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)

The present study was designed to examine and compare the peptide composition and relative immunochemical purity of GIH and Boots secretin preparations. Gastrointestinal peptides were measured by radioimmunoassay using antibodies to secretin, gastrin, immunoreactive cholecystokinin, vasoactive intestinal peptide, gastric inhibitory peptide, and somatostatin. Boots secretin was found to contain substantial quantities of gastrin, immunoreactive cholecystokinin, vasoactive intestinal peptide, gastric inhibitory peptide, and somatostatin. In contrast, GIH secretin contained only a very small amount of vasoactive intestinal peptide. GIH also contained approximately three to four times more secretin per unit as did Boots secretin. Intravenous infusion of Boots, but not GIH, secretin in seven healthy volunteers produced significant increases in venous plasma of all peptides. Results of these studies indicate that Boots secretin contains large and variable quantities of gastrointestinal peptides other than secretin and that the contents of both secretin and the other peptides vary among different lots. Because the quantity of these peptides is sufficient to increase significantly their blood levels and consequent biological effects, it is concluded that GIH is preferable to Boots secretin in the clinical evaluation of patients with suspected chronic pancreatitis or gastrinoma.
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PMID:Peptide characterization of secretin preparations. 286 51

Plasma cholecystokinin (CCK) and human pancreatic polypeptide (hPP) responses after ingestion of a liquid test meal rich in medium-chain fatty acids (MCFA) were studied in patients with chronic pancreatitis with or without diabetes mellitus (DM). Integrated response of plasma CCK was significantly lower in patients with chronic pancreatitis and DM than in the two other groups. There was no statistically significant difference between the healthy control subjects and the patients with chronic pancreatitis without DM in the integrated responses of hPP and plasma CCK. These results indicate that diabetic patients with a greatly destroyed pancreas do not release as much CCK as do nondiabetic patients with a mildly impaired pancreas. An MCFA meal is therefore considered safe in patients with a mildly impaired pancreas. For diabetic patients, however, care should be taken not to exacerbate the DM.
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PMID:Plasma cholecystokinin and pancreatic polypeptide responses after ingestion of a liquid test meal rich in medium-chain fatty acids in patients with chronic pancreatitis. 291 44

Plasma concentrations of human pancreatic polypeptide (HPP) parallel exocrine pancreatic secretion in response to stimulation with cholecystokinin. We determined prospectively the relationships among fasting HPP level, integrated HPP response to infusion of cholecystokinin, and output of trypsin and also the sensitivity, specificity, and predictive values of the fasting HPP level in the diagnosis of exocrine pancreatic disease. Our study group consisted of 19 patients with acute pancreatitis, 17 with chronic pancreatitis, and 25 with ductal adenocarcinoma of the pancreas and 27 control subjects. In the control patients and those with chronic pancreatitis, significant correlations were detected between HPP level and output of trypsin (P less than 0.001) in response to infusion of cholecystokinin and between fasting HPP and integrated HPP levels (P less than 0.004); no correlation was detected between HPP level and steatorrhea. The sensitivity, specificity, and negative and positive predictive values of the fasting HPP level for detection of either chronic pancreatitis or pancreatic cancer were similar and approximated 0.88, 0.67, 0.88, and 0.66, respectively. The HPP concentration had no value in detecting acute pancreatitis. Because the fasting HPP level has a high degree of negative predictability and is simpler to measure than the integrated HPP level or the output of trypsin, it may be a useful test in patients suspected of having either chronic pancreatitis or pancreatic cancer. A fasting HPP level of 125 pg/ml or greater could be used to exclude chronic pancreatitis or pancreatic cancer, but the finding of a value of less than 125 pg/ml necessitates use of other diagnostic tests for reliable determination of the presence of these diseases.
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PMID:Can plasma human pancreatic polypeptide be used to detect diseases of the exocrine pancreas? 298 84

The study of cytology in duodenal and/or pure pancreatic juice has been proposed in the differential diagnosis of pancreatic cancer. In our experience the sensitivity of cytology in duodenal juice, collected during Secretin-Cholecystokinin test, in diagnosing pancreatic cancer was 66.6%. False positive results were obtained only rarely (1.4%) in patients with chronic pancreatitis and benign diseases of the gastrointestinal tract. The cytological evaluation of pure pancreatic juice, obtained by ERCP, increases sensitivity up to 80-90%, especially when the combination of the results of ERCP and cytology is performed. Cytological examination of duodenal and/or pure pancreatic juice is a useful tool in detecting pancreatic malignancy and in differential diagnosis with chronic pancreatitis.
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PMID:Cytology in the diagnosis of pancreatic cancer. 320 68

To study the effects of trypsin on the pancreaticobiliary secretion and the release of secretin and cholecystokinin (CCK) to plasma, seven normal subjects were stimulated twice with duodenal perfusates containing 20 mM oleic acid (pH 6.0) with and without 1 g of bovine trypsin added per liter. In addition, six patients with advanced pancreatic insufficiency who received only the oleic acid were compared with eight normal subjects. The concentrations of secretin and CCK in plasma and the pancreatic enzyme and volume secretions were unaffected by the addition of trypsin, but the initial bile acid output and the bicarbonate secretion in the period after gallbladder emptying were reduced during perfusion with trypsin. The severely reduced enzyme secretion in chronic pancreatitis did not influence the basal or oleic acid-stimulated concentrations of the hormones in plasma. The study does not support the hypothesis of a trypsin-mediated negative feedback control of human pancreatic enzyme secretion. Furthermore, the reduced duodenal output of bicarbonate found in response to trypsin is not explained by changes in the release of secretin or CCK.
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PMID:Effect of trypsin on the hormonal regulation of the fat-stimulated human exocrine pancreas. 322 3

Secretin and cholecystokinin-pancreozymin had no effect on the secretion of human gastric lipase, in contrast to pentagastrin, which increased the gastric lipase output but not the enzyme concentration in gastric juice. The secretion of gastric lipase was not significantly different in patients with duodenal ulcer or chronic pancreatitis and in controls. In contrast, basal gastric lipase concentration was significantly lower in children with cystic fibrosis than in normal children. This shows that neither in adults nor in children is there a compensation for a decreased lipase secretion by an increased gastric lipase secretion.
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PMID:Human gastric lipase: variations induced by gastrointestinal hormones and by pathology. 324 86

In chronic pancreatitis, increased concentrations of Na+ and Cl- in sweat have been attributed to increased parasympathetic drive. It was postulated that similar changes might occur in saliva. To avoid masking increased parasympathetic drive, saliva was collected without stimulation. In patients with chronic pancreatitis, there were significant increases of concentrations of Na+ and Cl- in basal salivary concentrations. These differences disappeared when salivary secretion was stimulated with citric acid. Anatomic or neurologic modification of the salivary glands seemed unlikely as stimulated concentrations did not differ from those in the control subjects. Perfusion of cholecystokinin (CCK) did not modify concentrations of Na+ or Cl-. Parasympathetic blockade reduced salivary secretion in both patients and controls (p less than 0.001). As tubular absorption of Na+ and Cl- was constant and the volume of saliva was diminished, it followed that there was a reduction in Na+ and Cl- salivary output. As amylase secretion is under sympathetic control, atropine had little effect other than increasing the salivary amylase concentration. The secretory modifications observed with atropine were the same in both patients and control subjects, as the increased parasympathetic drive of the patients was blocked.
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PMID:[Effects of chronic pancreatitis on salivary secretion]. 344 6

Plasma cholecystokinin (CCK) responses after ingestion of a test meal in patients with mild chronic pancreatitis having abdominal pain were studied with a radioimmunoassay using the CCK specific antiserum (OAL-656) produced by a novel immunization procedure. Mean concentration of the fasting plasma CCK determined using CCK-8 as a standard was 31.5 +/- 5.8 pg/ml in six patients who had mild impaired exocrine function with pain, and was significantly higher than 10 healthy subjects (9.8 +/- 1.8 pg/ml). In those patients, the ingestion of a liquid test meal led to a peak of 75.1 +/- 25.4 pg/ml at 30 min, and the 120-min integrated CCK response (5427 +/- 1217.3 pg X min/ml) was significantly higher than in healthy subjects (1538 +/- 110.1 pg X min/ml).
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PMID:High plasma cholecystokinin levels in patients with chronic pancreatitis having abdominal pain. 353 53

Plasma concentrations of cholecystokinin (CCK) have been reported to be elevated in patients with chronic pancreatitis. The elevations are suggested to be due to increased release of CCK from the upper small intestine secondary to the absence of protease activity (trypsin and chymotrypsin) in the intestinal lumen. We have studied plasma CCK levels before and after liquid as well as solid meals in eight patients with pancreatic insufficiency due to advanced chronic pancreatitis and in eight healthy controls. CCK concentrations were measured with a sensitive and specific radioimmunoassay using an antibody directed against the sulfated tyrosyl region of CCK. No differences in basal or maximal postprandial plasma CCK levels between patients and controls were observed. In the liquid meal study, basal CCK concentrations in patients and controls were 2.2 +/- 0.7 and 2.5 +/- 0.4 pM, respectively, with maximal postprandial concentrations of 9.6 +/- 2.2 and 11.2 +/- 1.4 pM. In the solid meal study, basal CCK concentrations in patients and controls were 2.5 +/- 0.6 and 2.6 +/- 0.4 pM, respectively, with maximal postprandial concentrations of 9.4 +/- 1.6 and 8.6 +/- 1.4 pM. The only difference observed was a significantly longer time interval to maximal plasma CCK levels in patients as compared with controls after the liquid meal. Two patients with no detectable trypsin activity in the small intestinal lumen during a Lundh test meal had basal CCK levels of 1.3 and 1.8 pM. Thus, the present study does not support the hypothesis that trypsin is involved in the regulation of CCK release.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Plasma cholecystokinin concentrations in patients with advanced chronic pancreatitis. 356 43

Course and prognosis of 125 patients with chronic pancreatitis (CP) were evaluated. Follow-up period ranged from 1-20 years with a median of 6.3 years. The following conclusions were obtained. Recent increase of CP in our clinics was ascribed to alcoholic CP and idiopathic CP in the aged. Of 106 patients with pain, 74 showed improvement or disappearance of pain. Drinking habit and observation period were the main factors determining the rate of pain relief. Serial endoscopic retrograde pancreatography (ERP) showed aggravation in 17/47 patients, cholecystokinin-pancreozymin (CCK-PZ) secretin test in 4/40 patients, and oral glucose tolerance test (OGTT) in 7/25 patients. Exocrine function showed improvement in five patients, whereas endocrine function showed none. Improvement or aggravation of exocrine function was closely related to drinking habit. Main complications included 15 cases of peptic ulcer, 19 of pancreatic pseudocyst, and 15 of bile duct stenosis. Twenty-six patients died, often due to malignant neoplasms and diabetic complications. Those who continued drinking as much showed a lower survival rate than those who discontinued or decreased alcohol intake. The socioeconomic status deteriorated often due to pain or alcoholism. Three patients had to degrade jobs and six fell into inactive social life.
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PMID:Clinical course and prognosis of chronic pancreatitis. 362 35


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