The role of the beta-adrnergic receptor in the secretion of gastrin: studies in normal subjects and in patients with duodenal ulcers

Intravenous infusion of isoproterenol, a beta-adrenergic receptor stimulatory agent, increased serum gastrin concentration significantly more in patients with a duodenal ulcer than in healthy subjects. The rise in pulse rate, blood glucose concentration and in serum insulin was the same in both groups of subjects. Gastrin secretion was also increased significantly more in the patients than in the control subjects after a beef-meal. Basal serum gastrin concentrations were higher in the patients than in the control subjects and correlated to the rise in serum gastrin during both tests in the patients with a duodenal ulcer. Isoproterenol and meal stimulated gastrin secretion, expressed as percent of the basal value, were twice as higher in the patients as in the control subjects. The combined administration of isoproterenol and the meal had an additive effect on the rise in serum gastrin. Isoproterenol stimulated gastrin secretion was completely suppressed by propranolol, a beta-adrenergic receptor blocking agent, which had no effect on meal stimulated gastrin secretion. It is concluded that the mechanism of the hypersecretion of gastrin in patients with a duodenal ulcer did not involve a specific abnormality of the beta-adrenergic receptor or the receptor which recognized proteins and their digested products. There is no established role of beta-adrenergic receptor activity in the hypersecretion of gastrin in patients with duodenal ulcers. It is suggested that the beta-adrenergic receptor may have some yet unknown function unrelated to the acute secretory response of gastrin.     

Gallium-67 scanning for carcinoma of the lung

Gallium-67 citrate scanning was prospectively evaluated in 55 patients who had lung lesions suspected to be primary carcinoma on chest x-ray films and in whom subsequent histologic diagnosis was obtained. Of 47 patients with histologically proved carcinoma of the lung, 44 (94 per cent) had a positive 67Ga scan. No patient with a positive scan had a benign lesion, so that the positive scan accuracy rate was 100 per cent. All 8 patients with a benign lesion and 3 patients with a malignant lesion had negative scans, for a negative scan accurary rate of 72 per cent for benign lesions. These results give statistical validity for the usefulness of the 67Ga scan in diagnosing carcinoma of the lung (p less than 0.001). Tumor cell type had little effect on the sensitivity of 67Ga scan. The 67Ga scan was equally useful in the evaluation of peripheral and central lesions. There was little difference amount T1, T2, and T3 classified lesions in their ability to take up 67Ga. The 67Ga scan was competitive with mediastinoscopy in assessing mediastinal lymph node metastases and provides a noninvasive method of assessing hilar lymph node metastases. There was a good correlation between the clinical staging of patients with lung cancer based on a chest x-ray film and 67Ga scanning and the staging after surgical treatment based on the histology of the resected specimens.     

Cervical thymic cysts

A review of cervical thymus cysts and a case report are presented. This benign lesion was, as in most cases previously reported, situated laterally on the neck, deep to the anterior border of the sternocleidomastoid muscle and thus simulating a common branchial cyst preoperative.y. But unlike the latter most cases of cervical thymus cysts are recognised during childhood. They are believed to develop in remmants of thymic tissue which have failed to descend from the third branchial pouch into the mediastinum in the 6th to 8th week of embryonic life.     

Cardiac typing and the diagnostic challenge of the preinfarction state by direct body ballistocardiography

The proposed sensitivity of the DB-Bcg enables its gradation into four types-two normal, two abnormal. Their response to exercise shows specificity-amplified in the former, decreased in the latter. Illustrative material reveals deterioration of DB-Bcg forms with the earliest signs of cardiac symptomatology and is correlated with arteriographic evidence of coronary disease. This could not be corroborated either by the ECG, even post exercise, or changes in the PEP/LVET ratio. Improvement of the DB-Bcg following bed rest and/or therapy and by-pass grafting have been observed. Early application of the DB-Bcg, particularly in the young individual, may help meet the challenge of cardiac mortality.