Effects of ageing on peroxidase activity and localization in radish (Raphanus sativus L.) seeds.

Peroxidase activity was assayed in crude extracts of integument, cotyledons and embryo axis of radish seeds, deteriorated under accelerated ageing conditions. Over five days of ageing, in which germination decreased from 100 to 52%, the enzyme activity in integument was higher than that in other seed parts, increasing in the first days of ageing and then decreasing sharply in extremely aged seeds. Polyacrylamide gel electrophoresis analysis showed four peroxidase isoenzymes with MM of 98, 52.5, 32.8 and 29.5 kDa in the embryo axis of unaged seeds, and only the 32.8 and 29.5 kDa MM isoforms in the integument and cotyledons. In these parts of the seed, only the 29.5 kDa MM isoenzyme increased in activity in early days of ageing and decreased there-after. In the embryo axis, the 29.5 kDa MM isoenzyme activity increased slowly in the first day of ageing, while the 98 and 52.5 kDa MM isoenzyme activities disappeared. A cytochemical localization of peroxidase activity in the various tissues showed that main differences between unaged and extremely aged seeds occurred in the embryo axis.

Structural and histochemical changes during seed development of Brassica macrocarpa Guss.

During seed formation of Brassica macrocarpa the development of the embryo precedes that of the integuments; structural changes and histochemical changes are associated. Esterases, acid phosphatases, phenols and starch follow a sigmoid pattern, increasing during embryogenesis and decreasing during seed maturation. In the mature seed, esterase activity is localized in the embryo and in the cells of the mucilaginous, aleuronic and hyaline layers. Acid phosphatases are present in the mucilaginous cells, mainly in the column, the cell walls delimiting intercellular spaces of the cortical cylinder and the adhesion areas of the cotyledons. Phenols are scanty in the root apex, mucilaginous cells and the palisade layer, and abundant in the pigmented layer. Starch is absent in ripe seeds which have lipid and protein reserves. The major classes of storage proteins have molecular weights of 21, 22, 27 and 30 KD and accumulate in the late stages prior to complete drying. Esterases and acid phosphatases in mucilaginous cells of the seed integument suggest that these enzymes are involved in hydrolytic processes occurring prior to germination and that mucilages have a metabolic function in seed-soil interactions.

Carboxylestrase activity in the carrot seed and seedling.

This study shows that carboxylesterase activity is correlated to the differentiation of primary vascular tissue; it was also observed in epidermal cells, located between the outer and inner integuments and in the endosperm cells of carrot seed, and in seedlings. Our data support the idea that the detection of carboxylesterase activity associated with the detection of other enzymes related to secondary wall formation can be used as a molecular marker for the study of vascular differentiation, but cannot be used as an exclusive highly specific marker.

A pharmacodynamic study of two omeprazole regimens suitable for long-term treatment of duodenal ulcer.

BACKGROUND: The experience with long-term treatment of peptic ulcer with omeprazole is still scant, but the possibility cannot be excluded that its better pharmacodynamic effect on gastric acidity also has a positive result in the relapse rate. Moreover, this drug acts via a mechanism other than receptorial binding, and therefore its efficacy should not dissipate with time. This study was carried out to assess the pharmacodynamic properties and the possible changes with time of two dose regimens of omeprazole that could be suitable for long-term treatment in duodenal ulcer. METHODS: Twenty patients with endoscopically proven duodenal ulcer were studied by means of 24-h gastric pH-metry both in basal conditions and on the 5th day of acute treatment with 40 mg omeprazole in the morning. All the ulcers healed after 4 weeks, and thereafter 10 patients were randomized to receive orally 20 mg omeprazole daily at 0800 h in single-blind fashion (group A) and 10 to receive 20 mg omeprazole every other day (group B) for up to 6 months. At the end of the 1st, 3rd, and 6th month of these maintenance treatments 24-h gastric pH-metry was repeated to assess the antisecretory effect of each regimen over time. In group-B patients the test was performed on 2 consecutive days (without and with medication) at each time interval. The fasting gastrin values were also determined. The patients underwent esophagogastroduodenoscopy every 2 months. RESULTS: Three patients in group B were lost to follow-up for various reasons, and only seven remained eligible for final analysis. The two long-term regimens of omeprazole were able to increase significantly pH values (p < 0.02-0.001) and the times spent at and above pH 3.0 (p < 0.001) over 24 h compared with basal conditions. In group A the 24-h pH value obtained in the 6th month was higher (p < 0.02) than that in the 3rd month of maintenance treatment. In group B the pharmacologic effect tended to decrease on the day without medication compared with the day with medication, but the difference between them was significantly (p < 0.05) only at the 6-month interval. There was no significant difference between the gastrin levels of the two groups in the long-term treatment. No ulcer relapse was detected at any long-term endoscopic control in the two groups of patients. CONCLUSIONS: The two omeprazole regimens we tested are effective in reducing gastric acidity, and their pharmacodynamic action does not decrease with time. They are therefore suitable for maintenance treatment in acid-related disorders.

Short-term treatment of refractory reflux esophagitis with different doses of omeprazole or ranitidine.

Sixty patients who presented with erosive/ulcerative refractory reflux esophagitis were randomized to receive a 4- to 8-week treatment with omeprazole 20 mg daily, or ranitidine 150 mg twice daily. Patients not healed after treatment were given the same drugs at doubled doses for a second period of equal duration. Patients still unhealed after this received open treatment with omeprazole 20 mg twice daily for a third period of 4 to 8 weeks. Endoscopic assessment and clinical and laboratory evaluation were performed every 4 weeks until there was complete esophageal mucosal repair. After 4 weeks, complete healing was observed in 50% of patients on omeprazole 20 mg daily, compared with 20.7% on ranitidine 150 mg twice per day (p < 0.01). After 8 weeks, the figures were 79.3% versus 34.5% (p < 0.5). With doubled doses after 4 weeks, complete healing was achieved in 96.6% of patients on omeprazole 40 mg daily, compared with 64.2% on ranitidine 300 mg twice per day (p < 0.05). The eight still "refractory" patients (one omeprazole, seven ranitidine) healed completely with 8 more weeks of omeprazole 20 mg twice daily. Patients treated with omeprazole experienced faster relief of heartburn, which disappeared in 60% of patients after 4 weeks, as compared to 21% of patients treated with ranitidine (p < 0.006). Apart from the mode of treatment, the only factor that proved to be related to healing at multivariate analysis was the pretreatment severity of gastroesophageal reflux, as measured by esophageal pH monitoring. Our study confirms that omeprazole, even at a low dosage, is the choice for refractory reflux esophagitis.

[The ultrasonographic examination in hematuria. Evaluation of its diagnostic possibilities]. / L'esame ultrasonografico nelle ematurie. Valutazione delle sue possibilità diagnostiche.

Hematuria is a very frequent clinical occurrence and is connected with a number of genito-urinary diseases. Our present work is aimed at checking the usefulness of ultrasonography (US) in etiological diagnostic of hematuria. 516 patients with hematuria and 1788 controls were included in the present study. Renal and urological diseases were found in 74% of patients with hematuria and in 22.7% of those without. Their prevalence is analogous of the general population for those diseases easily detectable by US, such as cystic and heteroplastic diseases. On the contrary, no correspondence was observed for cases of inflammatory, for which echography has never been a reliable diagnostic tool. Furthermore, US sensitivity, if associated with hematuria, was 93%, specificity was 100%, diagnostic accuracy 99% and predictive value about 100%. Ultrasonography is easy to perform, well tolerated, involves low cost and may therefore be considered as the investigation technique of choice for the study of hematuria.

Pathophysiology of the gastric microcirculation.

Mucosal blood flow performs an extremely important role in microcirculation wherein alterations necessarily lead to severe gastric and duodenal mucosal lesions. The removal of back-diffused H+ ions through the adaptation of microcirculatory flow represents a valid defence mechanism. The blood flow's inability to contain H+ back-diffusion lies at the bottom of rapid-onset acute mucosal lesions; moreover, it probably contributes to the onset of chronic ulcer in certain areas already precariously supplied, because of the breakdown of the mucosal barrier or a further reduction in blood supply. Portal hypertension leads to altered blood flow in the gastric microcirculation. This haemo-dynamic condition brings about a series of endoscopically evident changes which are probably a consequence of the conspicuous increase in mucosal and submucosal vascular area. This haemodynamic situation may be an aetiopatho-genetic factor in the cirrhotic subject's marked sensitivity to gastric mucosal damage.

The stomach in liver cirrhosis. Endoscopic, morphological, and clinical correlations.

The stomachs of cirrhotic patients are frequently subject to a number of alterations, detectable by endoscopy, the presence of which indicates a disturbance in the mucosa. Several investigators believe that portal hypertension plays an etiopathogenetic role. Three groups of subjects were studied prospectively: 83 cirrhotic patients with portal hypertension, 53 cirrhotic patients without portal hypertension, and 135 control subjects. Snake skin, scarlatina rash, and petechia were the most frequent endoscopic findings in the cirrhotic patients with portal hypertension (P less than 0.001); these findings were also most frequently present in association with each other in this group. There was no correlation between the endoscopic findings, the clinical gravity of liver cirrhosis (Child-Pugh grade), and the gravity of esophageal varices (Beppu score). There were no characteristic inflammatory findings in the gastric mucosa. Hypergastrinemia was often observed in cirrhotic patients with and without angiodysplasias.

The duodenum in liver cirrhosis: endoscopic, morphological and clinical findings.

Endoscopic studies were performed to determine whether changes occurred in the duodenum related to portal hypertension in patients with liver cirrhosis. The total of 271 patients studied were subdivided into three groups: 83 patients with liver cirrhosis and portal hypertension, 53 with liver cirrhosis but no portal hypertension, and 135 controls. In the duodenum of cirrhotic patients with portal hypertension several changes were observed on endoscopy that were also present in the other two groups. Atrophy and vascular malformations, however, were present only in the duodenum of cirrhotic patients with portal hypertension, although in only a few patients and with statistical significance only for vascular malformations (p less than 0.01, phi = 0.21). Eleven percent of the patients had more than one endoscopic finding, but the associations of findings were without statistical significance. No statistically significant correlation was observed between the clinical severity of cirrhosis or the severity of esophageal varices and the endoscopic findings. Finally, there was no statistically significant difference between the histological findings of duodenitis in the three groups of patients.

A temporary endoscopic solution that significantly improves the prognosis of Bouveret's syndrome.

We report the case of a 73-year-old woman who was hospitalized for mild abdominal pain after her referral following a diagnostic assessment of acute lithiasic cholecystitis. After the spontaneus regression of her painful symptoms and fever and several days of well-being, her clinically acute abdominal features suddenly showed an obstruction of the upper gastrointestinal tract. An emergency esophagogastroduodenoscopy (EGDS) confirmed that a large gallstone completely obstructed the pylorus as previously demonstrated by an ultrasound examination of the gallbladder. During the course of endoscopy, removal of the gallstone from the duodenum was achieved by pulling it into the stomach; the patient underwent an operation, the gallstone was removed, and the cholecystoduodenal fistula resolved. Postoperative procedures and recovery were rapid and favorable.

[Ursodeoxycholic acid for the treatment of chronic diseases of the liver. Short-term results]. / L'acido ursodesossicolico nel trattamento delle malattie croniche di fegato. Risultati a breve termine.

The tolerance and the effect of ursodehoxycholic acid (UDCA) on the level of transaminases and gammaglutamyl-transpeptidase (GGT) has been estimated, over the short term, in 27 patients affected by compensated liver cirrhosis in comparison to 24 patients, representing the control group. The results were good with regard to GGT values, as a meaningful reduction was observed during the first month of therapy which then improved in the next five months. There was also a significant reduction in transaminase levels at the end of the second month of therapy, which was maintained until treatment was stopped; mean values however were not within the normal range. These results, together with tolerance of the drug confirm a role of UDCA in the treatment of chronic liver diseases in an advanced stage.

[Role of endoscopy in lymphomatous pathology of the digestive tract]. / Il ruolo dell'endoscopia nella patologia linfomatosa del tubo digerente.

Increasingly frequent reports of lymphoma with a gastro-intestinal primary location have stimulated much interest. Symptomatology has been shown not to be very specific, and scarcely different to that of other gastro-intestinal pathologics, both benign and malignant. The identification of some endoscopic pictures which suggest a lymphomatosic pathology and the possibility of collecting targeted biopsy samples, have placed endoscopy among the most important tests in the diagnostic and staging phase of gastro-intestinal lymphoma. This technique plays an equally important role in the follow-up period, since it allows the therapeutic efficacy of treatment to be assessed and the early identification of possible relapses.

[Therapy of resistant duodenal ulcer]. / Terapia dell'ulcera duodenale resistente.

Significant progress has been made in the treatment of duodenal ulcers since cimetidine went on the market. Furthermore widespread use of the H2 blockers has enable us to identify a group of patients who take 8-12 weeks to heal, despite effective treatment and who are now known as "slow" or non-responders. In tackling the problem of ulcers resistant to medical treatment, the paper details the possibilities offered by current solutions on the basis of personal experience as well as reports in the literature. The results obtainable by surgery are also assessed with emphasis on the identification of suitable patients for and the appropriate timing of his surgical option. Finally a therapeutic flow-chart providing guidelines for the rational selection of therapeutic strategies that still had to be based on uncodified personal preferences is proposed.

Prevalence of hepatitis B virus infection in chronic users of hepatotoxic drugs and alcoholic cirrhotic patients.

Anti-HBc prevalence in alcoholics, chronic hepatotoxic drugs users, exposed to both these factors, and not exposed to alcohol and drugs cirrhotic patients was compared. Anti-HBc prevalence was significantly higher both in alcoholics and in hepatotoxic drugs users cirrhotic patients, and no statistically significant difference was found between the prevalence of anti-HBc in these two groups. In male cirrhotic patients the risk of HBV infection was 4.4 times higher in chronic hepatotoxic drugs users, 4.7 times higher in alcoholics, and 6.9 times higher in patients exposed both to alcohol and drugs. These results support the hypothesis that also chronic consumption of hepatotoxic drugs may be associated with a greater prevalence of HBV infection.

Platelet thromboxane production in liver cirrhosis.

To determine whether platelet prostaglandin production in patients with liver cirrhosis was as impaired as platelet aggregation, serum thromboxane production was studied in 52 patients with liver cirrhosis; 12 patients had consumed more than 80 gr of alcohol/day, for more than ten years; 13 patients had also had diabetes mellitus for more than two years. A reduced thromboxane synthesis by platelets of liver disease patients was observed; the parallel decrease of both platelet thromboxane and serum PGE2 formation may also suggest a decrease in arachidonic acid availability for prostaglandin and thromboxane production. A smaller reduction of thromboxane and PGE2 formation in cirrhotics with diabetes mellitus or chronic alcohol intake was also observed.