Between August 1979 and August 1984, 46 untreated, inoperable patients with advanced squamous cell carcinoma of the head and neck were submitted to a combined modality of treatment based on four courses of polychemotherapy (vincristine, bleomycin, and methotrexate), rotated with three courses of radiotherapy, 20 Gy each. Forty-six patients entered the study: 45 were evaluable for their response to the treatment and 46 for toxicity effects. We observed 26 complete responses (57.7%) and 14 partial responses (31.1%); overall actuarial survival was 28% at 55 months. Mucositis occurred in 11 patients, 3 patients suffered from nausea and vomiting, 2 patients developed fever, and 1 had a platelet count of 50,000/mm3. One toxic death occurred: one patient developed an acute renal failure related to Methotrexate.

Adult↗

PubMedDate not supplied

The inhibitory effect of differently classified calcium antagonists on the calcium- and epinephrine-induced responses of isolated guinea-pig atria.

The effects of calcium antagonists diltiazem, flunarizine and N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide (W7) were investigated on the calcium- and epinephrine-induced responses of guinea-pig spontaneously beating atria. All these calcium antagonists showed negative chronotropic and inotropic effects. Diltiazem (3 x 10(-8) M to 1.8 x 10(-7) M) antagonized both the action of epinephrine and calcium in a different manner but at the same concentrations. Flunarizine (1 x 10(-6) M to 1 x 10(-5) M) also antagonized both the action of epinephrine and calcium; but flunarizine weakly inhibits the calcium response at concentrations which have considerable antiadrenergic action. Only at the highest concentrations did both calcium antagonists show a decrease of the epinephrine maximum effect. W7 (1 x 10(-5) M to 1 x 10(-4) M) showed a mainly non-competitive antagonism against epinephrine but was practically ineffective against calcium. The results obtained suggest that a pharmacological prerequisite exists for classifying a calcium antagonist as a calcium entry blocker in the atrial muscle. Such a drug does not produce selective inhibition to calcium- and epinephrine-induced responses. The ability or inability to inhibit the response to calcium represents the discriminant parameter for the action site of the calcium antagonist which are transmembranal fluxes or intracellular mechanisms respectively.

Animals↗

PubMedDate not supplied

Effect of cromakalim on spontaneous activity of castrated rat vas deferens.

After castration rat vasa deferentia exhibited spontaneous activity. Cromakalim which acts by opening K+ channels has been shown to suppress this spontaneous activity following castration. Glibenclamide, a potent blocker of the ATP-sensitive K+ channels, inhibited this contrasting effect of cromakalim. The concentrations of cromakalim and glibenclamide that were employed are consistent with those active in different kinds of smooth muscle. The presented data are compatible with the hypothesis that castration decreases potassium conductance and that such an effect could be responsible for spontaneous activity.

Animals↗

PubMedDate not supplied

Synthesis of pyrrolinylnaphthalenes and evaluation of their antinociceptive activity.

In this paper the regioselective preparation of (R/S)-1,2-dimethyl-3-[2-(6-substituted naphthyl)]-2H,5H-pyrrolines 2a-d is reported. These compounds were prepared by thermal dehydration of the corresponding alcohols (2R,3S/2S,3R)-1,2-dimethyl-3-[2-(6-substituted naphthyl)]-3-hydroxy-pyrrolidines (2R,3S/2S,3R)-1a-d with anhydrous FeCl3-SiO2, under vacuum. Pharmacological properties of (R/S)-2a-d are also described. Analgesic activity was investigated by the hot plate test, also in the presence of selective antagonists of mu, delta and kappa opioid receptors. Preliminary analysis of the side-effects was also accomplished using the rota-rod test. Interesting antinociceptive activity was shown by all compounds and in particular by (R/S)-2a (AD50 = 0.31 mg/kg); delta opioid receptors were found to be mainly involved in the pharmacological process and, in general, it was found that the compounds influenced locomotory activity to a much lesser extent than did morphine.

Analgesics↗

PubMedDate not supplied

First observations on enzymatic activity and protein content of vesicles separated from rat epididymal fluid.

Fluid of rat cauda epididymidis was obtained by flushing the duct with 0.25 mol l-1 sucrose in 0.01 mol l-1 Tris-HCl buffer pH 7.4. The fluid was centrifuged at 600 x g for 15 min and the sperm free supernatant was centrifuged at 47,000 x g for 1 h. The sediments observed with the electron microscope consisted of a heterogeneous population of membrane-bound vesicles similar to those seen in the intact organ. In the sediment containing the vesicles the activity of beta-galactosidase was mostly unavailable for the substrate showing a high degree of latency: the activity became soluble after a treatment with 0.5% saponin. The activity of N-acetyl-galactosaminadase instead, was mainly available for the substrate and soluble in buffer containing 0.6 mol l-1 KCl. It was then inferred that beta-galactosidase is located inside vesicles with no or little affinity for the membrane, while N-acetylglucosaminadase is bound to the external surface of vesicles. Supernatants and precipitates from suspensions of vesicles in buffered 0.5% saponin were analysed for proteins by gel electrophoresis. The electrophoretic patterns of the sediments were very different from those of supernatants and showed a number of bands greater than that of the latter. The vesicles are believed to arise from the epididymal epithelium, but their physiological role is unknown.

Animals↗

PubMedDate not supplied

Morphological and enzymatic study of membrane-bound vesicles from the lumen of the rat epididymis.

The epithelium of caput and cauda epididymidis of the rat was studied with transmission electron microscopy (TEM) and freeze-fracture techniques. In thin sections of both zones, the tissue consisted mainly of tall columnar cells (principal cells) with long sterocilia. Clusters of small membrane-bound vesicles were located in the lumen between or immediately over the stereocilia. Freeze-fracture replicas also displayed groups of smooth-surface vesicles in the same location. Membrane-bound vesicles isolated from the lumen of the rat epididymis were studied by TEM. In thin sections, some of them contained an electron dense material and others looked empty. In addition, the hydrolases: beta-galactosidase, N-acetyl-glycosaminidase, alpha-mannosidase, aryl-sulfatase and beta-glucuronidase were detectable in pellets of vesicles treated with Triton X-100. The results presented here indicate the presence of membrane-bound vesicles observed by two different methodologies in the rat epididymal fluid and demonstrate five glycosidases in their content.

Acetylglucosaminidase↗

PubMedDate not supplied

Does portal nutrition benefit liver protein synthesis?

There are only a few experimental investigations on the feasibility and potential advantages of intraportal nutrition in animals and only two uncontrolled studies in humans. The purpose of this study was to compare some metabolic variables in patients who received portal or systemic nutrition after elective surgery for colorectal cancer. Twenty patients were randomized to receive postoperatively for a week a hypocaloric, "protein sparing" standard infusion via the portal (catheter in the gastroepiploic vein) (10 patients) or systemic (10 patients) route. We evaluated the basal concentrations of some visceral and acute-phase proteins and their variations in the first postoperative week and the nitrogen balance. Statistical analysis was performed by the two-tailed Student t test. There was no difference in the daily changes of the visceral and acute-phase proteins after surgery in the two groups of patients, but in the portal group there was a significantly better recovery of the level of total protein, albumin, and cholinesterase at the end of the portal infusion vs the systemic group (p < or = .005, .03, and .02, respectively). In regard to the nitrogen balance, although there was no difference in the overall balance between portal and systemic nutrition, if we separate the acute phase of the injury from the later one we do not see any significant difference in the first period but we do see a highly significant advantage for the portal group during the last 2 days (p < or = .0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Epidemiology of acute hepatitis B in a university hospital in São Paulo, Brazil: retrospective study of two five-year periods.

CONTEXT: HBV infection is endemic in Brazil and acute HBV infection is still a common disease. OBJECTIVE: To analyze incidence, risk factors and evolution of acute HBV infection. SETTING: University Hospital. PATIENTS: 357 patients with acute HBV infection, comparing two periods: 1985-1989 vs. 1990-1994. RESULTS: The overall incidence declined from 50 new cases/year in 1985-89 (30% of all cases) to 25 new cases/year in 1990-94 (8% of all cases). Transmission among male homosexuals (3.9% of cases in 85-89) declined to 1.3% in 90-94 (p > 0.05). Amongst health care workers (HCW) it declined from 8.2% to 2.0% (p = 0.02). Conversely, heterosexual transmission increased from 4.8% to 10.1% (p = 0.06). Chronification of HBV infection following the acute episode was observed in 1.7%. Fulminant hepatic failure was seen in 3.4%. However, 27.2% of patients were lost to follow-up before normalization of the biochemical tests. CONCLUSIONS: The different patterns of risk factors observed is probably related to measures for preventing AIDS and to HCW vaccination programs. Chronification following acute episodes was not a common event.

Acute Disease↗

PubMedDate not supplied

Ten years of anti-smoking programs in Italy: a review.

A diverse anti-smoking program for the prevention of cancer and cardiovascular diseases has been ongoing in Italy since 1981, coordinated by the National Cancer Institute of Genoa and the Italian League Against Cancer of Genoa. The program includes several initiatives addressed to different target groups; schoolchildren and teachers, military personnel, doctors and nurses, and women. A preliminary inquiry on the attitudes and habits towards smoking was implemented by the distribution of questionnaires to the various groups involved in the program. An annual school-based anti-smoking program involves about 10,000 students aged four to 18 and their teachers. Meetings are delivered by experts to groups of 20 to 40 students with the aid of specific audiovisual material, which are periodically updated. Additional informative material, leaflets, and posters are distributed to both schoolchildren and teachers. Another educational program on primary prevention of smoking-related health hazards is addressed to military recruits, career soldiers, and medical officers. It consists of several initiatives: training of military doctors and nurses, lectures to military recruits, and distribution of informative material in the barracks. An annual meeting is organized to discuss program implementation and results. Surveys are carried out by distributing an anonymous questionnaire to health professionals in several Italian hospitals to assess the smoking habits of doctors and their attitudes and practices towards counseling patients against smoking. The results show marked differences in smoking habits in the cities under study. Annually since 1983, an updated course is organized and addressed to teachers of primary and secondary schools in Genoa. The aim of the course is to train school personnel and to help them to implement prevention programs in the schools, with the aid of experts in the field of prevention. A series of initiatives are addressed to women at different ages to sensitize them not only to the more common tobacco risks but also those regarding pregnancy, oral contraception, and so on. The survey was conducted on a representative sample of 12- to 65-year-old female population groups. It is the first of this kind in Italy to ascertain trends in smoking behavior among Italian women in relation to age, educational achievement, and occupation.

Adolescent↗

PubMedDate not supplied

[The quantification of tuberculous disease in an Italian area and the estimation of underreporting by means of record linkage].

The description and interpretation of tuberculosis spatial and temporal variations in Italy is rather difficult because of well-grounded suspicions of disease underestimation, related with the bad working of the compulsory notification system. In this study, the record-linkage technique was used to estimate the proportion of TB undernotification in an Italian area, in order to give a first quantitative estimate of tuberculosis at a geographical level. The area considered was the Local Health Agency of Florence (population in 1994: 803,588) in 1995. Information for record-linkage was taken from: the Regional TB Archive, Hospital Discharge files, Laboratories, Pathology Departments, the Regional AIDS Registry, the Regional Mortality Registry. The linkage among the different sources was based on first and last name, date and place of birth, or only on first and last name for the laboratories. Prevalent cases and relapses were excluded through comparison with various historical archives. Most cases signalled only in hospital discharges were re-evaluated through original medical records. In such a way, the original sample was reduced from 690 to 182 cases incident in 1995, diagnosed in the area considered, and mostly resident in the same area. Among these cases, 98 (53.8%) were unknown to the compulsory notification system. The most of them come from hospital departments (27 cases) and from laboratories (47 cases). Fourty-nine of the unknown cases concerned pulmonary TB. The notification rate in the area moves then from 10.5/1000 to 22.7/1000.

Disease Notification↗

PubMedDate not supplied

[Exercise test: abnormal ST segments restricted to recovery phase].

PURPOSE: To determine the incidence of atherosclerotic coronary artery disease (CAD) and or myocardial ischemia in patients (pt) with abnormal ST segments restrict to recovery phase (RRAST) of exercise testing (ET). MATERIAL AND METHOD: Retrospective study in 19 non consecutive pt with RRAST, related to coronary arteriography or exercise planar scyntillography (18 men, 58 +/- 9 years, 18 asymptomatic). RESULTS: RRAST corresponded to ST segment depression from 1 to 4 mm, with T inversion during early recovery (2 pt); late (14 pt) or both (4 pt). It was documented CAD (14 pt and 9) with artery-by-pass surgery); hypertensive myocardiopathy with normal coronary (3 pt), and mitral prolapse valve (1 pt). In 13 pt with coronary arteriography or exercise scyntillography, within the first 6 months from exercise testing, myocardial ischemia was confirmed in 8 pt in 3 pt, successive exercise testing showed RRAST reproductive in 2 cases. CONCLUSION: The authors report the high incidence of CAD and or transitory hypoperfusion during myocardial scyntillography in symptomatic men with middle age with RRAST during exercise testing.

Adult↗

PubMedDate not supplied

Perforated jejunal diverticulitis: personal experience and diagnostic with therapeutical considerations.

A case of perforated jejunal diverticulitis in a 87-year-old man is described and the literature is reviewed. Jejunal diverticulosis (JD) is estimated to occur in 0.02% to 1.3% of the adult population and is found most often in the elderly. The acute diverticulitis with perforation has been reported as high as 2.3% among patients with JD and is associated with high mortality. Clinical presentation mimic other more common acute intraperitoneal inflammatory conditions. Enteroclysis and abdominal CT are the most specific diagnostic tests. The common treatment is surgical resection of the involved segment. Laparoscopic resection and medical and medical/radiological approaches have also been proposed. Diagnostic and therapeutical aspects of this pathology are discussed.

Acute Disease↗