Pidotimod in the treatment of patients affected by bacterial exacerbations of chronic bronchitis.

A multicentre double-blind placebo-controlled study was conducted in order to assess the effects of pidotimod ((R)-3-[(S)-(5-oxo-2-pyrrolidinyl) carbonyl]-thiazolidine-4-carboxylic acid, PGT/1A, CAS 121808-62-6), a new synthetic biological response modifier, on the clinical picture of bacterial exacerbations of chronic bronchitis. Seven centres of respiratory diseases participated in the trial. A total of 137 patients, 103 males and 34 females (mean age: 65.0 years) were admitted to the study. The trial was subdivided into 3 phases. During the first 8-day phase (D0-D8), 68 patients received 800 mg pidotimod orally (one sachet) twice daily and an antibiotic treatment (amoxycillin plus clavulanic acid: 1 g twice daily), while 69 patients received placebo (one sachet) and antibiotic according to the same dosage schedule. In the second 7-day phase (D8-D15), while the double-blind therapy proceeded, the antibiotic treatment was stopped. The third phase (D15-D45) consisted of a 30-day follow-up period. Five clinical observations, at D0, D4, D8, D15 and D45, were scheduled. The Skin test, to evaluate immunocompetence, was carried out at D0, D15 and D45. The faster improvement of symptomatology (dyspnoea, cough, sputum, hyperpyrexia) in the patients in the pidotimod group compared with the placebo group was reflected in recovery time: mean 8.9 days in the pidotimod group versus 10.7 days in the placebo group (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Chest wall involvement by lung cancer: computed tomographic detection and results of operation.

The aim of this prospective study was to evaluate: (1) the role of computed tomographic scanning in predicting chest wall invasion by peripheral lung cancer and (2) the results of operation according to the depth of chest wall involvement and other potential indicators of long-term survival. One hundred twelve patients with non-small cell lung cancer adjacent to the pleural surface who underwent computed tomographic scanning and subsequent thoracotomy were entered into this study. Tumor invasion was confined to the visceral pleura in 53 patients, to the parietal pleura in 18 patients, and to intercostal muscles in 25 patients; invasion extended beyond this layer in 16 patients. The computed tomographic criteria for chest wall invasion were (1) obliteration of the extrapleural fat plane, (2) the length of the tumor-pleura contact, (3) the ratio between the tumor-pleura contact and the tumor diameter, (4) the angle of the tumor with the pleura, (5) a mass involving the chest wall, and (6) rib destruction. The computed tomographic criteria 1 and 3 were significantly related to pathologic findings. Sensitivity was 85% for criterion 1 and 83% for criterion 3, specificity being 87% and 80%, respectively. Long-term survival of patients with T3 disease critically depended on the lymph node state and completeness of resection. The adenocarcinoma cell type and the T4 category were unfavorable prognostic factors. The depth of chest wall invasion did not affect survival, except for extensive rib and soft tissue infiltration. En bloc resection yielded better results than discontinuous resection.

[Percutaneous needle aspiration biopsy in the diagnosis of pulmonary neoplasms]. / L'agobiopsia percutanea aspirativa nella diagnosi delle neoplasie polmonari.

The diagnostic efficacy of percutaneous needle biopsy (PNB) was assessed in 220 lung tumour patients. The results obtained prove this diagnostic technique to be extremely sensitive even though personal experience suggests that slight complications (pneumothorax, homophthoe) may occur.

[Transthoracic needle aspiration in infectious pathology]. / L'agoaspirazione transtoracica nella patologia infettiva.

A study was conducted on 20 patients with isolated or multiple patches of doubtful significance in the framework of neoplastic or infectious pathologies or in the presence of probably infectious diffuse or localised pulmonary infiltrations in immunodepressed patients or those in whom broad spectrum antibiotic treatment had failed. Percutaneous needle aspiration and sterile brushing was performed for the purpose of bacteriological examination in all patients. The result showed the clear superiority of needle aspiration (75% positive) over sterile brushing (25%). The first method is therefore recommended for use in the diagnosis of so-called "difficult" lung pathologies.

[Antibacterial and antifungal activity of isoflurane and common anesthetic gases]. / Attività antibatterica ed antifungina dell'isofluorano e dei comuni vapori anestetici.

An in vitro analysis was conducted to investigate the hypothetical antibacterial and antimycotic activity of the common anesthetic gases (halothane, enflurane, isoflurane, methoxyflurane) in view of the clinical absence of bronchopulmonary pathology after inhalation narcosis despite the many risk factors involved. For this purpose scalar dilutions of the four gases were prepared on cultures of Klebsiella pneumoniae and Candida albicans and the antibacterial action of the gases was tested in vitro. Even with the weaker concentrations used, halothane and methoxyflurane totally inhibited both microorganisms. Enflurane had less effect on Klebsiella p. and almost none on Candida. Isoflurane, a new halogen ether anesthetic was found to have an excellent inhibitory effect. In conclusion it is hypothesised that the anesthetic gases considered might have an in vivo antibacterial activity considering the experimental results obtained in vitro.

[Isolated endobronchial metastases]. / Metastasi endobronchiali isolate.

Endobronchial metastases account for about 5% of autoptic findings in patients with multiple secondary locations. Five cases are reported of patients with malignant neoplasms in various organs with metastases to the trachea and the large bronchi without involvement of the pulmonary parenchyma and therefore with negative radiographic and CT scan findings.

SAR studies in the field of calcium(II) antagonists. Effect of modifications at the tetrasubstituted carbon of verapamil-like compounds.

A number of fluorenyl and diphenylmethane analogues of verapamil, chosen as having the same substituents arranged in different ways around the quaternary carbon, were synthesized in order to evaluate the importance of the stereoisomerism at that point of the molecule. The compounds were tested with the Langendorff technique and coronary perfusion pressure (CPP), left ventricular pressure (LVP), and heart rate (HR) were recorded. While most of the compounds were almost inactive on these parameters, three of them did show interesting cardiovascular action. In particular they produced a more pronounced decrease in CPP than verapamil, with a less marked negative inotropic effect. Structure-activity relationships and the mechanism of action of the compounds are discussed.

Search for new Ca++ antagonists. Lipophilic oximes and phosphonates.

On the basis of the reported slow channel-inhibiting activity of oximes and phosphonates a series of compounds bearing such functions on lipophilic carriers were synthesized and studied. Among the compounds studied only (VI b) shows a slight cardiovascular activity. The surprising lack of activity of diethyl 3,4-dimethoxybenzyl-phosphonate (XIV), which is closely related to Fostedil, is discussed.

Analisis de 43 hepatectomias. / Analysis of 43 hepatectomies

Se analizan 43 resecciones hepaticas en relacion a su patologia y oportunidad operatoria, concluyendose que las hepatectomias por trauma deben diferirse hasta que el enfermo este estabilizado y que las hepactectomias en pacientes septicos se deben evitar en vista de la alta morbimortalidad que las acompana

Analisis de 43 hepatectomias. / Analysis of 43 hepatectomies

Se analizan 43 resecciones hepaticas en relacion a su patologia y oportunidad operatoria, concluyendose que las hepatectomias por trauma deben diferirse hasta que el enfermo este estabilizado y que las hepactectomias en pacientes septicos se deben evitar en vista de la alta morbimortalidad que las acompana

Amrinone relaxing effect on the isolated guinea pig trachea and its interaction with aminophylline.

The relaxing effect of Amrinone, an inotropic and vasodilating agent, was investigated on the isolated guinea pig tracheal smooth muscle in comparison and in association with Aminophylline. Amrinone (pD2 = 5.02 +/- 0.07) resulted more active than Aminophylline (pD2 = 4.25 +/- 0.08) in relaxing the isolated guinea pig trachea. The interaction curves of the two drugs showed the pattern typical for "competitive synergism", thus suggesting that Amrinone may act on tracheal muscle through inhibition of phosphodiesterase.

A report on the positive inotropic action of amrinone.

The inotropic action of amrinone was evaluated on isolated guinea-pig atria and on specimens of human atrial myocardium. The drug elicited a positive inotropic response in both the tissues. On spontaneously beating guinea-pig atria the influence on contractility was higher than on the rate. The magnitude of the response was influenced by temperature. Propranolol or phentolamine did not affect the positive inotropic action of amrinone. The efficacy of amrinone was higher than ouabain, in normal as well as in low extracellular calcium. Amrinone showed a positive inotropic action also at high extracellular potassium. The positive staircase was not reversed by amrinone, which had a higher positive inotropic effect at higher frequency of driving; the drug did not significantly delay the decline of contractile force in zero calcium. It is possible that the inotropic effect of amrinone in mainly due to an effect on influx of calcium into the cells.

Metastasis esplenica de un carcinoma de colon. / Splenic metastasis of a colon carcinoma

Se presenta un caso de metastasis esplenica de un adenocarcinoma de colon. Se hace una revision del tema, en especial su frecuencia y la topografia del tumor primitivo

Effect of vincamine on some enzymatic activities from various areas of the beagle dog cerebral cortex.

The effect of a chronic (3 months) treatment with vincamine on the enzymatic activities related to energy transduction was studied on several areas of the cerebral cortex of dog brain. About enzymatic activities of the four different cortical areas, in controls, no difference was observed between the enzymatic activities evaluated in the crude mitochondrial fraction, with regard to both the tricarboxylic acid cycle (citrate synthase, malate dehydrogenase) and the electron transport chain (total NADH-cytochrome c reductase, cytochrome oxidase). On the contrary, in the homogenate, lactate dehydrogenase, malate dehydrogenase and acetylcholine esterase showed different maximal activities. In the crude mitochondrial fraction the intravenous treatment with the three different doses of vincamine failed to cause any significant change as compared to controls. On the contrary, with regard to the enzymatic activities evaluated in the homogenate in toto, the analysis of variance revealed an effect on cytochrome oxidase at the dose of 3 mg/kg intravenously.

Resistance of airways in animals following tracheal plastic surgery.

A simple method for the evaluation of the tracheal lumens in rabbits following tracheal plastic surgery is described. The results are compared with those obtained by blood gas analysis and ray cinematography.

Biomicroscopic observations on the regulation of the mesenteric arteriolo-venular anastomoses.

The behaviour of the arteriolo-venular anastomoses was investigated. Observations were completed by the electrical stimulation of the superior mesenteric artery. During stimulation a constriction was induced in the arterioles while the gauge of the anastomoses was almost unchanged. An interpretation of this observation is given.