Search PubMed⌕ Search

Biomedical subjects

A Torsoli

Publications and source records attributed to A Torsoli.

At least 55 records · Page 3Linked to original sources
PubMed1988

Manometric measurement of human sphincter of Oddi length.

Length of biliary (CBD) and/or pancreatic (PD) sphincter of Oddi (SO) was measured during perendoscopic or intraoperative manometry in 21 control subjects and in 46 patients with biliary disease. When the high resting pressure (HPZ) and the phasic wave zone (PAZ) were considered, SO length was, in the control group, 9.5 +/- 0.5 mm (M +/- SE) and 9.4 +/- 0.6 mm at the level of the CBD-SO, and 7.7 +/- 0.6 mm and 6.9 +/- 0.5 mm at the level of the PD-SO. The physiological sphincter length appeared substantially shorter than the anatomical one, as reported in the literature. No significant differences were found between controls and patients with CBD stones. Endoscopic sphincterotomy without manometry reduced mean sphincter length length of the sphincterotomy was tailored to the manometric findings. Surgical partial sphincterotomy reduced sphincter length by only 46.7 +/- 10.3%.

Adult↗
PubMed1987

Early recognition of toxic megacolon.

Increased amounts of small bowel gas are a frequent finding on plain abdominal films in toxic megacolon (TMC), but they may also be found in patients with severe colitis. We studied 69 consecutive patients with severe ulcerative colitis to evaluate whether an increased gas content of the small intestine may identify patients prone to TMC. The intestinal gas was measured on plain abdominal films by means of a planimeter. On the basis of gas values, 38 patients showed a normal and 31 an increased amount of small intestinal gas. The outcome of the disease (complications, need for surgery, and mortality rate) and 18 clinical and hematochemical findings were compared in the two groups. Of the 31 patients with increased gas, seven developed TMC, whereas this complication was not observed in the 38 patients with normal gas. The only other different features between the two groups were blood pH and base excess, which were significantly higher in the patients with increased small bowel gas content. We therefore suggest that persistent abnormal gaseous distension of the small bowel, together with severe metabolic alkalosis, characterizes a subgroup of patients with severe colitis at high risk for the development of TMC. The strict surveillance of these patients led to early recognition of seven cases of TMC and prompt institution of aggressive medical treatment. Since all these patients survived, the early detection of TMC may improve prognosis.

Adolescent↗
PubMed1987

Laxative consumption in chronic nonorganic constipation.

We looked at laxative consumption and its relationship to bowel habits, total gastrointestinal transit time (TGITT), and symptoms in patients with chronic nonorganic constipation. Of the patients, 87.9% used laxative, 30% habitually. Laxative intake increased with age, so that habitual consumption was more frequent in patients with long-standing (greater than 10 years) constipation. Although habitual laxative users had a consistent trend toward lower bowel frequency and prolonged TGITT, no relationship was found among intake and observed bowel frequency, TGITT, or large bowel segmental transit time. Although laxatives induced more satisfactory or less difficult evacuations, they also caused diarrhea and mucus in the stool. Laxative consumption did not bring about any detectable improvement in the abdominal or extraabdominal symptoms usually associated with constipation.

Adolescent↗
PubMed1986

Frequencies and cyclical pattern of the human sphincter of Oddi phasic activity.

Basal frequency of sphincter of Oddi phasic contractility has been repeatedly measured during endoscopic manometry and reported to range, in control subjects, from (M +/- SE) 3.0 +/- 0.6 to 7.5 +/- 0.7 c/min. Recently, high frequency (greater than 8 c/min) phasic contractions or absence of phasic activity were recorded in patients with postcholecystectomy or pancreatic complaints, possibly suggesting a sphincter of Oddi dysfunction. In the present study, sphincter of Oddi (biliary tract) phasic contractility was measured by perendoscopic manometry in 13 subjects without specific clinical symptoms of biliopancreatic disease and with a normal common bile and pancreatic duct at ERCP. Four T-tube patients with no evidence of common bile duct stones or papillary stenosis were studied for comparison (transductal sphincter of Oddi manometry). Basal frequency was found to range from 0 to 7 c/min (M +/- SE: 2.99 +/- 0.46) in perendoscopic manometry (85 min of recording time) and from 0 to 12 c/min (2.0 +/- 0.3) in transductal manometry (2546 min of recording time). Long lasting transductal recordings also showed that frequency of activity derived from the sphincter area varied cyclically in close relation with the duodenal migrating motor complex. It is concluded that the sphincter of Oddi in man is likely to participate in the interdigestive gastrointestinal motor activity and that short perendoscopic recordings may not be representative of the overall sphincter of Oddi activity.

Adult↗
PubMed1986

Intraluminal pH and oesophageal motility in patients with gastro-oesophageal reflux.

The effect of intraluminal pH on motor activity of the lower oesophageal body was studied in patients with pathological gastro-oesophageal reflux. Liquid boluses with a pH range of 6.98-1.1, infused in the distal oesophagus of 21 patients during manometric recording of motor activity, elicited either secondary peristalsis or simultaneous contractions. Acid pH did not affect the threshold of distension required to elicit secondary peristalsis. Oesophageal responses to volumes of instillate did not differ in patients with normal and abnormal acid clearing test, nor in patients with a negative and positive acid perfusion test.

Adult↗
PubMed1985

Bombesin effects on human GI functions.

In this article some of the actions of amphibian skin peptide Bombesin (BBS) on human gastrointestinal and pancreatic functions are reviewed. BBS causes increases of lower esophageal sphincter pressure, delay of gastric emptying, inhibition of mechanical activity of duodenum and jejunum and gallbladder emptying. BBS also releases in man gastrin and stimulates gastric acid secretion. BBS administration induces release of insulin, glucagon and pancreatic polypeptide from human Islet of Langerhans and causes secretion of pancreatic bicarbonates and enzymes in duodenal juice and release of pancreatic enzymes in blood stream.

Bombesin↗
PubMed1985

Gastrointestinal transit time, frequency of defecation, and anorectal manometry in healthy and constipated children.

Total gastrointestinal transit time (TGITT), frequency of defecation, and anorectal manometry were evaluated in 63 pediatric patients referred for chronic nonorganic constipation; in 39, segmental transit times of the right and left colon and rectum were also measured. TGITT was significantly longer in chronically constipated children than in matched normal controls. Although bowel frequency was highly significantly correlated with TGITT in patients with prolonged transit time, not all children with prolonged TGITT had reduced bowel frequency. Moreover, not all children with constipation had prolonged TGITT. In children with idiopathic chronic constipation, slowing of intestinal transit occurred most frequently at the level of the distal colon and rectum. Anorectal motility variables were not significantly different in children with functional chronic constipation and in normal children. Maximal resting and pressure and mean intrarectal distending volume causing threshold inhibition in constipated patients did not significantly differ from the control values. Therefore, anorectal manometry did not detect relevant motor abnormalities in constipated children.

Anal Canal↗
PubMed1985

Incompletely and completely healed duodenal ulcers' outcome in maintenance treatment: a double blind controlled study.

A six month, double blind, controlled study was performed in 107 asymptomatic duodenal ulcer patients who, after short term cimetidine treatment, showed complete or incomplete endoscopic healing. Patients were stratified according to the type of healing and randomly allocated to cimetidine (200 mg at lunch, 400 mg at bedtime) or placebo. Endoscopic examinations were carried out after six months or when symptoms recurred. Eighty seven patients completed the maintenance trial. Of the 56 patients admitted to the study with complete healing, 30 were placed on cimetidine and 26 on placebo. Of the 31 patients admitted with incomplete healing, 15 were placed on cimetidine, and 16 on placebo. Results showed that, regardless of maintenance treatment, patients with incompletely healed ulcers had a higher ulcer crater recurrence rate, than patients with complete healing (71% vs 34%; p less than 0.005). A significantly higher ulcer crater recurrence was observed in incompletely healed ulcer patients, even when cimetidine or placebo treatment groups were considered separately. Irrespective of the type of healing, ulcer crater recurrence was more frequent in placebo treated patients than in those treated with cimetidine (67% vs 29%; p less than 0.001). We conclude that, in order to prevent a high ulcer recurrence rate, maintenance treatment should start only after the assessment of a complete endoscopic healing of duodenal ulcers.

Adult↗
PubMed1985

Famotidine (MK-208) in the treatment of gastric ulcer. Results of a multicenter double-blind controlled study.

The aim of the present investigation was to study the efficacy and safety of famotidine (MK-208), a new, potent, histamine H2 receptor antagonist, in promoting the healing of active gastric ulcer when compared to placebo. Of the 71 patients who took part in this multicenter double-blind study in Italy, 37 were administered famotidine 40 mg once daily and 34 placebo. Treatment duration was for up to 8 weeks, and endoscopic and clinical studies were performed at onset and week 4 and, if necessary, at weeks 6 and 8. All patients were carefully evaluated at regular intervals for adverse drug reactions by clinical and laboratory examinations. By the end of the study, 97% of the ulcers were healed in the famotidine group compared to 66% in the placebo group (p less than 0.01). Day and night pain decreased significantly more in the famotidine group than in the placebo group. Both treatments were well tolerated, and no alterations in laboratory tests were observed. Famotidine, therefore, proved effective in the treatment of gastric ulcer and was well tolerated on a short-term basis.

Adolescent↗
PubMed1984

Motor activity of the distal oesophagus and gastrooesophageal reflux.

The relationship between intraoesophageal pH value and motor activity of the lower oesophageal body and sphincter was investigated by simultaneous evaluation of intraluminal pressure and pH in 13 patients complaining of heartburn and regurgitation. One hundred and thirty one episodes of gastro-oesophageal reflux were recorded. One hundred and eighteen (90.1%) were preceded by a swallow (one to 12 seconds), 13 reflux episodes (9.9%) were not preceded by a swallow. Gastro-oesophageal refluxes preceded by swallow were accompanied by an equal number of normal and abnormal primary peristaltic sequences and, while recording at level of the lower oesophageal sphincter, occurred during inhibition of the sphincter. Frequency of abnormal primary peristalsis increased (p less than 0.01) during periods of low intraluminal pH (less than 5.0). An increase of at least 0.5 U in intraluminal pH occurred with 45.2% of normal primary peristalsis, 29.3% of abnormal primary peristalsis, 4.3% of secondary peristalsis, 3.5% of non-peristaltic contractions. The results of this study indicate that in patients with symptoms of reflux oesophagitis, gastro-oesophageal reflux appears to be related to swallow-induced lower oesophageal sphincter inhibition and not related to abnormal motor activity of the distal oesophageal body where an increased frequency of abnormal primary peristalsis appears to occur during low intraluminal pH and primary peristalsis appears to be the most important mechanism of oesophageal clearing.

Adolescent↗
PubMed1984

Manometric study of the sphincter of Oddi in patients with and without common bile duct stones.

Motor activity of the sphincter of Oddi has been evaluated in 34 patients who underwent ERCP examination. Manometric recordings from the common bile duct and the sphincter of Oddi were performed with a polyethylene triple lumen catheter. At ERCP 16 patients had undamaged biliary ducts; six had undergone cholecystectomy and six had gall bladder stones; 18 patients had common bile duct stones; nine of whom had undergone cholecystectomy, and seven had gall bladder stones. Length and amplitude of the resting sphincter pressure as well as frequency, duration, amplitude, and propagating pattern of phasic contractions did not significantly differ in patients with and without common bile duct stones. Sphincter of Oddi motor activity did not appear to be influenced by the variation in the diameter of the common bile duct or by previous cholecystectomy.

Adult↗
PubMed1983

Effects of bombesin on gastrin and gastric acid secretion in patients with duodenal ulcer.

The effect of bombesin, a possible neurotransmitter of gastrin release, upon gastrin and gastric acid secretion was investigated in 25 patients with duodenal ulcer and in 16 normal subjects. In patients with duodenal ulcer bombesin (10 ng/kg/min) produced an increase in plasma gastrin output (median 22.4 (range 7.5-75.8) pmol/l/min) similar to that obtained in normal subjects (median 24.4 (range 5.8-56.5) pmol/l/min), whereas gastrin stimulated by a meal was significantly higher in the group of patients with duodenal ulcer (median 20.7 (range 9.2-42.9) vs 16.2 (range 3.4-22.2) p<0.05). Peak acid output induced by bombesin was significantly higher in patients with duodenal ulcer than in normal subjects (median 24.4 (range 9.0-63.8) vs 14.0 (range 3.0-24.8) mmol/h, p<0.05) despite identical gastrin outputs. The ratio (%) obtained by dividing the acid secretory response to bombesin by the response to pentagastrin, however, was similar in both normal subjects and patients with duodenal ulcer (median 55 (range 20-116) vs 58 (range 31-95) respectively). The difference between the gastrin response to food and bombesin could be explained by the fact that bombesin releases gastrin directly, whereas a protein meal involves several mechanisms (neural, peptidergic, paracrine, endocrine), either stimulatory or inhibitory. The above results indicate that a higher concentration in antral and/or duodenal gastrin is unlikely to be present in patients with duodenal ulcer. An increased parietal cell mass could explain the higher gastric acid response after bombesin infusion in our group of patients with duodenal ulcer.

Adult↗
PubMed1982

Effect of bombesin on lower esophageal sphincter pressure in humans.

Intravenous infusion of bombesin in humans results in increased serum gastrin levels and increased lower esophageal sphincter pressure. To differentiate a gastrin- from a nongastrin-mediated mechanism, the effect of intravenous bombesin infusion on lower esophageal sphincter pressure was studied in 5 healthy subjects and in 5 antrectomized patients. Lower esophageal sphincter pressure was recorded by three continuously perfused catheters with side-openings located 5 mm apart. Blood samples were taken at regular intervals during the study periods to assay gastrin and pancreatic polypeptide. Manometric tracings and blood samples were coded and evaluated blindly. Lower esophageal sphincter pressure increased during bombesin infusion both in normal and antrectomized subjects. The increase had a delayed onset and persisted after discontinuation of bombesin. No correlation was found between lower esophageal sphincter pressure and serum gastrin or pancreatic polypeptide values. These data indicate that the effect of bombesin on lower esophageal sphincter pressure is not gastrin or pancreatic polypeptide mediated.

Adult↗
PubMed1978

Lower oesophageal sphincter response to intravenous infusions of pentagastrin in normal subjects, antrectomised and achalasic patients.

Lower oesophageal sphincter response to infusion of graded doses (0.003--0.050 microgram kg-1min-1) of pentagastrin was evaluated in four antrectomised patients as well as in six healthy subjects and seven achalasic patients in whom inhibition of antral gastrin release was maintained by continuous acidification (HC1 0.1 N) and aspiration of gastric antrum. In normal subjects and in antrectomised patients doses of pentagastrin required for half-maximal gastric acid secretion (0.012 microgram kg-1min-1) produced statistically significant increases of LES pressure. In achalasic patients, the infusion of pentagastrin did not affect LES pressure. These data seem to indicate that gastrin plays, at least in some degree, a physiological role in the regulation of LES tone. Insensitivity of LES to pentagastrin in achalasia suggests that the raised sphincter pressure in this disorder can not be attributed to gastrin.

Dose-Response Relationship, Drug↗