[New imaging methods in the diagnosis of carcinoma of the gallbladder].
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Biomedical subjects
Publications and source records attributed to L Trevisani.
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The pH values in 203 patients with various gastroduodenal pathologies were measured by means of a glass electrode inserted into the bioptic channel of the gastroscope. Analysis of the results confirms what we know of pH variations in gastric or duodenal ulcer cases and shows where perendoscopic pH measurements may be used beneficially. In particular it was found that mucous pH is not affected by H2 antagonists if these are taken more that 12 hours before the examination. Perendoscopic pH measurement appears to be a valuable tool in screening stomach lesions at risk in cases of chronic gastritis, since it facilitates the identification of atrophic or metaplastic lesions.
Total bile acid concentrations were estimated in fasting serum samples from 251 patients with chronic liver disease and 108 controls without liver disease, together with conventional liver tests. Serum bile acids level was significantly higher in patients with liver disease than in control group. Fasting serum bile acid concentration was raised in 172 of the 251 patients with impaired hepatic function (68.5%). Only gamma-glutamyltranspeptidase and transaminase tests exhibited a higher abnormality frequency. Two-hour postprandial serum bile acid concentrations were measured in 78 patients: the meal test shows a rise in sensitivity (+26.9%). Our results confirm that serum bile acids concentration represent a sensitive and reproducible test for hepatobiliary disorders.
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Four coagulation indices [fibrinopeptide A (FpA), X degradation products (XDPs), platelet factor (PF4), beta-thromboglobulin (beta-TG)] were assessed in 38 patients affected by large bowel cancer at different stages before surgery, 7 and 30 days after it, to evaluate the capacity of such neoplasia to influence coagulation. The reported study showed that (1) FpA levels were elevated in nearly all cases both before and after surgery (thus it is a useful index for the diagnosis of such neoplasia, although its levels are not influenced by the presence of metastases), (2) increased levels of XDPs were found in a significantly (p < 0.05) higher percent of patients 7 days after surgery (no significant differences were observed in relation to the cancer stage), (3) PF4 levels were in the normal range throughout the study, and (4) beta-TG levels were increased throughout the study in a high percentage of cases. It may be inferred that large bowel cancers may affect coagulation in either way(s), by triggering platelet activation and/or fibrinolysis. The most useful index for the diagnosis and follow-up of this neoplasia is FpA, although its levels are unaffected by the presence of metastases. The comprehensive evaluation of the four above-mentioned coagulation indices may give rise to the suspicion of large bowel cancer.
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