Does cholecystectomy always resolve biliary disease?

OBJECTIVE: To evaluate long-term effects of cholecystectomy on typical gallstone symptoms and associated digestive syndrome. DESIGN: Clinical prospective study on selected patients. SETTING: First Surgical Clinic--Catania University. SUBJECTS: 143 gallstone patients, divided in highly symptomatic Group 1 (79) and mild symptomatic Group 2 (64), who underwent cholecystectomy during period 1991/92. MAIN OUTCOME MEASURES: 125/143 patients compiled a set questionnaire to detect any subjective postoperative disorders and to evaluate whether they were similar to preoperative symptoms or were new ones. RESULTS: 125/143 patients completed the 12-month follow-up programme, which revealed a 30% (38/125) with postcholecystectomy symptoms and 13.4% (17) with a postcholecystectomy syndrome. Moreover, 10% (13) of the patients reported the same digestive symptoms as before treatment. Statistical analysis confirmed that cholecystectomy was efficacious in curing gallstone related symptoms and digestive disorders in both Groups with a general improvement in clinical picture (p > 0.01). No significant statistical difference in the incidence of postcholecystectomy dyspeptic symptoms was found between the 2 Groups. CONCLUSION: Cholecystectomy is often efficacious in curing both typical gallstone related symptoms and digestive syndrome. Cholecystectomy patterns of failure in curing digestive disorders is unpredictable preoperatively on the basis of clinical features of the disease.

Comparison between serum interleukin-2 concentrations in healthy adult and elderly subjects.

The serum interleukin-2 (IL-2) concentrations were evaluated in healthy elderly patients, enrolled under the SENIEUR protocol, and healthy adult controls. The aim of the study was to ascertain whether the reduced immune response, described during aging, is linked to deficient production of IL-2 or to its receptorial deficit, or if the reduced serum IL-2 concentrations observed during aging can be used as a biological immunodeficiency marker. The results obtained did not show any significant differences between the study groups, even if mean values were slightly decreased in the elderly group, as compared to the adult one. This finding does not justify the age-dependent deficiency of the immune response, i.e., to explain this condition, one needs another pathogenetic hypothesis. It is suggested that one such hypothesis could be the alteration of IL-2 receptors which undergo major cleavage and minor re-expression in the elderly, causing this way some receptorial changes with consequent reduction of T-helper activation.

A simplified method of pig islet isolation.

This study reports a simplified, low-cost, easily performed chemico-mechanical isolation method of the islets of Langerhans. The experimental study was carried out on 15 adult pigs. Our method used collagenase and a digestion chamber for islet isolation and yielded 2,240 +/- 613 islets per g treated pancreas after purification. This demonstrates that the method is reliable and can give satisfactory results.

[Oxiracetam treatment of exogenous post-concussion syndrome. Statistical evaluation of results]. / Trattamento con oxiracetam della sindrome post-commotiva esogena. Valutazione statistica dei risultati.

The aim of the study was to evaluate the clinical use of a GABOB by-product in the treatment of exogenous post-concussion syndrome. Thirty-six patients affected by this syndrome were included in the study and divided into two groups. Patients in the first group were treated with the drug, while patients in the second group were not treated. Variations in the average time taken for symptoms to disappear in both groups showed a statistically significant difference in favour of the drug-treated group of patients. Following an analysis of the results it was possible to affirm that the drug had a statistically significant effect in patients affected by medium-severe symptomatology.

Pathophysiology of the immune system in elderly subjects with or without diabetes and variations after recombinant interleukin-2.

This study reports two groups of elderly diabetic patients and normal subjects, with or without hypercholesterolemia and hypertriglyceridemia, who presented a decrease of the T lymphocyte-mediated function, proliferative capacity, phagocytosis, cytotoxicity and surface markers. This fall was more evident in hypercholesterolemic and hypertriglyceridemic subjects. The humoral responses and other parameters studied did not reveal significant variations. The authors also observed that recombinant interleukin-2 (rIL-2) stimulation determined a satisfactory response in healthy and diabetic subjects, while it did not normalize values in patients with altered lipid balance.