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Biomedical subjects

B Lentle

Publications and source records attributed to B Lentle.

26 records · Page 2Linked to original sources
PubMed1983

Gastrin, gastric emptying, and gastroesophageal reflux after ranitidine.

In a double-blind study comparing ranitidine to placebo in the treatment of symptomatic gastroesophageal reflux disease (GERD), we assessed gastric emptying time, gastroesophageal reflux, and gastrin response to food. Mean half-time for gastric emptying, measured using 99mTc-sulfur colloid, was 109 minutes in GERD and 102 minutes in nine healthy asymptomatic controls. This difference was not significant, but one-third of GERD had emptying times of 2 S.D.s beyond the mean for the normal controls. The patients with GERD refluxed an average of 2.3% (0.1-10%) of the isotope in 120 minutes compared with only 0.2% (0.0-0.5%) in control subjects. Reflux scans and gastric emptying times did not change with healing of esophagitis or with symptomatic improvement from ranitidine and antacids. There was no relationship between the percentage of the test dose refluxed into the esophagus and the rate of gastric emptying. The mean fasting gastrin concentration in GERD, 133 +/- 12 pg/ml, was higher than in healthy controls, 93 +/- 10 pg/ml (p less than 0.01). After stimulation with a standard meal, the integrated gastrin response (IGR) was similar in controls and GERD patients, but IGR was significantly higher after 6 weeks therapy with ranitidine. These results suggest that: 1) gastric emptying time may be prolonged in some patients with GERD, 2) basal but not food-stimulated gastrin concentrations may be abnormal in GERD, 3) reflux scans have limited use in the investigation of GERD, and 4) ranitidine therapy is associated with an increase in food-stimulated gastrin concentrations.

Adult↗
PubMed1982

Pathophysiologic and ultrastructural basis for intestinal symptoms in Fabry's disease.

Fabry's disease is a rare, sex-linked disorder of glycolipid metabolism. We describe a patient with watery diarrhea, early satiety, and asymptomatic cholelithiasis. The jejunal aspirate demonstrated bacterial overgrowth; sigmoidoscopy showed rectal angiokeratoma corpora diffusum. The gastric emptying rate measured with 99mTc-sulfur colloid was markedly prolonged and the fasting gastrin was elevated at 276 pg/ml. The (14C)glycocholate breath test demonstrated a markedly elevated peak at 4 h, associated with an increased fecal bile acid loss of 0.82 g/day. Oral cholecystogram showed a solitary radiolucent stone in a functioning gallbladder. The bile acid pool size and lithogenic index were normal. Light microscopy of small bowel and rectal biopsy specimens revealed normal surface epithelium, but enlarged and vacuolated ganglion cells in Meissner's plexus. Electron microscopy showed laminated and amorphous osmiophilic deposits within ganglion cells of the submucosal plexus, within smooth muscle cells of the muscularis mucosae, and within endothelial cells lining arterioles, venules, and capillaries, but not in autonomic nerve fibers or enterocytes. The diarrhea and early satiety responded promptly to metoclopramide and to tetracycline. The early satiety was likely on the basis of delayed gastric emptying due to deposition of sphingolipid within ganglion cells of the autonomic nervous system; the diarrhea was likely on the basis of intestinal stasis with bacterial overgrowth and bile salt wastage.

Adult↗
PubMed1979

Pulmonary manifestations in patients with malignant melanoma during BCG immunotherapy. A preliminary report.

Ten patients with malignant melanoma who were treated with bacillus Calmette-Guérin (BCG) were studied with chest roentgenograms, scintiscans with radioactive 67gallium citrate, and the single-breath diffusing capacity of carbon monoxide (Dsb). Three patients (stage 1B) with normal findings had no evidence of progression of disease. Seven patients had abnormal findings on at least one test. Two patients (stage 3B and stage 4B) with focal uptake in the lungs on the scintiscan had metastatic melanoma. Three patients (stage 3B) with diffuse uptake on the scintiscan and a reduced Dsb had no evidence of progression of disease. One patient (stage 1B) with an abnormal chest roentgenogram had a benign pleural effusion, and one patient (stage 4B) with a reduced Dsb was free of melanoma. A diffuse increase in the uptake of radioactive 67gallium in the lungs and a low Dsb may not indicate progression of melanoma. On the other hand, a focal uptake of 67gallium in the lungs is highly suggestive of metastatic disease.

Administration, Oral↗