[Aneurysm of the hepatic artery. Case report and review of the literature]. / L'aneurisma dell'arteria epatica. Case report e revisione della letteratura.

Hepatic artery aneurysms (HAAs) are considered rare even though their reports in the literature are becoming more and more frequent. The great improvement in the diagnosis of vascular diseases and the increasing incidence of atherosclerosis have resulted in a wider recognition of these pathologies. Differently from other splanchnic locations HAAs have a high risk of rupture (up to 80%) so that an aggressive treatment is required. Different therapeutic options are currently available: simple ligation of the artery, aneurysm excision and vascular reconstruction, transcatheter embolization. However, the therapeutic choice must be evaluated in each single case, depending on the size, aspect and locations of the aneurysm, and requiring an accurate study of the collateral vascular supply. Finally, since additional aneurysms in other sites are frequent, a dose follow up of these patients is recommended.

[A new inclusion complex of silibinin and beta-cyclodextrins: in vitro dissolution kinetics and in vivo absorption in comparison with traditional formulations]. / Nuovo complesso di inclusione tra la silibina e la beta-ciclodestrina: velocità di dissoluzione in vitro e assorbimento in vivo in confronto a formulazioni tradizionali.

The very low bioavailability of silybinin, the main constituent of silymarin, so far prevented the development of an oral pharmaceutical specialty based on this active ingredient. To overcome this difficulty, an inclusion complex between Silybinin and beta-Cyclodextrin was prepared. The new complex was compared in vitro tests (dissolution rate) and in a in vivo test (rat bile elimination) with silybinin, silymarin and one traditional formulation based on silybinin. The results show a dramatic increase in the dissolution rate of the complex (> 90% within 5 min) respect to the silybinin that confirm to be practically insoluble (< 5%). The in vivo results agree with the dissolution rates; after administration of the silybinin complex p.o., the silybinin concentration in the rat bile was near 20 times more than after administration of silybinin as is or in a traditional formulation. In the last two cases, the silybinin concentration was even 6 times less than after administration of the same amount of silymarin. These data show that the beta-CD complex solved the problem of the bioavailability of silybinin which, in the traditional formulation utilised as reference, proved to be not bioavailable.

[Intestinal obstruction in colorectal neoplasms. Our experience with 50 cases]. / L'occlusione intestinale nelle neoplasie del colon-retto. Esperienza su 50 casi.

From January 1985 to December 1989 in our Department 178 patients were operated for colorectal carcinomas. Fifty (28%) underwent emergency procedure for intestinal obstruction. The male-female ratio is about 1. The mean age is 79.6 (range 40-91), but 76% of patients is 60-85 years old. The rectum-sigmoid junction was the most affected (30%), followed by the rectum (18%) and the sigma (16%). Thirty-five (70%) patients underwent intestinal resection. The early postoperative death rate is 18% (9 cases). All the patients operated upon had Dukes stage B-C neoplasms.

Mass spectrometric identification of urinary and plasma metabolites of 2-(6'-carboxyhexyl)-3-n-hexylcyclohexylamine, a new antiaggregating agent.

The compound IBI-P-05006, 2-(6'-carboxyhexyl)-3-n-hexylcyclohexylamine, is an antiaggregating agent under development. IBI-P-05006 is an in vitro inhibitor of platelet aggregation. The biotransformation of this compound has been studied in the dog and rat. We present here a study on the metabolites of IBI-P-05006 found in dog and rat urine, and in dog plasma. Analyses were done by gas chromatography-mass spectrometry. In dog urine 15 metabolites were identified. Some of them were also found in dog plasma and in rat urine. The unmetabolized drug was found only in plasma. 10 different hydroxylated metabolites were characterized. The hydroxyl groups were introduced in the hexyl chain in positions omega-4, omega-3, omega-2, omega-1 and omega.

Mass spectrometric identification of urinary and plasma metabolites of 6-(6'-carboxyhexyl)-7-n-hexyl-1,3-diazaspiro-[4-4]-nonan-2,4-dione, a new cytoprotective agent.

The compound IBI-P-01028, or R,S-cis-6-(6'-carboxyhexyl)-7-trans-n-hexyl-1,3-diazaspiro-[4-4]-nona n-2,4- dione, is a new cytoprotective agent under development. To study the metabolites of this compound in laboratory animals, we administered it to dogs and rats, and analyzed extracts from dog and rat urine, and from dog plasma, by GC-MS. The metabolic profiles were different in the rat and dog. In the dog (plasma and urine), one metabolite was found, and in the rat urine two other metabolites were found. The unmetabolized drug was found only in the dog plasma and urine.

Nonprotein sulfhydryls as possible components of the protective effect of rosaprostol on the rat gastric mucosa.

Experiments were designed to examine the possibility that nonprotein sulfhydryl groups of the gastric mucosa could participate in the protection of rat gastric mucosa by rosaprostol (the Na salt of 9-hydroxy-8,12 trans-19,20-bis-nor-prostanoic acid). Gastric mucosal lesions and the content of nonprotein sulfhydryls were evaluated after orally administered absolute ethanol. Pretreatment with rosaprostol by gavage prevented gastric lesions and reduced or prevented the decrease of mucosal nonprotein thiols. N-ethylmaleimide, a sulfhydryl blocker, worsened the ethanol-induced gastric lesions and lowered further the non protein thiols. Both variables were improved by the PG analogue and by PGE2. These results suggest a possible role of endogenous nonprotein sulfhydryl groups in the gastric protective effect of rosaprostol.

[Teleconsulting and telediagnosis in emergency surgery]. / Teleconsulenza e telediagnosi in chirurgia d'urgenza.

A colour video picture transmission system in real time with data transmission via a broad wave optical fibre cable has been set up to link Turin University's Orthopaedic Traumatology Centre and Emergency Surgery Clinic. The system consists of two stations. The transmitter station is equipped with a mobile TV camera or TV monitor and various electrical medical equipment. The receiving station consists of a picture reception monitor. The coded video signal is transmitted via the optical fibre; sound transmission is via a special telephone line. This experimental system was set up to see if patients with multiple injuries could receive diagnosis at a distance, thus avoiding unnecessary travelling. Experience of 100 link-ups has demonstrated that the system effectively cuts diagnosis and therapy times and is as efficient as in loco inspection by a surgeon. In addition it can be used to provide specialised consulting services to rural hospitals without special equipment. This reduces waiting times for emergency treatment and can also prevent the pointless transfer of patients to big hospitals in cases where the specialist can prescribe intermediate therapy or surgery.

[Diagnostic and prognostic value of the carcinoembryonic antigen in colonic cancer]. / Valore diagnostico e prognostico del CEA nel carcinoma del colon.

A group of 50 patients operated for carcinoma of the colon in June 1980-December 1981 with a follow-up period of min. 2 months-max. 15 months is presented. C.E.A. measurements were taken in all patients pre and post-operatively and then every 2 months in an attempt to establish its diagnostic and prognostic value. In immediate diagnostic and prognostic terms, pre-operative C.E.A. appears to be insignificant. However both pre-operative C.E.A. and C.E.A. at a distance of 6 months were found to be reliable for long term (max. 15 months) prognosis.

[Clinical use of a minicomputer in the evaluation of chemico-clinical parameters in the diagnosis of hepato-biliary-pancreatic diseases of surgical significance. 3 methods compared]. / L'uso clinico di un minicomputer per la valutazione di alcuni parametri chimico-clinici nella diagnostica delle malattie epato-bilio-pancreatiche di interesse chirurgico. Tre metodi a confronto.

Bayes theorem; multivariance analysis, and the discriminating function of Mahalanobis applied to sixteen laboratory examinations employed in the diagnosis of diseases of the extrahepatic bile ducts and pancreas gave the following results: 1) the weight of each test was first measured in general terms, and then with regard to different levels of differentiation, with a classification in decreasing order in each case; 2) little redundancy was noted, and few examinations were of relatively negligible importance; furthermore, combinations of several tests did not lead to positive results; 3) reclassification according to the formula of Bayes and by means of the discriminating function proved sound supports for clinical decision, since they provided 70% and 80% of exact classification respectively; 4) the importance of the minicomputer in the construction of experimental diagnostic models was substantiated.

[Computerized methods in the diagnosis and prognosis of surgically treated bilio-pancreatic diseases]. / Metodi computerizzati per la diagnosi e la prognosi delle malattie bilio-pancreatiche di interesse chirurgico.

Multivaried and trend analyses were applied to a set of 27 periodic haematochemical checks on 37 patients given surgery for biliopancreatic pathology. Preoperative and postoperative data were separately analysed. The software employed was specially designed for the purpose. The discriminating function was used in the preoperative period to establish the best moment for diagnosis, which turns out to be 5 days after admission to hospital. Variance and regression analyses were used for short term prognosis by calculating survival chances. In one case the prognosis turned out to be distinctly inaccurate.

Gastric antisecretory, antiulcer and cytoprotective properties of 9-hydroxy-19,20-bis-nor-prostanoic acid in experimental animals.

9-Hydroxy-19,20-bis-nor-prostanoic acid (IBI-C83) was evaluated on gastric acid secretion and gastric lesions induced in laboratory animals by a variety of experimental conditions: compound IBI-C83 is proved effective in decreasing basal, histamine- and pentagastrin-stimulated total acid output in rats and in pentagastrin perfused dogs. The concentration of N-acetylneuraminic acid in the gastric fluid, a marker of mucus secretion, is enhanced in rats by IBI-C83. This drug prevents gastric damage induced by non-steroidal antiinflammatory compounds such as acetylsalicylic acid, indometacin and phenylbutazone, gastric ulcers following pylorus ligation, and facilitates healing of the gastric ulcers evoked by subserosal injection of acetic acid. A prominent feature of IBI-C83 is its capacity to protect the rat from gastric damage elicited by necrotizing agents such as absolute ethanol, hydrochloric acid and hypertonic saline. This property, called "cytoprotection" and common to naturally occuring prostaglandins, is independent on the antisecretory activity of IBI-C83 and is not shared, at least in the reported experimental models, by the H2-receptor antagonist cimetidine. In spite of the prostaglandin-like properties displayed in its cytoprotective activity, compound IBI-C83 does not affect cardiovascular functions, gastrointestinal transit and uterine motility.