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Biomedical subjects

F Pezzolla

Publications and source records attributed to F Pezzolla.

At least 19 recordsLinked to original sources
PubMed1992

[Postoperative morbidity and mortality in patients undergoing additional cholecystectomy during digestive surgery].

A retrospective case-control study was carried out to assess whether additional cholecystectomy in patients undergoing digestive surgery caused increased postoperative morbidity and mortality. During the period 1983-90, 70 patients underwent cholecystectomy at the same time as other surgery (25 gastric resections, 23 colon resections, 17 total gastrectomies, 2 fundoplicatio using Nissen's technique, 2 cases of Heller's operation, 1 truncular vagotomy and pyloroplasty). These cases were matched for sex, age (+/- 5 years) and type of primary operation with 70 controls (patients without additional cholecystectomy). Complications were significantly more frequent among the former group compared to controls (28.6% vs 11.4%, p = 0.02), in particular in the group of patients undergoing colon resection (34.8% vs 8.7%, p = 0.04). The frequencies of reoperation and mortality were also higher in patients undergoing additional cholecystectomy than in controls (10% vs 1.4%), but the difference was not statistically significant (p = 0.06). In conclusion, additional cholecystectomy during digestive surgery increases the risk of postoperative complications, in particular in colorectal surgery.

Adult↗
PubMed1992

Electrogastrography in non-ulcer dyspepsia.

Fasting and fed gastric electrical activity was recorded by cutaneous electrodes (electrogastrography) in 14 children with unexplained recurrent symptoms of upper intestinal dysfunction, and in 10 controls. The unexplained symptoms included vomiting, epigastric pain, fullness, and early satiety. Mean (SD) age was 7.0 (3) and 7.5 (2) years, respectively. Gastric emptying time of a solid-liquid meal was also measured by real time ultrasonography in all subjects (patients and controls). In all patients radiography and endoscopy excluded structural and focal abnormalities of the gastrointestinal tract. Gastric emptying time was significantly more prolonged in patients than in controls. It was also found that there were appreciable irregularities of gastric electrical rhythm (tachygastria, bradygastria, flat line pattern, and mixed arrhythmia) in 12 fasting and 10 fed patients, whereas controls showed short and rare episodes of arrhythmia during both fasting and fed recording periods. The percentage distribution of the total electrogastrographic energy power across three frequency bands of electrical activity (low, normal, and high) showed that patients were different from controls both for reduced activity of normal frequency and for increased incidence of high and low abnormal frequencies. It is concluded that gastric electrical abnormalities are found in a high proportion of children with recurrent unexplained upper gastrointestinal symptoms. Electrogastrography can be a valuable tool in the assessment of these patients.

Child↗
PubMed1992

[Cholecystectomy and duodenogastric reflux].

With the aim of evaluating whether cholecystectomy causes an increase in duodenogastric reflux (DGR) 34 patient (12 males and 22 females, mean age 50 years) were examined before and 6 months after cholecystectomy. DGR was evaluated by assaying total and individual biliary acids in gastric juice and was expressed as fasting bile reflux (FBR) in mumol/h. The histology of gastric mucosa in endoscopic biopsies taken from the antrum and body was also analysed. FBR of total biliary acids rose from 2.4 mumol/h before surgery to 41.33 mumol/h after cholecystectomy (p = 0.000). A significant increase was observed for all the individual biliary acids. Histological tests of gastric mucosa revealed an increased percentage of chronic atrophic gastritis of the antrum following cholecystectomy. Histological conditions in the body were unaltered. The results of this study show that there is a significant increase in DGR (months after cholecystectomy together with increased histological damage to the mucosa of the antrum. Further studies are necessary in order to evaluate whether the two phenomena are related.

Adult↗
PubMed1992

Reproducibility of cutaneous electrogastrography in the fasting state in man.

Cutaneous electrogastrography (EGGc), the recording of gastric electrical activity from the cutaneous abdominal surface, still presents a series of difficulties connected with the interpretation of signals. In this study, the authors evaluated the reproducibility of electrogastrographic data over a period of time by making recordings on three consecutive days in a group of healthy subjects. The recordings (lasting 1 hour) were made in the morning on fasting subjects. Three sets of bipolar cutaneous electrodes were placed on the abdomen around the pyloric radiological projection and the couple 3-6 corresponded to the antral axis. The spectral analysis of data was computed by fast Fourier transform. Their data confirmed that the 3-6 couple, corresponding to the antral axis, provides the strongest EGG signal. Each subject's mean gastric frequency and power were evaluated on the three consecutive recording days. The mean frequency was 2.83 +/- 0.22, 2.89 +/- 0.23, and 2.86 +/- 0.16 cpm on day I, day II and day III respectively. The mean power was 54.80 +/- 21.34, 46.86 +/- 21.52 and 49.25 +/- 19.55 microV 2 on day I, day II and day III respectively. The analysis of variance showed that the mean gastric frequency and power were not significantly different on the three days (p > 0.05). This shows that the frequency of the EGGc signal remains stable in the course of time and hence that EGGc is a reliable method of studying disorders in gastric electrical rhythm.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

A prospective study on duodenogastric reflux and on histological changes in gastric mucosa after cholecystectomy.

The authors carried out a prospective study to evaluate variations with time in postcholecystectomy duodenogastric reflux (expressed as "fasting bile reflux" in mumol/h) and in gastric mucosal damage. Ten patients underwent (before cholecystectomy, 6 months after surgery and after a median period of 4 years from surgery) a gastric drainage to assess total (enzymatic method) and single (high performance liquid chromatography) intragastric bile acids, and a gastroscopy with biopsies of the antrum and gastric body to assess histological damage to the mucosa. The results showed that there was a progressive increase in the fasting bile reflux of total bile acids with time (precholecystectomy median value 0.295 mumol/h; 6 months control median value 12.045 mumol/h; late control medial value 19.9 mumol/h; Friedman test, P = 0.0022). Examination of the gastric mucosa at the three moments of the study showed that histological damage worsened progressively. In fact chronic atrophic gastritis of the antrum was present in 10 percent of cases before surgery and in 50 percent 4 years after, and the prevalence of chronic superficial gastritis of the body progressed from 0 to 40 percent. Studies on larger groups of patients are necessary to evaluate whether these two phenomena are correlated.

Adult↗
PubMed1992

Gastric myoelectrical activity in the first trimester of pregnancy: a cutaneous electrogastrographic study.

Recently, it has been shown that changes in gastric electrical rhythm can be connected with clinical syndromes characterized by nausea and vomiting, among these the nausea of pregnancy. We studied gastric electrical activity during the first trimester of pregnancy in nine women with nausea and vomiting (study group) by means of cutaneous electrogastrography. Recordings were made before and after a standardized meal in the 6th-8th wk of gestation, and 2 months after voluntary interruption of pregnancy (VIP). The control group consisted of eight pregnant women without a history of nausea and vomiting. In the women in the study group there was more unstable cutaneous electrogastrographic (EGGc) activity and a reduced increase in postprandial power during pregnancy than after VIP, when a normal pattern with regular 3-cpm EGGc waves was reestablished. The coefficient of variation of gastric frequency during pregnancy was significantly higher than after VIP (p less than 0.01), whereas the postprandial to preprandial power ratio was lower (p less than 0.01). During the recording sessions, none of the subjects had clear episodes of tachygastria or bradygastria, and none of them had nausea, vomiting, or epigastric discomfort. Comparison of the EGGc data for the pregnant women in the study and control groups revealed a similar pattern of gastric electrical activity in the two, the only exception being the power ratio, which was lower in the study group (p less than 0.01). We conclude that pregnant women without symptoms of nausea and vomiting at the time of EGG recordings have normal 3-cpm myoelectrical activity, and that EGGc activity is more unstable and less responsive to the ingestion of food during pregnancy than after VIP. Furthermore, in pregnant women with a history of nausea and vomiting, EGGc activity is less responsive to the ingestion of food than it is in symptom-free pregnant women.

Adult↗
PubMed1991

[Reconstruction of the digestive tract after total gastrectomy. A comparison of Roux anastomosis with Nakayama's beta-anastomosis].

Digestive tract reconstruction following total gastrectomy can be classified into two types according to whether the duodenal tract is excluded or preserved. Two groups of patients who underwent digestive tract reconstruction excluding the duodenal tract following total gastrectomy due to cancer were compared retrospectively: Nakayama's anastomosis was used in 20 patients (57%), and a Roux-en-Y anastomosis was performed in 15 (43%). The main technical difference between the two groups consists in the distance between esophagojejunostomy and jejunojejuno anastomosis: 20 cm in the case of Nakayama's technique and 50 cm in the case of the Roux-en-Y reconstruction. Results showed that 40% of patients with Roux-en-Y anastomoses were asymptomatic compared to 60% of patients with Nakayama's beta-anastomosis (chi-square test, p = 0.36). The most frequent symptom in patients with Roux-en-Y reconstructions was a feeling of postprandial fullness (33%), whereas pyrosis (25%) was the most common compliant in patients with Nakayama's reconstruction. Endoscopy revealed the presence of esophagitis in 35% of patients with Nakayam's beta-anastomosis compared to 6.5% in patients with Roux-en-Y anastomosis (chi-square test, p = 0.012). Results confirm that a minimum distance of at least 50 cm between the esophagojejunal and jejunojejunal anastomoses is decisive in reducing the frequency of reflux esophagitis after total gastrectomy.

Adult↗
PubMed1991

Gastric electrical dysrhythmia following cholecystectomy in humans.

In order to observe the incidence of dysrhythmia in 20 patients who had undergone cholecystectomy, we recorded gastric electrical activity by means of serosal electrodes from the day of surgery to the 6th postoperative day. The difference between the incidence of dysrhythmia on the day of the operation and the other days is statistically significant (t test: p less than 0.001). Bradygastria was the most frequently observed dysrhythmia, both on the day of surgery and on the following days. It had a frequency of around 1.0-1.5 cpm and the episodes lasted for a minimum of 10 min to a maximum of 105 min (mean duration 32.6 min). Episodes of tachygastria were of varying duration, ranging from a minimum of 3 min to a maximum of 60 min (mean duration 18.5 min), whereas episodes of gastric tachyarrhythmia lasted between 2 min and 21 min (mean duration 5.4 min). Only 1 patient had an episode of nausea and biliary vomiting, associated with an episode of gastric tachyarrhythmia on the 1st postoperative day. None of the other patients had symptoms of impaired gastric function, such as nausea, vomiting, bloating and epigastric pain, at any time during the recording sessions. These findings suggest that in most cases, gastric electrical rhythm returns to normal within 24 h of cholecystectomy and further that gastric dysrhythmia is not related to symptoms of impaired gastric function. The etiological mechanism and clinical significance of gastric dysrhythmia, therefore, are still unclear.

Adult↗
PubMed1991

In vitro gallbladder motility in patients with radiolucent and radiopaque stones.

Twenty-five gallbladders were studied in vitro. Sixteen had radiolucent gallstones and 9 had radiopaque gallstones. The radiolucent gallstones had a cholesterol content of 94.17 +/- 3.76% and the radiopaque gallstones had a cholesterol content of 56.6 +/- 4.46%. Half the maximal response (ED50) to cholecystokinin octapeptide (CCK-OP) and to carbachol in strips from patients with radiolucent gallstones was 0.8 +/- 0.15 and 27.01 +/- 3.74 x 10(-7) M, respectively. In strips from patients with radiopaque gallstones, the ED50 was 0.4 +/- 0.08 and 14.92 +/- 3.07 x 10(-7) M, respectively. The ED50 values to CCK-OP and carbachol were greater in strips from specimens with radiolucent gallstones than in strips from specimens with radiopaque gallstones (p less than 0.05). There was no significant difference in the maximal contractile response of the two groups. It can be concluded that gallbladder sensitivity to CCK-OP and carbachol can be modified in relation to differences in the cholesterol and calcium content of the stones.

Adult↗
PubMed1991

Effects of age and obesity on fasting gastric electrical activity in man: a cutaneous electrogastrographic study.

We investigated the effects of age and obesity on the fasting cutaneous electrogastrogram (EGGc) by studying both young and aged, healthy men. All subjects underwent an electrogastrographic recording lasting 1 h, and frequency and power data were obtained by means of spectral analysis. In order to make a precise comparison of the data, each subject's body mass index (BMI) was calculated and each age group was subdivided into nonobese subjects, those with a BMI of less than 24.9 kg/m2, and obese subjects, those with a BMI of more than 25 kg/m2. Comparison of the mean frequency values of the gastric spectral peak did not reveal statistically significant differences among the groups (young vs. old, nonobese vs. obese). Comparison of the mean power values of the gastric spectral peak, on the other hand, showed that there was a statistically significant reduction in spectral power in the aged subjects compared with the young (p = 0.017 in the aged vs. young nonobese subjects and p = 0.009 in the aged vs. young obese subjects), and in the obese subjects compared with the nonobese (p = 0.00021 in the young and p = 0.00029 in the aged). Frequency, therefore, is the parameter of gastric electrical activity which may best be studied by means of EGGc as it is only very slightly affected by physiological parameters, such as age and the adiposity of subjects. EGGc, therefore, could be useful in the study of those gastric diseases associated with disorders in gastric electrical rhythm and rate.

Adult↗
PubMed1990

Duodenogastric reflux and gastric histology after cholecystectomy with or without sphincteroplasty.

Sixteen patients who had undergone cholecystectomy plus sphincteroplasty, 14 cholecystectomized patients and ten control patients were studied to evaluate whether differences existed in duodenogastric reflux and whether these were related to morphological damage of the gastric mucosa. Duodenogastric bile reflux during fasting was evaluated by measuring the concentration of total bile acids (by an enzymatic method) and single bile acids in the gastric juice by high performance liquid chromatography. The damage was evaluated histologically by systematic endoscopic biopsy of the antrum and body of the stomach. There was a statistically significant difference in fasting bile reflux between the three groups (Kruskal-Wallis test, P less than 0.001), and the group that underwent cholecystectomy plus sphincteroplasty had a significantly higher median value than the cholecystectomized group (P less than 0.05) and the control group (P less than 0.01). The distribution of chronic antral atrophic and superficial gastritis was different in the three groups (chi 2 test, P less than 0.005). Chronic atrophic gastritis was associated with cholecystectomy plus sphincteroplasty (P less than 0.01), while chronic superficial gastritis was more frequent in cholecystectomized patients. These results suggest that there may be more duodenogastric reflux after cholecystectomy plus sphincteroplasty than after cholecystectomy alone, and that there may be a correlation between the amount of duodenogastric reflux and the severity of mucosal damage.

Adult↗
PubMed1990

Sex steroid hormone receptors and human gallbladder motility in vitro.

This study was designed to investigate the relationship between estrogen and progesterone receptor levels and in vitro contractile response of gallbladder muscle strips to stimulation by carbachol and cholecystokinin-octapeptide (CCK-OP). Seventeen female postmenopausal patients cholecystectomized for gallstones were studied. Samples of the gallbladder wall were used for histological examination; motility was studied by Keane et al. [Surg Gynecol Obstet 1986; 163:555-560]; the estrogen and progesterone receptor levels were evaluated by immunoenzymatic assay. Positive correlations were found between the progesterone receptor level and the carbachol concentration that produced half the maximal response (ED50), and between the estrogen receptor level and the ED50 of CCK-OP. Our data confirm the presence of estrogen and progesterone receptors in the gallbladder and suggest that sex steroid hormones act on gallbladder motility by modulating the affinity of gallbladder receptors to CCK-OP and carbachol.

Carbachol↗
PubMed1989

Electrical activity recorded from abdominal surface after gastrectomy or colectomy in humans.

The visceral electrical activity recorded from the abdominal surface was studied before and after either total gastrectomy or colectomy. The patterns obtained from fast Fourier transform analysis demonstrated the disappearance of the power peak of approximately 3 cpm after gastrectomy, whereas colectomy did not result in the disappearance of the power peak of approximately 3 and 8-12 cpm. Only the frequencies of approximately 3.5-7.5 cpm were not present after colon surgery. These data demonstrate that the spectral power peaks at frequencies of approximately 3 cpm are entirely related to the stomach because they disappear after gastrectomy; the power peaks between 3.5 and 7.5 cpm are related to the colon because they are present after gastrectomy but not after colectomy; the power peaks between 7.5 and 11 cpm are related to the small intestine because they are present after either gastrectomy or colectomy. The authors conclude that the electrical activity recorded from the abdominal surface and analyzed by fast Fourier transform gives reliable information concerning the electrical activity of the stomach and small intestine, although it is less reliable concerning the electrical activity of the colon.

Abdomen↗
PubMed1989

[New method of non invasive examination of the gastroenteric tract].

A new non-invasive method for studying the gastrointestinal tract. The Authors, after a critical evaluation of the methods used to study gastrointestinal motility, evaluate the diagnostic power of electrical activity recorded from the abdominal surface. Physiological principles of gastrointestinal electrical activity, recording methods and statistical analyses of the signal are discussed. A review of the literature is included. It is suggested that this method represents a more accurate, non-invasive diagnostic tool for gastrointestinal disorders.

Electrodiagnosis↗
PubMed1987

The importance of gastric emptying in reflux esophagitis: an experimental research on pigs.

A study was conducted on pigs to evaluate the importance of gastric emptying rate in reflux esophagitis development. Gastric emptying was previously measured in 25 pigs. Then, the following operative procedures were carried out: Heller's cardiomyotomy, common bile duct ligature, cholecysto-gastric anastomosis, and extramucosal duodenal myotomy on 10 animals (group A); the same procedures except extramucosal duodenal myotomy on another 10 animals (group B); common bile duct ligature and cholecysto-gastric anastomosis on the last 5 animals (group C). Six months later, gastric emptying was measured again; whereas in group A a significant shortening of gastric emptying was found, the other 2 groups remained unchanged. Then, all the animals were sacrificed and the lower third of the esophagus was removed for histologic examination. In all the pigs undergoing cardiomyotomy (groups A and B) appearance of esophagitis was found. No signs of esophagitis were found in group C. The conclusions reached are cardiomyotomy is in all cases responsible for reflux esophagitis development; extramucosal duodenal myotomy is capable of shortening gastric emptying, but this does not affect reflux esophagitis development.

Animals↗