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Biomedical subjects

B N Catchpole

Publications and source records attributed to B N Catchpole.

17 recordsLinked to original sources

Raynaud phenomenon: the Jepson classification.

The Jepson classification of Raynaud phenomenon, based on its pathogenesis, is presented. Raynaud phenomenon can be induced in the fingers of the normal hand as the digital vessels are sensitive to the direct effects of cold. A 'local fault' in the digital arteries renders the fingers more susceptible to a fall of environmental temperature, as do limb artery occlusions which impair the digits' ability to maintain their temperature. Other vasoconstrictive influences act similarly to precipitate the onset of the phenomenon.

Female

Do big breasts disadvantage women with breast cancer?

The present study was undertaken in order to discover whether patients with breast cancer in large breasts experienced a delay in the detection of their cancer due to the bulk of the breast and consequently presented with more advanced tumours compared with women with small breasts. Mastectomy specimens were weighed and their dimensions measured, in particular recording breast mass and breast thickness (anterior-posterior depth). Tumour diameter, the number of involved lymph nodes and the oestrogen and progesterone receptor levels were measured as prognostic indices. Although there was no difference in receptor status of tumours from large and small breasts, on presentation, patients with big breasts had larger tumours and more involved lymph nodes than women with small breasts, whether breast size was assessed by weight or thickness. Women with large breasts may therefore be expected to fare worse than those with small breasts.

Breast

A heparin test as a predictor of postoperative deep vein thrombosis.

A heparin test was developed and tested to determine if it could predict which patients were likely to develop postoperative deep vein thrombosis (DVT). The test was based on the observation that approximately one-third of normal subjects have a reduced anticoagulation response to heparin. Fifty-four adult patients undergoing abdominal operations, and who were not receiving DVT prophylaxis, were pre-operatively given 20 u heparin/kg intravenously and the thrombin clotting time was determined 30 min later (TCT 30). Forty-two had a normal response of a TCT 30 greater than 120 s, the remainder having a positive test of TCT 30 less than 120 s. The heparin test accurately predicted four of the seven patients who developed postoperative DVT as determined by the 125I-fibrinogen test, and correctly identified 39 of the 47 who did not develop DVT (P less than 0.05). No patient developed clinical DVT. This simple test could be of practical value in clinical surgery in predicting which patients are at risk of postoperative DVT and require prophylaxis.

Adult

A study of the genesis of colic.

To investigate local events in the gut as well as the location and duration of discomfort associated with colic, mild phasic pain was induced by balloon distension and bolus injection of normal saline at various sites in the gut of 1 normal volunteer and 12 patients with gut disorders. Intraluminal pressures were recorded. Pain was experienced only when a rise in baseline pressure occurred in a segment of gut at least 6 cm and up to 32 cm long. Painful segmental pressure rises were often low compared with non-painful localised pressure rises. Induced phasic pain had all the characteristics of colic, usually lasted less than a minute in both small and large intestine, and while frequently beginning paracentrally, tended to spread across the midline with increasing severity.

Colic

Motor pattern of the left colon before and after surgery for rectal cancer: possible implications in other disorders.

The motility of the descending colon was studied in nine patients before and after resection of the rectum for cancer. This operation parasympathectomises and generally also sympathectomises the remaining left colon. Motor activity was significantly reduced by sleep before and after surgery. There was also a reduction in awake motility after surgery which is attributed to extrinsic denervation. The reduced motility may explain the increased frequency of motions passed after surgery.

Aged

Pseudo-obstruction.

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Bronchodilator Agents

Drug therapy for postragotomy gastric stasis.

An unusual but well-recognized complication of truncal vagotomy with a drainage procedure is severe gastric stasis (atony). In 6 patients presenting with this problem drug therapy was initiated after mechanical obstruction of the gastric outlet was excluded by radiology. Bethanechol chloride was successful in stimulating gastric peristalsis in all the patients, with consequent improvement of symptoms in 5 out of the 6 subjects. Metoclopramide alone was of no value in starting peristalsis but of pssible benefit once gastric motility had begun.

Adult

The role of the sympathetic nervous system in hypoglycaemia-stimulated gastric secretion.

The gastric secretory response to insulin is mediated predominantly by the vagus. The associated hypoglycaemia stress response is mediated by the sympathetic nervous system. Inhibition of the sympathetic response by simultaneous alpha and beta receptor blockade was studied in five healthy young adults. No appreciable modification of gastric secretory output resulted.

Adrenocorticotropic Hormone