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Biomedical subjects

A Spencer

Publications and source records attributed to A Spencer.

107 records · Page 6Linked to original sources
PubMed1978

Cimetidine for recurrent ulcer after vagotomy or gastrectomy: a randomised controlled trial.

In a randomised controlled trial cimetidine 1 g daily for six weeks was compared with placebo in the treatment of recurrent ulcers after gastrectomy or vagotomy for duodenal ulcer. Healing, assessed endoscopically, was seen in seven out of 12 patients given cimetidine and in five out of 12 controls. Four of the controls whose ulcers did not heal were subsequently treated with cimetidine, and in two the ulcers healed after six weeks. Pain recorded by the patient and consumption of alkalis were each slightly but not significantly less in the cimetidine-treated patients. When cimetidine is to be used for recurrent ulceration probably the dosage and duration of treatment should be increased.

Cimetidine↗
PubMed1978

Closure of gastrojejunostomy for the relief of post-vagotomy symptoms.

When dumping, diarrhoea or bile vomiting follows vagotomy and gastrojejunostomy, simple closure of the stoma, without alternative drainage, has been performed in 19 patients. Thirteen patients, 5 with truncal, 7 with selective and 1 with proximal gastric vagotomy, have been followed up for 1-6 years. Five were completely relieved of symptoms, 7 improved and there was only 1 complete failure. Bile vomiting was more often relieved than dumping or diarrhoea. The procedure is safe and significant gastric retention does not occur provided that at least one year is allowed to elaspse after the primary operation.

Adult↗
PubMed1977

Variation in proteins of single lesions from the intima of the aorta from a human patient with severe atherosclerosis.

A method is presented for grinding and extracting very small samples of tough fibrous tissue from single atherosclerotic lesions of human aortas. Grinding to a powder was easily accomplished while the samples were frozen in liquid nitrogen in a porcelain micromortar. Extractions of the powder were made first in the mortar and then in tapered centrifuge tubes. Salt soluble, dodecyl sulfate--mercaptoethanol--urea soluble and hot alkali soluble fractions were obtained, in addition to a hot alkali insoluble elastin residue from each sample. Variation in the protein composition of 23 samples from the lumenal surface of the severely atherosclerotic aorta of a 58-year-old human male were determined. The proteins soluble in the buffered-saline and the dodecyl sulfate-urea soluble polypeptides from each sample were analyzed by dodecyl sulfate--acrylamide gel electrophoresis. The amino acid compositions of the insoluble elastin fractions were determined. The 5 grossly normal intima samples had very similar gel electrophoresis band patterns and amino acid compositions. The 3 samples of necrotic gruel had markedly different dodecyl sulfate--urea soluble polypeptides than either normal or calcified tissue; they also had elastin fractions whose amino acid compositions were unique in that they contained 10 times more serine than elastin fractions from grossly normal intima. The 3 calcified samples had less saline or dodecyl sulfate soluble protein than either grossly normal or necrotic gruel samples, and had very altered elastin fraction compositions characterized by much higher contents of hydroxylysine than grossly normal intima. The elastin fractions of necrotic gruel and calcified tissue samples had little or no isodesmosine or desmosine, suggesting that little of the elastin found in healthy aorta tissue was present.

Amino Acids↗
PubMed1977

relA gene control of the synthesis of lipid A fatty acyl moieties.

The incorporation of [14C]acetate into the fatty acid moieties of lipid A was measured during amino acid starvation of rel+ and relA strains of Escherichia coli K-12. The synthesis of the beta-hydroxymyristate and other fatty acid moieties was inhibited two- to fourfold in rel+ strains, whereas no inhibition was observed in relA strains. The fatty acid compositions of the phospholipids synthesized after amino acid starvation or rel+ and relA strains were also determined.

Acetates↗
PubMed1972

The effects of levodopa therapy in patients with Parkinson's disease. I. Clinical response.

Eighty-eight patients with Parkinson's disease were treated with levodopa. A group of elderly patients 65 years and older was compared with a second group under the age of 65, and it was found that generally the younger patients could be treated with greater success than the older ones. Most of the elderly could not tolerate the large doses required to produce optimal physical recovery. Severity of complications forced discontinuance of treatment in a larger percentage of elderly patients. The rate of complications was about equal in the two groups, except the incidence of confusion, which was significantly higher in the elderly. Of the two deaths that occurred, both were in the older group. Results of treatment were better in patients whose families gave positive support.

Adult↗
PubMedDate not supplied

Chemotherapy and granulocyte colony stimulating factor-mobilized blood cell infusion followed by interferon-alpha for relapsed malignancy after allogeneic bone marrow transplantation.

BACKGROUND: Interferon-alpha (IFN) is known to promote graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation (allo BMT). This property may also be used to enhance a graft-versus-leukaemia effect (GVL) after donor leucocyte infusion (DLI), a mode of therapy increasingly offered to patients relapsing after allo BMT. AIM: The aims of the present study were to examine the efficacy and toxicity of IFN therapy administered after granulocyte colony-stimulating factor (G-CSF)-stimulated blood cells given as DLI in patients with acute myeloid leukaemia (AML), chronic myeloid leukaemia (CML), acute lymphoblastic leukaemia (ALL), acute undifferentiated leukaemia (AUL) and multiple myeloma relapsing after allo BMT. METHODS: Between October 1996 and September 1999, 27 patients (16 AML, four ALL, three CML, three multiple myeloma, one AUL) who relapsed after allo BMT were treated with chemotherapy followed by DLI, collected after G-CSF stimulation in all but two cases. Subsequently, IFN was given to patients without significant GVHD or rapidly progressive disease. The outcome after DLI with regard to remission rate, disease-free survival and GVHD was analysed. RESULTS: Eighteen patients received IFN following DLI, 14 of whom developed significant GVHD (grade II-IV acute or extensive chronic); thereafter, GVHD resolved with cessation of IFN alone in four patients, but 10 required systemic immunosuppression. Twenty-three patients were given chemotherapy and DLI as initial treatment of relapse; 10 achieved complete remission (CR), in four patients this was only after the onset of GVHD. The other four patients received chemotherapy and DLI as a consolidation of a chemotherapy-induced remission. The CR was durable only in patients with CML (3 of 3) and AML (4 of 8). CONCLUSIONS: Treatment with IFN induced GVHD in the majority of patients receiving DLI. The induction of GVHD and GVL by this approach produced excellent results in patients with CML and modest results in AML, but appeared to be less effective in myeloma and ALL.

Acute Disease↗
PubMedDate not supplied

Time course of stomach mineralization, plasma, and urinary changes after a single intravenous administration of gadolinium(III) chloride in the male rat.

In a previous experiment it was reported that the intravenous administration of gadolinium chloride (GdCl3) to rats results in a discrete band of interstitial mineralization in the fundic glandular mucosa of the stomach. To investigate the time course for the development of this lesion and its relationship to plasma calcium and phosphate concentrations, 2 experiments were carried out in male Sprague-Dawley rats given a single intravenous dose of 0.07 mmol/kg GdCl3. Plasma calcium and phosphate concentrations approximately doubled between 30 min and 12 hr postdose but had regressed back to near normal values by 24 hr. However, there were no observable clinical signs in treated animals. Histologically, there was progressive mineralization of the lamina propria of the neck region of the fundic glands from 6 hr postdose, forming a distinctive mineral band by 12 hr postdose. At 7 and 14 days postdose the mineral deposits were accompanied by mucous cell hyperplasia, interstitial fibrosis, and a very sparse infiltration of inflammatory cells. By 56 days postdose only occasional mineral deposits remained. Transmission electron microscopy showed mineral first nucleated on collagen in the interstitium, but there was no evidence of cell necrosis. X-ray microanalysis showed that the interstitial mineral was composed of calcium and phosphate in the form of hydroxyapatite; gadolinium (Gd) was only very rarely identified. These findings are consistent with metastatic mineralization. The source, cause, and the exact nature of the excess plasma calcium and phosphate are unknown, and the possible significance of this effect for clinical use of Gd-containing chelates in nuclear magnetic resonance imaging requires further investigation.

Animals↗
PubMedDate not supplied

Effects of resettlement on people with learning disabilities.

This article describes a small-scale study of the quality of life for people with learning disabilities after moving from a large group home with institutional features to community settings. The Life Experiences Checklist was chosen to provide objective measures of their quality of life before and after the move, and a semi-structured questionnaire was used to gain a more personal view of their life satisfaction. The results showed that the overall quality of life for the service users improved following resettlement. In particular, the home environment, leisure facilities, freedom and opportunities for service users had all increased significantly. Participants also reported having more choices and were more likely to take part in leisure and household activities. However, the range and quality of personal relationships experienced by the service users showed slight but not significant changes. These findings are discussed in relation to previous research, and the importance of quality evaluation is considered.

Community Health Services↗
PubMedDate not supplied

The long-term results of proximal gastric vagotomy.

Since 1969 we have performed proximal gastric vagotomy (PGV) in 514 patients. PGV without drainage was performed, before 1978, in 304 patients with one death (0.3%) and of these, 242 have been followed for from five to 13 years. Good clinical results were achieved in 78% but there were 32 recurrent ulcers. When two patients with Zollinger-Ellison Syndrome were excluded the late recurrence rate was 12.7%. There was no difference between the clinical results of men and women. When all the recurrent ulcers and two patients with gastric retention had been treated, mostly by operation, good results were recorded in 90% of our series. We conclude that PGV is the best operation at present available for uncomplicated duodenal ulcer.

Duodenal Ulcer↗