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Query: KEGG:D02003 (NBT)
 1,323 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe and evaluate two frequently used indirect methods for assessing exocrine pancreatic function: the N-benzoyl-L-tyrosyl-p-aminobenzoic acid test (NBT-PABA) and the pancreolauryl test. In both procedures, the patient is orally administered a substrate that is metabolized into two or more products by pancreatic enzymes. At least one of the reaction products is absorbed from the gut, conjugated, and excreted in urine, where it can be measured. Both tests can be used in the diagnosis and monitoring of cystic fibrosis, chronic pancreatitis, and pancreatic carcinoma, and in monitoring pancreatic enzyme replacement therapy to determine the appropriate dose. In comparison with the NBT-PABA procedure, the pancreolauryl test seems to have better specificity and sensitivity, undergoes almost no interference from other drugs or serum compounds, requires no complex hydrolytic conditions, and is independent of renal function.
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PMID:Two indirect tests of exocrine pancreatic function evaluated. 354 96

An investigation of fecal chymotrypsin activity on spot fecal specimens was carried out in three groups of subjects, divided as follows: 45 healthy controls (group C); 36 patients with gastroenterological diseases of extrapancreatic origin (group VP); and 42 patients with chronic pancreatitis (group CP). Nineteen patients of group CP underwent pancreozymin-secretin and NBT-PABA tests. The following results, expressed as mg of chymotrypsin/g of feces, were obtained: C = 0.610 +/- 0.203; CP = 0.291 +/- 0.154, p less than 0.001; VP = 0.560 +/- 0.234. FCT showed a sensitivity rate of 78.5% and a specificity rate of 71.6%. The fecal output of chymotrypsin correlated well with the pancreatic secretion of chymotrypsin (r = 0.59, p less than 0.01) and with the percentage of recovery of urinary PABA (r = 0.44, p less than 0.05). We conclude that chymotrypsin assay by the described method on spot stool specimens is a simple, reliable technique which may be considered a good screening test for pancreatic insufficiency. The test will not detect minimal pancreatic disease or minimal pancreatic dysfunction.
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PMID:A single-specimen fecal chymotrypsin test in the diagnosis of pancreatic insufficiency: correlation with secretin-cholecystokinin and NBT-PABA tests. 633 29

The changes in the residual function of the exocrine pancreas before and after the operation for chronic pancreatitis were examined with N-benzoyl-L-tyrosyl-p-aminobenzoic acid (NBT-PABA test) in 15 patients. The results of the NBT-PABA test classified by the surgical formula proved that no significant difference was found between the pancreatectomized group (pancreaticoduodenectomy and distal pancreatectomy) and the decompression group (pancreatojejunostomy and transduodenal exploration of the pancreatic duct), and no improvement on the outcome of the postoperative NBT-PABA test, as compared with the outcome of the preoperative test, was noted in both groups. When the state of the fibrosis of the pancreas was classified by the grade for comparison, it was observed that the outcome of the NBT-PABA test of grade 1, in which little fibrosis was made, was better than the outcome of the test of grade 3 before operation (p less than 0.01) and after operation (p less than 0.01). In each of the grades, however, no difference was found between the outcome of the preoperative NBT-PABA test, and that of the postoperative test. It was presumed from these findings that the residual function of the exocrine pancreas after operation was dependent largely on the degree of pancreatic fibrosis at operation.
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PMID:Residual function of exocrine pancreas after operation for chronic pancreatitis by N-benzoyl-L-tyrosyl-p-aminobenzoic acid test (NBT-PABA test). 633 64

The NBT-PABA test, an oral pancreatic function test, was performed in 67 patients with proven chronic pancreatitis (secretin pancreozymin test or intraoperatively) and was pathological in 60 (89.6%). Prolongation of urinary collection period from 6 to 9 hours did not improve the diagnostic value. In comparison with the NBT-PABA test the sensitivity of trypsin and chymotrypsin determination in stool was 40.6% and 62.2%, respectively. In severe exocrine pancreatic insufficiency when pathological fecal fat excretion was demonstrable (steathorrhea) the accuracy of fecal enzyme determination was clearly higher (59.1% and 91.8%, respectively). Thus the NBT-PABA test is an alternative diagnostic tool for exocrine pancreatic insufficiency when the secretin-pancreozymin test, and fecal enzyme and fecal fat determination are too complicated. However, as intact absorption of NBT-PABA is possible, the test only provides a qualitative and limited quantitative evaluation of pancreatic function.
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PMID:[The NBT-PABA test in the diagnosis of exocrine pancreatic insufficiency (author's transl)]. 696 54

Plasma concentrations and urinary excretion of para-aminobenzoic acid (PABA) were measured over a 6-hour period after administration of N-benzoil L-tyrosyl aminobenzoic acid (NBT-PABA) to 15 patients with chronic pancreatitis and 15 controls. The sum of plasma PABA concentrations at 1 hour and 2 hours was calculated for each subject. The resulting value proved to have a specificity of 100% and a sensitivity of 80%, as opposed to 86% and 67% respectively for urinary concentrations.
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PMID:[The PABA test in chronic pancreatitis: value of plasma para-amino benzoic acid determinations (author's transl)]. 697 62

The comparative sensitivity of 4 tubeless pancreatic function tests was evaluated in 125 patients with proved chronic pancreatitis associated with various degrees of pancreatic insufficiency. NBT-PABA, immunoreactive trypsin (IRT), and pancreatic isoamylase (P-iso) were studied in relation to the fecal chymotrypsin test (FCT) and steatorrhea. In advanced insufficiency (steatorrhea or FCT less than 20 micrograms/g) PABA, IRT, and P-iso were pathologically low in only 70-85% of patients. In less severe pancreatic insufficiency (FCT 21-120 micrograms/g) these tests yielded pathological results in 35-53% of patients. Thus the sensitivity of the three tests was comparable and rather low. IRT values (and P-iso) were constantly low or progressively decreasing in 64% of patients (30/47) studied repeatedly over an average of 17 months. The serum enzyme tests seem, therefore, to be valuable for monitoring pancreatic insufficiency, like the FCT. This is particularly important for the differential diagnosis of acute (reversible) and chronic (progressive) pancreatitis.
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PMID:Comparative diagnostic accuracy of four tubeless pancreatic function tests in chronic pancreatitis. 698 71

Two noninvasive tests for assessing pancreatic exocrine function, the cholesteryl-[14C]octanoate breath test and the HPLCN-benzoyl-tyrosyl-p-aminobenzoic acid/p-aminosalicylic acid (NBT-PABA/PAS) test, were simultaneously performed in nine patients with pancreatic exocrine insufficiency due to chronic pancreatitis and in nine healthy volunteers. 14CO2 output in breath and plasma PABA concentration rose slowly in patients but increased rapidly in healthy subjects. The measurement time giving the best discrimination between both groups was 120 min for the cholesteryl-[14C]octanoate breath test and 90 min for the plasma PABA test. At these points, both single-sample tests had essentially identical diagnostic sensitivity. The diagnostic sensitivities of the two single-sample tests were equal to that of the cumulative 6-h urinary PABA recovery and the cumulative 6-h urinary PABA/PAS ratio. We conclude that, for both the cholesteryl-[14C]octanoate breath test and the plasma PABA test, a single test sample is sufficient for rapid detection of impaired exocrine pancreatic function.
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PMID:Simultaneous assessments of exocrine pancreatic function by cholesteryl-[14C]octanoate breath test and measurement of plasma p-aminobenzoic acid. 772 Feb 53

Three-dimensional magnetic resonance cholangiopancreatography is currently the most exciting new imaging technique for chronic pancreatitis. Endoscopy-assisted duodenal intubation during the secretin-cholecystokinin test reduces intubation time in difficult cases. The NBT-para-amino benzoic acid test has been refined to enhance its discriminant power. The cholesteryl-[C13]octanoate breath test and the faecal elastase test are newer highly sensitive and specific tubeless tests. Pain in chronic pancreatitis continues to be a vexing therapeutic issue. Enzyme treatment continues despite criticism. Neurotensin is the new suspected mediator of the feedback mechanism, which is downregulated by enzyme therapy. Steroid ganglion block is an exciting therapeutic tool for pain relief. Endoscopic pancreatic sphincterotomy, Dormia basketing and pancreatic stenting in conjunction with extracorporeal shock wave lithotripsy should be performed early in chronic pancreatitis to prevent parenchymal atrophy with ensuing exocrine and endocrine pancreatic dysfunction. The modified Puestow's procedure preserves endocrine and exocrine pancreatic functions besides relieving pain. Closed loop insulin infusion allows superior management of pancreatic diabetes following near total pancreatectomy. The standardised incidence rate of pancreatic cancer is 16.5 in patients with alcoholic chronic pancreatitis and 100 for tropical chronic pancreatitis. Aggressive treatment protocols combining neo-adjuvant chemoradiation and intra-operative radiation with surgery are being used to improve the prognosis in this dismal complication of chronic pancreatitis.
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PMID:Chronic pancreatitis: diagnosis and treatment. 875 8

The aim of the presented study was a comparative evaluation of the three indirect pancreatic function tests: pancreolauryl-test (PLT), NBT-PABA test and faecal chymotrypsin (CH) efficacy in detecting pancreatic exocrine function impairment in advanced chronic pancreatitis (acp). 30 patients with severe chronic pancreatitis (marked structure changes in ultrasound and CT following Cambridge criteria) confirmed by abnormal secretin-cerulein test (SCT) and 10 healthy controls underwent PLT, NBT-PABA and CH tests. The degree of pancreatic function impairment in SCT was classified following Malfertheiner into 3 subgroups: 1-mild, 2-moderate and 3-severe. All the indirect pancreatic function test were performed using commercially available kits (Temmler-Werke for PLT, Hoffman-La Roche for NBT-PABA and Boehringer Mannheim for CH) according to manufacturer instructions. PLT revealed changes in 27 (0.9), NBT-PABA-in 25 (0.83) and CH-in 22 (0.73) patients with acp. On the other hand those test have shown normal pancreatic function: PLT-in 0.9, NBT-PABA-in 0.7 and CH-in 0.8 in control group. The sensitivity of those test was increased up to 0.94 (PLT and NBT-PABA) and up to 0.88 (CH) and in the subgroup of severely impaired pancreatic function test in SCT. The concomittant use of two indirect pancreatic function tests caused increase of sensitivity up to 0.93. Our results suggest that with PLT, NBT-PABA and CH impaired pancreatic function may be succesfully recognized in advanced chronic pancreatitis, in particular, when two of them are applied concomittantly.
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PMID:[Comparison of three indirect pancreatic function tests in severe chronic pancreatitis--personal observations]. 883 25

It has been suggested that enteric-coated pancreatin microsphere (ECPM) preparations with sphere sizes larger than 1.7 mm pass through the stomach at a slower rate than a meal and therefore may be less efficacious in restoring pancreatic enzyme activity than preparations with smaller sphere sizes. The aim of this study was to investigate the gastric transit profile of a 2-mm ECPM preparation in relation to that of a solid meal and to simultaneously measure enzyme activities in eight patients with pancreatic exocrine insufficiency due to chronic pancreatitis. Gastric transit was assessed by double-isotope scintigraphy. A pancake was labeled with 99mTc. A 2-mm ECPM preparation was labeled with 171Er. Intraluminal pancreatic enzyme activities were assessed during a 6-hr period with the cholesteryl-[14C]octanoate breath test (for carboxyl ester lipase activity) and the N-benzoyl-L-tyrosyl-p-aminobenzoic acid/p-aminosalicylic acid (NBT-PABA/PAS) test (for chymotrypsin activity). The ECPM preparation passed through the stomach more rapidly (median 24 min) than the pancake (median 52 min, P < 0.05). During ECPM therapy, mean cumulative 14CO2 outputs rose significantly from 30% to 70% (P < 0.05), but remained below outcomes in healthy volunteers. Mean cumulative plasma PABA concentrations rose significantly from 46% to 87% (P < 0.05) and were not significantly different from outcomes in healthy volunteers. In chronic pancreatitis, a 2-mm ECPM preparation does not pass through the stomach more slowly than a solid meal, but in fact faster. Digestion of ester lipids and proteins showed an improvement to subnormal and normal levels, respectively.
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PMID:Gastric transit and pharmacodynamics of a two-millimeter enteric-coated pancreatin microsphere preparation in patients with chronic pancreatitis. 950 26


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