Circadian variations of plasma somatostatin levels in healthy subjects.

The plasma levels of somatostatin-like immunoreactivity, growth hormone and insulin were measured using a RIA method in healthy volunteers every 4h during the day and every 2h at night, without waking the subjects. In the waking state the fluctuation of plasma somatostatin-like immunoreactivity level only occurred near to meal time. A marked episodic surge of plasma SLI (peak value, 127.25 +/- 4.40 pg/ml (mean +/- ES)) was noted at 0200 in the initial period of slow wave sleep (SWS) 2h after the peak of GH. Insulin showed no sharp peak and its pattern was unrelated to other two hormones studied. A positive correlation was observed between SLI and GH in plasma using the mean cosinor method: the acrophase of SLI was at 0018 about 1h later than GH (at 2315). The acrophase of insulin occurred at 1525, significantly different as compared with the previous two. From these findings, it is concluded that SLI in peripheral plasma fluctuates with a significant circadian rhythm and a nychthemeral maxima as GH and that, whatever its source, that it is related to plasma GH and not to plasma insulin.

Left ventricular diastolic filling improvement obtained by intravenous verapamil in mild to moderate essential hypertension: a complex effect.

In order to try and evaluate through what prevailing mechanism verapamil (V) can induce an improvement in left ventricular (LV) diastolic early filling in mild to moderate essential hypertension, 43 properly classified essential hypertensives, aged 41-74 years (mean age 58.1 +/- 10.3), and 20 age-matched normotensives were studied. All subjects underwent both echocardiographic evaluation and 99mTc radionuclide angiocardiography in basal conditions between 8.00 a.m. and noon, after an overnight rest. In essential hypertensives gated equilibrium angiocardiography was repeated 3 and 30 min after i.v. V (0.1-mg/kg bolus, followed by 0.005 mg/kg/min for the period of radionuclide data acquisition). Simultaneously, supine arterial pressure was measured with a cuff manometer. In 36 essential hypertensives a phono-echo evaluation was obtained, both at 3 and 30 min after V, deriving a LV isovolumetric relaxation index (IRTI). Among diastolic early filling indices, we particularly considered the ratio of peak filling rate (PFR) to peak ejection rate (PER) in order to take into account the interaction of systolic performance with LV relaxation and diastolic early filling. Three minutes after V the increase in PFR (from 2.47 +/- 0.5 to 3.04 +/- 0.8 EDV/s, p less than 0.001) and the upwards tendency of PFR/PER were coupled with the enhancement in ejection fraction (from 61.1 +/- 13.3 to 63.9 +/- 13.8%, p less than 0.001) and heart rate (from 70.3 +/- 12.6 to 77.7 +/- 12.2 b/min, p less than 0.001) and with the reduction in mean arterial pressure (from 122 +/- 16 to 107 +/- 14 mm Hg, p less than 0.001), systemic arterial resistance index (from 3,234 +/- 968 to 2,432 +/- 678 dyn s cm-5 m2, p less than 0.001) and end-systolic volume index (from 32.9 +/- 17.1 to 31.5 +/- 18.3 ml/m2, p less than 0.02). On the contrary, 30 min after V, when systolic indices, heart rate, mean arterial pressure and systemic arterial resistance index had returned towards baseline values, PFR/PER showed a persistent improvement when compared with basal values (0.71 +/- 0.12 vs. 0.63 +/- 0.08, p less than 0.005). No changes were observed in LV volumes and IRTI, either at 3 or 30 min. Moreover, also the pulmonary blood volume ratio was unchanged. A weak negative correlation was found between delta % of IRTI and delta % of PFR/PER 30 min after drug administration (r = 0.58, p less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)

Estimate of prevalence of glucose intolerance in chronic liver disease. Degree of agreement among some diagnostic criteria.

In patients with chronic liver disease, the reliability of various criteria generally used to diagnose impaired glucose tolerance and diabetes was evaluated. Twenty-one patients with chronic persistent hepatitis, 68 patients with chronic active hepatitis and 57 patients with liver cirrhosis were studied. All subjects underwent an oral glucose tolerance test (75 g). Impaired glucose tolerance and diabetes were diagnosed according to the criteria established by: the National Diabetes Study Group; Fajans and Conn; the European Diabetes Study Group; Deutsche Diabetes Gesellschaft; Kobberling & Creutzfeld criteria 1 and 2; Wilkerson; and the University Group Diabetes Program. The results obtained are in partial agreement with other reported data, showing a high prevalence of both impaired glucose tolerance and diabetes in chronic liver disease, with a positive correlation to the severity of hepatic involvement. However, our results show that the agreement among the criteria most frequently used for diagnosing impaired glucose tolerance and diabetes is still far from satisfactory.

Chemotherapy of primary and secondary liver cancer: is it useful?

The therapeutic efficacy of three different antiblastic regimens was tested in patients affected by primary or secondary liver cancer. The association of cyclophosphamide and adriamycin gave the best results, despite no partial remission observed with any treatment. As regards the efficacy of antiblastic therapy in this type of tumor, we must conclude that the only detectable effect is a transient improvement of the course of the disease.

[Reactivation of the allogenous component of experimental skin inflammation after exposure to ultraviolet rays]. / Riattivazione della componente algogena della flogosi cutanea sperimentale dopo esposizione a raggi ultravioletti.

The effects of U.V. radiation induced cutaneous erythema on an experimental inflammation focus in another part of the body have been studied. The skin inflammation caused by carbon dioxide snow was used as a model. The onset of erythema is followed by reactivation of the diminishing inflammation process. It is therefore deduced that such effects are transmitted humorally and that reactivation is caused by histamine circulation. Histamine is released locally from the U.V. induced erythema and, entering into the circulation, increased the permeability of the microvessels in the inflamed area. This sends inactive chemical mediators to the interstitial sector where the appropriate conditions for their activation exist.

[Reactivation of the algogenic component in experimental inflammation induced by histamine administration]. / Riattivazione della componente algogena nella flogosi sperimentalmente indotta dopo somministrazione di istamina.

The action of i.v. histamine on human skin inflammation experimentally induced with carbon dioxide snow in man is described. Histamine was injected when the skin reaction was on the wane to determine its possible reactivation of inflammation. Complete recrudescence of erythralgia was noted (reappearance of pain and of erythralgic halo, with a fresh spread of secondary hyperalgesia). It is felt that histamine was responsible. Its arrival to the reaction site through microvessels in a state of increased permeability during the remission of inflammation may be assumed to promote the passage of chemical mediators in the preactive stage from the vascular to the interstitial sector, and thus to pave the way for their activation.

Effects of calcitonin on limb blood vessels in human obstructive arterial disease.

To check the possibility of a vasoactive effect of calcitonin in man, the authors treated ten hospitalized patients (seven males and three females, mean age 66.3 +/- 3.24), suffering from obstructive arterial disease in the lower extremities, with 100 units M.R.C. i.m. daily, for a period of 15 days. Five patients presented Raynaud's phenomenon. Treatment (B) led to an improvement of subjective symptomatology and to the disappearance of Raynaud's phenomenon in comparison with symptoms before treatment (A) and after a placebo period of 15 days (C). With respect to instrumental parameters, calcitonin induced: a) a slight increase of segmental plethysmography values (height/width ratio of curves) if compared with A (p less than 0.05) and more significantly if compared with C (p less than 0.01 and less than 0.0125, from right and left sides, respectively); b) a small change in venous-occlusion plethysmography values, if compared with A and C, both in basal conditions and after the "ischaemic test"; c) a significantly lesser reduction of digital photoelectric plethysmography values (height/width ratio of curves) after the "cold test" in comparison with A (p less than 0.01, both on the second and on the third fingers of the right hand), as well as with C (p less than 0.01 and p less than 0.025, on the second and on the third fingers, respectively). The present investigation points out the vasoactive influence of calcitonin in human obstructive disease. Results show the improvement in collateral limb circulation and, above all, in the amount of cutaneous flow. Little information is available on the mechanism of this effect, for which only hypotheses can at present be advanced.