[Control on an injectables production line. I. Control of microporosity].
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Biomedical subjects
Publications and source records attributed to G Franchi.
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In fifteen awake, chronic cats single-unit recordings were obtained from 316 fibres isolated in the rostral portion of the corpus callosum (CC). Altogether, 304 units were reactive to peripheral stimuli. They were fired by hair bending, light touch or light pressure (S units; 79.3%) or by gentle rotation of joints and/or by pressure on muscle bellies or tendons (D units; 20.7%). All the reactive units were endowed with small and unilateral receptive fields (RFs) located in trigeminal (49.7%) or segmental (50.3%) regions. Trigeminal and forepaw units had the smallest RFs. All the trigeminal units were of the S type. Their RFs were located in either the ophthalmic, maxillar, and mandibular face districts or in the oral vestible. The vast majority of segmental units (146 out 153 fibres) had RFs in the forelimb. Very few units were fired by stimulation of the trunk (6 fibres), and only one had its RF in the tail. Almost half of the forelimb units (69 fibres) were fired by stimulation of the most proximal parts of the forelimb and of the shoulder; about one third (57 fibres) exhibited RFs located in the forepaw; the remaining units (20 fibres) had their RFs in the intermediate region of the forelimb. Neither the trigeminal nor segmental RFs ever extended across the midline. The distribution of the fibres within the CC conformed to a somatotopic pattern. The representations of the trigeminal and segmental regions were largely coextensive. Along the rostro-caudal axis of the CC, units with RFs in the mandibular, maxillar and ophthalmic divisions of the trigeminal region tended to lie in this order in the rostralmost 4 mm.(ABSTRACT TRUNCATED AT 250 WORDS)
Thirty-eight patients suffering from dermatological conditions of various natures were treated by means of the simultaneous application of a combination of three creams, the bases of which were sodium fusidate, ketoconazole and clobetasone butyrate respectively. Positive results, in the form of remission of symptoms, were obtained in 86.7% of the cases. Local tolerance was excellent in all cases and no adverse reactions were observed.
When the dorsal hand vein (DHV) is locally injected with somatostatin (SS) it spasms visibly. These spasms can be measured using the computerized venospasm technique. Acute, complete long-lasting tolerance (tachyphylaxis) develops following 2-4 injections of somatostatin. A revival of sensitivity to SS is induced in the fatigued vein by the local injection of naloxone. This suggests that endogenous opioids could participate partially or totally in SS tachyphylaxis. The analgesic effect displayed by somatostatin on the dramatic pain of the cluster attack is quantitatively similar to that of ergotamine; the therapeutic mechanism of both drugs has until now remained undefined.
Clinical experience of lysuride maleate acid in the treatment of 88 patients with occasional and 12 patients with chronic headache is reported. After 3-5 months observations the treatment was judged effective (excellent, good, satisfactory) in 72% of the cases and ineffective (poor, nil) in 28%. Side effects were few and short-lived, consisting mainly of slight nausea and asthenia. In 2 cases treatment was suspended as ineffective (in the patient's opinion).
Tachyphylaxis (TPX) to the spasmogenic activity of 5HT can be demonstrated in vivo in the superficial hand dorsal veins in man by the computerized venotest. The 5HT-TPX is reverted by previous local naloxone administration. Tachyphylaxis to 5HT is usually absent in the migraineur. The restored 5HT spasmogenic effect by naloxone suggests the possibility of local opioid apparatus participation in TPX to 5HT.
The dorsal hand vein, a suitable substrate for testing the effects of spasmogenic amines in vivo, exhibits a rapid tachyphylaxis to 5-hydroxytryptamine (5-HT)-induced vasoconstriction in healthy subjects. In the tachyphylactic vein, naloxone promptly restores and sometimes potentiates the sensitivity to 5-HT. The local opioid system could be excited by the 5-HT-induced release of noradrenaline (NA) into the neuromuscular junction, thereby participating in the 5-HT tachyphylaxis. Naloxone, antagonizing this mechanism, restores the 5-HT spasm. Therefore, the 5-HT tachyphylaxis could be due to an increased opioid modulation and not (or perhaps partially) to a depletion of the NA in the sympathergic neuron.
Using the computerized venotest, it is possible to evaluate both the venospastic activity of the vasoactive monoamines (NA,5-HT, DA) and the effects of the relative agonistic and antagonistic drugs. The ergot-derivatives are 5-HT and NA agonists at low doses, and are 5-HT antagonists at high doses. Dihydroergotamine timed release (DHE-TR) administered orally is capable at 12 hours following the last administration of producing a significant increase of 5-HT and NA venospasm. It is hypothesized that 12 hours after the last administration of DHE-TR, hematic concentrations, corresponding to clinical and therapeutic levels, capable of potentiating the monoamine venospasm still exists.
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A significant degree of supersensitivity to 5-HT and DA was detected when carrying out the computerized venotest on migraine patients during an attack. A similar supersensitivity was observed during morphine abstinence and naloxone-precipitated withdrawal in addicts. Mild abstinence after slight and short morphine treatment provoked monoamine supersensitivity in volunteers. In these conditions, the administration of morphine inhibited the 5-HT and DA supersensitivity. In spontaneous central panalgesia, monoamine supersensitivity is detectable, as well as in panalgesia induced in headache sufferers by means of PCPA 5-HT deprivation. By means of the venotest, the ergot derivatives were confirmed as being partial 5-HT agonists. These drugs can also carry out their therapeutic activity by potentiating 5-HT at a central level in 5-HT-deficient neurons. The presence of opiate receptors in the human vein is stressed. The high supersensitivity of the venous smooth muscle to 5-HT and DA both in headache and systemic pain sufferers and during morphine withdrawal suggests a pathophysiological analogy between these conditions.
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In arterio-venous malformations, arterial trans-catheter embolization can be considered as a definitive treatment, a pre-operative devascularizing technique, and a palliative treatment of those not surgically operable malformations. A very important point is choosing the correct way where to introduce the catheter and the embolizing devices. The most known devices are: synthetic fibrin foam (Gelfoam, Spongostan), Gianturco coils, and among the non reabsorbable devices a polyvinylic alcohol foam (Ivalon), the isobutyl-2-cyanoacrylate and silicone. Furthermore detachable balloons and bristle-brushes can be used. Many parameters must be taken into consideration: hemodynamic fluxes of the lesion, type of vascularization, extension of the lesion, aim of the embolization, possible risks. When embolizing large territories, the protocol must foresee several performances for the control of the embolized vessels, the presence of collateral circulation, the extension of the embolization and other afferent arteries to the lesion. Regarding the permanent occlusions it is preferable to utilize fragments of Ivalon, small silicone spheres or liquid silicone; finally, reabsorbable device must be used in the distal embolizations and non reabsorptible in the proximal embolizations. The best results have been achieved in the traumatic lesions where a direct communication exists between an artery and a vein. Among the arterio-venous malformations the best results have been achieved in cranio-facial angiomas with low flux. The possible complications are consequences of ischemia: necrotic musculo-cutaneous, cerebral or troncular changes.
The authors present their experience with 18 cases of hepatic arterial embolization: 9 for neoplasm, 8 for hemorrhage and 1 for vascular malformation. Aside from contral of acute arterial bleeding, this angiographic technique has extended its indications to the preoperative or palliative treatment of hepatic primary and secondary tumors and also to non surgical treatment of arterovenous and malformations. Compared to surgical ligation, embolization, being highly selective, produces less damage to the normal parenchyma. In case of inoperable tumors embolization produces some improvement of general conditions and has analgesic effect; while when operation is possible it may act as a preoperative devascularization procedure. Finally with employment of non absorbable material embolization may substitute surgery in presence of arterovenous malformation. The procedure has no controindications but it is essential that hepatic function is preserved and that portal flow dynamics are not altered. Among laboratory data to be investigated blood glucose level is particularly important since it may reveal ischemic damage. Possible complications due to reflux of emboli can be avoided with a correct technique and with some simple acquirements.
A series of 24 patients affected by hepatic abscess have been examined by means of CT. The localization observed was: 12 intrahepatic abscesses, 5 subdiaphragmatic, 7 subhepatic and 1 both intrahepatic and subdiaphragmatic. The advantages and disadvantages of the method are described, beside considerations on the examination technique.