Biomedical subjects
J Hotz
Publications and source records attributed to J Hotz.
[Therapy of acute pancreatitis].
The unpredictable course of acute pancreatitis needs a careful surveyance of the patient in the first days of the acute attack in order to apply therapeutic measures adequate to the severity of the symptoms. The avoidance of food or drink and gastric suction appears to be sufficient to prevent endogenous stimulation of the gland while there is probably no benefit of anticholinergic drugs or carboanhydrase inhibitors. Early adequate substitution of fluids using watery solutions, plasmaexpanders or blood is of decisive importance. For treatment of pains spasmoanalgetics, synthetic opium derivatives or infusion of procain are recommended. Tetracyclines should be given to prevent secondary infections. Trasylol is indicated only, if the benefit of the drug just now proven in one therapeutical trial will be confirmed in another study. The effectiveness of glucagon or calcitonin has not yet been proven. The medical treatment "by all means" is being replaced by elective surgical measures. After recovery etiological factors have to be determined by a number of routine investigations in order to prevent recurrency of the disease.
Effect of prolonged infusion of maximal and supramaximal doses of pancreozymin on pancreatic enzyme secretion in the rat--exhaustion or inhibition?
Secretion of trypsin, chymotrypsin, lipase and amylase was measured in male rats under urethane anaesthesia using a method of continuous perfusion of the duodenum. Prolonged infusion of cholecystokinin-pancreozymin (CCK-PZ) over a period lasting 200-360 min was administered either alone or together with a submaximal dose of secretin (1 unit/100 g - 10 min). Infusion of CCK-PZ was carried out using maximal doses (1--1.5 unit/100 g - 10 min) with and without secretin. Supramaximal doses of CCK-PZ (2 and 4 units/100 g - 10 min) were used only in combination with secretin. In all experiments secretion of enzymes showed a triphasic pattern including an initial peak followed by a plateau secretion after 10--20 min (phase 1), a decreasing second phase and finally base-line secretion (phase 3), thus demonstrating exhaustion of enzyme output from the gland with time. With increasing and supramaximal dose of CCK-PZ the cumulative output of enzymes from start to baseline secretion decreased progressively. Under the same conditions the levels of peak and plateau secretion were lower, the duration of plateau secretion was longer and the decreasing phase of secretion was shortened. These features indicate inhibition of secretion with increasing supramaximal doses of CCK-PZ infusion. Whereas the proteolytic enzymes and lipase reacted in a parallel way always amylase secretion was sustained on a higher level, implicating an alternative pathway for secretion.
[Lipid metabolism in experimental rat liver lesions].
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Inhibition of pancreatic secretion of enzymes by calcitonin.
Calcitonin in pharmacological dosage inhibits the secretion of enzymes in the human pancreas without influencing the production of fluid and bicarbonate. The degree of inhibition is the same in a juice stimulated by secretin alone and by secretin plus pancreozymin-cholecystokinin or caerulein. Thus the endogenous and the exogenously applied pancreozymin is inhibited in its action. The secretion of enzymes, which is induced cholinergically by carbamylcholine or insulin hypoglycemia, is not altered by calcitonin. The inhibitory action of CT is not counteracted by infusion of calcium thus showing that local depletion of calcium is not the mechanism of inhibition. Possible mechanisms are the direct interference with pancreozymin at the acinar cell and the inhibition of hormone-release from the pancreozyminproducing cells.
Long-term effects of calcitonin on gastric secretion in normals, peptic ulcer and high risk patients.
Using a 12-hour infusion of salmon synthetic calcitonin (S-CT), distinct and sustained inhibition of gastric acid and pepsin secretion has been demonstrated in 4 normal subjects, 3 patients with peptic ulcer disease and 3 high risk patients. In 3 patients with Zollinger-Ellison syndrome, treated in the same way, elevated serum gastrin was reduced by about 50% and acid secretion by more than 90%. In healthy volunteers oral administration of human synthetic CT (H-CT) led to reduction in basal and pentagastrin-stimulated acid and pepsin secretion by about 50%, lasting for more than 2 hours after the instillation of CT. In 4 subjects receiving CT intravenously, slight nausea and headache were registered, while there were no side effects after the oral route. Serum calcium did not change after i.v. or oral administration of CT. Wheras therapeutical applications of CT, given by i.v. route, seem to be restricted to selected cases, i.e. acute gastric ulcerations with imminent or existent bleeding, the eventual benefit or orally administered CT in peptic ulcer disease should be evaluated in controlled long-term trials.
[Effects of calcitonin and somatostatin on the stomach and the pancreas -- possible therapeutic principle?].
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[Summary of work session 4: Effects of calcitonin and somatostatin on the stomach and pancreas--a possible therapeutic principle].
Although calcitonin and somatostatin are polypeptid hormones of entirely different structure, in pharmacological doses they possess a similar effect to secretions of stomach and pancreas. Given intravenously, they generally inhibit the basal secretion of organs, stimulated by pentagastrin or pancreozymin, as well as the contraction of the gallbladder. Orally, calcitonin also suppresses by direct contact the secretion of the stomach. While calcitonin in higher doses shows only very slight and tolerable side effects (nausea, headache), somatostatin acts suppressively on many other hormone-regulated systems. Apart from this, disturbances of blood coagulation in monkeys and man were observed, findings which necessitate very careful application. Therapeutical trials appear reasonable with calcitonin in treating acute pancreatitis, in prophylaxis and treatment of stress ulcers with the danger of bleeding, in intensive care medicine, in preoperative procedure of Zollinger-Ellison syndrome as well as in duodenal ulcers (oral calcitonin). Double blind studies are carried out at present to answer most of these questions (acute pancreatitis, stress ulcers, duodenal ulcers), results of which should definitely be awaited.
[Calcium, pancreatic secretion and pancreatitis (author's transl)].
The concentration of calcium in the pancreatic juice is lower than in plasma. Two calcium fractions occur in the juice, the one associated with the enzyme protein and the other entering the juice via diffusion. In chronic pancreatitis the calcium concentration of the juice is increased in post-secretin periods. Hypercalcemia stimulates enzyme secretion and elevates calcium concentration in the juice. Hypocalcemia inhibits secretion of enzymes and fluid. Calcium is an important mediator substance for the secretion of pancreatic hydrolases at the intracellular level. In primary hyperparathyroidism with chronic hypercalcemia the prevalence of acute and chronic pancreatitis is 10--12 times higher than in normal population. In chronic pancreatitis caused by alcoholism, primary hyperparathyroidism, and chronic protein deficiency without alcoholism calcifying duct stones are seen in the pancreas in high frequency.
Proceedings: The secretion or organic anions by the isolated perfused pancreas of the cat.
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Pancreatic enzyme secretion in the conscious rat. Method and application.
1. A method for collecting duodenal juice and gastric content separately, in conscious rats, is described. Metal cannulas were implanted into the stomach fundus. For the main experiment a double lumen tube was inserted through the cannula via the pylorus into the duodenum. 2. The following secretion patterns were observed: a) In the resting state there was a constant flow rate of duodenal volume, bicarbonate, trypsin and amylase. b) Cholinergic stimuli were capable of increasing enzyme secretion as much as fourfold for a period of 30 to 40 min when administered as a single subcutaneous injection. This effect was annulled by atropine. c) Secretin and cholecystokinin-pancreozymin given together in a single injection s.c. or i.v., elicited a similarly strong response. d) Identical ranges of the secretion maxima were found with a tendency to decrease after the first hour, when the hormones were infused either s.c. or i.v. e) Doses from 0.5 to 25 U/100 g b.w. /hr showed identical responses. Doses below 0.2 U/100 g/hr were without effect. 3. Narcosis (pentobarbital) inhibited markedly the resting and stimulated enzyme secretion. 4. The method is suitable for examination of physiological and pharmacological effects on resting and stimulated enzyme secretion of the rat pancreas.
Calcium-binding protein in the duodenal mucosa of uremic patients and normal subjects.
In the present study we measured the content and determined the localization of a calcium-binding protein (CaBP) in the intestinal biopsy specimen of ten patients with severe renal insufficiency and in eight healthy individuals. In each patient a biopsy specimen of the iliac crest was obtained for evaluation of the degree of osteodystrophy. The CaBP was isolated from human kidneys. Its identity with human intestinal CaBP was suggested by acrylamid gel electrophoresis. Specific antibodies against it were developed in rabbits. The content of CaBP in duodenal mucosa biopsy material was measured by quantitative radial immunodiffusion. Its mean value in the duodenum of patients with renal insufficiency was 3.65 +/- 1.14 mug; in that of normal persons, 10.80 +/- 3.20 mug/mg of protein in the supernatant. There was neither a correlation between the type and duration of renal insufficiency and the CaBP content of the specimens nor between the degree of renal osteodystrophy and CaBP content. In normal persons the specific immunohistological activity indicating the presence of CaBP was found uniformly along the brush border and basement membrane of duodenal epithelial and the goblet cells. In uremic patients the fluorescence was markedly reduced in the typical locations, especially in the brush border area.
Unresponsiveness of exocrine rat pancreas to calcemic challenges (hypercalcemia, EDTA hypocalcemia or calcitonin administration) which influence stomach function.
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Exocrine pancreatic secretion and output of bile in humans under conditions of hypoglycemia and administration of atropine.
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Inhibition of gastric secretion in man by oral administration of calcitonin.
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Persistent inhibition of gastric secretion by an intravenous 12-hour infusion of calcitonin in normals, peptic ulcer and high risk patients.
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[Reduction of calcium-binding protein in the mucosa of the small intestine in uremic patients with renal osteodystrophy].
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[Calcitonin and gastric secretion: various effects of calcitonin on acid and pepsin secretion during stimulation with pentagastrin, betazol and insulin hypoglycemia].
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