pituitrin and Rupture--Spontaneous

Topics: Acute Disease; Esophageal and Gastric Varices; Esophageal Diseases; Gastrointestinal Hemorrhage; Humans; Lypressin; Rupture, Spontaneous; Somatostatin; Terlipressin; Vasoconstrictor Agents; Vasopressins

Topics: Acute Disease; Catheterization; Endoscopy, Gastrointestinal; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Liver Cirrhosis; Liver Transplantation; Portasystemic Shunt, Surgical; Radiography; Rupture, Spontaneous; Sclerotherapy; Somatostatin; Vasopressins

Topics: Abdomen, Acute; Adult; Aged; Hemostatics; Humans; Liver Diseases; Male; Middle Aged; Multiple Trauma; Pancreatic Neoplasms; Pancreaticoduodenectomy; Rupture, Spontaneous; Vasopressins; Water-Electrolyte Imbalance

Our aim was to report a new approach of endoscopic management (endoloop and encircling suture methods) for interstitial or cornual pregnancy and to determine the safety and effectiveness of these procedures and their effects on subsequent pregnancies.. This is an uncontrolled retrospective review of 24 patients treated for interstitial pregnancies through endoscopic operations with 14 to 72 months of follow-up at a large urban medical center. Blood loss, operation time, changes of serum human chorionic gonadotropin levels, the resumption of menstruation, and subsequent pregnancy after operation were analyzed.. Among 24 interstitial pregnancies, 3 had ruptured at the time of operation and 21 had not ruptured. Treatment consisted of either the vasopressin and electric cauterization method, the endoloop before evacuation of the conceptus method, or the encircling suture before evacuation of the conceptus method. The blood loss and operation time (mean +/- SD) for unruptured cases were 133 +/- 134 mL and 51.6 +/- 7.6 minutes in the vasopressin and electric cauterization group (n = 3), 32 +/- 22 mL and 28.5 +/- 6.4 minutes in the endoloop group (n = 15), and 40 +/- 17 mL and 35.0 +/- 5.0 minutes in the encircling suture group (n = 3). In 3 patients with ruptured pregnancy treated with the endoloop method, the blood loss and operation time (mean +/- SD) were 1100 +/- 854 mL and 82.5 +/- 51.6 minutes. Any of these operative methods resulted in rapid decline of serum human chorionic gonadotropin levels within 1 week with the exception of 1 case, in which the endoloop method was used; this patient needed additional treatment with methotrexate. Seventeen patients desired pregnancy in the future, and 15 eventually became pregnant. One of these 15 pregnancies ended in an ectopic pregnancy on the opposite side 6 months after the interstitial pregnancy. Three ended in a spontaneous abortion, and 11 were delivered by elective cesarean section at term before labor started. Operative records of cesarean section in 8 patients delivered at our institution showed little or no adhesions or defect in the cornual area of the previous operation.. The endoloop method and the encircling suture method are simple, safe, effective, and nearly bloodless. There were no uterine ruptures in the pregnancies subsequent to these methods of endoscopic management.

Topics: Adult; Blood Loss, Surgical; Cesarean Section; Chorionic Gonadotropin; Electrocoagulation; Endoscopy; Female; Humans; Menstruation; Pregnancy; Pregnancy Outcome; Pregnancy, Ectopic; Retrospective Studies; Rupture, Spontaneous; Time Factors; Treatment Outcome; Vasopressins

The relationship between plasma atrial natriuretic peptide (ANP) and antidiuretic hormone (ADH) both of which show high values after subarachnoid hemorrhage and cerebral vasospasm was studied. The subjects were 23 patients who were admitted because of aneurysmal subarachnoid hemorrhage during three years from March, 1989 to March, 1992 and in whom plasma ANP and ADH levels could be determined over time. Cerebral vasospasm was evaluated by the finding of cerebral angiography, clinical symptoms, and presence or not of low density areas on CT. Hyponatremia was defined as the serum sodium level of 130 mEq/l or less for two days or more. Angiographical vasospasm was found in 17 patients (85%), symptomatic vasospasm in 15 patients (65.2%), low density areas on CT in 9 patients (40.9%) and hyponatremia in 8 patients (34.8%). Symptomatic vasospasm was noted in 7 of the 8 patients (87.5%) with hyponatremia, low density areas on CT in 4 patients (50%), the detection rate being high. The plasma ANP and ADH levels were 76.7 +/- 32.1 pg/ml and 2.2 +/- 0.7 pg/ml respectively in the patients with symptomatic vasospasm against 38.3 +/- 21.3 pg/ml and 2.4 +/- 0.6 pg/ml respectively without symptomatic vasospasm, the plasma ANP level being significantly high in the patients with symptomatic vasospasm (p < 0.01). The plasma ANP and ADH were 71.2 +/- 33.8 pg/ml and 2.0 +/- 1.1 pg/ml respectively in the patients with low density areas on CT against 51.2 +/- 31.3 pg/ml and 1.8 +/- 0.5 pg/ml respectively without low density areas on CT.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Atrial Natriuretic Factor; Humans; Hyponatremia; Intracranial Aneurysm; Ischemic Attack, Transient; Rupture, Spontaneous; Subarachnoid Hemorrhage; Vasopressins

Measurement of plasma alpha-humanANP (ANP) and antidiuretic hormone (ADH) in 28 cases with aneurysmal subarachnoid haemorrhage (SAH) was carried out, and then compared with control subjects who were infused with hypertonic saline. In cases with hyponatremia (HN), statistical correlation between control subjects and cases without HN was not evident with regards to ANP and plasma osmolality (Posm), excreted fraction of filtrated sodium (FENa) and urinary Na/K. Furthermore, they secreted supernumerarilly in spite of HN. Cases with HN were further subdivided into two groups, they were those cases with negative total sodium balance at the time of appearance of HN, and those cases without total negative sodium balance. In the former, central venous pressure had a tendency to decrease, however, secretion of ANP and ADH was statistically not different in either groups. It appears that ANP regulated urinary sodium excretion against an osmotic or sodium load acts as a maintenance of homeostasis as an osmotic regulator. Cases with HN in which secretion of ADH was physiological, ANP secreted supernumerarilly in spite of hypoosmonaemia and hypovolaemia. Our findings may contribute to a better understanding of the pathophysiological processes leading to hyponatremia in cases with cerebral disorders, and may help to improve the treatment possibilities.

Topics: Adult; Aged; Atrial Natriuretic Factor; Female; Humans; Hyponatremia; Intracranial Aneurysm; Male; Middle Aged; Peptide Fragments; Rupture, Spontaneous; Subarachnoid Hemorrhage; Vasopressins

Seventeen tubal pregnancies were treated successfully with a laparoscopic procedure over the past four years. Four different laparoscopic techniques were used: salpingectomy, partial salpingectomy (midtube resection), fimbrial expression, and salpingotomy. "Preventive hemostasis" using vasopressin has made salpingotomy our treatment method of choice. Ruptured tubal pregnancy was not considered a contraindication to laparoscopic treatment. Four of the six women who were trying to conceive and were followed for longer than six months have had documented intrauterine pregnancies; one woman subsequently developed a contralateral tubal pregnancy which was treated by laparoscopic salpingotomy. Tubal ectopic pregnancy, even in the presence of rupture, can be managed effectively by a variety of laparoscopic techniques with benefits including minimal incision, short hospitalization, early return to full activity, and in many cases, a patent tube.

Topics: Fallopian Tubes; Female; Hemostasis, Surgical; Humans; Laparoscopy; Methods; Pregnancy; Pregnancy, Tubal; Recurrence; Rupture, Spontaneous; Therapeutic Irrigation; Vasopressins

Topics: Embolization, Therapeutic; Esophageal and Gastric Varices; Female; Gastrointestinal Hemorrhage; Humans; Male; Rupture, Spontaneous; Vasopressins

Topics: Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Rupture, Spontaneous; Somatostatin; Vasopressins

Topics: Angiography; Female; Hemoperitoneum; Humans; Infusions, Intra-Arterial; Mesenteric Arteries; Middle Aged; Rupture, Spontaneous; Splenic Vein; Varicose Veins; Vasopressins

Topics: Adult; Female; Humans; Hyponatremia; Hypothalamo-Hypophyseal System; Intracranial Aneurysm; Male; Middle Aged; Rupture, Spontaneous; Subarachnoid Hemorrhage; Vasopressins; Water-Electrolyte Balance