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Biomedical subjects

R C Russell

Publications and source records attributed to R C Russell.

At least 235 records · Page 13Linked to original sources
PubMed1974

Vagal control of glucagon release in man.

A significant fall in fasting plasmapancreatic-glucagon was produced by injection of atropine. After arginine infusion atropine reduced the normal rise of glucagon by 33% and glucose by 40%. Eleven patients studied during insulin hypoglycaemia after a selective vagotomy showed a peak rise in plasma-glucagon of 173 pg. per ml., which was not significantly different from the glucagon rise in ten preoperative controls (168 pg. per ml.). The glucagon response to insulin hypoglycaemia (81 pg. per ml.) in a matched group of ten patients with truncal vagotomy was significantly less than after selective vagotomy. This evidence of parasympathetic control of the alpha cell accords with morphological and laboratory-animal findings. Maintenance of normal glucagon release after selective vagotomy favours the use of this operation rather than the cruder truncal vagotomy.

Adult↗
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↗
PubMedDate not supplied

Endoscopic sphincterotomy complications and their management: an attempt at consensus.

Despite its relative safety (in comparison with surgery), and undoubted role in many clinical circumstances, biliary sphincterotomy is the most dangerous procedure routinely performed by endoscopists. Complications occur in about 10% of patients; 2 to 3% have a prolonged hospital stay, with a risk of dying. This document is an attempt to provide guidelines for prevention and management of complications, based on a workshop of selected experts, and a comprehensive review of the literature. We emphasize particularly the importance of specialist training, disinfection, drainage, and collaboration with surgical colleagues.

Cholangiopancreatography, Endoscopic Retrograde↗