A dose of 50 mg of acarbose was administered with a standard breakfast to 13 subjects with dumping syndrome. Significant attenuation of hyperglycaemia (p < 0.01) was observed, and rises in plasma gastric inhibitory polypeptide, insulin and enteroglycagon were reduced (p < 0.05). Plasma levels of neurotensin, vasoactive intestinal polypeptide and somatostatin were not affected. Dumping score was reduced, but this did not achieve statistical significance. In a longer-term study, 9 patients took acarbose, 50 mg t.i.d., for 1 month. No significant reduction in the number or severity of dumping attacks was observed, but a majority expressed a preference for the drug and some individuals experienced a marked improvement of symptoms.

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are common symptoms of anxiety and of affective disorder, and are not uncommon features of other psychiatric syn dromes. They are also common in various organic states (e.g. hypoglycaemia) and are frequently likened by patients to dreaming, which occurs at a time of demonstrable alteration in cerebral activity. Furthermore, these phenomena are disorders of per ception, which suggests some organic basis. Is it possible that depersonalisation/derealisation are always manifestations of demonstrable organic abnormality in the brain?Hyperventilation, too, is a common symptom of anxiety, and depersonalisation is common in hyper ventilation. Anxiety is frequent in most psychiatric syndromes, and it might be reasonable to suppose that whatever the primary psychiatric diagnosis, it is only the patient who is anxious and hyperventilating who develops depersonalisation. In such patients the depersonalisation would be the result ofthe changes in metabolism and cerebral blood flow produced by the hyperventilation. The hypothesis would be that only those patients who were over-breathing would be depersonalised, whilst those patients who were not over-breathing would not suffer depersonalisa lion. At the same time the proviso has to be made that not all patients who are over-breathing would necess arily experience depersonalisation, as there might be some individual variation in the propensity to develop this symptom.Having made this hypothesis, I set out to test it. As a first step! began to look for patients with deperson alisation who were not over-breathing, with a view to comparing various measures in them with patients who were over-breathing. It has, however, proved to be increasingly difficult, if not impossible, to find such patients who were not over-breathing. I think this may be because, since I have become aware of the hypothesis, I am not overlooking hyperventilation in such patients, whereas previously I might have been.Thus the investigation might not turn out to be as easy as it seemed at first, not an unfamiliar situation.In the meantime, however, the idea appears to have spread in this hospital and I have found over the past few months or more that it has been quoted to me as Levenson (1985) but which occurred when lithium and phenelzine were employed in therapeutic doses. The patient had never taken neuroleptic drugs.

Summary: Thirty healthy volunteers were recruited into a study to determine the effects on the gastrointestinal mucosa of 3 different delivery systems of oral potassium supplementation associated with diuretic therapy (Diumide-K ContinusR tablets, Napp; Lasikal tablets, Hoechst; Lasix and Slow-KR tablets, Hoechst, Ciba). The volunteers *were gastroscoped initially and after one week of treatment with one of the three therapies. There was a '60% incidence of erosions in the Lasix + Slow-K group, a 40% incidence in the Lasikal group, but no erosions in the group receiving Diumide-K Continus tablets. It is therefore concluded that Diumide-K Continus tablets incorporate the potassium in a delivery system which is unlikely to cause disruption to the gatrointestinal mucosa.

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