Late‐onset rapid gastric emptying: Identification of a new abnormal finding in patients with otherwise normal results on gastric emptying scintigraphy

2021 ◽  
Vol 33 (9) ◽  
Author(s):  
Richard McCallum ◽  
Carola La Follette ◽  
Alok Kumar Dwivedi ◽  
Irene Sarosiek ◽  
Anna Havey ◽  
...  
2012 ◽  
Vol 303 (7) ◽  
pp. E853-E864 ◽  
Author(s):  
Xinfu Guan ◽  
Xuemei Shi ◽  
Xiaojie Li ◽  
Benny Chang ◽  
Yi Wang ◽  
...  

Glucagon-like peptides (GLP-1/2) are cosecreted from endocrine L cells in the gut and preproglucagonergic neurons in the brain. Peripheral GLP-2 action is essential for maintaining intestinal homeostasis, improving absorption efficiency and blood flow, promoting immune defense, and producing efficacy in treatment of gastrointestinal diseases. However, it is unknown if CNS GLP-2 plays a physiological role in the control of energy homeostasis. Since GLP-1/2 are cotranslated from preproglucagongene and coproduced by prohormone convertase-1, it is challenging to knockout GLP-2 only. Instead, our laboratory has generated a Glp2r-floxed mouse line to dissect cell-specific GLP-2 receptor GLP-2R) action in the regulation of energy balance. Our objective was to determine if GLP-2R in the hypothalamus modulates feeding behavior and gastric emptying. We show that Glp2r mRNA and protein are highly expressed in the arcuate nucleus and dorsomedial nucleus of the mouse hypothalamus. Using the Cre-LoxP system, we generated mice that lack Glp2r expression in POMC neurons (KO; mainly in the hypothalamus). The KO mice showed hyperphagic behavior (such as increases in food intake and meal frequency), accelerated gastric emptying (assessed by [13C]octanoic acid breath test), and late-onset obesity, yet there was no decrease in basal metabolic rate. Infusion of GLP-2 (2.5 nmol into the 4th ventricle) suppressed food intake and gastric emptying, while GLP-2-mediated effects were abolished in the melanocortin receptor-4 (MC4R) KO mice. We conclude that Glp2r deletion in POMC neurons enhances feeding behavior and gastric motility, whereas icv GLP-2R activation suppresses food intake and gastric emptying through the MC4R signaling pathway. This study indicates that CNS GLP-2R plays a physiological role in the control of feeding behavior and gastric emptying and that this is mediated probably through the melanocortin system.


2016 ◽  
Vol 150 (4) ◽  
pp. S354-S355
Author(s):  
Anna Havey ◽  
Jesus R. Diaz ◽  
Irene Sarosiek ◽  
Alok Dwivedi ◽  
Richard W. McCallum
Keyword(s):  

2021 ◽  
Vol 75 (2) ◽  
pp. 159-164
Author(s):  
Martina Horváthová ◽  
Zuzana Bárdyová ◽  
Darina Budošová ◽  
Rastislav Husťak

Introduction: Gastric emptying scintigraphy (GES) is a safe, noninvasive method for assessing the ability of the stomach to empty which has been used clinically for many years. It is considered as a “gold standard” to assess gastric emptying of both solids and liquids allowing assessment of early, mid and late emptying, each of which may be altered by pathology. The aim of the study was to analyse standard diagnostic approach and evaluate patients` radiation exposure, who underwent GES in Slovakia. Methods: A retrospective cohort study included 55 patients from 2 departments of nuclear medicine (department A, B). Patients’ radiation exposure was determined by dosimetry program IDAC-Dose2.1. The radiopharmaceutical 99mTc-DTPA, always with the same activity, was applied orally to patients at Department B. The applied activity of the radiopharmaceutical at GES was 185 MBq. The radiopharmaceutical 99mTc MAA, with various activity, was applied orally to patients at Department A. Results: According to ICRP60, the eff ective dose (ED) of every patient undergoing GES was 0.77 mSv and, according to ICRP103, the dose was 0.836 mSv at Department B. Patients at Department A were exposed to ionizing radiation with 5-times lower intensity, compared with patients at Department B. It was caused by radiopharmaceutical activity correction. The ED medians according to ICRP60, and according to ICRP103 were 0.167 mSv (range 0.105–0.208 mSv) and 0.181 mSv (range 0.113–0.226 mSv) at Department A, respectively. Discussion: Adequate correction of applied radiopharmaceutical activity is an essential part of GES guidelines and in accordance with ALARA principles. For the accuracy of GES examination, it is necessary to follow a standard 4-hour protocol and an approach which ensures full-featured utilization of the examination while decreasing patient`s radiation exposure. Conclusion: The results of our study show relatively low ED associated with GES, but also confi rm that the GES methodology significantly affects the patient`s radiation exposure


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sharon Wolfson ◽  
Zoe Wilhelm ◽  
Antone R. Opekun ◽  
Robert Orth ◽  
Robert J. Shulman ◽  
...  

Gastroparesis ◽  
2021 ◽  
pp. 125-142
Author(s):  
Alan H. Maurer ◽  
Marvin I. Friedman ◽  
Jesus Diaz ◽  
Henry P. Parkman

2019 ◽  
Vol 156 (6) ◽  
pp. S-781-S-782
Author(s):  
Perry Orthey ◽  
Asad Jehangir ◽  
Simin Dadparvar ◽  
Henry P. Parkman ◽  
Alan H. Maurer

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