A case of double pylorus caused by recurrent gastric ulcers: a long-term endoscopic observation.
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alpha-Fluoromethyl histidine is an irreversible inhibitor of histidine decarboxylase. The injection of a single dose to pyloric-ligated rats inhibits gastric mucosal histidine decarboxylase in a dose-dependent manner but does not modify histamine content and gastric acid secretion even at the highest dose used. Administration of cimetidine increases histidine decarboxylase activity, decreases histamine level in gastric mucosa and inhibits gastric acid secretion. The co-administration of alpha-fluoromethyl histidine blocks the augmentation in enzyme activity, maintains lowered histamine level and prolongs the antisecretory action of cimetidine.
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The origin of extrinsic substance P fibers in the guinea pig pyloric wall was investigated by combining retrograde axonal tracing and indirect immunofluorescence techniques. After injection of Fast Blue into the pyloric wall labeled cells were found in the T7-T9 dorsal root ganglia and the nodose and jugular ganglia. About 60% of the labeled cells in the dorsal root ganglia contained substance P-like immunoreactivity. After local application of colchicine, a few substance P positive cells were observed in the nodose and jugular ganglia, some of which also contained Fast Blue.
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Patients with unresectable carcinoma of the pancreas head often present with intestinal obstruction during their disease, but the efficacy of a prophylactic gastrointestinal anastomosis is still under debate. Some investigators consider the population of patients who eventually develop this complication too small to justify the prophylactic use of this procedure. When done prophylactically, the gastrointestinal anastomosis tends not to function and close. Other surgeons have proposed supplementing the gastric bypass using technique alternatives. To demonstrate the low morbidity, the feasibility, and the advantages and disadvantages of this procedure, we report our personal experience with transection of the duodenum and re-establishment of the continuity of the alimentary tract with a duodenojejunal anastomosis performed in 34 patients.
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