ISSN:0257-2753    

DOI:10.1159/000171431

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

This article is a review of the historical, biochemical, and functional aspects of the enzyme diamine oxidase (DAO). The amine oxidase DAO, formerly called histaminase, is found in various tissues, but is especially active in the intestinal mucosa. Its function is the oxidative deaminating of several polyamines, essential substances for cell proliferation. DAO is thus a regulating enzyme in rapidly proliferating tissues such a bone marrow and intestinal mucosa. Results from several studies have demonstrated that both ornithine decarboxylase (ODC) and DAO activity rise during adaptive hyperplasia seen after small bowel resection. The ODC-dependent increase in polyamine content and subsequent increase in cell proliferative activity is probably downregulated locally in the villus tip by the increased DAO activity. DAO is normally present in very small amounts in the circulation and its basal plasma levels are positively correlated with the maturity and integrity of the intestinal mucosa. After intravenous administration of heparin, DAO is released from its capillary binding sites in the lamina propria into the peripheral circulation. Measurement of postheparin DAO release enhances its sensitivity and is now extensively studied to assess its value as follow-up or screening test for several enteropathies. Measuring basal as well as postheparin DAO levels has potential relevance following small bowel transplantation. Rejection of the small bowel graft leads to mucosal damage, which could conceivably lead to changes in DAO activity.

ISSN:0257-2753    

DOI:10.1159/000171432

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Luminal nutrition, hormonal factors and pancreatobiliary secretions are probably the major mediators of small intestinal adaptation. Their actions, as discussed in this paper, are likely to be interrelated. Direct local enterotrophic effects cannot account for all the actions of luminal nutrients. Additionally, hormonal factors have been shown to contribute to indirect effects of luminal nutrients and enteroglucagon is a likely mediator of adaptive responses. Furthermore, epidermal growth factor is a peptide for which there is convincing evidence of an enterotrophic action. Attention is drawn to the fact that pancreaticobiliary secretions may have a physiological role in stimulating small intestinal mucosal proliferation. Other factors may also influence small intestinal mucosal proliferation (e.g. prostaglandins, neurovascular mechanisms, bacteria). Additionally, polyamines are crucial in initiating cell division in the small intestine, but the detailed mechanisms of their action require further clarification. Finally, a number of therapeutic applications of small intestinal epithelial cell proliferation are discussed.

ISSN:0257-2753    

DOI:10.1159/000171433

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The digestive system is one of the major sources of nitric oxide, which, due to its smooth muscle-relaxing and vasodilating properties, appears to play a key role in the regulation of gastrointestinal motility, mucosal blood flow and gastroprotection. In addition nitric oxide takes part in the control of pancreatic secretion and liver functions. Recent studies suggest that the substance may be involved in the pathogenesis of achalasia, toxic megacolon, Hirschsprung’s disease and portal hypertensio

ISSN:0257-2753    

DOI:10.1159/000171434

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Prostaglandins protect the gastric mucosa by decreasing gastric acid secretion, increasing mucus and bicarbonate production and maintaining mucosal blood flow. Non-steroidal antiinflammatory drugs (NSAIDs) cause gastroduodenal damage and this is due, at least in part, to inhibition of mucosal prostaglandin production. Misoprostol is a synthetic analogue of prostaglandin E1 which has been used in the healing of ulcers and prevention of peptic ulcers in patients taking NSAIDs. Misoprostol is of equal efficacy to H2 antagonists in the healing of ordinary peptic ulcers (not associated with NSAIDs). Misoprostol is superior to placebo in healing NSAID ulcers during continued NSAID treatment but there have been no comparative trials with other ulcer-healing drugs. Misoprostol, H2 antagonists and sucralfate are of similar efficacy in prevention of NSAID-associated duodenal ulcers but misoprostol is more effective in prevention of gastric ulcers. Misoprostol has not been compared to omeprazole in this situation.

ISSN:0257-2753    

DOI:10.1159/000171435

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Hormonally mediated chronic refractory diarrhoeas constitute a rare but important group which often defy precise diagnosis when conventional routine diagnostic methods are used. Hormonal diarrhoea may occur in carcinoid syndrome, medullary carcinoma of the thyroid, thyrotoxicosis, gastrinoma, VIPoma, glucagonoma, somatostatinoma and systemic mastocytosis. Diagnosis of these conditions depends upon the awareness of clinicians, on clinical features and on documentations of high circulating hormones, if required, by using provocative tests. Precise localization of the tumours may be accomplished by ultrasonography, computerised axial tomography, angiography, percutaneous transhepatic portal and pancreatic venous sampling for the estimation of hormone concentrations. Benign tumours are removed surgically. Malignant neoplasms are treated either by surgery or chemotherapy depending upon the progress of the disease. Diarrhoea usually ceases when hormone levels are normalized following successful treatment.

ISSN:0257-2753    

DOI:10.1159/000171436

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Somatostatin and its long-acting analog octreotide (SMS 201-995) inhibit several gastrointestinal functions. Their effects have been studied in the treatment of small numbers of external pancreatic, intestinal and biliary fistulas. We treated 8 biliary, 4 pancreatic and 5 intestinal cutaneous fistulas with octreotide. Mean decreases in fistula output before octreotide treatment were not significant (p > 0.01 for each group). On the 1st day of octreotide treatment, mean fistula output decreased from 412 ± 60.4 to 234 ± 57.7 ml in the biliary, from 457.5 ± 57.5 to 217.5 ± 11.8 ml in the pancreatic and from 564 ± 49.2 to 217.5 ± 11.8 ml in the enterocutaneous fistula groups (p < 0.01 for each). No serious side effects were recorded. We conclude that octreotide is an important adjunct in the conservative treatment of external biliary, pancreatic and intestinal fistulas, by decreasing their o

ISSN:0257-2753    

DOI:10.1159/000171437

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0257-2753    

DOI:10.1159/000171438

出版商:S. Karger AG    

年代:1994

数据来源: Karger