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91.
In this study the effect of transient inhibition of the CA1 region of the dorsal hippocampus by lidocaine on amygdala kindling rate and amygdaloid kindled seizures was investigated. In experiment 1, rats were divided into four groups. In group 1, animals were implanted only with a tripolar electrode into the amygdala but in groups 2-4, two guide cannulae were also implanted into the CA1 regions of the dorsal hippocampi. Animals were stimulated daily to be kindled. In groups 3 and 4, saline or 2% lidocaine (1 microl/2 min) was also injected respectively into the hippocampus, 5 min before each stimulation. Results obtained showed that amygdala kindling rate and the number of stimulations to receive from stage 4 to stage 5 seizure were significantly increased in group 4. In experiment 2, lidocaine (1% and 2%) was infused (1 microl/2 min) into the hippocampus of amygdala kindled rats bilaterally and animals were stimulated at 5, 15 and 30 min after drug injection. Twenty four h before lidocaine injection, saline was also infused (1 microl/2 min) into the hippocampus as control. Obtained results showed that afterdischarge duration was reduced 5 min after lidocaine (1% and 2%) injection. Stage 5 seizure duration was also decreased 5 and 15 min after 2% lidocaine. Thus, it may be suggested that in amygdala kindling, activation of the hippocampal CA1 region has a role in seizure acquisition and seizure severity so that inhibition of this region results in decreasing of seizure severity and retards amygdala kindling rate.  相似文献   
92.

Study Objective

To present a surgical video in which bilateral uterine vasculature was ligated laparoscopically in order to preserve the uterus in a patient with postabortal hemorrhage.

Design

A case report (Canadian Task Force classification III).

Setting

A tertiary referral center in New Haven, CT.

Interventions

This is a step-by-step demonstration of laparoscopic ligation of the uterine vasculature in a patient with postabortal hemorrhage. The patient was a 33-year-old Para 4014 woman who presented with postabortal hemorrhage after she underwent an urgent dilation and evacuation for the management of symptomatic placenta accreta at 19 weeks of pregnancy. The patient underwent a physical examination when she presented to the emergency department with postabortal hemorrhage. She was hemodynamically stable, and the examination was negative for cervical or vaginal lacerations. Coagulation studies were negative for any coagulopathy. A pelvic ultrasound did not show any retained products of conception. As per the Society of Family Planning guidelines, uterine massage was performed, and uterotonics (i.e., methylergonovine maleate 0.2?mg intramuscularly and misoprostol 1000?mg per rectum) were given [1]. The postabortal hemorrhage persisted despite medical therapy with an approximate blood loss of 600?mL over 2 hours. An intrauterine tamponade balloon was placed, and the patient then underwent a uterine angiogram and bilateral uterine artery embolization secondary to continued vaginal bleeding despite medical management. She was closely monitored and noted to have another 500?mL of blood loss over 2 hours after completion of uterine artery embolization. At this point, she was resuscitated with 2?U red blood cells because she developed symptoms of hemodynamic instability. Her hematocrit was increased suboptimally after transfusion with stabilization of her vitals. The patient was then counseled on her surgical options because she had failed medical management, intrauterine balloon tamponade, and uterine artery embolization. She stated a strong desire to preserve her uterus. Given her overall hemodynamic stability, laparoscopic ligation of the uterine vessels was proposed, which she agreed on [2]. Risks of the laparoscopic approach were explained to the patient, which included injury to the uterus, ureters, blood vessels, and nerves as well as the possibility of conversion to laparotomy. The surgery started with exploration of the peritoneal cavity. Her uterus was noted to be significantly enlarged with many engorged vessels. In order to decrease the risk of uterine perforation in this bulky and highly vascular uterus, the surgeon decided not to place a uterine manipulator. The retroperitoneum was entered at the right pelvic sidewall. Pararectal and paravesical spaces were then developed. Ureterolysis was performed in order to free its peritoneal and uterine artery attachments. The uterine artery was skeletonized cephalad to the hypogastric bifurcation and was ligated with 5-mm vascular clips. The attention was then turned to the ovarian vessels at the cornu of the uterus. Peritoneal avascular windows were created inferior and superior to the vessels. The blood supply was then ligated with an absorbable suture, and the ligature was secured using the extracorporeal knot tying technique. The same steps were repeated on the left pelvic sidewall. The procedure was completed once excellent hemostasis was assured. Besides the technical steps of the procedure, pelvic anatomic landmarks have also been emphasized in this video for educational purposes.

Measurements and Main Results

Laparoscopic ligation of the uterine vasculature was performed without any complications. The operative time was 65 minutes, and blood loss was minimal. The patient had an uneventful postoperative course and was discharged home the day after her laparoscopic surgery.

Conclusion

The uterus was preserved with this minimally invasive approach for the management of postabortal hemorrhage. Laparoscopic ligation of the uterine vessels should be considered in hemodynamically stable patients who desire future fertility when managing postabortal hemorrhage.  相似文献   
93.
Noscapine suppresses angiotensin converting enzyme inhibitors-induced cough   总被引:1,自引:0,他引:1  
BACKGROUND: Dry cough is a common side-effect of the angiotensin converting enzyme inhibitors (ACEI) and is a major limiting factor of their use. It has been suggested that ACEI cause this side-effect by potentiation of the bradykinin effect. Previous work in our laboratory has shown that noscapine, an antitussive drug, inhibits the effect of bradykinin. METHODS: To investigate the effect of noscapine on ACEI-induced cough, 611 hypertensive patients who were being treated with ACEI were evaluated for the incidence of persistent dry cough. RESULTS: A cough had developed in 65 (10.6%) patients, two (3.1%) of whom also had severe respiratory distress that required hospitalisation and immediate discontinuation of the ACEI. Forty-two (64.6%) patients had developed a mild cough and 21 (32.3%) patients had developed a moderate to severe cough. The patients with moderate to severe cough received 15 mg of noscapine, orally three times daily, while they continued ACEI. Noscapine effectively resolved the cough in 19 (90%) patients within 4-9 days of starting treatment. CONCLUSION: Noscapine, possibly by inhibition of bradykinin synthesis, eliminates ACEI-induced cough in the majority of patients and allows them to continue with ACEI therapy.  相似文献   
94.
A simple isocratic, high-performance liquid chromatographic (HPLC) assay procedure was developed for the simultaneous determination of iodochlorhydroxyquin and hydrocortisone in ointments and creams using phenyl salicylate as an internal standard. Ointment samples were extracted by direct dissolution in ether. Homogeneous suspensions of the creams were prepared in the mobile phase. The samples were spiked by the addition of standard iodochlorhydroxyquin, standard hydrocortisone, and the internal standard and subsequently extracted with the mobile phase. HPLC was performed using a reverse-phase microparticulate C-18 column, a precolumn, and a UV detector set at 256 nm. A mobile phase containing methanol and 0.05 M phosphoric acid (70:30) was employed at a flow rate of 1 ml/min. The percent iodochlorhydroxyquin and hydrocortisone found to be present in eight commercial products is reported.  相似文献   
95.
The aim of this paper was to present baseline data on various saliva properties among a group of Saudi children aged 5 to 11 years and to study the relationship of these properties to some oral micro-organisms as well as to lip and oral mucosa dryness. The results showed a mean of resting and stimulated flow rate of 0.54 +/- 0.40 and 1.23 +/- 0.59 respectively and mean pH value of 7.27 +/- 0.38 and 7.5 +/- .035 respectively. Fluoride concentration was estimated to be 0.151 +/- 0.07 and 0.145 +/- 0.06 in resting and stimulated saliva respectively. Children with dry lip represented 33.9% of the sample population, whereas, those with dry mucosa represented only 0.8%. No significant sex difference was evident in all parameters. 59.1% of children showed medium buffering capacity in the resting saliva, whereas, the majority of children (73.7%) showed high stimulated buffering capacity. Children showed generally high Lactobacillus counts (Lb) in the resting and stimulated saliva (57.9% and 60.5% of children). The presence of yeast also in resting and stimulated saliva seemed high in general (40% and 53% of children had high count). However, Streptococcus mutans (S. mutans) counts showed no discriminating trend in both types of saliva. The data showed no significant association between flow rate and Lb counts in both resting and stimulated saliva although there was a trend toward higher counts associated with low flow rate. The same trend was observed in resting saliva although not significant. Similarly, low resting buffering capacity was associated with high counts of Lb among a high proportion of children (68.6% of children) although not significant. A significant reverse relation was evident between S. mutans counts and stimulated flow rate (p=0.049). The majority of children with normal level of saliva pH showed no yeast colonization (62.1%). The association was significant (p=.024). Similarly, the same association was observed in the medium and high buffering group (66.2%) (p=.040). It was concluded that salivary Lb count seems to be primarily affected by some local factors other than salivary properties, such as diet. Significant inverse relationship was found between S. mutans and stimulated salivary flow. Children in general showed high percentage of yeast reflecting the affect of poor diet among the studied population group. Buffering capacity and pH had an important role in yeast colonization.  相似文献   
96.
Recent mechanistic studies on the role of heat-shock proteins (HSPs) to induce innate and adaptive immune responses have resulted in conflicting reports. Whereas some groups reported that HSPs have direct immunological function, others emphasised the endotoxin contamination of HSP preparations and questioned the antigen-specificity of HSP vaccines. The present review will discuss these issues and suggest that HSPs have diverse and distinct immunological functions that could be superimposed on effects resulting from endotoxin contamination or misunderstood by using experimental procedures with inadequate controls. To understand the actual function of HSPs in their interaction with the immune system, methods and procedures need to be optimised and appropriate controls need to be used. These points should also clarify the conflicting findings about HSPs and promote our knowledge about other immuologically important components that may be present in HSP preparations.  相似文献   
97.
Eighty pathology cases were sent independently to each of two telepathology servers. Cases were submitted from the Department of Pathology at the University of Kerman in Iran (40 cases) and from the Institute of Pathology in Berlin, Germany (40 cases). The telepathology servers were located in Berlin (the UICC server) and Basel in Switzerland (the iPATH server). A scoring system was developed to quantify the differences between the diagnoses of the referring pathologist and the remote expert. Preparation of the cases, as well as the submission of images, took considerably longer from Kerman than from Berlin; this was independent of the server system. The Kerman delay was mainly associated with a slower transmission rate and longer image preparation. The diagnostic gap between referrers' and experts' diagnoses was greater with the iPATH system, but not significantly so. The experts' response time was considerably shorter for the iPATH system. The results showed that telepathology is feasible for requesting pathologists working in a developing country or in an industrialized country. The key factor in the quality of the service is the work of the experts: they should be selected according to their diagnostic expertise, and their commitment to the provision of telepathology services is critical.  相似文献   
98.
99.
Reversed-phase preparative HPLC of a methanol extract of the rhizomes of Eremostachys glabra yielded three new iridoid glycosides, namely, 6,9-epi-8-O-acetylshanziside methyl ester, 5,9-epi-penstemoside, and 5,9-epi-7,8-didehydropenstemoside. Their structures were elucidated on the basis of spectroscopic data interpretation. The free-radical scavenging activity of these compounds was assessed using the DPPH assay.  相似文献   
100.
Recently, a series of case reports and small studies has suggested that births involving assisted reproductive technology (ART) may have an increased risk of imprinting disorders such as Beckwith-Wiedemann syndrome and Angelman syndrome. Herein, the significance and implications of these findings are discussed. It is speculated that, although such imprinting disorders may be shown to be only rare complications of ART, epigenetic errors might account for a much wider spectrum of ART-related complications than is recognized currently. Addressing these questions should be a priority for research on cohorts of ART children.  相似文献   
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