[Cryptococcus neoformans: a rare cause of basal meningitis].
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Adult↗
Biomedical subjects
H Pointner
Publications and source records attributed to H Pointner.
[The value of laboratory tests (author's transl)].
The diagnostic significance of various laboratory tests was studied at a Medical University Clinic and a regional hospital. Requests for such tests were graded on admission according to the criteria: (a) necessary for differential diagnostic decision; (b) part of routine admission programme. Results were assessed according to the criteria: (a) clinical "proof"; (b) of value in differential diagnosis; (c) pointing to another diagnosis; (d) unhelpful. Analysis of the results provided an interesting agreement: all doctors graded seven to ten tests as necessary. Those with the highest information content were the classical tests--erythrocyte sedimentation rate, serum-electrophoresis and blood sugar levels. 45.6% of those graded as necessary proved informative; 7.2% of routinely ordered tests provided pointers to another diagnosis. This percentage is the contribution of laboratory tests beyond what doctors consider as necessary for diagnosis. This additional value of laboratory tests is relatively high so that a reasonably extensive programme of laboratory tests on admission appears justified, especially if one adds the time factor to cost-effectiveness.
Blood Glucose↗
[Serum gastrin following renal transplantation].
Basal and postprandial serum gastrin concentrations were determined in 26 renal transplant patients and compared with the values found in 5 normal subjects. All subjects received a solid test meal consisting of 25 g protein, 47 g fat and 58 g carbohydrates. All patients were in a non-uraemic state and received combined prednisolone-azathioprine treatment. 5 patients had a peptic ulcer. There was no significant difference in the mean serum gastrin concentrations of the two groups, either with respect to basal or postprandial values. On calculating mean gastrin concentrations of patients given high (over 20 mg daily) or low (under 20 mg daily) prednisolone dosage, again no difference was found in comparison with the normal subjects. Similarly, no difference was observed in the mean serum gastrin levels between ulcer patients and normal controls. We conclude from these results that, in contrast to the findings in chronic uraemic patients, gastrin metabolism is normal in renal transplant recipients and that the high indicence of gastrointestinal complications, especially peptic ulcer, cannot be due to a disturbed gastrin metabolism in these patients.
Adult↗
[Further examinations of the influence of somatostatin on triglyceride absorption (author's transl)].
7 healthy subjects received an oral fat load containing 100 g neutral fat on two test days. The test meal was followed by an infusion of somatostatin (500 micrograms/h) over three hours. On the first test day 150,000 E of an active fungal lipase (extracted from Rhizopus arrhizus) were given with the fat meal. On the second day placebo capsules were administered instead of lipase. No postprandial increase of serum triglyceride levels could be found in both examinations. These results suggest, that the influence of somatostatin on triglyceride absorption cannot be due to the inhibition of pancreatic lipase secretion.
Adolescent↗
Evaluation of the 75Se-l-selenomethionine test for pancreatic disease. Studies on gel filtration.
Radioselenium-secretin-pancreozymin tests have been performed in 22 normal subjects and in 23 patients with pancreatic exocrine insufficiency. Each subject received an intravenous injection of 40-100 mu Ci 75Se-l-selenomethionine as a bolus which was followed by an intravenous infusion of secretin-CCK-PZ (1 CU/kg/h) for 2 h. Duodenal juice was collected from a double-lumen Lagerlöf tube and the 75Se radioactivity measured. Gel filtrations on Sephadex G-50 were performed from samples of duodenal juice. Total duodenal radioactivity in pancreatic insufficient patients was significantly lower than in normal subjects 60-120 min after the start of the examination. When regarding the individual values of each subject an important overlap of normal and pancreatic insufficient persons could be observed. No difference in the gel filtration pattern was demonstrable between the two groups. From these results the use of 75Se-l-selenomethionine for diagnostic purposes in pancreatic diseases cannot be recommended.
Chromatography, Gel↗
[Comparison and clinical evaluation of electrophoresis methods: Cellulose-acetate electrophoresis with photometric evaluation and agarose-gel screening electrophoresis with immunologic quantification of the various proteins].
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Blood Protein Disorders↗
The influence of somatostatin on the absorption of triglycerides in partially gastrectomized subjects.
Serum triglyceride levels were measured in 10 partially gastrectomized patients after an oral fat load of 100 g. Postprandial triglyceride elevation was completely blocked by somatostatin infusion. This depression cannot be an effect of delayed gastric emptying, because all our patients were Billroth-II operated, but is considered to be due to a direct effect of somatostatin of intestinal absorption.
Adult↗
Somatostatin reduces the release of colony-stimulating activity (CSA) from PHA-activated mouse spleen lymphocytes.
PHA-activated lymphocytes release colony-stimulating activity (CSA) for macrophage-granulocyte precursor cells (colony forming units, CFUc) in the culture medium. Somatostatin, known to interfer with ribosomal protein synthesis, was demonstrated to reduce the release of CSA from PHA-treated mouse spleen lymphocytes.
Animals↗
[Long-term study of endocrine inhibition of exocrine pancreas secretion in the conscious dog].
A new model of a reversible long-term pancreatic fistula was used on an alert, unrestrained dog to test the effect of four substances of the GEP system on the exocrine pancreatic function. The results indicate that SST significantly inhibits not only the basal secretion but also the stimulated secretion of volume, bicarbonate, and trypsine. Calcitonine inhibits only the stimulated secretion whereas PGE1 inhibits only the secretin-stimulated output of trypsine. Glucagon inhibits secretin stimulation in all three parameters.
Animals↗
[Exocrine pancreatic function in chronic alcoholics in Austria (author's transl)].
97 chronic alcoholic patients were investigated with regard to exocrine pancreatic function. Chronic calcifying pancreatitis was radiologically established in 7.2% of the cases. Secretin-pancreozymin tests were performed in 30 patients. Pancreatic insufficiency was found in 8 patients, while 8 patients showed marked hypersection. The daily faecal fat excretion in 10 other patients with partial gastrectomy and Billroth II operation was 5.3 g. Pancreatic disorders were, thus, detected in 53.2% cases of chronic alcoholism. This is higher than expected for Austria.
Adult↗
[Long-term results after therapeutic starvation (author's transl)].
19 Persons with gross refractory obesity (7 men and 12 women) were treated by therapeutic starvation. The patients were controlled after 32 months, on average (range: 7 to 58 months), following completion of treatment. The study shows that 8 of the females gained weight, one of these attaining her pretreatment weight and another even exceeding the pretreatment figure. None of the males had regained his pretreatment weight but 4 showed an increase in comparison with the weight at the time of hospital discharge. During starvation the serum lipids showed a marked decrease, which was statistically significant in the case of cholesterol, but not triglycerides. At the time of follow-up examination the serum lipid values were about the same as before treatment. It is concluded that the long-term results of therapeutic starvation are beter in men than in women and yet this method of treatment should be attempted, when indicated according to strict criteria, in refractory cases of extreme obesity.
Body Weight↗
[Inhibition of postprandial increase in serum triglycerides by somatostatin in man (author's transl)].
A test meal containing 100 g neutral fat was administered to 10 healthy subjects. Serum concentrations of triglycerides, cholesterol, free fatty acids and gastrin were determined during an infusion of 1000 microng somatostatin/h over 3 hours. In comparison with a control group (infusion of normal saline solution), somatostatin caused almost complete suppression of the triglyceride increase. The free fatty acids showed a slight increase under somatostatin while there was no change in the cholesterol levels. Gastrin release was also completely blocked by somatostatin. The suppression of the serum triglycerides may be explained by the inhibition of digestion and absorption of fat in the small intestine under the influence of somatostatin which suppresses exocrine pancreatic secretion.
Adult↗
[The influence of somatostatin on serum gastrin concentrations in patients after total duodenopancreatectomy (author's transl)].
Serum gastrin concentrations were measured in insulin-dependent diabetics and in patients who had undergone total duodenopancreatectomy and gastrectomy. Administration of somatostatin markedly inhibited gastrin release in the diabetic patients with an intact gastrointestinal tract. This inhibitory effect of somatostatin, however, is not detectable in the group of operated patients, who display basically low plasma gastrin levels. A marked increase in the plasma gastrin level after withdrawal of somatostatin was observed in patients with a normal gastrointestinal tract. This rebound effect was only slight in the operated patients.
Diabetes Mellitus↗
[Changes in lipid metabolism during absolute fasting].
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Cholesterol↗
[ Somatostatin in insulin-dependent diabetics and in pancreatectomized patients (author's transl)].
The inhibitory effect of somatostatin on the secretion of glucagon permits the examination of the effect of glucagon on some metabolic parameters in the insulin-dependent diabetic patient. The results obtained in 5 insulin-dependent diabetics and in 4 pancreatectomized patients revealed an inhibitory effect of somatostatin on blood glucose in the juvenile-type diabetics, but failed to show this influence of somatostatin in the pancreatectomized patients. These observations indicate a participation of glucagon in the generation of hyperglycaemia in diabetes mellitus. However, the failure of somatostatin to influence the blood glucose level in pancreatectomized patients contrasts with the results obtained in dogs and emphasizes the difficulty and pit falls in the application of animal experiments with somatostatin to humans.
Animals↗
[Is there a feed-back mechanism between serum gastrin concentration and gastrin release (author's transl)].
The dialysability of gastrin heptadecapeptide was investigated in a model arrangement. The amounts of gastrin passing through the dialysis membrane during a 6-hour dialysis procedure are very small. Furthermore, the serum gastrin concentrations were measured during a 6-hour haemodialysis session with and without simultaneous pentagastrin infusion (0.003 mug/kg/h) in 8 patients on intermittent haemodialysis. There is a continuous decrease in the serum gastrin concentration during the 6-hour dialysis period with simultaneous pentagastrin infusion, while in the investigation without pentagastrin infusion phases of increase in serum gastrin levels are observed. In view of this different response of the serum gastrin curve it is suggested that a direct feed-back mechanism exists between the serum gastrin concentration and gastrin release, a mechanism which was interrupted by the pentagastrin infusion in the present investigation.
Feedback↗
Effect of alterations of blood glucose levels on gastric acid secretion, plasma gastrin, and plasma osmolality in man.
In 16 experiments on 4 healthy subjects, the effect of procedures which alter blood glucose, ie, infusion of 0.2 units/kg body wt/hr insulin and/or 0.66 g/kg body wt/hr glucose, on gastric acid secretion, plasma gastrin, and plasma osmolality was studied, Each subject underwent four different experimental procedures, each lasting 4 hr. All had in common one basal hour and the infusion of insulin in the second hour, but differed in the time of infusion of glucose or isotonic saline. To control for order effects, the four procedures were applied to the subjects in the form of a Latin square. Acid output was measured continuously be means of intragastric titration and a telemetering capsule; blood glucose, plasma gastrin, and plasma osmolaity were determined in 15-min intervals. An inverse relationship between blood glucose and acid output was found: Low glucose levels were associated with high rates of acid secretion, high glucose levels with low acid secretion. No noticeable changes occurred in either plasma gastrin or plasma osmolality. These results reveal a determining influence of blood glucose levels on acid secretion. On the basis of earlier work in animals it is concluded that this influence is exerted via the reciprocal activities of the hypothalamic satiety and feeding centers.
Adult↗
[GSP--a polypeptide from the pancreas with gastrin-like effect].
A peptide has been extracted from porcine pancreas which is capable to stimulate gastric acid secretion in the rat. This peptide consists of 13 aminoacids, it's molecular weight is about 1300. In comparison with antral gastrin there are several biochemical differences: GSP (gastrosecretagogue pancreatic polypeptide) reacts differently in gel filtration, ion exchange chromatography and electrophoreses and has a different aminoacid composition. The 4 amino acids of the C-terminal tetrapeptide of gastrin are not all present. GSP does not react with gastrin antibodies in radioimmunoassay. GSP may be a new gastrointestinal hormone by means of which the pancreas takes part in the regulation of gastric acid secretion.
Animals↗