Colonic myoelectric activity was recorded from six para- or quadriplegic subjects with spinal cord injury and seven normal controls via bipolar electrodes in contact with the rectal mucosa. Recordings were carried out in the fasting (basal) state and after stimulation by a standard meal and by 1.0 mg neostigmine intramuscularly. The recordings were visually analyzed for spike activity, average slow wave frequency, and percentage occurrence of subsets of slow wave frequency (2-4 and 5-12 cycles/min). The spinal-cord-injured subjects had significantly more spike wave activity in the basal state than did the controls (12.6 spikes per 10 min vs 3.3). However, meal stimulation did not lead to an increase in spike activity in the spinal-cord-injured subjects (13.7 spikes per 10 min vs 12.6) while it did in the controls (6.4 vs 3.3 spikes per 10 min). Neostigmine significantly increased spike activity in both groups. There was no difference in average slow wave frequency nor any slow wave subsets between the two groups studied. Thus persons with spinal cord injuries have higher basal colonic myoelectric activity than normals but lack a demonstrable gastrocolic reflex. We conclude that the central nervous system exerts a tonic inhibitory influence on basal colonic motility and appears to participate in the gastrocolic reflex.

Calcium channel blockers have been previously shown to decrease lower esophageal sphincter (LES) pressure and improve symptoms in achalasia. We performed a placebo-controlled, double-blind, crossover study to assess the effects of oral nifedipine and verapamil on LES pressure, amplitude of esophageal body contraction, and clinical symptomatology in eight patients with symptomatic achalasia diagnosed by endoscopy, barium swallow, and manometry. Patients were randomized to receive up to 20 mg nifedipine, 160 mg verapamil, or placebo and underwent esophageal manometry before (baseline) and after four weeks on each drug. Diary cards were kept to record and grade symptoms and drug plasma level determinations were correlated with manometric and clinical findings. Both nifedipine and verapamil caused a statistically significant decrease in mean LES pressure, but only nifedipine caused a significant decrease in the amplitude of contractions of the smooth muscle portion of the esophagus. No statistically significant differences in the overall clinical symptomatology were noted with any of the drugs, although some individual improvements in dysphagia and chest pain were noted. We conclude that, despite the reduction in LES pressure and contraction amplitude of the distal esophageal body, oral nifedipine and verapamil do not significantly alter the clinical symptomatology of patients with achalasia.

In the period April 1--15, 1977, nine residents of one Nebraska town experienced violent illnesses with short duration following ingestion of locally grown hydroponic cucumbers. Despite a thorough investigation, the etiologic agent of illness was not determined. From July 16--25, 1978, a second similar outbreak occurred in an adjacent city. Five individuals experienced illness similar to that which occurred in 1977, also following ingestion of hydroponic cucumbers grown at the same greenhouse involved in the 1977 outbreak. The carbamate insecticide, aldicarb, was detected in some cucumbers grown at the hydroponic greenhouse. The source of this chemical in the greenhouse could not be determined.