Preventive effect of nicardipine on hyperplastic changes in venous bypass grafts.

Nicardipine is a relatively new calcium channel blocker with important properties that could result in attenuation of the adverse proliferative changes in autogenous vein bypass grafts. In this experimental, randomized, controlled study, the effect of nicardipine on the pathologic findings in aortoaortic bypass graft was assessed. Forty-two male rabbits (Orycytolagus cuniculus) were randomized to three groups: group 1 received nicardipine and groups 2 and 3 placebo for 4 weeks, after which an aortaortic bypass was realized with an autogenous inferior vena cava segment. During the following 4 weeks, groups 1 and 2 received nicardipine, and placebo was continued in group 3. The animals were sacrificed at the end of the study to permit removal and evaluation of the bypass grafts. The mean intimal and medial thickness values for groups 1 and 2 were lower than those for group 3, indicating that nicardipine has a significant preventive effect on the hyperplastic changes in venous bypass grafts compared to placebo. The mean intimal and medial thickness values of group 1 were also lower than those of group 2, and the differences carried statistical relevance, suggesting that the use of nicardipine before grafting could potentiate its protective effect. To provide stimulus for further research, an attempt is made to relate the hyperplasia-preventing effect of nicardipine to possible mechanisms.

Pheochromocytoma presenting with headache, panic attacks and jaundice in a child.

Pheochromocytomas can mimic many unrelated diseases due to their various presenting signs; they are encountered very rarely in childhood. Recently, their neuropsychiatric aspects have become a subject of interest for many workers, but most of the findings reported previously have been observed in adults. We present a case report which is unique in that it concerns a child with pheochromocytoma and psychiatric findings consisting of depression and panic disorder, which were interpreted as being directly related to, since they disappeared after the removal of, the tumor. Depression was persistent and accompanied by a constricting-type headache, while panic disorder was acute and accompanied by a migraine-type headache. Another intriguing complication encountered in our case was jaundice; we considered that it could possibly have been due to an adverse effect of catecholamines on hepatocyte function. We conclude that a pheochromocytoma can be confused with neuropsychiatric disorders in children as well as in adults and that it should be considered in the differential diagnosis of such disorders.

Povidone-iodine in experimental peritoneal hydatidosis.

The effect of polyvinylpyrrolidone-iodine (PVP-I) on experimental peritoneal hydatidosis was evaluated in this randomized blind controlled study. Seventy-five white, 3-month-old rats were subjected to laparotomy. After the intraperitoneal inoculation of viable scolices, the rats were randomly divided into three groups. Their peritoneal cavities were irrigated with either 1 per cent PVP-I solution (the PVP-I group), hypertonic saline (the HS group) or Ringer's lactate (the control group). Each group was assigned a separate code number; observers blind to the meaning of the code numbers noted all findings during a period of 4 months, after which the rats were killed to allow assessment of the abdominal cavity. The results were decoded after the statistical analyses were completed. The incidence of peritoneal cysts was found to be lower (8.7 per cent) in the PVP-I group compared with the HS (50 per cent) and control (90.9 per cent) groups; the mean number of hydatid cysts per animal was also lower in the PVP-I group compared with the other two groups. We conclude that the scolicidal activity of PVP-I is significantly higher than that of hypertonic saline and that it can be employed as a prophylactic agent against peritoneal hydatidosis.