Can a relationship reflect the risk of calcium oxalate urolithiasis?

Different mathematical expressions have been proposed in the literature with the aim to reflect the risk of calcium oxalate urolithiasis. Such expressions, as well as a number of new relationships proposed by us, have been evaluated in 76 patients and 34 normal subjects. Stone-formers were divided into two groups: patients with normal calcium and oxalate excretion and patients with hypercalciuria and/or hyperoxaluria. The results obtained were comparatively evaluated. Several formulae gave some acceptable results, but none of them were excellent. This can be explained by the fact that these discrimination indexes more or less reflect supersaturation and/or inhibition deficit, but none of them reflect promoting factors such as heterogeneous nucleation and/or aggregation capacity.

[A retrospective study of 200 cases of lichen]

In this study the data on 200 patients affected by various features of lichen planus (LP) are reported. All subjects were in-patients of the Department of Dermatology, Bari, from 1973 to 1988. In 87% of cases the disease appeared as lichen tuber planus, and in 9% there was involvement of mucous membranes. Equal involvement of sex incidence has been found, and the patients were middle-aged (mean, 47 years). The lesion were not subsided in about 10% of cases. Associated fortuitous skin conditions were mainly alopecia areata and vitiligo. In addition, LP has been observed in association with diabetes (8%) and hepatic diseases (10%). These last values could appear relevant, but in our region, Apulia, both diabetes and hepatitis, and especially B-hepatitis, are very frequent diseases. Our clinical follow-up did not allow to consider LP as a symptom of other subsequent organic diseases.

[Clinico-pathogenetic observations on the subject of "superficial vasculitis"]

A clinical, histopathologic, laboratory and therapeutic study in 44 subjects with "superficial vasculitis", consecutively observed during the last two years, has been carried out. The findings showed that 1. the anamnesis was sometimes not relevant; 2. the clinical pictures were not in a regular manner correlated with histologic reports (a polymorphonuclear infiltrate with leukocytoclasis or a lymphomononuclear + one); and 3. a non-correlation between clinical, histologic and etiologic data. Infectious agents were responsible, mostly pyogenic bacteria, Mycobacterium tuberculosis, and hepatitis B virus; Chlamydiae were rarely responsible, whereas the etiologic role of Toxoplasma was uncertain. In this respect, drugs were not relevant. All these agents seem to act on the immunological response of the patient with previous microvascular changes (diabetes, chronic venous insufficiency). The latter condition seems to play a predominant role: the recovery of the lesions and/or their relapse shows the same behaviour both in case of etiological and symptomatic therapy.

Production of calcium oxalate monohydrate, dihydrate or trihydrate. A comparative study

Procedures to obtain calcium oxalate monohydrate, dihydrate and trihydrate are presented and discussed. The influence of several additives and conditions in the formation of calcium oxalate dihydrate crystals are comparatively evaluated. It seems that the presence of colloidal phosphate favours the formation of calcium oxalate dihydrate crystals through heterogeneous nucleation.

On the relation between citrate and calcium in normal and stone-former subjects

The aim of this work is to evaluate citrate in a group of patients with calcium oxalate urolithiasis and in a control group for detecting possible differences between the two groups. The mean urinary concentration in the stone-formers was found significantly lower than in the controls. Particularly interesting was the correlation study between citrate and calcium. It was found that patients with hypocitraturia have hypercalciuria. Thus, it is particularly interesting to point out the importance of citrate in preventing the risk of lithiasis in the group of stone-formers studied by us.

The role of hyperoxaluria in the formation of calcium oxalate urinary calculi, and its association with other biochemical measurements

The part played by hyperoxaluria in the formation of calcium oxalate urinary calculi was studied in 153 patients who had each been diagnosed as having calcium oxalate urinary calculi on one or more occasions. Seventy-seven of the patients excreted normal amounts of calcium (less than 6.2 mmol/d), and 76 had hypercalciuria (excretion greater than or equal to 6.2 mmol/d); each group was divided into a further two groups depending on whether the oxalate concentration was above or below 0.16 mmol/l. Pure calcium oxalate stones were more common in patients whose calcium excretion was normal, and mixed calcium oxalate and phosphate stones were more common among hypercalciuric patients. Urinary concentrations/day of magnesium, citrate, and phosphorus were significantly lower in the two groups in which the oxalate concentrations were below 0.16 mmol/l than in a normal control group, and magnesium and phosphorus were significantly lower in the two groups in which oxalate concentrations were less than 0.16 mmol/l than in the two in which they were above that value. The concentration of citrate was also lower, but not significantly so. In addition, the pH of the urine in patients with mixed stones was significantly higher in all groups than when the stones were composed of pure calcium oxalate.

Relation between calcium oxalate hydrate form found in renal calculi and some urinary parameters

In calcium oxalate urolithiasis, the monohydrate and dihydrate forms can be found. The aim of this paper is to examine a group of patients with calcium oxalate calculi to determine the calcium oxalate form and the possible relationship with calcium and other urinary biochemical parameters. It was found that calcium oxalate monohydrate is more frequent in the normocalciuric group and also is associated with a lack of inhibitory capacity, while a mixed calculus of calcium oxalate and phosphate or calcium oxalate dihydrate can be related with hypercalciuria.

Inhibitory effect of pyrophosphate, citrate, magnesium and chondroitin sulphate in calcium oxalate urolithiasis

The inhibitory capacity of pyrophosphate, citrate, magnesium and chondroitin sulphate was investigated, using the urine of 21 calcium oxalate stone-forming patients without metabolic alterations. The inhibitory effect of these substances was assessed by a combination of nephelometry (light scattering) and optical microscopy. The results showed that citrate and magnesium had an inhibitory effect in a significant number of cases. Pyrophosphate and chondroitin sulphate had a less marked effect. The main urinary lithogenic biochemical parameters of the patients were also studied to see if there was a relationship between them and the inhibitory capacity of the compounds.

Irradiation of the hypothalamic-hypophyseal area induces complete regression of mucocutaneous lesions in disseminated histiocytosis X

We report on a 54-year-old woman with disseminated histiocytosis X who had a complete regression of all mucocutaneous lesions within 1 month from the completion of radiation therapy (4500 cGy) to the hypothalamic-hypophyseal (H-H) area. This response lasted 12 months, after which new cutaneous and bone lesions appeared.

On the relation between citrate and calcium in normal and stone-former subjects

The aim of this work is to evaluate citrate in a group of patients with calcium oxalate urolithiasis and in a control group for detecting possible differences between the two groups. The mean urinary concentration in groups of stone-formers was found significantly lower than in the control group. Particularly interesting was the correlation study between citrate and calcium. It was found that patients with hypocitraturia have hypercalciuria. Thus, it is particularly interesting to point out the importance of citrate in preventing the risk of lithiasis in stone-formers studied by us.

[Introduction of an enzyme method for determining pyrophosphate in urine--a comparative study between patients with calculi and normal probands]

Interest aroused towards pyrophosphate as a possible inhibitor in calcium oxalate and phosphate lithiasis. A procedure for the quantitative determination of pyrophosphate in urine suitable for use in clinical laboratories is described. The reproducibility of the method was assessed by within-run and between-run reproducibility studies and the accuracy of the method was obtained by determining the amount of pyrophosphate recovered in urine samples. The present study compares the pyrophosphate excretion and concentration between a control group and a calcium oxalate stone former group.

The relation between orthophosphate and pyrophosphate in normal subjects and in patients with urolithiasis

In calcium lithiasis, inhibitors have a significant effect in reducing the crystallization process. This work evaluated orthophosphate in a group of patients with calcium oxalate lithiasis, and in a control group. The study of orthophosphate and pyrophosphate, showed differences between stone formers and the control group. These results could be attributed to a failure in the renal transformation of orthophosphate into pyrophosphate.

Investigation of GAGS on 24-hour and 2-hour urines from calcium oxalate stone formers and healthy subjects

The role of urinary glycosaminoglycans (GAGS) in calcium oxalate lithiasis is of great interest in urologic research. It has been claimed that GAGS are important inhibitors of calcium oxalate crystal growth and aggregation. The aim of this paper is to evaluate GAGS excretion and concentration in two groups of patients, calcium stone formers (with or without metabolic alteration) and a control group, to detect possible differences. The findings of this study show that significant differences exist not only in the 24-hour average excretion between stone formers without alteration and healthy subjects but also in the mean concentration values between the stone former and control groups. The same results are obtained from the 2-hour urine analysis. It is concluded that 2-h urine analyses of GAGS have the same or more practical value than a 24-h urine analysis and that the results must be expressed in terms of concentration.

Urolithiasis inhibitors and calculus nucleation

The possible inhibitors of heterogeneous nucleation were investigated. The effects of magnesium, pyrophosphate, citrate and Chondroitin Sulphate on calcium phosphate or uric acid heterogeneous nucleation of calcium oxalate were studied. It was found that whereas magnesium, pyrophosphate and citrate acted as effective inhibitors in the presence of calcium phosphate as heterogeneous nucleant, only chondroitin sulphate manifested important inhibitory effects when uric acid was the heterogeneous nucleant.

Absorption and excretion in the experimental animal of a 14C-ethylmaleimide labelled peptide fraction of bovine factor VIII with antihaemorrhagic activity

In this study the absorption and excretion of a peptide fraction from bovine Factor VIII (Vueffe) with antihaemorrhagic activity were investigated in rats and rabbits. The results obtained suggest that the peptide fraction may be absorbed from the gastrointestinal tract through an active transport or a process of nonselective pinocytosis. The radioactivity elimination was rapid and almost complete within 24 h. In addition no difference was observed between single or repeated dosing in the pharmacokinetic parameters. The evidence following routes of administration shows the good bioavailability of this peptide fraction of low molecular weight and confirms the efficacy after oral administration at very low doses.

Uric acid and its relationship with glycosaminoglycans in normal and stone-former subjects

Uric acid is implicated in calcium oxalate kidney stone formation. Conspicuously so far, two hypotheses have been proposed: direct induction of calcium oxalate precipitation by uric acid, and uric acid as anti-inhibitor by binding urinary glycosaminoglycans (GAGS). The aim of this work is to evaluate uric acid and the relationship with GAGS in a group of patients with calcium oxalate lithiasis, and in a control group for detecting possible differences between the two groups. It was found that the lower concentration of GAGS in stone formers could impede their inhibitory activity on the heterogeneous nucleation of uric acid in calcium stone formation.

Variations in the activity of urinary inhibitors in calcium oxalate urolithiasis

Opinions vary on the effects produced by urinary inhibitors of crystallisation. We describe a simple method for studying inhibitory effects in urine based on nephelometry and optical microscopy. It was concluded that the inhibitory effect of a given substance on calcium oxalate crystallisation depends on the particular sample of urine being examined and that the most effective inhibitor can be determined only by studying the urine of each patient individually.

Simple method for the study of heterogeneous nucleation in calcium oxalate urolithiasis

A simple method, based on optic microscopy and a counting chamber, has been devised for the study of heterogeneous nucleation in calcium oxalate urolithiasis. Calcium phosphate, uric acid, silica and macromolecular mucoprotein are proposed as possible nucleants. The importance of heterogeneous nucleation as a fundamental step in the formation of calcium oxalate calculi is demonstrated.

[Clinical significance of serum carnitine in the course and prognosis of dilated cardiomyopathy]

Serum carnitine is an essential cofactor for the transport of free fatty acids into the mitochondria. We determined the free and the total serum carnitine in 99 healthy blood donors and 58 patients with different forms of heart muscle disease. Thirty patients had dilated (DCM), 10 hypertrophic (HCM) and 8 alcoholic (ACM) cardiomyopathy and 10 patients had congestive heart failure of different etiology than cardiomyopathy (CHF). Free and total serum carnitine were determined by an enzymatic-spectrophotometric assay according to Pearson. Mean values for free and total serum carnitine were as follows: 47 and 74 mumol/l in controls (C; blood donors), 74 (P less than 0.01 vs. C) and 83 mumol/l in DCM, 66 (P less than 0.01 vs. C) and 89 mumol/l in HCM, 85 (P less than 0.01 vs. C) and 104 mumol/l (P less than 0.05 vs. C) in ACM and 86 (P less than 0.01 vs. C) and 129 mumol/l (P less than 0.01 vs. C) in CHF. Ten patients died during the mean observation time of 13 months, 8 patients with DCM and 2 with CHF; 9 of these 10 patients had initially a markedly increased serum carnitine. Patients with DCM were divided into two groups with normal (n = 15; 25-68 mumol/l) and increased (n = 15; greater than 68 mumol/l) free serum carnitine. Patients with increased serum carnitine showed a significantly higher mortality rate (47%) than patients with normal serum carnitine. It is concluded that free and total serum carnitine are elevated in patients with congestive heart failure, dilated and hypertrophic cardiomyopathy. The etiology of this carnitine metabolism disturbance is unclear but it is probably due to a secondary phenomenon in patients with congestive heart failure or primary myocardial hypertrophy. An increased serum carnitine is a poor prognostic sign in patients with dilated cardiomyopathy.

Histological changes in rabbits after application of medicaments and cosmetic bases (III)

An experimental study is reported of the irritant potential of oil of purcellin , isopropyl palmitate, nonyl phenol, Modulan , Amerchol and Acetulan when massaged in fixed amounts into the rabbit's skin daily for 30 days. Skin biopsies provided data on the number of epithelial cell layers, cell counts of the superficial dermis, and the fibre and basement membrane changes. All the test compounds induced changes in the form of increased number of epithelial cell layers and of the papillary dermis cell count, more marked for Acetulan or Amerchol . The difficulties in the evaluation of the results and their applications to human pathology are discussed.

Liver damage from verapamil

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Experimental sensitization of guinea pigs by drugs. Comparison of the maximization test with the wholly intradermal test

The capacity of tegobetain, pyrrolnitrin, tolcyclate and chlorquinaldol to induce delayed-type contact sensitization was studied in guinea pigs in 2 series of tests using the method of Magnusson & Kligman and the authors' modification of the wholly intradermal Draize technique. Histological examination of skin biopsies obtained from the test area demonstrated that tegobetain, pyrrolnitrin and tolcyclate are potential sensitizers.

Three controlled trials of weight loss with phenylpropanolamine

A multisite double-blind study was designed to determine the effectiveness of a phenylpropanolamine-caffeine combination in achieving weight loss. Two-hundred and one obese adult patients were divided into three separate groups in which phenylpropanolamine/caffeine was compared with either placebo (6 weeks), mazindol (6 weeks), or diethylpropion (8 weeks). In these clinical trials, phenylpropanolamine/caffeine proved to be as effective as mazindol and diethylpropion and significantly more effective than placebo in achieving weight loss. Overall, phenylpropanolamine/caffeine had fewer side effects than mazindol and diethylpropion. Its use as an effective anorectic agent in the treatment of obesity is reviewed.

Histological changes in rabbits after application of medicaments and cosmetic bases

A staged histological study of skin changes induced in rabbits by daily application of five bases used for topical medicaments and cosmetics, namely glycols, petrolatum, Modulan, Acetulan and Amerchol L 101, over periods of 100 days, is reported. Sections obtained every 10 days were examined for changes in the epithelium, in the character of the dermal infiltrate and in the superficial collagen fibers. Glycols showed no particular effects on the skin; petrolatum produced acanthosis and vacuolization in the epidermis, and mononuclear cell infiltration of the dermis but evident collagen changes. Lanolin derivatives produced acanthosis and vacuolization of the epidermis, with lymphomonouclear infiltration of the dermis and with dissociation of collagen; examination around the 30th day showed a tendency to basal layer disorganization by the infiltrate.

Histologic aspects of patch test reactions in allergic contact dermatitis

Twenty subjects with allergic contact dermatitis were patch tested with the responsible allergen applied to four fixed points on the back. Skin biopsies of the four sites were obtained after 6, 12, 24 and 48 hours, fixed in neutral formalin and stained with hematoxylin-eosin, Giemsa and toluidine blue. Sections were examined and lymphomonocytes, mast cells, eosinophils and basophils counted. In all cases the infiltrate consisted mainly of lymphomonocytes (80-82%); mast cells (5%) and basophils (0.2%) do not present clear variations within the given time. Eosinophils showed a definite numerical increase in six cases out of 20.