Biomedical subjects

I Giorgio

Publications and source records attributed to I Giorgio.

At least 19 recordsLinked to original sources

PubMed1995

Gastric emptying and myoelectrical activity in children with nonulcer dyspepsia. Effect of cisapride.

We examined the effect of oral cisapride on gastric emptying time and myoelectrical activity using real-time ultrasonography and cutaneous electrogastrography in 10 children with nonulcer dyspepsia. A clear dominant frequency close to 3 cpm was present both at baseline and after eight weeks of cisapride. After cisapride, nine children had an increase in the normal slow wave percentage and the mean percentage of normal slow wave was significantly different (71.90 +/- 5.19% vs 79.16 +/- 5.54%; P < 0.01). Moreover, an increased stability of the dominant frequency, determined by computing the coefficient of variation before and after cisapride, was found (28.12 +/- 1.72% vs 23.61 +/- 3.47%; P < 0.01). At baseline the gastric emptying time, expressed as T1/2, was 139.76 +/- 40.04 min and at eight weeks 119.76 +/- 30.04 min (P = 0.06). As regards the relationship between EGG and gastric emptying, the proportion of children with improved normal slow wave percentage was similar to that with improved T1/2 emptying (Z = 0.57, P = 0.57). Thus, gastric electrical activity seems to be an important factor in the pathophysiology of nonulcer dyspepsia in children.

Adolescent↗

PubMed1995

Incidence and risk factors of duodenal ulcer. A retrospective cohort study.

We evaluated the incidence and risk factors of duodenal ulcer (DU) in a cohort of patients who had undergone esophagogastroduodenoscopy in our institution from 1978 to 1982, without then finding a gastric or duodenal ulcer. Six hundred and twenty-one subjects entered the study, and 526 (84.7%) were traced in 1992. Forty-one cases of DU were found, an incidence rate of 6.7 per 1,000 person-years; the male/female ratio was 2:1. The diagnoses of peptic ulcer (PU) were validated by means of medical documentation. The odds ratio of DU was 2.3 (95% confidence interval 0.8-6.3) and 3.5 (1.4-9.0) in the II and III tertile of basal acid output (BAO) compared with the I tertile, and 2.6 (0.8-8.3) and 7.0 (2.3-20.7) in the II and III tertile of maximal acid output (MAO) compared with the I tertile. Cigarette smoking and the presence of PU among siblings of DU patients were risk factors for DU. Multiple logistic regression confirmed only the association of DU with MAO, cigarette smoking, and family history. By means of a nested case-control study, the risk of developing DU was assessed in subjects with Helicobacter pylori (HP) at the biopsy of gastric mucosa performed before the ulcer diagnosis. The odds ratio of DU in HP-positive subjects was 5.0 (95% confidence interval 0.6-45). The results of this study confirm the influence of gastric acid secretion, cigarette smoking, and family history in the pathogenesis of DU and suggest that HP infection not only favors relapse but could have an important role in the onset of the disease.

Adult↗

PubMed1995

[Effects of gastric resection by the Billroth II technic on reflux esophagitis associated with duodenal or pyloric ulcer].

Although duodenal ulcer and reflux esophagitis may frequently co-exist, it is not clear whether surgery for duodenal ulcer associated with reflux esophagitis should not be associated with anti-reflux plastic surgery. The authors make a retrospective evaluation of the prevalence of reflux esophagitis (endoscopic diagnosis) in a consecutive series of 633 patients undergoing elective gastric resection according to Billroth II for duodenal or pyloric ulcer during the period 1974-1992 and assess the effects of surgery on co-existent esophagitis. The prevalence of reflux esophagitis associated with duodenal or pyloric ulcer was 12.3%. In patients in whom stenosis represented the indication for ulcer surgery, the prevalence of esophagitis was 20%, whereas it was 5% in those operated because of failure to respond to medical therapy of hemorrhage (p = 0.000001). In 95% of patients, controlled endoscopically 6 months after surgery, Billroth II gastric resection led to the resolution or improvement of associated esophagitis. The authors conclude that by eliminating the main pathological factors of reflux esophagitis associated with duodenal ulcer (hypersecretion of gastric acid, impeded gastric emptying) gastric resection is sufficient to achieve the resolution of esophagitis.

Adult↗

PubMed1995

Surgical management of reflux esophagitis associated with duodenal ulcer.

The prevalence of associated reflex esophagitis and the effects of surgery for ulcer on coexistent esophagitis were assessed in 687 patients operated on for duodenal or pyloric ulcer. Eighty-one patients (12%) had a preoperative endoscopic diagnosis of reflux esophagitis. The association resulted to be more frequent in patients with pyloric or bulbar stenosis than in patients without stenosis (20% vs 5%, p = 0.000001). Billroth II gastric resection, performed in most cases, caused the healing or the improvement of esophagitis in 95% of cases as demonstrated at endoscopy 6 months after surgery, particularly in 98% of patients with pyloric or bulbar stenosis and in 80% of patients without stenosis (p = 0.05). Therefore, gastric resection, eliminating the main pathogenetic factors of reflux esophagitis associated with pyloric or bulbar stenosis (gastric acid hypersecretion, impaired gastric emptying), assures the healing of esophagitis in most cases. However, anomalies in Lower Esophageal Sphincter function might play an important role in the pathogenesis of reflux esophagitis in duodenal ulcer patients without stenosis. In these patients, on the basis of manometric and pH monitoring data, it may be useful to associate an anti-reflux procedure or a duodenal diversion with a gastric resection in presence of Lower Esophageal Sphincter hypotonia.

Adult↗

PubMed1994

Electrical activity recorded from abdominal surface before and after right hemicolectomy in man.

To explain the origin of the electrical signals obtained from the abdominal cutaneous surface (electrosplanchnogram, ESG), the ESG was recorded in 6 patients with carcinoma of the right colon without obstruction before and after right hemicolectomy. The analysis of colonic electrical activity was performed by means of spectral analysis that utilized fast Fourier transform method. Since the colonic electrical signal is highly complex and it may contain several frequencies concurrently the spectral frequency components were subdivided in ranges and the dominant frequency and power were calculated for each range before and after surgery. The pattern obtained from power profile, expressed as differences in power percentages before and after surgery, demonstrated that there were significant differences in power data from right hemicolectomized patients compared to cholecystectomized ones (p = 0.00001 and p = 0.001 in 2.5-3.5 and 3.6-7.5 cpm range, respectively). In particular, hemicolectomized patients showed a slight increase of power percentage in the 2.6-3.5 cpm range and a clear reduction in the 3.6-7.5 cpm range. These data suggest that there are several components of colonic origin in the cutaneous ESG signal which, in the right colon, are identifiable in the 3.6-7.5 cpm range.

Abdomen↗

PubMed1993

Influence of the method of digestive tract reconstruction on gallstone development after total gastrectomy for gastric cancer.

The aim of this study was to evaluate whether total gastrectomy performed for gastric cancer leads to an increased risk of cholelithiasis and whether the method of reconstruction of the digestive tract influences that risk. A total of 102 patients who had undergone total gastrectomy for gastric cancer between 1980 and 1990 were studied. The preoperative prevalence of cholelithiasis was 4% in men and 12% in women. Eighty-seven patients (85%) without gallstones before surgery were reexamined after gastrectomy. The postoperative prevalence of cholelithiasis in this group was 36% in men and 19% in women. Before surgery, the difference between the expected frequency of cholelithiasis (calculated on the basis of the data of a community survey) and the observed frequency was not statistically significant (p > 0.05) either in men or women. After surgery, the observed frequency of gallstones was significantly higher than the expected frequency in men (p < 0.0001) but not in women (p = 0.06). The risk of cholelithiasis was significantly higher in patients with Roux-en-Y reconstruction (n = 55) than in those with jejunal interposition (n = 32) (log-rank test, p = 0.03), and that risk was independent of age, sex, and body mass index.

Adult↗

PubMed1993

[Changes in slow and fast electrical activity of the gastro-duodeno-jejunal junction after cholecystectomy in humans].

The re-establishment of regular gastrointestinal electrical activity (Migrating Myoelectrical Complex-MMC- and slow wave) after cholecystectomy for gallstones was investigated in six female patients (50-77 years) by means of serosal electrodes implanted in the wall of the antrum, duodenum and jejunum during surgery. Five hour recordings were made on the first, third and fifth postoperative days, in patients who were on a liquid diet. The recordings were made after a twelve hour fast. On the fifth postoperative day, a test meal (250 g yoghurt) was given to the patients ant its effects on electrical activity were monitored for 2 hours. Even though MMC were present on the first and third postoperative days, a detailed study of their origin, the length of the Phase 3 and the speed of gastro-jejunal propagation showed that there existed an inhibition of gastric MMC until the fifth postoperative day and that intestinal MMC was slower than normal until the third postoperative day. On the fifth postoperative day, gastric inhibition disappeared since the length of the Phase 3 of the MMC of the stomach corresponds to those of the duodenum and jejunum, and the speed of propagation corresponded to that in normal subjects. Further, the slow wave frequency peculiar to each segment studied increased progressively from the first to the fifth postoperative day and the same was true of the slow waves with superimposed action potentials. In conclusion, notwithstanding the presence of MMC from the first postoperative day, it was only on the fifth day that normal coordination was restored and hence that patients were able to eat again.

Action Potentials↗

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

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

[Development of an integrated system of family medicine--pathologic anatomy service to start epidemiologic studies on tumors occurring in an area of southern Italy. First results].

In Italy there are eight tumor Population-Based Registries (PBRs) that publish incidence data, and only one of them (Ragusa) provides data for Southern Italy. Usually, PBRs are based on data collection from Pathologists and medical records. Our integrated system differentiates from traditional PBRs because the information comes from the General Practitioners (GPs) and is completed with the diagnosis provided by the Pathologists (Ps). During two years we have registered 1,057 new cancers on a middle period population of 212,644. GPs and Ps signed 395 and 879 incident cases, respectively. GPs alone provided 16.8%, Ps alone 62.6%, and either source 20.6% of total cases. After excluding non melanotic skin cancers and bladder carcinoma, the GPs-Ps integrated system counted 828 new cases in two years. These incidence data are the first in our region (Puglia). The 178 cases signed by GPs alone should have been lost if the informations of our PBR had been based only on local Ps' records. Moreover, 94 of GPs cases (11% of total cancers registered) were subjects who moved outside the area for diagnosis and treatment. Even if this article evaluates the effect of under-registration attributable to Ps or GPs, the cancer incidence data and the active involvement of GPs indicate that they could be usefully involved in the registration of cancer data.

Epidemiologic Methods↗

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

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

Cancer family syndrome: cytogenetic investigations, in vitro tetraploidy, and biomarker studies in a large family.

Fifty-five members of a family with the cancer family syndrome (CFS) were investigated for the following potential biomarkers for cancer proneness: (1) cytogenetics of peripheral blood lymphocytes and skin fibroblasts; (2) in vitro tetraploidy of dermal fibroblast monolayer cultures; (3) quantitative serum immunoglobulin determinations; (4) study of genetic linkage with respect to eight blood group markers including Kidd. Biological specimens were obtained from 14 patients affected with cancer, 21 subjects at risk, and 20 healthy subjects. None of the markers tested in this family, in order to identify a biomarker for the status of CFS gene carrier, was found to be useful. Our search for linkage to other biological markers (DNA RFLPs and NK cells) is in progress.

Adult↗

PubMed1989

[Cholecystectomy and adenomatous polyps of the colorectum].

The possible correlation between cholecystectomy and adenomatous polyps of the colorectum is evaluated by means of a retrospective study of 2 groups of patients: 90 patients subjected to endoscopic removal of one or more adenomatous polyps of the colon-rectum (histological diagnosis) and 90 control patients paired by sex and age, hospitalised for benign pathology and selected from among those submitted to totally negative colonoscopy. Ten patients (11.1%) were submitted to cholecystectomy among those with adenomatous polyps, 5 (5.5%) in the control group. Subdividing patients by sex women evidenced a relative risk of 5 (O.R. = 5/1, degree of confidence 95% = 0.7-33.4) but the figure was not statistically significant. For males, on the other hand, the relative risk was 1 (O.R. = 5/4). It is concluded that cholecystectomy may be considered a risk factor for the development of adenomas of the colon-rectum in females.

Adult↗

PubMed1989

Depressed level of natural killer cells in cancer family syndrome.

Individuals from kindred with cancer family syndrome (CFS) have an increased genetic risk for the development of adenocarcinoma of the colon as well as of several other organs. Previous studies have suggested that this high occurrence of adenocarcinoma in this as in other hereditary neoplastic syndromes may be correlated to an underlying abnormality in immunological tumor surveillance. In attempt to define a marker that might identify individuals within CFS kindred at risk of developing cancer, we determined natural killer (NK) cell number and NK cell function in affected and healthy members of a CFS family. We studied 13 cancer-affected patients, 20 unaffected but "at-risk" subjects, 20 healthy subjects and 26 normal individuals matched to the patients with colon cancer on the basis of sex and age. We determined the number of NK cells and their function concurrently, using a monoclonal antibody and a 51Cr-release assay with K562 as target cells. We found that the number of NK cells was significantly (P = 0.00004) reduced in cancer patients as compared with healthy subjects and normal controls. Of the 20 at-risk individuals 9 had levels lower than the norm, while 11 showed normal-values. Consequently, the mean percentage of NK cells of this group does not differ either from that of normal subjects or from that of cancer patients. Mean NK cell function was lower in cancer patients than in healthy members of the CFS family but the differences were not statistically significant. Therefore, the mean NK cell function per single cell, expressed as a ratio between cytotoxicity (LU) and the number of NK1-positive cells, resulted paradoxically in an increase when compared with that of normal subjects. The possible mechanisms for this dichotomy were examined.

Adolescent↗