Abstract
The effects of exogenous glucagon on a totally pancreatectomized patient were evaluated in both the acute postoperative and convalescent periods. In the acute postoperative phase, glucagon stabilized the blood glucose level and allowed the administration of an adequate amount of energy, while during the convalescent period, it proved useful in promoting the metabolism of lipids and amino acids and maintaining liver function. Moreover, we developed a glucagon aerosol which enabled frequent administration without causing major discomfort to the patient and raised the blood glucagon to satisfactory level.
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Shichiri M, Kawasaki R, Goriya Y, Yamasaki Y, Nomura M, Hakui N, Abe H. Glycaemic control in pancreatectomized dogs with a wearable artificial endocrine pancreas. Diabetologia 1983; 24: 179–184.
Horisawa M, Tange A, Shiogai Y, Domasu S, Hanasawa K, Hashimoto T, Uehara N, Nakane Y, Kodama M, Harano Y, Hidaka H. Use of artificial beta cell system in the management of totalpancreatectomized patients. Nippon Shokaki Geka Gakkai Zasshi (Jpn J Gastroenterol Surg) 1982; 15: 1430–1432. (in Japanese with English Abst.)
Müller WA, Berger M, Suter P, Cuppers HJ, Reiter J, Wyss T, Berchtold P, Schmidt FH, Assal JP, Renold AE. Glucagon immunoreactivities and amino acid profile in plasma of duodenopancreatectomized patients. J Clin Invest 1979; 63: 820–827.
Müller WA, Cuppers HJ, Telschow HZ, Micheli H, Wyss T, Renold AE, Berger M. Amino Acids and lipoproteins in plasma of duodenopancreatectomized patients: effects of glucagon in physiological amounts. Eur J Clin Invest 1983; 13: 141–149.
Dragstedt LR. Present status of lopocaic. JAMA 1940; 114: 29–32.
Akagi M, Kihara S, Takano S. Pre- and post-operative management of diabetic patients. Geka Chiryo (Surgical Therapy) 1986; 55: 821–828. (in Japanese)
Mishima M, Wakita Y, Nakano M, Hirota M, Ikei S, Akagi M. Promotion of nasal absorption of glucagon in rats and a totally pancreatectomized patient. Igaku no Ayumi (J Clin Exp Med) 1987; 140: 223–224. (in Japanese with English Abst.)
Nakai T, Yamada R, Baba M, Koyama E. A reevaluation of the glucagon provocative test for pheochromocytoma. Folia Endocrinol Jap 1980; 56: 855–867.
Scian LF, Westermann CD, Verdesca AS, Hilton JG. Adrenocortical and medullary effects of glucagon. Am J Physiol 1960; 199: 867–870.
Matsuyama T, Horie H, Namba M, Itoh H, Naonaka K, Tarui S, Yamatodani A, Wada H. Neither the catecholamines nor extrapancreatic glucagon play a significant role in recovery from hypoglycemia in totally pancreatectomized diabetic patients. Biomed Res 1985; 6: 81–84.
Okita K, Matsuda S, Hata K. Clinical use of glucagon and insulin in therapy of fulminant hepatic failure. Gastroenterologica Jap 1979; 14: 453–457.
Baker AL, Jaspan JB, Haines NW. A randomized clinical trial of insulin and glucagon infusion for treatment of alcoholic hepatitis. Gastroenterology 1981; 80: 1410–1414.
Yoshie T. Experimental studies on pathophysiology of total pancreatectomy and on its management. Kobe Daigaku Igakubu Kiyo (Med J Kobe Univ) 1979; 39: 83–95. (in Japanese with English Abst.)
Taniguchi T. Influence of estrogen on fat metabolism in totally depancreatectomized dogs. Arch Jpn Chir 1966; 35: 42–66.
Gill W, Mitchell GE, Boling JA, Tucker RE, Schelling GT, DeGregorio RM. Glucagon influence on gluconeogenesis and oxidation of propionic acid and threonine by perfused ovine liver. J Daily Sci 1985; 68: 2886–2894.
Duee PH, Pegorier JP, Peret J, Girard J. Separate effects of fatty acid oxidation and glucagon on gluconeogenesis in isolated hepatocytes from newborn pigs. Biol Neonate 985; 47: 77–83.
Heimberg M, Weinstein I, Kohout M. The effects of glucagon, dibutyryl cyclic adenosine 3′5′-monophosphate, and concentration of free fatty acid on hepatic lipid metabolism. J Biol Chem 1969; 244: 5131–5139.
Exton JH. Handbook of physiology. Washington DC: Am Physiol Soc 1972; 425–436.
Ezdinli EZ, Sokal JE. Comparison of glucagon and epinephrine effects in the dog. Endocrinology 1966; 78: 47–54.
Chiasson JL, Cook J, Liljequist JE, Lacy WW. Glucagon stimulation of gluconeogenesis from alanine in the intact dog. Am J Physiol 1974; 227: 19–23.
Chiasson JL, Liljenquist JE, Sinclair-Smith BC, Lacy WW. Gluconeogenesis from alanine in normal postabsorptive man: intrahepatic stimulatory effect of glucagon. Diabetes 1975; 24: 574–584.
Brockman RP, Bergman EN. Effect of glucagon on plasma alanine and glutamine metabolism and hepatic gluconeogenesis in sheep. Am J Physiol 1975; 228: 1627–1633.
Snodgrass PJ, Lin RC, Muller WA, Aoki TT. Induction of urea cycle enzymes of rat liver by glucagon. J Biol Chem 1978; 253: 2748–2753.
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Hirota, M., Ikei, S., Mishima, M. et al. Glucagon in the metabolic and nutritional management after total pancreatectomy —A case report—. The Japanese Journal of Surgery 19, 586–592 (1989). https://doi.org/10.1007/BF02471668
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DOI: https://doi.org/10.1007/BF02471668