[Effect of metoclopramide following selective proximal vagotomy with pyloroplasty]. / Zur wirkung von Metoclopramid nach selektiver proximaler Vagotomie mit Pyloroplastik.

In the early postoperative period after selective proximal vagotomy, there is often a delayed emptying of solid food. We examined the contraction of the antrum by intraluminal manometry in duodenal-ulcer-patients prior to (n = 20), 14 days after (n = 20) and 1--2 years after SPV with pyloroplasty. The motility was tested before and after i.v. injection of 20 mg metoclopramide. Preoperatively metoclopramide effected a significant rise of contraction in the antrum. 14 days after operation the motility was significantly reduced (85,7%--90,7%). Metoclopramide stimulated again the intraluminal pressure waves. Compared with the preoperative effect the metoclopramide induced motility also was reduced by 89,9% 1--2 years after operation the antral motility with or without metoclopramide injection had returned to preoperative values.

Alkyl-metal and aryl-metal bond chemistry in coordinately unsaturated polynuclear metal complexes.

A new class of coordinately unsaturated polynuclear rhodium and iridium alkyl, benzyl, and aryl derivatives of the form [RM(1,5-cyclooctadiene)](x) have been prepared by the reaction of the organolithium reagent with the cyclooctadienemetal chlorides at -78 degrees C. The x-ray crystal structure of [mu-CH(3)Rh (1,5-cyclooctadiene)](2) is reported. The analogous iridium dimer decomposes by an initial sequence of alpha-hydrogen abstraction and then reductive elimination of hydrogen to give [mu-CH(2)Ir(1,5-cyclooctadiene)](2). Formed in high yield by the decomposition of the ethylrhodium complex was [HRh(C(8)H(11))](4), a tetrahedral cluster with face-bridging hydride ligands. Also discussed are the reactivities of the benzyl and phenyl derivatives. Unique reaction pathways for C-H bond activation and scission in this chemistry are delineated.

[Experimental and clinical studies on the effect of combined treatment with cimetidine and somatostatin (author's transl)]. / Tierexperimentelle und klinische Untersuchungen zur Kombination von Cimetidin und Somatostatin.

Spontaneous hemostasis in the upper gastrointestinal hemorrhage is inhibited by the influence of gastric acid on blood coagulation and platelet aggregation in the mucosal lesions. In a clinical trial with the H2-receptor antagonist cimetidine and the peptide hormone somatostatin, applied continuously, rebleeding occurred in 25%. That may be caused by an insufficient reduction of acid secretion. Therefore in 4 dogs with gastric fistula we studied the inhibition of maximal stimulated gastric acid secretion (histamine, pentagastrin, insulin hypoglycemia) after simultaneous application of the two drugs. We found an additive effect by combining cimetidine and somatostatin. That was observed not only in the degree of reduction of acid secretion but also in prolongation of the inhibiting effect. In 4 patients with acute upper gastrointestinal hemorrhage and continuous bleeding after single cimetidine treatment we used the combined therapy (cimetidine and somatostatin) with good success. The patients could be operated after cessation of bleeding under good conditions.

[The effect of domperidone and metoclopramide on antral motility (author's transl)]. / Der Einfluss von Domperidon und Metoclopramid auf die Antrummotilität.

The effect of domperidone and metoclopramide on antral motility was studied by measuring the intraluminal pressure in the antrum of 10 normal persons and of 8 patients suffering from duodenal ulcer. Both drugs stimulated the rhythmic activity of the antrum. The antiemetic effect and the therapeutic effect of domperidone on complaints by gastrointestinal retention was the result of the influence on gastrointestinal motility, which is similar to that of metoclopramide.

[Dissolution of a radiolucent stone in the common bile duct by sodium cholate infusions through the T-tube (author's transl)]. / Auflösung eines röntgennegativen Steins im Ductus choledochus mittels Gallensalzinfusionen über T-drainage

A case of a retained gallstone in the common bile duct after cholecystectomy (in a 38-year old man) is reported in which infusions with saline and spasmolytics failed to flush out the retained stone into the duodenum. An infusion with sodium cholate over nine days through the T-tube was successful in dissolution of the radiolucent stone.