Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149521 (chronic pancreatitis)
 7,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intraoperative ultrasonography has facilitated the localization of insulinomas. In this report, we describe a patient who was found to have an insulinoma in association with an annular pancreas. Because such tumors can be in close approximation to major pancreatic ductal structures, intraoperative ultrasonography can be useful for not only localizing the lesion but also delineating the related anatomic features. Although the optimal management of an asymptomatic annular pancreas has not been determined, our patient had no evidence of chronic pancreatitis and no narrowing of the duodenal lumen; therefore, no bowel bypass procedure was done.
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PMID:Insulinoma in a patient with annular pancreas. 215 94

Thirty-six totally depancreatectomized patients were followed up for 4-124 months. Pancreatectomy had been performed because of fulminant pancreatitis (in 10), chronic hyperalgic otherwise untractable pancreatitis (in 7), exocrine carcinoma of the pancreas (in 16), cystadenocarcinoma of the pancreas (in 2) and insulinoma (in 1). The longest survival duration was in chronic pancreatitis patients: 57 +/- 17 months. A normal socio-professional reinsertion was obtained in 16 patients, mainly those with non-malignant pancreotopathies. At the end of the survey, ten of the carcinoma patients had died, versus none in the other groups. Diabetes mellitus was characterized by the absence of ketonuria, and the frequent occurrence of hypoglycemia (in 15 patients) and infection (in 6). Malabsorption caused osteomalacia in one patient.
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PMID:Survival and rehabilitation after total pancreatectomy. A follow-up of 36 patients. 300 Aug 43

Immunohistochemical studies of neuron-specific enolase were performed on pancreatic tissues from patients with insulinoma, nonfunctioning islet cell tumor, chronic pancreatitis, and pancreatic adenocarcinoma, and from 5 normal patients. The concentration of neuron-specific enolase was also measured in the sera of patients and in the pancreatic tissue, and the tissues were stained for carbohydrate antigen 19-9 by immunohistochemical techniques. Neuron-specific enolase was localized in nerve fibers, normal islet cells, and islet cell tumors; its concentration was elevated only in the tissue of islet cell tumors and in serum from patients with insulinoma. In the pancreatic tissue of pancreatitis or pancreatic adenocarcinoma, various changes in acini and islets were present. The altered islets stained clearly for neuron-specific enolase and could easily be distinguished from altered, unstained acini in cases of pancreatitis or pancreatic adenocarcinoma. Islets in the pancreatic tissue remained intact with various morphologic changes, although acini had degenerated severely. Carbohydrate antigen 19-9 was localized in all the carcinoma cells in the pancreatic tissue and in some of the normal pancreatic ducts. No cells were simultaneously immunostained by anti-neuron-specific enolase and anti-carbohydrate antigen 19-9 antibodies. Thus, neuron-specific enolase is a good marker for islet cell tumor, and is valuable for examining islets in pancreas with various disorders both alone and in combination with other tumor markers.
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PMID:Immunohistochemical study of neuron-specific enolase and CA 19-9 in pancreatic disorders. The value of neuron-specific enolase as a marker for islet cell and nerve tissue. 301 9

By convention, resection of the proximal pancreas includes the distal stomach (and duodenum) and resection of the distal pancreas includes the spleen. In 28 patients the stomach and spleen were preserved to minimize functional disability. In 13 patients with proximal pancreatectomy (7 men, median age 39 years) the pylorus and first 3 cm of duodenum were preserved. Indications were chronic pancreatitis (n = 9) and localized neoplasia (ampulla 2, duodenum 1, insulinoma 1). One patient died (aged 81 years), and 2 required re-operation for a pancreatic abscess or stenosed choledochojejunostomy. The 12 survivors are well at a median of 1.25 years (range 0.25-3.25 years). In 15 patients with distal pancreatectomy (6 men, median age 44 years) the spleen was preserved. Indications were islet cell tumour in 2 and chronic abdominal pain in 13,9 of whom had an isolated dorsal pancreas and 6 of whom had histological evidence of chronic pancreatitis. Recovery was uneventful apart from 2 patients with a fluid collection in the lesser sac, 1 needing percutaneous aspiration. In the absence of gross inflammatory adherence, partial pancreatectomy need not entail removal of the adjacent stomach or spleen.
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PMID:Conservative pancreatectomy. 404 11

The gastric inhibitory polypeptide (GIP) is the main hormone of the incretin type acting on the entero-insular axis. It is released after fat, glucose or meal ingestion. The variations of this secretion are described in obesity and in some pancreatic and gastrointestinal diseases: it is increased in maturity onset diabetes mellitus, obesity or duodenal ulcer, variable according to the food taken and the severity of the pancreatic lesion in chronic pancreatitis and cystic fibrosis, normal in insulinoma and decreased in celiac disease. The impaired absorption of the food-stuffs and the defective feed-back regulation of GIP secretion by insulin are the major causes of these variations. To a lesser degree, gastric acid secretion, gastric emptying and vagal control may also influence GIP secretion.
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PMID:Clinical aspects of GIP secretion. 628 Apr 23

The clinical investigations carried out in a 58 years woman complaining of malaise led to the discovery of an hypoglycaemia resulting from a secreting pancreatic insulinoma. In addition, a chronic pancreatitis, an endocrine hyperplasia (possible nesidioblastosis) and a villous adenomatosis of the pancreatic duct were diagnosed on two biopsies. The immunohistological tests performed on the insulinoma showed insulin, calcitonin and gastrin labelled cells. Electron microscopy displayed numerous neurosecretory granules. The peritumoral endocrine hyperplasia contained intermingled B, A and D cells respectively labelled by insulin, glucagon and somatostatin. Following the operation, the patient recovered without recurrence of the hypoglycaemia (three year follow-up). Factors which may explain such a rare pathological association are discussed.
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PMID:[Pancreatic insulinoma, adenomatosis of the Wirsung's duct and chronic pancreatitis. Apropos of a case]. 813 87

Under physiological conditions, the pancreas scarcely influences the function of the cardiovascular system, although the hormones produced in the healthy pancreas (insulin, glucagon and somatostatin) affect the myocardial contractility in pharmacological doses. Among the diseases of the pancreas, the pancreatic tumours (insulinoma, glucagonoma and vipoma), furthermore the acute and chronic pancreatitis involve cardiovascular complications, which influence the outcome of the disease. Although the clinical picture is dominated by the metabolic changes of the excessively produced hormones in pancreatic tumours, the cardiac and vascular effects of the hormones may be considerable. In acute necrotizing pancreatitis, enzymes released from the pancreas and inflammatory mediators transform acute necrotizing pancreatitis into "multiple organ disease"; one of the important forms of this disease is the cardiovascular shock syndrome. One of the best-known complications of chronic pancreatitis is the pancreoprive diabetes mellitus, and beside that other, nonspecific cardiac alterations (e.g. ECG-changes) may occur.
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PMID:[Cardiovascular complications of pancreatis diseases]. 928 88

The purpose of this manuscript is to provide an overview of the normal development of the pancreas as well as pancreatic pathology in children. Diagnostic imaging plays a major role in the evaluation of the pancreas in infants and children. Familiarity with the range of normal appearance and the diseases that commonly affect this gland is important for the accurate and timely diagnosis of pancreatic disorders in the pediatric population. Normal embryology is discussed, as are the most common congenital anomalies that occur as a result of aberrant development during embryology. These include pancreas divisum, annular pancreas, agenesis of the dorsal pancreatic anlagen and ectopic pancreatic tissue. Syndromes that can manifest pancreatic pathology include: Beckwith Wiedemann syndrome, von Hippel-Lindau disease and autosomal dominant polycystic kidney disease. Children and adults with cystic fibrosis and Shwachman-Diamond syndrome frequently present with pancreatic insufficiency. Trauma is the most common cause of pancreatitis in children. In younger children, unexplained pancreatic injury must always alert the radiologist to potential child abuse. Pancreatic pseudocysts are a complication of trauma, but can also be seen in the setting of acute or chronic pancreatitis from other causes. Primary pancreatic neoplasms are rare in children and are divided into exocrine tumors such as pancreatoblastoma and adenocarcinoma and into endocrine or islet cell tumors. Islet cell tumors are classified as functioning (insulinoma, gastrinoma, VIPoma and glucagonoma) and nonfunctioning tumors. Solid-cystic papillary tumor is probably the most common pancreatic tumor in Asian children. Although quite rare, secondary tumors of the pancreas can be associated with certain primary malignancies.
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PMID:Disorders of the pediatric pancreas: imaging features. 1553 62

MR imaging is a valuable tool in the assessment of the full spectrum of pancreatic diseases. MR imaging techniques are sensitive for the evaluation of pancreatic disorders in the following settings: (1) TI-weighted fat-suppressed and dynamic gadolinium-enhanced SGE imaging for the detection of chronic pancreatitis, ductal adeno-carcinoma, and islet-cell tumors; (2) T2-weighted fat-suppressed imaging and T2-weighted breath-hold imaging for the detection of islet-cell tumors;and (3) precontrast breath-hold SGE imaging for the detection of acute pancreatitis. Relatively specific morphologic and signal intensity features permit characterization of acute pancreatitis,chronic pancreatitis, ductal adenocarcinoma, insulinoma, gastrinoma, glucagonoma, microcystic cystadenoma, macrocystic cystadenoma, and solid and papillary epithelial neoplasm. MR imaging is effective as a problem-solving modality because it distinguishes chronic pancreatitis from normal pancreas and chronic pancreatitis with focal enlargement from pancreatic cancer in the majority of cases.MR imaging studies should be considered in the following settings: (1) in patients with elevated serum creatinine, allergy to iodine contrast, or other contraindications for iodine contrast administration; (2) in patients with prior CT imaging who have focal enlargement of the pancreas with no definable mass; (3) in patients in whom clinical history is worrisome for malignancy and in whom findings on CT imaging are equivocal or difficult to interpret; and (4) in situations requiring distinction between chronic pancreatitis with focal enlargement and pancreatic cancer. Patients with biochemical evidence of islet-cell tumors should be examined by MR imaging as the first-line imaging modality because of the high sensitivity of MR imaging for detecting the presence of islet-cell tumors and determining the presence of metastatic disease.
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PMID:MR imaging of the pancreas. 1593 14

In advanced chronic pancreatitis (CP), islets are preserved even in the midst of scarring. We recently showed in CP local production of interferon (IFN)gamma, transforming growth factor (TGF)beta and death receptor ligand TRAIL (tumor necrosis factor-related apoptosis-inducing ligand), along with functional death receptor neoexpression and apoptosis in exocrine but not in endocrine cells. However, islets are strongly induced for TRAIL-receptor (R)-4 lacking the functional death domain. TRAIL-R4 signaling in T cells induces NFkappaB, which activates antiapoptotic programs. Here, we demonstrate that in insulinoma cells CM, TGFbeta/IFNgamma/TRAIL in combination induced TRAIL-R4 surface expression. TRAIL/IFNgamma upregulated NFkappaB subunits and its target gene survivin while downmodulating IkappaB alpha mRNA. RelA transcriptional activity increased upon stimulation with IFNgamma and IFNgamma/TRAIL. In situ, normal pancreatic epithelia had low mRNA levels of NFkappaB subunits. These were higher in parenchymal areas of CP with severe fibrosis and highest in islets. NFkappaB-regulated proteins IkappaB alpha, survivin and another apoptosis inhibitor, cIAP1, were found in corresponding sites, again at highest levels in islets surrounded by fibrosis. In conclusion, islets in CP not only evade immune attack by nonexposure of functional death receptors in the presence of TRAIL-R4 but also additionally neoexpress NFkappaB and its target genes, survivin and cIAP1, to protect themselves from apoptosis.
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PMID:Parenchymal regression in chronic pancreatitis spares islets reprogrammed for the expression of NFkappaB and IAPs. 1612 31


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