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Biomedical subjects

J O Hunter

Publications and source records attributed to J O Hunter.

At least 91 records · Page 5Linked to original sources
PubMed1980

Vitamin D metabolism in patients treated with phenytoin and phenobarbitone.

There are many reports of abnormalities in calcium metabolism and even of frank osteomalacia in patients taking anticonvulsant drugs. Although enzyme induction has been suggested to be the cause of increased requirements for vitamin D leading to these changes, this has still to be proved. We have studied the metabolism of [3H]cholecalciferol and 25-hydroxycholecalciferol in subjects taking anticonvulsant drugs. The rate of removal of cholecalciferol from the plasma was no different from that in control subjects and no abnormality was detected in the production of disappearance of 25-hydroxycholecalciferol. However, plasma concentrations of 25-hydroxycholecalciferol fell more rapidly during the winter in epileptic subjects than in control subjects. Our results do not confirm that these changes are due to enzyme induction.

Calcifediol↗
PubMed1980

Benign liver nodules presenting as apparent hepatic metastases: a report of 5 cases.

Five cases are described in which hepatic nodules discovered as an incidental finding at laparotomy performed for other reasons were thought to be metastatic tumour. In each case histology and clinical course proved this assumption to be incorrect. It is emphasized that biopsy is mandatory in such circumstances to establish the diagnosis. Where the nature of the hepatic lesion might affect the choice of operative procedure frozen section examination should be performed at the time of surgery. Bacteriological culture may also be helpful.

Adult↗
PubMed1980

An evaluation of highly selective vagotomy in the treatment of chronic duodenal ulcer.

A randomized trial of highly selective vagotomy against truncal vagotomy and gastroenterostomy has been performed. Forty patients have been analyzed. All operations were performed by one surgeon with previous experience with highly selective vagotomy. Comparisons during the operation indicated that highly selective vagotomy took longer to perform and had a greater associated blood loss. Patients with highly selective vagotomy recovered more rapidly after operation as the duration of ileus postoperatively was shorter. Both operations effectively reduced basal and insulin-stimulated peak acid outputs. At the time of follow-up study, at six weeks and six months postoperatively, patients with highly selective vagotomy had significantly better over-all Visick gradings and had better gradings for the symptom of diarrhea. The differences between the two groups gradually diminished after a year, although diarrhea remained significantly worse in patients who had truncal vagotomy. There were no recurrences of ulcer in either group up to one year postoperatively. Highly selective vagotomy has significant advantages over truncal vagotomy and gastroenterostomy in the immediately postoperative period and up to one year after operation. Only a marked increase in bad results from highly selective vagotomy after a year could justify the continued use of truncal vagotomy and gastroenterostomy.

Adult↗
PubMed1979

Vitamin D metabolism in acute and chronic cholestasis.

To study the effects of acute and chronic cholestasis on vitamin D metabolism we investigated six cases of acute extrahepatic obstructive jaundice and eight cases of primary biliary cirrhosis (PBC) (three supplemented with vitamin D). Plasma 25-hydroxyvitamin D (25OHD) was low in the patients with PBC unsupplemented with vitamin D but normal in obstructive jaundice. None of the patients with PBC showed radiological or histological evidence of osteomalacia. In PBC, dietary intake of vitamin D was low but response to ultra-violet irradiation of the skin was normal even in those with a considerably raised serum bilirubin. Patients with PBC or obstructive jaundice had low levels of 25 hydroxyvitamin D binding protein which correlated with the serum albumin. The half-life of intravenously injected (3)H vitamin D(3) ((3)HD(3)) and the subsequent production of (3)H 25OHD were normal in all the patients with obstructive jaundice and in most with PBC. The two patients with PBC who produced less (3)H 25OHD than expected were receiving vitamin D supplements. The urinary tritium ((3)H) excretion after the injection of (3)HD(3) correlated with the serum bilirubin. After the injection of (3)H 25OHD(3) the urinary excretion of (3)H was minimal and did not correlate with the serum bilirubin, suggesting that the radioactivity appearing in the urine after the (3)H vitamin D(3) injection was associated with vitamin D metabolites other than 25OHD. Factors contributing to the low plasma 25OHD in primary biliary cirrhosis may be a low dietary intake of vitamin D, inadequate exposure to ultra-violet light, and a tendency to urinary wastage of vitamin D metabolites.

Acute Disease↗
PubMed1979

Double-blind controlled trial of cimetidine in the healing of gastric ulcer.

Sixty patients with gastric ulcers were treated for four weeks with either 1 g cimetidine per day or with identical tablets containing lactose. The healing rate, assessed by endoscopy, was 23 out of 35 (66%) in the patients given cimetidine and 13 out of 25 (52%) in those given placebo. The difference between the groups is not significant. During each of the four weeks of the study the cimetidine group experienced significantly fewer attacks of pain and consumed less antacids than the placebo treated patients.

Aged↗
PubMed1979

Cimetidine in the prevention of gastric ulcer relapse.

Twenty-five patients with healed gastric ulcers completed an 11-month double-blind controlled trial comparing cimetidine 1 g daily with placebo in the prevention of ulcer relapse. Ulcers recurred in 14 patients, 12 on placebo, 2 on cimetidine. In 11 patients, 9 on cimetidine, 2 on placebo, the ulcers remained healed at the end of the trial (P less than 0.002). Cimetidine 1 g daily significantly reduces the relapse rate in gastric ulceration.

Aged↗
PubMed1978

Abnormal vitamin D metabolism in cirrhosis.

Vitamin D metabolism was investigated in 10 patients with cirrhosis. Mean plasma 25 hydroxycholecalciferol (25 OHD) centration in alcoholic cirrhosis was lower than in controls but the difference was not significant. In three patients restudied after the summer, plasma 25 OHD had risen. In contrast to the finding in normal subjects, the half-life of intravenously administered 3H cholecalciferol was short in cirrhotics and showed no correlation with plasma 25 OHD. Furthermore, the appearance of 3H 25 OHD from 3H cholecalciferol was reduced compared to the control group four hours after injection. Increased rate of metabolism of cholecalciferol and deficient production of 25 ohd contribute to vitamin D deficiency in liver disease.

Adult↗
PubMed1977

Plasma concentrations of isosorbide dinitrate after oral administration of a sustained-release formulation to human subjects.

1. A peak of mean plasma concentrations of isosorbide dinitrate of 5.8 ng/ml was reached at 0.5 h after a single oral dose of 5 mg in a standard tablet formulation. Thereafter mean concentrations declined with a half-life of about 48 min. 2. A peak of mean concentrations of isosorbide dinitrate of 3.2 ng/ml was reached at 2--4 h after a single oral dose of 20mg in a sustained-realease capsule formulation (Iso Mack Retard). Thereafter mean concentrations declined by about twofold during 6 h and were still detectable at 12 h after dosing. 3. When corrected by dose/bodyweight variations, the mean area under the isosorbide dinitrate plasma concentration curve from the sustained-release capule was 76% of that from the standard tablet and this formulation-related difference in bioavailability was statistically significant (p less than 0.05). 4. The results showed that sustained-release formulation is a useful way to maintain plasma concentrations of isosorbide dinitrate for several hours.

Adult↗
PubMed1976

1-alphahydroxycholecalciferol in chronic renal failure. Studies of the effect or oral doses.

Four patients with advanced chronic renal failure and osteodystrophy were treated with 1-alphahydroxycholecalciferol, a synthetic vitamin D analogue, in a daily oral dose of 1.5 to 2.0 mug, for periods up to 1 year. They showed increased calcium absorption, positive calcium and phosphorus balances, moderate increases in serum calcium levels, marked reductions in serum alkaline phosphatase levels, a decrease in serum immunoreactive parathyroid hormone levels, and radiologic and histologic improvement in bone disease. One patient with proximal myopathy showed improvement in muscular strength. 1-Alphahydroxycholecalciferol appears to be effective therapy for renal osteodystrophy.

Administration, Oral↗
PubMed1973

Inheritance of type 2 Crigler-Najjar hyperbilirubinaemia.

The families of three patients with Crigler-Najjar hyperbilirubinaemia, type 2, whose plasma bilirubin levels had responded to phenobarbitone treatment, were investigated. All the parents and several relatives had mildly raised bilirubin levels. It is suggested that this condition may be an example of genetic heterogeneity and that the propositi had inherited two different abnormal genes. The separation of the Gilbert and type 2 Crigler-Najjar syndromes is at present arbitrary.

Adult↗