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Biomedical subjects

R Whitehead

Publications and source records attributed to R Whitehead.

At least 91 records · Page 5Linked to original sources
PubMed1976

Gastritis duodenitis, and circulating levels of gastrin in duodenal ulcer before and after vagotomy.

Biopsy specimens have been taken from five standard sites in the stomach and from the duodenal bulb in order to investigate the association of gastritis and duodenitis with duodenal ulcer. Twenty patients with chronic duodenal ulcer were investigated in this manner and in addition had gastric secretion tests and a radio-immune assay of serum gastrin under differing conditions. The patients were then treated either by a truncal vagotomy and pyloroplasty (TVP) or by a highly selective vagotomy without a drainage procedure (HSV). All the investigations were repeated three months postoperatively. Duodenal ulcer was usually associated with gastriitis, although this varied in extent and severity from patient to patient. In nearly all the patients, gastritis was present at the pyloric end of the stomach and along the lesser curve. In more than half of the patients, gastritis was also present in the body of the stomach but the fundus was usually spared. Chronic duodenitis was found in the duodenal bulb in all these patients. After vagotomy there was a marked increase in both the extent and severity of the proximal gastritis in both treatment groups but the distal gastritis remain almost unchanged. There was little change in the incidence of duodenitis after vagotomy but its severity was lessened. No correlation was found between the peak acid output (PAO) in response to Histalog and the severity of the gastritis or the duodenitis either before or after operation, with one exception. The postoperative PAO was significantly less in those patients who developed a severe proximal gastritis after vagotomy. No relationship was found between the severity of the distal gastritis and the levels of serum gastrin. No correlation was found between either the basal or peak acid output and the corresponding serum gastrin levels before or after vagotomy.

Biopsy↗
PubMed1975

Atrophic gastritis in gastrectomy specimens.

Examination of gastrectomy specimens has shown that atrophic gastritis and intestinal metaplasia are widespread and have the same distribution in cancer of the stomach as in gastric ulcer affecting the body. Their distribution is restricted to the distal part of the stomach in pyloric ulcer. After gastrojejunostomy the distribution is also like that seen in cancer. There is a close association of widespread atrophic gastritis and intestinal metaplasia with the development of cancer and a high cancer rate after stomach operation for benign conditions. The similarity of distribution of atrophic gastritis and intestinal metaplasia in the stomach with body ulcer to that in cancer and after gastrojejunostomy points to a higher cancer risk in the stomach containing a body ulcer.

Atrophy↗
PubMed1975

The histological classification of duodenitis in fibreoptic biopsy specimens.

Recent advances in biopsy techniques using fibreoptic instruments have refocussed attention on the condition on non-specific duodenitis. Investigation of the topography of duodenitis and its relationship to possible aetiological factors and to duodenal ulcer calls for a proper histological classification. Such a classification is proposed based on the subjective appearances and a quantitative examination of 747 fibreoptic biopsy specimens in a wide range of clinical conditions.

Biopsy↗
PubMed1974

Lack of harmful effect of oats on small-intestinal mucosa in coeliac disease.

It is well established that wheat, rye, and barley are harmful to patients with coeliac disease, but the effect of oats remains in doubt. Four patients with coeliac disease, who had shown complete mucosal recovery after prolonged treatment with a strict gluten-free diet, volunteered to consume oats in addition to their gluten-free diet for a period of one month and were studied by jejunal biopsy before and after the experimental period. The patients remained entirely symptom-free and, more important, the jejunal mucosa was undamaged as judged by appearances under dissecting and light microscopes, quantitative histological studies, and disaccharidase content. It is concluded that oats are harmless to coeliac subjects and can be included in a gluten-free diet.

Biopsy↗
PubMed1974

Identifying toxic fractions of wheat gluten and their effect on the jejunal mucosa in coeliac disease.

THE TOXICITY OF THREE FRACTIONS (A, B, AND C) OBTAINED BY ULTRAFILTRATION OF A PEPTIC: tryptic digest of gluten has been assessed by serial feeding experiments in patients with treated coeliac disease. The first fraction (A), which contains amino acids and oligopeptides, produced no damage to the jejunal mucosa. The other two fractions (B and C) both caused mucosal damage. Fraction B, which contains the products of digestion of smaller molecular weight, consists of polypeptides which are concentrated in the region of 8000 molecular weight. It contains no gliadin (molecular weight 50 000) or gluten. Ultrastructural evidence of damage was visible six hours after challenge with fraction B and by 10 hours histological abnormalities were also present. Ultrastructural abnormalities occurred early in the epithelial cells and preceded changes in the basement membrane and capillaries. The disaccharidases showed a pronounced depression in all three subjects by 24 hours. The rapid onset of damage after challenge, coupled with the evidence of recovery as soon as 72 hours later, is more in keeping with a direct action on the surface epithelial cells rather than an immune mechanism.

Amino Acids↗
PubMed1974

A morphological assessment of immunoreactivity in colonic Crohn's disease and ulcerative colitis by a study of the lymph nodes.

The mesenteric lymph nodes in total colectomy specimens from patients with ulcerative colitis or Crohn's colitis were assessed for immunological reactivity. Despite the suggestion of previous work using different methods that immunological difference between the diseases exist and may be important in pathogenesis, no significant differences were found in this study. Changes were observed in both diseases and when ulceration was present these consisted of both cellular and humoral immune reactivity. There was no evidence of diminished cell-mediated immunity in Crohn's disease and the presence of granulomata did not constitute any special immunological group.

Antigen-Antibody Reactions↗
PubMed1974

The plasma cells in inflammatory disease of the colon: a quantitative study.

Immunoglobulin-containing cells have been counted in the mucosa of colectomy specimens from patients with ulcerative colitis and Crohn's disease. An increase in IgA cells occurs in both when compared with normal. In Crohn's colitis the increase is significantly higher than in ulcerative colitis. The importance of these findings in relation to pathogenesis is discussed.

Biopsy↗