Emptying Curves Research Articles

Gastric emptying rate in Pleuronectes platessa L.

X‐ray studies of gastric emptying of Pleuronectes platessa force‐fed a moist, artificial diet give the relationship: image where GET is gastric emptying time (h), S is meal size (g), W is body weight (g) and T is temperature (°C).The corresponding gastric emptying curve is predicted to be: image where stomach contents (g net weight) are S0 at start and St at time th. Direct observations of residual stomach contents using serial slaughter are in close agreement with the predicted curve, save for small plaice (below 50 g body weight) which empty at only 50–60% of the rate found in larger fish.The small effects of body weight on gastric emptying rate may reflect the relatively small role of the stomach [Volume (ml) = 0.024 body weight (g)] in digestion when compared with other flatfish.The emptying curve established here can be used in field studies to estimate feeding rate on natural food items, provided fish greater than 50 g body weight are used and the energy density of the food is greater than 0.5 kcal/g wet weight. Smaller fish will have emptying rates which are only 30–60% of those found in larger fish; the change appears to be abrupt and corresponds to the size at which young plaice move offshore from their nursery grounds.

Studies on the gastric emptying related to the types of stomach forms in healthy subjects

Gastric emptying curves were studied on normal stomach using liquid food labeled 99mTc-DTPA, in supine position. Three patterns of gastric emptying curves were observed for whole stomach, fundic-body and antral area. In pursuit of gastric emptying movement, association between these emptying curves and stomach forms were analyzed on hook-shaped, horn-shaped, ptotic and cascadal stomachs. Association between T-ration of whole stomach emptying curve and gastric form were also studied and following results were obtained. Three emptying patterns were recognized for whole stomach emptying curve; simple decreasing curve in hook-shaped stomach, shoulder-forming decreasing curve in horn-shaped and ptotic stomachs and shoulder-forming rapid decreasing curve in cascadal stomach. Four patterns were recognized for fundic body emptying curves; simple decreasing curve in hook-shaped stomach, shoulder-forming decreasing curve in horn-shaped stomach, rapid decreasing followed by slow decreasing curve in ptotic stomach and shoulder-forming rapid decreasing curve in cascadal. The difference in emptying curves with respect to types of stomach forms were obvious in fundic body emptying curve rather than that of whole stomach. Two patterns were recognized for antral area, simple decreasing type and increasing then decreasing type. The former was for hook-shaped stomach and the latter was for other three forms. Shoulder formation observed in whole stomach and fundic-body curves was considered that it filled antrum but scarcely emptied to duodenum. It was imperative to refer three emptying curves of whole stomach, fundic-body and antral area for analyzing the gastric emptying. From T-ration viewpoint, emptying was done most swift in cascadal stomach, next hook-shaped stomach, ptotic stomach and horn-shaped stomach, successively.

Standardisation of tracer and type of meal in the evaluation of gastric emptying and colon transit rates in normal beagle dogs.

The transit 111In-labelled polymer beads of different particle sizes in the stomach and colon of five healthy Beagle dogs was monitored after intake of different kinds of meal by a gamma camera and data processor system. The various meals studied were a solid balanced type of dog food mixed with milk, pure milk, and finally a meal of raw meat. The polymer beads carried triethylenetetramine type functions which efficiently chelated 111In+3 from an aqueous solution of InCl3. These labelled beads were well mixed into the food before being offered to the dogs. Gastric emptying curves from which half-times of emptying (T 1/2) could be obtained are presented and statistically compared. Good quality images with quantification of the colon transit rate also became possible. It appeared that standardisation of the tracer and of the meal is compulsory for relevant and reproducible results.

Systolic function during exercise in patients with coronary artery disease

Global and regional systolic function during exercise were studied at cardiac catheterization with biplane cineangiography and micromanometer pressures in three groups of patients: an ischemia group (n = 22) with exercise-induced asynergy from coronary artery disease, a control group with no or minimal cardiovascular disease (n = 5) and a "scar" group (n = 5) with prior infarction and no new asynergy with exercise. Ventricular emptying curves at rest did not distinguish patients with coronary artery disease from control subjects. During exercise, end-systolic volume increased in all patients in the ischemia group; ejection fraction decreased from 62 to 51% p less than 0.001) despite an increased end-diastolic volume. Stroke volume decreased from 65 to 58 ml/m2 (p less than 0.001) and limited the average increase in cardiac index to 65%. The scar group had no decrease in stroke volume, but end-systolic volume failed to decrease during exercise, as it did in all control subjects (35 to 28 ml/m2, p less than 0.05). An exercise-induced decrease in peak left ventricular pressure in five patients (23%) in the ischemia group was not accompanied by more severe or extensive ischemia as judged by ejection phase indexes. There was a tendency for maximal positive first derivative of left ventricular pressure (dP/dt) to be less (1,912 versus 2,446 mm Hg/s, difference not significant), suggesting an abnormality of pressure generation, not shortening. Global function during exercise in the ischemia group was determined, in part, by the extent of regional dysfunction. Those in whom between three and five regions of eight regions studied had abnormal fractional shortening during exercise had a 6% decrease in ejection fraction, while those with six to eight abnormal regions had a decrease in ejection fraction of 15% (p less than 0.05). In addition, function of nonischemic, noninfarcted myocardium was studied at the base of the left ventricle in those with exercise-induced anteroapical ischemia (n = 4) and those with anteroapical infarction (n = 4). Base fractional shortening and shortening velocity were greater at rest in those with infarction (39% and 1.6 circ/s, respectively) than in control subjects (31% and 1.0 circ/s, respectively, p less than 0.01), indicating a chronic augmentation of shortening. Base shortening velocity during exercise in those developing anteroapical ischemia increased from 1.1 to 1.4 circ/s (p less than 0.005), suggesting an acute augmentation of function balancing the deterioration of anteroapical function. Systolic function in coronary artery disease is determined by acute and chronic alterations in regional function. During exercise, there is an interplay between regional dysfunction from ischemia or infarction and regional hyperfunction of nonischemic myocardium which determines global performance.

Technetium-99m labelled bran: A new agent for measuring gastric emptying

Bran was labelled with 99mTc-pertechnetate, ingested as part of a normal meal and used to measure gastric emptying in 15 normal subjects and in 15 patients with ulcerative colitis. There was no significant difference between the gastric emptying curves of the normal subjects and the patients, suggesting that rapid gastric emptying does not contribute to diarrhoea in ulcerative colitis.

Gastric emptying of a physiologic mixed solid-liquid meal.

The purposes of this study were to use a noninvasive scintigraphic technique to measure gastric emptying of liquids and solids simultaneously, to study the interactions between emptying of the liquid and solid components of meals in normal subjects, and to employ dual isotope gastric scintigraphy to evaluate gastric emptying of liquids and solids in patients with clinical evidence of gastric outlet obstruction. The solid component of the test meal consisted of chicken liver, labeled in vivo with Tc-99m sulfur colloid, and the liquid component was water mixed with In-111 DTPA. The rates of emptying were quantitated using a gamma camera on line to a digital computer. Twenty normal subjects were studied using this combined solid-liquid meal. Ten of them also ingested a liquid meal alone and ten a solid meal alone. Liquid emptied from the stomach significantly more rapidly than did solids. The emptying curve for liquids was exponential compared to a linear emptying curve for solids. The gastric emptying rate of the liquid component was slowed significantly by simultaneous ingestion of solids, but the emptying rate of solids was not affected by liquids. Several patients with clinical gastric outlet obstruction were evaluated. Both combined and selective abnormalities for gastric emptying of liquids and solids were demonstrated.

CHANGE OF PATTERN OF GASTRIC EMPTYING AFTER SELECTIVE PROXIMAL VAGOTOMY

The patterns of gastric emptying after selective proximal vagotomy (SPV) and SPV with pyloroplasty (SPV + D) were studed using a liquid labelled with 99mTc-DTPA. By means of on-line computer facility, it was possible to analyse the relative role of the Whole stomach and the antrum within the overall frame work of gastric emptying. In the time/activity curve of the whole stomach, all of 3 groups emptied in exponential curve. Comparing with normal subjects, SPV subjects were tending to empty slowly, while SPV + D subjects were tending to empty rapidly. In the time/activity curve of the antrum, normal and SPV + D subjects had two types of emptying--one was represented in the decreasing curve and another was represented in the increasing-decreasing curve. While SPV subjects had only one type of emptying which was represented in the increasing-decreasing curve. From a consideration of the pattern of gastric emptying curve, SPV subjects had two different emptying states compared with normal subjects--one was the delay of entering the antrum from the fundic side of stomach, and the other was that effective antral emptying did not readily start. While SPV + D kept more neally normal gastric emptying that it of SPV.

Normal left ventricular emptying in coronary artery disease at rest: Analysis by radiographic and equilibrium radionuclide ventriculography

The volume ejected early in systole has been proposed as an indicator of abnormal left ventricular function that is present at rest in patients with coronary artery disease with a normal ejection fraction and normal wall motion. The volume ejected in systole was examined by calculating the percent change in ventricular volume using both computer-assisted analysis of biplane radiographic ventriculograms at 60 frames/s and equilibrium gated radionuclide ventriculograms. Ventricular emptying was examined with radiographic ventriculography in 33 normal patients and 23 patients with coronary artery disease and normal ejection fraction. Eight normal subjects and six patients with coronary artery disease had both radiographic ventriculography and equilibrium gated radionuclide ventriculography. In all patients, there was excellent correlation between the radiographic and radionuclide ventricular emptying curves ( r = 0.971). There were no differences in the ventricular emptying curves of normal subjects and patients with coronary artery disease whether volumes were measured by radiographic or equilibrium gated radionuclide ventriculography. It is concluded that the resting ventricular emptying curves are identical in normal subjects and patients with coronary artery disease who have a normal ejection fraction and normal wall motion.

‘In vivo’ disintegration of hard gelatin capsules in fasting and non-fasting subjects

The dispersion of hard gelatin capsules in the stomach has been followed using a model formulation consisting of an ion exchange resin labelled with a gamma-emitting isotope and monitoring externally with a gamma camera. Capsule formulations were prepared giving both slow and fast in vitro disintegration times. Little dispersion of the capsule contents occurred in fasting subjects, whereas after food, the dispersion was more in keeping with the in vitro disintegration times. Gastric emptying curves could be related to the behaviour of the capsule in the stomach. In one case, the capsule lodged in the oesophagus and gradually emptied its contents into the stomach.

Biphasic venous emptying from the calves in venous-occlusion plethysmography.

The pathophysiological significance of the biphasic venous emptying curves from the lower limbs in venous occlusion plethysmography was examined in three patients peroperatively by clamping the iliac veins in different locations. The clinical significance of biphasic curves was analysed in fifty-four patients, thirty-one of whom were pregnant and twenty-three had a suspected deep vein thrombosis. It was found that the primary venous emptying time (PVET) was helfpul in locating the obstruction. Patients with femoral and pelvic vein thrombosis had shorter PVET than patients with pregnancy or other pelvic vein obstructions. With PVET of 0.5 sec, or shorter, thrombosis should be strongly suspected. The ratio between the slow and fast emptying phases was useless in localization of the intrapelvic process.

Study of Gastric Emptying Using a Ferromagnetic Tracer

A new ferromagnetic method for the measurement of gastric emptying is described. An inert tracer, magnesium ferrite, is added to a test meal. Its amount in the stomach is then measured at regular intervals by an external transducer using its ferromagnetic properties. The method is noninvasive and devoid of radiation exposure. The magnetic fields used are harmless. The feasibility, reliability, and reproducibility of the method are described. Gastric emptying was studied in 61 subjects. The shape of the gastric emptying curve conformed best to an exponential function. The mean half-time of gastric emptying was 49 +/- 17.4 min. In this limited series age and sex did not affect gastric emptying.

The Clinical Significance of Biphasic Venous Emptying Curves from the Lower Limb in Venous Occlusion Plethysmography

The Clinical Significance of Biphasic Venous Emptying Curves from the Lower Limb in Venous Occlusion Plethysmography

The Clinical Significance of Biphasic Venous Emptying Curves from the Lower Limb in Venous Occlusion Plethysmography

The utilization of venous occlusion plethysmography in the routine diagnosis of acute venous thrombosis in the leg has disclosed a previously unreported type of biphasic venous emptying curve that has proved to be of special diagnostic significance. The examinations were undertaken with a Dohn plethysmograph for segmental application of the calf. The emptying curves in question had an initial phase at the ordinary rapid rate, changing distinctly within 1.5 sec into a definitely slower phase of venous emptying. Biphasic emptying curves were found to be characteristic of patients with isolated, high venous obstruction, mostly acute thromboses, but more or less intact veins in peripheral parts of the leg. The same type of pathological emptying curves could be provoked by external compression of the femoral vein or Valsalva's manoeuvre, providing experimental evidence of the underlying mechanism. The venous emptying course might be similarly influenced also by varicose veins, pregnancy, and right heart failure. The diagnostic experience of biphasic emptying curves in clinical practice indicates, that this particular way of interpreting venous occlusion plethysmography is a valuable complement to phlebography in the detection of proximal venous obstructions in the lower limb, whether due to iliac thrombosis or elusive intrapelvic tumours.

The influence of certain commonly used drugs on the rate of gastric emptying in the normal human subject as determined by an intubation technique

The gastric emptying curve of five normal human subjects as obtained by repeated aspiration, measurement and reinjection of a test solution was essentially unaltered by clinical doses of atropine sulphate, amphetamine sulphate, prostigmine, nitroglycerine, “Syntropan,” acetyl-B-methylcholine chloride, ergotamine tartrate or sodium bicarbonate. Morphine sulphate produced a delayed inhibition of gastric emptying in each of five experiments.