspiration evaluation were analyzed. The nuclear sizes of small tissue fragments with overlapping nuclei, including three cases of normal pancreatic acini (mean diameter, 0.98, 1.17 and 1.04 x RBCs; coefficient of variation, 0.53, 0.83 and 0.62 x RBCs), 2 cases of islet cell tumor (mean diameter, 1.19 and 1.32 x RBCs; coefficient of variation, 1.88 and 1.4 x RBCs) and 3 cases of adenocarcinoma (mean diameter, 1.55, 1.86 and 1.72 x RBCs; coefficient of variation, 1.5, 1.7 and 1.9 x RBCs) were obtained with an image analyzer. The adjacent RBCs served as internal size controls. In Diff-Quik-stained, air-dried smears we relied on the accurate identification of pancreatic acini, which had the same size as the adjacent RBCs. Islet cell tumors had slightly larger nuclei, which were much more variable in size. The nuclei of adenocarcinoma were much larger than the surrounding RBCs and also showed marked variation in size. The composition of the pancreatic aspirate is important: ductal epithelium predominates in ductal carcinoma, and acini predominate in pancreatitis.
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PMID:Rapid assessment of Diff-Quik-stained pancreatic aspirates. A retrospective study of 40 intraoperative fine needle aspiration consultations, with measurement of nuclear size of look-alike small tissue fragments by image analysis. 750 88

Serum amylase shows the greatest increase among the various pancreatic enzymes that increase at the onset of acute pancreatitis. However, the diagnostic value of the total serum amylase activity has been questioned due to its lack of specificity. To differentiate hyperamylasemia due to pancreatic disease from that due to other causes, the activity of pancreatic amylase should be determined by using a monoclonal antibody that specifically binds to pancreatic or salivary amylase, or by electrophoresis. The most useful and accurate method for distinguishing pancreatic from salivary-type hyperamylasemia is isoamylase analysis by electrophoresis. In patients with acute pancreatitis, increase of Amylase-1 and -2 is accompanied by the appearance of Amylase-4, a minor component of the pancreatic-type isoamylases, and by disappearance of the salivary-type isoenzymes, thereby leaving a pattern of the pancreatic isoenzymes alone. This pancreatitis pattern persists for about 10 days after the onset of illness. Therefore, if such a pattern is found in a patient with clinical findings suggesting acute pancreatitis despite a normal serum amylase level, the patient can be diagnosed as having acute pancreatitis or a recent attack of the disease. However, the existence of an inherited trait of the pancreatitis pattern in some healthy individuals must be borne in mind. Patients with recurrent chronic pancreatitis also show pancreatic-type hyperamylasemia, whereas the pancreatic amylase activity decreases when pancreatic exocrine insufficiency progresses. Hyperamylasemia due to elevated salivary amylase activity is also common in patients with diabetic ketosis or malignancies such as lung cancer (adenocarcinoma). Hyperamylasemia is also found following various types of operation. In most cases, it is salivary-type hyperamylasemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Usefulness of amylase isoenzyme determination for the diagnosis of pancreatic diseases]. 754 79


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