William P. Chapman

MULTIPLE-BALLOON-KYMOGRAPH RECORDING OF INTESTINAL MOTILITY IN MAN WITH OBSERVATIONS ON THE CORRELATION OF THE TRACING PATTERNS WITH BARIUM MOVEMENTS

The balloon water manometer system has long been employed in animals and in man as a means of recording graphically the motility of the alimentary tract (1, 2). As others have done, we have used this method to study the behavior of adjacent segments of the small intestine in man under control conditions and in response to drugs and placebos (3, 4). The purpose of this communication is to describe the recording procedure and the evaluation of the tracing patterns. The results of the drug and placebo studies are to be reported elsewhere. Certain drawbacks to the use of the balloon water manometer system have been presented by Quigley (5). He has pointed out that this method necessitates using a large volume/pressure coefficient which does not maintain a linear relationship. The pressure, moreover, registered by the balloon varies depending on its changing shape and on the degree of patency of the intestinal lumen. These objections did not primarily concern us as we were interested in qualitative and relative quantitative changes in motility rather than in absolute measurements of intraluminal pressures. Various workers have described graphic records of motility in terms of their non-propulsive and propulsive character (6-9). Adler, Atkinson and Ivy (6) observed that in the colon of patients with colostomies low, relatively rapid wave patterns were non-propulsive while high, sustained contractions were associated with the forward movement of the intestinal contents provided adequate coordination existed between bowel segments. Abbott and Pendergrass (7) felt that a

THE EFFECT OF TETRAETHYLAMMONIUM ON THE SMALL BOWEL OF MAN

Present evidence indicates that tetraethylammonium ion blocks autonomic effector systems at their ganglia. Injection of the drug prevents the passage through the superior cervical ganglion of nerve impulses to the nictitating membrane of the cat (1). Similarly, there occurs inhibition of the effect on the decentralized heart of preganglionic stimulation of either vagal cardio-inhibitory fibers or of the cardio-accellerators (2). The sharp fall in arterial blood pressure accompanying intravenous injection results from ganglionic blockade of the sympathetic vasoconstrictor nerves (2). The action of tetraethylammonium has been extensively studied in man by Lyons and his associates (3 to 5). After single intravenous injection of 200 to 300 mgm. of the chloride salt there is a fall in blood pressure and a rise in heart rate. These values have usually returned to normal in 10 to 15 minutes after injection. There is an accompanying sensation of tingling and warmth of the face and extremities and sometimes drowsiness and momentary paralysis of accommodation. Serious reactions have not been reported. After giving nearly 100 injections of the drug we observed 1 marked reaction. This patient (Case 4) had an alarming and persistent tachycardia and fall in blood pressure which lasted for 5 days (6). The action of tetraethylammonium on the gastrointestinal tract has received relatively little attention. Lyons has reported that after intramuscular injection marked diminution in contractions occurs. His patients with peptic ulcer have received dramatic but temporary relief from ulcer pain. Cessation of gastro-intestinal motility has been observed fluoroscopically after ingestion of a barium meal, and abdominal cramps and diarrhea have been abolished. Gastric acidity is said to be diminished (4).

Temporal lobe epilepsy: Brief review: Responses on electrical stimulation of the amygdaloid region in six patients

Abstract 1.1. The subject of temporal lobe epilepsy is reviewed briefly. 2.2. Clinical data have been presented in six epileptic patients in whom behavior difficulties were a major problem in management. A diagnosis of temporal lobe epilepsy was made on the basis of the clinical features and the preoperative electroencephalographic tracings in all these patients. 3.3. Spiking was recorded from the depth electrodes implanted in the amygdaloid region in all six patients. 4.4. In all except one patient, electrical stimulation of the amygdala brought out many of the features of temporal lobe epilepsy. Included in the responses to electrical stimulation were elevation of heart rate and blood pressure, pupillary dilatation and changes in respiration. 5.5. While our current data do not permit us to ascertain the exact role of the amygdaloid region in the genesis of temporal lobe epilepsy, they do suggest that this region is part of the neurophysiologic unit involving temporal lobe epilepsy and behavior.

A severe reaction to tetraethylammonium chloride.

TETRAETHYLAMMONIUM salts have been found to block efferent autonomic impulses at both the sympathetic and parasympathetic ganglions.1 , 2 Because of this action, the drug is being employed in a var...

Comparative effects of pamine, banthine, and placebos on gastrointestinal motility. II. Radiographic study in eight adult subjects tested when fasting and following the administration of a standard meal.

In a previous study (1) it was found that the effect of Banthine on gastrointestinal motility varied depending on whether the subjects were fasting or had received a meal following the administration of the drug. This observation, as well as our interest in keeping the d~g testing situation as nearly comparable as possible to the conditions under which these medications are administered clinically, prompted us to include the taking of a standard meal as part of a study of the effect of Pamine on gastric evacuation and the movement of the head of the column of barium along the intestine. Our subjects were eight adult males whose ages ranged from 22 to 50 years. They had been previously tested with a single dose of Pamine under fasting conditions and again when this drug had been administered four times daily in a therapeutic dose for three weeks prior to retesting (2). Data in this report consist of the results of the effect on motility of Pamine given by the oral route in a single dosage of 5 mg. and 10 mg. and, as control observations, the effects of Banthine 50 mg. and 100 mg. and of placebo tested under similar conditions. A total of 80 tests were performed.