Biomedical subjects
M D Kerstein
Publications and source records attributed to M D Kerstein.
Effect of hemorrhagic shock on 5-hydroxytryptamine removal by dog lung.
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Prevention of pulmonary pathologic changes of trauma by indomethacin.
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Effect of hypovolemic hypotension and hypoventilation on lower esophageal sphincter pressure (LESP).
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Removal of circulating vasoactive hormones by the lung. Effect of cardiopulmonary bypass, pulmonary hypertension, hemorrhagic shock.
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The delays in the rehabilitation in lower extremity amputees.
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Serosal tears following colonoscopy.
After colonoscopic perforation, laparotomy was performed in a 28-year-old woman. Seromuscular tears and lacerations were found in an adjacent loop of sigmoid colon that appeared normal through the colonoscope. At laparotomy, the mucosa of that loop was entirely intact. Six weeks later, a laparotomy was again performed, revealing well-healed lacerations with extensive adhesion formation. The incidence of this complication in patients undergoing colonoscopy is unknown.
Intestinal calcium absorption: differences in transport between duodenum and ileum.
The interaction of calcium with sugar, sodium, and water absorption was studied in rats fed laboratory chow and in vitamin D-deficient and -repleted rats with the use of intestinal loops in vivo. Calcium absorption in the duodenum was enhanced by D-glucose only in the vitamin D-deficient state. In both vitamin D-deficient and -repleted ileum, calcium absorption decreased when NaCl was replaced by mannitol; however, it remained unchanged when NaCl was replaced by choline chloride or urea. Calcium absorption was enhanced by actively transported sugars and by increasing net water flow generated by differences in osmotic pressure and urea. Under all experimental conditions there was a strong association between net water and calcium absorption in the ileum. These findings suggest that calcium absorption is enhanced by solvent drag, although the role of sodium cannot be excluded entirely.
Acute and chronic venous insufficiency in the finger.
Venous hypertension with subsequent chronic venous insufficiency and its sequelae in the hand is reported as an uncommon complication of arteriovenous fistulae for hemodialysis.
Histologic and ultrastructural studies of canine pancreas fed an elemental diet.
A clinically available elemental diet (Vivonex-100) has been fed to healthy mongrel dogs. Compared to a regular chow diet and regulated so as to maintain a stable weight, no changes were noted on light or electron microscopy and six months' maintenance. Extrapolating, the pancreas shows no evidence of a "resting state" according to this data.
Pulmonary changes of hemorrhagic shock with normotensive cephalic perfusion.
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Venous hypertension as a complication of arteriovenous fistula for hemodialysis.
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Pancreatic enzyme response with an elemental diet.
Elemental diets can maintain or slightly improve the nutritional status without a major stimulatory effect on the pancreas. Six dogs were maintained with a regular chow diet, switched to an elemental diet and, subsequently, returned to a chow diet. Cannulation of the pancreatic duct through a duodenal cutaneous fistula revealed the enzyme response to be decreased in a dog maintained with an elemental diet, with no or only a slight weight gain. Return to a regular diet resulted in a return of pancreatic enzyme response.
5-Hydroxytryptamine extraction by the lung.
Both 5-hydroxytryptamine and norepinephrine are removed from blood during a single passage through the pulmonary vasculature of the dog; 5-hydroxytryptamine is removed to a greater degree than is norepinephrine. The magnitude of extraction of both 5-hydroxytryptamine and norepinephrine is similar to that previously determined in man. In the intact dog, imipramine inhibits the uptake of 5-hydroxytryptamine by the lung in a dose-dependent manner.
Elemental diet and bile induced pancreatitis.
The effectiveness of an elemental diet was investigated as both a prophylactic and therapeutic agent in experimental canine pancreatitis. Pancreatitis was induced by operative injection of a bile -saline solution mixture under pressure retrograde into the main pancreatic duct. In addition to a preinjection control sample, serial biopsies were obtained at 30 minute intervals for 90 minutes after injection and fixed for light and electron microscopic examinations. In addition, preoperative and postoperative blood samples were drawn and analyzed for amylase. After operation, half of the dogs from each original group were fed Vivonex-100, the other half from each group, regular laboratory chow, yielding four ultimate groups based on preoperative and postoperative diets. Successful induction of pancreatitis was evaluated by the difference between preoperative and postoperative amylase values, all of which were significant by group at the p less than 0.01 level. No ultrastructural evidence was found for the modification of zymogen granules with the pretreatment elemental diet nor were differences evident, histologically or ultrastructurally, in the severity of pancreatitis between the pretreated and nonpretreated groups. Finally, gross mortality figures demonstrated no efficacy of elemental diet for pretreatment prophylaxis of acute pancreatitis.
Eosinophilic cholecystitis.
A somewhat obese, 40-year old female presented with a classic history of gallbladder disease and a peripheral eosinophilia of 14% without an allergic history. A nonvisualizing oral cholecystogram was followed by an uneventful cholecystectomy. Pathological examination revealed a calculus in the cystic duct and a pure transmural eosinophilic infiltrate of the gallbladder wall. Postoperatively the peripheral eosinophilia returned to normal. Biopsies of the small bowel one year later showed focal mucosal eosinophilia when the patient had recurrent abdominal pain, diarrhea and peripheral eosinophilia. Eosinophilic cholecystitis may represent a descrete entity in search of an etiology or involvement of the biliary tract by eosinophilic gastroenteritis.
Pancreatic collection in the awake dog.
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