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Biomedical subjects

A Ertan

Publications and source records attributed to A Ertan.

At least 73 records · Page 4Linked to original sources

Campylobacter enterocolitis in New Orleans.

Campylobacter is being increasingly recognized as a common pathogen producing acute diarrheal illness. During 1981, all stool cultures at Charity Hospital were routinely screened for Campylobacter. Twenty-nine of 2,233 total cultures were positive. We performed a retrospective study to evaluate the disease's clinical picture and epidemiologic features. Campylobacter-positive cultures comprised 1.3% of all stool specimens and 21.6% of all positive cultures. Age, sex, and race in the Campylobacter group did not differ significantly from a comparison group. The distribution of the rates of Campylobacter-positive cultures did not show temporal trends. The clinical symptoms were nonspecific and the disease was usually self-limited, with diarrhea lasting from seven to ten days in untreated patients. The disease may occasionally be confused with a nonspecific inflammatory bowel disease. Thus, it is important that stool cultures be routinely screened for Campylobacter so that appropriate therapy can be administered.

Adolescent↗

Upper gastrointestinal lesions after potassium chloride supplements: a controlled clinical trial.

The effects of a new microencapsulated potassium chloride formulation on upper gastrointestinal tract mucosa was compared with that of a popular wax-matrix formulation in 48 healthy volunteers. After a week of KCl, subjects were gastroscoped, the endoscopist being blind to the type of preparation taken. Wax-matrix formulations were associated with a higher incidence of upper gastrointestinal lesions. The lesions were not accompanied by epigastric symptoms. Glycopyrrolate, given to some volunteers to decrease gastric emptying, aggravated the effects of potassium chloride.

Acute Disease↗

Inhibition of nocturnal gastric secretion in normal human volunteers by misoprostol: a synthetic prostaglandin E1 methyl ester analog.

Misoprostol (SC-29333) is a synthetic prostaglandin E1 analog that has been found to be a potent inhibitor of gastric secretion in animals. Nocturnal gastric antisecretory activity of misoprostol, in tablet form, was studied in 16 adult volunteers, under basal condition. The study was a randomized, double-blind, cross-over, comparison of placebo, and three graded doses of misoprostol (50, 100, and 200 micrograms). Misoprostol exhibited a statistically significant inhibition of total acid output only at the 200 micrograms dose and this inhibition was maintained for 3 h postadministration of the drug. The antisecretory effects of misoprostol were characterized by suppression of H+ ion but not of the volume of gastric secretion. No untoward effects were noted in the volunteers. As a consequence of the gastric antisecretory effects, the present studies indicate that misoprostol is a promising therapeutic agent for the treatment of peptic ulcer.

Adult↗

Somatostatin in human pancreatic and gastric juice.

Considerable amounts of IRS are secreted after secretin injection in human pancreatic juice collected during endoscopic retrograde cholangiopancreatography. The mean IRS levels in the pancreatic juice of non-diabetic patients were 79 +/- 10 (SE) pg/ml. The IRS levels in NIDDM were considerably higher, the mean value being 1635 +/- 313 (SE) pg/ml. The mean IRS level in IDDM were 312 +/- 151 (SE) pg/ml. In IDDM, those patients whose blood glucose levels were well controlled by insulin showed low pancreatic juice IRS ranging from non-detectable to 46 pg/ml. On the other hand, those with uncontrolled hyperglycemia showed IRS levels ranging form 452 to 1047 pg/ml. Gel-filtration profiles of IRS in pancreatic juice extracts were not consistent in all cases. Some showed IRS peaks eluting with SS14 and SS28, while others contained IRS species that were eluted in more retarded fractions. The retarded IRS fraction exhibited biological activity indistinguishable from that of SS14 as indexed using a quantitative cytochemical method.

Chromatography, Gel↗

A comparison of percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreatography in postcholecystectomy jaundice.

The Chiba percutaneous transhepatic cholangiography (CPTC) and endoscopic retrograde cholangiopancreatography (ERCP) are new techniques useful for accurately diagnosing cholestasis. Both, however, present certain advantages and disadvantages in different clinical settings. In our prospective study we compared and evaluated the two techniques in 21 patients with postcholecystectomy jaundice, analyzing success rate, complications, time spent, and costs. We found CPTC was preferable to ERCP for visualizing the bile ducts and for relative safety. Moreover, CPTC is not only more rapid, but also requires less expertise and costs less.

Adult↗

Immunoreactive somatostatin in human pancreatic secretion.

Somatostatin in human pancreatic juice collected during endoscopic retrograde cholangiopancreatography following secretin injection was determined by RIA. The mean immunoreactive somatostatin (IRS) levels in the pancreatic juice of 13 non-diabetics was 78 +/- 11 (SE) pg/ml. The IRS levels in 4 non-insulin-dependent diabetics ranged from 843 to 2286 pg/ml with a mean of 1559 +/- 392 (SE) pg/ml. This was significantly greater than non-diabetic values. The IRS in the pancreatic juice was immunologically indistinguishable from somatostatin14 but consisted of 2 major components, one corresponding to somatostatin14 and the other being of a molecular size of approximately 3000 daltons.

Adult↗

The effect of cholecystokinin-pancreozymin on circulating gastrin levels in man and dog.

Perfusion of the jejunum with a mixture of amino acids (MAA) stimulates cholecystokinin-pancreozymin (CCK) release in man. Since gastrin is normally found in the small intestine, studies were conducted to determine if MAA perfusion had an effect on circulating serum gastrin levels in man. In man, endogenous stimulation of CCK had no effect on gastrin release; however, when CCK was given exogenously (10% pure form), serum gastrin levels were significantly increased. In dogs, the 10% pure CCK given exogenously also significantly increased gastrin concentrations, while the pure CCK octapeptide did not. Cross-reactivity between CCK and the gastrin antibody was minimal and could not be shown to be responsible for the serum gastrin elevations. Neither the physiological release of CCK in humans nor exogenous administration of CCK octapeptide in dogs at a dose equivalent to maximal stimulation of pancreatic secretion in humans significantly altered peripheral venous serum levels of immunoreactive gastrin. Therefore, we conclude that the gastrinemic response of exogenous CCK (10% pure) in man and dog is probably due to an impurity in the CCK preparation; when studying the effects of CCK on the gastrointestinal tract, only the pure CCK or the octapeptide should be used.

Amino Acids↗

Thrombocytosis in patients with celiac sprue.

In 57% of the patients (12 of 25) seen with celiac sprue, as shown by clinical course and small bowel biopsy, peripheral blood thrombocytosis was present (range: 350,000 to 815,000 platelets per mm(3); mean: 546,000 +/- 44,060 SE). After clinical and histological remission, the platelet counts in these patients fell significantly (range: 188,000 to 300,0000 platelets per mm(3); mean 252,750 +/- 13,211 SE). There was no correlation between thrombocytosis and serum iron, folate, or vitamin B12 levels. Celiac sprue joins inflammatory bowel disease among gastrointestinal disorders as a consideration in the differential diagnosis of thrombocytosis. In these patients, thrombocytosis reflected active disease and was not present during remission. Evaluation of peripheral blood platelets may be useful in the assessment of patients with celiac sprue.

Adult↗

Mechanism of release of endogenous cholecystokinin by jejunal amino acid perfusion in man.

Ertan et al have shown that the perfusion of the proximal jejunum with a mixture of amino acids (MAA) in physiological concentration releases endogenous cholecystokinin (CCK) in man. In the present experiment, we investigate the mechanism by which jejunal MAA perfusion mediates an increase in exocrine pancreatic and biliary secretions. The effects of a bolus of topical anesthetic (oxethazaine, 0.5 mg/kg of 0.4% solution) or the simultaneous jejunal perfusion of a topical anticholinergic agent (atropine, 1 mg/liter) were studied in the same five normal patients on different days. Suppression of the response to jejunal MAA perfusion but not to intravenous infusion of CCK or jejunal saline perfusion, was noted in these normal subjects following jejunal application of oxethazaine and atropine. These results suggest a local involvement of the cholinergic mechanism for the endogenous release of CCK, while exogenous CCK acts directly on the pancreatic cells.

Amino Acids↗

Effects of somatostatin and a somatostatin agonist on diet-induced pancreatitis in mice.

We examined the effects of somatostatin-14 and the potent somatostatin agonist (N-acetyl-[Des(Ala1,Gly2),p-Cl-Phe6,D-Trp8]-somatostatin amide) on choline deficient, ethionine enriched diet (CDED)-induced acute pancreatitis in mice. Serum amylase determinations were performed, and specimens from the pancreas were examined by light and electron microscopy. No significant beneficial effects of somatostatin or its agonist were found in this model of acute pancreatitis.

Acute Disease↗

Galanin binding sites in rat gastric and jejunal smooth muscle membrane preparations.

Receptors for galanin in membranes from the rat gastric and jejunal smooth muscle were studied using [125I] radioiodinated synthetic porcine galanin. Specific binding was time and temperature dependent. At 32 degrees C radioligand was degraded in the presence of smooth muscle membranes in a time-dependent manner. At optimal experimental conditions, the equilibrium binding analyses showed the presence of a single population of high affinity binding sites in both the rat stomach and jejunum (Kd value of 2.77 +/- 0.78 nM and 4.93 +/- 1.74 nM for stomach and jejunal smooth muscle membranes, respectively). The concentration of the high affinity binding sites was 58.19 +/- 11.04 and 32.36 +/- 5.68 fmol/mg protein, for gastric and jejunal preparations, respectively. Specific binding was completely inhibited by 10(-6) M of nonradioactive galanin; was 75% blocked by 1 microM of galanin(9-29); it was 10% blocked by 1 microM of galanin(15-29). Galanin(1-15) at a concentration of 1 microM was ineffective for inhibiting [125I]galanin binding. Deletion of four C-terminal amino acid residues from galanin(9-29) to give galanin(9-25) also resulted in almost complete loss of affinity. Radioiodinated galanin and N-terminally deleted fragments had receptor binding potency in the following order: galanin(1-29) greater than galanin(9-29) greater than galanin(15-29). We conclude that the C-terminal part of the galanin chain is important for the rat gastric and jejunal smooth muscle membrane receptor recognition and binding and that N-terminal amino acid sequences are probably not so important, since galanin(1-15) was not active but galanin(9-29) retained most of the receptor binding activity.

Animals↗

Effect of pituitary adenylate cyclase activating polypeptide on rat pancreatic exocrine secretion.

A novel neuropeptide, pituitary adenylate cyclase activating polypeptide (PACAP), which has been isolated from ovine hypothalami, shows 68% homology with vasoactive intestinal peptide (VIP). Since VIP stimulates amylase secretion from the pancreas, we investigated the effect of PACAP and VIP on rat pancreatic exocrine secretion after intravenous injections of PACAP-27, PACAP-38, or VIP at doses of 2.5, 5 or 10 nmol/kg. Results showed: 1) Bolus injection of PACAP stimulated pancreatic amylase and protein secretions in a dose-dependent manner; and 2) Stimulation of amylase secretion with 10 nmol/kg of PACAP-27 was greater than that induced with the same dose of VIP or PACAP-38 (p less than 0.05).

Adenylyl Cyclases↗

Comparison of prolonged in vivo inhibitory activity of several potent bombesin (BN) antagonists on BN-stimulated amylase secretion in the rat.

New BN analogues designed to be competitive receptor antagonists at the BN/gastrin releasing peptide receptor(s) can exhibit diverse properties ranging from full antagonist, partial agonist or weak agonist activity, depending on the assay system and animal species employed. Here we evaluate the following 3 antagonists which have the most potent receptor affinities in several in vitro assay systems and are representative of 3 main classes of BN antagonists for their in vivo effects on pancreatic amylase secretion in the rat: [D-Cpa6,Phe14,psi 13-14]BN(6-14), [D-Phe6]BN(6-13) propylamide, and [D-Phe6]BN(6-13) methyl ester. After injection in the rat, the methyl ester was clearly the most potent antagonist and completely inhibited BN-stimulated amylase release at the 20 nmol/kg (IV bolus) for about 2 h. In contrast, the propylamide analogue at the 200 nmol/kg (IV bolus) dose produced incomplete inhibition of amylase release. Inhibition was transient and lasted for only about 1 h, possibly reflecting the significant agonist activity of this latter peptide in the rat pancreatic amylase secretion test in vitro. The psi-analogue, while being the longest acting analogue, was also incapable of lowering amylase to basal level at 50 times the BN dose, suggesting that it is a mixed agonist-antagonist in vivo as was also previously shown in vitro in the rat.

Amylases↗