A simultaneous manometric monitering of the common bile duct (CBD) and the duodenum were performed 2 weeks after choledocholithotomy on 15 patients whose common bile ducts were explored without sphincteroplasty and 30 patients with sphincteroplasty. These manometric studies were carried out by open-tip catheters intubated into the CBD and duodenum through the T-tube at the operation.
In patients without sphincteroplasty, no effects of the duodenal pressure on a CBD pressure profile were recognized, while a synchronized pressure profile of the CBD and the duodenum was obtained in patients with sphincteroplasty.
By stimulation with morphine (Morphine sulfate: 0.17mg/Kg iv bolus), waxing and waning of the pressured in the CBD without sphincteroplasty were observed with 20 cmH₂O in maximum at about 13 minutes after injection. However, in the CBD with sphincteroplasty, scale-over increase of the pressure curve was seen immediately after duodenal contraction caused by morphine stimulation.
A direct infusion of 5 ml of 0.1 N hydrochloride to the duodenum causes hyperperistalsis of the duodenum, which made a synchronized pressure profile in the CBD with sphincteroplasty but made no remarkable change in a pressure profile of the CBD without sphincteroplasty.
These findings conclude that the sphincter of Oddi plays an important role as a “pressure barrier” between the CBD and the duodenum, and that with the destruction of this sphincter by sphincteroplasty, a pressure profile of the CBD becomes close to that of the duodenum. This simultaneous manometric study of the CBD and the duodenum might be one of most valuable methods for evaluation of completeness of the sphincteroplasty.

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Manometric pressure profile of the lower esophageal sphincter (LES) was studied at 3 different points at the same level in 10 adult candidates from 18 to 25 years of age and 6 children from 3 months to 5 years of age who clinically have no abnormality in the upper gastrointestinal tract. This esophageal tube used for adult is Esophageal Motility Tube produced by Sherwood Company which has 3 side holes circularly located at every 120 degree at 5 cm proximal to the tip.For children was used our original tube which is a smaller 3-lumen tube with 3 side holes circulerly located at every 120 degree at 3 cm proximal to the tip.These 3 holes were always kept to face to the anterior (O o'clock), right posterolateral (4 O'clock) and left posterolateral (8 o'clock) in the esophagus, respectively. And pressure profile of LES was measured by a rapid pull through technique.
In the normal adults, high pressure zone (HPZ) which is a manometric representation of LES was observed to have 25.1cm H₂O at 0°, 16.1cm H₂O at 4° and 28.4cm H₂O at 8° in average in tone, and 34.5 mm at 0°, 40.4mm at 4° and 27.7mm at 8° in average in length. In normal children an average tone of HPZ was 13.9cm H₂O at 0°, 8.4cm H₂O at 4° and 17.4cm H₂O at 8°, and length of HPZ was 16.1mm at 0°, 20.3mm at 4° and 11.6mm at 8°. These findings indicate that there is an asymmetry in manometric profile of normal LES both in adults and children, with the highest tone at 8° and the lowest at 4°, and the longest length at 4° and the shortest at 8°.
In contrast with manometric profile of normal LES, pathological LES was assessed by the same technique in a patient with achalasia of the esophagus, a patient with systemic sclerodema, two patients with hiatal hernia, a patient with traumatic diaphragmatic hernia and a patient with Barrett esophagus. In any one of the above pathological conditions of LES, asymmetry in pressure profile was not observed.
The effect of gastrin on LES was further investigated in the same 10 adult candidates by the same technique. Only a slight increase in the tone was observed in 3 directions about 2 minutes after intravenous administration of tetragastrin (0.5 γ/kg).
This paper summarized our study on a manometric asymmetry of normal LES in contrast with manometric changes in various diseases that have pathological LES. Further study on these manometric charactaristics and their combinations might us a great advance in clarification of anti-reflux mechanism of LES.

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Effects of domperidone on gastric emptying and gastric, duodenal and gallbladder motility were investigated.
Intravenous injection of domperidone 2mg/kg produced an acceleration of gastric motility without increase in the tone while a marked increase in the amplitude of peristaltic waves with a slight decrease in frequency was observed. Domperidone also produced an acceleration of duodenal and gallbladder motility.
Domperidone produced an acceleration of transit of stomach contents in some cases, while in others gastric emptying was inhibited. This difference of the effect may be due to the previous tone of the pylorus.
The excitatory action of domperidone on gastrointestinal motility was suppressed to some degree after cervical vagotomy or vagus cooling and markedly inhibited by atropine. Tetrodotoxin reduced the excitatory effect of domperidone but did not abolish. Therefore, it is presumed that domperidone stimulates, at least in part, the gastrointestinal muscle itself as well as cholinergic neurons in the gastrointestinal wall or cholinergic receptors of the gastrointestinal muscle and that domperidone may also have a central nervous system stimulant action. On the other hand, domperidone appears to act directly on the gallbladder muscle.

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By means of a preparation technique based on the discontinuous sucrose density gradient, subcellular fractions were isolated from guinea pig intestinal smooth muscle cells.
A fraction which distributed to a 33% sucrose layer showed relatively high activities of 5'-nucleotidase, Na⁺·K⁺-ATPase and ouabain sensitive Na⁺·K⁺-ATPase. The fraction had a low NaN3 sensitive Mg²⁺-ATPase activity. On the other hand, the high activity of glucose-6-phosphatase showed a broad distribution. Though the sucrose density gradient proceeded over a series of fine layers, cross-contamination of microsome into the 33% sucrose fraction was not reduced. To reduce microsomal cross-contamination, another procedure was employed. The homogenization time of 77000×g sediment to be layered on the top of the sucrose density gradients was prolonged. This procedure did not change the distribution of K⁺ activated p-nitrophenylphosphatase, K⁺ activated ouabain sensitive p-nitrophenylphosphatase and ouabain sensitive Na⁺. K⁺-ATPase activities. The peak of NADH cytochrome c reductase activity was shifted to a 38% sucrose fraction from a 33% sucrose fraction and the activity of this marker enzyme in the 33% sucrose fraction decreased to 60% of that of the prior procedure.

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The local distension of the intestinal wall was carried out by inflating a thin rubber balloon which had been fixed in the lumen and the contractions of the circular muscle were recorded at the points of 5mm (Po₁) and 20mm (Po₂) oral to the fixed balloon. The contractions elicited by local distension was blocked by tetrodotoxin and atropine, or removing longitudinal muscle, with the myenteric plexus adhering to it, from the intestine at the distending region. When 2 to 3mm length of longitudinal muscle was stripped off around the intestine between Po₁ and Po₂, the contraction initiated at Po₁ never reached to Po₂. That is, the oral contraction did not propagate beyond the myenteric plexus-free region of the segment. When drugs were applied exclusively to the region around Po₂, tetrodotoxin and hexamethonium, but not atropine, abolished the contraction at Po₂, while the contraction at Po₁ was clearly observed. It is likely that the contraction observed at the point of Po₂ was evoked by non-cholinergic nervous mechanisms.

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The influence of intravenous administration of cimetidine on excitatory response of gastric secretion and motility of innervated or denervated pouchs caused by electrical stimulation of vagal and splanchnic nerves and administration of tetragastrin or histamine respectively were investigated. Dogs were anesthetized with nembutal, and also immobilized with gallamine triethioide. The following results were obtained.
(1) Administration of cimetidine inhibited the augmentation of gastric juice and acid output from the innervated corpus pouch by vagal and splanchnic nerve stimulation and vestibulo-gastric excitatory reflexes of gastric secretory functions via the vagal or splanchnic nerve.
(2) Augmentation of gastric acid output from the denervated corpus pouch caused by electrical stimulation of vagal and splanchnic nerves was inhibited by administration of cimetidine.
(3) Administration of cimetidine inhibited the augmentation of acid output from denervated corpus pouch caused by injection of tetragastrin or histamine.
(4) The excitatory responses of gastric motility caused by nerve stimulation and administration of tetragastrin or histamine could not be effected by cimetidine.
(5) No changes were observed in the gastric venous blood flow by continuous intravenous injection of cimetidine, but by rapid injection both the flow was augmented and the systemic blood pressure decreased transiently.
These results indicate that histamine stimulates gastric secretory cells directly.

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The role of the vagus in gastric motility was studied by mean of electric vagal stimulation in 44 dogs.
Firstly the optimal electric current for vagus was examined, and then the stomach contraction at stimulation was recorded by strain gages. The effect of various agents at stimulation was observed too. The results obtained were as follows.
1. Optimal electric stimulus (duration=5sec.)
1) frequency; 10Hz or 50-60Hz
2) voltage; 10-20V or 30-50V
3) width; 1-10msec.
2. The canine stomach was proved the contraction gradient for electrical stimulus.
3. The central nerve system appeared to have an inhibitory effect on the vagus.
4. Stimulus for the single body branch could not evoke the contraction.
5. Antral branch stimulation evoked contraction of not only the antrum but also that of the body.
6. The pyloric branch did not play any significant role under the above mentioned stimulus.
7. The conduction of the neural stimulation was completely blocked by regional infiltration of xylocaine.
8. Reserpine and neostigmine increased exitability of the stomach. Gastric movement at stimulation was abolished on atropinization.
These results indicate that the antral branch function favorably for the stomach body contraction. From the view point of enhancing the gastric motor (drainage) function, preserving the antral branch of the vagus is considered to support the advantage of selective proximal vagotomy technique.

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