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Biomedical subjects

G Brocco

Publications and source records attributed to G Brocco.

54 records · Page 3Linked to original sources
PubMed1985

Serum PABA and fluorescein in the course of Bz-Ty-PABA and pancreolauryl test as an index of exocrine pancreatic insufficiency.

Forty-six subjects (20 chronic pancreatitis, 7 chronic liver disease, 7 recovered from acute pancreatitis, 2 Crohn's disease, and 10 healthy controls) classified by S-C test as having normal pancreatic function (26 subjects), or moderate (10 subjects) and severe (10 cases) pancreatic insufficiency, were given, on different days, 1 g of oral PABA or 348 mg of oral fluorescein dilaurate. At the 1st, 2nd, and 4th hours (PABA) and the 2nd, 4th, and 6th hours (fluorescein) serum samples were taken for assay. In the presence of severe exocrine pancreatic insufficiency, the sensitivity of the fluorescein serum levels was higher than that observed for the PABA (100% and 80%, respectively), and quite similar to that shown by the urinary tests (100% and 70%, respectively). On the contrary, in presence of moderate pancreatic insufficiency, both the urinary test (pancreolauryl and (PABA) give a sensitivity higher than that found in the serum tests (30-40% and 10-30%, respectively). The parallel combination of both the serum or urinary tests does not significantly improve the sensitivity of the single test. These results suggest that the serum PABA and serum fluorescein tests can be valid choice when a prolonged urinary collection is difficult, i.e., in children and in elderly patients. However, the slight diagnostic gain does not justify the routine use of both urinary and serum tests.

4-Aminobenzoic Acid↗
PubMed1985

Plasma levels of lactoferrin in children suffering from cystic fibrosis.

Plasma levels of lactoferrin (LF) have been found to be increased in a few patients with cystic fibrosis (CF). This study was aimed at investigating plasma LF levels in children with CF (26 cases) and in controls (C) (19 cases). Plasma LF was measured by a radioimmunoassay method. Plasma LF levels were not significantly different in CF and in C, even though 10 CF patients showed LF levels above the mean + 2 SD value of the controls. Neither the duration of the disease nor the age of the controls was correlated with LF or with the exocrine pancreatic capacity. A significant relationship between the presence of an acute lung inflammation and LF levels was found. This study shows that LF is increased in CF only in the presence of an acute inflammatory state. Further studies are necessary to establish the usefulness of an LF assay as an index of the presence of an acute inflammatory process.

Adolescent↗
PubMed1985

Association of chronic alcoholic liver and pancreatic disease: a prospective study.

Seventy-two chronic alcoholics, 40 (all males) with chronic pancreatitis and 32 (23 males and nine females) with liver cirrhosis, were submitted to liver biopsy, endoscopic retrograde cholangiopancreatography and secretin-caerulein test in order to assess a possible liver involvement in chronic pancreatitis and viceversa, and to evaluate the existence of any relationship between the diseases of these two organs. Chronic pancreatitis patients were younger than cirrhotic patients and drank more than the cirrhotic females. Twenty-nine of the 40 patients had abnormal liver histology, five had micronodular cirrhosis and were older than the others. No relationship was found between the degree of pancreatic impairment and the type of liver injury. Five liver cirrhosis patients had an endoscopic retrograde cholangiopancreatography picture consistent with chronic pancreatitis; two were females with an alcohol intake lower than the one of the other females. In conclusion the association of chronic pancreatitis and liver cirrhosis was observed in a minority of cases, with the same percentage in the two groups, even if the cirrhotic subjects were older than the pancreatitics. Therefore we can postulate that different factors have roles in the pathogenesis of alcoholic cirrhosis and of chronic alcoholic pancreatitis. The association of the two diseases in two women with a relatively low alcohol intake supports this hypothesis.

Adult↗
PubMed1984

Carbenoxolone and prostaglandin E2 and F2 alpha gastric juice levels in man.

The purpose of the present study is to evaluate the effect of carbenoxolone after a non-oral administration on the levels of prostaglandins E2 and F2 alpha in gastric juice. The gastric secretion of 6 healthy volunteers (in basal conditions and after administration of a stimulus of 6 micrograms/kg weight of pentagastrin i.m.) was studied before and after seven days of treatment with 150 mg b.i.d. of carbenoxolone suppository. Concentration and output of prostaglandins E2 and F2 alpha (measured by radioimmunoassay), hydrochloric acid, pepsin and N-acetylneuraminic acid in gastric juice were determined. Compared to control values, no statistically significant difference in acid, pepsin or prostaglandin F2 alpha content, or in gastric juice volume, was observed after treatment. However a significant increase was observed in the concentration and output of prostaglandin E2 after administration of pentagastrin. The concentration and output of N-acetyl-neuraminic acid increased significantly only in basal conditions in carbenoxolone-treated subjects. The present study suggests that the cytoprotective action of carbenoxolone on gastric mucosa in man could be due to an increased prostaglandin E2 activity. This effect is observed after rectal administration, therefore suggesting that carbenoxolone also has a systemic action.

Carbenoxolone↗
PubMed1984

Is the 14C-triolein breath test useful in the assessment of malabsorption in clinical practice?

A 14C-triolein breath test was carried out on 49 subjects suffering from chronic pancreatitis or from other digestive diseases, and its results were compared with the daily fecal fat excretion. The 14CO2 peak excretion was abnormal in all the subjects with a fecal fat excretion above 14 g/day, whereas individual values of 14CO2 peak excretion in subjects without steatorrhea and with a fecal fat excretion ranging from 7.1 to 14 g overlapped. The lowest value observed in patients not suffering from steatorrhea was chosen as the lower normal limit of 14CO2 peak excretion. A test sensitivity as high as 64% was attained. The correlation between fecal fat and 14CO2 peak excretion was highly significant (r = 0.802; p less than 0.0001), and it followed a negative exponential function. Therefore, small variations in the 14CO2 peak excretion can be associated with a wide range of fecal fat excretion. Well-compensated diabetes secondary to pancreatitis did not interfere with the results of the test. In conclusion, in our experience this test proved to be a qualitative diagnostic tool with a low sensitivity.

Adolescent↗
PubMed1984

Long-term outcome of acute necrohemorrhagic pancreatitis. A 4-year follow-up.

This long-term follow-up of 27 patients treated with conservative surgery for necrohemorrhagic pancreatitis (NHP) showed that an almost complete recovery of the exocrine function is achieved within 4 years after discharge, while about half of the patients presented still abnormal endocrine function. The morphological sequelae, pointed out by endoscopic retrograde pancreatography in almost 50% of the cases, remained unchanged during the follow-up period. Therefore, these data seem to exclude an evolution of NHP towards chronic pancreatitis.

Acute Disease↗
PubMed1983

Reliability of the Bz-Ty-PABA and the pancreolauryl test in the assessment of exocrine pancreatic function.

The reliability of the para-aminobenzoic acid (PABA) test (performed in the conventional manner, i.e. without control day) and of the pancreolauryl test was assayed in respect of the exocrine pancreatic capacity measured by using the secretin-caerulein test in 57 subjects, 22 of which were suffering from chronic pancreatitis. When 50 and 20% urinary excretion of the orally administered Bz-Ty-PABA and pancreolauryl, respectively, were chosen as the lower normal limits, the PABA test showed a specificity quite similar to that of the pancreolauryl test (97 and 95%, respectively) despite the lack of a control day test, but a lower sensitivity (39 vs. 83%). The association of both tests was not advantageous compared with the pancreolauryl test alone.

4-Aminobenzoic Acid↗
PubMed1983

Lactoferrin concentration in the parotid saliva of patients with chronic pancreatitis.

Lactoferrin is present in pancreatic juice, and greatly increased concentrations are found in the pancreatic juice of patients with chronic pancreatitis. It is not known whether these high levels of lactoferrin represent a genetically determined defect predisposing to the later development of chronic pancreatitis or are simply a consequence of the disease. In view of the morphological and functional similarities between the pancreatic and parotid glands, we have measured the immunoreactive lactoferrin concentration in pure parotid saliva of 30 patients with chronic calcific pancreatitis, 26 controls, 5 patients with proven pancreatic cancer, 2 patients with Sjögren's disease and 2 patients with chronic recurrent parotitis. No difference in the lactoferrin concentration was detected between control subjects and patients with chronic pancreatitis or pancreatic cancer. Raised levels were found in the 4 patients with parotid gland disease. These findings suggest that increased lactoferrin secretion is confined to the exocrine pancreas in patients with chronic pancreatitis and is thus probably a phenomenon secondary to the disease.

Calcinosis↗
PubMed1982

Pancreatic exocrine function in rosacea.

As some rosacea patients complain of gastrointestinal troubles and the administration of pancreatic extracts ameliorates both dyspepsia and skin lesions, the pancreatic exocrine function in 21 subjects affected with rosacea has been investigated by means of the secretin-cerulein infusion test. 21 healthy controls have been studied for comparison. No difference was found between rosacea and control subjects for flow rate, bicarbonate and chymotrypsin concentration and output, while lipase concentration and output was significantly lower in rosacea patients, with a decrease ranging from 18.5 to 66% of normal values. Therefore, a deficient lipase secretion could be responsible, at least partly, for the clinical manifestations of rosacea.

Adult↗
PubMed1982

Gastric secretion, gastroduodenal histological changes, and serum gastrin in chronic alcoholic pancreatitis.

Controversial data have been reported on gastric acid secretion in patients with chronic pancreatitis. Moreover, studies on gastroduodenal morphological changes in patients with this disease and with other alcohol-related conditions have given different results. Basal and penta-gastrin-stimulated gastric secretion, histological changes of gastric and duodenal mucosa, and basal and meal-stimulated gastrin were measured in 21 patients with chronic alcoholic pancreatitis and in the following pair-matched groups: 21 chronic alcoholics and 21 control subjects (nonulcer dyspepsia), and in 19 patients with proven liver cirrhosis of alcoholic origin. No patient suffered from peptic ulcers. Moreover, gastric secretion was also measured in 51 patients with proven duodenal ulcers and in 34 healthy subjects. Basal acid output in patients with chronic pancreatitis was significantly higher (p less than 0.05) than in the other groups, except for the patients with duodenal ulcers. Peak acid output values in patient with chronic pancreatitis were similar to those measured in patients with duodenal ulcer, and they were higher than in the healthy subject group and in patients with liver cirrhosis, but statistical significance was not attained for patients with nonulcer dyspepsia. An increased frequency of duodenitis was found in patients with chronic pancreatitis, whereas an increased frequency of gastric metaplasia in the duodenal bulb was observed in all the patients with alcohol-related conditions considered. No relevant differences among the considered groups were found relating to gastric histological changes. Basal and meal-stimulated gastrin were similar in all the studied groups. This study suggests that in patients with chronic pancreatitis there is increased gastric secretion and probably an increased capacity for secretion of acid. Moreover, in patients with chronic pancreatitis, duodenitis seems to be frequent, but it probably is not directly related to chronic alcohol consumption.

Adult↗
PubMed1982

Presence of duodenopancreatic feedback in minipigs and possible interference from the bile.

In two minipigs chronic pancreatic and duodenal fistulas, which allowed the diversion and the intestinal replacement of pancreatic secretion, were prepared. In a third minipig a chronic biliary fistula was also prepared so the bile secretion could be fed back into the intestine through a duodenal catheter. In these animals a chronic gastric fistula was made so gastric secretion could also be collected. Diversion-replacement of pure pancreatic juice and of bile were carried out in the fasting state. This study confirms the presence of a feedback regulatory mechanism in exocrine pancreatic secretion in the pig. Moreover, it suggests that bile can interfere with this phenomenon.

Animals↗
PubMed1981

Effect of graded doses of secretin on parathormone serum levels in man.

5 healthy volunteers were submitted to i.v. infusion for 45 min of graded doses of commercial GIH secretin (0.01, 0.025, 0.05, 0.5, 1 and 2 CU/kg h-1). Parathormone serum levels were measured before and during the infusion. All the dosages of exogenous secretin were followed by a significant increase in serum PTH levels in a dose-dependent fashion. Commercial GIH secretin, even at low doses, seems to increase circulating parathyroid hormone levels significantly.

Dose-Response Relationship, Drug↗
PubMed1981

Effect of graded doses of PGE2 on pancreatic exocrine secretion of bicarbonate, chymotrypsin and cyclic nucleotides during i.v. infusion of secretin in man.

We have previously reported that PGE2 inhibits pancreatic enzyme secretion during Secretin-Caerulein infusion, but differing results have also been reported. In this study 10 tests were performed in 5 healthy volunteers as follows: each subject received secretin (GIH) 2 CU/Kg-h by continuous infusion for 2 hours and, several days later, Secretin at the same dose plus PGE2 (Upjohn) in step-wise doses (0.04-0.08-0.12 gamma/Kg min) increasing every thirty min form 30' to 120' min. Duodenal juice was collected in 10 min samples. The volume of each sample was recorded and bicarbonate, chymotrypsin, cAMP and cGMP contents were determined. Statistical evaluation was performed by Student's "t" test for paired data and the regression test. PGE2 significantly decreased chymotrypsin concentration under Secretin. Both cyclic AMP and GMP Secretin-induced secretions were significantly increased by the highest dose of PGE2. No correlation was found in the behaviour of bicarbonate, chymotrypsin and cyclic nucleotides, but it must be noted that our data concern duodenal contents and not pure pancreatic secretion.

Adult↗
PubMed1980

Urinary PABA recovery after oral N-benzoyl-L-tyrosyl-PABA administration combined with various exocrine pancreatic stimulants.

Eleven healthy volunteers (C) and nine patients affected by chronic relapsing pancreatitis (CP) were administered N-Benzoyl-L-Tyrosyl-PABA orally, at a dose of 150 mg combined, on different days, with: 1) water alone (schedule a); 2) Lundh meal (schedule b); 3) Secretin-Caerulein by i.v. infusion (0.5 CU/kg/hr and 75 ng/kg/hr respectively) (schedule c); 4) Caerulein by i.m. injection (300 ng/kg) (schedule d). The mean urinary PABA recovery in CP was lower than in C with all the schedules, but this was statistically significant only with schedules a and c (P less than 0.02 and P less than 0.05 respectively). With respect to b, c, and d, the mean urinary PABA recovery seemed to increase both in C and in CP as compared with schedule a, but only in the CP group with schedule b was the increase statistically significant (P less than 0.05). The present data show that the exocrine pancreatic stimulants do not improve the reliability of the PABA test.

4-Aminobenzoic Acid↗
PubMed1980

[Modification of an experimental model of chronic pancreatic and biliary fistula in the minipig (author's transl)].

An improvement in Corring's experimental model in the minipig is described. The model requires: -- a complete diversion of the biliopancreatic secretion and the possibility of its reintroduction into the duodenum; -- a particular anaesthesiological, technical and management problems taken up during the course of the research. Data are also given about basal pancreatic and biliary secretions in this particular experimental model.

Anesthesia↗
PubMedDate not supplied

Elastase-1 vs trypsin, lipase and amylase serum levels in pancreatic diseases.

Serum levels of elastase-1 were measured in 174 patients with pancreatic diseases and in 131 controls and were compared with the circulating levels of trypsin, lipase and amylase and with clinical data. In 48 patients with chronic pancreatitis serum enzyme levels were also compared with the pancreatic exocrine capacity. About 50% of the patients with chronic pancreatic disease showed increased levels of serum elastase, sometimes even in the face of long lasting pain-free periods, and/or of severe pancreatic impairment. On the contrary, serum trypsin and lipase were almost always either normal or below the normal range in the absence of painful relapses and/or in the presence of an impairment of the exocrine pancreatic function. A strict correlation was found between elastase-1 and trypsin (r = 0.778) and lipase (r = 0.834). However, controls and patients with chronic pancreatic diseases behaved differently, an increase in trypsin and in lipase levels being associated in the patients with chronic pancreatitis with an increase in elastase-1 values significantly larger than that observed in controls. These findings raise the hypothesis, at present unproven, that trypsin and lipase serum assays are more reliable indices of pancreatic exocrine function, whereas serum elastase-1 levels may indicate the presence of acute pancreatic episodes, even if subclinical, the importance of which, in the natural history of the disease, remains unknown.

Acute Disease↗