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Biomedical subjects

M Bortolotti

Publications and source records attributed to M Bortolotti.

At least 73 records · Page 4Linked to original sources
PubMed1981

[Effects of extramucosal duodenal myotomy in dogs (author's transl)].

Numerous experimental and clinical observations have established the role of hypertonic duodenal dyskinesia in the etiology of duodenogastric reflux and delayed emptying of the stomach. The original procedure proposed, section of the duodenal muscle fibres, demonstrated a relative hypotonia of the viscera and maintenance of antropyloroduodenal coordination. The present study confirms the effects of extramucosal duodenal myotomy after short- and long-term follow-up in dogs: reduction in gastric emptying time, absence of duodenal stagnation, and lack of morphological changes in the viscera. Unfavorable in duodenogastric reflux, it has favorable effects, on the contrary, on gastric emptying and antral function.

Animals↗
PubMed1981

Modifications in gastroduodenal motility induced by the extramucosal section of circular duodenal musculature in dogs.

The effect induced on the gastroduodenal motility by the extramucosal section of the circular layer of the first two parts of the duodenum, excluding the pylorus, was studied in a series of 5 dogs. The myoelectric and manometric activities of the antrum, pylorus, and duodenum were recorded by using special devices surgically implanted in the gut wall. The recordings were made 3 mo after operation, both during basal conditions and after stimulation with neostigmine. The results were statistically compared with those obtained in a control group of 4 dogs in which the electromanometric devices had been implanted 3 mo before. The gastric emptying time of a food-barium meal was determined radiologically before the operations, and 3 and 9 mo after. The results demonstrate that extramucosal duodenal myotomy: (a) significantly decreases the basal and stimulated motor activity of the duodenum, without noteworthy alterations of the gastroduodenal myoelectrical activity and coordination of motor waves; and (b) significantly shortens the gastric emptying time.

Action Potentials↗
PubMed1981

Clinical and manometric effects of nifedipine in patients with esophageal achalasia.

The effect of a new calcium antagonist, nifedipine, which has a spasmolytic activity on smooth muscle cells, was studied on the esophageal function of 20 patients with achalasia of mild and moderate degree. The study was carried out by using constantly perfused catheters and recording the pressure variations at the lower esophageal sphincter, before and after sublingual administration of 10-20 mg of nifedipine. The drug significantly decreased the lower esophageal sphincter pressure for more than 1 h. A clinical trial was also carried out by assessing the improvement of symptoms in achalasia patients taking sublingually a dose of 10-20 mg of nifedipine before each meal. After 6-18 mo of nifedipine therapy these patients underwent a placebo treatment, whereas an additional group of 9 achalasia patients was treated first with placebo followed by nifedipine. The nifedipine treatment gave excellent or good results in a large majority of patients of both groups. The moderate results were only 5 and the poor responses only 3. The clinical improvement induced by nifedipine was statistically significant when compared, not only with the pretreatment clinical state, but also with the results of the placebo treatment. No tachyphylaxis and few side effects were seen either during the manometric recordings or the longest periods of therapy. This study suggests that nifedipine may be advantageously used in the medical treatment of achalasia of mild or moderate degree.

Adult↗
PubMed1979

[Diagnosis of chronic reflux esophagitis. Role of endoscopic and histological examination].

Fibroendoscopic and histobioptic study of the distal oesophageal mucosa has been carried out in a series of patients suffering from gastro-oesophageal regurgitation. The regurgitation condition was verified and its extent established by means of anamnestic, spot-fluorographic and manometric-pHmetric investigations. On the basis of the analysis of relations between the extent of the oesophagitis assessed on the basis of endoscopy and that arising out of microscopic examination of the biopsy, it is concluded that there is no complete correspondence between the two techniques insofar as endoscopy can give false positive or false negative results. On the basis of these results and of those of functional investigations, histology is considered desirable even when the oesophageal mucosa is normal, if there are clinical and/or laboratory signs of gastro-oesophageal regurgitation.

Adult↗
PubMed1979

Prolonged manometric study of the gastroduodenal junction in man.

A study of the motor activity of the gastroduodenal (GD) junction has been carried out on 8 subjects by using an original probe provided with a suction cup, that allows not only a duodenogastric (DG) pull-though, but also a prolonged recording of the pyloric, antral and duodenal motor activity, in basal condition and after intraduodenal instillation of HCl 0.1 N and intravenous infusion of cerulein. The position of the probe was controlled with fluoroscopy and transmural potential difference. The DG pull-through did not show a zone of high pressure at the GD junction, but the prolonged study showed, during HC1 and cerulein administrations, a significant increase of the pyloric tonus.

Adult↗
PubMed1979

Pyloric reflux: a duodenal functional problem?

A manometric study of duodenal motor activity was performed in 8 duodeno-gastric (D.G.) reflux patients and in 5 healthy volunteers. The examination was done by an open-tip probe containing three catheters which was positioned in the descending portion of the duodenum. The evaluation of manometric data evidenced in D.G. reflux patients a Motility Index (M.I.) significantly higher than that of control subjects in all the three duodenal recording points both in basal conditions and after prostigmine stimulation. Evaluation of the percentage of coordinated waves showed that in D.G. reflex patients the waves had a frequency lower than that in normals. On the basis of these results we can conclude that the duodenum of patients with D.G. reflux exhibits hyperkinetic-dyskinetic disturbances suggesting an important role of the duodenum in determing D.G. reflux.

Adult↗
PubMed1978

Effect of highly selective vagotomy on gastric motor activity of duodenal ulcer patients.

The effect of highly selective vagotomy on the gastric emptying time of a food-barium meal and antral myoelectrical and manometrical activities was studied in two groups of duodenal ulcer patients: one with and another without delay in gastric emptying. Controls performed 1 and 3 months after operation showed that the group of patients with non-delayed preoperative gastric emptying kept a good emptying, only with sporadic, slight and transient disturbances of the gastric myoelectric activity. Conversely, the group of patients with delayed preoperative gastric emptying showed an increase in emptying time together with marked alterations in myoelectric and manometric activities.

Duodenal Ulcer↗
PubMedDate not supplied

Medical therapy of achalasia: A benefit reserved for few.

BACKGROUND: The rationale for medical therapy of initial achalasia and the results obtained over the last 20 years in our laboratory are presented. METHODS: Achalasic patients were selected as candidates for medical therapy on the basis of the presence of a slight esophageal dilation (<5 cm) on X-rays and a good manometric response to nifedipine administration. These patients were asked to take 10-20 mg of nifedipine sublingually 30-45 min before each meal for 2 weeks. Chronic medical therapy was continued only in those with an 'excellent' or 'good' clinical response to nifedipine and a lack of severe side effects. X-ray controls were planned every 6 months and manometric examination after the first 6 months. RESULTS: Of the 56 patients selected in the above-mentioned manner, 17 had an insufficient clinical response or severe side effects during the initial trial and did not continue medical therapy. Of the 39 patients who started chronic medical treatment, 13 are still on therapy and 26 stopped after an average of 2.8 years: 17 because they underwent dilation or myotomy; 4 for unknown reasons, and 5 apparently recovered. Esophageal manometry was carried out in 4 of the latter patients and revealed that the achalasic motor pattern had been replaced by a near-normal pattern. CONCLUSIONS: We believe that medical treatment of achalasia should be carried out not only in those patients who cannot undergo invasive procedures or do not respond well to them, but also in patients with initial achalasia selected using the above-mentioned criteria, because regression of the disease could take place in some of them.

Administration, Sublingual↗
PubMedDate not supplied

Effect of omeprazole on interdigestive gastroduodenal motility of patients with ulcer-like dyspepsia.

BACKGROUND/AIMS: As omeprazole, an antisecretory drug, is largely used in the treatment of acid-related diseases, we investigated its effects on the interdigestive gastroduodenal motility of ulcer-like dyspepsia. METHODOLOGY: Gastroduodenal motility was recorded manometrically in 9 patients complaining of ulcer-like dyspepsia with normal gastric emptying at scintigraphy, without ulcerative lesions and H. pylori infection at endoscopy, and without diseases known to affect gut motility (group ULD), and in a group of 9 healthy subjects as control (group C). After a period sufficient to record two consecutive phases III of the migrating motor complex (MMC) in patients of group ULD, omeprazole 20 mg was infused intravenously 30 min after the end of the last duodenal phase III and the recording was continued to the next one. RESULTS: With respect to the control group, the group ULD showed a significantly longer MMC cycle duration, a frequent absence of gastric phases III and a shorter duration of duodenal phases III. Omeprazole administration in group ULD was followed after 18.9 +/- 8.5 min by a typical gastroduodenal phase III and, consequently, the duration of the omeprazole-related cycle was significantly shortened. These omeprazole-related phases III started from the stomach in nearly all cases and showed a significantly longer duration at the duodenal level with respect to the spontaneous ones. CONCLUSIONS: Patients with ulcer-like dyspepsia showed a decrease in frequency and duration of gastroduodenal phases III. The omeprazole intravenous administration induced the anticipated appearance of an apparently normal gastroduodenal phase III, probably by suppressing the inhibitory action of acid secretion.

Adult↗
PubMedDate not supplied

[Changes caused by mineral water on gastrointestinal motility in patients with chronic idiopathic dyspepsia].

BACKGROUND: The antidyspeptic property of mineral waters has been based for ages on empirical data. In the present paper the effects of one of them (Tettuccio, Montecatini) on gastrointestinal motility of patients with dyspepsia has been evaluated. METHODS: The study was carried out on 24 patients with idiopathic dyspepsia and delayed gastric emptying at scintigraphy and 18 healthy subjects with normal gastric emptying. The gastric emptying of this mineral water was studied with a scintigraphic method in comparison with tap water, while its effects on gastroduodenal contractions were evaluated by of manometry. RESULTS: The gastric emptying of this mineral water was significantly faster than that of tap water, both in dyspeptic patients and in normals. Manometric examination showed that the administration of mineral water induced a brief decrease of phasic motor activity, followed by a progressive increase, which in some cases ended in an activity front of the Migrating Motor Complex. CONCLUSIONS: This mineral water has a stimulating effect on both gastric emptying and interdigestive cyclic motor activity of the gastroduodenal tract. Both these effects could be useful in the treatment of chronic idiopathic dyspepsia and impaired gut clearing.

Adolescent↗