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Biomedical subjects

M R Jacyna

Publications and source records attributed to M R Jacyna.

45 records · Page 3Linked to original sources
PubMed1987

Characteristics of cholesterol absorption by human gall bladder: relevance to cholesterolosis.

The characteristics of cholesterol uptake by 83 human gall bladders (obtained at cholecystectomy) were studied with a modified Ussing technique. Real and artificial biles labelled with 14C-cholesterol and 3H-dextran (the latter to correct for adherent mucosal bile) were used; all gall bladders absorbed cholesterol (average 3.5 nmol/cm2/minute). Recovery of the absorbed cholesterol from the tissue showed that about 4% was esterified over 60 minutes. In artificial bile the rate of absorption of cholesterol increased as the bile saturation index rose, but became constant once supersaturation was achieved. In contrast, supersaturated real bile permitted greater absorption of cholesterol, possibly due to enhanced cholesterol solubilisation. Preincubation of gall bladder tissue in sodium cyanide (5 mM) caused a 30% reduction in cholesterol uptake indicating that, although absorption is predominantly a "passive" process, there is a partial "active" component. There were no pronounced differences in the rate of cholesterol absorption as gall bladders became more diseased, but there was a reduction in the amount of cholesterol ester formed.

Absorption↗
PubMed1986

Pancreatic function and enzyme synthesis rates in mild chronic pancreatitis.

Incorporation of intravenous 75Se-methionine into duodenal juice proteins during pancreatic stimulation was measured as an index of pancreatic enzyme synthesis rates in 12 patients with a normal pancreatogram and in 6 with mild chronic pancreatitis. Isotope incorporation was significantly greater in subjects with mild chronic pancreatitis than in those with a normal pancreatogram. Thus in most patients in whom pancreatography demonstrates the characteristic radiological features of 'mild chronic pancreatitis' pancreatic acinar function is abnormal. The coexistence of morphological and functional abnormality implies that such patients do have chronic pancreatitis.

Bicarbonates↗
PubMed1986

Biliary cholesterol--friend or foe?

It has hitherto been assumed that the cholesterol in bile simply represents an excretory mechanism for cholesterol surplus to bodily requirements. However, recent evidence suggests that this is not the case and that biliary cholesterol has other functions. The functions consist of a mucosal protective effect against the toxic action of bile-salts and also a role in regulating dietary cholesterol absorption. Biliary cholesterol is clearly more than just an excretory substance and serves other important physiological roles.

Bile↗
PubMed1984

Comparative study of four antacids.

Four antacid preparations have been studied in a stratified, randomized, double-blind trial to evaluate criteria which determine patients' acceptance of this type of therapy. There was a considerable range of judgements about palatability, but preference was determined not only by factors such as the smell, taste, texture and after-taste of the preparation, but also by the order in which the antacids were tested and by the age and sex of the patient. The preparations also differed considerably in acid-neutralizing capacity and ability to bind bile salts, as well as cost. We conclude that individuals requiring antacid therapy should be allowed to chose from among a range of preparations, in order to maximize compliance.

Adult↗
PubMedDate not supplied

The management of young dyspeptic patients in the era of Helicobacter pylori.

The management of young dyspeptic patients remains controversial in the modern Helicobacter pylori era. The use of non-invasive screening for H. pylori in one proposed strategy has demonstrated a substantial reduction in the endoscopy workload by excluding H. pylori negative patients under the age of 45 years with uncomplicated dyspepsia. An alternative screening strategy proposes a 'test and treat' approach, with H. pylori positive patients proceeding directly to an empirical course of eradication therapy. Ednoscopy would be reserved for patients who failed to respond symptomatically or who were H. pylori negative on intial screening. At present there are few data available from clinical studies of putting the 'test and treat' policy into practice. Although there is likely to be a role for screening young dyspeptic patients for H. pylori in primary care, subsequent management requires well-planned studies in order to assess the benefits of any particular strategy.

Adolescent↗
PubMedDate not supplied

Referral patterns to a district general hospital gastroenterology outpatient clinic: implications for the 'two-week target'.

We defined the pattern and appropriateness of GPs' new-patient referrals to a large district general hospital gastroenterology department, and assessed the implications for workload in the context of the recently introduced 'two-week target'. Prospective data were collected on all new referrals over a two-month period and 426 new appointments were included, from which data were available on 390. Only six referrals were deemed inappropriate. Sixty-nine patients had a functional disorder, and GPs were less likely to diagnose this group at referral than the gastroenterologist was after the initial consultation. Nineteen per cent of all GP referrals were classified as urgent and 6% of these had a malignancy. Fifty per cent of patients with malignancy were not perceived as meriting an urgent referral by the GP Gastroenterology outpatient facilities are already overstretched and the implementation of the two-week target will add considerable strain to the current resources, with little gain in identifying malignancy.

Acute Disease↗
PubMedDate not supplied

Lansoprazole plus clarithromycin: evaluation of a new dual therapy for Helicobacter pylori eradication.

The aim of this pilot study was to evaluate the efficacy and safety of lansoprazole plus clarithromycin for eradication of Helicobacter pylori. A total of 26 patients with H. pylori infection were randomised to receive clarithromycin, 500 mg t.i.d. for 14 days, plus either lansoprazole, 30 mg o.m., (group L30, n = 13) or lansoprazole, 30 mg b.i.d., (group L60, n = 13). H. pylori status was determined pre-treatment and four to six weeks after completion of the study medication by histology and 13C-urea breath test. Two patients were unable to complete the course of medication. Of the remaining 24 patients, 14 (58%) successfully eradicated H. pylori--8/12 (67%) patients in group L30 and 6/12 (50%) in group L60. Side-effects were experienced by 17/26 (65%) of patients, most commonly a taste disturbance. The results from this pilot study suggest that dual therapy with lansoprazole plus clarithromycin is only a moderately effective regimen for eradicating H. pylori.

2-Pyridinylmethylsulfinylbenzimidazoles↗