Search PubMed⌕ Search

Biomedical subjects

J G Kingham

Publications and source records attributed to J G Kingham.

At least 37 records · Page 2Linked to original sources
PubMed1983

What is indigestion?

Ninety patients and 30 senior hospital doctors were questioned about indigestion and dyspepsia. There were marked discrepancies between the views of patients and doctors. Most doctors considered indigestion to be synonymous with dyspepsia and associated it with peptic ulcer. Patients, however, were not generally conversant with the term dyspepsia and linked indigestion with psychological factors, feeding patterns and bowel function rather than physical illness. The patients' concept of indigestion corresponded closely with medically-accepted features of irritable bowel syndrome. Uncritical use of these terms may lead to misinterpretation of the patient's complaint and inappropriate management.

Colonic Diseases, Functional↗
PubMed1982

Microscopic colitis-a cause of chronic watery diarrhoea.

Six patients with severe watery diarrhoea were found to have microscopic total colitis. None had any abnormality detectable by conventional tests used to diagnose inflammatory bowel disease-namely, barium radiology and endoscopy. The diagnosis could only be made by microscopic examination of biopsy specimens from the apparently normal colon. Anaemia, raised erythrocyte sedimentation rate, hypokalaemia, and hypoalbuminaemia were common findings. Small-bowel function was normal in all, though three patients had jejunal lesions of uncertain relevance but seemingly unrelated to the diarrhoea. The five patients given anti-inflammatory drugs showed a satisfactory response with improvement of the diarrhoea and colonic inflammation and return to normal of the abnormal laboratory findings. Microscopic colitis is responsible for a proportion of cases of intractable diarrhoea of obscure origin and rectal and colonic biopsies sould be undertaken in such cases.

Adult↗
PubMed1982

Slow cirrhosis--or no cirrhosis? a lesion causing benign intrahepatic portal hypertension.

We report the histological findings in livers from a group of 60 patients with benign intrahepatic portal hypertension. The lesion is benign in comparison with true cirrhosis in the sense that most of the patients survive many years from the time of diagnosis. The histological changes, in our view, differ from those of any variant of cirrhosis and generally do not progress even after many years. The essential features are: (1) irregular capsular thickening; (2) thickening of some portal tracts with fine fibrous septa radiating out from some of them; and (3) distortion of lobular architecture with hyperplastic expansion of some areas and compression of others and irregularly distributed central veins. We suggest that this is the lesion responsible for at least some cases of so-called idiopathic non-cirrhotic portal hypertension.

Follow-Up Studies↗
PubMed1981

Computed tomography in patients with an abdominal mass: effective and efficient? A controlled trial.

In 28 of 53 patients with a palpable abdominal mass computed tomography (CT) was used as the initial imaging technique, and conventional imaging was used in the remaining 25 patients. The diagnosis was established more quickly in the CT group, and the period of inpatient investigation was shorter. The cost of imaging investigations was higher for the CT group, but this difference was small when compared with the difference in cost of inpatient stay. CT seems accurate in the investigation of a palpable abdominal mass and particularly useful in excluding a pathological cause. The need for the latter is emphasised by the fact that no lesion could be found in 23 of the 53 patients.

Abdominal Neoplasms↗
PubMed1981

Non-cirrhotic intrahepatic portal hypertension: A long term follow-up study.

The clinico-pathological features and prognosis of 59 cases of non-cirrhotic portal hypertension seen at one hospital over a 30-year period are described. Diagnosis was made on operative wedge liver biopsy in most cases. All but two had clinical features of portal hypertension and 47 had bled from oesophageal varices. In 53, portal decompression was performed without operative death or variceal rebleeding. Subsequent liver histology in 16 cases up to 18 years after diagnosis showed no change in the majority. The relatively static morphology was reflected in the clinical course. Twenty-two patients have died but only 11 as a result of liver disease or its treatment. Actuarial analysis shows the five year survival to be 90 per cent and the 30-year survival 55 per cent in strong contrast to the grim prognosis for cirrhosis. The infrequency of operative liver biopsies and unfamiliarity with the disease lead to underdiagnosis.

Adolescent↗
PubMed1980

Pancreatic insufficiency following abdominal irradiation.

A case is reported of pancreatic insufficiency following abdominal irradiation for Hodgkin's disease in a man aged 47 years. The effects of radiation on the pancreas are discussed. It is suggested that post irradiation steatorrhoea may have a pancreatic as well as an enteric cause.

Celiac Disease↗
PubMed1979

Dapsone and severe hypoalbuminaemia. A report of two cases.

Severe hypoalbuminaemia developed in two patients on long-term dapsone treatment for dermatitis herpetiformis. The patients had been treated with dapsone for 3 and 11 years before the syndrome developed and both recovered completely when dapsone was withdrawn. Albumin-turnover studies revealed a great increase in intravascular albumin catabolism and a modest decrease in synthesis.

Adult↗
PubMed1979

Chlamydia, cytomegalovirus, and Yersinia in inflammatory bowel disease.

The relationship of three infectious agents, Chlamydia, cytomegalovirus, and Yersinia enterocolitica, to the aetiology, clinical course, and diagnosis of Crohn's disease was studied. There was no evidence of chlamydial infection in Crohn's disease and no indication either that cytomegalovirus alters the outcome of acute attacks or that infection with Y. enterocolitica is being misdiagnosed as Crohn's disease.

Acute Disease↗
PubMed1978

Hepatitis B in a hospital for the mentally subnormal in southern England.

The prevalence of hepatitis B viral (HBV) infection was assessed in 340 patients and 268 staff in a hospital for the mentally subnormal in Wessex. Hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen, antibody to HBsAg, e antigen (eAg), and antibody to eAg were used as markers of such infection. Forty patients and 10 staff had evidence of recent or current infection, while 149 patients and 50 staff had evidence of past infection. HBV markers were more common in mongols, epileptics, patients with cerebral palsy, and those of lower mental grades and reached a peak after 5-15 years of hospitalisation. eAg was detected in 12 out of 26 patients with HBsAg but in none of the four staff with HBsAg. Abnormal liver function values were found in 24 (60%) of the patients with recent or current HBV infection but in only 30 (19%) of those without HBV markers. Among the staff the prevalence of HBV markers correlated with the duration of employment and degree of contact with patients. Of those with recent or current infection, 4 (40%) had abnormal liver function values compared with 25 (12%) of those without HBV markers. Despite the high prevalence of markers clinically overt hepatitis B was rare.

Adolescent↗
PubMed1978

Acid hydrolases in monocytes from patients with inflammatory bowel disease, chronic liver disease, and rheumatoid arthritis.

A sensitive technique was used to estimate two acid hydrolases--N-acetyl-beta-glucosaminidase (N.A.G.) and beta-glucuronidase (B.G.)--produced by peripheral-blood monocytes. Enzyme levels were measured after in-vitro incubation of monocytes with or without stimulation by zymosan and endotoxin. Compared with controls, enzyme production and release in inflammatory bowel disease, chronic liver disease, and rheumatoid arthritis were markedly raised. It is suggested that various stimuli, including immunological ones, may be responsible for the release of such enzymes from monocytes and that such release may be a factor in the production of the chronic inflammation seen in these disorders.

Acetylglucosaminidase↗
PubMed1978

Selectivity of small intestinal exudate in celiac disease and Crohn's disease.

The small intestinal exudates of patients with protein-losing enteropathies produced by celiac disease or proximal jejunal Crohn's disease were compared with controls. The exudates in control subjects were highly selective, whereas those of the celiac and Crohn's disease subjects were relatively nonselective. It is believed that this loss of selectivity is secondary to basement membrane damage. An analogy is drawn with the renal lesion in nephrotic syndrome where basement membrane damage is associated with nonselective proteinuria.

Adult↗
PubMed1978

Autoradiographic study of the permeability characteristics of the small intestine.

This autoradiographic study demonstrates the distribution of a range of small solutes and macromolecules in the mucosa of the guinea-pig small intestine after intracardiac injection. The substances investigated were: 14C-urea, 3H-mannose, 3H-inulin, and 125I polyvinylpyrrolidone (PVP). Small bowel biopsies were taken at intervals from one to 60 minutes after injection and the tissues processed for autoradiography. Light microscopic examination of the autoradiographs showed that the compartmental distribution depended on the molecular size of the substances being studied. Urea and mannose, as small solutes, were uniformly distributed throughout the intravascular, extravascular, and epithelial compartments. Inulin was evenly distributed in the vessel lumen and extravascular space but there was a considerable drop in concentration in the epithelium. PVP exhibited the most marked gradients, the concentration being greatest in the vascular lumina, lower in the extravascular space, least in the epithelium. Thus there appear to be two barriers to macromolecular passage which are freely permeable to small solutes: the capillary wall and the epithelium. At a light microscopical level it is not possible to observe whether the limiting membrane of each of these barriers is the cell plasmalemmal membrane or the basement membrane. The selectivity of the epithelial barrier is greater than that of the capillary barrier.

Animals↗
PubMed1978

Treatment of HBsAg-positive chronic active hepatitis with human fibroblast interferon.

Two patients with HBsAg positive chronic active hepatitis have been treated with human fibroblast interferon 10(7) units daily for two weeks. Before treatment, both patients had high levels of hepatitis B surface antigen, core antibody, and DNA-binding antibody in the blood and one patient had a fourfold rise in serum AST. During treatment there was a striking fall in the core antibody titre and also in the DNA-binding antibody, which has been maintained for several months subsequently; in one patient the initially high AST level fell to normal. No significant adverse effects occurred, and these observations should encourage further trials of fibroblasts interferon in hepatitis B.

Adult↗
PubMed1978

DNA-binding antibodies and hepatitis B markers in acute and chronic liver disease.

A Farr technique has been used to assay antibodies to double-stranded DNA in the serum of patients with acute and chronic liver disease and carriers of HBsAg from the United Kingdom and Iraq. These antibodies were found in all groups from both countries. The highest levels were found in chronic active hepatitis and cirrhosis. In the Iraqi patients there was a strongly positive correlation between DNA-binding antibody levels and the presence of hepatitis B markers but not with disease activity. In the patients from the United Kingdom there was little correlation with disease activity and none with autoantibodies. Ninety-five per cent of asymptomatic carriers of HBsAG had elevated DNA-binding antibodies. It is suggested that hepatitis B-specific DNA might be one trigger to DNA antibody formation, though in liver disease a variety of factors are clearly operative.

Acute Disease↗