The electrical activity of the gastric antrum, up to 6 cm. from the pylorus, has been studied at operation by means of electrodes implanted through the serosa in 68 patients; electrodes were also attached to the mucosa in 13. Records made from the mucosal electrodes show the same frequency as the serosal electrodes. Control records made in 12 patients with gall‐stones showed a frequency of electrical waves in the region of 3 per minute (median 2.85 cycles per minute), which is significantly less than the frequency in 11 patients with gastric cancer, in 8 patients with gastric ulcer, and in 24 patients with duodenal ulcer.
SheffieldSUMMARY The pacesetter potential of the gastric antrum and proximal duodenum has been recorded in man by electrodes placed under the serosal coat of the gut. The typical 3 cycle/min of the stomach was found to be conducted across the pylorus into the first part of the duodenum at a rate (2 cm/sec) about four times as fast as its conduction in the more proximal antrum (0.5 cm/sec). A 3 cycle/min pacesetter potential could be detected as far distally in the duodenum as 10 cm from the pylorus.Rhythmic electrical waves are present in the smooth muscle of the stomach and the duodenum at all times, even when motor activity is in abeyance. These electrical cycles are known as the pacesetter potentials. When motor activity occurs, another type of electrical activity, known as spike activity or action potentials, is present during the latter part of the pacesetter potential. It was generally held that the pacesetter from the antrum of the stomach does not pass beyond the pylorus in animals (Allen, Poole, and Code, 1964) and the pylorus was termed an 'electrical insulator' (Bass, Code, and Lambert, 1961). However, in animal experiments, some workers have detected antral activity in the pylorus itself (Llanfranchi, Barbara, and Bartolotti, 1968) and in the duodenum (Daniel, Carlow, Wachter, Sutherland, and Bogoch, 1959: Bortoff andWeg, 1965;Bortoff and Davis, 1968). We have studied this question in man, using implanted electrodes, and have found that the pacesetter potential is conducted from the stomach to the duodenum. MethodStainless steel electrodes, 0-25 mm in diameter, were implanted just under the serosa of the distal 4 cm of the gastric antrum and the proximal 12 cm of the duodenum in 10 subjects, aged 28 to 52 years, undergoing cholecystectomy. The procedure was fully explained and informed consent was given by the patients. Two gastric electrodes were placed
The electrical and motor activity and the acid output of the stomach have been studied in 21 subjects at rest, and during stimulation with pentagastrin or histamine. All three parameters were increased by pentagastrin. Intravenous pentagastrin increased acid output at 0.06 pg/kg/h and electrical and motor activity at 0.6 pg/kg/h. The mean maximal rise in frequency of the electrical activity was 20 per cent. The coupling of the electrical and motor activity was augmented. Histamine increased the acid output but had no effect on electrical or motor activity. G~.~t r~e~t t .6 , 145-153.* Based on a communication to the Surgical Research Society -January 1970. 3-Sciind. J. Gastroenttrum of the stomach, under radiological CODtrol, and the following measurements were made.Electrical activity. A stainless steel electrode, 0.25 m m in diameter, projecting 1 m m above the side opening of a modified nasogastric tube was applied t o the antral mucosa by suction t o 20 c m of mercury, negative pressure. The indifferent electrode was a metal disc applied t o the scarified abdominal skin, coated with a thin layer of electrolyte jelly. Signals from the electrodes were fed t o a n A/C amplifier and recorded o n ultra-violet paper a t a sensitivity of 1 mv/cm. Parallel outputs from the amplifier were fed to a high pass and a low pass filter, and were also displayed.Motor activity. Intragastric pressure changes were recorded via a polyethylene tube of 1 m m internal diameter placed inside the above nasogastric tube, the distal end of the polyethylene tube being brought out opposite the electrode while the proximal end was connected to a Scand J Gastroenterol Downloaded from informahealthcare.com by Chulalongkorn University on 01/02/15For personal use only.
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