Rivista europea per le scienze mediche e farmacologiche = European review for medical and pharmacological sciences = Revue europeenne pour les sciences medicales et pharmacologiques最新文献

Wernicke's encephalopathy, neuropathy caused by a deficiency of thiamine is a syndrome characterized by memory troubles, mental confusion, ophthalmoplegia and nystagmus. The authors present a case that came up in a patient who underwent a subtotal gastrectomy because of malignant neoplasm of the stomach. More or less three months after the intervention the patient's general conditions were considerably declined and characterised by alimentary vomit, sensory obnubilation and neuromuscular deficit. After appropriate diagnostic ascertainments a repetition of the neoplastic disease was to be excluded locally and at a distance. So the authors analysed the different etiopathogenic possibilities to get a better clinical view of the syndrome in the surgical patient.

The most recent advances about cystic fibrosis genetics are revised. Their clinical applications are reviewed: prenatal diagnosis, heterozygote screening, genotype and phenotype correlation, gene therapy.

UV spectra of old sun lamps have been measured and found to contain significant amounts of UVC in addition to UVB and UVA irradiances. Their spectra are compared with that of a modern sunbed, a solar spectrum obtained with a solar elevation of 29.3 degrees and the extraterrestrial UV spectrum. The effects of UVC on human skin is rarely studied, but we know that UVB can be harmful. Old UVR lamps for cosmetic tanning irradiate significant amounts of UVB and UVC, and are therefore not recommendable. However, several action spectra indicate small health risks with limited UVA exposure, but a drastic increase in the UVA doses may be one reason for the increasing skin malignancies observed in western countries. Further research to clarify these observations has to be carried out.

Blood concentration of endogenous beta-endorphines can change during the clinical evolution of chronic bronchopneumopathies. The authors assessed the beta-endorphine concentrations in the pulmonary arterial and systemic arterial blood in 8 asthmatic patients during a symptom-free period and after methacholine-induced bronchospasm. The beta-endorphine analysis was performed in duplicate dor each sample, by means of a RIA assay. There is not difference in the systemic arterial blood concentration of beta-endorphines between asthmatic patients and normal subjects. Furthermore, there is no change in the beta-endorphine blood concentration during the passage through the pulmonary tissue after methacoline-induced bronchospasm.

It is well known that the endothelial cells represent one of the most active and versatile elements in the human organism. In fact apart from being the lining of the vessel wall they exert both antithrombotic and prothrombotic functions. Endothelial cells regulate the vasomotor tone and also have a part in the different immunological and inflammatory process. All these functions are possible because the endothelial cells produce many receptors on their surface. This paper is a review of the latest data on different roles played and substances produced by endothelial cells.

To investigate the relationship between lymphocytic gastritis and H. pylori infection, antral biopsy specimens from 162 patients with histological evidence of H. pylori infection, and from 177 subjects without colonization were retrospectively examined. Among patients with antral colonization, lymphocytic gastritis was identified in 8 cases (4.9%). Lymphocytic gastritis was not detected in specimens without H. pylori infection. Quantitation of the epithelial lymphocytic infiltration was carried out in all specimens and showed that cases with lymphocytic gastritis had a mean of 35.3 lymphocytes per 100 epithelial cells, compared with a mean of 2.6 and 2.4 respectively in chronic gastritis and normal mucosa. Among the 331 patients without lymphocytic gastritis, specimens colonized by H. pylori had a mean of epithelial lymphocyte counts significantly higher than those observed in both chronic gastritis and normal mucosa. These findings show a positive correlation between antral colonization by H. pylori and occurrence of lymphocytic gastritis, and suggest that the bacteria may have an important role in the induction of such particular form of antral inflammation.

A long-term follow-up which is still being carried out was started in the school-year 1985-86 in a Primary School of Rome and we suggested a written diet of 1300 calories and correct physical exercises. During this long follow-up we studied the changes in percentage of obesity of these subjects, considering their familiarity with obesity. It resulted that after a starting benefit due to the diet and the sport activity, which lasted till 1989, the youngsters with familiarity have subsequently regained the initial situation in 62.5% of cases, unlike those without familiarity who have kept themselves slim in 75% of cases. Even many other facts have been considered, as for example the psychologic approach, blood-tests for cholesterol, triglycerides etc, arterial pressure and above all a very careful feeding recall that has shown as the now obese subjects intake more calories than not obese one, with and excess of calories from fats to the detriment of carbon hydrates.

The Heat Shock Proteins (HSP) are a special category of proteins synthesized from 2 types of cells, one originating from ordinary organs and the other highly specialized ones from mammals. Their synthesis originates from a reaction of the cells to heat shock and therefore it can be thought of as a defense mechanism activated by the cells to protect themselves from the damage done by heat. HSPs are also qualified as "molecular chaperons" since they are present at the assembling of other proteins and they protect them from any possible anomalous interactions even if they do not take an active part in the final making up of the protein itself. This chaperone role is the base of the hypothesis that HSPs could take part in the processing and presentation of the antigens. Two hypothesis have been formed on the role of HSPs in the immunological process. 1) HSP could be antigens that call for an immediate immunological reaction; 2) HSP could set off a self destructive mechanism brought on by an immunological reaction. From all this it emerges that the immunological reaction to HSP has two angles. One is protective in that it allows the cells to eliminate micro foreign-organisms and the other is harmful due to a badly regulated immunological reaction. In some studies it has been demonstrated that patients with varying autoimmunological disorders as LES and rheumatoid arthritis (AR), have autoantibodies against HSPs. Moreover the HSPs of certain microorganisms induce the formation of autoantibodies in the host and the proliferation of T cells in the synovial fluid in patients with AR.(ABSTRACT TRUNCATED AT 250 WORDS)

Over the last thirty years white coat hypertension has been the object of numerous studies which suggest that the interactions between doctor and patient and environmental, psychological circumstances suffice to determine a significant increase of arterial pressure in subjects who are generally normotense. The aim of this study was to evaluate the prevalence of white coat hypertension in elderly subjects with hypertension which had been diagnosed recently using the traditional sphygmomanometric method three times in the space of one week. We divided 69 patients (age range 60 to 82 years) into three groups depending on their clinic pressures, i.e. patients with isolated systolic, systo-diastolic or diastolic hypertension. Non invasive 24 h pressure ambulatory monitoring was performed in each subject using a Takeda recorder TM 2420 and adopting a protocol for single measurements at 15 minutes intervals between 08.00 and 20.00 (daytime measurements) and 30 minutes intervals between 20.00 and 08.00 (night-time measurements). Ambulatory monitoring with less than 60 recordings, and those where measurements were not taken for over 60 minutes during the day or 90 minutes during the night were excluded from the study, and the mean daytime and 24 h pressure load was calculated. Monitoring conducted in 60 subjects (39 males and 21 females) was considered valid. Statistical analysis of the mean arterial pressure values of each subject determined by the two methods was performed using a t-test.(ABSTRACT TRUNCATED AT 250 WORDS)

The Calcitonin Gene-Related Peptide (CGRP) is a 37 aminoacid peptide displaying about 50% homology with amylin which is secreted from the pancreatic islets of Langerhans. The main form, the beta-CGRP, is produced by the enteric nervous system and perivascular nerves of the vasa vasorum. It represents the most powerful vasodilator yet discovered but its role is not yet completely clarified. Recently it has been implicated in the control of regional blood flow and some authors have hypothesized its role in the development of Non Insulin Dependent Diabetes Mellitus (NIDDM). CGRP and amylin seem to inhibit the release of insulin from beta-cells and to play a role in local paracrine control of insulin secretion. In addition it is also shown to decrease the uptake of glucose by striated muscle. This has led to the suggestion that CGRP might be a circulating hormone implicated in the regulation of peripheral insulin sensitivity. In this review we examine the possible role of CGRP in the development of peripheral insulin resistance and altered insulin secretion which is characteristic of NIDDM.