Pleurocidin, a novel antimicrobial peptide, induces human mast cell activation through the FPRL1 receptor.

Pleurocidins are a novel family of α-helical cationic antimicrobial peptides (CAPs) that are structurally and functionally similar to cathelicidins, one of the major CAP families. As cathelicidins stimulate mast cell chemotaxis and mediator release, we postulated that pleurocidins similarly activate mast cells. A screen of 20 pleurocidin peptides revealed that some were capable of degranulating the human mast cell line LAD2 (Laboratory of Allergic Diseases 2). Pleurocidin NRC-04 caused LAD2 to adhere, migrate, degranulate, and release cysteinyl leukotrienes and prostaglandin D2. Moreover, pleurocidin increased intracellular Ca(2+) mobilization in mast cells and induced the production of proinflammatory chemokines such as monocyte chemotactic protein-1/C-C motif chemokine ligand 2 (CCL2) and macrophage inflammatory protein-1ß/CCL4. Our evaluation of possible cellular mechanisms suggested that G proteins, phosphoinositol-3 kinase (PI3K), phospholipase C (PLC), and phosphokinase C (PKC) were involved in pleurocidin-induced mast cell activation as evidenced by the inhibitory effects of pertussis toxin (G protein inhibitor), wortmanin (PI3K inhibitor), U-73122 (PLC inhibitor), and Ro-31-8220 (PKC inhibitor), respectively. We also found that human mast cells expressed the N-formyl-peptide receptor 1 (FPRL1) receptor and FPRL1-specific inhibitor affected pleurocidin-mediated activation of mast cell. Our finding that the novel CAP pleurocidin activated human mast cell through G protein-coupled receptor signaling suggests that this peptide might have immunomodulatory functions.

Evaluation of placental drainage as a method of placental delivery in vaginal deliveries.

METHODS: We describe a prospective study, done over a 2-year period in which a total of 958 women having a vaginal delivery were randomised to the drainage method (478 women) or controlled cord traction method (480 women) for placental delivery. RESULTS: The mean age, parity, gestation and birth weight were similar in the two groups. The mean duration of third stage of labor was 3.24 min and 3.2 min in the placental drainage group in contrast to 8.57 min and 6.20 min in controlled cord traction method in primigravida and multigravida respectively. CONCLUSION: Placental drainage significantly reduces the duration of third stage of labour in vaginal deliveries.

Laparoscopic oxidized cellulose (Surgicel) application for small uterine perforations.

OBJECTIVES: To test the efficacy and safety of laparoscopic oxidized cellulose application at the uterine perforation site. METHODS: In a prospective study over a 3.5-year period a total of 30 women undergoing combined surgical termination of pregnancy and laparoscopic sterilization who had a small uterine perforation were recruited. Oxidized cellulose (Surgicel) was inserted and attached to the perforation site with a laparoscope. The end point was sealing of the perforation and complete hemostasis. Laparotomy was performed if hemostasis was not achieved. RESULTS: The mean age, parity and gestation were 31.4 years, 3.8 and 9.3 weeks. The perforations occurred in the fundal region (60%), anterior wall (16.7%), posterior wall (13.3%), upper lateral wall (3.3%) and lower lateral wall (6.7%). Mean size of perforations, respectively according to site were 4.3 mm, 3.2 mm, 3.4 mm, 3 mm and 3.5 mm in the five groups. Laparoscopic oxidized cellulose application was successful in all women with fundal, anterior, posterior and upper lateral uterine wall perforations. In two women with perforations on the lower lateral wall, due to excessive blood loss, oxidized cellulose fell off; laparotomy was performed and hemostasis was achieved with sutures. All 28 laparoscopically-treated women were discharged on the next day in good condition with no complications. CONCLUSIONS: Laparoscopic oxidized cellulose application appears to be a safe and effective treatment for small uterine perforations that are bleeding moderately.

Drotaverine hydrochloride vs. valethamate bromide in acceleration of labor.

OBJECTIVES: To compare the efficacy and safety of drotaverine hydrochloride and valethamate bromide in shortening the duration of labor. METHODS: In a randomized controlled trial of 150 nulliparous women in established labor with cervical dilation of 4 cm, 50 women were given drotaverine (group I), 50 women were given valethamate (group II) and another 50 women were not given any medication (group III). Duration of labor, mode of delivery, side effects, and neonatal outcome were measured in all cases. Appropriate non-parametric tests and chi(2) tests were used for assessment of statistical significance. RESULTS: In the three groups, 100%, 96% and 46% women delivered within 6 h, respectively. The injection-to-delivery interval was significantly reduced in the drotaverine group (193.96 min) in contrast to the valethamate group (220.68 min) and control group (412.84 min). The rate of cervical dilation was highest in the drotaverine group (2.04 cm/h) compared with the valethamate bromide group (1.86 cm/h) and control group (1.01 cm/h). There were no major maternal or fetal adverse effects in any group, but minor side effects were more common in the valethamate group. CONCLUSION: Both intramuscular drotaverine hydrochloride and valethamate bromide are effective in acceleration of labor; however, drotaverine accelerates labor more rapidly and is associated with less side effects.