gastrins and Vomiting

Topics: Anemia, Hypochromic; Body Weight; Bone Diseases; Chronic Disease; Diarrhea; Dumping Syndrome; Duodenal Obstruction; Duodenal Ulcer; Female; Follow-Up Studies; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastrins; Histamine; Humans; Insulin; Male; Methods; Pentagastrin; Peptic Ulcer; Peptic Ulcer Hemorrhage; Peptic Ulcer Perforation; Postoperative Complications; Recurrence; Stomach Ulcer; Vomiting

The G17DT is a novel human immunogen that raises antibodies to the growth factor gastrin 17 (G17). The purpose of this study was to determine the safety and efficacy of G17DT in combination with irinotecan in patients refractory to irinotecan, and to correlate efficacy with anti-G17 immune response.. Patients received G17DT immunogen as a single intramuscular injection of 500 μg at weeks 1, 5, 9, and 26. Irinotecan was administered as an intravenous infusion of 125 mg/m(2) over 90 min starting at week 5. Each cycle of treatment consisted of irinotecan administered once weekly for 4 weeks, followed by a 2-week rest period.. Of 161 patients who received G17DT, the best overall tumor response in the intent-to-treat population was complete response 0 (0 %), partial response 3 (3 %), stable disease 32 (32 %), and progressive disease 64 (65 %). Median survival was 217 days. About 94 (62 %) subjects evaluable for antibody titers were anti-G17 responders. Survival was significantly longer for anti-G17 responders compared with non-responders (9.0 vs. 5.6 months; P < 0.001). Toxicity was consistent with irinotecan (diarrhea, nausea, anemia, vomiting, fatigue, constipation, anorexia, and neutropenia) except for injection site reactions (pain 42 %, induration 13 %, edema 11 %, erythema 10 %, and three abscesses) attributed to G17DT in 52 % of the patients.. Treatment with G17DT in combination with irinotecan results in an acceptable anti-G17 immune response, which correlated with promising survival activity in patients refractory to irinotecan-based chemotherapy.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Cancer Vaccines; Colorectal Neoplasms; Diarrhea; Drug Administration Schedule; Female; Gastrins; Humans; Infusions, Intravenous; Injections, Intramuscular; Irinotecan; Male; Middle Aged; Nausea; Neutropenia; Treatment Outcome; Vomiting

The identification of vomit stains may be helpful for crime scene reconstruction. However, there is no specific and convenient method for identifying vomit stain. Therefore, to establish the procedure for forensic identification of vomit stains, we focused on four gastric mucosa-expressing proteins, pepsinogen I (PGA), pepsinogen II (PGC), gastrin (GAST), and mucin 5AC (MUC5AC). We developed enzyme-linked immunosorbent assay (ELISA) procedures for the detection of these four candidate proteins. The specificity and sensitivity of ELISA detection of these proteins were analyzed, and applicability for the identification of vomit in forensic casework samples was also investigated. We found the sensitivities of ELISA for detection of PGA, PGC, GAST, and MUC5AC from the standard protein (peptide) and from diluted gastric mucosa extract were 10.0-100.0 ng/ml and 1:200-1:1600, respectively. PGA and PGC were successfully detected in stomach contents and gastric mucosa samples; however, these also cross-reacted with some urine and semen samples, respectively, because of low level expression in these fluids. MUC5AC was positive for most gastric mucosa samples; however, it was difficult to detect in stomach contents. ELISA detection of GAST was not suitable for the identification of vomit. All aged samples stored up to 90 days gave positive results for ELISA procedures for PGA, PGC, and MUC5AC. Therefore, ELISA detection of these proteins might be applicable to aged samples. PGA was also detected in all actual vomit samples tested. These results suggest that ELISA for the detection of gastric mucosa-expressing proteins, especially PGA, could be an effective tool for the forensic identification of vomit.

Topics: Adult; Aged; Aged, 80 and over; Enzyme-Linked Immunosorbent Assay; Forensic Medicine; Gastric Mucosa; Gastrins; Gastrointestinal Contents; Humans; Middle Aged; Mucin 5AC; Pepsinogen A; Pepsinogen C; Sensitivity and Specificity; Vomiting

Topics: Barrett Esophagus; Carcinoma, Neuroendocrine; Colonic Polyps; Diagnosis, Differential; Diarrhea; Gastrinoma; Gastrins; Humans; Male; Middle Aged; Pancreatic Neoplasms; Recurrence; Vomiting; Weight Loss; Zollinger-Ellison Syndrome

A 4-yr-old cheetah (Acinonyx jubatus) with a 2-yr history of chronic intermittent vomiting and spiral bacteria-associated gastritis presented with dramatically increased vomiting frequency and marked intermittent abdominal distention. Physical examination revealed loss of muscle mass and poor fur coat quality. Contrast radiography was consistent with delayed gastric emptying due to presumed gastric outlet obstruction. Both Y-U pyloroplasty and incisional gastropexy were performed, and no subsequent vomiting has been observed for 3 yr with the exception of three episodes during the immediate postoperative period. The cause of delayed gastric emptying was not determined, although a gastric motility disorder associated with gastric bacterial infection and elevated gastrin levels was suspected.

Topics: Acinonyx; Animals; Female; Gastric Emptying; Gastrins; Gastritis; Gastrointestinal Motility; Pylorus; Stomach Diseases; Vomiting

Persistent severe vomiting in pregnancy may be caused by underlying disease and should be investigated. A patient with intractable vomiting associated with abdominal pain and dental enamel erosion in two pregnancies had a gastrinoma. Symptoms were successfully controlled with omeprazole in a third pregnancy. All three babies were healthy.

Topics: Adult; Anti-Ulcer Agents; Female; Gastric Acid; Gastrins; Humans; Nausea; Omeprazole; Pregnancy; Pregnancy Complications, Neoplastic; Pregnancy Outcome; Tomography, X-Ray Computed; Vomiting; Zollinger-Ellison Syndrome

To investigate changes in motility of the extrahepatic biliary system associated with emesis, we measured the volume of the gallbladder and flow resistance through the sphincter of Oddi, as well as antral and duodenal contractilities before and during retching in decerebrate paralyzed dogs. Motilities of the gallbladder, sphincter of Oddi, duodenum and antrum were enhanced with most episodes of fictive retching elicited by stimulation of the central part of the severed dorsal, as well as the ventral trunk of the thoracic vagus nerve. These enhanced motilities persisted until the end of retching. Motilities of the sphincter of Oddi and duodenum were sometimes transiently depressed at the beginning of retching. This depression in the sphincter continued for only 13 +/- 1.0 s, while the gallbladder contraction continued for 65 +/- 3.4 s. Motilities were rarely enhanced by vagal stimulation when retching was not elicited. These changes in motilities were abolished by bilateral vagotomy. The serum gastrin level was increased just after and 10 min after retching only when the ventral vagal trunk remained intact, while the plasma cholecystokinin level was not changed with retching. These results suggest that bile evacuation is interrupted with emesis despite contraction of the gallbladder during retching, since the sphincter of Oddi also contracts simultaneously.

Topics: Animals; Biliary Tract; Dogs; Electric Stimulation; Gallbladder; Gastrins; Gastrointestinal Motility; Muscle Contraction; Sphincter of Oddi; Time Factors; Vagus Nerve; Vomiting

Topics: Animals; Bile; Bile Ducts, Extrahepatic; Cholecystokinin; Dogs; Gallbladder; Gastrins; Movement; Sphincter of Oddi; Vomiting

The purpose of this study was to determine whether serum gastrin levels are increased by reflexogenic stimuli applied to the extrinsic muscles of the eye. Serum gastrin and blood glucose concentrations were measured in ten normal children aged between 5 and 12 yr during general anaesthesia with halothane and nitrous oxide and during strabismus surgery. Fasting basal concentrations of gastrin (33.6 +/- 14.8 pg.ml-1) and of glucose (4.43 +/- 0.72 mmol.L-1) were in the normal range of values for children. Intravenous atropine (0.01 mg.kg-1), general anaesthesia with halothane in nitrous oxide and oxygen by mask for three minutes, tracheal intubation, extraocular muscle stimulation and surgical stress did not cause any variation in the mean serum gastrin concentration. On the contrary, tracheal intubation and surgical stress increased blood glucose concentrations (P less than 0.05). There was no difference in the serum gastrin levels after extraocular muscle stimulation between children with positive or negative oculocardiac reflexes (44.5 +/- 16.7 pg.ml-1 vs 38 +/- 14.7 pg.ml-1, respectively). The incidence of vomiting predischarge was 60 per cent. Serum gastrin levels did not differ between children who vomited and children who did not (44.3 +/- 18.5 pg.ml-1 vs 47.1 +/- 16.9 pg.ml-1, respectively). Vomiting after strabismus surgery cannot be attributed to high gastrin serum levels. Consequently, it is unlikely that vomiting after strabismus surgery is linked to an "oculogastric reflex" with the vagus nerve as the efferent pathway.

Topics: Anesthesia, Inhalation; Blood Glucose; Child; Child, Preschool; Female; Gastrins; Halothane; Humans; Incidence; Intubation, Intratracheal; Male; Nitrous Oxide; Oculomotor Muscles; Reflex, Oculocardiac; Strabismus; Vomiting

Apomorphine (0.05 mg/kg intravenously) was given to conscious dogs, and gastrin levels were measured in peripheral venous blood with a radioimmunoassay. Apomorphine induced an increase of gastrin levels which peaked at 5 min. The peripheral dopamine D-2/DA2 receptor antagonist domperidone (0.2 mg/kg), but not halopemide (0.1-1 mg/kg) nor the D-1/DA1 receptor antagonist SCH 23,390 (0.1 mg/kg), blocked the gastrin response to apomorphine. Both domperidone and halopemide, but not SCH 23,390, blocked the apomorphine-induced vomiting. These results suggest that apomorphine increases gastrin levels by an action at D-2/DA2 receptors, which are situated outside the blood brain barrier and differ from the receptor inducing the vomiting.

Topics: Animals; Antipsychotic Agents; Apomorphine; Benzazepines; Dogs; Domperidone; Female; Gastrins; Male; Receptors, Dopamine; Tranquilizing Agents; Vomiting

Gastric distention was induced in intact dogs by giving a wide range of volumes (11 to 111 ml/kg) of a liquid test meal resulting in a significant (P less than 0.05) increase in plasma gastrin immunoreactivity at 10 and 25 minutes after distention. There was no significant decrease in gastrin immunoreactivity from 10 to 25 minutes of gastric distention. Pretreatment with atropine abolished the distention-induced gastrin release, indicating that distention-induced gastrin release in the intact dog was partially under cholinergic control. There was no relationship between the distending volume and magnitude of gastrin increase.

Topics: Acepromazine; Animals; Atropine; Dog Diseases; Dogs; Gastric Mucosa; Gastrins; Intubation, Gastrointestinal; Phenolsulfonphthalein; Radiography; Radioimmunoassay; Solutions; Stomach; Vomiting

The electrophysiological responses of neurons in the canine area postrema (AP) to ionophoretic application of neuropeptides and transmitters were studied and correlated with the presence or absence of an emetic response on systemic administration. Of 17 common neuropeptides 11 were emetic when applied systemically at doses of 0.03-0.35 mg/kg. The emesis was dose dependent and was no longer observed in animals with chronic ablation of the AP. The responses of 122 AP single units were recorded. Neurons were silent at rest, and most were excited by glutamate, apomorphine, and dopamine. Excitatory responses to each of eight emetic peptides were recorded in 22-65% of cells studied; no responses were found to two peptides that were not emetic. The response to glutamate was always a brief, high-frequency discharge; the responses to all 13 other excitatory substances were of long latency, low frequency, and long duration. With high ionophoretic current or multiple applications, units would frequently become spontaneously active for many minutes or longer. The similarity of response of so many substances on small neurons suggests a common ionic or metabolic mechanism underlying the response. The direct correlation between the occurrence of emesis on systemic administration and the presence of excitatory receptors on AP neurons provides strong support for the proposed role of the AP as the chemoreceptor trigger zone for emesis.

Topics: Action Potentials; Animals; Cerebral Ventricles; Dogs; Emetics; Gastrins; Glutamates; Glutamic Acid; Medulla Oblongata; Norepinephrine; Thyrotropin-Releasing Hormone; Vomiting

Apomorphine 0.001, 0.005, 0.05 and 0.1 mg/kg were given i.v. to conscious dogs and gastrin and insulin levels were measured in peripheral venous blood. The lowest dose of apomorphine (0.01 mg/kg) did not change gastrin levels but some times caused a decrease of insulin levels, whereas the higher doses (0.005-0.1 mg/kg) induced a dose dependent increase of both hormone levels. The peak shaped release responses appeared within a few minutes and the basal values were reached again within 20 to 30 min. Apomorphine within the dose range which induced a response of insulin and gastrin also caused nausea and vomiting. After pretreatment with haloperidol (0.1 mg/kg) no signs of sickness were observed and the response of gastrin to 0.01 and 0.05 mg/kg of apomorphine was almost completely blocked, whereas the insulin response to both these dose was inhibited to approximately 50%. We conclude that the release of gastrin and insulin can be activated by stimulation of dopaminergic receptors, the anatomical location of which is not clear. Possible sites for the dopaminergic receptors are the hypothalamic region or the vagal centres in the medulla oblongata.

Topics: Animals; Apomorphine; Dogs; Dose-Response Relationship, Drug; Female; Gastrins; Haloperidol; Insulin; Male; Nausea; Time Factors; Vomiting

Topics: Adult; Diabetes Complications; Diabetes Mellitus; Food; Gastric Emptying; Gastric Juice; Gastric Mucosa; Gastrins; Humans; Middle Aged; Pentagastrin; Stomach; Vomiting

The serum immunoreactive gastrin (IRG) level in infants with confirmed idiopathic hypertrophic pyloric stenosis (IHPS) has been determined and compared to that found in vomiting infants without IHPS, in normal infants, and in normal adults. The mean serum IRG level of normal infants (103 +/- 9 pg/ml (mean +/- SEM) exceeded that of normal adults (28 +/- 5 pg/ml). The preoperative mean serum IRG level in IHPS infants (256 +/- 26 pg/ml) was significantly higher than that of both normal infants and vomiting infants without IHPS (93 +/- 9 pg/ml). Twenty-five per cent (5/20) of the IHPS infants had serum IRG levels within the upper range of normal infants. Fasting serum IRG levels in IHPS infants were not altered immediately by pyloromyotomy. The results from this study suggest a relationship between gastrin and idiopathic hypertrophic pyloric stenosis.

Topics: Adolescent; Adult; Antigens; Female; Gastrins; Humans; Hypertrophy; Infant; Infant, Newborn; Male; Pyloric Stenosis; Vomiting

Peptic ulcer is a common problem in advanced renal failure, but most drugs for ulcers are hazardous in this condition. In a small open study cimetidine was given to nine patients with acid hypersecretion and endoscopically diagnosed duodenal ulceration who were undergoing haemodialysis. The patients obtained good pain relief and suffered no serious side effects. Both basal and stimulated acid output fell considerably and the plasma gastrin response to food increased during treatment. Two patients with recurrent vomiting during haemodialysis had a striking response to cimetidine, which suggested that such vomiting may be acid-mediated in some patients. These preliminary results suggest that cimetidine may prove to be an advance in the management of peptic ulcer in uraemic patients.

Topics: Adolescent; Adult; Cimetidine; Duodenal Ulcer; Female; Gastric Acidity Determination; Gastrins; Guanidines; Humans; Kidney Failure, Chronic; Male; Middle Aged; Renal Dialysis; Vomiting

Topics: Afferent Loop Syndrome; Anemia, Macrocytic; Diarrhea; Dumping Syndrome; Folic Acid Deficiency; Gastrectomy; Gastric Juice; Gastrins; Humans; Intestinal Absorption; Intrinsic Factor; Mucus; Osteoporosis; Postgastrectomy Syndromes; Stomach Neoplasms; Vitamin B 12 Deficiency; Vomiting

Topics: Adult; Aged; Chronic Disease; Dumping Syndrome; Duodenal Ulcer; Female; Gastrectomy; Gastric Juice; Gastrins; Gastroscopy; Humans; Hypotension; Male; Middle Aged; Pain, Postoperative; Pentagastrin; Postgastrectomy Syndromes; Pyloric Antrum; Pylorus; Radiography; Stomach; Stomach Ulcer; Tachycardia; Vomiting

Topics: Acetylcholine; Age Factors; Aging; Animals; Dimethylphenylpiperazinium Iodide; Esophagogastric Junction; Female; Gastrins; Humans; In Vitro Techniques; Infant; Male; Membrane Potentials; Muscle, Smooth; Norepinephrine; Opossums; Organ Size; Potassium Chloride; Pressure; Stress, Mechanical; Vomiting

Topics: Animals; Body Weight; Cineradiography; Dogs; Female; Gastrins; Gastroenterostomy; Gastrointestinal Motility; Glucose; Jejunum; Sodium Chloride; Stomach; Time Factors; Vomiting

Topics: Animals; Dogs; Gastrins; Intubation, Gastrointestinal; Nausea; Pressure; Pylorus; Time Factors; Vagus Nerve; Vomiting; Water