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Biomedical subjects

M Pirovino

Publications and source records attributed to M Pirovino.

At least 73 records · Page 4Linked to original sources
PubMed1982

[Importance of ultrasonography in the diagnosis of diffuse parenchymal disorders of the liver].

In a retrospective analysis, ultrasonographic findings were compared with the individual histological diagnosis in 49 patients with diffuse parenchymal liver disease and 5 healthy controls. Ultrasonography differentiates with great accuracy between normal liver tissue on the one hand and diffuse parenchymal liver disease such as cirrhosis and fatty liver on the other, but only poorly between cirrhosis and fatty liver. The combination of 4 single ultrasonographic criteria serves for diagnosis of liver cirrhosis with a very high degree of specificity but with low sensitivity. Among the various single criteria adopted, sound transmission is that for which interobserver variation is highest.

Diagnosis, Differential↗
PubMed1982

Acute hepatitis non-A, non-B; are there any specific light microscopic features?

Coded examination of liver biopsies from a total of 24 patients with acute hepatitis non-A, non-B revealed two main histological trends: (a) acute viral hepatitis with confluent necrosis (sublobular and bridging) carrying a relatively good prognosis and taking a chronic course in only four out of 14 patients (29%); and (b) acute viral hepatitis with severe portal infiltration rich in lymphocytes and plasma cells, lymph follicles with germinal centers and bile duct lesions, as described by Poulsen & Christoffersen. The latter group showed a very high tendency to transition to chronic hepatitis (six out of seven patients, 86%) or a course characterized by one or multiple acute relapses (one out of seven patients, 14%). Bile duct lesions, if present in biopsies of patients with acute hepatitis, are of diagnostic and prognostic value. They point to the etiological possibility of a hepatitis non-A, non-B and, at the same time, they indicate a high likelihood of evolution to chronic liver disease.

Adult↗
PubMed1982

Regression of liver cell adenoma. A follow-up study of three consecutive patients after discontinuation of oral contraceptive use.

Three consecutive young female patients with unresected liver cell adenoma and a history of contraceptive use of several years' duration were followed up over a period of 2-4.5 yr after withdrawal of hormonal medication. One patient presented multiple adenomas and in another, the adenoma was associated with a Budd-Chiari syndrome due to bilateral thrombotic hepatic vein occlusion. Complete regression of the adenomas was documented in all 3 patients by ultrasonography, liver radionuclide scan, laparoscopy, or computerized tomography. It is concluded that, in selected cases, conservative management after withdrawal of hormonal contraception may be a valid alternative to surgical therapy.

Adult↗
PubMed1982

[(Intrahepatic cholestasis with jaundice due to amyloidosis of the liver) ].

Two cases of severe intrahepatic cholestasis due to amyloidosis of the liver seen within 9 months are described and compared with the pertinent literature. In both, the diagnosis was established by needle biopsy of the liver, and the amyloidosis associated with a myeloma. The methods available for reaching a definite diagnosis are discussed, and the possible diagnostic importance of percutaneous transhepatic cholangiography, as performed in one of the two patients, is stressed. Amyloidosis of the liver complicated by jaundice is possibly not such a rare disease; it has a very poor prognosis, and the patients do not survive more than a few months.

Adult↗
PubMed1981

[Non-A, non-B viral hepatitis: occurrence, epidemiology and prognosis].

Out of 117 cases with acute viral hepatitis, 37 (32%) were classified as hepatitis A, 50 (43%) as hepatitis B and 30 (25%) as hepatitis non-A-non-B (NANB). In 21 of the 30 patients with hepatitis NANB, a possible mode of parenteral transmission could be found. The mean incubation period was 53 days. Only 3 patients had had blood transfusions. 14 (52%) of the 27 patients with sporadic hepatitis (without transfusions) had a mild course of the acute illness without, or with only mild, jaundice and transaminase values below 500 IU. The remaining 13 patients had a more severe form of acute hepatitis (bilirubin above 5 mg/dl, GPT above 500 IU), and in 11 of these 13 cases confluent necrosis was demonstrable on liver biopsy. 10 (37%) of the sporadic cases, of whom 8 had a mild form of acute hepatitis, and the 3 cases of posttransfusion hepatitis, were followed by a chronic course.

Hepatitis C↗
PubMed1981

[Unusual features of perihepatitis in the differential diagnosis of upper abdominal pain].

Over a period of 3 years acute perihepatitis has been diagnosed in 7 women. Clinically the pain was localized to the right upper abdomen in 4, whereas 1 patient complained of bilateral upper quadrant pain; 2 patients presented with exclusively left-sided upper abdominal symptoms. In the literature perihepatitis is characterized clinically as a syndrome limited to the right upper abdominal quadrant. However, our own experience shows that this disease entity must also be considered in the differential diagnosis of left-sided upper abdominal pain in young female patients.

Abdomen↗
PubMed1981

Digoxin-associated thrombocytopaenia.

A 60-year-old male patient had two episodes of thrombocytopaenia whilst being treated with digoxin, each of them reversible upon withdrawal of the drug. Bone marrow examination was consistent with peripheral platelet destruction as the main mechanism of the thrombocytopaenia. The inhibition of clot retraction test was positive, with a declining titer, after cessation of digoxin therapy, and this plus the finding of circulating immune complexes after incubation of the patient's serum with digoxin established digoxin as the offending agent. It is concluded that digoxin may be a rare cause of drug-induced immune-thrombocytopaenia.

Digoxin↗
PubMed1981

Acute viral hepatitis B with bridging necrosis: a follow-up study.

Forty patients with bridging necrosis (BN) on biopsies taken during the course of acute viral hepatitis B were included in a prospective study to assess the prognostic significance of this lesion. Of the 22 patients with complete clinical, biochemical and histological follow-up (histological follow-up 5-33 months), only two failed to eliminate HBs- and HBe-antigen in serum, a finding paralleled by transition to chronic active hepatitis and by the persistence of focal HBc- and HBs-antigen expression in liver tissue. Nineteen of 22 patients showed complete histological healing; one developed inactive cirrhosis. It is concluded that, in the setting of acute viral hepatitis B, the histological lesion of BN is of no particular prognostic significance, and that transition to chronic liver disease is much less frequent than has been assumed from previous studies of etiologically heterogeneous patient populations. Markers of poor prognosis are the failure of serological elimination of HBs- and HBe-antigen and the persistence of spotty expression of HBc- and HBs-antigen on immunofluorescence histology.

Acute Disease↗
PubMed1980

[Steady-state plasma and saliva concentrations of procainamide and N-acetyl-procainamide after a sustained release preparation].

With ordinary procainamide tablets a dosing interval of 3-4 hours must be chosen to achieve therapeutically useful plasma concentrations during the entire interval. The concentrations of procainamide and its N-acetylated metabolite, NAPA, have been studied in the plasma of 10 normal volunteers and 11 patients who were given a new sustained release preparation at 8 hour intervals. Blood samples were taken between two doses on the fourth day of treatment. Procainamide showed levels within the accepted therapeutic range during the entire dosing interval. A dose of 4.5 g per day per 70 kg body-weight is necessary in order to achieve adequate levels. NAPA concentrations did not fluctuate during the dosing interval and mean steady-state concentrations were influenced predominantly by the degree of renal function. Saliva to plasma concentration ratio, measured in four patients, showed huge inter- and intraindividual variability. Therefore, saliva concentrations measurements of procainamide and NAPA are of little clinical use.

Acecainide↗
PubMed1976

[Extranodular manifestations of generalized malignant lymphomas].

90 cases of malignant lymphoma in the autopsy material of the Institute of Pathology, University of Zurich (1970-1974) have been analyzed with reference to extranodular manifestations. 8% of the malignant lymphomas showed primary extranodular manifestations. The organs involved were (in decreasing order of importance) spleen, bone marrow, liver, kidneys, central nervous system, pancreas, adrenal glands, skin, lung and stomach. In 12% of cases only the lymphnodes were affected, whereas in the rest of the cases (80%) lymphnodes as well as extranodular organs were involved. In 78% of the malignant lymphomas the disease had had its origin in a solitary lymphnode or in a group of lymphnodes, the cervical lymphnodes predominating (30%). In 22% of the cases, extranodular organs (primarily the intestinal tract) had been the site of the primary clinical manifestations. The average time of survival was 17 months, including all grades of differentiation of the proliferating tumor cells. For the more unfavourable reticulum-cell type of malignant lymphoma the corresponding period was only 12.5 months.

Bone Marrow Diseases↗
PubMedDate not supplied

Prevalence and significance of anti-HBc IgM (radioimmunoassay) in acute and chronic hepatitis B and in blood donors.

Anti-HBc IgM was determined by a modified radioimmunoassay (RIA) in 35 patients with acute hepatitis B, 35 patients with chronic hepatitis B (7 with chronic persistent, and 28 with chronic active hepatitis), 157 HBsAg positive blood donors, and in 143 HBsAg negative but anti-HBc positive donors. The results of the RIA test were compared with those obtained by an ELISA technique. In chronic hepatitis, anti-HBc IgM was correlated with the occurrence of HBeAg, anti-HBe, Dane particles in the serum, HBsAg, and HBcAg in liver tissue and with biochemical and histological degrees of hepatic inflammatory activity. In acute self-limited hepatitis B, anti-HBc IgM (RIA and ELISA) was initially positive in all 35 patients. Twelve months after the acute illness, 94% of the patients were negative for anti-HBc IgM in the RIA test with only one patient showing a persistence of up to 18 months, whereas in the ELISA test anti-HBc IgM persisted in 17% of the patients over 2 years. In chronic hepatitis, the occurrence of anti-HBc IgM (RIA) showed a strong relation with the inflammatory activity, the anti-HBc IgM positive patients revealing a significantly more severe liver disease than did anti-HBc IgM negative patients. Anti-HBc IgM (RIA), however, did not correlate with the occurrence of HBeAg and Dane particles in the serum and HBcAg in liver tissue of patients with chronic hepatitis. Of the 157 HBsAg positive blood donors, anti-HBc IgM (RIA) could be demonstrated in 10 (6%), but in none of the 143 HBsAg negative, but anti-HBc positive donors, as compared to 43 (27%) and 9 (6%), respectively, in the ELISA test. Comparing the two test methods, the RIA exhibits higher specificity than did the ELISA due to a better blocking of nonspecific reactions, but possibly somewhat lower sensitivity. In this form, however, the RIA test is a more useful tool in the diagnosis of the different forms of hepatitis B virus infection and in determining the severity of chronic hepatitis B.

Blood Donors↗
PubMedDate not supplied

Nuclear particles of non-A, non-B type in healthy volunteers and patients with hepatitis B.

In an electron microscopic study, nuclear aggregates of virus-like spherical and tubular particles measuring 20 to 29 nm in diameter were found in 5 of 7 clinically healthy volunteers with normal liver histology, 6 of 10 patients with hepatitis B and 17 of 18 patients with hepatitis non-A, non-B. The incidence of hepatocytes containing nuclear particles was approximately 0.5 to 2% in all three groups. We conclude that these nuclear particles are not specific ultrastructural markers of hepatitis non-A, non-B in man as originally claimed for experimental hepatitis non-A, non-B in chimpanzees.

Adolescent↗
PubMedDate not supplied

Pneumococcal vaccination: the response of patients with alcoholic liver cirrhosis.

Patients with cirrhosis have an increased risk of dying from pneumococcal pneumonia. Their immunological response to pneumococcal vaccination is not known. We compared the antibody response to challenge with a 14-valent purified pneumococcal polysaccharide vaccine in 15 patients with biopsy-proven alcoholic liver cirrhosis, 10 healthy volunteers and 10 patients with chronic obstructive pulmonary disease. Preimmunization levels for Danish type 1 pneumococcal polysaccharide were lower among cirrhotics than patients with chronic obstructive pulmonary disease. Four and 12 weeks after immunization, no significant differences were found in antibody concentrations between the three groups. We conclude that patients with alcoholic cirrhosis can produce an adequate antibody response to pneumococcal polysaccharide antigen.

Adult↗
PubMedDate not supplied

Absence of detectable serum interferon in acute and chronic viral hepatitis.

Amounts of interferon were measured in sera from 59 patients with acute viral hepatitis and 49 patients with chronic hepatitis B and compared to those from patients with nonviral liver disease or influenza, and from healthy controls. In all patients with acute and chronic viral hepatitis, no serum interferon could be detected, confirming data from earlier studies of acute viral hepatitis in which no circulating interferon was found. Our results disprove the view that the amounts of serum interferon, detected at the time of the acute clinical illness, may be a determinant of outcome.

Acute Disease↗
PubMedDate not supplied

Amiodarone-induced hepatic phospholipidosis: correlation of morphological and biochemical findings in an animal model.

Morphological and biochemical investigations were performed in guinea pigs after 1, 3, 5 and 16 weeks of amiodarone feeding. The most prominent morphological finding was an increase in dense bodies in hepatocytes, Kupffer cells and in bile duct epithelia, reaching a maximum after 5 weeks of treatment according to morphometric analysis. Similar time courses were observed for the serum and liver tissue concentrations of amiodarone and desethylamiodarone and the--albeit minimal--extent of hepatocellular necrosis. Phospholipids in the liver homogenate were unchanged after 1 week, but significantly increased after prolonged amiodarone treatment. There was no significant alteration in the pattern of individual phospholipids. Serum and tissue concentrations as well as the extent of phospholipidosis do not appear to be a function of the duration of drug application. A very close correlation, however, was observed between the liver tissue concentration of amiodarone and the amount of dense bodies as a morphological expression of phospholipidosis.

Amiodarone↗