Interlateral asymmetry in the time course of the effect of a peripheral prime stimulus.

Evidence exists that both right and left hemisphere attentional mechanisms are mobilized when attention is directed to the right visual hemifield and only right hemisphere attentional mechanisms are mobilized when attention is directed to the left visual hemifield. This arrangement might lead to a rightward bias of automatic attention. The hypothesis was investigated by testing male volunteers, wherein a "location discrimination" reaction time task (Experiments 1 and 3) and a "location and shape discrimination" reaction time task (Experiments 2 and 4) were used. Unilateral (Experiments 1 and 2) and unilateral or bilateral (Experiments 3 and 4) peripheral visual prime stimuli were used to control attention. Reaction time to a small visual target stimulus in the same location or in the horizontally opposite location was evaluated. Stimulus onset asynchronies (SOAs) were 34, 50, 67, 83 and 100 ms. An important prime stimulus attentional effect was observed as early as 50 ms in the four experiments. In Experiments 2, 3 and 4, this effect was larger when the prime stimulus occurred in the right hemifield than when it occurred in the left hemifield for SOA 100 ms. In Experiment 4, when the prime stimulus occurred simultaneously in both hemifields, reaction time was faster for the right hemifield and for SOA 100 ms. These results indicate that automatic attention tends to favor the right side of space, particularly when identification of the target stimulus shape is required.

Gestational diabetes affects platelet behaviour through modified oxidative radical metabolism.

AIMS: Patients with Type 1 and Type 2 diabetes mellitus show altered platelet function including decreased nitric oxide synthase (NOS) activity and increased peroxynitrite production. Gestational diabetes mellitus (GDM) is a clinical condition which is ideal for evaluating short-term effects of impaired glucose metabolism, ruling out the possibility that the platelet abnormalities are a consequence of diabetic complications. The aim of the present work was to study NO metabolism in platelets from pregnant women with GDM. The production of peroxides was also studied as it is strongly involved in peroxynitrite formation. METHODS: Platelet NOS activity and peroxynitrite production, levels of hydroperoxides and thiobarbituric acid reactive substances (TBARS) in platelet membranes in the basal state and after in vitro peroxidative stress with phenylhydrazine were determined in 40 pregnant women with GDM, 40 healthy pregnant women (pregnant controls) of comparable age and gestational age, and 15 healthy non-pregnant women (controls). RESULTS: NOS activity was significantly increased in both groups of pregnant women compared with non-pregnant ones, and in GDM women compared with pregnant controls. Production of peroxynitrite was higher in GDM women than in pregnant controls, who also had significantly reduced production compared with non-pregnant women. Basal levels of peroxidation of the platelet membranes evaluated either by hydroperoxide content and TBARS levels or the susceptibility to peroxidation were increased in GDM patients in comparison with both control groups. CONCLUSIONS: We have shown a modification in platelet NO and peroxynitrite production and an increase in platelet indicators of oxidative stress in GDM women compared with healthy pregnant women which might be at the basis of a cellular dysfunction.

Sialic acid content in erythrocyte membranes from pregnant women affected by gestational diabetes.

Sialic acid (SA) content, membrane fluidity, and Na(+)/K(+)-adenosine triphosphatase (ATPase) activity were determined in erythrocyte membrane from 10 nonpregnant women (HNPW), 16 pregnant women affected by gestational diabetes mellitus (GDM), and 25 healthy pregnant women (HPW). In GDM patients the membrane erythrocyte SA content was significantly increased compared with HNPW and membrane fluidity was significantly increased in comparison with HPW. Erythrocyte membrane Na(+)/K(+)-ATPase activity was significantly reduced in GDM patients compared both to HNPW and to HPW subjects. A significant inverse correlation was found between 1-(4-trimethylaminophenyl)-6-phenyl-1,3,5-hexatriene (TMA-DPH) anisotropy and erythrocyte membrane SA content in HNPW and in HPW, while this significant correlation was not observed in GDM. The present results indicate that in comparison with normal pregnancy GDM is characterized by deep alterations of the erythrocyte plasma membrane physicochemical properties (increased fluidity) and functional activities (reduced Na(+)/K(+)-ATPase activity). These modifications might be at the basis of the altered blood viscosity and placental perfusion observed under such conditions. Moreover, these results show that in physiological pregnancy and in the nonpregnant state, the erythrocyte surface membrane fluidity is inversely correlated with SA content, while in GDM there is an unbalance of this relation, which might be associated with the microcirculatory abnormality present in this disease.

[Clinical experience in patients with chronic peripheral obliterating arteriopathy: defibrotide versus definite molecular weight heparan sulfate (MW 7500-15000 dalton)]. / Esperienza clinica in pazienti affetti da arteriopatia obliterante cronica periferica (AOCP): defibrotide versus eparan-solfato a peso molecolare definito (P.M. 7500-15000 dalton).

In a controlled study of 100 patients, mean age 65 years old, suffering from chronic peripheral obliterative arterial disease, Leriche's stage II, were randomised in two groups treated respectively with defibrotide (400 mg bid) or heparan-sulfate (40 mg bid) by the oral route for a period of 6 months. At basal and after 30, 90 and 180 treatment days, patients were assessed for pain, paresthesias, rigidity and or tiredness in the leg, Winsor index (WI) relative and absolute walking distance (RWD, AWD), and time of recovery from pain. In order to evaluate microcirculation the following parameters were tested: resting flow (RF), standing flow (SF), veno-arteriolar reflex (VAR) and a capillaroscopy study was conducted. All patients showed an improvement in the clinical and instrumental parameters but more pronounced in the defibrotide group; the difference between the beginning and the end of the therapy was significantly better for defibrotide (p < 0.01). The tolerability observed was good, no side-effects were reported during the study.

Modulation of human lymphoblastoid interferon activity by melatonin in metastatic renal cell carcinoma. A phase II study.

BACKGROUND: Numerous attempts to identify active cytotoxic agents for the treatment of metastatic renal cell carcinoma (RCC) have proved disappointing. However, several recent developments in biologic therapy of neoplastic disease have substantially improved the prospects for the treatment of advanced RCC. Melatonin (MLT), a hormone regulated by the pineal gland, has been shown to act on the immune system by causing the release of cytokines from activated T-cell populations. METHODS: A series of 22 patients with documented progressing RCC entered a trial in which the authors studied the effect of a long term regimen (12 months) with human lymphoblastoid interferon (IFN), 3 mega units (MU) intramuscularly 3 times per week, and MLT, 10 mg orally every day. RESULTS: Twenty-one patients were evaluable for response and toxicity. There were seven remissions (33%): three complete, involving lung and soft tissue and four partial, with a median duration at the time of this writing of 16 months. Nine patients achieved stable disease, and five progressed. General toxicity was mild. Fever, chills, arthralgias, and myalgias occurred rarely. Leukopenia and hepatic enzyme elevation were modest and always reversible. CONCLUSIONS: Response rate and toxic effects observed during this study warrant additional randomized studies to define the role of MLT's concomitant administration in the clinical response to IFN in metastatic RCC.

Cyclophosphamide, epidoxorubicin and Carboplatin as treatment for advanced-carcinoma of the bladder - a phase-ii study.

In advanced carcinoma of the bladder, the M-VAC chemotherapy schedule can yield positive results, but at the cost of very high toxicity. Recent studies have shown epidoxorubicin and to a lesser degree, carboplatin to be active against urothelial tumors, with cardiac, haematological and renal toxicity lower than that observed with CISCA or M-VAC chemotherapy regimens. In this study, we determined the toxicity and efficacy of cyclophosphamide 400 mg/m(2), epidoxorubicin 75 mg/m(2) and carboplatin 300 mg/m(2) in a 28-day course. From February 1990 to December 1991, we enrolled 33 advanced bladder cancer patients (25 males, 8 females), mean age 63 years. 31 patients were evaluable for toxicity and response. The major disease localizations were: locoregional 15 (48%), lymph nodes 6 (20%), liver 5 (16%), lung 3 (10%) and bone 2 (6%). A total of 186 cycles of therapy were administered, with a mean of 5.4 per patient. Six patients (19%) had a complete response (CR): 2 locoregional, 3 lymph node and 1 lung. Eleven patients (36%) had a partial response (PR), for an overall response rate of 55%. The median duration of response was 53 weeks and median survival for the entire group of patients was 40 weeks. No delays or interruptions due to sepsis occurred during therapy; haematological, cardiac and renal toxicity were below WHO grade 3. The efficacy of this chemotherapy regimen proved to be comparable to that of more aggressive schedules, while its toxicity was markedly lower.

Retroperitoneal germ cell tumor in postmenopausal woman.

A fifty-four-year-old woman presented with right renal colic and three months later a retroperitoneal tumor was diagnosed. After explorative laparotomy with biopsy, which showed a germ cell tumor, the patient received external beam radiotherapy, but died of metastatic diffusion nine months later. We believe this is a rare occurrence of a germ cell tumor in a postmenopausal woman.

[Posttraumatic functional exclusion of the kidney of nonvascular origin. Description of a case and review of the literature]. / Esclusione funzionale post-traumatica del rene da causa non vascolare. Descrizione di un caso e revisione della letteratura.

A review of published series about 56 cases with unilateral nonvisualization on excretory urography after external trauma have been described: the renal injury causing the nonvisualization was contusion in 8 patients, laceration in 13, rupture in 12 and renal pedicle in 19. The acquisition of the most important methods has allowed a total view as about minimal lesions (contusion, laceration), as rupture or fragmentation of the kidney and renal pedicle. We have evaluated 32 cases of renal traumatic injuries and we have studied one case with unilateral nonvisualization stressing the diagnostic, etiopathogenetic and therapeutic problems.

Therapeutic value of citicoline in the treatment of glaucoma (computerized and automated perimetric investigation).

The favourable neurotrophic effects obtained by means of the intramuscular administration of citicoline, one of the intermediate compounds of phospholipids, on the visual field of patients suffering from open-angle glaucoma are referred. The drug was administered at the dose of 1 gm for ten consecutive days. Visual field was examined by means of central computerized perimetry and automated perimetry. All patients had well controlled intraocular pressure through beta-blockers, but presented characteristic glaucomatous perimetric defects. It is suggested that citicoline might be administered as a useful complement to conventional hypotensive therapy, since it acts positively on the glaucomatous optic nerve damage.

Ultrastructural changes of Leydig cells in prepubertal varicocele.

Testicular biopsies from 25 boys, aged 11-17, with left clinically evident varicocele were studied. Electron microscopic observations documented diffuse histological changes of smooth endoplasmic reticulum, Golgi apparatus and mitochondria of Leydig cells. Ultrastructural modifications of these subcellular structures related to steroid hormone synthesis may impede the normal growth and maturation of the testis and impair fertility potential.

Periurethral neurofibroma.

A periurethral neurofibroma presenting as a midline perineal mass was removed in a three-year-old boy. An immunohistochemical study of S-100 protein distribution within the tumor tissue was performed.

Fertility in unilateral cryptorchidism: review of 104 cases.

Testicular maldescent adversely affects spermatogenesis, therefore the primary purpose of its correction is to preserve subsequent fertility. However, many patients, even with unilateral cryptorchidism, are infertile in spite of successful prepubertal orchidopexy. Out of our 104 patients treated for unilateral cryptorchidism before puberty, a decreased sperm density (spermatic concentration less than 20 X 10(6)/ml) was observed in 64 cases (61.54%), a normal sperm count in 32 cases (30.77%) and azoospermia in the remaining 8 cases (7.69%). Both congenital and acquired abnormalities may be associated with development of bilateral testicular impairment in unilateral cryptorchid males.

Varicocele in adolescents: ultrastructural aspects.

Twenty-four boys age 11-17 with moderate to large sized varicocele were studied. The duration of varicocele ranged from 11 to 20 months prior to surgery. Histological and ultrastructural studies of testicular specimens demonstrated bilateral abnormalities and the detrimental effect of varicocele on the future fertility of these young patients. These findings strongly support the necessity of an early surgical treatment of varicocele.

[Our experience in the surgical treatment of oncocytoma of the kidney]. / Notre expérience dans le traitement chirurgical de l'oncocytome du rein.

Five patients, two men and three women age range 38 to 84 years, were treated for oxyphil cell adenoma of the kidney. Clinical signs were present in three cases and tumor size varied between 7 and 15 cm. Treatment was by nephrectomy in 4 cases and ablation of adenoma in the fifth patient, the tumor being located in the only functioning kidney in the latter. Close follow up surveillance for 32 months failed to detect any recurrence. Clinical and pathologic features of this neoplasm and therapeutic choice in these cases are discussed below. Although radical surgery has been employed in the past as principal therapy, more precise pre- and perioperative diagnosis should allow more frequent use of conservative surgery: partial nephrectomy or tumor excision.

Pyelovesicostomy: an alternative to ureteropelvic junction-plasty in pelvic ectopic kidneys.

Pyelovesicostomy was performed in 2 cases of hydronephrosis in pelvic kidneys secondary to ureteropelvic junction obstruction. In the first patient, who presented with a solitary kidney, the procedure was done after failure of a dismembered pyeloplasty, while in the second patient the procedure was performed electively. Both patients had sterile urines and stable renal function, although some dilatation persisted in the first case. The indications and the functional aspects of this surgical solution are discussed.

[Cystic renal disease in childhood]. / La malattia cistica renale nell'infanzia.

In the last five years, in the Surgery Pediatric Department and in the Pediatric Nephrology and Dialysis Service of the Florence University, have been observed 13 patients with cystic renal diseases. In every single case, for the diagnosis we have considered the age of the patients and the examinations made to them. We payed attention mostly to the echography considered the main diagnostic examination, even in prenatal age.

[Ultrastructural modifications of the tunica muscularis in congenital obstruction of the upper urinary tract. Physiopathological interpretations and anatomo-clinical correlations]. / Modifications ultrastructurales de la tunique musculaire dans les obstructions congénitales des voies excrétrices urinaires hautes. Interprétations physiopathologiques et corrélations anatomo-cliniques.

Upper excretory pathway musculature was studied by electron microscopy, both at the level of the obstruction and proximally. Two types of lesion were investigated: pyelo-ureteral junction anomalies and primary obstructive mega-ureter. Two types of muscle cell are recognized in the excretory pathway walls, typical and atypical cells, the latter being considered as possessing pace-maker activity and constituting almost total population of muscles of calices and pelvis. However, they were few in number in the pyelo-ureteral region and were practically absent from the ureter. Various conclusions can be drawn from the findings in this study. Both typical and atypical cells are modified in the obstructed upper excretory pathways. Ultrastructural appearances of lesions are identical at the site of an proximal to the obstruction. Modifications in these cells were: a rich sarcoplasmic reticulum, an increase in number of mitochondria and glycogen particles, disorganized distribution of contractile or cytoskeletal filaments, altered contact zones between contiguous smooth muscle cells, increased richness of granular endoplasmic reticulum and excessive development of the Golgi apparatus. More chronic lesions show enhanced fibrosis with reduced muscle contractility, the fibrosis affecting mainly elastic fibers in young patients and collagen fibers in more elderly subjects. The development of fibrosis may be due to changes in the granular endoplasmic reticulum and the Golgi apparatus. From the practical point of view, increase in fibrosis with duration of course of obstruction is an argument for as early as possible surgical intervention.