ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The past year has witnessed a marked increase in the complexity of intracellular processes involved in the function of a polarized epithelial cell. The pancreatic acinar cell is perhaps the best studied such cell, and the classical model for stimulus-secretion coupling and secretory protein biosynthesis and export. In this review, I examine several new reports that impact on these themes. I include the identification of newly recognized pancreatic secretagogues; insights into the biochemical basis for hormone receptor affinity states and interconversion, desensitization, and internalization; lipid mediators of secretagogue action; patterns and regulators of intracellular calcium events along with their spatial and temporal patterns; regulated channels, transporters, and junctional communication in the acinar cell and cellular organelles; and new insights into regulated exocytosis.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Recent work in experimental pancreatitis continues to focus on clarifying pathophysiology and exploring potential therapeutic approaches. Advances in pathophysiology include discovery of a circulating actor involved in colocalization of lysosomal and digestive enzymes in pancreatic acinar cells; characterization of a protein that is increased in expression several hundredfold during the development of acute pancreatitis; identification of glutathione as an endogenous protective factor against pancreatic injury; and implication of microtubule disruption as a major event in cerulein-induced pancreatitis. Studies of potential therapies have failed to resolve outstanding issues concerning the therapeutic benefit of protease inhibitors and cholecystokinin receptor antagonists but suggest that agents that alter microvascular blood flow to the pancreas may affect the severity of injury to the gland.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The problems with total serum amylase as the primary test to diagnose acute pancreatitis continue to appear. Although lipase is emerging as the single best test to select for diagnosing acute pancreatitis, specificity problems, especially with the frequently utilized Ektachem (Eastman Kodak Co., Rochester, NY) assay, have not been generally appreciated. Currently, polymorphonuclear elastase appears to be the serum marker of choice for predicting clinical outcome of patients with acute pancreatitis, while phospholipase A2is falling out of favor. Pancreatic endocrine maximal stimulation tests may help the clinician diagnose patients with mild to moderate chronic pancreatitis.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Acute pancreatitis remains a frequent gastroenterologic disorder and is still burdened with a significant mortality. Alcohol abuse and gallstone disease remain the principal causes of pancreatitis but recent studies indicate that over 70% of patients with so-called idiopathic pancreatitis also have some form of biliary tract disorder. New techniques like endoscopic sphincterotomy, lithotripsy, and laparoscopic cholecystectomy offer new alternatives to treat the underlying gallstone disease in pancreatitis patients. The debate about anatomical variants as predisposing factors for pancreatitis continues and specific therapeutic agents are still not available.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

We review both the protein secretory and the necrosis fibrosis hypotheses and point out that they may be complementary rather than opposing hypotheses. Few advances have been made in the etiology and diagnosis of chronic pancreatitis, but more evidence shows that pancreas divisum is not a cause of this disorder. Magnetic resonance scanning cannot yet be recommended to detect chronic pancreatitis and noninvasive tests of pancreatic function are useless to detect mild or moderate exocrine insufficiency. The treatment of pain with pancreatic enzymes remains controversial and the claim that endoscopic therapy relieves pain has not been tested in randomized controlled trials. Finally, the treatment of steatorrhea remains a problem and will not be solved until simple, reliable methods to deliver enough lipolytic activity to the duodenum are developed.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Publications in the English language literature concerning pancreatic surgery between 1 April 1991 and 31 March 1992 are reviewed. Many reports concern the appropriate application of minimally invasive techniques in pancreatic disease. This applies especially to the treatment of pseudocysts. In the area of acute pancreatitis, an important analysis suggests that the timing of passage of gallstones is not important in determining the severity of gallstone pancreatitis. The features of mucin-producing tumors of the pancreas and papillary cystic pancreatic tumors are well described. The use of serologic markers and of fine-needle aspiration cytology in the diagnosis of early pancreatic carcinoma is evaluated. Improving results with pancreatic transplantation are leading to wider application of this procedure.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Experimental models andin vitrosystems allow study of mechanisms of pancreatic carcinogenesis and autonomous growth in carcinomas and identification of growth-promoting and inhibiting agents. Three new models in dog, hamster, and transgenic mice are described. New studies reaffirm a role for c-K-rasmutation in the development of carcinomas in the hamster but not in the rat pancreas. New dietary studies reaffirm a role for fat (fatty acid) as a promoter in the rat model, and demonstrate inhibition of pancreatic carcinogenesis in the hamster model by dietary supplements of p-carotene, vitamin C, selenium, and phenolic antioxidants. In several studies, effects of peptide hormones or their analogues on the growth of pancreatic carcinoma cell lines were correlated with the presence of appropriate receptors.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Diagnosis of pancreatic carcinoma remains a problem, with symptoms appearing late in the disease. A number of studies investigated the diagnostic utility of various serum markers; however, these markers fail to accurately and reliably diagnose the disease. Endoscopic ultrasound shows some promise for improved staging and diagnosis, and surgical resection remains the only chance for cure. The morbidity and mortality for the procedure continue to decline. The most commonly performed procedure, however, is a palliative one. Generally, for tumors of the pancreatic head, biliary bypass should be performed. Gastric bypass in this setting remains controversial. Chemotherapy remains ineffective in the treatment of pancreatic cancer. Nonsurgical approaches for palliation (eg, endoscopically placed stents) are effective in some patients, but the technique still has significant limitations.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID