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Biomedical subjects

C Callegari

Publications and source records attributed to C Callegari.

At least 19 recordsLinked to original sources

The source of urinary epidermal growth factor in humans.

To clarify the source of human urine EGF, we studied EGF renal clearance in 20 healthy, young adult subjects. Immunoreactive EGF was measured hourly in EDTA plasma, heparin plasma, serum and urine of 12 males and 8 females during a 3 h study period. Plasma and urine creatinine and creatinine clearance were measured and calculated hourly. Mean (and SEM) creatinine clearance was similar in males and females (118 +/- 12 vs 105 +/- 6 ml/min). EGF was not detectable in plasma, whereas relatively high levels were measured in serum (2.5 +/- 0.25 vs 1.5 +/- 0.18 ng/ml in males and females respectively p less than 0.05). Urine EGF excretion averaged 1641 +/- 233 ng/h in males and 1507 +/- 191 ng/h in females (p greater than 0.05). A significant correlation was observed between urine creatinine and urine EGF concentrations in both male (r = 0.98, p less than 0.01) and female (r = 0.94, p less than 0.01) subjects. EGF immunoreactivity in urine and serum eluted from G-75 sephadex columns similarly to recombinant 6000 Mr hEGF. Urine excretion of EGF approximated 1.5 micrograms/h or 25 ng/mg creatine. The high concentrations of EGF found in urine in the face of non-detectable levels of EGF in plasma favor the hypothesis that EGF in urine is derived from kidney synthesis and secretion. The significant positive correlation between urine creatinine and urine EGF suggests a functional correlation between glomerular filtration and the process of tubular EGF excretion.

Adult

Efficacy of addition of exogenous lactase to milk in adult lactase deficiency.

The efficacy of lactase by Kluyveromyces lactis in hydrolyzing milk lactose and reducing milk intolerance symptoms was tested in 52 proved lactose malabsorbers. The enzyme was added to milk administered to the patients, and H2 breath excretion (as an index of carbohydrate malabsorption), was determined by gas chromatograph technique, and milk intolerance symptoms were recorded. H2 mean excretion was 78.3 +/- 5.49 ppm after administration of intact whole milk 500 ml (test A), 43.5 +/- 4.99 ppm when lactase 2000 U was added to milk 500 ml immediately before administration (test B); 36.7 +/- 5.01 ppm when milk 500 ml was incubated for 12 h with lactase 1000 U (test C), and 29.7 +/- 4.35 ppm when the incubation was prolonged for 24 h (test D). Symptoms score was: test A = 5.85 +/- 0.56, test B = 3.71 +/- 0.45, test C = 2.77 +/- 0.63, test D = 1.7 +/- 0.68. A correlation index of r = 0.44 (p less than 0.01) was obtained between reduction in H2 mean excretion and reduction in symptoms score of a single individual. The addition of this lactase to milk seems to be effective in correcting lactose malabsorption, thus representing a convenient approach in milk intolerance.

Adult

Lactose malabsorption in adult patients with Crohn's disease.

In order to evaluate, in adult patients with Crohn's disease (CD), the prevalence of lactose malabsorption and intolerance, and the percentage who can tolerate a physiologic amount of milk in their diet, we tested 37 patients with CD (19 with intestinal resection, and 18 without) and 67 healthy controls (C) with the H2-breath test after they had ingested increasing loads of lactose as 10% solution (12.5 g, 25 g, and 50 g). Patients with malabsorption after the 12.5-g dose were tested further with 250 ml of milk. In the total group of patients and in the subgroup of those with resection, the prevalence of malabsorption was higher than in controls at all lactose loads; in patients who had not undergone resection, no significant difference was observed with the 12.5-g dose. Eleven of 18 patients who were malabsorbers with the 12.5-g dose had malabsorption also with 250 ml milk; however, only three of them (8% of the total group) experienced symptoms of intolerance. We conclude that, in adult patients with CD, 1) the prevalence of lactose malabsorption is increased, 2) in patients who have undergone intestinal resection, malabsorption occurs at a lower dose of the sugar than in patients who did not, and 3) since only 8% of patients experienced symptoms of intolerance after the ingestion of milk 250 ml, this amount can be empirically inserted in the daily diet of an adult with CD.

Adolescent

Anogenital ratio: measure of fetal virilization in premature and full-term newborn infants.

To provide normative data, we measured anogenital distances in 115 infants of 25 to 42 weeks gestational age and 10 pregnant women, including anus to fourchette (AF), anus to base of the clitoris (AC), and fourchette to base of the clitoris (FC). All infant measurements showed positive and significant correlations with body surface area, weight, length, and gestational age (P less than 0.001). However, the anogenital ratio (AF/AC) followed a normal distribution and did not correlate with any of the anthropometric variables or age. Mean (+/- SD) value in infants was 0.37 +/- 0.07, and in adults, 0.36 +/- 0.07. An anogenital ratio greater than 0.50 falls outside the 95% confidence limits, suggests labioscrotal fusion, and indicates a need for further evaluation. Because it is independent of body size and gestational age, the anogenital ratio should be useful in diagnosing androgen-induced labioscrotal fusion in both premature and full-term female infants.

Adult

Prevalence of autoimmune atrophic gastritis in vitiligo.

Gastric biopsies, and measurements of fasting serum gastrin levels and titers of antihuman parietal cell antibodies have been performed in 65 unselected patients with vitiligo. Histologic evidence of autoimmune atrophic gastritis has been obtained in 10 cases (15%), who were all positive for the antibodies and who had elevated gastrin levels. The study of gastric secretion after pentagastrin stimulation, performed in 7 of these patients, showed a markedly reduced acid output. The present study provides definite evidence of the association of autoimmune atrophic gastritis with a proportion of vitiligo cases and suggests the need for surveillance of these patients in terms of gastric neoplasia.

Adolescent

Depression and gastrointestinal illness: the joint use of biological and clinical criteria.

Occurrence and characteristics of depression were investigated in 37 consecutive patients suffering from gastrointestinal illness. More than 40% of patients with an organic digestive disease and about a quarter of those with functional gastroenterological complaints were found to suffer from a major depressive disorder according to DSM-III criteria. The dexamethasone suppression test--a laboratory marker of the endogenous depressive state--supported clinical diagnosis in several cases, yet its routine use to screen depression is not warranted because of its poor specificity. The results should alert the physician to include clinical and biological criteria for depression in the diagnostic work-up for gastrointestinal illness.

Adult

A single-specimen fecal chymotrypsin test in the diagnosis of pancreatic insufficiency: correlation with secretin-cholecystokinin and NBT-PABA tests.

An investigation of fecal chymotrypsin activity on spot fecal specimens was carried out in three groups of subjects, divided as follows: 45 healthy controls (group C); 36 patients with gastroenterological diseases of extrapancreatic origin (group VP); and 42 patients with chronic pancreatitis (group CP). Nineteen patients of group CP underwent pancreozymin-secretin and NBT-PABA tests. The following results, expressed as mg of chymotrypsin/g of feces, were obtained: C = 0.610 +/- 0.203; CP = 0.291 +/- 0.154, p less than 0.001; VP = 0.560 +/- 0.234. FCT showed a sensitivity rate of 78.5% and a specificity rate of 71.6%. The fecal output of chymotrypsin correlated well with the pancreatic secretion of chymotrypsin (r = 0.59, p less than 0.01) and with the percentage of recovery of urinary PABA (r = 0.44, p less than 0.05). We conclude that chymotrypsin assay by the described method on spot stool specimens is a simple, reliable technique which may be considered a good screening test for pancreatic insufficiency. The test will not detect minimal pancreatic disease or minimal pancreatic dysfunction.

4-Aminobenzoic Acid

Intestinal morphological changes during oral refeeding in a patient previously treated with total parenteral nutrition for small bowel resection.

This report describes a patient who, after a subtotal resection of small intestine for an embolic obstruction of the superior mesenteric artery, was maintained on total parenteral nutrition for 30 days and then refed. Cytoproliferative analysis of the intestinal mucosa, evaluated by peroral biopsies performed on days 1, 5, 14 and 30 after oral refeeding, demonstrated an increase in cell proliferation from 1 to 14 days after refeeding, followed by a return to starting values after 30 days. On days 1 and 5, we saw an intestinal hypoplasia that became a hyperplasia after 14 days of oral refeeding. Our data confirm the importance of oral nutrition for the small intestinal response after resection.

Aged

Effect of chemically defined formula diets on pancreatic mass in the rat.

To establish the effect of chemically defined formula diets on pancreatic mass, 58 male Wistar rats, weighing approximately 200 g, were fed orally one of the following diets for 20 days: standard diet; partially hydrolyzed diet; elemental diet. The diets were isocaloric and provided 73 cal/day per rat. At the end of the experiment, the rats were killed and pancreas removed to assess wet weight and DNA and RNA content. Compared to the controls, the elemental diet caused a reduction in pancreatic wet weight (p less than 0.005), pancreatic DNA (p less than 0.001), and RNA content (p less than 0.001). In the group fed partially hydrolyzed diet, only pancreatic DNA content showed an highly significant reduction when compared with the reference group (p less than 0.001), whereas the value of RNA failed to reach the statistical significance. We found an increase of the ratio mg RNA/mg DNA in the partially hydrolyzed and elemental diet groups. These results suggest that long-term nutrition with the partially hydrolyzed diet, and more strongly with the elemental diet, may induce pancreatic hypoplasia.

Animals

[Propranolol in children and adolescents with portal hypertension: its dosage and the clinical, cardiovascular and biochemical effects].

An adequate propranolol dose to reduce 25% the initial heart rate was searched in 19 children with portal hypertension. 13 were pre-hepatic and 6 hepatic hypertension, mean age: 6.96 +/- 3.48 years, range: 2-14 years. Treatment was started with 0.5 mg/kg/day increasing 0.25 mg/kg/day every third day, needing an average of 26 +/- 13 days (range: 6-54 days) to obtain the response. Daily dose ranged from 1 to 5.25 mg/kg/day (mean: 2.69 +/- 1.16). The highest daily dose was 175 mg, the lowest 23.4 mg (mean: 58.27 +/- 36.6 mg/day). Some parameters were evaluated before and after achieving the dose. There was a significant reduction of mean blood pressure (p < 0.01) and peripheral venous pressure (p < 0.05) in 68.4% of patients. A significant elevation (p < 0.001) of 24 hour urinary catecholamine levels occurred in 94.7%. Side effects were minimal. Propranolol could be considered a safe pharmacological option in these patients.

Adolescent

[Levels of blood pepsinogen I in the offspring of patients with duodenal ulcer].

Hyperpepsinogenemia I is a reliable subclinical marker of the genetical predisposition to suffer duodenal ulcer. For that reason we determine basal serum pepsinogen I (PG I) levels in 25 ulcerous patients and 75% of their offspring and to a control group matched by age and sex. PG I levels in patients and their offspring were significantly higher than those in controls and their offspring (p < 0.001). By establishing an upper normal value of PG I, we identified a subpopulation of normopepsinogenemic ulcerous patients and another with high values (9 normo PG I: 64.3 +/- 6.2 ng/ml vs 16 ulcerous patients with PG I levels: 142.1 +/- 19 ng/ml) (p < 0.001). Of 16 hyperpepsinogenemic patients, 11 offspring (27%) had increased values, what did not happen to any of the offspring of ulcerous patients with normal PG I or control group finding that 80% of male patients with high PG I gave birth to 1 or 2 children with increased values, suggesting a transmission thorough the male character. So gentic role plays an important place in our ulcerous patients but environmental factors appear to decisively influence on the establishment of the disease.

Adolescent