L'Ateneo parmense. Acta bio-medica : organo della Societa di medicina e scienze naturali di Parma最新文献

In this work we present a method which evaluates the facility of applying and reproducing ion fluxes in human cells using radioactive 22Na as a tracer. Intracellular sodium concentration, rate constants for total (oKNa TOT), ouabain-sensitive (oKNa OUABs) and ouabain-insensitive (oKNa OUABins), sodium efflux and relative effluxes obtained by multiplying the rate constant by the sodium concentration were measured in the red cells of 20 normal subjects. Our results have been shown to be comparable with those obtained in other reports and show a statistically significant relationship between intracellular sodium concentration and the rate constant for active sodium efflux: one would conclude that the intracellular sodium constant probably depends on the activity of the sodium pump genetically determined in each individual. Since such a method is precise can be exactly reproduced, it can be applied to the study of cellular metabolism of different clinical disorders characterized by significant fluid and electrolyte imbalances.

The working of the Na/K pump in the red cells of 6 patients with extensive burns was analyzed using radioactive substances with the aim of comparing their red cells with those of 20 normal subjects. In the red cells of patients with extensive burns was found that the intracellular sodium concentration was clearly increased, that the rate constant of ouabain-sensitive efflux diminished, and that the total sodium efflux was augmented by the increase of the ouabain-insensitive part. It is likely that the intra and extra-cellular transportation defects produce an accumulation of sodium inside the cell which succeeds in stimulating the activity of the pump. Although this pump is impaired, the high sodium concentration obtains a new steady state characterized by apparently normal ouabain-sensitive sodium efflux and by an increased ouabain insensitive efflux. The pathogenesis of these defects of cellular homeostasis which are linked to the presence of various complex mechanisms (shock, calorie balance, fluid and electrolyte imbalances, the circulation of "toxic substances" etc), in cases of extensive burns, has not been completely elucidated.

Obstructive lesions of the left common coronary trunk need surgery if our operability criteria: possibility of at least making a by-pass on the left descending anterior coronary branch and a not seriously compromised miocardial contractility exist. Of the 25 patients operated, there was a mortality of 8% and 3 intra-and post-operatory infarcts; two other patients died after some time (one for extracardiac causes). Other infarcts were not observed. 48% of the patients had incomplete riva-scolarization which after some time had an effect on the objective state of the patients but not on their survival. The authors conclude their studies by affirming that total surgical correction is indicated even on non susceptible patients on the basis of coronarography.

The Authors described a case of left hepatic artery aneurysm giving ris to haemobilia. A wide discussion is held on clinical and diagnostic aspects on this situation, often causing operations following each other, before that a correct surgical treatment is indicated. The patient underwent the left hepatic artery ligature, at present considered the choice method in the treatment of haemobilia following ruptured hepatic artery aneurysm.

The Authors describe four cases of chronic fistulous subphrenic abscess in abdominal and thoracic regions, which have come to their observation during the period of time between 1972-1979. The various locations of these abscess are being described together with the possible processes of formation, taking in to account, also for what emerges from literature, the silent course of the illness and the non specific characteristics concerning their symptomatology. Chronicity is a relatively rare condition and involves dangerous and prolonged exposures to the disease, any time the diagnosis is delayed. In the cases reported the first clinical symptoms of the abscess took place during a period of the ranging from 8 months to 6 years and 10 months after an operation. So one must think immediately to the disease when, even a long time after an operation on bile ducts or on gastroenteric canal, non specific clinical symptoms appear even though the clinical and radiological findings keep on being negative.

Our experience is based on 323 surgical operations on the mitral valve. Prosthetic valves were substituted in 308 patients and in 15 an anulo-valvulo-plastic operation. Mitral valve operation was associated with the correction of other heart lesions in 132 patients and in 197 patients, (objects of this study) surgery was carried out on the left atrio-ventricular valve. A detail report of the types of lesions found is made: 78 patients had massive calcification and 15 had a process of acute and subacute endocarditis. Mechanical prosthesis (Starr-Edwards 51; Björk-Shiley 77) were used 128 times and biologic prosthesis (Hancock 44; Carpentier-Edwards 7; Angell-Shiley) 54 times. Preference was given to the use of porcine prosthesis in patients presenting generic or specific controindications to anticoagulant therapy. Total mortality rate was 9,9% and in the last two years this fell to 5%. In our opinion, the sharp fall in mortality could be attributed to refined technic, better selection of cases, better myocardial protection consequent to the clinical use of cardioplegia and hypothermia.

Clinical studies were undertaken in our Department of Medical Clinic about the therapeutic effects of two associated beta-lactamines in various respiratory infections. 20 patients affected by acute and chronic bronchitis were treated with the following standard protocol: cefadroxil (500 mg) plus dicloxacillin (250 mg) were given simultaneously four times daily for 8 days. For the clinical evaluation of the therapeutic index of drugs, the following parameters were checked in all patients on admission and repeated at the end of treatment: subjective symptoms (dyspnea, cough), fever, WBC count, sedimentation rate, antistreptolysin titre, chest film and the functional indices of hepatic, renal, hemopoietic tissues. To study the pharmacokinetics we measured the amounts of drugs in the body fluids; plasma levels and urinary concentration were determined 6 hours after the first administration of drugs. Our observations show a synergism of action between the cefadroxil and dicloxacillin; the efficacy of this treatment is confirmed in the majority of the patients: 95% of patients affected by acute respiratory infections show a significant decrease in symptoms and 55% a complete recovery.

Lung function tests were examined on 28 welders using high chromium alloyed electrode for two years. Respiratory function change seem to be related to the duration of employment as welders. On the contrary, obstructive disease and alveolo-capillary impairment were found with same prevalence in groups of workers differently exposed to chromium. It presumably occurs because the exposure to chromium is quite short.

The effectiveness of Cimetidine in preventing complications, like acute pancreatitis and hemorrhagic gastritis, after operations on Vater papilla (ISP) is studied. In patients treated with Cimetidine the volume of nasogastric secretion was smaller and diastasemia and diastasuria treated values returned to the normal range earlier than in non-treated patients. In the latter group a case of pancreatitis and one of post-operative hemorrhagic gastritis were found. The treated patients, instead, did not suffer these complications. It was concluded that Cimetidine after IPS is useful, because it complies with the request that determined its employ.