Emotion-related gastritis

The relationship of emotional stress to abnormalities of the gastric mucosa was considered in a review of 788 consecutive upper gastrointestinal endoscopies. Fifty-three precent of patients with gastritis not related to any generally accepted predisposing or precipitating cause had significant emotional problems documented on their clinical records, while only 10% of the comparable group of duodenal ulcer patients and 25% of a similar group of medical in-patients had significant emotional problems documented. Since this difference was statistically significant (P less than 0.01 and P less than 0.05, respectively), the data suggest that emotional stress may play a contributing role in the production of gastric mucosal abnormaltieis.

Absence of effect of bran on blood-lipids

Healthy medical students were divided into two groups. One group was given double the normal fibre intake of their diet as a high-fibre-containing breakfast cereal; the other group (control) was given a breakfast cereal containing negligible amounts of dietary fibre. Otherwise the nutrient intake of the two groups was maintained constant. No differences in the serum-cholesterol, serum-triglyceride, serum-calcium levels were found between the two groups during or at the end of the study. The addition of a tolerable amount of dietary fibre to the diet does not affect serum-lipids.

Increase in urinary indican excretion in pancreatic steatorrhoea following replacement therapy

Urinary indican excretion was studied in 5 patients with steatorrhoea of pancreatic origin, 4 patients with steatorrhoea due to other causes, and 5 normal subjects. Treatment with pancreatic extract resulted in an immediate increase in indican excretion to above the normal range in patients with steatorrhoea due to pancreatic insufficiency. Administration of pancreatic extract did not result in a rise in the patients with steatorrhoea not due to pancreatic insufficiency, or in the normal subjects. In one patient with pancreatic insufficiency maintained on a low protein diet, the rise in indican excretion on replacement therapy was much slower and did not reach as high a level as in the patients on a normal protein diet. The possible mechanisms underlying these observations are discussed. It is suggested that the finding of a low indican excretion in the presence of steatorrhoea and its rise to above normal on pancreatic enzyme therapy is strongly suggestive of exocrine pancreatic insufficiency.

Control factors in the release of gastrin by direct electrical stimulation of the vagus

The release of gastrin by direct electrical stimulation of the vagus was studied together with the relative effects on the response of antral and duodenal acidification. As expected, gastrin levels increased to three times the normal simulated response following antral neutralization. In contrast, duodenal acidification failed to influence the vagal release of gastrin when the antrum was neutralized although it had a minor effect when the antrum was acidified. Thus the antral pH dominates over duodenal pH as a factor in controlling gastrin release. Surprisingly, atropine in doses which blocked acid release and produced marked cardiac effects failed to inhibit the release of gastrin from the antrum on vagal stimulation. This suggests that, using this model, vagal release of gastrin, if cholinergic, is highly resistant to atropine.

The content of vitamin E in British diets

1. Analysis of whole daily diets of normal subjects and of diets prepared in hospital to resemble the home diets of ambulant hospital patients showed that the majority of diets in Britain have a vitamin E content less than the lowest recommended intake of 5 mg/d, despite being generally satisfactory in calorie, protein and fat contents.

2. Comparison of measured intake of vitamin E with the intake calculated from food tables showed that the use of such tables may be unreliable.

3. Analyses of selected representative foods and of duplicate whole diets showed that the variations between measured vitamin E content of diets and those calculated from tables may be largely due to the great variability of tocopherol concentration in apparently similar samples of food.

Treatment of ocular myasthenia with corticotrophin

Nine patients with severe myasthenia gravis, including ocular symptoms, who did not respond to anticholinesterase therapy were given prolonged courses of corticotrophin. In all patients except one there was an initial deterioration, sometimes necessitating assisted respiration, followed by a marked improvement which persisted for many weeks and occasionally months. It is concluded that corticotrophin should be continued for at least two weeks as the onset of the remission might be delayed. Repeated courses or small maintenance doses prolonged the remission. Fluid retention and hypokalaemia were common unwanted effects but necessitated stopping the treatment in only one patient.