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Biomedical subjects

J H Saunders

Publications and source records attributed to J H Saunders.

At least 19 recordsLinked to original sources
PubMed1992

Laparoscopic cholecystectomy as a safe and effective treatment for severe acute cholecystitis.

OBJECTIVE: To evaluate the feasibility and safety of laparoscopic cholecystectomy in severe acute cholecystitis. DESIGN: Analysis of data collected prospectively from a consecutive series of 350 laparoscopic operations. SETTING: Two general surgical units in a teaching hospital. SUBJECTS: 31 patients with a diagnosis of severe acute cholecystitis based on clinical examination, investigation results, and operative findings. INTERVENTIONS: Initial intravenous fluids and broad spectrum antibiotics followed by laparoscopic cholecystectomy within 72 hours of presentation. MAIN OUTCOME MEASURES: Failure to complete the operation laparoscopically, length of postoperative stay in hospital, early postoperative morbidity, interval from operation to full activity, and return to work. RESULTS: Laparoscopic cholecystectomy was attempted in 19 patients with empyema of the gall bladder and 12 who had severe cholecystitis which failed to settle on medical management. A total of 29 operations were successfully completed with two conversions to open surgery. Two minor postoperative complications occurred, and one case of retained common bile duct stones with jaundice was treated by endoscopic retrograde cholangiopancreatography and papillotomy. Median postoperative hospital stay was two days, with return to normal activity in seven days and to work in two weeks. There were no deaths related to the operation. CONCLUSIONS: In the presence of severe acute cholecystitis laparoscopic cholecystectomy is feasible in most patients, with minimal risk of injury to surrounding structures and considerable benefits. It is recommended that laparoscopic cholecystectomy should be attempted in these patients when appropriate surgical skill is available.

Acute Disease↗
PubMed1978

Very long-term treatment of peptic ulcer with cimetidine.

In an open trial, 96 patients with endoscopically proven peptic ulcers were randomly allocated to treatment with cimetidine (1 g/day) for periods of 3, 6, 9, or 12 months. After their courses of treatment, the patients were followed up for at least 6 months. In 92% the ulcers had healed after treatment for 1 month, and in a further 5% the ulcers healed during the next 2 months. Ulcers recurred during treatment in 24% of patients and within 6 months of withdrawal of treatment in a further 43%. In nearly a third of patients the recurrences were asymptomatic and were discovered only through routine endoscopic studies. Continuous treatment with full doses of cimetidine for a year seems to prevent relapse of the majority of ulcers which have healed during treatment; but it does not cure the ulcer disease, since relapse generally occurs quite rapidly when treatment is discontinued.

Cimetidine↗
PubMed1977

Prevention of wound infection in abdominal operations by peroperative antibiotics or povidone-iodine. A controlled trial.

The wound-infection rate after abdominal operations was compared in 113 patients randomly allocated to an untreated control group, a group receiving preoperative lincomycin and tobramycin, or a group receiving local instillation of povidone-iodine. The wound-infection rate was 8.1% in 37 patients receiving antibiotics, 42.1% in 38 untreated controls, and 39.5% in 38 patients in the povidone-iodine group.

Abdomen↗
PubMed1977

Long-term effects and after-effects of treatment of duodenal ulcer with metiamide.

Three therapeutic regimens were investigated to find the best way of treating duodenal ulceration with the histamine H2-receptor antagonist metiamide. Relapse of duodenal ulceration was not prevented by nocturnal administration of metiamide. Recurrence was prevented by continued administration of metiamide for 1 year, but cessation of treatment was followed by rapid relapse or symptomless recurrence of the ulceration. Repeated short courses (1 month) of treatment resulted in slower symptomatic control and more rapid recurrence of the ulceration. The treatment of duodenal ulcer with H2-receptor antagonists requires further investigation.

Clinical Trials as Topic↗
PubMed1977

Inhibition of gastric secretion in treatment of pancreatic insufficiency.

The content of pancreatic enzymes in the duodenum was studied in two patients with pancreatic achylia after a standard meal supplemented with commercial pancreatic extract. Gastric transit of the enzymes, with appearance of near-normal amounts in the duodenal contents, occurred only after inhibition of gastric secretion and buffering of residual gastric acid with antacids. Gastric inhibition and neutralisation of acid are therefore necessary for the satisfactory treatment of patients with pancreatic exocrine insufficiency but normal gastric function.

Chronic Disease↗
PubMed1977

Potentiation of the action of azaserine on the rat pancreas by raw soya bean flour.

Rats were treated with raw soya flour to produce pancreatic hypertrophy and also received azaserine, a pancreatic carcinogen. The combined treatment resulted in the development of large numbers of hyperplastic nodules in the acinar tissue of the rat pancreas. We conclude that the pancreas of the rat stimulated to proliferate by raw soya flour provides a sensitive model for detecting and studying pancreatic carcinogens.

Animals↗
PubMed1977

Liquid and solid-state Cl- -sensitive microelectrodes. Characteristics and application to intracellular Cl- activity in Balanus photoreceptor.

When intracellular chloride activity (aiCl) was monitored with chloride-sensitive liquid ion exchanges (CLIX) microelectrodes in Balanus photoreceptors, replacement of extracellular chloride (Cl0) by methanesulfonate or glutamate was followed by a rapid but incomplete loss of aiCl. When propionate was used as the extracellular anion substitute, CLIX electrodes detected an apparent gain in aiCl, while a newly designed Ag-AgCl wire-in glass microelectrode showed a loss of aiCl under the same conditions. This discrepancy in Cl- washout when propionate replaced Cl0 is explained by the differences in selectivity of CLIX and Ag-AgCl electrodes for native intracellular anions and for the extracellular anion substitute which also replaces Cli and interferes in the determination of aiCl. Both electrodes indicate that ECl approximately Em when the cells are bathed in normal barnacle saline, and both electrodes showed the rate of Cl washout (tau approximately 5 min) to be independent of Cli when Cl0 was replaced by glutamate. Details of Ag-AgCl microelectrode construction are presented. These electrodes were tested and found to be insensitive to the organic anion substitutes used in this study. Selectivity data of CLIX electrodes for several anions of biological interest are described.

Animals↗
PubMed1977

Cation and anion sequences in dark-adapted Balanus photoreceptor.

Anion and cation permeabilities in dark-adapted Balanus photoreceptors were determined by comparing changes in the membrane potential in response to replacement of the dominant anion (Cl-) or cation (Na+) by test anions or cations in the superfusing solution. The anion permeability sequence obtained was PI greater than PSO4 greater than PBr greater than PCl greater than Pisethionate greater than Pmethanesulfonate. Gluconate, glucuronate, and glutamate generally appeared more permeable and propionate less permeable than Cl-. The alkali-metal cation permeability sequence obtained was PK greater than PRb greater than PCx greater than PNa approximately PLi. This corresponds to Eisenman's IV which is the same sequencethat has been obtained for other classes of nerve cells in the resting state. The values obtained for the permeability ratios of the alkali-metal cations are considered to be minimal. The membrane conductance measured by passing inward current pulses in the different test cations followed the sequence, GK greater than GRb greater than GCs greater than GNa greater than GLi. The conductance ratios obtained for a full substitution of the test cation agreed quite well with permeability ratios for all the alkali-metal cations except K+ which was generally higher.

Alkalies↗
PubMed1977

Effects of cimetidine and poldine on nocturnal gastric secretion in duodenal ulcer.

Cimetidine inhibited nocturnal secretion of acid but only slightly inhibited the nocturnal secretion of pepsin in patients with duodenal ulcer. Administration of cimetidine (200 or 400 mg), together with an anticholinergic drug (poldine), augmented the inhibition of the nocturnal secretion of acid and of pepsin. The combination of an H2-receptor-blocking drug with an anticholinergic drug will have therapeutic application in the management of duodenal ulceration.

Benzilates↗
PubMed1977

Enzymic activities of commercial preparations of pancreatic enzymes.

The enzymic activities of 20 commercial pancreatic extracts have been measured by standard (F.I.P.) methods of assay and the activities have been compared with a standard preparation of pancreatin supplied by the British Pharmacopoeia Commission. A wide range of enzymic activities was found. The tabulated cost per unit of enzymic activities provides a guide to one aspect of the potential therapeutic efficacy of pancreatic extracts in the treatment of pancreatic exocrine insufficiency.

Amylases↗