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Prostaglandin E₂ inhibits lesion formation in dextran sodium sulphate-induced colitis in rats and reduces the levels of mucosal inflammatory cytokines

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SCANDINAVIAN JOURNAL OF IMMUNOLOGY 2000年第1期51卷 23-28页

作者： Sasaki, S Hirata, I Maemura, K Hamamoto, N Murano, M Toshina, K Katsu, K Osaka Med Coll Dept Internal Med 2 Takatsuki Osaka Japan

Effects of rectally injected prostaglandin E-2 (PGE(2)) in rats with dextran sodium sulphate (DSS)-induced colitis were investigated in terms of histopathology, local myeloperoxidase (MPO) activity, local mRNA expression of interleukin-1 beta (IL-1 beta), tumour necrosis factor-alpha (TNF-alpha) and growth-regulated gene produced/cytokine-induced neutrophil chemoattractant (GRO/CINC)-1, and secretion of TNF-alpha and GRO/CINC-1. In animals with no PGE(2) treatment, DSS-induced erosion and ulceration were particularly severe in the rectum and extended to the proximal colon. Neutrophil infiltration was characteristically present in the lesions and surrounding mucosa. MPO activity at lesion sites was increased. IL-1 beta and GRO/CINC-1 mRNA expression was increased, while TNF-alpha mRNA expression was significantly decreased. GRO/CINC-1 secretion was increased but a similar elevation of TNF-alpha was not detected. In the PGE(2)-treated group, lesion formation was inhibited grossly and microscopically. Neutrophil infiltration and MPO activity in and around lesions were lessened. The reduction in TNF-alpha mRNA expression and secretion was not affected by PGE(2). The expression of mRNA for IL-1 beta and GRO/CINC-1 was reduced, as was the secretion of GRO/CINC-1. As mRNA expression and secretion of cytokines in lesions of non-PGE(2)-treated animals was similar to that reported in human ulcerative colitis, rectal injection of PGE(2) may prove to be an effective therapy.

关键词：碱基序列趋化因子CXCL1 趋化因子 CXC 趋化因子类/遗传学趋化因子类/代谢结肠炎溃疡性/化学诱导结肠炎溃疡性/免疫学结肠炎溃疡性/预防和控制细胞因子类/遗传学细胞因子类/代谢 DNA引物/遗传学硫酸葡聚糖/毒性地诺前列酮/投药和剂量地诺前列酮/药理学基因表达/药物作用生长物质/遗传学生长物质/代谢炎症介导素类/代谢胞间信号肽类和蛋白质类白细胞介素1/遗传学肠黏膜/药物作用肠黏膜/免疫学肠黏膜/病理学过氧化物酶/代谢 RNA 信使/遗传学 RNA 信使/代谢大鼠 Sprague-Dawley 肿瘤坏死因子α/遗传学肿瘤坏死因子α/代谢动物人类男(雄)性大鼠

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Two dosing regimens for preinduction cervical priming with intravaginal dinoprostone pessary: a randomised clinical trial

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BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1999年第9期106卷 907-912页

作者： Tan, LK Tay, SK Singapore Gen Hosp Dept Obstet & Gynaecol Singapore 169608 Singapore

Objective To compare the efficacy within 24 hours of a three-times-a-day intensive dosing regimen with a standard once daily dosing regimen using dinoprostone vaginal pessary in preinduction cervical priming. Design Randomised controlled trial. Setting Department of Obstetrics and Gynaecology, Singapore General Hospital. Participants One hundred singleton term primigravidae with cephalic presentation with unfavourable cervical scores (Bishop score less than or equal to 5) requiring induction of labour. Methods Eligible women were randomly assigned the standard regimen (3000 mu g dinoprostone [Prostin, Upjohn, Crawley, UK] once daily) or an intensive regimen (3000 mu g dinoprostone given sequentially three times daily four hours apart) for cervical priming until successful priming (Bishop score of greater than or equal to 6) or the onset of active labour occurred. Main outcome measures Number of women whose cervices were ripened successfully or who entered active labour within 24 hours of starting cervical priming, priming to induction interval, and priming to delivery interval. Results Forty-nine women were assigned to the standard regimen and 51 to the intensive regimen. The median number (range) of dinoprostone pessaries used was two (one to seven) in the standard regimen and three (one to nine) in the intensive regimen. Forty-two women (82.4%) who underwent the intensive regimen achieved successful cervical ripening or active labour within 24 hours, compared with 21 assigned to standard regimen (OR 6.2, 95% CI 2.3-17.4). This difference was statistically significant. The median intervals from priming to induction, and from priming to delivery, were also statistically significantly shorter in women treated with the intensive regimen. Thirty-five women (68.63%) assigned the intensive regimen experienced pain, compared with 21 (42.86%) in the standard regimen (OR 2.92, 95% CI 1.19-7.21), with two and one women in the respective regimens requiring opiate analgesics.

关键词：投药阴道内宫颈成熟/药物作用接生产科地诺前列酮/投药和剂量胎儿监测孕龄引产/方法催产药/投药和剂量子宫托妊娠结局治疗结果成年人女(雌)性人类妊娠

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Randomized comparison of glyceryl trinitrate and prostaglandin E2 for cervical ripening at term

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OBSTETRICS AND GYNECOLOGY 2000年第4期96卷 549-553页

作者： Chanrachakul, B Herabutya, Y Punyavachira, P Mahidol Univ Ramathibodi Hosp Dept Obstet & Gynecol Div Obstet & GynecolDept Nursing Bangkok 10400 Thailand

Objective: To estimate the adverse effects of glyceryl trinitrate compared with prostaglandin (PG) E2 vaginal tablet for cervical ripening in term pregnancy. Methods: One hundred ten women with term pregnancies referred for induction of labor with Bishop scores of 6 or less were randomly assigned to receive a 500-mu g glyceryl trinitrate tablet vaginally (n = 54) or a 3-mg PGE2 tablet vaginally (n = 56), every 6 hours for maximum of two doses. Subjects were sent to the labor ward for amniotomy or oxytocin if their Bishop scores were more than 6 or their cervices were not ripe 24 hours after treatment. Adverse effects, changes in the Bishop scores, progress, and outcomes of labor were assessed. Results: Glyceryl trinitrate was associated with fewer episodes of uterine tachysystole (0% versus 9%;P = .02). The median Bishop score after 12 hours was lower in women given glyceryl trinitrate compared with those given PGE2. Adverse effects, including headache and palpitations, were more frequent with glyceryl trinitrate than with PGE2. The cesarean rate was not significantly different between groups. Conclusion: Cervical ripening with glyceryl trinitrate resulted in fewer episodes of tachysystole, but there were significantly more minor side effects. It can be used for cervical ripening at term, but it was not as effective as PGE2. (Obstet Gynecol 2000;96:549-53. (C) 2000 by The American College of Obstetricians and Gynecologists.).

关键词：宫颈成熟/药物作用剖宫产术地诺前列酮/投药和剂量地诺前列酮/副作用引产一氧化氮供体/投药和剂量一氧化氮供体/副作用硝酸甘油/投药和剂量硝酸甘油/副作用催产药/投药和剂量催产药/副作用成年人女(雌)性人类妊娠

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Oral misoprostol and intracervical dinoprostone for cervical ripening and labor induction: A randomized comparison

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OBSTETRICS AND GYNECOLOGY 2000年第3期96卷 465-469页

作者： Bartha, JL Comino-Delgado, R Garcia-Benasach, F Martinez-Del-Fresno, P Moreno-Corral, LJ Hosp Univ Puerto Real Dept Obstet & Gynecol Cadiz Spain

Objective: To compare efficacy, safety, and tolerance of oral misoprostol with intracervical dinoprostone for cervical ripening and labor induction. Methods: Two hundred women were randomized to receive single doses of oral misoprostol 200 mu g or 0.5 mg of dinoprostone intracervically every 6 hours for a maximum four doses. Results: The intervals from administration of the drug to active phase of labor (11.1 hours [7-24] versus 15.8 hours [7.5-29.62], P = .01), to delivery (14.0 hours [8.42-27.61] versus 20.2 hours [16.7-32.8], P = .01), and to rupture of membranes (10.0 hours [4.95-24.7] versus 15.6 hours [8.2-29.2], P = .003) were significantly shorter in the misoprostol group. All those variables were not distributed normally, so results are presented as median and interquartile range. The rates of women who needed oxytocin (68% versus 52%, P = .03) and cesarean for failed induction (9% versus 1%, P = .01) were higher in the dinoprostone group. Conclusion: A single dose of 200 mu g oral misoprostol was more effective for cervical ripening and labor induction than 0.5 mg of dinoprostone intracervically every 6 hours, with a maximum of four doses. (Obstet Gynecol 2000;96:465-9. (C) 2000 by The American College of Obstetricians and Gynecologists.).

关键词：投药阴道内投药口服子宫颈/药物作用地诺前列酮/投药和剂量地诺前列酮/副作用剂量效应关系药物用药计划表引产米索前列醇/投药和剂量米索前列醇/副作用催产药/投药和剂量催产药/副作用治疗结果成年人女(雌)性人类婴儿新生妊娠

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Safety of extraovular catheter insertion for second-trimester abortion

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OBSTETRICS AND GYNECOLOGY 2000年第4期96卷 529-532页

作者： Ben-Arie, A Hazan, Y Goldchmit, R Hagay, Z Hebrew Univ Jerusalem Kaplan Med Ctr Dept Obstet & Gynecol IL-76100 Rehovot Israel

Objective: To evaluate the efficacy and safety of second-trimester abortions using transcervical catheter insertion and extraovular prostaglandin (PG) administration. Methods: Ninety women admitted for terminations of pregnancy at 17-24 weeks' gestation had transcervical catheters inserted and extraovular PGE, administered. Success rates were recorded, measured by induction of abortion within 24 hours, need for a complement uterine curettage, and complications. Results: The technique induced abortion in 67 women (74.4%). The induction-to-abortion median interval was 12 hours (7 and 22 hours, fifth and 95th percentiles, respectively). Thirty-seven women needed uterine curettages because of incomplete abortions or excessive uterine bleeding after fetal and placenta expulsion. One woman had shivering, weakness, and nausea attributed to systemic absorption of PC, and nine women developed systemic inflammatory response syndrome associated with transcervical catheter insertion. Two of those women had septic shock, one of whom deteriorated to a life-threatening situation. Conclusion: Transcervical catheter insertion for extraovular PG administration is effective for inducing second-trimester abortions. Although the method is considered safe, with generally few mild, treatable complications, we observed a high rate of systemic inflammatory response syndrome, bacteremia, and sepsis caused by transcervical catheter insertion before PG administration. A reconsideration of this method's safety is warranted. (Obstet Gynecol 2000;96:529-32. (C) 2000 by The American College of Obstetricians and Gynecologists.).

关键词：流产人工/副作用流产人工/方法导管插入术/副作用导管插入术/方法地诺前列酮/投药和剂量地诺前列酮/副作用催产药/投药和剂量催产药/副作用妊娠中期全身炎症反应综合征/病因学青少年成年人女(雌)性人类中年人妊娠

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Membrane sweeping in conjunction with labor induction

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OBSTETRICS AND GYNECOLOGY 2000年第4期96卷 539-542页

作者： Foong, LC Vanaja, K Tan, G Chua, S Natl Univ Singapore Hosp Dept Obstet & Gynaecol Singapore 119074 Singapore

Objective: To determine whether cervical membrane sweeping (stripping) during induction of labor is beneficial. Methods: We compared outcomes of labor after induction in pregnant women at term in a randomized trial. Women were assigned to having their membranes swept or not during induction. Outcome measures included duration of labor, maximum dose of oxytocin used, induction-labor interval, and mode of delivery. Results: We recruited 130 nulliparas (64 sweep, 66 nonsweep) and 118 multiparas (60 sweep, 58 nonsweep). Among nulliparas who received intravaginal prostaglandin (PG) E-2 and oxytocin, those who had simultaneous sweeping had significantly shorter mean (+/- standard error of mean) induction-labor interval (13.6 +/- 1.4 Versus 17.3 +/- 1.2 hours, P = .048), lower mean maximum dose of oxytocin (6.8 +/- 0.8 versus 10.35 +/- 1.1 mU/minute, P = .01), and increased normal delivery rates (vaginal delivery 83.3% versus 58.2%, P = .01). Sweeping also had a favorable effect on nulliparas who received oxytocin alone (mean induction-labor interval 5.8 +/- 3.1 versus 11.2 +/- 3.6 hours, P = .04;mean maximum dose 8.8 +/- 1.3 versus 16.3 +/- 1.9 mU/min, P = .01). Those differences were limited to women with unfavorable cervices. There were no differences in any outcome measures in multiparous women. Conclusion: Sweeping of the membranes during induction of labor had a beneficial effect on labor and delivery, which appeared to be limited to nulliparas with unfavorable cervices who needed cervical priming with PGE,. (Obstet Gynecol 2000;96:539-42. (C) 2000 by The American College of Obstetricians and Gynecologists.).

关键词：地诺前列酮/投药和剂量胚外膜引产/方法催产药/投药和剂量产次物理刺激成年人女(雌)性人类妊娠

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Cervical ripening and labor induction with a controlled-release dinoprostone vaginal insert: A meta-analysis

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OBSTETRICS AND GYNECOLOGY 2000年第3期95卷 474-474页

作者： Mussalli, NG 39-28 54th Street Woodside NY USA 11377

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Cervical ripening and labor induction with a controlled-release dinoprostone vaginal insert

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OBSTETRICS AND GYNECOLOGY 2000年第4期95卷 637-638页

作者： Hughes, E McMaster Univ Dept Obstet & Gynecol Hamilton ON L8N 3Z5 Canada

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REPEATED INTRACERVICAL INSTILLATION OF PROSTAGLANDIN-E2 EFFICACY AND SAFETY

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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 1992年第5期167卷 1482-1482页

作者： FRUCHTER, O 29 Greenbaum Haifa Israel 34987

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