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Biomedical subjects

M A Pelli

Publications and source records attributed to M A Pelli.

At least 55 records · Page 3Linked to original sources
PubMed1988

Colonic mass movements in idiopathic chronic constipation.

As relatively little is known of human colonic motor activity either in health, or in pathological conditions, we investigated mass movements in 14 chronically constipated patients and 18 healthy volunteers. Mass movements were recorded from proximal and distal colon during 24 h (12 noon-12 noon) by a colonoscopically positioned multilumen manometric probe and low compliance infusion system. Patients and controls differed significantly in the number (mean 2.6 (0.7) v 6.1 (0.9) (SE), p = 0.02) and duration (mean 8.2 (1.6) v 14.1 (0.8) s, p = 0.04) of mass movements. The data suggest that one pathophysiological mechanism of constipation may be decreased propulsive activity. A circadian pattern, with a significant difference between day and night distribution, was documented in both groups. The patients reported decreased defecatory stimulus concomitant with the mass movements.

Adult↗
PubMed1988

Oesophageal motor activity in rheumatoid arthritis: a clinical and manometric study.

Oesophageal motor function was clinically and manometrically investigated by means of a low-compliance system in 24 nonselected rheumatoid arthritis (RA) patients and 15 healthy controls. Dysphagia was referred by 37.5% of RA patients. Oesophageal motor abnormalities were discovered to be significantly present in a high percentage (62.5%) of patients with RA. However, there was no correlation between oesophageal motor abnormalities and any disease characteristic. It is concluded that a high percentage of RA patients have an oesophageal motor dysfunction, even in the absence of dysphagic symptoms.

Arthritis, Rheumatoid↗
PubMed1988

Manometric evaluation of cimetropium bromide activity in patients with the nutcracker oesophagus.

There are at present few therapeutic alternatives to calcium channel blockers for the medical treatment of patients with nutcracker oesophagus. For this reason, we evaluated by means of a low-compliance manometric system the effect of a new anticholinergic compound, cimetropium bromide (10 mg intravenously), on oesophageal variables of eight patients with nutcracker oesophagus, in a single-blind study. Eight age-matched healthy volunteers served as controls. In both patients and controls, cimetropium bromide significantly decreased lower oesophageal sphincter pressure and the distal and proximal mean contraction amplitude of the oesophageal body. Apart from an increase in pulse rate, no noteworthy side effects were observed. It is concluded that cimetropium bromide may be an effective therapeutic option in patients with nutcracker oesophagus.

Adult↗
PubMed1988

Do anticholinergics interact with histamine H2 receptor antagonists on night intragastric acidity in active duodenal ulcer patients?

The effect of administering low doses of famotidine or ranitidine alone or in combination with an M1-receptor-selective antagonist, pirenzepine, on night intragastric acidity was evaluated in 16 active duodenal ulcer patients to verify 1) whether anticholinergics and H2-antagonists have a synergic effect on inhibition of night gastric acidity, and 2) whether patients with vagal hypertone are more sensitive to anticholinergics than the remainder of the duodenal ulcer population. The endogastric pH was continuously recorded for 12 h (8 PM-8 AM) after random, single-blind administration of one of the following drug regimens: 20 mg famotidine, 150 mg ranitidine, 50 mg pirenzepine, 20 mg famotidine plus 50 mg pirenzepine, and 150 mg ranitidine plus 50 mg pirenzepine. Six patients with a basal acid output:peak acid output BAO:PAO greater than 0.3 were considered "vagal hypertone" subjects. Night gastric acidity inhibition was -39.6% with pirenzepine (p less than 0.001) and -73.7% and -71.5% with famotidine or ranitidine (p less than 0.001 vs. pirenzepine). The simultaneous administration of pirenzepine with famotidine or ranitidine provoked only a slight, insignificant increase in percent suppression, 5.1% and 6.3%, respectively, and did not modify either the time lag to onset of anti-H2 action or the duration of action. Patients with a BAO:PAO greater than 0.3 were not more sensitive to anticholinergic treatment than other duodenal ulcer patients. Our study furnishes evidence that combined administration of anti-H2 and anticholinergics is not significantly better than anti-H2 alone, in active duodenal ulcer patients.

Adult↗
PubMed1986

Colonic motility and gastric emptying in patients with irritable bowel syndrome. Effect of pretreatment with octylonium bromide.

This study was undertaken to evaluate (1) the colonic response to eating for a prolonged time in healthy subjects and patients with the irritable bowel syndrome (IBS); (2) the effect of octylonium bromide, a new smooth muscle relaxant acting by interfering with calcium ion mobilization, on the postprandial colonic motility; and (3) whether chronic gastric stasis could be responsible for both the dyspeptic symptoms often complained of by IBS patients and the faulty colonic response to eating. The colonic response to a 1000-kcal mixed meal in ten healthy subjects was characterized by two transient (from 0 to 60 and from 120 to 150 min postprandially, respectively) increases in colonic motor activity; ten IBS patients showed a continuous postprandial increase in colonic motor activity that was not terminated 180 min after eating. Treatment of IBS patients with octylonium bromide (80 mg, qid, per os) for 5-7 days reduced their colonic response to eating to a very short increase in colonic motor activity limited to the first 30 min. Finally, gastric emptying was not different in the two groups.

Adult↗
PubMed1985

Identification of muscarinic receptor subtype mediating colonic response to eating.

The colonic motor response to eating requires cholinergic transmission. Recent studies have identified two subclasses of muscarinic receptor, the M1 and the M2 subtype. The aim of this study was to evaluate the muscarinic receptor subtype responsible for mediating the gastrocolonic response. Spike potential (SP) activity and intraluminal pressure were recorded, during fasting and after eating a 1000-kcal mixed meal, from the distal colon of 10 healthy volunteers. In each subject three paired studies were carried out: either atropine (a nonselective antimuscarinic, 1 mg), pirenzepine (a selective M1 antimuscarinic, 10 mg), or saline were infused intravenously before eating, using a double-blind crossover design. The meal significantly increased colonic spike potential activity (17.6 +/- 3.9, SP/30 min) above fasting values (2.7 +/- 0.6, P less than 0.01) in the control study. There was no postprandial increase in spike potential activity (3.3 +/- 0.9, SP/30 min) after atropine. The meal also significantly increased spike potential activity (15.4 +/- 3.3 SP/30 min, P less than 0.01) above fasting levels and equal to that of the controls, in the pirenzepine study. These data suggest that the colonic motor response to eating is mediated through the M2 but not the M1 subtype of muscarinic receptors.

Adult↗
PubMed1983

Endoscopic retrograde cholangiopancreatography study in Alagille's syndrome: first report.

Endoscopic retrograde cholangiopancreatography revealed the association between intra- and extra-hepatic biliary tree hypoplasia in an 8-year-old boy affected by Alagille's syndrome. The patient, in whom chronic cholestasis had been present from birth, presented characteristic facies, retarded growth, hepatomegaly, and splenomegaly. Chromosome studies were normal. HIDA Tc 99m appeared late in the gallbladder and emptied into the bowel after 3 h. Endoscopic retrograde cholangiopancreatography showed marked and diffuse narrowing of the extrahepatic biliary ducts and uniform narrowing of the intrahepatic ducts with reduced arborization. Menghini needle biopsy revealed no interlobular ducts in the portal tracts. The last two techniques confirmed the clinical picture and made surgical diagnosis unnecessary. This is, as far as we know, the first time endoscopic retrograde cholangiopancreatography has been used in the diagnosis of Alagille's syndrome.

Bile Ducts↗
PubMed1981

The relationship between aminopyrine breath test and severity of liver disease in cirrhosis.

Twenty-two patients with cirrhosis were evaluated by the 2 hr.-(C14)-aminopyrine breath test, the conventional liver tests and two systems for grading the severity of liver disease. Twenty-three patients with noncirrhotic liver disease and 15 controls were also studied. Reduced 14CO2 values were found in 21 of the 22 cirrhotic patients and seven of those had noncirrhotic liver disease associated with severe functional reserve impairment. The values in patients with minor liver diseases or cholestasis were normal. In the cirrhotic patients 2 hr.-(C14)-aminopyrine breath test scores correlated with prothrombin time, retention of bromosulfalein, fasting serum bile acid, albumin, bilirubin, serum aspartate aminotransferase and, above all, with the scores of the two clinical rating systems. The 2 hr.-(C14)-aminopyrine breath test was superior to conventional tests in quantifying the degree of hepatic functional reserve and forecasting the prognosis.

Adult↗
PubMed1979

A double-blind, short-term clinical trial of pirenzepine in duodenal ulcer.

The effectiveness of pirenzepine in the treatment of duodenal ulcer was assessed in a double-blind clinical trial in comparison with placebo. Twenty-nine of 30 patients satisfactorily completed the trial. There was endoscopic ulcer healing in 4 of 14 pirenzepine treated patients (29%) after 2 weeks of treatment and in 11 of 14 (79%) after 6 weeks. There was no healing in 15 patients treated with placebo after 2 weeks and there were two ulcers healed after 6 weeks. The difference between pirenzepine and placebo was significant in both 2nd and 6th week. Duodenitis (evaluated by endoscopy) markedly improved in the pirenzepine grouu after 2 (4 of 9 patients) and after 6 weeks of treatment (8 of 9), while no, or only slight, improvement was observed in 8 of 8 patients in the placebo group. When evaluated by ulcer symptom relief and antacid tablet comsumption, pirenzepine proved to be considerable more efficacious than the placebo. The results of this study demonstrate that pirenzepine promoted duodenal ulcer healing, that it markedly improved peptic duodenitis and promoted rapid regression of symptomatology in parallel with endoscopic findings.

Adolescent↗
PubMed1978

[Transendoscopic retrograde cholangiography in the diagnosis of primary sclerosing cholangitis. Study of 6 cases].

Primary sclerosing cholangitis (PSC) is a rare disease of unknown etiology characterized by severe chronic inflammation, fibrosis and stenosis of variable length of the extra and/or intrahepatic biliary ducts in the absence of recent operative trauma, biliary stones, cancer or infection. Diagnosis has been made only at operation. The introduction of endoscopic retrograde cholangiography (ERC) offers the possibility of preoperative diagnosis. Six cases of PSC diagnosed by ERC are presented. Characteristic roentgenologic findings include strictures of variable length of extra and intrahepatic biliary ducts, beaded appearance and decreased arborization of intrahepatic biliary tree. The roentgenological anatomy of biliary tree at ERC influence the subsequent therapy, i.e. surgical therapy is indicated if a drainage can be performed above the site of the stenosis, while medical therapy (steroids and/or immunosuppressive drugs) is the choice when intrahepatic biliary tree is involved.

Adult↗
PubMed1978

[Evaluation of transendoscopic retrograde cholangio-pancreatography in 151 jaundiced patients].

Endoscopic retrograde cholangiopancreatography was performed for possible obstruction of the extra-hepatic bile ducts in 151 patients with jaundice. The endoscope findings (9 cases) and the retrograde cholangiopancreatogram (127 cases) provided a final diagnosis in 131 cases. A correct surgical indication was obtaines in a further 5 cases (90% diagnostic success overall). In 19 cases, unnecessary exploratory laparotomy was avoided by the demonstration of normal extrahepatic ducts. No complications were noted. It is concluded that this technique is virtually free from risks and offers prompt diagnosis in subjects with jaundice. This, of course, has a significant influence on the subsequent treatment.

Adult↗