Search PubMed⌕ Search

Biomedical subjects

D L Morris

Publications and source records attributed to D L Morris.

At least 361 records · Page 20Linked to original sources
PubMed1986

Haemorrhage from idiopathic annular ulcers of the small intestine.

Annular small bowel ulceration is rare. We report three patients who presented with signs of chronic gastrointestinal blood loss. In two patients the main presenting symptom was intermittent abdominal pain while the third patient subsequently developed abdominal pain during the course of investigation. Preoperative localisation of the source of haemorrhage proved difficult in each case. However in all three patients an easily identifiable lesion was found at laparotomy. We believe that laparotomy should be undertaken more readily in the investigation of patients with the combination of abdominal pain and gastrointestinal bleeding as these patients are likely to have an anatomically identifiable cause for their symptoms.

Abdomen↗
PubMed1986

Carcinoma of the gallbladder.

Gallbladder carcinoma is the fourth commonest gastrointestinal malignancy. Its growth is insidious and the majority of cases are advanced at the time of diagnosis. The recognized radiological features occur only in those with advanced disease. Cholecystectomy may be curative when carcinoma is confined to the gallbladder but the place of extensive surgery, chemotherapy or radiotherapy is unproven.

Adenocarcinoma↗
PubMed1985

Albendazole--objective evidence of response in human hydatid disease.

Thirty-two patients with cysts caused by Echinococcus granulosus were treated with albendazole in a dosage of 10 mg/kg/day. Reversible abnormalities in liver-cell function tests were seen in five patients. Some radiological evidence of remission (on serial computed tomographic or ultrasound scanning) was seen in 15 of 22 patients undergoing a therapeutic course of albendazole (as opposed to those treated before or after surgery). In five patients, the cysts virtually disappeared. Apart from reduction in size, the appearance of a halo around the cysts and the apparent disappearance of daughter cysts has been seen. Serological findings have not correlated well with radiological or clinical improvement. Serum and cyst concentrations of albendazole sulfoxide (the principal metabolite) have been measured.

Adolescent↗
PubMed1985

Reflux versus dysphagia: an objective evaluation of the Angelchik prosthesis.

Twenty-seven patients with proven longstanding gastro-oesophageal reflux underwent insertion of an Angelchik anti-reflux prosthesis. Preoperative studies included oesophageal manometry, endoscopy, acid reflux provocation test (ARPT) and 24 h oesophageal pH recording (24 h pH). Following operation mean lower oesophageal sphincter pressure was increased from 11 to 20 cmH2O. ARPT revealed significant pre-prandial reflux before operation in 16/24 compared with only 1/20 postoperatively; 24 h pH also showed an improvement in that 21/22 patients refluxed before operation compared with no significant reflux after. Dysphagia for solids of some degree was seen postoperatively in 26 patients and this was also demonstrated by delay in transit of a marsh-mallow swallow test. Severe dysphagia was seen in 4 patients and in 3 of these was related to rotation and displacement of the prosthesis necessitating removal.

Deglutition Disorders↗
PubMed1985

Absence of myocardial biochemical toxicity with a nonionic contrast agent (iopamidol).

To evaluate the myocardial metabolic effects of a new nonionic contrast agent, iopamidol, a randomized, double-blind study was performed comparing iopamidol with sodium meglumine diatrizoate (Renografin-76) in 23 patients with ischemic heart disease. Coronary sinus and arterial metabolic samples were obtained prior to and during the 20-minute period following the contrast left ventriculogram. Ten patients received iopamidol and 13 received Renografin-76. The chemical lactate extraction in the iopamidol group was 13 +/- 9% prior to left ventriculography and 17 +/- 12% following the contrast injection (p less than 0.005). In the Renografin-76 group, the lactate extraction was 23 +/- 13% and decreased significantly to 12 +/- 24% following the ventriculogram (p less than 0.01). In a subset of these patients (n = 10), [1-(14)C] lactate was infused as a tracer to quantitate the amount of lactate released by the myocardium. [1-(14)C] lactate analysis demonstrated that the fall in lactate extraction ratio following Renografin-76 was due to an increase in myocardial lactate release. In the Renografin-76 group there was a 53 +/- 37% increase in lactate release at 10 minutes after contrast agent injection (p less than 0.005), while in the iopamidol patients there was no significant change in lactate release following contrast ventriculography. The increase in lactate release in the Renografin-76 group suggests that myocardial ischemia is induced with this ionic contrast agent. In comparison, the nonionic contrast agent is less toxic to the myocardium and is not associated with the biochemical changes of cellular ischemia.

Aged↗
PubMed1985

Effect of antibodies to glucose oxidase in the apoenzyme reactivation immunoassay system.

The use of antiserum to glucose oxidase in the apoenzyme reactivation immunoassay system (ARIS) is described. Formation of an immune complex between apoglucose oxidase and antibodies to native glucose oxidase enables FAD conjugates to be detected with greater sensitivity and at higher temperatures. In the absence of antiserum to glucose oxidase, optimum activity with theophylline-FAD was at 23 degrees C whereas in the presence of the antiserum the optimum shifted to 32 degrees C and was accompanied by a sixfold increase in activity. At 37 degrees C in the absence of antiserum very little activity is found. The use of the antiserum makes it possible to perform ARIS assays at 37 degrees C and this is illustrated by description of an assay for theophylline.

Antibodies↗
PubMed1985

Alterations in left ventricular function, coronary hemodynamics and myocardial catecholamine balance with MDL 17043, a new inotropic vasodilator agent, in patients with severe heart failure.

To evaluate changes in myocardial energetics and systemic and cardiac sympathetic activity associated with improved left ventricular function after MDL 17043, a new inotropic vasodilator agent, systemic and coronary hemodynamics and myocardial catecholamine balance were determined in 17 patients with severe heart failure. After the administration of MDL 17043, cardiac index increased by 67% and pulmonary capillary wedge pressure decreased (25 +/- 5 to 14 +/- 7 mm Hg, p less than 0.01), indicating improved left ventricular function. Coronary sinus blood flow (75 +/- 29 to 111 +/- 51 ml/min, p less than 0.01) and myocardial oxygen consumption (9.9 +/- 3.3 to 11.8 +/- 5.4 ml/min, p less than 0.05) increased despite decreased myocardial oxygen extraction (11.7 +/- 2 to 10.1 +/- 3.3 vol%, p less than 0.05) and a higher coronary sinus oxygen content. Although transmyocardial lactate extraction remained unchanged, increased myocardial oxygen consumption has potential deleterious effects on myocardial metabolic function. Arterial norepinephrine concentrations and transmyocardial norepinephrine release also remained unchanged. These findings suggest that MDL 17043 improves left ventricular pump function, but produces no detectable change in systemic and cardiac sympathetic activity. Improved left ventricular function is associated with increased myocardial oxygen consumption despite primary coronary vasodilation.

Adult↗
PubMed1985

Potentiation by nifedipine and diltiazem of the hypotensive response after contrast angiography.

Arterial hypotension has been demonstrated after left ventriculography using currently available ionic contrast agents. This adverse hemodynamic response is significantly decreased with the newer nonionic contrast agents. Calcium channel antagonists also produce a hypotensive response. The potentially accentuated hypotensive response after bolus contrast angiography in patients receiving the calcium antagonists nifedipine and diltiazem was evaluated. Three contrast agents were compared: two ionic agents (Renografin-76 and Hypaque-76) and a nonionic agent (iopamidol). The hemodynamic response after left ventriculography was assessed in 125 patients, 65 receiving nifedipine or diltiazem and 60 not receiving these drugs. Baseline clinical characteristics were similar in all patient groups. The hypotensive response was significantly greater after left ventriculography with the ionic agents than with the nonionic agent. In those patients receiving nifedipine or diltiazem, the hypotensive response after bolus contrast angiography using the ionic agents occurred earlier after contrast injection (4.2 +/- 3.1 versus 12.9 +/- 6.0 seconds, p less than 0.0001), was more profound (maximal decrease in systolic arterial pressure, 48.5 +/- 13.9 versus 36.9 +/- 13.1 mm Hg, p less than 0.001) and was more prolonged (62.3 +/- 11.0 versus 36.4 +/- 12.0 seconds, p less than 0.0001) than in patients not receiving these drugs. A comparison of the two ionic contrast agents showed no significant difference in the hypotensive response. There was no difference in the hemodynamic response after angiography among patients receiving iopamidol alone and those receiving iopamidol and calcium antagonists. Thus, patients receiving the calcium antagonists diltiazem and nifedipine and undergoing left ventriculography with ionic contrast agents are at added risk for accentuation and prolongation of the hypotensive response.

Aged↗
PubMed1985

Prediction of mortality at endoscopy in bleeding peptic ulcer disease.

One hundred and forty two patients with bleeding peptic ulcers underwent emergency endoscopy. Seventy six had endoscopic stigmata of haemorrhage and nine subsequently died. There were no deaths amongst sixty six patients without stigmata (p less than 0.02). Patients with stigmata were also significantly more likely to experience further bleeding (p less than 0.001) and to require emergency operations (p less than 0.01). Excess risk attached to those with bleeding at the time of endoscopy and those with visible vessels or clot adherent to the ulcer but not to patients with staining of the ulcer base. Patients without stigmata or with staining alone should be managed conservatively. Clinical trials in bleeding peptic ulcer disease should only include patients in the high risk group.

Clinical Trials as Topic↗
PubMed1985

Noise mode response at peak exercise in a DDD pacemaker.

The noise sampling period has been recognized as a cause of apparent sensing malfunction in demand pacemakers. Physiologic signals as well as external electromagnetic interference can cause certain demand pacemakers to remain refractory and escape asynchronously at a specified rate. In this case, noise mode reversion pacing at the programmed lower rate limit of a Cordis 415A DDD pacemaker was observed during exercise when P-waves fell within the noise sampling period.

Cardiac Pacing, Artificial↗
PubMed1985

Albendazole treatment of pulmonary hydatid cysts in naturally infected sheep: a study with relevance to the treatment of hydatid cysts in man.

Albendazole was given orally to sheep with naturally occurring live pulmonary and hepatic cysts. The viability of pulmonary cysts was established before treatment by thoracotomy and needle puncture. Both 10 and 20 mg/kg/day doses were found effective in that no viable protoscoleces were found after six weeks' treatment in either group while untreated controls still had viable cysts. In addition, treated animals showed macroscopic and electron microscopic changes. Bone marrow toxicity probably occurred in two sheep.

Albendazole↗
PubMed1985

Systemic lactate kinetics during graded exercise in man.

To investigate the relationships between oxygen consumption (VO2) and the rates of systemic lactate appearance (Ra) and disappearance (Rd), six healthy males were studied at rest and during continuous graded exercise using a primed continuous infusion of lactate tracer. Subjects exercised for 6 min at 300, 600, 900, and 1,200 kg . m . min-1. L-(+)-[1-14C]lactate was infused intravenously, and arterial samples were drawn at rest and every 2 min throughout the exercise period. Ra and Rd were calculated using nonsteady-state equations. At rest Ra and Rd were 14.4 +/- 1.8 and 15.1 +/- 2.2 mumol . kg-1 . min-1, respectively. Near steady-state values were observed toward the end of the first two work loads. Ra and Rd values were 32.8 +/- 2.3 and 37.4 +/- 1.3 mumol . kg-1 . min-1 during min 5 and 6 at 300 kg . m . min-1 and were 59.1 +/- 2.6 and 55.4 +/- 2.3 mumol . kg-1 . min-1 during min 5 and 6 at 600 kg . m . min-1. Ra was significantly greater than Rd at both 900 and 1,200 kg . m . min-1. Ra and Rd averaged 145.4 +/- 10.5 and 110.2 +/- 5.6 mumol . kg-1 . min-1, respectively, during the last 2 min at 900 kg . m . min-1, and 309.4 +/- 20.8 and 169.7 +/- 10.6 mumol . kg-1 . min-1, respectively, at 1,200 kg . m . min-1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Metabolic fate of extracted glucose in normal human myocardium.

Glucose is an important substrate for myocardial metabolism. This study was designed to determine the effect of circulating metabolic substrates on myocardial glucose extraction and to determine the metabolic fate of glucose in normal human myocardium. Coronary sinus and arterial catheters were placed in 23 healthy male volunteers. [6-14C]Glucose was infused as a tracer in 10 subjects. [6-14C]Glucose and [U-13C]lactate were simultaneously infused in the other 13 subjects. Simultaneous blood samples were obtained for chemical analyses of glucose, lactate, and free fatty acids and for the the isotopic analyses of glucose and lactate. Glucose oxidation was assessed by measuring myocardial 14CO2 production. The amount of glucose extracted and oxidized by the myocardium was inversely correlated with the arterial level of free fatty acids (r = -0.71; P less than 0.0001). 20% (range, 0-63%) of the glucose extraction underwent immediate oxidation. Chemical lactate analysis showed a net extraction of 26.0 +/- 16.4%. However, isotopic analysis demonstrated that lactate was being released by the myocardium. In the 13 subjects receiving the dual-carbon-labeled isotopes, the lactate released was 0.09 +/- 0.04 mumol/ml and 49.5 +/- 29.5% of this lactate was from exogenous glucose. This study demonstrates that the circulating level of free fatty acids plays a major role in determining the amount of glucose extracted and oxidized by the normal human myocardium. Only 20.1 +/- 19.4% of the glucose extracted underwent oxidation, and 13.0 +/- 9.0% of the glucose extracted was metabolized to lactate and released by the myocardium. Thus, 60-70% of the glucose extracted by the normal myocardium is probably stored as glycogen in the fasting, resting state.

Adult↗
PubMed1985

Hemodynamic characteristics of patients with hypothermia due to occult infection and other causes.

Eighty-five consecutive patients with hypothermia were prospectively evaluated to assess clinical and laboratory data that would differentiate those patients with hypothermia caused by severe infection and bacteremia and those with hypothermia of other causes. Thirty-two patients had hemodynamic monitoring, allowing us to assess hemodynamic differences between the two groups. Clinical characteristics, including admission temperature, leukocyte count, mean arterial pressure, pulse rate, respiratory rate, arterial pH, and pulmonary capillary wedge pressure, did not distinguish between the two groups. However, patients with infection with bacteremia had lower calculated systemic vascular resistances (486.0 +/- 125.0 compared with 1759.9 +/- 331.0 dynes.s.cm-5; p = 0.001) and higher cardiac indices (7.1 +/- 1.9 compared with 2.8 +/- 0.7 L/min X M2; p = 0.006) than patients without severe infections. Thus, our data suggest that hemodynamic characteristics are different in patients with infection-related hypothermia and patients with hypothermia associated with other causes, and appear to depend on the underlying disease.

Adult↗