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Biomedical subjects

K G Leach

Publications and source records attributed to K G Leach.

At least 19 recordsLinked to original sources
PubMed1990

Effects of halothane, enflurane and isoflurane anaesthesia on renal plasma flow.

Effective renal plasma flow (ERPF) and linear cardiac output (aortic blood velocity) were measured in 15 patients who received halothane, enflurane or isoflurane in oxygen. All three agents caused a significant reduction in ERPF (P less than 0.05) and the effect was greater at 1.25 MAC than at 0.75 MAC. No significant difference was demonstrated between the agents. Linear cardiac output did not change significantly during the study, suggesting that the observed reduction in ERPF was not caused by cardiovascular depression.

Adult↗
PubMed1987

Gastric emptying and small bowel transit times in volunteers after intravenous morphine and nalbuphine.

Gastric emptying half-times and small intestinal transit times were measured in a double-blind crossover study of 17 volunteers who received an intravenous injection of nalbuphine (5 or 10 mg), morphine (5 mg) or placebo. Both times were monitored using a gamma camera after a radioactive test meal and gastric emptying half-time was calculated. Small intestinal transit time was measured by the appearance of radioactivity in the caecum and also of hydrogen in end tidal air. Gastric emptying was prolonged over placebo by nalbuphine 10 mg, which had more effect than nalbuphine 5 mg or morphine 5 mg; morphine 5 mg had less effect than nalbuphine 5 mg. Small intestinal transit time was prolonged over placebo by nalbuphine 10 mg more than by nalbuphine 5 mg or morphine 5 mg, which had approximately equal effects. In these respects, the potency ratio of nalbuphine appears roughly equivalent to morphine. Small intestinal transit times measured by end tidal hydrogen concentration and gamma camera showed close agreement.

Adult↗
PubMed1985

Serial measurement of renal plasma flow.

Effective renal plasma flow was measured two or three times in 1 h in 12 healthy volunteers. Radiohippuran (ortho-iodohippurate) was injected intravenously, and blood samples were obtained 8, 13 and 18 min post-administration. The problem of interference in succeeding measurements by activity from preceding injections was overcome by the use of three different radiolabels. These were, in order of use, 125I, 123I and 131I. The principal energies of gamma- and/or X-ray emission were 30, 160 and 365 KeV, respectively, allowing completely independent assay. A close correlation was observed between the results obtained for the three radionuclides over a wide range of renal plasma flow. The technique is relatively non-invasive and is presented as a suitable method for the important task of measuring renal plasma flow under the influence of drugs, especially of anaesthetics.

Adult↗
PubMed1984

Gastric emptying after surgery for the dumping syndrome.

The dumping syndrome following gastric surgery for peptic ulcer disease can cause severe morbidity. In this study the benefit of interposition of an antiperistaltic jejunal loop to reverse peristalsis and delay gastric emptying was assessed in four patients with severe symptoms by performing gastric emptying studies pre-operatively, and at 6 months and 24 months following surgery. Gastric emptying was delayed at 6 months but by 2 years had returned to pre-operative values. Patients' symptoms were improved at 6 months and remained so despite the deterioration in gastric emptying. This surgical procedure is of some value to patients with severe symptoms due to the dumping syndrome.

Dumping Syndrome↗
PubMed1983

Gastric emptying after intestinal resection in Crohn's disease.

Gastric emptying, using a liquid meal labelled with 99Tcm DTPA was studied in 6 patients with Crohn's disease who had diarrhoea following resection of the small intestine. Results were compared with those obtained in 6 normal subjects and 6 patients who had classic dumping symptoms following gastric surgery. The rate of gastric emptying of patients with Crohn's disease was similar to that of normal subjects, and differed markedly from gastric emptying in patients with the dumping syndrome (P less than 0 . 001). Diarrhoea in patients with Crohn's disease who have undergone intestinal resection is not due to rapid gastric emptying and would therefore be unlikely to respond to therapeutic measures designed to improve similar symptoms in patients who have the dumping syndrome.

Adult↗
PubMed1980

Evaluation of effective renal plasma flow during renography.

A method to determine effective renal plasma flow that requires only a single injection of 131-iodine hippuran and eliminates the necessity of obtaining blood samples is described. Good correlation was obtained between this procedure and a method requiring a blood sample. The technique should prove useful in determining effective renal plasma flow when difficulty is encountered in obtaining blood. However, before it is used as a method in its own right it must be compared to an independent method of measuring effective renal plasma flow.

Humans↗
PubMed1977

Distribution of 5-fluorouracil to body tissues compared after intraluminal, intravenous, and intramural administration in gastrointestinal cancer.

The distribution of 5-fluorouracil (5-FU) to various potential metastatic sites has been investigated in stomach and colorectal cancer patients, using intraluminal, intravenous, and intramural routes of administration at the time of surgery. The best overall concentrations of 5-FU in systemic blood, portal blood, liver, draining lymph nodes, tumor, and locally in the bowel wall was obtained after intramural injection. The intraluminal route of administration resulted in poor overall distribution of 5-FU. Intravenous administration tended to give levels between those obtained from intramural and intraluminal routes. There was no complication of 5-FU therapy. On the basis of this study we conclude that the intramural route is the most satisfactory for adjuvant administration of 5-FU with surgery. This might be expected to give better results than those obtained in clinical studies using intraluminal and intravenous routes. A controlled trial of 5-FU using the intramural route is indicated in gastric and colorectal cancer to demonstrate whether or not clinical benefit can be obtained.

Aged↗
PubMed1976

Evaluation of radiography and isotopic scintigraphy for detecting skeletal metastases in breast cancer.

Experience with technetium-phosphate compounds for skeletal scintigraphy in patients with breast cancer was analysed. When tumours were 5 cm or less in diameter (T1-2N0-1M0) metastases were demonstrated by radiographs in 1-7% (2/114). However, when radiography did not demonstrate metastases, lesions were found by scintigraphy in 41-3% (19/46). When lesions demonstrated by scintigraphy at the same site as abnormalities regarded as "benign" by radiography were excluded, 23% (11/46) had scintigraphs strongly suggestive of metastases. It is proposed that routine radiographic skeletal survey for patients presenting with breast cancer be abandoned, and replaced by skeletal scintigraphy, chest radiography, and specific localised radiographs of lesions demonstrated by scintigraphy. It is suggested that with this policy the development of expertise in interpreting scintigraphs will be accelerated, the cost of pre-treatment assessment will be reduced, and clinical management rationalised.

Bone Neoplasms↗
PubMed1976

Prediction of human spleen size by computer analysis of splenic scintigrams.

A method of assessing spleen size from splenic scintigraphs obtained using autologous heat damaged 99Tcm labelled red cells is described. The method depends on a "computed volume" estimate. The method has a correlation coefficient of 989 with the exsanguinated weight ofthe spleen after splenectomy and has been shown to have an accuracysuperior to methods previously described.

Computers↗
PubMed1975

Dextran 70 in prophylaxis of thromboembolic disease after surgery: a clinically oriented randomized double-blind trial.

A randomized double-blind trial of prophylaxis of thromboembolism in surgical patients judged by clinical morbidity has been completed. Altogether 831 patients over 40 years of age who underwent elective surgery of the stomach, biliary system, or colon received either dextran 70 or normal saline before the operation. Thirteen of the 435 patients on saline and three of the 396 on dextran developed pulmonary embolism. Eight of these 16 patients died of pulmonary embolism--seven in the saline group and one in the dextran group. As detected either clinically or by 125I-fibrinogen scanning the incidence of deep vein thrombosis was similar in the two groups. There was no increased incidence of excessive bleeding in patients on dextran though clinical impression suggested that some patients on dextran bled excessively. This trial showed that dextran 70 administered by intravenous drip during operation is effective in preventing pulmonary embolism and, in particular, reducing mortality from this cause. It seems to be as effective as subcutaneous heparin but is easier to administer and places less of a burden on nursing services.

Clinical Trials as Topic↗