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Smad3 knock-out mice as a useful model to study intestinal fibrogenesis

World Journal of Gastroenterology 2006年第8期12卷 1211-1218页

作者： Giuliana Zanninelli Antonella Vetuschi Roberta Sferra Angela D'Angelo Amato Fratticci Maria Adelaide Continenza Maria Chiaramonte Eugenio Gaudio Renzo Caprilli Giovanni Latella cattedra di Gastroenterologia Università degli Studi di L'AquilaL'AquilaItaly cattedra di anatomia umana Università degli Studi di L'AquilaL'AquilaItaly dipartimento di Medicina Sperimentale Università degli Studi di L'AquilaL'AquilaItaly Università degli Studi di Roma"La Sapienza" Roma Italy cattedra di Gastroenterologia I Università degli Studi di Roma"La Sapienza"RomaItaly

AIM： To evaluate the possible differences in morphology and immunohistochemical expression of CD3, transforming growth factor 131（TGF-131）, Smad7, α-smooth muscle actin （α-Sma）, and collagen types Ⅰ-Ⅶ of small and large intestine in Smad3 null and wild-type mice. METHODS： Ten null and ten wild-type adult mice were sacrificed at 4 mo of age and the organs （esophagus, small and large bowel, ureters） were collected for histology（hematoxylin and eosin, Masson thrichrome, silver staining）, morphometry and immunohistochemistry analysis. TGF-β1 levels of intestinal tissue homogenates were assessed by ELISA. RESULTS： No macroscopic intestinal lesions were detected both in null and wild-type mice. Histological and morphometric evaluation revealed a significant reduction in muscle layer thickness of small and large intestine in null mice as compared to wild-type mice. Immunohistochemistry evaluation showed a significant increase of CD3＋T cell, TGF-β1 and Smad7 staining in the small and large intestine mucosa of Smad3 null mice as compared to wild-type mice. α-Sma and collagen Ⅰ-Ⅶ staining of small and large intestine did not differ between the two groups of mice. TGF-β1 levels of colonic tissue homogenates were significantly higher in null mice than in wildtype mice. In preliminary experiments a significant reduction of TNBS-induced intestinal fibrosis was observed in null mice as compared to wild-type mice.

关键词： Transforming growth factor TGF-13 Fibrosis Smad proteins

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Ileal lesions in patients with ulcerative colitis after ileo-rectal anastomosis:Relationship with colonic metaplasia

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World Journal of Gastroenterology 2008年第34期14卷 5290-5300页

作者： Livia Biancone Emma Calabrese Giampiero Palmieri Carmelina Petruzziello Sara Onali Giuseppe Sigismondo Sica Marta Cossignani Giovanna Condino Kiron Moy Das Francesco Pallone cattedra di Gastroenterologia Dipartimento di Medicina InternaUniversità di "Tor Vergata" cattedra di anatomia ed Istologia Patologica Università di "Tor Vergata" cattedra di Gastroenterologia Dipartimento di Medicina InternaUniversità di "Tor Vergata" cattedra di Chirurgia Generale Università di "Tor Vergata" cattedra di Gastroenterologia Dipartimento di Medicina Interna Università di "Tor Vergata" GI Unit Department of Gastroenterology & Hepatology University of Medicine & Dentistry of New Brunswick

AIM:To assess whether in ulcerative colitis (UC) patients with ileo-rectal anastomosis (IRA), ileal lesions may develop in the neo-terminal-ileum and their possible relation with phenotypic changes towards colonic epithelium. METHODS: A total of 19 patients with IRA under regular follow up were enrolled, including 11 UC and 8 controls (6 Crohn’s disease, CD; 1 familial adenomatous polyposis, FAP; 1 colon cancer, colon K). Ileal lesions were identifi ed by ileoscopy with biopsies taken from the ileum (involved and uninvolved) and from the rectal stump. Staining included HE and immunohistochemistry using monoclonal antibodies against colonic epithelial protein CEP (Das-1) and human tropomyosin isoform 5, hTM5 (CG3). Possible relation between development of colonic metaplasia and ileal lesions was ***: Stenosing adenocarcinoma of the rectal stump was detected in 1 UC patient. The neo-terminal ileum was therefore investigated in 10/11 UC patients. Ileal ulcers were detected in 7/10 UC, associated with colonic metaplasia in 4/7 (57.1%) and Das-1 and CG3 reactivity in 3/4 UC. In controls, recurrence occurred in 4/6 CD, associated with colonic metaplasia in 3/4 and reactivity with Das-1 and CG3 in 2/3. CONCLUSION: Present fi ndings suggest that in UC, ileal lesions associated with changes towards colonic epithelium may develop also after IRA. Changes of the ileal content after colectomy may contribute to the development of colonic metaplasia, leading to ileal lesions both in the pouch and in the neo-terminal ileum after IRA.

关键词： Ulcerative colitis Ileo-rectal anastomosis Ileal lesions Colonic metaplasia

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Giardia lamblia infection in patients with irritable bowel syndrome and dyspepsia:A prospective study

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World Journal of Gastroenterology 2006年第12期12卷 1941-1944页

作者： Barbara Grazioli Giovanni Matera Costanza Laratta Giuseppina Schipani Giovanni Guarnieri Ester Spiniello Maria Imeneo Andrea Amorosi Alfredo Focà Francesco Luzza dipartimento di Medicina Sperimentale e Clinica Cattedra di Gastroenterologia Università di Catanzaro 'Magma Graecia' Catanzaro Italy dipartimento di Scienze Mediche Istituto di Microbiologia Università di Catanzaro 'Magna Graecia' Catanzaro Italy dipartimento di Medicina Sperimentale e Clinica Cattedra di Anatomia Patologica Universith di Catanzaro 'Magna Graecia' Catanzaro Italy

AIM： To evaluate the prevalence of Giardia lamblia （G. lamblia） infection in patients with irritable bowel syndrome （IBS） and dyspepsia and to establish which is the most accurate test to diagnose the infection in this setting. METHODS： One hundred and thirty-seven patients who consecutively attended the Outpatient Gastroenterology Clinic for the first time between January 2002 and Decernber 2003 due to symptoms of IBS and/or dyspepsia were recruited. All patients underwent clinical evaluation, first-step haematology and chemistry tests, serologic assays for celiac disease, lactose-H2 breath test, abdominal ultrasonography, and esophagogastroduodenoscopy. Helicobacterpylon status was evaluated. In patients with symptoms of IBS older than 45 years, colonoscopy was also performed. In all patients, duodenal biopsies and stool samples were examined for trophozoites and cysts of G. lamblia by several methods. RESULTS： G. lamblia was identified in 9 patients. The following diagnoses were also made： IBS （100/137, 73%）, functional dyspepsia （62/137, 45%）, organic dyspepsia （33/137, 24%）, and lactose intolerance （75/137, 55%）. A significant association was found between giardiasis and H pylori infection （x^2= 6.632, OR= 12.4, CI= 1.5-68.1）. There were no symptoms that reliably allowed the recognition of giardiasis. direct search of the parasite in duodenal biopsy and stool sample examinations gave concordant results in all cases while histological examination of duodenal biopsies displayed a low sensitivity （e.g., 22.2%）. CONCLUSION： In this consecutive series, diagnosis of *** infection accounted for 6.5% of patients with IBS and dyspepsia. Duodenal biopsies for diagnosis of giardiasis may be unnecessary if stool sample examination is performed.

关键词： Dyspepsia Giardiasis H pylori Irritablebowel syndrome

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different doses of consensus interferon plus ribavirin in patients with hepatitis C virus genotype 1 relapsed after interferon monotherapy:A randomized controlled trial

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World Journal of Gastroenterology 2006年第42期12卷 6861-6864页

作者： Giuseppe Alaimo Vito di Marco Donatella Ferraro Rosa di Stefano Salvatore Porrovecchio Francesca D’Angelo Vincenza Calvaruso Antonio Craxì Piero Luigi Almasio cattedra di Gastroenterologia Dipartimento Biomedico di Medicina Interna e Specialistica University of Palermo Italy cattedra di Virologia Di-partimento di Igiene e Microbiologia University of Palermo Italy

AIM： To assess the efficacy of different schedules of consensus interferon （CIFN） plus ribavirin in retreating chronic hepatitis C patients who relapsed after recombinant interferon （rIFN） monotherapy. METHODS： Forty-five patients （34 males and 11 females） with chronic hepatitis due to hepatitis C virus （HCV） genotype 1 who relapsed after a previous course of rIFN monotherapy were randomized to receive 9 μg CIFN three times per week for 52 wk （group A, n = 22） or 18 μg CIFN three times per week for 52 wk （group B, n = 23） in combination with ribavirin 800 to 1200 mg daily for 52 wk （according to body weight）. Virological response was evaluated at week 24 （ERR）, at the end of treatment （ETR） and at 76 wk （SVR）. RESULTS： By intention-to-treat analysis, subjects in group A had an EVR in 35% of cases, an ETR in 35% and a SVR in 27.3% of cases. Subjects in group B had an EVR in 32% of cases, an ETR in 35% and a SVR in 26.1% of cases. Treatment was stopped because of adverse effects （mostly intolerance） in 15 patients （6 in group A and 9 in group B）. IFN dose reduction was needed in 2 patients （1 in group A and 1 in group B）. Ribavirin dose was reduced in 2 patients in group A and 1 in group B respectively. Among the 15 subjects who received at least 80% of the intended schedule, the rate of SVR was 80% （6 in group A and 6 in group B）. CONCLUSION： CIFN in combination with ribavirin when given to HCV genotype 1 relapsers after rIFN monotherapy obtains an unsatisfactory rate of sustained viral clearance independently of dosage of the drug. This may be due to its scarce tolerability.

关键词： Interferon Ribavirin Hepatitis C virus Hepatitis C Relapser

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Impact of hepatitis C virus infection on lifestyle

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World Journal of Gastroenterology 2007年第19期13卷 2722-2726页

作者： Paola Scognamiglio Vincenzo Galati Assunta Navarra Maria Antonella Longo Maria Stella Aloisi Maria Giulia Antonini Massimo Puoti Piero Luigi Almasio Giuseppe Ippolito Enrico Girardi Istituto Nazionale per le Malattie Infettive "L. Spallanzani" IRCCS Roma Italy cattedra di Malattie Infettive Università di Brescia Italy cattedra di Gastroenterologia Università di Palermo Italy

AIM: To evaluate the impact of the diagnosis of hepatitis C infection on lifestyle habits such as smoking, drinking, sports activity and ***: A self-administered, anonymous question-naire was offered to out-patients with HCV infection consecutively attending three clinical centres in ***: Of the 275 respondents, 62.2% (171) were male. Mean age was 51 (range 20-80) years. Overall, after the diagnosis of hepatitis C, 74.5% of drinkers had modified (giving up or reducing) alcohol consumption, 21.3% of smokers had modifi ed their habits and 32.3% of subjects who reported sports activity had either stopped or reduced frequency of activity or chose a less fatiguing sport. Sixty-four percent of the respondents reported having modified their diet, most of them on physician's advice. CONCLUSION: After the diagnosis of hepatitis C many patients correctly modif ied their alcohol consumption and a minority their smoking habits. The reason for reported changes in diet and physical activity needs further investigations.

关键词： Hepatitis C virus Lifestyle habits Smoking Alcohol consumption diet Physical activity

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Complete pancreatic heterotopia of gallbladder with hypertrophic duct simulating an adenomyoma

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World Journal of Gastroenterology 2006年第11期12卷 1786-1787页

作者： Luca Pilloni Alessandro Cois Alessandro Uccheddu Rossano Ambu Pierpaolo Coni Gavino Faa Istituto di anatomia Patologica dipartimento di Citomorfologia Universita degli Studi di CagliariItaly Semeiotica Chirurgica dipartimento Chirurgico Materno Infantile e di Scienze delle Immagini Università degli Studi di CagliariItaly Istituto di anatomia Patologica dipartimento di Citomorfologia Università degli Studi di CagliariItaly

The gallbladder is an unusual location of pancreatic heterotopia, defined as the presence of pancreatic tissue lacking anatomical and vascular continuity with the main body of the gland. A 28-year-old man presented with anorexia, nausea and pain in the right upper abdomen. On physical examination, the abdomen was tender to palpation and Murphy sign was positive. The patient underwent a cholecystecomy. This case, in our opinion, is very interesting since it permits to consider a controversial issue in the pathology of the gallbladder. The histological appearance of ductal structure in pancreatic heterotopia resembles the histological picture of both Aschoff-Rokitansky （AR） sinuses and adenomyomas. This finding suggests that these lesions are linked by a common histogenetic origin. We suggest that the finding of an adenomyoma in the gallbladder should prompt an extensive sampling of the organ in order to verify the coexistence of pancreatic rests.

关键词： Pancreatic heterotopia Gallbladder Hypertrophic duct Adenomyoma Aschoff-Rokitansky sinuses

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Colonoscopic evaluation of hematochezia in low and average risk patients for colorectal cancer:A prospective study

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World Journal of Gastroenterology 2006年第45期12卷 7304-7308页

作者： Puglisi Carlo Russo Francesco Paolo Barbera Carmelo Incarbone Salvatore Aprile Giuseppe Bonanno Giacomo Russo Antonio cattedra di Gastroenterologia Università di Catania Azienda Ospedaliero Universitaria Policlinico-Catania Italy

AIM: To relate the endoscopic findings in patients with hematochezia with regard to age in “low and average risk” for colorectal cancer (CRC) and to localize signifi cant lesions in order to identify patients who need sigmoidoscopy or total colonoscopy. METHODS: This prospective study was performed in an open access GI endoscopy unit. Out of 4322 consecutive patients undergoing colonoscopy, 918 reported hema- tochezia. The fi nal study group comprized 180 patients aged below 45 and 237 over 45. Main exclusion criteria were a 1st-degree family history of colorectal carcinoma, patients reporting blood mixed with stools and/or pro- gressive colonic symptoms, or patients who had under- gone colon surgery for neoplastic lesions. RESULTS: Total colonoscopy could be performed in 96% of patients. Abnormal findings were observed in 34.3% of the younger and in 65.7% of the older ones. Findings were the presence of polyps in the distal colon (n = 2) and IBD in the proximal colon (n = 29) in the group of the younger patients, and polyps (n = 15), IBD (n = 13), and carcinoma (n = 6, 4 of the lesions were located proximal to the splenic flexure) in the elderly. Our f indings suggest that the diagnostic potential of total colonoscopy in patients younger than 45 referring scant hematochezia, is not mandatory. By exploring only the distal tract of the colon we have misdiagnosed two cases of IBD located in the ascending colon. In this group of patients additional risk factors must be identifi ed before performing a total colonoscopy. Regarding the patients older than 45 yr, the exploration of the distal colon would have led to our overlooking a carcinoma, two neoplastic polyps and one IBD located in the proximal colon. CONCLUSION: Young patients with scant hematochezia but without risk factors for neoplasia do not need a totalcolonoscopy, whereas is mandatory performing a total colonoscopy in older patients even in the presence of anal pathology.

关键词： Hematochezia Colonoscopy Neoplasia Colonic neoplasia

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A practical approach to the diagnosis of autoimmune pancreatitis

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World Journal of Gastroenterology 2011年第16期17卷 2076-2079页

作者： Luca Frulloni Antonio Amodio Anna Maria Katsotourchi Italo Vantini Department of Medicine University of Verona cattedra di Gastroenterologia Policlinico GB Rossi

Autoimmune pancreatitis is a disease characterized by specific pathological features,different from those of other forms of pancreatitis,that responds dramatically to steroid *** pancreatic parenchyma may be diffusely or focally involved with the possibility of a low-density mass being present at imaging,mimicking pancreatic ***,the most relevant problems lie in the diagnosis of autoimmune pancreatitis and in distinguishing autoimmune pancreatitis from pancreatic *** in the presence of a pancreatic mass the probability of tumour is much higher than that of pancreatitis,the physician should be aware that in focal autoimmune pancreatitis the first step before using steroids is to exclude pancreatic *** this review,we briefly analyse the strategies to be followed for a correct diagnosis of autoimmune pancreatitis.

关键词： Autoimmune diseases Pancreatitis Therapy diagnosis

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Intratumoral sampling variability in hepatocellular carcinoma: A case report

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World Journal of Gastroenterology 2007年第29期13卷 4019-4021页

作者： Giancarlo Senes Daniela Fanni Alessandro Cois Alessandro Uccheddu Gavino Faa dipartimento di Citomorfologia Divisione di Anatomia Patologica University of Cagliari Cagliari Italy dipartimento Chirurgico Materno Infantile e di Scienze delle Immagini Clinica Chirurgica University of Cagliari Cagliari Italy

The differential diagnosis between hepatocellular carcinoma （HCC） and regenerative liver nodules and other primary liver tumors may be very difficult, particularly when performed on liver biopsies. difficulties in histological typing may be often minimized by immunohistochemistry. Among the numerous markers proposed, CK18, Hep Par1 and glypican 3 （GPC3） are considered the most useful in HCC diagnosis. Here we report a case of HCC in a 72-year-old male with HBV- related chronic liver disease, characterized by a marked morphological and immunohistochemical intratumoral variability. In this case, tumor grading ranged from areas extremely well differentiated, similar to regenerative nodule, to undifferentiated regions, with large atypical multinucleated cells. While almost all sub nodules were immunostained by Hep Par 1, immunoreactivity for glypican 3 and for Ckl8 was patchy, with negative tumor region adjacent to the highly immunoreactive areas. Our case stresses the relevance of sampling variability in the diagnosis of HCC, and indicates that caution should be taken in grading an HCC and in the interpretation of immunohistochemical stains when only small core biopsies from liver nodules are available.

关键词： Liver Hepatocellular carcinoma Sampling variability Hep Par 1 GPC3 differentiation

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Replication of interleukin 23 receptor and autophagy-related 16-like 1 association in adult-and pediatric-onset inflammatory bowel disease in Italy

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World Journal of Gastroenterology 2008年第29期14卷 4643-4651页

作者： Anna Latiano Orazio Palmieri Maria Rosa Valvano Renata D'Incà Salvatore Cucchiara Gabriele Riegler Anna Maria Staiano Sandro Ardizzone Salvatore Accomando Gian Luigi de Angelis Giuseppe Corritore Fabrizio Bossa Vito Annese U.U. O.O. di Gastroenterologia ed Endoscopia Ospedale IRCCS-CSSSan Giovanni Rotondo (Fg) 71013 Italy cattedra di Gastroenterologia Università di PadovaPadova 35122 Italy Clinica Pediatrica Università "La Sapienza" Roma 00185 Italy cattedra di Gastroenterologia Università di NapoliNapoli 80131 Italy Clinica Pediatrica Università di Napoli Napoli 80131 Italy Unità di Gastroenterologia Ospedale "Sacco" Milano 20157 Italy Clinica Pediatrica Università di Palermo Palermo 90128 Italy Clinica Pediatrica Università di Parma Parma 43100 Italy

AIM: To investigate gene variants in a large Italian inflammatory bowel disease (IBD) cohort, and to analyze the correlation of sub-phenotypes (including age at diagnosis) and epistatic interaction with other IBD genes. METHODS: Total of 763 patients with Crohn's disease (CD, 189 diagnosed at age diagnosed diatric-onset disease. CONCLUSION: The present study confirms the association of IL23R polymorphisms with IBD, and ATG16L1 with CD, in both adult- and pediatric-onset subsets in our study population.

关键词： Inflammatory bowel disease Crohn'sdisease Ulcerative colitis Genetic predisposition Autophagy-related 16-like 1 Interleukin 23 receptor Genome-wide association study Pediatric inflammatorybowel disease

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