Akira Wakabayashi

The behavior of mucopolysaccharide in the pancreatic juice in chronic pancreatitis

In order to study whether or not mucosubstance increases occur in the pancreatic juice of patients with chronic pancreatitis, hexosamine was measured in duodenal aspirates during the secretin phase (S-40) following pancreozymin-secretin stimulation in 16 normal subjects, 37 patients with chronic pancreatitis,6 patients with alcoholism, 13 patients with gallstones, and 11 patients with peptic ulcer. The hexosamine concentrations in the pancreatic secretions showed a negative correlation with the bicarbonate concentrations and volume output. Rises in hexosamine concentration were seen in alcoholism and chronic pancreatitis, especially in alcoholic pancreatitis. This is probably intimately related with the repeated ingestion of large amounts of alcohol over long periods of time. Since high hexosamine values are noted in the relapsing type of chronic alcoholic pancreatitis, increases in viscosity due to mucosubstance increases in the pancreatic juice are probably related with the recurrence of acute attacks accompanying ductal stenosis or obstruction.

Serum amylase isozyme changes in chronic pancreatitis and their clincal significance

SummaryThe diagnostic usefulness of serum amylase isozyme measurement was investigated in 17 cases of definite chronic pancreatitis and 13 cases of suspected chronic pancreatitis, a total of 30 cases.Six types of serum isoamylase patterns were distinguished according to the character of the two main amylase activities at the fractions of fast-y globulin and pre-γ globulin.The amylase activity at the fast-γ fraction rises in acute exacerbation, and falls in cases of chronic calcifying pancreatitis and in cases with a marked decrease in pancreatic exocrine function. Especially, a fall in fast-γ amylase activity excellently reflects a decrease in pancreatic enzyme production. The measurement of amylase activity at the fast-γ fraction therefore appears to be a useful method for assessing pancreatic damage. The significance of a frequent rise in pre-γ amylase activity in chronic pancreatitis remains unknown.

Serum amylase isozymes in patients with chronic pancreatitis with hyperamylasemia.

SummaryIn order to clarify the relationship between hyperamylasemia and clinical states in chronic pancreatitis, serum amylase isozymes were studied in 39 cases of chronic pancreatitis including 13 cases of alcoholic pancreatitis.Hyperamylasemia in chronic pancreatitis is generally due to high pancreatic type isoamylase (P-amylase) activity in acute exacerbation, sometimes accompanied by a transient elevation in salivary type isoamylase (S-amylase). On remission, however, hyperamylasemia due to high S-amylase activity has been found. These were cases of advanced alcoholic pancreatitis, which exhibited a characteristic pattern of low serum P-amylase and high serum S-amylase activities while the clearance ratio (Cam/Ccr) was normal despite high S-amylase activity.It should be noted that hyperamylasemia in chronic pancreatitis may be caused by high S-amylase activity in addition to high P-amylase activity, especially in alcoholic pancreatitis.

Comparison of pancreatic dysfunction in chronic alcoholic pancreatitis and chronic gallstone pancreatitis.

SummaryComparative assessments of the endocrine and exocrine functions of the pancreas associated with gallstone pancreatitis or alcoholic pancreatitis were performed in a series of 86 patients, 20 with cholelithiasis, 12 with chronic alcoholism, 24 with chronic gallstone pancreatitis and 30 with chronic alcoholic pancreatitis and 32 healthy subjects were served as controls.The patients with cholelithiasis showed exocrine hypersecretion of the pancreas. In the patients with gallstone pancreatitis, all the assessed parameters of exocrine function were depressed.On the other hand, no pancreatic exocrine dysfunction was dispalyed in cases with chronic alcoholism. In the non-calcifying alcoholic pancreatitis, both the volume output and the maximum concentration and output of bicarbonate were diminished but depression in amylase output was not seen. All these parameters were lowered in patients with calcifying pancreatitis.Elevation of hexosamine concentration in the pancreatic juice was evident in alcoholic pancreatitis as compared with gallstone pancreatitis, being particularly prominent in cases of non-calcifying pancreatitis. Patients with alcoholic pancreatitis were observed to secrete viscous pancreatic juice richer in amylase and hexosamine content, than those in the patients with gallstone pancreatitis.Endocrine dysfunction of the pancreas is more frequent and intense in alcoholic pancreatitis than in gallstone pancreatitis.

Proceedings of the 23rd Autumn Meeting from October 14–16, 1981-Yonago City, Tottori, Japan

The methodology currently used in the field of physiology of intestinal absorption was reviewed and important progresses in our knowledge of mechanisms of intestinal absorption brought about by introduction of new methods were also summarized. The physiological methods currently employed can cover a broad range of investigations from those at an organ level, e.g. perfusion of intestinal segments, to those at a molecular level, e.g. transport studies in reconstituted systems with purified membrane proteins. By these methods, Na +-dependent mechanism of uphill uptake of various organic solutes and electrolytes across the brush border membrane have been largely clarified and active transport of various solutes is now explained on the basis of the concept of the secondary active transport. The mechanism of exit of solutes from the enterocytes have also been investigated in isolated cell suspensions and purified basolateral membrane vesicles, and some carriers responsible for the exit have been characterized. The charge transfer associated with organic solute transport has been studied by electrophysiological techniques. These studies indicate that organic solutes induce a Na + pathway and resultant Na + flow across the membrane causes a coupled flow of the cosubstrate. A relatively new problem is the transport of small peptides in intact form. Its physiological significance, comparative and developmental aspects are now under investigation in several laboratories. Vira l hepatitismRecent advances of its fundamental research