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Biomedical subjects

E J Boyd

Publications and source records attributed to E J Boyd.

At least 37 records · Page 2Linked to original sources
PubMed1988

Hypertrophic gastritis associated with increased gastric mucosal prostaglandin E2 concentrations in a patient with the carcinoid syndrome.

A case of a 69 year old man in whom hypertrophic gastritis was associated with the carcinoid syndrome is reported. Concentrations of prostaglandin E2 were increased in plasma, gastric juice, gastric mucosa and urine. He had marked hypochlorhydria in response to pentagastrin stimulation (Peak acid output (PAO) pg:0.2 mmol/h). After successful hepatic arterial embolisation of the metastases (as indicated by an 85% decrease in 24 h urinary 5-HIAA) the concentrations of prostaglandin E2 decreased in the plasma, gastric juice and gastric mucosa. The gastric mucosal hypertrophy regressed and secretion of acid in response to pentagastrin returned (PAO pg:9.0 mmol/h). These findings suggest that the carcinoid tumour was producing a substance which stimulated increased local synthesis of prostaglandin E2 in the gastric mucosa, with concomitant gastric mucosal hypertrophy and inhibition of gastric acid secretion.

Dinoprostone↗
PubMed1987

The effects of cigarette smoking on plasma concentrations of gastric antisecretory drugs.

Plasma concentrations of cimetidine and ranitidine were measured after oral administration (n = 5 for cimetidine, n = 5 for ranitidine) or intravenous administration (n = 6 for cimetidine, n = 4 for ranitidine) in habitual smokers, once when cigarettes were smoked and again on a separate day when cigarettes were prohibited. After oral administration plasma concentrations of both drugs rose more rapidly and peak plasma concentrations were achieved earlier when cigarettes were smoked. However, plasma concentrations of the drugs subsequent to the peak were significantly lower when cigarettes were smoked. Cigarette smoking had no effect on plasma blood concentrations of either drug when administered intravenously. In eight healthy smokers cigarette smoking increased the gastric emptying of a liquid test meal by 28% compared with non-smoking control rates. In habitual smokers cigarette smoking alters the blood concentrations of antisecretory drugs in a manner which appears attributable to an increase in the rate of gastric emptying. The observed changes in drug disposition may contribute to the loss of gastric secretory inhibition observed in duodenal ulcer patients who are smokers.

Adolescent↗
PubMed1986

Dissociation between pancreatic enzyme secretory and synthetic dose-responses to cholecystokinin in man.

The effect of varying the intensity of pancreatic stimulation on the synthesis of human pancreatic enzymes has not previously been studied. We have measured the secretion and synthesis of pancreatic enzymes in response to either secretin alone (1 CU.kg-1.h-1) or secretion plus increasing doses of cholecystokinin (CCK) (0.25, 0.5 or 1.0 IDU.kg-1.h-1). Enzyme synthesis was measured using the incorporation of 75Se-methionine (0.15 mCi (5.6 kBq).kg-1.h-1) into the trichloracetic acid-insoluble fraction of the duodenal aspirate. Outputs of trypsin, chymotrypsin, lipase and protein showed a bell-shaped dose response to increasing doses of cholecystokinin, with maximal outputs occurring in response to secretin plus cholecystokinin 0.5 IDU.kg-1.h-1. The rate of incorporation of 75Se-methionine increased with increasing doses of cholecystokinin and was maximal in response to secretion plus cholecystokinin 1.0 IDU.kg-1.h-1. There was therefore dissociation between the secretory and synthetic responses to increasing doses of cholecystokinin.

Cholecystokinin↗
PubMed1986

Diagnosis of exocrine pancreatic insufficiency in cystic fibrosis by use of fluorescein dilaurate test.

In the fluorescein dilaurate test fluorescein dilaurate is cleaved by the pancreas specific cholesterol ester hydrolase activity and the liberated fluorescein is absorbed and excreted in the urine. Fluorescein recovery is a reflection of exocrine pancreatic function. The test was evaluated in 14 patients with cystic fibrosis and 16 healthy volunteers. The test was well tolerated by patients, was easy to perform, and gave significantly lower values in the patients suffering from cystic fibrosis. The result of the pancreolauryl test was also correlated with the result of the faecal chymotrypsin test in 11 of the patients suffering from cystic fibrosis. A positive correlation was found between the two test results. The test is a practical and reliable index of pancreatic exocrine function and may have a useful role as a screening procedure.

Adolescent↗
PubMed1986

Pancreatic function and enzyme synthesis rates in mild chronic pancreatitis.

Incorporation of intravenous 75Se-methionine into duodenal juice proteins during pancreatic stimulation was measured as an index of pancreatic enzyme synthesis rates in 12 patients with a normal pancreatogram and in 6 with mild chronic pancreatitis. Isotope incorporation was significantly greater in subjects with mild chronic pancreatitis than in those with a normal pancreatogram. Thus in most patients in whom pancreatography demonstrates the characteristic radiological features of 'mild chronic pancreatitis' pancreatic acinar function is abnormal. The coexistence of morphological and functional abnormality implies that such patients do have chronic pancreatitis.

Bicarbonates↗
PubMed1985

Effects of a mast cell stabiliser (FPL 52694) on human gastric secretion.

The effects of a new monochrome mast cell stabilizer (FPL 52694) on gastric secretion have been studied in healthy volunteers. When administered orally for 3 days, FPL 52694 consistently reduced nocturnal and pentagastrin-stimulated secretion of acid by about 50%. Meal-stimulated gastric secretion was not affected by the drug. Inhibition of the gastric secretory response to pentagastrin was not significant when single doses of the drug were administered either into the stomach or the duodenum, but administration of multiple doses resulted in significant inhibition. The drug does not inhibit gastric secretion by injuring the gastric mucosa, since the gastric mucosal barrier to back diffusion of hydrogen ions is not affected. We conclude that this mast cell stabilizer provides an interesting tool for studying aspects of the physiological control of gastric secretion and may have a therapeutic role in peptic ulceration.

Adult↗
PubMed1985

Effects of some polycyclic drugs on gastric secretion and on the healing of duodenal ulcers.

Polycyclic drugs such as the dibenzazapine trimipramine have been shown to accelerate the healing of gastric and duodenal ulcers, possibly by inhibiting gastric secretion. We have therefore compared the effects of three polycyclic drugs (trimipramine, mianserin and quisultidine) on nocturnal and pentagastrin-stimulated gastric secretion. The patterns of the effects of the three drugs on gastric secretion differed. Although pentagastrin-stimulated secretion of acid was inhibited by trimipramine (13%), mianserin (38%), and quisultidine (29%), overnight gastric secretion was inhibited by mianserin (37%) and quisultidine (78%) but increased by trimipramine (16%). In view of its gastric inhibitory actions, the effects of mianserin on the healing of duodenal ulcers have been studied. In a pilot open trial seven out of eight duodenal ulcers healed after four weeks of treatment with mianserin 60 mg at night. A controlled, randomized long-term study is now scheduled in order to assess the role of mianserin in the management of ulcer disease.

Anti-Ulcer Agents↗
PubMed1985

Pancreatic enzyme synthesis in pancreatic disease.

In a prospective evaluation of patients suspected of having chronic pancreatitis, synthesis of pancreatic enzymes was measured by means of the incorporation of selenium-75-labelled methionine into the proteins of duodenal aspirate during stimulation of pancreatic secretion with secretin (1 CU X kg-1 X h-1) plus cholecystokinin (CCK) (1 IDU X kg-1 X h-1). The rate of pancreatic enzyme synthesis was increased in patients with chronic pancreatitis. Measurement of pancreatic enzyme synthesis was more sensitive in the detection of chronic pancreatitis than either the bicarbonate or the trypsin secretory response to secretin plus CCK. A combination of the bicarbonate secretory response with measurement of the rate of enzyme synthesis provided a positive predictive power of 100% when both tests were abnormal and a negative predictive power of 100% when both tests were normal, so that the combined test can be recommended both for excluding and confirming the presence of chronic pancreatitis.

Adult↗
PubMed1984

Effects of loxtidine, a new histamine H2-receptor antagonist, on 24-hour gastric secretion in man.

The gastric inhibitory effects of loxtidine, a new histamine H2-receptor antagonist, were studied in healthy volunteers. Doses of 20, 40 and 80 mg given in the evening reduced nocturnal acid secretion by 91, 97 and 95%, respectively, and nocturnal pepsin secretion by 86, 89 and 90%, respectively. The same doses also increased median 24-hour intragastric pH from 1.6 to 4.1, 5.4 and 5.5, respectively, but intragastric pH had returned to control values by the end of the 24-hour study period. Loxtidine at a dose of 40 mg twice daily rendered gastric contents virtually anacid throughout the 24-hour study period. The powerful gastric inhibitory effects of loxtidine denote a potential use in the treatment of peptic diseases.

Adult↗
PubMed1984

Omeprazole inhibits nocturnal and pentagastrin-stimulated gastric secretion in man.

The effect of omeprazole on the overnight and pentagastrin-stimulated gastric secretion of acid and pepsin have been studied in healthy male volunteers. After treatment with omeprazole, 30 mg or 60 mg daily for one week, overnight secretion of acid was reduced by 48 and 73%, respectively. During stimulation with pentagastrin, a single dose of 40 mg omeprazole reduced acid output by 98%, while after 80 mg, secretion of acid and pepsin was completely abolished. Omeprazole is one of the most potent gastric secretory inhibitors available at present, with potential for use in the therapy of ulcer disease.

Adult↗
PubMed1984

Comparative study of four antacids.

Four antacid preparations have been studied in a stratified, randomized, double-blind trial to evaluate criteria which determine patients' acceptance of this type of therapy. There was a considerable range of judgements about palatability, but preference was determined not only by factors such as the smell, taste, texture and after-taste of the preparation, but also by the order in which the antacids were tested and by the age and sex of the patient. The preparations also differed considerably in acid-neutralizing capacity and ability to bind bile salts, as well as cost. We conclude that individuals requiring antacid therapy should be allowed to chose from among a range of preparations, in order to maximize compliance.

Adult↗
PubMed1984

The fate of asymptomatic recurrences of duodenal ulcer.

Thirty-six patients in whom an asymptomatic duodenal ulcer had been detected endoscopically were followed up clinically and endoscopically during the following months. Ten of the patients were receiving either no treatment or placebo, and 26 patients were receiving maintenance treatment with either 150 mg ranitidine or 400 mg cimetidine at night. Treatment remained unchanged during the follow-up period. The cumulative annual rate of spontaneous healing was approximately one quarter, whether or not patients were receiving active maintenance therapy. However, the likelihood of developing symptoms during the year after detection of the asymptomatic ulcer was significantly greater in those patients receiving no treatment or placebo (77%) than in those receiving active maintenance therapy (27%). One patient, receiving no treatment, bled from his ulcer during the follow-up period. We conclude that routine endoscopic reexamination, to detect asymptomatic ulcer recurrences in patients receiving maintenance treatment for duodenal ulceration, is probably unnecessary, since the recurrences rarely cause clinical problems, despite prolonged failure to heal.

Cimetidine↗