In 11 juvenile diabetics and 13 control subjects, the secretin-pancreozymin test was performed. Duodenal-volume losses were corrected by use of radioactive vitamin B12 as marker substance. As compared to normal subjects, juvenile diabetics had significantly decreased pancreatic outputs of amylase, trypsin, chymotrypsin, and to a lesser degree, of bicarbonate. Clinical evidence of disease of the exocrine pancreas was missing. There was no discernible relationship between the abnormality of external pancreatic function and the duration of diabetes mellitus or the dose of insulin required. Possible factors that may be responsible for the exocrine deficiency of the pancreas in juvenile diabetics are discussed.
Carefully measured contrast medium instillation and generalized antibiotic prophylaxis lowered the post-ERCP pancreatitis rate from earlier values of 7.38°/o to present values of 1.3°/o. Additional administration of aprotinin and glucagon has no further prophylactic effects.
A new method is presented which allows quantitative pancreatic function test in patients with Billroth II resection. A lagerlöf tube and an endoscope with prograde optics is introduced without premedication and the tube placed into the afferent loop under visual control. The procedure was successfully applied in 12 patients in whom also retrograde pancreatography was tried. Comparison of the gained pancreatograms and the pancreatic secretion after secretin-pancreozymin stimulation showed that the function test is superior to radiology. Inactivity atrophy of the gland was not seen in healthy subjects.
Salivary, gastric, and pancreatic secretory responses to intravenous 13-norleucine-motilin (13-nle-motilin), a synthetic analog of motilin and biologically equivalent to the natural polypeptide, were studied in healthy volunteers. 13-nle-Motilin in doses of 100 ng/kg body wt/hr significantly stimulated gastric pepsin output, while H + secretion and serum gastrin levels remained unchanged. Enhanced pepsin secretion was not accompanied by an increase in gastric secretion of cyclic 3', 5'-adenosine monophosphate, nor did gastric mucosal levels of the cyclic nucleotide rise. A dose of 13-nle-motilin, which stimulated gastric pepsin output, did not exert any significant effect on salivary and pancreatic secretions.
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