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L Kayasseh

Publications and source records attributed to L Kayasseh.

At least 19 recordsLinked to original sources

Double-blind dose-finding study of olsalazine versus sulphasalazine as maintenance therapy for ulcerative colitis.

OBJECTIVE: To determine the therapeutic efficacy and safety of three doses of olsalazine compared with the standard dose of sulphasalazine. DESIGN: Randomized double-blind multicentre 6-month study comparing three doses of olsalazine (0.5, 1.25 and 2.0 g daily) and sulphasalazine 2.0 g daily for maintaining remission in patients with ulcerative colitis. SETTING: Public hospitals and private practices in Germany, Austria and Switzerland. PATIENTS: A total of 162 patients with ulcerative colitis in remission. RESULTS: According to intention-to-treat analysis, the failure rates of the different treatment groups were not significantly different (36, 49 and 24% for 0.5, 1.25 and 2.0 g olsalazine daily and 32% for 2.0 g sulphasalazine daily). Olsalazine and sulphasalazine showed a tendency towards lower failure rates in extended (28%) than in distal disease (44%). The withdrawal rate due to adverse effects was 4%, the most frequent single event being diarrhoea (2.5, 5.2 and 11.7% for 0.5, 1.25 and 2.0 g olsalazine daily and 0% for sulphasalazine daily). CONCLUSION: This study found no significant differences between the therapeutic efficacy or safety of 0.5-2.0 g olsalazine daily. Because of its sulpha-free formulation olsalazine may, however, be preferred to sulphasalazine.

Adolescent

Diagnosis of achlorhydria by plasma secretin determination--a tubeless approach.

To investigate the value of plasma secretin determination in the diagnosis of impaired gastric secretion, blood samples were drawn for secretin assay (radioimmunoassay) at specified intervals before and after pentagastrin stimulation in 10 healthy volunteers and 11 subjects with suspected hypo- or achlorhydria (less than 10 mEq HCl/2 h). The tests were performed twice, once with and once without aspiration of gastric juice for estimation of acid output. In six other patients with proven achlorhydria, the test was performed once without gastric aspiration. The best discrimination of a single plasma secretion level between controls and patients with hypo- and achlorhydria was obtained 60 min after pentagastrin stimulation. All controls and four subjects with an acid output more than 10 mEq/2 h had secretin levels within normal limits. In contrast, 12 of the 13 subjects with hypochlorhydria had abnormally low basal corrected secretin levels at 60 min, including nine achlorhydria patients. It is concluded that secretin determinations after pentagastrin stimulation may be a valuable diagnostic and epidemiological tool to identify patients with impaired gastric secretion.

Achlorhydria

[Comparison of tumor incidence in 251 first-degree relatives of 50 patients with colorectal carcinoma with those of the Basel population].

A tumor-centered family history obtained in 50 patients with colorectal carcinoma without polyposis coli revealed that first-degree relatives of such patients have a 3.6 times greater risk of developing colorectal carcinoma themselves. The simple and harmless family history method can be employed by any physician for the identification of healthy persons at high risk for colorectal carcinoma.

Adult

[Somatostatin in gastroenterological therapy].

Somatostatin (SST) has been shown by several controlled studies to be effective in halting acute severe bleeding from ulcerative and erosive lesions of the upper intestinal tract. Its efficacy for the treatment of bleeding esophageal varices is less certain, and more controlled studies are necessary. Intravenous administration of SST or subcutaneous application of the new synthetic SST-analogues produces a decrease in serum hormone levels and abolition of symptoms in patients with endocrine-active tumors such as vipoma, glucagonoma and carcinoid. SST has no effect on the outcome of acute pancreatitis, and experience with SST in treating intestinal fistulas is very limited.

Acute Disease

Plasma secretin and pancreatic response to various stimulants including a meal.

In dogs with gastric and duodenal Thomas cannulas, we investigated the threshold dose range of exogenous secretin and intraduodenal HCl for pancreatic bicarbonate secretion and, with a recently developed radioimmunoassay, measured the increase in plasma secretin concentrations. Synthetic secretin (2.5, 7.5, and 22.5 ng X kg-1 X h-1) was dissolved in saline or 0.1% dog albumin and given with or without a background infusion of 30 ng X kg-1 X h-1 of caerulein. The minimal dose of secretin that elicited a significant pancreatic bicarbonate response as well as an increase in plasma secretin concentration was 7.5 ng X kg-1 X h-1 when administered with albumin and 22.5 ng X kg-1 X h-1 without albumin. The threshold dose for duodenal HCl was 2 mmol X h-1. The threshold secretin dose for bicarbonate secretion and for an increase in plasma secretin levels was unchanged with a background caerulein infusion. Furthermore, postprandial secretin concentrations were measured. After a meat meal plasma secretin release appeared to occur in spikes up to 10 pmol X l-1 corresponding to secretin levels seen during infusion of 7.5 ng X kg-1 X h-1 of secretin and intraduodenal acid perfusion at a dose of 2 mmol X h-1.

Animals

[Endocrinology of exocrine pancreas function].

Recent advances in knowledge of the hormonal control of exocrine pancreatic secretion are discussed in the light of two main mechanisms of action: first, the effect of the main regulatory peptides on the exocrine pancreas, and second, the inhibitory mechanisms which may affect pancreatic secretion. A synthesis of the regulatory principles controlling exocrine pancreatic secretion is attempted.

Amino Acid Sequence

The release of pancreatic polypeptide by CCK-octapeptide and some analogues in the dog.

In dogs with gastric and pancreatic Thomas fistulas the effect of different cholecystokinin-like peptides upon pancreatic polypeptide (PP) release was studied in three ways: (a) Plasma PP concentrations were determined by radioimmunoassay in response to 135 pmol/kg/h of the synthetic C-terminal octapeptide of cholecystokinin (CCK-OP) (A), of three of its analogues (B, C, D) where methionine has been replaced by methoxinine, and in response to 45 pmol/kg/h of caerulein. The greatest rise in plasma PP concentration expressed as delta PP was achieved with caerulein (327 +/- 37 pM), when taking into account the threefold smaller dose used, followed by CCK-OP (536 +/- 67 pM) and analogues B (343 +/- 51 pM), C (87 +/- 46 pM), and D (32 +/- 15 pM). The order of potency with respect to stimulation of exocrine pancreatic secretion was the same: E and A precede B, C, and D. delta PP correlated linearly with the pancreatic protein output (r = 0.98, p less than 0.01). (b) CCK-OP was infused in four doses of 35, 70, 135, and 270 pmol/kg/h, and plasma PP concentrations and exocrine pancreatic secretion were monitored. The correlation between pancreatic protein output and delta PP was very close (r = 0.98, p less than 0.01). (c) Atropine sulfate (0.1 mg/kg, i.v.) reduced the PP response to the 135 pmol/kg/h dose of CCK-OP by 61%. We conclude from this that CCK-OP and related peptides do release PP and that their effect on exocrine pancreatic secretion is closely correlated with their PP-releasing capacity. The PP release may therefore be used as an indicator of the CCK-like activity of CCK fragments and analogues. CCK-OP may well represent one of the humoral stimulatory factors contributing to the release of PP, but this action appears to depend on a cholinergic background.

Animals

[Functional diagnosis of chronic pancreatitis].

Established and modern methods for assessment of exocrine pancreatic function are reviewed and discussed with regard to diagnostic workup in chronic pancreatitis. Determination of chymotrypsin in stool or oral admit BT-PABA suffice as screening methods, while more sensitive methods such as Lundh test, secretin, or secretin/pancreozymin are suitable for confirmation of diagnosis.

4-Aminobenzoic Acid

[Chemical structure and biological activity of cholecystokizin octapeptides with respect to the stomach and pancreas].

Dose response curves of the octapeptide of cholecystokinin (CCK-8) and 3 of its methoxinine analogues have been established in 4 conscious dogs with respect to gastric and pancreatic secretion. In the analogues the methionine was replaced by methoxinine in position 3 (B) and (D) or 6 (C). Of the 4 tested substances CCK-8 exhibited most activity with regard to pancreatic protein secretion, followed by B, C, and D. Analogue C had the strongest stimulating effect on gastric acid secretion, while its effect on pancreatic secretion was minor. Correlation of chemical structure with biological activity points to the importance of the methionine residue in position 6.

Animals

Somatostatin and cimetidine in peptic-ulcer haemorrhage. A randomised controlled trial.

In a randomised controlled trial somatostatin was compared with cimetidine in the treatment of severe and persistent gastrointestinal bleeding due to peptic ulcer. The study was of a sequential design and lasted 2.5 years, when the designated level of significance had been reached. Of the 20 patients studied, 10 received somotostatin and 10 received cimetidine. In 7 of the 10 pairs of patients somatostatin was more effective than cimetidine; in 2 pairs somatostatin and cimetidine were both ineffective; and in 1 pair they were equally effective. Somatostatin may therefore be suitable for controlling peptic-ulcer bleeding in many patients who are unsuitable for surgery.

Adult