This article reports an isotope dilution mass spectrometric method for the simultaneous measurement of testosterone (T), dihydrotestosterone (DHT), and 5 alpha-androstan-3 alpha, 17 beta-diol (3 alpha-diol) in human plasma and prostatic tissue. After addition of tri-deuterated steroids as internal standards to prostatic tissue homogenates or plasma samples, extraction was performed with diethylether. The extracts were purified by two chromatographic steps (Sep-Pak C 18 cartridge and Sephadex LH-20) and injected into a gas chromatograph coupled with a mass spectrometer after derivatization with heptafluorobutyric acid. This method was highly specific and showed good precision, accuracy, reproducibility and sensitivity. T, DHT, and 3 alpha-diol were measured in human plasma and in prostatic tissue of seven patients with benign prostatic hyperplasia (BPH) treated for 3 months with a long acting GnRH analog before surgery. Plasma levels of T, DHT, and 3 alpha-diol were reduced by GnRH analog treatment to castrate levels. The tissue concentrations of the same steroids, compared with those obtained from 19 untreated patients, showed a mean reduction of about 90% for DHT and 3 alpha-diol, and about 75% for T. These results suggest that about 90% of prostatic DHT and 3 alpha-diol depend on testicular activity because they are dramatically reduced after pharmacologic castration.

Androstane-3,17-diol↗

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Vasopressin receptors in human seminal vesicles: identification, pharmacologic characterization, and comparison with the vasopressin receptors present in the human kidney.

Because of the presence of a high density of vasopressin receptors in the epithelial cells of porcine seminal vesicles similar to the V2 vasopressin receptors of renal tubules, human seminal vesicles and kidney were investigated using quantitative binding and adenylate cyclase studies. Tissues were obtained at surgery from 17 patients with urologic diseases. A homogeneous class of vasopressin binding sites have been found in both seminal vesicles and renal medulla. However, the vasopressin receptors present in these tissues are different in terms of ligand specificity and adenylate cyclase activation. In seminal vesicles, the V1 vasopressin antagonist d(CH2)5 TyrMeAVP is 36-fold, more potent than the V2 agonist dVDAVP in displacing [3H]AVP binding, while in the medullopapillary portion of kidney dVDAVP is 24-fold, more selective than d(CH2)5 TyrMeAVP for the arginine vasopressin binding site. Furthermore, arginine vasopressin induces a dose-dependent increase in adenylate cyclase activity in renal membranes, while it was ineffective in seminal vesicle membranes. These results indicate that a very high affinity (0.2 nM), low capacity (14 fmoles/mg protein) class of vasopressin receptors is present in human seminal vesicles, having pharmacologic characteristics similar to the V1 subtype of vasopressin receptors. The presence of a high affinity (1.6 nM), high capacity (350 fmoles/mg protein) V2 subtype of vasopressin receptors in human renal membranes is also confirmed. The density of the vasopressin receptors present in human seminal vesicles is inversely correlated with patient age, consistent with a physiologic role for vasopressin in the regulation of accessory sex gland activity.

Adenylyl Cyclases↗

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Escin in pharmaceutical oral dosage forms: quantitative densitometric HPTLC determination.

A practical and reliable method for the quantitative determination of escin in pharmaceuticals was developed. The TLC-densitometric determination was performed without using spray or dipping reagents in order to provide a more rapid and simple analytical procedure. Chromatographic separations were obtained on analytical HPTLC silica gel plates and the elution was made with 3.5:4.5:2 PropOH-ethyl acetate-water (v/v/v). Densitometric analysis was performed directly at 212 nm, corresponding to lambda max of escin obtained by in situ-scanning. A second degree polynomial regression relationship was found between the peak areas and the amounts of the escin standard deposited in the range 1.15-6.90 micrograms. The method is specific, accurate and reliable and was applied successfully to the quantitative determination of escin in commercial samples.

Administration, Oral↗

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An optic micro-switch for an eyelid response to foster environmental control in children with minimal motor behaviour.

This study assessed whether two children (11.9- and 9.7-years-old) with profound multiple disabilities and minimal motor behaviour could learn to control environmental stimulation using an eyelid response with a newly developed micro-switch. The response consisted of raising the eyelid markedly (i.e. by looking upward or opening the eyes widely). The micro-switch developed for this target response consisted of an electronically regulated optic sensor mounted on an eyeglasses' frame. Data showed that the children learned the target eyelid response to activate the micro-switch and to increase their level of environmental stimulation. Responding was largely maintained at a 2-month post-intervention check. These results indicate that continued work in this area has positive implications for the rehabilitation of children with most serious disabilities.

Child↗

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Can loss and grief activate latent neoplasia? A clinical case of possible interaction between genetic risk and stress in breast cancer.

BACKGROUND: Nineteenth-century physicians working with cancer patients frequently reported that severe emotional losses and grief occurred in some cases before cancer. Research on psychoneuroimmunology seems to reactivate this interest and could give a possible convincing background. METHOD: We recently observed the case of a 45-year-old woman who developed symptoms of breast cancer (ductal infiltrating carcinoma, T1, N1, M0) 3 years after the loss of her only child. The affection for the child compensated inadequacies of her marriage, which became increasingly unstable. The child died in a dramatic accident at home, while his mother was near him but unable to help. RESULTS: The patient had a moderate genetic-familial risk of mammary cancer. Animal studies strongly suggest that stress, through neuroimmunomodulatory mediatory mechanisms, can significantly affect appearance and progression of mammary cancer. The patient developed long-lasting intense grief, despair and hopelessness. DISCUSSION: We discuss the case from three main standpoints: genetic and risk factors for breast cancer; findings which demonstrated a relationship between stress, neuroimmunomodulation and cancer in animals; data from autopsy studies which found foci of latent breast cancer in 20% of healthy women in the same age range. Stress does not create cancer. However we hypothesize that in this case it could have contributed by the activation of a latent neoplasia and/or by impairing immunosurveillance during a critical life phase.

Adult↗

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[Clinical and capillaroscopic evaluation of chronic uncomplicated venous insufficiency with procyanidins extracted from vitis vinifera].

BACKGROUND: The pharmacological treatment of non-complicated chronic venous insufficiency is a current and well-debated topic. The introduction of new products with action on the venous system, improved knowledge on the physiopathology of venous insufficiency and the possibility provided by new analytical instruments, have given new impulse to the consolidation of the clinical value of phlebotonics in this indication. METHODS: In light of this, 24 patients with non-complicated chronic venous insufficiency were treated with oral administration of Oligomeric Proanthocyanidins (Pycnogenols-OPC) 100 mg/day. To evaluate the therapeutic efficacy of the treatment, an instrumental evaluation by optical probe capillaroscope was employed in addition to the traditional subjective clinical parameters: swelling, itching, heaviness and pain. The videocapillaroscope examination was performed at the lower third of the leg and the first toe. Edema in the capillaroscopic field, the number of observable capillaries and the capillary dilatation were the parameter chosen to evaluate the efficacy of treatment. All patients completed the study with no reports of adverse events during the period of observation. RESULTS: The results obtained show a positive clinical response (improved or absent symptoms) in over 80% of patients, with significant improvement of symptoms already evident after the first 10 days of treatment. The mechanism of action of the OPCs explains the rapid reduction of the swelling of the lower limbs and correlated with this are the other evaluable symptoms: heaviness and itching. Particularly striking results were observed for itching and pain which completely disappeared during the course of therapy in 80% and 53% of the patients respectively. Noteworthy is the good correlation between the clinical and instrumental data, with improvement in a total of 70% of patients. CONCLUSIONS: The results obtained in the course of this clinical experience, with evident improvement already during the first weeks of treatment, the absence of adverse events added to the benefit of a once-a-day administration, justify the use of OPC in the treatment of non-complicated chronic venous insufficiency.

Adult↗

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Primary bone tumors and pseudotumors of the lumbosacral spine.

Primary tumors of the spine are relatively infrequent lesions compared with metastatic disease, multiple myeloma, and lymphoma which are the more frequent neoplasms of the spine and usually manifest with multifocal lesions and thus pose little diagnostic dilemma. However, in the presence of a solitary spinal lesion, the more uncommon primary tumors of the spine represent an important group of entities for diagnostic consideration. The most common benign and malignant primary tumors of the spine are enostosis, osteoid osteoma, osteoblastoma, giant cell tumor, aneurysmal bone cyst, osteochondroma, chordoma, chondrosarcoma, Ewing sarcoma, primitive neuroectodermal tumor, and osteosarcoma. The imaging features of these lesions are often characteristic. Radiologists should be aware of the appearance of these unusual tumors in order to provide a complete differential diagnosis.

Diagnosis, Differential↗

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Capsuloplasty for the treatment of recurrent anterior dislocation of the shoulder: long-term evaluations of the Putti-Platt method and Bankart method with anchors.

The authors compare two methods used for the treatment of recurrent anterior shoulder dislocations: Putti-Platt capsulomyoplasty, based on an overlapping suture of the free margins of the joint capsule and of the subscapularis muscle, and the Bankart method that uses anchors, based on the repair of the glenoid labrum, that is kept in site, together with the medial flap of the joint capsule, by suturing with the anchors previously stabilized to the neck of the glena. In this method, the subscapularis muscle is re-approximated without any overlapping or shortening. The Bankart method with anchors thus allows us to obtain anatomical repair of the lesion, with doubtless advantages for mobility, function and stability of the shoulder; this is confirmed by the comparison with results obtained out of 34 patients in this study, 15 of which submitted to the Putti-Platt method, 19 to the Bankart method with anchors. The latter had reduction of external rotation which in none of the cases exceeded 25% (a reduction that at times achieved 50% in patients submitted to the Putti-Platt method (p = 0.001); difficulties in work or sports were minimum or absent (p = 0.003), recovery time was more rapid, without compromising joint stability (p = 0.069); these data allow us to consider the Bankart method with anchors the surgical method that is most indicated for the treatment of anterior glenohumeral instability.

Adolescent↗

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[Use of adhesives in emergency surgery].

In a prospective study, the Authors present an analysis on the use of surgical adhesives in the wounds treatment. In sixteen months we have treated 157 patients exclusively with a surgical tissue adhesive 2-octylcianoacrylate to repair traumatic wounds and surgical ones. In the Emergency Department were treated 110 patients (70%) with 2-octylcianoacrylate for skin incisions, lacerations and the length of lesion. We have paid attention to prepare regular wound edges, irrigation and debridement when appropriate to reduce skin tension at the site of laceration. Forty-seven patients (30%) whit surgical skin incisions for thyroidectomy, appendicectomy, hernio-plastic and safenectomy were treated with 2-octyl-cianoacrylate. In both groups of patients, the surgical adhesive has made possible a simple and quick wounds repair as well as good aesthetic results. No relevant complications have been arisen. The writers recommend the surgical adhesive in Emergency Department to abridge waiting time and to avoid the psychological impact caused by local anaesthesia, suture and medications especially in the treatment of all wounds types in children.

Adolescent↗

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The Pediatric Bowel Management Clinic in children with severe chronic constipation. Personal experience.

The multifactorial nature of functional constipation in children suggests that a multidisciplinary management approach may be effective and leads to both patients and parents' satisfaction and significant short term improvement. The authors describe their experience with the study and treatment of children with severe chronic constipation in a newly-created Pediatric Bowel Management Clinic (BMC). Further studies will examine the long-term impact of the clinic.

Adolescent↗

PubMedDate not supplied

Management of severe blunt pancreatic trauma in children. Personal experience.

Blunt abdominal trauma is the most common cause of pancreatic injuries in children. Non-operative management of traumatic injuries in the absence of complete duct transection is safe in children and does not appear to be associated with adverse sequelae. The purpose of this report is to describe the diagnostic techniques, clinical management and survival of 9 children with traumatic injuries of the pancreas treated in our institution over a period of 7 year.

Adolescent↗