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Biomedical subjects

G Gasbarrini

Publications and source records attributed to G Gasbarrini.

At least 523 records · Page 29Linked to original sources
PubMed1983

Lymphocytotoxicity against autologous hepatocytes and membrane-bound IgG in viral and autoimmune chronic active hepatitis.

Membrane-bound IgG and lymphocytotoxic activity of total, T-enriched and T-depleted lymphocytes, using autologous hepatocytes have been evaluated in: (a) 31 patients with chronic active hepatitis (CAH) (six autoimmune and 25 hepatitis B virus - HBV-related); (b) five patients with inactive alcoholic cirrhosis; and (c) nine subjects with normal hepatic histology. Lymphocytotoxicity was positive in 83% of autoimmune CAH and 68% of HBV-related cases; it was confined to the T-depleted subpopulation in the first group, while it was present in both the T-enriched and T-depleted subpopulations in 81% of HBV-related cases. Membrane-bound IgG was present in 58% of group (a) and in none of the other groups. A linear pattern was found in four out of five autoimmune CAH patients with positive lymphocytotoxic activity. The autoimmune patient with lymphocytotoxic activity within the normal range did not show any membrane fluorescence. Among HBV-related CAH patients, 13 presented a granular pattern, two an associated granular and linear pattern and ten were negative. These data suggest that different lymphocytotoxic mechanisms are involved in the two forms of CAH studied.

Autoantibodies↗
PubMed1983

Effect of gluten-free diet on splenic hypofunction of adult coeliac disease.

Splenic function has been serially measured by counting pitted red cells in 15 coeliac patients, before and during a gluten-free diet. The basal percentage values of pitted cells decreased significantly during treatment but no correlation was observed between the duration of the gluten-free diet and the percentage of recovery of splenic function over basal values. Out of six coeliacs with pitted cell values consistent with splenic hypofunction, three showed a total recovery after gluten withdrawal. Our data suggest that, contrary to recent reports, hyposplenism in adult coeliac disease is improved by a gluten-free diet, and that environmental factors may be important in determining and maintaining this complication.

Adult↗
PubMed1983

Aldosterone related blood volume expansion in cirrhosis before and during the early phase of ascites formation.

Thirty-seven patients with liver cirrhosis (16 without ascites: group 1; 21 with untreated ascites at the first onset: group 2) were studied during controlled sodium intake (40 mmol/day). Renal plasma flow, glomerular filtration rate, urinary sodium excretion, plasma sodium and potassium, plasma renin activity, plasma aldosterone concentration, blood volume, and arterial pressure were evaluated. All the patients had normal renal perfusion, plasma sodium and potassium, and arterial pressure. Mean plasma renin activity and plasma aldosterone concentration were significantly depressed in group 1 (p less than 0.001, p less than 0.005 respectively) compared with 21 normal controls in identical experimental conditions. This was possibly a consequence of expanded blood volume (p less than 0.001 compared with controls) which was directly correlated with plasma aldosterone concentration (p less than 0.001). In group 2 plasma renin activity and plasma aldosterone concentration were normal in over 50% of cases. Blood volume was lower than in group 1 (p less than 0.002), but again related to plasma aldosterone concentration (p less than 0.01). In both groups plasma aldosterone concentration was hyperbolically and inversely correlated with urinary sodium excretion, but the two curves were progressively shifted to the left in respect to controls suggesting an enhanced renal tubular sensitivity to the hormone. The results suggest that aldosterone related renal sodium retention, with consequent blood volume expansion, occurs before ascites formation. The mineralocorticoid activity of aldosterone is amplified by an enhanced sensitivity of renal tubules which appears to increase as the disease progresses.

Adult↗
PubMed1983

Exocrine pancreatic function in the elderly.

We studied pancreatic bicarbonate and enzyme output in response to a continuous intravenous infusion of secretin, 1 CU/kg X h, and cerulein, 100 ng/kg X h, in 25 elderly subjects and in 30 young controls. Almost all elderly persons had pancreatic outputs within the range of controls. Only 3 aged individuals showed diminished enzyme output, but the reduction was very slight. We conclude that exocrine pancreatic function is not significantly influenced by aging.

Adult↗
PubMed1983

Occurrence and significance of IgG liver membrane autoantibodies (LMA) in chronic liver diseases of different aetiology.

The prevalence of liver cell membrane antibodies (LMA) was evaluated in the sera of 124 untreated patients with various chronic liver diseases, in 17 acute hepatitis patients and in 40 normal controls by indirect immunofluorescence on rabbit hepatocytes, isolated by non-enzymatic method. The presence of LMA was compared with the presence of HBs Ag, anti-HBc and non-organ specific autoantibodies (anti-nuclear antibody, ANA; smooth muscle antibody, SMA; anti-mitochondrial antibody, AMA; liver-kidney microsomal antibody, LKM). LMA was found in 83% of autoimmune chronic active liver disease (CALD), in 47% of cryptogenic CALD and in 42% of primary biliary cirrhosis (PBC). LMA prevalence both in HBsAg positive and HBsAg negative/anti-HBc positive CALD was 11%, significantly lower than in the other three groups. In the cryptogenic group the prevalence of non-organ specific autoantibodies was significantly lower than LMA prevalence. The 35 LMA positive sera were titred to end point dilution. Autoimmune cases presented titres higher than those of all the other groups. Adsorption experiments showed that in autoimmune cases LMA fluorescence is not blocked by pre-incubation with liver antigens LSP and LP2, while a mild blocking effect was observed in some HBsAg positive cases or PBC sera. No cross-reaction with mitochondrial antigens was observed in PBC sera. LMA can still be considered a marker of autoimmune CALD only when present at high titre and without cross-reactivity with other liver antigens.

Animals↗
PubMed1983

Ultrasonographic findings in portal hypertension: correlation with the presence and size of oesophageal varices.

This study assesses the usefulness of ultrasonography in the diagnosis of portal hypertension. Several ultrasonographic signs were correlated with the presence and size of oesophageal varices detected by endoscopy in 32 patients suffering from alcoholic liver cirrhosis. Ultrasonography is proposed as a simpler and earlier method for screening of portal hypertension than endoscopy.

Diagnostic Errors↗
PubMed1983

Possible role of pirenzepine on the release of pancreatic polypeptide in duodenal ulcer patients: preliminary results of a randomized cross-over study.

The effects of repeated oral doses of pirenzepine (100 mg daily for 7 days) and antacid (Maalox, 105 ml daily for 7 days) on the test-meal-stimulated release of pancreatic polypeptide (PP) were evaluated in 7 duodenal ulcer outpatients by means of a randomized cross-over study, with a wash-out period of one week between pirenzepine and antacid administration. The effects of pirenzepine (100 mg daily for 7 days) were also evaluated in 5 healthy adult volunteers. The stimulus test was performed on each fasting patient two days before the treatment started and after a 7-day treatment. Venous blood samples were obtained before the test meal (basal) and 3, 10 and 30 minutes after it. Plasma PP levels were estimated by means of a specific RIA. The results obtained showed that pirenzepine significantly inhibits the PP response to the test meal in the duodenal ulcer patients and in the healthy volunteers. The above-mentioned effects suggest that one of the mechanisms of action on the therapeutic activity of pirenzepine on peptic ulcer might be explained by the preservation of pancreatic secretion unimpaired by an increase in PP release after meal stimulus.

Adult↗
PubMed1982

Splenic function in childhood coeliac disease.

We measured splenic function using a simple, non-isotopic method in childhood coeliac disease. No patients were shown to have hyposplenism. This has important clinical and therapeutic implications.

Adolescent↗
PubMed1982

Ultrasonography in the diagnosis of portal hypertension: diminished response of portal vessels to respiration.

This study assesses the usefulness of ultrasound in the diagnosis of portal hypertension due to hepatic cirrhosis. Seventy-nine patients with portal hypertension and 45 control subjects underwent ultrasonography. Two factors were measured: (a) the caliber of the portal vein and (b) the caliber variation of the splenic and superior mesenteric veins during respiration. A lack of normal caliber variation (an increase during inspiration and a decrease during expiration) in these vessels is put forward as an ultrasonographic sign of portal hypertension, and the pathophysiological and clinical significance of this finding are discussed. The sensitivity of ultrasound in detecting portal hypertension, based on the measurement of caliber variation, was 79.7%, and the specificity was 100%. In contrast, the sensitivity of the method, assessed on the basis of portal dilatation, was only 41.8%.

Humans↗
PubMed1982

Impairment of blood pressure control in patients with liver cirrhosis during tilting: study on adrenergic and renin-angiotensin systems.

Mean arterial pressure, phenylalanine, tyrosine, norepinephrine and plasma renin activity (PRA) were determined in the plasma of 6 healthy controls and 8 patients with liver cirrhosis receiving a controlled sodium intake (40 mEq/day), after 1 h of bed rest and 10 min after being tilted up at 90 degrees. After resting, patients showed lower arterial pressure (p less than 0.025) and higher plasma levels of phenylalanine (p less than 0.005), tyrosine (p less than 0.05), norepinephrine (n.s.) and PRA (n.s.) than controls. In spite of a prolonged and marked stimulation of the adrenergic system induced by tilting, arterial pressure of cirrhotics, after an initial increase, decreased significantly. A significant PRA increase was observed in both groups but in patients it was greater and lasted longer, up to 30 min, when PRA and arterial pressure were inversely and significantly correlated. The adrenergic system of cirrhosis then appeared unable to maintain adequate levels of arterial pressure, even though hyperstimulated. The renin-angiotensin system played an important compensatory role in this contest.

Adult↗
PubMed1982

Observer variation in assessment of jejunal biopsy specimens. A comparison between subjective criteria and morphometric measurement.

in an observer variation study, the agreement rate reached by a pair of observers who measured 85 jejunal biopsy specimens using surface/volume ratio was compared with that reached by a pair of observers who subjectively assessed the same biopsy series. Both the agreement reached between the subjective observers and that reached between the objective observers proved significant by kappa statistics. However, both total and partial kappa values were greater for the pair of objective observers in every diagnostic category. Moreover, the percentage of agreement on the grading of all biopsy specimens, independent of the diagnostic categories, proved significantly higher for the objective observers. In the pair who made a qualitative assessment, interobserver variation was particularly evident in the grading of partial villous atrophy. Contrastingly, in the pair who made a quantitative assessment, agreement was present in all but one slide. The kappa values for the observers examining the same biopsy specimens on two separate occasions indicated closer agreement rates for the two objective observers. It is concluded that morphometric measurement is more reliable than subjective criteria in the assessment of jejunal biopsy specimens and that qualitative assessment of biopsy specimens should be coupled with quantitative histology.

Atrophy↗
PubMed1981

[Catecholamine and renin-angiotensin system in blood pressure control in patients with liver cirrhosis].

The changes induced by active tilting in arterial pressure, plasma renin activity, norepinephrine and its precursors phenylalanine and tyrosine were evaluated in 8 patients with liver cirrhosis and 6 healthy controls. The results suggest the inability of the adrenergic system, though hyperstimulated, to maintain arterial pressure homeostasis in cirrhosis with a compensatory hyperactive renin-angiotensin system. Derangements in catecholamine synthesis, possibly due to altered utilisation of precursors to alternative final products (weak neurotransmitters?) can be taken into account.

Adult↗