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Biomedical subjects

R I Hall

Publications and source records attributed to R I Hall.

82 records · Page 5Linked to original sources
PubMed1982

Chronic pancreatitis as a cause of gastrointestinal bleeding.

Chronic pancreatitis is an infrequently considered cause of gastrointestinal bleeding. Four cases are described who presented to a surgical unit in a year. One patient bled down the main pancreatic duct from a splenic artery pseudoaneurysm, one had a fatal haemorrhage from a superior mesenteric artery aneurysm which ruptured into the duodenum, and two were considered to have bled from vessels in the stomach or colon which were involved in the peripancreatic inflammatory tissues. The difficulties in diagnosing these patients are described and the report emphasises that the diagnosis should be considered in obscure cases of gastrointestinal bleeding especially where there is a history of alcohol abuse and left upper quadrant or epigastric pain.

Adult↗
PubMed1980

Decreased elimination of theophylline after influenza vaccination.

The elimination of theophylline is decreased after vaccination against influenza. In three patients receiving 200 mg of oxtriphylline (equivalent to 128 mg of theophylline) every 6 hours by mouth the serum theophylline levels rose after vaccination, and in four healthy volunteers given the same dose of oxtriphylline 24 hours after vaccination the half-life of theophylline increased by an average of 122%. Two of the three patients showed signs of a toxic reaction to the drug. These results suggest that the elimination of theophylline is impaired to a clinically important degree after influenza vaccination and that the resulting levels of the drug can be toxic even when conventional therapeutic doses of theophylline are given.

Aged↗
PubMedDate not supplied

The effect of choline supplementation on hepatic steatosis in the parenterally fed rat.

Information regarding hepatic function during total parenteral nutrition in rats is often extrapolated to the clinical situation, but the steatosis observed in that species may simply reflect choline deficiency and be irrelevant to man. The effect of choline supplementation on hepatic lipid content and triglyceride secretion was examined in parenterally fed rats. Eighty to 90-day-old rats were randomized into three groups; group I received oral Purina Chow ad libitum, groups II and III received identical total parenteral nutrition regimens with the exception that group III received supplemental choline. After 7 days, peripheral triglyceride uptake was inhibited with Triton WR1339, the rate of secretion of 14C-labeled triglyceride measured after a bolus injection of 1-14C-palmitic acid, and total hepatic lipid content was measured. Total hepatic lipid content was elevated in group II (86.3 mg/g) and group III (83.3 mg/g), and both differed significantly from the control group I (35.2 mg/g, p less than 0.01), but the choline supplementation appeared to make no difference. Hepatic secretion of 14C-palmitic acid as 14C-triglyceride was reduced in group II (0.73%/ml plasma), and group III (0.72%/ml plasma) compared to group I (1.06%/ml plasma, p less than 0.05), and was unaffected by choline. The hepatic steatosis produced in the parenterally fed rat did not appear to be due to choline deficiency but to some other factors which may be important in man.

Animals↗
PubMedDate not supplied

The effect of total parenteral nutrition on hepatic drug oxidation.

Hepatic dysfunction is a frequent complication of total parenteral nutrition (TPN), indicated by derangement of standard liver function tests. However, such changes are variable and nonspecific, and represent hepatic injury rather than changes in hepatic function. Antipyrine (Phenazone) clearance is a sensitive indicator of hepatic microsomal enzyme activity and provides a more specific indication of hepatic function. This was used to investigate the effect of different TPN regimens. Patients receiving a postoperative 2000 kcal TPN regimen providing all nonprotein calories as dextrose (n = 16) showed a 34% reduction of mean antipyrine clearance after 7 days of TPN compared to controls (n = 13, p less than 0.05). This effect was seen also in patients receiving a 1600 kcal dextrose-based regimen (n = 8). In patients receiving a 2000 kcal TPN regimen in which 500 kcal were provided as lipid (n = 10), mean antipyrine clearance was not significantly different from that of the control group. This study indicates the sensitivity of hepatic microsomal oxidative function, an important route of drug metabolism, to different TPN regimens.

Antipyrine↗
PubMedDate not supplied

Effect of different energy sources on hepatic triglyceride secretion during parenteral nutrition.

This study examines the effect of parenteral nutrition on hepatic triglyceride secretion in postoperative patients. Five patients received fluids and electrolytes only (D/S), 10 received a 2000-kcal total parenteral nutrition (TPN) formula with 25% of the nonprotein energy from lipid (LIPID-TPN), and 11 received a similar regimen with all of this energy from dextrose (CHO-TPN). After 7 days an intravenous bolus of 3H-glycerol was given and hepatic triglyceride secretion measured from the decay curve of plasma radiolabeled triglyceride content. Plasma triglyceride concentrations were similar in each group. Hepatic triglyceride secretion was 16.3 mg/kg/hr after D/S, 10.7 mg/kg/hr after LIPID-TPN, and 12.2 mg/kg/hr after CHO-TPN (NS). There was no correlation between the rate of hepatic secretion and dextrose intake. Both TPN regimens resulted in significant reductions in plasma concentrations of apoproteins A1 and B but this did not appear to be related to triglyceride secretion rates. Despite the similar rates of hepatic secretion the quantity of labeled glycerol secreted in triglyceride was significantly greater after CHO-TPN (17629 dpm/24 hr) than either D/S (10560 dpm/24 hr) or LIPID-TPN (7264 dpm/24 hr, p less than 0.05), indicating that recycling of exogenous lipid may have occurred after LIPID-TPN. This study indicates that hepatic triglyceride secretion is not suppressed by TPN, irrespective of the energy source, but suggests that the rate of secretion may have an upper limit.

Apoproteins↗
PubMedDate not supplied

Functional recovery in rabbit heart after preservation with a blood cardioplegic solution and perfusion.

Thirty-five isolated rabbit hearts were subjected to 60 minutes of storage after cardiac arrest with high K+ crystalloid cardioplegic solution at 5 degrees C. They were divided into five groups (n = 7 per group) according to the preservative protocol: group I (simple immersion in 0 degrees C normal saline solution), group II (simple immersion in 30 degrees C blood cardioplegic solution), group III (immersion and perfusion in 30 degrees C blood cardioplegic solution), group IV (simple immersion in 10 degrees C blood cardioplegic solution), and group V (immersion and perfusion in 10 degrees C blood cardioplegic solution). After storage for 1 hour, cardiac function, tissue water content, and the number of hearts capable of ejecting against a 100 cm H2O column afterload were recorded and compared among the five groups. Cardiac function in group II was not different from group I. Aortic pulse pressure and left ventricular developed pressure were lower in group II than in group III, IV, or V. Aortic developed pressure was higher in groups III and V (p < 0.05). Tissue water content in group I was significantly higher than in groups II, III, and V (p < 0.05). All hearts in groups III and V could eject against a 100 cm H2O afterload after preservation (p < 0.05 versus groups I, II, and IV). Factorial analysis among the groups using blood cardioplegic solution showed that either hypothermia or perfusion alone or the combination was a protective factor in providing functional recovery of stored hearts.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗