Biomedical subjects

S Anuras

Publications and source records attributed to S Anuras.

At least 37 records · Page 2Linked to original sources

PubMed1984

Anorectal manometry in healthy elderly subjects.

Sigmoidal, rectal, and anal functions were studied in ten healthy elderly women and ten healthy young women using a motility probe with three intraluminal transducers. No difference (P greater than 0.05) was found between elderly and young women in measurements of anal length, anal resting tone, anal squeeze pressure, anal pullthrough pressures at rest, and voluntary squeeze. Sigmoidal and rectal distention was produced by injecting air into balloons placed 16-17 cm and 6-7 cm above the anal verge, respectively. Measured values of anal responses to sigmoidal and rectal distention, and sensation and elasticity of the sigmoidal and rectal walls, were also not different (P greater than 0.05) between the two groups. These findings suggest that age does not affect sigmoidal, rectal, and anal functions.

Adult↗

PubMed1984

Small intestinal manometry in healthy elderly subjects.

Small intestinal manometry was performed on ten healthy elderly subjects (mean age, 72 years) and ten healthy young-adult subjects (mean age 25 years). All three phases of the migrating motor complex were observed in both groups during fasting. There were no differences in the motility index between the two groups, the frequency and the mean amplitude of contractions of phases 2 and 3, or the duration and the velocity of propagation of phase 3. After a meal the motility index and the frequency of contractions were significantly lower (P less than 0.05) in the elderly group. The results suggest that intestinal motility after a meal is less in the elderly than in young adults.

Adult↗

PubMed1984

Colonic pseudoobstruction.

Isolated colonic pseudoobstruction can occur in two forms, acute and chronic. Acute colonic pseudoobstruction is a transient problem that is usually associated with systemic illnesses. Chronic colonic pseudoobstruction usually recurs or persists. It may occur with or without underlying systemic diseases. Clinical manifestation and treatment of each form is different. Therefore, these two syndromes should be dealt with differently.

Cathartics↗

PubMed1984

Small intestinal motility in myotonic dystrophy patients.

We performed jejunal manometric studies on 10 myotonic dystrophy patients who had symptoms of disordered gastrointestinal motility. Reduced peristalsis of the duodenum and proximal jejunum was noted in 1 patient who had an upper gastrointestinal series, but the small bowel was radiographically normal in 8 other patients. None of the myotonic dystrophy patients had a normal jejunal manometry. The abnormalities included low amplitude contractions during phases 2 and 3 of the migrating motor complex and after eating, as well as a higher frequency of contractions during phase 2. Retrograde propagation of phase 3 occurred in 2 patients, and interruption of contractions during phase 3 occurred in 4 patients. The incidence of tonic contractions was also higher in myotonic dystrophy patients. We conclude that (a) abnormal small intestinal motility is common in patients with myotonic dystrophy and (b) jejunal manometry is more sensitive than barium radiographic studies in detecting small intestinal motility abnormalities in this disorder.

Adolescent↗

PubMed1984

Natural history of adult Hirschsprung's disease.

The natural history of adult Hirschsprung's disease was reviewed in 22 patients (four from our hospital and 18 from the literature). The diagnosis in nearly half the patients was made before age 30, and the oldest patients were 69 years of age. Male to female ratio was 4:1. Almost all patients had severe constipation since birth. Barium enema showed rectal narrowing in 77%, and colonic dilation in 100%. Anorectal manometry was performed in only four patients; three showed no relaxation with rectal distention. In all patients, rectal biopsy showed no ganglion cells. Appropriate operation for Hirschsprung's disease improved symptoms in over 80% of patients. Hirschsprung's disease should be considered in all adult patients who have had severe constipation since birth, especially if they are male.

Adult↗

PubMed1983

Chronic esophagitis in two sisters.

Two sisters developed symptoms of gastroesophageal reflux and gastric stasis during adolescence. Both developed severe erosive esophagitis and epithelial hyperplasia of the esophagus before 35 years of age. Both had a hiatal hernia, and esophageal motor function was poor in both. One of the sisters had also a peptic stricture of the esophagus, the other one a gastric bezoar. Jejunal motility was normal in both. Among 28 close family members surveyed, seven additional individuals out of three generations had frequent and severe reflux symptoms since adolescence. It is unlikely that the occurrence of chronic esophagitis at such young age in the two sisters is mere coincidence. It is conceivable that the two sisters and their family shared a defect similar to the one that has previously been made responsible for the familial occurrence of hiatal hernias and Barrett's esophagus.

Adult↗

PubMed1983

Inherited ophthalmoplegia with intestinal pseudo-obstruction.

A new inherited neuromuscular disease was identified in 4 patients (1 male, 3 females), offspring of consanguineous marriages, belonging to the same kindred. The proband was a 24-year-old female with history of ptosis and ophthalmoplegia since childhood and progressive intestinal pseudo-obstruction for the last 4 years of her life. A sural nerve biopsy showed axonal and demyelinating neuropathy. Muscle biopsies of pectoral and gastrocnemius revealed myopathic alterations with marked variation in muscle fiber size, atrophy of both fiber types and normal mitochondria. An upper gastrointestinal study showed barium in the stomach after 8 h and jejunal diverticula. Tests for absorption of fat, protein, carbohydrate, folic acid and vitamin B12 were normal. Serum levels of vitamin A and lipoproteins were also normal. The patient underwent partial gastrectomy and gastrojejunostomy. Postoperatively, she developed severe pancreatitis, sepsis, peritonitis and expired. Tissue samples from the proband and from her brother, revealed normal mucosa, but degeneration of smooth muscle of the stomach and small intestine. The myenteric plexus and vagus nerves were normal. The biochemical studies of contractile proteins (myosin, actin, tropomyosin) in the fresh and cultured smooth muscle cells of the proband obtained at the time of gastrectomy showed a 50-75% decrease in the synthesis of different contractile proteins. Turnover of contractile proteins and synthesis and turnover of collagen showed normal values. The reduction in synthesis of contractile proteins may account for the weak peristalsis and be a factor in the pathogenesis of the intestinal pseudo-obstruction.

Adult↗

PubMed1983

A familial visceral myopathy with external ophthalmoplegia and autosomal recessive transmission.

A new visceral myopathy family was identified. The disease in this family is transmitted by an autosomal recessive gene. Only 3 patients were identified from approximately 1500 family members. All 3 patients are the products of intermarriage. The patients had gastric atony, dilatation of the entire small bowel, and multiple diverticula throughout. Pathology of the jejunum showed fibrosis and degeneration, mainly of the longitudinal muscle layer, indistinguishable from that of previously reported families. Two of the patients also had ptosis and external ophthalmoplegia. Jejunal manometric studies were performed on the proband's asymptomatic mother and five siblings. All had normal esophageal manometric studies and upper gastrointestinal x-rays. The mother and three siblings had abnormal jejunal manometric studies characterized by the absence of phase 1 in some of the migrating motor complexes and increased motility indices in phase 2. We conclude that familial visceral myopathy can be transmitted by an autosomal recessive gene, and that jejunal manometry is a sensitive technique to identify asymptomatic heterozygotes.

Adult↗

PubMed1983

Jejunal manometry patterns in health, partial intestinal obstruction, and pseudoobstruction.

The purpose of this study was to determine the utility of jejunal manometry in evaluating patients having partial small intestinal obstruction or the pseudoobstruction syndrome. We studied 10 healthy volunteers, 9 patients with documented mechanical obstruction, and 3 patients with chronic intestinal pseudoobstruction during fasting and for 2 h after a 650-kcal meal. Contractile activity, especially during phase 2, was extremely variable in all individuals studied. After the meal, the most striking finding in mechanical obstruction was the regular occurrence of clustered contractions. These were defined as 3-10 regular contractions, occurring 1 per 5 s, preceded and followed by at least 1 min of absent motor activity. The associated periods of quiescent motor activity may account for the unexpectedly reduced frequency and motility index in obstructed patients compared with normal subjects after the meal. Two different contractile patterns occurred in patients with pseudoobstruction. Before and after the meal, infrequent and low-amplitude contractions occurred in 2 patients, and multiple, aborally migrating, clustered contractions occurred in the other patient with pseudoobstruction. Manometric abnormalities occur in both mechanical obstruction and pseudoobstruction. However, the technique is probably not more sensitive than radiologic procedures, and the abnormalities that are detected by manometry are not specific. Some of the same motility changes occurred in both disorders.

Adult↗

PubMed1983

Effects of a meal on the motility of the sigmoid colon and rectum in healthy adults.

Motility in the sigmoid and rectal areas was studied before, during, and after a 900-cal meal in 11 healthy subjects. A Honeywell esophageal pressure transducer with three transducers was used for the recording. A 900-cal meal significantly stimulated colonic motility during eating. The frequency of contractions was responsible for this increase while the amplitude of the contractions remained the same. Colonic motility returned to fasting levels immediately after the meal. Recording periods of 30 min were not capable of distinguishing individual variations in colonic motility because of long periods of inactivity but were adequate when groups of subjects were compared. Body position did not affect colonic motility. These studies suggest that a meal stimulates sigmoid and rectal motility in healthy subjects, but only during the consumption of the meal.

Adult↗

PubMed1982

Pathologic features of familial visceral myopathy.

Familial visceral myopathy is the most common cause of chronic primary (idiopathic) intestinal pseudo-obstruction. We studied four family groups with this disease and found that it has a characteristic morphologic appearance. Grossly, there is segmental dilatation of the alimentary tract, often involving multiple sites and most commonly producing a megaduodenum. Microscopically, the involved areas show a characteristic change consisting of degenerating muscle cells and fibrosis, which may involve the full thickness of the muscularis propria but is often more prominent in or limited to the external layer. Degenerating muscle cells appear pale, poorly defined, and fragmented. As residual thread-like remnants become surrounded by collagen or as muscle cells are destroyed, leaving apparent spaces surrounded by collagen, the longitudinal and circular muscles take on a vacuolated appearance easily recognized at low magnifications. Recognition of this change is greatly facilitated by use of a trichrome stain, and mild lesions may be recognized only with such stains. The nondilated segments of intestine show similar changes but of a less severe degree. Neural and vascular structures are apparently normal. Although the lesion most closely resembles progressive systemic sclerosis, the degenerating muscle cells and vacuolated appearance of the muscle serve to distinguish familial visceral myopathy from the latter entity.

Adolescent↗

PubMed1982

Cardiac arrest in two children with nonfamilial chronic intestinal pseudoobstruction on total parenteral nutrition.

Two children with nonfamilial chronic intestinal pseudoobstruction are reported. Both had no family history. They had an exploratory laparotomy to rule out mechanical intestinal obstruction, and required long-term parenteral nutrition to obtain sufficient nutrients. These two children had dilatation of the whole length of the small intestine, which differs from short segmental dilatation (megaduodenum) in patients with familial chronic intestinal pseudoobstruction. There were also differences in the histology of the gastrointestinal tract between these two patients although they had similar clinical manifestations. Both patients died from cardiac arrest, one after 2 years and the other after 4 months on long-term parenteral hyperalimentation. At autopsy, heart examination was normal in one patient, and a small infarction (0.4 mm diameter) was found in the other. Although mild hypokalemia was found in one case, and mild hyperkalemia in the other, the cause of cardiac arrest in these two children is not known.

Adolescent↗

PubMed1982

cAMP and calcium in generation of slow waves in cat colon.

Rhythmic oscillations in interactions between cAMP and calcium have been proposed to account for a variety of rhythmic phenomena in cells. This idea was investigated in relation to the rhythmic signals (electrical slow waves) found in the electromyogram of the cat colon. A longitudinal strip of muscularis propria from cat colon was studied in a superfusion bath that allowed recording of the electromyogram from eight sites that were 2 cm apart. The effect of increasing cAMP (by exposure of the tissue to cAMP, dibutyryl cAMP, isobutylmethylxanthine, theophylline, caffeine, and papaverine) was to reduce frequency and amplitude of slow waves and duration of migrating spike bursts. All these maneuvers raised tissue cAMP levels. Dibutyryl cGMP and cGMP had no effect. THe changes in slow waves, but not migrating spike bursts, seen with raised cAMP levels were partly reversed by raising the calcium concentration in the extracellular fluid. Raising the extracellular sodium and potassium concentrations had no effect. The results are consistent with the hypothesis that interactions between cAMP and calcium are involved in slow-wave generation in colon muscle.

1-Methyl-3-isobutylxanthine↗

PubMed1982

Responsiveness of longitudinal and circular muscle layers of the portal vein.

This study was performed to compare mechanical activity produced by acetylcholine and histamine in longitudinal and circular muscle layers of the portal vein. Peak tension was measured in longitudinal and circular muscle strips from portal veins of rabbits as they were superfused with acetylcholine and histamine (10(-6) to 10(-4) M). Responses to acetylcholine were three to four times greater in longitudinal muscle than in circular muscle; for example, acetylcholine (10(-5) M) produced contractions of 1.6 +/- 0.2 X 10(3) (mean +/- SE) dynes in longitudinal muscle and 0.4 +/- 0.09 X 10(3) dynes in circular muscle. In the same strips, histamine produced similar responses in the two layers: histamine (10(-5) M) produced contractions of 0.4 +/- 0.1 X 10(3) dynes in longitudinal and 0.4 +/- 0.1 X 10(3) dynes in circular muscle. Histological studies of portal vein muscle strips showed that the longitudinal muscle layer is three to four times thicker than the circular muscle layer. Thus, in response to acetylcholine, tension developed in each muscle layer is proportional to the thickness of that layer. In response to histamine, however, longitudinal muscle develops less tension than is predicted by the thickness of the muscle layer. We conclude that longitudinal and circular muscle layers of the rabbit portal vein differ in their responsiveness to histamine.

Acetylcholine↗

PubMed1982

Gastrointestinal manifestations of the muscular dystrophies.

Skeletal and cardiac muscle involvement is a recognized feature of the muscular dystrophies. Visceral smooth muscle involvement of the gastrointestinal tract is not as well appreciated. Gastrointestinal symptoms may herald the onset of a muscular disorder and may be the predominant feature of the disorder. In some instances, smooth muscle dysfunction may be the only clinical manifestation of the disease. The gastrointestinal manifestations of the various muscular dystrophies are reviewed. Clinical, radiographic, and histologic features are discussed. Further study of the histopathology and pathophysiology of visceral smooth muscle involvement in the muscular dystrophies will have a substantial impact on treatment that, to a large extent, remains empiric.

Adolescent↗

PubMed1981

Effects of autonomic drugs on cat colonic muscle.

The cat colon was divided in vitro into four equal segments, and one transverse and one longitudinal strip (1.5 cm x 2.5 mm) was taken from each. Transverse strips contracted rhythmically, each strip generating 0.9-1.2 g force. Longitudinal strips contracted irregularly, each strip generating 11.9-16.8 g force. Acetylcholine (10(-7) to 10(-5) M) and physostigmine (10(-8) to 10(-5) M) increased frequencies in longitudinal (P less than 0.05) but not in transverse strips (P greater than 0.05) and increased amplitudes in both (P less than 0.05). Atropine (10(-8) to 10(-6) M) reduced frequencies and amplitudes in longitudinal strips (P less than 0.05) but only amplitudes in transverse strips (P less than 0.05). Phenylephrine (10(-7) to 10(-5) M) and norepinephrine (10(-7) to 10(-5) M) increased amplitudes in transverse strips (P less than 0.05) but decreased frequencies and amplitudes in longitudinal strips (P less than 0.05). Isoproterenol (10(-7) to 10(-5) M) decreased frequencies an amplitudes in both transverse and longitudinal strips (P less than 0.05). Dopamine (10(-7) to 10(-5) M) decreased amplitudes in longitudinal strips (P less than 0.05). Tetrodotoxin (10(-7) M increased amplitudes in transverse (P less than 0.05) but not in longitudinal strips (P greater than 0.05). Both layers are affected by cholinergic and adrenergic drugs. Muscarinic receptors are excitatory in both. alpha-Adrenergic stimulations result in excitation in circular muscle and inhibition in longitudinal muscle. Circular muscle is dominated by an inhibitory neural tone.

Animals↗

PubMed1981

The familial syndromes of intestinal pseudoobstruction.

Ten reported families with chronic intestinal pseudoobstruction were reviewed. Although clinical manifestations and gastrointestinal contrast roentgenograms are similar in these families, the pathology and inheritance are quite different. Five families have degeneration and fibrosis of the gastrointestinal tract and urinary bladder, three have normal intestinal morphology, and one has degeneration of the myenteric plexus throughout the gastrointestinal tract. Four families are consistent with dominant inheritance, three are consistent with X-linked dominant transmission, and three are compatible with recessive inheritance. Patients in these families have a wide spectrum and degree of chronic and/or intermittent gastrointestinal symptoms. As many as 20% of the family cases discovered are asymptomatic. Operative procedures to drain or resect short dilated intestinal segments may help to relieve symptoms.

Female↗

PubMed1981

Radiation-induced recurrent intestinal pseudo-obstruction.

The syndrome of intestinal pseudo-obstruction is a complex of signs and symptoms of intestinal obstruction without evidence of mechanical obstruction of the intestinal lumen. A patient with radiation-induced intestinal pseudoobstruction is described. The patient is a 74-year old woman with a history of chronic diarrhea, recurrent episodes of crampy abdominal pain, nausea and vomiting since receiving a 13,000 rad radiation dose to the pelvis in 1954. She has been hospitalized on many occasions for symptoms and signs of bowel obstruction. Upper gastrointestinal contrast roentgenograms with small bowel follow-through done during these episodes revealed multiple dilated loops of small bowel with no obstructing lesion. Barium enemas revealed no obstructing lesion. Each episode resolved with conservative therapy. Other secondary causes for intestinal pseudo-obstruction were ruled out in our patient. She gave no history of familial gastrointestinal disorders. Although postirradiation motility abnormalities have been demonstrated experimentally this is the first report of radiation induced intestinal pseudo-obstruction.

Aged↗