Role of the proximal duodenum in gastrin regulation following antrectomy

Antrectomy is accepted as the most effective surgical treatment of recurrent duodenal ulcer after complete vagotomy. Although antrectomy is aimed at reducing serum gastrin levels, both human and experimental reports seem to indicate that gastrin concentrations may be unchanged following this operation. The probable source of gastrin has been considered to be the proximal third of the duodenum, since at this level increased tissue gastrin concentrations were found after antrectomy. The present study was carried out in order to gain insight into the mechanism by which the duodenum may compensate for the removal of the antrum. Forty white rats were randomly divided into two equal groups and underwent antrectomy with gastroduodenostomy or simple laparotomy. Three to four months after surgery, serum gastrin determinations were carried out by radioimmunoassay both in fasted and freely fed rats. The duodenum was then removed and its proximal third was used for G cell counts (immunoperoxidase method) and for assessment of G cell cytoplasmic granule distribution (electron-microscopic examination). Antrectomy significantly increased fasting serum gastrin levels (p less than 0.01), while it completely abolished the gastrin response to food ingestion (p less than 0.001). In antrectomized rats, the duodenal G cell number was significantly higher than in control rats (p less than 0.001), whilst the G cell cytoplasmic granule number remained unchanged. In conclusion, the present study indicates that in the rat the proximal duodenum increases its content of tissue gastrin following antrectomy mainly by enhancing the regional G cell density.     

Percutaneous cholecystostomy: diagnostic and therapeutic efficacy

Percutaneous cholecystostomy was performed in 32 patients for treatment of suspected cholecystitis (16 patients), decompression of biliary obstruction (six patients), or performance of diagnostic cholangiography (ten patients). The gallbladder was successfully catheterized in 32 of 32 patients (100%), and therapeutic or diagnostic benefit was achieved in 29 of 32 patients (91%). There were no major complications and no procedure-related deaths. There were four minor complications. In the 14 patients with severe cholecystitis there was substantial clinical improvement in 13. Five patients underwent catheter withdrawal after stabilization or long-term drainage. In biliary obstruction, hyperbilirubinemia was successfully treated with percutaneous cholecystostomy in five of six patients, and associated cholangitis was successfully treated in four of four. Ten patients underwent transcholecystic cholangiography; diagnostic visualization was achieved in all, including seven who underwent percutaneous cholecystostomy-assisted transhepatic biliary drainage. Percutaneous cholecystostomy is a safe and effective procedure in diagnosis and treatment of biliary tract problems.     

Dental radiography: efficacy in the assessment of intraosseous lesions of the face and jaws in asymptomatic patients

In this investigation the efficacy of dental radiography for the detection of occult intraosseous lesions of the face and jaws was evaluated. An analysis of 30 million health insurance records indicated that the period prevalence of malignant lesions was less than 5 cases/million/year, and for benign lesions approximately 100 cases/million/year. Data from a controlled observer-performance study showed that radiographic sensitivities ranged between 50% and 80%. The cost per true-positive finding was estimated to be +8.6 million per malignant case and +430,000 per benign case. An assessment of the dosimetric literature indicated that the benefits of radiographic screening as a means for early detection of a malignancy appear to be counterbalanced by the risk of causing a radiation-induced malignancy. Taken together, these data demonstrate that dental radiography is not efficacious for the purpose of detecting occult lesions.     

Central nervous system vasculitis

Neurological Sciences - Vasculitis is an inflammation of the vessel wall. It may be either primary or secondary. Primary vasculitis includes systemic vasculitis (large, medium, and small-vessel...     

白细胞三烯拮抗剂ONO-1078对豚鼠迷走神经电刺激引起气道痉挛及微血管渗漏作用

阿托品预先处理的豚鼠,电刺激迷走神经(10Hz,5ms,2V或10V,90s)引起气道阻力增高,气管、主支气管和肺内气道的依文思蓝渗出量增加,并随刺激强度加大而增强。白细胞三烯拮抗剂ONO-1078(0.03,0.1mg·kg^-1,iv)对气道阻力的增高无明显影响;但显著抑制微血管渗漏,在刺激强度低(2V)时更明显。结果提示白细胞三烯类参与神经原性炎症时的气道微血管渗漏反应。