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Biomedical subjects

A H Love

Publications and source records attributed to A H Love.

At least 19 recordsLinked to original sources
PubMed1992

Symptom index as a marker of gastro-oesophageal reflux disease.

Forty per cent of patients with heartburn may have no evidence of oesophagitis or of abnormal oesophageal acid exposure. The symptom index correlates symptoms that occur during pH monitoring with episodes of acid reflux, being the number of symptoms during reflux divided by the total number occurring during monitoring. This index was assessed in 61 patients with heartburn. In 39 patients with endoscopic evidence of oesophagitis or abnormal acid exposure times on pH monitoring, the symptom index had a sensitivity of 90 per cent. Of the 22 patients with no objective abnormality, the index was > or = 50 per cent in five (23 per cent) whose symptoms were presumably due to acid reflux despite results of other investigations being normal, suggesting an acid-sensitive oesophagus. The symptom index is a useful additional measure in the investigation of patients with suspected gastro-oesophageal reflux disease.

Esophagitis↗
PubMed1992

Serum copper and zinc in random samples of the population of Northern Ireland.

Serum copper and zinc concentrations (mumol/L) were measured in nonfasting subjects aged 25-64 y participating in two independent population surveys in Northern Ireland. In 1983-84, copper in 1144 males was 17.2 +/- 3.1 (mean +/- SD) and zinc was 12.1 +/- 1.7 (SD). Copper in 1055 females, neither pregnant nor taking estrogens or progestogens, was 19.0 +/- 3.9 and zinc was 11.6 +/- 1.4. In 1986-87 copper in 1142 males was 17.9 +/- 3.3 and zinc was 13.2 +/- 2.1. Copper in 1034 females was 20.1 +/- 3.9 and zinc was 12.7 +/- 2.0. Zinc but not copper concentrations decreased from early morning to late afternoon; both were unaffected by reported postprandial time. There was a positive relationship between copper and age for both sexes but zinc showed only a slight upward trend with age. A positive relationship between copper and the aggregation of classical risk factors for coronary heart disease was demonstrated.

Adult↗
PubMed1991

Grading of superficial antral gastritis: comparison of cell-counting and photographic-based methods.

A cell-counting technique and a photographic-based scoring system for assessing inflammatory cell infiltration were compared for agreement in 275 endoscopic gastric antral biopsies from 55 dyspeptic patients. Each biopsy was independently scored 0-5 for polymorphs and mononuclear cells using both methods, and a mean score was derived for each patient. There was a highly significant correlation between the mean patient scores obtained using each method (P less than 0.001). Agreement statistics showed that the mean score difference (cell-counting minus photographic score) was negative for polymorphonuclear and mononuclear cells, indicating that the photographic method yielded higher mean patient scores. Scatterplots of difference versus mean by the two methods showed that only 3.6 per cent of scores fell outside +/- 2 SD of the mean difference. The use of standard photomicrographs to grade superficial antral gastritis therefore provides accurate results, comparable to those obtained by cell counting, yet is a faster and much cheaper technique.

Biopsy↗
PubMed1991

A comparison of symptoms between non-ulcer dyspepsia patients positive and negative for Helicobacter pylori.

The role of Helicobacter pylori infection in the symptom complex associated with non-ulcer dyspepsia is uncertain, despite the presence of the organism in a high proportion of these patients. In order to exclude physician bias in history taking, 18 patients (9 female) diagnosed as non-ulcer dyspepsia, after endoscopy and gallbladder ultrasonography, underwent computer interrogation using the Glasgow Diagnostic System for Dyspepsia (GLADYS). Five antral and 3 fundal endoscopic biopsies from these patients were also histologically examined for the presence of Helicobacter pylori and quantitatively analysed for polymorph and chronic inflammatory cell densities per mm2 of lamina propria using computer-linked image analysis. In the group of 9/18 patients who were positive for Helicobacter pylori, there were significantly higher antral and fundal inflammatory cell counts than in negative patients. However, analysis of the GLADYS interrogation data showed no significant positive relationships between Helicobacter pylori positivity and any gastrointestinal symptoms. These results confirm a significant association between Helicobacter pylori and superficial gastritis but suggest that non-ulcer dyspepsia in patients with Helicobacter pylori colonisation is probably not a clinically identifiable and distinct syndrome.

Biopsy↗
PubMed1990

Quantitative histological study of mucosal inflammatory cell densities in endoscopic duodenal biopsy specimens from dyspeptic patients using computer linked image analysis.

Inflammatory cell counting in endoscopic biopsy sections was carried out on duodenal mucosal samples from defined sites in patients with duodenal ulcer, duodenitis but no ulcer, non-ulcer dyspepsia, and asymptomatic controls using computer linked image analysis. The variables measured included polymorphonuclear and mononuclear cells per mm of superficial epithelium and per mm2 lamina propria. Duodenal ulcer crater margin and mucosal biopsy specimens from endoscopically inflamed mucosa in the group with duodenitis but no ulcer showed significantly higher inflammatory cell counts than endoscopically normal non-ulcer dyspepsia and control mucosa. Biopsy specimens from non-ulcer dyspepsia patients showed significantly higher lamina propria polymorphs than control group mucosa. Endoscopically normal duodenal ulcer and duodenitis but no ulcer mucosa also showed significantly higher acute and chronic inflammatory cell counts than controls. The prevalence of Helicobacter pylori in duodenal biopsy specimens was low (0-22%) and unrelated to local inflammatory response. Despite histological appearances, duodenal biopsy specimens from non-ulcer dyspepsia patients showed significantly higher inflammatory cell infiltration than control specimens, suggesting that at least some represent part of a spectrum of subclinical peptic disease.

Adult↗
PubMed1990

Automated measurement of two indicators of human selenium status, and applicability to population studies.

We developed an automated system consisting of a centrifugal analyzer and an atomic absorption spectrophotometer with Zeeman background correction to produce a profile of the concentrations of selenium and the selenium-dependent enzyme glutathione peroxidase (EC 1.11.1.9) in serum and whole blood, for use in epidemiological surveys in Northern Ireland. No pretreatment of samples other than dilution is required, and at least 35 subjects can be screened within 24 h of venesection. For selenium in serum the between-run CV was 5.7% and 4.4% within run. For selenium in whole blood the CV was 5.9% between runs, 5.7% within run. The within-run CV for glutathione peroxidase was 0.92% for serum, 1.18% for blood; the between-run CV was 8.3% for serum. To illustrate the use of the system, we present the profile of selenium and glutathione peroxidase in serum and whole blood from 100 adults 25 to 64 years old.

Adult↗
PubMed1989

Superficial gastritis and Campylobacter pylori in dyspeptic patients--a quantitative study using computer-linked image analysis.

The purpose of this study was the quantitative assessment of mucosal inflammation and its relationship to Campylobacter pylori in gastric antral and body biopsies from patients with dyspepsia and controls. The study groups comprised patients with duodenal ulcer (DU; n = 20), duodenitis (DUN; n = 20), non-ulcer dyspepsia (NUD; n = 20). Using a semi-automatic, computer-linked image analyser (Kontron: MOP Videoplan), mucosal acute and chronic inflammatory cell densities were measured in defined gastric sites for each patient group and expressed as number per mm2 of lamina propria and number per mm length of epithelium. Measurements were also made on a group of asymptomatic controls (n = 9) who fulfilled strict exclusion criteria. All biopsies were analysed for the presence of Camplyobacter pylori (CP) with a Giemsa stain. Data between groups were compared using the Mann-Whitney U-test. In the antrum and body, the mononuclear cell count was significantly higher in lamina propria in DU patients than in DUN, NUD and controls. In the body, DU laminia propria mononuclear cell counts were higher than those of DUN and controls. Prevalence rates for CP for DU, DUN, and NUD were 94, 89, and 50 per cent for antral and 88, 83, and 56 per cent for body biopsies. Significant differences were present between CP-positive and negative subjects in the NUD group. Antral and body inflammation within these clinical groups shows a wide variation. Higher inflammatory cell counts in the DU group may reflect the prevalence of CP colonization.

Adult↗
PubMed1989

Investigation of the relationship between gastric antral inflammation and Campylobacter pylori using graphic tablet planimetry.

Gastric antral endoscopic pinch biopsies from a group of dyspeptic patients were analysed for acute and chronic inflammatory cell numbers in the lamina propria and surface epithelial layer using computer-linked graphic tablet planimetry, and independently graded for Campylobacter pylori (CP) infection using a visual scoring system with grade 1 assessed as patchy epithelial infection and grade 2 as a continuous layer of organisms on the mucosal surface extending into gastric pits. The study group consisted of 36 patients (18 duodenitis; 18 non-ulcer dyspepsia). Within the 140 biopsies analysed, grade 1 and 2 biopsies had significantly higher acute and chronic inflammatory cell counts than CP-negative biopsies (grade 0) in lamina and surface epithelium (P less than 0.001). Acute inflammatory cell counts were significantly higher in the surface epithelium in grade 1 (P less than 0.05) and grade 2 biopsies (P less than 0.001) but chronic inflammatory cells were only higher in grade 1 (P less than 0.01). No significant differences were present between grade 1 and grade 2 biopsies for any parameter. This study confirms that highly significant quantitative differences in the inflammatory status are related to the presence of CP.

Acute Disease↗
PubMed1989

Assessment of oesophagitis by histology and morphometry.

Morphometric measurements of nuclear area, nuclear concentration and nucleolar dimensions in defined tissue zones of orientated oesophageal biopsy sections were compared between three patient groups--asymptomatic/normal endoscopy (n = 8); symptomatic reflux/normal endoscopy (n = 17); and symptomatic/endoscopic oesophagitis (n = 15). No significant differences could be shown for any mean parameter between clinical groups. In a further group of 16 patients, identical morphometric measurements were made in non-orientated grasp biopsies and correlated with prolonged ambulatory pH data. No significant correlations could be shown between nuclear parameters and acid reflux measurements. These results suggest that morphometric measurement cannot be recommended as a diagnostic tool in the diagnosis of oesophagitis, although it may be useful in the assessment of individual therapeutic response in clinical trials.

Adult↗
PubMed1989

Communication skills training for medical students: an integrated approach.

Skills of communication are not easily taught to medical students. Three main clinical departments (general practice, medicine and mental health) of the Medical Faculty of the Queen's University, Belfast, introduced an integrated course in January 1988 to teach the basic principles. The course is held at the beginning of clinical training and is an integral part of the introductory clinical course. It was introduced in response to the Report of a Working Party of the Education Committee of the General Medical Council (1987) which advocated the need for improved training in history-taking and communication. It is a 12-week course and every Monday and Friday afternoon from 1400 to 1700 hours 12 students are seconded from ward work, four to the Department of Medicine, four to the Department of General Practice and four to the Department of Mental Health. Hand-outs about information to be obtained and interview style are standardized and the principles to be followed are clearly defined in an aide-mémoire. Staff from the Departments of General Practice and Mental Health experienced in teaching communication by videotape feedback and analysis of consultations prepared 12 tutors for their role and responsibilities. Procedures to be followed were carefully explained to all students beforehand. General practice and psychiatry traditionally have established teaching programmes in communication but the inclusion of the Department of Medicine has made a significant impact. Students have come to realize that the taking of a good history demands as much skill as the physical examination of the patient and is an important aspect of any clinical assessment.

Communication↗
PubMed1989

Outcome and benefits of upper gastrointestinal endoscopy in the elderly.

Presenting symptoms, physical findings and treatment were reviewed in 70 patients over 65 years old who underwent oesophago-gastro-duodenoscopy in the Royal Victoria Hospital, Belfast, during an 18-month period. Most frequent indications for the procedure were epigastric pain, retrosternal pain or haematemesis. Physical signs were present in only 54%. Abnormal endoscopic findings were detected in 97%. The majority of patients responded to subsequent treatment. It was not possible to identify clinical features associated with major gastrointestinal pathology, which aided selection of those subgroups of elderly patients who would most benefit from endoscopy.

Aged↗
PubMed1988

Reassessment of enteric endocrine cell hyperplasia in celiac disease.

Celiac disease is characterized by reversible, gluten-induced, architectural abnormalities of the intestinal mucosa. Villus atrophy is compensated for by an increase in the number of proliferating cells and an increase in crypt cell production rate, resulting in increased crypt length and girth. Several authors, employing various methods of quantitation, have reported enteric endocrine cell hyperplasia in celiac disease. The present study has re-evaluated enteric endocrine cell status in this disorder by employing methods of quantitation which more accurately take account of alterations of crypt morphology than those previously used. Numbers of endocrine cells expressed as cells per unit of crypt length are not increased in the celiac biopsies when contrasted with those from controls. Indeed, numbers of cells immunoreactive for gastrin, GIP, motilin and somatostatin were reduced in the celiac mucosa. Endocrine cell hyperplasia in the celiac small bowel is not as marked as was previously thought, and may lag behind that of the enterocyte population.

Adult↗
PubMed1987

Intragastric bile acid concentrations are unrelated to symptoms of flatulent dyspepsia in patients with and without gallbladder disease and postcholecystectomy.

It has been proposed that duodenogastric reflux may be the basic underlying mechanism which gives rise to symptoms of flatulent dyspepsia. Fasting and postprandial gastric juice bile acid concentrations were measured in patients with flatulent dyspepsia with and without gall bladder disease and postcholecystectomy. There were 13 patients with gall bladder disease, 12 with normal gall bladders and 13 postcholecystectomy. Gastric juice was obtained by intubation. Bile acid concentrations were compared with 21 controls and 15 asymptomatic subjects with gall bladder disease. For 21 patients with gall bladder disease who underwent cholecystectomy, levels were again assessed postoperatively to allow correlation with outcome. The occurrence of reflux and the resultant gastric juice bile acids did not correlate with symptoms. Concentrations postcholecystectomy, including asymptomatic subjects were significantly higher than controls (p less than 0.01). It is concluded that limited duodenogastric reflux is common and need not be associated with symptoms even when the resultant intra-gastric concentrations are higher than normal.

Adult↗
PubMed1987

Gastric emptying in patients with flatulent dyspepsia, with and without gallbladder disease.

It has been suggested that the symptoms of flatulent dyspepsia are caused by a functional disturbance of the upper gastrointestinal tract. The aim of this study was to investigate delayed gastric emptying as the basis of symptoms in patients with and without gallbladder disease and after cholecystectomy. There were 13 dyspeptic patients with gallbladder disease, 12 with normal gallbladders, and 13 post-cholecystectomy patients. Gastric emptying was measured by means of a 99mTc-labelled scrambled egg meal and external scintillation counter. The rate of emptying in the symptomatic groups was compared with that in 24 asymptomatic normal control subjects and 12 non-dyspeptic patients with gallbladder disease. Delayed gastric emptying tended to occur in patients with gallbladder disease with and without dyspepsia and was not specifically associated with symptoms.

Adult↗
PubMed1987

Psychologic aspects of flatulent dyspepsia.

Psychologic and social factors have been implicated in the aetiology of dyspepsia. In this study these factors were investigated in relation to flatulent dyspepsia, a symptom complex that has traditionally been associated with gallbladder disease. Subjects completed the Middlesex Hospital Questionnaire and the Life Events Inventory and were interviewed in detail, using a semi-structured format. Three groups of patients with flatulent dyspepsia--those with and without gallbladder disease and post-cholecystectomy--all had significantly more associated somatic symptoms than non-dyspeptic subjects with gallbladder disease or normal controls, thus indicating greater emotional upset amongst dyspeptic patients. There was little evidence that symptoms were related to stressful life events.

Adult↗
PubMed1987

Cisapride: influence on oesophageal and gastric emptying and gastro-oesophageal reflux in patients with reflux oesophagitis.

A preliminary, double-blind placebo controlled trial of cisapride in reflux oesophagitis was conducted. Eighteen patients were allocated to treatment with either placebo or cisapride, 10 mg three times daily, orally, before meals. Gastric emptying of a scrambled egg meal, oesophageal transit of a liquid bolus and ambulatory monitoring of oesophageal pH were assessed before and after four weeks' therapy. Overall, gastric emptying rates were not influenced by cisapride, although a small but significant reduction in gastric isotope retention, 20 minutes after meal ingestion was observed in patients on the active drug. Oesophageal transit times were not altered by cisapride. A small but significant reduction in the duration of gastro-oesophageal reflux followed cisapride therapy when compared with placebo.

Adult↗
PubMed1987

The effect of auranofin on glucose uptake by the isolated vascularly perfused, small intestine of the rat.

Auranofin at a concentration of 2.5 micrograms/ml had no effect on glucose uptake by the viable, isolated, vascularly perfused, small intestine of the rat and no net movement of water was detected. No effect on glucose uptake or water movement was found when intestines from rats fed 0.1 mg/Kg body weight per day for 4 weeks were perfused with drug free medium. Mucosal damage was seen in 1 of 2 rats fed Auranofin and examined histologically.

Administration, Oral↗