In order to evaluate the possible causal relationship between raised serum gastrin levels and the development of primary hyperparathyroidism (HPT) which is suggested from experimental studies we evaluated parathyroid function in a group of 32 patients with hypergastrinaemia and pernicious anaemia. The values for serum calcium and parathyroid hormone were determined as well as the fasting urinary excretions of cyclic AMP and calcium. There was no relationship between the serum gastrin levels and any of the other studied parameters and there was no consistent pattern suggesting parathyroid hyperfunction. A retrospective analysis of hospital records from 441 patients operated for primary HPT showed a prevalence of pernicious anaemia of 1.8%. This figure is higher than that found in the unselected age-matched population (0.31%). However, taken together this study does not support the hypothesis that hypergastrinaemia is of particular importance for the pathogenesis of primary HPT.
The postoperative motility of the small intestine was studied by means of pressure-sensitive endoradiosondes in patients who had undergone abdominal operations with and without enterotomy. The curves recorded were analysed qualitatively and compared with curves from healthy intact control persons. In 9 patients distinct activity was recorded between 20 min and 3 '/* hours after the operation and in 3 patients between 3 1/2 and 5 l/* hours postoperatively. No difference was found between cholecystectomized and gastreetomized patients. In a patient who had undergone duodenopancreatectomy, on the other hand, activity was delayed until 16 l/z hours postoperatively. The initial contraction waves were predominantly of type I, and only in a few cases were type 111 waves seen. The propulsive motility was studied by following the point of maximal signal strength. After only 1-41/2 hours after cholecystectomies and gastric resections this point lay above the symphysis pubis or at the right or left iliac fossa, indicating that the propulsive intestinal motility of the small intestine was not notably delayed postoperatively. Only after extensive operations was considerable delay in this motility observed.
The motility of the digestive tract in healthy persons was studied by means of pressure-sensitive endoradiosondes, under resting conditions during the night and after ingestion of food. In the stomach, slow pressure waves were observed with a frequency of 3-5 conbactions per min and pressures of up to 10 em HsO, as well as activity in the form of relatively rapid pressure increases of up to about 25 cm H,O---so-called type I1 waves. These waves were observed especially in the antrnm. After ingestion of food increased activity was recorded in the form of a higher frequency of type I1 waves. In the small intestine waves of botb type I and type II were recorded. Immediately following ingestion of food the intensity of both type I and type I1 waves increased. In the colon, waves of types I, 111 and IV were recorded. After ingestion of food the intensity of the type I11 and IV waves was increased.Activity during the night was considerably reduced in relation to that during the daytime. However, activity was recorded in all subjects; this was usually of type I, though bursts of type III waves were also recorded.
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