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At least 109 records · Page 6Linked to original sources
PubMed1992

Gastro-oesophageal and bile reflux--simultaneous quantitative assessment with gastric and gallbladder emptying evaluation: clinical applicability of a new computerized gammagraphic method.

The aim of this study was to develop a new computerized gammagraphic method to evaluate gastrooesophageal (GER), bileo-oesophageal (BER) and bileogastric reflux (BGR) simultaneously with gastric and gallbladder emptying: a long duration (60 min) and a dual energy detection (113Inm-sulphur colloid and 99Tcm-HIDA) test of the different refluxes during slow gastric emptying of an enteric feeding liquid meal. Forty patients with oesophagitis and 18 normal volunteers were evaluated. Good reproducibility of all the quantified parameters was found with r Spearman between 0.75 (P < 0.05) and 1.0 (P < 0.001). Patients with oesophagitis have a tendency for slower gastric emptying patterns (gastric emptying T1/2, GT1/2 P < 0.05). The calculated specificity for gallbladder emptying parameters was 77.8% for the gallbladder T1/2 BT1/2) and 94.4% for gallbladder residue at 60 min (BR60). The calculated accuracy for the GER index was 90%. The predictability for positive values was 95%, owing to a 90% sensitivity and 89% specificity. The predictability for negative values was 80%. The mean GER index in oesophagitis was greater than in controls (P < 0.001). The calculated specificity for BGR was 94.4% and reflux was detected in 12 out of 40 patients. The calculated specificity for BER was 83.3% for a '+' index and 94.4% for a '++' BER index. In 14 patients a positive BER index has been determined ('+' in three and '++' in 11 cases).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2000

Delay in gallbladder emptying during the perimenopausal period.

A pilot study has ascribed an important role in gallbladder motility and emptying to the perimenopausal period. To assess the effect of this period on gallbladder emptying and cholelithogenesis, 25 women in the perimenopausal period without gallbladder disease were submitted to cholangiography and two ultrasound exams. The time for gallbladder emptying and the presence of cholelithiasis were assessed. All patients presented a delay in gallbladder emptying with no relationship to the pre- or postmenopausal period. This finding was not related to lithogenesis. Gallbladder emptying time is longer during the perimenopausal period.

Adult↗
PubMed2000

Effect of rectal distension on gallbladder emptying and circulating gut hormones.

BACKGROUND: Abnormalities of upper gut motility, including a delay of gastric emptying and small bowel transit, found in patients with constipation may be secondary to factors originating in the colon or rectum as a result of faecal stasis. The aim was to determine if stimulation of mechanosensory function by rectal distension affects postprandial gallbladder emptying and release of gastrointestinal peptides participating in control of upper gut motility. MATERIALS AND METHODS: Eight healthy volunteers were studied with an electronic barostat and a plastic bag positioned in the rectum. Intrabag pressure was maintained at minimal distension pressure + 2 mmHg on one occasion and on a pressure that induced a sensation of urge on the other. Gallbladder volume and plasma concentrations of cholecystokinin (CCK), pancreatic polypeptide (PP) and peptide YY (PYY) were measured before and after ingestion of a 450-kcal mixed liquid meal. RESULTS: Rectal distension enhanced maximum gallbladder emptying from 66 +/- 7% to 78 +/- 5% (P < 0.05). Distension tended to increase integrated plasma PYY from 77 +/- 30 pM min to 128 +/- 40 pM min in the first hour after the meal (P = 0.08) and it suppressed integrated plasma PP from 1133 +/- 248 pM min to 269 +/- 284 pM min in the second hour (P < 0.05). Integrated plasma CCK concentrations were not significantly affected. CONCLUSION: Mechanosensory stimulation of the rectum enhances postprandial gallbladder emptying and influences postprandial release of gut hormones involved in the regulation of gastrointestinal motility in healthy subjects. These mechanisms may play a role in the pathogenesis of the upper gastrointestinal motor abnormalities observed in constipated patients.

Adult↗
PubMed1983

By-passing the sphincter of Oddi does not affect gallbladder emptying in the pig.

A study of the relationship between bile secretion and nutrition in the pig requires a complete and continuous collection of the bile and its reinfusion to the animal. In most of the studies performed in different species, bile has been directly reinfused into the duodenum, leading to the exclusion of the sphincter of Oddi from the biliary pathway. It has been postulated that such an exclusion could inhibit gallbladder emptying. The aim of the present work was to study postprandial gallbladder emptying in the pig, depending on the site of bile reinfusion, i.e. the duodenum or the lower bile duct. The gallbladder bile was coloured with indocyanine green (ICG) and marker secretion was recorded after a test-meal. The results showed that after meal intake, the gallbladder emptied over a similar period of time and according to similar kinetics, whatever the site of bile reinfusion.

Ampulla of Vater↗
PubMed1992

Real-time ultrasonography as a noninvasive tool for the examination of canine gallbladder emptying: a validation study.

An ultrasonographic measurement of the gallbladder volume based on an ellipsoid approximation of the gallbladder shape was validated in vivo in the dog. The mean difference between the ultrasonographically determined and the true gallbladder volumes amounted to 2.0 +/- 1.6 cm3 (mean +/- SD), whereas the regression line computed for the ultrasonographically measured versus true gallbladder volumes was y = 0.892x + 3.0, r = 0.955, p much less than 0.001. The ultrasonographic method enabled a noninvasive, repetitive measurement of either a meal- or caerulein-induced gallbladder emptying in the dog.

Animals↗
PubMed1994

Effect of single and multiple administrations of cisapride on postprandial gallbladder emptying in healthy humans.

Effects of a clinical dose of the prokinetic drug, cisapride, on postprandial gallbladder emptying were evaluated in 8 healthy normal volunteers. Gallbladder and gastric emptying after a liquid test meal were simultaneously measured by ultrasonography. Compared with placebo, a single oral dose of cisapride (5 mg) accelerated gastric emptying, but not gallbladder contraction. Cisapride enhanced gallbladder refilling. The same individuals took oral cisapride (15 mg TID) for 14 days, and were reassessed on the following day after oral 5 mg of cisapride. Fasting gallbladder volume was significantly increased. Although gallbladder contractility was not affected, the residual volume was significantly large. Gastric emptying rate returned to the control value. Fasting and post-test meal plasma CCK levels were not significantly attenuated by either single or multiple administration of cisapride. These results suggest that a clinical dose of cisapride may attenuate gallbladder motor function via mechanisms other than direct neural stimulation of the gallbladder.

Administration, Oral↗
PubMed1981

Gallbladder emptying with ceruletide in oral cholecystography.

In a consecutive series of 148 patients the gallbladder emptying in oral cholecystography was investigated after administration of ceruletide given in doses of 0.3 microgram/kg body weight intramuscularly and 0.03 and 0.05 microgram/kg intravenously. No essential side effects occurred. The effect of ceruletide seems to be on a par with that of cholecystokinin. A dose of 0.3 microgram/kg was found to be sufficient to assess the gallbladder emptying, but then in a few instances the emptying is delayed--up to one hour. The bile ducts are best demonstrated after intravenous administration of 0.05 microgram/kg.

Adolescent↗
PubMed1996

Gallbladder emptying and cholecystokinin response to fish oil and trioleate ingestion.

The aim of the present study was to compare gallbladder emptying, gastric emptying and release of cholecystokinin (CCK), gastrin and secretin after intragastric administration of fish oil and trioleate. After intravenous injection of 99mTc-HIDA, 30 ml of a lipid labelled with 111In was administered through a gastric tube. Using dual scintigraphy with two markers, gallbladder and gastric emptying were measured simultaneously for 120 min. Plasma concentrations of gastrin, secretin and CCK, were determined throughout the period. The emptying of the gallbladder was reduced by 27% and the release of CCK by 85% after fish oil as compared with trioleate. Gastric emptying as well as the release of gastrin and secretin were similar after the two types of fat. The results suggest that the reduced gallbladder emptying after fish oil may be due to a smaller release of CCK.

Adult↗
PubMed1991

Severely impaired postprandial gallbladder emptying despite unchanged cholecystokinin release in the early phase of biliary colic.

In the present article we report transitory severely impaired postprandial gallbladder emptying preceding biliary colic in a cholesterol gallstone patient. Gallbladder emptying 1 wk before and 3 wk after the biliary colic was normal. Treatment with ursodeoxycholic acid led to increased fasting gallbladder volumes, but the postprandial residual volume did not change. Postprandial cholecystokinin release appeared not to change during ursodeoxycholic acid treatment or during biliary colic.

Biliary Tract Diseases↗
PubMed1990

[Effects of drinking Tettuccio di Montecatini mineral waters on gallbladder emptying and functioning hepatic mass].

Real time echography and galactose loading test were used to evaluate changes in gallbladder emptying and functioning hepatic mass in dyspeptic patients after drinking Tettuccio mineral water. The above tests showed that Tettuccio mineral water is apt to provoke a rapid, intense gallbladder contraction which appeared to be slightly more protracted when the tests were repeated after two weeks of treatment with the mineral water. This action appears to be due to the composition of the alkaline sulfate saline water rather than to its osmolar concentration since the water is more effective in bringing about gallbladder emptying than saline solutions of higher osmolarity.

Adult↗
PubMed2003

[Assessment of autonomic maintenance of the activity related to the gallbladder emptying in patients with biliary pathology].

A group of 110 patients (51 men and 59 women) with biliary pathologies (71 patients with chronic non-calculous cholecystitis and 39 patients with gallbladder dysfunctions) was examined. The control group included 45 practically healthy people. There was a parallel study of gallbladder emptying by the dynamic ultrasonography method with 20.0 g of Sorbitum and spectrum analysis of the heart rate variability. The vegetative maintenance of the activity associated with gallbladder emptying in patients with biliary pathologies is characterized by the strengthened activity of the sympathetic nervous system and suprasegmented cerebral centers of the ergotropic orientation; at the same time the parasympathetic activity prevails in healthy people.

Adult↗
PubMed1992

An experimental design strategy for quantitating complex pharmacokinetic models: enterohepatic circulation with time-varying gallbladder emptying as an example.

A four-step strategy is proposed for determining appropriate experimental designs for investigating the pharmacokinetics of drugs characterized by complex compartmental models and this strategy has been applied to the pharmacokinetics of enterohepatic circulation (EHC). The four steps are (1) to establish an appropriate pharmacokinetic model, (2) to complete an identifiability analysis for the model to determine the route(s) of administration and sampling compartment(s) that are theoretically adequate for the quantitation of model parameters, (3) to carry out nonlinear least-squares fitting for the proposed number and timing of simulated error-free data points, and (4) to complete nonlinear least-squares fits of the model to data obtained by adding random error to the simulated data in step 3. The four-compartment model chosen for EHC of unchanged drug contained central, peripheral, gallbladder, and intestinal compartments and an intermittent gallbladder emptying rate constant. Identifiability analysis demonstrated that three alternative experimental designs for route(s) of administration and sampling compartment(s) are adequate for quantitating all model parameters, when the gallbladder emptying rate constant as a function of time is known (using controlled emptying from an engineered gallbladder in an animal model or quantitation in humans or animals using imaging techniques). Parameter estimates from fitting error-free data matched closely with the known values for all three experimental designs, indicating an adequate number and appropriate timing of data points. Results from fitting simulated data containing +/- 10% random error indicated unacceptable coefficients of variation and a nonrandom pattern in residual plots for one of the experimental designs.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Effect of somatostatin and thyrotropin-releasing hormone on cholecystokinin-induced gallbladder emptying.

The effect of somatostatin (0.05 and 1.5 micrograms/kg/hr) and of thyrotropin-releasing hormone (0.1 and 1.0 microgram/kg/hr) on cholecystokinin-induced gallbladder emptying was studied in healthy volunteers by means of real-time ultrasonography. In addition, the action of increasing doses (0.05, 0.15, 0.45, and 1.35 micrograms/kg/hr) of somatostatin on resting gallbladder volume was also evaluated. Somatostatin, at the dose of 0.05 microgram/kg/hr (shown to produce blood levels similar to those measured after a meal) significantly inhibited the gallbladder contraction in response to cholecystokinin. Kinetic analysis showed that the interaction of somatostatin and cholecystokinin is of the noncompetitive type. The higher dose of the peptide (1.5 microgram/kg/hr) completely suppressed cholecystokinin-induced gallbladder contraction. In experiments carried out using somatostatin alone, a progressive increase in gallbladder volume in response to increasing doses of peptide was observed. The administration of either dose of thyrotropin-releasing hormone did not affect gallbladder emptying in any of the subjects studied. It is concluded that somatostatin is a potent inhibitor of cholecystokinin action on the gallbladder. The clear effectiveness of a very low, presumably physiological, dose indicates that somatostatin may play a physiological role in the regulation of gallbladder motor activity and provides further evidence that the peptide may act as a true hormone in man. Thyrotropin-releasing hormone does not seem to affect gallbladder motility, at least under the experimental conditions of the present study.

Adult↗
PubMed1985

Abnormal gallbladder emptying in a subgroup of patients with gallstones.

Gallbladder stasis has been implicated in gallstone formation. Gallbladder filling and emptying were quantitated by computer-assisted cholescintigraphy in 41 normal subjects versus 26 patients with gallstones. Gallbladder contraction was induced by low-dose (1.2 U/kg . h) cholecystokinin infusion. Gallstone patients exhibited normal gallbladder filling, but emptying was significantly (p less than 0.01) reduced compared with controls. On closer inspection, the patients fell into two subgroups, separated by t1/2, the time to empty 50% of gallbladder contents, 19.1 min (mean + 2 SD of control). Fifteen patients (57.7%) with a normal t1/2 (less than 19.1 min) exhibited both normal filling and normal emptying. The remaining 11 patients (43.3%) with t1/2 greater than 19.1 min had grossly abnormal gallbladder emptying, significantly (p less than 0.001) different from both the previous patient subgroup and the controls. There was no significant difference in age, sex, prevalence of obesity, presence or absence of biliary colic, and gallstone size, number, or calcification between these two subgroups. Thus, defective gallbladder emptying is evident in a subgroup of gallstone patients, and is independent of clinical features, stone size, and number. Impaired emptying should be considered when assessing pathogenesis or medical therapy.

Cholecystokinin↗
PubMed1976

Effect of gastrin on pancreatic enzyme secretion and gallbladder emptying in man.

This study was designed to assess the effect of unsulfated synthetic human little gastrin (HG-17-I) on pancreatic secretion and gallbladder emptying in man. During continuous gastric and duodenal aspiration, 6 male subjects were given, on different days, either HG-17-I (7, 20, 60, 180 AND 540 PMOL KG-1 HR-1), chlecystokinin (0.1, 0.3, and 0.9 UKg hr-1) or 238 pmol kg-1 (500 ng kg-1) of HG-17-I as a rapid intravenous injection. Trypsin output and bilirubin output increased significantly (P less than 0.05) above basal levels during the infusion of both peptides. During HG-17-I infusion the highest trypsin output (2.08 +/- 0.22 Karmen U per 10 min) and bilirubin output (4.66 +/- 0.61 mg per 10 min) occurred during the 60 pmol kg-1 hr-1 dose, whereas highest acid output occurred during the 540 pmol kg-1 hr-1 dose. Rapid intravenous injection of HG-17-I produced a prompt and significant rise in trypsin, bilirubin, bicarbonate, and acid outputs. It is concluded that HG-17-I produced significant pancreatic enzyme secretion and gallbladder emptying at doses that are submaximal for acid secretion, suggesting that this may be a physiological effect of gastrin.

Adult↗
PubMed1983

The effects of Lipomul, CCK, and TRH on gallbladder emptying.

Tc-99m IDA compounds have been used in the quantitative analysis of motor function of the gallbladder. However, stimuli to provoke emptying have been variable and frequently nonphysiologic. To determine the utility and dependability of provocative agents for gallbladder emptying, we studied the effects of Lipomul, CCK, and TRH after the intravenous administration of Tc-99m disofenin. Computer processing of region-of-interest over the gallbladder permitted time/activity analysis of each study and computation of the ejection fraction (EF). Results showed that Lipomul consistently produced an effect on gallbladder emptying (EF 16-42%). CCK, while more dramatic in response, was less predictable (EF 8-100%). TRH favored accumulation of activity and did not cause gallbladder emptying. The combination of CCK and TRH decreased the rate of gallbladder emptying produced by CCK alone. We conclude that the availability, low cost, and dependable effect on gallbladder emptying make Lipomul the gallbladder stimulant of choice for clinical use.

Cholecystokinin↗
PubMed1989

Gallbladder emptying in perimenopausal women.

The relationship between female sex and cholelithiasis is not well clarified. There is some evidence that relates the pathogenesis of the gallstones to hormonal alterations. Perimenopausal women with dyspeptic symptoms revealed substantial delay in gallbladder emptying. Some elements related to the perimenopause may be responsible for the reduction of gallbladder emptying. This probably contributes to the pathogenesis of gallstones which are much more frequent during this period.

Adult↗