Biomedical subjects
Publications and source records attributed to W E Green.
Tracheal collapse after thyroidectomy is uncommon; when it occurs, complete airway obstruction is often sudden, unexpected and fatal. In this paper a patient treated for tracheal collapse by tracheostomy and followed up for 1 year is described and, from a review of the literature, a further 9 cases are presented. The aetiology of the condition, the patient at risk and the technique of management are discussed.
Explore the source record for details and available documents.
Abnormal acid production or handling is thought to be involved in duodenal ulceration. Gastric emptying of 25 mmol hydrochloric acid (250 ml 0.1 M solution) was studied by using an isotopic method in control and ulcer subjects. Plasma gastrin and secretin levels were simultaneously measured. Gastric emptying was significantly faster in ulcer subjects using several parameters. Plasma gastrin levels were suppressed in both groups, with equivocal differences between them. Mean plasma secretin levels showed no significant elevation in controls and at only one point in ulcer subjects. Mean elevation in plasma secretin levels during intermediate phase of gastric emptying (T30-70) correlated with rate of acid loss from stomach in both groups. Regression lines were significantly different in position, however, and indicated a higher threshold for secretin release in ulcer subjects. The significance of this in the pathogenesis of duodenal ulcer is discussed.
Gastrointestinal myoelectric activity was studied in three conscious fasted dogs with electrodes surgically implanted in the stomach and small intestine, during separate and combined intravenous infusions of 13-norleucine motilin (13-nle-motilin) and pentagastrin (PG). Basal recordings confirmed the presence of regular interdigestive myoelectric complexes (MC's). 13-nle-motilin infusion below 50 ng/kg-h was without effect: higher doses up to 400 ng/kg-h resulted in the interpolation of one or more MC's in the spontaneous sequence. The rate of aboral transit of 13-nle-molitin-induced MC's did not differ significantly from that of spontaneous MC's. When MC's were abolished by feeding or PG infusion, simultaneous 13-nle-motilin administration was without effect on spike activity, but slightly attenuated the accelerating effect of gastrin on the gastric pacemaker frequency. The myoelectric events triggered by 13-nle-motilin suggest that in the conscious dog the polypeptide may not act directly on the smooth muscle cell, as it does in vitro, but through an extra-enteric neural control mechanism which is uncoupled by gastrin.
Total 14C activity in juice secreted by gastric pouches of six dogs and seven isolated canine stomachs was determined in response to intravenous and intra-arterial infusions of histamine and [14C]histamine. The proportions of 14C attributable to histamine, Nalpha-methylhistamine (NalphaMeH), Nalpha,Nalpha-dimethylhistamine (NalphaNalphaMe2H), N-telle-methylhistamine (NtauMeH), imidazole acetic acid (ImAA), N-methylimidazole acetic acid (NtauMeImAA), acetylhistamine (AcH), and histaminol (HOH) were defined using thin-layer chromatography. Similar estimates were made at the end of infusions on blood, gastric mucosa, and gastric muscle. Methylation was the major, or sole, route of metabolism of histamine in the gastric mucosa, and the major product was inactive NtauMeH. Small quantities of the active NalphaMe derivatives, particularly NalphaNalphaMe2H, were identified in both the juice and mucosa. Little or no ImAA, NtauMeImAA, AcH, and HOH were present in juice from isolated stomachs while they did occur in the juice from intact dogs, demonstrating they are extragastric metabolites of histamine. A major mucosal function of methylation of histamine is inactivation, although NalphaMe derivatives formed may play a role in the secretagogue action of histamine.
Explore the source record for details and available documents.
Myoelectric activity induced by a synthetic analogue of the duodenal polypeptide motilin, was studied in isolated vascular-perfused canine duodenum and stomach, and in conscious dogs with serosal electrodes implanted in the stomach and the small intestine. In the isolated preparation, the duodenum was found to be four times as sensitive as the antrum to the polypeptide, showing a dose-dependent increase in spike activity within two minutes after administration of the polypeptide. By contrast, in the conscious fasted animal, the only response to motilin, above a threshold dose, was the interpolation of a premature migrating myoelectric complex in the spontaneous interdigestive sequence, appearing fifteen to twenty minutes after the start of infusion. Since the essential difference between the ex vivo and the intact intestine was the preservation of efferent and afferent nervous connections in the latter, it seems that in the conscious animal, the response to exogenous motilin is modulated by the innervation of the intestine, or, alternatively, motilin interacts with the centre controlling the pattern of motor activity in the small intestine rather than directly with smooth muscle. The latter hypothesis is supported by the observation that motilin had no effect on the motor activity of the small intestine during the infusion of pentagastrin which abolishes spontaneous migrating myoelectric complexes.
Explore the source record for details and available documents.
Explore the source record for details and available documents.