Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042961 (volvulus)
 4,305 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The successful application of laparoscopic surgery to gallbladder disease and acute appendicitis has encouraged clinical investigators to develop this technology further in an attempt to manage other pathologic disorders of the gastrointestinal (GI) tract. After gaining experience with various laparoscopic skills while performing clinical biliary tract surgery, appendectomy and then in a controlled animal laboratory, a pilot program for laparoscopic colonic surgery was initiated. Twenty patients with ages ranging from 43 to 88 years (mean age of 57 years) underwent laparoscope-assisted colon resection. In nine patients, a right hemicolectomy was performed and a sigmoid colectomy in eight. A low anterior resection, Hartman's procedure, and abdominal perineal resection were each performed in one patient. Indications for surgery were large villous adenomas or adenocarcinoma in 12, diverticular disease in 5, sigmoid endometrioma in 1, cecal volvulus in 1, and inflammatory bowel disease in 1. Eighty percent of patients were able to tolerate a liquid diet on the first postoperative day and 70% were discharged within 96 h eating a regular diet and having normal bowel movements. There were three operative complications: a 3 unit postoperative bleed managed without surgery, one patient developed marked edema of the rectosigmoid anastomosis requiring decompression with a rectal tube, and one individual with metastatic colon cancer was operated on for a mechanical small bowel obstruction 7 days after the initial laparoscopic surgery. Although laparoscope-assisted colonic surgery may still be considered a procedure in evolution, we feel that in time it has the potential to be as popular as laparoscopic cholecystectomy.
Surg Laparosc Endosc 1991 Sep
PMID:Minimally invasive colon resection (laparoscopic colectomy). 168 89

Recombinant Onchocerca volvulus Ag have been derived from expression libraries and examined for their ability to stimulate PBMC from patients infected with O. volvulus. Ten clones producing recombinant Ag were selected and plaque purified; lysogens were produced and found to express beta-galactosidase fusion proteins ranging in molecular mass from 115 to 138 kDa. When ammonium sulfate-precipitated lysates of these recombinant phage clones were examined for their ability to stimulate PBMC from a patient with onchocerciasis, all 10 recombinants produced stimulation above that to nonrecombinant phage. When individual fusion proteins, affinity purified on anti-beta-galactosidase linked to agarose, were used to stimulate PBMC from patients with onchocerciasis, only one of the recombinant Ag induced PBMC proliferation (stimulation index greater than 4) above that to Ag from nonrecombinant phage. Characterization of the DNA coding for this Ag showed it to be 1.2 kb in length with a small (90 bp) open reading frame; furthermore, it appears to be Onchocerca specific (on genomic dot blots) and single copy. Using overlapping peptides encompassing the entire open reading frame, one T cell epitope has been localized.
J Immunol 1990 Sep 01
PMID:The identification of an Onchocerca-specific recombinant antigen containing a T cell epitope. 169 1

Adult Onchocerca volvulus, extracted from nodules before, and at intervals of two weeks to 12 months after, a single 150 micrograms/kg dose of ivermectin, were examined longitudinally and by sequential transverse sections. The mean number of male worms per nodule fell, and the proportion of nodules with no male worm rose, within two weeks of ivermectin and remained so for 12 months. In female worms, at intervals after ivermectin, the percentages of the length of the lower genital tracts occupied by embryos at each stage of development, or by degenerating ova, embryos and microfilariae (mfs), were recorded: (a) in un(re-)inseminated worms whose original embryogenesis was continuing and in those in which it was completed; and (b) in worms, reinseminated post-ivermectin, in which a new embryogenesis had begun. The results indicated that: (a) the time needed for the zygotes of O. volvulus to develop to mfs is 8-12 weeks; (b) nearly 40 percent of females had not resumed mf production by 12 months after treatment; (c) many intrauterine mfs had not degenerated within the first two weeks of ivermectin; (d) some of the last embryos to mature to mfs did not degenerate but accumulated temporarily in the anterior uteri 8-16 weeks after ivermectin.
Trop Med Parasitol 1991 Sep
PMID:The embryogenesis of Onchocerca volvulus over the first year after a single dose of ivermectin. 180 Nov 40

Savanna species of the Simulium damnosum complex, the major vectors of the blinding savanna type of onchocerciasis, were considered to be rare in Liberia, until the dry season of 1988. In 1988 they became a serious nuisance, biting people at the Bong iron ore mine within the rain forest zone. S. damnosum s.str. and S. sirbanum were found breeding, in association with S. adersi a non man-biting savanna species, in a stream emerging from the mine's tailings pond. The local forest species were extremely rare in this stream. The water of the stream was characterized by an increased hardness and higher temperatures in comparison with those of natural watercourses in the area. The mass occurrence of flies was probably related to expansions of the tailings ponds, when rich nutrition was provided for the blackfly larvae by the decaying forests submerged by the rising water levels. The phenomenon did not recur in 1989 when only a few savanna flies were caught, and none were seen in the dry season of 1990. Although it is not known why the artificial environment of the tailings ponds was so attractive for the savanna species the events clearly demonstrated that savanna flies seasonally invading the area, possibly aided by the northeasterly harmattan winds, can become established in the rain forest zone if suitable conditions are met. No infections with Onchocerca volvulus were found in more than 1000 flies caught by vector collectors but, after experimental infection with the local forest strain, a few parasites developed to the infective stage. As yet there is no evidence that the occurrence of savanna flies in the rain forest zone of Liberia was of epidemiological significance.
Trop Med Parasitol 1991 Sep
PMID:A temporary focus of savanna species of the Simulium damnosum complex in the forest zone of Liberia. 180 Nov 41

Inbred CBA/Ca mice were vaccinated with Onchocerca volvulus or Onchocerca lienalis microfilariae (mf) and challenged 100 days later with the homologous or heterologous parasite. There was a major reduction in mf recoveries from immunised animals compared with controls when the sensitising and challenge infections were both of O. volvulus mf. Resistance was manifest within one week of challenge, and rose from an 87% reduction in recoveries on day 7 to a 96% reduction on day 15. Similar results were obtained for homologous sensitising and challenge infections with O. lienalis mf. Protection afforded by sensitisation with the heterologous parasite was also high, although the expression of resistance appeared to be delayed. Vaccination with O. lienalis mf led to a 45% level of cross-protection against O. volvulus at 7 days after challenge, which rose to 94% by day 15. Vaccination with O. volvulus mf stimulated cross-protection against O. lienalis at levels of 49% and 80% as measured 7 and 15 days after challenge. It is concluded that the mouse model may be of value in analysing immune responses directed against O. volvulus mf and that the cross-protection between Onchocerca species is an advantage that should be exploited in characterising the antigens involved.
Trop Med Parasitol 1991 Sep
PMID:Immunity to Onchocerca volvulus microfilariae in mice and the induction of cross-protection with O. lienalis. 180 Nov 42

The objective of this multidisciplinary clinical investigation was to test whether amocarzine was absorbed effectively and safely in patients of two races and either sex infected with Onchocerca volvulus while living in the holoendemic area of Esmeraldas Province, Ecuador. The prerequisite for a systemic onchocercacidal effect is the regular absorption of orally administered amocarzine. Single dosing after overnight fasting proved to produce irregular absorption of amocarzine, although some microfilaricidal effect was achieved. A pilot study with repeated low dose and postprandial administration of amocarzine showed a regular and predictable absorption with acceptable tolerability and a microfilaricidal effect lasting up to one year post-therapy. Since amocarzine and its major N-oxide metabolite are coloured agents, urine colorimetry was used to assess the urinary excretion of the N-oxide qualitatively. For the postprandial drug regimens plasma concentrations of amocarzine and its metabolite were determined at two selected time points in patients of two races and either sex; the results showed no major differences. Excision of onchocercal nodules was performed four months post-therapy. The pooled results of the histologic analysis of 100 patients with the same drug regimen read under blinded condition showed that 65% of the adult female worms were dead, 20% necrobiotic and 15% alive. The male worms were fewer and mainly necrobiotic. Control worm populations in Esmeraldas without chemotherapy showed that on the average 81.5% were alive and 18.5% dead. Amocarzine was also microfilaricidal producing a reduction of skin dwelling microfilariae to about 10% of the initial value within the first week after start of therapy and lasting for half a year at a 20% level. The reduction of ocular microfilarial was slower and reached 35-40% after one year. The general tolerability was acceptable to good. Reversible dermal reactions were usually mild and peaked as a rash in 57% of the patients on day 6. No prohibitive ocular intolerance was observed. Mild and reversible dizziness peaked on day 4 in 74% of patients. A positive reversible Romberg sign was found in 12 patients on day 4. Amocarzine, the first oral micro- and macrofilaricidal agent administered as a low dose repeat regimen (3 mg/kg twice daily and postprandial for three consecutive days) can be recommended for oral onchocercacidal therapy in adult patients. Clinical trials in juveniles should be encouraged.
Trop Med Parasitol 1991 Sep
PMID:Onchocercacidal effect of three drug regimens of amocarzine in 148 patients of two races and both sexes from Esmeraldas, Ecuador. 180 Nov 53

Twenty male patients from Guatemala infected with Onchocerca volvulus received a 3 mg/kg oral dose of amocarzine twice daily for three days. The patients were randomly assigned to the sequence fasting/non-fasting and non-fasting/fasting for the morning administration on days 1 and 3. All other doses were given after food intake. Blood samples on days 1 and 3 and urine fractions from days 3 to 5 were collected for the determination of the unchanged drug and of its N-oxide metabolite, CGP 13 231. The absorption of amocarzine and CGP 13 231 was slower and sustained for longer time in fed patients than in fasting ones. The mean AUC of amocarzine was significantly higher (about 20%) in fed patients. No significant difference was found for CGP 13 231. The relative improvement of bioavailability of amocarzine due to food was less prominent than previously obtained after a high dose of 1200 mg which demonstrated a bioavailability improvement of a factor of three. Therefore, saturable dose dependent absorption processes are likely to be involved for the administration in fasting conditions. Conversely, the concentrations of amocarzine in fed patients after 150 and 1200 mg were dose proportional, thus indicating linear kinetics. The cumulative urinary excretions of CGP 6140 ranged from 0.1 to 3.8% of the daily dose. Those of CGP 13 231 ranged from 31 to 64%. This total excretion was larger than that previously recorded in fasting patients after a single oral dose. The present results confirm the improvement of the bioavailability of the drug administered after food intake.
Trop Med Parasitol 1991 Sep
PMID:Influence of food related to dose on the pharmacokinetics of amocarzine and of its N-oxide metabolite, CGP 13 231, after oral administration to 20 onchocerciasis male patients from Guatemala. 180 Nov 54

The possible influence of sex, race and of postprandial administration conditions (either immediately after the end of meal or one hour later) on the plasma concentrations of amocarzine and its N-oxide metabolite, CGP 13 231, was investigated. 71 Ecuadorian patients (48 males and 23 females) of two different races (Indio and Negro) infected with Onchocerca volvulus participated in the study. The concentrations were measured on day 3 at times 3 and 6 h after postprandial administration in the morning of a treatment with either a dose of 5 mg/kg of amocarzine once daily (12 patients) or 3 mg/kg twice daily (59 patients) for 3 days. The concentrations of unchanged drug and of CGP 13 231 measured after the 5 mg/kg treatment were in the low range of those expected from dose proportionality by the comparison with the 3 mg/kg. After the 3 mg/kg dose, no significant difference in concentration of both compounds were detected between the male and female patients between Indio and Negro patients, between the administration immediately after food intake and one hour later. The only detected difference (P = 0.05) was that between Indio and Negro patients for the concentrations of CGP 13 231 at time 3 h. This difference was not confirmed at time 6 h. Therefore, the administration of amocarzine either immediately or one hour after food intake appeared to produce reproducible absorption conditions which were not influenced by sex and race.
Trop Med Parasitol 1991 Sep
PMID:Concentrations of amocarzine in plasma of 71 Ecuadorian patients of two different races receiving 3 mg/kg b.i.d. and 5 mg/kg o.d. oral postprandial doses for 3 days. 180 Nov 55

Skin punch biopsies were performed in 54 selected patients with onchocerciasis participating in a clinical trial with amocarzine (CGP 6140) in Ecuador and Guatemala. Skin snipping for counting microfilariae of Onchocerca volvulus was done before treatment (day 0) and day 4 and 8 following start of the therapy which consisted of 3 mg/kg amocarzine postprandially twice daily for three consecutive days. The mean microfilarial skin density has been reduced by 45% on day 4 and 95% on day 8. Skin punch biopsies were taken on day 5, within 1 cm from the snip site on the iliac crest. Histopathologic examination revealed that the vast majority of the microfilariae in the upper as well as in the deeper dermis were degenerated or necrotic, surrounded often (57%) by minute foci of fibrinoid change of the collagen. There was usually slight, less frequently moderate eosinophilic, lympho-plasmocytic and initial histocytic inflammatory reaction in the vicinity. Microfilariae were frequently (69%) found at the dermal-epidermal junction and in the epidermis. Occasionally (7%) intra-epidermal microabscesses were noted. Microfilariae were detected also in the lumen of some dermal lymphatic vessels. Therefore it is concluded that amocarzine showed marked microfilaricidal effects in the skin of patients with onchocerciasis as evidenced histologically by mainly destroyed or moribund microfilariae which induced a mild to moderate inflammatory cell reaction.
Trop Med Parasitol 1991 Sep
PMID:Microfilaricidal effect of amocarzine in skin punch biopsies of patients with onchocerciasis from Latin America. 180 Nov 56

Transmission electron microscopy was used to demonstrate the effects of amocarzine (CGP 6140) on the fine structure of Onchocerca volvulus microfilariae (mf) in skin biopsies from patients treated orally in Guatemala or transepidermally exposed in Liberia. After 6-10 hours exposure to the drug most mf did not show any alterations and only a few mf contained increased numbers of vacuoles in the cytoplasm and clefts between cuticle and hypodermis. At 20-48 hours after treatment most of the mf showed distinct signs of damage. Most frequently seen was disintegration of the cytoplasm of the afibrillar portion of the muscle cells. Some mf showed also disintegration of the myofilaments and of the internal structure of the mitochondria in the muscle cells. Other signs were progressive separation of the cuticle from the hypodermis, increase of intracellular vacuoles and clefts and in some mf condensation of the cytoplasm. The type and the site of the morphological alterations were the same after both forms of amocarzine administration. The degree of morphological changes increased with the length of time of exposure to the drug. Microfilariae with morphological alterations were nearly always surrounded by adherent host cells, mostly eosinophils and macrophages.
Trop Med Parasitol 1991 Sep
PMID:Fine structure of microfilariae in the skin of onchocerciasis patients after exposure to amocarzine. 180 Nov 59


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