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)

Diabetic ketoacidosis (DKA) is the commonest endocrine emergency encountered in clinical practice. Although in the last 3 decades the average worldwide immediate mortality has decreased from 10% to 5%, survival has not improved strikingly. The pathogenesis of DKA is currently attributed to a combination of two hormonal abnormalities--a relative insulin insufficiency and stress hormone excess (glucagon, catecholamines, cortisol and growth hormone). Withdrawal of exogenous insulin, pancreatic beta cell failure and insulin resistance are factors leading to relative insulin insufficiency. Factors leading to stress hormone excess include fasting, stress and dehydration. The combination of these two hormonal abnormalities leads to impaired carbohydrate utilization and ketonaemia which in turn results in metabolic acidosis with loss of water through acidotic breaths, rise in plasma lipids, hyperglycaemia and glycosuria leading to osmotic diuresis and further loss of water, excretion of partly neutralised ketoacids via the kidney with loss of cations (Na+ and K+). A net increase in protein catabolism which leads to an increased amino acid flux from muscle and an enhanced load of gluconeogenic precursor to the liver and a rise in blood pyruvate and lactate concentration. The prevention of either of these hormonal abnormalities will prevent the development of DKA. The successful outcome in the treatment of DKA is clearly related to the prompt recognition of the diagnosis and the precipitation factors, the severity of the initial metabolic derangements, the judicious use of fluid and electrolyte replacement, the choice, route and dosage of the insulin therapy and above all the close monitoring and meticulous clinical care of the patient throughout the entire course of the treatment. Current acceptable treatment of DKA include the following: adequate fluid replacement: low dose insulin therapy at frequent intervals; adequate potassium replacement from time of first insulin therapy with ECG monitoring; bicarbonate replacement if pH less than 7.1; broad spectrum antibiotics if infections is suspected and other supportive measures. The role of phosphate and magnesium replacement is still controversial. An awareness of the complications during the treatment of DKA including cerebral edema (paradoxical acidosis), altered central nervous system oxygenation, vascular thrombosis, shock, myocardial infarction, pancreatitis, infection, inhalation of vomitus , overhydration, underhydration , hypoglycaemia, hyperkalemia and hypokalemia all certainly help improve the morbidity and mortality of DKA.
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PMID:Current concepts of the pathogenesis and management of diabetic ketoacidosis (DKA). 633 Dec 71

Intrahepatic cholelithiasis is commonly associated with suppurative cholangitis and occurs equally in males and females. Patients usually present with a history of recurrent symptoms and a differential diagnosis which includes viral hepatitis, pancreatitis, myocardial infarction and perforated ulcer. Cholangiography including stereocholangiography is essential for localizing intrahepatic stones and ductal strictures. The guiding operative principle is to drain all infected bile distal to ducts obstructed with stones or stricture. This may also necessitate a bilioenterostomy with or without partial hepatic resection. Although these procedures are formidable in an acutely ill patient, a more simple but inappropriate choledocholithotomy and t-tube drainage done proximal to an obstructed intrahepatic duct will be ineffective and may result in continued sepsis and death.
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PMID:Twenty-two year experience with the diagnosis and treatment of intrahepatic calculi. 639 Jul 56

Rapid inhibition of tissue-type plasminogen activator (t-PA) in human plasma was measured by addition of 5 IU (50 ng) of purified t-PA per ml plasma and measurement of residual t-PA in the euglobulin precipitate after 5 min incubation at 37 degrees C. The recovery of both t-PA activity and t-PA related antigen in pooled plasma from healthy individuals was approximately 90 percent, indicating that one ml of pooled normal plasma inhibits less than 1 IU or 10 ng of t-PA within 5 min. Of 20 control subjects 13 had less than 1 IU inhibitor activity; 5 subjects inhibited between 1 and 3 IU of t-PA and 2 subjects inhibited around 4.5 IU. The inhibitor titer in the latter two had however decreased to 1.8 and 2.7 IU after two days. Markedly increased rapid inhibition of t-PA (greater than 4 IU per ml) was found in plasma of patients with severe liver disease (3 of 8), pancreatitis (4 of 8), malignancy (5 of 26), but only very occasionally and transiently in that of patients with myocardial infarction (5 of 28) or deep vein thrombosis (2 of 9). Increased inhibition was observed on the first day following coronary bypass (22 of 42) or open heart (16 of 27) surgery but this had disappeared in 15 of 16 patients on the fifth postoperative day. Titration of inhibitor levels revealed maximal amounts of 30 to 50 IU per ml plasma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Plasma levels of a specific inhibitor of tissue-type plasminogen activator (and urokinase) in normal and pathological conditions. 642 82

We attempted to modulate several determinants of the host immunologic profile to improve kidney transplant survival: (1) genotype matching of the cadaver donor with the recipient, (2) assessment in recipients of living related donors (LRD) for predisposition to generate suppressor cells in mixed lymphocyte culture (MLC), (3) pretransplant splenectomy and transfusions, and (4) posttransplant immunologic monitoring. Between January, 1979, and July, 1980, 48 primary renal transplants were performed and followed up between 6 and 24 months. Pretransplant splenectomy was performed, and transfusions were administered in 38 of 48 and 48 of 48 patients, respectively. Donors and recipients of 10 of 11 cadaveric transplants were genotyped and selected for one HLA haplotype identity. All 10 proved to also be one DR antigen matches. There were no cadaveric kidney losses, but one surgical antibody to T cell subtest were used to modulate rejection therapy. The LRD group (n = 37) included 13 HLA-identical, seven haploidentical low MLC reactors, and 17 haploidentical high MLC reactors. Three deaths occurred (diabetes and myocardial infarction, stroke, and pancreatitis). A three-component coculture assay was used in the LRD group before transplantation to determine the capacity to generate specific and nonspecific MLC suppressor cells. Suppressor cells were seen in 17 patients given standard immunosuppression postoperatively without rejection episodes. However, in 20 patients incapable of generating suppressor cells, seven biopsy-proved rejection episodes occurred. There were no kidney losses, with 44 of 48 surviving recipients demonstrating normal renal function.
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PMID:Kidney transplantation by use of splenectomy and transfusions, cadaver haplotype matching, suppressor cell assays, and T-cell monitoring. 645 82

beta-Galactosidase and associated activities (beta-glucosidase and beta-fucosidase) have been studied in rabbit and bovine liver and rabbit spleen. The physico-chemical (optimal pH, pI, MW) and kinetical (Km, Vmax, Ki) properties were determined for all the activities. Two enzyme forms were separated in rabbit spleen. beta-Galactosidase, beta-fucosidase and beta-glucosidase activities were catalyzed by the same enzyme in rabbit and bovine liver. The enzyme from bovine liver showed nonlinear double-reciprocal plots, suggesting a substrate-activation model, and the presence of more than one binding site in the enzyme. The enzyme activities of several glycosidases were determined in human sera fom control groups and from patients with diabetes mellitus, pancreatitis, hepatitis, cirrhosis, stomach and breast cancer, myocardial infarction and renal failure. The results show significantly different enzyme levels for several glycosidases in all the studied diseases. Experimentally-induced diabetes mellitus, alcoholism and nephrotoxicity in rats showed different glycosidase levels in several tissues, as compared with control groups.
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PMID:[Glycosidases of mammals: association of activities and changes of levels in some disorders]. 681 36

In order to further investigate hormonal changes and possible metabolic consequences in acute pancreatitis, 10 cases with a mild form of the disease was studied. The influence of tissue injury per se on the hormones in question was assessed from comparison with the hormone levels in the course of myocardial infarction (MI) in 9 cases. Insulin and glucose showed no consistent changes. Glucagon was suppressed on admission, 22 +/- 10 pg . ml-1, compared with the ultimate concentration, 40 +/- 20 pg . ml-1 (p less than 0.05), and with the initial value in MI, 74 +/- 32 pg . ml-1 (p less than 0.01). Serum calcitonin (CT) was strongly elevated initially, 348 +/- 313 pg . ml-1, compared with the ultimate level, 24 +/- 7 pg . ml-1 (p less than 0.001), and with the normal initial level in MI, 43 +/- 44 pg . ml-1 (p less than 0.01). Serum CT elevations were time-related to a slight reduction in corrected serum Ca, which might reflect a biological expression of this substance. In pancreatitis, parathyroid hormone (PTH) remained normal and unchanged throughout the study, whereas patients with MI had an increased level of this hormone on admission, 0.19 +/- 0.08 microgramEq . 1(-1), compared with the ultimate concentration, 0.09 +/- 0.03 microgram/q . 1(-1) (p less than 0.02) and with the initial concentration in pancreatitis, 0.11 +/- 0.06 microgramEq . 1(-1) (p less than 0.05). Supranormal PTH levels were found in more than half of the infarction patients on days 0 and 1.
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PMID:Characteristic changes in the concentrations of some peptide hormones, in particular those regulating serum calcium, in acute pancreatitis and myocardial infarction. 701 27

In this community hospital medical center, all patients undergoing laparoscopic cholecystectomy (LC) who had a subsequent emergency room visit or hospital admission were reviewed to define the incidence and presentation of complications after hospital discharge. This unselected population, which is isolated geographically, provides a useful approximation of mortality and morbidity after hospital discharge. Of 1231 patients, 800 (65%) had no subsequent hospitalization or emergency room visit within a 6-32-month follow-up, whereas 431 (35%) did. Fifty-six (4.6%) patients had surgical complications related to their LC. The most serious complications were myocardial infarction (n = 1, the only death), common duct stricture (n = 2), retained common duct stone (n = 2), cystic duct leak (n = 2), subhepatic fluid collection or abscess (n = 3), pancreatitis (n = 3), and pulmonary (n = 5). Abdominal pain was the most common presenting symptom (62%), and 72% (42/56) occurred within 14 days, whereas, only 4% (15/375) patients with nonsurgically related complications presented within 14 days. In this study, emergency room visits and hospitalizations after LC occurred more commonly (35%) than generally appreciated, were usually minor, and were not related to the operative procedure, but serious late surgical complications occasionally appeared weeks to months postoperatively.
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PMID:Complications of laparoscopic cholecystectomy after hospital discharge. 761 45

Anatomical variations in aortic root pathology, including combinations of dissection, aneurysmal dilatation, annuloaortic ectasia, and valve disease, defy standardized repair and mandate application of various surgical reconstructions. To examine these techniques, and their influence on morbidity and mortality, we reviewed 53 consecutive patients undergoing aortic root procedures. Thirty-two patients underwent total root reconstruction. Of these, 21 underwent Bentall procedures, 9 had a modification thereof, and 2 underwent a Cabrol reconstruction. Less extensive pathology was corrected in 21 patients with a partial root reconstruction. These included aortic valve replacement (AVR) and a separate tube graft in 14 patients, AVR and primary aortic repair +/- wrapping in 4 individuals, and AVR and patch aortic root enlargement in 3 patients. Mean age was 53.2 years (range 20 to 79). Nearly 20% had undergone previous cardiac surgery and 7.5% were emergencies. Early mortality was 4%. Complications included dysrhythmias (48%), myocardial infarction (4%), stroke (4%), pneumonia (14%), and pancreatitis (2%). There were no reoperations for bleeding. Three late complications, one pseudoaneurysm and two perivalvular leaks, were successfully repaired. Late deaths (13.7%) were caused by congestive heart failure (3), myocardial infarction (MI) (1), cancer (1), stroke (1), and accidental fall (1). Kaplan-Meier analysis reveals 1-, 5-, and 10-year survivals of 98%, 81%, and 66%. Survival and mortality data did not differ between groups, and except for the incidence of atrial dysrhythmias, complication rates also were not significantly different. This series illustrates the need for and the successful application of a selective approach to aortic root reconstruction.
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PMID:Selectivity in aortic root reconstruction. 799 93

One hundred and fourteen consecutive patients with unresectable hepatocellular carcinoma were treated by chemoembolization using ethiodized oil (Lipiodol), anticancer agents. Ninety patients had concomitant chronic liver disease. Hepatocellular carcinoma (HCC) was diagnosed by US, contrast enhanced CT, fine needle biopsy and alpha-feto-protein level. Admission criteria were as follows: tumor confined to the liver with or without hilar nodal involvement, Child class A or B, white blood cell count above 2.000/mmc and platelet count above 75,000/mmc. All the patients underwent angiographic chemoembolization with Lipiodol and anticancer agents. In 98 patients we performed transcatheter hepatic arterial embolization (TAE) with Gelfoam or for Ivalon sponge. In 16 patients TAE was not performed because of portal thrombosis (7 cases) or technical reasons (9 cases). Mitomycin was used in 40 patients and dihydroxyanthracenedione (DADH) in 58 patients. In the TAE group 83 patients were Child A and 15 Child B. In 27 patients HCC was mononodular whereas in 71 it was multinodular. In 41 patients the tumor was more than 5 cm in diameter (in multinodular tumors only the larger lesion was taken into account). In 56 patients chemoembolization plus TAE was repeated. Seven patients died within one month after treatment: two from myocardial infarction, two from liver failure, two from digestive haemorrhage and one from necrotizing pancreatitis. Long-term survival rates were investigated in relation to prognostic factors: anti-cancer agent, number of nodes, tumor size and Child stage using Kaplan-Meier method. Survival rate at 12, 24 and 36 months are 64%, 38%, and 30% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The treatment of hepatocellular carcinoma by chemoembolization]. 802 66

The authors observed 32448 cases of alimentary toxoinfection (AT), 96.8% of which were females. Acute surgical abdominal conditions arose in 3.6% of them: appendicitis, cholecystitis, pancreatitis. Aggravation of chronic diseases occurred in 11.6% of the patients, hypertension and cholelithiasis being most frequent. 119 patients developed myocardial infarction, 266 hypertension crisis. The occurrence of acute and chronic diseases were analyzed in relation to common pathogenetic features, role of infection, intoxication, microcirculatory disturbances and hemostatic impairment. AT are suggested as risk factors of certain diseases likely to deteriorate prognosis.
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PMID:[Food poisonings as a risk factor for the development of acute and the exacerbation of chronic diseases]. 803 5


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