[Delayed gastric emptying in diabetes mellitus]

Function of gastric motility was studied in thirty one diabetes mellitus patients by testing gastric emptying time (GET). The test was performed by giving patients food labelled with 99mTc. The results showed that GET in patients with diabetes mellitus was significantly delayed as compared with that in the controls (P less than 0.001). 15 among the 31 diabetic patients had delayed GET, accounting for 48.4%. There was no difference in age, duration of the disease, treatment regimen and microvascular complications between patients with delayed GET and those with normal GET. The only difference was the obviously increased incidence of autonomic nerve dysfunction in the former group of patients (P less than 0.05). We concluded that the incidence of delayed gastric emptying time was higher in diabetic patients with autonomic neuropathy.

[Pharmacological studies of N-4-(hydroxycarbophenyl) retinamide]

Our studies show that the growth of transplantable chondrosarcoma in rats is inhibited significantly by N-4-(hydroxycarbophenyl) retinamide (RII) at a dosage of 50 mg/kg. RII show a weak ability to induce the differentiation of HL-60 cells at a concentration of 1 umol/L. However, most of the HL-60 cells were induced to differentiate along granulocyte lineage after exposure to RII (1 mumol/L) and S86019 (10 micrograms/ml). Flow cytometry studies indicated that the majority of HL-60 cells were arrested in G1 phase by RII plus S86019. Northern blot analysis clearly demonstrated that c-myc expression was inhibited after treating HL-60 cells with RII plus S86019 for 12 hours. Moreover, thymidylate synthetase mRNA transcription was inhibited in those differentiated cells.

[Iodine levels in salt for human consumption and aspects of iodine prophylaxis in Yugoslavia]

Iodine content of iodinated salt intended only for human consumption was eyamined in samples from all domestic manufacturers (salt mines in: Tuzla, Pag, Ulcinj, Ston, Nin, Seca-Portoroz). Sampling was made from commercially available packs (1 kg) or from food industries (large packs). It was established that iodine content of examined samples (57) varied considerably and ranged from 1.8 to 12.2 mg iodine/kg salt. Iodinated salt from the Tuzla and Pag salt mines contained iodine within the prescribed limits in both small and large packs. Similar finding of iodine content was in the small packs of the Ulcinj salt mines, however, their large packs (10 kg) had a markedly low level of iodine (1.8-4.7 mg). Lower iodine content was also noted in salts (1 kg) from the Nin, Ston and Seca-Portoroz mines. Of the 57 examined samples in 70% iodine content was lower than the prescribed dose (7.6 mg). In addition, some mines had low iodine content in all of the 100% of their respective samples. Ever since iodine prophylaxis was introduced in Yugoslavia a number of factors influenced the decrease of iodine intake by the organism to a considerable degree. The results of our investigations and some epidemiological data indicate that the issue of increasing the amount of iodine from the present 7.6 to 15 mg iodine/kg salt should be reconsidered. Besides, it is necessary to arrange the systematic quality control of iodinated salt.

Prolactin secretion in myotonic dystrophy

In order to evaluate prolactin secretion in females with myotonic dystrophy (MD) prolactin responses to TRH, metoclopramide and bromocriptine were studied in 13 women with myotonic dystrophy (10 normoprolactinaemic and 3 hyperprolactinaemic) and 8 healthy women. Following TRH administration mean maximal net increase was significantly higher in a group of normoprolactinaemic patients with MD in comparison to controls (p less than 0.05). In three patients with increased basal prolactin levels an exaggerated prolactin response to TRH has been observed. Normal prolactin response in a group of normoprolactinaemic as well as in hyperprolactinaemic patients have been observed following metoclopramide bolus injection. Following bromocriptine administration, maximal net decrease in prolactin levels has been found to be greater in normoprolactinaemic patients compared to healthy subjects, although the difference was statistically insignificant. The suppressive action of bromocriptine was more pronounced in patients with hyperprolactinaemia. Those results showed that there is some derangement in prolactin secretion in myotonic dystrophy leading to increased prolactin levels in some patients. Although the mechanism of this derangement has not been clarified yet it seems that it is not mediated via dopaminergic receptors.

[Influence of culture conditions on the growth of murine bone marrow stromal colony-forming cells (CFU-f) in vitro]

Several factors which may influence the colony-forming efficiency of mouse CFU-f, including media, culture dishes, mouse strains, and O2 concentrations in the incubator were tested. Among them, the O2 concentration was found to be the most important factor, when a mixed gas consisting of 5% O2, 5% CO2 and 90% N2 was used to replace the usual 5% CO2 in air, the colony-forming efficiency of CFU-f increased markedly and the influence of other factors on cell growth diminished. Although the use of a lit candle to consume O2 in the air provided good conditions for colony formation of several tumor cell lines in soft agar, it is not suitable for the growth of CFU-f.

[Serum antithyroid antibodies in patients with pernicious anemia]

We investigated the incidence of thyroid auto-antibodies and their relationship to antigastric antibodies in 20 euthyroid patients with pernicious anaemia. To evaluate possible thyroid dysfunction we also measured total level of thyroid hormones (TT3 and TT4) and TSH in our patients. Histologic evidence of autoimmune atrophic gastritis and intestinal metaplasia was obtained in 15 patients. We found that it was surprisingly high incidence of thyroid auto-antibodies in patients with pernicious anaemia, particularly in the group with intestinal metaplasia (antithyreoglobulin antibodies 71% and antimicrosomal antibodies 100%). The incidence of antigastric antibodies in these patients was similar to that of those with significant antithyroid antibodies (16/18). Total triiodo thyronine and TSH were significantly higher in the patients with pernicious anaemia than in the control group (p less than 0.05), in the normal range. The results of our study suggest that this upset in immunological physiology is due to a more generalized defect in immune tolerance.

[Adrenocortical "incidentalomas" as a diagnostic and therapeutic problem]

P. Carpenter (1986) used the term "incidentalomas" in connection with all incidentally discovered adrenal masses. Previously these masses were frequent incidental discoveries at autopsies, but now, with the increasing use of abdominal computed tomography. In the last 10 years 5 patients with incidentally diseases, significant number of them have been detected. In the last 10 years 5 patients with incidentally discovered adrenal masses (4 males and 1 female, aged from 37 to 66 years) were examined and treated in our Department. Long-lasting arterial hypertension was found in all of them, and in one patient here was impaired glucose tolerance with further evolution of diabetes. A possible excessive secretion of glucocorticoids, mineralocorticoids, androgenes and catecholamines was excluded. However, markedly elevated urinary excretion of pregnanediol, proved in all patients, indicated to a possible preservation of the first reaction in the biosynthesis of cortisol, at least synthesis of pregnenolone from cholesterol. One patient, submitted to a regular functional and morphological evaluation of previously discovered 'incidentaloma', showed no sign of expansion or pathological hormonal activity. Four patients were operated because of the suspected expansion and malignant alteration of the adrenal nodus. The histological proof of adrenocortical adenoma or hyperplasia, composed of the 'fasciculata-like' cells, postoperatively maintained elevated values of steroid precursors in urine, and also a finding of adrenocortical noduses in remained adrenal noduses, confirmed the presumption that such masses could be the non-essential finding in long-lasting arterial hypertension and degenerative changes during aging.

[Cytocidal action of homoharringtonine on L1210 cells in vitro]

The proliferation of L 1210 cells ceased rapidly after they were exposed to homoharringtonine (HH) 1 microgram/ml during exponential growth phase. However, 25.3% of the cells were still able to form colonies in soft agar if HH was removed after 24 h of incubation (the colony-forming efficiency for control cells was 62.5%). The clonogenic cells survived from the treatment were still sensitive to HH-continuous exposure. The IC50 of the treated and control cells were 15 and 20 ng/ml, respectively. Yet, the sensitivity of the treated cells to cytarabine decreased enormously. For instance, the survival rate of HH-treated cells remained at 100% level after they were exposed to cytarabine 4-8 micrograms/ml for 1 h, but only 40% control cells survived from the same treatment. When cells were continuously exposed to HH 0.4 micrograms/ml, the colony-forming efficiency decreased exponentially as a function of exposure time. The T1/2 of the clonogenic cells was about 18 h. The DNA contents in L 1210 cells was measured with a flow-cytometer. The results showed that the cell-cycle progress in all cells was interrupted by HH, regardless which phase they belonged to. So the cells seemed to be in a "frozen" state and the histogram unchanged.

[Secondary prevention of esophageal cancer--intervention on precancerous lesions of the esophagus]

In 1983, intervention of precancerous lesion of esophagus was undertaken in the high risk area of esophageal cancer, Heshun Village, Linxian County. It had been expected that cancerous degeneration rate of esophageal dysplasia should be reduced by 50% so as the prevention of esophageal cancer could become possible. 6758 subjects of the general population aging from 40 to 65 were examined by esophageal exfoliative cytology, 1729 had marked dysplasia and 2411 had mild dysplasia of esophageal epithelium. Those with marked dysplasia were randomized into 3 groups to take their respective medication: antitumor B (Chinese herbs); retinamide (4-Ethoxycarbophenylretinamide) and placebo. The subjects with mild dysplasia were divided randomly into 2 groups for treatment by riboflavin and placebo. 95% of the subjects had taken 90% or more of the total medication for 3 years, at the end of which they were reexamined by esophageal exfoliative cytology. The reexamination rate was 94.1%. The incidence of esophageal cancer in the antitumor B group (3.9%) was reduced by 53% as compared with that of the placebo group (8.3%). This difference had statistical significant (means 2 = 7.672, P less than 0.05). The incidence of esophageal cancer in retinamide and riboflavin groups were reduced by 33.7% and 19% as compared with those of the control groups. The regression rate of dysplasia in the treatment groups were increased than that of the control groups. The above results showed that our hypothesis about the secondary prevention of esophageal cancer is correct. The intervention of precancerous lesion of the esophagus is effective in the prevention of esophageal cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

[Chemoprevention of cancer of the uterine cervix--preliminary study on the intervention of the cervical precancerous lesion by retinamide RII]

Twenty seven women with mild, moderate or severe cervical dysplasia proven by pathology were treated by retinamide RII suppository. Retinamide RII suppository, 10 mg QD, was given intravaginally for six months (three months as a course). Clinical examination, Papanicolaou cytology and tissue biopsy under colposcope were carried out before and after treatment. The results indicated that after the second course, 26 out of 27 patients responded; of them, precancerous lesions disappeared in 24 and even normal squamous epithelium was observed in 3. The overall response rate was 96.29% and the marked response rate was 88.89%. The general side effects were mild. There was little cervical and vaginal irritation which was well tolerated. The results of this clinical trial make available a practical base for chemoprevention of cervical cancer.