[Chronic hepatitis B in children. A study of 29 cases].
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Adolescent↗
Biomedical subjects
F Sessa
Publications and source records attributed to F Sessa.
Pancreatic polypeptide (PP) cells in the PP-rich lobe of the human pancreas are identified ultrastructurally and immunocytochemically as F cells.
The ultrastructure of immunohistochemically identified PP cells has been investigated by applying the serial semithin/thin section technique to the human pancreas, with special reference to the posterior part of the head, reputed to originate from the ventral primordium. PP cells of this area differ from those already identified in the rest of the pancreas and correspond to a cell, not yet described in the human pancreas, characterized by larger granules of very variable shape and structure. Such granules resemble those of so-called "F cells", i.e. the PP cells of dog uncinate process and cat duodenal lobe, also coming from the ventral primordium. Thus, human "ventral lobe" PP cells have peculiar potentialities which are expressed in distinctive structural patterns of presently unknown functional meaning.
Fetus↗
Pancreatic polypeptide rich tissue in the annular pancreas. A distinctive feature of ventral primordium derivatives.
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Humans↗
Chronic viral hepatitis B in infancy.
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Chronic Disease↗
Alpha and beta subunits of glycoprotein hormones in argyrophil pituitary tumors with small granule cells.
A group of 33 functionless pituitary tumors with small argyrophil groups (SAG) were collected from a series of 200 pituitary adenomas (16.5% of all adenomas). Histologically, the tumors showed an unusually high frequency of trabecular patterns, perivascular pseudo-rosettes, and oncocytoid transformation. Immunoreactivity for glycoprotein hormone alpha-chain was found in more or less numerous cells of 20 cases (64.5% of SAG tumors). Thirteen of these cases also showed specific beta-chain immunoreactivity, especially for follicle-stimulating hormone (FSH) beta-chain, which was present in 11 tumors. Various admixtures of immature, oncocytic, sparsely granulated, and densely granulated cells were observed ultrastructurally, with prevalence of the latter cell variants in tumors showing immunoreactive cells and prevalence of the former cell variants in tumors lacking immunoreactive cells. It is suggested that some relationship may exist between SAG cell (glycoprotein hormone precursor cells?) tumors--or at least part of them--and glycoprotein hormone cell lines. Anyway, whatever their origin and interpretation, SAG cell tumors seem to represent a distinct clinicopathologic entity.
Adenoma↗
Histopathology of chronic delta hepatitis.
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Chronic Disease↗
Endocrine-paracrine cells in pancreatic exocrine carcinomas.
Eleven cases of primary pancreatic adenocarcinomas have been investigated histochemically, immunohistochemically and with electron-microscopy. Endocrine-paracrine (EP) cells were present in six of these tumours. In one case numerous 5HT-enterochromaffin cells (EC) of the intestinal type and a few somatostatin immunoreactive D cells were found. Two cases contained insulin-immunoreactive cells and another case displayed glucagon-IR elements. In the remaining two cases argyrophilic cells were present. These findings demonstrate that polypeptide hormone or amine production is not restricted to islet cell tumours. It is suggested that both endocrine and exocrine components of the tumours studied might have derived from a common precursor.
Adenocarcinoma↗
The diffuse endocrine-paracrine system of the gut in health and disease: ultrastructural features.
At least 16 types of endocrine-paracrine cells have been identified ultrastructurally in the gastrointestinal mucosa. The production of hormones and local messengers such as 5-hydroxytryptamine, gastrin, cholecystokinin, somatostatin, secretin, gastric inhibitory peptide (GIP), enteroglucagon (glicentin, GLI), motilin, neurotensin, substance P and the enkephalins, by these cells, has been established. Progress has also been made in cytological studies of gut and pancreatic endocrine tumours. Argentaffin EC cell carcinoids, gastrinomas (of several ultrastructurally different varieties of gastrin cells), L-cell tumours and D-cell tumours are among those cytologically and functionally defined in the gut. Functionally undefined tumours include the so-called non-argentaffin carcinoids arising in various parts of the gut, some of which have been characterised cytologically as gastric ECL cell tumours and gastroduodenal P-D1-cell tumours. Gastrinomas, vipomas and rare argentaffin carcinoids are among gut-related pancreatic endocrine tumours. Non-functional paragangliomas, usually with some neuromatous component, occur in the duodenal wall. Extrapancreatic vipomas display ultrastructural features of ganglioneuroblastomas with peptidergic granules.
Animals↗
Immunohistochemistry of brain 5-hydroxytryptamine.
An immunohistochemical assay for 5-hydroxytryptamine (5HT) has been developed, validated by parallel radioimmunoassay and a series of tests with monoamines or related molecules, and applied to the detection of 5HT in rat brain sections. The procedure seems to be more sensitive and specific than the classical Falck-Hillarp technique. Among amines and related compounds tested, only 5-methoxytryptamine has been found to cross-react. 5HT-immunoreactive neurons and/or fibres have been observed in the spinal cord, brain stem, hypothalamic nuclei, epiphysis and subcommissural organ, thalamus, striatum, corpus callosum, amygdala, hippocampus, olfactory tubercle, and cerebral cortex.
Animals↗
Gastric gastrinoma and diffuse G cell hyperplasia associated with chronic atrophic gastritis. Endoscopic detection and removal.
Chronic atrophic gastritis and a sessile polyp were diagnosed during gastroscopy of a patient with splenomegaly and portal hypertension. The polyp was removed endoscopically. Histologically, it proved to be an endocrine tumour, which was identified as gastrinoma by immunohistochemistry. Then, hypergastrinemia was found and gastrectomy was performed to ensure complete removal of the tumour. The surgical specimen showed G cell hyperplasia of the antro-pyloric mucosa and severe atrophic gastritis with scattered argyrophil micronodules in the corpus-fundus region. 3 years after this treatment the patient is well.
Adenoma, Islet Cell↗
A retrospective study of the role of delta agent infection in children with HBsAg-positive chronic hepatitis.
The prevalence of intrahepatic delta antigen and/or anti-delta antibody was retrospectively investigated in 102 children with chronic HBsAg-positive hepatitis who were seen consecutively in three medical institutions between 1974 and 1982. Delta infection markers were found in 13 patients (12.7%) who exhibited high serum titers of anti-delta antibody; intrahepatic delta antigen was detected in ten. Eleven of the 13 children had severe progressive liver disease associated in all but one with absence of hepatitis B virus replication as evaluated by analysis of serum hepatitis B virus DNA. The factors which seem to increase the risk of delta infection in children who are hepatitis B virus carriers are geographic origin, a history of exposure to blood derivatives and age. A further 37 of 102 children had chronic active hepatitis (20 patients) or cirrhosis (17 patients) without evidence of delta infection. These results indicate that delta infection occurs in children with chronic hepatitis. This possibility should be considered in investigation of children with HBsAg-positive chronic liver disease. Although the delta agent is an important cause of progressive liver disease in children who are chronic HBsAg carriers, severe liver injury and especially cirrhosis can occur without evidence of delta infection.
Adolescent↗
A histological study of hepatitis delta virus liver disease.
The histopathology of hepatitis delta virus disease was studied in carriers of HBsAg with chronic hepatitis delta antigen-positive hepatitis and in serial biopsies of patients with acute hepatitis delta virus hepatitis that progressed to chronicity. There was no histologic feature distinctive of hepatitis delta virus from other types of viral hepatitis. Biopsy specimens of patients with chronic disease exhibited portal and periportal inflammation with piecemeal necrosis, conforming to a picture of aggressive hepatitis often accompanied by cirrhosis. Characteristic was a marked intralobular infiltration by mononuclear cells and a degenerative eosinophilic change of the hepatocytic cytoplasms conducive to the formation of acidophilic bodies. Liver specimens from patients with hepatitis delta virus hepatitis exhibited aspects of focal, confluent and bridging necrosis. The disease progressed to chronicity irrespective of the original histological features. The expression of intrahepatic hepatitis delta antigen was reduced in the phase of the acute hepatitis but increased in parallel with the development of chronic active liver disease. In late-stage cirrhosis, expression of hepatitis delta antigen was usually low.
Acute Disease↗
Celiac disease presenting as chronic hepatitis in a girl.
A case of celiac disease presenting as an asymptomatic chronic persistent hepatitis in an 11-year-old girl is reported. Liver biopsy performed because of long-standing elevation of serum transaminase levels showed a mild portal fibrosis with mononuclear infiltrate. Immunofluorescence staining did not reveal deposits of immunoglobulins or complement in the liver specimen. Although the girl was totally asymptomatic, she had steatorrhea, a delayed bone age, and an abnormal D-xylose test. A jejunal biopsy showed villous atrophy and increased intraepithelial lymphocytes. On a gluten-free diet the level of transaminases fell to normal within 1 month and remained normal. According to biological remission, a second intestinal biopsy performed after 1 year of gluten-free diet revealed a normal intestinal mucosa. Our report suggests that an underlying chronic intestinal disorder, and particularly celiac disease, must be ruled out when evaluating a child with elevated levels of serum transaminase.
Celiac Disease↗
Idiopathic hepatic copper toxicosis in a child.
A 10-year-old Italian boy with chronic liver disease and copper overload is described. Biological and histopathological findings are similar to those described in children with Indian childhood cirrhosis. This report suggests that a disease akin to Indian childhood cirrhosis but different from Wilson disease can be found in non-Indian children probably representing a new, possibly inherited, disease of copper metabolism leading to copper overload in the liver.
Child↗
[99mTc-MIBI characterization of breast microcalcifications. Correlations with scintigraphic and histopathologic findings].
INTRODUCTION: Microcalcifications which do not belong to focal lesions are a difficult diagnostic problem to solve with mammography. We investigated the yield of 99mTc-Sestamibi (MIBI) scintigraphy in the assessment of the benign or malignant nature of these lesions and compared nuclear medicine with histologic and immuno-histochemical findings. MATERIAL AND METHODS: Twenty-seven areas of microcalcifications (0.3-5 cm in largest diameter) were considered; no solid masses or cysts were detected by mammography and sonography. The mammographic features of these microcalcifications were suggestive of malignancy in 3 cases and of benignity in 14; the diagnosis was questionable in the other 10 cases. MIBI scintigraphy was considered positive for malignancy when there was tracer uptake in the breast. Cytologic samples of all lesions were obtained with fine-needle aspiration under stereotactic guidance. Histology was performed in the 13 lesions considered malignant or dubious at mammography, independent of their cytology; histology was combined with immunohistochemical tests to assess intracellular mitochondria count and the number of vessels. The other 14 lesions, which were benign at mammography and cytology, were followed-up yearly for two years, and no change in clinical or radiological findings was demonstrated. RESULTS: Histology diagnosed 8 ductal carcinomas (3 invasive carcinomas and 5 carcinomas in situ) and 5 benign lesions (1 sclerosing adenosis and 4 fibrocystic diseases, 3 of them associated with ductal hyperplasia). Scintigraphy was positive in 4/8 malignant lesions (3/3 invasive carcinomas, 1-3.5 cm in largest diameter; 1/5 carcinomas in situ, 5 cm in largest diameter) and negative in 4/5 benign lesions (we had one false positive in a fibrocystic disease associated with ductal hyperplasia). Tracer uptake was observed in all lesions with a high intracellular mitochondria count, except for 2 carcinomas in situ (0.3 and 0.8 cm in largest diameter, respectively); no benign or malignant lesion was well vascularized. Scintigraphy was negative also in the other 14 benign lesions with no histology. CONCLUSIONS: 99mTc-MIBI scintigraphy was able to characterize both invasive ductal carcinomas and benign lesions, which results hold even though our series was small because of the selection criteria we used. Thus, all invasive ductal carcinomas were identified and we had only one false positive (1/19) in benign lesions. In contrast, the technique was inadequate in carcinomas in situ, probably because their size and biological patterns vary greatly. Thus, scintigraphy was negative in 4/5 lesions (all < 1 cm O) and positive in only 1/5 (5 cm O). Therefore we conclude that 99mTc-MIBI scintigraphy cannot replace stereotactically-guided fine-needle aspiration in breast microcalcifications with questionable mammographic findings.
Adult↗
Premonitory symptoms in migraine without aura: a clinical investigation.
Thirty-three out of 100 patients affected by migraine without aura, reported premonitory symptoms in at least 50% of attacks and were considered to be affected by complete or premonitory common migraine. This group had a greater positive familiarity for migraine, a lower mean age of onset, and a higher average number of trigger factors compared with other patients. These three differences were statistically significant; hence we hypothesized that patients with migraine attacks generally preceded by premonitory symptoms have a stronger constitutional migraine trait with a premature weakening of their antinociceptive adaptation systems to the environment and to stressful events.
Adult↗