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Biomedical subjects

S Mattioli

Publications and source records attributed to S Mattioli.

At least 55 records · Page 3Linked to original sources
PubMed1990

Ambulatory 24-hr pH monitoring of esophagus, fundus, and antrum. A new technique for simultaneous study of gastroesophageal and duodenogastric reflux.

A method for outpatient 24-hr simultaneous recording of pH in the distal esophagus, fundus, and antrum was developed in order to detect acid, alkaline, alkalacid gastroesophageal reflux, and duodenogastric reflux and to study these phenomena in patients complaining of gastroesophageal reflux and dyspepsia related symptoms. Two hundred ninety-four studies were performed in 42 healthy volunteers and 237 patients. Three-probe ambulatory 24-hr esophagogastric pH monitoring applicability, tolerability, and capability to determine a relationship between symptoms which occurred during the tests, gastroesophageal reflux, and duodenogastric reflux episodes were assessed. Eighty-nine percent of the three-probe esophagogastric pH studies were easily performed. The examination was tolerated well by 86.1% of the patients and poorly by 13.9%. A temporal correlation between symptoms and pH activities was recognized in 61.3% when the esophageal tracing was considered (acid gastroesophageal reflux recording) and in 95.6% when the three pH traces were simultaneously interpreted. Alkalacid gastroesophageal reflux and duodenogastric reflux total percentage times were significantly higher in patients complaining of dyspeptic symptoms than in patients only affected by typical gastroesophageal symptoms. Three-probe 24-hr ambulatory esophagogastric pH monitoring is a simple, well-tolerated test that should be routinely adopted for the study of patients complaining of unclear upper gastrointestinal tract symptomatology.

Adolescent↗
PubMed1989

Reliability of 24-hour home esophageal pH monitoring in diagnosis of gastroesophageal reflux.

Twenty-four-hour home esophageal pH monitoring is proposed in order to study gastroesophageal reflux (GER) so that prolonged use of costly hospital equipment and staff can be curtailed and the diagnostic accuracy of the examination improved. Eighty-six patients affected by GER symptoms and 20 healthy volunteers underwent 24-hr home esophageal pH monitoring, x-rays, and endoscopy of the upper gastrointestinal tract to investigate reliability of outpatient recording. Fifteen more patients consecutively underwent out- and inpatient recording to detect possible differences between these methods in the two daily periods. Outpatient monitoring was well tolerated in 94.7% of the patients; 14.3% of them markedly reduced their routine activities. The range of normality of outpatient recording does not differ from that of inpatients. In the 15 patients who consecutively underwent out- and inpatient monitoring, no significant differences were reported. The sensitivity of 24-hr home esophageal pH recording is 0.85, the specificity 1, the accuracy for negative prediction 0.68, and the accuracy for positive prediction 1. The reliability of 24-hr home esophageal pH monitoring is comparable to inpatient recording. It allows hospital cost reduction and is also better tolerated by patients but has not greatly improved the diagnostic accuracy of the gastroesophageal reflux pH monitoring.

Adult↗
PubMed1989

Peripheral venous nutrition in surgical patients: techniques, indications and results.

Peripheral venous nutrition (PVN) has been proposed to avoid complications resulting from central venous catheterization in surgical patients. Using lipid emulsions 3 standard diets (with final osmolarity not higher than 900 mOsm/1, non-protein calories from 1675 to 2177, electrolytes 110 mEq, Cal/N ratio from 130/1 to 170/1) were worked out. They are suitable for total nutrition of non-hypercatabolic patients and for nutritional postoperative maintenance of patients undergoing major digestive tract surgery. The three diets were tested in 118 patients. Frequency and type of phlebitis and the nutritional status before and after treatment were evaluated in patients submitted to PVN and in 2 groups of 10 patients who received S-D5W infusions and Protein Sparing Nutrition (N = 12.8 g, total Cal. = 690, electrolytes = 110 mEq, osmolarity = 493 mOsm/l, pH = 7) in the postoperative period. Frequency of phlebitis was significantly lower in PVN patients than in control groups. 15 day treatment did not increase the frequency of phlebitis. In medium-term treated patients the mean daily nitrogen balance was always positive. Perioperative PVN achieved a statistically significant reduction of nitrogen losses with respect to PSN and S-DSW infusion.

Adult↗
PubMed1987

Effects of pregnancy on cardiac function and myosin enzymology in the rat.

Previous studies of cardiac function during pregnancy, while suggesting that this condition is associated with improved myocardial contractility, have been biased by the altered in vivo loading conditions. Therefore, we have investigated intrinsic cardiac function and contractile protein biochemistry during pregnancy in isolated rat hearts under controlled loading conditions. Animals were impregnated and studied after 1 and 3 wk and 2-3 days postpartum (gestation 21 days). The data show that hearts from pregnant animals (at 3 wk) had improved contractile performance as manifested by an 11% increase in fractional shortening, a 20% increase in velocity of circumferential fiber shortening, and an upward-shifted force-velocity relationship. These findings were paralleled by a 16% increase in Ca2+-activated myosin and an 11% increase in actin-activated ATPase activities. Thus pregnancy in the rat is associated with slightly improved cardiac contractility and biochemistry. This may relate directly to the hormonal status of the pregnant animal or to the effects of chronic volume overload.

Actins↗
PubMed1987

Pathophysiology and natural history of acquired short esophagus.

The choice of therapy--whether medical or surgical--for patients with gastroesophageal reflux (GER) is often a subject of debate. After a period in which surgery was almost the exclusive mode of treatment in patients with severe complications resulting from GER or in patients who did not respond to medical therapy, long-term follow-up showed that in 20 cases of GER in which only medical treatment was given, a progressive shortening of the esophagus--frequently in the absence of esophagitis--had developed. To investigate the pathophysiology of acquired short esophagus, we studied 34 patients--20 from the initial group and 14 who already had this condition. Clinical assessment consisted of interview, radiologic examination of the upper digestive tract, endoscopic and histologic examinations, and 24-hour home esophagogastric pH monitoring. We noted that acid GER causes shortening in the presence of severe mucosal lesions, while "nonacid" GER--a combination of gastric, pancreatic, and hepatic secretions--causes shortening of the esophagus even without evident mucosal lesions. Symptom evaluation, acid GER pH recording, and endoscopy are not sufficient for determination of the current choice of therapy. It is also important to quantify GER that results from the mixing of gastric and biliopancreatic secretions with use of the esophagogastric pH recording. This should reduce the possibility of silent shortening of the esophagus.

Adult↗
PubMed1987

Surgical therapy in "early gastric cancer".

Regarding early gastric cancer (E.G.C.) some authors propose total gastrectomy while others believe that partial resection is the best solution especially when the site is in the distal portion. The histological characteristics of E.G.C. in 49 patients were examined: 95.9% of the EGCs were found in the antropyloric region and 4.1% in the corpus-fundus. 47 patients were submitted to distal gastrectomy and 2 to total gastrectomy due to localization in the fundus. The overall survival rate after 5 yrs. is 83%. The incidence of the antropyloric localization, the rarity of metastases to the lymph node stations of the 2nd and 3rd level, the way in which intramural spread, occurs and, above all, the optimal survival rate obtained after partial resection, indicate that partial gastrectomy for distal gastric tumors is a radical operation, with a low surgical mortality rate, followed by a prolonged symptom-free survival.

Adenocarcinoma↗
PubMed1986

Behaviour of basement membrane antigens in gastric and colorectal cancer. Immunohistochemical study.

Eighty gastric and colorectal lesions including cases of dysplasia and carcinoma were studied by immunohistochemical techniques to investigate the behaviour of laminin, type IV collagen and fibronectin. Their distribution was examined on frozen and formalin-fixed, paraffin-embedded samples. In the same lesions, interruption, fragmentation and absence of basement membrane (BM) antigen-staining were observed. Carcinomas with well differentiated glandular structures were always surrounded by a well defined BM as in normal, non-pathological tissues. On the contrary, undifferentiated areas arranged in nests or sheets were usually negative for laminin and type IV collagen. Anomalous BM staining was strictly related to the degree of differentiation of tumor tissue, while no correlation existed between carcinoma staging and BM antigen presence, either in gastric or colorectal neoplasms. Immunostaining with antibody against type IV collagenase showed a massive positivity in the early gastric carcinomas examined, while in colorectal cancer only granulocytes showed it.

Antigens↗
PubMed1984

Early gastric cancer. Clinico-pathological analysis of 125 cases of early gastric cancer (EGC).

The frequency and the pathological findings of 125 early gastric cancers (ECGs), and particularly of small and minute lesions, were evaluated in a retrospective study of 839 surgical specimens of gastric carcinoma. Sixty two ECGs were believed to have risen from gastric epithelium, 27 from areas of intestinal metaplasia, and 3 from cardio-pyloric mucosa. The remaining lesions showed mixed histological patterns. The most frequent macroscopic type was IIc (24.8%) followed by IIb (16.8%), I (16.8%), and III (14.4%). In 63 cases (50.4%) the cancer was limited to the mucosa. In all specimens, and particularly in small and minute lesions, the surrounding mucosa was accurately analyzed to detect any lesions, from which the cancer could have developed. Intestinal ECGs, especially if protruded, seem to arise from areas of intestinal metaplasia or of chronic atrophic gastritis. Rarely ECGs seem to stem from polypoid lesions both hyperplastic and adenomatous. On the contrary, most important seems to be the role of ulcerative lesions, since in 14 cases of our series, carcinomatous foci were observed within the regenerative epithelium covering the crater. No correlation was found between histologic type, size, staging, and frequency of node metastasis; this suggests the existence of ECGs with different biologic behaviour.

Adult↗
PubMed1981

[Carcinomas in situ of the breast].

In situ carcinomas of the breast represent a clinical reality of recent decades that oncologists have to face today. Their observation is rendered increasingly frequent thanks to the improvements made in radiological techniques for early diagnosis and mass screening, and better health education. Reference is made to cases of lobular and ductal in situ cancer observed at the Bologna Surgical Clinic. Recommendations are made with respect to the drawing up of a rational treatment plan.

Adult↗
PubMed1979

[Treatment of cancer of the breast with Patey's modified radical mastectomy].

Patey's operation was used to treat breast cancer in 658 cases between 1956 and 1976 at the Bologna University Surgical Clinic. Follow-up in 562 cases revealed 5-yr and 10-yr survival rates substantially similar to those obtained by Halsted and others. It is felt that the type of operation used is of relative importance for survival, since breast cancer is dependent on other factors that require careful appraisal in each case.

Breast Neoplasms↗
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

Exocrine pancreatic function after total gastrectomy.

The secretion of bicarbonate, lipase, and chymotrypsin into the duodenum in response to exogenous stimulation with secretin, 1 CU/kg-h, plus caerulein, 100 ng/kg-h, was investigated in 12 patients, on an average, 20.7 months after total gastrectomy and in 14 control subjects. The secretion of bicarbonate and lipase was significantly lower in patients than in controls. The reduction in outputs compared with the control values was 47.9%, 38.7%, and 24.2% respectively for bicarbonate, lipase, and chymotrypsin. Eight of the 12 patients (67%) had steatorrhoea. No significant correlation was found between this parameter and lipase output. It is concluded that the exocrine pancreatic function is impaired in the majority of patients subjected to total gastrectomy. The impairment, which particularly affects bicarbonate and lipase, is generally mild to moderate.

Adult↗
PubMedDate not supplied

Dissection of the esophagus after dilatation of a cervical diaphragm.

The authors report a case of a very large esophageal mucosal dissection observed during an esophagoscopy performed 7 days after dilatation of a cervical esophageal web. They treated this dissection by positioning an endoesophageal balloon which obtained the fast, overlapping closure of the torn mucosal layers and at the same time allowed both gastric drainage and enteral feeding via a pump.

Aged↗