Effects of mebudipine and dibudipine, two new calcium channel blockers on voltage-activated calcium currents of PC12 cells

Mebudipine and dibudipine are two newly synthesized dihydropyridine (DHP) calcium channel blockers that have been shown to have considerable relaxant effects on vascular and atrial smooth muscle. The in vitro half-lives of mebudipine and dibudipine are reported to be significantly longer than that of nifedipine. In this study, we investigated the effects of mebudipine and dibudipine on voltage-activated Ca2+ channels on differentiated PC12 cells and compared their potencies to amlodipine. Our results point to absence of voltage-activated Ca2+ currents in undifferentiated PC12 cells. It is also concluded that mebudipine and dibudipine, like amlodipine are L-type calcium channel blockers. When tested in a range of 10-100 μM, mebudipine is at least as potent as amlodipine in inhibition of peak Ba2+ currents in differentiated PC12 cells while dibudipine is significantly less potent compared to amlodipine and mebudipine. © 2007 Akadémiai Kiadó, Budapest

Evaluation of onlay island flap technique in shallow urethral plate hypospadiasis

Background: Hypospadias is one of the most common congenital genital anomalies in males that necessitates to be operated early in infancy (when 6 to 9 months old). On the other hand, hypospadias is a challenging field of pediatric urology with multiple reconstruction techniques. A perfect hypospadias repair is supposed to return urethral continuity with sufficient caliber, eradicate phallus curvature, and supply an acceptable appearance with low complications. Objectives: This study aimed to evaluate the outcomes of using onlay island flap technique in the repair of hypospadias with shallow urethral plate. Patients and Methods: In this prospective study within June 2012 to December 2013, we performed onlay island flap procedure to repair hypospadias with shallow urethral plate measuring less than 6 millimeter. This technique was selected for all types of hypospadiasis except subcoronal type. Nesbit�s dorsal plication procedure was established for chordee. In cases with very small glans, urethroplasty was performed without glansplasty. Results: Twenty three patients with mean age of 30 (range 10 -60) months underwent onlay island flap repair; all had a shallow urethral plate < 6 mm, 3 had a very small glans, and 18 had chordee. Meatus was located in distal shaft in 5 cases, mid shaft in 8, proximal in 6 and penoscrotal type in 4 patients. Chordee was corrected with Nesbit�s dorsal plication in 16 cases. Complications were: meatal stenosis in 2 cases and urethrocutaneous fistula in 2 patients, all of which were repaired surgically. Mean follow up time was 13 (3 -20) months. All cases that had glansplasty have excellent esthetic appearance. Conclusions: This technique offers acceptable results regarding meatal stenosis, urethrocutaneous fistula and esthetic outcome. © 2016, Growth & Development Research Center

LONG TERM FOLLOW-UP OF KASAI OPERATION FOR BILIARY ATRESIA: A SINGLE CENTER EXPERIENCE

Children who are operated for biliary atresia by the Kasai procedure have approximately 30% chance of survival for 5 years. In an attempt to define the role of this operation for biliary atresia, the surgery records of the past 15 years were reviewed. The aim of this study was to assess the benefits achieved from this operation in infants with biliary atresia. This study was conducted in the department of pediatric surgery Taleghanei Medical Center from 1986 to 2000. A total of 36 cases, 15 boys and 21 girls were reviewed retrospectively. All the operations were performed uniformly by Kasai procedure by three investigators. Data regarding patient history, clinical presentation, laboratory and radiological features, operative finding, complication and mortality were collected and retrospectively studied. In these series 36 cases were classified as three groups. Group A, represented the successful category after the Kasai operation (11 patients, 30.5%) characterized by survival of more than 3 years and no jaundice. Group B (2 patients, 5.5%) was defined as survival of more than 3 years, but with jaundice, and group C (23 patients 63.8%) was defined by survival of less than 3 years (this group was further divided to subgroups). It seems that jaundice is the main prognostic factor after operation

Assessment of the analgesic effects of extrapleural infusion of ropivacaine in neonates with esophageal atresia (EA) repair

Insufficient control of post-thoracotomy pain can produce breathing dysfunction and long term staying in neonatal intensive care unit (NICU). It can increase the incidence of pulmonary complications such as atelectasis, pneumonia and respiratory failure. The aim of this study was to determine the analgesic effect of continuous extrapleural nerve block, using ropivacaine, in neonates younger than 7 days old with esophageal atersia (EA) and the incidence of atelectasis and duration of hospitalization in NICU. For this purpose, from February 2007 till January 2009 in Mofid children's hospital, 68 neonates under 7 days old whom were candidate for thoracotomy due to esophageal atresia were, randomly divided into two groups in a controlled clinical trial. The cases received extrapleural infusion of ropivacaine 0.5 (0.1 mL/kg/h for 48 h) and controls received acetaminophen 20 mg/kg three times a day via the rectal route. Hemodynamically unstable patients and those who suffered from hospital infections were excluded from the study. After the surgery, all patients had spontaneous breathing without endotracheal tube and stable hemodynamic in NICU. Pain level was determined for each neonate, based on the neonatal infant pain scale (NIPS) grading. The incidence of atelectasis in the first 48 h after operation and throughout the NICU staying were also determined. Results showed that there were no significant difference in the mean age, sex proportions and mean weight between the two groups. The mean pain score in the group received ropivacaine (1.9 ± 0.7) was significantly less than the control group (5.2 ± 0.6) (p < 0.001). Five percent of cases (n = 1) and 100 of the control group (n=20) had pain scores equal or greater than 3 (p < 0.001). The incidence of atelectasis among cases was less than the control group (35 vs. 65 respectively; p = 0.58). Duration of hospitalization in the case group (12 ± 5.6 days) had no significant difference from the control group (13.6 ± 4.8 days) (p = 0.3) In conclusion, the results showed that continuous extrapleural infusion of ropivacaine reduces the pain noticeably and atelectasis relatively, after thoracotomy in neonates younger than 7 days suffering from EA, compared to the acetaminophen group. © 2010 by School of Pharmacy

Effects of mebudipine and dibudipine, two new calcium channel blockers on voltage-activated calcium currents of PC12 cells

Mebudipine and dibudipine are two newly synthesized dihydropyridine (DHP) calcium channel blockers that have been shown to have considerable relaxant effects on vascular and atrial smooth muscle. The in vitro half-lives of mebudipine and dibudipine are reported to be significantly longer than that of nifedipine. In this study, we investigated the effects of mebudipine and dibudipine on voltage-activated Ca2+ channels on differentiated PC12 cells and compared their potencies to amlodipine. Our results point to absence of voltage-activated Ca2+ currents in undifferentiated PC12 cells. It is also concluded that mebudipine and dibudipine, like amlodipine are L-type calcium channel blockers. When tested in a range of 10–100 μM, mebudipine is at least as potent as amlodipine in inhibition of peak Ba2+ currents in differentiated PC12 cells while dibudipine is significantly less potent compared to amlodipine and mebudipine

Complications of Transanal One-stage Endorectal Pull-through Procedure in Infants with Hirschsprung's Disease

Introduction: Hirschsprung's disease(HD) is a common congenital disease. In 80% of cases, the recto sigmoid junction is involved. Recently, one-stage transanal endorectal pull-through(TAEPT) procedure has been popular, but it could have several complications. In this research, we have studied the complications of this procedure. Methods: During a four year period, 86 infants clinically suspected to have HD were admitted at our center. HD was confirmed by rectal biopsy and all were candidates for TAEPT operation. A Swenson-like procedure was performed and in 30 cases, prophylactic Hegar dilatation was done 2 weeks after operation. Results: Anal stricture was seen in 12 cases(14%) of which 10 cases were treated by anal dilation and 2 cases were corrected by surgical management. Entrocolitis was seen in 4 cases(5%) who were treated by medical management. In 2 cases, retrocolic abscess was present that was treated by spontaneous drainage via tube drain. There was no anastomotic stricture after starting prophylactic anal bouginage. Conclusion: TAEPT has many advantages and few complications. It seems that one of the most common complications is anastomotic stricture that responds well to prophylactic bouginage. We recommend prophylactic anal bouginage with Hegar probe 2 weeks after operation. A long-term follow-up is needed to evaluate the outcomes of these operations