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At least 19 recordsLinked to original sources
PubMed1979

Improved diagnostic accuracy of a modified oral pancreatic function test.

The oral pancreatic function test (PFT) depends upon urinary recovery of p-aminobenzoic acid (PABA) released by chymotrypsin hydrolysis of orally administered N-benzoyl-L-tyrosyl-p-aminobenzoid acid. The diagnostic value of the test is limited because falsely abnormal results frequently occur in patients with bowel or liver disease in whom PABA recovery is impaired by abnormal absorption or hepatic conjugation, even though pancreatic function is normal. To overcome this problem, we have modified the oral PFT to correct for impaired PABA absorption and conjugation. Results of the oral PFT have been compared with urinary recovery of an equivalent dose of free PABA in order to derive a PABA excretion index (PEI). When the modified oral PFT is used, the PEI clearly distinguished patients with pancreatic disease from normal subjects. In patients with small-bowel or liver disease and normal exocrine pancreatic function, the PEI results were similar to those of normal subjects, although a previous oral PFT had been falsey abnormal. The modified test can therefore distinguish abnormal results due to pancreatic disease from the falsely abnormal results found in liver and small-bowel disease.

4-Aminobenzoic Acid↗
PubMed1979

The diagnostic value of the oral pancreatic function test.

An oral pancreatic function test (PFT) using the synthetic peptide N-benzoyl-L-tyrosyl-p-aminobenzoic acid can assess pancreatic exocrine function, since urinary recovery of the ingested dose is an indirect index of chymotryptic activity. We have studied 34 subjects using this oral PFT, which correctly distinguished the control group (8 subjects) from the pancreatitis group (10 patients), results correlating well with Lundh test findings. However, the test was falsely abnormal on 9 out of 16 occasions in patients with bowel or liver disease. We therefore conclude that the present test cannot distinguish small-bowel disease from pancreatic disease, which is often the diagnostic problem, and is also frequently falsely abnormal in the presence of chronic liver disease.

4-Aminobenzoic Acid↗
PubMed1988

Pancreatic function tests in the diagnosis of pancreatic cancer.

Based on the relevant literature data and on personal experience, the author discusses the mechanisms of pancreatic function impairment in patients with pancreatic cancer, and the role of pancreatic function tests in the diagnosis of this disease. Although pancreatic function is reduced in the vast majority of patients with pancreatic cancer, at present pancreatic function tests are of limited value in the diagnostic approach to this tumor. This is mainly due to the fact that in most cases, patients with pancreatic cancer are seen when the cancer is in an advanced stage, and it can be rather easily diagnosed with currently available imaging techniques.

Humans↗
PubMed1976

Continuous secretin infusion with pancreozymin pretreatment as a pancreatic function test.

This paper deals with a pancreatic function test with the submaximal dose of secretin given by continuous infusion after injection of cholecystokinin-pancreozymin (CCK-PZ) in the submaximal dose. The active elimination of bladder bile by CCK-PZ pretreatment decreased the influence of biliary contamination, and the volume output and the bicarbonate concentration were stabilized by the continuous infusion of secretin. As a result, the coefficients of variation in the volume output and the bicarbonate concentration were calculated to be about 15 and about 5%, respectively. These variations were considerably smaller than those obtained in the standard secretin test. Therefore, the present study is expected to improve the diagnostic means for pancreatic excretory dysfunction.

Amylases↗
PubMed1989

Pancreatic function testing. Methods to identify exocrine insufficiency.

The diagnosis of chronic pancreatitis is ideally established by an appropriate clinical history and confirmatory radiologic imaging. However, in cases where imaging results are normal or equivocal, pancreatic function testing is necessary. Direct (intubation) tests are generally accepted as the best methods for study of pancreatic exocrine capacity, but indirect tests, which are well tolerated and generally simple to perform, are gaining interest. Their shortcoming is that they are too insensitive to reliably differentiate patients with early exocrine dysfunction (ie, before malabsorption has occurred) from controls. Sensitivity is not improved by combining two or more studies. However, several modified tests (eg, two-stage paraaminobenzoic acid test, pancreolauryl test) have improved specificity and are able to distinguish pancreatic from other causes of steatorrhea. Their reproducibility in individual cases is of value in sequential studies and in patients with established pancreatic exocrine deficiency to seek evidence of improvement or deterioration in function and to determine patient compliance with replacement therapy.

4-Aminobenzoic Acid↗
PubMed1992

Fecal immunoreactive lipase: a new tubeless pancreatic function test.

Immunoreactive lipase (IRL) was measured in 368 stool samples from 231 individuals by means of a new enzyme-linked immunoabsorbent assay technic, to test its validity as an indicator of exocrine pancreatic insufficiency. Ninety-seven stool samples from 64 healthy volunteers showed a logarithmically normal distribution of IRL values and a median IRL concentration of 17 micrograms/g (range, 2.75-117.3 micrograms/g) with a statistically calculated lower normal limit of 4 micrograms/g. In 100 stool samples from patients with chronic pancreatitis and proven steatorrhea the median IRL concentration of 6 micrograms/g (range, 0.002-107 micrograms/g) was significantly lower than that of normal controls and of 52 stool samples from patients with chronic pancreatitis without steatorrhea (IRL, 40 micrograms/g; range, 0.55-302 micrograms/g), 45 stool samples from 23 patients with celiac disease (IRL, 96 micrograms/g; range, 6.05-563 micrograms/g), and 30 stool samples from 26 patients with chronic diarrhea (IRL, 57 micrograms/g; range, 4.2-573 micrograms/g). It is concluded that fecal IRL is a promising new enzyme test with low diagnostic sensitivity (34%) but excellent diagnostic specificity (98%) in chronic pancreatitis and for diagnostic study of chronic diarrheal disorders. In contrast to fecal chymotrypsin, the test results are unaffected by pancreatic enzyme replacement therapy.

Adult↗
PubMed1979

[Modern pancreatic function tests].

The functional diagnostics is a corner-pillar of the difficult diagnostics of pancreas. Despite new tests many wishes remain open. The secretine-pancreozymine test and the Lundh-test give good informations, but they are expensive and for the patients considerably stressing. They certainly are not regarded as screening tests. The suitable and justifiable tests for epidemiologic examinations (estimations of stool enzymes and of serum isoamylase) are less specific and sensitive. A differentiation between chronic pancreatitis and neoplasm of the pancreas is not possible with the help of the functional diagnostics. The results of functional examinations may be correctly evaluated only within all informations which concentrate at the patient's bed.

4-Aminobenzoic Acid↗
PubMed1979

Improved sensitivity of the BTPABA pancreatic function test in animals with meals of raw egg white.

An indirect exocrine pancreatic function test (PFT) which measures the ability of a test to hydrolyze a chymotrypsin-labile peptide (N-benzoyl-L-tyrosyl-PABA), was carried out in rats and swine with simulated partial exocrine pancreatic insufficiency. When spray-dried egg white (SDEW), which contains an inhibitor of chymotrypsin, was administered as a test meal with the PFT, the degree of pancreatic insufficiency was more pronounced. The results suggest that SDEW or raw egg while may be useful as a test meal to be given in conjunction with the PFT in humans in order to accentuate moderate degrees of pancreatic insufficiency and improve the sensitivity of this indirect test of pancreatic function.

4-Aminobenzoic Acid↗
PubMed1989

Exocrine pancreatic function tests.

Despite the development in the last two decades of new imaging techniques for the detection of pancreatic disease, discrepancies between functional and morphological findings can be remarkable. Pancreatic function tests may aid in the detection of disease at an earlier stage in some patients and can assess the degree of functional damage which is helpful in assessing patients for supplemental therapy. While direct intubation methods are invasive and time consuming, they remain the gold standard against which the other investigations have to be assessed. An indirect test, such as the pancreolaural test, has been shown to be a useful addition to ultrasound for the screening of pancreatic disease. Pancreatic markers and radioisotope methods have failed to live up to early promise, but fecal tests can be used effectively to monitor enzyme replacement. A judicious combination of pancreatic function tests and imaging techniques may be able to rationalize investigation and treatment of pancreatic disease.

Diagnostic Imaging↗
PubMed1986

Tubeless pancreatic function tests used in combination for screening of pancreatic disease.

The diagnostic efficacy of some tubeless screening tests was examined in chronic pancreatitis patients with different degrees of pancreatic insufficiency. Results of the Pancreolauryl and Lipiodol tests were equal in the same patients. Sensitivity of the Lipiodol test, starch tolerance test and PABA test was 80%, 90% and 57%, respectively. Specificities were 48%, 57% and 100%. Sensitivity increased considerably when two tubeless tests were used in combination: 99% and 90% of patients had at last one abnormal result with starch tolerance + Lipiodol and PABA + Lipiodol tests, respectively. The specificity did not change significantly. Combination of tubeless tests seems to be useful for screening of mild and moderate pancreatic diseases because false negative results of single tests caused possibly by non-parallel enzyme secretion can be avoided.

4-Aminobenzoic Acid↗
PubMed1978

Plasma cyclic AMP levels during a secretin-caerulein pancreatic function test in liver and pancreatic disease.

Plasma cyclic AMP levels were determined during a 40 minute secretin infusion (1 Cl.U kg-1h-1) followed by a 40 minute combined secretin (1 Cl.U kg-1h-1) caerulein (75 ng kg-1h-1) infusion. In nine healthy subjects, both secretin alone and secretin in combination with caerulein did not affect plasma cyclic AMP levels. The same was observed in six patients with chronic pancreatitis. By contrast, in patients suffering from liver disease (nine cases) or extrahepatic cholestasis (six cases), secretin elicited large increases in plasma cyclic AMP concentration; the mean values attained being, respectively, seven and four times higher than before the infusion. On the other hand, increases in plasma cyclic AMP 10 minutes after a bolus injection of glucagon (1 mg) were four times lower in the liver disease group as compared to the controls. The results reported here suggest that the liver plays a major role in the degradation of plasma cyclic AMP produced by target tissues responding to secretin, and in the release of cyclic AMP under glucagon. Liver disease reduce the capacity of the liver to clear cyclic AMP from the blood. The pancreas does not contribute significantly to the cyclic AMP in the blood.

Ceruletide↗
PubMed1989

The fecal chymotrypsin photometric assay in the evaluation of exocrine pancreatic capacity. Comparison with other direct and indirect pancreatic function tests.

Fecal chymotrypsin (FCT) has been measured by a new photometric method (Monotest Chymotrypsin; Boehringer, Mannheim) in 78 patients: 44 with chronic pancreatitis and 34 not affected by any pancreatic disease. The results were compared with those from other tests of pancreatic secretory (secretin-cerulein test) and digestive [serum and urinary p-aminobenzoic acid (PABA) and pancreolauryl] capacity. When FCT values were severely reduced (below 6.7 U/g), from 90 to 100% of the patients also presented abnormal pancreatic secretory and digestive capacity. On the other hand, 87% of the patients with normal FCT (above 20 U/g) presented normal secretory and digestive capacity. Patients with intermediate FCT values (between 6.7 and 20 U/g) showed normal or abnormal pancreatic secretory and digestive capacity with the same probability. Therefore, FCT, carried out as a first test, seems to identify subjects that need no further pancreatic function tests (normal and severely impaired FCT) and patients who need other more complex functional investigations (intermediate FCT values).

Biomarkers↗