Magnolia officinalis reduces the long-term effects of the status epilepticus induced by kainic acid in immature rats.

During critical periods of neurodevelopment, the immature brain is susceptible to neuronal hyperexcitability, alterations such as hyperthermia, hypoxia, brain trauma or a preexisting neuroinflammatory condition can trigger, promote and prolong epileptiform activity and facilitate the development of epilepsy. The goal of the present study was to evaluate the long-term neuroprotective effects Magnolia officinalis extract, on a model of recurrent status epilepticus (SE) in immature rats. Sprague-Dawley rats were treated with kainic acid (KA) (3 mg/kg, dissolved in saline solution) beginning at day 10 P N every 24 h for five days (10 P N-14PN). Two experimental groups (KA) received two treatments for 10 days (14-24 P N): one group was treated with 300 mg/kg Magnolia Officinalis (MO) (KA-MO), and another was treated with 20 mg/kg of celecoxib (Clbx) (KA-Clbx) as a control drug. A SHAM control group at day 90 P N was established. Seizure susceptibility was analyzed through an after-discharge threshold (ADT) evaluation, and electroencephalographic activity was recorded. The results obtained from the ADT evaluation and the analysis of the electroencephalographic activity under basal conditions showed that the MO and Clbx treatments protected against epileptiform activity, and decreases long-term excitability. All rats in the KA-MO and KA-Clbx groups presented a phase I seizure on the Racine scale, corresponding to the shaking of a wet dog. In contrast, the KA group showed phase V convulsive activity on the Racine scale. Similarly, MO and Clbx exerted neuroprotective effects on hippocampal neurons and reduced gliosis in the same areas. Based on these results, early intervention with MO and Clbx treatments to prevent the inflammatory activity derived from SE in early phases of neurodevelopment exerts neuroprotective effects on epileptogenesis in adult stages.

Effect of Electrical Stimulation of the Nucleus of the Solitary Tract on Electroencephalographic Spectral Power and the Sleep-Wake Cycle in Freely Moving Cats.

BACKGROUND: The nucleus of the solitary tract (NTS) plays a determinant role in the antiepileptic effects of vagus nerve stimulation (VNS). One mechanism underlying the efficacy of VNS is the induction of cortical changes, detected by electroencephalogram (EEG), which can be mediated by the NTS through its projections to the cerebral nuclei responsible for modulating cortical activity. The effect of the electrical stimulation of the nucleus of the solitary tract (ENTS) on EEG activity and sleep states in freely moving animals is unknown. OBJECTIVE: This study aims to analyze the effects of ENTS on the EEG spectral power and sleep-wake cycle in freely moving cats. METHOD: EEG was performed on the left amygdala and both pre-frontal cortices for 23 hours under baseline conditions and with ENTS in freely moving cats. The changes induced by ENTS on the EEG spectral power and the architecture of the sleep-wake cycle were analyzed. RESULTS: ENTS increased the theta and beta band power for 12 hours. Furthermore, an increase in wakefulness occurred in the first six hours, followed by an increase in the total time of rapid eye movement (REM) sleep. CONCLUSION: ENTS produces a long-lasting increase in the theta and beta band power, which favors wakefulness and REM sleep in freely moving cats.

Endometrioma complicado por absceso ovárico espontáneo / Endometrioma complicated by spontaneous ovarian abscess

RESUMEN OBJETIVO: reportar un caso de endometrioma complicado con absceso ovárico, exponer y discutir los factores de riesgo asociados, con la finalidad de difundir esta rara alteración y establecer el diagnóstico oportuno. CASO CLÍNICO: paciente de 34 años de edad, que acudió a consulta al Hospital Santa Rosa de Lima (Ensenada, Baja California Norte), con antecedente de dolor pélvico crónico de 5 meses de evolución y fiebre intermitente. El tratamiento con antibiótico de amplio espectro no mostró reacción satisfactoria. El ultrasonido transvaginal del ovario derecho mostró una imagen compatible con endometrioma. Mediante laparotomía se disecó la cápsula y se drenaron múltiples adherencias tubo-ováricas. El informe histopatológico confirmó el diagnóstico de endometrioma complicado por absceso. CONCLUSIÓN: es importante conocer los factores de riesgo para definir la causa de un absceso en un endometrioma, a través de la historia clínica detallada. La sospecha y diagnóstico oportuno es trascendental para reducir la morbilidad y mortalidad de esta complicación. Cualquier mujer con endometriosis en etapa avanzada es susceptible de complicaciones, como la formación de un absceso ovárico espontáneo.

ABSTRACT OBJETIVE: To report a case of Endometrioma complicated with ovarian abscess, expose and discuss the factors of risk associated with the purpose of disseminating this rare alteration and establishing the appropriate diagnosis. CASE REPORT: A 34 year old, seen at the Santa Rosa de Lima Hospital in Ensenada, Baja California, for a history of 5 months long chronic pelvic pain with intermittent fever, under treatment with broad spectrum antibiotic with no improvement. Transvaginal ultrasound revealed a compatible image with an endometrioma on the right ovary, followed by a laparotomy, capsule dissection and release of multiple tube-ovarian adhesions. The histo-pathological report confirmed that it was an ovarian endometrioma complicated by abscess. CONCLUSION: We emphasized in the study the risk factors and define a cause of an endometrioma and the clinical history details. Prevention and a good diagnoses as a priority to reduce morbi-mortality. It is very important to know that any woman with advanced stage history of endometriosis is susceptible to complications.

[Recurrent pregnancy loss: a literature review]. / Pérdida recurrente del embarazo: revisión bibliográfica.

Background: The definition of recurrent pregnancy loss varies according different authors and consensus: the American Society for Reproductive Medicine (ASRM) defines RPL when two or more pregnancy losses occur, and the European Society of Human Reproduction and Embryology (ESHRE) defines it as three or more pregnancy losses, not necessarily intrauterine. To this day, there is no uniform approach that serves as a guide in the diagnosis and treatment of this condition; this is why, in up to 50% of the cases of RPL, it will not be possible to identify the specific etiology. Objetive: To report on the recurrent pregnancy loss, in order to harmonize concepts and suggest a diagnosis and treatment for this condition approach. Method: The search strategy included, but was not limited to keywords like: recurrent abortion, infertility, habitual abortion, primary antiphospholipid syndrome, lupus anticoagulant, anti-cardiolipin antibodies and anti B2 glycoprotein I.

Anti-epileptogenic effect of high-frequency stimulation in the thalamic reticular nucleus on PTZ-induced seizures.

BACKGROUND: Deep brain stimulation, specifically high-frequency stimulation (HFS), is an alternative and promising treatment for intractable epilepsies; however, the optimal targets are still unknown. The thalamic reticular nucleus (TRN) occupies a key position in the modulation of the cortico-thalamic and thalamo-cortical pathways. OBJECTIVE: We determined the efficacy of HFS in the TRN against tonic-clonic generalized seizures (TCGS) and status epilepticus (SE), which were induced by scheduled pentylenetetrazole (PTZ) injections. METHODS: Male Wistar rats were stereotactically implanted and assigned to three experimental groups: Control group, which received only PTZ injections; HFS-TRN group, which received HFS in the left TRN prior to PTZ injections; and HFS-Adj group, which received HFS in the left adjacent nuclei prior to PTZ injections. RESULTS: The HFS-TRN group reported a significant increase in the latency for development of TCGS and SE compared with the HFS-Adj and Control groups (P < 0.009). The number of PTZ-doses required for SE was also significantly increased (P < 0.001). Spectral analysis revealed a significant decrease in the frequency band from 0.5 Hz to 4.5 Hz of the left motor cortex in the HFS-TRN and HFS-Adj groups, compared to the Control group. Conversely, HFS-TRN provoked a significant increase in all frequency bands in the TRN. EEG asynchrony was observed during spike-wave discharges by HFS-TRN. CONCLUSION: These data indicate that HFS-TRN has an anti-epileptogenic effect and is able to modify seizure synchrony and interrupt abnormal EEG recruitment of thalamo-cortical and, indirectly, cortico-thalamic pathways.

[Electrical stimulation of the vagal nerve: from experimental to clinical aspects]. / Estimulación eléctrica del nervio vago: de lo experimental a lo clínico.

INTRODUCTION AND AIMS: This review focuses its attention on the studies that have been conducted to determine the influence of electrical stimulation of the vagal nerve on experimentally induced convulsive activity and its application in the clinical field. The literature published to date describes an anticonvulsive effect on the seizures triggered by pharmacological agents and by electrical stimulation such as electroshock, and in the amygdaline electrical kindling model a delay in the generalisation of the convulsive activity is observed. DEVELOPMENT: The first experimental observations showed that electrical stimulation of the vagal nerve can have effects on EEG activity, including synchronisation and desynchronisation of the electrical activity of the brain, as well as promoting an increase in the amount of REM sleep. These observations served as the basis for the renewed interest in the electrical stimulation of the vagal nerve in experimental models and testing its effectiveness in patients with medication-resistant epilepsy. Nevertheless, the mechanisms accounting for the anticonvulsive effect remain unknown. CONCLUSIONS: These observations open up the possibility of studying the role played by neurotransmitters and neuromodulators in the anticonvulsive process of the electrical stimulation of the vagal nerve in experimental models of epilepsy and offer evidence of its possible action in the human brain.

Inflammatory cytokine production by immunological and foreign body multinucleated giant cells.

Multinucleated giant cells (MGC) are a common feature of granulomas. The mechanism of their formation has been studied extensively, but their function has not been completely characterized. A new method for the in vivo production of MGC was developed involving subcutaneous injection of microscopic nitrocellulose particles with adsorbed mycobacterial antigens into the footpads of sensitized BALB/c mice (immune [I]-MGC), or by nitrocellulose administration to non-sensitized mice (foreign body [FB]-MGC). The development of granulomas with a highly enriched MGC population was observed 2 weeks after the nitrocellulose injection. MGC were larger with a greater number of nuclei in I-MGC than in FB-MGC. From days 7-28 after nitrocellulose administration, the production of interleukin-1alpha (IL-1alpha) and tumour necrosis factor-alpha (TNF-alpha) was demonstrated in both MGC types by in situ reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. After 2 months, the MGC had ceased production of IL-1alpha and TNF-alpha, but the expression of transforming growth factor-beta (TGF-beta) was very high, occurring together with extensive fibrosis. These results suggest that MGC are an active source of inflammatory cytokines, which can contribute to the initiation, maintenance and down-regulation of granulomatous inflammation induced by immunological and inert substances.

Vagus nerve prolonged stimulation in cats: effects on epileptogenesis (amygdala electrical kindling): behavioral and electrographic changes.

PURPOSE: To analyze the effect of prolonged (daily) electrical vagus nerve stimulation (VNS) on daily amygdaloid kindling (AK) in freely moving cats. METHODS: Fifteen adult male cats were implanted in both temporal lobe amygdalae, both lateral geniculate bodies, and prefrontal cortices. A bipolar hook (5-mm separation) stainless steel electrode also was implanted in the unsectioned left vagus nerve. AK only was performed on five of the cats as a control. The remaining 10 cats were recorded under the following experimental conditions: VNS (1.2-2.0 mA, 0.5-ms pulses, 30 Hz) for 1 min along with AK (1-s train, 1-ms pulses, 60 Hz, 300-600 microA), followed by VNS alone for 1 min, four times between 11:00 a.m. and 2 p.m. At different times, VNS was arrested, and AK was continued until stage VI kindling was reached. RESULTS: The behavioral changes evoked by VNS were as follows: left miosis, blinking, licking, abdominal contractions, swallowing, and eventually yawning, meowing, upward gaze, and short head movements. Compulsive eating also was present with a variable latency. Outstanding polygraphic changes consisted of augmentation of eye movements and visual evoked potentials while the animal was awake and quiet, with immobility and upward gaze. An increase of the pontogeniculooccipital (PGO) wave density in rapid eye movement (REM) sleep also was noticeable. AK was completed (to stage VI) in the control animals without a vagus nerve implantation in 23.4+/-3.7 trials. In animals with VNS, the AK was significantly delayed, remaining for a long time in the behavioral stages I-III and showing a reduction of afterdischarge duration and frequency. Stage VI was never reached despite 50 AK trials, except when the vagus nerve electrodes were accidentally broken or vagal stimulation was intentionally arrested. Under these circumstances, 24.4+/-8.16 AK trials alone were necessary to reach stage VI of kindling. CONCLUSIONS: Our results indicate that left, electrical VNS interferes with AK epileptogenesis. This anticonvulsant effect could be related to the increase of REM sleep.

Fatal meningoencephalitis caused by Scedosporium inflatum (Scedosporium prolificans) in a child with lymphoblastic leukemia.

A fatal case of meningoencephalitis caused by Scedosporium inflatum (Scedosporium prolificans) in a 5-year-old boy with acute myeloblastic leukemia who was given intrathecal treatment is reported. Itraconazole treatment was ineffective. The fungus was identified on brain sections at autopsy and was not observed in any other organ. As no other portal of entry was detected, meningoencephalitis may have originated via direct introduction of the fungus at therapeutic lumbar puncture.

[Course of the visual evoked potentials in intracranial tuberculous granuloma]. / Etude évolutive des PEV au cours d'un granulome tuberculeux intracrânien.

The case in study is a 13-year-old male with tubercular granuloma in the optic chiasma, affecting the right optic nerve and causing temporary loss of vision in that eye. Evoked visual potentials are performed and a first examination reveals that loss of vision was preceded by an alteration of response through the right optical path. The physiopathology is discussed and an evolutionary study of the lesion is made, evaluating the usefulness of EVPs in the diagnosis and follow-up in these patients.

Laparoscopic sterilization as an outpatient procedure.

Since June 1972, more than 2,000 laparoscopic sterilizations have been performed as outpatient procedures using neuroleptanalgesics. Electrocoagulation, spring-loaded clips or tubal rings were the methods used for tubal occlusion. All laparoscopies were performed in a family planning clinic. The surgical facilities were minimal and did not include general anesthesia equipment or a blood bank. The nearest hospital was about one-half mile from the clinic. The procedures were performed by a physician assisted by two paramedical personnel and a technician. Patients were scheduled to be at the clinic on the morning of the procedure and were discharged three to six hours after the procedure. Only one patient required hospitalization for treatment of a complication: her aorta was punctured during placement of the Tuohy needle. The patient was admitted to a local hospital and underwent laparotomy for repair; her subsequent recovery was uneventful. No bowel or bladder burns have occurred. Minor complications (emphysema of the abdominal wall, bleeding from the tubes, infections) have occurred in less than 4% of the patients. The results of this study indicate that laparoscopy in an outpatient clinic is safe and presents minimal additional risks to the patient if the surgeon is experienced.

PIP: From June 1972 to March 1976, 2035 laparoscopic sterilizations were performed at the Asociacion Demografica Salvadorena free-standing outpatient clinic. Methods used were electrocoagulation, spring-loaded clips, or tubal rings. The service was set up in a small treatment room, and performed under local anesthesia. There was a hospital near the clinic as a back-up facility. Patients were discharged 3-6 hours after the operation. The surgeon was unable to perform sterilization in only .49% of the patients, and surgical complications occurred in only 2.7% of all patients. It is suggested that laparoscopic sterilization in an outpatient clinic can be safe if the surgeon is skilled, a well-equipped hospital is near, and ready transportation is adequate.

A comparative study of spring-loaded clips and electrocoagulation for female sterilization.

The surgical, immediately postoperative and delayed postoperative complications and complaints associated with spring-loaded clips and electrocoagulation as techniques of tubal sterilization at laparoscopy were evaluated in a comparative study. Each of the two techniques was randomly assigned to 150 subjects. All sterilizations were performed as outpatient procedures. Subjects were followed-up during the first six weeks and again at about six months after sterilization. Rates of complications (surgical and early postoperative) were similar for the two procedures. None of the subjects required subsequent hospitalization. Technical difficulties at surgery were more frequent with the spring-loaded clip technique, principally as a result of mechnical problems with the prototype laparoscope and clip applicator. Postoperative pelvic and abdominal pain were reported by a significantly higher proportion of the patients when the spring-loaded clip was used (spring-loaded clips, 43.6%; electrocoagulation, 31.5%). At the six-month follow-up examination, rates of abnormal pelvic findings and changes in menstrual cycle formation were similar for the two techniques of tubal occlusion. There was one procedure failure among the electrocoagulation patients and none among the spring-loaded clip patients.

Male sterilization in El Salvador: A preliminary report.

The expectation that male sterilization would not be an acceptable method of fertility control to the Latin American male has not been upheld in the initial phases of male sterilization programs in Colombia, Costa Rica, Guatemala, and El Salvador. On the contrary, in all of these programs and also at the Asociación Demográfica Salvadoreña, a free-standing, non-profit family planning clinic in San Salvador, the initial success has been impressive, with 180 men accepting sterilization during the first two years (February, 1972 to February, 1974). All sterilizations were performed by excising a 10-15 mm segment of each vas and ligating each vas end. Procedures were performed on an outpatient basis using a local anesthetic. Follow-up examinations were conducted at one week and three months after the procedure. Although complications were reported by 24.0% of the subjects at the one-week follow-up, the complications were minor: most were scrotal infections not requiring antibiotic therapy. Rates of complications were low for subjects returning for a three-month examination and semen test. Only one subject had a positive semen test.