Percutaneous US-guided radiofrequency ablation of hepatocellular carcinomas: results in 15 patients.

BACKGROUND: The majority of patients with hepatocellular carcinoma (HCC) cannot undergo surgery because of multifocality, location or advanced cirrhosis. Our experience with percutaneous radiofrequency ablation for treatment of patients suffering from unresectable hepatocellular carcinoma is described here. PATIENTS AND METHODS: Fifteen patients (ten men and five women) with eighteen primary hepatocellular tumors underwent percutaneous radiofrequency ablation. The mean diameter of the HCCs was 32 mm (ranging from 15 mm to 62 mm). The patients were treated under ultrasound guidance using either a 18-gauge internally cooled electrode or a 14-gauge electrode with four expandable hooks. RESULTS: Complete necrosis was achieved in 15 lesions after one session of RF ablation. The persistence of a small portion of viable tissue was seen in two lesions. One lesion was not evaluable. After a mean follow-up period of 9.2 months (range 3-24 months), eleven patients (76%) showed no sign of local or distant recurrence, one patient developed a new lesion and one of two patients with persistence of viable tissue obtained a complete necrosis after the injection of percutaneous ethanol. Moreover, a major complication (intraperitoneal bleeding requiring surgical treatment) and three minor complications (1 pleuric effusion and 2 perihepatic fluid collections that resolved spontaneously) were observed. CONCLUSION: RF ablation is a simple, well-tolerated and effective procedure for the treatment of unresectable hepatocellular carcinomas.

[Dyspepsia and Helicobacter pylori infection. A study of a population of workers]. / Dispepsia ed infezione da Helicobacter pylori. Studio su una popolazione di lavoratori.

We studied 102 workers in a mechanical factory. All subjects were tested by a questionnaire screening dyspeptic symptoms in the last three months, their frequency, absenteeism period, spontaneous drugs intake and a consultant gastroenterologist request. All subjects were tested for specific IgG against Helicobacter pylori with immunoassay Elisa. Dyspepsia was present in 61% of cases. Positivity for Helicobacter pylori infection was in 76%, absenteeism in 82%, consultant request in 21% of dyspeptic workers. Our results suggest, according to literature, the high frequency of Helicobacter pylori infection in dyspeptic patients: furthermore dyspepsia should be considered as an important cause of absenteeism.

[Alcoholism and home environment]. / Alcolismo e ambiente domestico.

Alcoholism is a very important social problem in our Country. Nevertheless our knowledge about the frequency and the features of alcoholism in the household environment is poor; until recently this kind of alcoholism was considered a female problem. The authors studied two homogeneous groups of male and female alcoholics. Females have a greater tendency to drink in the household. This behaviour is due to socio-cultural condition rather than to different psychological features. The authors also reported the importance of the family in the etiology, evolution and treatment of alcoholism.

[Lymphocyte subpopulations in patients with liver cirrhosis]. / Sottopopolazioni linfocitarie in pazienti con cirrosi epatica.

We have characterized some subset of T-lymphocytes by monoclonal antibodies in 30 patients affected by hepatic cirrhosis. The OKT3 cells was significantly decreased so as OKT8. The OKT4/OKT8 ratio was significantly raised. The reduction of OKT3 was similar to that observed by other Authors. Our other results have a correlation with the alcoholic etiology of the observed disease.

[Serum levels of IgE in liver cirrhosis]. / Livelli sierici di IgE in corso di cirrosi epatica.

In a study of 18 subjects with liver cirrhosis, mainly of alcoholic origin, the Authors found an average increase in the serum levels of IgE, IgG, IgA, and IgM, with respect to control subjects (p less than 0.001). Nonetheless, no correlation was found in either of the cirrhotic or control groups, between serum levels of IgE and other immunoglobulins. Also, in 11 of the 18 patients with cirrhosis, a linear and direct correlation between the amount of decreased phagocytic activity in the liver (studied by hepatic scanning, using Technetium Tc 99m sulfur colloid), and the increase in serum levels of IgG (p less than 0.001) and of IgA (p less than 0.05), but not of IgE, was observed. In respect to the controls, patients with cirrhosis also showed a significant decrease in circulating T-lymphocytes OKT8+ (p less than 0.05), and a significant increase in the OKT4+/OKT8+ ratio (p less than 0.01), but no significant modification of the eosinophils and circulating T-lymphocytes OKT3+ and OKT4+. A significant correlation was present in the patients with cirrhosis, but not in the controls, between the serum levels of IgE and circulating eosinophils (p less than 0.05), and between the levels of IgM and the OKT4+/OKT8+ ratio (p less than 0.05). In the healthy control subjects, a linear, inverse correlation was present between serum IgE and circulating OKT8+ (p less than 0.05) and a direct, linear correlation was found between IgE and the OKT4+/OKT8+ ratio (p less than 0.05); both, on the other hand, were absent in the patients with cirrhosis.(ABSTRACT TRUNCATED AT 250 WORDS)

[Mixed cryoglobulinemia with peripheral neuropathy in a case of HBsAg-positive chronic active hepatitis]. / Crioglobulinemia mista con neuropatia periferica in un caso di epatite cronica attiva HBsAg positiva.

We have observed a patient who developed a severe progressive peripheral neuropathy in the course of HBsAg positive chronic active hepatitis in whom high serum levels of cryoproteins was detectable, as described just once in the past. The role of HB virus in the pathogenesis of cryoglobulinemia and in the development of peripheral neuropathy was discussed.

[Intestinal absorption of iron observed in 2 cases of porphyria cutanea tarda]. / L'assorbimento intestinale del ferro osservato in due casi di porfiria cutanea tarda.

Two cases of porphyria cutanea tarda (PCT) are reported. Iron absorbtion has been studied by a radioisotopic method in these two patients. Our findings confirm the hypothesis of possible genetic association between PCT and hemochromatosis.