Gastric acidity following longitudinal pancreaticogastrostomy

BACKGROUND/AIMS: The main aim of this study was to investigate whether pancreatic juice released into the stomach during longitudinal pancreaticogastrostomy and pancreatico-cysto-gastrostomy have an effect on gastric acidity. METHODOLOGY: We selected twenty-nine patients with chronic pancreatitis of whom 22 underwent longitudinal pancreaticogastrostomy and 7 pancreatico-cysto-gastrostomy due to painful chronic pancreatitis. Twenty-four hour gastric monitoring was carried out for every patient before and 6 weeks after the operation. Early and late results were evaluated. RESULTS: Following postoperative check-up we found that intervention had resulted in effective pain relief in 83% of patients. The median pain scores were reduced from 120 (range 30-220) to 40 (range 10-190). Patients had no digestive problems from pancreatic enzyme substitution. There were no postoperative deaths. Statistical evaluation of the 24-hour gastric pH monitoring before and after the operation showed no alteration in gastric pH levels. CONCLUSIONS: These results show that intractable pain can be relieved by pancreaticogastrostomy. We consider pancreaticogastrostomy as the operation of choice for the relief of intolerable pain in selected patients with chronic pancreatitis associated with pancreatic duct dilatation.     

Assessment of postoperative digestive function after pancreatico-duodenectomy: a comparison of reconstruction techniques

BACKGROUND/AIMS: Malabsorption is a frequent complication following pancreatico-duodenectomy (PD) for pancreatic carcinoma. Gastrojejunostomy followed by Billroth I type of reconstruction (PD III) has been advanced to prevent this disorder. We compared postoperative digestion and absorption determined by 131I-triolein, D-xylose and pancreatic function diagnostant (PFD) after extensive PD followed by one of two reconstructive procedures. MATERIAL AND METHODS: Postoperative digestive and absorptive functions in patients operated by Child's method (PD II) were compared with patients in whom the stomach emptied proximal to the pancreas and bile duct (PD III). RESULTS: The absorption of D-xylose was significantly higher (1.24 +/- 0.36 g vs. 0.72 +/- 0.21 g) in the PD III group. No difference was noted in pancreatic endocrine secretion between the two groups. Biliary scintigraphy revealed increased bile secretion in the PD III group. CONCLUSIONS: These results suggest that PD III is superior to PD II following extensive PD.     

Pancreatic duct patency after pancreaticogastrostomy: long-term follow-up study

BACKGROUND/AIMS: To clarify whether the pancreatic duct remains patent during long-term follow-up of patients after pancreaticogastrostomy. In a previous study of pancreaticogastrostomy with post-operative follow up for 3 years after surgery, we found that the orifice of the pancreatic duct was difficult to detect in some patients because of swelling of the gastric mucosa. Previous studies have not examined pancreatic duct patency during long-term follow-up. METHODOLOGY: Between July 1985 and August 1989, 20 patients underwent a pylorus-preserving pancreaticoduodenectomy with reconstruction by pancreaticogastrostomy. Five of these patients were followed up post-operatively for more than 9 years to determine the patency of the pancreatic duct. All pancreatic anastomoses were performed by the telescopic method. RESULTS: All 5 patients were female, with a mean age of 65.4 years (range: 54-75). Median post-operative follow-up was 10.8 years (range: 9-12). The indications for surgery were carcinoma of the ampulla of Vater in 4 patients and chronic pancreatitis in 1 patient. Pancreatic duct patency was confirmed in 4 patients by gastroscopy and pancreatography. However, the anastomotic orifice could not be detected in the remaining patient because of complete coverage by the gastric mucosa. In this patient, pancreatic exocrine and endocrine function deteriorated with dilation of the distal pancreatic duct. The patient underwent a second operation involving dissociation of the pancreatico-gastric anastomosis and resection of about 1 cm of the fibrous, proximal portion of the pancreas. Reconstruction was performed with a Roux-en-Y pancreaticojejunostomy and a mucosa-to-mucosa anastomosis. CONCLUSIONS: Although pancreaticogastrostomy has been applied as a safe and straightforward method for reconstruction after pancreaticoduodenectomy, anastomotic stenosis is a potential late complication of this approach.     

Esophageal anastomosis: an experimental model to study anastomotic healing and the use of lyophilized collagen

This experimental study assessed the use of lyophilized collagen to reinforce cervical esophageal anastomosis in rabbits. Twenty New Zealand White rabbits weighing 2.3-3.2 kg were used. In group I (n = 10) a 1-cm-long segment of the esophagus was excised and the two free edges anastomosed, to mimic the conditions found in newborn esophageal atresia. Group II (n = 10) had a segmental esophageal resection and end-to-end anastomosis as in group I but the anastomotic site was circumferentially covered with lyophilized type I collagen film. The resected segments were processed immediately and served as controls for the postoperative tissue in each animal. The animals were starved for the first 24 h and water was given on the 2nd postoperative day; on the 3rd postoperative day the animals were allowed a normal diet. Two rabbits in group II died on the 7th and 8th postoperative days because of a fistula. All the rabbits were killed on the 10th postoperative day and 4-cm segments of esophagus with the anastomosis at the centre were removed. At this time gross leakage was detected in four animals (one in group I and three in group II). Each anastomosis was evaluated for bursting pressure, collagen content, and histologic appearance. Bursting pressure was higher in group I. Collagen (measured as hydroxyproline) levels in anastomotic and adjoining 1-cm segments were compared with concentrations in control segments resected during operation. In group II animals there was a significant reduction in the lowering of hydroxyproline concentrations around the anastomosis. Microscopic evaluation revealed no significant differences between the two groups. This experiment showed no demonstrable benefit from the use of lyophilized collagen in preventing the esophageal anastomotic leakage that occurs in repaired esophageal atresia.     

Highly sensitive and specific ELISA with monoclonal antibody capture to measure Dermatophagoides farinae 1-specific IgE

BACKGROUND: Management of the pancreatic stump after pancreaticoduodenectomy (PD) is still a matter of debate. Pancreaticojejunostomy (PJ) is used commonly but is associated with a significant incidence of pancreatic leaks. Pancreaticogastrostomy (PG) is an alternative that has been reported to be safer. METHODS: The study is a retrospective analysis of all patients having PD for ampullary carcinoma in one surgical unit at All India Institute of Medical Sciences over 18 years, with PG being the only drainage procedure for the pancreatic stump. RESULTS: Among 125 patients having PD for ampullary carcinoma, overall morbidity rate was 28%, mortality rate was 4.8%, with no cases of leakage from the pancreaticogastrostomy. CONCLUSIONS: In world literature (including the current series), the leakage rate of PG is 2.5% (14 of 553) with only 2 deaths (2 of 14) due to leakage from PG. Our large experience and these data conclusively prove the safety of pancreaticogastrostomy, which should be the drainage procedure of choice for the pancreatic stump following pancreaticoduodenectomy.     

In vivo effects of tumor necrosis factor-alpha or flavone acetic acid in combination with doxorubicin on multidrug-resistant B16 melanoma

BACKGROUND: A soft pancreas with a main pancreatic duct (MPD) with normal diameter has been considered a high risk for pancreatic anastomotic leakage because of a relatively high output of pancreatic juice, but data are lacking. METHODS: An attempt was made to assess the relationship between the consistency of the pancreas, MPD diameter, pancreatic juice output, and pancreatic leakage after partial pancreatoduodenectomy. The pancreatic parenchyma was classified as of soft, intermediate, and hard consistency in 70 consecutive patients undergoing operation (groups 1, 2, and 3, respectively) by one surgeon. The MPD diameter was determined by means of endoscopic pancreatography or abdominal ultrasonography. Pancreatic juice output was measured for 21 days after operation by using a catheter inserted into the MPD. Anastomotic leakage was identified radiologically by using contrast medium. RESULTS: The mean (SD) pancreatic juice output during a period of 10 days (postoperative days 5 to 14) was 1554 (1073) ml in group 1 (n = 29), 1513 (1060) ml in group 2 (n = 13), and 187 (220)ml in group 3 (n = 28) (groups 1 and 2 versus group 3, p < 0.0001). The MPD diameter was 3.0 (1.6) mm in group 1, 5.9 (2.5) mm in group 2, and 6.6 (2.6) mm in group 3 (group 1 versus groups 2 and 3, p = 0.0001). Anastomotic leaks occurred in four (14%) patients in group 1, three (23%) in group 2, and none in group 3 (p < 0.05). CONCLUSIONS: Patients with a pancreatic parenchyma with an intermediate or normal consistency produced more pancreatic juice and had a higher leak rate.     

Pathophysiological and possible physiological roles of kinins in the pancreas

The i.v. infusion of a low dose of the cholecystokinin agonist caerulein elicited a sustained secretion of amylase into the biliopancreatic duct of rats. Pretreatment with the bradykinin antagonist icatibant (Hoe-140) had no effect on unstimulated amylase release and did not affect caerulein-induced amylase secretion. An i.v. infusion of bradykinin in doses not producing a pancreatic oedema elicited an increase in pancreatic juice production lasting 20-40 min after the end of the infusion. This pro-secretory effect was also visible at higher doses in captopril-pretreated rats producing an oedema similar to that observed in caerulein-induced pancreatitis. Using the Monastral blue method, it was found that the kininase II blocker captopril induced an opening of endothelial gaps in pancreatic capillaries. This effect was blocked by icatibant suggesting that kinins are formed in the pancreas under basal conditions. Thus, kinins appear not to be involved in the regulation of the production of digestive enzymes. However, kinins may have a modulatory role in the production of pancreatic juice and in the microcirculatory regulation in the pancreas.     

Reconstruction technique after pancreaticoduodenectomy

The many techniques proposed for the reconstruction of the digestive path after pancreaticoduodenectomy show the continuous research of the most anatomical and safest way to achieve the best results. Most of the technical variations concern the treatment of the pancreatic stump and are directed to prevent the pancreatic fistula that is the most frequent cause of postoperative mortality and morbidity. None of the pancreatico-digestive reconstruction ways is absolutely better than the others and we think neither the total obstruction of the Wirsung duct is the solution of the problem of the pancreatic fistula. The accuracy and technical precision, the availability to modify the technique in relationship to different anatomy and functional conditions of the pancreatic stump are essential to improve the results. To achieve this goal is decisive the experience and patients volume of the surgeon and of the institutional team.     

The influence of Roux-Y versus Longmire-Gütgemann reconstruction on the composition of pancreatic juice

Both methods of reconstruction after gastrectomy lead more or less to an insufficiency of pancreas. Therefore investigations on rats should further clarify which defects are obvious after both operation methods. Wistar rats were divided into 3 groups. In 2 groups a gastrectomy was performed while one was reconstructed according to the method of Roux-Y, the other was treated according to the method of Longmire-Gütgemann. The first group was a sham operated control group. 3 months after this operation pancreatic juice was collected over the time of 6 hours. Volume and protein content were determined as well as a differentiation of the proteins by means of the 2D electrophoresis which separates the molecules according to isoelectric focus and the molecular weight. The results show a significant increase of the volume of pancreatic juice after both operations. Whereas the protein content is also altered the number of proteins is significantly decreased. Especially proteins with an alkaline isoelectric focus are significantly diminished. The molecular weight of the proteins is also changed. Low molecular protein fragments which were not observed in the sham operated group are increased especially in the Roux-Y group. This means that the production of enzymes is changed after both operations. The pH optimum as well as the viability of the protein enzymes is shifted. Since the changes are more pronounced after Roux-Y operation signs of pancreatic insufficiency should be expected more frequently after this operation.     

Effects of glycosaminoglycans on the glomerular changes induced by Adriamycin

BACKGROUND: A model of moderate acute necrotizing pancreatitis is essential for the study of the pathophysiology of the disease and novel therapies. We tried to establish a model of bile salt-induced acute necrotizing pancreatitis in rats. METHODS: Acute pancreatitis was induced by retrograde infusion of bile salt into the cannulated pancreatobiliary duct. Twenty-six rats wee divided into 3 groups. Group I (n = 8) received 0.2 ml of glycodeoxycholic acid (GDOC) 10 mmol/l; group II (n = 10) 0.2 ml of 2.5% sodium taurodeoxycholate (NaTDC); group III (n = 8) the mixture of 0.2 ml GDOC 10 mmol/l and 10 U enterokinase. Serum levels of amylase and lipase, hematocrit, mean arterial pressure and heart rate were determined at baseline and 5 hours later. Then the pancreas was removed for histopathology and grading (0-3; absent-severe) with regard to leukocyte infiltration, edema, necrosis, hemorrhage and acinar cell vacuolization. RESULTS: Serum levels of amylase and lipase increased significantly in 5 hours in all the groups. Serum amylase levels were significantly lower in group III than in group II. No significant difference of serum lipase was found among the groups. Group II had the highest scores of necrosis and acinar cell vacuolization, whereas group III had the highest scores of leukocyte infiltration and edema. The degree of necrosis was significantly more severe in group II than in group I. The hematocrit increased significantly in 5 hours in groups I and II. The mean arterial pressure in 5 hours decreased significantly in group I. There was no significant difference of the changes of heart rate in 5 hours among 3 groups. CONCLUSIONS: Intraductal infusion of NaTDC was a good method to induce moderate acute necrotizing pancreatitis in rats. GDOC caused mild pancreatitis, and pancreatic injury was aggravated when enterokinase was added. The severity of pancreatic histopathology was not correlated with the changes of serum levels of pancreatic enzymes, hematocrit or mean arterial pressure at the early stage of pancreatitis.     

Experimental biliary reconstruction with a Dacron graft which preserves the function of papilla Vater

Roux-en-Y cholangiojejunostomy has been widely accepted as a method of biliary reconstruction after resection of the bile duct, however complications such as cholestasis, cholangitis and peptic ulcer attributable to the loss of papillary functions are frequently encountered after this procedure. In this point of view, the author experimentally studied biliobiliary anastomosis with a Dacron vascular graft to preserve normal bile passage through the duodenal papilla. End-to-end choledocho-graft-choledochostomy with a Dacron vascular graft coated with collagen (Hemashield) was carried out in 10 pigs. Out of them three died of complications during the 13th to 26th the POD, and seven were sacrificed 6 weeks after the operation. Two weeks after biliary grafting (n = 3) the grafts were surrounded by thin fibrous tissue and microscopically collagen fibers infiltrating into pores of the graft were noted, however after 6 weeks the grafts were spontaneously detached from the bile duct and floated in bile. The covered fibrous tissue was remained and the anastomotic site was replaced with soft granulation tissue, where infiltration of inflammatory cells were microscopically noted. Caliber of the anastomotic site was not smaller and but for slight elevation of total bile acid level blood biochemistry did not show cholestasis and cholangitis. The papillary function was manometrically well maintained. A Dacron graft shielded by collagen seemed to be inadequate material as a permanent bile duct graft, however granulation tissue after spontaneous removal of the graft may be covered with biliary epithelium, and may heal maintaining normal papillary function.     

Effect of unilateral nephrectomy of the localization of aortic sudanophilic lesions in cholesterol-fed rabbits

The method of polar coordinate mapping of lesions on the aortic wall around orifices was used to study the effect of unilateral nephrectomy on sudanophilic lesions in rabbits. Four groups of six rabbits each were studied. Group I had a right nephrectomy with a short renal artery stump. Group II had a sham right nephrectomy. Group III had a left nephrectomy with a short renal artery stump and Group IV a sham left nephrectomy. All groups were allowed to recover for one week and were then fed rabbit chow enriched with 2% cholesterol and 6% corn oil for a four-week period. Groups I and III showed a marked alteration in lesions around the stump with both proximal and distal peaks. Group I also showed the development of skewing of the left renal lesion to the left, presumably because of a change in aortic flow due to removal of the proximal right renal flow. The right renal artery had a lesion skewed to the right; this was not altered by left nephrectomy and was probably due to coeliac flow. The data provides strong evidence that sudanophilic lesions in rabbit aortas are altered by local flow disturbances.     

Treatment of herpes simplex & varicella zoster infection

Fourteen patients underwent pancreaticoduodenectomy between January 1991 and February 1995 for periampullary carcinoma. In the first 8 patients pancreaticojejunostomy was performed; two of them developed pancreatic leak and died. In the subsequent 6 patients, pancreaticogastrostomy was performed; in this group there was no pancreatic leak and no perioperative mortality. THere was no difference between the two groups in preoperative bilirubin level, duration of jaundice, diameters of the common bile duct and pancreatic duct at surgery, operative time and blood loss. Postoperatively, the patients undergoing pancreaticogastrostomy fared better; they were started on oral feeds earlier (6.0 +/- 0.6 vs 10.2 +/- 0.8 days, p < 0.001), became ambulatory earlier (7.2 +/- 0.4 vs 12.3 +/- 1.5 days, p < 0.001) and had less loss of body weight at the time of discharge (2.2 +/- 0.2 vs 3.8 +/- 0.4 Kg, p < 0.001).     

Ether extract of fetal calf serum protects cultured rat cortical neurons against glutamate cytotoxicity

OBJECTIVE: To elucidate the role of Helicobacter pylori in relapsing disease after partial gastrectomy for peptic ulcer. DESIGN: Retrospective study of gastroscopies between January 1985 and February 1988. SETTING: Department of Surgery, Helsinki University Central Hospital, Finland. PARTICIPANTS: One hundred and fifty-five patients, who had undergone partial gastrectomy for peptic ulcer disease. MAIN OUTCOME MEASURES: Correlation between clinical and laboratory data, macroscopic findings at gastroscopy and histopathology. RESULTS: At gastroscopy 41 patients showed an ulcer at the site of anastomosis or in the gastric stump and two patients had a history of a previous ulcer recurrence. The median time interval between operation and relapse was 4 years. There was no correlation between ulcer recurrence, sex, age, ABO blood group or other diseases. Smokers and patients using non-steroidal anti-inflammatory drugs (NSAIDs) or alcohol had more relapses, but the difference was not significant. The recurrence rate was higher after Billroth II (BII; 34%) than after Roux-en-Y (14%; P = 0.03) or Billroth I (BI) reconstruction (24%). Giemsa staining demonstrated H. pylori in the gastric stump of 37% of the patients. H. pylori expression was related to age but unrelated to sex, ABO blood group, NSAID use, smoking or alcohol consumption. H. pylori positivity was more common (52%) after BI than after BII (28%; P = 0.04) or Roux-en-Y resection (40%). Recurrent ulcer was more often found in gastric remnants with normal mucosa (36%) than in those with H. pylori-positive gastritis (18%; P = 0.03) or H. pylori-negative gastritis (26%). CONCLUSION: It seems that H. pylori infection plays a minor role in the pathogenesis of ulcer recurrence after partial gastrectomy for peptic ulcer disease. Eradication of H. pylori of the remnant stomach is therefore presumably not effective in preventing ulcer recurrence.     

Monitoring of gastric acidity following ductal decompression surgery for chronic pancreatitis

The accepted decompression methods of chronic pancreatitis are the longitudinal pancreaticogastrostomy and the conventional pancreaticojejunostomy. The aim of the present study was to estimate the effect of these types of drainage operations on gastric acidity and to evaluate the clinical results. Between Jan. 1992 to 1996 56 patients with chronic pancreatitis were selected into the investigation who were operated in our clinic. A 24 hour gastric monitoring was taken on every patient before and 6 weeks after the operation. Following a complete postoperative check up we found that both types of operations are effective for pain relief (71%). Retrospectively 83% of the patients had no digestive problems due to pancreatic enzyme substitution. According to our statistical evaluation of 24 hour gastric pH monitoring test no alteration was detected in gastric pH in both groups pre- and postoperatively. On the basis of pH measuring and evaluated data we consider that pancreaticogastrostomy is a good operation choice to relieve intractable pain in selected patients with chronic pancreatitis associated with duct dilatation.     

Disaster-related psychiatric care system in the United States

We report herein the case of a 57-year-old man in whom malignant lymphoma originating in the gastric remnant was confirmed 25 years after a subtotal gastrectomy with Billroth II reconstruction had been performed for gastric ptosis. Gastroscopy revealed an ulcerated tumor on the fornix, and histologic examination of the endoscopic biopsy specimens demonstrated malignant lymphoma. Thus, total gastrectomy with splenectomy, pancreatectomy, and resection of the previously anastomosed jejunal stoma were performed. Histologic examination of the stomach remnant confirmed a diagnosis of B-cell lymphoma of the large-cell type. Although we were unable to study the surgical specimen from the initial operation, the possible relationship between pseudolymphoma and malignant lymphoma has been presented in the literature, which is reviewed following this case report.     

Positive association between dietary fat intake and risk of gastric stump carcinoma in rats

Effect of high- and low-fat diets on gastric stump carcinogenesis was experimentally investigated. A total of 130 Wistar male rats weighing 250-300 g received either sham operation or Billroth II partial gastrectomy, the resection of the distal two-thirds glandular stomach and reconstruction of gastro-jejunostomy. After surgery, each group of rats was switched from a standard diet (CRF-1) to a special diet containing either 15% soybean oil (high-fat) or 0.5% soybean (low-fat), fed ad libitum and tap water, and were killed 50 weeks after surgery. Gastric tumours were observed only in the animals that underwent gastrectomy while no tumours were detected in the animals following the sham operation. Tumours located invariably at the gastrojejunostoma, were carcinomas or adenomas in histology. Carcinomas developed in 12 of 29 gastrectomy animals (41%) fed the high-fat diet and 4 of 27 gastrectomy animals (15%) fed the low-fat diet. The difference was significant (P < 0.05). The incidence of adenoma was also significantly higher in the gastrectomy animals fed the high-fat diet (38%) than that in those fed the low-fat diet (15%) (P < 0.05). A daily faecal output of bile acids was significantly greater in the gastrectomy animals fed the high-fat diet (19.0 +/- 16.4 micromol/day) than that in those fed the low-fat diet (11.2 +/- 6.2 [micromol/day; P < 0.05). This study suggests that increased fat intake is associated with a high risk of gastric stump carcinoma.     

Pancreatic exocrine secretion during the first days after weaning in pigs

Feed replacement at weaning plays an important role in the induction of pancreatic maturation. To understand the changes in the exocrine pancreas at weaning and the relation to postweaning problems, we studied the function of the exocrine pancreas and changes of intestinal hemolytic Escherichia coli in four pigs. The pigs were chronically fitted with pancreatic duct catheters and T-shaped cannula inserted into the duodenum for reintroduction of pancreatic juice. One day before weaning (at 30 d of age), pancreatic juice was collected for 1 h before and 1 h after a morning and an evening suckling. The pigs were not creep fed, but from weaning the pigs received a standard weaning diet ad libitum. On d 1, 2, 3, and 5 after weaning, pancreatic juice was collected continuously for the 24-h period. The total pancreatic secretion was measured at hourly intervals, 1.5-mL samples were taken for analysis, and the remaining juice was returned to the animal. On these days, samples from the duodenum, ileum, and rectum were also taken for analyses of hemolytic E. coli. From the day before to 5 d after weaning, a gradual increase in pancreatic secretion was observed concerning volume (P < .001) and protein (P < .01) and trypsin (P < .02) levels. An increase (P < .01) in hemolytic E. coli in the duodenal contents was also documented during this period. We assume that the gradual increase in the measured variables of pancreatic secretion is related to the increasing consumption of solid feed. However, the appearance of E. coli and disappearance of milk components from the gastrointestinal tract could be other factors stimulating the exocrine pancreas.     

Wound healing of intestinal anastomosis after digestive surgery under septic conditions: participation of local interleukin-6 expression

This study aimed to evaluate the integrity of anastomotic wound healing after digestive surgery under septic conditions and to observe local interleukin-6 (IL-6) expression around the anastomotic segment. Experimental animals were separated into lipopolysaccharide (LPS) and control groups. Each was injected with LPS or normal saline solution into the peritoneal cavity 24 hours before transection and anastomosis of the colon. The anastomotic bursting pressure (ABP) and tissue hydroxyproline concentration (HP) were measured as indicators of wound healing. Immunohistochemical staining for IL-6 was performed on tissue samples obtained from the anastomotic segment, lung, liver, and kidney. The reactive cells were counted by light microscopy. The ABP and HP were significantly lower in the LPS group than the control group 7 days after the surgery. In the LPS group, IL-6 expression around the anastomotic segment was enhanced 1 and 6 hours after surgery but suppressed 24 hours afterward. In contrast, IL-6 expression in lung, liver, and kidney was enhanced in the LPS group 24 hours after surgery but not in the control group. It is suggested that anastomotic wound healing is impaired after digestive tract surgery under septic conditions, and local IL-6 expression participates in wound healing.     

Molecular forms of gastrin in antral mucosa, plasma and gastric juice during vagal stimulation of anesthetized cats

Gastrin was released by electrical vagal stimulation in anesthetized cats. Antral mucosa, blood and gastric juice samples collected during vagal stimulation were subjected to gel filtration in order to characterize the different molecular forms of gastrin. In antral mucosa component III (gastrin-17) predominated. Besides, the antrum contained 5 per cent component II (gastrin-34, "big" gastrin), 1 per cent component I and trace amounts of component IV (gastrin-14 or "mini" gastrin). Immediately after vagal stimulation, component III (gastrin-17) appeared in the gastric venous effluent followed within a few minutes by component IV (gastrin-14). Component I and II (gastrin-34) were not detectable in any of the plasma samples. We suggest that component III (gastrin-17) is released from the antral mucosa and is then rapidly metabolized to component IV (gastrin-14) possibly to a significant extent in the fundic region of the stomach. Large amounts of component III (gastrin-17) were found in the vagally-induced gastric juice. Only very small amounts of degradation products were present, indicating that cat gastrin is relatively resistant to peptic degradation and acid hydrolysis.