Nasotracheal intubation using fiberoptic bronchoscopy in infants and children

Journal of Anesthesia -     

Stoichiometric salt-linkage formation of trimethylammonium glycol chitosan iodide with a carboxylic type ion exchanger

The adsorption of trimethylammonium glycol chitosan iodide (TGCI) on Dowex CCR-2 resin was investigated at different pH values and resin weights. The concentration of Na⁺ or Ca²⁺ ions, released by the ion exchange reaction with TGCI, was measured by inductively coupled plasma spectroscopy. It was found that the amount of the released ions is comparable to that of the absorbed TGCI. This indicates that the salt-linkage formation of carboxylate ions of the exchanger with ⊕N(CH₃)₃-groups in TGCI follows a stoichiometric relationship. This result is discussed in connection with the form of the polymer layer adsorbed on the solid surface.     

Resorption of subretinal fluid by transepithelial flow of the retinal pigment epithelium

The efficiency of flow through the retinal pigment epithelium (RPE) was calculated by studying the postoperative course of the subretinal fluid after nondrainage surgery of rhegmatogenous retinal detachment. In ten eyes of ten patients the preoperative volume of the subretinal fluid, area of the RPE participating in resorption of the fluid, elapsed time until resorption of the fluid, and efficiency of the flow were studied using B-scan ultrasonography. The flow through the RPE was 261 l/cm² per day and could drain more than 50% of the vitreous volume to the choroidal circulation. These data coincide well with early reattachment of neural retina in nondrainage surgery. No statistically significant difference in this flow was seen between young and old patients.     

Analysis of orthograde fast axonal transport and nonaxonal transport along the optic pathway of albino rabbits during increased and decreased intraocular pressure

Orthograde fast axonal and nonaxonal transport through the optic disc was studied quantitatively and autoradiographically in albino rabbits during elevated (30 or 50 mmHg), normal (13–15 mmHg) and decreased (0–4 mmHg) intraocular pressure (IOP). In cases of intraocular hypertension up to 50 mmHg, autoradiographic findings of a disturbed orthograde fast axonal transport were seen in the optic disc within 3 hr. The blockage was relatively mild and uniform, and was distributed adjacent to the extension line of sclera. Despite this histological evidence of blockage, a quantitative analysis showed no statistically significant decrease in axonally transferred radioactivity within 3 hr. Decrease in the transferred material was evident at 6 hr, and the extent of decrease was mild (ca. 20% at the most prominent portion). In cases of moderate intraocular hypertension (30 mmHg) for 6 hr, a quantitative analysis showed no decrease in axonal transport. After 3–6 hr of intraocular hypotension (0–4 mmHg), papilledema did not develop and autoradiographically there was no accumulatjon of axonal components. Axonally transferred material remained quantitatively at the same level as in the control animals. Nonaxonal transport along the optic nerve was doubly enhanced in cases of intraocular hypertension up to 50 mmHg, and was reduced to one thrid at level of 0–4 mmHg. Filtration of intraocular fluid through the optic disc appears to be the largest component of the nonoxonal transport.     

Axoplasmic transport blockage therapy in herpes zoster ophthalmicus

Three patients with herpes zoster ophthalmicus were treated with an oral administration of colchicine and corticosteroid, while another seven were given systemic corticosteroid, vitamins, and sedatives. Colchicine inhibited the formation of new skin lesions but did not suppress the already grown vesicles. The effect of colchicine was attributed to a blockage of intra-axonal dissemination by neurotrophic virus.     

Inhibition of hemorrhagic and edematogenic activities of snake venoms by a broad-spectrum protease inhibitor, murinoglobulin; the effect on venoms from five different genera in Viperidae family.

In order to obtain basic data on the effect of broad-spectrum protease inhibitor against local symptoms of Viperidae snake envenomation, inhibitory capacity of rat murinoglobulin on local hemorrhagic and edematogenic activities of venoms from Crotalus atrox, Bothrops jararaca, Lachesis muta muta, Trimeresurus flavoviridis and Echis carinatus sochureki were examined. Murinoglobulin, pre-incubated with the crude venoms at 37 degrees C for 15 min, inhibited hemorrhagic activity of all five venoms to various extents. The activity of C. atrox was almost completely inhibited at the murinoglobulin/venom ratio (w/w) of 20. The activity of B. jararaca, Lachesis muta muta and T. flavoviridis venoms was considerably inhibited at the ratio of 20 (77.2, 80.0 and 86.2% inhibition, respectively), however some of the activity still remained even at the ratio of 40 (84.2, 79.8 and 86.2% inhibition, respectively). Among the five venoms, E. c. sochureki venom is quite resistant to murinoglobulin treatment and statistically significant inhibition was only found at the ratio of 40 (64.1% inhibition). Fibrinolytic and gelatinase activities were more susceptible to murinoglobulin inhibition. The treatment at the ratios of 10 and 20 almost completely inhibited respectively the fibrinolytic and the gelatinase activities of all the venoms. Murinoglobulin treatment also significantly inhibited the edematogenic activity of L. muta muta, T. flavoviridis and Echis carinatus sochureki. The treatment of murinoglobulin at the ratio of 40 considerably suppressed the swelling up to 60 min after subcutaneous injection of L. muta muta and E. c. sochureki venoms, and up to 30 min after T. flavoviridis venom injection. Murinoglobulin is a potent inhibitor against local effects of multiple snake venoms in Viperidae family.     

Retrospective analysis of clonality and detection of residual disease in myeloid leukemia by FISH on long-term stored bone marrow smears

Abstract Background. Fluorescence in situ hybridization (FISH) has allowed the detection of numerical chromosomal aberrations in interphase nuclei on fresh or frozen smears of leukemia.
Methods. To analyze clonality and residual disease in myeloid leukemia retrospectively, we applied FISH to bone marrow smears stored at ambient temperature for up to 9 years.
Results: When hybridization efficiency was investigated on stored control smears from patients without hematological malignancy, more than 96% of nuclei showed the expected number of signals using DNA probes specific for chromosome 7, X or Y. In combination with cell morphology, we observed much higher hybridization efficiency in blasts and granulomonocytic cells compared with lymphoid and erythroid cells. On the basis of good hybridization efficiency for old smear specimens, we applied FISH to stored bone marrow smears of myeloid leukemias, in which either loss of chromosome 7 or loss of sex chromosomes had been verified previously by conventional cytogenetics (one patient with chronic myelomonocytic leukemia (CMML) and four with acute myeloid leukemia (AML; three M2 and one M7)). As a result, the loss of chromosome was detected in blasts from all patients and was observed in mature granulocytes, except in M7. In the CMML patient and one AML (M2) patient with t(8;21), lymphoid and erythroid cells also showed the loss of chromosomes, suggesting that it should occur at stem-cell level. A high amount of residual disease was detected in the morphological remission samples in one AML (M2) patient after induction therapy. The patient eventually succumbed to relapse.
Conclusion Thus, the present FISH technique is useful to analyze the clinical significance of clonality and the residual disease in myeloid leukemia, retrospectively.     

Bucolome, a potent binding inhibitor for furosemide, alters the pharmacokinetics and diuretic effect of furosemide: potential for use of bucolome to restore diuretic response in nephrotic syndrome.

To determine whether bucolome (5-n-butyl-1-cyclohexyl-2,4,6-trioxoperhydropyrimidine), a nonsteroidal anti-inflammatory agent, can reverse diuretic resistance of furosemide in patients with nephrotic syndrome, we examined the inhibitory effect of bucolome on the protein binding of furosemide in serum and urine. Bucolome significantly inhibited the protein binding of furosemide not only in serum but also in urine of preparation albumin (UPA), which mimics urinary albumin concentration in patients with nephrotic syndrome by ultrafiltration method. The binding percentage of furosemide to albumin was approximately 70% in UPA. With coadministration of bucolome to healthy volunteers, renal clearance of furosemide was increased, reflecting the increase of the free fraction of furosemide in serum. Furthermore, coadministration of bucolome caused a significant increase of urine volume and sodium concentration in urine. Even at higher urine levels of furosemide, the inhibitory effect of bucolome on the protein binding of furosemide in UPA remains constant, and changes in pH at weakly acidic pH levels (pH 5.5-6.5) did not alter the inhibitory effect of bucolome. Interestingly, coadministration of bucolome with furosemide in doxorubicin (Adriamycin)-induced nephrotic syndrome model rats alleviated the diuretic resistance. These results suggest that bucolome has a potent inhibitory effect on the protein binding of furosemide in the urine and can partially restore the diuretic response of furosemide in patients with nephrotic syndrome by increasing the free fraction of furosemide at the site of action.     

Evaluation of beam hardening and photon scatter by brass compensator for IMRT

When a brass compensator is set in a treatment beam, beam hardening may take place. This variation of the energy spectrum may affect the accuracy of dose calculation by a treatment planning system and the results of dose measurement of brass compensator intensity modulated radiation therapy (IMRT). In addition, when X-rays pass the compensator, scattered photons are generated within the compensator. Scattered photons may affect the monitor unit (MU) calculation. In this study, to evaluate the variation of dose distribution by the compensator, dose distribution was measured and energy spectrum was simulated using the Monte Carlo method. To investigate the influence of beam hardening for dose measurement using an ionization chamber, the beam quality correction factor was determined. Moreover, to clarify the effect of scattered photons generated within the compensator for the MU calculation, the head scatter factor was measured and energy spectrum analyses were performed. As a result, when X-rays passed the brass compensator, beam hardening occurred and dose distribution was varied. The variation of dose distribution and energy spectrum was larger with decreasing field size. This means that energy spectrum should be reproduced correctly to obtain high accuracy of dose calculation for the compensator IMRT. On the other hand, the influence of beam hardening on k_Q was insignificant. Furthermore, scattered photons were generated within the compensator, and scattered photons affect the head scatter factor. These results show that scattered photons must be taken into account for MU calculation for brass compensator IMRT.