cholecystokinin and Peptic-Ulcer

Topics: Bicarbonates; Cholecystokinin; Duodenal Ulcer; Gastric Acid; Gastric Inhibitory Polypeptide; Gastrointestinal Hormones; Gastrointestinal Motility; Glucagon-Like Peptides; Humans; Pancreas; Pancreatic Polypeptide; Peptic Ulcer; Secretin; Somatostatin

Information concerning GEP hormones has progressively advanced since the initial discovery of a GEP hormone, secretin, in 1902. Studies in this area flourished with the advent of radioimmunoassay, and have provided an understanding of the secretion, regulation, metabolic actions, and role in certain diseases of major GEP hormones. Measurement of GEP hormones has achieved importance in clinical medicine and allowed understanding of the pathophysiology of several clinical disorders. The decade to come should witness additional advances in this rapidly expanding field.

Topics: Chemical Phenomena; Chemistry; Cholecystokinin; Diabetes Mellitus; Diarrhea; Endocrine System Diseases; Gastric Inhibitory Polypeptide; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Hypoglycemia; Motilin; Neoplasms; Neurotensin; Pancreatic Polypeptide; Peptic Ulcer; Secretin; Skin Diseases; Somatostatin; Substance P; Vasoactive Intestinal Peptide

Topics: APUD Cells; Cholecystokinin; Gastric Inhibitory Polypeptide; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Motilin; Pancreatic Polypeptide; Peptic Ulcer; Secretin; Somatostatin; Vasoactive Intestinal Peptide

Different types of vagotomy have been widely used in the treatment of peptic ulcer disease. A close relationship between the vagus nerve and the release or action of gastrointestinal hormones is necessary for the optimal activation of the gastrointestinal tract. The serum concentrations of the antral hormone gastrin are elevated after all types of vagotomy. The postvagotomy hypergastrinemia is due to the change in pH in the antral lumen or the gastric motility changes, both of which may lead to a proliferation of G cells. The reduction in pancreatic secretion after vagotomy is not due to changes in intestinal hormone release, but may be caused by the interruption of a postulated enteropancreatic reflex. Postprandial GIP release and serum insulin levels are not affected by vagotomy, but basal GIP levels are increased after vagotomy. Postprandial pancreatic polypeptide release is nearly abolished by vagotomy, but seems to normalize in the later postoperative course. These findings may be important for the interpretation of pathophysiologic changes after vagotomy.

Topics: Animals; Cholecystokinin; Dogs; Gastric Inhibitory Polypeptide; Gastrins; Gastrointestinal Hormones; Glucagon; Glucagon-Like Peptides; Humans; Insulin; Insulin Secretion; Pancreas; Pancreatic Polypeptide; Peptic Ulcer; Secretin; Somatostatin; Vagotomy

Topics: Animals; Calcium; Cholecystokinin; Duodenal Ulcer; Eating; Gastric Mucosa; Gastrins; Histamine; Humans; Islets of Langerhans; Pentagastrin; Pepsin A; Peptic Ulcer; Prostaglandins; Radioimmunoassay; Rats; Secretin; Vagus Nerve

Topics: Acetylcholine; Adrenal Cortex; Animals; Antacids; Anticoagulants; Carrageenan; Cholecystokinin; Duodenal Ulcer; Enzyme Activation; Gastric Acidity Determination; Gastric Mucosa; Humans; Hydrogen-Ion Concentration; Pepsin A; Pepsinogens; Peptic Ulcer; Secretin; Vagotomy; Vagus Nerve; Xanthines

Topics: Animals; Biogenic Amines; Carcinoid Tumor; Cholecystokinin; Chromaffin System; Diabetes Mellitus; Digestive System; Digestive System Physiological Phenomena; Gastric Juice; Gastrins; Gastrointestinal Hormones; Gastrointestinal Neoplasms; Glucagon; Humans; Insulin; Insulin Secretion; Intestines; Pancreas; Pancreatic Neoplasms; Peptic Ulcer; Secretin; Syndrome

Topics: Animals; Bicarbonates; Cholecystokinin; Dogs; Glucose; Humans; Insulin; Insulin Secretion; Islets of Langerhans; Microscopy, Electron; Pancreas; Pancreatic Diseases; Parasympathetic Nervous System; Peptic Ulcer; Secretin; Stomach Neoplasms; Vagotomy; Vagus Nerve

Topics: Animals; Autonomic Nervous System; Cholecystokinin; Dogs; Gastrectomy; Gastrins; Gastroenterostomy; Gastrointestinal Motility; Humans; Peptic Ulcer; Pylorus; Secretin; Vagotomy

This prospective study was undertaken to determine the effect of partial gastrectomy without vagotomy on postprandial gallbladder contraction and secretion of cholecystokinin (CCK) and pancreatic polypeptide (PP) in 22 peptic ulcer patients randomly assigned to either Billroth II (N = 11) or Roux-en-Y (N = 11) anastomosis. The patients were studied within two weeks before surgery and at six months postoperatively. After surgery basal gallbladder volumes were larger than preoperatively (P less than 0.02). Integrated postprandial gallbladder contraction was not significantly affected by gastrectomy, either in the patients with Billroth II anastomosis (2276 +/- 268 vs 1985 +/- 362%/60 min) or in those with Roux-en-Y anastomosis (2045 +/- 327 vs 2445 +/- 352%/60 min) when studied pre- and postoperatively, respectively. Similarly, integrated postprandial plasma CCK secretion was not significantly changed by either Billroth II gastrectomy (200 +/- 31 vs 166 +/- 21 pM/60 min) or Roux-en-Y gastrectomy (146 +/- 26 vs 147 +/- 12 pM/60 min). However, integrated postprandial PP secretion was significantly (P less than 0.05) lower after Billroth II gastrectomy (6.8 +/- 2.4 vs 2.2 +/- 1.0 nM/60 min), while the reduction in plasma PP after Roux-en-Y gastrectomy just failed to reach statistical significance (6.0 +/- 1.5 vs 3.4 +/- 0.9 nM/60 min). Similarly, the PP response, but not the gallbladder response, to an intravenous bolus injection of 1 IDU CCK/kg body weight was significantly decreased after gastrectomy independent of the type of anastomosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Anastomosis, Roux-en-Y; Cholecystokinin; Cholelithiasis; Female; Food; Gallbladder; Gastrectomy; Humans; Jejunum; Male; Middle Aged; Muscle Contraction; Pancreatic Polypeptide; Peptic Ulcer; Postoperative Complications; Postoperative Period; Prospective Studies; Random Allocation

Physiology of gastric acid secretion is one of the earliest subjects in medical research and education. Gastric acid secretion has been sometimes inadequately expressed as pH value rather than amount of gastric H(+) secreted per unit time. Gastric acid secretion is regulated by endocrine, paracrine and neurocrine signals via at least three messenger pathways: gastrin-histamine, CCK-somatostatin, and neural network. These pathways have been largely validated and further characterized by phenotyping a series of knockout mouse models. The complexity of gastric acid secretion is illustrated by both expected and unexpected phenotypes of altered acid secretion. For examples, in comparison with wild-type mice, gastrin and CCK double knockout and SSTR(2) knockout mice displayed a shift in the regulation of ECL cells from somatostatin-SSTR(2) pathway to galanin-Gal1 receptor pathway; a shift in the regulation of parietal cells from gastrin-histamine pathway to vagal pathway; and a shift in the CCK(2) receptors on parietal cells from functional silence to activation. The biological function of glycine-extended gastrin in synergizing gastrin-17 has been revealed in gastrin knockout mice. The roles of gastric acid secretion in tumorigenesis and ulceration have not been fully understood. Transgenic hypergastrinemic INS-GAS mice developed a spontaneous gastric cancer, which was associated with an impaired acid secretion. Gastrin knockout mice were still able to produce acid in response to vagal stimulation, especially after H. pylori infection. Taken together, phenotyping of a series of genetically engineered mouse models reveals a high degree of complexity of gastric acid secretion in both physiological and pathophysiological conditions.

Topics: Animals; Cholecystokinin; Gastric Acid; Gastrins; Gene Targeting; Helicobacter Infections; Helicobacter pylori; Humans; Mice; Mice, Knockout; Paracrine Communication; Peptic Ulcer; Receptors, Somatostatin; Stomach Neoplasms

We have studied the basal release of cholecystokinin (CCK) and the CCK response to gastrin-releasing peptide (GRP) in man. GRP infusion was followed by a substantial and immediate release of CCK. Pancreatico-duodenectomy or antrectomy with or without duodenal exclusion or antrectomy with truncal vagotomy did not significantly change the basal release of CCK or the GRP-induced CCK release. These results indicate that both basal and GRP-induced release of CCK predominantly originate from the small intestine below the duodenum and the upper part of the jejunum and is unchanged by duodenal exclusion and vagal denervation of the small intestine.

Topics: Cholecystokinin; Duodenum; Female; Gastrin-Releasing Peptide; Gastrointestinal Hormones; Humans; Infusions, Parenteral; Male; Middle Aged; Pancreas; Peptic Ulcer; Peptides; Pyloric Antrum; Vagotomy, Truncal

Course and prognosis of 125 patients with chronic pancreatitis (CP) were evaluated. Follow-up period ranged from 1-20 years with a median of 6.3 years. The following conclusions were obtained. Recent increase of CP in our clinics was ascribed to alcoholic CP and idiopathic CP in the aged. Of 106 patients with pain, 74 showed improvement or disappearance of pain. Drinking habit and observation period were the main factors determining the rate of pain relief. Serial endoscopic retrograde pancreatography (ERP) showed aggravation in 17/47 patients, cholecystokinin-pancreozymin (CCK-PZ) secretin test in 4/40 patients, and oral glucose tolerance test (OGTT) in 7/25 patients. Exocrine function showed improvement in five patients, whereas endocrine function showed none. Improvement or aggravation of exocrine function was closely related to drinking habit. Main complications included 15 cases of peptic ulcer, 19 of pancreatic pseudocyst, and 15 of bile duct stenosis. Twenty-six patients died, often due to malignant neoplasms and diabetic complications. Those who continued drinking as much showed a lower survival rate than those who discontinued or decreased alcohol intake. The socioeconomic status deteriorated often due to pain or alcoholism. Three patients had to degrade jobs and six fell into inactive social life.

Topics: Age Factors; Alcoholism; Calcinosis; Cholecystokinin; Chronic Disease; Female; Glucose Tolerance Test; Humans; Longitudinal Studies; Male; Pain; Pancreatitis; Peptic Ulcer; Prognosis; Quality of Life; Sex Factors

Topics: Adult; Cholecystokinin; Chronic Disease; Humans; Middle Aged; Narcotics; Nerve Block; Pain; Pain Management; Pancreas; Pancreatic Ducts; Pancreatic Extracts; Pancreatic Pseudocyst; Pancreatitis; Peptic Ulcer; Secretin

The present study was undertaken to determine whether bypassing the duodenum in patients with Billroth II gastrectomy affects plasma cholecystokinin (CCK) release in response to ingestion of fat. Plasma CCK concentrations were measured by radioimmunoassay using two antibodies; antibody 1703 binds to all carboxyl-terminal CCK-peptides containing at least 14 amino acid residues, while antibody T204 is specific for the sulphated tyrosine region of CCK. There were no significant differences among fasting plasma CCK concentrations in seven patients with Billroth II gastrectomy (1.3 +/- 0.4 fmol/ml, antibody 1703; 2.6 +/- 0.4 fmol/ml, antibody T204), six patients with Billroth I gastrectomy (0.6 +/- 0.3 fmol/ml, antibody 1703; 2.9 +/- 0.5 fmol/ml, antibody T204), and nine normal subjects (0.7 +/- 0.1 fmol/ml, antibody 1703; 1.9 +/- 0.3 fmol/ml, antibody T204). Ingestion of 250 ml 20% Intralipid induced similar increases in plasma CCK in patients with Billroth II gastrectomy (11.2 +/- 2.0 fmol/ml, antibody 1703; 10.1 +/- 2.4 fmol/ml, antibody T204) as in patients with Billroth I gastrectomy (11.8 +/- 2.0 fmol/ml, antibody 1703; 8.4 +/- 1.1 fmol/ml, antibody T204). However, the increments in plasma CCK in patients with gastrectomy (11.5 +/- 1.4 fmol/ml, antibody 1703; 9.3 +/- 1.4 fmol/ml, antibody T204) were significantly (p less than 0.01) greater than those in normal subjects (4.7 +/- 0.8 fmol/ml, antibody 1703; 4.1 +/- 0.7 fmol/ml). Similarly, the integrated plasma CCK secretion in patients with Billroth II gastrectomy (510 +/- 58 fmol/ml X 120 min, antibody 1703; 458 +/- 69 fmol/ml X 120 min, antibody T204) and in patients with Billroth I gastrectomy (457 +/- 143 fmol/ml X 120 min, antibody 1703; 365 +/- 61 fmol/ml X 120 min, antibody T204) were significantly (p less than 0.05) greater than in normal subjects (230 +/- 49 fmol/ml X 120 min, antibody 1703; 162 +/- 24 fmol/ml X 120 min, antibody T204). It is concluded that the plasma CCK response to oral fat is significantly greater in patients with partial gastrectomy than in normal subjects, and that patients with Billroth I and Billroth II gastrectomy have similar increases in plasma CCK after ingestion of fat.

Topics: Administration, Oral; Adult; Cholecystokinin; Fat Emulsions, Intravenous; Fats; Female; Gastrectomy; Humans; Male; Middle Aged; Peptic Ulcer; Radioimmunoassay; Time Factors

Topics: Adolescent; Adult; Aged; Aprotinin; Cholecystokinin; Duodenal Ulcer; Female; Humans; Male; Middle Aged; Peptic Ulcer; Stomach Ulcer; Trypsin

Unsoluble gastric mucus and gastric juice from 11 normal volunteers were separated by centrifugation and investigated for hemostatic properties. Unsoluble gastric mucus added to citrated blood shortened reaction time and increased duration of maximum amplitude of thrombelastographic recordings, indicating an acceleration of hemostatic processes. On the other hand gastric juice inhibited coagulation and enhanced fibrinolytic activities, as shown by thrombelastographic recordings, prothrombin time, partial thromboplastin time, and euglobulin lysis time. Unsoluble gastric mucus accelerated hemostasis even more after stimulation by secretin-pancreozymin, as evidenced by thrombelastographic recordings. Gastric juice of patients with duodenal ulcers showed a significant change of these parameters to the opposite after pentagastrin. We conclude, that stimulation respectively inhibition of HCl and proteases, following pentagastrin respectively secretin-pancreazymin may influence hemostatic properties of gastric juice and gastric mucus as well.

Topics: Blood Coagulation Tests; Cholecystokinin; Fibrinolysis; Gastric Juice; Hemostasis; Humans; Pentagastrin; Peptic Ulcer; Secretin; Solubility

Topics: Cholecystokinin; Gastrectomy; Humans; Peptic Ulcer; Peptic Ulcer Perforation; Trypsin Inhibitors; Vagotomy, Proximal Gastric

Topics: Cholecystokinin; Follow-Up Studies; Gastrectomy; Humans; Peptic Ulcer; Trypsin Inhibitors; Vagotomy, Proximal Gastric

Topics: Cholecystokinin; Chronic Disease; Humans; Pancreas; Pancreatic Juice; Pancreatitis; Peptic Ulcer; Stimulation, Chemical

Topics: Cholecystokinin; Gastric Inhibitory Polypeptide; Gastric Juice; Gastric Mucosa; Humans; Peptic Ulcer

Topics: Cholecystectomy; Cholecystokinin; Cholelithiasis; Duodenal Ulcer; Humans; Peptic Ulcer; Pylorus; Vagotomy

The availability of pure intestinal hormones and the development of radioimmunoassays for their measurement has expedited research into many aspects of gastrointestinal endocrinology. A complex balance evidently exists between the different intestinal hormones and also the rest of the endocrine system. Polyendocrinopathies have been described, and, so far, two diseases due to intestinal hormone excess (Zollinger-Ellison syndrome and the syndrome of watery diarrhea, hypokalemia and achlorhydria) elucidated. It seems likely that many more gastrointestinal endocrine diseases await discovery.

Topics: Cholecystokinin; Diagnosis, Differential; Diarrhea; Digestive System; Endocrine Glands; Esophagogastric Junction; Gastrins; Gastrointestinal Hormones; Humans; Hypoglycemia; Intestinal Diseases; Intestine, Large; Pancreas; Peptic Ulcer; Prostaglandins; Pylorus; Secretin; Syndrome; Zollinger-Ellison Syndrome

Topics: Cholecystokinin; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Intestinal Secretions; Peptic Ulcer; Secretin; Stomach

Topics: Celiac Disease; Cholecystokinin; Clinical Laboratory Techniques; Diarrhea; Feces; Gastric Juice; Gastric Mucosa; Hormones; Humans; Hydrogen-Ion Concentration; Intestine, Small; Jejunum; Pancreas; Peptic Ulcer; Secretin; Time Factors

Topics: Adult; Cholecystokinin; Duodenum; Female; Gastric Juice; Gastric Mucosa; Gastrointestinal Motility; Humans; Male; Middle Aged; Peptic Ulcer; Secretin; Stomach

Topics: Cholecystokinin; Cholelithiasis; Duodenal Ulcer; Esophageal Achalasia; Gastrins; Gastritis; Gastrointestinal Hormones; Humans; Pancreatic Diseases; Peptic Ulcer; Secretin; Stomach Neoplasms; Stomach Ulcer

Topics: Animals; Cholecystokinin; Duodenal Ulcer; Eating; Electric Stimulation; Gastric Juice; Gastrins; Gastrointestinal Hormones; Humans; Hydrogen-Ion Concentration; Parasympatholytics; Peptic Ulcer; Pyloric Antrum; Radioimmunoassay; Secretin; Secretory Rate; Stomach Ulcer; Vagus Nerve; Zollinger-Ellison Syndrome

Topics: Biliary Tract; Cholecystokinin; Gastrins; Gastrointestinal Hormones; Humans; Pancreas; Peptic Ulcer; Secretin; Stomach

Topics: Animals; Bile; Cats; Ceruletide; Cholecystokinin; Drug Synergism; Duodenal Ulcer; Gastric Acidity Determination; Gastric Fistula; Gastric Juice; Gastrins; Gastrointestinal Hormones; Infusions, Parenteral; Pancreatic Juice; Peptic Ulcer; Peptides

Topics: Cholecystokinin; Duodenal Ulcer; Duodenum; Gastric Juice; Gastric Mucosa; Gastrins; Gastrointestinal Hormones; Humans; Intestinal Secretions; Pepsin A; Peptic Ulcer; Secretin; Stomach Ulcer

Topics: Animals; Cats; Cholecystokinin; Depression, Chemical; Dogs; Gastric Juice; Gastrins; Humans; Pepsin A; Peptic Ulcer; Peptides; Pylorus; Secretin; Vagotomy

Topics: Adult; Amino Acid Sequence; Animals; Anura; Cholecystokinin; Female; Gastric Juice; Gastrins; Humans; Intubation, Gastrointestinal; Male; Peptic Ulcer; Peptides; Skin; Stimulation, Chemical; Stomach; Tissue Extracts

Topics: Animals; Anura; Cholecystokinin; Gastrins; Humans; Peptic Ulcer; Peptides; Skin; Tissue Extracts

Topics: Cholecystokinin; Gastric Acidity Determination; Gastritis; Humans; Pancreas; Pancreatitis; Peptic Ulcer; Secretin

Topics: Amylases; Animals; Cholecystokinin; Chymotrypsin; Digestion; Digestive System; Dogs; Gastrins; Humans; Intestinal Absorption; Lipase; Lipid Metabolism; Pancreas; Peptic Ulcer; Postoperative Complications; Proteins; Secretin; Trypsin; Vagotomy

Topics: Animals; Bicarbonates; Chlorides; Cholecystokinin; Depression, Chemical; Dogs; Liver; Mesenteric Veins; Pancreatic Juice; Peptic Ulcer; Secretin; Secretory Rate; Vena Cava, Inferior

Topics: Animals; Cholecystokinin; Dogs; Duodenum; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastroenterostomy; Humans; Peptic Ulcer; Secretin

Topics: Adult; Amylases; Carboxypeptidases; Cholecystokinin; Chymotrypsin; Gastrectomy; Humans; Lipase; Middle Aged; Pancreas; Peptic Ulcer; Secretin; Trypsin

Topics: Adult; Aged; Carcinoma; Cholecystography; Cholecystokinin; Duodenal Ulcer; Duodenum; Electrophoresis; Female; Gastrectomy; Humans; Male; Middle Aged; Pancreatectomy; Peptic Ulcer

Topics: Biliary Tract Diseases; Cholecystokinin; Gastrectomy; Humans; Peptic Ulcer; Postoperative Complications