The present study was undertaken to compare the effectiveness of a new water-soluble benzodiazepine, midazolam, to diazepam, both administered im for protection against diethyl-p-nitrophenyl phosphate (paraoxon) toxicity. Adult male Sprague-Dawley rats were pretreated with midazolam or diazepam (0.32-32.0 mg/kg) alone or in combination with atropine (10.0 mg/kg). Twenty minutes later 2 X LD50 of paraoxon was injected sc and the incidence of seizures and death were recorded for 24 hr. In another series of experiments, the LD50 of paraoxon was evaluated in the rats pretreated im with atropine (10.0 mg/kg) and midazolam or diazepam (10.0 mg/kg). Pretreatment with atropine alone did not prevent paraoxon-induced seizures but did reduce mortality. Both benzodiazepines were very effective alone or when combined with atropine in reducing the incidence of paraoxon-induced seizures. When given alone, neither benzodiazepine protected against paraoxon-induced mortality. However, when combined with atropine both benzodiazepines dramatically decreased the lethality of 2 X LD50 of paraoxon. In equal doses given im, midazolam proved to be more potent than diazepam.

No abstract

No abstract

Persistent or recurrent hyperparathyroidism in patients with chronic renal failure may be a frustrating problem. We report a case history of a peritoneal dialysis patient who underwent total parathyroidectomy with autotransplantation for secondary hyperparathyroidism, developed tertiary hyperparathyroidism, and in an attempt to control hypercalcemia underwent seven partial resections of the autotransplant. Subsequently, a total excision of the parathyroid autograft was performed, but the patient continued to have hyperparathyroidism and unexpectedly was found to have a hyperplastic fifth parathyroid gland identified by thallium-technetium subtraction scan. The fifth gland was removed, and a part was implanted in the right forearm; however, the autoimplant had to be completely removed because of rapidly developing hypercalcemia. Hypercalcemia was controlled, but elevated levels of parathormone persisted. Remaining parathyroid tissue could not be found.

No abstract