Plasma gastrin levels were measured by radioimmunoassay before and after a test meal associated with 40 ml ethanol in 21 patients presenting with chronic calcifying pancreatitis, in 10 apparently normal subjects drinking since at least 5 years 100 g alcohol a day, in 14 subjects presenting hepatic alcoholic cirrhosis and in 18 apparently normal non alcoholic controls. Post-stimulation gastrin concentration were higher in chronic pancreatitis patients or in normal alcoholics (peak post-stimulation value: 74 +/- 41 and 74 +/- 43 pg/ml respectively) than in cirrhotics or non alcoholic controls (45 +/- 26 and 41 +/- 15 pg/ml respectively) (m +/- SD).
SUMMARY Two patients with the Smith‐Lemli‐Opitz syndrome were examined clinically and at autopsy. In addition to the features characteristic of the syndrome, there was evidence in both patients of significant developmental anomalies at all levels of the central nervous system, but mainly affecting the cerebral and cerebellar cortex. Both patients were microcephalic and one had anomalies of the carotid artery. Examination of samples of peripheral nerves, autonomic structures and skeletal muscles revealed no significant abnormalities. These findings appear to be important features of the syndrome which have not been emphasized previously. RÉSUMÉ Implication neurologique dans le syndrome de Smith‐Lemli‐Opitz; données cliniques et neuropathologiques Deux malades présentant un syndrome de Smith‐Lemli‐Opitz ont été examinés cliniquement et à l'autopsie. En plus des manifestions habituelles du syndrome, il a été observé chez les deux sujets des anomalies de développement significatives à tous les niveaux du système nerveux central mais principalement au niveau des cortex cérébraux et cérébelleux. Les deux malades étaient microcéphales et l'un d'entre eux présentait des anomalies de la carotide. L'examen d'échantillons de nerfs périphériques du système autonome et des muscles squelettiques n'a pas révélé d'anomalies significatives. Ces données ajoutent à ce syndrome des caractéristiques sur lesquelles l'accent n'avait pas encore été mis. ZUSAMMENFASSUN Neurologische Beteiligung beim Smith‐Lemli‐Opitz Syndrom: klinische und neuropathologische Befunde Es wurden 2 Patienten mit einem Smith‐Lemli‐Opitz Syndrom zunächst klinisch und später bei der Autopsie untersucht. Außer den für dieses Syndrom charakteristischen Merkmalen fand man bei beiden Patienten signifikante Entwicklungsanomalien im gesamten ZNS, hauptsächlich jedoch im cerebralen und cerebellaren Cortex. Beide Patienten waren mikrocephal und einer hatte Anomalien der A. carotis. Die Untersuchung der peripheren Nerven, der autonomen Strukturen und Skelettmuskeln ergab keine eindeutigen Anomalien. Diese Befunde sprechen wichtige Merkmale dieses Syndroms an, die früher noch nicht hervorgehoben wurden. RESUMEN Afectación neurológica en el sïndrome de Smith‐Lemli‐Opitz. Hallazgos clïnicos y neuropatológicos Dos pacientes con el síndrome de Smith‐Lemli‐Opitz fueron examinados desde el punto de vista clínico y con autopsia. Además de los rasgos característicos del síndrome, había evidencia en ambos pacientes de anomalías significativas del desarrollo en todos los niveles del SNC, pero afectando sobre todo el córtex cerebral y cerebeloso. Ambos pacientes eran microcefálicos y uno tenía anomalías en la arteria carótida. El examen de muestras de nervios periféricos, estructuras autónomas y músculos esqueléticos no mostraron anomalías significativas. Estos hallazgos aparecen como rasgos importantes del síndrome, que no habían sido citados anteriormente.
As it has been previously shown, the pancreatic secretory response to an intraduodenal infusion of oleic acid is increased in animals accustomed to daily ethanol consumption compared to matched controls. This action has been verified in dogs provided with a Thomas cannula and consuming 2 g kg-1 ethanol or not, daily since 3 years. An intravenous infusion of 0.75 mg kg-1 h-1 of atropine suppresses the difference between alcoholic and non-alcoholic animals. Therefore, the increased release of CCK-PZ in response to meal, which is characteristic of chronic alcoholic animals, is under cholinergic control.
Fifty-five patients with endoscopically confirmed gastric ulcers received either cimetidine (28 patients) or pirenzepine (27 patients) in a randomized double-blind manner. Fifty-seven per cent of the patients treated with cimetidine and 48% of those treated with pirenzepine presented with endoscopically healed ulcers after 4 weeks of treatment. By 8 weeks complete healing had occurred in 83% of the patients taking cimetidine and 76% of those taking pirenzepine. These differences were not statistically significant. Severity of pain on entering the study was correlated with slower healing of the ulcer. Side effects occurred in 5 of 27 patients in the pirenzepine group and 3 of 28 in the cimetidine group. They were mostly mild and did not differ from side effects observed in other studies.
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