Search PubMed⌕ Search

Biomedical subjects

F Stadil

Publications and source records attributed to F Stadil.

At least 73 records · Page 4Linked to original sources
PubMed1979

Serum disappearance rate of gastrin-17 after vagotomy.

Six duodenal ulcer patients were investigated before and after truncal vagotomy and pyloroplasty. Four doses of gastrin-17 were injected intravenously (15.625, 31.25, 62.5, and 125 micrograms/kg body weight); the gastric secretory response and the disappearance rate of gastrin were measured. After vagotomy the basal level of gastrin increased from 64 pg/ml to 106 pg/ml. When corrected for the basal levels of gastrin, the peak levels and disappearance rate of gastrin-17 were observed to be the same after vagotomy as before (half-life before vagotomy, 5.6 min; after, 5.8 min). This indicates that vagus does not influence the metabolism of exogenous gastrin-17. The gastric secretion of acid was reduced to 30% after vagotomy, which shows that there is a synergism between vagus and gastrin-17.

Duodenal Ulcer↗
PubMed1979

Delay in the diagnosis of insulinomas.

The median diagnostic delay in 32 patients with verified insulinomas was 2 3/4 years (range 1/4--18). The median delay in the 1939--1958 period was shorter (2 years, n = 17) than in the 1959--1978 period (3 years, n = 15). Thus, modern developments with insulin estimations were without noticeable effect upon the diagnostic delay. The findings can probably only be explained by a poor awareness of the insulinoma syndrome in the medical profession.

Adenoma, Islet Cell↗
PubMed1979

Clinical diagnosis of metastatic carcinoid tumours.

Eighteen patients with metastatic carcinoid tumours were admitted to surgical gastroenterological department of Rigshospitalet during the period 1974--1978. Thirteen had primary carcinoid tumours in the terminal ileum, two in the lungs, one in the pancreas, one in the testis, and one possibly in the retroperitoneum. All patients had distant metastases, 13 in the liver. Carcinoid syndrome with flusing and diarrhoea was present in 15 patients (83%). The time elapsing from onset of symptoms until diagnosis was on an average 2 1/2 years. The most valuable screening test for carcinoid syndrome was determination of the excretion of 5-hydroxy-indol- acetic-acid. The most sensitive investigation for determination of primary tumour and/or metastases was abdominal angiography, which was positive in all cases. Other radiological investigations were less sensitive.

Adult↗
PubMed1979

The clinical diagnosis of the Zollinger-Ellison syndrome.

Recent clinical experiences with 34 Z-E patients indicates that the clinical features and course of the syndrome is less dramatic than described originally. Eighty-five per cent of the patients presented stories of abdominal complaints lasting more than five years and resembling the complaints presented by duodenal ulcer patients (DU). Ulcers were present in 91 per cent of the patients. Fifty-one per cent had either ectopic or multiple ulcers. One third had a single duodenal ulcer resembling an ordinary ulcer. No patients died from complications to the ulcer diathesis. Marked hypersecretion of acid and gastrin was present in the ZE group (BAO:33.7 +/- 7.4; PAO:62.8 +/- 6.1 meq H+/h; gastrin: 5094 pmol/l), but because of great individual variation in the ZE, some overlapping with the acid and gastrin measurements of the DU was seen. The diagnostic value of provocative tests using secretin, calcium, glucagon and food stimulations demonstrated a considerable overlapping between the two groups, indicating that these tests are of little clinical value. Tumours were found in half the patients, revealing malignancy in ten. The ZE can be diagnosed in most cases by combining symptomatology, with measurements of acid and gastrin.

Adult↗
PubMed1979

Localization of gastrinomas by transhepatic portal catheterization and gastrin assay.

Gastrinomas were localized by concurrent blood sampling in the hepatic vein and portal vein tributaries in 10 of 12 Zollinger-Ellison patients. In one patient, the portal vein could not be catheterized; in the other, a gastrin gradient could not be picked up in either of two examinations. Six of the patients were subsequently operated upon: 5 had pancreatoduodenal resection and 1 had laparotomy at which metastases were found. Four of the resections were probably curative as the patients have done well without treatment since with concentrations of gastrin in serum near zero. The observation period ranges from 17 to 20 mo. It is concluded that transhepatic catheterization of the hepatic vein and portal vein tributaries with blood sampling for gastrin determination permit the verification of the Zollinger-Ellison diagnosis and the localization of the gastrinomas. The latter may lead to the selection of a curative operative treatment in some of the patients.

Blood Specimen Collection↗
PubMed1979

Synchronous oscillations in the basal secretion of pancreatic-polypeptide and gastric acid. Depression by cholinergic blockade of pancreatic-polypeptide concentrations in plasma.

The effect of cholinergic blockade on the concentrations of pancreatic-polypeptide (PP) in plasma was studied in 19 patients with duodenal ulcer (DU) and 16 control subjects. PP concentrations increased with age both in control subjects and in DU patients. In the DU patients atropine or benzilonium, an antimuscarinic agent with minimal cerebral actions, reduced PP concentrations from 47 (8-220) to 28 (7-53) pmol/liter, n = 18, median and total range. In the control subjects atropine suppressed the PP concentrations from 17 (0-257) to 11 (0-41) pmol/liter, n = 15. Cholinergic blockade had only a minor effect in 1 patient and 1 control, both with high PP concentrations. Both in the DU patients and in the control group the suppression by the cholinergic blockade was most marked in subjects with elevated PP concentrations. Spontaneous acid and PP secretion were measured simultaneously in 25 DU patients. No correlation was found between median acid secretion and median concentrations of PP. However, in the individual patient a positive covariation was found between fluctuations in spontaneous acid secretion and fluctuations in PP concentration. P less than 0.005. We conclude that plasma concentrations of PP in the basal state are suppressible by cholinergic blockade and that PP concentrations fluctuate synchronously with the spontaneous secretion of gastric acid. These results suggest that PP concentrations in plasma before and after cholinergic blockade may possibly serve as indicator of abdominal vagal tone.

Adult↗
PubMed1978

Prevalence of endocrine abnormalities in patients with the Zollinger-Ellison syndrome and in their families.

To evalute the frequency of associated and hereditary endocrinopathies in the Zollinger-Ellison syndrome, 10 patients with the syndrome were studied. In seven of them, coexisting endocrine disease was found. In six, the Zollinger-Ellison syndrome was probably a feature of multiple endocrine adenomatosis type I, whereas Cushing's syndrome in the remaining patient may have been caused by the production of an ACTH-like substance by a mixed pancreatic tumor. A total of 109 family members, including all living first degree relatives over 15 years of age, were screened for endocrine abnormalities. All six patients with evidence of multiple endocrine adenomatosis type I had relatives with endocrinopathies. In the families of the four other patients with the Zollinger-Ellison syndrome, no endocrine abnormalities were found. During this study four new cases of pituitary tumor, 17 of hyperparathyroidism, seven of the Zollinger-Ellison syndrome and one of insulinoma were detected. Although most of the disorders were asymptomatic, this clearly indicates that patients suffering from Zollinger-Ellison syndrome and also their families should undergo detailed endocrine studies.

Adolescent↗
PubMed1978

Vagal, cholinergic regulation of pancreatic polypeptide secretion.

THE EFFECT OF EFFERENT, PARASYMPATHETIC STIMULATION UPON PANCREATIC POLYPEPTIDE (PP) SECRETION WAS STUDIED IN THREE WAYS: (a) Plasma PP concentrations increased in response to insulin-induced hypoglycemia in both normal subjects, from 11 pM (9.5-12.5) to 136 pM (118-147), n = 8 (median and interquartile range) and in duodenal ulcer patients, from 33 pM (21-52) to 213 pM (157-233), n = 7. The PP response to hypoglycemia was diminished by atropine in normal subjects (P < 0.005) and completely abolished by vagotomy in the duodenal ulcer patients. (b) Electrical stimulation, 8 Hz, of the vagal nerves in anesthetized pigs induced an increase in portal PP concentrations within 30 s from 32 pM (28-39) to 285 pM (248-294), n = 12. Minimal stimulatory frequency was 0.5 Hz and maximal stimulatory frequency 8-12 Hz. Atropine inhibited the PP response to electrical stimulation. Median inhibition with 0.5 mg of atropine/kg body wt was 74%, range 31-90%, n = 6. The response was eliminated by hexamethonium. Adrenergic alpha and beta blockade did not influence the release of PP in response to vagal stimulation. (c) Acetylcholine stimulated, in a dose-dependent manner, the secretion of PP from the isolated perfused porcine pancreas, half-maximal effective dose being 0.19 muM; maximal PP output in response to 5 min stimulation was 228 pmol, range 140-342 pmol, n = 5. Atropine completely abolished this response.The results of the present study together with the previously demonstrated poor PP response to food in vagotomized patients, indicate that vagal, cholinergic stimulation is a major regulator of PP secretion.

Acetylcholine↗
PubMed1978

The effect of beta-adrenergic and cholinergic blockade on the circadian rhythm of gastrins in serum.

The importance of beta-adrenergic and cholinergic mechanisms to the circadian rhythm of gastrins in serum was studied in 15 healthy volunteers. The subjects were investigated during peroral treatment with 1) a beta-adrenergic blocking drug (propranolol), 2) an anticholinergic drug (glycopyrron), 3) both drugs, and 4) without treatment. Gastrin concentrations were measured with an antiserum that measures all four main components of gastrin in serum, and with a gastrin-17 specific antiserum. A circadian rhythm was observed with both antisera. The total immunoreactivity in serum increased from 39 pg per ml +/- 3 (mean and S.E.M.) in the morning to a peak at 2300 (77 +/- 7), followed by a nadir at 0400 (38 +/- 2). The circadian rhythm was maintained during administration of the drugs, but the concentrations of component III (gastrin-17) were reduced by beta-adrenergic blockade, while the anticholinergic treatment increased the concentrations of the other gastrin components. The inhibition of gastric secretion of acid by anticholinergics is presumably due to an action on the parietal cells; according to this study, the inhibition is connected by an increased gastrin stimulus. Beta-adrenergic blockade, on the other hand, seems to reduce the gastrin stimulus and might be of therapeutical interest in duodenal ulcer disease.

Adrenergic beta-Antagonists↗
PubMed1977

Effect of truncal vagotomy on gastroduodenal content of gastrin.

The vagal influence on gastroduodenal content of gastrin was studied in duodenal ulcer patients. Endoscopic biopsies were assayed for total concentrations of gastrin, and fractionated for measurements of gastrin components before and after total vagotomy. Antral concentration was 17-0 +/- 2-0 mug gastrin/g mucosa (mean +/- s.e.m.) in 52 unoperated patients compared with 25-2 +/- 3-2 mug in 32 vagotomized patients. In 14 patients studied before and 3 months after vagotomy antral content was almost doubled (10-9 +/- 2-3 and 20-4 +/- 2-9 mug respectively). In the duodenal bulb the concentration was 2-4 +/- 0.3 mug in 37 unoperated patients and 2-2 +/- 0.4 mug in 19 vagotomized patients. In 6 patients in whom measurements were made throughout the duodenum, gastrin concentrations were slightly but significantly lower 3 months after vagotomy. Fractionations of pooled homogenates on Sephadex G-50 showed that gastrin component III (gastrin-17) made up 95 per cent of the antral gastrins before and after operation. In the duodenum component III constituted more than half of the gastrins preoperatively, but only one-third postoperatively. The total amount of gastroduodenal gastrin was considerably increased by vagotomy, and it is well established that in serum the gastrin concentration is also higher postoperatively. The most likely implication of these findings is that in man the vagus, directly or indirectly, suppresses gastrin production.

Duodenal Ulcer↗