[Review of 1000 hematuric patients in the hospitals in Rome, with special reference to the methods of diagnosis and therapy].
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A dose-ranging crossover study of orally administered bentiromide was conducted in 47 patients with chronic pancreatic disease and 61 healthy volunteers. Four doses (100 mg, 500 mg, 1 g, and 5 g) and postdosing urine collection periods (0-3, 0-6, 0-12, and 0-24 h) were studied. Of these, the 500-mg dose and 0-6-h urine collection period afforded maximal separation of urinary arylamine excretion rates between the two populations. At this dose and collection period, the lower limit of normal (mean - 2 SD) for the control group was 57%; none of the healthy volunteers had 6-h arylamine excretion rates less than 50%. The agent was well tolerated except at the 5-g dose level, where nausea, vomiting, and diarrhea were common. Bentiromide appears to be a useful agent in the assessment of exocrine pancreatic function.
The influence of thrombin inhibitors, which differ both in their chemical structure and type of inhibition on thrombin-induced microthrombosis was studied in rat lungs. The antithrombotically effective doses and blood levels of the compounds correlated with their kinetic constants for inhibition of thrombin. In preventing microthrombosis, some of the synthetic inhibitors tested surpassed the effectiveness of heparin and approached that of the naturally occurring inhibitor hirudin.
Atherosclerotic lesions of aorta and arteries were induced in guinea pigs fed a diet supplemented with 1% cholesterol and vitamin D2 (0.75 million IU/kg of diet) for 6 weeks. Histopathological observation revealed intimal proliferation and calcification of the intima and media, but no atheroma was present at the sites of arterial injury. However, the biochemical findings revealed accumulation of cholesterol, mainly esterified, and calcium in the aorta. Significant correlation between the calcium and phosphorus contents in the aorta indicates the presence of a probable calcium-phosphate complex. Synergism for the induction of atherosclerotic lesions was shown between high cholesterol and excess vitamin D2. Sodium 4-(hexadecylamino)benzoate (cetaben) (90 mg/kg/day, p.o.) and trisodium ethane-1-hydroxy-1,1-diphosphonate (EHDP) (5 mg/kg/day, s.c.) inhibited the development of atherosclerotic lesions induced in this manner. These effects were associated with a significant reduction of serum and aortic cholesterol levels and a significant elevation of HDL-cholesterol levels caused by cetaben, and a significant reduction in aortic calcium caused by EHDP. These two drugs and clofibrate, however, had no significant effect on the regression of pre-established atherosclerotic lesions.
A comparative study using the oral test with chymotrypsin substrates p-(N-acetyl-L-tyrosyl)- and p-(N-benzoyl-L-tyrosyl) aminobenzoic acid (Ac-Tyr-PAB and Bz-Tyr-PAB) was carried out in 43 adults divided into four groups comprising controls (n = 18), chronic pancreatitis (n = 13), after acute pancreatitis (n = 7), and celiac sprue (n = 4), after separate administration of both derivatives and determination of PABA urinary output in 6 and 8 hours. Both derivatives were diagnostically comparable. The specificity of both derivatives in the investigated group in 6 and 8 hours was 100%, and test sensitivity in patients with chronic pancreatitis, was in 6 hours 90.9% for Ac-Tyr-PAB and 72.7% for Bz-Tyr-PAB, and 8 hours 81.8% for both compounds. Differentiation between the controls and the chronic pancreatitis group was better in Ac-Tyr-PAB, as adjudged by the sensitivity and significance of the Student t-test criterion.
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The effects of two types of synthetic inhibitor of fibrinolytic enzymes (omega-aminocarboxylic acids, benzamidine derivatives) on intravascular fibrinolysis and fibrinogenolysis were studied in rats. Generalised primary fibrinogenolysis was produced by infusion of human plasminogen-streptokinase complex, secondary fibrinolysis was induced by infusion of the thrombin-like enzyme batroxobin. The inhibitors exerted different effects on the hyperfibrinolytic states. The omega-aminocarboxylic acids (PAMBA, AMCA) inhibited fibrinolysis more effective than fibrinogenolysis. In contrast, the benzamidines (APPA, NANP) were more potent inhibitors of fibrinogenolysis. Aprotinin examined for comparison behaved like the benzamidine derivatives.
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Pancreolauryl test (PLT), a tubeless pancreatic function test, was performed in 40 consecutive patients suffering from chronic pancreatitis, in 21 patients with miscellaneous digestive diseases, and in 18 control subjects to assess its diagnostic sensitivity and specificity. N-benzoyl-L-tyrosyl-p-aminobenzoic acid test (PABA test) and secretin-cerulein test were also carried out to compare the diagnostic value of PLT with that of these two pancreatic function tests. PLT was abnormal in 22 of 40 patients with chronic pancreatitis (55%). In particular, pathological results were found in all patients with severe pancreatic insufficiency and only in four of 14 patients with mild to moderate insufficiency. PABA test showed a slightly lower sensitivity in severe insufficiency, and the same sensitivity in mild-moderate insufficiency. PLT was normal in all control subjects and in 17 of 21 patients with nonpancreatic digestive diseases. Its specificity (90%) was slightly higher than that of PABA test (82%). The results indicate that PLT may be used to support a diagnosis of severe pancreatic exocrine insufficiency, while in mild or moderate insufficiency its diagnostic value is limited.
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Eleven adult Basenji dogs with immunoproliferative small intestinal disease (IPSID) were studied. Two items of history related to the digestive tract were characteristic: (i) chronic intractable diarrhea in most dogs, and (ii) progressive emaciation. Anorexia was intermittent in only a few dogs. In addition, skin lesions of various degrees of severity were observed, including alopecia of pinnae and ventrum, hyperpigmentation and hyperkeratosis of pinnae, and necrosis and ulcerations of margins of pinnae. The cause of the skin lesions was not determined; however, hypothyroidism did not appear to contribute to the skin changes. Standard hematologic and serum chemical values were not consistently abnormal. However, a poorly regenerative anemia, mild neutrophilia, and increased aspartate aminotransferase and alanine aminotransferase activities were generally observed in severely affected dogs. The Pelger-Huet anomaly was identified in dog 3. Maldigestion and malabsorption as determined by the N-benzoyl-L-tyrosyl-p-aminobenzoic acid and d-xylose test was documented to varying degrees in dogs with IPSID. Maldigestion was correlated with functional pancreatic exocrine insufficiency. Severe malabsorption was documented in only 3 dogs. Serum gastrin values were evaluated in these dogs because of a prior observation of parietal cell hyperplasia and gastric ulceration. Hypergastrinemia was documented in 3 dogs. Additional studies will be necessary to determine whether an acid hypersecretory state contributes to the pathogenesis of IPSID in Basenjis.
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A 2-month-old infant developed severe methemoglobinemia following topical pharyngeal application of a common benzocaine containing agent ( Cetacaine ). Although a number of reports of this complication have appeared in recent years, this is apparently the first case reported in the Otolaryngology literature. The pathophysiology, pharmacology, and treatment of this condition are reviewed.
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Transport of methotrexate by L1210 sensitive and resistant cell lines was studied using [3H]methotrexate and methotrexate. The intracellular and cellular efflux of drug was analyzed by radioligand binding assay and high performance liquid chromatography. It was shown that the initial, rapid uptake of [3H]methotrexate was not methotrexate but rather [3H]p-aminobenzoylglutamate, even when the [3H]methotrexate was greater than 97% homogeneous. In the mutant cell line, the impurity could account for all of the apparent methotrexate uptake at 1 to 10 micro M extracellular drug. Similarly, the rapid efflux of [3H]methotrexate was also shown to be all, or in part, 3H-impurities, in both the mutant and sensitive cell lines. These results do not conflict with the currently accepted model of a carrier-mediated process for reduced folate and antifolate transport but do suggest that the quantitative interpretation of the early time points of transport experiments be more critically evaluated, especially when mutant cell lines are being analyzed.
B.T.PABA has been evaluated as a new pancreatic exocrine function diagnostant. In this study, it was used as a new absorption test. After ingestion of 1 gm of B.T.PABA and the test meal, PABA in 6-h collected urine was determined. The urinary PABA excretion rate in Billroth I type postgastrectomy patients, 8-14 days after surgery, was lower than that of controls and that in Billroth II patients, 10-14 days after surgery, was the lowest of the three. However, the PABA excretion values of postgastrectomy patients 10 months to 20 years after surgery recovered nearly to the normal level of PABA excretion. These decreases in PABA excretion were considered to be caused by postgastrectomy digestion-absorption impairment. In addition, there was a significantly high correlation between the conventional 131I-labeled albumin absorption test and the B.T.PABA test. Therefore, it was concluded that the B.T.PABA test can be used as a simple absorption test.
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