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Biomedical subjects

D M Grace

Publications and source records attributed to D M Grace.

At least 55 records · Page 3Linked to original sources
PubMed1979

Norethindrone acetate inhibition of splanchnic triglyceride secretion in conscious glucose-fed siwne.

The effects of conventional doses of two synthetic contraceptive steroids on the concentration and rate of secretion of plasma triglycerides from the splanchnic region were investigated. Studies were undertaken in miniature swine under steady state conditions produced by prolonged constant hypercaloric intravenous infusions of glucose. The steroids, alone or in combination, were administered with the high carbohydrate diet for at least 2 weeks prior to study of splanchnic metabolism and were also infused intravenously during the studies. Splanchnic triglyceride secretion was determined from measurements of plasma flow and transsplanchnic radiochemical gradients of plasma triglycerides. Compared with studies in the untreated animal, norethindrone acetate significantly reduced the arterial concentration (1.1 +/- 0.1 vs. 0.7 +/- 0.1 mM) and rate of splanchnic secretion of plasma triglyceride fatty acids (2.0 +/- 0.4 vs. 0.8 +/- 0.1 micro mol/min.kg body wt(0.75)) and decreased the percent of free fatty acids entering the splanchnic region that was converted to plasma triglycerides (22 +/- 5 vs. 13 +/- 3%, P < 0.05). Ethynylestradiol, in the dose employed, had no significant effect on these variables; however, ethynylestradiol and norethindrone acetate together gave responses similar to norethindrone acetate alone. When the glucose was given intraduodenally vs. intravenously, values for splanchnic metabolism of triglycerides were unchanged. The hypolipemic effect of norethindrone acetate in glucose-fed swine was attributable to inhibition of hepatic triglyceride secretion.-Wolfe, B. M., and D. M. Grace. Norethindrone acetate inhibition of splanchnic triglyceride secretion in conscious glucose-fed swine.

Animals↗
PubMed1978

Cholesterol oxidation in primates by simultaneous sterol balance and breath analysis.

Six female adult rhesus monkeys and baboons with exteriorized enterohepatic circulations were simultaneously assessed following [26-14C]cholesterol pulse labeling by 14CO2 breath analysis and combined isotopic and chromatographic sterol balance during metabolic steady state. Bile acid synthesis and/or secretion were compared with 14CO2 breath analysis of cholesterol oxidation during short term physiological changes, and with total bile acid diversion and feedback inhibition, and biliary tract obstruction. Cholesterol oxidation by breath analysis compared closely with acidic sterol losses during steady-state conditions (145.6 +/- 23.9 vs 144.6 +/- 24.4 mg/24 h) and was sensitive enough to detect changes resulting from diurnal variation and fasting. The 14CO2 test detected inhibition of bile acid synthesis consequent to bile acid feedback (355 +/- 32 to 88 +/- 31 mg/24 h, P less than 0.001) or biliary tract obstruction (158 +/- 27 to 60 +/- 28 mg/24 h, P less than 0.05) but underestimated increased synthesis induced by acute bile diversion (245 +/- 24 vs. 868 +/- 104 mg/24 h, P less than 0.01 at 24 h). Insignificant 14C was detected by carcass analysis following cessation of exhaled 14CO2.

Animals↗
PubMed1978

Angiography in determining the cause and treatment of gastrointestinal bleeding.

Angiography is useful in the diagnosis of active gastrointestinal bleeding if the rate is greater than 0.5 mL/min. For upper gastrointestinal bleeding, endoscopy is the preferred initial investigation and angiography is used for diagnosis only if the site of bleeding is still obscure. Angiography is the preferred method for investigation of massive lower gastrointestinal bleeding if results of sigmoidoscopy are negative. Vasopressin infusion is most useful for control of bleeding from esophageal varices, erosive gastritis and diverticular disease of the colon. Embolization with Gelfoam or clot is possible for massive hemorrhage from a single source in poor-risk patients. This is most successful for gastric or duodenal bleeding since the collateral blood supply prevents infarction. Some of the methods and complications of embolization are discussed and examples are given. Standard surgical principles should still apply in most cases.

Adult↗
PubMed1978

Cholesterol gallstones and biliary lipid metabolism in the primate.

A primate model for the study of cholesterol gallstones is described. Bile became supersaturated with cholesterol in 7 female adult baboons with exteriorized enterohepatic circulations during 0.2 g per kg per day of cholestyramine treatment. Cholestyramine decreased bile acid pool size (1.38 +/- 0.7 to 0.45 +/- 0.02 mmole, P less than 0.001) and secretion rate (12.7 +/- 0.9 to 5.6 +/- 0.5 mmoles per 24 hr) while cholesterol secretion remained unaltered. Although biliary lipid and bile acid composition were similarly affected by treatment in both cholecystectomized and intact animals, cholesterol stones formed only in the latter. Thus metabolic alterations in biliary lipid metabolism as well as the presence of the gallbladder were necessary for stone formation.

Animals↗
PubMed1977

Rectal wall bleeding--an overlooked source of massive lower gastrointestinal hemorrhage.

Two cases of acute massive bleeding from the rectum are described. In both cases, the diagnosis was made angiographically. Some points of angiographic technique are discussed. In both cases, there had been previous negative sigmoidoscopy. Care must be taken to include the entire rectum on the films obtained during injection of the inferior mesenteric artery regardless of findings on sigmoidoscopy.

Adult↗
PubMed1977

Air embolism with neurologic complications: a potential hazard of central venous catheters.

In two patients air embolism caused by disconnection of subclavian venous catheters resulted in cerebral damage. Both patients were receiving long-term parenteral nutrition; both were in an upright position and were slightly dehydrated at the time the embolism occurred. The occurrence of air embolism during the insertion of central venous or subclavian catheters is well known, but the development of this complication in patients in whom the intravenous line becomes disconnected has not been stressed. It is important to recognize and treat the condition promptly. Also important in the prevention of this condition is catheterization in patients who are properly hydrated and who are in the Trendelenburg position, and care of the catheter thereafter.

Catheterization↗
PubMed1977

Comparison of cryotherapy and surgery for treatment of spontaneous mouse tumour.

Spontaneous mammary adenocarcinoma was implanted subcutaneously into the flank or leg of inbred C3H/HeJ mice. Excision or cryotherapy of flank tumours was followed by cure in 47 and 52% respectively. Amputation or cryotherapy of tumours of the hind leg resulted in a cure in 70% for each method. Rechallenge of surviving mice resulted in initial delay of growth in mice treated by cryotherapy, but final host acceptance and survival were the same for each method of treatment. The tumour was grown in tissue culture; significant antibody levels after cryotherapy could not be detected by a mixed antiglobulin technique. It is concluded that cryotherapy can destroy the tumour, but this method offers little immunologic advance for weakly antigenic tumours. Careful monitoring of temperature is essential for successful cryotherapy. In the same series of experiments barbiturate anesthesia and tumour exploration did not alter tumour growth or mortality.

Adenocarcinoma↗
PubMed1976

Liver-originating isoenzymes of alkaline phosphatase in the serum: a paraneoplastic manifestation of a malignant schwannoma of the sciatic nerve.

A case of malignant schwannoma of the sciatic nerve is described associated with hepatic dysfunction in the absence of hepatic metastases. An elevated serum alkaline phosphatase activity was present with an isoenzyme pattern indicating hepatic involvement. These abnormalities disappeared after extirpation of the tumour. The patient is well, with no evidence of metastases, over two years later. It is concluded that the abnormality of serum alkaline phosphatase was induced by the tumour, and that the liver can be involved in the paraneoplastic syndrome.

Alkaline Phosphatase↗
PubMed1976

Dexon: an excellent suture for midline incisions.

In a period of 18 months, 100 midline incisions of 93 patients were closed with interrupted 0 Dexon sutures. The Smead-Jones far-and-near stitch was used. There were no early disruptions and no incisional hernias in follow-up periods ranging from 5 days to 14 months. Four wound infections healed readily without prolonged drainage. Incisional pain was minimal in all patients. A group of 18 patients with potential for poor healing because of hemorrhage, sepsis, malignancy and steroids had no wound complications apart from an acceptable rate of infection. It is concluded that interupted 0 Dexon with wide fascial placement provides an excellent closure for midline incisions.

Abdomen↗
PubMed1975

Gelfoam embolization of the left gastric artery for bleeding ulcer: experimental considerations.

A bleeding gastric ulcer was surgically created in 18 dogs, and the left gastric artery was successfully catheterized by percutaneous techniques in 15. Nine of these dogs were treated with vasopressin infusion which did not arrest the hemorrhage. A total of 11 dogs (five of them following unsuccessful vasopressin therapy) underwent embolization with strips of Gelfoam, and hemorrhage stopped in ten. This technique of embolization is concluded to be of value in the management of gastric hemorrhage.

Angiography↗
PubMed1975

Creation of a reliable gastric bleed in dogs for angiographic studies.

A method of creating a brisk and reliable bleed from the left gastric artery of the dog has been developed. This has been quantitated and emonstrated by celiac and left gastric arteriography. Such a model lends itself to studies on the pharmacologic or embolic control of bleeding of the stomach.

Angiography↗
PubMed1975

Duodenal obstruction related to benign biliary tract disease.

Duodenal obstruction in six patients was related to biliary tract disease and previous abdominal surgery. Causes of obstruction were adhesions to the inflamed gallbladder, adhesions to the gallbladder bed after cholecystectomy, intramural hematoma after transduodenal exploration of the common bile duct and severe pancreatitis after common bile duct exploration. Measures that may possibly prevent duodenal obstruction include early recognition and treatment of cholelithiasis, positioning of omentum between duodenum and gallbladder bed after cholecystectomy, avoidance of transduodenal exploration where possible and careful duodenal closure if necessary, avoidance of forceful dilation during common bile duct exploration, and a decrease in the number of negative explorations by increased use of cystic duct cholangiography

Adult↗