A relatively simple differential screening test for GABA or glycine antagonists using rat electroretinography

Intravitreal injection of GABA- and glycine-antagonists had specific and reversible effects on the ERG of rats. For example, picrotoxin induced characteristic rhythmic potentials. The effect was common to other GABA-antagonists, such as bicuculline, N-methylbicuculline and penicillin G. Strychnine caused the appearance of a- and c-like waves in response to low intensity flash stimuli in addition to the suppression of the b-wave commonly seen with agents such as asparate following higher intensity flash stimuli. The strychnine-like effect was common to other glycine-antagonist tested, such as brucine, morphine and laudanosine. The quanternization of the glycine-antagonists abolished the strychnine-like activity and endowed the ability to induce the rhythmic potentials characteristic of GABA-antagonists. This relatively simple method of observing either rhythmic potentials or a negative deflection (a-like wave) to a low intensity stimulus (about 1.0 log unit above dark threshold) in the ERG should be useful for the rapid screening of the predicted and new GABA--and glycine-antagonists.     

Clinical evaluation of etidocaine in continuous caudal analgesia for pelvic floor repair and post-operative pain relief

A randomized double-blind trial compared 1-0% etidocaine and 1-5% lignocaine (both with 1/200,000 adrenaline), for caudal anaesthesia for pelvic floor repair. Etidocaine was highly effective for the surgical procedure, with rapid onset of action, adequate muscle relaxation and longer duration of action. Its use for post-operative analgesia may be hindered by the concomitant immobilization of the legs. The problem of tachyphylaxis with etidocaine needs further investigation.     

Rapid formation of a staghorn calculus in the canine kidney. A surgical model

A model for immediate production of staghorn calculi in dogs is described. A paste made of gray investment is injected into the renal pelvis and allowed to solidify for 30 min. Calculi thus formed have a striking similarity to naturally occurring staghorn calculi and can be utilized by urology teaching programs to initiate residents in the technique of anatrophic nephrolithotomy.     

Intestinal bypass surgery for morbid obesity. Long-term results

Since 1962, jejunoileal bypass has been performed on 59 male and 171 female subjects, aged 18 to 55 years; these patients were followed clinically. Postoperative weight loss at two years averaged 37% in men and 35% in women. Hypokalemia (23%), hypocalcemia (22%), hypoalbuminemia (9%), metabolic acidosis (14%), elevated liver enzyme values (41%), and hyperbilirubinemia (6%), were the most commonly encountered blood chemical alterations. Complications were arthritis syndrome (men, 8%; women, 19%). urinary calculi (men, 24%; women, 10%), cholelithiasis (men, 10%; women, 9%), liver impairment (men, 2%; women, 6%), and major emotional upset (men, 8%; women, 9%). Forty-nine percent of the men and 51% of the women required rehospitalization for management of complications, surgery for hernia, anorectal disorders, nutritional support, and metabolic study. There were 19 bypass-related deaths (8%), including 10 due to liver failure.     

Visual outcomes following lensectomy and vitrectomy for combined anterior and posterior persistent hyperplastic primary vitreous

OBJECTIVE: To determine the visual outcome after surgery for persistent hyperplastic primary vitreous using modern vitreoretinal techniques. DESIGN: Retrospective medical record review during a 5-year period (June 1992 to June 1997). Information recorded for each patient included age, medical history, sex, results of preoperative ocular examination, age at diagnosis, procedure performed, intraoperative and postoperative complications, location and number of sclerotomy sites, type of aphakic rehabilitation, amblyopic therapy given, final visual acuity, and length of follow-up. RESULTS: Fourteen patients who underwent surgical management of combined anterior and posterior persistent hyperplastic primary vitreous were identified. Eleven patients underwent aphakic rehabilitation and aggressive amblyopic therapy consisting of occlusive therapy for several waking hours each day. One additional older patient received aphakic rehabilitation only. Ten eyes (71%) achieved a visual acuity of 20/300 or better, and 8 (57%) obtained a final visual acuity of 20/100 or better. Average length of follow-up was 22 months (range, 4-57 months). Nine patients were fitted with an aphakic soft contact lens, 2 older patients had a posterior chamber intraocular lens placed at the time of vitrectomy, and 1 patient wore aphakic spectacles. CONCLUSIONS: With modern vitreoretinal techniques, aphakic rehabilitation, and aggressive amblyopic therapy, useful vision can be obtained in the majority of patients with combined anterior and posterior persistent hyperplastic primary vitreous.     

Gastrostomy button causing perforation of the posterior gastric wall

A gastrostomy button complication, not previously reported, is described. The button, with an inflatable balloon, was used for nutrition. The patient had had a gastrostomy for 4.5 y, with the same type of gastrostomy button for the previous 2 y and the same device for 1 y. The tip of the button caused a perforation of the posterior stomach wall, leading to death.     

Atherosclerotic cardiovascular disease, lipemic disorders, hypertension, obesity and diabetes mellitus in the population of a metropolitan area of southeastern Brazil. III--Hypertension

Premature ejaculation is a common sexual disturbance among men. Both open-label and double-blind studies have demonstrated the effectiveness of serotonergic medications for this disorder. These studies support the hypothesis that the serotonergic system has an important role in the modulation of sexual response, especially attainment of orgasm. Serotonergic dysfunction also has been linked to the pathogenesis of panic disorder. Several studies have demonstrated the efficacy of serotonergic drugs in this disorder. The purpose of the present study was to examine the efficacy of fluoxetine, a serotonin selective reuptake inhibitor for the treatment of comorbid premature ejaculation and panic disorder, in 10 men in an open-label design. The patients were given 20 mg of fluoxetine for 8 weeks of the study. Parameters pertaining to sexual function and measures of anxiety were examined. Improvement of premature ejaculation was noted as of week 2 of the study, whereas measures of panic and sexual satisfaction became statistically significant only as of week 4. Further studies with larger samples and longer periods of follow-up are needed in order to determine the usefulness of fluoxetine for the treatment of comorbid premature ejaculation and panic disorder.