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Biomedical subjects

Y Horiguchi

Publications and source records attributed to Y Horiguchi.

At least 271 records · Page 15Linked to original sources

Pancreatic excretion test and barrier hypothesis in progression of chronic pancreatitis.

Simultaneous data of the pancreozymin-secretin test and the pancreatic excretion test with 5,5-dimethyl-2,4-oxazolidinedione DMO) were reported for 50 patients with chronic pancreatitis. The pancreozymin-secretin test was abnormal in 90% of the patients, while the pancreatic DMO excretion test showed abnormality in 100% of the patients. The dynamic process of pancreatic excretory dysfunction is discussed. Over 60% of patients with low to moderate grade chronic pancreatitis showed a discordant pattern of decreased DMO output with normal bicarbonate concentration or normal volume flow. Approximately 96% of patients with advanced grade chronic pancreatitis had a excretory pattern of decreased DMO output with low bicarbonate concentration and decreased volume flow. These findings may further develop a barrier hypothesis in chronic pancreatitis. In the early stage of chronic pancreatitis, when functional capacity of the duct is preserved fairly well, the extraductal barrier to the rapid DMO diffusion into the ducts (diffusion barrier) may be primarily responsible for impaired pancreatic DMO excretion. With progression of chronic pancreatitis, the intraductal barrier (outflow barrier) may become pronounced and precipitate pancreatic excretory dysfunction for DMO. The concept of pancreatic barriers may well serve to systematize major histologic alterations observed in chronic pancreatitis.

Adult↗

Relation of exocrine pancreatic function to the diameter of the pancreatic and common bile ducts.

One hundred and thirty-nine patients were examined for possible chronic pancreatitis by means of both pancreozymin-secretin test and endoscopic pancreatography of pancreatocholangiography. Pancreatic function as assessed by the pancreozymin-secretin test was impaired in 89 (64%) of the entire group. No significant relationship was demonstrated between pancreatic secretion of fluid, bicarbonate and amylase and the diameter of main pancreatic duct in both the entire group of the subgroup of patients with pancreatic dysfunction. On pancreatogram no gross morphological abnormalities were found in a high proportion of patients whose pancreatic function was impaired in minimal to moderate degree. There was a significant linear correlation between the diameters of the main pancreatic duct and common bile duct. These data question the value of endoscopic pancreatography in the diagnosis of low to moderate grade chronic pancreatitis.

Adult↗

Pancreatic excretion of 5,5-dimethyl-2,4-oxazolidinedione in patients with chronic pancreatitis.

Abnormal pancreatic excretion of 5,5-dimethyl-2,4-oxazolidinedione (DMO) was demonstrated in 44 patients with chronic pancreatitis (14 with calcification and 30 without calcification). Pancreatic excretion of DMO in patients with chronic pancreatitis, as well as in normal subjects, depended on plasma DMO concentration and secretory volume. In the postsecretin 60-min period, almost all patients showed a decrease in total DMO output of duodenal aspirate over the observed range of plasma DMO concentration. More than half the patients without calcification gave a discordant pattern between the DMO output and volume, ie, decreased DMO output with normal volume secretion, while most of patients with calcification had low DMO output with decreased volume flow. The data of the pancreozymin-secretin test suggested that chornic pancreatic inflammation was moderate or minimal in patients without calcification and far advanced in those with calcification. From these results the hypothesis was advanced that DMO diffusion into the pancreatic ducts might be primarily impaired in the relatively early stage of chronic pancreatitis, and as the inflammation progressed to the final stage, DMO outflow from the ducts to the duodenum would be disturbed with evolving diffusion impairment of the compound. Total DMO output, when expressed as the output at a level of 10 mg/100 ml of plasma DMO (standard DMO output), was significantly reduced in chronic pancreatitis during a 60-min period after secretin stimulation. DMO in duodenal content, when expressed in terms of maximal concentration ratio of duodenal juice/plasma for the compound (maximal J/P ratio), was significantly low in chronic pancreatitis during the last 40-min period after secretin stimulation. These two parameters can therefore be used as indices of pancreatic excretion of DMO. The present technique may well become an effective diagnostic tool for early detection of chronic pancreatitis.

Adult↗