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The principal action of IFN is anti-viral, rather than antiproliferative and immunomodulatory. All three actions are required to resolve pre-neoplastic uterine cervix pathologies, above all if they are at an early stage or associated with viral cytopathic effects.

Kodak Surecell Kit, a new immunoenzymatic test for Chlamydia detection, was evaluated. The Authors compared the sensitivity, specificity and cost between the tissue culture and the immunoenzymatic test. They conclude that the immunoenzymatic test, Kodak Surecell, is sufficiently faithful. It is a rapid and cheap method.

The paper discusses the genesis of vestibular papillomatosis: some researchers affirm that it is epithelio-paraphysiological whereas others maintain that it is a subclinical stage of HPV infection. In some cases "true" symptomatic papillomatosis may be remedied by human leucocyte alpha-IFN treatment.

The Authors point out the importance of histiocytes in Papanicolaou smears. Histiocytes are associated with endometrial carcinoma on tissue sections and may be seen on cervicovaginal smears as well. Smears obtained from 120 women, with clinical signs of endometrial diseases, were evaluated to determine the correlation between the presence of histiocytes in the cervicovaginal smears and endometrial adenocarcinoma. Histiocytes were quantified as minimal [less than 5 per high-power field (hpf)], moderate (5-10 hpf) or heavy (greater than 10/hpf). The histiocytes were found in smears from 80 women. Five adenocarcinomas, 9 hyperplasias were detected in 20 patients with moderate or heavy smears. The Authors conclude that the presence of histiocytes among postmenopausal women who have cervicovaginal smears should not be ignored. The data indicate that, in the absence of endometrial cells, histiocytes on cervicovaginal smears of postmenopausal women are associated with more elevated relative risk for endometrial carcinoma.

The diagnostic role of arteriography in the evaluation of hepatocellular carcinoma is pointed out. In the identification of large lesions angiography achieves a sensitivity of 100%. However, when evaluating small lesions (under 5 or 3 cm in diameter), the sensitivity is reported to be 82-89%. To increase the sensitivity, different special techniques have been developed which require angiographic placement of a catheter. These include CT arteriography, CT arterial portography and CT after intraarterial injection of iodized oil. Particularly with the two latter techniques, the sensitivity in identification of small hepatocellular carcinoma reaches a value of 91-95%. Angiography can also be proposed for the characterization of neoplastic lesions in cirrhotic livers. Its specificity is 72% in the differential diagnosis of hepatocellular carcinoma and adenomatous hyperplastic nodules. Small grade I hepatocellular carcinoma can simulate this benign lesion at angiography, as well as at histology. Finally, angiography may still play a role in the preoperative staging of hepatocellular carcinoma both for the diagnosis of satellite lesions and for the identification of vascular invasion.

Magnetic resonance imaging during arterial portography (MRAP) was performed by the authors in a selected group of 12 patients with hepatic lesions. A low dose of gadopentetate dimeglumine (4 mL of a 0.5-mol/L solution, corresponding to a dose of 0.05-0.07 mmol/kg) was injected into the superior mesenteric artery during acquisition of breath-holding gradient-echo or rapid acquisition spin-echo images. Images were always acquired during the first passage of gadopentetate dimeglumine through the liver parenchyma. An increase in liver-to-lesion contrast was obtained with MRAP imaging (contrast-to-noise ratio = 8 +/- 1.8 vs 19 +/- 2.7). Signal intensity enhancement of the liver was high (signal-to-noise ratio = 9.48 +/- 2.42), while the lesion presented no significant enhancement (signal-to-noise ratio = 0.55 +/- 0.22). Lobar portal vein thrombosis was detected in one patient owing to lack of enhancement of the left lobe of the liver. No side effects related to administration of iodinated and paramagnetic contrast agents were observed. This new technique provides specific enhancement of liver parenchyma with improved liver-to-lesion contrast.

The performance of the infrared scanning radiometer (IRSR) is strongly stressed in convective heat transfer applications where high spatial frequencies in the signal that describes the thermal image are present. The need to characterize more deeply the system spatial resolution has led to the formulation of a cascade model for the evaluation of the actual modulation transfer function of a sampled IR imaging system. The model can yield both the aliasing band and the averaged modulation response for a general sampling subsystem. For a line scan imaging system, which is the case of a typical IRSR, a rule of thumb that states whether the combined sampling-imaging system is either imaging-dependent or sampling-dependent is proposed. The model is tested by comparing it with other noncascade models as well as by ad hoc measurements performed on a commercial digitized IRSR.

Some authors suggested that MR imaging could represent an effective diagnostic alternative in the study of pathologic conditions of mother and fetus during pregnancy. To verify the actual role of MR imaging, we examined 20 patients in the 2nd and 3rd trimester of gestation, after a preliminary US examination. Fifteen patients presented fetal or placental pathologies; in 4 patients the onset of the pathologic condition occurred during pregnancy; in 1 case of US diagnosis of fetal ascites, MR findings were normal and the newborn was healthy. As for placental pathologies, our series included a case of placental cyst, two hematomas between placenta and uterine wall, and two cases of partial placenta previa. As for fetal malformations, we evaluated a case of omphalocele, one of Prune-Belly syndrome, a case of femoral asymmetry, one of thanatophoric dwarfism, a case of thoracopagus twins with cardiovascular abnormalities, two fetal hydrocephali, and three cases of pyelo-ureteral stenosis. As for maternal pathologies during pregnancy, we observed a case of subserous uterine fibromyoma, one of right hydronephrosis, one of protrusion of lumbar intervertebral disk, and a large ovarian cyst. In our experience, MR imaging exhibited high sensitivity and a large field of view, which were both useful in the investigation of the different conditions occurring during pregnancy. In the evaluation of fetal and placental abnormalities, especially during the 3rd trimester, the diagnostic yield of MR imaging suggested it as a complementary technique to US for the evaluation of fetal malformations and of intrauterine growth retardation.

The ISSVD has attempted to separate dystrophic lesions from VIN in order to draw up a standard nomenclature based on histopathological characteristics so as to obtain comparable data. But the definition of the dysplastic evolutive possibilities of hyperplastic lesions is still an open problem. In this study 40% of VIN I, 100% of VIN II and 16.6% of VIN III were associated with hyperplastic lesions. 16.6% of VIN III were associated with sclerosing lichen. In this case, a hyperplastic phase could have been followed by a distrophic one since the patient was 73 years old. The overall frequency of cellular atypia in vulvar dystrophy was therefore 14.66%; it increased to 41.66% during the hyperplastic phase. The age of patients increased in parallel to the severity of lesions. No decrease in the mean age of incidence was noted except in those cases associated with HPV. The potential uncontrolled increase of hyperplastic alterations could have been produced by the absence of an inhibitory incidence stimulus, as has been noted in the resistance to topical steroid therapy in some cases of squamous hyperplasia. The localisation of cellular atypia, however, indicates surgical treatment.

A new lipophilic compound, Gd-BOPTA, presenting a high rate (38.6%) of biliary excretion was tested as an hepato-specific MR contrast agent. Its adequacy was compared to that of Gd-DTPA in laboratory animals. T1-weighted spin-echo sequences (TR 220 ms, TE 20 ms) both before and after the administration of the 2 contrast agents (doses: 0.25, 0.5, and 1.0 mmol/kg) showed better liver enhancement with Gd-BOPTA than with Gd-DTPA. Gd-BOPTA superiority was more evident at lower doses, while at 1.0 mmol/kg a comparable enhancement was achieved. Inversion recovery sequence at the T-null of liver parenchyma before contrast (TR 800 ms, TE 30 ms, TI 100 ms) was performed after the injection of 0.1 and 0.5 mmol/kg of Gd-DTPA and Gd-BOPTA. This sequence allowed the good and long-lasting liver enhancement achieved with Gd-BOPTA to be even better demonstrated, while Gd-DTPA provided only a slight and early enhancement with 0.1 mmol/kg and returned to baseline values 60' after the injection of the highest dose (0.5 mmol/kg). Gd-BOPTA proved to be a good contrast agent to obtain prolonged liver enhancement, thus providing the radiologist with the long time needed to acquire conventional T1-weighted pulse sequences.

The authors attempt to correlate the response to dexamethasone suppression test (DST) with a clinical response to antidepressant drugs in 68 patients with major depression. Antidepressants that influence noradrenergic or serotonergic transmission with relative different potencies were selected and used in standard doses for 6 weeks. The response was evaluated weekly by raters blind to DST results and to antidepressant medications prescribed. The retrospective analysis failed to correlate DST response with outcome of treatment. Therefore the present results suggest that this laboratory test does not help to identify subgroups of depressed patients responding preferentially to various antidepressant drugs.

The validity of the dexamethasone ofe suppression test was evaluated for the differential diagnosis of major and minor depressive disorders. Thirty-eight out-patients (14 major depressed, 14 minor depressed and 10 normal controls) were studied. The Research Diagnostic Criteria of Spitzer et al. (1978) were used to classify these patients. Six out of the 14 major depressed patients had an abnormally high plasma cortisol at 4 p.m. and at 11.00 p.m. after midnight 2 mg-dexamethasone. None of the 14 minor depressed patients and none of the 10 controls had an abnormal response to dexamethasone. Based on these results, the dexamethasone suppression test has a sensitivity of 43%, a specificity of 100% and a high predictive value.

Daily rhythms of free plasma tryptophan in man are reported from a study in twelve normal volunteers on stated dietary and environment conditions. Measurements of tryptophan were been obtained according to Bloxam's modifications of traditional methods. The Authors describe the results and discuss the importance of free plasma tryptophan levels as a marker of 5-HT brain metabolism.

Plasma cortisol suppression following 1 mg dexamethasone administration was investigated in patients with affective disorders. Twenty-nine depressed outpatients, 8 bipolar depressed inpatients during manic or hypomanic phase, and twelve healthy volunteers entered the study. Depressed patients were divided into 2 groups according to Research Diagnostic Criterio of Spitzer et al. (1978). The first group consisted of 10 patients affected by minor depressive disorders. The second group was formed of 19 patients with major depressive disorders (7 bipolar, 12 unipolar). No difference between patients and controls was found in baseline 4.00 p.m. serum cortisol levels. Healthy volunteers, patients with minor depressive disorders and bipolar subjects in manic or hypomanic phase showed normal suppression. On the other hand, only 42% of patients with major depressive disorders showed suppression. These results suggest that altered response to dexamethasone is a state-dependent phenomenon. Moreover, a dexamethasone suppression test is able to identify subgroups of suppressor in affected patients.

Blood lipids and lipoproteins were evaluated in male and female subjects of various ages with acute myocardial infarct. Values were within the limits of normal in less than 50%, mostly in the aged. II B (24%), IV (18%) and II A (11%) lipoprotidaemic pictures were the most common. It is felt that abnormal values are not necessarily part of the infarct picture; if present, they are mainly of the II B type.

The aim of the present investigation was to study the effects of a single 100-micrograms i.v. administration of the synthetic heptadecapeptide [beta-Ala1-Lys17]ACTH1-17-4-amino-N-butylamide (ACTH 1-17) on the left ventricular performance. The systolic time intervals (STI) were recorded in 20 healthy adult young subjects (10 treated with ACTH 1-17 and 10 receiving placebo) before as well as 20, 40, 60 and 80 min after the i.v. ACTH 1-17 or placebo infusion. The STI were recorded immediately after blood withdrawal for measuring cortisol, aldosterone, adrenaline and noradrenaline plasma levels. A highly significant statistical difference was demonstrated for preejection period (PEP) and preejection period/left ventricular ejection time (PEP/LVET) ratio between subjects treated with ACTH 1-17 and subjects receiving placebo. As expected, a significant increase of cortisol and aldosterone plasma levels was observed in subjects treated with ACTH 1-17. The difference of adrenaline and noradrenaline plasma levels was statistically highly significant between subjects treated with ACTH 1-17 and those receiving placebo. The lack of increase in PEP and PEP/LVET ratio recorded in subjects treated with ACTH 1-17 is consistent with an increased left ventricular contractile performance. An increased plasma catecholamine release is postulated as the mechanism of this improvement.

As yet, a valid tissue characterization of human breast diseases has not been possible with conventional MR techniques. On the basis of the experimental thesis according to which fibroadenomas and carcinomas have a slight, though significant, difference in T1 relaxation times, we employed specific inversion recovery sequences at the T null of the breast glandular and adipose tissues, to enhance the differences in the signal intensities of the various pathologies. We examined 16 (6 cystic dysplasias, 5 fibroadenomas, 3 carcinomas, and 1 phylloid fibroadenoma) selected patients with the above-mentioned sequences in addition to the routine T1- and T2-weighted spin echo sequences. The following conclusions were reached by evaluating the characteristic signal intensities: MR spin echo sequences allow solid lesions to be distinguished from cystic ones; MR inversion recovery sequences allow fibroadenomas to be distinguished from carcinomas with 88% accuracy.

With the purpose of detecting spontaneous variation of systolic time intervals (STI), 20 normal subjects have been examined and the STI has been recorded for 5 consecutive days at the beginning of the test and 20, 40 and 60 min afterwards. Significant differences were found for PEP, LVET and the PEP/LVET ratio between observations (p less than 0.05) and between days (p less than 0.01). All the values of the STI at the fifth day are rather near the values recorded at the last observation of the first day. This may be related to the presence of some factor (catecholamine release induced by emotional stress?) resulting in physiological changes which are reduced by repetition of the test. This hypothesis was confirmed in a second series of normal volunteers where the STI were recorded simultaneously with sampling of blood for assessing circulating CA levels. A highly significant correlation (p less than 0.001) was recorded between PEP, PEP/LVET and plasma CA making it evident that increase of PEPI and PEP/LVET is directly correlated with the reduction of plasma CA level.

In this study, flunarizine, a selective calcium-channel blocker, was employed in the prophylactic treatment of headache and was compared with methysergide in terms of efficacy. The trial was conducted with 104 patients (53 treated with flunarizine and 51 treated with methysergide) and lasted six months--one month of pretreatment and five months of therapy. Patients in both groups experienced a highly significant reduction in the number and duration of migraine attacks. Unlike those in the methysergide group, patients treated with flunarizine achieved a significant reduction in the intensity of attacks with very negligible side effects.