Role of nitric oxide and prostaglandins on the effects of endotoxin on gastric emptying

control group and did not modify the LPS action. L-NIL did not affect GE either in control or LPS treated rats. Reduced expressionof nNOS was detected in fundus, corpus and antropyloric region of LPS treated rats when compared with that seen in control animals (51 ±7%, 49-8% and 43_+6% reduction respectively). Low endotoxemla induces a delay in gastric emptying of solid nutrient mealsthrough the endogenoussynthesis of prostaglandins,probably vie COX-2. Nitric oxide derived from nNOS is involved in physiological gastric emptying and a reduction in the presenceof this enzymein the gastric wall may contribute to the deterioration of gastric function under endotoxemia.

2359 Relationship Between Manipulation-Induced Intestinal Inflammation And Delayed Gastric Emptying Following Abdominal Surgery Wouter J. De Jonge, Renes M. Van Den Wijngaard, Reel Bennnk, Guy E. Boeckxstaens, Acad Medical Ctr, Amsterdam Netherlands Background: Postoperative ileus follows every abdominal surgery. Recently, in vitro data suggested that impaired contractility of the rat small intestine following abdominal surgery resulted from late influx of inflammatory cells caused by intestinal manipulation (Kalff et al., 1998). Whether this inflammation is confined to the small intestine and is associated with changesin gastrointestinalmotility in vivo in other parts of the gut remains unknown.Therefore, we evaluated the effect of intestinal manipulation and subsequent inflammation on gastric emptying in mice, Methods: FemaleBalb/C mice were anaesthetizedwith ketamine/xylazine. Animals underwent only anaesthesia(C, n=8), a skin incision (SI, u=8) or a laparotomy followed by manipulation of the small intestine (L+M, n=8). After 24 h and 48 h, gasl~ emptying was measured using pin-hole scintigraphic imaging after oral gavege of a 99Tc labeledsemi-liquid meal (1.5 % methylcellulose)at 16 min intervals,After the gastric emptying study, the animals were killed and tissue (stomach, ileum, colon) was isolatedand processed for immuno-histochemical staining of CD4, CD8, LFA-1 expressing cells. Results: After 24 h, gastric emptying was significantly delayed after L+M compared to L or C (C: 24 _+ 4 %, SI: 25 ± 4%, L+M: 53 _+ 4% of the residual activity present 48 min after gavaga, p
2362 Does 6autric Pacing Improve Motility Status of the Stomach Remnant After Whipple Prom? Jacek Sobocki, Piotr J. Thor, Oept of Pathopflysiology, Krakow Poland BACKGROUND:Gastroparesisand prolonged ileus belong to the leading early postoperative complicationsafter Whipple procedure.The aim of this study was to confirm whether electrical pacing improves motility status of the gastric remnant after pancreatic head resection. METHODS: 14 patients with postoperativegastroparesis after standard Whipple (12) and pyloruspreserving Whipple (2) procedure ware included into the prospective study and divided into two gmupa. Group A (conventional pharmacotherapy)consisted of 8 patients after standard Whipple, and group B consisted of 6 patients: 4 after standard and 2 after pylorus-preservihg Whipple procedure. Group B patients were scheduledfor gastric pacing. Serum glucose level did nut exceed 12 mmol/I under continuos insulin infusion. No other serious complications were observed in both groups. Paralytic gastroparesis was confirmed by USG and X-ray examinations. Gastric retention was monitored every 12 hours. All patients were subjected to cutaneous electrogastrography (cEGG). Silicon covered nasogastric electrode, 1 mm in dimeter, connectedto computer prepmgramableelectrical stimultor was used. Patients completed questionnairefor symptoms score (4 symptoms, scale 0-3 pts each). RESULTS:Gastric retention was reduced to 0 within up to 60 hours in group B (p
2360 The Contribution Of Antral Peristalsis In Gastric Emptying Of A Low-CMod¢ Liquid Meal In Man Is Of Minor Importance Trygve Hausken, HaukelandUniv Hosp, Bergen Norway; Marco Mundt, Melvin Samsom, Univ Medical Ctr, Utrecht Netherlands Background : The contribution of antral peristalsis responsiblefor transpyloric flow of gastric liquids is still poorly understood.Aim: To investigatethe relationshipbetweenantropyloroduodenai pressure waves, antroduodenai pressure gradients, and transpyloric flow of a lowcaloric, liquid meal. Methods : In 8 healthy volunteers, intraluminal pressures were recorded from antrum and proximal duodenum.Transpyloric flow was monitored simultaneouslyusing duplex ultrasonography 5 rain before meal (300 mL meat soup, 12 kcal), during 3 rain of ingestion and 10 rain postprandiully. Results : Transpyloric emptying occurred aS sequences of alternating periods of emptying-reflux-emptying.45.3±28 % (mean_+SO)of the s eguences were associated with occluding anfral peristalsis, 21.5_+18 % were associated with nonoccluding peristaltic related antral contractions, and 35.7_+36 % of the sequenceswere not associated with peristalsis. The pressure-gradientsbetweenthe antrum and proximal duodenum causingtranspyloric emptying were very low ranging from 0.1 to 2.6 kPa (mean values). The pressure-gradientsduring non-peristaltic related emptying (0.15_+0.8 kPa) ware significanfly lower (p
Prevalence Of Abnormal Gastric Emptying Is About Thirty Percent in Well-Regulated Diabetic Patients Not Selected On The Basis Of Upper Gastrointestinal Symptoms Melvin Samsom, Univ Medical Ctr, Utrecht Netherlands; Reinoud Vermeijden, Eemland Hnsp, Amersfoort Netherlands; Sytze Van Dam, EmestieneVan Doom, Andre J. Smout, Univ Medical Ctr, Utrecht Netherlands Background: Many studies have reported abnormal gastric emptying in patientswith diabetes mellitus. Most studies have evaluatedsmall numbers of patients or have been performed in selectedpatient groups. Dataon the prevalenceof abnormal gastric emptying in a large group of relatively wall-regulated,unselectedpatients with diabetes mellitus are lacking. Aim was to evaluategastric emptying in diabeticpatientsnot selectedon the basis of upper gastrointestinal symptoms, prospectively.During 10 months (Jan 2000 to Oct 2000) diabetic patientsattending the outpatient clinic of 2 hospitals were invited to undergo a gastric emptying test, Gastric emptying was measured using 100 mg 13C-enrichedoctanoic acid addedto a solid meal (240 kCal). Breath samples were taken every 15 min up to 4 hours postprandially. Breath samples were analysedusing an isotope ratio mass spectrometer (Breathmat, Finnegan,Bremen). The lag phase, tl/2 and retention at 120 min were calculated using a nonlinear curve fitting procedure followed by multiple regression analysis. Results: Gastric emptying tests were performed in 124 diabetic patients (57F, 76 type I, age 45.7 (SO 11.6) yr, weight 81.3 (15.5) kg). Glucose control was moderate to good in 83% of the patients (glycHb<9%). The distribution curve of gastric emptying half times in the patients with diabetesmellitus showed a shift towards a delayin gastric emptyingcomparedto the healthyvolunteers.Gastricemptying waSsignificantly slower in the diabeticsthan in the healthyvolunteers (tl/2 (mean+ SEM): rain 101.2 (3.2) vs 76.8 (5.1) min, pmean + 2SD) was observed in 34 (27%) diabetics. The T1/2 was correlated to both the tleg (r=0.74, p
2361 Role of Nitric Oxide and Prostagisndinson the Effects of Endutoxin on Gastric Emptying Sara Calstayud, EugeniaGarcu-Zaregoza,Elsa Ouinfana, Univ. of Valencia, Valencia Spain; Vicente Felipo, Inst de Clenoias Citioiogicas, Valencia Spain; Juan V. Esplugues, M. Delores Barrachina, Univ of Valencia, Valencia Spain We have previously shown that low doses of endotoxin delay gastric emptying of nutrient solid meals in rats by activating a nervous reflex involving capsaicin-sensifiveafferent neurons and a NANC-efferentpathway. The aim of the present study was to determine the peripheral mediators involved in the endutoxlo effect. Gastric emptying of solids (GE) was measured in conscious SO rats (250-300 g) fasted for 16 hours. Rats were allowed access ad/ibitum to their usual rat chow (3 h) before E. Coil lipopolysaccharide(I_PS,40 izg/kg, i.p.) or saline (1 ml/kg, i.p.) administration. Four hours later, the animals were killed, their gastric contents weighed and GE calculatedas [(1 - weight of gastric contents / weight of food eaten) x 100]. Some rats were pretreated with indomethacin (5 mg]kg s.c. - 60 min), dexamethasone(5 mg/kg s.¢, -16 and -1 h), a non-specific NOS inhibitor (NG-nitro-L-arginine, L-NNA, 10 mg] kg i.p., -15 min), a nNOS inhibitor (7-nitruindazole, 7-NI, 20mg/kg i.p., -15 min,) or an iNOS inhibitor (L-NB-(1-iminoetbyl)lysine, L-NIL, 2.5-10 mo]kg Lp, -15 min), Expressionof nNOS was evaluatedby western blot in the gastric wall of control and L.PStreated rats. A significantly reduced GE was observed in LPS treated rats when compared with that of control animals (23±7% and 57_+3% respectively,p
2364 The ~C-octanoic-acid Breath Test: Validation of a New Non-lnvasive Method to Measure Gastric Emptying in Rats, Nathalie Van Heddeghem, ReneatSchoonjans, Bruno Van Vlem, Hugo Verdievel, Wouter Vandamme, Norbert Lameire, Martine De Vos, Univ Hosp, Ghent Belgium Background/Objectives:Rat models, to measure gastric emptying (GE)(pellets, phenol red), require killing of rats. Isotopic methods have been flawed by movement artifacts or the necessity to anesthesizethe animals. We developedand tried to validate a non-invasivetest model, adaptedfrom the ~3C-octanoic-acidbreath test applied in humans, to measure GE in

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