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Biomedical subjects

N Basso

Publications and source records attributed to N Basso.

At least 109 records · Page 6Linked to original sources

Transduodenal papillostomy as a routine procedure in managing choledocholithiasis.

The purpose of this study was to evaluate the results of transduodenal papillostomy as a routine procedure in managing choledocholithiasis in treating common bile duct (CBD) stones. From 1973 to 1978, 117 patients underwent transduodenal papillostomy for CBD lithiasis. The operation was carried out in standard manner, and all patients had preoperative telecholangioscopy, cholangiography, and biliary manometry. The mean age of patients was 53.7 years, and women predominated in a ratio of 4.5:1.0. Papillostomy was performed together with cholecystectomy for CBD stones in 111 patients (group 1). In five patients, we had to perform a choledochotomy to remove the stones after an unsuccessful papillostomy (group 2). Eight patients who previously had cholecystectomies underwent papillostomy for retained or recurrent stones (group 3), and three patients had a choledochoduodenostomy for recurrent stones after a previous cholecystectomy and papillostomy (group 4). Complications included two deaths in group 1 (1.9%). No mortality was observed in groups 2 and 4. Moreover, the overall morbidity was due to six cases of wound infection, one case of postoperative bleeding, one case of phlebitis, and three cases of cholangitis. The mean length of hospital stay was 12.9 days, considering all the groups. Lack of confidence with this procedure may explain the different results reported in the literature for transduodenal papillostomy, which on the basis of this study has been shown to ba a valid alternative to supraduodenal choledochotomy in treating CBD stones.

Adult↗

Effect of ceruletide on rest pain in patients with arterial insufficiency of the lower extremity.

The effect of ceruletide (CRL), a synthetic decapeptide analogue of cholecystokinin, on rest pain and arterial blood flow was evaluated in 8 patients with advanced, occlusive atherosclerosis of the lower extremities. CRL 1, 2, or 4 ng kg-1 or placebo were infused intravenously in random order, and in a double-blind fashion. Pain relief, assessed by a scoring system, was significantly better (p less than 0.01) following the 2 and 4 ng kg-1 doses of CRL (2.71 and 2.66, respectively) than following placebo (0.75). Arterial blood flow was not affected by either CRL in any dose or by placebo. Pretreatment with naloxone, a pure opioid antagonist, abolished the analgesic effect of CRL. Following the 2 ng dose of CRL, beta-endorphin levels were significantly elevated from a basal value of 125 +/- 15 pg/ml to 191 +/- 35 pg/ml 5 h after CRL administration (p less than 0.05). Circulating levels of ACTH, prolactin and GH were not affected by CRL. It is concluded that CRL was effective in relieving ischaemic rest pain, and that the mechanism was related to the release of endogenous opioids.

Adrenocorticotropic Hormone↗

Angiotensin--forming enzyme active at the physiological Ph in the brain of normal and nephrectomized rats.

Enzymatic activity generating angiotensin at pH 5.5 and 7.2 has been detected in different areas of the central nervous system (CNS) of the rat. Control animals and those subjected to bilateral nephrectomy 48 h before the experiment (Nx) were analyzed. The different areas of the CNS were studied by the incubation of tissue homogenates in the presence (enzyme concentration) or not (enzyme activity) of an excess of added angiotensinogen. Concentration was determined by incubation at pH 7.2 and 5.5 while activity was evaluated only at pH 7.2. The enzymatic renin-like concentration at both pHs did not change after Nx thus showing they do not depend on plasma and vascular renin. On the other hand the activity of the enzyme showed a significant increase in the cerebral cortex and cerebellum after Nx suggesting an increased concentration of renin substrate and/or different concentrations of inhibitors or activators of the enzymatic system in those areas.

Animals↗

Evidence of early structural change in the artery wall of two-kidney one-clip Goldblatt hypertensive rats.

Vascular structural changes were studied during the development of two-kidney one-clip renal hypertension. The weight of the arteries and the concentration and total amount of ribonucleic acid, deoxyribonucleic acid, alkali-soluble proteins, collagen and elastin of the vascular wall were measured. Tritiated thymidine uptake was also determined 15 and 30 days after clipping. Hypertension developed in 58% of the animals while the rest remained normotensive. A significant increase in artery weight and in the total amount of nucleic acids and proteins was found in hypertensive rats. The uptake of 3H thymidine by the arteries of hypertensive rats was significantly increased 15 days after clipping. This increment showed a significant correlation with blood pressure levels. Present data seem to indicate that the increase in vessel wall dimensions observed is partly due to an increase in the number of smooth muscle cells during the acute phase; this alteration appears to be mainly due to the rise in blood pressure.

Animals↗

The renin-angiotensin-aldosterone system in rats of both sexes subjected to chronic hypobaric hypoxia.

Plasma renin activity (PRA), plasmatic aldosterone, haematocrit, haemoglobin concentration and plasma proteins were measured in 36 Wistar rats of both sexes submitted to 380 mmHg in hypopressure chamber during 7 months and in a group of control animals (15 male and 15 female rats). PRA was significantly increased in hypoxic male (P less than 0.05) and female (P less than 0.01) rats. On the contrary, plasma aldosterone concentration did not show any significant variation. There thus was a clear dissociation between the plasmatic renin-angiotensin system and the aldosterone in rats of both sexes submitted to severe chronic hypobaric hypoxia.

Aldosterone↗

Studies with bombesin in the Zollinger--Ellison syndrome.

Preliminary data showed that bombesin stimulated serum gastrin levels in patients with the Zollinger-Ellison syndrome (ZES). In this study, the total immunoreactive gastrin and the different molecular forms of gastrin were measured in 16 patients with ZES (11 with proved pancreatic gastrinoma, 2 with proved duodenal gastrinoma and 3 with uncertain tumour localization) following bombesin infusion and following calcium infusion in 13 patients. In all patients with gastrinoma (both pancreatic and duodenal) bombesin augmented serum gastrin levels. In patients with pancreatic gastrinoma calcium infusion was a more potent stimulator of gastrin secretion than bombesin. In the 2 patients with duodenal gastrinoma bombesin was more potent than calcium in stimulating serum gastrin levels with a basal/stimulated gastrin level ratio similar to the ratio found in patients with incomplete antrectomy. These data suggest that gastrin-producing cells from duodenal gastrinomas may be more closely related to the normal antral G cells than to the gastrin-producing cells from pancreatic gastrinomas. Furthermore, the comparison between the basal/calcium and the basal/bombesin stimulated gastrin levels may help in differentiating preoperatively patients with pancreatic gastrinoma from patients with retained antral mucosa. In all the patients studied, bombesin augmented the concentration of all of the gastrin components considered. These data support the hypothesis that G 34, G 17 and the N-terminal G 17 fragment are all present in gastrinomas.

Bombesin↗

Management and long-term results in patients with two-thirds gastrectomy and stomal ulcer.

In 67 patients with two-thirds gastrectomy and endoscopically proven stomal ulcer, serum gastrin levels were measured under basal conditions and after intravenous infusion of bombesin (15 ng/kg/min), calcium (4 mg/kg/hour) and secretion (2 units/kg). All patients underwent medical or surgical therapy. The long-term results were evaluated according to the Visick grading system (average follow-up, 3.1 years).

Antacids↗

Cimetidine and antacid prophylaxis of acute upper gastrointestinal bleeding in high risk patients. Controlled, randomized trial.

A randomized, controlled clinical trial was performed to compare the efficacy of prophylactic cimetidine treatment, antacid treatment and no treatment in high risk patients. Sixty patients received cimetidine (200 mg every 6 hours), 52 patients received antacids (Maalox, 10 ml/hour), and 56 patients received no treatment. One hundred thirty-five patients completed the study. Eight patients in the control group and one patient in the antacid-treated group presented with upper gastrointestinal bleeding. No bleeding occurred in the cimetidine-treated group. Patients considered at low risk had no bleeding. Cimetidine or antacid prophylaxis significantly decreased the incidence of upper gastrointestinal bleeding in the high risk patients.

Antacids↗

Effect of ceruletide on pituitary-hypothalamic peptides and on emotion in man.

In order to clarify the mechanism of the analgesic effect of ceruletide (CRL), the peptides B-endorphin (BE), ACTH, prolactin (PRL), growth hormone (GH) and substance P were determined in the basal state and following IV CRL administration in 11 patients. CRL, at the dose of 2 ng/kg/min, significantly augmented BE levels in the plasma, and in CSF. Substance P levels were significantly augmented by CRL in the plasma, while ACTH levels were significantly augmented in CSF. GH and PRL levels were not affected by CRL. Placebo had no effect on any of the measured peptides. The effect of CRL on mood and anxiety, known to be affected by opioids, was studied in 14 patients with psychogenic headache. The effect of histamine induced headache on State trait anxiety inventory and on Mood adjective check list was studied before and after administration of placebo or CRL. CRL significantly diminished anxiety when compared to placebo. Elation, surgency and egotism were significantly augmented while skepticism was significantly diminished by CRL. The CRL effect on mood and pain may be mediated by augmented levels of neurohormones both in the plasma and in CSF.

Adrenocorticotropic Hormone↗

Water-salt balance, plasma renin activity and catecholamine excretion in renovascular hypertension in the rat.

Water-electrolyte balance, plasma renin activity and urinary catecholamine excretion were studied for a period of 10 weeks after clipping the renal artery in the rat. Two groups of rats were examined; in Group I, a silver clip was applied on the left renal artery leaving the contralateral kidney untouched; in Group II, both renal arteries were clipped. Neither water-salt retention nor the increase inthe activity of the renin-angiotensin system or in the neural tone seem to be essential in the development of high arterial pressure after renal ischemia. All these factors would seem to be secondary mechanisms the contribution of which would depend on the experimental model or the hypertensive period under consideration.

Animals↗

Influence of sodium on experimental renovascular hypertension in rats.

1. Rats on normal sodium diet (group 1) and on chronically maintained low sodium diet (group 2) were studied during a control period, after clipping the renal artery (two-kidney, one-clip hypertension) and after nephrectomy (one-kidney, one-clip hypertension). 2. The low sodium diet neither prevented the development nor changed the severity of two-kidney, one-clip hypertension, and the latter was not accompanied by an increase in plasma renin activity. 3. After nephrectomy arterial pressure further increased and plasma renin activity decreased in group 1, and both remained unchanged in group 2. 4. Blood volume was the same in both groups 10 days before and 10 days after nephrectomy. 5. Sodium does not seem to be 'necessary' in the two-kidney, one-clip hypertension although it may play an enhancing role in the one-kidney model.

Animals↗

Humoral and neurogenic factors in two-kidney renovascular hypertension.

A "bolus" dose (110 microgram) of the angiotesin II (A II)-blocker 1-Sar-8-Ala-A II (Saralasin, S) followed by its slow rate infusion (5 microgram/min/rat) for thirty min, was injected before and after the complete ganglionic blockade by pentolinium (P) in unanaesthetized unilaterally clipped renal hypertensive rats (the opposite kidney remained untouched). Pentolinium was also injected like a "bolus" dose (3 mg) followed by slow infusion (0.1 mg/min/rat) for thirty min. The observations were made until the fifth week after clipping the left renal artery. A consistent maximal hypotensive response was observed after the "bolus test" with both drugs. When S was the first drug injected, an inverse correlation was found between the percent decrease in arterial pressure (BP) by S and the percent decrease in BP by P (r = --0.83, P < 0.01, n = 8). Thus whenever a greater hypotensive effect was obtained by S, a smaller neural pressor component remained to be blocked by P. On the other hand, when P was the first drug injected a lesser A II pressor component remained to be blocked by S in the hypertensive rats. The results suggest that a considerable A II pressor effect in two-kidney renovascular hypertension is mediated via neurogenic mechanisms from the first week. A direct pressor vasoconstriction was found to be significant in cases with very high plasma-renin activity.

Angiotensin II↗