Biomedical subjects

E Xynos

Publications and source records attributed to E Xynos.

At least 55 records · Page 3Linked to original sources

PubMed1993

Differences in manometry and 24-H ambulatory pH-metry between patients with and without endoscopic or histological esophagitis in gastroesophageal reflux disease.

UNLABELLED: In this study, our objective was to examine prospectively, by endoscopy and histology of the esophageal mucosa, the severity of reflux esophagitis and any possible correlation between endoscopic and histological findings on the one hand, and manometric and 24-h ambulatory pH-metry measurements on the other. Forty-two patients with gastroesophageal reflux were prospectively examined. The results were compared with those of 18 healthy controls. Methods used were: 1) upper alimentary endoscopy and grading of severity of esophagitis, 2) esophageal mucosa biopsies, to estimate severity of esophagitis on histology, 3) standard esophageal manometry, by using a water perfused catheter with four side holes, and 4) standard 24-h ambulatory esophageal pH-metry. RESULTS: The severity of esophagitis as determined by both endoscopy and histology was significantly inversely related to the amplitude (p < 0.001) and duration (p < 0.01) of esophageal peristalsis at 5 cm proximal to LES; it was significantly related to the pH-metry total composite score (p < 0.001 for endoscopy, p < 0.05-0.01 for histology), the total reflux time (p < 0.001 for endoscopy, p < 0.01 for histology), the duration of longest reflux episode (p < 0.001 for endoscopy, p < 0.01 for histology), the number of reflux episodes lasting more than 5 min (p < 0.05 for endoscopy), and the frequency-duration index of reflux episodes (p < 0.001 for endoscopy, p < 0.01 for histology). Furthermore, strength reduction of peristalsis (< 60 mm Hg x s) was associated with acid exposure greater than 40%, in esophagitis patients. We conclude that the severity of reflux esophagitis, not only through endoscopy but also histologically, is related to the amount of reflux, as expressed by the duration and frequency of the reflux episodes. A very high amount of reflux is in turn associated with impairment of the esophageal body motility, as expressed by the amplitude and strength of esophageal body peristalsis.

Adult↗

PubMed1993

The effect of floppy Nissen fundoplication on esophageal and gastric motility in gastroesophageal reflux.

Thirty-five patients with gastroesophageal reflux (GER) proved on ambulatory esophageal hydrogen monitoring were surgically treated by a floppy Nissen fundoplication. Postoperatively, reflux and symptoms related to it were almost completely abolished. Transient bloating syndrome was observed in five instances. The operation significantly improved esophagitis (p < 0.01), increased lower esophageal sphincter pressure (p < 0.01) and increased amplitude of esophageal peristalsis (p < 0.01). However, postoperative motility of the esophagus as detected by manometry was still impaired as compared with that for the control group. Delayed esophageal transit did not improve postoperatively, although no dysphagia was accounted. Impaired esophageal motility in GER was associated with delayed gastric emptying, which, however, improved postoperatively. It is concluded that esophageal and gastric motor abnormalities are rather primary disorders in GER. After successful fundoplication, esophageal dysmotility, aggravated by reflux esophagitis, improves to some extent, while gastric emptying is enhanced.

Adult↗

PubMed1993

The effect of erythromycin in gastric emptying of solids and hypertonic liquids in healthy subjects.

We report our study of the effect of erythromycin on gastric emptying of solid and liquid meals in 10 healthy subjects. On different occasions, subjects consumed either a radiolabeled 50% glucose solution, or a radiolabeled standard solid meal after placebo, and after receiving 200 mg of erythromycin intravenously. Erythromycin accelerated the gastric emptying of the hypertonic liquid meal by significantly decreasing the duration of lag phase (p < 0.0001), by significantly increasing the emptying rate at the postlag period (p < 0.001), and by significantly decreasing the duration of the postlag period (p < 0.0001) and the meal remaining in the stomach at 15 (p < 0.05), 30 (p < 0.001), and 60 (p < 0.01) min postprandially. In addition, erythromycin administration induced a significant plasma fall at 15 (p < 0.05) and 30 (p < 0.01) min and a significant increase in pulse rate at 15 and 30 min (p < 0.01) after consumption of the hypertonic glucose solution, whereas three subjects experienced symptoms suggesting dumping syndrome. Furthermore, erythromycin administration enhanced the gastric emptying of solids by almost abolishing the duration of lag phase (p < 0.0001) and by reducing the overall t1/2 of emptying (p < 0.0001), whereas less food was retained in the stomach at 60 (p < 0.001) and 120 (p < 0.0001) min postprandially. Conversely, the postlag t1/2 of the solid meal emptying was not affected by erythromycin, as compared to placebo. We conclude that erythromycin has gastrokinetic properties, affecting the gastric emptying of both liquids and solids.

Adult↗

PubMed1992

Erythromycin accelerates delayed gastric emptying of solids in patients after truncal vagotomy and pyloroplasty.

OBJECTIVE: To find out if erythromycin (a motilin agonist) accelerated gastric emptying after vagotomy and in normal subjects. DESIGN: Double blind controlled study. SETTING: Two referral centres. SUBJECTS: 15 patients who had previously undergone vagotomy and who did (n = 8) or did not (n = 7) have symptoms of gastric stasis and 10 normal controls. INTERVENTIONS: A standard meal containing 185 x 10(5) Bq -99mTc was eaten after either erythromycin 200 mg or 40 ml placebo (normal saline) had been given intravenously. Subjects were then scanned by gamma camera. MAIN OUTCOME MEASURES: Measurement of: the length of time from completion of the meal to the onset of gastric emptying; the length of time from completion of the meal until half of the meal had left the stomach; the length of the time from the onset of gastric emptying until half of the meal had left the stomach; and the percentage of the meal that was left in the stomach at 60 and 120 min after the end of the meal. RESULTS: Gastric emptying was significantly delayed in those patients with symptoms compared with normal subjects and patients without symptoms. Erythromycin accelerated the first two phases of gastric emptying in all patients and normal subjects, but did not affect the length of time from the onset of gastric emptying until half the meal had left the stomach. CONCLUSION: Erythromycin could be a useful gastrokinetic agent in patients with symptoms of gastric stasis after vagotomy.

Adult↗

PubMed1992

Surgical treatment of the enterogastric reflux syndrome: preoperative and postoperative estimation by 99mTc-HIDA scintigraphy.

Twenty-nine patients with enterogastric reflux syndrome after anti-ulcer gastric surgery underwent a revisional Roux-en-Y gastrectomy. The diagnosis of enterogastric reflux syndrome was based on symptomatology and endoscopy in the first eight patients. The latter 21 patients had, in addition, a 99mTc-HIDA scintigraphy for the documentation and measurement of reflux. An enterogastric reflux index > 20 per cent is considered to justify symptoms due to reflux. Three of the first eight patients continued postoperatively to experience the same symptoms as before. These symptoms were eventually attributed to other than enterogastric reflux syndromes. The latter 21 patients were relieved from their preoperative symptoms and classified as Visick I and II (18 patients) and Visick III (3 patients). The authors conclude that enterogastric reflux syndrome must be documented on scintigraphy before the patient is subjected to revisional anti-reflux surgery in order for failures due to misdiagnosis to be avoided.

Adult↗

PubMed1991

Enterogastric reflux after various types of antiulcer gastric surgery: quantitation by 99mTc-HIDA scintigraphy.

In 28 controls and 142 patients subjected to a variety of antiulcer procedures, the enterogastric reflux (EGR) was quantitated by 99mTc-HIDA scintigraphy and expressed as the EGR index on 229 different occasions. The EGR index was calculated according to two different formulas: one based on the maximal radioactivity over the gastric area as a percentage value of the total abdominal activity (EGR-Im) and the other based on the relative maximal radioactivity over the gastric area as a percentage value of the relative hepatobiliary activity (EGR-It). There was a significant positive correlation of values between the two methods (P less than 0.0001). In patients with an EGR-Im greater than 20% or EGR-It greater than 57% and postgastric surgery symptoms some of the symptoms were attributed to EGR, an antireflux procedure is expected to relieve those symptoms. Sixteen of these patients underwent Roux-en-Y gastrectomy and their preoperative symptoms were relieved.

Duodenal Ulcer↗

PubMed1991

Hydatid disease of the liver. Diagnosis and surgical treatment.

A series of 155 cases of hepatic hydatid disease, occurring in 121 patients, were operated on at the Naval and Veterans Hospital of Athens. Ultrasonography and computerized axial tomography provided the preoperative diagnosis in 89 and 93 percent of the cases respectively in recent years. Thirty one percent of the cases presented with complications, the commonest of these being infection of the cyst (10 percent) and rupture of the cyst into the bile ducts (17 percent). Total cystectomy was performed in three cases and removal of the endocyst with its content in the remaining 152. The remaining cavity was either externally drained (57 cases), or filled with omentum (omentoplasty--95 cases). External fistula and infection of the residual cavity occurred in 32 and 56 percent after simple drainage and in 4 and 2 percent respectively after omentoplasty. Differences are statistically significant (p less than 0.001). Hospitalization was also significantly longer after drainage than after omentoplasty (p less than 0.01). Obstructive jaundice after intrabiliary rupture of the cyst was more successfully managed after additional choledochoduodenostomy than after simple drainage of the common bile duct. Intrapericoneal recurrence of hydatid disease occurred in two cases. The conclusion of the present study is, that ultrasonography and computerized axial tomography provide an acceptable rate in the diagnosis and that omentoplasty offers a very low complication rate in the management of hydatid cystic disease of the liver.

Adult↗

PubMed1990

Serum and urine alpha--amylase isoenzymes levels after operative cholangiogram. A prospective clinical and biochemical study.

Serum and urine total alpha-amylase isoenzymes values were estimated in two groups of patients, who underwent either elective cholecystectomy and operative cholangiogram (group A-59 patients) or cholecystectomy without operative cholangiogram (group B - 68 patients). Serum and urine total alpha-amylase and pancreatic isoamylase (p-type) values were statistically significantly increased within the first 24 postoperative hours as compared to the preoperative levels only in group A (p less than 0.05). No clinical signs of pancreatitis were observed. Serum lipase alterations did not reach any statistically significant difference in either group. It is concluded that transient hyperamylasaemia after preoperative cholangiogram may be due to a reversible chemical pancreatitis caused by the infused opacifying agent into the common bile duct.

Adult↗

PubMed1990

Varicosis coli totalis: report of a case of idiopathic aetiology.

A case of colonic varices manifesting with rectal bleeding in a young patient is presented. There was no evidence of portal hypertension or any other cause. Familial history was also negative. Diagnosis was established by barium enema, colonoscopy and angiography. On colonoscopy, varices involved the entire colon. At operation, dilatation of the subserosal small veins of the entire small and large bowel was confirmed. The patient underwent a subtotal colectomy with ileorectal anastomosis with satisfactory result.

Adult↗

PubMed1989

Distribution of G-cells in the antrum and duodenum and D-cells in the fundus, antrum, duodenum and pancreas of the guinea pig.

Antral and duodenal G-cells and fundic, antral, duodenal and pancreatic D-cells were demonstrated immunocytochemically and their population size was estimated in guinea pigs of both sexes. The population of antral (210 + 18.03 SD cells/cm) and duodenal (13.20 + 3.12 SD cells/cm) G-cells is lower in guinea pigs than in dogs. Antral and duodenal G/D-cell ratios (1.6/1 and 1.2/1) are also lower in the guinea pig than in man. Antral G- and D-cell populations are greater in male (210 + 18.03 SD cells/cm and 128.2 + 17.63 SD cells/cm) than in female (176 + 13.8 SD cells/cm and 108.4 + 6.9 SD cells/cm) guinea pigs. The percentage of pancreatic D-cells is greater in the guinea pig (20-25%) than in man and rat. It is concluded that the differences in gastric and duodenal G- and D-cells between guinea pigs and other species possibly reflect different gastric secretory functions. Sex related differences in the endogenous sex hormones can explain differences in gastric secretion between the two sexes. Pancreatic D-cells possibly exert their action on neighbouring endocrine cells through different pathways from those seen in man and rat.

Animals↗

PubMed1989

Vagotomy for duodenal ulcer resistant to H2-receptor antagonists.

One hundred and twenty-seven male patients were subjected to antiulcer surgery for duodenal ulcer resistant to H2-receptor antagonist treatment. Fifty-four (group A) had been on conservative treatment for up to 6 months, while the remaining 73 (group B) had been on conservative treatment for more than 6 and up to 20 months. Of the group A, 43 underwent truncal vagotomy with pyloroplasty (group A1) and 11 highly selective vagotomy (group A2). Of group B, 52 underwent truncal vagotomy with pyloroplasty (group B1) and 21 highly selective vagotomy (group B2). Follow-up ranged between 18 and 72 months (mean 37 months). There were one ulcer recurrence in group A1, none in group A2, nine in group B1 and five in group B2, the difference between group A and group B being statistically significant (p less than 0.05). There was significantly higher nonulcer-associated morbidity after truncal than after highly selective vagotomy (p less than 0.05). No significant difference in the degree of peak acid output reduction was observed between the patients with and those without ulcer recurrence. These findings show that the administration of H2-receptor antagonists for more than 6 months in duodenal ulcer patients who, however, fail to have their ulcer healed is associated with high recurrence rate after vagotomy. It is suggested that such patients should undergo vagotomy as soon as they fulfill the criteria of resistance to H2-receptor antagonists. If conservative treatment has lasted for more than 6 months, vagotomy plus antrectomy has to be considered as the surgical treatment for these patients, with the possible cost of higher nonulcer-associated morbidity.

Adult↗

PubMed1989

Alterations in pancreatic B-, A- and D-cell populations following administration of corticosteroids. Immunocytochemical study in rats.

Prednisolone was administered to two groups of rats for 2 or 4 weeks, respectively. A third group served for control. Serum glucose and insulin levels were measured, and changes in population size along with alterations in staining density of the intracellular granules in pancreatic B-, A- and D-cells were assessed. Two weeks of prednisolone treatment induced significant increases in the staining density of the intracellular granules of B- and D-cells as well as the population size of A-cells, while significant hyperglucosaemia and hyperinsulinaemia were observed. Four weeks of prednisolone administration induced significant increases in population size of B- and D-cells and significant decrease in the population size of A-cells, while hyperglucosaemia and hyperinsulinaemia were even greater. It is concluded that corticosteroids cause an increase in pancreatic B-cell activity and, eventually A-cell numerical atrophy by altering the glucose metabolism. The changes in activity of D-cells possibly reflect functional adaptation to increased B-cell activity.

Animals↗

PubMed1988

Fundic, antral and pancreatic D-cell population changes following oophorectomy and sex hormone administration in guinea pigs. Experimental immunocytochemical study.

Twelve female guinea pigs were given estradiol and another 12 testosterone for 18 days. A third group of 15 animals underwent oophorectomy and a group of 8 animals served as controls. Gastric and pancreatic D-cells were quantitated in all four groups. Oophorectomy and androgens significantly increased and estrogens significantly decreased gastric D-cell populations. Additionally, estrogens significantly decreased D-cell population in pancreatic islets. It is concluded that the alterations in gastric and pancreatic D-cell populations, which are induced by sex hormone administration and oophorectomy, possibly reflect a hormonal adaptive attempt to restore gastric secretory functions within the normal range.

Animals↗

PubMed1988

Familial occurrence of hyperdynamic circulation status due to intrahepatic fistulae in hereditary hemorrhagic telangiectasia.

The cases of two brothers with intrahepatic arterio-venous shunt causing hyperdynamic circulation in hereditary hemorrhagic telangiectasia are presented. There was a strong family history of fatal liver involvement in all members of the previous generation. The first patient had embolization of the right hepatic artery with symptomatic relief, but developed cirrhosis with portal hypertension seven years later. The second patient developed cirrhosis with portal hypertension, and died following rupture of esophageal varices, within a year. It is suggested not only that hereditary hemorrhagic telangiectasia is transmitted as a dominant trait, but that there is also a hereditary transmission of hepatic involvement in this disease.

Adult↗

PubMed1987

Duodenal G- and D-cell changes following corticosteroid administration. Immunocytochemical long-term study in guinea pigs.

Prednisolone administration in guinea pigs for 20 days induces significant hypergastrinemia and duodenal G-cell hyperplasia. Hypergastrinemia and duodenal G-cell hyperplasia are less prominent following 40 days of prednisolone administration and this could be partly attributed to the duodenal D-cell increased activity, which represents an adaptive response to the alterations of gastric secretory functions induced by corticosteroids.

Animals↗

PubMed1987

Alterations in serum gastrin levels and antral G- and D-cell population following extensive proximal small bowel resection (radioimmunoassay and immunocytochemical study in dogs).

Twelve dogs underwent an extensive proximal small bowel resection. Basal and postprandial serum gastrin levels increased significantly one and two months after the resection compared to the respective preoperative levels. The increase in serum gastrin levels two months after the resection was less prominent than the respective increase one month postoperatively. Antral G- and D-cell populations increased significantly two months after the resection compared to the respective populations before the resection. It is concluded that hypergastrinaemia following small bowel resection is due to the quantitative elimination of the inhibiting hormonal factors of gastric secretion and gastrin release. The adaptive increase of antral D-cell population could explain the temporary character of hypergastrinaemia.

Animals↗

PubMed1987

Alterations in serum gastrin levels and antral G- and D-cell population following corticosteroid administration. RIA and immunocytochemical long-term study in guinea pigs.

Fourteen guinea pigs were given prednisolone daily for 20 days and 11 for 40 days. Another 20 formed the two control groups. Short-term prednisolone treatment significantly increased serum gastrin levels and antral G-cell population as compared to the control group. The same parameters significantly decreased following 40 days of prednisolone treatment as compared to the group of short-term prednisolone treatment. Forty days of prednisolone treatment significantly increased antral D-cell population as compared to the control and short-term prednisolone treatment groups. It is concluded that hypergastrinaemia and antral G-cell hyperplasia following corticosteroid administration is temporary and is accompanied by antral D-cell hyperplasia.

Animals↗

PubMed1986

Sex related differences in serum gastrin concentrations and G- and D-cell populations of the gastric mucosa in guinea-pigs (experimental RIA and immunocytochemical study).

In the present study antral G-cells which secrete gastrin and antral and fundic D-cells which secret somatostatin, an inhibitor of gastric acid secretion were revealed immunocytochemically and the population size estimated along with serum gastrin levels in ten male and eight female guinea pigs. Serum gastrin, antral G-cells, antral D-cells and fundic D-cells were 41.90 +/- 6.10 SD pg/ml, 210 +/- 18.03 SD cells/cm, 128.20 +/- 17.64 SD cells/cm and 121 +/- 17.91 SD cells/cm respectively in males and 35 +/- 4.62 SD pg/ml, 176 +/- 13.80 SD cells/cm, 108.40 +/- 6.90 SD cells/cm and 106.8 +/- 6.50 SD cells/cm respectively in females. The differences in serum gastrin levels, antral G-cell population and antral D-cell population between the two sexes were statistically significant (P less than 0.05, P less than 0.001, P less than 0.01). It is possible that endogenous androgens induce a relative hyperplasia and endogenous oestrogens a relative hypoplasia of G-cells. Antral D-cell differences may reflect an adaptive hormonal mechanism to the possible different states of gastric secretory functions.

Animals↗