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Biomedical subjects

E Amdrup

Publications and source records attributed to E Amdrup.

At least 73 records · Page 4Linked to original sources
PubMed1978

Gastroesophageal sphincter pressure and serum gastrin studies following food intake before and after vagotomy for duodenal ulcer.

Gastroesophageal sphincter pressure (GESP) and serum gastrin concentration (SGC) were determined in the basal state and after a protein meal in six patients with duodenal ulcer (DU), six patients after parietal cell vagotomy (PCV), six patients after selective gastric vagotomy plus drainage (SGV + D), and six patients after selective gastric vagotomy plus precise antrectomy (SGV + A). No correlation in the resting state between GESP and SGC was observed. After food ingestion, DU patients showed a sustained rise in GESP which lasted up to the end of the experiment. The vagotomized patients, however, showed no rise in sphincter pressure after food intake--rather a tendency to a decrease in pressure occurred. On the contrary, SGC rose significantly after food ingestion in patients with SGV + D or PCV, while in DU patients this rise was less significant. Patients with vagotomy and antrectomy showed no rise in SGC. These results do not suggest that SGC and extrinsic vagal innervation in the resting state play a significant role in the maintenance of the tone of GES. After food ingestion an interaction may occur between intact vagal innervation and rise in SGC in order to obtain an adequate rise in GESP.

Adult↗
PubMed1978

Gastric ulcer in old age.

One hundred and eleven (16%) of 701 patients with gastric ulcers, admitted to Kommunehospitalet, Copenhagen, from 1955 to 1964, were 70 years of age of older. Of those elderly patients, 43 were treated surgically, 68 non-surgically. The incidences of hemorrhage and extragastric diseases were significantly greater in older patients, whereas the incidence of pain, site of pain, ulcer size, and location, incidence of combined ulcers and gastric retention did not differ from those observed in younger patients. The duration of symptoms was shorter in the aged, though the difference was not significant. Prognosis was less favourable in the aged, largely due to a higher incidence of hemorrhage (47%) and of accessory diseases (47%). The mortality in elderly patients suffering from hemorrhage and accessory diseases was 64% during hospitalization, but only 4% in patients without accessory diseases. Follow-up and autopsy studies of discharged patients revealed that ulcers healed in only half of the non-surgical patients and that surgery was ultimately necessary in 50% of these. It was concluded that the factors which prescribed surgical treatment in elderly patients with gastric ulcers did not differ considerably from those in younger patients. The risk was greater, but this was also true in non-surgical treatment. Close cooperation between surgeon and physician was essential, both pre- and postoperatively, since accessory diseases were very significant for the outcome.

Age Factors↗
PubMed1977

[Parietal cell vagotomy (PCV): the treatment of choice of duodenal ulcer].

Gastric resection or vagotomy plus drainage are not easy alternatives for the treatment of duodenal ulcer. More complications are met after resection, more relapses after vagotomy, whereas the postoperative sequelae are the same for both operations. Vagotomy of the parietal cells is designed to prevent all such sequelae by leaving the innervation of the antrum intact so that drainage can be omitted. Experience has so far shown that very few complications occur, whereas severe and slight dumping and diarrhoea are virtually eliminated. Gastric emptying times are slightly affected (a little longer for solids and a little quicker for fluids), but drainage in non-stenosing cases of duodenal ulcer is not necessary. The true average incidence of recurrences after this operation cannot yet be determined, since the results of the published series vary considerably. This may be due to the continuous progress being made in the development of the surgical technique. Random studies comparing this operation with other forms of duodenal management are urgently required. It is, of course, essential for surgeons practising the new operation must, as in the case of other delicate surgial procedures, to receive a proper training at specialised centres.

Animals↗
PubMed1977

Parietal cell (highly selective or proximal gastric) vagotomy for peptic ulcer disease.

Parietal cell vagotomy has been in clinical use for 7 years in elective treatment of nonobstructive duodenal ulcer, and for even a shorter period for complicated cases and for gastric ulcer The evolution of the surgical technique has not yet come to an end and the ability to perform the procedure is still improving. It can therefore be questioned, if this operation is yet ripe for a realistic clinical trial, and the great variation in recurrence rate reported in pilot series as well as in prospective randomized clinical trials points to the possibility that we will have to wait several years before the anticipated mean recurrence rate is known. At present it can be stated that even if gastric emptying is not quite undisturbed, the addition of a drainage procedure in nonobstructive cases is unnecessary. The same may be true in some patients with pyloric obstruction. Furthermore, the mortality rate is very low and the incidence of moderate-to-severe dumping and diarrhea is virtually nil.

Animals↗
PubMed1977

Antral denervation of parietal cell vagotomized dogs. Effect upon gastric emptying and motility, Heidenhain pouch acid secretion and serum gastrin concentration.

In ten Heidenhain pouch (HP) dogs who previously had undergone parietal cell vagotomy (PCV) with gastroduodenostomy, the antral nerves were cut, and the PCV thus converted to a selective gastric vagotomy (SGV). Mean gastric emptying rate was unaffected but antral motility changed considerably, the stomach became big and slack, and the emptying of a food-barium meal became purely passive. While the duodenal bulb was often filled with gastric content before antral denervation, this happened very seldom afterwards. Fasting, food-stimulated and 24-hour HP acid secretion increased significantly after denervation, but this was not accompanied by any significant changes in serum gastrin concentration. This indicates that other factors than gastrin must be responsible for the increased HP acid response to a meal after antral denervation.

Animals↗
PubMed1977

Influence of parietal cell vagotomy and selective gastric vagotomy on gastric emptying rate and serum gastrin concentration.

Gastric emptying of a solid meal and serum gastrin concentration were studied in 26 patients with duodenal ulcer disease before and after parietal cell vagotomy (PCV), selective gastric vagotomy with drainage (SGV + D), or parietal cell vagotomy with drainage. PCV had no significant effect on gastric emptying rate, whereas emptying was significantly delayed after SGV + D. The integrated gastrin output 60 to 300 min after the test meal was insignificantly altered after PCV, but significantly increased after SGV + D. It is concluded that the drainage procedure did not normalize the disturbed gastric emptying after SGV. The prolonged hypergastrinemia period after food stimulation may reflect stasis.

Adult↗
PubMed1977

The effect of insulin on food-stimulated secretion of gastrin after parietal cell vagotomy and selective gastric vagotomy.

Serum gastrin concentration was measured in 11 patients with Parietal Cell Vagotomy and Drainage (PCV + D) and in 11 patients with Selective Gastric Vagotomy and Drainage (SGV + D) in the basal state, after a meal, and after a meal in combination with insulin-hypoglycaemia. Insulin had an early and transitory, but significant, inhibitory effect on the food-induced rise in serum gastrin concentrations. This inhibition was the same whether the patients had a PCV + D or SGV + D, indicating that it has no relation to the vagal innervation of the antrum. In the second hour after the meal the integrated gastrin output was significantly higher when insulin was added to a meal in patients with PCV + D but not in patients with SGV + D. This may indicate a certain, possibility sensitizing, effect of the vagal antral nerves.

Adult↗
PubMed1976

170 patients five years after selective gastric vagotomy--with an uncontrolled comparison of ulcer recurrence following either Heineke--Mikulicz or Finney pyloroplasty.

The study concerns 170 patients treated for duodenal ulcer by selective gastric vagotomy and either HM- or FP. A 5-year follow-up showed a 4% recurrence rate. Insulintest 2-3 months after surgery was Hollander negative in 78%, late positive in 17% and early positive in 5%. 72% of the tests were unchanged after 5 years. 25% had moderate severe dumping. In the HM-group of 84 patients, 6 patients displayed ulcer recurrence. In the F-group of 86 patients, one displayed recurrence. All patients with recurrence (and one without) in the HM-group had operatively demonstrated pyloroplasty stenosis. None of the patients in the F-group had clinical symptoms of gastric stasis. The only variable in the treatment of the patients was the pyloroplasty method, and it thus seems reasonable to implicate the pyloroplasty method in the incidence of recurrence. The difference in recurrence between the two groups was not, however, statistically significant, and the value of a prospective randomized study of patients treated by selective gastric vagotomy and different pyloroplasty forms is pointed out.

Duodenal Ulcer↗
PubMed1975

Parietal cell vagotomy in dogs. Influence on heidenhain pouch acid secretion, serum gastrin concentration, gastric emptying and motility.

No change was observed in fasting Heidenhain pouch (HP) acid secretion and fasting serum gastrin concentration following parietal cell vagotomy (PCV) in six dogs whereas significant increase in food-stimulated pouch secretion and serum gastrin concentration was observed. The increase in pouch secretion after PCV took place mainly in the first 2 h after meal. The maximum serum gastrin concentration was reached at 15 min after feeding before as well as after PCV. Maximum in HP secretion was reached later, at 120 min before and at 90 min after surgery. Gastric emptying studies, using a food-barium meal, showed a slight decrease in the emptying rate after PCV in two dogs, while it was unchanged in the others. Cineradiography showed an unaffected antral motility in all dogs after PCV.

Animals↗