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Biomedical subjects

L Gullo

Publications and source records attributed to L Gullo.

At least 109 records · Page 6Linked to original sources
PubMed1984

Inhibitory effect of atropine on cholecystokinin-induced gallbladder contraction in man.

We have studied the effect of atropine on cholecystokinin (CCK)-induced gallbladder contraction in 7 healthy volunteers by means of real-time ultrasonography. Two series of tests were carried out in random order and on separate days. In one series of tests, CCK alone was infused for 4 successive 15-min periods at sequentially increasing doses of 0.0021, 0.0042, 0.0084, and 0.0168 Ivy dog units (IDU) X kg-1 X min-1. In the other series of tests, an infusion of a low dose of atropine, 5 micrograms X kg-1 X h-1, was added to the hormone infusion. The smallest dose of CCK which significantly contracted the gallbladder was 0.0042 IDU X kg-1 X min-1. The highest dose of CCK infused, 0.0168 IDU X kg-1 X min-1, produced almost total contraction of the organ. In all subjects, the infusion of atropine completely blocked the gallbladder response to 0.0042 and 0.0084 IDU X kg-1 X min-1, and partially inhibited (by 52%) the response to the highest dose. In 2 subjects in whom a higher dose of atropine, 15 micrograms X kg-1 X h-1, was tested, gallbladder contraction was totally abolished, even when the largest dose of CCK was infused. Contrary to what is generally believed, the results indicate that the response of human gallbladder to CCK is largely dependent on cholinergic innervation.

Adult↗
PubMed1984

Serum immunoreactive trypsin response to secretin injection in patients with chronic pancreatitis.

Serum immunoreactive trypsin response to secretin injection (75 clinical units iv over a 2-min period) was studied in patients with chronic pancreatitis and in control subjects. Secretin stimulation caused a slight but significant increase of basal serum immunoreactive trypsin concentration in normal subjects and a marked increase in chronic pancreatitis patients with mild to moderate insufficiency. In patients with severe insufficiency and steatorrhea it had very little effect. The integrated immunoreactive trypsin response to secretin injection in patients with mild to moderate insufficiency was significantly higher compared to controls and to patients with severe insufficiency. In the latter patients it was significantly lower than in controls. A markedly elevated response of serum immunoreactive trypsin to secretin administration seems to differentiate chronic pancreatitis patients with mild to moderate insufficiency from those with severe insufficiency and from controls.

Adult↗
PubMed1984

Effect of secretin stimulation upon serum immunoreactive trypsin in patients with carcinoma of the pancreas.

The response of serum immunoreactive trypsin (IRT) to the intravenous injection of secretin (75 clinical units) was evaluated in 14 patients with carcinoma of the pancreas and in 20 healthy control patients. A striking increase of serum IRT concentration after secretin, which was much more marked than in those in the control group, was found in patients with localized carcinoma of the pancreas, whereas no increase was observed in those with more diffuse carcinoma.

Adult↗
PubMed1983

Comparative study of serum pancreatic isoamylase, lipase, and trypsin-like immunoreactivity in pancreatic disease.

Serum total amylase, pancreatic and salivary isoamylase, lipase and trypsin-like immunoreactivity (TLI) were measured in 16 patients with acute pancreatitis, 37 patients with chronic pancreatitis, 11 patients with pancreatic cancer, and 53 control subjects in order to evaluate the relative value of these tests in the diagnosis of pancreatic disease. In acute pancreatitis patients studied within 2 days from the onset of pain all pancreatic enzymes were abnormally high. In chronic pancreatitis patients serum pancreatic isoamylase and TLI were abnormally low in 8 out of 10 patients with severely impaired pancreatic exocrine function, while lipase was abnormally low in 6 patients. During acute exacerbations of the disease elevated levels of pancreatic isoamylase and lipase, but not of TLI, were found in about one third of cases. In patients with pancreatic cancer the pattern of changes in serum pancreatic enzymes was variable since levels within, below and above the normal range were found. The results demonstrate that in acute pancreatitis all serum pancreatic enzymes had the same diagnostic sensitivity, however serum lipase determination is the most convenient because of its simplicity and low cost. In chronic pancreatitis serum pancreatic isoamylase and TLI may be useful in detecting severe pancreatic insufficiency. In pancreatic cancer serum pancreatic enzymes lack diagnostic specificity.

Adult↗
PubMed1983

Exocrine pancreatic function in the elderly.

We studied pancreatic bicarbonate and enzyme output in response to a continuous intravenous infusion of secretin, 1 CU/kg X h, and cerulein, 100 ng/kg X h, in 25 elderly subjects and in 30 young controls. Almost all elderly persons had pancreatic outputs within the range of controls. Only 3 aged individuals showed diminished enzyme output, but the reduction was very slight. We conclude that exocrine pancreatic function is not significantly influenced by aging.

Adult↗
PubMed1983

Pancreolauryl test for pancreatic exocrine insufficiency.

Pancreolauryl test (PLT), a tubeless pancreatic function test, was performed in 40 consecutive patients suffering from chronic pancreatitis, in 21 patients with miscellaneous digestive diseases, and in 18 control subjects to assess its diagnostic sensitivity and specificity. N-benzoyl-L-tyrosyl-p-aminobenzoic acid test (PABA test) and secretin-cerulein test were also carried out to compare the diagnostic value of PLT with that of these two pancreatic function tests. PLT was abnormal in 22 of 40 patients with chronic pancreatitis (55%). In particular, pathological results were found in all patients with severe pancreatic insufficiency and only in four of 14 patients with mild to moderate insufficiency. PABA test showed a slightly lower sensitivity in severe insufficiency, and the same sensitivity in mild-moderate insufficiency. PLT was normal in all control subjects and in 17 of 21 patients with nonpancreatic digestive diseases. Its specificity (90%) was slightly higher than that of PABA test (82%). The results indicate that PLT may be used to support a diagnosis of severe pancreatic exocrine insufficiency, while in mild or moderate insufficiency its diagnostic value is limited.

4-Aminobenzoic Acid↗
PubMed1983

Effect of bombesin on serum immunoreactive trypsin in healthy subjects and in patients with chronic pancreatitis.

We studied the effect of bombesin (9 ng/kg X min for 30 min by intravenous infusion) on serum immunoreactive trypsin in healthy subjects and in chronic pancreatitis patients. Bombesin administration caused a marked and significant increase of serum immunoreactive trypsin concentration in healthy subjects. The increase occurred in the first 15 min after the beginning of bombesin infusion and persisted for the duration of the study (2 h). In patients with chronic pancreatitis, the increase was much less pronounced. In these patients, the integrated immunoreactive trypsin response to bombesin was significantly correlated with bicarbonate, lipase, and chymotrypsin outputs into the duodenum. The response of serum immunoreactive trypsin to bombesin stimulation seems to vary according to the degree of pancreatic exocrine dysfunction and to reflect the functional capacity of acinar cell mass.

Adult↗
PubMed1982

HLA-B13 and chronic calcific pancreatitis.

In view of a possible role of genetic factors in the etiology of chronic calcific pancreatitis, we undertook a study of the frequency of HLA antigens in this disease. Sixty-four patients with chronic calcific pancreatitis were typed for the HLA-A, -B and -C loci. Fourteen of these 64 patients (21.9%) were found to have antigen B13 compared to 7.5% of 425 controls. These results have a P value of 0.00059 which remains significant (P = 0.020) even when multiplied by the total number of antigens tested. Sex, alcoholism, age at the clinical onset of the disease, presence of pain, and diabetes had no apparent influence on the distribution of HLA alleles. The significant association between chronic calcific pancreatitis and HLA antigen B13 further supports the role of genetic factors in the etiology of the disease.

Adolescent↗
PubMed1982

Cardiovascular lesions in chronic pancreatitis: a prospective study.

We prospectively investigated fifty-four consecutive patients with proven chronic pancreatitis and 54 control subjects for the presence of cardiovascular lesions. Clinical and laboratory evidence of arterial involvement was found in 18 patients (33%) and in five controls (9%) (P less than 0.01). Electrocardiographic alterations indicating coronary heart disease were found in eight patients and in three controls, and peripheral symptoms and signs indicating obliterative atherosclerotic disease of the lower extremities were found in 12 patients (two had associated electrocardiographic changes) and in two controls. No significant differences in the prevalence of the major vascular risk factors were observed between patients with vascular lesions and those without, and between patients and control subjects. It is concluded that patients with chronic pancreatitis have more frequent cardiovascular lesions which tent to develop at an earlier age, compared to the general population. The possibility that chronic pancreatitis may favor the development of these lesions is discussed.

Adolescent↗
PubMed1982

Effects of morphine on human pancreatic secretion: studies on pure pancreatic juice.

Data concerning the effects of morphine on human pancreatic secretion are fragmentary and inconclusive. In the present study, we evaluated the effects of morphine on pure pancreatic secretion in nine subjects with external transduodenal drainage of the main pancreatic duct performed after biliary tract surgery. Intravenous infusion of a small dose of morphine, 40 microgram/kg/h, during pancreatic stimulation with secretin and cholecystokinin, caused a significant increase in volume, bicarbonate, and calcium secretion, and a significant decrease in protein secretion. The stimulatory effect on water and electrolyte secretion was rapid and much more pronounced, reaching about 45-50% of the control levels, whereas the inhibition of protein output was slightly delayed and of lesser magnitude, reaching about 20-25% of the control values. Both effects were long-lasting. The addition of naloxone, potent opiate antagonist, prevented in part the effects of morphine on pancreatic secretion, suggesting that specific opiate receptors might be involved in these effects.

Adult↗
PubMed1982

Influence of adrenal cortex on exocrine pancreatic function.

The exocrine pancreatic function of 8 patients with chronic adrenocortical insufficiency was studied and compared with 12 control subjects. The secretion of bicarbonate, lipase, and chymotrypsin in response to secretin and caerulein was significantly reduced in patients with adrenocortical insufficiency. The mean reduction in bicarbonate, lipase, and chymotrypsin output compared with the control values was 42%, 66%, and 53%, respectively. Chronic glucocorticoid substitution therapy restored pancreatic function almost to normal. It is concluded that the adrenal cortex plays an important role in maintaining the function of the exocrine pancreas in humans. The possible mechanisms are discussed.

Addison Disease↗
PubMed1981

Thyrotropin-releasing hormone inhibits pancreatic enzyme secretion in humans.

Recent studies have shown that thyrotropin-releasing hormone is present in gastrointestinal tissues and has effects on gastrointestinal motility and secretion. In the present study, we have investigated in healthy subjects the effects of various doses of thyrotropin-releasing hormone on secretin-cholecystokinin-stimulated pancreatic secretion. Intravenous infusion of thyrotropin-releasing hormone at doses of 4, 20, and 100 microgram/30 min, administered during a constant pancreatic stimulation with secretin (0.5 Clinical Units/kg/h) and cholecystokinin (0.5 Ivy dog units/kg/h), produced a significant decrease in lipase and chymotrypsin secretion without affecting volume and bicarbonate secretion. The decrease appeared immediately with the lowest dose of TRH employed, and was progressively more marked with increasing doses of the hormone. Compared with the control experiments, the maximal inhibition of lipase output reached -17.6%, -37.2%, and -43%, and the maximal inhibition of chymotrypsin output -18.2%, -39.3%, and -44.9%, for the three doses of thyrotropin-releasing hormone employed, respectively. It is concluded that TRH has a marked inhibitory effect on the enzymatic component of the pancreatic secretion stimulated by submaximal doses of secretin and cholecystokinin. The physiologic importance of this effect remains to be defined.

Adult↗
PubMed1980

Stimulation of pancreatic secretion by sulpiride.

Sulpiride is a nonsedative neuroleptic, pharmacologically related to metoclopramide, which has previously been shown to affect various gastric functions and to exert a beneficial effect in the treatment of duodenal ulcer. In the present study the authors investigated the effects of sulpiride on pancreatic exocrine secretion. The intravenous injection of sulpiride (100 mg) during a constant infusion of secretin (0.5 CU/kg/hr) and cholecystokinin (0.5 IDU/kg/hr) significantly increased outputs of bicarbonate and enzymes in nine healthy subjects. The increase was maximal 20-30 min after sulpiride administration and lasted for the duration of the study (1 hr). Compared to presulpiride control levels, the mean maximum percent increase was 35% for bicarbonate, 39% for lipase, and 32% for chymotrypsin. It is concluded that sulpiride augments pancreatic secretion stimulated by submaximal doses of secretin and cholecystokinin. The mechanism of this effect is unknown.

Adult↗
PubMed1980

Cortisol and pancreatic secretion. Observations on pure pancreatic juice.

In view of the conflicting results in the literature, we undertook a study of the effects of intravenous administration of control on the external secretion of the pancreas. The study was carried out in five subjects with external transduodenal drainage of the main pancreatic duct, performed after biliary tract surgery. The intravenous injection of cortisol, 100 mg, during a constant intravenous infusion of secretin and cholecystokinin did not cause any significant change in pancreatic secretion. The results do not confirm previous findings in man indicating an inhibitory effect of glucocorticoids given intravenously on exocrine pancreatic secretion.

Female↗
PubMed1980

Serum trypsin-like immunoreactivity after endoscopic retrograde cholangiopancreatography.

Serum trypsin-like immunoreactivity (TLI) was studied in 31 patients before and after endoscopic retrograde cholangiopancreatography. None of the patients developed clinical acute pancreatitis. Generally, the serum TLI peak was observed within the first 6 hours after the examination. Most patients (73%) showed a pathologically high TLI but very high values were not frequent (19%). Successful pancreatic opacification was followed by a significant increase in serum TLI which was pathologically high in nearly all cases (18/20). On the contrary, after cholangiography alone abnormal values were less frequent (4/8) and the increase was not significant. In most patients TLI and amylase responses were in agreement. A significant, though poor, linear relation was found between serum TLI and serum amylase 3, 6 and 12 hours after the examination.

Amylases↗
PubMed1980

Serum immunoreactive trypsin after secretin stimulation in chronic pancreatitis.

Serum immunoreactive trypsin (IRT) response to secretin injection was studied in 13 patients with chronic pancreatitis with different degrees of exocrine dysfunction and in 10 control subjects. The maximal increase of serum IRT from basal values and the integrated trypsin output (ITO) after secretin administration were significantly correlated with the output of chymotrypsin into the duodenum during caerulein-secretin infusion (p < 0.01), but not with the output of lipase nor of bicarbonate. Serum IRT response to secretin stimulation was greater in 4 of the 5 patients with chronic pancreatitis with mild to moderate exocrine dysfunction than in the control group, suggesting an increased regurgitation of IRT into the blood stream by the pancreas, probably due to some degree of obstruction to pancreatic secretory flow in absence of severe acinar cell damage. Conversely, the response of serum IRT after secretin administration in 7 of the 8 patients with severe exocrine pancreatic deficiency was lower than in control subjects, probably because of the advanced distruction of the acinar pancreatic tissue. The response of serum IRT to secretin stimulation seems to vary following pancreatic function impairment and might reflect the degree of pancreatic exocrine dysfunction in chronic pancreatitis.

Adolescent↗
PubMed1980

Serum gastrin in chronic pancreatitis.

Fasting serum gastrin and gastrin response to a protein meal were measured in a group of patients with chronic pancreatitis and in controls. No significant differences were found between the two groups of subjects. In patients with chronic pancreatitis no relation was found between gastrin release and the severity of pancreatic exocrine insufficiency.

Adult↗