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Biomedical subjects

L O Tim

Publications and source records attributed to L O Tim.

At least 19 recordsLinked to original sources
PubMed1985

Bombesin and G-17 dose responses in duodenal ulcer and controls.

Gastric acid and pepsin secretion and serum gastrin concentrations were measured in nine patients with uncomplicated duodenal ulcer (DU) and 10 normal controls in the fasting state and in response to graded doses of bombesin, a tetradecapeptide gastrin releaser, and, for reference, synthetic gastrin G-17. Serum gastrin with bombesin stimulation was significantly greater in duodenal ulcer (maximum 467 pg/ml) than in controls (153 pg/ml), while in seven of the DU group tested gastrin levels after a meal were not different from that seen in five of the normal controls. Gastric acid concentrations and outputs were greater in duodenal ulcer with both stimuli. Secretory responses were then related to serum gastrin levels; despite increasing gastrin levels with bombesin stimulation, peak outputs achieved with bombesin were only 50% of G-17 maximum in normals and up to 90% of maximum in duodenal ulcer. Up to the point of peak response to bombesin, acid and pepsin outputs were the same with exogenous and endogenous gastrin, ie, bombesin acted only via G-17. Furthermore, in direct comparison of duodenal ulcer and normals with G-17 infusion, acid and pepsin outputs related to serum gastrin were congruent up to 75% of duodenal ulcer maximum, at which point normals reached their maximum level. These data have shown that duodenal ulcer patients are not more sensitive to either exogenous or endogenous gastrin; we have also shown regulatory defects in duodenal ulcer patients not previously described: an exaggerated release of gastrin with bombesin stimulation, and a defective inhibition of acid and pepsin secretion with higher doses of bombesin.

Adult↗
PubMed1983

Prolonged inhibition of basal gastric acid secretion by calcitonin in man.

This study was performed to investigate the effect of prolonged (6-hour) infusions of salmon calcitonin on basal gastric acid secretion and serum gastrin and calcium levels in 9 normal volunteers. Three tests, during which gastric acid secretion was measured continuously for 8 hours, were performed on each subject. After 1 hour, calcitonin 2,5 or 5,0 micrograms/h or a saline placebo (in random order) was infused intravenously for 6 hours. Calcitonin significantly inhibited basal gastric acid secretion, the effect reaching statistical significance (P less than 0,05) after 90 minutes with the larger dose and after 150 minutes with the smaller dose. Eight of the 9 tests using the larger dose and 6 of the 9 using the smaller dose rendered the subjects achlorhydric. The changes in acid secretion occurred independently of a slight drop in serum calcium levels. No changes in blood gastrin levels occurred. Calcitonin is capable of completely abolishing gastric acid secretion when infused over a long period.

Adult↗
PubMed1982

A suction-abrasive cytology tube for the diagnosis of esophageal carcinoma.

A simple, easily constructed, and inexpensive suction-abrasive cytology tube was developed to study esophageal cytology. The reliability of this method for the diagnosis of esophageal carcinoma was evaluated in 101 patients. Of 47 patients with esophageal carcinoma, 93% were diagnosed correctly on exfoliative cytology. There were no false diagnoses of cancer. The cytology tube was well tolerated by all patients and provided a rapid and reliable method of diagnosis. As a screening procedure, this method may be applicable for widespread use to detect early esophageal cancer in high-risk populations.

Adult↗
PubMed1982

Intramural haematoma of the oesophagus. The role of endoscopy.

The clinical, radiological and endoscopic aspects of 2 cases of intramural oesophageal haematoma are presented. The diagnosis was firmly established at endoscopy, and both patients responded to conservative therapy. The value of endoscopy in the diagnosis and management of this condition is emphasized.

Esophageal Diseases↗
PubMed1982

Thyrotoxicosis presenting as dysphagia. A case report.

Thyrotoxicosis may manifest with dysphagia. The case of an elderly male with dysphagia as the initial symptom is discussed. It is suggested that thyrotoxicosis is included in the differential diagnosis of dysphagia in the elderly, particularly if muscle weakness is also present.

Aged↗
PubMed1981

Cystadenoma of the pancreas: report of a case diagnosed by endoscopic retrograde pancreatography.

The first case of a cystadenoma of the pancreas occurring in an African patient is reported. cystadenoma of the pancreas is a rare tumour. It should be suspected when a patient presents with a pancreatic cyst but without a history of pancreatitis, alcoholism or abdominal trauma. Estimation of the serum amylase level, selective coeliac and superior mesenteric arteriograms, and endoscopic retrograde pancreatography (ERP) are helpful in making the preoperative diagnosis. The ERP appearances in cystadenoma of the pancreas are described.

Adult↗
PubMed1981

Pitfalls in the diagnosis of gastrointestinal tuberculosis.

Gastrointestinal tuberculosis is difficult to diagnose since it mimics many other abdominal conditions and has protean manifestations. The disease can present as an abdominal mass, bowel perforation, Crohn's disease and dysentery. These presentations are discussed with representative cases to illustrate the diagnostic difficulties. It is emphasized that to obviate the diagnostic pitfalls, tuberculosis should always be considered in the differential diagnosis of unusual gastrointestinal presentations particularly because radiological and laboratory tests may be noncontributory.

Abdominal Neoplasms↗
PubMed1980

Gastric acid secretion and serum gastrin levels in patients with chronic renal failure on regular hemodialysis.

Previous studies of gastric secretory function and serum gastrin levels in patients with chronic renal failure (CRF) have yielded conflicting results. In a study of 30 patients on regular hemodialysis, serum gastrin levels were higher than normal (p less than 0.05), and the gastric secretory response to pentagastrin was normal for the group as a whole. There were, however, 8 patients who were hypochlorhydric (4 achlorhydric) and 7 who were hyperchlorhydric. The patients with gastric hyposecretion were older, predominantly male and this group was associated with the highest gastrin levels as well as the highest incidence of gastrointestinal hemorrhage. Chronic gastritis is thus more common in CRF than generally believed and may be responsible for much of the morbidity from gastrointestinal complications during hemodialysis.

Adolescent↗
PubMed1980

The rarity of ulcerative colitis in South African blacks.

Ulcerative colitis is rare in black populations of sub-Saharan African. Only 18 cases were reported up to 1975. Since then, in four years, an additional 13 patients have been diagnosed at Baragwanath Hospital, Johannesburg. This hospital, with 2,700 beds, serves a population of approximately 1 1/2 million blacks. The low frequency of ulcerative colitis is in accord with the uncommonness of other noninfective large bowel diseases and contrasts with their high prevalences in white populations. Reasons for the uncommonness of ulcerative colitis in blacks are not known but consumption of their still largely traditional diet, insufficient exposure to environmental changes linked with urbanization and genetic factors may be responsible. All patients in this series, save one, were females. They were urbanized, belonged to upper social and educational strata and consumed a Western, or partially Westernized diet.

Adult↗
PubMed1979

The witchdoctor and the bowel.

Most urban Blacks consult witchdoctors for diverse reasons. The potent effects of their herbal medicines can result in damage to almost any part of the gastro-intestinal tract, and the outcome may be fatal. Diseases induced by witchdoctors therefore constitute an important facet of the disease spectrum of recently urbanized Blacks. Possible reasons for the strong influence of the witchdoctor are given. It is suggested that there should be a reappraisal of medical training in a Black society, so that cognizance can be taken of the important role played by witchdoctors.

Adult↗
PubMed1979

Endoscopic retrograde cholangiopancreatography in the management of traumatic pancreatic pseudocysts. A report of 2 cases.

The results of endoscopic retrograde cholangiopancreatography (ERCP) in 2 patients with traumatic pancreatic pseudocysts are described. As a pre-operative procedure, this investigation provided useful information on the exact site of duct disruption. In both patients, the pancreatic pseudocysts were drained via a posterior cyst gastrostomy, and they have remained well since surgery. Follow-up ERCP at 6 and 12 months demonstrated complete stenosis at the site of duct disruption. The value of ERCP in the pre-operative and follow-up management of traumatic pancreatic pseudocysts is discussed.

Adolescent↗
PubMed1979

Diagnosis of upper gastro-intestinal lesions by endoscopy, cytology and biopsy.

A prospective consecutive series of 210 upper gastrointestinal endoscopic procedures, at which material for both cytological and histopathological examination was obtained, was conducted at Baragwanath Hospital. The purpose of the study was to determine the respective and combined diagnostic value of endoscopic visualization, cytological brushings and histological sections in benign and malignant lesions of the oesophagus and stomach; and in particular to assess the contribution, if any, of exfoliative cytology to the diagnostic regimen. Endoscopic visualization alone was inconclusive or incorrect in 13% of procedures, cytology alone in 9%, and biopsy alone in 12% (the latter 2 figures corrected for adequacy of material submitted). When assessed together, the diagnostic accuracy achieved by all 3 techniques was 99%. The major contribution of cytology was the correct positive diagnosis in 20% of procedures, performed on patients with malignant lesions, whose initial biopsy specimen was inadequate or normal. It is concluded that for maximal diagnostic accuracy of upper gastro-intestinal lesions, a combined approach, utilizing endoscopic examination, lesion-directed brushings and biopsy specimens, is required.

Adult↗
PubMed1979

Amoebic liver abscess in patients presenting with jaundice. A report of 5 cases.

Five patients with severe jaundice resulting from amoebic liver abscess are described. All had features of hepatic parenchymal damage and cholestasis, and 1 patient developed hepatic coma. In addition, acute tubular necrosis and renal failure occurred in 3 patients. Four patients in the series survived. The importance of early recognition and treatment of amoebic liver abscess in patients presenting with jaundice is emphasized, so that the serious and often fatal complications of hepatic and renal failure can be prevented.

Adult↗