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Biomedical subjects

G Biasco

Publications and source records attributed to G Biasco.

At least 91 records · Page 5Linked to original sources

Early gastric cancer in Italy. Clinical and pathological observations on 80 cases.

Of 542 gastric cancer patients operated in the period between 1976 and 1982, we found early gastric cancer (EGC) in 80 cases (15.3%). Patients with EGC did not show specific symptoms if compared with patients affected by gastric or duodenal peptic ulcer, gallstones, functional disorders of the upper gastrointestinal tract, or advanced gastric cancer (AGC). Single-contrast radiology showed a low sensitivity, especially in the depressed lesions. In contrast, endoscopy alone diagnosed 64 EGCs (80.0%) as malignant lesions. The five-year overall survival rate of the EGC patients was 85.9% and that of AGC patients was 43.8%. From a pathological point of view, our results confirm the usefulness of the studies on EGC for the comprehension of gastric carcinogenesis. The clinical relevance of EGC is linked to the good prognosis; however, the absence of clear symptoms and lack of alternative diagnostic methods to the endoscopy cast some doubts on the feasibility of mass detection programs.

Adenoma↗

Prevalence of autoimmune atrophic gastritis in vitiligo.

Gastric biopsies, and measurements of fasting serum gastrin levels and titers of antihuman parietal cell antibodies have been performed in 65 unselected patients with vitiligo. Histologic evidence of autoimmune atrophic gastritis has been obtained in 10 cases (15%), who were all positive for the antibodies and who had elevated gastrin levels. The study of gastric secretion after pentagastrin stimulation, performed in 7 of these patients, showed a markedly reduced acid output. The present study provides definite evidence of the association of autoimmune atrophic gastritis with a proportion of vitiligo cases and suggests the need for surveillance of these patients in terms of gastric neoplasia.

Adolescent↗

Alopecia areata.

Explore the source record for details and available documents.

Adolescent↗

Can antigliadin antibody detect symptomless coeliac disease in children with short stature?

Duodenal biopsy and tests for antigliadin antibodies were done in 108 children with short stature unassociated with gastrointestinal symptoms. Other investigations for causes of growth failure were also carried out. In 88 patients, the cause of short stature could not be determined (group I). In 9 patients (8.3%) biopsy showed total villous atrophy, indicating probable coeliac disease (group II), while 7 patients had mild partial villous atrophy (group III). 4 patients (3.7%) had complete growth hormone deficiency. Antigliadin antibodies detected by immunofluorescence (IFL-AGA) were positive in 8 of the 9 group II patients. Symptomless coeliac disease is therefore a commoner cause of short stature than is hypopituitarism; by use of the IFL-AGA test it is possible to select patients for biopsy, thereby identifying most of the coeliac patients. If duodenal biopsies had been limited to IFL-AGA positive patients, 18 biopsies would have been carried out and coeliac disease would have been diagnosed in 8 of the 9 patients.

Adolescent↗

Candida albicans infection of gastric ulcer frequency and correlation with medical treatment. Results of a multicenter study.

This paper reports the results of a multicenter prospective study of 188 consecutive patients affected by gastric ulcer, verified by endoscopy, in whom the frequency of a mycotic infection of the lesion was evaluated as well as the eventual influence of such pathology on the efficiency of medical treatment, the healing rate, and the healing time. A mycotic infection, defined as penetration of the periulcerous mucosa by the fungi, was found in only 13 patients (6.9%). No significant differences were found in the healing rate and healing time among these patients treated with H2-receptor antagonists and a control group of 43 matched gastric ulcer patients treated in the same period with the same therapy. It would appear from the data that mycotic infections of the gastric ulcer do not modify the efficiency of medical treatment.

Candida↗

Detection of coronary artery disease by two-dimensional echocardiography and transesophageal atrial pacing.

Two-dimensional echocardiography was performed at rest and during rapid transesophageal atrial pacing in 85 patients undergoing coronary arteriography for evaluation of chest pain. Transesophageal atrial pacing was performed with 10 ms pulses of 6 to 27 mA intensity; the rate was progressively increased up to 150 beats/min. Four patients were excluded: two because atrial capture was not achieved and two because of chest discomfort induced during transesophageal atrial pacing. Of the remaining 81 patients, 56 had significant coronary artery disease (greater than or equal to 75% stenosis of at least one major coronary vessel) and 25 had no significant coronary artery disease; 25 of the 56 patients with coronary artery disease had no wall motion abnormalities at rest. The test was considered positive if wall motion abnormalities were detected during pacing. Wall motion abnormalities occurred in 3 of 25 patients without coronary artery disease (specificity 88%) and in 51 of 56 patients with coronary artery disease (sensitivity 91%). Wall motion abnormalities developed in 20 of the 25 patients with coronary artery disease and normal regional wall motion at rest (sensitivity 80%); sensitivity for one, two and three vessel disease was 85% (17 of 20 patients), 94% (15 of 16 patients) and 95% (19 of 20 patients), respectively. In patients without coronary artery disease, wall motion score was 18 at rest and 17.7 +/- 0.9 during pacing (p = NS). In patients with coronary artery disease, wall motion score decreased from 15.2 +/- 3.6 at rest to 11.6 +/- 4.1 during pacing (p less than 0.001). In patients with coronary artery disease and normal regional wall motion at rest, wall motion score decreased from 18 at rest to 14.4 +/- 3.1 during pacing (p less than 0.001). Thus, two-dimensional echocardiography during transesophageal atrial pacing appears both sensitive and specific in detecting patients with coronary artery disease. This new procedure is a feasible and reliable alternative to exercise two-dimensional echocardiography.

Adult↗

[Evaluation of the ejection fraction using 2 simplified echocardiographic methods in patients with ischemic heart disease and left ventricular asynergy].

UNLABELLED: This study was undertaken to assess the reliability of two simplified echocardiographic methods (Method A and B) in evaluating ejection fraction (E.F.) in patients with left ventricular wall motion abnormalities (WMA). Method A was obtained with a microprocessor that allows the superimposition of a calibrated ellipse to left ventricular end-diastolic and end-systolic silhouettes; the shape of the ellipse was modified to obtain the best superimposition of the ellipse outline to the endocardium. E.F. was then obtained with the formula: VD-VS/VD where VD and VS were the ellipse volumes at end-diastole and end-systole. In method B E.F. was obtained averaging 3 regional E.F. obtained with a longitudinal axis and 3 different transverse diameters. In a group of 40 patients with WMA and excellent 2D echo images the correlation between echocardiographic and angiographic values was r = 0.76 for method A and r = 0.92 for method B. Method B was also tested in a group of 25 consecutive unselected patients with left ventricular WMA; in this group the correlation with angiographic values of E.F. was r = 0.84. IN CONCLUSION: in patients with WMA method B must be preferred because it is easier to perform and presents a better correlation with angiographic data than method A.

Adult↗

Two-dimensional echocardiographic recognition of complications of cardiac invasive procedures.

Two-dimensional echocardiography allowed prompt recognition of a major complication of a cardiac invasive procedure in 6 patients. In 5 cases, a preinvasive echocardiographic study was available for comparison. In 1 patient with perforation of the ventricular septum by a temporary pacemaker, the catheter was visualized as it passed through the ventricular septum, with the tip located against the left ventricular posterolateral wall. In another patient, the intimal flap caused by aortic dissection after left-sided heart catheterization was clearly visualized. In 2 patients with hemopericardium secondary to cardiac perforation during right-sided cardiac catheterization, 2-dimensional echocardiography revealed pericardial effusion not noted in studies performed before the invasive procedure. Two patients in whom hemopericardium occurred from injury by the pericardiocentesis needle also were studied by 2-dimensional echocardiography. Postpericardiocentesis images revealed new intrapericardial abnormalities (a thrombus-like mass and fibrinous strands) not present in the echocardiographic studies performed before pericardiocentesis. Real-time 2-dimensional echocardiography appears to be a good tool in the recognition of the emergencies secondary to cardiac invasive procedures.

Adult↗

Colonic involvement in adult patients with Henoch-Schoenlein purpura.

Henoch-Schoenlein purpura is a haemorrhagic syndrome, rare in the adult but well known in paediatric pathology. The clinical manifestations are usually: arthralgia, skin rash, renal and gastrointestinal involvement. Although the small bowel is more frequently involved, cases of oesophageal, gastroduodenal and colo-rectal localization have been rarely reported. We describe endoscopic features of two cases of Henoch-Schoenlein syndrome with extensive colonic involvement. No previous endoscopic documentation of this localization has been reported in our available literature.

Aged↗

Diagnosis of aneurysm of the thoracic aorta. Comparison between two non invasive techniques: two-dimensional echocardiography and computed tomography.

In order to assess the respective values of two-dimensional echocardiography (2D echo) and computed tomography (CT) in the evaluation of aneurysms of the thoracic aorta, 14 patients with angiographically proven aneurysms of the thoracic aorta (three of which were dissecting aneurysms) were studied. The entire thoracic aorta was visualized in 10/14 patients by 2D Echo and in all patients by CT. An intimal flap was recognized by 2D echo in each case with a dissection whereas such a recognition was never possible with CT. CT identified calcification of the wall of an huge aneurysm of the ascending aorta in one case and a thrombotic stratification in the lumen of the descending thoracic aorta in another case; both abnormalities were missed by echocardiography probably because of inappropriate gain setting. In conclusion, 2D Echo and CT are both useful in the evaluation of aneurysms of the thoracic aorta; 2D echo appears to be superior in the recognition of an intimal flap due to dissection whereas CT allows a better recognition of the configuration, extension and tissue modifications of the aneurysm.

Adult↗

Early gastric cancer. Clinico-pathological analysis of 125 cases of early gastric cancer (EGC).

The frequency and the pathological findings of 125 early gastric cancers (ECGs), and particularly of small and minute lesions, were evaluated in a retrospective study of 839 surgical specimens of gastric carcinoma. Sixty two ECGs were believed to have risen from gastric epithelium, 27 from areas of intestinal metaplasia, and 3 from cardio-pyloric mucosa. The remaining lesions showed mixed histological patterns. The most frequent macroscopic type was IIc (24.8%) followed by IIb (16.8%), I (16.8%), and III (14.4%). In 63 cases (50.4%) the cancer was limited to the mucosa. In all specimens, and particularly in small and minute lesions, the surrounding mucosa was accurately analyzed to detect any lesions, from which the cancer could have developed. Intestinal ECGs, especially if protruded, seem to arise from areas of intestinal metaplasia or of chronic atrophic gastritis. Rarely ECGs seem to stem from polypoid lesions both hyperplastic and adenomatous. On the contrary, most important seems to be the role of ulcerative lesions, since in 14 cases of our series, carcinomatous foci were observed within the regenerative epithelium covering the crater. No correlation was found between histologic type, size, staging, and frequency of node metastasis; this suggests the existence of ECGs with different biologic behaviour.

Adult↗

Intestinal morphological changes during oral refeeding in a patient previously treated with total parenteral nutrition for small bowel resection.

This report describes a patient who, after a subtotal resection of small intestine for an embolic obstruction of the superior mesenteric artery, was maintained on total parenteral nutrition for 30 days and then refed. Cytoproliferative analysis of the intestinal mucosa, evaluated by peroral biopsies performed on days 1, 5, 14 and 30 after oral refeeding, demonstrated an increase in cell proliferation from 1 to 14 days after refeeding, followed by a return to starting values after 30 days. On days 1 and 5, we saw an intestinal hypoplasia that became a hyperplasia after 14 days of oral refeeding. Our data confirm the importance of oral nutrition for the small intestinal response after resection.

Aged↗

Proliferative and antigenic properties of rectal cells in patients with chronic ulcerative colitis.

Two markers related to preneoplasia were studied simultaneously in ulcerative colitis (UC). The renewal of the rectal epithelial cells together with expression of second-trimester fetal antigen (STFA) were evaluated in nine patients with UC and four healthy subjects. Endoscopic biopsies were incubated with tritiated thymidine. Cell renewal was studied with microautoradiography, and the antigenic properties of the cells were evaluated by indirect immunofluorescence. At the time of the study, all the UC patients were in a mildly active or in a quiescent stage of the disease; their biopsies did not show dysplastic or neoplastic changes in epithelial cells. STFA was expressed in five UC patients. The analysis of cell renewal in this group revealed a shift of the proliferative compartment towards the luminal surface of the colonic crypts. By contrast, the patient group with STFA-negative reactions showed a pattern of cell proliferation similar to that observed in the controls. These results suggest that the expression of STFA in colonic mucosa is associated with an expansion of the epithelial stem cell population or with arrested cell differentiation, and it may represent a phenotypic marker of proneness of the mucosa toward neoplastic development.

Adolescent↗

[Spontaneous microcavitations in the right cardiac chambers. Microcavitations in the right sections].

Spontaneous echocardiographic contrast has been occasionally detected in the left ventricle of patients with mitral valve prosthesis. Only one case has been so far described in which spontaneous microbubbles have been detected in the right ventricle. We report the clinical and echocardiographic findings of five patients in whom spontaneous echocardiographic contrast was detected in right cardiac chambers: one patient had pulmonary embolism, three patients had mitral valve disease and tricuspid regurgitation, one patient had a congestive cardiomyopathy. These microbubbles can be produced by gas development due to lateral pressure drop secondary to tricuspid regurgitation or to gas absorbed from the intestine, that reach the heart through shunts between the portal and the systemic veins.

Adult↗

[Abnormal intracavitary dynamic echoes. II. In vivo study].

UNLABELLED: Dynamic intracavitary echoes (DIE's) suggesting regional stasis of blood, were detected in 17 patients (pts) (6 with mitral stenosis, 1 with mitral prosthesis, 5 with congestive cardiomyopathy, 5 with left ventricular aneurysm). DIE's were observed in the left atrium in all pts with mitral stenosis and in the patient with a prosthetic valve, in the left ventricle in the remaining pts. In 5 pts a thrombus was detected in the cardiac chamber in which DIE's were observed. In 4 pts direct inspection (at surgery or autopsy) of the cardiac chamber in which DIE's were detected revealed the presence of non-coagulated blood. All pts with DIE's in the left atrium were in atrial fibrillation. In one case with mitral stenosis DIE's disappeared after commissurotomy. IN CONCLUSION: DIE's suggesting regional stasis of blood may be detected in pts with clinical conditions characterized by slow cardiac flow; this phenomenon may be caused by red cell aggregation occurring in those conditions.

Adolescent↗

[Our experience with the effectiveness and tolerance of ibuproxam in rheumatology].

The tolerance and effectiveness of Ibuproxam were investigated in 54 patients with arthrosis, R.A., ankylosing spondylitis, and fibrositis. Statistically significant reduction of pain at the end of the treatment was accompanied by decreased limitation of joint movement and morning stiffness. Simultaneous investigation of clinical and biological tolerance showed that the drug is infrequently responsible for side-effects that are always of negligible importance. Oesophagogastroduodenoscopy in subjects with a prior history and/or signs of active pathology of the upper digestive tract did not reveal exacerbation or recrudescence of lesions, nor the appearance of acute lesions.

Arthritis, Rheumatoid↗