High-dose epirubicin in the prophylactic treatment of T1G2 superficial bladder tumors.

OBJECTIVES: To evaluate the activity and safety of intravesical instillations of 80 mg epirubicin in a selected patient population with T1G2 primary and multiple superficial bladder tumors. To assess the completeness of the transurethral resection (TUR) at 4 weeks (second look) and to compare the histology of local and review pathology. METHODS: One hundred and sixty-nine patients have been histologically assessed both locally and extramurally for T1G2 superficial bladder tumors. Epirubicin (80 mg/instillation) started within 20 days after TUR was administered weekly during the first month and then monthly for another 11 months. Assessments for relapse were carried out according to the standard methods. RESULTS: Histological consistency for T1G2 between local and extramural assessments was found in 85.2% of cases. At the median follow-up time of 38 months, the overall relapse rate was 43.3%. Treatment was very well tolerated: no systemic adverse events were reported and local adverse events were confined to chemical cystitis which in 3% required treatment discontinuation. CONCLUSIONS: Epirubicin (80 mg/instillation) appeared effective in the prophylaxis of relapse in primary and multiple T1G2 superficial bladder tumors. A second TUR at 3-4 weeks is necessary in T1 tumors. Excellent concordance between local and review pathology was found.

[Extrinsic ureteral endometriosis: diagnostic laparoscopic contribution]. / Endometriosi ureterale estrinseca: contributo diagnostico laparoscopico.

A case of extrinsic ureteral endometriosis diagnosed with laparoscopy is described. Endometriosis, a common disease in premenopausal women, should be considered in differential diagnosis in patients with ureteral obstruction. Usually, the diagnosis of ureteral involvement is made at surgery. Laparoscopy is, therefore, an important diagnostic aid in women with distal ureteral obstruction not attributable to calculous.

Ano-rectal manometry as an evaluating test for impaired ano-rectal function in diabetes mellitus.

Diarrhea and/or rectal incontinence may represent a sign of autonomic neuropathy in diabetes. The present investigation was performed to study ano-rectal function and reactivity to appropriate stimuli in 20 diabetic patients with or without autonomic neuropathy (14 insulin-dependent diabetics; 6 non-insulin-dependent diabetics; mean age 39.2 years; mean duration of diabetes 12.6). Twenty-five healthy subjects (mean age 43.5 years) were studied as controls. All subjects underwent ano-rectal manometry by means of special open-ended-tip catheters connected with a 6-channel polygraph. A rectal latex balloon was inflated with 30 or 60 ml air to induce a stimulus which, under normal conditions, is apt to relax the internal sphincter and to contract the external one (ano-rectal inhibitory reflex). Eleven diabetics had symptoms and signs of autonomic neuropathy: 8 of these (73%) showed marked abnormalities of ano-rectal function (i.e. no response even to maximum stimulus or contraction of both sphincters). All non-neuropathic patients showed a normal pattern of ano-rectal manometry. A relationship between abnormal response to rectal stimulation and the presence of autonomic neuropathy involving the pelvic parasympathetic section or regional intramural plexuses may be suspected and demonstrated in diabetic neuropathic patients.

A follow-up of the protein pattern after operations in patients treated with an oral enzyme.

The sera of 32 patients have been studied in order to assess the behaviour of the main proteins, which could be identified with a two-dimensional electrophoresis, after operation. 20 of them were given an oral enzyme preparation of trypsin/chymotrypsin (Chymoral 100/F); the others were given no therapy. The analysis was performed comparing the relative concentration of 17 proteins in the pre-operative phase and the fifth day after the operation. Some variations known already and induced by this therapy (like the increase of alpha-1-antitrypsin), have been confirmed, but it has also been demonstrated, in the patients treated with Chymoral, a clear reduction of the constant loss of albumin and pre-albumin, which occurs after an operation.

[Use of a new selective stain for demonstrating the vagal fibers in gastric surgery. Experimental study]. / L'impiego di un nuovo colorante selettivo per evidenziare le fibre vagali nella chirurgia gastrica. Studio sperimentale.

Scalar concentrations (0.4%-0.2%-0.1%-0.05%) of methylene blue in a 7.02% ascorbic acid solution have been used in animals and humans for visualizing vagal branches at gastric level. These solutions constitute a simplified variation of Lee's test and the most effective for determining vagal fibres proved to be the 0.1% concentration.

Changes in the lung alveolar proteins in some experimental conditions.

The Authors have directed their research to the alveolar lining (the surfactant) proteins and they have particularly studied its alterations in shock pathological conditions. Some rats have been subjected to haemorrhagic and toxic shock, by Escherichia Coli's lipopolysaccharide; then lung washing has been performed and on extracted liquid proteins have been studied by two-dimensional immunoelectrophoresis (TDI). The obtained data have been encouraging and very useful for studies process.

The proteins of the lung alveolar lining.

The protein composition of the lung washing has been analysed by immunochemical methods: it has been possible to demonstrate the presence of many proteins, mainly albumin, immunoglobulins and beta-globulins, some of them seem laying in the alveolar lining and having the function of stabilizing the surfactant system.