Treatment of proctalgia fugax with topical nitroglycerin: report of a case.

PURPOSE: We report a single case of proctalgia fugax that responded to 0.3 percent nitroglycerin ointment. METHODS: Case report. RESULTS: A single case of proctalgia fugax responded to topical application of 0.3 percent nitro glycerin ointment with no significant side effects. CONCLUSIONS: Nitroglycerin ointment is a newly described treatment for several painful anal conditions. We describe a single case of levator spasm or proctalgia fugax responding to topical application of nitroglycerin. This is only a single case report, and conclusive evidence awaits completion of a controlled clinical trial.

Chloride transport activation by plasma osmolarity during rapid adaptation to high salinity of Fundulus heteroclitus.

Transition from low salt water to sea water of the euryhaline fish, Fundulus heteroclitus, involves a rapid signal that induces salt secretion by the gill chloride cells. An increase of 65 mOsm in plasma osmolarity was found during the transition. The isolated, chloride-cell-rich opercular epithelium of sea-water-adapted Fundulus exposed to 50 mOsm mannitol on the basolateral side showed a 100% increase in chloride secretion, which was inhibited by bumetanide 10(-4) M and 10(-4) M DPC (N-Phenylanthranilic acid). No effect of these drugs was found on apical side exposure. A Na+/H+ exchanger, demonstrated by NH4Cl exposure, was inhibited by amiloride and its analogues and stimulated by IBMX, phorbol esters, and epithelial growth factor (EGF). Inhibition of the Na+/H+ exchanger blocks the chloride secretion increase due to basolateral hypertonicity. A Cl-/HCO3- exchanger was also found in the chloride cells, inhibited by 10(-4) M DIDS but not involved in the hyperosmotic response. Ca2+ concentration in the medium was critical for the stimulation of Cl- secretion to occur. Chloride cell volume shrinks in response to hypertonicity of the basolateral side in sea-water-adapted operculi; no effect was found on the apical side. Fresh-water-adapted fish chloride cells show increased water permeability of the apical side. It is concluded that the rapid signal for adaptation to higher salinities is an increased tonicity of the plasma that induces chloride cell shrinkage, increased chloride secretion with activation of the Na+K+2Cl- cotransporter, the Na+/H+ exchanger and opening of Cl- channels.

Regulation of C1q receptor expression on human polymorphonuclear leukocytes.

The C1q receptor (C1qR) is expressed on a variety of cells, including polymorphonuclear leukocytes (PMN), in which stimulation by the C1qR leads to activation as measured by superoxide production. To investigate the expression and modulation of the C1qR on PMN, the binding of biotinylated C1q to PMN in suspension was measured by flow cytometry. Biotinylated C1q bound in a saturable and specific manner to PMN and the use of low ionic strength buffers enhanced binding. Covalent coupling of C1q to Sepharose beads allowed the affinity precipitation of a single 125-kDa band from surface iodinated PMN. The apparent molecular mass of the C1qR increased to 135 kDa upon reduction. Freshly isolated PMN had a uniform expression of C1qRs and phorbol myristate acetate induced a unimodal up-regulation of receptors. The inflammatory peptide FMLP rapidly up-regulated receptors by up to fivefold, and the high level of expression remained constant over 45 min. Taxol inhibited the FMLP induction of C1qR up-regulation, indicating that the ability to move the intracellular stores of C1qR depends on normal microtubule functioning. Thus, the C1qR is a constitutively expressed protein of the human PMN plasma membrane and it is rapidly up-regulated from a discrete intracellular pool of preformed molecules with the same kinetics as CR1 and CR3. It is likely that the C1qR is a component of the PMN complement receptor exocytic vesicle (CREV), in which CR1 and CR3 are also stored.

Successful pregnancy and vaginal delivery after heart transplantation.

Successful pregnancy and delivery in women with serious cardiovascular diseases have been reported. We describe here a patient with a transplanted heart, treated with cyclosporine and prednisone, who underwent pregnancy and vaginal delivery with good outcomes for mother and infant.

Nifedipina en pre-eclampsia severa / Nifedipine in severe preeclampsia

Se estudiaron 12 pacientes con pre-eclampsia severa (PES) a las cuales se les administró nifedipina por vía sublingual para el manejo de la tensión arterial. Los valores tensionales pre y post-tratamiento fueron: T. A. Sistólica 178,5 ñ 12.1 / 147,3 ñ 15,2 mm Hg, T. A. Diastólica 115,8 ñ 8,4 / 96,1 ñ 9,4 mm Hg, T. A. Media 136,6 ñ 6,5 /113,2 ñ 9,9 mm Hg. Estas diferencias resultaron estadísticamente significativas. Ningún caso desarrolló eclampsia. El control tensional alcanzado permitió adecuar la duración del embarazo a la madurez fetal. No hubo efectos colaterales materno-fetales ni en los recién nacidos. Nuestros datos sugieren que la nifedipina es efectiva y segura para el manejo de la hipertensión arterial en la PES. Sin embargo es necesaria una mayor experiencia para asegurar la inocuidad de la droga durante la gestación

Nifedipina en pre-eclampsia severa / Nifedipine in severe preeclampsia

Se estudiaron 12 pacientes con pre-eclampsia severa (PES) a las cuales se les administró nifedipina por vía sublingual para el manejo de la tensión arterial. Los valores tensionales pre y post-tratamiento fueron: T. A. Sistólica 178,5 ñ 12.1 / 147,3 ñ 15,2 mm Hg, T. A. Diastólica 115,8 ñ 8,4 / 96,1 ñ 9,4 mm Hg, T. A. Media 136,6 ñ 6,5 /113,2 ñ 9,9 mm Hg. Estas diferencias resultaron estadísticamente significativas. Ningún caso desarrolló eclampsia. El control tensional alcanzado permitió adecuar la duración del embarazo a la madurez fetal. No hubo efectos colaterales materno-fetales ni en los recién nacidos. Nuestros datos sugieren que la nifedipina es efectiva y segura para el manejo de la hipertensión arterial en la PES. Sin embargo es necesaria una mayor experiencia para asegurar la inocuidad de la droga durante la gestación (AU)