Disturbances in anorectal function in patients with diabetes mellitus and faecal incontinence.

Objective: The pathophysiology of faecal incontinence in diabetes mellitus is poorly understood. The study was designed to document the anorectal dysfunctions in diabetic patients with faecal incontinence.

Methods: Multiport anorectal manometry and electromyography were done in 11 diabetic patients with faecal incontinence and in 20 healthy controls.

Ondansetron reduces nausea induced by gastroduodenal stimulation without changing gastric motility.

The involvement of 5-hydroxytryptamine3 (5-HT3) receptors in gastric motor and sensory responses to distension and duodenal lipid was investigated. Subjects were studied on four occasions during which isotonic saline or 20% Intralipid (2 kcal/ml) was infused intraduodenally (1 ml/min) while the proximal stomach was distended with air (100 ml/min). Subjects received either 8 mg ondansetron (5-HT3 antagonist) or placebo orally in random order.

Role of cholecystokinin as a regulator of solid and liquid gastric emptying in humans.

The role of endogenous cholecystokinin (CCK) in the regulation of gastric emptying remains controversial. We therefore studied the effect of the CCK-A receptor antagonist loxiglumide on gastric emptying of a high-caloric solid-liquid meal in humans. Gastric emptying was assessed in eight volunteers using intravenous loxiglumide or placebo in a randomized double-blind order.

Appetite regulation by carbohydrate: role of blood glucose and gastrointestinal hormones.

To investigate the mechanisms by which intestinal carbohydrate affects eating behavior, seven fasted, healthy male volunteers received intraduodenal infusions of glucose or saline over a 90-min period while blood glucose levels were matched by use of intravenous glucose and saline infusions. A second study examined the effect of intraduodenal glucose on eating behavior when the gastrointestinal hormone response was inhibited by intravenous octreotide. Intravenous glucose infusion did not affect hunger or satiety.

Influences of fat, energy, and time of day on mood and performance.

Paired studies testing the effects of lower energy high-fat, low-CHO meals (3181 kJ, fat:CHO energy ratio 54:41) and higher energy low-fat, high-CHO meals (3599 kJ, fat:CHO energy ratio 7:88) were conducted in 18 healthy males. The meals were eaten at 1030 h by group A (nine subjects) and 1230 h by group B (nine subjects). Subjective lassitude increased following ingestion of all four meals, but there was little change in performance.

Cholecystokinin-A receptors modulate gastric sensory and motor responses to gastric distension and duodenal lipid.

Background & Aims: The combination of duodenal lipid and gastric distention induces meal-like fullness followed by nausea in healthy subjects. The aim of this study was to assess the role of cholecystokinin (CCK) A receptors in these changes using a CCK-A antagonist loxiglumide.

Methods: Twelve healthy subjects were studied on four occasions, during which either 0.

The effect of short-term dietary supplementation with glucose on gastric emptying of glucose and fructose and oral glucose tolerance in normal subjects.

Recent observations indicate that gastric emptying may be influenced by patterns of previous nutrient intake. The aims of this study were to determine the effects of a high glucose diet on gastric emptying of glucose and fructose, and the impact of any changes in gastric emptying on plasma concentrations of glucose, insulin and gastric inhibitory polypeptide in response to glucose and fructose loads. Gastric emptying of glucose and fructose (both 75 g dissolved in 350 ml water) were measured in seven normal volunteers on separate days while each was on a "standard' diet and an identical diet supplemented with 440 g/day of glucose for 4-7 days.

Psychometric scores and persistence of irritable bowel after infectious diarrhoea.

Background: Although previous studies have shown that psychological disturbances are frequently associated with the irritable bowel syndrome (IBS), the relation was not necessarily cause and effect. The development of chronic bowel symptoms resembling IBS after an episode of acute gastroenteritis has allowed us to examine prospectively the role of psychological factors.

Methods: 75 patients with acute gastroenteritis completed a series of psychometric tests soon after admission to hospital.

Morphological observations on the fate of liposomes in the regional lymph nodes after footpad injection into rats.

Multilamellar liposomes composed of equimolar egg phosphatidylcholine and cholesterol and containing carboxyfluorescein or colloidal gold were injected subcutaneously into the footpad of the hind-leg of rats. The draining popliteal lymph nodes of animals killed at time intervals after injection were then dissected and sections examined by fluorescence microscopy (carboxyfluorescein), light microscopy using an immunogold silver kit to enhance gold particles or by transmission electron microscopy. Morphological observations confirmed that subcutaneously injected liposomes accumulate in large numbers in the draining lymph node.

Fat increases vection-induced nausea independent of changes in gastric emptying.

Vection and fat delay gastric emptying and can induce nausea. Therefore, we studied the interaction between vection and fat on the production of nausea and the relationship between the severity of symptoms and changes in gastric emptying. Twelve healthy males consumed two liquid test meals, a zero-fat and a high-fat meal.

Abnormal sensitivity to duodenal lipid infusion in patients with functional dyspepsia.

Background And Objectives: Patients with functional dyspepsia exhibit increased sensitivity to gastric distension (mechanoreceptors) and to meals rich in fat (chemoreceptors). The aim of this study was to test whether these patients were abnormally sensitive to intraduodenal lipid, and whether this stimulus altered gastric mechanosensitivity.

Methods And Design: Experiments were conducted on 10 patients and 10 healthy controls.

Calcium Channel Activity during Pollen Tube Growth and Reorientation.

We have shown previously that the inhibition of pollen tube growth and its subsequent reorientation in Agapanthus umbellatus are preceded by an increase in cytosolic free calcium ([Ca2+]c), suggesting a role for Ca2+ in signaling these processes. In this study, a novel procedure was used to measure Ca2+ channel activity in living pollen tubes subjected to various growth reorienting treatments (electrical fields and ionophoretic microinjection). The method involves adding extracellular Mn2+ to quench the fluorescence of intracellular Indo-1 at its ca2+-insensitive wavelength (isosbestic point).

Nutrient-specific modulation of gastric mechanosensitivity in patients with functional dyspepsia.

Intraduodenal lipid infusion induces symptoms and increases sensitivity to gastric distension in patients with functional dyspepsia. To test whether these effects are specific for lipid, we compared the effects of intraduodenal infusions of either lipid or glucose on symptoms and gastric sensory and motor responses to gastric distension. Eighteen dyspeptic patients and nine controls were studied.

The effect on hunger and satiety of slowing the absorption of glucose: relationship with gastric emptying and postprandial blood glucose and insulin responses.

To investigate the relative potency of short-term control mechanisms for carbohydrate satiety, ten fasted, healthy male volunteers consumed a 250-ml, 30% glucose drink with and without the addition of guar gum (2%). Gastric emptying, hunger and fullness ratings and blood glucose and insulin levels were monitored over the following 3 h and energy intake was recorded from a test meal given 3.5 h after the drinks.

Influences of dietary and intraduodenal lipid on alertness, mood, and sustained concentration.

The effects of intraduodenal and dietary lipid on alertness, mood and performance in a task requiring sustained attention were investigated in two studies. The first experiment compared the effect of duodenal infusion of either 100 g/l Intralipid (8.36 kJ/min) or isotonic saline (9 g NaCl/l) in paired studies carried out on two non-consecutive days on five male volunteers.

Functional bowel disorders. A multicenter comparison of health status and development of illness severity index.

In a multicenter study of patients with painful functional bowel disorders (FBD), we compared the demographic, health status, and diagnostic features of patients with FBD and developed a functional bowel disorder severity index (FBDSI) for research and clinical care. Two hundred seventy patients with FBD in the United States, England, and Canada were surveyed on symptoms and health status, and their physicians made a diagnosis and rated illness severity as mild, moderate, or severe. Comparisons of 22 demographic and clinical variables were made by study site in addition to physicians' severity ratings.

Hereditary proctalgia fugax and constipation: report of a second family.

A second family with hereditary proctalgia fugax and internal anal sphincter hypertrophy associated with constipation is described. Anorectal ultrasonography, manometry, and sensory tests were conducted in two symptomatic and one asymptomatic subjects within the same family and further clinical information was obtained from other family members. The inheritance would correspond to an autosomal dominant condition with incomplete penetration, presenting after the second decade of life.