Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01350 (gastrin)
 9,683 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the light of 24 cases, routine total gastrectomy in the treatment of Zollinger-Ellison's syndrome should be abandoned in favour of the removal of gastrin-secreting tissue. This treatment which gives just as good results on the ulcer disease, also has the advantage of removal of the tumour tissue malignant in almost 2/3 of cases. Removal of the gastrin secreting tissue thus becomes the operation of choice. Total gastrectomy remains a last resort operation if it proves impossible to find or remove the gastrinoma, or, if after removal of the original tumour, there occurs a relapse of the ulcers or spread of the neoplasm.
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PMID:[The removal of gastrin secreting tissue in the treatment of Zollinger-Ellison syndrome (author's transl)]. 32 22

Gastrinomas were localized by concurrent blood sampling in the hepatic vein and portal vein tributaries in 10 of 12 Zollinger-Ellison patients. In one patient, the portal vein could not be catheterized; in the other, a gastrin gradient could not be picked up in either of two examinations. Six of the patients were subsequently operated upon: 5 had pancreatoduodenal resection and 1 had laparotomy at which metastases were found. Four of the resections were probably curative as the patients have done well without treatment since with concentrations of gastrin in serum near zero. The observation period ranges from 17 to 20 mo. It is concluded that transhepatic catheterization of the hepatic vein and portal vein tributaries with blood sampling for gastrin determination permit the verification of the Zollinger-Ellison diagnosis and the localization of the gastrinomas. The latter may lead to the selection of a curative operative treatment in some of the patients.
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PMID:Localization of gastrinomas by transhepatic portal catheterization and gastrin assay. 45 40

Several gastrointestinal peptides with proven or suggested endocrine or paracrine functions influence gastric acid secretion, gastrointestinal motility, and mucosal blood flow. Increased or decreased release of such factors could participate in the pathogenesis of duodenal ulcer disease by inducing increased gastric acid concentration in the duodenal bulb. To date, increased stimulation of parietal cells by gastrin has been demonstrated only in patients with gastrinoma, G-cell hyperplasia, gastric outlet obstruction, hyperparathyroidism, excluded antrum, and short bowel syndrome, but not in the usual duodenal ulcer disease. Also, a defective inhibition of parietal cell function by endocrine or paracrine factors, such as gastric inhibitory polypeptide, secretin, somatostatin and vasoactive intestinal polypeptide, seems not to exist in patients with duodenal ulcer disease. However, as long as the physiology of gastrointestinal peptides in gastric secretion and motility is not understood, a possible role of these factors in the pathogenesis of simple duodenal ulcer disease cannot be excluded.
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PMID:Endocrinology of duodenal ulcer. 51 78

Retained-antrum syndrome is a rare condition, occurring in Billroth II gastrectomised patients, in which an ulcer recurs associated with high levels of circulating gastrin. Some gastrin tests are useful to differentiate a retained antrum from a gastrinoma, but a firm diagnosis is sometimes very difficult. We have studied two cases of retained-antrum syndrome both by gastrin tests and by [99mTc] pertechnetate scintiphotography. By this method a prominent area of activity was observed on the anatomic site of the duodenal stump bottom. It appeared after 20 or 30 min and lasted for the 2 hr of observation. After surgical resection, no area of activity was observed at the scintiphotographic followup. No false positive was observed out of the more than 30 subjects studied. Scintiphotography by pertechnetate seems able to demonstrate the presence and the size of retained gastric antrum in B II gastrectomised patients with recurrent ulcer.
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PMID:Retained gastric antrum syndrome diagnosed by [99mTc] pertechnetate scintiphotography in man: hormonal and radioisotopic study of two cases. 63 24

The effects of recent diagnostic and therapeutic advances were assessed in 65 patients with the Zollinger-Ellison syndrome (ZES). Twenty-seven patients seen between 1955 and 1970 were compared with 38 patients seen between 1971 and 1977. The earlier patients had a higher incidence of virulent ulcer disease (56% vs. 24%), other endocrinopathies (48% vs. 13%), and malignant gastrinoma (44% vs. 25%). Earlier diagnosis is the result of liberal use of serum gastrin measurements and provocative tests for gastrin release (calcium and secretin), and an increased awareness of this syndrome. Because their basal gastrin values were in a range that overlapped ordinary ulcer disease, 47% of patients encountered in recent years required provocative testing with secretin for diagnosis. If the gastrin concentration falls to normal following resection of a gastrinoma, the tumor has probably been completely removed. In our patients, gastrin measurements after total gastrectomy had no prognostic significance in regards to clinical progression or regression of the neoplasm. Of 12 patients treated with cimetidine, nine experienced symptomatic improvement, and three did not. Resection of the gastrinoma should be attempted if the lesion is solitary and located in the body or tail of the pancreas, or if it is an isolated duodenal lesion. Otherwise, total gastrectomy remains the treatment of choice. In 38 patients, total gastrectomy with Roux-en-Y esophagojejunostomy was followed by 97% survival and minimal difficulties with nutrition or dumping.
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PMID:The Zollinger-Ellison syndrome--23 years later. 68 1

An adequate therapy must be directed towards the cause of the recurrent ulcer. This is incomplete vagotomy in most cases, more seldom a hypergastrinemia with stasis in the antrum after insufficient drainage, in hyperparathyroidism, in hyperplasia of the antral G cells or in gastrinoma. After confirmation of the diagnosis by endoscopy, a causal diagnosis must therefore be made which includes secretion analysis and determination of the gastrin profile (feeding test, glucagon provocation test, secretion or calcium infusion). Criteria for evaluation and clinical conclusiveness are shown in examples. The indication scheme, whether revagotomy alone, resection alone or the combination of the two corrective operations should be performed is determined according to these criteria. So far, 41 patients have been operated on with good results in accordance with this graduated indication.
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PMID:[Recurrent ulcer following vagotomy: completion of vagotomy or resection (author's transl)]. 81 80

Twenty patients with gastric basal hipersecretion over 15 mEq/hr and a suspicion on a Z-E syndrome or gastrinoma were studied by means of histamin gastric analisis, calcium test and measurement of lower esophageal sphincter pressures. In none of them a pancreatic tumour was found at operation, being their post-operative course normal up to a 60 months follow-up. The use of these everyday techniques is proposed for medical centers which have no facilities for gastrin radioimmunoassay techniques.
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PMID:[Is basal hypersecretion an indication of the presence of Zollinger-Ellison syndrome?]. 87 24

Sixty-five patients with peptic ulcer disease were evaluated for gastrinoma (Zollinger-Ellison syndrome) by measuring changes in serum gastrin concentration after intravenous (i.v.) administration of calcium or secretin, or both. The presence of gastrinoma was established in all 20 patients whose serum gastrin increased by 395 pg/ml or more after i.v. calcium and in all 18 patients whose serum gastrin concentration increased by 110 pg/ml or more after i.v. secretin. The experience with these 65 patients shows that stimulation by calcium or secretin may confirm the presence of gastrinoma in cases where the diagnosis would otherwise remain obscure. Although a positive response to calcium or secretin is diagnostic for gastrinoma a negative response does not exclude this diagnosis. Stimulation with secretin is preferred for screening for gastrinoma because it is quicker and more reliable than calcium.
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PMID:Use of calcium and secretin in the diagnosis of gastrinoma (Zollinger-Ellison syndrome). 93 Dec 3

A patient with documented ZE syndrome responded to intravenous magnesium infusion by increased gastric acid output and increased serum gastrin concentration. A patient with acid hypersecretion but no gastrinoma had no substantial alteration in acid output or serum gastrin concentration following magnesium administration. This suggests that magnesium caused gastrin to be released from a gastrinoma.
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PMID:The effect of magnesium sulfate infusion on acid secretion and on serum gastrin concentration in a patient with gastrinoma. 95 79

In contrast to normal physiologic feedback suppression of serum gastrin by secretin, a paradoxic rise in the serum gastrin level has been observed in patients with gastrinoma after the administration of exogenous secretin. Exploitation of this phenomenon in the differential diagnosis of gastrinoma has been restricted by limited individual experience. Serial serum specimens for gastrin radioimmunoassay were collected from 13 patients with histologically proved gastrinoma both before and after the administration of Boot's secretin, 3 units per kilogram. Thirty-nine others with histologically proved gastrinoma who had been studied with exogenous secretin were identified in the literature. Both the peak gastrin and the integrated gastrin responses were increased after secretin administration in each of the patients in this combined series, although the magnitude of the increase was small in four patients. The absence of physiologic suppression by secretin implies neoplastic autonomy of gastrin releasing sites. While an augmented gastrin response to secretin is commonly seen in patients with gastrinoma, from a physiologic standpoint, a lack of suppression constitutes a positive secretin suppression test. Accumulated experience is consistent and suggests that this test is an important adjunt in the differential diagnosis of hypergastrinemia.
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PMID:Diagnosis of gastrinoma by the secretin suppression test. 98 59


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