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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Injuries to the pancreas and gastrointestinal tract following blunt abdominal trauma continue to be a significant cause of morbidity and mortality in the pediatric age group. Optimal treatment of these injuries is frequently hampered by considerable delays in diagnosis. Factors contributing to these delays include the location of much of the duodenum and the pancreas in the retroperitoneum resulting in an absence of initial symptoms and signs, the often trivial nature of some of the responsible blunt traumatic accidents, inappropriate child-parent or child-physician communication, failure to achieve a meaningful physical examination in uncooperative or unconscious patients, and false negative paracentesis. Eighty per cent of these injuries occurred in boys. Eleven of 16 patients with pancreatic trauma had pseudocysts. A persistently elevated serum amylase level was invariably noted and epigastric mass was palpable in eight patients. Significant delays in diagnosis were prevalent and pseudocysts was misdiagnosed as appendicitis in three cases. Internal drainage by cystgastrostomy or cystjejunostomy was effective operative treatment. In instances of acute pancreatic injuries, sump drains, gastrostomy, cholecystostomy, and total parenteral hyperalimentation were useful therapeutic adjuncts. There was one death for a 6.2 per cent mortality rate. Forty patients had gastrointestinal injuries involving the duodenum in 17, jejunum in 14, ileum in seven, and stomach in two. Perforations occured in 65 per cent of cases, obstructing hematomas in 30 per cent, and mesenteric avulsions in 5 per cent. Associated injuries were observed in 15 patients (37.5 per cent). Pain and tenderness were the only consistent findings. Upper gastrointestinal contrast studies were diagnostic of duodenal hematomas. Eighty per cent of perforations were managed by simple closures and 20 per cent by resection and anastomosis. Obstructing hematomas unassociated with other injuries may be expected to resolve without requiring operation in 50 per cent of patients managed conservatively. Complications occurred in 35 per cent of patients and the mortality rate was 12.5 per cent (five deaths).
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PMID:Pancreatic and gastrointestinal trauma in children. 112 20

Levels of amylase, trypsin, chymotrypsin, and lipase in the pancreas and small intestinal chyme were measured in females from four lines of chickens. Two of the lines had undergone 32 generations of divergent selection for 56-day body weight, and in the other two lines selection for high or low weight had been relaxed for 5 generations. The diet used in the present experiment was that under which selection had been practiced (20% crude protein and 2,685 kcal of ME/kg). Comparisons between divergently selected lines at common ages revealed higher enzyme levels for high- than low-weight lines. When comparisons were made at a common body weight (80 +/- 5 g) there were no differences between lines. These results suggested that correlated responses in feed intake were mediating the regulation of digestive enzyme levels in the pancreas and in intestinal chyme of growth-selected lines of chickens. Chicks from high-weight lines had elevated enzyme levels after a mild feed restriction compared with those provided ad libitum access to feed. It was hypothesized that hyperphagia associated with the high-weight lines in combination with a mild feed restriction and the associated meal feeding stimulated synthesis and secretion of digestive enzymes.
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PMID:Correlated responses in lines of chickens divergently selected for fifty-six-day body weight. 3. Digestive enzymes. 137 44

Ninety-one pancreatic injuries, 47 from blunt trauma, were reviewed with respect to management principles stressed in qi previous reviews. The pancreatic complication rate was 25%. Blunt injury was suspected preoperatively in only 30%. Even short-term observation led to morbidity. Operations done more than 6 hours after admission had a higher complication rate (45%) than those done less than 6 hours after admission (18%). Penrose drainage without a sump was not associated with increased complications. Distal pancreatectomy was done 32 times; splenectomy was done in only 18 patients. Individual duct ligation was rarely done and did not result in a high fistula rate. Pancreatic stump oversew with nonabsorbable suture was associated with a higher rate of pancreatic complications than absorbable suture (58% vs 30%). Only 56% of patients receiving distal pancreatectomy required hyperalimentation. Postoperative serum amylase values were not useful, and amylase values from drainage fluid predicted complications only when they were above 100,000 U/L. Details of pancreatic trauma management are less important than early operation in minimizing morbidity.
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PMID:Diagnosis and treatment of pancreatic injuries. An analysis of management principles. 169 47

An alteration in the serum elastase 1 level in a previously non-diabetic patient, who unfortunately developed the hyperosmolar hyperglycemic non-ketotic syndrome (HHNS), was observed after intravenous hyperalimentation for 6 days. The patient underwent the therapy because of the occurrence of severe persistent anorexia which appeared as a side effect of treatment of lung cancer with combined anticancer drugs. In parallel with progressive dehydration, levels of serum elastase 1 and urine glucose became greatly elevated at an earlier stage of HHNS. A slight increase in serum alpha 1-antitrypsin was observed. However, there were no significant changes in serum amylase activity and serum alpha 2-macroglobulin level before or during HHNS. The elevation of the serum elastase 1 level was considered to be due to serum electrolyte abnormalities and the defect of serum alpha 2-macro-globulin elevation. Rehydration therapy with half-normal saline solution immediately produced negative urine glucose, but the serum elastase 1 level only gradually normalized after improvement of HHNS.
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PMID:Significance of increased serum elastase 1 level during the hyperosmolar hyperglycemic non-ketotic syndrome. 244 40

A 39-year-old heavy drinker was admitted to Saga Medical School Hospital on February 21th, 1987. He had suffered from dyspnea, chest pain and lumbago three weeks prior to admission. His chest X-ray showed right hydropneumothorax and right lower lobe atelectasis and his CT scan showed a cystic lesion in the mediastinum. His laboratory data showed a high level of amylase in serum, urine and pleural effusion. A fistula connecting the pancreas to right pleural cavity was demonstrated by endoscopic retrograde cholangiopancreatography (ERCP). In addition, bronchoscopy showed complete obstruction of the right lower bronchus (B7). These bronchoscopic findings and hydropneumothorax on his chest X-ray suggested the leakage of pancreas juice through the pancreatico-pleural fistula injured the lung tissue directly and produced a bronchopleural fistula. In this case, hyperalimentation and drug therapy using protease inhibitor resulted in successful closure of the fistula and reexpansion of the collapsed lung.
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PMID:[A pancreatico-bronchial fistula with right hydropneumothorax]. 261 2

Despite the obese Zucker rat's hyperphagia on carbohydrate diets such as laboratory chow, this laboratory has found that its satiety response to glucose and other simple sugars is comparable to that of its lean control rat. To further investigate carbohydrate satiety in the Zucker rat, the short-term feeding behavior of obese and lean rats was observed following intragastric infusions (7.2 kcal in 10 ml) of corn starch and the starch hydrolysates Polycose and dextrin. There were no reliable between-genotype differences in the feeding inhibitory effects of Polycose and dextrin. However, in obese rats, the satiety effect of corn starch was delayed and reduced compared to that observed in lean rats (p less than 0.04). To modify the effect of corn starch, rats were administered 0.2 or 0.6 mg/infusion of the carbohydrate digestive inhibitor acarbose (Bay g 5421). Acarbose significantly reduced the satiety effect of corn starch in lean rats (p less than 0.001), and further attenuated satiety in obese rats (p less than 0.02). Since secretion of pancreatic amylase, the enzyme that initiates starch digestion, is decreased in obese rats, this result suggests that alterations of digestive and/or absorptive processes may underlie the obese rat's impaired satiety response to complex carbohydrate.
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PMID:Satiety in the obese Zucker rat: effects of carbohydrate type and acarbose (Bay g 5421). 262 81

Bulimia is an episodic compulsive urge to overeat often followed by recurrent attempts to lose weight by self-induced vomiting. Seven young women with this eating disorder and associated benign bilateral painless parotid enlargement are described. The glandular swelling was generally intermittent, with parotid enlargement usually developing 2 to 6 days after a binge overeating episode had stopped. Several had hypokalemic alkalosis and a moderate elevation in serum amylase levels. None had clinical evidence of pancreatitis, and a parotid gland biopsy in one patient was normal. The clinician should be alerted to the association of benign parotid enlargement with this syndrome.
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PMID:Benign parotid enlargement in bulimia. 616 Jul 96

The effect of feeding an alpha-amylase inhibitor (BAY e 4609, 700 mg/100 g food) for 20 or 90 days on the enzymes of the exocrine pancreas of the rat was investigated. The amylase inhibitor-fed rats gained significantly less weight despite a higher food intake than control rats on a standard diet. Fecal weight increased threefold. Pancreatic wet weight, pancreatic DNA, protein and insulin concentrations were not influenced. The amylase content of the pancreas was significantly diminished compared with controls. The trypsin level increased and the changes in the amount of lipase were not significant. Also in response to an infusion of 15 or 60 IU CCK/kg/h combined with 0.5 clinical units of secretin/kg/h amylase secretion was significantly diminished after both feeding periods compared with controls, while trypsin output increased as did the output of lipase to a lesser extent. The enzyme pattern of the pancreatic juice reverted to normal when the animals consumed the control diet again. Gut weight and length increased significantly in the experimental animals. It is concluded that the changes in the pancreatic enzymes are induced by altered food intake. The amylase inhibitor prevents the digestion of starch and by this carbohydrate absorption. As a consequence, hyperphagia develops resulting in an increased protein and fat intake. Unlike trypsin a negative feedback regulation does not exist between alpha-amylase concentration in the gut and pancreatic enzyme secretion.
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PMID:Influence of short- and long-term feeding of an alpha-amylase inhibitor (BAY e 4609) on the exocrine pancreas of the rat. 616 90

Rats fed either a low (2p. 100) or high (40 p. 100)-fat diet were exposed to 22 or 5 degrees C. The resulting hyperphagia adequately compensated energy losses as judged from body weight. The cold-induced hyperphagia was accompanied by a non-parallel increase in pancreatic hydrolases. Amylase and lipase were not increased above the adaptive levels they had respectively reached in the heat with a high-starch or high-lipid diet. Chymotrypsinogen, on the contrary, responded to increased intake of both diets. It also responded to the higher protein concentration in the high-fat diet caused by isocaloric replacement of starch by fat. Colipase varied independently of lipase and was increased additively by fat and protein intakes. Consequently, although limiting for lipase in the warm, colipase rose to a 1:1 ratio in the cold. Increased intake had a consistent pleiotropic effect evidenced by an increase of amylase with the high-fat diet and of lipase with the low-fat diet. The net effect was a significant increase in the lipid-digesting potential of the organism of lipid-fed animals upon exposure to cold, while the starch-digesting potential remained unaffected in starch-fed animals.
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PMID:Pancreatic hydrolases in cold-induced hyperphagia of rats fed a low or high-fat diet. 657 35

Acute and chronic experiments in adult mongrel dogs were performed to investigate the influences of a low residue diet (Group I) and an elemental diet (Group II) on pancreatic function. 1) In the acute experiment, intraduodenal administration of the low residue diet produced a significant increase in amylase output in pancreatic juice, while the elemental diet die not. 2) Intragastric administration of the low residue diet or elemental diet to conscious dogs showed little difference between the two groups regarding secretin and gastrin release, at the same pH. 3) Long term enteral hyperalimentation showed that it is the low residue diets which enhance pancreatic secretions. 4) In both groups, carbohydrate metabolism, liver function and electrolyte balance were satisfactorily maintained during long term enteral hyperalimentation and morphologic changes of the liver, pancreas and small intestine were not evident. 5) From the viewpoint of nutritional management, low residue diets should be prescribed in some cases of alimentary surgery.
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PMID:Effects of long term enteral hyperalimentation on pancreatic secretion in dogs. 677 30


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