Intraoperative parathormone measurement in patients with multiple endocrine neoplasia type I syndrome and hyperparathyroidism.

Total or subtotal parathyroidectomy is considered the treatment of choice for multiple endocrine neoplasia type I (MEN-I)-associated primary hyperparathyroidism (HPT). However, persistent or recurrent HPT is frequently observed. The development of a rapid two-site immunoradiometric assay (IRMA) method for measuring intact parathormone (PTH) has provided a valuable tool for recognizing possible surgical failures. Our experience includes 16 MEN-I patients (10 females, 6 males) of mean age 35.5 years operated on between 1990 and 1996. Total parathyroidectomy (TPTX) with autotransplantation of parathyroid tissue was the standard treatment. Blood samples for PTH measurement were drawn at the induction of anesthesia (basal value), 10 and 20 minutes after the removal of each gland, and 60 minutes after TPTX. Rapid PTH measurement, which required only 15 minutes of incubation at 37 degrees C, showed a highly significant correlation (p < 0.0001) with the standard method. Circulating PTH levels exhibited a stepwise decrease during TPTX, reaching a mean value of 22.3% of the baseline 20 minutes after removal of the last gland. Two patients showed a prompt decrease of PTH after removal of the single enlarged gland, featuring the kinetics observed in the adenomas. One of these two patients was successfully treated with more conservative surgery. None of the patients showed persistence or recurrence of HPT. In our experience, intraoperative measurement of PTH seems to be a valuable adjunct in both the diagnosis of multiglandular involvement and the prediction of surgical treatment in patients with primary parathyroid hyperplasia.

2-(4-Pyridyl)-delta 2-1,3,4-oxadiazolines from isonicotinoylhydrazones and diazomethane as potential antimycobacterial and anti-HIV agents. V.

The 5-aryl-4-methyl-2-(4-pyridyl)-delta 2-1,3,4-oxadiazolines 3, previously synthesized along with isomer 4-aryl-1-methoxy-1-(4-pyridyl)-2,3-diaza-1,3-butadienes 2 from benzaldehyde isonicotinoylhydrazones and diazomethane, were tested for in vitro activity against both M. tuberculosis and some atypical mycobacterial strains as well as against human immunodeficiency virus (HIV-1). Some halophenyl derivatives, 3e, 3g, 3i, 3j, were found to display MIC ranges from 1 to 10 (micrograms/ml against H 37 Rv and a clinical isolate tubercular strain, whereas against M. avium (MAC) the MICs were higher than 20 micrograms/ml. When the combinations of oxadiazolines with ethambutol, acting as inhibitor of cell wall synthesis, were assayed on MAC strain a synergistic effect was demonstrated for 3g and 3h trifluoromethyl derivatives. The antimycobacterial profiles of 2 and 3 analogues are compared and discussed. As shown by compounds 2, no substantial anti-HIV in vitro activity was found in selected delta 2-oxadiazolines; a moderate cytotoxicity, however, appears to be a common property.

Halogenated isoniazid derivatives as possible antimycobacterial and anti-HIV agents--III.

As part of a research directed to the synthesis of novel isoniazid derivatives with potential activity on mycobacteria and HIV virus, the acetophenone-isonicotinoylhydrazones 3 and the 4-aryl-1-methoxy-1-(4-pyridyl)- 2,3-diaza-1,3-butadienes 5, obtained by reaction between isonicotinoylhydrazones and diazomethane, have been prepared and tested for such activities. Both classes of derivatives showed interesting growth inhibitory activity on non-tubercular mycobacteria, including the emerging M. avium. Such activity appears to be linked to fluorine and/or chlorine presence on benzene rings. In contrast, none of the compounds submitted to the anti-AIDS in vitro screening, displayed any protection against HIV-1 virus-induced cytopathic effect in T4-lymphocyte cell lines.

Nimesulide in the treatment of mastalgia.

Sixty patients with mastalgia, either idiopathic or secondary to dysplastic lesions, were treated with oral nimesulide (100mg tablets twice daily) for 15 days. Breast tension and pain, assessed at baseline and on completion of the treatment period, improved or resolved with therapy. Indeed, breast pain (which most likely manifests as a consequence of periductal inflammation) was most noticeably reduced. The drug was well tolerated in nearly all patients. These results support the usefulness of nimesulide and other nonsteroidal anti-inflammatory drugs in the treatment of mastalgia.

Halogenated isoniazid derivatives as possible antitubercular and antineoplastic agents. Note 1.

Halogenated arylhydrazones, 2-aryl-4-thiazolidinones and their 1,1-dioxides containing isoniazid (INI) moieties were prepared and explored for antimicrobial (against bacteria, Candida and mycobacteria) and antitumor activities. None of the tested compounds showed any marked antimicrobial effect. Furthermore, among the compounds submitted to NCI in vitro primary antitumor screening, those bearing 3-fluoro or -chlorophenyl substituents were found to possess selective inhibitory effects on the growth of non small cell lung cancer, whereas those with para-phenyl substituents displayed selective effects, sometimes statistically significant, against leukemias.

Fluorocontaining D-cycloserines. Synthesis and in vitro evaluation of antimicrobial and antiviral activities.

Some fluoroacylderivatives at the side chain NH2 of D-cycloserine were synthesized and evaluated in vitro for antimicrobial activity against bacteria and tubercular or non-tubercular mycobacteria. Against the used Gram-positive and Gram-negative strains only trifluoroacetamide 1 exhibited comparable MIC values and lower MBC values than those of parent antibiotic. Other fluoroacycloserines, inactive at all on these bacteria, were found to inhibit the growth of mycobacteria when tested in liquid media. The in vitro anti-Herpex Simplex virus type-2 (HSV-2) activity was also investigated on HEp-2 and Vero cells. The obtained results demonstrated an antiviral activity of the compounds 1 and 3 when tested on Vero cell-lines, whereas the same cycloserine is inactive.

Activity of lavandino essential oil against non-tubercular opportunistic rapid grown mycobacteria.

Four samples of lavandino essential oil were investigated for their antimycobacterial activity, and were found to be very effective against some strains of non-tubercolar Mycobacteria (NTM). The mechanism of this effect is discussed.

[Methodological specifications on the Todd method and preliminary results]. / Precisazioni metodologiche sul metodo di todd e risultati preliminari.

In order to measure the potentiality and kinetics tissue fibrinolysis we have modified Todd's histochemical method preparing at least six sections taken from same sample tissue, by infraoperatory biopsy, esponing them to a fibrin film at a constant concentration; we have also chosen to incubate the section at 10, 20, 30, 45, 60 min. The measurement of the areas of fibrin, of tissue and fibrinolysis, at the above mentioned times, has been effected at standard magnification (15 X) by an image analyser (Videoplan) scale 1:8. For each sample we suggest to elaborate an Index of the Potentiality of Fibrinolysis (formula; see text) and an Index of the Kinetics of the Fibrinolysis (formula; see text). Applying this method to two different groups of thyroid disease (struma and adenoma) we have not pointed out any statistically significant difference.

Hemostatic disorders in 25 patients with limited and uncomplicated thyroid and breast cancer: prophylactic and therapeutic considerations.

In order to evaluate the efficacy of an anticoagulant treatment in neoplasia, we have looked for the existence and the possible role of hemostatic unbalance in patients affected by limited and uncomplicated thyroid and breast cancer by examining hemostasis in 25 patients. Our data allowed us to evidentiate an accelerated and increased fibrinoformation associated with the presence of plasminogen's activation inhibitor which overlaps the increased plasminogen's activators. We evidentiated also an increase of platelet functions in vitro and of their activation in vivo. These findings support the hypothesis of a possible role played by hemostasis alterations in the pathogenesis of thromboembolic complications, cancer growth and/or metastatization, and justify prophylactic and therapeutic anticoagulation.

[Sequential scintiscanning with 99mTc-HIDA in the study of some aspects of post-operative dynamics of the proximal digestive tract]. / La scintigrafia sequenziale con 99mTc-HIDA nello studio di alcuni aspetti della dinamica post-operatoria del digerente prossimale.

The authors exploited the elective biliary excretion of 99mTc-HIDA at adequate concentrations to afford visibility of intestinal segments more directly wetted by bile in a study of sequential hepatobiliary scintigraphy designed to explore the parts of the duodenum and jejunum that are excluded to the transit of gastrointestinal contents in many surgical procedures involving the proximal digestive tract. They illustrate their case material with several representative examples; these are described in detail to show the validity, usefulness and versatility of the scintigraphic technic under discussion.

[Oxolinic acid treatment of urinary sepsis in patients with renal insufficiency]. / Trattamento con l'acido ossolinico delle sepsi urinarie nei pazienti con insufficienza renale.

The effect of oxolinic acid, administered at the rate of 750 mg twice/day, has been studied on 31 patients with urinary tract infections. Many of them had a marked impairment of renal function due to nephropathies of various origin. Favourable results, with sterile urine and complete remission of symptoms, were obtained in 73.3%. Patients who were resistant to previous different therapies, were successfully treated. Oxolinic acid was on the whole well tolerated and proved to be effective also in patients with impaired renal function. In some of the latter an improvement in renal function occurred as a result of the effective urinary infection care. The tolerability of oxolinic acid was good: only one patient interrupted the treatment because of insomnia; other 4 had transient and mild side-effects.