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Biomedical subjects

J R Mathias

Publications and source records attributed to J R Mathias.

60 records · Page 4Linked to original sources

Mesenteric fibromatosis associated with familial polyposis.

This patient represents the 25th case report of mesenteric fibromatosis in patients with Gardner's syndrome. Her family genealogy reveals polyposis of the colon in nine members in four generations. In addition, one member has papillary carcinoma of the thyroid and one has newly discovered osteomas. To our knowledge, this family may be the first to manifest this combination of extracolonic lesions with familial polyposis, and the case supports a single-gene etiology for the complete syndrome.

Adult↗

Migrating action potential complex of cholera: a possible prostaglandin-induced response.

Distal ileal loops of New Zealand white rabbits exposed to cholera toxin demonstrated the presence of a highly organized myoelectric pattern defined as the migrating action potential complex (MAPC). We investigated the mechanism by which cholera enterotoxin stimulates MAPC activity. Certain anti-inflammatory drugs have altered the secretory component of cholera diarrhea. We investigated effects of these anti-inflammatory drugs on the MAPC. Indomethacin, 5.0 mg/kg iv, abolished all MAPC activity. Indomethacin, 1.5 mg/kg iv, or acetylsalicylic acid, 150 mg/kg given intragastrically, altered propagation velocity and at times its direction of propagation, but did not abolish the MAPC. An infusion of prostaglandin F2alpha, 2 microng/kg per min intraluminally, induced MAPC activity similar to that of the cholera complex. Indomethacin, 5.0 mg/kg iv, produced no significant changes in number of complexes or propagation velocity. These observations suggested that inhibition of the cholera complex by indomethacin may result from the alteration of prostaglandin synthesis and that prostaglandins may initiate the motility component of cholera diarrhea.

Action Potentials↗

Intestinal myoelectric activity in response to live Vibrio cholerae and cholera enterotoxin.

The myoelectric response of the rabbit ileum was studied in response to live Vibrio cholerae culture, a whole cell lysate of cholera, and the purified enterotoxin. Each cholera preparation produced a series of highly organized migrating action potential complexes (MAPC). An MAPC was defined as action potential discharge with a duration of 2.5 s or longer, followed by similar activity on at least one other consecutive electrode site. The mean and modal onset time of MAPC activity occurred 4 h after the infection with live Vibrio cholerae culture, the freeze-dried whole cell lysate preparation, or the purified enterotoxin. After the onset of activity this pattern persisted for the duration of the recording period (up to 12 h). The MAPC had a mean propagation velocity of 0.85+/-0.07 cm/s (mean+/-SEM), which remained constant with time. Direct visual observation of the loop revealed that the MAPC's resulted in contractions that propelled intraluminal contents in an aborad direction. The mean fluid output from the 12-cm ileal loops was 6.4+/-1.1 ml/h (mean+/-SEM). Control experiments consisted of recordings from: (a) a ligated ileal loop into which nothing was placed; (b) a ligated ileal loop into which either uninfected culture broth or 0.9% NaCl solution was injected; (c) a ligated ileal loop infused with 0.9% NaCl solution at a rate of 11.2 ml/h, and (d) rapid injection of 1.0, 2.5, 5.0, or 10.0-ml boluses of 0.9% NaCl into the proximal catheter. MAPC activity was not observed in any of the control experiments. These studies indicate that in addition to a secretory component to cholera, there exists a highly organized MAPC that results in contractions that propel intraluminal contents in an aborad direction.

Action Potentials↗

Long-term response to subtotal colectomy in colonic inertia.

The purpose of this study was to determine the long-term outcome of patients who had previously undergone subtotal colectomy for severe idiopathic constipation at the University of Florida between 1983 and 1987. In addition, we aimed to determine whether preoperative motility abnormalities of the upper gastrointestinal tract are more common among those patients who have significant postoperative complications after subtotal colectomy. We evaluated 13 patients who underwent subtotal colectomy for refractory constipation between 1983 and 1987 at the University of Florida. Preoperatively, all patients exhibited a pattern consistent with colonic inertia as demonstrated by means of radiopaque markers. Each patient was asked to quantitate the pain intensity and frequency of their bowel movements before and after surgery. In seven patients an ileosigmoid anastomosis was performed, whereas in six patients an ileorectal anastomosis was used. Abdominal pain decreased after subtotal colectomy. Patients with abnormal upper gastrointestinal motility preoperatively experienced greater postoperative pain than those with normal motility regardless of the type of anastomosis. In addition, the number of postoperative surgeries was similar in those patients with abnormal upper motility compared to those with normal motility. Overall, the total number of bowel movements per week increased from 0.5 +/- 0.03 preoperatively to 15 +/- 4.5 (P < 0.007) postoperatively. The results of our study suggest that patients with isolated colonic inertia have a better long-term outcome from subtotal colectomy than patients with additional upper gastrointestinal motility abnormalities associated with their colonic inertia.

Adolescent↗

Relationship of reproductive hormones and neuromuscular disease of the gastrointestinal tract.

Functional disorders of the gastrointestinal tract comprise a common but ill-defined group of diseases; they primarily afflict women. Although predominantly involving nerve and muscle, the cellular and molecular bases of the pathogenesis of these functional disorders are unknown. Clinical studies indicate that some result from neural dysfunction within the enteric nervous system, others may be due to muscular problems, and the causes of still others remain unknown. Laboratory studies have shown that ovarian products such as progesterone, luteinizing hormone, human chorionic gonadotropin, and relaxin (but not estrogen), are neural antagonists of gastrointestinal motility. The production and secretion of these ovarian substances are controlled by gonadotropin-releasing hormone (GnRH) released from the hypothalamus; they probably act on gamma-aminobutyric acid receptors and alter chloride influx into the cell. GnRH analogs are effective drugs that downmodulate the hypothalamic-pituitary-gonadal axis and inhibit the secretion of gonadal products involved in such hormone-dependent diseases as endometriosis and prostate cancer. Acting on the GnRH receptors (seven transmembrane domain receptors) on myenteric neurons, GnRH analogs are also effective neural modulators in such disorders as functional bowel disease. These analogs are a promising new group of compounds that may be used to treat difficult gastrointestinal problems.

Chorionic Gonadotropin↗