Atrial natriuretic peptide and verapamil can prevent gentamicin induced acute renal failure in the rat

Summary: Calcium channel blockers are able to improve renal function in acute renal failure (ARF) and natriuretic peptides can also exert beneficial effects. At present it is unknown whether administration of atrial natriuretic peptide (ANP) and a calcium channel blocker given before a toxic lesion can prevent gentamicin induced ARF. the mechanisms of action of natriuretic peptides and calcium channel blockers are different and, as yet, it has not been clarified if combined administration can augment the effects on renal function. After a basal period we investigated the effects of verapamil (VER, 0.66 mg/kg), ANP, (30 μg/kg) and a combination of both (identical doses as described individually). the drugs were given intravenously for a period of 40 min (infusion period) before gentamicin (15 mg/kg, i.v.) was administered for induction of ARF. Basal values for glomerular filtration rate (GFR, mL/min) were around 1.8 with no differences between the groups. At the end of the infusion period (before application of gentamicin) GFR was significantly elevated with VER + ANP (3.13 ± 0.51), ANP (2.70 ± 0.59) and VER (2.34 ± 0.47) compared to controls (saline, 1.7 ± 0.48). After application of gentamicin GFR significantly dropped in the control group (0.77 ± 0.21, 0.75 ± 0.19, respectively), indicating development of ARF. In contrast with VER + ANP, ANP and VER GFR could be maintained for 30 min (2.47 ± 0.39, 2.28 ± 0.33, 2.22 ± 0.43, respectively) and 130 min (2.11 ± 0.32, 1.86 ± 0.29, 2.11 ± 0.28, respectively) after gentamicin. Moreover ANP and VER revealed natriuretic activity and, due to their vasorelaxing potency, also influenced arterial blood pressure. We conclude that both VER and ANP are able to prevent early gentamicin induced ARF when given before the toxic lesion. Both drugs induce hyperfiltration while infused, in particular when administered in combination.     

Rekonstruktion nach Unterschenkelfehlheilung

Trauma und Berufskrankheit - Fehlheilungen am diaphysären Unterschenkel lassen sich im Einzelnen folgendermaßen charakterisieren: · Infekt, oberflächlich/tief, ·...     

Komplikationen navigierter Eingriffe an der Wirbelsäule

Both 2D and 3D computer navigation systems have become important tools in the operative treatment of spinal injuries. 2D navigation utilizes a modality-based dataset from the C-arm, while 3D-navigation is based on a non-modality-based dataset from conventional computed tomography or on 3D modality-based ascertainment of data by an isocentric C-arm equipped with an appropriate computer. Experimental and clinical studies have shown increasing accuracy of transpedicular screw placement with all types of computer navigation than with traditional implantation, but unsatisfactory levels of precision are still recorded even when computer navigation is used. Before computer navigation systems can be used with sufficient precision it is necessary to know the potential sources of error for each of the various modalities. These extend from the data acquisition through data transfer and preparation of the dataset for use in computer navigation to intraoperative use of each navigation system. Those who are starting to use such systems must undergo a specialized course of instruction followed by supervised training, and any surgeon who applies them must be sufficiently experienced and well informed to be able to view them with a well-founded criticism; only then are identification and consequent avoidance of complications of computer navigation possible.     

Attitudes toward male fertility control: results of a multinational survey on four continents

BACKGROUND: Following extensive research activity to develop an effective agent to control male fertility, such a product may be available for use within approximately 5 years. However, little is known concerning contraceptive knowledge, desires and attitudes of men in different countries, and their acceptance of male fertility control (MFC). METHODS: A survey of >9000 males aged 18-50 years was performed in nine countries on four continents in 2002. The objective was to compare, on a cross-cultural basis, the knowledge, attitudes and acceptability of MFC among men and assess their willingness to use such a method. RESULTS: Between 50 and 83% of the male respondents currently use contraceptive methods, and 55-81.5% reported that both partners participate in selecting the method of contraception employed. Overall acceptance of hormonal MFC was high (>55%), with 28.5-71.4% of survey participants of various nationalities expressing the willingness to use such a method. CONCLUSION: While MFC appears to be well accepted overall, the willingness to use this type of contraception varies widely between differing population groups. The specific characteristics and profile of any MFC product will have to be carefully evaluated to accurately assess its acceptance, both by men and their female partners.     

Über den „sekretorischen Mittelohrkatarrh“

Zusammenfassung Der sekretorische Mittelohrkatarrh stellt, was zumeist zu wenig berücksichtigt wird, keine einheitliche Erkrankung dar. In der Mehrzahl der Fälle handelt es sich um eineseröse Entzündung mit Exsudat, serologische Untersuchungen sowie klinische Beobachtungen und Erwägungen sprechen eindringlich dafür, in den anderen Fällen liegt infolge eines Tubenverschlusses durch Tumordruck oder Narbenstriktur einHydrops (Transsudat) vor, wobei nicht feststeht, ob dieser ex vacuo oder durch Stauung zustande kommt. In Fülen von Tumor begünstigt vielleicht die Kachexie die Bildung des Transsudates.Nach Abschluß meiner Arbeit mußte ich feststellen, daß mir bei der Durchsicht des Schrifttums eine Arbeit vonN. Rh. Blegvad, erschienen in der Monatsschrift für Ohrenheilkunde 1932 unter dem Titel Ist der Begriff Tubenokklusion aufrecht zu erhalten ? völlig entgangen war. So sehr ich dieses Versehen bedauere, so sehr hat es mich gefreut, in dieser Arbeit vielfach den gleichen Gedankengängen begegnet zu sein, wie ich sie oben, vollkommen unabhängig davon, entwickelt habe.Herrn ProfessorZange, zum 60. Geburtstag.     

Distraction Osteogenesis of Ankylosed Front Teeth with Subsequent Orthodontic Fine Adjustment

OBJECTIVE: Conventional therapeutic approaches to correct ankylosed anterior teeth in infraposition require compromises involving esthetics and function. The combined approach of distraction and early orthodontic fine adjustment, not yet established as a routine, promises better results concerning the bone conditions and gingival development. CASE HISTORIES: Both female patients had suffered a trauma to the front teeth during early mixed dentition resulting in ankylosed central incisors in infraposition. At the ages of 14 years and 2 months and 15 years and 2 months, respectively, we carried out segment distraction by means of a bone-supported internal distractor followed by orthodontic fine adjustment after having shortened the consolidation phase. Both ankylosed front teeth could be successfully aligned, leading to an increase in bone and harmonization of the gingival margin in the dental arch. At ten and 14 months after the conclusion of treatment, we observed only few deviations in the dental situation compared to posttherapeutic findings. CONCLUSION: From a functional and esthetic point of view, therapy involving combined orthodontics and surgery is superior to conventional therapy. Orthodontic fine adjustment should be considered as a continuation of the distraction procedure.