dinoprost and Postoperative-Complications

Topics: Alprostadil; Angiography; Arterial Occlusive Diseases; Dinoprost; Epoprostenol; Humans; Intestinal Obstruction; Postoperative Complications; Prostaglandins E; Prostaglandins F; Raynaud Disease

The comparative safety of methods used to perform second-trimester abortion is an important public health concern. Morbidity and mortality studies have indicated that dilation and evacuation (D&E) is safer than instillation abortion, which is safer than hysterotomy and hysterectomy. In the third phase of the Joint Program for the Study of Abortion, the adjusted relative risk of serious complications associated with the intraamniotic instillation of urea and prostaglandin F2 alpha (the safest abortifacient regimen) was 1.9 times that associated with D&E (95% confidence interval, 1.2-3.1). An analysis of abortion mortality in the United States from 1972 to 1981 revealed a death-to-case rate of 4.9 per 100,000 abortions associated with D&E, 9.6 with instillation methods and over 60 with hysterotomy and hysterectomy. Little information exists concerning potential late sequelae of second-trimester abortion. D&E appears to be the safest method of second-trimester abortion available in the United States.. The comparative safety of methods used to perform 2nd-trimester abortion is an important public health concern. Morbidity and mortality studies have indicated that dilation and evacuation (D&E) is safer than instillation abortion, which is safer than hysterotomy and hysterectomy. In the 3rd phase of the Joint Program for the Study of Abortion, the adjusted relative risk of serious complications associated with the intraamniotic instillation of urea and prostaglandin F2alpha (the safest abortifacient regimen) was 1.9 times that associated with D&E (95% confidence interval, 1.2-3.1). An analysis of abortion mortality in the US from 1972-81 revealed a death-to-case rate of 4.9/100,000 abortions associated with D&E, 9.6 with instillation methods and over 60 with hysterotomy and hysterectomy. Little information exists concerning potential late sequelae of 2nd-trimester abortion. D&E appears to be the safest method of 2nd-trimester abortion available in the US.

Topics: Abortion, Induced; Abortion, Legal; Amnion; Blood Coagulation Disorders; Dilatation; Dilatation and Curettage; Dinoprost; Embolism, Amniotic Fluid; Female; Fever; Humans; Hysterectomy; Postoperative Complications; Pregnancy; Pregnancy Trimester, Second; Prostaglandins F; Risk; Saline Solution, Hypertonic; United States; Urea; Uterine Hemorrhage

N-acetylcysteine has been used to treat a variety of lung diseases, where is it thought to have an antioxidant effect. In a randomized placebo-controlled double-blind study, the effect of N-acetylcysteine on systemic inflammation and oxidative damage was examined in patients undergoing lung resection, a human model of acute lung injury.. Eligible adults were randomized to receive preoperative infusion of N-acetylcysteine (240 mg/kg over 12 h) or placebo. Plasma thiols, interleukin-6, 8-isoprostane, ischaemia-modified albumin, red blood cell glutathione and exhaled breath condensate pH were measured pre- and post-operatively as markers of local and systemic inflammation and oxidative stress.. Patients undergoing lung resection and one-lung ventilation exhibited significant postoperative inflammation and oxidative damage. Postoperative plasma thiol concentration was significantly higher in the N-acetylcysteine-treated group. However, there was no significant difference in any of the measured biomarkers of inflammation or oxidative damage, or in clinical outcomes, between N-acetylcysteine and placebo groups.. Preoperative administration of N-acetylcysteine did not attenuate postoperative systemic or pulmonary inflammation or oxidative damage after lung resection.. NCT00655928 at ClinicalTrials.gov.

Topics: Acetylcysteine; Aged; Antioxidants; Biomarkers; Breath Tests; Dinoprost; Double-Blind Method; Female; Glutathione; Humans; Interleukin-6; Lung; Male; Middle Aged; Oxidative Stress; Pneumonectomy; Pneumonia; Postoperative Complications; Preoperative Care; Serum Albumin; Serum Albumin, Human; Treatment Outcome

Ischemia modified albumin (IMA; Ischemia Technologies, Inc) blood levels rise in patients who develop ischemia during percutaneous coronary intervention (PCI). It is not known whether IMA elevations correlate with increases in other markers of oxidative stress, ie, 8-iso prostaglandin F2-A (iP).. We compared IMA versus iP plasma levels in 19 patients (mean age 62.8+/-11.9 years) undergoing PCI and 11 patients (mean age 64+/-13.6 years) undergoing diagnostic angiography (controls). In the PCI patients, blood samples for IMA and iP were taken from the guide catheter before PCI and after balloon inflations, and from the femoral sheath 30 minutes after PCI. IMA was measured by the albumin cobalt binding (ACB) test and plasma iP by enzyme immunoassay. During PCI, all 19 patients had chest pain and 18 had transient ischemic ST segment changes. IMA was elevated from baseline in 18 of the 19 patients after PCI. Median IMA levels were higher after PCI (101.4 U/mL, 95%CI 82 to 116) compared with baseline (72.8 U/mL, CI 55 to 93; P<0.0001). Levels remained elevated at 30 minutes (87.9 U/mL, CI 78 to 99; P<0.0001) and returned to baseline at 12 hours (70.3 U/mL, CI 65 to 87; P=0.65). iP levels were raised after PCI in 9 of the 19 patients. However, median iP levels were not significantly different immediately (P=0.6) or 30 minutes after PCI (P=0.1). In the control group, IMA and iP levels remained unchanged before and after angiography (P=0.2 and 0.16, respectively).. IMA is a more consistent marker of ischemia than iP in patients who develop chest pain and ST segment changes during PCI.

Topics: Aged; Albumins; Angina Pectoris; Angioplasty, Balloon, Coronary; Biomarkers; Blood Proteins; Chest Pain; Coronary Angiography; Dinoprost; Electrocardiography; F2-Isoprostanes; Female; Humans; Immunoenzyme Techniques; Male; Middle Aged; Myocardial Ischemia; Postoperative Complications; Predictive Value of Tests; Sensitivity and Specificity; Troponin T

A total of 60 patients underwent injection of prostaglandin (PG)F2 alpha into the affected tube and corpus luteum. Two serum samples, with a mean interval of 2.1 days, were taken pre-operatively and human chorionic gonadotrophin (HCG) and progesterone were determined by fluoroimmunoassay retrospectively. Cases requiring a second intervention (n = 8) were compared with uncomplicated cases (n = 52). The receiver-operator characteristic curve was used to determine optimal discriminatory levels of each diagnostic test. Among the complicated cases, 75% had progesterone values > 20 nmol/l and 100% had a daily HCG increase > 50 IU/l. The corresponding figures for the uncomplicated cases were 17% and 23% respectively. A 'high-risk' group representing 12% of the patient material was identified, and was biochemically profiled by serum progesterone values > 20 nmol/l, together with daily HCG changes > +50 IU/l/day. These patients had an 86% risk for a second intervention. Conversely, 88% of patients had only a 4% risk for such an intervention. We conclude that the combined use of two sequential serum HCG samples and one serum progesterone sample, the last of each taken not more than 24 h pre-operatively, can predict the risk for a complicated course following local injection of 15-methyl-PGF2 alpha for small tubal pregnancies.

Topics: Chorionic Gonadotropin; Combined Modality Therapy; Dinoprost; Female; Humans; Injections; Postoperative Complications; Predictive Value of Tests; Pregnancy; Pregnancy, Tubal; Preoperative Care; Progesterone; Risk Factors; Trophoblasts

Fifty women underwent vaginal hysterectomy with or without anterior and posterior colporrhaphy. After the operations the women were allocated randomly to one of three groups. One group (17 patients) received daily vaginal suppositories of 10 mg of prostaglandin E2. The second group (15) received a daily intravesical solution of 50 micrograms of prostaglandin F2 alpha dissolved in 100 mL of normal saline. The third group (18) received a daily instillation of 100 mL of saline and served as the control group. The postvoiding residual urinary volume was checked daily through a suprapubic catheter, which was removed once the residual volume was less than 50 mL. The prostaglandin did not shorten the time required for postoperative bladder drainage. The rates of febrile morbidity and hospital stay were the same in all three groups. Since most of the women in the study voided spontaneously within three days, the "sit and wait" approach seems reasonable in such patients, and prophylactic treatment to enhance bladder function after vaginal operations does not seem justified.

Topics: Administration, Intravesical; Aged; Dinoprost; Dinoprostone; Female; Humans; Hysterectomy, Vaginal; Length of Stay; Middle Aged; Pessaries; Postoperative Complications; Prospective Studies; Urinary Catheterization; Urination Disorders; Urodynamics

One hundred patients undergoing vaginal surgery for genital prolapse were randomly allocated to one of four post-operative management groups which included a control group and three groups receiving differently acting pharmacological agents (distigmine bromide, phenoxybenzamine hydrochloride, and prostaglandin F2 alpha) variously reported as being useful in preventing urinary retention after vaginal surgery. The incidence of an elevated residual volume in the control group was 10.7%. All the pharmacological agents appeared to increase by about three times the incidence of an elevated residual urinary volume with statistical significance (P less than 0.05) being noted for distigmine bromide and PGF2 alpha. While this increased incidence occurred irrespective of the type of surgery in the case of distigmine bromide and phenoxybenzamine . HCl, the increase was most marked (P less than 0.01) when PGF2 alpha was used after anterior repair surgery.

Topics: Dinoprost; Female; Humans; Phenoxybenzamine; Postoperative Complications; Prospective Studies; Pyridinium Compounds; Urinary Retention; Vagina

One hundred twenty eight women underwent midtrimester induced abortion with: 1) combined regimen of intramniotic prostaglandin (PG) F2a injection and intracervical laminaria tents (group A, 50 women), 2) intramniotic PGF2a injection only (group B, 51 women) and 3) laminaria tents followed by intracervical PGF2a tablets insertion (group C, 27 women). The mean induction-abortion time (+/- SE) was 24.9 +/- 1.7 hours for group A, 28.2 +/- 2.2 hours for group B (p greater than 0.05) and 42.1 +/- 3.4 hours for group C, significantly longer than goup A and B (p less than 0.001 and p less than 0.01 respectively). In 48 hours 98% of the patients of group A, 90% of group B (p less than 0.05) and 59% of group C (p less than 0.001) completed the abortion procedure. Parous women of group A and B presented similar induction - abortion time, while in nulliparous the use of laminaria shortened the abortion procedure significantly (p less than 0.05). The complications rate was low. In conclusion, the intracervical PGF2a insertion is a simple but very slow abortion procedure with high failure rates. The intramniotic PGF2a injection is a successful method for late midtrimester medical pregnancy termination and the concurrent use of laminaria tents shortens the abortion procedure, particularly in nulliparous, reduces the number of prostaglandins' reinjections and increases the incidence of successful abortion within 48 hours.. 128 women underwent midtrimester induced abortion with the following: 1) a combined regimen of intraamniotic prostaglandin F2alpha (PGF2alpha) injection and intracervical laminaria tents (group A, 50 women); 2) intraamniotic PGF2alpha injection only (group B, 51 women); and 3) laminaria tents followed by intracervical PGF2alpha tablets insertion (group C, 27 women). The mean induction-abortion time (+or -SE) was 23.9 +or-1.7 hours for group A, 28.2 +or-2.2 hours for group B (p0.05), and 42.1 +or-3.4 hours for group C, which was significantly longer than groups A or B (p0.001 and p0.01). In 48 hours, 98% of the patients in group A, 90% of group (p0.05), and 59% of group C (p0.001) completed the abortion procedure. Parous women in groups A and B presented similar induction-abortion time, while among nulliparous women, the use of laminaria shortened the abortion procedure significantly (p0.05). The complications rate was low. In conclusion, the intracervical PGF2alpha insertion is a simple but very slow abortion procedure with high failure rates. The intraamniotic PGF2alpha injection is a successful method for late midtrimester medical pregnancy termination and the concurrent use of laminaria tents shortens the abortion procedure, particularly in nulliparous women, reduces the number of PG reinjections, and increases the incidence of successful abortion within 48 hours.

Topics: Abortion, Induced; Adult; Amnion; Cervix Uteri; Dinoprost; Female; Humans; Injections; Postoperative Complications; Pregnancy; Pregnancy Trimester, Second; Tablets

Prostaglandin F2 alpha 10 mg was administered intravesically in a double-blind placebo-controlled study to promote micturition in cases of urinary retention after operative treatment of urinary stress incontinence in women. Fifteen of 18 patients (83%) succeeded in voiding after treatment with prostaglandin F2 alpha, but the placebo was ineffective in all 18 patients (P less than 0.001). Although the effect of prostaglandin F2 alpha on bladder muscle contraction was short-lived, it seemed to enhance the restoration of bladder motor function with no serious side effects, and thus to be clinically useful in the treatment of post-operative urinary retention.

Topics: Administration, Intravesical; Adult; Aged; Clinical Trials as Topic; Dinoprost; Double-Blind Method; Female; Humans; Middle Aged; Postoperative Complications; Prostaglandins F; Random Allocation; Urinary Incontinence, Stress; Urination Disorders

The delay in spontaneous micturition after pelvic surgical procedures is a significant complication. This study was performed to establish the validity of intravesical instillation of prostaglandin F2 alpha in the prevention of urinary retention after vaginal surgery. For this purpose 102 patients were randomly and alternatively allocated to receive either 16 mg of prostaglandin F2 alpha diluted in 40 mL of saline or saline only given intravesically. Similar numbers of patients with vaginal hysterectomy (27 versus 31), vaginal repair (12 versus 11), and repair with Kelly urethral plication (12 versus 9) were included in the study and control group, respectively. The frequency of urinary retention in the women treated with prostaglandin F2 alpha was decreased significantly as compared with those treated with saline alone (P less than .02). But this was true for women undergoing vaginal hysterectomy only. There was also a significantly shorter hospitalization of women receiving prostaglandin F2 alpha (P less than .05) and there were no side effects.

Topics: Bacteriuria; Dinoprost; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Male; Muscle Contraction; Postoperative Complications; Prostaglandins F; Urethra; Urinary Bladder; Urination Disorders; Vagina

The impact of systemic inflammation on clinical outcomes after CABG surgery is still controversial. In this study, we evaluated the impact of the markers of inflammation, endothelial damage and platelet activation on clinical outcomes after on- and off-pump CABG.. A group of 191 consecutive on- and off-pump CABG patients were prospectively studied. Blood samples were drawn before surgery, 18-36h after the procedure and 5-7 days postoperatively and analyzed for 8-iso-prostaglandin F. Elevation of 8-iso-PGF. Links between preoperative 8-iso-PGF

Topics: Aged; beta-Thromboglobulin; Biomarkers; C-Reactive Protein; Cardiopulmonary Bypass; Coronary Artery Bypass; Coronary Artery Disease; Dinoprost; Female; Follow-Up Studies; Hospital Mortality; Humans; Incidence; Inflammation; Male; Middle Aged; Poland; Postoperative Complications; Postoperative Period; Predictive Value of Tests; Preoperative Period; Prospective Studies; Survival Rate

Elevated asymmetric dimethylarginine (ADMA) is associated with an increased risk of coronary artery disease. A prognostic value of ADMA following coronary artery bypass grafting (CABG) is unknown. The aim of the current study was to assess the effect of CABG on ADMA and oxidative stress and determine their associations with postoperative complications.. In 158 consecutive patients (35 women, 123 men, aged 65.2 ± standard deviation 8.2 years) undergoing isolated, elective CABG procedure, we measured plasma ADMA and 8-iso-prostaglandin F2α (8-iso-PGF2α) preoperatively and twice postoperatively: 18-36 h and 5-7 days after surgery. The primary end points were postoperative myocardial infarction (PMI) and in-hospital cardiovascular death.. ADMA increased from 0.56 ± 0.06 μmol/l at baseline by 68% to 0.94 ± 0.11 μmol/l at 18-36 h after CABG, and then decreased by 20% to 0.75 ± 0.12 μmol/l on 5-7 days postoperatively (P = 0.0001 for all comparisons). A similar pattern of changes was observed for 8-iso-PGF2α. Thirteen (8.2%) patients developed PMI, and 6 patients (3.8%) died during the early postoperative period because of extensive PMI. PMI and early perioperative mortality were positively associated with ADMA and 8-iso-PGF2α.. A marked increase of ADMA and oxidative stress is observed within the first days following CABG, and is associated with unfavourable early post-CABG outcomes, including PMI and in-hospital cardiovascular death.

Topics: Aged; Arginine; Coronary Artery Bypass; Dinoprost; Female; Hospital Mortality; Humans; Male; Middle Aged; Myocardial Infarction; Oxidative Stress; Postoperative Complications

Oxidative stress has been associated with mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, little is known about oxidative stress in postoperative cognitive dysfunction (POCD) in aging. The aim of this study was to investigate urinary excretion rate of 8-isoprostane:creatinine (U8-isoPG:Cr) and malonaldehyde:creatinine (UMDA:Cr) to predict short-term POCD in elderly patients undergoing general and orthopedic surgery. 72 patients aged above 65 years were enrolled in this prospective observational study. Each patient underwent cognitive testing to determine POCD performed by an investigator before surgery and 1 week after surgery. Morning urine was collected at baseline, 1, 2, and 7 days postoperatively. U8-isoPG was performed using enzymelinked immunosorbent assay (ELISA), and UMDA levels were measured by chemiluminescence detection. Creatinine levels were also analyzed if differences in the oxidative biomarkers were observed in the urine creatinine concentration. (1). Of 72 patients who completed cognitive testing, postoperative cognitive dysfunction was detected in 29.2 % (n = 21) of patients in 7 days. (2) U8-isoPG:Cr levels in 7 days postoperatively were significantly higher in POCD patients compared with the non-POCD group (p = 0.01). When measuring change from baseline, U8-isoPG:Cr levels were higher than that of control groups (p = 0.01). (3) UMDA:Cr levels were significantly elevated in 1 and 2 days postoperatively in both groups (p < 0.05). U8-isoPG:Cr level seems to be a valuable marker to detect lipid peroxidation early in POCD patients. However, it will also be important to take into account or reduce potential confounders to improve the identification of changes in the status of oxidative stress as a marker for POCD.

Topics: Aged; Aging; Biomarkers; Cognition Disorders; Dinoprost; Enzyme-Linked Immunosorbent Assay; Female; Humans; Luminescent Measurements; Male; Malondialdehyde; Neuropsychological Tests; Orthopedic Procedures; Oxidative Stress; Postoperative Complications; Postoperative Period

Myeloperoxidase (MPO) is a lysosomal enzyme that may be involved in oxidative stress-mediated kidney injury. Using a two-step approach, we measured the association of four polymorphisms across the length of the MPO gene with systemic markers of oxidative stress: plasma MPO and urinary 15-F(2t)-isoprostane levels. Adverse outcomes were measured in a primary cohort of 262 adults hospitalized with acute kidney injury, and a secondary cohort of 277 adults undergoing cardiac surgery with cardiopulmonary bypass and at risk for postoperative acute kidney injury. Dominant and haplotype multivariable logistic regression analyses found a genotype-phenotype association in the primary cohort between rs2243828, rs7208693, rs2071409, and rs2759 MPO polymorphisms and both markers of oxidative stress. In adjusted analyses, all four polymorphic allele groups had 2-3-fold higher odds for composite outcomes of dialysis or in-hospital death or a composite of dialysis, assisted mechanical ventilation, or in-hospital death. The MPO T-G-A-T haplotype copy-number was associated with lower plasma MPO levels and lower adjusted odds for the composite outcomes. Significant but less consistent associations were found in the secondary cohort. In summary, our two-step genetic association study identified several polymorphisms spanning the entire MPO gene locus and a common haplotype marker for patients at risk for acute kidney injury.

Topics: Acute Kidney Injury; Aged; Cohort Studies; Coronary Artery Bypass; Dinoprost; Female; Genetic Association Studies; Genetic Markers; Haplotypes; Humans; Isoprostanes; Male; Middle Aged; Oxidative Stress; Peroxidase; Polymorphism, Single Nucleotide; Postoperative Complications; Prognosis

Cyclosporine (CyA) is associated with many side effects, including endothelial dysfunction and transplant vasculopathy (TxV). We previously demonstrated that CyA results in impairment of nitric oxide bioavailability and enhanced sensitivity to endothelin-1 (ET-1). In this study, we evaluated rapamycin (SRL) for its effects on the endothelium.. Lewis rats (n = 8) were injected with SRL (1.5 mg/kg), CyA (5 mg/Kg), or saline (Con) intraperitoneally daily for 2-weeks. Thoracic aortic segments were assessed for endothelial-dependent (Edep) and independent (Eind) relaxation after exposure to acetylcholine and sodium nitroprusside by deriving the percent maximum relaxation (Emax). ET-1 plasma levels were also measured. Thoracic aortic expression of endothelial nitric oxide synthase (eNOS), ET(A) and ET(B) receptors (Rc), were determined. Oxidative injury was assessed by changes in 8-isoprostane levels. CyA exposure resulted in lower Edep vasorelaxation compared with control and SRL (Emax: SRL, 58+/-4%; CyA, 24+/-7%; Con, 52+/-8%; P=0.001). No differences in Eind vasorelaxation were seen. CyA exposure also increased sensitivity to ET-1 (% maximum contraction [Cmax]: Con, 211+/-8%; SRL, 230+/-5%; CyA, 259+/-3%; P=0.04). Only SRL treatment reduced ET-1 plasma levels. CyA reduced eNOS expression by 30% and increased ETA Rc expression by 34% compared with both Con and SRL (P=0.02). CyA resulted in higher 8-isoprostane levels (CyA, 50+/-2%; SRL, 3+/-3%; Con, 2+/-5%; P=0.02).. CyA results in vascular dysfunction characterized by impairment of Edep vasorelaxation and enhanced sensitivity to vasospasm. SRL did not impair Edep vasorelaxation or increase sensitivity to vasospasm while lowering ET-1 levels and preserving eNOS protein expression. We conclude that SRL is less deleterious to the vasculature than CyA and may prevent TxV by these mechanisms.

Topics: Acetylcholine; Animals; Aorta, Thoracic; Cyclosporine; Dinoprost; Endothelin-1; Endothelium, Vascular; Enzyme Induction; Gene Expression Regulation; Immunosuppressive Agents; Male; Models, Animal; Nitric Oxide; Nitric Oxide Synthase Type III; Nitroprusside; Organ Transplantation; Oxidative Stress; Postoperative Complications; Rats; Rats, Inbred Lew; Receptor, Endothelin A; Receptor, Endothelin B; Sirolimus; Vasoconstriction; Vasodilation

Cardiac surgery using cardiopulmonary by-pass and, to a greater extent, lung resection, causes acute lung injury that is usually subclinical. Analysis of mediators in exhaled breath condensate is a promising means of monitoring inflammation in a variety of airway diseases but the contribution of the airway lining fluid from the lower respiratory tract is uncertain. We compared the analysis of markers of lung injury in exhaled breath condensate and bronchoalveolar lavage in endotracheally intubated patients before and after coronary artery bypass graft surgery with cardiopulmonary bypass and lobectomy. The neutrophil count and leukotriene B4 concentration in bronchoalveolar lavage fluid rose after coronary artery bypass graft surgery (p < 0.05), but there was no significant change in leukotriene B4, hydrogen peroxide, or hydrogen ion concentrations in exhaled breath condensate. By contrast, after lobectomy, the concentration in exhaled breath condensate of leukotriene B4, hydrogen peroxide and hydrogen ions rose significantly (p < 0.05). Exhaled breath condensate is a safe, noninvasive method of sampling the milieu of the distal lung and is sufficiently sensitive to detect markers of inflammation and oxidative stress in patients after lobectomy, but not after the milder insult associated with cardiac surgery.

Topics: Aged; Breath Tests; Bronchoalveolar Lavage Fluid; Cohort Studies; Coronary Artery Bypass; Dinoprost; F2-Isoprostanes; Female; Humans; Inflammation Mediators; Leukotriene B4; Male; Mass Spectrometry; Middle Aged; Pneumonia; Postoperative Complications; Probability; Prognosis; Risk Assessment; Sensitivity and Specificity; Severity of Illness Index; Statistics, Nonparametric

Topics: Aged; Biomarkers; Cardiac Output, Low; Cardiac Surgical Procedures; Coronary Artery Bypass; Dinoprost; F2-Isoprostanes; Female; Heart Valve Prosthesis Implantation; Humans; Male; Postoperative Complications

Postoperative hypomagnesemia is common in patients who have undergone cardiac operations and is associated with clinically significant morbidity resulting from atrial and ventricular dysrhythmias. Magnesium supplementation may increase the cardiac index in the early postoperative period.. The action of the magnesium cation on coronary vascular reactivity was studied. Segments of canine epicardial coronary artery were suspended in organ chambers to measure isometric force (95% O2/5% CO2, 37 degrees C).. In coronary segments constricted with prostaglandin F2alpha (2 x 10[-6] mol/L), acetylcholine and adenosine diphosphate (10[-9] to 10[-4] mol/L) induced vasodilation in arteries with endothelium (n=10, each group; p < 0.05). Acetylcholine-mediated vasodilation was blocked by NG-monomethyl-L-arginine (10[-4] mol/L) and NG-nitro-L-arginine (10[-4] mol/L), two inhibitors of nitric oxide synthesis from L-arginine (n=10, p < 0.05). The removal of magnesium from the organ chamber solution impaired vasodilation in response to acetylcholine and adenosine diphosphate. However, normal endothelium-dependent vasodilation could be restored by return of magnesium to the bathing solution. Vascular relaxation in response to bradykinin (10[-9] to 10[-6] mol/L), which was found to induce endothelium-dependent vasodilation independent of nitric oxide production, was unaffected by magnesium removal (n=10).. Hypomagnesemia selectively impaired the release of nitric oxide from the coronary endothelium. Because nitric oxide is a potent endogenous nitro-vasodilator and inhibitor of platelet aggregation and adhesion, hypomagnesemia could promote vasoconstriction and coronary thrombosis in the early postoperative period.

Topics: Acetylcholine; Adenosine Diphosphate; Animals; Arrhythmias, Cardiac; Bradykinin; Cardiac Output; Cardiac Surgical Procedures; Coronary Thrombosis; Coronary Vessels; Dinoprost; Dogs; Endothelium, Vascular; Enzyme Inhibitors; Female; Infusions, Intravenous; Magnesium; Male; Nitric Oxide; Nitric Oxide Synthase; Nitroarginine; omega-N-Methylarginine; Pericardium; Platelet Aggregation Inhibitors; Postoperative Complications; Vasoconstriction; Vasoconstrictor Agents; Vasodilation; Vasodilator Agents

The relationship between intestinal motor activity and the influence of prostaglandin F2alpha (PGF) and cisapride were investigated during the early postoperative period in 26 patients who underwent abdominal surgery. Records of intestinal motility were made using an infusion catheter. PGF, 0.4 microg/kg per minute, given intravenously over 60 min, and cisapride, 5 mg, given intraintestinally, were administered to 13 patients each, first immediately after the operation, and then after the migrating motor complexes (MMCs) had reappeared following a period of intestinal quiescence. The MMCs were reestablished within the first postoperative day. Both PGF and cisapride stimulated irregular, high-amplitude contractions; however, the MMCs reappeared following these induced contractions only if the drugs were administered just after the postoperative MMCs became evident. These prokinetic drugs did not affect gastrointestinal hormone concentrations, but induced contractile activity even in the early postoperative period. Although the findings of this study demonstrate that these drugs may be useful as prokinetic agents to promote recovery from postoperative ileus just after the reappearance of MMCs in the early postoperative period, their precise mode of action has not been established.

Topics: Abdomen; Cisapride; Dinoprost; Female; Gastrointestinal Agents; Gastrointestinal Motility; Humans; Infusions, Intravenous; Intestinal Obstruction; Male; Middle Aged; Piperidines; Postoperative Complications; Surgical Procedures, Operative

Cyclical motor activity of the gastrointestinal tract, normally occurring during the interdigestive period in several mammals, is disrupted in the post-operative ileus. We determined the recovery from the disappearance of cyclical motor activity, from the stomach to the colon, in dogs after laparotomy with the force transducers. Moreover, we examined the effects of Leu13-motilin (KW-5139) and prostaglandin F2 alpha (PGF2 alpha), administered in the early post-operative period, on the gastrointestinal motility. Following laparotomy, the cyclical motor activity reappeared firstly in the ileum and the colon, then in the jejunum and the duodenum, and finally in the stomach. The reappearance time of the phase III contractions in the stomach was 105.8 +/- 10.6 h (n = 4). In the early post-operative period, KW-5139 (0.5 microgram kg-1, i.v.) induced phase-III-like contractions, whereas PGF2 alpha (50 micrograms kg-1, i.v.) induced simultaneously occurring contractions over the whole gastrointestine. The treatment with KW-5139 (0.5 microgram kg-1, i.v.) four times (twice daily on the first and the second post-operative day) significantly (P < 0.05) shortened the time required to recover the phase III contractions in the stomach (64.2 +/- 2.2 h, n = 4), whereas that with PGF2 alpha (50 micrograms kg-1, i.v.) four times did not (111.3 +/- 17.2 h, n = 4). The present results indicate that, after laparotomy, the cyclical motor activity recovers faster in the distal intestine than in the proximal intestine and the stomach, and that KW-5139, but not PGF2 alpha, shortens the reappearance time of the phase III activity in the stomach.

Topics: Analysis of Variance; Animals; Biomechanical Phenomena; Dinoprost; Dogs; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical; Gastrointestinal Motility; Hormones; Intestinal Obstruction; Male; Motilin; Postoperative Complications; Random Allocation; Stimulation, Chemical

Laparoscopic injection has become an important tool in tubal pregnancy. Intratubal injection of 5 mg of prostaglandin F2 alpha (PG F2 alpha) was successful at a serum human chorionic gonadotropin (hCG) level of more than 2500 mlU/ml. Intrauterine pregnancy occurred 112 days after laparoscopic treatment, during earlier removal of the contralateral tube.

Topics: Adult; Chorionic Gonadotropin; Combined Modality Therapy; Dilatation and Curettage; Dinoprost; Fallopian Tubes; Female; Humans; Infant, Newborn; Injections, Intralesional; Laparoscopy; Male; Ovarian Cysts; Ovariectomy; Postoperative Complications; Pregnancy; Pregnancy, Tubal

Over the past years laparoscopic surgery has become widely accepted in the treatment of tubal pregnancy and instillation of prostaglandin is well established. However, the failure rate is around 20%. This report describes a case of tubal pregnancy treated according to this procedure where the therapy initially seemed to be successful. Instillation of prostaglandin F2 alpha was followed by decreasing beta-HCG values, which continued to decrease after discharge. Thus, rupture of the operated tube on day 17 after surgery was completely unexpected.

Topics: Adult; Chorionic Gonadotropin; Chorionic Gonadotropin, beta Subunit, Human; Dinoprost; Dinoprostone; Fallopian Tube Diseases; Female; Humans; Injections, Intralesional; Injections, Intramuscular; Laparoscopy; Peptide Fragments; Postoperative Complications; Pregnancy; Pregnancy, Tubal; Rupture, Spontaneous

A child with post-obstructive urinary concentrating defect was studied for the possible pathophysiological role of prostaglandins and an eventual therapeutic approach. Increased urinary excretion of prostaglandins was corrected by indomethacin, with resultant increased nephrogenous cyclic AMP and partial improvement in the concentrating defect. The addition of a thiazide restored urinary concentration. These results add clinical support to the conception of the important role of prostaglandins in the mechanism of post-obstructive hyposthenuria. This therapeutic regimen is advocated for prolonged post-obstructive concentrating defect.

Topics: Child, Preschool; Dinoprost; Dinoprostone; Humans; Hydrochlorothiazide; Indomethacin; Kidney Concentrating Ability; Male; Polyuria; Postoperative Complications; Prostaglandins E; Prostaglandins F; Urethral Obstruction

In the Dept. of Obstetrics of the Gera district hospital prostaglandin F2 alpha has been applied for priming and therapeutic abortion since 1979. A total of 600 women, among them 482 primigravidae, 47 with missed abortion and 71 having been admitted on behalf of the abortion panel's decision, underwent therapeutic abortion. Age distribution, clinical course, unwanted side effects and early complications after intracervical-extraamnial instillation of 5 mg prostaglandin F2 alpha have been investigated. Application of prostaglandin F2 alpha can be considered the method of choice in particular when therapeutic abortion is indicated in younger women or in patients showing suspect findings in cervical smear cytology.

Topics: Abortion, Induced; Adolescent; Adult; Cervix Uteri; Dinoprost; Female; Gels; Humans; Postoperative Complications; Pregnancy; Pregnancy Trimester, First; Prostaglandins F

To improve the accuracy of diagnosis of Hirschsprung's disease by means of anorectal manometry, prostaglandin F2 alpha (PGF2 alpha) and scopolamine-N-butylbromide (Buscopan) were used. Normal rectoanal reflex was facilitated by PGF2 alpha in 6 out of 7 children and was abolished or markedly inhibited in 12 out of 13, when Buscopan was given. Obscure rectoanal reflexes in 7 normal neonates were clarified following the administration of PGF2 alpha. On the other hand, atypical rectoanal reflexes observed in 7 children with Hirschsprung's disease were unchanged with either PGF2 alpha or Buscopan. Therefore the use of PGF2 alpha or Buscopan facilitates the manometric diagnosis of Hirschsprung's disease. In 9 postoperative children with Hirschsprung's disease the reflexes were obscure. Five of these 9 reflexes became clear after the administration of PGF2 alpha and 4 remained unchanged. As the normal rectoanal reflex was enhanced by PGF2 alpha, the obscure reflex seen in the postoperative period can be positive or negative, using PGF2 alpha.

Topics: Adolescent; Butylscopolammonium Bromide; Child; Child, Preschool; Dinoprost; Hirschsprung Disease; Humans; Infant; Infant, Newborn; Infusions, Intravenous; Manometry; Postoperative Complications; Prostaglandins F; Reflex; Scopolamine Derivatives

71 abortions after prenatal diagnosis of genetic defects have been performed between 1974 and 1983. Mean duration of pregnancy was 21 weeks, mean hospital stay 10 days. In 28 per cent an intraamnial prostaglandin induction was done, which was successful in 85 per cent. Extraamnial prostaglandin application was combined with oxytocin in 51 per cent, which was followed by abortion in 51 per cent within 26 hours. Primary hysterectomy was performed in 4 per cent and rupture of the membranes combined with oxytocin infusion in 6 per cent. Complication rate overall was 20 per cent. In 6 per cent the following complications have been observed: 1 perforation with lesion of intestine, 1 cervical rupture with hemorrhage, 1 colpaporrhexis, 1 shock. Pelveoperitonitis and rupture of the symphysis pubis in one case each (3 per cent). Other complications, like fever, hemorrhages and thrombophlebitis have been observed in 11 per cent. Midtrimester abortion after prenatal diagnosis of genetic defects should be done only in experienced clinics. Special importance in prophylaxis of complications of abortion has chorion biopsy to predate prenatal diagnosis in the 6th till 12th gestational week.

Topics: Abortion, Induced; Adult; Dinoprost; Female; Follow-Up Studies; Genetic Diseases, Inborn; Gestational Age; Humans; Hysterectomy; Intraoperative Complications; Oxytocin; Postoperative Complications; Pregnancy; Prenatal Diagnosis; Prostaglandins F