Search

Sympathetic skin response from the forehead and from the hand obtained by using electric, acoustic stimuli and during deep breathing was recorded in normal subjects and in patients suffering from Horner's syndrome in order to characterize this clinical picture neurophysiologically. The reliability of the method points to its possible usefulness in the pre-postganglionic differential diagnosis also.

Epidemiological surveys on Parkinson's disease that have been carried out in different parts of the world have suggested that the disease is uniformly distributed in white populations. The position with regard to the Mediterranean peoples is still controversial, because of the large variation of the frequencies observed in the different areas that have been investigated. We therefore studied the frequency of Parkinson's disease in the Local Health Service of Ferrara, northeastern Italy (mean population, 187,000). Based on 394 patients, the mean incidence per year for the period from 1967 through 1987 was 10.01/100,000. The incidence rate of Parkinson's disease among cases with early onset was found to be statistically higher in rural areas as compared with urban ones (6.32/100,000 vs 3.11/100,000). Moreover, the study revealed a significantly higher incidence rate among agricultural workers (20.6/100,000). These results would seem to give further support to the hypothesis of a possible causal role of environmental factors that are mainly linked to agriculture, most likely due to the continual exposure to toxic agents in this area. However, further studies, which are not exclusively epidemiological, are necessary before any conclusions may be drawn, because many confounding variables may account for the results from surveys of this type.

The association between Multiple Sclerosis (MS) and DR2 HLA antigen is well known in Caucasoids. In the past few years a significant correlation has been found between DQwl and MS in North-East Scotland and in several other countries. In previous HLA studies in Italian MS patients, a lack of any association or an increased frequency of DR2 have been observed; however, the results of most Italian surveys derive from heterogeneous sample of affected individuals. This study was carried out in a homogeneous population of patients living in and originating from the province of Ferrara, Northern-Italy. Among the prevalence cases, 116, indigenous, unrelated patients, were typed for HLA-A-B, -DR and DQ antigens. The comparisons with 185 healthy individuals, originating from the same area, revealed an increased prevalence of DR2 antigen in Ferrara MS patients. This antigen does not appear to be related to the clinical variables of the disease.

Spatial-temporal dissemination of neurological signs is an essential criterion for establishing a definite diagnosis of Multiple Sclerosis (MS). Unfortunately, we often observe patients who present a history consistent with MS but without objectivity indicating the presence of at least two or more distinct lesions of Central Nervous System (CNS). In recent years, many Authors have emphasized the use of Multimodal Evoked Responses (MER), Cerebrospinal Fluid (CSF) analysis for the research of Oligoclonal Bands (OB), and Magnetic Resonance Imaging (MRI) as highly sensitive techniques for demonstrating the spreading of the lesions. This study, carried out to evaluate whether the combined use of these three methods would increase the diagnostic MS sensitivity, comprises 62 patients classified in Definite (n = 24). Probable (n = 18) and Possible (n = 20) MS according to the clinical criteria of McAlpine. All our cases fulfilled a complete ER evaluation (VER, SER, BAER), a paired CSF and serum Isoelectric focusing (IEF) and a cerebral MRI. Moreover, IgG Index was also estimated. CSF IEF was the most sensitive test in Definite (91.7%) and Possible (80.0%) MS, nearly followed by MRI (87.5% and 45.0% respectively). VER (87.5% and 60.0%) and SER (87.5% and 65.0%). On the contrary, MRI showed the higher sensitivity in Probable MS (94.4%). The course of the disease influenced only SER and VER in all diagnostic group, while the duration correlated positively with BAER and VER. Only VER and BAER, finally, supplied additional information about the not revealed clinically or by MRI CNS disorders. Thus, our data further emphasize the value of combining these laboratory tests for establishing an early and more accurate diagnosis of MS.

We studied a group of 48 patients with systemic amyloidosis and end-stage renal disease (ESRD) treated with chronic dialysis to analyze the clinical course and the factors which can influence survival. This group was compared to a control group of 63 nondiabetic patients without amyloidosis with ESRD treated with hemodialysis. The median survival of the experimental group was 52 months; 1-, 2- and 6-year actuarial survival was 72, 62, and 44%, while in the control group it was 95, 91, and 81%, respectively (p less than 0.001). Survival was significantly shorter for patients with amyloidosis who rapidly (less than 3 months) progressed to ESRD or who had an acute deterioration in renal function immediately prior to the need for dialysis. The median survival in these cases was 4 and 1.5 months, respectively. Age, the presence or the degree of renal failure at the moment of diagnosis, and the type of amyloidosis did not affect the survival of these patients. Despite a shorter period of time spent on dialysis, these patients had a similar number of hospital admissions, cardiovascular and infectious events as the control patients, but more gastrointestinal disorders (bleeding and chronic diarrhea) and blood access problems. In conclusion, amyloidotic patients maintained on chronic dialysis have high morbidity and mortality rates. Nevertheless, acceptable survival is predictable in stable patients who progress slowly to ESRD.

Fructose 2,6-bisphosphate inhibits phosphoglucomutase. The inhibition is mixed with respect to glucose 1,6-bisphosphate and non-competitive with respect to glucose 1-phosphate. In contrast with fructose 1,6-bisphosphate and glycerate 1,3-bisphosphate, which also possess inhibitory effect, fructose 2,6-bisphosphate does not phosphorylate phosphoglucomutase. Fructose 2,6-bisphosphate preparations contain contaminants which can explain artefactual results previously reported.

The frequency of diabetes mellitus reported in subjects affected by Bell's palsy varies widely. In this investigation, a case-control study, we encountered a frequency of 24.8%. In addition, arterial hypertension and lipid disturbances were found to affect subjects with Bell's palsy more frequently than controls. These findings appear to suggest a primarily ischaemic pathogenesis for most cases of idiopathic peripheral facial paralysis. Furthermore, the finding of significantly lower taste impairment in diabetics than in non-diabetics with Bell's palsy may support the hypothesis of a vascular rather than a metabolic pathogenesis in these cases also. In fact, the vessels supplying the distal portion of the facial nerve, probably more affected in the diabetic patients in order to preserve taste sensation, have such a particular anatomical configuration that this might favour the onset of a diabetic small vessel disease which, in turn, would represent a factor of easier decompensation.

The prevalence of multiple sclerosis (MS) in the Italian studies presently available is reported to be between 3.3 and 19.5 per 100,000. All these studies, however, have been undertaken in populations exceeding 300,000 and probably offer underestimates of MS frequency. Current sanitary organization in Italy is inadequate for epidemiological search and many patients with MS may be overlooked when large populations are studied. So, accurate estimates of MS frequency are possible only as a result of intensive surveys in small population groups. Prevalence figures of 53 and 32 per 100,000 have been recently reported by Dean et al. who studied the frequency of MS in small population groups in Sicily. The present study reports the results of a similar survey in the district of Copparo (population 45,153) in northern Italy. The prevalence of probable MS found in Copparo was 31 per 100,000. This result confirms the findings of Dean et al. in southern Italy and supports Dean's opinion that the true frequency of MS in Italy as a whole is higher than that indicated by the Italian studies.

Levels of glucose 1,6-P2 but not fructose 2,6-P2 were found decreased in skeletal muscle of alloxan-diabetic ketotic rats. Administration of both insulin and vanadate restored the altered values without affecting fructose 2,6-P2 concentrations. In normal rats, insulin increased muscle levels of both sugars, and vanadate decreased glucose 1,6-P2 without changing fructose 2,6-P2 levels. Enzymatic activities involved in glucose 1,6-P2 and fructose 2,6-P2 metabolism were not affected under any experimental condition.

Pig tissues show four enzymatic activities of glucose 1,6-P2 synthesis: (A) 2 [glucose 1-P]----glucose 1,6-P2 + glucose; (B) glucose 1-P + ATP----glucose 1,6-P2 + ADP; (C) glucose 1-P + fructose 1,6-P2----glucose 1,6-P2 + fructose 6-P; (D) glucose 1-P + glycerate 1,3-P2----glucose 1,6-P2 + glycerate 3-P. Brain is the tissue with highest capability of glucose 1,6-P2 synthesis. With the exception of skeletal muscle, activity "D" represents the highest activity of glucose 1,6-P2 synthesis. In muscle, activity "B" is the major activity. The existence of a specific glucose 1,6-P2 synthase which catalyzes reaction "D" is confirmed. Two peaks of such an enzyme are isolated by ion-exchange chromatography. There is an enzyme which specifically catalyzes reaction "C", not previously described. There is a glucose 1-P kinase not identical to phosphofructokinase.

We carried out an intensive incidence, prevalence, and mortality survey of motor neuron disease (MND) in the province of Ferrara, northern Italy. Based on 72 patients, the mean incidence per year for the period 1964 through 1982 was 0.98 cases per 100,000. On December 31, 1981, the prevalence rate was 3.95 per 100,000. In the 19-year period the average mortality rate was 0.83 per 100,000 per year. The disease was more common in men, in individuals aged 50 to 70 years, and in residents in rural areas engaged in agricultural work. A retrospective case-control study, confirming a significantly higher frequency of MND in farmers and persons living in rural areas, revealed that the disease was more common in the lower social classes to which most unskilled and heavy laborers belong. In addition, a significantly increased risk for MND was found in patients with previous histories of trauma, but confounding variables may account for this association.

The present study describes 3 adult patients with hemolytic uremic syndrome (HUS) leading to chronic renal failure. Following renal transplantation, the 3 patients developed microangiopathic hemolytic anemia associated with acute rejection crises and graft failure. In 2 patients the renal histology of the transplanted kidney was consistent with HUS. It is concluded that, in adult patients, HUS may recur after renal transplantation and contribute to renal graft failure.

Fructose 2,6-bisphosphate affects phosphoglucomutase from plant and animal sources in a similar way. As previously found with rabbit muscle phosphoglucomutase, fructose 2,6-bisphosphate cannot substitute for glucose 1,6-bisphosphate as a cofactor in the reaction catalyzed by phosphoglucomutase from potato tubers, pea seeds, and string-beans. In the presence of glucose 1,6-bisphosphate, fructose 2,6-bisphosphate inhibits phosphoglucomutase from potato tubers. Activation of phosphoglucomutase from plant sources by fructose 2,6-bisphosphate reported by others was probably due to contamination of the commercial preparation of fructose 2,6-bisphosphate by glucose 1,6-bisphosphate.

The relationship between the concentration of several phospholipids in amniotic fluid and the ocurrence of neonatal RDS was established some years ago. However the methods used for the determination of those substances are sophisticated and time consuming. They require specalized equipment and take at least 2 or 3 hours. CLEMENTS described a semiquantitative method which overcomes these disadvantages. The present study compared the concentration of lecithin, shingomyelin, lysolecithin and the L/S ratio against the results obtained when processing the same samples with the CLEMENTS Test. the results are expressed in mg/100 ml. for the different phospholipids and the test was evaluated as positive, intermediate or negative. a statistically significant correlation has been found between the values of lecithin, lysolecithin and L/S ratio and the results of the CLEMENTS Test, respectively. No correlation could be found with sphingomyelin (Figs. 1-4). It is concluded that the CLEMENTS Test can be a useful tool as a screening test available to any obstetrical centre.

1. Glycerate 1,3-P2-dependent glucose, 1,6-P2 synthase has been purified 2000-fold from pig skeletal muscle, with a yield of 75%. 2. The enzyme possesses fructose 1,6-P2-dependent glucose 1,6-P2 synthase and phosphoglucomutase activities, which represent 0.1 and 60% of the main activity, respectively. 3. Both glucose 1-P and glucose 6-P can act as acceptors of the phosphoryl group from glycerate 1,3-P2. 4. The Km values are 19 microM and 67 nM for glucose 1-P and glycerate 1,3-P2, respectively. 5. The enzyme is inhibited by glycerate 2,3-P2, fructose 1,6-P2, glycerate 3-P, phosphoenolpyruvate and lithium, the inhibition pattern varying with the compound.

In the context of a multidisciplinary study program whose purpose is to investigate the genetic aspects of Huntington's Chorea (HC), the authors conducted an epidemiological descriptive research extended to the population residing in the province of Ferrara in a time period including the years from 1971 to 1987. On December 31st, 1987 we estimated a prevalence rate of 1.89 cases of HC per 100,000 inhabitants; in the years 1971-1987 the incidence rate was of 0.11 per 100,000/year and the mortality rate of 0.06 per 100,000/year. In the last years considered for the study, the incidence and the prevalence showed a relative increase indicating that HC still exists in the ferrarese population, despite a greater public awareness. With the aim to organize preventive actions and to reach the preclinical diagnosis of the disease we singled out 83 subjects at risk the study area.

Synopsis A new formulation for dermatological use and hair care was studied. Phosphate diesters of the nonyl-phenol type in association with cocoimidazoline derivatives are compared with four commercial formulations. Foaming capacity, eye and skin irritation, keratin solubilization and defatting properties were studied. The mixture was the best foamforming formulation and the best defatting agent. Also, it was non-irritant for skin and eyes at adequate dilutions and did not dissolve keratin. It is a good formulation for dermatological use and hair care, due to its detergent properties. It ranks high among safe products.

Results of intensive prevalence surveys on multiple sclerosis carried out in different small regions of Italy have suggested that this country falls into the high-frequency zone for the disease. To verify this hypothesis by studying a large population, we conducted intensive incidence and prevalence survey in the province of Ferrara, northern Italy (mean population, 386,000). Based on 128 patients, the mean incidence per year for the period 1965 through 1979 was 2.2 cases per 100,000. On October 24, 1981, the prevalence rate was 46.1 cases per 100,000. The results support the view that northern Italy is a high-risk area for multiple sclerosis.

Incidence and prevalence investigations on childhood epilepsy, throughout the world, have suggested wide variations in the frequency of convulsive disorders. Also the few studies presently available from Italy mirror such a disagreement. However, these studies cannot be completely comparable owing to a marked methodological dishomogeneity in definition of epilepsy, classification of seizures, and ascertainment, collection, and selection of the cases. Therefore, to verify the true frequency of childhood epilepsy in our country, we performed an epidemiologic study of convulsive disorders in 0-14 age children of the U.S.L. 34 (Copparo, Northern Italy). The prevalence per 1.000 children on October 24, 1981 was 6.14 (6.4 if standardized to the Italian population). The average annual incidence for the period 1964 through 1980 was 95.1 per 100,000 (98.9 if standardized). These results, similar to those found in other Western countries, support the view that the frequency of childhood epilepsy in Italy as a whole is higher than that indicated by previously published Italian studies and furthermore suggest that epilepsy is evenly distributed in Europe and the United States. Antecedents which could be considered potential causes of seizures were found in 40.2% and 43.6% of the incidence and prevalence cases, respectively; for both groups, perinatal brain injuries were the most frequent event. These results point out the urgency of planning precautionary measures in Italy to improve prenatal and perinatal medical care.

Phosphoglucomutase, in addition to catalyzing the interconversion of glucose 1-P and glucose 6-P, catalyzes both the synthesis of glucose 1,6-P2 from glucose monophosphate and either fructose 1,6-P2 or glycerate 1,3-P2, and the hydrolysis of glucose 1,6-P2. Vanadate inhibits the mutase activity, activates the synthase activities, and does not affect the phosphatase activity. These effects suggest that the "exchange" step postulated for the phosphoglucomutase pathway is specifically inhibited by vanadate.

Recent investigations on multiple sclerosis (MS) distribution in Italy, based on relatively small population groups, contradict the current thesis, derived from studies undertaken in populations exceeding 300,000, of a lower spreading of the disease in Mediterranean Europe. Intensive surveys on small populations strengthen the suggestion that Italy is a high-risk area, although MS studies based on prevalence rather than incidence could also be biased by geographic variables making prevalence unsuitable for comparing MS prevalence rates found in different years and/or zones. We report a further epidemiologic study in Barbagia, Sardinia, insular Italy, undertaken both to establish the MS incidence in the last 20 years, and to estimate a new prevalence rate. Based on 31 probable incident cases, the mean incidence per year for the years 1961-1980 was 2.9 per 100,000 (3.2 if age- and sex-standardized to the Italian population). On October 24, 1981, the prevalence per 100,000 was 65.3 (77.9 if standardized to the Italian population). These results confirm that in Barbagia, MS occurs more frequently than expected in a Mediterranean area, and give further support to the idea that MS frequency in Italy is similar to that established for most central and northern European countries.

The pattern electroretinogram obtained in patients affected by multiple sclerosis were compared with those in a normal population. The pattern electroretinogram amplitude in multiple sclerosis optic neuritis frequently appeared normal, but pattern electroretinogram amplitude abnormalities were found in patients suffering from recurrent multiple sclerosis optic neuritis. Pattern electroretinogram examination appears a useful method in the differential diagnosis between axonal and demyelinating optic nerve impairment.

Most available Italian studies indicate that the prevalence of multiple sclerosis (MS) in Italy is lower than 20 per 100,000. Much higher prevalence figures, however, have been recently found in small communities in Sicily. On this basis, it has been suggested that the frequency the MS in Italy has been seriously underestimated and that the true prevalence for MS is probably similar to that established for northern European countries. This paper reports the results of a survey of MS in the various public health districts of the province of Ferrara. The public health districts are homogeneous medical units serving small populations and therefore represent ideal areas for epidemiological purposes. The total prevalence rate of probable MS for the whole province has been found to be at least 26.9 per 100,000. This result supports the view that the frequency of MS in Italy is higher than that indicated by most published studies, but not that Italy is an area of high risk for MS.