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PubMed1986

Colonic transit scintigraphy. A physiologic approach to the quantitative measurement of colonic transit in humans.

Colonic transit scintigraphy was developed to quantitatively evaluate colonic transit. Using this technique the progression of a radiolabeled marker from cecal instillation to defecation was studied in 7 normal male volunteers. An 8-ml bolus containing 50 mu Ci of indium 111-diethylene triamine pentaacetic acid was instilled into the cecum via a 2-mm tube, which was passed orally, and serial scintigrams were obtained over 48 h. By 48 h, 70.7% +/- 9.1% (mean +/- SEM) of the instilled activity had been defecated. The cecum and ascending colon emptied rapidly, with a half-emptying time of 87.6 +/- 27.0 min. Geometric center analysis showed an initial logarithmic progression of activity in the proximal colon and a linear progression distally. This study suggests that the transverse colon, not the cecum and ascending colon, may be the primary site for fecal storage. Colonic transit scintigraphy is a safe, physiologic, and quantitative method for evaluating the colonic transit of fecal material and may provide a useful tool for evaluating normal and abnormal large intestinal physiology.

Adult↗
PubMed1986

[Type of behavior and superoxide dismutase activity in the brain of rats (a comparison of 2 Tryon strains)].

Differences in the type of behaviour in capable ("maze-bright") and incapable ("maze-dull") Tryon rats have been demonstrated in the situation with pain-irritated partner by the method of "emotional resonance". Most "bright" rats belonged to the type not avoiding the signals of another pain-irritated rat, they revealed a persistent ecologically defensive reaction of preferring a small closed space. The type of anxiety behaviour prevailed in the group of "dull" rats. In the open field test "bright" rats were characterized by low locomotor activity and high level of defecation and "dull" rats by high activity and low defecation. Increased levels of superoxide dismutase activity and high content of thiobarbituric acid-reactive material were observed in brains of dull rats. The interrelations between behavioural and molecular levels of defensive response to stress is discussed.

Animals↗
PubMed1985

[Fundamental study on ceftizoxime suppositories in adults and children].

The pharmacokinetics of newly developed ceftizoxime suppository (CZX-S) was studied in healthy volunteers and in children, compared with that of intramuscular CZX and intravenous CZX: In 8 volunteers (aged 19 to 24 years), each of 500 mg (potency) CZX-S containing 3%, 4% and 5% sodium caprate was compared with 500 mg intramuscular CZX and 500 mg intravenous CZX as a single administration in the cross-over method. In addition each of 500 mg CZX-S containing 4% and 5% sodium caprate was studied in 2 groups of 8 volunteers (aged 22 to 24 years) and of 8 volunteers (aged 19 to 27 years); each CZX-S was given 3 times a day successively for 5 days. The pharmacokinetics of 125 mg and 250 mg CZX-S, which contained 3% sodium caprate, were also evaluated as a single administration in 9 children (aged 6 years 4 months to 12 years 0 month) and in 11 children (aged 7 years 8 months to 12 years 4 months), respectively. The irritabilities of CZX-S were studied in all subjects who participated in this trial. The feeling of foreign body, the feeling of defecation, the burning sensation and the pain were evaluated in volunteers; the feeling of defecation and the pain were evaluated in children. The results were as follows: I. Pharmacokinetics in healthy volunteers 1. Given as a single administration The mean peak concentrations of serum CZX were occurred 30 minutes after 500 mg CZX-S containing 3%, 4% and 5% sodium caprate, which were 10.5 mcg/ml, 12.3 mcg/ml and 12.4 mcg/ml, respectively. These values were 1.35 mcg/ml, 1.60 mcg/ml and 1.69 mcg/ml at the conversion unit of 1 mg dose per 1 kg body weight. The mean peak serum CZX concentration of CZX-S containing 3% sodium caprate was slightly lower than that of CZX-S containing 4% or 5% sodium caprate, but was 1.9 times higher than that of the ABPC suppository. There was no marked difference among 3 preparations of CZX-S in mean Tmax and T1/2. Cmax of CZX-S containing 3% sodium caprate was 1.40 mcg/ml at the conversion unit of 1 mg/kg. AUC of CZX-S containing 3% sodium caprate was slightly smaller than that of CZX-S containing 4% or 5% sodium caprate, but 3.1 times that of the ABPC suppository in healthy volunteers. When 500 mg CZX was intramuscularly administered by one shot to 8 volunteers, Tmax was same as that of CZX-S or was slightly later.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1986

Treatment of fecal incontinence in children with spina bifida: comparison of biofeedback and behavior modification.

Two experiments compared the effects of biofeedback training to behavior modification in the treatment of 33 children aged 5 to 16 who had fecal incontinence secondary to myelomeningocele. Biofeedback involved providing visual feedback and rewards for successively stronger sphincter contractions during training sessions and requiring 50 sphincter contraction exercises daily. Behavior modification involved attempting to defecate immediately after the evening meal each day, receiving a reward for defecating in the toilet without an enema or suppository, and receiving an enema if unsuccessful for two consecutive days. In experiment I, eight children were offered biofeedback alone in an attempt to replicate previous studies. Biofeedback alone was found insufficient; addition of behavior modification was necessary. Experiment II systematically investigated the relative contribution of these two treatments. Overall, patients who received only behavior modification for three months showed as much clinical improvement as patients who received behavior modification plus biofeedback. This suggests that previous reports, because they have not controlled for nonspecific treatment effects, have overestimated the value of biofeedback in this population. However, a subgroup of patients (27%) were identified for whom biofeedback provided additional, specific benefit. These were children who had spinal cord lesions below L-2 and who initially had two or more bowel movements daily. The combination of behavior modification and biofeedback resulted in a greater than 50% reduction in the frequency of incontinence for 64% of patients, and results were well maintained at follow-up one year later.

Adolescent↗
PubMed1985

[Anteposition of the anus. A cause of constipation in children].

Certain forms of severe constipation, unresponsive to medical treatment and classified as "idiopathic", have been thought to be anatomical anomalies due to anterior-displacement of the anus. The difficulty in defecation varies with the anal anomaly: this may range from passing of feces every 3-4 days to sub-occlusion episodes due to obstruction of the rectum from phecaloma and with sign of malnutrition, anemia and hypotrophy. Anatomically the anomaly is characterized by an anterior positioning of the anus which deviates the terminal part of the rectum in a horizontal plane creating a "cul-de-sac" which arrests normal fecal advancement. Fecal stasis in the rectal ampulla leads to an increase in the distensibility of the rectum with loss of the normal stimulus to defecate and contractile activity. Diagnosis is made by physical examination, barium enema (which reveals the rectal "cul-de-sac" and the distension of the colon) and ano-rectal manometry to rule out Hirschsprung diseases. The authors report their experience with 11 cases of anterior displacement of the anus, presenting a simple surgical treatment and the favorable results.

Anal Canal↗
PubMed1983

Factors controlling the volume of feces produced by triatomine vectors of Chagas' disease.

Triatomine species influenced volume of feces produced; Triatoma dimidiata produced the largest volume of feces followed by Panstrongylus megistus, Rhodnius prolixus, and Triatoma infestans. Moreover, stage and sex affected fecal production; 5th-stage female nymphs excreted the largest volume of feces. The amount of blood ingested was significantly correlated with the volume of feces produced in 10 out of 11 experimental groups. Triatome size and volume of feces produced were less closely correlated. Indeed, a "threshold" minimum amount of blood must be ingested before bugs are stimulated to defecate. The defecation habits of triatomines probably influence the vectorial capacity of a triatomine species to a lesser degree than do the density of domestic infestations, host affinity, and the degree of adaptation to the domestic habitat.

Animals↗
PubMed1980

[Effect of mercuric chloride on the analysis of nitrites in pork products].

The effect of HgCl2 on nitrite determination was studied. 0,184 mmol/l to 184 mmol/l Hg Cl2 were added during the defecation or only at the time of analysis with an autoanalyser. Hg Cl2 was added to salami, bacon, dry sausage at different time of ripening and cooked ham. An effect was noted only when Hg Cl2 was added at the defecation time. After cold water extraction, the more the added Hg Cl2, the more "titrated" nitrite. After hot extraction with water and borate, the effect of Hg Cl2 was weaker but significant. The role of Hg Cl2 was important for the accurate determination of nitrites during the ripening of some products: in 16 hours old dry sausage the effect was weak (+40%), but became large (+600%) after 2 weeks of ripening. It is proposed to use Hg Cl2 at the concentration of 4 mmol/l for the determination of total nitrites. The free nitrites should be analysed separately without Hg Cl2.

Animals↗
PubMed1984

Practical toxicologic diagnosis.

Strychnine toxicosis is characterized by inducible tetanic seizures and metaldehyde poisoning by fine fasciculations progressing to generalized tremors and seizures. Intoxication with 1080 causes seizures, random running movements, vomiting, defecation, urination, acidosis and hyperglycemia. Intoxication with rodenticides causing coagulopathy is characterized by hemorrhage into body cavities but not necessarily external hemorrhage. Anticholinesterase insecticides cause salivation, urination and defecation, while chlorinated hydrocarbon insecticides cause CNS disturbances. Ethylene glycol intoxication results in ataxia, depression, coma, vomiting and tachypnea, followed by acute renal failure. Urea poisoning causes bloat and CNS signs in cattle. Monensin intoxication in horses lasts several days and causes stiffness, colic, uneasiness and recumbency. Salt poisoning results in depression, seizures and hypernatremia. Lead poisoning is associated with central and peripheral nervous system signs, as well as increased numbers of nucleated RBC and basophilic stippling of RBC. Arsenic poisoning results in GI pain, diarrhea, weakness and death. Copper toxicosis in sheep is manifested by hemolytic anemia, hemoglobinemia and hemoglobinuria. Plants that may intoxicate domestic animals include sorghum, greasewood, halogeton, water hemlock, Japanese yew, larkspur, lupine, milk-weed, philodendron, oleander, castor bean and precatory bean.

Animals↗
PubMed1984

Management of constipation in the elderly.

In the elderly, the history--including dietary habits, onset, duration, and change in bowel pattern--is very important. Recent changes could suggest bowel disease such as carcinoma or a disordered metabolism. If the defecation stimulus is repeatedly denied by voluntary contraction of the external anal sphincter, the normal defecation reflex may be blunted and, in time, completely lost.

Age Factors↗
PubMed1983

[Experimental and clinical evaluation of an ampicillin suppository (KS-R1) in children].

Plasma levels of ampicillin (ABPC) after the single rectal insertion of KS-R1 at doses of 125 and 250 mg in 154 children reached a peak at 11 approximately 15 minutes in children of age less than 1 year old, at 16 approximately 20 minutes in children of 1 approximately 3 years, 4 approximately 6 years and more than 7 years old with the highest levels of 11.50, 8.69, 10.33 and 8.30 micrograms/ml, respectively. Highest plasma levels of ABPC were 6.48, 8.00, 12.32 and 17.83 micrograms/ml by the administration of KS-R1 at doses of less than 10.9 mg/kg, 11.0 approximately 15.9, 16.0 approximately 20.9 mg/kg and more than 21.0 mg/kg, respectively, with dose-dependent response which were observed at 11 approximately 15 minutes or 16 approximately 20 minutes. There was no difference of plasma levels between the administration of 125 and 250 mg of KS-R1. The pain of insertion was observed in 0.6% of total 167 cases, the feeling of defecation in 2.4% and the discharge of suppository or its dissolved material or defecation within 30 minutes after insertion in 12.6%, without the influence of patients ages and dosage level. These figures were almost the same as those after the insertion of other suppositories such as erythromycin suppository or antipyretic suppository. Clinical effectiveness of KS-R1 was examined in 51 childish patients with various infections. KS-R1 was rectally given to them at doses of average 41.6 mg/kg/day divided into 3 to 4 times for 7 days. All cases showed excellent and good effects. Bacteriologically, all pathogens which were isolated from 12 patients were eradicated.

Age Factors↗
PubMed1981

[Sudden death during continous electrocardiographic recording by Holter's method].

The case of a 79 year old patient who died during continuous electrocardiographic recording by Holter monitoring is reported. There was a previous history of respiratory insufficiency, postero diaphragmatic myocardial infarction and left hemiplegia. Death occurred suddenly at home after defecation. Analysis of the recording showed multiple polymorphic ventricular extra-systoles, often occuring in doublets at the beginning of the record. Death was caused by a salvo of three ventricular extrasystoles triggering ventricular tachycardia which rapidly degraded to irreversible ventricular fibrillation. This major arrhythmia may have been due either to adrenergic stimulation from the effort of defecation or to acute myocardial infarction. This case underlies the value of Holter monitoring in the assessment of the gravity of an arrhythmia. It is also of interest because of the absence of an R on T phenomenon before the terminal event.

Aged↗
PubMed1981

[Treatment of chronic colitis with an herbal combination of Taraxacum officinale, Hipericum perforatum, Melissa officinaliss, Calendula officinalis and Foeniculum vulgare].

Twenty four patients with chronic non-specific colitis were treated with a herb combination. As a result from the treatment, the spontaneous and palpable pains along the large intestine disappeared in 95.83 per cent of the patients by the 15th day of their admission to the clinic. Defecation became daily in the patients with obstipation syndrome, but a combination of Rhamus frangula, Citrus aurantium, C. carvi was added to the herb combination already indicated. Defecation was normalized in patients with diarrhea syndrome. The pathological admixtures in feces disappeared.

Adult↗
PubMed1995

[Treatment of constipation in pregnant women. A multicenter study in a gynecological practice].

Constipation is a common problem during pregnancy. It is essential to relieve the condition without putting the developing child at risk or further stressing the mother. The fact that lactulose is not absorbed in the small intestine is of great significance when treating constipation during pregnancy, as it presents no threat to the foetus. Lactulose also does not appear in breast milk so that the treatment can also be continued during nursing. The present study was an open base-line controlled study to show the efficacy, safety and acceptability of dry lactulose (Duphalac Dry) in pregnant women suffering from chronic or occasional constipation. It was a multi-center study in 12 gynecological practices. 62 women aged between 19 and 40 years were treated during 4 weeks with lactulose. 34% had chronic constipation and the remaining 66% constipation due to the pregnancy. The main criteria for efficacy were frequency of defecation and consistency of stools. There was overall judgement of the efficacy by patients and doctors. Safety was assessed by the number of reported side-effects and compared to the reported concomitant symptoms before treatment. Here also, the patients and their doctors gave a global impression. In addition, patients rated the product flavor and administration methods. The frequency of defecation was significantly increased after 1 week (4.0 vs. 2.5 [median per week], p < 0.001) and normalized after 2 weeks (6 stools per week). Also, the consistency of the stools was normalized during the treatment. The global assessment of efficacy by the treating physicians was good or very good in 84% of the cases and by the patients in 81%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Spinal dural fistula with peri-medullar venous drainage].

Clinical and neuroradiological findings of 8 patients with a spinal dural arteriovenous fistula are reviewed. Disturbance of micturition or defecation and weakness of the legs were always present and the most frequent initial symptom was a progressive spastic paraparesis. Duration of symptoms before diagnosis was 2 years. Lumbar puncture showed elevation of proteins and myelography demonstrated dilated perimedullar posterior veins. In every case, magnetic resonance imaging of the spinal cord (T2- weighted images) revealed intramedullary high signal intensity of the conus medullaris and selective angiography confirmed the site of the dural fistula. Each patient was treated with endovascular method consisting in liquid adhesive embolization (0.2 cc of N-butyl cyanoacrylate) with hyperselective catheterism of the dorsospinal artery. Embolization procedure was successful in 6 cases with large improvement of leg weakness and partial regression of disturbed micturition and defecation. The pathophysiological mechanisms explaining the clinical signs are discussed.

Aged↗
PubMed1994

[Female dyschesia, functional associations and pelvic disorders].

OBJECTIVES: Although the usual methods of exploring anorectal disorders give information on specific aspects of defecation, they do not take into account the related effect of disorders involving the pelvic contents including the genital and urinary tract. We therefore used physical examination and global imaging to demonstrate the effect of urinary and genital anomalies in female patients with dyschesia. METHODS: A prospective study was conducted in 50 consecutive female patients (age range 21-83) who consulted for dyschesia. The following protocol was used. History taking included a search for urinary and gynaecology surgery or medical treatment and the number of pregnancies and instrumental deliveries as well as a precise scoring of defecation disorders. The general physical examination included a search for signs of prolapsus or ulcerations. A rectocolpocystogram was performed in all patients. RESULTS: There were 7 patients under 40 years of age, 25 from 41 to 61 years and 18 over 61. Urinary incontinence was the most frequent functional complaint (80%). In 92% of the patients, the rectocolpocystogram revealed associated anatomic anomalies. Dynamic stimulation was associated with cervicocystoptosis (72%), hysteroptosis (50%) and rectocele (66%). CONCLUSION: Female dyschesia is a complex phenomena involving the anatomic status of the urinary, genital and anorectal tracts. Therapeutic management should be based on a complete examination including an evaluation of the pelvic contents and the perineum.

Adult↗
PubMed1994

[Solitary ulcer of the rectum].

In line with the literature, the authors consider that solitary ulcer of the rectum, either isolated, multiple or histological, like suspended proctitis, inverted hamartomatous polyp, deep cystic colitis, is a complication of rectal prolapse, which usually shares the same clinical symptoms. Solitary ulcer of the rectum is generally discovered on proctoscopy and is due to the strain exerted on the rectal mucosa by 2 opposing forces:violent effort of defecation against an anal and/or perineal obstruction. The reduction of these pressure and counterpressure forces with age and progressive alteration of the pelvic floor accounts for the progression of acute lesions towards chronic or attenuated lesions or even complete resolution. The therapeutic strategy should therefore decrease trauma by facilitating defecation by a combination of hygiene and dietary advice and biofeedback retraining, and surgical reduction of the anal obstruction and prolapse and correction of any perineal insufficiency.

Barium Sulfate↗
PubMed1993

[Constipation in childhood--from the pediatric viewpoint].

Chronic constipation is a common problem in paediatric practice. The majority of the toddlers can be successfully treated by conventional therapy. Young infants with constipation or older children with longstanding stool impaction with or without encopresis should be referred to a centre for further diagnostic and therapeutic management. Children with a paradoxical contraction of the external anal sphincter during attempted defecation on anorectal manometry profit form bio-feedback-training by learning a normal defecation pattern.

Biofeedback, Psychology↗
PubMed1993

[Analyses of ventricular arrhythmias in patients with progressive systemic scleroderma (PSS) by ambulatory electrocardiography].

Disorder of cardiac conduction and automaticity have been widely reported in patients with progressive systemic scleroderma (PSS). In the present study, ventricular arrhythmias were monitored by 24-hour ambulatory electrocardiographic recording (Holter monitor) in 30 female patients with PSS and 20 apparently healthy female controls. The following results were obtained: 1) In the waking state, 8 cases of 30 patients showed grade III, IVA or IVB of ventricular arrhythmias, according to Lown's classification. On the other hand, ventricular arrhythmias, such as grade III, IVA or IVB, were not observed in the control group. 2) In the patient group, grade IVA arrhythmias were observed during defecation, driving or light working, and grade IVB were during defecation, urination, light working or sleeping. These results suggest that it is important to examine arrhythmias by Holter monitors in patients with PSS.

Adult↗