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[Therapeutic regional anesthesia following an accidental intra-arterial injection. A case report on anesthesiologic care following incorrect injection of Reparil (sodium escinate)].

Symptomatology and therapeutic measures after accidental brachial intra-arterial injection of sodium escinate were explained by means of a case report. We obtained long-acting analgesia and sympathicolysis in the upper extremity by an anaesthesia of the ganglion stellatum followed by repeated interscalene plexus brachialis blockade. Even in very severe cases of accidental intra-arterial drug injection surgical procedures should be accompanied with therapeutic regional anaesthesia technics.

Adult↗

[Therapeutic effect of a combination of bufenine and beta-escine as an oral delayed-action drug in obliterating arterial diseases of the lower limbs].

Reference is made to the clinical and instrumental results observed in 40 subjects with chronic obliterating arteriopathy of the lower limbs treated for 90 days with a projective protocol based on a per os retard combination of bufenine and beta-escine. Attention is drawn to the vasoactive and antioedemigenic activity of the combination, its good tolerance, and easy administration.

Administration, Oral↗

[Treatment of upper limb lymphedema after mastectomy with escine and levo-thyroxine].

Lymphoedema of the upper limb is the most serious and most crippling complication of mastectomy. An account is given of the factors possibly responsible, and a classification of the different forms is proposed. When fibrosis has set in, treatment is followed by very disappointing results, being at best able to bring about a partial, but transitory reduction in limb volume and consistency. Reference is also made to results obtained in 70 cases with two substances, 1-thyroxine and escine (somatoline), applied by massotherapy in postural drainage, ionophoresis, and pressotherapy, according to the requirements of each case. The results were distinctly satisfactory, though the outstanding fact was the maintenance of the response throughout many follow-up controls. It is felt, therefore, that somatoline can be usefully given in cyclic form, both in cases treated in an early stage, and also in all patients were lymphoedema is a likely risk after mastectomy.

Arm↗

Possible involvement of a small G-protein sensitive to exoenzyme C3 of Clostridium botulinum in the regulation of myofilament Ca2+ sensitivity in beta-escin skinned smooth muscle of guinea pig ileum.

The effects of exoenzyme C3 of Clostridium botulinum on Ca(2+)- and drug-induced tension developments were investigated in beta-escin skinned smooth muscle of guinea pig ileum to test the involvement of a small G-protein in the regulation of myofilament Ca2+ sensitivity. C3 is known to ADP-ribosylate the rho p21 family of small G-proteins. Treatment with C3 (0.35 microgram/ml, for 30 min) shifted the pCa-tension curve rightward along the Ca2+ concentration axis, indicating a decrease in Ca2+ sensitivity of the contractile elements. The inhibitory effect of C3 was not preserved after treatment with GDP beta S (1 mM), an antagonist of GTP for the binding to G-proteins. Stimulation of muscarinic receptors with carbachol (CCh, 100 microM) shifted the pCa-tension curve leftward, indicating Ca2+ sensitization of tension development. The Ca(2+)-sensitizing effect of CCh was not observed after C3 treatment. When GTP gamma S (10 microM), an activator of G-proteins, was applied at a plateau of tension development produced by a moderate concentration of Ca2+, further increase in tension was elicited and the effect of GTP gamma S was inhibited by C3 treatment. The results suggest the possible involvement of a rho p21-like small G-protein in the regulation of Ca2+ sensitivity of smooth muscle myofilaments.

Animals↗