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Biomedical subjects

G Labò

Publications and source records attributed to G Labò.

At least 55 records · Page 3Linked to original sources
PubMed1984

Ultrasonic endoscopy--the gastrointestinal wall.

Endoscopic ultrasonography (EUT) allows the visualization of the gastric wall structure. Four and sometimes five distinct layers have been identified. The 1st inner layer echogenic seems to correspond to the mucosa, the 2nd echopoor to the muscularis mucosae, the 3rd echogenic to the submucosa, the 4th echopoor to the muscularis propria and the 5th echogenic to the serosa. In pathological conditions this architecture changes considerably. Infiltration and extension of lesions can be precisely established. Moreover, involvement of neighbouring organs can be preoperatively detected. It is still difficult to establish, only on the EUT data, whether a lesion is benign or malignant. EUT of the stomach is a new method of investigation which can be further developed but already shows a considerable interest.

Adult↗
PubMed1984

Ultrasonographic study of portal venous system in portal hypertension and after portosystemic shunt operations.

One hundred sixty patients with portal hypertension were examined by means of ultrasonography in order to evaluate the sensitivity of this technique in the diagnosis of intrahepatic portal hypertension and in the detection of portal vein thrombosis. Thirty-eight of these patients were selected for a portosystemic shunt and were reexamined after operation to assess the value of ultrasonography as a screening test for the patency of surgical portosystemic shunts. In patients with intrahepatic portal hypertension the main ultrasonographic findings observed were dilatation of the portal trunk of more than 1.3 cm (56.6% of cases), patency and dilatation of the umbilical vein (5.8%), presence of intra-abdominal collateral vessels (11.6%), splenomegaly with dilatation of splenic vein radicles at the hilus (91.3%), and disappearance of normal caliber variations during respiration in splenic or mesenteric veins (78.5% and 88.4%, respectively). The disappearance of normal caliber variations proved a highly specific and sensitive finding. Partial or total occlusion of the portal trunk was observed at ultrasonography in 19 of 21 (90.5%) patients with portal vein thrombosis. Surgical portosystemic shunts were displayed in 28 of 37 patients (75.7%). Ultrasonography seems to be the most important noninvasive tool in the diagnosis of portal hypertension. In patients selected for surgical portosystemic shunts ultrasonography supplies morphologic data regarding liver parenchyma and abdominal vascular anatomy, and it should be performed as a routine screening test for assessment of surgical shunt patency.

Humans↗
PubMed1984

Serum immunoreactive trypsin response to secretin injection in patients with chronic pancreatitis.

Serum immunoreactive trypsin response to secretin injection (75 clinical units iv over a 2-min period) was studied in patients with chronic pancreatitis and in control subjects. Secretin stimulation caused a slight but significant increase of basal serum immunoreactive trypsin concentration in normal subjects and a marked increase in chronic pancreatitis patients with mild to moderate insufficiency. In patients with severe insufficiency and steatorrhea it had very little effect. The integrated immunoreactive trypsin response to secretin injection in patients with mild to moderate insufficiency was significantly higher compared to controls and to patients with severe insufficiency. In the latter patients it was significantly lower than in controls. A markedly elevated response of serum immunoreactive trypsin to secretin administration seems to differentiate chronic pancreatitis patients with mild to moderate insufficiency from those with severe insufficiency and from controls.

Adult↗
PubMed1984

Effect of secretin stimulation upon serum immunoreactive trypsin in patients with carcinoma of the pancreas.

The response of serum immunoreactive trypsin (IRT) to the intravenous injection of secretin (75 clinical units) was evaluated in 14 patients with carcinoma of the pancreas and in 20 healthy control patients. A striking increase of serum IRT concentration after secretin, which was much more marked than in those in the control group, was found in patients with localized carcinoma of the pancreas, whereas no increase was observed in those with more diffuse carcinoma.

Adult↗
PubMed1984

Anorectal manometry in the diagnosis of Hirschsprung's disease--comparison with clinical and radiological criteria.

In 34 consecutive patients in whom the diagnosis of Hirschsprung's disease (HD) was suspected, the reliability of clinical symptoms, radiological parameters, and anorectal manometry was retrospectively and blindly evaluated by three independent investigators. In 19 patients the diagnosis of HD was histologically proved, while in the remaining 15 cases the diagnosis of idiopathic constipation was justified by persistent success of medical treatment at regular follow-up. Anorectal manometry was correctly diagnostic in all the patients who were examined. The recto and inhibitory reflex, recorded in all the patients with idiopathic constipation was absent in patients suffering from HD. Moreover, other manometric parameters, peculiar to HD were found: a significant lower anal resting pressure and pain threshold, as well as a decreased frequency of spontaneous rhythmic oscillations. The reliability of radiological and clinical data for these diagnoses appeared to be inadequate. Therefore, the diagnosis of HD can be confidently stated only on the basis of manometric investigations.

Adolescent↗
PubMed1983

Relationships between iodothyronine peripheral metabolism and ketone bodies during hypocaloric dietary manipulations.

Relationships between iodothyronine and metabolic substrate metabolism during undernutrition were evaluated in four normal subjects who fasted for 48h (Group I) and in four groups (II to V) of obese patients who underwent selective dietary manipulations: 360 calories [carbohydrate (CHO) 40 g/day]; 800 calories containing respectively 19 g/day - ketogenic - (K) and 112 g/day - non ketogenic - (NK) of CHO; and a step-diet programme (during which total calories were progressively reduced from 2500 to 500). Serum T3 levels decreased significantly and constantly during fasting, 360 and 800 K studies, and transiently during the 800 NK diet. During the step-diet programme, a significant fall was found only when 1250 K or less were given. Conversely, serum reverse T3 rose significantly and constantly during 360 and 800 K diets, while a transient increase was found during the 800 NK diet. During the step-diet programme reverse T3 rose only when 750 calories were given. Ketogenesis developed in all studies but one (800 NK), and in the step-diet programme significantly below the 1000 calorie step. Other substrate modifications in each study were also evaluated. Serum T3 levels showed a significant correlation with ketone bodies (KB) in all the ketogenic studies, while no correlation was found in non ketogenic study (800 NK). During the step-diet programme ketone bodies and iodothyronine modifications appeared to be related to the amount of calories. Based on these results, we suggest a relationship between the dietary-induced modifications of iodothyronine metabolism and the development of ketogenesis.

Acetoacetates↗
PubMed1983

Ileal enteroglucagon cells after ileal-duodenal transposition in the rat.

The changes occurring in the ileal wall and in enteroglucagon cells were studied in a rat model of intestinal adaptation, obtained by the transposition of a segment of distal ileum into the mid-duodenum (6 rats, compared with 6 transected controls). After 40 days, the transposed ileal segment, compared to the equivalent segment in the controls, showed striking increase in weight, especially of the epithelium (1,585 +/- 127 vs. 305 +/- 42 mg, mean +/- SEM, p less than 0.0005). The calculated weight of enteroglucagon cells in the segment showed a smaller, but significant increase (1.7 +/- 0.3 vs. 0.8 +/- 0.2 micrograms, p less than 0.05). Plasma enteroglucagon was markedly raised (239 +/- 28 vs. 61 +/- 7.1 pmol/l, p less than 0.0005) and showed a greatly increased meal-stimulated response (1,521 +/- 284 vs. 83 +/- 43 pmol, p less than 0.0005), thus suggesting hyperactivity of enteroglucagon cells.

Animals↗
PubMed1983

Comparative study of serum pancreatic isoamylase, lipase, and trypsin-like immunoreactivity in pancreatic disease.

Serum total amylase, pancreatic and salivary isoamylase, lipase and trypsin-like immunoreactivity (TLI) were measured in 16 patients with acute pancreatitis, 37 patients with chronic pancreatitis, 11 patients with pancreatic cancer, and 53 control subjects in order to evaluate the relative value of these tests in the diagnosis of pancreatic disease. In acute pancreatitis patients studied within 2 days from the onset of pain all pancreatic enzymes were abnormally high. In chronic pancreatitis patients serum pancreatic isoamylase and TLI were abnormally low in 8 out of 10 patients with severely impaired pancreatic exocrine function, while lipase was abnormally low in 6 patients. During acute exacerbations of the disease elevated levels of pancreatic isoamylase and lipase, but not of TLI, were found in about one third of cases. In patients with pancreatic cancer the pattern of changes in serum pancreatic enzymes was variable since levels within, below and above the normal range were found. The results demonstrate that in acute pancreatitis all serum pancreatic enzymes had the same diagnostic sensitivity, however serum lipase determination is the most convenient because of its simplicity and low cost. In chronic pancreatitis serum pancreatic isoamylase and TLI may be useful in detecting severe pancreatic insufficiency. In pancreatic cancer serum pancreatic enzymes lack diagnostic specificity.

Adult↗
PubMed1983

Endoscopic manometry in the diagnosis of the postcholecystectomy pain syndrome.

A manometric study of the distal biliary tract was carried out by means of a side-hole perfused catheter passed through the papilla Vateri during duodenoscopy in patients with postcholecystectomy biliary pain not due to stones or inflammation of the biliary tree. The sphincter of Oddi showed in these cases a significantly higher basal tone than in controls with superimposed phasic pressure waves of high amplitude. The basal pressure of the common bile duct was also higher than in controls. These manometric findings may help differentiate the functional papillary stenosis from other causes of the postcholecystectomy pain syndrome and may be useful in settling the question of performing sphincterotomy in these patients.

Ampulla of Vater↗
PubMed1983

Exocrine pancreatic function in the elderly.

We studied pancreatic bicarbonate and enzyme output in response to a continuous intravenous infusion of secretin, 1 CU/kg X h, and cerulein, 100 ng/kg X h, in 25 elderly subjects and in 30 young controls. Almost all elderly persons had pancreatic outputs within the range of controls. Only 3 aged individuals showed diminished enzyme output, but the reduction was very slight. We conclude that exocrine pancreatic function is not significantly influenced by aging.

Adult↗
PubMed1983

Insulin resistance in patients with polycystic ovaries: its relationship to body weight and androgen levels.

Using a combined infusion of somatostatin, insulin and glucose, insulin resistance was assessed in vivo in two groups of females with polycystic ovaries (PCO), obese (PB-PCO) and normal weight (NO-PCO) and in two groups of matched (for age, sex and body mass index) controls (OB and NO). A steady state plasma glucose (SSPG) and insulin (SSPI) was attained after 90 min. OB-PCO and NO-PCO showed higher SSPG with respect to matched controls. The SSPG levels were related to body mass index (r = 0.69; P less than 0.001). The SSPG values were significantly correlated with the fasting insulin levels (r = 0.47; P less than 0.003). Gonadotrophin and steroid peripheral blood concentrations were also evaluated in the PCO females. A significant correlation was found between the SSPG values and the dehydroepiandrosterone sulphate levels (r = 0.46; P less than 0.05) and between the fasting insulin levels and the androstenedione concentrations (r = 0.64; P less than 0.01). Moreover, significant correlation coefficients were found between the glucose to insulin ratio and the A (r = -0.59; P less than 0.01) and the DHEA-S (r = -0.50; P less than 0.05) plasma levels. Finally, no relationship between body mass index and A or DHEA-S levels was found in PCO females considered as a group. We conclude that insulin resistance is present in females with PCO and it is mainly due to the presence of obesity, but other factors such as androgen levels, probably of adrenal sources, must be considered as a cause.

Adult↗
PubMed1983

Medical treatment of Zollinger-Ellison syndrome with ranitidine.

Ten patients with Zollinger-Ellison syndrome (4 with intact stomach and 6 with previous partial gastrectomy) received ranitidine (600-1200 mg daily) for 2-24 months (mean 14 months). The inhibitory effect of ranitidine on acid secretion was evaluated by measuring acid output during the third hour following a single drug administration in all cases, and by the 24-hour intragastric pH profile in 5 patients. Therapeutic efficacy was assessed by clinical and endoscopic criteria. Ranitidine at different dosages, related to the rate of acid secretion, was effective in controlling peptic disease and diarrhoea in the majority of patients. The secretory parameters used in this study allowed evaluation of the inhibitory effect of ranitidine on acid secretion, in order to select the best therapeutic dose and to decide on surgical cure in the patients non-responsive even to the highest dosage.

Adolescent↗
PubMed1983

Ultrasonographic findings in portal hypertension: correlation with the presence and size of oesophageal varices.

This study assesses the usefulness of ultrasonography in the diagnosis of portal hypertension. Several ultrasonographic signs were correlated with the presence and size of oesophageal varices detected by endoscopy in 32 patients suffering from alcoholic liver cirrhosis. Ultrasonography is proposed as a simpler and earlier method for screening of portal hypertension than endoscopy.

Diagnostic Errors↗
PubMed1983

Pancreolauryl test for pancreatic exocrine insufficiency.

Pancreolauryl test (PLT), a tubeless pancreatic function test, was performed in 40 consecutive patients suffering from chronic pancreatitis, in 21 patients with miscellaneous digestive diseases, and in 18 control subjects to assess its diagnostic sensitivity and specificity. N-benzoyl-L-tyrosyl-p-aminobenzoic acid test (PABA test) and secretin-cerulein test were also carried out to compare the diagnostic value of PLT with that of these two pancreatic function tests. PLT was abnormal in 22 of 40 patients with chronic pancreatitis (55%). In particular, pathological results were found in all patients with severe pancreatic insufficiency and only in four of 14 patients with mild to moderate insufficiency. PABA test showed a slightly lower sensitivity in severe insufficiency, and the same sensitivity in mild-moderate insufficiency. PLT was normal in all control subjects and in 17 of 21 patients with nonpancreatic digestive diseases. Its specificity (90%) was slightly higher than that of PABA test (82%). The results indicate that PLT may be used to support a diagnosis of severe pancreatic exocrine insufficiency, while in mild or moderate insufficiency its diagnostic value is limited.

4-Aminobenzoic Acid↗
PubMed1983

Effect of bombesin on serum immunoreactive trypsin in healthy subjects and in patients with chronic pancreatitis.

We studied the effect of bombesin (9 ng/kg X min for 30 min by intravenous infusion) on serum immunoreactive trypsin in healthy subjects and in chronic pancreatitis patients. Bombesin administration caused a marked and significant increase of serum immunoreactive trypsin concentration in healthy subjects. The increase occurred in the first 15 min after the beginning of bombesin infusion and persisted for the duration of the study (2 h). In patients with chronic pancreatitis, the increase was much less pronounced. In these patients, the integrated immunoreactive trypsin response to bombesin was significantly correlated with bicarbonate, lipase, and chymotrypsin outputs into the duodenum. The response of serum immunoreactive trypsin to bombesin stimulation seems to vary according to the degree of pancreatic exocrine dysfunction and to reflect the functional capacity of acinar cell mass.

Adult↗
PubMed1982

Atrioventricular block induced by swallowing in a patient with diffuse esophageal spasm.

A patient had syncope induced by swallowing. Electrocardiographic monitoring during eating and esophageal balloon inflation demonstrated a second-degree atrioventricular block (Mobitz type II) with dizziness. Radiologic and manometric examinations of the esophagus showed diffuse esophageal spasm associated with hypertension of the upper esophageal sphincter (UES), gastroesophageal reflux, and a sliding hiatal hernia. Cineradiographic observations were made during ingestion of a meal mixed with barium; at the time of cardiac dysrhythmia, the proximal part of the esophagus containing the bolus assumed a balloonlike shape, while the distal part and the UES contracted. On the basis of these observations and review of all published cases, we propose the pathways of this esophagocardiac reflex and discuss up-to-date treatment.

Aged↗