[Carcinoma of the middle tract of the extrahepatic bile duct: our experience with 7 cases].
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Biomedical subjects
Publications and source records attributed to P Marini.
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Lisuride was investigated for therapeutic effects in 19 patients with advanced Parkinson disease, no longer satisfactorily responding to routine L-Dopa therapy. The patients were treated with oral Lisuride (0.6-2.5 mg/die) and L-Dopa. The follow-up was at least 6 months. We noted a significant improvement on the Webster Rating Scale at 1st, 3rd and 6th months. Disability and on-off phenomen were reduced. Side effects were few. Lisuride is a valuable tool in this type of patient.
In 1984 and 1985, a non-random survey was conducted among healthy Africans living on the campus of the University of Niamey, Niger. Of 238 asymptomatic subjects, 17.6% carried hepatitis B surface antigen (HBsAg) in their serum, while 50.8% demonstrated protective anti-HBs antibodies. Antibodies to delta virus were detected in 29.3% of HBsAg-positive sera. This suggests that hepatitis B virus (HBV) and hepatitis delta virus (HDV) are common in Niger, and the factors that increase the likelihood of HBV transmission may also enhance the risk of HDV transmission.
Glutamate dehydrogenase (GDH) activity and its allosteric modulation by purine nucleotides were studied in platelet preparations from 4 patients with a nondominant form of adult-onset olivopontocerebellar atrophy (OPCA) and in affected and nonaffected members of two families with a dominant form of OPCA. A partial deficiency of GDH activity (40 to 50% of control values) was present in 3 patients with nondominant OPCA and in 2 patients, father and son, with a dominant form of OPCA. Platelet GDH from these patients and controls was regularly inactivated by 2 mM guanosine-5'-triphosphate (GTP) and simulated one- to twofold by 2 mM adenosine-5'-diphosphate (ADP). In the presence of 0.2% Triton X-100, the activating effect of ADP was enhanced four- to sixfold. The partial deficiency in maximum catalytic activity observed in these patients persisted under all conditions used for enzyme assay. In affected members, but not in one unaffected member of another family with a dominant type of OPCA, GDH activity was in the control range but was not activated by ADP in either the presence or absence of Triton. These results suggest that there may be at least two possible alterations of GDH in patients with OPCA: one which decreases the maximum catalytic activity and one which impairs the regulatory properties of the enzyme. Furthermore, this study suggests that platelet GDH determination in patients with OPCA may provide a simple and useful tool to classify these disorders and to understand the basic pathophysiological mechanisms involved.
The anterograde and retrograde axonal flow of acetylcholinesterase were studied in the sciatic nerve of alloxan-diabetic rats after five weeks of experimental diabetes. A slight reduction of the anterograde axonal flow of the enzyme was found in alloxan-diabetic compared to control rats. Sedimentation analysis revealed a major reduction of anterograde axonal flow of the light globular forms of the enzyme (G1 + G2), which are probably conveyed by slow transport. There was also a minor reduction of the anterograde flow of the globular form G4, while no modification of the axonal flow of the heavy asymmetric form A12 was found. Both G4 and A12 molecular forms are conveyed by fast axonal transport. In contrast, no abnormality of the retrograde axonal flow of acetylcholinesterase was observed. Ganglioside treatment antagonized the decline of the anterograde axonal flow of the enzyme in alloxan-diabetic rats. These results are consistent with the view that experimental diabetic neuropathy is associated with axonal transport defects, and suggest a protective effect of ganglioside treatment against neuronal damage(s) related to the diabetic syndrome.
An extrinsic total ophthalmoplegia developing two years before radiologic evidence of bronchial carcinoma and onset of Eaton-Lambert myasthenic syndrome is reported. Clinical and ENG data showed the neuromuscular location of the ophthalmoplegia, but repeated Tensilon and Prostigmine tests were negative. CT scan and CSF examinations revealed neither carcinomatous metastases nor inflammatory CNS disease. The case is an exceptional example of a paraneoplastic myasthenic syndrome long confined to the oculomotor muscles.
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Nine patients with uni-or bilateral stenosis of vertebral arteries, not associated with other lesions of supraaortic trunks are reported. They showed a vertebrobasilar insufficiency syndrome not due to other assessable causes. Seven of them underwent surgical treatment always as reimplantation of the vertebral into the subclavian artery. The procedure was unilateral also in cases with bilateral lesions. In all 7 patients a favourable result was obtained: 5 patients recovered completely and 2 showed a marked improvement. The study demonstrates that the surgical repair of symptomatic unilateral lesions of vertebral arteries is able to cure the vertebrobasilar insufficiency syndrome.
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The technique of liver arterialization with the left gastric artery after portocaval shunt in the rat is described. The operation was carried out with three different modalities, and the best results were obtained when suturing was carried out after enlargement of the arterial caliber (0.4-0.5 mm external diameter), advantage of a vessel bifurcation. Eighty percent of the anastomosis were patent without any anticoagulant treatment 1 month after surgery. Preliminary results show the positive effect of liver arterialization compared to treatment with portocaval shunt alone.
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Rat soleus muscle was partially denervated by resecting the L5 mixed nerve. Muscle reinnervation was monitored 10, 30 and 50 days after surgery. The extent of recovery was found to be dependent on the number of axons remaining in the muscle and appeared not to be influenced by the time allowed. If animals were treated daily with 5 mg/kg of gangliosides the enlargement of the motor units was further enforced. The index of sprouting (expressed as the ratio between the percentage of muscle reinnervation due to a certain number of motor neurons in reinnervation and in normal conditions) was increased in a significant way by gangliosides treatment, i.e. one motor unit can expand up to about 4.5-fold, but if the animal was treated with gangliosides the motor unit can expand up to about 6.3-fold. These results showed that motoneuron sprouting capacity is increased by treatment animals with gangliosides.
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Seventy eight arterial and venous reconstructions using expanded microporous PTFE (IMPRA-grafts) are reported. This prosthetic material has been employed, by itself or in addition to autogenous vein segments when the saphenous vein was not available or inadequate in length or quality. Long term results show that 83% of vascular repairs are patent up to 36 months post-operatively. Since the prosthesis has been used in vena cava reconstructions, in patients with severe impairment of the distal arterial tree and in some cases in whom previous surgical treatment had failed, these results are favorable and encouraging.