Search PubMed⌕ Search

Biomedical subjects

E Masci

Publications and source records attributed to E Masci.

At least 37 records · Page 2Linked to original sources
PubMed1989

Manometric evaluation of the interdigestive antroduodenal motility in subjects with fasting bile reflux, with and without antral gastritis.

The interdigestive antroduodenal motor activity was studied in 15 patients with bile reflux without gastritis (group A), 17 with bile reflux and chronic antral superficial gastritis (group B) and in nine healthy controls (group C), by manometric recording of phases of the interdigestive motility complex (IDMC) over 240 minutes, or until two consecutive migrating motor complexes (MMCs) had been recorded, whichever the shorter. In the patients with bile reflux the occurrence of MMCs was decreased and median duration of the IDMC was significantly prolonged (group A = 162.5 min; group B = 185.0 min), compared with controls (group C = 92.0 min; p less than 0.01 v groups A and B). There were no differences in motility pattern between patients with and without gastritis, suggesting that motor abnormalities are not caused by gastritis, but may precede its occurrence. Delayed occurrence of motor activity fronts increases duodenogastric reflux, but correlation with gastric mucosal lesions was not shown, suggesting that other mechanisms are involved.

Adult↗
PubMed1987

Effects of FCE20700, a new PGE2 derivative, on gastric acid secretion and cytoprotective processes in man.

The pharmacodynamic effects of FCE20700, a new PGE2 derivative, have been investigated in 6 healthy volunteers given single intragastric (i.g.) and intraduodenal (i.d.) doses of 1 and 2 mg and placebo, according to a double-blind, within-subjects design. For 30-270 min following i.g. administration the effect of FCE20700 on peptone-stimulated gastric acid secretion (AS) was assessed by i.g. titration, and serum gastrin (G) levels were also determined. For the same period after i.d. dosing the effect of the compound on pentagastrin-stimulated AS and on mucoproteins and bicarbonate content in the gastric juice was measured. Blood pressure (BP), heart rate and possible side-effects were monitored. Following i.g. administration there was a moderate, dose-related, significant inhibition of AS; significant inhibition of G levels was observed only after the highest dose. After i.d. administration there was a very modest though dose-related and significant inhibition of AS; a brief maximal increase in mucoproteins and in bicarbonate levels was apparent after the 1 mg dose. After i.d. but not after i.g. administration of 2 mg there was a modest but significant decrease in BP. No side-effects of clinical relevance were reported. The results appear to suggest a major activity of FCE20700 on cytoprotection rather than in inhibiting gastric acid secretion. The observed change in BP may indicate that after i.d. administration there will be some systemic effects of FCE20700.

Adult↗
PubMed1987

Interdigestive motility pattern in subjects with duodenogastric bile reflux.

The role of antroduodenal motility in the pathogenesis of duodenogastric biliary reflux is widely accepted, but few and conflicting data are available on the possible motor abnormalities related to this phenomenon in the fed and in the fasting state. In an attempt to define the motility pattern of the antroduodenal region associated with bile reflux in the fasting state, 20 subjects with proven duodenogastric reflux and without disorders of the upper gastrointestinal tract have been studied, and the results have been compared with those observed in 6 control subjects without evidence of reflux. The interdigestive motility complex (IDMC) has been evaluated (mean duration of IDMC and frequency and site of onset of migrating motor complexes). In subjects with duodenogastric reflux a significant increase (p less than 0.01) in the mean duration of IDMCs (179 +/- 22.19 min) was observed, in comparison with controls (108.5 +/- 37 min). A considerable reduction in the frequency of migrating motor complexes (MMC) was also observed, while no differences in the site of onset and the propagation of MMCs and in the percentage of time recorded occupied by the single phases of IDMC were found. This evidence suggests a strict relationship between duodenogastric reflux and the occurrence of phase III of IDMC and supports the hypothesis that the IDMC abnormalities are the cause and not the consequence of biliary reflux. The reduced incidence of MMC may also account for the high incidence of chronic gastritis due to prolonged contact in the fasting state between the gastric mucosa and the duodenal content.

Adult↗
PubMed1987

Duodenogastric reflux: correlations among bile acid pattern, mucus secretion, and mucosal damage.

Forty-five patients with bile reflux at endoscopic examination, confirmed by titration of bile acids in gastric juice, were admitted to the study and divided into three groups in accordance with histologic results: normal findings, chronic superficial gastritis, and chronic atrophic gastritis. Bile acid pattern was determined in duodenal samples by high-performance liquid chromatography titration, and the mucoprotein content of gastric juice was assessed. The results of qualitative analysis of bile acid showed an increase of deoxycholic acid in patients with atrophic gastritis (p less than 0.05) in comparison with controls; determination of taurine and glycine conjugates showed an increase of taurodeoxycholic acid in patients with atrophic gastritis (p less than 0.01) compared with controls. The composition of mucus was altered only in patients with atrophic gastritis. Whether the increase in deoxycholic acid in biliary reflux is a factor in the development of chronic atrophic gastritis or is secondary to the increase of gastric pH, detectable in this condition, is still uncertain. However, the increase of deoxycholic acid and its taurine conjugates may be a factor that leads to persistence of mucosal lesions.

Adult↗
PubMed1987

Gastric cancer in chronic atrophic gastritis. Associated gastric ulcer adds no further risk.

Atrophic gastritis with intestinal metaplasia is generally considered a precancerous lesion. We followed 261 patients with chronic atrophic gastritis and intestinal metaplasia, with and without gastric ulcer, every 12 months for 9 +/- 2 years by means of endoscopic and histological examination. In the presence of dysplasia, however, studies were carried out every 6 months in moderate cases, or every 3 months in severe cases. Patients with gastric ulcer received medical therapy for 8 weeks; if healing did not occur, treatment was continued. Only subjects with healed ulcers were admitted to the follow-up. To date, 205 subjects have been included in the study. Over a 10-year period, 16 patients with recurrent gastric ulcer and 12 patients with cancer in situ or in an early stage, were subjected to surgery. One case of advanced cancer was observed. Cancer has been found in five of 95 cases of atrophic gastritis with gastric ulcer (5.2%), and in 7 of 166 cases of atrophic gastritis without gastric ulcer (4.2%). The difference was not statistically significant. Our results confirm that gastric ulcer per se is not a high-risk condition, but it must be considered as an epiphenomenon on a background of epithelial atrophy.

Adenocarcinoma↗
PubMed1987

Luminal bicarbonate outflow in chronic antral erosions is suppressed by pirenzepine.

The effects of pirenzepine and ranitidine on luminal HCO3- outflow occurring in subjects with chronic antral erosions have been investigated in a double-blind study. Thirty outpatients with chronic erosions of the gastric antrum were randomly treated for 4 weeks with either pirenzepine 50 mg b.i.d. or ranitidine 150 mg b.i.d. Endoscopic appearance and intragastric bicarbonate content were assessed before and after treatment. At endoscopic follow-up pirenzepine was found to be significantly more effective than ranitidine in promoting disappearance of antral erosions. In the ranitidine group the abnormally high intraluminal HCO3 content was reduced only in healed subjects, while no changes were observed in patients with persisting erosions. In contrast pirenzepine induced normalization of intragastric bicarbonate both in healed and in unhealed patients. The results suggest that pirenzepine suppresses luminal HCO3 leakage by functionally strengthening mucosal defences even before anatomical repair is obtained.

Adult↗
PubMed1985

Effect of nifedipine on gastric acid secretion and gastrin release in healthy man.

Nifedipine, a calcium-channel antagonist widely used in cardiovascular disease, has recently been reported to be effective in the treatment of oesophageal motor disorders. The effect of a single therapeutic dose of nifedipine (20 mg p.o.) has been evaluated on basal and submaximal pentagastrin-stimulated gastric secretion and meal-stimulated gastrin release in healthy man. In comparison with placebo, nifedipine significantly decreased both basal and stimulated gastric acidity and juice volume, whereas only a slight but insignificant reduction in meal-stimulated gastrin levels was observed after drug administration. The results are in agreement with previous reports that calcium is involved in stimulus-secretion coupling in the human parietal cell. They do not confirm the effect of calcium on G-cells, although it is likely that doses of nifedipine higher than those commonly used might be effective in the reduction of gastrin secretion.

Adult↗
PubMed1985

Effect of L-dopa with and without inhibition of extra cerebral dopa decarboxylase on gastric acid secretion and gastrin release in man.

The present study was undertaken to investigate the possibility that central nervous system monoaminergic pathways may play a role in the control of gastric acid and gastrin secretion in man. Submaximal pentagastrin stimulated (0.25 micrograms/kg/h) gastric acid secretion, as well as basal gastrin concentrations were studied in two groups of subjects. The first group received oral administration of placebo and the catecholamine precursor L-dopa (500 mg); the second group was treated with placebo and the association of L-dopa (100 mg) plus carbidopa (35 mg) after pretreatment with carbidopa (50 mg every six hours for four doses), a schedule which is known to increase brain catecholamine concentrations. In comparison with placebo, stimulated gastric acid secretion was reduced by L-dopa alone, whereas was not modified by L-dopa plus carbidopa. Basal gastrin concentrations were increased after L-dopa and after L-dopa plus carbidopa. These data show that basal gastrin concentration is raised by central catecholamine augmentation; but gastric acid secretion seems to be influenced by changes of peripheral catecholamine concentrations. It is suggested that dopamine and perhaps noradrenaline, but not adrenaline, are important in these effects.

Adult↗
PubMed1985

Comparison of ranitidine, domperidone maleate and ranitidine + domperidone maleate in the short-term treatment of reflux oesophagitis.

In the treatment of reflux oesophagitis, either drugs preventing regurgitation of gastric juice in the lower oesophagus or pharmacological agents increasing the pH of the refluxing material are employed. In the present study 45 outpatients with reflux oesophagitis were randomly treated with either ranitidine (150 mg b.i.d.) or domperidone maleate (20 mg t.i.d.) or both drugs for six weeks. Before and after treatment the severity of dyspeptic symptoms and the grade of endoscopic and histological changes were assessed. The three therapeutic regimens were significantly and equally effective in inducing symptomatic relief and promoting endoscopic and histological disappearance or improvement of oesophagitis. The combined use of ranitidine and domperidone maleate failed to show any additional benefit compared with treatment with either drug alone.

Clinical Trials as Topic↗
PubMed1984

Early detection of pancreatic lesions in chronic alcoholism: diagnostic accuracy of ERP.

In order to detect early pancreatic changes in chronic alcoholism, we reviewed pancreatograms (ERP) in 35 patients with alcoholic chronic liver disease who had no clinical evidence of pancreatitis. The patients were grouped by the length of history of alcohol intake (group 1: 5-15 years; group 2: more than 15 years), and on the basis of daily alcohol intake (group 1: 100-150 g/day; group 2: 150-200 g/day; group 3: more than 200 g/day). Pancreatic changes were present at ERP in 48.6% of patients, suggesting mild pancreatitis in 15 patients and advanced pancreatitis in two. Pancreatic lesions were significantly more frequent (p less than 0.01) in those who took more than 200 g of alcohol each day. There was no correlation with the length of history of alcoholism or with hepatic lesions. Our data confirm that asymptomatic pancreatitis is frequent in chronic alcoholism and that ERP can detect pancreatic lesions not otherwise demonstrable.

Adult↗
PubMed1984

Lack of effect of domperidone on gastrin release: evidence for a peripheral activity of the drug.

The effect of intravenous administration of domperidone, a dopamine receptor antagonist with peripheral activity, on basal and submaximal pentagastrin-stimulated gastric acid secretion and gastrin release has been evaluated in healthy volunteers. No significant changes were observed in the parameters studied. The lack of effect on gastrin release appears to confirm that domperidone is unable to penetrate the blood brain barrier in appreciable amounts in adults.

Adult↗
PubMed1983

Effect of sulpiride isomers on gastric acid and gastrin secretion in healthy man.

The effects of the antidopaminergic drug sulpiride on gastric acid secretion and gastrin release have been evaluated in 42 healthy individuals. Basal and submaximal pentagastrin (0.5 micrograms/kg-h)-stimulated gastric acid secretion, as well as basal and meal-induced gastrin secretion, were studied after acute intramuscular administration of racemic sulpiride (100 mg) and its L-(50 mg) D-(50 mg) isomers. Racemic and L-sulpiride significantly decreased stimulated serum gastrin concentration, but they did not affect fasting serum gastrin or basal and stimulated gastric acidity. D-sulpiride significantly decreased gastric acid secretion, without affecting serum gastrin levels. While the effects of racemic and L-sulpiride are analogous to those of other antidopaminergic drugs, D-sulpiride mimics the action of dopamine, at least at gastric level. These data support the hypothesis that the D-isomer may possess agonist-antagonist activity at dopamine receptors. Since racemic sulpiride has been used with conflicting results in the therapy of patients with peptic ulcer, in the light of the present results it would be of interest to study separately the efficiency of the D- and L-isomers of the drug in healing peptic ulcer.

Adult↗
PubMed1983

Dopaminergic control of gastric acid and gastrin secretion in man: lack of effects after acute oral administration of ibopamine, an analogue of dopamine.

The effect of oral administration of the dopaminergic drug, ibopamine, at the dose of 200 mg and 400 mg, on basal and submaximal pentagastrin (0.25 microgram kg-1 h-1) stimulated gastric acid secretion as well as basal serum gastrin concentration has been evaluated in 24 healthy individuals. In comparison with placebo no significant changes were observed in all the variables studied. The lack of effects on gastric acid secretion might be due to a selective stimulation of dopaminergic receptors not active in the regulation of gastric acidity or not present in gastric mucosa, while unchanged serum gastrin secretion is possibly due to a poor crossing of blood-brain barrier by ibopamine.

Adult↗
PubMed1983

Ranitidine vs metoclopramide in the medical treatment of reflux esophagitis.

45 patients with symptomatic reflux esophagitis were randomly treated with either Ranitidine (150 mg b.i.d.) or Metoclopramide (10 mg t.i.d.) for six weeks. The severity of dyspeptic symptoms and the grade of endoscopic and histological esophagitis were assessed before and after treatment. Both drugs proved significantly effective in inducing symptomatic and endoscopic improvement, but Ranitidine appeared significantly superior in promoting disappearance or improvement of endoscopic esophagitis. Moreover Ranitidine was found to significantly reduce the severity of histological changes, whereas Metoclopramide was unable to do so.

Adult↗
PubMed1981

Effect of loperamide and naloxone on gastric acid secretion in healthy man.

The effect of acute oral administration of three different doses (4, 8, and 16 mg) of loperamide, a peripheral opiate agonist, on basal and submaximal pentagastrin-stimulated gastric acid secretion was evaluated in healthy volunteers. Both basal and stimulated gastric secretion were significantly lowered by 8 and 16 mg of the drug in comparison with a control study, while 4 mg was ineffective. Naloxone, a specific opiate antagonist, decreased slightly but not significantly both basal and pentagastrin-stimulated gastric acid secretion, when infused intravenously at the rate of 30 micrograms/kg/h, but completely abolished the inhibitory effect of loperamide on gastric acidity. These data also suggest that opiates may be involved in the regulation of gastric acid secretion in man by acting at a peripheral site, as loperamide does not cross the blood-brain barrier.

Adult↗