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Biomedical subjects

G K Patel

Publications and source records attributed to G K Patel.

10 recordsLinked to original sources
PubMed1982

Mechanisms of gastroesophageal reflux in patients with reflux esophagitis.

We evaluated the mechanisms of gastroesophageal reflux in 10 patients with reflux esophagitis and compared the results with findings from 10 controls. The patients had more episodes of reflux (35 +/- 15 in 12 hours, as compared with 9 +/- 8 in the controls) and a lower pressure of the lower esophageal sphincter (13 +/- 8 mm Hg as compared with 29 +/- 9 in the controls) (P less than 0.001). Reflux occurred by three different mechanisms: transient complete relaxation of the lower esophageal sphincter, a transient increase in intra-abdominal pressure, or spontaneous free reflux associated with a low resting pressure of the lower esophageal sphincter. In controls 94 per cent of reflux episodes were caused by transient sphincter sphincter relaxation. In the patients 65 per cent of episodes of reflux accompanied transient sphincter relaxation, 17 per cent accompanied a transient increase in intra-abdominal pressure, and 18 per cent occurred as spontaneous free reflux. The predominant reflux mechanism in individual patients varied: some had normal resting sphincter pressure and reflux that occurred primarily during transient sphincter relaxation, whereas others with low resting sphincter pressures had spontaneous free reflux or reflux that occurred during an increase in intra-abdominal pressure.

Adult↗
PubMed1982

Extended and limited types of Barrett's esophagus in the adult.

Columnar epithelium-lined lower esophagus (CLLE) or Barrett's esophagus was found in 34 patients diagnosed by endoscopic biopsy. In one-half of them, the CLLE extended up to 30 cm from the incisors (limited group) and in the other half, it reached above this level (extended group). Eight patients with stricture and limited CLLE had the lesion in the lower third of the esophagus, whereas 6 of 8 with strictures in the extended group had narrowing in the upper third of the esophagus. Two other patients with extended CLLE were seen with bleeding from Barrett's ulcer, 3 had adenocarcinoma, and the remaining 4 had CLLE without these complications. The three classic histologic types were encountered in both groups. However, in the extended group there was more of the intestinal type and less of the junctional type of epithelium, the latter being seen mostly in the limited group. The extended group had very low lower esophageal sphincter (LES) pressures (mean, 7.3 mm Hg) with severe reflux. The limited group had a higher mean LES pressure (11.2 mm Hg) with less severe reflux. In both groups, LES pressure and reflux improved following effective antireflux operation; some patients who continued to have demonstrable reflux and a lack of improvement in LES pressure despite antireflux operation, the disease progressed, as evidenced by extension of CLLE.

Adenocarcinoma↗
PubMed1981

Granular cell myoblastoma of the esophagus. Report of two cases.

Granular cell myoblastoma (GCM) of the esophagus is a rare, usually benign tumor, most often discovered incidentally during upper endoscopy, surgery, or autopsy. Although some reports have questioned the safety of endoscopic biopsy of granular cell tumors of the esophagus, we feel that the procedure can be performed safely and accurately. For the unwary, histological examination may lead to a misdiagnosis of squamous cell carcinoma. Although some reports of malignant esophageal tumors can be found, in general, if the histologic appearance of the tumor is benign, malignant transformation or metastasis is unusual. Surgical resection for malignant and for large symptomatic benign tumors is the treatment of choice. In, however, individuals with histologically benign tumors. who are asymptomatic or who are not considered good surgical candidates, careful observation with endoscopic follow-up can be safely done.

Adult↗
PubMed1979

Glucagon effects on the human small intestine.

In healthy volunteers, the effects of intravenously administered glucagon on small intestinal function was investigated. Bolus doses resulting in plasma glucagon concentrations of greater than 800 pg/ml (5 min after injection) abolished jejunal contractions for 4.4 +/- 0.4 (SEM) min after a latency period of 49 +/- 4 sec. During continuous intravenous glucagon infusion, jejunal dilatation and increase in mean transit time (MTT) occurred at plasma levels greater than 720 pg/ml, while inhibition of water and electrolyte absorption was observed only with plasma glucagon concentrations of 1760 +/- 114 pg/ml. Under these conditions, the propulsion of fasting intestinal contents was slowed without change in flow rate. The observed effects cannot be attributed to the simultaneously occurring rise in plasma insulin and glucose concentrations. Short-term increases in circulating glucagon concentration inhibit intestinal tone, contractions, and propulsion with only a minor effect on water and electrolyte absorption limited to a narrow concentration range of plasma glucagon. Neither effect occurs at glucagon levels likely to occur under physiologic concentrations. The latency period preceding the abolition of jejunal contractions suggests that glucagon does not act directly on intestinal smooth muscle cells.

Adult↗