[Continuous daily blood-sugar profile in relation to serum insulin in subjects with normal metabolism and ideal or normal weight (author's transl)]

Continuous blood-sugar measurement is at present the most suitable method for testing daily blood sugar profile. It allows to relate variations in blood sugar levels in metabolically normal subjects to body weight. Mean blood-sugar level and postprandial blood-sugar variations are greater in those of normal than of ideal weight. At the same time, metabolically normal subjects of normal weight have a high insulin secretion in the fasting and postprandial states. This makes it likely that those of normal weight, although it is only slightly different from those of ideal weight, have already reached a transitional stage to an increased diabetes risk from over-weight.

Effects of secretin and cholecystokinin on motor activity of human jejunum. A radiotelemetering study of jejunal motility during secretin and cholecystokinin intravenous infusion

The effects of intravenous administration of secretin and cholecystokinin (CCK) on motility of the human jejunum were investigated with pressure-sensitive radiotelemetering capsules. Secretin inhibited and CCK stimulated the spontaneous motor activity of this part of the small intestine. Raising the dosages of the two hormones caused increasing effects. It seems likely, therefore, that both hormones play a role in the regulation of intestinal motility in man.

Effects of somatostatin on gastric secretion and gastrin release in man

Somatostatin, a recently synthesized hypothalamic growth hormone release-inhibiting factor (GIF), was used in the cyclic and linear form. In all subjects studied, the cyclic GIF inhibited gastrin secretion during basal conditions as well as during a standard food stimulus, with immediate rebound after the infusion was stopped. Similar responses were observed in a hypophysectomized patient, indicating that this effect of GIF was independent of suppression of growth hormone secretion. Cyclic and linear GIF, when administered in normal subjects during an infusion of synthetic human gastrin I, almost totally suppressed gastric secretion. The results indicate that GIF is a potent inhibitor of gastric secretion and gastrin release.

Influence of ethanol, caffeine and intragastric cooling on gastrin and insulin secretion in man

In man, oral administration of coffee (277 mg caffeine) caused a striking increase in gastrin secretion, as measured by radioimmunoassay. The radioimmunologically measurable insulin and blood glucose remained unaffected. In response to oral ingestion of ethanol, only a slight but biologically not impressive gastrin and insulin increase was found. Intragastric cooling did not have any distinct bearing on the release of gastrin and insulin. Results indicate that gastrin is an important mediator of the stimulatory effect of caffeine on gastric acid secretion, whereas ethanol acts directly on the parietal cells by local irrigation and not via gastrin release.

Effect of acetazolamide on the insulin response to intravenous administration of secretin

In 15 subjects, secretin administered intravenously increased the insulin secretion significantly as well as volume and bicarbonate content of the duodenal juice. The inhibition of the exocrine pancreas by acetazolamide did not influence the <i>β</i>-cytotropic effect of secretin. The loss of this effect in patients suffering from chronic pancreatic insufficiency seems, therefore, to be caused, not by the decreased volume and bicarbonate secretion, butby other unknown factors.

A review of the management of 100 cases of benign stricture of the oesophagus

One hundred cases of benign stricture of the oesophagus treated over a period of 11 years from 1960 to 1971 under the care of the senior author (D.M.M.) at Frenchay Hospital Thoracic Unit are reviewed. The results indicate that the commonest site of the lesion is in the lower third of the oesophagus and that the commonest cause is peptic oesophagitis due to gastric reflux and associated hiatus hernia. As the disease is commoner in the elderly a conservative medical regimen of dilatation, antacids, and posturing is recommended as the first line of treatment. When this fails surgery is necessary. Collis (1965) managed 69 patients by gastroplasty. Belsey (1965) reported his experience with colon transplants, while Brain (1967) and Allison (1970) advised jejunal transplantation. Our experience has shown that in view of the old age and often poor physical condition of these patients resection of the stricture and oesophagogastric anastomosis is a relatively safe and simple procedure. The results obtained indicate that 25% of patients operated on will require future dilatations.