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Biomedical subjects

I N Marks

Publications and source records attributed to I N Marks.

At least 163 records · Page 9Linked to original sources
PubMed1976

Maximum acid output and risk of peptic ulcer.

The relationship between the capacity to secrete acid and the risk of peptic ulcer has been examined prospectively in 114 healthy symptom-free students and retrospectively in 2361 patients with and without ulcers. The risk of ulcer was found to increase as te maximum acid output (M.A.O.) increased, and the risk of recurrent ulceration, after vagotomy and drainage for duodenal ulceration, was found to increase as the postvagotomy M.A.O. increased. The risk of recurrent ulcer, at any postvagotomy M.A.O., was always greater than the risk of ulceration in a healthy individual with an equivalent M.A.O.. The addition of an antrectomy to a vagotomy restored the risk of recurrent ulcer towards that of a healthy individual developing his first ulcer. The therapeutic benefit of adding an antrectomy to a vagotomy could not be attributed solely to its enhancement of the percentage reduction in M.A.O. from 65% to 95%. The major therapeutic effect of an antrectomy seems to be achieved independently of its action on M.A.O.

Drainage↗
PubMed1976

Maximum acid output and position of peptic ulcers.

In a retrospective analysis of 2218 tests of gastric secretion 27% of patients with duodenal ulcers had an abnormal capacity to secrete acid. The abnormality was evident only in patients who had had symptoms for longer than three years, and was greatest in patients who had had symptoms for six to nine years. There was no significant difference between the capacity to secretic acid in patients who had symptoms of duodenal ulcer for less than three years and the capacity to secretic acid in normal controls. The tendency for the capacity to secrete acid to increase with duration of symptoms was also evident in patients with gastric ulcers. The positions in which ulcers were found were closely related to the maximum acid output (M.A.O.), and to the age of patients. The site of recurrent ulcers, after vagotomy and drainage, was also related to the M.A.O. after vagotomy. These influences of ageing and vagotomy on the site of ulcers can be attributed to their antecedent effect on the M.A.O. It is suggested that the capacity to secret acid alone is not responsible for the genesis of peptic ulcers but that it influences the position in which an ulcer may develop under the influence of an unknown ulcerogenic factor.

Adult↗
PubMed1976

Histamine H2-receptor antagonists in the treatment of duodenal ulcers.

A double-blind trial of histamine H2-receptor antagonists and placebo was carried out in 46 patients with endoscopically proven duodenal ulceration. H2-receptor antagonists (metiamide and cimetidine) produced a significantly greater degree of completely healed ulcers and fewer complete failures than placebo. The results of the trial indicate that H2-receptor antagonists promote the healing of ulcers. The action of these compounds would appear to be related to the inhibition of acid secretion. Neither the duration of the illness, rate of recurrence of the ulcers of level of gastric acid secretion materially affected the healing rate in indvidual patients. There were no serious side-effects over the 6-week period of drug administration, but the metiamide was replaced by cimetidine because reports from other centrea indicated that agranulocytosis was associtated with metiamide therapy.

Antacids↗
PubMed1976

[The natural history of alcohol-induced pancreatitis (authors transl)].

Alcohol-induced pancreatitis (AIP), although essentially a chronic pathological disorder, covers a wide spectrum of clinical syndromes ranging from fulminating to more chronic and even painless varieties. The clinical features, complications and treatment of AIP are presented with special reference to differences between the clinically acute and chronic forms of the disease.

Abdomen, Acute↗
PubMed1975

Chronic pancreatitis and alpha-1-antitrypsin.

110 patients with proven chronic pancreatitis have been studied to assess the prevalence of the various Pi phenotypes of alpha1-antitrypsin in this disease compared with a control group of 116 blood-donors. The phenotype PiMZ (including Mweak) was significantly more prevalent and PiMM significantly less so in the patients with pancreatitis. It is possible that a heterozygous deficiency of this protease inhibitor renders the pancreas more vulnerable to aetiological agents (e.g., alcohol).

Blood Donors↗
PubMed1975

Incidence of Crohn's disease at Groote Schuur Hospital during 1970-1974.

In the period 1970-1974, 45 patients with Crohn's disease were seen. The incidence of the disease seems to be increasing. Twenty-nine of the patients were White, and 16 Coloured. The disease involved the small bowel alone in 9 patients, the ileocaecal region in 17, the large bowel alone in 4 and both the small and the large bowel in 15. Alone or in combination, abdominal cramps and diarrhoea were the commonest modes of presentation. The type of therapy used is discussed. Only 10 patients in this study have not as yet required surgery. Salazopyrin, steroids, antibiotics and azathioprine have been used with varying success in the treatment of most of the patients. Crohn's disease has a high degree of morbidity, but a low mortality rate.

Adolescent↗
PubMed1975

Clinical and hormonal aspects of pancreatic diabetes.

The prevalence of diabetes due to chronic pancreatitis would appear to be increasing. In western countries this is associated with the known increase in alcohol consumption and AIP. Malnutrition may be etiologic in tropical areas. The incidence of diabetes in chronic pancreatitis is dependent on a number of factors. It is more common in alcohol-induced pancreatitis, rarely occurs after the first attack but tends to increase with time and rises markedly in calcific pancreatitis. Abnormal glucose tolerance occurred in 91% of patients with calcific pancreatitis and 70% of patients with noncalific AIP in our follow up of five to 12 years. This stresses the importance of serial regular glucose tolerance tests in these patients (Table I). The insulin-reserve is severely depleted in most patients who do not yet demonstrate abnormal glucose tolerance, indicating that pancreatitis regularly affects the islets and that nearly all patients are potential diabetics. The beta cells appear to respond better to oral glucose, glucagon or secretin than to i.v. glucose suggesting a selective glucose receptor loss or block to hyperglycemia in chronic pancreatitis. The alpha cells seem to be more resistant to the effects of chronic pancreatitis but true hypoglucagonemia was found in 16% of patients. In addition, stimulated growth hormone secretion may be deficient in pancreatic diabetes. These last two factors, among others, may be responsible for the protracted and even fatal hypoglycemia to which some patients with AIP on insulin therapy are liable. The danger of drug-induced hypoglycemia, coupled with the infrequency of vasculopathy, retinopathy and nephropathy in pancreatic diabetes has induced us to keep these patients hyperglycemic and glycosuric rather than in a sugar-free state, as long as symptoms are contained. Recurrent abdominal pain, marked weight loss and associated steatorrhea often raise special problems in the management of the pancreatic diabetic.

Acute Disease↗
PubMed1974

A comparison between secretin alone and sequential and simultaneous secretin and cholecystokinin administration in the assessment of pancreatic function.

Pancreatic volume, bicarbonate and enzyme secretion were studied after sequential and after simultaneous secretin and cholecystokinin (CCK) stimulation and the results compared. No statistical difference between sequential or simultaneous stimulation was noted. A comparison of secretin alone with simultaneous secretin plus cholecystokinin stimulation showed that the combination yielded a significantly higher trypsin concentration. Volume and bicarbonate were unchanged.

Bicarbonates↗