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This chapter looks at Nâzım’s first years in Moscow, between the spring of 1922 and the summer of 1924. Beginning with the arrival of Nâzım and his friends in the Soviet capital and the time they spent at a summer camp outside Moscow, attention then shifts to a discussion of Communist University of the Toilers of the East and the other educational institutions established by the Comintern in the early 1920s. Subsequent sections trace the backgrounds of the other Turkish students whom Nâzım and his friends encountered at the university, and the individuals with whom Nâzım and Vâlâ socialized during their initial months in Moscow. The final section of this chapter discusses Nâzım’s poetry from these years, and in particular his adoption of the Russian Futurist style.

The introduction to this book opens with a personal vignette from the author’s life in Istanbul in the 1990s, then segues into a brief discussion of Nâzım Hikmet’s continued importance as a cultural figure in Turkey. It outlines some of the most significant differences between this biography of Nâzım and previous ones, including the research undertaken for this book in Russia, Istanbul, Amsterdam, and Washington, DC. Another important difference relates to context, as this book does not treat Nâzım Hikmet’s life in isolation. Rather, it situates him within the broader story of his generation of late imperial “border-crossers,” i.e., individuals whose lives were significantly impacted by the cross-border experiences of their younger years. The introduction ends with a pledge to “breathe life” back into a literary and historical figure who, while the subject of much biographical attention, has usually been treated in one-dimensional terms.

This chapter discusses Nâzım Hikmet’s family and life between 1902 and 1920 within the larger context of events unfolding during the final years of the Ottoman Empire’s existence. Nâzım grew out of a long history of border-crossers, whose colorful lives and cosmopolitan backgrounds had for years contributed to Nâzım’s elite but downwardly-mobile bloodline. “Macro” sections of this chapter investigate broader political developments relating to the Young Turks, pan-Turkism, and socialism during the first two decades of Nâzım’s life. Discussion then shifts toward Nâzım Hikmet’s changing poetic voice during the course of the Balkan Wars, World War I, and the postwar British occupation of Istanbul.

Chapter 3 recounts Nâzım and Vâlâ’s activities in Ankara and Bolu in the spring and summer of 1921. Its earliest sections focus primarily upon broader developments occurring in the region. These include the efforts of ex-Young Turk officials to resurrect their political careers after the Ottoman Empire’s defeat; the Congress of Peoples of the East that was held in Baku, Azerbaijan; and Mustafa Suphi’s ill-fated return to Anatolia. The chapter then focuses more closely upon Nâzım and Vâlâ’s activities, discussing their experiences in Ankara, the months they spent in Bolu working as teachers for the Ankara government, and their subsequent decision to leave Bolu for Tbilisi, Georgia.

This chapter examines Nâzım’s personal, professional, and literary lives in Istanbul between October 1928 and mid-1934. Upon returning “home” to Istanbul in late 1928, Nâzım was involved in a series of conflicts. In 1929, he broke with the TKP, an organization which had been an important part of his life for eight years. Shortly thereafter, he began working for a journal, Resimli Ay (“Illustrated Monthly”), run by Sabiha and Zekeriya Sertel, with whom Nâzım would develop important life-long friendships. Writing for Resimli Ay, Nâzım mercilessly attacked a number of influential figures in the Turkish literary elite, earning some powerful enemies in the process. The chapter then discusses Nâzım’s courtship and marriage to Piraye, as well as his incarceration in 1933–34. It concludes with a discussion of Nâzım’s poetry and other writings from the early 1930s.

Chapter 6 discusses the period from mid-1924 until late 1928. It begins with Nâzım’s return to Istanbul, where he was supposed to work on behalf of the Turkish Communist Party, which was still a legal organization in Turkey. However, Nâzım’s time in Turkey was beset with difficulties, both personal and political. Nüzhet, whom Nâzım had married when she had visited him in Moscow, broke up with him shortly after his return to Istanbul. More ominously for Nâzım, the Turkish government cracked down on politics in the wake of the Sheikh Sait rebellion of March, 1925, closing all opposition parties. Wanted by Turkish authorities due to his work for the TKP, Nâzım escaped back to Moscow, where he would again reside until the second half of 1928. Nâzım continued to write during these years, with sections of this chapter examining his changing poetic styles in the 1920s. The chapter ends with Nâzım returning once again to Turkey at the end of 1928 in order to undertake ‘clandestine’ work for the now-illegal TKP.

This chapter begins in 1948, with Nâzım’s ten-year anniversary of incarceration, and ends with his escape from Turkey in June 1951. After providing a “macro” account of Turkey’s changed relations with the US and USSR after World War II, this chapter looks at Nâzım’s rekindled connection with his first cousin Münevver Andaç, who in 1948 paid an unexpected visit to him in prison. This development set off a chain of events leading Nâzım to break off his relationship with his wife Piraye. Energized by his new romance with Münevver, Nâzım revived his efforts to gain an early release. On the heels of an international campaign to win his freedom, Nâzım received an amnesty in July 1950. Continued official harassment in Turkey, however, led him to flee the following year. The chapter concludes with Nâzım escaping into an uncertain future in the Eastern Bloc.

Chapter 11 looks at Nâzım’s early months and years in the USSR and Eastern Bloc, up until Stalin’s death in March 1953. It begins with a discussion of the twelve days Nâzım spent in Romania while he awaited a decision from Moscow regarding his future. This chapter then examines Nâzım’s early days in the Soviet capital, looking specifically at his relationship with İsmail Bilen, an old friend dating back to their days at KUTV. Subsequent sections discuss Nâzım’s involvement in the International Youth Festival in East Berlin, his undertaking of a mission to Bulgaria, and the unearthing in Moscow of old party files denouncing Nâzım as a “Trotskyite.” The chapter concludes with a discussion of Nâzım’s new writing in the Soviet Union during the last years of Stalin.

This chapter discusses Nâzım’s life in the Eastern Bloc from the mid-1950s until the end of the decade. Nâzım was doing well materially and emotionally, traveling frequently throughout the Eastern Bloc and elsewhere, and living with his physician/lover Dr. Galina Kolesnikova. During these years, Nâzım was common-law married to one woman, living with another, and falling in love with a third as he pursued Vera Tulyakova, a married mother thirty years his junior. Nâzım’s triple life was protected by the Iron Curtain, which served as both his narrative foil and a practical instrument. This chapter ends with a discussion of Nâzım’s publications in the Eastern Bloc in the second half of the 1950s.

This epilogue examines Nâzım’s legacy and explains what happened to others whose lives were discussed in this book. It goes up to the late 1980s, focusing upon the late-life activities of the last of Nâzım’s friends, lovers, and comrades. Another section discusses the TKP in the aftermath of Nâzım’s death. The final section of the epilogue offers a concluding analysis of Nâzım’s life, his generation, and the transition from the late imperial age to a post-imperial one. The book ends with a return to the original point of contact with Nâzım: on the shores of the Bosphorus, awaiting his brother-in-law Refik to pick him up in the motorboat.

This prologue recounts the morning of June 17, 1951, when Nâzım Hikmet escaped by motorboat from Turkey to the Eastern Bloc. He was forty-nine years old at this time, and was Turkey’s best-known poet. Nâzım Hikmet was also a communist, someone who had spent years of his life behind bars for refusing to renounce his politics. On this particular morning, he was riding away from his former life across the turbulent waters of the Black Sea. Yet the poet-communist’s future was an uncertain one, as he had a checkered political past in Moscow. Had Nâzım Hikmet escaped from a Turkish frying pan, only to jump into a Stalinist fire?

Chapter 2 details the journey that Nâzım and his best friend Vâlâ Nureddin took to Ankara in the early months of 1921. The two had resolved to escape the British occupation of Istanbul so that they could join the resistance movement forming in Ankara under the leadership of Mustafa Kemal (Atatürk). This chapter also introduces Şevket Süreyya (Aydemir), who would become a good friend and traveling companion of Nâzım and Vâlâ during a later stage of their journey. While tracing Nâzım and Vâlâ’s progress across Anatolia, discussion shifts to larger events occurring during these years, including the collapse of the Russian Empire, Ottoman efforts to bring back its POWs from Russia, and the creation, in Baku, of the Turkish Communist Party under the direction of the erstwhile pan-Turkist Mustafa Suphi. The final sections of this chapter return to Nâzım and Vâlâ as they make their way toward Ankara, meeting up with a group of Turkish Spartakists en route. The chapter ends with Nâzım and Vâlâ’s arrival in Mustafa Kemal’s capital in a much different frame of mind from that with which they had departed Istanbul.

Chapter 13 examines the years between 1960 and Nâzım’s death in 1963. It discusses various personal matters, such as the breakdown of Nâzım’s relationships with Dr. Galina and Münevver Andaç, and his 1960 marriage to Vera Tulyakova. Other sections of this chapter look at Nâzım’s involvement in short-wave radio and TKP-related projects in Leipzig, East Germany. In the early 1960s, Münevver Andaç escaped from Turkey with her children, Süleyman Nuri sought revenge, and Nâzım sank into depression and an obsession with death. With respect to both his writing and his everyday life, Nâzım tied up loose ends and prepared for the end.

Chapter 8 discusses events in Turkey and the USSR during the years 1934–38. It begins with an examination of the Soviet–Turkish frontier in the 1930s, the tightening of which coincided with the emergence of increasingly violent regimes in both states. Nâzım was released from prison in 1934, and soon after returned to his pugnacious public persona. In Moscow, meanwhile, İsmail Bilen was consolidating his power over Turkish communists in the USSR during an era of purges. The chapter then turns to a discussion of Nâzım’s writing in the mid-1930s, which marked the last of his last legal publications to appear in Turkey during his lifetime. Comparing Nâzım’s career with that of another Futurist by the name of Ercümend Behzad (Lav), this chapter concludes with an examination of the nature of literary fame in early republican Turkey.

Chapter 9 discusses Nâzım Hikmet’s life between 1938 and 1948. In 1938, Nâzım was arrested on charges of inciting mutiny in the army and navy, trumped up claims which nevertheless resulted in a prison sentence of twenty-eight years and four months. During the early years of this term, Nâzım believed that he would be released soon. As time passed, however, and it became clear that his sentence would not soon be commuted, Nâzım began to focus more upon survival for himself and Piraye, taking on menial jobs as a means of supporting his family. Other sections of this chapter take place in Moscow, and trace İsmail Bilen’s career in the Soviet capital. The chapter concludes with a discussion of Nâzım’s writing during these years, including his initial work on Human Landscapes from My Country, which would later go on to be considered his masterpiece.

Red Star Over the Black Sea tells the story of Nâzım Hikmet and his generation. Nâzım Hikmet (1902–63) is best-known as a poet and communist whose daring flight by motorboat from Turkey to the Eastern Bloc captured international headlines in 1951. Born at the turn of the twentieth century and coming of age in the early 1920s, the women and men of Nâzım Hikmet’s generation were the last of the Ottomans. Children of empire, they had grown up amid an era of porous frontiers. By the time this generation had reached its third decade, however, the doors had already begun to close behind them. Drawing upon previously untapped archival materials and personal papers from Moscow, Istanbul, Amsterdam, and Washington, DC, this book tells the story of Nâzım Hikmet and his generation.

Nâzim Hikmet is perhaps Turkey’s best-known literary figure from the twentieth century, due at least in part to his dramatic life story and flight from Turkey to the Soviet Union in 1951. During th...

Agnes Kefeli has written a first-rate monograph examining an issue in Russian imperial history that has generally been described in terms of “apostasy.” The “lapsing” of Tatar Christians in the nin...

Glucagon-like peptide-1 (GLP-1), an important mediator of postprandial glycaemia, could potentially be stimulated by delivering small quantities of nutrient to a long length of distal gut. We aimed to determine whether enteric-coated pellets, releasing small amounts of lauric acid throughout the ileum and colon, could reduce glycaemic responses to meals in type 2 diabetes, associated with stimulation of GLP-1.Eligible patients, who had type 2 diabetes controlled by diet or metformin, were each studied on two occasions in a hospital setting. After an overnight fast, patients consumed 5 g active pellets (47% lauric acid by weight) or placebo with breakfast (T = 0 min) and lunch (T = 240 min), in a crossover design with order randomised by the hospital pharmacy and allocation concealed by numbered containers. Patients and investigators making measurements were blinded to the intervention. Blood was sampled frequently for blood glucose (the primary outcome) and hormone assays.Eight patients were randomised (four to receive either intervention first), and all completed the study without adverse effects. Blood glucose was lower after breakfast (T = 0-240 min, area under the curve (AUC) 2,075 ± 368 vs 2,216 ± 163 mmol/l × min) and lunch (T = 240-480 min, AUC 1,916 ± 115 vs 2,088 ± 151 mmol/l × min) (p = 0.02 for each) after active pellets than after placebo. Plasma GLP-1 concentrations were higher after breakfast (p = 0.08) and lunch (p = 0.04) for active pellets. While there were no differences in insulin or glucose-dependent insulinotropic polypeptide concentrations, glucagon concentrations were higher after breakfast and lunch (p = 0.002 for each) for active pellets.Delivering small amounts of nutrient to the ileum and colon can stimulate substantial endogenous GLP-1 release and attenuate postprandial glycaemia. This novel approach has therapeutic potential in type 2 diabetes.Australian New Zealand Clinical Trials Registry ACTRN12612000600842.The study was funded by Meyer Nutriceuticals.

In the final decades of the 19th century, a crisis broke out in the relations between government officials and Muslim communities in the province of Kazan. A cultural borderland located within a centralizing imperial heartland, Kazan represented one of the oldest and most important sites of Muslim--state interaction in the Russian Empire. (1) From the late 1870s onward, however, Muslim--state relations in the region deteriorated sharply in the face of state efforts to assert more direct control over the administration of the region's Muslim populations. Muslim opposition to these initiatives, taking the form of demonstrations and mass petition campaigns, would occur on an almost yearly basis throughout the final three decades of the century. How did Muslims in late imperial Russia view the tsarist state and its institutions? For decades during the Cold War, scholars discussing the relations between the tsarist state and non-Russian communities in the empire emphasized the theme of conflict, stressing the importance of identity and "national resilience" in the face of "Russian" rule. (2) More recently, however, this conflict-oriented view of Muslim--state relations in the empire has come under increasing pressure from scholars, mainly working with tsarist state archival sources, who instead have stressed the importance of state institutions (3) and their engagement by Muslims in the empire. (4) Perhaps the most forceful critique of older conflict-oriented scholarly narratives has come from Robert D. Crews. (5) Crews argues that Muslims "looked to the state" to protect their interests, particularly with respect to matters pertaining to faith. (6) Instead of viewing tsarist officials as enemies, writes Crews, Muslims saw them as "agents of a shari'a to be realized in its entirety," and as allies of Muslims seeking to protect the cause of "true religion." (7) Muslims meanwhile viewed threats to Islam as emanating less from state authorities than from "within the community in the form of neighbors who did not attend communal prayers alongside other villagers or townspeople." In the view of Muslims, Crews writes, "religion" not only found accommodation among tsarist officials but in fact "came to depend upon the institutions of state." (8) This article looks beyond these narratives of rejection and embrace in an investigation of a series of protests taking place within Muslim communities in the Volga region in the late 19th century. (9) I argue that, while Muslims did not reject tsarist institutions to the degree outlined in many older studies, (10) neither did Muslim subjects of Russia commonly view tsarist officials as defenders of the Islamic faith. (11) Indeed, in the second half of the 19th century, Muslim--state relations in the region were becoming increasingly complex, with Muslims looking to strengthen the role of some institutions of state authority while resisting others. Even in Kazan, one of the most administratively integrated regions of the empire, Muslims were becoming increasingly alienated from tsarist authorities in the region, including both civil and spiritual officials. (12) Beginning with a discussion of Islamic spiritual (dukhovnoe) administration in Russia, this article examines a series of protests, petition campaigns, and mass rumors circulating in and around the province of Kazan in the final decades of the 19th century, as well as the response of local officials to these events. I pay special attention to the language of Muslim--state communications, especially with regard to what I describe as the use of "Islamic discourses"--that is, the invocation of terminology drawn from Islamic civilization. (13) How, I ask, did a series of conflicts pertaining mainly to administration come to be articulated--by tsarist officials and Muslim protesters alike---in terms of faith? (14) Islamic Administration in Late Imperial Russia Kazan Muslims, like other non-Russian populations of the empire, were governed through a system of spiritual administration that was religious in form but largely administrative in content. …

Postprandial hypotension occurs frequently, particularly in the elderly. The magnitude of the fall in blood pressure (BP) and rise in heart rate (HR) in response to enteral glucose are greater when gastric emptying (GE) or small intestinal infusion are more rapid. Meal ingestion is associated with an increase in splanchnic blood flow. In contrast, gastric distension may attenuate the postprandial fall in BP. The aims of this study were to evaluate, in older subjects, the comparative effects of intraduodenal glucose infusion, at a rate similar to GE of oral glucose, on BP, HR, superior mesenteric artery (SMA) flow, and blood glucose. Eight healthy subjects (5 men, 3 women, age 66–75 yr) were studied on two occasions. On day 1, each subject ingested 300 ml of water containing 75 g glucose. GE was quantified by three-dimensional ultrasonography between time t = 0–120 min, and the rate of emptying (kcal/min) was calculated. On day 2, glucose was infused intraduodenally at the same rate as that on day 1. On both days, BP, HR, SMA flow, and blood glucose were measured. The mean GE of oral glucose was 1.3 ± 0.1 kcal/min. Systolic BP ( P < 0.01), SMA flow ( P < 0.05), and blood glucose ( P < 0.01) were greater and HR less ( P < 0.01) after oral, compared with intraduodenal, glucose. There were comparable falls in diastolic BP during the study days ( P < 0.01 for both). We conclude that the magnitude of the fall in systolic BP and rise in HR are less after oral, compared with intraduodenal, glucose, presumably reflecting the “protective” effect of gastric distension.

Objective Enterally administered glucose modifies gut sensation, diminishes hunger, and slows gastric emptying by suppressing antral motility and stimulating pyloric pressures. We aimed to clarify the mechanism of small intestinal glucose sensing. Methods We studied eight healthy males twice, in random order. An antroduodenal manometry catheter was positioned with a sleeve sensor across the pylorus. Benzocaine, or vehicle alone, was given into the proximal duodenum as a bolus, followed by continuous infusion for 105 min (T=-15 to 90 min). Glucose was also infused into the proximal duodenum at 3 kcal/min for 90 min (T=0-90 min). Sensations of hunger, bloating, and nausea were assessed with visual analog questionnaires, blood was sampled at intervals, and energy intake at a buffet meal (T=90-120 min) was measured. Results Perceptions of bloating and nausea were markedly less with benzocaine when compared with vehicle (P

Background: The regulation of gastrointestinal function and energy intake by fatty acids depends on their chain length. Animal studies suggest that lauric acid (C12) may have more potent suppressive effects on energy intake than does oleic acid (C18). Objective: We compared the effects of equicaloric loads of C 12 and C 18 on antropyloroduodenal (APD) motility, plasma concentrations of cholecystokinin (CCK) and peptide YY (PYY), appetite, and energy intake. Design: Thirteen healthy men (aged 20-46 y) were studied on 3 occasions in double-blind, randomized fashion. APD pressure waves, plasma hormones, and appetite perceptions were measured during 60-min intraduodenal infusions of 1) C 12,2) C 18, or 3)0.9% saline as control (rate: 4 mL/min; energy load for C12 and C18: 0.4 kcal/min); between 60 and 90 min, the subjects consumed a meal. Energy intake at a buffet meal was quantified. Results: C 12 and C 18 both reduced antral (P < 0.001) and duodenal (P < 0.01) pressure waves and stimulated isolated pyloric pressure waves (P < 0.01) and plasma CCK (P < 0.001), with no differences between them. Although C12 and C18 both increased basal pyloric pressure (P < 0.05), C12 had a greater effect than did C18 (P < 0.01). In contrast, although both C12 and C 18 increased plasma PYY (P < 0.001), C18 had a greater effect than C12. C12, but not C18, suppressed energy intake (P < 0.05). Conclusions: At the load administered, C12, but not C18, suppressed energy intake, and C12 was a more potent stimulant of basal pyloric pressure. These discrepant effects are not apparently accounted for by changes in CCK or PYY secretion.

There is evidence from studies in animals that the effects of both fat and CCK on gastrointestinal function and energy intake are attenuated by consumption of a high-fat diet. In humans, the effects of exogenous CCK-8 on antropyloroduodenal motility, plasma CCK, peptide YY (PYY), and ghrelin concentrations, appetite, and energy intake are attenuated by a high-fat diet. Ten healthy lean males consumed isocaloric diets (∼15,400 kJ per day), containing either 44% (high-fat, HF) or 9% (low-fat, LF) fat, for 21 days in single-blind, randomized, cross-over fashion. Immediately following each diet (i.e., on day 22), subjects received a 45-min intravenous infusion of CCK-8 (2 ng·kg−1·min−1), and effects on antropyloroduodenal motility, plasma CCK, PYY, ghrelin concentrations, hunger, and fullness were determined. Thirty minutes after commencement of the infusion, subjects were offered a buffet-style meal, from which energy intake (in kilojoules) was quantified. Body weight was unaffected by the diets. Fasting CCK ( P < 0.05), but not PYY and ghrelin, concentrations were greater following the HF, compared with the LF, diet. Infusion of CCK-8 stimulated pyloric pressures ( P < 0.01) and suppressed antral and duodenal pressures ( P < 0.05), with no difference between the diets. Energy intake also did not differ between the diets. Short-term consumption of a HF diet increases fasting plasma CCK concentrations but does not affect upper gut motility, PYY and ghrelin, or energy intake during CCK-8 infusion, in a dose of 2 ng·kg−1·min−1, in healthy males.

Джеймс Мейер констатирует, что, несмотря на множественные пересечения истории Российской и Османской империй, русисты и оттоманисты представляют два изолированных друг от друга исследовательских сообщества. Настоящая статья построена как руководство для русистов, желающих привлечь архивные материалы из хранилищ современной Турции и оттоманистов, нуждающихся в материалах из мусульманских коллекций на территории бывшего СССР. Обзор основан на непосредственном исследовательском опыте Мейера, который включает работу в османских архивах в Стамбуле (Basbakanlik Arsivi), архивах и рукописных отделах библиотек Петербурга, Казани, Баку, Уфы и Симферополя. Помимо анализа собственно тематики архивных коллекций, в статье содержатся практические рекомендации относительно условий работы в том или ином архиве, справочной литературы и пр. В заключении автор выражает надежду, что в будущем русисты будут обладать достаточным знанием тюркских языков, персидского и арабского, а специалисты по Османской империи – знанием русского, что позволит пересекать искусственные архивные и дискурсивные границы.

The effects of fat on gastric emptying (GE), gut hormones, and energy intake are dependent on digestion to free fatty acids (FFAs). In animals, small intestinal oleic acid inhibits energy intake more potently than the triacylglyceride (TG) triolein, but there is limited information about the comparative effects of FFA and TG in human beings. We compared the effects of FFA and TG on GE, gut hormone secretion, appetite, and energy intake in healthy males.Nine men (age, 23 +/- 2 y; body mass index, 22 +/- 1 kg/m(2)) were studied on 3 occasions to evaluate the effects of (1) 40 g oleic acid (FFA, 1830 kJ), (2) 40 g macadamia oil (TG, 1856 kJ; both 600-mL oil-in-water emulsions stabilized with 4% milk protein and labeled with 15 MBq (123)I), or (3) 600 mL 4% milk protein (control, 352 kJ), administered intragastrically, on GE, plasma cholecystokinin (CCK) and peptide-YY (PYY) levels, appetite perceptions, and subsequent energy intake.GE of FFA was much slower than that of TG (P.05), with greater retention of FFA, than TG, in the proximal stomach (P.001). Hunger was less (P.05), and fullness was greater (P.05), after FFA when compared with control and TG. Increases in plasma CCK and PYY levels were greater after FFA than TG or control (P.05). Energy intake tended to be less after FFA compared with TG (control, 4754 +/- 610 kJ; TG, 5463 +/- 662 kJ; FFA, 4199 +/- 410 kJ).FFAs empty from the stomach more slowly, but stimulate CCK and PYY and suppress appetite more potently than TG in healthy human beings.

Animal studies suggest that the effects of fatty acids on gastric emptying and pancreatic secretion are both concentration and load dependent, while their suppressive effect on energy intake is only load dependent. We postulated that, in humans, the modulation of antropyloroduodenal pressure waves, plasma cholecystokinin (CCK) and peptide YY (PYY) concentrations and energy intake by intraduodenal lauric acid, a fatty acid with 12 carbon atoms (‘C12’) would be load, but not concentration, dependent. Two groups of 12 healthy males were each studied on three separate occasions in double-blind randomized fashion. Antropyloroduodenal pressure waves, plasma CCK and PYY, and appetite perceptions were measured during intraduodenal infusions of C12 at (1) different loads of (i) 0.2, (ii) 0.3 and (iii) 0.4 kcal min−1 (all 56 mm) for 90 min, and (2) different concentrations of (i) 40, (ii) 56 and (iii) 72 mm (all 0.4 kcal min−1) for 60 min. Energy intake at a buffet meal consumed immediately following each infusion was quantified. Suppression of antral and duodenal pressure waves, stimulation of pyloric pressure waves, stimulation of plasma CCK and PYY, and suppression of energy intake, were related to the load of C12 administered (r > 0.65, P < 0.05). In contrast, there were no concentration-dependent effects of C12 on any of these parameters. In conclusion, in humans, the effects of intraduodenal C12 on antropyloroduodenal motility, plasma CCK and PYY and energy intake appear to be related to load, but not concentration, at least at the loads and concentrations evaluated.

Based upon research undertaken in Turkey, Russia, Azerbaijan, and the Crimea, this article consists of three principal and interconnected fields of inquiry. The first focuses upon changing Russian and Ottoman policies toward the immigration of Russian Muslims to the Ottoman Empire in the second half of the 19th century. The second examines questions that complicate the historiographical narrative surrounding this immigration, including issues such as Muslim return immigration to Russia and the retention of Russian citizenship by Muslim immigrants in the Ottoman Empire. The third examines the increasingly contested nature of citizenship and its role in the relations between Russian Muslims and the Russian and Ottoman bureaucracies. This section investigates battles between Ottoman and Russian bureaucrats who assert authority over Muslims of ambiguous citizenship status and the strategies deployed by Russian Muslims to take advantage of this ambiguity in their dealings with the bureaucracies of both empires.

Upper gastrointestinal motor function and incretin hormone secretion are major determinants of postprandial glycemia and insulinemia. However, the impact of small intestinal flow events on glucose absorption and incretin release is poorly defined. Intraluminal impedance monitoring is a novel technique that allows flow events to be quantified. Eight healthy volunteers were studied twice, in random order. A catheter incorporating six pairs of electrodes at 3-cm intervals, and six corresponding manometry sideholes, was positioned in the duodenum. Hyoscine butylbromide (20 mg) or saline was given as an intravenous bolus, followed by a continuous intravenous infusion of either hyoscine (20 mg/h) or saline over 60 min. Concurrently, glucose and 3- O-methylglucose (3-OMG) were infused into the proximal duodenum (3 kcal/min), with frequent blood sampling to measure glucose, 3-OMG, insulin, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). The frequency of duodenal pressure waves and propagated pressure wave sequences was reduced by hyoscine in the first 10 min ( P < 0.01 for both), but not after that time. In contrast, there were markedly fewer duodenal flow events throughout 60 min with hyoscine ( P < 0.005). Overall, blood glucose ( P < 0.01) and plasma 3-OMG concentrations ( P < 0.05) were lower during hyoscine than saline, whereas plasma insulin, GLP-1, and GIP concentrations were initially ( t = 20 min) lower during hyoscine ( P < 0.05). In conclusion, intraluminal impedance measurement may be more sensitive than manometry in demonstrating alterations in duodenal motor function. A reduction in the frequency of duodenal flow events is associated with a decreased rate of glucose absorption and incretin release in healthy subjects.

To examine the clinical effectiveness of patient encounters during humanitarian assistance (HA) missions performed by the 48th Combat Support Hospital in Afghanistan.Data were prospectively gathered from missions in the villages of Aroki (January 21, 2003), Tangee (March 25, 2003), and Turkman (April 22, 2003). Health care providers evaluated the effectiveness of each patient encounter using a data-gathering instrument with clearly defined outcome measures.A total of 1,887 patients were seen during the three missions. Forms were incomplete for 112 patients and not used for 33 dental patients. For the remaining 1,742 individuals, probable cures were achieved as follows: adult males, 31%; adult females, 52%; male children, 46%; and female children, 54% (all patients, 46%, p0.001). After adjusting for acute care that was supportive in nature during the final mission, probable cures were achieved as follows: adult males, 22%; adult females, 16%; male children, 34%; and female children, 27%. During this final operation, 73% (p0.001) of patients received care that was unnecessary, unlikely to produce a cure, or was merely supportive in nature.During HA missions performed by the 48th Combat Support Hospital, the majority of patient encounters did not result in curative treatments. The effectiveness of medical care during HA missions cannot be assumed and future operations should include assessments of outcomes to optimize their value.

We have evaluated the effects of fatty acid chain length on ghrelin, peptide YY (PYY), glucagon-like peptide-2 (GLP-2) and pancreatic polypeptide (PP) secretion and hypothesized that intraduodenal administration of dodecanoic ("C12"), but not decanoic ("C10"), acid would decrease plasma ghrelin and increase PYY, GLP-2 and PP concentrations. Plasma hormone concentrations were measured in seven healthy men during 90-min intraduodenal infusions of: (i) C12, (ii) C10 or (iii) control (rate: 2 ml/min, 0.375 kcal/min for C12/C10) and after a buffet-meal consumed following the infusion. C12 markedly suppressed plasma ghrelin and increased both PYY and GLP-2 (all P < 0.05) compared with control and C10, while C10 had no effect. Both C10 and C12 increased PP concentrations slightly (P < 0.05). We conclude that the effects of intraduodenal fatty acids on ghrelin, PYY and GLP-2 secretion are dependent on their chain length.

Enterally administered lipid modulates antropyloroduodenal motility, gut hormone release, appetite, and energy intake. We hypothesized that these effects would be dependent on both the load, and duration, of small intestinal exposure to lipid. Eleven healthy men were studied on four occasions in a double-blind, randomized, fashion. Antropyloroduodenal motility, plasma CCK and peptide YY (PYY) concentrations, and appetite perceptions were measured during intraduodenal infusion of lipid (Intralipid) at 1) 1.33 kcal/min for 50 min, 2) 4 kcal/min for 50 min, and 3) 1.33 kcal/min for 150 min, or 4) saline for 150 min. Immediately after the infusions, energy intake was quantified. Pressure wave sequences (PWSs) were suppressed, and basal pyloric pressure, isolated pyloric pressure waves (IPPWs), plasma CCK and PYY stimulated (all P < 0.05), during the first 50 min of lipid infusion, in a load-dependent fashion. The effect of the 4 kcal/min infusion was sustained so that the suppression of antral pressure waves (PWs) and PWSs and increase in PYY remained evident after cessation of the infusion (all P < 0.05). The prolonged lipid infusion (1.33 kcal/min for 150 min) suppressed antral PWs, stimulated CCK and PYY and basal pyloric pressure (all P < 0.05), and tended to stimulate IPPWs when compared with saline throughout the entire infusion period. There was no significant effect of any of the lipid infusions on appetite or energy intake, although nausea was slightly higher ( P < 0.05) with the 4 kcal/min infusion. In conclusion, both the load, and duration, of small intestinal lipid influence antropyloroduodenal motility and patterns of CCK and PYY release.

An abnormality in transit is commonly considered to account for unexplained gastrointestinal (GI) symptoms. Since the symptoms of delayed transit overlap with those of accelerated transit, direct measurement of GI transit is needed to establish an accurate diagnosis. Similarly, since symptoms originating from one part of the gut may overlap with symptoms from another, localizing transit abnormality to one organ vs. another using direct measurement is an important part of diagnostic evaluations. Consequently, noninvasive tests of GI transit should be done early in the evaluation to guide therapy. We now have tools to measure transit accurately; results of transit tests often depend on the conditions selected for the test, so test results will match clinical expectations most closely when test conditions are selected to reproduce the circumstances for symptom production. This review describes the most commonly used methods for the measurement of GI transit including the gastric emptying test for some dyspeptic symptoms, small bowel transit test for dyspeptic symptoms and diarrhea, colonic transit test for constipation, and factors that influence the result of these studies. As we make progress in our understanding of the pathophysiology of transit disorders, the clinical usefulness of these diagnostic tests will be further enhanced.

There is evidence that CCK and glucagon-like peptide-1 (GLP-1) mediate the effects of nutrients on appetite and gastrointestinal function and that their interaction may be synergistic. We hypothesized that intravenous CCK-8 and GLP-1 would have synergistic effects on appetite, energy intake, and antropyloroduodenal (APD) motility. Nine healthy males (age 22 ± 1 yr) were studied on four separate days in a double-blind, randomized fashion. Appetite and APD pressures were measured during 150-min intravenous infusions of 1) isotonic saline (control), 2) CCK-8 (1.8 pmol·kg−1·min−1), 3) GLP-1 (0.9 pmol·kg−1·min−1), or 4) both CCK-8 (1.8 pmol·kg−1·min−1) and GLP-1 (0.9 pmol·kg−1·min−1). At 120 min, energy intake at a buffet meal was quantified. CCK-8, but not GLP-1, increased fullness, decreased desire to eat and subsequent energy intake, and increased the number and amplitude of isolated pyloric pressure waves and basal pyloric pressure ( P < 0.05). Both CCK-8 and GLP-1 decreased the number of antral and duodenal pressure waves (PWs) ( P < 0.05), and CCK-8+GLP-1 decreased the number of duodenal PWs more than either CCK-8 or GLP-1 alone ( P < 0.02). This was not the case for appetite or isolated pyloric PWs. In conclusion, at the doses evaluated, exogenously administered CCK-8 and GLP-1 had discrepant effects on appetite, energy intake, and APD pressures, and the effects of CCK-8+GLP-1, in combination, did not exceed the sum of the effects of CCK-8 and GLP-1, providing no evidence of synergism.

We recently reported that intraduodenal infusion of lauric acid (C12) (0.375 kcal/min, 106 mM) stimulates isolated pyloric pressure waves (IPPWs), inhibits antral and duodenal pressure waves (PWs), stimulates release of cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1), and suppresses energy intake and that these effects are much greater than those seen in response to isocaloric decanoic acid (C10) infusion. Administration of C12 was, however, associated with nausea, confounding interpretation of the results. The aim of this study was to evaluate the effects of different intraduodenal doses of C12 on antropyloroduodenal (APD) motility, plasma CCK and GLP-1 concentrations, appetite, and energy intake. Thirteen healthy males were studied on 4 days in double-blind, randomized fashion. APD pressures, plasma CCK and GLP-1 concentrations, and appetite perceptions were measured during 90-min ID infusion of C12 at 0.1 (14 mM), 0.2 (28 mM), or 0.4 (56 mM) kcal/min or saline (control; rate 4 ml/min). Energy intake was determined at a buffet meal immediately following infusion. C12 dose-dependently stimulated IPPWs, decreased antral and duodenal motility, and stimulated secretion of CCK and GLP-1 ( r > 0.4, P < 0.05 for all). C12 (0.4 kcal/min) suppressed energy intake compared with control, C12 (0.1 kcal/min), and C12 (0.2 kcal/min) ( P < 0.05). These effects were observed in the absence of nausea. In conclusion, intraduodenal C12 dose-dependently modulated APD motility and gastrointestinal hormone release in healthy male subjects, whereas effects on energy intake were only apparent with the highest dose infused (0.4 kcal/min), possibly because only at this dose was modulation of APD motility and gastrointestinal hormone secretion sufficient for a suppressant effect on energy intake.

The determinants of postprandial blood glycemia are controversial. We assessed the effects of variations in the initial rate of small intestinal glucose delivery on blood glucose, plasma insulin, and incretin responses in both health and type 2 diabetes. Eight controls and eight patients with type 2 diabetes managed by diet alone underwent paired studies. On both days subjects received an intraduodenal glucose infusion (t = 0-120 min); on one day the infusion rate was variable, being more rapid initially (3 kcal/min) between t = 0 and 15 min and slower (0.71 kcal/min) subsequently (t = 15-120 min), whereas on the other day, the infusion rate was constant (1 kcal/min) from t = 0 to 120 min (i.e. on both days 120 kcal of glucose were administered). Between t = 0-180 min blood glucose, plasma insulin and plasma glucose-dependent insulin-releasing polypeptide were greater with the variable, compared with the constant, infusion. Between t = 0 and 30 min the magnitude of the rise in plasma glucagon-like peptide-1 was greater with the variable, compared with the constant infusion (P < 0.01, both groups). We conclude that modest variations in the initial rate of duodenal glucose entry may have profound effects on subsequent glycemic, insulin, and incretin responses.