G Pappalardo

S-adenosyl-L-methionine (SAM) has proven to be fairly stable in gastric and duodenal juices as well as in bile. It was, therefore, administered orally to six healthy subjects. No increase in SAM levels was observed in the systemic blood. SAM was then directly injected into a jejunal loop of nine patients undergoing cholecystectomy. SAM concentrations increased significantly in venous mesenteric and systemic blood. Infusions of methionine directly into the jejunum by the same method used for SAM did not induce any increase in SAM concentrations in the mesenteric or systemic blood.

A large experience in specific immunotherapy is reviewed in order to assess the safety of this treatment. From 1968 through September 30, 1993, 300,086 injections were administered to 6,319 patients suffering from allergic asthma and/or rhinitis. Systemic reactions reported during the whole period were 184 (0.061%) in 134 subjects (2.1%) and consisted of: urticaria (59.3%), mild asthmatic attacks (23.9%), asthma and urticaria (9.7%), and spasmodic rhinitis (7.1%). The absence of cases of anaphylaxis confirms the safety of specific immunotherapy. This kind of treatment should be considered as first-line therapy, if carried out in a specialized setting.

Neurofibromatosis (NF) is a relatively common disorder characterized by cutaneous pigmented maculas, multiple neurofibromas and Lisch nodules (pigmented iris hamartomas). This disorder is retained being a neurocristopathy. Melanocytes are neural crest derivates too. Twenty-six patients with neurofibromatosis associated to cutaneous malignant melanoma have been reported till now, but data on association between these two pathologies are lacking. One more case of malignant cutaneous melanoma in a patient with neurofibromatosis is reported and the hypothesis of a more frequent association than usually believed of these two pathologies is discussed.