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J R Hamilton

Publications and source records attributed to J R Hamilton.

At least 109 records · Page 6Linked to original sources
PubMed1987

Treatment failure in celiac disease due to coexistent exocrine pancreatic insufficiency.

A 17-year-old white adolescent had a history of chronic diarrhea, delayed puberty, and growth failure. Investigations excluded cystic fibrosis, Shwachman syndrome, and endocrine causes of growth failure. Severe steatorrhea was diagnosed from fecal fat studies, and a jejunal suction biopsy showed total villus atrophy, consistent with a diagnosis of celiac disease. Following introduction of a gluten-free diet, his appetite and growth improved, but he continued to have abdominal discomfort and loose offensive bowel motions. One year later, severe steatorrhea was present. A repeat jejunal biopsy showed partial recovery of villus architecture. Serum immuno-reactive trypsinogen level was low, which was highly suggestive of exocrine pancreatic failure. Results of quantitative pancreatic stimulation test confirmed the presence of primary pancreatic insufficiency. After introduction of oral pancreatic enzyme supplements with meals, his gastrointestinal symptoms resolved and growth velocity accelerated. Previously, primary pancreatic insufficiency has only been described in elderly patients with long-standing untreated celiac disease. This case, however, emphasizes that pancreatic failure can occur with celiac disease at any age. Determination of a serum immunoreactive trypsinogen level should be considered a useful screening tool for pancreatic insufficiency in patients with celiac disease who have not responded to a gluten-free diet.

Adolescent↗
PubMed1986

Behçet's syndrome involving the gastrointestinal tract--a diagnostic dilemma in childhood.

Behçet's syndrome is very rare in children, especially those under 10 years of age. Clinical and radiological features are described in 4 children, including 2 under the age of 5 years, with the syndrome. As in other pediatric cases reported, the incomplete form of Behçet's syndrome was present in each case. All 4 patients had oral and genital mucosal effects, arthritis and gastrointestinal and dermatological manifestations. Ophthalmological symptoms occurred in only 1 patient. Radiologically, the 4 cases demonstrated the spectrum of gastrointestinal involvement, from minimal irregularity and thickening of the terminal ileum to gross irregularity and deformity of the terminal ileum and cecum. Because of the difficulty in differentiating Behçet's syndrome from other forms of inflammatory bowel disease it is suggested that in children with gastrointestinal involvement, 3 major criteria be present before the diagnosis of Behçet's syndrome is made.

Adult↗
PubMed1986

Insanity legislation.

The McNaughton Rules, which are used when someone pleads insanity at the time of a homicide, are out of date and unsatisfactory. Suggestions have been made about how the insanity defence can be reformulated. The preference of a defence of diminished responsibility means abandoning an ancient and humane principle of not convicting those who are so mentally disordered as not to be responsible for their actions. There is a need for Parliament to consider changes to the law both to prevent the mentally disordered being sent to prison inappropriately, and because the Mental Health Act 1983 has not taken account of rare cases where an offender such as an epileptic might be found legally insane but not mentally disordered.

Commitment of Persons with Psychiatric Disorders↗
PubMed1986

Alanine enhances jejunal sodium absorption in the presence of glucose: studies in piglet viral diarrhea.

We measured the response of jejunal sodium (Na) absorption to neutral amino acid (L-alanine) and to dipeptides (L-alanyl-L-alanine, glycylsarcosine) in normal piglets and in piglets with acute viral diarrhea after experimental infection with transmissible gastroenteritis (TGE) virus. In the TGE jejunum villi were blunted, crypts were deepened, and the epithelium was composed of relatively undifferentiated cells with reduced disaccharidase, decreased sodium-potassium-stimulated ATPase, and elevated thymidine kinase activities. The response of Na absorption to a maximal concentration of L-alanine (20 mM) or D-glucose (30 mM) was significantly blunted in TGE jejunum in Ussing chambers. However, the addition of L-alanine together with D-glucose caused a significantly greater increment of Na absorption than either L-alanine or D-glucose alone in control and TGE tissue. The effect of Na absorption of the dipeptide L-alanyl-L-alanine (10 mM), which was rapidly hydrolyzed by control and TGE mucosa, was similar to that of L-alanine (20 mM), while glycylsarcosine, a poorly hydrolyzed dipeptide, did not change net Na absorption in the jejunum. Our data support the concept of separate carrier systems for neutral amino acid and hexose in the crypt-type intestinal epithelium characterizing viral enteritis. We speculate that a sodium-cotransporting amino acid, if added to oral glucose-electrolyte solutions, could benefit oral rehydration therapy in acute viral diarrhea; neither of the dipeptides tested here can be expected to enhance absorption to any greater extent than its constituent amino acids.

Alanine↗
PubMed1986

Intestinal repair in chronically undernourished rabbits.

To assess the effect of chronic undernutrition on intestinal epithelial repair after injury, we studied 10-wk-old rabbits, nutritionally deprived for 6 wk (body weight 1.95 +/- 0.2 kg versus controls, 2.68 +/- 0.7 kg, p less than 0.001). Intestinal structure and function were assessed 4, 24, 48, 72, or 96 h after a 90-min vascular occlusion of a 20-cm segment of midintestine in undernourished and control-diet animals. Tritiated thymidine autoradiography showed that movement of epithelial cells along the crypt-villus axis was significantly curtailed in undernourished rabbits after sham operation or after ischemic injury. In sham-operated rabbits, no significant differences were observed in mucosal structure, disaccharidase and Na-K-ATPase activities, or Na transport (Ussing chambers) between nutritionally deprived and control diet rabbits. Four and 24 h after ischemic injury, significant but similar structural and functional small intestinal abnormalities occurred in both diet groups; recovery of enzyme function was not significantly delayed but crypt-villus length recovery was minimally delayed in undernourished rabbits. Glucose-stimulated Na absorption diminished in short circuited jejunum from malnourished but not from control diet animals 24 h after injury and was normal in both diet groups at 72 h. After transient small intestinal villus cell injury we observed suppressed epithelial proliferation but no consistent impact on epithelial differentiation in nutritionally deprived rabbits.

Animals↗
PubMed1985

Altered jejunal permeability to macromolecules during viral enteritis in the piglet.

We studied the macromolecular permeability of segments of jejunum from 2-wk-old piglets after the animals had been experimentally infected with an invasive enteric virus, transmissible gastroenteritis virus. Jejunal segments were mounted in Ussing chambers at stages of the infection, and permeability was measured using three probe molecules of differing molecular weights. In control tissue, permeability to horseradish peroxidase was 2.6 times higher across segments with Peyer's patches than across segments without Peyer's patches, whereas polyethylene glycol 4000 and mannitol permeabilities were the same in patch and nonpatch segments. Twelve hours after infection, when virus had invaded the mucosa causing a structural lesion, and before diarrhea had begun, horseradish peroxidase permeability increased in non-patch-containing segments to equal that across patch-containing tissue. At this early 12-h stage, polyethylene glycol 4000 and mannitol permeation were unchanged in patch-containing segments compared with controls. Ninety-six hours after transmissible gastroenteritis infection, when diarrhea was severe, horseradish peroxidase permeability in patch-free segments had returned to normal and patch-containing tissue permeability was diminished below control levels. Increased macromolecular permeability appears to occur only in the very early invasive stage of this viral enteritis and only in patch-free segments. Any consideration of the immunologic relevance of these complex phenomena must take into account the specialized function of the Peyer's patch regions of the small intestine.

Animals↗
PubMed1985

Treatment of acute diarrhea.

The application of new pathophysiologic information to the treatment of diarrheal diseases has greatly enhanced the outlook for millions of young patients in many developing countries. This article outlines the basis and nature of these therapeutic advances in the belief that they are relevant, not only in Asia and South America, but also throughout North America.

Child, Preschool↗
PubMed1985

Effect of Cultural Practices, Soil Phosphorus, Potassium, and pH on the Incidence of Fusarium Head Blight and Deoxynivalenol Levels in Wheat.

In a survey conducted in 1984 in Essex, Lambton, and Middlesex Counties of Ontario, Canada, greater incidences of head blight and greater concentrations of deoxynivalenol in grain were observed in fields of winter wheat planted after corn than in those planted after soybeans, barley, and mixed grains. Neither head blight nor deoxynivalenol level were correlated significantly with soil P, K, or pH. Head blight was reduced in wheat planted after corn where the residues from a preceding corn crop were plowed down or where seed was treated with Vitaflo 280. However, head blight and deoxynivalenol levels were not affected significantly by the level of N application, cultivar, other diseases or herbicides.

Journal Article↗
PubMed1985

D-Glucose transport in piglet jejunal brush-border membranes: insights from a disease model.

We measured glucose transport in jejunal brush-border membrane vesicles isolated from piglets with acute viral diarrhea, comparing our results with those from control animals. Characterization of membranes from both study groups demonstrated comparable purity and integrity. In the presence of an inwardly directed Na SCN gradient, D-glucose accumulated in control vesicles to a concentration several times the 60-min equilibrium level. "Overshooting" uptake was much lower and more gradual in vesicles from 40-h transmissible gastroenteritis (TGE)-infected pigs compared with control pigs. Equilibrium kinetic studies, in which gramicidin was used to clamp membrane potential at zero, demonstrated a pattern of Na-dependent D-glucose transport in 40-h TGE-infected membranes that differed greatly from the control pattern. From an Eadie-Hofstee plot of stereospecific Na-dependent D-glucose uptake into control vesicles, a pattern suggesting two carrier populations emerged: one with a low-affinity, apparent Km equaling 52.63 +/- 13.81 mM and the other a high-affinity apparent Km equaling 3.92 +/- 0.24 mM for D-glucose. In 40-h TGE-infected membranes, the pattern conformed to a single line, suggesting a homogeneous population of low-affinity carriers, (Km = 37.03 +/- 1.92 mM), which did not differ from the low-affinity carriers seen in control animals. We conclude that the absence of the high-affinity D-glucose carriers in jejunal brush-border membrane is an important determinant of the defective glucose transport that characterizes viral diarrhea. Because previous studies have strongly suggested that in acute TGE diarrhea the epithelium is composed of relatively undifferentiated crypt-type cells, we speculate that high-affinity D-glucose carriers are lacking in normal crypt epithelial cells and that they are incorporated into brush-border membranes of jejunal enterocytes as the cells differentiate in the course of their migration from crypt to villus.

Alkaline Phosphatase↗
PubMed1985

Impact of chronic protein-calorie malnutrition on small intestinal repair after acute viral enteritis: a study in gnotobiotic piglets.

To investigate the effect of chronic protein-calorie malnutrition on intestinal repair after an enteric infection, we examined small intestinal structure, enzyme activity, and sodium transport in undernourished piglets during the acute and convalescent phases of a viral enteritis, transmissible gastroenteritis (TGE). Gnotobiotic pigs, nutritionally deprived from the age of 7 days, gained less weight than dietary controls from 14 days of age until the end of the study. Animals from malnourished and control diet groups were inoculated with TGE virus at 22-23 days and studied during the acute (40 h) and convalescent (4, 10, and 15 days) stages of this experimental enteritis along with noninfected dietary controls. After TGE infection, we observed a further decrease in weight gain and an increased mortality only in undernourished pigs. In jejunum and ileum of both dietary groups at 40 h after TGE infection, we observed comparable structural lesions, similar decreased activities of mucosal enzymes (sucrase, lactase, sodium-potassium-dependent ATPase), and increased thymidine kinase activities. Also we noted comparable diminution of glucose-stimulated jejunal sodium absorption in both dietary groups at 40 h. In control diet pigs, transport abnormalities recovered by 4 days after TGE infection and normal mucosal structure and enzyme activity returned over 4-15 days. In undernourished piglets, structural repair and enzyme abnormalities were prolonged when compared with the control diet group; glucose-stimulated sodium transport did not recover until 10 days after infection and never regained the enhanced activity seen in noninfected undernourished controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Viral diarrhea.

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Biological Transport, Active↗