Comparison of elastase-1 with amylase, lipase, and trypsin-like immunoreactivity in the diagnosis of acute pancreatitis.

Serum elastase-1, amylase, lipase, and trypsin-like immunoreactivity were measured in a group of 17 consecutive patients with acute pancreatitis. When assayed within 24 h of the onset of symptoms, all enzymes were found to be elevated, thus showing similar sensitivity. Elastase-1 did not improve the diagnostic score of the other enzymes studied. Owing to their much quicker and less expensive determinations, amylase and lipase should be considered the best initial markers of pancreatic injury. However, during the course of pancreatitis, amylase and in a lesser degree lipase returned to normal in more cases than elastase or trypsin; both were still elevated in 90% of the patients 10 days after the onset of the symptoms. Thus, trypsin and/or elastase-1 should be reserved for cases of doubtful or delayed diagnosis. The specificity and the positive predictive value of these enzymes need to be evaluated.

[Biotechnology and ethics]. / Biotechnologie en ethiek.

Biotechnology confronts us with ethical questions, that cannot be satisfactorily answered on the basis of traditional ethics in every case. The reason is that the development of technology influences traditional ethical conceptions and often gives rise to a wide variety of ethical views (abortion, euthanasia). After a general discussion of the causes of ethical differences, the role of technological developments in this regard is examined. This leads to the conclusion that technology is not ethically neutral. The increase of science and technology is ethically good. This conclusion does not imply that each of science or technology is also good. After the discussion of the relationship between ethics and technology in general, the results are applied to biotechnology.

[Dilemmas in ethology]. / Dilemma's van de ethologie.

Taught by the history of biology, ethologists try to adhere as rigidly as possible to the method used in natural science. They therefore are hesitant in using concepts which are ultimately derived from the human world of inner experience. In order to examine this question, the present paper first deals with the strength and the weakness of the natural scientific method, which is followed by a discussion of the manner in which this makes itself felt in biology. Although the method used in natural science is fully applicable in biology, particular phenomena (such as pain) will not be considered because of the character of this method. However, this does not detract from the reality of these phenomena and in that sense does not make them any less objective. If ethology wishes to do justice to animals, it is not be able to avoid including phenomena such as consciousness, pain, etc., in its investigations, even though the problem of extrapolating human self-experience to animals will continue to exist.

[The significance of the 3d phase of life]. / De betekenis van de derde levensfase.

After a short discussion of the changed situation of the elderly in society, the question is taken up whether old age has a value of its own. Is it only a period of life in which all capacities diminish or are there perhaps fundamental human values which specifically belong to old age. The author answers that, although there are no such values, it nevertheless can be said that some values which are important in each period of life have more chance to be realized in old age. Discussed are in this connection values such as love, friendship, resignation, realistic attitude, religion, gratitude and wisdom. Some of these values are neglected in modern society with its 'activistic' culture, and of some of them the full meaning is narrowed down. This leads to the conclusion that not only the elderly would profit from the cultivation of the said values, but also society as a whole.

Enhancement of the amylase-creatinine clearance ratio in pregnancy.

The renal clearance of amylase, expressed as a proportion of simultaneous creatinine clearance (Cam/-Ccr), was determined in 131 women in various stages of pregnancy. No abnormal serum levels of amylase were found. A moderate but significant increase in Cam/Ccr occurred during the last 15 weeks of pregnancy. Possible causes for this change were investigated in smaller groups of subjects. No increase in rapidly cleared isoamylase could be detected. No modification in renal tubular handling of protein could be evidenced, as assessed by measurements of the renal clearance of beta 2 microglobulin, expressed as a proportion of simultaneous creatinine clearance. An incrased glomerular permeability to amylase probably accounts for elevated Cam/Ccr in pregnancy.

Effect of caerulein on gamma-glutamyl transpeptidase and alkaline phosphatase in the duodenal juice in chronic pancreatitis.

During infusion of caerulein, the output of gamma-glutamyl transpeptidase and biliary alkaline phosphatase is significantly more increased in chronic pancreatitis patients than in normal subjects. The presence of the gall-bladder is necessary to observe this effect of caerulein. It is not related to the discharge of large amounts of both enzymes by the diseases pancreas.