Il saggio prende spunto da un ricordo d’infanzia annotato nello Zibaldoneil 26 marzo 1820, che Leopardi rubrica sotto la voce “Servitori”. A partire da questo appunto, il contributo indaga la ...presenza del motivo della servitù, e del rapporto servo-padrone, nel diario leopardiano e nei ricordi autobiografici raccolti nella Vita abbozzata di Silvio Sarno, intrecciandolo dapprima con le considerazioni rousseauiane sul tema (Émile e Confessions) e poi con il concetto arendtiano di ‘vita activa’. Attraverso l’analisi di temi (la schiavitù, il pubblico e il privato, il consumo alimentare, l’egoismo) e di figure emblematiche (il domestico, il tiranno, il monofago, il viaggiatore solitario), il saggio mostra le implicazioni autobiografiche, storiche (l’«umanità degli antichi») e filosofiche dell’interesse leopardiano per il motivo della servitù: la desolata presa d’atto che la società moderna condivide con la natura un inevitabile egoismo, nella misura in cui il bisogno del singolo prevale su valori durevoli e pubblici come la gloria e l’onore.
Il saggio cerca di spiegare le ragioni per le quali Leopardi non usava postillare i propri libri, che facevano parte di una Biblioteca di famiglia raccolta e conservata religiosamente dal padre ...Monaldo. Le pochissime eccezioni si giustificano con la necessità di correggere errori. Il dialogo con gli autori dei libri che leggeva avviene in altro modo: con la trascrizione all’interno di un manoscritto di passi selezionati, che poi vengono commentati e annotati. The «purity» of the printed page. Leopardi's annotations at a distance The essay tries to understand the reasons why Leopardi did not usually write on his books, which were part of the “sacred” body of the Family Library gathered by his father Monaldo. We can explain a few exceptions with the necessity to correct mistakes. Leopardi dialogues with his authors by incorporating some passages into his manuscript, where he feels free to comment on them.
Il saggio ricostruisce l’antichissima tradizione degli ‘adynata’ astronomici, in cui l’osservazione dei fenomenti astrali derivata dalla scienza diventa strumento espressivo della sofferenza d’amore. ...Dopo un sintetico excursus dall’antichità greca e latina al Seicento, il saggio si focalizza su due autori che sembrano rifarsi a questa lunga tradizione: Baudelaire e Proust. Nel primo l’immaginario astrale è presente soprattutto nei “poèmes en prose” dello Spleen de Paris, dove troviamo le immagini di due eventi ritenuti impossibili: il sole nero e la luna strappata dal cielo dalle maghe tessale. La poetica del secondo, che pur non cita mai esplicitamente questi due ‘adynata’, si serve, nella Recherche, di un immaginario astrale diffuso: anche qui, come in Baudelaire, la perdita dell’oggetto, e il senso di im-potenza che questa ingenera, è la causa scatenante della ferita d’amore ma anche delle possibilità creative dell’artista.
Background
: It is not established whether virological status affects the efficiency of
α-fetoprotein (AFP) as a hepatocellular carcinoma (HCC) marker among patients with chronic liver disease (CLD).
...Methods
: We enrolled in a case-control study 170 HCC and 170 CLD patients, matched for age, sex, CLD and HBsAg/anti-HCV status. The AFP sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. PPV and NPV were evaluated for three additional HCC prevalences (5, 10, and 20%).
Results
: The best discriminating AFP value was 16 ng/ml. A value of 20 ng/ml (above which investigations for HCC are recommended) had equivalent sensitivity (60.0 vs. 62.4%) and specificity (90.6 vs. 89.4%). PPV of 20 ng/ml was 84.6% but decreased to 25.1% at 5% tumor prevalence. NPV was 69.4% and rose to 97.7% at 5% prevalence. In the different groups of infected patients PPV ranged from 80.0 to 90.9%, falling to 17.4–34.5% at 5% prevalence. In non-infected patients PPV was 100% at any HCC prevalence. NPV ranged from 59.0 to 73.0%, reaching 96.5–98.1% at 5% prevalence.
Conclusions
: In CLD patients, AFP monitoring misses many HCCs and inappropriately arouses suspicion of malignancy in many patients. Its usefulness is barely affected by the infection responsible for CLD. An AFP elevation could be more indicative of HCC in non-infected patients.
BACKGROUND
It is not known whether putative etiologic factors and clinical and pathological features of hepatocellular carcinoma (HCC) differ between young adult and older white patients.
METHODS
We ...examined the characteristics of 498 consecutive patients with HCC age < 50 years (Group 1: 54 patients) and age; ce 50 (Group 2: 444 patients), an age beyond which the tumor occurrence rate briskly increases.
RESULTS
Demographic characteristics, alcohol and coffee intake, and cigarette smoking did not differ between the two groups. Group 1 had a greater prevalence of the hepatitis B surface antigen (HBsAg) carriers (P = 0.006), while the prevalence of either past hepatitis B virus infection (P = 0.008) or antivirus C antibodies (P = 0.016) was higher in Group 2. The lack of both hepatitis B and C virus serologic markers was more common in Group 1 (P = 0.018). In these patients, HCC was less frequently superimposed on cirrhosis (P = 0.002) and was more advanced at the time of diagnosis. In fact, despite a better histologic differentiation grade (P = 0.019), monofocal (solitary and massive) tumors were larger (P = 0.012), small lesions (;cc5 cm) less frequent (P = 0.028), and either diffuse (P < 0.001) or massive (P = 0.011) types more common. An elevation of serum α‐fetoprotein was less frequent in group 1 (P = 0.016), but this difference disappeared when the “diagnostic” cut‐off of 400 ng/mL was considered. Albeit the prevalence of presenting symptoms did not significantly differ between the two groups, the clinical stage was more advanced in young patients (P = 0.004). The 9‐year cumulative rate of survival was similar in the 2 groups.
CONCLUSIONS
An early exposure to the virus and/or an accelerated hepatocarcinogenesis in HBsAg carriers can be inferred. Moreover, in the period of life at low risk for hepatoma: (1) the impact of nonalcoholic chemical carcinogenesis seems to be greater; (2) the tumor occurrence is less dependent on cirrhosis development; (3) although histologically better differentiated, the neoplasm is more advanced at the time of diagnosis; and (4) the long term survival is similar to that of the patients age 50 years or older. Cancer 1996;77:2223‐32.
Background. The prevalence of the different hepatocellular carcinoma (HCC) macroscopic types, and the association between these types and age, gender, blood group, alcohol and coffee intake, smoking ...habit, hepatitis virus markers, underlying cirrhosis, and cancer histologic type were retrospectively assessed in 416 unselected patients (321 with cirrhosis).
Methods. The gross pathologic types of HCC were assessed by ultrasonography combined, in most cases, with computed tomography and angiography.
Results. Solitary HCC was the most common cancer type (54.8%), followed by the multinodular (31%), diffuse (7.7%), and massive (6.5%) types. Cirrhosis and blood group other than O were independent risk factors for multinodular HCC (relative risk RR 1.6, P < 0.05; and RR 1.7, P < 0.005, respectively); the absence of cirrhosis and a heavy smoking habit were risk factors for the massive type (RR 4.9, P < 0.001; and RR 3.3, P < 0.01, respectively); and blood group O for the solitary type (RR 1.4, P < 0.001). The prevalence of highly undifferentiated cells increased as the tumor size did, so that grade IV cell atypia was associated with massive size of the carcinoma (P < 0.05). In cirrhotic patients, advanced liver dysfunction was associated with diffuse HCC (P < 0.05). As far as solitary HCC is concerned, the tumor size was greater in noncirrhotic than in cirrhotic patients (7 ± 0.4 cm versus 4.8 ± 0.15, P < 0.001).
Conclusions. In Italian patients, HCC presents most frequently as a solitary nodule. The presence or absence of cirrhosis, blood group, and smoking habit can influence the likelihood of developing certain HCC shapes. The probability of harboring highly undifferentiated cells increases as the cancer increases in size. In cirrhosis, advanced liver dysfunction may predispose to diffuse HCC.
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