Sluggish gallbladder emptying and gastrointestinal transit after intake of common alcoholic beverages.

To study the movement along the gut and the effect upon the gallbladder volume of alcoholic beverages taken in the interdigestive state. The study comprised three research blocks attended by 12 healthy subjects each. Within a given research block volunteers underwent three examination sessions held on separate days, being offered an alcoholic beverage, or an aqueous ethanol solution of an identical proof, or a corresponding volume of isotonic glucose solution; the order of administration of the drinks was randomized. The beverages tested were: beer (4.7% vol, 400 ml), red wine (13.7% vol, 200 ml), whisky (43.5% vol, 100 ml) within the "Beer", "Wine", and "Whisky" research block, respectively. Gastric myoelectrical activity was examined electrogastrographically, gastric emptying with ¹³C-sodium acetate breath test, orocaecal transit with lactulose H2 breath test, gallbladder emptying with ultrasonography, breath ethanol with alcotest. The study showed that alcoholic beverages were emptied from the stomach significantly slower than isotonic glucose. Alcoholic beverages produced by fermentation only (beer, red wine) were emptied from the stomach more slowly than ethanol solutions of identical proof, while gastric evacuation of whisky (distillation product) and matching alcohol solution was similar. The slower gastric evacuation of alcoholic beverages and ethanol solutions could not be ascribed to a disorganization of the gastric myoelectrical activity. The orocaecal transit of beer and red wine did not differ from that of isotonic glucose, whereas the orocaecal transit of whisky and high proof ethanol was markedly prolonged. Red wine and whisky, and to a similar extent control ethanol solutions caused an inhibition and delay of gallbladder emptying. We concluded that alcoholic beverages taken on an empty stomach exert a suppressive effect upon the transport function of the digestive tract and gallbladder emptying. The extent of this action depends on the type of a beverage (whether it is obtained from fermentation only, or fermentation followed by distillation) and ethanol concentration therein.

13C-methacetin breath test correlates with clinical indices of liver disease severity in patients with primary biliary cirrhosis.

This prospective study intended to ascertain if cytochrome P450 dependent liver function is affected in early and late histological stages of primary biliary cirrhosis (PBC). The study included 32 female PBC patients (mean age 55.4 years, range 33-70) and 16 aged-matched healthy women (mean age 52.6 years, range 38-65). In every subject a 13(C)-methacetin breath test (13(C)-MBT) was applied, and the results were related to histological Ludwig's staging system and several indices of liver disease severity comprising the MAYO-1, MAYO-2, MELD, and Child-Pugh score. The 13(C)-MBT differentiated healthy controls from the patients with Ludwig IV and Ludwig III histopathological stages of PBC. The most significant relationships (i.e. explaining >50% of the variance) were found between measurements of the momentary breath 13(C) elimination from 6 to 18 minutes as well as the 15-min or 30-min cumulative elimination and the MAYO-1 or MAYO-2 scores. The breath test poorly correlated with histopathological features of PBC, however, it accurately discriminated cirrhotic from non-cirrhotic patients (momentary breath 13(C) elimination at 40 min, AUROC 0,958). In conclusion, 13(C)-MBT correlates with clinical scoring systems, especially those specifically designed for PBC (Mayo model) and accurately recognizes the disease at the stage of cirrhosis up to 40 minutes of the test duration.

Multichannel electrogastrography under a magnifying glass--an in-depth study on reproducibility of fed state electrogastrograms.

We checked on reproducibility of parameters of a multichannel electrogastrogram in adults after intake of typical, applied in electrogastrography, test meals. Recordings of multichannel electrogastrograms were accomplished in four blocks comprising 18 subjects (nine healthy volunteers and nine patients with functional GI disorders) each. Every subject had two examinations taken 1-2 days apart, and a third one was accomplished at least 2 weeks before or after the two other sessions. The registration involved a 30-min fasted and a 2-h postprandial period after one of the meal stimuli tested within a given block: 400 mL water, 400 g yoghurt (378 kcal), a scrambled eggs sandwich (370 kcal), a pancake (355 kcal). From among the parameters reflecting the propagation of the gastric slow waves, the average percentage of slow wave coupling (APSWC) exhibited a good (coefficient of variation for paired examinations CV(p) < or = 10%) to moderate (10 < CV(p) < or = 30%) reproducibility. On the other hand, the reproducibility of the maximum dominant frequency difference and the spatial dominant power difference was found to be unsatisfactory. The reproducibility of the multichannel electrogastrographic parameters did not differ between healthy volunteers and patients with functional GI disorders. Gender or the kind of a test meal did not affect the reproducibility of the electrogastrographic parameters either. The medium-term reproducibility was not any worse than the short-term one. From among the parameters of a multichannel electrogastrogram intended to quantify the propagation of slow waves, only the APSWC offers a reproducibility potentially good enough for clinical applications.

How reproducible is cutaneous electrogastrography? An in-depth evidence-based study.

AIM: To check on reproducibility of parameters of the cutaneous electrogastrogram registered at a close or a distant time span. METHODS: Twenty-two volunteers recruited by an advertisement (11 females and 11 males, median age 25 years, range: 18-35) underwent three surface electrogastrography examinations of which two were taken on consecutive days and the third one was accomplished at least 2 weeks before or after the two other sessions. The examination involved a 30-min fasted recording, followed by a 90-min postprandial registration after intake of a 394-kcal mixed solid-liquid test meal. RESULTS: Parameters of the electrogastrogram pertaining to the frequency of the gastric slow waves exhibited good to moderate reproducibility, whereas fair reproducibility characterized parameters expected to describe the power of gastric slow waves. With the exception of the difference fed minus fasted power (DeltaDP), in no instance was the medium term reproducibility any worse than the short term one. Categorical data analysis revealed that the relative time share of normogastria postprandially exhibited a better reproducibility than in the fasted period. The Cohen's kappa-value of 0.459 for the DeltaDP for the medium term reproducibility placed this parameter within the range of moderate agreement between repeat examinations. Of the two two-parameter combinations considered, the alliance of the fasted and fed normogastria performed worse than any of those parameters considered alone, whereas a combination of the DeltaDP with the fed-state normogastria revealed a kappa-value amounting to 0.510 for the medium term reproducibility. CONCLUSIONS: The feasibility of some electrogastrographic parameters to convey clinically useful information may be hampered by their fair reproducibility. Recoding of parameters of the cutaneous electrogastrogram from primary continuous to secondary categorical may help achieve a better agreement between repeat examinations.

Supervised and Unsupervised Learning Systems as a Part of Hybrid Structures Applied in EGG Signals Classifiers.

This paper aims at investigating an unsupervised learnt neural networks in classifier applications and comparing them to supervised perceptron type nets. The proposed solutions focus on combing the time-frequency preliminary analysis by means of wavelet transform with application of self organizing maps. Using wavelet transform as a feature extraction tool allowed to reveal important parameters included both in time and frequency domain of non-stationary electrogastrographic signals, which were classified in elaborated systems. Proposed structures were tested using the set of clinically characterized EGG signals of 62 patients, as cases with different level rhythm disturbances from bradygastria up to tachygastria together with some artifacts of non-stationary character such as muscle thrill etc. Additionally similar control group of healthy patients was analyzed. The results of the proposed methodology are illustrated in the measure of sensitivity and specificity, where the best classifier based on Kohonen maps with preliminary wavelet processing reached the performance above 90%.

Gastrectomy in the rat using two modifications of esophagojejunal anastomosis. general status, local histological changes and relationships to bone density.

Gastrectomy (GX) was carried out in the male rat according to the Longmire and the Roux-en-Y procedure. The focus of the postoperative investigations was to evaluate the influence of post-GX morphological changes occurring at the site of two types of end-to-end esophagojejunal anastomosis (with and without invagination), in particular food intake, body weight gain, food efficiency, hematocrit and bone density. GX failed to alter food intake, fasting blood glucose, alpha-amino nitrogen, or free fatty acids, but led to uniformly decreased body weight, food efficiency and serum gastrin, and increased serum osteocalcin, indicating high turnover osteopenia. However, irrespective of the type of (digestive tract) reconstruction (Longmire or Roux-en-Y), the invagination anastomosis was associated with lower mortality, fewer complications, less early postoperative weight loss, less intensive tissue changes at the anastomotic site, and improvement of bone density and hematocrit. Bivariate and multivariate regression analysis revealed that bone density was negatively influenced by epithelial hyperplasia of the anastomotic tissue, while hematocrit was positively influenced by bone density. In contrast, food intake appeared to have no influence. It was concluded that (1) the histological status of the esophagointestinal anastomosis varies depending on the surgical technique applied and (2) the type of anatomical reconstruction of the digestive tract (Longmire vs. Roux-en-Y) and food intake may be of minor importance for the bone and hematological status of GX rats. Future investigations are justified to clarify whether esophagojejunal proinflammatory tissue factors may contribute to the GX-mediated damage of bone mineral and bone marrow, thereby leading to low body weight.

[The respiratory system of workers employed in the casting and processing of copper]. / Uklad oddechowy u pracowników zatrudnionych przy odlewaniu i przetwarzaniu miedzi.

The aim of the study was to examine the influence of work in exposure to copper on the respiratory system. The study was carried out in 267 men aged (x +/- SD) 40.6 +/- 7.2 yrs, workers of a colour metal mill. 134 of them dealt with casting and processing of copper (the mean weighed concentration of copper on work posts was below 0.05 mg x m-3) and 133, not employed in a contaminated environment, comprised the control group. The subjects were divided into five groups according to the degree of energy expenditure at work and, additionally cigarette smoking was taken into account. All subjects underwent medical examination and spirometry. However the mean values of the ventilatory parameters in the compared groups did not significantly differ (p > 0.05), the multivarious regression analysis has shown a decreasing trend of FEV1 and FVC with relation to the exposition to copper and tobacco smoking. The frequency of chronic bronchitis as well as of radiological changes was not increased. The authors conclude: 1. At copper concentration not exceeding the MAC, and an advantageous microclimate, this exposition only slightly diminishes the pulmonary ventilation and does not cause other comprehensible pulmonary pathological sequelae, especially chronic bronchitis. 2. Tobacco smoking is a favourable factor for the occurrence of chronic bronchitis.

Effect of peripherally and centrally administered calcitonin on gallbladder emptying in dogs.

The effect of calcitonin on meal-stimulated gallbladder emptying (GBE) was examined after intravenous (i.v.) and intracerebroventricular (i.c.v.) administration in six mongrel dogs. The gallbladder contraction was surveyed by means of real-time ultrasonography in conscious dogs. Calcitonin given i.v. elicited an immediate and strong inhibition of postprandial GBE-the integrated 0- to 120-min gallbladder response was 118.1 +/- 8.0%.h after placebo, whereas it was 91.8 +/- 2.1%.h, 59.4 +/- 17.9%.h (P < 0.001), and 14.2 +/- 20.5%.h (P < 0.001) after 3.6, 18.0, and 90.0 pmol.kg-1 calcitonin, respectively. After i.c.v. administration (1.8 and 18.0 pmol.kg-1), only the higher calcitonin dose exerted a moderate inhibitory effect on postprandial GBE. The calcitonin doses required to evoke a 50% inhibition of meal-stimulated GBE were 15- to 10-fold lower after i.v. than i.c.v. application. Peripherally given calcitonin brought about a dose-dependent increase in the interdigestive gallbladder volume-the linear regression of the relative gallbladder volume versus calcitonin dose was y = 11.60 [ln(dose + 1)] + 97.02 (r = 0.864, P < 0.001). Intravenous application of calcitonin did not affect caerulein-induced GBE. The results obtained imply that: (i) calcitonin exerts an inhibitory influence on meal-induced GBE and that this effect is more pronounced after i.v. than after i.c.v. administration, and (ii) peripherally given calcitonin does not inhibit caerulein-induced gallbladder contraction in the dog.

Gastric emptying in hyperthyroidism.

OBJECTIVES: We undertook a prospective study to survey gastric emptying of a solid meal in patients with hyperthyroidism until euthyroidism was reached after pharmacological treatment with thiamazole. METHODS: Eleven women (aged 33.2 +/- 3.2 SE yr) with recently diagnosed hyperthyroidism participated in the study. Thyroid function parameters and gastric emptying were examined on three occasions, before treatment, during the third week of treatment, and after euthyroidism was restored. The control group was composed of 12 age-matched healthy women (aged 34.5 +/- 2.3 yr). Gastric emptying of a 390-kcal 99mTc-labeled solid meal was continuously recorded under a gamma camera over 90 min. A power-exponential model was used for analysis of the gastric emptying course. Three gastric emptying parameters were computed: t1/2, the gastric half-emptying time, S, the curve shape parameter, and K, the slope of the curve. RESULTS: Pretreatment solid phase gastric emptying of the patients was not statistically significantly different from that of the healthy control subjects: t1/2, 82.8 +/- 4.9 vs 93.5 +/- 6.0 min; S, 0.996 +/- 0.103 vs 1.032 +/- 0.064; and K, 8.42 +/- 0.47 vs 7.64 +/- 0.39 min(-1) x 10(-3). Gastric emptying during the third week of treatment did not change in comparison with pretreatment gastric emptying: t1/2, 84.3 +/- 8.2 min; S, 1.014 +/- 0.123; and K, 8.92 +/- 1.12 min(-1) x 10(-3). On the other hand, a slight increase in rate of gastric emptying was observed after the restoration of euthyroidism (t1/2, 74.6 +/- 5.8 min, and K, 9.65 +/- 0.76 min(-1) x 10(-3), p < 0.05 vs healthy control subjects for both parameters), but no significant change was observed in the shape parameter (S, 0.980 +/- 0.066). CONCLUSIONS: In women with hyperthyroidism, gastric emptying of solids does not differ significantly from that observed in age-matched healthy control subjects and remains unaffected during pharmacological treatment. After restoration of euthyroidism, a slight but statistically significant increase in the rate of gastric emptying occurs in patients as compared with healthy control subjects.

Simultaneous assessment of gallbladder emptying in the dog by real-time ultrasonography and strain gauge.

Patterns of meal- and cerulein-induced gallbladder emptying (GBE) were compared in four dogs equipped with a force transducer implanted onto the body of the gallbladder, and in four unoperated animals. GBE was examined by real-time ultrasonography in conscious dogs. In two dogs the ultrasonographic measurement of GBE was performed simultaneously with the registration of the strain exerted on the force transducer fixed on the gallbladder body. Implantation of the force transducer onto the gallbladder impaired neither postprandial nor cerulein-induced GBE. The contractile response of the gallbladder exhibited a non-linear relationship to the gallbladder volume. The reduction of gallbladder volume to 50% of its basal value was accompanied by an increase in strain amounting to about 16% of the maximum response, whereas a pronounced augmentation of the strain was observed with gallbladder volume ranging between 30% and 10% of the basal value. On the other hand, the contractile response of the gallbladder registered by means of a force transducer was linearly related to the angle alpha contained between two radii passing from the gallbladder center towards the edges of the strain gauge: y = 0.852 alpha-30.97 (r = 0.959, P < 0.001) in the case of i.v. cerulein infusion at stepwisely increasing doses (0.7-2.2-7.4-22.2-66.5 pmol.kg-1 h-1), and y = 0.640 alpha-17.40 (r = 0.869, P < 0.001) for a 1-h constant-rate 22.2 pmol.kg-1 h-1 cerulein infusion.

Gastric emptying in hypothyreosis.

The purpose of this study was to compare the solid phase gastric emptying (GE) in hypothyreotic patients before treatment and after euthyreosis has been reached. Ten female patients (aged 44.8 +/- 9.5[SD] y) with recently diagnosed hypothyroidism were included in the study. Their thyrometabolic state and GE were examined before treatment and after a median of 5 1/2 months (range 2 1/2-12 1/2), i.e., when euthyreosis was achieved. The control group consisted of 12 healthy women (aged 34.5 +/- 8.1y). GE of a 390-kcal 99mTc-labelled solid meal was continuously recorded under a gamma camera during 90 min. A power-exponential model was used for the analysis of the GE course. Compared to the controls, the solid phase GE of the hypothyreotics was characterized by a significantly lower curve shape parameter S (0.745 +/- 0.217 vs. 1.032 +/- 0.223, p < 0.01) and slope of the curve K (4.8 +/- 2.2 min-1.10(-3) vs. 7.6 +/- 1.3 min-1.10(-3), p < 0.01). Restoration of euthyreosis resulted in an increase of both parameters, making the GE pattern no longer statistically significantly different from that encountered in healthy subjects. The treatment did not affect the gastric half emptying time T1/2 (median: 125 min and 130 min before and after the treatment, respectively; healthy controls: 94 min). A wide variation of individual GE data was found either before or after the treatment, and in a few cases delayed GE persisted despite an effective substitutive treatment. The GE kinetics was, however, in no way related to the severity of the disease. Further research on the pathogenesis of this phenomenon is warranted.

[Evaluation of stomach emptying under extreme obstruction of gastrointestinal transit treated with gastro-intestinal or duodenal-intestinal anastomosis]. / Ocena oprózniania zoladkowego w warunkach wysokiej niedroznosci przewodu pokarmowego leczonej zespoleniem zoladkowo-jelitowym lub dwunastniczo-jelitowym.

The purpose of the present study was to compare gastric emptying in two groups of dogs in which a gastrojejunal or duodenojejunal Roux-en-Y anastomosis was performed over the site of an experimental obstruction in the distal duodenum. The experiment was carried out on 10 mongrel dogs. Gastric emptying was assessed twice in each dog before the experiment (control examination); the solid phase of the test meal was labelled with 99mTc. Following a control examination, the dogs were divided into two groups of 5 animals each, and subjected to the above mentioned surgical procedures. Postoperative gastric emptying was carried out 3 weeks after the operation, and then at 3 and 6 months following the procedure. The following parameters describing quantitatively gastric emptying were determined: mean transit time MTT0-60. MTT0-120 and total mean transit time MTT0-180. The comparison of these parameters revealed statistically significant differences confirming delay of gastric emptying in dogs with a gastrojejunal anastomosis.

[Evaluation of stomach emptying in patients with hyperthyroidism]. / Ocena kinetyki oprózniania zoladka u chorych z nadczynnoscia tarczycy.

The study aimed at the evaluation of the kinetics of gastric emptying (GE) of a solid meal in hyperthyroid patients during a pharmacological treatment with thiamazole until the moment of euthyroid restoration. Fourteen female patients ((33.4 +/- 2.6 y, mean +/- SE) with recently diagnosed hyperthyreosis took part in the study. Twelve age matched healthy women (34.5 +/- 2.3 y) constituted a control group (C). Every patient underwent the GE examination before treatment (I). In 12 patients the GE was reexamined on the 3rd treatment week (II). After the achievement of euthyroid, which happened after 4.5 mo (median; interquartile range 2.0 to 7.3 mo), a third GE measurement was taken in 13 patients (III). The GE of a 99mTc-labelled solid meal was measured with the use of a gamma camera. Time-activity curves from the gastric region of interest were used, after subjection to appropriate corrective procedures, to calculate the mean gastric transit time (MTT 90) and the fraction of the test meal retained in the stomach after 90 min (F90). Before the treatment and on the third week of management the GE of hyperthyroidism was not statistically significantly different from that of healthy controls (MTT90:39.44 +/- 0.30 min [I] 39.31 +/- 0.64 min [II] and 40.06 +/- 0.29 [C]; F90:46.6 +/- 1.9% [I], 47.9 +/- 3.7% [II] and 50.8 +/- 2.4% [C]). The restoration of euthyreosis was accompanied by a slight but statistically significant increase in the GE -p < 0.05 in the case of F90 vs the pre-treatment situation. Also the patients' GE was found then to be slightly but statistically faster than in healthy controls (MTT90:38.72 +/- 0.39 min [III], and F90: 42.2 +/- 2.3% [III] -p < 0.05 vs [C] for both parameters). We conclude that in hyperthyreotic women the GE of solids does not differ significantly from age-matched healthy female controls and remains unchanged during a pharmacological treatment. After achievement of euthyreosis a slightly but statistically significantly faster GE is observed in the patients when compared to healthy controls.

[Evaluation of gastric emptying in patients with hypothyroidism]. / Ocena kinetyki oprózniania zoladka u chorych z niedoczynnoscia tarczycy.

The study aimed at the evaluation of the gastric emptying (GE) kinetics in hypothyroid patients before and after a substitutive treatment with L-thyroxin. Twelve female hypothyroid (aged 45.3 +/- 8.7 years, mean +/- SD) and a control group of 12 healthy women (aged 34.5 +/- 8.1 years) were examined. The GE of a 99mTc-labelled solid meal was measured with the use of a gamma camera in every patient before the treatment, and in 10 of them a repeat GE examination was performed after the restoration of euthyroid; the median duration of the treatment was 5.5 mo (range 2.5 to 12 mo). The mean gastric transit time (MTT90) and the fraction of the test meal retained in the stomach after 90 min (F90) were statistically significantly greater in untreated hypothyroid than in healthy controls (MTT90: 42.01 +/- 1.86 min patients vs 40.06 +/- 1.00 min controls, p = 0.0043; F90: 64.3 +/- 15.4% patients vs 50.8 +/- 8.2% controls, p = 0.0173). In ten patients in whom a second GE measurement was taken after the achievement of euthyroid, a slight increase of the GE was observed (MTT90:41.46 +/- 1.49 min before vs 41.04 +/- 1.81 min after the treatment, NS) which was then no longer statistically significantly different from that of the healthy controls. No relationship was found between the GE and the severity of clinical symptoms of hypothyroidism. GE remained, however, slowed in some patients despite the restoration of euthyreosis. We conclude that: (I) long-lasting hypothyreosis is accompanied by a slightly slowed GE of solids, and (II) restoration of euthyreosis does not imply a parallel improvement of the hypothyroidism-associated delay in GE.

Noninvasive evaluation of kinetics of gallbladder emptying and filling in the dog. A real-time ultrasonographic study.

Patterns of gallbladder contraction induced by a meal or cerulein were examined by means of real-time ultrasonography in conscious dogs. The postprandial gallbladder emptying was characterized by two parameters of the power-exponential function: the gallbladder half emptying time T1/2 = 47.3 +/- 4.7 min and the curve shape parameter S = 0.866 +/- 0.036. Cerulein infused at stepwise increasing rates of 0.7, 2.2, 7.4, 22.2, and 66.5 pmol/kg/hr, administered each for 10 min, evoked a gallbladder contraction to 87.4 +/- 3.8%, 66.7 +/- 2.4%, 44.5 +/- 1.5%, 25.9 +/- 2.1%, and 11.9 +/- 2.0% of the basal volume, respectively. The dependence of the gallbladder emptying on the dose of cerulein was described by the equation of linear regression y - 21.33 [ln(dose + 1)] + 95.81 (r = -0.963, P < 0.001). Accordingly, the cerulein dose required to evoke a 50% reduction of the gallbladder volume amounted to 7.6 pmol/kg/hr (95% confidence interval: 6.8-8.6 pmol/kg/hr). A plateau at the level of about 44% of the basal gallbladder volume characterized the time-course of the gallbladder emptying between 20 and 60 min of the infusion at a constant rate of 7.4 pmol/kg/hr. On the other hand, the 1-hr infusion of 22.2 pmol/kg/hr evoked a continuous decrease in the gallbladder volume with a nadir of 10.2 +/- 0.7% achieved at 60 min. Refilling of the gallbladder, contracted after a 1-hr infusion of cerulein, was complete within 30 and 60 min after the end of infusion for rates of 7.4 pmol/kg/hr and 22.2 pmol/kg/hr, respectively. The time course of the gallbladder filling after cessation of 1-hr infusion of cerulein at 7.4 pmol/kg/hr was described by the equation of linear regression of relative gallbladder volumes vs time: y = 1.732x + 48.61 (r = 0.739, P < 0.001). Refilling of the gallbladder was faster during the first 30 min (y = 2.191x + 7.13, r = 0.885, P < 0.001) and slower between 30 and 60 min (y = 1.218x + 74.97, r = 0.533, P < 0.001) after the end of a 1-hr infusion of cerulein at a rate of 22.2 pmol/kg/hr.

Partial gastric resection for peptic ulcer--comparison of the effect of variant reconstructive procedures on gastric emptying, gastric acid secretion and gastrin release in the early postoperative period I. Roux-en-Y and Billroth-II gastroenteroanastomosis.

Fourteen patients subjected to partial gastric resection with vagotomy and a gastroenterostomy (Roux-en-Y, in 11 patients and of Billroth type-II in 3) underwent examinations of the gastric emptying (GE) of a radiolabelled solid meal, as well as of gastric acid and gastrin secretion before surgery and/or within 5.5 weeks postoperatively. The surgery resulted in a significant delay in GE-the median T1/2 nearly doubted from 77 min before to 151 min after the operation (p < 0.01). The GE pattern did not, however, change significantly, as reflected by a median curve shape parameter S amounting to 1.05 and 0.87 before and after the surgery, respectively. The Roux-en-Y reconstruction brought about a pronounced delay in GE with T1/2 exceeding the border of the mean T1/2 + 2SD of healthy controls in 7 (64%) out of 11 patients. On the other hand, no one of the B-II operated patients had a slowed GE. The basal and pentagastrin-stimulated gastric acid secretion was decreased by an average of 71% (from 6.2 +/- 0.7 to 1.8 +/- 0.6 mmol h-1, p < 0.001) and 82% (from 25.2 +/- 3.0 to 4.4 +/- 1.2 mmol h-1, p < 0.001), respectively. The surgery did not affect the fasting serum gastrin concentration (53.2 +/- 4.9 pre- vs 51.0 +/- 11.5 ng.l-1 postoperatively), whereas the postprandial gastrin release decreased significantly-AUC0-120: 9838 +/- 1377 ng.l-1 min before and 6863 +/- 1024 ng.l-1 min after the operation, p < 0.01.

Partial gastric resection for peptic ulcer--comparison of the effect of variant reconstructive procedures on gastric emptying, gastric acid secretion and gastrin release in the early postoperative period II. Billroth-I gastroduodenostomy and comparison versus gastroenteroanastomotic procedures.

Gastric emptying (GE) of a radiolabelled solid meal, gastric acid secretion and gastrin release was measured before and/or by 91/2 weeks postoperatively in 12 patients with partial gastric resection supplied with Billroth-I gastroduodenoanastomosis and usually (n = 10) with truncal vagotomy [B-1+(VT))]. The results obtained were compared to those derived from another study involving 14 patients with partial gastric resection supplied with a gastroenterostomy (of Roux-en-Y type in 11, and Billroth-II type in 3 subjects) and truncal vagotomy [Roux(B-II)+VT]. The B-I+(VT) procedure affected significantly neither the overall GE (the median T1/2 was 75 min before and 95 min after the surgery) nor the GE pattern-the median curve shape parameter S was 0.73 before and 1.07 after the operation. The basal and pentagastrin-stimulated gastric acid secretion was reduced by an average of 79% (from 8.6 +/- 2.5 to 1.8 +/- 0.5 mmol h-1, p < 0.05) and 77% (from 22.0 +/- 2.8 to 5.0 +/- 1.5 mmol h-1, p < 0.05) after the B-I+(VT), respectively. Moreover, after the B-I+(VT) a decrease in the fasted serum gastric concentration (78.3 +/- 17.0 before vs 62.4 +/- 6.9 ng l-1 after the surgery) and in the postprandial gastrin release (AUC0-120: 11716 +/- 2482 ng l-1 min before vs 9753 +/- 1183 ng l-1 min after the surgery) was found; the relevant differences were, however, statistically not significant. In patients with a preoperatively normal GE, a markedly slowed GE (T1/2 above the limit of the mean T1/2 +2SD in healthy controls) was found in 5 out of 8 (62%) patients after the Roux-en-Y procedure, and only in 1 out of 7 (14%) patients after the B-I or B-II procedure. With regard to the postoperative data, the Roux (B-II)+VT resulted in lower gastric acid secretion and gastrin release than the B-I+(VT) procedure but the relevant differences were statistically not significant.

Effect of cigarette smoking on gallbladder emptying and filling in man.

OBJECTIVE: The effect of cigarette smoking on gallbladder (GB) emptying and refilling after a fatty meal was examined in 10 healthy volunteers (four women and six men, mean age 27.6 yr). METHODS: On three different days, the subjects underwent in randomized order: a control test without smoking (C), or they smoked two cigarettes during the early (0-20 min; S0-20), or late (20-40 min; S20-40) phase of the meal-induced GB emptying. GB volumes were measured ultrasonographically before the meal and at 10, 20, 30, 40, 60, 90, 120, 150, and 180 min postprandially. Two-way ANOVA was applied for statistical assessment of the results. RESULTS: The fasted GB volumes amounted to 15.7 +/- 1.8 cm3 (C), 15.0 +/- 1.7 cm3 (S0-20), and 18.4 +/- 2.3 cm3 (S20-40), F2;18 = 1.524, NS. Maximum GB emptying was observed until 60 min after the meal, with a nadir of the GB volume amounting to 7.3 +/- 1.3 cm3 (C), 6.6 +/- 1.2 cm3 (S0-20), and 7.1 +/- 1.1 cm3 (S20-40). No significant difference was found between the stimuli tested when absolute GB volumes were considered: F2;180 = 2.725, NS. Analysis of the GB emptying-refilling curves normalized for the fasted GB volume revealed that a significant inhibitory effect was produced by smoking two cigarettes during the late phase of GB emptying on the subsequent GB refilling: F2;162 = 11.066, p < 0.001 for the whole curve, and F2;72 = 7.126, p < 0.005 for the refilling phase. A significant contrast was found next between S20-40 and the control day (p < 0.001 whole curve; p < 0.005 refilling phase only), as well as between S20-40 and S0-20 (p < 0.001 whole curve; p < 0.025 refilling phase only). CONCLUSION: We conclude that smoking two cigarettes does not disturb the fatty meal-induced GB contraction in healthy humans. Subsequent GB refilling is delayed if smoking takes place during the late phase of the postprandial GB contraction.