PubMed Health⌕ Search

Biomedical subjects

S Anuras

Publications and source records attributed to S Anuras.

At least 19 recordsLinked to original sources
PubMed1991

Neuromuscular disease of the gastrointestinal tract.

Gastrointestinal motility is the function of gastrointestinal smooth muscle. It is controlled by both the intrinsic and extrinsic nerves of the gastrointestinal tract and, to a lesser degree, the gastrointestinal hormones. Therefore, any abnormality of the above factors, theoretically, can cause gastrointestinal dysmotility. In a clinical situation, commonly seen is gastrointestinal dysmotility caused by either smooth muscle or intrinsic and extrinsic nerves dysfunction. Diseases that cause smooth muscle dysfunction include familial visceral myopathies, nonfamilial visceral myopathies, collagen disease, muscular dystrophies, amyloidosis, thyroid disease, and so on. Diseases that cause enteric nerve dysfunction include familial visceral neuropathies, nonfamilial visceral neuropathies, diabetes mellitus, Chagas' disease, ganglioneuromatosis of the intestine, visceral neuropathy of carcinomatosis, Parkinson's disease, and so on. The patients with neuromuscular disease of the gastrointestinal tract have a wide range of clinical manifestations regardless of the underlying cause. At one end of the spectrum, the patients may be asymptomatic, and at the other end of the spectrum, the patients may have functional obstruction of the gastrointestinal tract. Plain abdominal x-rays, upper gastrointestinal (UGI) and small bowel x-rays, enteroclysis, barium enema, and manometric studies are useful for the work-up of these patients. Enteroclysis is especially helpful in ruling out mechanical obstruction of the small intestine in patients with chronic intestinal pseudo-obstruction. Treatment is mainly symptomatic and supportive. There is no effective drug to improve gastrointestinal motility. Surgery may be helpful in selected cases of severe gastrointestinal dysmotility.

Gastrointestinal Diseases↗
PubMed1990

Right atrial myxoma with a nonembolic intestinal manifestation.

A 5-year-old male with right atrial myxoma without interatrial communication who presented with abdominal pain, vomiting, fever, and guaiac positive stool is reported. He was later found to have ischemia of a jejunal segment necessitating segmental resection. Although his symptoms persisted postoperatively, surgical removal of a right atrial myxoma was followed by complete resolution of his intestinal symptoms. We demonstrated that the mesenteric vasculitis was of nonembolic origin, and we speculate autoimmune arteritis as a possible mechanism.

Child, Preschool↗
PubMed1988

Intestinal pseudo-obstruction syndrome.

Intestinal pseudo-obstruction is a syndrome of many causes. Attempts must be made to determine the cause and the extent of the involvement of the gastrointestinal tract in each patient, because they will dictate the method of treatment for that patient. Family history must be taken from all primary chronic intestinal pseudo-obstruction patients. If it is positive, genetic counseling and proper medical management can be given to newly identified cases in the family.

Colonic Diseases↗
PubMed1987

Changes in colorectal function in patients with chronic colonic pseudoobstruction.

Motility studies of the lower bowel, radiology to exclude other gastrointestinal involvement, and rectal biopsies were carried out in 11 patients, age 21-60 years, with isolated chronic colonic pseudoobstruction. Repeated plain abdominal x-rays during symptomatic periods revealed massive gaseous colonic distension in all. Seven patients had the primary form while four patients had an underlying disease which could have been responsible for the chronic colonic pseudoobstruction. Lower bowel motility was decreased in patients with the primary form. Rectal wall elasticity was increased in both the primary and secondary form. Some of the abnormalities measured may suggest myogenic abnormalities of the sigmoid or rectal wall. No specific neural or muscular morphologic defect was identified in colonic transmural sections in eight patients except in the patient with Hirschsprung's disease. Five of seven patients with primary colonic pseudoobstruction achieved symptomatic relief only after subtotal colectomy and ileoproctostomy.

Adult↗
PubMed1987

Intestinal motility disorders of infants and children: classification, clinical manifestations and roentgenology.

Diseases affecting intestinal motility in the pediatric age group are reviewed as to pathophysiology, clinical manifestations, and imaging investigation. Acute disease includes classical paralytic ileus (which has unique causes and manifestations in the infant) and acute regional bowel paralysis. Perinatal motility disorders consist of a group of related clinical syndromes which have in common functional intestinal obstruction. Chronic motility disorders are divided into those diseases in which the principal abnormality is in the bowel or those entities where the gut is affected as part of a generalized disease. Regional muscle disease includes Hirschsprung's disease and allied disorders. Some recognized causes of chronic functional obstruction of bowel include megacystis-microcolon-intestinal hypoperistalsis syndrome, rare enzymatic disorders, several discrete forms of chronic intestinal pseudoobstruction, as well as some less well-defined entities. Clinical and pathologic nature and methods of imaging investigation of these entities are considered.

Abdominal Muscles↗
PubMed1986

Chronic intestinal pseudoobstruction in young children.

We studied 8 young children (4 boys and 4 girls) with chronic intestinal pseudoobstruction. Intestinal pseudoobstruction, recurrent urinary tract infections, and dysuria occurred between the ages of a few weeks to 5 yr old. All had marked dilatation of the entire gastrointestinal tract distal to the esophagus, and megacystis. Conventional pathologic examinations of the full-thickness specimens of the gastrointestinal tract were normal in 5 and abnormal in 2 patients. The abnormalities included increased fibrosis and lipofuscin pigment in the smooth muscle cells. Myenteric plexus examination, using the Smith's method in 2 patients, was normal. Biopsy specimens from urinary bladders examined in 3 patients revealed separation of individual smooth muscle cells by collagen fibers. Intestinal manometric studies performed in 3 patients showed only weak and infrequent contractions during fasting and after feeding. Severe and extensive dysfunction of the gastrointestinal and urinary tracts with relatively normal histologic appearance are typical for these children.

Abdomen↗
PubMed1986

A familial visceral myopathy with dilatation of the entire gastrointestinal tract.

We are reporting a new kindred in which familial visceral myopathy was identified in four siblings. There was no other symptomatic case identified in this 75-member, four-generation family, suggesting an autosomal recessive inheritance. All patients had recurrent symptoms of intestinal obstruction, and 3 died from malnutrition. Gastrointestinal lesions showed marked dilatation of the entire digestive tract from the esophagus to the rectum, which is different from other types of familial visceral myopathies. Microscopic examination of the gastrointestinal smooth muscle showed degeneration and increased fibrosis indistinguishable from other types of familial visceral myopathy.

Adult↗
PubMed1986

The colon in the pseudoobstructive syndrome.

Colonic pseudoobstruction can occur as part of a generalized chronic intestinal pseudoobstruction syndrome or as an isolated entity. Isolated colonic pseudoobstruction can occur in two unrelated forms: the acute and chronic forms. Acute colonic pseudoobstruction is frequently a hospital-acquired disease that arises as a complication of other illnesses. The syndrome must be recognized and treated with early colonoscopic decompression to prevent cecal or colonic perforation. Chronic colonic pseudoobstruction is a syndrome of many causes. The prognosis of patients with chronic colonic pseudoobstruction is much better than that of generalized chronic intestinal pseudoobstruction, because the patients become asymptomatic with appropriate operations. The pathogenesis of acute colonic pseudoobstruction and several types of chronic colonic pseudoobstruction is not known. Further investigations should include bacteriologic study, histopathologic studies (examinations of smooth muscle and myenteric plexus), and examination of extrinsic nerves of the colon. With these approaches, a better understanding of the pathogenesis of these syndromes will be achieved.

Colonic Diseases↗
PubMed1985

Effect of substance P on opossum duodenal smooth muscle.

Opossum duodenum was cut into strips measuring 2.0 X 15.0 mm. Strips cut along the oral-caudal axis were called longitudinal strips, while those cut 90 degrees to that axis were called circular strips. Each strip was placed in a heated, oxygenated organ bath and attached to a force-displacement transducer. Substance P produced tonic contraction in longitudinal strips and tonic and phasic contraction in circular strips. The ED50 for longitudinal and circular muscle was 1.9 X 10(-7) M and 2.8 X 10(-7) M, respectively. Longitudinal muscle was 1.3 times more sensitive to substance P than circular muscle. Phenoxybenzamine, atropine, curare, propranolol, haloperidol, and tetrodotoxin had no effect on the substance P-produced contractions in circular and longitudinal muscle. Trifluoperazine (10(-5) and 10(-4) M), D600 (10(-7) M), and nifedipine (10(-8) and 10(-7] inhibited both tonic and phasic contraction in circular and longitudinal strips. These studies suggest that substance P acts on both muscle layers at a site located at the muscle cell and that it produces tonic and phasic contraction through similar calcium-activating pathways.

Animals↗
PubMed1985

Familial visceral myopathy: the role of surgery.

Familial visceral myopathy is a form of chronic intestinal pseudoobstruction in which fibrosis of the smooth muscle of the alimentary tract causes protean symptoms of disordered visceral motility. Based on our 8 year observation of six members of one family with familial visceral myopathy and review of the few well-documented case reports of this disease, we have confirmed a role for surgeons in tissue diagnosis, case identification, and palliation of incapacitating symptoms of familial visceral myopathy after obtaining dynamic radiographic assessment of the entire alimentary canal. Because the duodenum and colon are the usual sources of major dysmotility symptoms, patients incapacitated by duodenal or colonic pseudoobstruction may benefit from bypass or resective operations.

Adult↗
PubMed1985

Effects of age and sex on anorectal manometry.

We studied rectal and anal function in 18 healthy elderly and 18 healthy young adults using intraluminal pressure transducers and a rectal balloon. Both age groups consisted of nine females and nine males. Age did not affect anal length, highest anal resting tone, anal pullthrough pressures obtained during rest and voluntary squeeze, threshold of the rectosphincteric reflex (RSR), amplitude of RSR with 60 ml rectal distension, threshold of sensation, critical volume, and rectal wall elasticity. Sex did not affect anal length, threshold of RSR, amplitude of RSR with 60 ml rectal distension, the critical volume and rectal wall elasticity. But the highest anal resting tone, anal pullthrough pressures obtained during rest and voluntary squeeze, and threshold of rectal sensation were significantly higher in the males than in the females. While aging did not affect anal and rectal function, sex did. Males achieved higher anal canal pressures. Therefore, statistical comparison between different groups of subjects is valid only if the groups are matched for sex.

Adult↗
PubMed1979

Surgical treatment in familial visceral myopathy.

In a kindred with a familial visceral myopathy, seven patients had operations seeking relief of chronic abdominal pain and other symptoms of intestinal obstruction; one patient had an 80% cystectomy and a Y-V-plasty of the bladder neck for urinary retention. Five patients with megaduodenum had bypass operations; a side-to-side duodenojejunostomy was done in four and a retrocolic gastrojejunostomy in one. Two of these died of postoperative complications, and one developed symptomatic adhesions. Two other patients who had duodenojejunostomy have done well for 6 years and 1 1/2 years respectively. One patient with dilation of the distal jejunum and proximal ileum had relief of intestinal obstructive symptoms from jejunostomy to decompress the destal jejunum. One patient who had a resection of the descending and sigmoid colon for sigmoid volvulus has done well for four years. Three of these seven patients developed peritonitis postoperatively, and two had symptomatic adhesions after operations. Duodenal aspiration from a patient who developed postoperative peritonitis grew E. coli, 10(13) colonies per ml. After review of the results of operations in other families and in our kindred, we favor side-to-side duodenojejunostomy in megaduodenum. Duodenal aspirate must be cultured before operation. Evidence of bacterial overgrowth in the aspirate should prompt appropriate antibiotic treatment to reduce the likelihood of sepsis.

Abdomen↗
PubMed1979

Effects of some autonomic drugs on duodenal smooth muscle.

Longitudinal muscle strips (LMS) and circular muscle strips (CMS), 2 mm wide and 1.5--2 cm long, from opossum duodenum were exposed to some autonomic agonists. The cholinergic agonists, acetylcholine, carbachol, methacholine, and bethanechol stimulated only tonic contractions in LMS and tonic followed by phasic contractions in CMS. These effects were abolished by atropine 10(-6) M. The ED50S of all cholinergic agonists for LMS were significantly lower than for CMS. Norepinephrine caused initial contraction (abolished by phenoxybenzamine, 10(-4) M), followed by relaxation (abolished by propranolol, 10(-5) M), and isopropylnorepinephrine caused relaxation (abolished by propranolol, 10(-5) M) in both layers. There were no differences in relative potencies for adrenergic agonists between the layers. Tetrodotoxin did not affect the response to adrenergic agonists. Thus, the potency of cholinergic agonists is greater in longitudinal than in circular muscle, and the layers respond differently to cholinergic agonists. The alpha-adrenergic receptors mediate contraction and beta-adrenergic receptors mediate relaxation on the duodenal smooth muscle.

Acetylcholine↗
PubMed1978

Idiopathic chronic intestinal pseudo-obstruction. Use of central venous nutrition.

Patients with idiopathic chronic intestinal pseudo-obstruction suffer from malnutrition because of inability to maintain adequate oral intake without the development of obstructive symptoms. We have successfully used central venous nutrition in two patients with this syndrome, both on a short-term and long-term home-maintenance basis. Hyperalimentation can provide adequate nutrition in patients with intestinal pseudo-obstruction until normal bowel function returns or until definitive therapy for this chronic disease is found.

Child↗
PubMed1978

Liver disease in renal transplant recipients.

Liver disease is a common complication in renal transplant recipients. Several types of liver disease can occur. The most common are acute and chronic hepatitis. The variety of acute hepatitis include hepatitis A, hepatitis B, cytomegalovirus hepatitis, herpes simplex hepatitis and azathioprine hepatitis. The incidence of azathioprine hepatitis may not be as high as initially suggested. Chronic hepatitis is a serious problem because the disease seems to be progressive despite prednisone therapy. The causes of this chronic hepatitis are not fully known, although hepatitis B, cytomegalovirus and herpes simplex virus have been implicated. Discontinuation of azathioprine therapy has no appreciable effect on the course of chronic hepatitis.

Animals↗
PubMed1978

Recurrent hepatitis following halothane exposures.

The existence of hepatotoxicity due to halothane remains subject to debate. Three cases are presented in which multiple exposures to halothane were followed in several instances by evidence of postoperative fever and/or hepatitis. In one case, hepatitis with bridging necrosis developed; the patient responded to long-term steroid therapy. In another, fulminant hepatic necrosis proved fatal. A brief review of halothane hepatitis is given. Otherwise unexplained fever and hepatitis following the use of halothane, especially if recurrent or accompanied by evidence of hypersensitivity, should contraindicate subsequent use of that drug.

Biopsy↗
PubMed1978

Carcinoma of the papilla of Vater. A review of fifty-seven cases.

Fifty-seven cases of carcinoma of the papilla of Vater are reviewed. Clinical and pathologic features as well as results of various surgical treatments are summarized. The Whipple operation may be the operation of choice for cancer of the papilla of Vater, offering a chance for cure and obviating further surgery.

Adult↗