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)

The most important diagnostic step in the management of patients with severe acute pancreatitis is the discrimination between acute interstitial and necrotizing pancreatitis. Measurement of C-reactive protein, lactic acid dehydrogenase, alpha-1-antitrypsin, and alpha-2-macroglobulin and contrast-enhanced CT are useful in detecting the necrotizing course of acute pancreatitis. C-reactive protein, lactic acid dehydrogenase, and contrast-enhanced CT offer detection rates of 85 per cent to more than 90 per cent for pancreatic necrosis. Surgical decision-making in necrotizing pancreatitis should be based on clinical, morphologic, and bacteriologic data. Patients with focal pancreatic necrosis, in general, respond well to medical treatment and do not need surgery. Extended (50 per cent or more) pancreatic necroses, infected necroses, and intrapancreatic parenchymal necroses plus extrapancreatic fatty tissue necroses are indicators for surgical management. The decision for the timing of operation in patients with proved necrotizing pancreatitis should be based on clinical criteria: the development of an acute surgical abdomen, generalized sepsis, shock, persisting or increasing organ dysfunction, or some combination thereof despite maximum intensive care treatment for at least 3 days. Major pancreatic resection for the treatment of necrotizing pancreatitis appears disadvantageous. Necrosectomy and continuous local lavage allow debridement of devitalized tissue and preservation of vital pancreatic tissue. Postoperative local lavage thus results in an atraumatic evacuation of necrotic tissue, the bacterial material, and biologically active substances. The hospital mortality rate of patients treated with necrosectomy and continuous local lavage (the Ulm protocol) is below 10 per cent. Nevertheless, controlled prospective clinical trials should be performed in order to bring more precision to our clinical decisions in respect to the role of surgery for this disease.
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PMID:Surgical management of necrotizing pancreatitis. 265 62

Experimental study had been conducted on 18 healthy adult mongral dogs of both sex, weighting from 7.5-11 kg, randomly divided into four groups. Experimental models of acute hemorrhagic necrotizing pancreatitis (AHNP) were established by retrograde injecting 1 ml/kg of sodium taurocholate directly into the pancreatic duct. The dogs were treated respectively with intravenous infusion of Salviae miltiorrhizae (5 g/kg), 654-2(5 mg/kg) or normal saline. The results showed that PaO2, PaCO2 and pH did not change in early stage of AHNP. The contents of lactic acid dehydrogenase (LDH), albumin and lipid peroxide (LPO) of bronchoalveolar lavage fluid in the AHNP group were significantly higher than that of Salviae miltiorrhizae group (P less than 0.05). The necrosis and disruption of conjunction of endothelial cells resulting from the defects of vascular wall were noted under transmission electron microscope. Both pulmonary vascular and type II pneumocyte were normal in the Salviae miltiorrhizae group. These results suggested that Salviae miltiorrhizae possess the effect of protecting endothelial cells of pulmonary vascular and type II pneumocyte, which could function as scavenger of oxygen-derived free radicals.
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PMID:[Protective effects of Salviae miltiorrhizae and anisodamine (654-2) against early lung injury in acute hemorrhagic necrotizing pancreatitis in the dog]. 273 1

The purpose of this study is to elucidate the pathophysiology of the acute pancreatitis and set up the criteria for assessing the severity of this disease. One hundred and fifty seven cases of acute pancreatitis were treated at the First Surgical Department of Tokyo University Hospital and its affiliated hospitals. They consisted of 24 severe cases, 76 moderate cases, and 57 mild cases according to our classification. In early stage ten parameters, namely, abnormalities of white cell count, platelet count, hematocrit, lactic acid dehydrogenase, blood urea nitrogen, serum calcium, base excess, PaCO2 and fasting blood glucose and age within 24 hours after admission and X-ray CT scan within 48 hours as early prognostic signs, enabled us to predict severe, moderate, or mild pancreatitis. More than 4 weeks later than the onset of acute pancreatitis, X-ray CT scan, white blood cell count, elevation of serum FDP level, endotoxemia and fall of plasma opsonic index served as good indicators to evaluate the severity of abdominal sepsis. In experimental pancreatitis, CH50 and opsonic index were remarkably decreased at 6 and 12 hours after induction of acute pancreatitis. As the above results, determination of early prognostic signs immediately after onset and late prognostic signs 3-4 weeks after onset is very important to evaluate and manage the acute pancreatitis patients.
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PMID:[Pathophysiology and prognosis of acute pancreatitis--early and late prognostic signs]. 408 48