Digestion

Urban, Ernest; Ricks, Phillip M.

doi: 10.1159/000198408pmid: 7353730

Rats were subjected to serial venesections 3 days prior to and then sequentially for 4 weeks after surgical removal of either the proximal or distal half of the small bowel. Total serum protein concentration and protein electrophoretic patterns were determined on these sera. Both sham-operated and unoperated animals served as controls. The data showed differences in serum proteins in the first week after operation between the three groups of operated rats and the unoperated controls. However, there were no significant differences in serum proteins between the sham-operated and the two types of resected animals. This indicates that the combined effects of laparotomy, anesthesia, pre- and postoperative fasting outweighed any additional early effects of loss of 50% small bowel on serum proteins. The study also demonstrates the necessity of having both unoperated and sham-operated control groups in designing experiments involving surgical extirpation of intestine.

Koch, M.M.; Giampieri, M.P.; Lorenzini, I.; Jezequel, A.M.; Orlandi, F.

doi: 10.1159/000198409pmid: 6766420

Chenodeoxycholic acid (CDCA) is an effective treatment for dissolving gallstones but experimental studies have suggested that it might be hepatotoxic. The present study is concerned with a group of patients undergoing medical therapy for gallstones for periods of 30 days up to 14 months with CDCA (15 mg/kg/day). Routine functional tests, determination of some liver microsomal enzymes and stereological studies of the liver tissue have been performed and the data have been compared with those obtained before treatment. No significant changes were observed in the functional tests throughout the study. Also the microsomal mixed function oxidase system seemed unaffected by CDCA therapy. The histological features of the liver biopsies were not appreciably different from those observed prior to treatment. Although there were large interindividual variations, the volume density of parenchymal steatosis and of the lipocytes remained comparable in the same individual. The ultrastructural features noted in untreated subjects such as curled mitochondrial cristae, slight intracellular bile retention, increased surface density of the rough endoplasmic reticulum were still evident after 14 months of treatment. No additional changes were noted. These results show that no evidence of hepatotoxicity seems to develop in man under therapy with CDCA at the dose considered. But the structural abnormalities observed before treatment appear to persist even in subjects under long-term therapy.

Horák, J.; Horký, J.; Rábl, M.

doi: 10.1159/000198410pmid: 7353731

The effects of 8-hour haemoperfusion through an activated charcoal column on fulminant hepatic failure were assessed in 10 dogs. The survival in the perfused animals was significantly prolonged and the onset of liver encephalopathy was markedly delayed compared to the controls. Significant decrease in plasma bilirubin and total plasma phenols was found in the perfused group. No other laboratory changes due to haemoperfusion were found. The charcoal column retained its adsorptive capability throughout the experiment as judged from phenol clearance values. In spite of current scepticism regarding its clinical use, further trials with haemoperfusion in acute liver failure seem to be warranted.

Kirk, A.P.; Summerfield, J.A.

doi: 10.1159/000198411pmid: 6766419

In a retrospective study of 755 patients undergoing endoscopic retrograde cholangiopancreatography from 1973 to 1977 at the Royal Free Hospital, 38 (5%) had a juxtapapillary diverticulum. This resulted in a significantly higher failure rate of cannulation of the ampulla of Vater (40 vs. 20% in the remainder of the group; p < 0.02). The presence of a juxtapapillary diverticulum was also significantly associated with an increase of cholelithiasis (48 vs. 24%; p < 0.01), and with jaundice or cholangitis developing after cholecystectomy (27 vs. 8%; p < 0.001). There was no evidence that the diverticula were the cause of biliary or pancreatic obstruction.

Borella, L.E.; Lippmann, W.

doi: 10.1159/000198412pmid: 7353732

A simple non-radioactive method for the simultaneous assessment of stomach emptying and intestinal propulsion in intact fasted conscious rats was developed employing Amberlite pellets. The Amberlite pellets were administered by gastric gavage and the rats were killed 20 or 120 min later. The number and percent of the pellets in the stomach and intestines and the distance travelled by each pellet in the small intestine were determined. The distance travelled by the leading pellet in the small intestine was employed as a parameter to determine effects on intestinal propulsion independent of the stomach emptying activity. Chlorisondamine (s.c), atropine (s.c), pentobarbital (i.p.) and sesame seed oil (p.o.) inhibited both stomach emtying and intestinal propulsion in a dose-related manner. All these agents also caused a dose-related displacement of the pellets in the small intestine which resulted in a more cephalad-oriented distribution of the pellets. Propantheline (s.c.) exerted a dose-related inhibition on the stomach emptying but not on intestinal propulsion. Carbachol (s.c.) increased both the rate of stomach emptying and that of propulsion in the small intestine.

Dupuis, Y.; Crouzoulon, G.; Fournier, P.

doi: 10.1159/000198413pmid: 7353733

The unidirectional influx of Ca (measured by in vitro methods) was similar along the intestine of the adult rat, from Treitz ligament to ileo-caecal valve. In in vivo ligated loop experiments, the rate of Ca absorption was similar during 30 min irrespective of site, sex and the presence of L-xylose in the Ca solution. On the contrary, these factors modified the quantity of Ca absorbed. After 30 min, absorption stopped in the male ileum whereas it continued (1) in the male jejunum; (2) in the ileum of the female, and (3) in the male ileum in the presence of xylose (absorption being proportional to xylose concentration). Thus, in the adult rat, the duration rather than the rate is the decisive factor in Ca uptake.

Mignon, M.; Vallot, T.; Galmiche, J.P.; Dupas, J.L.; Bonfils, S.

doi: 10.1159/000198414pmid: 7353734

Inhibition of gastric acid secretion by the combined use of cimetidine and pirenzepin has been studied in 5 cases of Zollinger-Ellison syndrome. In 4 acute cases i.v. cimetidine and i.m. pirenzepin were administered together as a treatment and were successful in 3 out of the 4 cases as judged by the disappearance of clinical symptoms and healing of the gastroduodenal and jejunal mucosal ulcerations. Secretory measurements indicated that addition of pirenzepin to cimetidine resulted in larger and more prolonged inhibition of acid secretion in these patients. The continuous record of intragastric pH in the 5th patient, over 24-hour periods, confirmed the above findings. Despite the use of large doses of pirenzepin, no significant side effects were noticed.

Simon, Bernd; Kather, Horst

doi: 10.1159/000198415pmid: 6243592

The effects of meclofenamic acid on basal and hormone-stimulated adenylate cyclase in human colonic mucosa were tested. It is shown that meclofenamic acid is a relatively specific inhibitor of the stimulatory action of prostaglandins on the level of mucosal adenylate cyclase. This compound did not inhibit significantly the effects of vasoactive intestinal peptide (VIP) on the human enzyme system. VIP_18-28 did not act as a partial agonist and did not inhibit the response to the intact VIP. Our studies suggest the existence of distinct receptor sites for both secretagogues (VIP and prostaglandins) in human colonic mucosa.

Budillon, G.; Parrilli, G.; D’Agostino, L.; Capuano, G.; Mazzacca, G.; Menzies, I.S.

doi: 10.1159/000198416pmid: 7353735

The effect of intravenous cholecystokinin (CCK) on intestinal permeability in normal subjects and patients after cholecystectomy has been studied by measuring the fraction of orally administered lactulose excreted in the urine. CCK induced a marked increase in lactulose excretion in normal subjects when given in a hyperosmolar solution (49.4 mg lactulose during 5 h rising to 114.3 mg with CCK, p < 0.001). CCK failed to affect lactulose excretion when given to normal subjects in an isosmolar solution, and also when given to post-cholecystectomy patients in either hyper- or isosmolar solutions. The ‘CCK effect’ is therefore related to gallbladder emptying. It is suggested that conjugated bile acids released following gallbladder contraction can affect intestinal permeability by enhancing the action of hypertonic solutions on the small intestinal mucosa.