Correlations Between the Density of Tryptase Positive Mast Cells (DMCT) and that of New Blood Vessels (CD105+) in Patients with Gastric Cancer.

Mast cells proteases, tryptase and chymase are directly involved in the growth and progression of solid tumors due to their important role in tumor angiogenesis. We examined the density of tryptase positive mast cells and the mean density of new blood vessels in gastric malignant tumors of patients with and without Helicobacter pylori infection, using immunohistochemical staining for tryptase (for mast cells) and CD 105 (for new vessels). Tryptase and CD 105 expression was detected in gastrectomy specimens. In this study, mast cell density correlates with angiogenesis and the growth and progression of gastric cancer. It also shows that the participation of Helicobacter pylori infection in the growth and progress of gastric neoplasia is due to an increase of peritumoral angiogenesis, with subsequent local and distant tumor spread and perivascular growth, but without perineural and nodal involvement.

Role of capsule endoscopy Pillcam COLON 2 in patients with known or suspected Crohn's disease who refused colonoscopy or underwent incomplete colonoscopic exam: a case series.

BACKGROUND: Almost 70-80 % of patients with Crohn's disease and virtually all patients with ulcerative colitis have colorectal mucosa involvement. Colon capsule endoscopy is an interesting option for patients unable or unwilling to undergo colonoscopy. We report our experience with the second-generation colon capsule PillCam(®) COLON 2 in the detection of significant lesions in patients with known or suspected Crohn's disease, who refused colonoscopy or underwent incomplete colonoscopic exam. METHODS: We have retrospectively reviewed the results of capsule endoscopy in 6 patients who refused colonoscopy (n = 3) or underwent incomplete colonoscopic exam (n = 3) between March 2011 and October 2012. In all patients, a CT scan was obtained before capsule endoscopy to rule out significant stenosis. RESULTS: In our series of 6 patients, 4 had both small bowel and colonic involvement. The use of the PillCam(®) COLON 2 capsule allowed a thorough examination and evaluation of the mucosal lesions with high acceptability, the method being perceived as noninvasive by the patients. No adverse events related to the capsule or bowel preparation were recorded. CONCLUSION: In this patient population, PillCam(®) COLON 2 capsule endoscopy was safe. The capsule findings had an important impact on treatment decisions and patient management.

Evaluation of histologic features with potential prognostic value in ulcerative colitis.

Inflammatory bowel diseases (IBD) are a complex, heterogeneous, idiopathic, inflammatory, chronic entity with common clinical, endoscopical and histological features including some well-defined diseases (UC and CD), but also a group of indeterminate colitis. Ulcerative colitis is the most frequent and prominent member of IBD. The current study is trying to evaluate the impact of various histologic features on UC's evolution and outcome--an issue that has generated considerable interest in the academical environment. We gathered a cohort of 20 consecutive patients with positive clinical, endoscopical, histologic and imagistic diagnosis of UC who were prospectively enrolled for close clinical, biochemical, endoscopic and histologic surveillance. Every patient underwent an ileo-colonoscopy and multiple biopsies were taken from inflamed and normal areas of the mucosa. All these procedures were repeated after a year (12 months) of follow-up. This study is presenting the correlation between Mayo score for assessment of ulcerative colitis activity and several histologic features: Geboes histologic score for ulcerative colitis, basal plasmacytosis and vascular lesions using Pearson correlation test. The most promising prognosis value has basal plasmacytosis, confirming previous studies. These data emphasize the need of a more complex, clinical, endoscopic and histologic system of semi-quantitative assessment of UC lesions in order to stratify patients according to their risk to relapse.

Histological and nonhistological criteria in the evaluation of liver involvement in chronic hepatitis C.

The treatment of chronic viral hepatitis is based mainly on interferon therapy. This therapy has many drawbacks, among which potentially dangerous side-effects. Moreover, the majority of the patients are asymptomatic at the time of diagnosis, and most of them will never develop cirrhosis, liver failure or hepatocellular carcinoma, making the decision to treat a difficult one. Currently, the best method of selection is liver biopsy, considered "the gold standard" for recommending antiviral treatment. The histological aspect can vary in different hepatic areas and the smaller the bioptic fragment, the more probable is the histopathologist's error in correctly defining the hepatitis. There has been made important progress in defining the degree of liver involvement using serological tests, with the purpose of avoiding liver biopsy, but this approach has not yet proven to be superior. At present, the benefits of the pretreatment liver biopsy outbalance the risks. The future developments in the domain of antiviral drugs or nonhistological tests for evaluating the liver injury (circulating cytokines, subtypes of collagen) will show if the liver biopsy could be abandoned.

The immunopathogenesis of viral hepatitis.

The outcome of the HBV and HCV infections is influenced by the status of the immune system. Both of the viruses are believed not to be directly cythopathic, and the host immune response is responsible for the viral clearance and cellular injury. An energic response of the natural immunity allows the control of the virus. Rapid development of specific neutralizing antibodies is essential for the clearance of VHB. The chronic phase of the disease is often associated with abnormal and weak T-cell response and viral persistence. The pathogenesis of the HCV infection is not yet completely understood. HCV persists in patients without any apparent evidence of immune deficits depending on virus or host-related factors. The recent studies revealed that both cellular and humoral immunity appear to be active, despite the progression of the disease.