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Biomedical subjects

M Valentini

Publications and source records attributed to M Valentini.

107 records · Page 6Linked to original sources
PubMedDate not supplied

Gastric cyto-secretory correlations in peptic ulcer.

BACKGROUND/AIMS: Maximal acid output, parietal cell mass, serum pepsinogen A (PGA) and total peptic activity (TPA) in gastric juice were studied and compared in duodenal ulcer and in different gastric ulcer sites. METHODOLOGY: 152 peptic ulcer patients were studied. 64 cases of gastric ulcer (GU) were subdivided according to Johnsons's classification and compared with 88 duodenal ulcer (DU) patients diagnosed for the first time. 40 normal subjects were studied as controls. RESULTS: Duodenal ulcer is characterized by normo-hyperparietalism, normo-hyperchloridria and an increase in peptic activity. In cases of GU, such correlation is not only conditioned by the topographic seat of the ulcer, but by the histological condition of the gastric mucosa too. Body GU is characterized by hypoparietalism, hypochloridria, hyper-PGA and hyper-TPA. Pre-pyloric GU is characterized by normo-hyperparietalism, normo-hyperchloridria, hyper-PGA and hyper-TPA. In GU the cyto-secretory behavior is characterized by the histology of the body mucosa with prevalence of preatrophic-atrophic gastritis in case of body GU and prevalence of superficial gastritis in case of GU type II and III. CONCLUSIONS: The results confirm the anatomic-functional analogy between DU and type II and III GU. If considered from the functional point of view, these conditions differ considerably from those that are characteristic of type I GU (as they closely follow the chronic gastritis pattern).

Duodenal Ulcer↗
PubMedDate not supplied

Prognostic value of S-phase fraction in T3N0M0 gastric cancer. Implications for adjuvant chemotherapy.

INTRODUCTION: The prognosis of patients with T3N0M0 gastric cancer is still unfavourable and the role of adjuvant chemotherapy is unclear. We addressed this study to evaluate whether the analysis of the S-Phase Fraction (SPF) might have prognostic implications in serosa-positive, node-negative gastric cancer. MATERIALS AND METHODS: Specimens of resected gastric cancer were studied by flow cytometry for SPF analysis. Consecutive patients with stage pT3N0M0, adequate follow-up information and sufficient archival tumor tissue were considered eligible for the study. The tumor SPF indices were related to the timing of recurrences, the relapse rate and the disease-free survival of patients. RESULTS: The analysis was carried out on samples of 137 patients with surgically-resected, stage pT3N0M0 gastric cancer. SPF resulted high and low in 39% and 61% of cases, respectively. Fifty-seven patients relapsed (42%) and early recurrences (within 18 months after surgery) occurred more frequently among cases with high SPF (p < .03). Patients with high SPF tumors showed a worse relapse rate and disease-free survival than patients with low SPF tumors. (p < .005). CONCLUSION: The SPF analysis showed prognostic differences among patients with stage pT3N0M0 gastric cancer. These data may be of value in the planning of future adjuvant chemotherapy trials in gastric cancer.

Adult↗
PubMedDate not supplied

[ACE inhibitors and vagal activity: the effect of captopril and lisinopril on cardiovascular reflexes].

The influence of the ACE-inhibitors captopril and lisinopril on parasympathetic activity in normotensive subjects was evaluated. Three cardiovascular tests which explored chiefly parasympathetic function (deep breathing, lying to standing and Valsalva test) were performed in 10 normotensive volunteers (mean age 26.1 years) in both basal conditions and after four days of treatment with either captopril (25 mg twice a day) or lisinopril (20 mg once a day). Mean blood pressure was not influenced by captopril, whereas it was significantly lowered with lisinopril (from 94.4 +/- 6.8 to 88.7 +/- 5.7 mmHg; p < 0.05). Neither drug interfered with heart rate or with the results of the deep breathing and Valsalva tests. The 30/15 ratio, an index of heart rate variability during the lying to standing test, significantly worsened after assumption of both captopril (from 1.37 +/- 0.18 to 1.21 +/- 0.14; p < 0.05) and lisinopril (from 1.31 +/- 0.17 to 1.20 +/- 0.11; p < 0.05). Although our subjects had a lisinopril-induced drop in blood pressure, their heart rate remained steady. This finding confirms previous studies reporting the lack of reflex tachycardia during ACE-inhibition. The slight effect of ACE-inhibitors on the results of deep breathing and Valsalva tests suggests that such drugs do not directly stimulate vagal activity; the significant decrease of the 30/15 ratio may be due to a functional impairment of the baroreflex mechanism.

Adult↗
PubMedDate not supplied

[The diagnostic and therapeutic validity of pneumoradiography of breast cysts in the light of personal experience with 236 cases].

Personal experience of 236 breast cyst aspirations is reported. In 224 cases, insufflation was also successful and pneumocystomammography was carried out, associated always with cytological examination of the aspirated fluid. In 2 cases, the examination made possible a diagnosis of cyst degeneration (0.8%). The number of recurrences was minimal (2.8%). It is concluded that the technique is diagnostically and therapeutically useful.

Adult↗
PubMedDate not supplied

Nocturnal gastric acidity pattern in gastro-oesophageal reflux disease with or without oesophagitis.

The reasons why few patients with gastro-oesophageal reflux disease develop oesophagitis are not yet clear. One of the factors whose role is still debatable is the gastric acid secretory state. The aim of this study was to evaluate whether differences exist in nocturnal gastric acidity between patients with oesophagitis and refluxers without oesophageal lesions. We studied 65 patients with gastro-oesophageal reflux disease, 37 of whom presented erosive oesophagitis, while 28 had no oesophageal lesions. Thirty-one healthy volunteers were used as controls. In both patients and controls intragastric and intraoesophageal pH were measured continuously using 2 in-dwelling glass electrodes, placed in the gastric corpus and in the oesophagus. Mean intragastric pH was calculated over 3 nocturnal time periods: 11.00 p.m.-07.00 a.m.; 11.00 p.m.-03.00 a.m.; 03.00 a.m.-07.00 a.m. Patients with oesophagitis had a lower nocturnal gastric pH (1.6 +/- 0.2) than either refluxers without oesophagitis (2.2 +/- 0.3) (p = 0.05) or controls (2.6 +/- 0.4) (p = 0.02). The difference occurred entirely in the second part of the night. Furthermore, in the same time period, oesophagitis sufferers had a higher percentage of oesophageal acid exposure at pH < 2 (0.7 +/- 0.2) than refluxers without oesophagitis (0.2 +/- 0.1) (p = 0.05), suggesting that gastric findings are of pathogenetic relevance. Patients with reflux oesophagitis have a higher nocturnal intragastric acidity than refluxers without oesophagitis. This difference, confined to the second half of the night, may be due to an altered circadian pattern of gastric acid secretion and may partially explain why only some refluxers develop oesophagitis.

Adult↗
PubMedDate not supplied

Conservation surgery for breast cancer.

Advances in early diagnosis of breast cancer have allowed most patients to come to treatment at an early stage (in the US in 1993, 75% of cases were stage I-II). In these cases, conservation surgery has played in the last two decades the role of first choice thearpy following randomized studies which definitely showed the same safety and effectiveness as compared to conventional mastectomy. In time, indications for breast conservation therapy underwent modifications as for the size and site of primary tumor, and the presence of concomitant metastases to ipsilateral axillary lymph nodes. Absolute contraindications are still a multicentric diseases, and the presence of diffuse microcalcifications, while tumors over 3 cm in diameter may be amenable to conservation therapy with primary chemotherapy, retroareolar tumors can be resected with central quadrantectomy and clinically evident axillary metastases do not influence local treatment. There are still open problems as for the extent of peritumoral parenchymal excision, indications for complementary radiotherapy and axillary lymphadenectomy.

Breast Neoplasms↗
PubMedDate not supplied

The onset of CML in blastic crisis: molecular features.

The lack of distinguishing characteristics between lymphoid blastic crisis (BC) of Philadelphia (Ph)+ chronic myeloid leukemia (CML) and Ph+ acute lymphoblastic leukemia (ALL) remains an exciting dilemma. Indeed, the genetic defect of approximately half of Ph+ ALL patients is identical to that identified in CML. Here we report the case of one patient admitted with immunological and molecular patterns indicative of Ph+ ALL. The patient was brought into complete remission by chemotherapy and was transplanted with an HLA identical sibling donor, but relapsed a few months later with immunological and molecular evidence of BC of CML, displaying myeloid markers and lacking lymphoid antigens and immunoglobulin heavy chain (IgH) rearrangement. This suggest a CML case with an initial BC without a previous chronic phase or supervening on a subclinical CML.

Adult↗
PubMedDate not supplied

Evaluation of the risk for metachronous colorectal neoplasms following intestinal polypectomy: a clinical, endoscopic and pathological study.

BACKGROUND/AIMS: Surveillance programs are recommended for patients with previous intestinal polypectomy because of the high rate of adenomatous recurrences and risk of subsequent colorectal cancer. The parameters to identify patients at higher risk and the length and schedules of follow-up have not yet been established. We considered some clinical, endoscopic and pathological parameters in order to assess the probability of developing new colorectal neoplasms and eventually to schedule proper surveillance programs. METHODOLOGY: Patients with removed adenomas were enrolled into a clinico-endoscopic follow-up, comprehensive of two colonoscopies the first at 1 year and the second at 3 years. We evaluated the risk of new neoplasms dividing the patients into four groups according to the number and size of the adenomas removed and the parameters considered. RESULTS: Of 164 patients enrolled 156 completed the study. We had an overall 21.3% of adenomatous recurrences at 1 year and 12.8% at 3 years. Most of the adenomas removed were tubular and small in size (< 1 cm). The percentage of patients who had adenomas with advanced pathological features was 1.82% at 1 year and 0.64% at 3 years. The increase in number and size of the adenomas removed on the initial colonoscopic examination was the only one parameter statistically significant, X(2)1 (trend) 5.11; p<0.05 at the first follow-up and X(2)1 (trend) 4.87; p<0.05 at the second follow-up. CONCLUSIONS: Patients with previous single adenoma showed few recurrences of extremely benign histological features. Since they do not require short-term endoscopic examination, it would be reasonable to defer the next colonoscopy for at least another 5 years. During follow-up, patients with multiple polyps had adenomas with advanced pathological features so it was useful to follow-up at 1 year. The tendency for advanced pathological features of removed polyps was not seen at 3 years, suggesting the importance of long-term follow-up, but with longer intervals.

Adenoma↗