Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0153418 (Pylorus)
 119 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since 1978, 252 patients from different centers in the world have undergone pylorus-preserving pancreatoduodenectomy. Fifty-five per cent of the patients had malignant tumors in the region of the head of the pancreas. The overall operative mortality rate was 2.8%. Anastomotic leakage and fistulae occurred in 19% of the patients. Pancreatic, biliary, and enteric fistulae represented 11%, 4%, and 4%, respectively. Peptic ulcers were subsequently diagnosed in seven patients (3%), two of whom required vagotomy and antrectomy. Delayed recovery of gastric function was the most common complication of this operation, with an overall incidence of 30%. Although the cause of this gastric dysfunction is unknown, its transient nature in most patients makes expectant therapy with gastric tube drainage the best remedy when the problem is encountered. Pylorus-preserving pancreatoduodenectomy decreased the incidence of postgastric surgery syndromes that are commonly associated with the standard Whipple operation. The existing data support the continued use of the operation and the need for future laboratory and clinical investigation of its physiologic impact.
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PMID:Pylorus-preserving pancreatoduodenectomy. A clinical and physiologic appraisal. 302 95

Pylorus ligation changed the morphology and location of gastric lesions induced by water-immersion stress (WI stress) in rats; linear lesions in the corpus mucosa disappeared, and punctate lesions appeared in both the corpus and antrum, in association with the loss of H+ and the gain of Na+ in the gastric contents. Oral administration of antipeptic drugs such as amylopectin sulfate and sulfated glyptide or porcine pepsin significantly prevented or aggravated the lesions, respectively, although another type of elongated lesion appeared in response to high doses of antipeptic drugs. These antipeptic drugs or exogenous pepsin significantly reduced or increased pepsin activity, respectively, without effect on the acid output. Similar punctate lesions were produced in the atropinized rats (10 mg/kg) by instillation of acid solution (100 mM HCl plus 54 mM NaCl) with pepsin into the pylorus-ligated stomach and subjecting to WI stress. On the other hand, when the gastric contents were drained through a fistula to prevent accumulation of gastric juice in the pylorus-ligated stomach, WI stress again induced linear lesions only in the corpus mucosa. Acid hypersecretion in these rats induced by intravenous infusion of histamine, tetragastrin, or carbachol significantly aggravated the severity of lesions but did not change their morphology. These results suggest that pepsin in the presence of acid is prerequisite for development of gastric lesions in pylorus-ligated rats induced by WI stress. The morphological alterations may be accounted for by the distensions of the stomach due to accumulation of gastric juice in the lumen caused by pylorus ligation, but not due to acid hypersecretion.
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PMID:Importance of pepsin and stomach distension in morphological alterations of stress-induced gastric lesions in pylorus-ligated rats. 312 79

The advantages of gastric diversion over pylorus ligation in rat gastric mucosal integrity and acid secretion studies over 6 hr were investigated. Mucosal injury developed in 80% of pylorus-ligation controls. Atropine (5 mg/kg) or cimetidine (40 mg/kg) had no effect on this injury (2.9 mm2 +/- 0.9 and 2.8 mm2 +/- 0.7, respectively, vs 3.1 mm2 +/- 1, mean +/- SEM, N = 10); however vagotomy increased it (13.7 mm2 +/- 1.5, mean +/- SEM, N = 10, P less than 0.001). Gastric diversion produced no mucosal injury. Pylorus-ligation H+ output was higher than that of gastric diversion (390.5 mumol +/- 54.8 vs 61 mumol +/- 2.5, mean +/- SEM, N = 10, P less than 0.001). Cimetidine (40 mg/kg) depressed H+ output of gastric diversion (21.3 mumol +/- 1.2 vs 61 mumol +/- 2.5, mean +/- SEM, N = 10, P less than 0.001), but not of pylorus ligation (424 mumol +/- 74.2 vs 390.5 mumol +/- 54.8, mean +/- SEM, N = 10). Vagotomy or atropine depressed pylorus-ligation H+ output (P less than 0.001), but each allowed an output (36.6 mumol +/- 5.5 and 120 mumol +/- 29, respectively, mean +/- SEM, N = 10) significantly (P less than 0.001) higher than that associated with it in gastric diversion (16 mumol +/- 1.4 and 17.1 mumol +/- 1.6, respectively, mean +/- SEM, N = 10). This study demonstrates that in the rat pylorus ligation, in contrast to gastric diversion, injures the gastric mucosa, stimulates H+ secretion, and overshadows the efficacy of antisecretory agents.
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PMID:Gastric diversion or pylorus ligation for gastric mucosal integrity and acid secretion studies in the rat? 318 Sep 81

Pylorus-preserving resections of the stomach were fulfilled in 118 patients with type I ulcers. The detected drop of the acid production in the stomach with ulcers of such localization was considered to be an indication to the removal of not more than 1/2 of the stomach. A necessary condition of pyloropreserving resection is the leaving of the pylorus zone not more than 2-3 cm. Two patients died (one from peritonitis and one from pulmonary insufficiency), 5 patients had disturbed evacuatory function of the stomach related with anastomosis. Long-term results were followed-up in 113 patients. All the patients returned to their normal activity, the pain syndrome disappeared, the dumping syndrome was absent. Complete inhibition of free hydrochloric acid was noted. There were no recurrences.
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PMID:[Pylorus-sparing gastric resection in the surgical treatment of mediogastric ulcers]. 340 89

In two 5 year periods (1975 to 1979 and 1980 to 1984), 96 patients underwent pancreatoduodenal resection, which included 74 partial pancreatic resections and 22 total pancreatectomies. Thirty-seven of these patients had resections with preservation of the pylorus. Substantial reductions in perioperative mortality (2 percent versus 10 percent) and morbidity (26 percent versus 49 percent) (p less than 0.05) were achieved in the latter period. Pylorus preservation, with a mortality and morbidity of 3 percent and 27 percent, respectively, did not increase operative risk or compromise long-term survival in patients with malignant disease. In comparison, relatively high mortality and morbidity rates (14 percent and 59 percent) accompanied total pancreatectomy without improved long-term survival. Five year actuarial survival for nonpancreatic periampullary adenocarcinomas was 58 percent. Thus, we recommend pancreatoduodenectomy with preservation of the pylorus for resection of periampullary tumors. These patients, whose only possibility for cure is a major pancreatic resection, should not be denied this opportunity on the basis of reports from a previous era.
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PMID:Decreased morbidity and mortality after pancreatoduodenectomy. 394 45

Pylorus and bile-duct restrictions did not prevent the anteriad migration of Hymenolepis diminuta in rat small intestine after food feeding. However, migration was inhibited when the common bile-duct was occluded. The results indicate that pancreatic secretion is the migratory cue for Hymenolepis diminuta in rats.
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PMID:Pancreatic secretion is the migratory cue for Hymenolepis diminuta in rat small intestine. 409 90

In the rat nephrectomy raises the serum gastrin concentration but makes the parietal cells refractory to gastrin. Pylorus ligation stimulates the gastric acid output by a long vago-vagal reflex in innervated animals and by an intramural reflex in chronically vagotomized animals. Nephrectomy reduced the acid response to pylorus ligation in vagally intact rats but enhanced it in vagotomized rats. The acid response to pylorus ligation in all the experimental groups was inhibited by a muscarinic blocker, atropine, and by an H2-antagonist, metiamide. The serum gastrin concentration was raised by nephrectomy and by vagal denervation. Histamine mobilization from gastric endocrine cells is reflected in the activity of gastric histidine decarboxylase. The enzyme activity in pylorus-ligated innervated rats was raised by pentagastrin, atropine, and metiamide. In nephrectomized rats the basal enzyme activity was high, and it was raised further, slightly but significantly, by pentagastrin. The basal enzyme activity in pylorus-ligated rats was also quite high after vagotomy, and it was raised further by pentagastrin. After vagotomy + nephrectomy the basal enzyme activity was very high; it was not raised further by pentagastrin. It appears that both vago-vagal and intramural reflexes involve a cholinergic and a histaminergic pathway, that gastrin is not important for the neurally mediated acid response elicited by pylorus ligation, and that the postulated histaminergic pathway does not involve histamine derived from the gastric endocrine-like cells.
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PMID:Mechanism of gastric acid response to pylorus ligation: effects of nephrectomy. 666 25

Effects of 4 weeks of treatment with oral cimetidine, 100 mg/kg twice daily, on gastric secretion and plasma gastrin levels were studied in rats. Pylorus ligation-induced and pentagastrin-stimulated gastric secretions were little changed at days 1, 3, and 10 after cessation of cimetidine treatment as compared to the controls. Histamine-stimulated acid secretion was significantly higher in the cimetidine-treated group than in the controls at day 3 after cimetidine treatment but was unchanged at days 1 and 10. A single oral administration of cimetidine at 100 mg/kg significantly increased plasma gastrin levels 4 hr after the treatment in refed rats but not at 2 and 8 hr later. Plasma gastrin levels significantly decreased at days 3 and 10 after cessation of cimetidine treatment as compared to the controls. Thus, while prolonged treatment with cimetidine induces a transient increase in response of parietal cells to histamine and a reduction of food-stimulated gastrin release, it does not seem to induce other appreciable changes in gastric secretion.
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PMID:Gastric secretory conditions and plasma gastrin levels in rats after prolonged treatment with cimetidine. 669 31

1. Pylorus ligation stimulated the acid output in vagally intact rats. The serum gastrin concentration and the gastric mucosal histamine content were not affected. The gastric histidine decarboxylase activity was initially slightly elevated and then greatly reduced (12-20 hr after ligation).2. Pylorus ligation stimulated the acid output in chronically, but not in acutely, vagotomized rats. Chronic vagotomy raises the serum gastrin concentration, the gastric histamine content and histidine decarboxylase activity. The serum gastrin concentration was further raised by pylorus ligation. The histamine content was initially lowered but returned to preligation values after 20 hr. The histidine decarboxylase activity first decreased, but increased to very high levels 5-6 hr after ligation. Twelve hours after ligation it was lower than before ligation.3. Following pylorus ligation pentagastrin and histamine stimulated the acid output in vagally intact and in acutely vagotomized but not in chronically vagotomized rats. By contrast, pentagastrin raised the histidine decarboxylase activity in vagally intact and in chronically vagotomized, but not in acutely vagotomized rats.4. The two major populations of endocrine cells of the oxyntic gland area (ECL cells and A-like cells) are argyrophil, store histamine and are capable of taking up exogenous DOPA and of decarboxylating it to dopamine which is retained in the cytoplasm for several hours. As evidenced by light and fluorescence microscopy pylorus ligation did not affect their argyrophilia or their ability to produce and store dopamine.5. Pylorus ligation caused ultrastructural changes in the gastrin cells of the pyloric gland area and in the histamine-storing ECL and A-like cells of the oxyntic gland area. The two endocrine cell types in the oxyntic gland area were enlarged by pylorus ligation, more so after 16 hr than after 4 hr. The size of the gastrin cells seemed unaffected. In all three cell types pylorus ligation reduced the number of cytoplasmic granules. There was no increase in the Golgi area or in the endoplasmic reticulum in any of the endocrine cell types of the oxyntic gland area. It appears unlikely that the ultrastructural changes of the ECL and A-like cells reflect an increased rate of histamine mobilization.6. The acid response to pylorus ligation probably reflects neuronal reflex mechanisms exclusively. There is no evidence that gastrin or histamine released from gastric endocrine cells mediate the response.
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PMID:Gastric acid response to pylorus ligation in rats: is gastrin or histamine involved? 709 72

Gastric lesions were developed in the communication box paradigm (CB) in mice as well as in the activity-stress paradigm (AS) in rats. Treatment with sulpiride (10-320 mg/kg, p.o.) attenuated these psychological stress-induced gastric lesions in a dose-dependent manner, while it failed to suppress those induced by physical stress such as restraint water-immersion (WI) and indomethacin treatment (IND). In contrast, treatment with famotidine (0.32-10 mg/kg, p.o.) dose-dependently attenuated the gastric lesions induced by physical stress but not those by psychological stress. Pylorus-ligation study revealed that famotidine strongly reduced gastric acid secretion, whereas sulpiride minimally affected that. It was also demonstrated that physical stress (WI) enhanced acid secretion while psychological stress (CB and AS) rather depressed that. These results suggest that the mechanisms of gastric lesion formation are clearly different between physical and psychological stress and that sulpiride specifically attenuates psychological stress lesions possibly through a central mechanism.
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PMID:Sulpiride specifically attenuates psychological stress-induced gastric lesions in rodents. 749 80


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