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

46 patients, who suffered from chronic renal insufficiency (serum creatinine: 1,4-14,9 mg%) and had not yet been dialysed, were given a secretin-pancreozymin-test. Statistical evaluation of the results and comparison with a healthy reference group showed amylase secretion, total secretory volume and bicarbonate secretion to be significantly reduced in patients with serum creatinine levels above 4,0 mg%. No signs of secondary hyperparathyroidism (laboratory data, osseous changes) were observed. Blood base excess and increased serum creatinine levels were significantly related. Together with influences of low protein diet metabolic acidosis going along with chronic renal insufficiency is consequently considered to be the pathogenic factor responsible for alterations in the exocrine function of the pancreas and for the occurrence of chronic pancreatitis.
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PMID:[The exocrine pancreatic function in chronic renal insufficiency (author's transl)]. 3 41

Seven patients were investigated 8--22 months after duodenectomy and pancreatectomy for chronic pancreatitis or cancer. Seven other patients, admitted for minor surgery, served as controls. 40 ml 100 mmol/l HCl was infused over 5 min into the jejunum 10 cm beyond the gastrojejunal stoma in the duodenectomized patients and 10 cm beyond the pylorus in the controls. Plasma immunoreactive secretin (IRS) increased from 3.0 +/- 0.8 pmol/l (mean +/- S.E.M.) to 9.8 +/- 0.5 pmol/l (p less than 0.01) in the duodenectomized patients. In the controls the increase was significantly higher than in the patients (p less than 0.01)--from 1.5 +/- 0.3 pmol/l to 19.5 +/- 3.3 pmol/l (p less than 0.01). The study shows that the jejunum is able to release IRS after acid infusion in duodenectomized patients.
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PMID:Immunoreactive secretin release in patients after duodenectomy and partial or total pancreatectomy. 4 89

Angiography before and after the administration of Glucagon was performed in 33 adult patients with symptoms suggesting a pancreatic lesion. Preferently the pancreatographic effect was evaluated. The results were compared with those of the angiography following the administration of Secretin and Tolazoline. The pancreatographic effect was visualized in 70% of the patients examined with Glucagon and the rate of visualization of the effect with Secretin and Tolazoline was 60% and 74.5% respectively. The representation of the small vessels could be enhanced with Glugacon only in 15% for the arteries and in 12.5% for the veins, whereas using Secretin and Tolazoline the improvement raised up to 78% of the cases. -- The pancreatographic effect as an additional sign is useful in the differential diagnosis of the chronic pancreatitis (mottled) and the carcinoma of the pancreas (defect or absence of the effect).-- The superselective technique is recommendable. Using this method an improvement of the pancreatographic effect can be achieved already. In pharmacoangiography Tolazoline gives better results than Glucagon.
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PMID:[The pancreatographic effect during pharmacoangiography of the pancreas following the administration of glucagon (author's transl)]. 13 54

The practical approach to the investigation of diarrhea must be logical and based on anatomic considerations. The site of the underlying disorder may be determined by the clinical picture, and the logic of investigation will be influenced by the history. Important specific investigation in a case of colonic diarrhea include a careful rectal examination, stool inspection, sigmoidoscopy, rectal biopsy and barium enema study. Colonoscopy has been used, but its role has yet to be defined. In a case of small-bowel steatorrhea or diarrhea quantitative chemical estimation of the daily output of stool fat is useful, and to this investigation is added a small-bowel radiograph series and, if the radiographic findings are abnormal, small-bowel biopsy. Other investigations for small-bowel disease may include the breath test with carbon-14-labelled glycocholic acid, the lactose tolerance test, duodenal aspiration for giardiasis, analysis of serum immunoglobulins and, on occasion, isolation of vasoactive intestinal polypeptide hormone (which may aid the diagnosis of functioning tumours of the pancreas or small bowel). Investigations for pancreatic steatorrhea include abdominal radiography, performance of the secretin test and testing of the response to pancreatic replacement therapy. In some patients it may be useful to use endoscopic retrograde cholangiopancreatography to differentiate pancreatic carcinoma and chronic pancreatitis.
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PMID:Symposium on diarrhea. 3. Investigation of chronic diarrhea. 19 Nov 73

Plasma cyclic AMP levels were determined during a 40 minute secretin infusion (1 Cl.U kg-1h-1) followed by a 40 minute combined secretin (1 Cl.U kg-1h-1) caerulein (75 ng kg-1h-1) infusion. In nine healthy subjects, both secretin alone and secretin in combination with caerulein did not affect plasma cyclic AMP levels. The same was observed in six patients with chronic pancreatitis. By contrast, in patients suffering from liver disease (nine cases) or extrahepatic cholestasis (six cases), secretin elicited large increases in plasma cyclic AMP concentration; the mean values attained being, respectively, seven and four times higher than before the infusion. On the other hand, increases in plasma cyclic AMP 10 minutes after a bolus injection of glucagon (1 mg) were four times lower in the liver disease group as compared to the controls. The results reported here suggest that the liver plays a major role in the degradation of plasma cyclic AMP produced by target tissues responding to secretin, and in the release of cyclic AMP under glucagon. Liver disease reduce the capacity of the liver to clear cyclic AMP from the blood. The pancreas does not contribute significantly to the cyclic AMP in the blood.
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PMID:Plasma cyclic AMP levels during a secretin-caerulein pancreatic function test in liver and pancreatic disease. 20 44

A new test using N-benzoyl-L-tyrosyl-p-aminobenzoic acid (N-BT-PABA) for an evaluation of exocrine pancreatic function was compared with a pancreozymin-secretin test in 38 subjects. Urinary recovery of PABA, which is absorbed from the intestine and conjugated in the liver after an oral administration of N-BT-PABA, depends mainly on chymotrypsin activity. The recovery rate of PABA in urine decreases in chronic pancreatitis, in which chymotrypsin activity in the duodenal juice is disturbed. The recovery rate of PABA in calcifying chronic pancreatitis was 40.2 +/- 15% and significantly less than 81.2 +/- 7.4% in normal subjects (P less than 0.01). The amount of PABA in urine during eight hours was correlated with parameters of volume output- bicarbonate concentration and amylase output stimulated by injections of pancreozymin and secretin (P-S test). The new test using N-BT-PABA is useful for the evaluation of exocrine pancreatic function in general practice.
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PMID:Oral administration of chymotrypsin labile peptide for a new test of exocrine pancreatic function (PET) in comparison and pancreozymin-secretin test. 30 13

The diagnosis of both acute and chronic pancreatitis continues to be a challenge despite the development of new techniques and the refinement of old methods. The problem is best approached by the application of a combination of tests which can provide a reasonable degree of sensitivity and specificity applicable to the different forms of pancreatitis. In acute pancreatitis an elevation of serum amylase and amylase/creatinine clearance ratio is diagnostically useful. In chronic pancreatitis, several tests are needed to enhance the diagnostic yield, and such tests can include the secretin-pancreozymin test, ERCP, fecal fat measurement, Lundh test meal, and the administration of the synthetic peptide BZ-Ty-PABA.
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PMID:Laboratory aids in the diagnosis of pancreatitis. 34 Aug 13

Secretin (1 CU/Kg) plus Caerulein (100 ng/Kg) or Cholecystokinin (1 or 2 IvyU/Kg) were given by rapid intravenous injection (Schedule 1) or by continuous infusion (Schedule 2) to 63 control subjects (C) and 69 patients affected by chronic pancreatitis (CP). Duodenal juice was collected for two and four 30-minute periods in schedule 1 and schedule 2, respectively. Volume, bicarbonate, and enzyme content were measured. Secretin-Daerulein, by rapid intravenous injection, showed a strong overlapping between C and CP values and led to some side-effects. Secretin-Caerulein by continuous intravenous infusion gave almost identical results as the Secretin-Cholecystokinin.
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PMID:The role of caerulein in tests of exocrine pancreatic function. 34 11

In Germany alcohol is responsible for 40--60 per cent of cases with chronic or chronic relapsing pancreatitis. The histologic lesions for a long time remain clinically asymptomatic. Their degree depends on the duration and the total amount of alcohol which is ingested. Promoters of alcoholic damage to the pancraes are a high intake of fat and protein and a genetic disposition. Acute application of alcohol leads to an inhibition of pancreatic secretion when the entrance of gastric acid into the duodenum is prevented. Otherwise a weak stimulation occurs with release of secretin. Chronic application of alcohol after a few months abolishes the initially seen inhibition and leads to an increase of enzyme secretion of the gland. The raised concentration of protein in the pancreatic juice is the cause of precipitation of protein plugs, and thus probably leads to the alterations which are typical for chronic pancreatitis.
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PMID:[Effect of alcohol on the human and animal pancreas (author's transl)]. 35 68

The study here reported was undertaken to assess the value of assay of the specific isoamylase form arising from the pancreas (P-type) as an index of pancreatic exocrine insufficiency. Measurements were made of serum total amylase activity, serum P-type isoamylase activity, and the amount of P-type isoamylase relative to creatinine (Upam/Ucr) in the urine in a series of patients with clinically suspected chronic pancreatitis and pancreatic insufficiency as determined from the pancreatic secretory response to secretin stimulation. Abnormally low values for P-type isoamylase in the serum and urine of these patients were infrequent. Conversely, values within the normal ranges for serum P-type isoamylase and Upam/Ucr were common. It is concluded that while subnormal values for P-type isoamylase in the serum and urine may be viewed as supportive evidence for pancreatic insufficiency, failure to find such values does not exclude this condition.
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PMID:Value of pancreatic-type isoamylase assay as an index of pancreatic insufficiency. 42 91


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