ABSTRACT
Pentagastrin (Peptavlon, ICI 50123) is known as a powerful stimulator of gastric acid secretion. Several authors have demonstrated a close relationship between gastric acid secretion and gastric blood flow. In this study the general hemodynamic properties of pentagastrin were investigated qualitatively and quantitatively. The study was performed on anesthetized mongrel dogs. Blood flow was assessed with non-cannulating electromagnetic flow probes. Pentagastrin was injected intravenously at intervals of 2 min in amounts between 1 ng and 8192 ng/kg, following a logarithmic scale. Pentagastrin dose-dependently increased splanchnic blood flow in a reversed U-shaped manner. The major vasoactivity occurred in two organ areas--the gastric area and the pancreatico-duodenal area. Pentagastrin increased blood flow in these areas to 300% and 350% of initial value, respectively, at a dose of 2-4 microgram/kg. Since heart rate, cardiac output, and arterial pressure were not influenced, pentagastrin had no general hemodynamic effect. This was confirmed by blood flow measurements in the renal a., common carotid a., and femoral a. It was therefore concluded that the splanchnic blood flow increase was due to an extreme decrease of splanchnic vascular resistance.
Subject(s)
Hemodynamics/drug effects , Pentagastrin/pharmacology , Animals , Blood Pressure/drug effects , Cardiac Output/drug effects , Celiac Artery/drug effects , Dogs , Dose-Response Relationship, Drug , Female , Heart Rate/drug effects , Hepatic Artery/drug effects , Male , Mesenteric Arteries/drug effects , Pancreas/blood supply , Pentagastrin/administration & dosage , Regional Blood Flow/drug effects , Renal Artery/drug effects , Stomach/blood supply , Vascular Resistance/drug effectsABSTRACT
We evaluate whether highly selective vagotomy (HSV) might disturb functional integrity of the lower esophageal sphincter (LES). Special interest was directed to changes in position of the LES in relation to the diaphragm, LES pressure, and pH reflux pattern. The conditions of 20 patients were evaluated by manometric studies and by 12-hour overnight pH measurements before and 14 days after HSV; five of them were also studied one year after HSV. The results indicate: (1) There is a slight elongation of the LES in the early postoperative phase, which seems to disappear after one year. (2) The position of the diaphragm as measured manometrically by the pressure inversion point descends in relation to the LES 14 days after HSV, and it does not seem to return to its original position after one year. (3) There is no significant change in LES pressure after HSV. (4) There is no increase in reflux after HSV.
Subject(s)
Esophagogastric Junction/physiopathology , Vagotomy/adverse effects , Adult , Duodenal Ulcer/surgery , Female , Gastroesophageal Reflux/physiopathology , Humans , Hydrogen-Ion Concentration , Male , Manometry , Middle Aged , Pressure , Vagotomy/methodsABSTRACT
The results of a prospective study of 60 patients with nonobstructive duodenal ulcer treated by highly selective vagotomy show that the gastric acid secretion postoperatively is effectively reduced. Judgment of completeness of highly selective vagotomy is only possible by means of an intragastric pH-metry during operation. The Hollander test answers it insufficiently. In a number of patients, highly selective vagotomy caused a fast initial phase of gastric emptying of porradge. The impression is that the contractional activity of the antrum has the same pattern before and after highly selective vagotomy.
