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Biomedical subjects

H Aste

Publications and source records attributed to H Aste.

At least 19 recordsLinked to original sources

Effect of sulglycotide in the prevention of duodenal ulcer relapse.

OBJECTIVE: To evaluate the effectiveness of sulglycotide, a gastroprotective drug, as maintenance treatment for patients with duodenal ulcer. DESIGN: A randomized double-blind study. METHODS: A total of 119 patients with recently healed duodenal ulcers were randomly allocated, in a double-blind fashion, to receive sulglycotide 200 mg twice daily (60 patients) or placebo (59 patients) for 1 year. Patients underwent clinical assessment every third month and endoscopy at 6 and 12 months, or earlier if relapse was suspected. RESULTS: The cumulative endoscopic relapse rates, compared using the log rank test, were 37 and 52% after 6 and 12 months, respectively, in the sulglycotide group and 62 and 71% (P = 0.03), respectively, in the placebo group. CONCLUSIONS: Sulglycotide is moderately effective as a maintenance treatment for duodenal ulcer disease.

Anti-Ulcer Agents

Correlation between family history of colorectal cancer and pathological and clinical features of the disease.

Familial aggregation of colorectal cancer occurs even among sporadic cases that are not part of defined genetic syndromes. First-degree relatives of patients with "sporadic" colorectal cancer have a three- to fourfold increased risk of the same cancer. The aim of the present study is to investigate the relationship between a first-degree family history of colorectal cancer and the pathological and clinical features of the tumor (site, Dukes' stage, age at diagnosis, sex, and patient survival). Four hundred and sixty-one patients with colorectal cancer were evaluated (250 males and 211 females) and information obtained on their family history of cancer. Sex, age, and stage of disease were the only parameters that correlated significantly with survival. No relationship between family history of colorectal cancer and the prognostic variables was observed.

Adult

Primary gastric lymphoma.

The records of 30 patients with primary gastric lymphoma and a minimum of 5 years of follow-up were reviewed and clinical and pathologic prognostic factors analyzed. The overall 5-year survival was 40% (median 23 months). No significant relationship between surgical and patient age, sex, duration of symptoms, macroscopic appearance, or size of the primary lesion or degree of serosal infiltration was demonstrated. Stage of disease and site of primary had an impact on prognosis. Survival was improved in patients with stage I-II disease (P < 0.05) and in patients with primary located in the distal third of the stomach (P < 0.05). Although histology in all three classifications did not correlate well with survival, patients with low-grade lymphoma according to Kiel showed improved outcome (P < 0.05). Five-year survival of 11 patients with positive lymph nodes, 6 of whom were treated with cytotoxic therapy, was 54% and comparable to that of 7 patients (56%) with no nodal involvement who did not receive chemotherapy after surgery.

Adult

[Colorectal adenocarcinoma in patients with familial anamnesis positive for malignant neoplasms of the large intestine].

Familial aggregation of colorectal cancer occurs also among sporadic cases that are not part of defined genetic syndromes. First degree relatives of patients with "sporadic" colorectal cancer have a 3-4 fold increased risk of the same cancer. The aim of the present study is to investigate the relationship between a first degree family history of colorectal cancer and pathological and clinical features of the tumor (site, Dukes' stage, age at diagnosis, sex and survival of patients). 461 patients with colorectal cancer were evaluated (250 males and 211 females) after obtaining informations about their family history of cancer. 52 (11.25%) of them reported to have at least one close relative affected by intestinal cancer. Sex, age and stage of the disease are the only parameters that significantly affect survival. No relationship between family history of colorectal cancer and prognostic variables was observed.

Adenocarcinoma

Flow cytometric DNA index in the prognosis of colorectal cancer.

The authors investigated the relationship between flow cytometric DNA index (DI, defined as the ratio of the DNA content of malignant cells to that of normal cells) and other prognostic factors (grade and stage, anatomical site, age and sex) with the survival of 115 patients with colorectal cancer. Multiple biopsy specimens from 62 patients were taken during colonoscopy before surgery. Additional samples from 53 patients were obtained from paraffin-embedded material. All patients were treated with surgery only. Fresh-frozen material gave higher incidence of DNA aneuploidy than paraffin-embedded material (79% versus 41%). The patients with DNA diploid tumors (DI = 1) had a better overall survival than those with DNA aneuploid tumors (DI = 1). Among DNA aneuploid tumors, those with DI greater than 1.2 (excluding DI = 2) were worse than those with DI = 1.2 (excluding DI = 1) and DI = 2. Cox's regression analysis showed that pathologic stage was more important for prognosis than DNA index, whereas age, sex, histologic grade, and anatomic site were removed from the analysis as not relevant for prognosis. Relative risk of death (RR), in reference to patients with DI = 1 and Stages A + B (RR = 1), were RR = 1.8 for patients with carcinomas with Stage C. RR = 2.7 for patients with carcinomas with DNA near-diploid and DNA tetraploid tumors. RR = 3.5 for those with DI greater than 1.2 (excluding DI = 2), and RR = 8.0 for those with Stage D. These data indicate that flow cytometrically evaluated DI values have a relevant independent power for predicting the clinical outcome of colorectal cancer patients.

Aged

Palliative bipolar electrocoagulation treatment of malignant gastroesophageal strictures.

Seventeen patients with non-resectable circumferential malignant strictures of the esophagus (n = 13) or the gastroesophageal junction (n = 4) were treated with a bipolar electrocoagulation tumor probe (BICAP). None had received prior radiotherapy or chemotherapy. The mean tumor length was 7.2 cm. After treatment swallowing was improved in 86.7% of the patients. The mean duration of response to the first treatment was 18 days. Three major complications (1 fatal hemorrhage, 2 tracheoesophageal fistulae) and two minor complications (chest pain) were observed. The overall actuarial survival rate after 13 months of follow-up was 20%. The BICAP tumor probe can be considered an efficacious and safe device in selected patients with long, circumferential esophageal cancers.

Actuarial Analysis

DNA flow cytometry of endoscopically examined colorectal adenocarcinomas.

The purpose of the study was to evaluate the correlation of DNA-ploidy of colorectal adenocarcinomas (adk) with histological and clinical parameters including the survival of the patients. Multiple biopsies from 95 adk were taken during colonoscopy prior to surgery. The samples were used to obtain nuclei suspensions for specific staining of DNA content and high resolution flow cytometry. DNA-aneuploidy, i.e. the presence of more than one G0/G1 peak, was detected in 67/95 cases (71%). The individual-specific control mucosa was DNA-diploid in all cases. The mean fraction of S-phase cells was 7.2% in control mucosa and 13.6% in adk. DNA-ploidy did neither correlate with Dukes' stage nor with differentiation degree. Among the patients studied for the correlation of DNA ploidy with survival for a period extending to 30 months (n = 51), the DNA aneuploid group was estimated to be about 5 times as risky as the DNA diploid group with respect to the odds of dying. We conclude that DNA flow cytometry of colorectal adk may predict clinical outcome and be helpful in addition to histopathology.

Adenocarcinoma

Endoscopic papillosphincterotomy and surgical sphincteroplasty for the treatment of bile duct stones: a comparative analysis.

UNLABELLED: One hundred and ten subjects with cholelithiasis entered this retrospective study. Early and late results of 73 patients treated by endoscopic papillosphincterotomy (EPST) were compared to those of 37 patients who had surgical transduodenal papillo-sphincteroplasty (SST). The comparative analysis was made in terms of clinical, biochemical and ultrasonographic findings. The follow-up period ranged from 1 to 5 years in the first group and from 1 to 15 years in the second group. EPST and SST proved to be comparable in regard to operative mortality and morbidity. EPST failed in removing large or impacted bile duct stones in 47% of cases, while SST was uniformly successful. Long-term results were good in most patients, either when treated by EPST or SST. The 5-year failure rate was 8% after EPST and 0% after SST. In the surgical group, the 15-year failure rate was 5%. Serum alkaline phosphatase levels were higher after EPST than after SST, suggesting the persistence of some degree of biliary stasis in endoscopically managed patients. Pneumobilia was detected more often in surgical patients, indicating that SST does create a wide and permanent communication between the duodenum and the biliary system. IN CONCLUSION: 1) EPST may achieve acceptable success rates with low mortality and morbidity, even in high risk patients; 2) the high number of long-term good clinical results seems to indicate that sphincter re-stenosis after EPST is rare, at least for the first 5 years from operation; 3) SST is an effective and safe procedure, ensuring excellent long-term results, provided that the technique of and the indication for are correct (including Wirsung assessment); 4) the wide and permanent stoma created by SST is not associated with recurrent cholangitis, if bile duct re-stenosis does not occur.

Ampulla of Vater

Long-term postoperative results in 54 cases of early gastric cancer: the choice of surgical procedure.

Surgical experience on the management of early gastric carcinoma (EGC) related to a series of 54 subjects was observed from 1974 to 1984. Thirty-four patients were male, 20 were female; median age was 61.84 (range 22-79) years. Malignancy always occurred in the middle or distal third of the stomach. A partial subtotal gastrectomy (two-thirds of the stomach) with Roux en Y or Billroth II reconstruction was performed. Omentectomy and lymph node dissection of the primary and secondary groups of nodes, according to General Rules, was always performed. Age-corrected 5- and 10-year survival rates were 95.7% and 84.3%, respectively. Based on their experience, the authors discuss the surgical approach to EGC stressing the need for an accurate lymph node dissection and pointing out that results of subtotal gastrectomy are similar to that reported in the literature for total gastrectomy. The only absolute need for a total gastrectomy may be the presence of an EGC in the proximal third of the stomach. To this end the authors compare their results with 5- and 10-year series from Japanese and western countries reported in the literature.

Adult

Growth of cells from esophageal squamous cell carcinoma biopsies in a reconstituted basement membrane.

Cells from esophageal carcinoma biopsies were cultured on or inside a three-dimensional basement membrane matrix (matrigel). Their growth was compared to cells derived from control esophageal biopsies. Cells from both normal and neoplastic tissue attached poorly to tissue culture plastic. Matrigel coating improved adhesion and growth. When cells were grown inside a matrigel matrix, a striking difference was noticed between carcinoma cells and controls. Carcinoma cells grew invasively in the three-dimensional substrate and digested the matrix after a few weeks; control cells did not grow and only a few necrotic cells were visible with time. Matrigel provided a better growth substrate than plastic for esophageal derived cells and discriminated between carcinoma-derived and control cells when used as a three-dimensional growth substrate. Our studies suggest a possible use of matrigel for the selective growth of tumor cells derived directly from tissue biopsies.

Basement Membrane

CA 19-9 and CA 50 in benign and malignant pancreatic and biliary diseases.

Serum concentrations of the CA 19-9 and CA 50 antigens were determined in 129 patients with malignant and benign biliary and pancreatic diseases. Values for the two markers were highly correlated (P less than 0.001). The concentrations of CA 19-9 and CA 50 were positive in 84.6% and 80.7% of patients with pancreatic cancer, respectively. The overall specificity of CA 19-9 (92.4%) was slightly higher than that of CA 50 (88.5%). The sensitivity of CA 50 (91.3%) was greater than that of CA 19-9 (73.9%) in patients with diseases of the biliary tract. Elevated concentrations of CA 19-9 (12.9%) and CA 50 (35.2%) were also found in a number of cases with benign disease, especially in patients with obstructive jaundice. These data suggest that both CA 19-9 and CA 50 can be useful markers of pancreatic cancer in nonjaundiced patients. The joint use of the two markers does not yield a better diagnostic resolution than the use of either one alone.

Adenocarcinoma

Family history of colorectal cancer as a risk factor for benign and malignant tumours of the large bowel. A case-control study.

The relationship between first degree family history of colorectal cancer and the risk of benign or malignant tumours of the large bowel was investigated in a case-control study. Two groups of cases (283 patients with adenomatous polyps and 414 patients with adenocarcinoma of the large bowel) and 2 groups of controls (399 polyp-free subjects and 456 hospitalized patients) were interviewed. Since no difference in the frequency of family history between the 2 control groups was detected, these were lumped together. A 3-fold increase in risk of adenomatous polyps in relatives of patients with colon cancer was observed (OR = 3.18, 95% CI 2.06-4.89). The relative risk of colorectal cancer among relatives of patients with adenocarcinoma was 2.36 (95% CI 1.54-3.60). No significant difference in the frequency of first degree relatives with a history of cancer of the large bowel was detected between patients with colorectal cancer and those with adenomatous polyps. When only history of colorectal cancer among parents was considered, the results closely paralleled those of the previous analysis.

Adenoma

Flow cytometric DNA ploidy in colorectal adenomas and family history of colorectal cancer.

Flow cytometric DNA ploidy of colorectal adenomas resected from 34 patients and the corresponding patient family history in first-degree relatives were evaluated. The samples with at least two separate G0-G1 peaks were defined as DNA aneuploid. The correlation between DNA ploidy and family history was evaluated using two-by-two contingency tables. This correlation was highly statistically significant: seven of nine patients (78%) with positive family histories, and five of 25 (20%) with negative family history had adenomas with DNA aneuploid stemlines (P = 0.0068). The overall DNA aneuploidy incidence was 12 in 34 cases (35.2%). The combined information of DNA aneuploidy and positive family history of colorectal cancer in patients with colorectal adenomas may help to better understand the process of colon carcinogenesis and to identify patients who have a higher risk for developing a malignancy.

Adenoma

DNA flow cytometry of endoscopically examined colorectal adenomas and adenocarcinomas.

DNA ploidy of 64 colorectal adenomas and 49 adenocarcinomas, examined endoscopically, was studied by flow cytometry. We found DNA aneuploidy in none of the 105 normal mucosa samples (0%), in 20 adenomas (31%), and in 36 adenocarcinomas (74%). DNA ploidy of adenomas correlated with size (P = 0.02) and degree of dysplasia (P less than 0.01) but not with histologic type. Adenomas had a 45% incidence of DNA aneuploid stem lines in the DNA index range of 0.80-1.20, compared with 8% in the case of adenocarcinomas. The distribution of the DNA index values of adenocarcinomas was approximately normal, with a mean value 1.63 +/- 0.28. The mean DNA index for the three cases of "carcinoma in adenoma" with invasion of the stalk of the adenoma was 1.52 +/- 0.18. These results, using DNA flow cytometry, provide evidence for the progression of colorectal adenoma to adenocarcinoma. The classification of adenomas according to DNA ploidy may be information of considerable practical value to the clinician in predicting risk of further adenomas and/or risk of cancer.

Adenocarcinoma

Tissue sampling from the common bile duct through endoscopic retrograde cholangiopancreatography, endoscopic papillo(sphinctero)tomy and drainage in juxtapapillary malignancies.

In 22 patients with radiological evidence of a malignant stricture or an obstruction of the common bile duct, endobiliary tissue specimens were obtained through endoscopic retrograde cholangiopancreatography. An endoscopic papillo(sphinctero)tomy was necessary in 9 of the 22 patients. The following techniques were employed: (1) forceps biopsy of the papillary infundibulum and/or of the common bile duct; (2) brush cytology in the same sites as above; (3) biliary juice cytology obtained by a nasobiliary drainage tube. In 8 patients, two different sampling techniques were used. The final diagnosis was established by means of pathological evaluation of surgical or necroscopic material. The diagnostic adequacy was 100% for biopsy, 88% for brush cytology, and 62% for bile cytology. The sensitivity was 100%, 66%, and 25%, respectively, for the above techniques. From 6 cases without biliary cancer, the specificity was 100%. These data show that biopsy specimens alone provide a definitive preoperative diagnosis in most cases, provided adequate samples are obtained.

Aged