Effect of baclofen on the acid pocket at the gastroesophageal junction.

Previous studies established that a pocket of highly acidic gastric juice is present postprandially at the gastroesophageal junction in man. The GABA-B agonist baclofen inhibits postprandial reflux events through its effects on the lower esophageal sphincter (LES). The aim of the current study was to investigate whether baclofen would affect the location and the extent of the postprandial acid pocket in healthy volunteers. Twelve healthy volunteers underwent acid pocket studies on two different occasions, at least 1 week apart. LES position was determined preprandially with pull-through manometry. Dual pH electrode and manometry probe stepwise pull-through (1 cm/minute, LES-10 to +5 cm) was performed at 30-minute intervals for 150 minutes, with administration of placebo or baclofen 40 mg after the first and ingestion of a liquid meal after the second pull-through. After placebo, a significant drop in intragastric gastric pH was present at the gastroesophageal junction after the meal, reflecting the acid pocket, and this was associated with a drop in LES pressure. Baclofen did not affect the presence of the acid pocket, but prevented the postprandial drop in LES pressure, and the extent of the acid pocket above the upper margin of the manometrically located LES was significantly decreased by baclofen (1.6 ± 0.7 vs. 0.3 ± 0.4 cm at 60 minutes, 2.2 ± 0.6 vs. 0.2 ± 0.6 at 90 minutes, and 1.5 ± 0.5 vs. 0.7 ± 0.7 cm at 120 minutes, all P < 0.05). Baclofen does not alter the intragastric acid pocket, but limits its extension into the distal esophagus, probably through an increase in postprandial LES pressure.

[Adaptive skills, cognitive functioning and behavioural problems in adolescents with 22q11.2 deletion syndrome]. / Adaptieve vaardigheden, cognitief functioneren en gedragsproblemen bij adolescenten met het 22q11.2-deletiesyndroom.

BACKGROUND: The 22q11.2 deletion syndrome (22q11.2DS) has a highly variable phenotype with a multitude of somatic and psychiatric features. Little is known about the adaptive skills of adolescents with 22q11.2DS. AIM: To investigate adaptive functioning, intelligence and behavioural problems and their interrelationship in adolescents with 22q11.2DS. METHOD: We interviewed the parents of 37 adolescents with 22q11.2DS using the Vineland Adaptive Behavior Scales. We assessed the intelligence of the adolescents by means of the Wechsler Intelligence Scales. Parents, adolescents and teachers were required to complete the Achenbach behavioural questionnaire. RESULTS: We found that adolescents with 22q11.2DS had impaired adaptive skills; these skills were significantly more impaired than the adolescents' overall intelligence, i.e. their I.Q. Socialisation was a relatively well-developed domain compared to daily living skills. All respondents reported that the number of internalising problems exceeded the number of externalising problems. There was no correlation between adaptive functioning and behavioural problems, age or gender. CONCLUSION: The evaluation of adaptive skills in these adolescents is a first step on the road to the development of measures aimed at improving their functioning in society.

Method for isolation of non-esterified fatty acids and several other classes of plasma lipids by column chromatography on silica gel.

A method is described for isolation from human plasma of non-esterified fatty acids, cholesteryl esters, triglycerides, cholesterol and diglycerides, monoglycerides, and some phospholipids by extraction and silica gel column chromatography. All of these lipid classes except diglycerides and cholesterol were separated cleanly in seven elution steps. Diglycerides and cholesterol were isolated together. Recovery of model compounds which represent the most significant classes of plasma lipids during the column chromatographic step was nearly complete. The overall recovery of added heptadecanoic acid from plasma specimens was 81% after both sample isolation steps. The overall recovery of added synthetic pentadecanoic acid and heptadecanoic acid ester lipid homologues from plasma was 80-91% after both sample preparation steps. About 6 h are required for extraction and isolation in duplicate of these lipid classes from twenty plasma specimens. Alternatively, non-esterified fatty acids can be isolated from twenty plasma specimens in duplicate within 4 h by a variation of the full procedure.