Prevalence of previously undiagnosed gallstones in a population with multiple risk factors.

This study was aimed at investigating whether it is possible, on the basis of the presence of multiple factors, to select a population with a higher prevalence of gallstones than that predicted simply on the basis of age and sex. Thus, we selected and screened for the presence of previously undiagnosed gallstones subjects with at least four of the following variables: female sex, age over 40, obesity, diabetes, biliary colic, family history of gallstones or cholecystectomy, hypertriglyceridemia, parity, and oral contraceptive use. The a priori probability (or expected prevalence) of having previously undiagnosed gallstones was calculated for each subject on the basis of sex and age according to data derived from epidemiological studies performed in Italy in the general population.

The natural history of gallstones: the GREPCO experience. The GREPCO Group.

During the cross-sectional studies (February 1981 to July 1984) performed by the Group for Epidemiology and Prevention of Cholelithiasis (GREPCO) in Rome, Italy, 161 subjects were identified as having gallstones. Ten subjects did not participate in the prospective follow-up. At entry, 33 of the 151 remaining subjects were symptomatic, and 118 were asymptomatic.

Epidemiology of gallstone disease in Italy: prevalence data of the Multicenter Italian Study on Cholelithiasis (M.I.COL.).

This study was designed to obtain a general overview of gallstone disease in Italy. A total of 18 cohorts in 10 Italian regions were enrolled in this survey. Four cohorts were excluded from analysis because of a participation rate of less than 50 percent.

Treatment of type C chronic active hepatitis with interferon-alpha 2a. Treatment duration does not influence biochemical remission but does decrease the relapse rate.

Few data are as yet available on the influence of interferon (IFN) treatment duration on biochemical remission and posttreatment relapse of chronic type C hepatitis. We investigated whether duration of recombinant IFN-alpha 2a treatment influences the remission and relapse rates in type C chronic active hepatitis (CAH). Sixty-two CAH patients were randomly assigned to receive 3 MU of i.

Goserelin in premenopausal advanced breast cancer: clinical and endocrine evaluation of responsive patients.

Medical ovariectomy with goserelin is an alternative to surgical oophorectomy. To evaluate the relationship between tumor regression and endocrine changes induced by therapy, 40 premenopausal patients with advanced breast cancer were given 3.6 mg of goserelin subcutaneously fortnightly for the first 4 doses and every 28 days thereafter.

The effect of ursodeoxycholic acid on serum enzymes and liver histology in patients with chronic active hepatitis. A 12-month double-blind, placebo-controlled trial.

A reduction in serum enzymes has been already observed by administering ursodeoxycholic acid to patients with chronic active hepatitis. The aim of this study was to assess whether the liver histological activity of inflammation was modified by a 12-month treatment with ursodeoxycholic acid. Thirty-six patients with chronic active hepatitis, fulfilling the inclusion criteria, were admitted to the trial.

Formestane: effective therapy in postmenopausal women with advanced breast cancer.

Aromatase inhibitors are a useful therapeutic option in the management of endocrine-dependent advanced breast cancer. Formestane (Lentaron) is the first irreversible aromatase inhibitor to be extensively investigated. In a phase II study to determine the effects of formestane on serum estradiol and urinary 17-hydroxycorticosteroid (17-OHCS) levels and to evaluate its clinical activity, 72 postmenopausal patients with advanced breast cancer were given formestane 250 mg intramuscularly every 2 weeks.

Early postprandial energy expenditure and macronutrient use after a mixed meal in cirrhotic patients.

The effect of meal ingestion (9 kcal/kg of body weight, 53% carbohydrate, 30% fat, 17% protein, as a liquid formula) on energy expenditure and oxidation rate of carbohydrate, fat, and protein was assessed by indirect calorimetry and urinary nitrogen excretion before and for 3 hours after eating in stable cirrhotic patients and control subjects of comparable age. Postprandial modifications of substrate and hormone levels were also studied. Compared with basal values, the mean +/- SD resting energy expenditure during the first 3 hours after meal ingestion increased similarly in cirrhotic patients (+0.

Increased energy expenditure in cirrhotic patients with hepatocellular carcinoma.

Basal energy expenditure was measured by indirect calorimetry in 12 cirrhotic patients with hepatocellular carcinoma. Values were compared to those observed in 12 cirrhotic patients without hepatocellular carcinoma but with similar nutrition status. Energy expenditure was also predicted in each patient by the Harris-Benedict equation.

Prevalence of hepatitis C virus antibodies and hepatitis C virus-RNA in an urban population.

Several studies had been carried out on anti-hepatitis C virus (HCV) prevalence in populations with blood exposure risks and in blood donors. New tests are now available which allow the investigation to extend to other parameters such as antibody type and HCV-RNA. In this study the prevalence of anti-HCV c100-3 and the associated epidemiological, clinical, and virological markers were evaluated in subjects from an urban population located in central Italy.

Prevention of gallstone migration from the gallbladder into the cystic duct.

Biliary colic is caused by an increased pressure within the gallbladder lumen due to gallbladder contraction against an impacted stone in the cystic duct. It should be possible to prevent the passage of stones into the cystic duct by avoiding those body positions (mostly the supine position) in which the neck of the gallbladder is located in the downward position.

[Assessment of gallbladder motility in patients with alcoholic hepatic cirrhosis after a fatty meal. A real-time ultrasonography study].

Gallbladder emptying after fatty meal administration was investigated by real-time ultrasonography in 10 patients with alcoholic cirrhosis of the liver, and 10 normal controls. Gallbladder volume was measured using the sum of cylinders method before and 5', 15', 20', 30', 60', 90', and 120' after fatty meal administration. Patients with liver cirrhosis presented the gallbladder volume significantly increased after 15' and 20', and significantly reduced after 60' and 90' in respect to controls.

Doppler flowmetry and the diagnosis of breast lumps.

The aim of the study was to ascertain the reliability of a Doppler signal in the diagnosis of breast cancer. Computerized blood flow analysis was performed on 117 patients who presented with a breast lump at the Division of Diagnostic Oncology of the Istituto Nazionale Tumori of Milan. The values of systolic peak and diastolic frequency were evaluated in relation to the histologic diagnosis.

Incidence and indications for cholecystectomy in a public health district of a small town in central Italy.

There are major differences in cholecystectomy rates between different countries. We prospectively recorded all gallbladder operations in L'Aquila, Italy (a small town in central Italy with a population of about 98,700 inhabitants) from June 15, 1987 to June 14, 1988. During that year 210 cholecystectomies were performed (women and girls = 71.

Accumulation of active androgens in breast cyst fluids.

80 breast cyst fluids (BCF) from 57 patients were divided by K+/Na+ ratio: 56 with ratio over 1 (type I) and 24 with ratio less than 1 (type II). Significantly higher amounts of testosterone, dihydrotestosterone and dehydroepiandrosterone sulphate (DHAS) were found in type I than in type II cysts. A positive relation was found between testosterone and dihydrotestosterone in both types.

Problems after hysterectomy. A comparative content analysis of 60 interviews with cancer and non-cancer hysterectomized women.

Sixty patients who had undergone hysterectomy for neoplastic pathologies (30 cases) and benign pathologies (30 cases) were interviewed with the aim of understanding the relationship they had with the disease, the loss of the uterus and sexuality. Out of the cancer group 21 cases showed fear of recurrence of the disease, 19 cases showed sexual dysfunctions, while only 9 patients referred to having experienced the loss of the uterus as a traumatic event for their femininity. Non-cancer patients revealed reactive sexual difficulties.

[Failed dissolution of a gallstone by methyl tert-butyl ether: importance of predicting gallstone chemical composition].

In December 1986 we attempted direct chemical litholysis using methyl-tertiary-butyl-ether (MTBE) in a sixty-year-old man with severe ischemic heart disease who had suffered frequent episodes of biliary colic due to a radiolucent gallstone. MTBE was infused for a total of 17 hrs over a period of 5 days; however the gallstone diameter remained unchanged. The patient was subsequently cholecystomized and chemical analysis revealed that the gallstone was a pigment stone.

Anti-melanoma monoclonal antibody 225-28S: evaluation of toxicity in man.

To investigate possible undesirable effects due to the intravenous administration of a reagent of a xenogenic nature (monoclonal antibody 225-28S) in man, a toxicologic study was carried out on 85 patients with metastatic cutaneous melanoma. Two reagents were tested in this study: purified monoclonal antibody (MoAb) 225-28S and its F(ab')2 fragment. Purified MoAb was labelled with 131I and F(ab')2 fragment with 131I, or 123I, or 111In or 99Tc.

Cell kinetics as a prognostic tool in patients with metastatic malignant melanoma of the skin.

The 3H-thymidine labeling index (LI) was determined on 178 lesions, four of which were primary, from 129 patients with malignant melanoma. The overall analysis showed a wide variability of LI values, from 0.01% to 31.

Erythrocyte fatty acid composition and gallstone disease: results of an epidemiological survey.

Within a cross-sectional study on the epidemiology of gallstone disease (GD) and its related factors, relation of GD to habitual dietary fat types has been investigated. Gallbladder status was assessed by ultrasound; fatty acid composition of the habitual diet was estimated by GLC of erythrocyte fatty acids. No differences in erythrocyte fatty acid composition were observed between women without gallstones, women with gallstones (aware and unaware of their condition), and women who had cholecystectomies.

Biliary secretion of phosphatidylcholine and its molecular species in cholecystectomized T-tube patients: effects of bile acid hydrophilicity.

The aim of the present study was to establish whether the oral administration of bile acids with different hydrophilic properties affects the amount of phosphatidylcholine as well as the pattern of PC molecular species secreted in bile. We studied the biliary output of total and individual PC species in cholecystectomized T-tube patients, with a total biliary outflow, after oral administration of 750 mg of ursodeoxycholate (3 patients) or deoxycholate (3 patients). The latter experiments were repeated after 3 days of taurine supplementation (1500 mg daily) in order to increase, by means of the tauro-conjugation, the hydrophilicity of the secreted BA.

Influence of tauroursodeoxycholic and taurodeoxycholic acids on hepatic metabolism and biliary secretion of phosphatidylcholine in the isolated rat liver.

Studies were carried out using an isolated rat liver system to define: the contribution of exogenous phosphatidylcholine (PC) to biliary phospholipid secretion; and its hepatic metabolism during perfusion of the livers with conjugated bile salts with different hydrophilic/hydrophobic properties. A tracer dose of sn-1-palmitoyl-sn-2-[14C]linoleoylPC was injected as a bolus into the recirculating liver perfusate, under constant infusion of 0.75 mumol/min of tauroursodeoxycholate or taurodeoxycholate.

Relationships between bile salts hydrophilicity and phospholipid composition in bile of various animal species.

Bile salts and phospholipids from bile of chicken, dog, sheep, rat, ox, pig, guinea-pig and man were analyzed by high-performance liquid chromatography. Bile salts showed marked differences in their hydrophilic properties, owing to hydroxyl structure and type of conjugation. Phospholipids were generally similar, containing 90-95% of phosphatidylcholine which was made of molecular species containing palmitic acid in the sn-1 position.