Prostaglandin E2 for cervical ripening: a randomized comparison of Cervidil versus Prepidil

OBJECTIVE: Our purpose was to compare the efficacy and safety of two standardized preparations of prostaglandin E2, Prepidil and Cervidil, for ripening of the cervix and initiation of labor. STUDY DESIGN: This was a prospective randomized study. Subjects in whom induction of labor was indicated were randomly assigned to receive either Prepidil (n = 36), an intracervical prostaglandin E2 gel, or Cervidil (n = 37), a controlled-release hydrogel pessary, as a cervical ripening agent. Inclusion criteria included (1) a Bishop score of < or = 7, (2) a cervix < 4 cm dilated, and (3) < or = 2 cm of cervical dilatation if effacement was > 70%. Each agent was administered according to the manufacturer's recommendations. RESULTS: There was no difference in Bishop scores between the two groups at the completion of the ripening process. The following mean times were shorter for the pessary group than for the gel group: (1) insertion of the ripening agent to vaginal delivery (20.6 vs 26.4 hours, p = 0.017), (2) time to achieve cervical ripening (11.1 vs 15.2 hours, p < 0.001), (3) time to achieve active labor (18.3 vs 25.5 hours, p = 0.019), and (4) hospital stay (3.7 vs 4.4 days, p = 0.03). Labor was initiated without the use of oxytocin in 24% of patients in the pessary group versus 3% of those in the gel group (p = 0.014). CONCLUSION: Both prostaglandin E2 agents are effective in achieving cervical ripening; however, the controlled-release pessary achieves ripening over a shorter time period. Furthermore, because time to achieve vaginal delivery and length of stay are shorter, the use of oxytocin is less frequent, and there is no increase in complications, the overall cost is expected to be less with the use of Cervidil as compared with Prepidil.     

High-performance liquid chromatographic separation of Porphyromonas gingivalis fimbriae

A right lung cancer case is presented, aged 65 years, obese, submitted to a right lung resection. Stress is laid on the difficult evolution concerning the haemodynamics and particularly the breathing owing to the association of risk factors.     

Carotenoid composition and vitamin A value of Brazilian loquat (Eriobotrya japonica Lindl.)

Six sample lots of loquat commercialized in Campinas, Brazil were analyzed for their carotenoid composition beta-carotene (7.8 micrograms/g), zeta-carotene (0.1 micrograms/g), neurosporene (1.1 micrograms/g), beta-cryptoxanthin (4.8 micrograms/g), 5,6-monoepoxy-beta-cryptoxanthin (0.6 micrograms/g), violaxanthin (1.6 micrograms/g), (0.8 micrograms/g) and auroxanthin (0.9 micrograms/g) were identified beta-Carotene and beta-cryptoxanthin were the principal pigments, being responsible for 44% and 27%, respectively, of the total carotenoid content (17.6 micrograms/g). Both were also the principal contributors to the vitamin A value of 175 RE/100g. The carotenoid composition of the Brazilian loquat resembles that of the Japanese loquat variety Tanaka.     

Transchoroidal approach to the third ventricle: an anatomic study of the choroidal fissure and its clinical application

OBJECTIVE: We review the anatomic features of the lateral ventricle, the foramen of Monro, the third ventricle, and the choroidal fissure, and we describe the transchoroidal approach to the third ventricle. This approach consists of opening the taenia fornicis of the choroidal fissure in the body of the lateral ventricle and approaching the third ventricle between the two internal cerebral veins. This route allows further posterior enlargement of the foramen of Monro without sacrificing any neural structures. When necessary, the anterior septal vein can be sacrificed. METHODS: Twenty adult cadaveric brains and four adult cadaveric heads were studied, using a magnification ranging from 3 times to 40 times, after perfusion of the arteries and veins with colored latex. RESULTS: The choroidal fissure is a natural cleft between the thalamus and the fornix, and it is identified by following the choroid plexus in the lateral ventricle. The choroid plexus in the body of the lateral ventricle originates from the tela choroidea of the roof of the third ventricle and is apparently attached to the fornix by the taenia fornicis and to the thalamus by the taenia choroidea. The taenia is actually the ependyma that covers the internal wall of the ventricular cavity and the choroid plexus. CONCLUSION: An understanding of the choroidal fissure is fundamental for use of the transchoroidal approach. Unlike transforaminal, subchoroidal, subforniceal, and interforniceal approaches to the third ventricle, which sacrifice some neural or vascular structures, the transchoroidal approach follows a natural route, and certainly it is one of the options to be considered when entry into the third ventricle is required.     

The use of nonhomologous scatchard analysis in the evaluation of ligand-protein interactions

Scatchard plots are widely used for the graphical presentation of receptor-ligand binding data. When a combination of labelled and unlabelled ligand molecules is used in a binding assay, equations for Scatchard plots are readily available if the labelled and unlabelled ligands have similar binding affinities. In this article, Everardus van Zoelen, Roel Kramer, Herman van Moerkerk and Jacques Veerkamp present mathematical equations to obtain the binding characteristics of an unlabelled ligand in a Scatchard plot, which has a dissociation equilibrium constant different from that of the labelled ligand used.