Effect of capsaicin-containing red pepper sauce suspension on upper gastrointestinal motility in healthy volunteers

Afferent nerves play a major role in the regulation of gastrointestinal motility. The questions remains if specific food ingredients can selectively activate such fibers. The aim of the study was to investigate the effect of intraesophageal application of a capsaicin-containing red pepper sauce (Tabasco) suspension on upper gastrointestinal motility in a controlled trial. After a baseline recording [esophageal motility, balloon distension, electrogastrogram (EGG)], red pepper or saline solution was infused intraesophageally in seven healthy volunteers. At 30 min gastric emptying and orocecal transit time were determined using a [13C]acetate and H2-lactulose breath test. Infusion of red pepper sauce suspension significantly increased the amplitudes (65.8 +/- 3 to 78.5 +/- 4.7 mm Hg, P < 0.05) and propagation velocity (2.9 +/- 0.3 to 4.25 +/- 0.3 sec, P < 0.05) of esophageal pressure waves and LES pressure (17.8 +/- 1.4 to 23.7 +/- 2.6 mm Hg, P < 0.05). It significantly decreased perception and discomfort threshold of intraesophageal balloon distension, reduced the percentage of normal electrical activity in the EGG, and delayed gastric emptying (saline: T(1/2) 42.9 +/- 12.0 min vs red pepper: T(1/2) 66.8 +/- 19.0 min, P < 0.05). Despite the prolongation of gastric emptying, orocecal transit time was not altered, indicating an actual increase of intestinal transit. Esophageal application of capsaicin-containing red pepper sauce suspension had profound changes on upper gastrointestinal motility, which could improve clearance and protection of the esophagus and could lead to retention of the irritant in the stomach and faster transit through the small bowel.     

Multilocus linkage identifies two new loci for a mendelian form of stroke, cerebral cavernous malformation, at 7p15-13 and 3q25.2-27

Cerebral cavernous malformation (CCM) is a Mendelian model of stroke, characterized by focal abnormalities in small intracranial blood vessels leading to hemorrhage and consequent strokes and/or seizures. A significant fraction of cases is inherited as an autosomal dominant trait with incomplete penetrance. Among Hispanic Americans, virtually all CCM is attributable to a founder mutation localized to 7q ( CCM1 ). Recent analysis of non-Hispanic Caucasian kindreds, however, has excluded linkage to 7q in some, indicating at least one additional CCM locus. We now report analysis of linkage in 20 non-Hispanic Caucasian kindreds with familial CCM. In addition to linkage to CCM1, analysis of linkage demonstrates linkage to two new loci, CCM2 at 7p13-15 and CCM3 at 3q25.2-27. Multilocus analysis yields a maximum lod score of 14.11, with 40% of kindreds linked to CCM1, 20% linked to CCM2 and 40% linked to CCM3, with highly significant evidence for linkage to three loci (linkage to three loci supported with an odds ratio of 2.6 x 10(5):1 over linkage to two loci and 1.6 x 10(9):1 over linkage to one locus). Multipoint analysis among families with high posterior probabilities of linkage to each locus refines the locations of CCM2 and CCM3 to approximately 22 cM intervals. Linkage to these three loci can account for inheritance of CCM in all kindreds studied. Significant locus-specific differences in penetrance are identified. These findings have implications for genetic testing of this disorder and represent an important step toward identification of the molecular basis of this disease.     

Sarcomas of the stomach

Sarcomas of the gastric wall, other than lymphomas, are a heterogeneous group of stromal malignant neoplasms composed of round and spindle cells. Many are malignant forms of epithelioid leiomyoma. Small cell size, high cellular density, a high rate of mitotic activity, and cellular pleomorphism are helpful clues in distinguishing malignant from benign gastric stromal tumors. Sarcomas of the stomach are aggressive, rapidly growing neoplasms. Among 44 examples metastasis occurred in three-fourths of the patients, usually within the first year after diagnosis.     

Closure of a large radiogenous vesico-rectovaginal fistula with rehabilitation of the continence

Successful treatment of a large vesico-rectovaginal fistula following irradiation of a 53 years old woman. The healing was attained by four steps: 1. Derivation of urine by bilateral nephrostomy. 2. Derivation of faeces by preter-natural anus. 3. Abdomino-vaginal closure of the fistula by Bastiaanse's method. 4. Reposition of the sigmoid. Complete restoration of natural conditons.     

Effects of dextran, gelatine and homologous plasma on circulation in shock caused by severe anemia in the dog

Irreversible shock is produced in 28 anaesthetized mongrel dogs by withdrawal of erythrocytes and substitution by dextran, gelatine or plasma to an average Hb of 4.5g%. In contrast to other shock models cardiac output and perfusion pressure are not decreased by this preparation. In order to maintain arterial blood pressue above 90 mm Hg significantly more gelatine than dextran or serum has to be infused. There is no difference in hemodynamic responses after treatment with dextran or gelatine respectively. Both groups treated with colloidal solutions have the same survival rate of 38%. In the serum substituted dogs, however,survival rate is significantly greater (83%). Very likely this is due to a greater buffer capacity preventing severe acidosis, which is observed in the animals treated with colloidal solutions.