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Biomedical subjects

H Meshkinpour

Publications and source records attributed to H Meshkinpour.

At least 55 records · Page 3Linked to original sources
PubMed1982

Colonic dysfunction in multiple sclerosis.

Multiple sclerosis is a central nervous system disease frequently accompanied by urinary symptoms and severe constipation. In order to investigate the pathophysiology of these symptoms, we studied colonic motor and myoelectrical activity, as well as colonic volume-pressure relationships (colonometrograms) and have correlated these data with cystometry and electrophysiologic studies of the central and peripheral somatosensory nervous system. The study group consisted of 7 patients with advanced multiple sclerosis marked by symptoms and signs of somatic and visceral nervous system dysfunction including severe constipation. Ten normal volunteers served as control subjects. The multiple sclerosis group demonstrated electrophysiologic evidence of lesions in the somatosensory neuroaxis central to the lumbosacral spinal cord. Abnormal cystometrograms suggested visceral central nervous system dysfunction. Colonometrograms in the multiple sclerosis group demonstrated a more rapid pressure rise than in the control group (p less than 0.01). The multiple sclerosis group failed to demonstrate the postprandial increase in colonic motor and myoelectrical activity observed in the control group (p less than 0.01). Abnormal colonometrograms and absent postprandial colonic motor and myoelectric responses may be features of visceral neuropathy in patients with advanced multiple sclerosis and severe constipation.

Colon↗
PubMed1982

Gastrointestinal pathology in patients with chronic renal failure associated with spinal cord injury.

Clinical and histological data on 23 consecutive patients with end stage renal disease associated with spinal cord injury were reviewed. They had been maintained on hemodialysis for a mean duration of 17 months. Various gastrointestinal abnormalities were detected in 20 patients. Thirteen patients (56%) were found to have secondary amyloidosis involving the gastrointestinal tract. The incidence of peptic ulcer disease and cholelithiasis were both higher than that reported in postmortem examinations of the general population.

Adult↗
PubMed1981

Reflux gastritis syndrome. Role of upper gastrointestinal microflora.

Bacteriologic samplings of the upper gastrointestinal tract bile acids profile of the intestinal contents were performed in eight patients with reflux gastritis syndrome and three asymptomatic patients who had had gastric surgery. All symptomatic patients showed colonization of the gastric and/or intestinal samples with strains of enteric Gram-negative bacteria and Pseudomonas. However, no single specific group or species was consistently associated with reflux gastritis syndrome. The concentration of total and conjugated bile acids was significantly greater in symptomatic patients. Presence of free bile acids was correlated with heavier bacterial colonization. To evaluate the effect of antibiotic therapy on bacterial flora and symptoms, patients were studied for three separate four-week evaluation periods. Following the first evaluation period, they were assigned to receive either doxycycline or placebo in a crossover fashion during the second and third periods. Total symptom scores did not differ significantly and no specific patterns were evident in the bacterial flora. These observations support the hypothesis that microbial flora is an associated factor in reflux gastritis syndrome and may play an important role only in certain individual patients.

Adult↗
PubMed1980

Dialysis-induced changes in muscle strength.

Little is known about the acute effects of hemodialysis on muscle strength. Rapid changes in hemodynamic and biochemical parameters are known to occur during dialysis and may alter muscle performance. Ten patients maintained on chronic hemodialysis had measurements of quadriceps muscle and handgrip strength performed before and after dialysis. In seven of these patients maximum static inspiratory and expiratory pressures (PI max and PE max respectively) were similarly determined. Quadriceps muscle strength improved in 6 patients, decreased in 3 and remained unchanged in 1. Handgrip strength increased in 5 patients, decreased in 3, and remained unchanged in 1. PI max decreased in 6 patients and increased in 1, and PE max decreased in 4 patients and increased in 3. No significant correlation was found between the changes in strength of the tested muscle groups and the serum concentrations of sodium, potassium, calcium, phosphorus, urea nitrogen, and creatinine, changes in blood pressure of fluid balance. The dialysis-induced changes in biochemical parameters may exert opposing effects on neuromuscular performance. This may explain the diversity of the results obtained in this study.

Adult↗
PubMed1980

Colonic mucosal potential differences in the management of 21-hydroxylase deficiency.

Use of the colonic potential difference as a means of assessing the efficacy of different suppressive steroid regimens was explored in a patient with incomplete 21-hydroxylase deficiency. Changes in the potential difference were found to closely reflect changes in the plasma concentration of hormones such as aldosterone, androstenedione, dehydroepiandrosterone, and dehydroepiandrosterone sulfate. Dexamethasone, which produced the most marked change in the potential difference, also produced the most suppression of the plasma steroid concentrations. It is suggested that the colonic potential difference can be used as a simple alternate means of assessing the efficacy of suppressive steroid therapy in some patients with 21-hydroxylase deficiency.

Action Potentials↗
PubMed1980

Reflux gastritis syndrome: mechanism of symptoms.

Despite numerous observations indicating the deleterious effect of refluxed intestinal contents upon the stomach, the mechanism of injury and symptoms in the reflux gastritis syndrome is unclear. Much speculation has centered around the role of bile acids in the production of symptoms and histologic damage. Accordingly, the aims of our study were (a) to determine whether administration of autologous intestinal contents into the stomach can produce the symptoms of the reflux gastritis syndrome, (b) to measure and conpare the concentrations of bile acids in upper intestinal contents of postsurgical patients with and without the syndrome, and (c) to determine whether artificial bile acid solutions can reproduce the symptoms reported by the patients. Eleven patients with reflux gastritis syndrome and 10 asymptomatic postgastric surgery patients were evaluated. Autologous intestinal contents obtained after cholecystokinin injection and normal saline were infused in a random, double-blind fashion into the stomach of the patients. Determinations for total and individual bile acids, as well as the bile acid conjugated/unconjugated and glycine/taurine ratios were made on aliquots of upper intestinal contents of symptomatic and asymptomatic patients. Finally, saline and two artificial bile acid solutions with bile acid compositions similar to those of upper intestinal contents from symptomatic and asymptomatic patients were infused in random, double-blind fashion into the stomach of 8 patients from each group. Positive symptom responses to autologous intestinal contents were found in 10 of 11 symptomatic patients and only 2 of 10 asymptomatic patients (P < 0.01), both of whom showed positive responses to both autologous intestinal contents and saline. No symptomatic patients had a positive response to saline. Symptomatic patients had bile acid concentrations significantly greater (P < 0.001) than asymptomatic patients. A positive response to artificial bile acid solution infusion was found in only 1 symptomatic patient. It is concluded that (a) symptoms of the reflux gastritis syndrome are reproduced by gastric infusion of upper intestinal contents and (b) bile acids alone are not responsible for the production of symptoms.

Adult↗
PubMed1980

A unique muscular ring of the jejunum.

Muscular malformations of the gastrointestinal tract are rare conditions. This communication describes a unique case of such a malformation which developed as a muscular ring in the jejunum. The ring consisted of muscular stricture with a vascular stroma and scattered ganglion cells, covered with pyloric type glands. A similar lesion, which probably represents a hamartoma, has not been reported previously.

Diagnosis, Differential↗
PubMed1979

Esophageal motor function in Graves' disease.

Esophageal motor function was studied in 10 patients with untreated Graves' disease and 15 healthy volunteers who served as controls. A noncompliant recording system with a triple-lumen assembly was used. Resting upper- and lower-esophageal-sphincter pressures, amplitude, duration, and velocity of peristaltic contractions in the body of the esophagus, and the number of repetitive and simultaneous contractions were measured. There was no significant difference in peristaltic amplitude and duration between the controls and the patients with Graves' disease. However, there was a significant increase in velocity of contractions in Graves' disease as compared with controls. On restudy of 5 patients who became euthyroid after treatment with 131I, all the measured parameters were unchanged except for velocity of the peristaltic contractions. The value for this measurement decreased essentially to the same as that found in the control subjects. It is concluded that: (1) thyrotoxicosis increases the propagation velocity of esophageal contraction, and (2) thyroid hormones may play a physiologic role in the control of esophageal motor function.

Adult↗
PubMed1979

Cimetidine in the treatment of acute alcoholic pancreatitis. A randomized, double-blind study.

A double-blind study was made of the comparative effectiveness of cimetidine in the treatment of acute alcoholic pancreatitis. The study group was composed of 27 patients with acute episodes of alcoholic pancreatitis of mild to moderate severity. The patients were randomized into 2 groups, either receiving cimetidine, 300 mg four times daily or a placebo. Both groups were given intravenous fluids and meperidine hydrochloride (Demerol) as needed. There were no significant differences between the 2 groups as measured by a variety of clinical and laboratory parameters. The mean value of the daily serum amylase in the placebo group declined steadily to normal; hyperamylasemia in this group persisted for 52 +/- 11 hr (mean +/- SE). By contrast, serum amylase in the cimetidine group peaked at 24 hr after the start of treatment and remained abnormal slightly longer; the duration of hyperamylasemia in the group was 69 +/- 10 hr. It is concluded that: (1) cimetidine is not superior to a placebo in the management of mild to moderately severe acute alcoholic pancreatitis and (2) serum amylase activity in patients with acute alcoholic pancreatitis given cimetidine tends to be greater and hyperamylasemia is of somewhat longer duration than in those treated with a placebo.

Acute Disease↗
PubMed1979

Significance of endoscopically visible blood vessels as an index of atrophic gastritis.

The endoscopic criteria for atrophic gastritis are. 1. pale mucosa; 2. shiny surface and 3. prominent submucosal vessels. To evaluate the diagnostic accuracy of circumscribed atrophic gastritis based on these findings, we studied 184 consecutive upper gastrointestinal endoscopies. The endoscopic diagnosis of atrophic gastritis was made only if two endoscopists both agreed on the findings and interpretation. The location of the atrophic pattern and whether it was circumscribed or diffuse were recorded. Two biopsy specimens were than obtained. Histologic material was interpreted by a pathologist who had no prior knowledge of the endoscopic findings. Twenty-five patients (13%) had atrophic gastritis endoscopically; in four it was diffuse and in 21 it was circumscribed. Utilizing the criteria of Whitehead, et al, atrophic gastritis was diagnosed histologically in three of four patients with diffuse gastritis but in one of those considered to have circumscribed atrophic gastritis. It is concluded from these preliminary data that a circumscribed atrophic mucosal pattern is a frequent endoscopic finding that does not necessarily represent atrophic gastritis histologically.

Adult↗
PubMed1977

A unique multisystemic syndrome of unknown origin.

A unique multisystemic syndrome of polyneuropathy, anasarca, polycythemia, pigmentation, and endocrinopathy that occurred outside of Japan is reported, along with the results of postmortem examination. A review of the literature on this syndrome is presented, and the possible etiological considerations are discussed.

Adult↗
PubMed1977

Effect of cholestyramine on the symptoms of reflux gastritis. A randomized, double blind, crossover study.

Bile acids have been proposed to be important in the pathophysiology of the syndrome of "bile reflux gastritis" after surgery. To examine the role of cholestyramine, an ion exchange resin that binds bile acids, on symptoms of this syndrome, we did a randomized, double-blind crossover study on 16 patients. No differences in frequency of abdominal pain, nausea, vomiting, or bitter taste were observed among cholestyramine (4 g, three times daily for 3 weeks), placebo, and routine (dietary restriction and ad libitum antacid) treatment periods. We conclude that this regimen of cholestyramine was ineffective in symptomatic treatment of bile reflux gastritis.

Adult↗