Clonidine prevents sevoflurane-induced agitation in children

In a double-blinded trial, 40 male children (age 2-7 yr) undergoing circumcision were randomly assigned to receive clonidine 2 microg/kg IV or placebo after anesthetic induction. For induction and maintenance of anesthesia, we used sevoflurane as the sole anesthetic. For pain treatment, a penile block was performed before surgery. After surgery the incidence and severity of agitation was measured during an observation period of 2 h. Severe agitation was treated with midazolam. In 16 placebo and 2 clonidine-treated patients agitation was observed (P < 0.001). In 6 patients of the Placebo group, agitation was graded as severe, whereas none of the patients in the Clonidine group developed severe agitation (P = 0.02). During the postoperative period heart rate and blood pressure were significantly decreased in clonidine treated patients (P < 0.05). We conclude that clonidine effectively prevents agitation after sevoflurane anesthesia. IMPLICATIONS: The recovery from sevoflurane anesthesia may be complicated by the presence of agitation in pediatric patients. Clonidine 2 microg/kg IV after anesthetic induction effectively reduces the incidence of agitation without resulting in clinically relevant bradycardia and hypotension.     

The characteristics of fractures in Polish adolescents aged 16–20 years

The aim of the study was to identify associations between fractures in childhood and family, anthropometric and lifestyle factors. Among 1,246 subjects aged 16.3–20.6 years (539 boys, 707 girls), based on a questionnaire, 869 were fracture-free while 377 (30.26%) had fractures. Of those reporting fractures, 146 reported multiple fractures (12% of studied population, 39% of all fractures). More boys had fractures than girls (35.6% vs 24.9%, p < 0.001). Fracture sites included: forearm (37%), fingers (23%) wrist (16%), ankle (14%), humerus (10%), tibia (8%) clavicle (7%) and femoral shaft / neck (3%). Among adolescents with multiple fractures, 52% also reported fractures in at least one family member, compared with 29% of those without a fracture history. Fractures in siblings and mothers (but not fathers) accounted for 44% of the liability in adolescents fractures. Subjects with multiple fractures reported more time at the computer than those without fractures and reported more time participating in team sports, and 18.6% avoided milk, whereas 12.4% of those without fractures reported milk-free diets. Using a logistic regression model, none of the lifestyle factors, except for computer use, were independently associated with fractures. Fractures, particularly multiple fractures, are common in childhood and adolescence. Familial clustering of fractures suggests shared genetic and environmental factors are responsible.     

Effectiveness of the B subunit of cholera toxin in potentiating immune responses to the recombinant hemagglutinin/adhesin domain of the gingipain Kgp from Porphyromonas gingivalis

The hemagglutinin/adhesin HArep domain is present in the gingipains HRgpA and Kgp and in the hemagglutinin HagA of Porphyromonas gingivalis and is felt to be important in the virulence of this bacterium. In the present study, we determined the immunogenicity of recombinant HArep from the gingipain Kgp (termed Kgp-rHArep) and the effectiveness of the B subunit of cholera toxin (CTB), compared to other adjuvants in potentiating a specific response to Kgp-rHArep following intranasal (i.n.) immunization of mice. Furthermore, we determined the effectiveness of anti-Kgp-rHArep antibodies in protection against P. gingivalis invasion of epithelial cells. Evidence is provided that Kgp-rHArep was effective in inducing immune responses following systemic or mucosal immunization. Kgp-rHArep induced both a Th1- and Th2-type response following i.n. immunization. Immunization of mice with Kgp-rHArep and CTB, either admixed or chemically conjugated to the antigen, via the i.n. route, resulted in a significant augmentation of the systemic and mucosal immune response to Kgp-rHArep, which was similar to or higher than the responses seen in mice immunized with antigen and the other adjuvants tested. CTB and the heat-labile toxin of Escherichia coli potentiated a Th1- and Th2-type response to Kgp-rHArep, whereas the adjuvant monophosphoryl lipid A preferentially promoted a Th1-type response to the antigen. Furthermore, anti-Kgp-rHArep antibodies were shown to protect against P. gingivalis invasion of epithelial cells in an in vitro system. These results demonstrate the effectiveness of certain mucosal adjuvants in potentiating and in altering the nature of the immune response to Kgp-rHArep following i.n. immunization, and provide evidence for the potential usefulness of Kgp-rHArep for the development of a vaccine against periodontal disease.     

Binding of cadmium on metallothionein in man: an analysis of a fatal poisoning by cadmium iodide

This study presents data on the organ distribution of cadmium, and Cd-protein complexes in the body of a man fatally poisoned with CdJ₂, after an oral dose of about 5 g.The levels of cadmium in different tissues were (in g per g fr. wt.): liver and kidney cortex about 80, kidney medulla, heart and testes 8.9–10.0, bile 1.9, brain 0.5 and blood 1.1.Almost all cadmium detected in the organism was bound to a low molecular weight protein, tentatively identified as metallothionein.Total amount of 18 mg cadmium was excreted in urine within 6 days of hospitalization, most likely due to Ca-EDTA treatment.The data are suggestive that cadmium induced biosynthesis of metallothionein in the subject.This paper was presented at the 2nd Symposium of Toxicology and Seminar of Pharmacology, Dvoák, September 18–19, 1970.     

PARTICIPATION OF PROSTANOIDS IN CHEMICAL ACTIVATION OF THE PERICARDIAL PRESSOR REFLEX IN DOGS

1. Experiments were performed on anaesthetized, open-chest dogs to determine the reflex effects on systemic blood pressure and heart rate produced by stimulation of the parietal pericardium with bradykinin, prostacyclin, prostaglandin E₂ (PGE₂), prostaglandin D₂ (PGD₂) and arachidonic acid. 2. Pericardial application of bradykinin (1 μg) consistently elicited reflex increases in blood pressure and heart rate, whereas application of prostanoids or arachidonic acid in doses up to 10 μg failed to produce any cardiovascular responses. 3. Indomethacin, applied either directly to the parietal pericardium (1 μg/ml) or given intravenously (5 mg/kg) caused a long lasting reduction of the reflex responses to bradykinin. The reflex effects of bradykinin could be temporarily restored by treatment of the pericardium with either prostacyclin (0.1 μg/min) or PGE₂ (0.1 μg/min). PGD₂ (0.1-1 μg/min) did not influence the bradykinin induced pericardial reflex. 4. Superfusion of arachidonic acid (3 μg/min) over the pericardium amplified the reflex effects of bradykinin when given before, but not when given after indomethacin treatment. 5. The results indicate that locally formed prostanoids, specifically prostacyclin and PGE₂, can facilitate activation of the pericardial pressor reflex by bradykinin. The findings may be relevant to the changes in cardiovascular activity occurring during pericardial inflammation.     

Analysis of micronuclei in blue mussels and fish from the Baltic and North Seas

Micronuclei (MN) were analyzed in erythrocytes of flounder (Platichthys flesus) and wrasse (Symphodus melops) and in gill cells of blue mussels (Mytilus edulis). The organisms were collected from three study stations in the Baltic Sea and from seven stations in the North Sea (Karmsund area, Norway) 4 times. The statistically significant differences obtained were related to the season, sex of the fish, and sampling locality. Higher MN frequencies were found in fish and mussels collected from the most polluted study stations in the North Sea. The same tendency could be described in the Baltic Sea; however, it was masked by the recent oil spill from the Butinge oil terminal. Our results showing higher MN frequencies in presumably what were the most polluted study locations suggest that MN tests in fish and mussels may be used for the detection of genotoxic effects in a marine environment. The endpoint is well characterized and can be easily recognized, and the technique is convenient to use in field samplings following standard procedures and protocols.     

SPECT imaging of cerebral arteriovenous angiomas. A preliminary report

BACKGROUND AND PURPOSE: The purpose of this study was to demonstrate scintigraphic evaluation of cerebral perfusion in patients with intracranial hemangiomas. MATERIAL AND METHOD: The examination was carried out in 12 patients aged from 12 to 67 years. In all the patients cerebral angiomas were previously diagnosed and all of them were qualified for intravascular embolization. Brain scintigraphy was performed after IV injection of 99mTcECD and included the dynamic phase with images obtained every 2 seconds for 1.5 minutes and SPECT imaging. The semiquantitative analysis of regional cerebral blood flow was based on the comparison between activity in two symmetrical regions of interest. Cerebral angiography combined with intravascular embolization followed the scintigraphic examination. RESULTS: Based on angiograms, the size of the nidus was estimated at 1.0 to 9.0 cm. In 8 patients the dynamic study showed an increased tracer accumulation in the region of angioma. On SPECT images the nidus was visualized as focally decreased perfusion in all cases. A decreased tracer accumulation in the area adjacent to the nidus was detected in 8 patients. The ratio of activity in the region of angioma to activity in normally perfused tissue calculated using the semiquantitative analysis was 52% to 89%. CONCLUSIONS: SPECT images and dynamic phase of cerebral perfusion scintigraphy allow perfusion changes caused by the presence of intracranial angiomas to be identified.