PubMed Health⌕ Search

Biomedical subjects

M D Kaye

Publications and source records attributed to M D Kaye.

At least 37 records · Page 2Linked to original sources
PubMed1981

Pentagastrin in diffuse oesophageal spasm.

The effect of pentagastrin on oesophageal motility was studied in six subjects with idiopathic diffuse oesophageal spasm (IDOS). Pentagastrin was administered by continuous intravenous infusion in doses of 1 microgram/kg/h, 5 micrograms/kg/h, and 10 micrograms/kg/h. Saline infusion was used as a control. No subject experienced pain during pentagastrin infusion. Two developed dysphagia and repetitive contractions with 'wet' swallows during the saline infusion and the lowest pentagastrin infusion. Contraction amplitude was increased only with 'dry' swallows during the 10 micrograms/kg/h infusion period. Contraction duration was increased with both 'wet' and 'dry' swallows during the 1 microgram/kg/h infusions, and with 'dry' swallows during the 10 micrograms/kg/h infusion. Propagation velocity was not altered by pentagastrin. We conclude that gastrin released physiologically by eating probably does not contribute to symptom production in IDOS. Moreover, it seems unlikely that pentagastrin, at least in these doses, can be exploited for diagnostic purposes.

Esophageal Achalasia↗
PubMed1981

Anomalies of peristalsis in idiopathic diffuse oesophageal spasm.

Oesophageal manometry revealed 'interrupted peristalsis'--proximal sequential contraction with simultaneous pressure increases in the mid-oesophagus and sequential contraction distally--and abnormally slow distal propagation of peristalsis in seven of a consecutive series of 12 patients with idiopathic diffuse oesophageal spasm (IDOS). These two abnormalities occurred together in six patients. It is proposed that 'interruption' of peristalsis and 'slow' distal propagation are apparent rather than real, and that they reflect failure of normal luminal obliteration during oesophageal contraction. This arguments is extended to the 'aperistalsis' of achalasia. It is also proposed that IDOS, achalasia, and related idiopathic motor disorders may share a common pathogenetic abnormality--namely, functional obstruction at the level of the lower oesophageal sphincter. According to this hypothesis, the presentation of the patient and the progression of his disease are determined by the degree and duration of that obstruction, and the functional reserve of the oesophageal body musculature.

Adult↗
PubMed1979

Scanning electron microscopy of rectal mucosa in Crohn's disease.

Rectal biopsies from healthy control subjects, and from patients with Crohn's disease whose rectal mucosa appeared normal by sigmoidoscopy and light microscopy, were examined by scanning electron microscopy. Appearances within both groups were quite variable, and no clear differences between the groups could be distinguished.

Adolescent↗
PubMed1979

The immunobiology of placentation.

A review of the current theories on the nature of the placental allograft and the evolution of placentation in the presence of a cellular immune response highlights the inability of current hypotheses to explain the success of both invertebrate and vertebrate placentation. Only one theory -- "the anatomical separation of the fetus from the mother" -- appears relevant. How this separation might develop during implantation is discussed.

Animals↗
PubMed1979

On the relationship between gastric pH and pressure in the normal human lower oesophageal sphincter.

The effect upon the lower oesophageal sphincter (LOS) of acid in the proximal stomach was investigated in 12 young healthy subjects. The cardia was perfused in turn with solutions at pH 7, 4, 3, 2, and 1, during successive withdrawals of three perfused pressure-recording catheters, openings of which were at the same axial level. Although there was considerable individual variation, there was a direct and significant relationship between LOW pressure and the acidity of the solution perfused. The results suggest that resting LOS pressure and the acidity of the solution perfused. The results suggest that resting LOS pressure may be determined in part by the pH of the gastric content.

Adult↗
PubMed1979

Effect of ethanol upon gastric emptying.

The effect of ethanol upon gastric emptying in healthy human subjects was studied by measuring the gastric emptying rates of three 750 ml meals, the osmolalities, energy densities, and pH of which were similar. Meal A, which contained 80 ml alcohol, emptied more rapidly than meal B, which contained 40 ml ethanol and 63.3 g dextrose; and meal B emptied more rapidly than meal C, which contained 126.6 g dextrose but no ethanol. The slower rate of emptying of the dextrose meal (C) was not due to an increased gastric secretory rate, as serial measurements of gastric pH were substantially and significantly higher with this than with the other two meals; nor was it due to a greater degree of duodenogastric reflux, as serial measurements of gastric bile acid concentrations were similar for the three meals. We conclude that the duodenal osmoreceptor mechanism is relatively insensitive to ethanol; that the relationship between energy density and gastric emptying rate does not hold in the case of ethanol; and that the gastro-oesophageal reflux which occurs in response to ethanol is not due to impairment of gastric emptying.

Adult↗
PubMed1979

Achalasia and diffuse oesophageal spasm in siblings.

We report the occurrence of achalasia and diffuse oesophageal spasm in brother and sister. The familial occurrence of these unusual disorders is consistent with the possibility that they share a common aetiology and indicates the potential importance of genetic predisposition.

Adult↗
PubMed1978

Induction of gastro-oesophageal reflux by alcohol.

In order to establish whether alcohol in amounts in amounts customarily imbibed during social drinking causes gastro-oesophageal reflux, 12 healthy young individuals, without symptoms of gastro-oesophageal reflux, were studied twice. Each time, distal oesophageal pH was monitored continuously for three hours after a standard meal which included either 180 ml 100 proof vodka or 180 ml water. The order of studies with and without alcohol was random. Peak blood alcohol concentrations ranged between 0.63 and 1.29 g/l. Eleven of the 12 subjects refluxed more after alcohol; and the difference in mean reflux scores for studies with and without alcohol was highly significant. We conclude that relatively modest quanttities of alcohol induce gastro-oesophageal reflux in healthy people.

Adult↗
PubMed1977

Relative concentrations of individual nonsulfated bile acids in the serum and bile of patients with cirrhosis.

The relative concentrations of individual nonsulfated bile acids were determined in samples of serum and bile obtained simultaneously from 16 patients with biopsy-proven alcoholic cirrhosis. A highly significant (P less than 0.001) correlation was found between the fasting relative concentrations of each of the three major bile acids (cholic, chenodeoxycholic, and deoxycholic) in serum and bile. This relationship persisted after manipulation of bile acid pools produced by feeding of individual bile acids. We conclude that the relative concentrations of individual nonsulfated bile acids in serum accurately reflect those in bile and that measurement of individual serum bile acids may be used for screening and serial determination purposes. In particular, low levels of biliary deoxycholate can be reliably predicted by serum measurements.

Adult↗
PubMed1977

An autoradiographic study of the implantation of transferred mouse blastocysts.

Mouse blastocysts collected on day 4 were cultured in [3H]thymidine (0.01 muCi/ml) for 24 h and transferred to the uteri of pseudopregnant recipients. Autoradiography revealed that when such blastocysts were allowed to develop for 48 h in utero, label was apparent in the nuclei of decidual cells. The experimental conditions were physiological since blastocysts developed into normal offspring when gestation was allowed to proceed in pseudopregnant recipient animals. The transfer of foetal DNA into maternal decidual cells may be of important immunological significance.

Animals↗
PubMed1977

Postprandial gastro-oesophageal reflux in healthy people.

Distal oesophageal pH was monitored for three hours after a standard meal in 10 young healthy subjects without symptoms of gastro-oesophageal reflux. Episodes of reflux occurred in nine of these subjects; and, in five, oesophageal pH was less than 5 for between 11 and 75% of the first postprandial hour. Intermittent incompetence of the lower oesophageal sphincter after food must, therefore, be regarded as a normal phenomenon. The method described would be suitable for the evaluation of agents believed to weaken or to strengthen the lower oesophageal sphincter.

Adult↗
PubMed1977

A circumferentially-sensitive miniature pressure sensor for study of human esophageal motility.

Manometric systems in current use for study of human esophageal motility consist of sensors with a restricted radial disposition. Since both upper and lower esophageal sphincters are asymmetrical structures, such sensors are not ideal for sphincteric pressure measurements. In this report, we describe a circumferentially sensitive sensor (MT) which consists essentially of a miniature transducer mounted within a sealed fluid-filled chamber, surrounded by a pressure-sensitive silastic diaphragm. This device is accurate and sensitive. It was compared in 10 young healthy men with a standard perfused catheter system (PC) composed of three catheters, whose side openings were at the same axial level, connected to external transducers. Pressures recorded from the lower esophageal sphincter were significantly higher with the MT than with the PC; and in the upper esophageal sphincter, the rapid pressure changes associated with deglutition were far more faithfully reproduced with the MT. Contractile pressures recorded after swallowing from the body of the esophagus were similar with the two systems, provided that catheters were perfused at a rapid rate (approximately 8 ml/min for each catheter). This preliminary evaluation indicates that this MT has significant advantages as compared with currently available systems.

Adult↗
PubMed1976

Sororal occurrence of diffuse esophageal spasm.

In this report, we have described two sisters with classical symptoms, radiological appearances, and manometric features of diffuse esophageal spasm. To the best of our knowledge, familial occurrence of this disorder has not been documented previously.

Esophageal Diseases↗
PubMed1976

Responses of the competent and incompetent lower oesophageal sphincter to pentagastrin and abdominal compression.

Responses of the lower oesophageal sphincter (LOS) to pentagastrin, given by continuous intravenous infusion in doses ranging between 0 and 9 mug/kg/h, and to external abdominal compression were measured by infused catheters in healthy subjects and in a group of patients with reflux oesophagitis. In separate experiments, pressures were measured both by sensors stationary within the LOS, and by repeated continuous withdrawals of sensors from stomach to distal oesophagus. In normal subjects, doses of pentagastrin within the physiological range (0.9 mug/kg/h) produced modest but statistically significant increases in LOS pressure. By comparison, sphincteric responses in patients with oesophagitis were small and a dose of 4-5 mug/kg/h was the lowest that produced a significant increase in LOS pressure. During abdominal compression increases in LOS pressure did not significantly exceed increases in intragastric pressure in either patients or normal subjects. This was so at all doses of pentagastrin that were tested. Hence, there was no evidence of synergism between the effects of pentagastrin and abdominal compression upon the LOS. We infer from our findings that gastrin does play a modest role in the physiological regulation of human LOS tone. Relative insensitivity of the incompetent LOS to pentagastrin represents, we believe, sphincteric muscle failure. Our results are not consistent with the hypothesis that LOS incompetence is due to loss or impairment of an adaptive response of the LOS to alterations in intra-abdominal pressure.

Abdomen↗