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Biomedical subjects

A G Sunshine

Publications and source records attributed to A G Sunshine.

7 recordsLinked to original sources

Caloric content of a meal affects duration but not contractile pattern of duodenal motility in man.

The variability of the fasted duodenal contractile pattern and the patterns of contraction during the fed phase was examined in normal volunteers. Prolonged recordings from the duodenum and proximal jejunum were achieved using a series of transducers mounted on a 2.3-mm catheter. A total of 58 interMMC intervals and the response to 18 meals was examined. There was marked inter- and intrasubject variability in the fasted state, even within one study. The phase II pattern was examined in detail and propagated single peaks, propagated clusters, and repeated propagated clusters are described. Single peaks could be propagated as rapidly as 16 cm/sec. Single peaks were propagated more rapidly than propagated multiple peaks. During phase III, duodenal contractions occurred at 11.3 +/- 0.09/min and jejunal contractions at 10.73 +/- 0.15/min. The rate of progression of the onset of phase III was 0.145 +/- 0.015 cm/sec. The effect of the caloric content of the meal was examined by determining the effect of 150-kcal, 300-kcal, and 600-kcal meals on the fed pattern. Increasing caloric content increased the duration of the fed pattern but had no effect on the total or normalized motility index or on the change in motility index over time during the fed pattern. The types of contractions seen during the fed pattern are described. Propagated clusters over at least 16 cm are common during the fed phase in normals, with 10% of all contractions seen during the fed phase being propagated over 28 cm. No difference in the patterns of contractions or their propagation was seen with the different caloric contents of the meals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Colonic slow-wave analysis. Limitations of usefulness of fast Fourier transform (FFT).

The fast Fourier transform (FFT) has been used to determine frequency components of colonic slow-wave activity. We studied the effect of (1) recorder filter characteristics, (2) number of data points and, (3) data window overlap technique and ingestion of a 1000-kcal meal on the resulting power spectrum. Human rectosigmoid slow-wave activity was recorded in nine normal subjects and stored on FM tape for computer analysis. The dynograph filter characteristics were tested using square wave signals, and derived compensation factors were applied to the FFT before viewing. The dynograph filter, when set to optimize visualization of slow waves, attenuates low frequencies nonlinearly. Failure to compensate for the dynograph filter results in inaccurate detection of slow-wave frequencies. FFT of 1-min data gives a different power spectrum than an FFT of 4 min data, indicating a rapidly changing waveform. FFT's of 1 min of data when examined over time fail to demonstrate a consistent frequency spectrum, confirming this conclusion. The lower frequencies in the normal human rectosigmoid are present at the greatest power. These studies indicate that the colon has slow waves of irregular frequencies, in contrast to the stomach or small intestine. No change in the dominant frequency was seen following the ingestion of a 1000-kcal meal.

Adult↗

The effect of nonsteroidal antiinflammatory drugs on upper gastrointestinal tract symptoms and mucosal integrity.

Gastrointestinal side effects are the most common adverse reactions to the use of nonsteroidal anti-inflammatory drugs (NSAIDs), but their true incidence is controversial. Studies have shown an approximate 20% incidence of upper gastrointestinal symptoms in patients using aspirin and a 10% incidence in patients using some other NSAIDs, such as ibuprofen. Because symptom assessment is subjective and may correlate poorly with objective evidence of gastroduodenal injury, studies of endoscopic and fecal blood loss have been used to assess mucosal injury. Whereas high doses of aspirin may produce overt mucosal injury in a majority of patients and normal volunteers, ibuprofen causes significantly less qualitative and quantitative damage in a dose-dependent manner. Daily doses of 1,200 mg of ibuprofen may produce endoscopic injury and fecal blood losses similar to placebo. Although epidemiologic evidence shows a strong correlation of daily aspirin use to gastric ulcer and upper gastrointestinal hemorrhage, other NSAIDs have not been definitively linked to these lesions; no epidemiologic study has established NSAIDs as a cause of duodenal ulcer or gastric lesions when given in low doses. NSAIDs, particularly ibuprofen, in low doses can be considered to have low gastroduodenal toxicity.

Animals↗

Chronic severe constipation. Prospective motility studies in 25 consecutive patients.

The purpose of this study was to determine the patterns of gastrointestinal and anal sphincter motility in 25 consecutive patients with severe constipation. Three patterns of abnormal motility were observed in 68% of the patients: (a) isolated anal sphincter dysfunction (20%), (b) a generalized disorder of gastrointestinal motility (24%), and (c) rectosigmoid dysfunction (24%). The remaining patients had either a previously unrecognized primary disorder leading to constipation or the irritable bowel syndrome. Duration of symptoms, laxative usage, or other historical features failed to distinguish each of the groups. Anal sphincter dysfunction was diagnosed by demonstrating impaired sphincter relaxation during rectal distention. Generalized motor disorders were diagnosed by demonstrating impaired colonic and esophageal function together with an abnormality in gastric emptying. Rectosigmoid dysfunction was manifest by an impaired rectosigmoid motor response to feeding without evidence of other organ dysfunction. These studies indicate that a high percentage of patients with more severe degrees of constipation have a serious but sometimes treatable disorder of bowel function, rather than the irritable bowel syndrome.

Adult↗