Lung cancer single intramedullary metastasis vs delayed radionecrosis. A case report.

Intramedullary metastases are rare, accounting for 0.9-5% of spinal metastases. Radiation myelopathy is considered one of the most distressing complications of radiotherapy. In both cases symptoms are aspecific, and there are no characteristic neuroradiologic findings. We describe a case of single intramedullary metastasis from lung microcytoma in a 55-year-old man with a history of malignancy, treated by radiotherapy five years previously. The patient returned to our observation complaining of pain and paraesthesia in the left C7 area. Spinal MRI and rachicentesis findings were aspecific. Ten days later a new MRI showed that the lesion size had increased, and neoplastic cells were found in CSF. Intramedullary metastases are extremely rare, accounting for 0.1-0.4% of all CNS tumors. The risk of developing delayed radionecrosis varies with the total dose administered. In both cases diagnosis is histological, while contrast-enhanced MRI is highly sensitive and specific in identifying and characterizing the lesion. In case of metastatic lesions the prognosis is unfavorable. Differential diagnosis is important because it has a strong effect on patient management.

Clarithromycin in the treatment of bacterial relapses of chronic bronchitis.

Clarithromycin is a new semisynthetic macrolide, Erythromycin A derivative, which is bactericidal for the most of growing aerobic and anaerobic Gram-positive and Gram-negative organisms. The drug has also a potent activity against the pathogens surviving into intracellular medium and, just like all other macrolides, achieves its effect by inhibiting protein synthesis. Our study investigated the efficacy and tolerability of Clarithromycin in 11 ambulatory patients (8 m, 3f) suffering from bacterial relapses of chronic bronchitis. The macrolide was administered at the oral dosage of 250 mg twice daily for a period ranging from 7 to 11 days, only after microbiological evaluation of sputum. There was a withdrawal because one of the three bacteria isolated from sputum sample was resistant to Clarithromycin, 7 patients were clinically cured, 3 showed only clinical improvement. In all the ten patients there was eradication of causative agents. No adverse events or changes in biochemical and haematological tests were observed.

[Pefloxacin in the treatment of lower respiratory tract infections]. / La pefloxacina nel trattamento delle infezioni delle basse vie respiratorie.

Pefloxacin is an antibacterial agent belonging to the group of quinolones having a methyl-carboxylic acid which possesses a high activity as compared to other quinolonic drugs. In this study we tested the efficacy and tolerability of the drug in the treatment of 25 patients with environmental L.R.T.I. (Low Respiratory Tract Infections). The microbiological and clinical characteristics of the drug were tested in this study. Excellent results were obtained in 96% of the patients treated and the tolerability was also very good.

[Pentoxifylline in the blood rheological and coagulative changes in chronic respiratory failure]. / La pentossifillina nelle alterazioni emoreologiche e coagulative dell'insufficienza respiratoria cronica.

In this study, some hemorheological and coagulative parameters (blood viscosity, erythrocyte filtrability, CPA, platelet aggregation) have been evaluated in 40 patients with Chronic Respiratory Failure. The results obtained document in these patients, important hemorheologic changes. 11 patients with most serious rheologic changes have been treated with Pentossifillina. A significative improvement of the explored parameters and of the clinical condition has been checked after treatment.

[Serum tumor markers in lung neoplasms (correlation with histological types)]. / Utilizzazione di alcuni markers tumorali sierici nelle neoplasie del polmone (rapporto con i quadri istologici).

The AA. have tested serum levels of ferritin, alpha-1-antitripsyn, C4 and Phosphohexoseisomerase (PHI) in 50 patients affected by primary lung cancer, 40 patients affected by chronic lung diseases and a control group of 40 healthy males and females. All the test have a percentage of pathological case higher in the group of neoplasms than in the group of chronic diseases and ferritin seems to have the highest sensitivity. Obtained results have been correlated also to the morphoradiological and histological kind of neoplasm. "Peripheral" morphoradiological kind and III WHO histological kind are the group with more pathological cases. All the data have been statistically controlled.