review of literature on clinical pancreatology - The Pancreapedia

percent in early identification forms <strong>of</strong> severe acute pancreatitis, with a correlation coefficient<strong>of</strong> 0.81. The correlation was good even in combination with organic disfunction (0.66) and therisk <strong>of</strong> death (0.54). The predictive capacity <strong>of</strong> sepsis has been reduced (0.44). Thedynamics <strong>of</strong> this cytokines show a significant decrease in concentrations forms mild disease(batch A) and in severe forms treated with peritoneal extended lavage (lot B). In conversely,the subjects treated by conventional methods (lot C) the decrease was not significantbetween the first and tenth days <strong>of</strong> admission. A similar dynamic has been recorded aftershort peritoneal lavage, lasting three days. At large in, the concentrations <strong>of</strong> interleukin 17evolved in parallel with those <strong>of</strong> interleukin 6 [153].Zinc and copperThe aims <strong>of</strong> one study were to measure the concentrations <strong>of</strong> zinc (Zn), copper (Cu), andmetallothionein and the Cu/Zn superoxide dismutase activity as elements engaged in anessential manner in the prooxidative and antioxidative balance <strong>of</strong> organism and todemonstrate the degree to which metallothionein and Cu/Zn superoxide dismutase areinvolved in the inflammatory processes occurring in the pancreas. The concentration <strong>of</strong>metallothionein was measured by immunoenzymatic method. Serum Cu/Zn superoxidedismutase activity was determined using a commercial test. The measurements <strong>of</strong> Zn andCu concentrations in serum were assessed with the use <strong>of</strong> flame atomic absorptionspectrometry. Lowered serum Zn concentration and higher Cu level were observed in theserum <strong>of</strong> patients with chronic exacerbated pancreatitis and chronic pancreatitis. Thesignificant increase <strong>of</strong> metallothionein concentration and Cu/Zn superoxide dismutase activitywas observed in the blood <strong>of</strong> patients with chronic exacerbated pancreatitis and chronicpancreatitis. In slices <strong>of</strong> the pancreas during pancreatitis, it was observed inimmunohistochemical reaction the variable involvement <strong>of</strong> Cu/Zn superoxide dismutase andmetallothionein. The results presented in these studies indicate an essential and variableinvolvement <strong>of</strong> antioxidants such Cu/Zn superoxide dismutase and metallothionein anddisordered Cu and Zn homeostasis depending on the progression <strong>of</strong> inflammatory processesin patients with pancreatitis [154].Prop<strong>of</strong>olThe use <strong>of</strong> prop<strong>of</strong>ol is controversial in patients with a history <strong>of</strong> acute pancreatitis or thosetaking drugs, including certain chemotherapeutic drugs that are associated with pancreatitis.To investigate this issue, it was <strong>review</strong>ed the medical records <strong>of</strong> all children who werediagnosed with pancreatitis while receiving chemotherapy for acute leukemia during a 5-yearperiod. A temporal relationship between prop<strong>of</strong>ol use and development <strong>of</strong> acute pancreatitiscould not be established. Prop<strong>of</strong>ol can thus be considered for general anesthesia in childrenwho are receiving chemotherapeutic drugs that are themselves associated with acutepancreatitis or those who have a history <strong>of</strong> chemotherapy-induced pancreatitis [155].Genetic polymorphismSystemic inflammatory reaction in acute pancreatitis is associated with activation <strong>of</strong> thecoagulation system. The prothrombotic component <strong>of</strong> the coagulation system, which maypromote microvascular thrombosis and vital organ injury, is strengthened by genetic factorssuch as polymorphism <strong>of</strong> plasminogen activator inhibitor type 1 (PAI-1) and factor V Leiden(FVL) mutation. It was now studied the occurrence <strong>of</strong> FVL and PAI-1 4G/5G polymorphismsin patients with acute pancreatitis This case control association study included 397 patientswith acute pancreatitis and 310 controls. Severe acute pancreatitis was determinedaccording to the Atlanta Classification. Genotyping was performed by matrix-assisted laserdesorption/ionization-time-<strong>of</strong>-flight mass spectrometry-assisted genotyping method. Factor VLeiden was identified in 5 (3.3 %) <strong>of</strong> 152 cases <strong>of</strong> severe acute pancreatitis and in 8 (3.3 %)