Search PubMed⌕ Search

Biomedical subjects

M R Lewin

Publications and source records attributed to M R Lewin.

At least 37 records · Page 2Linked to original sources
PubMed1989

Duodenal and antral mucosal prostaglandin E2 synthesis in a study of normal subjects and all stages of duodenal ulcer disease treated by H2 receptor antagonists.

We tested the hypothesis that the production of prostaglandin E2 (PGE2) is impaired in duodenal ulcer disease and affected by treatment and healing. This was investigated by a study of maximal PGE2 synthesis rates in duodenal and antral mucosal biopsies obtained at endoscopy. The patients were divided into three groups. Group (a): endoscopically normal controls (n = 56); group (b): treatment controls (non-DU disease: gastric ulcer or oesophagitis treated by histamine H2 receptor antagonists) (n = 41); and group (c): patients with DU disease (n = 183) further subdivided into group (c1) active ulcer not on treatment (n = 47), (c2) treated active ulcer (n = 35), (c3) healed ulcer on treatment (n = 86), and (c4) healed ulcer not on treatment (n = 15). Group (a) synthesised (mean (SD] 106.6 (39.0) pg PGE2/mg wt of tissue from the duodenal bulb and 129.9 (56.9) from the second part of the duodenum. No difference was found between group (a) and (b) at either site. Group (c1) ulcer rim made 49.8 (22.7) and at all stages ulcer rim and scar made less than the control duodenal bulb (p less than 0.02). Uninvolved duodenal bulb form groups (c1) (63.4 (31.0], (c2) (83.6 (38.5], and (c3) (81.5 (31.1], however, also made significantly less than controls (p less than 0.02) and a similar though non-significant trend was seen in group (c4). Biopsies from the second part of the duodenum did not synthesise significantly less than the control group but a similar trend was noticed at each stage of ulcer treatment. Biopsies of control antrum synthesised 124.5 (32.2) but only 93.7 (44.2) in group (cl) (p < 0.005). All stages of duodenal ulcer healing were associated with a decreased capacity to synthesise the major prostaglandin PGE2 at the ulcer site and the uninvolved duodenal bulb and, in acute untreated duodenal ulcer, the uninvolved antrum. This decreased capacity may be the consequence of the disease process itself and not secondary to the treatment, indicating a basic pathophysiological abnormality which may explain the characteristic tendency of the disease to relapse.

Adult↗
PubMed1989

Comparison of relapse rates and of mucosal abnormalities after healing of duodenal ulceration and after one year's maintenance with cimetidine or sucralfate: a light and electron microscopy study.

Forty six patients with endoscopically diagnosed duodenal ulceration were randomly allocated to treatment with either sucralfate 1 g qds (n = 24) or cimetidine 200 mg tds and 400 mg nocte (n = 22). When the ulcers healed, a maintenance dose of sucralfate 1 g bd or cimetidine 400 mg nocte was given for one year (or until relapse if earlier). Biopsies of duodenal mucosa adjacent to ulcer sites for light and electron microscopy were obtained before and after healing and again after one year's maintenance if the ulcer remained healed. Duodenal biopsies were also taken from 20 age and sex matched controls. Rates of healing and relapse during maintenance did not differ between the two treatments, although relapses occurred earlier with cimetidine. In the three year post-maintenance follow up period 10/13 cimetidine patients relapsed compared with four of 11 sucralfate patients (p less than 0.05), the relapses occurring significantly earlier in the cimetidine treated patients (p less than 0.05). Mucosal biopsies from both treatment groups still showed considerable abnormalities after healing. During maintenance, however, the sucralfate scores fell significantly (p less than 0.02) to near control levels unlike the cimetidine scores which remained raised at pretreatment values. The histological and ultrastructural changes were not predictive of later relapse. These findings favour the use of sucralfate in preference to cimetidine for maintenance treatment in the prevention of relapse of healed duodenal ulcers.

Adolescent↗
PubMed1989

Comparison of the significance of three histopathological thresholds of malignancy in experimental colorectal tumours.

The purpose of this experiment was to study sequential histogenesis of colonic epithelial tumours in the dimethylhydrazine (DMH) induced rat colon cancer model. Seventy outbred female Wistar rats treated with DMH (40 mg/kg, subcutaneously weekly for five weeks) were killed and autopsied in batches of 10 every five weeks from the 10th to 40th weeks from first treatment. The resulting 378 colonic lesions were assigned to benign or malignant categories using each of three standard histopathological thresholds of malignancy: alpha, the transition from dysplasia to intraepithelial carcinoma; beta, invasion through the crypt basement membrane; and gamma, invasion through the muscularis mucosae. These comprised 79 'benign' and 299 'malignant' or 273 'benign' and 141 'malignant' lesions depending on the threshold (alpha or gamma) assigned (p less than 0.001). Decreasing ratios of pre-threshold to post-threshold lesions between 15 and 40 weeks (alpha, 2.0 to 0.051; beta, 3.5 to 0.57; gamma, 8.0 to 0.87) provide some support for an 'adenoma-carcinoma' progression for each. Comparison of time-dependent prevalence curves confirms that the alpha threshold (cyto-architecture) is qualitatively different from the beta and gamma thresholds (invasion), showing that the adenoma-carcinoma and de novo hypotheses need not be mutually exclusive. The time-dependent prevalence data support de novo origin of some carcinomas, as well as at least two other modes of accrual for neoplastic lesions.

1,2-Dimethylhydrazine↗
PubMed1988

The protective effect of Meciadanol (O-methyl-3(+)-catechin) on experimental ulceration.

Meciadanol, (O-methyl-3(+)-catechin), a histidine decarboxylase inhibitor was shown to have a marked protective action against experimental peptic ulceration in three rat models. The three methods used to induce ulceration were the instillation of absolute alcohol, pyloric ligation following an ulcerogenic South Indian diet and the instillation of rice bran oil into the stomach after pyloric ligation. Meciadanol was shown to reduce incidence, numbers and areas of ulceration and protected mast cells against degranulation and to preserve a normal vascular patterns. Furthermore, Meciadanol reduced gastric acid output and concentration in the pylorus ligation model. These results indicate that Meciadanol may be useful for the treatment of peptic ulcers in humans.

Animals↗
PubMed1988

The role of the liver in the protection by elemental diets against experimental colon cancer.

This study investigates the mechanism whereby the elemental diet 'Vivonex' protects against experimental colon cancer. A total of 240 Wistar rats were randomly allocated to three dietary groups: (A) Vivonex HN, (B) Vivonex HN with 0.05% added cholesterol and (C) control standard powdered diet. All received a colon cancer-producing regimen of dimethylhydrazine (DMH) at a dose of 40 mg/kg BW, s.c., once weekly for 5 weeks. Ten weeks following the first DMH injection, then at 5 weekly intervals until the 40th week, 10 randomly selected rats from each dietary group were weighed, killed and necropsied. Total liver weights were recorded with samples kept for total lipid extraction and cholesterol and phospholipid assay. Each colon underwent macroscopic examination and all neoplasms were recorded. Results showed that control rats had a constant total liver lipid content over the 40 weeks and an increased incidence, number and development of colonic neoplasms with time. In contrast, Vivonex fed rats had significantly elevated total liver lipids, cholesterol and phospholipids over the 40 weeks compared to controls and a significantly reduced number and rate of development of colonic neoplasms. Rats fed on Vivonex + cholesterol had total liver lipids intermediate and significantly different from both the Vivonex and control groups and a similar result was seen in tumour development with time. This study shows that a Vivonex diet results in an increase in hepatic lipids, this effect being partially reversed with dietary cholesterol. The protective effect of Vivonex feeding in the DMH model of colon cancer may thus be mediated in part by the liver.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Low power interstitial Nd YAG laser photocoagulation in normal and neoplastic rat colon.

The effects of low power (1-2 Watts), long exposure (30-400 seconds), interstitial Nd YAG laser therapy on dimethylhydrazine induced rat colonic neoplasms and normal rat colon have been studied. After a single exposure with appropriate laser parameters, dimethylhydrazine induced rat colonic neoplasms underwent coagulative necrosis, sloughed off over a four day period, and left an ulcer which healed within 28 days. Inadequate laser energy resulted in incomplete tumour necrosis whilst excessive laser power or energy increased the likelihood of perforation. Treatment of normal colon with 1 Watt for 30 seconds or longer resulted in coagulative damage which healed by granulation. Mean colonic bursting pressures were significantly decreased one hour after treatment with 1 Watt for 75 or 100 seconds compared with untreated colon (p less than 0.05 and p less than 0.001 respectively) but not in colon treated with 1 Watt for 30 or 50 seconds. In animals treated with 1 Watt for 100 seconds mean bursting pressures were significantly lower than untreated animals when the animals were killed two, four, and seven days after lasering (p less than 0.001 in each case) but not in animals killed at 11, 17, or 21 days. The technique may be of value in the treatment of some inoperable colorectal cancers and sessile polyps in man.

Animals↗
PubMed1988

Endogenous prostaglandin E2 synthesis preserved following cytoprotection by Roter (bismuth subnitrate) in the rat alcohol model of gastric ulceration.

The protective effect of the compound preparation Roter, principally bismuth subnitrate and the other base constituents of these tablets, magnesium carbonate and sodium bicarbonate, were assessed using the standard alcohol model of gastric ulceration in the rat. Groups of ten rats were studied with Group A as controls, Group B alcohol alone, Group C pretreatment with base components followed by alcohol, Group D pretreatment with bismuth subnitrate followed by alcohol and Group E pretreatment with full formulation Roter followed by alcohol. The study was assessed by measurement of areas of gastric ulceration and tissue prostaglandin E2 (PGE2) levels. Alcohol alone caused gross ulceration and reduction in PGE2 synthesis compared to controls (P less than 0.001). Pretreatment with tablet base gave only marginal protection whilst bismuth subnitrate gave marked protection against ulceration compared to alcohol alone (P less than 0.001). Full formulation Roter also gave marked protection against ulceration compared to alcohol alone (P less than 0.001) and this was associated with PGE2 synthesis indistinguishable from controls but significantly greater than in the alcohol alone group (P less than 0.001). It was not possible to determine whether the normal PGE2 synthesis was the cause or the result of protective effect of Roter and the accompanying reduction in ulceration. It was possible however to conclude that using this model of experimental ulceration. Roter and bismuth subnitrate are 'cytoprotective' and this was associated with the preservation of normal prostaglandin synthesis.

Animals↗
PubMed1988

The relationship between faecal bile acids and the development of experimental colon cancer.

Human metabolic studies have suggested a positive association between dietary intake, faecal bile acid excretion and the development of colon cancer. Similar investigations in experimental models of this disease have also implicated faecal bile acids but in both animals and man the results remain equivocal. This study sequentially examines the outputs and concentrations of faecal bile acids in dimethylhydrazine (DMH) treated groups of rats (n = 10), killed at 5-weekly intervals from the 10th to 40th week following the first injection. The sequential results showed that both the output and concentration of faecal bile acids decreased with time and accompanied an increase in both the incidence and numbers of colonic neoplasms over the 40 weeks of the study. When the animals were grouped according to the histological classification of their tumours, the faecal bile acids did not differ between animals with and without tumours. Further, when the latter group were sub-divided into those with adenomas alone and those with carcinomas, faecal bile acid outputs and concentrations did not differ between them, nor when they were compared with the tumour-free animals. The results of this study do not support a role for faecal bile acids in the dimethylhydrazine-induced model of experimental colon cancer in rats.

Animals↗
PubMed1987

Changes in serum lipids related to the presence of experimental colon cancer.

People at risk from coronary heart disease and large bowel cancer are drawn from the same urbanised, industrialised Western populations. Whilst changes in blood lipids are well recognised in heart disease, little is known of their role in large bowel cancer. This study investigates serial alterations in blood lipids in the 1,2-dimethylhydrazine (DMH) rat model of colon cancer. Eighty Wistar rats received a 5 weekly regimen of DMH. At week 10, and at 5 weekly intervals until week 40, random groups of 10 rats were killed and blood taken for total and free cholesterol, phospholipids, triglycerides and liver enzymes. All colonic neoplasms were histologically classified either as adenomas or carcinomas with groups being allocated into tumour-free (n = 16) or tumour-bearing (n = 54), the latter group being further sub-divided into animals with adenoma alone (n = 8) and those with carcinoma (n = 46). Results were considered both sequentially and according to tumour status. Sequential results showed that with increase in colonic neoplasms with time there were accompanying increases in free and % free cholesterol and in phospholipids (P less than 0.001). There were no changes in total cholesterol, triglycerides or liver enzymes. Results according to tumour status showed that whilst there was no difference in total cholesterol or triglycerides between tumour-free and tumour-bearing rats, there was a significant increase in free (P less than 0.01) and % free cholesterol (P less than 0.001) and a decrease in phospholipids in the tumour-bearing animals (P less than 0.001). There was no difference in any serum lipid between tumour-free and adenoma-bearing rats. In animals with carcinoma, while there was no difference in total cholesterol or triglycerides, there was an increase in free (P less than 0.005) and % free cholesterol (P less than 0.001) and a decrease in phospholipids (P less than 0.001) compared to tumour-free rats. The data show for the first time a clear relationship between blood lipids and the presence or absence of large bowel cancer.

1,2-Dimethylhydrazine↗
PubMed1987

The ulcerogenic and protective action of rice and rice fractions in experimental peptic ulceration.

The ulcerogenic and protective effects of various rice fractions in the diet were studied in the pylorus ligated ulcer model in the rat. Oil present in rice and particularly rice bran becomes ulcerogenic on storage and in this model results in a significant increase in the median (range) numbers of ulcers from six (one to ten) to nine (six to 15) (P less than 0.05). The ulcerogenic effect of stored rice bran oil was reversed by cysteine which significantly reduced the ulcer incidence from 100% to 60% (P less than 0.005) and the numbers of ulcers from 26 (six to 70) to one (zero to four) (P less than 0.001). Fresh rice bran significantly reduced the numbers of ulcers from six (one to ten) to one (one to four) (P less than 0.05). Similarly, unmilled rice and freshly milled newly harvested rice was also shown to be protective in this model by significantly reducing the ulcer incidence from 87.5% to 50% and 0% respectively (P values less than 0.025) and the numbers of ulcers from three (zero to 17) to one (zero to one) and zero (zero to zero) respectively (P values less than 0.001). These results could in part explain the geographical distribution of duodenal ulceration, where the incidence is high in all the rice eating areas of the world, and provide a plausible hypothesis to explain the mechanism of dietary ulcerogenesis.

Animals↗
PubMed1987

Plasminogen activators in experimental colorectal neoplasia: a role in the adenoma-carcinoma sequence?

An important step in the transition from adenomatous polyp to invasive carcinoma is the degradation of the epithelial basement membrane. By the generation of plasmin, plasminogen activators may play an important role in regulating the extracellular protease activity required for this event to occur. The production of biofunctional urokinase and of tissue plasminogen activator was therefore investigated in the dimethylhydrazine induced rat model of colorectal neoplasia. Both adenomatous polyps (p values less than 0.001) and colorectal carcinomas (p values less than 0.001) were demonstrated to produce a significant excess of both urokinase and tissue plasminogen activator when compared with macroscopically normal colon. There was, however, no increased production of either enzyme by macroscopically normal preneoplastic colon when compared with control colon. This enhanced capacity of colorectal tumours to produce plasminogen activators and generate plasmin is thus a feature of both the premalignant as well as the malignant phenotype. These enzymes may contribute to the malignant potential of adenomatous polyps and to the invasive capacity of established carcinomas.

Animals↗
PubMed1987

Bypass induced liver disease: an experimental study of the effect of post-operative protein supplementation and metronidazole therapy in an animal model.

An animal model of jejuno-ileal bypass (JIB) with post-operative weight loss and liver dysfunction was established in the rat. The role of a protein supplemented diet and post-operative metronidazole was investigated using this model. The use of a protein supplemented diet alone markedly reduced the detrimental effects of JIB. Although a beneficial effect was also noted with post-operative metronidazole, it was less marked and there appeared to be no additive benefit when both were used together. The results of this study would support the routine use of a protein enriched diet post-operatively in patients undergoing JIB.

Animals↗
PubMed1986

Plasminogen activators in human colorectal neoplasia.

A crucial step in the transition from adenomatous polyp to invasive colorectal cancer is the degradation of the epithelial basement membrane. Plasminogen activators may play a part in regulating the extracellular protease environment necessary for this to occur. Both functional and antigenic activity of the two principal activators of plasminogen, tissue plasminogen activator and urokinase, were measured in 30 colorectal cancers, matched samples of mucosa, and eight adenomatous polyps. Both polyps (p less than 0.01) and carcinomas (p less than 0.001) had raised urokinase activities compared with normal mucosa, the activity being highest in the carcinomas. Activity of tissue plasminogen activator, however, was diminished in both polyps (p less than 0.01) and carcinomas (p less than 0.001) compared with normal mucosa, the values being lowest in carcinomas. Plasmin generation by urokinase--in contrast with tissue plasminogen activator--is fibrin independent and thus less subject to physiological control.

Colonic Neoplasms↗