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Biomedical subjects

A Morelli

Publications and source records attributed to A Morelli.

At least 163 records · Page 9Linked to original sources
PubMed1994

Effect of erythromycin administration on upper gastrointestinal motility in scleroderma patients.

BACKGROUND: Gastrointestinal involvement is frequent in patients with scleroderma. Erythromycin, a macrolide antibiotic, has been shown to accelerate gastric emptying in normal subjects and diabetic patients. The present study investigated the effects of acute erythromycin administration on gastric and gallbladder motility in patients with scleroderma and gastrointestinal involvement. METHODS: Twelve scleroderma patients and 14 healthy subjects were investigated. Each subject was investigated on 4 different days. Gastric and gallbladder emptying and gastric motility were determined by sonography and manometry, and the effect of 2 mg/kg/h erythromycin in fasted patients or after semisolid meal evaluated. RESULTS: The half-time of gastric emptying in response to semisolid meal was 121.3 +/- 14.0 min (SE) in scleroderma patients and 45.7 +/- 10.4 min in healthy subjects (P < 0.01). The peak of gallbladder emptying occurred later in scleroderma patients (95.0 +/- 5.0 min) than in healthy subjects (45.0 +/- 8.0 min) (P < 0.01). Erythromycin stimulated gastric and gallbladder motility in fasted subjects, as shown by manometry and sonography, and accelerated gastric and gallbladder emptying when administered immediately before the meal (P < 0.01). CONCLUSIONS: Erythromycin accelerates gastric and gallbladder emptying in scleroderma patients and might be helpful in the treatment of gastrointestinal motor abnormalities in these patients.

Adult↗
PubMed1994

Analysis of hepatitis B surface antigen expression on leucocyte subpopulations by two-color fluorescence with flow cytometry.

We have analyzed the expression of HBsAg on different subpopulations of peripheral blood cells from hepatitis B virus (HBV) infected patients using two-color immunofluorescence and flow cytometry. An average of 7.4 +/- 0.8% and 9.8 +/- 1.2% HBsAg + cells were found among cells from acute and chronic hepatitis B patients, respectively. When studied by two-color immunofluorescence, HBsAg was limited to cells expressing the B-cell restricted antigen CD19 (16.7 +/- 2.4%), whereas for the other subsets studied (CD3+, CD4+, CD8+, CD67+, CD68+) the percentage of positivity was lower than 4%. The expression of viral antigen on B cells might be relevant for a number of functional interactions between HBsAg+ B and T lymphocytes.

Acute Disease↗
PubMed1994

[Monitoring of antithrombin III in general surgery].

The authors studied the effects of surgery on hemocoagulation parameters (PT, PTT, PLT, Fibrinogen, AT III). 30 patients, undergoing extrahepatic surgery were observed. Measurements were performed before, during and immediately after procedure, and 24 hs and 48 hs later. Results showed a significant drop of AT III activity (p < 0.05) throughout the surgical procedure with a prompt reversal to normal values right after the end of it. Fibrinogen values continuously increased from the end of surgery (compared to intra-op values) (p < 0.05) up to 48 hs (p < 0.01). PTT values decreased at the end of surgery (p < 0.05) and returned to normal during the following 24 hs. No thromboembolic and hemorrhagic complications were observed during the postoperative phase, with all patients being discharged after surgical resolution of pathologies. In conclusion accurate monitoring of hemocoagulation parameters (especially AT III) seems to be useful in order to prevent thromboembolic and/or hemorrhagic complications during and after surgery.

Adult↗
PubMed1994

False positive EBNA IgM and IgG antibody tests for infectious mononucleosis in children.

OBJECTIVES: To assess the reliability of the Monolert test, a new enzyme-linked immunosorbent assay for the diagnosis of acute infectious mononucleosis (IM). DESIGN: A retrospective laboratory and clinical analysis of 38 children diagnosed with acute IM. SETTING: A suburban pediatric practice in Connecticut. PATIENTS: Thirty-eight children (ages 18 months to 17 years) who were diagnosed with acute IM using the Monolert test during the period October 1992 to August 1993. RESULTS: Eighty-three percent of these children had no evidence of Epstein-Barr virus infection on subsequent investigation. The false positive results of the Monolert test could not be explained on the basis of elevated antibody titers to either cytomegalovirus or Borrelia burgdorferi. CONCLUSION: Monolert is a poor screening test and is of little apparent value as a diagnostic test for acute Epstein-Barr virus infection in pediatric patients.

Acute Disease↗
PubMed1994

[Diagnosis and treatment of intrauterine pregnancy associated with tubal pregnancy. Description of a clinical case].

Description of a clinical case. In the last decade we have witnessed an increase in both ectopic and twin pregnancies. These events have various causes, such as PID, tubal plastic surgery, the use of agents for the induction of ovulation and many others. The number of intra- and extra-associated pregnancies (phenomenon that was considered quite rare in the past) has also been increasing. A medical case that has come under our observation is being discussed. A woman patient arrived in our ward with typical symptomatology of threatened abortion at the 8th week of amenorrhea. The echographic test showed an intra-uterine pregnancy in regular progress associated with right latero uterine tumefaction. The Douglas cavum was full of liquid of probable hematic nature. The promptly performed laparoscopy confirmed the suspicion of intra and extra uterine associated pregnancy. The consequent right adnexectomy through laparotomy led to the solution of the case.

Adult↗
PubMed1994

Effect of erythromycin on gastric and gallbladder emptying and gastrointestinal symptoms in scleroderma patients is maintained medium term.

OBJECTIVES: Scleroderma patients frequently present esophageal and gastric emptying abnormalities and small bowel dysfunction. Erythromycin, a macrolide antibiotic, has been found to accelerate gastric and gallbladder emptying in both healthy subjects and diabetic patients. Our objective was to investigate the effects of 4-wk oral erythromycin administration on the gastric and gallbladder emptying, gastrointestinal symptoms (early satiety, abdominal pain, nausea, bloating, vomiting, and constipation), and motilin plasma levels of patients with scleroderma. METHODS: 12 scleroderma patients were investigated before and after 4-wk treatment with 250 mg oral erythromycin three times a day. The effect of a single i.v. dose of 2 mg/kg/h erythromycin on gastric and gallbladder emptying before starting the oral treatment was also evaluated. Gastric and gallbladder emptying after a solid meal were evaluated by sonography. RESULTS: Single i.v. administration of erythromycin before the meal reduced gastric emptying T1/2 from 121.3 +/- 14.0 to 45.5 +/- 7.3 min (p < 0.01) and accelerated gallbladder emptying without affecting the peak. Four-week oral administration of erythromycin reduced gastric emptying T1/2 from 121.3 +/- 14.0 min to 46.5 +/- 8.3 min (p < 0.01). Peak gallbladder emptying was also significantly accelerated, while total emptying remained unchanged (p < 0.01). Furthermore, 4-wk erythromycin administration reduced both motilin plasma levels (from 223.4 +/- 53.8 to 145.4 +/- 67.2 pmol/L, p < 0.01) and symptoms of nausea, vomiting, and abdominal pain (p < 0.01), and increased bowel movements in a subset of scleroderma patients with intestinal pseudo-obstruction. CONCLUSIONS: Erythromycin stimulates gastrointestinal motility in patients with scleroderma. Administered medium-term, it accelerates gastric and gallbladder emptying and alleviates gastrointestinal symptoms.

Drug Administration Schedule↗
PubMed1993

Brush-border-enzyme-mediated intestine-specific drug delivery. Amino acid prodrugs of 5-aminosalicylic acid.

5-Aminosalicylic acid (5-ASA) is the active principle of a number of preparations aimed at the treatment of inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, but its efficacy is limited by early absorption and metabolism. The possibility to exploit the selective hydrolytic activity of brush border enzymes such as aminopeptidase A and carboxypeptidases was studied by preparing the following four amino acid prodrugs of 5-ASA: 5-(N-L-aspartylamino)-2-salicylic acid, disodium salt (18), 5-(N-L-glutamylamino)-2-salicylic acid, disodium salt (19), [(5-aminosalicyl)-L-prolyl]-L-leucine, sodium salt (25), and [[5-(N-L-glutamylamino)salicyl]-L-prolyl]-L-leucine, disodium salt (28). In these compounds, the peptide bond is selectively split by the intestinal brush border aminopeptidase A (compounds 18, 19, and 28) and carboxypeptidases (compounds 25 and 28).

Amino Acids↗
PubMed1993

Impaired colonic motor response to cholinergic stimulation in patients with severe chronic idiopathic (slow transit type) constipation.

Chronic idiopathic constipation, especially the slow transit type, is a troubling problem often afflicting young women. The pathophysiological basis for this entity is unknown, although a defective cholinergic innervation has been postulated. We tested the hypothesis that cholinergic colonic innervation is deranged in this condition by studying colonic motor activity after strong cholinergic stimulation with edrophonium chloride in 14 women complaining of slow transit constipation. Unlike healthy subjects, constipated patients showed minimal or no response to edrophonium injection. It is concluded that in slow transit constipation there is an important alteration of colonic cholinergic activity and that edrophonium chloride may represent a useful test drug for colonic pathophysiological investigations.

Adult↗
PubMed1993

5-hydroxytryptamine 3-receptor antagonist modulates gallbladder emptying and motilin release induced by erythromycin.

In the present study we evaluated the effect of ondansetron (formerly indicated as GR38032F), a potent and selective type-3 5-hydroxytryptamine receptor antagonist, on erythromycin-induced gallbladder emptying and motilin release, as well as gallbladder emptying induced by a regular meal in healthy volunteers. Gallbladder emptying was evaluated by sonography. Ondansetron, at the dose of 0.05 mg/kg, significantly reduced (P < 0.001 by ANOVA) the gallbladder emptying induced by 2 mg/kg/hr erythromycin, but did not increase basal gallbladder volume or inhibit gallbladder emptying induced by a regular meal. Ondansetron also inhibited the motilin release induced by erythromycin (P < 0.001, by ANOVA). These results suggest that serotoninergic mechanisms modulate the effects of erythromycin on the gastrointestinal tract. The exact site of action of ondansetron remains to be identified.

Adult↗
PubMed1993

Motilin and erythromycin stimulate pepsinogen secretion by chief cells isolated from guinea pig stomach.

BACKGROUND: Motilin and erythromycin bind the same receptor in the gastrointestinal muscle cells. Motilin stimulates pepsinogen secretion in humans and dogs. However, it is unclear whether it acts directly on gastric chief cells or via other neurotransmitters. METHODS: Isolated gastric chief cells were obtained from guinea pig stomach by collagenase digestion and calcium chelation with ethylene glycol-bis(B-amynomethyl ether)-N,N,N',N'-tetraacetic acid. RESULTS: Significant stimulation of pespinogen secretion induced by motilin occurred at 1 pmol/L, half maximum at 10 pmol/L, and maximum at 100 pmol/L. Erythromycin caused significant stimulation at 1 pmol/L, half maximum at 100 pmol/L, and maximum at 1 nmol/L. Atropine (1 mumol/L) had no effect on either motilin- or erythromycin-induced pepsinogen secretion. Motilin and erythromycin determined a threefold increase in the intracellular calcium concentrations. Pretreatment of isolated chief cells with motilin and erythromycin induced a reversible, dose- and time-dependent desensitization of the pepsinogen secretion stimulated by carbachol and cholecystokinin but not that stimulated by secretin, vasoactive intestinal peptide, or prostaglandin E2. CONCLUSIONS: Motilin and erythromycin directly stimulate pepsinogen secretion in isolated chief cells.

Animals↗
PubMed1993

Biochemical characterization of a phosphatidylinositol 4,5-bisphosphate-specific phospholipase C activity in gills and digestive gland of the marine mussel Mytilus galloprovincialis Lam.

1. Polyphosphoinositide-specific phosphodiesterase (phospholipase C, PLC) activity against phosphatidylinositol 4,5-bisphosphate, present in gill and digestive gland homogenates of mussel (Mytilus galloprovincialis Lam.), has been biochemically characterized. 2. The enzyme was strictly modulated by free calcium ion concentration in both tissues and maximally activated at 10(-5) M Ca2+ (19 +/- 4 and 11 +/- 2 nmol phosphatidylinositol 4,5-bisphosphate hydrolysed/min/mg of protein for gill and digestive gland PLC, respectively, at 19 degrees C). Optimum pH at 10(-5) M Ca2+ was around 7.0 in both cases. The Ca(2+)-stimulated PLC activity showed high specificity for PIP2; the KMa for PIP2 were 150 and 170 microM for the gills and digestive gland, respectively. 3. Good substrate dispersion was obtained in the presence of sodium deoxycholate; the concentration routinely used in the assay (0.08%) produced a 9-fold activation of both gill and digestive gland PLC, consistent with previous reports. 4. The possible biochemical and physiological role of the enzyme in mussel tissues is discussed.

Animals↗
PubMed1993

Ultrastructural analysis of Drosophila ovarian follicles differing in yolk polypeptide (yps) composition.

Drosophila ovarian follicles were examined ultrastructurally to study the vesicular traffic in the cortical ooplasm. The endocytic pathway leading to the production of yolk spheres was visualized following in vivo or in vitro exposure to peroxidase. The Golgi apparatus and the yolk spheres of wild-type ovarian follicles were preferentially labelled by fixation with osmium zinc iodide (OZI). Labelling of wild-type ovarian follicles was compared to that of several mutant follicles--L186/Basc, fs(2)A17 and ap4--which are defective in vitellogenesis. In these mutants, the Golgi apparatus and the vesicles nearby were either scantly labelled or not labelled at all. In oocytes from flies homozygous for the gene fs(1)1163, the Golgi apparatus was labelled as in the controls, but no yolk spheres appeared to be labelled with OZI at any of the developmental stages. In several Drosophila strains, the pattern of OZI label in the cortical ooplasm was seen to vary in relation to the number of yp structural genes. In starved Drosophila females, OZI labelling of the cortical ooplasm appeared restricted to the Golgi apparatus and to an extended tubular network. A similar labelling pattern was also detected in in vitro cultured vitellogenic follicles. Refeeding, topical application of juvenile hormone analogue to starved females or hormone addition to the culture medium, all caused the yolk spheres to become labelled with OZI and to incorporate peroxidase. These observations prove that impairing endocytic uptake by either mutation or lack of juvenile hormone prevents fusion of coated vesicles and tubules with the yolk spheres and leads them instead to form an intermediate cell compartment with Golgi-derived vesicles.

Animals↗
PubMed1993

Enterocytozoon bieneusi detection in a patient with human immunodeficiency virus infection and chronic diarrhoea: response to albendazole treatment.

Diarrhoea is a common symptom among HIV-infected subjects. An infective cause is often missed. However, more recent knowledge about pathogens has led to the identification of newly recognized unusual microorganisms, such as Microsporidia. We report a case of infestation with these agents in an HIV-infected subject with chronic diarrhoea.

AIDS-Related Opportunistic Infections↗
PubMed1993

Hydrogen breath test and scintigraphic gastrocolic transit time in diabetics with autonomic neuropathy.

We assessed gastrocolic transit time in 10 diabetic patients with autonomic neuropathy and 10 healthy age-matched controls by measuring breath hydrogen rise and scintigraphic bolus progression after ingestion of an isosmotic lactulose solution containing 99m-Tc-diethylentriamine-pentaacetic acid. Mean transit time in diabetics with autonomic neuropathy was significantly slower with respect to controls, with a good correlation between the two techniques. Moreover, diabetics had a significantly shorter discharge time (defined as the period that elapses between the arrival of the meal into the cecum and the hydrogen increase in the expired air). It is concluded that the selective lipid malabsorption seen in diabetic patients could be the result of cecal-ileal reflux, as a contaminating consequence of the last ileal loop. A possible motor innervation defect of the ileo-cecal valve is postulated in these subjects.

Adult↗
PubMed1993

Adenocarcinoma of the duodenal bulb in a young coeliac woman.

Coeliac sprue patients display an increased frequency of malignant neoplasms of the gastrointestinal tract. These neoplasms are chiefly represented by lymphomas, occurring in patients over 50. We describe the onset of a duodenal adenocarcinoma in a young woman with coeliac disease and discuss the unusual features of this case.

Adenocarcinoma↗
PubMed1992

Oral bile acid treatment and the patient with Zellweger syndrome.

The cerebrohepatorenal syndrome of Zellweger is a congenital syndrome of multiple manifestations, including hepatomegaly and liver dysfunction. Treatment is generally of a supportive nature, aimed at improving nutrition and growth, controlling the central nervous system symptoms and limiting progression of liver disease. Because the liver disease in Zellweger syndrome may be attributed to an overproduction and accumulation of cholestanoic acids, exacerbated by diminished primary bile acid synthesis, we hypothesized that primary bile acid administration would be beneficial in improving liver function by a mechanism involving down-regulation in the synthesis of these atypical bile acids. We report here the clinical and biochemical responses to primary bile acid administration in a 2-mo-old boy who was seen with the typical signs of Zellweger syndrome. Liver disease was evident from hepatomegaly and elevated serum liver enzymes and bilirubin. The diagnosis was supported by markedly elevated serum very long chain fatty acids and the bile acids dihydroxycholestanoic acid and trihydroxycholestanoic acid. Confirmation of the lack of peroxisomes was established by electron microscopy. When the patient was 6 mo old, the primary bile acids cholic acid and chenodeoxycholic acid, (100 mg each/day) were administered orally. A significant improvement in biochemical indices of liver function occurred with a normalization of the serum bilirubin and liver enzymes and a histological improvement in the extent of inflammation and bile duct proliferation and disappearance of cannalicular plugs. Serum and urinary cholestanoic acids showed a significant decrease within a few days. A striking and sustained increase in growth was observed after therapy, and an improvement in neurological symptoms was noted. In conclusion, this study indicates that primary bile acid therapy improves liver function and growth in the patient with peroxisomal dysfunction and should be considered in the supportive therapies for this condition.

Administration, Oral↗
PubMed1992

Effect of erythromycin on gallbladder emptying in diabetic patients with and without autonomic neuropathy and high levels of motilin.

A reduction of gallbladder emptying in response to neural or hormonal stimulation has been reported in patients with diabetes mellitus. Decreased gallbladder emptying may be a key factor in the pathogenesis of gallbladder stones. Few drugs, if any, are able to stimulate gallbladder emptying. However, in a previous study we demonstrated that erythromycin, a macrolide antibiotic, stimulates gallbladder emptying and motilin release in healthy human subjects by an atropine-sensitive pathway. Therefore, the present study was designed to evaluate the effect of erythromycin on gallbladder emptying and motilin release in diabetic patients with or without cardiac autonomic neuropathy (AN). Thirteen diabetic patients, six with AN, and 10 healthy subjects were enrolled in the study protocol. Gallbladder emptying was determined by sonography after ingestion of a standard meal and during infusion of erythromycin alone or together with 6 micrograms/kg/hr atropine. We found that 100 mg/hr erythromycin caused a significant reduction in gallbladder volume in both healthy subjects and diabetic patients. The ejection fraction (mean +/- SE) of 45.3 +/- 8.2% and 37.3 +/- 5.0% was similar. The presence of AN had no influence on gallbladder emptying induced by erythromycin. Basal motilin plasma levels were 111.5 +/- 14.5 pmol/liter in diabetic patients and 63.3 +/- 6.0 pmol/liter in healthy subjects (P < 0.01). However, patients with AN had higher (130.0 +/- 11.9 pmol/liter) motilin plasma levels than patients without (74.0 +/- 9.4 pmol/liter, P < 0.01). Erythromycin administration caused an approximately twofold increase in plasma motilin concentrations in healthy subject and patients without AN, but did not stimulate motilin release in neuropathic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗