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Biomedical subjects

W Müller-Duysing

Publications and source records attributed to W Müller-Duysing.

At least 19 recordsLinked to original sources

Fate of antacid gel in the stomach. Site of action and interaction with food.

The site of action of a high-power Al-Mg antacid gel (buffering capacity 70 meq/10 ml) and its interaction with food was examined in 10 healthy volunteers. Combined pH-metries in antrum and corpus were performed in each volunteer on four occasions. In a randomized study design, antacid or placebo were given 1 hr after either a protein or a carbohydrate pancake, of which only the former had any acid-buffering capacity. Before the meal, pH was higher in the antrum than in the corpus (median antrum: 3.2, corpus 1.5). In the corpus, a protein pancake but not a carbohydrate pancake raised the pH (median pH after protein pancake: 3.5; after carbohydrate pancake: 1.4). In the antrum, the protein pancake had no effect, but the carbohydrate pancake decreased the pH (median pH after protein pancake: 3.1; after carbohydrate pancake: 2.0). The antacid had no effect in the corpus after either pancake. It raised intraluminal pH markedly in the antrum after a carbohydrate pancake (median antral pH before antacid: 2.0; after antacid: 3.3), whereas its effect in the antrum was weak after a protein pancake. In vitro experiments were conducted to explain the in vivo results: in contrast to a carbohydrate pancake, a protein pancake reduced the buffering capacity of the antacid by direct interaction. In conclusion, the effect of an antacid gel on intragastric pH is predominantly localized in the antrum and is attenuated in the presence of proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Is there a relationship between gastric mucosal blood flow and stress lesions in hemorrhagic shock?

The relationship between gastric mucosal blood flow and stress lesion formation during hemorrhagic shock was studied in anesthetized dogs. Shock was induced by graded arterial bleeding. Blood flow was measured by means of the radioactive microsphere technique. Mapping of blood flow was achieved by measuring the microsphere accumulation in mucosal and muscle segments of 1-2 cm side length of the entire stomach. To produce a varying incidence of lesions the metabolic acidosis of shock was either fully corrected by intravenous sodium bicarbonate (n = 5), partially corrected (n = 4) or left uncorrected (n = 3). Mucosal lesions developed more frequently in dogs without correction than in dogs with partial correction or full correction. In 4 dogs not subjected to shock, no mucosal lesions were observed at the end of the experiments. Mucosal blood flow varied from segment to segment by a factor of up to 20, but individual segments tended to maintain their relative flow values during shock. Correction of metabolic acidosis did not significantly affect blood flow. Likewise, flow was similar in segments with and without lesions. Therefore, low regional blood flow did not predispose to the development of lesions and high flow did not prevent them. We conclude that focal mucosal ischemia alone does not lead to stress lesion formation during hemorrhagic shock.

Animals↗

Novel approach to quantify duodenogastric reflux in healthy volunteers and in patients with type I gastric ulcer.

A new method is described which allows simultaneous measurement of gastric emptying and duodenogastric reflux and avoids transpyloric intubation. After intragastric instillation of a liquid lipid meal in six healthy volunteers the fractional gastric emptying rate was 2.9 +/- 0.3 in the upright and 2.5 +/- 0.6 SEM X 10(-2)/min in the supine position, respectively (p greater than 0.5). The duodenogastric reflux rate (expressed as fraction of the intraduodenal amount of duodenal marker) was 0.30 (range 0.03-0.81) and 0.22 (0.01-0.55) X 10(-2)/min, respectively (p greater than 0.2). Atropine (40 micrograms/kg) decreased the supine gastric emptying rate to 1.1 +/- 0.2 (p less than 0.05) and increased the supine duodenogastric reflux rate to 2.74 (0.04-9.80) X 10(-2)/min (p less than 0.05). Fasting duodenogastric reflux rate was similar in the supine and upright position, 0.49 (0.04-0.89) and 0.42 (0.06-0.97) X 10(-2)/min, respectively (p greater than 0.5). Fractional gastric emptying rate was similar in 10 volunteers and 17 patients with type I gastric ulcer (2.1 +/- 0.4 vs 1.7 +/- 0.2 SEM X 10(-2)/min, p greater than 0.2). Their duodenogastric reflux rates were also similar, 0.65 (0.01-5.24) vs 1.10 (0.01-10.83) X 10(-2)/min (p greater than 0.5). We conclude therefore that (1) gastric emptying and both fasting and postprandial duodenogastric reflux are independent of the posture; (2) fasting and postprandial reflux are of similar magnitude; (3) atropine shows gastric emptying and increases duodenogastric reflux; and (4) patients with type I gastric ulcer have neither slowed gastric emptying nor increased duodenogastric reflux.

Adult↗

Diabetic gastroparesis: treatment with domperidone--a double-blind, placebo-controlled trial.

6 patients with severe symptomatic diabetic gastroparesis were studied in a placebo-controlled randomized manner to establish if intravenous domperidone accelerates the delayed gastric emptying of a semisolid homogenized meal. Domperidone, 10 mg intravenously, shortened the gastric emptying half-time in all of the 6 patients significantly, but not in the healthy control subjects. These results suggest that intravenous domperidone may be potentially beneficial to diabetic gastroparesis patients by improving delayed gastric emptying.

Adult↗

Effect of liquid meals on duodenogastric reflux in humans.

In humans duodenogastric reflux and gastric emptying were measured simultaneously by a two-marker technique that avoids transpyloric intubation. The duodenal marker consisted of 99mTc-labeled Hepatobida and was infused intravenously at a constant rate. Hepatobida was cleared almost exclusively by the liver and entered the duodenum at a constant rate via the bile. The gastric marker consisted of 51CrCl2 and was used to measure total intragastric volume by the double-sampling technique. Duodenogastric reflux occurred both after meals and under fasting conditions. Reflux rate was on the average 13 times smaller than emptying rate. It was higher with a lipid than with a protein meal and was independent of the rate of gastric emptying. The gastric concentration and total amount of duodenal contents were higher after lipid than protein meals. Since gastric emptying of a protein meal was faster than emptying of a lipid meal, the increased gastric concentration and accumulation of duodenal contents after lipid meals are due to a slowed gastric clearing and increased reflux of duodenal contents. Under fasting conditions, the reflux was lower and the gastric concentration of duodenal contents was higher than with both types of meals. Hence regurgitated duodenal contents may cause more damage to the gastric mucosa under fasting conditions than postprandially.

Adult↗

Effect of gastric and transpyloric tubes on gastric emptying and duodenogastric reflux.

The effect of thin and pliable gastric and transpyloric duodenal tubes on gastric emptying was studied in healthy volunteers. Gastric emptying was unaffected by both gastric and transpyloric tubes. Gastric emptying was also similar whether a milk-cream meal was instilled via a tube or was swallowed. The effect of a transpyloric tube on postprandial and fasting duodenogastric reflux was studied by using a technique that does not require a transpyloric tube in order to measure reflux. Duodenogastric reflux was similar in the fasting state and after feeding and was not affected by a transpyloric tube. In conclusion, thin and pliable gastric and transpyloric tubes do not affect gastric emptying and duodenogastric reflux in humans, and, in addition, the mode of administration of a meal does not affect gastric emptying.

Duodenum↗