Robert J. Bolt

Association of Inflammatory Bowel Disease and Large Vascular Lesions

A case of inflammatory bowel disease with associated multiple large vessel vascular lesions similar to that seen in Takayasus arteritis is described in a 15-year-old female. It is suggested that this type of vascular lesion may represent another rare systemic manifestation of inflammatory bowel disease.

Transoral small-bowel biopsy as an aid in the diagnosis of malabsorption states.

IT was in 1880 that Mansons1 report first established tropical sprue as a clinical entity. Eight years later, Gees2 classic account of a distinct type of diarrhea, occurring in people of all ages...

A Clinical Evaluation of Tubeless Gastric Analysis

Summary The azure A cation exchange resin test for the presence of free hydrochloric acid is an extremely simple test applicable to surveys of large groups of individuals. The reliability of the test in distinguishing those persons who do not secrete hydrochloric acid is supported by the results noted in our series of cases and in reports published elsewhere. The substance used in carrying out the test has so far proved to be relatively free of serious side-effects. The use of the test in cases of severe renal disease, gastric obstruction, diarrhea, and malabsorption syndromes requires further evaluation, but in all probability the test will prove to be undependable under such circumstances.

Differential Response to Various Stimulants in the Body and Antrum of the Canine Stomach

SummaryThis study was initiated to evaluate gastric motility with the use of extraluminal force transducers in unanesthetized dogs. The contractile activity of the circular and longitudinal muscle in both antrum and body of the canine stomach was monitored in the interdigestive state and under the influence of food, acetylcholine, and 5-hydroxytryptophane. The latter two chemicals were infused for a 30-min. period. Each of the two muscle layers in antrum and body had a maximum frequency of 5 contractions per minute. This activity was continuous during 30 min. only under the influence of food and 5-hydroxytryptophane. Acetylcholine stimulant effects did not persist beyond the initial 10 min. of infusion. Amplitude of contractions under spontaneous or induced activity varied. The height of these contractions were circular antrum > longitudinal antrum > circular body > longitudinal body. This method of recording muscle contractility is believed to be useful for quantitatively assaying gastric activity without compromise of physiologic environment.

Effect of Bile and Fat on Gastric Motility under the Influence of Various Stimulants

SummaryThis study was initiated to evaluate the effect on contractility of the longitudinal and circular muscles of the canine gastric body and antrum when micellar fat or bile was instilled in a Thiry loop of duodenum. These studies were performed while the animals were stimulated by food, acetylcholine, and 5-hydroxytryptophane (5-HTP). The latter two chemicals were infused for a 30-min. period. Micellar fat in the duodenum tended to decrease the frequency and amplitude of contractions only in those experiments using 5-HTP or the lower dose of acetylcholine (50 µg./kg./min.) as stimulants. This trend was not seen when bile alone or saline was placed in the duodenal loop. The data were evaluated by a motility index technic and analyzed by a paired comparison method.

Action of a New Synthetic Antispasmodic in Patients with Gastrointestinal Complaints

Summary Used under controlled conditions, Centrine has previously been shown to be effective in controlling gastric acidity, secretory rate, and motility. 1 When used in the therapy of peptic ulcer patients it has proven to be of value in conjunction with routine basic therapy consisting of a Meulengracht diet, magnesium trisilicate, and phenobarbital. No adverse hematologic effects have occurred in 66 patients treated with Centrine. Side effects due to its atropinelike action have not been disturbing or of serious nature. The dosage is, in all respects, similar to that of atropine sulfate and it is 50 to 100 times as potent as Banthine.

A pedigree of multiple polyposis of the colon.

Summary A kindred is described in which some 16 members are known to have multiple polyposis of the colon, with six additional persons very probably affected. The problems in preventive medicine raised by such families are briefly discussed.

Therapeutic trial of silicone in peptic ulcer

Summary and conclusionIn a controlled double-blind trial of the therapeutic effectiveness of silicone in patients with duodenal ulcer, the silicone tested was shown to be slightly less effective than placebo medication. The relatively good early response of chronically recurring ulcer disease appeared to be due to the emotional impact of “a new treatment of ulcers.”

Silicones in experimental peptic ulceration

SummaryIn the search for a silicone as uniformly successful as the one used earlier, in preventing and treating experimental peptic ulceration in animals, 30 different silicones were used in pylorus-ligated rats, Mann-Williamson dogs and histamine ulcerated dogs. None were found to be uniformly effective and the initial encouraging results reported by us could not be reproduced with subsequent silicone preparations.

Evaluation Of Present Day Treatment Of Peptic Ulcer

The treatment of peptic ulcer is an ever increasing problem to the internist and surgeon alike. Those who attempt to treat the ulcer patient consrientiously are daily confused by the multiplicity of articles and conflicting results found in the literature today. There are many advocates of a strict antacid and dietary regimen and almost as many others claim that antacids and diet are valueless. Many substances have been proposed as sure cures for the peptic ulcer patient, only to have this claim upset by reports indicating that placebos are just as effective. It is extremely difficult for the average busy practitioner to weigh the evidence and sift the facts in an attempt to determine what actually constitutes the most adequate present day method of therapy. It is the purpose of this paper to summarize and clarify the modern treatment of peptic ulcer. In 1828 Abercrombie (1) first introduced the use of milk, farinaceous foods and lime water in the treatment of this disease. Johnson (2) just three years later introduced the use of soda, magnesia arid chalk. In 1835 Cruveilhier (3) emphasized the use of good dietary hygiene and in 1872 Fox (4) stressed the importance of rest. Since that time the treatment of peptic ulcer has been modified very little. The basis for the moderii day treatment of peptic ulrer was established by the year 1872; only antispasmodics, sedatives, and psychotherapy have been added. The etiology of peptic ulcer remains almost as ohmwe as it was in 1872. S o single etiologic factor has been found but many factors have been presented as playing a role in the cmmhon of this disease. Decreased tissue resistance secondary to the loss of the normal mucous harrier has been advanced by some authors as the basic cause of peptic ulceration. No good evidence has appeared to show a decrease in mucin content arid the use of gastric mucin in the treatment of peptic ulcer has been discouraging. Other investigators have postulated the presence of gastric atrophy as the Cause of decreased tissue resistance and