Biomedical subjects
R B Terry
Publications and source records attributed to R B Terry.
Operative cholangiography. Review of 7,529 operations on the biliary tree in a community hospital.
Primary operation for cholelithiasis ranks third in frequency among general surgical procedures performed in this country each year [16]. The mortality and morbidity associated with retained common duct stones are apparent to all biliary surgeons. Although operative cholangiography is a standard procedure in many centers, some still use this adjunct to biliary surgery infrequently, as shown by the 51 percent performance rate in the present study. However, the literature is replete with evidence supporting the routine use of cholangiography. In the present report positive findings on common duct exploration almost doubled when operative cholangiography was added to the clinical and operative criteria for common duct exploration. Our experience indicates that common duct exploration is not always required when the patient has jaundice if normal operative cholangiograms support the patient's history and other laboratory findings. Cholangiography was also found to be accurate in the five cases in which a secondary biliary procedure had to be performed.
Effect of acute hemorrhage on gastrin secretion rate and blood levels of gastrin and insulin in normal dogs and in dogs after vagotomy.
Ten dogs were used to study antral gastrin secretion in hemorrhagic shock. Dogs that had a vagotomy were compared with normal dogs. Acute hemorrhage, imposed upon operative stress, produced increased gastrin secretion in normal dogs but not in dogs after vagotomy. During the acute hemorrhage, the level of circulating gastrin in normal dogs increased to about 50 to more than 100 per cent of the control values. The concentration of gastrin in the dogs having a vagotomy was essentially unchanged in the face of acute hemorrhage. Results of this study suggest that the increased concentration of circulating gastrin in normal dogs subjected to severe stress may play a role in the development of a stress ulcer.
Exercise fails to improve postprandial glycemic excursion in women with gestational diabetes.
The effect of an acute period of moderate intensity exercise on maternal glycemic excursion following a mixed nutrient meal was studied. Five normal (NL) and six gestational diabetic (GDM) subjects were enrolled. A randomized crossover design was used to compare fasting glucose and insulin levels, peak glucose and insulin levels and incremental area of the glycemic and insulin curves following a mixed nutrient meal with or without an exercise stress that took place 14 h earlier. Exercise consisted of upright stationary cycling for 30 min at a heart rate consistent with 60% VO2max. The clinical characteristics of normal and gestational diabetic subjects were comparable. Mean values (+/-SEM) with, versus without, exercise for fasting glucose (NL: 78.9 +/- 2.6 vs. 80.0 +/- 2.6 mg/dl; GDM: 86.4 +/- 2.0 vs. 82.1 +/- 3.5 mg/ dl), peak glucose (NL: 132.3 +/- 10.4 vs. 139.1 +/- 15.6 mg/dl; GDM: 165.8 +/- 5.5 vs. 160.3 +/- 7.8 mg/dl), the area under the glycemic curve (NL: 5758 +/- 1038 vs. 6393 +/- 1281 mg/dl.min; GDM: 8,178 +/- 890 vs. 8,331 +/- 563 mg/dl.min) did not differ. Similarly, plasma insulin levels did not differ between protocols for either group of subjects. Exercise has been proposed as a treatment to reduce glycemia in gestational diabetes. Results from this study indicate a single bout of exercise did not blunt the glycemic response observed following a mixed nutrient meal.
Effects of exercise-induced weight loss on low density lipoprotein subfractions in healthy men.
One-year changes in low density lipoprotein (LDL) peak flotation (Sf) rate and serum mass concentrations of LDL of Sf 0 to 7 (small LDL), LDL of Sf 7 to 12 (large LDL), intermediate density lipoprotein (IDL) of Sf 12 to 20, and very low density lipoprotein (VLDL) of Sf 20 to 400 were compared between men assigned at random to a 1-year exercise program (N = 48) or to a sedentary control condition (N = 31). Distance run among exercisers varied substantially (mean +/- SD: 12.7 +/- 8.9 km/week). Mean changes were not significantly different between the exercise and control groups for any of the low to very low density lipoprotein measurements. However, within the exercise group: 1) distance run correlated negatively with changes in the mass concentrations of small LDL; and 2) weight loss and reduced upper body obesity correlated positively with changes in small LDL, IDL, and VLDL mass and negatively with change in LDL peak flotation rate. Analyses with partial correlations suggest that weight loss may primarily affect LDL mass distributions through metabolic processes associated with high density lipoprotein2 or small VLDL (Sf 20 to 60). The decrease in small LDL concentrations and the increase in LDL peak flotation rate suggest that exercise-induced weight loss may be effective in reducing coronary heart disease risk in persons genetically predisposed to a high-risk lipoprotein profile.