Taste aversion learning and schedule-induced alcohol consumption in rats

Twelve hungry rats were exposed to the intermittent delivery of food with a 5% (v/v) ethanol solution freely available. All developed high levels of schedule-induced alcohol polydipsia within ten 1-hr sessions. Immediately following the eleventh session half of the animals received an intraperitoneal injection of lithium chloride (experimental group) and the other half received an injection of sodium chloride (control group). Their alcohol intakes did not differ during the twelfth session and so the treatments were repeated following the thirteenth session. During the fourteenth session, the experimental group drank very little alcohol compared to the control group, indicating that they had learned a taste-aversion to the alcohol in only two conditioning trials. These results extend previous work on the role of taste aversion in suppressing alcohol intake by demonstrating that the technique can be used to suppress schedule-induced alcohol polydipsia as well as thirst-motivated alcohol intake.     

Invitation to attend a health check in a general practice setting: the views of a cohort of non-attenders

Two hundred and fifty-nine men and women aged 20-45 years who did not respond to an offer from their general practitioner for a health check were interviewed at home to explore the reasons for non-response. There was no support for the view that the invitation aroused anxiety or that the administrative arrangements had been a barrier to acceptance. Many subjects were not really interested (44%) or just forgot to attend (24%). Crises at work or home (26%) and current attendance at a doctor (16%) were other reasons offered, while 11% felt screening to be in appropriate. There is little that can be done to change these rates except by a shift of public opinion to more consumer demand for health checks or by more opportunistic health checks when people attend their doctors for other reasons. The dangers of marketing health checks to increase consumer demand are discussed in the light of these findings and other work.     

Auditory stimulation alters the pattern of 2-deoxyglucose uptake in the inner ear

The 2-deoxy-d-glucose (2-DG) autoradiographic technique was adapted for application to the inner ear. The uptake of [¹⁴C]2-DG during silence was compared with that observed during exposure to wide band noise (WBN) or pure tones at an intensity level of 85 dB SPL. In silence, the highest levels of 2-DG uptake were observed in the spiral ligament, spiral prominence and stria vascularis, with approximately equal levels of uptake in each structure. The high levels of 2-DG uptake observed in the ligament and prominence are suprising, and suggest a more active role for these structures in cochlear function than has previously been suspected. Levels of uptake in the organ of Corti, spiral ganglion and VIIIth nerve were much lower, although well above background. During exposure to WBN, 2-DG uptake increased markedly in the VIIIth nerve, and spiral ganglion throughout the cochlea, and in the organ of Corti in the lower basal turn. 2-DG uptake did not change significantly in the spiral ligament or stria vascularis. During pure tone exposure, increased 2-DG uptake was noted in localized regions of the VIIIth nerve and spiral ganglion.     

Management of the patient presenting as an emergency with hypergastrinemia

The emergency management of patients presenting with the Zollinger-Ellison syndrome (ZES) consists of medical measures to control acid-pepsin hypersecretion; emergency surgery should be confined to urgent complications of ulceration or tumor growth and spread. Operation for ulcer complications should be restricted to conventional surgical procedures with biopsy of suspicious lesions. Emergency total gastrectomy or resection of pancreas and duodenum is contraindicated. Once the emergency has been controlled, the diagnosis of ZES can be confirmed by basal serum gastrin measurements and the secretin provocation test. Other endocrine adenopathies should be excluded. An attempt is then made to localize the tumor(s) and any metastases. With techniques such as selective portal venous sampling, it may be possible to define the small group of patients with lesions amenable to surgical cure. For the remainder, continued control of gastric secretion can be achieved by H₂-receptor antagonists, but elective total gastrectomy or the combination of vagotomy with pharmacological blockade offer valid alternatives in long-term management. Effective medical or surgical control of the peptic ulcer diathesis means that tumor progression is now the major cause of death in ZES patients, and advances in the fields of chemotherapy and radiotherapy are urgently required to control this aspect of the disease.

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Résumé Le traitement des malades atteints de Syndrome de Zollinger-Ellison consiste dans l'emploi d'agents thérapeutiques susceptibles de contrôler l'hypersecrétion acido-peptique gastrique. Le traitement chirurgical est à réserver aux complications de l'ulcère et aux tumeurs à développement et à extension rapide. Les complications ulcéreuses doivent être traitées par les méthodes conventionnelles cependant que la biopsie des lésions doit être systématique lors de l'intervention.La gastrectomie totale d'urgence ou la duodénopancréatectomie sont contre-indiquées.Le diagnostic de Zollinger Ellison doit de toute façon être confirmé par le dosage de la gastrinémie et par le test à la secrétine. Les tumeurs endocriniennes éventuellement associées doivent être recherchées systématiquement. Il convient également de localiser la tumeur et ses éventuelles métastases à l'aide du prélèvement étage du sang portai de façon à définir les lésions susceptibles d'être guéries chirurgicalement. Le contrôle définitif de l'hypersécrétion acido-peptique peut être obtenu par l'administration permanente des antagonistes H2-recepteurs encore qua le gastrectomie totale élective ou que l'association de la vagotomie hypersélective et des antagonistes puisse être envisagée.Le contrôle efficace de la diathèse ulcéreuse peptique par les moyens médicaux ou les interventions chirurgicales décrites permet d'affirmer que la cause principale de la mort des malades atteints du syndrome de Zollinger Ellison reléve de la progression inexorable du processus tumoral. Les progrés de la chimiothérapie et de la radiothérapie devraient apporter une solution á ce probléme dans un proche avenir.

     

Effect of rioprostil on aspirin-induced gastrointestinal mucosal changes in normal volunteers

Rioprostil, a 15-deoxy-16-methyl prostaglandin E1, was evaluated for its effect on aspirin-induced gastrointestinal mucosal changes in normal volunteers. Fifty-six normal male volunteers were evaluated by endoscopy in a double-blind, placebo-controlled study. Aspirin was given at a dose of 975 mg four times per day. Rioprostil was given at doses of 60, 120, and 300 micrograms four times per day. Rioprostil, at both antisecretory and subantisecretory doses, prevented or reduced aspirin-induced injury. Increased stool frequency was the most common side effect and appeared to be a dose-related effect of rioprostil occurring at only antisecretory doses.     

Review article

Review in this Article:
George W. Brown and Tirril Harris, The Social Origins of Depression .