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In low dosages erythromycin imitates the effect of motilin on the gastrointestinal motility. In vitro experiments show that erythromycin is a motilin agonist: it displaces motilin which is bound to its receptor; it directly acts on smooth musculature and it possesses the same animal and tissue specificity. Structural changes cause adequate changes in the binding affinity and in the contractile activity. Several motilides such as erythromycin derivatives with prokinetic properties have no antibiotic activity, but they cause a distinct increase of the prokinetic activity. Motilides may be defined as a new group of prokinetic substances: the motilinomimetics. Erythromycin normalises the delayed evacuation of the stomach of solid and fluid food in diabetic, idiopathic and postvagotomy gastroparesis. For the treatment of gastrooesophageal reflux disease, gastritis, pathological overgrowth of the small intestine, hypokinesia of the gallbladder and the chronic obstipation erythromycin appears as a promising medicament. The substances with a stronger effect may become even still more useful medicaments. A better understanding of the relation between motilin and motilides may lead to new knowledge about the regulation of the gastrointestinal motility.

Four examples of false negative diagnoses in computer tomography are discussed. The patients were suffering from tumours in the sella turcica, beside the sella turcica and in the cerebellopontine angle. With reference to the two patients with a process beside the sella turcica, the differential diagnosis of these processes (of which the clinical syndrome is characterized by ophthalmoplegia) is discussed. The diagnostic reliability of computer tomography seems to be inferior for these perisellar processes than for other localizations. Angiography and pneumoencephalography are the methods of choice in the diagnosis of these processes.