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)

Pancreatic uptake of a natural amino acid, L-methionine, was measured in 58 patients using a scintillation camera. This was possible by labelling L-methionine with 11C, a short-lived isotope produced in a cyclotron. Time-activity-curves obtained in areas of interest selected over the pancreas in 25 normal subjects and in 14 alcoholic patients showed a plateau or a slight increase of activity with time. In contrast, in 19 patients with chronic pancreatitis an initial increase in radioactivity was followed by a decrease for 10 to 20 minutes and then by a plateau. The ratio of the height of the plateau at the 50th minute to the height of the peak was 0.74 +/- 0.21 in these patients, whereas it was 0.96 +/- 0.09 in the other subjects (P less than 0.001). This result was compared with direct measurements of 11C radioactivity and of amylase and bicarbonate in duodenal aspirate. The median amount of 11C incorporated into protein at the 70th minute was 53% of total activity in the control group, 28% in alcoholic patients, and only 3% in chronic pancreatitis, the differences between these values were highly significant. The absence of a peak of radioactivity in the duodenal juice, and the existence of a correlation between total 11C output and amylase output suggested that there was no release of protein in the duodenum in chronic pancreatitis. These results also suggested that the peak observed by external detection could be due to amino acid back-diffusion from the pancreas into the blood. External detection with 11C-L-methionine could be used for the assessment of pancreatic dysfunction in man.
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PMID:11C-L-methionine for evaluation of pancreatic exocrine function. 617 85

L-methionine uptake by the parotid gland and pancreas has been compared in 27 patients using a non-invasive methodology. L-methionine was labelled with 11C, a positron emitter with a short half life produced in a cyclotron. 11C-L-methionine concentration was measured in the parotid glands and in the pancreas by external detection using a positron emission tomographic system. 11C-L-methionine uptake by the parotid glands was 4.3 X 10(-3) +/- 1.9 X 10(-3)% of the injected dose per millilitre of tissue (mean +/- SD) in a group of 11 normal non-alcoholic subjects. The uptake was 3.6 +/- 1.3 (X10(-3) in a group of nine alcoholic subjects without pancreatic disorder and it was 4.9 +/- 1.5 (X10(-3) in a third group of seven patients with chronic pancreatitis. These values did not significantly differ. In contrast median pancreatic uptake of 11C-L-methionine was nil in chronic pancreatitis and was lower than that seen in normal subjects (15.3 X 10(-3)% ml, p less than 0.001) and in alcoholic subjects (11.5 X 10(-3)% ml, p less than 0.002). Thus neutral long chain amino acid transport in the parotid gland appears to be independent of that in the exocrine pancreas in chronic pancreatitis. This absence of relationship between the parotid gland and the pancreas in pancreatic disease is in contradiction with the demonstration made in animals of an interaction between these two glands. These results, however, are in agreement with the conclusions drawn from the data collected from the saliva test used by several authors.
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PMID:Comparison of 11C-L-methionine uptake by the parotid gland and pancreas in chronic pancreatitis studied by positron emission tomography. 660 32

Positron emission tomography (PET) was used to assess possible pancreatic disease in 100 patients. Following injection of 10-15 mCi (370-740 MBq) of 11C-L-methionine, 4-12 transverse sections 2 cm thick were obtained. In 85 patients with a definite diagnosis (45 normal, 9 acute pancreatitis, 18 chronic pancreatitis, and 13 cancer), PET showed a sensitivity of 85.0%, a specificity of 97.8%, and an accuracy of 91.8%, higher than with transmission computed tomography (CT) or ultrasonography, despite relatively low spatial resolution; this can be explained by the fact that exocrine pancreatic function was altered prior to morphological change. In 22 normal subjects, 0.011 +/- 0.003% (mean +/- S.D). of injected 11C was found in 1 ml of liver tissue and 0.015 +/- 0.005% in 1 ml of pancreatic tissue; the pancreas-to-liver concentration ratio was 1.3 +/- 0.4. Hepatic 11C concentration was identical in the four groups of patients. Pancreatic uptake of 11C-L-methionine was significantly lower in patients with chronic pancreatitis (n = 13) and pancreatic carcinoma (n = 10) (p less than 0.001); however, it was not possible to distinguish cancer from chronic pancreatitis because the same functional alteration occurred in both.
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PMID:The role of positron emission tomography in the detection of pancreatic disease. 697 92

Synthesis of pancreatic enzymes was measured in 7 patients with chronic pancreatitis and 10 patients with no pancreatic disease, on the basis of the incorporation of 75Se-methionine into pancreatic exocrine proteins. Two of the patients with chronic pancreatitis had normal exocrine function. Pancreatic secretion was stimulated by intravenous infusion of secretin (1 clinical unit x kg-1 x h-1) and cholecystokinin (1 Ivy dog unit x kg-1 x h-1). 75Se-methionine (3.0 microCi x kg-1) was added to the infusion. Synthetic rates were significantly greater in all the patients with chronic pancreatitis, including the two individuals with normal responses to stimulation with secretin and cholecystokinin. Studies of synthetic rates may therefore be able to confirm the diagnosis of chronic pancreatitis before exocrine insufficiency becomes manifest.
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PMID:Pancreatic synthetic rates: a new test of pancreatic function. 713 48

Highly potent substances are produced by the immune system. These substances include cytokines and oxidant molecules, such as hydrogen peroxide, free radicals, and hypochlorous acid. The purpose of immune cell products is to destroy invading organisms and damaged tissue, bringing about recovery. However, oxidants and cytokines can damage healthy tissue. Excessive or inappropriate production of these substances is associated with mortality and morbidity after infection and trauma, and in inflammatory diseases. Oxidants enhance interleukin-1, interleukin-8, and tumor necrosis factor production in response to inflammatory stimuli by activating the nuclear transcription factor, NF kappa B. Sophisticated antioxidant defenses directly and indirectly protect the host against the damaging influence of cytokines and oxidants. Indirect protection is afforded by antioxidants, which reduce activation of NF kappa B, thereby preventing up-regulation of cytokine production by oxidants. Cytokines increase both oxidant production and antioxidant defenses, thus minimizing damage to the host. While antioxidant defenses interact when a component is compromised, the nature and extent of the defenses are influenced by dietary intake of sulfur amino acids, for glutathione synthesis, and vitamins E and C. In animal studies, in vivo and in vitro responses to inflammatory stimuli are influenced by dietary intake of copper, zinc, selenium, N-acetylcysteine, cysteine, methionine, taurine, and vitamin E. Information from animal studies has yet to be fully translated into a clinical context. However, N-acetylcysteine, vitamin E, and a cocktail of antioxidant nutrients have reduced inflammatory symptoms in inflammatory joint disease, acute and chronic pancreatitis, and adult respiratory distress syndrome. Impaired antioxidant defenses may contribute to disease progression after infection with human immunodeficiency virus. Powerful arguments have been advanced for treatment with antioxidants to slow progression of acquired immunodeficiency syndrome.
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PMID:Nutritional antioxidants and the modulation of inflammation: theory and practice. 792 42

The traditional ductal model for the development of chronic pancreatitis leaves many questions unanswered and it has not facilitated management. An alternate philosophy centres on the acinar cell as the site of mounting oxidant stress, usually as a result of steady exposure to xenobiotics that induce cytochrome P450 mono-oxygenases while depleting glutathione: ductal changes are regarded as secondary, disease-compounding manifestations of the oxidant environment. Within this framework each burst of oxidant stress jeopardises exocytosis, to trigger an attack of pancreatitis by interfering with the methionine-to-glutathione transsulphuration pathway, which interacts closely with ascorbate and selenium. The resulting diversion of free radical oxidation products into the pancreatic interstitium causes mast cells to degranulate, thereby provoking inflammation, the activation of nociceptive axon reflexes, and profibrotic interactions.
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PMID:A framework for the aetiogenesis of chronic pancreatitis. 983 31

The Manchester 'oxidant stress' hypothesis for the development of pancreatitis accommodates published information on both chronic pancreatitis and acute pancreatitis. Oxidant stress, mainly from reactive xenobiotic metabolites, is perceived as the pivotal pre-morbid problem in chronic pancreatitis and, by depleting glutathione, targets the exocytosis mechanism of the pancreatic acinar cell. Inhalation exposure to petrochemical products is identified as an independent risk factor in patients at Manchester Royal Infirmary, where some 50% of patients referred have non-alcoholic disease. This paper describes the development of antioxidant therapy, using supplements of methionine, vitamin C and selenium, and its validation in a placebo-controlled trial, followed by a retrospective cross-sectional study in 94 consecutive patients for an average of 30 months. Antioxidant therapy emerges as a safe and effective medical alternative to surgery for painful chronic pancreatitis.
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PMID:Chronic pancreatitis at Manchester, UK. Focus on antioxidant therapy. 983 34

There was conducted operative treatment of patients with complicated chronic pancreatitis. Intravenous infusion of aminoacid cocktail with enhanced content of glutamine, methionine with the selenium addition was applied in the complex of therapy. Under the influence of modified cocktail during 3 days there was observed more complete restoration of the ascorbic acid (AA) level and lowering of her oxidated forms content. This effect became more potent in addition of AA (0.75 per one infusion).
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PMID:[The status of ascorbate oxidation-reduction system of blood in patients with chronic pancreatitis throughout parenteral nutrition]. 1058 6

In patients with complicated chronic pancreatitis--the workers of sea transports complex operative treatment with application of intravenous infusion of aminoacid cocktail (AC) based on "Aminosyn-PF" composition was done. In some patients the modified AC composition with enhanced contents of glutamin, methionine and addition of selenium was applied. After AC infusion during three days more pronounced restoration of SH-groups the whole blood proteinic and non-proteinic fraction was observed, and the influence of modified composition was more pronounced.
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PMID:[The status of thiol-disulphide blood system in patients with chronic pancreatitis in the course of parenteral nutrition]. 1062 98

Positron emission tomography (PET) can be used for the quantitative analysis of amino acid metabolism. The aim of this study was to investigate whether pancreatic exocrine function can be evaluated by [11C]methionine PET in chronic pancreatitis (CP) patients. Dynamic PET scan of the pancreas and liver was performed in eight healthy subjects and seven patients with CP after intravenous (i.v.) injection of [11C]methionine. Simultaneously, duodenal juice was collected with the background of continuous i.v. administration of secretin (125 ng/kg/h). The radioactivity ratio of the pancreas to that of the liver (PLR) was calculated by regions of interest (ROI) analysis. Amylase output and bicarbonate concentration were measured in the duodenal aspirates. The PLR of CP patients was significantly lower than that of healthy subjects at all time points after methionine injection. The PLRs at 4.5 minutes (PLR4.5) after methionine injection were positively correlated with the amylase output, mean bicarbonate concentration, and volume of duodenal aspirates (R = 0.74, 0.69, 0.46). It is concluded that [11C]methionine PET would be a noninvasive method for the evaluation of exocrine pancreatic function, which may represent total amino acids uptake of viable acinar cells in the pancreas.
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PMID:[11C]methionine positron emission tomography for the evaluation of pancreatic exocrine function in chronic pancreatitis. 1124 78


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