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Biomedical subjects

B E Chatterton

Publications and source records attributed to B E Chatterton.

At least 55 records · Page 3Linked to original sources
PubMed1991

Relationships between oesophageal transit and solid and liquid gastric emptying in diabetes mellitus.

In 87 randomly selected diabetic patients (67 type 1, 20 type 2) and 25 control subjects, gastric emptying of digestible solid and liquid meals and oesophageal transit of a solid bolus were measured with scintigraphic techniques. Gastrointestinal symptoms, autonomic nerve function and glycaemic control were evaluated in the diabetic patients. Gastric emptying and oesophageal transit were slower (P less than 0.001) in the diabetic patients compared with the control subjects, and each was delayed in about 40% of them. There was a relatively weak (r = 0.32; P less than 0.01) relationship between solid and liquid gastric emptying, and no significant correlation (r = 0.11, NS) between oesophageal transit and gastric emptying of the solid meal. Scores for upper gastrointestinal symptoms and autonomic nerve function correlated weakly (r = 0.21; P less than 0.05) with both oesophageal transit and gastric emptying. Gastric emptying of the liquid meal was slower (P less than 0.05) in patients with blood glucose concentrations greater than 15 mmol/l. These results indicate that gastric emptying in patients with diabetes mellitus should be assessed by liquid as well as by solid test meals and that oesophageal transit should not be used as a predictor of generalised diabetic gastroenteropathy.

Diabetes Mellitus↗
PubMed1991

Cross sectional and longitudinal study of bone mineral content of the distal forearm in adult premenopausal women.

The range of fat corrected distal forearm mineral content (FMC) (at a site which comprises approximately 75% cortical and 25% trabecular bone) and the effect of aging on FMC were determined in normal premenopausal women. In 106 women (mean age 39; range 18-56) the mean FMC was 1.184 (SD 148) g/cm; fat correction increased this to 1.239 (SD 148) g/cm. There were significant correlations between fat corrected FMC and height, weight and BMI (r greater than 0.16; P less than 0.05). In 43 of these women (mean age 35; range 18-51) repeat measurements of FMC were performed. The last measurement was separated from the first by a mean time interval of 27 +/- 3 months. There was no significant change in uncorrected FMC (baseline 1.185 +/- 0.21 g/cm compared with their final measurement 1.182 +/- .020 g/cm; P = 0.51). Fat-corrected FMC (baseline 1.229 +/- .021 g/cm compared with 1.223 +/- .020 g/cm later) tended to decrease although this change was not significant (P = 0.06). Age ranked cusum analysis demonstrated a non-significant fat-corrected rate of change in FMC of -.3% yr in those over 35 years of age (P less than 0.10). This data suggests that if there is any distal forearm bone loss before the menopause it is negligible.

Adolescent↗
PubMed1991

Role of the proximal and distal stomach in mixed solid and liquid meal emptying.

The role of the proximal and distal stomach in the emptying of solids and liquids from the stomach remains unclear. We have used a dual isotope technique to quantify proximal and distal stomach emptying of a solid (100 g of 99mTc labelled liver/ground beef) liquid (either 200 ml of normal saline (eight subjects) or 25% dextrose (seven subjects) labelled with 113mIn-diethylenetriaminepenta-acetic acid) mixed meal. A manometric catheter simultaneously measured antral, pyloric, and duodenal motor activity. The liquid component dispersed rapidly throughout the stomach and emptied after a minimal lag period. The emptying of the 25% dextrose was delayed compared with the saline. This delay was associated with increased retention of the liquid in the distal stomach, a significant increase in localised phasic pyloric contractions, and a suppression of antral contractions. The solid component initially resided wholly within a proximal stomach reservoir area. Solids then redistributed from proximal to distal stomach during the emptying of liquid from the stomach. Dextrose delayed gastric emptying of solids compared with saline by increasing the solid lag period and retention in the proximal stomach. There was no significant difference between saline and dextrose meals in the distal stomach retention of solid or in the linear rate of emptying after the lag period. We conclude that, contrary to general opinion, the proximal stomach plays an important role in the control of gastric emptying of solids while the distal stomach is important in the emptying of nutrient liquids.

Adolescent↗
PubMed1991

Use of technetium-99m(V)thiocyanate to measure gastric emptying of fat.

Technetium-99m(V)thiocyanate was evaluated as a radio-pharmaceutical for measuring gastric emptying of fat. Olive oil was labeled with 99mTc(V)thiocyanate by direct extraction from acidic thiocyanate solution. After incubation with dilute HCl (pH 1.4) at 37 degrees C for 3 hr, approximately 5% of the total radioactivity eluted into the aqueous phase. When incubated with human gastric juice (pH 1.8 and 2.2), approximately 8% of the activity was detected in the aqueous phase at 3 hr. Scintigraphic studies performed in two rabbits showed that olive oil labeled with 99mTc(V)thiocyanate emptied slowly from the stomach, with a gastric half-emptying time (T50) of more than 3 hr. A low-nutrient soup labeled with 113mIn-DTPA and mixed with 99mTc(V)thiocyanate labeled oil was consumed by six human volunteers. The oil emptied much more slowly (p less than 0.02) (median T50 = 198 min) than the aqueous component (median T50 = 30 min). These observations indicate that 99mTc(V)thiocyanate is a suitable pharmaceutical to measure gastric emptying of extracellular fat.

Adult↗
PubMed1990

Hyperglycaemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus.

In 10 patients with Type 1 (insulin-dependent) diabetes mellitus gastric emptying of a digestible solid and liquid meal was measured during euglycaemia (blood glucose concentration 4-8 mmol/l) and during hyperglycaemia (blood glucose concentration 16-20 mmol/l). Gastric emptying was studied with a scintigraphic technique and blood glucose concentrations were stabilised using a modified glucose clamp. Patients were also evaluated for gastrointestinal symptoms, autonomic nerve function and glycaemic control. When compared to euglycaemia, the duration of the lag phase before any of the solid meal emptied from the stomach (p = 0.032), the percentage of the solid meal remaining in the stomach at 100 min (p = 0.032) and the 50% emptying time for the solid meal (p = 0.032) increased during hyperglycaemia. The 50% emptying time for the liquid meal (p = 0.042) was also prolonged during the period of hyperglycaemia. These results demonstrate that the rate of gastric emptying in Type 1 diabetes is affected by the blood glucose concentration.

Adult↗
PubMed1990

The relative contributions of age and years since menopause to postmenopausal bone loss.

We have estimated the relative contributions of age and menopause to forearm mineral density in 485 normal postmenopausal women up to age 75 yr. In 87 pairs matched for years since menopause, in which 1 member was below 61 yr and the other was 61 yr or older, the mean bone density was significantly lower in the older than in the younger subjects despite their identical years since menopause (P less than 0.001). Further analysis suggested a model for bone loss after the menopause which comprises a menopausal component of exponential type and an age-related component which is linear and starts in the mid-50s. According to this model, a 70-yr-old woman has lost 11% of her bone due to menopause and 18% as a function of age. Thereafter, the age-related function is dominant. Early menopause is associated with a self-limiting loss of bone which does not progress further until aging exerts its effect. The main conclusion is that the significance of early menopause as a risk factor for osteoporosis has been overstated.

Age Factors↗
PubMed1990

Kit preparation of technetium-99m-mercaptoacetyltriglycine: analysis, biodistribution and comparison with technetium-99m-DTPA in patients with impaired renal function.

Technetium-99m-mercaptoacetyltriglycine (99mTc-MAG3) was prepared by a frozen solution method, enabling the preparation of kits yielding a product substantially free of lipophilic impurities (96% 99mTc-MAG3). However, biliary activity was not completely eliminated as HPLC-purified 99mTc-MAG3 was also excreted by that route. Sequential 99mTc-DTPA and 99mTc-MAG3 renal scans were performed in 15 patients with renal dysfunction, including renal transplant recipients. In all cases, the 99mTc-MAG3 kit preparation provided superior images to 99mTc-DTPA at all levels of renal function due to a higher target-to-background ratio and a plasma clearance twice as fast as 99mTc-DTPA. Interpretation of delayed 99mTc-MAG3 images, however, was complicated by biliary excretion which will limit quantitative estimates of renal clearance. A 99mTc-MAG3 kit is likely to be of value in renal transplant assessment and in cases of significant renal impairment but would not appear to offer major advantages over 99mTc-DTPA in routine renal imaging.

Chromatography, High Pressure Liquid↗
PubMed1989

Gastric and oesophageal emptying in patients with type 2 (non-insulin-dependent) diabetes mellitus.

Gastric emptying of a digestible solid and liquid meal and oesophageal emptying of a solid bolus were measured with scintigraphic techniques in 20 randomly selected Type 2 (non-insulin-dependent) diabetic patients receiving oral hypoglycaemic therapy and 20 control subjects. In the diabetic patients, the relationships between oesophageal emptying, gastric emptying, gastrointestinal symptoms, autonomic nerve function and glycaemic control were examined. The percentage of the solid meal remaining in the stomach at 100 min (p less than 0.001), the 50% gastric emptying time for the liquid meal (p less than 0.05) and oesophageal emptying (p less than 0.05) were slower in the diabetic patients compared to the control subjects. Scores for upper gastrointestinal symptoms and autonomic nerve dysfunction did not correlate significantly (p greater than 0.05) with oesophageal, or gastric emptying. The 50% gastric emptying time for the liquid meal was positively related (r = 0.58, p less than 0.01) to the plasma glucose concentration at the time of the performance of the gastric emptying test and the lag period, before any solid food emptied from the stomach, was longer (p less than 0.05) in subjects with plasma glucose concentrations during the gastric emptying measurement greater than the median, compared to those with glucose concentrations below the median. These results indicate that delayed gastric and oesophageal emptying occur frequently in Type 2 diabetes mellitus and that delayed gastric emptying relates, at least in part, to plasma glucose concentrations.

Aged↗
PubMed1989

Cross-over study of fat-corrected forearm mineral content during nandrolone decanoate therapy for osteoporosis.

We have previously reported an increase in forearm bone mineral content (BMC) during therapy for osteoporosis with the anabolic steroid, nandrolone decanoate. However, it has recently been claimed that part of this increase is spurious, due to a decrease in forearm fat during the treatment. We have therefore analyzed the data from a cross-over study of the effects of this agent on 70 osteoporotic women, using the fat correction procedure supplied by the manufacturer of the forearm densitometer. There was a significant rise (p less than 0.001) in the mean fat-corrected BMC (BMC[fc]) on nandrolone decanoate (50 mg intramuscularly every 2 or 3 weeks) and a non-significant fall in mean BMC[fc] off the drug. The mean time-weighted rate of change in the fat-corrected value was +29 +/- 5 mg/cm/year on nandrolone decanoate and -5 +/- 5 mg/cm/year off nandrolone decanoate (p less than 0.001). Nandrolone decanoate produces a significant gain in forearm mineral content even after allowing for changes in forearm fat content during therapy.

Aged↗
PubMed1989

Extra-adrenal phaeochromocytoma: report of three interesting cases.

The clinical, laboratory and operative findings from three cases of extra-adrenal phaeochromocytoma are reviewed. Some of the difficulties encountered in localizing such a neoplasm are highlighted. Data from intraoperative catecholamine monitoring on the three patients are also presented. Adequate alpha and beta blockade produced stable cardiovascular parameters during surgery in all three individuals.

Abdominal Neoplasms↗
PubMed1988

Proximal, distal and total stomach emptying of a digestible solid meal in normal subjects.

The gastric fundus and antrum probably play different roles in the emptying of solids and liquids in man, but there is little information about the intragastric distribution of food. We have used a new radionuclide technique to quantify proximal, distal and total stomach emptying of a digestible solid meal (100 g of 99Tcm-labelled liver/ground beef given with 150 ml of 10% dextrose) in 13 normal subjects. A proximal reservoir area was seen after consumption of the meal, and used to define the proximal stomach region. A line drawn immediately below this area divided the total stomach region into proximal and distal stomach. Emptying from the total stomach exhibited two phases--an initial lag period (median 41 min, range 21-57 min), followed by approximately linear emptying. Redistribution of food from the proximal to the distal stomach was a major component of the lag period in 11 of the 13 subjects. In the remaining two subjects, redistribution was rapid (proximal 50% emptying time of 4 and 10 min) and antral retention was the major component of the lag period. In seven subjects, a region of reduced activity (contraction band) was seen. The midpoint of this band closely approximated to the line used to divide proximal and distal stomach. We suggest that a contraction band may be responsible for the proximal gastric reservoir seen after meal consumption and plays an important role in the redistribution and emptying of digestible solid food from the stomach. There is considerable variation between normal subjects in the rate of transfer of digestible solid food from the proximal to the distal stomach.

Adult↗
PubMed1987

The relation of forearm mineral density to peripheral fractures in postmenopausal women.

Forearm bone mineral density was measured in 557 postmenopausal women from whom a history of fractures was also obtained. Known cases of osteoporosis were excluded. The mean age of the subjects was 59 years. Ninety-eight of the subjects had sustained a fracture since the menopause and 37 had done so before the menopause. There had been 188 fractures in all. The mean bone density was significantly lower in the subjects who had experienced a fracture than in those who had not experienced a fracture; this was also true of subjects who had suffered a fracture before the menopause. The lowest bone densities were observed in subjects who had suffered forearm fractures, followed by those who had suffered fractures of the rib, ankle and foot. The mean bone density in subjects with more than one fracture was significantly lower than in those with only one fracture. The difference in bone density between subjects with and without a history of fractures was most significant in the younger subjects and became progressively less significant with age. The estimated relative fracture risk was 3.1 in the group with the lowest bone densities and zero in the group with the highest bone densities.

Female↗
PubMed1987

Effect of cisapride on gastric and esophageal emptying in insulin-dependent diabetes mellitus.

The effects of cisapride on gastric emptying, esophageal emptying, gastrointestinal symptoms, and glycemic control were evaluated in 20 insulin-dependent diabetics who had delayed gastric emptying of the solid or liquid component of a meal, or both. A double-isotope technique was used to measure gastric emptying, and esophageal emptying was measured as the time for a bolus of the solid meal to enter the stomach. On 2 days each patient received cisapride (20 mg) or placebo orally, 60 min before an esophageal and gastric emptying test. A third gastric and esophageal emptying test was performed after each patient had orally taken 10 mg of cisapride or placebo q.i.d. for 4 wk. Single-dose cisapride increased esophageal emptying (p less than 0.01) and both solid and liquid gastric emptying (p less than 0.001). The response to cisapride was most marked in patients with the greatest delay in esophageal and gastric emptying (p less than 0.05). After administration of cisapride for 4 wk, gastric emptying of solid and liquid were faster (p less than 0.001), but esophageal emptying was not significantly different from the placebo test. Upper gastrointestinal symptoms were less after cisapride (p less than 0.05), whereas there was no change on placebo (p greater than 0.2). Plasma glucose and glycosylated hemoglobin concentrations were not different after cisapride compared with placebo. These results indicate that single-dose cisapride increases esophageal emptying in insulin-dependent diabetics and that chronic administration of cisapride is effective in the treatment of diabetic gastroparesis.

Adult↗
PubMed1987

Effects of cisapride on gastric and esophageal emptying in progressive systemic sclerosis.

The effects of cisapride on gastric emptying, esophageal emptying, and gastrointestinal symptoms were evaluated in 8 patients with progressive systemic sclerosis who had delayed gastric emptying of the solid or liquid component of a meal, or both. A double-isotope technique was used to measure gastric emptying, and esophageal emptying was measured as the time for a bolus of the solid meal to enter the stomach. Gastrointestinal symptoms were assessed by a questionnaire. On 2 days each patient received cisapride (10 mg) or placebo intravenously, 5 min before an esophageal and gastric emptying test. After these 2 days each subject took cisapride (10 mg q.i.d., p.o.) for 1 mo. Cisapride improved solid and liquid gastric emptying (p less than 0.001), but had no significant effect on esophageal emptying (p less than 0.1). Upper gastrointestinal symptoms were reduced after cisapride (p less than 0.001), and no side effects were reported. These results indicate that gastroparesis is a treatable cause of morbidity in progressive systemic sclerosis.

Adult↗