Blockade of neuronal tryptamine receptors by metoclopramide

The variations with age and blood pressure in the cyclic nucleotide phosphodiesterase activator content of rat aorta were studied. Activator content increased with age and was less in mineralocorticoid-hypertensive than in control rats. These variations were more pronounced in the particulate than in the soluble fraction of aorta. The data do not demonstrate any relationship between the activator level and blood pressure, but they suggest that the activator may modulate cyclic nucleotide metabolism in rat aorta.     

Alternating Current Electrocution Detection and Termination by an Implantable Cardioverter Defibrillator

A patient with an ICD accidentally grasped a power line and was electrocuted. He was unable to release the cable during electrocution though he remained conscious. After receiving a shock from his ICD. the powerline was released. ICD interrogation revealed inappropriate detection of alternating current and delivery of a shock.     

The Effect on Plasma Glucose,Insulin and Glucagon Levels of Treatment of Diabetic Rats with the Medicinal Plant Rhazya stricta and with Glibenclamide,Alone and in Combination

Because many diabetic patients in the United Arab Emirates use medicinal plants as a supplement to treatment with insulin or oral hypoglycaemic agents, the effect on plasma glucose, insulin and glucagon concentrations of simultaneous treatment of streptozotocin-diabetic rats with Rhazya stricta extract and glibenclamide has been examined. Treatment of control rats with the extract at oral doses of 0.5, 20 and 4.0 g kg^? did not significantly affect the concentration of glucose, insulin or glucagon for up to 4 h after administration of the extract. The same doses in diabetic rats reduced the glucose level 1 h (2 and 4 gkg^?) and 2h (4 gkg^?) after administration of the extract. This was accompanied by significant increases in insulin concentration 1, 2 and 4 h after administration of the extract at doses of 2 and 4 gkg^?. Glibenclamide (2.5, 5.0 and 10.0 mgkg^?) dose-dependently reduced glucose and glucagon levels, and increased that of insulin in normal and diabetic rats. Simultaneous treatment of normal and diabetic rats with the plant extract (0.5, 20 and 5.0 gkg^?) and glibenclamide (5.0 mg kg^?) significantly exacerbated the effects on glucose, insulin and glucagon induced by the extract or by glibenclamide when given separately. When the plant extract was given at doses of 0.5, 2 and 4 g kg^? per day for 6 consecutive days the glucose level was reduced by approximately 6, 8 and 30%, respectively. No significant effect was seen on the levels of cholesterol or protein. These results imply that co-administration of the extract with glibenclamide might adversely interfere with glycaemic control in diabetic patients.     

QUANTITATIVE ASSESSMENT OF RESIDUAL ANTIDEPOLARIZING BLOCK (PART I)

A method is presented for the assessment of residual curarizationafter the use of anti-depolarizing muscle relaxants which doesnot involve the necessity for establishing control observations.The ulnar nerve at the elbow was stimulated with a train offour pulses repeated intermittently. The muscle response tothis train of four stimuli was recorded and analyzed using threeratios of twitch height (or electromyographic responses). Ratio(a) was taken as the height of the first response of the trainto the height of the control response (i.e. the response beforemuscle relaxant was given), ratio (b) as the height of the secondresponse to the height of the first response, and ratio (c)as the height of the fourth response to the height of the firstresponse. There was a highly significant positive linear associationbetween ratio (a), which involves the use of a control response,and the other two ratios, (b) and (c), which do not involvea control response.     

Multislice Computed Tomographic Findings in Symptomatic Patients After Amplatzer Septal Occluder Device Implantation

Background: Complications of transcatheter closure of atrial septal defects (ASDs) include pericardial effusion, tamponade, and even death. Transthoracic echocardiography in the adult is often limited by poor acoustic windows that lead to incomplete device assessment. Advances in multislice computed tomography (MSCT) provide an alternative modality to assess the anatomy of the Amplatzer Septal Occluder (ASO) device.
Objective: The purpose of this study was to determine the feasibility of MSCT in providing anatomic information in patients with persistent or recurrent symptoms after transcatheter closure of ASDs with ASO devices.
Methods: A retrospective analysis of adult patients who underwent ASO device implantation with subsequent MSCT imaging as a result of symptoms from June 2006 to May 2007 was performed. Data analysis included age, gender, size of ASO device, relationship of the device to surrounding structures, symptoms, and the length of time between device implantation and onset of symptoms.
Results: Eleven patients were identified with a mean age of 41 years. Patients presented with symptoms 1 week to 2.4 years after implantation. ASO size ranged from 8 to 36 mm. MSCT provided detailed information in all 11 cases regarding anatomic location of the device with respect to surrounding structures. Nonobstructive coronary plaque disease was identified in one patient. Two patients had pericardial effusions.
Conclusions: Cardiac symptoms after ASO implant deserve thorough investigation. MSCT is feasible in the assessment of such patients and offers a unique assessment of the device to surrounding anatomic structures and should be considered as a useful adjunct to echocardiography in symptomatic patients.     

THE PATHOLOGICAL AND BIOLOGICAL NATURE OF SCREEN-DETECTED BREAST CARCINOMAS: A MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY

Traditional and immunohistochemical markers of prognosis were examined in 455 mammary carcinomas derived from breast cancer screening and compared with those of 277 carcinomas presenting symptomatically over the same period. Tumours detected by population screening under the U.K. National Health Service Programme do not differ from those detected by other screening projects, but compared with symptomatic cancers, screen-detected cancers are more likely to be in situ and if invasive, to be smaller, of lower grade, and to have invaded vessels, perineural spaces, and lymph nodes less frequently. Tubular and cribriform types are more often represented in screened patients. Immunohistochemical markers which have been proposed as being related to likely tumour behaviour (epidermal growth factor receptor, c-erbB-2 protein, oestrogen and progesterone receptors, cathepsin D, p53, and retinoblastoma protein) do not distinguish screen-detected from ‘clinical’ cancers. It is concluded that cancers diagnosed at screening do not differ biologically from those presenting clinically, but are the same lesions detected at an earlier stage of their natural history. © 1997 John Wiley & Sons, Ltd.     

Two daytime icodextrin exchanges decrease brain natriuretic peptide levels and improve cardiac functions in continuous ambulatory peritoneal dialysis patients

Aim: Peritoneal dialysis patients with ultrafiltration failure frequently have fluid overload. It is known that the increase in the ultrafiltration is associated with decrease in the left ventricle (LV) dysfunction. This study was designed to examine the potential effects of serum brain natriuretic peptide (BNP) on cardiac functions and to determine the relationship between BNP and cardiac parameters in continuous ambulatory peritoneal dialysis (CAPD) patients with ultrafiltration failure. Methods: Twenty‐eight patients with high or high‐average membrane permeability as indicated by the peritoneal equilibration test were enrolled and randomized to receive either once or twice daily icodextrin. Serum BNP levels and echocardiographic measurements were evaluated at baseline and at the end of the eighth week. The correlations between the percentage changes of parameters from baseline were also studied. Results: In both groups there was a significant decrease in serum BNP, LV mass, heart rate (HR) and cardiothoracic index (CTI) and an improvement in ejection fraction (all P < 0.05). However, the percentage of change in all these parameters was significantly better in the twice daily compared with once daily group (all P < 0.05). Furthermore, the percentage decrease in BNP was positively correlated with the percentage decrease in HR, LV mass and BP. Conclusion: Twice daily icodextrin treatment might be useful in hypervolaemic CAPD patients for the improvement of cardiac functions. BNP monitoring may be useful to follow up these patients.