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Biomedical subjects

K Ewe

Publications and source records attributed to K Ewe.

At least 55 records · Page 3Linked to original sources
PubMed1989

Gastrointestinal transit of undigestible solids measured by metal detector EAS II.

A new method was developed to measure gastrointestinal transit: a metal particle is followed on its way through the gastrointestinal tract by means of a portable metal detector. Deviation of measured localization of the metal particle from the exact site was 0.5-1.0 cm depending on its size and distance from the search probe. A metal sphere of 6 mm diameter can be located accurately in the body at a distance of 2-12 cm from the abdominal surface. Emptying of a metal particle from the stomach, its arrival at the caecal area and its passage through the colon into the rectum can be registered and hence, gastric residence time, small intestinal transit and transit through different parts of the colon were determined. Gastric residence time at the interdigestive phase was (mean +/- SD) 67 +/- 52 min in 20 persons with a range of 9-185 min. When gastric emptying was recorded by pH sensitive radiotelemetering capsule in 10 persons, correlation of both methods was r = 0.99. Small intestinal transit averaged 110 +/- 56 min in six healthy volunteers when breakfast was eaten after the marker had left the stomach. It was delayed to 218 +/- 34 min (P less than 0.01) when fasting was continued. Large intestinal transit of the metal marker was compared to whole body transit of radio-opaque ('Hinton') markers. In nine normal persons, 70% of the Hinton markers were excreted together with the metal particle. It is concluded that this new method is suitable for studying a large variety of physiological, pathophysiological and pharmacological questions concerning gastrointestinal transit.(ABSTRACT TRUNCATED AT 250 WORDS)

Digestive System Physiological Phenomena↗
PubMed1989

Postoperative recurrence of Crohn's disease in relation to radicality of operation and sulfasalazine prophylaxis: a multicenter trial.

Recurrence rate is high after operation for Crohn's disease. A multicenter trial was performed to study the effect of radical or nonradical operation and of sulfasalazine prophylaxis versus placebo on postoperative recurrence rate in 232 patients with Crohn's disease. Sixteen medical and surgical centers participated in the study, 7 operating radically and 9 nonradically. The follow-up period lasted 3 years, the allocation to drug treatment was randomized and double blind. Recurrence was significantly less frequent and occurred later in patients who were operated nonradically. Patients on sulfasalazine prophylaxis had a better prognosis than on placebo. This effect was statistically significant in the first 2 years of treatment. Both strategies were additive: nonradical operation and sulfasalazine had the best prognosis, radical operation and placebo was worst. It is concluded that postoperative recurrence is best prevented by resecting nonradically and prescribing 3 g of sulfasalazine daily at least over 2 years.

Adolescent↗
PubMed1989

Enteric protein loss in various gastrointestinal diseases determined by intestinal alpha 1-antitrypsin clearance.

Intestinal protein loss was measured by means of faecal alpha 1-antitrypsin clearance (alpha 1 ATC) in patients with various gastrointestinal diseases. In healthy controls and in patients with various gastrointestinal diseases there is a remarkable intraindividual fluctuation of the faecal protein loss from day to day. Alpha 1 AT clearance calculated from a three-day stool collection is usually sufficient to indicate enteric protein loss in Crohn's disease, ulcerative colitis, celiac sprue, and Whipple's disease. However, in two patients with intermittent diarrhea coinciding with edema and hypalbuminemia excessive enteric protein loss was observed on one day during a two week stool sampling period only. In one of these patients suction biopsies showed histologically intestinal lymphangiectasia of a 10 cm segment of the upper jejunum. The alpha 1 ATC is a suitable and cheap method to determine enteric protein loss without the use of radioactive tracers and therefore can be used in clinics without departments of nuclear medicine. In contrast to the conventional Gordon test the use of the endogenous marker alpha 1 AT facilitates the determination of faecal protein loss over long time periods, which might be of value in the diagnosis of intermittent occurring enteric protein loss. Furthermore, the endogenous marker alpha 1 AT is of use in following the course of illness and in monitoring the efficacy of therapy in patients with enteric protein loss.

Adult↗
PubMed1989

Comparison of maximal postprandial serum cholylglycine concentration with the retention of 75Se-homotaurocholic acid in ileal dysfunction.

The retention of 75Se-homotaurocholic acid (75SeHCAT) was measured in 12 healthy controls and in 21 patients with Crohn's disease and compared with the maximum postprandial rise in the serum concentration of cholylglycine (CG) in order to detect bile acid malabsorption. The retention of 75SeHCAT was lowered in all patients with inflammation or resection of the terminal ileum over a length more than 20 cm. In 64% of these patients bile acid malabsorption could also be detected by the absence of a significant rise of the postprandial CG serum level but only if the loss of the ileal function exceeded 30 cm. Although less sensitive than the 75SeHCAT retention, the CG method is simpler to apply in terms of laboratory technology and does not involve exposure to radioactivity. The CG method appears to be of use to detect bile acid malabsorption in certain cases. In the case of negatively if still bile acid malabsorption is suspected more sensitive tests such as 75SeHCAT retention should be carried out to further evaluate bile acid malabsorption.

Adolescent↗
PubMed1988

Diarrhoea and constipation.

Drug-induced constipation is mostly caused by changes in gut motility, whilst diarrhoea is more frequently caused by an increase in intestinal fluid secretion. In both instances the drug has to reach the enteric nervous system or the enterocyte, either via the blood or from the lumen, in sufficient concentrations to affect the mediators that regulate motility and fluid transport. Diarrhoea and constipation are frequently mentioned as side-effects of drugs, and therapeutic agents for almost all organ systems have been implicated. However, both these side-effects are usually mild or moderate, and rarely necessitate interruption of drug treatment. An exception to this rule is the antibiotic-associated colitis seen in patients treated with antibiotics such as lincomycin or clindamycin; in principle almost all antibiotics may cause this severe and potentially life-threatening complication. Other rare forms of severe, drug-induced colitis and diarrhoea result from toxic or anaphylactic reactions against gold preparations, cytostatic agents and sulphonamides. Ischaemic colitis due to vascular complications has been described in some women taking oral contraceptives, and in patients treated with vasopressin or digitalis.

Constipation↗
PubMed1988

Intestinal transport in constipation and diarrhoea.

Approximatively 10 liters of fluid enter the gastrointestinal tract with food and endogenous secretions, and only less than 100 ml or 1% leave it with the faeces. Minor changes of this equilibrium in the intestinal transport may cause diarrhoea or constipation. Functions of small and large intestine differ markedly in transport of electrolytes and water. The relatively leaky epithelium of the small intestine allows for rapid equilibrium of osmolality in both directions while the tight epithelium of the colon preserves electrolytes and water once they have been absorbed. It may compensate secretory diarrhoea of the small intestine for instance caused by bacterial toxins to a certain degree unless it is overwhelmed leading to an overflow type of diarrhoea. On the other hand, small changes of net fluid transport in the colon in either direction will lead to diarrhoea or constipation since there is no compensating mechanism behind it. Mechanisms involved in the regulation of transintestinal electrolyte and water movements are the energy providing Na+,K+-ATPase, the mediators of membrane permeability and active Cl- secretion such as cAMP and Ca2+ and substances affecting the tight junctions. Various substances may affect one or more of these regulatory mechanisms. Laxatives are one of those.

Biological Transport, Active↗
PubMed1988

Treatment of ulcerative colitis with olsalazine and sulphasalazine: efficacy and side-effects.

The effects of olsalazine were studied mainly in patients with ulcerative colitis who were intolerant to sulphasalazine, and for relapse prevention. A crossover design with sulphasalazine, 3 g/day, and olsalazine, 1.5 g/day, was applied to compare the side-effects of each drug and to evaluate their therapeutic efficacy. A total of 41 patients with mild or moderately severe left-sided colitis or proctitis were assigned to a randomized treatment schedule. Olsalazine and sulphasalazine were similar in their therapeutic efficacy. Twelve patients complained of adverse effects while on sulphasalazine and 4 patients during olsalazine treatment (p less than 0.05). It is concluded that olsalazine is a safe and effective drug for the treatment of mild or moderately severe ulcerative colitis, and is comparable to sulphasalazine, though with reduced side-effects.

Adult↗
PubMed1988

Simplified determination of intestinal protein excretion based on alpha 1-antitrypsin clearance.

Intestinal alpha 1-antitrypsin clearance in 6 healthy controls and 21 patients with Crohn's disease was measured simultaneously by two different methods. Faecal alpha 1-antitrypsin loss, determined conventionally by weight and alpha 1-antitrypsin concentration of the homogenized three day stool was compared with the faecal alpha 1-antitrypsin loss, which was calculated from weight of the three day stool sample and the mean alpha 1-antitrypsin concentration determined in three 1 g aliquots of the morning stool obtained at the three consecutive days during the collecting period. There was a significant correlation when comparing faecal alpha 1-antitrypsin loss (y = 0.96x + 10; r = 0.952) and intestinal alpha 1-antitrypsin clearance (y = 1.05x - 6.5; r = 0.974) measured by the different methods. Filling the aliquots by a standardized spoon into a vial prepared with a defined volume of solvent makes it possible to take a diluted, homogenized, and centrifuged stool sample out of the vial by the laboratory staff avoiding open faecal work up. The simplified method of measuring intestinal alpha 1-antitrypsin clearance permits to integrate the determination of enteric protein loss into routine diagnostics comparable to the faecal occult blood method.

Adolescent↗
PubMed1987

Calcium and magnesium transport and influence of 1,25-dihydroxyvitamin D3. In vivo perfusion study at the colon of the rat.

Calcium and magnesium transport at different luminal concentrations (1.25, 2.5, 5 and 10 mmol/l) and under the influence of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] were studied in vivo at the perfused colon of the rat. Net absorption of calcium and of magnesium were saturated with increasing concentrations of the perfusate. Net absorption of one ion was not affected by an increasing concentration of the other ion. 1,25(OH)2D3 (100 ng/day given subcutaneously for 4 days) stimulated net absorption of calcium and of magnesium. Presence or absence of calcium or magnesium, respectively, had no effect on the absorption of the other ion under 1,25(OH)2D3 stimulation. The results demonstrate that the colon of the rat is capable of absorbing calcium as well as magnesium. These observations suggest that calcium and magnesium in the rat colon are absorbed by two separate active transport mechanisms, which both are sensitive to 1,25(OH)2D3.

Animals↗
PubMed1987

Effect of bisacodyl on intestinal electrolyte and water net transport and transit. Perfusion studies in men.

The effect of bisacodyl on intestinal electrolyte, glucose, and water transport, and transit was studied in 6 healthy volunteers by intestinal perfusion. A 5-lumen tube with an occluding balloon allowed constant perfusion (10 ml/min) of 30 cm of the upper jejunum and a rapid collection of the perfusate free of contaminants. A phenol red bolus was injected into the tube and its passage through the test segment was calculated by dye dilution formula. A 1-hour control period was followed by a test period with 6 mg/h bisacodyl and followed by 2 other 1-hour control periods. Net absorption of Na+ (0.35 +/- 0.08 mmol/min) and water (1.7 +/- 0.6 ml/min) changed to net secretion (Na+ -0.93 +/- 0.3 ml/min; water -6.6 +/- 1.9 ml/min), glucose absorption decreased from 25.4% +/- 1.1 to 6.3 +/- 0.5 mg/min and K secretion was enhanced. 62 +/- 2.1% of bisacodyl was absorbed in the 30-cm jejunal segment. Mean transit time decreased from 8.5 +/- 1 to 4.4 +/- 0.7 min and mean flow rate increased from 8.4 +/- 0.6 16.6 +/- 1.9 ml/min. There was an inverse linear relationship between mean transit time and mean flow rate. All the effects of bisacodyl were fully or at least partially reversible. Volume and calculated radius of the test segment remained constant and did not change under bisacodyl. It is concluded, that the secretory effect of bisacodyl is mainly responsible for the decreased mean transit time rather than a direct effect on motility.

Adult↗