A study of the time course of conversion of edematous to hemorrhagic pancreatitis.

We studied the conversion of acute edematous pancreatitis (AEP) to acute hemorrhagic pancreatitis (AHP) in an experimental model in cats. In the model, 16,16 dimethyl PgE2 effects this conversion by increasing microvascular permeability. First, we induced AEP in cats and then gave PgE2 at increasing intervals after the induction of AEP to see how long an interval would still allow conversion.

New perspectives in the surgical management of chronic pancreatitis.

Although the etiology of pain in chronic pancreatitis remains uncertain, that symptom remains the most common indication for surgery in these patients. Current endoscopic and imaging techniques now permit accurate definition of the morphology of the disease. Thus, surgical intervention can be more selectively applied to address specific abnormalities.

Surgical treatment of pancreatic cancer. The United States experience.

About 28,000 new cases of pancreatic cancer are diagnosed yearly in the United States. The diagnosis is now made up to two months more quickly than just a few years ago, but this has had no impact on survival. In most institutions, 20-25% of patients have resectable lesions.

The cause and management of the pain of chronic pancreatitis.

The cause of pain in chronic pancreatitis appears to be related to ductal and parenchymal hypertension and possibly to pancreatic ischemia. The management of pain needs a multidisciplinary approach. Medical measures such as abstinence from alcohol and therapy with mild analgesics are useful.

Treatment of acute alcoholic pancreatitis in cats.

We created acute pancreatitis in cats by instilling ethanol (20 ml of a 40% solution) into the stomach and then perfusing activated pancreatic enzymes through the main pancreatic duct. Edematous pancreatitis developed within 24 h as the enzymes leaked out of the duct into the surrounding pancreatic parenchyma. We tested the effects of a number of agents on the amelioration of the severity of the pancreatic inflammation.

Surgical palliation for pancreatic cancer. The UCLA experience.

We reviewed the records of 340 patients with a tissue diagnosis of pancreatic cancer treated at UCLA Medical Center between 1973 and 1988. Sixty-one patients underwent pancreatic resection (group I), 173 had some form of surgical palliation (group II), and 106 had neither (group III). The diagnosis was made 1 to 2 months more quickly in the last 8 years of the review than in the first 8 years, but the effect of early diagnosis on curability was negligible.

Lymph node involvement as a prognostic factor in pancreatic cancer.

The finding of metastatic disease in lymph nodes predicts a poor outcome for patients with adenocarcinoma of the head of the pancreas. Nodal metastases occur in as many as one-half of the patients who currently undergo resection with small tumors (less than 2 cm in diameter). There is some evidence that a more extensive lymphatic and soft tissue resection than is commonly done could prolong survival.

Low dose dopamine protects against hemorrhagic pancreatitis in cats.

Acute hemorrhagic pancreatitis (HP) is probably associated with decreased blood flow in its early phases, as well as with an increase in microvascular permeability. Dopamine (DOP; 5 micrograms/kg-min) is a splanchnic vasodilator, and also has beta-adrenergic effects that can prevent increases in microvascular permeability. We hypothesized that low dose dopamine might have beneficial effects on both blood flow and microvascular permeability, thus ameliorating the severity of the disease.

Pancreatic cystic endocrine neoplasms.

A rare case of cystic pancreatic endocrine tumor is presented, and the literature is reviewed. The patient was initially misdiagnosed as having a pancreatic pseudocyst, and that condition was managed accordingly. Persistence of the cystic lesion and reoperation led to the correct diagnosis and management.

The pathology of chronic pancreatitis.

We describe the current concepts of the pathology of alcoholic and obstructive chronic pancreatitis (CP). These 2 types of CP possess distinct pathological features. Alcoholic CP is associated with a lobular distribution of the lesions, with both obstruction (from protein plugs) and dilatation of the canalicular and intercalated ducts.

Pancreatic duct pressure, duct permeability and acute pancreatitis.

The relationship between pancreatic duct pressure, duct permeability to macromolecules and the development of acute pancreatitis was studied in a cat model. Perfusion of the pancreatic duct with 15 mM glycodeoxycholic acid, ethanol administration, or secretagogue-stimulated pancreatic secretion against greater than 50 per cent duct obstruction resulted in an increase in peak pancreatic duct pressure in all animals. Duct permeability to 20,000 molecular weight dextran molecules was increased in 22 of 29 experimental animals compared with two of 22 control animals (P less than 0.

Surgical palliation for pancreatic cancer.

The effectiveness of surgical palliation for pancreatic cancer has been reviewed. Jaundice should be relieved early as this eliminates distressing pruritus, improves the quality of life, and avoids the sequelae of prolonged extrahepatic obstruction. The procedure may prolong survival, but this has not been proved.

Acute hypercalcemia, pancreatic duct permeability, and pancreatitis in cats.

We investigated the effects of hypercalcemia on pancreatic duct permeability and pancreatitis in cats. Acute hypercalcemia was maintained by an infusion of calcium gluconate; controls received saline solution. Chronic hypercalcemia was maintained by diet and by vitamin D and dihydrotachysterol injections.

Possible mechanisms of acute pancreatitis induced by ethanol.

We investigated the effect of intravenous and intragastric ethanol on pancreatic duct pressure, duct permeability to dextran molecules (20,000 molecular weight), and on the development of acute pancreatitis in an experimental model of the disease. Intragastric ethanol caused a small increase in pancreatic duct pressure (6 to 7 mm Hg) and an increase in duct permeability to dextran. Intravenous ethanol with exclusion of the sphincter of Oddi did not increase pancreatic duct pressure or permeability.

Vasoactive drugs, microvascular permeability, and hemorrhagic pancreatitis in cats.

We investigated the mechanisms by which 16,16-dimethyl prostaglandin E2 and histamine induced pancreatic hemorrhage in an experimental model of acute pancreatitis in cats. In normal animals, when large molecular weight dextran molecules were infused into the systematic circulation, they were recovered in secretin-stimulated pancreatic juice in low concentrations. Both 16,16-dimethyl prostaglandin E2 (in a dose that increased splenic artery blood flow and microvascular permeability) and histamine (in a dose that increased permeability only) increased the amount of dextran recovered in pancreatic juice.

Treatment of acute pancreatitis with beta-adrenergic agonist drugs.

An increase in microvascular permeability may be important in the pathogenesis of acute pancreatitis. beta-adrenergic receptor agonist drugs are known to inhibit the increase in microvascular permeability induced by histamine and related vasoactive substances. These inflammatory mediators have been shown to be released during the course of experimental and human pancreatitis.

[Determination of formaldehyde concentration in a low-pressure sterilizer].

Two methods are described in determining the concentration of Formaldehyde in the sterilisation chamber of a regular commercial sterilizer. The measurement and flow of the concentration is ascertained during a routine sterilization procedure. With regard to the biological efficiency test of the examined apparatus the stability of the active Formaldehyde concentration is controlled.

Effects of oral agents on pancreatic duct permeability. A model of acute alcoholic pancreatitis.

The main pancreatic duct can be made permeable to molecules of up to 20,000 daltons by oral pretreatment with aspirin and ethanol. Because pancreatic enzymes have similar molecular weights, we hypothesized that activated pancreatic enzymes would leak from a permeable duct and produce pancreatitis. Four groups of cats were pretreated with either milk, aspirin, ethanol, or aspirin and ethanol for 48 hr.

[Antibiotic-resistant Corynebacteria--a new problem of infection in immunosuppressed patients].

Corynebacterium species can normally be found on the skin and mucous membranes but rarely cause infections. They are sensitive to most antibiotics. Two patients with severe aplastic anemia undergoing antilymphocyte globulin therapy developed septicemia with a highly antibiotic-resistant corynebacterium (JK-group) only sensitive to vancomycin.

Use of ciprofloxacin in the treatment of Pseudomonas aeruginosa infections.

The therapeutic efficacy and safety of ciprofloxacin was studied in 30 patients with Pseudomonas aeruginosa infections. In 20 patients ciprofloxacin was given alone and in 10 patients (including 8 compromised hosts) in combination with an aminoglycoside (9) or azlocillin (1). Ciprofloxacin was given in doses of 500 mg orally or 200-300 mg i.