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Biomedical subjects

H D Watts

Publications and source records attributed to H D Watts.

12 recordsLinked to original sources
PubMed1980

How gastric emptying of carbohydrate affects glucose tolerance and symptoms after truncal vagotomy with pyloroplasty.

It is commonly assumed that both abnormal glucose tolerance and postcibal symptoms after truncal vagotomy with pyloroplasty (V&P) are the result of rapid gastric emptying of carbohydrate; yet such correlations have not been established. These studies measured gastric emptying in symptomatic patients with V&P and normal subjects and sought correlations between rates of emptying and the time-courses of serum glucose and insulin as well as between emptying and symptoms. Gastric emptying in the V&P varied widely with different isocaloric meals of hypertonic glucose, taken in the erect vs. supine position, or of hypotonic starch taken in the erect posture as a solution or as solid balls of paste. Glucose and starch solutions were emptied abnormally rapidly in the erect posture, while glucose taken supine, and the starch balls were emptied more slowly. By contrast, all four meals emptied at about the same rates in the normal subjects. In both the V&Ps and the normals, there were weak correlations evident between the amount of carbohydrate emptied in the first 30 postcibal minutes and the rises in serum glucose or insulin. However, the presence or absence, the timing, and the qualitative nature of postcibal symptoms observed in the V&Ps did not correlate well with either the speed of emptying or the osmolarity of the carbohydrate meals.

Blood Glucose↗
PubMed1979

National Cooperative Crohn's Disease Study: extraintestinal manifestations and perianal complications.

Among 569 patients with Crohn's disease, 24% had a history of at least one extraintestinal manifestation and 36% had a history of perianal disease before randomization. Multiple extraintestinal manifestations occurred in the same patient more frequently than would be expected by chance. Seventy-six percent of patients with ileocolitis had perianal disease, extraintestinal manifestations, or both. This was significantly greater than the 58% incidence in patients with disease confined to the small bowel. Perianal complications alone were significantly more common in patients with colitis or ileocolitis than in those with disease of only the small bowel. This was true also of internal fistulization. There was a significant positive association between perianal disease and the presence of extraintestinal features. Perianal abscess appeared to respond to sulfasalazine and anal fissure to prednisone or azathioprine. These results require confirmation in larger series of patients.

Adult↗
PubMed1978

The lower esophageal ring and esophageal reflux.

Although the lower esophageal ring is an important cause of dysphagia in adults, its pathogenesis is unknown. To better define the relationship between the lower esophageal ring and esophageal reflux, we analyzed, retrospectively, the records of 18 hospitalized patients with radiologically demonstrated rings (16 confirmed by endoscopy and/or surgery). In 16 of these patients, evidence of esophageal reflux including at least one of the following was present: overt esophagitis noted at endoscopy or surgery (14 cases), histologic evidence of esophagitis (3 cases), and/or symptoms of pyrosis or free reflux (13 cases). These findings suggest that 1. reflux is frequently associated with lower esophageal rings and may play a role in their pathogenesis; 2. the radiologic finding of a ring should serve as a clue to the possibility of esophageal reflux and 3. long-term control of dysphagia in these patients may depend upon control of the associated reflux as well as mechanical disruption of the ring.

Adult↗
PubMed1976

Postemetic hematomas: a variant of the Mallory-Weiss syndrome.

Of forty-four patients with the Mallory-Weiss syndrome, nine (20 per cent) had endoscopic evidence of small submucosal hematoma(s) lying in or adjacent to the region of the the tear. These small hematomas are believed to occur most commonly as a variant of the Mallory-Weiss lesion.

Alcoholism↗
PubMed1976

The potential role of protein in the absorption of fat.

Stabilization of triglyceride emulsions by proteins was studied in vitro using either chemical or optical methods to measure to amount of fat emulsified under standard conditions of emulsification. Concentrations, pH, and degree of digestion of protein emulsifiers were varied to determine how such manipulations affected emulsion stabilization. Proteins from endogenous as well as exogenous sources were capable of stabilizing triglyceride emulsions, and this effect varied with protein concentration. Peptic digests of a prototype protein retained the efficacy of the undigested protein, while further digestion of the protein in pancreatic proteases decreased, but did not abolish, the emulsifying power of the protein. Emulsion stabilization by peptic digests of protein still persisted despite alterations in pH from 1 to 7. Such emulsions were capable of being hydrolyzed by pancreatic lipase and could be absorbed from the gut of bile-deficient rats. These emulsions also speed the initial rates of fat absorption from animals with an intact bile supply. We conclude that stabilization of luminal emulsions by dietary or endogenous protein may facilitate fat absorption similar to the way that detergent-stabilized emulsions have been previously shown to have these effects.

Animals↗
PubMed1976

The effect of acute hyperglycemia on gastric emptying in man.

Older work in man with meals of carbohydrates in water has indicated that such meals slow gastric emptying in proportion to their osomolarities. Nevertheless, different carbohydrates have been found to have differing efficacies per milliosmole. One possibility which would explain such discrepancies among carbohydrates is that hyperglycemia induced by carbohydrate absorption itself contributes to the slowing of gastric emptying. To test this possibility, normal subjects were made acutely hyperglycemic with intravenous loads of glucose during the ingestion of various liquid test meals, and rates of gastric emptying of these meals were compared in the same subjects during periods of induced hyperglycemia with rates of gastric emptying under euglycemia conditions. Induced hyperglycemia significantly slowed the rate of emptying of meals containing fat + protein, or protein, but did not significantly alter emptying of meals containing only NaCl. It is concluded that hyperglycemia does exert some effect on gastric emptying, but that these effects of hyperglycemia are variably expressed, depending on the presence of other factors which themselves slow gastric emptying.

Blood Glucose↗
PubMed1976

Lesions brought on by vomiting: the effect of hiatus hernia of the site of injury.

From an extensive review of the published cases of lesions of the esophagus and stomach brought about by vomiting and a supplemental review of local experience with the Mallory-Weiss syndrome, the influence of hiatus hernia on the lesion site can now be defined. Mallory-Weiss lesions located in the gastric cardia are commonly associated with hiatus hernia. By contrast, those occurring in the distal esophagus and those that overlie the cardioesophageal junction are only rarely associated with hernia. The Boerhaave lesion occurs most probably in the absence of hiatus hernia and in 2 of 3 previously reported cases wherein a hernia was present, a combined gastroesophageal rupture occurred. A newly recognized postemetic form of gastric rupture is clearly distinguished from other causes of this lesion and its characteristic location is described. A unifying hypothesis is proposed in which the location of lesions occurring during emesis is determined by the presence of a hiatus hernia during retching.

Adult↗
PubMed1975

Brucellosis.

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Aged↗