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Biomedical subjects

W H Hall

Publications and source records attributed to W H Hall.

At least 55 records · Page 3Linked to original sources

Effect of fluoroscopic tube placement on basal gastric secretion collections.

To determine whether fluoroscopic positioning of nasogastric tubes is useful in the measurement of basal gastric acid output, four subjects were studied six times each and two subjects ten times each. Fluoroscopic positioning was used or not used according to random sequences. No more gastric juice was obtained in the collections after fluoroscopic positioning of the nasogastric tube than after blind placement. The results suggest no routine need to use fluoroscopic tube placement in the absence of prior gastric surgery.

Adolescent↗

Gastric emptying of hypertonic glucose in diabetes mellitus and duodenal ulcer.

Gastric emptying of hypertonic glucose liquid meals was studied in diabetes, duodenal ulcer, and hospitalized controls by means of the 10% glucose 30-minute test meal, with phenol red as nonabsorbable marker. Acid secreted into the meal was measured. Results revealed no significant difference in gastric emptying between controls and patients with duodenal ulcer and diabetes mellitus. Among diabetics, some individuals empty this meal more rapidly than normal. The results show that alterations of gastric emptying cannot account for the late peaks observed on oral glucose tolerance tests in diabetics, nor for any tendency toward reactive hypoglycemia in duodenal ulcer. They suggest that autovagotomy may occur in some diabetics.

Diabetes Mellitus↗

Antibiotic penetrance of ascitic fluid in dogs.

Antibiotic concentrations in ascitic fluid after parenteral therapy may be important in the treatment of peritonitis. We have created ascites in dogs by partial ligation of the inferior vena cava. Ascitic fluid volume was measured at the time each antibiotic was administered. Nine antibiotics were studied in the same three dogs. Antibiotic concentration in ascitic fluid was found to vary inversely with ascites volume. Percentage of penetration (ratio of ascites peak to serum peak x100) ranged from 5.8 to 65% among the drugs studied. Only metronidazole showed a statistically significant higher percentage of penetration than other antimicrobials. Concentrations in ascitic fluid after single doses of cephalothin (15 mg/kg) and the aminoglycosides (2 mg/kg, gentamicin and tobramycin; 7.5 mg/kg, amikacin and kanamycin) did not exceed the minimum inhibitory concentration of many gram-negative rods and may justify the use of higher than usual initial parenteral doses, or possibly initial intraperitoneal administration in seriously ill patients.

Aminoglycosides↗

Cephalosporin and aminoglycoside concentrations in peritoneal capsular fluid in rabbits.

To study the penetration of antibiotics into peritoneal tissue fluid, a subcutaneous tissue capsule model was modified by implanting multiple, perforated spherical capsules in the peritoneal cavity of rabbits. Capsules became vascularized, encased in connective tissue, and filled with fluid having a mean protein concentration of 3.6 g/100 ml. Capsular fluid was obtained by percutaneous needle aspiration and assayed for antibiotic by the disk plate bioassay technique. Cephalosporins were administered intramuscularly at a dose of 30 mg/kg. Mean peak concentrations of cephaloridine and cefazolin were significantly higher than cephalothin and cephapirin in capsular fluids, but the percent penetration (ratio of capsular mean peak to serum mean peak) ranged from 8.7 to 16.9% and was not significantly different among the cephalosporins. At 24 h the capsular concentration of cefazolin was significantly greater than for the other cephalosporins (P < 0.001). Lower rabbit serum protein binding observed at high in vivo concentrations may have enabled cefazolin to penetrate capsular fluid, but in vitro protein binding studies did not confirm a decrease in serum protein binding at high concentrations within the clinical range. Kanamycin and amikacin showed comparable capsular fluid peak concentrations as did gentamicin and tobramycin. The percent penetration ranged from 15.2 to 34.5% for the aminoglycosides. The only statistical difference was that amikacin penetration was significantly higher than that for tobramycin. Mean capsular concentrations of amikacin, cefazolin, and cephaloridine compared most favorably with the minimum inhibitory concentration of gram-negative bacilli at the dosages used in this study.

Aminoglycosides↗

Effect of calcium infusions of serum calcium and gastric acid secretion.

37 patients were studied with calcium infusions. Of these, 20 had previously undergone truncal vagotomy and pyloroplasty for duodenal ulcer disease, and 17 were unoperated patients with duodenal ulcer disease. Calcium was given intravenously either at a dose of 5 mg/kg/h for 3 h, or 4 mg/kg/h for 4 h. Gastric juice was collected by continuous suction. Results showed the 3-hour infusion raised calcium more than the 4-hour infusion. Top serum calcium achieved, however, did not correlate with calcium-stimulated gastric acid output, either with or without vagotomy. Stimulated gastric acid secretion was markedly less with vagotomy than without. It is suggested that the level of gastric acid stimulated by infusions might discriminate complete, from incomplete, vagotomies better than insulin, and that the 4-hour infusion is safer.

Calcium↗

Transient tuberculous meningitis.

Tuberculous meningitis generally is considered to be relentlessly progressive, unless specific therapy is administered. The "aseptic meningitis" of a 56-year-old diabetic patient proved to be tuberculous and regressed spontaneously. Review of the literature shows that spontaneous healing of tuberculous meningitis has been described and demonstrated previously. Awareness of this entity and its recognition are important because this disease may be a focus for subsequent tuberculosis of other organ systems.

Humans↗

Attenuated influenza virus in normal adults: role of pulmonary function studies in vaccine trials.

A live attenuated virus, influenza A/Hong Kong/68(H3N2)-ts-1[E], was administered to 10 normal volunteers. Infection resulted in minor upper respiratory tract symptoms in one volunteer. An isolate from one volunteer contained a presumed revertant wild-type virus, but no clinical significance could be ascribed to this infection. Since infection with natural influenza A virus adversely affects airway dynamics, serial tests of pulmonary function were performed, including measurements of forced expiratory flow rates, lung volumes, diffusing capacity, closing volume, and total pulmonary resistance at various frequencies by the oscillometric technique. All tests performed before and on days 3, 30, and 60 after administration of virus yielded normal results throughout the study; these results suggested that there was no inflammatory response to the candidate vaccine in either the large or the small airways. Determination of total pulmonary resistance by the oscillometric technique proved to be a simple and acceptable procedure and may be useful in large-scale epidemiologic studies.

Adult↗

Sleep patterns and gastric acid secretion in duodenal ucler disease.

Five normal volunteers and five patients with duodenal ulcer (DU) disease were studied for five consecutive nights. All subjects underwent placement of a nasogastric tube, continuous collection of gastric juice, and continuous electroencephalographic monitoring of sleep. Gastric juice was collected in 20-minute samples by remote suction (Gomco). Blood samples were drawn every 20 minutes on the third night via an indwelling venous needle. Results showed no significant correlations between the sleep variables and the gastric acid secretion measures or between the sleep variables and serum gastrin levels. Acid secretion decreased from hour 1 to hour 2 in controls and in patients with inactive DU disease, while it increased in patients with active DU disease. Each subject had at least one night of recording in which continuous gastric secretion was less than 0.1 mEq per 20-minute sample. It appears unlikely that the gastric discomfort of DU patients can be attributed to acid hypersecretion triggered by rapid eye movement sleep.

Duodenal Ulcer↗

Pasteurella multocida peritonitis in hepatic cirrhosis with ascites.

Two patients with spontaneous Pasteurella multocida peritonitis in association with cirrhosis and ascites are described. Both patients had close contact with domestic animals, but neither had been bitten. Both patients died, but only one as a result of his infection. We are aware of only one previous report of cirrhosis with spontaneous peritonitis caused by this organism. P. multocida should be considered as a possible cause of peritonitis in cirrhotic patients with a history of close contact with animals, particularly cats.

Animals↗

Gastric acid secretory differences in patients with Heineke-Mikulicz and Finney pyloroplasties.

To study gastric emptying and secretion, liquid meals of 10% glucose lasting 15 and 30 min, and physiological saline meals lasting 30 min, all containing phenol red as a gastric nonabsorbable marker, were given to postvagotomy patients with Finney or Heineke-Mikulicz pyloroplasties. No differences in emptying were found. A small but statistically greater amount of acid was found in the stomach with the 15-min glucose meal after Heineke-Mikulicz pyloroplasty. This represented greater acid secretion into glucose meals generally after Heineke-Mikulicz pyloroplasties, because of the larger volume contained in the stomach at 15 min. 15-min glucose meal acid secretion correlated with basal acid concentration but not with insulin-stimulated gastric acid output. The small excess of acid in the Heineke-Mikulicz group's 15-min glucose meals may represent a small, maintained excess of gastric acid in this group detected only in the brief glucose meals due to rapid and erratic gastric emptying of liquids after vagotomy.

Gastric Juice↗

Protein-losing enteropathy in lymphoma of the small intestine.

A patient with crampy abdominal pain was found to have involvement of the jejunum and ileum with innumerable small polypoid filling defects. At laparotomy, dilated serosal lymphatics were seen, and a diagnosis of lymphoma was established on the basis of intestinal and lymph node biopsy. Later, he was determined to have protein-losing enteropathy, and this parameter was used to assess his response to chemotherapy directed at the lymphoma.

Adult↗

Effect of protein concentration and binding on antibiotic assays.

ASSAY CURVES, USING A DISK DIFFUSION METHOD FOR THE ANTIBIOTICS GENTAMICIN AND CEFAZOLIN, WERE PREPARED WITH: saline, saline plus 10% serum, and ascitic, synovial, cerebrospinal, and pleural fluids. The curves were compared with a standard curve prepared with pooled human serum. The pH, total protein, glucose, blood urea nitrogen, sodium, potassium, calcium, phosphorus, chloride, CO(2) content, uric acid, cholesterol, bilirubin, serum glutamic oxalacetic transaminase, CPK, LDH, and alkaline phosphatase were determined and compared for all fluids. Measurements for cefazolin levels were falsely elevated in those fluids with low protein content when serum was used as a reference standard. There was a linear inverse relationship between the protein content of the fluids and the cefazolin level with serum as the standard for the assay of this highly protein-bound antibiotic. No discrepancies were observed in the assay curves for gentamicin, an antibiotic known not to be bound by serum proteins.

Anti-Bacterial Agents↗

The origins of some hitherto undescribed inbred mouse strains.

The origins of 7 inbred mouse strains (OUBW, OUCW, OUGW, OUYW, OUBCr, OUF and OUW) are reported. 6 of these strains have been in existence for a number of years, and 4 of them have not been mentioned in the literature. 2 of the strains have been referred to in published work, but because of incorrect designation may have caused some confusion. The remaining strain (OUBCr), which has considerable research potential, has been developed from a mutation in an NZB subline.

Animals↗