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

The effect of relieving pancreatic duct obstruction after the onset of hemorrhagic pancreatitis was investigated. Hemorrhagic pancreatitis was produced in 20 pigs by a bile salt-trypsin retrograde injection technique. In half the pigs the pancreatic duct was permanently ligated, and in the other half the ductal obstruction was relieved 2 h after the onset of hemorrhagic pancreatitis. The overall mortality rate was the same in both groups by 24 h. No difference was found between the groups in the gross and microscopic appearance of histological samples taken from the pancreas immediately after death. The biochemical parameters measured to assess the severity of pancreatitis such as calcium, BUN, creatinine, glucose, proteins, and hematocrit did not show any difference between the two groups. The serum amylase level, a measure of ductal obstruction, was less at 24 h and even lower at 48 h in the release group as compared to the non-release group. This difference suggests that the ductal obstruction was relieved, as the amylase levels declined at 24 and 48 h. Hemodynamic variables, including cardiac output, pulmonary artery pressure, pulmonary wedge pressure, central venous pressure, and aortic pressure were followed. No significant difference was found in any of these parameters between the two groups. The absence of any significant differences in hemodynamic status, histopathological findings, and biochemical analysis in our pigs, if translatable to man, does not lend support to early operative intervention in gallstone pancreatitis in the hope that those patients who already have hemorrhagic pancreatitis will benefit from early pancreatic ductal decompression.
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PMID:The role of ductal obstruction on the course of hemorrhagic pancreatitis in the pig. 350 Sep 89

Pancreatic stones that were removed from the pancreatic ducts of patients with chronic calcifying pancreatitis were decalcified so the organic matrix could be studied by scanning and transmission electron microscopy. The observations made by scanning electron microscopy were compared with those made on undecalcified stones, and the findings were correlated with light microscopic observations. After the calcium carbonate was removed, the stones consisted of multiple partitions arranged like a sponge. They were embedded in a gel-like matrix. The organic partitions frequently were composed of dense surface layers and sparse central reticular accumulations, which had surrounded and bound calcium carbonate crystals. The organic matrix was heterogeneous in texture. Some areas had dense, regular, proteinaceous fibrous material. Deposits resembling fibrin were observed. Altered cellular constituents appeared to make up minor portions of the matrix. Calcium carbonate, which was precipitated in vitro in pancreatic juice, resembled the morphology of pancreatic stones more than that of pure calcium carbonate crystals. These results are consistent with the coformation of pancreatic stones from constituents in the pancreatic juice [including pancreatic stone protein (PSP), glycosaminoglycans, and occasional cells] and precipitated calcium carbonate.
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PMID:Fine structure of the organic matrix of human pancreatic stones. 357 6

Scanning electron microscopy (SEM) and energy dispersive x-ray fluorescence (EDXRF) have been used in this study to investigate the morphology, nature, and arrangement of major, minor, and trace elements in human pancreatic calculi (PC) obtained from patients with alcoholic and tropical pancreatitis. The present study has confirmed previous observations that PC are rich in CaCO3 (as calcite) and many other elements. Further, we have shown for the first time that the amorphous nidus contained only iron, chromium, and nickel, whereas the outer shell contained calcium and 17 other elements. Based on our studies, we postulate the formation of PC to be taking place in multilayers and multistages. Formation of inner protein nidus in the form of a cobweb is the first stage, then calcite is deposited on this fibrous network as tiny crystals. Because of their high surface area and high surface activity, other metallic ions are incorporated onto it through co-precipitation, adsorption, and/or lattice substitution. This study has further shown that irrespective of the etiology for chronic pancreatitis, the structure and composition of PC are the same suggesting a common pathway for lithogenesis in the pancreatic duct.
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PMID:Ultrastructure and elemental composition of human pancreatic calculi. 362 20

Case records from 21 dogs with hypercalcemia and hyperparathyroidism were evaluated. The dogs were greater than or equal to 7 years old, and 6 were Keeshonds. The most common clinical signs were polydipsia/polyuria, listlessness, and muscle weakness. The serum calcium concentrations were 12.1 to 19.6 mg/dl. Serum phosphorus concentrations were low in 5 dogs, within the reference range in 13 dogs, and high in 3 dogs that also had high concentrations of BUN. Twenty dogs had a parathyroid adenoma, and 1 had a parathyroid carcinoma. Nineteen dogs had their parathyroid tumor surgically removed. Within 5 days of tumor removal, 11 of the 19 dogs became hypocalcemic and the remaining 8, normocalcemic. Nine of the 11 hypocalcemic dogs developed clinical signs. Iatrogenic hypercalcemia was induced in 7 of 16 dogs treated orally with calcium carbonate plus vitamin D. Only 1 of 19 dogs that had their parathyroid tumor excised died in hypocalcemic tetany. Two additional dogs died within 2 weeks of surgery, one because of pancreatitis, the other due to renal failure. Eight dogs died 9 to 37 months after surgery of unrelated problems. Eight dogs were alive for at least 7 to 28 months after surgery.
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PMID:Primary hyperparathyroidism in dogs: 21 cases (1976-1986). 365 3

Previous studies on pancreatic calculi (PC) from alcoholic pancreatitis and our recent studies on calculi from tropical pancreatitis have shown them to consist mainly of CaCO3 with minute quantities of Mg. However, no attempt was made to look for other elements in PC. This is because of the difficulty in obtaining adequate samples of PC, coupled with the technical limitations in analyzing multi-elements from small samples. In this study, our aim was to analyze the major, minor and trace elements of PC from different parts of the world. DC plasma emission spectroscopy, a modern method that permits determination of multiple elements from small samples, was used in elemental analysis. We identified 17 elements in addition to calcium. Selenium was looked for but was absent. It was interesting that the elemental composition of PC in four patients from different geographical areas with divergent etiological factors remained the same. Absence of Se is of interest, as Se deficiency is associated with pancreatic fibrosis in experimental animals and it is often noted in chronic alcoholics and the malnourished. This preliminary study emphasizes the need for analysis of the elemental composition of pancreatic juice in normals and in conditions predisposing to chronic pancreatitis, to understand lithogenesis and possibly also the etiology of, at least, some types of pancreatitis.
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PMID:DC plasma emission spectroscopic analysis of pancreatic calculi. 368 Oct 37

Pancreatic stone protein, a novel protein isolated from pancreatic stones of patients suffering from chronic calcifying pancreatitis and secreted in normal human pancreatic juice, was measured by radial immunodiffusion in pure pancreatic juice. Patients with chronic calcifying pancreatitis of different etiologies had significantly lower levels of pancreatic stone protein when compared with other pancreatic diseases and controls. Pancreatic stone protein suppresses in vitro calcium carbonate precipitation and therefore stabilizes normally supersaturated pancreatic juice. The decreased pancreatic stone protein levels observed could be a key factor in the growth of calcium carbonate crystals and stone development during the course of chronic calcifying pancreatitis.
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PMID:Pancreatic stone protein. II. Implication in stone formation during the course of chronic calcifying pancreatitis. 392 21

Oral feedings should be withheld in all patients with acute pancreatitis. A mild form of acute alcoholic pancreatitis does not necessarily require the administration of a nasogastric tube and central venous catheter, which should, however, be administered in all patients with more severe disease, with an unknown pathogenesis, and with complications. In most of those patients a central venous catheter is not only required for parenteral nutrition, but also for control of fluid administration. Glucose is recommended as the primary energy source (7-12 mg/kg/min); amino acids should be given at a calories (kcal/kg) to nitrogen (g/kg) ratio of 135:1. Fat is not recommended as the primary nonprotein energy source initially in the course of pancreatitis. Frequent serum controls of electrolytes and glucose are necessary to control electrolyte and insulin therapy. Calcium administration should be carried out with caution.
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PMID:[Parenteral nutrition in acute pancreatitis]. 393

The first lesion of chronic calcifying pancreatitis (CCP), the most frequent form of chronic pancreatitis is the formation in the ducts of plugs build up of protein and calcium carbonate which are at the origin of pancreatic calculi. Pancreatic juice is supersaturated in calcium carbonate. A novel protein, the pancreatic stone protein (PSP) has been purified from human pancreatic juice and its amino-acid composition has been determined. It is biosynthesized in the acinar cell as well as enzymes. PSP prevents the formation of calcium carbonate crystals in a supersaturated solution. Its secretion is decreased in patients presenting with CCP. It is proposed that this decrease plays an important part in the pathogenesis of CCP.
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PMID:[Pancreatic lithogenesis]. 396 39

Left ventricular contractility following induction of experimental pancreatitis (EP) was studied. Contractility was evaluated by analyzing the left ventricular end systolic pressure-diameter relationship (sigma ES). Sigma ES is independent of large changes in preload, afterload, and heart rate, but sensitive to changes in ventricular contractility. Following injection of 100,000 IU trypsin in 4% taurocholate into the pancreas to induce EP, seven of eight dogs survived 5 hr. These dogs exhibited an initial significant reduction in mean arterial pressure (MABP) which stabilized at 90% of control at 3-5 hr post-EP. Cardiac output (CO) dropped slowly after EP induction (from 3.08 +/- 0.43 to 2.22 +/- 0.22 liters/min) associated with no significant change in peripheral resistance. Stroke work and stroke volume were markedly depressed reflecting the changes in MABP and CO. No consistent changes in +dP/dt or -dP/dt were observed. The ratio of endo/epicardial blood flow was unchanged as was blood Ca2+ levels throughout the experiment. Ventricular contractility as reflected by sigma ES tended to improve (from 49.7 to 69.6 mm Hg/mm at 4 hr following EP). Therefore, it was concluded that these animals exhibited no loss of ventricular contractility during EP.
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PMID:Canine left ventricular function during experimental pancreatitis. 396 70

From 1948 to 1983, 28 patients with parathyroid carcinoma underwent treatment and analysis at the Massachusetts General Hospital. This represents about 2 percent of the 1,200 patients with hyperparathyroidism managed during the period. Patient ages ranged from 18 to 72 years (mean 45 years) with equal numbers of both sexes (14 women and 14 men). There are several hallmarks that are clues to an increased index of suspicion preoperatively. Nine of the patients (32 percent) presented with palpable neck masses. Eleven patients (39 percent) had a serum calcium level greater than 14 mg/100 ml. Significant elevations of the parathyroid hormone level were noted with values two to three times normal. The incidence and severity of metabolic complications were prominent. These complications included renal stones in 18 patients (64 percent), bone disease in 14 patients (50 percent), peptic ulcer disease in 5 patients (18 percent), parathyroid crisis in 4 patients (14 percent), and pancreatitis in 2 patients (7 percent). Eleven of the patients underwent previous surgical therapy at other institutions, and 17 patients had their initial operation at our institution. Cervical parathyroid carcinomas that ranged from 1.5 to 27 g and 1.5 to 6 cm were excised. The characteristic appearance was a gray-white, stone hard parathyroid mass with invasion of adjacent tissue. The outcome was favorable for 16 surviving patients, with 14 (50 percent) showing no evidence of recurrence 2 to 17 years postoperatively and 2 alive with persistent disease 3 years after operation. Twelve patients died. Of these, eight had unsuccessful initial operative intervention with capsular rupture and dissemination of cancer, one had advanced disease with mediastinal extension which was unresectable, and three died from unrelated causes. Recurrences became apparent within 6 months to 3 years after operation and unfortunately denoted incurable disease. The mean survival time after operation in patients with recurrent disease was 7.6 years, ranging from 1 to 22 years. Carcinoma of the parathyroid gland is a rare entity. Although it is difficult to diagnose preoperatively, there should be an increased index of suspicion in those hyperparathyroid patients with palpable neck masses, profound hypercalcemia (greater than 14 mg/100 ml), marked increase in the parathyroid hormone level to greater than twice normal, and significant metabolic complications. The initial operation must be aggressive yet meticulous with en bloc resection of the parathyroid tumor and all adjacent invaded tissues, avoiding capsular violation or tumor spillage.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Natural history of parathyroid carcinoma. Diagnosis, treatment, and results. 398 91


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