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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 7 (1993), S. 0 
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A double-blind, randomized, placebo-controlled crossover study was performed to assess the influence of one week of selective M1-muscarinic receptor blockade on pancreatic exocrine secretion in man. Ten healthy subjects received telenzepine (3 mg p.o.) and placebo each for 8 days, with a 6-day drug-free washout interval between treatment sequences. On Day 8 of each sequence, pancreatic secretion was stimulated for 2 h by infusion of submaximal secretin (0.2 U.kg/h) followed by maximal stimulation with secretin (1.0 U.kg/h) and ceruletide (120 ng.kg/h). Telenzepine had no significant effect on secretory parameters during submaximal stimulation with secretin. During maximal stimulation, total protein, secretory volume, and output of amylase, trypsin and bicarbonate were unexpectedly increased by telenzepine. These findings might be partially explained by removal of the inhibitory influence of pancreatic polypeptide, which was depressed by telenzepine. Acute studies have shown that M1-receptor antagonists inhibit exocrine secretion. Our results suggest that adaptation of physiological mechanisms governing the exocrine pancreas may occur after one week of receptor blockade by a therapeutic dosage of telenzepine, to the extent that M1-blockade no longer inhibits secretion.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Intraduodenal proteases exert a negative feedback on pancreatic secretion. Aim: To investigate the effect of two pancreatic enzyme preparations (enteric-coated tablets, and capsules with enteric-coated microtablets) on postprandial pancreatic and bile acid secretion, gastroduodenal motility and release of gastrin and pancreatic polypeptide in healthy humans. Methods: Twenty healthy males were studied on two different days one week apart. After an overnight fast a nine-lumen motility tube was positioned with the distal tip at the Treitz angle. On each study day, 30 min after an interdigestive migrating motor complex-phase III, a semi-liquid test meal was given either alone (n=20) or with enzymes (3 tablets (n=10) or 2 capsules with microtablets (n=10); 40000 U lipase and 2000 proteases) in a randomized order, and the study continued over 2 h. Motility was continuously recorded with four ports in the antrum and three in the duodenum, using a low-compliance pneumohydraulic perfusion system. Secretion of human-specific pancreatic elastase and bile acids was measured by a standard duodenal intubation perfusion technique. Plasma concentrations of gastrin and pancreatic polypeptide were measured by specific radioimmunoassays. Results: Postprandial pancreatic secretion was significantly reduced by administration of microtablets (median 82 mg/2 h vs. 70 mg/2 h, P〈0.02) but not by tablets (median 59 mg/2 h vs. 58 mg/2 h, N.S.). No changes were observed in bile acid secretion, antroduodenal motility or release of gastrin and pancreatic polypeptide. Conclusions: Oral administration of pancreatic enzymes at normal therapeutic doses significantly inhibits postprandial pancreatic secretion in healthy humans, when capsules with enteric-coated microtablets are given. Exogenous pancreatic enzymes have no significant effect on bile acid secretion, gastroduodenal motility and hormone release.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 0167-0115
    Keywords: Cholecystokinin ; Chronic pancreatitis ; Pancreatic polypeptide
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 69 (1991), S. 168-172 
    ISSN: 1432-1440
    Keywords: Vitamin B12 ; Folic acid ; Chronic pancreatitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Vitamin B12 malabsorption was reported earlier to occur in patients with exocrine pancreatic insufficiency, and pancreatic extracts were shown to improve the absorption of vitamin B12. We investigated serum levels of vitamin B12 and serum folate in patients with chronic pancreatitis and different degrees of pancreatic insufficiency. 137 patients (84 males, 53 females, age 34–72 years) with chronic pancreatitis (C.P.) were included in the study. 123 of 137 (89.8%) patients had a pathologic pancreatic function test result, classified into mild (n=24), moderate (n=61) or severe (n=38) insufficiency. The normal range of serum vitamin B12 and folic acid was established in 58 healthy controls and was found to be 190–1020 pg/ml for serum vitamin B12 and 2.4–16.1 ng/ml for folic acid. 7 patients (5.7%) with C.P. had vitamin B12 serum levels below 190 pg/ml; 4 of these had severe and 3 had mild or moderate exocrine pancreatic insufficiency. However there was no overall correlation between the degree of pancreatic insufficiency and vitamin B12 values. Serum levels of Vitamin B12 were 512±48 pg/ml in mild, 493±52 pg/ml in moderate and 428±45 pg/ml in severe exocrine insufficiency. Serum folic acid below 2.4 ng/ml were present in 5 patients (3.6%). Folic acid serum levels were 8.34±0.76 ng/ml in mild, 6.34±0.52 ng/ml in moderate and 7.45±0.53 ng/ml in severe exocrine insufficiency. We conclude that vitamin B12 deficiency is a rare finding in chronic pancreatitis and does not strictly depend on the degree of exocrine pancreatic insufficiency. In clinical practice enzyme supplementation in patients with severe pancreatic insufficiency is obviously sufficient for normal vitamin B12 absorption. Folic acid deficiency is also unfrequently found in chronic pancreatitis.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 71 (1993), S. 542-546 
    ISSN: 1432-1440
    Keywords: Gastric emptying ; Mixed solid-liquid meal ; Obesity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The purpose of this study was to determine whether obese patients have different rates of solid and liquid gastric emptying compared to healthy controls. Twenty-four obese patients (7 males, 17 females) were investigated prior to dietary restriction. The patients had a weight excess above ideal weight ranging from 25% to 216% (mean weight 118.1 ± 6.5 kg). The control group consisted of 8 healthy subjects (4 males, 4 females), within 10% of the ideal weight. The solid phase of the test meal consisted of 40 g bread, 30 g ham, 10 g margarine, and two scrambled eggs labeled with 99mTc. For the liquid phase, 200 ml orange juice was labeled with 201Tl. Three-minute counts of both tracers were taken for 106 min using a large field-of-view gamma camera. In obese patients, a significantly shortened lag phase for the emptying of solids was observed (27.0 ± 3.3 versus 38.4 ± 4.1 min; P 〈 0.05). Half-emptying time (105.9 ± 6.7 versus 100.7 ± 5.7 min), emptying rate (0.60 ± 0.04 versus 0.71 ± 0.07%/min), and total emptying of solids (49.4 ± 3.6 versus 50.5 ± 5.0%) were not different from controls. Obese subjects had a trend to slowed liquid emptying (half-time 82.7 ± 4.8 versus 69.9 ± 6.9 min; emptying rate 0.59 ± 0.03 versus 0.65 ± 0.03%/min; total emptying 59.8 ± 2.9 versus 66.0 ± 3.3 %), but this was not statistically significant. There was no correlation between weight or body surface area and rate of solid or liquid gastric emptying. It is concluded that no relevant disturbance in gastric emptying is related to the pathogenesis of obesity.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1289
    Keywords: Schlüsselwörter Colonamyloidose ; Chronisch-entzündliche Darmerkrankung ; Ischämische Colitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Bei einem 56jährigen Patienten wird 1/97 die Erstdiagnose einer chronisch-entzündlichen Darmerkrankung des Kolons gestellt, die am ehesten einem Morbus Crohn entspricht. Sechs Monate später wird histologisch eine massive Colonamyloidose beschrieben, die retrospektiv bereits bei der Erstmanifestation der Erkrankung vorlag. Weitere Organbeteiligungen können nicht nachgewiesen werden können. Die immunhistochemischen Untersuchungen schließen eine AA-Amyloidose aus. Vermutlich liegt eine Leichtkettenamyloidose vor. Unter Therapie mit 5-ASA befindet sich der Patient seit über einem Jahr in klinischer Remission. Die Amyloidablagerungen persistieren, dagegen findet sich weiterhin kein Anhalt für eine Beteiligung anderer Organsysteme.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1573-2568
    Keywords: Cholecystokinin ; pancreatic polypeptide ; diabetes mellitus ; autonomic neuropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The present study was undertaken to investigate postprandial responses of cholecystokinin (CCK) and pancreatic polypeptide (PP) and their interrelationship in patients with diabetes mellitus (DM) with and without autonomic neuropathy (AN). Twenty-two patients with DM (seven with AN and 15 without AN) and 14 age-matched healthy controls were studied. AN was diagnosed according to several tests of cardiovascular autonomic function. CCK and PP plasma levels were measured by specific radioimmunoassays before and at several time points after the oral administration of a test meal. Basal CCK plasma levels in DM patients were normal, whereas basal PP plasma levels were increased (139±18 vs 72±7 pg/ml;P〈0.01). Integrated postprandial CCK response was increased in DM patients (208±27 vs 110±14 pmol/liter/2 hr;P〈0.05), mainly due to the patients with AN. Postprandial PP response was increased in DM patients without AN (37,273±5241 vs 13,418±3299 pg/ml/2 hr;P〈0.001) but not in those with AN (8887±3461 pg/ml/2 hr). Moreover, PP response was closely (P〈0.002) correlated with the degree of AN. A direct and linear correlation between postprandial CCK and PP responses was found in healthy controls (r=0.78;P〈0.005) but not in DM patients. We conclude that the CCK response to a meal is increased in diabetic patients with AN, whereas the PP response is increased only with an intact autonomic nervous system. It is suggested that the correlation between postprandial hormonal responses in healthy subjects is due to the potency of CCK as PP releasing agent and that this interaction does not work in diabetic patients.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 42 (1997), S. 720-723 
    ISSN: 1573-2568
    Keywords: BAROSTAT ; NONULCER DYSPEPSIA ; VISCERAL HYPERSENSITIVITY ; H. PYLORI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Visceral hypersensitivity is claimed to beinvolved in the pathogenesis of nonulcer dyspepsia(NUD). We evaluated whether gastric hypersensitivity isa consistent finding in an unselected group of NUDpatients. In 11 patients and 20 healthy controls, astandardized gastric distension was performed using agastric barostat. Perception was scored by aquestionnaire and compared between the two groups. Therewas a linear pressure/volume relationship duringgastric distension in both groups. The pain threshold inNUD patients was significantly lower compared tocontrols [5.5 ± 4.0 mm Hg above minimaldistending pressure (mdp) and 10.2 ± 2.2 mm Hg above mdp,respectively, P 〈 0.004], irrespective of the H.pylori status. However, more than 50% of the NUDperception scores were in the control range at mostdistension levels. Gastric hypersensitivity could be confirmed inNUD patients as a group. However, there is aconsiderable overlap concerning perception in responseto distension between unselected NUD patients andcontrols.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 38 (1993), S. 482-489 
    ISSN: 1573-2568
    Keywords: gallbladder emptying ; exocrine pancreatic function ; cholecystokinin ; pancreatic polypeptide ; chronic pancreatitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gallbladder dynamics, cholecystokinin (CCK), and pancreatic polypeptide (PP) release were studied in 14 patients with chronic pancreatitis (CP) (2 females, 12 males; age range 24–56 years) and 12 control subjects (4 females, 8 males, 21–50 years). On day 1, gallbladder contractility was investigated after ceruletide intravenous infusion (2.5 ng/kg/min for 10 min). On day 2, a mixed standard test meal (1450 kJ) was administered orally. Gallbladder volume was assessed at three time intervals before (−30, −15, 0 min) and at 5, 10, 20, 30, 40, 50, 60, 80, 100 and 120 min after stimulation by means of ultrasonography. CCK and PP plasma levels were determined at each time interval.Exocrine pancreatic function was assessed using the pancreolauryl serum test (PLT). Six patients with CP had severe exocrine pancreatic insufficiency (EPI) (PLT〈1.8 μg/ml) with steatorrhea, eight patients had mild-moderate EPI. Fasting gallbladder volume was increased in CP (32.3±3.1 cm3) as compared to controls (20.5±1.2 cm3) (P〈0.01). Peak gallbladder contraction (percent of initial volume) in CP ranged from 5 to 55% (controls: 8–46%) following ceruletide and from 17 to 86% (controls: 27–80%) following the test meal (NS). There was no correlation between the degree of EPI according to PLT and peak gallbladder contraction. Gallbladder emptying in CP patients was not different from controls, although the postprandial CCK response was significantly impaired (P〈0.01). Postprandial PP response in CP was correlated with the PLT result (r=0.78;P〈0.01) but not with gallbladder emptying or refilling time. We conclude that gallbladder emptying and refilling following the oral administration of a test meal or the stimulation with a pharmacological dose of ceruletide is normal in patients with chronic pancreatitis. Postprandial gallbladder emptying is not influenced by the degree of exocrine pancreatic insufficiency.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 367 (1985), S. 41-50 
    ISSN: 1435-2451
    Keywords: Gastric resection ; Indirect pancreatic function test ; Secondary pancreatic insufficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 45 Patienten wurden 1–37 Jahre nach distaler Magenresektion (B IIn = 34, B In = 11) einem indirekten Pankreasfunktionstest (PLT-Test) mit Fluoresceindilaurat als Substrat unterzogen. Bei 11 Patienten mit chronischer Pankreatitis wurde die Diagnose durch spezifische Untersuchungen gesichert, wobei alle einen pathologischen Pankreasfunktionstest aufwiesen. Die PLT-Testergebnisse waren in 69,7% pathologisch in der Gruppe nach B II-Resektion ohne primäre Pankreaserkrankung und in 63,6% in der Gruppe nach B I-Resektion. Eine Malabsorption konnte bei allen Patienten durch die unveränderte Resorption von freiem Fluorescein ausgeschlossen werden. Die Ergebnisse sind Ausdruck einer sekundären Pankreasinsuffizienz nach distaler Magenresektion. Bei Patienten mit Anzeichen einer Mangelernährung nach Magenresektion sollte ein indirekter Pankreasfunktionstest durchgeführt werden und nach Evaluierung einer exokrinen Störung eine Substitution mit Pankreasfermenten erfolgen.
    Notes: Summary Forty-five patients, 1–37 years following gastric resection (B IIn = 34, B In = 11) underwent an oral pancreatic function test with fluorescein dilaurate (PLT). Out of this group 11 patients suffered from a chronic pancreatitis proven by specific examination. All patients with chronic pancreatitis had pathological PLT-test results. In the B II-patients without primary pancreatic disease there were pathological PLT-test results in 69.7% and 63.6% in the B I-patients, respectively. In the resected patients malabsorption was excluded by unchanged fluorescein-excretion pattern following oral ingestion of free fluorescein. The results indicate a secondary pancreatic insufficiency following distal gastric resection. Patients with signs of malnutrition after gastric resection should undergo an indirect pancreatic function test. Substitution therapy with pancreatic enzymes is indicated following evaluation of exocrine function impairment.
    Type of Medium: Electronic Resource
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