PubMed Health⌕ Search

Biomedical subjects

I Ihse

Publications and source records attributed to I Ihse.

At least 163 records · Page 9Linked to original sources
PubMed1983

Influence of dietary fiber on exocrine pancreatic function in the rat.

Dietary fiber inhibits pancreatic enzyme activity--i.e., trypsin, lipase and amylase--in buffer solutions and in human duodenal juice in vitro. It is well established that oral administration of trypsin inhibitor stimulates the secretion and growth of the rat pancreas. In the present study, trypsin inhibitor (Trasylol) as well as dietary fiber such as pectin of low (37%) methoxylic esterification and wheat bran were found to stimulate pancreatic enzyme secretion in acute experiments in conscious rats with bile-pancreatic fistulae. Feeding for 10 days with wheat bran resulted in increased pancreatic weight and in increased protein and trypsinogen content. Administration of pectin of high (73%) methylic esterification caused increased pancreatic protein content and that of low methylic esterification increased pancreatic trypsinogen activity/milligram tissue. The results suggest that pectin and wheat bran may interfere with the feedback regulation of pancreatic enzyme secretion exerted by intraluminal trypsin, and, like trypsin inhibitor, have a secretagogue and trophic effect on the pancreas.

Amylases↗
PubMed1983

Percutaneous transhepatic cholangiography and drainage. Risks and complications.

An analysis of 237 consecutive PTC/PTD procedures revealed radiographically demonstrable complications in 21 per cent (50/237 cases: bile-contrast medium leakage 24 cases, haemobilia 18 cases) and clinically registered complications in 11% (26/237 cases: bile or blood leakage with or without peritonitis in 10 cases). Two deaths occurred. When possible, a drainage catheter was inserted for decompression. This was performed on 184 occasions in 139 patients--failure rate was 5 per cent. Unsuccessful attempt to introduce a drainage catheter constituted a major complication risk occurring in 5/13 cases (38%). Signs of infection were frequent though these complications were not a major problem in this series. Various possibilities to reduce complications and infections are discussed.

Adenoma, Bile Duct↗
PubMed1983

Effects of pectin on glycaemia and insulinaemia after starch loading in normal, alloxan diabetic, and pancreatic duct-occluded rats.

In normal rats, and in rats with reduced intraluminal amylolytic activity, acute administration of low methoxyl pectin with soluble starch via an oro-gastric tube was found to delay starch digestion. In normal rats pectin slightly lowered plasma glucose levels after a starch load. In pancreatic duct-occluded rats, in which intestinal pancreatic digestive enzyme activities are markedly reduced, an increased insulin secretion and a reduced glucose response were seen after starch loading even without the addition of pectin, when compared to normal control rats. In these duct-occluded rats pectin was found to further reduce starch digestion, and markedly suppress plasma glucose levels after a starch load without changing plasma insulin levels. In moderately alloxan diabetic rats, in which intestinal amylase activity also was substantially reduced, pectin reduced the glucose response to starch to a similar extent (about 30%) as in duct-occluded rats without changing the impaired insulin response. The results suggest that pancreatic insufficiency accompanied by reduced intraluminal activities of pancreatic digestive enzyme activities may be associated with a decreased glucose and an increased insulin response to starch loading and that the ability of dietary fibre to reduce postprandial glycaemia may, inter alia, involve an inhibiting action by fibre on starch digestion, especially manifested in conditions of amylolytic insufficiency.

Amylases↗
PubMed1983

Effects of dietary fiber on pancreatic enzyme activities of ileostomy evacuates and on excretion of fat and nitrogen in the rat.

Ileostomized rats were fed diets with different fiber content. The addition of 5% pectin to the diet caused an increase in the wet weight, fat content, amylase activity per gram, and lipase output of the ileostomy evacuates. Twenty percent wheat bran in the diet increased weight, fat and nitrogen content, and trypsin output of the evacuates. In normal rats pectin added to a meal containing 3H-labeled triolein increased the isotope activity of the feces, indicating an impaired fat absorption. In rats operated on with occlusion of the pancreatic ducts with a tissue glue, the fat absorption was, however, not significantly affected by pectin. The results of the study show that fiber can cause a change in the intestinal enzymatic milieu of ileostomized rats and can cause steatorrhea, which can be explained, at least partly, by malabsorption.

Amylases↗
PubMed1983

Treatment of unresectable pancreatic carcinoma with 5-fluorouracil, vincristine, and CCNU.

Forty-seven patients with unoperable pancreatic cancer were included in a controlled, prospective study of combination chemotherapy. Twenty-five of the patients were allocated to cyclic treatment with 5-fluorouracil, CCNU, and vincristine in accordance with a special schedule. The other 22 patients served as untreated controls. There were no differences between the two groups with regard to survival time or quality of life. Side effects of the drugs given were common in the treatment group.

Aged↗
PubMed1983

Regulatory effects on the pancreas of intraduodenal pancreatic juice and trypsin in the Syrian golden hamster.

The effect of intraduodenal trypsin activity on pancreatic exocrine secretion was studied in conscious Syrian golden hamsters provided with bile-pancreatic fistulae. The secretion (secretory volume, amylase and protein output) was stable during a collection period of 14 h without any duodenal infusions. Infusion into the duodenum of bicarbonate or bile did not affect the secretion. When, however, bile-pancreatic juice or trypsin was administered intraduodenally, a marked depression of amylase and protein output was found. After addition of trypsin inhibitor--in a dose sufficient to eliminate all trypsin activity--to either of the two infusates the secretion was restored to the initial values. In a long-term experiment (10 days) repeated subcutaneous injections of cholecystokinin caused a significant increase of pancreatic protein and amylase content in the hamster. Oral trypsin inhibitor administration for 10 days had similar, although not so pronounced effects. Subcutaneous secretin administration was without effect in this respect. The results show that pancreatic enzyme secretion in the Syrian golden hamster is controlled by a negative feedback regulation exerted by intraluminal trypsin. The findings also suggest that both cholecystokinin and orally administered trypsin inhibitor exert trophic effects on the pancreas.

Amylases↗
PubMed1983

Effects of serum from trypsin inhibitor fed rats on enzyme secretion and protein synthesis by exocrine pancreatic cells.

Oral feeding of trypsin inhibitor is known to stimulate rat pancreatic enzyme secretion and cause hypertrophy of the pancreas. In an attempt to detect a possible serum factor(s) responsible, the effects of serum from trypsin inhibitor fed rats on enzyme secretion and protein synthesis by isolated exocrine rat pancreatic cells in suspension were studied. Serum from trypsin inhibitor fed rats stimulated the secretion of pancreatic enzymes significantly more than serum from control rats. The data suggest that a humoral factor or factors may be involved in the stimulation of pancreatic enzyme secretion by oral trypsin inhibitor. Serum from trypsin inhibitor fed rats as well as serum from control rats stimulated the 3H-leucine incorporation into protein (protein synthesis) to a significant extent. There was, however, no difference in the effects of the two types of sera in this respect.

Amylases↗
PubMed1983

Management of pancreatic pseudocysts.

The management of pancreatic pseudocysts was reviewed in 41 patients, 28 of whom were treated surgically, 9 by non-surgical percutaneous drainage and 4 expectantly. In 20 patients an internal drainage was created and in 15 an external drainage. Hospital mortality was 2% (1/41) and postoperative mortality 4% (1/28). External drainage was associated with 40% early complications and 33% recurrent cysts or chronic internal or external fistulas; the corresponding figures for internal drainage were 15% and 5%, respectively. The 4 patients who were managed expectantly with disappearance of the cysts had an uneventful course. The advent of ultrasound and computerized tomography (CT) has been of great diagnostic value. As external drainage proved inferior to internal drainage in the present study, percutaneous puncture guided by ultrasound or CT and creation of non-operative external drainage is not a recommended treatment. Expectant management with repeated ultrasound examinations may be chosen in selected cases.

Adult↗
PubMed1982

In vitro inhibition of pancreatic enzyme activities by dietary fiber.

Trypsin, amylase, lipase and phospholipase activities were assayed in buffer solutions and in human duodenal juice after incubation with different types of dietary fiber. In buffer solutions, trypsin activity was slightly reduced and amylase activity heavily reduced by pectin of low methylic esterification (LM pectin). Lipase activity was markedly reduced by LM pectin and also moderately reduced by pectin of high methylic esterification (HM pectin). Phospholipase was hardly influenced at all by fiber. Activities of pancreatic enzymes in human duodenal juice were examined after in vitro incubation with pectins, guar gum, wheat bran and ispaghula. Ispaghula did not affect the enzymes except for lipase activity, which was moderately inhibited. The other fiber preparations examined reduced amylase activity by 35-100% at fiber concentrations of up to 1.5 g%, lipase by 40-95% and trypsin by 40-85%. LM pectin had the strongest inhibitory effect among the different fiber preparations studied. Phospholipase activity was only influenced by the pectins, which caused a 75% reduction. It is concluded that dietary fiber of different kinds has the capacity to inhibit pancreatic enzyme activities. This inhibitory effect is dependent on the type of fiber and differently affects the different enzymes. Further, the inhibition seems to be more pronounced when exerted in human duodenal juice than in conventional buffer systems.

Buffers↗
PubMed1982

Exocrine pancreatic secretion in acute experimental pancreatitis.

Reports on pancreatic enzyme secretion during acute pancreatitis are sparse and contradictory. In this study pancreatitis was induced by injection into the pancreatic ducts of sodiumtaurodeoxycholate (NaTDC) and trypsin, and the effect on secretory volume, protein, amylase and bicarbonate secretion was studied. In healthy rats the pancreatic secretion was stable throughout the experimental period. Induction of pancreatitis caused a marked reduction of both secretory volume and protein output of pancreatic juice. Exogenous hormonal stimulation by secretin, cerulein or a combination of both hormones did not affect volume or protein output. Also when measuring bile-pancreatic juice, pancreatitis caused a significant reduction of secretory volume and a gradual decrease of protein output. Amylase output was rapidly and markedly reduced, whereas bicarbonate output was unaffected by the induction of pancreatitis. Pancreatographic studies showed that the impaired secretion was rather a result of ductal and parenchymal injury than of ductal obstruction. Thus, the results of the present study suggest that pancreatic enzyme secretion is markedly reduced during acute experimental pancreatitis. The findings should be considered when evaluating present therapeutic measures and when searching for new ones in acute pancreatitis.

Acute Disease↗
PubMed1982

Effect of dietary fiber on pancreatic enzyme activity in vitro.

The importance of various factors for dietary fiber effects on pancreatic enzyme activities was studied in vitro. Pectin of high methylic esterification and guar gum, which reduced enzyme activities, particularly lipase activity, increased the viscosity of duodenal juice. Increasing duodenal juice viscosity by polyethlene glycol also caused a reduction particularly of lipase activity. Pectin of low methylic esterification, which reduced especially amylase and lipase activities, significantly lowered duodenal juice pH. Lowering duodenal juice pH by hydrochloric acid caused a reduction especially of amylase and lipase activities. Pretreating fiber at acid pH tended to increase its enzyme-inhibiting properties. Trypsin adsorption to wheat bran was partly reversible by buffer washings. Changing ionic strength and incubation time appeared relatively unimportant for the effects of the fiber on enzymes. It is assumed that the inhibitory effects of the fiber on enzymes are attributed inter alia to effects on viscosity, pH, and adsorption, and further that gastric acidification of fiber and conditions lowering intestinal pH may enhance these effects.

Adsorption↗
PubMed1982

Influence of gastrointestinal hormones on the course of acute experimental pancreatitis.

The influence of exogenous administration and endogenous release of certain g.i. hormones on the course of acute experimental pancreatitis was studied. Administration of 2 g of a pellet diet every eight hours decreased survival, as did repeated s.c. administration of the cholecystokinin-analogue caerulein. Also oral administration of a trypsin inhibitor--releasing intestinal factors or hormones stimulating pancreatic enzyme synthesis and secretion--decreased survival. On the other hand repeated s.c. administration of secretin or an anticholinergic drug (Pro-Banthine), or oral administration of 0.1 N HCl every eight hours did not influence survival. At blind macroscopic evaluation, caerulein was found to cause signs of more severe disease. All pancreatic rats had increased S-amylase levels, but there was no difference between any of the groups. In peritoneal fluid, however, caerulein caused an increase in the amylase activity. The results suggest that elevated S-levels of g.i. hormones, which primarily stimulate pancreatic enzyme synthesis and secretion, are harmful in acute experimental pancreatitis.

Acute Disease↗
PubMed1982

Local excision for ampullary carcinoma. An alternative treatment for patients unfit for pancreatectomy.

Thirteen cases of ampullary carcinoma treated with local excision are presented. Seven of the patients had been deemed not fit to stand a Whipple's operation. One patient died within 1 month postoperatively. Median postoperative survival was 22 months, and mean survival was 33 months. One patient is alive 11 years after the operation. Where the tumor is localized, the procedure may be considered a suitable treatment for the patient whose general condition does not allow a more extensive operation.

Adult↗
PubMed1982

Effect of bili-digestive anastomosis on experimental pancreatic carcinogenesis.

Hamsters were subjected to cholecysto-duodenostomy and a small suprapancreatic bile-duct resection in order to preclude bile reflux into the pancreatic ducts. The model was used to investigate the role of bile reflux in the pancreatic carcinogenic action of BHP (N-nitrosobis(2-hydroxypropyl)amine). The carcinogen was given by weekly injection for 20 or 24 weeks. No statistically significant effects of the bile deviation on tumour frequency were found at the end of either time. BHP per se did not induce tumours in any preferential area of the gland. The tumours thus were uniformly distributed. Corresponding distribution was found in the hamsters with choledochoduodenostomy. The histologic appearance of the pancreatic lesions was the same in hamsters with and without choledochoduodenostomy. The findings do not support the concept of bile reflux as an aetiologic factor in experimental pancreatic carcinogenesis.

Animals↗
PubMed1981

Evaluation of intended radical surgery in carcinoma of the gallbladder.

The records of 44 consecutive patients with carcinoma of the gallbladder from 1968 to 1977 were reviewed. All patients were investigated with a view to resection of the tumour and this was carried out in 10 patients, all macroscopic tumour being excised in 6. The basic operation was cholecystectomy, but liver resection (4 patients), liver resection and colectomy (3 patients) and pancreaticoduodenectomy (1 patient) were also carried out. Of these 10 patients, 3 died in hospital, while of the 34 patents in whom a palliative procedure was possible, 15 died during their hospital treatment. The median survival times were 4 months and 3 months respectively. Only one patient in this series is alive and symptom-free at 36 months. It is concluded that radical surgery, of itself, does not confer any advantage to the group of patients with carcinoma of the gallbladder. Alternative strategies for diagnosis and treatment of this condition are discussed.

Adult↗
PubMed1981

[Experience with the percutaneous transhepatic insertion of a bile duct endoprosthesis (author's transl)].

In thirty patients with extrahepatic cholestasis because of a malignant tumor a permanent bile endoprosthesis was inserted nonsurgically. As prosthesis a teflon tube (OD/ID4.0/3.0mm) was used without side holes (13 cases) or with side holes (17 cases). The bile was drained through the endoprosthesis during a period of 1-32 weeks. The drainage function of the endoprosthesis without side holes was classified as partially effective in seven cases and as insufficient in six cases. The drainage function of the endoprosthesis with side holes was judged as optimal in four cases, partially effective in ten and insufficient in three cases. The dysfunction of the endoprosthesis in nine of thirty cases was caused by lack of side holes, spontaneous occlusion or spontaneous dislocation of the prosthesis. Eight patients developed symptoms of cholangitis. In four cases sepsis occurred after insertion of the prosthesis. One patient died from the sequelae of an intrahepatic pseudoaneurysm, which had developed from a damaged segmental artery following the transhepatic bile drainage.

Adult↗
PubMed1981

Influence of hormonal stimulation by caerulein on acute experimental pancreatitis in the rat.

The influence of hormonal stimulation by caerulein administration on acute experimental pancreatitis was investigated in the rat. An experimental model of moderate acute pancreatitis was selected after injecting buffer solution containing sodium taurodeoxycholate and various concentrations of trypsin into the bile-pancreatic duct. During acute experimental pancreatitis caerulein administration increased the mortality rate, the incidence of ascites and the activity of amylase in ascites. Caerulein rendered the pancreatitis more severe also as judged from blind macroscopic evaluation. Amylase and insulin levels in serum and plasma were elevated 6 and 25 h after induction of pancreatitis irrespective of caerulein administration. In pancreatitic rats caerulein decreased the activities of digestive enzymes in pancreatic tissue. The results show that hormonal stimulation by the cholecystokinin-pancreozymin analogue caerulein during acute experimental pancreatitis is harmful.

Acute Disease↗