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Biomedical subjects

R Caprilli

Publications and source records attributed to R Caprilli.

At least 91 records · Page 5Linked to original sources
PubMed1984

Abnormal patterns of colonic mucin secretion after ureterosigmoidostomy.

Colonic epithelial mucin was investigated histochemically in biopsy specimens from a group of patients who had undergone ureterosigmoidostomy. For comparison, colonic biopsy samples from uninvolved mucosa adjacent to carcinomas from another group of patients and from a group of patients undergoing sigmoidoscopy for hemorrhoids were also studied. The high-iron diamine-alcian blue (HID-AB; pH 2.5) method was used, and the proportions of HID-positive and AB-positive cells were assessed semiquantitatively. In both ureterosigmoidostomy and cancer groups, highly significant increases in the proportions of AB-positive cells (sialomucins) were observed, particularly in the middle and lower segments of the crypts. Ureterosigmoidostomy introduces a high risk for the development of colonic carcinoma. Morphologic features that could account for such a high risk were investigated, and an abnormal pattern of colonic mucin secretion after ureterosigmoidostomy was demonstrated. Although this abnormality cannot be related specifically to ureterosigmoidostomy, data from the present investigation suggest that histochemical studies of colonic specimens from patients who have undergone ureterosigmoidostomy may provide a useful tool for follow-up studies.

Aged↗
PubMed1983

Colonic electromyography in chronic constipation.

Myoelectric activity of the sigmoid has been studied in 12 patients with chronic nonorganic constipation and 10 control subjects. All patients showed total gastrointestinal transit time longer than 96 h, with left-colonic or rectocolonic slowed transit. Electrical and mechanical activity was recorded by means of an intraluminal probe with bipolar suction electrodes and open-ended tips. Two groups of frequencies of slow waves, a slower rhythm at approximately 3 cycles/min and a faster rhythm at approximately 6 cycles/min were recorded in patients and control subjects. The mean frequency of the slower rhythm was significantly (p less than 0.005) higher in patients with constipation than in control subjects, whereas the frequency of the faster rhythm and the incidence of both rhythms were similar in the two groups. Mechanical activity showed no difference in terms of motility index and percentage of activity between patients and control subjects. Results of the study indicate that patients with left colonic constipation show an increase in frequency of the slower colonic rhythm in the very segment in which slowing down of transit occurs. It is suggested that the higher slow-wave activity in the sigmoid induces an increase in segmenting contractions and therefore may be responsible for the slowing down of intestinal transit.

Chronic Disease↗
PubMed1980

Risk factors in toxic megacolon.

A retrospective analysis of data from a series of 22 patients with toxic megacolon complicating ulcerative colitis was performed in an attempt to detect factors associated with the fatal outcome of the attack. Of the 25 clinical findings studied, significant differences between survivors (17) and nonsurvivors (5) were observed in only seven. In nonsurvivors, duration of the disease was longer and blood pH and standard bicarbonate levels higher, whereas serum potassium, calcium, phosphorus, and beta-globulins were lower. Discriminant analysis showed that three pairs of features, namely potassium-beta-globulins, potassium-bicarbonate, and potassium-blood pH provided a good discrimination between survivors and nonsurvivors. Results of this study indicate that the severity of the electrolyte and metabolic disorder appears to be an important risk factor in toxic megacolon. Intensive fluid and electrolyte replacement should therefore be considered a crucial point for successful management of toxic megacolon.

Adult↗
PubMed1978

Salt-losing diarrhoea in idiopathic proctocolitis.

The faecal output of chloride, sodium and potassium was studied in 14 patients with active idiopathic proctocolitis, in an attempt to establish a relationship between faecal electrolyte output and acid-base balance data. 7 patients with ileostomy and 8 healthy volunteers were used as controls. The daily faecal excretion of chloride and sodium in proctocolitis was significantly in excess of normal, whereas that of potassium was within the normal range. From the comparison with the results in patients with ileostomy it is concluded that colitic colon has an impaired capacity to absorb chloride and sodium but retains the ability to secrete potassium. The intestinal loss of chloride in addition to that of sodium and water may be regarded as a salt-losing diarrhoea and may account for the metabolic alkalosis commonly found in proctocolitis.

Acid-Base Equilibrium↗
PubMed1976

Blood pH: a test for assessment of severity in proctocolitis.

Acid base balance was studied in 58 patients with active idiopathic proctocolitis; the condition of 10 of them was complicated by toxic megacolon. Arterial blood pH increased progressively with increased severity of the colitis and as the lesions became more widespread. Statistically significant differences were observed in pH values between the mild/moderate and severe forms and between the severe and complicated forms ('toxic megacolon'). A linear correlation was found between pH and the amount of intestinal gas, pulse rate, and plasma albumin.

Carbon Dioxide↗
PubMed1975

Double-blind comparison of the effectiveness of azathioprine and sulfasalazine in idiopathic proctocolitis. Preliminary report.

A double-blind therapeutic trial of azathioprine in 20 patients with acute proctocolitis was performed over a 3-month period. Azathioprine was compared with sulfasalazine in patients paired and treated in a sequential order. Clinical, laboratory, endoscopic, biopsy, and radiologic data were assessed by semiquantitative criteria. No significant difference in the effect of the drugs was observed. Both azathioprine and sulfasalazine produce significant improvement in clinical symptoms, some laboratory findings (ESR, serum iron), and endoscopic and biopsy findings (P smaller than 0.05). Radiologic improvement was less evident (P smaller than 0.10). On the overall final evaluation of the trial, 14 patients were improved, and 6 remained stationary or worsened (P smaller than 0.10). This short-term trial confirms previous uncontrolled experiences of one of the authors on larger series of patients.

Acute Disease↗
PubMed1975

Effects of bombesin and bombesin-like peptides on gastrointestinal myoelectric activity.

Gastrointestinal myoelectric activity was studied during intravenous infusion of bombesin and bombesin-like peptides in conscious dogs with electrodes chronically implanted at different levels between the stomach and the rectum. The peptides used were bombesin, the COOH-terminal hepta- octa-, and nonapeptide of bombesin, and litorin, a new natural peptide isolated from the skin of Litoria aurea. Bombesin significantly increased the frquency of pacesetter potentials (PP) in tha antrum, duodenum, jejunum, and ileum. In the duodenum and jejunum the increase of PP frequency showed linear correlation with the reduction of PP amplitude. The propagation velocity of PP was clearly reduced. Spikes were not affected in the antrum and ileum, whereas they were abolished in the duodenum and jejunum. In the duodenum the increase of PP frequency and the slowing down of propagation velocity was followed by the loss of PP phase lock and the appearance of a characteristic electric pattern, consisting of an irregular sequence of small and slow potentials ("electric disorganization"). The mechanical counterpart was the disappearance of intraluminal pressure activity. In the colon the effect of bombesin on electric activity was not consistent. Neither the COOH-terminal heptapeptide nor the octapeptide of bombesin showed a significant effect on myoelectric activity, whereas the effect of COOH-terminal-nonapeptide and litorin was similar to that of bombesin. Thus, the characteristic electric changes of PP produced by bombesin appear to be related to the sequence of the nine amino acids in the COOH-terminal residue of the bombesin molecule.

Amino Acid Sequence↗
PubMedDate not supplied

Intestinal gas in ulcerative colitis.

Intestinal gas was measured planimetrically on plain abdominal films from 25 healthy subjects and 47 patients with active ulcerative colitis (mild, moderate, severe and toxic megacolon). Compared with controls, significant colonic distention was found in toxic megacolon. Gas in the small bowel was significantly increased in toxic megacolon and in severe colitis but was within the normal range in the mild and moderate forms. Two groups of patients with severe colitis were identified, showing either normal or increased gas content in the small bowel. Two of seven patients in the latter group developed toxic megacolon in spite of intensive medical treatment. Intestinal gas values showed a linear correlation with arterial blood pH, ESR and body temperature. No correlation was found between intestinal gas and other features of severity. It is suggested that an abnormal collection of gas in the small bowel loops associated with metabolic alkalosis corresponds to an early stage of a toxic complication ("impending megacolon").

Adult↗
PubMedDate not supplied

Evaluation of Crohn disease activity with magnetic resonance imaging.

BACKGROUND: The purpose of this study was to assess the accuracy of magnetic resonance imaging (MRI) in evaluating Crohn disease (CD) activity. The intestinal inflammatory activity is usually present in patients under pharmacologic treatment, despite their clinical remission. METHODS: Twenty patients with CD, all under pharmacologic treatment, were prospectively studied by MRI at 1.5 T as a periodic control. Positivity of three acute-phase reactants was considered an index of biologic activity (BA). T2-weighted, T2-weighted fat-suppressed turbo spin-echo, and breath-hold T1-weighted turbo field-echo sequences, before and after gadolinium intravenous injection, were obtained. A negative superparamagnetic contrast agent was orally administered. The following MRI parameters were qualitatively evaluated by three radiologists at the level of the affected bowel and compared with clinical data: wall thickness (WT), wall T2-weighted signal (T2W), wall contrast enhancement (WE), amount of fibrofatty proliferation (FP), and T2-weighted signal of fibrofatty proliferation on fat-suppressed images (T2FP). The kappa coefficient of agreement was calculated. The Spearman rank correlation was used for the analysis of clinical and radiologic data. RESULTS: Nineteen of 20 patients were in clinical remission (Crohn Disease Activity Index < 150). On the basis of laboratory tests, nine of 20 patients had biologically active disease. An excellent correlation was found between BA and WE, T2W, and T2FP (0.900, 0.927 and 0.961, respectively; p < 0.0001), and a lower correlation was found between BA and WT and between BA and FP (0.78 and 0.62). Excellent statistical correlation was also found between WE and T2W and between WE and T2FP (0.876 and 0.892). CONCLUSIONS: An excellent statistical correlation was found between biologically "active" disease and the following MRI parameters: wall gadolinium enhancement, wall hyperintensity on T2-weighted fat-suppressed images, and hyperintensity of fibrofatty proliferation on T2-weighted fat-suppressed images. Therefore, MRI can be valuable in assessing CD activity.

Administration, Oral↗