[Our experience in the percutaneous treatment of varicocele]. / La nostra esperienza nel trattamento percutaneo del varicocele.

For its high incidence among young men and its affecting male fertility, varicocele requires an accurate screening, as well as an early and definitive treatment. The Authors report their experience in the treatment of varicocele with sclerotherapy: 24 patients underwent sclerotherapy of the left internal spermatic vein with a success rate of 91%. Complications never required hospitalization or surgery. Percutaneous therapy represents thus the treatment of choice in case of varicocele: compared with surgery, it offers similar clinical results and a lower recurrence rate, and it can be performed on an outpatient basis. Surgery should be performed only when anatomic variants make percutaneous treatment not feasible.

[Effects of H2 blockers on blood levels of parathormones and calcitonin in normal subjects]. / Effetti degli H2-bloccanti sui livelli plasmatici di paratormone e calcitonina in soggetti normali.

It has recently been reported that cimetidine (CMT) treatment can reduce parathormone (PTH) levels and that histamine (HA) plays an important role in the physiological modulation of PTH secretion. Thus far, no correlation has been sought with calcitonin (CT) or prolactin (PRL) which are themselves capable of modifying electrolyte and mineral homeostasis. Six healthy subjects were subjected to i.v. boli with H2-blockers (4 with cimetidine (CMT) 200 mg; 2 with ranitidine (RNT) 50 mg) in order to assess their effect on serum Ca, P, CT and PTH and to verify whether the increase in PRL induced by CMT but not by RNT, correlated with PTH and CT changes. Personal data show that neither CMT nor RNT modify basal levels of Ca, P, PTH and CT; the delta % of PRL was significantly higher after CMT than after RNT but no correlation was evident between each pair of hormones. It is concluded that more information is needed about the histamine modulation of PTH secretion.

[H2 histamine antagonists and the hypothalamo-hypophyseal-gonadal axis: effect of short-term treatment on serum levels of prolactin, FSH, LH and testosterone in male ulcer patients]. / Gli H2 istamino antagonisti e l'asse ipotalamo-ipofisi-gonadi: effetto del trattamento a breve termine sui livelli sierici di prolattina, FSH, LH e testosterone in ulcerosi di sesso maschile.

Serum prolactin (PRL ng/ml) was measured in 7 male patients on cimetidine (CMT) and in 13 on ranitidine (RNT) before therapy and 5, 10, 15 and 30 days after; at the same intervals FSH (ng/ml), LH (ng/ml) and testosterone (ng/ml) were measured in 5 patients too, in order to ascertain hypothalamic, pituitary, gonadal dysfunction caused by H2 histamine blockers. In agreement with other authors, FSH, LH and testosterone were not affected: no statistical difference was found between basal values and the times of follow-up. In RNT-treated patients PRL showed a little, but not significant increase; in CMT-treated group PRL increased with a peak on 10th day (19.41 +/- 2.14 ng/ml vs. 9.50 +/- 1.72 ng/ml; P less than 0.01); on 30th day PRL levels were still higher than basal ones (15.85 +/- 2.38 ng/ml vs. 9.50 +/- 1.72 ng/ml; P less than 0.05). Unlike other trials we observed that PRL rises very early in oral treatment with CMT, perhaps for resetting of inhibiting factors, it trends to decrease and reach basal values shortly after 30th day notwithstanding therapy. It is now widely accepted that H2 blocker's action is on central histaminergic pathways modulating PRL secretion; in our opinion, the measured differences of PRL secretion with CMT and RNT in short term observations, are produced by different crossing of blood-brain barreer.

[Kinetic analysis of bromosulfophthalein in alcoholic liver disease]. / L'analisi della cinetica della bromosulfonftaleina (BSF) nell danno epatico da alcool.

The Authors evaluated BSF kinetics in 100 subjects affected by hepatic disorders of different degrees of progression produced by chronic alcoholic abuse in comparison with 22 healthy subjects. CBSF and Ke, model independent parameters, were found to discriminate better among groups; model dependent parameters showed, above all, a progressive reduction of fractional hepatic uptake (a) as liver damage worsens and a typical pattern of cirrhosis, especially of decompensated form, characterized by a high fractional hepatic plasma reflux (b). BSF kinetics also showed the early cholestatic effect produced by alcohol. Even if kinetic analysis proved useful, from a clinical point of view, the Authors feel that the simple 45 min BSF retention test and still better the one for Ki (uncorrected initial slope of the disappearance curve) are sufficient to detect and discriminate among the different stages of liver alcoholic diseases.