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Biomedical subjects

P G Reasbeck

Publications and source records attributed to P G Reasbeck.

At least 19 recordsLinked to original sources
PubMed1998

Treatment of oesophageal carcinoma at a small rural hospital.

Twenty patients were treated for carcinoma of the mid- or lower oesophagus over a 3-year period by a general surgeon working in a small rural hospital of 165 beds. Fourteen patients underwent oesophagectomy and six had palliative intubation. There were no hospital deaths, and no anastomotic complications; immediate and longer term outcomes were similar to those reported from larger, specialist units. Acceptable results for the surgical treatment of this disorder can be obtained by a generalist working in a small peripheral unit.

Adenocarcinoma↗
PubMed1988

Incidence of deep vein thrombosis after major abdominal surgery in Brisbane.

There is some evidence that postoperative deep vein thrombosis (DVT) may be commoner in cool than in warm climates. To determine whether this complication is less common in the subtropical climate of Brisbane than in more temperate locations, the incidence of DVT after major abdominal surgery was assessed by 125I fibrinogen scanning. In order to avoid overestimating the incidence of DVT, abnormal scans were accepted as diagnostic only if the DVT was confirmed by venography or if the abnormality on the scan fulfilled more stringent criteria than have previously been applied. Thirty-six of 152 patients (24 per cent) developed a DVT; this incidence was significantly lower than in one previous study from Melbourne and higher than that found in South-East Asia and East Africa, but was not significantly different from that reported from Sydney, Japan and several centres in North America and Britain. There was no apparent seasonal variation in the incidence of the complication. The geographical variation in incidence of postoperative DVT may have been overestimated in previous reports and may be at least partly due to variations in screening technique.

Adult↗
PubMed1988

Calcitonin gene-related peptide: enteric and cardiovascular effects in the dog.

We have measured the effects of intravenous infusion of calcitonin gene-related peptide at doses of 2.5, 10, and 50 pmol/kg.min on net jejunal water and solute fluxes and on plasma somatostatin concentrations in dogs. The hemodynamic effects and the pharmacokinetics of the peptide were also assessed. Using the triple-lumen perfusion technique in unsedated restrained animals it was shown that the highest dose of the peptide stimulated a transient net jejunal water and electrolyte secretion, and induced diarrhea in 4 of 6 animals receiving it. The peptide also induced dose-dependent tachycardia, hypotension, and increases in plasma immunoreactive somatostatin. All three doses of calcitonin gene-related peptide produced plasma immunoreactive peptide levels within the elevated range previously measured in human patients with medullary thyroid carcinoma. Calcitonin gene-related peptide may have a major role in the pathogenesis of secretory diarrhea in medullary thyroid carcinoma.

Animals↗
PubMed1987

Foramen of Winslow hernia.

Two cases of caecal herniation through the foramen of Winslow are presented. The diagnosis was made at laparotomy, but could have been suspected from the clinical features and plain abdominal X-rays. Early operative intervention is the key to avoiding strangulation and the high mortality associated with this uncommon internal hernia.

Adult↗
PubMed1987

Smooth muscle tumours of the upper gastrointestinal tract.

Forty-six patients with smooth muscle tumours of the stomach and small intestine were treated surgically at the Princess Alexandra Hospital between 1970 and 1986. Leiomyomas were three times more common than leiomyosarcomas, but malignant tumours occurred more frequently in the small intestine than in the stomach. Gastric tumours tended to present with gastrointestinal bleeding, in contrast to intestinal lesions which presented predominantly with abdominal pain. Although leiomyomas tend to be smaller at operation than leiomyosarcomas, the size of a smooth muscle tumour is not reliable in discriminating between benign and malignant lesions. Therefore all smooth muscle tumours of the upper gastrointestinal tract should be excised as widely as possible, including local lymphatics in the dissection where practicable, so as to maximize the likelihood of radical extirpation of malignant lesions. Approximately one-third of patients with leiomyosarcomas have metastases at the time of surgery; the 5 year survival rate after surgical treatment of leiomyosarcomas of the upper gastrointestinal tract is less than 50%.

Adolescent↗
PubMed1986

The effect of somatostatin on dumping after gastric surgery: a preliminary report.

Many of the features of the dumping syndrome may be manifestations of hypovolemia and mechanical distension of the gut, resulting from abnormal fluid secretion in the upper gastrointestinal tract. The object of the present study was to assess the effect of somatostatin, an inhibitor of upper gastrointestinal secretions, on the response to a dumping provocation test, using a double-blind, placebo-controlled method. Four patients were studied; two had undergone total gastrectomy for gastric carcinoma and two had undergone gastric bypass for morbid obesity. Each subject received, on two separate occasions, a challenge of 200 ml of 50% glucose administered orally after an overnight fast. Somatostatin in 150 mm of NaCl (250 micrograms bolus followed by 300 micrograms/hr infusion) was given intravenously during one dumping provocation test and placebo (150 mm of NaCl) during the other according to a Latin square design. When the subjects received the placebo there were significant increases in pulse rate and packed cell volume after oral glucose (p less than 0.05, paired t test), which did not occur when they received somatostatin. The glucose challenge also produced a more rapid increase in serum osmolality and blood glucose during administration of placebo than when somatostatin was given. Marked diarrhea developed in all placebo-treated subjects but in none when they received somatostatin; however, three of the subjects developed marked abdominal pain during dumping provocation tests when treated with somatostatin, which did not occur when placebo was given. Although somatostatin appears to suppress some of the objective responses to a dumping provocation test, it may not prove particularly useful in the treatment of dumping symptoms.

Blood Glucose↗
PubMed1985

Selenium absorption by canine jejunum.

Deficiency of the trace element selenium causes disease in domestic animals and may also be implicated in the pathogenesis of some human illness. In this study, the triple-lumen perfusion method was used to measure the rate of absorption of trace quantities of selenium (50 micrograms/liter in a physiological electrolyte solution) from the jejunum when given as D,L-selenomethione, D,L-selenocystine, or sodium selenite to healthy dogs in vivo. Selenium absorption from the test segment (expressed as percent administered dose per centimeter +/- SEM) was 1.97 +/- 0.04 from D,L-selenomethionine, 1.15 +/- 0.06 from D,L-selenocystine, and 0.51 +/- 0.07 from sodium selenite (P less than 0.01, N = 5). In separate studies in four anesthetized dogs, the jejunum was perfused with L-[75Se] selenomethionine while concentrations of 75Se were measured in the portal venous blood; these studies established that [75Se]selenomethionine disappearing from the gut lumen corresponded quantitatively to 75Se appearing in the portal venous effluent (74 +/- 6%) and incorporated into intestinal tissue (24 +/- 5%). These results are consistent with the hypothesis that the absorption of amino acid-bound selenium is accelerated by the specific amino acid active transport mechanisms in the gut mucosa. Sodium selenite is absorbed more slowly, possibly by simple diffusion through the intestinal mucosa, than the amino acid-bound selenium compounds.

Animals↗
PubMed1984

An evaluation of pelvic lymphoscintigraphy in the staging of colorectal carcinoma.

Lymphoscintigraphy was used to delineate the lymphatic drainage of the rectum and distal colon in 18 patients with carcinoma of the rectum or sigmoid colon, in four with inflammatory disease of the large bowel and in 20 controls without colorectal pathology. Abdominal imaging was performed after submucosal injection of either 4 mCi 99mTc-antimony sulphide colloid or 0.5 mCi 99mTc-dextran into the rectum through a proctoscope. In nine patients with colorectal carcinoma, abdominal imaging was performed immediately pre-operatively and the excised specimen of large bowel was also imaged in vitro immediately postoperatively. The presence or absence of nodal uptake of radionuclide on abdominal scanning did not discriminate between normal and diseased large bowel, and the extent of nodal uptake demonstrated either by abdominal scans or by in vitro scans of excised specimens bore no relationship to the presence or absence of nodal metastases demonstrated histologically in the cancer patients. Pelvic lymphoscintigraphy as performed in this study has no demonstrable value in the diagnosis or staging of colorectal cancer.

Aged↗
PubMed1984

Somatostatin treatment of gastrointestinal fistulas: evidence for a rebound effect on withdrawal.

Three patients with external fistulas from the gastrointestinal tract were treated with somatostatin, a peptide which inhibits pancreatic, gastric and intestinal secretion. Although somatostatin reduced fistula output in two patients and possibly prevented haemorrhage in one, it did not induce fistula closure in any; moreover on withdrawal of somatostatin one patient developed life threatening gastrointestinal haemorrhage and a transient fistula hypersecretion occurred in the others. This experience of somatostatin treatment was less favourable than that previously reported in other small series. Positive nitrogen balance was probably not maintained during treatment in the three patients reported here and in one patient in a previous study in whom somatostatin was ineffective; the peptide may only promote fistula closure in adequately nourished patients.

Abdominal Muscles↗
PubMed1984

Nasogastric intubation after intestinal resection.

Despite some evidence that gastric decompression may be unnecessary after some abdominal operations and in the treatment of paralytic ileus, the use of nasogastric suction after extensive abdominal operations, particularly intestinal resection, remains a subject of some debate. In a randomized prospective trial, 52 patients with suture lines constructed in the gastrointestinal tract received no postoperative nasogastric drainage unless acute gastric dilation or copious vomiting developed postoperatively, while 45 similar patients were allocated to receive routine postoperative nasogastric aspiration. Only 12 patients in the nonintubated group required subsequent insertion of a nasogastric tube, while in the remaining 40, nasogastric drainage was avoided completely. Postoperative loss of fluid from the intestine was significantly greater in the patients undergoing routine nasogastric drainage, although the requirement for intravenous fluid therapy was the same in both groups. There were no significant differences between the two groups in the incidence of postoperative complications. Routine nasogastric aspiration after gastric or intestinal resection does not confer significant advantages to outweigh its discomfort and potential morbidity for patients and should be replaced by selective intubation when required postoperatively.

Adolescent↗
PubMed1984

Secretion of neurotensin and its effects on the jejunum in the dog.

The triple-lumen perfusion technique was used to assess the effect of neurotensin on the canine jejunum; net water and electrolyte fluxes were measured during intravenous infusion of neurotensin and during preceding and succeeding control infusions of sodium chloride. A pharmacologic dose of neurotensin (70 pmol X kg-1 X min-1) converted basal net jejunal water and electrolyte absorption to net secretion (p less than 0.02); 3.2 pmol X kg-1 X min-1 of the peptide significantly inhibited net water and electrolyte absorption (p less than 0.05), and induced a transient but consistent increase in jejunal transmural potential difference; however, 1.3 pmol X kg-1 X min-1 had no significant effect on net jejunal water and electrolyte fluxes. Neurotensin (1.3 pmol X kg-1 X min-1) induced a rise in plasma neurotensinlike immunoreactivity which was greater than the increment occurring after a normal meal, but which could be reproduced in the same animals by infusion of oleic acid into the ileum. This latter stimulus, however, had no effect on jejunal potential difference, or net water and electrolyte fluxes. These observations do not support a hormonal role for neurotensin in the postprandial regulation of intestinal function in the dog, although they do not rule out the possibility of physiologic paracrine activity.

Action Potentials↗
PubMed1983

Iliac compression syndrome: a myth, a rarity or a condition frequently missed?

A case of the iliac compression syndrome is reported and the literature on the subject reviewed. The anatomical abnormality which may cause symptoms in this condition is a frequent radiological and necropsy finding whose significance has been the subject of considerable debate. Evidence is presented that left iliac vein compression by the overlying right common iliac artery may cause symptoms of venous hypertension in the absence of venous thrombosis. As the condition may carry a risk of iliofemoral thrombosis with subsequent major morbidity and is surgically correctable it should be considered in the differential diagnosis of all patients presenting with oedema of the left leg.

Adult↗
PubMed1983

Effects of bombesin, calcitonin, and enkephalin on canine jejunal water and electrolyte transport.

The aim of this investigation was to study the effects of the peptides bombesin, calcitonin, and enkephalin on net jejunal water and electrolyte fluxes using the triple-lumen gut perfusion technique in conscious dogs. Intestinal transport was measured during intravenous infusions of bombesin (1 microgram/kg/hr, 8 studies), or calcitonin (3 micrograms/kg/hr, 5 studies), or methionine enkephalin (20 micrograms/kg/hr, 6 studies); each dog was used as its own control with infusion of 150 mmol/liter NaCl preceding and succeeding each peptide infusion. Net water absorption was reduced from a control value of 17 +/- 4.18 to 7 +/- 1.79 microliter/cm/min by bombesin (P less than 0.05) and increased from a control value of 15 +/- 3.95 to 29 +/- 5.58 microliters/cm/min by enkephalin (P less than 0.05). Bombesin reduced net sodium and chloride absorption, while enkephalin increased net absorption of sodium and bicarbonate. Calcitonin did not have any detectable effect in the dose used in this study in dogs. We conclude that bombesin and enkephalin can effect the transport of water and electrolytes in the canine jejunum.

Animals↗