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Objective To discuss the effectiveness and safety of selective iliac artery embolization in treating severe postpartum hemorrhage.Methods Eighteen cases of postpartum severe hemorrhage were treated by embolizing iliac artery with gelatin and/or steel coil.4-26 months later,5 cases were scanned with 16 layer MD(multi-detector)spiral CT with pelvic artery reconstruction and hormones(E2?P?T?FSH?LH?PRL)examination taken in 8 cases.Results Arteries were re-opened in cases embolized with gelatin.Two possible results may occur in those embolized with steel coil including one with uterus mainly supplied by ovarian arterian assisted by re-opened uterus artery and the other mainly fed by re-opened uterus artery.Hormones of the 8 cases were normal.Two women got re-pregnant after embolization.No serious complication related to embolization was found.Conclusion Iliac arterial embolization is safe and effective for the control of severe postpartum hemorrhage.(J Intervent Radiol,2006,15:218-220)
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Objective To investigate renal histopathological changes and cli ni cal characteristics in 20 women with preeclamptic nephropathy or gestational pro teinuria.Methods Between 1999 and 2002, 20 women who suffered from preeclampsia or proteinuria during pregnancy underwent postpartum renal biopsies from fifth d ay to third month after delivery. One woman repeated her renal biopsy half year later. Each biopsy specimen was divided into three parts,and processed and stain ed for conventional light microscopy(LM), immunohistology (IH) and electron micr oscopy (EM) examination. The clinicopathological data were studied and women wer e followed up after discharge for a long time. Results Sixteen of 20 women were diagnosed as preeclampsia, whose altered glomeruli demonstrated a typical endoth elial lesion (endotheliosis), and mild to moderate proliferation of mesangial ce lls. IH revealed either negative or mild IgG、IgM and C3 deposits. Focal glomeru losclerosis (FGS) was observed in one of 16 cases, whose microproteinuria (0 49 g/24 h) lasted for more than one year, meanwhile the proteinuria of other 15 wo men disappeared completely within 3～6 months after delivery. Besides, one was I gA nephropathy (IgAN) complicated preeclamptic nephropathy, whose proteinuria de creased obviously after delivery, but remained microhematuria, and endothelial l esion disappeared in repeat biopsy after half year. One was IgAN and received a treatment of adrenocorticosteroid and immunosupressive agents because of macropr oteinuria. One was mild mesangial proliferative glomerulonephritis presenting co nstant microhematuria and microproteinuria. One was typeⅠmembranous nephropathy , whose proteinuria decreased remarkably after delivery as well. Conclusions Ren al histopathological changes of preeclampsis are typical endothelial lesion, and often recover completely within 6 months after delivery. Recovery may be delaye d in the case of FGS accompanied. Pregnancy may aggravate primary renal damage w hich will be improved after delivery. Postpartum renal biopsy is safe and benefi cial to early diagnosis, treatment and prognosis.
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AIM To study the pharmacokinetics of SJ SPM. METHOD The pharmacokinetics of SJ SPM was studied after oral doses in dog and in rat, compared with the pharmacokinetics of ASPM. Rat orally administed 40 mg?kg -1 SJ SPM, 72 h urine and bile recoveries were studied. Blood,urine and bile concentrations were tested with agar diffusion method. Pharmacokinetic parameters were calculated by 3p87 program in computer. RESULTS The plasma drug concentration time data for each subject were analyzed and fitted with a linear two compartment model. Following oral doses of 30,20,10 mg?kg -1 SJ SPM in dog, drug is rapidly and widely distributed throughout the body and lag time are 18～30 min; T max 1 43～2 44 h; C max 1 02～2 94 ?g?ml -1 ; T 1/2? 0 48～1 81 h; T 1/2? 8 40～10 52 h; Oral doses of 30,20,10 mg?kg -1 SJ SPM in dog and 120,80,40 mg?kg -1 in rat resulted in linear increase in the peak serum levels and areas under the serum concentration time curve. The MRT of SJ SPM,ASPM in rat and dog did not change significantly with an increase in oral dosage. Under the same conditions, the pharmacokinetics of ASPM was studied in dog, Oral doses of 30,20,10 mg?kg -1 ASPM in dog, lag time are 0 37～0 44 h; C max 0 87～3 34 ?g?ml -1 ; T max 1 49～2 26 h; T 1/2? 0 59～1 17 h; T 1/2? 7 42～12 04 h; MRT 7 56 h; AUC 7 65, 17 44, 26 25 ?g?ml -1 ?h -1 respectively. Following oral doses of 120,80,40 mg?kg -1 SJ SPM in rat, T max 1 57～2 45 h; C max 0 39～3 14 ?g?ml -1 ; T 1/2? 1 36～1 77 h; T 1/2? 15 63～20 64 h;MRT 13 0 h; AUC 8 44,16 54,37 58 ?g?ml -1 ?h -1 .Rat orally administered 40 mg?kg -1 SJ SPM, 72 h urine and bile recoveries are 2 18% and 4 70% respectively. CONCLUSION There are no significantal difference between SJ SPM and ASPM statistic.
