Stimulation of glycerol production in fat cells by cholera toxin.
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Biomedical subjects
Publications and source records attributed to N F Pierce.
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The site, nature, magnitude, and duration of fluid and electrolyte loss into the small intestine during the acute and recovery phase of human cholera was defined in 27 Indian patients. 11 subjects without cholera served as controls. The marker perfusion technique employed was shown, in preliminary experiments, to measure accurately jejunal and ileal fluid and electrolyte transmucosal transport rates under conditions of cholera diarrhea. Fluid loss into the lumen occurred from jejunal and ileal mucosa. The fluid was isotonic in both regions. Bicarbonate concentration was significantly higher in ileal than jejunal fluid during all phases of the disease. Bicarbonate concentration in both regions was significantly higher in acute cholera than during convalescence. Fluid loss into the intestinal lumen ranged from 0.07 to 10.9 ml/hr per cm. Losses were significantly greater from jejunum than ileum. Net ileal absorption was recorded in five of 10 acute cholera studies. During the acute phase of the disease, net jejunal fluid transport showed a positive correlation with fasting intestinal flow rate and stool output. Stool output was also positively correlated with jejunal fasting intestinal flow rates. Recovery of normal fluid and electrolyte absorptive function was usually complete in both jejunum and ileum by the sixth day after admission. These findings in human cholera validate the animal models of choleraic diarrhea and suggest that similar measurements of small intestinal secretory function in other nonspecific diarrheal diseases using the marker perfusion technique may be rewarding.
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A controlled comparison of furazolidone and tetracycline in the treatment of cholera indicates that, in either dosage used, furazolidone reduced total stool volume by 50% and duration of diarrhoea by 40%. These results are comparable to those achieved with tetracycline, which was given in presently recommended dosage. Both furazolidone and tetracycline significantly reduced the rate of stool output within 18 to 24 hours of starting antibiotic treatment. Furazolidone was significantly less effective than tetracycline in rapidly and consistently terminating vibrio excretion. One convalescent carrier of cholera vibrios was identified among control patients; none was identified among patients treated with either tetracycline or furazolidone. All Vibrio cholerae strains tested were sensitive to tetracycline and furazolidone, but larger concentrations of the latter were required to achieve inhibition of growth. It is concluded that tetracycline remains the antibiotic of choice in cholera but that furazolidone would be a useful adjunct to cholera therapy when tetracycline is unobtainable or if strains of V. cholerae with clinically significant resistance to tetracycline should be encountered.