摘要:

This paper is concerned with the place of gastrin determination in ulcer surgery. Only the acid-stimulating properties of gastrin are considered. The role of the vagus in the gastrin response to a test meal was investigated in patients with duodenal ulcer. 50 patients were studied before and 3, 6 and 12 months after highly selective vagotomy without (25 patients) and with Wangensteen-pyloroplasty (25 patients). Basal and stimulated gastrin concentrations in serum, as determined by radioimmunoassay, were higher 3 months after the operation and 3 h after the test meal gastrin levels were still 50% higher than the basal levels. No difference was found between the patients treated with highly selective vagotomy and the patients treated with HSV and additional pyloroplasty. 6 and 12 months after the operation a moderate decrease of gastrin secretion was observed, but basal as well as stimulated levels were still elevated after 12 months compared to the values before operation. Our results indicate that the pattern of gastrin secretion changes as time passes after highly selective vagotomy with or without additional pyloroplasty.

ISSN:0014-312X    

DOI:10.1159/000127872

出版商:S. Karger AG    

年代:1976

数据来源: Karger

摘要:

Using a swine shock ulcer model, three pharmacological agents, methylprednisolone, vitamin A and methysergide were evaluated, as they protect gastric mucosa against acute ulceration. Following haemorrhagic shock (3 h duration; mean arterial pressure 40 mm Hg) nine of the ten control animals (90%) developed gastric ulceration. Of the six test animals treated with intravenous methylprednisolone during the shock, only one (17%) developed gastric lesions (p < 0.02; χ2= 5.76). Of the ten test animals pretreated with massive doses of parenteral vitamin A, only three (30%) developed lesions (p < 0.05; χ2 = 5.21). In contrast to this, treatment with methysergide, a serotonin antagonist, did not significantly effect the ulceration rate, since four of the six test animals (67%) had gastric lesions. The results suggest that methylprednisolone and vitamin A do protect the gastric mucosa from experimental stress ulceration, but their mechanisms of action remain obscure and further investigation is needed to judge their value in clinical us

ISSN:0014-312X    

DOI:10.1159/000127873

出版商:S. Karger AG    

年代:1976

数据来源: Karger

摘要:

Following abdominal surgery, insulin and glucose concentrations in the portal vein, and a peripheral vein are compared in patients during control periods and after oral administration of glucose. During the control period, the glucose concentrations are identical in both veins. After glucose loads with the prompt increase of portal glucose concentration the portal-peripheral difference also increases (p < 0.01). During the control period the insulin concentration in the portal vein is double as compared to peripheral blood (p < 0.005). After glucose load the increasing portal insulin as well as the peripheral and portal glucose correlate with the portal-peripheral insulin difference (p < 0.001). Furthermore, there is a significant positive correlation between the peripheral glucose area as a parameter of glucose tolerance and the portal insulin area as a semiquantitative parameter of insulin secretory capacity (p < 0.001). It can be concluded that in the early postoperative period in patients with a diminished oral glucose tolerance (large glucose areas) there is an even greater insulin response in comparison to patients with normal oral glucose tolerance. On the other hand, however, in those patients with diminished glucose tolerance, the insulin response is essentially delayed.

ISSN:0014-312X    

DOI:10.1159/000127874

出版商:S. Karger AG    

年代:1976

数据来源: Karger

摘要:

The mechanism for the high lactate production during hypothermic kidney perfusion has not been clarified previously. The metabolism of lactate and acetate was studied in 23 dog kidneys during continuous hypothermic perfusion. The perfusions were performed in a Gambro machine with a perfusate based on human serum albumin. With a perfusate containing fatty acid extracted albumin, which was almost free of fatty acids, the glucose uptake of the kidney was more pronounced than during perfusion with a fatty acid-rich perfusate. The high glucose uptake under this perfusion condition was associated with a lower lactate production and a higher glucose oxidation rate. In perfusions with a perfusate containing lactate at a concentration of 2.5 mmol/l a considerable lactate uptake of the kidney was shown. By isotope dilution technique the production and uptake rate of lactate was estimated at 4.4 and 8.0 µmol/g kidney and day in two experiments. The labeled lactate carbon was recovered in CO2, and glucose in the perfusate indicating a continuous oxidation and gluconeogenesis. Acetate was used by the kidney both for oxidation and for gluconeogenesis. Addition of acetate to the ordinary fatty acid-rich perfusate caused an enhanced lactate production from the perfused kidney. The results indicate that the high lactate production during hypothermic perfusion of kidneys is mainly dependent on a metabolic blockade at the level of pyruvate dehydrogenase

ISSN:0014-312X    

DOI:10.1159/000127875

出版商:S. Karger AG    

年代:1976

数据来源: Karger

摘要:

The extent to which changes in tissue energy metabolism correspond to the severity of a hemorrhagic shock condition has been studied. In cats, 50% of the blood volume was withdrawn within 10 min, resulting in a fatal outcome within 3 h (range from 45 min to 3 h). Skeletal muscle and blood samples were taken prior to the hemorrhage and in the agonal phase or after 2 h in compensated bled animals. Tissue levels of ATP, CrP, G-6-P, lactate and glucose as well as blood levels of glucose, lactate and pyruvate were determined enzymatically. The results showed no depletion of phosphagen levels in the agonal phase, while glycolytic metabolites, lactate in particular, demonstrated a close correlation to circulatory deterioration and imminent death.

ISSN:0014-312X    

DOI:10.1159/000127876

出版商:S. Karger AG    

年代:1976

数据来源: Karger

摘要:

Four groups of experiments were focused on two problems: first, the replacement of the substracted amount of blood, and second, the correction of the peripheral reactions to substantial blood loss, namely vasoconstriction and acidosis. We stuck to a simple plan in our experiments: lost blood was entirely collected and retransfused. In 26 cases out of 37, we used isoproterenol hydrochloride (Isuprel®-WINTHROP) to open the peripheral vascular bed. In six different groups, we followed the response to variations of retransfusion and administration of isoproterenol. Several parameters were studied: arterial blood pressure, central venous pressure, rectal temperature and pH. The association of blood transfusion with injection of isoproterenol, in adequate amounts to correct hypovolemia and to prevent vasoconstriction, is undoubtedly the best treatment of hemorrhagic shock

ISSN:0014-312X    

DOI:10.1159/000127877

出版商:S. Karger AG    

年代:1976

数据来源: Karger

摘要:

The process of healing of skin excisions and skin burns of equal sizes has been compared in rabbits. Excisions heal definitely quicker than burns, despite the fact that the part of the skin exposed to the burning agent does not undergo necrosis. Small excisional wounds heal more rapidly than larger ones but the healing rate of burn wounds in our series was independent of their size. Secondary excision of the burned tissue accelerates the healing process. Thus the healing time of burn wounds seems to depend more on clearing the wounds of the necrotic tissue than on the mere repair of the skin loss.

ISSN:0014-312X    

DOI:10.1159/000127878

出版商:S. Karger AG    

年代:1976

数据来源: Karger

摘要:

The effect of segmentary sectioning of the proximal jejunal tunica muscularis on intestinal propulsion was studied in the rat. Care was taken to avoid damage to the mucosa. In no instance was perforation or occlusion of the intestines observed. Myotomy was followed by a significant slackening of the passage of a test meal during the first 15 min after feeding, while the total transit time was virtually unchanged. Sectioning the musculature of the intestinal wall is shown to be responsible for retardation of bowel passage.

ISSN:0014-312X    

DOI:10.1159/000127879

出版商:S. Karger AG    

年代:1976

数据来源: Karger