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Biomedical subjects

A I Morris

Publications and source records attributed to A I Morris.

At least 55 records · Page 3Linked to original sources
PubMed1989

Orocaecal transit time in health and in thyroid disease.

Altered bowel habit commonly occurs in thyroid disease. We measured orocaecal transit in healthy volunteers and in hyperthyroid and hypothyroid patients before and after treatment, using the lactulose hydrogen breath test incorporating a standard liquid meal to obtain a more physiological assessment. Mean transit time in 12 control subjects was 85 (8) minutes (mean (SE)) (mean coefficient of variation between replicate studies, 8.6% (3%)). In eighteen hyperthyroid patients transit was more rapid at 49 (4) minutes (p less than 0.01). Ten hypothyroid patients had a transit time similar to controls at 91 (9) minutes. Transit time returned to normal in thyrotoxic patients after treatment but in eight hypothyroid patients retested, it remained unchanged. Our findings suggest that (a) the inclusion of a liquid meal provides a reproducible method of measuring orocaecal transit using the lactulose hydrogen breath test, (b) rapid small bowel transit in thyrotoxicosis may be one factor in the diarrhoea which is a feature of the disease and (c) if altered gut transit is the cause of sluggish bowel habit in hypothyroidism, delay in the colon, and not small bowel, is likely to be responsible.

Adult↗
PubMed1989

Gastrointestinal manifestations of Addison's disease.

Gastrointestinal symptoms are a common feature of Addison's disease, but the diagnosis may be delayed because of the nonspecific nature of the symptoms. This report describes nine patients with Addison's disease who presented to our unit over the past 3 yr. Eight had severe or unusual gastrointestinal symptoms at presentation. One, already known to have Addison's disease, required several admissions to the hospital because of unexplained abdominal pain and vomiting before inadequate glucocorticoid replacement was diagnosed. All but one had previously attended the hospital, but the diagnosis of Addison's disease had been overlooked. Five eventually presented in crisis. It is important to exclude Addison's disease in all patients with unexplained abdominal symptoms.

Abdominal Pain↗
PubMed1988

Plasma alkaline phosphodiesterase I in intrahepatic cholestasis induced by alpha-naphthylisothiocyanate in rats.

1. Administration of alpha-naphthylisothiocyanate (ANIT) to rats produced dose-dependent increases in plasma bile acid and bilirubin concentrations. Similar increases in plasma bile acid and bilirubin concentrations were evident in bile duct ligated rats, indicating that the severity of cholestasis is almost identical in both models. 2. Plasma alkaline phosphodiesterase I was increased by only 50-80% while alkaline phosphatase was increased more than threefold after ANIT administration. This is in contrast to an earlier study [S. R. Simpson, K. Rahman & D. Billington (1984) Clinical Science 67, 647-652] where, after bile duct ligation, serum alkaline phosphodiesterase I was elevated sixfold before any increase in alkaline phosphatase activity became apparent. Thus, plasma alkaline phosphodiesterase I does not offer as sensitive a marker of intrahepatic cholestasis (induced by ANIT) as it does of extrahepatic cholestasis (induced by bile duct ligation). 3. Hepatic alkaline phosphodiesterase I was unaffected by ANIT pretreatment while hepatic alkaline phosphatase was increased up to seven times. It is suggested that raised plasma alkaline phosphodiesterase I is due to regurgitation of the biliary enzyme rather than overspill of the enzyme from liver into blood. 4. Gel filtration showed that 24 h and 96 h after ANIT administration, rat serum contained a high molecular weight form of alkaline phosphodiesterase I, suggesting a different isoenzyme profile.

1-Naphthylisothiocyanate↗
PubMed1988

Comparison between the cellobiose/mannitol and 51Cr-labelled ethylenediaminetetra-acetate absorption tests in the detection of coeliac disease.

1. The cellobiose/mannitol and 51Cr-labelled ethylenediaminetetra-acetate (51Cr-EDTA) absorption tests have been compared with respect to their ability to detect altered intestinal permeability in coeliac disease. 2. In patients with clinically proven coeliac disease, 13 out of 14 (93%) had abnormal urinary cellobiose/mannitol ratios, while only five out of 12 (42%) had abnormal urinary recoveries of 51Cr-EDTA. Thus, the cellobiose/mannitol absorption test is more sensitive in recognizing coeliac disease and this difference was significant (P less than 0.02). 3. Possible reasons for this difference in the sensitivity of the two absorption tests are discussed.

Adult↗
PubMed1988

Addison's disease presenting as anorexia nervosa in a young man.

A young man with a long history of obsessional traits and food fads presented with anorexia, vomiting and marked weight loss. He showed little concern for his physical state and his vomiting was frequently witnessed as self-induced. A diagnosis of anorexia nervosa was made and he took his own discharge from hospital. He was readmitted one month later, severely cachectic and with biochemical abnormalities consistent with advanced Addison's disease which was subsequently confirmed. He responded dramatically, both mentally and physically, to corticosteroid therapy. It is likely that anorexia nervosa, relatively rare in males, was a manifestation of the psychological abnormalities commonly seen in severe Addison's disease.

Addison Disease↗
PubMed1987

Is SPECT of the spleen worthwhile in the evaluation of liver disease severity?

SPECT of the spleen has been performed with 99Tcm-sulphur colloid in 53 patients, and SPECT of the liver has been performed in 57 patients. All patients had histologically proven liver disease and were classified by the degree of severity, Group A-severe, Group B-moderate, Group C-mild. The patients were further classified as cirrhotic and non-cirrhotic. Eight controls were also studied. There is positive though poor correlation between splenic volume and uptake (r2 = 0.55). Splenic volume and uptake are significantly different in Group A patients compared with all other groups (p less than 0.001). They are also significantly different in cirrhotics versus non-cirrhotics and cirrhotics versus controls (p less than 0.001). Splenic SPECT was unhelpful in distinguishing between moderate and mild liver disease. SPECT of the spleen is a time consuming technique but a useful adjunct to liver SPECT in patients with portal hypertension.

Electronic Data Processing↗
PubMed1987

Palliative laser therapy for malignant dysphagia.

Seventy six patients with dysphagia caused by malignant tumours of the oesophagus or gastric cardia have been treated using the Neodymium Yttrium Aluminium Garnet (NdYag) laser. The laser was set to deliver 80-100 watts of power for 0.5-1 second pulses. To obtain improvement, patients on average needed four treatment sessions with a mean energy per treatment of 3586 joules. Follow up endoscopy and laser treatment was at four week intervals, unless the clinical or endoscopic results indicated otherwise. The immediate result was to allow 32% of patients to swallow anything they liked, a further 54% were able to take most solids and 9% were improved, or maintained on liquids only. The mortality of laser recanalisation and associated treatment was 5%. The improvement in swallowing was maintained until death in all but 15% of these patients, some of the 15% needed intubation to allow adequate swallowing. Endoscopic, or surgical intubation was required immediately in five patients after an initial laser course failed to provide improvement. The mean survival of the whole group was 19 weeks (range one to 112 weeks).

Adult↗
PubMed1986

Alcohol enhances vitamin C excretion in the urine.

Urinary ascorbic acid excretion was measured on four consecutive days in 9 normal male volunteers for 4 hr before and after drinking nothing (control), 0.58 g alcohol/kg body wt as whisky or lager or water (11./70 kg body wt). The normal reduction in ascorbic acid excretion under control conditions was abolished by drinking water. Alcohol in either form produced a 47% increase in urinary ascorbic acid excretion. A similar ascorbiuresis in chronic alcoholics would be an additional factor in the causation of vitamin C deficiency in these patients.

Adult↗
PubMed1985

Liver volume and uptake assessment using 123I-BSP tomography.

Liver volume and parenchymal cell uptake of 123I-bromosulphthalein (BSP) has been assessed using the technique of single photon emission tomography (SPET). These results have been compared with a clinical scoring of disease severity and also with results for liver volume and tomographically assessed uptake of 99Tcm-sulphur colloid (SC). Comparisons of volume estimation, geometric mean (GM) uptake curves and a distribution index derived by a mapping technique with both radiopharmaceuticals, show that 123I-BSP tomography is feasible. A short acquisition time is required in order to obtain tomographic information before there is significant biliary excretion. There was a significant difference between the mean percentage uptake of 123I-BSP in the three groups of liver disease severity (P less than 0.002). This technique merits further evaluation in the study of the assessment of functional liver impairment.

Female↗
PubMed1985

Advances in gastrointestinal endoscopy and laser therapy; the way ahead.

Modern flexible fibreoptics enable gastroenterologists to visualise and treat many lesions and conditions in the upper gastrointestinal tract and colon. Therapeutic endoscopy is forming a larger proportion of many unit's workload and the newer techniques to stop or prevent rebleeding are the subject of much research and development. Developments in the fields of operative endoscopy, small intestinal endoscopy, and endoscopic ultrasound are also progressing rapidly. The place of video-endoscopy is still to be established but potentially has several advantages over fibreoptic endoscopy. Laser therapy has been well established as a means of treating gastrointestinal haemorrhage from peptic ulcers, and has potential use in the treatment of angiomatous lesions. It is increasingly being used both for palliation and 'cure' of malignancy and neoplasia in the gastrointestinal tract. The use of such lasers depends upon thermal damage, but newer types of non-thermal laser therapy, using pulsed lasers, or dye lasers with prior tumour sensitisation are rapidly going to be applied to the treatment of gastrointestinal disease.

Aged↗
PubMed1984

Is there a place in the United Kingdom for intensive antacid treatment for chronic peptic ulceration?

Sixty nine patients with chronic duodenal or juxtapyloric ulceration were studied in a prospective double blind randomised trial to compare the efficacy of antacid and placebo at high (30 ml seven times daily) and low (10 ml as required) doses. After four weeks ulcers had healed in 12 out of 18 patients (67%) receiving "low dose" antacid compared with in six out of 17 patients (35%) receiving low dose placebo; ulcers had also healed in six out of 19 patients (32%) receiving "high dose" antacid compared with in two out of 15 patients (13%) receiving high dose placebo. Overall, the effect of antacid was superior to that of placebo in healing ulcers (p less than 0.05) and the effect of low dose treatment was superior to that of high dose treatment (p less than 0.01). There were no significant differences between antacid and placebo at eight weeks. Antacid was better than placebo in relieving pain, but the difference was not significant. Poor compliance and high incidence of diarrhoea made high dose antacid an impractical treatment. Low dose antacid was associated with a significantly better rate of healing than high dose antacid and was far better tolerated. This low dosage of antacid should be considered to be an active treatment in trials of ulcer healing.

Adolescent↗
PubMed1984

Respiratory responses of diabetics to hypoxia, hypercapnia, and exercise.

The respiratory responses of 52 diabetics and 65 non-diabetic controls to hypoxia, hypercapnia, and exercise were studied. Twenty five per cent of the diabetics had evidence of impaired sensitivity to hypoxia or decreased ventilatory response to hypercapnia, while 7% of the diabetics who performed the exercise tests had an abnormal pattern of respiration during exercise; 33% of the diabetics who performed all three tests of respiratory reflex action had at least one abnormal test response. There was no correlation between the presence of an abnormal respiratory response and the presence of clinical diabetic complications. Abnormal respiratory reflexes could not be predicted from the results of the "routine" pulmonary function tests. The possibility that the abnormal respiratory responses were due to autonomic neuropathy is discussed.

Adult↗