Pancreas necrosis

B12. Block, S., Maier, W., Bittner, R., Biichler, M., Malfertheiner, P., and Beger, H. G., Identification of pancreas necrosis in severe acute pancreatitis Imaging procedures versus clinical staging. Gut 27, 1035-1042 (1986). 

It remains unexplained why the teleost Atlantic cod (Gadus morhua) failed to acquire MHC class II system with its invariant chain, and reactive CD4 T cells. Was it never acquired in the cod lineage, or was it lost to deletion, or is the cod operating an unusually effective innate immune system Indeed, it appears fliat the cod expanded its entire innate and the MHC class 1 adaptive immune system. There is adequate response to endotoxin, and to bacterial (Aeromonas salmonicida Vibrio anguillarum) and viral (pancreas necrosis virus) pathogens [987-989]. 

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. 

A patient with acute pancreatitis may develop many severe local and systemic complications. Local complications involve fluid collection, necrosis, or abscess in the pancreas. A pancreatic fluid collection (or pancreatic pseudocyst) is a collection of tissue, pancreatic enzymes, and blood that forms weeks after acute pancreatitis. Many pancreatic pseudocysts resolve spontaneously, but some require surgical drainage.5 Rupture of a pancreatic pseudocyst with associated erosion and hemorrhage of major abdominal blood vessels can have a mortality approaching 60% thus, continued monitoring of a pseudocyst is prudent.6... 

Pancreatic necrosis is a diffuse inflammation of the pancreas with infectious etiology. Pancreatic necrosis occurs within the first 2 weeks of acute pancreatitis and develops in 10% to 30% of patients with acute pancreatitis. The necrotic pancreas can become secondarily infected with enteric gramnegative bacteria (such as E. coli), and disseminated infection may result from pancreatic necrosis.7,8... 

Pancreatic abscess is a collection of pus that forms in the pancreas 4 to 6 weeks after acute pancreatitis. Pancreatic abscess is usually less life-threatening than pancreatic necrosis or pancreatic pseudocyst and can be managed with percutaneous drainage.5... 

Ten healthy rats were studies in total. Eight rats were treated with variable doses of coulombs and two rats were used as controls. ECT in the rat pancreas produced local necrosis and appears safe and reproducible in the healthy rat tissue the next step is to examine its feasibility in a pig model pancreas, before evaluating it clinically for pancreatic tumors. 

Pancreatitis and altered pancreatic secretion can occur at any time during long-term glucocorticoid treatment (SED-12, 986 SEDA-14, 339 160). Necrosis of the pancreas during glucocorticoid treatment has been described and can be lethal. Impairment of pancreatic function can predispose to glucocorticoid-induced pancreatitis. Two other cases of glucocorticoid-induced pancreatitis have been reported (161). 

Other systemic effects have been observed in a small number of individuals intentionally or accidentally ingesting white phosphorus containing poison or firework. Some of these effects, such as fatty infiltration of the pancreas (Humphreys and Halpert 1931), splenomegaly (Greenberger et al. 1964), and necrosis of the adrenal medulla and cortex (Wechsler and Wechsler 1951), are consistent with effects that have been widely reported in... 

Pancreatic abscess A circumscribed intraabdominal collection of pus, usually in proximity to the pancreas, containing little or no pancreatic necrosis, which arises as a consequence of acute pancreatitis or pancreatic trauma. 

Based on the studies that indicated the relationship between a decrease in vitamin C concentration and morphological changes within the pancreas, it was suggested that assaying the level of vitamin C can constitute a useful indicator of pancreatic necrosis. 

L2. Lankisch, P. G., Pfichthofer, D., and Lehnik, D., No strickt correlation between necrosis and organ failure in acute pancreatitis. Pancreas 20, 319 (2000). 

Ul. Uhl, W., and Biichler, M., PMN-elastase in comparison with CRP, antiproteases, and LDH as indicators of necrosis in human acute pancreatitis. Pancreas 6, 253 (1991). 

Pancreas (pig only) Intravenous, inhalation, Exocrine pancreas Acinar cell necrosis... 

A 13-month-old boy presented with an acute abdomen and surgery was performed for a suspected perforated appendicitis (113). The appendix was normal but the pancreas was enlarged, edematous, and covered with fibrin, with areas of superficial necrosis. The serum amylase activity was 528 lU (normal under 200 lU). 

Ethionine is an acutely toxic compound that targets the liver and pancreas in animals, and possibly humans. Ethionine inhibits intracellular S-adenosy-Imethionine mediated methylation, and cause widespread liver and pancreatic necrosis. 

Laboratory testresults vary depending on the severity of the inflammatory process, whether damage is confined to the pancreas or involves contiguous organs, and the time course from the onset of the acute attack (see Table 39-3). Serum concentrations of prointlammatory cytokines such as tumor necrosis factor-a and interleukin-6 are markers of disease severity, but elevations are not specific for pancreatitis and the tests are not widely available. ... 

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