Biomedical subjects

W A Bauman

Publications and source records attributed to W A Bauman.

At least 19 recordsLinked to original sources

PubMed1995

Pulmonary function survey in spinal cord injury: influences of smoking and level and completeness of injury.

Spirometry was performed on 165 subjects with spinal cord injury (84 with quadriplegia and 81 with paraplegia). Subjects were characterized by level of lesion as: high quadriplegia (HQ, C4 and above not requiring mechanical ventilation), low quadriplegia (LQ, C5-8), high paraplegia (HP, T1-7), and low paraplegia (LP, T8-L3). Thirty-nine subjects had complete motor lesions, and 126 had incomplete motor lesions. Nonsmokers (54 with quadriplegia and 53 with paraplegia) were defined as those who had never smoked or those who had stopped smoking for 1 year. Current smokers (28 with quadriplegia and 28 with paraplegia) were defined as those who currently smoked cigarettes, cigars, and/or pipe or those who had quit for < or = 1 year. We found by linear regression analysis that forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal voluntary ventilation (MVV) were inversely correlated with the level of injury (i.e., the higher the level of injury, the lower the parameter). In the HQ group, those with complete injury had significantly lower pulmonary function parameters than those with incomplete lesions. In contrast, there were no significant differences in pulmonary function parameters between complete and incomplete lesions in subjects in the LQ, HP, and LP groups. In the LQ, HP, and LP groups, the FEV1 and PEF were significantly lower in smokers than in nonsmokers. Thus, this study demonstrates the effects of completeness of injury and smoking on pulmonary function in a large group of subjects with spinal cord injury.

Adolescent↗

PubMed1995

Resting metabolic rate in subjects with paraplegia: the effect of pressure sores.

OBJECTIVE: To determine the overall effect of paraplegia and pressure sores on resting metabolic rate. DESIGN: Unblinded, case-control study using a convenience sample. SETTING: Hospital primary care setting. PATIENTS: Fourteen individuals with paraplegia and pressure sores (PS-Para), 24 with paraplegia in good health (NPS-Para), and 23 non-spinal cord injury (SCI) controls. MAIN OUTCOME MEASURES: The planned outcome measures consisted of resting metabolic rate, percent of predicted resting metabolic rate, resting metabolic rate per kilogram body weight, and resting metabolic rate per meter squared body surface area. Post hoc analyses were used to identify the effect of completeness of lesion, smoking, and pressure sores on percent of predicted resting metabolic rate and resting metabolic rate per kilogram body weight. RESULTS: Percent of predicted resting metabolic rate and resting metabolic rate per kilogram body weight were significantly higher in the PS-Para group than in the NPS-Para or control groups (115% +/- 4% vs 100% +/- 2% or 107% +/- 2%, p < .05) and (25.9 +/- 1.2 vs 21.4 +/- 0.6 or 22.5 +/- 0.4 kcal/kg, p < .05, respectively). The resting metabolic rate per meter squared body surface area was significantly higher in the PS-Para group than in NPS-Para group (973 +/- 39 vs 874 +/- 20kcal/m2, p < .05). In the PS-Para group, current smokers had significantly higher resting metabolic rate per kilogram body weight than nonsmokers (27.3 +/- 1.7 vs 24.0 +/- 1.4kcal/kg, p < .01). Controlling for the effects of smoking in a multiple regression model, those in the PS-Para group had significantly (p < .001) greater percent of predicted resting metabolic rate and resting metabolic rate per kilogram body weight than those in the NPS-Para group. CONCLUSIONS: These findings indicate that individuals with SCI may have a decreased percent of predicted resting metabolic rate and those with pressure sores may have a hypermetabolic state. This hypermetabolic state is significantly higher than that resulting from smoking. Because ordinary prediction equations for energy expenditure may not be accurate when applied to subjects with paraplegia and pressure sores, quantification of energy needs by indirect calorimetry is recommended.

Basal Metabolism↗

PubMed1995

Bronchodilatory effects of ipratropium bromide in patients with tetraplegia.

Airway hyperresponsiveness was recently described in patients with chronic cervical spinal cord injury (tetraplegia). The response was attributed to unopposed cholinergic broncho-constrictor activity due to loss of sympathetic innervation of the airway. To determine if the administration of a cholinergic antagonist alters resting airway tone in these patients, ipratropium bromide (72 micrograms) was administered by aerosol to 25 tetraplegic patients. We found that 12 of 25 patients (48%) had significant improvement (defined as > or = 12%) in forced expired volume in 1 s (FEV1) and/or forced vital capacity (FVC). A significant correlation between airway responsiveness and complaints of dyspnea at rest, completeness of injury (sensory), or smoking history was not found. These findings of improved airflow after the use of an anticholinergic bronchodilator agent provides further evidence that transection of the cervical cord results in unopposed parasympathetic activity and a resultant increase in resting airway tone.

Adult↗

PubMed1995

Measurement of body fat in individuals with tetraplegia: a comparison of eight clinical methods.

Spinal cord injury (SCI) is a unique condition that markedly alters body composition, raising the possibility of having undefined effects on the traditional assumptions for body composition. In order to determine appropriate methods for the analysis of body composition in this population, 12 subjects with tetraplegia were studied for absolute weight as fat and percent fat by the following methods; bioelectrical impedance (BIA), dual energy X-ray absorptiometry (DEXA), total body potassium (TBK), total body water (TBW), and four anthropometric methods: Durnin and Womersley (DUR), Jackson and Pollack (J and P), Sloan (SLN) and Steinkamp et al (STK). The eight methods were compared with the mean of all means (24.4 +/- 2.2% fat), which was assumed to be the best estimate of percent fat. Four methods: BIA, DEXA, TBW and STK were not significantly different, while TBK, DUR, J&P and SLN were significantly (P < 0.009) different from the mean of the means. Using only the non-significantly different methods, repeat computation revealed TBW to have the smallest difference from the mean (0.1 +/- 2.8%), and DEXA to have the strongest correlation with the line of identity (r = 0.96, P < 0.0001). In conclusion, BIA, DEXA, TBW, and STK are equally valuable for estimating fat in those with tetraplegia.

Absorptiometry, Photon↗

PubMed1995

The relationships among serum uric acid, plasma insulin, and serum lipoprotein levels in subjects with spinal cord injury.

Relationships were investigated among serum uric acid (UA), the insulin response to a standard oral glucose load (75 g), and serum lipoprotein levels in 197 individuals with chronic spinal cord injury (SCI). All subjects had normal liver and renal function. None had a prior history of diabetes mellitus or gout. The mean age of subjects was 50 +/- 1 years, duration of injury (DOI), 18 +/- 1 years, and body mass index (BMI), 25 +/- 0.4 kg/m2. No significant differences were found between those with paraplegia or quadriplegia for any of the parameters measured. The mean serum UA values were not significantly different among the subgroups of subjects with normal glucose tolerance, impaired glucose tolerance, or diabetes mellitus (5.6 +/- 0.2 mg/dl, 5.6 +/- 0.2 and 5.7 +/- 0.3, respectively). Approximately one-half of the subjects had an abnormality in oral glucose tolerance. The levels of serum UA (p < 0.001) and serum triglycerides (TG) (p < 0.01) in the subgroup with hyperinsulinemia were significantly higher than in the subgroup with normal insulin levels. By linear regression analyses, the serum UA concentration was positively correlated with peak plasma insulin level (r = 0.31, p < 0.001), and BMI (r = 0.20, p < 0.01), but not with age, DOI, or peak glucose. The data suggest that in subjects with chronic SCI, as in the healthy able-bodied population, hyperuricemia is associated with hyperinsulinemia, obesity and abnormal lipoprotein metabolism.

Adult↗

PubMed1995

Serum testosterone and growth hormone/insulin-like growth factor-I in adults with spinal cord injury.

Aging is associated with relative growth hormone and/or testosterone (T) hormone deficiency, and those with SCI may have a premature deficiency of these two hormones. The effects of SCI, duration of injury (DOI), and advancing age with that of human growth hormone (hGH) and insulin-like growth factor I (IGF-I), as well as potential associations between them, were studied. Data were obtained from 20 male subjects with SCI and 16 gender- and age-matched controls. Serum total and free T were lower in subjects with SCI compared with controls (mean +/- SEM, 3.12 +/- 0.29 versus 4.68 +/- 0.28 ng/ml, p < 0.001 and 1.89 +/- 0.18 versus 2.46 +/- 0.22 ng/ml, p < 0.05, respectively). Nine of the 20 subjects with SCI, but none of the controls, had abnormally low serum total T. Arginine-stimulated values for hGH were lower in the group with SCI compared with controls (198 +/- 18 versus 267 +/- 27 ng/ml, p < 0.05). Serum luteinizing hormone and follicular stimulating hormone, as well as body mass index, were not significantly different between the groups. Serum total and free T were correlated with advancing age in controls (r = 0.62, p < 0.01 and r = 0.51, < 0.05, respectively) but not in SCI (r = 0.19, p > 0.43 and r = 0.39, p = 0.09). However, serum total and free T declined with increasing DOI in SCI (r = 0.56, p < 0.01 and r = 0.44, p = 0.05, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

Diagnosis-related group refinement with diagnosis- and procedure-specific comorbidities and complications.

Diagnosis-related groups have been revised through more refined uses of secondary diagnoses. Under the refined diagnosis-related groups, patients are distinguished with respect to classes of secondary diagnoses that are disease- and procedure-specific. Each class represents a different level of utilization for a given principal diagnosis or surgical procedure. The refined system was evaluated with national data from the Medicare program. Estimates of hospital costs and utilization based on refined diagnosis-related groups were more precise than those based on unrefined diagnosis-related groups. This approach to diagnosis-related group refinement does not represent a radical departure from the current diagnosis-related group framework and does not require new data collection efforts. Moreover, a payment system based on the refined model is less affected by the ordering of the diagnoses than under the existing diagnosis-related group system. How the refined diagnosis-related group framework can accommodate future refinements at all levels of the classification scheme is also discussed.

Adult↗

PubMed1995

Insulin-induced release of plasminogen activator from human blood platelets.

Incubation of washed platelets in Tyrode buffer, pH 7.5, with insulin (200 microU/ml) and CaCl2 (1.2 mM) at 37 degrees C for 3 h resulted in a threefold increase of plasminogen activator activity in the supernatant over the basal level as determined by both the amidolytic assay and the proteolysis of alpha-casein through the formation of plasmin from plasminogen. This plasminogen activator showed no plasmin-like activity and was inhibited by anti-tissue plasminogen activator antibody as well as by type 1 plasminogen activator inhibitor. The substrate specificity and the inhibition of the enzymic activity by various inhibitors indicated that the platelet plasminogen activator (pPA) was related to tissue-type plasminogen activator of relative molecular weight 56,000. Fibrinolytic activity of pPA and its insulin-dependent release were demonstrated by the shortening of euglobulin lysis time and by the clot lysis time of platelet-rich plasma from normal and type I diabetes mellitus patients. Treatment of platelet membranes with insulin also increased the release of pPA. Increased levels of adenosine 3',5'-cyclic monophosphate (cAMP) in platelets by incubation with various agents completely inhibited the insulin-induced release of the activator. On the other hand, inhibition of platelet aggregation by aspirin had no effect on the release of pPA, indicating that the effect of cAMP was not due to the inhibition of platelet aggregation by the nucleotide.

Alprostadil↗

PubMed1995

Effect of provocative maneuvers on heart rate variability in subjects with quadriplegia.

This study investigated heart rate variability (HRV) in individuals with quadriplegia who have disruption of autonomic control of the heart. Seven male subjects with neurological complete quadriplegia and seven with incomplete quadriplegia were studied at rest and during provocation. HRV was measured by power spectral analysis using a fast Fourier transform. Two spectral components were generated: 1) the high-frequency (HF) peak, a reflection of parasympathetic activity, and 2) the low-frequency (LF) peak, primarily sympathetic activity with some parasympathetic input. Results of the provocative maneuvers were grouped into one composite variable. Significant differences in the LF spectral component were found between the groups with complete and incomplete lesions in the supine position and after provocation (LF supine: P = 0.01; LF provocation: P = 0.002). After provocation, significant differences were demonstrated in the HF spectral component between these groups (P = 0.005). In contrast to previous findings, a LF component in subjects with complete quadriplegia was observed; this LF component decreased after provocation, suggesting the parasympathetic component withdrew during stressful maneuvers. There also appeared to be general downregulation of parasympathetic activity to the heart in subjects with complete quadriplegia. The presence of an increased LF spectral component during provocation in those with incomplete lesions implies sympathetic stimulation of the heart and may be used as a marker of sympathetic activity in individuals with quadriplegia.

Cold Temperature↗

PubMed1995

Prevalence of cigarette smoking in a group of male veterans with chronic spinal cord injury.

Male veterans with spinal cord injury (SCI) were surveyed regarding their smoking history. Subjects (n = 250) were placed in one of two categories: never smokers (smoked < or = 100 cigarettes in lifetime), or ever smokers (divided into former smokers, quit smoking for > 1 year, or current smokers). Never smokers constituted 23.2%, and ever smokers constituted 76.8% of the sample. Among the ever smokers, 59.4% had quit, compared with 49.1% in the general population (p < 0.05). In the former smokers, 23% had quit before injury, 24% quit within 1 year of injury, and the remaining 53% quit > 1 year after injury. In this sample veteran SCI population, the number of current smokers is comparable to that found in the general population. The lower number of never smokers with SCI (23.2%) compared with the general population (49.9%) most likely reflects the smoking habits of a veteran population.

Adult↗

PubMed1995

The effect of cisapride on segmental colonic transit time in patients with spinal cord injury.

OBJECTIVES: The pathophysiological consequences of spinal cord injury (SCI) on function of the colon are complex and poorly understood. Regardless of the mechanism, many patients with SCI have deficient bowel control, which is frustrating and difficult to treat. We designed a study to assess whether a new prokinetic medication, cisapride, might be useful in this setting. METHODS: Total and segmental colonic transit time were measured using the radiopaque marker technique in nine subjects with spinal cord injury and seven control subjects after the double-blind administration of cisapride (10 mg q.i.d.) or placebo. RESULTS: In five quadriplegic subjects with prolonged colonic transit time, administration of cisapride was found to reduce left-sided colonic transit time from 24.2 to 13.8 h. In three of these five subjects, cisapride administration resulted in subjective improvement. No effect of cisapride on right-sided, rectosigmoid, or total colonic transit time was observed. CONCLUSION: The data suggest that cisapride might be a useful adjunctive measure in treating a subset of SCI patients with colonic inertia, but a larger study is needed before this can be routinely recommended.

Adult↗

PubMed1994

Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: a model of premature aging.

One hundred veterans with paralysis due to spinal cord injury (SCI), equally divided between those with paraplegia and quadriplegia, and 50 able-bodied veteran controls underwent a 75-g oral glucose tolerance test (OGTT). In subjects with SCI, 22% were diabetic by criteria established by the World Health Organization (WHO), whereas only 6% of the control group were diabetic. Eighty-two percent of the controls had normal (NL) oral glucose tolerance, compared with 38% of those with quadriplegia and 50% of those with paraplegia. Subjects with diabetes mellitus (DM) were older in both the SCI and control groups, but those with SCI developed carbohydrate disorders at younger ages than did the control group. SCI subjects had significantly higher mean glucose and insulin values at several points during the OGTT when compared with controls, suggesting an accentuated state of insulin resistance in those with SCI. Mean fasting plasma glucose (FPG) values for both SCI and control groups were significantly higher in subjects with DM compared with those with NL glucose tolerance. When the FPG value was compared between SCI or control subjects with abnormalities in glucose tolerance, the subgroups with SCI and NL or impaired glucose tolerance (IGT) had significantly lower FPG levels than the respective control subgroups, suggestive of decreased hepatic glucose output in SCI.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Composition↗

PubMed1994

Blunted growth hormone response to intravenous arginine in subjects with a spinal cord injury.

The influence of the activities of daily living on human growth hormone (hGH) release and plasma insulin-like growth factor (IGF-I) levels is not known. Individuals with spinal cord injury (SCI) and paralysis generally have reduced levels of activity compared with ambulatory subjects. We studied sixteen subjects with SCI and sixteen nonSCI subjects matched for age, gender and body mass index (BMI) as controls. After an intravenous infusion of arginine hydrochloride (30 g/subject over 30 minutes), mean plasma hGH values at 30 and 60 minutes were significantly lower in the group with SCI compared with the control group (3.4 +/- 0.7 versus 10.7 +/- 2.5 ng/ml, p < 0.01; and 5.2 +/- 1.5 versus 12.5 +/- 2.7 ng/ml, p < 0.05). Also, peak and sum hGH responses were significantly lower in the group with SCI than in the control group (5.8 +/- 1.5 versus 14.1 +/- 2.8 ng/ml, p < 0.01; and 15.2 +/- 3.1 versus 34.8 +/- 7.2 ng/ml, p < 0.02). Controlling for age and BMI, the results remained significant. However, the mean plasma IGF-I level was significantly lower in SCI subjects younger than 45 years old than in the similar subgroup of age-restricted controls (202 +/- 19 versus 324 +/- 27 ng/ml, p < 0.05), whereas, a comparison of subgroups of subjects 45 years or older did not reveal a significant difference. These findings support the hypothesis that decreased daily physical activity results in depression of the hGH/IGF-I axis in younger individuals with SCI and may be considered to be a state of premature aging.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

Transient decrease of binding of insulin to platelets in acute ischemic heart disease.

The specific binding sites of 125I-insulin in platelets from nondiabetic patients with acute myocardial infarction and unstable angina pectoris was significantly decreased (192 +/- 84/cell) during the acute ischemic condition when compared with normal platelets (496 +/- 76/cell; p < 0.001, n = 9). A relatively low mean plasma insulin level (20 microU/mL) with an elevated mean glucose level (130 mg/dL) was noted. The decreased binding of insulin and the relatively low mean plasma insulin level during the acute ischemic condition improved into the normal range during 8 to 12 weeks of recuperation. The decrease of insulin binding sites in the acute phase and their subsequent increase during recovery were directly related to the hormone-induced increase in sensitivity to prostaglandin E1 through the stimulation of adenosine 3',5'-cyclic monophosphate formation in platelets by the prostanoid.

Acute Disease↗

PubMed1994

Chronic baclofen therapy improves the blunted growth hormone response to intravenous arginine in subjects with spinal cord injury.

Human GH (hGH) secretion is stimulated by vigorous physical activity, whereas immobilization reduces its release. In paralyzed subjects with spinal cord injury (SCI), it has recently been shown that the release of hGH to provocative stimulation and plasma insulin-like growth factor-I (IGF-I) levels are reduced. The acute administration of baclofen, a gamma-aminobutyric acid derivative, has been shown to stimulate hGH release. The present study investigated the effect of chronic administration of baclofen on the provocative testing of hGH secretion and plasma IGF-I levels. Sixteen subjects with SCI were studied; eight subjects were treated (40-80 mg/day; > 6 months) with baclofen (Bac+), and eight were not (Bac-). Additionally, 8 non-SCI subjects were studied as controls. The groups were matched for gender and age. The subjects were not receiving any medications known to influence hGH secretion. After an overnight fast, arginine hydrochloride (30 g/subject) was infused iv over 30 min, with blood drawn for hormone determinations at baseline and 30, 60, 90, and 120 min. In the Bac- group compared with the Bac+ group, the arginine-stimulated mean plasma hGH levels at 30 and 60 min (P < 0.05) and peak and sum plasma hGH levels (P < 0.01) were reduced. There were no significant differences in the plasma hGH response between the Bac+ group and the control group. Plasma IGF-I levels may reflect the integrated tissue response to hGH. A significant inverse relationship was present between age and plasma IGF-I levels for the control and Bac+ groups, but not for the Bac- group. The mean plasma IGF-I level was significantly reduced in the Bac- compared with the Bac+ group. No significant differences in mean plasma IGF-I levels were noted between the Bac+ and control groups. SCI is associated with body composition changes and metabolic alterations that may be exacerbated by reduced activity of the hGH-IGF-I axis. Oral chronic baclofen therapy appears to reverse the deleterious effects of paralysis and immobilization on hGH physiology.

Adult↗

PubMed1994

Bronchial hyperresponsiveness after cervical spinal cord injury.

Cervical spinal cord injury results in interruption of sympathetic airway innervation, which originates from the upper thoracic spine, whereas parasympathetic nerve supply, arising in the vagal nuclei of the brainstem, remains intact. To assess the effect of such an altered neural environment on airway reactivity, bronchoprovocation testing was performed on eight subjects with nonacute traumatic lesions of the cervical spine, all of whom were lifetime nonsmokers without history of respiratory symptoms prior to their injury. Bronchial challenge was subsequently repeated after pretreatment with the anticholinergic agent, ipratropium bromide, an inhibitor of airway muscarinic receptors. All subjects demonstrated hyperresponsiveness to methacholine (the concentration of methacholine producing a fall in FEV1 of 20 percent from baseline [PC20] = 1.42 +/- 1.61 [SD] mg/ml). Airway hyperreactivity was completely blocked by pretreatment with inhaled ipratropium bromide (mean PC20 > 25 mg/ml [p < 0.0001]). The bronchial hyperresponsiveness observed in this population most likely reflects the loss of sympathetic airway innervation and resultant unopposed cholinergic bronchoconstrictor tone which results from transection of the cervical spine. Blockade of methacholine hyperresponsiveness with ipratropium bromide suggests a muscarinic receptor-mediated phenomenon.

Administration, Inhalation↗

PubMed1994

Inhibition of bronchial hyperresponsiveness by the GABA-agonist baclofen.

gamma-Aminobutyric acid (GABA) is a well-known inhibitory transmitter of the central nervous system. Recently, the presence of GABA and its receptors has been confirmed in peripheral tissues, including lung tissue. gamma-Aminobutyric acid and the GABA-agonist baclofen have been shown in animal studies to inhibit airway responsiveness to various bronchoconstricting agents. The results of these investigations suggest the possibility of a role for baclofen in the therapy of human airway hyperreactivity. We recently showed that subjects with cervical spinal cord injury (quadriplegia) uniformly exhibit hyperresponsiveness to methacholine. The interruption of sympathetic airway innervation and resultant unopposed cholinergic tone occurring after transection of the cervical spine are thought to explain this phenomenon. We compared bronchial responsiveness with methacholine (PC20) in a control group of otherwise healthy quadriplegic nonsmokers (n = 8) with a similar group of subjects (n = 6) maintained on baclofen for the relief of muscle spasm. Mean PC20 (mg/ml) among the control group was 1.42 +/- 1.6(SD) vs 15.0 +/- 9.1 in the baclofen group (p = 0.001). The inhibition of bronchial hyperresponsiveness in subjects with cervical spinal cord injury maintained on chronic baclofen therapy suggests the drug's ability to block neuronal acetylcholine release within airways, as well as a possible direct effect on airway smooth muscle. This action of baclofen, along with its documented ability in animal lung to inhibit release of other inflammatory mediators, supports further investigation of this drug as a potential therapeutic agent for asthma treatment.

Adult↗

PubMed1994

Gastric emptying rates to liquid or solid meals appear to be unaffected by spinal cord injury.

OBJECTIVES: There is controversy with regard to the effect of spinal cord injury (SCI) on gastric emptying times of liquids. The emptying rates of solids in subjects with SCI have not yet been addressed. Thus, the gastric emptying rates for both liquids and solids were studied by radionuclide imaging in subjects with chronic SCI. METHODS: After an overnight fast, subjects with SCI were evaluated for gastric emptying rates for iso-osmolar (normal saline) and hyperosmolar (glucose) liquids and a mixed meal of liquids and solids. Twenty-five subjects received normal saline (500 ml). Of these 25 subjects, 16 and 4 others (a total of 20 subjects) received 75 g glucose dissolved in 225 ml water. Each of the liquid meals was labeled with 300 microCi technetium-99-m-diethylenetriaminepentaacetic acid (99mTc-DPTA). The mixed meal consisted of egg white labeled with 300 microCi technetium-99m-sulfur colloid (99mTc-SC) between two slices of toast with water (110 ml). Each test meal was followed by anterior radionuclide imaging of the stomach with the subject seated. The results were compared with those of matched healthy nonSCI subjects from the literature. RESULTS: Compared with gastric emptying times reported in the literature in healthy subjects without SCI, no significant differences were noted in those with SCI with regard to rates of gastric emptying for liquids (whether iso- or hyperosmolar) and for solids. CONCLUSIONS: Our findings do not support the previously reported results of a delay in gastric emptying for liquids in subjects with SCI. We have extended our findings of essentially normal rates of gastric emptying of liquids to that of solids.

Adult↗