Intravenous ketorolac as an adjuvant to pediatric patient-controlled analgesia with morphine

The multiglycosides of Tripterygium wilfordii (TII), a ready-made Chinese herbal medicine used for the treatment of rheumatoid arthritis, have been shown to cause oligospermia in patients. In the present study, the antifertility effects of TII and tripchlorolide (T4, isolated from TII) were observed in male rats. In rats fed with TII at a dose of 10 mg.kg.d for 7 weeks, the seminiferous tubules were essentially not influenced. However, most of the sperm heads along the surface of the tubular lumen were transformed from the normal sickle-shaped to round shaped, suggesting a possible mutagenic action. There was minimal testicular change but prominent epididymal spermatozoa damage in all rats treated with T4 (0.05 mg.kg.d) for 7 weeks. The epididymal spermatozoa showed various structural abnormalities, including disrupted connecting pieces and cracked midpieces, and more than 80% of the spermatozoa were decapitated. No significant changes were seen in the main visceral organs. The data suggest that T4 may have good prospects as a male contraceptive.     

The use of Wallstent in malignant constrictions of the gastrointestinal tract

Prosthesis implantation in malignant oesophageal stenosis, postoperative gastric outlet obstruction and jejunal stenosis is a quick and efficient method. The expansile metal stents are a new alternative to conventional plastic prosthesis. The Wallstent is made of surgical steel alloy elements braided in tubular fashion. The Wallstent is delivered in a small diameter device, but it expands to a much larger size after placement than the inner diameter of plastic stent. The small predilatations diameter makes implantation of the Wallstent less prone to cause complications or severe discomfort to the patient. The authors implanted seven Wallstents in six patients. One patient had oesophageal cancer, one ischaemic jejunal stenosis and four jejunal stenosis due to extraluminal tumour recurrences following total gastrectomy for cancer. The authors discuss in detail the usefulness of the Wallstent implantation in two cases with malignant disease of the oesophagus and jejunum. They remained symptoms free for 7 and 10 months after Wallstent implantation until death. Despite their higher initial cost, the metal stents are cost effective because of the absence of early and severe complications and the decrease in the hospitalization.     

Genetic influence on serum igd levels

In order to better understand the factors determining serum levels of IgD, total serum IgD and IgE were studied in 23 nonallergic twin pairs, consisting of 16 monozygotic (Mz and 7 same-sex dizygotic (Dz) pairs. Both immunoglobulins were measured by a paper disc solid phase radioimmunoassay, sensitive to 1 microgram/dl of IgD and 1 I.U./ml of IgE. Also studied were 10 paired sera taken at different times from 10 healthy subjects of similar mean age to the twins and 21 randomly paired sera from unrelated subjects. The intrapair variance of both serum IgD and serum IgE levels were significantly less in Mz than in Dz twins (P less than 0.05). Thus, there appears to be a genetic influence over serum IgD levels, probably to a similar degree to that previously shown to exist for serum IgE levels. Heritability was calculated to be 0.759 for IgD and 0.697 for IgE. Also, the intraclass correlation coefficient (rI) for IgD in monozygotic twin pairs was 0.9370 (P less than 0.001) and for IgE was 0.8602 (P less than 0.001). It appears likely that the number of genetic loci controlling serum IgD levels is similar to, or less than, the number controlling serum IgE levels because the random pair/Dz pair variance ratio was lower for IgD than for IgE.