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Biomedical subjects

I T Gilmore

Publications and source records attributed to I T Gilmore.

At least 55 records · Page 3Linked to original sources
PubMed1987

Cigarette smoking and inflammatory bowel disease.

In a case-control study 280 patients with inflammatory bowel disease and matched community controls taken from general practitioner lists were questioned about their smoking habits. Whether assessed by current or previous habits, patients with Crohn's disease were more likely to be or have been smokers than their matched controls and the association appeared strongest at disease onset (matched relative risk 4.1, p less than 0.001). In contrast, patients with ulcerative colitis assessed in the same way were less likely to be smokers compared with their matched controls, with the association being equally strong at disease onset and currently (matched relative risk 0.17, p less than 0.001). Among patients with ulcerative colitis who were exsmokers, 76% reported stopping smoking before disease onset compared with 13% of exsmokers with Crohn's disease. Contrary to earlier reports, there were only small and nonsignificant increases in the risk of Crohn's disease or ulcerative colitis in exsmokers. The strength, temporal precedence, and contrasting nature of the associations are evidence that smoking has an important etiologic role in inflammatory bowel disease. Smoking appears to be a factor in determining whether Crohn's disease or ulcerative colitis develops in predisposed individuals.

Adult↗
PubMed1987

Is SPECT of the spleen worthwhile in the evaluation of liver disease severity?

SPECT of the spleen has been performed with 99Tcm-sulphur colloid in 53 patients, and SPECT of the liver has been performed in 57 patients. All patients had histologically proven liver disease and were classified by the degree of severity, Group A-severe, Group B-moderate, Group C-mild. The patients were further classified as cirrhotic and non-cirrhotic. Eight controls were also studied. There is positive though poor correlation between splenic volume and uptake (r2 = 0.55). Splenic volume and uptake are significantly different in Group A patients compared with all other groups (p less than 0.001). They are also significantly different in cirrhotics versus non-cirrhotics and cirrhotics versus controls (p less than 0.001). Splenic SPECT was unhelpful in distinguishing between moderate and mild liver disease. SPECT of the spleen is a time consuming technique but a useful adjunct to liver SPECT in patients with portal hypertension.

Electronic Data Processing↗
PubMed1985

Liver volume and uptake assessment using 123I-BSP tomography.

Liver volume and parenchymal cell uptake of 123I-bromosulphthalein (BSP) has been assessed using the technique of single photon emission tomography (SPET). These results have been compared with a clinical scoring of disease severity and also with results for liver volume and tomographically assessed uptake of 99Tcm-sulphur colloid (SC). Comparisons of volume estimation, geometric mean (GM) uptake curves and a distribution index derived by a mapping technique with both radiopharmaceuticals, show that 123I-BSP tomography is feasible. A short acquisition time is required in order to obtain tomographic information before there is significant biliary excretion. There was a significant difference between the mean percentage uptake of 123I-BSP in the three groups of liver disease severity (P less than 0.002). This technique merits further evaluation in the study of the assessment of functional liver impairment.

Female↗
PubMed1984

Mesophase formation during cholesterol gallstone dissolution in human bile: effect of bile acid composition.

Duodenal bile obtained from patients with gallstones who were acutely infused with chenodeoxycholic acid, ursodeoxycholic acid, or cholic acid were examined for the propensity toward the formation of a liquid crystalline mesomorphic phase when cholesterol gallstones were incubated in these bile acids. Bile taken from patients infused with ursodeoxycholic acid was found to be enriched in ursodeoxycholic acid; mesophase formation was detected in these samples but not in bile from patients infused with chenodeoxycholic acid or cholic acid.

Bile↗
PubMed1983

Experience with transjugular liver biopsy.

The results of 193 transjugular liver biopsies performed with a modified needle are described. An adequate specimen was obtained in 97%, and complications were rare, although puncture of the liver capsule does occur and caused bleeding in two patients. Fever after the procedure was reduced by ultrasonic cleaning of the needle. Although not easy, this technique is safe and preferable in the management of selected patients, but in most patients percutaneous biopsy is to be preferred.

Biopsy, Needle↗
PubMed1983

Bone disease after jejuno-ileal bypass for morbid obesity.

Fifteen patients who had undergone a 14 inches X 4 inches jejuno-ileal bypass operation for obesity, 3 to 4 years earlier, were investigated by iliac bone biopsy, radiology and routine biochemistry, including 25-hydroxy-vitamin D and parathyroid hormone estimations. Two patients had histological osteomalacia which was mild in one. A further 9 patients had abnormal bone biopsies, there being an excess of trabecular bone surface covered by osteoid with a normal or reduced amount of calcification front. Six of these 9 showed an increase in trabecular resorption, although in none were there excessive numbers of osteoclasts. The likely explanation for these findings is that these 9 patients had early osteomalacia with mild hyperparathyroidism, making a total of 11 patients out of 15 with osteomalacia. Radiology and blood chemistry were poor predictors of histological bone disease.

Adult↗
PubMed1983

The biliary and urinary metabolites of [3H]17 alpha-ethynylestradiol in women.

The metabolism of 17 alpha-ethynyl[6,7-3H]estradiol (3H-EE2) (50 micrograms) given orally was studied in two groups of women: (a) six subjects from whom duodenal bile samples were obtained after 4 h by endoscopic aspiration; (b) two subjects with bile-duct (T-tube) drainage. The first group eliminated 16.6 +/- 7.8% (mean +/- S.D.) of the dose in urine over 72 h, the second group 28.6% and 27.5%. Biliary excretion by the latter was 41.9% and 28.3% of the dose, respectively, during the first 24 h after dosing. The metabolites excreted in bile and urine were largely polar conjugates: 1-12% of the 3H was ether extractable. Approx. 70-90% of urinary and biliary 3H was extractable following beta-glucuronidase-arylsulphohydrolase hydrolysis. Both beta-glucuronides and arylsulphates were excreted. Unchanged 3H-EE2 was the principal 3H-labelled component of the glucuronide and arylsulphate fractions of bile, and it was a major component of urinary fractions. 2-Hydroxy-EE2 and 2-methoxy-EE2 were identified as conjugated biliary metabolites.

Aged↗
PubMed1982

Direct measurement of hepatic extraction of chenodeoxycholic acid and ursodeoxycholic acid in man.

1. The hepatic extraction ratios of chenodeoxycholic acid and ursodeoxycholic acid have been measured in 12 patients without, and 20 patients with, liver disease. 2. Ten of the patients without liver disease were studied during cardiac catheterization, with a continuous infusion technique. Two of the patients without liver disease and all those with liver disease received an intravenous bolus of [14C]chenodeoxycholic acid or [14C]ursodeoxycholic acid, during transvenous liver biopsy. 3. The extraction ratio of chenodeoxycholic acid was 0.63 +/- 0.03 (mean +/- mean +/- SEM) and of ursodeoxycholic acid 0.53 +/- 0.01, in the patients without liver disease. In those with mild liver disease, extraction was slightly impaired (chenodeoxycholic acid; 0.49 +/0 0.03; ursodeoxycholic acid: 0.43 +/- 0.05), whereas in those with more severe liver disease it was greatly reduced (chenodeoxycholic acid: 0.16 +/- 0.08; ursodeoxycholic acid: 0.07 +/- 0.01). 4. The results suggest that (a) direct measurements confirm the accuracy of indirect estimates of hepatic extraction of chenodeoxycholic acid, (b) hepatic extraction of chenodeoxycholic acid is lower than that of cholic acid and glycocholic acid, but higher than that of ursodeoxycholic acid, (c) progressive impairment of the extraction ratios of these two bile acids occurs as the severity of liver disease increases, and (d) the ratios are correlated with indocyanine green extraction ratios.

Adult↗
PubMed1982

Comparison of the Trucut and Surecut liver biopsy needles.

The Trucut and Surecut liver biopsy needles have been compared in a prospective randomised study. Although the Surecut specimens were longer and heavier they tended to fragment during processing. Trucut specimens were subject to less artefact and were rated more highly by the histopathologist. However, the majority of biopsies obtained by both needles were satisfactory for diagnostic purposes.

Biopsy↗
PubMed1982

Effects of individual taurine-conjugated bile acids on biliary lipid secretion and sucrose clearance in the unanesthetized dog.

The effect of three taurine-conjugated bile acids on bile flow, induced biliary secretion of phospholipids and cholesterol, and the hepatobiliary clearance from plasma of sucrose and erythritol (two uncharged, nonmetabolizable permeability probe molecules) was assessed in the unanesthetized bile fistula dog under steady-state conditions. Synthetically prepared chenodeoxycholyltaurine, cholytaurine, or urological rate for randomized 90-min periods, and four 10-min samples of bile were taken at the end of each period. Induced bile flow (per mumoles of bile acid) was calculated to be about one-third higher with ursodeoxycholyltaurine than with the other bile acids. Induced phospholipid secretion was identical for all bile acids, but cholesterol secretion differed: the two dihydroxy taurine conjugates induced considerably more cholesterol per molecule bile acid or phospholipid than colyltaurine. Further, ursodeoxycholyltaurine induced significantly more cholesterol secretion than chenodeoxycholyltaurine. Erythritol clearances were identical for all bile acids, and sucrose clearance, although slightly higher for chenodeoxycholyltaurine than ursodeoxycholyltaurine, was similar for all three conjugated bile acids. The results indicate that, for these two 3,7-dihydroxy bile acids, the orientation of the 7-hydroxyl group on the steroid nucleus has a marked influence on cholesterol secretion into bile and bile flow but not on the apparent permeability of the hepatobiliary tree.

Animals↗