Biomedical subjects

J K Sillery

Publications and source records attributed to J K Sillery.

5 recordsLinked to original sources

PubMed1992

Appendiceal US scans: histologic correlation.

High-resolution in vitro ultrasonography (US) of 20 surgical appendiceal specimens was performed to compare appearances of appendiceal tissue at US with corresponding histologic features. With an articulated-arm system and micropositioner, precise spatial correlation was achieved. As elsewhere in the gastrointestinal tract, five distinct echo layers were observed. Normal and inflamed specimens demonstrated these layers, but the architecture became disorganized and indistinct in cases of appendicitis. Three measurements were made for each specimen: (a) overall cross-sectional diameter, including the lumen, (b) thickness of the submucosal echo layer, and (c) the combined thickness of both walls, excluding the lumen. For the inflamed specimens, a substantial increase in the thickness of the summed wall measurements was found. Wall US appearance alone may be misleading in differentiation of normal and abnormal appendices.

Adolescent↗

PubMed1989

Beneficial effects of glucose polymer and an H2-receptor blocker in a patient with a proximal ileostomy.

A patient with an ileocolectomy and proximal ileostomy for Crohn's disease had severe diarrhea and steatorrhea. An oral electrolyte solution containing glucose polymer was shown to improve water and electrolyte absorption. Ileal contents were abnormally acidic. Therapy with an H2-receptor blocker raised ileal pH, improved the efficiency of fat absorption, and promoted a gain in body weight.

Adult↗

PubMed1988

Absorption of triglyceride by human small intestine: dose-response relationships.

Healthy subjects with ileostomies (ileostomates) were fed six breakfasts of 5-100 g linseed oil. This lipid source was chosen so that linolenic acid could be used as a fatty acid probe. Phenol red was included in the meal so that mouth-to-stoma transit could be measured as the t 1/2 of phenol red. Ileostomy effluent was collected over 24 h and the dose of lipid ingested was related to lipid output and to intestinal transit time. The coefficient of variation for mouth-to-stoma transit was less than 12%. The slopes of the least-square lines relating lipid ingested to lipid output and to mouth-to-stoma transit time were positive and significantly different (p less than 0.05) from 0. The ileostomate's small intestine absorbed linolenic acid with 98% efficiency. A delay in mouth-to-ileum transit, associated with increasing lipid loads, is one obvious mechanism that maintains the intestine's absorptive efficiency.

Adult↗

PubMed1985

Absorption of carbohydrate-electrolyte solutions in rat duodenojejunum. Implications for the composition of oral electrolyte solutions in man.

Commonly used oral electrolyte solutions are based on glucose, or sucrose, and 90 mM Na+. We had been disappointed with the ability of such solutions to improve Na+ absorption in patients with extensive resection of distal small bowel. Therefore, we tested the effect on net Na+ and water transport of combinations of different carbohydrates (glucose, sucrose, and glucose polymers) and NaCl in the rat duodenojejunum. Absorption was measured under steady-state conditions in unanesthetized animals which were infused with a different combination every hour for up to 5 hr. Of the various combinations, 10 mM glucose polymer (equivalent to 56 mmol of glucose as glucose oligosaccharides), or 60 mM glucose promoted net Na+ absorption from 120 mM NaCl and 20 mM KCl, but the glucose polymer infusate promoted more rapid water absorption than did the infusate containing glucose. The infusate of 10 mM glucose polymer in saline was initially hypotonic (276 mosmol/kg), but it became isotonic (298 mosmol/kg) as the glucose polymer was hydrolyzed during its passage through the duodenojejunum. In contrast, an infusate of 60 mM sucrose with 120 mM NaCl and 20 mM KCl remained hypertonic (320 mosmol/kg), and it did not promote water and Na+ absorption by the duodenojejunum. The efficacy of 10 mM glucose polymer with 120 mM NaCl should be tested in patients with short-bowel syndrome due to distal bowel resection.

Animals↗

PubMed1985

Absorption of starch by healthy ileostomates: effect of transit time and of carbohydrate load.

Recently, breath hydrogen studies and intubation techniques have indicated that in excess of 10% of starch in normal foods may be malabsorbed in the small intestine and enter the colon. We evaluated starch absorption in healthy subjects with ileostomy. First, unabsorbed starch was quantified in ileostomy effluent from six ileostomates who ingested constant diets of wheat and potato starch for four days. Daily unabsorbed starch ranged from 1.3% to 5.0% of total ingested starch. Second, starch from a radiolabeled solid meal containing 50 g potato starch was measured under control conditions and after altering transit time with either loperamide, or magnesium citrate. Loperamide significantly decreased the amount of unabsorbed starch in all six ileostomates (p less than 0.05), while magnesium citrate significantly increased starch malabsorption in all six subjects (p less than 0.05). Third, starch absorption was measured after single solid meals containing 25, 50, 75, and 100 g potato starch. There was a linear relationship between starch input and output. Mean output expressed as a percent of input remained constant. We conclude that the degree of starch malabsorption by the small intestine of ileostomates may be less than that estimated by indirect methods in intact humans. The amount of unabsorbed starch is directly related to the quantity ingested and to the small intestinal transit time.

Adult↗