In 240 patients with predefined indications, the validity of ultrasound imaging as a primary diagnostic procedure was examined prospectively. Ultrasonography revealed normal intestinal findings in 150 patients and pathological lesions in 90 subjects. All patients underwent subsequent endoscopic, radiological, or surgical examination. In 7 patients with Crohn's disease and in 2 patients with radiation colitis, the ultrasound findings were false-negative. In the other 9 cases, ultrasonography suggested false-positive results. Ultrasonographic examination of the small intestine and large bowel had a very high overall validity, with a sensitivity of 90% and specificity of 94%.

SUMMARY Graded doses of 0-6, 1'3, and 3.3 pmol/kg/min of vasoactive intestinal peptide (VIP) were intravenously infused over 30 minute periods in four healthy volunteers and plasma VIP levels were measured by radioimmunoassay. Even with the smallest dose of VIP, plasma concentrations rose markedly above normal values. Infusion of higher VIP doses resulted in mean plateau levels of circulating VIP which were in the range of VIP values found in the Verner-Morrison syndrome. After cessation of the VIP infusions, plasma VIP levels fell strikingly by first order kinetics with an average disappearance half-time of one minute. The apparent metabolic clearance rate was about 9 ml/kg/min and the apparent volume of distribution for VIP was approximately 14 ml/kg. During infusion of the highest VIP dose, previously shown to induce one-fifth maximum pancreatic juice secretion, plasma concentrations of glucose, free fatty acids, and calcium were slightly but significantly raised, the pulse rate and the amplitude of blood pressure were increased, and cutaneous flushing occurred. The spectrum of effects accords well with some abnormalities seen in the Verner-Morrison syndrome. The present data, however, do not support a role for VIP as a circulating hormone, at least under physiological conditions.Vasoactive intestinal peptide (VIP) was originally isolated from hog small intestine (Said and Mutt, 1970). It has been found in high concentrations not only in the entire gastrointestinal tract Polak et al., 1974) but it has also been shown to be present in central and peripheral neurons (Bryant et al., 1976;Said and Rosenberg, 1976).It remains a matter of debate whether VIP predominantly acts as a local tissue hormone, plays its major role as a neurotransmitter substance, or acts as a circulating hormone (Bryant et al., 1976 levels of VIP had been produced by the originally administered VIP infusions, the same VIP dosage was repeated in additional volunteers and the plasma levels of VIP were measured. On the data obtained a pharmacokinetic analysis was performed. In addition, some routine laboratory parameters were assessed. MethodsFour healthy male volunteers (mean age 23 + 1 years, mean body weight 72 ± 2 kg) with no history or physical findings of gastrointestinal or renal diseases were studied. All subjects gave informed written consent. The experimental protocol had been approved by the Local Ethical Committee. On separate days, in random order, four series of tests were done on each subject. After an overnight fast, the individual study was started. Through an indwelling antecubital catheter, saline solution (0-15 M NaCI) was infused at 30 ml/h with a syringe pump (Model 71100, Braun, Melsungen, W. Germany) for a basal period of 30 minutes. Then 1049 on 13 May 2018 by guest. Protected by copyright.

In a prospective randomised study, the effect of acupuncture on sham feeding stimulated gastric acid secretion was investigated. In eight healthy volunteers (five men, three women, mean (SEM) age 26-3 (4.7) years) various methods of acupuncture were performed. Apart from the sham procedure, the acupuncture was performed at the classic acupuncture points. Electroacupuncture reduced gastric acid secretion expressed as median (range) significantly during the first 30 minute period to 1-6 (0-5.2) mmol compared with 3-8 (2.3-14-5) mmol (p<0.05) during control period (sham feeding without acupuncture). Inhibition of gastric acid secretion by electroacupuncture was also significant during the second 30 minute period (0-2 (0-5.6) v 3-6 (0.3-9.1) mmol; p<0.05) and for peak acid output (0.8 (0.2-5.1) v 7'6 (3.4.12-1) mmol; p<0.05). Transcutaneous electrical nerve stimulation also resulted in significant reduction of gastric acid secretion during the first 30 minute period (1-0 (0-3.6) mmol v 3-8 (2.3-14.5) mmol; p<005), and peak acid output (3-6 (1*2-12*0) v 7*6 (3.4-12-1) mmol; p<0.05). The classic needle acupuncture, laser acupuncture, and sham acupuncture had no significant effect on gastric acid secretion. This study shows firstly that in healthy volunteers, only the versio;is of acupuncture using more pronounced stimulation (electroacupuncture, transcutaneous electrical nerve stimulation), but not those with only mild stimulation of the nerves (classic needle acupuncture, laser acupuncture), and secondly only acupuncture performed at defined points lead to significant reduction in gastric acid secretion. (Gut 1994; 35: 1026- MethodsEight healthy subjects (five men, three women, mean (SEM) age 26-3 (4.7) years) took part in the study. As one participant failed to complete the study, the data of seven volunteers were considered for evaluation. Different methods of acupuncture used included needle acupuncture, electroacupuncture, laser acupuncture, and transcutaneous electric nerve stimulation. Apart from sham acupuncture the acupuncture was performed at the classic acupuncture points. For the control period sham feeding without acupuncture was given in all subjects in the study.The subjects gave their written informed consent, and the study protocol was accepted by the ethics commission

The present study was performed to compare pain‐related oesophageal motility, gastro‐oesophageal reflux and ST‐segment deviations in patients with intermittent chest pain and normal or pathological coronary angiography. Thirty patients (11 males, 19 females; mean age 54.8 years) with normal and 15 patients (12 males, 3 females; mean age 66.7 years) with pathological coronary angiography were investigated by 24‐h oesophageal pressure, pH and ECG recording. Chest pain correlated with motility abnormalities or gastro‐oesophageal reflux occurred in 33% (10/30) of patients with normal coronary arteries and in 26% of patients with pathological coronary angiography. Symptomatic and asymptomatic ST‐segment changes were less frequently observed in patients with normal angiography (4/30) than in patients with pathological coronary angiography (7/14; P = 0.02). Oesophageal dysfunction coincided with ST‐segment deviation in 6.7% (2/30) of patients with normal and 40% (6/15) of patients with pathological coronary angiography (P = 0.02). The conclusions reached were: (1) pain‐correlated abnormal motility or gastro‐oesophageal reflux occurred in patients with normal and pathological coronary angiography at the same frequency; (2) ambulatory motility and pH recording alone does not appear to differentiate between cardiac and non‐cardiac chest pain; (3) simultaneous ECG recording reveals a significant correlation of ST‐segment deviation and gastro‐oesophageal reflux or abnormal motility in patients with coronary artery stenosis.

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