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Biomedical subjects

I Giorgio

Publications and source records attributed to I Giorgio.

54 records · Page 3Linked to original sources
PubMedDate not supplied

In vitro electro-mechanical activity of the human colon. Simultaneous recording of the electrical patterns of the two muscle layers.

Electrical and mechanical activity on longitudinal and circular layers of the human sigmoid colon were simultaneously studied. Recordings were obtained from two electrode sites spaced 3 cm apart in a piece of colon which had been resected surgically and perfused in an organ bath. Spontaneous electrical activity of the colon showed slow waves and spikes. Slow waves were present for only 24.5% and 12% of the recording time on the longitudinal and circular layers, respectively, and they appeared as localized activity which was irregular in amplitude and varying in frequency. Electrical coupling between the two muscle layers was rarely seen and slow waves were not associated with pressure changes. Spiking activity were recorded as short and long spike bursts on both muscle layers. Short spike bursts were localized activity superimposed on slow waves. The associated mechanical activity, which consisted of single weak pressure changes or prolonged contractions with summation, was determined by slow wave frequency. Long spike bursts were seen at irregular intervals and were either propagated or not propagated activity associated with electrical oscillations ranging from 24 to 46 cpm. Mechanical activity consisted of sustained tonic contractions propagated or not propagated in the same way as the electrical pattern. Coordinated electrical activity of the two muscle layers seldom occurred when spontaneous activity was being recorded. Electrical activity on both muscle layers was very sensitive to stretching and could be initiated or modulated by pharmacological agents. In particular, our findings showed that stimulation induced coordinated spiking activity on the two muscle layers and caused mechanical activity, propagated orally or aborally, which consisted of long lasting, high amplitude contractions.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine↗
PubMedDate not supplied

Effect of cimetidine and ranitidine on gastric electrical activity in man.

Electrical activity was recorded in six post-cholecystectomy patients using bipolar serosal electrodes. Three patients were treated with intravenous cimetidine bolus in doses of 200 mg every four hours. Another three patients were treated with intravenous ranitidine bolus in doses of 50 mg every six hours. The frequency and the amplitude of the gastric electrical control activity (ECA) and the incidence of electrical response a activity (ERA) were evaluated before and after the administration of the drugs. The administration of cimetidine and ranitidine did not produce any statistically significant variation in the frequency and amplitude of the gastric ECA and the incidence of ERA. These results show that the effects of the H2-antagonists on gastric electrical activity had no clinical relevance.

Cimetidine↗
PubMedDate not supplied

[Recovery of gastroduodenojejunal electric activity after cholecystectomy. In situ study in mam].

The recovery of gastrointestinal electrical activity--migrating myoelectrical complex (MMC) and slow waves--was studied in six women (50-77 years) after cholecystectomy for gallstones: serosal electrodes in pairs are implanted in the wall of the antrum, duodenum and jejunum during surgery. Five hour recordings were made on the first, third and fourth postoperative days (pOD), in starvation condition with hydric intake only. The recordings were made after a twelve hour fast. On the fourth postoperative day, a test meal (250 g yogurt) was given to the patients and its effects on electrical activity were recorded for 2 hours. Even though MMC were present on the first and third postoperative days, a detailed study of their origin, the length of the phase 3 and the speed of gastro-jejunal propagation showed an inhibition of gastric MMC until the fourth pOD, moreover that intestinal MMC was slower than normal until the third pOD. On the fourth postoperative day, gastric inhibition disappeared since the length of the phase 3 of the MMC in the gastric level corresponded to those of the duodenum and jejunum. Furthermore the speed of propagation corresponded to that in normal subjects. Further, the slow wave frequency peculiar to each segment studied increased progressively from the first to the fourth pOD just like the slow waves with action potentials. In conclusion, notwithstanding the presence of MMC from the first postoperative day, it was only on the fourth day that normal coordination was restored and hence that patients were able to eat again.

Action Potentials↗
PubMedDate not supplied

[Restarting of electric gastric activity in situ after a minor gastric intervention].

The restarting of the electrical gastric activity after an extramucous myotomy according to the Heller's techniques with Dor's fundoplicatio was observed in a woman by 3 pairs of electrodes implanted in the wall of the gastric fundus, corpus and antrum at 3, 11 and 20 cm from the pylorus. The electrical activity was recorded on the day of surgery and on the 1st, 3rd and 5th postoperative day. Feeding was allowed on the 5th day. The gastric frequency decreased significantly on the 1st (2.92 +/- 0.09 c/min), increased on the 3rd (3.29 +/- 0.04 c/min.) and appeared normal on the day of surgery and on the 5th day (3.10 +/- 0.09 c/min). The pattern of the Potential Pacesetter (PP) changed during the observation: it appeared with a great amplitude on the day of surgery, slowed on the 1st, was polyphasic on the 3rd and shorter and weaker on the 5th day. The spiking activity was observed on the 3rd day for 20 minutes and it allowed to establish the restoration of the normal migrating complexes. A decrease of the gastric frequency and an increase of the slow wave progression was induced by the first alimentary resumption (yoghurt). The gastric frequency increased and the velocity of the slow wave progression decreased as soon as the ingestion was over. The receptive relaxation of stomach should be related to these latter phenomena.

Action Potentials↗
PubMedDate not supplied

Antibodies to hepatitis C virus and chronic hypertransaminasemia in southern Italy.

In an ecographic survey for gallstones, executed on a systematic sample from the municipal electoral roll of a town in Southern Italy, 164 subjects were found with ALT more than twice the upper normal limit (unl). Five years later 138 of these were re-examined; 76 still had ALT greater than 2 unl (group A), 41 still abnormal (group B) and 21 normal (group C). Anti-HCV antibodies were found in 52 subjects of group A (68%). 18 of group B (44%) and 2 of group C (9.5%). The odds ratio of ALT greater than 2 unl (A vs C) in anti-HCV+ was 20.6 and of a still elevated ALT (A + B vs C) was 14.1. Logistic regression was used to eliminate the effect of possible confounding factors (sex, age, alcohol, drugs, HBV markers) on the relationship chronic ALT increase and anti-HCV positivity but the odds ratio was still 18.9 (A vs C) and 11 (A + B vs C). These findings suggest that anti-HCV antibodies are strongly associated with chronic hypertransaminasemia at the population level in Southern Italy.

Adult↗
PubMedDate not supplied

[Prevention of duodenal ulcer recurrence by the use of anti H2. Comparison of continuous long-term and seasonal therapy].

The Authors have assessed the incidence of ulcer recidivation in patients with cicatrized bulbar ulcers following anti H2 treatment using two maintenance therapy protocols: 1) 400 mg/day of cimetidine in a single evening dose for 1 year (continuous therapy); 2) the same dose of cimetidine administered at the same time but only for 4 months a year (February-March and September-October) (seasonal therapy). Ninety patients with cicatrized ulcers which had been diagnosed using endoscopy were randomly assigned to the two treatment protocols. Protocols were followed for a least one year with endoscopic controls every 6 months. There were no significant differences between continuous and seasonal therapy in relation to the recurrence of duodenal ulcers (Log Rank test p less than 0.05). Cox's proportional hazard model was used to assess the effect of the two treatment protocols on ulcer recurrence eliminating the influence of sex, age and smoking; it was seen that only smoking influenced the incidence of recidivation (p less than 0.05). These results suggest that seasonal maintenance therapy with anti H2 is as efficacious as continuous therapy in preventing the recurrence of ulcers.

Adult↗
PubMedDate not supplied

Electrogastrography: possibilities and limits.

A cutaneous electrogastrogram (EGG) is a recording of the electrical activity of the stomach by means of electrodes placed on the abdominal skin surface. Recently, there has been an increased interest in the cutaneous EGG due to the development of new recording techniques and improved methods of signal analysis, and as a result of these developments recent studies have been able to demonstrate that alterations in gastric electrical activity may be accompanied by unexplained nausea and vomiting. In spite of the diagnostic potential of the cutaneous EGG, there are numerous problems which must be resolved before widespread clinical use is possible. The authors review the current status of the cutaneous EGG and describe their own experience of its use in the study of certain organic gastric diseases.

Electrodiagnosis↗
PubMedDate not supplied

Asymptomatic gallstones. What to do in patients undergoing colonic surgery for cancer?

Twenty-three patients who underwent elective surgery for colorectal cancer in our hospital between 1983 and 1989, underwent concomitant cholecystectomy for asymptomatic gallstones. In order to assess whether additional cholecystectomy increases postoperative morbidity and mortality, a comparison was made between these cases and 23 controlled patients (without gallstones) matched for sex, age (+/- 3 years), Dukes stage and type of primary colonic surgery. The duration of postoperative stay was similar in the two groups (14.1 +/- 4.5 days vs 12.4 +/- 2.3 days). Postoperative complications were more frequent among the case patients than among the controls (34.8% vs 8.7%, p = 0.04), and the same was true for the mortality (8.7% vs 0%). During the same period, another 11 patients with asymptomatic cholelithiasis were operated on for colorectal cancer but in these patients gallstones were left in place. Two of the patients died postoperatively and only one of the remaining 9 (11.2%) had an episode of biliary pain. The results of our study would suggest that in patients undergoing surgery for colorectal cancer the risk entailed in carrying out an additional cholecystectomy for asymptomatic gallstones is greater than the risk of future morbidity caused by gallstones left in place.

Aged↗
PubMedDate not supplied

Complications after elective gastric resection for duodenal ulcer. Multivariate analysis of risk factors.

The records of 545 consecutive patients, who underwent elective Billroth II gastric resection for pyloric or duodenal ulcer were examined retrospectively to identify a group of high-risk patients for life threatening postoperative complications or death. Thirty-two preoperative clinical, endoscopic, surgical and haematological variables were analyzed by stepwise logistic regression. Major complications occurred in 39 patients (7%) and eight patients (1.5%) died. The patient characteristics associated with the major complications and death were liver cirrhosis (Odds ratio 6.7 95% Confidence interval 1.3-33.8), white blood cell count > 10,000/mm3 (Odds ratio 5.5 95% Confidence interval 1.7-17.3), previous abdominal surgery (Odds ratio 4.6 95% Confidence interval 1.7-12.1), and ulcer penetrating contiguous structures (Odds ratio 3.3 95% Confidence interval 1.2-8.9). There was no statistically significant interaction between the above risk factors in causing complications or death. It can be concluded that even if only one of these four risk factors is present in patients undergoing elective surgery for duodenal ulcer a riskless technique, such as proximal gastric vagotomy, should be used instead of Billroth II gastric resection.

Aged↗