Conversion of Hollander Tests in Man From Positive to Negative

Abstract

Thirty-five patients underwent duplicate Hollander tests with and without administration of propranolol hydrochloride. Acid concentration in the gastric juice after insulin injection was regularly lower with betaadrenergic blockade. Maximal levels of free acid concentration achieved were less with administration of propranolol in 30 out of 35 patients. Whereas 28 out of 35 (80%) were positive by Hollander's criteria in the routine test, after administration of propranolol only about half as many 16 of 35 (43%) patients could be considered positive. Acid output was measured in four and was lower in all after administration of propranolol. The results could not be explained by an altered blood glucose response to insulin. These data indicate that after vagotomy the gastric acid response to insulin (Hollander test) is influenced to a large degree by beta adrenergic factors confirming Hollander's conclusion in 1948: "a positive response does not imply of necessity that the surgeon failed to interrupt the gastic vagi completely."