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Biomedical subjects

L K Harding

Publications and source records attributed to L K Harding.

At least 109 records · Page 6Linked to original sources
PubMed1982

The efficacy of peritoneal lavage at elective abdominal operations.

Human serum albumin microspheres of 1 micrometer diameter labelled with technetium-99 m were evaluated as a model for bacteria in two animal species. Peritoneal lavage recovered comparable amounts of an inoculum of microspheres and simultaneously instilled Escherichia coli. A prospective study was undertaken of 38 patients undergoing elective abdominal operations. Three lavages, each of 500 ml normal saline, were used. Over 80 per cent of the saline was recovered in 37 of the 38 patients with a median of 93 per cent. Recovery of microspheres was assessed from above the spleen, from Morison's pouch and from the pouch of Douglas. There was no difference in the recovery rates from the three sites of placement but significantly fewer microspheres were recovered via a right subcostal incision (median 59 per cent) compared with an upper midline incision (median 91 per cent).

Abdomen↗
PubMed1982

Bile diversion after total gastrectomy.

A method for studying bile reflux into the oesophagus after total gastrectomy is described using 99Tcm-HIDA and an external imaging system. Two reconstructions were studied: oesophagojejunostomy with a diverting entero-anastomosis (omega reconstruction 6 studies) and Roux-en-Y reconstruction (20 studies). The incidence of reflux on scanning correlated well with the incidence of oesophagitis, and the finding of reflux was almost always associated with severe symptoms. The omega procedure was unsuccessful in diverting bile in 5 patients despite an entero-anastomosis as wide as 12 cm. The Roux-en-Y reconstruction was unsuccessful in diverting bile in 5 patients all of whom had a diverting limb 35 cm in length; none of the 9 patients with a diverting limb longer than 35 cm refluxed (range 40--50 cm).

Bile Reflux↗
PubMed1982

Application of gravitational clustering analysis to liquid gastric emptying.

A gravitational clustering analysis was applied to principal component weighting factors and t1/2 values from 100 liquid gastric emptying studies. Using principal components, groups of patients with clinical features in common were identified, whereas the analysis of the t1/2 values failed to differentiate them.

Duodenal Ulcer↗
PubMed1980

Hypoglycemic coma, jaundice, and pure RBC aplasia following chlorpropamide therapy.

Five weeks following the initiation of chlorpropamide therapy for diabetes mellitus, hypoglycemic coma, cholestatic jaundice, and RBC aplasia developed in a 41-year-old woman. Within 40 days of stopping the drug, she had made a complete recovery. To our knowledge, this is the first case in which these three complications of chlorpropamide have occurred simultaneously.

Adult↗
PubMed1979

Interrelations between serum gastrin levels, gastric emptying and acid output before and after proximal gastric vagotomy and truncal vagotomy and antrectomy.

In a prospective study of proximal gastric vagotomy and truncal vagotomy and antrectomy measurements were made, before and after operation, of acid output, gastrin output and gastric emptying of a solid and a liquid meat extract meal. No relationships were demonstrable between acid output and gastrin output. Truncal vagotomy and antrectomy (TVA) produced rapid early emptying of both meals combined with gross prolongation of the overall emptying of the solid meal. Truncal vagotomy and antrectomy reduced the intergrated gastrin output after either meal. Proximal gastric vagotomy (PGV) produced rapid early emptying of the liquid meal with no alteration in the early emptying of the solid meal; however, overall solid meal emptying was delayed. Proximal gastric vagotomy increased basal, peak and integrated gastrin output. In preoperative patients slow solid meal emptying was associated with higher gastrin output but after PGV the reverse was found, the slowest emptiers having the lowest gastrin output. These findings do not support the contention that a pyloroplasty should be added to PGV to reduce the hypergastrinaemia produced by the operation.

Clinical Trials as Topic↗
PubMed1978

Gastric emptying after treatment of stenosis secondary to duodenal ulceration by proximal gastric vagotomy and duodenoplasty or pyloric dilatation.

A consecutive series of 12 patients with stenosis secondary to duodenal ulceration were treated by proximal gastric vagotomy (PGV) and duodenoplasty or PGV and dilatation of the stenosis. Three months after operation the rate and pattern of gastric emptying of a solid meal was measured in each patient and compared with 18 patients with uncomplicated duodenal ulcer treated by PGV alone. Two patients developed gastric stasis in the early postoperative period which resolved with medical treatment. All patients were asymptomatic and were eating normally three months after operation. There was no significant difference in the rate of gastric emptying postoperatively between the patients who had stenosis and those who had uncomplicated duodenal ulcers. These results indicate that despite early postoperative difficulties in some patients pyloric dilatation or duodenoplasty with PGV are both effective treatments for stenosis due to duodenal ulceration.

Adult↗
PubMed1977

Abnormalities of gastric emptying and pyloric reflux in uncomplicated hiatus hernia.

We have measured the rate of gastric emptying of solid and liquid meals by an external scanning technique and have studied pyloric reflux by a radiological technique. Investigations were performed in patients with uncomplicated hiatal hernia, patients with uncomplicated duodenal ulcer and normal controls. There was a significant delay in the emptying of both solid and liquid meals in the patients with hiatal hernia compared with both the duodenal ulcer patients (solid meals P less than 0.01, liquid meals P less than 0.025) and with normal controls (solid meals P less than 0.05, liquid meals P less than 0.001). Duodenogastric reflux was observed in 35% of hiatal hernia patients compared with 24% of duodenal ulcer patients and no incidence in the controls.

Gastric Emptying↗
PubMed1977

Mean cerebral transit time in demented and normal elderly persons.

The mean cerebral transit time (MCTT) was measured in 31 elderly subjects, approximately half of whom suffered from chronic dementing illness. The results indicated a significant correlation between the MCTT and arm-to-head circulation time. Both times increased significantly with age. There was no difference in MCTT between demented and non-demented patients.

Aged↗
PubMed1976

The association of duodenogastric reflux with dumping and gastric retention.

Gastric emptying of solid and liquid meals together with duodenogastric reflux has been measured in a prospective trial of proximal gastric vagotomy and truncal vagotomy and antrectomy. Three abnormalities of motility associated with postoperative symptoms have been defined. If more than one abnormality was present in an individual there was an 80 per cent incidence of associated symptoms. Proximal gastric vagotomy produced significantly fewer abnormalities of gastro-duodenal motility than did truncal vagotomy and antrectomy.

Bilirubin↗