alpha-chymotrypsin and Intestinal-Diseases

In 96 consecutive patients who underwent a 72-h faecal fat determination because of suspected nutrient malassimilation (maldigestion and/or malabsorption) faecal chymotrypsin (F-Chym) was estimated with a commercial photometric test (Monotest Chymotrypsin), comparing F-Chym concentrations in the first 24-h stool with the total 72-h F-Chym output. In the first 24-h faeces, the F-Chym concentration, calculated as a mean of three random samples, did not significantly differ from a single value obtained after homogenization. In known pancreatic disease, a F-Chym concentration less than 3.0 U/g wet faeces distinguished well between steatorrhoic patients (n = 12) and nonsteatorrhoic (n = 13) (positive predictive value (PV), 91%; negative PV, 86%) but was less suitable as a screening test for pancreatic steatorrhoea in the unselected patient group (positive PV, 61%; negative PV, 98%). Although the estimation of 72-h F-Chym output could differentiate between various subgroups of patients to a certain extent, the positive PV for discovery of pancreatic steatorrhoea in a single patient was low. Four patients had excessively high F-Chym output and increased bile acid excretion after ileal resection (n = 3) and radiation ileitis (n = 1), respectively, possibly indicating the removal of an inhibitory mechanism of pancreatic and biliary secretion in these conditions.

Topics: Adult; Celiac Disease; Chymotrypsin; Exocrine Pancreatic Insufficiency; Feces; Female; Humans; Intestinal Diseases; Male; Middle Aged; Postgastrectomy Syndromes; Predictive Value of Tests; Sensitivity and Specificity; Weight Loss

Exocrine pancreatic insufficiency in the dog has been assessed by the oral administration of the synthetic peptide N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BT-PABA), a specific substrate for pancreatic chymotrypsin. The subsequent assay of PABA in either the plasma or the urine clearly differentiated control animals from those with exocrine pancreatic insufficiency (EPI), the results being unaffected by combination of this pancreatic function with a xylose absorption test. Possible interference with the specificity of the peptide test for the diagnosis of EPI was examined in six animals with small intestinal disease. In a group of four animals, with features resembling chronic tropical sprue in man, the results were comparable to those of the control group. In the fifth case, however, the results were indistinguishable from those of the EPI group, the estimation of sodium PABA absorption and the assay of proteolytic activity in the duodenal juice demonstrating that this was due to defective hydrolysis of the peptide. In the sixth case, diffuse intestinal lymphosarcoma and a marked villous atrophy were associated with an apparent reduction in the absorption of sodium PABA. However, although the plasma PABA concentrations following oral BT-PABA were subnormal, they were distinctly higher than those of the EPI group. These findings suggest that small intestinal abnormalities do not affect PABA absorption sufficiently to interfere with the specificity of the peptide test for the detection of severe EPI in the dog. This insufficiency may occasionally be secondary to small intestinal disease.

Topics: 4-Aminobenzoic Acid; Absorption; Aminobenzoates; Animals; Chymotrypsin; Dog Diseases; Dogs; Duodenum; Exocrine Pancreatic Insufficiency; Female; Intestinal Diseases; Intestinal Secretions; Lipid Metabolism; Male; Pancreatic Function Tests; para-Aminobenzoates; Trypsin; Xylose

The composition of serum seromucoid, the protein fraction of serum not precipitated by 0.6 M perchloric acid, has been shown to vary with the technique of preparation. Immunochemical examination revealed that 91.5% of the protein present in the seromucoid fraction of serum was alpha 1 acid glycoprotein, the remainder consisting of alpha 1 antitrypsin, alpha 1 antichymotrypsin, beta 2 glycoprotein, haemopexin, albumin, and pre-albumin. Serum alpha 1 acid glycoprotein concentration determined by radial immunodiffusion correlated well with serum seromucoid concentration although the former was usually 0.4 g/l lower. The determination of serum alpha 1 acid glycoprotein by an immunological method is more precise than the seromucoid method and is not subject to interference from other proteins.

Topics: Adolescent; Adult; Albumins; alpha 1-Antichymotrypsin; alpha 1-Antitrypsin; Chymotrypsin; Female; Hemopexin; Humans; Immunodiffusion; Immunoelectrophoresis; Inflammation; Intestinal Diseases; Male; Middle Aged; Orosomucoid; Prealbumin; Trypsin Inhibitors

Topics: Animals; Chymotrypsin; Dogs; Intestinal Diseases; Necrosis; Shock, Hemorrhagic; Trypsin Inhibitors

Topics: Celiac Disease; Cholesterol; Chromium; Chymotrypsin; Expert Testimony; Feces; Follow-Up Studies; Humans; Intestinal Diseases; Lipoproteins; Male; Middle Aged; Occupational Diseases; Pancreas; Pancreatic Diseases; Trypsin

Topics: Body Weight; Celiac Disease; Child, Preschool; Chymotrypsin; Cystic Fibrosis; Duodenum; Feces; Humans; Infant; Intestinal Diseases; Liver Diseases; Pancreas; Pancreatic Diseases; Time Factors

Topics: Adult; Aged; Breast Neoplasms; Carcinoma; Cholecystitis; Chymotrypsin; Colorimetry; Duodenal Ulcer; Female; Hepatitis; Humans; Intestinal Diseases; Liver Cirrhosis; Lung Diseases; Lung Diseases, Obstructive; Male; Middle Aged; Neoplasm Metastasis; Pancreatitis; Pregnancy; Respiratory Tract Infections; Trypsin Inhibitors

Topics: Chemical Phenomena; Chemistry; Chymotrypsin; Escherichia coli; Gastric Juice; Gastrointestinal Agents; Intestinal Diseases; Intestine, Small; Intrinsic Factor; Pepsin A; Trypsin; Vitamin B 12

The material comprises 25 patients with gluten-induced enteropathy and 16 patients with various intestinal disorders. The intestinal contents were aspirated in four subsequent periods of 20 minutes each after ingestion of a standard meal. The volume, pH, and the concentration of alpha-amylase, trypsin, chymotrypsin, and lipase were determined in the collections. Only minor deviations from normal pH-levels were observed. In both groups of patients, the secretion of lipase, and to a minor degree that of amylase, were more markedly reduced than the secretion of the proteolytic enzymes. With the exception of the values of trypsin, concentrations of enzymes were seen to be below the lowest normal value in approximately one-third of the patients throughout the period of digestion. It is concluded that the pancreatic function was genuinely reduced in several patients with enterogenous malabsorption. It may be explained as an unspecific effect of the malabsorption.

Topics: alpha-Amylases; Celiac Disease; Chymotrypsin; Digestion; Duodenum; Enzymes; Female; Humans; Hydrogen-Ion Concentration; Intestinal Diseases; Lipase; Male; Pancreas; Trypsin

Topics: Appendix; Body Fluids; Chemistry Techniques, Analytical; Chymotrypsin; Cysts; Enzyme Therapy; Exudates and Transudates; Female; Gelatin; Humans; Hyaluronoglucosaminidase; Intestinal Diseases; Mucocele; Ovary; Peritoneal Cavity; Peritoneum; Surgical Procedures, Operative; Trypsin