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)

Thyrotropin-releasing hormone (TRH) has been shown to be present and have actions in the human gastrointestinal tract. We have studied urine TRH immunoreactivity (TRH-ir) levels in healthy subjects and patients with acute pancreatitis, gallstones, ulcerative colitis, or acute gastritis. The urine samples were prepurified by SP-Sephadex-C-25 cation exchange chromatography, subjected to reverse-phase high-pressure liquid chromatography, and assayed in our TRH radioimmunoassay. The mean urine TRH immunoreactivity values of healthy subjects were 4.42 +/- 1 ng/l (x +/- SEM); of patients with acute pancreatitis on the 1st day of hospitalization, 23 +/- 7 ng/l; on the 2nd day, 7 +/- 1 ng/l; and on the 3rd day 9 +/- 2 ng/l. Only the urine TRH levels of the pancreatitis patients on day 1 differed significantly (p less than 0.05) from the levels of the healthy subjects. Circulating TRH appears to be derived mostly from the pancreas, where the islets during acute pancreatitis are affected, and TRH is released into circulation and urine.
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PMID:Increased urinary levels of thyrotropin-releasing hormone immunoreactivity in acute pancreatitis. 241 Sep 74

To determine the effects of a distal splenic arteriovenous fistula on endocrine function and pancreatic blood flow, 25 dogs underwent proximal pancreatectomy with the pancreatic tail left in situ and free intraperitoneal drainage of the pancreatic duct. Group A served as controls. In groups B through E, ligation of all nonpancreatic splenic vessels was accomplished. In group B, no further manipulations were performed. In group C, an arteriovenous fistula was created. Groups D and E were identical to groups B and C, respectively, except for the induction of bile pancreatitis. During intravenous glucose tolerance testing, the mean (+/- SEM) basal-to-peak insulin difference was 10.1 +/- 3.5 microU/mL in group A, 16.3 +/- 3.6 microU/mL in group B, 14.8 +/- 5.1 microU/mL in group C, 16.4 +/- 3.1 microU/mL in group D, and 13.0 +/- 4.4 microU/mL in group E. Corresponding mean (+/- SEM) glucose clearance values were as follows: -0.907% +/- 0.24%/min, -0.867% +/- 0.14%/min, -1.056% +/- 0.21%/min, -1.365% +/- 0.26%/min, and -0.887% +/- 0.20%/min. These values were not significantly different. Ligation of all splenic arterial and venous branches resulted in a 64.8% to 78.3% reduction in splenic artery blood flow that was restored to 60.9% to 84.9% of basal flow by an arteriovenous fistula (groups C and E). In conclusion, the creation of a splenic arteriovenous fistula was not beneficial in this model and other factors (rejection or technical) should be considered in vascular thrombosis following segmental pancreatic transplantation.
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PMID:An in situ evaluation of distal splenic arteriovenous fistula on pancreas function in an isolated pancreas segment. 241 26

Normothermic ischemia tolerance is an important aspect of organ procurement and transplantation. The function of pancreas and kidney autografts was investigated in totally pancreatectomized or nephrectomized canine recipients. In 30 dogs the left limb (tail) of the pancreas was removed but left in the abdominal cavity after cessation of blood flow to produce warm ischemia for 30, 60, and 120 min (10 dogs at each time point), and then was flushed with cold Ringers' lactate and transplanted to the iliac vessels. Twenty dogs with fresh pancreatic transplants were controls. The success rate of pancreas transplants with warm ischemia of 1/2 and 1 hr was the same as that of controls (80%); however, after 1 hr normothermia 5/10 dogs had episodes of hyperglycemia for 1 week before glucose levels came back to normal. All but one graft with 2 hr warm ischemia failed. Intravenous glucose tolerance test (IVGTT) mean (+/- SEM) K values were not different in the successful groups, i.e., no warm ischemia: -1.55 +/- 0.15%; 1/2 hr warm ischemia: -1.81 +/- 0.18%; 1 hr warm ischemia: -1.64 +/- 0.09%. Amylase levels increased after transplant with maximum values at Day 2, then returned to normal, but the levels remained elevated in recipients of grafts subjected to longer normothermia with evidence of pancreatitis after 1 hr warm ischemia. Fifteen kidney grafts were treated similarly with warm ischemia exposure of 1/2 hr (n = 9) and 1 hr (n = 6) before being flushed and autotransplanted, and were compared to 16 fresh kidney transplants. After 1/2 hr warm ischemia none of the kidney grafts failed but 78% of the recipients had elevated serum creatinine and urea nitrogen levels which returned slowly to normal after 3 to 4 weeks. There was only one long-term survivor after 1 hr warm ischemia. Thus the pancreas seems to be more resistant to warm ischemia damage than is the kidney. This difference should be taken into consideration in regard to organ procurement for clinical transplantation.
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PMID:Definition of normothermic ischemia limits for kidney and pancreas grafts. 242 97

The lack of a potent and specific cholecystokinin (CCK) receptor antagonist has greatly hampered studies of the role of CCK in controlling pancreatic growth, enzyme release, pancreatitis, and pancreatic carcinoma. Asperlicin, a newly described, CCK antagonist, has been shown to be a potent, competitive inhibitor of CCK-induced gallbladder and ileal muscle contraction. In this study, the effects of asperlicin on CCK- and carbachol-stimulated pancreatic enzyme release from dispersed guinea pig acini were investigated. Cholecystokinin caused a dose-dependent release of amylase and lipase. Half-maximal release of amylase (17.9% +/- 2.1%, mean +/- SEM, percent of total content) and lipase (27.3% +/- 2.1%) was seen with CCK 10(-11) mmol/L) both p less than 0.01). Asperlicin (10(-11) to 10(-4) mmol/L) caused a substantial inhibition (10(-11) mmol/L) of CCK-induced amylase release with a 50% maximal effective inhibitory dose of 10(-9) mmol/L (p less than 0.01) and maximum inhibition at 10(-6) mmol/L. Asperlicin was approximately 1000-fold more potent than proglumide (a previously described CCK receptor antagonist) which had a 50% effective inhibitory dose of 10(-6) mmol/L) and a maximal effect at 10(-4) mmol/L. Asperlicin (10(-10) to 10(-4) mmol/L) failed to alter carbachol-induced amylase release. Asperlicin is a new, potent CCK antagonist for pancreatic CCK receptors and should prove useful as an investigational tool. Such receptor antagonists may have therapeutic potential.
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PMID:Asperlicin: a unique nonpeptide cholecystokinin antagonist. 244 81

The effect of pancreatitis on magnetic resonance T1 and T2 relaxation times was evaluated in two different models of acute pancreatitis in the rat. Acute edematous pancreatitis was induced by repetitive intraperitoneal injections of the cholecystokinin-analogue caerulein; acute hemorrhage pancreatitis was induced by retrograde infusion of the bile salt sodium taurocholate into the pancreatic duct. T1 and T2 relaxation times were obtained in vitro from fresh pancreatic specimens at 37 degrees C with a 0.25 resistive spectrometer. In both edematous and hemorrhagic pancreatitis, significant prolongation of T1 and T2 was noted as early as 1.5 hours after the initiation of pancreatitis when compared with normal rat pancreas. Maximal prolongation occurred at 7 hours in the caerulein model with T1 of 966 +/- 46 msec (mean +/- SEM) (normal + 278 +/- 12 msec) and T2 of 75.9 +/- 2.9 msec (normal = 32.8 +/- 3.3 msec), and after 6 hours in the bile salt model with T1 of 798 +/- 40 msec and T2 of 92.5 +/- 3.3 msec. After the time point of maximal prolongation, T1 and T2 gradually decreased toward the normal values. The prolongation of T1 and T2 paralleled each other throughout the time course of pancreatitis in both models. The prolongation of both relaxation times correlated closely with pancreatic weight, water content, and amylase concentration in serum and ascites. The present determination of T1 and T2 relaxation times by in vitro spectrometry suggests that magnetic resonance imaging has the potential for detecting early pathologic changes in acute pancreatitis and thus may be helpful for an early clinical diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Experimental acute pancreatitis. In vitro magnetic resonance characteristics. 244 17

In pancreatic allograft transplantation with bladder exocrine drainage, falls in urinary amylase (UA) levels have been shown to be an earlier marker of rejection than rises in fasting blood glucose levels. Nevertheless, this is often too late for reversal of the rejection process. In an attempt to diagnose rejection earlier, fine-needle aspiration biopsy was correlated with UA and graft histology. Sixteen dogs were given total pancreatic allografts, 10 without immunosuppression and 6 with triple therapy. FNAB and needle-core biopsies were performed on days 0, 2, 4, 7, 9, 24, and 30 and/or at functional rejection, defined as a fasting UA level of less than 5000 IU/L. Cytocentrifuge preparations of the FNABs were evaluated by total corrected increment (TCI) scores. These increased significantly from 1.0 (+/- 0.4; mean +/- SEM) 6 days, to 3.0 (+/- 1.2) 4 days before functional rejection. The increase was due to the presence of blast cells and macrophages. The TCI of healthy immunosuppressed grafts remained below 1.6 for 30 days after transplantation and was greater than 5.0 when pancreatitis or acute rejection was seen on conventional histology. Minimal histologic change had significantly lower TCI scores than both acute rejection (P less than 0.01) and pancreatitis (P less than 0.001). Acute rejection and pancreatitis were distinguished by a significant difference in increments of monocytes/lymphocytes and macrophages. In contrast to FNAB, UA levels did not differentiate minimal change from acute rejection but were a reliable marker of end-stage rejection.
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PMID:Early diagnosis of rejection of canine pancreas allografts by fine-needle aspiration biopsy. 245 21

The rate of clearance of technetium-99m labelled diethylene triamine pentacetic acid (99mTc DTPA) was measured in 32 patients with adult respiratory distress syndrome to determine if a more rapid clearance rate, possibly reflecting a more severe abnormality of pulmonary function, was associated with a reduced likelihood of recovery from pulmonary failure. Although the mean rate of clearance from lung to blood (T1/2LB) of 99mTc DTPA was more rapid in the patients (T1/2LB = 29 (SEM 3.2) min than in 42 normal subjects (T1/2LB = 59 (1.8)min), there was no difference between the clearance rate in the 18 patients who recovered from respiratory failure (T1/2LB = 31 (5) min) and the 14 who died (T1/2LB = 27 (4) min). Additionally, not all patients studied had abnormally rapid clearance rates. In 12 of the 32 patients the T1/2 fell within the range for normal individuals; this was found more commonly in patients who were predisposed to develop adult respiratory distress syndrome by pancreatitis or massive blood transfusion. These data suggest that a single measurement of 99mTc DTPA clearance in patients with established respiratory failure and adult respiratory distress syndrome is of no value in assessing the likelihood of recovery from this condition.
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PMID:Failure of aerosolised 99mTc DTPA clearance to predict outcome in patients with adult respiratory distress syndrome. 332 12

Ninety consecutive patients underwent surgery for coronary artery disease. Eighty-one (90%) did not require blood transfusion in the immediate postoperative period; nine patients received 16 units of blood, 6 of whom bled excessively; 2 were re-explored. Twelve had post-operative haemoglobins below 8.5 G/dl during their stay. They were transfused a total of 28 units of blood before discharge. Post-operative blood loss in the 9 transfused early averaged 894 +/- 176 ml (SEM). Loss from the not transfused patients averaged 481 +/- 18 ml (p less than 0.001). Patients transfused later had a mean loss of 510 +/- 36 ml (P NS). Sixty-nine patients were not transfused. Haemoglobin on the first post-operative day was 11.3 +/- 1.3 G/dl (SD). This declined to 10.2 +/- 1.2 G/dl on the fifth day. Discharge haemoglobin was 10.5 +/- 1.2 G/dl. Two patients died, one of myocardial infarction on the third day and the other of pancreatitis on the fourth. Both had had early blood transfusion. Haemoglobins were above 10 G/dl. Of the 69 untransfused patients 17% had supraventricular arrhythmias. Ten percent had serous wound discharges; 3 were infected. There were no sternal dehiscences. It is concluded that bank blood transfusion with its attendant hazards and expense is easily avoidable in most patients. This saving of resources will increase the availability of blood and rare groups for surgery.
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PMID:Reduction of blood use in surgery for coronary artery disease. 378 68

Administration of total parenteral nutrition (TPN) solutions high in branched chain amino acids (BCAA) is thought to improve metabolic support during stress. This prospective, randomized, double blind study compared 45 per cent BCAA with 25 per cent BCAA in 12 patients. Seven patients had multiple trauma; two, gastrointestinal surgery; one, pancreatitis; and two, cirrhosis. The TPN regimen was 1.0-1.5 gm/kg/day amino acids and 30-45 glucose kcal/kg/day. The BCAA formula used was high in isoleucine and valine, but not leucine. Amino acid plasma levels, blood chemistries, 3-methylhistidine excretion, and nitrogen balance were studied. Control studies showed negative nitrogen balance (-7.1 +/- 2.9 gm) (mean +/- SEM), elevated insulin (61 +/- 21 microunit/ml), and elevated 3-methylhistidine (3MH) excretion (688 +/- 309 micromol); plasma leucine (93 +/- 11 nmol/ml) and isoleucine (37 +/- 23) were low, and valine (155 +/- 20) was elevated. Plasma methionine (40 +/- 9) and tyrosine (70 +/- 12) were high normal. Phenylalanine (85 +/- 5) was elevated. Both groups showed increased nitrogen excretion and positive nitrogen balance during the study (25 per cent, 2.0 +/- 1.4 gm/day; 45 per cent, 1.2 +/- 2.6 gm/day). Three-methylhistidine excretion changed little in either group (557 +/- 149, 414 +/- 91), insulin rose (135 +/- 27, 65 +/- 19), and plasma leucine (82 +/- 4, 71 +/- 9) changed little. Plasma isoleucine (51 +/- 3, 155 +/- 16) and valine (173 +/- 11, 691 +/- 23) both rose, more in the 45 per cent group. Methionine (67 +/- 12, 37 +/- 4) and tyrosine (51 +/- 6, 50 +/- 10) changed little.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of total parenteral nutrition with 25 per cent and 45 per cent branched chain amino acids in stressed patients. 393 93

Some patients with hypertriglyceridemia and acute pancreatitis have marked hypocalcemia and high levels of plasma free fatty acids (FFAs). This study tests the hypothesis that increased plasma FFAs can significantly reduce the calcium level in vivo, a phenomenon which is different from local formation of calcium soaps due to lipolysis of adipose tissue lipids. Free fatty acid elevation was induced in rats by the administration of heparin and by the infusion of triglycerides. The results show that, compared with controls, induction of elevated FFA (from 1.57 +/- 0.08 mEq/L to 5.64 +/- 0.35, mean +/- SEM) causes the concentration of calcium to fall rapidly (from 9.04 +/- 0.06 mg/dl to 8.42 +/- 0.10, p less than 0.001). There is a significant (p less than 0.001) positive correlation between spontaneous baseline concentration of FFA and the responsiveness of calcium concentration to FFA challenge. At near-normal levels of FFA there is a significant (p less than 0.001) correlation between the magnitude of increased FFA concentration and decreased calcium concentration. Additional studies in vivo and in vitro show that elevated plasma triglycerides per se did not interfere with measurement of calcium concentration; however, FFA-albumin complexes bind calcium and lower its measured value. These findings suggest that (a) changes in the concentration of FFA occurring spontaneously may affect measured serum calcium concentration; (b) the observed depression of serum calcium concentration may be due in part to intravascular sequestration of calcium by FFA, but increased flux of circulating calcium-FFA complexes into extravascular and intracellular sites may also be important; (c) the markedly increased FFA concentration in some patients with acute pancreatitis may contribute significantly to hypocalcemia and calcium flux in these patients. As parathyroid hormone secretion, function, or integrity may be impaired in pancreatitis, the depressant effect of FFA could be even greater in that disease than in this model.
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PMID:Depression of serum calcium by increased plasma free fatty acids in the rat: a mechanism for hypocalcemia in acute pancreatitis. 402 61


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