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Biomedical subjects

G Lake-Bakaar

Publications and source records attributed to G Lake-Bakaar.

3 recordsLinked to original sources

Urinary immunoreactive trypsin excretion: a non-invasive screening test for pancreatic cancer.

The ratio of renal clearance of immunoreactive trypsin relative to renal clearance of creatinine was measured in 71 subjects including 27 controls and patients with cancer of pancreas, chronic pancreatitis, and acute pancreatitis. The upper limit of the control range was 4.1 x 10(-5) (mean + 2SD). 6 of 9 patients (67%) with acute pancreatitis had raised values. All 18 patients with chronic pancreatitis had values within the control range. In contrast, all 17 patients with carcinoma of pancreas had raised clearance ratios. The test may therefore prove valuable in distinguishing between chronic pancreatitis and cancer of pancreas.

Acute Disease

Serum immunoreactive trypsin concentration after a Lundh meal. Its value in the diagnosis of pancreatic disease.

The changes in serum trypsin concentration have been measured in 47 subjects for up to 2 hours after a Lundh meal. In 18 healthy controls, mean fasting trypsin concentration was 285 +/- 125 ng/ml (mean +/- 2 SD). The maximum increase after the Lundh meal (the trypsin response ratio) was 6.7 +/- 7.5%. Six patients with chronic renal failure had elevated fasting serum trypsin concentrations (range 460-1100 ng/ml) but trypsin response ratios fell within the control range. Of five patients with relapsing pancreatitis, two had raised and three normal or low fasting trypsins. After stimulation two had elevated trypsin response ratios; one of the two had evidence of main duct obstruction. Eleven out of 12 patients with chronic pancreatitis (with or without insufficiency) had low fasting trypsin concentrations (range 0-120 ng/ml) Seven of the 12 also had raised trypsin response ratios. In six patients with cancer of the pancreas, fasting trypsin was low in three, normal in two, and raised in one. Both patients with a normal fasting level had a raised trypsin response ratio. The combination of a single estimation of fasting serum trypsin concentration followed by serial measurements after a Lundh meal provides a useful screening test for chronic pancreatic disease.

Chronic Disease