{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T06:31:02Z","timestamp":1768890662262,"version":"3.49.0"},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1974,3]]},"abstract":"<jats:p>In this investigation, the measurement of trypsin levels in duodenal juice following a standard test meal (Lundh test) was evaluated as a test of pancreatic function, and a study was made of diseases and other factors which may influence its diagnostic efficiency. The method of trypsin assay, which required only basic laboratory equipment, gave a linear concentration-activity curve, with a threshold at 50 \u03bcg of crystalline trypsin per ml. Intestinal juice could be frozen and stored for up to six weeks with no detectable loss of tryptic activity.<\/jats:p>\n                  <jats:p>The normal control values were very similar to those found by other workers and were unaffected by the sex or age of the subject. When used to assess 32 patients in whom the presence or absence of pancreatic disease had been clearly established, the test had a diagnostic success rate of 94%.<\/jats:p>\n                  <jats:p>Retrospective analysis of results from 98 patients showed that trypsin levels were generally grossly reduced in patients with chronic pancreatitis or carcinoma of the head of the pancreas. Trypsin levels were normal in most patients with steatorrhoea not of pancreatic origin. Levels were generally depressed to intermediate levels in patients with a diabetic glucose tolerance, with or without steatorrhoea, but no other sign of pancreatic insufficiency. Some lowering of trypsin levels was also noted in patients having an obstruction of the common bile duct. A small but significant depression of tryptic activity was noted in patients with villous atrophy and no pancreatic disease.<\/jats:p>","DOI":"10.1136\/gut.15.3.173","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"173-179","source":"Crossref","is-referenced-by-count":19,"title":["Factors influencing duodenal trypsin levels following a standard test meal as a test of pancreatic function"],"prefix":"10.1136","volume":"15","author":[{"given":"I. J.","family":"Zeitlin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Sircus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1974,3,1]]},"reference":[{"key":"ref_1","year":"1967","unstructured":"Bock 0. A. A., Bank, S., Marks, I. N., and Jackson, W. P. U. (1967)."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"812","DOI":"10.7326\/0003-4819-59-6-812","article-title":"External pancreatic secretion in diabetes mellitus","volume":"59","author":"Chey, W.Y.; Shay, H.; Shuman, C.R.","year":"1963","unstructured":"Chey, W. Y., Shay, H., and Shuman, C. R. (1963). External pancreatic secretion in diabetes mellitus. Ann. intern. Med., 59, 812-821.","journal-title":"Ann. intern. Med"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/S0016-5085(19)34205-2","article-title":"Normal duodenal trypsin values in response to secretin-pancreozymin stimulation with preliminary data in patients with pancreatic disease","volume":"53","author":"Choi, H.J.; Goldstein, F.; Wirts, C.W.; Menduke, H.","year":"1967","unstructured":"Choi, H. J., Goldstein, F., Wirts, C. W., and Menduke, H. (1967). Normal duodenal trypsin values in response to secretin-pancreozymin stimulation with preliminary data in patients with pancreatic disease. Gastroenterology, 53, 397-402.","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1136\/gut.8.4.408","article-title":"Measurement of tryptic activity in intestinal juice as a diagnostic test of pancreatic disease","volume":"8","author":"Cook, H.B.; Lennard-Jones, J.E.; Sherif, S.M.; Wiggins, H.S.","year":"1967","unstructured":"Cook, H. B., Lennard-Jones, J. E., Sherif, S. M., and Wiggins, H. S. (1967). Measurement of tryptic activity in intestinal juice as a diagnostic test of pancreatic disease. Gut, 8, 408-414.","journal-title":"Gut"},{"key":"ref_5","first-page":"184","article-title":"Studies in pancreatic function. IV. The use of the secretin test in the diagnosis of tumors in and about the pancreas","volume":"18","author":"Dreiling, D.A.","year":"1951","unstructured":"Dreiling, D. A. (1951). Studies in pancreatic function. IV. The use of the secretin test in the diagnosis of tumors in and about the pancreas. Gastroenterology, 18, 184-196.","journal-title":"Gastroenterology"},{"key":"ref_6","first-page":"165","article-title":"Intestinal enterokinase. Mechanisms of its 'secretion' into the lumen of the small intestine","volume":"1","author":"Hadorn, B.; Steiner, N.; Sumida, C.; Peters, T.J.","year":"1971","unstructured":"Hadorn, B., Steiner, N., Sumida, C., and Peters, T. J. (1971). Intestinal enterokinase. Mechanisms of its 'secretion' into the lumen of the small intestine. Lancet, 1, 165-166.","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1001\/archinte.1925.00120090028002","article-title":"Pancreatic and hepatic activity in diabetes mellitus","volume":"35","author":"Jones, C.M.; Castle, W.B.; Mullholland, H.; Bailey, F.","year":"1925","unstructured":"Jones, C. M., Castle, W. B., Mullholland, H., and Bailey, F. (1925). Pancreatic and hepatic activity in diabetes mellitus. Arch. intern. Med., 35, 315-336.","journal-title":"Arch. intern. Med"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"299","DOI":"10.2337\/diab.18.5.299","article-title":"Standardization of the oral glucose tolerance test","volume":"18","year":"1969","unstructured":"Klimt, C. R., Prout, T. E., Bradley, R. F., Dolger, H., Fisher, G., Gastineau, C. F., Marks, H., Meinert, C. L., and Schumacher, 0. P. (1969). Standardization of the oral glucose tolerance test. Diabetes, 18, 299-310.","journal-title":"Diabetes"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/j.0954-6820.1967.tb11534.x","article-title":"Testing of exocrine function of pancreas in diabetes mellitus by use of \"7Se-methionine and of secretin","volume":"182","author":"Lahdevirta, J.","year":"1967","unstructured":"Lahdevirta, J. (1967). Testing of exocrine function of pancreas in diabetes mellitus by use of \"7Se-methionine and of secretin. Acta med. scand., 182, 345-351.","journal-title":"Acta med. scand"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/S0016-5085(62)80025-0","article-title":"Pancreatic exocrine function in neoplastic and inflammatory disease; a simple and reliable new test","volume":"42","author":"Lundh, G.","year":"1962","unstructured":"Lundh, G. (1962). Pancreatic exocrine function in neoplastic and inflammatory disease; a simple and reliable new test. Gastroenterology, 42, 275-280.","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1136\/gut.10.11.913","article-title":"Measurement of duodenal tryptic activity and 7\"Se-selenomethionine pancreatic scanning compared as tests of pancreatic function","volume":"10","author":"McCarthy, D.M.; Brown, P.","year":"1969","unstructured":"McCarthy, D. M., and Brown, P. (1969). Measurement of duodenal tryptic activity and 7\"Se-selenomethionine pancreatic scanning compared as tests of pancreatic function. Gut, 10, 913-920.","journal-title":"Gut"},{"key":"ref_12","first-page":"607","article-title":"The normal and abnormal pancreatic scan","volume":"37","author":"Melmed, R.N.; Agnew, J.E.; Bouchier, I.A.D.","year":"1968","unstructured":"Melmed, R. N., Agnew, J. E., and Bouchier, I. A. D. (1968). The normal and abnormal pancreatic scan. Quart. J. Med., 37, 607-624.","journal-title":"Quart. J. Med"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/0005-2744(70)90144-0","article-title":"The cellular localization of enterokinase","author":"Nordstrom, C.; Dahlquist, A.","year":"1970","unstructured":"Nordstrom, C., and Dahlquist, A. (1970). The cellular localization of enterokinase. Biochim. biophys. Acta. (Amst.)., 198, 621-622.","journal-title":"Biochim. biophys. Acta. (Amst.)"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/BF02997405","article-title":"The external secretion of the pancreas and diabetes mellitus","volume":"10","author":"Pollard, H.M.; Miller, L.; Brewer, W.A.","year":"1943","unstructured":"Pollard, H. M., Miller, L., and Brewer, W. A. (1943). The external secretion of the pancreas and diabetes mellitus. Amer. J. dig. Dis., 10, 20-23.","journal-title":"Amer. J. dig. Dis"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1148\/87.4.641","article-title":"Pancreatic scanning","volume":"87","author":"Sodee, D.B.","year":"1966","unstructured":"Sodee, D. B. (1966). Pancreatic scanning. Radiology, 87, 641-645.","journal-title":"Radiology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"242","DOI":"10.7326\/0003-4819-61-2-242","article-title":"The exocrine pancreas in diabetes mellitus","volume":"61","author":"Vacca, J.B.; Henke, W.J.; Knight, Jr, W.A.","year":"1964","unstructured":"Vacca, J. B., Henke, W. J., and Knight, W. A., Jr. (1964). The exocrine pancreas in diabetes mellitus. Ann. intern. Med., 61, 242-247.","journal-title":"Ann. intern. Med"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1136\/gut.8.4.415","article-title":"Simple method for estimating trypsin","volume":"8","author":"Wiggins, H.S.","year":"1967","unstructured":"Wiggins, H. S. (1967). Simple method for estimating trypsin. Gut, 8, 415-416.","journal-title":"Gut"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.15.3.173","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T14:30:03Z","timestamp":1765636203000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.15.3.173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1974,3]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1974,3,1]]},"published-print":{"date-parts":[[1974,3]]}},"alternative-id":["10.1136\/gut.15.3.173"],"URL":"https:\/\/doi.org\/10.1136\/gut.15.3.173","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1974,3]]}}}