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Biomedical subjects

R Smallwood

Publications and source records attributed to R Smallwood.

At least 37 records · Page 2Linked to original sources

Lack of effect of omeprazole, a potent inhibitor of gastric (H+ + K+) ATPase, on hepatic lysosomal integrity and enzyme activity.

The substituted benzimidazole, omeprazole, is a potent inhibitor of the ATP-dependent proton pump of the parietal cell. Since there is accumulating evidence that hepatic lysosomes also possess an ATP-dependent proton pump system to maintain internal acidification, and since antibodies to the putative lysosomal proton pump protein are immunologically similar to the parietal cell (H+ + K+) ATPase, we studied the effects in rats of six days of omeprazole treatment on hepatic lysosomal function. Omeprazole, 5 mg kg-1, a dose five times the ED50 for gastric acid secretion inhibition in rats, did not alter the activity of three representative lysosomal enzymes in liver (acid phosphatase, beta-galactosidase and N-acetyl-beta-glucosaminidase) nor did it alter lysosomal enzyme latency, a measure of the integrity of the lysosomal membrane. Furthermore, bile flow and the secretion of lysosomal enzymes into bile were also unaffected by omeprazole. These data indicate that in rats short-term treatment with omeprazole, in doses that markedly inhibit gastric acid secretion, has no major biological effect on liver lysosomal integrity and lysosomal enzyme activity.

Acetylglucosaminidase↗

Circadian temperature variation in healthy aged and in Alzheimer's disease.

Circadian temperature variation was monitored in healthy older adults and in health-, age-, and sex-matched Alzheimer's dementia patients. Oral and rectal temperatures were analyzed for mean level, amplitude, and phase using cosinor analyses. Mean 24-hour temperature level was not altered by dementia. A significant sex effect, however, was observed among dementia patients with women exceeding men in mean 24-hour temperatures and across daytime time periods. Cosinor-derived phase and amplitude measures were unaffected by dementia or by sex. This indicates that the primary neuronal degeneration characteristic of Alzheimer's disease in its early stages does not disable the neural pathway(s) controlling circadian temperature regulation. Some impairment in temperature homeostatic regulation may be present, however, because a greater intrasubject temperature variability was observed in Alzheimer men than in control men.

Age Factors↗

Human antroduodenal motility, pyloric closure, and domperidone.

The action of the peripheral dopamine antagonist, domperidone, on human antroduodenal coordination, has been studied in a double-blind study. Thirty dyspeptic patients without antroduodenal pathology were studied at upper alimentary endoscopy, being studied for two 10-minute periods before and after receiving intravenous domperidone (20 mg) or placebo. Antral and proximal duodenal contractions were recorded with Fogarty balloon catheters and pyloric closure recorded as the fall in impedance measured across four small electrodes maintained at the pylorus. Domperidone significantly increased the number of antral contractions. When spontaneous duodenal activity was present, domperidone reduced the number of isolated duodenal contractions (no preceding antral contractions within 10 seconds) without detectably altering the behaviour of the pylorus.

Adult↗

The recognition and treatment of the irritable bowel syndrome.

The irritable bowel syndrome (IBS) is characterized by abdominal pain and/or altered bowel habit in the absence of detectable organic bowel disease. By convention, people with simple constipation are not usually included in this group of patients. IBS is a symptom-complex with many synonyms such as irritable colon, functional bowel disorder, nervous diarrhoea or spastic colon.

Adult↗

Large bowel myoelectrical activity in man.

The myoelectrical activity of human colon and rectum has been studied by three types of electrode in man--intraluminal (suction), serosal and cutaneous. The patterns obtained indicate a high degree of consistency between the methods and the value of surface electrodes is emphasized. Gradient along the large bowel of both frequency and percentage electrical activity have been observed and possible physiological roles are postulated for them. By correlating the features of regular electrical and corresponding regular motor waves an alteration in the myoelectrical pattern is observed in the region of the rectosigmoid junction.

Cecum↗

Glucagon and the colon.

The effect of glucagon on human colonic myoelectrical activity is described. By means of intraluminal, serosal, and surface electrodes, recordings from all areas of the large bowel have been obtained. Glucagon inhibited both electrical and pressure rhythms in all subjects tested. Evidence is produced to suggest a direct action on colonic smooth muscle. A controlled trial using glucagon during routine barium enema examinations suggests that it may prove to be useful for hypotonic examinations of the colon where painful spasm is present.

Barium Sulfate↗

The immediate and delayed effects of different types of vagotomy on human gastric myoelectrical activity.

The immediate and delayed effects of different types of vagotomy on the antral myoelectrical activity have been studied in 52 patients who had previously undergone either highly selective vagotomy (HSV) or truncal vagotomy and pyloroplasty (TV + P) for the treatment of chronic duodenal ulceration up to eight years previously. The frequency of the electrical activity was not statistically different between the two types of operation. After HSV the triphasic waveshape of the antral myoelectrical activity was retained; it was recorded more frequently in the delayed tests (98.0 plus or minus 1-7%) of the recording period than in immediate tests (74-7 plus or minus 6-5%) whereas mean amplitude in the immediate tests (1-59 plus or minus 0-13 mV) was not significantly changed in the delayed tests (1-49 plus or minus 0-08mV). After TV + P the waveform was more sinusoidal in shape, being recorded more often in the delayed tests (91-7 plus or minus 2-7%) than in the immediate tests (41-4 plus or minus 8-9%) although the mean amplitude between the immediate (0-090 plus or minus 0-06 mV) and delayed tests (0-94 plus or minus 0-07 mV) was not significantly different. The only significant change in the myoelectrical activity with the passage of time after vagotomy was an increase in the percentage activity.

Action Potentials↗

Urodynamic observations following spinal trauma.

A method of the urodynamic investigation of paraplegic and quadriplegie patients is described. Serial measurements of the urethral pressure profile in patients with developing reflex micturition demonstrate a rising pressure at the external urethral sphincter with time following spinal trauma. Patterns of micturition with detrusor-sphincteric imbalance are described in patients with both early and well-established reflex micturition.

Adolescent↗

The effect of stimulation on the myoelectrical activity of the rectosigmoid in man.

The myoelectrical activity of the rectosigmoid has been studied in 66 subjects at rest and after stimulation with either pentagastrin 6.0 mug/kg hr intravenously in 21 cases, neostigmine 0.5 mg intramuscularly in 20 cases, or two bisacodyl suppositories in 19 cases. Two electrical rhythms were present at rest. A faster rhythm (frequency 6-9 cycles/min) predominated and its incidence was significantly increased by neostigmine at all levels in the rectosigmoid and by bisacodyl in the rectum only. The incidence of the slower rhythm (frequency 2.5-4.0 cycles/min) was significantly increased by pentagastrin which had no effect on the faster rhythm. The amplitude of each basic electrical rhythm rose when its incidence was increased. Motor waves were augmented corresponding to which of the two electrical rhythms was increased after stimulation.

Bisacodyl↗

Methods of measuring intracranial pressure via the fontanelle without puncture.

It is suggested that non-invasive techniques for measuring intracranial pressure should be suitable for use in the unsedated infant and should be capable of measuring pressure continuously. Methods described by other authors are reviewed. After investigation of 18 patients the technique relying upon the pulsation of the fontanelle described by Purin was rejected as being difficult to perform and applicable only in certain patients with large fontanelles. The technique of using a modified Schiotz tonometer was examined but rejected on grounds of inaccuracy, the need to perform the measurement with the infant in a vertical position, and the varying compressibility of the fontanelle. A method for indirectly estimating intracranial pressure using a modified aplanation principle is described, and a comparison of the pressures so measured and needle pressures is reported. The possible uses of a `fontanometer' using the aplanation principle are discussed and a preliminary report given of its use to monitor the changes of intracranial pressure caused by drugs.

Age Factors↗

The developing liver: the steady-state disposition of propranolol in pregnant sheep.

The steady-state disposition of the beta-adrenoreceptor blocking drug, propranolol, and its metabolite, 4-hydroxypropranolol, was studied in the anesthetized pregnant sheep near term. Following infusion of propranolol to the mother, steady-state plasma concentrations were obtained at three dosage levels in each of the eight animals studied. Blood samples were obtained from : (i) maternal facial artery and hepatic vein; (ii) umbilical vein, and (iii) fetal carotid artery, portal vein, and right hepatic vein. Although total propranolol concentrations in maternal plasma were different from those in umbilical venous plasma, the concentrations of unbound drug were similar, suggesting that unbound drug had equilibrated across the placenta. Approximately 10% of propranolol was unbound in maternal plasma, compared with 30% in fetal plasma. Hepatic extraction of propranolol by the maternal liver was high, so that only 3 to 4% of the drug presented to the liver escaped uptake. In contrast, fetal hepatic extraction was low. Negligible amounts were removed from portal vein blood (right lobe), although one third was extracted from umbilical vein blood (left lobe). Mean peripheral arterial concentrations of 4-hydroxypropranolol were 2- to 3-fold higher in the fetus than in the mother. We conclude that the fetus is exposed to significant concentrations of propranolol and that the fetal hepatic extraction of this drug is considerably less efficient than in the adult. In contrast to the adult liver, the fetal liver does not appear to act as a single homogeneous organ, but rather as two distinct subunits.

Animals↗