Biomedical subjects
J R Hamilton
Publications and source records attributed to J R Hamilton.
Psychological problems in children with abdominal pain.
The prevalence of psychological problems was investigated in 44 children with abdominal pain of organic origin (Crohn's disease, 24; ulcerative colitis, 20), 16 children with non-organic abdominal pain, and 30 pain-free controls. A self-report battery of five tests was used to measure personal, family, and social adjustment. Compared with controls, all three abdominal-pain groups showed psychological problems. Of significance were depression and low self-esteem in patients with Crohn's disease, depression in those with ulcerative colitis, and low self-esteem in those with non-organic pain. No differences were found between patients with organic and those with non-organic pain. These findings indicate that psychological distress accompanies both organic and non-organic abdominal pain in children and that psychological evaluation may not readily distinguish organic from non-organic cases.
Myocardial contusion associated with fracture of the sternum: important features of the seat belt syndrome.
Recent legislation has led to increasing numbers of car occupants wearing seat belts and presumably the number of injuries attributable to seat belts will also increase. The commonest such injury is a fracture of the sternum, and blunt myocardial damage is a logical sequel although often unsuspected and therefore unsought. Confirmation is difficult and ECG changes are usually absent or not specific. In three consecutive patients admitted with a fractured sternum we found raised blood levels of CK-MB (creatine kinase-myocardial band) and believe these indicate myocardial contusion. We therefore feel that an isolated fracture of the sternum should be considered a more serious injury than is initially apparent, as these patients are at risk of developing cardiac complications.
Surgery for benign esophageal stricture.
The long-term results of five different operations for benign lower esophageal reflux stricture, carried out over the 5 year period 1973 to 1977, are presented and evaluated. The 94 patients, 51 women and 43 men (mean age 61 years), underwent one of the following procedures: I, transthoracic Nissen fundoplication (26 patients); II, Bingham gastroplasty (20 patients); III, colon interposition (17 patients); IV, jejunal interposition (10 patients); and V, jejunal bypass (21 patients). Residual dysphagia (mean follow-up period 62 months) was significantly less in groups III, IV, and V (p less than 0.05), the more radical procedures, 87% of the patients having no dysphagic symptoms. This observation was corroborated by the greatly reduced (one sixth) number of postoperative dilatations required and also by the reduced need for reoperation. Only the colon interposition group, however, had an acceptable operative mortality (0%). The Bingham gastroplasty group also had a 0% operative mortality but achieved less good functional results, only 55% of patients having no dysphagic symptoms. Further analysis of functional results showed groups III, IV, and V to be superior regardless of the preoperative grade of stricture. The pros and cons of surgical antireflux procedures coupled with dilatation versus radical procedures to excise the stricture are presented. We conclude that, for an established benign stricture of the lower esophagus, colon interposition may offer the best long-term relief from dysphagia, with very low operative mortality.
Mental Health Act 1983.
Explore the source record for details and available documents.
Impact of malnutrition on the developing gut: studies in suckling rats.
Explore the source record for details and available documents.
Jejunal bypass of the cardia for benign stricture: report of six cases.
Explore the source record for details and available documents.
Quantitative determination of macromolecular transport rate across intestinal Peyer's patches.
We used horseradish peroxidase (HRP) (mol wt, 40,000) to compare in vitro, in Ussing chambers, the rates of protein transport across segments of piglet jejunum with and without Peyer's patches. The mean HRP transport rate across intestinal segments with a patch, 25.2 +/- 4.2 SE ng . min-1 . cm-2 (22 animals), was increased threefold (P less than 0.0005) compared with control (no patch) tissue, 7.9 +/- 1.0 ng . min-1 . cm-2 (n = 29). Neither rate showed saturation with increasing concentrations of HRP; both were inhibited 75-95% by a temperature drop from 37 to 15 degrees C. Transport across patch-containing tissue was inhibited 48 +/- 6% (n = 5, P less than 0.0025) by 1 mM NaF, but NaF had no consistent effect on the transport across tissue without Peyer's patches. We conclude that HRP transport is increased across Peyer's patches. This transport is dependent on metabolism and does not involve specific receptors. These findings support the concept that the Peyer's patch serves an antigen-sampling function in the gut.
Radionuclide angiography as the primary investigation in chemodectoma: concise communication.
A technique is described for investigating tumors of the carotid body and glomus jugulare. The examination comprises an easily performed radionuclide angiogram, and has been used to investigate 30 patients. This technique demonstrated seven carotid-body tumours, including two unsuspected clinically, and one tumor of the glomus jugulare. There was also one patient with a false-positive test for bilateral carotid-body tumors. Angiographic and/or surgical confirmation was obtained in all cases but one. A significant incidence of complication during contrast angiography was noted (two cases of transient hemiparesis). The radionuclide angiogram proved safer than contrast angiography and more reliable than clinical examination; it therefore appears to be the method of choice as the primary screening test in patients with suspected carotid-body and glomus-jugulare tumors.
Fecal clearance of alpha 1-antitrypsin: a reliable measure of enteric protein loss in children.
Explore the source record for details and available documents.
An evaluation of D-xylose absorption measurements in children suspected of having small intestinal disease.
Explore the source record for details and available documents.
Intestinal glucose transport in acute viral enteritis in piglets.
1. We studied intestinal glucose transport in pigs during the acute and convalescent phases of an invasive viral enteritis, transmissible gastroenteritis. 2. When diarhoea was severe 40 h after experimental infection, net absorption of glucose, Na+ and water, measured by marker perfusion in the jejunum, was reduced; the enhancement of Na+ and water absorption in response to increasing perfusate glucose concentrations up to 120 mmol/l was diminished compared with the response observed in control and convalescent pigs. 3. Measured in vitro, 40 h after infection, unidirectional fluxes of 3-O-methyl-D-glucose across the jejunal epithelium were reduced and net absorption of the sugar was obliterated. Phlorizin (0.05 mmol/l), which completely inhibited net 3-O-methyl-D-glucose absorption in control tissue, had no significant effect on transmissible gastroenteritis jejunum. 4. Our data suggest that in this invasive viral enteritis, which closely resembles human rotavirus enteritis, glucose absorption is impaired as a result of defects in both active and passive glucose flux. 5. Differences between the mechanisms of viral diarrhoea, demonstrated by our study and those of the enterotoxigenic diarrhoeas, should be taken into consideration in formulating active therapeutic measures for children with acute viral diarrhoea.
Effect of chronic malnutrition on intestinal structure, epithelial renewal, and enzymes in suckling rats.
Explore the source record for details and available documents.
Effect of cortisone on postnatal development of ion transport in rabbit small intestine.
To study the effect of corticosteroids on postnatal maturation of Na+ transport in the small intestine, we studied 10-12-day-old suckling rabbits after they had received cortisone acetate, 20 mg/kg SC on days 3, 4, and 5 of life. When killed, the cortisone-injected animals weighed significantly less than saline-injected controls. In jejunal villus enterocytes isolated from this cortisone-treated group, the specific activities of sucrase and Na+-K+-ATPase were significantly greater than those in control enterocytes. Studied in Using chambers, a significant electrical and ion-flux response to glucose was observed in the jejunal epithelium of the treated group, but not in controls. We conclude that exogenous cortisone, administered early in life, can stimulate the precocious development not only of certain epithelial enzymes but also glucose-facilitated Na+ transport in the jejunum of the rabbit.
Dietary fluids and diarrhea in babies.
Explore the source record for details and available documents.
Infectious diarrhea: clinical implications of recent research.
Explore the source record for details and available documents.
Response of the rat small-intestine epithelium to methotrexate.
We studied jejunal epithelial structure and function in rats 24, 48, 96, and 192 hours after a single intravenous injection of methotrexate (MTX) 30 mg/kg. The acute effect of the drug on the gut at 24 and 48 hours was characterised, as expected, by reduced mitoses in crypts, shortened villi, and depressed activity of thymidine kinase (an enzyme normally confined to intestinal crypt cells). At 96 hours, when MTX was no longer detectable in serum, the intestine had entered a proliferative phase characterised by increased crypt mitoses, accelerated migration of enterocytes along villi, and the presence on villi of epithelial cells with the enzyme profile of crypt cells, decreased disaccharidase, alkaline phosphatase, and Na+-K+ATPase activities and increased thymidine kinase activity. Although the enzyme data suggested that enterocyte maturation was defective during this proliferative phase, glucose-stimulated Na+ transport, normally a function of fully differentiated villus cells, was normal at 96 hours. Measured both in Ussing chambers and in suspensions of enterocytes isolated from villi, Na+ transport responded normally to glucose at 96 hours, although the response had been significantly depressed at 24 hours. These findings cannot be attributed to MTX-induced malnutrition, as all comparisons included pair-fed controls. We conclude that, in the MTX-induced malnutrition, as all comparisons included pair-fed controls. We conclude that, in the small intestine under conditions of altered epithelial renewal, some components of enterocyte function may be affected more than others. Comparing the present experimental model with another intestinal disorder, acute viral enteritis, in which proliferative activity is excessive, it is clear that the nature of the original intestinal injury is a significant determinant of the pattern of enterocyte response.