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Biomedical subjects

W Sircus

Publications and source records attributed to W Sircus.

At least 55 records · Page 3Linked to original sources
PubMed1976

The relation between functioning parietal cell and gastrin cell masses in two groups of duodenal ulcer patients.

1. Serum gastrin concentrations before and after a standardized meal were determined in twenty-eight patients with duodenal ulcer and in ten normal control subjects. 2. In response to pentagastrin, thirteen of the duodenal ulcer subjects secreted acid within the limits of normal and fifteen secreted in excess. 3. The differences in the basal serum gastrin concentrations between the three groups, normal subjects, acid "normosecretors" and hypersecretors were not statistically significant but that of the hypersecretors was suggestively low. 4. The integrated gastrin response and peak gastrin responses to meals were higher in duodenal ulcer patients with normal acid secretion than in the hyper-secretors but the values for the latter were not different from normal subjects. 5. Stabilization of intragastric pH by infusion into the antrum of sodium bicarbonate during the test meal response period did not alter these differences between the two ulcer patient groups. 6. A significant inverse correlation exists between the maximal acid output and the integrated gastrin response in both normal subjects and hypersecreting duodenal ulcer patients. 7. The evidence (a) supports the existence of an inverse relationship between the functioning parietal cell and gastrin cell masses, (b) shows the gastrin response in normosecreting ulcer subjects to be inappropriately high, and (c) suggests that excessive vagotonia exerts trophic effects upon both parietal cell mass and gastrin cell mass.

Adolescent↗
PubMed1976

A comparison of the acid and gastrin secretory responses to hypoglycaemia and meals in duodenal ulcer with and without acid hypersecretion to pentagastrin.

In 60 uncomplicated duodenal ulcers (DU), maximum acid output (MAO) and acid output following insulin hypoglycaemia (IAO) were measured, and in 30 patients also the serum gastrin responses to insulin and to standard meals, In 7 normal controls, all 4 items were measured. Thirty-six of the DU had MAO within normal limits (normosecretors) and 24 were hypersecretors. Hypoglycaemic vagal response was higher in all DU than in normals and was, in normo-secreting DU associated with an abnormally large functioning G cell mass. This mass is not increased in hypersecreting DU and the greater vagal capacity is related to a supranormal parietal cell mass. An unknown mechanism, perhaps genetic, directs the trophic effects of an increased vagal drive to the gastrin cell mass in one group of DU and to the parietal cell mass in the other.

Adult↗
PubMed1975

Neglected coeliac disease.

A review has been carried out of patients diagnosed as having coeliac disease some years previously and subsequently lost to follow-up. Most were unaware of the need for continuing treatment and had returned to a normal diet. The resulting morbidity was slight, although one patient had died of a small-bowel lymphoma. If untreated coeliac disease is indeed a pre-malignant condition, then it is suggested that there must be a large population at risk, with no motivation to return to treatment other than the risk of malignancy itself.

Adolescent↗
PubMed1975

Studies on duodenal ulcer. I. The clinical evidence for the existence of two populations.

Secretory and clinical characteristics of 339 hospital patients with uncomplicated duodenal ulcers, 182 with pyloro-duodenal stenosis, 124 operated upon in Copenhagen by proximal vagotomy and 174 in whom bleeding or perforation was the reason for admission were studied. The results indicate that all duodenal ulcer subjects secrete more acid than normal, but that in approximately half of them acid secretion to maximal stimulation does not rise outwith the range of normal and most of these are of O blood group. These patients are classified as Type I duodenal ulcer. The character of acid hypersecretion beyond two standard deviations of the mean of the maximal acid output in normal subjects appears to be determined mainly by the possession of A, B and AB blood group: these hypersecreting ulcer patients are classified as Type II. The complications of perforation and bleeding and stenosis are linked mostly to the O group subjects and not to acid hypersecretion as such, but the strongest family prevalence is in the A, B, AB series and in them also the disease appears earlier. A hypothesis is presented to explain the aetiology of the two types.

ABO Blood-Group System↗
PubMed1974

Role of gastric irradiation in management of peptic ulceration and oesophagitis.

Twenty-four patients with peptic oesophagitis or ulceration of the stomach or duodenum have been treated with irradiation of the stomach. They were selected on the grounds of their unsuitability for surgery because of associated medical conditions or because of failure of repeated gastric surgery. Twenty of the patients (83%) were 60 years of age or over. Of those treated 19 (79%) obtained complete symptomatic relief. Endoscopic improvement occurred in most cases. Acid reduction to an average of 30% of the pretreatment levels was noted at 11 months and 58% at 30 months. No morbidity was observed attributable to the irradiation.

Adult↗
PubMed1974

Factors influencing duodenal trypsin levels following a standard test meal as a test of pancreatic function.

In this investigation, the measurement of trypsin levels in duodenal juice following a standard test meal (Lundh test) was evaluated as a test of pancreatic function, and a study was made of diseases and other factors which may influence its diagnostic efficiency. The method of trypsin assay, which required only basic laboratory equipment, gave a linear concentration-activity curve, with a threshold at 50 mug of crystalline trypsin per ml. Intestinal juice could be frozen and stored for up to six weeks with no detectable loss of tryptic activity. The normal control values were very similar to those found by other workers and were unaffected by the sex or age of the subject. When used to assess 32 patients in whom the presence or absence of pancreatic disease had been clearly established, the test had a diagnostic success rate of 94%. Retrospective analysis of results from 98 patients showed that trypsin levels were generally grossly reduced in patients with chronic pancreatitis or carcinoma of the head of the pancreas. Trypsin levels were normal in most patients with steatorrhoea not of pancreatic origin. Levels were generally depressed to intermediate levels in patients with a diabetic glucose tolerance, with or without steatorrhoea, but no other sign of pancreatic insufficiency. Some lowering of trypsin levels was also noted in patients having an obstruction of the common bile duct. A small but significant depression of tryptic activity was noted in patients with villous atrophy and no pancreatic disease.

Adult↗
PubMed1973

The metabolism of salicylazosulphapyridine in ulcerative colitis. I. The relationship between metabolites and the response to treatment in inpatients.

The metabolism of salicylazosulphapyridine was studied in 16 patients with ulcerative colitis admitted to hospital. The acetylator phenotype was determined on admission. The mean serum concentration (mug/ml) (at steady state eight +/- two days in patients responding to treatment) of SASP, total SP, and 5-ASA were 18.7 +/- 12.8; 53.7 +/- 23.1; and 1 +/- 0.9 for slow acetylators and 17.6 +/- 7.1; 31 +/- 9.0 and 1 +/- 0.9 for fast acetylators respectively. Twenty-four hour urinary excretion of SASP, total SP, and 5-ASA were 4.6% +/- 3.1; 52% +/- 9.6 and 22.3 +/- 6.7% of the administered dose respectively. Serum total SP concentration of 20 to 50 mug/ml appeared to coincide with clinical improvement in the absence of any side effects related to salicylazosulphapyridine. No such relationship could be shown with serum SASP, individual metabolites, or 5-aminosalicyclic acid.

Acetylation↗
PubMed1972

Comparative evaluation of water recovery test and fluoroscopic screening in positioning a nasogastric tube during gastric secretory studies.

Acid secretion studies were carried out in 50 patients. Fluoroscopy or a modified water recovery test was used to position the nasogastric tube. For every patient each positioning procedure was used on one of two consecutive days, and acid output studies were performed. The tests were assessed by two observers and accepted or rejected. Analysis revealed no significant differences between the acid studies irrespective of the method used for positioning the nasogastric tube. Rejection rates by either procedure showed no significant difference. Practical considerations favour the continued use of water recovery as a means of positioning the nasogastric tube for gastric secretion studies.

Analysis of Variance↗