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

Differences in metabolic homeostasis in 12 patients with initial vs. eight patients with repeated attacks of acute pancreatitis have been compared during the acute phase of the disease. As a group, subjects with a previous history of pancreatitis had significantly lower glucagon concentrations (P less than 0.002) for the over all 24-hour study period. Conversely, the serum concentrations of blood sugar, insulin, growth hormone, gastrin, cortisol, nonesterified fatty acids, triglycerides and cholesterol failed to distinguish between the two patient groups. Likewise, immunoreactive plasma parathyroid hormone and calcitonin levels were comparable in both patient populations. Of the measurements considered, it would appear therefore that plasma immunoreactive glucagon is the best indicator of previous pancreatic inflammation. Evaluation of parenchymal integrity during an episode of acute pancreatitis would be of prognostic and therapeutic value in this disease.
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PMID:First 24 hours of acute pancreatitis. A biochemical and endocrine evaluation of initial versus repeated attacks. 69 15

It is evident that ethanol by itself or one of its metabolites produces alterations in transport, metabolism and disposition of carbohydrates. Ethanol acts via changes in the redox state of co-factors; e.g. ethanol-induced hypoglycemia is due, partly, to the inhibition of hepatic gluconeogenesis by ethanol as a consequence of the increased NADH2/NAD ratio in patients whose glycogen stores are already depleted. On the other hand, hyperglycemia has also been described in patients with alcoholism. Although its mechanism is still obscure, abnormal hormonal secretion of insulin, catecholamines and glucocorticoids has been incriminated. Finally, structural changes of the liver and pancreas such as cirrhosis and pancreatitis produced by chronic alcohol consumption should also be considered as pathogenetic factors in a variety of clinical states involving deranged carbohydrate metabolism.
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PMID:Alcohol induced changes of carbohydrate metabolism [author's transl]. 70 66

The exocrine and endocrine pancreas was investigated according to the fluorescence histochemical method of Flack and Hillarp. 1) Green fluorescent adrenergic fibers were regularly seen associated with arteries and arterioles in the exocrine pancreas. 2) Cholinergic fibers as shown by cholinesterase activity, were also found in the parenchyma of pancreas. 3) Yellow fluorescent cells scattered in the exocrine parenchyma and localized to a population of pancreatic islet cells with a characteristic distribution at the islet periphery was found. 4) By the fluorescence microscopic observation, inter-or intralobular pancreatic ducts, involving the zymogen granules, can also be seen after treatment with HCL vapor. 5) Yellow fluorescent cells, beta-cells containing insulin, remained at the Islet periphery. At present, the above mentioned yellow fluorescent cells are identified as containing HPP (Human pancreatic polypeptide) according to the immunofluorescence technique. With the use of the Falck and Hillarp histochemical technique ethionine induced pancreatitis in cats has been investigated. 1) After seven days of ethionine (5 mg/kg BW oral ad.) treatment, pancreas showed histochemical changes such as hemorrhage, fat necrosis, destruction of acinar cells and degranulation of zymogen from the parenchyma of pancreas. 2) Oral administration of ethionine for ten days induced severe degranulation, rupture of vessels, especially of veins and venules and later influenced arteries or arterioles. 3) Necrosis and fibrosis began to appear in the spaces between the cellular debris and marked pancreatic atrophy could be found. 4) The destruction of Islets of Langerhans can be found in the ethionine induced pancreatic parenchyma. On the other hand, an increased number of Islets of Langerhans was also observed in the site of lobule. 5) The presented findings may also suggest that the duration of administration of ethionine is more important factor than graded doses of ethionine in the production of ethionine is more important factor than graded doses of ethionine in the production of ethionine induced pancreatitis in cats.
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PMID:Fluorescence histochemical study of the pancreas in the cat. 79 42

The prevalence of diabetes due to chronic pancreatitis would appear to be increasing. In western countries this is associated with the known increase in alcohol consumption and AIP. Malnutrition may be etiologic in tropical areas. The incidence of diabetes in chronic pancreatitis is dependent on a number of factors. It is more common in alcohol-induced pancreatitis, rarely occurs after the first attack but tends to increase with time and rises markedly in calcific pancreatitis. Abnormal glucose tolerance occurred in 91% of patients with calcific pancreatitis and 70% of patients with noncalific AIP in our follow up of five to 12 years. This stresses the importance of serial regular glucose tolerance tests in these patients (Table I). The insulin-reserve is severely depleted in most patients who do not yet demonstrate abnormal glucose tolerance, indicating that pancreatitis regularly affects the islets and that nearly all patients are potential diabetics. The beta cells appear to respond better to oral glucose, glucagon or secretin than to i.v. glucose suggesting a selective glucose receptor loss or block to hyperglycemia in chronic pancreatitis. The alpha cells seem to be more resistant to the effects of chronic pancreatitis but true hypoglucagonemia was found in 16% of patients. In addition, stimulated growth hormone secretion may be deficient in pancreatic diabetes. These last two factors, among others, may be responsible for the protracted and even fatal hypoglycemia to which some patients with AIP on insulin therapy are liable. The danger of drug-induced hypoglycemia, coupled with the infrequency of vasculopathy, retinopathy and nephropathy in pancreatic diabetes has induced us to keep these patients hyperglycemic and glycosuric rather than in a sugar-free state, as long as symptoms are contained. Recurrent abdominal pain, marked weight loss and associated steatorrhea often raise special problems in the management of the pancreatic diabetic.
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PMID:Clinical and hormonal aspects of pancreatic diabetes. 80 21

Diazoxide was given orally to nine hypertensive patients with renal failure and its effect on blood pressure and on glucose metabolism was studied. There was no long-term antihypertensive effect. During treatment insulin release and glucose assimilation after an intravenous glucose load were frankly impaired, but this impairment was reversible after stopping the treatment. Two major complications (diabetic ketoacidosis and pancreatitis) were observed. In view of these observations, the authors are of the opinion that oral diazoxide is contraindicated in the treatment of hypertension in patients with renal failure.
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PMID:Oral diazoxide contraindicated in severe hypertension with renal failure. 81 Feb 87

Unmodified synthetic somatostatin, given as a 200-microgram intravenous bolus, plus 200 microgram infused over 3 hours, had no effect on basal plasma insulin and pancreatic glucagon-like immunoreactivity (GLI) levels, both in controls and in patients with chronic pancreatitis. Somatostatin inhibited insulin-hypoglycaemia-induced pancreatic GLI release in controls and in patients with pancreatitis, and prolonged the insulin-induced fall in blood glucose in the patients. Arginine, presumably via insulin release, caused a fall in free fatty acids (FFA) in controls, which was inhibited by somatostatin. Somatostatin abolished the rebound rise in plasma FFA in patients with pancreatitis after insulin-hypoglycaemia. This effect may be related to inhibition of pancreatic GLI release or may be a direct action of somatostatin on lipolysis.
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PMID:The effects of somatostatin on hormonal and metabolic responses in chronic pancreatitis. 89 37

A case report is presented of a 38-year-old alcoholic welfare patient. Drainage of a pancreatic abscess, which had to be repeated, pyloromyotomy, cholecystectomy and sphincterotomy were undertaken in 1972 at another hospital. He was admitted on the present occasion because of weight loss, severe attacks of pain and diabetes. At operation multiple necrotic areas were found in the pancreas, with many stones in the parenchymatous tissue and in the main pancreatic duct and one large stone close to the pailla acting like a valve. Sub-total duodenopancreatectomy, resection of the pyloric region of the stomach, retrocolic hepaticojejunostomy and gastroenteroanastomosis was performed. The postoperative recovery took place without complications. 5 days after discharge the patient died in a hypoglycaemic coma at another hospital. He had administered 400 U. insulin to himself whilst in a drunken state. A short description is given of the aetiology and pathogenesis of calcifying pancreatitis. The choice of the surgical technique depends on the operative findings and the aim of therapy. Attention is called to the increase in late mortality in patients with pancreatectomy who do not abstain from alcohol.
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PMID:[Fatal outcome of a case with calcifying alcoholic pancreatitis (author's transl)]. 97 84

The effect of insulin treatment in acute pancreatitis was studied in a double-blind investigation. Fifteen patients with clinical signs of acute pancreatitis were treated with intravenous infusion of glucose and insulin only. Twelve patients were free from pain within four hours of commencement of treatment. Within eight hours all fifteen were free from abdominal pain. Fourteen patients with pancreatitis established by the same criteria were treated with glucose infusions without insulin. Only four of the patients in this group became free from pain within four hours. The role of intravenously infused insulin with respect to the more beneficial effect in the first group is discussed.
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PMID:Role of intravenously infused insulin in treatment of acute pancreatitis. A double-blind study. 109 32

Alloxan diabetes was induced in inbred rats that then were divided into four groups consisting of unoperated diabetic controls, sham-operated diabetic controls, rats given pancreaticoduodenal isografts, and rats given duct-ligated pancreas isografts. The animals were studied for from 18 months (controls) to two years (transplants) and the following important results were obtained: 1) In striking contrast to the diabetic controls, pancreas transplants of both types produced immediate and permanent relief of hyperglycemia, immediate and lasting elevation of serum insulin levels, a normal weight and growth curve, and good health for two years. Removal of the graft was followed by recurrence of severe diabetes. 2) Pancreas transplants of both types prevented the widespread and severe renal, ophthalmic and neural lesions of diabetes that were found in the diabetic controls. 3) The duct-ligated pancreas graft and pancreaticoduodenal transplant were equally effective in controlling diabetes. Ligation of the pancreatic duct was not followed by significant morphologic or clinical evidence of pancreatitis or by loss of endocrine function. 4) Portal venous drainage of the pancreas transplant was unnecessary for good endocrine function.
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PMID:Long term studies of pancreas transplantation in experimental diabetes mellitus. 109 93

Ten adolescent and young adults with cystic fibrosis (CF) have had well-documented recurrent attacks of acute pancreatitis. The diagnosis of CF in each patient was delayed because they did not have pancreatic insufficiency. The diagnosis of CF was documented by the typical pulmonary involvement and elevated sweat sodium and chloride levels in all cases and a positive family history in six of the ten patients. Two patients were diagnosed as having acute pancreatitis before the diagnosis of CF was made, thus indicating that acute pancreatitis may be the presenting complaint in the young adult with CF. The diagnosis of acute pancreatitis was based on the presence of severe abdominal pain, usually with vomiting, tenderness in the mid-epigastrium, elevated serum and urinary amylase and serum lipase. Attacks were precipitated by fatty meals, alcohol ingestion; postcholecystectomy and tetracycline administration. In some patients no precipitating event could be elicited. Intravenous secretin-pancreozymin stimulation tests revealed a diminished bicarbonate secretion with little effect on the secretion of the zymogen enzymes. A mild attack of pancreatitis occurred after secretin-pancreozymin stimulation. The endocrine pancreatic function tested in four patients was normal as revealed by the glucose tolerance tests and determinations of serum insulin, growth hormone and free fatty acid. Transduodenal pancreatograms were performed in three patients; one showed a normal pancreatic duct, one showed duct obstruction and in the third patient a beady type of narrowing was found. The selenomethionine Se 75 uptake of the pancreas was noted only in the head of the pancreas. This suggests that loss of function occurs initially to a greater extent in the tail and body of the pancreas. Three patients died and showed characteristic lesions of CF.
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PMID:Recurrent acute pancreatitis in patients with cystic fibrosis with normal pancreatic enzymes. 111 Aug 67


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