[Digestive system hormones. I. Physiology].
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Over the coming decades gastroenterology,--similarly to other branches of medicine,--will be confronted with AIDS and related disorders. In this article the gastrointestinal organ-associated symptoms are briefly reviewed with special reference to: esophagus, stomach, hepatobiliary system and the guts. Some special endoscopic problems of this field have also been mentioned.
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Tumor-caused weight loss is frequently associated with a high rate of lipolysis and fat oxidation. In order to differentiate the effect of weight-loss from the tumour-dependent regulation of fat metabolism, we studied weight-stable and well nourished patients (ideal body weight 109 +/- 4% (+/- SEM), body mass index 25.1 +/- 0.9 kg/m2). Parameters of lipolysis (glycerol-, fatty acid concentrations) and the calorimetric determined fat oxidation rate of five male tumor patients were examined before and during an euglycaemic insulinclamp (0.2 mU insulin/kg/min). Concomitant with a high rate of lipolysis (glycerol concentration 112 +/- 20 mumol/l, free fatty acid concentration 0.72 +/- 0.13 mmol/l) and fat oxidation (60% of energy expenditure) there was a low normal insulin level (5.9 +/- 0.5 mU/l). Insulin reduced lipolysis and fat oxidation and stimulated glucose oxidation. Weight-stable tumor patients have a high basal rate of lipolysis and fat oxidation; yet the insulin dependent regulation of the fat metabolism is intact, as we have already shown for weight-losing cancer patients.
Malt lymphomas are lymphomas developed from mucosa associated lymphoid tissue and may involve many sites such as the gastrointestinal tract, salivary glands, thyroid gland lung, breast and female genital tract. Histologically, their diagnosis is based upon the existence of four elements: centrocyte-like cells that are responsible for lymphoepithelial lesions that are sometimes very difficult to demonstrate reactive or residual follicles and plasma cells. We study 2 cases of gastric Malt lymphoma and one of alpha heavy chain disease involving the small intestine and the stomach and we try to define the common features of Malt lymphoma, alpha chain disease and non-secretary IPSID, which all present the clinical tetralogy mentioned above.
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Mortality from colon-rectal cancer is rising steadily in Italy; of malignant tumours, those of the nitestine come second after those of the lung. Hence the ned for early diagnosis based on the search for occult blood in the stools. This test takes on important significance for screening purposes in subjects at risk. Alongside diagnosis it is important to effect primary prevention diet, food and environmental factors). A negative result of the identification of occult blood in the stools absolutely does not exclude tumour of the intestinal tract. A positive finding, on the other hand, does not necessarily confirm the presence of a tumour. Such an investigation was carried out at the Analysis Laboratory of the Sant'Antonio di Ovada Hospital, Health Unit 74, in the period between October '87 and June '88. The samples were taken from hospitalised patients and from out-patients. The samples from hospitalised patients totalled 324 and 20 proved positive for occult blood; of the out-patient samples (176), positivity was observed in 12. Hospitalised patients were recontrolled and results were confirmed positive. The out-patients did not present for further controls.