Effect of 1-phenylpentanol on release of secretin and exocrine pancreatic secretion in dogs and humans

1-Phenyl-1-hydroxy-N-pentane is a synthetic derivative of an ingredient of Curcuma longa that is used as a condiment and dye. The effects of 1-phenyl-1- hydroxy-N-pentane on release of secretin, gastrin, and pancreatic secretion of bicarbonate and protein were studied in both dogs and humans. In fasting dogs with gastric fistulas and modified Herrera's pancreatic fistulas, intraduodenal administration of 1-phenyl-1-hydroxy-N-pentane (pH 6.7) in three different doses (25, 50, and 100 mg/kg) resulted in significant increases in both plasma secretin concentration and bicarbonate output. The increases in the two variables were dose related. The bicarbonate output and plasma secretin concentration produced by the doses of 1-phenyl-1-hydroxy-N-pentane correlated well. No significant change occurred in either protein output or plasma gastrin concentration. The effect of intragastric 1-phenyl-1-hydroxy-N-pentane on release of secretin and pancreatic secretion was also studied in the digestive state. While gastric pH was maintained at 5.5 by intragastric titration with 1 N NaOH after intragastric administration of 5% liver extract solution, intragastric administration of 1-phenyl-1-hydroxy-N-pentane (100 mg/kg) resulted in significant increases in both plasma secretin concentrations and pancreatic bicarbonate output. In the same experiment, the plasma gastrin concentration did not change significantly, whereas gastric acid secretion decreased significantly after the 1-phenyl-1-hydroxy-N-pentane administration. In 6 human volunteers, both plasma secretin concentration and pancreatic bicarbonate output significantly increased when 2% 1-phenyl-1-hydroxy-N-pentane solution, 30 ml/30 min, was infused in the upper jejunum. Again, no increase in the protein output was apparent. These studies indicate that endogenous secretin is released by an agent other than acid and suggest strongly that the increased pancreatic bicarbonate secretion is attributed to the increased plasma concentration of secretin. 1-Phenyl-1-hydroxy-N-pentane may be a useful agent for release of secretin in subjects with achlorhydria, severe hyposecretory state, or total gastrectomy.

Cholinergic role on release and action of motilin

In conscious dogs with gastric fistula and platinum electrodes on the antrum, duodenum and jejunum, IV atropine 100 micrograms/kg/hr and hexamethonium 10 mg/kg/hr, blocked cyclic increases in fasting plasma motilin concentration (PMC) and spontaneous migrating myoelectric complexes (MMCs) of both antrum and duodenum. The two drugs also blocked occurrence of premature MMCs produced by synthetic porcine motilin. In anesthetized dogs, electrical stimulation of cervical vagi with stimulation parameters: 9 V, 10 c/s, 5 msec, caused a significant increase in both portal and femoral venous PMC which was blocked by atropine. Fractionations of vagus nerve extracts by gel filtration using Sephadex G-50 superfine column revealed most of motilin-like immunoreactivity (MLI) with the same mobility as pure porcine motilin. Studies suggest that cholinergic influence plays a significant role on release of motilin.

One-stage reconstruction of the hypopharynx using myomucosal tongue flap and dermal graft

Reconstruction of the hypopharynx following total laryngectomy and total pharyngectomy provides a one-stage procedure to reconstitute the food conduit. A myomucosal advancement tongue flap forms the anterolateral walls, and the dermal graft forms the posterior wall of the reconstruction. Sixteen patients underwent reconstruction by this method. Thirteen required total laryngectomy and total pharyngectomy for extensive carcinomas. Two other patients who had previous laryngectomy and hypopharyngeal recurrence had pharyngectomy and repair by tongue flap and dermal graft. A third patient required laryngopharyngectomy following recurrence after supraglottic laryngectomy. No postoperative deaths have occurred. Anteriolateral defects of up to 8 cm in size can be reconstructed providing the neck can be flexed. Larger posterior defects superior to the eustachian tube can be closed. In two patients minor fistulas developed which closed spontaneously. One other patient had a delayed wound dehiscence and infection with fistula and carotid blowout. The patient had undergone previous surgery and radiotherapy. Deglutition was good to excellent in most patients. Three patients required esophageal dilatation with resolution. Cinegraphic studies have demonstrated the tongue to propel a bolus and to modulate speech which shows this repair to create a dynamic conduit. One patient had difficulty in swallowing because the left hypoglossal nerve was resected. Seven patients were alive with no evidence of disease 2 to 30 months postoperatively. Four patients who were free of their original disease died from other causes. Four patients died from original disease 5 to 23 months postoperatively. At present, one patient is alive with disease. Tongue flap and dermal graft provide a reliable and one-stage reconstruction following laryngopharyngectomy and should be considered as an alternative to distant flap and intestinal interposition reconstructive procedures.

Alpha-thalassemia in two Mediterranean populations

We used restriction endonuclease analysis to determine the incidence of alpha-thalassemia in two Mediterranean islands. In a random population sample, the gene frequency of deletion-type alpha-thalassemia-2 (-alpha) was 0.18 in Sardinians and 0.07 in Greek Cypriots. All cases were the rightward crossover type. From these frequencies and the known incidence of hemoglobin-H disease in these populations, we calculated the frequency of the alpha-thalassemia-1 genotype (--) and determined that it was low. We also found that beta-thalassemia homozygotes in sardinia have a higher incidence of alpha-thalassemia than normals and beta thalassemia heterozygotes because a significantly greater number of these homozygotes are also homozygous for the alpha-thalassemia-2 lesion. These findings support the theory that coinheritance of alpha-thalassemia mitigates the severity of beta-thalassemia and suggest that the protection is most pronounced when two alpha-globin genes are deleted.

A comparative study of argon and krypton laser. Photocoagulation in the treatment of presumed ocular histoplasmosis syndrome

Ninety eyes from 88 patients with active macular subretinal neovascular membranes of presumed ocular histoplasmosis were treated with photocoagulation: 45 eyes with blue-green argon laser and 45 with red krypton laser. Final visual results are compared between these two series and natural course of the disease. The krypton laser photocoagulated eyes obtained better final visual results when compared with both the argon laser treated series and natural course.

Solid-phase synthesis and biological activities of gastrointestinal hormones: secretin and motilin

Many successful solid-phase syntheses of peptide chains in the region of 20-40 amino acid residues have now been routinely reported. Utilizing standard solid-phase synthetic methodologies but, particularly, new and powerful purification techniques we have been developing rapid and efficient preparative routes for the numerous neuro-gastrointestinal peptides. In the present study, secretin and motilin were obtained in 16% and 10% yields, respectively, after simplified two-step purification of hydrogen fluoride-cleaved peptides by gel filtration followed by preparation high performance liquid chromatography. Peptides were essentially homogeneous by TLC and analytical high performance liquid chromatography. Secretin was found to have full biological activity when tested against a standard sample of natural material for effects on pancreatic secretion in the dog. Motilin exhibited full biological activity on interdigestive motility in the dog. Secretin has been reported to undergo rearrangement with loss of bioactivity during purification and prolonged storage. We observed no obvious problems during our abbreviated purification schedule and have found no loss of purity of peptide which has been kept for 6 months as power lyophilized from dilute acetic acid.

Gastric and small intestinal myoelectric dysrhythmia associated with chronic intractable nausea and vomiting

We describe a patient with symptoms of severe nausea, vomiting, epigastric bloating and pain, and marked weight loss due to a gastrointestinal motility disturbance. Motility abnormalities were characterized by uncoordinated high pressure (as high as 300 mm Hg) contractions and uncoordinated interdigestive motor complexes in the duodenum and small intestine, and tachygastria often associated with tachyarrhythmia in the gastric myoelectric activity recordings. Uncoordinated interdigestive myoelectric complexes again were found in the duodenum and small intestine. These abnormal myoelectric activities observed in the in-vivo study were confirmed in the in-vitro study. After distal hemigastrectomy and gastrojejunostomy, the symptoms of nausea, vomiting, and epigastric pain decreased considerably. Thus, the motility abnormality found in the study appears to be responsible for the symptoms described. This is probably a new clinical entity. The importance of manometric and myoelectric study of a gastrointestinal motility for unexplained nausea and vomiting is emphasized.

beta zero thalassemia in Sardinia is caused by a nonsense mutation

We report the characterization of a molecular lesion of beta thalassemia in Sardinia. Beta thalassemia in this area is predominantly the beta zero type with low levels of beta-globin mRNA. Translation assay of this messenger RNA in a cell-free system showed beta-globin chain synthesis only with the addition of an amber (UAG) suppressor transfer RNA. Double-stranded complementary DNA prepared from reticulocyte mRNA from a Sardinian patient was cloned in a bacterial plasmid and a beta-globin complementary DNA containing clone was isolated and sequenced. At the position corresponding to amino acid number 39, a single nucleotide mutation converted a glutamine codon (CAG) to an amber termination codon (UAG). We previously reported an amber nonsense mutation at amino acid 17 as a cause of Chinese beta zero thalassemia. Thus, beta zero thalassemia in Sardinia represents the second example of a nonsense mutation, and we predict that other beta zero thalassemias with mutations at various points along the beta-globin chain will be found to form a discrete subgroup of beta zero thalassemia. These experiments further illustrate the heterogeneity of lesions that lead to defective globin chain synthesis in beta thalassemia.

Effect of sodium oleate on plasma secretin concentration and pancreatic secretion in dog

The effects of sodium oleate and triglyceride infused into the duodenum of dogs with chronic pancreatic fistulas on pancreatic secretion and plasma immunoreactive secretin were investigated. The responses were compared with those following intravenous secretin infusions. Oleate markedly increased pancreatic water and bicarbonate secretion in a dose-related fashion, and these increases were accompanied by a small, but significant rise in the level of circulating immunoreactive secretin. No change in pancreatic secretion or in plasma secretin level was observed by the administration of triglyceride. Comparison of the bicarbonate response after oleate infusion with that after secretin administration suggests that the pancreatic stimulatory effect of intraduodenal sodium oleate is mediated to a major extent by the release of endogenous secretin.

Role of secretin on postprandial gastrin release in the dog: a further study

To determine the physiologic role of secretin on gastric secretory function, the effects of secretin in a physiologic dose on gastrin release and gastric acid secretion were studied in four dogs with vagally innervated fundic pouches. Three sets of experiments were performed in each dog: (1) meal alone, (2) meal after intravenous cimetidine to suppress acid secretion and release of secretin, and (3) meal after intravenous cimetidine with simultaneous intravenous secretin, 0.03 clinical unit (CU)/kg-hr. A significant increase in plasma secretin concentration occurred after ingestion of a meal. The postprandial increase in the secretin level was abolished by intravenous cimetidine 200 mg, whereas intravenous cimetidine resulted in a marked increase in the postprandial plasma gastrin concentration which was significantly greater than that after a meal alone. A plasma secretin level comparable to that of the postprandial period could be achieved in the same fasting dogs by intravenous secretin, 0.03 U/kg-hr in 2% dog albumin solution. The postprandial plasma gastrin concentration and acid secretion following intravenous cimetidine were significantly decreased by simultaneous intravenous secretin at a dose of 0.03 U/kg-hr. The observations indicate that secretin plays a significant role in the regulation of release of gastrin and gastric secretion of acid in the postprandial state in dogs.

Secretin is an enterogastrone in the dog

To determine the physiological significance of secretin on gastric secretion, effects of normal rabbit serum (control) and rabbit antisecretin serum (anti-S) on meat meal-stimulated gastric secretion of acid and pepsin from vagally innervated fundic pouches were studied in four dogs with gastric fistulas. The intravenous administration of control serum did not affect the postprandial rise in plasma secretin concentration, whereas intravenous anti-S virtually eliminated the circulating plasma secretin. Both plasma gastrin concentration and acid output following intravenous anti-S were significantly greater than those following intravenous control serum. However, pepsin outputs in the two groups of experiments were not significantly different. In the same dogs in the fasting state, during intravenous infusion of secretin in doses of 0.06 and 0.125 U . kg-1 . h-1, the acid output stimulated by intravenous human synthetic gastrin in a dose of 0.25 micrograms . kg-1 . h-1 was significantly less than that during intravenous saline. The studies indicate that secretin in a physiological dose can inhibit postprandial release of gastrin and gastric secretion of acid, and thus secretin is an enterogastrone in the dog.

[Antenatal diagnosis of sickle-cell anaemia by DNA analysis of amniotic fluid cells. A preliminary study in the French West-Indies (author's transl)]

The genetic polymorphism previously reported to be associated with the sickle-cell (beta S) gene in black U.S.A. citizens was studied in the population of two French West-Indies islands in order to evaluate its potential application to the antenatal diagnosis of sickle-cell anaemia. The polymorphism consists of a change in the DNA sequences located near the 3' end of the beta globin gene. The change can be detected by means of the restriction endonuclease Hpa I. When cellular DNA is digested with this enzyme, the beta globin gene is contained in a DNA fragment measuring either 7.6 or 13.0 kilobases (kb). In 70% of SS homozygous subjects in Martinique and 57% in Guadeloupe the beta S gene was carried by a 13.0 kb DNA fragment, whereas the normal beta A gene was carried by a 7.6 kb DNA fragment. This polymorphism would make it possible to detect the foetal beta S gene in the DNA of amniotic fluid cells by linkage analysis.

The release of biologically active secretin-like immunoreactivity into duodenal lumen of dogs

1. Immunoreactive secretin in the duodenal contents was determined in four conscious and four anaesthetized dogs in which hydrochloric acid (0.1 N) was infused into the duodenum at 2.2 ml./min. In the conscious dogs, immunoreactive secretin concentration in duodenal juice increased from 5-7 to 40-60 ng/ml. after infusion of HCl. In anaesthetized dogs, luminal immunoreactive secretin concentration increased from 2-3 to 12-16 ng/ml. after acid infusion. In both groups of dogs, a 20- to 30-fold increase in the total output of luminal immunoreactive secretin was observed. 2. Duodenal juice collected from anaesthetized dogs after diversion of both bile and exocrine pancreatic secretion was found to be the only source of luminal immunoreactive secretin. No immunoreactive secretin was found in either bile or pancreatic juice. 3. Gel filtration of the duodenal juice on a Sephadex G-50 column indicated that the immunoreactive secretin-like material in the duodenal juice possesses a molecular size similar to that of natural porcine secretin. 4. Immunoreactive secretin was partially purified from dog duodenal juice by chromatography on a SP-Sephadex column and found to be capable of stimulating pancreatic bicarbonate and water secretion in dogs.

Actions of motilin on gastrointestinal motility and plasma immunoreactive motilin concentration in interdigestive and postprandial states

Among biological actions of motilin on gastrointestinal motility, its action to induce phase III, activity front, of interdigestive myoelectric complex (IMC) appears to be of physiological significance. Synthetic motilin in a dose as little as 0.06 microgram/kg-h was shown to induce phase III in dog. A cyclic increase in fasting plasma immunoreactive motilin concentration (PIMC) occurred in phase III in dog and in a later part of phase II in man, suggesting strongly that there is an intimate relationship between cyclic increase in fasting PIMC and IMC. The observation also suggested that gastric acid secretion increases in phase II and phase III of IMC. The cyclic increase in the acid secretion may be related to a coincidental cyclic increase in PIMC. Ingestion of a meat meal results in a significant decrease in PIMC and abolishes the cyclic increase in PIMC, while IMC changes to digestive pattern after a meal. The significant decrease in PIMC is not attributed to the 3 known gut hormones including gastrin, octapeptide of CCK and secretin.

Electrogastrographic study of patients with unexplained nausea, bloating, and vomiting

A method of recording gastric myoelectric activity with a peroral suction electrode was evaluated, and the recording was compared with that obtained by implanted electrodes on the serosal surface of the stomach of laparotomized humans. In a group of patients with unexplained nausea, epigastric bloating, and vomiting, abnormal antral myoelectric activities were found by a peroral electrode, in contrast to a regular pacesetter potential (frequency: 3-4/min) in control subjects. These abnormalities were confirmed by the recordings from the implanted electrodes in the same subjects. The study indicates that peroral recording of gastric myoelectric activity is a useful diagnostic method for the detection of gastric myoelectric activity abnormalities in humans.

Lymphoma of the vitreous associated with renal transplantation and immunosuppressive therapy

A renal transplant patient presented with a uveitis unresponsive to high doses of steroids. A pars plana vitrectomy was performed for diagnosis. Light and transmission electron microscopy confirmed the diagnosis of lymphoma of the vitreous. Six percent of the renal transplant recipients develop tumors. This frequency is 100 times greater than the general population. Reticulum cell sarcoma is the predominant type being 350 times more common in renal transplant recipients than in the general population. The patient was taking immunosuppressive drugs which depress the immunologic surveillance. Antigenic neoplastic cells may arise by somatic mutations and may proliferate producing neoplasms with loss of the surveillance mechanism. The case presented illustrates that persons immunosuppressed may develop an eye tumor presenting as uveitis.