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R Calabuig

Publications and source records attributed to R Calabuig.

34 records · Page 2Linked to original sources

The propulsive behavior of the opossum sphincter of Oddi.

This study investigates whether the phasic contractions of the opossum sphincter of Oddi (SO) delay bile flow by acting as a resistor or facilitate bile flow by acting as a pump. The common bile duct (CBD) and an adjacent segment of duodenum from eight opossums were studied in a propulsion evaluation system in vitro. This system required the production of hydrostatic work by the SO to transfer fluid from the CBD to the duodenum when the pressure in the duodenum was equal or greater than the pressure in the CBD. Fluid movement from the CBD to duodenum and duodenum to CBD was studied at pressure gradients up to 50 cmH2O before and after sodium nitroprusside (10(-7) M) inhibition of smooth muscle contractile activity. All preparations propelled fluid from the CBD to the duodenum against a pressure gradient ranging from 10 to 50 cmH2O. The SO emptied the CBD in a monoexponential fashion, with a time constant of 1.52 +/- 0.7 min, until CBD pressure was reduced to 8.5 +/- 3.2 cmH2O, when propulsion ceased. Superimposed on the CBD pressure waveform were pressure pulses of 1-2 cmH2O in amplitude that resulted from the contractions of the SO. CBD pressure was higher at the start than at the end of a periodic pressure pulse, whereas CBD pressure was stable between pulses. The frequency of the pressure pulses was greatest at the maximal CBD pressure (9.4/min) and decreased significantly when the basal pressure was reached (1.5/min, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Ampulla of Vater↗

Gallbladder and gastrointestinal motility after hemorrhagic shock.

The alterations in fasting gallbladder and gastrointestinal motility during hemorrhagic shock were investigated. Eight opossums implanted with a gallbladder cannula, gastrointestinal bipolar electrodes, and a carotid catheter were subjected to hemorrhagic shock of 30 mm Hg for 60 minutes by the removal of arterial blood. Shed blood was reinfused after the shock period. Fasting gallbladder volume and gastrointestinal electrical activity were studied before, immediately after, and 24 hours after hemorrhagic shock. Control measurements demonstrated a slow-wave frequency maximal in the duodenum (18.1 +/- 1.1 waves/min), with a plateau in the proximal third of the small bowel, decreasing thereafter. The migrating motor complex (MMC) had a duration of 118 +/- 28 minutes. The average volume of the gallbladder before shock was 5.4 +/- 1.5 ml. Gallbladder volume fluctuated with the MMC, being maximal during phase I and minimal in phase III. The volume of blood removed to reduce mean arterial pressure to 30 mm Hg was 45 +/- 5 ml/kg. Immediately after the shock and blood reinfusion, slow-wave frequency decreased by 40% in the antrum and 25% in the small bowel. The MMC was of shorter duration (91 +/- 22 minutes; p less than 0.05), and gallbladder volume increased to 7.0 +/- 1.7 ml (p less than 0.05). Fluctuations in gallbladder volume during the MMC were absent. Twenty-four hours after shock, slow-wave frequency, MMC, and gallbladder volume had returned to normal and were not different from control measurements. Ischemic damage to the gastrointestinal tract is postulated as the cause of gallbladder dysfunction and altered intestinal motility after hemorrhagic shock.

Animals↗

[Gastric emptying in reflux esophagitis. Effect of metoclopramide and cinitapride].

The gastric emptying of solids was evaluated with radionuclide techniques in 16 patients with reflux esophagitis, demonstrated by two of the following methods: endoscopy, pathology, and/or pH measurement. The percentage of radionuclide remaining within the stomach was 80.8 +/- 17% after 45 minutes, 63.3 +/- 10% after 75 minutes, and 48.8 +/- 19% after 105 minutes, with a half time (T1/2) of gastric emptying of 103.4 +/- 6 minutes. These results showed significant differences in T1/2 with those from a control group of healthy individuals, the gastric emptying being slower in patients with esophagitis (103.4 min vs 85.3 min; p less than 0.01). Subsequently, a double blind study to assess the effect of metoclopramide and cinitapride on gastric emptying in patients with reflux esophagitis was carried out. Cinitapride accelerated the gastric emptying of solids with statistically significant differences when compared with placebo (84 min vs 104 min, p less than 0.05). In this study, metoclopramide showed a tendency to accelerate gastric emptying, although it did not achieve a significant difference with placebo.

Aged↗

Gastric emptying and bezoars.

Bezoars are conglomerates of undigested material in the stomach, which appear as a late complication of gastric surgery and are presumably related to secondary motility changes. We studied the gastric emptying of a technetium-99m-(Tc 99m) labelled solid meal in 10 patients who presented with a bezoar 1 to 20 years after vagotomy and pyloroplasty, vagotomy and antrectomy, vagotomy and gastrojejunostomy, or hemigastrectomy. The results were compared with the emptying data of operated patients without bezoars. The gastric retention of Tc 99m-labelled solids at 45, 75, and 105 minutes was 85 +/- 15 percent (mean +/- SD), 79 +/- 17 percent, and 65 +/- 24 percent, respectively. No differences were found when results were compared with those of operated patients without bezoars. We concluded that factors other than the gastric digestive phase are the main contributors to bezoar formation.

Aged↗

Gastric emptying in marathon runners.

Radionuclide gastric emptying studies using 99m-Tc human serum albumin egg omelette have been carried out in 10 long distance runners at rest and during a 90 minute run at sustained speed. Resting values are compared with controls comprising 10 sedentary subjects. Runners show a significantly accelerated basal gastric emptying (runners t 1/2 = 67.7 (5.9) min; sedentaries t 1/2 = 85.3 (4.5) min, p less than 0.001). The exercise had no significant effect on gastric emptying in these trained subjects (exercise t 1/2 = 66.8 (5.9) min, p = NS), suggesting adaptation to exercise.

Adaptation, Physiological↗

Inhibition of sphincter of Oddi motility in Australian possum by cholic acid.

The effect of intravenous administration of cholic acid on sphincter of Oddi (SO) and gallbladder motility was studied. Bolus doses of cholic acid, 20 to 60 mg/kg, produced inhibition of SO wave frequency, a fall in gallbladder pressure and enhanced bile flow. However, hydrocortisone, 10 and 20 mg/kg, produced comparable elevation in bile flow with no effect on SO and gallbladder motility. The effect of cholic acid on SO motility was not influenced by prior treatment with atropine. Phentolamine or propranolol administration did not influence SO wave frequency SO wave frequency, but subsequent injection of cholic acid resulted in a decrease in SO wave frequency. Gallbladder pressure was not influenced by atropine, phentolamine, or propranolol, and these agents did not influence the cholic acid-induced fall in gallbladder pressure. These findings suggest that bile acids influence the motility of the biliary tract.

Ampulla of Vater↗

Surgical gauze pseudotumor.

Gauze forgotten at operations can be potentially life threatening, but such cases are seldom reported because of the medicolegal implications. We have presented a series of seven patients with long-term surgical gauze retention, four after pelvic operations, one after cholecystectomy, one after laryngectomy, and one after mastectomy. The median time interval between operation and gauze removal was 5 years. In three patients this was diagnosed as a tumoral mass, in three as an intestinal occlusion, and in one the gauze was found incidentally. All foreign bodies were removed and no patient died. The clinical and diagnostic aspects of retained surgical gauze have been discussed and the need for radiopaque markers in them have been emphasized.

Bandages↗

Gastric emptying after truncal vagotomy and pyloroplasty.

We have studied the gastric (fundic and antral) emptying of solids and liquids by a radionuclide method in 20 patients after truncal vagotomy and pyloroplasty (TVP) and in 10 control subjects. Gastric emptying of solids in TVP patients was similar to that of the control group (NS), but fundic emptying did not show a lag phase and was significantly faster. A significantly higher percentage of the solid fraction of the test meal filled the antrum (32 +/- 16% versus 20 +/- 9%; p less than 0.05), and this quantity was constant during the study period. Gastric emptying of liquids was greatly hastened after surgery. In 22 min 50 +/- 16% had left the stomach (versus 40 +/- 14% in controls; p less than 0.001). At 90 min the amount of liquid remaining in the stomach was similar to that in the control subjects. TVP accelerates fundic emptying of solids, which are transferred to an overfilled, paretic antrum. Liquids are emptied by a bimodal pattern with a precipitous initial emptying followed by a second slower phase.

Adult↗

Thyroidal hemiagenesis.

Three cases of thyroidal hemiagenesis have been reported. The patients were euthyroid and presented with adenomatous goiters; one uninodular and the others multinodular in the contralateral lobe. In two cases the diagnosis was established by the thyroid stimulation test and confirmed at operation. In one case, this test was not performed and the hemiagenesia was discovered at routine surgical exploration of the scintigraphically absent lobe. From our cases and review of the literature we have concluded that the anomaly is usually discovered while searching for a contralateral pathologic abnormality, a thyroid stimulation test is essential for a preoperative suspicion, it occurs more frequently among women and in the left lobe, and ours are the first cases reported from Spain.

Adenocarcinoma↗

Meckel's diverticulum: value of ectopic tissue.

Cases of symptomatic Meckel's diverticulum treated surgically on an emergency basis during the last decade are reviewed. A series of 18 patients were divided into two groups depending on the presence or absence of ectopic tissue in the diverticulum. Group 1 consisted of five patients (28 percent) without ectopic tissue, and Group 2 consisted of 13 patients (72 percent) with ectopic tissue (8 gastric ectopia, 2 pancreatic ectopia, and 3 both gastric and pancreatic ectopia). Previous clinical records related to Meckel's diverticulum were found for 54 percent of the patients in Group 2 and for none of those in Group 1. The most common acute manifestations were intestinal occlusion (seven patients), digestive hemorrhage (five patients), and peritonitis (three patients). The postoperative course was 7 days in Group 1 and 15 days in Group 2 regardless of the surgical technique used. We conclude that the presence of ectopic tissue in patients with Meckel's diverticulum seems to be the main risk for occurrence of an acute nonmechanical complication. This complication appears more frequently and with more severity in young patients.

Adult↗

Perineal necrotizing infection.

Perineal necrotizing infection is a severe disease that ever since its first description by Fournier in 1883 has been referred to by many names prompted by its protean nature in terms of location and suspected etiology. We treated nine patients with PNI. The infection began as a perineal abscess of long evolution (7 days +/- 2 SD) in eight patients. The ninth patient had had an inguinal herniorrhaphy 3 days before. The cultures of the exudates and tissues always yielded aerobic and anaerobic mixed flora of colorectal origin, except in one instance, in which S. aureus and hemolytic streptococcus A were identified. The treatment was medical support and wide surgical debridement of the infected tissues. In six patients a left transverse colostomy was performed. Only one patient died, of septic shock. On the basis of the results in our series and on a review of the literature, it is our opinion that PNI is a mixed bacterial infection that despite its origin, clinical appearance and microbiologic findings, is highly uniform in terms of clinical course and treatment. Therapy is based on radical surgical debridement with excision of all necrotic tissue. The current plethora of terms seems impractical and confusing. We propose a rather comprehensive term perineal necrotizing infection for the sake of clarity.

Adult↗