Localization of neuroglobin in the brain of R6/2 mouse model of Huntington's disease

Neuroglobin (Ngb) is expressed in the central and peripheral nervous system, cerebrospinal fluid, retina, and endocrine tissues where it is involved in binding O₂ and other gasotransmitters. Several studies have highlighted its endogenous neuroprotective function. Huntington's disease (HD), a dominant hereditary disease, is characterized by the gradual loss of neurons in discrete areas of the central nervous system. We analyzed the expression of Ngb in the brain tissue of a mouse model of HD, in order to define the role of Ngb with respect to individual cell type vulnerability in HD and to gender and age of mice. Our results showed different expressions of Ngb among neurons of a specific region and between different brain regions. We evidenced a decreased intensity of Ngb at 13 weeks of age, compared to 7 weeks of age. The double immunofluorescence and fluorescence resonance energy transfer (FRET) experiments showed that the co-localization between Ngb and huntingtin at the subcellular level was not close enough to account for a direct interaction. We also observed a different expression of Ngb in the striatum, depending on the sex and age of animals. These findings provide the first experimental evidence for an adaptive response of Ngb in HD, suggesting that Ngb may exert neuroprotective effects in HD beyond its role in reducing sensitivity to oxidative stress.

Biologic Effects of Ultrasound on Liver Cells of Rat Embryos

Experiments on the biologic effects of ultrasound (US) were carried out on rat embryos exposed for 120 s to a US beam showing features similar to those already employed for diagnostic purposes. Electron microscopic investigation of the liver parenchyma of rat embryos confirmed results obtained from adult guinea pigs with the same duration of exposure, i.e. diffuse vacuolization of cytoplasma and varying degrees of mitochondrial damage.

Reduced GABAB receptor subunit expression and paired-pulse depression in a genetic model of absence seizures

Neocortical networks play a major role in the genesis of generalized spike-and-wave (SW) discharges associated with absence seizures in humans and in animal models, including genetically predisposed WAG/Rij rats. Here, we tested the hypothesis that alterations in GABA(B) receptors contribute to neocortical hyperexcitability in these animals. By using Real-Time PCR we found that mRNA levels for most GABA(B(1)) subunits are diminished in epileptic WAG/Rij neocortex as compared with age-matched non-epileptic controls (NEC), whereas GABA(B(2)) mRNA is unchanged. Next, we investigated the cellular distribution of GABA(B(1)) and GABA(B(2)) subunits by confocal microscopy and discovered that GABA(B(1)) subunits fail to localize in the distal dendrites of WAG/Rij neocortical pyramidal cells. Intracellular recordings from neocortical cells in an in vitro slice preparation demonstrated reduced paired-pulse depression of pharmacologically isolated excitatory and inhibitory responses in epileptic WAG/Rij rats as compared with NECs; moreover, paired-pulse depression in NEC slices was diminished by a GABA(B) receptor antagonist to a greater extent than in WAG/Rij rats further suggesting GABA(B) receptor dysfunction. In conclusion, our data identify changes in GABA(B) receptor subunit expression and distribution along with decreased paired-pulse depression in epileptic WAG/Rij rat neocortex. We propose that these alterations may contribute to neocortical hyperexcitability and thus to SW generation in absence epilepsy.

Early-onset progressive ataxia associated with the first CACNA1A mutation identified within the I–II loop

Familial hemiplegic migraine type 1, spinocerebellar ataxia type 6 (SCA6) and episodic ataxia type 2 (EA2) are allelic disorders associated with mutations in the CACNA1A gene, which encodes the alpha1 subunit of the P/Q-type calcium channel (Ca(V)2.1). SCA6 and EA2 share a number of clinical features, such as prominent cerebellar involvement and good response to acetazolamide therapy. However, while SCA6 develops as a late-onset, progressive ataxia, EA2 has an earlier, and episodic, onset. We report on two sisters with a heterogeneous clinical phenotype. The first developed progressive cerebellar ataxia after age 30, without noticeable episodes of vertigo or headache. A 1 year trial with acetazolamide did not produce significant results. The other reported episodes of vertigo, headache and gait imbalance since late childhood, with good response to acetazolamide, before developing moderate chronic cerebellar ataxia. Brain MRI showed cerebellar atrophy, especially in the vermis, in both patients. Direct sequencing of CACNA1A identified a heterozygous 1360G>A mutation in exon 11 resulting in the substitution of alanine for threonine at residue 454 (p.Ala454Thr). This is the first description of a change residing in the cytoplasmic I-II loop associated with a clinical phenotype.

BIS - AAI and clinical measures during propofol target controlled infusion with Schnider's pharmacokinetic model

AIM

The A-line autoregressive index (AAI) and the Bispectral Index Score (BIS) are two commercially available indexes of anesthetic depth widely used in clinical practice. The aim of the current study was to compare the accuracy of AAI, BIS, Schnider's predicted effect-site concentration of propofol (Ce propofol) to assess depth of anesthesia.

METHODS

Forty-four patients scheduled for major elective abdominal surgery received target effect-site controlled infusion of propofol. Target effect-site (Ce propofol) was started at 1.5 mug/mL and increased every 4 min by 1.0 microg/mL until 5.5 microg/mL were achieved. At every step sedation level was estimated, using AAI, BIS, Observer's Assessment of Alertness/Sedation scale (OAA/S), loss of eyelash reflex and Ce propofol.

RESULTS

We enrolled 44 patients, 20 males and 24 females, ASA I/II 18/26, 48+/-10 years, 68.2+/-9 kg, 165+/-7.1 cm, body mass index (BMI) 25+/-3.5. At increasing Ce propofol BIS-AAI values decreased progressively (BIS range 97-38) (AAI range 97-17). Values of BIS < or = 50, of AAI < or = 48 and of Ce propofol > or = 5.1 resulted in OAA/S=0, while values of BIS < or = 62, AAI < or = 53 and Ce propofol < or = 3.5 resulted in OAA/S=2. Loss of eyelash reflex occurred when values were BIS < or = 64 and AAI < or 61.

CONCLUSION

BIS, AAI, propofol site effect concentration revealed information on sedation level and consciousness but no gold standard yet exists because of consistent overlap between ''conscious'' and ''not conscious'' states.

Comparison of the effects of felodipine and cilazapril on exercise performance in patients with mild to moderate hypertension. A crossover study

This double-blind crossover study was designed to compare the effects of felodipine and cilazapril on exercise performance in hypertensive patients. After a 2-week placebo run-in period, 40 patients with mild to moderate hypertension were randomized into two parallel groups to receive either felodipine (10 mg) or cilazapril (5 mg) for 4 weeks. After another 2-week washout period, treatments were then crossed over for a further 4-week study period. All patients were given an extensive rest and exercise evaluation at the end of the placebo period. Extensive rest and exercise evaluations were repeated after a 4-week treatment period and again after the second washout period and after the second 4-week treatment period. Before each exercise test, epinephrine, norepinephrine and dopamine plasma levels and plasma renin activity were measured. Two groups were similar at baseline for systolic and diastolic blood pressure and heart rate as well as for laboratory and hormonal variables and duration of exercise test. At the end of treatment diastolic blood pressure was significantly reduced in the felodipine group (p = 0.019). Duration of exercise test was longer than at baseline (p = 0.031) in the felodipine group. Plasma dopamine levels were significantly increased in the cilazapril group. Plasma renin activity significantly increased in the felodipine group. In conclusion, our data show that the two drugs have the same effectiveness in resting conditions but that felodipine is more effective in lowering maximum exercise diastolic blood pressure and in improving exercise time with an double product increase (not significant); it has no statistically significant effect on maximal exercise systolic blood pressure.

Aggresome formation by anti-Ras intracellular scFv fragments. The fate of the antigen-antibody complex

Diverting the antigen from its normal intracellular location to other compartments in an antibody-mediated way represents a mode of action for intracellular antibodies [Cardinale, A., Lener, M., Messina, S., Cattaneo, A. & Biocca, S. (1998) FEBS Lett., 439, 197-202; Lener, M., Horn, I.R., Cardinale, A., Messina, S., Nielsen, U.B., Rybak, S.M., Hoogenboom, H.R., Cattaneo, A. & Biocca, S. (2000) Eur J Biochem. 267, 1196-205]. In the case of p21Ras, the sequestration of the antigen in aggregated structures in the cytoplasm of transfected cells leads to the inhibition of its biological function. We have further investigated the intracellular fate of the antigen-antibody complex by analyzing the effect of proteasome inhibitors on the formation and the intracellular localization of the aggregates. Overexpression of anti-Ras scFv fragments or inhibition of proteasomes activity leads to the formation of large perinuclear aggresomes formed of ubiquitinated-scFv fragments in which p21Ras is sequestered and degraded in an antibody-mediated way. Disruption of microtubules by nocodazole completely abrogates the accumulation of scFv fragments in a single aggresome and induces the dispersion of these structures in the periphery of the cell. Cotransfection of the GFP-scFv with a myc-tagged ubiquitin and colocalization with specific anti-proteasome antibodies indicate the recruitment of exogenous ubiquitin and proteasomes to the newly formed aggresomes. Taken together these results suggest that the intracellular antigen-antibody complex is naturally addressed to the ubiquitin-proteasome pathway and that the mechanism of ubiquitination does not inhibit the antibody binding properties and the capacity to block the antigen function.

Effects of high-dose furosemide and small-volume hypertonic saline solution infusion in comparison with a high dose of furosemide as a bolus, in refractory congestive heart failure

BACKGROUND

Diuretics, have been accepted as first-line treatment in refractory heart failure, but a lack of response is a frequent event. A randomised single blind study was performed to evaluate the effects of the combination of high-dose furosemide and small-volume hypertonic saline solution (HSS) infusion in the treatment of refractory NYHA class IV congestive heart failure (CHF).

MATERIALS AND METHODS

Sixty patients (21 F/39 M) with refractory CHF (NYHA class IV) of different etiologies, unresponsive to high oral doses of furosemide, ACE-inhibitors, digitalis, and nitrates, aged 65-90 years, were enrolled. They had to have an ejection fraction (EF) <35%, serum creatinine <2 mg/dl, BUN </=60 mg/dl, a reduced urinary volume and a low natriuresis. The patients were randomised in two groups (single blind): group 1 (11 F/19 M) received an i.v. infusion of furosemide (500-1000 mg) plus HSS (150 ml of 1.4-4.6% NaCl) b.i.d. in 30 min. Group 2 (10 F/20 M) received an i.v. bolus of furosemide (500-1000 mg) b.i.d., without HSS, during a period lasting 6-12 days. Both groups received KCl (20-40 mEq.) i.v. to prevent hypokalemia. All patients underwent at entry a physical examination, measurement of body weight (BW), blood pressure (BP), heart rate (HR), evaluation of signs of CHF, and controls of serum Na, K, Cl, bicarbonate, albumin, uric acid, creatinine, urea and glycemia and daily during hospitalization, as well as the daily output of urine for, Na, K and Cl measurements. Chest X-ray, ECG and echocardiogram were obtained at entry during and at the discharge. During the treatment and after discharge the daily dietary Na intake was 120 mmol with a drink fluid intake of 1000 ml daily. An assessment of BW and 24-h urinary volume, serum and urinary laboratory parameters, until reaching a compensated state, were performed daily, when i.v. furosemide was replaced with oral administration (250-500 mg/day). After discharge, patients were followed as outpatients weekly for the first 3 months and subsequently once per month.

RESULTS

The groups were similar for age, sex, EF, risk factors, treatment and etiology of CHF. All patients showed a clinical improvement. Six patients in both groups had hyponatremia (from 120 to 128 mEq./l) at entry. A significant increase in daily diuresis in both groups was observed (from 390+/-155 to 2100+/-626, and from 433+/-141 to 1650+/-537 ml/24 h, P<0.05). Natriuresis (from 49+/-15 to 198+/-28 mEq./24 h) was higher in group 1 vs. group 2 (from 53.83+/-12 to 129+/-39 mEq./24 h, P<0.05). Serum Na (from 135.9+/-6.8 to 142.2+/-3. 8 mEq./l, P<0.05) increased in the group 1 and decreased in the group 2 (from 134.7+/-7.9 to 130.1+/-4.3 mEq./l). Serum K was decreased (from 4.4+/-0.6 to 3.9+/-0.6, and 4.6+/-9 to 3.6+/-0.5 mEq. /l, P<0. 05) in both groups. BW was reduced (from 73.8+/-9.1 to 63. 8+/-8.8, and from 72.9+/-10.2 to 64.5+/-7.5 kg, P<0. 05) in both groups. Group 2 showed more patients in NYHA class III than group 1 (18 vs. 2 patients, P<0.05). Group 2 showed an increase of serum creatinine. Serum uric acid increased in both groups. BP values decreased, and HR was corrected to normal values in both groups. Group 2 showed a longer hospitalization time than group receiving HHS infusion (11.67+/-1.8 vs. 8.57+/-2.3 days, P<0.001). In the follow-up (6-12 months), none of the patients from group 1 were readmitted to the hospital and they maintained the NYHA class achieved at the discharge. Group 2 showed 12 patients readmitted to hospital and a higher class than at discharge.

CONCLUSION

Our data suggest that the combination of furosemide with HSS is feasible and it appears that this combination produces an improvement of hemodynamic and clinical parameters, reduces the hospitalization time and maintains the obtained results over time in comparison with those receiving high-dose furosemide as bolus.

Angiotensin-converting enzyme gene deletion polymorphism determines an increase in frequency of migraine attacks in patients suffering from migraine without aura

Many authors have reported an association between the angiotensin-converting enzyme (ACE)-D allele and coronary heart disease and other cardiovascular diseases. The mechanism underlying the positive associations between the ACE-D alleles and diseases are not yet clear. Previous reports showed an association between migraine without aura and ACE-D allele polymorphism. The study is aimed to evaluate if the DD genotype could also be associated with the frequency and duration of migraine without aura. In 302 patients suffering from migraine without aura (at least for 1 year), with no history of cardiovascular diseases and major risk factors for ischemic events, the genotypes of the ACE gene, plasma ACE activity, and the frequency (weekly) and duration of migraine attacks were evaluated. No drugs were given before (4 weeks) and during the study. The same evaluations were performed in 201 subjects without migraine. The molecular biologist and the physician evaluating the patient data were blinded to the clinical history and ACE-DD gene determination. Genotypes were determined by polymerase chain reaction amplification. Plasma ACE activity was performed by the HPLC method. The groups were similar for sex, age and smoking habit (migraines: 302 patients (200 F/102 M), mean age 37.8 +/- 8.2 years; control: 201 subjects (127 F/74 M), mean age 37.5 +/- 9.3 years). Patients with migraine without aura showed higher incidence of the ACE-DD gene (48.34%) than control subjects (37.32%), p < 0.05. The frequency of migraine (average attacks per week) was higher in patients with DD (2.11 +/- 1.9) than in patients with ID (1.54 +/- 1. 44), p < 0.05. No difference in duration of migraine attacks (hours per week) was observed. Plasma ACE activity was increased in patients with the ACE-DD gene. Our data suggest that ACE-DD gene polymorphism could have an important role in determining migraine attacks and the frequency of these attacks. Further data are needed through further studies, especially on the biomolecular level.

Diverting a protein from its cellular location by intracellular antibodies. The case of p21Ras

We describe the use of phage libraries to derive new antibodies against p21Ras to be used for intracellular expression in mammalian cells. A panel of single-chain antibody fragments, binding to Ras, were analyzed and characterized for their capacity to interfere in vitro with (a) the intrinsic GTPase activity of Ras and (b) the binding of Ras to its effector Raf, and were found not to neutralize its function, according to these biochemical criteria. When expressed intracellularly in mouse 3T3 K-Ras transformed cells all the anti-Ras single-chain variable fragments (scFv) tested inhibited cell proliferation, as assessed by bromodeoxyuridine incorporation. Double immunofluorescence analysis of transfected cells using confocal microscopy confirmed that anti-Ras antibody fragments colocalize with endogenous Ras, at subcellular locations where the protein Ras is not normally found. These data suggest that the ability of phage-derived anti-Ras scFv fragments to inhibit the function of Ras in vivo is a rather general and frequent property and that the range of antibodies that can be successfully used for intracellular inhibition studies is much greater than anticipated, exploiting the mode of action of diverting protein traffic.

Tolerability and efficacy of high-dose furosemide and small-volume hypertonic saline solution in refractory congestive heart failure

Thirty patients aged 65-85 years, with refractory New York Heart Association (NYHA) class IV congestive heart failure (CHF) were treated with an intravenous infusion of furosemide (250-2000 mg/d) and small-volume hypertonic saline solution (150 mL of 1.4-4.6% NaCl) twice a day for 6 to 12 days. A daily fluid oral intake of 1000 mL and previous cardiac therapy were maintained. Clinical signs and symptoms of CHF, such as dyspnea, edema and weakness, improved, as did severity of illness as defined by NYHA class. The infusion was well tolerated. After a 12-month follow-up, 24 patients (80%) were alive and in the NYHA class assigned on discharge from the hospital. This therapeutic combination is effective and well tolerated and should represent an innovative approach to the management of refractory CHF.

Effect of subcutaneous sumatriptan on head temperature in migraines

Sumatriptan, a selective 5-hydroxy-triptamine (5-HT1) receptor agonist, has been used recently in the treatment of acute migraine. Some in vitro experiments suggested that sumatriptan has vasoactive properties in vascular beds distinct from cerebral circulation. In view of this we investigated the vascular effects of the standard 6 mg subcutaneous (s.c.) dose of sumatriptan, on the surface areas of the head using thermography, a simple and reliable method for detecting temperature changes. The head temperature of 127 patients (double-blind), 102 migraines (52 during headache attack and 50 headache-free) and 25 healthy control subjects were evaluated using thermography in basal condition and 30, 60, 90, and 120 min after s.c. sumatriptan injection of placebo. During the entire observation period systemic blood pressure (SBP), heart rate (HR) and continuous electrocardiogram (ECG) were detected automatically. A significant head temperature decrease was observed after s.c. sumatriptan administration, in both healthy controls and migraine subjects; placebo administration did not show any change of temperature. In migraine patients during headache attack, head temperature reduction corresponded to the relief of headache symptoms. This vasoconstrictor effect detected with thermography is not isolated to cranial circulation but it is also systemic. In fact, we observed a significant increase (p < 0.05) in both systolic and diastolic systemic blood pressure. No significant changes in heart rate and ECG abnormalities were otherwise detected. These findings suggest that sumatriptan is effective in the treatment of migraine attack, but it must be used with caution in migraines with concomitant hypertension.

Succinate sumatriptan evaluation by Doppler echocardiography in patients with migraine

Recent reports show that sumatriptan administration increases blood pressure and vascular resistance both in systemic and pulmonary circulation. This study was performed to evaluate by echo-Doppler technique the hemodynamic effects of subcutaneous sumatriptan administration. Forty-one migraine subjects (26 males, 15 females), mean age 36 +/- 2 years (range 36-39 years), and 20 healthy control subjects (14 males, six females), mean age 36 +/- 2 years (range 36-39 years) were randomized (double-blind) to receiving sumatriptan (group A) or placebo (group B). After a 2-week complete pharmacological washout, clinical examination, electrocardiogram, and Doppler echocardiography were performed at baseline, 15, 30, 45, and 60 min after sumatriptan or placebo administration. No significant differences were found between the two groups regarding Doppler echocardiographic parameters (aortic integral, pulmonary integral, end-systolic and end-diastolic diameters) and heart rate; only a slight but not significant increase in arterial blood pressure was observed in group A. Our data show that succinate sumatriptan can be used with safety in patients without hypertension and other cardiovascular disease.

The mode of action of Y13-259 scFv fragment intracellularly expressed in mammalian cells

The anti-p21ras Y13-259 single-chain Fv fragment (scFv) neutralizes the activity of p21-ras when intracellularly expressed in different systems. We have studied the mode of action of this inhibition in 3T3 K-ras fibroblasts and demonstrated that (i) this antibody fragment is highly aggregating when cytoplasmically expressed and (ii) the p21-ras antigen is sequestered in these aggregates in an antibody-dependent manner. This co-segregation leads to an efficient inhibition of DNA synthesis. These results suggest that an antigen can be diverted from its normal location inside the cells in an antibody mediated way, prospecting a new mode of action for intracellular antibodies in vivo.

Pregnancy at forty and over: a case-control study

We compared obstetric prognosis in 327 women > or = 40 years old (148 nulliparas, 279 multiparas) with 20-30-year-old matched controls who delivered at our department between 1988 and 1990. Gestational diabetes and chronic hypertension were the only more frequent antepartum complications in cases than controls (2.4% vs. 0.3% and 3.4% vs. 0.3%, respectively). There were more premature deliveries in cases than controls (19% vs. 8%) but no difference in postdate deliveries. Cesarean section was more frequent in cases than controls in both nulliparas (64% vs. 30%) and multiparas (43% vs. 12%). Incidence of abdominal delivery for acute obstetrical indications was not increased in older gravidas. Significant differences were observed in low birthweight (17% vs. 5%) and 5-min Apgar score < 7 (8% vs. 2%). Most of the abnormal Apgar scores were recorded after cesarean section; values for vaginally-delivered infants were comparable in older and younger women. Perinatal mortality was similar in the two groups.

[Neonatal hyperthyroidism. A clinical contribution]

A case of female child who had transient signs of hyperthyroidism after the birth is presented. Authors describe the clinical course and discuss the possible pathogenetic mechanisms. The importance of a timely diagnosis, a correct therapy and follow-up is emphasized.

[Neonatal screening for congenital hypothyroidism in a suburban hospital: assessment of eleven years' experience]

Congenital hypothyroidism is one of the commonest endocrine diseases in infancy; the diagnosis is delayed it can lead to mental impairment. Since a precocious diagnosis, based on clinical symptoms and signs, is often difficult, screening at birth is very useful. Substitute L-T4 therapy presents some problems as it is impossible to assess the right dose before. The results of an eleven years long screening in a peripheral hospital are reported: 6408 babies were examined and congenital hypothyroidism was present in three cases, depending respectively on agenesia, ectopia and hypoplasia of the thyroid gland.

[Ultrasound-guided percutaneous injection of ethanol in Plummer's adenoma. Our experience with 8 patients]

The authors report their experience in the study of 8 patients showing symptoms of thyroid hyperfunction (Plummer's adenoma) and treated with US-guided percutaneous ethanol injection. The treatment consisted in injecting sterile ethanol in varying amounts (2 to 5 ml) according to nodule size, using a fine needle under US guidance. The patients underwent 3 to 6 injections, according to biochemical (T3-T4-TSH) and scintigraphic findings. Follow-up at 12 months showed regression of clinical symptoms, a trend of hormone levels toward normalization and recovery of previously suppressed parenchymal function. No significant complications were observed, except for a transient thyrotoxic crisis in the patient bearing the largest nodule. The treatment of Plummer's adenoma by means of percutaneous ethanol injection under US guidance appears to provide specific clinical and technical advantages over other conventional treatments.

[Pseudotumor cerebri due to the cessation of corticosteroids. A case report]

Cerebral pseudotumour is an endocranial hypertensive syndrome marked by the absence of focal neurological signs, the integrity of neuroradiological tests and an increased liquor pressure with normal composition of the liquor itself. It is normally self-limiting but if endocranial hypertension persists it may severely affect sight. It may be idiopathic or secondary to a number of conditions. The authors report a case of cerebral pseudotumour following the suspension of corticosteroid treatment. The pathology resolved rapidly following lumbar puncture. The paper focuses on the pathogenetic mechanisms and the still undefined therapeutic possibilities.

[Condylomata acuminata in childhood: description of a case]

Recent advances in understanding human papillomavirus imply that HPV infections are increasing in both men and women. HPV may cause subclinical disease and play a role in genital tumors. In prepuberal children the problem remains uncommon and can offer a difficult task of management and epidemiologic evaluation.

[Iatrogenic Cushing's syndrome in a patient with complex angiomatosis. Description of a case]

Hemangiomas present to physicians with some of the most difficult treatment problems known to medicine. Many modalities are available but all suffer some degree of complications. The Authors describe a case of Cushing's syndrome after steroid therapy of serious capillary-cavernous hemangiomas. This experience points out treatment problems and need of team management.

[The evolution of dental echography: clinical and experimental research. The ultrasonic anatomy of the teeth and periodontal tissues]

Early clinico-experimental findings with real-time B-mode Echography of the odontological district are reported. On the basis of previous in vitro application references and using a unidimensional A-Mode technique, preliminary data of in vivo ultrasound semeiotics regarding the tooth and its periodontal structures are outlined experimentally. Although current "in vivo" experience relates exclusively to front central and para-central teeth, it can be hypothesised that further technical and methodological developments of echographic instruments may permit systematic employment of ultrasound diagnosis in the odontological sector.

[Does CDDP have radiosensitizing properties in the treatment of solid tumors in advanced stage?]

Various experimental and clinical studies have signalled the radiosensitizing properties of CDDP (Cis-dichloro diammine platinum). Twenty eight patients with advanced solid tumours were included in a pilot study incorporating classic fraction (2.00 Gy X 5 weeks) radiotherapy and weekly doses of 30 g/sq.m CDDP. A complete response was obtained in 21 patients with 11 of them NED at a mean follow-up period of 4-16 months. The toxicity of the treatment was low and no kidney damage or ototoxicity was encountered. The results obtained by the combined treatment are encouraging but a correct assessment will require a randomised trial on a bigger patient sample.

Biologic effects of ultrasound on liver cells of rat embryos

Experiments on the biologic effects of ultrasound (US) were carried out on rat embryos exposed for 120 s to a US beam showing features similar to those already employed for diagnostic purposes. Electron microscopic investigation of the liver parenchyma of rat embryos confirmed results obtained from adult guinea pigs with the same duration of exposure, i.e. diffuse vacuolization of cytoplasma and varying degrees of mitochondrial damage.

[Experimental studies on possible biological effects of ultrasonic diagnosis: ultrastructural analysis of rat embryo]

Within the limits of a systematic research on the biological effects of the ultrasounds, the authors refer on their personal experience on rat's embrions treated, for 120 seconds, with a ultrasonic beam having the common characteristics used in diagnostic investigations. The ultra-structural studies on the hepatic parenchyma substantially confirm the previous results obtained in the adult cavy, exposed for the same period of time, i.e. a diffuse cytoplasmic vacuolization and an unstable mitochondrial damage. Various suggestions are advanced on the particular sensibility that the mitocondria show because of the ultrasonic action. The authors explain the limits of their experimentation in this specific sector of the scientific research.

[Echographic symptomatology of closed abdominal injuries]

The importance of echography is emphasised in the diagnosis of closed abdominal injuries. The symptomatology of the possible types of alternative revealable by echography--fluid exudates and parenchymal injuries--are discussed in detail. Personal experience of parenchymal injuries to the liver, spleen and kidneys is then described.

[Blepharophimosis, ptosis and epicanthus inversus]

Blepharophimosis, ptosis and epicanthus inversus is a rare well-documented autosomal dominant disorder. Described here is a family with typical features of this syndrome in eleven cases in five generations. Syndrome is discussed and blepharophimosis underlined. Blepharophimosis is also a minor defect in the contest of complex malformation syndromes having different aetiology (mendelian inheritance, chromosomal abnormality, toxic agents). The Authors believe that blepharophimosis, for its clinical evidence, is an important guide sign.

[Biological effects of ultrasonics used in diagnosis. Experimental studies on the incorporation of tritiated thymidine into rat hepatocytes]

In order to evaluate the possible effects of diagnostically employed ultrasounds on DNA turnover, 35 Wistar strain rats were subjected to an ultrasonic frequency band of 2.25 MHz for exposure times varying from 10 to 500 seconds. Upon administration of thymidine tritiate, it was observed that capacity to absorb the substance remained largely normal in those rats exposed for up to 40 seconds, but was diminished where longer exposure times were employed.

[Histoenzymatic research and internal irradiation. V. Histochemical modifications in rat liver with the use of colloidal Au198]

The histochemical behaviour of succinic dehydrogenase, isocitric dehydrogenase, acid phosphatase and acetylglucosaminidase activities was studied in rat liver treated with Au198-colloidal. In these experimental conditions it was found that the hepatocytes present changes in the enzymatic activities examined, generally proportional to the doses employed. With lower doses of radionuclides, the histoenzymatic changes have a local character and are completely reversible after a month. With higher doses they take on a more extensive character. These findings suggest that Au198 could be used clinically with due precautions.

[Histoenzymatic studies and internal irradiation. III. Histoenzymatic changes of the kidney treated with chloromeridrin Hg 197]

The histochemical behaviour of alkaline phosphatase, adenosintriphosphatase, acid phosphatase and acetylglucosaminidase activities was studied in rat kidney treated with Chloromeridrin Hg. In these experimental conditions it was found that the nephrocytes in the proximal convoluted tubule present changes in the enzymatic activities examined, generally proportional to the doses employed. With lower doses of radionuclides, the histoenzymatic changes have a local character and are completely reversible after a month. With higher doses they take on a more extensive character and persis to some extent one month after treatment. These findings suggesti that Hg could be used clinically with due precautions.