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Hepatobiliary scintigraphy was used to evaluate the action of fenoverine in 16 patients suffering from dyskinesia of the biliary tract; the drug was administered in doses of 300 mg per day per os for 20 days, the patients being subjected to hepatobiliary scintigraphy before and after treatment. The following parameters--accurate indicators of the motor coordination of the biliary tract--were evaluated: tracer appearance time in the gallbladder (Tc) and in the intestine (Ti). After treatment there was a normalization of these two parameters which initially were extended. Statistical analysis showed a highly significant reduction in these times. Stress is laid on the importance of hepatobiliary scintigraphy in the diagnosis of biliary dyskinesia and on the effectiveness of fenoverine in the treatment of this conditions.

After a rapid review of the reciprocal effects of hGH and testosterone in somatic development during puberty, the behaviour of the growth hormone after appropriate stimulation was examined in prepuberal subjects with underdeveloped gonads. These subjects revealed defective secretion of the hormone which may be explained by a reduction in the efficiency of the diencephalohypophyseal factors controlling puberty and sexual function.

Boutonneuse fever has become endemic in some parts of Sicily and the Italian mainland over the last five years. An account is given of the features assisting its clinical recognition and serological verification. The main nosographical aspects of the disease are described. The conditions required for certain, probable and presumed diagnosis are stated, stress being laid on the prime importance of timely clinical assessment, and the possibility of serological ascertainment when the disease is waning, or even later. Serum diagnosis via complement fixation or microagglutination will be positive in the second half of the second seven-day period of fever. It is specific with Rickettsia conorii antigens, though these have not been easy to find so far. The Weil-Felix reaction with Proteus OX19 and OX2 is significantly positive in advanced coalescence. While this is always a practical possibility, it is of indicative, and usually retrospective, value only.

The effect of treatment with insulin, testosterone propionate and HCG on testicular damage in alloxan-induced diabetes was investigated in the rat. Both insulin and HCG offered protection, whereas testosterone, although it reduced blood sugar, did not have this effect. The protective action of HCG may be dependent on a reactive incretion of hypophyseal FSH.

After a review of the literature on heart damage in rickettsiosis, the data from a clinical and ecgraphic investigation of 17 patients suffering from boutonneuse fever are reported. There was little cardiovascular involvement and inconstant hypotension but two heart complications are described, one myocardial ischaemia which cleared up a few days after the end of the diseases, and an atrial fibrillation that lasted two days. Stress is laid on the need for constant ecgraphic monitoring, even in this minor rickettsiosis.

The typical papulomacular picture of boutonneuse fever is described. A series of atypical exanthemas is presented: simply erythemato-macular and typhus-like, nodular, vesicular. Skin biopsies showing the endothelial, thrombotic and parietal aspects of periadventitial infiltration (this being sometimes moderately and extensively pericapillary) are also presented. The reason for the absence of extensive thrombisation in extensive, marked rickettsiotic endothelitis are discussed, and stress is laid to the hitherto little-discussed, but significant involvement of dermal collagen.

Data relating to three statistical, clinical and epidemiological research projects covering a total of 350 cases of peripheral obliterating arteriopathy, collected by the same group from different Sicilian provinces and based on the same classification, are presented. Athersclerosis was a prominent feature (50% in the eastern provinces, 60% in the west), especially in the 6th decade of life. Diabetes, alone or in association with athersclerosis, was also more common in the west (18%) as opposed to the east (5--%). Burger's disease was noted in 3% and infection in 8% (presumably viral on 3.5%). Comparison is made with the national statistics produced by Corsi and the partial results of other Sicilian workers. The clinical data showed: a) the disease appeared at least 10 years earlier in subjects with athersclerosis and diabetes; 2) these subjects was also more exposed to the risk of coronary and cereabral involvement; c) asymptomatic forms were observable in 8% of atherosclerotics and 20% of those with both diabetes and athersclerosis. Reasons for the increase of degenerative forms throughout the world are discussed. Correct, systematic examination for the detection of forms with few or no symptoms is definitely required.

Marked deposits of calcium salts were noted in the triceps and gluteal and peritrochanteric areas in a 16-yr-old girl. Blood calcium values basal and after stimulation were normal. The classification of the case as a form of pseudotumoral calcinosis universalis is discussed.

Complications are rare in boutonneuse fever. This is clear from the brief review offered of the relevant literature. Reference is made to the clinical records of a personal series collected in Sicily during the current endemo-epidemic expansion of the disease through some regions of Italy. Primary complications appear in the form of cutaneous vesicles, a pyramidally located psychosensorial syndrome, transient atrial fibrillation and myocardial ischaemia, anuria with hyperazotaemia and another severe renal impairment. Careful clinical investigation of cases with unusual symptoms is recommended, coupled with systematic pathogenetic examination along modern lines.

Humans show little sensitivity to the bites of healthy Rhipicephalus sanguineus and the skin lesion is extremely slight. The "tache noire" - innoculation eschar - corresponding to the infecting bite of the tick with R. conori is discussed and histopathological findings reported. The patient is frequently unaware of the eschar on his body and elements relating to the duration of the infecting bite are deduced. Apart from its typical features, the tache noire may be very small, with surrounding hyper-ergic reaction, or it may even not be present, depending on different conditions of tissue reactivity. The pathogenesis is mentioned and the need for careful research for diagnostic purposes stressed.