[Adrenocortical carcinoma and its treatment with mitotane. Description of a case]. / Il carcinoma corticosurrenalico e il suo trattamento con mitotane. Descrizione di un caso.

Adrenocortical carcinoma is a rare tumor with a poor prognosis. The clinical features and rational bases of pharmacologic therapy of adrenocortical carcinoma are discussed in the light of the case of a patient with a bulky, inoperable tumor whose treatment with mitotane was followed by a dramatic regression though several, important side effects.

[Treatment of amyloidosis with dimethyl sulfoxide (DMSO)]. / Trattamento dell'amiloidosi con dimetilsulfossido (DMSO).

In this study we have investigated the role of oral dimethylsulfoxide (DMSO) therapy in 2 patients with primary amyloidosis (AL) and in 2 patients with secondary amyloidosis (AA) to long-standing rheumatoid arthritis. DMSO treatment produced no beneficial effects in the patients with idiopathic amyloidosis. Instead the patients with secondary amyloidosis experienced a subjective improvement, a decrease of inflammatory activity of the rheumatoid arthritis and an unequivocal improvement of renal function following 3-6 months of DMSO therapy. No serious side effects of DMSO were observed except for unpleasant breath odour. We conclude that a treatment with oral DMSO may prolong life of patients with secondary amyloidosis.

[Beta-blocking agents alone or combined with diuretics or alpha-adrenolytics in the treatment of essential arterial hypertension]. / I beta-bloccanti, da soli o associati con diuretici o alfalitici, nel trattamento dell'ipertensione arteriosa essenziale.

The Authors examine the antihypertensive effectiveness of the beta-adrenergic receptor blocking agents, according to their personal experience and a review of the bibliography. It is not cleared yet how these drugs reach their hypotensive effect. It is reasonable to assume however that several factors are involved: cardiac output, intravascular volume changes, plasma renin activity and peripheral resistance. Thirty patients suffering from essential hypertension not complicated by cardiac or renale failure were treated. Patients were allocated at random into one of three subsets of ten. In group A oxprenolol was given for 8 weeks and the dose was gradually increased up to 300 mgs daily. Oxprenolol was administered in combination with clortalidone in group B and with phentolamine in group C. A clinically satisfactory reduction in blood pressure was attained in no subset, despite the significant decrease of mean blood pressure. The blockade of beta-adrenergic receptors alone has proved to be less effective than the combined administration of oxprenolol and clortalidone or of oxprenolol and phentolamine. No differences were observed between the two combinations.

[Role of alpha 1-antitrypsin and alpha-2 macroglobulin in hepatopathies]. / Ruolo dell'alpa 1-antitripsina e dell'alfa 2-macroglobulina nelle epatopatie.

Two pictures of alpha 1-antitrypsin deficiency, one associated with alpha 2-macroglobulin deficiency and one isolated case of the latter deficiency have been observed in three patients suffering from cirrhosis of the liver and/or hepatoma. On the basis of these cases, the literature on the subject is reviewed. The unusually high incidence of such anti-enzymatic deficiencies (three cases in the first eleven patients studied) in severe liver pathology, calls for a reassessment of such research and suggests that these tests should be carried out on a routine basis in cases of cryptogenetic cirrhosis and probably for long-term prognosis in cases of viral hepatitis.

[Erythrocyte changes during alcoholism and chronic liver diseases]. / Alterazioni eritrocitarie in corso di etilismo e di epatopatie croniche.

50 patients with chronic liver disease and/or alcoholism were studied. 28 cases of anemia were found and macrocytes (and target m.), spurr-cells, spherocytes and stomatocytes observed. For each of these abnormalities the authors report the observed incidence and discuss the literature's data about the pathogenesis. A personal research on the influence of the liver's impaired capability of protein synthesis was also carried out. The usefulness of a careful examination of the blood film is finally stressed, in patients with liver disease and to discover alcoholic subjects still "healthy".

[Gamma glutamly transpeptidase in chronic anicteric hepatopathies]. / La gamma-glutamil-transpeptidasi nelle epatopatie cronich anitteriche

Serum levels of gammaGT were determined in 51 patients suffering from bioptically verified chronic anictereric liber disease. GammaGT proved to be much more sensitive than the other enzymes studied and presented a significant increase particularly in cases of steatosis and chronic "alcoholic" liver disease with a markedly steatosic character.