Effects of calcium channel antagonists and Bay K 8644 on the analgesic response to pentazocine and U 50488H.

1. The effects of diltiazem, nifedipine and verapamil and the calcium channel agonist Bay K 8644 on the analgesic responses to the subcutaneous (s.c.) or intracerebroventricular (i.c.v.) administration of pentazocine and U 50488H were investigated in mice. 2. The three calcium channel antagonists and Bay K 8644 reduced the number of writhes induced by the intraperitoneal administration of acetic acid. 3. The analgesic responses to the low doses of pentazocine (s.c.) were additive with the effects of diltiazem, nifedipine or Bay K 8644; while, in contrast, the higher doses produced underadditive responses. Only verapamil increased the effects of the i.c.v. administration of the opioid. 4. The effects of U 50488H (s.c.) were additive with those of diltiazem and Bay K 8644; verapamil only increased the response to the lower dose of the opioid. Nifedipine plus pentazocine always induced underadditive responses. The i.c.v. effects of U 50488H were only increased by verapamil. 5. These findings are discussed in relation with a possible interaction of kappa agonists with calcium channels in the central nervous system.     

Complication and mortality rate after percutaneous endoscopic gastrostomy are low and indication-dependent*

Abstract

Objective. Percutaneous endoscopic gastrostomy (PEG) is often used for the feeding of patients with malnutrition due to dysphagia, and despite more than 30 years experience, numerous questions on its benefit remain. This was a prospective observational study to assess the safety of PEG. Material and methods. One hundred and nineteen patients mean age 63 years (21–91 years) who were admitted to the Hannover Medical School between November 2010 and March 2012 and had an indication for PEG according to the German guidelines were included. Primary endpoints were the following: reason for indication, date of in-hospital mortality after PEG insertion, death within 3 months after PEG placement, and complications. Results. Most patients (54.6%) received PEG for dysphagia caused by tumors and second (29.4%) for neurologic diseases with a minor proportion of dementia (3%). About 73% of our patients had no complications at all and only 10% suffered severe effects. We saw only 1 case of aspiration, which did not lead to pneumonia. The 30-day mortality was 10%, and no patient died as a result of the PEG procedure. Significantly more patients with neurologic disorders died within 24 weeks of PEG placement than tumor patients (60% versus 27.7%, respectively, p = 0.002, n = 100). Conclusion. It is important to select patients receiving PEG very carefully. The patients’ indications, their primary disease, and their capability for mental cooperation are essential. If these aspects are taken into account, PEG is a safe method with few mainly mild complications.     

Possible role of nitric oxide in the antinociceptive action of intraventricular bradykinin in mice

The i.c.v. administration of bradykinin (4, 8 and 16 μg) induced antinociception in mice which was resistant to naloxone; furthermore, the induction of tolerance to morphine by a single s.c. injection (100 mg/kg, 24 h before test doses of the peptide) did not affect antinociception. Since bradykinin is known to increase nitric oxide (NO) in peripheral tissues, we studied the possibility that its antinociceptive action may be related to NO effects in the central nervous system. Bradykinin effects were antagonized by previous treatment with N^G-nitro- -arginine or concomitant i.c.v. administration of bradykinin and methylene blue. The immediate precursor of NO, -arginine, which by itself produces analgesia, also reduced bradykinin effects; moreover, tolerance to -arginine significantly decreased the response to the peptide. These results suggest that NO is involved in antinociception induced by i.c.v. administration of bradykinin.     

乳白色斑块：二期梅毒口腔黏膜罕见损害（德语）

一例37岁女性患者表现出口腔黏膜“乳白色斑块”4个月，其主诉为口腔粗糙感和吞咽时灼热感。根据临床表现，组织学及血清学检查尤其出现泛发性无痛性淋巴结病，可诊断为二期梅毒。虽然乳白色斑块是二期梅毒相对罕见的临床表现，但有时可为该病的唯一表现．也是灰白色黏膜损害的重要鉴别诊断考虑，尤其在中欧目前梅毒发病率持续上升的背景下。     

唐氏综合征新生儿患者的一过性骨髓增生综合征：对来自AML—BFM和ESPED研究项目的115例患儿的综述和分析

一过性骨髓增生综合征(TM S)见于唐氏综合征(又称21三体综合征)的新生儿,其发生率可达10%,本病的典型特征为骨髓原始细胞增生,在外周血可见巨核母细胞和(或)有核红细胞。TM S的大多数病例可无症状,只有小部分患儿因白细胞增多、血小板减少、贫血、肝肿大而出现临床症状。几乎所