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)

Diuretics can result in various undesired biochemical changes, such as impotence, skin rashes, nausea, dizziness and lethargy as well as subjective side effects. The side effects are mostly predictable, their effects depending on both the circulatory blood volume and on the transport of water and solute in the renal tubules. Two of the commonest side effects are mild hypovolaemia, when any diuretic is used, and mild hypokalaemia when the non-potassium-sparing diuretics, such as thiazides and frusemide are used. Its occurrence is dose dependent and can be corrected by potassium supplements, but potassium-retaining diuretics, which also correct the often associated fall in serum magnesium, are preferable. Many reports link hypokalaemia with cardiac arrhythmias, but some dispute this association in the absence of the concomitant use of digoxin. Hyponatraemia rarely occurs, but can be life threatening. Calcium excretion is markedly reduced, but unlike other electrolyte disturbances from diuretics, this may be valuable: some suggest diuretics have an anti-osteoporotic action. Diuretics increase glucose and insulin resistance and should be used sparingly in diabetics. They rarely cause a non-ketotic hyperosmolar coma. Urate is raised, but clinical gout is not common. Cholesterol elevation has been reported in some studies, but long-term studies indicate that lipid changes are minor. Other rare side effects are not predictable from their pharmacological actions and these include the occurrence of skin rashes, thrombocytopenia, pancreatitis and interstitial nephritis; and ototoxicity from frusemide.
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PMID:Adverse reactions to diuretics. 148 14

Safety and efficacy of shock-wave lithotripsy and bile acid dissolution therapy of patients with gallbladder calculi with a radiopaque rim were evaluated. Eighty-six patients with symptomatic solitary stones were treated by this noninvasive therapy and were followed up to 18 months. Three different lithotripsy treatment modalities were used. Up to 1600 shock wave discharges were applied. Patients in group A (n = 20) were treated with an electrohydraulic water-bath lithotripter at a discharge voltage of 18 +/- 1 kV (mean +/- SD), group B patients (n = 25) were treated with an electrohydraulic water-cushion lithotripter at 19 +/- 2 kV, and group C patients were treated (n = 41) with the same lithotripter at 22 +/- 2 kV. Five to eight months after lithotripsy, 15% in group A were free of fragments compared with only 4% in group B (NS vs. group A), and 38% in group C had no stones (NS vs. group A; P = 0.007 vs. B). Thirteen to eighteen months after lithotripsy, the respective results were 59% in group A, 37% in group B (NS vs. group A), and 68% in group C (NS vs. group A; P = 0.05 vs. group B). Patients with fragments of less than or equal to 3 mm in diameter showed significantly better fragment clearance than those with larger fragments. The frequency of adverse effects was not significantly different between the three groups. Biliary colic occurred in 43% of the patients and mild biliary pancreatitis in 3 patients. Endoscopic sphincterotomy was required in 1 patient, and elective cholecystectomy was performed in 6 patients. Using a water-cushion lithotripter at high-power setting, selected patients with solitary gallbladder stones with a radiopaque rim may be treated safely and successfully by shock-wave lithotripsy combined with bile acid dissolution therapy.
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PMID:Noninvasive therapy of gallbladder calculi with a radiopaque rim. 153 35

The malnourished alcoholic patient requires frequently hospitalization for treatment and an adequate nutritional support is necessary for recovery of their health. The objective of the present study was to evaluate the nutritional value of an enteral diet based on "soya milk", corn sugar, coconut oil and water. Seven alcoholics, males, with 36.4 year mean age, without any clinical evidence of hepatic cirrhosis and/or pancreatitis, were submitted to three periods of metabolic nitrogen balance (NB), with multiple levels of protein intake (0.4, 0.6 and 0.8 grams of proteins/kg of body weight/day). The nitrogen intake (NI), the fecal nitrogen (FN) and the urinary nitrogen (UN) were determined, and the NB and protein digestibility value were calculated. The net protein utilization (NPU) was calculated by correlation studies between the NI and NB, with a value of 101.3%. The mean true digestibility was 100.1% and the mean requirement for that population was 0.5g protein/kg of body weight/day. Using a 97.5% confidence limit, the protein requirement of the enteral diet was calculated to be 0.8g protein/kg of body weight/day. The enteral diet based on "soya milk" can be profitable for this group of patients. It is a good alternative for use in enteral nutrition, easily available, well tolerable, and of high biological value.
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PMID:[Nutritional value of soya milk in the treatment of malnourished alcoholic patients]. 166 22

The therapeutic effect and the mechanism of action of the synthetic trypsin inhibitor camostate were studied in a rat model of acute interstitial pancreatitis induced by four subcutaneous injections of 20 micrograms/kg body weight of cerulein at hourly intervals. Rats with acute pancreatitis were given either 100 mg/kg body weight camostate or volume- and pH-adjusted water via an orogastric tube 30 min after the last cerulein injection. The elevation of serum amylase activity was significantly reduced by camostate treatment and the peak value was seen 1 hr earlier than that observed in the rats that did not receive camostate. Camostate also inhibited the reduction in pancreatic content of lipase and amylase seen during experimental pancreatitis. These effects were accompanied by alleviation of the histologic signs of acute pancreatitis such as cellular infiltration and acinar cell vacuolization. After oral administration, camostate and its metabolite were absorbed from the intestine and were detectable in plasma for more than 6 hr in concentrations high enough to have antiprotease activity. In addition, camostate in the duodenum was able to increase pancreatic juice flow and protein output and to stimulate endogenous secretin release. These results suggest that oral administration of camostate reduces the severity of cerulein-induced acute pancreatitis by releasing endogenous secretin and by its antiprotease activity.
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PMID:Beneficial effects of the synthetic trypsin inhibitor camostate in cerulein-induced acute pancreatitis in rats. 774 26

The purpose of this study was to investigate whether stress plays a role, morphologically and enzymatically, in the development of severe pancreatitis in rats. Acute hemorrhagic pancreatitis was induced by two intraperitoneal injections of cerulein (40 micrograms/kg body wt) at intervals of 1 h under water-immersion stress for 5 h, whereas water-immersion stress alone did not induce any morphologic and enzymatic changes in the pancreas. In this model, hemorrhagic pancreatitis developed continuously, and the serum amylase level and activation of zymogen proteases in pancreatic tissue were significantly higher than in cerulein-induced pancreatic tissue 5 h after the first cerulein injection. Furthermore, the effects of cerulein on the serum amylase level and activation of zymogen proteases were dose related. Even 5 micrograms/kg body wt of cerulein, which did not induce any evident edematous change in the pancreas, could activate the zymogen proteases of pancreatic tissue fairly well under water-immersion stress compared with pancreatitis induced by 40 micrograms/kg body wt of cerulein alone. These results indicate that stress accelerates the activation of zymogen proteases induced by cerulein and suggest the possibility that stress may play some role in the development of severe pancreatitis.
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PMID:Does stress play a role in the development of severe pancreatitis in rats? 169 53

This experimental study was undertaken to clarify the role of pancreatic enzymes and endotoxin in the pathogenesis of pulmonary edema in acute pancreatitis, paying special attention to the effects of two different intravenous infusions: lactated Ringer's solution (LR) and Dextran 40 (D40). After acute pancreatitis was induced in dogs by injecting autologous gallbladder bile into the main pancreatic duct, plasma endotoxin levels increased markedly in both the LR and D40 groups, and PaO2 decreased more significantly in the D40 group. Extravascular lung water (EVLW) increased more significantly in the D40 group than in the LR group, in spite of the fact that colloid-hydrostatic pressure gradient (CHPG) had been maintained more efficiently in the D40 group. Significant correlation between EVLW and plasma endotoxin level was delineated in both groups, but the slope of the regression line in the D40 group was much greater than that of the LR group. Infusion of trypsin and elastase into the pulmonary artery in normal dogs caused moderate elevation of EVLW in the D40 group, but there was no significant alteration in the LR group. The changes of PaO2, EVLW, and CHPG after infusion of endotoxin were similar to those in the animals with experimental acute pancreatitis. In conclusion, endotoxin appears to play an important role in the pathogenesis of pancreatitis-induced pulmonary edema by causing an increase in pulmonary vascular permeability, and under these circumstances the infusion of large amount of colloid solution promotes the development of pulmonary edema.
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PMID:[An experimental study on the pathogenesis of pulmonary edema in acute pancreatitis, with special interest to the effects of colloid infusion and the role of endotoxin]. 172 52

Dynamic positron emission tomography (PET) was performed following an intravenous bolus injection of 15O-water for the assessment of regional pancreatic blood flow in 4 normal volunteers and 11 patients with pancreatic cancer. The regional pancreatic blood flow index (PFI) was calculated by the autoradiographic method assuming the time-activity curves of the aorta as an input function. The mean PFI value was 0.514 +/- 0.098 in the normal pancreas but it was decreased in pancreatic cancer (0.249 +/- 0.076) (p less than 0.01), with a concomitant decrease in the pancreatic region distal to the tumor. On the other hand, in cases with body or tail cancer, the part proximal to the tumor (nontumorous head region) had a similar PFI value (0.554 +/- 0.211) to that of normal cases. Thus, a PET study with 15O-water permits quantitative assessment of pancreatic blood flow which decreased in both pancreatic cancer and concomitant obstructive pancreatitis distal to the tumor.
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PMID:Assessment of pancreatic blood flow with positron emission tomography and oxygen-15 water. 179 67

In spite of continuous progress in intensive care during the past two decades, there is no definite proof that the prognosis of critically ill patients with acute renal failure has actually improved. Nevertheless, the development of hemofiltration and hemodiafiltration and of the continuous methods has extended the therapeutic spectrum and allows therapy to be adapted to the specific cardiovascular and metabolic situation of the individual patient. Detoxification is carried out intracorporeally in peritoneal dialysis or extracorporeally by means of filters and membranes with different filtration properties. Peritoneal dialysis is seldom indicated in operative patients, because of its low efficiency and the hypercatabolism that is often observed, except in situations where continuous abdominal lavage is desired, as in peritonitis or necrotizing pancreatitis. The standard detoxification method is hemodialysis in which the filter is perfused in the opposite direction to blood flow. Solute transport is the result of diffusion, osmosis and, to a minor extent, convection, and the elimination of small molecules is favored. As huge amounts of dialysate have to be used, a central water regeneration unit is the technical prerequisite for hemodialysis. In critically ill patients bicarbonate dialysis should be preferred, because it is hemodynamically better tolerated. Hemofiltration relies on convection rather than diffusion through a membrane with a cut-off between 20,000 and 50,000 daltons. The ultrafiltrate largely resembles plasma water. Fluid loss is substituted by appropriate electrolyte solutions allowing space for negative balances and hypercaloric parenteral nutrition. Hemofiltration is better tolerated than hemodialysis and was introduced to improve the elimination of toxic middle molecules. In intensive care units without access to hemodialysis or intermittent hemofiltration continuous arteriovenous hemofiltration (CAVH), first proposed by P. Kramer, has become an alternative, mainly because of its simplicity and the absence of hemodynamic side effects. The drawback of this method is its limited efficiency. In hypercatabolic patients daily ultrafiltration rates of 10-15 l will not reduce blood urea sufficiently. The same holds true for severe hyperkalemia. One attempt to increase efficiency is predilution, which involves adding part of the substitution fluid before the filter, to enhance blood flow and to increase the effective filtration pressure by lowering the oncotic pressure of the plasma. Predilution will increase the net urea clearance by some 20%. Another way to enhance filtration is to apply negative pressure to the membrane with the aid of an infusion pump at the filtrate side. The development of better filters with smaller resistances may further increase filtration rates.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Extrarenal elimination procedures in acute kidney failure]. 228 6

A case of spontaneous oesophageal rupture or Boerhaave syndrome is described. The absence of the typical initial vomiting together with a clinical picture that successively indicated repeated myocardial infarction, pancreatitis and pulmonary abscess delayed diagnosis by 4 days, after which emergency thoracotomy, performed on the identification of extravisceral overflow by contrast radiography using a water-soluble medium, revealed necrotic inflammation of the oesophagus, mediastinum and left lung that was so severe that only thoracic drainage was possible. After an initial improvement the patient died of septic shock on the 16th postoperative day.
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PMID:[Spontaneous esophageal rupture or Boerhaave's syndrome. Presentation of a case]. 233 50

Exocrine proteins contained in human pancreatic juice were analyzed by reversed-phase high performance liquid chromatography (RP-HPLC). Pancreatic juice was saved by endoscopic retrograde cannulation of the main pancreatic duct in 17 persons: 12 without pancreatic disease, 3 patients suffering from recurrent acute pancreatitis probably due to pancreas divisum, 1 patient with a carcinoma of the pancreas, and 1 patient with chronic calcified pancreatitis. The juice proteins were separated on a silica column (Nucleosil 300-7 RP) by use of a multistep acetonitrile/water gradient (+0.1% trifluoroacetic acid). Up to 18 individual peaks could be separated by one analytical run (60 min). Molecular weight analysis by sodium dodecyl sulfate-gel electrophoresis indicated the presence of enzymes such as amylase, prophospholipase A2, procarboxypeptidases, trypsinogens, and chymotrypsinogens in certain peaks. Small residual enzymatic activities correlating with certain peaks were detected for amylase and chymotrypsin, and high residual activities were found for phospholipase A (recovery of enzymatic activity compared with the original sample amounted to 65%). Significant amounts of cathodic trypsin-like immunoreactivity were found in two certain peaks. By always loading 350 micrograms of protein/injection on the column the profiles of various samples showed similar patterns. Repeated injections of aliquots revealed highly reproducible profiles. RP-HPLC offers precise, reproducible, and rapid separation of the major proteins of human pancreatic juice.
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PMID:Resolution of human exocrine pancreatic juice proteins by reversed-phase high performance liquid chromatography (HPLC). 234 40


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