Combined experimental and numerical analysis of the flow structure into the left ventricle.

Fluid dynamics is used for diagnosis in cardiology only to a partial extent. Indeed several aspects of cardiac flows and their relation with pathophysiology are unknown. The flow that develops into the left ventricle is here studied by using a combination of numerical and experimental models. The former allows a detailed three-dimensional analysis, the latter can be used in conditions, like in presence of turbulence, that are out of reach of the current computational power. The three-dimensional flow dynamics is analyzed in terms of its vortical structure. The study, within its limitations, provides further physical understanding about the intraventricular flow structure. This could eventually support the development of cardiac diagnostic indicators based on fluid dynamics.

[Impact of laparoscopy on the management of adrenal diseases. A retrospective study of 220 patients]. / Evolution de la prise en charge de la pathologie surrénalienne depuis l'avènement de la laparoscopie. Une étude rétrospective de 220 patients.

OBJECTIVE: Soon after its introduction in 1992, laparoscopic adrenalectomy became the gold standard in the surgical management of most adrenal tumors. The aim of this study was to assess the influence of laparoscopy on surgical indications. PATIENTS AND METHODS: Between 1994 and 2003, 220 adrenalectomies were performed, 179 among them by a laparoscopic approach. There were 137 females and 83 males. The mean age was 53 years (range 15-83 years). RESULTS: The indications of adrenalectomy were: Cushing syndrome 18%, pheochromocytoma 31%, Conn syndrome 16%, incidentaloma 21%, and malignant tumours 13%. Laparoscopic approach was performed in 81% of the cases and the conversion rate was 11%. There were 3 postoperative deaths (2 after laparoscopy). The mean hospital stay was 7.6 days in the laparoscopic group, and 13.6 days in the open surgery group. CONCLUSIONS: This study is consistent with the findings of the literature supporting that there are no indications for the open procedure in case of small benign lesions. The video-asisted adrenalectomy had not changed the management of the adrenal incidentaloma. Today, the laparoscopic approach seems to be adapted also for malignant disease.

Lack of influence of sulglycotide on naproxen bioavailability in healthy volunteers.

We explored the bioavailability and kinetics of naproxen (N) in 12 healthy volunteers treated orally with single doses of 500 mg and retreated after a washout period with the same dose of N plus sulglycotide (S) 200 mg. Naproxen blood levels were measured by high-performance liquid chromatography (HPLC) in samples collected at 0.5, 1, 2, 4, 8, 12, and 24 h of dosing with N or with N + S. No statistically significant difference in terms of naproxen blood levels emerged as the product was administered alone or concurrently with sulglycotide. Peak plasma concentrations and AUC values were 71 +/- 3.16 micrograms/ml and 685 +/- 27 micrograms/ml/h, respectively for N alone, and 72.5 +/- 2.85 micrograms/ml and 651 +/- 28 micrograms/ml/h, respectively for N + S. The difference was not significant. Similarly, the kinetic behavior of naproxen was not modified by the simultaneous presence of sulglycotide, as shown by the t1/2 beta-values obtained with N alone (8.39 +/- 0.31 h) and with N + S (7.93 +/- 0.30 h), and likewise by the distribution volumes at equilibrium (7.63 +/- 0.42 and 7.9 +/- 0.38, respectively), Cmax (63.3 +/- 2.86 and 60.4 +/- 2.9 micrograms/ml, respectively) and tmax (0.95 +/- 0.06 and 1.10 +/- 0.10 h, respectively). From these findings it seems legitimate to claim that sulglycotide can be administered concurrently with naproxen to prevent possible gastric injury by the anti-inflammatory agent thanks to its wellknown antiulcer and cytoprotective activity on the gastric mucosa, without any undue interference with the absorption (hence effectiveness) of naproxen.

Lack of effect of a single-dose of sulglicotide on the bioavailability of diclofenac.

The bioavailability of diclofenac (D) was assessed in 12 healthy volunteers treated orally with single doses of 100 mg (retard formulation) and subsequently retreated with the same dose of (D) plus sulglicotide (S) 200 mg. (D) blood levels were measured by GLC in samples collected after 1, 2, 4, 6, 8, 12, 24 h. No relevant difference was seen in (D) bioavailability after (S) administration; after 8 h plasma levels of (D) were slightly higher after (S) (p less than 0.05), but this difference can be considered incidental only. Thus, sulglicotide does not interfere with the bioavailability of diclofenac, and can be administered concurrently with the latter to prevent possible gastric injury by the antiinflammatory drug.

Protective effect of sulglycotide on human gastric mucosa exposed to taurocholic acid.

Sulglycotide is a non-systemic drug used in the treatment of peptic ulcer. It seems also to possess cytoprotective action. A double-blind cross-over study on the influence of oral sulglycotide on gastric mucosal cell loss induced by taurocholic acid (20 mM + HCl 7mM in 100 ml normal saline) was carried out in sixteen healthy volunteers by means of the DNA-loss technique. Each subject received either sulglycotide (400 mg thrice daily) or a placebo in random order on the basis of a double-blind cross-over design. Sulglycotide appeared to reduce the gastric cell loss induced by taurocholic acid. These results can explain the therapeutic effect of sulglycotide in peptic disease.

Correlation between lowered PgE2 levels and alkaline reflux gastritis in patients subjected to Billroth II. Pylorogastrectomy: possible improvement with sulglycotide.

In patients subjected to pylorogastrectomy with anterior gastroenterostomy (Billroth's operation II) the remaining gastric mucosa is exposed to the damaging action of bile with consequent reduction of locally generated prostaglandins. The purpose of the present study was to explore the correlation between PgE2 levels in such postgastrectomy patients before and after treatment with sulglycotide. Twelve patients with clinical, endoscopic and histological evidence of alkaline reflux gastritis were treated with sulglycotide in daily doses of 1600 mg for 30 days. At termination there was a definite clinical, endoscopic and histological improvement with significant (p less than 0.001) increase of PgE2 levels.