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)

Three markers of free radical oxidation of lipids--9 cis, 11 trans isomer of linoleic acid, conjugated dienes and ultraviolet fluorescence products--were measured in the phospholipid fraction of duodenal juice collected in the first 10 min after an intravenous injection of secretin. The volume of aspirate was similar in 11 controls and in 25 patients who had sustained an attack of pancreatitis 6 weeks earlier--acute pancreatitis (AP) 10, chronic pancreatitis (CP) 15. The concentration of each marker was very significantly higher in the patients; the output of the isomer gave the best discrimination from controls; and ultraviolet fluorescence products were substantially higher in the subgroup with CP than with AP. The serum % molar ratio of the isomer to linoleic acid was measured in 25 controls, 14 AP and 17 CP patients: the highest levels were found in the CP group. Heightened hepatic free radical activity involving lipid isomerization as well as lipid peroxidation pathways is a feature of pancreatitis--probably antedating the attack and persisting well after clinical recovery--the difference between CP and AP being in the degree of abnormality. We argue that these hepatic changes mirror changes in pancreatic-acinar cells and that increased free radical activity in both organs is due to a shortfall of antioxidants in the face of cytochromes P450 induction by xenobiotics. Therefore, a combination of preventive and chain-breaking antioxidants may be useful in preventing further attacks of pancreatitis and controlling background pain in chronic disease.
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PMID:Heightened free radical activity in pancreatitis. 237 63

In 93 patients with known exocrine pancreatic function (secretin-pancreozymin test), NMR spectrometry and chloroform-methanol extraction of quantitatively collected, homogenized and lyophilized stools provided significantly correlated results with respect to stool fat concentration (r = 0.872) and total stool fat excretion/day (r = 0.983). In 83% of 24 patients with total stool fat excretion/day of more than 15 g (chloroform-methanol extraction), the indication for enzyme replacement was also established by stool fat concentrations of more than 35% determined by NMR spectrometry, irrespective of whether stool fat was measured in total stools or in 3 consecutive unhomogenized samples. In the remaining (17%) patients total stool fat excretion/day was only slightly elevated (16-21 g). Interestingly, in only 58% of patients actually needing enzyme replacement, did the secretin-pancreozymin test reveal a reduction of stimulated enzyme secretion to below 15% of the lower normal limit. The results indicate that NMR spectrometry of lyophilized samples of 3 consecutive unhomogenized stools is suitable for stool fat quantitation and for establishing the indication for enzyme replacement in chronic pancreatitis.
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PMID:NMR spectrometric stool fat analysis--a new technique for quantifying steatorrhea and establishing the indication for enzyme replacement in chronic pancreatitis. 241 99

The diagnostic value of serum enzyme provocative tests (SEP) is disputed. In particular, the specificity of the test has not been adequately investigated. New interest in the test has arisen with the introduction of pancreas-specific serum enzyme tests. It has been shown that a poststimulatory increase of serum enzymes is found in chronic pancreatitis with well preserved exocrine function, but also in healthy individuals and particularly cigarette smokers. Recently it has been postulated that the lack of a poststimulatory enzyme response is typical of advanced chronic pancreatitis. We investigated the effect of secretin (1 CU/kg i.v.) on serum levels of amylase, pancreasisoamylase, lipase and trypsin for 30 minutes in 48 volunteers without pancreatic disease (19 non-smokers, 19 smokers and 10 patients with hypoxemia). Mean values of all enzymes were significantly higher after stimulation. Enzyme response of trypsin and lipase was more pronounced than that of amylase or pancreasisoamylase. However, depending on the enzyme studied, no significant increase of serum values was found in 47.4% to 89.5% of smokers, 26.3 to 68.4% of non-smokers and 10 to 50% of patients with hypoxemia. The marked variability of enzyme response in controls demonstrates the low specificity of this test. Therefore, SEP are of no diagnostic value in pancreatic disease.
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PMID:[Changes in the serum pancreas enzyme following i.v. stimulation with secretin in subjects with a normal pancreas]. 243 65

In an effort to develop a model of chronic alcoholic pancreatitis in Sprague-Dawley rats fed a nutritionally adequate diet, 3 groups of 15 animals each were fed Wayne Rodent-Blox ad libitum, Lieber-DeCarli diet with 40% of carbohydrate calories replaced by ethanol ad libitum and isocaloric amounts of Lieber-DeCarli diet respectively for a period of 18 months. Rats were anesthetized and basal and secretin-stimulated pancreatic juice was obtained. Pancreatic glands were isolated and divided into portions for histology, biochemical analyses, and cell fractionation. The homogenate, zymogen granule fraction, mitochondrial-lysosomal fraction, microsomal fraction and postmicrosomal supernatant as well as aliquots of pancreatic juice were analyzed for cathepsin B, acid phosphatase, beta-D-glucoronidase, arylsulphatase and leucine naphthylamidase. All of the ethanol-fed animals developed morphological changes akin to human chronic pancreatitis. There were focal areas of parenchymal degeneration with fibrosis, protein plug formation and tubular complexes. In the pancreatic tissue of animals fed ethanol, total protein, trypsinogen (and free trypsin) were increased and amylase was decreased. While acid phosphatase was increased in all of the particulate fractions, cathepsin B was increased in the zymogen granule and mitochondrial-lysosomal fractions. Basal and post-secretin pancreatic juice did not show a significant increase in digestive or lysosomal enzymes. It is suggested that focal degenerative changes may be due to trypsin generated by intracellular activation of digestive enzymes by lysosomal enzyme cathepsin B.
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PMID:Alcoholic pancreatitis in rats fed ethanol in a nutritionally adequate liquid diet. 244 6

A disturbed intraduodenal milieu and pancreatic scarring in advanced chronic pancreatitis (CP) may lead to changes of gut and pancreatic hormones. In the present study, the gastroduodenal mucosal content of several regulatory peptides was determined in 8 patients with severe calcific CP and 8 healthy volunteers. In addition, hormone release into the bloodstream was estimated after intraduodenal acid/glucose stimulation in the control subjects and 8 CP patients each with or without secondary diabetes mellitus (DM), and in 8 patients with juvenile DM, so that disturbed gut hormone release could be attributed either to CP or DM. While VIP release into the circulation was similar in all participants, mucosal levels of VIP and substance P were significantly elevated in the duodenal bulb and descending duodenum of CP patients. The somatostatin content of gastroduodenal mucosa in CP was at least as high as in normals. Gastrin was significantly more abundant only in the duodenal bulb of CP patients, while plasma gastrin was normal. Duodenal CCK concentrations tended to be elevated in the duodenal bulb, but not significantly. The release of secretin seemed to be higher in type-1 diabetics than in CP patients. The mucosal pattern of GIP was nearly identical in CP patients and controls. Compatible with this finding, the GIP release did not show any peculiarities in CP with or without DM or in DM. Basal and stimulated plasma levels of motilin were abnormally high in CP. Pancreatic polypeptide plasma levels were normal in DM, but significantly reduced in CP, especially in CP with DM. Fasting PP and stimulated pancreatic enzyme outputs were linearly related.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic pancreatitis and diabetes mellitus: plasma and gastroduodenal mucosal profiles of regulatory peptides (gastrin, motilin, secretin, cholecystokinin, gastric inhibitory polypeptide, somatostatin, VIP, substance P, pancreatic polypeptide, glucagon, enteroglucagon, neurotensin). 246 85

This is a report on five patients who had acute attacks of pancreatitis (three cases complicated by pseudocysts). They all showed pancreatic calcifications on plain abdominal X-ray (n = 5), computed tomography (n = 3), or at postmortem examination (n = 1). Despite calcifications, the exocrine pancreatic function, as tested with the secretin-pancreozymin test and fecal fat analysis, was either normal or returned to normal. The conclusion is that pancreatic calcifications do not indicate severe exocrine pancreatic insufficiency and the necessity for pancreatic enzyme substitution. Calcifications are not necessarily a sign of chronic pancreatitis. They may result rather from scars following acute pancreatitis.
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PMID:Pancreatic calcifications in patients with normal pancreatic function. 247 21

Pancreatic function was determined (using the secretin-pancreozymin test) before the use of gluten-free diet in 22 patients with endemic (celiac) sprue. Water and bicarbonate secretion were within normal limits, if anything there was a trend to high-normal values. Remarkable and apparently characteristic for celiac sprue was the only slight contraction of the gallbladder after intravenous injection of submaximal doses of cholecystokinin-pancreozymin (CCK). Secretion of the 3 enzymes amylase, lipase and trypsin was decreased in about one third of cases, the difference relating both to the concentrations and the amount secreted, compared with normal control values was significant (P greater than 0.01). But in no case was the reduced enzyme secretion so marked that one would expect maldigestion. Multivariate non-linear discriminance analysis demonstrated that pancreatic secretion in sprue is quite distinct from that in healthy subjects and those with chronic pancreatitis. It is assumed that there is a pattern of exocrine pancreatic secretion typical for sprue.
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PMID:[Pancreatic secretion in domestic sprue]. 257 24

Eighteen patients with chronic pancreatitis and 12 healthy controls were subjected to hormonal stimulation by continuous secretin plus cerulein intravenous infusion or a rapid injection of secretin. In both tests total serum amylase, lipase, and TLI (trypsin-like immunoreactive substances) levels were measured. Continuous intravenous infusion does not bring about changes in the serum levels of the enzymes studied; rapid injection of secretin, however, induces changes in the serum levels of TLI and lipase (but not amylase) which makes it possible to distinguish patients with chronic pancreatitis in its early stages from advanced chronic pancreatitis but is of doubtful value in distinguishing healthy subjects from those suffering with chronic pancreatitis.
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PMID:Changes in serum pancreatic enzymes after hormonal stimulation in chronic pancreatitis. 258 46

It was established during observation over time (within the period from 10 to 12 years) that the overwhelming majority of patients with chronic cholecystopancreatitis and primary chronic pancreatitis progressed to a different degree to enzyme-secreting pancreatic failure according to the pancreozymine tests. At the same time in 2/5 of all the cases, enzyme-secreting failure turned out substantial by the end of the indicated period. During the years of prospective studies, every tenth patient with chronic pancreatitis developed secondary diabetes mellitus. The degree of pancreatic enzyme secretion and carbohydrate metabolism abnormalities depended on the number of disease exacerbations suffered by the patient. Secondary gastroduodenal ulcers occurred in 27 out of 647 patients observed over time, and all the cases were associated with a considerable reduction of pancreatic bicarbonate secretion (according to the secretin test). Pancreatogenous pleural exudate was recorded in 1.4% of all the cases of chronic pancreatitis. During the observation period, 16 out of the 647 patients died from chronic pancreatitis associated with progressive exocrine pancreatic failure and malabsorption.
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PMID:[A prospective multiyear study of the course of chronic recurrent pancreatitis]. 258 77

The results of 407 secretin-pancreozymin tests were analysed by a variety of statistical methods, in an attempt to optimize diagnostic yield. The best diagnostic yield accrued from selection of a point corresponding to 95% specificity and 60% sensitivity on each of two virtually superimposable receiver-operator curves--using either bicarbonate output or a discriminant function derived from multivariate analysis--and the anticipated yield approximated to that realised in a further prospective series of 150 cases. At a 25% hypothetical local prevalence of chronic pancreatic disease (including chronic pancreatitis and pancreatic cancer), the positive predictive value was 80%, the negative predictive value 88% and the efficiency was 86%--values that are not dissimilar to those reported in a study in which both hormones were given simultaneously by constant intravenous infusion for 105 min with multivariate analysis of the results. We conclude that (a) measurement of bicarbonate output in 30 min after an appropriate dose of secretin given as a bolus injection yields results that are comparable to those obtained when secretin and pancreozymin are given by constant intravenous infusion in doses to evoke maximal secretory responses; and (b) the yield of hormone tests using duodenal intubation is far from ideal.
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PMID:On optimising the diagnostic yield of secretin pancreozymin tests. 261 13


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