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Biomedical subjects

M Hobsley

Publications and source records attributed to M Hobsley.

At least 109 records · Page 6Linked to original sources
PubMed1975

Hypersecretion and length of history in duodenal ulceration.

Maximal gastric secretion, measured by the histamine-infusion test, was, as expected, significantly greater in a group of 81 patients with duodenal ulcer than in a group of 72 controls. After standardising for the effect of stature on maximal secretion, only 24 of the patients were found to be true hypersecretors. However, maximal secretion in the ulcer group increased with length of history of symptoms, and extrapolation back to zero length of history suggested that there was no significant hypersecretion at that time. These facts support the hypothesis that it is the presence of the ulcer that leads to hypersecretion rather than the converse. Possible mechanisms involved are chronic ingestion of antacids to counter dyspepsia, or gastric distension due to pylorospasm.

Adolescent↗
PubMed1975

The predictive accuracy of the postvagotomy insulin test: A new interpretation.

Insulin-stimulated gastric secretion alone, without reference to basal secretion, has been examined in 45 male patients with duodenal ulcer in whom no gastric operation had been performed and in 124 patients following vagotomy for duodenal ulcer. Gastric juice was examined in terms not only of conventional indices, observed volume, titratable acidity and acid output, but also Vg, the volume corrected for pyloric loss and duodenal reflux. The range of secretion of the unoperated subjects was established in terms of peak and half-totwo-hour values for all indices. By reference to these ranges, secretion of postvagotomy subjects could be divided into two groups: (a) those with secretion within the preperative range, and (b) those with secretion less than the lower limit of the preoperative range. The best discrimination was given by Vg; those within the preoperative range (peak Vg in excess of 140 ml/hour and Vg half to two hours in excess of 105 ml/hour) had a 50% liability to recurrent ulcer, while those below the preoperative range had a zero liability to recurrent ulcer. Of the conventional indices acid output gave the best discrimination, which was almost as good as Vg. Peak acid output of 8 mmol/hour or acid output one half to two hours of 525 mmol/hour discriminated into two groups, with a 50% or zero liability to recurrent ulcer. Titratable acidity (Hollander's index of secretion), being highly susceptible to reflux, was not an adequate discriminant.

Chlorides↗
PubMed1975

Stability of insulin-induced gastric secretion after vagotomy.

Gastric secretory response to insulin-induced hypoglycaemia was stuided in 21 subjects following vagotomy and a drainage procedure for duodenal ulcer. Eighteen subjects had one early test, ie, within one month of operation, and at least one late test, ie, six months or more after operation. Seven subjects had at least two late tests. When the insulin test results were expressed in terms of their Hollander status,there was as much variability with time as expected from previous reports. However, when results were expressed in terms of new criteria, decribed in the previous paper, the insulin status of postvagotomy patients remained constant with time.

Drainage↗
PubMed1974

Duodenal reflux during insulin-stimulated secretion.

Insulin-stimulated secretion has been studied in 67 subjects with intact vagi. The relationship between the changes in the concentrations of hydrogen and sodium ions in individual 10-minute samples showed a highly significant negative correlation. In quantitative terms, this correlation could be explained by the mixing of isotonic gastric juice and duodenal reflux but not by back-diffusion. In 37 subjects duodenal juice was labelled with either bromsulphalein (BSP) or indocyanine green (ICG), both dyes being excreted only in the bile. In aspirated gastric juice there were highly significant positive correlations between the concentration of the dye and the concentration of duodenal reflux calculated from a formula based on the output of sodium ions. The volume of duodenal reflux occurring during insulin-stimulated secretion was estimated from the sodium output in normal controls, in preoperative patients with duodenal ulcer, and in patients following vagotomy with or without a drainage procedure. Reflux following gastrojejunostomy greatly exceeded that occurring in all other groups. Reflux following vagotomy with no drainage procedure was less than that in preoperative patients, and in patients in whom pyloroplasty or gastrojejunostomy had been performed.

Duodenal Diseases↗
PubMed1974

The dumping syndrome and the hydrogen ion concentration of the gastric contents.

Forty patients after vagotomy (truncal vagotomy 18, selective vagotomy 22) with a drainage procedure were given 200 ml of 50% dextrose by mouth (dumping provocation test), the symptoms induced being noted, and any fall in plasma volume was assessed by serial measurement of the haematocrit. An insulin gastric secretion test was also performed on each patient.TWENTY OF THE PATIENTS HAD DUMPING SYMPTOMS OF VARYING SEVERITY AFTER ORDINARY MEALS: in all 20 patients these symptoms were reproduced by the dumping provocation test, which also produced similar symptoms in a further three patients. The hydrogen ion concentration of the gastric contents was significantly lower in the basal state and after insulin hypoglycaemia in those patients with dumping symptoms than in those without such symptoms. Furthermore there was a significant inverse correlation between the hydrogen ion concentration of the gastric contents in the basal and stimulated state and the rate of plasma volume fall. The results show that the occurrence of the dumping syndrome after vagotomy with a drainage procedure is related to the hydrogen ion concentration of the gastric contents. The possible significance of this finding is discussed.

Adult↗
PubMed1974

Primary FRSC (Eng). I. Evaluation of assessment techniques.

In five consecutive Primary Examinations for the Fellowship of the Royal College of Surgeons of England, the scores of candidates in the multiple choice question paper, written paper, and oral interview have been analysed for mutual correlations and for the reproducibility of the written paper score. The conclusions reached were that all these scores correlate with each other, that no score can be left out without reducing the reliability of the examination, that the marking of written papers in a close-marking system is remarkably reproducible, and that the oral score contributes most, the multiple choice question paper the least, to the overall assessment.

Anatomy↗