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Histological examination of the gastric mucosa was performed in 44 patients with primary Sjogren's syndrome with extraglandular symptoms (mean age 51.9, range 22-76). Biopsy specimens were taken from each of three separate regions: the antrum, the corpus, and the transitional zone between the antrum and the corpus. The incidence of chronic atrophic gastritis was considerably higher in patients with Sjogren's syndrome than in the controls. In the young patients with Sjogren's syndrome atrophic lesions were more common both in the antrum and in the corpus than in the control group. In middle aged patients, however, only the antrum, and in the elderly only the corpus, was much more commonly affected than in the controls. AU three types ofchronic atrophic gastritis occurred in patients with Sjogren's syndrome. Decreased gastric acid secretion was associated mainly with atrophic gastritis of types A and AB, whereas hypergastrinaemia occurred almost exclusively in gastritis of type A.Among the gastrointestinal manifestations of Sjogren's syndrome (SS), chronic atrophic gastritis (CAG) is the most common finding. In several investigations the incidence of CAG in patients with SS was more than 65%. 1 2 In the earlier studies, however, only a small number of relatively old patients with SS were examined, and the gastric involvement was analysed in a mixed group of patients, including those with primary and secondary SS. Because only the corpus mucosa was studied the types of CAG were not determined.In our study histological examination of the antrum and corpus mucosa was performed simultaneously in patients with primary SS. Gastric acid secretion and serum gastrin concentrations were also measured, and the type of CAG was determined. Correspondence to: Dr Pokorny. Accepted for publication 14 February 1990 Patients and methods Forty four female patients with primary SS with extraglandular symptoms were studied because of abdominal complaints in 38 cases (epigastric pain in 15 and dyspepsia with or without nausea in 23), and for other reasons, such as anaemia, weight loss, or lack of appetite, in six cases. Twenty one of the 44 were taking non-steroidal anti-inflammatory drugs or corticosteroids, or both, regularly, and 14 were taking them only occasionally. The mean age of the patients was 51-9 years (range 22-76) and the mean duration of disease was 10-3 years (range 1-23). All patients met the criteria for primary SS. The Copenhagen criteria, with two modifications, were used for the diagnosis of keratoconjunctivitis sicca and xerostomia. These were as follows: the parotid gland flow rate stimulated with 2-0% citric acid solution was considered abnormal if -1-5 ml/10 min/gland, and parotid gland scintigraphy or sialography, or both, were performed.34An Olympus GIF XQ fibrescope was used for endoscopic examination of the stomach. Two to five mucosal biopsy specimens were taken from the antrum, the corpus, and the transitional zone between the antrum and the corpus for histological examination. The specimens we...

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The effect of capsaicin injected into the superior mesenteric artery has been studied on the intestinal blood flow in dogs. Capsaicin evoked a marked dose-dependent increase in mesenterial blood flow in the dose range of 0.1-7 micrograms/kg. The intestinal vasodilatatory effect of capsaicin could invariably be demonstrated after pretreatment with adrenoceptor and dopamine receptor antagonists, as well as with the ganglion blocking agent hexamethonium. Pretreatment with atropine significantly reduced, but did not abolish the increase in intestinal blood flow elicited by capsaicin. Concomitant administration of somatostatin significantly inhibited both the atropine-sensitive and the atropine-resistant components of the effect of capsaicin injected into the superior mesenteric artery. Our results indirectly support the assumption that the intestinal vasodilatatory effect of capsaicin may be mediated by substance P release from capsaicin-sensitive paravascular nerve fibres associated with the blood vessels of the gastrointestinal tract. It is suggested that sensory substance P-containing nerve fibres may be involved in the regulation of the vascular reactions of the gut.

The authors have examined the effect of locally (intra-artcrially) given insulin and glucagon on the absorption and portal transport of glucose from the isolated jejunal loop of the dog. The insulin rcduccd significantly the rate of portal glucose transport, while the quantity of glucosc absorbed remained unchanged. Under the influence of glucagon the blood flow through the isolated intestinal loop and the rate of the portal glucose transport both increased. In the majority of the cases an amount of sugar exceeding the quantity of the glucose that disappeared from the lumen of the intestine appeared in the venous blood of the jejunal loop during the experimental period. On the basis of their experiments the authors suggest the ability of glucagon to mobilize glucose from the intestinal wall.