AIM:Portal hypertensive gastropathy (PHG) defines a pathological endoscopic picture characterized by the presence of alterations of the gastric mucosa found in patients with hepatopathy associated to an initial or evident portal hypertension. Gastropathy appears with two forms of different seriousness: the mild form, characterized by diffused congestion, petechiae of gastric mucosa (scarlatina type rash) and by the presence of typical hyperemic and edematous polygonal areas, delimited by a thin snake skin reticulation. In the severe form, together with such aspects, mucosal erosion, red spots, or a diffused hemorrhagic gastropathy are added. The pre-eminent pathogenetic element of such lesions seems to be the pathological increase of the portal pressure. The role of the Helicobacter pylori (H. pylori) in the development of these alterations, in terms of prevalence of infection in hepatopathic subjects, is still controversial. The authors have performed a research to verify if the H. pylori infection is correlated to the presence and/or to the gravity of PHG.METHODS:One-hundred and nine patients, all suffering from hepatitis C virus (HCV)-correlated liver cirrhosis, with clinical and/or instrumental signs of portal hypertension have been analysed.RESULTS:The histological prevalence of the infection from H. pylori in our statistical analysis was of 23.8% (26/109 patients).CONCLUSIONS:The H. pylori infection appears to be not significant for the determination and the preservation of PHG.

Diabetic MedicineVolume 22, Issue 12 p. 1780-1781 Circulating erythropoietin in diabetes mellitus C. M. Bruno, C. M. Bruno Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, and *Department of Gastro-Hepatology, Molinette Hospital, Torino, ItalySearch for more papers by this authorD. Cilio, D. Cilio Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, and *Department of Gastro-Hepatology, Molinette Hospital, Torino, ItalySearch for more papers by this authorC. Sciacca, C. Sciacca Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, and *Department of Gastro-Hepatology, Molinette Hospital, Torino, ItalySearch for more papers by this authorR. Pellicano, R. Pellicano Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, and *Department of Gastro-Hepatology, Molinette Hospital, Torino, ItalySearch for more papers by this author* C. M. Bruno, C. M. Bruno Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, and *Department of Gastro-Hepatology, Molinette Hospital, Torino, ItalySearch for more papers by this authorD. Cilio, D. Cilio Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, and *Department of Gastro-Hepatology, Molinette Hospital, Torino, ItalySearch for more papers by this authorC. Sciacca, C. Sciacca Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, and *Department of Gastro-Hepatology, Molinette Hospital, Torino, ItalySearch for more papers by this authorR. Pellicano, R. Pellicano Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, and *Department of Gastro-Hepatology, Molinette Hospital, Torino, ItalySearch for more papers by this author* First published: 01 December 2005 https://doi.org/10.1111/j.1464-5491.2005.01698a.xCitations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References 1 Spallone V, Maiello MR, Kurukulasuriya N, Barini A, Lovecchio M, Tartaglione R et al. Does autonomic neuropathy play a role in erythropoietin regulation in nonproteinuric type 2 diabetic patients? Diabet Med 2004; 21: 1174– 1180. 2 Spivak JL, Pham T, Isaacs M, Hankins WD. Erythropoietin is both a mitogen and survival factor. Blood 1991; 77: 1228– 1233. 3 Koury MJ, Bondurant MD. Erythropoietin retards DNA breakdown and prevents programmed death in erythroid progenitor cells. Science 1990; 248: 378– 381. 4 Weatherall DJ, Provan AB. ‘Red cells I: inherited anaemias’. Lancet 2000; 355: 1169– 1175. 5 Casadevall N. Cellular mechanism of resistance to erythropoietin. Nephrol Dial Transplant 1995; 6: 27– 30. 6 Macdougall IC, Cooper A. The inflammatory response and epoetin sensitivity. Nephrol Dial Transplant 2002; 17 (Suppl. 1): S48– 52. 7 Birgegard G, Caro J. Increased ferritin synthesis and iron uptake in inflammatory mouse macrophages. Scand J Haematol 1984; 33: 43– 48. 8 Means RT, Krantz SB. Progress in understanding the pathogenesis of the anaemia of chronic disease. Blood 1992; 80: 1639– 1647. Citing Literature Volume22, Issue12December 2005Pages 1780-1781 ReferencesRelatedInformation

AIM:The aim of our study was to investigate circulating levels of intercellular adhesion molecule-1 (sICAM-1) and vascular cellular adhesion molecule-1 (sVCAM-1) in cirrhotic patients, with and without chronic anaemia, to establish whether there was a relationship between inflammatory activity and anaemia.METHODS:We investigated 14 anaemic (mean hemoglobin value 10.65+/-1.06 g/dL) and 14 non anaemic (mean hemoglobin value 13.8+/-0.89 g/dL) subjects affected by virus C-related liver cirrhosis comparable for sex, age and degree of liver dysfunction such as expressed by Child-Pugh classification. Circulating sICAM-1 and sVCAM-1 were measured by EIA commercial kit (R&D System Co, Abington, UK) and mean+/- standard deviation values in two groups were compared by t-test and Kruskall-Wallis test.RESULTS:Mean+/-standard deviation sICAM-1 was 35.06+/-4.06 ng/mL in anaemic and 23.39+/- 6.1 ng/mL in non anaemic cirrhotic patients. Mean+/-standard deviation sVCAM-1 was 47.66+/-8.18 ng/mL in anaemic 31.77+/-6.08 ng/mL in non anaemic patients, respectively. Statistical analysis showed a significant difference between the two groups both in sICAM-1 (p=0.01) and sVCAM-1 (p=0.03) values.CONCLUSIONS:Our study show that chronic anaemia, in liver cirrhosis, is associated to a greater increase of circulating adhesion molecules and suggests that inflammation may contribute to persistence of anaemic state, worsening the outcome of cirrhotic patients.

Internal Medicine JournalVolume 34, Issue 1-2 p. 71-72 Biliary hamartomas (von Mayenburg complex): magnetic resonance imaging in a case report Clinical-scientific Note S. Neri, S. Neri Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this author B. Mauceri, B. Mauceri Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this author D. Cilio, D. Cilio Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this author C. Sciacca , C. Sciacca Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this authorP. Di Prima, P. Di Prima Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this author M. Finazzo, M. Finazzo Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this author S. Neri, S. Neri Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this author B. Mauceri, B. Mauceri Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this author D. Cilio, D. Cilio Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this author C. Sciacca , C. Sciacca Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this authorP. Di Prima, P. Di Prima Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this author M. Finazzo, M. Finazzo Department of Internal Medicine and Systemic Diseases University of Catania and Department of Imaging Science Ospedale Civico, Palermo ItalySearch for more papers by this author First published: 10 February 2004 https://doi.org/10.1111/j.1444-0903.2004.00521.xCitations: 12 Funding: A 60% financial grant was funded by the Ministry of University, Italian Government. Conflicts of interest: None Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume34, Issue1-2January 2004Pages 71-72 RelatedInformation

This paper describes 2 cases of a rare biliary cystic disease. A patient with Caroli's disease and another with bile duct swelling that were initially diagnosed by ultrasound and power color Doppler. Diagnosis was later confirmed by additional instrumental examinations. The first case was totally asymptomatic and only identified by chance, while the second was symptomatic and determined severe pain and dyspepsia. In both pathologies US B mode imaging and power color Doppler examination revealed the characteristic lesions of the intrahepatic biliary tree diseases and ruled out their vascular nature and communication with the portal and arterial tree.

Pathophysiology of endothelin-1, a vasoconstrictor and a mitogenic peptide, has been extensively investigated in recent years. The authors have examined the main clinical and experimental evidence regarding the involvement of this peptide in some medical emergencies, namely myocardial infarction, stroke and hepato-renal syndrome. Literature data suggest an emerging pathophysiological role for endothelin in such clinical conditions.

Background. Hepatitis C virus infection (HCV) is a major cause of chronic liver disease with the risk of evolution towards hepatic cirrhosis and hepatocellular carcinoma. Numerous studies have documented the possibility of HCV transmission through blood transfusions during surgery or during intravenous drug use. The percentage of the risk of sexual transmission, in the general population not presenting the aforesaid risks is still very controversial. The aim of this study was to evaluate the concomitant levels of seropositivity for anti-HCV, in the partners of patients with chronic HCV liver disease, but no history of previous transfusions or use of intravenous drugs.Methods. The study included 196 anti-HCV positive spouses with a clinical diagnosis of active chronic hepatitis, aged between 20 and 75 years (mean age 53 years, SD +/- 11 years). HCV infection was diagnosed by positivity of serum samples for anti HCV (EIA), confirmed by RIBA II and by circulating HCV-RNA detected by polymerase chain reaction (PCR). All partners underwent anti-HCV assay (EIA), confirmed by RIBA II in the event of positivity.Results. The mean period of cohabitation was 27 years (range 3-37, SD +/- 9.8 years). The positivity of anti HCV in both subjects affected 11 couples (5.6%). Of these couples, the viral genotype was also available in 3 cases which proved to be identical in the index patient and the partner, whereas it was not possible to identify the genotype in other couples owing to scarce compliance.Conclusions. The data obtained from this study confirm the possibility of the sexual transmission of HCV. However, in the context of subjects not belonging to "high risk" groups, this method of transmission does not appear to be important if compared with that of other viruses (HBV and HIV).

The role of circulating endothelin-1, a potent vasoconstricting peptide, in liver cirrhosis is still controversial. It has been postulated that endothelin-1 may play a role in the circulatory derangement occurring in cirrhotic subjects, and increased plasma endothelin-1 levels have been reported in these patients. In this study we looked for a relationship between the severity of the liver disease according to Child’s classification and plasma endothelin-1 concentrations in a group of cirrhotic patients compared with a healthy control group. Twenty-two cirrhotic patients and 10 healthy controls, matched for sex and age, were selected for study after informed consent. The etiology of cirrhosis was posthepatitis B in 8 of 22 cases, posthepatitis C in 13 of 22 cases, and alcoholism in 1 patient. According to Child’s classification, 6 patients were in class A, 6 in class B, and 10 in class C. Plasma endothelin-1 was measured by a commercial RIA kit (Amersham UK). Mean±SD plasma endothelin-1 levels were 8.8±0.9 pg/ml in controls and 9.2±1.1 pg/ml in all cirrhotic patients (P>0.05). In each subgroup of cirrhotics, plasma endothelin-1 was 8.6±1.2 pg/ml in Child A, 8.9±1.9 pg/ml in Child B, and 10.6±1.5 pg/ml in Child C groups, respectively. There were no statistical differences between control subjects and Child A and B cirrhotic patients (P>0.05). A significant increase in endothelinl was observed only in the Child C group versus either group A or B (P=0.004). Our results show that alterations of circulating endothelin-1 do not occur in all cirrhotic patients; higher plasma levels than controls are only detectable in patients with more-severe hepatic failure. We do not know whether increased endothelin-1 levels are a consequence of hemodynamic disorders occurring in the advanced phase of liver cirrhosis or play a pathogenic role.

Authors describe a case of syndrome of Gordon, a rare genetic disease characterized by hypertension, hyperkalemia and normal glomerular filtration rate. The potential causes of disease are discussed and literature data are reviewed.