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

A case report is presented of a patient with acute postoperative pancreatitis who developed a pancreatic abscess secondary to Candida albicans. Recovery followed operative drainage and amphotericin B therapy. Because this is the only such patient in the author's career experience, and because only one other report currently addresses the problem, this report is offered.
Pancreas 1989
PMID:Pancreatic abscess secondary to Candida albicans. 271 1

Urinary and serum zinc levels were determined in 51 patients with chronic pancreatitis. Urinary zinc excretion in patients with chronic calcified pancreatitis (832 +/- 111 micrograms/day) (mean +/- SE) but not in noncalcified pancreatitis (684 +/- 65 micrograms/day) was significantly higher than in normal controls (418 +/- 46 micrograms/day). The urinary zinc excretion increased with deterioration of exocrine pancreatic function. Serum zinc levels in advanced pancreatitis (105.9 +/- 4.5 micrograms/100 ml) were significantly higher when compared to the pancreatitis with normal exocrine pancreatic function (91.6 +/- 3.0 micrograms/100 ml), but the difference was less pronounced than for urinary zinc excretion. This may be due to complicating diabetes, which usually lowers serum zinc. Serum zinc and urinary zinc excretion were low in a patient with chronic calcified pancreatitis complicated with a pulmonary abscess and hypoalbuminemia. In conclusion, urinary and serum zinc levels in chronic pancreatitis were increased as a result of exocrine pancreatic dysfunction. Association of diabetes may lower serum zinc, and associated malnutrition depresses both urinary and serum zinc levels.
Pancreas 1989
PMID:Urinary and serum zinc levels in chronic pancreatitis. 271 4

Supramaximal stimulation of the rat pancreas in vivo with caerulein elicits a sharp decline in pancreatic juice volume and protein outputs and initiates acute edematous pancreatitis within 30 min. Because of the similar effects of caerulein and bombesin on pancreatic exocrine function, we examined in unconscious rats (a) the effects of a continuous, 4-h intravenous infusion of varying doses (0.2-40.0 nmol/kg/h) of bombesin on pancreatic juice volume and protein output, and (b) whether supramaximal doses of bombesin produce acute edematous pancreatitis. A maximal, fivefold and 17-fold rise in pancreatic juice volume and protein output was achieved with intravenous doses of 1.0 and 4.0 nmol of bombesin/kg/h, respectively. Pancreas weights in rats infused with bombesin as high as 40.0 nmol/kg/h were not significantly different from control animal values (no bombesin infusion) and serum amylase concentrations were only moderately (twofold) elevated over control values in rats i.v. infused with 4.0-40.0 nmol of bombesin/kg/h. The pancreas in rats treated with the highest dose of bombesin (40.0 nmol/kg/h) revealed sparsely scattered microvacuoles in a few acinar cells and minor evidence of interacinar edema. It is concluded that supramaximal stimulation of the rat pancreas in vivo with bombesin fails to elicit acute edematous pancreatitis and appears to be related to the ability of bombesin, in contrast to supramaximal doses of caerulein, to continuously stimulate maximal pancreatic juice secretion.
Pancreas 1989
PMID:Pancreatic exocrine function in unconscious rats treated with submaximal, maximal, and supramaximal doses of bombesin tetradecapeptide. 271 5

Pancreas specimens from 76 autopsies were examined histologically to evaluate the degree and extent of interstitial fibrosis (IF) and its clinicopathologic relationships. Fifty-two cases (68%) showed IF, a fairly high prevalence, that was not statistically related to age. There was a significantly higher prevalence of IF in patients with diabetes mellitus, most of whom had type 2 diabetes. No statistically significant relationships between IF and the cause of death or other clinical conditions were found. Acinar atrophy, periductal fibrosis, and nonpapillary ductal hyperplasia were often associated with IF. All cases with periductal fibrosis (PF) also showed IF, so PF may be a part of this process. Eight cases (11%) of chronic terminal pancreatitis were noted, which is defined as a lesion of moderate to severe chronic inflammation and various degree of IF in cases without any clinical evidence of pancreatic disease before death.
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PMID:Interstitial fibrosis in the pancreas. 271 53

We examined the ability of a highly potent synthetic protease inhibitor, nafamostat mesilate (FUT-175), to protect the rat pancrease against AP induced by a supramaximal dose of caerulein (CR). Rats received a 6-h, continuous intravenous (iv) infusion of either CR alone or CR + a 6-h infusion of either 2.5, 5.0, 10.0, 25.0, or 50.0 mg of FUT-175/kg/h. Pancreas weights and serum chymotrypsinogen concentrations were significantly elevated by approximately 85 and 75%, respectively, over values in saline infused rats. Pancreas weights in rats treated with CR + FUT-175 at doses from 2.5-25.0 mg/kg/h were significantly reduced by approximately 20% compared to rats given CR along, and histology showed a reduction in the extent and size of acinar cell vacuolization and reduced interstitial edema compared to rats treated with CR alone. Serum chymotrypsinogen concentrations in rats treated with CR and either 5.0 or 10.0 mg of FUT-175/kg/h were significantly lower than in rats given CR alone. Significant mortality occurred in rats infused with FUT-175 at doses of either 25.0 or 50.0 mg of FUT-175/kg/h. These data indicate that serine proteases appear to be involved in the pathogenesis of CR induced AP in rats and that FUT-175 administered in low doses (2.5-10.0 mg/kg/h) provides significant protection against this form of pancreatitis.
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PMID:The effects of nafamostat mesilate (FUT-175) on caerulein-induced acute pancreatitis in the rat. 273 29

Acute terminal pancreatitis (ATP) was defined as a postmortem entity of localized acute pancreatitis without any clinical evidence of pancreatic disease. Based on the deliberate examinations of pancreatic tissue from 76 autopsies, we found 10 cases (13%) that met the criteria of ATP. Shock as an immediate cause of death was a statistically significant factor in our cases of ATP. There were two pathological types of ATP, one periductal and the other perilobular. These two types of ATP implied that there would be at least two different mechanisms for the development of acute pancreatitis: pancreatic duct and periduct damage, and acinar cell injury at the periphery of lobules.
Pancreas 1989
PMID:Acute terminal pancreatitis. 273 81

Pancreas divisum (PD) is a congenital anomaly present in 6-10% of the population. Computed tomography (CT) examinations in eight of 15 patients (53%) with endoscopic retrograde pancreatography (ERCP)-proven PD were interpreted as showing enlargement of the pancreatic head. Two of these had carcinoma, three had pancreatitis limited to the ventral pancreas, and three were normal. Criteria to distinguish nonpathologic enlargement of the pancreatic head due to PD alone from pathologic causes may include homogeneous parenchyma and an absence of other abnormal signs on CT. Because PD may simulate a pancreatic head mass, the radiologist should be familiar with this variant, and ERCP should precede biopsy unless other evidence of malignancy is present.
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PMID:Enlargement of the pancreatic head in patients with pancreas divisum. 274 93

The regeneration of the rat exocrine pancreas from a hormone-induced pancreatitis was investigated. In a previous study it was shown that the [3H]thymidine labeling index of interstitial cells increases 20- to 30-fold on day 1.5 after the induction of pancreatitis. Here we show by electron microscopic autoradiography that 80% of the labeled interstitial cells are fibroblasts. Their replication, fine structure, and collagen biosynthesis was further investigated: By day 2.5 numerous mitotic figures were found, indicating an enhanced proliferative activity of fibroblasts at the early stage of pancreatic regeneration. The ultrastructural analysis revealed that many fibroblasts contain abundant cytoplasm with a well-developed rough endoplasmic reticulum, prominent Golgi complexes, and secretory granules filled with fibrillar material. In contrast, the pancreatic fibroblasts of saline-infused control animals were shown to be spindle-shaped and to contain only very little cytoplasmic organelles. The collagen biosynthesis was quantified by in vivo labeling with [3H]proline and quantification of [3H]hydroxyproline in pancreatic protein hydrolysates. The collagen biosynthesis of experimental pancreata was measured to be 15 times that of controls on days 1.5 and 2.5 after the induction of pancreatitis and to remain fourfold elevated on days 3.5 through 10.5. In pulse-chase experiments using [3H]proline as the labeled precursor for collagen, the newly synthesized collagen was shown to be degraded with a half-life of 35 h. We conclude that replication of pancreatic fibroblasts and collagen biosynthesis as well as collagen degradation play important roles in the early phase of pancreatic regeneration.
Pancreas 1989
PMID:Fibroblast structure and function during regeneration from hormone-induced acute pancreatitis in the rat. 275 41

The influences of combined adrenalectomy and castration and of a replacement therapy with estradiol and glucocorticoids were examined in the rat pancreas. At the light microscope level, the surgical treatment changed the overall shape of the acini and caused widening of intralobular and interlobular spaces as well as partial depletion of zymogen granules. A significant reduction of the acinar lumen size was observed in castrated-adrenalectomized (CasX-AdreX) animals. This could be reversed by a replacement therapy with glucocorticoids. Moreover, triamcinolone even caused a significant lumen enlargement as compared to sham-operated animals. Such an enlargement was not observed with dexamethasone. Both these glucocorticoids caused an increase in zymogen granule content of the acinar cell. At the ultrastructural level, hitherto undescribed type of precipitates was observed in the acinar lumen of CasX-AdreX rats. Precipitates that exhibited a laminated aspect were identified as luminal laminated bodies. The latter could have some interest from the etiological point of view of certain pancreatic diseases, such as cystic fibrosis and pancreatitis. Replacement therapy with estradiol did not affect the frequency of these precipitates, but glucocorticoid had a significantly inhibitory effect. From our observation, it is clear that some steroid exert a profound influence on the acinar cell and that a replacement therapy with glucocorticoids or estradiol do not totally restore the normal aspect of the pancreas acinar tissue. It suggests that some unknown factors from adrenals or testis are still required in addition to glucocorticoids and estrogens for the maintenance of the structural integrity of the gland.
Pancreas 1989
PMID:Influence of steroids on the exocrine pancreas: presence of laminated bodies in the acinar lumen following castration and adrenalectomy. 275 43

Pancreatitis may be associated with thoracic complications, notably chronic massive pleural effusion (CMPE) and, rarely, pseudocysts with mediastinal extension (PME) and enzymatic mediastinitis (EM). Our personal experience with 14 cases of thoracic complications (nine CMPE, two PME associated with pleural effusion, and three EM of 670 patients who underwent surgery; of these, 191 had acute and 479 had chronic pancreatitis) during 16 years (1970-1986) is reported. In the patients with CMPE, the initial symptoms were progressive dyspnea eventually associated with cough and chest pain. In the PME cases, there was dysphagia associated with left subscapular pain and left chest pain. The initial signs in the patients with EM were sudden dyspnea, cyanosis, retrosternal pain, tachycardia, and acute heart failure. A fistula between the pancreatic ductal system and the pleural cavity in seven of the nine patients with CMPE was demonstrated by intraoperative pancreatography and/or cystography. On the contrary, preoperative endoscopic pancreatography demonstrated the sinus tract in only three of the seven. In both cases of PME, computed tomography (CT) provided a correct diagnosis that was confirmed at surgery. In the patients with EM, the diagnosis was suggested by the clinical appearance and was confirmed by the chest roentgenogram and by CT. All patients had operations after varying periods of unsuccessful 2-4-week-long conservative treatment. One patient with infected ascites died postoperatively. There were no thoracic recurrences of pancreatic disease among the other patients at a 10-month-10-year follow-up observation after surgery.
Pancreas 1989
PMID:Thoracic complications of pancreatitis. 275 44


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