Francesco Andreoli

Anorectal continence and bladder function

The effect of sacral resection up to S-2 has been investigated in two patients with “chordomas”, surgical division of the spinal roots was unilateral and bilateral, respectively. Anal manometry, electromyography of the sphincters, and the ascertaining of tactile, thermic, and painful stimuli perception in the perineum and anal canal were executed to determine the effects of denervation on anorectal continence. Vesical function was tested by vesical manometry. Results differ strongly between the two patients: the first, with unilateral loss of S-2, has perfect anorectal continence. The second, with bilateral loss of S-2, is incontinent and unable to discriminate rectal contents. It is sufficient to retain only one S-2 root for the maintenance of physiologic continence, including distinction between different types of bowel contents (gaseous or solid) passing through the anal canal. The same is true concerning bladder function.

Gastric Continuous pH Monitoring: A New Apparatus in Chronobiological Research

Among the tools required for a future clinical chronobiology, the instrumentation described here represents only the hardware that has to be complemented with appropriate software for as-one-goes analysis of variables such as gastric acidity. The software is available to determine reference standards against which excess or deficit in gastric acidity or any other pertinent variable can be assessed chronobiologically (Cornelissen et al., 1985; Halberg et al., 1985). This is the more important since several signs and symptoms of diseases related to gastric acid secretory function show prominent circadian, ultradian and infradian variations (Tarquini, 1980). The chronobiological assessment of endoluminal gastric pH, therefore, seems most appropriate to define physiopathological aspects and schedule a proper therapy of these diseases.