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  • 1
    Electronic Resource
    Electronic Resource
    Effect of intravenous glucose on intravenous amino acid-induced gallbladder contraction and CCK secretion (1994)
    Springer
    Digestive diseases and sciences 39 (1994), S. 268-274 
    Details
    ISSN: 1573-2568
    Keywords: hyperglycemia ; amino acids ; parenteral nutrition ; gallbladder motility ; cholecystokinin ; pancreatic polypeptide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The present study was undertaken to investigate the effect of acute hyperglycemia on the gallbladder contraction induced by intravenous administration of high doses of amino acids (Vamin 18, 250 mg protein/kg/hr). Six healthy volunteers were studied in random order on two occasions during normoglycemia and hyperglycemia with blood glucose levels stabilized at 15 mmol/liter. Gallbladder volumes, measured with ultrasonography, were studied for 60 min before and for 120 min during intravenous infusion of amino acids (IVAA). Administration of IVAA resulted in a significant reduction (P〈0.05) in gallbladder volume from 32±5 cm3 to 17±2 cm3 during normolgycemia. During hyperglycemia no significant changes in gallbladder volume were observed in response to IVAA. No significant changes in plasma CCK concentration, the major hormonal stimulus for gallbladder contraction, occurred in response to IVAA. During hyperglycemia, pancreatic polypeptide (PP) secretion, as an indirect measure of vagal cholinergic tone, in response to IVAA was significantly (P〈0.05) reduced compared to normoglycemia. It is concluded that: (1) administration of high doses of IVAA results in significant gallbladder contraction, (2) high doses of IVAA do not stimulate CCK secretion, (3) acute hyperglycemia inhibits IVAA-induced gallbladder contraction, and (4) acute hyperglycemia inhibits basal and stimulated plasma PP secretion, suggesting impaired vagal-cholinergic tone during hyperglycemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02090196
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  • 2
    Electronic Resource
    Electronic Resource
    Postprandial gallbladder motility and plasma cholecystokinin at regular time intervals after injection of octreotide in acromegalics on long-term treatment (1992)
    Springer
    Digestive diseases and sciences 37 (1992), S. 1685-1690 
    Details
    ISSN: 1573-2568
    Keywords: acromegaly ; octreotide ; somatostatin ; gallbladder motility ; cholecystokinin ; pancreatic polypeptide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The increased risk of gallstone formation in acromegalics treated with the somatostatin analog octreotide has been related to an impaired gallbladder emptying. To determine the duration of these inhibitory effects, meal-stimulated gallbladder motility, plasma cholecystokinin (CCK), and pancreatic polypeptide (PP) were measured in five acromegalics treated for 6–32 months with 200–300 μg octreotide daily. Meal tests were performed 45 min, 8 hr and two weeks after the last 100-μg subcutaneous dose. Results were compared with those in normal subjects. Integrated postprandial gallbladder contraction (−125±194 cm3/120 min) and integrated PP secretion (−0.1±0.2 nmol/liter/120 min) were completely suppressed in the 45-min study, but significantly improved (P〈0.05) when measured 8 hr (1376±322 cm3/120 min and 3.0±1.0 nmol/liter/120 min) and two weeks (1437±263 cm3/120 min and 10.6±1.6 nmol/liter/120 min) after the last dose of octreotide. The integrated gallbladder contraction in acromegalics at 8 hr was comparable to that at two weeks and to that in normal subjects, but the integrated PP response at 8 hr was significantly smaller (P〈0.05 vs two weeks and vs normals). Integrated plasma CCK secretion at 45 min (0.13±0.06 nmol/liter/120 min) was not statistically significantly different from the response at 8 hr (0.15±0.02 nmol/liter/120 min) and from that in normal subjects, but it was significantly increased at two weeks after cessation of octreotide (P〈0.05 vs 45 min and 8 hr). In conclusion, during long-term octreotide treatment in acromegalics, initial abolishment of postprandial gallbladder emptying is completely reverted to normal values 8 hr after the last subcutaneous dose. No major differences in postprandial plasma CCK at 45 min and at 8 hr were observed when compared with normal subjects, whereas plasma PP responses were diminished.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01299859
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  • 3
    Electronic Resource
    Electronic Resource
    Influence of orlistat on the regulation of gallbladder contraction in man (1996)
    Springer
    Digestive diseases and sciences 41 (1996), S. 2404-2408 
    Details
    ISSN: 1573-2568
    Keywords: orlistat ; tetrahydrolipstatin ; lipase inhibitor ; gallbladder motility ; cholecystokinin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Orlistat (tetrahydrolipstatin) is a potent inhibitor of gastric and pancreatic lipase activity causing a diminution of free fatty acids in the intestinal lumen. The release of cholecystokinin (CCK) critically depends on the presence of free fatty acids in the small intestine. Postprandial CCK release and gallbladder contraction might be decreased by orlistat, potentially resulting in an increased risk of gallstone formation. In this double-blind, placebo-controlled, six-way crossover study, six healthy volunteers ingested in a randomized order three isocaloric test meals (250 ml) of identical osmolality with either orlistat (200 mg) or placebo: (a) a pure-fat meal (25 g triglycerides), (b) a mixed meal containing fat (8 g; 29% of caloric content), protein (10 g; 17%), and dextrose (32 g; 54%), and (c) a fat-free meal containing albumin (25 g; 46%) and dextrose (32 g; 54%). Gallbladder volumes were determined by ultrasonography, and plasma CCK, pancreatic polypeptide and gastrin levels by RIA. Gallbladder contraction (AUC, % × 90 min; difference of means ± 95% CI) in subjects receiving orlistat or placebo did not significantly differ after intake of the pure-fat meal (443 ± 1174), the mixed meal (313 ± 1170), or the fat-free-meal (−760 ± 1180). The release of CCK (AUC; pM × 90 min; difference of means ± 95% CI) was not different between orlistat and placebo after ingestion of the pure-fat meal (−18 ± 64), the mixed meal (−45 ± 62), and the fat-free meal (27 ± 63). Likewise, the release of pancreatic polypeptide and gastrin was similar after intake of the meals with either orlistat or placebo. A single dose of orlistat did not reduce gallbladder motility after ingestion of meals with differing fat contents. The safety of long-term treatment with orlistat with respect to gallstone formation remains to be determined.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02100135
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  • 4
    Electronic Resource
    Electronic Resource
    Plasma cholecystokinin and gallbladder responses to intraduodenal fat in gallstone patients (1989)
    Springer
    Digestive diseases and sciences 34 (1989), S. 353-359 
    Details
    ISSN: 1573-2568
    Keywords: plasma cholecystokinin ; cerulein ; gallbladder motility ; cholescintigraphy ; gallstones
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Impaired gallbladder emptying is one of the various factors suggested to be involved in the pathogenesis of gallstones. The present study was undertaken to determine whether gallbladder emptying, endogenous cholecystokinin (CCK) secretion, or their interrelation is altered in patients with gallstones. After intraduodenal administration of 60 ml corn oil, plasma CCK concentration was measured by a sensitive and specific radioimmunoassay and gallbladder emptying by cholescintigraphy. Patients with gallstones (N=20) produced significantly less endogenous CCK (105±17 pmol/liter 60 min; P 〈0.001) than control subjects (191±11 pmol/liter 60 min, N=20); gallbladder emptying in the patients was significantly decreased at 5, 10, 40, 45, and 50 min but the reduction in gallbladder emptying did not reach statistical significance at 60 min (patients 44±8%, control subjects 60±4%). In addition, the gallbladder responsiveness to intravenous infusion of the synthetic CCK analog cerulein was investigated. Based on the results of gallbladder emptying in response to endogenous and exogenous CCK, four subgroups of gallstone patients were identified: (1) a group (N=7) with normal gallbladder sensitivity to CCK, (2) a group (N=6) with significantly increased gallbladder sensitivity to CCK, (3) a group (N=6) with impaired gallbladder emptying after corn oil due to a significantly reduced endogenous CCK secretion but with normal gallbladder sensitivity to CCK, and (4) one patient whose gallbladder was unresponsive to CCK and was found to have chronic cholecystitis at surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01536255
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