Biomedical subjects
Publications and source records attributed to R Franceschini.
The purpose of this study is to discuss diaphyseal fractures of the tibia treated by intramedullary Küntscher nailing. This is based on 368 cases treated over the last 20 years. Closed intramedullary osteosynthesis favours the healing process, resulting in the early formation of callus which is of good quality and abundant. A careful review of the cases showed a 93.7% incidence of good results.
Beta-endorphin, ACTH and cortisol secretion were measured in twelve healthy adult males after nasal spray administration 200 IU salmon calcitonin. A significant increase in plasma beta-endorphin, from 19.2 ng/l under basal conditions to a peak of 27.1 ng/l at 30 min was recorded. Plasma ACTH and cortisol were not affected. In individual subjects the beta-endorphin level was increased in eight of the twelve, ACTH rose in three and cortisol did not change in any of them. The data indicate that calcitonin induced a beta-endorphin increase independent of enhanced corticotrophin-cortisol release.
Beta-endorphin appears to be involved in the hormonal response to suckling in some animals. The peripheral secretory patterns of beta-endorphin, prolactin and cortisol were investigated in serial venous blood samples taken during suckling from eight healthy women who were breast-feeding on the third or fourth day of the puerperium. Plasma levels of prolactin and beta-endorphin increased significantly during suckling reaching a peak after 20 min, levels of cortisol remained unaffected. It is suggested that the increased beta-endorphin derives from an extra-hypophyseal source.
Ten obese and 10 control subjects were studied in basal conditions and after ingestion of a standard mixed test meal. Blood glucose, insulin, somatostatin (SLI) and vasoactive intestinal polypeptide (VIP) concentrations were determined before and 30, 60, 90, 120, 180 and 240 min after the start of the meal. Basal SLI levels in the obese (14.4 +/- 0.7 ng/l) were not significantly different from those in the controls (15.5 +/- 0.8 ng/l), whereas after the meal a blunted secretory response was recorded. Baseline plasma VIP levels were higher in the obese (29.7 +/- 1.5 ng/l) than in the control subjects (19.8 +/- 1.3 ng/l) and, similarly to the controls, were unaffected by meal ingestion. Data suggest that in the course of obesity an enhanced VIP secretion in association with a diminished SLI responsiveness to meals occurs.
Two cases of pancreatic cystoadenoma are reported. The value of ultrasound as the first choice imaging technique approach is stressed.
The Authors evaluate cystourethrography with and without chain as a method to study urethral diseases. Indications and complications are considered positively, because they allow an easy and safe control of the cases operated.
We report on 5 neonates with obstructive urinary tract candidiasis in whom percutaneous nephrostomy had a major role in management. The advantages of percutaneous nephrostomy in this setting include prompt drainage of the obstructed renal pelvis or ureter, direct access to obtain specimens from the renal pelvis to confirm the diagnosis, direct irrigation of the fungus balls with amphotericin B and an access route for fragmentation of fungus balls by guide wire manipulation. In 3 cases percutaneous placement of the nephrostomy tube was successful in obtaining and maintaining access to the renal pelvis, while in 2 surgical intervention was required because of problems maintaining placement of the percutaneous catheters. Percutaneous nephrostomy with antegrade amphotericin B irrigation, coupled with systemic antifungal therapy, is the mainstay of treatment. The usefulness of ultrasonography in the early diagnosis of renal candidiasis also is emphasized.
Seven patients suffering from prostatic cancer were treated with a slow-release D-Trp-6-LHRH preparation for a period of 24-32 months. LH, FSH, PRL and testosterone levels were evaluated before and at the end of treatment and then 40 days later. Baseline and GnRH-, TRH-, and HCG-stimulated hormonal values decreased after treatment. The possibility that a long-term treatment with GnRH analogues induces a sustained suppression of pituitary and testicular function is suggested.
The arginine vasopressin (AVP) concentrations were determined in plasma and in cerebrospinal fluid (CSF) during a 24-hour period in 7 male patients suffering from hydrocephalus of differing etiologies. Blood and ventricular CSF samples were simultaneously collected every 2 h during the day (08.00-22.00) and every hour during the night (24.00-07.00). In both plasma and CSF, the AVP levels did not show significant time-related circadian variations. No significant correlation was found between the plasma and CSF AVP values during the 24-hour period. The data obtained indicate the absence of the plasma and CSF AVP circadian rhythm in hydrocephalic patients and suggest that in these patients, and possibly in healthy humans, physiological stimuli which are able to induce variations in the plasma AVP concentration during daily life do not alter the CSF AVP content.
Seven patients suffering from prostatic cancer were treated with a depot form of D-Trp-6-luteinizing hormone-releasing hormone (LH-RH), a LH-RH agonist analogue (3 mg i.m. every 28 days) for a period of 24-32 months. The peptide induced a sharp and long-lasting inhibition of both gonadotropin and testosterone secretion. A sustained suppression of pituitary and testicular function was observed 40 days after the treatment was suspended. Testicular biopsies performed in all patients showed a marked impairment of Leydig cell mass and a complete spermatogenic arrest with a tubular derangement and fibrosis. Results indicate that the long-term continued gonadotropin-releasing hormone agonist analogue therapy induces not only a functional inhibition of testicular androgenesis but also anatomical testicular damage whose reversibility does not seem to be probable.
Somatostatin concentration was determined in plasma and in cerebrospinal fluid during a 24-h period in 7 male patients suffering from hydrocephalus of differing aetiologies. Blood and ventricular cerebrospinal fluid samples were taken every 2 h during the day (08.00-22.00 h) and every hour during the night (24.00-07.00 h). Simultaneously, plasma growth hormone levels were also evaluated. Plasma SRIH levels showed significant circadian variations with highest values in the daytime and lowest values during the night. Cerebrospinal fluid SRIH did not show any significant time-related circadian changes. Plasma GH levels showed the well-known circadian pattern in the majority of patients. No significant correlation was found between the plasma GH and plasma or cerebrospinal fluid SRIH values recorded during the 24-h period. Results suggest that peripheral SRIH does not play any major role in the control of the 24-h GH secretory pattern in man.
The plasma concentrations of vasoactive intestinal polypeptide and prolactin were measured before and after an exhaustive and a submaximal exercise test in 7 male marathon runners. A significant increase of vasoactive intestinal polypeptide was recorded after both tests, whereas the prolactin increase was observed only after the exhaustive exercise test. No significant correlation was found between the plasma vasoactive intestinal polypeptide and the plasma prolactin values recorded during the two exercise tests. Data suggest that the exercise-induced prolactin release occurs independently from variations of the vasoactive intestinal polypeptide levels in peripheral circulation.
Plasma somatostatin levels were determined during a 24-hour period and after a meal test in 7 and 5 elderly subjects (76-90 years), respectively. The data obtained were compared with those recorded in young adult subjects (22-30 years). Increased basal somatostatin values were found in elderly subjects (20.0 +/- 1.5 pg/ml) when compared to young adults (14.1 +/- 0.6 pg/ml; p less than 0.01). Also, the mean 24-hour somatostatin levels were higher in the elderly (21.3 +/- 0.8 pg/ml) than in young adults (16.7 +/- 0.5 pg/ml; p less than 0.01), and minor diurnal variations were found in the former group. The response to the meal test was less evident in the elderly than in the control group. The data obtained indicate an increased basal somatostatin production associated with a diminished variability throughout the 24-hour period and in relation to meals.
A chronobiological study was carried out in seven elderly male subjects (78-84 years) to evaluate the 24-h beta-endorphin secretory pattern. Seven young adult males (28-37 years) made up the control group. Blood samples were drawn every four hours from 08.00 to 20.00 h and every two hours from 24.00 to 06.00 h. ACTH and cortisol levels were also determined in the same plasma samples. Mean 24-h beta-endorphin values in the elderly (32.6 +/- 1.1 ng/l) and in the young adult male subjects (29.5 +/- 1.4 ng/l) did not differ statistically, but the circadian rhythm was absent in the elderly subjects. In the elderly, plasma ACTH and cortisol concentrations showed a circadian rhythm similar to that observed in the adult subjects. However, in the elderly patients, in contrast to that in the adult subjects, the multilinear regression analysis did not show any statistically significant correlation between the beta-endorphin, ACTH and cortisol 24-h plasma concentrations.
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Plasma and cerebrospinal fluid (CSF) beta-endorphin levels were determined by a RIA method in seven hydrocephalic male patients. The samples were simultaneously collected every two hours from 8 AM to 12 midnight and every hour from 1 AM to 7 AM. In both plasma and CSF beta-endorphin levels showed significant time-related variations during the 24 hour period. These results suggest the existence of diurnal CSF beta-endorphin variations analogous to those observed in plasma.
In 7 patients with congestive heart failure acute oral administration of ibopamine, a new dopamine derivative, induced a significant decrease in serum prolactin and aldosterone without affecting serum growth hormone or cortisol. The Metoclopramide-induced secretion of prolactin and aldosterone was blunted in 6 patients pretreated with 200 mg ibopamine. The data are consistent with a dopaminergic effect of ibopamine due to a peripheral action, probably on D-2 receptors.
Basal and TRH-stimulated TSH secretion was evaluated in six patients suffering from prostatic cancer, before and after antiandrogenic treatment performed using a long-acting LHRH analogue, D-Trp-6-LHRH. Although serum testosterone values dropped to minimal levels after treatment, TSH secretion remained unchanged. Observed results suggest that pharmacological castration does not affect the regulatory mechanisms involved in the control of TSH secretion.