Diabetes and cholelithiasis.
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Biomedical subjects
Publications and source records attributed to L Trevisani.
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In order to quantify and classify ciliary changes of bronchial epithelium in chronic bronchitis, an ultrastructural study on biopsy specimens of 30 patients submitted to bronchoscopy was performed. Fourteen patients were affected by endoscopically and clinically confirmed chronic bronchitis, 8 showed an endoscopic picture of chronic bronchitis but without the clinical features of this pathology, 8 were free of chronic bronchitis. The mean percentage of abnormal cilia in control subjects (1.9 +/- 1.0%) was significantly lower than in patients either with only 'endoscopic' chronic bronchitis (5.7 +/- 2.6%; p less than 0.001) or with 'clinical' chronic bronchitis (14.8 +/- 15.9%; p less than 0.05). Like the ciliary body, the ciliary tip can also show some abnormalities. It is possible to subdivide them in two types: (1) ciliary membrane blebs; (2) ciliary membrane extrusions, variously shaped and sized, with homogeneous content. Bronchial cilia abnormalities become more serious as soon as the clinical picture worsens and this is likely to contribute to the impairment of the mucociliary clearance in chronic bronchitis patients.
Twenty-nine patients with peripheral intrathoracic lesions underwent real-time US and US-guided biopsy. The lesions were mainly atypical fluid collections in 3 patients and mainly solid in the extant 26. Biopsies performed with fine aspirating or cutting needles (20-22 gauge) were successful in all patients; an unquestionable diagnosis was made in 27 cases with cytology and/or histology. Only one patient experienced mild asymptomatic pneumothorax after biopsy, which did not require chest-tube drainage. The authors stress the important diagnostic role of US-guided fine-needle biopsy as an useful and safe method for the evaluation of peripheral intrathoracic lesions.
Unsuspected abnormalities are occasionally detected during real-time examinations. To determine the frequency of such findings detected during the standard ultrasound examination of the entire abdomen, the records of 765 consecutive patients were reviewed. A significant number of occult abnormalities were detected: approximately one-fourth of all abnormalities were found in the abdominal survey. The influence of the abdominal survey on the clinical management and improved radiological consultation are discussed.
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Multiple biopsies were taken from 50 patients with endoscopic appearance of duodenitis in order to study the relationship between gastric metaplasia in duodenum and the presence of Campylobacter-like organisms (CLOs) and the development of duodenal ulcer disease. Metaplasia was found in at least one biopsy specimen from 46 of the 50 patients; CLOs were seen in 25 of the 50 patients, only in metaplastic areas. In four cases a "transitional epithelium" with the presence of cells containing few apical mucoid granules and absorbent-type brush border as well as goblet cells was seen. In two cases, this epithelium was colonized by a small number of CLOs. Gastric heterotopia appears to be a rare condition.
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A histological study was performed in order to evaluate the prevalence of Campylobacter-like organisms (CLO) and gastric antral lesions in 85 rheumatoid arthritis (RA) patients using NSAIDs, and in 100 nonrheumatoid outpatients comparable in terms of sex and age, not using NSAIDs. Histological evidence of gastritis was a common finding both in RA patients (88.2%) and in nonrheumatoid outpatients (89.0%). On the other hand, CLO were detected in a significantly lower proportion (p less than 0.001) of RA patients than outpatients (30.6 and 59.0%, respectively). Considering each NSAID used separately (aspirin, diclofenac sodium and ketoprofen), no significant difference in the presence of CLO in the three groups was found; in the small group of patients treated with aspirin, however, bacteria were never detected. MICs of each NSAID used against 15 isolates of Campylobacter pylori were also determined.
Aging and female sex are major risk factors for cholesterol gallstones: in addition to hepatic secretion of lithogenic bile, decreased gallbladder contractility may play a role in such physiological conditions. This study was aimed at evaluating the effect of age and sex on gallbladder kinetics in healthy subjects. Gallbladder volume was measured on the US images of 157 fasting subjects using the sum-of-cylinders method. No significant difference was observed between males and females. On the contrary, age was shown to have a significant positive correlation with fasting gallbladder volume, particularly in males. In a second group of 63 healthy volunteers gallbladder volumes were evaluated both before and after a standard meal. The subjects were grouped according to age, and fasting gallbladder volume appeared to be significantly greater in the groups formed by older people. Gallbladder volumes were compared in younger groups (under 35), and gallbladder emptying resulted to be much more complete in males than in females. On the contrary, no significant difference was observed between males and females over 50--which suggests a possible role of sex- and age-related hormonal factors. The above changes in gallbladder function may facilitate bile stasis which might in turn contribute to the increased risk for cholesterol gallstones notoriously associated with advanced age and female sex.
Since the exact mechanisms of the pathogenicity of Campylobacter pylori are not known, we performed an ultrastructural study with the aim of focusing on patterns of possible physical contact between C. pylori and gastric epithelium, and of considering them in relation to the bacterial pathogenicity. Among 20 random consecutive patients referred for routine gastroscopy, we studied ultrathin sections from the 11 patients with Campylobacter-like organisms, and recognized three patterns of physical contact between bacteria and epithelial cells. These patterns seem in accord with published data of C. pylori toxicity, and they could represent different evolutive stages of the infection.
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The authors report 20 patients in whom a large number of dead or severely damaged yeast cells, supposedly Candida albicans yeasts, were the possible cause of chronic recurrent diarrhea and abdominal cramps. It is suggested that the presence of large numbers of these microorganisms in stools may be considered among the possible etiologies of diarrhea in the 'irritable bowel syndrome'. The possible source of these yeast-like cells, the causes of cell damage, and the mechanisms by which these organisms may induce diarrhea should be investigated.
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We have carried out ultramicroscopical investigations on 30 patients with endoscopical aspects of congestive or erosive duodenitis associated or not with bulbar ulcer in relation to the presence of Campylobacter-like organisms (CLO), considered as a possible etiologic agent of peptic disease. Bacteria were found in all of the 14 patients with duodenal ulcer and in only five patients without ulcer. The ultrastructural studies provided elements for the evaluation of epithelial colonization of the duodenal bulb by CLO and which may lead to a new interpretation of gastric metaplasia.
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