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Biomedical subjects

P Lilja

Publications and source records attributed to P Lilja.

28 records · Page 2Linked to original sources
PubMed1979

Pancreatic enzymic activities of commercial pancreatic enzyme preparations incubated in human small intestinal juice.

The activities of amylase, lipase, phospholipase and trypsin of twelve commercial pancreatic enzyme preparations were measured under identical conditions. Human small intestinal juice was chosen as incubation medium. A wide variation of enzymatic activities was found in preparations in tablet form contrary to preparations in granulated form. A prerequisite for a successful therapy is enzymically potent pancreatic extracts with high enzyme content per table, capsule or recommended dose of granulated preparation. Therefore, some preparations seem to be preferable to others for clinical purposes.

Amylases↗
PubMed1979

Trypsin as a regulator of pancreatic secretion in the rat.

The effect of intraduodenally administered trypsin on pancreatic exocrine secretion was investigated in conscious rats surgically prepared with bile--pancreatic fistulae. Introduction of NaHCO3 into the duodenum did not influence pancreatic secretion. Reintroduction of bile--pancreatic juice into the duodenum, however, suppressed pancreatic protein output, mainly because of changes in protein concentration. Infusion of trypsin into the duodenum in the absence of intraluminal pancreatic juice significantly suppressed the secretory volume and pancreatic enzyme output; addition of trypsin inhibitor to the trypsin infusion resulted in an immediate increase of pancreatic secretion. Trypsin inhibitor per se, however, was without effect. Bile--pancreatic juice affected amylase, kipase, and trypsinogen output in a parallel fashion; after addition of trypsin inhibitor to the infusion the inhibitory effects on pancreatic enzyme output was reversed in a parallel manner. The results support the hypothesis that pancreatic exocrine secretion is regulated by a feedback mechanism exerted--at least partly--by intraluminal trypsin.

Amylases↗
PubMed1979

Effects of intestinal amylase and trypsin on pancreatic secretion in the pig.

Pigs were surgically prepared with external pancreatic fistulae and duodenal cannulae in order to elucidate whether the proposed intestinal feedback control of pancreatic secretion in the pig--as in rat and man--is exerted by trypsin. Furthermore, the effect of intraluminal amylase on pancreatic secretion was studied. Reintroduction of pancreatic juice into the duodenum or infusion of trypsin into the duodenum depressed the volume of the pancreatic flow and the protein output markedly. Introduction of amylase into the duodenum did not significantly affect the pancreatic secretion. Thus, it seemed as it trypsin but not amylase was involved in the suppression exerted by pancreatic juice on exocrine pancreatic secretion in the pig.

Amylases↗
PubMed1978

Zinc and copper concentrations in serum, blood and liver in moderate experimental pancreatic insufficiency.

Serum and liver concentrations of zinc and copper were studied in the rat after ligation of the pancreatic duct. Ligation of the bile duct was done close to the duodenum and high up in the hilum of the liver. The bile flow was by-passed into the intestine via a plastic catheter. The surgical method used was found suitable for a study of moderate exocrine pancreatic insufficiency since significant--although markedly reduced--concentrations of amylase and trypsin were estimated in intestinal contents at sacrifice 19 weeks after the operation. The serum zinc level was unaffected by duct ligation except for a slight decrease after 2 weeks. Similarly zinc in whole blood was unaffected. The copper concentration in serum was, however, significantly enhanced during in first 10 weeks. The copper zinc ration was markedly increased in duct ligated rats during the whole period. Zinc and copper concentrations in liver tissue were significantly decreased after 19 weeks. The findings suggest that a decrease function of exocrine pancreas might induce a disturbed balance of zinc and copper in the rat.

Amylases↗
PubMed1978

Hereditary pancreatitis-a report on two kindreds.

Two Swedish kindreds with hereditary pancreatitis are reported. The onset of symptoms was in early childhood. Otherwise the clinical course did not differ from the non-hereditary form. In no patients were found signs of alcohol-overconsumption, hyperparathyreoidism, hyperlipidemia or mucoviscoidosis. Three patients with intractable pain and frequent hospitalization were operated on with pancreatico-jejunostomy as described by Puestow-Gillesby, with excellent results. Although the observation periods are short (0.5, 2 and 4 years, respectively) it seems legitimate to recommend the operation also for the hereditary form of pancreatitis if intractable pain or frequent exacerbations are present.

Adult↗
PubMed1977

Total pancreatectomy for cancer. An appraisal of 65 cases.

Sixty-five patients operated with total pancreatectomy were reviewed with respect to factors influencing operative mortality and morbidity, long-term survival, and metabolic sequelae. The diagnoses were pancreatic cancer in 58 patients, periampullary cancer in three, cancer of the bile duct in two and leiomyosarcoma of the duodenum and cystadenocarcinoma of the pancreas in one patient, respectively. In nine of the 58 cases with cancer of the caput, the histological examination revealed multicentricity of the tumor. In 44%, there were signs of degeneration and fibrosis in the distal part of the gland. Hospital mortality was 23% for the entire series. After 1970 the hospital mortality was 17%, and among patients operated by senior surgeons especially trained in pancreatic surgery, the hospital mortality was 12% during the whole period. The peroperative bilirubin levels seemed to influence survival time. Among 24 patients operated before 1975 in whom the operating surgeon judged the operation as radical, a five year survival of 21% was recorded. In patients without detectable lymph node metastases, the mean survival time was 25 months. The postoperative exocrine insufficiency and diabetes were possible to control. A blood sugar level above 10 micromol/l was found to significantly decrease the frequency of hypoglycemic attacks. Total pancreatectomy appears to be the surgical procedure preferred when radical treatment is selected.

Aged↗
PubMed1977

Feedback regulation of pancreatic enzyme secretion by intestinal trypsin in man.

In a patient a papilla Vateri tumor completely prevented the bile-pancreatic flow into the intestine although the pancreatic juice was secreted into the bile duct via a common channel. Consequently, the bile-pancreatic juice was possible to sample via a percutaneous transhepatic cholangiography (PTC) catheter. This made it possible to study the effect of duodenal infusion of different substances on the bile-pancreatic secretion. In repeated experiments a suppression of the secretion was observed by intraduodenal trypsin as well as the patient's own bile-pancreatic juice. In the presence the bile-pancreatic juice intraduodenal trypsin inhibitor infusion caused a marked stimulation of the secretion. The results are in accordance with the hypothesis that trypsin in the upper part of the intestine exerts a negative feedback regulation of the pancreatic secretion in man.

Aged↗
PubMed1977

Time-related enzyme concentrations in duodenal aspirates after ingestion of a test meal.

The concentration of trypsin, pancreatic iso-amylase, phospholipase, and lipase were determined in intestinal content during the first two hours of digestion of a test meal. In normal subjects the concentration curves for all enzymes displayed a typical biphasic pattern. In patients with chronic pancreatic disease, the typical variations of the enzyme concentrations were markedly diminished. In patients with celiac disease, the initial peak of the trypsin and phospholipase activities seemed to be delayed, and in patients operated upon with a Polya gastric resection the concentrations of trypsin and phospholipase increased gradually. In these two disorders the lipase concentration curve was of quite a different, uncharacteristic pattern. It is suggested that the concentration curves of the enzymes reflect pancreatic secretion. Furthermore, the secretion of lipase in celiac disease and following gastric resection seems to be 'non-parallel'. Owing to a fairly considerable variation in the values from different individuals, it seems reasonable to conclude that in clinical practice determination of enzyme concentration curves after a test meal probably does not improve the reliability of the conventional Lundh test.

Amylases↗
PubMed1977

Intestinal activities of trypsin, lipase, and phospholipase after a test meal. An evaluation of 474 examinations.

After indirect stimulation of the pancreas by means of a test meal the intestinal activities of trypsin were determined in 452 subjects, lipase in 117, and phospholipase in 57. Trypsin levels were subnormal in 88%, lipase levels in 80%, and phospholipase levels in 81% of patients with chronic pancreatic disease. The outcome of repeated tests (trypsin) was completely consistent in 20 out of 22 patients. Calculations of ratios between the enzymes studied suggested that lipase was the enzyme most susceptible to pancreatic damage. Also in cases of celiac disease and after Polya gastric resection, the decrease of the intestinal lipase concentrations was more marked than that of the other enzymes. In 9% of the cases of chronic pancreatic insufficiency the diagnosis would have been overlooked if either lipase or trypsin had been determined as the sole enzyme. In clinical practice it is recommended to estimate at least two enzymes, because abnormal ratios may be of diagnostic value and because the two different groups of enzymes provide a mutual check on the secretory capacity of pancreatic enzymes. On the whole, the test was found to be reliable, simple, physiological, and inexpensive in terms of resources, and it is highly recommended as a routine test of the pancreatic function.

Chronic Disease↗