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G Hyland

Publications and source records attributed to G Hyland.

8 recordsLinked to original sources
PubMed1991

How reliable is measurement of the anorectal angle by videoproctography?

The anorectal angle can be determined either by constructing a straight line along the lower border of the rectum (Method A) or by using the central longitudinal axis of the lower rectum (Method B). We have used a computer program to derive the centroid of the rectum for Method B. The coefficients of variation for angles measured at rest, during maximum pelvic floor contraction, and during attempted defecation were 0.616, 0.351, and 0.358, respectively, compared with 0.993, 0.972, and 0.968 for Method B. The presence of a rectocele had no influence on the measurement of the anorectal angle in incontinence, but there was a significant difference in assessment of the angle between constipated patients (P less than 0.05) and controls (P less than 0.05). Posterior indentation of the rectum had no significant influence on measurement of the angle in any group. These data indicate that a computer-derived centroid is more reliable for measurement of angles, but a correction factor for anterior rectocele is needed in constipated patients and controls.

Anal Canal↗
PubMed1989

Anorectal function after abdominal rectopexy: parameters of predictive value in identifying return of continence.

Posterior abdominal rectopexy was performed in 12 patients with a full-thickness rectal prolapse: 9 had faecal incontinence. The prolapse was successfully controlled in all cases and six of nine patients were rendered continent. Physiological studies in patients were compared with age- and sex-matched controls. Preoperative anal pressures were significantly lower than in controls at rest (R), during maximum pelvic floor contraction (Sq) and attempted defaecation (St) (R, P less than 0.005; Sq, P less than 0.005; St, P less than 0.005). Anorectal angles were significantly more obtuse in patients than in controls (R, P less than 0.05; St, P less than 0.025). None of these parameters changed significantly after abdominal rectopexy. Median rectal emptying significantly decreased after operation (preoperative 83 per cent/min; postoperative, 58 per cent/min, P less than 0.05). Median perineal descent during attempted defaecation also significantly decreased after operation (preoperative, 8.5 cm; postoperative, 7.1 cm; P less than 0.025). Parameters which predicted return of continence included: delayed leakage during the saline infusion test (P less than 0.025), a narrow anorectal angle during pelvic floor contraction (P less than 0.025), minimal pelvic floor descent during contraction (P less than 0.05), and a long anal canal at rest (P less than 0.05) and during pelvic floor contraction (P less than 0.025).

Adult↗
PubMed1988

Physiological changes after postanal repair and parameters predicting outcome.

Nineteen patients have been studied before and 3 months after postanal repair. Physiological parameters have been compared with 16 age- and sex-matched controls. Twelve patients were substantially improved whereas seven obtained no clinical benefit. Pre-operative resting (P less than 0.005), squeeze (P less than 0.005) and strain (P less than 0.005) anal pressures at 2 cm were significantly less than controls. Similarly, pressures during all three events at 4 cm were significantly less than controls (resting P less than 0.05, squeeze P less than 0.005, strain P less than 0.025). Median volume of first leak during saline infusion was significantly less than controls (P less than 0.005) as was the total tolerable volume (P less than 0.005). Videoproctographic parameters which differed significantly from controls included pelvic floor descent at rest (P less than 0.005), during contraction (P less than 0.005) and straining (P less than 0.05); resting and squeeze perineal descent (P less than 0.005); and anal canal length at rest and straining (P less than 0.005). Anorectal angles, rectal compliance, rectal sensation and emptying did not differ from controls. None of these parameters was improved by postanal repair. Patients not improved by operation could be detected pre-operatively by low resting (P less than 0.05), squeeze (P less than 0.025) and strain (P less than 0.05) anal pressure at 2 cm as well as by videoproctographic evidence of increased pelvic floor descent at rest (P less than 0.01), during contraction (P less than 0.005) and straining (P less than 0.005), excessive perineal descent at rest (P less than 0.05), during contraction (P less than 0.05) and during attempted defaecation (P less than 0.05) and a short anal canal at rest (P less than 0.05) and during straining (P less than 0.025).

Adult↗
PubMed1977

Abnormalities of liver function following extensive jejunoileal bypass and resection in rats.

A greater than 90% jejunoileal bypass similar to the type performed in man for morbid exogenous obesity was performed in 70 adult female Wister rats; in an additional 70 rats a greater than 90% jejunoileal resection was performed. The control group consisted of 46 rats, which were not subjected to any experimental measures. Following operation the bypass group demonstrated a significantly greater weight loss than did the resection group. Total plasma protein, albumin, and glutamic oxalacetic transaminase all decreased from the control in both the resection and bypass groups; the decrease, however, was more significant in the bypass than in the resected group. These results suggest the possible production of a hepatotoxic factor in the excluded small bowel segment.

Alanine Transaminase↗
PubMed1975

The effects of small-bowel resection or bypass on the rat skeleton.

The bones of adult rats became progressively osteopenic 1 to 5 weeks following jejunoileal bypass or resection. These changes were accompanied by increased levels of metaphyseal enzyme activities as well as by loss of histochemically identifiable osteoid. Osteoid tissue and the ability to mineralize skeletal collagen were recovered more rapidly and fully in the resection group than in the bypass group. Metaphyseal alkaline phosphatase concentrations increased in both groups coincident with the elevated lysosomal enzymes levels, and the skeletons showed a calcium deficit (low Ca/HOPr ratio) within the first 3 weeks. In resected rats the osteopenia and bone blood chemistry were consistent with hyperparathyroidism secondary to impared Ca absorption. In bypassed rats the results suggest that the osteopenia might be related to the release of a "resorptive factor" from the excluded intestinal segment.

Acid Phosphatase↗
PubMed1973

Limy bile.

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Aged↗