Pancreas functions

The pancreas is a gland in the abdomen lying in the curvature of the stomach as it empties into the duodenum. The pancreas functions primarily as an exocrine gland, although it also has endocrine function. The exocrine cells of the pancreas are called acinar cells. They produce an alkaline fluid known as pancreatic... 

Diastase or amylase is formed when malt is produced by the germination of barley grains. Malt is therefore a good source of the enzyme. Diastase is also secreted by the salivary glands (when it is known as ptyalin), and also by the pancreas. Its function is to hydrolysef starch to a mixture of maltose and dextrin ... 

Autoimmune diseases may inflict on each organ or cell. Manifestations range from affecting a single cell type and its specific function (such as the (3-cell of the islands in the pancreas) to systemic diseases which have a detrimental effect on an entire organ system (e.g. the vasculature) of even many different organs. Table 1 summarizes some clinically important diseases. 

Pituitary Adenylyl Cyclase-activating Polypeptide (PACAP) is a 38-amino acid peptide (PACAP-38), which is widely expressed in the central nervous system. PACAP is most abundant in the hypothalamus. It is also found in the gastrointestinal tract, the adrenal gland and in testis. Its central nervous system functions are ill-defined. In the periphery, PACAP has been shown to stimulate catecholamine secretion from the adrenal medulla and to regulate secretion from the pancreas. Three G-protein coupled receptors have been shown to respond to PACAP, PAQ (PACAP type I) specifically binds PACAP, VPACi and VPAC2 also bind vasoactive intestinal peptide (VDP). Activation of PACAP receptors results in a Gs-mediated activation of adenylyl cyclase. 

Pancreas Oral cholecysto-graphic agent iopanoate ( ) experimental Unknown excretion into pancreatic duct Schmiedl U etal (1994) Imaging of exocrine pancreatic function investigation of the bioavailability of weak organic acids as potential pancreatic contrast agents for computed tomography. Invest Radiol 29 689-694... 

Artificial organs that perform the physical and biochemical functions of the heart, hver, pancreas, or lung are one class of organ replacements. A rather different target of opportunity is the development of biologieal materials that play a more passive role in the body for example,... 

Knowledge of the biochemistry of the porphyrins and of heme is basic to understanding the varied functions of hemoproteins (see below) in the body. The porphyrias are a group of diseases caused by abnormalities in the pathway of biosynthesis of the various porphyrins. Although porphyrias are not very prevalent, physicians must be aware of them. A much more prevalent clinical condition is jaundice, due to elevation of bilirubin in the plasma. This elevation is due to overproduction of bilirubin or to failure of its excretion and is seen in numerous diseases ranging from hemolytic anemias to viral hepatitis and to cancer of the pancreas. 

Amylase enters the blood largely via the lymphatics. An increase in hydrostatic pressure in the pancreatic ducts leads to a fairly prompt rise in the amylase concentration of the blood. Neither an increase in volume flow of pancreatic juice nor stimulation of pancreatic enzyme production will cause an increase in senm enzyme concentration. Elevation of intraductal pressure is the important determinant. Stimulation of flow in the face of obstruction can, however, augment the entry of amylase into the blood, as can disruption of acinar cells and ducts. A functional pancreas must be present for the serum amylase to rise. Serum amylase determination is indicated in acute pancreatitis in patients with acute abdominal pain where the clinical findings are not typical of other diseases such as appendicitis, cholecystitis, peptic ulcer, vascular disease or intestinal obstruction. In acute pancreatitis, the serum amylase starts to rise within a few hours simultaneously with the onset of symptoms and remains elevated for 2 to 3 days after which it returns to normal. The peak level is reached within 24 hours. Absence of increase in serum amylase in first 24 hours after the onset of symptoms is evidence against a diagnosis of acute pancreatitis (76). 

KATAOKA K, DiMAGNO E p (1998) Effect of chronic amylase inhibition on pancreatic growth and acinar cell secretory function in rats. Pancreas. 17 50-56. 

Improvement of glucose utihzation (Leklem., 1998). Non-starchy polysaccharide Improving the immune function and increased insulin release from the pancreas (Masayoshi et a/.,1987). 

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... 

As patients lose exocrine function of the pancreas, they have decreased ability to absorb lipids and protein ingested with normal dietary intake. Weight loss from nutritional malabsorption is a common symptom of chronic pancreatitis not often seen in acute pancreatitis. Fatty- or protein-containing stools are also common carbohydrate absorption is usually unaffected. Even though patients with chronic pancreatitis have decreased ability to absorb lipid from the gastrointestinal tract, there does not appear to be an increased incidence of fat-soluble vitamin deficiency in these patients.34... 

Glucose intolerance may occur because of chronic destruction of the endocrine function of the pancreas.35... 

Insulin and glucagon are produced in the pancreas by cells known as islets of Langerhans. P-Cells make up 70% to 90% of the islets and produce insulin, whereas P-cells produce glucagon. The main function of insulin is to decrease blood glucose levels, whereas glucagon, along with other counterregulatory... 

A pancreas with normal (3-cell function is able to adjust insulin production to maintain normal blood glucose levels. 

Treatment of type 1 DM requires providing exogenous insulin to replace the endogenous loss of insulin from the non-functional pancreas. Ideal insulin therapy mimics normal insulin physiology. 

The pancreas is a small retroperitoneal organ located behind the stomach on the posterior abdominal wall.1,3 The pancreas has both exocrine and endocrine functions. The exact nationwide prevalence of all diseases of the pancreas has not been fully quantified however, DM, both types 1 and 2, affect nearly 21 million people in the United States alone. Some reasons for pancreas transplants include ... 

The pancreas is an exocrine gland and an endocrine gland. The exocrine tissue produces a bicarbonate solution and digestive enzymes. These substances are transported to the small intestine where they play a role in the chemical digestion of food. These functions are fully discussed in Chapter 18 on the digestive system. 

Pancreatic juice neutralizes the acidic chyme entering the duodenum from the stomach. Neutralization not only prevents damage to the duodenal mucosa, but also creates a neutral or slightly alkaline environment optimal for the function of pancreatic enzymes. The pancreas also secretes several enzymes involved in the digestion of carbohydrates, proteins, and lipids. 

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