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Biomedical subjects

M Atkinson

Publications and source records attributed to M Atkinson.

At least 127 records · Page 7Linked to original sources

Esophageal intraluminal pH recording in the assessment of gastroesophageal reflux and its consequences.

Intraluminal pH in the lower esophagus has been recorded during a 3-hr period following a ligh meal and a consecutive 12-hr nocturnal period in 20 patients with typical symptoms and radiological evidence of gastroesophageal reflux and in 10 patients without such signs of reflux. Evidence of acid reflux was obtained in 3 of the patients without reflux during the postcibal period but in only one during the 12-hr nocturnal period. In contrast all except one of the 20 patients who had evidence of reflux showed spells of high acidity both in the postcibal and nocturnal periods. There was no clear correlation between the frequency of paf high acidity in the nocturnal period. Those patients with endoscopic evidence of severe esophagitis showed a significantly longer duration of high esophageal acidity in the nocturnal period. We conclude that nocturnal exposure of the esophageal mucosa to acid is a major factor in the causation of reflux esophagitis.

Esophagitis

An evaluation of multiphasic screening on admission to hospital. Precis of a report to the National Health and Medical Research Council.

A controlled study of admission multiphasic screening (AMS) at a large general hospital showed that AMS had no significant effect on a variety of indices of inpatient progress. Owing to a 64% increase in estimated cost of investigations with AMS, the total hospital admission cost was increased by approximately 5%. Under the conditions of this study, AMS added to the cost of hospitalization without associated evidence of benefit to the patient.

Australia

An improved isolation procedure for the gas chromatographic analysis of urinary polyamines.

The isolation of polyamines from urinary hydrolysates in a sufficiently pure state for subsequent analysis by gas chromatography has proved to be difficult. However, by using columns of Porapak-Q and ion-exchange resins, urinary hydrolysates are readily purified and formation of trifluoroacetyl derivatives of polyamines proceeds in high yield without carryover of artifacts in the gas chromatographic elution profile. Good yields from the trifluoroacetylation reaction are not achieved if large quantities of salts or urinary pigments are present. By obtaining the polyamine carbonates in the final stages of the method described, the trifluoroacetylation reaction yields excellent derivatives of nanogram or microgram amounts, particularly after standing over-night at room temperature. The procedure described in detail should permit routine urinary polyamine analysis where rapidity, ease of handling many samples, freedom from complications and artifacts are a consideration.

Cadaverine

Oesophageal motor changes in diabetes mellitus.

Radiography and manometry have been used to study oesophageal motor function in a group of 31 diabetics, 23 of whom had alimentary or genitourinary symptoms attributed to autonomic neuropathy. Peristalsis was of diminished amplitude and oesophageal emptying in the 15 degrees Trendelen-Peristalsis was of diminished amplitude and oesophageal emptying in the 15 degrees Trendelenburg position was delayed. The lower oesophageal sphincter pressure was reduced. The changes seldom caused symptoms and they were not confined to those diabetics with alimentary or genitourinary symptoms attributable to autonomic neuropathy. They suggest that autonomic neuropathy in diabetes is widespread and often subclinical. Degeneration of the ganglion cells of the oesophageal myenteric plexus is associated with hypersensitivity of the oesophageal smooth muscle to cholinergic agents. Bethanecol, a cholinergic drug with muscarinic actions, accelerated oesophageal emptying and increased the lower oesophageal sphincter pressure to normal levels in our diabetics but the hypersensitivity to this drug found in the presence of ganglion cell degeneration was not seen. This implies that in diabetic autonomic neuropathy the predominant lesion is in the preganglionic fibres of the vagus rather than in the myenteric plexus of the oesophageal wall.

Diabetes Mellitus

Evaluation of benefits of screening tests done immediately on admission to hospital.

Evidence was sought of improved inpatient progress and reduced hospital costs when a battery of investigations were done at the time a patient was admitted to hospital. The outcome in 500 admission-tested patients was compared with that in two other groups of 500 control patients. No significant differences were found among the three groups in a variety of indices of inpatient progress. Because of an estimated 64% increase in the cost of investigating inpatients with admission testing, the total cost of hospital care was increased by about 5%. Under the conditions of this study, admission testing added to the cost of hospitalization, without associated evidence of benefit to the patient.

Australia

Vagal impairment of gastric secretion in diabetic autonomic neuropathy.

Gastric acid output in response to insulin-induced hypoglycaemia and pentagastrin was measured in 18 diabetic patients with symptoms of autonomic neuropathy. Two patients had achlorhydria but the rest responded normally to pentagastrin. The acid output evoked by insulin-induced hypoglycaemia was low in 10 of the 16 patients who secreted acid in response to pentagastrin. These changes suggest that vagal impairment is common in diabetics with autonomic symptoms, which might explain the infrequency of duodenal ulcer in diabetics.

Achlorhydria

Rapid detection and isolation of mycoplasmas from cell cultures.

An improved medium for the isolation of Mycoplasma species from contaminated cell cultures is reported. A modification of the mycoplasma detection method using the uridine/uracil uptake ratio method is described. Results obtained using this method with mycoplasma contaminated cell cultures and with contaminated cell cultures treated with the antibiotic Lincomycin are presented.

Animals

Hiatus hernia.

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Anemia