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Biomedical subjects

D A Dreiling

Publications and source records attributed to D A Dreiling.

At least 109 records · Page 6Linked to original sources
PubMed1977

Effects of duodenal alkalinization on pancreatic secretion.

Effects of duodenal alkalinization on pancreatic secretion were evaluated in seven dogs including two antrectomized dogs with chronic duodenal fistulas. Continuous intravenous injection of secretin or secretin plus CCK PZ was administered as a stimulus for the pancreatic secretion. Intraduodenal infusion of alkaline solutions such as pancreatic juice (pH 8.6), bile (pH 8.1), bicarbonate solution (160 mEq./I., pH 8.6) and TRIS buffer solution (0.3 M, pH 9.5) caused a moderate increase in protein output and a modest or no increase in flow but no change in bicarbonate output. During infusion of pancreatic juice, varied doses of secretin (0, 0.015, 0.03, 0.06 u./kg./min.), or secretin (0.03 u./kg./min.) plus CCK-PZ (0.05 u./kg./min.) were administered intravenously. For example, under the stimulation of secretin (0.03), flow increased modestly (17.7%), an increase which was of statistical significance. Protein output also showed a significant increase of 35.7%. There was, however, no response of the pancreas to the infusion of pancreatic juice when the gland was stimulated by secretin plus CCK-PZ. Antrectomy did not alter the effect of alkaline intraduodenal infusions on pancreatic secretion.

Animals↗
PubMed1977

Giardia lamblia. A case presentation of chronic cholecystitis and duodenitis.

A case of chronic cholecystitis and duodenojejunitis secondary to Giardia lamblia is presented. Though well documented as a cause of duodenitis, this condition is not a common finding in the United States and hence the diagnosis is not made routinely. This case illustrates an instance where giarditic duodenojejunitis may have been masquerading as a chronic cholecystitis.

Child↗
PubMed1977

The pancreas and immunoglobulins. II. Immunoglobulin levels in the pancreatic secretions of patients with chronic pancreatitis.

A comparison of the pancreatic excretory immunoglobulin levels of G, A, M in the normal and chronic pancreatitis patient reveals no satistically significant differences. Further study is indicated to determine whether or not there is a difference between the group as a whole and those patients with chronic pancreatitis whose symptoms continue after cessation of ethanolism.

Adult↗
PubMed1977

Papillary cystadenocarcinoma of the pancreas.

Papillary cystadenocarcinoma is a rare lesion of the pancreas. A case is reported in a 38-year old female where radical resection of an extensive lesion resulted in a four-year survival without evidence of recurrence.

Adult↗
PubMed1977

Biliary bacteriology based on intraoperative bile cultures.

This paper presents a study of bile cultures taken during 174 operations on the extrahepatic biliary tract. Twenty-six per cent of the cultures were positive. Septic complications developed in 33.3% in this group. Since septic complications must be the result of intraoperative contamination from the infected bile, an argument is presented for prophylactic preoperative antibiotic administration as well as for routine culture of the bile at time of surgery.

Abscess↗
PubMed1976

The pancreatic involvement in disseminated "collagen" disorders. Studies of pancreatic secretion in patients with scleroderma and Sjögren's "disease".

In this study of 66 patients with Sjögren's syndrome and/or scleroderma abnormal pancreatic secretory patterns were observed in 43 patients, 17 of 23 with Sjögren's and 19 of 31 with scleroderma. Pancreatic insufficiency was often associated with depressed gastric secretion and/or abnormal gallbladder function. While in both disorders digestive complaints are attributable to one or more dysfunctions, the pathogenetic factors in scleroderma appear to be more varied and require careful investigation for complete elucidation. Antibiotics, antimetabolites and steroid therapies are also additional causal factors involved in the initiation of gastrointestinal dysfunction and pathology.

Gallbladder↗
PubMed1976

Influence of a synthetic prostaglandin analog on pancreatic secretion.

Effects of a synthetic prostaglandin analog-16--16-dimethyl prostaglandin E2, methyl ester (16-diMe-PGE2)--on pancreatic secretion were evaluated in seven dogs with chronic duodenal fistulas. Graded doses of 16-diMe-PGE2 were administered intravenously (0.1, 0.3, 0.5, and 1.0 mug per kilogram, intraduodenally, or intragastrically (15, 30, 50, 100 mug per kilogram) with the pancreas in the resting state or in response to (1) secretin and (2) secretin with cholecystokinin-pancreozymin. Profound and prolonged inhibition of volume and bicarbonate concentration of secretion occurred in the resting and stimulated gland. ED50 was 0.31 mug per kilogram intravenously (1/75 the ED50 for PGE1) and 25 mug per kilogram intraduodenally. As with PGE1, stimulation of enzymes occurred, even with doses that were subthreshold for inhibition of volume and HCO3. Like PGE1, 16-diMe-PGE2 has a dual action on the intact canine pancreas (stimulation of enzymes and inhibition of volume and electrolytes), but is much more potent, has a prolonged action, and is active intraduodenally and intragastrically. Nonsteroid inhibitors of endogenous prostaglandin synthesis did not alter these effects.

Animals↗
PubMed1976

"Cycloperistaltic" intestinal segment: a new method to prevent excessive fluid loss in permanent ileostomies.

A 10-15 cm. long isolated intestinal segment, in which peristalsis has been altered to run in a circular fashion, was interposed in a series of permanent ileostomy-bearing dogs and in two clinical cases with severe diarrhea after total colectomy. Excellent results in both patients confirmed the experimental findings. Technically the method is easily accomplished by cutting the antimesenteric site of the intestinal segment lengthwise and resuturing it transversely. Two major advantages of this technic are postulated. First, the retarding action of the isolated loop does not depend on the great variations observed in peristaltic activity of the small intestine which in some patients results in obstruction. Second, the blood supply to the loop is unlikely to be impaired. Possibly both these advantages derive from the fact that the loop is twisted only 90% instead of 180 degrees required in the ordinary reversed loop interposition.

Animals↗
PubMed1976

The microcirculatory correlator: a new instrument for the intraoperative evaluation of visceral circulatory integrity.

The microcirculatory correlator probe has been used on multiple occasions on the abdominal viscera and clear pulse-wave tracings have been obtained from all the intra-abdominal organs. There is a linear correlation between deflection of pulse-wave and intestine blood flow in an isolated loop of intestine under low flow conditions. The probe has been used in two circumstances to good clinical advantage.

Animals↗
PubMed1975

Secretion analysis: secretin testing in pancreatic cancer.

Modern testing of pancreatic function and the diagnosis of pancreatic disease is facilitated by the addition of augmented stimulus to the standard stimulus used in secretin testing. The combined standard-augmented secretin test protocol enables not only diagnosis using the classical patterns of secretion (qualitative and quantitative defects), but also permits delineation of secretory capacity. In the abnormal patient, the augmented test increases the defect in the characteristic diagnostic parameter. Thus, there is fixation of flow in pancreatic cancer and fixation of bicarbonate in pancreatic inflammation.

Amylases↗
PubMed1975

Pancreatic exocrine secretion during and after pregnancy.

Pancreatitis occurring in late pregnancy and in the puerperium has been documented as an entity unrelated to cholelithiasis or hyperlipidemia. Canine pancreatic exocrine function has been studied during pregnancy and the puerperium. Pancreatic secretion was evaluated in eight pregnant female mongrel dogs prepared with Thomas duodenal and gastric fistulae, during pregnancy (corresponding to the third trimester in humans), during the puerperium, and several months after whelping. Basal secretion (volume and HCO3) was increased during pregnancy and the puerperium. The response to exogenous secretin (submaximal and maximal) was unchanged during pregnancy but decreased in the puerperium. Resting enzyme output was increased during pregnancy and the puerperium; the responses to cholecystokinin-pancreozymin during pregnancy were even more profoundly increased. Although the mechanism is speculative, these alterations in pancreatic function might contribute to the development of pancreatitis in pregnancy and the puerperium.

Animals↗
PubMed1975

Crohn's disease of the colon. II. Controversial aspects of hemorrhage, anemia and rectal involvement in granulomatous disease involving the colon.

In 160 cases with granulomatous colitis or ileocolitis, blood was found in the stool in 72 or 45%. Massive bleeding occurred in four patients (25%); overt bleeding in 51 (32%) and occult bleeding, repeated guaiac positive stools, in 17 (11%). Thus, clinically obvious bleeding occurred in about one patient in three. Of the four patients with massive hemorrhage one required subtotal colectomy, one right hemicolectomy and the other two were controlled by medical measures including blood transfusion. In each of the surgical cases, the massive bleeding originated in the region of the cecum. An additional patient, not in the series, required proctectomy as a life-saving measure following subtotal colectomy. Clinically obvious rectal bleeding in Crohn's colitis is approximately ten times as frequent as in regional enteritis but only one-third as frequent as in ulcerative colitis. There was no correlation between rectal bleeding and rectal involvement determined radiologically or by signoidoscopy, in the whole series but there was a strong association in the small group of Crohn's colitis with rectal involvement (86% with bleeding) and a significantly greater proportion of patients with colitis with rectal involvement and hemorrhage (P smaller than 0.02). Anemia is common in both groups but in Crohn's colitis it is almost always, 75%, associated with rectal blood loss, whereas in ileocolitis this association is much less marked, 40%, indicating other important causes of anemia when there is small bowel disease. The bleeding patient with Crohn's colitis should be managed medically initially. Uncontrollable, continuous, or massive hemorrhage may require angiography and early surgical intervention.

Adolescent↗