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Biomedical subjects

N D Grace

Publications and source records attributed to N D Grace.

At least 91 records · Page 5Linked to original sources

Studies in sheep on the absorption of magnesium from a low molecular weight fraction of the reticulo-rumen contents.

1. Six sheep, three animals per diet, were prepared with rumen fistulas and fed on frozen grass or grass-maize pellets to give magnesium intakes of 1.79 and 2.23 g/d respectively. The mean apparent availabilities of Mg in sheep fed on frozen grass and grass-maize pellets were 0.31 and 0.36 respectively. 2. The rumen contents were fractionated by straining the digesta through linen cloth and then differentially centrifuged to give 20,000 g and 100,000 g supernatant fractions. 3. In all sheep, regardless of diet, at 4 and 16 h after a meal, 50 and 60% respectively of the total Mg in the rumen contents was found in strained rumen fluid while 30 and 38% respectively of the total Mg was found in the 100,000 g supernatant fraction. 4. The net absorption of Mg from the temporarily isolated and washed reticulo-rumen was studied using either 100,000 g supernatant fractions of rumen contents from sheep fed on one or other of the two diets, or inorganic buffers containing the same concentration of Mg and other macroelements. 5. The Mg was readily absorbed from the 100,000 g supernatant fraction placed in the rumen with the rate of absorption being 7.3 mumol/l per min (505 mg/d) from the supernatant fraction obtained from sheep fed on frozen grass and 11.3 mumol/l per min (781 mg/d) from the supernatant fraction from sheep fed on grass-maize pellets. In the same sheep, the previously described rates of Mg absorption from the 100,000 g supernatant fraction were similar to those obtained from the comparable inorganic buffers. 6. The effects of varying concentrations of potassium and sodium on the net absorption rate of Mg (as 24Mg) and on the one-way efflux of Mg (as 28Mg) from supernatant fractions or rumen fluid and inorganic buffers were investigated using the temporarily-isolated and washed rumen in three sheep. Although the net absorption rate of 24Mg from supernatant fractions or buffers containing similar K concentrations varied significantly between sheep, a similar percentage decrease in the absorption rates of both 24Mg and 28Mg was found for each sheep as the K concentration was increased. 7. One pair of sheep was fed on the frozen grass and the other pair was fed on the grass-maize pellets. Their daily intakes of K were then increased to 50 g/d for 14 d by intrarumen infusion of potassium chloride. In three of the four sheep the plasma Mg concentration fell within 12 h of the start of the KCl administration.(ABSTRACT TRUNCATED AT 400 WORDS)

Absorption↗

Granulocytopenia complicating colchicine therapy for primary biliary cirrhosis.

A case is presented of a 76-yr-old woman with primary biliary cirrhosis and adult polycystic liver disease who developed bone marrow toxicity associated with chronic low-dose colchicine therapy. Two months after starting colchicine therapy (0.6 mg b.i.d. p.o.), the patient developed hematologic toxicity as evidenced by transient but profound granulocytopenia which promptly reversed 4 days after the drug was stopped. Bone marrow examination revealed moderate hypocellularity of all cell lines and striking dysplastic changes in the late myeloid and erythroid series. There was no apparent toxicity involving other organ systems. The patient fully recovered. This case is compared with previous descriptions of colchicine toxicity.

Aged↗

The clinical significance and natural history of the double pylorus.

The double pylorus is a fistulous communication between the gastric antrum and duodenal bulb. In most instances, it is believed to be a complication of peptic ulcer disease. In prior reports, the longest follow-up has been only 5 years. We report four cases of double pylorus, three of which have been followed medically (one for 7 years), and a fourth which required surgery for recurrent pain after 10 years of medical treatment. In previously reported cases, only 20% have required surgery, usually for refractory symptoms, whereas 80% of patients have been managed medically and have been free of complications. In one of our cases, the mucosal bridge separating the pylorus from the fistula perforated, with coalescence of the two channels into one large gastroduodenal passage. There were no serious clinical symptoms or sequelae caused by this additional destruction of tissue. We conclude that the double pylorus is a destructive but relatively benign complication of peptic ulcer disease.

Aged↗

Phosphorus kinetics in the sheep.

1. Ten castrated young adult sheep were brought indoors and given lucerne chaff (four animals with a phosphorus intake of 2 . 40 g/d) and fresh Ruanui ryegrass (six animals with a P intake of 3 . 72 g/d) to determine various kinetic indices of their P metabolism. 2. The results obtained from combined nutritional balance and 32P radioactivity measurements were analysed using the simulation, analysis and modelling computer (SAAM) program. Since the plasma P specific activity curve was described by at least four exponential terms, a four compartmental model (M1, M2, M3 and M4) was used to describe the experimental values. 3. The mean mass of the total exchangeable P pool (MT) for the lucerne chaff-fed and Ruanui ryegrass-fed sheep was 25 . 5 and 28 . 8 g respectively, while the total P transport (VT) to the exchangeable pool (MT) was markedly lower for sheep given lucerne chaff compared to those given Ruanui ryegrass (54 . 1 v. 111 . 3 mg/kg body-weight per d). Likewise the rate of P absorption (Va), faecal endogenous loss of P (Vf), urinary P excretion (Vu) as well as the movement of P to (Vo+) and from (Vo-) the skeleton and soft tissue was also lower in the lucerne chaff-fed sheep. 4. The availability of P, that is the proportion of ingested P which is absorbed, was 0 . 56 and 0 . 62 for the sheep given chaff and fresh herbage respectively. 5. The P metabolism of one sheep (sheep no. 30) differed from the other sheep in that its plasma inorganic P concentration was higher (95 v. 54 mg/l). This was associated with a larger first compartment (M1), a more rapid P transport between M1, and M2, an increase in (Vo) and a marked increase in (Vu).

Animal Feed↗

Prolonged cholestasis and progressive hepatic fibrosis following imipramine therapy.

This report describes a middle-aged female who received imipramine for 7 days, developed severe cholestatic jaundice with features similar to primary biliary cirrhosis, and then improved clinically over the next 12 mo. Biochemical and histologic abnormalities persisted over a 14-yr period of follow-up, though subsequent administration of haloperidol may have influenced the long-term course. High levels of circulating immune complexes were also found 14 yr later, which raises questions about the relationship of primary biliary cirrhosis to drug-induced liver injury. A review of the literature on imipramine- and phenothiazine-related hepatic injuries reveals multiple similarities, and this case provides further evidence for a common hepatic reaction to the two drugs.

Antigen-Antibody Complex↗

Some effects of sulphur intake on molybdenum metabolism in sheep.

1. To investigate the effects of sulphur intake on molybdenum metabolism in sheep, ewes were given intakes of 0.3 or 3.5 mg Mo and 0.98, 1.33, 1.73 or 3.23 g S/d in a 2x4 factorial experiment with two replicates lasting 35 d. 99Mo with 0.1 mg carrier Mo was infused intravenously for the last 14 d and, when 99Mo concentrations in urine and faeces had attained plateaux (days 11-14), stable Mo and 99Mo balance trails were conducted; samples of blood and rumen contents were taken principally for studies of Mo distribution. 2. Increases in S intake caused the following changes in Mo metabolism; absorption decreased, urinary and faecal endogenous excretion decreased and retention increased; Mo concentrations in rumen contents decreased but the predominant association with the solid phase was unaffected; Mo concentrations in plasma decreased, but a higher proportion was associated with the protein fraction; Mo in protein-free plasma became apparently less ultrafiltrable at the glomerulus. 3. The pattern of response to S for each factor was generally curvilinear, the first increment in S intake having by far the greatest effect. The effect of S was generally greatest at the higher Mo intake. 4. It is suggested that the manifold effects of S on Mo metabolism are related to a common interaction in the rumen leading to the formation of Mo-complexes, possibly thiomolybdates, which are poorly absorbed but even more poorly excreted.

Animals↗

Gastroesophageal reflux and bleeding esophageal varices.

The incidence of gastroesophageal reflux was evaluated with the use of a pH probe in 12 patients with cirrhosis and recent variceal hemorrhage and in 15 healthy control subjects. Short episodes of reflux occurred in 42% of the patients and in 47% of the controls. During an observation period of 1 hr, the cumulative duration of reflux was similar in patients (2.5 +/- 1.3 min) and controls (3.1 +/- 1.4 min). Mean lower esophageal sphincter pressures were normal in both groups but did not show a significant correlation with the duration of reflux. These data support previous observations that gastroesophageal reflux dose not appear to be a contributing factor in the development of variceal hemorrhage.

Adult↗

Lower esophageal sphincter pressure and serum gastrin levels after mapped antrectomy.

We investigated the effect of mapped antrectomy with gastroduodenostomy on serum gastrin levels in fasting patients and resting lower esophageal sphincter (LES) pressure. Serum gastrin levels in fasting patients were lower in those who had an antrectomy without vagotomy (P less than .05) as compared to control subjects or patients with antrectomy and vagotomy. Resting LES pressure was similar in patients and controls and was not affected by the presence or absence of vagotomy. These findings suggest that (1) mapped antrectomy and gastroduodenostomy without vagotomy are followed by a decrease in serum gastrin and (2) resting LES pressure is not affected by mapped antrectomy and a decrease in serum gastrin level.

Adult↗

[Unusual esophageal motility disorder (author's transl)].

A 31 year-old female initially presented with clinical features consistent with achalasia, which were relieved by the Heller procedure. Several years later manometric tracings excluded the diagnosis of achalasia, and suggested a motility disorder of the esophageal body. A long esophageal myotomy was performed and was followed by a marked improvement in symptoms and a normalization of the manometric tracing. Multiple histologic sections from the surgical specimen revealed the absence of ganglion cells, a feature not previously described in motor disorders other than achalasia. These findings suggest that classification of esophageal motility disorders on the basis of manometric and histologic findings might not be possible and that surgical treatment should be directed towards the predominant symptoms.

Adult↗

Lower esophageal sphincter pressure and serum motilin levels.

The gastrointestinal hormone motilin has recently been proposed as having a physiological role in the determination of lower esophageal sphincter (LES) strength. The present study was performed to evaluate the effect of gastric alkalinization of LES pressure and serum motilin levels. Instillation of 0.1N NaHCO3 into the stomach resulted in a significant increase in LES pressure (P less than 0.01) without affecting serum motilin levels. No correlation was found between fasting serum motilin levels and resting LES pressure (r = -0.31). These observations do not support the theory that LES pressure increases during gastric alkalinization are mediated through motilin release.

Adult↗

Does lower esophageal sphincter incompetency contribute to esophageal bleeding?

The purpose of this study is to determine whether lower esophageal sphincter (LES) incompetency is a common occurrence in patients with liver cirrhosis and contributes to the development of variceal bleeding. Resting LES pressure (17.8 +/- 1.1 mm Hg) in 35 patients with cirrhosis was similar to that of our control population (17.3 +/- 2.0 mm Hg). No differences were found among patients with ascites, variceal hemorrhage, or with different degrees of hepatic decompensation. In both patients and control subjects the LES responded with a significant pressure increase to gastric alkalinization. Symptoms and radiological evidence of gastroesophageal reflux were extremely uncommon in patients with liver cirrhosis. Based on these data it is unlikely that acid-pepsin regurgitation is a significant factor in the development of variceal hemorrhage.

Adult↗

Studies on the flow of zinc, cobalt, copper and manganese along the digestive tract of sheep given fresh perennial ryegrass, or white or red clover.

1. Sheep fitted with a rumen fistula and either a re-entrant cannula at the proximal duodenum or a re-entrant cannula at the terminal ileum were given twice daily 480-520 g dry matter as fresh perennial ryegrass, or white or red clover. Flows of digesta were corrected to 100% recovery of chronic oxide. 2. The quantities (g/24 h) of zince and cobalt leaving the stomach were significantly greater than those in the food. No significant change was found in the quantities of copper and manganese. Significantly smaller quantities of Co (all three diets) and Zn (all diets except red clover) left the small intestine than those which entered this region. No significant differences in the quantities of Cu and Mn entering and leaving the small intestine were found. Significantly smaller quantities of Zn, Co, Cu and Mn were excreted in the faeces than entered the large intestine. 3. From the flow results it was determined that there was a significant net secretion of Zn and Co in the stomach, and a significant net absorption of Zn (except with the red-clover diet) and Co from the small intestine, and of Zp Co Cu and Mn from the large intestine.

Absorption↗

Use of blood component therapy for gastrointestinal bleeding in patients with cirrhosis of the liver.

A prospective study was designed to compare the administration of available fresh blood and component therapy in the treatment of gastrointestinal bleeding in patients with cirrhosis of the liver. Fifty bleeding cirrhotic patients were randomly assigned to treatment: 17 patients recieved 51 percent fresh blood (Group 1), 16 patients received 22 percent fresh blood (Group 2), and 17 patients received 25 percent component therapy consisting of packed cells, fresh frozen plasma, and platelet concentrate (Group 3). The mortality rate was unaffected by the type of blood replacement. Neither the blood replacement requirement (Group 1:51 plus or minus 0.9 units Group 2:5.5 plus or minus 0.8 units, Group 3:7.1 plus or minus 1.1 units) nor the duration of bleeding (Group 1:39 plus or minus 0.8 days, Group 2:6.3 plus or minus 2.4 days, Groups 3:5.8 plus or minus 1.0 days) were significantly different. There was no correlation between the mean age of blood or plasma received and the units of blood replaced or the duration of bleeding. Patients with severe coagulation abnormalties had a significantly increased mortality. Component therapy was as effective as the fresh blood regimen in cirrhotic patients with acute gastrintestinal hemorrhage.

Blood Transfusion↗