Effect of clarithromycin on esophageal motility.

As clarithromycin (CLA), an antibiotic commonly used for Helicobacter pylori eradication, stimulates gastroduodenal motility, we investigated whether it also stimulates esophageal motility. In 15 normal subjects, esophageal motility was recorded using a low-compliance manometric system with two ports in the esophageal body, one port in the lower esophageal sphincter (LES), and five ports in the antroduodenal tract to monitor the occurrence of phases I-III of the migrating motor complex. Thirty minutes after the occurrence of a duodenal phase III, we infused intravenously, randomly, and in a double-blind manner, CLA 100 mg in five subjects (group A), CLA 250 mg in five subjects (group B), and normal saline in the remaining five subjects (group C). LES tone and post-deglutitive residual pressure, as well as the amplitude and duration of the esophageal contractions, were measured each minute and averaged over a post-infusion period of 30 min. Both group A and B showed a LES tone significantly higher than that of group C after CLA infusion, whereas the post-deglutitive residual pressure was not significantly different from that of group C. The LES tone of group B was significantly higher than that of group A. Group B, but not group A, showed a wave amplitude and duration significantly higher than that of group C. In conclusion, CLA is able to stimulate LES tone and esophageal contractions with a dose-related effect.

[Aneurysms of the abdominal aorta]. / Gli aneurismi dell'aorta addominale.

The authors report 73 cases of abdominal aortic aneurysms with particular emphasis to early and long-term results as well as postoperative complications: 4 patients died at admission, 16 were treated with medical therapy, and 53 underwent surgery. Surgical patients were stratified in two groups: 18 emergency cases (group 1) and 35 elective cases (group 2). Early results showed the highest mortality in group 1 cases presenting with shock. Late results, at the end of the follow up, (6 months-8 years), showed a 56.6% 5-year survival rate, with overlapping survival rates after the immediate postoperative period. The most frequent postoperative complications were thrombosis of prosthesis and lymphorrhea. Survival rates of emergency cases were influenced by early diagnosis and prompt aorta clamping. Before surgery an haemodynamic evaluation of all vascular districts seems necessary in elective cases to prevent complications of atherosclerotic disease.

[What is the best treatment in massive pulmonary embolism: anticoagulants, thrombolytics or surgical embolectomy?]. / Quale trattamento per l'embolia polmonare massiva: gli anticoagulanti, i trombolitici o l'embolectomia chirurgica?

The aim of this work was to identify the best treatment available for massive pulmonary thromboembolism which still remains a frequent and sometimes lethal complication for surgical and non-surgical patients. The Authors underline the difficulties of diagnosis and the need for therapy at the earliest possible stage. At present, clinical management involves the use of: anticoagulants, thrombolytic agents and surgical embolectomy. In conclusion, the authors state that pulmonary thromboembolism, even when massive, has been transformed into a medically interesting pathology which can be cured using heparin and thrombolytic agents. However, surgical treatment is mandatory when patients reveal adverse effects to drug therapy, when medical therapy is insuccessful, or when patients are seriously ill with recurrent cardiac arrest.

Glutathione redox cycle enzyme activities in erythrocytes of multiple sclerosis patients.

The erythrocytes of multiple sclerosis patients with elevated superoxide dismutase levels were tested for the activities of glutathione redox cycle enzymes. No differences were observed between multiple sclerosis and normal control erythrocytes when the activities were referred to either hemoglobin concentration or lactate dehydrogenase content. Our results indicate that no adaptative changes occur in the activities of glutathione redox cycle enzymes in erythrocytes of multiple sclerosis subjects as a consequence of an elevated superoxide dismutase level.

Glutathione peroxidase, glutathione S-transferase and glutathione reductase activities in normal and neoplastic human breast tissue.

Glutathione peroxidase (GSH-Px), glutathione S-transferase (GSH-Tr) and glutathione reductase (GSSG-Rx) activities have been determined in normal and neoplastic human breast tissues. Large interindividual variations in the activities of all enzymes tested were found in both tumor and non-tumor specimens. In general a significant increase in the activities of the 3 enzymes was found in tumors, whereas in fibroadenoma they were as high as in healthy tissues. When a comparison was made between normal and neoplastic tissues of the same individual, GSH-Tr and GSSG-Rx activities were found to be higher in 15 and 11 cases, respectively, out of 17. GSG-Px activity was higher in all cases. From measurement of GSG-Px activity with both H202 and cumene hydroperoxide, it was deduced that human breast contains only the selenium-dependent form.

Superoxide dismutase, reduced glutathione and TBA-reactive products in erythrocytes of patients with multiple sclerosis.

Superoxide dismutase, reduced glutathione and lipid peroxides levels were determined in the erythrocytes of multiple sclerosis patients. Superoxide dismutase activity and the malonyldialdehyde production rate were found to be significantly enhanced. The isoelectric focusing pattern of superoxide dismutase from multiple sclerosis and normal subjects erythrocytes was substantially overlapping. Our results indicate the occurrence of a higher susceptibility of multiple sclerosis erythrocytes to lipid peroxidation.