Selective fetal malnutrition: the effect of ethanol and acetaldehyde upon in vitro uptake of alpha amino isobutyric acid by human placenta.
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Acetaldehyde↗
Biomedical subjects
M Atkinson
Publications and source records attributed to M Atkinson.
Structural deterioration of prosthetic oesophageal tubes: an in vitro comparison of latex rubber and silicone rubber tubes.
In a series of 100 patients with carcinoma of the oesophagus or cardia undergoing palliative intubation at endoscopy using a latex rubber or a silicone rubber tube 2 cases of tube fragmentation were encountered and are described. The effects of hydrochloric acid, bile and irradiation on the tubes have been studied in vitro. After incubation in hydrochloric acid (0.1 mol/l), the breaking force of latex rubber tubes fell by 31 per cent (48 N) (but did not change significantly for silicone rubber tubes. The addition of bile to the hydrochloric acid (0.1 mol/l) did not further influence the breaking force of either type of tube. Megavoltage irradiation with 7500 rad did not affect the breaking strength of silicone rubber tubes but caused a reduction of breaking strength of latex rubber tubes. These findings suggest that silicone rubber has advantages over latex rubber as a material for prosthetic oesophageal tubes.
Aged↗
Effect of ethanol upon placental uptake of amino acids.
The effect of ethanol infusion upon placental uptake of amino acids was studied in pregnant sheep. Blood ethanol levels of 150-260 mg/dl obliterated the normal uptake of amino acids by the in vivo placenta. However, when human placental villi were incubated in vitro with ethanol at 300 mg/dl, there was no inhibition of uptake of 14C alpha-amino isobutyric acid (AIB). In contrast, 2-20 mM, but not 50 or 200 micro M, acetaldehyde significantly inhibited AIB uptake (% inhibition at 90 min: 2 mM, 23.5 +/- 9.6%; 5 mM, 33.8 +/- 4.7%; 10 mM, 54.6 +/- 2.9%; 20 mM, 61.5 +/- 7.5%; p less than 0.01 for all 4 concentrations). When human placental villi were preincubated with 10 micro M acetaldehyde, washed, and incubated with 14C-AIB in the absence of acetaldehyde, there was significant residual inhibition of AIB uptake. The data suggest that ethanol-associated placental injury may contribute to the pathophysiology of the fetal alcohol syndrome.
Acetaldehyde↗
Vagal function in relation to gastro-oesophageal reflux and associated motility changes.
Vagal function in 28 patients with gastro-oesophageal reflux was examined by determining gastric secretory response to insulin-induced hypoglycaemia and pulse-rate variation with respiration. Gastric secretory studies were also performed on 13 patients with duodenal ulcer who had not undergone operations. In all patients the presence and degree of oesophagitis were determined endoscopically and mucosal biopsy and oesophageal manometry were performed. Seven of the 28 patients with gastro-oesophageal reflux showed evidence of impaired vagal efferent function in the upper alimentary tract. No such impairment was found in those patients who showed manometric evidence of oesophageal spasm secondary to gastro-oesophageal reflux. Low pulse-rate variation with respiration was found in 12 of 27 patients with gastro-oesophageal reflux, suggesting dysfunction of cardiac vagal fibres. Impairment of efferent vagal supply may be a causative factor in some patients with gastr-oesophageal reflux but does not seem to be important in oesophageal spasm secondary to gastro-oesophageal reflux.
Adult↗
Treatment of a patient with clinical features of both eosinophilic gastroenteritis and polyarteritis nodosa with oral sodium cromoglycate.
A young patient who suffered from allergic respiratory disease presented with an illness characterized by abdominal pain, diarrhea, and weight loss. Investigations revealed radiological and pathological features consistent with a diagnosis of eosinophilic gastroenteritis. Because of extensive gastric ulceration, treatment with corticosteroids was withheld and in its place oral sodium cromoglycate therapy given. The patient's intestinal symptoms rapidly responded to this treatment and remained controlled for a period of five months. The patient subsequently developed a systemic illness with features of polyarteritis nodosa.
Adult↗
Outlook with conservative treatment of peptic oesophageal stricture.
In order to assess the outlook for patients with peptic oesophageal strictures treated by Eder Puestow dilatation at fibreoptic endoscopy, 50 patients were followed up for periods ranging from nine months to four years. Twenty patients (40%) required only a single dilatation, and the remaining 30 (60%) required multiple dilatations. The frequency of dilatation tended to decrease with time. There was one death attributable to the procedure. Two patients developed an adenocarcinoma at the site of the stricture. We conclude that conservative management of peptic oesophageal stricture combining the use of dilatation at fibreoptic endoscopy with medical measures to control gastro-oesophageal reflux offers a relatively safe means of providing symptomatic relief, maintaining nutrition, and allowing the patient an acceptable quality of life.
Aged↗
Endoscopic insertion of fine-bore feeding tubes.
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Endoscopy↗
Cimetidine in treatment of reflux oesophagitis with peptic stricture.
Twenty patients with reflux oesophagitis causing a tight peptic oesophageal stricture entered a randomised double-blind crossover trial in which they received cimetidine, 1.6 g daily, and matching placebo each for six months. The gross endoscopic appearances of oesophagitis, though not the grades of histopathological changes, showed significant improvement during treatment with cimetidine. The need for dilatation of the strictures, however, was not reduced.
Aged↗
Effect of different operation policies on mortality from bleeding peptic ulcer.
The outcome in bleeding gastric and duodenal ulcer has been compared in two hospitals in Nottingham which take their patients randomly from a common source according to a fixed daily admission rota. Bleeding seemed equally severe in the two groups but 66 (32%) of 206 patients were operated upon at hospital A compared with 44 (46%) of 96 at hospital B (P=0.03), where operations also tended to be done earlier. Postoperative mortality-rates were virtually identical at the two hospitals, but at hospital B the overall death-rate from bleeding ulcer was higher, partly because of its higher operation-rate. The value of an aggressive surgical policy in bleeding peptic ulcer is questionable.
Adult↗
Management of malignant dysphagia by intubation at endoscopy.
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Deglutition Disorders↗
Tube introducer and modified Celestin tube for use in palliative intubation of oesophagogastric neoplasms at fibreoptic endoscopy.
A new method for palliative intubation of inoperable neoplasms at or near the cardia is described. A guidewire is passed through the stricture, which is dilated using Eder Puestow metal olive dilators. The tube to be inserted is mounted on an introducer, which grips its distal end from inside, and is slid into position along the wire under radiological control. Twenty-five patients have been intubated with one death directly resulting from the procedure. The method provides a simple and relatively safe means of relieving dysphagia and improving nutrition.
Deglutition Disorders↗
Circadian rhythm disorders in manic-depressives.
Seven circular manic-depressives were studied through complete of cycles of mania and depression. In five subjects, there was evidence that a circadian rhythm free-ran fast (p less than 0.005 and p less than 0.002 in two of the subjects), and in five subjects, there was evidence that lithium slowed a circadian rhythm. The palliative benefit of lithium may derive from slowing or delaying an overfast circadian clock to prevent desynchronization. Two subjects whose circadian clocks seemed too slow were lithium nonresponders (p less than 0.05). As circadian clock frequency may be transmitted on an X-chromosome gene and may increase with age, a circadian etiology is consistent with the genetics and age distribution of manic-depressive illness. Affective disturbances could be evolutionary remnants of the photo-periodic seasonal responses in animals.
Adult↗
A prospective, randomised study of endoscopy and radiology in acute upper-gastrointestinal-tract bleeding.
318 patients admitted to hospital with acute upper-gastrointestinal-tract bleeding were entered into a prospective randomised comparison of investigation by either endoscopy or radiology. Although the diagnostic yield was higher in the endoscopy group than the radiology group, there was no difference between the two groups in management or survival, and the accuracy of the findings as judged independently at operation and/or necropsy was also similar in the two groups. These findings case doubt on the need to provide emergency endoscopic facilities for the investigation of patients with acute upper-gastrointestinal-tract bleeding where radiological services are already adequate.
Acute Disease↗
Fibreoptic endoscopic palliative intubation of inoperable oesophagogastric neoplasms.
Palliative intubation for inoperable malignant strictures at the cardia was done on 16 occasions in 13 patients using fiberoptic endoscopy. Preliminary dilatation was performed, and the Celestin tube was mounted on an introducer and passed over a guide wire inserted with a fiberoptic endoscope. Only one death resulted from the procedure and all the 12 patients who left hospital were swallowing satisfactorily on discharge. The method provided a simple and relatively safe means of relieving dysphagia and improving nutrition.
Cardia↗
Diseases of the alimentary system. Dysphagia.
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Deglutition Disorders↗
Esophageal intraluminal pH recording in the assessment of gastroesophageal reflux and its consequences.
Intraluminal pH in the lower esophagus has been recorded during a 3-hr period following a ligh meal and a consecutive 12-hr nocturnal period in 20 patients with typical symptoms and radiological evidence of gastroesophageal reflux and in 10 patients without such signs of reflux. Evidence of acid reflux was obtained in 3 of the patients without reflux during the postcibal period but in only one during the 12-hr nocturnal period. In contrast all except one of the 20 patients who had evidence of reflux showed spells of high acidity both in the postcibal and nocturnal periods. There was no clear correlation between the frequency of paf high acidity in the nocturnal period. Those patients with endoscopic evidence of severe esophagitis showed a significantly longer duration of high esophageal acidity in the nocturnal period. We conclude that nocturnal exposure of the esophageal mucosa to acid is a major factor in the causation of reflux esophagitis.
Esophagitis↗
An evaluation of multiphasic screening on admission to hospital. Precis of a report to the National Health and Medical Research Council.
A controlled study of admission multiphasic screening (AMS) at a large general hospital showed that AMS had no significant effect on a variety of indices of inpatient progress. Owing to a 64% increase in estimated cost of investigations with AMS, the total hospital admission cost was increased by approximately 5%. Under the conditions of this study, AMS added to the cost of hospitalization without associated evidence of benefit to the patient.
Australia↗