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)

Conditions which resulted in colonic preservation such as strangulated hernia, intestinal volvulus, and mesenteric infarction were once the main reasons for a major intestinal resection leading to the short bowel syndrome. Now Crohn's disease is the most common underlying diagnosis; such patients often have a jejunostomy. A measurement of the residual jejunal length from the duodenojejunal flexure makes possible predictions of patient outcome. Patients with a jejunostomy and less than 100 cm jejunum usually need long-term parenteral support, whereas 50 cm or more of jejunum usually suffices for adequate oral nutrition if the colon is preserved. While patients with and without a colon have problems with nutrient absorption, those with a jejunostomy also have problems of water, sodium and magnesium losses. Stomal losses may exceed oral intake and all such patients ('secretors') need parenteral supplements. Fluid and sodium losses can be reduced by octreotide, omeprazole or H2 blockers but not sufficiently to avoid the need for intravenous supplements. Colonic preservation increases the incidence of calcium oxalate renal stones (20%). Patients with and without a colon have a high prevalence of gallstones (40%). Clinically important intestinal adaptation occurs in those with a colon but not in those with a jejunostomy. Many surgical techniques, including small bowel transplantation, have been suggested to improve absorption, but as the quality of life of most patients with a short bowel is good with current treatments, they are not at present recommended.
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PMID:The short bowel syndrome: what's new and old? 844 53

We administered potassium iodide and propylthiouracil per rectum, in conjunction with intravenous dexamethasone and propranolol, for emergent treatment of a patient in thyroid storm with small bowel obstruction. Shortly after initiation of this treatment, the patient successfully underwent two emergent surgical procedures for resection of an intestinal volvulus with advanced peritonitis. Serum levels of iodide and propylthiouracil showed substantial absorption of these drugs via the rectal route. Measurement of 24-h urinary-free iodide indicated that the bioavailability of potassium iodide delivered by retention enema was at least 40%. Parenteral iodide preparations have been unavailable in the past, and continue to be difficult to obtain emergently. Rectal administration of inorganic iodide is an effective, readily available and less expensive alternative to parenteral sodium iodide for patients in thyroid storm with upper gastrointestinal tract dysfunction.
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PMID:Rectal administration of iodide and propylthiouracil in the treatment of thyroid storm. 856 81

Ruminal and abomasal contents were collected from cows with left abomasal displacement (L), right abomasal displacement (R-), or abomasal volvulus (R+), before the abomasum was corrected, as well as one and three days later, pH and concentrations of sodium (Na), potassium (K), magnesium (Mg), calcium (Ca), phosphate (P), and chloride (Cl) were determined. Results were compared with those from healthy control cattle fed a balanced diet. Ruminal concentrations of Na and Ca were reduced in cattle with abomasal displacement, whereas those of K, P and Cl were increased, and those of Mg and pH remained nearly unchanged. Concentrations of K and P before abomasal correction were lower in cattle with L than in those with R+, and declined after the correction. Concentrations of Cl decreased continuously after the abomasum was corrected in cattle with L, whereas they increased after replacement in cattle with R and declined later. These findings imply that cattle with abomasal displacement took up less feed before surgical correction and that ruminal contents backed up in the rumen, whereby the backup was less with L than with R+, and that the backed-up contents passed on after the abomasum was corrected. The results also indicate that a reflux of abomasal contents into the rumen took place in cattle with all forms of abomasal displacement, whereby with R+ increased amounts of abomasal contents passed into the rumen following correction and were then later passed out. Compared to controls, abomasal concentrations of Cl were increased in cattle with displacement and the concentrations of K, Mg, Ca, and P were reduced. Before abomasal correction, pH was decreased in cattle with L and unchanged in those with R- and R+. The concentrations of Na and K before correction in L were lower than those with R+, whereas the concentrations of K, Mg, Ca, and P were higher. After abomasal correction, the concentrations of Na declined, and those of K, Mg, Ca, and P increased. On the third day after abomasal correction, pH and the concentrations of K, Mg, Ca, and P were lower and the concentrations of Cl higher than in controls. These findings indicate that before abomasal correction in cattle with abomasal displacement secretion from the abomasal glands was increased, abomasal contents backed up in the abomasum, whereby the secretion/backup was less with L than with R+, and that the backed-up contents are passed on after the abomasum is corrected. The findings also suggest that the increased rate of secretion from the abomasal glands or abomasal motility disorders continues on to the third day after abomasal correction.
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PMID:[pH, sodium, potassium, magnesium, calcium, phosphate and chloride in the rumen and abomasal contents of cows with abomasal displacement]. 864 9

The cDNA sequence encoding an Onchocerca volvulus collagen, Ovcol-1, has been isolated and the corresponding native antigen has been identified. The cDNA encodes an open reading frame of 96 amino acid residues containing an uninterrupted 66-residue Gly-X-Y repeat triple-helical (TH) domain (where X and Y may be any amino acids) flanked by a 26-residue amino non-TH domain and a 4-residue carboxyl non-TH domain. The size (9.7 kDa) and structure of the deduced molecule are unique among previously identified collagen chains. This novel collagen type has been designated "mini-chain collagen." Native Ovcol-1 is aqueous soluble and resolves by sodium dodecyl sulfate-polyacrylamide gel electrophoresis at 14.2 kDa under reducing conditions. Immunoelectron microscopy of adult female O. volvulus localized Ovcol-1 to the cuticles of both the adult worm and uterine microfilaria. A group of individuals from an area in Ecuador where O. volvulus is hyperendemic have been classified as putatively immune (PI) to O. volvulus infection. Analysis of the humoral immune responses to Ovcol-1 demonstrated that immunoglobulin G3 (IgG3) of PI individuals preferentially recognized this antigen in comparison to IgG3 of infected individuals.
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PMID:The novel cuticular collagen Ovcol-1 of Onchocerca volvulus is preferentially recognized by immunoglobulin G3 from putatively immune individuals. 897 7

The objectives of this study were to investigate the determinants of the anion gap (AG) in cattle and to evaluate the utility of AG in detecting hyperlactatemia in sick neonatal calves and adult cattle. The AG was calculated as AG = ([Na+] + [K+])-([Cl-] + [HCO-3]), with all values in mEq/L. The AG of healthy neonatal calves (n = 16) was 29.6 +/- 6.2 mEq/L (mean +/- SD), and the blood L-lactate concentration ranged from 0.5 to 1.2 mM/L. The AG was significantly (P < .05) correlated with serum phosphate (r = .66) and creatinine (r = .51) concentrations. The AG of neonatal calves with experimentally induced diarrhea (n = 16) was 28.6 +/- 5.6 mEq/L, and the blood L-lactate concentration ranged from 1.1 to 2.9 mM/L. The AG was significantly correlated with blood L-lactate concentration (r = .67), serum phosphate concentration (r = .63), creatinine concentration (r = .76), and blood pH (r = -.61). The AG of adult cattle with abomasal volvulus (n = 41) was 20.5 +/- 7.8 mEq/L, and the blood L-lactate concentration ranged from 0.6 to 15.6 mM/L. The AG was significantly correlated with blood L-lactate concentration (r = .60), serum phosphate concentration (r = .71), creatinine concentration (r = .65), albumin concentration (r = .47), total protein concentration (r = .54), blood pyruvate concentration (r = .67), and blood pH (r = -.41) but not plasma beta-OH butyrate concentration. The results indicate that the AG in cattle is only moderately correlated with blood L-lactate concentration and is similarly correlated with serum phosphate and creatinine concentrations in neonatal calves and adult cattle, as well as with serum albumin and total protein concentrations in adult cattle. Anion gap determination is of limited usefulness in predicting blood L-lactate concentration in sick cattle, whereas the correlation between AG and serum creatinine concentration in sick cattle suggests that an increased AG should alert the clinician to the potential presence of uremic anions.
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PMID:Determinants and utility of the anion gap in predicting hyperlactatemia in cattle. 912 93

To explore the possibility for development of an immunodiagnostic test for Dracunculus medinensis infections, the antibody responses (IgG1, IgG2, IgG3, IgG4 and IgE) to antigen preparations made from adult female worms (ADGW) and first stage larvae (LVGW) of D. medinensis were analysed. By sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE)/Western blotting, sera from individuals with patent D. medinensis infection reacted extensively and similarly with ADGW and LVGW over a broad molecular weight range (5-200 kDa). Sera from individuals infected with Onchocerca volvulus (the major cross-reacting infection) had a more pronounced reaction with ADGW than LVGW, and only with antigens of molecular weights above 23 kDa. These findings were used to design an enzyme-linked immunosorbent assay (ELISA) with high sensitivity and specificity for D. medinensis infection. The most promising results were obtained when detecting for specific IgG4. Thus, when using LVGW, the assay had a sensitivity of 83% and a specificity of 97%. Refining the antigen into a low molecular weight filtrate improved the sensitivity to 92%, and the sensitivity was further improved (to 96%) when combining the results from two or more antibody types measured simultaneously, without affecting the specificity. The results were encouraging for the prospects for developing an applicable immunodiagnostic test for patent D. medinensis infections based on detection of specific serum antibodies.
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PMID:Studies on immunodiagnosis of dracunculiasis. I. Detection of specific serum antibodies. 970 66

This is a report of a 54-year-old schizophrenic patient with a 15-year history of ingesting metal objects (pica). He presented with severe anemia (hemoglobin of 3 g/dl and hematocrit of 8.3%) and leukopenia (white blood count of 1,300/mm3). Work-up revealed copper deficiency (copper level of <0.05 microg/ml) and elevated zinc levels (280 microg/ml). The zinc toxicity was produced by the zinc content in the coins ingested by the patient over a period of many years. He was initially treated with -acetylcysteine and sodium bicarbonate followed by intravenous copper sulfate. He was also placed on Adolph's meat tenderizer and pancreatin thrice a day orally to loosen the massive amount of metallic objects including coins in his bowel and allow them to pass out in his feces. He was also continued on oral copper sulfate. His copper levels began to rise and reached a maximum of 0.72 microg/ml, and his zinc level fell to 153 microg/ml. However, as he refused surgery to remove the metal objects from his bowel and continued to ingest more coins, there was continued absorption of zinc, which later overcame the efforts to reduce the zinc level and increase copper levels in his blood. He finally succumbed to sepsis and multiorgan failure. Autopsy revealed a coin mass in the stomach weighing 1,870 grams in addition to a sigmoid volvulus caused by another coin bezoar in the colon.
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PMID:Case report of sideroblastic anemia caused by ingestion of coins. 1142 Dec 92

D-lactic acidosis is a rare complication in children with short bowel syndrome. It results from fermentation of dietary carbohydrate by luminal bacteria in the small bowel caused by bacterial overgrowth. We present the case of a 14-year-old boy who had been diagnosed with short bowel syndrome from surgical treatment of midgut volvulus five years previously. His nutritional status was maintained by total parenteral nutrition and enteral feeding as tolerated. During hospitalization, episodic confusion and hyperpnea developed. The investigation showed severe metabolic acidosis with serum bicarbonate of 9 mmol/L and a wide anion gap. The serum D-lactic acid was 11.21 mmol/L. There was no evidence of renal or hepatic failure. Therefore, D-lactic acidosis from enteral carbohydrate overload was diagnosed. The treatment was correction of metabolic acidosis by sodium bicarbonate infusion and carbohydrate restriction. The results of the therapy were satisfactory. Early detection and appropriate treatment is necessary to avoid morbidity and mortality following this complication of short bowel syndrome.
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PMID:Recurrent D-lactic acidosis in a child with short bowel syndrome. 1592 40

Although urolithiasis is common in spinal cord injury patients, it is presumed that the predisposing factors for urinary stones in spinal cord injury patients are immobilization-induced hypercalciuria in the initial period after spinal injury and, in later stages, urine infection by urease-producing micro-organisms, e.g., Proteus sp., which cause struvite stones. We describe a patient who sustained C-7 complete tetraplegia in a road traffic accident in 1970, when he was 16 years old. Left ureterolithotomy was performed in 1971 followed by left nephrectomy in 1972. Probably due to adhesions, this patient developed volvulus of the intestine in 1974. As he had complete tetraplegia, he did not feel pain in the abdomen and there was a delay in the diagnosis of volvulus, which led to ischemia of a large segment of the small bowel. All but 1 ft of jejunum and 1 ft of ileum were resected leaving the large bowel intact. In 1998, suprapubic cystostomy was performed. In 2004, this patient developed calculus in the solitary right kidney. Complete stone clearance was achieved by extracorporeal shock wave lithotripsy. Stone analysis: calcium oxalate 60% and calcium phosphate 40%. Metabolic evaluation revealed hyperoxaluria, hypocitraturia, and hypomagnesiuria. Since this patient had hyperoxaluria, the stool was tested for Oxalobacter formigenes, a specific oxalate-degrading, anerobic bacterium inhabiting the gastrointestinal tracts of humans; absence of this bacterium appears to be a risk factor for development of hyperoxaluria and, subsequently, calcium oxalate kidney stone disease. DNA from the stool was extracted using the QIAamp DNA stool Mini Kit (Qiagen, Chatsworth, CA). The genomic DNA was amplified by polymerase chain reaction using specific primers for oxc gene (developed by Sidhu and associates). The stool sample tested negative for O. formigenes. The patient was prescribed potassium citrate mixture; he was advised to avoid oxalate-rich food, maintain recommended levels of calcium in his diet, and take live bio-yogurt. Two months later, 24-h urinary oxalate decreased from 0.618 to 0.411 mmol/day; 24-h urine citrate increased from 0.58 to 1.10 mmol/day. Six months later, an oxalate absorption test was performed. The patient swallowed a capsule, soluble in gastric juice, containing 50 mg (0.37 mmol) sodium [13C2]oxalate corresponding to 33.8 mg of [13C2]oxalic acid. The amount of labeled oxalate, excreted in urine, was measured by a gas chromatographic-mass spectrometric assay. Oxalate absorption, expressed as the percentage of the labeled dose recovered in the 24-h urine after dosing, was 8.3% (reference range: 2.3-17.5%). In addition to other conventional measures, oral administration of O. formigenes or lactic acid bacteria mixture to promote bacterial degradation of oxalate in the gut, and thus combat hyperoxaluria, may play a role in prevention of calcium oxalate kidney stones.
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PMID:Hyperoxaluria, hypocitraturia, hypomagnesiuria, and lack of intestinal colonization by Oxalobacter formigenes in a cervical spinal cord injury patient with suprapubic cystostomy, short bowel, and nephrolithiasis. 1761 9

Excretory-secretory (ES) products of nematodes and other helminths are the first molecules to interact with cell surfaces and soluble proteins within the host. In the present study, ES products of the filarial nematode Onchocerca ochengi were investigated as a model for Onchocerca volvulus, the causative agent of river blindness. These products were collected from adult and larval stages in vitro over a period of 7 days, to compare their immunological recognition in cattle and human sera, infected with species of Onchocerca. From the 156 sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) ES products or extracts, protein bands showed different patterns between female and male products. A comparison of antibody recognition of the different ES products by sera from infected cattle and humans, when analysed by enzyme-linked immunosorbent assay (ELISA), revealed a relatively higher reactivity of the female somatic extract to human and cattle sera compared to ES products of both genders. Nevertheless, similar reactivity of the O. ochengi male and female ES products to human and cattle sera was noticed. As a result, the interaction of ES products with the surface of the host and immune system often led to host responses, including the generation of antibodies. The O. ochengi ES products are therefore good sources of potential immunogenic proteins. The identification of these ES products is in progress, with the aim of developing vaccine candidates against human onchocerciasis.
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PMID:Immune recognition of excretory and secretory products of the filarial nematode Onchocerca ochengi in cattle and human sera. 2636 Oct 43


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