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Prognostic analysis and complications of traumatic carotid cavernous fistulas after treatment with detachable balloon and/or coil embolization.

OBJECTIVE: To explore the causes of the formation of traumatic carotid-cavernous fistulas and the therapeutic effect of detachable balloon and/or coil embolization and the prevention of its complications. METHODS: From October, 1992 to March, 2002, 17 patients with traumatic carotid-cavernous fistulas were treated with detachable balloon and/or coil embolization in our hospital. The clinical data and imaging features of CT, MR and selective angiogram of these patients were analyzed. RESULTS: One week after treatment with embolization, the clinical symptoms of the 17 patients were remitted, and optic cacophony, nystagmus, exophthalmos and dropsy of conjunctiva disappeared. Two patients manifested surgical complications, one patient died. Sixteen patients survived. They were all followed up for more than 2 years, which showed one patient had handicap in movement, and in one patient the signs and symptoms of traumatic carotid-cavernous fistulas reoccurred 2 months after treatment. CONCLUSIONS: The detachable balloon and/or coil embolization is safe and reliable. It is a good method to treat traumatic carotid-cavernous fistulas.

Adolescent↗

[Activity of nuclear factor kappa B in rat pulmonary tissue after entrance of amniotic fluid into blood and inhibition with dexamethasone].

OBJECTIVE: To investigate the relationship between nuclear factor kappa B (NF-kappaB) and pulmonary injury in amniotic fluid embolism model of rat. METHODS: Seventy female Wistar rats were divided into five groups randomly: control group (6), amniotic fluid group (16), amniotic fluid + dexamethasone group (14), meconium group (20) and meconium + dexamethasone group (14). Different amniotic fluid was injected into jugular vein (dexamethasone was injected at 0.1 mg/100 g after entrance of amniotic fluid into blood) and blood pressure was examined. Pulmonary tissue was taken at 60 minutes. NF-kappaB activity was measured by Western-blot and percentage of NF-kappaB p65 positive cells in pulmonary tissue was determined by immunohistochemistry (HE). RESULTS: Dropsy, bleeding and neutrophil (PMN), macrophage, leukomonocyte infiltration were seen in four experimental groups. But none was found in control group. NF-kappaB activity in meconium group was 438,698 +/- 13,092, higher than those in amniotic fluid group, 377,982+/- 7,445, and in control group, 267,691 +/- 12 382 (F = 11.3, P < 0.01). With dexamethasone treatment, NF-kappaB activity was decreased, which was 308,826 +/- 13,771 in amniotic group and 339,516 +/- 17,358 in meconium group, respectively (t = 20.4 and t = 13.84, P < 0.01). Percentage of NF-kappaB p65 positive cells was higher in meconium group, 49.1 +/- 7.0, than in amniotic fluid group, 33.3 +/- 2.7, and control group, 13.3 +/- 2.1 (F = 1.17, P < 0.01). With dexamethasone treatment, the percentage decreased significantly to 22.9 +/- 3.0 and 21.4 +/- 3.6, respectively (t = 6.75 and t = 10.1, P < 0.05). CONCLUSIONS: NF-kappaB activity and percentage of NF-kappaB p65 positive cells are increased significantly, which is associated with pulmonary injury after entrance of amniotic fluid into blood and dexamethasone could inhibit NF-kappaB translocation to the nucleus to degrade NF-kappaB activity and alleviate pulmonary injury. NF-kappaB may be relevant to the occurrence and development of multiple organ dysfunction syndrome.

Amniotic Fluid↗

[Experimental study on anti-arthritis effect of jiawei mufangji decoction in rats].

OBJECTIVE: To explore the therapeutic effect of Jiawu Mufangji Decoction (JMD) in treating rats with adjuvant arthritis (AA) and its mechanism. METHODS: AA model rats induced by Freund's complete adjuvant were treated with JMD by gastrogavage starting from 18 days after modeling. On the 39th day, body weight, spleen and thymus index, and swelling degree of paw of the AA rats were measured, pathological changes of the ankle joint tissue were observed using HE staining, and serum levels of interleukin-1beta (IL-1beta) and tumor necrosis factor a (TNF-alpha) were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: JMD could relieve the symptoms of AA rats, decrease the paw swelling, improve the weight and spleen and thymus index, reduce the dropsy of joints and lymphocytes infiltration, inhibit the proliferation of synovium, and obviously lower the serum levels of interleukin-1beta and TNF-alpha. CONCLUSION: The therapeutic effect of JMD might be related to its action in down-regulating the serum levels of IL-1beta and tumor necrosis factor alpha.

Animals↗

[Activity and role of tryptase after entrance of amniotic fluid into blood in rats].

OBJECTIVE: To investigate the activity and role of tryptase after entrance of amniotic fluid into blood in rats. METHODS: Thirty female Wistar rats (20 day pregnancy) were divided into the control group (10, injected with normal saline), amniotic group (10, injected with amniotic fluid), meconium group (10, injected with 1% meconium). After injection, pulmonary tissue was taken out. Tryptase activity was measured by special substrate. The histology of pulmonary tissue was determined by immunohistochemistry (HE). RESULTS: (1) Dropsy, hemorrhage, and infiltration of neutrophil (PMN), macrophage, leukomonocyte were observed in two experimental groups, but no such changes were found in control group. (2) After injection, tryptase activity in meconium group 176.4 +/- 8.6 and amniotic fluid group 165.4 +/- 7.4 was significantly higher than preexperimental groups 146.8 +/- 8.9 and 147.8 +/- 9.5, respectively (t = 7.58 and t = 4.64, P < 0.01); tryptase activity in control group was 145.3 +/- 10.6 before injection and 146.9 +/- 9.4 after injection, respectively, there was no difference (t = 0.37, P > 0.05). After injection, tryptase activity in meconium and amniotic fluid groups was significantly increased than that in control group (F = 30.66, P < 0.05). CONCLUSION: The activity of tryptase was significantly increased after entrance of amniotic fluid into blood in rats. Degranulation of mast cells to release tryptase may be the important cause of the pathophysiologic change after entrance of amniotic fluid into blood. These results suggest a role for mast cell activation in the mechanism of amniotic fluid embolism. This method is sensitive and effective for diagnosis of amniotic fluid embolism in clinic.

Amniotic Fluid↗

[Thoracoamniotic shunts and thoracocentesis in fetal therapy].

BACKGROUND: The not heart thoracic anomalies are caused by different abnormalities in the embryonic period with similar physiopathologic mechanisms. The prenatal treatment by means of decompression can improve substantially the clinical results in these patients. OBJECTIVE: To evaluate, in a qualitative way, the effect of the thoracoamniotic shunts and thoracocentesis in the perinatal outcome in fetuses with not heart thoracic anomalies. METHODS: Twenty-two articles were revised describing 308 cases of fetuses with congenital cystic adenomatoid malformation (CCAM), 25 cases of hydrothorax and 55 cases of broncopulmonary sequestration (BPS). We analyzed the adverse prognostic factors that indicated the treatment election in uterus as well as complications and perinatal outcome. RESULTS: Of the 388 cases of not heart thoracic anomalies, 250 fetuses were managed conservatively, and in 102 fetuses handling in uterus was started. Hydrops was identified as the worst prognostic factor to these fetuses, with a survival rate of 55.7%. The global survival was of 56.5% (155 cases) in the fetuses with CCAM, 98.1% (52 cases) in the fetuses with BPS and of 80% (20 cases) in the fetuses with hydrothorax. CONCLUSIONS: When having a fetus with some of these pathologies, it should be evaluated in an individual and integral way; according to the gestational age when diagnosed, as well as the type of lesion and the presence or absence of fetal dropsy to decide between fetal therapy or expectant handling.

Amnion↗

[Construction and identification for cell strain of anti-human sperm protein 22 monoclonal antibodies].

OBJECTIVE: To prepare monoclonal antibodies of mice anti-human sperm protein 22 (SP22) and to identify their specificities. METHODS: BALB/c mice were immunized with human SP22, monoclonal antibodies were prepared by hybridoma technique and the sensitivity and specificity of SP22 McAb were investigated by ELISA and Western-blot assay, respectively. The distribution of human SP22 in sperm were shown by immunohistochemistry. RESULTS: Three strains of hybridoma cells were obtained, with the affinity constant (K) of 1.0 x 10(7) L/mol and the titers were 1:10(3) and 1:3,200 in the mixed supernatant of cell cultures and abdominal dropsy, respectively. IgG isotype of the antibody was identified as IgG1. Western blot demonstrated that there was a specific recognition between human SP22 and the obtained monoclonal antibody. Immunohistochemistry displayed that human SP22 mainly distributed on the acrosome surface of human sperm. CONCLUSION: The monoclonal antibodies of anti-human 22 was prepared by the technique of hybridoma cell has higher titer and specificity, which can combine specially with the SP22 protein on the surface of human sperm.

Animals↗

Kidney disease in medieval Serbian manuscripts from the Chilandar monastery (Mount Athos, Greece).

In the Chilandar monastery (Mount Athos, Greece) library, a collection of medical texts written in the Old Serbian Slavonic language was discovered in 1952. Because of its size and comprehensiveness, this manuscript was named the Chilandar Medical Codex. The Collection contains several manuscripts, which according to modern medical terminology, the manuscripts can be classified as texts on Internal Medicine, Infectious diseases, Toxicology, Pediatrics, Pharmacology and Surgery, belonging to different time periods. The oldest part, Text on uroscopy, is considered to have been written in 13th or 14th century and consists of 35 text pages divided into 62 paragraphs. Following the popular uroscopy methodology of macroscopic examination of urine, this text contains detailed descriptions of urine characteristics (color, consistency, sediment, odor), as well as a convincing Hippocratic description of urine formation from the filtration of metabolic and waste materials (involving the four humors) rather than blood and fumes (toxic metabolites) according to the theory of Theophilus Protospatharius and Isaac Israeli. Precise descriptions of normal and pathological urine characteristics are provided. Although kidney anatomy and function is unclear, the urinary bladder is very undoubtedly described as an organ for urine collection. In the Chilandar Medical Codex, there are about one hundred descriptions of kidney and urinary tract diseases and disorders. Many symptoms and syndromes such as hematuria, dysuria, pyuria, renal colic, anuria, polyuria, edema and dropsy, urine retention and fever, are incorporated in the broader clinical pictures of lithiasis of the kidney and/or bladder, pyelonephritis, cystitis, necrotic renal disease indicative of renal tuberculosis and tumors, acute and chronic nephritis, renal failure, and gout. Specific pharmacological prescriptions, mostly simple or compound herbal medicines, are given for each of those renal ailments.

Greece↗

Developmental abnormalities in chicken embryos after injection proteolysis inhibitors from Ascaris suum.

It has been found that trypsin and alpha-chymotrypsin inhibitors isolated from Ascaris suum act embryotoxically and teratogenically on White Leghorn chicken embryos. Mortality rate for the chicken embryos on day 15 of incubation was 45.0 +/- 3.5% after injection of trypsin inhibitor and 44.0 +/- 3.5% after adminstration alpha-chymotrypsin inhibitor. Gross examination of surviving embryos and their dissection revealed pathological changes (abdominal dropsy, umbilical hernia, subcutaneous oedema, hemoperitoneum, hemopericardium), symptoms indicating retardation in growth (lack of down, retarded ossification of long bones, decreased mean body weight) as well as malformations (schistocelia, micrognathia, cyclopia, crossed beak, cranial deformities) after injection of inhibitors from Ascaris. The highest incidence of embryos with pathological changes and malformations was found after administration of alpha-chymotrypsin inhibitor. The most commonly occurring abnormality was schistocelia (21.4 +/- 3.88%). Growth malformations were not found in the control groups. The trypsin and alpha-chymotrypsin inhibitors present in Ascaris homogenate have a significant disturbing effect on the development of the chicken embryo.

Animals↗

[Experimental study on the survival of venous flap with different pedicle styles].

OBJECTIVE: To study a new method of venous flap that is improved on its persistence and quality. METHODS: New Zealand white rabbits were subdivided randomly into 4 groups. All rabbits were operated by harvesting a flap from the latero-abdominal wall and then sutured it in the original position. Group A: the superficial epigastric vein in the pedicle was left open (only one inflow vein remained). Group B: the pedicle vein of the proximal and distant end were left open (keeping an inflow vein and a principal out). Group C: the pedicle vein and a tributary vein were left open (keeping an inflow vein and a tributary outflow vein). Group D: the pedicle vein and two tributary veins were left open (keeping an inflow vein and two tributary outflow veins). Survival rate, MDA of the tissue, histology and ultra-microstructure were examined. RESULTS: Survival rate of A, B, C, D were improved in order. Statistic difference is significant (P < 0.05) between group and group other than C and D. The content of MDA was heightened with statistically significant differences (A > B > C > D) among the four groups 8 hours postoperatively, but fell back to the normal level in group D and C and kept a high level in group A and B at 72 hour postoperatively. Histology and ultra-microstructure exam showed that degeneration of collagen fiber and karyopyknosis of cell is more obvious in Group A and Group B than Group C and Group D. CONCLUSIONS: The higher survival rate of venous flap is possible by designing the more reasonable venous flap outputs pedicles which can alleviate the high tension dropsy and maintain the valid equilibrium of pour with flow in the venous flap.

Animals↗

Vinegar: medicinal uses and antiglycemic effect.

Vinegar folklore is as colorful as it is practical. Legend states that a courtier in Babylonia (c. 5000 BC) "discovered" wine, formed from unattended grape juice, leading to the eventual discovery of vinegar and its use as a food preservative. Hippocrates (c. 420 BC) used vinegar medicinally to manage wounds. Hannibal of Carthage (c. 200 BC), the great military leader and strategist, used vinegar to dissolve boulders that blocked his army's path. Cleopatra (c. 50 BC) dissolved precious pearls in vinegar and offered her love potion to Anthony. Sung Tse, the 10th century creator of forensic medicine, advocated hand washing with sulfur and vinegar to avoid infection during autopsies. Based on the writings of US medical practitioners dating to the late 18th century, many ailments, from dropsy to poison ivy, croup, and stomachache, were treated with vinegar, and, before the production and marketing of hypoglycemic agents, vinegar "teas" were commonly consumed by diabetics to help manage their chronic aliment. This review examines the scientific evidence for medicinal uses of vinegar, focusing particularly on the recent investigations supporting vinegar's role as an antiglycemic agent. Epidemiologic studies and clinical trials were identified by a MEDLINE title/abstract search with the following search terms: vinegar, glucose; vinegar, cancer; or vinegar, infection. All relevant randomized or case-control trials were included in this review.

Acetic Acid↗

[The application of lymphovenous anastomoses in the treatment of primary lymphedema of the lower extremities at the edema stage].

The experience with clinical observation and surgical treatment of 217 patients with primary lymphedema of the lower extremities at stage II, IIIA (stage of "dropsy") is summarized. The working classification and developed complex of the diagnostic methods used are presented. The indications for the operations of creation of the lymphoangiovenous, lymphonodulovenous anastomoses, and as well the use of combined operations are considered; their effectiveness in different types of lesions of the lymphatic vessels is assessed. The methods for prevention of the erysipelatous inflammation recurrence with the use of endolymphatic intranodular administration of antibiotics are suggested. A complex of the developed measures permitted to obtain a satisfactory result at the nearest postoperative period in 74% of the patients, at the period of from 4 to 7 years--in 57%.

Adolescent↗

[Diagnosis of angiologic function in unilateral leg edema following combined treatment of cervix cancer].

For the clarification of the genesis of a unilateral dropsy of the legs which had appeared in 16 women after operative and radiologic therapy of a carcinoma of the cervix apparative angiological functional investigations were carried out. A slightly diminished plethysmographic drainage volume in a Doppler-sonographically unhandicapped deep venous flow off corresponded to the clinical picture of the secondary lymphatic oedema. The findings were compared with the behaviour of the parameters in thrombosis of the iliofemoral vein and test persons with healthy vessels. Only in two cases a venous component in form of a stenosis of the pelvic veins and a postthrombotic syndrome, respectively, could be objectified. Since the methodology renders possible a differentiation of lymphatic oedema and phleboedema, it is suitable for non-invasive controls of the course and has practical significance in the after-care of female patients with carcinoma of the cervix.

Combined Modality Therapy↗

[Ventriculoscopy in pediatric neurosurgery].

Ventriculoscopy is a simple, safe and informative method of examination of the lateral and third ventricles of the brain in childhood. In hydrocephalus of non-tumorous origin ventriculoscopy makes its possible, as a rule, to determine the origin of the dropsy and its character. The diagnosis of tumor of the brain of intraventricular or paraventricular localization and also of a tumor growing into the lumen of a cerebral ventricle is made on the basis of direct and indirect signs found during a visual examination. The histological nature of the process may be determined by biopsy of the pathological tissue collected during ventriculoscopy.

Brain Neoplasms↗

[Septate gallbladder and acute cholecystitis in a four-year-old girl (author's transl)].

A case of a four year old girl, first seen at the emergency ward for an abdominal pain, is reported. Exploration revealed a mass at the right hypochondrium which a laparotomy labeled as a dropsy gallbladder with a complete transversal septum at the union of the gallbladder's body and infundibulum. Microscopic examination showed an acute cholecystitis. A classification of septate gallbladders is performed and embryology revised. Microphotographs of human embryo are presented making etiopathogenesis of this case understandable. The scanty bibliography on this topic makes this case extremely rare.

Acute Disease↗

Na-K-ATPase activity in the guinea pig stria vascularis in experimentally-induced endolymphatic hydrops.

The effect of endolymphatic hydrops on the Na-K-ATPase activity in the guinea pig stria vascularis was electron microscopically and enzyme cytochemically investigated one year after experimental induction. The morphological observations revealed intercellular dropsy in the basal infoldings of the marginal cells, and shrinkage and disappearance of intermediate cells. Moreover, shrinkage of the marginal cells, especially of the basal infoldings, was occasionally observed. In spite of these morphological alterations, the Na-K-ATPase activity was still detected on the plasma membrane of the basal infoldings of most marginal cells. No remarkable differences were found among the cochlear turns of the specimens examined. However, no reaction product was detected on the basolateral plasma membrane of severely degenerated marginal cells. The present results indicate that the Na-K-ATPase of the plasma membrane of the basal infoldings of the marginal cells plays an important role in the maintenance of the unique ion concentration of the endolymph even in the endolymphatic hydropic condition, and that the Na-K-ATPase activity is attenuated in severely atrophic cells.

Animals↗

[Early thrombosis of the portal vein after orthoptic liver transplantation. A case report].

We report on a case of early portal vein thrombosis occurring after liver transplantation in a patient with alcoholic cirrhosis. Although this complication is usually accompanied by acute graft failure and/or gastroesophageal bleeding, in this patient the portal thrombosis occurred with the appearance of general dropsy and encephalopathy, serum protein deficiency and a slight rise in liver function test values. Echo-Doppler and arteriography showed portal thrombosis, arterial hyperflow and the persistence of a large spontaneous spleno-renal shunt, identified before the transplant had taken place. Endoscopy did not reveal gastroesophageal varices. Since there was no sign of serious ischemic damage or of a serious deterioration of liver function, the patient was treated non-operatively. Some particular hemodynamic aspects implicated in the appearance of portal thrombosis in our case are discussed. However, the authors consider that spontaneous portal-systemic shunt, in the presence of advanced cirrhosis, inverted portal flow, without gastroesophageal varices, can be considered as a surgical total diverting shunt and should be taken as a risk for portal thrombosis after transplantation.

Diabetes Mellitus, Type 1↗

[Nonnius, 'dietetics' and oenology].

In a short historical perspective we restrain the meaning of the concept oenology to the importance of wine as a treatment of well defined internal diseases, with special attention to the 16th and 17th centuries and to the personality of Nonnius. Hippocrates was the first physician who ascertained the healing value of wine. He recommended white wine in cases of dropsy and red wine in order to stimulate hunger and to nourish the body. The opinion of the Ancients concerning wine remained almost unchanged during the Middle Ages. Eight chapters of Nonnius' "Diaeteticon" are dedicated to wine. The Antwerp scholar agrees with Galen, who teaches that "dark and sweet wines produce much blood, while white and light ones produce but little blood, so that the first ones are proper to feed the body and the other ones to get rid of liquids through the urine.' Nonnius further discusses honey-wine and 'mulsa' or hydromel. But it is not before the latest half century that oenology has made enormous progress due to the use of new techniques and as a result of the practice of oenotherapy by conscientious researchers, based upon serious scientific research. However, two fundamental remarks have to be made: the daily quantity shall not exceed four glasses, divided over the two principal meals, and wine shall always be drunk with food. Recent research proves that wine may be a helpful adjuvant, when the blood circulation is at stake.

Dietetics↗

Immunization with bacterial antigens: infections with motile aeromonads.

Motile aeromonads are a heterogeneous group of organisms which are involved in a number of disease syndromes of warm water fish. They are commonly associated with bacterial haemorrhagic septicaemia, infectious dropsy, red mouth disease, ulcerative conditions etc. A variety of factors has been considered to be associated with virulence including haemolysins, proteases, surface array protein, acetylcholinesterase etc. We have studied the immune response of Indian major carps to antigens of motile aeromonads. The Indian major carp, Labeo rohita, showed immunological memory and secondary response on booster administration. The extent of protection showed good correlation with titres of agglutinating antibody. When polyvalent vaccine was used, the fish showed antibody titres against all the component strains. However, the level of antibody was less compared to immunization by monovalent vaccines. Cross-reacting antibodies induced by monovalent vaccines showed varying degrees of protection.

Aeromonas↗