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Biomedical subjects

G Verme

Publications and source records attributed to G Verme.

At least 73 records · Page 4Linked to original sources
PubMed1989

Immunohistochemical research on HDV infection in Chinese patients with chronic liver disease.

The prevalence of HDAg in the liver of Chinese patients with chronic hepatitis and hepatocellular carcinoma was determined by using direct immunofluorescence and immunoperoxidase. Six patients (6.3%) out of 95 HBsAg carriers with inflammatory liver disease and neoplasia were found to be HDAg positive. HDAg was shown in the liver of 6 patients (7.6%) among 79 patients with chronic hepatitis. The relative frequency of HDAg in cirrhosis-B, chronic active hepatitis B and chronic persistent hepatitis B was 14.3%, 7.1% and 5.9% respectively. These results suggest that a sizeable number of HBsAg carriers are superinfected with HDV. In view of the large amount of HBV carriers in China, the relative minor but distinct presence of HDV poses an important community health problem.

Carcinoma, Hepatocellular↗
PubMed1988

Inhibition of hepatitis B virus replication by vidarabine monophosphate conjugated with lactosaminated serum albumin.

Vidarabine (ara A) produces severe dose-dependent side-effects. To examine whether its monophosphate ester (ara-AMP) can be effective in the treatment of chronic hepatitis B when given in reduced dosage as a conjugate with lactosaminated human serum albumin (L-HSA), which selectively enters hepatocytes, five patients with chronic type B hepatitis (HBsAg/HBV-DNA positive for at least 2 years) were treated with the conjugate. The daily dose of conjugate given (35 mg/kg) contains 1.5 mg ara-AMP, whereas the usual daily dose of free ara-AMP is 5-10 mg/kg. In three patients HBV-DNA fell to undetectable levels and remained negative in two; in one of them anti-HBe developed. In the other two patients HBV-DNA decreased but was detectable during treatment--one received three cycles of therapy, and became HBV-DNA negative and anti-HBe positive 45 days after the end of treatment; the other remained HBeAg/HBV-DNA positive. No adverse effects were observed, and biochemical variables (including aminotransferases) remained unchanged or decreased with viraemia. No antibodies (IgM and IgG classes) that bound the conjugate were detected. Thus L-HSA-ara-AMP inhibits HBV replication as well as free ara-AMP but at a third to a sixth of the dose.

Adult↗
PubMed1988

Pancreatic steatorrhea and pulmonary tuberculosis.

The authors present a case of exocrine pancreatic insufficiency in a 37 yr old woman treated for pulmonary tuberculosis. The exocrine pancreatic failure is suggested to be secondary to previous pancreatic tuberculosis since no other cause of pancreatic disease was found and the diarrhea with steatorrhea started 6 mth after the lung disease. Steatorrhea was promptly reverted after institution of oral therapy with pancreatic supplements and the patient gained 7 kg of body weight during the successive follow-up of 4 yr.

Adult↗
PubMed1988

Chronic HDV (hepatitis delta virus) hepatitis. Intrahepatic expression of delta antigen, histologic activity and outcome of liver disease.

The expression of intrahepatic delta antigen (HDAg) was studied in relation to the morphologic features of HDV hepatitis and the outcome of liver disease. The study was performed in 101 patients followed up for an average of 12 years; one or more liver biopsies were available from each patient, giving a total of 167 specimens. The histologic features were assessed using numerical scores. A significant positive relation was observed between the number of HDAg-positive cells and the extent of portal inflammation (Spearman's rank coefficient 0.75). The highest degree of inflammation and intrahepatic expression of HDAg was found before the elimination of the virus, while the outcome of HDV disease was unrelated to the severity of the initial morphologic lesion. These results suggest that the individual immune response may play an important role in the pathogenesis of HDV hepatitis.

Adolescent↗
PubMed1988

Percutaneous transhepatic cholangioscopy with a 2.8 mm fiberscope.

The authors describe their initial experience with a 2.8 mm (8.5F) fiberscope. The instrument, used to refine interventional radiology maneuvers of the intra- and extra-hepatic bile ducts, caused no additional discomfort to the 18 patients treated. The fiberscope permitted differentiation between different causes of biliary stenosis in the few cases where doubt persisted after percutaneous cholangiography. Brushing was also performed wherever necessary. The color, and thus the composition, of bile duct stones could also be determined. This has helped us to plan the therapy with methyl-tert-butyl-ether (MTBE) in patients with cholesterol stones. Compared with traditional fiberscopes (diameter of 5mm or more) the new instrument is easier to use, and allows more peripheral ducts to be reached, but is expensive and has a smaller field of view and fewer possibilities for therapeutic applications.

Bile Duct Diseases↗
PubMed1988

Cisapride versus placebo in reflux esophagitis. A multicenter double-blind trial.

In a 6 to 12-week double-blind trial, the effect of cisapride (10 mg q.i.d.) was compared with that of placebo in 63 patients with esophagitis confirmed by endoscopy and/or biopsy. In only one patient (3%) in the cisapride group but in 43% of the placebo patients (p = 0.001), symptoms had not improved after 6 weeks. Forty patients continued treatment until week 12. At that time, control endoscopy showed a significantly (p = 0.005) higher rate of healing (no erosions, ulcers, or bleeding mucosa) in the cisapride patients (63%) than in the placebo patients (12%). At week 12, only three of the 21 cisapride patients still had moderate reflux symptoms, whereas eight of the 19 placebo patients had moderate or severe symptoms (p less than 0.05). Cisapride patients also took significantly (p less than 0.001) less antacids during the trial. These results show that cisapride, 10 mg q.i.d., heals esophagitis lesions and greatly reduces associated symptoms. The treatment was well tolerated.

Adult↗
PubMed1987

Liver transplantation in hepatitis delta virus disease.

Seven patients with hepatitis delta virus (HDV) cirrhosis underwent liver transplantation. In every case the HDV infection was florid but accompanied by an inactive hepatitis B virus (HBV) infection. The patients were given anti-HB surface antigen (HBsAg) serum globulins and HBV vaccine. Two patients cleared the HBsAg and the HDV, and are alive and well 14 and 15 months, respectively, after transplantation. HDV infection recurred in the other five patients: hepatitis developed in three, another died, and the fifth was re-transplanted for causes unrelated to viral hepatitis (reinfection was shown by the presence of HD antigen in the graft). Liver transplantation is feasible in patients with HDV disease but involves a high risk of HDV reinfection that cannot be predicted by the virological pattern of the native HBV infection or prevented by conventional HBV prophylaxis.

Adult↗
PubMed1987

Natural killer response to exogenous interferon in delta hepatitis: boost or depression defined within the first week of therapy.

Six patients with hepatitis B surface antigen (HBsAg)-positive chronic active liver disease and superimposed delta virus infection were followed up for changes of natural killer (NK) cell function during a 3-month course with median doses of recombinant leukocyte alpha interferon (rIFN). Careful record of the off-therapy NK function means revealed that 3 subjects were boosted, 2 were depressed, and 1 was unchanged. The NK activity patterns showed that after the start of therapy the maximal shift from the off-therapy mean was concentrated in the first week; then the trend, although confirmed, had a gentler slope on the follow-up. This indicated that the first week reflects the availability of rIFN-sensitive NK cells and characterizes the immunological competence of the patient; whilst later in follow-up, suppressive control mechanisms or loss of receptor affinity tend to blur the response. The serum levels of delta RNA dropped in the NK-boosted patients; persistently negative RNA together with clearance of intrahepatic delta antigen was demonstrated solely in that 1 patient showing 164% NK cell function increment in the first week. This study shows that paradoxical responses to exogenous rIFN are not confined to cancer patients, as indicated so far, but may appear in other subjects as well, and reflect the peculiar response of the individual; whenever an NK-dependent clearance of virus-infected cells is required, recognition of the early pattern of reactivity would be useful.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Percutaneous transhepatic cholangioscopy with an 8.5 French endoscopic catheter. Technic and preliminary results].

The authors describe their preliminary personal experience in bile duct endoscopy with a very small diameter catheter (8.5 F) much less traumatic than traditional choledochoscope (15 F). The CE can be reutilized after sterilization; an angiographic guide wire up to 0.042" can be introduced in the operating channel. The CE was used in 3 patients with uncertain cholangiographic diagnosis. Instrument introduction is facilitated when simple technical manoeuvres are followed; there were no difficulties in report interpretation. An experienced interventional radiologist and an endoscopist are needed to handle the instrument. Cytologic sample, biopsy and gallstone lithotomy instruments will increase diagnostic and therapeutic possibilities of the system: for this a wider CE use in the immediate future to complete interventional radiology manoeuvres can be expected.

Bile Duct Diseases↗
PubMed1987

Colonoscopy in inflammatory bowel disease. Diagnostic accuracy and proposal of an endoscopic score.

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."

Colitis, Ulcerative↗
PubMed1986

[Clinical evaluation of chemical cholelitholysis using methyl tertiary butyl ether in lithiasis of the bile ducts].

Personal experience is reported in the treatment of calculosis of the biliary ways using MTBE and injected through percutaneous biliary drainage catheters placed surgically or endoscopically in 11 patients in whom surgery appeared to be contraindicated or particularly dangerous. In 10 out of the 11 cases chemical cholelitholysis was successful and the technique is therefore proposed as a valid alternative to surgery in ductal cholelitholysis when sphincterotomy and endoscopic removal of the stones cannot cure the conditions.

Adult↗
PubMed1986

[Prevalence of peptic ulcer in patients with various hepatopathies].

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.

Adult↗