Effect of ascorbic acid on desferrioxamine-induced urinary iron excretion in idiopathic hemochromatosis

The effect on urinary iron excretion (UIE) of vitamin C administered orally 2 h after the start of an 8-hour desferrioxamine (DF) i.v. infusion was studied in 12 patients with untreated idiopathic hemochromatosis (IH). Mean +/- SEM basal UIE of 324.6 +/- 84.6 micrograms/24 h increased after a 1-gram i.v. DF infusion to 8,778.5 +/- 1,191.4 micrograms/24 h; when vitamin C 1 or 2 g were added to DF i.v. infusion, there were further increases to 11,241.5 +/- 1,486.1 (p less than 0.01) and 13,531.2 +/- 1,697.2 micrograms/24 h (p less than 0.05 versus the last value), respectively. Basal UIE did not significantly increase after oral vitamin C administration alone. No side effects were observed.

Effects of somatostatin infusion in four patients with malignant carcinoid syndrome

Somatostatin (4 micrograms/min, cyclic form) was infused for 24 h on six occasions in four patients with carcinoid ileal tumor and multiple liver metastases. During infusion, spontaneous flushes and/or diarrhea were markedly reduced with a return to the pretreatment pattern on the next day. Urinary 5-hydroxyindole acetic acid excretion and plasma gastrin were not significantly changed, whereas plasma insulin presented the expected decrease and rebound. These results confirm that carcinoid symptoms are somatostatin-sensitive but do not provide evidence that serotonin or gastrin play a major role in inducing these symptoms.

[Evaluation of hematometric parameters and plasma ferritin levels in patients treated with ferritin-containing preparations]

Ferritin has been administered in immediately bioavailable solution form, and in solid form, with exclusively duodenal bioavailability, to two groups of patients suffering from sideropenic dyserythropoietic anaemia. The results obtained point to a significant stimulating action on erythropoiesis documented by the increase in reticulocytes and red cells. This increase is certainly relatable to the increase of available iron and to its incorporation in the erythrocytes, as demonstrated by the increase in ferritinaemia, sideraemia, haemoglobin and mean corpuscular haemoglocbin concentration. The data obtained showed the bioavailable fluid form to be more active than the solid.

Treatment of radiolucent gallstones with CDCA or UDCA. A multicenter trial

Patients with radiolucent gallstones (diameter less than 1.5 cm) and functioning gallbladder were treated for 6-12 months with CDCA (38 patients, 12-15 mg/kg/day) or UDCA (78 patients randomly allocated to receive 5-6 or 10-12 mg/kg/day). Complete dissolutions and partial plus complete dissolutions were respectively 26 and 58% for CDCA, 14 and 58% for UDCA at the lower dose, and 29 and 71% for UDCA at the higher dose. Statistical analysis did not show any significant difference between the three different treatments. In patients with stones of 4-10 mm diameter treated with UDCA, complete dissolution occurred at the lower dose in 0 of 14 cases while complete dissolutions occurred at the higher dose in 5 of 18 cases, suggesting that the latter dose may be more effective (0.05 less than P less than 0.1). A highly significant correlation was demonstrated between gallstone size and number of dissolutions with both doses of UDCA. No side effects were observed with UDCA, while with CDCA diarrhea occurred in 28% and a transient increase in SGOT in a single patient. 1 patient on UDCA required emergency cholecystectomy for acute cholecystitis. Dyspeptic and/or pain symptom-atology improved in 65 and 85% of the patients treated with CDCA and UDCA, respectively. No variations in the blood lipids were observed.

Radiolucent gallstone dissolution with bedtime UDCA administration

26 patients (20 females and 6 males, mean age 40.5 years +/- SEM 2.20, mean weight 60.2 kg +/- 1.98) with radiolucent gallstones of diameter less than or equal to 10 mm were treated for 6 months with ursodeoxycholic acid (UDCA), a single dose of 600 mg at bedtime. The rate of partial + complete dissolutions was 85%, reaching 100% for gallstones of less than 4 mm diameter. No side effects were observed. In a similar series of patients treated with UDCA t.i.d. at mealtimes (10--12 mg/kg/day) a slightly lower dissolution rate was obtained but the difference was not statistically significant.

Role of seminal prostaglandins in male fertility. I. Relationship of prostaglandin E and 19-OH prostaglandin E with seminal parameters

Prostaglandin (PG) E and 19-OH PGE, now considered to be the most important of the human seminal prostaglandins, were assayed in infertile and normal men. In the 15 volunteers PGE and 19-OH PGE levels were 23-89 microgram/ml, respectively. In the 4 groups of infertile patients in whom either PGE or 19-OH PGE levels were increased or decreased with respect to normal, sperm concentration and motility were significantly reduced. The negative effects of low levels of seminal prostaglandins on sperm concentration and motility might be correlated respectively with decreased adenylcyclase and testicular androgen activity. The negative effects of high levels of prostaglandins on the seminal fluid might be due either to an inhibition in testicular DNA synthesis or to a decreased sensitivity of the receptors to high titers of prostaglandins.

Relationship between seminal PGE and 19-OH PGE and seminal fructose in man

Seminal PGE, 19-OH PGE and fructose were assayed in normal volunteers and in infertile patients. From data obtained it appears that seminal PGE are probably not synthesized exclusively at seminal vesicles level since no relationship was observed between PGE and fructose. On the other hand the seminal vesicles appear to be the preferential site of seminal 19-OH PGE production since a close relationship was observed between 19-OH PGE and fructose in those case in which these prostaglandins were below minimum normal values. Various hypotheses are advanced in order to interpret the lack of correlation in the presence of high 19-OH PGE levels.

[Progressive external ophthalmoplegia and disorders of ventricular conduction. Apropos of 3 recent cases]

The authors report 3 cases with an association of progressive external ophthalmoplegia (OEP) and disordered intracardiac conduction. These cases, and the twenty or so similar ones reported in the literature, show that this association is important for two reasons:--there is a therapeutic importance in that the condition affects young patients, who are at risk from sudden death due to the conduction defect; for this reason electrocardiographic follow-up must be regular, and an intracavitary pacemaker must be introduced definitively at the least indication;--there is a physiopathological importance in that the effect of the myopathies on the myocardium is well known, but most information relates to the diffuse cardiomyopathies, and in only 10% of cases are there conduction defects. By contrast, the conductive tissue appears to be involved in all cases of OEP, while cardiac failure is rare. It seems likely, therefore, that cases of OEP have a pathogenesis different from that of the diffuse myopathies, whether or not these involve the external occular muscles.

Poly-hormonal evaluationof pulsatile adenohypophysis incretory activity during sleep in normal, experimental and pathologic conditions

Secretory patterns of some anterior pituitary hormones were recorded during sleep, and related to EEG-phases. The same observations were carried out in conditions in which the normal sleep course was intentionall (i.e., repeated arousals, administration of tryptophan) or pathologically (i.e. chronic schizophrenia) modified. Plasma gonadotropins (lh, fsh), growth hormone and ACTH were assayed. In basal conditions, the well-known peak of HGH, which corresponds to the delta phase of sleep, was confirmed. This peak is strictly linked to the number and duration of stage 4 sleep, and follows it in its experimental and/or pathological disturbances. The secretion of ACTH, on the other hand, seems to be completely independent from the morphology of sleep. The secretion of this hormone is typically phasic; along with this phasic secretion, a background secretion is detectable, which increases steadily during the sleep span, with maximal values in the early morning hours. Gonadotropin secretion is pulsatile, episodic and completely independent from the sleep phases, in basal as well as in experimental and pathologic conditions.