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Biomedical subjects

H Worning

Publications and source records attributed to H Worning.

At least 55 records · Page 3Linked to original sources
PubMed1983

Glucose tolerance and B cell function in chronic alcoholism: its relation to hepatic histology and exocrine pancreatic function.

Glucose tolerance and B cell function were assessed in 30 consecutive chronic alcoholic patients without overt diabetes mellitus. Plasma glucose, insulin, and C peptide concentrations were measured during an oral glucose tolerance test. All patients underwent a liver biopsy and an exocrine pancreatic function test (Lundh test). Compared with the controls, the three groups of alcoholic patients (those with histologically normal livers, n = 12; those with steatosis, n = 10; and those with cirrhosis, n = 8) all had a two-fold increase in plasma concentrations of insulin as well as C peptide in the fasting state, despite normal fasting levels of glucose. After oral glucose all groups of patients had elevated plasma levels of glucose, insulin, and C peptide compared with the controls. The C peptide/insulin ratio was similar to that in the controls in all groups of alcoholics. Patients with decreased exocrine pancreatic function (n = 7) had a significantly lower insulin and C peptide response to glucose than the patients with normal exocrine pancreatic function. It is concluded that (1) chronic alcoholics even with histologically normal livers have endogenous insulin resistance, and (2) associated damage to the exocrine pancreas is more common than previously recognized and decompensation of B cell function could be demonstrated in patients with decreased exocrine pancreatic secretion.

Adolescent↗
PubMed1982

B cell function in patients with chronic pancreatitis and its relation to exocrine pancreatic function.

Exocrine pancreatic function was evaluated by a Lundh meal test and a secretin-cholecystokinin test in 16 patients with chronic pancreatitis. B cell function was assessed by measuring the concentration of C-peptide after stimulation with oral glucose and intravenous glucagon. The Cc-peptide response to intravenous glucagon and oral glucose was closely correlated (r = 0.88, p less than 0.01). Plasma C-peptide after glucagon was significantly correlated to the post-prandial concentration of lipase (r = 0.72, p less than 0.001), amylase (r = 0.64, p less than 0.05) and to amylase output (r = 0.64, p less than 0.05). Eight out of nine patients treated with insulin had residual B cell function, but it diminished significantly with increasing duration of diabetes. We conclude that B cell function is correlated to pancreatic enzyme secretion and that patients with insulin-treated diabetes secondary to chronic pancreatitis have a residual insulin secretion similar to that of patients with Type 1 (insulin-dependent) diabetes.

Adult↗
PubMed1982

Chronic pancreatitis in Copenhagen. A retrospective study of 64 consecutive patients.

A longitudinal study of 64 patients with chronic pancreatitis is presented. The patients were followed up for a median period of 4 years. Pain was the dominant symptom in 43 of the patients, but only 5 patients had pancreatic resection because of pain. Alcoholism was the etiology in 45 patients. Complications were common: 34 patients developed steatorrhea and 29 diabetes. Two major groups of associated diseases contributed to a high morbidity in chronic pancreatitis: 24 patients presented with duodenal ulcer, and 8 developed malignant tumors. This number is significantly higher than expected in a matched population (P less than 0.01). Twenty-six of the patients died within the observation period from complications of chronic pancreatitis (38%), from malignant neoplasms (15%), or from other causes (46%). The calculated mortality rate after 7 years of observation was close to 50%. Most patients were recruited from the lower social classes, and most were unemployed. We conclude that chronic pancreatitis in Copenhagen is associated with a high morbidity, a high mortality, and a poor social prognosis.

Adolescent↗
PubMed1982

Incidence of alcoholic chronic pancreatitis in Copenhagen.

A retrospective study of 126 patients with chronic pancreatitis diagnosed from 1970 to 1979 is presented. The aim was to evaluate whether the incidence of chronic pancreatitis had increased and to present briefly the clinical aspects of chronic pancreatitis in Copenhagen. The annual incidence of chronic pancreatitis rose from 6.9 to 10.0 per 100,000 during the 10 years of the study. This increase was only due to an augmentation in the number of patients with alcoholic chronic pancreatitis. Clinical aspects of chronic pancreatitis were similar to those found in other European countries. The present study suggests that alcoholic chronic pancreatitis will be a commoner disease in Denmark in the future.

Adult↗
PubMed1982

Exocrine pancreatic function in patients with dyspepsia.

The exocrine pancreatic function was studied in 460 patients suffering from dyspepsia (defined as abdominal pain, chronic diarrhoea, and/or weight loss) by measuring the duodenal concentrations of amylase and lipase after a test meal (Lundh test). In 159 of the patients (35 per cent) a reduced pancreatic function was found. In 143 out of these a diagnosis of possible or verified chronic pancreatitis was made. In about half of these 143 patients, the diagnosis chronic pancreatitis was clinically unexpected. Consequently, chronic pancreatitis is to be suspected as a cause of dyspepsia when more usual causes have been excluded.

Adult↗
PubMed1981

Meal-stimulated secretin release in man: effect of acid and bile.

Nine normal subjects were studied before and after intragastric instillation of a liquid meal. Gastric emptying rates of acid and pancreaticobiliary secretions were quantitated by means of a dilution indicator technique. A significant, positive correlation was found between load of acid to the duodenum and the concentration of secretin in plasma. No correlation was found between load of the bile acids and plasma secretin. The buffering capacity of gastric contents should be taken into account when fasting and postprandial periods are compared. Plasma secretin concentration remained low during the first postprandial hour. Maximum secretin concentrations and duodenal disappearance rate of acid was observed 1 1/2-2 h after instillation of the meal. In contrast, trypsin output was maximum within 10 min. The data support the concept that in man release of secretin is governed principally by the amount of hydrogen ions emptied into duodenum and indicate the importance of secretin in the late postprandial period, when the acidity of the gastric contents is high.

Adolescent↗
PubMed1981

Effect of Pentagastrin, secretin, and cholecystokinin on gastric secretion of pepsin in man.

In eight volunteers the effect of pentagastrin (0.15, 1.0 and 6.0 microgram/kg body weight/h), secretin (0.5 and 1.0 clinical units/kg b.w./h), and cholecystokinin (CCK) (0.5 and 1.0 Ivy dog units/kg b.w./h) on the gastric secretion of pepsin was investigated to ascertain whether interaction occurred. A high intraindividual variation was found, and also a significant washout of pepsin in the initial period after stimulation. Pepsin secretion was stimulated after pentagastrin (50% above basal level) and even more after secretin (75%-200% above basal level), whereas no stimulation but a tendency for depression was seen after CCK. With the doses of gastrointestinal hormones used in this investigation, no interaction between secretin and CCK on gastric secretion of pepsin in man was demonstrated.

Adult↗
PubMed1980

Correlation between exocrine pancreatic secretion and serum concentration of human pancreatic polypeptide in chronic pancreatitis.

Concentrations of human pancreatic polypeptide (HPP) in serum were measured in the fasting state and after a meal in 19 control subjects and 24 patients with chronic pancreatitis (CP). The severity of CP was characterized on the basis of the duodenal lipase concentration after a test meal (Lundh test). Basal and postprandial HPP concentrations were significantly (p less than 0.01) decreased in severe and moderate chronic pancreatitis and in diabetes secondary to pancreatitis. There was only a weak correlation (r = 0.44; p less than 0.05) between exocrine secretion and delta HPP in CP. Fifty-eight percent of patients with CP had serum concentrations of HPP within the normal range, limiting the value of serum HPP measurement in the diagnosis of CP.

Adult↗
PubMed1980

The effect of enzyme substitution in patients with pancreatic insufficiency.

Concentrations of pancreatic enzymes in the upper intestine during digestion of a meal were studied with and without different preparations of pancreatic extracts in 34 patients with severely decreased exocrine pancreatic function and in 17 patients with a partial gastrectomy (Billroth-II) and very low enzyme concentrations in the efferent loop. Granulated Pankreatin induced a dose-related increase in concentrations of amylase, lipase, and trypsin in the patients studied. The standard dose of 10 ml induced normalization of amylase and trypsin concentrations in a considerable number of patients, whereas the lipase concentration still was far below normal value. The increased concentrations of lipase resulted in a marked reduction of the fecal fat excretion. The induced increase in enzyme concentrations was for all enzymes significantly higher in the partially gastrectomized patients. Eight other pancreatic supplementary preparations were tested; only one of these was able to induce significant increases in enzyme concentrations.

Amylases↗
PubMed1979

Physiological significance of secretin in the pancreatic bicarbonate secretion. II. Pancreatic bicarbonate response to a physiological increase in plasma secretin concentration.

The pancreatic response to physiological concentrations of secretin obtained after minute boluses of exogenous secretin was studied in 16 normal volunteers. Output of bicarbonate into the duodenum was measured by duodenal aspiration in 5 subjects and by endoscopic cannulation of the pancreatic duct in 11 subjects. Pure natural porcine secretin was injected intravenously in doses of 125, 250, and 500 fmol x kg-1 body weight (0.0013, 0.0027, and 0.0054 clinical units x kg-1). All three doses of secretin increased plasma secretin concentration, duodenal bicarbonate concentration, and duodenal bicarbonate output significantly. The bicarbonate output measured by the two techniques did not differ significantly. The increments in median plasma secretin concentration were 1.6, 3.0, and 6.4 pmol x 1(-1) after secretin, 125, 250 and 500 fmol x kg-1, and the corresponding 15-min bicarbonate output 283, 442, and 1435 micromol, respectively. The concentrations of secretin in plasma found after these doses of secretin are of the same order of magnitude as the secretin concentrations found during physiological conditions in man. It is concluded that the physiological concentrations or secretin influence pancreatic bicarbonate secretion.

Bicarbonates↗
PubMed1979

Depression of exocrine pancreatic secretion by collection through duodenoscopic catheters.

Two dogs were equipped with gastric and duodenal cannulas permitting quantitative collection of pure pancreatic juice. Two series of experiments were performed: 1) collection through a short catheter, length 35 cm, volume 0.3 ml, and internal diameter 1.0 mm, and 2) collection through a long catheter used for duodenoscopic cannulation in man, length 110 cm, volume 1.7 ml, and internal diameter 1.0 mm at the tip and 1.4 mm in the other part of the catheter. After a basal period of 30 min the secretion was stimulated with secretin in the doses 0.1, 0.5, and 2.0 clinical units/kg/h, each dose being infused over a period of 30 min. With the long catheter the dose-response curve for fluid and bicarbonate was shifted to the right. The basal secretion of fluid was depressed 40%; with increasing secretory rates the depression was less pronounced. No significant depression of the bicarbonate concentration was seen. The protein secretion was insignificantly reduced.

Animals↗