[Lamotrigine in the therapy of resistant epilepsy]. / Lamotrigina nella terapia dell'epilessia resistente.

OBJECTIVE: To evaluate the efficacy of lamotrigine as single agent in patients with refractory epilepsy. MATERIALS AND METHODS: Forty-seven adult patients with refractory epilepsy, in the initial phase received carbamazepine (1208 +/- 82.9 mg/day) plus lamotrigine (561.7 +/- 76.8 mg/day); during the second phase they received lamotrigine alone (206.4 +/- 44.4 mg/day). RESULTS: Lamotrigine monotherapy significantly improved the number of seizures per week in comparison to lamotrigine combined with carbamazepine (p < 0.0001). CONCLUSIONS: Lamotrigine as single agent is more effective than carbamazepine + lamotrigine in patients with refractory epilepsy.

[Efficacy of vigabatrin associated with carbamazepine in the treatment of epilepsy. Follow up 1993-1996]. / Efficacia del vigabatrin in associazione a carbamazepina nel trattamento dell'epilessia. Follow-up 1993-1996.

PURPOSE: To verify tolerance and clinical efficacy of vigabatrin (VGB), a new antiepileptic drug, in an add-on therapy with carbamazepine (CBZ). PATIENTS AND METHODS: From september 1993 to december 1996, 35 patients with partial complex seizures (CPC) and CPC plus secondary generalization were treated, with VGB plus CBZ, VGB dose was 1.41 +/- 0.26 (g/die +/- SD) and CBZ 2.28 +/- 0.60 (g/die +/- SD). RESULTS: Patients were followed-up every 4 months showing an improvement between 61.5% and 68.8% from baseline. CONCLUSIONS: In all patients we observed an improvement during the follow-up period. Side effects were mild and well tolerated.

[Lamotrigine: monotherapy in refractory epilepsy]. / Lamotrigina: monoterapia nelle epilessie resistenti.

CBZ (mean 1219 mg, DS +/- 94.6) + LTG (mean 55.8 mg, DS +/- 80) were administered in 31 subjects with refractory partial complex and/or partial secondary generalized seizures. The age ranged from 18 to 62 years (mean/yr 37.1, DS +/- 12.5). This first trial is concluded after a period of 8-12 months (mean 11.4, DS +/- 11.2). A follow trial with LTG at lower dose monotherapy ranged from 125-250 mg (mean 190.32, DS +/- 40.6) was conducted in same patients. There was a 82.2% (DS +/- 15.3) reduction in total seizure frequency with LTG monotherapy compared to LTG + CBZ = 53.5 (DS +/- 29.3). The difference remained highly significant (p < 0.0001) in favor of LTG monotherapy. The LTG leads major improvement if submitted like a single drug in therapy resistant epilepsy.

[Felbamate: a long-term study in subjects with refractory epilepsy]. / Felbamato: uno studio protratto nel tempo in soggetti con epilessia resistente.

UNLABELLED: 18 patients with refractory complex partial seizures with or without secondary generalization resistant at common AED were studied. They were treated in a open label study with felbamate for a 22 months period. Felbamate monotherapy show a statistical significant improvement in the control of seizures in these patients versus CBZ therapy. No severe side effects were reported specially aplastic anemia or hepatic failure. At present, after 2 years, all the patients are still treated with felbamate. CONCLUSIONS: felbamate appears to be an effective new AED: the most adverse effects occurring during administration of FBM are mild to moderate gastrointestinal (nausea, vomiting and anorexia) and central nervous system (headache, sonnolence, diplopia, dizziness and insomnia) disturbances. These adverse effects last, generally, for three weeks and allow to continue the treatment.

[Lamotrigine: first experience in Italy]. / Lamotrigina: prime esperienze in Italia.

LTG, lamotrigine is a new antiepileptic agent chemically unrelated to any established drugs in use. The safety and the efficacy of LTG (564.5 +/- 74.4) mg/day was evaluated as add-on therapy (plus CBZ) in a placebo controlled study of 34 patients with refractory partial complex and/or partial secondary generalized seizures. The incidence of adverse effects of the drug is low and the unwanted effects are reversible. The long half-life and lack of effect on other AEDs will render LTG an easily dosable addiction to a patient's existing regimen. Reduction in the total number seizures was recorded in 61.4% of patients. We conclude that LTG is an effective AED for treatment of therapy-resistant partial seizure.

[Gamma-vinyl-GABA: first experiences in Italy. II]. / Gamma-vinil-GABA: prime esperienze in Italia. Part II.

The long term efficacy of GVG was studied in patients with drug resistant CPC and CPC plus secondarily generalized seizures. GVG was started as monotherapy followed by add-on therapy with carbamazepine (CBZ), phenobarbital (PB), valproate (VPA). The results suggest: 1) loss of efficacy of gamma-vinyl-GABA during long-term use, and 2) at present, GVG appears to be an effective safe antiepileptic drug for initial monotherapy.

[Chronic administration of lithium and rubidium in rats. General behavior, explorative behavior and electric activity of the brain]. / Trattamento cronico con litio e rubidio del ratto. Comportamento generale, comportamento esplorativo e attività elettrica cerebrale.

We have studied the rat under chronic treatment with lithium carbonate and rubidium chloride both given ip. For a four week period we have recorded, once a week, weight, rectal temperature, tail-flick, motor co-ordination and general activity in a one-arm radial maze and in a Boissier-Simon table. At the end of the fourth week surface (SEEG) and deep EEGrams (DEEG: hippocampus, amygdala) were recorded from treated and control animals. FFT (Hanning window) was performed both for SEEG and DEEG. The findings are: 1) No changes in weight, rectal temperature, tail-flick and motor coordination (rotarod). 2) In the one-arm maze and in the Boissier-Simon table rubidium is in contrast to the effects of lithium, it causes increased activity and aggression 3) the EEGrams were analyzed by means of FFT as power in preselected bands of frequency. The results, on the whole, suggest, since these two ions have opposite effects on brain norepinephrine metabolism, that they may be useful in the treatment of PMD.

[Gamma-vinyl-GABA: the first trials in Italy]. / Gamma-vinil-GABA: prime esperienze in Italia.

Vigabatrin (gamma-vinyl-GABA), a structural analogue of GABA, is a selective inhibitor of GABA transaminase. Vigabatrin has been effective in patients with refractory epilepsy. We treated patients with complex partial seizures and some of them also with secondary generalized seizures. Vigabatrin was administered as "add on therapy" (Table 1) and monotherapy (Table 2). As to table 1, concerning a variety of treatments and too few patients we could not reach any definitive statistical conclusion (paired Student's t test not significant). In table 2 the paired Student's t test was significant with p < 0.01. Longer follow-up is needed to determine whether the clinical effect is maintained and no severe side effects appear.

[The biological and electrophysiological parameters in the rat chronically treated with Lobelia inflata L]. / Parametri biologici ed elettrofisiologici nel ratto trattato cronicamente con Lobelia inflata L.

In this paper we have studied the rat under chronic treatment with Lobeline sulphate ip. For a three week period we have recorded, once a week, weight, rectal temperature, tail-flick, motor coordination and general activity in a one-arm radial maze and in a Boissier-Simon table. At the end of the third week surface (SEEG) and deep (DEEG) EEG were recorded both from treated and control animals. The findings are: 1) no changes was observed in weight, rectal temperature, tail-flick and motor coordination; 2) the treated rats showed an increased general activity both in a one-arm radial maze and in the Boissier-Simon table; 3) the EEG effects were analyzed and quantified, by means of Fast Fourier transform, as total power and as power in preselected bands of frequency. The lobeline sulphate seems to produce both in SEEG and hippocampus a shift toward low frequencies and in amygdala a drift toward high frequencies.

[Effects of prolonged administration of dapiprazole in rats]. / Effetti di una prolungata somministrazione di dapiprazolo nel ratto.

In this paper we have studied the rat under chronic treatment with dapiprazole ip. (a drug with alpha-adrenergic blocking properties). For a 4 week period we have recorded, once a week, weight, rectal temperature, tail-flick, general activity and explorative behaviour on rotarod and one-arm radial maze. Surface (SEEG) and deep (DEEG) EEGrams were also recorded at the end of the experiments (4th week). SEEG and DEEG underwent the Fourier analysis (Fast Fourier Transform--see text). The findings were: 1) No change was observed in weight, rectal temperature and tail-flick time, glycemia and haematocrit. 2) Motor coordination on rotaroad dropped in 1st and 3rd week of treatment. 3) The treated rats, when in a one arm radial maze, showed signs of sedation (no grooming) from 2nd week of treatment. 4) SEEG and DEEG recordings showed a slowing activity; Fourier analysis confirmed these results. The slowing of activity (4) well agrees with the signs of sedation and behaviour (2, 3). It seems thus confirmed that alpha-adrenergic blockade is a feature of the drug together with the psychotropic effects previously described.

[Bombesin, dermorphin, physalaemin and sauvagine: effects on superficial and depth EEG tracings in epileptic and non-epileptic rats]. / Bombesina, dermorfina, fisalemina e sauvagina: effetti sui tracciati SEEG e DEEG nel ratto epilettico e non.

The effects of bombesin, sauvagine, physalaemin and dermorphin on rat CNS were observed. These peptides were administered to non-epileptic and epileptic rats: SEEG and DEEG were recorded. On the normal electrical background activity of rat brain only physalaemin had no effect. All the other peptides gave rise to slow activity with different duration. In the epileptic rat only sauvagine showed no effect whilst physalaemin reduced the epileptic activity, bombesin seemed to strengthen the action of metrazol and dermorphin blocked it at the onset. These observations will undergo FFT (Fast Fourier Transform) analysis.

[Biological and electroencephalographic parameters in rats in relation to Passiflora incarnata L]. / Parametri biologici ed elettroencefalografici nel ratto correlati a Passiflora incarnata L.

In this paper we have studied the rat under chronic treatment with Passiflora oral. For a three week period we have recorded, once a week, weight, rectal temperature, tail flick, motor coordination and general activity in a one-arm radial maze. At the end of the third week surface (SEEG) and deep (DEEG) EEG were recorded from treated animals. The findings are: 1) no change was observed in weight, rectal temperature, tail-flick and motor coordination. 2) The treated rats, when in a one-arm radial maze showed a diminished general activity. 3) SEEG and DEEG recordings showed "normal" electric activity.

Effect of timolol on the movement of water in the anterior chamber of the rabbit eye.

In the anterior chamber of the rabbit eye the following were determined: the rate of appearance, the inflow and the outflow of water under control condition and after pretreatment with timolol 0.5% ophthalmic solution. In the aqueous humor HCO3(-), Na+, K+ content and pH was determined. Results suggest that timolol acts on the inflow (production) of aqueous humor.

Effect of bombesin on glucose transport system in biomembranes.

Bombesin is able to stimulate the glucose transport system supported by a contractile glucose binding protein (GBP) in biomembranes. The increase of glucose transport indicates that bombesin affects GBP.

Serial CEA levels in colorectal carcinoma on adjuvant immuno(chemo)therapy--further follow-up. Modulation of adjuvant treatment.

Serial plasma CEA levels have been studied preoperatively (testing A); one day after surgery (B); 10--15 days after surgery (C); 4 (D), 8 (E), 12 (F), 16--18 (G), and 22--24 (H) months after surgery in a series of 45 patients affected by colorectal carcinoma who started soon after surgery a protocol of adjuvant immuno(chemo)therapy with Levamisole and BCG. Postoperative follow-up was from one to 26 months, with 28 patients followed for at least one year. Fourteen patients had recurrences: two of these had false-negative CEA tests, three had persistent high CEA levels after surgery, nine had increasing levels 9--12 months before clinical recurrence; and nine of these 14 patients showed frankly pathologic preoperative plasma CEA levels. Six patients who did not have a recurrence but (both at clinical and instrumental evaluation) who had two consecutive high plasma CEA levels, were put on prophylactic polichemotherapy. The prognostic importance of CEA levels both pre- and postoperatively, the possibility of "modulating" postoperative adjuvant treatments on the basis of CEA levels, and the problem of unexplained fluctuations of plasma CEA levels with the putative metabolic linkages are discussed.

Serial CEA levels in colorectal carcinoma on adjuvant immuno (chemo) therapy.

Serial CEA levels have been studied preoperatively, and one day, 10--15 days, four months, and eight months after surgery in a group of colon cancer patients who started soon after surgery a protocol of adjuvant immuno(chemo)therapy with Levamisole R and BCG R. Results showed a decrease of mean values of plasma CEA levels from preoperatively to four months after surgery, while eight months after surgery a slight increase was noted. Some of the patients in whom disease recurred showed persistent high levels of CEA, while one patient was consistently a false-negative notwithstanding a bone recurrence. While the prognostic value of serial CEA determinations is confirmed, the possibility of restarting (or intensifying) a protocol of adjuvant immunochemotherapy given high CEA levels and a negative clinical picture is discussed.

Salt-losing diarrhoea in idiopathic proctocolitis.

The faecal output of chloride, sodium and potassium was studied in 14 patients with active idiopathic proctocolitis, in an attempt to establish a relationship between faecal electrolyte output and acid-base balance data. 7 patients with ileostomy and 8 healthy volunteers were used as controls. The daily faecal excretion of chloride and sodium in proctocolitis was significantly in excess of normal, whereas that of potassium was within the normal range. From the comparison with the results in patients with ileostomy it is concluded that colitic colon has an impaired capacity to absorb chloride and sodium but retains the ability to secrete potassium. The intestinal loss of chloride in addition to that of sodium and water may be regarded as a salt-losing diarrhoea and may account for the metabolic alkalosis commonly found in proctocolitis.