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Biomedical subjects

P R Ellis

Publications and source records attributed to P R Ellis.

At least 19 recordsLinked to original sources
PubMed1995

The effect of high-molecular-weight guar gum on net apparent glucose absorption and net apparent insulin and gastric inhibitory polypeptide production in the growing pig: relationship to rheological changes in jejunal digesta.

The present study was designed to determine the quantitative effects of starchy meals containing guar gum on rates of net apparent glucose absorption and net apparent insulin and gastric inhibitory polypeptide (GIP) production in growing pigs. The effects of these meals on the viscosity of jejunal digesta were also examined and correlated to changes in glucose absorption. Four growing pigs were each given either a low-fat semi-purified diet (control) or the same diet supplemented with a high-molecular-weight guar gum at concentrations in the diet of 20 or 40 g/kg. Blood samples were removed simultaneously via indwelling catheters from the mesenteric artery and the hepatic portal vein. Samples of jejunal digesta were removed via a T-piece cannula and used immediately for viscosity measurements at 39 degrees. The 'zero-shear' viscosity of each sample was then calculated. Blood-flow measurements were made using an ultrasonic flow probe fitted to the hepatic portal vein. All measurements were made at intervals of 10 or 30 min during a 4 h postprandial period. Meals containing guar gum significantly increased (P < 0.05) the viscosity of jejunal digesta, an effect that was strongly dependent on the concentration of guar gum in the original diet. No significant differences in blood-flow rates were found between the control and guar-containing diets. Both concentrations of guar gum significantly reduced (P < 0.05) glucose absorption and insulin and GIP secretion rates over the 4 h postprandial period. An inverse relationship between the rate of glucose absorption and the 'zero-shear' viscosity of jejunal digesta was found. This study also provides direct evidence for the important role played by the enteroinsular axis in modifying the glycaemic response to a meal containing guar gum.

Animals↗
PubMed1991

Vascularized single toe joint transfer to the hand.

We report a retrospective review of our series of thirty-one single joints harvested from the toe in twenty-six patients and transferred to the metacarpophalangeal or proximal interphalangeal joint of the finger. Twenty-six transfers were done in traumatic cases and five in congenital. Follow-up averaged 22.6 months. Average range of motion was from 17.1 degrees to 44.3 degrees, with an arc of 27.2 degrees. The congenital group had an average motion ranging from 14.4 degrees to 27.2 degrees and an arc of 12.8 degrees. The traumatic group's motion was from 17.6 degrees to 47.6 degrees and an arc of 30.0 degrees. Complication rates were significant, with fifty percent of the patients experiencing one or more complications. Although vascularized joint transfer is a demanding procedure, it provides a reasonable alternative to arthrodesis and with further refinement in technique may become a reliable treatment option.

Adolescent↗
PubMed1991

Blood glucose, plasma insulin and sensory responses to guar-containing wheat breads: effects of molecular weight and particle size of guar gum.

The effectiveness of guar gum in reducing post-prandial blood glucose and plasma insulin levels in human subjects seems to depend mainly on its ability to increase the viscosity of digesta in the small intestine. However, the precise relationship between the rheological properties of guar gum (either in vitro or in vivo) and the changes in blood metabolites and hormones is unknown. The aim of the present study, therefore, was to investigate the effects of wheat breads containing guar gum samples varying in molecular weight (Mw) and particle size (characteristics that strongly influence the rheological properties of guar gum) on post-prandial blood glucose and plasma insulin levels in healthy subjects. The sensory qualities of breads containing guar-gum flours of different Mw were also evaluated using a hedonic scoring technique. No significant differences in the post-prandial blood glucose responses were found between the control and guar breads. However, all the guar breads elicited significant (P less than 0.05) decreases in the post-prandial rise in plasma insulin, an effect that did not appear to be influenced by large variations in Mw or particle size of guar gum. Moreover, the sensory qualities of guar bread were markedly improved by using low Mw grades of guar gum.

Adolescent↗
PubMed1991

Importance of the rate of hydration of pharmaceutical preparations of guar gum; a new in vitro monitoring method.

Dietary supplements of guar gum are known to improve blood glucose control in diabetic patients. The efficacy of guar is probably dependent mainly upon its capacity to hydrate rapidly and thus to increase viscosity in the small intestine post-prandially. Measurement of the rate of hydration in vitro might therefore be a useful index of the effectiveness of guar formulations. A simple method for monitoring the hydration rate of guar gum has been developed, which involves measuring the changes in viscosity at discrete time intervals over a period of 5 h using a Brookfield RVT rotoviscometer. Six different samples of guar gum (four pharmaceutical preparations and two food grades of guar flour) were hydrated in sealed glass jars rotated at 6 rev min-1 in order to prevent particle aggregation. Marked differences in hydration rate and ultimate (maximum) viscosity between the different guar samples were observed. Three of the four pharmaceutical preparations were lower in viscosity than the food grades of guar flour during the first 60 min of hydration. Two of the preparations hydrated so slowly that even after 5 h they attained viscosity levels of only 60% of their ultimate viscosity. These results may explain why some guar gum preparations are clinically ineffective.

Dietary Fiber↗
PubMed1989

Management of the traumatized joint of the finger.

Selection of the reconstructive technique for the traumatized joint requires a careful consideration of the condition of the injured and adjacent joints, the needs and desires of the patient, and an understanding of the advantages and disadvantages of the available options. The MP joint is the key to a useful arc of motion, providing 77 per cent of the total arc of flexion. Every effort should be made to preserve its maximum pain-free movement. PIP joint motion, although important in maintaining grip strength, can more readily be sacrificed to provide stability when MP joint motion is normal. Arthrodesis provides a pain-free stable joint with a sacrifice of motion. It may be indicated in young patients in whom heavy loading is likely; in joints with a fixed, painful deformity, instability, or loss of motor; and in the salvage of failed implant arthroplasty. Arthrodesis is generally contraindicated where physes are open. PIP joint arthrodesis is well tolerated in the index finger with minimal morbidity. Motion of MP joints and PIP joints of the long, ring, and small fingers, however, should be preserved using other techniques when possible. Resection arthroplasty may be useful in selected cases of post-traumatic arthroplasty where other treatment techniques are not available. Soft tissue interposition techniques are useful in specific cases. Eaton volar plate arthroplasty provides good results where 50 per cent of the articular surface is preserved. The technique, however, requires precision to avoid rotational malalignment. Perichondrial resurfacing provides a reasonable alternative in patients younger than 40 years of age who have a relatively well maintained joint contour, preferably involving a single joint surface. Prior infection is a relative contraindication. MP joints generally produce better results than PIP joints. Swanson interposition arthroplasty remains the most widely accepted implant technique, providing improved stability and earlier motion than simple resection arthroplasty. Reported arcs of motion range from a minimum of 29 degrees to a maximum of 85 degrees, with results generally better for MP than for PIP joints. Complications are common and include implant fracture, lateral instability of the PIP joint, and, occasionally, synovitis. Patient satisfaction, however, has been consistently reported as high. The use of Swanson arthroplasty in acute cases remains controversial, although several authors report favorable results. Silicone arthroplasty is contraindicated in joints with open physes. Allograft small joint reconstruction provides replacement bone and articular surface without donor site morbidity. Experience with the technique, however, has been limited. Increasing concern over the transmission of infectious diseases may make this option less desirable.(ABSTRACT TRUNCATED AT 400 WORDS)

Arthroplasty↗
PubMed1988

Evaluation of guar biscuits for use in the management of diabetes: tests of physiological effects and palatability in non-diabetic volunteers.

A guar-shortbread biscuit has been successfully developed and tested for possible use in the dietary management of diabetes. A dose-response study was undertaken to estimate the amount of guar gum needed in the biscuit recipe to reduce postprandial glycaemia and insulinaemia. A control biscuit and three types of guar biscuit corresponding to a low, medium and high dose of guar (2.9, 6.0 and 9.1 g of guar respectively) were given to 8 non-diabetic subjects, and blood glucose and plasma insulin levels were determined at fasting, and at the postprandial times 30, 60, 90 and 120 min. Integrated insulin increments were estimated by calculation of the area under the curve. Sensory analysis of the biscuits was carried out by 36 non-diabetic panellists using a standard smiley chart containing hedonic phrases. No significant differences in the blood glucose increments were found between the control biscuit and the guar biscuits. However, all three guar biscuits produced smaller insulin rises than the control at all the postprandial times; statistically significant falls were indicated at the 60-min peak and 120-min times and for the integrated values. A linear regression model describing the relationship between integrated insulin and the dose of guar ingested is proposed. We have estimated from this model that a reduction of 209 mU/min/l in the integrated insulin can be achieved for every 1 g of guar incorporated into the biscuit. Mean hedonic scores indicated that all the guar biscuits were palatable, particularly the low-dose variety which was given a score almost identical to that of the control. A significant insulin-sparing effect in non-diabetic subjects was achieved using a palatable guar biscuit containing less than 3 g of guar flour.

Administration, Oral↗
PubMed1983

COSREEL.

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Animals↗
PubMed1981

Guar bread: acceptability and efficacy combined. Studies on blood glucose, serum insulin and satiety in normal subjects.

1. Bread alone and supplemented with guar gum at three levels (50, 100 and 150 g/kg) was given to eleven non-diabetic subjects, and blood glucose and serum insulin were determined preprandialy, and at 30 min and 60 min after commencement of the meal. Ths satiating effect, up to 120 min, of the guar bread and its acceptability to the same group of normal volunteers was also studied. 2 No significant differences in blood glucose were observed between control and guar breads at 30 min and 60 min, apart from 100 g guar/kg bread at 30 min (P less than 0.05). A significant difference in serum insulin was indicated between: control and 50 (P less than 0.02) and 150 (P less than 0.02) guar/kg breads at 30 min; control and 50 (P less than 0.05), 100 (P less than 0.001) and 150 (P less than 0.05) guar/kg breads at 60 min. 3. There were no significant differences in the satiety scores for control and guar breads. Significant increases in satiety attributed to 150 g guar/kg bread were found when compared to: 50 g guar/kg bread immediately after eating (P less than 0.05), 100 g guar/kg bread at 60 min (P less than 0.02) and 50 and 100 g guar/kg breads at 120 min (both P less than 0.05). 4. There was a positive correlations between hedonic score and relative replacement of guar (r 0.62, P less than 0.001, n 44) and from the regression line it was found that 50 and 100 g guar/kg breads produced hedonic scores close to a neutral response of 5, whereas 150 g guar/kg bread at a predictive score of 6.3 appeared to be unacceptable to our subjects. 5. Guar bread at the 100 g/kg level (59 g guar/kg bread) reduced the serum insulin by 48% at 60 min and is found to be an acceptable food product at this level of incorporation. However, more information is required to demonstrate the possible satiating potential of guar bread.

Adult↗