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Biomedical subjects

S Sarna

Publications and source records attributed to S Sarna.

At least 163 records · Page 9Linked to original sources

Pirenzepine in the treatment of reflux oesophagitis. A placebo-controlled, double-blind study.

The efficacy of 50 mg pirenzepine twice daily in the treatment of reflux oesophagitis was compared with that of placebo in 47 patients over a period of 12 weeks. The 23 patients receiving pirenzepine experienced decreases in symptoms after 4 weeks (p less than 0.001) and 12 weeks (p less than 0.02) of treatment significantly greater than those in the 24 patients receiving placebo. The decreases in symptoms were associated with significantly less use of antacids by the pirenzepine group (p less than 0.01) during the first 4 weeks. Endoscopically, oesophagitis was healed or improved in 54.5% of patients receiving pirenzepine and in 18.2% of patients receiving placebo (p less than 0.05) after 4 weeks of treatment. After 12 weeks of treatment healing or improvement was seen in 55.0% and 35.0% of patients, respectively (difference not significant). Histologic improvement did not differ significantly between the groups. Our results suggest that pirenzepine is useful in the management of reflux oesophagitis.

Adult↗

Multifactorial primary prevention of cardiovascular diseases in middle-aged men. Risk factor changes, incidence, and mortality.

In a randomized five-year multifactorial primary prevention trial of vascular diseases, hyperlipidemias, hypertension, smoking, obesity, and abnormal glucose tolerance of the high-risk test group (n = 612 men) were treated with dietetic-hygienic measures and hypolipidemic (mainly probucol and clofibrate) and antihypertensive (mainly diuretics and beta-blockers) agents. A matched high-risk control group (n = 610) and a low-risk control group (n = 593) were not treated. The program markedly improved the risk factor status, yet the five-year coronary incidence tended to be higher in the intervention group than in the control group (3.1% vs 1.5%), while the stroke incidence was significantly reduced (1.3% vs 0%). The coronary events tended to be accumulated in subgroups treated with beta-blocking agents or clofibrate, but there were few in those receiving probucol or diuretics. Thus, the intervention program significantly reduced development of stroke, but the occurrence of cardiac events was not prevented. Possible adverse drug effects offsetting the probable benefit of improved risk profile are not excluded.

Antihypertensive Agents↗

Snoring as a risk factor for hypertension and angina pectoris.

The association of snoring with hypertension and ischaemic heart disease (IHD) was tested by postal questionnaire in a population of 3847 men and 3664 women aged 40-69 years. Hypertension associated highly significantly with snoring, the relative risk (RR) of hypertension between habitual snorers and never snorers being 1.94 in men and 3.19 in women. This association was also found when adjusting for body-mass index. A significant association between angina pectoris and habitual snoring was observed in men (RR = 2.22). In women the relative risk was not significant. An association between habitual snoring and angina pectoris in men was also found after adjusting for hypertension and body-mass index (RR = 2.01, p less than 0.01). The relative risks for myocardial infarction and hospital admission for IHD for habitual snorers were non-significant.

Adult↗

Active specific immunotherapy with supportive measures in the treatment of palliatively nephrectomized, renal adenocarcinoma patients. A thirteen-year follow-up study.

The results of a 13-year (1971-1984) follow-up of specific active immunotherapy using polymerized autologous tumor tissue with adjuvants and supportive measures, following palliative nephrectomy in 71 patients suffering from advanced renal adenocarcinoma, are presented. The control patient group comprised 56 patients who received the best possible conservative treatment available. The statistically calculated life expectancy in the immunotherapy group is 44.5 months (SE 5.7) and in the control group 19.0 months (SE 3.3). The difference is statistically highly significant (generalized Wilcoxon [Breslow], t = 14.9, p less than 0.0001). There were no serious side effects from the immunization. The supportive measures entailing the administration of factors involved in cell regulatory functions mediated by the central nervous system, amino acids, trace elements, hormones and vitamins has still to be optimized.

Adjuvants, Immunologic↗

A randomized double-blind study using CaNa2EDTA, a phospholipase A2 inhibitor, in the management of human acute pancreatitis.

In a randomized double-blind study the effect of CaNa2EDTA, a phospholipase A2 inhibitor, was tested as a treatment for acute pancreatitis. CaNa2EDTA was infused intravenously during the first 2 days after admission to hospital, in addition to normal conservative treatment. CaNa2EDTA decreased the serum phospholipase A2 activity and appeared to promote recovery from the illness. To what extent the inhibition of serum phospholipase activity may prevent the progress of severe haemorrhagic pancreatitis or diminish mortality and morbidity in acute pancreatitis should be investigated in further studies.

Acute Disease↗

Adoptive transfer of immunity against solid fibrosarcoma in mice with splenocytes and peritoneal exudate cells obtained after in vitro sensitization and in vivo immunization with cis-dichlorodiamine platinum(II) treated fibrosarcoma cells.

Co-cultivation of splenocytes with cis-dichlorodiamine platinum (II) treated tumor cells generate cytotoxic splenocytes, which when injected into normal mice, render them resistant to tumor challenge. Significant increases in mean survival time and 33% of tumor free survivals were observed in mice exposed to a tumor challenge on the 10th day after injection of sensitized splenocytes. Splenocytes peritoneal exudate cells obtained after in vivo immunization of mice with cis-dichlorodiamine platinum(II) treated cells retarded tumor growth in vivo when injected in different combinations in tumor bearing mice. Maximum survival time of tumor bearing mice and 20% tumor free survivals were observed when the animals were injected with a combination of immune splenocytes and normal peritoneal exudate cells. The increase in the number of macrophages of immunotherapeutically treated mice suggests that host macrophages have been activated. Splenocytes and macrophages obtained from immunotherapeutically treated mice showed an increase in cytotoxicity against tumor cells in vitro.

Animals↗

Computerized analysis of spike-burst activity of the upper gastrointestinal tract.

Although the electrical recording of spike-burst activity is a well-established technique, the visual-manual analysis of the electrical tracings is laborious and time consuming. Current automated methods for analyzing upper gastrointestinal spike-burst activity involve the use of computer systems capable of storing large quantities of data. We describe herein an automated system for counting myoelectrical spike bursts that provides online detection of spike bursts using a laboratory computer. Because only the parameters that describe each burst are stored, only a minimal amount of computer memory is required. Subsequent analysis of stored information yields tabular or graphical output of data. Results of the computer analysis are comparable with those obtained by visual-manual assessment.

Animals↗

Familial factors in mortality with control of epidemiological covariables. Swedish twins born 1886-1925.

A Cox proportional hazard regression analysis was carried out that evaluated age-specific death risk among 21,890 twins born in Sweden during 1886 through 1925 and followed during 1962 through 1980. Cotwin's survival was used as the primary covariable, and auxiliary covariables were smoking, marital status and, among men, police registration for alcohol abuse. In each age, sex and zygosity group, except the oldest DZ males, cotwin's mortality had a significant, independent, positive relationship to the mortality risk of the individual. The auxiliary covariables, except marital status among females, had significant, independent, positive relationships to mortality among the youngest twins of both zygosity groups and in the middle age group of MZ twins. In the oldest age group, the death of MZ cotwins was the only variable significantly related to the individual's mortality. Heritability estimates for the age-specific probability or death risk, developed by different methods for different analysis groups, range between 0.4 and 0.6. They have reasonable internal consistency, are not much affected by the covariates, and are in agreement with other studies that did not control covariates.

Aged↗

Health related psychosocial correlates of neuroticism: a study of adult male twins in Finland.

Some health related psychosocial correlates of the Eysenck neuroticism scale were examined in a questionnaire study of 1501 monozygotic (MZ) and 3455 dizygotic (DZ) male twin pairs representing the adult male twin population in Finland. In analyses of the individuals, 34% of the variance in neuroticism was associated to: psychological variables (stress of daily activities, life satisfaction, quality of sleep, and extroversion - the explanatory rate of this variable set was 30%), psychotropic drugs (5%), alcohol use (4%), and smoking (2%). Neuroticism was also associated to social, life change, and medical variables. In pairwise analyses, the heritability estimate (h2) was 0.54 for pairs living together and 0.39 for pairs living apart. It seems that heritability estimates are confounded by the closer intrapair relationship between members of MZ than DZ pairs. In pairwise analyses, 23% of the intrapair difference of neuroticism in MZ pairs was associated to intrapair differences in the aforementioned variables. The following explanatory rates were found: psychological variables, 21%; psychotropic drugs, 2%; alcohol use, 2%; and smoking, 1%. Neuroticism of pairs discordant for background variables showed similar intrapair differences as between individuals in the following variables: service vs farming work, use of alcohol, use of antacids, hypertension, heavy physical work, quality of sleep, changes of workplace for negative reasons, smoking, and use of tranquillizers. It appears that in Finland environmental factors explain at least 61% of the variability in neuroticism, and that factors determining neuroticism are also associated to health related behavior such as smoking, use of alcohol and psychotropic drugs.

Adult↗

Effect of smoking on the fetal coronary arteries.

The effects of maternal smoking on the fetal coronary arteries were studied in 50 babies who died during the first month of life. The intimal layers of the coronary arteries of babies whose mothers smoked during pregnancy were smaller than those of babies of non-smoking mothers. The difference was independent of sex, birthweight, heartweight and infection. Tobacco smoking seems to prevent normal development of the intimal layer of fetal coronary arteries.

Birth Weight↗

Predicting the outcome of rheumatoid arthritis. A Soviet-Finnish co-operative study.

The prognostically important signs and symptoms in the early stage of rheumatoid arthritis were studied in 136 patients selected and treated in Moscow and in 139 patients in Heinola, Finland. The follow-up time was 3 years. The outcome was poor in patients with early signs of radiological destruction in the joints, with rheumatoid factor in serum, with early functional disability or deficient flexion of the fingers, with multiple affliction of the finger, metatarsophalangeal or wrist joints, with marked morning stiffness, and with CRP in the serum. The age of the patients did not influence the outcome in Moscow, whereas in Heinola the mean age was higher in patients with a poor outcome. Despite the marked differences in the therapeutic methods and the outcome for patients, the prognostically important signs and symptoms were very similar in both centres.

Arthritis, Rheumatoid↗

Character of urinary tract infections and pyelonephritic renal scarring after antireflux surgery.

We followed 40 girls who had undergone antireflux surgery (the Politano-Leadbetter technique) at the mean age of 5.2 years until they reached a mean age of 9.5 years. Each girl was matched with a control. The pairs were matched for age at the onset of urinary tract infections and time of operation or selection, number as well as grade (1 to 3) of severity of the preoperative episodes and grade (II to IV) of reflux. Followup time for each member of the pair was identical. Postoperatively, the incidence of pyelonephritic urinary tract infection episodes (grade 3) was significantly less (p less than 0.01) among the operated than the nonoperated cases (9 versus 29), while the number of symptomatic lower urinary tract infections (grade 2) was virtually the same (14 versus 19) in both groups. The operated cases had more asymptomatic bacteriuria (26 versus 12 episodes) so that the total numbers of episodes of bacteriuria (grades 1 through 3) were similar in both groups. Antireflux surgery did not prevent the progression of pyelonephritic renal scarring, which continued equally in operated and nonoperated cases.

Child↗

Morphine versus motilin in the initiation of migrating myoelectric complexes.

The roles of morphine and motilin in the initiation of migrating myoelectric complex (MMC) cycles were studied in four conscious dogs. Morphine or motilin boluses and morphine or motilin infusions were administered to healthy conscious dogs, each implanted with a set of 12 electrodes on the small intestine. The durations of premature phase IIIs initiated by morphine and motilin were not significantly different from each other or from control values. The premature phase IIIs initiated by morphine boluses propagated significantly faster over the 1st half of small intestine than the control or motilin bolus-initiated phase IIIs. The latent period for the onset of phase IIIs after morphine was not significantly different from that after motilin. Morphine infusion (50 micrograms X kg-1 X h-1) generally initiated one or two premature MMC cycles and then disrupted further MMC cycling. Motilin infusion (0.3 microgram X kg-1 X h-1) initiated one premature MMC cycle, and then further cycling continued at the normal rate. We conclude that morphine acts on both the MMC-initiating and MMC-propagating mechanisms, whereas motilin acts only on the MMC-initiating mechanism. Morphine has both excitatory and disruptive effects on MMC cycling, while motilin has only excitatory effects.

Animals↗

Cause-and-effect relationship between motilin and migrating myoelectric complexes.

We investigated the cause-and-effect relationship between plasma motilin levels and migrating myoelectric complexes (MMCs). Each dog was implanted with a set of eight bipolar electrodes on the small intestine. Premature phase IIIs were initiated by morphine bolus injections. Plasma samples were assayed for motilin and gastrin. All spontaneous and morphine-initiated phase IIIs were associated with peaks of plasma motilin, which always occurred after phase IIIs had started in the proximal duodenum. The plasma motilin level decreased consistently during phase I and started to increase again only after phase II had started in the duodenum. Either a meal or somatostatin infusion disrupted MMC cycling, but morphine boluses overcame this disruption and initiated phase IIIs that propagated distally. The phase IIIs thus initiated were associated with peaks in plasma motilin levels. In contrast, bolus injections of motilin did not initiate phase IIIs during the fed state or during somatostatin infusion. Our findings suggest that endogenous motilin does not initiate spontaneous MMCs. Instead, MMC contractions release motilin. The physiological role of motilin, thus released, may be to act as an endocrine agent to coordinate secretory and motor events with the start of phase III activity in the upper small intestine.

Animals↗

Effect of motilin on the opossum upper gastrointestinal tract and sphincter of Oddi.

We studied the effect of motilin on myoelectric activity of the sphincter of Oddi (SO) and upper gastrointestinal tract in conscious opposums. In 17 animals, bipolar electrodes were implanted on the gastric antrum, SO, duodenum, and jejunum. Subsequent 8-h recordings reconfirmed our previous findings that SO spike burst rate changed with interdigestive cycles of the gastrointestinal migrating myoelectric complex (MMC), becoming maximal during passage of phase III activity through the duodenum. In eight animals, peak motilin levels were shown to occur concurrently with maximal SO spike burst rate and MMC phase III activity in the duodenum. Motilin infusion (0.3 and 0.9 micrograms X kg-1 X h-1), given for 30-60 min starting 10 min after duodenal phase III, elicited premature MMC activity that originated in the stomach. Maximal SO activity occurred coincident with passage of premature phase III activity through the duodenum. Pulse intravenous doses of motilin (25-1,600 ng/kg) generally caused an immediate increase in spike burst activity in the gastric antrum, duodenum, and SO that lasted 3-5 min and was often followed by a premature MMC, usually starting in the antrum and progressing through the duodenum and jejunum. Increases in SO spike burst rate also occurred concurrent with motilin-induced, premature duodenal phase III. Motilin given at 5-60% of the duodenal MMC cycle length elicited premature MMCs at 10-60% of the cycle, but no premature MMCs were elicited by any of the motilin doses at the 5% intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

Ampulla of Vater↗

Motor function of the opossum sphincter of Oddi.

We studied the opossum sphincter of Oddi (SO) because in this species the SO is approximately 3 cm in length and its extraduodenal location permits recording of motor activity with negligible interference from duodenal motor activity. The SO segment of 120 animals was evaluated by one or more of the following: (a) intraluminal manometry; (b) electromyography; (c) common bile duct (CBD) flow monitored by a drop counter; (d) cineradiography of intraductal contrast medium; and (e) histologic examination. SO pull-throughs using an infused catheter of 0.6-mm o.d. invariably showed a high pressure zone (HPZ) of 18 +/- 3 SE mm Hg in the terminal 4-5 mm of the SO segment. This HPZ had a narrow lumen, 0.5-0.7 mm in diam, and prominent circular muscle. The HPZ in the terminal SO had both active and passive components. HPZ with minimal amplitude and a paucity of underlying smooth muscle were present inconstantly at the junction of the SO segment with the CBD and pancreatic duct, respectively. The dominant feature of the SO segment was rhythmic peristaltic contractions that originated in the proximal SO and propagated toward the duodenum. These contractions occurred spontaneously at a rate of 2-8/min, ranged up to 200 mm Hg in magnitude, had a duration of approximately 5 s and were not abolished by tetrodotoxin. Concurrent myoelectric and manometric recordings showed that each phasic contraction was immediately preceded by an electrical spike burst. Simultaneous recordings of cineradiography, CBD inflow of contrast medium, SO manometry, and SO electromyography indicated that rhythmic peristaltic contractions stripped contrast medium from the SO into the duodenum. During SO systole, CBD emptying was transiently interrupted, whereas SO filling occurred during the diastolic interval between SO peristaltic contractions. SO distention increased the frequency of SO peristalsis. We conclude that (a) the dominant feature of the opossum SO is rhythmic peristaltic contractions that originate in the proximal SO and propagate toward the duodenum; (b) these forceful SO peristaltic contractions are myogenic in origin and serve as a peristaltic pump that actively empties the SO segment; (c) CBD outflow occurs passively during SO diastole, but is interrupted transiently during each SO peristaltic contraction; and (d) a short HPZ with active as well as passive components exists in the distal SO segment and acts as a variable resistor to SO outflow.

Ampulla of Vater↗

Cleft lip and palate in Finland in 1948-75: correlations to infections, seasonal and yearly variations.

Comparison of the patient records of the Finnish Red Cross National Cleft Center and the Central Register of Congenital Malformations showed a statistically significant yearly fluctuation as well as an increasing trend in the incidence of both cleft lip (and palate) and isolated cleft palate during the period 1948-1975. Almost significant difference was found in the monthly incidence of CL(P) with the peak in children born in April, while no such difference could be noticed in CP or both groups combined. The rapid increase and similarity of the incidence curves of both CL(P) and CP is suggestive of the action of simultaneous and similar exogenous agents in the pathogenesis of both types. In patients with CL(P) the etiological factor was considered to have been active 35 weeks and in CP 31 weeks before delivery. The monthly number of clefts was compared to the number of serologically verified infections (influenza A, respiratory syncytical, mumps, measles, rubeola, parainfluenza, adenoviruses as well as Mycoplasma pneumoniae) in the years 1971-75. No statistically significant correlation was found in this respect.

Cleft Lip↗