Biochemical studies on the ability of pentamethylmelamine to interact in vivo with DNA and proteins in a sensitive murine ovarian reticular cell sarcoma

The metabolism of 14C-PMM and its irreversible interaction with DNA and proteins were studied in M5076/73A reticular cell sarcoma, a murine solid tumor previously shown to be sensitive to the drug. Metabolism and irreversible binding were determined 0.25, 1, 8 and 104 hours after a single i.p. injection of radiolabelled PMM, tumor and liver macromolecular binding were compared with two differently 14C-labelled PMM, i.e. ring- and methyl-PMM. Ring-PMM derived macromolecular binding appeared to have more relevance in vivo and had a similar time profile in both liver and tumor. Ring-PMM derived DNA binding was then related to metabolic steps between PMM and 2,2,4,6 TMM and 2,2,4,6 TMM itself and 2,4,6 TriMM.

Etoposide (VP-16-213) in malignant brain tumors: a phase II study

Twenty-two consecutive patients with recurrent malignant brain tumors after radiation therapy and systemic combination chemotherapy with BCNU and vincristine, four of whom were not evaluable due to early death, were treated with etoposide (VP-16-213) (50-100 mg/m2 for five days every three weeks). Response, defined as improvement in both clinical examination and computed tomography scan in absence of glucocorticoids dosage increase, was observed in three (17%) of 18 evaluable patients, lasting greater than 21, seven, and two months, respectively. Six additional patients had stable disease for greater than 10, seven, four, four, three, and two months: all of them had improvement of clinical symptoms but no variation in their scans. Overall median survival from the start of VP-16-213 was 4.5 months (range, 1-23 + months), whereas patients with response or stable disease had a median survival of eight months. Overall, treatment was well tolerated. In 10 patients concomitant plasma and cerebrospinal fluid samples were evaluated with a high-performance liquid chromatographic method for drug assay. The concentration of VP-16-213 in cerebrospinal fluid was less than 1% that found in plasma, even in the two patients with response. The activity of etoposide in patients with malignant, lomustine-vincristine-resistant brain tumors suggests an interesting potential use for this drug.

[Emergencies in valvular surgery]

Ninety patients who underwent emergency cardiac valve surgery from January 1976 to December 1981 are reported. Patients were divided in two groups: those operated on native valves are included in group I; patients with prosthetic valves operated because of leakage or malfunction, in group II. In group I (57 patients) the aetiology was: rheumatic heart disease (34 cases); acute endocarditis (16 cases); sequelae of recent endocarditis (2 cases); luetic infection (1 case); sequelae of myocardial infarction (1 case); rupture of mitral chordae in mixomatous valve (3 cases). The emergency operation was prompted in 22 patients by cardiogenic shock, in 13 patients by intractable pulmonary edema, in 21 patients by low output syndrome, in one case by ventricular arrhythmias. In group II (33 cases) the causes of reoperation were: in 27 cases leakage (in 13 due to active endocarditis); in 6 cases variance of the occluder or thrombosis. The emergency originated in 12 cases from cardiogenic shock, in 11 cases from intractable pulmonary edema, in 9 cases from low output syndrome, in 1 case from ventricular arrhythmias. Twenty-six patients died perioperatively in group I and 17 in group II. Mean follow-up in group I was 26 months. Among 27 patients there were two deaths; 25 patients are alive and well (one has been reoperated again). Mean follow-up in group II was 21 months. Among the 15 patients observed there were 6 deaths (3 after re-reoperation); 9 patients are alive and well (one has been re-reoperated).' The Authors feel that surgery is mandatory in all such patients to ensure satisfying long term results, in spite of high perioperative mortality rate.

Long term results of isolated mitral and aortic valve replacement. A statistical evaluation

589 patients were followed up between 1972 and 1977 after aortic (285) or mitral valve (304) replacement. Three hundred and thirty patients had a ball valve (Starr-Edwards) and 259 a disc valve (Björk-Shiley). The average follow up was 37 months for the mitral patients and 40 months for the aortic. The results were analyzed by statistical methods based on multifactor analysis (cluster) in order to test the homogeneity of the different groups of patients. Survival and embolism were followed by actuarial rates. The survival rate between AVR patients at 72 months was 93 per cent for the Björk and 71 per cent for the Starr valve was a statistically significant difference. The survival of MVR at 48 months was 84 per cent for Starr and 78 per cent for Björk prostheses; no significant difference was found on statistical analysis. Embolic episodes occurred at a rate of 16 per cent for the Björk and 14 per cent for the Starr valves in AVR, and 10 per cent for the Björk and 18 per cent for Starr prostheses in MVR. These differences were not significant. By the cluster analysis based on different parameters (age, valve lesion, NYHA class, duration of symptoms, C/T ratio, size of the left atrium) it was shown that no proper risk factors were found between the parameters under consideration. We conclude that in both aortic and mitral valve replacement, the most important risk factor is the type of prosthesis and the presence of the prosthesis itself.

Aneurysms involving the aortic arch. Report on thirteen surgically treated patients

Since the beginning of 1980, 13 patients with aneurysms of the aortic arch have been operated in our department. In 4 cases the aneurysm was limited to the aortic arch, while in 10 patients the ascending aorta was involved. In 7 patients an emergency procedure was required. Eleven patients were operated using deep hypothermia and circulatory arrest, in 2 right axillary and femoral artery cannulation with moderate hypothermia was used. In 5 patients a concomitant aortic insufficiency was corrected with a mechanical valve. Three patients died in the hospital. Transient cerebral dysfunctions occurred in 4 patients. Deep hypothermia and circulatory arrest provided a convenient method especially in older patients. Bleeding due to generalized coagulopathy and bleeding diathesis was one of the major problems. The methods adopted to avoid these complications are reported and discussed in detail.

On the inverse problem in flow cytometry recovering DNA distribution from FMF data

The problem of recovering DNA distribution from cytofluorometric experimental data was investigated. Theoretical analysis led to a convenient formulation of the problem and to uniqueness results for its solution. A minimization algorithm has been implemented to get the optimal estimate of G1, S, G2, and M phase percentages. This algorithm was tested in some experimental cases.

Flavonoids from Dittrichia viscosa

The isolation and structural elucidation of two flavonoids I and II found in Dittrichia viscosa, L., syn. Inula viscosa L., is reported.

Results of Valve Replacement Surgery with Mechanical Prostheses

The clinical study is reported of the results of heart valve replacement surgery with a new pyrolytic carbon tilting disc prosthesis manufactured in Italy.

From March 1977 to January 1981, at the «De Gasperis» Cardiosurgery Center, this prosthesis has been implanted in 644 patients: 283 for mitral valve replacement, 240 for aortic valve replacement, and 121 for the replacement of both mitral and aortic valves.

To have a sufficiently long period of post-surgery follow-up, we considered the results of 207 patients (124 cases of isolated mitral valve replacement and 83 cases of isolated aortic valve replacement), who underwent surgery consecutively from March 1977 to December 1979.

The hospital mortality was 10.5% for mitral valve replacement and 4.8% for aortic valve replacement. All patients who were discharged from hospital, except 2, were subjected to clinical, electrocardiographic, phonocardiographic, ecocardiographic and radiological checks.

The average follow-up period was approximately 20 months: clinical results were satisfactory. The probability of survival, expressed by actuarial curve, was, three years after surgery, 94% for patients who underwent mitral valve replacement and 97.5% for those who underwent aortic valve replacement. The probability of embolism was, three years after surgery, 8.5% for patients with mitral replaced and 5% for aortic.

Even if further confirmations are needed the mortality rate and the probability of embolism related to this new prosthesis, are lower, over the same period of follow-up, than that found in the groups of patients who underwent valve replacement surgery, at the same Center, with Starr-Edwards and Björk-Shiley prostheses.

The phonocardiographic and ecocardiographic characteristics of this new prosthesis were also investigated.

Results of valve replacement surgery with mechanical prostheses

The clinical study is reported of the results of heart valve replacement surgery with a new pyrolytic carbon tilting disc prosthesis manufactured in Italy. From March 1977 to January 1981, at the "De Gasperis" Cardiosurgery Center, this prosthesis has been implanted in 644 patients: 283 for mitral valve replacement, 240 for aortic valve replacement, and 121 for the replacement of both mitral and aortic valves. To have a sufficiently long period of post-surgery follow-up, we considered the results of 207 patients (124 cases of isolated mitral valve replacement and 83 cases of isolated aortic valve replacement), who underwent surgery consecutively from March 1977 to December 1979. The hospital mortality was 10.5% for mitral valve replacement and 4.8% for aortic valve replacement. All patients who were discharged from hospital, except 2, were subjected to clinical, electrocardiographic, phonocardiographic, echocardiographic and radiological checks. The average follow-up period was approximately 20 months: clinical results were satisfactory. The probability of survival, expressed by actuarial curve, was, three years after surgery, 94% for patients who underwent mitral valve replacement and 97.5% for those who underwent aortic valve replacement. The probability of embolism was, three years after surgery, 8.5% for patients with mitral replaced and 5% for aortic. Even if further confirmations are needed the mortality rate and the probability of embolism related to this new prosthesis, are lower, over the same period of follow-up, than that found in the groups of patients who underwent valve replacement surgery, at the same Center, with Starr-Edwards and Björk-Shiley prostheses. The phonocardiographic and echocardiographic characteristics of this new prosthesis were also investigated.

Hexamethylmelamine and pentamethylmelamine tissue distribution in M5076/73A ovarian cancer-bearing mice

The distribution of hexamethylmelamine (HMM), pentamethylmelamine (PMM), and their metabolites N2,N2,N4,N6-tetramethylmelamine (TMM) and N2,N4,N6-trimethylmelamine (TriMM) was investigated in different tissues of M5076/73A ovarian cancer-bearing mice given 100 mg/kg ip of either drug. The area-under-the-curve (AUC) values of HMM and PMM, expressed in microgram/g x min after these drug treatments, were 2432 and 1296 in tumor, 6290 and 8141 in liver, 9779 and 21,294 in spleen, 6840 and 10,800 in kidney, 4003 and 4295 in heart, 1569 and 1327 in brain, 163,689 and 50,809 in adipose tissue, 88,725 and 45,070 in lymph nodes, 15,033 and 18,992 in small intestine, and 393 and 351 in plasma, respectively. The elimination rate of HMM for the different organs was similar, with a half-life of 37-48 mins; PMM disappeared with more variability, the half-life being 19-46 mins. While TMM concentrations were not very different from those of HMM or PMM, TriMM was much higher in all organs evaluated, particularly the brain, where AUC values were 21-24 times those of the administered drug.

[Current role of angiography in the diagnosis of hepatic cavernous hemangioma]

46 cases of cavernous hemangioma of the liver, studied by angiography, are reported. Part of them were studied with echotomography and CT too, and 28 with angiotomography. In author's opinion based on experience, angiographic diagnosis of the lesion is, in presence of typical angiographic patterns, always confirmed, while echotomography and CT are not specific, especially in differential diagnosis with neoplastic malignant, primitive or secondary, hepatic lesions. Diagnostic algorithm needs, in their opinion, an initial echotomographical phase and, in presence of positive pictures for expansive hepatic mass with clinical suspicion for haemangioma, angiography and angiotomography for complete and specific diagnosis.

Effect of chloramphenicol, antimycin A and hydroxamate on the morphogenetic development of the dimorphic ascomycete Endomycopsis capsularis

Mitochondrial protein synthesis, primary (antimycin-sensitive) respiration and secondary (antimycin-insensitive, salicyl-hydroxamate-sensitive) respiration, have been characterized in the dimorphic yeast Endomycopsis capsularis. The inhibition by chloramphenicol (CAP) of the morphogenetic development from the yeast-like form to the mycelial structure in this yeast could represent the intervention in the morphogenetic process of mitochondrial protein synthesis, since chloramphenicol blocks in vivo and in vitro mitochondrial protein synthesis. In fact, other functions such as primary and secondary respiration, do not seem to play a role in the morphogenetic development since their inhibition by antimycin A (AA) or by salicyl-hydroxamic acid (SHAM) does not affect the process. In addition, mitochondrial protein synthesis has been shown to be uninhibited by the two respiratory inhibitors.

Zygosity test based on growth measures: a Bayesian approach

A statistical index is proposed in order to determine twin zygosity based on weight and height measures and a Bayesian test of hypotheses. Some Roman twin data are analyzed on the basis of the Euclidean distance index, which appears to be the best for an easy calculation and for its genetic interpretation based on the formulation of genetic distance.

[Angiographic control of portocaval anastomoses. A study of hepato-portal circulatory changes after shunt (author's transl)]

The hepatoportal circulatory changes which occur after porto-systemic shunts have been evaluated in 55 cirrhotic patients studied by post-operative arterioportography. In every one of these cases the shunt was patent. After side to side portocaval shunt (28 patients) the arterioportography shows the complete drainage of the splanchnic blood into the inferior vena cava. A reversed flow was observed in 20 patients. After conventional spleno renal shunt (eight patients) a maintained hepatopetal flow was present only in early angiographic controls, while in later controls all splanchnic blood flow was towards the renal vein, with evidence of reversed portal flow. Even after mesocaval shunt (ten patients) the splanchnic flow was hepatofugal. Instead, after distal splenorenal Warren shunt (two cases) the hepatopetal portal flow seems to be unaffected as evidence by angiography 15 days post-operatively. An increased of the hepatic artery diameter and its intrahepatic branches was observed in 20 out of 27 controls. This hepatic artery "hepertrophy" is related in increased hepatic artery blood flow which seems to be, according to Burchell [5], an important factor in the reestablishment of the liver circulation after portocaval shunt.

[Control of the patency of porto-systemic anastomoses]

After having discussed the direct and indirect methods to control the patency of porto-systemic anastomoses, the Authors report on their series of 42 cases (28 side-to-side porto-cava shunts, 6 end-to-side porto-cava shunts, 6 spleno-renal shunts, 2 mesenterico-cava shunts) where the postop. control was carried out with portography, hepatic superselective arteriography in 29 cases, transcaval catheterism of the anastomosis in 6 patients, and pre-op., and post-op. echotomography in 15 cases. Portography revealed 39 cases of patent anastomosis and thrombotic occlusion in 3 cases. The typical sign of shunt patency is the visualisation of the inferior V.C. and the less frequent disappearance of right gastric reflux. Furthermore the investigations consented the evaluation of altered post-shunt hepato-portal flow: side-to-side porto-cava shunt (25 patent anastomoses) revealed a complete deviation of portal glow towards the I.V.C. and in 15 cases there was inverted portal flow; portography after splenorenal shunt (5 cases of patent anastomosis) showed a preserved hepatopetal portal flow only in early controls (7 days) while in all long term controls it was hepatofugal. In 13 cases the morphology of the hepatic arterial system was compared before and after surgery; in 12 cases the hepatic artery was larger and its intrahepatic branches more tortuous after surgery Ultrasonography revealed only 8 patent shunts out of 15 examined since the amount of gas in the bowel rendered the exam technically insufficient.

[Percutaneous transhepatic cholangiography and percutaneous transhepatic drainage in diagnosis and palliative treatment of obstructive jaundice (author's transl)]

The authors report their experience about transhepatic cholangiography with skinny needle and external-internal drainage. Results seem to be satisfactory, regarding low frequency of complications, diagnostic reliability of cholangiography and therapeutic palliative efficacy drainage. It is possible to conclude that drainage, as palliative technique in neoplastic patients, is superior or almost equivalent to surgical palliative derivation.

Encoding of the angular position of the two distal joints of the spiny lobster antennae by a single mechanoreceptor

In the spiny lobster antennae, the two distal joints (J2, J3) rotate in approximately the same plane, their combined movements extending and flexing the flagellum forwards and backwards from the cephalothorax. A single mechanoreceptor (the chordotonal organ CO J2.J3) provides information about movement and angular position of these two joints. Four categories of static sensory neurones were identified. The specific neurones are selectively sensitive to either the J2 position or the J3 position. Homo-directional neurones code J2- and J3-flexed positions or J2- and J3-extended positions. Hetero-directional neurones code the position of each of the two joints in opposite ways, increasing and then decreasing their activity when J3 and J2 are successively flexed. The origin of these different kinds of static response is discussed with regard to the morphology and mechanical properties of the chordotonal organ and to the distribution of the bipolar sensory neurones on the elastic sheet which forms this proprioceptor. Its functional properties are briefly discussed with regard to the contribution of the CO J2.J3 to reflex actions. The sensitivity of this receptor is compared to that of joint receptors in other species.

[Angiographic follow-up of abdominal tumours in children following radio and chemotherapy (author's transl)]

The authors report 13 cases of pediatric abdominal tumours (1 hepatoblastoma, 8 neuroblastomas, 4 Wilms' tumours) angiographically evaluated following radiation and chemotherapy. The results suggest possible indications for radical surgery, in patients previously considered inoperable.

[Angiography in pre- and post-operative diagnosis of paediatric portal hypertension (author's transl)]

The authors report 31 cases of portal hypertension in childhood, including pre- and post-operative angiographic studies of 13 shunt operations. Preoperative angiography serve both to define the origin of the hypertension and to visualize compensatory collateral circulation. Postoperative angiography permits evaluation of the efficiency of the shunt, based on patency of anastomosis and reduction of collaterals, and has proved to be safe even when repeated or in emergency conditions.

[Role of angiography in studying posttraumatic abdominal masses in pediatric patients]

In infancy and neonatal period, post-traumatic space-occupying masses often can be associated to malignant, clinically not identified, lesions. Radiodiagnostic non-invasive techniques cannot, in many cases, demonstrate extension, nature and localization of such a lesion, when angiography, in personal experience, shows quite even malignancy and extension without false negatives, and is essential, in our opinion, for evaluation of therapeutic policy and follow-up.

Equilibrium stability of a diffusion process in population genetics

De Finetti introduced a model of a continuously reproducing population with phenotypic assortative mating for a pair of dominant-recessive autosomal genes. In this paper it is rigorously proved that this model admits of stable equilibria which lie above the Hardy--Weinberg parabola in the de Finetti diagram.

Arterial and venous blood viscosity in ischemic lower limbs in patients affected by peripheral obliterative arterial disease

Blood, plasma and serum viscosity, packed red cell volume, and plasma fibrinogen concentration was measured in a group of 13 subjects, suffering from peripheral obliterative arterial disease of the lower limbs (stage III or IV), awaiting surgery, and in 9 control subjects, none of whom showed signs of circulatory disease of the lower limbs either by clinical examination or by instrumental measurements. The blood samples were taken from the: (a) antecubital vein; (b) femoral vein; (c) femoral artery. In the patients venous blood viscosity was significantly higher than arterial blood viscosity. No significant differences have been found between the femoral and the antecubital vein, but in the femoral vein blood viscosity was slightly higher. Packed red cell volume and plasma viscosity were slightly but significantly higher in venous blood, while no difference was seen in serum viscosity and in plasma fibrinogen concentration. In the control subjects blood viscosity values were decidedly lower than in patients and no statistically significant differences were to be found between artery and vein, even if viscosity values were lower in artery. These results support the hypothesis that an interrelation exists between hyperivscosity syndrome and vascular ischaemia-inducing diseases.

Action of cinnarizine on the hyperviscosity of blood in patients with peripheral obliterative arterial disease

Cinnarizine, a drug capable of improving blood flow, was studied for its action on blood viscosity and its main components in patients affected by peripheral obliterative arterial diseases (POAD). Both acute and chronic administration of the drug diminished the increased whole-blood viscosity in patients, without affecting plasma and serum viscosity, hematocrit, plasma fibrinogen concentration, and plasma osmolality. Since cinnarizine also led to a significant increase of peripheral muscular blood flow, it was hypothesized that this action may be due to an increased deformability of the red cells, and may play a considerable role in the therapeutic approach to POAD.

Twin azygotic test for the study of hereditary qualitative traits in twin populations

Following previous formulations of a model of qualitative analysis of twin population data independent of zygosity, a new Bayesian approach has been developed. The present model can be applied to any qualitative genetic trait in twin population data, provided no specific source of variation be introduced by the twin condition, and allows not only estimation of the frequencies of mono- and dizygosity as well as the gene frequencies, but also verification of the trait's mode of inheritance.

Coordination behaviour of antithyroid drugs against the Fe(I)(NO)2 group in solution: ESR and FT-NMR study

The binding sites of some types of antithyroid drugs in the presence of the Fe(I)(NO)2 paramagnetic probe were investigated. Coordination behaviour in solution of different structured ligands was determined by means of ESR parameters and 13C FT-NMR spectra. Selective isotopic substitution with 15NO combined with computer simultation was used to elucidate overlapping ESR patterns. A correlation between chemical structure and antithyroid activity of the pharmacological bases is suggested.

[Radiologic patterns of pulmonary edema in chronic pulmonary diseases (author's transl)]

Three atypical patterns of cardiac failure and pulmonary edema, as frequently seen in chronic obstructive pulmonary diseases, are described; I. regional; II. miliary-like; III. Swiss-cheese like. Their importance in early diagnosis of pulmonary edema is discussed in the light of a review of a series of 98 patients whose pulmonary function was also investigated. Examples and statistical data are drown from this series.

Genetic selection and equilibrium stability

The problem of the equilibrium stability of a phenotypic selection process, with a single pair of autosomal alleles, has been numerically studied, on the basis of previously established reproduction differential equations.

Asymptotic behaviour of the mean of a phenotypic diffusion process

Asymptotic genotypic frequencies are evaluated as functions of selection parameters and initial conditions of a phenotypic diffusion process. On the basis of asymptotic relations between genotypic frequencies some analytic results about equilibrium are obtained.

Correlation between the concentration of isoleucine transfer RNA and the isoleucine content of hemoglobin in rabbit and sheep reticulocytes

A correlation has been found between the concentration of isoleucine tRNA in reticulocytes and isoleucine content of rabbit and sheep hemoglobins: in rabbit reticulocytes, which synthesize a hemoglobin containing 8 residues of isoleucine per molecule, the isoleucine accepting activity is more than twice as high as in sheep reticulocytes, which produce a hemoglobin devoid of isoleucine.