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Biomedical subjects

A Colantoni

Publications and source records attributed to A Colantoni.

67 records · Page 4Linked to original sources
PubMedDate not supplied

An inducible cell line (Natasha), from a neuroblastoma patient with circulating HSR-positive blasts, expressing neurohormones.

A cell line, established from a neuroblastoma patient, expresses NCAM and L1 cell adhesion molecules. Two chromosomal abnormalities were present in bone marrow (10%) and cell line (82%) metaphases: (i) a homogeneously staining region (HSR) at the distal part of chromosome 14, and (ii) an insertion of unidentified dark G-banding material in 1 p36. The identification in the patient of chr 14-HSR-positive tumour cells, before the in vitro adaptation, suggests a direct HSR formation without preceding double minutes (dms; or a very early in vivo dms----HSR transformation). N-myc was amplified in the HSR. Cells expressed proopiomelanocortin and corticotropin releasing factor mRNAs. Untreated cells were relatively differentiated; nevertheless they dramatically responded to retinoic acid, forming extensive neurites, growth-cones, cell-cell and cell-neurite junctions. Neurofilaments and synaptic figures containing many dense core granules were identified. This differentiation was irreversible. This cell line is therefore useful for the study of differentiation and in particular for the involvement of neurohormones in the differentiation process.

Antigens, Neoplasm↗
PubMedDate not supplied

Ursodeoxycholic acid does not improve the clinical course of primary sclerosing cholangitis over a 2-year period.

BACKGROUND: Ursodeoxycholic acid has been shown to be a useful agent in the clinical management of patients with primary biliary cirrhosis and autoimmune chronic active hepatitis. Its efficacy is presumed to be based upon its ability to act as a detergent and to incite a choleresis. Recent additional data suggest it also reduces HLA antigen expression on liver and biliary epithelial cells and impairs T cell reactivity. METHODS: A randomized controlled study of 59 patients with primary sclerosing cholangitis was performed over a 24 months period with 3 groups being studied. Group I consisted of 20 patients who were given ursodeoxycholic acid 300 mg orally twice a day; group II consisted of 19 patients who were given colchicine 0.6 mg orally BID; and group III was an untreated medical control group. All three groups were seen at regular 3-month intervals and had quarterly, annual and terminal studies performed to assess their disease status. RESULTS: No difference between groups was evident after two full years of therapy when parameters of liver injury, liver function, liver size and hepatic copper content were compared between groups. Similarly, no difference in ERCP findings was evident between groups either at entry or after two years of therapy. CONCLUSIONS: These data suggest that ursodeoxycholic acid is no better than colchicine or simple medical follow-up. Thus, neither ursodeoxycholic acid or colchicine can be considered to be effective therapies for primary sclerosing cholangitis.

Adult↗
PubMedDate not supplied

Current and future therapies for HCV infection: what should the end point for treatment be?

Based upon all of the available data relating to the natural history, chemical course, and response to therapy of HCV, the following recommendations are made: 1) The primary end point for HCV therapy should be HCV clearance from all tissue sites, eg plasma, liver and others 2) Therapy should be provided for patients with early infections as they have the best chance of achieving a virologic response 3) Therapy should be offered to patients with cirrhotic disease, as prevention of hepatic decompensation and degeneration to hepatic cancer is possible 4) End stage decompensated disease should be treated, particularly if liver transplantation is being considered, in an effort to either eliminate or ameliorate disease recurrence 5) Combination therapies are preferable to monotherapy as they enhance the likelihood of a therapeutic response. Some of these include agents that reduce the frequency of IFN-induced untoward events (NSAIDs) 6) The approach to HCV infection should be to view it as an infectious disease. In this way, multi-agent therapy could be used to prevent the emergence of drug resistant mutants as well as to obtain earlier clearance of the infection than is possible with monotherapy.

Antiviral Agents↗
PubMedDate not supplied

Treatment of HCV positive individuals with normal serum ALT levels.

A substantial number of cases of chronic hepatitis C infection can be shown to have normal or near normal serum ALT levels. Major questions that arise when such cases are seen are: should such patients be treated; if so for how long; and what is the end point of therapy. The reported experience of such patients treated by IFN is reviewed.

Alanine Transaminase↗
PubMedDate not supplied

Interferon treatment of HCV positive cirrhotic patients.

An estimated 3.5 million people in the United States have chronic hepatitis C. Each year, 8,000 to 10,000 of these chronically infected patients die of a liver-related complication of their infection. The introduction of effective blood screening assays has resulted in a remarkable decrease in the incidence of post-transfusion HCV infection. Nonetheless, hepatitis C remains an important clinical problem. Some important new treatment programs can help prevent the development and progression of compensated cirrhosis to either decompensated cirrhosis or HCC. Patients who present to the health care system with advanced chronic active hepatitis or cirrhosis have been treated with interferon. Of those studied, only IFN therapy has been shown to induce remissions of the hepatic inflammatory process and to eliminate viral infection in most treated cases. However, it is widely held assumption that cirrhotic individuals do not respond to IFN therapy and that the treatment of decompensated cirrhotic individuals with HCV infection is dangerous. We believe that this assumption is false. In many studies, cirrhotic patients with chronic hepatitis C have been shown to respond to IFN therapy. However, they do so at a rate of half that reported for individuals with non-cirrhotic chronic active hepatitis. There have been no reports of hepatic decompensation as a consequence of IFN treatment of cirrhotic individuals with chronic hepatitis C. The use of IFN for cirrhotic patients is reviewed.

Antiviral Agents↗
PubMedDate not supplied

Liver transplantation for chronic viral liver disease.

Liver transplantation (LTx) for chronic viral liver disease has evolved rapidly during the last two decades. The major problem in cases of LTx for viral hepatitis is the extremely high rate of recurrent viral infection in the liver allograft. While recurrent hepatitis C virus (HCV) infection typically causes a mild hepatitis and has a slow progression, hepatitis B virus (HBV) infection of the liver allograft has been reported to result in cirrhosis in as short a period of time as 1 year. The risk of graft infection is greatest for patients with actively replicating virus. The high rate of disease recurrence, and the accelerated course of both HBV and HCV related liver disease post LTx, is a consequence of the high viral loads experienced by the allograft and the life-long immunosuppression required to prevent allograft rejection. Thus, efforts to clear virus prior to LTx, in order to prevent disease recurrence, are extremely important. In cases where this is not possible, the use of treatments directed at controlling or inhibiting recurrent disease in the allograft are essential. Hepatitis B immunoglobulin (HBIg) is an example of the latter, while the recent introduction of nucleoside analogues, molecules targeted at essential steps in viral replication such as lamivudine and famciclovir, are example of the former. The use of these two agents is likely to markedly change current approaches to transplantation for viral hepatitis.

Hepatitis B, Chronic↗
PubMedDate not supplied

Liver transplantation for alcoholic liver disease.

The experience from many transplant centers has shown that orthotopic liver transplantation is a safe and successful procedure for the treatment of end-stage chronic alcoholic liver disease. Once an appropriate psycho-medical evaluation is completed and patients are chosen carefully for abstinence, the survival rate of alcoholics who undergo liver transplantation is equal if not better than that of individuals transplanted for other causes of liver disease. While the initial ostracism of alcoholics from transplant centers no longer exists, the issues of recidivism and disease recurrence remain as concerns. The available data on liver transplantation for alcoholics, recidivism, and long-term survival are reviewed.

Alcoholism↗
PubMedDate not supplied

Liver transplantation after successful resection of a superficial gastric cancer.

The case of a cirrhotic woman being evaluated for liver transplantation who was found to have a superficial gastric carcinoma is presented. The gastric carcinoma was confirmed by endoscopy and histologically on two separate occasions. Following gastric resection, the transplant was a success and she remains well without tumor recurrence two years after the resection and one year following liver transplantation.

Carcinoma, Signet Ring Cell↗
PubMedDate not supplied

Liver transplantation for hepatocellular carcinoma?

The worldwide experience of the largest transplant programs with hepatic resection and liver transplantation for primary hepatic cancer are reviewed. The pros and cons for resection as well as for transplantation are presented. The choice between resection or transplantation may depend upon the geographic location of the individual patient, their financial resources, the availability of specific surgical expertise, as well as a panoply of medical/surgical factors that define what can or cannot be accomplished. In the absence of limiting factors, transplantation appears to be the surgical method of choice for small neoplastic lesions less than 5 cm in diameter, particularly when the number of lesions is small (< or = 3) and the cancer occurs in the setting of cirrhosis. Surgical resection is the preferred procedure for larger lesions and for those occurring in individuals without confounding cirrhosis.

Carcinoma, Hepatocellular↗