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Biomedical subjects

P H Layer

Publications and source records attributed to P H Layer.

7 recordsLinked to original sources
PubMed1997

[Clinical aspects and classification of acute pancreatitis].

Clinically acute pancreatitis is characterized by severe abdominal pain and systemic symptoms, such as nausea, vomiting and circulatory shock. In most cases the diagnosis is verified, and differential diagnoses are excluded, by elevated serum enzyme activities as well as characteristic findings in imaging procedures. The mild form of acute pancreatitis (about 80%) is characterized by an uncomplicated course and recovery within 72 hours in response to adequate therapy. By contrast, severe pancreatitis (about 20%) shows formation of necroses and a protracted course which frequently is dominated by development of systemic complications with subsequent failure of individual or several organ systems. On this background, early discrimination between mild and severe pancreatitis is important for therapeutic management and assessment of prognosis. Several classifications have been suggested in recent years but their use has been limited because they partly depend on complicated multiscoring systems. On the other hand, it has been possible to establish simple severity markers such as serum CRP and PMN-elastase that correlate well with further clinical course and outcome.

Acute Disease↗
PubMed1995

Delivery and fate of oral mesalamine microgranules within the human small intestine.

BACKGROUND/AIMS: Oral use of mesalamine in inflammatory bowel disease requires slow-release preparations to prevent premature absorption and inactivation. Resulting luminal concentrations within the human small intestine are unknown. The aim of this study was to determine human intestinal delivery patterns of mesalamine from a microgranule preparation (Pentasa; Ferring Arzeimittel, Kiel, Germany) effective in Crohn's disease with small bowel involvement. METHODS: A multilumen tube for duodenal, jejunal, and ileal aspiration and marker perfusion was placed in 6 normal subjects. Levels of luminal, plasma, and urinary mesalamine and its main metabolite, acetyl mesalamine, were measured for 7 hours after ingestion of mesalamine (500 mg) with a labeled meal. RESULTS: Gastric emptying of mesalamine paralleled the meal, and its release occurred throughout the small intestine (cumulative, 20% of dose). For 4 hours, mean luminal mesalamine and acetyl mesalamine concentrations were 52 and 38 micrograms/mL (duodenum), 59 and 82 micrograms/mL (jejunum), and 64 and 104 micrograms/mL (ileum). Cumulative colonic delivery was 82% (7% dissolved, 75% in microgranules), and urinary excretion was 3.5%. CONCLUSIONS: Although the major part of continuous-release mesalamine is delivered to the colon, large proportions are liberated and available at high concentrations within the small intestinal lumen, thus explaining its therapeutic efficacy in small intestinal Crohn's disease.

Administration, Oral↗
PubMed1992

Adrenergic modulation of interdigestive pancreatic secretion in humans.

Whether the adrenergic pathways participate in the control of interdigestive pancreatic function in humans is uncertain. To determine if changes in alpha- or beta-adrenergic tone modulate interdigestive pancreatic enzyme output, 16 healthy subjects were intubated with an orojejunal tube to collect and quantify pancreatic trypsin secretion and record motility. After observation of a complete interdigestive cycle (control period), eight groups of two subjects each received 2-hour intravenous infusions of the alpha- and beta-agonist epinephrine (50 ng.kg-1.min-1), the alpha-antagonist phentolamine (5 mg/2 min followed by 500 micrograms/min), the beta-antagonist propranolol (5 mg/2 min followed by 80 micrograms/min), or saline as control, alone or in combination. Drugs were assigned in a random mode according to a 2(3) factorial design. Analysis of variance showed that epinephrine decreased trypsin output by 43% (P less than 0.05). By contrast, trypsin output was increased fourfold in the presence of phentolamine (P less than 0.01), whereas propranolol had no effect. These data suggest that an inhibitory alpha-adrenergic tone modulates human interdigestive pancreatic enzyme secretion whereas beta inputs are less important.

Adrenergic Fibers↗