[Allergies in gastroenterology].
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Biomedical subjects
Publications and source records attributed to A Perasso.
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The histological pattern of fundic and antral mucosa was evaluated in endoscopically bioptic material obtained from 32 dyspeptic patients in the absence of circumscribed lesions of the stomach, duodenum, hepato-biliary area and pancreas, and in 30 asymptomatic controls. The data obtained failed to reveal any significant differences between the dyspeptic patients and the asymptomatic control group as regards the presence of chronic inflammatory alterations of the fundic or antral mucosa. Furthermore, the present findings reconfirmed the well-known progression with age, of the gastric inflammatory damage both in the antral and fundic area in the two groups considered without evidence of significant differences between them. Therefore, in conclusion dyspepsia "sine materia" does not have a histological pattern of chronic gastritis either of the fundus or of the antrum as its substrate.
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The aim of this experience has been to evaluate the chief cell mass and serum pepsinogen I in gastric ulcer patients. Comparisons were also made with parietal cell mass and acid secretion. Chief cell mass and serum pepsinogen I are not only influenced by the localization of ulcer but, also, by the histological condition of fundic mucosa. In fact, the behaviour of serum pepsinogen I and chief cell mass in type I gastric ulcer is the same observed in case of fundic chronic gastritis without gastric ulcer. In case of gastric ulcer type I with superficial fundic gastritis it emerges normozymogenism with hyperpepsinogenemia++ I, with preatrophic fundic gastritis hypozymogenism with normopepsinogenemia, with atrophic fundic gastritis hypozymogenism with hypopepsinogenemia I. In type II and III gastric ulcer the chief cell mass and serum pepsinogen I behaviour as they do in duodenal ulcer with hyperpepsinogenemia although hypozymogenism is present.
Aim of this experience has been to evaluate the behavior of the chief cell mass, of the parietal cell mass and of the serum pepsinogen I in patients operated on for duodenal ulcer by the Billroth II compared to patients with chronic fundic gastritis in non operated stomach and to healthy controls. From the results, even in operated patients, emerges a progressive reduction of the two cell masses, in relation to the different degree of chronic gastritis of the stump, in analogy with chronic fundic gastritis in non-operated stomach. In chronic superficial gastritis no differences emerge between operated patients and patients with chronic superficial fundic gastritis in non operated stomach, while with the getting on the inflammation, it can be observed a higher fall of the parietal cell mass in operated subjects than in non operated ones. Such differences are even greater in relation with the evaluation of the time elapsed between the operation and the evaluation of the two cell masses. Furthermore, no significant differences have emerged between the two groups of patients as for serum pepsinogen I. Such data is not discriminant between the two conditions.
An increased gastroenteric mucosal permeability is generally considered a pathophysiological mechanism in the urticaria-angioedema syndrome caused by adverse reactions to foods. Since pirenzepine, an antimuscarinic receptor drug, exerts a cytoprotective activity on digestive mucosa, the authors evaluated the clinical efficacy of pirenzepine and terfenadine (antihistamine), alone or associated, in the treatment of patients with urticaria-angioedema syndrome due to food allergy. Furthermore, additional endoscopy and biopsy studies were performed in order to provide experimental evidence about the cytoprotective activity of this treatment. The results of the present investigation confirm the clinical efficacy, with improvement of histological parameters, of pirenzepine treatment in adverse reactions to foods, as previously demonstrated by our group, and suggest further investigations on the functional mucosal impairment hypothesized in this pathological condition.