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Biomedical subjects

B J Harrison

Publications and source records attributed to B J Harrison.

65 records · Page 4Linked to original sources

Hidradenitis suppurativa: evidence for an endocrine abnormality.

Women patients with premenstrual exacerbation of hidradenitis suppurativa have been studied to determine if an endocrine abnormality can be detected. A functional disorder of the hypothalamopituitary axis was found in 13 patients with hidradenitis when compared with 9 controls. In response to a combined thyrotrophin releasing hormone and gonadotrophin releasing hormone test, the prolactin and TSH responses were significantly greater in the hidradenitis patients than the controls. No significant differences were found in the mean basal levels of oestrogen, progesterone, testosterone, dehydroepiandrosterone sulphate, T3 and T4. These results may reflect a disturbance of feedback signals from peripheral hormones, rather than a primary dysfunction of the control of specific anterior pituitary cells.

Adult↗

Effects of dopamine and dobutamine on the distribution of pulmonary blood flow during lobar ventilation hypoxia and lobar collapse in dogs.

Hypoxic pulmonary vasoconstriction was induced in the left lower lobe of fifteen dogs by ventilating the lobe with 7% O2 or by absorption collapse, and the distribution of flow between the lobe and the remainder of the lung was measured with electromagnetic flow probes. The lobar to total blood flow ratio was reduced by lobar ventilation hypoxia and decreased further during lobar collapse. In seven dogs, an infusion of 20 micrograms kg-1 min-1 of dopamine produced an increase in total blood flow, an increase in pulmonary artery pressure (P less than 0.01), and an increase in lobar to total flow ratio (P less than 0.05) during both hypoxic states. There was a significant fall in arterial PO2 (P less than 0.01) during ventilation hypoxia. Similar changes in total and lobar to total flow ratio (P less than 0.01) were observed in eight dogs given 20 micrograms kg-1 min-1 of dobutamine, but there were no changes in pulmonary artery pressure. The greater increase in total flow (+ 111%) resulted in a marked increase in mixed venous PO2 and no significant changes in arterial PO2 in this group of dogs. It is concluded that both drugs produce an increase in lobar to total blood flow ratio and shunt fraction, but that the mechanisms causing the redistribution of flow may differ.

Animals↗

Comparative analysis of the development of wing-flapping and flight in the fowl.

The development of wing-flapping rate, lateral flight, wing area, and the ratio of wing area to body weight are described in the Japanese quail (Coturnix coturnix japonica) and three chickens (Gallus gallus) to determine common developmental phenomena and to assess the effects of domestication. The chickens were the White Leghorn (a commercial egg producer), the Cornish X Rock (a commercial meat producer), and the Red Jungle fowl (the probable ancestor of domestic chickens). All birds performed drop-evoked wing-flapping on the day of hatching, at least 1 week before lateral flight was possible. Flapping rate of chickens doubled between hatching (approximately 4-6 Hz) and 13 days (approximately 9-12 Hz), after which it leveled off. Japanese quail (JQ) maintained a high flapping rate (approximately 11-13 Hz) during the 21 days after hatching. The Jungle fowl (JF) and JQ flapped the fastest and the White Leghorn (WL) and Cornish X Rock (CR) chickens flapped the slowest. The JF, WL, and JQ developed lateral flight at 7-9 days. The CR first flew 1-2 weeks later but subsequently became flightless. The WL, JF, and JQ had similar ratios of wing area to body weight; the ratios increased to a peak at 11-15 days and later declined. The ratio of the very heavy, essentially flightless, CR was approximately one-half that of the flighted JQ, WL, and JF. The wing-flapping frequencies of the domestic WL and CR chickens approximated that of the JF, suggesting that domestication did not affect the motor pattern generator for flight. The artificial selection of the CR for high body weight drastically diminished its flight performance by producing an unfavorable ratio of wing area to body weight. The JF and the domestic WL both flew well and had similar ratios. Domestication affected flight performance but not the neural circuitry producing wing-flapping. The central nervous system is much more conservative in its response to selection than the peripheral effector structures that it drives.

Animals↗

The use of radiotelemetry techniques for the in vivo assessment of antacids.

The use of the pH radio pill for the assessment of antacid effect has been evaluated. The correlation between the pH pill and a conventional pH electrode system was high (r2 = 0.997). The records of in vivo pH against time allow unique measurements of antacid efficacy (defined as the integrated area under the pH against time curve) and duration of action to be obtained. Using a free pill, antacid assessments were performed in 13 subjects in the left lateral position. The effects of repeated antacid administrations were studied in five subjects using a pH pill which was prevented from leaving the stomach by tethering it to the teeth. These longer studies were performed in the sitting position. The efficacy (p less than 0.02) and duration of action (p less than 0.02) of sodium citrate 0.3 M were less in those subjects in whom the pill was tethered. The differences between the results of the studies using either a free or a tethered pill can be attributed to posture. The overall duration of action of sodium citrate 15 ml was short, the mean (SEM) value being 42.4 (4.5) minutes in the left lateral position and 21.2 (4.0) minutes in the upright position.

Aluminum Hydroxide↗

A study of persons aged 65 and over in the Leeds Metropolitan District.

A study of the elderly living in the community and in institutional care in the Leeds Metropolitan District is outlined. Four populations of persons aged 65 and over were examined: those living in their own homes; in sheltered housing; in social services aged persons' hostels (Part III accommodation); and in hospitals. Findings on one key concept--coping ability--are discussed. Those living in their own homes were most able to cope. Many living in institutions were well able to cope in the community according to the criteria of mobility and functional ability. The relationship between age, morbidity, and coping ability were examined. Women were more likely to report the presence of a long-term illness than men. Housebound respondents in the community were twice as likely to be suffering from non-traumatic locomotor disorders, eyesight disorders, and cerebrovascular disease than respondents in the community sample taken as a whole.

Activities of Daily Living↗

Gastric fistula following splenectomy: its cause and prevention.

Gastro-cutaneous fistula following splenectomy, a rare but serious occurrence, may result in death or prolonged disability. Six previous cases have been reported in detail, while 8 others have been mentioned briefly. The current report reviews the literature and describes 4 additional instances of this complication. Two of the 4 patients died. Sever factors, acting singly or incombination, may predispose to the development of post-splenectomy gastrocutaneous fistulas. These include direct surgical trauma to the gastric wall, generalized arteriosclerotic disease, hematoma in the gastrosplenic omentum, and reflection of gastric muscle fibers into the gastrosplenic ligament. The usual site of rupture of stomach is along the greater curvature in the fundic portion. In circumstances in which splenectomy is associated with known or suspected compromise of the blood supply to this portion of the stomach, a method of enfolding the greater curvature is proposed to prevent the development of a gastro-cutaneous fistula. Awareness of the possibility of this uncommon but serious complication will aid in its early recognition and treatment.

Adult↗

Asymptomatic primary hyperparathyroidism.

The criteria used in selecting patients with asymptomatic hyperparathyroidism (HPT) for surgery remain controversial. Do patients with asymptomatic HPT have less severe disease (smaller glands and less derangement of biochemistry) than those with symptoms? We studied a consecutive series of 111 patients with HPT surgically treated and compared the symptomatic patients (n = 83) and asymptomatic patients (n = 28). There were no significant differences between the two patient groups with respect to age, serum calcium, PTH (intact 1-84), and excised gland weights (adenomas). Hypercalcemia was cured in all patients. The natural history of mild or asymptomatic HPT is unknown, but we summarize the current knowledge relating to mortality, cardiovascular/renal disease, psychiatric and neuromuscular disorders, and bone disease. Symptoms of HPT do not correlate with the degree of biochemical and pathological derangement. Furthermore clinical assessment does not predict severity of disease and should not be the sole basis of selection for surgery. The results of surgery for primary HPT permit us to advocate a liberal approach to the selection of asymptomatic patients for operation.

Humans↗

Ablative or non-ablative therapy for Graves' hyperthyroidism in patients with ophthalmopathy?

In our view there are no properly controlled trials which support a beneficial effect on ophthalmopathy from surgical or radioiodine-based deliberate ablation for hyperthyroidism. The theoretical basis for this approach can be questioned and we still know too little about the pathogenesis of ophthalmopathy to draw any firm conclusions about the likely effects of ablation. There are established risks with ablation. Like the majority of European thyroidologists, we prefer antithyroid drugs for the initial treatment of hyperthyroidism complicated by Graves' ophthalmopathy and individualise treatment for recurrent hyperthyroidism based on the patient's preference, but do not recommend ablation routinely in presence of eye signs.

Graves Disease↗