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Biomedical subjects

R Burakoff

Publications and source records attributed to R Burakoff.

53 records · Page 3Linked to original sources
PubMed1989

Comparison of the effects of leukotrienes B4 and D4 on distal colonic motility in the rabbit in vivo.

Leukotrienes (LTs) have been shown to contract smooth muscle of the small and large intestine in vitro, and an increased mucosal synthesis of leukotrienes has been reported to occur in ulcerative colitis. The purpose of this study was to evaluate the effects of LTs B4 and D4 on the myoelectric and mechanical activity of the rabbit distal colon in vivo and to determine how these effects were modified by indomethacin. LTB4 had a weak excitatory action on both electrical and mechanical activity but this was not statistically significant; LTD4 on the other hand caused a significant dose-related increase in spike potential frequency and contractile activity. Indomethacin alone (1 mg/kg) had no significant effect on the electrical or mechanical activity of the colon but blocked the effects of subsequently administered LTD4. It is concluded from these data that at least part of the excitatory action of LTD4 results from its causing the synthesis and release of excitatory prostaglandins. However, whereas leukotrienes have the potential to play an important role in modulating colonic motility, it seems most likely that this effect would occur after pathological stimulus rather than in the normal healthy colon.

Animals↗
PubMed1989

Metronidazole-induced pancreatitis.

We present a case of a 22-yr-old female who developed acute pancreatitis coincident with metronidazole therapy, with documented recurrence when inadvertently rechallenged on two separate occasions. These episodes were unrelated to alcohol ingestion, gallbladder disease, or other known causes of pancreatitis. Only one other case of metronidazole-induced pancreatitis was found in the English literature. Known toxicities of metronidazole are discussed, as well as potential mechanisms by which metronidazole may have induced pancreatitis in our patient. Since metronidazole is used to treat a host of infectious and inflammatory conditions, its causal relationship with pancreatitis must be carefully considered. We suggest that metronidazole be discontinued when clinical or biochemical features of acute pancreatitis occur, once other known causes of pancreatitis have been excluded.

Acute Disease↗
PubMed1988

The irritable bowel syndrome and food hypersensitivity.

Ten patients with irritable bowel syndrome were evaluated for food hypersensitivity with skin testing (IgE) and IgG serum antibodies (RAST panel) to common food antigens. Patients also underwent an open elimination diet for 2 weeks followed by a 48-hour challenge of each food that was considered to be suspicious from patients diary, positive skin prick test, and/or positive IgG antibodies. Six patients had positive skin scratch test results and only one patient had RAST IgG food antibodies greater than 3,000 cpm which is a marked increase above normal. None of the patients however had an exacerbation of their irritable bowel symptoms with a food challenge. We conclude therefore that positive skin testing and IgG serum antibodies are not reliable indicators of food hypersensitivity in irritable bowel syndrome and that food hypersensitivity does not seem to play a role in the symptoms related to the irritable bowel syndrome.

Adult↗
PubMed1987

Pyoderma gangrenosum associated with ulcerative colitis: treatment with disodium cromoglycate.

Pyoderma gangrenosum is an uncommon skin disorder that is associated with ulcerative colitis, Crohn's disease, polyarthritis, and other conditions. Clinically it is usually characterized by painful ulceration of the skin and subcutaneous tissues, predominantly of the lower limbs. Treatment is empirical and often unsatisfactory. We report two cases of pyoderma gangrenosum associated with inflammatory bowel disease successfully treated with topical disodium cromoglycate.

Administration, Topical↗
PubMed1985

Watery diarrhea syndrome due to an adrenal pheochromocytoma secreting vasoactive intestinal polypeptide.

A 55-year-old woman presented with several protracted episodes of diarrhea; it was found to be secretory in origin. In the course of evaluating the diarrhea, an ultrasound of the abdomen was performed which disclosed a large right adrenal mass. Endocrinologic studies revealed elevated serum levels of gastrin, vasoactive intestinal polypeptide (VIP), catecholamines, and its metabolites. Surgery was performed successfully without any intraoperative complications, and postoperatively the patient was asymptomatic without further episodes of diarrhea. Histologically the tumor was a pheochromocytoma with neuroendocrine granules of vasoactive intestinal polypeptide and norepinephrine. To our knowledge, there have been six previously reported cases of pheochromocytoma secreting vasoactive intestinal polypeptide. In a patient with secretory diarrhea of unknown etiology, the adrenal glands as well as the pancreas should be examined by ultrasound and/or computerized tomography for the presence of a mass. Should an adrenal mass be discovered, it is necessary to evaluate the tumor for catecholamine production, despite the absence of clinical symptoms of a pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1985

Colonic myoelectric activity in persons with spinal cord injury.

Colonic myoelectric activity was recorded from six para- or quadriplegic subjects with spinal cord injury and seven normal controls via bipolar electrodes in contact with the rectal mucosa. Recordings were carried out in the fasting (basal) state and after stimulation by a standard meal and by 1.0 mg neostigmine intramuscularly. The recordings were visually analyzed for spike activity, average slow wave frequency, and percentage occurrence of subsets of slow wave frequency (2-4 and 5-12 cycles/min). The spinal-cord-injured subjects had significantly more spike wave activity in the basal state than did the controls (12.6 spikes per 10 min vs 3.3). However, meal stimulation did not lead to an increase in spike activity in the spinal-cord-injured subjects (13.7 spikes per 10 min vs 12.6) while it did in the controls (6.4 vs 3.3 spikes per 10 min). Neostigmine significantly increased spike activity in both groups. There was no difference in average slow wave frequency nor any slow wave subsets between the two groups studied. Thus persons with spinal cord injuries have higher basal colonic myoelectric activity than normals but lack a demonstrable gastrocolic reflex. We conclude that the central nervous system exerts a tonic inhibitory influence on basal colonic motility and appears to participate in the gastrocolic reflex.

Adult↗
PubMed1985

Early gastric cancer. Clinicopathologic study.

The incidence and clinicopathologic features of early gastric cancer encountered among surgical specimens from gastric resections for carcinoma in a recent three-year period, 1977 to 1979, at the Mallory Institute of Pathology were studied and compared with those of a pre-endoscopic period 10 years earlier, 1967 to 1969. It was found that early gastric cancer now comprises a greatly increased proportion of lesions leading to gastric resection, mainly as a result of endoscopy and biopsy of gastric ulcers of benign appearance. In the recent period, there were six early gastric cancers in a total of 22 gastric resection specimens compared with one in 27 gastric resections performed for carcinoma in the pre-endoscopy period. Five of the six patients in the recent period are alive without evidence of disease four to five years following surgical resection. The single patient in the earlier period died postoperatively. Applying the classification of the Japanese Endoscopic Society, there were three depressed or ulcerated lesions (type IIc or III), three elevated or polypoid lesions (type I or IIa), and a single flat lesion (type IIb). All three ulcerated lesions were interpreted as benign peptic ulcers on conventional upper gastrointestinal studies. Findings on endoscopic biopsy were positive in all cases (six of six). Although not encountered frequently in the United States, early gastric cancer, nonetheless, appears to be indistinguishable from the disease as it is described in Japan in terms of its pathologic morphology, growth patterns, coexistent or related lesions of the stomach, and curability by surgical resection. If early gastric cancer is to be recognized more frequently, knowledge of the disease and a high index of suspicion on the part of physicians are essential.

Adenocarcinoma↗
PubMed1985

Esophageal manometry in familial amyloid polyneuropathy.

The motility of the esophagus was studied by esophageal manometry in eight patients with familial amyloid polyneuropathy. All eight patients had an abnormality of the lower esophageal sphincter. Seven of eight had a borderline or decreased lower esophageal sphincter pressure and the other patient had a non-relaxing lower esophageal sphincter pressure. Six of eight patients had abnormalities of the body of the esophagus consisting of either simultaneous or decreased amplitude of contractions involving the smooth or striated muscle or both. In addition, seven of eight patients had diarrhea and six of these seven patients had evidence for steatorrhea. The manometric abnormalities observed were consistent with deposition of amyloid in smooth and striated muscle as well as in the enteric nervous system. Esophageal manometry appears to be a sensitive technique to determine if the gastrointestinal tract is involved in familial amyloid polyneuropathy.

Adult↗
PubMed1983

Esophageal manometry in systemic amyloidosis. A study of 30 patients.

The motility of the esophagus was studied by esophageal manometry in 24 patients with primary amyloidosis and six with secondary amyloidosis. Resting lower esophageal sphincter pressure was decreased in 12 patients with primary amyloidosis and two with secondary amyloidosis; 12 of these 14 patients complained of heartburn. Abnormalities in the motility of the body of the esophagus were found in nine patients with primary amyloidosis and one with secondary amyloidosis. No abnormality of the upper esophageal sphincter was demonstrated in any of the 30 patients. Six of the nine patients with primary amyloidosis exhibiting the most marked esophageal motor dysfunction had striking evidence of peripheral and/or autonomic nervous system involvement. No consistent pattern of motility disorder was observed in either group. The manometric abnormalities observed are consistent with a random deposition of amyloid in the esophagus involving a myopathic and/or neuropathic component.

Adult↗
PubMed1983

The effect of verapamil on the lower esophageal sphincter pressure in normal subjects and in achalasia.

Verapamil hydrochloride is an organic calcium antagonist that is known to decrease the contraction of smooth muscle. The purpose of our study was to determine if verapamil has a similar effect on the resting lower esophageal sphincter pressure in normal subjects and in patients with achalasia. Esophageal manometry was performed using a continuously perfused catheter assembly. Infusion of verapamil (0.15 mg/kg) over a 2-min period resulted in a statistically significant decrease in resting lower esophageal sphincter pressure in both normal subjects (n = 8) and patients with achalasia (n = 7) within 10 min postinfusion. This study suggests that verapamil may have potential as a drug therapy in treating the clinical symptoms of achalasia and diffuse esophageal spasm.

Adult↗