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Biomedical subjects

C Winters

Publications and source records attributed to C Winters.

At least 37 records · Page 2Linked to original sources
PubMed1987

A study of patient acceptance of double-contrast barium enema and colonoscopy. Which procedure is preferred by patients?

To our knowledge, no previous study has addressed the question of which method of evaluation of the lower gastrointestinal tract is preferred by patients, air-contrast barium enema or colonoscopy. Over a four-month period, we asked 189 consecutive patients who had undergone colonoscopy to express their preference for either air-contrast barium enema or colonoscopy. A clear preference for colonoscopy was expressed by our patients in terms of comfort and polyp detection despite higher cost. Time lost from work and post-procedure constipation were significantly less for colonoscopy than for barium enema. These factors should be considered in the evaluation of suspected lower gastrointestinal tract disease.

Adult↗
PubMed1987

Esophageal acid sensitivity in Barrett's esophagus.

Esophageal acid sensitivity was evaluated in 15 patients with Barrett's esophagus and in 15 patients with reflux esophagitis uncomplicated by Barrett's. Patients with Barrett's esophagus had sensitivity to esophageal acid perfusion less frequently than those with uncomplicated reflux esophagitis (66 vs. 100%; p less than 0.05). Moreover, patients with Barrett's esophagus with acid sensitivity took longer to develop pain during acid perfusion (p less than 0.05), and overall, experienced less severe symptoms (p less than 0.01) than those with reflux esophagitis. Over a 2-week period, as judged by diary, the Barrett's group had less frequent (p less than 0.01) and less severe (p less than 0.01) heartburn symptoms than the other patients. These results indicate that patients with Barrett's esophagus have significantly reduced esophageal acid sensitivity and, as a consequence, have an impaired ability to recognize acid reflux.

Adult↗
PubMed1987

Patient preference in upper gastrointestinal studies: roentgenography versus endoscopy.

We prospectively compared roentgenography and endoscopy of the upper gastrointestinal tract in terms of patient acceptance and tolerance. Endoscopy was significantly better tolerated and easier overall for patients. Patients found no difference between endoscopy and radiography with respect to pain or life-style interruption. Patients stated that they would prefer endoscopy to roentgenography if repeat evaluation were needed. We conclude that UGI endoscopy is better tolerated and more acceptable to patients than UGI roentgenography.

Adult↗
PubMed1987

Barrett's esophagus. A prevalent, occult complication of gastroesophageal reflux disease.

A prospective study of patients with symptoms of gastroesophageal reflux was undertaken to determine the prevalence of Barrett's esophagus and reevaluate the diagnostic approach necessary to detect this complication. Endoscopy with mucosal biopsy was performed in 97 subjects. Twelve (12.4%) were found to have Barrett's esophagus. The sensitivity and specificity of the endoscopic and radiologic examinations for Barrett's esophagus were prospectively evaluated. Endoscopy (92%) was significantly more sensitive than radiology (24%) in detecting Barrett's esophagus (p less than 0.001). The frequency and severity of reflux symptoms among patients determined to have Barrett's esophagus, reflux esophagitis, or normal esophageal biopsies were quantitatively similar in all three groups, except for significantly greater daytime heartburn in those with reflux esophagitis (p less than 0.01). These data indicate that Barrett's esophagus complicates gastroesophageal reflux more often than previously believed.

Barrett Esophagus↗
PubMed1986

Solid-phase gastric emptying in patients with Barrett's esophagus.

Delayed gastric emptying as a pathophysiologic factor in patients with gastroesophageal reflux (GER) is controversial. In order to further evaluate this question, we studied a population with severe reflux, specifically, patients with Barrett's esophagus. Solid-phase gastric emptying was measured in 17 patients and in 17 healthy volunteers using radionuclide imaging. Gastric emptying was variable among these patients with 70% normal, 18% rapid, and only 12% slow studies. From these observations, we conclude that delayed gastric emptying is unlikely to be a major factor in the pathogenesis of Barrett's esophagus.

Adult↗
PubMed1986

Biliary dyskinesia with associated high amplitude esophageal peristaltic contractions.

A 60-yr-old woman with recurrent biliary-type pain and pancreatitis was found to have abnormal biliary manometrics. Sphincter of Oddi basal and phasic contraction pressures were significantly elevated. Esophageal manometrics revealed high amplitude peristaltic contractions that were unassociated with chest discomfort. High amplitude dysmotility syndromes may perhaps represent a spectrum of disease involving the entire gastrointestinal tract.

Ampulla of Vater↗
PubMed1984

Esophageal bougienage in symptomatic patients with the nutcracker esophagus. A primary esophageal motility disorder.

A wide variety of therapies have been suggested for patients with painful esophageal motility disorders. In a prospective, double-blind, cross-over clinical trial, we evaluated the effectiveness of mercury bougienage ("placebo," 24 F; "therapeutic," 54 F) in eight symptomatic patients with the nutcracker esophagus (NE). There were no significant differences between the placebo or therapeutic dilators in relation to chest pain, dysphagia, lower esophageal sphincter pressure, or amplitude. Chest pain scores after completion of this trial were significantly lower than baseline scores, irrespective of the sequence of dilators used. No subjective or objective improvement could be demonstrated when "therapeutic bougienage" was compared with "placebo bougienage" in patients with the NE. The improvement in symptoms at the completion of the study may result from the close physician-patient interaction, suggesting that this may be more important than the actual size of the bougie.

Adult↗
PubMed1983

The localization of histochemical and autoradiographic products in the scanning electron microscope by means of atomic number contrast.

The role of atomic number contrast and backscattered imaging in the localization of histochemical products and reagents is reviewed. Particular attention is given to the localization of enzymatically released products. A backscattered imaging method is presented which permits the simultaneous demonstration of two label elements in a cryosection examined in the scanning electron microscope. An azo-dye method for the localization of acid phosphatase is combined with an autoradiographic technique for demonstrating [3H]thymidine incorporation. Atomic number contrast, produced by backscattered electrons, permits the detection of a bromine-labelled azo dye, denoting sites of acid phosphatase activity within a cryosection and the simultaneous display of the sites of the silver deposited in an overlying photographic emulsion. The former reveals acid phosphatase to be predominantly associated with thymocyte death and macrophage activity in mouse thymus. The latter pin-points the thymocytes as the main sites of [3H]thymidine incorporation. Atomic number contrast has a useful potential for differentiating between spatially separated histochemical products of differing atomic number in a structural context and also allows a flexible degree of subsurface localization.

Animals↗
PubMed1982

The elemental composition of the chloragosomes of two earthworm species (Lumbricus terrestris and Allolobophora longa) determined by electron probe X-ray microanalysis of freeze-dried cryosections.

The elemental composition of the chloragosomes of the two earth-worm species, one with complex highly active Ca-secreting calciferous glands (L. terrestris) and the other with non-secretory glands (A. longa), was determined by the electron probe X-ray microanalysis of unfixed freeze-dried cryosections. The predominant constituents of the chloragosomes of both species were P, Ca, Zn and S, with lesser quantities of K, Cl and Fe. The most striking species differences in chloragosomal chemistry were the higher concentrations (expressed as relative mass fractions) of P(x 2.1), Ca(x 1.5), and Zn(x 2.3) in L. terrestris, and the much higher S(x 19.6) in A. longa. These differences were discussed in relation to the general ecophysiology of the two species, and more specifically in relation to heavy metal uptake and binding.

Animals↗
PubMed1982

Nucleotide sequence analysis of the complement resistance gene from plasmid R100.

The multiple antibiotic resistance plasmid R100 renders Escherichia coli resistant to the bactericidal action of serum complement. We constructed a plasmid (pOW3) consisting of a 1,900-base-pair-long restriction fragment from R100 joined to a 2,900-base-pair-long fragment of pBR322 carrying ampicillin resistance. E. coli strains carrying pOW3 or R100 were up to 10,000-fold less sensitive to killing by serum complement than were plasmid-free bacteria or bacteria carrying pBR322. Nucleotide sequencing revealed that 875 of the 1,900 bases from R100 correspond exactly to part of the bacterial insertion sequence IS2. The remaining 1,075 bases contained only one sizeable open reading frame; it covered 729 base pairs (243 amino acids) and was preceded by nucleotide sequences characteristic of bacterial promoters and ribosome binding sites. The first 20 amino acids of the predicted protein showed features characteristic of a signal sequence. The remainder of the predicted protein showed an amino acid composition almost identical with that determined for the traT protein from the E. coli F factor. Southern blot analysis showed that the resistance gene from R100 does not hybridize to the serum resistance gene from ColV,I-K94 isolated by Binns et al.; we concluded that these genes are distinct.

Bacterial Outer Membrane Proteins↗