H. Necheles

Fat absorption in young and old age.

Summary A modification of the chylomicron technic is presented. A definite diminution in the rate of absorption of fats by aged people has been observed by the use of the chylomicron technique. Following the administration of lipase or of Tween 80, definite alterations in the chylomicron curves of both young and old people were produced. The explanation for the observed phenomena are discussed on the basis of the theory that fat may be absorbed in the unhydrolyzed state. It is our opinion that our results lend support to this view. The results indicate that further investigation in the field of fat absorption, particularly its relationship to the degenerative diseases, is warranted.

Physiological and clinical study of patients after subtotal gastrectomy

In a group of 44 patients the body weight, emptying time, size, motility and secretion of the stomach, its mucosa by gastroscopy, and the erythrocyte and differential count and hemoglobin was studied. The body weight seemed to be a fairly good indicator of postoperative results after subtotal gastric resection. The results of all functional tests and observations performed varied too much to be considered as reliable indicators of clinical and results.

Secretin inactivating enzyme in liver.

Summary The presence and isolation in a partially purified form of a substance from dogs liver which destroys secretin and has the characteristics of an enzyme are described; it is heat labile, does not dialyze, is most active in pH range 3-5 and shows an initial linear relationship of activity to increasing concentration and incubation time. It acts also on nonspecific substrates such as hemoglobin and casein. SIE was found also in dogs kidney. The enzyme may be a cathepsin and not a specific “secretinase.” Secretin is inactivated by plasmin at neutral pH; it is possible, as indicated by Rogers, that “secretinase” in blood might be identified with this enzyme.

Studies on constitution and ulcer

While it is known that ulcer “runs” in families, nothing has been known about gastric functions of the healthy members of such families, which have to be considered as potential ulcer patients. Therefore, the gastric function was tested in 82 healthy relatives of ulcer patients, not having stomach or intestinal complaints. The response of this group to an Ewald meal revealed too low values for free acidity in both males and females and the presence of much free acid in the resting stomachs of a great number of them. The abnormal response to the Ewald meal and possibly also the high acidity of the resting stomach may be interpreted as predisposing to gastritis. It may be the expression, however, of an abnormal gastric mechanism, so far unknown, which may produce both, abnormal secretion and ulcer. Dietary, hygienic, and social adjustment as prophylaxis for ulcer is advocated among the healthy members of ulcer families.

Pancreozymin-Cholecystokinin Injected by Portal and Systemic Routes.

Summary When pancreozymin-cholecystokinin (Cecekin) was administered to dogs by constant infusion, volume of pancreatic secretion was significantly less after portal than after systemic injection; when given in a single dose, volume remained the same regardless of route of injection. As Cecekin contains secretin, the effect on volume is due, probably, to this hormone and not to pancreozymin. Neither the route (portal versus systemic) nor the mode of injection (single dose versus constant infusion) changed the amylase or trypsin concentration of pancreatic secretion. With the experimental procedures employed, the physiological effect of cholecystokinin seems to be unmodified by intraportal injection.

Studies on old age

In a group of old people varying in age between 61 and 89 with an average age of 77, and a control group of young people varying in age between 19 and 39, with an average of 27 years, blood studies were performed and the following average results obtained for the old and young group respectively: 1. Blood pressure 136/72 and 118/70. 2. Hemoglobin, 75 and 81% Sahli. 3. Red blood count, 3.85 millions and 4.14 millions. 4. Serum proteins, 7.38 and 6.98. 5. Serum diastase, 113 and 114 units. 6. Serum lipase, 1.50 and 2.04 units. 7. If the blood diastase and lipase values of the older group are recalculated on the basis of the serum protein concentration of the younger group, the values are 107 and 1.42 units respectively. The difference between the serum lipase in the young and in the aged, namely —30.4% is significant and considerable. Changes in fat metabolism in the aged may be responsible for this difference. The values for serum diastase and serum lipase parallel those found in previous work for the stimulated pancreatic secretion of diastase and lipase in young and old people. The significance of the findings is discussed.

A New and Simple Method for Preparing Large Pavlov Pouches.

Summary A new, simple and efficient method for preparation of Pavlov pouches in described, leaving intact more than 50% of the normal vagus supply to the pouch. The pouch has hardly any basal (fasting) secretion, with no free and very little combined acid. These pouches respond with maximal secretion, both volume and acidity, to food and histamine.

The effect of phrenicotomy on gastrointestinal mechanisms.

Summary Section of the left phrenic nerve is followed by gastric hypotonia and hypokinesia and the presence of a large gas bubble in the fundus of the stomach. Gastric emptying time is shortened considerably. The barium appears to puddle in a moderately contracted intestine. There were no symptoms observed which could be associated with the so-called gastro-cardiac symptom complex. When phrenicotomy is done simultaneously with vagotomy, the vomiting and the gaseous distention of the gastro-intestional tract associated with bilateral supradiaphragmatic vagotomy only, are not seen.

Depression of gastric motility by insulin.

Subcutaneous injection of 0.65 units of insulin per kg. of body weight into dogs was followed in most instances by a prolonged depression of gastric motility and tone. This depression was coincidental with low values for blood sugar. As the blood sugar rose to medium and slightly subnormal value, the typical insulin hypermotility appeared.

A study of the functions of the stomach following pyloric obstruction and gastro-enterostomy

Gastric secretion was studied in dogs having gastrostomies followed by partial pyloric stenosis and subsequent gastro-enterostomy. The results were variable: no change in volume and acid secretion was noted in some animals, an increase in others, and a decrease in a third group. Neither peptic nor anastomotic ulcers were observed in any of the animals. Gastro-enterostomy in dogs with partial pyloric obstruction cannot be relied upon to produce rapid emptying of the stomach or a reduced gastric acidity.