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Biomedical subjects

A S Ward

Publications and source records attributed to A S Ward.

At least 55 records · Page 3Linked to original sources
PubMed1990

Supraceliac clamping: an underused alternative in aortic surgery.

In the majority of patients undergoing abdominal aortic surgery, proximal clamping can be readily achieved below the renal vessels. In some situations however, this may be difficult, impossible or ill advised, and an alternative method of control must be sought. We describe the technique and report our personal experience with supraceliac clamping, a maneuver which merits more widespread use in emergency and difficult infrarenal aortic surgery.

Aorta, Abdominal↗
PubMed1987

Adventitial cystic disease of the popliteal artery.

A case of adventitial cystic disease of the popliteal artery is described and the subject reviewed. Now that radiologists will often follow arteriography with angioplasty or thrombolytic therapy, it is particularly important that this condition is recognised.

Humans↗
PubMed1980

Some aspects of ultrasound in the diagnosis and assessment of aortoiliac disease.

The presence and severity of aortoiliac atherosclerosis were assessed in 60 normal limbs and 54 limbs with peripheral vascular disease by means of arteriography, clinical examination and ultrasound analysis. The latter involved common femoral sonogram analysis with particular measurement of the pulsatility index, a study of transit time ratios and measurement of the half recovery time during reactive hyperemia. The transit time data were of limited value and only capable of diagnosing aortoiliac disease when complete occlusion was present. The pulsatility index and half recovery time were more sensitive indicators of aortoiliac disease, and both were superior to clinical examination alone. Their values became increasingly abnormal with increasing severity of disease, and both reverted to normal after successful aortoiliac surgery. When it was possible to directly inspect the aortoiliac segment at operation, the half recovery time accurately predicted the presence or absence of aortoiliac disease in every case, and its use as a reliable screen for aortoiliac disease is particularly recommended.

Adult↗
PubMed1978

Platelet aggregation in patients with peripheral vascular disease.

Platelet aggregation has been studied in 28 control subjects and 46 patients with peripheral vascular disease. The platelets from the patients with peripheral vascular disease were significantly more sensitive to the aggregating effects of adenosine diphosphate and adrenaline than those from the control group (P less than 0.001). In addition, spontaneous platelet aggregation was observed in vitro in several of the vascular patients; this response was not apparent in the control group. Increased platelet aggregation could add to the vascular impairment in the unoperated subject and might also play a part in premature graft failure. Platelet function studies should perhaps be included as a routine in the assessment of patients with peripheral vascular disease.

Adenosine Diphosphate↗
PubMed1977

The long term results of profundaplasty in femoropopliteal arterial occlusion.

The long term results of profundaplasty in the treatment of femoropopliteal arterial occlusion have been reviewed. Fifty patients have been studied with a mean follow-up period of 4 years (range 6 months to 8 years). Intermittent claudication was abolished or substantially improved in 5 of the 25 cases (20 percent); rest pain was relieved in 10 of the 25 cases (40 per cent), the remainder requiring a major amputation. Lumbar sympathectomy produced little additional benefit in either group. The mortality rate in the rest pain group was high and only 5 patients survived for more than 3 years with both legs intact. The state of the distal 'run-off' and the degree of preoperative profunda stenosis appeared to have little influence on the clinical outcome. After operation pedal pulses were restored in 16 per cent of those presenting with claudication. Profundaplasty was without significant effect on the ankle systolic pressure index both in patients with claudication and those with rest pain.

Aged↗
PubMed1976

Effect of vagotomy on the gastric secretory response to intraduodenal osmotic agents in man.

The effect of intraduodenal infusion of hypertonic saline and glucose on pentagastrin-stimulated gastric secretion was investigated in 35 normal subjects, 32 duodenal ulcer patients and 32 patients after truncal vagotomy and pyloroplasty. A significant gastric inhibitory response occurred after 0.51 M saline and 1-03 M glucose in the normal subjects and duodenal ulcer patients but after vagotomy there was no inhibition. This finding suggests that the inhibitory effect of these agents depends, at least in part, on a vagal reflex in man. The response to very high glucose concentrations persisted after vagotomy and it seems likely that a humoral mechanism may be involved in this situation.

Adult↗
PubMed1976

Gastric emptying in control subjects and patients with duodenal ulcer before and after vagotomy.

The emptying of a solid meal labelled with Indium 113mDTPA from the stomach was studied with a gamma camera in 26 normal subjects, 27 patients with duodenal ulcer, on 41 occasions after truncal vagotomy and pyloroplasty and 38 times after highly selective vagotomy. Applying the method of principal component analysis to the results, differences were detected between control and duodenal ulcer subjects and two probable subgroups of duodenal ulcer were observed. Half emptying times did not reveal these patterns. After vagotomy, delayed emptying was general at one week. At one month, patients after highly selective vagotomy had a more normal result than those with truncal vagotomy and pyloroplasty (TV), but by six months no significant difference in overall emptying rate was found, although changes in the pattern of gastric emptying persisted in some patients after TV.

Adult↗
PubMed1975

Failure of secretin release in patients with duodenal ulcer.

The release of secretin was studied in 12 normal subjects and 23 patients suffering from proved duodenal ulceration. After infusing acid directly into the duodenum mean plasma levels (plus or minus S.E.M.) of secretin rose in normal subjects to 52.6 plus or minus 4.8 ng/1 at six minutes but to only 37.5 plus or minus 3.6 ng/1 in duodenal-ulcer patients, a significant difference. The impairment of secretin release was as great in patients with a recent onset as in those who had had symptoms of a duodenal ulcer for a long time, raising the possibility of it being a primary defect. Patients who smoked 20 or more cigarettes a day had a particularly reduced secretin release, in accord with the greater incidence of ulcers in heavy smokers.

Adolescent↗
PubMed1975

Effect of vagotomy on secretin release in man.

The release of secretin by intraduodenal acid has been measured by means of a highly sensitive radioimmunoassay in 12 normal subjects, 23 duodenal ulcer patients, and 14 vagotomized patients (6 TV + P; 4 SV + P;4 HSV). A highly significant response occurred in all three groups. There was no significant difference between the groups either in the magnitude or timing of this response, though the absolute values for pre-stimulation and peak secretin were significantly smaller in preoperative duodenal ulcer patients than in either the normal subjects or the vagotomized patients. The secretin response was similar after truncal, selective, and highly selective vagotomy. These results suggest that secretin release is not dependent on intact vagal innervation of the small intestine in man.

Adult↗
PubMed1974

The role of secretin in the inhibition of gastric secretion by intraduodenal acid.

The effect of intraduodenal acid on pentagastrin-stimulated gastric secretion has been investigated in 12 normal subjects and 23 patients with chronic duodenal ulceration. Plasma secretin levels were monitored during each test using a highly sensitive radioimmunoassay. Significant inhibition of gastric secretion occurred in the normal subjects and duodenal ulcer patients. A significant rise in plasma secretin was observed in both groups after intraduodenal acid though there was a complete lack of correlation between the magnitude of the secretin response and the degree of gastric inhibition. Ten subjects received intraduodenal acid and a subsequent intravenous infusion of exogenous secretin (0.125-0.25 units/kg over six minutes). Gastric inhibition occurred after the acid instillation but not after secretin infusion despite plasma secretin levels greatly in excess of those produced by intraduodenal acid. These results suggest that release of secretin by itself cannot explain the gastric inhibitory response to intraduodenal acid in man.

Adult↗