The role of surgery in the treatment of primary gastric lymphoma has been recently re-evaluated. We report the results of a series of 37 operated patients for primary gastric lymphoma (PGL). All ...patients underwent gastrectomy with D2 lymphadenectony and bilateral liver biopsies. Postoperative histopathological classification was compared to preoperative staging data. No mortality and low morbidity were observed in this series of patients. We found a high incidence of mixed grading of tumors and a relatively high incidence of lymph node metastases in low grade lymphoma. Relying on preoperative biopsies and imaging techniques could lead to preoperative staging inaccuracy and therefore to inappropriate treatment planning. For these reasons we advocate systematic primary surgery in PGL. Surgery could be useful for staging purposes and seems to be curative in stage IE.
Multilateral comparison of outcomes drawn from multiple groups pervade the social sciences and measurement of their variability, usually involving functions of respective group location and scale ...parameters, is of intrinsic interest. However, such approaches frequently mask more fundamental differences that more comprehensive examination of relative group distributional structures reveal. Indeed, in categorical data contexts, location and scale based techniques are no longer feasible without artificial and questionable cardinalization of categories. Here, Ginis' Transvariation measure is extended and employed in providing quantitative and visual multilateral comparison tools in discrete, continuous, categorical, univariate or multivariate settings which are particularly useful in paradigms where cardinal measure is absent. Two applications, one analyzing Eurozone cohesion in terms of the convergence or divergence of constituent nations income distributions, the other, drawn from a study of aging, health and income inequality in China, exemplify their use in a continuous and categorical data environment.
Supercritical CO2 extraction of essential oil from Thymus vulgaris leaves was studied using experimental data recently obtained in the Florys S.p.A. laboratory. Mass transfer coefficients in the ...supercritical and solid phases from extraction curves at 40°C and 20 MPa were evaluated using a mathematical model based on the local adsorption equilibrium of essential oil on lipid in leaves. The adsorption equilibrium constant was fitted to these experimental data, and internal and external mass transfer resistances were calculated, allowing identification of the mechanism controlling the extraction process.
Specific conductivities, densities, heat capacities, and enthalpies of dilution at 25‡C were measured forN,N,N-octylpentyldimethylammonium chloride (OPAC) in water-urea mixtures at various urea ...concentrations mu as functions of the surfactant concentration ms. From conductivity data, the cmc and the degree of the counterion dissociation Β of the OPAC micelles were calculated. The cmc increases linearly with increasingmu while Βvs. mu is a smooth concave curve. From the experimental thermodynamic data, the apparentYΦ and partialY2 molar properties (volumes, heat capacities, and relative enthalpies) are derived as functions of mu andms. The effect of urea on the dependences of the different properties on ms are discussed. From data in the premicellar region the standard partial molar volumesV20 and heat capacitiesCp20 were evaluated. It was observed thatV20 increases linearly withmu whileCp20 decreases. The properties of OPAC in the dispersed and micellized forms at the cmc were obtained and, therefore, the thermodynamic functions of micellization were calculated on the basis of the pseudo-phase transition model.
Giant cell transformation of hepatocytes combined with variable degrees of hepatocyte necrosis and liver fibrosis is distinctly uncommon in adults. In this age group it has most often been associated ...with autoimmunity, drug reaction and viral infection. Prognosis is considered quite severe ranging from mild fibrosis to established cirrhosis. We report a case of giant cell hepatitis that occurred in a 30 yrs old man, who had been taking ticlopidine for 3 years. The causative role of the drug is uncertain because aminotransferase did not fall after withdrawal. The patient fulfilled most of the criteria for a diagnosis of autoimmune hepatitis and was treated accordingly with prednisolone and azathioprine. Immunosuppressive therapy led to a clinical, biochemical and histological response.
A reversed-phase high-performance liquid chromatography (HPLC) method with diode-array detection for the quantification of several human salivary peptides is described. Sample pretreatment consisted ...of the acidification of whole saliva by phosphate buffer. This treatment produced precipitation of mucins, α-amylases and other high-molecular-mass salivary proteins, simultaneous inhibition of intrinsic protease activities and reduction of sample viscosity. Direct HPLC analysis by diode-array detection of the resulting acidic sample allowed one to quantify histatin 1, histatin 3, histatin 5, statherin, as well as uric acid, in normal subjects. Moreover, the groups of peaks pertaining to proline-rich proteins and cystatins were tentatively identified. The method can be useful in assessing the concentration of salivary peptides from normal subjects and from patients suffering oral and/or periodontal diseases.
Flutamide is a nonsteroidal antiandrogen drug used in the treatment of prostatic cancer. Hepatotoxic reactions due to flutamide have been reported with an incidence ranging from 1% to 5%. These ...reactions are usually reversible upon withdrawal of the drug but can occasionally be life-threatening. The mechanism of flutamide-associated hepatotoxicity is not well established. We report a case of a 69-year-old man with prostatic carcinoma in whom flutamide induced an acute hepatitis which resolved completely soon after drug withdrawal. In this patient, we have studied the possible involvement of an immunological mechanism in causing flutamide hepatitis by investigating the presence of circulating antibodies directed against reactive metabolites of flutamide bound to liver proteins with enzyme-linked immunosorbent assay technique. Although, in the present case, we have failed to detect IgG reacting with rat liver microsomes incubated in vitro with flutamide, this does not completely rule out the possibility of an immunological involvement in flutamide hepatotoxicity. The possibility of severe flutamide-related injury, independently of the underlying pathogenic mechanism, strongly suggests the need for careful monitoring of liver enzymes in patients taking this drug.
To evaluate the prevalence of iron overload in chronic hepatitis C and its relationship with liver histology.
Serum iron, unsaturated iron binding capacity and ferritin levels were determined in 204 ...consecutive anti-hepatitis C virus positive subjects, whereas hepatic iron concentration, hepatic histological grading and staging, hepatitis C virus genotypes were further assessed in a subgroup of 50 patients who underwent liver biopsy for chronic hepatitis.
An increase in the serum markers of iron metabolism was more frequently found in subjects with aminotransferase activities above the normal range, whereas hepatic iron overload, established by direct hepatic iron determination, was found only in 9/50 (18%) patients with chronic hepatitis C. No serum iron marker could reliably predict hepatic iron stores. Patients with mild iron overload usually showed active hepatitis and fibrosis, whereas iron overload was not present in patients without fibrosis or with very mild fibrosis. Two out of nine patients with iron overload were shown to be beta thalassaemia heterozygous, and two were heterozygous carriers of a putative haemochromatosis gene mutation (His63Asp).
Many anti-hepatitis C virus positive patients with elevated aminotransferase activities have serum ferritin levels above the normal range, but only a minority of patients with chronic hepatitis C have a mild iron overload. In chronic hepatitis C, a relationship does exist between hepatic iron content and liver fibrosis.
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