[Endoscopic papillotomy and gallstone removal in acute cholangitis--emergency papillotomy].
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Biomedical subjects
Publications and source records attributed to V Varró.
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This report presents the clinical features of 15 cases of early gastric cancer detected amont altogether 144 gastric cancers diagnosed with the aid of gastroscopy and directed biopsy in a series of 2953 patients. Since the clinical and laboratory data of the patients with early gastric cancer do not provide satisfactory diagnostic evidence, careful X-ray examination must be carried out in all cases with long-standing symptoms relating to the upper part of the abdomen, especially in patients over 40 years old. Gastroscopy is essential in the clarification of any suspected pathological signs indicated by the radiologists and, furthermore, in all cases in which no radiological diagnosis was reached to account for the patient's symptoms. During gastroscopy multiple biopsy specimens should be taken from all lesions which may mask any type of the early cancers. The importance of regular endoscopic examination of high-risk persons for gastric cancer is emphasized.
This is a critical survey of the results of recent investigations on gastrointestinal peptide hormones. The following subjects are dealt with: molecular homology and heterogeneity; mechanism of action of gastrointestinal peptide hormones; hormone-receptor binding; trophic effect; metabolism of gastrointestinal peptide hormones; relationship between humoral and neural regulation in the nervous system.
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The catabolism of the 14C-labelled pentagastrin was investigated in rats. The following results were found: -- the labelled BOC-glycine fragment is split off the pentagastrin in the small intestine -- it is absorbed through the intestinal wall, and -- enters first the portal and then the systemic circulation.
BOC-14C-glycine pentapeptide undergoes hydrolysis on incubation with tissue homogenates. The enzyme activities responsible for hydrolysis have the pancreas, lung and small intestine as their sites. No enzyme activity is demonstrable in liver, kidney and muscle. While intrapulmonary enzyme activity is marked by thermolability, the activities of the pancreatic and intestinal tissues are scarcely affected by heat. The optimum pH is 7.1 for the pulmonary, 7.1 and 10 for the pancreatic and small intestinal enzyme activity. EDTA has proved inhibitory to the enzyme activities of all three organs, in contrast to Gordox and to soybean trypsin inhibitor which leave these activities unaltered.
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With the isolated jejunum loop technique investigations of prostaglandin E2 and F2 alpha were made on canine intestinal absorption and transport of glucose and on the circulation of the intestinal loop. These compounds decreased glucose absorption; intra-arterial prostaglandin administration decreased the portal transport of glucose, but intraluminal administration caused an increase. PGE2 enhanced the circulation of the intestinal loop; intra-arterial PGF2 alpha diminished this circulation, whereas on intraluminal PGF2 alpha had no significant effect.
The effect of intraarterial glucagon injection on the glycogen content of the intestinal mucosa of the dog and the rat has been investigated. In both species significant glucagon-induced reduction of mucosal glycogen contents was revealed.
In vitro experiments were carried out to examine the enzymatic activity in various organ homogenates of the dog, which inactivates the biological activity of the synthetic cholecystokinin-octapeptide (CCK-OP). The highest splitting activity was found in the renal cortex; substantially lower activities were registered in the lung, pancreas and small intestine. It seems interesting that neither the gallbladder nor the saliva and the serum contained measurable amount of the CCK-OP splitting activity. An effort was made to characterize the CCK-OP inactivating principle found in the renal cortex. It was ascertained that the CCK-OP was inactivated by a peptidase which is heat sensitive, has a pH optimum of 7,4 and could be inhibited by chelating agents (EDTA) and epsilon-aminocaproic acid. The fact that most of the enzyme function is associated with the sediment obtained at 12 000 g speaks in favour of its mitochondrial origin.
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The metabolism of labelled BOC-14 C-glycine-pentapetide was investigated in rats, both in blood and urine. We report on the following findings: --radioactivity could be measured in the blood even after the disappearance of the bioactive- and immunoreactive pentapeptide. --the bulk of the radioactivity in the blood after 8 minutes originates from a metabolite which, after subsequent systematic chemical identification, proved to be the BOC-14C-glycine fragment of the pentapeptide. --the radioactivity in the urine comes entirely from this split product of the labelled pentapeptide --the organ distribution of radioactivity of labelled pentapeptide was checked after i.v. administration; 1 minute after the injection, most of the radioactivity was found in the liver, followed by the kidney, pancreas, jejunum and lung. After 1 hour, radioactivity could be detected only in the kidneys. It was concluded that the N-terminal amino-acid of the naturally occurring pentagastrin (glycine) remains linked to the BOC protecting group in the course of the catabolism of the molecule and this fragment is excreted in the urine.
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