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Biomedical subjects

G Del Favero

Publications and source records attributed to G Del Favero.

At least 55 records · Page 3Linked to original sources
PubMed1990

How does liver dysfunction influence serum CA 19-9 in pancreatic cancer?

Serum CA 19-9 was determined in 83 control subjects, 99 patients with pancreatic cancer, 104 with chronic pancreatitis and 137 with extra-pancreatic diseases mainly of gastrointestinal origin in order to evaluate whether hepatic factors can influence circulating CA 19-9 in pancreatic cancer. Sensitivity, specificity and accuracy of this test in determining pancreatic malignancy were: 74%, 83% and 57%. We divided patients into two groups: group A (159 cases) and group B (181 cases) with and without anatomical liver damage (presence of primary or metastatic cancer, cirrhosis, hepatitis, steatofibrosis, cholangitis). Group A presented higher CA 19-9 values as compared to group B. Significant correlations were found in group B but not in group A between CA 19-9 and ALT, ALP and total bilirubin. Multiple regression analysis (CA 19-9 dependent and ALT, ALP and total bilirubin predictor variables) was significant only in group B. The standardized partial regression coefficients found to be significant were those of ALP and total bilirubin. We can conclude that CA 19-9 is an index of pancreatic cancer with satisfactory sensitivity and specificity. The presence of anatomical liver damage seems to increase the value of this index, probably releasing CA 19-9 into the bloodstream. Extra-hepatic cholestasis may also be an important factor in elevating CA 19-9 probably by reducing the hepatic catabolism of this glycoprotein.

Adult↗
PubMed1990

Is computed tomography a reliable indicator of stone solubility?

This study was undertaken to ascertain whether CT evaluated stone densiometry, prior to treatment, is able to identify patients with high likelihood of success with litholisis. Eight patients with single radiolucent stone (less than 15 mm diameter) in a functioning gallbladder that showed no reduction in size after 12 months treatment with UDCA (10 mg/Kg/day) were submitted to CT scan to determine stone densitometry. Seven patients still had a radiolucent stone after therapy; six out of seven stones showed densitometric values over 50 Hounsfield units, which we considered the upper normal limit for stones consisting of cholesterol. CT can be a useful tool to identify patients at high risk for oral dissolution therapy failure.

Cholelithiasis↗
PubMed1990

[Does Helicobacter pylori have a direct proteolytic effect in ulcerative disease?].

Helicobacter pylori (H.p.), has been shown, experimentally, to exert a proteolytic activity against mucous fractions. Aim of this study was to assess the prevalence of H.p. in peptic ulcer and to analyze its possible influence on gastric mucus components, on peptic activity in gastric juice and the possible action on peptic secretion. 223 patients undergoing upper gastrointestinal endoscopy were analyzed for the presence of H.p. in the mucosa: 99 duodenal ulcer patients (D.U.), 58 gastric ulcer patients (D.U.) and 66 dyspeptic subjects. In each patients, three contiguous gastric biopsies were taken at the antrum: the first was evaluated for gastritis (Whitehead Criteria), the two other analyzed for H.p. with a rapid urease test. In a subgroup of 25 D.U. and 18 G.U. patients, two other biopsies were taken at the fundus corpus of the stomach, to evaluate peptic secretion. To determinate mucous components (acid and neutral glycoproteins, galactose and N-acetylneuraminic acid), gastric juice samples were collected during endoscopy. H.p. was present in 89% of antral biopsies in D.U., in 56% of G.U. and in 51% of D., and was associated to antral gastritis. As regard gastric juice components, we observed an increase and a decrease of acid glycoproteins, respectively, in D.U. and G.U. patients with H.p. infection. An increase of peptic activity has been found in the gastric juice of both gastric and duodenal ulcer patients H.p. positive (G.U. p less than 0.05). On the contrary, no significant differences were observed on peptic activity in the fundus-corpus biopsies between H.p. positive and H.p. negative patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Diagnostic utility of a new monoclonal antibody pancreatic isoamylase assay in chronic pancreatic diseases.

In order to evaluate the efficacy of a monoclonal pancreatic (P) isoamylase assay in the diagnosis of chronic pancreatic disease and to compare the behavior of this test with that of amylase and elastase 1, these three enzymes were measured in the sera of 39 healthy controls, 28 patients with pancreatic cancer, 50 with chronic pancreatitis and 60 with extra-pancreatic diseases. In patients with chronic relapsing pancreatitis, increased P-isoamylase and elastase 1 values were found in similar percentages (about 70%), whereas the percentage for elevated amylase values was lower (52%). Elastase 1 was increased in 52% of patients with pancreatic cancer, while the other two enzymes were only occasionally elevated. The levels for all three enzymes were abnormal in some patients with extra-pancreatic diseases. It may be concluded that this assay for P-isoamylase determination is sufficiently sensitive and reliable in detecting pancreatic inflammation, even though some limitations concerning its specificity should be born in mind.

Adolescent↗
PubMed1990

Deoxyribonuclease I serum activity in pancreatic cancer.

In patients with pancreatic cancer deoxyribonuclease I (DNase I) serum levels were compared with those of other known pancreatic enzymes. Serum deoxyribonuclease I, elastase 1, immunoreactive trypsin, amylase and phospholipase A2 were determined in 40 healthy controls, 28 patients with pancreatic cancer, 49 with chronic pancreatitis and 40 with extra-pancreatic diseases. The analysis of variance showed a significant difference among groups for serum DNase I values. However, none of the 3 groups of patients had a mean deoxyribonuclease I value higher than that of the healthy controls. In pancreatic cancer and chronic pancreatitis patients, increases in the 4 pancreatic enzymes values were found in percentages that were higher than those for DNase I. A significant correlation was found between DNase I and phospholipase A2, but not between DNase I and elastase 1, immunoreactive trypsin and amylase serum activities. The findings indicate that deoxyribonuclease I serum determination is an even less satisfactory index of pancreatic malignancy than the other pancreatic enzymes. Rather than expressing pancreatic damage, any variations in this enzyme appear more likely to reflect an aspecific phenomenon.

Adult↗
PubMed1990

[X-ray diffraction study of biliary calculi. Morphological and composition correlations of calculi].

In this study, we examined the composition of crystallographic structure of biliary stones in 106 patients (27 male, 79 female). The material has been obtained following cholecystectomy. In 70 cases (66%), the monohydrate cholesterol was the main constituent, alone (33%) or in combination with calcium salts (32%). In 52% of the cases, we found presence of vaterite, aragonite and calcite. The anhydrous cholesterol was determined in 28 subjects (26%), alone (9.4%) or associated with calcium salts (16%). Cholesterol was completely absent in 8 cases: of them, 4 presented an aspecific diffrattografic picture and 4 revealed presence of calcium carbonate. Finally, no correlation was found between epidemiological data (sex or age) and macroscopic feature of biliary stones (chemical and morphological structure).

Calcium↗
PubMed1989

Tumor-associated trypsin inhibitor in patients with chronic pancreatic diseases.

Serum TATI (tumor-associated trypsin inhibitor) was measured in 41 control subjects, 30 patients with pancreatic cancer, 53 with chronic pancreatitis, and 47 with extrapancreatic diseases, mainly of gastrointestinal origin. TATI was found to be elevated in some subjects in all groups of patients; patients with chronic pancreatitis studied during an acute exacerbation of the disease had the highest percentage (68%) of pathological values. TATI was found to be correlated with elastase 1, tissue polypeptide antigen, and total and pancreatic isoamylase. A significant relationship was also found between TATI and serum creatinine levels.

Adult↗
PubMed1989

Alpha-fetoprotein, tissue polypeptide antigen and ferritin in diagnosing primary hepatocellular carcinoma in patients with liver cirrhosis.

This study was undertaken in order to compare the usefulness of three indices of tumour proliferation in detecting primary hepatocellular carcinoma (HCC) and in differentiating this neoplasm from liver cirrhosis. In 10 patients with HCC and in 63 with liver cirrhosis serum alpha-fetoprotein (AFP), tissue polypeptide antigen (TPA) and ferritin were assayed. Increased levels of AFP but not of TPA and ferritin were observed in HCC as compared to liver/cirrhosis. The receiver-operating characteristic curves demonstrated that AFP is more discriminating between HCC and liver cirrhosis than the other two markers. Correlations between liver function tests and serum markers were observed in liver cirrhosis but no in HCC. We can conclude that AFP is more useful than TPA and ferritin in detecting HCC in patients with liver cirrhosis, owing to the high frequency of false positive results of the latter two indices in liver cirrhosis. Liver dysfunction is probably involved in increasing all these markers of malignancy, thus reducing the specificity of these tests.

Adult↗
PubMed1989

Does bile play a fundamental role in inducing and influencing acute reflux pancreatitis in rat?

Acute pancreatitis by closed duodenal loop in two groups of rats, with or without biliary diversion, was induced to ascertain any role that bile might have in codetermining and influencing the disease. Both the histological findings and the serum amylase levels showed the presence of mild acute pancreatitis in both groups. The histological and/or biochemical findings and the survival rates were similar for rats with and rats without biliary diversion. We may therefore conclude that the closed duodenal loop causes acute pancreatitis of a mild degree in the rat; bile did not appear to play a fundamental role in inducing or in influencing the outcome of the acute pancreatic inflammation in this experimental model.

Acute Disease↗
PubMed1989

Renal tubular dysfunction in pancreatic cancer and chronic pancreatitis.

Urinary excretion of alpha-glucosidase (AGL), gamma-glutamyltransferase (GGT) and ribonuclease (RNase), and serum amylase and immunoreactive trypsin (IRT) were determined in 38 control subjects, 48 patients with pancreatic cancer, 77 with chronic pancreatitis and 47 with extrapancreatic diseases in order to ascertain the presence of a renal tubular damage and to investigate its etiology. A significantly increased frequency of pathological results for all urinary enzymes was documented in the various groups of patients as compared to controls. Significant correlations were detected among AGL, GGT and RNase. Considering the subjects as a whole, GGT and RNase excretions correlated with serum IRT and amylase; the two urinary enzymes were found to be higher when jaundice was present. In chronic pancreatic disease enzymuria was related to increased serum pancreatic enzymes; in extrapancreatic diseases it was associated to hyperbilirubinemia. The vast majority of patients with pancreatic cancer and elevated urinary enzymes presented hepatic metastases and/or jaundice. We can conclude that an anatomical and functional tubular impairment is detectable in some patients with chronic pancreatic and extrapancreatic diseases. Tubular damage seems to least in part to be related to pancreatic inflammation and necrosis in chronic pancreatic disease, while jaundice may be found to play an important role in diseases of the hepatobiliary tract. In pancreatic cancer, liver dysfunction (presence of liver metastases and/or extrahepatic cholestasis) also appears to be involved in altering tubular cells.

Adult↗
PubMed1989

Do CA 19-9 and TPA play a minor role as compared to AFP in diagnosing primary hepatocellular carcinoma?

This study was undertaken in order to compare the ability of 4 tumour markers to discriminate between liver cirrhosis patients with or without hepatocellular carcinoma (HCC). Serum alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), CA 19-9 and tissue polypeptide antigen (TPA) were determined in 63 patients with liver cirrhosis and in 25 patients with HCC in liver cirrhosis. All 4 serum markers were found to be increased in a number of liver cirrhosis patients, regardless of the presence of HCC. AFP was found to be more elevated in HCC patients as compared to the other group; no difference was observed for CA 19-9, CEA and TPA. A significant correlation was detected in HCC patients between AFP and TPA. Significant correlation were detected in all except HCC patients between liver function tests and TPA. We can conclude that AFP determination remains as yet the only suitable marker able to detect HCC in liver cirrhosis. The newly introduced serum marker CA 19-9 is, as previously reported, unhelpful for CEA. TPA can in some instances (i.e. in the absence of an important hepatic cell necrosis or cholestasis) provide a clue to neoplastic growth.

Adult↗
PubMed1989

Urinary elastase 1 in chronic pancreatic disease.

Serum and urine elastase 1, its renal output and clearance and urinary gamma-glutamyltransferase and ribonuclease excretions were measured in 16 patients with pancreatic cancer, 23 with chronic pancreatitis and in 22 healthy controls in order to evaluate elastase 1 plasma-urine transfer in chronic pancreatic disease and to investigate any factors that might influence the clearance of this enzyme. In an additional group of 17 patients with different pancreatic diseases the serum molecular size distribution of elastase 1 after chromatography was ascertained. An increased urinary elastase 1 output was found in 4/16 patients with pancreatic cancer and in 6/23 with chronic pancreatitis. No correlation was found between circulating elastase 1 and its urinary output; a negative correlation was detected between the serum levels of this enzyme and its clearance. The excretion of ribonuclease and gamma-glutamyltransferase was correlated with elastase 1 output and clearance. While the majority of elastase 1 in serum was accounted for by high molecular forms, probably the expression of complexes with serum inhibitors, free circulating enzyme was present in all patients with high serum elastase 1. Our findings suggest that elastase 1 urinary excretion increases in some patients with chronic pancreatic disease regardless of the neoplastic or inflammatory nature of the illness. Although the availability of different amounts of ultrafiltrable enzyme may play a role in influencing elastase 1 plasma-urine transfer, renal tubular damage appears to be the most important factor influencing the increase in the urinary output of elastase 1.

Adult↗
PubMed1989

[Ca 19-9 in the diagnosis of pancreatic carcinoma].

This study was undertaken in order to ascertain the role of CA 19-9 in pancreatic cancer diagnosis. Therefore CA 19-9 was determined in the sera of 83 control subjects, 108 patients with pancreatic cancer, 112 with chronic pancreatitis and 126 with extrapancreatic diseases. Sensitivity, specificity and accuracy in detecting pancreatic cancer were: 75%, 86% and 61% respectively. The receiver-operating characteristic curves showed that CA 19-9 is able to well discriminate pancreatic cancer from controls; satisfactorily it differentiated pancreatic malignancy from chronic pancreatitis and other benign extrapancreatic diseases. Extrapancreatic neoplasms were not accurately separated. No difference was detected in CA 19-9 levels between pancreatic cancer patients with or without hepatic metastases. We can conclude that CA 19-9 is a test for pancreatic malignancy with a satisfactory sensitivity and specificity in respect of other pancreatic and extrapancreatic benign pathologies; the presence of hepatic metastases is only one of the factors which may increase its serum levels.

Adult↗
PubMed1988

Renal factors in serum trypsinogen 1 metabolism and excretion in chronic pancreatic disease.

In order to investigate the role of renal factors in affecting trypsinogen 1 metabolism and excretion in chronic pancreatic disease, serum immunoreactive trypsin (IRT), urinary IRT, gamma-glutamyltransferase (GGT), alpha-glucosidase (AGL) and RNase outputs and the molecular size distribution of serum and urine IRT were studied in 8 control subjects, 18 cases with pancreatic cancer, and 23 cases with chronic pancreatitis. Serum chromatography demonstrated that most immunoreactivity eluted as trypsinogen 1. Smaller amounts of immunoreactivity at higher molecular weights were also observed. Urine chromatography displayed both trypsinogen 1 and heavier molecular forms. An inverse linear correlation was noticed between creatinine clearance and serum trypsinogen 1 levels. Multiple regression analysis (urinary IRT output dependent and GGT, AGL, and RNase predictor variables) showed a significant linear correlation. RNase was found to be the most important parameter in explaining urinary IRT output. Mild variations in the glomerular function seem to be able to influence serum trypsinogen 1 levels. Urinary IRT excretion is principally explained by a disturbance in the tubular reabsorption of low molecular weight proteins, such as RNase.

Adult↗
PubMed1988

Combined determination of serum CA 19-9 and tissue polypeptide antigen: why no improvement in pancreatic cancer diagnosis?

CA 19-9 and tissue polypeptide antigen (TPA) were determined in the sera of 28 control subjects, 29 patients with pancreatic cancer, 26 with chronic pancreatitis and 62 with benign and malignant extra pancreatic diseases in order to compare their usefulness in diagnosing pancreatic cancer, to verify whether the combined assessment of the two indices could improve the results given by a single parameter and to speculate on the role of liver dysfunction in increasing their serum levels. The sensitivity, specificity and accuracy of CA 19-9 and TPA in diagnosing pancreatic malignancy were: 76, 85 and 61% for CA 19-9 and 79, 52 and 32% for TPA. The receiver-operating characteristic curves showed that CA 19-9 and TPA similarly discriminate pancreatic cancer from controls and chronic pancreatitis, while CA 19-9 is more useful than TPA in differentiating pancreatic malignancy from benign and malignant extra pancreatic abdominal diseases. TPA did not seem to add further information as compared to CA 19-9 alone when both markers were combined. Liver dysfunction may contribute to increasing serum levels of both markers.

Antigens, Neoplasm↗
PubMed1988

Renal involvement in chronic pancreatic disease: effects on trypsin and amylase plasma-urine transfer.

This study was undertaken in order to ascertain the behaviour of amylase and trypsin fractional clearances in chronic pancreatic disease and to speculate on the factors involved. Renal tubular function was also assessed in these patients. An increase of both clearances was found in a number of patients with pancreatic cancer and chronic pancreatitis. Amylase urinary output seems to be mainly related to the circulating enzyme levels; urinary IRT is principally accounted for by a functional tubular impairment. Tubular damage was observed in a number of patients with chronic pancreatic disease. This was related to pancreatic inflammation in chronic pancreatitis and to several factors, among which jaundice and pancreatic damage, in pancreatic cancer.

Amylases↗