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Biomedical subjects

W R Ellis

Publications and source records attributed to W R Ellis.

At least 37 records · Page 2Linked to original sources
PubMed1985

Stones in the common bile duct: experience with medical dissolution therapy.

Thirty-one patients with radiolucent common bile duct stones received medical treatment. Nineteen had Rowachol, a terpene preparation, eight (42%) achieving complete stone disappearance within 3 to 48 months. Fifteen (including 3 of the above) took Rowachol with bile acid (chenodeoxycholic in 11, ursodeoxycholic in 4) for 3 to 60 months: 11 (73%) achieved complete dissolution within 18 months. Persistent symptoms and complications settled on conservative management: 8 (25%) patients required admission (2 biliary colic, 1 obstructive jaundice, 4 cholangitis, 1 pancreatitis). One patient died of a myocardial infarction during recovery from pancreatitis; the other continued treatment, 2 achieving complete dissolution/disappearance. Oral dissolution therapy with Rowachol and bile acids should be considered when endoscopic sphincterotomy or surgery is not feasible, but careful attention to potential complications is required while stones persist.

Adult↗
PubMed1984

Pilot study of combination treatment for gall stones with medium dose chenodeoxycholic acid and a terpene preparation.

Thirty patients with radiolucent stones in a radiologically functioning gall bladder were treated for up to two years with a combination of Rowachol (one capsule twice daily), a mixture of cyclic monoterpenes, and chenodeoxycholic acid (7.0-10.5 mg/kg/day). The patients were not selected for body weight or size of stones. All complete dissolutions diagnosed by oral cholecystography were confirmed or refuted by ultrasound examination. Control of symptoms was excellent, only one patient withdrawing from the study because of persistent biliary pain. No evidence of hepatotoxicity was detected biochemically, and diarrhoea due to chenodeoxycholic acid was minimal at this dose. Stones disappeared completely in 11 patients (37%) within one year and in 15 (50%) within two years. These results compared favourably with those obtained with similar doses of chenodeoxycholic acid alone, in particular those of the National Co-operative Gallstone Study (complete dissolution in 13.5% of patients at two years). Treatment with a combination of medium dose chenodeoxycholic acid with Rowachol for radiolucent gall stones is economical, effective, and likely to minimise persistent symptoms and adverse effects of treatment.

Adult↗
PubMed1984

The effects of 3,5,5-trimethylcyclohexanol on hepatic cholesterol synthesis, bile flow and biliary lipid secretion in the rat.

The chemical trimethylcyclohexanol (TMC) is closely related to menthol, the major component of a terpene preparation with known choleretic and cholelitholytic activity. Its effects on hepatic cholesterol synthesis and bile secretion were examined in the rat. In both acute and long-term dosing experiments TMC significantly inhibited hepatic S-3-hydroxy-3-methylglutaryl coenzyme A (HMGCoA) reductase. TMC was a potent choleretic, with detectable effects on bile flow at low doses, which also reduced coupling of cholesterol secretion to bile salt secretion. Single large doses tended to lower biliary cholesterol output and caused significant reduction in cholesterol saturation index after biliary diversion for 1 h. TMC and its widely prescribed ester cyclandelate, which is rapidly degraded to TMC after ingestion, should be investigated further as potential cholelitholytic treatments in man.

Animals↗
PubMed1984

Rhizosphere Response as a Factor in Competition Among Three Serogroups of Indigenous Rhizobium japonicum for Nodulation of Field-Grown Soybeans.

Rhizosphere response was studied as a factor in competition among indigenous Rhizobium japonicum serogroups for the nodulation of soybeans under field conditions. R. japonicum serogroups 110, 123, and 138 were found to coexist in a Waukegan field soil where they were determined to be the major nodulating rhizobia in soybean nodules. Competitive relationships among the three serogroups in that soil and in rhizospheres were examined during two growing seasons with several host cultivars with and without inoculation and with a nonlegume. Enumeration of each of the three competitors was carried out on inner rhizosphere and nonrhizosphere soil by immunofluorescence with serogroup-specific fluorescent antibodies. Rhizobia present in early- and late-season nodules were identified by fluorescent antibody analysis. Populations of each serogroup increased gradually in host rhizospheres, not exceeding 10/g of rhizosphere soil during the first few weeks after planting, whereas numbers in fallow soil remained at initial levels (10 to 10/g). The rhizosphere effects were minor in host plants during this period of nodule initiation and were about the same for all three serogroups. Although serogroup 123 gave no evidence of dominance in early host rhizospheres, it clearly dominated in nodule composition, occupying 60 to 100% of the nodules. High densities of all three serogroups were observed in host rhizospheres during flowering. Rhizosphere populations, especially of serogroup 123, were still high during pod fill and seed maturation. The rhizosphere responses of the R. japonicum serogroups were much greater with the soybean cultivars than with oats, but even in host rhizospheres the R. japonicum populations were greatly outnumbered by other bacteria. The success of serogroup 123 in achieving nodulation does not appear to be due to superior colonization of the host rhizosphere.

Journal Article↗
PubMed1983

Bone disease after jejuno-ileal bypass for morbid obesity.

Fifteen patients who had undergone a 14 inches X 4 inches jejuno-ileal bypass operation for obesity, 3 to 4 years earlier, were investigated by iliac bone biopsy, radiology and routine biochemistry, including 25-hydroxy-vitamin D and parathyroid hormone estimations. Two patients had histological osteomalacia which was mild in one. A further 9 patients had abnormal bone biopsies, there being an excess of trabecular bone surface covered by osteoid with a normal or reduced amount of calcification front. Six of these 9 showed an increase in trabecular resorption, although in none were there excessive numbers of osteoclasts. The likely explanation for these findings is that these 9 patients had early osteomalacia with mild hyperparathyroidism, making a total of 11 patients out of 15 with osteomalacia. Radiology and blood chemistry were poor predictors of histological bone disease.

Adult↗
PubMed1982

Gall-stone dissolution and recurrence: are we being misled?

Oral cholecystography repeated at six-months intervals is the standard method for determining reduction in size of gall stones (partial success) and complete dissolution of stones (complete success). In a comparative study of oral cholecystography and cholecystosonography six out of 14 patients with gall stones achieving complete success by oral cholecystographic criteria had stones still detectable by ultrasonography. Repeat oral cholecystography in a further 11 patients receiving post-dissolution maintenance treatment detected stones in two, whereas ultrasonography detected stones in seven. In future complete dissolution of gall stones should be reported only if both oral cholecystography and ultrasonographic studies give negative results and the progress of patients receiving post-dissolution maintenance treatment is monitored by ultrasonography rather than serial oral cholecystography.

Chenodeoxycholic Acid↗
PubMed1981

The effect of cholesterol feeding on gallbladder bile acids of the rabbit. Evidence that lithocholic acid is a primary bile acid in the rabbit.

The bile acid in gallbladder bile of rabbits fed a normal diet or one containing 2% (w/w) cholesterol have been determined by gas chromatography-mass spectrometry. The predominant bile acids in normally fed rabbits were 3 alpha, 7 alpha, 12 alpha-trihydroxy-5 beta-cholan-24-oic acid (cholic acid), 3 alpha, 12 alpha-dihydroxy-5 alpha-cholan-24-oic acid (allodeoxycholic acid) and 3 alpha, 12 alpha-dihydroxy-5 beta-cholan-24-oic acid (deoxycholic acid) with very much smaller amounts of 3 alpha-hydroxy-5 beta-cholan-24-oic acid (lithocholic acid) and 3 alpha, 12 beta-dihydroxy-5 beta-cholan-24-oic acid. In the cholesterol-fed animals the lithocholate became a predominant bile acid. Sulphated bile acids accounted for less than 1% of the total bile acids. It is proposed that lithocholic acid may be a primary bile acid in the cholesterol-fed rabbit, formed by an alternative pathway of biosynthesis involving hepatic mitochondria.

Animals↗
PubMed1981

A comparison of two methods of whole gut lavage for colonoscopy.

Two forms of bowel preparation for colonoscopy were compared--19 patients were given 5 per cent mannitol solution orally while a further 19 were infused with isotonic saline via a nasogastric tube. Both methods proved equally acceptable to the patients and endoscopists. Saline led to a rise in body weight (+0.75 +/- 0.35 kg) and blood pressure (+7.5 +/- 2.8 mmHg) while mannitol caused a significant fall in both body weight (-0.74 +/- 0.28 kg) and blood pressure (-3.8 +/- 2.9 mmHg). Plasma volume measurements were carried out on 17 patients; 8 receiving saline showed a rise (+0.22 +/- 0.08 l) while 9 taking mannitol experienced a fall (-0.17 +/- 0.08 l). Twelve further subjects prepared with a combination 10 per cent mannitol and isotonic saline showed a small fall in plasma volume (-0.08 +/- 0.05 l). Mannitol proved an acceptable preparation for colonoscopies but a fall in body weight, blood pressure and plasma volume posed a small risk to the elderly subject and in view of the known risks of mannitol during diathermy this form of preparation was not considered a suitable alternative to isotonic saline.

Administration, Oral↗
PubMed1979

Liver disease among homosexual males.

5% of 2612 homosexual males attending genitourinary clinics were found to be hepatitis-B surface-antigen (HBsAg) positive. Liver biopsy was done in 25 who had abnormal liver-function tests but no symptoms or signs of liver disease, and 14 (56%) of these proved to have chronic active hepatitis or active cirrhosis. Neither the liver-function tests nor the viral markers in serum reflected the severity of the liver disease. 38% of a group of 118 HBsAg positive patients were HBeAg positive, and sexual contacts of these individuals may be at serious risk of infection.

Carrier State↗
PubMed1979

The influence of ammonia and octanoic acid on liver regeneration in the rat.

1. We have investigated the effect of intermittent doses of ammonia and octanoic acid on liver regeneration in the rat after partial hepatectomy. Regeneration was assessed by uptake of tritiated thymidine into liver deoxyribonucleic acid. 2. We have found a reduction in hepatic regenerative response in animals treated with ammonium acetate as a source of ammonia. 3. No inhibiting effect of octanoic acid on liver regeneration was found, at the dose used. 4. The implications of the results for management of fulminant hepatic failure are discussed.

Ammonia↗
PubMed1978

Two cases of giant intestinal gas cyst.

Large gas cysts of the colon are uncommon and only some 30 cases have been reported (Moss, 1975). They usually arise from the sigmoid colon and are always associated with diverticular disease (Schenken and Cochran, 1972). In view of their rarity, 2 further cases with different presenting factors are discussed.

Aged↗
PubMed1977

Studies on plasma cytotoxicity and liver regeneration in fulminant hepatic failure.

The possibility that the blood of patients with fulminant hepatic failure might contain substances which prevent or delay liver regeneration was investigated using a microcytotoxicity assay system based on the culture of isolated rabbit hepatocytes in vitro. Results showed significant cytotoxicity of the plasma as compared to controls, an effect which was reduced by charcoal haemoperfusion. The effect was also reduced in vitro by heating and dialysis. The bile acids chenodeoxycholic and lithocholic acid were cytotoxic when added to control human plasma. Evidence was also obtained from a completely different in vivo assay system that high blood levels of ammonia may inhibit hepatic regeneration.

Ammonia↗