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Biomedical subjects

H H Trout

Publications and source records attributed to H H Trout.

30 records · Page 2Linked to original sources
PubMed1979

Carotid sinus syndrome: treatment by carotid sinus denervation.

Hypersensitive carotid sinus is a rare cause of spontaneous syncopal attacks. It must be differentiated from the other more common causes, such as intrinsic cardiac disease, vasovagal responses, postural hypotension and cerebrovascular insufficiency, although it may accompany these conditions. The definition of carotid sinus syncope is syncope elicited by stimulation of a hypersensitive carotid sinus. Nineteen patients with carotid sinus syncope were treated by carotid sinus denervation. Ages ranged from 48 to 83 with a mean of 65.5 years. Symptoms of marked dizziness or syncope were reproduced by gentle compression over the carotid bifurcation, while ECG monitoring revealed bradycardia or transient asystole. Seventeen patients had carotid arteriograms, eleven of which were normal. One patient had stenosis of the external carotid artery, while five had stenosis of the internal carotid. The right carotid sinus was involved in ten patients, the left in three and both sides in six. All patients underwent unilateral or bilateral carotid sinus denervation. Five patients with internal carotid stenosis had concomitant carotid endarterectomy. Complete relief of symptoms or marked improvement was noted in all but one patient. Postoperative follow-up ranged up to 15 years. Carotid sinus denervation is a simple, effective method of treating this disorder.

Aged↗
PubMed1978

The relative effects of lesser curvature vagotomy and esophageal vagotomy on the acid secretory effect of proximal gastric vagotomy.

Proximal gastric vagotomy is an operation consisting of division of all vagal fibers to the acid-secreting portion of the stomach. These fibers are usually divided along the lesser curvature of the stomach; however, because of a high rate of duodenal ulcer recurrence in some series, it has become apparent that it is important to divide the vagal fibers to the stomach leaving the main vagal trunks along the distal 5 cm of esophagus in order to achieve both adequate control of acid secretion and also a lower duodenal ulcer recurrence rate. The data presented in this study of ten mongrel dogs suggest that, in the dog, division of the vagal fibers along the lesser curvature is more important in reducing acid secretion than is esophageal vagotomy; but the data also emphasize the contribution of the vagal fibers along the distal esophagus since a marked reduction in 2 DG-stimulated acid secretion can only be achieved by dividing the vagal fibers around the distal esophagus as well as those along the lesser curvature.

Animals↗
PubMed1978

Effect of proximal gastric vagotomy on feeding stimulated Heidenhain pouch acid secretion and gastrin release.

Truncal vagotomy (TV) is known to increase the feeding stimulated acid output of Heidenhain pouches. A series of experiments were performed in dogs to see if proximal gastric vagotomy (PGV) also had this effect. Dogs were prepared with gastric fistulas (GF) and Heidenhain pouches (HP). Gastric function testing included three categories of tests: (1) serum gastrin determinations and Heidenhain pouch acid secretion after feeding, (2) gastric emptying and simultaneous Heidenhain pouch acid secretion, and (3) gastric and Heidenhain pouch acid secretion and serum gastrin levels after insulin. Compelte testing consisting of two control and two post-PGV tests was accomplished in five dogs in each category. Insulin testing confirmed that an adequate PGV was performed because GF peak acid output in response to 0.5 U/kg insulin IV was reduced 88% by PGV (p less than .01). In response to two separate meals peak acid output (PAO) from the HP's was not increased significantly after PGV: Meal I pre-PGV 450 +/- 112 vs post-PGV 400 +/- 99 muEq/15 min; Meal II pre-PGV 256 +/- 62 vs post-PGV 304 +/- 150 muEq/15 min. This finding may represent an important physiologic difference between PGV and truncal vagotomy.

Animals↗
PubMed1977

Endotoxemia and large intestinal blood flow in subhuman primates.

The hemodynamic effects of Escherichia coli endotoxin (LD80) were measured in the large intestine of anesthetized Rhesus monkeys to determine whether this organ contributes to the pathogenesis of experimental shock. Inferior mesenteric arterial blood flow (IMF) was measured with an electromagnetic flowmeter. Pressures within the aorta (AP) and portal vein (PP) were recorded. Distribution of colon blood flow was measured with radioactive microspheres: Ce, Sr, and Cr were injected into the left heart. Reference blood samples were obtained from a femoral artery. Mean control IMF was 22.9 +/- 2.2 (SE) ml/min. Aortic pressure was 113 +/- 11 mm Hg, and PP was 6 +/- 1 mm Hg. Arterial blood pH was 7.43 +/- 0.02; pO2 and pCO2 were 93.4 and 37.1 mm Hg, respectively. All parameters were measured at hourly intervals for 4 hr. Neither IMF nor its distribution within the colon changed during the entire observation period. Aortic pressure fell to a low of 60 +/- 6 mm Hg (p less than 0.02) at 3 hr; PP, pO2 and pCO2 were unchanged by endotoxin. Arterial blood pH fell to 7.315 +/- 0.020 at 4 hr (p less than 0.01). These observations indicate that the colon is not a "target organ" of endotoxic shock in subhuman primates, despite considerable hypotension and metabolic disturbances subsequent to near lethal endotoxemia.

Animals↗
PubMed1977

Gastric acid secretion in gastric fistula dogs after antral denervation and antrectomy.

Acid secretion in Pavlov pouches in dogs is known to increase after antrectomy in response to histamine and gastrin. Dogs with gastric fistulae were tested with histamine and tetragastrin as a control study. The vagal nerve fibers to the antrum were divided and the dogs underwent repeat testing. Finally an antrectomy was performed and final dose-response data were collected. After antrectomy there was an increased acid response to histamine and tetragastrin. We postulate that the vagal fibers innervating the antrum are probably not a factor in this increase. Furthermore, we believe that the increased acid secretion after antrectomy observed in the dog and the decrease known to occur in the human being is a species difference and is not related to the pouch method of study used in earlier studies of the antrectomized dog.

Animals↗