摘要:

Cholecystokinin (CCK) is known to inhibit gastric acid secretion and gastric emptying but its physiological role in the inhibition of gastric functions is not settled. In this study performed on 16 young male subjects, gastric acid secretion and emptying rate were determined after intragastric administration of 8 % peptone meal alone or in combination with intravenous infusion of graded doses of CCK-8 (5–80 pmol/kg·h) or with addition of vegetable oil to meal without or with pretreatment with loxiglumide, a specific CCK antagonist. CCK-8 infusion at lower dose (5 pmol/kg·h) was ineffective but at higher doses (20–80 pmol/kg·h) it resulted in a significant reduction in acid output by 39 and 43 % and a decrease in gastric emptying from 54% to 40 and 22%, respectively. Pretreatment with loxiglumide abolished almost completely the inhibition of both gastric acid and gastric emptying by CCK-8. Fat added to peptone meal reduced gastric acid secretion by 42–65% and decreased gastric emptying to 24–32%. The pretreatment with loxiglumide tended to reduce fat-induced inhibition of gastric acid secretion and gastric emptying but the difference in the inhibition of gastric functions between the tests without and with loxiglumide was not significant. This study provides evidence that exogenous CCK administered at pharmacological doses is a potent inhibitor of gastric acid secretion and gastric emptying and probably acts via specific CCK receptors. In contrast, fat induces inhibition of gastric acid secretion and gastric emptying that cannot be fully attributed to hormonally

ISSN:0012-2823    

DOI:10.1159/000200218

出版商:S. Karger AG    

年代:1990

数据来源: Karger

ISSN:0012-2823    

DOI:10.1159/000200253

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Ten patients with various metastatic pancreatic tumours have received Sandostatin (octreotide) for up to 5 years, initially 50 μg t.i.d. subcutaneously but increased over 6–12 months to 500 μg t.i.d. Three patients showed no biochemical or clinical response to Sandostatin. In the remaining patients, treatment was extremely effective: tumour secretions fell by nearly 60% and clinical symptoms improved or resolved in all. At 5–6 months, all patients showed worsening symptoms and rising hormonal concentrations. Although relapses were initially responsive to Sandostatin (at 500 μg t.i.d.), patients eventually became unresponsive to all therapies, and all died within 6 months of the development of this resistive phase. Side effects were minimal and long-term therapy was well tolerated. Steatorrhoea and the development of gallstones were not ob

ISSN:0012-2823    

DOI:10.1159/000200254

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The role of endogenous prostaglandins as modulators of antral hormone release and gastric acid secretion was studied in the intact human stomach. The subjects (n = 9) received indomethacin prior to gastric perfusion at pH > 7 or 7 to < 2 increased twofold the basal plasma levels of somatostatin (p < 0.05) and suppressed basal and vagally stimulated gastrin release (p < 0.05) and gastric acid secretion (p < 0.05). Indomethacin prior to acidification had little effect in the basal state. Following stimulation the release of somatostatin increased, as indicated by a twofold elevation of somatostatinlike immunoreactivity in the gastric lumen (p < 0.05), but there was less inhibition of plasma gastrin (p < 0.05) and gastric acid secretion (p < 0.05) as compared to acidification alone. During alkaline gastric perfusion, indomethacin increased circulating somatostatin (p < 0.05) levels without affecting plasma gastrin or gastric acid. Indomethacin given against intravenously infused somatostatin (0.1 μg•kg-1·h-1) partially reversed the inhibited gastrin response to vagal stimulation without affecting somatostatin-suppressed gastric acid secretion. The effects of indomethacin against pentagastrin were marginal. In conclusion: Gastric acidification in man stimulates plasma release of somatostatin in parallel to suppressing gastrin release and gastric acid secretion. Endogenous prostanoids participate to regulate antral hormone interactions and may have dual actions on antral somatostatin, as negative modulators of release and as mediators of somatostatin effects on the gastrin cell. It is suggested that an unrestricted release of antral somatostatin is reflected in the gastric lumen rather than in the circulat

ISSN:0012-2823    

DOI:10.1159/000200219

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Twenty-four patients with 26 apudomas have been treated with Sandostatin (octreotide) in Belfast. The 2 patients with vipoma showed an excellent response clinically and biochemically. Of 15 patients with carcinoids, Sandostatin improved the diarrhoea in 70%, flush in 58%, and wheeze in 100% of patients. Patients with insulinoma and the Zollinger-Ellison syndrome were unresponsive to Sandostatin. In general, the response to Sandostatin appeared to decline as the tumour size increased and tumour markers rose. Side effects have not been a problem.

ISSN:0012-2823    

DOI:10.1159/000200255

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The incidence, presentation, and treatment strategies of abdominal carcinoid tumours are discussed. In the Trent Region of the UK, carcinoid tumours have an incidence of 0.7 cases/100 000 population. The small bowel is the commonest site (36%) followed by the lung (22%) and appendix (13%). Analysis of the presenting symptoms and signs in 24 cases of small bowel cancer demonstrated diarrhoea in 17, pain in 17, and flushing in 12. Treatment strategies comprise surgery and drug therapy. Sandostatin has a role in preventing the release of pharmacologically active tumour products. A long-term trial of Sandostatin in patients with carcinoid syndrome is underway. Experience to date indicates Sandostatin is indicated: where surgery and drugs (cyproheptadine and codeine phosphate) in combination have failed to control symptoms; where the patient is unfit for surgery; and to cover anaesthesia and surgery as prophylaxis against the risks of carcinoid crisis.

ISSN:0012-2823    

DOI:10.1159/000200256

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The antacid ES Riopan was acidified ex vivo to pH 2.5 to completely eliminate its buffering capacity and was then tested as a mucosal protective agent. The pH 2.5 acidified antacid solution was named activated aluminum complex. Activated aluminum complex was 8.2 times more potent than its parent antacid in protecting against acidified aspirin-induced gastric lesions in the rat. Activated aluminum complex had a duration of action greater than 10 h in the ethanol-induced gastric lesion model, while ES Riopan was active for 6 h. Activated aluminum complex was able to inhibit both acid- and nonacid-mediated ulcers in the stomach and intestine. Its mucosal protective activity was not blocked by pre-treatment with indomethacin. These results demonstrate that the nonbuffering antacid activated aluminum complex exerted a more potent and longer-lasting mucosal protective activity than its parent antacid. The activity was probably due to the presence of a hexaaquoaluminum cation and supports the argument that antacids possess mucosal protective effects independent of their acid-neutralizing capacity.

ISSN:0012-2823    

DOI:10.1159/000200220

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Twenty-two patients with moderate to severe carcinoid syndrome received Sandostatin in doses ranging from 50 to 500 μg b.i.d. subcutaneously in addition to their usual drug therapies. Symptoms were reported improved in 60% of patients following a test period of Sandostatin. Lack of effect was observed in 5 patients and a lethal complication (obstructing intestinal tumour) occurred in 1. Of 13 patients who received Sandostatin for 3–36 months, 9 remain under control; 3 patients died – 1 from carcinoid spread and the other 2 from unrelated causes. Side effects have been few and mild. In summary, Sandostatin is a valuable agent in the management of carcinoid synd

ISSN:0012-2823    

DOI:10.1159/000200257

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Twenty-four children with chronic active hepatitis due to hepatitis B virus (HBV) infection, who were positive for HBeAg and had increased levels of transaminases, were included in a controlled study of treatment using recombinant interferon-α (rIFN-α), 10 MU/m2 body surface, intramuscularly, 3 times a week over a period of 3 months. During therapy, a significant decrease in HBV-DNAp was observed in the 12 patients treated. By the end of therapy, the HBV-DNA had disappeared in 3 children, the same occurring in 1 child (33 % overall) during the course of the 4th month. By this time, all the controls remained with HBV replication markers (p < 0.05). The 4 treated patients who responded became HBeAg-negative, developing anti-HBe during the first 12 months after therapy. In the control group, the HBV-DNA disappeared in 3 children in the 7th month of follow-up. All of the children remained HBsAg-positive. The therapy with rIFN-α was well tolerated, secondary effects consisting of a flu-like syndrome and a slight decrease in leukocytes and platelets. At the second biopsy, 15 months after the beginning of therapy, a significant decrease in Knodell’s index of histological activity was observed in the responders. In the light of these results and since treated children lost viral replication markers in a shorter period of time than the controls, who seroconverted spontaneously, we consider that rIFN-α may be useful in the treatment of chronic heptitis B in chil

ISSN:0012-2823    

DOI:10.1159/000200221

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Nine patients with persistent hyperinsulinaemic hypoglycaemia of infancy (PHHI), aged 3 days to 11 months, received octreotide therapy at a dose of 5–10 μg s.c. every 4–8 h according to glucose response. The response to octreotide was variable and unpredictable. Two patients could not be weaned off intravenous glucose and 2 others could be weaned off but required continuous nasogastric feedings. In the remaining 5 patients relatively normal feeding schedules were instituted. Long-term ambulatory treatment is an attractive alternative to surgery in such patients if the family can cope with the injections and dietary regimens. Although octreotide suppresses growth hormone secretion, all patients continue to grow during octreotide treat

ISSN:0012-2823    

DOI:10.1159/000200258

出版商:S. Karger AG    

年代:1990

数据来源: Karger