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Biomedical subjects

F Di Mario

Publications and source records attributed to F Di Mario.

At least 217 records · Page 12Linked to original sources

Carcinoembryonic antigen in gastric juice collected during endoscopy. Value in detecting high-risk patients and gastric cancer.

In order to ascertain the role of gastric carcinoembryonic antigen (CEA) determination in detecting patients with a risk for gastric cancer, 69 subjects were studied; 23 were referred for endoscopy because of dyspepsia but without obvious macroscopic lesions, 27 with duodenal ulcer, 11 with benign gastric ulcer, 8 with gastric cancer. The following results were obtained by subdividing the material according to the histologic interpretation of the results of gastric mucosal biopsies: (1) in the presence of minor histologic abnormalities of the gastric mucosa, CEA in gastric juice was under 100 ng/ml in all but five cases; and (2) in moderate or severe chronic atrophic gastritis (associated or otherwise with intestinal metaplasia or dysplasia), and in gastric cancer, gastric CEA ranged between 224 and 3120 ng/ml in all but two cases. Although not diagnostic for gastric cancer, gastric CEA is a promising test in detecting patients at risk, including those with dysplasia of the gastric mucosa.

Adolescent↗

Gastric epithelial dysplasia and sulphomucin-type intestinal metaplasia.

The HID-AB histologic staining technique, which distinguishes sulphomucin from sialomucin types of intestinal metaplasia, was employed in endoscopic gastric mucosal biopsies to evaluate their frequency of association with epithelial dysplasia. Sulphomucin-type intestinal metaplasia was found in 33% of the cases under observation; moderate or severe dysplasia was only associated with this type of intestinal metaplasia. Its precancerous significance can be ascertained only by means of prospective studies.

Adult↗

[Benign and malignant gastric ulcers: is their localization relevant in their differential diagnosis?].

A study of potentially benign or malignant ulcer in the stomach was made to assess its role in the differential diagnosis between these two conditions. In the 201 patients observed, no statistically significant differences in frequency in the various sites were noted as regard either benign or malignant lesions. The site of the ulcer cannot be taken as indicative of its nature.

Adolescent↗

Actual role of pepsinogen group I in the study of upper gastrointestinal diseases.

The role of serum PG I in screening patients with chronic atrophic gastritis and gastric cancer, and in detecting peptic ulcer patients with high relapse risk, was ascertained in 276 subjects. Although not diagnostic per se, PG I was found to be under 20 micrograms/L in patients with chronic atrophic gastritis and in some gastric cancer or partially gastrectomized patients. In patients presenting with relapsing duodenal ulcer, PG I values were significantly higher than in the non-relapsing ones, but a satisfactory identification of all the duodenal ulcer patients with high relapse risk was not possible on this basis. Even the correlation between PG I and MAO was not accurate in every subject considered. These results suggest that the value of PG I is limited to assessing patients with upper gastrointestinal diseases in which a reduction of peptic secretion, and therefore of PG I in serum, is present.

Duodenal Ulcer↗

Pepsinogen Group I radioimmunoassay and total serum pepsinogen colorimetric determination: a comparative study in normal subjects and in peptic ulcer patients.

Pepsinogens, proteolytic enzymes produced by peptic cells of the stomach and discharged into the gastric lumen as well as into the blood have been divided into two groups: PG-I, originating from chief cells, and PG-II, mainly from antrum peptic cells. Both total serum pepsinogen (s-Pg) and PG-I have been separately reported as being significantly increased in gastric (GU) and duodenal ulcer (DU) patients and related to maximal acid output. In order to ascertain the relationship between s-Pg measured by means of the colorimetric Uete method, and PG-I determined by RIA method, these were assayed in 72 control subjects, 35 GU and 95 DU patients. s-Pg was found to be significantly increased both in GU and DU patients in comparison with control subjects. Likewise PG-I was significantly enhanced in GU and DU patients as compared with controls. A significant direct correlation between s-Pg and PG-I was found in all the subjects studied (r = 0.732).

Adult↗

Are biopsy forceps helpful in the endoscopic evaluation of ulcer diameter?

A hand-made papier-mâché stomach model with hollowed-out ulcers was employed for evaluating the accuracy in estimating ulcer diameters by means of endoscopy. The opened biopsy forceps were also used as a reference marker. Ten endoscopists with various degrees of experience were involved in the study. All the endoscopists underestimated the ulcer diameters; the use of the forceps, resulted in an improvement, in particular in the case of the comparatively inexperienced endoscopists. A stomach model may be helpful in the subjective assessment of the endoscopists' ability to estimate ulcer size.

Biopsy↗

Is mild gastric epithelial dysplasia an indication for follow-up?

We evaluated the changes over 1-55 months in mild gastric epithelial dysplasia (a relatively frequent, but not widely studied histological lesion) in 20 patients (11 with benign gastric ulcer, eight with chronic gastritis, and one after Billroth 2 operation), in order to ascertain whether to follow-up such patients in the future. Regression of the lesion was documented in 13 (65%), and no change in six (30%). Progression from mild to moderate dysplasia occurred in only one patient (5%). As mild dysplasia regresses or remains unchanged in most patients, at least over the short-term, specific follow-up is probably unnecessary. Nevertheless, a rational program of monitoring the associated precancerous conditions is in order.

Adult↗

Risk of hepatitis B virus infection following upper gastrointestinal endoscopy: a prospective study in an endemic area.

A prospective survey, comprising 623 consecutive upper gastrointestinal endoscopies (in 588 patients) was carried out simultaneously at two endoscopy centres of a Mediterranean country, without altering the routine procedures. Each patient was tested for HBsAg, and sera found to be HBsAg-positive were tested for HBeAg/antiHBe: 40/588 (7.1%) subjects were found to be HBsAg-positive and 6 of them were HBeAg-positive. Sera of the first 5 HBsAg-negative patients in whom the same endoscope and/or biopsy forceps were used after a HBsAg-positive subject, were tested for antiHBc to ascertain antecedent HBV immunity: 77/136 (56.6%) were found to be antiHBc-positive. Forty-eight out of the 59 individuals "at risk" lacking evidence of previous HBV infection were contacted 6 months after endoscopy: none reported symptoms of hepatitis; 40 of them had blood tests for HBsAg and antiHBc: none showed serum markers of HBV infection. It is therefore concluded that, in spite of the high number of HBsAg carriers among endoscopy candidates, the risk of HBV spread during upper G.I. endoscopy is very low, even in high prevalence areas.

Adult↗

Gastric epithelial dysplasia in relapsing and nonrelapsing gastric ulcer.

In 50 patients with benign gastric ulcer (eight relapsing, 42 nonrelapsing) the evolution of the edge and scar histological characteristics was studied with special regard to the pressure and modification of epithelial dysplasia. The patients were endoscopically followed-up; for 1 to 74 months. Dysplasia was present in 29% of observations made in active ulcer and in 19% of patients with scarring gastric ulcer. Severe dysplasia was found only in one case. During follow-up, regression of the dysplastic changes was documented in 64% of the cases, progression from mild to moderate dysplasia in 4%, while no change was recorded in 32%. Appearance of dysplasia or progression from mild to moderate was seen in 62% of the relapsing cases, as opposed to 14% of the nonrelapsing cases (p less than 0.005). Dysplastic changes, usually mild, are relatively frequent in the mucosa both at the edge and scar of gastric ulcer, but they tend to disappear with the healing of the ulcer. Appearance or progression in severity of dysplasia during follow-up are rare, but significantly more frequent in relapsing ulcers, which therefore require more careful follow-up.

Adult↗

Epithelial dysplasia in endoscopic gastric mucosal biopsies.

To define the frequency of gastric epithelial dysplasia (precancerous lesion), 1463 biopsies from 842 endoscopically studied patients were reassessed. Mild dysplasia was found in 19.9% of the cases, moderate in 4.1%, severe in 0.95%. Since the clinical and biological significance of the lesion is still an open question, indications for follow-up are discussed in the light of personal views, together with a critical evaluation of the recently proposed classifications.

Biopsy↗

Pirenzepine in duodenal ulcer. A multicentre double-blind controlled clinical trial, First of two parts.

Eighty-four patients with endoscopically-proved active duodenal ulcer were admitted to a multicentre double-blind trial with either pirenzepine tablets (25 mg three times per day for 1 week followed by 25 mg two times per day for 3 weeks) or placebo. Seventy-nine patients completed the trial, 44 treated with pirenzepine and 35 with placebo. After 4 weeks, complete healing had been achieved in 52% of the pirenzepine-treated patients and in 34% of the placebo-treated ones. Symptomatic responses were signigicantly better in those receiving pirenzepine than in those receiving placebo. In addition, the supplementary antacid consumption was significantly lesser in the pirenzepine group than in the placebo group. No important side-effects were observed in the two groups.

Adult↗