Exacerbation of diarrhea after iodinated contrast agents in a patient with VIPoma.
Explore the source record for details and available documents.
Adenoma, Islet Cell↗
Biomedical subjects
K L Koch
Publications and source records attributed to K L Koch.
Cryptosporidiosis in hospital personnel. Evidence for person-to-person transmission.
An intern responsible for the care of a patient with chronic cryptosporidiosis developed acute diarrhea and serologic evidence of cryptosporidium infection. Sera from 26 hospital personnel exposed to the patient and 18 personnel with no exposure were examined with an indirect immunofluorescent antibody procedure for the presence of antibodies to Cryptosporidium. Eight (31%) exposed personnel--5 nurses, 2 house officers, and 1 student--had positive antibody titers (1:10 or more). The frequency of positivity in the nurse-housestaff-student group (8 of 18, 45%) was significantly greater (p less than 0.05) than that in the attending physicians and respiratory therapists (0 of 8). The former group had significantly more exposure to the patient's feces than did the latter group (p less than 0.01). Three of eighteen control personnel (17%) had positive cryptosporidium antibody titers. These findings suggest that Cryptosporidium may be transmitted from person to person in the hospital environment and that serologic evidence of infection is common among hospital personnel.
Adult↗
Tachygastria and motion sickness.
Cutaneously-recorded electrogastrograms (EGGs) were obtained from 21 healthy volunteers who were seated within a drum, the rotation of which produced vection or illusory self-motion. Fourteen subjects developed symptoms of motion sickness during vection and in each the EGG frequency shifted from the normal 3 cpm to 5-8 cpm, tachygastria, an abnormal pattern. In 6 of 7 asymptomatic subjects, the 3 cpm EGG pattern was unchanged during vection. It was concluded that illusory self-motion produces tachygastria and motion sickness in susceptible subjects.
Adolescent↗
Opioid drugs cause bile duct obstruction during hepatobiliary scans.
Hepatobiliary scans using Tc-IDA are reliable in making the diagnosis of acute cholecystitis. Commonly, opioid drugs are administered in patients with acute cholecystitis to relieve pain. Opioid drugs cause biliary sphincter spasm. Whether these drugs adversely affect hepatobiliary scans is unknown. We studied 13 healthy volunteer subjects, performing three hepatobiliary scans in each one. Scans were performed without opioid drugs and 30 minutes after intramuscularly administered meperidine, morphine, hydroxyzine, hydroxyzine plus meperidine, butorphanol, and nalbuphine. Opioid drugs markedly delayed clearance of Tc-IDA from the common bile duct, simulating common bile duct obstruction. Hydroxyzine alone caused an insignificant delay. We have concluded that opioid drugs cause bile duct obstruction in healthy persons. If opioid drugs are administered before a diagnostic hepatobiliary scan, delayed clearance of Tc-IDA from the common bile duct might lead to an erroneous diagnosis and indicate a potentially unnecessary common bile duct exploration. Opioid drugs should not be administered for several hours before a diagnostic hepatobiliary scan.
Acute Disease↗
Migrating action-potential complexes in vitro in cholera-exposed rabbit ileum.
The objective of this study was to determine whether cholera-exposed rabbit ileum exhibits altered myoelectric activity in vitro, without central nervous system connections. Whole-cell lysate of Vibrio cholerae, 100 mg in 1 ml saline, was injected into the jejunum of New Zealand White rabbits. Segments of ileum were removed at 12 and 24 h after inoculation and studied in vitro using myoelectric recording techniques. Propagating ring contractions were visualized and corresponded to intense action-potential activity that propagated over consecutive electrode sites. This altered myoelectric activity was similar to the previously described migrating action-potential complex (MAPC) in vivo after infection of rabbit ileum with live V. cholerae, its wholecell lysate, or the purified enterotoxin choleragen, with one exception. All MAPC activity propagated aborally in the in vivo-infected loops; in contrast 26% of the MAPCs propagated retrograde in the in vitro loops. Control segments were injected with saline, and no in vitro MAPCs were observed. Thus, the MAPC stimulated by cholera toxin may be maintained by the enteric nervous system of the gut wall. Although a role for extrinsic nerves is not excluded, our observations suggest that the small intestine may work autonomously, independent of the central nervous system.
Action Potentials↗
Cryptosporidiosis in a patient with hemophilia, common variable hypogammaglobulinemia, and the acquired immunodeficiency syndrome.
A 36-year-old man had chronic, debilitating diarrhea due to cryptosporidiosis. This patient had longstanding common variable hypogammaglobulinemia and recurrent bacterial infections. Immunologic evaluation after discovery of Cryptosporidium showed lymphopenia with persistently reduced numbers of helper/inducer cells (OKT-4), variable numbers of suppressor/cytotoxic cells (OKT-8), OKT-4/OKT-8 ratio of 0.09, and increased levels of serum alpha-interferon, all of which describe the acquired immunodeficiency syndrome. Oocysts of Cryptosporidium were found in feces from the patient's cat, thus identifying a possible source of his infection. The patient had disseminated candidiasis, cytomegalovirus pneumonia, and cryptosporidiosis when he died.
Adult↗
Antibodies to herpes simplex type 1 in patients with active duodenal ulcer.
One hundred seventy-two patients requiring upper gastrointestinal tract endoscopy were examined prospectively for evidence of herpes simplex virus type 1 (HSV-1) infection. No viruses were recovered from active ulcers (11 with duodenal and eight with gastric ulcers). Using both enzyme-linked immunosorbent assay (ELISA) and standard complement fixation methods, patients with endoscopically proved active duodenal ulcer had significantly higher mean serum antibody levels to HSV-1 (but not to cytomegalovirus) than those without evidence of peptic ulcer. Neither patients with a history of or evidence of past peptic ulcer nor those with active gastric ulcer had higher serum antibody levels to HSV-1 compared with subjects without ulcers. These data provide support for an association between active duodenal ulcer and HSV-1 infection, the nature of which is not defined by these studies.
Antibodies, Viral↗
Ergonovine-induced esophageal spasm in patients with chest pain resembling angina pectoris.
We studied the effect of ergonovine maleate (EM) on esophageal motor activity in 18 consecutive patients with angina-like chest pain. Significant coronary artery disease was excluded in each patient by cardiac catheterization studies. Baseline esophageal motility was abnormal in 12 patients (66%). After injection of EM, ten patients developed their typical chest pain at the onset of repetitive contractions. Thus, chest pain and esophageal dysfunction were clearly linked. Compared with saline injection, only the repetitive contractions were significantly increased after AM in these patients (P less than 0.01). Amplitude and duration of contractions were increased after EM, but not significantly. Due to potentially serious adverse effects, however, EM cannot be recommended for routine use as a provocative agent.
Adult↗
Orbital pseudotumor and Crohn disease.
Explore the source record for details and available documents.
Adolescent↗
A changing dental profession demands a changing curriculum.
Explore the source record for details and available documents.
Curriculum↗
Effect of autonomic nervous system manipulations on gastric myoelectrical activity and emotional responses in healthy human subjects.
OBJECTIVE: The aim of this study was to determine the gastric myoelectrical and emotional responses provoked by two psychophysiological stimuli known to cause in one case increased sympathetic nervous system activity and in the other increased parasympathetic nervous system activity. METHODS: Electrogastrograms (EGGs) were recorded, and interbeat intervals (IBIs) were obtained from electrocardiographic recordings from 20 subjects during baseline and in response to a shock avoidance task (shock stimulus) and forehead cooling (dive stimulus). After each experimental period, subjects reported their emotional experience by rating descriptors ranging from serenity to excitement. RESULTS: During the shock stimulus, IBIs decreased significantly (p < .05), gastric tachyarrhythmias increased (p < .05), and emotional arousal increased, as indexed by reports of increased interest, excitement, and activation. In contrast, during the dive stimulus, IBIs increased (p < .05), but there were no associated changes in gastric myoelectrical activity or emotional arousal. CONCLUSIONS: Acute stress can evoke arousal and dysrhythmic gastric myoelectrical activity, and these acute changes, which occur in healthy individuals, may provide insight into functional gastrointestinal disorders.
Adult↗
Asian hypersusceptibility to motion sickness.
A rotating optokinetic drum was used in three laboratory studies to test the hypothesis that Asian subjects are hypersusceptible to motion sickness. The results of the first study showed that Chinese women compared to European-American and African-American women experienced significantly more severe symptoms of motion sickness and greater disturbance of normal gastric myoelectric activity. A second study yielded similar results using American-born children of Asian parents. The results of a third study using Chinese men and women were similar and showed a significant increase in vasopressin during rotation. Possible genetic mechanisms that may account for these results are discussed.
Adolescent↗
Dyspepsia of unknown origin: pathophysiology, diagnosis, and treatment.
Dyspepsia is a vague term for the nonspecific symptoms of upper abdominal discomfort, prolonged postprandial fullness or early satiety, nausea, vomiting, and upper abdominal bloating. Many common and accepted diseases and disorders such as gastroesophageal reflux and irritable bowel syndrome cause dyspepsia symptoms; these disorders should be identified and treated. However, many patients with dyspepsia symptoms have normal radiographic and endoscopic evaluations; in these patients, neuromuscular of functional disorders of the stomach ranging from gastric dysrhythmias to gastroparesis may be the cause of dyspepsia symptoms. A practical approach to the evaluation and treatment of dyspepsia symptoms attributed to gastric neuromuscular dysfunction of unknown origin is described.
Chronic Disease↗
Gastric dysrhythmias and the current status of electrogastrography.
Myoelectrical activity recorded simultaneously from mucosal, serosal, and cutaneous electrodes has confirmed that the 3-cpm signal from such electrodes reflects gastric slow-wave activity. Now, the observation that patients with unexplained nausea and vomiting may have very rapid slow-wave frequencies (tachygastrias) and very slow, slow-wave frequencies (bradygastrias) suggests that electrogastrography, a reliable and noninvasive technique, may be useful in the diagnosis and management of patients with upper abdominal symptoms and gastroparesis.
Electrodiagnosis↗