85 results on '"van Tongeren JH"'
Search Results
2. Delayed diagnosis of glucagonoma syndrome.
- Author
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Alkemade JA, van Tongeren JH, van Haelst UJ, Smals A, Steijlen PM, and van de Kerkhof PC
- Subjects
- Adult, Diagnosis, Differential, Fatal Outcome, Female, Humans, Middle Aged, Syndrome, Time Factors, Erythema diagnosis, Glucagonoma diagnosis, Pancreatic Neoplasms diagnosis
- Abstract
The classical presentations of necrolytic migratory erythema associated with alpha cell pancreatic tumour have been well documented. In addition, the occurrence of extracutaneous hallmarks of this disease such as weight loss, diabetes, anaemia, stomatitis and diarrhoea have been described in various reports. Here we report three cases with glucagonoma syndrome. Early detection is important in view of the malignant course of the disease. However, diagnosis is sometimes complicated by the fact that some patients may fail to show the characteristic feature of glucagonoma syndrome.
- Published
- 1999
- Full Text
- View/download PDF
3. The effect of a natural high-fibre diet on faecal and biliary bile acids, faecal pH and whole-gut transit time in man. A controlled study.
- Author
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Nagengast FM, van den Ban G, Ploemen JP, Leenen R, Zock PL, Katan MB, Hectors MP, de Haan AF, and van Tongeren JH
- Subjects
- Adult, Aged, Case-Control Studies, Cholic Acid, Cholic Acids analysis, Colonic Neoplasms diet therapy, Colonic Neoplasms prevention & control, Deoxycholic Acid analysis, Energy Metabolism, Humans, Hydrogen-Ion Concentration, Middle Aged, Nutrition Assessment, Time Factors, Bile Acids and Salts analysis, Bile Acids and Salts chemistry, Dietary Fiber, Feces chemistry, Gastrointestinal Transit
- Abstract
Dietary fibre possibly protects against colonic cancer by effects on bile acid metabolism. We investigated the effect of a natural high-fibre diet on secondary bile acid formation. Twelve healthy subjects on an habitual low-fibre diet (for 4 weeks) consumed a high-fibre menu for 10 weeks (experimental group). A control group of 10 subjects consumed their regular high-fibre diet during this period. Faecal and biliary acid composition, faecal weight, faecal pH and gut transit time were studied before and after 6 and 10 weeks of fibre addition. Changes in the experimental group were compared to changes in the control group. The concentration, but not the excretion, of the secondary faecal bile acids was reduced in the experimental group. Faecal weight increased, faecal pH dropped and gut transit time was not altered. The biliary deoxycholic acid content decreased and the cholic acid content increased after 6 weeks, but returned to baseline values after 10 weeks of fibre addition. This study shows that a natural high-fibre diet lowers secondary faecal bile acid concentration through an increase in stool weight. The 7 alpha-dehydroxylation of primary bile acids is probably not or only transiently inhibited.
- Published
- 1993
4. Zinc uptake by blood cells of rats in zinc deficiency and inflammation.
- Author
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Naber TH, van den Hamer CJ, van den Broek WJ, and van Tongeren JH
- Subjects
- Animals, Leukocytes, Mononuclear metabolism, Male, Neutrophils metabolism, Rats, Rats, Wistar, Stress, Physiological blood, Erythrocytes metabolism, Inflammation blood, Leukocytes metabolism, Zinc blood, Zinc deficiency
- Abstract
In zinc deficiency, the function of leukocytes is impaired. However, the results of studies on the zinc concentration of blood cells in zinc deficiency are conflicting, probably in part because of technical and analytical problems. The aim of this study was to investigate, under standard conditions, the uptake of 65Zn-labeled zinc by blood cells, taken from zinc-deficient rats and from rats in which an inflammation is induced. In both conditions, the serum zinc concentration is reduced. In clinical practice, this makes it difficult to determine whether the decrease in serum zinc is the result of a real or an apparent zinc deficiency. In stress, like an inflammatory disease, the decrease of zinc reflects an apparent zinc deficiency because of redistribution of serum zinc into the liver and because of decrease in serum albumin concentration. Over 70% of the serum zinc is bound to albumin. Blood cells from zinc-deficient and control rats were isolated using a discontinuous Percoll gradient and incubated under nearly physiological conditions in a 65Zn-containing medium. A significant increase in the in vitro uptake of 65Zn-labeled zinc by the blood cells of zinc-deficient rats was seen: erythrocytes 1.3, mononuclear cells 2.0, and polymorphonuclear cells 2.6 times the control values. During inflammation, no change in 65Zn-labeled zinc uptake by erythrocytes and mononuclear cells was demonstrated after 2 d, although the serum zinc and albumin concentrations were decreased, but a small but significant increase in zinc uptake by polymorphonuclear cells was observed. This study of 65Zn uptake in vitro under standard conditions may prove of value for distinguishing in patients real zinc deficiency from apparent zinc deficiency owing to, e.g., stress, although additional experiments should be performed.
- Published
- 1992
- Full Text
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5. Disposition of mesalazine from mesalazine-delivering drugs in patients with inflammatory bowel disease, with and without diarrhoea.
- Author
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Rijk MC, van Schaik A, and van Tongeren JH
- Subjects
- Adult, Aged, Aminosalicylic Acids chemistry, Aminosalicylic Acids urine, Delayed-Action Preparations standards, Drug Carriers, Feces chemistry, Female, Gastrointestinal Transit, Humans, Inflammatory Bowel Diseases complications, Inflammatory Bowel Diseases urine, Male, Mesalamine, Middle Aged, Aminosalicylic Acids pharmacokinetics, Aminosalicylic Acids therapeutic use, Diarrhea etiology, Inflammatory Bowel Diseases drug therapy, Sulfasalazine therapeutic use
- Abstract
The disposition of mesalazine from the azo compounds sulphasalazine and olsalazine (Dipentum) and from the slow-release mesalazine drugs Pentasa, Asacol, and Salofalk was studied in 20 patients with inflammatory bowel disease. Ten of them had diarrhoea, and 10 had normal stools. On the last 2 days of a 7-day maintenance treatment with each of the study drugs urine and faeces were collected for determination of mesalazine, acetyl-mesalazine, and unsplit azo compound. In patients with and without diarrhoea the urinary and the faecal excretion of acetyl-mesalazine was lowest during treatment with olsalazine. The proportion of acetyl-mesalazine in faeces was highest during treatment with Pentasa in both groups. The presence of diarrhoea was associated with a decrease in the proportion of acetyl-mesalazine in faeces during treatment with all drugs, not significant only for Pentasa. The proportion of unsplit azo compound in faeces increased in the case of diarrhoea to almost 50%. It is concluded that in patients with inflammatory bowel disease diarrhoea substantially influences the disposition from all these drugs except Pentasa.
- Published
- 1992
- Full Text
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6. Relapse-preventing effect and safety of sulfasalazine and olsalazine in patients with ulcerative colitis in remission: a prospective, double-blind, randomized multicenter study. The Ulcerative Colitis Multicenter Study Group.
- Author
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Rijk MC, van Lier HJ, and van Tongeren JH
- Subjects
- Adolescent, Adult, Aged, Aminosalicylic Acids adverse effects, Double-Blind Method, Female, Humans, Male, Middle Aged, Recurrence, Sulfasalazine adverse effects, Survival Analysis, Aminosalicylic Acids therapeutic use, Colitis, Ulcerative prevention & control, Sulfasalazine therapeutic use
- Abstract
Forty-nine patients with ulcerative colitis in remission were entered into a prospective, double-blind, multicenter trial comparing the relapse-preventing effect and safety of 4 g sulfasalazine and 2 g olsalazine daily during 48 wk. Of the 46 evaluable patients, 23 were assigned to sulfasalazine and 23 to olsalazine. Seven of 23 patients (30.4%) relapsed on sulfasalazine and six of 23 patients (26.1%) on olsalazine (95% confidence interval of the difference -22.0% to 30.3%). The relapse-free survival curves did not differ significantly at any time during the trial period. In both treatment groups, three patients dropped out because of adverse effects. Four patients on sulfasalazine and six patients on olsalazine experienced minor adverse effects. One patient on sulfasalazine had mild leukopenia, and four patients on sulfasalazine and one patient on olsalazine had decreased levels of haptoglobin. Thus, sulfasalazine and olsalazine are equally effective in maintaining remission of ulcerative colitis and are accompanied by a similar incidence of adverse effects.
- Published
- 1992
7. Bacterial acetylation of 5-aminosalicylic acid in faecal suspensions cultured under aerobic and anaerobic conditions.
- Author
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van Hogezand RA, Kennis HM, van Schaik A, Koopman JP, van Hees PA, and van Tongeren JH
- Subjects
- Acetylation, Aerobiosis, Anaerobiosis, Bacteriological Techniques, Humans, Mesalamine, Aminosalicylic Acids metabolism, Bacteria metabolism, Feces microbiology
- Abstract
After oral administration of 5-aminosalicylic acid a substantial proportion of the acetylated form is excreted in the faeces. We have studied the role of the faecal microflora in acetylating 5-aminosalicylic acid. In faeces incubated under both aerobic and anaerobic conditions there was acetylation of 5-aminosalicylic acid. Of the anaerobic bacteria isolated from a 10(8) faecal dilution 44% were able to acetylate 5-aminosalicylic acid. We conclude that the normal faecal microflora contribute to the acetylation of 5-aminosalicylic acid.
- Published
- 1992
- Full Text
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8. Sulphasalazine and prednisone compared with sulphasalazine for treating active Crohn disease. A double-blind, randomized, multicenter trial.
- Author
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Rijk MC, van Hogezand RA, van Lier HJ, and van Tongeren JH
- Subjects
- Adolescent, Adult, Crohn Disease physiopathology, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Male, Severity of Illness Index, Crohn Disease drug therapy, Prednisone therapeutic use, Sulfasalazine therapeutic use
- Abstract
Objective: To determine whether sulphasalazine plus prednisone is more effective than sulphasalazine alone in treating active Crohn disease., Design: Randomized, double-blind, placebo-controlled trial., Setting: Multicenter trial in one university hospital and nine general hospitals., Patients: Patients with active Crohn disease and a Van Hees Activity Index of 140 or more. Of 71 patients who were randomly assigned, 60 completed treatment and were analyzed., Interventions: For 16 weeks, 30 patients received sulphasalazine, 6 g/d (or 4 g/d if adverse effects occurred) and prednisone, 30 mg/d initially. Prednisone therapy was tapered in increments of 5 mg/2 wk to 10 mg/d after 8 weeks. Thirty other patients received sulphasalazine and a placebo., Measurements and Main Results: In the first 6 weeks of treatment, the Van Hees Activity Index decreased to a median of 70% (interquartile range, 57% to 81%) of the initial value in patients treated with sulphasalazine and prednisone and to a median of 87% (interquartile range, 70% to 94%) in patients treated with sulphasalazine alone (P = 0.001). In the last 4 weeks of treatment, the corresponding figures were 63% (interquartile range, 40% to 75%) and 70% (interquartile range, 54% to 90%) (P = 0.10). The Crohn's Disease Activity Index decreased in the first 6 weeks to a median of 65% (interquartile range, 57% to 86%) in patients receiving sulphasalazine and prednisone and to a median of 75% (interquartile range, 58% to 101%) in patients receiving sulphasalazine alone (P = 0.13). In the last 4 weeks of treatment, the corresponding figures were 65% (interquartile range, 42% to 90%) and 76% (interquartile range, 49% to 110%) (P = 0.19)., Conclusions: The use of prednisone in addition to sulphasalazine in patients with active Crohn disease results in a significantly faster initial improvement, but not in a significantly better result after 16 weeks of treatment, when disease activity is measured by the Van Hees Activity Index.
- Published
- 1991
- Full Text
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9. Determination of sodium azodisalicylate, salazosulphapyridine and their metabolites in serum, urine and faeces by high-performance liquid chromatography.
- Author
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van Hogezand RA, van Balen HC, van Schaik A, Tangerman A, van Hees PA, Zwanenburg B, and van Tongeren JH
- Subjects
- Aminosalicylic Acids blood, Aminosalicylic Acids urine, Chromatography, High Pressure Liquid methods, Feces analysis, Humans, Sulfasalazine blood, Sulfasalazine urine, Aminosalicylic Acids analysis, Sulfasalazine analysis
- Published
- 1984
- Full Text
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10. Long-term treatment with cimetidine in duodenal ulceration.
- Author
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Bardham KD, Blum A, Gillespie G, Larkworthy W, Mekel R, Moshal M, Smith PM, Venables CW, Van Tongeren JH, and Walan A
- Subjects
- Clinical Trials as Topic, Drug Evaluation, Follow-Up Studies, Histamine H2 Antagonists therapeutic use, Humans, Placebos, Recurrence, Time Factors, Duodenal Ulcer drug therapy, Histamine H2 Antagonists administration & dosage
- Published
- 1977
- Full Text
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11. The Zollinger-Ellison syndrome. Observations on eight patients.
- Author
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Lamers CB, Berretty PJ, Bijvoet OL, Joosten HJ, Lubbers EJ, Muller H, Nadorp JH, Nielander DO, Penn W, Prenen H, Schillings PH, Termote UA, and Van Tongeren JH
- Subjects
- Adult, Celiac Disease complications, Diarrhea complications, Esophagitis complications, Female, Gastrins blood, Gastrins metabolism, Gastrins urine, Humans, Hyperparathyroidism complications, Male, Middle Aged, Neoplasm Metastasis, Radiography, Zollinger-Ellison Syndrome complications, Zollinger-Ellison Syndrome diagnostic imaging, Zollinger-Ellison Syndrome pathology, Zollinger-Ellison Syndrome diagnosis
- Published
- 1974
12. Acid citrate dextrose reduces platelet retention during in vitro and in vivo dog hemoperfusion: a comparative study of different charcoal adsorbers.
- Author
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Tangerman A, Snel P, van Schaik A, and van Tongeren JH
- Subjects
- Adsorption, Animals, Cell Adhesion drug effects, Citrates blood, Dogs, Glucose adverse effects, Glucose pharmacology, Humans, Leukocyte Count, Leukocytes drug effects, Platelet Aggregation drug effects, Platelet Count, Blood Platelets drug effects, Charcoal, Citric Acid, Glucose analogs & derivatives, Hemoperfusion
- Abstract
Hemoperfusion through charcoal adsorbers has often been proposed for use in exogenous and endogenous intoxication. A serious drawback of this technique is the often encountered loss of platelets and leucocytes. In vitro hemoperfusion studies with heparinized human blood and in vivo hemoperfusion of heparinized Labrador dogs through different types of charcoal adsorbers (Becton-Dickinson [B-D], Gambro, Haemocol) clearly demonstrated that addition of the anticoagulant acid citrate dextrose (ACD) might reduce the loss of platelets. ACD seemed to have no distinct influence on leucocyte retention.
- Published
- 1981
- Full Text
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13. 'Inappropriate' hypergastrinaemia of antral origin: a rare cause of peptic ulcer disease.
- Author
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Lamers CB, Diemel JM, Roeffen W, and Van Tongeren JH
- Subjects
- Adult, Gastrins blood, Humans, Male, Pyloric Antrum metabolism, Zollinger-Ellison Syndrome complications, Zollinger-Ellison Syndrome metabolism, Gastrins metabolism, Peptic Ulcer etiology
- Published
- 1980
14. A new sensitive assay for measuring volatile sulphur compounds in human breath by Tenax trapping and gas chromatography and its application in liver cirrhosis.
- Author
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Tangerman A, Meuwese-Arends MT, and van Tongeren JH
- Subjects
- Breath Tests, Chromatography, Gas, Humans, Respiration, Sulfur analysis, Liver Cirrhosis metabolism, Sulfhydryl Compounds analysis, Sulfides analysis
- Abstract
A new analytical technique is described for measuring volatile sulphur compounds in human breath. The sulphur compounds were trapped and concentrated onto Tenax GC and then assayed by gas chromatography, using a specific sulphur detector. The detection limit amounts to about 0.2 ng/l (0.1 ppb). Among the sulphur volatiles, dimethylsulphide and methanethiol were quantitatively analysed in 100 ml of breath of 20 normal subjects and 35 cirrhotic patients. Dimethylsulphide in the breath of cirrhotics (113.4 +/- 31.9 ng/l, mean +/- SEM) was significantly elevated (p less than 0.05) compared with normals (21.1 +/- 1.7 ng/l). The concentration of methanethiol in the breath of normals and of most cirrhotics was less than 1 ng/l. In only five cirrhotics could methanethiol be detected in 100 ml of breath (3-23 ng/l). Dimethyldisulphide and hydrogen sulphide were not present in detectable amounts in the breath of normals. In cirrhotics, dimethyldisulphide was detected in a few cases. Ethanethiol was absent in the breath of both normals and cirrhotics.
- Published
- 1983
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15. Effect of treatment with cimetidine for one year on gastrin cell and parietal cell function and sensitivity to cimetidine in patients with duodenal or gastric ulcers.
- Author
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Festen HP, Lamers CB, Tangerman A, and van Tongeren JH
- Subjects
- Cimetidine blood, Duodenal Ulcer blood, Duodenal Ulcer prevention & control, Gastric Acid metabolism, Gastric Mucosa drug effects, Gastrins blood, Humans, Middle Aged, Recurrence, Stomach Ulcer blood, Stomach Ulcer prevention & control, Cimetidine therapeutic use, Duodenal Ulcer physiopathology, Gastric Mucosa physiopathology, Guanidines therapeutic use, Stomach Ulcer physiopathology
- Abstract
Twenty-two duodenal and 16 gastric ulcer patients were treated with 400 mg cimetidine twice daily for one year after their ulcers had healed. No change in gastric acid secretion was observed before and after treatment in 20 duodenal and 13 gastric ulcer patients. Similarly, the inhibitory effect of 200 mg cimetidine on gastric acid secretion was unaltered in 11 duodenal and 6 gastric ulcer patients studied and cimetidine blood concentration were unchanged in 9 duodenal and 4 gastric ulcer patients after one year. In 7 duodenal and 6 gastric ulcer patients the serum gastrin response to a standard test meal before and after treatment was identical.
- Published
- 1980
- Full Text
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16. Stability of disodium azodisalicylate (olsalazine) and metabolites in urine and faeces stored at different temperatures.
- Author
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van Hogezand RA, van Schaik A, van Hees PA, and van Tongeren JH
- Subjects
- Drug Stability, Humans, Mercuric Chloride pharmacology, Mesalamine, Temperature, Aminosalicylic Acids analysis, Feces analysis
- Abstract
Methods: The stability of disodium azodisalicylate, 5-aminosalicylic acid and acetyl-5-aminosalicylic acid dissolved in distilled water and in urine or mixed with faeces to which HgCl2 was added, was studied at -20 degrees C, 4 degrees C and room temperature., Results: In water, no marked differences were found between the three storage regimens. In urine, disodium azodisalicylate and acetyl-5-aminosalicylic acid were stable, while the 5-ASA concentration decreased when stored at 4 degrees C and room temperature. In faeces stored during seven days, a marked decrease in 5-aminosalicylic acid concentration to about zero was found when it was kept at 4 degrees C and room temperature. No marked change in the concentration of disodium azodisalicylate and 5-aminosalicylic acid added to the faeces-HgCl2-mixtures appeared.
- Published
- 1988
- Full Text
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17. The natural history of coeliac sprue, and factors which may influence it.
- Author
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Cluysenaer OJ and Van Tongeren JH
- Subjects
- Adult, Biopsy, Child, Duodenum pathology, Female, Glutens, Humans, Jejunum pathology, Male, Middle Aged, Celiac Disease diagnosis, Celiac Disease diet therapy, Celiac Disease pathology
- Published
- 1978
18. Effect of sulphasalazine in patients with active Crohn's disease: a controlled double-blind study.
- Author
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Van Hees PA, Van Lier HJ, Van Elteren PH, Driessen M, Van Hogezand RA, Ten Velde GP, Bakker JH, and Van Tongeren JH
- Subjects
- Adolescent, Adult, Clinical Trials as Topic, Double-Blind Method, Female, Humans, Male, Middle Aged, Random Allocation, Crohn Disease drug therapy, Sulfasalazine therapeutic use
- Abstract
The response of active Crohn's disease to sulphasalazine (4-6 g per day) has been studied in a placebo-controlled trial. The study was carried out at two hospitals. From August 1977 to August 1979 all patients with established Crohn's disease were examined for their eligibility for the trial. A nine-item index of inflammatory activity was used as the primary measure of response. The variables in this index were serum albumin, ESR, body weight released to height, abdominal mass, temperature, stool consistency, bowel resection, and extraintestinal symptoms related to Crohn's disease. A favourable response to therapy was defined as a decrease of the activity index with 25% or more at the end of the trial period, compared with the initial value. Twenty-six patients (13 in each treatment group) have been followed up for six months. The response of active Crohn's disease to sulphasalazine was significantly better than to placebo.
- Published
- 1981
- Full Text
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19. Human intestinal glutathione S-transferases.
- Author
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Peters WH, Roelofs HM, Nagengast FM, and van Tongeren JH
- Subjects
- Adult, Age Factors, Aged, Cytosol enzymology, Electrophoresis, Polyacrylamide Gel, Epithelium enzymology, Female, Humans, Intestine, Large enzymology, Intestine, Small enzymology, Isoelectric Focusing, Liver enzymology, Male, Middle Aged, Glutathione Transferase metabolism, Intestinal Mucosa enzymology
- Abstract
Cytosolic glutathione S-transferases were purified from the epithelial cells of human small and large intestine. These preparations were characterized with regard to specific activities, subunit and isoenzyme composition. Isoenzyme composition and specific activity showed little variation from proximal to distal small intestine. Specific activities of hepatic and intestinal enzymes from the same patient were comparable. Hepatic enzymes were mainly composed of 25 kDa subunits. Transferases from small intestine contained 24 and 25 kDa subunits, in variable amounts. Colon enzymes were composed of 24 kDa subunits. In most preparations, however, minor amounts of 27 and 27.5 kDa subunits were detectable. Separation into isoforms by isoelectric focusing revealed striking differences: glutathione S-transferases from liver were mainly basic or neutral, enzymes from small intestine were basic, neutral and acidic, whereas large intestine contained acidic isoforms only. The intestinal acidic transferase most probably was identical with glutathione S-transferase Pi, isolated from human placenta. In the hepatic preparation, this isoform was hardly detectable. The specific activity of glutathione S-transferase showed a sharp fall from small to large intestine. In proximal and distal colon, activity seemed to be about equal. In the ascending colon there might be a relationship between specific activity of glutathione S-transferases and age of the patient, activity decreasing with increasing age.
- Published
- 1989
- Full Text
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20. Effect of sulphapyridine, 5-aminosalicylic acid, and placebo in patients with idiopathic proctitis: a study to determine the active therapeutic moiety of sulphasalazine.
- Author
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van Hees PA, Bakker JH, and van Tongeren JH
- Subjects
- Adult, Clinical Trials as Topic, Double-Blind Method, Humans, Male, Middle Aged, Aminosalicylic Acids therapeutic use, Proctitis drug therapy, Sulfanilamides therapeutic use, Sulfapyridine therapeutic use, Sulfasalazine therapeutic use
- Abstract
Suppositories of sulphapyridine, 5-aminosalicylic acid, and placebo were used in 45 patients with idiopathic proctitis to determine the active part of sulphasalazine. Each patient used one of the suppositories twice daily for four weeks in a double-blind controlled trial. Complete clinical remission with normal rectal mucosa on sigmoidoscopy occurred in 60% of patients given 5-aminosalicylic acid, but in only 13% and 27% of those given sulphapyridine and placebo respectively. Twelve patients were included twice. In eight of these patients 5-aminosalicylic acid was given one time and sulphapyridine (two patients) or placebo (six patients) another time. Clinical remission occurred in each patient with 5-aminosalicylic acid, but in only one patient during other therapy. The results suggest that 5-aminosalicylic acid is the active therapeutic moiety of sulphasalazine.
- Published
- 1980
- Full Text
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21. Cimetidine in the treatment of severe ulcerative reflux oesophagitis; results of an 8-week double-blind study and of subsequent long-term maintenance treatment.
- Author
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Festen HP, Driessen WM, Lamers CB, and Van Tongeren JH
- Subjects
- Cimetidine administration & dosage, Clinical Trials as Topic, Double-Blind Method, Female, Humans, Male, Middle Aged, Cimetidine therapeutic use, Esophagitis, Peptic drug therapy, Guanidines therapeutic use
- Published
- 1980
22. Disposition of disodium azodisalicylate in healthy subjects. A possible new drug for inflammatory bowel disease.
- Author
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van Hogezand RA, van Hees PA, Zwanenburg B, van Rossum JM, and van Tongeren JH
- Subjects
- Administration, Oral, Aminosalicylic Acids administration & dosage, Aminosalicylic Acids blood, Half-Life, Humans, Kinetics, Mesalamine, Sulfapyridine metabolism, Sulfasalazine administration & dosage, Sulfasalazine blood, Sulfasalazine metabolism, Aminosalicylic Acids metabolism, Crohn Disease
- Abstract
The disposition of disodium azodisalicylate and salicylazosulfapyridine was studied in 6 healthy volunteers. After a single oral dose (1.0 g disodium azodisalicylate; 2.3 g salicylazosulfapyridine) maximum serum concentrations of the intact compound ranged between 1.4 and 6.8 mumol/L and 32 and 114 mumol/L, respectively. Mean residence time and serum half-life of disodium azodisalicylate were considerably longer than those of salicylazosulfapyridine, probably because of a higher apparent volume of distribution. Both compounds were largely split by colonic bacteria and comparable amounts of the active moiety, (acetyl-)5-aminosalicylic acid, were recovered in feces. During long-term ingestion of disodium azodisalicylate (1.0 g/day) it took 6-19 days to reach a steady state. Serum concentrations of disodium azodisalicylate at steady state were low: 2.2-8.4 mumol/L. The serum half-life was 6-10 days. It is concluded that the disposition of disodium azodisalicylate is similar, in important respects, to that of salicylazosulfapyridine. Disodium azodisalicylate, therefore, deserves therapeutic trial.
- Published
- 1985
- Full Text
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23. Long-term treatment with histamine H2-receptor antagonists in Zollinger-Ellison syndrome.
- Author
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Lamers CB, Festen HP, and van Tongeren JH
- Subjects
- Adult, Cimetidine administration & dosage, Cimetidine adverse effects, Depression, Chemical, Drug Evaluation, Female, Humans, Male, Metiamide administration & dosage, Metiamide adverse effects, Time Factors, Zollinger-Ellison Syndrome physiopathology, Cimetidine therapeutic use, Gastric Juice metabolism, Gastric Mucosa metabolism, Guanidines therapeutic use, Metiamide therapeutic use, Thiourea analogs & derivatives, Zollinger-Ellison Syndrome drug therapy
- Abstract
Continuous treatment of three Zollinger-Ellison patients with histamine H2-receptor antagonists for 14, 26 and 31 months resulted in effective relief of complaints and marked reduction in gastric acid secretion. In one of the patients the dose of cimetidine had to be doubled after 15 months of treatment because of a rise in basal gastric acid secretion accompanied by recurrent diarrhea. Fasting and secretin-stimulated serum gastrin levels were not affected by long-term treatment with histamine H2-receptor antagonists. No side-effects were observed in the three patients on long-term treatment.
- Published
- 1978
24. Major haemorrhage in Crohn's disease.
- Author
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Bruyns E, Lubbers EJ, and Van Tongeren JH
- Subjects
- Adolescent, Adult, Colonic Diseases etiology, Duodenal Diseases etiology, Female, Humans, Intestine, Small, Male, Crohn Disease complications, Gastrointestinal Hemorrhage etiology
- Published
- 1979
25. Colonic absorption of secondary bile-acids in patients with adenomatous polyps and in matched controls.
- Author
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van der Werf SD, Nagengast FM, van Berge Henegouwen GP, Huijbregts AW, and van Tongeren JH
- Subjects
- Adenoma, Bile Duct metabolism, Chenodeoxycholic Acid metabolism, Cholesterol, Dietary metabolism, Cholic Acids metabolism, Clinical Trials as Topic, Deoxycholic Acid metabolism, Female, Humans, Intestinal Absorption, Male, Bile Acids and Salts metabolism, Intestinal Polyps metabolism, Intestine, Large metabolism
- Published
- 1982
- Full Text
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26. Cimetidine in anastomotic ulceration after partial gastrectomy.
- Author
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Festen HP, Lamers CB, Driessen WM, and Van Tongeren JH
- Subjects
- Clinical Trials as Topic, Double-Blind Method, Drug Evaluation, Humans, Recurrence, Time Factors, Cimetidine therapeutic use, Gastrectomy, Guanidines therapeutic use, Peptic Ulcer drug therapy
- Abstract
In order to assess the efficacy of cimetidine in patients with endoscopically anastomotic ulcer after partial gastrectomy, 21 such patients entered a double-blind prospective clinical trial. At endoscopy after 4 wk of treatment, 8 of 12 patients treated with 1 g of cimetidine daily compared with 1 of 9 patients who received a placebo had healed ulcers (P less than 0.05). Evaluation of symptoms relief supported the efficacy of cimetidine compared with placebo. Healing rate after 1 mo of treatment with cimetidine was 67% and increased to 86% after 2 mo. During 1 year of maintenance therapy with 800 mg cimetidine daily, 3 of 19 patients relapsed. No serious side effects were observed. The results of this study demonstrate a beneficial effect of cimetidine on healing and symptoms of anastomotic ulcers.
- Published
- 1979
27. The glucagonoma syndrome: stimulus-induced plasma responses of circulating glucagon components IRG9000 and IRG3500.
- Author
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Hendriks T, Jansen JB, and van Tongeren JH
- Subjects
- Arginine pharmacology, Calcitonin pharmacology, Calcium pharmacology, Chromatography, Gel, Fasting, Female, Glucagon immunology, Humans, Middle Aged, Molecular Weight, Radioimmunoassay, Somatostatin pharmacology, Tolbutamide pharmacology, Adenoma, Islet Cell blood, Glucagon blood, Glucagonoma blood, Pancreatic Neoplasms blood
- Abstract
Plasma responses of the major immunoreactive glucagon (IRG) components have been investigated in a case of glucagonoma syndrome. Fasting plasma IRG was 4155 pg/ml. Gel chromatography of plasma revealed that 66% of immunoreactivity was present as IRG9000, while IRG3500 accounted for an additional 26%. The appearance in peripheral plasma of these two glucagon fractions was examined after administration of a number of compounds. IRG levels were clearly elevated after arginine and tolbutamide. Both calcium and calcitonin induced a biphasic rise of IRG, the increase being slower after calcium administration. Somatostatin suppressed plasma IRG levels. All tests induced changes in both IRG3500 and IRG9000. In general, relative changes were more pronounced in IRG3500 than in IRG9000, while absolute changes were greater in IRG9000. The shape of the response curves of IRG3500 and IRG9000 was quite similar after arginine, calcium and somatostatin. After tolbutamide the IRG9000 response was delayed as compared to the IRG3500 component. During the latter part of the calcitonin infusion, IRG9000 remained elevated while IRG3500 was back at its starting level.
- Published
- 1984
- Full Text
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28. Inhibition of secondary bile acid formation in the large intestine by lactulose in healthy subjects of two different age groups.
- Author
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Nagengast FM, Hectors MP, Buys WA, and van Tongeren JH
- Subjects
- Adult, Aged, Aged, 80 and over, Bile Acids and Salts analysis, Feces analysis, Female, Humans, Hydrogen-Ion Concentration, Intestine, Large drug effects, Liver metabolism, Male, Middle Aged, Time Factors, Aging metabolism, Bile Acids and Salts biosynthesis, Disaccharides pharmacology, Intestine, Large metabolism, Lactulose pharmacology
- Abstract
Secondary bile acids have been implicated in colonic carcinogenesis. Transformation of primary into secondary bile acids (7 alpha-dehydroxylation) in the large bowel is a pH-dependent process. Inhibition of this reaction could be achieved by lowering colonic pH. We, therefore, studied the effects of lactulose (a non-absorbable disaccharide), which is capable of acidifying colonic contents, on secondary bile acid metabolism. Because this metabolism is age dependent, lactulose was given (0.3 g kg-1 twice daily for 12 weeks) to nine middle-aged (age 31-54 years; mean 45.7) and ten elderly subjects (age 56-81 years; mean 66.4). Twice before, and after 6 and 12 weeks' lactulose administration, biliary and faecal bile acids, whole gut transit time, faecal weight and dry weight, and faecal pH were recorded. The concentration of (iso)lithocholic and deoxycholic acid in faeces was higher in elderly subjects (P less than 0.05) but the excretion was comparable. After lactulose the concentration and excretion of the major secondary bile acids decreased. The primary bile acid fraction rose from 5% before, to more than 20% after, lactulose (P less than 0.05). Faecal weight increased and faecal dry weight decreased, resulting in a higher faecal water output during lactulose. Whole gut transit time did not change. The faecal pH dropped after 6 (P less than 0.05) and further after 12 weeks' lactulose (P less than 0.05). The percentage deoxycholic acid in bile was higher, and cholic acid lower, in elderly subjects (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1988
- Full Text
- View/download PDF
29. Quantitative determination of C2-C8 volatile fatty acids in human serum by vacuum distillation and gas chromatography.
- Author
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Tangerman A, van Schaik A, Meuwese-Arends MT, and van Tongeren JH
- Subjects
- Caprylates blood, Chemistry, Pharmaceutical methods, Chromatography, Gas methods, Humans, Fatty Acids, Volatile blood
- Published
- 1983
- Full Text
- View/download PDF
30. Prevalence of achlorhydria in a normal population and its relation to serum gastrin.
- Author
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Bins M, Burgers PI, Selbach SG, van Wettum TB, Lamers CB, and van Tongeren JH
- Subjects
- Adult, Fasting, Female, Gastric Acid metabolism, Gastric Acidity Determination, Gastric Juice analysis, Humans, Hydrogen-Ion Concentration, Male, Middle Aged, Pentagastrin, Achlorhydria blood, Alcian Blue blood, Indoles blood, Phenazines blood, Phenothiazines blood, Resorcinols blood
- Abstract
In a middle-aged group of normal subjects achlorhydria after maximal stimulation with pentagastrin was found in 12 out of 366 males (3%) and 2 out of 198 females (1%); 13 of these 14 (93%) had an elevated serum gastrin, of which nine were more than two times normal. In another 11 persons a moderately elevated serum gastrin - less than two times normal - was found in absence of achlorhydria. At least seven of them had hypochlorhydria. Of 540 persons with a normal serum gastrin one had achlorhydria. Determination of the serum gastrin appeared to be fairly reliable as a method of detecting achlorhydria.
- Published
- 1984
31. Letter: Streptozotocin in the Zollinger-Ellison syndrome.
- Author
-
Lamers CB and van Tongeren JH
- Subjects
- Adolescent, Adult, Drug Evaluation, Female, Gastrectomy, Gastrins blood, Humans, Zollinger-Ellison Syndrome blood, Zollinger-Ellison Syndrome pathology, Streptozocin therapeutic use, Zollinger-Ellison Syndrome drug therapy
- Published
- 1975
- Full Text
- View/download PDF
32. Estimation of radiation dosage and transmutation effect of 14-C involved in measuring rate of albumin synthesis with 14-C-carbonate.
- Author
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Yap SH, Hafkenscheid JC, Goossens CM, Buys WC, Binkhorst RA, and van Tongeren JH
- Subjects
- Aortic Aneurysm metabolism, Body Burden, Carbon Dioxide analysis, Female, Humans, Liver Cirrhosis metabolism, Male, Middle Aged, Peptic Ulcer metabolism, Respiration, Risk, Urea urine, Albumins biosynthesis, Carbon Radioisotopes, Carbonates, Radiation Dosage
- Abstract
For direct measurement of the rate of albumin synthesis Na2 14CO3 was used intravenously. The assessment of the radiation hazard involved in the study was based on the knowledge of the minimum dose of Na214CO3 necessary for a sufficient incorporation of 14C in the guanidine-C of arginine in albumin to obtain measurable radioactivity. By measurement of expired 14CO2 and excreted 14C-urea in the urine during a 5-hr period following intravenous administration of Na214CO3 in five subjects, some quantitative data on 14C retention and radiation dosage were obtained. In comparison with animal studies, the rate of expiration of 14CO2 in man is slower. About 50% of the total radioactivity injected was lost through the respiratory route in the first hour. The total amount of expired 14C during the 5 hr of investigation was about 75% of the injected dose for the five subjects. The amount of 14C excreted as urinary 14C-urea during the 5 hr of investigation is very small in comparison with the expired 14C; it was only about 0.5% of the dose injected. The total absorbed radiation dose after complete elimination of 14C from the body was calculated with various assumptions. The extra risk of genetic damage due to disintegration of retained 14C in comparison with that of natural 14C in the body during 30 living years is about 50%.
- Published
- 1975
33. Treatment of the dumping syndrome with the somatostatin analogue SMS 201-995.
- Author
-
Hopman WP, Wolberink RG, Lamers CB, and Van Tongeren JH
- Subjects
- Adult, Blood Glucose analysis, Drug Evaluation, Dumping Syndrome physiopathology, Female, Hematocrit, Humans, Insulin blood, Male, Middle Aged, Octreotide, Pulse, Somatostatin therapeutic use, Dumping Syndrome drug therapy, Somatostatin analogs & derivatives
- Abstract
In six patients suffering from severe early dumping and six patients with late dumping after peptic ulcer surgery, the effect of the somatostatin analogue SMS 201-995 was compared with placebo. In early dumpers subcutaneous administration of 50 micrograms SMS 201-995 prior to meal ingestion induced a strong improvement of dumping symptoms as reflected by a decrease of the Sigstad dumping score from 12 +/- 2 during placebo to 5 +/- 2 (p less than 0.05). Furthermore, the postprandial increase of pulse rate was abolished; maximum pulse rate decreased from 85 +/- 7 beats/min to 67 +/- 7 beats/min (p less than 0.05). SMS 201-995 did not significantly affect postprandial changes in packed cell volume. In late dumpers 50 micrograms SMS 201-995 reduced peak plasma insulin after oral glucose from 173 +/- 16 mU/L during placebo to 35 +/- 9 mU/L during SMS 201-995 (p less than 0.05) and increased individual plasma glucose nadirs from 1.9 +/- 0.3 mmol/L to 7.5 +/- 3.3 mmol/L (p less than 0.01). Both in early and late dumpers SMS 201-995 improved postprandial expiratory breath hydrogen excretion indicating slowing of gastrointestinal hurry. SMS 201-995 is a powerful therapeutic agent for the management of patients suffering from the dumping syndrome after gastric surgery.
- Published
- 1988
- Full Text
- View/download PDF
34. Unconjugated serum bile acids as a marker of small intestinal bacterial overgrowth.
- Author
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Masclee A, Tangerman A, van Schaik A, van der Hoek EW, and van Tongeren JH
- Subjects
- Adult, Aged, Diarrhea blood, Diarrhea microbiology, Enterobacteriaceae metabolism, Fasting, Food, Humans, Ileum surgery, Intestinal Diseases blood, Intestinal Diseases surgery, Middle Aged, Bile Acids and Salts blood, Enterobacteriaceae growth & development, Intestinal Diseases microbiology, Intestine, Small microbiology
- Abstract
Non-invasive methods to detect small intestinal bacterial overgrowth often lack specificity in patients who have undergone an ileal resection or have an accelerated intestinal transit. Since elevated serum unconjugated bile acid levels have been found in patients with clinical signs of bacterial overgrowth, we studied the clinical value of unconjugated serum bile acids as a marker of small intestinal bacterial overgrowth. Patients with culture-proven bacterial overgrowth had significantly elevated fasting unconjugated serum bile acid levels (median and range: 4.5; 1.4-21.5 mumol l-1) as compared to healthy subjects (0.9; 0.3-1.7 mumol l-1, P less than 0.005), to persons with an accelerated intestinal transit (1.0; 0.3-1.9 mumol l-1, P less than 0.005) and to persons who have undergone an ileal resection (2.1; 0.7-3.6 mumol l-1, P less than 0.005). The same was true 30 and 60 min after ingestion of a Lundh meal. Serum unconjugated bile acid levels above 4 mumol l-1 were found in eight of 10 patients with culture-proven small intestinal bacterial overgrowth whereas serum levels above 4 mumol l-1 were found in none of the patients from the three control groups. These results suggest that determination of unconjugated serum bile acids is of clinical value in the evaluation of patients suspected of small intestine bacterial overgrowth.
- Published
- 1989
- Full Text
- View/download PDF
35. Home parenteral nutrition via arteriovenous fistulae.
- Author
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Engels LG, Skotnicki SH, Buskens FG, and van Tongeren JH
- Subjects
- Adolescent, Adult, Aged, Female, Home Care Services, Humans, Male, Parenteral Nutrition adverse effects, Thrombosis etiology, Arteriovenous Shunt, Surgical, Parenteral Nutrition methods
- Abstract
Vascular access for home parenteral nutrition was achieved with arteriovenous fistulae during an average 14.3 months in seven patients. Two Cimino fistulae and six bovine grafts were used. The only complication was bovine graft thrombosis which occurred in six instances despite anticoagulant therapy. Thrombectomy could successfully be performed in three graft thrombosis. Considering complication rates arteriovenous fistulae are valuable alternatives for central venous catheters in long-term parenteral nutrition at home.
- Published
- 1983
- Full Text
- View/download PDF
36. Intracolonic environment and the presence of colonic adenomas in man.
- Author
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van der Werf SD, Nagengast FM, van Berge Henegouwen GP, Huijbregts AW, and van Tongeren JH
- Subjects
- Adenoma metabolism, Bacteria isolation & purification, Colon metabolism, Colonic Neoplasms metabolism, Feces microbiology, Female, Humans, Intestinal Absorption, Male, Middle Aged, Risk, Time Factors, Adenoma microbiology, Colonic Neoplasms microbiology, Deoxycholic Acid metabolism
- Abstract
A promoting effect of large bowel contents on colonic carcinogenesis as seen in the animal model is still incompletely explored in man. We investigated simultaneously deoxycholate absorption (as marker of colonic mucosal exposure to tumour promoting bile salt metabolites), mouth-anus transit time, and the ratio of anaerobic to aerobic bacteria in stool in 10 persons with colonic adenomas and in 10 age matched control subjects. We found that anaerobic/aerobic ratios and colonic deoxycholate absorption were higher in patients with colonic adenomas (p less than 0.002 and p less than 0.001) and that these parameters were clearly interrelated, which also applied to intestinal transit times and the anaerobic/aerobic ratios. These data are consistent with a promoting effect of the intracolonic environment on development of adenomas in man. Long term induction of a more aerobic colon flora and shortening of intestinal transit time may diminish bile-salt induced tumour promotion in adenoma patients.
- Published
- 1983
- Full Text
- View/download PDF
37. The relation between basal gastric pH and serum gastrin.
- Author
-
Bins M, Burgers PI, Selbach SG, van Wettum TB, Lamers CB, and van Tongeren JH
- Subjects
- Adult, Aged, Female, Gastric Acid physiology, Gastrins metabolism, Gastritis, Atrophic metabolism, Humans, Hydrogen-Ion Concentration, Male, Middle Aged, Gastric Acid metabolism, Gastrins blood
- Published
- 1982
- Full Text
- View/download PDF
38. Double-blind comparison of 5-aminosalicylic acid and acetyl-5-aminosalicylic acid suppositories in patients with idiopathic proctitis.
- Author
-
van Hogezand RA, van Hees PA, van Gorp JP, van Lier HJ, Bakker JH, Wesseling P, van Haelst UJ, and van Tongeren JH
- Subjects
- Adult, Aminosalicylic Acids administration & dosage, Double-Blind Method, Female, Humans, Male, Mesalamine, Suppositories, Aminosalicylic Acids therapeutic use, Proctitis drug therapy
- Abstract
Suppositories containing 300 mg 5-aminosalicylic acid (1.96 mmol) or 425 mg acetyl-5-aminosalicylic acid (1.96 mmol) were used in 40 patients with idiopathic proctitis to determine the efficacy of acetyl-5-aminosalicylic acid in treating this bowel inflammation. Each patient was treated with 5-aminosalicylic acid or acetyl-5-aminosalicylic acid suppositories twice daily for 4 weeks in a double-blind trial. Four patients were included twice in the trial. The second time they were treated with the alternative regimen. Six patients in the acetyl-5-aminosalicylic acid group did not complete the trial, four of them because of diarrhoea. Complete clinical remission with normal rectal mucosa on sigmoidoscopy was achieved in 10 out of 18 patients on 5-aminosalicylic acid and in only two out of 15 in the acetyl-5-aminosalicylic acid group (P = 0.03). A favourable histological improvement was demonstrated with 5-aminosalicylic acid suppositories, but the difference with acetyl-5-aminosalicylic acid was not significant (P = 0.059). Three of the four patients who received both drugs recovered with 5-aminosalicylic acid; in none of them was acetyl-5-aminosalicylic acid effective. The results from this study and from previous investigations show that acetyl-5-aminosalicylic acid is not superior to placebo.
- Published
- 1988
- Full Text
- View/download PDF
39. Age dependent differences in human bile acid metabolism and 7 alpha-dehydroxylation.
- Author
-
van der Werf SD, Huijbregts AW, Lamers HL, van Berge Henegouwen GP, and van Tongeren JH
- Subjects
- Adult, Age Factors, Aged, Cholic Acids metabolism, Colon metabolism, Deoxycholic Acid metabolism, Diet, Female, Humans, Intestinal Absorption, Kinetics, Male, Middle Aged, Risk, Bile Acids and Salts metabolism, Cocarcinogenesis, Colonic Neoplasms etiology
- Abstract
It has been suggested that transformation of secondary bile acids into (co)carcinogenic compounds may have a role in the development of cancer of the large bowel. Because of age dependent differences of this disease we undertook a study of cholic and deoxycholic acid metabolism of eleven young adults (group A, 20-30 years old) and eleven elderly persons (group B, 55-75 years old) with a double isotope dilution method. Daily food intake was standardized individually and gut transit time measured with radioopaque pellets and labelled chromium chloride. The 7 alpha-dehydroxylation fractions (the ratio of deoxycholic acid input rate from the large bowel to cholic acid synthesis rate) were higher in group B (P less than 0.01) due to higher deoxycholic acid input rates (P less than 0.005), especially when individuals from both groups with rapid gut transit were compared. As contributory factor was recognized the higher fractional turnover rate of cholic acid in group B. Pool sizes and synthesis rates of cholic acid and gut transit times were similar. In group A, but not in B, gut transit times correlated with deoxycholic acid input rates (P less than 0.01). The differences in bile acid metabolism may be related to a more effective colonic absorption of deoxycholic acid in the elderly persons with a concomitant decrease of active ileal absorption of cholic acid in the elderly persons. Differences in diet or gut transit time between both groups do not seem to be the underlying mechanism.
- Published
- 1981
- Full Text
- View/download PDF
40. Mucosal lesions and malabsorption in celiac sprue.
- Author
-
Cluysenaer OJ, Schillings PH, and van Tongeren JH
- Subjects
- Biopsy, Celiac Disease physiopathology, Humans, Jejunum pathology, Leukocyte Count, Lymphocytes, Celiac Disease pathology, Intestinal Absorption, Intestinal Mucosa pathology
- Published
- 1982
- Full Text
- View/download PDF
41. Comparative study of the value of the calcium, secretin, and meal stimulated increase in serum gastrin to the diagnosis of the Zollinger-Ellison syndrome.
- Author
-
Lamers CG and Van Tongeren JH
- Subjects
- Adolescent, Adult, Aged, Clinical Trials as Topic, Eating, Female, Humans, Male, Middle Aged, Zollinger-Ellison Syndrome blood, Calcium, Gastrins blood, Secretin, Zollinger-Ellison Syndrome diagnosis
- Abstract
To evaluate the usefulness of provocation tests in the diagnosis of the Zollinger-Ellison (ZE) syndrome stimulation tests with calcium, 15 mg/kg. 3 h, and secretin GIH, 1 U/kg.30 s, were performed in 15 patients with histologically proven or suspected ZE syndrome. Nine of these 15 patients were without previous gastric surgery and in them meal stimulated serum gastrin levels were measured as well. These tests were also performed in normal subjects and in patients with duodenal ulcer, antrectomy, total gastrectomy, and achlorhydria. All tests were considered to be positive if a more than 50% increase in serum gastrin was found. The results indicate that secretin stimulation is the provocation test of first choice in the diagnosis of this syndrome. This test is most valuable for the following reasons: (1) there were few (two out of 15) false-negative test results in ZE patients; (2) there were no false-positive tests in 69 patients without gastrinoma; (3) it was easy and quick to perform; and (4) there were no adverse reactions. The two ZE patients with negative secretin stimulation tests had negative calcium provocation tests as well, in spite of histologically proven gastrinoma. In 11 patients with suspected or proven ZE syndrome and basal serum gastrin levels of less than 1000 pg/ml a rather good correlation (r = 0-841; P less than 0-01) was found between the percental increase in serum gastrin after stimulation by calcium and secretin. Meal stimulated serum gastrin levels are helpful only in patients without previous gastric surgery.
- Published
- 1977
- Full Text
- View/download PDF
42. Prevalence of endocrine abnormalities in patients with the Zollinger-Ellison syndrome and in their families.
- Author
-
Lamers CB, Stadil F, and Van Tongeren JH
- Subjects
- Adolescent, Cushing Syndrome complications, Endocrine System Diseases epidemiology, Endocrine System Diseases genetics, Female, Humans, Male, Multiple Endocrine Neoplasia complications, Pedigree, Pituitary Neoplasms etiology, Zollinger-Ellison Syndrome genetics, Endocrine System Diseases complications, Zollinger-Ellison Syndrome complications
- Abstract
To evalute the frequency of associated and hereditary endocrinopathies in the Zollinger-Ellison syndrome, 10 patients with the syndrome were studied. In seven of them, coexisting endocrine disease was found. In six, the Zollinger-Ellison syndrome was probably a feature of multiple endocrine adenomatosis type I, whereas Cushing's syndrome in the remaining patient may have been caused by the production of an ACTH-like substance by a mixed pancreatic tumor. A total of 109 family members, including all living first degree relatives over 15 years of age, were screened for endocrine abnormalities. All six patients with evidence of multiple endocrine adenomatosis type I had relatives with endocrinopathies. In the families of the four other patients with the Zollinger-Ellison syndrome, no endocrine abnormalities were found. During this study four new cases of pituitary tumor, 17 of hyperparathyroidism, seven of the Zollinger-Ellison syndrome and one of insulinoma were detected. Although most of the disorders were asymptomatic, this clearly indicates that patients suffering from Zollinger-Ellison syndrome and also their families should undergo detailed endocrine studies.
- Published
- 1978
- Full Text
- View/download PDF
43. Disposition of 5-aminosalicylic acid by 5-aminosalicylic acid-delivering compounds.
- Author
-
Rijk MC, van Schaik A, and van Tongeren JH
- Subjects
- Adult, Aminosalicylic Acids administration & dosage, Delayed-Action Preparations, Feces analysis, Female, Humans, Male, Mesalamine, Sulfasalazine administration & dosage, Aminosalicylic Acids metabolism, Azo Compounds administration & dosage
- Abstract
The disposition of 5-aminosalicylic acid (5-ASA) from 5-ASA-delivering drugs was studied in eight healthy volunteers. Time-related urinary excretion and faecal excretion of 5-ASA and acetyl-5-ASA were measured after a single oral dose of the azo compounds sulphasalazine and olsalazine, of the slow-release compounds Pentasa, Asacol, and Salofalk, and of plain 5-ASA. Plain 5-ASA was rapidly excreted into urine and had a low faecal recovery, indicating fast absorption proximally in the intestine and little availability to the colon. After ingestion of both azo compounds and slow-release compounds, urinary excretion of 5-ASA was markedly delayed and reduced, and faecal excretion was enhanced. At all points of time there was a significant but not very marked difference in urinary excretion of 5-ASA after ingestion of the azo compounds and the slow-release compounds, in favour of the azo compounds. A significantly larger proportion of the ingested 5-ASA, moreover, was excreted in faeces after intake of azo compounds as compared with slow-release compounds.
- Published
- 1988
- Full Text
- View/download PDF
44. Hypergastrinemia of antral origin in duodenal ulcer.
- Author
-
Lamers CB, Ruland CM, Joosten HJ, Verkooyen HC, van Tongeren JH, and Rehfeld JF
- Subjects
- Adult, Duodenal Ulcer physiopathology, Duodenal Ulcer surgery, Gastrectomy, Gastric Juice metabolism, Gastric Mucosa analysis, Gastric Mucosa metabolism, Gastrins metabolism, Humans, Hyperplasia, Male, Pyloric Antrum analysis, Pyloric Antrum surgery, Recurrence, Secretory Rate, Duodenal Ulcer blood, Gastrins blood, Pyloric Antrum metabolism
- Abstract
A case of recurrent duodenal ulcer, basal gastric hypersection, and hypergastrinemia of antral origin is presented. The diagnosis was suggested preoperatively by stimulation tests with secretin and food. Billroth II antrectomy led to normalization of serum gastrin within half an hour. The gastrin content of the antral mucosa was not increased, neither was antral G-cell hyperplasia demonstrable. Postoperatively the basal gastric acid output and fasting serum gastrin levels were normal, without a postprandial increase in serum gastrin concentrations. The case does not support the existence of a specific disease called antral G-cell hyperplasia.
- Published
- 1978
- Full Text
- View/download PDF
45. Jejunal lymphoma in a patient with primary adult-onset hypogammaglobulinemia and nodular lymphoid hyperplasia of the small intestine.
- Author
-
Lamers CB, Wagener T, Assmann KJ, and van Tongeren JH
- Subjects
- Adult, Female, Humans, Hyperplasia, Intestine, Small pathology, Jejunal Neoplasms pathology, Lymphoma pathology, Mesentery, Agammaglobulinemia complications, Jejunal Neoplasms complications, Lymph Nodes pathology, Lymphoma complications
- Abstract
A patient is presented with primary adult-onset hypogammaglobulinemia and nodular lymphoid hyperplasia of the small intestine complicated by a jejunal lymphoma. The tumor was resected and was classified as a malignant diffuse histiocytic lymphoma with involvement of mesenteric lymph nodes. Gastroenterological, immunological, histological, and immunopathological studies on this case are reported. The possibility that nodular lymphoid hyperplasia of the small intestine in hypogammaglobulinemia is a premalignant condition is discussed.
- Published
- 1980
- Full Text
- View/download PDF
46. Serum gastrin response to acute and chronic hypercalcaemia in man: studies on the value of calcium stimulated serum gastrin levels in the diagnosis of Zollinger-Ellison syndrome.
- Author
-
Lamers CB and Van Tongeren JH
- Subjects
- Acute Disease, Chronic Disease, Humans, Calcium, Gastrins blood, Hypercalcemia blood, Zollinger-Ellison Syndrome diagnosis
- Abstract
In this study the effect of calcium infusion over 3 h without gastric aspiration on serum gastrin was determined in fifteen normal subjects, ten patients with duodenal ulcer, nine with stomal ulcer, five with total gastrectomy, six with achlorhydria and sixteen with proved or presumed Zollinger-Ellison (ZE) syndrome. Serum gastrin only rose significantly in the patients with ZE-syndrome or achlorhydria. An increase of above or below 50% of basal value seems to be a valuable criterion by which to differentiate between patients with and without ZE-syndrome. Serum gastrin levels in forty-four patients with chronic hypercalcaemia (72+/-24 pg/ml, mean+/-SD) were not significantly different from the levels in 100 normal subjects (66+/-18 pg/ml; P greater than 0.10). However, in one patient with ZE-syndrome and in two patients with achlorhydria serum gastrin values were markedly higher during chronic hypercalcaemia than during normocalcaemia. It is concluded that acute or chronic hypercalcaemia without gastric aspiration does not lead to hypergastrinaemia in the absence of ZE-syndrome or achlorhydria.
- Published
- 1977
- Full Text
- View/download PDF
47. Postprandial serum gastrin levels in patients with combined hypergastrinaemia and hyperchlorhydria.
- Author
-
Lamers CB and Van Tongeren JH
- Subjects
- Gastrectomy, Gastric Juice metabolism, Humans, Postoperative Period, Time Factors, Zollinger-Ellison Syndrome surgery, Eating, Gastrins blood, Zollinger-Ellison Syndrome blood
- Abstract
We have determined the serum gastrin response to a standard test meal in 13 unoperated patients with combined fasting hypergastrinaemia (more than 150 ng/l) and basal hypersecretion of gastric acid (BAO more than 10 mmol/h). In 10 of 11 patients with proved of presumptive Zollinger-Ellison syndrome the peak postprandial rise in serum gastrin concentration was less than 50 per cent of basal value. The integrated gastrin response to feeding ranged from 71-9 to 211-8 mug/lX 150 min. In 2 patients with proved hypergastrinaemia of antral origin, however, serum gastrin rose to 223 per cent and 255 per cent respectively of basal value after ingestion of the meal. The integrated postprandial serum gastrin responses in these patients were 66-8 and 22-0 mug/lX 150 min. Two patiets with Zollinger-Ellison syndrome and total gastrectomy showed peak serum gastrin levels after feeding of 174 and 255 per cent of basal concentration. The integrated postprandial gastrin secretions were 365 and 366 mug/l X 150 min respectively. It is concluded that the serum gastrin response to feeding, when expressed as percentage change, may be helpful in the differential diagnosis of unoperated patients with fasting hypergastrinaemia and basal gastric acid hypersecretion.
- Published
- 1979
- Full Text
- View/download PDF
48. Is discrimination between type A and B atrophic gastritis clinically useful in achlorhydria?
- Author
-
Bins M, Burgers PI, Selbach SG, van Wettum TB, Schuyt-van Etten TJ, Poels LB, Lamers CB, and van Tongeren JH
- Subjects
- Achlorhydria metabolism, Antibodies, Gastric Mucosa cytology, Gastric Mucosa immunology, Gastrins blood, Humans, Achlorhydria classification, Gastritis classification, Gastritis, Atrophic classification
- Abstract
We tested the validity of the concept that chronic atrophic gastritis can be subdivided into type A and B in hospital patients and normal subjects with proven pentagastrin-refractory achlorhydria. Classification was based on the determination of the basal serum gastrin and parietal cell antibodies. Of 59 hospital patients with achlorhydria, 71% could be classified as belonging to either type A or B; for 29% the criteria for neither type were fulfilled. Of 14 asymptomatic persons with achlorhydria found in 564 normal persons, five could be classified as having type A gastritis, and one as type B gastritis. In eight (53%) persons, an elevated serum gastrin was found in the absence of parietal cell antibodies, representing an intermediate type of atrophic gastritis. Because one-third of the hospital patients and more than half the persons with achlorhydria in a normal population had to be classified as belonging to an intermediate type, the discrimination between type A and B atrophic gastritis in achlorhydria seems to be of limited practical value.
- Published
- 1983
- Full Text
- View/download PDF
49. Treatment of intractable pruritus in patients with cholestatic jaundice by plasma exchange and plasma perfusion.
- Author
-
Geerdink P, Snel P, van Berge Henegouwen GP, Huybregts A, Tangerman A, Kunst VA, and van Tongeren JH
- Subjects
- Humans, Perfusion, Pruritus etiology, Cholestasis complications, Plasmapheresis, Pruritus therapy
- Published
- 1978
50. Serum concentrations of immunoreactive calcitonin in patients with hypergastrinaemia.
- Author
-
Lamers CB, Hackeng WH, Thien T, and van Tongeren JH
- Subjects
- Calcitonin immunology, Chronic Disease, Humans, Multiple Endocrine Neoplasia blood, Zollinger-Ellison Syndrome blood, Calcitonin blood, Gastrins blood
- Abstract
In order to test tthe hypothesis that chronically elevated serum gastrin levels induce hypercalcitoninaemia, we have measured serum calcitonin levels in patients with chronic hypergastrinaemia. Basal serum calcitonin concentrations were found to be elevated in 2 of 23 patients with Zollinger-Ellison syndrome, but not in 16 patients with hypergastrinaemia due to achlorhydria or a single patient with primary hypergastrinaemia of antral origin. Both Zollinger-Ellison patients with hypercalcitoninaemia (0.31 and 0.79 ng/ml) had multiple endocrine adenomatosis type 1, but no medullary carcinoma of the thyroid. The hypercalcitoninaemia in these patients does not seem to be related to multiple endocrine adenomatosis type 1, since serum calcitonin was normal in 12 normogastrinaemic patients with hyperparathyroidism from families with multiple endocrine adenomatosis type 1. We conclude that chronically elevated serum gastrin levels do not result in hypercalcitoninaemia.
- Published
- 1980
- Full Text
- View/download PDF
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