Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01275 (glucagon)
 26,492 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pancreatojejunal anastomosis disruption still represents the main postoperative complication after pancreatoduodenectomy. In this study, a technique of occlusion of the residual pancreatic stump instead of pancreatojejunal anastomosis is proposed. Between March, 1981 and August, 1987, we performed 51 pancreatoduodenectomies, using Neoprene injection in the Wirsung duct, for carcinoma of the pancreatic head (28 cases), ampullary carcinoma (12 cases), islet cell carcinoma (5 cases), and chronic pancreatitis (6 cases). We observed a 33.3% overall morbidity, with a 5.8% operative mortality. The complications observed seemed not to be related to the technique of pancreatic stump occlusion, except for 2 pancreatic fistulas which spontaneously resolved. Abdominal ultrasound and computed tomography scan performed during the follow-up did not show any significant morphological alteration of the residual stump. Pancreatic endocrine function was assessed in 10 patients by evaluating blood glucose, plasma insulin and plasma glucagon levels both fasting and after oral glucose, and intravenous arginine infusion. These tests were performed before surgery and 15 days, 6 months, 1, 2, and 3 years after surgery. The results showed that 60% of the patients had impaired glucose tolerance before surgery and the percentage did not significantly change up to 3 years later (75%). No patient developed diabetes mellitus, and only 1 patient progressed from a normal to an impaired glucose tolerance. In conclusion, intraductal injection of Neoprene after pancreatoduodenectomy seems to be a safer procedure compared to pancreatojejunal anastomosis and does not induce a post-surgical diabetes.
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PMID:Pancreatoduodenectomy with occlusion of the residual stump by Neoprene injection. 254 44

Biphasic contrast studies are generally advocated as the best current barium examination for the upper GI tract. Two recent prospective blinded trials compared the diagnostic results of a biphasic contrast examination--employing a medium-density barium suspension and glucagon--and endoscopy. Both methods appear to have nearly equal merit for the detection of peptic ulcer and gastric carcinoma. One of the trials demonstrated a relative inability of the barium examination to depict reflux esophagitis other than the severe variety, an inability that had been previously recognized. Earlier Japanese studies showed excellent results from biphasic studies in the detection of early and advanced gastric carcinoma. Because gastric carcinoma may present as a wide variety of lesions, ranging from minute alterations in mucosal relief through ulcers to masses, the values from these Japanese studies also test the sensitivity and specificity of the radiographic examination in demonstrating non-neoplastic lesions of the stomach. Ample data have shown that a radiographic examination compares favorably with endoscopy in the detection of esophageal carcinoma. The usefulness of a radiographic examination as a primary examination if disturbances of esophageal motor function are suspected is generally recognized. A state-of-the-art radiographic examination (ie, a biphasic examination, preferably with drug-induced hypotony) therefore appears to represent an appropriate initial examination in evaluation of most disorders of the upper GI tract. If this examination prompts the slightest suspicion of a malignant tumor, endoscopy should follow for the purpose of obtaining biopsy specimens. Endoscopy is not necessary if duodenal ulcers have been diagnosed by means of radiography; in typically benign gastric ulcers, radiographic follow-up without endoscopy may safely be considered. If in elderly patients multiple small gastric polyps have been detected, endoscopy is not needed. If complaints persist after negative results at radiographic examination, however, endoscopic intervention must be considered. If the complaints suggest reflux esophagitis, the clinician can choose between treatment and endoscopy. In a patient with acute upper GI bleeding, primary endoscopy may be preferred. This diagnostic approach in which endoscopy is employed as complementary to the barium examination is in most parts of the world a cost-effective one. It is also the safest possible option; although endoscopic complications are rare, their absolute number cannot be ignored if every patient had to undergo endoscopy. A biphasic approach with a medium-density barium suspension can be attempted in nearly every patient; if the patient proves unable to cooperate for an optimal double-contrast examination, a single-contrast examination can be performed with the same barium swallowed.
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PMID:Use of barium in evaluation of disorders of the upper gastrointestinal tract: current status. 268 69

A 53-year-old Japanese man with a skin eruption characteristic of glucagonoma syndrome had had misdiagnoses for 10 years. The plasma glucagon level was not abnormally high on the first admission, and 4 years later the level was elevated as determined by the 30 gm arginine tolerance test. An alpha cell carcinoma detected in the tail of the pancreas was associated with a lymph node metastasis; the skin eruption cleared up 10 days after the partial pancreatectomy with lymphadenectomy. The clinical features of glucagonoma syndrome should be given attention.
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PMID:Glucagonoma syndrome. 284 81

The importance of distinguishing between malignant islet cell tumour and pancreatic carcinoma is emphasized in this report of a 57-year-old woman who presented with an epigastric mass. Clinically and radiologically it was diagnosed as a pancreatic adenocarcinoma. A fine-needle aspiration biopsy specimen obtained under ultrasonic guidance showed tumour cells suggestive of an islet cell tumour. Immunostaining and electron microscopy were performed on the aspirate. The tumour cells stained positive with antibodies to keratin, glucagon and gastrin; ultrastructural examination revealed neurosecretory granules, confirming the diagnosis of an islet cell tumour. Angiography was performed to assess the possibility of debulking the mass. This case demonstrates the value of immunohistochemistry and electron microscopy on fine-needle aspiration biopsy specimens of the pancreas to differentiate islet cell tumours, which are potentially curable, from pancreatic adenocarcinomas, which carry a 5-year survival rate of less than 2%.
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PMID:Fine-needle aspiration biopsy of an islet cell tumour simulating pancreatic carcinoma. 284 41

Acute effects of somatostatin analog (SMS 201-995) on pancreatic hormones were studied in two patients with malignant islet-cell carcinoma. Before and after subcutaneous injection of somatostatin with a doses of 50 micrograms, blood glucose (BG), serum growth hormone (hGH), C-peptide immunoreactivity (CPR), plasma immunoreactive glucagon (IRG) and gastrin were assayed, and changes in elution patterns of IRG and gastrin were also analyzed on Bio-Gel P-30 column chromatography. In Patient 1 with glucagonoma syndrome and hypergastrinemia, a prompt and remarkable decrease in plasma IRG and gastrin was observed after the injection of SMS 201-995 in association with a decrease in blood glucose, and then IRG and gastrin increased gradually. The suppressive effect continued for at least 6 hours. On gel filtration of the plasma obtained before the injection of the analog, three major peaks, greater than 20000, 9000 and 3500 molecular-weight (mol wt) fractions, were seen in IRG fraction. The decrease in plasma IRG observed at 1 hour after the injection was mainly due to a marked decrease in the 3500 molecular weight fraction. In addition, a slight decrease in the 9000 mol wt fraction was seen. At 4 hours after the injection, the 3500 mol wt peak returned to the previous level, while the 9000 mol wt peak decreased further. On the other hand, the gastrin elution pattern of plasma obtained before the injection revealed three major gastrin peaks, greater than 20000, 7000 and 5000 mol wt fraction. The changes in the gastrin elution pattern after the injection were similar to those of the IRG elution pattern. In Patient 2 with Zollinger-Ellison's syndrome, the plasma gastrin level decreased gradually for 5 hours after the injection. On gel filtration of the plasma obtained before the injection, two major gastrin peaks, 7000 and 5000 mol wt fraction, of which the large-molecular fraction was more prominent than the small-molecular fraction, were observed. After the injection, a marked decrease in the small-molecular fraction and a gradual decrease in the large-molecular fraction were observed for 4 hours, accompanied by a decrease in plasma gastrin. At 7 hours after the injection, the smaller fraction was augmented again. The serum CPR and hGH was slightly suppressed after the injection in both patients. The adverse effects of slight nausea and vomiting were noticed only in Patient 1.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Inhibitory effects of somatostatin analog (SMS 201-995) on pancreatic hormones in patients with malignant islet-cell carcinoma]. 285 26

A case of prostatic carcinoma with the cellular patterns of an adenocarcinoma and carcinoid tumor is reported. The tumor contained ultrastructural dense core neuroendocrine granules, and immunoperoxidase staining revealed prostatic acid phosphatase, prostatic-specific antigen, chromogranin, neuron-specific enolase, serotonin, adrenocorticotrophic hormone (ACTH), somatostatin, parathormone, calcitonin, bombesin, and glucagon but no insulin. The patient had exhibited hypercalcemia that may have been related to hormone production by the tumor. The literature on the endocrine aspect of the prostate and its tumor is reviewed.
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PMID:Prostatic carcinoma with endocrine features. A report of a neoplasm containing multiple immunoreactive hormonal substances. 289 Dec 93

A case of multiple nonfunctional pancreatic islet cell tumor in multiple endocrine neoplasia type I (MEN I) is reported. The patient was a 41-year-old woman who had a past history of thyroid cancer (papillary carcinoma) and hyperparathyroidism due to parathyroid adenoma. Later, a nonfunctional pituitary tumor and five nonfunctional pancreatic tumors were found simultaneously and the patient was finally diagnosed as having MEN I. Following surgical enucleation, the pancreatic tumors were histopathologically diagnosed as benign islet cell tumors. One of them (tumor 3) exhibited a solid nodular pattern while the others showed gyriform patterns. They were divided histochemically and immunohistochemically into three types: two (tumors 1 and 2) produced a single hormone (glucagon), one (tumor 3) produced five (insulin, glucagon, somatostatin, gastrin and pancreatic polypeptide) and the remaining two (tumors 4 and 5) produced two (glucagon and pancreatic polypeptide). Electron microscopically, three types of endosecretory granules were found in the tumor cells of tumor 3 but only one type was found in tumor 4. However, in the tumor 4 extract, glucagon, pancreatic polypeptide, C-peptide, somatostatin, vasoactive intestinal peptide and growth hormone releasing factor were detected by radioimmunoassay. These findings suggest that these pancreatic tumors were both multicellular and multihormonal.
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PMID:Multiple nonfunctional pancreatic islet cell tumor in multiple endocrine neoplasia type I. A case report. 290 67

In 34 patients suspected of having pancreatic cancer glucose homeostasis and insulin secretion in response to intravenous glucagon (1 mg) were studied prospectively. Twelve patients had pancreatic cancer at laparotomy and the remainder were designated a control group. Responses were also measured in 12 healthy volunteers. There was no significant difference in the rise of blood glucose between the groups after glucagon. The mean plasma insulin concentrations rose rapidly in both groups after glucagon but were significantly lower in the pancreatic cancer group. In patients with obstructive jaundice the plasma insulin response was a better discriminator of pancreatic cancer. Abnormal pancreatic beta-cell function is detectable in patients with pancreatic carcinoma before any change in glucose homeostasis, particularly in patients with obstructive jaundice. The glucagon stimulation test may be useful in the earlier diagnosis of pancreatic carcinoma before the development of clinically overt diabetes mellitus.
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PMID:Abnormal insulin secretion in carcinoma of the pancreas: response to glucagon stimulation. 295 94

Neuroendocrine (NE) neoplasms of the human bronchopulmonary tract were examined by electron microscopy, immunocytochemistry, and gel electrophoresis of cytoskeletal proteins from microdissected tissue samples. All samples (carcinoids, well-differentiated NE carcinoma, NE carcinomas of intermediate type, NE carcinomas of the small cell type) contained significant numbers of cells that immunostained for one or more of the following neuroendocrine markers tested: bombesin, calcitonin, ACTH, leu-enkephalin, gastrin, serotonin, somatostatin, alpha-melanocyte-stimulating hormone, vasoactive intestinal peptide, glucagon, insulin, substance P, and neuron-specific enolase. Electron microscopy revealed typical NE cell features, including variable abundant and frequently heterogeneous neurosecretory granules. Tumor cells contained filaments specifically stained with different conventional and monoclonal antibodies to cytokeratins and displayed punctate plasma membrane staining with antibodies to desmoplakins, in agreement with the electron microscopic demonstration of tonofilament bundles and desmosomes. Immunocytochemistry for NE markers and cytoskeletal proteins on consecutive sections revealed both cytokeratins and neuroendocrine substances in single cells. Using gel electrophoresis of cytoskeletal proteins of tissue regions extracted with high salt buffer and detergent, we could detect, in the tumors tested, appreciable amounts of cytokeratin polypeptides 8, 18, and 19, i.e., major cytokeratins also found in certain other lung carcinomas such as adenocarcinomas. Tumor cells were not significantly stained with antibodies to other intermediate filament proteins such as vimentin, desmin, glial filament protein, and neurofilament protein. The results show that NE substances can be synthesized in cells containing a typical epithelial cytoskeleton, i.e., cytokeratin filaments and desmosomes. These findings support the notion of an epithelial character of these tumors and appear in contrast with recent reports that neurofilaments are the only type of intermediate filaments present in carcinoids and other pulmonary NE tumors. These observations may have important implications for the histogenesis of NE carcinomas and for diagnostic pathology.
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PMID:Coexpression of neuroendocrine markers and epithelial cytoskeletal proteins in bronchopulmonary neuroendocrine neoplasms. 298 72

A case of simultaneous presentation of a small-cell carcinoma involving the ovary and the uterine endometrium is reported. We consider the endometrium as the primary localization of the tumor. The epithelial origin and neuroendocrine differentiation were confirmed by electron microscopy. Tumor cells were attached by small desmosomes, and in the cytoplasm typically neurosecretory granules measuring 100-200 nm were found. Immunohistochemically, no content of polypeptide hormones (ACTH, Calcitonin, Gastrin, Glucagon, Insulin, Somatostatin and VIP) were encountered. The tumor stained strongly for neuronspecific enolase. The histogenetic possibilities are shortly presented.
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PMID:Simultaneous presentation of a small-cell carcinoma involving the ovary and the uterine endometrium. 298 80


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