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

The authors report 3 cases and report the diagnostic usefulness of two signs of minor cholestasis described by one of them in 1966. A relative increase, in the absence of obvious virus hepatitis or cirrhosis, of the serum bilirubin, cholesterol, lipids and alkaline phosphatase, together with B.S.P. excretion. suggest minor cholestasis. The sign of "metacritical aggravation" when there is some suspicion of minor cholestasis, the supervision of the course of the disease, or a retrospective inquiry, permit, in the presence of minor symptoms, such as, pain, fever, jaundice, or pruritus, one to make the diagnosis of minor cholestasis. The latter is due either to the presence of small gall stones in the common bile duct, or to inflammation of the ampulla of Vater, or sphincter of Oddi, a Vaterian ampulloma, pancreatitis, or following damage to the common bile duct. In practice, liver biopsy confirms the diagnosis, and intravenous cholangiography, by the perfusion method, is usually able to demonstrate obstruction of the common bile duct.
 ...
PMID:[Relative increase and metacritic aggravation in the diagnosis of anicteric cholestasis]. 16 83

At first the review deals with significance of the apoproteins for the metabolism of the lipoproteins, especially VLDL. Thus, for instance the apo-C is a cofactor for the lipase of the fatty tissue which hydrolyses the chylomicron-TG. The author enters examples of the secondary hyperlipoproteinaemias: hyperlipoproteinaemias in diseases of the liver and of the kidneys, in pancreatitis and in diabetes. In cholestasis an abnormal lipoprotein called LP-X is observed, in other diseases of the liver the beta2LP corresponding to the VLDL-intermediate. Causes for increases of lipoproteins in renal diseases are probably disturbances of the protein metabolism. There are close correlations between hyperlipoproteinaemias and pancreatitis. In diabetes primary hyperlipoproteinaemias in maturity-onset-diabetes are to be differed from clearly secondary ones in juvenile-onset-diabetes as well as such ones in nephropathy. The therapy of the secondary hyperlipoproteinaemias is shortly discussed.
 ...
PMID:[Secondary hyperlipoproteinemias]. 19 82

Activities of organelle specific enzymes (succinate dehydrogenase, glucose-6-phosphatase, acidic DNAase, acidic RNAase, acidic and alkaline phosphatases) were measured in homogenates and subcellular fractions of liver tissue of patients with cholelithic disease. Liver tissue samples analyzed were investigated also by light and electron microscopy. The data obtained were considered in connection with localization of cholelith in biliary system, type of inflammation, presence of subhepatic cholestasis and of accompanying syndrome of pancreatitis. Typical alterations were observed in the activity of organelle specific enzymes and in the ultrastructure of mitochindria, lysosomes and endoplasmic reticulum in cholelithic disease. The most distinct alterations in the enzymatic activities were found in choledocholithiasis as well as in subhepatic jaundice.
 ...
PMID:[Changes in organelle-specific enzyme activity and the ultrastructure of liver cells in cholelithiasis]. 19 99

The enzyme gamma-glutamyl transpeptidase is widely distributed throughout the body, notably kidney, seminal vesicles, pancreas, liver, spleen and brain. Being one of the enzymes of the gamma-glutamyl cycle, it is involved in aminoacid transport, catalysing a transpeptidation reaction between gamma-glutamyl peptides and most common amino acids. Methods of assay of the enzyme are based on its ability also to act on synthetic amides of glutamic acid; kinetic methods monitoring the release of p-nitroaniline from the substrate L-gamma-glutamyl p-nitroanilide are the most satisfactory. In diseases of the liver, the highest levels occur in association with cirrhosis, alcoholism, hepatic secondaries and cholestasis. As the enzyme is present in the endoplasmic reticulum of the hepatocyte, its activity is increased in situations leading to microsomal enzyme induction. Raised levels can also occur in pancreatitis, diabetes, myocardial infarction, congestive cardiac failure, chronic renal failure, cerebrovascular accidents, cerebral tumours and chronic obstructive pulmonary disease. Although the lack of specificity must be recognised, the estimation can be useful in the elucidation of some clearly defined problems arising during investigation of patients with suspected hepatic disease, especially where performed as part of a biochemical profile.
 ...
PMID:Role of gamma-glutamyl transpeptidase activity in the diagnosis of hepatobiliary disease. 24 76

Fine-needle cholangiography (FNC) in the jaundiced patient is well established, but its role in the diagnostic work-up of nonjaundiced patients has not been emphasized. We present 44 consecutive nonjaundiced patients with a serum bilirubin level of 2.4 mg% of less who underwent FNC. The indications were recurrent RUQ pain (77%), painless cholestasis (16%), and relapsing pancreatitis (7%). In all but two patients, one or more inconclusive techniques [oral cholecystography, ultrasonography, intravenous cholangiography, or endoscopic retrograde cholangiography (ERC)] had been employed prior to FNC. Biliary tract opacification was successful in 35 of 44 (80%). In nine of 35 (26%) choledocholithiasis and/or cholelithiasis was present. In four (11%) a significant extrahepatic biliary stricture was noted. More than five needle insertions were often required for successful entry. No complications occurred. Indications for FNC should be extended to include nonjaundiced patients with RUQ pain or painless cholestasis in whom oral cholecystography, ultrasonography, and intravenous cholangiography have been of no diagnostic help. The relative ease and low cost of FNC make it preferable to ERC in these patients.
 ...
PMID:Fine-needle cholangiography (FNC) in the nonjaundiced patient. 26 37

A series of 62 patients referred for endoscopic retrograde cholangiopancreatography is reported. The pancreatic or biliary ductular systems were demonstrated in 42, the success rate of cannulation improving with experience. The technique was diagnostic in 25 of 31 patients referred with hepatobiliary problems and in 3 of 11 with suspected pancreatic pathology. In a further seven patients in this latter group the examination was helpful in management. Duodenoscopy, without duct cannulation, demonstrated carcinoma of the periampullary region in two patients. Pancreatitis occurred in two patients and cholangitis in one. There are few contra-indications to the examination which should be undertaken early in the investigation of patients with cholestasis.
 ...
PMID:Initial experience with endoscopic retrograde cholangiopancreatography: the role in clinical practice. 27 98

Endoscopic papillotomy would appear to have distinct advantages in non-operative treatment of common bile duct stones. To investigate the effects of this procedure on the papilla and adjacent organs, diathermy papillotomy was performed at laparotomy in three monkeys. White-cell count and levels of liver function parameters temporarily increased during the follow-up period of twelve months, suggesting that diathermy papillotomy might have brought about some pathological changes in the hepatobiliary system of monkeys, whereas no definite evidence of cholestasis or pancreatitis were noticed, and an excellent condition of papillotomy orifice and adjacent ogans was revealed at autopsy about 1 year after diathermy papillotomy.
 ...
PMID:An experimental study on endoscopic papillotomy in monkeys. 41 Jun 39

Endoscopic papillotomy was performed in 50 of 53 patients, 31 females, with an age range of 29 to 87 years, a mean of 63.1. The indications for the procedure included retained or recurrent choledocholithiasis, primary choledocholithiasis and papillary stenosis, which were responsible for persistent or intermittent cholestasis. The procedure was successful in all but three patients in whom the primary diagnosis was papillary stenosis. The major complications were bleeding in three patients, pancreatitis in one patient and an infected pseudocyst in one patient. Surgical intervention was not required, and there were no deaths. Endoscopic papillotomy has proved to be safe, producing a permanent biliary enteric fistula, thus reducing the probability of formation of recurrent stones. It has been shown to reduce hospitalization and convalescence, permitting an earlier return to normal activity.
 ...
PMID:Endoscopic management of choledocholithiasis and papillary stenosis. 43 89

The chronic pancreatitis population of Wadsworth VA Hospital over the past five years was screened for two-fold or greater alkaline phosphatase elevation at any time during their course, as a marker for either distal common bile duct stenosis or other hepatobiliary disease. Forty-seven of 207 patients screened met this criterion and are reviewed in detail. Of the 16 patients with persistent alkaline phosphatase elevation (group B), 15 had proven common bile duct stenosis, demonstrating a clear pathophysiologic role of partial bile duct obstruction in their liver disease. Three had developed secondary biliary cirrhosis, marking this entity the commonest cause of secondary biliary cirrhosis at our hospital. Of the remaining 31 patients with transient alkaline phosphatase elevation (group A), only 4 had proven duct abnormalities which may resolve during recovery. Alcoholic liver disease was demonstrated with normal extrahepatic ducts in the remainder in group A adequately studies. Persistent greater than two-fold alkaline phosphatase elevation in pancreatitis thus represents a reliable marker of distal common bile duct stenosis, whose sequelae may include cholangitis and secondary biliary cirrhosis and which requires operative intervention in these cases. When a persistent alkaline phosphatase elevation greater than two-fold is encountered in a chronic pancreatitis patient, adequate cholangiography and liver histology are both necessary to confirm and grade this frequent and treatable complication.
 ...
PMID:Common bile duct stenosis from chronic pancreatitis: a clinical and pathologic spectrum. 51 65

Important experiences are reported from an analysis of 500 examinations. The ERCP gives eminent possibilities for the improvement of the pre- and postoperative diagnostics of the bile ducts, particularly in unclear cholestasis and in conditions after operations of the bile ducts. The ERCP is little suited for the early diagnosis of the carcinoma of the pancreas and for the ascertainment of the diagnosis in easy and moderate forms of chronic pancreatitis. Of particular value is the possibility to clear the causes of recidivations of pancreatitis as well as of complications of the severe chronic pancreatitis with regard to operative consequences.
 ...
PMID:[Possibilities and limitations of endoscopic retrograde cholangiopancreaticography (ERCP)]. 51 32


1 2 3 4 5 6 7 8 9 10 Next >>