Proceedings: Release of prostaglandins in canine gastric secretions in response to graded pentagastrin stimulation.
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Biomedical subjects
Publications and source records attributed to R R Dozois.
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The gastric acid response to graded doses of insulin given by continuous infusion was studied in four dogs, each surgically provided with a gastric fistula. All doses of insulin resulted in a prolonged plateau of hypoglycaemia and the degree of hypoglycaemia correlated significantly (p <0.05) with the insulin dose, up to 0.15 u/kg hr. Similarly, graded doses of insulin (up to 0.15 u/kg hr) produced graded acid responses and both the peak acid output and the total acid output correlated significantly with blood glucose changes. No initial inhibitory phase of acid secretion followed the start of the infusion, but a dose-related delay in the onset of the acid response was observed. Our results indicate that insulin provides a quantitative glycopenic stimulus producing a quantitative vagal acid response.
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In view of the disadvantages of the standard insulin test for completeness of vagotomy a continuous insulin infusion test has been developed. Twenty-six tests were carried out on 12 healthy male volunteers. A dose of 0.04 unit of soluble insulin/kg/hr was found to produce the highest acid secretion with the least severity of symptoms of hypoglycaemia. The pattern of response was a plateau of acid secretion and of hypoglycaemia, and repeated studies in six subjects showed that the results were reproducible. Evaluation of this test after vagotomy and comparison with the standard insulin test are now required.
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Results from epidemiologic studies have provided insights into the etiology of large bowel cancer. Markedly diverse incidences of colorectal cancer exist in various parts of the world and within different regions of a given country. Studies of migrant populations have revealed a role for environmental factors, particularly dietary, in the etiology of colorectal cancers. Genetic factors and inflammatory bowel disease also place certain individuals at increased risk. Sedentary lifestyle, cholecystectomy, and ureterosigmoidostomy may also increase the risk of developing large bowel cancer.
Approximately 5% of rectal cancers are locally advanced with adherence to the vagina, uterus, bladder, prostate, or other structures. Sacral involvement is fortunately rare in primary cancers. In about 50% of patients there is histologic confirmation of tumor invasion in the area of adherence. It is important to recognize the nature of these tumors pre-operatively so that the patient can be prepared for an exenterative procedure should this be necessary. When these tumors are removed en bloc, 5-year survival rates of 50% can be obtained with survival depending on the presence or absence of regional metastasis and also the presence or absence of histologic tumor invasion into adjacent structures.