Pancreas and

Selenium. Selenium, thought to be widely distributed throughout body tissues, is present mostly as selenocysteine in selenoproteins or as selenomethionine (113,114). Animal experiments suggest that greater concentrations are in the kidney, Hver, and pancreas and lesser amounts are in the lungs, heart, spleen, skin, brain, and carcass (115). 

Manganese. The adult human body contains ca 10—20 mg of manganese (124,125), widely distributed throughout the body. The largest Mg " concentration is in the mitochondria of the soft tissues, especially in the Hver, pancreas, and kidneys (124,126). Manganese concentration in bone varies widely with dietary intake (126) (see Table 10). 

Two CCK receptor subtypes, CCK and CCKg are known. A related receptor, the gastrin receptor, has also been described. CCK receptors predominate in the gastrointestinal tract and pancreas and are also localized in discrete brain regions. CCKg receptors predominate in the brain. A 71623... 

P-Adrenoceptors have been subdivided into P - and P2-adrenoceptors. A third subset called nontypical P-adrenoceptors or P -adrenoceptors have been described but are stiU the subject of debate. In terms of the interactions with various subsets of P-adrenoceptors, some antagonists are nonselective in that they antagonize the effects of activation of both P - and P2-adrenoceptors, whereas others are selective for either P - or P2-adrenoceptors. P - and P2-adrenoceptors coexist in almost all organs but generally, one type predominates. The focus herein is on the clinically relevant P -adrenoceptor-mediated effects on heart and on P2-adrenoceptor-mediated effects on smooth muscles of blood vessels and bronchioles, the insulin-secreting tissue of the pancreas, and skeletal muscle glycogenolysis for side effects profile (36). 

FIGURE 24.3 (a) A duct at the junction of the pancreas and duodenum secretes pancreatic juice into the duodenum, the first portion of the small intestine, (b) Hydrolysis of triacylglycerols by pancreatic and intestinal lipases. Pancreatic lipases cleave fatty acids at the C-1 and C-3 positions. Resulting monoacylglycerols with fatty acids at C-2 are hydrolyzed by intestinal lipases. Fatty acids and monoacylglycerols are absorbed through the intestinal wall and assembled into lipoprotein aggregates termed chylomicrons (discussed in Chapter 25). 

A large and rapidly growing number of clinical trials (phase I and phase II) evaluating the potential of DNA vaccines to treat and prevent a variety of human diseases are currently being performed ( http // clinicaltrials.gov) however, there is yet no licensed DNA vaccine product available for use in humans. The clinical trials include the treatment of various types of cancers (e.g., melanoma, breast, renal, lymphoma, prostate, and pancreas) and also the prevention and therapy of infectious diseases (e.g., HIV/ABDS, malaria, Hepatitis B vims, Influenza vims, and Dengue vims). So far, no principally adverse effects have been reported from these trials. The main challenge for the development of DNA vaccines for use in humans is to improve the rather weak potency. DNA vaccines are already commercially available for veterinary medicine for prevention of West Nile Vims infections in horses and Infectious Hematopoetic Necrosis Vims in Salmon. 

Despite recent developments, effectiveness of chemotherapy is still rather limited for most types of cancer, including tumors of the colon, lung, kidney, pancreas, and liver. Why some cancers respond better than others may be explained by factors relating to the anatomy and physiology of the cancer-ridden organ or... 

Zollinger-Ellison syndrome (ZES) is characterized by the development of a tumor (gastrinoma) or tumors that secrete excessive levels of gastrin, a hormone that stimulates production of acid by the stomach. In most cases, the tumor or tumors arise within the pancreas and/or the upper region of the small intestine (duodenum). 

Niacin is used as adjunctive therapy for the treatment of very high serum triglyceride levels in patients who present a risk of pancreatitis (inflammation of the pancreas) and who do not experience an adequate response to dietary control. 

Insulin is available as purified extracts from beef and pork pancreas and is biologically similar to human insulin. However, these animal source insulins are used less frequently today than in years past. They are being replaced by synthetic insulins, including human insulin or insulin analogy. 

Merkord J, Weber H, Kroning G, Henningshausen G (2001) Repeated administration of a mild acute toxic dose of di-n-butyltin dichioride at intervals of 3 weeks induces severe lesions in pancreas and liver of rats. Human and Experimental Toxicology, 20(8) 386-392. 

The commonest causes of obstructive (posthepatic) jaundice are cancer of the head of the pancreas and a gallstone lodged in the common bile duct. The presence of bilirubin in the urine is sometimes referred to as choluria—therefore, hepatitis and obstruction of the common bile duct cause choluric Jaundice, whereas the Jaundice of hemolytic anemia is referred to as acholuric. The laboratory results in patients with hepatitis are variable, depending on the extent of damage to parenchymal cells and the extent of micro-obstruction to bile ductules. Serum levels of ALT and AST are usually markedly elevated in hepatitis, whereas serum levels of alkaline phosphatase are elevated in obstructive liver disease. 

Raiser, E. Runstadter, R H and Mendelsohn, R. J Electrolyte concentrations in sweat and saliva comparison in patients with cysticfibrosis of pancreas and other conditions Amer. J Dis Child (1956),... 

The several liters of fluid that are secreted each day by the GIT mucosa, pancreas and gall bladder, and other associated glands are necessary for the digestion of feedstufifs. Due to efficient reabsorption, less than 100 ml of fluid and only a small percentage of the secreted electrolytes are lost in the feces. The disturbances of mucosal secretion and reabsorption of water and electrolytes caused by various bacterial toxins, such as cholera, are well established. 

The portal vein is the primary vessel leading into the liver it receives deoxygenated venous blood flow from the small intestine, stomach, pancreas, and spleen (Fig. 19-1). The inflow from these organ systems accounts for approximately 75% of... 

FIGURE 20-1. Anatom ic structure of the pancreas and biliary tract. (From Berardi RR, Montgomery PA. Pancreatitis. In DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiologic Approach. 6th ed. New York McGraw-Hill 2005 722, with permission.)... 

Autolysis of the pancreas can occur when zymogens are activated in the pancreas before being released into the duodenum. Acute pancreatitis can result from the initial injury to the zymogen-producing cells, which is followed by neutrophil invasion of the pancreas, and that ends in further activation of enzymes within the pancreas. This cascade of events can be destructive to the pancreas and harmful to the patient. 

It is common practice to discontinue oral feedings during an attack of acute pancreatitis. In theory, discontinuation of oral intake will decrease the secretory functions of the pancreas and minimize further complications from the disease. Some patients can be fed with minimal oral intake. Tube feeding delivered via a nasojejunal tube will feed the patient beyond the ampulla of Vater, minimizing stimulation of the pancreas.15,16 If oral intake is discontinued for a protracted period, total parenteral nutrition must be used to maintain adequate nutrition.17,18... 

Chronic pancreatitis is an inflammatory process that occurs over a long period of time. The inflammation damages the enzyme-producing cells in the pancreas and can also disrupt or destroy the endocrine function of the pancreas by causing diffuse... 

Differentiating an episode of acute pancreatitis from chronic pancreatitis maybe difficult because the clinical presentations can be similar. The diagnosis of chronic pancreatitis is made by looking for the effects of chronic pancreatic inflammation and scarring on the pancreas and the patient as a whole. Computed tomography or ERCP will allow visualization of chronic calcified lesions in the pancreas when present.37... 

P-glycoprotein is not only expressed in tumor cells, but also in cells of several healthy tissues. In liver it was detected in the biliary canalicular surface of hepato-cytes and the apical surface of small biliary ductules. In the small intestine and colon, it is localized in the apical surface of columnar epithelial cells, and in kidneys it is found in the brush border membrane of proximal tubules. Moreover, it is detectable on the apical surface of small ductules in the pancreas and on the surface of cells in the medulla and cortex of adrenals [2]. 

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