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PubMed1997

Calcification of lumbar ligamentum flavum and facet joints capsule.

STUDY DESIGN: The incidence of calcification in ligamentum flavum and posterior capsule demonstrated by computed tomography was reviewed in a series of 147 patients in whom 419 lumbar levels were studied. OBJECTIVES: To find a relationship between mechanical lumbar pathology and the calcification of the ligamentum flavum and posterior capsule. SUMMARY OF BACKGROUND DATA: Calcification of the ligamentum flavum and posterior capsule has been found in diffuse idiopathic skeletal hyperostosis and in metabolic disorders. Although this fact is considered a manifestation of degenerative disease of the spine, it barely has been studied, and many questions remain unresolved. METHODS: Calcifications were classified according to location as follows: 1) ligamentum flavum: upper attachment, lateral or capsular extension, caudal attachment, interlaminar portion or 2) posterior capsule. RESULTS: The following statistical associations were found: 1) degenerative facet joint disease with posterior capsule and lateral or capsular extension calcifications, 2) lumbarized vertebra with lateral or capsular extension and upper attachment calcifications, and 3) isthmic spondylolisthesis with lateral or capsular extension calcification.

Adult↗
PubMed2002

SBA-positive fibers between the CD ampulla, mesenchyme, and renal capsule.

During kidney development, the CD shows two peculiarities. First, the tip of the CD ampulla is always found at a specific distance from the organ capsule. Second, the CD growth occurs as a perfectly straight elongation. It is unknown whether the CD-specific growth is dependent on hormonal action or on structural elements. Histochemical experiments on neonatal rabbit kidney yielded new insight into the interface of the CD ampulla and the surrounding nephrogenic mesenchyme. Incubation of tissue sections with soybean lectin (SBA) showed the existence of fibers extending in a radial course from the ampullar tip through the mesenchyme toward the organ capsule. SBA labeling did not colocalize with collagen type I, III, IV, V, and VI, laminin, fibronectin, and tenascin. It is assumed that while the kidney increases in volume the structural fixation of the ampullar tip by the SBA-positive fibers causes CD ampullae to maintain a constant distance from the organ capsule. The connection would explain the linear extension of the CD in relation to the organ capsule. In addition, the presented data suggest that the SBA-positive fibers between ampullar tip and organ capsule create a structural microcompartmentation of the nephrogenic zone.

Animals↗
PubMed2006

Clinical utility of wireless capsule endoscopy: experience with 200 cases.

GOALS: To evaluate the indications and diagnoses made with 200 small bowel capsule endoscopies in an academic medical center. BACKGROUND: Wireless capsule endoscopy (PillCam SB) has recently become available as a new tool in the evaluation of patients with small bowel diseases. Its impact on patient care and usefulness in clinical practice has steadily been gaining ground, yet there are few studies that evaluate large numbers of patients. METHODS: A retrospective review of wireless capsule endoscopies was performed between September 2003 and January 2005. Reviewed are the indications for the studies, number of complete and incomplete examinations, evaluation of gastric and small bowel transit times, findings made on examination, and the percent of diagnoses made and diagnoses suspected for each study indication. RESULTS: A total of 200 cases were reviewed. Indications included anemia (66% of cases), gastrointestinal hemorrhage (31% cases), abdominal pain (21% cases), diarrhea (11% cases), and other indications such as evaluation of abnormal radiographic findings or surveillance of inflammatory bowel disease (9% cases). The average patient age was 61.5 years (SD +/- 19.1 years). Males comprised 49% of patients. The wireless capsule endoscopy study completely evaluated the entire small bowel in 87% of cases. The most common cause for an incomplete examination was premature battery failure in 8% of cases. Only 9.5% of studies were normal without findings. Small bowel ulcerations were present in 38% of studies. Vascular ectasias were present in 23% of studies. Overall, a diagnosis was made in 23% of all studies, whereas a diagnosis was suspected based on the findings in an additional 31% of studies. The indication with the highest percentage of diagnoses made or suspected was gastrointestinal hemorrhage, with a diagnostic yield of 65%, followed by anemia 61%, diarrhea 36%, and pain 17%. CONCLUSIONS: Wireless capsule endoscopy is a valuable diagnostic tool in the evaluation of occult small bowel lesions, and was most effective in patients with gastrointestinal hemorrhage and anemia.

Endoscopes, Gastrointestinal↗
PubMed1978

The capsules of Corynebacterium equi and Streptococcus equi.

The capsules of Corynebacterium equi and Streptococcus equi were examined by electron microscopy after staining with ruthenium red. They were compared with the capsule of Klebsiella pneumoniae which had previously been examined using the same procedure (Springer & Roth, 1973). The capsule of C. equi had a laminated appearance. When S. equi was grown on solid medium, its capsule appeared as radially arranged projections capped by a thick electron dense layer. When grown in liquid medium, S. equi produced a capsule which showed as short thick projections with no layer external to them.

Cell Wall↗
PubMed1973

Changes in Amount of Polyphenols and Activity of Related Enzymes during Growth of Tobacco Flower and Capsule.

Developmental stages of tobacco (Nicotiana tabacum L. cv. Burley 21) flower and capsule were correlated with tissue contents of polyphenols and activities of phenylalanine ammonialyase, polyphenoloxidase, and peroxidase. Chlorogenic acid, scopolin, and scopoletin were present in most tissues, whereas rutin and two dihydroxyphenolic glycosides concentrated primarily in the corolla and placenta, respectively. Ovules contained only chlorogenic acid. As development progressed, polyphenols accounted for nearly 15% of the dry weight in the green capsule of field-grown plants. Fertilization triggered a rapid increase of chlorogenic acid in the ovary. When l-phenylalanine-U-(14)C was fed to the detached green capsules and capsule parts, an incorporation of radioactivity into chlorogenic acid and dihydroxyphenolic glycosides occurred which suggested in situ synthesis of these compounds. This was subtantiated by a positive correlation between phenylalanine ammonia-lyase activity and polyphenol accumulation. High polyphenoloxidase activity was associated mainly with the ovary, whereas peroxidase activity was maximal during senescence of all tissues. Polyacrylamide gel slab electrophoresis revealed five cathodic bands and one diffuse zone with poly-phenoloxidase activity in flower extracts. Two anodic poly-phenoloxidase isozymes appeared only in the fertilized ovary. Among 17 peroxidase isozymes, six cathodic forms were present throughout floral development, and the anodic ones increased in number and activity at the later stages of capsule growth.

Journal Article↗
PubMed1986

Hair follicle response of the golden Syrian hamster flank organ to continuous testosterone stimulation using silastic capsules.

The hamster flank organ has served as a model to study androgen-dependent responses of the skin, but the quantitative response of hair follicles to androgenic stimulation has been neglected. We assayed the hair follicle response to testosterone (T) and compared it to the response of the sebaceous glands and of the dermal pigment in the Golden Syrian hamster flank organ. Because of biologic variation in male animals and uneven absorption of hormone from parenteral injections, we implanted silastic capsules 0.25, 0.5, 1, and 2 cm in length filled with crystalline T subcutaneously into female hamsters for 6 weeks. Hair follicle response to T was more sensitive than sebaceous gland or pigment. Diameters of hairs under the sebaceous gland increased significantly from control values of 27.7 +/- 1.0 micron to 38.0 +/- 1.6 micron at the lowest dose of T tested, the 0.25-cm capsule (p less than 0.001). There was an increase in the absolute number of hairs under the sebaceous gland as the flank organ enlarged, from 27.9 +/- 9.9 control to 55.3 +/- 5.8 with the 2-cm T capsule. There was no concomitant increase in hair density, 14.4 +/- 3.5 hairs/mm control vs 12.5 +/- 1.1 hairs/mm with the 2-cm capsule. Hair follicles lateral to the sebaceous gland did not show the same response to androgen stimulation. Sebaceous gland and pigmentation responded in a dose-dependent fashion, the maximum effect being achieved with a 1-cm T capsule. We conclude that T affects hair by specifically stimulating growth of individual hairs physically under the sebaceous gland. As the whole flank organ enlarges more hairs are recruited to become larger but no new follicles appear. These studies also confirm that there are different sensitivities to androgen within the various androgen-dependent components of the hamster flank organ, with increase in hair diameter being highly sensitive. This model should be useful for the specific and quantitative assessment of androgenic and antiandrogenic substances on hair growth and ultimately by useful for therapy of hirsutism.

Animals↗
PubMed2006

Guidelines for capsule endoscopy: diagnoses will be missed.

BACKGROUND: Capsule endoscopy represents a significant advance in the investigation of intestinal disease. National Institute of Health and Clinical Excellence, European Society of Gastrointestinal Endoscopy and American Society for Gastrointestinal Endoscopy guidelines support capsule endoscopy in obscure GI bleeding, Crohn's disease and the evaluation of non-steroidal anti-inflammatory drug side-effects, polyposis syndromes and coeliac disease. AIM: To determine whether the application of guidelines leads to missed diagnoses that would have been made if less stringent indications were adopted. METHODS: Retrospective analysis of 100 consecutive unselected capsule endoscopy examinations at Homerton Hospital, from October 2003 to November 2005. All referrals accepted following traditional investigations. Indications and findings were recorded. Comparison made as to whether diagnoses would have been missed if guidelines had been followed and capsule endoscopy not performed. RESULTS: Among the subjects 37 patients were children and 55 were male. Indications included recurrent bleeding and anaemia, assessment of Crohn's disease, 'others', i.e. assessment of coeliac disease, Peutz-Jehgers syndrome, Blue Rubber Bleb syndrome or non-specific abdominal pain. In patients with coeliac disease, widespread enteropathy was confirmed, with additional diagnoses of delayed gastric emptying and colitis. For those with abdominal pain findings included angiodysplasia, lymphoid hyperplasia and distal small bowel ulcers. CONCLUSIONS: Capsule endoscopy in patients with non-conventional indications yielded abnormal pathology, such as ulcers and inflammation. If published guidelines had been followed such diagnoses would have been missed.

Adult↗
PubMed1978

Plasma, bone, hip capsule and drain fluid concentrations of ampicillin and flucloxacillin during total hip replacement after intravenous bolus injection of magnapen.

1. A rapid intravenous bolus injection of 4.0 g Magnapen (which contains 2.0 g of ampicillin and 2.0 g of flucloxacillin) was to seven patients undergoing total hip replacement immediatly before induction of general anesthesia. Postoperatively the patients patients received 2.0 g Magnapen by intramuscular injection every 6 h for up to 72 h until removal of the wound drains. 2. The plasma, bone, hip capsule and drain fluid concentrations of ampicillin and flucloxacillin were measured by a differential small plate microbiological assay method using Sarcina lutea and a penicillinase producing Staph. aureus Russell as the test organisms. 3. The mean +/- s.e. mean concentrations of ampicillin after this regimen were 4222.2 +/- 285.0 microgram/ml (plasma), 65.6 +/- 1.3 microgram (g (hip capsule), 19.1 +/- 3.8 microgram/g (cancellous bone), and 211.1 +/- 65.6 microgram/g (ground up bone) respectively. 4. The mean +/- s.e. mean flucloxacillin concentrations after this regime were 137.2 +/- 28.4 microgram/ml (plasma), 61.8 +/- 15.0 microgram/g (hip capsule), 47.1 +/- 9.5 microgram/g (cancellous bone) and 139.4 +/- 21.8 microgram/g (ground up bone) respectively. 5. An intravenous bolus injection of Magnepen (4.0 g), given immediately before induction of general anaesthesia, provides concentrations of ampicillin and flucloxacillin in plasma, hip capsule, cancellous and ground up bone, and drain fluid that exceed the MICs of these antibiotics against Staph. aureus and E. coli. 6. The plasma, hip capsule, cancellous and ground up bone concentrations of ampicillin after this dose of Magnapen do not, however, exceed the MICs of the Gram negative anaerobes that sometimes cause postoperative wound infections in these patients.

Aged↗
PubMed1991

[The deciduous hoof capsule (Capsula ungulae decidua) of the equine fetus and newborn foal].

The term Eponychium is used to describe the deciduous hoof capsule in veterinary-medical and embryological literature. In other aspects of veterinary medicine, the term is generally reserved for the perioplic corium of the permanent hoof. In order to clarify this double usage, the structure and origin of the hoof epidermis from 10 equine fetus at different stages of development and 4 newborn foals were investigated and described using light microscopical techniques. Epidermal tubules and lamellae are already present in the non-cornified fetal hoof epidermis. These structures, along with the formation of a white line, allow this epidermis to be divided into the same segments as are commonly used when referring to the permanent hoof. The greatest part of the deciduous hoof epidermis consists of the sole and frog, with significant portions forming in the coronary corium and that of the hoof wall as well. The perioplic corium only makes up insignificant portions of the fetal hoof capsule, however. Between the second half of the gestation period and birth, this deciduous (primary) hoof capsule is continually being replaced from below by newly-forming, cornified permanent hoof capsule. On the basis of its structure and origin, we therefore suggest that the term "deciduous hoof capsule (Capsula ungulae decidua)" be used as a replacement for the word "Eponychium" when referring to the primary hoof epidermis.

Animals↗
PubMed2005

Capsule endoscopy: current indications and future prospects.

Capsule endoscopy represents a significant advance in the investigation of small bowel diseases and the beginning of wireless endoscopic imaging. Capsule endoscopy involves swallowing a video capsule endoscope, which is painless and relatively safe. Its use has been established for suspected small bowel bleeding, and the role of capsule endoscopy in the investigation of inflammatory bowel disease, iatrogenic disease, polyposis syndromes and coeliac disease is evolving. It is likely that in many instances it will become the next test after standard endoscopic evaluation. Early data suggest that capsule endoscopy improves outcome in patients with suspected small bowel bleeding, but more data are required on outcomes for the other indications.

Endoscopes↗
PubMed1991

Comparison of alpha 1 adrenoceptors in the prostate capsule of men with symptomatic and asymptomatic benign prostatic hyperplasia.

The objective of this study was to compare the binding and functional properties of alpha 1 adrenoceptors in prostate capsules obtained from men with symptomatic and asymptomatic benign prostatic hyperplasia (BPH) undergoing simple retropubic prostatectomy and cystoprostatectomy respectively. Saturation experiments using 125I-Heat demonstrated that the density and binding affinity of alpha 1 adrenoceptors in the prostate capsules obtained from men with symptomatic and asymptomatic BPH were similar. Non-cumulative dose response experiments using phenylephrine demonstrated that the magnitude of the contractile response to phenylephrine was 4-fold greater in the prostate capsules from men with symptomatic BPH than from those with asymptomatic BPH. The EC50 of phenylephrine in the prostate capsules of men with symptomatic and asymptomatic BPH was similar. A correlation between alpha 1 adrenoceptor density and phenylephrine Emax was not observed, implying that either alpha 1 adrenoceptors are not localised exclusively to the prostate smooth muscle or that spare alpha 1 adrenoceptors exist. This study suggests that the neuropharmacological properties of the prostate capsule may play a significant role in the development of infravesical obstruction in the ageing male population.

Dose-Response Relationship, Drug↗
PubMed2004

Interference between pacemaker and video capsule endoscopy.

The wireless capsule video endoscopy is useful in patients with occult blood loss, but is contraindicated in patients with cardiac pacemaker (PM). No case of interference has been published. We report the case of a patient with a PM implanted in the abdominal wall. After capsule ingestion, cardiac monitoring showed no modification of the PM compartment (VOO, unipolar mode) but the capsule recording reveal more than 3 hours of loss of image. The wireless capsule endoscopy is safe in patients with PMs in VOO mode. Nevertheless important interference was noted in the recording when the capsule was near the PM.

Aged↗
PubMed2002

Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology.

OBJECTIVE: Small bowel pathology can be diagnosed using enteroscopy (which has limitations) and by x-ray (which is not sensitive for flat lesions). For the first time ever, we used a new technique, wireless-capsule video endoscopy, to diagnose small bowel pathology. Our aim was to prove the effectiveness and safety of this technology. METHODS: We used the Given (M2A) system in 35 patients, aged 18-80 yr, who suffered from unexplained GI bleeding or in whom there was a clinical suspicion of small bowel disease. All patients had a small bowel x-ray. Patients with suspected narrowing of the bowel or a clinical suspicion of intestinal obstruction, or with a history of major abdominal surgery, were excluded from the study. No pregnant women or patients with diabetes mellitus were included. RESULTS: Abnormal findings were found in 29 of 35 (82.9%) patients. Twenty-two of 29 (75.9%) patients had significant pathological findings explaining their clinical situation. Diagnostic yield was therefore 62.9% (22 of 35 patients). Among the various findings, the capsule detected ulcers, erosions, angiodysplasia, and submucosal lesions. The source of bleeding was found in 15 of 20 patients with iron deficiency anemia. There were no immediate significant side effects and none reported up to 1 month after ingestion of the capsule. The capsule was evacuated by all patients. CONCLUSIONS: The wireless-capsule video endoscope, in our study of feasibility, was proven to be a safe, painless, ambulatory, and effective procedure, with a high diagnostic yield. Its major importance is in diagnosing small bowel pathology where all other imaging techniques have failed.

Adult↗
PubMed2005

Feasibility and safety of string wireless capsule endoscopy in the diagnosis of esophageal varices.

OBJECTIVE: To assess the feasibility, safety, accuracy, and acceptability of "string-capsule endoscopy" in the evaluation of esophageal varices. MATERIAL AND METHODS: Strings were attached to the wireless capsule endoscopy device to allow its controlled movement up and down the esophagus. Time of recording and discomfort associated with the procedure was documented. Patient's preference compared to conventional esophago-gastro-duodenoscopy (EGD) was recorded. An independent endoscopist blinded to EGD diagnoses assessed the diagnostic accuracy of pictures obtained. RESULTS: Thirty patients with clinical liver cirrhosis (mean age: 54.4 yr; mean MELD score: 12.5, and mean Child-Pugh score: 6.3) were enrolled; 19 for surveillance and 11 for screening purposes. The procedure was safe (no strings were disrupted and no capsule was lost). The mean recording time was 5.8 min (2.9-8.7), the accuracy 96.7%, and discomfort was minimal. The majority (83.3%) of patients preferred string-capsule endoscopy to EGD. CONCLUSIONS: String-capsule endoscopy was feasible, safe, accurate, highly acceptable, and preferred by cirrhotic patients undergoing screening/surveillance of esophageal varices. The technique may prove to be more cost effective than conventional EGD.

Adult↗
PubMed2005

Bravo capsule placement in the gastric cardia: a novel method for analysis of proximal stomach acid environment.

BACKGROUND: Intragastric pH monitoring is currently done using catheter-based pH systems. This study assessed the feasibility of proximal intragastric pH recording with the Bravo wireless pH monitoring system using novel methodology. METHODS: Nine asymptomatic volunteers and 9 symptomatic patients were studied. One pH capsule was positioned under direct endoscopic visualization so that the device straddled the squamocolumnar junction (SCJ) with the attachment well positioned on squamous mucosa and the pH electrode 1.5-2 cm distal to the SCJ. A second capsule was placed 6 cm proximal to the SCJ. The signal from each capsule was recorded by a separate receiver synchronized for time. RESULTS: Successful placement and interpretable recording for >42 h from both pH capsules was achieved in 16 (88%) of 18 subjects. Data capture were 98.3% in the cardia and 97.7% in the esophagus. Two failures occurred due to premature capsule detachment (one esophageal and one gastric). The acid environment in the cardia was similar in asymptomatic controls and symptomatic patients and exhibited less meal-related buffering than is typical of more distal intragastric recordings. In addition, nadir gastric cardia pH was almost always less than nadir esophageal pH during reflux events. CONCLUSIONS: Twenty-four hour gastric cardia pH monitoring is feasible with the Bravo system and can be added to esophageal pH monitoring to assess concomitant cardia acidity. Instantaneous cardia pH defines the potential nadir esophageal pH during reflux events.

Cardia↗
PubMed1990

Evidence that the capsule around mycobacteria grown in axenic media contains mycobacterial antigens: implications at the level of cell envelope architecture.

The intracellular growth of pathogenic mycobacteria has been linked to the presence of an electron transparent zone (ETZ or capsule), which surrounds the phagocytized bacteria and prevents the diffusion of lysosomal enzymes in infected macrophages. Recently, it was suggested that this capsule may be a bacterial structures, even being present in test tube-grown pathogenic mycobacteria (FEMS Microbiol. Lett. 1988, 56, 225-230). In the present paper, we show that under special fixation and embedding conditions, this capsule was clearly observed among 7 strains of mycobacteria grown in axenic media and also in M. leprae extracted and purified from experimentally infected armadillo or nude mice. In the case of bacteria treated likewise but subject to a prior dehydration step, this capsular structure disappeared suggesting its lipidic nature. Ultrathin sections of M. intracellular after immunolabelling showed for the first time that this capsule obtained mycobacterial antigens confirming its mycobacterial origin. It is suggested that the mycobacterial capsule may be formed of inert lipids, in which surface antigens are embedded.

Antigens, Bacterial↗
PubMed1992

Genome diversity at the serA-linked capsule locus in Escherichia coli.

Individual isolates of Escherichia coli synthesize one of more than 70 chemically distinct polysaccharides which form the capsule. In this article we review the genetics of capsule production in E. coli and highlight what this is beginning to reveal in terms of the genetic basis of the structural diversity of polysaccharides. The serA-linked capsule locus can take three different allelic forms. Two of these are associated with capsule genes and are themselves internally variant, whilst the third form has not so far been implicated in capsule biogenesis. Thus the serA-linked region of the E. coli genome is strikingly polymorphic.

Carbohydrate Dehydrogenases↗
PubMed1988

Attempts to demonstrate a polysaccharide capsule in Neisseria gonorrhoeae.

The presence or absence of a polysaccharide capsule on the human pathogen Neisseria (N.) gonorrhoeae is still a topic of controversy. For this reason we compared the results obtained by light microscopy (dry India ink-Fuchsin stain) and electron microscopy (Alcian blue-lanthanum nitrate stain) of encapsulated strains of N. meningitidis and Streptococcus (S.) pneumoniae and of non-encapsulated strains of S. pneumoniae and Escherichia (E.) coli with those obtained using the same methods on strains of pilliated and non-pilliated N. gonorrhoeae. After staining with India ink-Fuchsin no capsules could be demonstrated on any of the N. gonorrhoeae strains studied. If present the capsules on these cells are too delicate to be identified by light microscopy. After treatment with Alcian blue-lanthanum nitrate sections of cells of N. meningitidis and S. pneumoniae generally showed the presence of a capsular layer. Sections of cells of the non-encapsulated strain of S. pneumoniae which possess C (common)-polysaccharide also showed surface associated capsule-like material. Similarly the surface of the cells of the E. coli strain showed material which appeared to be tufts of pili and/or M (mucoid)-antigen. In experiments where the N. gonorrhoeae cells were harvested as early as after six hours of growth a capsule-like material was demonstrated on cells of all strains studied.

Culture Media↗