ABSTRACT
Previous studies have demonstrated the ability to stop seizures in animal models with injection of antiepileptic medication directly onto the seizure focus. The present experiments describe automated detection and focal therapy for seizures in the laboratory setting. Focal seizures were created in Sprague-Dawley rats using bicuculline, a GABA antagonist. Computerized detection of seizures was linked to a programmable infusion pump to deliver either diazepam (DZP) or pH-balanced vehicle (VEH) directly onto the seizure focus. Mean numbers of seizures following initial delivery of drug were 2.9+/-1.45 for the VEH-treated group and 0.2+/-0.42 for the DZP-treated group (P<0.0001, Student's t-test, nonpaired, one-tailed). In another series of experiments, early injection of DZP shortened seizure duration. Three DZP-treated animals died. This model provides proof-in-principle for the development of a clinically applicable treatment for intractable partial epilepsy. Such therapy might avoid some of the problems inherent to systemic administration of antiepileptic drugs.
Subject(s)
Anticonvulsants/administration & dosage , Drug Delivery Systems , Epilepsy/drug therapy , Animals , Anticonvulsants/therapeutic use , Automation , Behavior, Animal , Diagnosis, Computer-Assisted , Diazepam/administration & dosage , Diazepam/therapeutic use , Drug Delivery Systems/instrumentation , Electroencephalography , Epilepsy/diagnosis , Epilepsy/physiopathology , Epilepsy/psychology , Equipment Design , Male , Pharmaceutical Vehicles/administration & dosage , Pharmaceutical Vehicles/therapeutic use , Rats , Rats, Sprague-Dawley , Time FactorsABSTRACT
Video thoracoscopy is a technique that allows a minimally invasive approach to common thoracic surgical problems. This article reports three patients with recurrent spontaneous pneumothorax managed by video thoracoscopic apical bleb resection and describes the surgical technique.
Subject(s)
Pneumothorax/surgery , Thoracoscopy/methods , Adult , Humans , Male , Recurrence , ThoracoscopesSubject(s)
Aneurysm, Ruptured/diagnosis , Aortic Aneurysm, Abdominal/diagnosis , Arteriovenous Fistula/diagnosis , Aged , Aneurysm, Ruptured/complications , Aorta, Abdominal , Aortic Aneurysm, Abdominal/complications , Arteriovenous Fistula/etiology , Humans , Male , Renal Veins , Rupture, Spontaneous , Vena Cava, InferiorABSTRACT
Herpes simplex encephalitis (HSE) is commonly treated empirically with acyclovir without confirmatory brain biopsy. Three consecutive adults with molecularly verified mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome presented with, and were treated for, apparent HSE. MELAS syndrome in adults may present as an atypical, recurrent form of HSE and should be added to the list of neurologic diseases that can mimic HSE.
Subject(s)
Encephalitis/diagnosis , Encephalitis/microbiology , Herpes Simplex , MELAS Syndrome/diagnosis , Adolescent , Adult , Base Sequence , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Male , Molecular Probes/genetics , Molecular Sequence DataABSTRACT
This study investigates whether aspirin injury to the human gastric mucosa can be prevented by profound acid suppression with omeprazole, in a randomised, double blind, crossover design according to latin square. It was concluded that profound acid suppression can prevent aspirin induced gastric mucosal injury in normal subjects. This approach may prevent the development of peptic ulcers and their complications in patients taking aspirin and other non-steroidal anti-inflammatory drugs.
Subject(s)
Aspirin/adverse effects , Gastric Acid/metabolism , Gastrointestinal Hemorrhage/prevention & control , Omeprazole/therapeutic use , Adult , Double-Blind Method , Gastric Acidity Determination , Gastric Mucosa/drug effects , Gastrointestinal Hemorrhage/chemically induced , Humans , Male , Randomized Controlled Trials as TopicABSTRACT
1. We investigated the effect of the haemostatic agent ethamsylate on aspirin-induced gastric mucosal bleeding. 2. Eighteen healthy subjects were studied three times: at the end of 48 h periods of treatment with (a) placebo, (b) aspirin 600 mg four times daily, (9 doses) and (c) aspirin 600 mg four times daily with each dose preceded by ethamsylate 500 mg. 3. At the end of each treatment period gastric mucosal bleeding into timed gastric washings was quantified using the orthotolidine reaction. 4. Aspirin increased bleeding from a rate on placebo of 1.2 microliters 10 min-1 geometric mean (95% confidence limits) (0.7-1.8) microliters 10 min-1 to 20.0 (11.6-34.2) microliters 10 min-1, (P less than 0.01). The rate of bleeding after aspirin preceded by ethamsylate [14.1 (8.5-23.4) microliters 10 min-1] was not significantly different from that after aspirin alone. 5. We conclude that ethamsylate does not reduce acute aspirin-induced gastric mucosal bleeding in healthy humans.