Giornale di clinica medica最新文献

In the present paper we have evaluated the accuracy of a fully automated liquid-chromatographic method to study the variations of serum bile acid concentration after oral administration of 500 mg of chenodeoxycholic as a bile acid tolerance test. The study population consisted of 11 subjects with liver cirrhosis (L.C.), 6 with chronic active hepatitis (C.A.H.) and of 15 healthy volunteers, as a control. A clear linear correlation was observed between the integrated peak area and the concentration of each bile acid. Bile acids were detected at a minimum concentration of 5 ng. Intra-assay variation, based on 10 consecutive determinations, was limited to a range of 0.42% and 3.23%. Compared to control group, L.C. and C.A.H. patients showed significantly higher levels of total bile acids and of CDCA. Significative was also the increase of glycine- and taurine-conjugates as well as the decrease of the ratio between the two. The present method, fully automated and using a low cost enzymatic reagent, has yielded an accurate analysis of bile acid fractions on a minute volume of serum in a short examination time.

The aim of the present study is to evaluate the real need and the sensitivity of serum myoglobin levels as an early index for the diagnosis of acute myocardial infarction. A total of 62 patients (38 suffering from acute myocardial infarction, 16 from "angina pectoris", 8 from heart failure) and 20 healthy volunteers were included in the study. The patients with acute myocardial infarction were divided in 3 subgroups according to the time passed between the beginning of the pain and their admittance to our Department (Coronary Care Unit), that was, less than 6 hours, between 6 and 12 hours, between 12 and 24 hours. Among the patients with "angina", 8 presented spontaneous crisis whereas 4 had crisis only during treadmill test. 8 of the healthy volunteers received intramuscular injections of physiological solution every 12 hours during the 3 days preceding the study. In all subjects serum myoglobin level were measured by radioimmunoassay; in patients with acute myocardial infarction serum CK and MBCK levels with enzymatic method were measured too. No variation of plasma myoglobin levels was seen in patients with angina, neither in healthy volunteers had they received or not intramuscular injections. The low increase in plasma myoglobin levels observed in patients with heart failure might be due to a deficit of renal function. Serum myoglobin levels were significantly elevated in all the patients with acute myocardial infarction, whereas plasma CK and MBCK levels were significantly high only 6 hours after the necrosis. In myocardial infarction the levels of myoglobin rise during the first hours, peak at 10 hours and return to normal in 20 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Parathyroid surgery needs an appropriate diagnosis and a preoperative localization. We conducted a prospective study to compare the efficacy of 4 different imaging modalities in 17 patients: thallium-technetium subtraction scintigraphy, ultrasonography, computed tomography and arteriography. The sensitivity was: scintigraphy 58%, echotomography 86%, Tc 92% and arteriography only 33%. Neck exploration confirmed the imaging results. We found 15 cases of adenomas (2 cases of double adenoma) and 1 case of hyperplasia; in 1 patient, no lesions were found. We conclude that the association of such techniques appears to be the optimal strategy in about 100% of the patients.