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Biomedical subjects

P J Collins

Publications and source records attributed to P J Collins.

At least 19 recordsLinked to original sources
PubMed1991

Lithium carbonate in chronic schizophrenia--a brief trial of lithium carbonate added to neuroleptics for treatment of resistant schizophrenic patients.

The value of lithium carbonate as an adjunctive treatment of resistant schizophrenia was tested in a 4-week clinical trial using a single-blind, randomized, consent design. Treatment and control groups were drawn from a population of detained patients in an English special (maximum security) hospital. The 2 groups were comparable in terms of age, sex, severity of symptoms, length of hospitalization and concurrent neuroleptic dosage. The addition of lithium carbonate to the treatment regimen did not result in symptomatic improvement in patients completing the treatment protocol. The ethical and practical difficulties raised by the trial are discussed.

Adult↗
PubMed1991

Effect of cisapride on delayed gastric emptying in gastro-oesophageal reflux disease.

Some patients with gastro-oesophageal reflux disease have delayed gastric emptying. This study investigates the effect of cisapride on gastric emptying in 34 patients with proved reflux and delayed gastric emptying of solids. They were enrolled in a double blind controlled crossover study. Placebo or cisapride (10 mg) tablets were given three times a day for three days followed by further assessment of gastric emptying. The protocol was repeated with the crossover tablet. Gastric emptying was assessed by a dual radionuclide technique. The percentage of a solid meal remaining in the stomach at 100 minutes (% R100 minutes) and the time taken for 50% of the liquid to empty (T50 minutes) were calculated and analysed by the Wilcoxon matched pairs signed ranks test and expressed as medians (ranges). For gastric emptying of solids the initial % R100 minutes (70 (60-100)%) was not significantly different from placebo (71 (35-100)%). After cisapride treatment a significant acceleration (p less than 0.001) in gastric emptying occurred (% R100 minutes, 50.5 (28-93)%). Similarly with gastric emptying of liquids, the initial T50 minute value was 26.5 (12-82) minutes, after placebo the value was 28 (11-81) minutes, but this was significantly accelerated with cisapride (p less than 0.03) to 22.5 (6-61) minutes. The acceleration in gastric emptying occurred in the proximal portion of the stomach for gastric emptying of both solids and liquids suggesting that this is the principal site of action of cisapride. We conclude that cisapride significantly accelerates gastric emptying of both solids and liquids in patients with gastro-oesophageal reflux disease and delayed gastric emptying.

Adolescent↗
PubMed1991

Role of the proximal and distal stomach in mixed solid and liquid meal emptying.

The role of the proximal and distal stomach in the emptying of solids and liquids from the stomach remains unclear. We have used a dual isotope technique to quantify proximal and distal stomach emptying of a solid (100 g of 99mTc labelled liver/ground beef) liquid (either 200 ml of normal saline (eight subjects) or 25% dextrose (seven subjects) labelled with 113mIn-diethylenetriaminepenta-acetic acid) mixed meal. A manometric catheter simultaneously measured antral, pyloric, and duodenal motor activity. The liquid component dispersed rapidly throughout the stomach and emptied after a minimal lag period. The emptying of the 25% dextrose was delayed compared with the saline. This delay was associated with increased retention of the liquid in the distal stomach, a significant increase in localised phasic pyloric contractions, and a suppression of antral contractions. The solid component initially resided wholly within a proximal stomach reservoir area. Solids then redistributed from proximal to distal stomach during the emptying of liquid from the stomach. Dextrose delayed gastric emptying of solids compared with saline by increasing the solid lag period and retention in the proximal stomach. There was no significant difference between saline and dextrose meals in the distal stomach retention of solid or in the linear rate of emptying after the lag period. We conclude that, contrary to general opinion, the proximal stomach plays an important role in the control of gastric emptying of solids while the distal stomach is important in the emptying of nutrient liquids.

Adolescent↗
PubMed1991

Comparative effects of duodenal and ileal intubation on gastric emptying and postprandial antral, pyloric, and duodenal motility.

The influence of gastric and small-intestinal intubation on fed patterns of antropyloroduodenal motility and gastric emptying of a solid meal has been investigated in normal volunteers. In 10 subjects a manometric assembly was passed as far as the fourth part of the duodenum; in 8 other subjects the terminal ileum was intubated; and a further 8 subjects were not intubated. The manometric assemblies were similar, apart from their length, and both incorporated a sleeve/side hole assembly located across the pylorus. All subjects ingested a meal of 100 g 99mTc-labelled liver/ground beef. There was no significant difference in either the lag phase or the linear emptying phase of gastric emptying between the control and duodenal intubation groups. The emptying phase of the test meal, but not the lag phase, was slower (p less than 0.01) in the ileal intubation group than in the non-intubated and duodenal intubation groups. There were fewer (p less than 0.01) antral pressure waves in the ileal than in the duodenal intubation group. We conclude that ileal but not duodenal intubation has an important inhibitory influence on gastric emptying and antral motility.

Adult↗
PubMed1990

A two-dimensional acrylamide gel electrophoresis/computer software approach to decoding the human genome.

The human genome sequencing initiative is sure to be an expensive and time-consuming project. To maximize the quality of the initial thrust, it is necessary to concentrate on sequencing those genes that are actively involved in crucial biological processes, both normal and otherwise. To identify the protein products of these genes, we propose the use of two-dimensional acrylamide gel electrophoresis and powerful computer software. The two-dimensional gels can then be scaled to yield sufficient amounts of the protein for direct amino acid sequence analysis. The amino acid sequence then provides the direct link back to the gene.

Amino Acid Sequence↗
PubMed1989

Computer-analysed 2-D electrophoresis.

A service is now available for analysing 2-dimensional gels and comparing them to existing databases, broadening the number of laboratories which can study protein expression using the technique.

Computer Graphics↗
PubMed1989

Protein database development: identification of glycosylated and phosphorylated proteins in unfractionated rat fibroblast lysates.

In this paper, techniques are demonstrated for unambiguously mapping phosphoproteins and glycoproteins into a protein database of unfractionated fibroblast proteins. These methods allow for precise registration of subsets of proteins with the image of total proteins. The methods are also applicable to database mapping of antigens identified by indirect immunodetection methods and receptor molecules identified with photoaffinity ligands.

Animals↗
PubMed1989

Fitness to plead and psychiatric reports.

The role of the psychiatrist in the determination of fitness to plead is reviewed by reference to 77 pre-trial psychiatric reports prepared on 31 Special Hospital patients detained under the provision of Section 5(1)(c) (Unfit to Plead) of the Criminal Procedure (Insanity) Act 1964. Each psychiatric report was analysed using a standardized checklist which addressed the legal criteria used to determine fitness to plead, the nature of the alleged offence and the clinical diagnosis. The results showed that almost 40% of the reports made no mention of fitness to plead at all and that only one-third of the reports made a statement about fitness to plead which was supported by reference to standard legal criteria. The results of this study support earlier work which has suggested that psychiatrists have a poor understanding of the issues surrounding fitness to plead and criminal responsibility. These findings are discussed in relation to recommendations made by the Report of the Committee on Mentally Abnormal Offenders, 1975 (Butler Report) and legislative changes introduced by the Mental Health Act 1983.

Forensic Psychiatry↗
PubMed1988

Relationship of the motor activity of the antrum, pylorus, and duodenum to gastric emptying of a solid-liquid mixed meal.

The postprandial motor activity of the antrum, pylorus, and duodenum in 15 healthy volunteers was compared with the profiles of emptying of the solid and liquid components of a meal. The liquid component of the meal emptied rapidly in an exponential manner, whereas the solid remained in the fundus of the stomach until approximately 80% of the liquid had emptied and then emptied in a linear manner. The onset of solid emptying was associated with an increase in the rate of occurrence of antral pressure waves (p less than 0.05), and the half-time for solid emptying (t1/2 - lag period) was inversely correlated (p less than 0.05) with the rate of coordinated contractions involving the antrum. The substitution of 25% dextrose in normal saline as the liquid component of the meal increased the half-time for liquid emptying from a median of 8 to 40 min (p less than 0.01), increased the lag period for solid emptying from 40 to 87 min (p less than 0.01), and increased the rate of occurrence of isolated pyloric pressure waves during the solid lag phase from 7 to 58/h (p less than 0.05), but did not affect the slope of solid emptying or the rate of coordinated contractions involving the antrum during the solid emptying period.

Adolescent↗
PubMed1988

Proximal, distal and total stomach emptying of a digestible solid meal in normal subjects.

The gastric fundus and antrum probably play different roles in the emptying of solids and liquids in man, but there is little information about the intragastric distribution of food. We have used a new radionuclide technique to quantify proximal, distal and total stomach emptying of a digestible solid meal (100 g of 99Tcm-labelled liver/ground beef given with 150 ml of 10% dextrose) in 13 normal subjects. A proximal reservoir area was seen after consumption of the meal, and used to define the proximal stomach region. A line drawn immediately below this area divided the total stomach region into proximal and distal stomach. Emptying from the total stomach exhibited two phases--an initial lag period (median 41 min, range 21-57 min), followed by approximately linear emptying. Redistribution of food from the proximal to the distal stomach was a major component of the lag period in 11 of the 13 subjects. In the remaining two subjects, redistribution was rapid (proximal 50% emptying time of 4 and 10 min) and antral retention was the major component of the lag period. In seven subjects, a region of reduced activity (contraction band) was seen. The midpoint of this band closely approximated to the line used to divide proximal and distal stomach. We suggest that a contraction band may be responsible for the proximal gastric reservoir seen after meal consumption and plays an important role in the redistribution and emptying of digestible solid food from the stomach. There is considerable variation between normal subjects in the rate of transfer of digestible solid food from the proximal to the distal stomach.

Adult↗
PubMed1987

Gastric and esophageal emptying in dystrophia myotonica. Effect of metoclopramide.

Gastric and esophageal emptying were measured using scintigraphic techniques in 16 patients with dystrophia myotonica and in 22 normal volunteers. Gastric emptying of a solid meal was slower than the normal range (defined as the mean +/- two standard deviations obtained in the normal volunteers) in 15 of the 16 patients, and gastric emptying of the liquid meal was slower than the normal range in 10 of the patients. Esophageal emptying was also markedly delayed in patients, with 15 of 16 patients having an emptying time longer than the normal range. There was no relationship between gastrointestinal symptoms, or the severity of the peripheral (skeletal) muscle weakness, and either gastric or esophageal emptying. Oral administration of metoclopramide resulted in a significant improvement in gastric emptying of the solid meal and a nonsignificant trend toward more rapid liquid emptying, but no change in esophageal emptying. These results indicate that there is a very high prevalence of gastric and esophageal smooth muscle dysfunction in dystrophia myotonica and that gastroparesis is likely to be a treatable cause of morbidity in this disease.

Adult↗
PubMed1986

Abnormalities of gastric and esophageal emptying in polymyositis and dermatomyositis.

Gastric and esophageal emptying were assessed using scintigraphic techniques in 13 patients with polymyositis or dermatomyositis and in 13 normal volunteers. Esophageal emptying was significantly delayed in patients, with 8 of 13 patients being outside the normal range. Gastric emptying was also markedly slower in patients than in controls, with 8 patients being outside the normal range for solid emptying and 8 patients beyond the normal range for liquid emptying. The 5 patients with dysphagia all had delayed esophageal emptying, but both gastric and esophageal emptying were delayed in some asymptomatic patients. There was a significant correlation between esophageal emptying and both solid and liquid gastric emptying in the patients. Both gastric and esophageal emptying correlated with the severity of the peripheral (skeletal) muscle weakness. These results indicate that profoundly delayed gastric and esophageal emptying are common in polymyositis and dermatomyositis, implying frequent malfunction of the smooth muscle of the upper gastrointestinal tract in this disease.

Adolescent↗
PubMed1986

Gastric emptying after gastric bypass.

Gastric emptying of two test meals, consisting of ground beef and water and ground beef with 25 percent dextrose was measured with a scintigraphic technique in patients after gastric bypass surgery and in control subjects. Solid emptying was slower and liquid emptying was more rapid after gastric bypass and 25 percent dextrose emptied as rapidly as water. The pattern of gastric emptying after gastric bypass would favour more rapid initial absorption with liquid calories and may also be implicated in the dumping syndromes sometimes seen after gastric bypass.

Adult↗
PubMed1986

Effect of increasing the caloric/osmotic content of the liquid component of a mixed solid and liquid meal on gastric emptying in obese subjects.

A dual isotope scintigraphic technique was used to assess the effect of increasing the caloric content of the liquid component of a mixed solid and liquid meal on gastric emptying in control and obese subjects. For the two test meals used gastric emptying of solid was significantly slower in the obese subjects compared to the control subjects. In both obese and control subjects the substitution of 25 per cent dextrose for water as the liquid component of the meal resulted in a significant delay of both solid and liquid emptying. The magnitude of this change was similar in obese and control subjects. The results suggest that the duodenal receptor mechanisms which slow gastric emptying are not defective in obesity.

Adult↗
PubMed1985

Disorders of gastric emptying and the application of radionuclide techniques.

There has been a greatly increased understanding of the physiology of gastric emptying in normal subjects, and of the pathophysiology and pharmacological treatment of gastric emptying disorders associated with the development and application of methods to quantify gastric emptying in humans. The non-invasive measurement of gastric emptying by means of radionuclide-labelled food markers has widespread clinical and research applications.

Domperidone↗