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Biomedical subjects

F Cianchi

Publications and source records attributed to F Cianchi.

24 records · Page 2Linked to original sources

[A case of primary hepatic carcinoid. A report of its surgical resolution].

Primary hepatic carcinoid tumors are extremely rare; conversely, the liver is the most frequent site of metastases from gastrointestinal carcinoids. Clinically, primary lesions are characterized, in most cases, by the absence of an overt endocrine syndrome. Histologic findings and immunohistochemical demonstrations of chromogranin and neuron specific enolase, generally, enable the neuroendocrine origin of these neoplasms to be established. Prognosis after surgical treatment of primary hepatic carcinoids seems to be more favorable when compared with other hepatic carcinomas.

Aged↗

Anterior rectocele and anorectal dysfunction.

The two types of anterior rectocele, "distension" of Type 1 rectocele (T1R) and "displacement" or Type 2 rectocele (T2R), have different anatomical, clinical and therapeutic profiles. The aim of this study was to assess anorectal function in patients with distension or displacement rectocele. Three groups of female patients and one group of healthy female subjects were studied. Both the 10 Group 1 subjects, who had been diagnosed as having T1R, and 10 Group 2 women who had been diagnosed as having T2R, were symptomatic for digital evacuation of the rectum. The 10 Group 3 females had complained of sever idiopathic constipation but had no defecatory disorders. The control group was made up to 10 healthy volunteers. All patients and controls underwent clinical evaluation, colonic transit time (CTT), computerized anorectal manometry (CAM), and defecography. Bowel movements and clinical evaluation were similar for both rectocele groups. In Group 1, CAM detected significantly higher anal pressure (P < 0.05) and more impaired rectoanal inhibitory reflex (RAIR) (P < 0.01) in comparison to the other patients and controls. In Group 2, the lowest anal pressure (P < 0.001) was noted but RAIR was normal. Defecographic results, at rest and during evacuation, showed a significantly (P < 0.001) higher anorectal angle and a more abnormal pelvic floor descent in Group 2 than in the other study groups and controls. Therefore, peculiar anorectal function was present in patients with anterior rectocele. A pelvic floor dyssynergia was noted in the distension rectocele group, while a fall of the pelvic floor was noted in the displacement rectocele group.

Adult↗

Helicobacter pylori and duodenal ulcer: evidence for a histamine pathways-involving link.

OBJECTIVES: A "gastrin link" has been suggested to explain the statistically relevant association between Helicobacter pylori and duodenal ulcer. Given the well known, although not entirely clarified, relationships between gastrin and histamine, the purpose of this study was to assess whether gastric mucosal histamine pathways and, more specifically, histamine-storing cells are involved in the Helicobacter pylori-duodenal ulcer route. METHODS: Fasting serum gastrin, gastric mucosal histamine content, and mucosal density of both enterochromaffin-like cells and mast cells were compared in 11 H. pylori-positive, non-duodenal ulcer subjects, in 16 duodenal ulcer patients (all H. pylori positive), and in 11 H. pylori-negative control subjects. RESULTS: Fasting serum gastrin concentration and mucosal histamine content were significantly higher in the duodenal ulcer group than in controls, whereas H. pylori-positive, non-ulcer subjects had values that were intermediate between those of the other two groups. Enterochromaffin-like cell density was significantly greater in duodenal ulcer patients than in the other groups. CONCLUSIONS: These results demonstrate the involvement of histamine pathways in H. pylori infection and duodenal ulcer. The most original finding in this study was that enterochromaffin-like cell density is three times greater in duodenal ulcer patients than in H. pylori-positive, non-ulcer subjects. This could explain the previous report of an exaggerated acid response to gastrin in duodenal ulcer patients when compared with H. pylori-positive, non-ulcer subjects and thus provide further insight into the pathogenesis of ulcers.

Biopsy↗

Nitric oxide synthase and VIP distribution in enteric nervous system in idiopathic chronic constipation.

Idiopathic chronic constipation has been correlated to neural abnormalities that consist of a reduced number of myenteric plexus neurons and a decreased concentration of VIP-positive nerve fibers within the circular muscle. Recent studies hypothesized the involvement of nitric oxide in motility disorders of the human gut. To date, no information is available on nitric oxide involvement in idiopathic chronic constipation. The density of VIP- and nitric oxide-producing neurons was evaluated by immunocytochemistry using anti-VIP and anti-nitric oxide synthase antibodies in five patients with idiopathic chronic constipation. A low total neuron density was found at the myenteric plexus. The density of VIP-positive neurons was low while that of nitric oxide synthase-positive neurons was high at both plexuses. Our data confirm that idiopathic slow-transit chronic constipation is due to abnormal neurogenic factors. The presence of numerous nitric oxide synthase-positive neurons, all along the colon and at both plexuses, supports the hypothesis that an excessive production of nitric oxide may cause the persistent inhibition of contractions.

Adult↗

Technical aspects and clinical indications of 24-hour intragastric bile monitoring.

Bilitec 2000 is a new device which spectrophotometrically detects the presence of bilirubin in the refluxate. It is, up to date, the only method able to monitor for 24 hours the exposure time of esophageal and/or gastric mucosa to bilirubin-containing reflux. From the technical point of view, a particularly relevant aspect is the necessity of associating pH and Bilitec monitorings. The reason why is that, even in the stomach where Bilitec itself is adequate for assessing the exposure time to duodenogastric reflux, the damaging capability of the different components of reflux strictly depends upon pH. The most correct position inside the stomach for gastric monitoring is the 5 cm-below-the-LES-distal-border-position. The diet needs to be standardized in order to avoid false positive results due to the ingestion of foods with absorption close to bilirubin absorption. Ranges of normality will soon be available from a collaborative European Study. At variance with the indications for esophageal monitoring which are wide (the same as for pH-monitoring), indications for gastric Bilitec monitoring are represented only by severe dyspeptic symptoms possibly related to duodenogastric reflux. An antrum-confined C gastritis in the absence of history of consumption of gastro-lesive drugs strongly suggests the possibility of duodenogastric reflux. In this case, Bilitec monitoring can provide further evidence by measuring the time of exposure of the gastric mucosa to reflux.

Bile Reflux↗

[Giant mesenteric fibromatosis: a case report].

The fibromatoses represent a broad group of fibroblastic proliferations characterized by infiltrative growth and a tendency toward recurrence but, unlike malignant fibrous tumors, they do not metastasize. Mesenteric fibromatosis arising from the mesentery of the small bowel is rare. It may be sporadic or may occur in association with polyposis coli and other soft tissue tumors as a component of Gardner's syndrome. We report a case of mesenteric fibromatosis in a 52-year-old man with no evidence of Gardner's syndrome. The neoplasm occupied the whole abdominal cavity, weighing 12 kg, with the greatest diameter being 50 cm. Histological findings (i.e moderate degree of cellularity, lack of nuclear pleomorphism and mitotic figures) allowed to rule out malignancy. Surgical removal is actually the only effective treatment for mesenteric fibromatosis. Excision must be as wide as possible in order to prevent local recurrence. Until now, no satisfactory results have been obtained with external radiotherapy. More recently, anti-inflammatory drugs have been used in the management of this tumor.

Fibroma↗