Search PubMed⌕ Search

Biomedical subjects

D A Edwards

Publications and source records attributed to D A Edwards.

At least 109 records · Page 6Linked to original sources
PubMed1978

Results of Heller's operation for achalasia of the cardia.

A survey of 102 patients with achalasia of the cardia treated by cardiomyotomy is reported. The technique of operation was unchanged throughout and the patients were followed up for a maximum of 22 years. Only 6 patients (5.8 per cent) developed renewed symptoms of reflux and 7 patients (6.8 per cent) had peptic strictures. Over 80 per cent of the patients had no dysphagia or regurgitation postoperatively, but 61 per cent still complained of achalasic pain. The development of mucosal hernias after cardiomyotomy and the use of drinking times in the assessment of outflow at the cardia are discussed.

Adolescent↗
PubMed1978

The anti-reflux mechanism after cardiomyotomy.

Only 18 or 83 patients who had had a cardiomyotomy for achalasia could be induced to reflux barium. Mucosal herniation through the myotomy was shown in most by radiography. Perfusion manometry showed a higher pressure zone in the oesophagogastric junction region in 22 of 24 patients studied. This high pressure zone responded to an increment in abdominal pressure by a greater increment. The same response was seen in a patient with a small hiatal hernia and myotomy. We concluded that the persisting high pressure zone seen by perfusion manometry is likely to be caused by the hiatus, and that the hiatus rather than the sphincter is likely to be responsible for the incremental response of the high pressure zone to increased abdominal pressure. The anti-reflux mechanism after cardiomyotomy is more likely to be the hiatal mechanism than persisting sphincter fibres.

Cardia↗
PubMed1978

Lower oesophageal sphincter tone in patients with peptic stricture.

Radiographic studies of 161 patients with a stricture within the cardiac sphincter segment showed that in appropriate circumstances all patients could herniate stomach and reflux barium freely, but that the sphincter could obliterate the lumen and sustain this contraction by its basal tone in at least 122. The sphincter could also relax and contract in response to a swallow. The capacity to remain closed depended on the position of the patient and on circumstances in which hiatal flow and reflux did not occur. Manometric studies of the cardiac sphincter were made in a further 14 patients with a stricture in the sphincter segment, and appropriate circumstances the "basal tone" of the sphincter was found to be within our range of normal.

Esophageal Stenosis↗
PubMed1978

Reminiscences on the antireflux mechanism.

A common view is that the lower esophageal sphincter is the sole component of the antireflux mechanism. Other methods of investigation especially radiology, and the effects of surgery suggest that the position of the sphincter and the size and shape of the hiatus are at least as important as the sphincter in the control of reflux and recent appropriate manometric studies support this view. The development of some of the ideas about what is and what is not a significant component is reviewed. A unifying hypothesis is offered which proposes that the sphincter is of primary importance in resisting the challenge of intragastric pressure developed by contraction of the stomach wall which may lead to physiologic reflux; whereas the position of the sphincter and the size of the hiatus are concerned with resisting the challenge of intra-abdominal pressure. The physiologic component has a limited capability of resisting intra-abdominal pressure so that when the anatomic component fails, pathologic reflux occurs.

Esophagogastric Junction↗
PubMed1977

Olfactory system damage and brain catecholamines in the rat.

Although a number of studies have reported that bulbectomy results in a fall in telencephalic norepinephrine (NE) content, the present study is the first to examine the relationship between the locus and extent of olfactory system damage and the depletion of telencephalic catecholamines after olfactory system surgery. Our findings indicate that the often reported depletion of telencephalic NE after olfactory bulb ablation is not due to removal of the olfactory bulbs per se, but instead is the result of incidentally produced destruction of tissue, caudal to the bulbs, through which noradrenergic fibers ascend on their way to various regions of the telencephalon.

Animals↗
PubMed1977

Involvement of the ventromedial and anterior hypothalamic nuclei in the hormonal induction of receptivity in the female rat.

Bilateral lesions of the ventromedial hypothalamic area virtually eliminated the estrogen-induced display of sexual receptiveness in the female rat. Such lesions usually diminished sexual responsiveness to combined estrogen-progresterone stimulation, although not all lesions were equally effective in this regard. Damage to the anterior hypothalamic area was without apparent effect on the hormonally-induced display of receptivity, suggesting that previous observations to this effect are probably related to incicental damage to the ventromedial hypothalamic area incurred during placement of the lesions. This study complements other work indicating that the ventromedial hypothalamic area is relatively rich in estradiol concentrating cells and that estrogen implants to this area induce sexual receptivity in spayed female rats. Together, these studies affirm that the ventromedial hypothalamic area plays a critical role in the hormonal induction of receptivity in female rats.

Animals↗