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Query: UMLS:C0149521 (chronic pancreatitis)
 7,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To establish a new experimental model of chronic pancreatitis (CP) with diabetes, we investigated pancreatic endocrine function, blood flow, and histopathology in CP induced by repetition of cerulein injection plus water immersion stress in rats. CP rats were treated with water immersion stress for 5 hr and two intraperitoneal injections of 20 micrograms/kg body weight of cerulein once a week for 16 weeks. In the CP group, pancreatic contents of protein, amylase, elastase, and lipase significantly decreased to 64, 38, 23, and 68% of the control group, respectively. In oral glucose tolerance test (glucose 2 g/kg body wt), blood glucose level in the CP group was 212.1 +/- 97.8 mg/dl (mean +/- SD) at 30 min and was significantly higher than the control group (126.3 +/- 15.4 mg/dl)(P < 0.05). Two of seven rats in the CP group showed an obvious diabetic insulin in the CP group was 640.1 +/- 148.7 pM, significantly lower than in the control group (1133.4 +/- 242.0 pM)(P < 0.001). However, insulin content in the pancreas was 12.37 nmol/pancreas). In CP rats, winding and dilatation of surface blood vessels and gland atrophy were evident. Marked fibrosis, fatty changes, and destruction of lobular architecture were also demonstrated microscopically, although the structure of each pancreatic islet was preserved and each islet was fully stained with anti-insulin antibody. In the CP group, pancreatic blood flow by the hydrogen gas-clearance method was 197.6 +/- 33.0 ml/min/100 g, which was significantly less than the control group (276.2 +/- 19.1 ml/min/100 g) (P < 0.001). Thus, we conclude that the CP model induced by cerulein plus stress is a new CP model with diabetes in rats, in which the glucose tolerance was impaired without loss of insulin reserve.
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PMID:New chronic pancreatitis model with diabetes induced by cerulein plus stress in rats. 758 14

Measurement in faeces of the principal nutrients, fat (F), water (W) and nitrogen (N) is useful to assess digestive and absorptive functions and thus to monitor patients' progress and response to therapy in malabsorption/maldigestion syndromes. Presently available techniques are not ideal in clinical practice for serial analysis as they are time-consuming and require unpleasant and prolonged handling of the stools. The present study aimed to evaluate the accuracy and precision of near infrared reflectance analysis (NIRA) in routine measurement of fat, nitrogen and water faecal contents compared with Van de Kamer (VDK), Kjeldahl (KJ) and gravimetric-by-lyophilization (LY) methods, respectively. Fat, nitrogen and water (n = 34), were measured in the 1-day faecal collections of 15 healthy subjects and 19 patients (10, coeliac disease; 6, chronic pancreatitis; 3, small-bowel Crohn's disease). A highly significant linear correlation was found between VDK, KJ, LY methods and NIRA analysis. Very low values of intra-assay coefficient of variation indicated a remarkable analytical precision of NIRA. A recovery test at different concentrations in the useful range was performed for all three nutrients, to assess the accuracy of NIRA. Quantitative recoveries were between 95 and 105%. Data from the present study show that NIRA analysis is reproducible, accurate and rapid (less than 1 min). These characteristics make NIRA serial analysis useful in clinical practice to monitor progress and response to therapy in patients with malabsorption/maldigestion syndromes.
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PMID:Quantitative determination of faecal fat, nitrogen and water by means of a spectrophotometric technique: near infrared reflectance analysis (NIRA). Assessment of its accuracy and reproducibility compared with chemical methods. 775 14

Four-hour intravenous ethanol infusion at two doses of 0.5 and 1.0 g/kg.hr caused mild, but significant, rises in serum amylase and pancreatic water content as well as pancreatic histological changes such as interstitial edema in rats. These doses of ethanol also caused an impaired pancreatic adenylate energy charge levels and increased pancreatic mitochondrial fragility. The dose of 0.2 g/kg.hr caused only marginal changes in these parameters. Moreover, gabexate mesilate (FOY) at the dose of 20 mg/kg.hr inhibited almost completely all these pancreatic injuries induced by ethanol, exerting significant protective effects. These results suggest that impaired pancreatic energy metabolism and increased mitochondrial fragility seem to play an important role in the pathogenesis of ethanol-induced pancreatic injuries, and that some unknown protease activity, which can be inhibited by FOY, also seems to play an important role. Finally, FOY seems to be useful in protecting the exocrine pancreas in the alcoholic patients. Excessive intake of ethanol often precedes the development of both acute and chronic pancreatitis, and pancreatitis occurs more commonly in alcoholics than in the general population. Thus, alcohol has been reported to be one etiological factor in the pathogenesis of human pancreatitis. However, little is known about the mechanism whereby alcohol induces pancreatic acinar cell injuries. Moreover, there have been few reports regarding the effect of ethanol on pancreatic adenylate energy metabolism. Recently, we have reported the important role of subcellular organellar fragility in the triggering of pancreatic injuries in other models of pancreatitis such as secretagogue-induced and pancreatic duct obstruction. In this study, we evaluated the effect of ethanol administration at various doses on the exocrine pancreas from several parameters including pancreatic adenylate energy charge levels and subcellular organellar fragility as well as the protective effect of a synthetic protease inhibitor, gabexate mesilate (FOY) [ethyl-4-(6-guanidino hexanyloxy benzoate) methanesulfonate; M.W. 417 daltons].
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PMID:Protective effect of gabexate mesilate (FOY) against pancreatic injuries induced by ethanol in rats. 782 81

Pure pancreatic juice composition was studied, after secretin and cerulein stimulation in 29 people from Burundi (Central Africa): 17 controls and 12 alcoholic chronic pancreatitis (CP) patients. Results were compared to similar data in France. African controls had a similar pancreatic response to hormones apart from a much lower lipase secretion than French controls. In the early non-calcified stage of African CP water and bicarbonate secretion were markedly diminished while protein and lipase concentrations were enhanced. In the late stage, secretion was exhausted except that of calcium. Nutritional data were obtained under the same conditions in 40 African controls and in 34 CP patients (including all patients tested for secretion). African controls had a very low fat intake (35.2 +/- 2.6 g/day), and patients had a higher protein and fat intake (144.7 +/- 5.9 and 66.2 +/- 4.8 g/day, respectively) than local controls: as in other countries, CP was associated with a diet enriched in alcohol, fat and protein.
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PMID:Exocrine pancreatic secretion in normal controls and chronic calcifying pancreatitis patients from Burundi: possible dietary influences. 851 89

With the purpose of enhancing efficacy of health-resort treatment of chronic pancreatitis, patients with relevant clinical form and stage of the disease course, early revealed distinguishing features of disturbances in the exocrine function of pancrease should be referred to those health resorts having adequate mineral waters. 75 patients with chronic pancreatitis presenting with various type pancreatic secretion derived benefit from differentiated use of mineral water and physiotherapeutic procedures.
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PMID:[Principles of the differentiated use of the natural and preformed therapeutic factors of a health resort in patients with chronic pancreatitis]. 913 86

We evaluated the diagnostic significance of the K-ras point mutations at codon 12 in duodenal lavage fluid (DLF) compared with pure pancreatic juice (PPJ). The DLF was easily and safely collected by injecting distilled water into the duodenum and then aspirating through the working channel of the endoscope during endoscopic retrograde cholangiopancreatography. Two types of DLF are collected this way: DLF 1 is collected just after insertion of the endoscope into the duodenum and DLF 2 is collected after cholangiopancreatography and/or collection of the PPJ using secretin. Analysis of K-ras mutations was performed using enriched polymerase chain reaction. In patients with pancreatic carcinoma (PC), K-ras mutations were detected in 14 of 23 (60.9%) in DLF 1, 16 of 21 (76.2%) in DLF 2, 14 of 20 (70.0%) in PPJ, and 19 of 21 (90.5%) in either DLF 1 or DLF 2. In patients with noncancerous pancreatic diseases consisting of pancreatic cystic diseases and chronic pancreatitis, the incidence of K-ras mutations was 2 of 21 (9.5%) in DLF 1 and 7 of 19 (36.8%) in DLF 2. These values were lower than that in PPJ, and there was significant difference between the incidence in DLF 1 and PPJ. These results suggested that DLF may provide a new and useful material for analysis of K-ras codon 12 point mutations in the diagnosis of PC.
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PMID:Analysis of K-ras codon 12 point mutations using duodenal lavage fluid for diagnosis of pancreatic carcinoma. 1009 Apr 10

The purpose of this study was to investigate the morphological changes in the islets observed in a new chronic pancreatitis model with diabetes induced by repetition of cerulein injection plus water-immersion stress in rats. The rats of this model were treated with water-immersion stress for 5 h and two intraperitoneal injections of 20 micrograms/kg body weight of cerulein once a week for 16 weeks. In the stress and cerulein group, 62% of the islets exhibited infiltration of mononucleated cells, and/or peri- and intrainsular fibrosis. On immunohistochemical study, some islets showed reduced density of the insulin immunoreactivity. The glucagon-producing cells decreased in number. With electron microscopy, various endocrine changes were observed, mainly in the B cells. The changes included scattered debris damage with reduction of secretary granules, and vesiculation of the endoplasmic reticulum. Numerous fibroblasts clustered around the islets, and proliferating collagen fibers invaded the islets. The microvascular changes consisted of bleeding and damage to the endothels. In the pancreas treated with stress alone or cerulein alone, significant endocrine damage was not observed. In conclusion, chronic repetitive treatment with stress and cerulein, together with poor islet circulation due to fibrosis and vascular changes, resulted in the endocrine cellular damage.
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PMID:Morphological study of pancreatic endocrine in an experimental chronic pancreatitis with diabetes induced by stress and cerulein. 1044 84

The intraportal site is the most common site for islet transplantation. Many other sites have been tried experimentally, including the spleen, which has successfully lead to insulin independence in a number of animal models. Nevertheless, there are no detailed reports of total pancreatectomy and splenic islet autotransplantation in humans. Five patients underwent total pancreatectomy and splenic islet autotransplantation for chronic pancreatitis. Four patients had a pylorus-preserving total pancreatectomy and one patient a duodenal-preserving pancreatectomy. In three cases islets were embolized into both the portal vein and spleen. Two patients received splenic islet transplants alone. Islets were transplanted by retrograde venous infusion via the short gastric veins (n = 3), splenic vein stump (n = 1), and the left gastroepiploic vein (n = 1). The total volumes of transplanted pancreatic digest in those receiving combined intraportal and splenic autografts (n = 3) were 15.8, 13.0, and 13.5 ml. The volumes in those receiving a splenic-alone autograft (n = 2) were 12.0 and 5 ml. The mean rise in portal pressure was 18 cm of water. Complications related to the splenic autograft included a wedge splenic infarct, an emergency splenectomy, and a portal vein thrombosis in one patient having a combined intraportal and splenic autograft. Two patients developed insulin independence. two patients were still insulin independent at 1-year follow-up, and all had normal HbA1c levels (mean 5.6, range 5.2-6.3). Splenic islet autotransplantation, after total pancreatectomy, does lead to insulin independence. However, in our experience the combined procedure has a high morbidity because of splenic infarction and venous thrombosis.
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PMID:The risks of total pancreatectomy and splenic islet autotransplantation. 1078 62

The intake of larger quantities of alcoholic beverages leads to manifold functional disturbances and organ injury in the upper gastrointestinal tract. These damaging effects of alcohol are frequently the cause of complaints, such as heart burn, symptoms of dyspepsia and diarrhoea. Examples of more pronounced organ injury which can occur even following a single episode of heavy drinking are tears in the mucosa at the junction of the esophagus and the stomach (Mallory-Weiss-lesion) and hemorrhagic erosions in the stomach and/or the duodenum which may lead to massive bleeding. In the small intestine alcohol abuse interferes with the absorption of glucose, amino acids, lipids, water, sodium and vitamins (especially thiamine and folic acid). This inhibition of absorption of nutrients may contribute to nutritional deficiencies frequently observed in alcoholics. Acute alcohol ingestion can also damage the mucosa in the upper region of the small intestine and may lead to the disruption of the tips of the villi. Chronic alcohol abuse increases markedly the prevalence of bacterial overgrowth in the small intestine. The findings of human and animal studies suggest that the mucosal injury together with bacterial overgrowth favour the following sequence of events: Alcohol induced mucosal injury in the small intestine increases the permeability of the mucosa to macromolecules, such as endotoxin and/or other bacterial toxins, into the blood or lymph. This results in the release of potentially toxic cytokines and other mediators like Kupfer cells and other phagocytes. These cytokines and other mediators, in turn, exert multiple injurious effects on the microcirculation and membranes. The result is cell damage and even cell death (apoptosis, necrosis) in the liver and other organs. Chronic alcohol abuse is one of the most important risk factors for the development of cancers of the tongue, larynx, pharynx and esophagus. In many countries alcohol abuse is the most important cause for the development of chronic pancreatitis. In the initial phase the disease is frequently characterised by episodes of 'acute' pancreatitis. These episodes develop only on the basis of prolonged alcohol abuse leading to subclinical damage of the gland. The latter is found in about 20-50% of patients with chronic alcohol abuse while the clinically overt pancreatitis is observed in only 1%-3% of alcoholics. Despite numerous studies performed in animal experiments and man the pathogenesis of alcoholic pancreatitis until now has not been clarified.
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PMID:[Alcohol, the gastrointestinal tract and pancreas]. 1080 79

The involvement of pancreatic acinar cell apoptosis and its relation to glucocorticoid exposure were investigated in spontaneously occurring chronic pancreatitis in male Wistar Bonn/Kobori (WBN/Kob) rats. Although most lobules were not inflamed in 10-week-old WBN/Kob, increased apoptosis of pancreatic acinar cells, confirmed by TUNEL staining was focally observed (0.10 +/- 0.10 vs. 0.05 +/- 0.10/field in 10-week Wistar rats). Localized hemorrhagic lesions and brown foci in the splenic lobes were apparent, with significant decrease in pancreas weight in 20-week WBN/Kob rats along with marked apoptosis (1.95 +/- 0.31 vs. 0.07 +/- 0.04/field in 20-week Wistar rats). Electron microscopy revealed apoptotic bodies to be present in acinar cells. Pancreatic myeloperoxidase activities, indirect indices of granulocyte infiltration, as well as histologic scores were significantly increased at 15 and 20 weeks, and endogenous corticosterone levels were significantly decreased at 10, 15, and 20 weeks as compared with values for age-matched Wistar rats. Prednisolone in the drinking water (0.01 mg/mL; calculated dose, 1.03 0.03 mg/kg/d) for 10 weeks significantly attenuated increases in numbers of apoptotic acinar cells and pancreatic myeloperoxidase activities and tended to reduce the histologic scores in 20-week WBN/Kob rats as compared with the vehicle group. In summary, (a) apoptosis of pancreatic acinar cells is involved in chronic pancreatitis, (b) endogenous corticosterone is decreased, and (c) prednisolone treatment attenuates both apoptosis of pancreatic acinar cells and chronic pancreatitis in male WBN/Kob rats. We conclude that apoptosis of acinar cells related to decreased corticosterone may be a trigger of chronic pancreatitis in this model.
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PMID:Apoptosis of acinar cells is involved in chronic pancreatitis in Wbn/Kob rats: role of glucocorticoids. 1103 75


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