A Tranquilizer-Anticholinergic Preparation in Functional Gastrointestinal Disorders: A Double-Blind Evaluation

Chlordiazepoxide plus clidinium bromide (Librax®) was evaluated and compared with a placebo by means of a random sample, double-blind crossover technique in 42 patients presenting ordinary functional gastrointestinal disorders.Results:• 73.9 percent excellent-to-good response to the active drug in patients receiving it before they received the placebo, compared with 44.5 percent in those who did not receive it until after the placebo period.• 58.9 percent excellent-to-good response to the active drug in patients who received it after the placebo period, as compared with 31.8 percent in those receiving the placebo last.• Overall clinical response 67.5 percent excellent-to-good with the active drug as compared with 37.5 percent with the placebo.• Excellent-to-good results in 12 follow-up patients receiving the known active drug.• Statistically significant symptomatic response in four of eight target symptoms.The tranquilizer-anticholinergic preparation used appeared to improve not only patient outlook and attitudes but to effectively relieve both the physiologic and psychic manifestations of common functional gastrointestinal disorders.     

Plasma Digoxin Concentrations in Patients with Atrial Fibrillation

Plasma digoxin concentrations were measured by radioimmunoassay in 116 patients with atrial fibrillation on long-term oral treatment with the drug, and in 23 patients with digoxin toxicity. The mean concentrations were 1·4 ng./ml. and 3·1 ng./ml., respectively. Though an overlap occurred between the therapeutic and toxic ranges, toxicity is unlikely to occur below a level of 2 ng./ml. Plasma concentration showed a poor correlation with resting heart rate during atrial fibrillation. In patients with good renal function, however, a significant correlation was found between oral dose and plasma concentration. No evidence was obtained for increased sensitivity to therapeutic concentrations of the drug in elderly subjects, but the doses required to achieve these concentrations tended to be less than in younger patients.     

THE EFFECT OF INSULIN, ALLOXAN DIABETES, AND ANOXIA ON THE ULTRASTRUCTURE OF THE RAT HEART

Hearts from normal and alloxan diabetic rats were perfused in vitro with a bicarbonate-buffered medium containing glucose. Transport of glucose through the cell membrane was stimulated with insulin or by induction of anaerobiosis. The organs were rapidly fixed and examined by electron microscopy. Transport stimulation was not associated with any increase in the number of sarcolemmal invaginations or subsarcolemmal cytoplasmic vesicles. It was concluded that glucose transport and the effects of insulin or anoxia do not involve pinocytosis. The relationship of pinocytosis to glucose transport is discussed. The appearance of numerous lipid inclusions at the Z line level of the sarcomeres in the diabetic and anoxic myocardia is described.     

An Analysis of the Striated Muscle Fiber Action Current

A method is presented for determining the magnitude of the ionic current associated with the propagated spike potential. Parameters of the action current are then compared to various aspects of the response as recorded in a phase plane. The findings also include evidence for (a) Na⁺ ion as the major inward current carrier, (b) a fairly constant membrane conductance during the terminal phase (~1 msec.) of the spike potential, and (c) the influence of Ca⁺⁺ ion concentration on the action current.