Search PubMed⌕ Search

Biomedical subjects

D J Shearman

Publications and source records attributed to D J Shearman.

At least 73 records · Page 4Linked to original sources
PubMed1982

Measurement of gastric emptying after gastric bypass surgery using radionuclides.

The pattern of gastric emptying has been assessed after gastric bypass surgery using a double isotope technique for measuring solid and liquid emptying with a scintillation camera. Eleven control subjects and 12 patients, 12 months post-gastric bypass, were studied. Stomal and gastric pouch size were assessed at endoscopy. Solid emptying was slower and liquid emptying was more rapid after gastric bypass surgery. Initial rapid emptying of solid occurred in the 4 patients with the smallest pouch diameters. There was no correlation between stomal size and rates of solid or liquid emptying nor between the weight loss produced by the operation and the rates of solid or liquid emptying, stoma or pouch size.

Adult↗
PubMed1982

Is there an HLA antigen association with duodenal ulcer?

To assess the influence of ethnic origin on the incidence of HLA antigens in duodenal ulcer, we typed 160 white Australian patients (including 22 born in Greece or Italy) and 320 blood donor controls for the HLA-A and -B loci. 5 of the 22 (22.7%) southern European patients, but only 19 of the 138 (13.8%) of the remaining duodenal ulcer patients were found to have antigen B5 compared with 27 (8.4%) of the controls. HLA-B12 was found in 55 (34.4%) duodenal ulcer patients (including 6 of the 22 southern European patients) and 117 (36.6%) controls. No significant association of duodenal ulcer with HLA-B5 or HLA-B12 was found when differences in racial origin of patients were taken into account.

Adult↗
PubMed1982

Escherichia coli antibody-secreting cells in the human intestine.

Mononuclear cells were isolated from the mucosa and submucosa of small intestine and colon of 22 subjects with localized, anatomically remote disease and four subjects with Crohn's disease (nine specimens) by sequential treatment with EDTA and collagenase. The effects of isolation techniques on cell yields and viability were examined. Secretion of specific IgA, IgM and IgG antibodies to common faecal Escherichia coli strains by individual mononuclear cells was studied using a haemolytic plaque assay. A majority of specific antibody secreting cells secreted IgA antibody. This response was greatest and most consistent in the distal colon but extended from stomach to rectum. There was no evidence of a primary defect in IgA antibody response in the few subjects with Crohn's disease available for study.

Antibodies, Bacterial↗
PubMed1982

Converting a stomach to a uterus: the microscopic structure of the stomach of the gastric brooding frog Rheobatrachus silus.

Rheobatrachus silus is a rare aquatic frog of eastern Australia. The female ingests the eggs after fertilization and broods them in the stomach until fully formed. "Gastric brooding" takes place in the fundus and proximal part of the body of the stomach, which dilates to accommodate the growing young. The surface epithelium becomes attenuated and the cells contain fewer mucus droplets. The acini of the glands are less numerous because of stretching, and they contain oxyntic cells that show evidence of profound suppression or regression. Morphometric studies on the limited number of samples show that the oxyntic cells are attenuated with few surface projections, sparse tubulovesicular reticulum, and a few pepsinogen granules and mitochondria. Eight days after ejection of the young, and 4 days after feeding commences, the lining shows a return of gastric pits and glands. The oxyntic cells show many surface projections and a proliferation of the tubulovesicular reticulum and mitochondria. These findings suggest that the eggs, tadpoles, and juvenile frogs release a substance, or substances, that inhibit acid secretion immediately after the eggs are ingested and that persist throughout brooding.

Animals↗
PubMed1982

Antibodies in serum and secretions 1 year after salmonella gastroenteritis.

The antibody response in serum and intestinal fluid in eight patients 1 year after their recovery from salmonella gastroenteritis was measured by solid phase radioimmunoassay and compared to the immune response within a few weeks of infection, reported previously in these and other patients. High concentrations of intestinal antibody were found in six patients compared to the concentrations found in 10 control subjects. By contrast the serum antibody concentration in the patients was only marginally higher than in the controls. The use of IgA and IgG specific antisera in the assay confirmed the presence of IgA antibody in the absence of IgG antibody in the gastrointestinal secretions, and the predominance of IgG antibody in the serum. The prolonged immune response in the gut after acute bacterial gastroenteritis supports the possibility of effective immunization against diseases entering via the gut.

Adult↗
PubMed1982

Low molecular weight IgM in selective IgA deficiency.

Thirty-nine persons with selective IgA deficiency were studied. These comprised 27 subjects found by population screening and 12 by other means. Low molecular weight (LMW) serum IgM was sought in 28 of the 39 persons. Nine of the 28 (32%) had LMW IgM detectable by a sensitive gel filtration technique. Of 17 patients discovered by screening, five (29%) had LMW IgM. In the nine positive persons, LMW IgM constituted up to 17% of the total serum IgM concentration. Eight of the nine IgA deficient persons with LMW IgM, had clinical disease while associated disease in the entire IgA deficient population was less frequent. Serum immune complexes were demonstrated in five of seven subjects with LMW IgM using a C1q-dependent radioimmunoassay; four of these had immune complex associated disorders, three with polyarthritis and one with glomerulonephritis. Because circulating immune complexes are frequently detected in IgA deficient persons without disease, it is proposed that the presence of LMW serum IgM in IgA deficiency may be associated with disease due to the formation of specific pathogenic immune complexes.

Adolescent↗
PubMed1980

Long-term treatment of duodenal ulcer with cimetidine. Intermittent or continuous therapy?

Forty-eight patients with chronic duodenal ulcers which were healed with cimetidine were allocated at random into two equal groups to assess different ways of using cimetidine during one year of treatment. Twenty-four patients received intermittent six-week courses of cimetidine for each relapse, and 24 patients were treated with maintenance administration of cimetidine (400 mg twice a day) continuously. Only one patient in the group receiving continuous therapy suffered clinical recurrence, but asymptomatic ulceration was found in four others. The group of patients who were receiving intermittent therapy suffered a total of 36 clinical recurrences. Three of these patients required prolonged treatment to heal their ulcers, and seven developed asymptomatic ulcer. The number of relapses varied from none to five. No way of predicting the individual prognosis was found. Intermittent treatment was an acceptable alternative in approximately half of the patients treated in this way, and was a failure in one-quarter of the group.

Adult↗
PubMed1980

Double-blind trial of trimipramine in the treatment of duodenal ulcer.

Twenty-three patients with chronic duodenal ulcer were allocated randomly to receive either trimipramine 25 mg or placebo, as a single night-time dose, for six weeks. Ulcer healing was determined by endoscopy. The ulcer healed in two of 10 patients receiving trimipramine and in seven of 13 patients receiving placebo. Trimipramine in this dosage does not assist ulcer healing.

Clinical Trials as Topic↗
PubMed1980

Relapse rate of duodenal ulcer after cessation of long-term cimetidine treatment: a double-blind controlled study.

Patients with a healed duodenal ulcer and who were symptom-free following 12 months of maintenance treatment with cimetidine 400 mg twice daily were randomized double-blind to a further 6 months therapy with either cimetidine 400 mg twice daily or placebo 2 tablets twice daily. Twenty-six patients received placebo and 15 patients cimetidine. Relapse was defined as symptoms for 3 out of 7 consecutive days and ulcer recurrence was confirmed by independent endoscopy. One of 15 patients on cimetidine relapsed: 20 of 26 patients on placebo relapsed. This relapse rate (77%) is similar to that found in previous studies after only 6 weeks cimetidine therapy (71%). This study suggests that 12 months cimetidine does not change the tendency of duodenal ulcer to recur and that the relapse rate is no greater than after 6 weeks cimetidine.

Adolescent↗
PubMed1980

Whipple's disease: a case with circulating immune complexes.

A patient with Whipple's disease was studied for 56 wk from diagnosis, during which time he received continuous antibiotic therapy. Intramucosal bacillary bodies detected by electron microscopy disappeared within 12 wk and a threefold fall in antibody titer to Hemophilus influenza type B bacillus occurred during this period. Circulating immune complexes of IgG class were consistently detected during the first 28 wk of treatment but not subsequently. IgM class immune complexes were detected at a time when mucosal recovery had occurred and when IgG complexes were no longer detectable. A further rise of IgM immune complexes could be induced by enteric challenge with bovine serum albumin in our patient but not in control subjects. The detection of serum immune complexes in Whipple's disease may reflect the entry of foreign antigen through intestinal mucosa. These observations also support the possibility of an underlying defect of antigen exclusion in this disorder, which persists despite apparent mucosal recovery.

Antibodies, Bacterial↗
PubMed1980

Specific IgM and IgG antibodies in IgA deficiency.

Evidence of an abnormality of IgM- and IgG-specific antibody responses was sought in subjects with selective IgA deficiency. Twenty-four patients having a serum IgA level less than 0 . 37 g/l were detected by local-population screening. Total IgM and IgG levels were measured as well as specific antibody to the lipopolysaccharides of six 0 serotypes of E. coli which are frequently isolated from human faeces. Serum IgM-class E. coli antibodies were significantly lower in IgA-deficient patients than in age- and sex-matched controls. The respective IgG-class antibody was generally elevated although more variation existed in this class. There was no correlation of specific antibody in either class with the degree of IgA deficiency. Possible explanations for these patterns of antibody response are discussed. It is concluded that some subjects with 'selective IgA deficiency' may be deficient in specific IgM antibody responses to certain antigens.

Antibody Specificity↗
PubMed1980

Measurement of intestinal antibody by radioimmunoassay.

The study of antibody responses in the intestine has been greatly hampered by lack of reproducible sensitive assays. An assay for measuring antibody against bacteria capable of regularly detecting gut antibody in gastroenteritis is described. It is based on absorption of antibody onto bacteria and measurement of the amount of antibody bound using radiolabelled anti-immunoglobulin antibody. Anti-light chain antibody is used to detect all classes of antibody as well as partially degraded antibody which retains the capacity to bind; anti-alpha and anti-gamma antibody is used to measure IgA and IgG antibody. The sensitivity of the assay depends on the use of anti-immunoglobulin antibody purified by affinity chromatography and allows measurement of nanogram amounts of antibody. Its specificity and kinetics are described and the particular advantages it provides in the measurement of antibacterial antibody in the intestine are discussed.

Antibodies, Bacterial↗
PubMed1979

Prevention of duodenal ulcer relapse by cimetidine: a one-year double-blind trial.

Fifty-one patients with duodenal ulcer which was healed by a six-week course of cimetidine completed a one-year double-blind study to compare the effects of cimetidine and placebo on the prevention of ulcer relapse. Patients were allocated at random to receive either 400 mg of cimetidine twice daily or placebo. Ulcer relapse was assessed by regular clinical follow up and endoscopy. A total of six of the 24 cimetidine-treated patients (25%) suffered a relapse compared to 25 of the 27 of placebo-treated patients (92.6%). Out of this total number of relapses, asymptomatic relapse with ulceration discovered by routine endoscopy at six months or one year, occurred in three patients receiving cimetidine and eight patients receiving placebo. Cimetidine prevents recurrence in patients with duodenal ulcer disease.

Adult↗
PubMed1979

Circulating immune complexes in IgA deficiency.

Circulating immune complexes (IC) were demonstrated in patients with serum IgA deficiency. Sixteen of thirty-one IgA deficient patients had serum IC detected by solid phase C1q radioimmunoassay for IgG class complexes. The presence of cryoglobulins (thirteen out of thirty-one patients) and increased polyethylene glycol precipitation (ten out of thirty patients) provided additional evidence for the presence of IC. Fourteen patients were asymptomatic but seven had clinical evidence of disease which could have been IC mediated: two with glomerulonephritis, three with polyarthritis, one with vasculitis and one with thyroiditis. Serum IC remained detectable in multiple samples over several months but this correlated poorly with the presence or absence of disease. Serum antibody to IgA was detected in fifteen out of thirty-one patients. There was no direct relationship between the presence of IC and the level of serum anti-IgA antibody; however, this antibody was shown to be present in the IC isolate in eight patients. It is proposed that a considerable portion of the IC load in IgA deficiency results from defective antigen exclusion at the level of the mucosa.

Adolescent↗