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Abstract.: The aim of this prospective study was to assess the effectiveness in healing anal fissure (AF) of lacidipine, a calcium channel blocker with a better tolerability in comparison to other calcium antagonists. Twenty-one consecutive patients (16 women, 76.2%) with AF (16 chronic, situated posteriorly in 17 patients (81.0%), anteriorly in 4) with a mean age of 37.1 years (SD, 13.6, range, 20–6) were treated with oral lacidipine (6 mg daily) and warm sitz baths for 28 days, adding only stool softeners for patients with constipation. Blood pressure, pain scores (assessed from 0 to 10 on a visual analogue scale) and fissure healing were monitored at 14 days, 28 days and 2 months. At the 14-day and 28-day follow-ups, the mean systolic and diastolic pressures were not significantly different from pre-treatment levels. Seven patients (33.3%) developed side effects, but only one, who developed dyplopia, withdrew from the study at the 14-day control (non-compliance rate with treatment, 4.8%). Pain scores were significantly reduced after 14 days and continued to show a significant reduction throughout the treatment period. Three fissures (14.3%) healed by 14 days and a total of 19 (90.4%) after 28 days: among the healed AF no recurrences were seen at the 2-month control. Among the two treatment failures, one was the patient who withdrew from the study at the 14-day control due to dyplopia and the other was a patient who failed to heal up to the 2-month follow-up, although completely asymptomatic. Both patients underwent left lateral sphincterotomy and healed. In conclusion, oral lacedipine is quite well tolerated and may offer a promising alternative treatment for AF.

Optical absorption spectra in the range 5×104- 400 cm-1 and Raman spectra are studied in polypyrrole, as function 1) of the sample preparation; 2) of the temperature (10-300 K) and 3) of the nature of dopant counterions (BF4, SO4, ClO4, NO3).

Abstract: Large polyps are sessile or pedunculated lesions that are larger than or equal to 3 cm in size. Sixty-six colonoscopic piecemeal excisions of large pedunculated and sessile polyps (75 percent of 88 recognized large polyps) were performed over eight years. The macroscopic feature of the lesions and the result of an extensive snare biopsy were the deciding factors for endoscopic as opposed to surgical removal. Only three complications (4.5 percent) were recorded (two hemorrhages and one colonic wall burn syndrome), none of which required surgery. Fifty patients with 52 adenomatous lesions had colonoscopic follow-up (range, 3 to 85 months). Of 36 sessile ademonas, two cases of residual (5.5 percent) and four of recurrent disease (11 percent) were observed. Colonoscopic removal is an alternative to local surgical excision of large benign colorectal polyps, and often can be an alternative method to elective colectomy in elderly and high-risk patients.

Summary Four different methods to measure in parallel the erbB2 protein expression (p185neu) were evaluated in order to: a) compare two enzyme immunoassays with the immunohistochemical assays (IHC) and western blotting (WB) and b) extrapolate eventual relationships between erbB2 and biological parameters.

The importance of N,N' asymmetrically disubstituted piperazines in pharmaceutical and medicinal chemistry does not need to be emphasized. Such a basic moiety is present in a number of drugs belonging to different classes, and especially in those of the central and peripheral nervous system. In recent times the interest connected with piperazines appears to be a fast growing topic in drug research.

Good results in the treatment of skin tumors have been obtained by an alkaloid of colchicum (colcemid).

Riassunto L'A. riferisce sul trattamento Roentgen di 32 tumori endocranici. Discute la tecnica di trattamento e la possibilità di lesioni da raggi X sul tessuto cerebrale sano. Ritiene indicato l'uso di dosi alte.

A summary of the results obtained by the Italian Breast Cancer Group in 122 patients with advanced breast cancer randomized over four different treatments: testosterone propionate, given i.m. 3 times a week at the dose of 100 mg per injection; cyclophosphamide, administered i.m. 25 times a month at the dose of 100 mg/day; testosterone + cyclophosphamide i.m. at the above doses; HMNT (4-hydroxy-17 methyl-19-nortestosterone) given i.m. 3 times a week at the dose of 100 mg/day. The criteria for patient selection and methods of evaluation were, with some modifications, these used by the American Breast Cancer Group. Objective improvements were observed in 26.9% of patients treated with testosterone propionate, in 15.6% of patients treated with cyclophosphamide, in 23.5% of those treated with testosterone + cyclophosphamide and in 20% of patients treated with HMNT. The most interesting result, worth of further evaluation, is that observed with the combined testosterone + cyclophosphamide therapy, which yielded the highest number of objective improvements in patients in menopause for less than one year.

No abstract.

Fibre glass fabrics coated by polypyrrole or other polyene polymers in ‘doped’ state show high performances in trapping viruses from contaminated water. Also, the complete recovery of adsorbed viruses was easily performed. These findings suggest a completely new type of application for such materials.

The metal ion catalyzed chlorination of 1-chlorobutane, 1-chlorohexane, methyl-pentanoate, and methyl-heptanoate by protonated N-chloroamines proceeds by a free radical chain mechanism and the chain carrying species was shown not to be a chlorine atom, but an amino radical cation.

Ninety ET patients diagnosed according to the PVSG criteria were enrolled in a phase II study (sponsored by the Schering-Plough Company) designed to evaluate the efficacy, safety and tolerability of a two years treatment with PEG Interferon alpha-2 b (PEG Intron). The patients, observed in 16 Italian Centres belonging to the GIMEMA Cooperative Group and judged at high risk, had been previously treated with cytoreductive (97%) and antiplatelet (91%) drugs. At the study start the patients, 60 F and 30 M, mean age 45 years, showed splenomegaly in 22% of cases. The Hematological Response (HR: PLT<500 x109/L) was observed in 64/81 (79%) and 48/55 (87%) of the patients on PEG Intron treatment at the end of the first and second year, respectively; the spleen enlargement disappeared in 75% of cases. The Bone Marrow data reported in the study CRFs document that the baseline increase of cellularity, of granulopoyesis, of megakaryocytes (MK) number, size and ploidy significantly decreased during PEG Intron treatment, while the MK displasia and fibrosis rate globally increased. In these patients a revision of the Bone Marrow biopsy slides was blindly performed by an Expert Pathologist Panel by applying the WHO criteria. The evaluation of two-thirds of cases showed the following distribution at the baseline: true ET (23%), IMF-0 (pre-MF 17%), IMF-1 (early MF 40%), IMF-2/3 (classical MF 3%), MPD-U (17%). Interestingly, the true ET patients never showed spleen enlargement that, otherwise, was present in IMF-0 (20%) and IMF-1/2/3 (42%) patients. The patients with true ET did not show any bone marrow evolution during the PEG Intron treatment, while the IMF-1/2/3 picture significantly increased. Moreover, the rate of the HR at the end of the first year was higher in true ET(93%) respect to the IMF-0 (60%) and IMF-1/2(71%) patients. These preliminary data show that the patients classified as true ET (WHO Criteria) are not splenomegalic, have no myelofibrotic evolution and reach a better response to the IFN treatment.

Ninety ET patients diagnosed according to the PVSG criteria were enrolled in a phase II study (sponsored by the Schering-Plough Company) designed to evaluate the efficacy, safety and tolerability of a two years treatment with PEG Interferon alpha-2 b (PEG Intron). The patients, observed in 16 Italian Centres belonging to the GIMEMA Cooperative Group and judged at high risk, had been previously treated with cytoreductive (97%) and antiplatelet (91%) drugs. At the study start the patients, 60 F and 30 M, mean age 45 years, showed splenomegaly in 22% of cases. The Hematological Response (HR: PLT<500 x109/L) was observed in 64/81 (79%) and 48/55 (87%) of the patients on PEG Intron treatment at the end of the first and second year, respectively; the spleen enlargement disappeared in 75% of cases. The Bone Marrow data reported in the study CRFs document that the baseline increase of cellularity, of granulopoyesis, of megakaryocytes (MK) number, size and ploidy significantly decreased during PEG Intron treatment, while the MK displasia and fibrosis rate globally increased. In these patients a revision of the Bone Marrow biopsy slides was blindly performed by an Expert Pathologist Panel by applying the WHO criteria. The evaluation of two-thirds of cases showed the following distribution at the baseline: true ET (23%), IMF-0 (pre-MF 17%), IMF-1 (early MF 40%), IMF-2/3 (classical MF 3%), MPD-U (17%). Interestingly, the true ET patients never showed spleen enlargement that, otherwise, was present in IMF-0 (20%) and IMF-1/2/3 (42%) patients. The patients with true ET did not show any bone marrow evolution during the PEG Intron treatment, while the IMF-1/2/3 picture significantly increased. Moreover, the rate of the HR at the end of the first year was higher in true ET(93%) respect to the IMF-0 (60%) and IMF-1/2(71%) patients. These preliminary data show that the patients classified as true ET (WHO Criteria) are not splenomegalic, have no myelofibrotic evolution and reach a better response to the IFN treatment.

Ninety patients with Essential Thrombocythemia (ET) where object of a phase II prospective multicentre study designed to evaluate efficacy, safety and tolerability of a two years treatment with PEG Interferon α-2b (PEG Intron, Schering Plough). The patients, 30 M and 60 F, 18–72 years old (median 45), observed in 16 Hematological Institutions of the Gruppo Italiano Malattie Mieloproliferative Croniche (GIMMC), received the ET diagnosis according to the PVSG criteria. At PEG Intron treatment start the patients showed: previous cytoreduction 97% (IFN α 31%), platelet count >1000 x 109/L 81%, splenomegaly 22%. At the end of the first year The PEG Intron starting dose of 25 μg/week resulted increased to a mean value of 55 μg/week and the Hematological Response (HR = Plts <500x109/L) was registered in 79% of the patients still on treatment. At the end of second year 65 patient still receiving PEG Intron (mean dose 31 μg/week) showed a maintenance of the HR (66%), a Partial Response (17%) and a Minor Response (17%). By utilizing the data included in the study CRFs we preliminarily evaluated the bone marrow biopsy and aspirate both performed at baseline, after 1 and 2 years in 89 and 86, 79 and 67, 57 and 50 patients, respectively. Data concerning the bone marrow biopsies after 1 year of treatment are reported: BONE MARROW BIOPSY BASELINE % 1 YR % 2 YRS % Cellularity increased 56 51 48 Granulopoiesis increased 51 54 39 Erytropoiesis increased 29 24 23 MK number increased 99 90 84 MK size increased 78 69 62 MK ploidy 54 51 42 MK dystrophy 52 56 59 Fibrosis mild 40 37 46 Fibrosis moderate 7 25 26 The increase of bone marrow fibrosis registered after one year (representative also of second year data) resulted not related to patient gender, age >45 years, platelet count >1000 x109/L, Hb <12 g/dL, splenomegaly, previous IFN treatment, PEG Intron dose >50 μg/week. In conclusion, the present study shows that in ET patients a two years PEG Intron treatment, able to induce and to maintain the Hematological Response in the majority of cases, is associated to a decrease of bone marrow cellularity, granulopoiesis, erytropoiesis, MK number, size and ploidy and, moreover, with an increase of MK dystrophy and of bone marrow fibrosis. These preliminary data on bone biopsy and aspirate will be object of a planned centralized reevaluation by a Panel of Pathologists and Clinicians.

Ninety patients with Essential Thrombocythemia (ET) where object of a phase II prospective multicentre study designed to evaluate efficacy, safety and tolerability of a two years treatment with PEG Interferon α-2b (PEG Intron, Schering Plough). The patients, 30 M and 60 F, 18–72 years old (median 45), observed in 16 Hematological Institutions of the Gruppo Italiano Malattie Mieloproliferative Croniche (GIMMC), received the ET diagnosis according to the PVSG criteria. At PEG Intron treatment start the patients showed: previous cytoreduction 97% (IFN α 31%), platelet count >1000 x 109/L 81%, splenomegaly 22%. At the end of the first year The PEG Intron starting dose of 25 μg/week resulted increased to a mean value of 55 μg/week and the Hematological Response (HR = Plts <500x109/L) was registered in 79% of the patients still on treatment. At the end of second year 65 patient still receiving PEG Intron (mean dose 31 μg/week) showed a maintenance of the HR (66%), a Partial Response (17%) and a Minor Response (17%). By utilizing the data included in the study CRFs we preliminarily evaluated the bone marrow biopsy and aspirate both performed at baseline, after 1 and 2 years in 89 and 86, 79 and 67, 57 and 50 patients, respectively. Data concerning the bone marrow biopsies after 1 year of treatment are reported:

The authors have compiled the present work from their personal experience with more than 600 patients, having made as many as 10,000 radiographs of them. The patients observed were suffering from various diseases of the organs below the diaphragm. Many of these patients had had a surgical operation and anatomicopathological findings had been verified thereby.