Search PubMed⌕ Search

Biomedical subjects

R Naccarato

Publications and source records attributed to R Naccarato.

At least 163 records · Page 9Linked to original sources
PubMed1989

Alpha-fetoprotein, tissue polypeptide antigen and ferritin in diagnosing primary hepatocellular carcinoma in patients with liver cirrhosis.

This study was undertaken in order to compare the usefulness of three indices of tumour proliferation in detecting primary hepatocellular carcinoma (HCC) and in differentiating this neoplasm from liver cirrhosis. In 10 patients with HCC and in 63 with liver cirrhosis serum alpha-fetoprotein (AFP), tissue polypeptide antigen (TPA) and ferritin were assayed. Increased levels of AFP but not of TPA and ferritin were observed in HCC as compared to liver/cirrhosis. The receiver-operating characteristic curves demonstrated that AFP is more discriminating between HCC and liver cirrhosis than the other two markers. Correlations between liver function tests and serum markers were observed in liver cirrhosis but no in HCC. We can conclude that AFP is more useful than TPA and ferritin in detecting HCC in patients with liver cirrhosis, owing to the high frequency of false positive results of the latter two indices in liver cirrhosis. Liver dysfunction is probably involved in increasing all these markers of malignancy, thus reducing the specificity of these tests.

Adult↗
PubMed1989

Mutagenic activity in gastric juice and urine of subjects with chronic atrophic gastritis, gastric epithelial dysplasia and gastric cancer.

Gastric juice and urine samples from consecutive patients who underwent endoscopy for upper GI tract complaints were examined for the presence of mutagens. Patients endoscopically and histologically diagnosed as having either chronic atrophic gastritis (CAG) or gastric cancer (GC) had higher than normal levels of mutagens in their gastric juice and urine. The gastric juice pH of these patients was also elevated and, in the case of the CAG patients, contained detectable levels of nitrites. No correlation was however found between gastric mutagen levels and urinary mutagen excretion in the individuals examined.

Adult↗
PubMed1989

Renal tubular dysfunction in pancreatic cancer and chronic pancreatitis.

Urinary excretion of alpha-glucosidase (AGL), gamma-glutamyltransferase (GGT) and ribonuclease (RNase), and serum amylase and immunoreactive trypsin (IRT) were determined in 38 control subjects, 48 patients with pancreatic cancer, 77 with chronic pancreatitis and 47 with extrapancreatic diseases in order to ascertain the presence of a renal tubular damage and to investigate its etiology. A significantly increased frequency of pathological results for all urinary enzymes was documented in the various groups of patients as compared to controls. Significant correlations were detected among AGL, GGT and RNase. Considering the subjects as a whole, GGT and RNase excretions correlated with serum IRT and amylase; the two urinary enzymes were found to be higher when jaundice was present. In chronic pancreatic disease enzymuria was related to increased serum pancreatic enzymes; in extrapancreatic diseases it was associated to hyperbilirubinemia. The vast majority of patients with pancreatic cancer and elevated urinary enzymes presented hepatic metastases and/or jaundice. We can conclude that an anatomical and functional tubular impairment is detectable in some patients with chronic pancreatic and extrapancreatic diseases. Tubular damage seems to least in part to be related to pancreatic inflammation and necrosis in chronic pancreatic disease, while jaundice may be found to play an important role in diseases of the hepatobiliary tract. In pancreatic cancer, liver dysfunction (presence of liver metastases and/or extrahepatic cholestasis) also appears to be involved in altering tubular cells.

Adult↗
PubMed1989

[Basal and postprandial blood gastrin in peptic ulcer. The physiopathological considerations in relation to different locations of the lesion].

A different pathophysiological mechanism is widely accepted for gastric and duodenal ulcer. In particular, the exact role of gastrin in the determinism of nonhormone-dependent peptic ulcer disease has been completely clarified. The aim of the present study was to analyse fasting and postprandial serum gastrin levels in 99 duodenal ulcer patients, 17 gastric ulcer patients and 11 subjects presenting an association of gastric and duodenal ulcer. The possible correlation between postprandial gastrin concentrations and basal and maximal acid output in the 3 groups of patients has also been investigated. Fasting serum gastrin levels do not appear different among the 3 classes of patients, while postprandial gastrin concentrations are statistically higher at 15 minutes in duodenal ulcer patients and in subjects with the association of gastric and duodenal ulcer as compared to gastric ulcer patients. Mean fasting and stimulated gastrin levels are higher in gastric ulcer females than in males during the entire test and with a statistically significant difference at 30 minutes. The concentrations of the hormone are not different in males of the 3 groups of patients at basal time, while they are statistically lower at 15 and 30 minutes in gastric ulcer males compared to those with duodenal ulcer and the association of the localization. Finally, positive correlation has been observed between B.A.O. and M.A.O. and postprandial gastrin concentration in the 3 groups of patients, while there is an inverse correlation between the previous parameters as regards sex, both in gastric and duodenal ulcer.

Adult↗
PubMed1989

Hyperthyroidism associated with primary cirrhosis. Two case reports.

Only a single case of Graves' disease has been reported so far in Primary Biliary Cirrhosis (PBC), whereas hypothyroidism is a rather common association. We report two cases of hyperthyroidism associated with PBC. A common pathogenic mechanism involving HLA II class antigens is suggested.

Female↗
PubMed1989

[Clinical usefulness of the blood gastrin curve after protein meal in duodenal ulcer].

Conflicting data are present in the literature on pathophysiological role of serum gastrin and peptic ulcer disease. The aim of this study was to evaluate, in duodenal ulcer patients, the possible correlation between post-prandial serum gastrin concentrations and some epidemiological (sex, family history, onset of the disease, blood group status, smoking habit, alcohol consumption) and clinical (effectiveness of therapy, bleeding episodes) factors. The gastrin levels were expressed in absolute values and as per cent increase of fasting serum gastrin concentrations. As regards sex, the per cent increase of fasting serum gastrin concentration was significantly higher in females (No. 16) than in males (No. 60) at 30 and 60 minutes (192.25% vs 116.52% and 105.42% vs 40.96% respectively; p less than 0.05 and p less than 0.005). Post-prandial serum gastrin concentrations, expressed as per cent increase, were higher in heavy drinkers (No. 14) and statistically significant at 120 minutes (40.57% vs 9.58%, p less than 0.025); as well as in smoker patients (No. 31), at 15, 30 and 60 minutes (227.59% vs 123.52%, 177.23% vs 101.62%, 0.025 and p less than 0.05). Post-prandial gastrin was unrelated to blood group status, onset of the disease, family history, effectiveness of medical treatment and bleeding episodes.

Adult↗
PubMed1989

[Famotidine in the short and long term treatment of duodenal ulcer: clinical and physiopathologic study].

UNLABELLED: The aim of this study was to evaluate the clinical efficacy of short and long-term treatment with famotidine 40 mg/daily at bed time in duodenal ulcer disease. 45 patients with endoscopically proven active duodenal ulcer undertaken the study. Endoscopic evaluations were performed at 6 weeks, 3 and 6 months from the start of the study. The following parameters were evaluated: pepsinogen group I and gastrin levels in serum, pH, acid and neutral glycoprotein, N-acetylneuraminic acid, pepsin in gastric juice collected during the upper gastrointestinal endoscopy. 6 weeks healing rate was 91.1%. After the third month of follow-up 14.2% of the patients presented an endoscopical proven episode of relapse. No relapses were observed at the end of the study (after 6 months of treatment). Acid glycoprotein, N- acetylneuraminic acid and pepsin concentrations significantly decreased after 6 weeks of treatment (p less than 0.0125, p less than 0.025, p less than 0.005 respectively), while serum levels of pepsinogen group I, gastrin and gastric pH increased (p less than 0.0005, p less than 0.005, p less than 0.025). After 6 months period of therapy, a significant increase of neutral glycoproteins (p less than 0.01) and a decrease of pepsin (p less than 0.005) and acid glycoproteins (p less than 0.01) was observed. On the contrary, gastric N- acetylneuraminic acid, pH, serum gastrin and pepsinogen group I presented the pre-trial values. IN CONCLUSION: 1) famotidine appears to be an effective and safe therapy for duodenal ulcer treatment; 2) it seems to act not only by inhibiting gastric acid secretion but also influencing some parameters related to the gastric mucosal barrier.

Adolescent↗
PubMed1989

[Intragastric pH determination as a screening test in the diagnosis of chronic atrophic gastritis].

A simple routine endoscopic screening test has been sought for the diagnosis of chronic atrophic gastritis. An endoscopic-bioptic study was therefore carried out on 850 subjects presenting consecutively at a Digestive Endoscopy Department with dyspeptic-pain symptomatology. In a first sample of 389 patients, 2 biopsies of the gastric body and 2 of the gastric antrum were carried out, independently of the endoscopically documented macroscopic picture. Atrophic changes were in this way encountered in 65 patients (16.7%). In a second group of 461 patients, intragastric pH was determined extemporaneously during endoscopy. pH was = or greater than the chosen threshold value (3.5) in 117 patients and less than this value in 344. In all subjects with pH greater than 3.5 and, by comparison, in 130 with pH less than 3.5 biopsy was carried out on the gastric mucosa, 2 biopsies of the body and 2 of the antrum. Using this approach it was possible to determine the presence of atrophic changes in the gastric mucosa in 57 of 117 (48%) and in 25 of 130 (20%) respectively. In total, chronic atrophic gastritis was diagnosed in 83 of 461 subjects (18%). This percentage is comparable to that observed in the frequency of chronic atrophic gastritis using the more demanding and less selective test of bioptic sampling indiscriminately for all patient. So, the straight-forward determination of intragastric pH in a sample of gastric juice taken during digestive endoscopy would appear to meet the criteria demanded for a screening test and its wider use is recommended in routine endoscopic practice.

Adolescent↗
PubMed1988

CA 19-9 determination in gastric juice: role in identifying gastric cancer and high risk patients.

Gastric juice CA 19-9 levels were determined in 23 patients affected by gastric cancer, in 57 patients affected by chronic atrophic gastritis of different severities and in 55 'healthy' controls, undergoing endoscopy for upper gastrointestinal tract symptoms. Increased CA 19-9 levels were documented in chronic atrophic gastritis patients as well as in gastric cancer patients, the difference with respect to controls being statistically significant. However, there was considerable overlap between different groups. In particular, gastric cancer patients had CA 19-9 levels similar to those detected in moderate and severe chronic atrophic gastritis. CA 19-9 correlated with gastric juice pH and CEA concentration. Its values were not influenced by the patients' age or sex. In our opinion CA 19-9 gastric juice determination, although not useful in singling out patients harboring gastric neoplasia, may be used in identifying patients 'at risk' for gastric cancer and who might then be referred for more accurate investigations.

Adult↗
PubMed1988

Smooth liver surface may conceal cirrhosis. Evidence for the late development of nodular surface of the cirrhotic liver.

A 22-year-old male student with HBs Ag + acute hepatic necrosis was admitted to our clinic for further examination. Since his liver function worsened, laparoscopy with direct vision hepatic biopsy was performed. Macroscopically, the surface of the liver did not show the characteristic nodular appearance, in contrast to histological alterations suggestive of liver cirrhosis. Eight months later, a second laparoscopic/bioptic examination was performed. The liver surface appeared nodular, while the histological picture was unchanged vis-a-vis the first examination. The discrepancy between the macroscopic findings observed at the first laparoscopy and those seen eight months later, would suggest that cirrhosis initially develops "inside" the liver and can only be detected histologically; the characteristic nodularity of the liver surface "emerges" subsequently.

Adult↗
PubMed1988

Renal factors in serum trypsinogen 1 metabolism and excretion in chronic pancreatic disease.

In order to investigate the role of renal factors in affecting trypsinogen 1 metabolism and excretion in chronic pancreatic disease, serum immunoreactive trypsin (IRT), urinary IRT, gamma-glutamyltransferase (GGT), alpha-glucosidase (AGL) and RNase outputs and the molecular size distribution of serum and urine IRT were studied in 8 control subjects, 18 cases with pancreatic cancer, and 23 cases with chronic pancreatitis. Serum chromatography demonstrated that most immunoreactivity eluted as trypsinogen 1. Smaller amounts of immunoreactivity at higher molecular weights were also observed. Urine chromatography displayed both trypsinogen 1 and heavier molecular forms. An inverse linear correlation was noticed between creatinine clearance and serum trypsinogen 1 levels. Multiple regression analysis (urinary IRT output dependent and GGT, AGL, and RNase predictor variables) showed a significant linear correlation. RNase was found to be the most important parameter in explaining urinary IRT output. Mild variations in the glomerular function seem to be able to influence serum trypsinogen 1 levels. Urinary IRT excretion is principally explained by a disturbance in the tubular reabsorption of low molecular weight proteins, such as RNase.

Adult↗
PubMed1988

Gastric cell c-AMP stimulating autoantibodies in duodenal ulcer disease.

Gastric cell c-AMP stimulating antibodies (GCS-Ab) were studied in 30 patients with duodenal ulcer (DU) disease. Semipurified immunoglobulin (Ig) preparations from 13/30 patients stimulated c-AMP production in parietal cell enriched gastric cell suspensions obtained from male guinea pig stomachs. Maximum stimulation (varying between 260 and 547%) was reached after four hours incubation with 2 and 4 mg/ml Ig concentrations. The 13 patients with gastric cell stimulating antibodies (GCS-Ab), all male patients, developed the disease at a younger age (nine of 13 under the age of 30), had a longer duration of symptoms (mean 18.4 years), and had a higher incidence of DU in their families (61%). Eight of 13 (61%) in the GCS-Ab+ group did not respond to anti-H2-R drugs, whereas in the negative patients only three of 17 (18%) were classified as 'non-responders'. Remarkably few conventional autoantibodies were detected in our series. Gastric cell stimulating antibodies are a new addition to the growing list of receptor antibodies in human diseases and the described in vitro test should provide an easier tool for screening large populations.

Adult↗
PubMed1988

Gastric ulcer and stomach aging: pathophysiology and clinical implications.

138 consecutive patients with endoscopically and histologically confirmed benign gastric ulcer were investigated in order to evaluate the relationship between aging and parameters relating to gastric ulcer pathophysiology and natural history: prevalence in dyspeptic patients referred to an endoscopic unit, recurrences, gastric acid secretory capacity, peptic activity, incidence of precancerous and neoplastic changes. On the basis of our results, different populations of gastric ulcer patients seem to be identifiable: (1) young patients (aged under 40), with low prevalence and recurrence rates, with acid capacity above normal range, high peptic activity and no risk for precancerous or neoplastic changes, (2) middleaged subjects (41-50), with high prevalence and recurrence rates, high peptic activity and acid activity within the normal range, atrophic gastritis, intestinal metaplasia, dysplasia and low incidence of cancer, and (3) elderly patients (aged over 50), with lower prevalence and recurrence rates, frequent association with chronic atrophic gastritis, impaired acid and peptic secretion, in whom one may observe either an association of the ulceration with cancer or evolution of dysplasia into neoplasia. These observations confirm that elderly and middle-aged gastric ulcer patients should undergo routine follow-up, and that pathophysiological data should be taken into account before deciding upon antiulcer therapy.

Adult↗
PubMed1988

Combined determination of serum CA 19-9 and tissue polypeptide antigen: why no improvement in pancreatic cancer diagnosis?

CA 19-9 and tissue polypeptide antigen (TPA) were determined in the sera of 28 control subjects, 29 patients with pancreatic cancer, 26 with chronic pancreatitis and 62 with benign and malignant extra pancreatic diseases in order to compare their usefulness in diagnosing pancreatic cancer, to verify whether the combined assessment of the two indices could improve the results given by a single parameter and to speculate on the role of liver dysfunction in increasing their serum levels. The sensitivity, specificity and accuracy of CA 19-9 and TPA in diagnosing pancreatic malignancy were: 76, 85 and 61% for CA 19-9 and 79, 52 and 32% for TPA. The receiver-operating characteristic curves showed that CA 19-9 and TPA similarly discriminate pancreatic cancer from controls and chronic pancreatitis, while CA 19-9 is more useful than TPA in differentiating pancreatic malignancy from benign and malignant extra pancreatic abdominal diseases. TPA did not seem to add further information as compared to CA 19-9 alone when both markers were combined. Liver dysfunction may contribute to increasing serum levels of both markers.

Antigens, Neoplasm↗