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Lanzanova C, Arrigoni A, Valoti P, Alfieri M, Locatelli S. Agronomic performance, chemical composition and Fusarium verticillioides resistance of Italian white maize varieties. Quality Assurance and Safety of Crops & Foods 2019. [DOI: 10.3920/qas2018.1451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- C. Lanzanova
- Council for Agricultural Research and Economics (CREA), Research Centre for Cereal and Industrial Crops, via Stezzano 24, 24126 Bergamo, Italy
| | - A. Arrigoni
- Council for Agricultural Research and Economics (CREA), Research Centre for Cereal and Industrial Crops, via Stezzano 24, 24126 Bergamo, Italy
| | - P. Valoti
- Council for Agricultural Research and Economics (CREA), Research Centre for Cereal and Industrial Crops, via Stezzano 24, 24126 Bergamo, Italy
| | - M. Alfieri
- Council for Agricultural Research and Economics (CREA), Research Centre for Cereal and Industrial Crops, via Stezzano 24, 24126 Bergamo, Italy
| | - S. Locatelli
- Council for Agricultural Research and Economics (CREA), Research Centre for Cereal and Industrial Crops, via Stezzano 24, 24126 Bergamo, Italy
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Arrigoni A, Bargiacchi S, Benatti P, Heouaine A, Mareni C, Messerini L, Montera MP, Mori S, Percesepe A, Presciuttini S, Rocci MP, Sala P. Collection of Italian Hereditary Non-Polyposis Colorectal Cancer (HNPCC) Pedigrees. Tumori 2018; 82:151-79. [PMID: 8644378 DOI: 10.1177/030089169608200210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A Arrigoni
- Servizio di Gastroenterologia ed Endoscopia Digestiva, Ospedale San Giovanni Antica Sede, Torino, Italy
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Bertario L, Aste H, Arrigoni A, Fracasso P, Rossini FP, Rossetti C, Valanzano R. Clinical Aspects and Management of Hereditary Non-Polyposis Colorectal Cancer (HNPCC). Tumori 2018; 82:117-21. [PMID: 8644373 DOI: 10.1177/030089169608200205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hereditary non-polyposis colorectal cancer (HNPCC) is an autosomical dominant trasmitted disease phenotypically defined according to the “Amsterdam criteria” as follows: at least 3 affected relatives, one of whom first degree relative of other two, at least two successive generations affected. Important cardinal features are: 1 prevalent proximal location of cancers (above splenic flexure); 2 multiple synchronous or methachronous large bowel cancers; 3 early age of onset (<50 years); 4 presence of extracolonic cancers (endometrium, stomach, urinary tract, skin). The treatment is essentially surgical and total colectomy with ileo-rectum anastomosis is already proposed as standard procedure with annual endoscopic examination of retained rectum. The screening of individuals at risk, so determined by the analysis of pedigree or the results of molecular tests, must be performed every 1-2 years by colonoscopy starting around the age of 25 years. In this review are described and analysed the spectrum of the disease with particular attention to the frequency and characteristics of extracolonic cancers. Moreover, the guidelines of the surveillance and screening are reported following the data of the literature and as proposed by the International Collaborative Group (ICG-HNPCC).
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Affiliation(s)
- L Bertario
- Divisione Chirurgia Apparato Digerente, Istituto Nazionale dei Tumori, Milano, Italy
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Arrigoni A, Andriulli A, Gindro T, Piantino P, Capussotti L, Rizzetto M. Pattern Analysis of Serum alpha-fetoprotein in the Early Diagnosis of Hepatocellular Carcinoma in Liver Cirrhosis. Int J Biol Markers 2018; 3:172-6. [PMID: 2466093 DOI: 10.1177/172460088800300305] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In a surveillance program for hepatocellular carcinoma (HCC), serum alpha-fetoprotein (AFP) was determined every 4 months in 164 patients with liver cirrhosis. Ultrasonography (US) was performed yearly or as dictated by abnormal AFP levels. During a follow-up of 32.5 ± 20.8 months HCC was identified by US in 16 patients. In 9 of them the AFP levels rose steadily over 4 months, increasing 7, 8 and 12 months in 3 cases before the lesion became detectable by US. In 4 patients tumors developed despite persistently normal AFP levels. Nine more patients showed abnormal fluctuations of AFP but HCC was not detected. AFP sensitivity was higher at a low cutoff point (40 ng/ml) while specificity of the test appeared higher at the 200 ng/ml cutoff point. An AFP value rising steeply over a few months appeared more reliable than a fixed preset threshold in indicating carcinomatous transformation. Screening for AFP can be expected to uncover about 3/4 of HCC developing in cirrhotics with few false-positive reactions. The test may have a unique role in identifying a subset of liver tumors whose early expression is AFP production.
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Affiliation(s)
- A Arrigoni
- Division of Medicine, Santo Spirito Hospital, Bra (To), Italy
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Recanati F, Arrigoni A, Scaccabarozzi G, Marveggio D, Melià P, Dotelli G. LCA Towards Sustainable Agriculture: The Case Study of Cupuaçu Jam from Agroforestry. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.procir.2017.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ruppert SM, Hawn TR, Arrigoni A, Wight TN, Bollyky PL. Tissue integrity signals communicated by high-molecular weight hyaluronan and the resolution of inflammation. Immunol Res 2015; 58:186-92. [PMID: 24614953 DOI: 10.1007/s12026-014-8495-2] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The extracellular matrix polysaccharide hyaluronan (HA) exerts size-dependent effects on leukocyte behavior. Low-molecular weight HA is abundant at sites of active tissue catabolism and promotes inflammation via effects on Toll-like receptor signaling. Conversely, high-molecular weight HA is prevalent in uninjured tissues and is anti-inflammatory. We propose that the ability of high-molecular weight but not low-molecular weight HA to cross-link CD44 functions as a novel form of pattern recognition that recognizes intact tissues and communicates "tissue integrity signals" that promote resolution of local immune responses.
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Affiliation(s)
- S M Ruppert
- Division of Infectious Diseases, Stanford University School of Medicine, 300 Pasteur Drive, Rm. L-133, Stanford, CA, 94305-5107, USA
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7
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Pellicano R, Ribaldone DG, Saracco GM, Leone N, De Angelis C, Arrigoni A, Morello E, Sapone N, Cisarò F, Astegiano M. Benefit of supplements in functional dyspepsia after treatment of Helicobacter pylori. MINERVA GASTROENTERO 2014; 60:263-268. [PMID: 25384804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Functional dyspepsia, though benign, leads to deterioration of the quality of life and high costs for healthcare systems. The optimal therapy for functional dyspepsia is still to be defined because of its multifactorial pathogenesis. In an open multicentric study of patients with functional dyspepsia, we prospectively evaluated the benefit of treatment with a food supplement composed of sodium alginate, carbonate calcium, pineapple, papaya, ginger, α-galactosidase and fennel (Perdiges, Bioten Snc, Turin, Italy). METHODS Ninety-one consecutive patients were included, suffering from functional dyspepsia, who had been previously submitted to therapy to eradicate the infection from Helicobacter pylori (H. pylori) and were waiting to perform the Urea Breath Test (UBT). The primary goal was to establish the percentage of patients who continued to abstain from proton pump inhibitors (PPI) as they waited to carry out the UBT, differentiating between patients who were treated (N.=55) with Perdiges and those who were not (N.=36). Our secondary goal was to document the differences within the 2 groups in terms of symptoms perceived between the start and end of the observation period. The wellness reported, during or in absence of treatment with Perdiges, was evaluated by the use of the VAS scale (Visual Analogical Scale) completed before the start of the treatment and after 30 days. RESULTS All the patients treated with Perdiges (55/55, 100%) and 31/36 (86.1%) patients who were not (P=0.008) continued to abstain from PPI in the period awaiting the UBT. The VAS scale of those who took Perdiges improved on average by 1.78 points versus a worsening of 0.08 points of those who did not take it (P<0.0001). Furthermore, while among those who took Perdiges there was a statistically significant improvement (P<0.0001) in the VAS scale, between the baseline and the end of treatment, a worsening of 0.08 points (P=0.78) was noticed among the patients who did not take it. CONCLUSION Perdiges is significantly effective in the period following treatment to eradicate the infection from H. pylori in patients with functional dyspepsia. This allows to reduce the need to use antisecretive drugs. Further randomised studies, with wide ranging case histories, must assess its long-term efficacy.
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Affiliation(s)
- R Pellicano
- Department of Gastroenterology and Hepatology San Giovanni Battista (Molinette) Hospital Turin, Italy -
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8
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Cesca F, Yabe A, Spencer-Dene B, Arrigoni A, Al-Qatari M, Henderson D, Phillips H, Koltzenburg M, Benfenati F, Schiavo G. Kidins220/ARMS is an essential modulator of cardiovascular and nervous system development. Cell Death Dis 2011; 2:e226. [PMID: 22048169 PMCID: PMC3223693 DOI: 10.1038/cddis.2011.108] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The growth factor family of neurotrophins has major roles both inside and outside the nervous system. Here, we report a detailed histological analysis of key phenotypes generated by the ablation of the Kinase D interacting substrate of 220 kDa/Ankyrin repeat-rich membrane spanning (Kidins220/ARMS) protein, a membrane-anchored scaffold for the neurotrophin receptors Trk and p75NTR. Kidins220 is important for heart development, as shown by the severe defects in the outflow tract and ventricle wall formation displayed by the Kidins220 mutant mice. Kidins220 is also important for peripheral nervous system development, as the loss of Kidins220 in vivo caused extensive apoptosis of DRGs and other sensory ganglia. Moreover, the neuronal-specific deletion of this protein leads to early postnatal death, showing that Kidins220 also has a critical function in the postnatal brain.
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Affiliation(s)
- F Cesca
- Department of Neuroscience and Brain Technologies, The Italian Institute of Technology, Genoa, Italy.
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9
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Arrigoni A, Sprujevnik T, Alvisi V, Rossi A, Ricci G, Pennazio M, Spandre M, Cavallero M, Bertone A, Foco A, Rossini FP. Clinical identification and long-term surveillance of 22 hereditary non-polyposis colon cancer Italian families. Eur J Gastroenterol Hepatol 2005; 17:213-9. [PMID: 15674100 DOI: 10.1097/00042737-200502000-00013] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To assess the efficacy of a hereditary non-polyposis colon cancer (HNPCC) identification and surveillance policy. METHODS Familial clustering of colorectal cancer (CRC) and extracolonic cancers (ECs) was investigated in 1520 consecutive CRC patients and relatives. HNPCC was identified by Amsterdam criteria, and individuals at risk were offered biennial colonoscopy and other examinations, starting from age 25 years. RESULTS Twenty-two HNPCC families were identified. The CRC prevalence was 27.8% (121/435), decreasing from 59.4% in the first generation to 24.4% and 8% in the second and third generation, respectively. Twenty-nine patients had multiple CRC and 34 patients (in 12 families) had ECs.A total of 199/331 at-risk individuals accepted surveillance. The mean follow-up was 48+/-32 months. CRCs were detected at first surveillance in four out of 199 surveilled individuals (2%); in two surveilled individuals (1%), three CRCs developed during follow-up. The overall CRC incidence was 7/199 (3.5%) in surveilled individuals and 5/132 (3.7%) in unsurveilled individuals. CRCs were less advanced in surveilled than in unsurveilled patients. Eleven individuals had 22 adenomas (one with high-grade dysplasia). Three individuals had adenomas at first surveillance; two of them and eight more individuals during surveillance. Seven surveilled individuals and six unsurveilled individuals, all belonging to families with a history of EC, had EC during the study period. All patients with CRC detected by surveillance are alive. One of the unsurveilled patients who had CRC died 18 months after the diagnosis. CONCLUSIONS Data confirm the importance of the family history collected in each patient with CRC for identification of HNPCC and support the efficacy of repeated colonoscopies for early diagnosis and prevention of CRC in at-risk members. Reasons for surveillance failure could be an accelerated progression of small adenomas and a lesion missing at colonoscopy. Longer follow-up is required to assess the efficacy of surveillance for EC.
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Affiliation(s)
- A Arrigoni
- Division of Gastroenterology, Department of Oncology, S. Giovanni A.S. Hospital, Turin, Italy.
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10
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Degiuli M, Mineccia M, Bertone A, Arrigoni A, Pennazio M, Spandre M, Cavallero M, Calvo F. Outcome of laparoscopic colorectal resection. Surg Endosc 2004; 18:427-32. [PMID: 14752626 DOI: 10.1007/s00464-002-9267-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2002] [Accepted: 04/16/2003] [Indexed: 02/08/2023]
Abstract
BACKGROUND The aim of this study was to assess the feasibility and safety of laparoscopic surgery for colorectal diseases. METHODS A retrospective review was undertaken of all patients undergoing a laparoscopic colorectal procedure (LCP) for large bowel disease. All operations were performed by a single experienced team. Patients were divided chronologically into three consecutive groups (G1, G2, and G3). Data collection included the incidence and cause of both "proper" and "mandatory" conversions to laparotomy, the incidence and type of early and late postoperative complications, incidence of operative mortality, and the length of hospital stay. The incidences of conversion to laparotomy and of early and late postoperative complications were also determined as related to diagnosis, type of LCP attempted, and chronological group. RESULTS Between January 1996 and December 2001, a total of 108 patients (49 men and 59 women) with a mean age of 65.1 years underwent an LCP for colorectal disease. Proper conversion to open surgery was necessary in five patients (4.6%), whereas a mandatory conversion was needed in 10 with patients advanced cancer (9.2%). The overall morbidity rate was 11.9%. There were no anastomotic leaks. In two patients (1.85%) developed a complication requiring reoperation. Postoperative mortality was nil. Mean postoperative hospital stay was 7.2 days. The rates of conversion and of early and late complications decreased through the three chronological periods. No trocar site recurrences were observed in the cancer patients. CONCLUSION Laparoscopic colorectal surgery performed in experienced centers is safe; the observed morbidity and mortality rates are low and acceptable and compare favorably to those observed after standard open surgery.
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Affiliation(s)
- M Degiuli
- Department of Oncology, Division of Surgery, San Giovanni Battista di Torino Hospital, Via Cavour 31, 10123 Turin, Italy.
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Pennazio M, Arrigoni A, Sprujevnik T, Bertone A, Cavallero M, Spandre M, Calvo F, Mineccia M, Berardengo E, Canavese G, Alvisi V. Autoimmune polyglandular syndrome type II associated with jejunal gastrointestinal stromal tumor: diagnosis by capsule endoscopy. Endoscopy 2004; 36:248-9. [PMID: 14986230 DOI: 10.1055/s-2004-814260] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- M Pennazio
- Division of Gastroenterology, Department of Oncology, S. Giovanni AS Hospital, Turin, Italy.
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12
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Gismondi V, Bonelli L, Sciallero S, Margiocco P, Viel A, Radice P, Mondini P, Sala P, Montera MP, Mareni C, Quaia M, Fornasarig M, Gentile M, Pietro G, Rossini P, Arrigoni A, Meucci GM, Bruzzi P, Varesco L. Prevalence of the E1317Q variant of the APC gene in Italian patients with colorectal adenomas. Genet Test 2003; 6:313-7. [PMID: 12537656 DOI: 10.1089/10906570260471859] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Loss of APC is an initial, rate-limiting event in inherited and sporadic colorectal tumorigenesis. Rare germline APC mutations have been identified in patients with multiple colorectal adenomas. Recently, the E1317Q APC variant has been associated with a predisposition to the development of multiple colorectal adenomas. In this study, the prevalence of the E1317Q variant was examined in 182 patients with single or multiple colorectal adenomas, and in 235 controls. In all, E1317Q was identified in two of 182 patients with adenomatous polyps (1.1%) and in two of 235 controls (0.8%) (p = 0.59). The risk of harboring adenoma(s) among subjects bearing the E1317Q variant was 1.29 (95% CI 0.09-18.0). No difference in the prevalence of E1317Q between cases with single (2.0%) or multiple colorectal adenomas (0.7%) and controls (0.8%) was found. None of the subjects with a family history of colorectal cancer carried the E1317Q variant. In conclusion, our results confirm that only a very small fraction of colorectal adenomas may be associated with the presence of E1317Q.
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Affiliation(s)
- V Gismondi
- National Cancer Institute-Genova, 16132 Genova, Italy
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Biancone L, Pavia M, Del Vecchio Blanco G, D'Incà R, Castiglione F, De Nigris F, Doldo P, Cosco F, Vavassori P, Bresci GP, Arrigoni A, Cadau G, Monteleone I, Rispo A, Fries W, Mallardi B, Sturniolo GC, Pallone F. Hepatitis B and C virus infection in Crohn's disease. Inflamm Bowel Dis 2001; 7:287-94. [PMID: 11720317 DOI: 10.1097/00054725-200111000-00002] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Patients with Crohn's disease (CD) are at higher risk of hepatitis C (HCV) and B virus (HBV) infection, because of surgical and/or endoscopic procedures. However, the prevalence of HCV and HBV infection in CD is unknown. This issue may be relevant because of the growing use of immunomodulatory drugs in CD. The purpose of this study was to assess, in a multicenter study, the prevalence and risk factors of HCV and HBV infection in CD. The effect of immunomodulatory drugs for CD on the clinical course of hepatitis virus infections and of interferon-alpha (IFN-alpha) on the course of CD was examined in a small number of patients. Sera from 332 patients with CD and 374 control subjects (C) were tested for the following: hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), HBcAb, HBeAg, HBeAb, anti-HCV, and HCV-RNA. An additional 162 patients with ulcerative colitis (UC) were tested as a disease control group. Risk factors were assessed by multivariate statistical analysis. Infection by either HCV or HBV was detected in 24.7% of patients with CD. In the age groups younger than 50 years, HCV prevalence was higher in CD than in C (p = 0.01). HCV infection in CD was associated with surgery (OR 1.71; 95% CI 1.00-2.93; p = 0.04), blood transfusions (OR 3.39; 95% CI 1.04-11.04; p = 0.04), and age (OR 2.3; 95% CI 1.61-3.56; p < 0.001). The event CD-related surgery appeared to be the main risk factor for HCV infection in CD. HCV prevalence was higher in CD (7.4%) than in UC (0.6%) (p = 0.001). HBcAb positivity was higher in CD (10.9%) and UC (11.5%) than in C (5.1%) (CD vs. C: p = 0.016; UC vs. C: p = 0.02), associated with age (OR 2.08; 95% CI 1.37-3.17; p = 0.001) and female gender (OR 2.68; 95% CI 1.37-3.17; p = 0.001) in CD and to UC duration (OR 1.20; 95% CI 1.06-1.36; p = 0.002). Immunomodulatory drugs did not influence the course of HBV or HCV infection in seven patients with CD, and IFN-alpha for chronic hepatitis C did not affect CD activity in six patients with CD. It is concluded that HBV prevalence is higher in CD than in C at all ages, whereas HCV prevalence is increased in young patients with CD, because of a greater need for surgery. The higher HCV (but not HBV) prevalence in CD than in UC suggests that the host immune response may influence the risk of HCV infection. Although a relatively high proportion of patients with CD showed HBV and/or HCV infections, this should not influence treatment strategies for CD.
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Affiliation(s)
- L Biancone
- Università di Roma Tor Vergata, Rome, Italy.
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Saracco G, Ciancio A, Ghisetti V, Rocca G, Cariti G, Andreoni M, Tabone M, Roffi L, Calleri G, Ballaré M, Terreni N, Sartori M, Tappero GF, Traverso A, Poggio A, Orani A, Maggi G, Di Napoli A, Arrigoni A, Rizzetto M. Treatment with interferon-alpha2b of naive non-cirrhotic patients with chronic hepatitis C according to viraemia and genotype. Results of a randomized multicentre study. The North West Italian Hepatological Group. Eur J Gastroenterol Hepatol 2001; 13:149-55. [PMID: 11246614 DOI: 10.1097/00042737-200102000-00010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To establish whether tailoring the dosage of interferon (IFN)-alpha2b in non-cirrhotic naive patients with chronic hepatitis C according to hepatitis C virus (HCV) genotype and viraemic level improves the rate of sustained response (normal alanine aminotransferase values and HCV-RNA negativity 6 months after the end of therapy). PATIENTS A total of 538 consecutively collected HCV-positive patients with non-cirrhotic chronic hepatitis who had not been previously treated. METHODS Quantitative viraemia and genotype were determined in each patient by a core laboratory. The patients were randomized to: Group 1, 86 patients with genotype non-1 and viraemia < 1,000,000 HCV genome equivalents/ml (GenEq/ml) treated with 3 Million Units (MU) IFN three times weekly (t.i.w.) for 1 year; Group 2, 42 patients with genotype 1 and viraemia < 1,000,000 GenEq/ ml treated with 3 MU IFN t.i.w. for 1 year; Group 3, 46 patients with genotype 1 and viraemia < 1,000,000 GenEq/ ml treated with 5 MU IFN t.i.w. for 1 year; Group 4, 85 patients with genotype non-1 and viraemia > 1,000,000 GenEq/ml treated with 3 MU IFN t.i.w. for 1 year; Group 5, 88 patients with genotype non-1 and viraemia > 1,000,000 GenEq/ml treated with 5 MU IFN t.i.w. for 1 year; Group 6, 94 patients with genotype 1 and viraemia > 1,000,000 GenEq/ml treated with 3 MU IFN t.i.w. for 1 year; Group 7, 97 patients with genotype 1 and viraemia > 1,000,000 GenEq/ml treated with 5 MU IFN daily for 2 months followed by 5 MU t.i.w. for a further 10 months. RESULTS According to an intention-to-treat analysis, a sustained virological response (negative HCV-RNA by polymerase chain reaction 6 months after the end of therapy) was observed in 42% of Group 1 patients, in 21% of Group 2 patients versus 24% of Group 3 patients [P = not significant (NS)], in 28% of Group 4 patients versus 35% of Group 5 patients (P = NS), and in 8.5% of Group 6 patients versus 12% of Group 7 patients (P = NS). CONCLUSIONS Even though a trend towards a therapeutic improvement is observed, the adoption of more aggressive IFN protocols, such as induction therapy, does not appear to significantly improve the rate of sustained response in patients with chronic hepatitis C associated with HCV genotype 1 and highly viraemic levels compared with standard therapy. Moreover, patients with only one unfavourable predictive factor (genotype 1 or high viraemia) do not gain major therapeutic benefits when treated with high doses of IFN.
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Affiliation(s)
- G Saracco
- Dipartimento di Gastroenterologia, Ospedale Molinette, Torino, Italy.
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15
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De Giorgio R, Barbara G, Stanghellini V, Cogliandro RF, Arrigoni A, Santini D, Ceccarelli C, Salvioli B, Rossini FP, Corinaldesi R. Idiopathic myenteric ganglionitis underlying intractable vomiting in a young adult. Eur J Gastroenterol Hepatol 2000; 12:613-6. [PMID: 10912477 DOI: 10.1097/00042737-200012060-00006] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Inflammatory infiltration of intestinal myenteric plexuses (i.e. myenteric ganglionitis), along with severe intestinal motor abnormalities, may accompany paraneoplastic syndromes, neurological disorders and gastrointestinal infections, although rare cases can be idiopathic. In this report, we describe the case of a patient who presented with chronic intractable vomiting and weight loss associated with idiopathic myenteric ganglionitis mainly involving the stomach. Tissue analysis showed that the inflammatory infiltrate comprised T lymphocytes (CD4+ and CD8+), and peptide immunolabelling revealed a marked decrease of substance P/tachykinin immunoreactive staining in nerve fibres and myenteric neurones. Following systemic steroid therapy, the patient's symptoms dramatically improved, and after one year of follow-up his general condition remains satisfactory. The possible mechanisms leading to symptom generation and gastric dysmotility in the context of an idiopathic myenteric ganglionitis are discussed.
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Affiliation(s)
- R De Giorgio
- Department of Internal Medicine & Gastroenterology, University of Bologna, Italy
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Pennazio M, Arrigoni A, Rossini FP. Enteroscopic identification of an adenocarcinoma of the small bowel in a patient with previously unrecognized hereditary nonpolyposis colorectal cancer syndrome. Am J Gastroenterol 1999; 94:1962-6. [PMID: 10406269 DOI: 10.1111/j.1572-0241.1999.01240.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Tumors of the small bowel are uncommon and seldom suspected on a clinical basis. Together with the relative inaccessibility of the small bowel to endoscopic investigation, the rarity of these tumors undoubtedly delays their diagnosis. The case reported is of a patient with an adenocarcinoma of the jejunum presenting as gastrointestinal bleeding of obscure origin. Diagnosis was by push enteroscopy, after several years of unsuccessful radiological and upper and lower endoscopic evaluation. The patient's family fulfilled the Amsterdam criteria for hereditary nonpolyposis colorectal cancer syndrome, which was previously unrecognized. This report emphasizes the value of push enteroscopy and the limits of radiography of the small bowel when investigating patients with obscure GI bleeding. It also underlines the importance of a careful evaluation of the pedigree (concerning history of colorectal and extracolonic cancer) of all patients, including those who present with adenocarcinoma of the small bowel; it is similarly important to consider the possibility of small bowel cancer in members of families with hereditary nonpolyposis colorectal cancer (HNPCC) syndrome.
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Affiliation(s)
- M Pennazio
- Department of Oncology, S. Giovanni A.S. Hospital, Turin, Italy
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Bertoni G, Sassatelli R, Nigrisoli E, Pennazio M, Tansini P, Arrigoni A, Rossini FP, Ponz de Leon M, Bedogni G. Dysplastic changes in gastric fundic gland polyps of patients with familial adenomatous polyposis. Ital J Gastroenterol Hepatol 1999; 31:192-7. [PMID: 10379478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Fundic gland polyps are the most common gastric lesion in patients with familial adenomatous polyposis and are traditionally considered a condition with no malignancy potential. However, some reports have recently questioned this view. AIMS To prospectively evaluate their prevalence and the associated dysplastic/malignant changes in a series of affected patients. PATIENTS AND METHODS Thirty-seven affected patients were carefully investigated by upper endoscopy over a three-year period. Multiple (at least 10) complete excisions of any representative polyp of the body-fundus were performed and a thorough pathological search for microscopic adenomatous/dysplastic changes carried out. RESULTS Of 37 patients, 19 (51.3%) showed gastric fundic gland polyposis and 18 of them gave consent for polypectomies. Overall, 425 endoscopic polypectomies were performed, with a mean of 23.6 +/- 14.6 per patient. At pathology, all excised polyps of the body-fundus were found to be fundic glandular. Microscopic adenomatous changes within such polyps were identified in 8 (44.4%) patients. All the adenomatous foci revealed mild dysplasia with no case of severe atypia or carcinoma. Patients with microadenomas showed a significantly higher total number of gastric polyps compared with those without microadenomas (p < 0.03). No other differences between the two groups were observed. Two further patients presented microadenomas in apparently normal antral mucosa and one also showed a 6 mm antral adenoma with mild dysplasia. Finally, the search for Helicobacter pylori was always negative. CONCLUSIONS Patients with familial adenomatous polyposis and gastric fundic gland polyps have a high prevalence of microscopic adenomatous foci within such lesions; nevertheless, these foci seem not to be associated with signs of severe atypia or carcinoma. Moreover, microadenomas are ubiquitous throughout the stomach, as well as in the rest of the gut, and their natural history is still undefined. Thus, their malignancy potential remains uncertain. More extensive follow-up is warranted to better investigate the long-term biological behaviour of these lesions but, at present, our data do not support the need for a change in the usual intervals of upper endoscopy surveillance in familial polyposis patients with or without gastric fundic glands polyps.
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Affiliation(s)
- G Bertoni
- Digestive Endoscopy Service, S. Maria Nuova Hospital, Reggio Emilia
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Gindro T, Arrigoni A, Martinasso G, Rosina F, Perardi S, Cappello N, Benedetti P, Actis GC, Verme G, Rizzetto M. Monoethyl glycine xylidide (MEGX) test evaluation in primary biliary cirrhosis: comparison with Mayo score. Eur J Gastroenterol Hepatol 1997; 9:1155-9. [PMID: 9471020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE To evaluate the clinical and prognostic value of the monoethyl glycine xylidide (MEGX) test in patients with primary biliary cirrhosis (PBC) in comparison with the Mayo score (Mayo). DESIGN A prospective study. METHODS MEGX determinations at enrolment were compared to the Mayo score as well as to conventional clinical and laboratory parameters in 92 patients with PBC. RESULTS The MEGX test yielded higher basal values in long-term survivors compared to patients that were transplanted or died during the follow up; patients belonging to the last two groups displayed significantly higher Mayo scores at baseline. Although values for prothrombin time, serum albumin, alkaline phosphatase, cholesterol, cholinesterase, and gamma-glutamyltranspeptidase were significantly different in survivors compared to either transplanted or dead patients at univariate analysis, the multivariate analysis demonstrated an independent prognostic value for the MEGX and the Mayo score solely. The best discrimination between probability of death or survival was achieved with a cutoff value of 25 ng/ml for the MEGX test and of 6 for the Mayo score. When plotting both MEGX test and Mayo score, the point distribution displayed a bimodal trend, and the wide range of values given by the MEGX test was observed to supply a more precise assessment of liver reservoir and a better discrimination of progressive changes in liver function; the limited range of the Mayo score for values below 6 could only identify gross deteriorations. CONCLUSION Our data show that the asymptomatic progressive functional deterioration occurring during the natural history of PBC can be monitored by the MEGX test because it appears to be able to identify abnormalities prior to the onset of alterations in conventional laboratory and/or clinical parameters which are likely to affect the Mayo score.
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Affiliation(s)
- T Gindro
- Department of Gastroenterology, Molinette Hospital, Turin, Italy
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Bertario L, Arrigoni A, Aste H, Fracasso P, Ponz de Leon M, Tonelli F, Heonaine A. Recommendations for Clinical Management of Familial Adenomatous Polyposis. Tumori 1997; 83:800-3. [PMID: 9428910 DOI: 10.1177/030089169708300504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- L Bertario
- Department of Surgery of the Digestive Tract, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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20
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Bertoni G, Sassatelli R, Nigrisoli E, Pennazio M, Tansini P, Arrigoni A, Ponz de Leon M, Rossini FP, Bedogni G. High prevalence of adenomas and microadenomas of the duodenal papilla and periampullary region in patients with familial adenomatous polyposis. Eur J Gastroenterol Hepatol 1996; 8:1201-6. [PMID: 8980941 DOI: 10.1097/00042737-199612000-00013] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Patients with familial adenomatous polyposis (FAP) are traditionally considered to be at high risk for duodenal-papillary and periampullary adenomas and cancer. AIM To evaluate prospectively the prevalence, histology and clinical significance of ampullary and periampullary macroscopic and microscopic lesions in our population of affected patients. SETTING Three gastroenterological departments of northern Italian hospitals. PATIENT AND METHODS Twenty-five affected patients were carefully investigated over a 24-month period by end-viewing and side-viewing upper panendoscopy. Biopsies were performed on representative macroscopic lesions and randomly on normal-appearing papillary and periampullary mucosa. RESULTS Seven patients had macroscopic adenomas of the duodenal papilla, three of the periampullary region and five at both sites (cumulative prevalence 40%). An additional six patients had macroadenomas in the rest of the duodenum (overall prevalence 64%). Microscopic adenomas were identified in nine and two patients in the papilla and periampullary region, respectively, and in three at both sites (overall prevalence 44%). Thus, a total of 17 (68%) patients presented macro- or microadenomas at these locations. The prevalence rose to 72%, when a further patient with macroadenomas in the rest of the duodenum only was included. Malignancy was not encountered and severe dysplasia was observed only in a macroadenoma of the second duodenal portion. A higher frequency of macroadenomas in the papilla and periampullary region was significantly correlated with the presence and number of such lesions in the rest of the duodenum (P = 0.04). No other significant association was detected either between micro- or macroadenomas at different sites or with the demographic, clinical and pathological features. CONCLUSION This study confirms that the duodenal papilla and periampullary region are sites with high prevalence of macro- and microscopic adenomas in patients with FAP. However, our data do not seem to support a higher frequency and malignancy potential of such lesions as compared to polyps in the rest of the duodenum. Nevertheless, these findings warrant a periodic, careful examination of the duodenum with either end-viewing or side-viewing endoscopy, the need for random biopsies of the papilla and periampullary region and the removal of any larger or rapidly growing lesions detected.
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Affiliation(s)
- G Bertoni
- Digestive Endoscopy Service, S. Maria Nuova Hospital, Reggio Emilia, Italy
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Abstract
We prospectively evaluated the diagnostic yield of push enteroscopy using either the Olympus SIF 10-LY fiberscope or the SIF-100 video enteroscope in 120 patients suspected of having small-bowel pathology. Insertion beyond the ligament of Treitz, checked by fluoroscopy, ranged from 30 to 150 cm (median 100). The source of bleeding was identified in 25 (41%) of 61 patients referred for gastrointestinal bleeding of obscure origin; vascular malformations were the most common finding, followed by neoplasias. Of 16 patients with inherited polyposis syndromes, multiple distal duodenal or jejunal hamartomas were diagnosed in five of six with Peutz-Jeghers syndrome and multiple duodenal or jejunal adenomas in six of 10 with familial adenomatous polyposis. Overall, isolated vascular malformations were successfully cauterized in three patients, and polypectomy was performed in 12 patients. Endoscopic and histological alterations, in both duodenum and jejunum, were found in 16 of 43 patients with diarrhea and/or malabsorption of unclear origin. The remaining 27 had normal duodenal and jejunal mucosal appearances; six had abnormal histological findings only in the jejunum and one both in the duodenum and in the jejunum. If we take jejunal histology as diagnostic, the sensitivity of duodenal histology was 74% and the specificity was 100%. We conclude that push enteroscopy provides useful diagnostic information and has therapeutic capabilities in patients with small-bowel pathology.
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Affiliation(s)
- F P Rossini
- Department of Oncology, S. Giovanni AS Hospital, Turin, Italy
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Rossini FP, Arrigoni A, Pennanzio M. Treatment and follow-up of large bowel adenoma. Tumori 1995; 81:38-44. [PMID: 7571051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The current clinical interest in large bowel adenoma is due to the evidence that most carcinomas arise in benign adenomas and therefore endoscopic removal of adenomas interrupts the sequence that leads to cancer. Colonoscopy is the best method for the detection and treatment of adenomas, with a diagnostic accuracy of 94% and a low incidence of complications. The majority of polyps can be resected by snare polypectomy. Regarding small polyps, snare polypectomy without current application is recommendable and hot biopsy should be avoided owing to a non negligible risk of hemorrage. Though clinical significance of small polyps is controversial, in our experience and in other studies they have a potential for malignant progression (2.4% of adenomas containing invasive carcinoma are 6 mm or less in diameter) and those located in the rectosigmoid are predictive of proximal neoplasms. If endoscopic polypectomy significantly reduces the incidence of colorectal cancer, patients submitted to adenoma removal have an increased risk for metachronous adenomas. Surveillance is therefore mandatory, once the presence of synchronous adenomas has been ruled out (clean colon). Risk factors for adenoma recurrence are family history, age, size of adenoma, multiple adenomas, dysplasia, villous histotype. Holding in due consideration compliance, risk of complications, logistic problems and costs, the following guide-lines can be proposed: total colonoscopy at the time of endoscopic polypectomy (to obtain a "clean colon") and, in the case of unsatisfactory examination, within one year. first check at 3 years and, if negative, subsequent check at 5 years. for small tubular adenomas surveillance is indicated only in the case they are multiple. The evaluation of some intermediate bio-markers might contribute to the predictive determination of adenoma recurrence, with the goal to select groups of patients with the highest risk of recurrence of adenomas.
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Affiliation(s)
- F P Rossini
- Department of Oncology, San Giovanni A.S. Hospital, Turin, Italy
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Perri F, Iuliano R, Valente G, Angelillo IF, Arrigoni A, Campra D, Recchia S, Andriulli A. Minute and small early gastric cancers in a Western population: a clinicopathologic study. Gastrointest Endosc 1995; 41:475-80. [PMID: 7615226 DOI: 10.1016/s0016-5107(05)80006-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Early endoscopic diagnosis improves the prognosis of patients with gastric cancer, as shown by the finding that 5-year survival rates exceeding 90% are observed in Japanese patients with early gastric cancer. It has been hypothesized that tumor size may have prognostic significance; therefore, a distinction between minute, small, and large early gastric cancers has been proposed. The aim of this study was to determine the prevalence of minute and small early gastric cancers in Western countries and to compare their clinicopathologic features with those of large early gastric cancers. Of 465 Italian patients with gastric cancer who were studied, 20.5% had an early gastric cancer, and 34.7% of these were minute or small. Tumor size is correlated with intramural spreading and metastasis to perigastric lymph nodes. Nodal involvement occurs more frequently in the diffuse than in the intestinal type of early gastric cancer. Long-term survival rate is not correlated with tumor size, intramural spreading, or nodal metastasis. The minute and small early gastric cancers of Italian patients are indistinguishable from those occurring in Japanese patients. These lesions are more common than previously thought and should be carefully searched for by endoscopists. The correlation of tumor size with intramural invasion and perigastric lymph node metastasis suggests that minute and small early gastric cancers are precursors of large early gastric cancers. Although the distinction between minute, small, and large early gastric cancers is of low prognostic value, the distinction might be useful for selecting different therapeutic approaches.
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Affiliation(s)
- F Perri
- Division of Gastroenterology, Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo (FG), Italy
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Abstract
BACKGROUND Morphologic, histochemical, and cytoproliferative characteristics differentiate hyperplastic polyps from adenomas. Even so, these polyps are indicators of populations with a high colorectal cancer risk. Since changes in mucosal cell proliferation are highly predictive biomarkers of the adenomacarcinoma sequence, this study examined the cytoproliferative profiles of mucosa bearing hyperplastic polyps, in a search for the significance of such lesions in bowel carcinogenesis. METHODS Proliferative activity demonstrated by immunohistochemical detection of the in vitro uptake of bromodeoxyuridine was evaluated in the rectal mucosa of 26 patients with hyperplastic polyps, 35 with adenomas < 1 cm, 60 with adenomas > 1 cm, 10 with adenomas + synchronous hyperplastic polyps, and 400 controls. RESULTS An upward shift of the major DNA synthesis zone to the intermediate and surface crypt compartments was found in all four patients groups. Significant hyperproliferation, on the other hand, was only observed in patients with large adenomas or hyperplastic polyps, or small adenomas and synchronous hyperplastic polyps. CONCLUSIONS These findings suggest that hyperplastic polyps are morphologic indicators of tumor initiation in the rectal mucosa and its ensuing hyperproliferation. Abnormalities in the distribution of proliferation in the mucosa do not appear to be specifically associated with the morphogenesis of hyperplastics polyps.
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Affiliation(s)
- M Risio
- Dept. of Pathology, Ospedale S. Giovanni Vecchio, Turin, Italy
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Arrigoni A, Pennazio M, Rossini FP. Rectosigmoid polyps as markers of proximal colonic neoplasms: a cost benefit analysis of different diagnostic protocols. Anticancer Res 1995; 15:563-7. [PMID: 7763038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The predictive value of hyperplastic polyps of the rectosigmoid for neoplastic lesions in the proximal colon is controversial. Some authors who deny predictive value have proposed a protocol which entails initially biopsying rectosigmoid polyps, and only in the case of adenomas then proceeding to total colonoscopy (protocol 1). The diagnostic and economic efficiency of this protocol, and of an alternative which entailed the full exploration of the colon during the initial examination in the case of rectosigmoid polyps (protocol 2), were evaluated by retrospectively simulating their application to 216 patients who had undergone total colonoscopy. A proximal neoplastic pathology was present in 49.5% of patients with rectosigmoid adenoma, 27.3% of patients with distal non neoplastic polyps alone (33.3% if only distal hyperplastic polyps were considered) and 11% of patients with no distal polyps. Protocol 1 gave rise to a higher cost ($ 58,413), not only compared to protocol 2 ($ 50,276), but also compared to total colonoscopy in all patients ($ 57,008); there was also a larger number of patients who eluded diagnosis (29%, against 16% in protocol 2). In terms of cost per lesion detected and of colorectal cancers prevented (on the basis of an evolution to cancer of 5% of adenomas), total colonoscopy for all patients on principle is advantageous compared to either protocol ($ 864 per proximal lesion and $ 7,082 per cancer prevented). Since distal hyperplastic polyps are also predictive of proximal neoplastic pathology, when rectosigmoid polyps are detected it is both indicated and economic to proceed with the exploration of the entire colon during the initial examination. This appears to be a reasonable compromise compared to total colonoscopy on principle, which has higher overall costs. The latter management, however, should not be ruled out, since it has a better diagnostic yield and lower cost per lesion detected and per cancer prevented.
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Affiliation(s)
- A Arrigoni
- Department of Oncology, San Giovanni Antica Sede Hospital, Torino, Italy
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Abstract
BACKGROUND AND STUDY AIMS Endoscopic exploration of the small bowel is potentially of prime importance in studying gastrointestinal bleeding of obscure origin, diarrhea and malabsorption, neoplasia, and other clinical conditions, but the method is still problematic because of the limited efficacy of sonde-type enteroscopes. This study evaluates the diagnostic yield of two push-type enteroscopes fitted with tip deflection and a biopsy channel. PATIENTS AND METHODS Seventy-two consecutive patients underwent enteroscopy using either an Olympus SIF-10 LY fiberscope or an Olympus SIF-100 video enteroscope. The depth of insertion was always checked by fluoroscopy, and ranged 30-120 cm beyond the ligament of Treitz. RESULTS Angiodysplasia was identified as the source in eight of 20 patients referred for gastrointestinal bleeding of obscure origin, and electrocoagulation was successfully performed in one case. A jejunal polyp was the cause of obscure bleeding in one patient. Radiological evidence of neoplasia/lymphoma located in the third portion of the duodenum or in the upper jejunum was ruled out in 10 of 12 patients. A normal jejunal appearance was found in two patients with lymphoma, subsequently confirmed by a normal enteroclysis. Duodenal or jejunal polyps were removed in seven of nine patients with familial polyposis. Endoscopic and histological alterations were found in nine of 24 patients with diarrhea or malabsorption. In addition, jejunal histology supplied the diagnosis in five patients with a normal endoscopic mucosal appearance. Only 18% of patients described slight, transient pain, and there were no complications. The tolerance and diagnostic efficacy were the same with both instruments. CONCLUSIONS Even though push-type enteroscope exploration is restricted to the jejunum, the instruments are safe and efficacious in clinical practice, and permit indepth study of small bowel anatomy and pathology.
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Affiliation(s)
- M Pennazio
- Gastroenterology and Gastrointestinal Endoscopy Service, San Giovanni Hospital, Turin, Italy
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29
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Pennanzio M, Arrigoni A, Rossini FP. Hyperplastic polyps and risk of proximal colonic neoplasms. Gastrointest Endosc 1994; 40:777-8. [PMID: 7859988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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30
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Abstract
Endoscopic recanalization was attempted in 17 patients with obstruction caused by colorectal cancer who were at high surgical risk on account of their poor clinical condition. Combined use was made of pneumatic and mechanical dilation, debulking with a diathermal snare, and photoablation with neodymium-yttrium-aluminum-garnet laser. Successful recanalization was obtained in 94% of cases. The only failure was in a patient with a neoplasm of the rectosigmoid junction. Elective surgery was not performed on the patients after recanalization because of the presence of severe concomitant disease or diffuse metastasis. Patients were followed for 6.25 +/- 6.17 months with 1.6 +/- 0.7 treatments within the first month to stabilize patency and then with an average of 0.88 +/- 0.63 treatments per month to maintain patency. Only 2 patients had recurrence of obstruction, and the actuarial survival was 63% at 6 months and 23% at 1 year. Endoscopic treatment has proved effective because it allows rapid recanalization with resolution of emergency and maintenance of patency in patients for whom elective surgery is not indicated. In selected cases, therefore, endoscopic recanalization is a sound alternative to emergency surgery.
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Affiliation(s)
- A Arrigoni
- Department of Oncology, San Giovanni A.S. Hospital, Turin, Italy
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Arrigoni A, Gindro T, Aimo G, Cappello N, Meloni A, Benedetti P, Molino GP, Verme G, Rizzetto M. Monoethylglicinexylidide test: a prognostic indicator of survival in cirrhosis. Hepatology 1994; 20:383-7. [PMID: 8045499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
The aim of this study was to assess the value of the monoethylglicinexylidide assay, a dynamic liver function test based on the determination of the serum concentration of lidocaine major metabolite, as a predictor of survival in cirrhosis. For this purpose, the predictive value of monoethylglicinexylidide was evaluated in comparison with the Pugh score, ascites, encephalopathy and a number of different biochemical parameters as collected from the prospective follow-up of 118 patients with cirrhosis. A stepwise regression analysis was performed on the variables of prognostic value according to the Cox model and with respect to 1-yr survival; because Pugh score and monoethylglicinexylidide were the sole variables selected, they were proved to supply independent prognostic information. The most reliable cutoff values for discrimination between death and survival were 25 ng/ml or less for monoethylglicinexylidide and less than 9 for the Pugh score. In 74 patients without overt signs of liver failure (i.e., Pugh < or = 9), monoethylglicinexylidide provided a wide range of results (i.e., 4 to 77 ng/ml), namely values ranging from very low to elevated. Of the 38 patients with satisfactory Pugh scores (< or = 9) but poor monoethylglicinexylidide values (< or = 25), 11 died during follow-up and 3 underwent liver transplantation, despite having shown no clinical signs of liver failure at entry. On the bases of discriminant levels, the monoethylglicinexylidide test is suitable for adoption as a reliable and sensitive indicator of survival in patients with cirrhosis because it supplies more accurate prognostic information compared with the Pugh score.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Arrigoni
- Department of Gastroenterology, Molinette Hospital, Turin, Italy
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Molino G, Arrigoni A. Design of a computer-assisted programme supporting the selection and clinical management of patients referred for liver transplantation. Ital J Gastroenterol 1994; 26:31-43. [PMID: 8025304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The paper describes the knowledge-base of the expert system OLT 1, developed to support medical decision-making in patients referred for liver transplantation. The paper goes through the real clinical problems, and describes both structural (organization of the domain knowledge) and functional aspects (reasoning algorithm and strategies for clinical decision). According to the programme, patients referred to Liver Transplant Centres may be enrolled and ranked in the waiting list, included in a stand-by list for treatment and re-evaluation, or discharged. All decisions are made on the basis of well-assessed and objective criteria.
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Affiliation(s)
- G Molino
- Dipartimento di Fisiopatologia Clinica, Università di Torino, Ospedale S. Giovanni, Italy
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Abstract
PURPOSE The aim of this study was to determine the spatial distribution and histotype of small colorectal polyps and to determine the validity of distal-small colorectal polyps as markers of proximal neoplasms. METHODS In 366 patients who underwent total colonoscopy and removal of all polyps, the presence and features of polyps were recorded. The relationship between proximal neoplasms and distal polyps was investigated in 216 of 366 subjects who had no personal or familial history of colorectal neoplasia. RESULTS Of 366 patients, 96 were free from polyps. A total of 733 small colorectal neoplasms was removed from the remainder: 79.9 percent neoplastic and 20.1 percent hyperplastic, inflammatory, or hamartomatous. High-grade dysplasia was noted in 2.7 percent of the neoplastic polyps. One adenoma containing invasive carcinoma was observed. In the subset of 216 patients, proximal neoplasms were found in 11.4 percent of those with no distal polyps, 33.8 percent of those with distal-small colorectal polyps only (P < 0.01), and 58.8 percent of those with at least one polyp > 5 mm in diameter (P = 0.001). The proximal neoplasm percentage was the same in patients with at least one adenomatous-small polyp and those with only hyperplastic-small polyps. CONCLUSIONS A distal-small colorectal polyp, whether adenomatous or hyperplastic, may be a proximal neoplasm marker. Total colonoscopy is thus justified in all patients with distal polyps, regardless of their size and histotype.
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Affiliation(s)
- M Pennazio
- Department of Gastroenterology, S. Giovanni A. S. Hospital, Turin, Italy
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Rossini FP, Arrigoni A, Pennazio M. Octreotide in the treatment of bleeding due to angiodysplasia of the small intestine. Am J Gastroenterol 1993; 88:1424-7. [PMID: 8362842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Three patients with a history of bleeding due to small bowel angiodysplasia (repeated melena or occult fecal blood with serious anemia) were treated for 10-40 months with octreotide, a somatostatin analog that reduces the splanchnic flow. A dose of 0.1 mg subcutaneously twice a day was followed by an increase in hemoglobin, and reduction or elimination of the need for transfusions. There were no further melena episodes, and stool hemoglobin became stably negative in two cases. Suspension of the drug after 6 months in one case was followed by renewed bleeding, and resumption led to a further response. Lower doses tried in another case were ineffective. Although these uncontrolled clinical cases do not prove its efficacy, octreotide appears to be beneficial in the control and prevention of bleeding due to diffuse small bowel angiodysplasia. There is no evidence that it results in regression of angiodysplasias, as they persisted in the patient subjected to control jejunoileoscopy.
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Affiliation(s)
- F P Rossini
- Department of Gastroenterology and Gastrointestinal Endoscopy, S. Giovanni A. S. Hospital, Turin, Italy
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35
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Andriulli A, Gremo L, Limerutti G, Bianchi A, Berti E, Arrigoni A, Napolitano G, Cirillo R. Sonographic classification of gallstones and outcome of extracorporeal shock wave lithotripsy. J Stone Dis 1993; 5:96-104. [PMID: 10148596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The success of extracorporeal shock wave lithotripsy (ESWL) for gallstone elimination is dependent on the lithotripter's ability to reduce the stone to fragments less than 5 mm in diameter, but wide variation in successful fragmentation rates have been reported even with the same instrument. This variation is probably due in part to differences in stone composition. Tsuchiya et al. have recently related the pre-operative ultrasound properties of gallstones to their chemical compositions. In the present study, 138 patients with cholecystolithiasis were treated with ESWL and results were evaluated in light of the pre-treatment sonogram patterns as classified by the aforementioned authors. Complete fragmentation (CF), i.e., fragments less than 5 mm, was achieved in 90% of patients with type I a patterns (pure cholesterol stones); stone number, diameter, and volume had no effects on fragmentation. Significantly lower CF rates were obtained with I b and I c (mixed cholesterol), and type II (combination) stones (p less than 0.0003). No fragmentation at all was achieved in the six stones with type III (bilirubinate) patterns. Twelve months after treatment, 45%, 25%, and 9% of the patients with type 1 a, type I b, and types I c or II (the latter two combined), respectively, were stone-free. Pure and mixed cholesterol gallstones without calcification seem to respond best to ESWL; effective treatment can be expected even when stones are numerous (4-10) or large ( greater than 35 mm). We recommend the inclusion of ultrasound properties of gallstones in the selection criteria for candidates for ESWL.
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Affiliation(s)
- A Andriulli
- Division of Gastroenterology, Ospedale Regionale "Casa Sollievo della Sofferenza," I.R.C.C.S., San Giovanni Rotondo, Italy
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36
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Pennazio M, Arrigoni A, Spandre M, Loverci C, Cavallero M, Gemme C, Bertone A, Risio M, Sinicco A, Raiteri R. Endoscopy to detect oral and oesophageal candidiasis in acquired immune deficiency syndrome. Ital J Gastroenterol 1992; 24:324-7. [PMID: 1515657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cytologic evidence of candidiasis was sought on endoscopic oesophageal brushings from 116 patients with acquired immune deficiency syndrome (AIDS) to determine the reliability of oesophagoscopy and the possibility of predicting Candida spp. oesophagitis from concomitant oral candidiasis or oesophageal symptoms. Oesophageal candidiasis was present in 42 patients and constituted the first opportunistic infection in 19 patients. Sensitivity and specificity were, respectively, 98% and 96% for oesophagoscopy, 69% and 42% for oral candidiasis, 52% and 74% for oesophageal symptoms, and 83% and 35% for the presence of at least one of these last two parameters. Endoscopy also proved to be the examination of choice for diagnosis, and cytology was needed only when it was negative. Oral candidiasis and oesophageal symptoms were not sufficient to predict oesophageal candidiasis. Endoscopy would seem to be indispensable to the diagnosis of oesophageal candidiasis and its differentiation from other forms, thus preventing any empirical resort to unwarranted forms of treatment. It is also indicated for staging purposes in asymptomatic patients, since oesophageal candidiasis is one indicator of the transition to full-blown AIDS.
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Affiliation(s)
- M Pennazio
- Dipartimento di Oncologia, Ospedale San Giovanni Antica Sede, Torino, Italy
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37
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Iuliano R, Arrigoni A, Recchia S, Andriulli A, Canavese V, Rodinò S, Giglio A, Verme G. [Early gastric cancer. Survival and prognostic factors in 95 consecutive cases]. MINERVA GASTROENTERO 1991; 37:205-9. [PMID: 1805972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In order to characterize prognostic factors and therapeutic strategies for EGC, we have studied 95 patients operated on from 1980 to 1988. EGC was limited to the mucosa in 36% and extended to the submucosa in 64% of the cases. Lymph nodes involvement was observed in 13 patients; in 12 of them EGC extended to the submucosa. Gastric resection was performed in 73 and total gastrectomy in 22 patients with a postoperative mortality of 6% and 16% respectively. During the follow-up 8 patients died for causes related to EGC, 8 for unrelated causes. The 5 years survival rate was 79, without differences according to site, type, size and histology of EGC, lymph nodes involvement, type of gastrectomy; only EGC limited to the mucosa was associated with a better survival experience (96% vs 70% of tumors extended to the submucosa p less than 0.05). The prognosis of EGC is good and a curative surgery may be accomplished, especially if the lesion is limited to the mucosa. In EGC extended to the submucosa an accurate lymphadenectomy may further improve the prognosis, while total gastrectomy--de principe--carries a higher postoperative mortality, without significant improvement of the long term prognosis.
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Affiliation(s)
- R Iuliano
- Servizio di Gastroenterologia ed Endoscopia Digestiva, Ospedale Ciaccio, Catanzaro
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38
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Ottobrelli A, Lagget M, Arrigoni A, Gindro T, Bosio C, Balbo G, Rizzetto M. [Eosinophilic gastroenteritis and ascites. Clinical case]. MINERVA GASTROENTERO 1991; 37:131-4. [PMID: 1742398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We report the case of a patient with recurrent subocclusive episodes and diarrhea (no malabsorption) associated with ascites, in the absence or liver, kidney or heart disease. The demonstration of hypereosinophilia in the peripheral blood and in the ascites fluid and the failure to identify parasitic or haematological disorders have led to a through examination of the stomach (Endoscopy, Echoendoscopy), small bowel (X-rays and Computerized Axial Tomography) and colon (colonoscopy) in a search for parietal lesions. The absence of segmental lesions and the observation of CAT images of diffuse, regular thickening of the ileum and of the mesentery, coupled with the monotonous clinical history spanning over three decades, have led to a diagnosis of eosinophilic gastroenteritis with involvement of the serosal layer. Serosal involvement is rare in eosinophilic disease of the gut; in analogy with other cases reported in the literature, steroids have improved clinical symptoms and normalized the hematological picture.
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Affiliation(s)
- A Ottobrelli
- Divisione di Gastroenterologia, Ospedale S. Giovanni Battista, Molinette - Torino
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39
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Andriulli A, Recchia S, De Angelis C, Mazzucco D, Berti E, Arrigoni A, Verme G. Endoscopic ultrasonographic evaluation of patients with biopsy negative gastric linitis plastica. Gastrointest Endosc 1990; 36:611-5. [PMID: 2279657 DOI: 10.1016/s0016-5107(90)71180-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- A Andriulli
- Division of Gastroenterology, Ospedale San Giovanni Battista, Torino, Italy
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40
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Piantino P, Arrigoni A, Brunetto MR, Gindro T. Alpha-fetoprotein in hepatic pathology and hepatocarcinoma. J Nucl Med Allied Sci 1989; 33:34-8. [PMID: 2480419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We have examined a population of 1099 patients, suffering of HCC and chronic hepatitis of different nature, to determine the frequency and significance of alpha-fetoprotein elevation. Moreover we have followed up a group of 206 patients with liver cirrhosis referred to our department of hepatology in Turin, from January 1981 through April 1989. The AFP test with a cut-off of 50 ng/ml, is positive in 67.2% of tumor patients and in 12.9% of chronic hepatitis. No differences exist in patients carriers of hepatitis B virus versus alcoholic or criptogenetic subjects. Twenty-one out of 206 cirrhotic patients followed-up have developed HCC during the observation period (36.5 +/- 22.4 months). Fifteen out 21 patients (71%) showed an increase of AFP values. In 14 patients the HCC was graded as small (less than 4 cm of diameter at US) and in other 7 as advanced or multifocal. The underlying cirrhosis was alcoholic in 11 (53.3%), cryptogenic in 5 (23.8%), and hepatitis B chronic infection related in 5 (23.8%). Serological surveillance has led, to the identification of 71% of the tumors developing during this study. Using the time-course of AFP as the diagnostic parameter of the risk of HCC, we obtained the best performance in term of sensitivity, specificity and diagnostic accuracy. Screening patients at risk of HCC, using abdominal US and AFP testing, is an effective way of determinating small lesions, but how much early determination of HCC in a cirrhotic patient will improve the prognosis remain to be defined.
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Andriulli A, Arrigoni A, Gindro T, Karbowiak I, Buzzetti G, Armanini D. Canrenone and androgen receptor-active materials in plasma of cirrhotic patients during long-term K-canrenoate or spironolactone therapy. Digestion 1989; 44:155-62. [PMID: 2697627 DOI: 10.1159/000199905] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Plasma levels of canrenone and androgen receptor-active materials (ARM) were determined during long-term oral K-canrenoate or spironolactone therapy in cirrhotics with chronic recurrent ascites. Mean plasma canrenone level was approximately 3 times higher under K-canrenoate than under spironolactone treatment; moreover, the levels were not dose related. Either type of treatment did not affect plasma aldosterone and testosterone concentrations. Plasma ARM during K-canrenoate treatment did not change, whereas in the spironolactone group a 3-fold increase of ARM occurred (p less than 0.05). No dose-related effect was evident with the latter treatment. The lower incidence of gynecomastia in the K-canrenoate group was not correlated with values of plasma canrenone or ARM (p greater than 0.05). Our study questions the traditional view that the mode of action of spironolactone is via its metabolite canrenone. The two antialdosterone drugs, although equally effective in clearing ascites from cirrhotics, appear to act through partially different metabolites. The lower incidence of antiandrogenic or estrogen-like side effects during K-canrenoate seems to be related to metabolites other than canrenone itself.
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Affiliation(s)
- A Andriulli
- Divisione di Gastroenterologia, Ospedale San Giovanni Battista Molinette, Torino, Italia
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Arrigoni A, Andriulli A, Gindro T, Verme G. The use of diuretics in preventing ascites recurrence. Br J Clin Pract 1988; 42:116-20. [PMID: 3207572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Pera A, Bellando P, Caldera D, Ponti V, Astegiano M, Barletti C, David E, Arrigoni A, Rocca G, Verme G. Colonoscopy in inflammatory bowel disease. Diagnostic accuracy and proposal of an endoscopic score. Gastroenterology 1987. [PMID: 3781186 DOI: 10.1016/0016-5085(87)90856-0] [Citation(s) in RCA: 170] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Colonoscopy is used in the differential diagnosis of inflammatory bowel disease but its accuracy and the "weight" of the various endoscopic signs have not been assessed. In a prospective study 357 patients with 606 colonoscopies, in whom the endoscopic appearances were those of ulcerative colitis, Crohn's colitis, or indeterminate colitis, were followed-up for an average period of 22 mo. A final, definite, endoscopy-independent diagnosis was reached by means of autopsy, surgery, or histology on biopsy in 71% of patients. Accuracy of colonoscopy was 89%, with 4% errors and 7% indeterminate diagnoses. Errors were more frequent in severe inflammatory activity (9%). The most useful endoscopic features in this differential diagnosis were discontinuous involvement, anal lesions, and cobblestoning of mucosa for Crohn's disease, and erosions or microulcers and granularity for ulcerative colitis. After selecting the endoscopic features with best predictive value, an "endoscopic score" was calculated by means of "likelihood ratios."
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Andriulli A, Arrigoni A, Gindro T, Verme G. [Prevalence of peptic ulcer in patients with various hepatopathies]. Minerva Med 1986; 77:1801-5. [PMID: 3774200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Aim of this study was to re-evaluate the overall prevalence of a peptic disease in 350 patients with liver diseases of different etiology and severity. A normal endoscopic picture was found in 82% of cases. Peptic lesions were found in 18% of total cases and were located in the duodenal (10.9%) and gastric (7.1%) wall. On the basis of the 15-20% rate, which most Authors think to be a reasonable estimate of the overall ulcer prevalence in normal population, the prevalence rate in this survey would suggest that there is no association between ulcer and liver disease. Ulcers were more commonly present in cirrhotic than in noncirrhotic patients. Both alcohol intake and cigarette smoking were identified as two ulcerogenic events in these patients while portal hypertension and etiology of liver disease were irrelevant factors. The contemporary occurrence of the three ulcerogenic factors (cirrhosis, smoking, and alcohol intake) in a given patient seems to potentiate each others as ulcerogenic event. It is concluded that patients with liver diseases share the same risk of developing a peptic disease as the general population.
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De Francesco A, Andriulli A, Acquaviva F, Piantino P, Arrigoni A, Massarenti P, Balzola F. [Effects of normal-caffeine and decaffeinated coffee on serum levels of total gastrin (G1-34), gastrin 1-17 and pepsinogen I]. Minerva Dietol Gastroenterol 1986; 32:361-7. [PMID: 3822201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Acquaviva F, DeFrancesco A, Andriulli A, Piantino P, Arrigoni A, Massarenti P, Balzola F. Effect of regular and decaffeinated coffee on serum gastrin levels. J Clin Gastroenterol 1986; 8:150-3. [PMID: 3745848 DOI: 10.1097/00004836-198604000-00009] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We evaluated the hypothesis that the noncaffeine gastric acid stimulant effect of coffee might be by way of serum gastrin release. After 10 healthy volunteers drank 50 ml of coffee solution corresponding to one cup of home-made regular coffee containing 10 g of sugar and 240 mg/100 ml of caffeine, serum total gastrin levels peaked at 10 min and returned to basal values within 30 min; the response was of little significance (1.24 times the median basal value). Drinking 100 ml of sugared water (as control) resulted in occasional random elevations of serum gastrin which were not statistically significant. Drinking 100 ml of regular or decaffeinated coffee resulted in a prompt and lasting elevation of total gastrin; mean integrated outputs after regular or decaffeinated coffee were, respectively, 2.3 and 1.7 times the values in the control test. Regular and decaffeinated coffees share a strong gastrin-releasing property. Neither distension, osmolarity, calcium, nor amino acid content of the coffee solution can account for this property, which should be ascribed to some other unidentified ingredient. This property is at least partially lost during the process of caffeine removal.
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Saracco G, Recchia S, Arrigoni A, Andriulli A, Verme G. [Endoscopic sclerosis of esophageal varices for the prevention of re-bleeding: our experience]. Recenti Prog Med 1985; 76:185-7. [PMID: 3875883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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49
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Ferlito A, Doglioni C, Bontempini L, Arrigoni A. Metachronous coexistence of laryngeal pseudolymphoma and squamous cell carcinoma. An unreported case. ORL J Otorhinolaryngol Relat Spec 1984; 46:202-9. [PMID: 6462636 DOI: 10.1159/000275710] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
An unreported case of metachronous coexistence of laryngeal pseudolymphoma and squamous cell carcinoma is described. The long follow-up of the patient (above 11 years), without any evidence of lymphoreticular disease elsewhere, was in favor of a diagnosis of lymphoid hyperplasia of the larynx. The occurrence in the same organ of a squamous cell carcinoma has allowed the thorough investigation of the reactive lesion. The additional cases of laryngeal pseudolymphoma reported in the English literature are reviewed.
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50
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Pegreffi P, Rebesan P, Arrigoni A. [The Augustine operation in the treatment of chronic, isolated or combined, injuries of the posterior cruciate ligament]. Chir Organi Mov 1984; 69:45-50. [PMID: 6488986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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