PubMed Health⌕ Search

Biomedical subjects

M Atkinson

Publications and source records attributed to M Atkinson.

At least 73 records · Page 4Linked to original sources
PubMed1985

Sulfasalazine and renal tubular function: lack of an effect.

Sulfasalazine (SASP) is frequently used in the treatment of chronic inflammatory bowel disease (IBD), particularly colitis. Because the drug poses a theoretical risk for renal tubular damage, 26 patients, 8-18 years of age, with Crohn's ileocolitis were studied. Thirteen children were receiving SASP while 13 served as disease controls. Renal tubular function was assessed by measurement of urinary beta 2-microglobulin and n-acetylglucosaminidase activity. No abnormalities were found on routine measurement of renal function. Similarly, urinary beta 2-microglobulin and n-acetylglucosaminidase activities were within normal limits for patients receiving SASP, as well as for disease controls. Although there is a theoretical risk for renal tubular damage from the prolonged use of SASP, this study would suggest that IBD patients receiving the drug are at no greater risk for renal injury than their counterparts not receiving the medication.

Adolescent↗
PubMed1985

Ethanol and fetal nutrition: effect of chronic ethanol exposure on rat placental growth and membrane-associated folic acid receptor binding activity.

Rat placental composition and specific folate receptor activity were measured at 20 days gestation in dams exposed to chronic high doses of ethanol (6%, vol/vol) throughout gestation and in isocalorically pair-fed controls. Ethanol-exposed fetuses were smaller (ethanol = 3.28 +/- 0.08 vs. control = 4.01 +/- 0.10 g, p less than 0.001), but their placentae were larger (experimental = 0.534 +/- 0.02 vs. control = 0.399 +/- 0.01 g, p less than 0.001). The increased weight appears to be secondary to hyperplasia as total DNA was increased while the wet/dry, RNA/DNA, and protein/DNA ratios were not different. Despite larger placentae, specific folate receptor activity was significantly reduced in the ethanol-exposed tissue, whether expressed relative to membrane protein, placental weight, or total placental binding. These results confirm that ethanol exposure is placentotoxic and suggest an additional mechanism by which ethanol may lead to intrauterine growth retardation; namely, decreased folate receptor activity.

Animals↗
PubMed1985

A study of swallowing difficulties in first degree relatives of patients with achalasia.

Of 167 patients with achalasia asked to provide details of swallowing difficulties among their first degree relatives, 159 completed the survey (95% response rate). One thousand and twelve first degree relatives were identified, and 14 were reported to have dysphagia including two with reported achalasia. Review of the case notes of these 14 relatives showed, however, that in none was achalasia confirmed. Heartburn affected 54 (5%) of the relatives, an incidence similar to that in the general population. These findings suggest that adult achalasia is not inherited in an autosomal recessive manner and that environmental factors during early life do not play an important aetiological part.

Adolescent↗
PubMed1985

Effect of intrauterine ethanol exposure on fetal lung growth.

Lung weight, DNA, RNA, protein, and total body weight were analyzed in fetuses from 14 pregnant Sprague-Dawley rats fed a nutritionally complete liquid diet containing v/v 6% ethanol (ethanol group). Each ethanol rat was matched with an isocalorically pair-fed animal (control group) who received the same liquid diet with carbohydrate substituted for ethanol. The rats were killed on day 20 of gestation. The mean maternal blood ethanol concentration at 0700 h on day 20 was 170 +/- 22 (SE) mg/dl. Compared to controls, ethanol fetuses had reduced body weight (21%), lung dry weight (39%), lung wet weight/body weight ratio (10%), DNA (21%), RNA (25%), protein (28%), and protein/DNA ratio (8%) (p less than 0.05). The results indicate that prenatal ethanol exposure inhibits cellular growth in the fetal lung, resulting in hypoplastic lungs which have fewer and smaller cells. The effect on the lung appears to be greater than on the body as a whole. These hypoplastic lungs may be predisposed to the development of pulmonary disease and may explain observations of more frequent and severe lower respiratory infections in children with prenatal ethanol exposure.

Animals↗
PubMed1985

Impairment of vagal function in reflux oesophagitis.

Autonomic nervous function in reflux oesophagitis was assessed by measuring the response of the lower oesophageal sphincter to abdominal compression, gastric secretory response to insulin-induced hypoglycaemia and pulse rate variability with respiration. Rise in intra-abdominal pressure normally causes an increase in lower oesophageal sphincter pressure through a vagally mediated mechanism. In 59 of 83 patients with reflux oesophagitis the sphincter response was subnormal, and this was commoner in older patients but was unrelated to the presence of a hiatal hernia. During oesophageal acid perfusion, the onset of pain, but not that of disordered motility, was delayed in those with an abnormal sphincter response suggesting impairment of afferent autonomic function. Efferent gastric vagal function, assessed by the gastric secretory response to insulin induced hypoglycaemia and expressed as a ratio of the maximal acid output after pentagastrin, was subnormal in 15 of 27 patients with reflux oesophagitis. Pulse rate variability with deep respiration, an indicator of one aspect of non-alimentary vagal function, was subnormal in 18 of 62 patients with reflux oesophagitis. There was no correlation between abnormalities in these three tests of vagal function or with the severity of oesophagitis. These findings suggest that vagal impairment is common in reflux oesophagitis. As impairment of vagal function is not confined to the alimentary system it is unlikely to be simply a consequence of reflux oesophagitis and may be important in the pathogenesis of gastro-oesophageal reflux.

Adult↗
PubMed1985

Studies of incidence and prevalence of achalasia in the Nottingham area.

The incidence of achalasia in the Nottingham area between 1966 and 1983 has been examined using hospital diagnostic indices supplemented by personal endoscopy files. All patients were traced and the date of death recorded where relevant. A total of 53 cases was confirmed and the incidence was 0.51 cases/10(5)/year and the prevalence on 31 December 1983, was 8/10(5). The age-specific incidence of the disease increased in older groups. The duration of dysphagia before diagnosis was no less with greater availability of manometry and endoscopy.

Adolescent↗
PubMed1982

Palliative intubation of oesophagogastric neoplasms at fibreoptic endoscopy.

Of one hundred and twenty-one patients with neoplastic obstruction of the oesophagus or cardia 118 underwent palliative intubation at fibreoptic endoscopy on a total of 135 occasions. Sixty had adenocarcinoma, 49 had squamous carcinoma, and in nine the oesophagus was involved by a growth arising elsewhere. Satisfactory swallowing ws restored in 112 patients. Thirteen patients died in hospital shortly after the procedure. Five fatal and 10 non-fatal perforations were sustained in 135 intubation procedures. Complications of tube function included food blockage on 26 occasions, tumour overgrowth on seven occasions, displacement on 16 occasions, disappearance of the tube in two patients, and late oesophageal perforation on nine occasions. Fifty-six patients survived for three months, 33 for six months, and 10 for a year after intubation. Comparison with series in the literature of patients who underwent surgical palliative intubation suggests that endoscopic palliation has lower mortality and morbidity, and an increased survival time, and is now the method of choice for palliation of oesophagogastric neoplasms.

Adenocarcinoma↗
PubMed1980

Treatment of a patient with clinical features of both eosinophilic gastroenteritis and polyarteritis nodosa with oral sodium cromoglycate.

A young patient who suffered from allergic respiratory disease presented with an illness characterized by abdominal pain, diarrhea, and weight loss. Investigations revealed radiological and pathological features consistent with a diagnosis of eosinophilic gastroenteritis. Because of extensive gastric ulceration, treatment with corticosteroids was withheld and in its place oral sodium cromoglycate therapy given. The patient's intestinal symptoms rapidly responded to this treatment and remained controlled for a period of five months. The patient subsequently developed a systemic illness with features of polyarteritis nodosa.

Adult↗
PubMed1979

Cimetidine in treatment of reflux oesophagitis with peptic stricture.

Twenty patients with reflux oesophagitis causing a tight peptic oesophageal stricture entered a randomised double-blind crossover trial in which they received cimetidine, 1.6 g daily, and matching placebo each for six months. The gross endoscopic appearances of oesophagitis, though not the grades of histopathological changes, showed significant improvement during treatment with cimetidine. The need for dilatation of the strictures, however, was not reduced.

Aged↗
PubMed1979

Effect of different operation policies on mortality from bleeding peptic ulcer.

The outcome in bleeding gastric and duodenal ulcer has been compared in two hospitals in Nottingham which take their patients randomly from a common source according to a fixed daily admission rota. Bleeding seemed equally severe in the two groups but 66 (32%) of 206 patients were operated upon at hospital A compared with 44 (46%) of 96 at hospital B (P=0.03), where operations also tended to be done earlier. Postoperative mortality-rates were virtually identical at the two hospitals, but at hospital B the overall death-rate from bleeding ulcer was higher, partly because of its higher operation-rate. The value of an aggressive surgical policy in bleeding peptic ulcer is questionable.

Adult↗
PubMed1978

Tube introducer and modified Celestin tube for use in palliative intubation of oesophagogastric neoplasms at fibreoptic endoscopy.

A new method for palliative intubation of inoperable neoplasms at or near the cardia is described. A guidewire is passed through the stricture, which is dilated using Eder Puestow metal olive dilators. The tube to be inserted is mounted on an introducer, which grips its distal end from inside, and is slid into position along the wire under radiological control. Twenty-five patients have been intubated with one death directly resulting from the procedure. The method provides a simple and relatively safe means of relieving dysphagia and improving nutrition.

Deglutition Disorders↗
PubMed1978

Circadian rhythm disorders in manic-depressives.

Seven circular manic-depressives were studied through complete of cycles of mania and depression. In five subjects, there was evidence that a circadian rhythm free-ran fast (p less than 0.005 and p less than 0.002 in two of the subjects), and in five subjects, there was evidence that lithium slowed a circadian rhythm. The palliative benefit of lithium may derive from slowing or delaying an overfast circadian clock to prevent desynchronization. Two subjects whose circadian clocks seemed too slow were lithium nonresponders (p less than 0.05). As circadian clock frequency may be transmitted on an X-chromosome gene and may increase with age, a circadian etiology is consistent with the genetics and age distribution of manic-depressive illness. Affective disturbances could be evolutionary remnants of the photo-periodic seasonal responses in animals.

Adult↗
PubMed1977

A prospective, randomised study of endoscopy and radiology in acute upper-gastrointestinal-tract bleeding.

318 patients admitted to hospital with acute upper-gastrointestinal-tract bleeding were entered into a prospective randomised comparison of investigation by either endoscopy or radiology. Although the diagnostic yield was higher in the endoscopy group than the radiology group, there was no difference between the two groups in management or survival, and the accuracy of the findings as judged independently at operation and/or necropsy was also similar in the two groups. These findings case doubt on the need to provide emergency endoscopic facilities for the investigation of patients with acute upper-gastrointestinal-tract bleeding where radiological services are already adequate.

Acute Disease↗
PubMed1977

Dysphagia.

Explore the source record for details and available documents.

Aged↗
PubMed1977

Fibreoptic endoscopic palliative intubation of inoperable oesophagogastric neoplasms.

Palliative intubation for inoperable malignant strictures at the cardia was done on 16 occasions in 13 patients using fiberoptic endoscopy. Preliminary dilatation was performed, and the Celestin tube was mounted on an introducer and passed over a guide wire inserted with a fiberoptic endoscope. Only one death resulted from the procedure and all the 12 patients who left hospital were swallowing satisfactorily on discharge. The method provided a simple and relatively safe means of relieving dysphagia and improving nutrition.

Cardia↗