Beneficial effect of enalapril in spontaneously hypertensive rats cardiac remodeling with nitric oxide synthesis blockade.

AIMS: To study the efficiency of an angiotensin converting enzyme inhibitor on the blood pressure (BP) and the myocardium remodeling when spontaneously hypertensive rats (SHRs) are submitted to nitric oxide synthesis (NOs) blockade (with L-NAME) and simultaneously treated. METHODS: Young adult male SHRs were separated in four groups (n = 5) and treated for 20 days: Control, L-NAME, L-NAME+Enalapril, and Enalapril. The alterations of the BP, heart mass/body mass ratio and stereological parameters for myocytes, connective tissue and intramyocardial vessels were studied among the groups. RESULTS: The SHRs with NOs blockade showed a great modification of the myocardium with extensive areas of reparative and interstitial fibrosis and accentuated hypertrophy of the cardiac myocytes (cross sectional area 60% higher in animals taking L-NAME than in Control SHRs). Comparing the SHRs with NO deficiency (L-NAME group), the Control SHRs and the Enalapril treated SHRs significant differences were found in the BP and in all stereological parameters. The NO deficiency caused an important BP increment in SHRs that was partially attenuated by Enalapril. This Enalapril effect was more pronounced in Control SHRs. A significant increment of the intramyocardial vessels was observed in NO deficient SHRs and Control SHRs treated with Enalapril demonstrated by the stereology (greater microvascular densities in treated SHRs). CONCLUSION: Enalapril administration showed a beneficial effect on vascular remodeling and myocardial hypertrophy in SHRs. In SHRs with NO blockade, however, the beneficial effect of Enalapril occurred only in vascular remodeling.

[Use of anal dilators in the conservative therapy of anal rhagades]. / L'uso dei dilatatori anali nella terapia conservativa della ragade anale.

The AA. refer their results in the treatment of anal fissure, using surgical and conservative methods. In their experience, internal lateral sphincterotomy, according to the literature, is the best treatment. The use of anal dilators is effective, but it always needs the patient's compliance.

[Thromboembolectomy by Fogarty's catheter (experience in 416 interventions)]. / La tromboembolectomia mediante catetere di Fogarty (esperienza su 416 interventi).

Thrombo-embolectomy by means of a Fogarty balloon catheter became part of routine surgical practice more than twenty years ago with a standardized method and technique. The authors report on a surgical population spread over ten years' activity (1975-1985) in the Institute of Surgical Pathology of the University of Verona with records of 416 emergency operations to remove thrombo-embolisms. Owing to its lack of operative mortality and the minimal trauma it causes, the technique is now strongly indicated and widely used. On the basis of their experience, however, the authors stress the need to adhere to certain basic principles: early recognition of the disease (within 12 hours); early anticoagulation of patients; immediate surgery. It is only by adopting such a policy that better results may be obtained in future and the number of amputations reduced.

[Calcitonin test]. / Test della calcitonina.

Considering that the Calcitonin is one of the main therapeutic means in the senile Osteoporosis, the authors go over and over the necessity of a simple diagnostic test in order to point out the sensitiveness and resistance to the drug in subjects suffering from this pathology. After a single subministration of the drug to the subjects suffering from Osteoporosis at a high turn-over, it has been considered as sensitive at the therapeutic effect. Subjects in whom, a lowering of the calcemia under 0.3 mEq/1 was obtained within ten hours since the drug had been given.

[Current state of sympathectomy in peripheral reconstructive surgery]. / Attualità della simpaticectomia nella chirurgia ricostruttiva periferica.

The Authors present the results got regarding operations of sympathectomy together with operations of distal by-pass at the Institute of Surgical Pathology of the University of Verona from 1979 to 1983. Among the 106 cases, in 58 (55%) sympathectomy was performed with a aorto-bifemoral or iliac-femoral by-pass at the same time, in 48 (45%) pas performed with more distal by-pass. At follow-up in the 72% of the cases a clinical improvement as been noticed, in the 14.5% of the cases a steady result as been found, and in the 12.6% of the cases an aggravation of the situation. Furthermore the clinical stage of the disease (according to Fountain) as been compared with the operation. The Authors concluded that the sympathectomy carried out together with other vascular surgical operations is still a good procedure if the patients are within 70 years of age, no diabetics and pith a sufficient perfusion pressure of the ankle. Moreover, paradoxically, the sympathectomy is much more useful on stage II or III than on stage IV.

Skeletal changes in a case of Goltz's syndrome (focal dermal hypoplasia).

Goltz's syndrome (focal dermal hypoplasia) is a rare congenital disease only 50 cases of which have been recorded in the literature. Complex changes in the skin and the skeleton occur in this disease. Although the bone changes have been described in nearly all reported cases, these have only been reported in the orthopaedic literature in one case (Lynch, 1981) in which the disease was accompanied by an aneurysmal bone cyst in the pelvis. The disease is hereditary but is not sex-linked, although all the reported cases have been female. This is because the disease is lethal in males during gestation (Gorlin et al., 1963). The case reported by us, however, brought her pregnancy to term and gave birth to a male infant with no malformations either of the bones or the skin.

[Bloodless treatment of fractures of the clavicle using O-shaped soft bandages]. / Il trattamento incruento delle fratture di clavicola con bendaggio soffice ad O (BSO).

The authors, on the basis of the clinico-radiographic revieping of 45 patients suffering from clavicle fracture and treated through "O"-shaped soft bandage, state the results obtained: they particularly point out the advantages of such method in the fractures of clavicle 3rd medium, with single rima in patients aged between 10 and 70.

[Functional retraining in osteosynthesis of the femur]. / Rieducazione funzionale nell'osteosintesi di femore.

Kinesis therapy is now an integral and essential stage in osteosynthetic surgery. According to the different anatomical zones, a series of functional exercises designed to restore joint movement in fractures of the femur are described.

[Neurologic and cerebrovascular pathology during treatment with oral contraceptives]. / Patologia vascolare encefalica e neurologica in corso di trattamento con contraccettivi orali.

PIP: Between 1970-1978 a total of 3146 women aged 12-50 were hospitalized in the neurologic division of the Regional Hospital of Borgo Trento, Italy. Of these, only 47 patients, average age 27.8, were on oral contraceptives (OCs); average hospitalization time was of 9.7 days. Main complaints were headache, nausea, vomiting, depression, and vertigo. However, only 12 of 47 patients presented with symptoms: 5 cases, or 41.6%, of anomalous encephalogram, and 7 cases, or 58.4%, of cerebrovascular problems. These clinical manifestations are often reported in other studies. The article contains an extensive review of the medical literature published on the subject.^ieng