Effects of neonatal bilateral eye enucleation on postnatal development of the monoamines in posterior thalamus of the rat

Summary Levels of dopamine (DA), noradrenaline (NA) and 5-hydroxytryptamine (serotonin, 5-HT) and their metabolites, and the activities of tyrosine hydroxylase (TH), tryptophan hydroxylase (TPH) and monoamine oxidase A and B (MAO-A and MAO-B) have been determined in the rat posterior thalamus after enucleation during postnatal development. DA and 5-HT turnover rate have been measured as 3,4-dihydroxyphenylalanine (DOPA) and 5-hydroxytryptophan (5-HTP) accumulation rates after central decarboxylase inhibition by 3-hydroxybenzylhydrazine (NSD-1015). The major changes were an increase in noradrenergic and serotoninergic metabolism in enucleated animals compared with control animals. A decrease of the MAO-A to MAO-B ratio during postnatal development was found.Abbreviations DA dopamine - DOPAC 3,4-dihydroxyphenylacetic acid - HVA homovanillic acid - DOPA 3,4-dihydroxyphenylalanine - NA noradrenaline - MHPG 3-methoxy-4-hydroxyphenylgly-col - NMN normetanephrine - TRP tryptophan - 5-HTP 5-hydroxytryptophan - 5-HT serotonin - 5-HIAA 5-hydroxy-3-indolacetic acid - TH tyrosine hydroxylase - TPH tryptophan hydroxylase - MAO-A monoamine oxidase-A - MAO-B monoamine oxidase-B Recipients of fellowships from I.I.E. del FISS Reincorporación de doctores y tecnólogos del M.E.C., and Perfeccionamiento de doctores y tecnólogos del MEC, Spain     

Management of bacterial peritonitis and exit‐site infections in continuous ambulatory peritoneal dialysis*

SUMMARY: Peritonitis and exit‐site infections remain the most important limitations to the delivery of continuous ambulatory peritoneal dialysis (CAPD). Contamination of the peritoneum, from endogenous or exogenous sources, is responsible for most peritonitis episodes. Patients usually present with a cloudy bag, although other causes should be distinguished. Clinical suspicion of peritonitis should be followed rapidly by microbiological examination and empirical treatment. Microbiological confirmation allows for subsequent treatment based on sensitivities. Other interventions such as catheter removal may be appropriate in some patients. Exit‐site infections should also be identified and treated early. Peritonitis may be further prevented by adequate exit‐site care, hygienic methods, and techniques to minimise early contamination of the exit site. Mupirocin may also have a role in preventing infections caused by Staphylococcus aureus.     

Pressure stability of nasal CPAP and bilevel devices

Summary Question of the study   Nasal continuous positive airway pressure (CPAP) prevents collapse of the upper airway during sleep in patients with obstructive sleep apnea provided that a positive transmural pressure can be maintained during inspiration. We examined pressure-flow characteristics in seven CPAP and bilevel devices during spontaneous breathing.
Methods   The CPAP devices were set to a pressure level of 9.8  hPa (10  cm H₂O) and adapted to a pneumotachograph using a standard CPAP hose and an outlet valve. We continuously measured flow, volume and pressure during resting ventilation and increasing voluntary hyperventilation and analysed the dependence of the variables on a breath-to-breath basis.
Results   Mean CPAP pressures differed between the devices (9.9 – 10.6  hPa) despite the same settings. In all machines pressure fell during inspiration to 8.4 – 9.8  hPa and increased during expiration to 11.1 – 11.7  hPa. This effect increased with higher flow rates. Maximum expiratory pressures rose to 12 – 19  hPa at peak flow rates of 2 l/s, mean expiratory pressures to 9.5 – 16  hPa. Inspiratory pressures dropped to 8.5 – 4.5  hPa (minimum) and 10.5 – 6.0 (mean). Bilevel devices showed a higher stability than CPAP devices. Pressure swings during the respiratory cycle increased the additional work of breathing.
Conclusions   Due to differences in mean and effective CPAP levels CPAP devices are not simply exchangeable but should be individually adapted. Patients with higher minute ventilation might benefit from more stable CPAP machines. The impact on patients' compliance remains to be evaluated.     

Decreased incidence of headache after accidental dural puncture in caesarean delivery patients receiving continuous postoperative intrathecal analgesia

To examine the effects of prolonged (> 24 h) intrathecal catheterization with the use of postoperative analgesia on the incidence of post–dural puncture headache (PDPH), charts of 45 obstetric patients who had accidental dural puncture following attempts at epidural block were reviewed retrospectively. Three groups were identified: Group I (n = 15) patients had a dural puncture on the first attempt at epidural block, but successful epidural block on a repeated attempt; Group II (n=17) patients had a dural puncture with immediate conversion to continuous spinal anaesthesia with catheterization lasting only for the duration of caesarean delivery; Group III (n= 13) patients had an immediate conversion to spinal anaesthesia and received post–caesarean section continuous intrathecal patient–controlled analgesia consisting of fentanyl 5 (ig'ml^-1 with bupivacaine 0.25 mg·ml^-1 and epinephrine 2 μg·ml^-1 with catheterization lasting >24 h. No parturient in group III developed a PDPH. This was substantially lower ( P < 0.009) than the 33% incidence for group I and the 47% incidence for group II. The incidence of a PDPH did not differ between group I and II. Similarly, there was no difference between group I and II with regard to requests for a blood patch. Patients receiving continuous intrathecal analgesia had excellent pain relief, could easily ambulate and none complained of pruritus, nausea, vomiting, sensory loss or weakness. In conclusion, indwelling spinal catheterization > 24 h with continuous intrathecal analgesia following accidental dural puncture in parturients may for some patients be a suitable method for providing PDPH prophylaxis and postoperative analgesia.     

Double-bundle technique: Endoscopic posterior cruciate ligament reconstruction using tibialis posterior allograft

Recently, attention has been given to the double-bundle technique for treating the posterior cruciate ligament (PCL)-deficient knee. We present an arthroscopic PCL reconstruction using a double-bundle technique with 3-stranded tibialis posterior (TP) allograft that has not been described before. The anterolateral bundle of the PCL is reconstructed using 2-stranded TP allograft and the posteromedial bundle using 1-stranded TP allograft. Three-stranded TP allograft will be an alternative graft choice for PCL reconstruction.     

胫后动脉内踝上皮支皮瓣的临床应用

目的　探讨一种修复足踝部软组织缺损的有效方法。　方法　从 1999年 2月～ 2 0 0 2年6月 ,采用胫后动脉内踝上皮支血管为蒂的逆行岛状小腿内侧皮瓣修复足跟后部软组织缺损 2例、内踝部软组织缺损 2例以及踝前与足背软组织缺损 4例。　结果　临床应用 8例 ,皮瓣面积最小为 7cm×5cm ,最大 2 2cm× 7cm ,术后 8例皮瓣全部成活 ,随访 3～ 2 4个月 ,皮瓣感觉恢复 ,质地良好 ,外形不臃肿。　结论　胫后动脉内踝上皮支皮瓣血运可靠 ,手术切取简便安全 ,皮瓣厚薄适中 ,质地好 ,不牺牲胫后血管 ,是一种修复足踝部软组织缺损较好方法。     

Radiofrequency Procedures

Abstract:   Radiofrequency is a minimally invasive, target-selective technique that has been in clinical use for more than 25 years and has demonstrated success at reducing pain in several chronic pain conditions, including trigeminal neuralgia, chronic low back pain, postherpetic neuralgia, and complex regional pain syndrome. However, the success of radiofrequency in chronic pain has not been adequately reproduced in good-quality, randomized controlled trials, and its use in the management of neuropathic pain is under some debate. In addition, conventional radiofrequency occasionally leads to worsening and even new onset of neuropathic pain. Nevertheless, clinical experience suggests that radiofrequency may be a useful tool in the overall management of refractory neuropathic pain. Pulsed radiofrequency in particular is a minimally destructive procedure that may offer new opportunities and a broader perspective for therapy with radiofrequency.     

Continuous flow synthesis of peptides using a polyacrylamide gel resin (Expansin™)

The continuous flow syntheses of endothelin 1, proendothelin 2. ATP binding site of the CDC2 kinase 3, and fragment 18-30 of an actin 4, have been performed by using a polyacrylamide gel resin Expansin? (about 0.6 mmol NH₂/g) with the glycolamidic ester handle as labile anchorage. In addition, we report here a method of air oxidation which reduces the formation of side-products related to the formation of intermolecular disulfide bridges.     

垂体后叶素对家兔血糖、血钾影响作用实验研究

目的:本实验研究以垂体后叶素注射家兔前、后取得全血而得到血清,分为对照组和实验组来研究垂体后叶素对家兔血糖、血钾影响作用。方法:以半自动生化分析仪、日立717测定,统计学配对设计方法、t检验处理,观察对照组与实验组比较,血糖差异(P<0.01)、血钾差异(P<0.01)。结果:垂体后叶素对家兔有明显升高血糖、升高血钾作用。结论:此项实验研究为糖尿病发病原因、机理进一步探讨,提供有力依据。