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Biomedical subjects

A T Axon

Publications and source records attributed to A T Axon.

At least 253 records · Page 14Linked to original sources
PubMed1981

Disinfection in upper-digestive-tract endoscopy in Britain.

A contaminated endoscope may infect patients at upper-gastrointestinal-tract endoscopy (oesophago-gastro-duodenoscopy and endoscopic cholangio-pancreatography) either by the transmission of infection from one patient to another or by inoculation of potentially pathogenic bacteria which have multiplied in the instrument and ancillary equipment during storage. These dangers can be eliminated by careful disinfection with glutaraldehyde, other aldehyde disinfectants, or povidone-iodine. Few centres in Britain are using an effective disinfection procedure and of those who have used glutaraldehyde (the most widely employed) 37% have had serious problems with staff sensitivity. A quick, effective, and safe method for the disinfection of fibreoptic instruments is urgently needed.

Cross Infection↗
PubMed1981

Pseudostone at ERCP due to juxtapapillary diverticulum.

Juxtapapillary diverticula of the duodenum are often encountered at endoscopic retrograde cholangio pancreatography (ERCP) and their presence causes a prominent "pseudostone" appearance on the retrograde cholangiogram in many patients with otherwise normal, i.e. stone-free, ducts. This may lead to inappropriate surgery if not recognised.

Aged↗
PubMed1981

Passive permeability in experimental intestinal damage in rats.

1. Experiments were performed to study the absorption of two simultaneously administered polar probes of different molecular size from closed intestinal loops in rats subjected to various mucosal structural lesions. 2. Absorption of mannitol (molecular radius approximately 0.40 nm) was significantly decreased in rats with villous atrophy and crypt hypoplasia induced by the cytostatic agent methotrexate. The absorption of lactulose (radius approximately 0.54 nm) was also decreased, in contrast to the increased absorption which was found in an earlier study when villous atrophy with crypt hyperplasia was induced by infection by a nematode. The effect of local damage to villous tips, produced by the intraluminal presence of a detergent, was to increase significantly the absorption of lactulose. 3. In conjunction with the findings of earlier studies, these results support the hypothesis that there are at least two routes for the permeation of polar molecules. Small molecules such as mannitol probably pass through numerous cellular pores with a maximum radius lying between 0.40 and 0.54 nm and absorption is closely related to mucosal surface area. Larger molecules such as lactulose are probably restricted to less numerous extracellular pathways and absorption may be related to cell shedding or other areas of mucosal damage.

Animals↗
PubMed1981

Pancreatic exocrine function in systemic sclerosis.

Lundh tests of pancreatic exocrine function were performed on twenty unselected patients with systemic sclerosis. Three patients had very low levels of tryptic activity in their intestinal juice and only nine had results which were unequivocally normal. Eight patients had biochemical steatorrhoea, but in six this was associated with intestinal bacterial overgrowth and a seventh had primary biliary cirrhosis. The remaining patient had no cause for steatorrhoea other than the marked pancreatic insufficiency which had been demonstrated. Although pancreatic damage may contribute to malabsorption in systemic sclerosis, it appears to be less important than other factors such as intestinal bacterial overgrowth.

Adolescent↗
PubMed1981

Double-blind clinical, endoscopic and histological comparison of hydrotalcite/dimethicone suspension and magnesium hydroxide/aluminum hydroxide suspension in the treatment of symptomatic gastritis.

A double-blind, randomized trial was undertaken to compare the clinical, endoscopic and histological response to 6-weeks' treatment with hydrotalcite/dimethicone suspension or magnesium hydroxide/aluminum hydroxide suspension in 36 patients with symptomatic gastritis. Significantly more patients (P less than 0.05) showed symptomatic improvement in the antacid-treated group than in the hydrotalcite/dimethicone-treated group and more had a reduction in histological inflammatory scores (P less than 0.01), although there was little correlation between histology and symptoms. There was no evidence from this study that the bile acid binding and anti-foaming properties of hydrotalcite/dimethicone suspension were of any benefit in the treatment of patients with symptomatic gastritis.

Adult↗
PubMed1980

Colonoscopy and the detection of dysplasia in patients with longstanding ulcerative colitis.

The role of colonoscopy in the surveillance of patients with ulcerative colitis for dysplasia was investigated in 43 patients with longstanding disease extending proximally beyond the splenic flexure. The examination was well tolerated and no complications were recorded. Dysplasia was found in 9 patients in one or more biopsies and was severe in 2, moderate in 1, and mild in 6. Both the patients with severe dysplasia had a carcinoma at subsequent operation. Colonoscopy may allow complete examination of the colon and biopsy of suspicious lesions and, since dysplasia may spare the rectum, colonoscopy with biopsy is a desirable component of any surveillance programme of the at-risk colitic.

Adolescent↗
PubMed1980

Effect of cimetidine on the gastric bacterial flora.

Bacteriological studies were carried out on samples of gastric juice obtained from 31 patients with peptic ulcer before and immediately after a month's course of cimetidine. After cimetidine there were major increases in both total bacterial counts and counts of nitrate-reducing organisms and qualitative changes suggesting the establishment of a flora which included large numbers of "faecal" organisms.

Aerobiosis↗
PubMed1980

Endoscopic retrograde cholangiography and pancreatography in investigation of post-cholecystectomy patients.

102 severly symptomatic post-cholecystectomy patients were studied by endoscopic retrograde cholangiography (ERCP), and successful ampullary cannulation was achieved in 101. All 29 patients with jaundice were correctly classified into intrahepatic and extrahepatic causes. 8% (73) patients with abdominal pain but no history of jaundice had retained biliary calculi, and 25% had an abnormal pancreatogram suggesting pancreatitis. The measurement of bileduct calibre alone did not reliably distinguish between the presence or absence of retained stones. It is suggested that ERCP is the investigation of choice in the symptomatic post-cholecystectomy patient.

Adolescent↗
PubMed1980

Treatment of distal ulcerative colitis (proctosigmoiditis) in relapse: comparison of hydrocortisone enemas and rectal hydrocortisone foam.

Thirty patients with distal colitis (proctosigmoiditis) in relapse were randonly allocated to twice daily treatment with traditional aqueous hydrocotrisone enemas (Cortenemas) or a suspension of hydrocortisone in an inert foam base (Colifoam). Each treatment contained the same amount of hydrocortisone. Clinical, sigmoidoscopic, and histological response was assessed after two weeks. Both agents were effective, and broadly similar in terms of objective improvement, but subjective improvement was greater with the foam preparation, and several patients expressed a preference to this mode of treatment.

Administration, Topical↗
PubMed1980

Small intestinal structure and passive permeability in systemic sclerosis.

Seventeen patients with proven systemic sclerosis had a peroral jejunal biopsy performed. Four biopsies were regarded as showing abnormalities, which were mostly confined to the deeper structures, although in two there was a minimal degree of villous atrophy without epithelial cell changes. Passive intestinal permeability, as assessed by the cellobiose/mannitol test, was normal in all patients. In contrast, seven patients had a low xylose test result, which in five of them could be accounted for by impaired renal function, small intestinal bacterial contamination, or altered gastrointestinal transit. These results indicate that passive intestinal permeability is unaltered in systemic sclerosis, and that malabsorption, when it occurs, is caused by other factors.

Adolescent↗
PubMed1980

Intestinal permeability and screening tests for coeliac disease.

In disease states of the small intestine--for example, gluten-sensitive enteropathy--there is an increased permeability to large molecules. This increased permeability extends to polar molecules of intermediate size such as disaccharides, whereas small polar molecules are malabsorbed. A recently-developed oral test, based on the simultaneous administration of two test substances, cellobiose (a disaccharide) and mannitol (a small polar molecule) has been used to investigate permeability in a variety of gastrointestinal diseases, the result of the test being expressed as the ratio (cellobiose/mannitol) of the five hour urinary recoveries of the two probe molecules. Results for patients with pancreatic insufficiency, intestinal bacterial overgrowth, primary hypolactasia, ileocolic or colonic Crohn's disease, and ulcerative colitis were comparable with those in normal controls, whereas in 23 out of 24 untreated coeliacs, and five out of eight patients with Crohn's disease involving the more proximal small bowel, the cellobiose/mannitol ratio was clearly abnormal. A study of its application as a screening procedure for coeliac disease showed that the test was both sensitive and accurate, with fewer false-positive and false-negative results than other recognised screening tests--namely, the xylose test, reticulin antibodies, and blood folate estimations.

Adult↗
PubMed1980

Increased incidence of faecal coliforms with in vitro adhesive and invasive properties in patients with ulcerative colitis.

Faecal samples were collected from 23 patients with active ulcerative colitis, 15 patients with established ulcerative colitis in remission, 20 patients with active colitis of cause other than ulcerative colitis, and 20 normal control subjects. Ten coliform colonies were randomly selected from the faecal sample cultures and serotyped before the testing of each different serotype from each sample for adhesive or invasive properties on HeLa cell monolayers. In the patients with both active ulcerative colitis and ulcerative colitis in remission and those with other types of colitis one serotype tended to dominate the faecal coliform flora. In normal controls more variety was encountered. Thirty-five per cent of the patients with active ulcerative colitis and 27% of the patients with ulcerative colitis in remission had at least one adhesive or invasive faecal coliform as compared with 5% of the patients with other types of colitis and 5% of the normal controls. These findings are significant (P < 0.05) and may have aetiological and therapeutic significance.

Adhesiveness↗
PubMed1980

Controlled trial of intravenous hyperalimentation and total bowel rest as an adjunct to the routine therapy of acute colitis.

Thirty-six patients (27 with ulcerative colitis and 9 with Crohn's disease) completed a prospective controlled therapeutic trial of intravenous hyperalimentation (IVH) and total bowel rest in acute colitis. All patients received prednisone 40 mg/day which was reduced every 3 days or more depending on the response to treatment. The trial was completed either when the prednisone was reduced to 10 mg/day or when the patient came to colectomy. In the control group (5 males, 12 females; mean age 44.7 yr), 6 came to surgery and 11 responded medically in a mean time of 23.7 days. In the IVH group (8 males, 11 females; mean age 37.4 yr) 9 came to surgery and 10 responded medically in a mean time of 21.2 days. The results of this trial show that IVH with total bowel rest has no primary therapeutic effect in acute colitis.

Acute Disease↗