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

We propose a rapid enzymatic micromethod for the specific determination of lipase (EC 3.1.1.3) activity in serum and duodenal fluid. Free linoleic acid produced during 10-min incubation of 10 mul of sample with 1 ml of substrate (trillinolein emulsion) at 30 degrees C is converted by lipoxygenase (EC 1.99.2.1), in a coupled reaction, to its hydroperoxide, which is measured photometrically after solubilizing the reaction mixture in ethanol. Lipase activity is calculated from the rate of hydroperoxide formation, with linoleic acid as primary standard. The velocity of the reaction is greatest at pH 8.8, 35-37 degrees C, and a deoxycholate concentration of 3.6 mmol/liter. The energy of activation is 6.7 kcal/mol. The differing "apparent" Km values obtained for lipase in undiluted serum (4 X 10(-5) mol/liter) and in albumin-based diluents (1 X 10(-5) mol/liter) indicate the presence of a competitive inhibitor in the serum matrix. We detected no lipase activity in urine. Results by the proposed method correlate well with those by a copper soap extraction method (r = 0.95), but values are significantly higher for pancreatitis patients' sera (slope 1.6). The linear dynamic range extends to 1000 U/liter. Hemolysis, lipemia, and hyperbilirubinemia do not interfere. The normal range is 40-60 U/liter. Lipase activity of pancreatitis patients generally exceed 1000 U/liter during the acute phase and 250 U/liter for as long as 10 days after it.
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PMID:Lipoxygenic micromethod for specific determination of lipase activity in serum and duodenal fluid. 1 45

The renal handling of beta-2-microglobulin, amylase and albumin was studied in patients with acute pancreatitis. The data were compared with results obtained from patients with glomerular proteinuria and from patients with tubular proteinuria. Initially during acute pancreatitis, the clearance ratio (clearance protein/clearance creatinine) for beta-2-microglobulin was increased dramatically (77-fold) compared to normals. After four to seven days this ratio had fallen and was elevated only 7-fold. The corresponding figures for amylase were 3.3 and 1.8 times and for albumin 9 and 5 times respectively. In glomerular disease, the clearance ratios for beta-2-microglobulin, amylase and albumin were increased 6, 1.1, and 154 times and in tubular disease 448, 1.1, and 28 times, respectively. The electrophoretic pattern of the urinary proteins during pancreatitis was mostly normal. In a few cases, slight tubular proteinuria was noticed. Amylase activity in serum and urine from patients with pancreatitis was found to sediment, (S20,W = 4.6) in a sucrose gradient, identical to amylase from normal serum and urine. The marked increase in the excretion of beta-2-microglobulin probably reflects interference of the kidney function at the proximal tubular level. Determinations of this protein in urine may be of value in studies of kidney dysfunction that can accompany pancreatitis.
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PMID:Renal handling of beta-2-microglobulin, amylase and albumin in acute pancreatitis. 8 64

Continuous peritoneal dialysis significantly prolonged mean length of survival and reduced lethality rate of taurocholate-induced pancreatitis in the rat. The effect was improved by compensating protein loss due to pancreatitis and dialysis treatment. The beneficial effect of intravenous albumin treatment was enhanced when combined with dialysis treatment. Using hypothermic dialysate or adding aprotinin intraperitoneally had no additional effect.
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PMID:Continuous peritoneal dialysis as treatment of acute experimental pancreatitis in the rat. I. Effect on length and rate of survival. 31 26

An experience with 68 patients with hemorrhagic pancreatitis identified at operation or autopsy is reported. Sixteen of the patients were subjected to operation, and 6 survived after celiotomy and peritoneal irrigation. There were no survivors in the unoperated group. Death when the pancreas is hemorrhagic and due to pancreatitis occurs an average of 10 days after the onset of symptoms or within 7 days of hospitalization. In eight patients who presented in coma, the diagnosis was not established before death. Early recognition of patients with hemorrhagic pancreatitis can be facilitated by the routine use of amylase and methemalbumin determinations and peritoneal lavage. Translocation of large volumes of albumin-rich fluid from the intravascular compartment to the retroperitoneum and pleural and abdominal cavities is in part responsible for many of the signs, symptoms, and complications of hemorrhagic pancreatitis. These include hemoconcentration, hypotension, tachycardia, tachypnea, ascites, abdominal distress, respiratory insufficiency, and renal failure. Adequate initial resuscitation and intensive follow-up are probably the most important elements in the management of patients with hemorrhagic pancreatitis. Careful monitoring of fluid and electrolytes and blood gases is required to avoid shock and renal and pulmonary failure. The need for careful monitoring is emphasized by the number of our patients in whom inadequacies of fluid replacement and ventilation were often not appreciated until the patient was in extremis from shock or respiratory or renal failure. Antibiotics are indicated in patients with biliary tract disease and penetrating ulcer in whom the risk of secondary infection is considerable. Associated diseases that initiated pancreatitis and that in themselves may be life-threatening, such as acute cholecystitis or cholangitis, should be promptly treated by operation. Diagnostic and therapeutic lavage are justified in the treatment of hemorrhagic pancreatitis. Resection of the necrotic pancreas should be considered when the patient fails to improve after lavage and nonoperative resuscitation.
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PMID:Hemorrhagic pancreatitis. 45 56

A general review of bisalbuminemia is presented. Besides congenital bisalbuminemia there is an acquired form of bisalbuminemia that appears following treatment with high dosis of penicillin and cephalosporin, or in cases of acute pancreatitis after the development of a pancreatic pseudocyst. There is one type of abnormal albumin that migrates faster than normal albumin (rapid variant) and another type that is slower (slow variant). Different subtypes of each one have been recognized. There is no immunological difference between normal albumin and the variants. From a clinical point of view, bisalbuminemia per se does not cause any observable alterations. This is an important finding, however, because of the possibility that some physiologic or pharmacologic substances may not be bound to the abnormal variants as well as to normal albumin. When bisalbuminemia appears following an episode of pancreatitis it may be indicative of a pancreatic pseudocyst.
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PMID:[Bisalbuminemia (author's transl)]. 52 68

Pancreatitis was induced in 11 miniature pigs by infusing a bile salt-trypsin solution into the pancreatic duct. Seven animals served as sham-operated controls. Serum ionized calcium, total calcium, albumin, total protein, inorganic phosphorus, urea nitrogen, magnesium, insulin, glucagon, and hematocrit were determined every six to 12 h over a period of one week in both test and control animals. We observed significant decreases in ionized and total calcium, modest decreases in albumin, and significant increases in the inorganic phosphorus, urea nitrogen, and hematocrit in the pancreatitic pigs. The latter two findings were consistent with early acute hypovolemia. Glucagon and insulin appeared to play no role in the hypocalcemia. Glucagon concentrations increased to the same degree in both test and control animals, probably as a result of the stress of being handled and operated on. The highest concentrations of inorganic phosphorus and the lowest concentrations of both ionized and total calcium were seen 18 h after the induction of pancreatitis in the test animals. These findings suggest that parathyrin (parathormone) was not being secreted in adequate amounts, or that the target organs were unresponsive to parathyrin.
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PMID:Biochemical changes in a porcine model of acute pancreatitis. 65 76

A closed duodenal loop was created by the obstruction of the duodenum on either side of the common bile duct. Acute haemorrhagic pancreatitis developed within 24 h with interlobular oedema, marked acinar cell necrosis, intra-abdominal fat necrosis and ascites. Plasma amylase activity was greatly increased together with a marked decrease in albumin. There was a temporary abnormality of liver function tests due to obstruction of bile. When the duodenal obstruction was released and the animals allowed to survive there was at 3 weeks a marked reduction in the pancreatic acinar cells with fibrosis and areas of necrosis and chronic inflammatory cell infiltration. Plasma amylase activity was normal but there was an increase in total plasma protein at 3 weeks. This technique of a closed duodenal loop in the rat gives a simple, reliable and economic experimental model for studies on acute and chronic fibrotic pancreatitis.
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PMID:Acute and chronic pancreatitis in the rat caused by a closed duodenal loop. 73 44

The influence of amylase assay technique on the renal amylase/creatinine clearance measurement was determined by analysis of serum and urine specimens obtained from 10 normal subjects. CAm/CCr averaged 2.19 +/- 0.18% with a saccharogenic technique, 1.52 +/- 0.2% with an iodometric technique, and 0.80 +/- 0.08% with a chromogenic technique. Each of these values differed significantly (P less than 0.05) from the other two. Recovery studies were carried out by adding partially purified human salivary or pancreatic amylase to human newborn serum or urine (which contain minimal endogenous amylase). Equal amylase activity was recovered from serum and urine by the saccharogenic technique whereas recovery from urine was less than 50% of that from serum using the iodometric and chromogenic techniques. The accuracy of the chromogenic technique is markedly improved by the addition of albumin to the urine assay system. Although it appears that only the saccharogenic method provides an accurate estimate of CAm/CCr, each assay technique distinguished the elevated CAm/CCr of patients with pancreatitis from the normal range established for that technique. Accurate clinical interpretation of CAm/CCr measurment requires knowledge of the amylase assay technique used.
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PMID:Influence of amylase assay technique on renal clearance of amylase-creatinine ratio. 87 Mar 74

Bisalbuminaemia in pancreatitis is a transient abnormality related to the presence, on electrophoresis of the serum, of a fast-moving albumin; this abnormal form is also found, in large amounts, in the ascitic or pleural effusions of the patients. Experiments reported here indicate clearly that the fast albumin can be produced by a degradation of normal serum albumin by the proteolytic enzymes of the pancreas (chymotrypsin or elastase in association with carboxypeptidases A and B). Stuctural analysis of the isolated fast albumin of the patients shows that the C-terminal end of the molecule is different from normal serum albumin, which can be understood by a limited enzymatic degradation by chymotrypsin or elastase followed by the action of carboxypeptidases. The discovery of bisalbuminaemia in a patient affected by pancreatitis is suspicious of the presence of an ascitic or pleural effusion and of a pancreatic pseudo-cyst with a fistula emerging in the effusion.
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PMID:[Bisalbuminaemia in pancreatitis: structural modifications of human serum albumin by proteolytic enzymes of the pancreas (author's transl)]. 97 22

Acute pancreatitis was produced in five dogs by injecting bile into the pancreatic duct. The capillary permeability effects of the exudate formed within the peritoneal cavity were studied by injecting the exudate intradermally into puppies. The amount of radioactively labeled albumin escaping from the circulation and appearing at the intradermal injection site was used as a measure of capillary permeability. It was observed that the peritoneal exudate, especially that produced in the early stage of bile induced pancreatitis, contains one or more substances which result in an increased capillary permeability when injected intradermally into puppies.
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PMID:Vascular permeability induced by pancreatic exudate formed during acute pancreatitis in dogs. 98 58


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