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Biomedical subjects

N D Finlayson

Publications and source records attributed to N D Finlayson.

At least 55 records · Page 3Linked to original sources
PubMed1980

The effect of age on the intravenous sodium glycocholate test.

The clearance of an injected dose of sodium glycocholate has been studied in a group of 23 control subjects who had no evidence of liver disease. A significant correlation was found between bile salt clearance and age. No significant difference was found between the bile salt clearance of male and female subjects. Data derived from a simple compartmental model indicated that decreased clearance of bile salt with age was not specifically related to degenerative changes in hepatocellular integrity, hepatic uptake of bile salts or bile flow.

Adolescent↗
PubMed1980

Sedation for upper gastro-intestinal endoscopy. A comparison of oral temazepam and i.v. diazepam.

Temazepam 20 mg orally was compared with titrated doses of i.v. diazepam as sedation for elective upper gastro-intestinal endoscopy. The mean time from taking oral temazepam to endoscopy was 66 min, and from i.v. diazepam to endoscopy was 10 min. The endoscopists found that the sedation achieved was the same in both groups and allowed adequate examination of the upper alimentary tract. The oral presentation, avoiding the pain of injection and the possible shorter duration of action, made oral temazepam preferable to i.v. diazepam.

Administration, Oral↗
PubMed1980

Bile salt transport in the Dubin-Johnson syndrome.

Serum bile salt measurements and intravenous clearance of glycocholate were performed in a woman with Dubin-Johnson syndrome. Fasting conjugated cholate concentration was raised and prolonged intravenous clearance of sodium glycocholate revealed a secondary rise in conjugated cholate concentration after two hours. The intravenous clearance of bromsulphthalein also showed a secondary rise. These findings support the proposal that Dubin-Johnson syndrome is not homogeneous and that in some patients a abnormality of bile salt clearance coexists with an abnormality of bilirubin nd bromsulphthalein clearance.

Aged↗
PubMed1980

Are serum bile salt concentrations raised in hyperlipidaemia?

We have studied serum fasting and postprandial primary bile salt concentrations in a group of 10 consecutive hyperlipidaemic subjects. The efficiency of hepatic bile salt clearance in the same subjects was aslo studied using an injected dose of sodium glycocholate. No increase in serum fasting or postprandial concentrations of the primary bile salts were observed and hepatic bile salt clearance was only marginally abnormal in one subject. The presence of hyperlipidaemia does not invalidate the use of serum conjugated bile salt analysis for the detection of liver diseases.

Aged↗
PubMed1980

Weight loss in primary biliary cirrhosis.

Duodenal bile salt concentrations were measured throughout one day in six patients with primary biliary cirrhosis while they were eating a normal ward diet. Five of them had lost weight; none had ascites. Each patient had a radiologically normal small bowel and a normal jejunal biopsy. No clear relationship between high faecal fat excretion and abnormally low duodenal bile salt concentration was found. Xylose absorption was abnormal in five patients. If weight loss in primary biliary cirrhosis is due to malabsorption, factors other than a reduced small intestinal bile salt concentration must be important.

Aged↗
PubMed1979

Are increased individual susceptibility and environmental factors both necessary for the development of primary biliary cirrhosis?

A daughter, her mother, and an unrelated close friend developed primary biliary cirrhosis (PBC). The mother and the close friend nursed the daughter through her terminal illness and presented with PBC PBC within 21 months after her death. Half of the asymptomatic first-degree relatives in the two families had serum autoantibodies, including one with antimitochondrial antibody, suggesting some genetic susceptibility to abnormal immune reactions. It is concluded that some environmental factor may be present in PBC, perhaps in addition to a genetic susceptibility to that factor.

Adult↗
PubMed1979

Iodine 131 labelled ioglycamic acid (Biligram) for scintiscanning in hepatobiliary disorders.

Iodine-131 labelled Biligram has been evaluated as a radiopharmaceutical for dynamic scintiscanning of the liver and biliary tract. In 10 normal subjects there was good visualisation of the liver and gallbladder. In 18 patients 131I Biligram was found to be unsatifactory for differentiating parenchymal liver disease from biliary tract obstruction owing to inability to demonstrate the gallbladder when liver function was more than mildly deranged. Quantitative analyses of blood clearance and hepatic activity curves for 131I Biligram were not clinically helpful. Urinary excretion of 131I Biligram increased with the degree of hepatic dysfunction.

Biliary Tract Diseases↗
PubMed1979

Paracetamol metabolism in chronic liver disease.

The plasma concentrations and urinary excretion of paracetamol and its glucuronide, sulphate, cysteine and mercapturic acid conjugates were measured in eight normal subjects, eight patients with mild liver disease and seven patients with severe liver disease following an oral dose of 1.5 g of paracetamol. The mean plasma paracetamol half-life was similar in normal subjects (2.43 h +/- 0.19) but was significantly prolonged in all patients with severe liver disease (4.25 h +/- 1.15:p = less than 0.001). Prolongation of the paracetamol half-life was related to reduced plasma albumin and increased prothrombin time. The mean ratios of plasma concentrations of unchanged paracetamol to paracetamol glucoronide and sulphate were significantly greater in patients with sever liver disease than the normal subjects. There were no significant differences in the overall 24-h urinary excretion of paracetamol and its glucuronide, sulphate, cysteine and mercapturic acid conjugates in the three groups. The glutathione conjugation of paracetamol did not seem to be impaired in patients with severe liver disease as evidence by the production of normal amounts of the cysteine and mercapturic acid conjugates. There is thus no evidence that they are at increased risk of hepatotoxicity when given a single therapeutic dose of paracetamol.

Acetaminophen↗
PubMed1979

Effects of lysine vasopressin and glypressin on the fibrinolytic system in cirrhosis.

In eight patients with cirrhosis of the liver and portal hypertension an intravenous infusion of lysine vasopressin induced a rapid increase in the plasma level of the fibrinolytic proenzyme plasminogen activator. In contrast, triglycyl lysine vasopressin (glypressin; GVP), in a dose known to lower portal venous pressure, produced no fibrinolytic response. This lack of fibrinolytic response represents an advantage of GVP over lysine vasopressin in addition to its longer in vivo half-life and lower cardiotoxicity. Clinical trials of GVP in the treatment of bleeding oesophageal varices are needed.

Aged↗
PubMed1979

Sea blue histiocytosis in a patient with chronic non-neuropathic Niemann-Pick disease.

A patient with Niemann-Pick disease is reported together with family studies. Her liver and bone marrow were shown to be infiltrated with sea blue histiocytes. Other organs, spleen and lung, were presumably also involved but histological proof was not obtained. Enzyme assay of leucocytes, lymphocytes, and cultured skin fibroblasts showed the patient to be deficient in sphingomyelinase activity. In fibroblasts, activity was 5% of normal while for the parents activity was about 50% of normal. The expected partial deficiency was not found using leucocytes or lymphocytes from the parents. Heat stability studies on fresh fibroblast extracts from the propositus indicated that residual sphingomyelinase activity was slightly more labile than that of the controls. It seems clear that chronic Niemann-Pick disease without neurological involvement is associated with sea blue histiocytosis.

Bone Marrow↗
PubMed1978

Primary biliary cirrhosis and coeliac disease: an association?

The association of primary biliary cirrhosis and coeliac disease, not previously reported, was observed in 4 patients. In each case, the two conditions were diagnosed simultaneously, and although symptoms were due to coeliac disease, initial investigation drew attention to the liver condition. All the patients responded to a gluten-free diet and remain well 2 years later. Primary biliary cirrhosis remains asymptomatic in 3 patients, but pruritus has developed in the 4th. The significance of this association is unclear and may merit formal study. Coeliac disease should be considered as a possible cause of unexplained weight loss in primary biliary cirrhosis.

Aged↗
PubMed1978

Premedication for upper gastrointestinal endoscopy: a comparative study of flunitrazepam, diazepam and neuroleptanalgesia.

Flunitrazepam or diazepam with atropine and a combination of phenoperidine, droperidol and cyclizine (neuroleptanalgesia) were compared as premedication in three groups of 25 patients undergoing routine upper gastrointestinal endoscopy. Drug doses were titrated carefully against response and all three regimes were found to be similar in terms of safety, patient co-operation, relaxation and speed of recovery. Neuroleptanalgesia however produced a statistically significant rise in endtidal pCO2 and systolic blood pressure. The benzodiazepines, and in particular flunitrazepam, produced a significantly greater amnesia for the procedure, patients given these drugs being more willing to undergo repeat endoscopy.

Anti-Anxiety Agents↗
PubMed1977

Antipyrine, paracetamol, and lignocaine elimination in chronic liver disease.

The plasma half lives of antipyrine, paracetamol, and lignocaine given by mouth were measured in 23 patients with stable chronic liver diseases of varying severity. Fifteen patients received all three drugs and 19 at least two. The half life of paracetamol was abnormally prolonged in nine out of 17 patients (mean 2-9 hours, normal 2-0 hours), of antipyrine in 10 out of 19 patients (mean 30-4 hours, normal 12-0 hours), and of lignocaine in 19 out of 21 patients (mean 6-6 hours, normal 1-4 hours). Prolongation of the half lives of all three drugs was significantly correlated with an increase of the vitamin-K1-corrected prothrombin time ratio and a reduction in serum albumin concentration. There was no correlation with serum bilirubin concentration or serum alanine aminotransferase activity. This suggests that impaired drug elimination was related to depressed hepatic protein synthesis. Considerable prolongation of the half life of one drug was invariably associated with delayed elimination of the others. The half life of lignocaine, however, was always the most prolonged and was a highly sensitive indicator of hepatic dysfunction. The pharmacokinetic characteristics of a drug as well as the severity of liver disease should be taken into account when considering drug dosage in patients with chronic liver disease.

Acetaminophen↗
PubMed1976

Death in acute upper gastrointestinal bleeding. Can endoscopy reduce mortality?

In a retrospective analysis of 64 deaths from acute upper gastrointestinal bleeding in Edinburgh Royal Infirmary, 46 of the patients (72%) were found to have been over 60 years of age. Recurrent or continuous bledding occurred in 24 cases; after exclusion of deaths from sudden exsanguination (9) and from bleeding varices with subsequent hepatic failure (11), only 4 patients died from recurrent bleeding. Other causes of death were postoperative complications (20) and other severe concomitant disease (20). These results suggest that improved diagnostic techniques such as endoscopy may not significantly reduce the mortality from acute upper gastrointestinal bleeding.

Acute Disease↗