Biomedical subjects
Publications and source records attributed to V Fazio.
A combination of external and contact irradiation treatment has been used successfully in treatment of selected patients with carcinoma of the rectum. The advantages include eliminating a permanent colostomy. If the treatment is unsuccessful in controlling the lesion, electrocoagulation and abdominoperineal resection are still available.
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Sixty-six patients underwent ileorectal anastomasis for Crohn's colitis sparing the rectum between 1957 and 1972. Excellent results were achieved in 26 patients and satisfactory results in 12. Unsatisfactory progress necessitated further surgery in 21 patients. Seven patients with diversionary ileostomies and ileorectal anastomoses never had their ileostomies closed. No anastomotic leaks developed. Five patients died from causes not directly related to the ileorectal anastomosis. These results indicate that ileorectal anastomosis is a safe and useful procedure for selected patients with Crohn's colitis.
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Nine cases of duodenal fistula complicating Crohn's disease are reported. All nine patients were male. Four patients had Crohn's disease of the ileum and five had ileocolitis. No patient had primary duodenal Crohn's disease. Because attempt at primary closure of the duodenal defect may fail, our treatment of choice has been formal cross cut two-layered duodenojejunal anastomostis with extensive drainage of the area postoperatively. This treatment has been associated with no mortality and little morbidity, and no late recurrence of duodenal fistula.
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The aim was to confirm the influence of HLA Class II antigens on the progression of HCV infection and to assess the relationship between these antigens and histological damage, HCV viral load and HCV genotype. 143 patients were enrolled and divided into three groups. Group A included 34 anti-HCV positive, HCV-RNA negative patients with ALT persistently normal; group B included 39 patients with HCV-RNA positive and abnormal ALT level; group C included 70 normal subjects. Serological HCL typing was performed with lymphocytotoxicity test by Terasaky and McClelland, using lymphobeads HLC class II. The frequency of HLA DR11 (5) was significantly higher in the control group (52.9%) and in group A (64.7%), than in group B (28.2%). Allele HLA DR6 was demonstrated in a similar proportion (26%) among control group and group B, while HLA DR14 (6) was less frequent among controls (18% vs 1.4%). In group A the frequency of HLA DR14 (6) was 3% compared to group B, HLA DR17 (3) was prevalent (15.4%) in group B. Liver damage was associated with the detection of HLA DR14 (6) and HLD DR17 (3) antigens. Significantly lower levels of HCV-RNA were measured in subjects with HLA DR11 (5) than in these with either DR6 or DR17 (3). HLA class II antigens appear crucial for resolution or progression of HCV hepatitis. The punctual identification of these genetic factors may, therefore, prove to be useful in predicting disease evolution, in guiding the appropriate therapy for patients with poor prognosis, and in encouraging the development of now therapeutic strategies.