Esophageal motor dysfunction years after radiation therapy.

Well-known complications of radiation to the esophagus are acute esophagitis and strictures. Although radiologic studies have demonstrated motor abnormalities after radiation treatment, clinical aspects have not been described adequately, nor have manometric evaluations been reported. Clinical presentation of dysphagia long after treatment also has not been reported. We describe herein three patients who presented with dysphagia years after radiation therapy. Radiographic, endoscopic, histologic, and manometric studies supported our conclusion that these patients suffered from radiation-induced esophageal motor dysfunction. This report indicates the need, in the proper setting, to consider radiation-induced motor dysfunction as a cause of dysphagia even decades after radiation treatment.

Oestradiol increases baseline growth hormone levels in the male rat: possible direct action on the pituitary.

The effect of oestradiol treatment on the secretion of growth hormone (GH) was investigated in normal unrestrained male rats with chronic i.v. cannulae and in hypophysectomized male rats with autotransplanted pituitaries. The effect of gonadectomy of normal rats on the plasma GH secretory pattern was also evaluated. Baseline plasma GH levels were elevated following estradiol treatment of normal male rats (1.5 mg kg-1 per 15 days). Gonadectomy of male rats also resulted in increased baseline GH levels, although the effect was less apparent than after oestradiol administration. The pulse height was not influenced by gonadectomy or oestradiol administration. In male rats with the pituitary autotransplanted to the kidney capsule, oestradiol caused a dose-dependent increase in plasma GH levels, while there was no such effect of testosterone. These results suggest that the stimulatory influence of oestradiol on baseline GH levels is, at least partly, due to a direct effect on the pituitary. Plasma prolactin levels were elevated in rats with pituitary transplants receiving oestradiol. It is concluded that oestrogen administration to normal male rats increases baseline plasma GH levels, possibly by an effect exerted directly at the pituitary level.

Urinary amino acids and organic acids in the Sjögren-Larsson syndrome.

A metabolic study of urine samples obtained from 35 patients with the Sjögren-Larsson syndrome (SLS) has been performed by means of a series of chemical tests, as well as by analysis of the amino acid pattern by high-voltage paper electrophoresis. Organic acids were analysed by gas-chromatography-mass spectrometry and qualitative analyses for mono- and disaccharides were performed by thin-layer chromatography on cellulose. No error in the amino acid, organic acid or carbohydrate metabolism was found in the SLS-patients in the present study.

3-hydroxydecanedioic acid and related homologues: urinary metabolites in ketoacidosis.

Urine from patients with ketoacidosis was found to contain a number of aliphatic 3-hydroxy dicarboxylic acids. The acids were purified by silicic acid chromatography and their structures determined by gas chromatography-mass spectrometry of different derivatives. The major compound was 3-hydroxydecanedioic acid. Minor compounds were 3-hydroxyoctanedioic acid, 3-hydroxyoctenedioic acid, 3-hydroxydecenedioic acid, 3-hydroxydodecanedioic acid, 3-hydroxydodecenedioic acid, 3-hydroxytetradecenedioic acid, and 3-hydroxytetradecadienedioic acid. The excretion of 3-hydroxydecanedioic acid correlated positively with the excretion of hexanedioic acid, another metabolite constantly found in ketoacidosis (Pettersen et al., Clin. Chim. Acta 38: 17-24, 1972). We suggest that the 3-hydroxy dicarboxylic acids are formed from fatty acids by a combination of omega-oxidation and incomplete beta-oxidation.

Treatment of hypertension with labetalol.

Labetalol, a new antihypertensive drug which combines alpha- and beta-blocking properties, was used in an open clinical trial in a mixed group of 47 adult patients with mainly essential hypertension, many of whom had been poorly controlled on other drugs. Labetalol lowered lying and standing blood pressures significantly when given alone or when combined with other antihypertensive drugs and it was generally well tolerated. It is easy to use, and in some severe cases has been dramatically effective. Mean daily dose was 767 mg. A postural hypotensive effect was seen especially in patients taking concomitant diuretics but was not troublesome. Labetalol reduced heart rate in patients who were not on previous or concomitant beta-blocker therapy. Side effects were few and did not cause major problems. A transiently or persistently weakly positive ANF was noted in nine patients; the significance of this is uncertain at this stage and needs further assessment. Raynaud's phenomenon, which had complicated previous beta-blocker therapy in some patients, improved with labetalol.