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Biomedical subjects

I Giorgio

Publications and source records attributed to I Giorgio.

At least 37 records · Page 2Linked to original sources

Gastric electrical dysrhythmia following cholecystectomy in humans.

In order to observe the incidence of dysrhythmia in 20 patients who had undergone cholecystectomy, we recorded gastric electrical activity by means of serosal electrodes from the day of surgery to the 6th postoperative day. The difference between the incidence of dysrhythmia on the day of the operation and the other days is statistically significant (t test: p less than 0.001). Bradygastria was the most frequently observed dysrhythmia, both on the day of surgery and on the following days. It had a frequency of around 1.0-1.5 cpm and the episodes lasted for a minimum of 10 min to a maximum of 105 min (mean duration 32.6 min). Episodes of tachygastria were of varying duration, ranging from a minimum of 3 min to a maximum of 60 min (mean duration 18.5 min), whereas episodes of gastric tachyarrhythmia lasted between 2 min and 21 min (mean duration 5.4 min). Only 1 patient had an episode of nausea and biliary vomiting, associated with an episode of gastric tachyarrhythmia on the 1st postoperative day. None of the other patients had symptoms of impaired gastric function, such as nausea, vomiting, bloating and epigastric pain, at any time during the recording sessions. These findings suggest that in most cases, gastric electrical rhythm returns to normal within 24 h of cholecystectomy and further that gastric dysrhythmia is not related to symptoms of impaired gastric function. The etiological mechanism and clinical significance of gastric dysrhythmia, therefore, are still unclear.

Adult↗

Effects of age and obesity on fasting gastric electrical activity in man: a cutaneous electrogastrographic study.

We investigated the effects of age and obesity on the fasting cutaneous electrogastrogram (EGGc) by studying both young and aged, healthy men. All subjects underwent an electrogastrographic recording lasting 1 h, and frequency and power data were obtained by means of spectral analysis. In order to make a precise comparison of the data, each subject's body mass index (BMI) was calculated and each age group was subdivided into nonobese subjects, those with a BMI of less than 24.9 kg/m2, and obese subjects, those with a BMI of more than 25 kg/m2. Comparison of the mean frequency values of the gastric spectral peak did not reveal statistically significant differences among the groups (young vs. old, nonobese vs. obese). Comparison of the mean power values of the gastric spectral peak, on the other hand, showed that there was a statistically significant reduction in spectral power in the aged subjects compared with the young (p = 0.017 in the aged vs. young nonobese subjects and p = 0.009 in the aged vs. young obese subjects), and in the obese subjects compared with the nonobese (p = 0.00021 in the young and p = 0.00029 in the aged). Frequency, therefore, is the parameter of gastric electrical activity which may best be studied by means of EGGc as it is only very slightly affected by physiological parameters, such as age and the adiposity of subjects. EGGc, therefore, could be useful in the study of those gastric diseases associated with disorders in gastric electrical rhythm and rate.

Adult↗

Cancer family syndrome: cytogenetic investigations, in vitro tetraploidy, and biomarker studies in a large family.

Fifty-five members of a family with the cancer family syndrome (CFS) were investigated for the following potential biomarkers for cancer proneness: (1) cytogenetics of peripheral blood lymphocytes and skin fibroblasts; (2) in vitro tetraploidy of dermal fibroblast monolayer cultures; (3) quantitative serum immunoglobulin determinations; (4) study of genetic linkage with respect to eight blood group markers including Kidd. Biological specimens were obtained from 14 patients affected with cancer, 21 subjects at risk, and 20 healthy subjects. None of the markers tested in this family, in order to identify a biomarker for the status of CFS gene carrier, was found to be useful. Our search for linkage to other biological markers (DNA RFLPs and NK cells) is in progress.

Adult↗

[Cholecystectomy and adenomatous polyps of the colorectum].

The possible correlation between cholecystectomy and adenomatous polyps of the colorectum is evaluated by means of a retrospective study of 2 groups of patients: 90 patients subjected to endoscopic removal of one or more adenomatous polyps of the colon-rectum (histological diagnosis) and 90 control patients paired by sex and age, hospitalised for benign pathology and selected from among those submitted to totally negative colonoscopy. Ten patients (11.1%) were submitted to cholecystectomy among those with adenomatous polyps, 5 (5.5%) in the control group. Subdividing patients by sex women evidenced a relative risk of 5 (O.R. = 5/1, degree of confidence 95% = 0.7-33.4) but the figure was not statistically significant. For males, on the other hand, the relative risk was 1 (O.R. = 5/4). It is concluded that cholecystectomy may be considered a risk factor for the development of adenomas of the colon-rectum in females.

Adult↗

Depressed level of natural killer cells in cancer family syndrome.

Individuals from kindred with cancer family syndrome (CFS) have an increased genetic risk for the development of adenocarcinoma of the colon as well as of several other organs. Previous studies have suggested that this high occurrence of adenocarcinoma in this as in other hereditary neoplastic syndromes may be correlated to an underlying abnormality in immunological tumor surveillance. In attempt to define a marker that might identify individuals within CFS kindred at risk of developing cancer, we determined natural killer (NK) cell number and NK cell function in affected and healthy members of a CFS family. We studied 13 cancer-affected patients, 20 unaffected but "at-risk" subjects, 20 healthy subjects and 26 normal individuals matched to the patients with colon cancer on the basis of sex and age. We determined the number of NK cells and their function concurrently, using a monoclonal antibody and a 51Cr-release assay with K562 as target cells. We found that the number of NK cells was significantly (P = 0.00004) reduced in cancer patients as compared with healthy subjects and normal controls. Of the 20 at-risk individuals 9 had levels lower than the norm, while 11 showed normal-values. Consequently, the mean percentage of NK cells of this group does not differ either from that of normal subjects or from that of cancer patients. Mean NK cell function was lower in cancer patients than in healthy members of the CFS family but the differences were not statistically significant. Therefore, the mean NK cell function per single cell, expressed as a ratio between cytotoxicity (LU) and the number of NK1-positive cells, resulted paradoxically in an increase when compared with that of normal subjects. The possible mechanisms for this dichotomy were examined.

Adolescent↗

Electrical activity recorded from abdominal surface after gastrectomy or colectomy in humans.

The visceral electrical activity recorded from the abdominal surface was studied before and after either total gastrectomy or colectomy. The patterns obtained from fast Fourier transform analysis demonstrated the disappearance of the power peak of approximately 3 cpm after gastrectomy, whereas colectomy did not result in the disappearance of the power peak of approximately 3 and 8-12 cpm. Only the frequencies of approximately 3.5-7.5 cpm were not present after colon surgery. These data demonstrate that the spectral power peaks at frequencies of approximately 3 cpm are entirely related to the stomach because they disappear after gastrectomy; the power peaks between 3.5 and 7.5 cpm are related to the colon because they are present after gastrectomy but not after colectomy; the power peaks between 7.5 and 11 cpm are related to the small intestine because they are present after either gastrectomy or colectomy. The authors conclude that the electrical activity recorded from the abdominal surface and analyzed by fast Fourier transform gives reliable information concerning the electrical activity of the stomach and small intestine, although it is less reliable concerning the electrical activity of the colon.

Abdomen↗

[Surface electrogastrography (EGG) in cancer: influence of the localization and tumor characteristics on the spectral components of the signal].

1) The present paper concerns the relationship between localization and extension of gastric cancers and the spectral characteristics of the EGG in 73 subjects (32 women and 41 men). 2) The recordings were made in the morning (during 1 h) on fastened patients. Three sets of bipolar cutaneous electrodes were placed on the abdomen around the pyloric radiological projection taken for axis (radius 7 cm; angle 60 degrees); sampling period for analysis is 1 per sec. The spectrum is computed (FFT) for 256 samples in each channel. 3) In the control subjects (n = 72: 24 women and 48 men), the "normal characteristics" of the peak EGG are the following: frequency: 2.89 +/- 0.2 c/min; amplitude 40 +/- 20 microV (2-5 derivation), whatever the age. 4) In the cancerous subjects significative increase of the mean spectral component amplitude of the gastric frequency was always found in all different localizations. However, this criterion of amplitude was missing for the corpus localization. 5) The process of infiltration of the wall was accompanied by a significative decrease of the mean frequency. But in ulcerous, vegetant or stenosant cases the frequency was not affected in contrast with the amplitude. 6) In extensive cases the decrease of the frequency was more important. If in several cases (early cancers, mucous cancers of the lesser or greater curvature), no significative abnormality of the spectrum was observed, abnormalities are frequent in cardiac, fundic and antral neoplasies.

Adult↗

[New method of non invasive examination of the gastroenteric tract].

A new non-invasive method for studying the gastrointestinal tract. The Authors, after a critical evaluation of the methods used to study gastrointestinal motility, evaluate the diagnostic power of electrical activity recorded from the abdominal surface. Physiological principles of gastrointestinal electrical activity, recording methods and statistical analyses of the signal are discussed. A review of the literature is included. It is suggested that this method represents a more accurate, non-invasive diagnostic tool for gastrointestinal disorders.

Electrodiagnosis↗

[The spectral component of electrogastrography (EGG): factors of variation in normal subjects, and in patients with cancer and ulcers].

A study of the spectral analysis of the electrogastrography has been mad in man in a non-invasive condition: normal subjects in two groups: young and old subjects (n = 72) were compared with gastric cancers (n = 42) and ulcerous (n = 22) subjects. Morning recording (10-11 h a.m.), in fasting conditions, were repeated every three successive days. In normal subjects, the mean frequency of the spectral gastric component is very stable (2.8 +/- 0.2 cycles per min), whatever be the sex, the age of the body weight. In normal subjects, the mean spectral amplitude (y) varied with the derivation: in derivation 3-6 (according to the antro-pyloric axis) is the greatest amplitude (y = 52 +/- 22 microV). In the cancerous condition, the range of the frequencies increases, but the mean frequency does not change (2.8 +/- 0.3 cycles per min). However, in 7 cancerous subjects the frequencies (x) fell beyond the limits of the population with an (x) being either less than or equal to 2.4 or greater than or equal to 3.2 cycles per min. In a great proportion (forty-seven per cent) of the cancerous subjects, an important and significant increase of amplitude is recorded (at least in one derivation). In these cases, the location of the cancer is the cardia, the fundus or the pylorus. The amplitudes fall significantly beyond those observed in ulcerous patients. The possible explanations of these variations and the applications to the future monitoring of patients are discussed.

Adolescent↗

[Spectral characteristics of electrogastrography in gastric cancer. Possibilities of screening].

A standardised application of electrogastrography (EGG) using spectral analysis was used in 182 subjects (72 normals, 74 cancerous and 36 ulcerous) in a large range of the aging (10 to 70 years). The conditions of derivations from the abdominal surface electrodes (n = 6) are following: bipolar distance 14 cm around the pyloric point at 0 degrees (antrum axis), 60 degrees and 120 degrees. In fasting situation in normal subjects the gastric frequency (N) and the spectral amplitude (Y) of the most energetic component of EGG was 2.89 +/- 0.2 c/min for N and 54 +/- 44 microV for Y in antropyloric axis. In the cancerous group a significative increase of mean amplitude is observed (P = 0.01). On the contrary any mean change of frequency was observed (2.89 +/- 0.3 c/min). The individual comparison with normal parameters leads to following selection: neoplasia, n = 42/74 cases (57%); ulcer, n = 13/36 (36%); however 7/72 normal subjects (10%) fall in this abnormal class as false positive. After an ingestion of tea (120 ml) giving a volumetric stimulation, the modifications of frequency are not significative contrary to the amplitude increase. Finally, the association of one or two abnormalities leads to the following percentages: 66% in cancerous, 45% in ulcerous and 23% in normal subjects. Thus a better proportion of abnormalities was observed in cancerous subjects with the stimulation but this procedure may lead to an increase of false abnormality in the non-neoplastic subjects.

Adult↗

[Relationship between taenia coli electric activity and circular fibers. Study of the human transverse colon].

First results of the comparison between the electrical activity of taenia coli and circular muscle are described. Experimental techniques consisted in recording electrical activity for 83 h in 12 patients during the post-operative period after cholecystectomy. Bipolar wire electrodes were surgically inserted in each muscle of the transverse colon's median portion. Statistical treatment leads to the principal conclusion as follows: Whatever type of muscles we have investigated, always could be found slow rhythmic components (called electro-control activity, ECA) in frequency ranges of 1-5 c/min and 9-12 c/min. Major part of taenia coli ECA is in frequency range between 1-5 c/min. ECA in this frequency range can be found in 21% of circular ECA, 23% of taenia coli ECA and 9% of common ECA (% means percents of total recording time). Higher frequencies are found in 7% of circular ECA, 4% of taenia coli ECA and 3% of common ECA. Using long time constant (more than 2 s) the bursts of spikes (10-50 microV) meaning active responses are always accompanied with slower components of important amplitude (greater than or equal to 100 microV): In the discrete mode of activity (DERA) short bursts (during 1-2.5 s) always follow the ECA, whereas in the continuous mode of activity (CERA) mostly longlasting bursts (up to 30 s) could be found. The bursts represent 14% of total time, namely in 8% of longitudinal ECA, 4% of circular ECA and 2% of common ECA. ECA of taenia coli in the case of common ECA is always prolonged. Typical slow waves of greater amplitude (greater than or equal to 500 microV) different from ECA are frequently recorded probably due the intensive contractile process.

Action Potentials↗

[Reorganization of the electrical activity of the transverse colon after cholecystectomy. Study in humans with implanted electrodes].

Electrical activity of the colon was investigated in the postoperative period in 12 patients, 1 to 6 days after cholecystectomy. The polygraphic records are obtained during 2 hours each day late in the morning (10-12 h) in a preprandial situation from serosal implantation of bipolar copper wires inserted into each circular and longitudinal layer in narrow portion of the middle part of the transverse colon. The time presence diagrams was built up after recognition of the basic patterns activity previously definite by Sarna as follows: Electro-Control-Activity, with it slow waves (ECA), Electro-Response-Activity (ERA) with Discrete bursts (DERA) or Continuous ones (CERA). In the former postoperative period 1 to 3 days ECA is present with a low range frequency 1-5 c/min. The higher frequency (10-12 c/min) activity arises sporadically, in this case associated with DERA bursts. From the 4th day all activities ECA and DERA increase significantly. The continuous response activity CERA may be observed in all periods but more frequently from the 3rd day with the same mean duration (12.4 +/- 1.85 s for the circular fibers and 21.6 +/- 2.56 s for the longitudinal ones); the predominance of longitudinal activity duration is significative (p = .001). The complex CEC (26-40 c/min) associated with CERA is observed only in 3% of the time recording. Thus after the onset of colonic motility with DERA and CERA in the 3th day, the normalization is obtain the 6th day with the predominant rythm of 1-2 c/min.

Cholecystectomy↗

Gallstones and uterine fibroids.

In a series published in 1961, an unusual frequency of hysterectomies for uterine leiomyomas (fibroids) was reported in women with gallstones. The purpose of this study was to confirm the association between gallstones and uterine leiomyomas with a patient control study and to investigate its physiopathologic basis comparing the cholesterol saturation of bile in women with gallstones, in women with leiomyomas but no gallstones and in those in the control group with no gallstones or leiomyomas. Patients admitted to the surgical department have, routinely, echography of the gallbladder before and manual exploration of the pelvic floor during surgical intervention. For the first part of the study, we collected information concerning the diagnosis of leiomyomas from the operating room registers and about the diagnosis of gallstones from the clinical records. In 1982, 42 of 139 women operated upon consecutively for gallstones and five of 69 operated upon for other diseases of the gastrointestinal tract had leiomyomas, a statistically significant difference (chi-square test, p less than 0.001). This difference persisted stratifying women with gallstones and those in the control group for age. In the second part of the study, we examined the bile collected at duodenal drainage after gallbladder stimulation with cholecystokinin, in 11 young women with radiolucent gallstones (echography and cholecystography), in ten women with leiomyomas (gynecologic examination and pelvic echography) but no gallstones (echography) and in 11 women with no leiomyomas (gynecologic examination or pelvic echography) or gallstones (echography). Cholesterol, phospholipids and total bile acids in the biliary tract were analyzed with standardized enzymatic methods. The cholesterol saturation index of the biliary tract was higher in patients with leiomyomas than in those in the control group (Wilcoxon rank sum test, p less than 0.01) and similar to that of women with radiolucent gallstones. These data suggest that gallstones and leiomyomas are associated diseases, probably sharing a common cause.

Adult↗

Serum and bile lipids in young women with radiolucent gallstones.

To investigate the relationship between blood and bile lipids, serum cholesterol, high density lipoprotein cholesterol, and triglycerides were correlated with cholesterol saturation index of bile in 21 women-10 with radiolucent gallstones and 11 without stones. All of the women had regular menstrual cycles, were normolipidemic, and on a hospital diet. On the same morning, blood and the darkest duodenal bile were taken after cholecystokinin (CCK) stimulation. Standard laboratory procedures were used to analyze serum and bile lipids. We found: 1) statistically significant (t test, p less than 0.05) but only slight hypercholesterolemia (+ 12%) in patients with gallstones; 2) a negative correlation of serum cholesterol with cholesterol saturation index of bile, both in the control group (r = -0.654, p less than 0.05) and in gallstone patients (r = -0.665, p less than 0.05); 3) a correlation of high density lipoprotein cholesterol with cholesterol saturation index only in normal women (r = -0.619, p less than 0.05); 4) conversely, a correlation of triglycerides with the same index in only gallstone patients (r = 0.641, p less than 0.05). With the stepwise multiple regression analysis (independent variables: diagnosis of gallstones, serum cholesterol, HDL cholesterol, triglycerides; dependent variable: biliary cholesterol saturation index), only gallstone diagnosis and serum cholesterol influenced significantly (F test, p less than 0.05) the biliary cholesterol saturation index. These findings suggest that young women with radiolucent gallstones are slightly hypercholesterolemic, that in women both with and without gallstones there is a negative correlation between serum cholesterol and biliary cholesterol saturation, but women with gallstones have a higher cholesterol saturation index of the bile than women without gallstones with the same level of cholesterol in the blood.

Adult↗

Preliminary observation on human tubal electrical activity in vivo.

The authors have set up a new technique for recording the human tubal electrical activity in vivo. A polyethylene catheter was used with six couples of electrodes placed on the tube of 5 women during simple laparohysterectomy. The slow electrical activity was recorded by means of a 8-channel paper amplifying recorder for 3-5 days from surgery. The fimbria showed frequencies between 1.25 and 3.3 c/min, the ampulla showed higher frequencies (1-5 c/min), the isthmus showed little electrical activity. The propagation signal velocity ranges between 0.25 and 0.5 cm/sec. The amplitude ranges between 50 and 200 V. The propagation occurs mainly in the distal-proximal direction.

Adult↗