Benign duodenocolic fistula: an unusual case of gastrointestinal bleeding.
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Aged↗
Biomedical subjects
F Perri
Publications and source records attributed to F Perri.
Antibody response to Helicobacter pylori CagA and heat-shock proteins in determining the risk of gastric cancer development.
OBJECTIVE: To investigate whether the systemic antibody response to Helicobacter pylori heat shock protein B can be considered, in addition to anti cytotoxin-associated protein [CagA) antibody determination, a further serological marker of increased risk of gastric cancer development. METHODS: A total of 98 Giemsa positive Helicobacter pylori patients (28 with gastric cancer, 30 with duodenal ulcer and 40 with nonulcer dyspepsia) were studied. Serum samples obtained from all patients were tested for IgG antibodies to CagA (116 kDa), VacA [89kDa) and heat skock protein B (54 kDa) antigens of Helicobacter pylori by the Western blot technique. RESULTS: 26/28 patients [(92.9% with gastric carcinoma, 29/30 patients [96.7%) with duodenal ulcer and 30/40 patients (75.0%) with non-ulcer dyspepsia were seropositive for CagA protein. The prevalence of serum IgG antibody to CagA in the cancer patients was not significantly higher than in duodenal ulcer and non-ulcer dyspepsia patients. The prevalence of antibodies to VacA was not significantly different between gastric carcinoma and non-ulcer dyspepsia patients. In contrast the prevalence of systemic antibodies to heat skock protein B was significantly higher in gastric cancer patients (78.6%) than in duodenal ulcer (36.7%, p=0.002) or nonulcer dyspepsia patients (52.5%, p=0.029). CONCLUSIONS: The detection of antibodies to heat shock protein B is proposed as an additional test which, in association with the determination of serum antibodies to CagA, could help in determining the risk of developing severe gastroduodenal disease, and gastric cancer, in particular.
Antibodies, Bacterial↗
Cruveilhier-Baumgarten syndrome: an efficient spontaneous portosystemic collateral preventing oesophageal varices bleeding.
The protective role of large spontaneous portosystemic shunts in oesophageal varices bleeding due to portal hypertension in liver cirrhosis is still debated. A series of 20 consecutive patients with haemodynamically efficient collaterals involving the para-umbilical-epigastric venous route (evaluated by Echo-Doppler flowmetry) is reported. All patients presented absent or mild oesophageal varices at endoscopy. During a mean follow-up period of 23.5 months, no patient developed large varices or experienced variceal bleeding. Hepatic encephalopathy was present in 35% of patients. Haemodynamically efficient spontaneous portosystemic shunts may protect cirrhotic patients from the risk of oesophageal varices forming and bleeding. The diversion of large amounts of blood from portal to systemic circulation correlates with the higher trend of hepatic encephalopathy in these patients.
Adult↗
"Mixed" triglyceride breath test: methodological problems and clinical applications.
Laboratory assessment of pancreatic function is unpleasant for the patient and time-consuming for the investigator since it requires duodenal intubation and measurement of maximal pancreatic enzyme output by means of perfusion techniques. Non-invasive indirect tests such as bentiromide test, pancreolauryl test and faecal fat measurement have been introduced in clinical practice but their results depend on the collaboration of the patient in collecting urine or stool. Moreover, faecal fat reflects fat malabsorption but it is neither sensitive nor specific to evaluate exocrine pancreatic function. With the aim to determine whether steatorrhea is due to pancreatic insufficiency, several 14C- (or 13C) breath tests have been developed in which triolein, trioctanoin, tripalmitin, and cholesteryl-octanoate are used as marker substances. In 1989, G. Vantrappen and its group in Leuven developed a breath test in which a new substrate was used: the [1,3-distearyl, 2[carboxyl-13C]octanoyl glycerol] or 13C-"mixed"-triglyceride (MT). The "mixed triglyceride breath test" (MTBT) was shown to be an excellent test of exocrine pancreatic insufficiency when compared with the maximal lipase output after CCK-pancreozymin stimulation. Aim of this paper is to review the methodology of the MTBT and its actual and future applications in clinical practice.
Breath Tests↗
Association of ankylosing spondylitis with hairy cell leukemia: a previously once reported case.
We report a case of ankylosing spondylitis associated with hairy cell leukemia. This is the second observed case (I3) of ankylosing spondylitis with a B-type lymphoproliferative disorder which allows us to make some observations about the pathogenesis of these rare diseases.
Adult↗
Association of ankylosing spondylitis and monoclonal gammopathy: clinical case report and pathogenetic considerations.
Monoclonal gammopathy has rarely been reported in ankylosing spondylitis. We observed a patient with ankylosing spondylitis and monoclonal gammopathy with no signs of malignancy, chronic infections or amyloidosis. This association may show some possible pathogenetic mechanisms involved in these two different diseases of still uncertain etiology.
HLA Antigens↗
The aminopyrine breath test.
The metabolic basis and clinical application of the aminopyrine breath test (ABT) as a measure of liver function is reviewed in this article. Several papers have been published in the 20 years that have elapsed since the test was validated in man by Hepner and Vesell. Nevertheless, even if the aminopyrine breath test has been shown to be a non-invasive, reliable and semiquantitative liver function test with diagnostic and prognostic accuracy, it is not yet extensively used in clinical practice, probably because it is not widely known to clinicians. The aminopyrine breath test, like other newer tests (phenacetin, caffeine and erythromycin breath tests), allows the effects of drugs on hepatic cytochrome P-450 to be explored both in normal subjects and in liver patients. This interesting field of application is sure to expand the appeal of the aminopyrine breath test in the future.
Aminopyrine↗