[Clinical considerations on malignant carcinoids: bronchial, gastric, ileocolic involvement]. / Considerazioni cliniche sui carcinoidi maligni: a proposito di alcune osservazioni a localizzazione bronchiale, gastrica, ileocolica.

Six cases of malignant neuroendocrine tumours (3 bronchial, 1 ileocolic) are presented; diagnostic and clinical features, functional behaviour and the results of the treatment are discussed. Early functional manifestation (diarrhoea) was observed only in the first case of ileocolic tumour: in this patient the diarrhoea disappeared after the operation but further relapse occurred at the recurrence of the pathology. In the second ileocolic tumour diarrhoea with increased levels of 5 HT appeared later on, after the operation, expressing repeated disease. In one malignant bronchial carcinoid with early spinal secondary, the typical flushes appeared only after the explosion of metastatic spread. No functional disorders were observed in one patient with metastasis localised only in the bones. On the basis of actual knowledge the authors discuss the pathogenetic hypothesis of these events. Even though these experience limited, it may remark the importance of the quantity and quality of produced hormones, of the localization of metastasis in the liver and portal district and the unconstant production of clinical symptoms. The importance of A-chromogranin and of NSE as specific markers is discussed; the studies on the chromogranin have furthermore demonstrated the possible effect of the inhibitors of protonic pump on structural, hyper-dysplastic modification of gastric mucosa and this requires further investigation.

Insulin-like growth factor 1 (IGF-1) in multinodular goiters: a possible pathogenetic factor.

In order to support previous in vitro studies which had stressed a possible autocrine role for Insulin-like Growth Factor 1 (IGF-1) in thyroid growth regulation, we have investigated the presence of IGF-1, as detected by means of radioimmuno assay and of immunocytochemistry, in thyrocytes from normal thyroid and from multinodular goiter. Our study revealed that IGF-1 is detectable in thyroid cells from multinodular goiter and, to a lesser extent, from normal thyroid. Both techniques used in this study demonstrated that thyrocytes are the site of accumulation of IGF-1 and that stromal cells contain lower amounts of this growth factor. The findings of the present study seem to suggest that thyrocytes could produce IGF-1 in vivo. This feature gives further support to the hypothesis that IGF-1 may regulate thyroid growth and therefore it might be involved in the pathogenesis of multinodular goiter.

The use of somatostatin in acute pancreatitis--results of a multicenter trial.

This study involves a multicenter trial aimed at evaluating the comparative beneficial therapy of somatostatin and traditional symptomatic therapy in the management of acute pancreatitis. According to our final data somatostatin has not proved to be any better than traditional medical treatment. Nevertheless, in our opinion, the advantage of a single and expeditious therapy makes somatostatin administration preferable to the combined employment of several therapeutic measures usually applied in these circumstances.

[Traumatic and foreign body lesions of the colon and rectum. Clinical and therapeutic considerations]. / Lesioni traumatiche e da corpi estranei del colon e del retto. Considerazioni cliniche e terapeutiche.

On the basis of observations made in 69 patients with traumatic lesions and those caused by foreign bodies in the colon and rectum, supplemented by the data emerging from literature, some clinical and therapeutic considerations are expressed on the subject. A tactic of treatment based on the material examined and, in the present state, advisable as a possible plan of treatment for the said lesions is also proposed.