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In order to investigate the pancreatic function in patients with thalassaemia major, plasma glucose and immunoreactive C-peptide levels were determined in 9 diabetic thalassaemic patients and in 7 controls after arginine infusion. Mean basal and peak values and C-peptide areas in thalassaemic patients did not differ significantly from those of the controls. However, in the thalassaemic group there was a greater variation in values, since pancreatic beta-cell function was found either normal, reduced or increased. These findings could suggest that different factors may lead to diabetes which complicates thalassaemia, i.e. insulin-resistance, probably due to liver damage subsequent to iron deposition and infectious hepatitis, and insulinopenia, probably due to beta-cell lesion following iron storage in the pancreas.

The radiographic patterns of the skeleton of 73 patients affected by multiple myeloma (MM) were compared to the correspondent scintigraphic findings. Whole body scans were performed using 99m Tc-diphosphonates (bone scintigraphy), and 99m Tc-microcolloids (bone marrow scintigraphy). The results indicate that: a) radiography is more sensitive and accurate than scintigraphy in detecting typical myeloma-related bone lesions; b) bone scintigraphy is useful in detecting alterations in particular locations--i.e., sternum, ribs, scapulae, etc.--which are difficult to demonstrate by plain X-rays; moreover, the recovery of the fractures can be visualized; c) bone marrow scintigraphy is employed to demonstrate the presence of marrow expansion, of cold/hot spots, and relative marrow uptake, related to phagocytic activity. Since in adult men red marrow is confined to the epiphysis of long bones and to the spine, all the diseases affecting bone marrow cause medullary expansion/reduction, which are both easily detected by specific radiopharmaceuticals. The peripheral expansion is clearly documented especially in distal humeri and femora since marrow uptake is included, in healthy adults, in the axial and proximal appendicular skeleton. In spite of its yielding unique information, bone marrow scintigraphy remains an additional technique of bone scan, because of its low diagnostic accuracy.

The clinical applications of the radioimmunoassay evaluation of the carcinoembryonic antigen (CEA) are examined here, with special reference to the follow-up of patients undertaking radiotherapy for uterus cancers, portio and bladder cancers, whether after surgery of not. In addition the Authors point out the levels of negativity for every test method, so that the possible crossed reaction with CEA-like substances can be taken into account.

Acute and chronic voltage-threshold of cardiac stimulation was studied in patients with complete A-V block. Endocardial unipolar electrode with three different cathodial surface areas were used (54, 22 and 12 sqmm), and tested with rectangular stimulus of variable duration (from 0.2 to 3.5 msec.). The results show that the threshold values, at first implantation and at pulse-generator replacements, are low when short-duration stimulus and smaller electrode surface area are used. The practical advantages of this study are evident.

Plasma and red cell folate mean contents have been found to be significantly lower in 41 symptom-free beta-thalassaemia heterozygotes than in 21 controls. Such decreases must be considered as effects of an increased folate utilization caused by the enhanced total, both effective and ineffective, erythropoiesis. Since no close correlation has been found between packed cell volume and plasma or red blood cell folate levels, it seems that in 'healthy' beta-thalassaemia subjects, the degree of anaemia is not influenced by folate body reserves. However, the frequent finding of reduced red cell folate contents suggests that further folate imbalance might lead to clinically significant degrees of folate deficiency.

The tumor marker CA-125 is an embryonal glycoprotein detectable in tissues derived from celomatic epithelium. Serum CA-125 was determined by RIA in 66 patients with various ovarian pathologies (16 malignant at stage III-IV and 50 benign). Six patients with ovarian carcinoma were monitored during the first week after surgery and chemotherapy for a total of 150 days of treatment. We observed that CA-125 serum level is consistently above the normal range (greater than 35 U/ml) in all malignant diseases. In benign pathology, levels above the normal were found to be represented almost exclusively by ovarian endometriosis. Furthermore, the results demonstrate that chemotherapy alone is capable of lowering CA-125 serum levels. This tumor marker may be of great advantage in diagnosis and follow-up of ovarian malignancy.

A study of relative bioavailability of two digoxin formulations was carried out on 28 healthy volunteer human subjects of both sexes. A commercial digoxin in tablet form was compared with a new commercial formulation which contains a solution of digoxin in soft gelatin capsules. The parameters investigated were: plasma levels, area under the plasma level-time curve, daily urinary excretion of digoxin and a series of polycardiographic measurements, all the parameters being evaluated in a steady-state condition (14 days of treatment). All the parameters investigated demonstrated better bioavailability in the capsules than in the tablets, the average improvement being 26.1%. The better bioavailability of digoxin capsules also resulted in more rapid and wider variations in the polycardiographic parameters.

Intestinal transit patterns were studied in 20 normal volunteers. It was found that small changes in transit time occurred in the passage from the caecum to the sigmoid and rectum, and that most subjects evacuated the capsule 38 hr after its ingestion.

In this paper are reported the results obtained by a simple, reproducible and sensitive rT3 RIA, in unextracted serum, using the PEG separation technique. The linear correlation coefficient of the results obtained from extracted and unextracted sera, in a population of 60 adults and 35 child controls was 0.984, with a minimal spread of the data.

The purpose of this study was to compare the new multiple allergosorbent chemiluminescent assay (MAST CLA) system with the RAST and skin prick tests as an adjunct to the diagnosis of inhalant allergies. In this report, MAST CLA and RAST have given similar results, but no technique is as sensitive as skin tests for allergen-specific diagnosis of inhalant allergic disease.

Serum CA 125 was detected by RIA in a total of 66 patients with various ovarian pathologies (16 malignant and 50 benign). Six patients with ovarian carcinoma were monitored during the 1st week after surgery (2 patients underwent only explorative laparatomy) and during chemotherapy for a total of 150 days of treatment. We observed that CA 125 serum level is consistently above the normal range (greater than 35 U/ml) in all malignant diseases. In benign pathology, levels above the normal were found to be represented almost exclusively by ovarian endometriosis. Furthermore, the results demonstrate that the chemotherapeutic regime alone is capable of lowering CA 125 serum levels.

Diethyl-HIDA, a new hepatobiliary radiopharmaceutical labeled with 99mTc, was used in the preoperative diagnosis of biliary atresia and in the postoperative evaluation of hepatic-porto-enterostomy function. The good results obtained in the four first cases suggest extensive use of the method, with the aim of a more precocious and more attendable diagnosis.

Endocrine studies were made on 23 female patients aged 13 to 29 years, with delayed puberty or primary amenorrhoea and beta thalassaemia major, and 12 healthy controls, of whom six were prepubertal and six were in Tanner's stage 3-4. Each patient and control received a single intravenous dose of 100 micrograms gonadotrophin releasing hormone (GnRH), and one week later, 10 U/kg body weight of human menopausal gonadotrophin (hMG) to stimulate ovarian function. The patients had decreased gonadotrophin reserves when compared with those of normal controls, only one of 23 patients had an intact luteinising hormone and follicle stimulating hormone response. Most of the thalassaemic patients with delayed puberty showed normal gonad response to human menopausal gonadotrophin (hMG), but three had very low responses, when compared with that of controls. The gonadal failure was even more severe in four of six patients with primary amenorrhoea. It is important to assess hypothalamic-pituitary-gonadal function in young women with beta thalassaemia major, so that those with glandular dysfunction may be started on replacement therapy.

The relationships between the serum levels of estradiol, progesterone and prolactin have been analysed in normal women in relation to age, to menstrual cycle, and in oral contraceptives users. We have been able to detect significant differences between the prolactinemia values during the cycle in different age groups as well as following oral contraceptives. A word of caution is presented for the evaluation of the prolactin blood level which should always be related to the physiological phase of the cycle and to the age of the subjects.

Intestinal transit time was studied in two groups of 8 patients with irritable colon. In the first group, the time was longer than normal, whereas in the second it was accelerated. Three subjects in each group received a placebo, while the other five received 60 mg/day bromopride for 15 days. No change in transit time was noted in the controls. Two subjects in Group I displayed a significant reduction in transit time after bromopride, while deceleration and normalisation were observed in 4/5 patients in Group II.

Prolactin release following breast pump aspiration is less than that following suckling. The long-term effects of this decreased prolactin response are not yet known and therefore the use of the breast pump should be limited to selected cases and for the shortest possible time.

The occurrence and extent of a circadian rhythm in the circulating concentrations of atrial natriuretic peptide (ANP) is still a matter of controversy. In a group of hospitalized normal volunteers (6 men and 4 women, 16-76 years old), we investigated the circadian variability of ANP and its temporal relation with the circadian rhythms of blood pressure (BP) and heart rate (HR), by using a chronobiological inferential statistical method. At the end of a synchronizing period of 1 week (the diet and the daily schedule were standardized), the subjects underwent automatic BP and HR monitoring, and blood sampling for 24 h. A statistically significant mean circadian rhythm was demonstrated for ANP, BP, and HR. The mean circadian acrophase of ANP was calculated to occur around 4 a.m. BP and HR rhythms appeared to be in antiphase with ANP rhythm, i.e. the peak of BP and HR rhythms more or less coincided with a trough in ANP rhythm. ANP appears to be anticipatory in its circadian periodic rise to awakening. Therefore, postural changes cannot fully account for the diurnal variations observed.