Search PubMed⌕ Search

Biomedical subjects

R M Kirk

Publications and source records attributed to R M Kirk.

At least 55 records · Page 3Linked to original sources
PubMed1981

Pancreatic exocrine function after truncal and highly selective vagotomy.

We have measured plasma glucose and immunoreactive trypsin concentrations and serum pancreatic amylase activities in single blood samples following truncal vagotomy (TV) in 13 patients and highly selective vagotomy (HSV) in 14 patients. Our results show that an increased incidence of exocrine pancreatic insufficiency occurs postoperatively regardless of the type of vagotomy. Glucose concentrations were significantly higher after TV, suggesting that HSV is preferable for patients at risk of or suffering from diabetes mellitus.

Adult↗
PubMed1979

Endoscopic monitoring of the gastric lesser curve following proximal gastric vagotomy.

The lesser curve gastric mucosa was examined endoscopically in 60 patients, 3 to 6 days after performing proximal gastric vagotomy. Minor and equivocal changes were seen in only 3 patients. Three patients had adjunctive splenectomy but did not show any evidence of mucosal vascular insufficiency in the proximal stomach. Our findings do not confirm a report from other investigators of lesser curve gastric ulceration attributed to partial ischaemia short of lesser curve necrosis. Endoscopy should be considered in patients developing unexplained features following proximal gastric vagotomy.

Adult↗
PubMed1979

Vascularity at sites of gastro-jejunal anastomoses.

Recent interest in vascularity in relation to peptic ulceration poses the question of relationship between three entities: (1) site of gastro-jejunal (post-anastomotic) ulcer, (2) site of the anastomotic line and (3) site of junction and possible vascular anastomosis between gastric and jejunal circulations in the region of the anastomosis. Vascular injection studies in dogs show that the main gastric and jejunal circulations run up to, but do not communicate across, the surgical anastomosis, there being a line of least vascularity at the anastomosis. Since anastomotic ulcers occur distal to the anastomotic line, this supports the view that such ulcers are situated wholly in an area of jejunal circulation.

Animals↗
PubMed1977

Can the singularity of chronic peptic ulcers be described by catastrophe theory and explained by biofeedback?

The damaging effect of hydrochloric acid within the lumen of the stomach and duodenum should be diffuse, but chronic peptic ulcers are discrete and usually single. The search for localizing effects on acid attack, or localized defects in mucosal defense have so far been fruitless. If attacking forces increase, or mucosal defense diminishes to the point where ulceration occurs, mucosal breakdown should be progressive. In chronic peptic ulceration, however, the process usually seems to be self-limiting. The catastrophe theory of René Thom may describe the progressive change in the forces that leads to eventual breakdown in mucosal continuity. Possibly this catastrophe triggers off biofeedback mechanisms that hold in check further progress of the ulcer.

Chronic Disease↗
PubMed1976

Reducing outpatient attendances.

Outpatient attendances can be reduced by indirect contact by letter and telephone; this frees the consultant to concentrate on patients attending for the first time. Such methods have not yet been fully exploited in the National Health Service.

Outpatient Clinics, Hospital↗
PubMed1976

Exploration of the abdomen.

The findings at 1500 consecutive laparotomies are reported. The likelihood of finding an alternative condition to the preoperative diagnosis and of discovering important incidental findings is so high that complete abdominal exploration should be carried out whenever possible at routine abdominal operations. However, laparotomy is no substitute for careful preoperative investigation. Routine preoperative endoscopy is recommended before all operations on the upper gastrointestinal tract. If no cause for symptoms is found at operation no procedure should be carried out; the placebo effect of laparotomy and subsequent assurance often leads to alleviation of the symptoms.

Abdomen↗
PubMed1975

Gastric mucosal resection in the treatment of peptic ulcers: a 1-10 year clinical follow-up.

The clinical results of gastric mucosal resection are reported after a 1-10-year follow-up in which 76 per cent of patients were followed up for more than 5 years. There were 3 postopertive deaths in 152 patients. Mucosal antrectomy with vagotomy for duodenal ulcer in 96 patients, and for recurrent ulcer in 9 patients, has not been followed by a single recurrence. Gastric mucosal resection alone for the treatment of gastric ulcer in 21 patients resulted in 1 recurrence. Although vagotomy combined with resection is currently out of fashion for the initial treatment of duodenal ulcer in Britain, mucosal gastric resection has technical advantages in combination with vagotomy for the cure of recurrent ulcers following duodenal ulcer surgery.

Duodenal Ulcer↗
PubMed1974

Sacral agenesis.

Explore the source record for details and available documents.

Acute Kidney Injury↗