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)

By the use of [11C]methionine and positron computed tomography (PCT), images of the pancreas were obtained in 32 patients. The injection of between 10 and 20 mCi of this product enables four to six transverse sections to be obtained. Seventeen of the patients studied had no exocrine pancreatic disease, and in all these cases the pancreas was clearly visible. In four cases of pancreatic carcinoma and one of retroperitoneal tumor, there were abnormalities visible. In five cases of chronic pancreatitis, no pancreatic uptake was observed. In a sixth case, concentration was visible, but only in the head of the pancreas. One case of acute pancreatitis, which showed no concentration during the acute phase, returned to normal after recovery. When visible, the pancreas was easily located and distinguishable from the intestinal image, except in two cases that were uninterpretable for technical reasons. No false positive or negative was observed, but a differential diagnosis between cancer and pancreatitis was impossible.
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PMID:[11C]methionine pancreatic scanning with positron emission computed tomography. 31 98

A comparison of images obtained using 75Se-methionine revealed changes in the shape and position of the pancreas when the patient was in the supine and right lateral decubitus positions. These changes, which were appreciable and often marked in 93% of 168 patients with a probable normal pancreas, sometimes helped in the interpretation of an image. Similar changes were noted in 12 (63%) of 19 patients with chronic pancreatitis where an adequate image could be obtained.
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PMID:Change in shape and position of the pancreas with posture of the patient. 42 62

By contract with the National Cancer Institute, the accuracy of diagnostic techniques was assessed in 184 patients suspected of having pancreas cancer. Of 138 patients who were operated upon, 89 were found to have pancreas duct cancer, 30 had cancer of a different site of origin in the head of the pancreas region and in 19 there was no evidence of cancer at operation. All of the 46 patients who were not operated upon, 13 proven to have cancer and 33 patients discharged as free of cancer, were followed in our clinic. The majority of our patients presented with signs and symptoms of biliary obstruction. Computerized transaxial tomography (CTT) gave a "correct" diagnosis in 31 of 33 patients (94%) with proven cancer, there were 2 patients with a false negative report and a false positive diagnosis occurred in 8 of 20 patients (40%) without cancer. Celiac angiography (CA) gave a correct diagnosis in 78 of 94 patients (83%) with cancer, a false negative in 17%, and a false positive in 32%. 76Selenomethionine pancreas scan correctly diagnosed 27 of 36 patients (75%) with cancer, gave a false negative in 25% and a false positive in 31%. Ultrasonography gave a correct diagnosis in 18 of 27 patients with cancer (67%), a false negative in 33% and a false positive in 28%. Endoscopic retrograde cholangiopancreatography diagnosed correctly 8 of 11 cases (73%) of cancer, there were false negative diagnoses in 3 cases (27%) and false positives in 3 of 14 patients (21%). Duodenal aspiration techniques gave a very low percentage of correct diagnoses. Chronic pancreatitis most commonly gave rise to a false positive diagnosis. Serum alkaline phosphatase was elevated in 82% of patients, gave 18% false negatives and 33% false positives. Carcinoembryonic antigen (CEA) was elevated (greater than 2.5 ng/ml) in most of the pancreas cancer patients but also in patients with other cancers and with non-cancerous diseases. In our hands, CTT, CA, alkaline phosphatase, 75Se-methionine and ultrasonography, in descending order, have given the highest percentage of correct diagnoses but false positive and false negative diagnoses prevented any single test from being conclusive.
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PMID:The value of diagnostic aids in detecting pancreas cancer. 63 74

A well known in physiology fact is that stimulation with enterohormones (secretin, cholecystokinin) causes a steep increase in the synthesis of pancreatic enzymes, and this might affect the plasma level of amino acids. In view of this, this level was studied in healthy subjects and patients with chronic pancreatitis. Hormonal stimulation was observed to cause in healthy subjects a significant rapid fall of the levels of all amino acids, which was greatest in the 20th minute. A less evident fall of the amino acid level was observed in chronic pancreatitis. A high correlation was noted (r = 0.9) between the value of amino acid fall in plasma and the degree of failure of the exocrine pancreatic function measured with the NBT-PABA test. All results are an encouraging indication that plasma amino acid level fall may be used for the assessment of the pancreatic exocrine potential. In the analysis of individual amino acids the most significant fall was noted of methionine, serine, valine, isoleucine, glutamine and tyrosine.
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PMID:[Level of amino acids in blood plasma as a test for exocrine pancreatic function]. 221 24

The overlapping features of the acquired diseases acute pancreatitis and chronic pancreatitis on the one hand, and of chronic pancreatitis and pancreatic involvement in the congenital condition cystic fibrosis on the other, suggest that the basic mechanism of pancreatic injury may be the same in each illness. We propose that pancreatic oxidant stress is the common denominator and, furthermore, that this is facilitated by a shortfall of micronutrient antioxidants in the face of heightened free radical activity through different sources. If so antioxidant supplements should alleviate symptoms. This deduction was supported by an exploratory dose-seeking study that spanned five years in 20 patients with recurrent (non-gall stone) acute or chronic pancreatitis and confirmed by a 20-week double-blind placebo-controlled crossover trial of the successful combination (daily doses of 600 micrograms organic selenium, 0.54 g vitamin C, 9000 IU B-carotene, 270 IU vitamin E and 2 g methionine) in a further 20 cases. A randomised trial of glutathione precursors, given intravenously for 24 hours after admission in patients with a first attack of acute pancreatitis, is in progress. Long-term trials of oral antioxidant formulas are planned in patients with cystic fibrosis.
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PMID:Rationale for antioxidant therapy in pancreatitis and cystic fibrosis. 224 39

Our published dietary and pharmakokinetic studies in 15 patients with idiopathic chronic pancreatitis and 15 age- and sex-matched controls suggested that a combination of subnormal antioxidant intakes and chronic induction of the cytochromes P450 facilitates the pancreatic problem. We have now attempted to determine the relative importance of these two factors by studying a group of 15 institutionalized patients with epilepsy (EP), but without abdominal pain, who were on long-term treatment with anticonvulsant inducers of cytochromes P450 so that their clearance of theophylline (which reflects cytochromes P450 activities, and thereby provides an index of antioxidant demand) was as high as in the patients with chronic pancreatitis (CP) (mean +/- s.d., 123 +/- 59 ml/kg/h versus 120 +/- 62 respectively), and significantly higher than in controls (74 +/- 16 ml/kg/h, P less than 0.02). Canonical variate analysis of the drug kinetic and dietary data provided two functions with which to separate the three groups. The first function, heavily weighted on selenium, separated the controls from the other two groups whose values were lower; the second function, equally weighted on methionine and vitamin C, separated the EP group from the CP group whose values were generally lower. The results suggest that enzyme induction per se is not the critical factor in the development of CP. Instead, suboptimal availability of antioxidants in the face of increased demand--in particular of those substances that protect cells against non-biological free radicals--may be the key consideration, a deduction reinforced by observations in patients with epilepsy who went on to develop chronic pancreatitis.
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PMID:Antioxidants, enzyme induction, and chronic pancreatitis: a reappraisal following studies in patients on anticonvulsants. 322 2

Incorporation of intravenous 75Se-methionine into duodenal juice proteins during pancreatic stimulation was measured as an index of pancreatic enzyme synthesis rates in 12 patients with a normal pancreatogram and in 6 with mild chronic pancreatitis. Isotope incorporation was significantly greater in subjects with mild chronic pancreatitis than in those with a normal pancreatogram. Thus in most patients in whom pancreatography demonstrates the characteristic radiological features of 'mild chronic pancreatitis' pancreatic acinar function is abnormal. The coexistence of morphological and functional abnormality implies that such patients do have chronic pancreatitis.
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PMID:Pancreatic function and enzyme synthesis rates in mild chronic pancreatitis. 374 94

Gamma-topography of the abdominal region and radiometry of duodenal aspirates were used for examination of 707 patients with different gastroenterological pathology using various modes of the administration of 75Se-methionine (intravenously, per os, into the duodenal and cecal lumens, intra-arterially in the celiac trunk and superior mesenteric artery). The RP administered intravenously was accumulated in health in the liver and pancreas. The drug fixation by the proximal part of the jejunum was also typical of chronic pancreatitis, the degree of fixation being well correlated with a period of disease. A jejunum image on gamma-topograms proved to be determined not by radioactivity of the jejunum in passage of labeled pancreatic juice but by extraction of the radionuclide from the blood by its wall. In transduodenal administration of the radionuclide its major part was rapidly absorbed and accumulated in the liver. At the same time a considerable part of the drug remained at the site of administration and retained there for several days. There was almost no absorption of the drug in the cecum and ascending colon. Like in the duodenum, the drug retained at the site of administration for a long time. Intestinal extravasal trophicity was assumed.
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PMID:[Results of the clinical use of 75Se-methionine in gastroenterology with different modes of administration]. 395 13

Altogether 110 patients with different pancreatic diseases were examined on the Picker magna-scanner 500 I (USA) with 75Se-methionine (9.2 MBq). Glucose load at a dose of 0.33 g/kg is recommended 50 min before examination increasing RP accumulation in the pancreas parenchyma and improving scanographic image. It is pointed out that the coincidence of scanographic and pathohistological diagnoses in pancreas cancer is noted in 62.5%, in cystic formations in 89%, and in chronic pancreatitis in 93% cases.
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PMID:[Pancreatoscanography with 75Se-methionine following glucose loading]. 396 10

In a prospective evaluation of patients suspected of having chronic pancreatitis, synthesis of pancreatic enzymes was measured by means of the incorporation of selenium-75-labelled methionine into the proteins of duodenal aspirate during stimulation of pancreatic secretion with secretin (1 CU X kg-1 X h-1) plus cholecystokinin (CCK) (1 IDU X kg-1 X h-1). The rate of pancreatic enzyme synthesis was increased in patients with chronic pancreatitis. Measurement of pancreatic enzyme synthesis was more sensitive in the detection of chronic pancreatitis than either the bicarbonate or the trypsin secretory response to secretin plus CCK. A combination of the bicarbonate secretory response with measurement of the rate of enzyme synthesis provided a positive predictive power of 100% when both tests were abnormal and a negative predictive power of 100% when both tests were normal, so that the combined test can be recommended both for excluding and confirming the presence of chronic pancreatitis.
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PMID:Pancreatic enzyme synthesis in pancreatic disease. 403 92


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