Biomedical subjects
Publications and source records attributed to H Van Kley.
Hyperamylasemia after narcotic administration is found in some patients. To determine the source of the amylase, serum isoamylases were separated by column chromatography in a group of patients with response to a Prostigmin-morphine challenge. The increment of amylase activity was pancreatic amylase.
A series of cystic ovarian tumors was studied with regard to amylase activity in the cyst fluid. Large amounts of amylase activity were present only in those patients with endosalpingeal-type lining epithelium (serous ovarian neoplasms). The amylase activity from two such patients was further characterized using G75 Sephadex chromatography, DEAE Sephadex chromatography, agarose gel chromatography, isoelectric focusing, and heat inactivation studies. Serous ovarian neoplastic amylase (SONA) exhibited properties different from amylases of pancreatic and salivary gland origin. Serous ovarian neoplastic amylase (SONA) may be a pancreatic and salivary gland origin. Serous ovarian neoplastic amylase (SONA) may be a useful biochemical marker in diagnosing and managing patients with serous ovarian neoplasms.
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A simple and inexpensive procedure is described to include pancreatic lipase in the protocol for evaluation of pancreatic function by duodenal aspiration. The method involves dilution with an albumin solution, a 2-hr incubation with a commercially available substrate mixture, and manual titration with a burette. Results comparable to assay with a pH-stat were obtained. Assay for pancreatic lipase is recommended as a part of the diagnostic procedure of duodenal aspiration.
Definite inherited defect in hereditary pancreatitis (HP) is not known. A new kindred with 3 definite and 6 suspected cases of HP was investigated for possible inherited abnormalities. No aminoaciduria (except for a slight rise in urinary histidine in one patient) and no hyperparathyroidism, hyperlipidemia, or chromosomal abnormality was present. An increase in serum IgM level of a polyclonal type was noted in 3 definitely affected sisters and also in 2 nonaffected members. Serum alpha-1-antitrypsin and serum trypsin inhibition were normal. However, very marked dilatation and ectasia of the pancreatic duct were found in the propositus. Reviewing the data from this family and previously described kindreds, it is postulated that the genetic abnormality in HP encompasses a wide variety of structural and anatomical defects in the sphincter of Oddi or the pancreatic ductal system. These predispose to intermittent obstruction of the duct with concomitant activation of enzymes and ductal metaplasia. In suspected cases an early effort should be made to outline the pancreatic duct as the defect may be amenable to surgery.
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