Showing papers in "Digestive Diseases and Sciences in 1970"
TL;DR: In this paper, the conditions of genetic selection that may have led some groups of men to have persistently high levels of intestinal lactase throughout life, and others not, are considered.
Abstract: The principal conclusion reached in Part I of this article (1) was that the group differences found in primary adult lactose intolerance among the world's peoples are largely genetic in origin. In this part, after a review of recent research that adds to Part I in important ways, we turn to a consideration of the conditions of genetic selection that may have led some groups of men to have persistently high levels of intestinal lactase throughout life, and others not. Low incidence of intolerance, it is held, would develop over time in a group that has an abundant milk supply, that has alternate foodstuffs inadequate in amount and quality, and that consumes milk in lactose-rich forms. Since such selection cannot have occurred among groups that did not use milk, areas of nonmilking in the modern world are first delimited. The origins and diffusion of dairying are then sketched to determine the length of time that milk was consumed in various regions. With the background thus gained, the present-day occurrence of various Old World groups with high and low incidences of intolerance is explained. All groups studied so far within the traditional areas of nonmilking are found to have high incidences of intolerance. Overseas groups, such as American Negroes, whose ancestors came from nonmilking regions also have high incidences of intolerance. Within the areas of milking in Africa and Europe, moreover, the known group differences in tolerance are found to be in accord with the hypothesis. Then, that the hypothesis may further be confirmed, specific additional research efforts are suggested.
263 citations
TL;DR: The synthesis of the proposed structure confirmed its correctness, and established that all the biologic properties of the hormone are also present in this partial sequence.
Abstract: The structural studies of Mutt and Jorpes have led to a tentative amino-acid sequence for the C-terminal portion of cholecystokinin-pancreozymin. The synthesis of the proposed structure confirmed its correctness, and established that all the biologic properties of the hormone are also present in this partial sequence. A selected group of analogs and derivatives of the natural sequence has been synthesized to clarify the significance of the different structural features of this molecule.
166 citations
TL;DR: Unintentional alterations in either the rate or amount of drug absorption can lead to ineffective oral therapy on the one hand, or toxic reactions on the other.
Abstract: Absorption from the intestine is dependent on: (1) the physiochemical state of the substance, (2) the nonabsorptive physiologic functions and state of the intestine, (3) the metabolic activity and functions of the absorbing cell, and (4) the structure of the absorbing surface. Certain changes within each of the four categories will produce uniform or predictable changes in drug absorption which may be applied generally. Other alterations produce highly predictable effects on absorption of certain classes of drugs, while still other alterations, particularly those in metabolic activity, produce changes which are specific for a single agent or group of structurally related agents. Unintentional alterations in either the rate or amount of drug absorption can lead to ineffective oral therapy on the one hand, or toxic reactions on the other.
134 citations
TL;DR: Data suggest an inhibitory beta receptor in the human distal esophagus, while Stimulation of these receptors results in decreased LES resting pressure, while blockade of the receptors produces an increase in smooth muscle contraction—probably by removing inhibitory control.
Abstract: Intraesophageal manometry was performed on 14 healthy male volunteers divided into two groups. Group 1, composed of 4 subjects, received first phenylephrine (an alpha adrenergic stimulating drug) and then phentolamine (an alpha adrenergic blocking drug) intravenously. No effect on esophageal motility was observed following administration of either drug; however, adequate alpha stimulation or blockade of esophageal adrenergic receptors was probably not accomplished. Group 2 was composed of 10 subjects who received first isoproterenol (a beta stimulating drug) and then alprenolol (a beta blocking drug) intravenously. A significant decrease in resting pressure of the lower esophageal sphincter (LES) was observed in all of 9 subjects following isoproterenol. No effect was observed in the body of the esophagus. Following beta blockade with alprenolol, changes were observed in the body of the esophagus and in the LES. In the body of the esophagus, a rise in amplitude of contraction occurred in 9 of 10 subjects and prolongation of contraction was noted in 7 of 10 subjects. Changes in the LES were the most striking. Increase in amplitude of sphincteric contraction following deglutition was seen in 9 of 10 subjects. Prolongation of sphincteric contractions was most dramatic and was recognized in all 10 subjects. These data suggest an inhibitory beta receptor in the human distal esophagus. Stimulation of these receptors results in decreased LES resting pressure, while blockade of the receptors produces an increase in smooth muscle contraction—probably by removing inhibitory control.
71 citations
TL;DR: Patients with cirrhosis and various degrees of impairment of renal function are measured and it is unlikely that increased blood levels of angiotensin, catecholamines, or 5-HT are the cause of the disturbance in renal circulation.
Abstract: Plasma renin activity (PRA), whole blood 5-hydroxytryptamine (5-HT), and 24-hr urinary excretion of catecholamines, metanephrines, and 5-hydroxyindoleacetic acid (5-HIAA) were measured in patients with cirrhosis and various degrees of impairment of renal function. PRA was highest in those with ascites and correlated with glomerular filtration rate (Ccr) and effective renal plasma flow (CPAH). PRA decreased after the renal blood flow was increased by infusion of dopamine, suggesting that increased PRA is the result of renal circulatory impairment in cirrhosis rather than its cause. Further stimulation of the renin-angiotensin system may lead to aggravation of fluid retention in patients with diminished renal blood flow. It is unlikely that increased blood levels of angiotensin, catecholamines, or 5-HT are the cause of the disturbance in renal circulation.
54 citations
TL;DR: Emptying and absorption of ethanol from the stomach were studied using test meals of 350 ml containing phenol red and ethanol instilled into the stomachs of 7 healthy subjects, and acid output in response to ethanol meals was equal to that in Response to water meals.
Abstract: Emptying and absorption of ethanol from the stomach were studied using test meals of 350 ml containing phenol red and ethanol (60 mg/ml) instilled into the stomachs of 7 healthy subjects. Emptying was allowed to proceed normally and the gastric contents were aspirated at different intervals on different days. Emptying was compared to water meals of equal volume containing no ethanol. Emptying of ethanol meals and water meals proceeded at the same rate up to 30 min when about 90% of the meal had left the stomach. Absorption of ethanol was related directly to the time present in the stomach. The mean coefficient of absorption of ethanol was 4.7 ml/min, and this was constant throughout the 30 min. Acid output in response to ethanol meals was equal to that in response to water meals.
50 citations
TL;DR: The studies suggest that the bile of patients with cholelithiasis has a composition from time to time which is favorable for the formation of gallstones, and the greater the caloric intake, the more frequently will bile have a composition which favors cholesterol precipitation.
Abstract: Studies on bile composition with respect to diet, quantity, and composition have been carried out. The composition of Ttube bile has been studied in a group of patients having cholecystectomy for cholelithiasis, and a group of patients having cholecystectomy for other reasons. Our studies suggest that the formation of cholesterol gallstones is related to two factors: (1) An increase in biliary cholesterol concentration when caloric and daily protein intake increases and (2) an increased intake of calories irrespective of diet composition. The in-vitro conditions for precipitation and solubilization of biliary cholesterol are now rather well established. In addition, the changes in biliary cholesterol, bile salts, and phospholipid concentration may be studied under defined experimental conditions. Our studies suggest that the bile of patients with cholelithiasis has a composition from time to time which is favorable for the formation of gallstones. The variations in bile composition appear to be dependent upon the diet: the greater the caloric intake, the more frequently will bile have a composition which favors cholesterol precipitation.
49 citations
TL;DR: Most lactose intolerant subjects were not aware of milk intolerance; the condition is not usually symptomatic in Israel and evidence in favor of a genetic etiology emphasized.
Abstract: Lactase deficiency and lactose tolerance were studied in several Jewish communities in Israel. Lactase deficiency was found in 60% of biopsied subjects. Forty-one biopsies were peroral and 22, surgical; histologically, the jejunal mucosa of all specimens was normal. Lactose tolerance tests were performed on 217 subjects, 118 patients and 99normals. A low glucose rise was found in 44.4% of Yemenites, 62.5% of North Africans (Sephardi), 72.2% of others (Sephardi), 79.2% of Ashkenazi, 84.2% of Iraqis and 85.0% of others (Oriental); the overall incidence was 71.1%. Statistical analysis confirmed that the population studied was heterogenous. Most subjects with a low glucose rise had symptoms during the test. Milk intake, low in almost all subjects, did not correlate with lactose tolerance. Most lactose intolerant subjects were not aware of milk intolerance; the condition is not usually symptomatic in Israel. Lactase deficiency in various population groups has been reviewed and evidence in favor of a genetic etiology emphasized.
48 citations
TL;DR: Seven cases of late carcinoma developing in the stomach after surgery for benign conditions are presented, and the value of gastroscopy, and of cytology and biopsy under direct vision is emphasized to detect this complication in its early stage.
Abstract: Seven cases of late carcinoma developing in the stomach after surgery for benign conditions are presented. Gastroscopic biopsies demonstrated a higher incidence of atrophic gastritis in these patients than in a control group, and frequent polypoid formation at or near the anastomotic site. These changes were seen more often in patients with gastrojejunostomy than in patients with the Billroth I operation. Since the radiographic approach was unsatisfactory, the value of gastroscopy, and of cytology and biopsy under direct vision is emphasized to detect this complication in its early stage.
47 citations
TL;DR: A patient with neonatal, leucine-sensitive hypoglycemia resistant to medical therapy including diazoxide and in whom a subtotal pancreatectomy was performed at age 3 months, the histopathologic findings in this case included the diffuse neoformation of islet cells (nesidioblastosis) from exocrine elements.
Abstract: The subject of this report was a patient with neonatal, leucine-sensitive hypoglycemia resistant to medical therapy including diazoxide and in whom a subtotal pancreatectomy was performed at age 3 months. The histopathologic findings in this case included the diffuse neoformation of islet cells (nesidioblastosis) from exocrine elements. Many of such islet cells stained densely as beta cells with the aldehyde-fuchsin stain. It is possible to implicate the exocrine pancreas via the process of nesidioblastosis in the pathogenesis of leucine-sensitive hypoglycemia and leucine as the most likely agent responsible for the induction of this process.
45 citations
TL;DR: It was found that the buffered acetylsalicylate test meals were emptied more rapidly from the stomach than test meals containing unbuffered (pH 2.8) acetyl salicylic acid.
Abstract: Test meals of 200 ml containing acetylsalicylic acid or buffered acetylsalicylate were given to 19 healthy subjects. Studies were made of the rate of gastric emptying and the gastric absorption of acetylsalicylic acid. It was found that the buffered acetylsalicylate test meals (pH 7.0) were emptied more rapidly from the stomach than test meals containing unbuffered (pH 2.8) acetylsalicylic acid. After 10 min, considering the means of amounts of aspirin absorbed, there was at least 10 times less absorbed from the buffered solution. No bleeding into the gastric contents was observed in response to any test meal.
TL;DR: A table of peak acid outputs utilizing the augmented histamine test and based on age, sex and body weight of the individual was devised using the method of least squares and it is felt that these tables are helpful in recognizing individuals with duodenal ulcer or its diathesis.
Abstract: The value of gastric analysis in the clinical management of patients with duodenal ulcer disease has been limited by lack of information on the expected normal gastric acid production following maximal stimulation A table of peak acid outputs utilizing the augmented histamine test and based on age, sex and body weight of the individual was devised using the method of least squares Results of the peak acid output in 64 patients with proven duodenal ulcer and in 38 normal controls, when compared to the computed normal values based on age, sex and body weight, revealed that 90% of patients with duodenal ulcer fell outside the expected normal range, and 92% of the normal subjects fell within the computed normal range It is felt that these tables are helpful in recognizing individuals with duodenal ulcer or its diathesis
TL;DR: There is an absolute reduction in zinc content of cirrhotic liver and this reduction bears no relationship to the amount of collagen present, which means patients with Laennec's cirrhosis are deficient in zinc.
Abstract: Liver samples obtained from 43 consecutive autopsies were analyzed for their content of zinc, hydroxyproline and nitrogen. Mean liver zinc was 2.36 and 1.27µg/mg nitrogen for histologically normal and cirrhotic samples, respectively. Hepatic zinc did not correlate with hepatic hydroxyproline. It is concluded that there is an absolute reduction in zinc content of cirrhotic liver and that this reduction bears no relationship to the amount of collagen present. If low levels of zinc in liver can be equated with zinc deficiency, patients with Laennec's cirrhosis are deficient in zinc.
TL;DR: The effect of ethanol on the mucosa of the Heidenhain pouch in dogs was studied by instilling ethanol in concentrations of 10, 20 and 40% using changes in ionic fluxes of an acid solution and mucosal alterations to measure the effects of ethanol.
Abstract: The effect of ethanol on the mucosa of the Heidenhain pouch in dogs was studied by instilling ethanol in concentrations of 10, 20 and 40% using changes in ionic fluxes of an acid solution and mucosal alterations to measure the effects of ethanol. The instillation of 20 or 40% ethanol resulted in increased insorption of H+ and increased exorption of Na+ into the pouch lumen. Following the administration of 20 and 40% ethanol, the mucous layer and mucin content of the lining epithelial cells decreased markedly. Hourly bathing with the acid test solution aggravated the injury and induced bleeding, but hourly instillation of a buffer solution minimized the damage. Ionic fluxes returned to pre-ethanol levels 2 hr after 20% ethanol and 3–4 hr after 40% ethanol. Partial restoration of mucosal damage occurred in 4–6 hr and was complete in 24 hr.
TL;DR: The effect of intravenous CCK-PZ and intravenous secretin on small intestinal motor activity was studied in 5 unanesthetized dogs and a prompt and almost complete inhibition of jejunal activity was observed.
Abstract: The effect of intravenous CCK-PZ and intravenous secretin on small intestinal motor activity was studied in 5 unanesthetized dogs. Intrajejunal pressure was recorded through a modified Mann-Bollman fistula. In ten experiments with each of two doses (0.1 units/kg and 0.4 units/kg), CCK-PZ caused a prompt and moderate increase in amplitude and rate of pressure waves. In ten experiments with each of two doses of secretin (0.25 units/kg and 1.0 units/kg), a prompt and almost complete inhibition of jejunal activity was observed.
TL;DR: It would seem that in the Chinese, at least, and presumably in other ethnic groups, the major factor influencing lactase activity is the dietary content of lactose, provided milk intake continues at the high level found in most Western European populations, beyond the normal age of weaning.
Abstract: From a critical review of the literature, it would appear that, in animals, intestinal lactase is an adaptive enzyme, with adaptation occurring in 5–8 weeks. In man, short-term attempts at adaptation have not been successful, although a fall in lactase activity or lactose absorption has been found after substrate withdrawal in some subjects. The expression of any biologic phenomenon is related to the sum of the effects of numerous genetic or environmental factors. It would seem that in the Chinese, at least, and presumably in other ethnic groups, the major factor influencing lactase activity is the dietary content of lactose. Adaptation of intestinal lactase occurs, provided milk intake continues at the high level found in most Western European populations, beyond the normal age of weaning. If lactose intake is reduced at or shortly after weaning, then lactase activity appears to decline over a period of years. This is analogous to the postweaning decline in lactase activity found in animals.
TL;DR: Light and electron microscopic studies were performed in an in vivo preparation of rat ileum fixed during well-defined conditions of solute absorption and the histochemical localization of ATPase to the apical and lateral cell membranes satisfies some of the postulates of a serial membrane theory.
Abstract: In order to study morphologic events taking place during intestinal absorption of water and electrolytes, light and electron microscopic studies were performed in an in vivo preparation of rat ileum fixed during well-defined conditions of solute absorption Water absorption was significantly greater (019±0012 ml/cm/hr) in animals perfused intraluminally with isotonic saline than in mannitolperfused ones (004±0015 ml/cm/hr) Structural alterations during water absorption consisted of dilatation of epithelial cell intercellular spaces, lymphatics, and capillaries The changes were quantitated and shown to be significantly different when saline perfused animals were compared to the mannitol-perfused group These morphologic observations and the histochemical localization of ATPase to the apical and lateral cell membranes satisfies some of the postulates of a serial membrane theory The intercellular spaces appear to represent the second compartment, and the capillaries and lymphatics appear to represent the third compartment of the model The exact role of the intestinal epithelial cell in fluid absorption and the site of Membrane A has not been determined
TL;DR: The rarity of carcinomas of the small intestine makes it appear that the association is more than simple coincidence, despite an increasing incidence of carcinoma associated with ulcerative colitis.
Abstract: Despite an increasing incidence of carcinoma associated with ulcerative colitis, carcinoma accompanying regional enteritis of the small intestine and/or colon is rare. We have found that only 17 cases of carcinoma of the small intestine associated with regional enteritis have been reported previously; we have reported 2 cases seen at the Cleveland Clinic. Each patient had a relatively long history of regional enteritis with symptoms referable to intermittent, incomplete obstruction of the small intestine. Both patients underwent operation because of increasing intestinal obstruction. The rarity of carcinomas of the small intestine makes it appear that the association is more than simple coincidence.
TL;DR: Until the true incidence of malignancy in the retained rectum is established, subtotal colectomy with careful lifelong follow-up would appear to be the most acceptable therapy for Gardner's syndrome.
Abstract: The complete pedigree of the family with Gardner's syndrome, first reported by Weiner and Cooper, is presented and the natural history of this autosomal dominant disorder is reviewed. Two new cases were found among members of the third generation. Fifteen years after total colectomy, the only affected survivor from the second generation developed a metastasizing adenocarcinoma of the third portion of the duodenum. In addition to features of the classic triad, the dental abnormalities found in all affected survivors in this family appear to be a consistent manifestation of the syndrome. No structural or numerical chromosome abnormalities were found in karyotypes prepared from peripheral white blood cells, a mandibular osteoma or testicular cells. All affected individuals should be advised of the high risk of producing affected offspring. Careful evaluation of all family members at risk will allow identification of affected individuals long before intestinal symptoms develop and should permit appropriate surgical therapy before malignant degeneration of the colon can occur. Until the true incidence of malignancy in the retained rectum is established, subtotal colectomy with careful lifelong follow-up would appear to be the most acceptable therapy for Gardner's syndrome. Even total colectomy may not be curative, since the small bowel mucosa carries a small but definite premalignant potential.
TL;DR: A method of recording the gastric electrical activity in man with electrodes introduced perorally into the Gastric cavity and applied by suction against the mucosa is described.
Abstract: A method of recording the gastric electrical activity in man with electrodes introduced perorally into the gastric cavity and applied by suction against the mucosa is described. This method was utilized in 40 adult subjects in good health and who were fasted 12 hr prior to the investigation; they were placed in the supine position. The gastric antrum was specially studied. The pacesetter potential and the fast spiking activities occurring during the contractions were recorded.
TL;DR: It is indicated that central nervous system control areas for gastric secretion in the rat were located in structures bordering the cerebral ventricles but that secretion inhibiting dose of drug placed in this area did not reduce the incidence of stress-induced gastric hemorrhage.
Abstract: The development of a simple, rapid technic for placing drugs into the rat lateral cerebral ventricle permitted comparison of intravenous and intracerebroventricular drug administration on gastric acid secretion and cold-plus-restraint (stress) induced gastric hemorrhage. Intravenous effective dose50's (micrograms) to reduce titratable acid output in 2-hr pylorus-ligated rats were: clonidine 1.0; atropine methylbromide 1.2; atropine sulfate 2.7; chlorpromazine 20.5; imipramine 397.0; morphine 837.7; and chlordiazepoxide 3419. The intravenous ED50's for inhibition of stress-induced gastric hemorrhage were (micrograms): atropine methylbromide 64.0; atropine sulfate 902.4; clonidine >4.0; chlorpromazine >256; morphine >256; chlordiazepoxide >2048; and imipramine >256. Intracerebroventricular administration of the drugs produced a different ranking of activity for inhibition of titratable acid output (ED50 in micrograms); atropine methylbromide 0.1; atropine sulfate 0.5; clonidine 3.7; morphine 5.5; chlorpromazine 99.2; chlordiazepoxide >1024; and imipramine >4096. However, the order of activity for intracerebroventricular inhibition of stress-induced gastric hemorrhage was similar to the intravenous route in that atropine methylbromide was most active, 7.8 μg, followed by atropine sulfate, 54.8 μg, and no ED50's were obtainable for the other drugs tested. This study indicated that central nervous system control areas for gastric secretion in the rat were located in structures bordering the cerebral ventricles but that secretion inhibiting dose of drug placed in this area did not reduce the incidence of stress-induced gastric hemorrhage.
TL;DR: Suction biopsies of normal and celiac jejunal mucosa have been studied using a scanning electron microscope to suggest a loose attachment of the cells to each other and to the supporting connective tissue, which in turn suggests a mechanical explanation for the increased cell loss and turnover in celiac disease.
Abstract: Suction biopsies of normal and celiac jejunal mucosa have been studied using a scanning electron microscope. The normal villus pattern, crypt openings and surface details have been demonstrated and contrasted with the appearance of the mucosa in untreated celiac disease and in patients on a gluten-free diet. In the celiac the epithelial cells are smaller and more rounded than normal, an abnormality which may persist after gluten withdrawal. This appearance suggests a loose attachment of the cells to each other and to the supporting connective tissue, which in turn suggests a mechanical explanation for the increased cell loss and turnover in celiac disease.
TL;DR: Two patients with hepatorenal toxicity resulting from sniffing a popular spotremover containing trichloroethylene are described in this article, suggesting that the closed-circuit type of inhalation employed by sniffers, and the alcoholic consumption which frequently accompanies the habit may potentiate the toxicity of the hydrocarbon.
Abstract: Two patients with hepatorenal toxicity resulting from sniffing a popular spotremover containing trichloroethylene are described. These complications are uncommon when trichloroethylene is used for clinical anesthetic purposes, suggesting that the closed-circuit type of inhalation employed by sniffers, and the alcoholic consumption which frequently accompanies the habit may potentiate the toxicity of the hydrocarbon. Although glue is more commonly sniffed by teenagers, spot-remover containing trichloroethylene appears to be associated with more serious complications and is another agent to be added to the causes forhippie hepatitis.
TL;DR: Esophageal erosions seemed likely to have been of major significance in the cause of death of 12 patients, either as a source for luminal hemorrhage or as the portal of entry for septicemia.
Abstract: Review of 705 autopsied cases of leukemia and lymphoma showed eight with grossly evident esophageal infiltration, five of which had had clinically manifest esophageal obstruction Microscopic esophageal infiltrates were found in 271% of 384 cases in which sections of the esophagus were available for review In both leukemia and lymphoma, esophageal involvement was usually associated with widespread and extensive involvement elsewhere; exceptions were chiefly accounted for by invasive extension into the esophagus from regional lymphoma masses Of 131 patients with microscopic esophageal erosions, 41 had complicating esophageal moniliasis Esophageal erosions seemed likely to have been of major significance in the cause of death of 12 patients, either as a source for luminal hemorrhage or as the portal of entry for septicemia
TL;DR: The results rule out pyloroplasty as the primary factor responsible for the observed increased rate of gastric emptying, and suggest that the osmoreceptor mechanism described by Hunt is disrupted by vagotomy.
Abstract: To determine whether pyloroplasty or a disrupted osmoreceptor mechanism is primarily responsible for the increased gastric emptying of hypertonic sugar solutions after vagotomy and pyloroplasty, test meals of 10% glucose (556 mOsm/kg) and NaCl (200 mOsm/kg) were administered to duodenal ulcer patients with no prior operation, after vagotomy and pyloroplasty, and in patients with prior vagotomy, hiatal herniorrhaphy, and no pyloroplasty. Hypertonic glucose meals were emptied more rapidly than normal after both operations. The hypotonic NaCl meal was emptied no faster postoperatively than it was preoperatively. The results rule out pyloroplasty as the primary factor responsible for the observed increased rate of gastric emptying. Instead, the data suggest that the osmoreceptor mechanism described by Hunt is disrupted by vagotomy.
TL;DR: In this paper, the influence of vasoactive catecholamines, epinephrine and norepinephrine, has been investigated in regard to the comparative ulcerogenicity on the gastric glandular mucosa of the rat.
Abstract: The influence of the vasoactive catecholamines, epinephrine and norepinephrine, has been investigated in regard to the comparative ulcerogenicity on the gastric glandular mucosa of the rat. The unique extensive, hemorrhagic necrosis, and ulcerations which appear in the fundus—but not the antrum—following single injections of these drugs are readily quantified because of the continuous nature of the lesion. A standard assay has been developed with this new ulcer model, which results in extensive mucosal ulceration (43% of fundus with lesions) in 100% of treated animals after only 5 hr. The optimal procedure requires the single intraperitoneal epinephrine injection of 0.4 mg/kg to young adult Sprague-Dawley rats 4 hr after pylorus occlusion, and the sacrifice of animals 1 hr after injection. This experimental gastric lesion is dependent upon the presence of gastric acid, and is completely inhibited by bilateral vagotomy, and almost completely inhibited by the presence of a magnesium-aluminum hydroxide gel-type antacid.
TL;DR: Gastric ulcers were produced in rats by forced muscular exercise (“exertion ulcers”) and are proposed as an assay for antiulcer agents, with main advantages are rapidity, simplicity, reproducibility and quantitation.
Abstract: Gastric ulcers were produced in rats by forced muscular exercise (“exertion ulcers”). These ulcers were multiple, bleeding, located in the corpus, consisted of hemorrhagic necrosis of the mucosa, and could easily be counted. The animals were fasted overnight prior to exertion. Female rats were more sensitive than males to this type of ulcer. Agents known to reduce gastric acidity (anti-cholinergics, antacids, mercuric acetate) prevented their formation, as did prednisolone. Neither adrenalectomy nor administration of desoxycorticosterone affected these ulcers. During exertion, volume and acidity of gastric juice were reduced. Although the pathogenesis of these ulcers remains to be elucidated, the following chain of events is offered as a hypothesis: Exertion (severe stress) → vascular shock → impairment of gastric circulation → gastric anoxia → decreased resistance to autodigestion → ulcers.
TL;DR: In an attempt to ascertain which of these two modalities is more sensitive in detecting esophageal disease, 27 patients with biopsy-proven progressive systemic sclerosis were studied and manometry provided the more accurate index of esophages involvement.
Abstract: Progressive systemic sclerosis commonly involves the esophagus. Both conventional recumbent barium esophagrams with fluoroscopy and esophageal manometry have been used to determine such involvement. In an attempt to ascertain which of these two modalities is more sensitive in detecting esophageal disease, 27 patients with biopsy-proven progressive systemic sclerosis were studied. Manometry provided the more accurate index of esophageal involvement. Indeed, as demonstrated in this study, normal barium studies do not exclude extensive esophageal disease.
TL;DR: Gastrin appears to enhance gastric motility through specific effects on gastric electric activity through specific Effects on gastrin pentapeptide and synthetic human gastrin I.
Abstract: In each of 9 dogs, eight electrodes were implanted serially from the fundus to the pylorus on the anterior serosal surface of the stomach. After recovery, the effect of a gastrin pentapeptide and synthetic human gastrin I on the pattern of electric activity was determined. Both hormones given subcutaneously (2.5 μg/kg) had similar effects. They increased the mean frequency of the gastric pacesetter potential (PP) from 5.2 to 6.0 cycles/min. These hormones also increased the mean incidence of bursts of action potentials associated with cycles of the antral PP from 10 to 86%, but they did not consistently alter the velocity of PP propagation in the corpus (0.3 cm/sec) or antrum (1.7 cm/sec). The duration of the bursts of action potentials, 10 min after gastrin pentapeptide, was approximately 4 sec both in the corpus and in the antrum, but the width of the caudally progressing band of action potentials was greater in the antrum (3–6 cm) than in the corpus (less than 3 cm). The onset of changes in the pattern of electric activity occurred within 2 min after an intravenous infusion of gastrin pentapeptide (0.1 μg/kg/min) was started, and the effects began to subside between 3 and 5 minutes after the intravenous infusion was stopped. Gastrin appears to enhance gastric motility through specific effects on gastric electric activity.
TL;DR: Although it is believed that this disease is part of the spectrum of ulcerative colitis, its anatomic confinement to the distal colon allows prediction of a much more benign clinical course.
Abstract: Ulcerative colitis confined to the rectum or rectum and sigmoid was studied in 234 patients. During a prolonged period of follow-up, these patients had an extremely benign clinical course when compared with that experienced with the diffuse disease. A minimum of morbidity and not a single death occurred. Only 10 patients required operation on the colon for control of disease. Extracolonic manifestations were virtually absent. No malignant degeneration occurred. Although we believe that this disease is part of the spectrum of ulcerative colitis, its anatomic confinement to the distal colon allows prediction of a much more benign clinical course.