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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 60 (1982), S. 1363-1368 
    ISSN: 1432-1440
    Keywords: Serum trypsin ; Evocative test ; Exocrine pancreas ; Serumtrypsin ; Pankreasevokationstest
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die basalen Serumkonzentrationen von Trypsin und Amylase sind von geringer Aussagekraft für die Funktion des exokrinen Pankreas. Nach Sekretin-Stimulation ist ein signifikanter Unterschied in der Reaktionskinetik von Serum-Trypsin und -Amylase feststellbar, wahrscheinlich aufgrund der erheblichen Molekularge-wichtsdifferenz (21,000 vs 52,000 Daltons) beider Enzyme. Bei Personen mit unauffälligem Sekretin-Pankreozymin-Test steigt Trypsin im Serum in etwa 70% der Fälle poststimulatorisch an, während die Serumamylase unverändert bleibt. Bei mäßiger exkretorischer Insuffizienz ist der Trypsinanstieg reduziert und bei schwerer Insuffizienz in der Regel aufgehoben. Basal und poststimulatorisch niedriges Trypsin bestätigen in 93% der Fälle das Ergebnis einer schweren und in 54% der Fälle das einer leichten Pankreasfunktionseinschränkung im SP-Test. Bei Diabetes mellitus mit basal niedrigem Serum-Trypsin kann durch Sekretinevokation eine exkretorische Insuffizienz ausgeschlossen werden. Das poststimulatorische Verhalten der Serumamylase läßt keinen eindeutigen Funktionsbezug erkennen. Die unterschiedliche Serumkinetik von Trypsin und Amylase läßt vermuten, daß Trypsin im Serum primär duktulärer Genese und Pankreasenzyme von der Größe der Amylase primär azinärer Genese sind.
    Notes: Summary The diagnostic value of basal serum trypsin and amylase values in the assessment of pancreatic exocrine function is limited. Secretin injection evokes a significantly different response in the serum kinetics of trypsin and amylase, due probably to their difference in molecular weight (21,000 vs 52,000 Daltons). Serum trypsin increases in 70% of people with normal secretin-pancreocymin test after stimulation with secretin, whereas amylase remains unchanged. The post-stimulatory rise in trypsin is lower in mild exocrine insufficiency and almost completely abolished in severe exocrine insufficiency. The diagnosis of severe exocrine insufficiency is confirmed in 93% and that of mild insufficiency in 54% by low basal and post-stimulatory levels of serum trypsin. In diabetics with low basal values the post-stimulatory rise in serum trypsin confirmed normal pancreatic function. The poststimulatory kinetics of serum amylase shows no clear correlation to pancreatic function. From the divergent serum kinetics of trypsin and amylase it may be concluded that trypsin is primarily of ductular and amylase primarily of acinar origin.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Ultrasound ; Computed tomography ; Endoscopic retrograde cholangiopancreatography ; Chronic pancreatitis ; Pancreatic tumor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary From February to November 1981 the diagnostic relevance of ultrasound (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) was compared prospectively in 75 patients with suspected pancreatic disease. Final diagnosis was confirmed by autopsy, surgery, clinical course, and further laboratory data. Thus it was possible to exclude pancreatic disorders in 32 patients. By ERCP we diagnosed all tumors; sensitivity was 100%. Sensitivity of US and CT were 63% each. In five cases US made the false positive diagnosis” pancreatic malignant tumor” (specifity 93%), CT and ERCP in two cases (specifity 97% each). In chronic pancreatitis specifity of US and ERCP were 100% and specifity of CT was 98%. Sensitivity of ERCP amounted to 93%, CT and US revealed 74% and 52%, respectively. We conclude that ERCP is the best morphologic diagnostic tool in differentiating chronic pancreatitis from pancreatic carcinoma. US is a good screening method and CT reveals good diagnostic results in acute pancreatitis.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 61 (1983), S. 193-198 
    ISSN: 1432-1440
    Keywords: Pancreolauryltest (PLT) ; Sensitivity ; Specificity ; Chronic pancreatitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The diagnostic accuracy of a tubeless pancreatic function test — Pancreolauryl (PLT) — was evaluated on 97 patients and healthy controls: we found a pathological result of PLT in 31 (88,6%) of 35 patients with proven chronic pancreatitis and a normal PLT in 30 (90%) of 33 controls with no pancreatic disease. In 29 patients with a defined gastrointestinal disease other than chronic pancreatitis the test result was pathological in 51%. This result points towards a limited specifity of the PLT in this latter group, but shows its usefulness as an indicator for maldigestion accompanying the primary disease. In comparison to firmly established diagnostic means for chronic pancreatitis the PLT result was in accordance with the Secretin-Ceruletide function test in 81,3% with ERCP in 80,9% and with computertomography in 76,4%.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1440
    Keywords: Ulcus duodeni ; antacid ; ranitidin ; healing ; ultrastructural pattern
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To evaluate and further characterize duodenal ulcer healing macroscopical, histological, and ultrastructural criteria were examined in 24 patients with active duodenal ulcer disease under two different treatment schedules. After the endoscopic confirmation of an active duodenal ulcer patients were randomly assigned to treatment with either an antacid (group A) or with an H2 blocker (group B). Tissue specimen were taken during endoscopy from the margin and 1 cm from the ulcer before therapy and from the ulcer scar or the previous ulcerated region after a 4 week treatment. A macroscopic ulcer healing by endoscopic criteria was confirmed in 83% of the patients in group A and in 83% of group B. The prominent histological feature of duodenal ulcer healing was a significant increase of PAS positive epithelial cells. Ultrastructural changes of the duodenal mucosa were still present at the end of the treatment, even in the presence of complete macroscopic healing. The ultrastructural healing process shows constant patterns independent from the type of treatment. The characteristic morphological feature by electron microscopy of the healing duodenal ulcer is the appearance of a metaplastic mucus secreting cell of the antrum-type. The devastated mucous structure during the ulcerative phase regains the normal net-like structure after 4 weeks therapy.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 64 (1986), S. 1186-1191 
    ISSN: 1432-1440
    Keywords: Acute pancreatitis ; Serum elastase 1 ; Diagnosis ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Serum elastase 1 was determined in the serum of 38 patients with acute pancreatitis, using specific radioimmunoassay technique. Serving as controls were 36 healthy people, 33 patients with chronic pancreatitis, 49 patients with various GI-tract diseases, and 6 patients with pancreatic carcinoma. Sensitivity of elastase 1 for the diagnosis “acute pancreatitis” was 97% after admission to the hospital and 100% within 48 h after onset of acute pancreatitis. The determination of elastase 1 is clearly superior to that of trypsin, pancreatic lipase, or pancreatic amylase, if diagnosis has to be made more than 48 h after the onset of the disease. The specificity is restricted, because there are some cases with chronic pancreatitis and GI-diseases with raised values. There is no possibility to estimate the severity of acute pancreatitis by measuring serum elastase 1.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 65 (1987), S. 144-146 
    ISSN: 1432-1440
    Keywords: Campylobacter pyloridis ; Duodenal ulcer ; Electron microscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The ultrastructure of campylobacter-like organisms found within duodenal biopsy specimens from 7 of 24 patients (28%) with active duodenal ulcer is described. Their curved shape and variable size are similar to what has previously been reported in descriptions of light microscopies. The organisms were found at the edge of active duodenal ulcers exclusively near neutral-mucous producing antral cells, to which they can adhere. The presence of these bacteria within cells and in the intercellular fluid implies that they can penetrate through the cell membrane or through tight intercellular junctions. The occurrence of these bacteria as well as numerous polymorphonuclear leukocytes in the afflicted regions suggests that the bacteria originally described by Warren and Marshall are indeed pathogenic and that their influence on ulcer healing should be included in designing treatment protocols.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1440
    Keywords: Pancreatic lipase ; Enzyme immunoassay ; Serum levels ; Chronic pancreatitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The determination of basal pancreatic serum enzymes is of little value in the diagnosis of chronic pancreatitis. The organ specificity of a recently introduced immunochemical method of determining pancreatic lipase is guaranteed. The diagnostic value of the basal and stimulated serumlipase determination by the immunochemical assay in chronic pancreatitis was investigated on 84 patients and controls. In 46 patients with chronic pancreatitis the serum increase of pancreatic lipase after secretin stimulation (1 U/kg) was significantly (P〈0.01) higher than the pancreatic lipase increase in patients with non-pancreatic intestinal disorders and in healthy controls. Patients with chronic pancreatitis deserve to be classified in subgroups, according to the degree of the exocrine pancreatic insufficiency established by means of the secretin-ceruletide test. Of the patients with chronic pancreatitis and a slight to moderate exocrine pancreatic insufficiency 87% show an abnormal serum pancreatic-lipase increase and differ significantly (P〈0.01) from patients with severe exocrine insufficiency who exhibit an increase of the pancreatic serum lipase only in exceptional cases. Specificity is limited, since an abnormal serum lipase increase after stimulation is found in 20% of controls.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1440
    Keywords: Immunoreactive phospholipase A2 ; Serum catalytic phospholipase A2 activity ; Necrotizing pancreatitis ; Diffuse peritonitis ; Multiple injuries
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To study the source and role of circulating phospholipase A2 (PLA2) catalytic activity we monitored the serum from patients with necrotizing pancreatitis (n=8), diffuse peritonitis (n=6), and multiple injuries (n=11). Immunoreactive PLA2 serum protein concentration was analysed using a fluoroimmunoassay based on an antibody against human pancreatic PLA2. Serum PLA2 catalytic activity was analysed using a radiochemical method based on a substrate with tritiated palmitic acid in beta position. In necrotizing pancreatitis immunoreactive PLA2 and PLA2 catalytic activity both increased. Obviously, in necrotizing pancreatitis the major part of serum catalytic activity stems from the pancreas. In patients with diffuse peritonitis and multiple injuries, as a rule, immunoreactive phospholipase A2 serum concentration appears to be within the normal range. In contrast, in these patients we demonstrated high serum catalytic PLA2 activity comparable to that in necrotizing pancreatitis. The source of catalytic PLA2 activity in peritonitis and multiple injuries seems not to be the pancreas. There was a correlation between pulmonary insufficiency and serum PLA2 catalytic activity in patients with necrotizing pancreatitis, peritonitis, and multiple injuries.
    Type of Medium: Electronic Resource
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  • 9
    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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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Medical microbiology and immunology 182 (1993), S. 233-242 
    ISSN: 1432-1831
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Helicobacter pylori urease was characterized by means of an enzyme histochemical electron microscopic technique. Ultrastructural analysis revealed no urease activity in one strain; in sevenH. pylori strains (43.75%), urease activity was associated with the cell membrane. Eight strains (50.0%) showed reaction product located within the cytoplasm. Urease activity showed no correlation with localization of activity. Our results demonstrate thatH. pylori urease is not uniform in allH. pylori strains, and differences in activity and localization of urease activity may account for different virulence activities.
    Type of Medium: Electronic Resource
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