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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The amylase/creatinine clearance ratio (Cam/Ccr ratio) was determined in 239 subjects. In 87 hospitalised patients without pancreatic disease (controls) the Cam/Ccr ratio was 3.02 +/- 0.69 (mean +/- ISD). The ratio was above the normal range in all patients with acute pancreatitis but was normal in those with chronic pancreatitis and carcinoma of the pancreas. In 18 patients with choledocholithiasis a raised ratio distinguished those with pancreatitis as assessed independently by the surgeon at laparotomy from those with a macroscopically normal pancreas. Raised Cam/Ccr ratios were also found in diabetics with ketoacidosis and in three patients with fulminant alcoholic liver disease. Though a positive correlation was found between the Cam/Ccr ratio and serum creatinine concentration, abnormally high ratios did not occur in 30 patients with chronic renal failure. A significant increase in Cam/Ccr ratios was produced in six healthy volunteers by intravenous injection of glucagon. However, it is unlikely that hyperglucagonaemia alone accounts for the increased Cam/Ccr ratio seen in acute pancreatitis, as no correlation was found between the clearance ratio and the plasma glucagon concentration in a series of patients. In two other patients in whom excess circulating pancreatic polypeptide was detected the Cam/Ccr ratio was normal. It is concluded that, in view of the sensitivity and relative specificity of finding an increased Cam/Ccr ratio in acute pancreatitis, its determination should be valuable clinically, especially in those cases of hyperamylasaemia where the cause is in doubt. The mechanism whereby the ratio is increased is unknown, and it is unlikely that either glucagon or pancreatic polypeptide is a major factor in its production.
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PMID:Mechanism and specificity of increased amylase/creatinine clearance ratio in pancreatitis. 60 90

The association of bone lesions, polyarthritis and cutaneous nodules with pancreatic disease is being recognized and reported more frequently. In adults all forms of pancreatitis and carcinoma of the pancreas have been involved, but in the few children described these complications have been associated with acute traumatic pancreatitis. This paper describes two cases of acute traumatic pancreatitis in which polyarthritis and limb pains were noted after 2 to 3 weeks. In one child osteolytic lesions and periostitis were seen on roentgenograms 7 weeks after the onset of pancreatitis. In the other child minor roentgenographic changes were not seen until 5 months after the onset; however, bone scans showed clear-cut abnormalities after 1 month. Almost complete resolution could be expected within a year. Serum lipase and amylase concentrations remained elevated during the acute illness. Disseminated fat necrosis is apparently related to the excess amounts of circulating lipase.
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PMID:Polyarthritis and bone lesions complicating traumatic pancreatitis in two children. 64 64

After a short description of the physical principles of ultrasound, the indications and usefulness of the real time B-scan technique in the non-invasive diagnosis of cardiac and abdominal diseases are discussed. A correct diagnosis was made in 90% of the cardiac cases (valve abnormalities, pericardial effusion, cardiac aneurysm, cardiomyopathy), whereas the diagnosis by ultrasound was correct in only 81.1% of the abdominal cases (diffuse and localized liver diseases, pancreatitis, pancreatic cyst, carcinoma of the pancreas, cholelithiasis, renal cyst, renal tumours, aortic aneurysm). The advantages of the real time B-scan technique lie in the two-dimenstional clear representation of intracardiac and intraabdominal structures with the possibility of undertaking quantitative measurements. Furthermore, it is a non-invasive and safe method, which can be repeated as often as necessary and can complete the diagnositic spectrum of radiology, endoscopy and nuclear medicine.
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PMID:[Ultrasonic diagnosis of cardiac and abdominal diseases using real time b-scan technique (author's transl)]. 65 98

A simple method of percutaneous fine needle aspiration biopsy of malignant lesions in and around the pancreas following radiological localization is described. Biopsy was performed in 28 patients. Twenty-three were eventually considered to have malignant disease and biopsy was positive in 19 of these (83%), including 16 of 18 patients with carcinoma of the pancreas (89%). One patient developed an exacerbation of pancreatitis following the procedure. Surgery became unnecessary in 5 of the 18 patients with positive biopsies. From these results and from a review of the literature on percutaneous fine needle aspiration biopsy, we believe that this is a simple, relatively painless, reasonably safe and reliable method of obtaining a preoperative diagnosis and advocate the procedure as desirable in all patients in whom malignant disease is suspected and can be localized radiologically.
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PMID:Fine needle aspiration biopsy of malignant lesions in and around the pancreas. 65 5

Indications for endoscopic retrograde cholangiography (ERCP) have been poorly defined. We studied the symptoms in 161 patients who underwent ERCP and evaluated the results from four groups of indications: cholestasis, pancreatitis, suspected carcinoma of the pancreas, and pain of unknown etiology. The likelihood of finding abnormalities is discussed.
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PMID:Endoscopic retrograde cholangiopancreatography. A review of the rewards and indications. 70 Mar 14

The extensive experience of the authors in endoscopic retorgrade pancreaticography is correlated with data in the literature to illustrate the spectrum of characteristic changes and diagnostic accuracy in several entities. These include chronic pancreatitis, calculous pancreatitis, necrotizing lesions and pseudocysts, carcinoma of the pancreas, and papillary stenosis, spasm, and carcinoma.
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PMID:Endoscopic retrograde pancreaticocholangiography in chronic diseases of the pancreas and in papillary stenoses. 70 Mar 15

Comparative studies between activity of serumlipase, lipaseevocationstest and endoscopic retrograde cholangiopancreaticography (ERCP) in 45 patients with chronic pancreatitis, pancreatic cysts or pancreatic carcinoma confirm, that elevated enzyme values after caerulein stimulation indicate an alteration of the pancreatic parenchyma. However, this findings does not give information on the etiology of the damage. On the basis of the presented results it seems that the lipase-evocationstest has only limited value as screening method within the total of clinical methods for the assessment of light and medium severe stages of chronic pancreatitis and accompanying forms of pancreatitis. There is no evidence that this method may be used for screening for carcinoma of the pancreas. A positive result gives a valuable information, but the lack of an increase of lipase activity does not exclude the existence of pancreatic affection. In each case with clinical suspicion for pancreatic disease further diagnostic investigation by the ERCP and additional radiographic methods should be performed.
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PMID:[The importance of the serumlipaseevocationtest and the retrograde pancreaticography for the diagnosis of chronic pancreatic affections (author's transl)]. 84 Jan 29

Carcinoembryonic antigen (CEA) activity was assayed in plasma and in pure pancreatic juice from eight patients with carcinoma of the pancreas, 28 patients with pancreatitis, and 13 controls with no demonstrable pancreatic disease. Juice specimens were obtained via direct transduodenal cannulation of the pancreatic duct. The mean pancreatic juice CEA activities in controls, pancreatitis, and pancreatic carcinoma were 8.1 ng/ml, 18.6 ng/ml, and 309 ng/ml, respectively. Pancreatic juice CEA activity in patients with cancer of that organ was significantly higher than in those with pancreatitis or in controls. None of the 32 subjects with both pancreatic juice CEA activity less than 30 ng/ml and plasma CEA less than 2.5 ng/ml had pancreatic cancer. Three of the four patients with CEA elevations in both fluids above these levels harbored this malignancy. These findings suggest that combined measurement of CEA activity in plasma and pancreatic juice may help in diagnosing pancreatic disease.
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PMID:Carcinoembryonic antigen (CEA) activity in pancreatic juice of patients with pancreatic carcinoma and pancreatitis. 100 Apr 75

Serum RNase (ribonuclease) of normal persons and of patients with pancreatitis, carcinoma of pancreas, or other neoplasms was determined with poly(C) as substrate. Strikingly abnormal elevations occur in the serum RNase of patients with pancreatic cancer. There is no elevation in the serum RNase level of patients with pancreatitis. Average serum RNase values of 52 normal persons, 10 patients with pancreatitis, 30 patients with pancreatic cancer, 28 patients with breast cancer, 11 patients with lung cancer, 20 patients with colon cancer, six patients with stomach cancer, and four patients with liver cancer, respectively, were 104, 120, 383, 131, 173, 197, 194, and 152 units/ml of serum. Ninety percent of the patients with pancreatic cancer were above the level of 250 units of serum and 90% of all patients with varied cancers were below this level. In the presence of severe renal insufficiency, marked elevation of serum RNase was also observed. Serum RNase, because of its unique specificity, pancreatic origin, and its abnormal elevation in sera of patients with pancreatic cancer, serves as a reliable biochemical marker of carcinoma of the pancreas in the presence of normal renal function.
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PMID:Elevated serum ribonuclease in patients with pancreatic cancer. 106 80

The epidemiological patterns for pancreatic and biliary cancers reveal more differences than similarities. Pancreatic carcinoma is common in western countries, although 2 Polynesian groups (New Zealand Maoris and native Hawaiians) have the highest rates internationally. In the United States the disease is rising in frequency, predominating in males and in blacks. The rates are elevated in urban areas, but geographic analysis uncovered no clustering of contiguous counties except in southern Louisiana. The origin of pancreatic cancer is obsure, but a twofold increased risk has been documented for cigarette smokers and diabetic patients. Alcohol, occupational agents, and dietary fat have been suspected, but not proven to be risk factors. Except for the rare hereditary form of pancreatitis, there are few clues to genetic predisposition. In contrast, the reported incidence of biliary tract cancer is highest in Latin American populations and American Indians. The tumor predominates in females around the world, except for Chinese and Japanese who show a male excess. In the United States the rates are higher in whites than blacks, and clusters of high-risk counties have been found in the north central region, the southwest, and Appalachia. The distribution of biliary tumors parallels that of cholesterol gallstones, the major risk factor for biliary cancer. Insights into biliary carcinogenesis depend upon clarification of lithogenic influences, such as pregnancy, obesity, and hyperlipoproteinemia, exogenous estrogens, familial tendencies, and ethnic-geographic factors that may reflect dietary habits. Noncalculous risk factors for biliary cancer include ulcerative colitis, clonorchiasis, Gardner's syndrome, and probably certain industrial exposures. Within the biliary tract, tumors of the gallbladder and bile duct show epidemiological distinctions. In contrast to gallbladder cancer, bile duct neoplasms predominate in males; they are less often associated with stones and more often with other risk factors. In some respects, bile duct and pancreatic tumors are alike. The male predominance of both tumors, an association between cholecystectomy and pancreatic cancer, and other considerations have prompted the notion that the same biliary carcinogens may affect the bile duct, ampulla of Vater, or, by reflux, the pancreatic duct. Various epidemiological and interdisciplinary approaches are needed to further clarify the origins of biliary tract and pancreatic cancers, but nutritional studies hold special promise in laying the groundwork for prevention of these tumors.
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PMID:Cancers of the pancreas and biliary tract: epidemiological considerations. 110 53


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