摘要:

ABSTRACTUsing a radiolabelled bran preparation, a large field of view gamma‐camera and a computer, a method has been developed to define and analyse the gastrointestinal transit profile of solids. Unprocessed bran, labelled with technetium (99mTc) sulphur colloid is incorporated into biscuits cooked in a microwave oven. With this preparation, less than 3.4% of the isotope dissociated from the bran in a gastric milieu, and more than 90% of recovered radionuclide activity, were retained with the solid phase during small intestinal transit in subjects with stable ileostomy function. A normal range for gastric emptying (GE), small intestinal transit (IT) and colonic filling (CF) was established in 15 healthy volunteers. Anterior and posterior images were taken until all isotope was present in the colon. Using regions of interest for the stomach and colon, decay corrected geometric mean curves for GE and CF were generated. GE was characterized by a lag phase followed by a linear emptying phase. The GE profile (mean and standard deviation) was described by ‘power exponential’ parameters of half‐emptying time (1.6 ± 0.4 h) and β(1.5 ± 0.2). The IT time was 3.9 ± 1.5 h. The onset of CF was determined visually (4.1 ± 1.5 h), and the time of 50% CF filling was determined from the colonic filling curve (5.5 ± 1.4 h). This technique should provide a useful, practical, clinical and research test to study the pathophysiology and pharmacology of intestinal mo

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1989.tb00815.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTSome infants intolerant to cow's milk protein (CMP) are often also intolerant to other food proteins including soy protein (SP). The effect of CMP and SP in infants recovering from diarrhoeal disease was studied in 22 infants who were maintained on an hypo‐allergenic formula for 4–6 weeks. The infants were then challenged successively, initially with SP, followed 24 h later with CMP and then rechallenged with SP 24 h after CMP provocation. Three groups were recognized on the basis of clinical symptoms and mucosal changes following SP challenge.Group 1 comprised four infants who developed clinical and histological reactions on SP challenge. The subsequent CMP challenge, 24 h after the initial SP challenge, resulted in clinical symptoms in three of the four infants, and they developed increased mucosal injury. Rechallenge with SP in the three infants caused development of severe clinical symptoms.Group 2 comprised 12 infants who developed histological reaction but had no clinical symptoms to initial SP challenge. The subsequent CMP challenge caused further progression in mucosal pathology in 11 of the 12 infants and six also had associated clinical symptoms. Rechallenge with SP in the latter six infants resulted in development of clinical symptoms in three and tolerance to SP in three infants.Group 3 comprised six infants who tolerated SP and CMP but one of these infants developed mild histological changes to CMP. The progression of mucosal injury following SP and CMP challenge was associated with a significant decrease in mucosal disaccharidases, alkaline phosphatase levels and presence of reducing sugar in the stools. The 1 h blood xylose level continued to decrease significantly following the pre‐SP, post‐SP, and post‐CMP challenge.It appears that the small bowel mucosa of young infants recovering from diarrhoea1 disease remains sensitive not only to CMP but also to SP. The feeding of these proteins in rapid successive sequence to infants with mucosal damage might result in further progression of the mucosal injury. Thus, the exclusion for a variable period of time of antigenic food proteins like CMP and SP from the diet of young infants recovering from diarrhoea might reduce the risk of inducing mucosal sensitivity to these proteins in susceptibl

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1989.tb00816.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTThe diagnostic value of endoscopic biopsy from the ulcer margin (six specimens) and the base (six specimens) in 46 cases of gastric malignancy was evaluated. The biopsy positive rates for malignancy from the ulcer margin and the base were 42 of 46 (91.3%) and 37 of 46 (80.4%), respectively (P= 0.2312). The diagnostic positive rate was increased to 95.6% (44 of 46) when the results of 12 biopsy specimens obtained from the ulcer margin and the base were combined. The diagnostic positive rate was not statistically different when the morphology or the location of the gastric malignancy was considered. No complication of massive bleeding or perforation was found after both sites had been biopsied. It is concluded that the margin and the base of a gastric malignant ulcer are both suitable and diagnostically effective for endoscopic biopsy. If the ulcer margin of the gastric malignancy is difficult to approach, the ulcer base appears to be a satisfactory alternative site for endoscopic biopsy.

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1989.tb00817.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTH2‐Receptor antagonists and omeprazole, a H‐K ATPase inhibitor, inhibit acid secretion from the parietal cells. The ultrastructural changes of the parietal cells after treatment have been described, but the changes in the mitochondrial activity which reflect the energetic metabolism were not well defined. To study the effect of omeprazole and H2‐receptor antagonists on the mitochondrial activity of the parietal cells, endoscopic biopsies were taken from nine patients with duodenal ulcer before and after treatment with either 10 mg or 20 mg omeprazole each morning, or 150 mg ranitidine twice daily for 2 weeks, given in a double‐blind randomized manner. Three patients with healed duodenal ulcer who were on maintainence treatment with 150 mg ranitidine nightly for 1 year had an endoscopy performed after 4 and 12 months and two non‐ulcer dyspeptic patients were recruited as controls. Three biopsies were taken during each endoscopy from the body of the stomach. The mitochondrial activity was assessed by the reaction of succinic dehydrogenase with nitroblue tetrazolium and of cytochrome oxidase with naphthoic acid mixed withN‐phenyl‐p‐phenylenediamine, according to the intensity of the staining reaction. After treatment with omeprazole or ranitidine, the mitochondrial activity decreased appreciably and returned to the pretreatment level on cessation of treatment. Patients on maintainence ranitidine showed decreased mitochondrial activities after 4 months, which, however, returned to pretreatment levels in two patients. It is concluded that short‐term treatment with omeprazole or ranitidine resulted in reversible suppression of mitochondrial activity while long‐term treatment with ranitidine resulted in an initial suppression followed by a tendency to return to pretreatment level despite

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1989.tb00818.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTTwo hundred and fifty‐three cases of acute viral hepatitis admitted to Ibn Al‐Khateeb Infectious Disease Hospital, Baghdad, were studied prospectively regarding the viral aetiological agent. The most common cause was infection with one of the non‐A, non‐B viruses (51%). The second most common cause was infection with the hepatitis B virus (32%); two of these patients had hepatitis δ‐co‐infection. Hepatitis A virus was responsible for 15% of the cases, and hepatitis δ‐virus superinfection in

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1989.tb00819.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Thirty‐eight children, aged 1–15 years, with portal hypertension and recent variceal bleeding, were treated with repeated endoscopic sclerotherapy. Thirty‐six of them had extrahepatic portal venous obstruction. Obliteration of varices was achieved in 35 (92%) patients requiring an average of 5.3 sessions per patient. Major complications occurred in seven patients, three of whom had oesophageal perforations and four had oesophageal stricture. Sclerotherapy significantly reduced the rate of rebleeding after the start of sclerotherapy and more so after variceal obliter

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1989.tb00820.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTThirty‐six patients with fulminant viral hepatitis were studied. Enzyme immunoassay was used to detect the presence of HBsAg, IgM anti‐HBc, and IgM anti‐HAV. Non‐A, non‐B virus was the most common aetiological agent (61.1%) followed by hepatitis B virus (HBV; 30.6%) and hepatitis A virus (8.3%). Presence of IgM anti‐HBc confirmed the diagnosis of HBV infection in three cases who were negative for HBsAg. Similarly, in one case who was positive for HBsAg, absence of IgM anti‐HBc suggested superinfection with some other agent. Survival was significantly higher (P<0.01) in the hepatitis A virus (HAV) group (66.6%) compared with non‐A, non‐B (31.2%) and HBV groups (27.3%). Fever at the onset of illness was seen in all patients with HAV, 54.5% of patients with HBV and 38.88% of patients with non‐A, non‐B infection (P<0.01). The median time interval between the first symptom and the onset of encephalopathy was 16, 13 and 8 days in HAV, HBV and non‐A, non‐B groups, respectively, but this difference was statistically

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1989.tb00821.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTPlasma levels of human atrial natriuretic peptide (hANP) were investigated in patients with liver cirrhosis, and the relationships between plasma hANP levels and the following factors were studied: presence of ascites, serum and urine electrolytes, plasma renin activity, angiotensin I and II, aldosterone, catecholamines, prostaglandin derivatives, conventional liver function tests and circulating blood volume.Plasma hANP level was significantly (P<0.05) elevated in patients with ascites (mean = 58.6 pg/mL, s.e.m. = 8.8) compared with cases without ascites (mean = 36.6 pg/mL, s.e.m. = 2.6). With the disappearance of ascites, the level fell to normal in most cases. Urine sodium excretion was positively correlated with plasma hANP in patients without ascites, but not in patients with ascites. The plasma hANP level was disproportionately high for the rate of urinary Na excretion in cirrhotics with ascites. The plasma hANP level was not correlated with any of the other factors such as blood volume, renin‐angiotensin‐aldosterone levels, catecholamines and liver function tests.These results suggest that plasma hANP levels are elevated in cirrhotic patients especially with ascites, but the natriuretic response of the kidney to this raised hANP level can be impaired in patients with liver cirrhosis and asci

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1989.tb00822.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1989.tb00823.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACTRecent developments in recombinant DNA techniques have allowed an understanding of the molecular genetics of many diseases, some affecting the gastrointestinal tract and liver. DNA probes which detect sequences within or near disease genes can be selected by direct approaches, if the gene product or primary gene function is known, or by indirect methods when the chromosomal location is known. Such probes have resulted in extensive family studies which can now define risks to family members of developing a genetic disease. The development of the polymerase chain reaction will also be of considerable use in clinical genetics and in the diagnosis of some infectious diseases. The techniques are summarized and examples of their use are given. A glossary of terms is also provided.

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1989.tb00824.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY