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Biomedical subjects

M Osnes

Publications and source records attributed to M Osnes.

At least 127 records · Page 7Linked to original sources
PubMed1980

Exocrine pancreatic secretion and immunoreactive secretin release after repeated intraduodenal infusions of bile in man.

The exocrine pancreatic secretion of water, bicarbonate, amylase, trypsin, chymotrypsin, and lipase and the plasma concentration of immunoreactive secretin (IRS) were studied before and after repeated intraduodenal infusions of cattle bile in man. After endoscopic cannulation of the main pancreatic duct, juice was collected in 5-min samples for 20 min. A solution of 6 g dried cattle bile in 60 ml water was then infused into the duodenum through a separate catheter attached to the outside of the duodenoscope. Juice was collected for another 20 min. After this period a solution of 6 g dried cattle bile in 40 ml water was infused into the duodenum, and juice again collected for 20 min. Blood was frequently drawn from an arm vein for estimation of plasma concentration of secretin by radioimmunoassay. Both bile infusions caused significant rises in flow rate, bicarbonate concentration and output, and IRS (p less than 0.05). Enzyme concentrations decreased significantly after intraduodenal bile infusions (p less than 0.05). Outputs of enzymes rose significantly after the first bile infusion; however, a rise after the second bile infusion was found only for amylase. Further, a significant decrease in amylase and lipase concentration was found after the second bile infusion. The findings indicate that the increase in proteolytic enzyme and lipase secretion was due to a washout phenomenon. The increase in the plasma concentration of secretin after repeated bile infusions, with a corresponding effect on flow rate and bicarbonate secretion, indicates that secretin may be the main factor responsible for the exocrine pancreatic secretion caused by intraduodenal bile infusions.

Adult↗
PubMed1980

The influence of intraduodenal administration of pancreatic juice on the bile-induced pancreatic secretion and immunoreactive secretin release in man.

The exocrine pancreatic secretion of water, bicarbonate, amylase, and protein and the plasma levels of immunoreactive secretin (IRS) were studied after intraduodenal infusions of bile and pancreatic juice. Pancreatic secretion was obtained by endoscopic cannulation of the main pancreatic duct. Bile and pancreatic juice were infused into the duodenum through separate catheters attached to the outside of the duodenoscope. The unstimulated secretion was collected for 20 min. After intraduodenal stimulation of the pancreatic secretion with a nearly neutral solution of dried cattle bile, juice was collected for another 20-min period. Then, pure pancreatic juice was infused into the duodenum. It was shown that pancreatic juice reduced the flow rate and output of bicarbonate, amylase, and protein significantly (p less than 0.05). A significant reduction in plasma concentration of IRS (p less than 0.05) was also found. In the controls, i.e., when no pancreatic juice was instilled into the duodenum, a further increase in flow rate, bicarbonate secretion, and IRS was found. It is concluded that the exocrine pancreatic secretion and IRS release induced by intraduodenal administration of bile may be depressed by reinfusions of pancreatic juice. The corresponding effect on bicarbonate secretion and IRS release found in this study supports the view that secretin may play an important role in the exocrine pancreatic secretion induced by intraduodenal infusion of bile.

Adult↗
PubMed1979

Endoscopic choledochoduodenostomy for common bileduct obstructions.

Endoscopic choledochoduodenostomy (E.C.D.S.) was done in six patients with common bileduct obstructions. After E.C.D.S., jaundice disappeared and the patient's general condition improved. There were no complications. E.C.D.S. may be a suitable alternative to conventional surgery in patients with common bileduct obstructions.

Aged↗
PubMed1979

Nonoperative internal drainage of obstructive common bile ducts.

A new nonoperative method for internal drainage of common bile duct obstructions by endoscopic retrograde cannulation of the papilla of Vater is described. After introduction of a tube in the common bile duct, a substantial decrease in serum activity of bilirubin, alkaline phosphatase, and gamma-glutamyl transferase was found. In addition, a rapid improvement of the clinical condition could be observed. No serious complications occurred. It is concluded that internal drainage of common bile duct obstructions might be of great value in the preoperative treatment of patients with common bile duct obstructions.

Aged↗
PubMed1979

Effect of diclofenac and naproxen on gastroduodenal mucosa.

The increases in medan scoresfluence on gastroduodenal mucosa of naproxen, 500 mg/day, and diclofenac, 100 mg/day, for 1 wk was investigated in 14 subjects in a double-blind randomized crossover study. Endoscopic examination of the gastroduodenal mucosa was carried out before and after each drug with regard to gastritis and hemorrhagic and erosive lesions. A 20-cm visual analogue scale was used for grading severity of mucosal changes. Naproxen caused statistically significant increases inmedian scores for all 3 variables, and 10 subjects showed a score increase in at least 1 variable; reaction to diclofenac occurred in only 4 subjects and the changes in median scores were not significant.

Adult↗
PubMed1979

Endoscopic retrograde brush cytology in patients with primary and secondary malignancies of the pancreas.

Endoscopic retrograde brush cytology (ERBC) was performed in 29 patients with primary pancreatic malignancies verified later by histology. Results were positive in 21 patients, suspicious in five, and negative in three. ERBC performed in seven patients with uncertain findings at endoscopic retrograde cholangiopancreatography (ERCP) was positive for malignancy in six and suspicious in one. Endoscopic aspiration cytology (EAC) performed in 10 patients with primary tumours was positive for malignancy in three, suspicious in two, and negative in five cases. ERBC and/or EAC performed in five cases with secondary tumours were positive for malignancy in one and negative in four. It is concluded that ERBC gives a high rate of positive or suspicious (90%) diagnosis of malignancy in patients with primary pancreatic lesions. In secondary tumours cytology seems to be negative in most cases. The study further shows that many of the malignant tumours found by ERP are secondary lesions. Cytology is often able to detect malignancy when ERP has proved inconclusive.

Adenocarcinoma↗
PubMed1979

The unstimulated pancreatic secretion obtained by endoscopic cannulation, and the plasma secretin levels in man.

The technique of collecting juice from the main pancreatic duct by siphonage is described. The juice was collected in 5-min fractions under basal conditions for 20 min (32 subjects) and extended to 60 min (6 subjects). Flow rate and bicarbonate concentration were significantly higher during the first collected samples, whereas concentrations of amylase and protein rose during the first 20 min of the study. All variables remained nearly constant after this period. Immunoreactive secretin (IRS) in peripheral plasma was significantly higher immediately after cannulation of the main pancreatic duct, as compared to the pre-endoscopic level. When the catheter was left in the duct and pancreatic juice drained, the IRS stabilized at a level not significantly different from the pre-endoscopic level. Positive correlations were found between flow rate and plasma level of IRS and between flow rate and bicarbonate concentrations. A negative correlation was found between the flow rate and concentrations of amylase and protein. The higher flow rate, plasma level of IRS, and bicarbonate concentration at the beginning of the examination may be due to the presence of acid and/or bile in the duodenal contents shortly after the endoscope enters the duodenum. Later in the procedure the levels have stabilized, which indicates that little or no acid or bile is passing into the duodenum. It is also concluded that secretin may be one factor responsible for the basal pancreatic secretion in man.

Adult↗
PubMed1978

Comparison of endoscopic retrograde and intravenous cholangiography in diagnosis of biliary calculi.

The results of endoscopic retrograde cholangiography (E.R.C.) and intravenous cholangiography (I.V.C.) were compared in patients undergoing surgery for biliary calculi. E.R.C. gave a significantly higher rate of correct diagnosis of gallbladder calculi (p = 0.026) and common bileduct calculi (p = 0.002) than I.V.C. Biliary stones may thus frequently be present in patients with a normal I.V.C. and E.R.C. may reduce the rate of diagnostic errors in patients with symptoms of biliary disease.

Cholangiography↗
PubMed1978

Endoscopic retrograde cholangiography in primary biliary tract carcinoma.

The appearance of primary biliary tract carcinoma revealed at endoscopic retrograde cholangiography in 16 patients and surgically confirmed, are classified as to location, type of margin of the lesion and degree of obstruction. Differential diagnosis towards infiltrating tumour of the gallbladder is considered. The conclusion is drawn that endoscopic retrograde cholangiography will establish the diagnosis of malignancy of the biliary tract with an acceptable certainty.

Adult↗
PubMed1978

Exocrine pancreatic secretion and immunoreactive secretin (IRS) release after intraduodenal instillation of bile in man.

Six subjects with a normal endoscopic pancreatogram were investigated after an overnight fast by means of a side-viewing duodenoscope. After cannulation of the main pancreatic duct, juice was collected in five-minute samples for 20 minutes. An iso-osmolar solution of 6 g cattle bile was then infused into the duodenum through a separate catheter attached to the outside of the duodenoscope, and pancreatic juice collected in five-minute samples for another 20 minutes. Blood was frequently drawn from an arm vein through an indwelling catheter for estimation of immunoreactive secretin (IRS) by radioimmunassay. The flow rate of pancreatic juice and outputs of bicarbonate, amylase, and protein increased significantly after intraduodenal infusion of bile. A significant rise in plasma IRS was also found after instillation of bile in the duodenum.

Adult↗
PubMed1978

Bacteriological studies of common duct bile in patients with gallstone disease and juxta-papillary duodenal diverticula.

Bile samples from the common duct were collected at cholecystectomy and cultivated aerobically and anaerobically. Two groups of patients were studied, patients with juxta-papillary duodenal diverticula and patients without diverticula. All patients had chronic cholecystitis and concrements in the gallbladder, but no biliary obstruction. A significantly higher incidence of positive cultures was found in patients with diverticula than in the control group. The positive samples contained bacterial species belonging to the intestinal flora. We propose an ascending route of infection and assume that bacteria may play a role in the formation of gallstones so often seen in patients with juxta-papillary duodenal diverticula.

Adult↗