The release of thromboxane B2 and 6-keto-PGF1 alpha following pulmonary embolism.

It has been shown in animals that acute obstruction of pulmonary artery branches is followed by an early but shortly lived increase in blood levels of thromboxane B2 and a subsequent longer-lasting increase in blood levels of 6-keto-PGF1 alpha. Our study was conducted on twelve patients with acute pulmonary embolism. Nine were treated with urokinase; three could not be given thrombolytic or anticoagulant drugs due to bleeding peptic ulcer (2 cases) or recent cerebral hemorrhage (1 case). HPLC and RIA tests were performed on arterial blood samples at diagnosis and after 1, 6, 12 and 24 hours. Findings were compared with those in a control group of 6 healthy subjects. There was a difference in prostanoid behaviour between the untreated and urokinase treated patients. Among the former mean TxB2 was significantly raised at clinical onset and began to decline after 6-12 hours, approaching the mean level found among the controls after 24 hours. In contrast 6-keto-PGF1 alpha was raised after 1 hour and gradually declined thereafter. In the subjects treated with urokinase TxB2 was already close to the mean control level after 1 hour; 6-keto-PGF1 alpha had increased after 1 hour but had returned near the control level after 12. The behaviour of prostanoids appears to match the clinical course.

Tuberculosis of the larynx. Today.

Forty-one cases of laryngeal tuberculosis accounting for 0.79% of the TB cases observed in 1975-85 are examined. The M/F ratio was 9.2:1; the mean age 52 years 9 months. In all cases current or earlier tubercular lesions on the pulmonary parenchyma were also noted. The laryngeal sites affected were as follows, in order of frequency: true vocal cords, epiglottis, false cords and laryngeal ventricles, arytenoid and interarytenoid area, subglottic area. The patients were treated with R/AMP, INH, EMB or SM, EMB with satisfactory results. Two cases required exeresis of laryngeal lesions and 3 tracheotomy.

[Changes in the primary resistance to Mycobacterium tuberculosis in Piedmont 1965-1979]. / Modificazioni del fenomeno della resistenza primaria del micobatterio tubercolare in Piemonte nel perido 1965-1979.

A comparison is made of the data drawn from Hospital statistics for the period 1965-79 with regard to antibiograms from patients with first T. B. observations. A progressive reduction in primary resistance in the general sense was noted, with an increase in the case of RAMP only. There was a constant decrease for INH, PAS and ETB, whereas SM, KM and CS values were stationary. The conclusion is drawn that the reduction in primary resistance notwithstanding the continual employment of these drugs must be attributed to the fact that the resistant mycobacteria have depressed proliferative capacity and virulence. Primary resistance, therefore, while a good pointer to the epidemiology of T.B. infection, is not a cause for concern from the therapeutic standpoint.

[Double-blind study of the bronchodilating action of the aminophylline-clenbuterol combination in asthmatic patients]. / Studio in doppio cieco dell'attività broncodilatatrice dell'associazione aminofillina-clenbuterolo nei pazienti asmatici.

The results obtained with the administration of aminophylline and clenbuterol either separately or in association, to a group of patients with chronic obstructive bronchopneumopathies are reported. The two drugs had a more or less identical broncho-dilatory effect with the beta 2-stimulant acting earlier but for a shorter time. The simultaneous administration of both drugs gave distinctly better results.

[Blood copper levels in a group of patients with asbestosis]. / Tassi sierici di cupremia in un gruppo di soggetti affetti da asbestosi.

Colorimetry was used to assay blood copper levels in 13 asbestosis patients (mean age 55.5) selected by excluding all cases with an evident clinical anamnesis of dietary imbalances or other significant pathologies. The results show increased blood copper in 11 out of 13 patients, the mean level in this group being significantly higher than that in a control group (p less than 0.01). The phenomenon, already described in other interstitial lung diseases, may well be attributable to enhanced reabsorption of the metal due to the intensified activity of a copper enzyme lysyl oxidase that is involved in collagen synthesis.

[Comparison of protective effects induced by the ultrasonic mist of nicardipine + fenoterol versus nicardipine + fenoterol + ipratropium bromide]. / Raffronto tra la protezione nei confronti della nebbia ultrasonica indotta dalla nicardipina + fenoterolo versus quella indotta da nicardipina + fenoterolo + ipratropium bromuro.

A comparison is presented of the protective effect of ultrasound mist induced by nicardipine + fenoterol and nicardipine + fenoterol + ipratropium bromide in a group of 11 patients with chronic bronchial asthma in a phase of relative clinical stability. The data collected show that the three-drug combination was more effective than the use of nicardipine and fenoterol.

[Clinico-pathological aspects of farmer's lung. Review of the literature and personal cases]. / Aspetti clinico-patologici del farmer's lung. Revisione della letteratura e casistica personale.

Data are presented on 9 subjects with Farmer's lung encountered in 1981-85. In all cases dyspnea arose within several hours after exposure to the allergen and in 4 cases only a few minutes after exposure. The radiological picture was altered in 7 cases (6 miliary pictures and 1 case of medial and basal nodulation). In functional terms 6 restrictive and 3 mixed forms were identified. The specific bronchial provocation test was positive wherever it was performed. Bronchoalveolar lavage revealed predominantly lymphocytic alveolitis in the most recent cases. Transbronchial biopsy also revealed the presence of pulmonary granulomatosis in various stages of development. Finally skin tests were positive to various antigens in several cases while specific precipitin were found in all cases. These data are compared with reports in the literature.

[Radioscintigraphic correlation in interstitial pneumopathy. Case presentations]. / Correlazioni radioscintigrafiche nelle pneumopatie interstiziali. Contributo casistico.

Radiological and scintigraphic findings in 82 patients (58 male, 24 female) were compared. The patients were hospitalised in 1981-86 with sarcoidosis (43 cases), silicosis (26), asbestosis (9) extrinsic allergic alveolitis (3), lung disease caused by hard metals (1). Gallium scintigraphy was positive in 61 patients (74.39%). More precisely, the response was positive in 57 cases in both analogic and quantitative terms and in 4 only quantitatively. The radiological (radiography and stratigraphy) finding was significant in 42 of the 61 gallium-positive cases and negative in the remaining 19. In the 21 gallium-negative cases (25.61%) the radiological finding was significant in 9, negative in 12. The study confirms the real value of gallium scintigraphy in the diagnosis and follow-up of interstitial lung disease in line with views presented in the recent literature.

[Scintigraphic findings with a positive marker in generalized lymphadenopathy syndrome (L.A.S.)]. / Rilievi scintigrafici con marcante positivo nella sindrome linfoadenopatica generalizzata (L.A.S.).

The behaviour of gallium scintigraphy in a group of 15 drug addicts suffering from LAS is examined. The examination was positive in 11 patients with no pleuro-pulmonary lesions that could be demonstrated by clinical or radiological examination. This is in line with similar observations in AIDS cases and may reflect the preactivation of monocytes and macrophages documented in HIV infection.

[Blood chemical parameters in the monitoring of inoperable bronchogenic carcinoma]. / Parametri ematochimici nel monitoraggio del carcinoma broncogeno non operabile.

Serum variations of 3 standard lung cancer markers (ferritin, carcinoembryonic antigen, gastrointestinal cancer antigen) were assessed in 27 patients with inoperable lung cancer diagnosed histologically and confirmed by cytology and/or histology. The study reveals that ferritin is the most sensitive marker.

[Use of miocamycin in the acute exacerbation of chronic obstructive bronchopneumopathy. Case material contribution]. / L'impiego della miocamicina nelle riacutizzazioni della broncopneumopatia cronica ostruttiva. Contributo casistico.

18 patients with chronic obstructive bronchitis were treated with 900 mg myomycin a day. The clinical parameters examined were the quantity and organoleptic characteristics of the expectoration, coughing, and body temperature. These parameters were studied immediately before and 7.14 and 21 days after the start of treatment. Myomycin was found to be satisfactorily effective with minimal toxicity and well tolerated.

[Skin reactions with ubiquitous multiple antigens as a test of survival in patients with inoperable bronchogenic carcinoma]. / La cutireazione con antigeni plurimi ubiquitari come test di sopravvivenza nei pazienti affetti da carcinoma broncogeno inoperabile.

Fifty-three patients suffering from inoperable, non-microcytoma, bronchogenic carcinoma in which a skin reaction with ubiquitous antigens (tetanus, diphtheria, streptococcus, tuberculin, proteus, tricophyton, candida) had been carried out were followed up to check on the possible relationship between skin reactivity and survival period. A significant correlation was found between the degree of positivity and duration of survival, with mean survival values greater than 69.1 weeks being observed in patients positive to five or more antigens. Among preliminary tests, it would therefore appear that skin reaction with ubiquitous may provide indications for predicting survival.

[Post-actinic pulmonary fibrosis. Longitudinal study of 279 cases]. / La fibrosi polmonare post-attinica. Indagine longitudinale su 279 casi.

The incidence and extent of postactinic pulmonary fibrosis was investigated in relation to the different types of radiation therapy. For this purpose, 131 patients treated with fast electron (for breast cancer) and 148 patients treated with TCT (for breast cancer and cancer of other nature) observed in the period 1976-1987 were followed up (from 13 months to 7 years). The frequency of postactinic fibrosis was much less in the first group of patients than the second (6.61% vs 18.99%); further, the functional damage in these patients proved less and developed in a less unfavourable way.

[Histo-radiological and histo-bronchoscopic correlates in neoplastic pathology of the lung. Personal case series]. / Correlazioni isto-radiologiche e isto-broncoscopiche nella patologia neoplastica del polmone. Casistica personale.

Data are presented on a series of 100 lung cancer patients, diagnosed histologically and encountered in 1984-87. The percentage distribution of the various histotypes and their relationship with radiological and endoscopic aspects were examined. The data obtained are then compared with those reported in the literature.

[Data on cellular subpopulations in bronchoalveolar lavage in silicosis and asbestosis patients. Case contribution]. / Dati sulle sottopopolazioni cellulari nel lavaggio broncoalveolare nei silicotici ed asbestosici. Contributo casistico.

Data on the cytology of BAL performed on 8 silicosis and 5 asbestosis patients with different degrees of radiological profusion and functional impairment are examined. The prevalently neutrophilic alveolitis reported in the literature in these forms of pneumoconiosis is confirmed, while differences were found between the percentage of lymphocyte subpopulations in the two diseases.

[Epidemiologic study of 1665 cases of bronchogenic neoplasms collected at the S. Luigi Gonzaga Hospital between 1973 and 1979]. / Studio epidemiologico su 1665 casi de neoplasie broncogene raccolte all' Ospedale "S. Luigi Gonzaga" fra il 1973 e il 1979.

Data regarding 1,665 cases of benign and malignant lung cancers are examined and frequency behaviour analysed by histological type, sex, age groups and site of onset. Results are compared with other reported data and it is concluded that there is a considerable increase in dyskaryokinesis in both sexes, especially females (particularly epidermoid forms), and that there is a shift in maximum incidence towards more advanced age groups. No variation was seen, however, with respect to the frequency of bronchial tree localisation.

[Clinical aspects of respiratory pathology in scleroderma. Case reports]. / Aspetti clinici della patologia respiratoria nella sclerodermia. Contributo casistico.

Six cases of scleroderma with pulmonary involvement, either isolated or accompanied by other visceral signs, observed between 1985 and 1987 have been examined. Patients were undergoing treatment with cortisone drugs in 4 cases and azathioprine in 2. Chest X-ray documented a picture of nodular opacities in 3 cases, reticular in 2 and miliariform in 1. B.A.L. revealed a picture of prevalently neutrophil alveolitis in all subjects, while transbronchial biopsy showed a finding of macrophagic infiltration in 2 cases, and one of fibroblastic proliferation in 4. The anatomoclinical damage was reflected adequately by spirometric tests and above all by the DLCO, while Gallium 67 scan and measurement of the A.C.E. were not very sensitive.

[Comparison of the bronchodilating activity of procaterol and nicardipine in chronic forms of bronchial asthma]. / Raffronto tra l'attività broncodilatatoria del procaterolo e della nicardipina nelle forme croniche di asma bronchiale.

The bronchodilatory activity of one beta 2-stimulation (procaterol) and one calcium antagonist (nicardipine) both recently introduced was compared in a group of chronic asthmatics in the clinical remission phase. The experiment took the form of the randomised double blind administration of procaterol or nicardipine or a placebo twice a day for 15 days with spirometric tests being performed before, during and after the experiment. The results show that nicardipine does have a bronchodilatory effect though less than the beta 2-stimulant.

[Ultrasonic spray protection against bronchospasm. Comparison of fenoterol and a combination of salbutamol and ipratropium bromide]. / La protezione verso il broncospasmo da nebbia ultrasonica. Confronto tra fenoterolo e associazione di salbutamolo ed ipratropium bromuro.

Nine patients with clinically stable bronchial asthma who had received no drug treatment in the preceding 48 hours were examined. The patients were subjected to 5 minutes ultrasound spray after the double blind administration of either fenoterol or salbutamol + ipratropium bromide. Respiratory function was assessed before and 30, 60 and 90 minutes after cessation of the stimulation. The results showed no significant difference in the protection against the ultrasound spray provided by fenoterol and the combination of salbutamol + ipratropium bromide.

[Double-blind study on the effects of famotidine on bronchial tone and on expectoration]. / Studio in doppio cieco sugli effetti della famotidina sul tono bronchiale e sull'espettorazione.

A double blind test using famotidine and a placebo was conducted on 14 patients with hypersecretory, chronic bronchitis. No other drug treatment was given during the test or in the ten days preceding it. VC, FEV1, Sgaw and daily excrete volume were measured before the test and 7, 14 and 21 days after it began. The data collected indicate that H2 receptors have no influence on bronchial calibre or secretions.