Membrane potential and mechanical responses of the opossum esophagus to vagal stimulation and swallowing

Studies were performed in anesthetized opossums. The electrical changes, recorded using a suction electrode applied to the outside of the esophagus, and mechanical activity, recorded by an intraluminal catheter, were monitored from 5 cm above the lower esophageal sphincter. Swallowing was associated with membrane hyperpolarization followed by depolarization and spike burst. Electrical stimulation of the decentralized vagus also caused a prompt hyperpolarization followed by an overshoot depolarization. Single pulses of stimulation caused primarily hyperpolarization. The amplitude and duration of hyperpolarization increased with increasing frequencies of vagal stimulation. Spike burst occurred as the membrane potential was recovering from the peak hyperpolarization and moving toward peak depolarization. The latency of onset of spike burst decreased with increasing frequency of vagal stimulation. The muscle contraction occurred after a latency. The latency of contractions, like the latency of spike burst, decreased with increased frequency of vagal stimulation. These studies show that (a) membrane hyperpolarization is present during the latent period of contraction associated with swallowing, suggesting that swallow-induced esophageal response may be mediated by vagal inhibitory pathway to the esophagus and (b) spike bursts can be temporally dissociated from depolarization by changing the vagal stimulation frequency, suggesting that spike burst and depolarization may be mediated by different excitatory mechanisms.

The inhibitory effect of clonidine on the oestrogen-primed rat isolated uterus

The investigation was undertaken to study the mechanism of the inhibitory effects of clonidine on the oestrogen-primed rat isolated uterus. Clonidine produced dose-dependent relaxations of the rat isolated uterus which were competitively blocked by yohimbine but not by prazosin. Metiamide, a specific H2-histamine receptor antagonist, inhibited clonidine-induced responses only at a high concentration (1.0 X 10(-6)M). Propranolol, a beta-adrenoreceptor antagonist produced competitive antagonism of the clonidine responses. Like clonidine, noradrenaline also produced dose dependent relaxations of the rat isolated uterus. The responses to noradrenaline were not antagonized by either prazosin or yohimbine but were competitively antagonized by propranolol. The responses to clonidine were significantly inhibited by reserpine pretreatment (5 mg/kg; i.p., 24 h before) whilst responses to noradrenaline were significantly increased by this treatment. It is concluded that clonidine inhibits the uterus via an action on alpha 2-adrenoreceptors and possibly also to a lesser extent on H2-histamine receptors, leading ultimately to release of noradrenaline from endogenous stores which causes relaxation by acting on beta-adrenoreceptors.

Influence of successive vagal stimulations on contractions in esophageal smooth muscle of opossum

Studies were performed in anesthetized opossums to investigate the influence of successive vagal stimuli on esophageal contractions. Mechanical activity was recorded manometrically 5 cm above the lower esophageal sphincter. Contractions in the esophagus were evoked by electrical stimuli of 2.5 mA, and 1-ms pulse duration applied to the cervical vagi, at various train durations and frequencies. Paired or multiple stimuli of 1-s train length were also tested at different interstimulus intervals (ISI). Paired stimuli at an ISI of less than or equal to 3 s and at a frequency of less than or equal to 10 Hz showed refractoriness, i.e., the contractions to the first stimulus inhibited the contraction to the second stimulus. A frequency of 50 Hz showed initial inhibition, i.e., the second stimulus inhibited the contraction to the first stimulus. Repetitive stimuli applied at a rate of 8/min (ISI 6.5 s) evoked contractions to each stimulus. At 15/min, every second or third contraction was inhibited. With stimuli applied at 30/min, contractions occurred only in response to the first and/or the last stimulus; depending upon the frequency of vagal stimulation. The intervening stimuli did not evoke any contractions. A long train stimulus produced an initial, a terminal, or both contractions depending on the stimulation value. These studies show that (a) vagal efferent stimulation causes initial inhibition and refractoriness in the esophageal smooth muscle; (b) the degree of initial inhibition increases with increasing frequency of stimulation; (c) the occurrence of contractions only at the onset and the end of a long train stimulus may be due to the influence of initial inhibition and refractoriness.

A computer-assisted technique for 24-hour esophageal monitoring

Modern computer design offers the opportunity to rapidly and objectively analyze the large quantity of data obtained during prolonged intraesophageal monitoring. The purpose of this study is: (1) to describe a rapid automated technique for acquisition and analysis of esophageal parameters, using a microcomputer; and (2) to compare computerized versus manual analysis of physiograph recordings. Ten normal subjects underwent 24-hr computerized monitoring of intraesophageal function, including: (1) pH recording at 5 and 10 cm above the lower esophageal sphincter (LES); (2) pharyngeal contraction; (3) esophageal contraction at 5 and 10 cm; (4) posteriorly directed LES pressures; and (5) gastric pressure. Segments from several studies were chosen for comparison of physiograph data with that obtained by computer. No significant differences were found except for the number of esophageal contractile events. This difference stems from a problem of shifting baseline related to subject position. Thus, the computer can be used for analysis of large quantities of data obtained from prolonged esophageal monitoring.

Vasoactive intestinal peptide causes peristaltic contractions in the esophageal body

Vasoactive intestinal peptide (VIP) caused a dose-dependent fall in lower esophageal sphincter (LES) pressure and dose-dependent contractions in the body of the esophagus. The response to VIP in the esophagus or LES was not modified by atropine, phentolamine, haloperidol, pyrilamine, methysergide, indomethacin and tetrodotoxin, showing that is exerts direct action at the esophageal smooth muscle. These studies suggest that VIP causes contraction in the esophageal body and relaxation of the LES by a direct action on the smooth muscle. It is possible that VIP may be the common mediator of noncholinergic, nonadrenergic neurons that cause relaxation of the lower esophageal sphincter and contraction in the esophageal body.

Mechanism of action of histamine in the estrogen-primed rat uterus

Histamine produced a dose-dependent relaxation of uterine strips obtained from the estrogen-primed rat uterus. The responses to histamine were blocked competitively by metiamide (10(-8)-10(-8) M), a specific H2-receptor antagonist. Propranolol, a selective beta-receptor blocker also produced competitive antagonism of the responses to histamine in the same dose range (10(-8)-10(-6) M). The pA2 value obtained for metiamide (8.9) was not significantly different from that obtained for propranolol (8.6). Nialamide (2.2 X 10(-6) M), the monoamine oxidase inhibitor, and cocaine (4.3 X 10(-6) M), the selective noradrenaline uptake blocker, potentiated the responses to histamine. However bretylium (2.4 X 10(-5) M), and adrenergic neuron blocker inhibited the responses to histamine. The combined effect of tyramine and histamine was found to be additive. Our data suggest that the histamine-induced relaxation of rat uterus may be produced through the stimulation of presynaptic H2-receptors which causes the release of noradrenaline. The released noradrenaline acts on the postsynaptic beta-receptors and produces relaxation of the rat uterus.

Comparative studies of the effects of 5-hydroxytryptamine and noradrenaline on the rat anococcygeus muscle

The effects of 5-hydroxytryptamine (5HT) and noradrenaline (NA) have been studied on rat anococcygeus muscle. 1. 5HT and NA produced a dose-dependent contraction of rat anococcygeus muscle. Cyproheptadine (1.0 X 10(-6) M), a specific 5HT receptor blocker, failed to inhibit the responses to either 5HT or NA. 2. However, phentolamine, a specific alpha receptor antagonist competitively blocked the responses to 5HT and NA. 3. The responses to 5HT were inhibited in the reserpinized (5 mg/kg i.p. 24 h) and 6-hydroxydopamine (6-OHDA) pre-treated preparations. 6-OHDA produced a leftward shift of the dose-response curve of NA. Reserpine pre-treatment potentiated lower doses of NA and the threshold dose of NA was significantly decreased. 4. Nialamide (2.2 x 10(-6) M), the mono-amine oxidase inhibitor produced a significant leftward shift of the dose-response curve of both 5HT and NA. Pyrogallol (2.3 x 10(-5) M), the catechol-o-methyl transferase inhibitor also potentiated the responses to both 5HT and NA, but the potentiation was significant at lower doses of 5HT and NA. 5. Our data suggest that 5HT- and NA-induced contractions in rat anococcygeus muscle are mediated through common alpha adrenoceptors. 5HT actions are probably indirect, mediated through the release of NA.

Modulation of esophageal peristalsis by vagal efferent stimulation in opossum

Experiments were performed on anesthetized opossums to study the influence of vagal efferent stimulation on peristalsis in the esophageal smooth muscle using various stimulus parameters. Current intensity, pulse duration, frequency, and train duration were varied systematically. Electrical and mechanical activities were recorded simultaneously at 5, 3, and 1 cm above the lower esophageal sphincter (LES). Vagal efferent stimulation produced a spike burst and contraction with a latency after the termination of the stimulus. This latency varied at different sites with the same stimulus parameters. For example, a stimulus of 5 mA, 0.5 ms, 10 Hz, and 1-s train produced latencies for the electrical response of 1.48 +/- 0.04, 2.2 +/- 0.12, and 3.5 +/- 0.09 s (+/- SEM) at 5, 3, and 1 cm above LES, respectively. The differences in latency were statistically significant (P less than 0.01). The latency of response at any one site also changed with different stimulus parameters; e.g. at 1 cm above LES, the latency of electrical response at 10 Hz was 3.5 +/- 0.09 s, but at 20 Hz the latency was 2.01 +/- 0.06 s when current intensity, pulse, and train duration remained at 5 mA, 0.5 ms, and 1 s. This decrease in latency with increasing frequency was statistically significant (P less than 0.01). By changing stimulus parameters, antiperistalsis or peristalsis with different speeds of propagation could be induced. Antiperistalsis or simultaneous responses occurred near threshold stimulus parameters. Suprathreshold stimuli produced peristaltic responses. Speed of peristalsis in the distal esophagus was 1.82 +/- 0.08 cm/s with swallowing, which was not different from 1.98 +/- 0.14 cm/s (P greater than 0.05) with vagal stimulation of 5 mA, 0.5 ms, 10 Hz, and 1-s train. These studies suggest that: (a) peristalsis in the smooth muscle part of the esophagus can be explained entirely on the basis of peripheral mechanisms, and (b) the central nervous system may modulate the occurrence, polarity, and speed of propagation by modifying the intensity and frequency of vagal activation.

Pharmacological investigations into the effects of histamine and histamine analogs on guinea pig and rat uterus

The effects of histamine and its analogs 2-(2-pyridyl) ethylamine (PEA) and 4-methylhistamine (4 MH) have been studied on uterine preparations obtained from estrogen-primed guinea pigs and rats. (1) Histamine and 4 MH, a specific H2-receptor agonist produced relaxation in estrogen-primed rat uterus, whereas these agonists produced contraction in the estrogen-primed guinea pig uterus. (2) PEA, a specific H1-receptor agonist produced contraction in the guinea pig uterus but had no effect on the rat uterus. (3) Metiamide blocked responses to histamine and 4 MH in the rat uterus, whereas mepyramine blocked responses to histamine and PEA in the guinea pig uterus. (4) Propranolol produced competitive antagonism with histamine in the rat uterus, whereas it had no significant effect on the histamine or PEA responses in the guinea pig uterus. (5) Reserpine pretreatment completely abolished the responses to histamine and 4 MH in the rat uterus but did not alter the response in the guinea pig uterus. (6) Our data suggest that in rat uterus only H2-receptors are present and they are indirectly through the release of noradrenaline. In the guinea pig uterus both H1- and H2-receptors are present and are excitatory and directly acting.

Relation between electrical and mechanical activity in esophageal smooth muscle

Experiments were performed in anesthetized opossums. Electrical and mechanical activity was recorded simultaneously from the esophageal body at 5, 3, and 1 cm above the lower esophageal sphincter (LES). Esophageal responses were evoked by electrical stimulation of vagal efferents or by induced swallowing. Electrical and mechanical activity was associated in 86% and dissociated in 14% of the 1,200 responses examined. The frequency of dissociation was dependent on the site in the esophagus and the frequency of vagal efferent stimulation (P less than 0.05). The interval between the onset of electrical and mechanical events, called electromechanical delay, had a regional gradient: 5 cm above LES greater than 3 cm greater than 1 cm (P less than 0.01). This delay was also dependent on the frequency of stimulation. The amplitude of spike burst and the number of spikes in a burst closely correlated with the amplitude of contraction. These studies show that electromechanical responses and dissociations are dependent on the regional level in the esophagus and the frequency of vagal stimulation.

Histaminergic H1 and H2 excitatory receptors in the guinea pig uterus and taenia coli

Histamine, 2-(2-pyridyl)ethylamine (PEA), a specific H1 receptor agonist, and 4-methylhistamine (4-MH), a specific H2 receptor agonist, produced a dose-dependent contraction of estrogen-primed guinea pig uterus and taenia coli. Mepyramine (10(-7) M), a specific H1 receptor antagonist, competitively blocked the responses to histamine and PEA in both the preparations. Metiamide (10(-6) M), a specific H2 receptor antagonist, inhibited the responses to histamine and 4-MH in the guinea pig uterus and taenia coli. Our data suggest the presence of both H1 and H2 receptors in the guinea pig uterus and taenia coli. Both receptors appear to be excitatory in nature.

VIP as a possible neurotransmitter of non-cholinergic non-adrenergic inhibitory neurones

Many peripheral autonomic nerves are neither cholinergic nor adrenergic. Such nerves are widely distributed in the gastrointestinal, urogenital and respiratory tracts, and in blood vessels. The nature of their neurotransmitter is not known. We have previously reported that vasoactive intestinal polypeptide (VIP) is a potent inhibitor of opossum lower oesophageal sphincter (LOS) and that its inhibitory effect is exerted directly on the sphincter muscle. Subsequent studies have confirmed the inhibitory effect of VIP on LOS in other species. Recently, very high tissue levels of VIP have been reported in the LOS and other gastrointestinal sphincters. Furthermore, VIP has been localized to intramural neurones and is released upon electrical stimulation of the vagus nerve. We report here that immunoantagonism of VIP with a high-titre antiserum antagonized inhibitory neuromuscular transmission in the LOS. These findings provide evidence of a role for VIP as an inhibitory neurotransmitter.

Influence of vagus nerves on electrical activity of opossum small intestine

Experiments were performed in anesthetized opossums to study the nature of vagal control on the small bowel. Electrical activity was recorded in the duodenum, jejunum, and ileum with silver chloride electrodes. Slow waves and spike potentials were observed at all three sites. There was a decreasing frequency gradient of slow waves and the incidence of slow waves with spikes in the aboral direction. Vagotomy had no effect on the electrical activity. Vagal stimulation at threshold stimuli inhibited spike potentials in all three segments of small intestine, but slow waves were not affected. Vagal stimulation after sectioning of the gut proximal to the electrodes converted the response from inhibition to excitation. These studies suggest that a) vagus carries both excitatory and inhibitory influences to the small bowel; b) inhibitory influences are dominant in the intact opossum small intestine; and c) the nature of the response obtained with vagal stimulation may be explained on the basis of the paths taken by inhibitory and excitatory fibers.

Evidence against purinergic inhibitory nerves in the vagal pathway to the opossum lower esophageal sphincter

Studies were performed on anesthetized opossums. Lower esophageal sphincter pressures were measured with waterfilled and continously perfused catheters anchored in the sphincter. Administration of adenosine 5'-triphosphate (ATP) and ADP in the left gastric artery usually produced an initial contraction followed by a more prolonged inhibition. Adenosine, on the other hand, produced only inhibition. The effect of ATP was not modified by phentolamine (1 mg/kg), propranolol (1 mg/kg) or atropine (30 micrograms/kg). Tetrodotoxin partially antagonized (P less than 0.05) the inhibitory effects of ATP and adenosine, but augmented the excitatory effect of ATP (P less than 0.05). 2-2'-Pyridylisatogen tosylate selectively antagonized the effects of ATP without modifying the effect of adenosine. This antagonist, however, did not modify the resting sphincter pressure or the vagal stimulated sphincter relaxation. Dipyridamole enhanced the inhibitory effect of adenosine, but did not augment vagal stimulates sphincter relaxation. There was no cross-tachyphylaxis between ATP and adenosine. Tachyphylaxis, either to ATP or adenosine, did not inhibit the vagal stimulated sphincter relaxation. These studies show that: (a) ATP and adenosine may act on different receptor sites to modify sphincter pressure; (b) only a small part of the inhibitory effect of ATP and adenosine is mediated by the inhibitory neurons; (c) neither ATP nor adenosine appears to be the inhibitory transmitter released by the noncholinergic, nonadrenergic inhibitory neurons in the vagal pathway to the lower esophageal sphincter.

Effects of sodium nitroprusside and verapamil on lower esophageal sphincter

Infusions of verapamil (V) and sodium nitroprusside (NP) caused dose-dependent reductions in the lower esophageal sphincter pressure (LESP) in anesthetized opossums. Verapamil caused a gradual fall during the infusion and a gradual recovery upon cessation of the infusion. On the other hand, NP caused a prompt reduction and a prompt recovery. Both the agents also caused a fall in arterial blood pressure, but the fall in LESP was not related to the fall in the blood pressure. Both the agents antagonized the tonic and the phasic components of the LESP and, in large doses, both drugs almost abolished the LESP. Esophageal contractions were also antagonized by both agents, although verapamil was more effective than nitroprusside in this regard. These studies show that phasic and tonic components of LESP are not related to distinctive verapamil and nitroprusside sensitive calcium activation systems. Moreover, the V- and NP-sensitive calcium activation systems may lie in series rather than parallel.

Morphological evaluation of opossum lower esophageal sphincter

Studies were performed in the opossum to evaluate the morphological characteristics of the lower esophageal sphincter. The sphincter and the esophageal body were identified manometrically and fixed in situ by perfusion with aldehyde fixative. Light microscopy revealed that: (1) longitudinal muscle layers of the sphincter and the esophageal body were similar in thickness and compactness, and (2) circular muscle of the sphincter was thicker and was composed of muscle fasciculi with abundant intervening connective tissue as compared to the compact muscle fasciculi of the circular muscle of the esophageal body. Electron microscopy showed the circular muscle fibers of the sphincter to have irregular protuberances from their surfaces, whereas the circular muscle fibers of the esophageal body possessed smooth surfaces. Several types of junctional complexes between adjacent muscle fibers were observed; however, there was no difference in their distribution in the sphincter or esophageal body. The majority of the nerve varicosities contained a mixture of agranular (350 to 450 A) and large dense core vesicles (800 to 1600 A); varicosities containing small granular vesicles were not found in any area of the esophagus. When varicosities were cut along the longitudinal axis of the axon, they often showed grouping of similar vesicle types in different areas along the axon varicosities. There was no difference in the type of varicosities found in the sphincter or the esophageal body. These studies show that: (1) circular muscle of the sphincter can be morphologically distinguished from that of the esophageal body; (2) there is no difference in the morphology of the nerve terminals or the vesicle types in the two areas; and (3) classification of the varicosities based upon the predominance of the vesicle types may be artifactual because of sampling error.

Electrical activity of the opossum lower esophageal sphincter in vivo. Its role in the basal sphincter pressure

Studies were performed in anesthetized opossums to investigate the electrical activity that may characterize the lower esophageal sphincter. The stomach and lower end of the esophagus were immobilized on a specially prepared stage to eliminate movement artifacts. Extracellular electrical activity was recorded with bipolar needle electrodes. The sphincter pressure was measured with a continuously perfused catheter system. The lower esophageal sphincter showed continuous spike activity with or without phasic variations in their occurrence. The usual frequency of the spikes was 20 to 50 per min, and their duration was 81.2 +/- 8.9 msec (mean +/- SE). The spike potentials ceased with esophageal distention, which also caused a fall in the sphincter pressure. The spikes were abolished by isoproterenol and they increased with bethanechol. Correlation of the spike activity with the pressure revealed that the sphincter pressure was higher when the spike potentials were present, but a major part of the pressure existed in the absence of any spike activity. These studies show that: (1) the oppossum lower esophageal sphincter is characterized by continuous spike potentials, and (2) the major fraction of the basal pressure is, however, independent of the spike potentials.

Evidence of 5-HT participation in vagal inhibitory pathway to opossum LES

Studies were performed in anesthetized opossums to investigate the nature of vagal-stimulated sphincter relaxation, which is resistant to antagonism by a combination of hexamethonium and atropine. The sphincter pressures were measured with water-filled and continuously perfused catheters anchored in the lower esophageal sphincter. Neither increase in the doses of hexamethonium and atropine nor addition of diphenhydramine further modified the vagal response. However, administration of 5-methoxydimethyltryptamine in the presence of hexamethonium and atropine abolished vagally stimulated sphincter relaxation. In animals pretreated with parachlorophenylalanine, addition of atropine and hexamethonium also abolished vagally stimulated sphincter relaxation. In the experiments in which lower esophageal sphincter relaxation on vagal stimulation was abolished, the local stimulation of intramural neurons still produced normal lower esophageal sphincter relaxation. These studies suggest that 5-hydroxytryptamine may participate in the vagal inhibitory pathway to the lower esophageal sphincter.

Gastrin content of columnar mucosal lining the lower (Barrett's) esophagus

Tissue gastrin was determined in 36 biopsies obtained from the esophagus and 35 biopsies from the stomach in 12 patients with Barrett's esophagus. Histology of the mucosa from the area adjacent to the biopsy sites was also examined. Esophageal biopsies were obtained from three different sites in each patient. The gastric biopsies were obtained from the antrum, fundus, and the area just distal to the lower border of the lower esophageal sphincter. The columnar mucosa lining the esophagus was of three distinct types, namely, fundic, transitional (cardiac), or specialized. None of these epithelia nor the squamous epithelium showed any detectable gastrin. In contrast, antral mucosa had very high gastrin content; smaller amounts of gastrin were detected in duodenal epithelium, whereas fundic mucosa sometimes contained small amounts of gastrin.

Effects of 5-hydroxytryptamine on the lower esophageal sphincter in vivo: evidence for multiple sites of action

Intravenous administration of 5-hydroxytryptamine (5-HT) caused a dose-dependent contraction in the lower esophageal sphincter in the opossum. The smallest dose of 5-HT which caused a detectable contraction of the sphincter was 0.5 mug/kg, and a maximal sphincter contraction was produced by a dose of 40 mug/kg. Methysergide converted the contractile effect of 5-HT to a dose-dependent fall in the sphincter pressure; maximal inhibition of 77.2 +/- 7.2% of the resting pressure occurred with a dose of 40 mug/kg. The inhibitory effect of 5-HT was antagonized by tetrodotoxin, 5 MeO-DMT, and 5-HT tachyphylaxis. 5 MeO-DMT enhanced 5-HT-induced contraction of the sphincter. In the presence of 5 MeO-DMT and methysergide, 5-HT still caused a brief contraction of the sphincter; this contraction appeared to be due to stimulation of postganglionic cholinergic neurons as it was antagonized by tetrodotoxin or atropine. Reserpinization caused enhancement of the sphincter contraction by 5-HT. In the reserpinized animals in the presence of methysergide, 5-HT caused a small initial contraction followed by prolonged inhibition; atropine antagonized the initial contraction, while inhibition was antagonized by 5 MeO-DMT. These studies are consistent with the view that 5-HT exerts several different effects on the sphincter. 5-HT causes contraction of the sphincter by its direct action on the muscle and also by stimulation of cholinergic excitatory neurons. In addition, 5-HT inhibits the sphincter by stimulation of nonadrenergic inhibitory neurons.

Clinical trial in patients with diabetes mellitus of an insulin-like compound obtained from plant source

Clinical study of an insulin-like compound obtained from vegetable source (vegetable insulin) was carried out on nine patients with diabetes mellitus. The active hypoglycaemic principle, purified protein extract, was obtained from fruits as well as from tissue cultures of the plant Momordica charantia L. This extract was homologous to insulin obtained from animal pancreas. It showed a consistent hypoglycaemic effect in patients with diabetes mellitus. The average fall in blood sugar level at the peak effect of vegetable insulin was found to be statistically significant. The onset of action was within 30-60 min with the peak effect six hours after the administration of the dose of plant insulin. No hypersensitivity reaction to this extract was observed in the group of patients studied.

Physiological and clinical studies on norms and variations in counts of circulating basophile leucocytes

Variations in the counts of circulating basophile leucocytes in 225 subjects were studied. The results obtained are as follows: 1) The counts (per mm3) show a gradual rise with growth, from infancy to adolescence, and maintain a fair constancy in adults. 2) No significant sex difference was found in the peripheral basophile counts. 3) A definite diurnal variation in the counts exists, which is lowest in the morning and highest in the evening. 4) the counts are altered in different phases of the menstrual cycle. 5) Pregnant women show lower counts than nonpregnant women. 6) Surgical trauma and a single electroconvulsive shock lowers the counts significantly but variations are not significant after meals and physical exercise. 7) Smokers have slightly higher counts than non-smokers. 8) course of irradiation therapy lowers the counts significantly in patients with inoperable noplastic diseases. 9) Counts show insignificant variation with alteration of blood glucose level. The results mentioned above are discussed.

The histologic spectrum of Barrett's esophagus

To define the histology of the columnarlined esophagus, we obtained esophageal biopsies from various levels with manometric control from 11 patients. There were three types of columnar epithelia above the lower esophageal sphincter: atrophic gastric-fundic-type epithelium with parietal and chief cells; junctional-type epithelium with cardiac mucous glands; and distinctive specialized columnar epithelium with a villiform surface, mucous glands and intestinal-type goblet cells. When present, specialized columnar epithelium was always the most proximal, and gastric fundic epithelium the most distal epithelium. Junctional epithelium was interposed between gastric fundic and specialized columnar or squamous epithelium. Four patients had unequivocal esophagitis in squamous epithelium, but its presence and severity did not correlate with inflammation in or length or type of distal columnar epithelium. Histoligic study of the columnar-lined esophagus demonstrated a spectrum of epithelial patterns. This heterogeneity helps to explain prior discrepant reports.

Genesis of basal sphincter pressure: effect of tetrodotoxin on lower esophageal sphincter pressure in opossum in vivo

Currently it is believed that lower esophageal sphincter closure is maintained by tonic neurohormonal activity. Studies were performed to evaluate the role of neural and myogenic activity in the genesis of resting sphincter pressure in the opossum. The neural activity in the sphincter was blocked by intravenous administration of the puffer fish poison, tetrodotoxin, in intact animals. The respiration in these animals was assisted with a respirator, their blood pressure was supported by intravenous administration of Ringer's solution, and their body temperature was maintained by heating lamp. The lower esophageal sphincter pressures were measured with water-filled and continuously perfused catheters which were anchored to the lower esophageal sphincter using a new technique. Tetrodotoxin blocked the sphincter response to neural stimulation with vagal stimulation, esophageal distention, and local electrical stimulation of the sphincter. The mean resting sphincter pressure before tetrodotoxin was 59.0 +/- 2.6 mm Hg, and it was 64.4 +/- 6.9 mm Hg after tetrodotoxin (P greater than 0.05). During neural block with tetrodotoxin, the sphincter response to administration of isoproterenol or bethanechol was similar to that during the control period (P greater than 0.05). These studies show that: (1) Tetrodotoxin can be administered in intact animals to achieve complete block of neural activity in the lower esophageal sphincter; (2) sphincter muscle is not adversely affected by tetrodotoxin; and (3) block of neural activity does not alter the resting lower esophageal sphincter pressure.

The mechanism of action of gastrin on the lower esophageal sphincter

Gastrin I or pentagastrin caused contraction of the lowe esophageal sphincter in anesthetized oppossums. The contraction was not modified, either qualitatively or quantitatively, by 30 or 1000 mug per kg atropine pretreatment. Moreover, neural block with tetrodotoxin did not influence the effect of gastrin on the sphincter pressure. H2 receptor antagonist, metiamide, did not modify the magnitude of the contractile response of the lower esophageal sphincter to gastrin I. These studies show: a) gastrin does not cause sphincter contraction by stimulating cholinergic neurons: and b) gastrin does not exert an inhibitory effect on the sponcter pressure by stimulating H2 receptors. We suggest that gastrin may contract the lower esophageal sphincter by a direct action on the sphincter muscle.

Effect of dopamine on the esophageal smooth muscle in vivo

Intravenous administration of dopamine caused a dose-dependent reduction in the lower esophageal sphincter pressure and contractions in the lowermost part of the body of the esophagus in the opossum. A dose of 5 mug per kg produced maximal response. The onset of contractions in the body occurred around 20 sec after the onset of the sphincter response. The effect of dopamine was different from isoproterenol, which caused no contractions in the body and caused reduction in sphincter pressure, and from phenylephrine, which also caused no contractions in the body but caused contraction of the sphincter. Moreover, the effect of 5 mug per kg of dopamine was blocked by haloperidol but not by phentolamine, propranolol, bilateral cervical vagotomy, or tetrodotoxin. These studies suggested the presence of selective dopamine receptors which mediated contraction of the esophageal body and relaxation of the sphincter muscle. Since vagal stimulation also causes contraction in the body and relaxation of the sphincter, it was possible that vagal effect on the esophagus was mediated by dopamine receptors. However, haloperidol did not block the effect of electrical stimulation of vagus nerve on body of the esophagus or the lower esophageal sphincter.

Is gastrin a major determinant of basal lower esophageal sphincter pressure? A double-blind controlled study using high titer gastrin antiserum

Studies were performed in anesthetized opossums to determine the influence of binding of circulating gastrin with a high titer gastrin antiserum on lower esophageal sphincter pressure. Gastrin antiserum or control antiserum was administered intravenously in successive doses of 0.02, 0.1, and 0.5 ml/kg on separate days. The lower esophageal sphincter pressures were measured for 1 h before and for 1 h after antiserum administration. The control serum caused no binding of opossum circulating gastrin, nor did it modify lower esophageal sphincter pressure. On the other hand, the administration of gastrin antiserum resulted in the binding of 85-90% of circulating gastrin, but it did not reduce sphincter pressure. A continuous infusion of 0.25 mug-kg-1-h-1 of synthetic human gastrin I caused a significant (P less than 0.05) increase in the sphincter pressure, a 30-fold increase in gastric acid output, and a fourfold increase in immunoreactive gastrin in the opossum blood. Prior treatment with 0.1 ml/kg of gastrin antiserum antagonized and 0.2 ml/kg of the antiserum abolished the gastrin-stimulated gastric acid secretion and the stimulating effect of gastrin on lower esophageal sphincter pressure. However, neither dose of antiserum modified basal lower esophageal sphincter pressure. It is concluded that circulating gastrin may be an important determinant of basal sphincter pressure.

Cytomorphological variations and blood histamine in bronchial asthma

The absolute counts on basophil and eosinophil leucocytes, percentage of vacuolated eosinophil cells and whole blood histamine were determined in 30 controls and 34 patients with bronchial asthma. The basophil counts rose from the quiescent to pre-attack stage and then fell in the acute stage of bronchial asthma. The eosinophil counts, the percentage of vacuolated eosinophils and the blood histamine content increased significantly during an asthmatic attack. An attack of bronchial asthma was precipitated if the blood histamine rose to or above 200 ng/ml or a 50% rise occurred from its quiescent level. The inter-relationship between cytomorphological variations and blood histamine content in various stages of bronchial asthma is discussed.

Gastric acid secretory responses to graded intravenous doses of histamine in hookworm anemia

Dose-response curves for the effect of continuous infusion of histamine on gastric acid secretion were obtained in 10 patients with iron deficiency anemia due to hookworm infection. Each patient was studied with 4 doses (40, 60, 80 and 100 mug/kg/h) of histamine acid phosphate administered for 3 h, on separate days, in random fashion. The acid output increased with the dose of histamine, the maximal acid output was reached in all patients at the dose of 100 mug/kg/h. The dose of histamine when calculated according to body weight correlated well with the maximal acid output; the absolute dose of histamine had no correlation with the maximal acid response. The dose-response curve of stimulated acid output in anemia patients was much flatter than in control patients.