134 patients with radiolucent gallstones were randomly allocated to receive either placebo or 1 of 3 different doses of chenodeoxycholic acid (CDCA); 750, 1,500, or 3,000 mg). The initial dose was lowered if not well tolerated. 107 patients were treated for more than 3 months. Among them, stones dissolved in 21 and were smaller in 25 patients. Partial or complete dissolution occurred in 4 of the 13 receiving 375 mg/day, 14 of 37 receiving 750 mg, 24 of the 38 receiving 1,500 mg and 4 of 8 receiving 3 000 mg/day. The number of responders to the therapy was significantly greater in the groups of patients receiving 1,500 mg/day or 17–24 mg/kg body weight than in any other group. However, side effects, i.e., diarrhea and transaminase increase, are also dose related. It appears from this study that the optimal dose of CDCA may be between 17 and 20 mg/kg body weight.
The period of the pacesetter potentials (PP) in the normal human stomach was studied when infusing HCl (75 mEq/l) or saline in the stomach or duodenum. When a 350-ml volume of saline was infused into the stomach, an 11 % increase of the PP period was observed. With 350 ml of acid solution, the maximum increase was 40%. This occurred 8 min after the onset of infusion, at the moment when the serum gastrin level was significantly lowered. When the acid solution was infused into the duodenum, a flow rate of acid dependent increase of the PP period occurred (43% with 4 ml/min). Saline induced no change. A single intravenous injection of secretin (0.5 U/kg) induced an increase in the PP period whose maximum (35%) occurred 4 min after the injection. The results suggest that gastric myoelectrical activity may be affected by a hormonal regulation in which endogenous secretin and gastrin would determine opposite responses.
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