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Proximal gastric motility in critically ill patients with type 2 diabetes mellitus

World Journal of Gastroenterology 2007年第2期13卷 270-275页

作者： Nam Q Nguyen Robert J Fraser Laura K Bryant Marianne Chapman richard h holloway Department of Gastroenterology Hepatology and General Medicine Royal Adelaide Hospital South Australia Investigation and Procedures Unit Repatriation General Hospital South Australia Anaesthesia and Intensive Care Royal Adelaide Hospital South Australia

AIM： To investigate the proximal gastric motor response to duodenal nutrients in critically ill patients with longstanding type 2 diabetes ***： Proximal gastric motility was assessed （using a barostat） in 10 critically ill patients with type 2 diabetes mellitus （59±3 years） during two 60-min duodenal infusions of Ensure （1 and 2 kcal/min）, in random order, separated by 2h fasting. Data were compared with 15 non-diabetic critically ill patients （48 ± 5 years） and 10 healthy volunteers （28 ±3 years）. RESULTS： Baseline proximal gastric volumes were similar between the three groups. In diabetic patients, proximal gastric relaxation during I kcal/min nutrient infusion was similar to non-diabetic patients and healthy controls. In contrast, relaxation during 2 kcal/ min infusion was initially reduced in diabetic patients （P 〈 0.05） but increased to a level similar to healthy humans, unlike non-diabetic patients where relaxation was impaired throughout the infusion. Duodenal nutrient stimulation reduced the fundic wave frequency in a dose-dependent fashion in both the critically ill diabetic patients and healthy subjects, but not in critically ill patients without diabetes. Fundic wave frequency in diabetic patients and healthy subjects was greater than in non-diabetic ***： In patients with diabetes mellitus, proximal gastric motility is less disturbed than nondiabetic patients during critical illness, suggesting that these patients may not be at greater risk of delayed gastric emptying.

关键词： Proximal gastric function Diabetes mellitus type 2 Critical illness Enteral nutrition

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Nutritional care in hospitalized patients with chronic liver disease

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World Journal of Gastroenterology 2015年第45期21卷 12835-12842页

作者： Dep K huynh Shane P Selvanderan hugh AJ harley richard h holloway Nam Q Nguyen Discipline of Medicine University of Adelaide North Terrace Department of Gastroenterology and hepatology Royal Adelaide Hospital North Terrace

AIM: To evaluate the practice of nutritional assessment and management of hospitalised patients with cirrhosis and the impact of malnutrition on their clinical ***: This was a retrospective cohort study on patients with liver cirrhosis consecutively admitted to the Department of Gastroenterology and hepatology at the Royal Adelaide hospital over 24 mo. Details were gathered related to the patients' demographics, disease severity, nutritional status and assessment, biochemistry and clinical outcomes. Nutritional status was assessed by a dietician and determined by subjective global assessment. Estimated energy and protein requirements were calculated by Simple Ratio Method. Intake was estimated from dietary history and/or food charts, and represented as a percentage of estimated daily requirements. Median duration of follow up was 14.9(0-41.4) mo. RESULTS: Of the 231 cirrhotic patients(167 male, age: 56.3 ± 0.9 years, 9% Child-Pugh A, 42% ChildPugh B and 49% Child-Pugh C), 131(57%) had formal nutritional assessment during their admission and 74(56%) were judged to have malnutrition. In-hospitalcaloric(15.6 ± 1.2 kcal/kg vs 23.7 ± 2.3 kcal/kg, P = 0.0003) and protein intake(0.65 ± 0.06 g/kg vs 1.01 ± 0.07 g/kg, P = 0.0003) was significantly reduced in patients with malnutrition. Of the malnourished cohort, 12(16%) received enteral nutrition during hospitalisation and only 6(8%) received ongoing dietetic review and assessment following discharge from hospital. The overall mortality was 51%, and was higher in patients with malnutrition compared to those without(hR = 5.29, 95%CI: 2.31-12.1; P hospitalised patients with cirrhosis and is associated with higher mortality. Formal nutritional assessment, however, is inadequate. This highlights the need for meticulous nutritional evaluation and management in these patients.

关键词： Liver cirrhosis Nutrition assessment Mortality Mal

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Impact of bolus volume on small intestinal intra-luminal impedance in healthy subjects

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World Journal of Gastroenterology 2010年第17期16卷 2151-2157页

作者： Nam Q Nguyen Laura K Bryant Carly M Burgstad Robert J Fraser Daniel Sifrim richard h holloway Department of Gastroenterology & hepatology Royal Adelaide HospitalAdelaide 5000Australia Investigation and Procedures Unit Repatriation General HospitalDaw Park 5041Australia Department of Medicine Centre for Gastroen-terological ResearchK.U.LeuvenLeuven 3000Belgium

AIM: To assess the impact of bolus volume on the characteristics of small intestinal (SI) impedance ***: Concurrent SI manometry-impedance measurements were performed on 12 healthy volunteers to assess the pattern of proximal jejunal fluid bolus movement over a 14 *** subject was given 34 boluses of normal saline (volume from 1 to 30 mL) via the feeding tube placed immediately above the proximal margin of the studied segment.A bolus-induced impedance event occurred if there was > 12% impedance drop from baseline,over ≥ 3 consecutive segments within 10 s of bolus injection.A minor or major imped-ance event was defined as a duration of impedance drop he minimum volume required for a detectable SI impedance event was 2 mL.A direct linear relationship between the SI bolus volume and the occurrence of impedance events was noted until SI bolus volume reached 10 mL,a volume which always produced an impedance flow *** was a moderate correlation between the bolus volume and the duration of impedance drop (r = 0.63,P he number of propagated channels (r = 0.50,P high volume boluses were associated with more major impedance events (≥ 10 mL boluses = 63%,3 mL boluses = 17%,and had an impact on the type and length of propagation of SI impedance events and a threshold of 2 mL is required to produce an event.

关键词： Bolus volume health Impedance Luminal flow Small intestine

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Proximal gastric response to small intestinal nutrients is abnormal in mechanically ventilated critically ill patients

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World Journal of Gastroenterology 2006年第27期12卷 4383-4388页

作者： Nam Q Nguyen Robert J Fraser Marianne Chapman Laura K Bryant richard h holloway Rosalie Vozzo Christine Feinle-Bisset Department of Gastroenterology Hepatology and General MedicineRoyal Adelaide HospitalSouth Australia University Department of Medicine University of AdelaideSouth Australia Department of Intensive Care Royal Adelaide HospitalSouth Australia Department of Gastroenterology Hepatology and General MedicineRoyal Adelaide HospitalSouth Australia Department of GastroenterologyUniversity of AdelaideSouth Australia

AIM： To determine the response of the proxima stomach to small intestinal nutrients in critically ill patients. METhODS： Proximal gastric motility was measured in 13 critically ill patients （49.3 ± 4.7 years） and 12 healthy volunteers （27.7 ± 2.9 years） using a barostat technique. Recordings were performed at baseline, during a 60-rain intra-duodenal infusion of Ensure^R （2 kcal/min）, and for 2 h following the infusion. Minimum distending pressure （MDP）, intra-bag volume and fundic wave activity were determined. RESULTS： The MDP was higher in patients （11.7 ± 1.1 vs 7.8 ± 0.7 mmhg; P 〈 0.01）. Baseline intrabag volumes were similar in the 2 groups. In healthy subjects, a ‘bimodal＇ proximal gastric volume response was observed. In patients, the initial increase in proximal gastric volume was small and delayed, but eventually reached a maximal volume similar to that of healthy subjects. In healthy subjects, the proximal gastric volume rapidly returned to baseline level after nutrient infusion （median 18 min）. In contrast, the recovery of volume to baseline was delayed in critically ill patients （median 106 min）. In 6 patients, the volume had not returned to baseline level 2 hours after nutrient infusion. In patients, fundic volume waves were less frequent （P 〈 0.05） and had lower amplitude （P 〈 0.001）, compared to healthy subjects. CONCLUSION： In critical illness, proximal gastric motor responses to small intestinal nutrient stimulation are abnormal.

关键词： Proximal gastric response Small intestinal nutrient Critical illness

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Gastroesophageal reflux disease after diagnostic endoscopy in the clinical setting

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World Journal of Gastroenterology 2013年第16期19卷 2514-2520页

作者： Nora B Zschau Jane M Andrews richard h holloway Mark N Schoeman Kylie Lange William CE Tam Gerald J holtmann Department of Gastroenterology and hepatology Royal Adelaide Hospital Faculty of health Sciences University of AdelaideAdelaide Department of Gastroenterology and hepatology Lyell McEwin Hospital Department of Gastroenterology and hepatology University of Queensland School of Medicine Princess Alexandra Hospital

AIM: To investigate the outcome of patients with symptoms of gastroesophageal reflux disease (GERD) referred for endoscopy at 2 and 6 mo post endoscopy. METhODS: Consecutive patients referred for upper endoscopy for assessment of GERD symptoms at two large metropolitan hospitals were invited to participate in a 6-mo non-interventional (observational) *** two institutions are situated in geographically and socially disparate areas. Data collection was by selfcompletion of questionnaires including the patient assessment of upper gastrointestinal disorders symptoms severity and from hospital records. Endoscopic finding using the Los-Angeles classification, symptom severity and it's clinically relevant improvement as change of at least 25%, therapy and socio-demographic factors were assessed. RESULTS: Baseline data were available for 266 patients and 2-mo and 6-mo follow-up data for 128 and 108 patients respectively. At baseline, 128 patients had erosive and 138 non-erosive reflux disease. Allmost all patient had proton pump inhibitor (PPI) therapy in the past. Overall, patients with non-erosive GERD at the index endoscopy had significantly more severe symptoms as compared to patients with erosive or even complicated GERD while there was no difference with regard to medication. After 2 and 6 mo there was a small, but statistically significant improvement in symptom severity (7.02 ± 5.5 vs 5.9 ± 5.4 and 5.5 ± 5.4 respectively); however, the majority of patients continued to have symptoms (i.e. , after 6 mo 81% with GERD symptoms). Advantaged socioeconomic status as well as being unemployed was associated with greater improvement. CONCLUSION: The majority of GORD patients receive PPI therapy before being referred for endoscopy even though many have symptoms that do not sufficiently respond to PPI therapy.

关键词： Gastroesophageal reflux disease Epidemiology Proton pump inhibitor Acid suppressive therapy Endoscopy Barrett’s esophagus Functional gastrointestinal disorders

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Gastro-oesophageal reflux disease and eosinophilic oesophagitis: What is the relationship?

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World Journal of Gastrointestinal Pathophysiology 2018年第3期9卷 63-72页

作者： Stephanie Wong Andrew Ruszkiewicz richard h holloway Nam Q Nguyen Discipline of Medicine University of Adelaide Department of Gastroenterology and hepatology Royal Adelaide Hospital Anatomical Pathology SA Pathology

Eosinophilic oesophagitis(EoE) and gastro-oesophageal reflux disease(GORD) are the most common causes of chronic oesophagitis and dysphagia associated with oesophageal mucosal eosinophilia. Distinguishing between the two is imperative but challenging due to overlapping clinical and histological features. A diagnosis of EoE requires clinical, histological and endoscopic correlation whereas a diagnosis of GORD is mainly clinical without the need for other investigations. Both entities may exhibit oesophageal eosinophilia at a similar level making a histological distinction between them difficult. Although the term proton-pump inhibitor responsive oesophageal eosinophilia has recently been retracted from the guidelines, a relationship between Eo E and GORD still exists. This relationship is complex as they may coexist, either interacting bidirectionally or are unrelated. This review aims to outline the differences and potential relationship between the two conditions, with specific focus on histology, immunology, pathogenesis and treatment.

关键词： Relationship Pathogenesis Eosinophilic oesophagitis histological features Gastro-oesophageal reflux disease

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Glucocorticoid directly induces osteoclastogenesis but has no effect on bone resorption

Glucocorticoid directly induces osteoclastogenesis but has n...

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The Third International Congress on Osteoporosis

作者： J Xu L huang WR holloway GC Nicholson JS Qiu M h Zheng Departments of Orthopaedic Surgery University of Wetern AustraliaNedlands6009WA

＜正＞Glucocorticoid-induced osteoporosis is characterised by reduction of bone formation and activation of bone *** action of glucocorticoid on osteoclastic bone resorption however is not fully *** giant cell tumours of bone（GCT） are considered to arise from a neoplasm of mesenchymal stromal *** GCT have the capacity to recruit macrophages and multinucleated osteoclast-like giant cells,we have therefore used osteoclast-like giant cells and macrophage-like cells from GCT as a source to study the effect of glucocorticoids on osteoclast and their precursor *** have demonstrated that by fluorescence in-situ hybridisation and RT-PCR,both macrophage-like cells（putative osteoclast precursor cells） and

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一种高甜度天然甜味剂的来源——野生红色浆果(Dioscoreophyllum cumminsii)的种子繁殖

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亚热带植物科学 1978年第1期 44-46页

作者： h.L.O.holloway 徐雄

光能抑制野生红色浆果(Dioscoreophyllum cumminsii)种子的萌发。在荫蔽下,经10周后,可获得80—85%的萌发。用0.1%—0.5%赤霉酸溶液预先处理,可以消除光的抑制作用,并促进其萌发。这些技术也许可能大规模地用种子来栽培野生红色浆果,以... 详细信息

光能抑制野生红色浆果(Dioscoreophyllum cumminsii)种子的萌发。在荫蔽下,经10周后,可获得80—85%的萌发。用0.1%—0.5%赤霉酸溶液预先处理,可以消除光的抑制作用,并促进其萌发。这些技术也许可能大规模地用种子来栽培野生红色浆果,以及在商业上利用这种浆果的可能

关键词：赤霉酸赤霉素浆果 Dioscoreophyllum cumminsii 种子发芽种子繁殖有性繁殖甜度

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菲律宾的北巴拉望断块—其与亚洲大陆的关系和在南中国海演化中的作用

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海洋石油 1983年第4期 21-35页

作者： N.h.holloway 陶国保

民都洛岛、巴拉望岛北部和礼乐滩(西南菲律宾群岛)一起构成了一个陆块,即北巴拉望断块,它位于岛弧-大洋构造背景之内。这些地区的二叠纪到早第三纪岩石反映了这个断块具有与菲律宾群岛其余部分截然不同的地质成因和历史。这些岩石还表明... 详细信息

民都洛岛、巴拉望岛北部和礼乐滩(西南菲律宾群岛)一起构成了一个陆块,即北巴拉望断块,它位于岛弧-大洋构造背景之内。这些地区的二叠纪到早第三纪岩石反映了这个断块具有与菲律宾群岛其余部分截然不同的地质成因和历史。这些岩石还表明,北巴拉望断块在漂移前一度曾处于同华南陆地相邻的位置上。在中国大陆的沿岸和岸外地区,以及在台湾和北巴拉望断块,识别出了四个明显的晚第三纪以前的区域性不整合。这些不整合的同时性以及不整合沉积单元的岩相关系有力地表明,所有这些地区都具有一部共同的晚第三纪以前的历史。相反,在整个巴拉望地区出现于中中新统顶部的一个重要区域不整合在亚洲陆地却完全缺失。自中生代以来分隔北巴拉望断块和亚洲大陆的南中国海盆地的引张作用,从西到东大体是一致的。然而,有明显的证据表明,这种引张作用是由间隔短暂的大陆地壳减薄阶段和近代海底扩张阶段造成的。根据先前的观察,並利用南中国海最新的扩张磁异常资料,编绘出了一套复原图,它们展示了南中国海从晚三叠世到上新世的演化。这些复原图说明:(1)在体罗纪和白垩纪的大部分时期内,北巴拉望断块位于会聚大陆边缘的背景内;(2)菲律宾岛弧系开始形成于晚白垩世;(3)后来从晚始新世起,该弧系发生了逆时针转动;(4)古新世到中中新世,南中国海张开;(5)早到中中新世,在北巴拉望断块和巴拉望俯冲系之间发生了碰撞。

关键词：巴拉望不整合地质构造断块晚第三纪南中国海亚洲大陆

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惰性气体化学的二十五年

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世界科学 1988年第3期 16-19页

作者： John h.holloway 许明李平定

今年我们庆祝了惰性气体化学发现的第二十五周年。这一发现动摇了一个延续了近七十年的信念,那就是,“惰性气体”家族的成员中,没有一个能够生成在热力学上稳定的化合物。至今,四分之一世纪过去了,对这一领域的起源,发展以及更值得引起... 详细信息

今年我们庆祝了惰性气体化学发现的第二十五周年。这一发现动摇了一个延续了近七十年的信念,那就是,“惰性气体”家族的成员中,没有一个能够生成在热力学上稳定的化合物。至今,四分之一世纪过去了,对这一领域的起源,发展以及更值得引起注意的最新进展作一回顾是适宜的。

关键词：氟化物 XeF 卤化物化合物氟化学无机化学正离子阳离子

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