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At least 19 recordsLinked to original sources
PubMed1978

New dimensions in the laboratory diagnosis of pancreatic disease.

The laboratory diagnosis of pancreatic disease has been made more precise by certain modifications in older methods and by the introduction of a variety of new technical procedures. The principal human isoamylases may now be distinguished and their activities in serum and urine measured. A test has been devised which helps indicate the presence of acute pancreatitis by showing relatively increased excretion of amylase in the urine as compared with creatinine. The ratio of amylase to creatinine in the urine appears to be a good index of relative hyperamylasuria. A screening test for pancreatic-type hyperamylasuria has been formulated that allows increased urinary excretion of this isoamylase to be identified. These additions and developments have sharpened the interpretation of hyperamylasemia and hyperamylasuria and have added new dimensions to the laboratory diagnosis of pancreatic disease.

Acute Disease↗
PubMed1979

An analysis of pancreatic sonography in suspected pancreatic disease.

To assess the value of pancreatic sonography in patients suspected of having pancreatic disease, our first 500 pancreatic examinations using gray scale imaging were reviewed in a prospective manner without clinical information. Various parameters of each examination were recorded. The pancreas was localized by its relationships to surrounding vessels and the duodenum. The ability to define the head, body, and tail of the pancreas as well as anterior--posterior size measurements were noted and recorded. A retrospective clinical pathologic follow-up was then carried out and correlated with the ultrasonic findings. Four categories of patients were identified. The features seen in pancreatic ultrasonography of the entire group, as well as those seen in the individual categories, were analyzed. This analysis indicates that pancreatic sonography can be used in patients suspected of having pancreatic disease, defining both normal and abnormal pancreas. A high index of suspicion for the type of abnormality present can be achieved.

Follow-Up Studies↗
PubMed2026

The Effect of Pancreatic Exocrine Insufficiency and Pancreatic Enzyme Replacement Therapy on Gut Microbiome Composition in Pancreatic Disease: A Prospective Cohort Study.

OBJECTIVES: Increasing evidence demonstrates that pancreatic exocrine insufficiency (PEI) is associated with harmful changes to the gut microbiome. The mainstay of PEI treatment is with pancreatic enzyme replacement therapy (PERT), which has been shown to lead to significant survival benefit in pancreatic disease. The aim of this study was to determine how treatment of PEI with PERT affects gut microbiome composition. METHODS: This is a prospective observational cohort study of patients being treated for pancreatic disease at a single centre. PEI status of patients was assessed at the time of recruitment using published diagnostic criteria. Pre-PERT samples were taken before treatment was started and post-PERT samples were taken after at least 4 weeks of treatment. To profile the gut microbiome composition, shotgun metagenomic sequencing was performed with DNA extracted from stool samples. RESULTS: 25 patients with pancreatic disease were included. The abundance of pathogenic bacteria, such as Viridans group Streptococcus and Campylobacter species, was significantly increased in the gut microbiome of patients with PEI compared to those without PEI. Following PERT treatment, analysis of the gut microbiome of treated patients showed a significant reduction in the abundance of multiple pathogenic species, such as those from Viridans group Streptococci, compared to untreated PEI patients. CONCLUSIONS: Treatment with PERT leads to significant changes in the gut microbiome composition of patients with pancreatic disease. Changes include a significant reduction in potentially pathogenic bacteria and so may contribute to the survival benefits seen with PERT treatment in pancreatic disease.

gut microbiome↗
PubMed1979

Trypsin and lactoferrin levels in pure pancreatic juice in patients with pancreatic disease.

Levels of immunoreactive trypsin were measured in pure pancreatic juice obtained endoscopically from 44 patients with suspected pancreatic disease. Patients with pancreatic cancer all had low trypsin concentrations (median 3.6 micrograms/ml, range 0.6--12.0), but those with chronic pancreatitis had very variable levels (median 14.2 micrograms/ml, range 3.2--76.8), showing a considerable overlap with patients without pancreatic disease (median 37.1 micrograms/ml, range 10.4--66.0). When levels of lactoferrin in pancreatic juice were measured, all patients with chronic pancreatitis were found to have much higher levels (all greater than 900 ng/ml) than control subjects or patients with pancreatic cancer (all less than 400 ng/ml). The combined measurement of trypsin and lactoferrin in pure pancreatic juice appeared to be more promising than any other currently available test for the separation of patients with pancreatic cancer from those with chronic pancreatitis.

Chronic Disease↗
PubMed1979

Prospective study of ultrasonography in chronic pancreatic disease.

Grey-scale ultrasonography was used in 212 unselected patients in whom the presence or absence of pancreatic disease was subsequently confirmed by other means. Ultrasonographic criteria were established in the first 92 patients and by reference to previous experience. The remaining 120 patients were studied prospectively. The accuracy and clinical impact of the ultrasonographic diagnosis were judged alongside a standard clinical assessment. Clinical diagnoses were tentative and inaccurate. Ultrasound failed in three cases; otherwise it detected all the 33 patients with chronic pancreatic disease and correctly distinguished cancer from chronic pancreatitis. The ultrasonographic diagnosis of a normal pancreas was always correct, but four false-positive diagnoses were made in patients subsequently judged to have no pancreatic disease. Ultrasonography gave more accurate or more confident and accurate information than the clinical assessment in 57 of the 98 patients studied as problems in diagnosis. With this degree of accuracy ultrasonography should be the first imaging investigation in patients suspected of suffering from pancreatic disease. In our gastrointestinal unit the combination of grey-scale ultrasonography with techniques designed to outline the duct systems (such as endoscopic pancreatography) provides precise diagnosis and documentation of pancreatic disease.

Chronic Disease↗
PubMed2025

The molecular mechanism of cuproptosis and research progress in pancreatic diseases.

PURPOSE: Cuproptosis has been proven to be a novel mode of cell death, distinct from other types of cell death such as necrosis, ferroptosis, pyroptosis, and apoptosis. This study aims to systematically review the molecular mechanisms of cuproptosis in recent years and its research progress in pancreatic diseases. METHODS: By searching PubMed and Web of Science databases, 113 key literatures were included for thematic analysis, covering the molecular mechanism of cuproptosis and its role in the occurrence and development of pancreatic cancer, acute and chronic pancreatitis, diabetes, pancreatic cyst, pancreatic injury and pancreatic neuroendocrine tumor. RESULTS: Cuproptosis refers to the accumulation of copper ions in cells, which leads to instability of ferritin and aggregation of acylated proteins, resulting in oxidative stress-related cell death. Recent studies have shown that cuproptosis plays an important role in the occurrence and development of various pancreatic diseases, such as pancreatic cancer, acute and chronic pancreatitis, diabetes, pancreatic cysts, pancreatic injuries and pancreatic neuroendocrine tumor. The inducers of cuproptosis, such as disulfiram, chloroquinolones, and perilla phenols, alleviate pancreatic cancer by promoting cell cuproptosis. Copper chelators such as tetraethylenepentamine and tetrathiomolybdate promote the recovery of pancreatic injury by inhibiting cell cuproptosis. CONCLUSIONS: Cuproptosis plays a crucial role in the pathogenesis of pancreatic diseases. Further research on the cuproptosis pathway may become a potential target for the treatment of pancreatic diseases.

Animals↗
PubMed1979

alpha-Amylase of human pure pancreatic juice: effects of pancreatic disease and the occurrence of variant forms in pancreatic juice from healthy volunteers.

Pure pancreatic juice (PPJ) from healthy human volunteers and from patients with pancreatic or liver disease was subjected to isoelectric focussing (IEF) and assayed for alpha-amylase activity. In PPJ from most normals, a single predominant form of amylase was found, comprising congruent to 83% of the total activity recovered, and having pIapp congruent to pH 6.8. In PPJ from six normals, variant principal forms of amylase were found at pH congruent to 6.4 or pH congruent to 7.3, in addition to the peak at pH 6.8. IEF patterns of PPJ from individuals with pancreatic or liver disease were indisquishable from patterns obtained with PPJ from the control group of healthy volunteers.

Amylases↗
PubMed1978

[The oral administration of N-benzoyl-L-tyrosyl-paraaminobenzoic acid (PFT) in the assessment of exocrine pancreatic function and its value within the diagnostic approach to pancreatic disease (author's transl)].

Exocrine pancreatic function was determined by the oral administration of N-benzoyl-L-tyrosyl-PABA in 343 persons, including controls, patients with diseases of the pancreas, and patients with non-pancreatic disease. The results revealed a sensitivity of 85% in chronic pancreatitis and of 78% in carcinoma of the pancreas. The specificity of the PFT amounted to 92%. No toxic side effects were noted. The PFT is likely to be a useful screening procedure for pancreatic disease.

4-Aminobenzoic Acid↗
PubMed1979

Screening for pancreatic disease: A comparison of grey-scale ultrasonography and isotope scanning.

The efficiency of ultrasound in the diagnosis of pancreatic disease was compared prospectively with that of selenomethionine isotope scanning in 46 patients presenting with abdominal pain or weight-loss or with jaundice. Of 14 patients who later proved to have pancreatic carcinoma, all had an abnormal isotope scan and 13 had an abnormal ultrasound scan. Of 10 patients with chronic pancreatitis, all had an abnormal isotope scan and 9 had an abnormal ultrasound scan. The small advantage of selenomethionine was, however, offset by a higher false-positive rate: of 22 patients who proved not to have pancreatic disease, 13 had abnormal isotope scans compared with only 3 with ultrasound. Review of earlier experience with the two techniques yielded similar results: in pancreatic carcinoma and chronic pancreatitis, isotope scanning gave slightly fewer false-negative results than ultrasound but many more false-positives. Because of its lower false-positive rate, because it avoids ionising radiation, and because it can usually distinguish carcinoma from pancreatitis, ultrasound is the procedure of choice for initial investigation of patients with suspected pancreatic disease.

Chronic Disease↗
PubMed1978

Radioimmunoassay of lactoferrin in pancreatic juice as a test for pancreatic diseases.

Lactoferrin, a protein present in pancreatic juice and other exocrine secretions, was measured by radioimmunoassay in pure pancreatic juice obtained by endoscopic cannulation of the pancreatic duct. Lactoferrin concentrations were high in pancreatic juice from patients with chronic pancreatitis, but they were considerably lower in juice from control subjects and patients with carcinoma of the pancreas. The measurement of lactoferrin concentrations in pure pancreatic juice may be useful in the diagnosis of pancreatic diseases.

Chronic Disease↗
PubMed1979

Multiple imaging modalities for the study of pancreatic disease.

Gray scale ultrasonography (US) and computed tomography (CT) have enhanced the role of various imaging modalities in the evaluation of patients with suspected pancreatic disease. When these anatomical studies are normal or equivocal, a functional, radionuclide pancreas scan may be useful. Pancreatic imaging can be achieved using ultrasound, transmission CT, single photon radionuclide imaging, and positron emission CT. A diagnostic imaging decision chart for the evaluation of patients with possible pancreatic disease is useful in choosing the correct imaging modality in a specific situation. Such a chart and its theoretic basis are described in this review. The need to optimize the pancreatic work-up with respect to cost-benefit decisions and diagnostic accuracy, sensitivity, and specificity are of particular concern to the physician. Of all the potential areas for disease, the pancreas has been and remains a particularly difficult diagnostic problem.

Humans↗
PubMed1979

Gray scale ultrasound and endoscopic ductography in the diagnosis of pancreatic disease.

Seventy-two patients were examined by ultrasonography and endoscopic pancreaticography (ERCP) because of clinical suspicion of pancreatic disease. The following final diagnoses were obtained. Carcinoma of the pancreas: 20 patients; pancreatitis: 27 patients; other diseases: 17 patients; no organic disease: 8 patients. In this series, carcinoma of the pancreas was demonstrated with almost equal efficacy by the two methods used. Cysts in the pancreas were better demonstrated by ultrasonography, while ERCP was superior in demonstrating chronic pancreatitis. The diagnostic results with the exclusive use of one method was not satisfactory, but by combining the two methods an adequate diagnostic accuracy was obtained. Thus in the 47 patients with pancreatic disease, organic abnormalities were demonstrated by the two combined methods in 46 (98%). In 41 of the 47 patients (87%) the exact nature of the lesion could be assessed by combining the two methods.

Adolescent↗
PubMed1979

Synovial fat necrosis associated with ischemic pancreatic disease.

A 59-year-old man with ischemic pancreatic disease, polyarthritis, and cutaneous nodules has shown histopathologic findings indicative of disseminated fat necrosis in a percutaneous biopsy specimen from the right knee. The histopathologic findings in the synovium included necrotic fat cells, distorted fat cells and adjacent lymphocytes, lipid laden histiocytes, and giant cells. In prior histopathologic studies of the joint involvement associated with this disorder, fat cell necrosis has been found only in the periarticular tissues, and the synovium has appeared normal or showed nonspecific inflammation. However, the present study shows that the synovial membrane may also be the site of fat necrosis and an associated inflammatory reaction; thus patients with this disorder may manifest arthritis in addition to periarthritis.

Arteriosclerosis↗
PubMed1979

Multifocal myocardial necrosis and fibrosis in pancreatic diseases of children.

From a review of 2,000 autopsies of children, 16 cases of extensive necrosis and scarring fibrosis of the myocardium were found. These lesions involved mainly the left ventricle and spared the endocardium, the pericardium, and the coronary vessels. These necrotic of fibrotic heart lesions were found to be closely associated with various pancreatic diseases: cystic fibrosis (11 cases), pancreatic lipomatosis (2 cases), extensive small bowel resection (3 cases, 2 of which were associated with acute interstitial pancreatitis). To explain these unexpected associations, two hypotheses can be put forth: (1) The lack of absorption of some presently undetermined substances indispensable for the correct trophicity of the myocardium, and (2) the release in the blood of proteolytic enzymes with consecutive activation of phlogistic substances such as kinins.

Acute Disease↗
PubMed1979

Serum immunoreactive trypsin concentration after a Lundh meal. Its value in the diagnosis of pancreatic disease.

The changes in serum trypsin concentration have been measured in 47 subjects for up to 2 hours after a Lundh meal. In 18 healthy controls, mean fasting trypsin concentration was 285 +/- 125 ng/ml (mean +/- 2 SD). The maximum increase after the Lundh meal (the trypsin response ratio) was 6.7 +/- 7.5%. Six patients with chronic renal failure had elevated fasting serum trypsin concentrations (range 460-1100 ng/ml) but trypsin response ratios fell within the control range. Of five patients with relapsing pancreatitis, two had raised and three normal or low fasting trypsins. After stimulation two had elevated trypsin response ratios; one of the two had evidence of main duct obstruction. Eleven out of 12 patients with chronic pancreatitis (with or without insufficiency) had low fasting trypsin concentrations (range 0-120 ng/ml) Seven of the 12 also had raised trypsin response ratios. In six patients with cancer of the pancreas, fasting trypsin was low in three, normal in two, and raised in one. Both patients with a normal fasting level had a raised trypsin response ratio. The combination of a single estimation of fasting serum trypsin concentration followed by serial measurements after a Lundh meal provides a useful screening test for chronic pancreatic disease.

Chronic Disease↗
PubMed1979

Intestinal lysosomal enzymes in the diagnosis of pancreatic disease.

Acid hydrolases (lysosomal enzymes) were analyzed and compared with trypsin in duodenal juice obtained after a test meal (Lundh test). The possible diagnostic role of acid hydrolases in pancreatic disease was investigated. In all patients with chronic pancreatitis normal values of acid hydrolases but subnormal trypsin activities were found. In pancreatic cancer normal values of acid hydrolases and normal trypsin values were seen in three patients with small tumors, whereas five patients with more advanced cancer of the pancreas had decreased trypsin activity and three of them high activities of acid hydrolases in duodenal juice. In five patients operated on with a gastroenteroanastomosis acid hydrolases were markedly increased. Five patients had no activity of acid hydrolases in the aspirate, probably reflecting technical failure with dislodgement of the catheter from the duodenum to the stomach. In conclusion the assay of acid hydrolases does not seem to increase the diagnostic value of the conventional Lundh test (trypsin).

Acetylglucosaminidase↗