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KMID : 0371319720140060001
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Journal of the Korean Surgical Society
1972 Volume.14 No. 6 p.1 ~ p.7
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The Clinical Significance of Changes in Duodenal Aspirate Enzymes in Biliary and Pancreatic Disease
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Abstract
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The object of this study was to compare the effects of duodenal stimulation using secretin, pancreo
zymin and the effect of heparin in sex controls and five patients with biliary or pancreatic disease.
Measurements were made of the duodenal aspirate for amulase, lipase and trypsin as cholate and
bilirubin.
Studies were made on six control persons who were thought to have normal biliaty and pancreatic
function. Two patients with cholelithiasis, two with chronic relapsing pancreatitis, and one with acute
pancreatitis were selected for special study.
All subjects were examined in the fasting state after having been on normal diets. Under fluoros
copic contril a Rehfuss tube was placed in the duodenum and a Levin tube in the stomach. Specimens
were aspirated from each tube at ten minute intervals.
After the duodenal aspirate become crystal clear the secretions were collected continuously over a ten
minute period. Then pancreozymin was injected intravenously, followed other drugs. In each case test
samples were withdrawn every ten minute.
The following measurements were performed:
1. Amylase by Nelson´s method (1944)
2. Lipase by Cherry and Crandall method (1932)
3. Trypsin by Anson´s method (1938)
4. Bilirubin by the modified White´s method (1958)
5. Cholate by Irvin et al. method (1944)
The results can be summaried as follows: (See TableⅠ)
1. In control group:
Volume 2.4㎖/㎏
Amylase 236.5m./㏄
Lipase 28.1㎖/㏄
Trypsin 20.5㎎/㏄
Cholate 50.3㎎/100㏄
Bilirubin 10.4㎎/100㏄
2. In cholelithiasis the enzymatic changes in the duodenal aspirate were similar. However, the cholate
was 31.5㎎/100㏄ and the bilirubin also decreased to 5.1㎎/100㏄.
3. In chronic relapsing pancreatitis the volume of duodenal aspirate was markedly decreased to 1.5
㎖/㎏.
The enzymes were also decreased to:
Amylase 51.7㎖/㎏
Lipase 10.9㎖/㏄
Trypsin 13.8㎎/㏄
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