[Afferent connections in the ventromedial hypothalamus of rats demonstrated by retrograde transport of horseradish peroxidase]

Projections into rat ventromedial hypothalamus were studied with retrograde transport of horseradish peroxidase (HRP). Following injection of HRP into ventromedial hypothalamus, labeled neurons were found in cortical and medial amygdaloid nuclei, ipsilateral mediodorsalis thalamus (MD), dorsal raphe nucleus, and contralateral sensorimotor cortex. Futhermore, labeled axons that connect directly amygdala with hypothalamus (DAH) also were found.

[Behavioral effects of medial-dorsal thalamic, mediobasal hypothalamic and amygdaloid lesions in the rat]

Experiments were carried out to examine the effects of restricted brain lesions on activity, emotionality and aggressiveness of rats. The open-field activity test, the number of defecations test and the interspecific aggressiveness test were, respectively, employed. Lesions were placed on medial thalamus (MD), ventromedial (VM) or arcuate (ARH) hypothalamic nuclei, medial (AME) or intercalate (ICL) amygdaloid nuclei. No aggressiveness was detected in the rats under experiment, independently of the type of lesion. The open-field activity test given significant differences between control rats and animals with VM, ARH, AME or ICL lesion. Remarkable changes in the emotionality were found only between sham-operated controls and MD lesioned rats. It was concluded that hypothalamus and amygdala lesioned nuclei play a role in the neural mediation of activity, while medial thalamus influences the mediation of emotional response.

Ampicillin-associated colitis. Case report

A case of ampicillin-associated colitis is described. The authors stress the importance of emergency colonoscopy for the correct diagnosis and treatment of severe diarrhea and hemorrhage occurring during treatment with antibiotics.

[Treatment with transcutaneous electric stimulation in chronic pain. Long-term study of 100 cases]

The Authors report the experience about 100 cases of patients affected by chronical pain syndromes where the medical treatment has been uneffective. After a follow-up of 2 years about, only in 14% of the patients treated by S.E.N.T., the benefit has been clear and prolonged.

Artificial excretion of weakly bound middle molecules by hemoanadiafiltration

The concept of a subtractive therapeutic intervention in several diseases (shock, acute liver, failure, poisoning) to remove toxic middle molecules (MM) has led to the devising of a particular ultrafiltration system (anadiafiltration) to clear weakly bound MM. Clinical hemoanadiafiltration (HADF) with a polyacrylonitrile filter and in vitro experiments with a series of marker substances, have shown HADF efficacy in clearing MM, irrespective of their molecular weight, with protein binding K between 50 and 150.

Sickle cell disease in Sicily

The chemical and physical properties of haemoglobin S derived from homozygotes for this haemoglobin in Sicily were examined, as well as some erythrocytic characteristics. Sicilian Hb S was identical to that found in USA black patients in electrophoretic mobility on both starch and citrate agar media, solubility, mechanical precipitation rate of oxyhaemoglobins, and minimum gelling concentration, as well as by peptide mapping and amino-acid analysis of all beta-chain peptides. Taken together with the presence in Sicily of African blood group markers and certain historical considerations, it seems clear that the source of Hb S in Sicily is Africa. While the clinical severity in nine Sicilian children did not seem remarkably different from the disease in the USA, the most severe and fatal complications were not seen. Mean Hb F Was 10.5% and 2,3-diphosphoglycerate (2,3-DPG) values were higher in Sicilian homozygotes than in black USA counterparts (21.79 mumol/g Hb vs 15.16). Red cell AT values were also slightly higher in Sicilian patients. The presence of concomitant thalassaemia was excluded by both family studies and globin chain synthetic ratios. In conclusion, haemoglobin S in Sicilian homozygotes is identical to Hb S found in USA blacks. Although the severity of the disease seems quite similar in both groups of patients, other erythrocytic properties were found to be different. Whether these factors influence severity remains to be elucidated.

K cell activity in acute lymphoblastic leukaemia of childhood

Lymphocyte subpopulations were studied in 28 children with acute lymphoblastic leukaemia at different stages of the disease. T and B lymphocytes, present in low percentages at diagnosis, increased towards during remission in most patients. All patients off therapy had normal values of T and B lymphocytes. K cell activity, which was increased during remission in several patients, was normal in all patients off therapy. Further prospective studies will establish whether determination of K cell activity is an indicator of the stage of the disease.

Cardiotoxicity from orphenadrine intoxication in humans

Eight cases of Orphenadrine intoxication were treated in the Resuscitation Centre of Rome's University Medical School. All these cases arrived in coma, after taking an overdose of Orphenadrine in an attempt at suicide. The clinical signs and therapy are reported in detail; the cardiovascular side-effects, in particular those involving arrhythmias are dangerous and life threatening. From the clinical data it is believed that these changes in rhythm are mostly due to the autonomic nervous system (A.N.S.). In fact all the 8 patients survived, without treatment never having been treated with cardiokinetic or antiarrhythmic drugs, but a few were given Diazepam as well as respiratory assistance, cardiovascular assistance, and forced diuresis.

Gastric gastrinoma and diffuse G cell hyperplasia associated with chronic atrophic gastritis. Endoscopic detection and removal

Chronic atrophic gastritis and a sessile polyp were diagnosed during gastroscopy of a patient with splenomegaly and portal hypertension. The polyp was removed endoscopically. Histologically, it proved to be an endocrine tumour, which was identified as gastrinoma by immunohistochemistry. Then, hypergastrinemia was found and gastrectomy was performed to ensure complete removal of the tumour. The surgical specimen showed G cell hyperplasia of the antro-pyloric mucosa and severe atrophic gastritis with scattered argyrophil micronodules in the corpus-fundus region. 3 years after this treatment the patient is well.

A case of gastric teratoma

This paper reports a case of gastric teratoma in a 3-mth-old boy, with macroscopic and microscopic observations. Forty-five instances of gastric teratoma, including the present case, have been reported.

Influence of pregnancy on glucagon levels in insulin-dependent diabetic women

Eight insulin-dependent non pregnant (IDD-NP), 10 insulin-dependent pregnant (IDD-P) and 9 pregnant control women were studied. During intravenous arginine challenge (ATT) there were lower glucose and higher glucagon plasma levels in the IDD-P when compared to the IDD-NP. IRG levels in response to ATT were also significantly higher in diabetic than in non diabetic control pregnant women. These results seem to indicate that pregnancy in diabetic women, in contrast to that observed in normal women, enhances glucagon secretion with impairment of the physiological mechanism of the facilitated anabolism present in normal pregnancy.

[Our experience in laparoscopic diagnosis in general and emergency surgery (author's transl)]

After a brief review of the history of laparoscopy starting from the first endoscope, the authors remark on the great usefulness, ease, and essential harmlessness of the procedure. They list all the possible uses of laparoscopy in general and emergency surgery, exemplifying their claims with the illustration of personal cases and recommending widespread use of the method in surgery.

[The indications for laparoscopy in the diagnosis of hemoperitoneum (author's transl)]

In consideration of the well-known difficulties associated with the precise diagnosis of hemoperitoneum, the authors offer their personal experience in support of laparoscopy as a diagnostic aid in such dramatic events. They review 23 cases of emergency laparoscopy performed in the First Institute of Clinical Surgery of the University of Catania between January 1978 and January 1979. Recalling that the procedure was applied to patients as young as 3 and as old as 80, they confirm the opinion expressed from other quarters, namely that laparoscopy is an essentially harmless and rapid procedure conducive to very accurate diagnosis in view of appropriate planning of therapeutic treatment.

Regulation of body cholesterol pools. Influence of cholesterol input and excretion in an animal model

Biliary cholesterol excretion closely parallels lecithin excretion in the rat and may be increased by feeding an excess of choline and decreased by choline deficiency. To determine the relative influence of cholesterol input and excretion on whole body cholesterol metabolism, we have measured by compartmental analysis rates of cholesterol transport and pool sizes when both input and choline-mediated biliary excretion were increased and diminished. In choline-deficient animals with impaired excretion, plasma cholesterol was reduced. However, in deficient animals more cholesterol was transported into the slowly exchanging pool to increase pool size, and, when input was increased (by addition of cholesterol to diet), the slowly exchanging pool was even more markedly enlarged. In contrast, when excess choline was fed, plasma cholesterol was increased but excretion so exceeded transport into the slowly exchanging pool that pool size was actually reduced. Furthermore, in choline-fed animals with unimpaired excretion, addition of cholesterol to the diet to increase input did not result in pool expansion. Thus, in this model, cholesterol excretion and tissue deposition were reciprocally related, and, regardless of plasma cholesterol concentration and cholesterol input, stores were found to increase only when biliary excretion was impaired.