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PubMedDate not supplied

Role of bradykinin potentiation in the antihypertensive effect of captopril in conscious rabbits with two-kidney, one-clip hypertension.

The role of bradykinin potentiation in the antihypertensive effect of captopril was assessed in conscious rabbits with two-kidney, one-clip hypertension. On the 35th day after clipping the renal artery, a bolus injection of bradykinin 0.2 microgram/kg was repeated at 15-min intervals three times before and for 180 min after the administration of captopril 0.5 mg/kg. The magnitude and duration of captopril-induced hypotension were more marked in hypertensive rabbits than in controls. The bradykinin-induced hypotension was markedly enhanced by captopril. However, the bradykinin potentiation by captopril was not correlated with its vasodepressive effect. On the other hand, a close relationship (r = 0.825, p less than 0.001) was observed between plasma renin activity and the maximum reduction in blood pressure induced by captopril. The experiment performed after sodium depletion for 7 days revealed that the bradykinin potentiating effect of captopril was not affected by sodium depletion. Therefore, it is concluded that the vasodepression by captopril does not necessarily depend on its bradykinin potentiating action and the latter is not influenced by the renin-angiotensin system or fluid volume depletion.

Animals↗
PubMed1991

Improvement of cardiac contractile response to beta-adrenergic stimulation in normal and two-kidney, one-clip hypertensive rats treated with nitrendipine.

To evaluate the effect of nitrendipine on cardiac hypertrophy and inotropic response to isoproterenol in two-kidney, one-clip (2K,1C) renovascular hypertension, male Wistar rats (n = 56) were divided into a clipped group (K) (n = 28) and a sham group (S) (n = 28). Twenty-one days after surgery, the rats were placed in metabolic cages where they received either a normal diet (S and K rats) or a similar one containing N (18 mg/day) (SN and KN rats) during 3 weeks. Arterial pressure and body weight were measured twice a week. At the end of the experimental period, the hearts were excised, the ventricles were weighed, and cardiac proteins were measured by the Lowry method in seven hearts of each group. In the remaining hearts, the left ventricular papillary muscle was excised and mounted in a bath where the developed tension (dt) and the maximal rate of rise of developed tension (+T) were recorded in basal conditions, and after cumulative doses of isoproterenol (10(-11) to 10(-4) M). The arterial pressure, ventricular weight, and cardiac proteins were similar in S, SN, and KN groups and were significantly higher in the K group (p less than 0.05). No difference in the basal values of +T and dt were observed among the four groups. The increment in +T after isoproterenol was higher in treated (KN and SN) than in nontreated (K and S) groups (p less than 0.05). In conclusion, nitrendipine enhances the contractile response to isoproterenol and reverses the cardiac hypertrophy in the 2K, 1C model.

Animals↗
PubMed1997

Repair of an arterial perforation of the internal carotid artery using Hemashield wrapping with aneurysm clip reinforcement: technical note.

OBJECTIVE: To review a technique used to repair a hole in the carotid artery encountered during the dissection and clipping of a giant paraclinoid aneurysm. METHODS: The technique of repair involves wrapping the artery using a woven double velour material impregnated with bovine collagen (Hemashield; Meadox, Oakland, NJ) and securing the material around the carotid artery with an aneurysm clip. The intravascular pressure of the carotid artery provides the counterforce necessary to seal the hole. RESULTS: The carotid artery was slightly narrowed after the treatment. The patient made an excellent recovery from surgery. CONCLUSION: This technique provides an alternative means of repairing a defect in the walls of intracranial arteries.

Aged↗
PubMed1987

Spring clip sterilization: long-term follow-up.

Between 1978 and 1984, 186 women had interval laparoscopic and postpartum Hulka clip sterilization at the University of Missouri Health Sciences Center. We reached 109 (58%) of these women for follow-up. All had had their sterilization procedures at least one year earlier, and the average duration of follow-up was 3 1/2 years. The procedure failed in four patients, for a failure rate of 3.7%; three of these failures occurred more than 12 months after sterilization. These data suggest that long-term (more than 12 months) follow-up studies may be necessary to document more accurately the failure rate of Hulka clip sterilization.

Adolescent↗
PubMed1998

Neuromonitoring of an experimental model of clip compression on the spinal nerve root to characterize acute nerve root injury.

OBJECTIVES: To evaluate the sensitivity of an electro-monitoring method in acute nerve root injury, and to determine a proposed criterion for irreversible electrophysiologic degradation. STUDY DESIGN: Acute nerve root injury was induced by a clip compression model in rabbits, mimicking nerve root injury by a transpedicular screw. A common neuromonitoring technique, spinal somatosensory-evoked potential, was used to study the electrophysiologic change during the procedure. SUMMARY OF BACKGROUND DATA: With the advent of the transpedicular screw system, increased risk of injury to the spinal root because of the passage of screws is not unexpected. Although both an experimental model and a clinical application in intraoperative neuromonitoring of spinal cord function have been established, the value of neuromonitoring of an acute spinal root injury remains obscure. Several neurophysiologic surveillance techniques have been used successfully to monitor the potential injury to the spinal cord during orthopedic procedures around the spinal cord and spinal column. Spinal somatosensory-evoked potential, which has the advantages of high amplitude and quick recording time, is used to detect nerve root impairment during the insertion of transpedicular screws. METHODS: Experimental acute nerve root injury was induced in rabbits by direct hemostatic clip compression on the nerve root (S1) during different time intervals. Spinal somatosensory-evoked potential elicited by stimulating the sciatic nerve and recorded from a needle electrode at the L6-L7 interspinous ligament was monitored immediately before and after compression. RESULTS: Spinal somatosensory-evoked potential is sensitive enough to detect the compromise of a single nerve root and that a decrease in the amplitude is the most reliable and sensitive sign. With this model, there was a statistically significant correlation between the compression time and reduction of amplitude and delay of latency. The criterion for irreversible electrophysiologic change was an amplitude loss of more than 20% and a delay in latency immediately after nerve root compression. CONCLUSIONS: It was concluded that spinal somatosensory-evoked potential can provide immediate feedback of nerve root injury and should be considered for use during the dynamic phase of transpedicular screw insertion.

Animals↗
PubMed1996

Repair of implant overdenture clip attachments: technical note.

A technique is described for repositioning the clip attachments of implant overdentures during repair or relining procedures using a direct method. During maintenance procedures, clip attachments must be repositioned correctly to prevent torquing of the bar and abutments and precautions taken to avoid locking the prosthesis to the undercut areas of the bar. This technique ensures proper positioning of the attachments and decreases the amount of polymerization shrinkage.

Dental Clasps↗
PubMed2004

Titanium clip prosthesis.

OBJECTIVE: Prostheses for the reconstruction of a defective ossicular chain should be stable and firmly anchored to the ossicular remnants. This will prevent a defective connection from causing diminished sound transmission efficiency and will keep the prosthesis from tilting or even losing contact, which would result in a sound transmission block. Through temporal bone experimentation, we have consequently developed a very lightweight titanium prosthesis, which is fastened onto the stapes head with a clip mechanism. METHODS: When temporal bone experiments using laser Doppler vibrometry confirmed that the prosthesis functioned well acoustically and when luxation experiments proved that it could be safely used without the risk of stapes dislocation, the prosthesis was used in a clinical application within an observational study. The University of Dresden Otorhinolaryngological Hospital as well as seven surgeons from five other hospitals participated in the study. RESULTS: The results of 133 operations showed that, in over 90% of the cases, the prosthesis could be implemented without problems and with good mechanical stability. The first acoustical results obtained during the first year from 49 patients showed a sound transmission improvement range from 12 dB to 14 dB. CONCLUSION: With the clip prosthesis, it seems possible to further improve defective middle ear function, which would allow the patient to regain social hearing after middle ear reconstruction. The reliability of the fastening is an innovation. Revision operations showed a stable prosthesis-stapes complex in the middle of a recurring cholesteatoma and the prosthesis could always be easily pulled from the stapedial suprastructure.

Auditory Threshold↗
PubMed2004

No clip, no ligature laparoscopic appendectomy.

Laparoscopic appendectomy (LA) is one of the common procedures being carried out in general surgery. The technique of bipolar coagulation (BC) has been effectively employed in obstetric and gynecologic procedures but has not been used for intestines. We present the technique of LA using BC at our center. The technique consisted of identifying the appendix and coagulating the appendicular stump with bipolar coagulation until there were no bubbles at the cautery site, and a constriction ring formed at the site of coagulation. Sixty patients with acute or recurrent appendicitis underwent the procedure. The median duration of BC was 90 seconds. The median duration of surgery was 25 minutes, postoperative hospital stay was 3 days, and time to oral feeds was 12 hours. The technique of laparoscopic appendectomy by bipolar coagulation is very simple and economical. The duration of surgery is less than for the standard technique of laparoscopic appendectomy; no clip applicators, needle holders or knot pushers are required, and no foreign materials like ligatures or clips are needed.

Adult↗
PubMed2005

Surgical clips: a nidus for foreign body reaction after hepatic resection.

This case report describes a patient who underwent segment IV hepatic resection and 7 months later developed an abdominal wall abscess. This was a foreign body reaction to the surgical clips. The patient required an exploratory laparotomy with debridement and excision of the inflammatory mass in the anterior abdominal wall. Although occurrence is rare, foreign body reactions to surgical clips have been reported, especially as a complication of laparoscopic surgery.

Aged↗
PubMed2001

Noninvasive vasectomy using a focused ultrasound clip: thermal measurements and simulations.

INTRODUCTION: Conventional surgical vasectomy may lead to complications including bleeding, infection, and scrotal pain. Noninvasive transcutaneous delivery of therapeutic focused ultrasound has previously been shown to thermally occlude the vas deferens. However, skin burns and inconsistent vas occlusion have presented complications. This study uses bio-heat transfer simulations and thermocouple measurements to determine the optimal ablation dosimetry for vas occlusion without skin burns. METHODS: A 2-rad ultrasound transducer mounted on a vasectomy-clip-delivered ultrasound energy at 4 MHz to the canine vas deferens co-located at the focus between the clip jaws. Chilled degassed water was circulated through an attached latex balloon, providing efficient ultrasound coupling into the tissue and active skin cooling to prevent skin burns. Thermocouples placed at the vas, intradermal, and skin surface locations recorded temperatures during ablation. Procedures were performed with transducer acoustic powers of 3-7 W and sonication times of 60-120 s on both the left and right vas deferens (n = 2) in a total of four dogs (precooling control, 3 W/120 s, 5 W/90 s, 7 W/60 s). Measurements were compared with bio-heat transfer simulations modeling the effects of variations in power and sonication time on tissue temperatures and coagulation zones. RESULTS: Active skin cooling produces a thermal gradient in the tissue during ablation, allowing sufficient thermal doses to be delivered to the vas without skin burns. However, low-power, long-duration heating produced excessive tissue necrosis due to thermal diffusion, while high power and short heating times reduced the therapeutic window and produced skin burns presumably due to direct ultrasound absorption. CONCLUSIONS: Both simulations and experiments suggest that a therapeutic window exists in which thermal occlusion of the vas may be achieved without the formation of skin burns in the canine model (power = 5-7 W, surface intensity = 1.4-1.9 W/cm2, time = 20-50 s). This range of ablation parameters will help guide future experiments to refine incisionless vasectomy using focused ultrasound.

Animals↗
PubMed1994

Analgesia after laparoscopic sterilisation. Effect of 2% lignocaine gel applied to Filshie clips.

We performed a randomised controlled study in patients undergoing day case laparoscopic sterilisation to assess whether coating Filshie clips with 2% lignocaine gel prior to application to the Fallopian tubes would reduce postoperative pain. Sixty-two patients were studied, in 33 of whom the Filshie clips were coated in sterile 2% lignocaine gel. Pain scores in the lignocaine gel group were significantly lower than in the control group at 1 h after return to the ward, but no differences were found immediately on return to the ward, or at discharge or at 24 h. There were no significant differences between the two groups in postoperative analgesic requirements or in side effects.

Administration, Topical↗
PubMed2004

Surgical pearl: the safety pin as a better alternative to the versatile paper clip comedo extractor.

Acne vulgaris is a very common, chronic inflammatory disease of the pilosebaceous apparatus. The comedo extractor is the instrument primarily used for comedo extraction. There are many types of more costly instruments available, but extraction can be achieved with the help of a modified versatile paper clip and disposable syringes. The disposable syringe is a good option for acne surgery, but a safety pin has been found to be more effective than the clip comedo extractor for extracting the comedo. The safety pin can be regarded as a "two-in-one" instrument for piercing the lesion and for extracting the keratinous material from the pilosebaceous canals.

Acne Vulgaris↗
PubMedDate not supplied

Increased renal prostanoid synthesis after unclipping the one-kidney, one-clip hypertensive rat: effect of renal denervation.

Renal denervation of hypertensive one-kidney, one-clip (1K, 1C) rats resulted in a minor fall in blood pressure (216, s.e.m. = 4, to 182, s.e.m. = 4, mmHg) 24 h later, which returned to predenervation levels with 1 week. Subsequent unclipping led to a similar fall in blood pressure in denervated (202, s.e.m. = 4 to 142, s.e.m. = 3) and sham-denervated (211, s.e.m. = 5 to 147, s.e.m. = 4) rats. Unclipping also resulted in a marked rise in urinary PGE2 and 6-keto PFG1 alpha in both denervated and sham-denervated animals. It appears that 1K, 1C hypertension, 8 weeks after clipping, is only slightly dependent on renal nerves. Unclipping results in increased renal synthesis of PGE2 and PGI2 which is not dependent on intact renal innervation.

Animals↗
PubMed1997

Effects of one-clip, one-kidney hypertension in chronically catheterized pregnant ewes.

1. Hypertension secondary to renal disease was studied in non-pregnant and pregnant ewes to determine whether there were any changes in arterial pressure and the distribution of cardiac output and, in particular, whether uteroplacental blood flow was affected. 2. In six non-pregnant, chronically catheterized, uninephrectomized ewes, a reduction in renal blood flow (RBF) to 40-50% of control caused hypertension within 3 h. This was maintained for as long as RBF was reduced (72 h) and returned to control 24 h after the occluder around the renal artery was released. When this experiment was repeated in 16 uninephrectomized pregnant ewes (118-134 days gestation) hypertension occurred within 3 h and was sustained for as long as RBF was reduced (between 24 and 72 h). Arterial pressure returned to control within 24-72 h of restoring RBF. 3. Compared with non-pregnant ewes, pregnant ewes had similar arterial pressures, higher cardiac outputs (CO; P < 0.001) and heart rates (HR; P < 0.001), lower total peripheral resistances (TPR; P < 0.001) and similar blood flows to brain, ovary, pancreas, kidney and spleen. Splenic vascular resistance (VR) was greater (P = 0.006), gut blood flow was greater (P < 0.05) and gut VR was less (P < 0.05). Myoendometrial blood flow/g was greater (P < 0.005) and myoendometrial VR was less (P = 0.006). 4. In pregnant sheep with renal clip hypertension, there was no change in CO and HR, but TPR increased (P < 0.01), as did plasma renin activity. Gut, brain, pancreatic and myoendometrial VR were increased as long as RBF was reduced; in addition, myoendometrial VR remained high for the rest of the experiment. Placental blood flow was unchanged at 3 h; 24-72 h later it was reduced (P < 0.05) and remained low. Placental VR was increased 24-72 h after RBF was restored when ewes were again normotensive. 5. Thus, one-clip, one-kidney renal hypertension in the pregnant ewe was due to increased TPR associated with a fall in uteroplacental blood flow that persisted even when RBF was restored and ewes were normotensive. This reduction in uteroplacental blood flow could account for the high foetal morbidity and mortality that occurs in pregnant women with renovascular hypertension.

Animals↗
PubMed1996

Evaluation of post-operative analgesia following laparoscopic application of Filshie clips.

OBJECTIVE: To evaluate the efficacy of injecting 1% lignocaine into the subserosal aspect of the cornual end of the fallopian tubes to control post-operative pain after laparoscopic Filshie clip application. DESIGN: A double blind, randomised controlled trial. SETTING: The day surgery unit of the Dunedin Public Hospital, Otago, New Zealand. PARTICIPANTS: Fifty-nine women attending the public hospital requesting sterilisation. INTERVENTIONS: The experimental group received an infiltration of 1% lignocaine into the subserosal aspect of the cornual end of the fallopian tubes. The control group received an infiltration of normal saline in the same site. MAIN OUTCOME MEASURES: The use of post-operative pethidine and the scores obtained on a modification of the McGill present pain intensity score, a visual analogue scale of present pain, a pain relief score and comparisons of time to first analgesia use. RESULTS: The use of pethidine in the experimental group was significantly reduced [P = 0.001] Pain relief scores indicated significant benefit from the intervention. The time to first analgesic use was significantly greater in the experimental group. CONCLUSION: Lignocaine infiltration at the cornual end of the fallopian tubes during laparoscopic Filshie clip application is highly effective in producing post-operative pain relief.

Adult↗
PubMed1982

Study of Bleier tubal clip for fertility control.

Sterilization by oviduct occlusion with plastic mono-construction clips was carried out on a series of 21 doe-rabbits; effective sterilization resulted. Subsequent oviduct re-anastomosis over nylon splints resulted in 58% restoration of fertility as proven by term pregnancies. There were no complications attributable to the clip application.

Animals↗
PubMed2005

Feasibility and outcome of automated static perimetry in children using continuous light increment perimetry (CLIP) and fast threshold strategy.

PURPOSE: Visual field testing in children is always a challenge as testing is hampered by fatigue effects, easy distraction and lack of comprehension. For that reason new testing strategies for automated perimetry have mainly been evaluated on adults. We tested the feasibility and outcome of automated static perimetry in children in a standard clinical setting. METHODS: Twenty-eight children aged 5-14 years were examined at the Twinfield perimeter, including healthy children, children with unilateral pathologies (normal eye tested) and children with strabismus. Fast threshold strategy (FT) and continuous light increment perimetry (CLIP) strategy were used in a randomized order. One eye per subject was examined and each test was performed twice. RESULTS: Reliable results were obtained in many children starting from the age of 8 years. In children aged 13 years and over, adult testing strategies were possible in most cases with good reproducibility. No significant difference was found between the children with strabismus and the other children. Mean sensitivity (MS) increased and fixation losses decreased as a function of age. Continuous light increment perimetry showed a lower number of abnormal fields and fewer false-positive errors compared to FT. CONCLUSION: Automated static perimetry is possible in many children in a clinical setting using a commercially available Twinfield perimeter in a session of clinically practical duration. Test performance was not only dependent on age, but also on the child's maturity and ability to concentrate. Especially in children up to the age of 8 years, testing with the ramp stimulus (CLIP) was easier than with a staircase strategy (FT).

Adolescent↗