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Biomedical subjects

B Kerzner

Publications and source records attributed to B Kerzner.

At least 37 records · Page 2Linked to original sources
PubMed1985

Chronic nonspecific diarrhea: the value of a preliminary observation period to assess diet therapy.

Eighteen children with chronic, nonspecific diarrhea were evaluated prospectively to determine "basal" fat consumption and the response of their diarrhea to diets containing either 25% or 50% of total calories as fat. In the observation period, prior to initiating any alteration in dietary fat content, diarrhea subsided. Only five of the 18 patients had a low fat intake (less than 27% of total calories) at the outset of the study, and spontaneous resolution of the diarrhea precluded an assessment of the effect of altering fat intake on stool frequency. We are, therefore, impressed that a preliminary observation period, in which details of the diarrhea are documented, is essential to evaluate any treatment modality for this poorly defined condition.

Child, Preschool↗
PubMed1984

Large scale preparation of selected glucose oligomers and polymers by gel filtration chromatography.

A method for isolating relatively large quantities of glucose oligomer and polymer subfractions from a corn starch hydrolysate is described. Employing large columns of Bio-Gel P-2 (40-80 microns) at room temperature, we can prepare each day 0.5 to 1.2 grams of oligomeric fractions containing three to four adjacent homologues. The columns are homemade, require no flow adapters, and are operated by gravity elution with water as the solvent. The means for avoiding and overcoming potential difficulties, such as microbial contamination and declining flow rate, are described. With the use of the described method, we can operate a single column continuously for up to twelve months.

Carbohydrates↗
PubMed1983

A new micromethod for the quantification of low molecular weight oligomers of polyethylene glycol.

We describe a gas-liquid chromatographic technique for quantifying the low molecular weight (Mr 106-634) oligomers of polyethylene glycol (PEG) in clinical specimens. The deionized sample, containing tetra-ethylene glycol as an internal standard, is applied on column. This technique readily quantifies as little as 2.5 micrograms of an individual oligomer; with such a quantity, the coefficient of variation is +/- 2.5 percent (N = 25 analyses). Small volumes (250 microliter) of urine are conveniently analyzed, and a single column can be utilized for the analysis of approximately three hundred specimens. We have analyzed timed urine specimens from humans who received 0.15 g of PEG 400 per kilogram. Individuals varied markedly with regard to the total amount of PEG excreted into the urine; each subject, however, consistently excretes a uniform percentage of the ingested dose. The urinary oligomeric profile of PEG does not vary from subject to subject nor from hour to hour, during the first six hours following oral administration, so that a random urine obtained during this period provides a reliable clinical specimen. This technique should facilitate clinical studies that utilize polyethylene glycol 400 as an index of passive intestinal transport.

Adult↗
PubMed1983

Thin-layer and gel permeation chromatographic separation of low molecular weight polyethylene glycol oligomers.

We describe a gel permeation and a thin-layer chromatographic technique for the complete resolution of oligomers of ethylene glycol up to a chain length of fourteen ethylene oxide [OCH2CH2] units. We employed columns of Bio-Gel P-2 with 0.02 mol/l ammonium acetate as the eluant to prepare milligram quantities of each of the individual oligomers. Thin-layer chromatography on silica gel G plates with an ethyl acetate/methanol/water solvent provides a sensitive and simple method for monitoring multiple specimens. We determined the flame ionization detector response of purified individual ethylene glycol oligomers relative to tetraethylene glycol. These data permit the accurate quantification of the oligomeric profile of commercially available mixtures of low molecular weight polyethylene glycols (PEG). When PEG 400 is administered orally to normal subjects, aged three months through adulthood, they excrete in their urine a mixture of unmetabolized oligomers with a mean molecular weight of 360 +/- 14 daltons. The ability to measure absolute, rather than relative, amounts of ethylene glycol oligomers will permit more accurate studies of passive intestinal permeability in human subjects.

Chromatography, Gas↗
PubMed1983

Antibiotic management of complicated appendicitis.

A prospective, randomized, double-blind clinical trial was undertaken comparing gentamicin, ampicillin, and clindamycin (GAC) to gentamicin, ampicillin, and placebo (GAP) in children with complicated appendicitis. Of the 64 patients enrolled in this study, 33 were assigned to the GAC group and 31 received GAP. A single GAC patient (3%) was considered a therapeutic failure in comparison to seven children (23%) in the GAP group (P less than 0.05). Duration of fever was significantly prolonged in the GAP patients (4.7 +/- .8 days versus 2.9 +/- .5 days) when compared to the clindamycin treated children (P less than 0.05). Duration of leukocytosis was 3.2 +/- .4 days for GAC patients and 4.9 +/- .9 days for those on the GAP protocol (P = 0.08). On the basis of this experience the routine use of gentamicin, ampicillin, and clindamycin is recommended for all children with complicated appendicitis.

Ampicillin↗
PubMed1982

Acetylthiocholinesterase staining activity of rectal mucosa. Its use in the diagnosis of Hirschsprung's disease.

Increased acetylthiocholinesterase (AchE) reactivity in the rectal lamina propria and lamina muscularis mucosae was used to diagnose Hirschsprung's disease. We processed 131 specimens with the AchE reaction; 43 were suction biopsy specimens and the rest were full-thickness specimens. Of the 68 specimens in which neurocytes were present, none demonstrated a diffuse increase in the number of nerve fibers. However, 15 showed focal increases in the numbers of fibers that were not large enough to be regarded as indicative of Hirschsprung's disease. All patients with a diffuse increase in nerve fibers, regardless of the type of biopsy, were shown to have Hirschsprung's disease. The AchE staining reaction did, however, produce a 29% rate of false-negative reactions (16 of 56 specimens) in patients with Hirschsprung's disease. These data demonstrate that an abnormal pattern of AchE reaction is diagnostic of aganglionic megacolon, whereas a normal pattern does not exclude the disease.

Acetylcholinesterase↗
PubMed1981

Variations in glycerol kinetics in Reye's syndrome.

Glycerol kinetics and adverse affects were studied in nine patients with Reye's syndrome. Glycerol was given by continuous infusion over 2 hr, half over the first 0.5 hr and the remainder over the next 1.5 hr. The dose was adjusted to keep intracranial pressure less than or equal to 15 mmHg. At steady state, serial blood samples were collected during glycerol infusion and analyzed by an enzymatic assay specific for glycerol. At 0.75 to 1.75 gm/kg/2 hr glycerol doses, the serum levels ranged from 1.48 to 5.83 mg/ml. Total body clearance ranged from 1.99 to 5.1 ml/kg/min. Glycerol clearance was not related to serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), or serum ammonia levels. Glycerol provided effective control of intracranial pressure in all patients. Temporary elevation of serum creatinine and blood urea nitrogen (BUN) and presence of hemolysis in two patients, appeared to be related to glycerol.

Adolescent↗
PubMed1981

The jejunal absorption of glucose oligomers in the absence of pancreatic enzymes.

We compared the absorption of carbohydrate from solutions of glucose oligomers and glucose in jejunal Thiry-Vella fistulae, a preparation deprived of pancreatic secretions. The studies were performed with two concentrations (90 and 360 mg/dl) of both glucose and the glucose oligomers. Carbohydrate absorption from glucose solutions (33.1 +/- 2.8, 115.9 +/- 8.9 micrograms/cm/min) was significantly greater (P less than 0.025; P less than 0.005) than that from oligomer solutions (26.6 +/- 2.1 and 92.4 +/- 9.0 micrograms/cm/min). Thin-layer analyses of the perfusates demonstrate digestion of oligomers with a chain length up to eleven and suggest digestion of oligomers of even greater chain length. Atrophy of the jejunal mucosa occurred over the course of the study as evidenced by a decrease in the ratio of villous height to crypt depth from 3.8 to 0.3, and by a 80% decrease in the activity of maltase, sucrase, and lactase. Atrophy was accompanied by a significant decline in the absorption of both glucose oligomers (P less than 0.005) and glucose (P less than 0.01) from the more concentrated solutions but the decrement in absorption of both carbohydrates was similar: glucose oligomers, 79.3 +/- 19.4 micrograms/cm/min; and glucose, 69.8 +/- 14 micrograms/cm/min (P greater than 0.20). Water absorption was enhanced by both carbohydrates, but there was no demonstrable difference between solutions of glucose and glucose oligomers. The osmolality of the solutions clearly influenced water absorption (P less than 0.025) but failed to effect the absorption of carbohydrates.

Animals↗
PubMed1981

Thyroid status and muscarinic receptor density and affinity in rat intestinal smooth muscle.

Hypothyroid and hyperthyroid states are associated with constipation and diarrhea, respectively. To determine the possible involvement of the cholinergic system in these disorders we studied the effect of thyroid status (thyroidectomy or thyroxin injection for 10-20 weeks) on intestinal smooth muscle muscarinic receptors. Receptor density and affinity were determined in the ileum and colon with [3H]-quinuclidinyl benzilate (QNB), and compared with the responsiveness of isolated muscle strips to cumulative doses of bethanechol. Neither the affinity nor the density of muscarinic receptors was significantly altered by chronic hypo- or hyperthyroidism: KD approximately 1nM; Bmax approximately 200 fmole/mg protein. Similarly, there was no change in functional response of the ileum or colon to cholinergic stimulation. The results suggest that chronic hypothyroidism or hyperthyroidism do not alter muscarinic receptors in rat ileal or colonic muscle.

Animals↗
PubMed1979

Ileovesical fistula. Failure of T.P.N. role of oral 14C PEG (polyethylene glycol) and charcoal in diagnosis.

A patient with regional enteritis presenting with symptoms of fecaluria and pneumaturia is presented. Most of the established technics such as upper gastrointestinal series, cystography, cystoscopy and colonoscopy failed to demonstrate the fistula in this patient. 14C PEG as a nonabsorbable marker was given by mouth and a seven-fold increase in the counts at the fourth hour of urine collection confirmed the presence of an ileovesical fistula. This increase in counts was not seen when 14C PEG test was repeated after closure of this fistula surgically and was also not seen in a similar disease control patient and a healthy normal volunteer. Total parenteral nutrition with intralipids, Freamine II and glucose given in a peripheral vein for 45 days failed to close this fistula.

Administration, Oral↗
PubMed1978

Double-blind evaluation of deanol in tardive dyskinesia.

We administered deanol acetamidobenzoate, 2.0 g/day for four weeks, a double-blind, placebo-controlled crossover trial, to 14 patients with tardive dyskineasia. The patient population included both inpatients and outpatients. The response was evaluated by subjective clinical impression and scoring of filmed sequences. Patients' conditions improved significantly from baseline scores while receiving both deanol and placebo, but there was no distinction between the two treatments.

Adult↗
PubMed1978

Effect of lithium on plasma chlorpromazine levels.

The interaction of lithium and chlorpromazine (CPZ) was studied in healthy volunteers in a randomized crossover study. Each subject ingested two doses of CPZ (100 mg) as the liquid concentrate: (1) without concurrent lithium therapy and (2) after a 7-day treatment with lithium carbonate (900 mg/day). When CPZ was administered with lithium, peak plasma CPZ levels were 40.3% (mean) lower than those without lithium (p = 0.006), and the area under the CPZ plasma concentration time curve was 26.6% smaller (p = 0.08). The time to reach peak plasma CPZ levels was similar in both groups. All subjects slept for 4 to 6 hr after oral CPZ and had a maximum fall in both systolic (8 to 32 mg Hg) and diastolic (5 to 23 mg Hg) blood pressure at the time of peak plasma CPZ concentration. This lithium-CPZ interaction may explain the low plasma CPZ levels reported previously in psychiatric patients taking both lithium and CPZ.

Adult↗
PubMed1977

Transmissible gastroenteritis: sodium transport and the intestinal epithelium during the course of viral enteritis.

Sodium transport, mucosal structure, and epithelial enzymes were studied in piglets killed 10, 25, 40, 72, or 144 hr after infection with a standard dose of transmissible gastroenteritis virus. Glucose-stimulated Na transport measured in short-circuited jejunal epithelium and suspensions of villous enterocytes became progressively more abnormal during the first 40 hr, but recovered completely by 144 hr. As Na transport deteriorated, jejunal mucosal villi shortened and crypts deepened; cells isolated from the villi became more crypt-like in their enzyme profile, with high levels of thymidine kinase and low levels of sucrase activity 40 hr after infection. At 40 hr, when diarrhea is severe, little if any virus has been found in the epithelium. Our data suggest that the relatively undifferentiated crypt type enterocytes on the villi constitute an important determinant of altered Na transport and diarrhea in this invasive viral enteritis.

Animals↗
PubMed1977

Clinical, laboratory, and epidemiologic features of a viral gastroenteritis in infants and children.

We studied 27 infants admitted to the hospital with acute diarrhea caused by human rotavirus (HRV) and obtained additional data on fecal excretion from ten outpatients with the same infection. The disease was characterized by watery diarrhea with fever and vomiting at the onset, isotonic dehydration, compensated metabolic acidosis, and increased concentrations of sodium and chloride but low concentrations of sugar in stools. Diarrhea usually ceased in three to four days when oral feedings were reduced or stopped but recurred mildly in four patients. Of 57 household contacts, 12 were symptomatic, 6 had HRV in their stools, and 19 had significantly increased serum HRV antibody titers. These features of the disease accord with available information on the pathogenesis of HRV infection. Knowledge of the clinical pattern of this newly diagnosable infection should help physicians to recognize and treat quickly this highly infectious, potentially dangerous illness.

Adult↗
PubMed1976

Adverse drug reactions-a matter of opinion.

The accurate identification of adverse drug reactions (ADRs) is difficult because ADRs usually present no unique clinical or laboratory findings that demarcate them from the manifestations of concurrent illnesses. The identification of ADRs depends on the clinical assessments of physicians-sometimes the clinician treating the patient and at other times a clinical pharmacologist. Considering the complex and subjective nature of clinically identifying ADRs, how accurately are ADRs identified? To answer this question, three clinical pharmacologists each independently evaluated 60 selected cases to determine if medication, alcohol, or "recreational" drugs had caused the hospitalization. The three clinical pharmacologists agreed on only 30 cases (50%), and 27 of these were thought to be unrelated to medications. In 19 of the 30 cases about which the clinical pharmacologists disagreed, they disagreed on whether or not a medication-or alcohol-related event had occurred at all. The clinical pharmacologists disagreed with the physicians treating the patient in 22% to 37% of the cases, but because of the differences among the pharmacologists, the treating physicians agreed with at least one of them in 95% of the cases. Complete agreement between the clinical pharmacologists and the treating physicians occurred in 47% of the cases. This degree of disparity in the clinical identification of ADRs shows that the evaluation of ADRs is subjective and imprecise. The accurate identification of ADRs awaits the development of an objective technique for recognizing ADRs.

Alcoholic Intoxication↗