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Biomedical subjects

W Montorsi

Publications and source records attributed to W Montorsi.

At least 37 records · Page 2Linked to original sources
PubMed1988

Prostaglandin cytoprotection in man: effectiveness of rosaprostol.

We studied the effect of a new prostaglandin analogue, 9-hydroxy-19,20-bis-norprostanoic acid (rosaprostol), on the duodenal mucosa of humans after administration of 40% ethanol. Eighteen healthy volunteers entered the study, which followed a blind cross-over design. At time 0 all the volunteers received rosaprostol or placebo; 5 minutes later, 40% ethanol (50 ml dose) was given. The mucosa was examined for lesions 3, 60 and 180 min later under endoscopy, light and scanning microscopy. It was found that: (i) 40% ethanol damaged the duodenum, with blood extravasation, inflammation and necrosis of the mucosa, (ii) rosaprostol significantly protected the mucosa 3 min after 40% ethanol, and (iii) the damage became worse after 3 h when placebo was given, whereas it was reduced after 1 h when PG was administered. The results suggest that PGs not only protect the mucosa against ethanol damage, but also stimulate its recovery.

Adolescent↗
PubMed1988

[Microsurgery and associated therapies for the treatment of lymphedema of the limbs].

Between 1967 and 1986, 170 cases of primary or secondary lymphedema of upper or lower limbs were operated upon using the indirect lymphaticovenous anastomosis technique proposed by Degni. For the lymphedema of upper limbs secondary to axillary lymphadenectomy for breast cancer, satisfactory results were obtained in 40% of cases, the figure rising to 72 and 74% for primary and secondary lymphedema of lower limbs respectively. When surgery is unsuccessful or contraindicated a new therapeutic method is proposed: thermotherapy as developed by Pr. Chang's team in Shanghai based on an ancient traditional Chinese medical method. With the collaboration of a biomedical engineer, a new microwave oven has been constructed and tested for the treatment of lymphedema, and its characteristics are described. Treatment is ambulatory, 45 minutes per day, 5 days per week over 3 weeks. It is very important that patients wear an elastic contention stocking (40 mmHg) between sessions. A total of 55 patients have been treated in this way, most (45) failing to improve after other medical or surgical treatment. All cases treated were of severe lymphedema and subjective and objective (ultrasonography) improvement was noted in 51%, the other 49% obtaining only subjective relief. According to Chinese authors results are maintained after 10 years. Follow up of the present series has been a maximum of one year and longer surveillance is necessary to assess long-term efficacy.

Bandages↗
PubMed1987

Prevention and early diagnosis of cancer in the rectal stump of ulcerative colitis patients after colectomy and topical treatment.

Ulcerative colitis with malignant degeneration and dysplasia can be a precancerous lesion. Therefore, it is necessary to prevent or, at least to diagnose as early as possible any development toward neoplasia in the colon or rectum of the colitis patients. The only reliable guide for a risk of malignant tissue degeneration is dysplasia of the mucosa. A group of 31 patients was studied after total colectomy with ileorectal anastomosis and subsequent topical treatment with enemas containing sulphasalazine and corticosteroids. Two of these patients had mild rectal dysplasia before surgery, seen in a biopsy specimen obtained endoscopically. All the patients were followed for a long time after surgery, with endoscopy and microscopic and ultrastructural observation of rectal biopsy material taken from different sites in the mucosa, both from areas that looked dysplastic by endoscopy and from those that appeared normal. The two patients with presurgical dysplasia, when examined later, one 12 months and one 18 months after surgery, had no rectal dysplasia; the mucosal covering was moderately complete and the anastomosis was functioning. It is considered that to prevent development of cancer in the rectal stump, colectomy should always be followed by regular topical treatment and there should be a check-up at short intervals for early diagnosis of any premalignant areas that might develop. Regression of such lesion was observed to lesser degrees after continuous treatment with the topical medication.

Adolescent↗
PubMed1986

Modifications of the vein wall after microsurgical end-to-side artero-venous anastomosis.

The repercussions on the venous wall of the creation of 20 artero-venous anastomoses (AVA) between the femoral artery and vein of the rat have been evaluated. The rats were killed 7, 15, 30, and 90 days after AVA, and AVAs were examined by optical microscopy and by scanning electronic microscopy. Deposits of whitish material that nearly completely occluded the venous lumen were seen, especially in the group studied longer than 90 days. These venous wall lesions, which resemble arteriosclerotic lesions, must be attributed to the new hemodynamic situation created by the AVA. The implications of such findings for the long-term validity of venous graft in vascular microsurgery and the long-term patency of the AVA in hemodialyzed children are discussed.

Animals↗
PubMed1986

Cytoprotection by PGE2, pirenzepine or vagotomy: a transmission and scanning electron microscopic study in rats.

We have studied the effects of PGE2, the anticholinergic pirenzepine and vagotomy on the rat gastric mucosa after challenge with ASA+0.15N HCl or absolute ethanol. The damage was evaluated by quantitative macroscopic examination, light and electron (transmission and scanning examinations) microscopy. We found both macroscopically and microscopically that pirenzepine and PGE2 were effective against ASA+0.15N HCl, but under microscopic examination they were seen to be uneffective 1 hr after absolute ethanol. Vagotomy showed some protection against ASA+0.15N HCl but was totally uneffective against absolute ethanol. The results stress the differences between ASA+0.15N HCl and absolute ethanol damage and show that "cytoprotection" is possible when the mucosa is challenged with noxious agents that do not act by hyperosmolar effects.

Animals↗
PubMed1986

Methyl tert-butyl ether fails to dissolve retained radiolucent common bile duct stones.

Methyl tert-butyl ether (MTBE) has been recently proposed as a new therapeutic modality for the dissolution of cholesterol gallstones. To further evaluate efficacy and tolerability of this new litholytic agent, we have administered MTBE to 3 patients with nonobstructive radiolucent common bile duct stones after recent surgery. Methyl tert-butyl ether (8-11 ml/day) was infused after aspiration of bile via a Teflon catheter inserted through the postoperative T tube. Gentle aspiration and reinfusion were performed continuously to generate stirring. The total amount of MTBE retrieved during the entire procedure was equivalent to approximately 30% of the volume infused. In all cases, MTBE failed to dissolve the radiolucent stones, which were then dissolved with continuous infusion of monooctanoin via the biliary catheter. The characteristic odor of MTBE was detected on the breath of the patients, and nausea and somnolence developed during the treatment. Serum hepatic and pancreatic enzymes did not change after MTBE. In the third subject, who received 11 ml/day of MTBE for 2 consecutive days (total of 22 ml), histologic evidence of duodenitis was found around the papilla. In our opinion, the lack of efficacy of MTBE in dissolving retained radiolucent common bile duct stones was mainly related to its leakage from the common bile duct into the duodenum and the ensuing local chemical toxicity and systemic absorption. As MTBE needs a persistent stone-solvent contact to exert its litholytic action and, at the same time, its toxicity prevents the infusion of larger doses, MTBE use should be restricted to stones placed in closed chambers, such as the gallbladder.

Aged↗
PubMed1986

Topical treatment of experimental skin lesions in rats: macroscopic, microscopic and scanning electron-microscopic evaluation of the healing process.

The effects of the topical antiseptic agents mercurochrome and silver nitrate and of sodium hyaluronate on the process of wound healing were assessed by macroscopic examination, light microscopy histology, electron microscopy and scanning electron microscopy of wounds made by cutting or by abrasion of the skin of rats. It was found that wounds treated with hyaluronic acid underwent longer periods of inflammation (proportional to the presence of mastocytes) and greater amounts of collagen deposition than wounds that were either untreated controls or treated with silver nitrate or mercurochrome, but this did not impede the formation in the early stages of healing of bridges of fibrin between the edges of the wounds.

Administration, Topical↗
PubMed1986

Differential diagnosis of Crohn's disease of the colon from ulcerative colitis: ultrastructure study with the scanning electron microscope.

Mucosal biopsies from patients with Crohn's disease and with ulcerative colitis were studied by scanning electron microscopy. Important abnormalities of the mucosal surface were found in both diseases. For Crohn's disease, the characteristic abnormality was loss of the regularity of the polygonal units, but with preservation of the mucosal integrity and of the normal mucosal design. For ulcerative colitis, the abnormalities were disorganization of the cells, signs of sloughing, and superficial erosions. Patients with Crohn's disease always had a significantly increased number of muciparous cells, while those with ulcerative colitis had obvious signs of decreased mucus production. The lesions of ulcerative colitis could be seen under the scanning electron microscope in mucosal areas that appeared normal endoscopically. We feel therefore that scanning electron microscopy of biopsy specimens from patients with inflammatory bowel diseases can be of great help in differential diagnosis.

Colitis, Ulcerative↗
PubMed1984

[Bile-dependent gastrointestinal dyspepsia].

"Indigestion" caused by organic and functional alterations in the biliary ways was examined. The difficulty of accurately identifying this form of dyspepsia, whose frequency explains the interest it arouses, is emphasised. Dyspepsia attributable to dyskinesia of the biliary ways and post-cholecystectomy syndrome is specifically analysed. After a review of the results obtained by the medical and surgical treatment of biliary dyspepsia, a more accurate nosologic and pathogenetic classification of the disease is recommended, together with a more detailed definition of the action mechanism of the biliary acids.

Bile Ducts↗
PubMed1984

[Jejuno-ileal latero-lateral bypass. Defects of mechanical sutures].

In 6 of our patients operated upon for pathological obesity, complete recanalization of the jejunum closed by a mechanical suture upstreams of the jejuno-ileal latero-lateral anastomosis resulted in failure of the intestinal bypass. We have modified our technique and instead of closing the jejunum with a mechanical stapler we now divide it, then bury and attach together its two ends to avoid torsion and invagination. The operation is completed by creating an anti-reflux system at the terminal end of the excluded ileum.

Humans↗
PubMed1984

The treatment of retained biliary stones with monooctanoin: report of 16 patients.

The aim of this study was to estimate efficacy, safety, and tolerance of monooctanoin in 16 patients with retained radiolucent biliary stones and indwelling biliary drainage. Monooctanoin was infused continuously at a rate of 3-4 ml/h. Monitoring of pressure with a manometer broken off at 20 cm prevented the development of excessive pressure in the common bile duct. The mean volume of the compound instilled (+/- SD) was 848 +/- 393 ml (range 80-1450) and the mean duration of treatment was 13 +/- 6 days (range 2-23). Monooctanoin induced disappearance of stones in 11 of 16 patients giving a success rate of 69%. Three patients exhibited a partial dissolution of stones which were then successfully removed through the postoperative T-tube. The two failures can be attributed to the type of stones mainly composed of bile pigments. Side effects from the infusion of monooctanoin were only minor and easily controlled by reducing the infusion rate of the solution. Laboratory tests, including hepatic and pancreatic enzymes, remained stable. In one subject endoscopic and histological evidence of mild duodenitis was found when pre- and posttreatment features were compared. On the basis of these data, we recommend monooctanoin to treat biliary-retained cholesterol stones.

Adult↗