Search

The role of antioxidants in the pathogenesis of reflux esophagitis (RE), Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) remains unknown. We evaluated the associations among dietary antioxidant intake and these diseases. We performed an assessment of dietary antioxidant intake in a case control study of RE (n = 219), BE (n = 220), EAC (n = 224), and matched population controls (n = 256) (the Factors Influencing the Barrett's Adenocarcinoma Relationship study) using a modification of a validated FFQ. We found that overall antioxidant index, a measure of the combined intake of vitamin C, vitamin E, total carotenoids, and selenium, was associated with a reduced risk of EAC [odds ratio (OR) = 0.57; 95% CI = 0.33-0.98], but not BE (OR = 0.95; 95% CI = 0.53-1.71) or RE (OR = 1.60; 95% CI = 0.86-2.98), for those in the highest compared with lowest category of intake. Those in the highest category of vitamin C intake had a lower risk of EAC (OR = 0.37; 95% CI = 0.21-0.66; P-trend = 0.001) and RE (OR = 0.46; 95% CI = 0.24-0.90; P-trend = 0.03) compared with those in the lowest category. Vitamin C intake was not associated with BE, and intake of vitamin E, total carotenoids, zinc, copper, or selenium was not associated with EAC, BE, or RE. In conclusion, the overall antioxidant index was associated with a reduced risk of EAC. Higher dietary intake of vitamin C was associated with a reduced risk of EAC and RE. These results suggest that antioxidants may play a role in the pathogenesis of RE and EAC and may be more important in terms of progression rather than initiation of the disease process.

We present a case of a miscarriage at 16 weeks of gestation due to infection and transplacental passage of Salmonella group C. This was identified as being Salmonella Virchow from genital tract swab culture, and placental Gram-staining revealed numerous colonies of Gram-negative bacilli within the fibrin between the placental villi, confirming a true villitis associated with a hematogenous infection. Based on the patient's history, it was suggested that she had contracted the salmonella infection from eating undercooked eggs. Treatment of salmonella infection in pregnancy is controversial, and antibiotic therapy should be reserved for cases of invasive disease, using amoxicillin or a cephalosporin.

This study analyses the relationship between the level of experience of both surgeon and radiographer and the radiation dose administered in theatre, during fixation of extracapsular proximal femoral fractures. From the 63 dynamic hip screw procedures performed, 10 were done by Senior House Officers (SHOs), 10 by Consultants and 43 by Registrars, whereas Basic Radiographers were involved in all cases. Fractures were classified as two part, three part or four part. A four part fracture required higher levels of radiation dose and screening time as compared with a two part fracture. All two part fractures were screened by radiographers of similar experience; however, the radiation dose and screening time were different amongst different levels of surgeon. The highest radiation dose and screening times were recorded when an SHO was the operating surgeon and the lowest when a registrar was the surgeon. The two part and three part fractures performed by registrars were subdivided according to the experience of the radiographer. In both cases a statistically significant difference was found between the dose of radiation administered in theatre and the years of experience of the radiographers (p < 0.05).

Using Mg2+ macroelectrodes based on the sensor ETH 7025 and accurate Mg2+-EDTA buffer solutions, the apparent Mg2+-ATP dissociation constant (Kapp) was measured at 25 and 37 degrees C in background solutions mimicking the cationic intracellular milieu of muscle cells. The mean +/- SD (in microM) at 25 degrees C was 157.0 +/- 13 (n = 4), 127.5 +/- 12.0 (n = 11), 101.0 +/- 9.0 (n = 4) and at 37 degrees C was 106.6 +/- 9.6 (n = 4), 87.4 +/- 4.9 (n = 4), 78.1 +/- 2.0 (n = 4) at pH values of 6.7, 7.2, and 7.7, respectively. The dependence of Kapp at 25 degrees C on the ionic strength was also measured, the mean +/- SD (microM) being 61.9 +/- 2.2 (n = 3), 127.5 +/- 12 (n = 11), and 243.0 +/- 11.8 (n = 3) at ionic strengths of 0. 087, 0.156 (normal background), and 0.3 m, respectively. These values are larger than the Kapp values most commonly used in the literature (87.4 microM compared to 38 microM at pH 7.2 and 37 degrees C) to estimate the [Mg2+]i in 31P NMR experiments, attributed to the difficulties in setting the [Mg2+]i without the use of Mg2+ buffer solutions. If these new values are used, the literature values for [Mg2+]i estimated by 31P NMR increase by a factor of around 1.5, making them similar to values obtained by direct Mg2+ microelectrode measurements., (Copyright 1997 Academic Press.)

Using antibodies to a complementary peptide of somatostatin, putative somatostatin binding proteins were characterized on canine parietal cells. A synthetic peptide (S-C1) was derived from the complementary mRNA sequence for somatostatin-14. Antiserum containing antibodies to S-C1 inhibited competitively 125I-Tyr11-somatostatin binding to canine oxyntic mucosal membranes. Canine parietal cell preparations were incubated with carbachol in the presence or absence of somatostatin and antisera to S-C1. Antibodies to S-C1 produced a decrease in carbachol-stimulated 14C-aminopyrine uptake comparable with that produced by 10(-6) M somatostatin. In immunocytochemical studies by light microscopy, antibodies to S-C1 produced positive staining of parietal cells throughout the oxyntic gland area. By electron microscopy using immunogold techniques, binding by antibodies to somatostatin C-1 was localized ultrastructurally to basolateral and intracellular membranes and to secretory canalicular membranes of parietal cells. These studies support the conclusion that antibodies to the somatostatin complementary peptide demonstrate properties similar to those of somatostatin in that they inhibit carbachol-stimulated aminopyrine uptake and 125I-somatostatin binding. Furthermore, these antibodies localize to specific regions on plasma membranes of parietal cells, which may represent somatostatin binding sites.

A prospective, controlled, randomized study of 80 patients undergoing esophageal operations was undertaken, in which one group of patients was given digoxin and the other was not. The incidence of cardiac dysrhythmia was compared in each group. Twenty-six patients underwent operation for benign disease. Equal numbers were digitalized or not and no dysrhythmias occurred. Fifty-four patients underwent operation for malignant disease. Of 26 in the group digitalized, 12 suffered dysrhythmia (46%). Of 28 not digitalized, 9 suffered dysrhythmia (32%). Overall, 39% of patients with malignant disease suffered a dysrhythmia compared with none with benign disease (p < 0.002 by chi 2).

We evaluated effects of duodenojejunal (DJ) feeding on gastric pH and selected gastrointestinal hormones in 13 randomly selected patients in an intensive care unit (ICU). To obtain baseline values for gastric pH, a nasogastric (NG) tube was placed in each patient and gastric pH was measured every 30 minutes for 2 hours. To obtain control values, a Dobbhoff tube was placed fluoroscopically and 0.45 percent saline solution (NaCl), 75 ml, was infused for 1 hour and gastric pH was measured again; the previously placed NG tube was left in position. Then, by randomization, either 0.45 percent NaCl (pH = 5) was continued (n = 6) or a high-nitrogen, isotonic, enteral feeding solution (Osmolite HN, pH = 6.4) (n = 7) was infused, both at 75 ml/h. Gastric pH was noted hourly for 96 hours; antacid (Maalox TC, 15-ml aliquots) was given by NG tube when the pH was 4 or less. After 96 hours, the infusion was stopped and gastric pH was noted for 4 additional hours. Before and during initial saline solution infusion; after 24, 48, 72, and 96 hours of continuous infusion; and 4 hours after stopping the infusion, peripheral venous blood was obtained for measurement of plasma gastric inhibitory polypeptide (GIP) and serum gastrin. Data were analyzed by ANOVA (RMD), Fishers' exact test, and the unpaired t-test. Groups did not differ demographically. Throughout the infusion, gastric pH tended to be higher with the enteral feeding solution than with saline solution, but this was significant only at 24 hours. Less antacid was required with the enteral feeding solution at 24 and 48 hours than with saline solution. Plasma GIP levels were significantly higher with the enteral feeding solution than with saline solution during most of the infusion. Serum gastrin levels did not differ between the groups. In this cohort, infusion of the enteral feeding solution tended to maintain a gastric pH of more than 4 and was associated with increased plasma GIP levels, which may inhibit gastric acid secretion. Early enteral feeding may benefit certain ICU patients.

The effect of pH changes on Ca2+ transport by isolated heart mitochondria was measured. Two components of Ca2+ transport were identified, an accumulation dependent on mitochondrial respiration and a Na+-dependent efflux. A decrease of pH over the range 7.7-6.7 reduced the initial rate and the total amount of respiration dependent Ca2+ accumulation. At pH 7.2 the [Na+] required to activate half-maximal efflux, k1/2, was 7.5 +/- 1.1 mM. Decreasing the pH over the range 7.7 to 6.9 increased the k1/2 from 3.6 to 11.6. The effect of acidosis was more profound on the respiration dependent Ca2+ uptake than the Na+-dependent efflux.

As a result of a fall, a young athlete sustained a type 2 epiphyseal fracture of the proximal tibia. Three days later it became apparent that the popliteal artery had thrombosed and a successful arterial reconstruction was carried out.

Specific binding of radiolabeled gastrin by gastric mucosal cells prepared from guinea pigs was detected and examined. Specific cell binding of gastrin was found to be both pH and temperature dependent. Maximum binding of radiolabeled gastrin by gastric mucosal cells was demonstrated at pH 7.4 and at 4 degrees C. Substantial degradation of 125I-gastrin occurred during incubation with gastric mucosal cells. Gastrin degradation was detected both by loss of immunological reactivity with antibodies to gastrin and by abolition of subsequent specific binding after prior incubation with gastric mucosal cells. Degradation of gastrin was most marked with incubations conducted at pH 7.4 and at low pH (pH 2.0), suggesting the activities of at least two gastrin-degrading enzyme systems in the gastric mucosal cell preparation.

The purpose of this present study was to develop a method for stimulation of acid secretion by the isolated perfused rat stomach. Rat stomachs were perfused in situ via the abdominal aorta and celiac axis with Krebs-Ringer bicarbonate buffer in the presence or absence of 10% ovine erythrocytes. The gastric lumen was perfused with distilled water and gastric contents were collected at frequent intervals through a catheter at the pylorus. Sixty minute gastric acid output in response to various concentrations of pentagastrin was determined by titration of gastric contents with 0.01 N NaOH to pH 7.0. During arterial perfusion with Krebs-Ringer bicarbonate buffer in the absence of ovine erythrocytes gastric acid output was 2.50 +/- 0.58 SEM microEq H+/h, which did not increase in response to perfusion with Krebs-Ringer bicarbonate buffer containing pentagastrin. However, inclusion of 10% ovine erythrocytes in the arterial perfusate resulted in substantial stimulation of gastric acid by pentagastrin: maximal acid output, achieved with a pentagastrin dose of 0.6 microgram/kg/h, was 23.5 +/- 3.73 microEq H+/h (p less than 0.01). The results of the present study demonstrate the capacity of the isolated vascularly perfused rat stomach to secrete acid and provide a model for studying interactions of gastrointestinal regulatory peptides and their physiologic roles in the regulation of gastric acid secretion.

In order to examine hepatic clearance of gastrointestinal regulatory peptides, rat livers were perfused in situ, and radiolabelled somatostatin (S-14, S-28), gastrin-releasing peptide (GRP-14, GRP-27), and vasoactive intestinal peptide (VIP) were injected into the portal vein and hepatic venous effluent was collected. S-14 and S-28 were not affected significantly by hepatic transit: 91.6 +/- 2.8% (SEM) of S-14 and 95.9 +/- 2.2% of S-28 were recovered, and neither peptide was degraded by hepatic transit, as determined by immunoprecipitation and gel chromatography. GRP-14 and GRP-27 were also not affected by hepatic transit: 91.5 +/- 1.6% of GRP-14 and 94.4 +/- 2.4% of GRP-27 were recovered intact. In contrast, when radiolabelled VIP was infused into the portal vein, 56.7 +/- 7.4% of injected labelled VIP appeared in the hepatic venous effluent, of which only 33.5 +/- 1.2% was intact peptide. Results of these studies indicate that enteric VIP released into the splanchnic/portal circulation is cleared by hepatic transit. However, somatostatin and GRP peptides appear to traverse the liver intact and could potentially produce systemic biological effects.