Cranial osteolytic metastases as the only recurrence of gastric carcinoma.

The purpose of this case report is to increase the knowledge about bone metastatic pattern in gastric cancer. A 59-year-old man presented with headache three years after a total gastrectomy for signet-ring cell carcinoma. Head computed tomography and magnetic resonance imaging showed multiple osteolytic lesions of the cranial vault and base, consistent with metastatic or haematological disease. Bone scintigraphy confirmed areas of accumulation only in the skull. An extensive search didn't show any other tumor. Bone biopsy revealed metastatic signet-ring cell carcinoma. In gastric cancer, bone metastases are generally associated with metastases in lymph nodes, liver, and lung, and have a higher frequency in the thoracolumbar spine. However, cranial bone metastases presenting with headache may be the only manifestation of gastric cancer recurrence.

Peripheral neuropathy associated with ischemic vascular disease of the lower limbs.

This paper deals with the possible identification of somatic and autonomic nerve damage in patients with peripheral obliterative arterial disease (POAD) at different stages of the disease, with a well-reproducible technique like electroneurographic evaluation of nerve conduction. In 64 patients with intermittent claudication, 19 patients with pain at rest, and 7 patients with trophic ulcers, electroneurographic evaluation of motor (tibial and peroneal) and sensory (superficial peroneal and sural) nerve conduction was performed. The median nerve (motor and sensory) was used as control. A severe impairment of sural and superficial peroneal nerve velocities was evident in many claudicant patients and in all patients with pain at rest and trophic ulcers, with a progression in the conduction abnormalities in advanced stages of the disease. Motor nerve conduction showed only minor reductions in patients with claudication and pain at rest, although some of them did show very poor velocity values. In 21 patients with intermittent claudication and sensory nerve abnormalities, the autonomic fibers activity, evaluated by the skin sympathetic response (SSR) test, was significantly depressed, thus suggesting an involvement of the local autonomic system in the ischemic disease. A correlation exists between the severity of the somatic nerve damage and the stage of the vascular insufficiency. However, in the group of claudicant patients, the evidence of similar ischemic threshold (claudication distance) may be associated with a marked difference in the amount of somatic nerve damage. The somatic and autonomic nerve alterations may play a relevant role in the progression of the disease toward critical limb ischemia.

Inhibition of neutrophil function in vitro by nimesulide. Preliminary evidence of an adenosine-mediated mechanism.

Nimesulide (CAS 51803-78-2) is a methane sulphoanilide derivative provided with specific anti-inflammatory activity. In human polymorphonuclear leucocytes (PMNs), the activity of nimesulide has been suggested to be based on the inhibition of the oxidative burst. However, the effect of the compound on PMNs function seems to be very complex. In order to give a major insight into the mechanism of action of nimesulide, the effect of the drug was studied in vitro on human PMNs functions, such as free radical generation and enzyme release, and on cytosolic free calcium levels, following the activation with specific stimuli. Moreover, the hypothesis that nimesulide could act by interfering with the adenosine cell receptor system was also evaluated. Nimesulide (1-50 mumol/l showed a dose-dependent inhibitory activity on superoxide anion and chemiluminescence production from PMNs stimulated with the oligopeptide fMLP, the ionophore A23187, and the phorbol ester PMA. Enzyme release was significantly reduced, when fMLP and A23187 represented the stimulating agents, while no effect at all was observed with PMA. Studies with the fluorescent calcium chelating dye FURA 2/AM showed that nimesulide was able to reduce free cytosolic calcium increase produced by fMLP and the ionophore ionomycin. The preincubation of cells with the specific adenosine receptor antagonist theophylline was able to significantly reverse the inhibitory activity of nimesulide, either on free radical production and enzyme release, and on free cytosolic calcium increase sustained by fMLP and the ionophores.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in the levels of growth hormones, insulin, cortisol, thyroxine and somatomedin-C/IGF-1, with increasing gestational age in the fetal pig, and the effect of thyroidectomy in utero.

1. Blood samples were taken from 30 chronically catheterized pig fetuses in utero. Levels of growth hormone, insulin, cortisol, thyroxine and somatomedin-C/IGF-1 were measured in the plasma of intact fetuses and the plasma of thyroidectomized fetuses at various gestational ages during the latter part of pregnancy. 2. Growth hormone levels were high (mean +/- SEM: 83 +/- 9 ng/ml and remained constant throughout this period. 3. Insulin levels were also constant and ranged between 4 and 14 mU/l. 4. Cortisol levels showed a general increase from 400 nmol/l at 97 days to 1200 nmol/l at term and this increase was not affected by thyroidectomy. 5. IGF-1 levels were lower than in the sows (48.0 +/- 3.0 ng/ml) and did not change throughout this period. 6. Thyroxine levels were also unchanged at about 92 +/- 4 nmol/l. 7. Thyroidectomy resulted in lower (P less than 0.001) thyroxine levels (28 +/- 3 nmol/l) but had no effect on the levels of any other hormone.

Effect of haemorrhage on plasma lysine vasopressin and the cardiovascular responses to vasopressin in the pig fetus.

The effect of haemorrhage on plasma lysine vasopressin concentrations and the cardiovascular effects of intravenous injections of synthetic lysine vasopressin were studied in twenty-four chronically catheterized pig fetuses aged between 81 and 114 d gestation (term = 114 +/- 1 d). Removal of 15-20% of the estimated blood volume reduced mean arterial blood pressure and elevated plasma vasopressin concentrations above the mean basal value of 2.2 +/- 0.3 muu./ml. The vasopressin concentration in plasma of fetuses younger than 104 d was insignificantly affected at 30 and 60 min after the bleed, whereas the corresponding values in older fetuses were raised by 12.7 +/- 7.2 muu./ml (d.f. = 7) and 16.0 +/- 6.0 muu./ml (d.f. = 7) respectively. The pituitary concentration of vasopressin was also greater towards the end of gestation. Plasma osmolality was unaffected by fetal blood loss. Maternal concentrations of vasopressin did not change from the basal values of 1.0 +/- 0.1 muu./ml (d.f. = 16). Injection of vasopressin raised fetal blood pressure and decreased heart rate. These results demonstrate that lysine vasopressin is present in the circulation of the pig fetus at 81 d (0.72 gestation), and that near term fetuses respond to haemorrhage more rapidly, and to a greater degree than younger fetuses.