A B S T R A C T Lipolytic activity was studied in esophageal and gastric aspirates obtained with a nasogastric tube from 14 healthy adult subjects. Samples were collected from esophagus, first at 30-35 cm and then at 40-45 cm from the nose, as the subject, after drinking 15-30 ml of a cream-milk mixture, swallowed small amounts of water. The samples from stomach were taken last and usually contained a small amount of cream-milk mixture. Lipolytic activity was assayed using chylomicron, milk, and corn oil triglyceride as substrate. Esophageal and gastric samples both contained lipolytic activity which hydrolyzed long-chain triglyceride to diglyceride, monoglyceride, and FFA, had a pH optimum of 5.4, and was not affected by either 0.5 M NaCl or 4 mM sodium taurodeoxycholate. The activity, expressed as nanomoles of chylomicron triglyceride hydrolyzed per milliliter per minute, ranged from 0 to 145 in upper esophageal, 5 to 303 in lower esophageal, and 50 to 357 in gastric samples. Only a trace of lipolytic activity was found at pH 5.4 in saliva collected from the parotid, submandibular, and sublingual glands, thus excluding those tissues as a source of the activity found in esophageal and gastric aspirates. The findings suggest that in man glands in or near the pharynx secrete a lipase that acts in the stomach to hydrolyze long-chain triglyceride to partial glycerides and FFA. It is proposed that this reaction is the first step in the digestion of dietary fat and that the amphi-
We prospectively evaluated 24 patients with systemic lupus erythematosus for clinical, histologic, and serologic evidence of sicca syndrome. Abnormalities suggestive of sicca syndrome in patients with systemic lupus were identified by parotid scan (58%), questionnaire (-%), labial biopsy (50%), Schirmer's test (21%), and parotid flow rate (13%). An increased frequency of autoantibodies to gamma globulin and cellular antigen SS-A was detected in lupus patients with histologic changes on labial biopsy. The serologic findings are similar to those of patients with sicca syndrome alone with the exception of the reduced incidence of anti-SS-B in patients with systemic lupus.Sicca syndrome (Sjogren's syndrome) results from a lymphocyte mediated destruction of exocrine glands. It can occur alone or in association with various
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