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.

[The effect of GH on erythropoiesis in vivo]. / Effetto, in vivo, del GH sull'eritropoiesi.

It has been demonstrated that the direct and/or indirect stimulation of hematopoiesis is one of the effects of the growth hormone (GH) in vitro. In order to study the effect of GH on erythropoiesis in vivo, the variation of hemochrome in a group of 8 subjects with GH deficiency (GHD) were monitored during a substitutive therapy with biosynthetic GH (rhGH) at dose of 0.4 U/kg/week. Hemoglobin (Hb), hematocrit (Ht), mean corpuscular volume (MCV), number of red blood cells (RBC) were analysed in all subjects at the beginning and after 9 months of treatment. The effectiveness of therapy was demonstrated by statistically significant variations in height, height SDS, growth velocity, serum levels of IGF-I. After 9 months of rhGH therapy, a significant increase was observed in all values considered with exception of MCV. In conclusion Gh would appear to stimulate erythropoiesis, directly or indirectly, and these results would appear to indicate an in vivo confirmation.

[The TRH test in Turner syndrome]. / TRH-test nella sindrome di Turner.

In order to evaluate the functionality of the hypothalamic-hypophyseal-thyroid axis in Turner's syndrome (TS), 27 subjects, aged between 5.1 and 16.1 years old, were studied, 14 of whom were karyotype 45,XO and 13 affected by mosaicism. The TRH test (200 mcg i.v.) was performed in all subjects using a single bolus. TRH titers were assayed in serum samples collected at 0, 15, 30, 60 and 90 minutes, and anti-microsome and anti-thyroglobulin, T4 and T3, were assayed in the basal sample; the latter were also assayed in the blood sample collected at 120 minutes. These results were compared with those obtained using the same test in a group of age- and sex-matched controls. Anti-thyroid antibodies and basal levels of T3 and T4 were within the norm in 26 subjects; a high basal value of TSH was only found in one patient with chromosomic mosaicism with an elevated response to TRH and a high titer of anti-microsomic antibodies. Apart from this no statistically significant differences were found in patients compared to control subjects in relation to TSH values at all stages of the test and between the two groups of TS; no significant results were found in the comparison between the areas below the curves (AUC). On the basis of these results the Authors conclude that it is not possible to reveal alterations in thyroid function attributable to hypothalamic and hypophyseal anomalies in this group of patients either with karyotype 45,XO and mosaicism.

[Effect of sex on the increase of GH induced by galanin, alone or in combination with GHRH with or without pyridostigmine in pubescent subjects]. / Influenza del sesso sull'increzione di GH indotta dalla galanina, da sola ed in associazione con GHRH e/o piridosstigmina, in soggetti puberi.

Growth hormone response to galanin (GAL) and growth hormone releasing hormone have been demonstrated to be higher in females than in males, and moreover the cholinergic system appears to be able to enhance them. On the basis of this presumption, we evaluated the GH response (expressed as area under the curve: AUC-GH) to galanin (GAL, 10 mg/kg i.v.) or GHRH (1 mg/kg i.v.) either alone or associated together and with pyridostigmine (PD, 60 mg p.o.), and to saline infusion as a control, in 5 males and 5 females, in puberty, aged 16 +/- 0.4 years old (mean +/- SD). In females tests were performed during the follicular phase of the menstrual cycle. GAL alone cannot provoke a response from GH unless associated with GHRH. The contemporary administration of PD does not increase the extent of the response. The latter did not differ between sexes. The GHRH-GAL association induced a higher response in GH compared to GAL alone and GAL-PD, without any differences between the sexes. Lastly, the combination GHRH-GAL-PD induced responses that were comparable to GHRH and GAL alone. Therefore GAL does not act alone but enhances the effect of GHRH and the cholinergic system appears to be involved as a modulator. Moreover, the effect of GAL is comparable in both sexes.

[Beta-pancreatic function in adult patients with GH deficiency]. / Studio della funzionalità beta-pancreatica in pazienti adulti con deficit di GH.

We investigated the beta-pancreatic function in response to a standard oral glucose tolerance test (OGTT) and a tolbutamide test in a group of GH-deficient adult subjects and in a group of control subjects. Fasting plasma glucose levels were normal in all subjects; the insulin levels, basal (0.19 +/- 0.02 vs 0.99 +/- 0.08) and, as n-AUC, after OGTT (195.2 +/- 23 vs 520.5 +/- 69) and tolbutamide test (33.6 +/- 4.4 vs 177.7 +/- 12.1) (means +/- ES), were significantly lower (p less than 0.001) in the GH-deficient subjects compared to controls. These data indicate a reduced beta-cell activity, secondary to absence of trophic effect of GH on pancreatic beta-cells, in GH-deficient adults.

[No correlation between insulinemic levels and arterial hypertension in obese females]. / Assenza di correlazione tra livelli insulinemici ed ipertensione arteriosa in donne obese.

High blood pressure and impaired glucose tolerance are frequently associated with obesity: it has been suggested that hyperinsulinemia could represent one of the possible pathogenetic connections between obesity and systodiastolic hypertension. In order to verify this hypothesis we examined fasting and post-load insulin and glucose levels in a group of 102 obese females, 58 hypertensive and 44 normotensive. All of the subjects underwent standard OGTT in order to measure their glycemic and insulinemic levels. No differences were found between two groups, as regard age and degree of obesity; blood pressure values were significantly different (p less than 0.01). No significative differences were detected for glycemic and insulinemic levels between hypertensive and normotensive subjects. These results indicate that hyperinsulinemia is not the prominent link between obesity and arterial hypertension; the relationship between these two conditions may be indirect.

[Blood prolactin patterns in hepatic cirrhosis]. / Osservazioni sul comportamento della prolattinemia in corso di cirrosi epatica.

Variations in PRL secretion were observed during chronic hepatic disorders. The aim of our study was to evaluate the behaviour of PRL in patients affected by hepatic cirrhosis. 6 patients (4 males and 2 females) were studied and matched with a group of healthy controls. In all subjects PRL values were evaluated in basal conditions and after TRH stimulation. The results obtained showed higher basal levels of PRL, together with higher and more prolonged TRH responses in patients with hepatopathies than in controls (p < 0.01). These abnormalities in PRL secretion during hepatic cirrhosis could be due to alterations of neurotransmitters at central level.

[Circadian rhythm of melatonin in liver cirrhosis]. / Ritmo circadiano della melatonina (aMT) nella cirrosi epatica.

The liver plays an important role in the intermediate metabolism of numerous substances involved in hormonal action. Starting from the presupposition that the pineal has an inhibitory effect on the reproduction system through melatonin (aMT) and that hepatic cirrhosis can be included among the pathologies characterised by sexual disorders, the authors felt that it was interesting to evaluate the light/darkness rhythm of aMT in some patients suffering from hepatic cirrhosis in order to highlight the possible pathogenetic role of aMT in causing the altered sexual activity observed in this pathology. A total of 4 subjects (3 males and 1 female), with a mean age of 60.5 years, suffering from hepatic cirrhosis and a matched group of healthy controls were included in the study. Circadian changes in aMT plasma levels and plasma levels before and after TRH stimulus (200 micrograms) of aMT and PRL were studied in all subjects. The results revealed the presence of a circadian rhythm of aMT with a nocturnal peak secretion in both groups; in patients with cirrhosis, however, the rhythm appeared to be "out of phase" and presented a late and prolonged increase in aMT compared to controls. Responses to TRH did not show any differences in aMT between the two groups, but the response to PRL was higher and longer than in hepatopathic patients. These findings showed an alteration in the secretory pattern of aMT in cirrhotic patients which can be attributed to reduced hormone metabolism at an hepatic level. The altered response to PRL is attributable to an altered neurotransmitter function at the central level.

[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.

[Tolerability to terizidone (TZ) in the treatment of pulmonary tuberculosis in dialyzed patients]. / Tollerabilità del terizidone (TZ) nel trattamento della tubercolosi polmonare in pazienti dializzati.

Six dialysed patients affected by tuberculosis involving the respiratory apparatus were included in the study. Antimycobacterial treatment consisted of polychemiotherapeutic combinations using terizidone (TZ). The need to resort to this drug may be explained by the need to exclude normally used drugs (R/AMP, INH, SM) due to resistance, allergy or organ meiopragia. Five patients received terizidone at a dose of 600-900 mg/day for the entire course of treatment, whereas it was necessary to abandon treatment in one patient due to the onset of depressive symptoms which then rapidly regressed following the suspension of TZ therapy. The good level of tolerance demonstrated in the 5 remaining cases confirm the inclusion of this drug in the treatment of a limited number of cases of tuberculosis in dialysed patients.

[Comparative study of the bronchodilating action of fenoterol and ipratropium bromide administered by aerosols in acute attacks of asthma]. / Raffronto comparativo tra l'attività broncodilatatrice del fenoterolo e dell'ipratropium bromuro somministrati per via aerosolica nell'attacco acuto d'asma.

Eighteen patients hospitalised with acute bronchial asthma are examined. Nine were given aerosol treatment with an ipratropium bromide solution and 45 minutes later with a phenoterol solution. The remaining 9 were given the same treatment in reverse order. The results obtained showed that phenoterol has a stronger bronchodilatory activity than ipratropium bromide, especially when administered after the anticholinergic product.

[Efficacy of the simultaneous aerosol administration of fenoterol and 2(alpha-thenoylthio)propionylglycine]. / Efficacia della somministrazione aerosolica contemporanea del fenoterolo e della 2(alfa-tenoiltio)propionilglicina.

The aim of the present study was to investigate the effect of a new mucolytic drug 2-alpha-tenoiltium-propionylglycine (2-alpha-TPG) administered in spray form together with a selective beta 2 stimulant, fenoterol. A double blind test was conducted on 26 patients to whom 2-alpha-TPG-fenoterol and placebo-fenoterol were given in spray form in two daily doses for 15 days at 10 day intervals. The data suggest the existence of an additive effect between the mucolytic drug (2-alpha-TPG) and the beta 2 stimulant (fenoterol) that would justify the use of the combination in the treatment of such patients.

[Correlation between lipid pattern and body mass index in obesity]. / Correlazione fra quadro lipidico ed indice di massa corporea nell'obesità.

Lipid plasma levels were measured in a group of 519 obese subjects, aged 7-66 years, divided according to age, sex and BMI. Lipidemia and total cholesterolemia increased both with age and BMI, irrespective of sex; LDL and VLDL increased in relation to age and, with less evident differences, to BMI. Triglycerides increased in the age bracket from adolescent to adult, especially in males, whereas their increase in relation to BMI showed no difference between the sexes. Chylomicron plasma levels remained steady both in relation to age and BMI.

[Impaired glucose tolerance in obesity in children and adolescents]. / Ridotta tolleranza glucidica nell'obesità infanto-giovanile.

The incidence of impaired glucose tolerance (IGT) in obese juvenile has not yet been well defined. Glycemic and insulin responses to OGTT were evaluated in 398 obese juveniles (and 70 healthy control subjects) to investigate possible correlations with age, body mass index (BMI) and obesity duration. Subjects were subdivided into two groups according to OGTT results: obese with normal glucose tolerance (OB-NGT) and obese with impaired glucose tolerance (OB-IGT). IGT was found in 11% of subjects but no correlations were observed in relation to age, BMI and obesity duration. There was no difference in the glycemic response to OGTT in terms of the biological parameters examined. Insulin plasma levels were twice as high in OB-NGT in comparison to control subjects and OB-NGT. Basal insulinemia increased with BMI in OB-IGT but not in OB-NGT.

[Problems of pulmonary pathology in drug addicts]. / Problemi di patologia polmonare nei tossicodipendenti.

The hospitalisation of a group of drug addicts with pulmonary diseases leads to an examination of the relationship between drug addiction and bronchopneumopathies in the light of experience and reported data. After a brief examination of cases, the most frequently observed forms of bronchopulmonary disease are reviewed together with differences in the clinical course of the diseases in drug-addicted and other patients.

[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.

[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.

[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.

[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.