Giornale di clinica medica最新文献

Fourteen children between 5 and 12 years old at P1 B1 Tanner's pubertal stage were studied. Seven of them were affected by familiarly short height and seven had a constitutional growth delay. All those patients (responders) except two (hyporesponders) turned out positive to GH stimulation tests (GH to I.T.T., GH to clonidine test). We have treated with clonidine (0.100 mg/m2 for six months) all patients and there were significant results: higher values of basal GH and increase in the response to the clonidine test also in patients hyporesponders before treatment.

Several studies are present in the literature about the efficacy of medical treatment with biliary acid, orally administered, on the symptomatic gallstone patients. Both this drugs act, with different mechanisms, on the same pathophysiological pathway, represented by the supersaturated bile in cholesterol. Aim of the present investigation was to study the possible modifications of serum bile acids pattern and of lipoproteins in a large sample of gallstone patients under long-term treatment with biliary acids. One hundred and twelve patients with radiolucent gallstones entered the study; 54 received chenodeoxycholic acid (CDCA) and 58 ursodeoxycholic (UDCA) at dosage of 15 mg/kg/daily. Blood samples for determination of serum cholesterol, triglycerides, phospholipids, lipoproteins, total and fractionated biliary acids were collected from each subjects every three months for a mean "follow-up" of 24 months. The levels of serum cholesterol, triglycerides and phospholipids showed a mild decrease only in the patients under therapy with CDCA, while no modifications were detected using UDCA. The same was found for two other parameters, HDL-cholesterol and lipoproteins, with both treatments during the overall period of follow-up. The biliary acids levels showed a significant increase only in the patients treated with CDCA, but no differences were found between "responders" and "non responders" to the therapy.

The ability of Interferon (IFN) alpha, beta and gamma to induce IgA production from IgA deficient patients lymphocytes was tested "in vitro". In affected patients IgG and IgM production was similar to the normal cases but no effect on IgA production was observed. In normal cases variable concentration of alpha- beta- and gamma-IFN resulted in different immunoglobulin production. In IgA selective deficiency a low number of SmIgA bearing cells and defective transformation in IgA-plasma cells was noted as possible primary defect.

In this study, we examined the composition of crystallographic structure of biliary stones in 106 patients (27 male, 79 female). The material has been obtained following cholecystectomy. In 70 cases (66%), the monohydrate cholesterol was the main constituent, alone (33%) or in combination with calcium salts (32%). In 52% of the cases, we found presence of vaterite, aragonite and calcite. The anhydrous cholesterol was determined in 28 subjects (26%), alone (9.4%) or associated with calcium salts (16%). Cholesterol was completely absent in 8 cases: of them, 4 presented an aspecific diffrattografic picture and 4 revealed presence of calcium carbonate. Finally, no correlation was found between epidemiological data (sex or age) and macroscopic feature of biliary stones (chemical and morphological structure).