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Biomedical subjects

L Lundell

Publications and source records attributed to L Lundell.

186 records · Page 11Linked to original sources
PubMed1972

Gastric secretion and its facilitation as related to gastric mucosal histamine.

1. In conscious rats provided with Pavlov or Heidenhain pouches the acid and pepsin responses to vagal stimulation, or infusions of gastrin, histamine, methacholine, and to various combinations of these stimulants have been established. The concomitant mobilization and increased formation of gastric mucosal histamine have also been examined.2. Histamine evoked graded acid responses in the Pavlov and Heidenhain pouches. The innervated pouch was more sensitive to histamine than the denervated. Stimulation of pepsin secretion was apparent only in the Heidenhain pouch.3. The acid response to vagal stimulation evoked by 2-deoxy-D-glucose was facilitated by infusion of histamine, but not that of pepsin, the secretion of which was depressed.4. Acid secretion in response to graded infusion of methacholine was enhanced by background infusions of histamine in subthreshold, sub-maximal and maximal dosages.5. The acid response to vagal stimulation was enhanced by a background infusion of gastrin, but not that of pepsin, the secretion of which was depressed.6. A background infusion of a large dose of histamine depressed the maximal acid response to gastrin in both types of pouches.7. Administration of histamine restrained the accelerating effect of gastrin on histidine decarboxylase activity, probably by a feed-back coupling.8. The increase in gastric mucosal histamine, as reflected in its urinary excretion, in response to gastrin infusion was enhanced by vagal stimulation.9. The amounts of histamine that can be mobilized and newly formed in the gastric mucosa have been evaluated and found to be fully adequate for efficient stimulation of the parietal cell.

Animals↗
PubMed1971

Inhibition of gastric secretion by atropine in conscious rats.

1. The effect of atropine on acid and pepsin secretion, stimulated by feeding, vagus excitation or infusions of gastrin, histamine and methacholine, was studied in conscious rats provided with a Pavlov or a Heidenhain pouch.2. The acid and pepsin secretion in response to food was substantially suppressed by atropine in the Pavlov pouch.3. The strong stimulatory effect of 2-deoxy-D-glucose on acid and pepsin secretion in the Pavlov pouch was almost abolished by atropine.4. A plateau secretion of acid obtained by infusion of submaximal doses of hog gastrin II, was significantly inhibited by atropine in the Pavlov and the Heidenhain pouch.5. Methacholine-induced acid and pepsin secretion in the denervated Heidenhain pouch was nearly completely inhibited by atropine.6. A plateau secretion of acid evoked by infusing histamine in a near maximal dosage was inhibited by atropine to the same extent as the gastrin-induced secretion in the Pavlov pouch.7. The mode of action of atropine as a gastric secretory inhibitor is discussed.

Animals↗
PubMedDate not supplied

Lower esophageal sphincter characteristics and esophageal acid exposure following partial or 360 degrees fundoplication: results of a prospective, randomized, clinical study.

In a prospective, randomized, clinical trial, we compared a partial (180-200 degrees, Toupet) with a total fundoplication (360 degrees, Rossetti) in the surgical treatment of gastroesophageal reflux disease. Seventy-one patients entered the trial; 33 were allocated to a partial fundoplication and 38 to a 360 degrees fundic wrap. Each patient was investigated prior to as well as 3 and/or 6 months after the operation, including an endoscopic and clinical assessment. Manometry was carried out via a triple lumen catheter and the pressure in the high pressure zone (HPZ) in the distal esophagus was measured as well as the length of the intraabdominal segment by a "station pull-through" technique. Acid exposure of the esophageal mucosa was evaluated by ambulatory 24-hour pH measurements. Acid exposure of the esophageal mucosa was "normalized" by the 2 operations. In addition, the length of the HPZ was increased to a "normal" level by both operations. The pressure of the HPZ was, however, "normalized" only in patients allocated to a Rossetti fundoplication, whereas patients operated on with a partial fundoplication had a significantly lower HPZ pressure (p less than 0.01). The clinical assessment revealed excellent results in both groups with no significant differences between the 2 operations except for a higher incidence of dysphagia at 3 months after a Rossetti fundoplication (p less than 0.01), which disappeared during the subsequent 3 months.

Adult↗
PubMedDate not supplied

Impact of complete gastric fundus mobilization on outcome after laparoscopic total fundoplication.

With the objective of further optimizing the outcome of antireflux surgery, we have studied the importance of dividing the short gastric vessels when performing a laparoscopic total fundoplication. Ninety-nine consecutive patients with chronic gastroesophageal reflux disease (GERD) were enrolled in the trial. Forty-seven patients (25 men, age 52 +/- 1.6 years [mean +/- standard error]) were randomized to undergo a laparoscopic Nissen-Rossetti total fundic wrap with intact short gastric vessels, whereas 52 patients (29 men, 48 +/- 1.4 years) had complete division of these vessels. Quality of life was assessed by means of the psychological general well-being and gastrointestinal symptom rating scale indices. The 6- and 12-month follow-up data are reported. Two patients were converted to open surgery. Mobilization of the fundus significantly prolonged the operative time (120 vs. 104 minutes, P = 0.05); otherwise the complication rates were similar in the two groups. Both procedures were equally effective in controlling gastroesophageal reflux at 6 and 12 months' postoperatively. Division of the short gastric vessels had no significant impact on the point prevalence of postfundoplication complaints at the given follow-up time points. Quality of life was significantly improved by both operative procedures and remained "normal" throughout the follow-up period. Dividing all short gastric vessels had no impact on the functional outcome during the first year of recovery after a total laparoscopic fundoplication.

Adult↗
PubMedDate not supplied

Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial.

The aim of this prospective, randomized study was to determine whether laparoscopic cholecystectomy should be performed as an early or a delayed operation in patients with acute cholecystitis. After diagnostic workup, patients were randomized to one of two groups: (1) early laparoscopic cholecystectomy (i.e., within 7 days after onset of symptoms) or (2) initial conservative treatment followed by delayed laparoscopic cholecystectomy 6 to 8 weeks later. Seventy-four patients were placed in the early-operation group, and 71 patients were assigned to the delayed-operation strategy. There was no significant difference in conversion rates (early 31% vs. delayed 29%), operating times (early 98 [range 30 to 355] minutes vs. delayed 100 [45 to 280] minutes), or complications. Failure with the conservative treatment strategy was noted in 26% of these patients. The total hospital stay was significantly shorter in the early group (5 [range 3 to 63] days) vs. the delayed group (8 [range 4 to 50] days; P<0.05). Despite a high conversion rate, early laparoscopic cholecystectomy offered significant advantages in the management of acute cholecystitis compared to a conservative strategy. The greatest advantage was a reduced total hospital stay.

Acute Disease↗