Haemolysis after etomidate: comparison of propylene glycol and lipid formulations

We sought to determine if the solvent in the formulation of etomidate is responsible for haemolysis in patients. In a randomized, prospective, double-blind study of 49 patients undergoing otolaryngological surgery, patients received etomidate dissolved in propylene glycol or in lipid emulsion. Concentrations of free haemoglobin and haptoglobin were measured before and for up to 360 min after injection of etomidate. Free haemoglobin concentrations increased by 216.8 mg litre-1 in patients who received the propylene glycol formulation and by 11.8 mg litre-1 in the lipid emulsion group (P < or = 0.0004). Correspondingly, reductions in haptoglobin concentrations were significantly greater in the propylene glycol group (P < or = 0.002). We conclude that with respect to haemolysis, lipid emulsion is superior to propylene glycol as a solvent for etomidate.      

Unusual complication of temporary pacing wires in children.

There have been numerous complications described concerning temporary epicardial pacing wires including infection, bleeding, and coronary artery graft disruption. We report a case in which the heart was ensnared by the pacing wire, resulting in cardiac decompensation during attempted removal. This complication may be avoided by assuring that a smaller loop of pacing wire remains in the pericardium.     

The immunomodulatory effects of a novel agent, leflunomide, in rat cardiac allotransplantation

Abstract We assessed the immunomodulatory effect of leflunomide (LEF) in a heterotopic abdominal model of rat heart transplantation using a major histocom-patibility mismatch (DA X LEW). The endpoint of this study was cardiac rejection assessed by abdominal palpation of the ventricular impulse and confirmed by laparotomy and histology. In this study, LF was investigated using four dosages (5, 10, 20 and 30 mg/kg per day orally) against cyclosporine (CsA) (15 mg/kg per day orally) and FK506 (1 mg/kg per day orally). The ability of LEF to prevent rejection and reverse ongoing acute rejection was assessed. The results showed that untreated hearts were fully rejected by day 5 and that LEF at 5 mg/kg was significantly better than any other dose tested, was superior to FK 1 mg/kg, and was as effective as CsA 15 mg/kg in preventing rejection after a short course of treatment. After a longer course, 10 and 20 mg/kg LEF proved more effective than 5 mg/kg in controlling rejection and as efficacious as 1 mg/kg FK and 15 mg/kg CsA. In the control of ongoing established early rejection. LEF proved to be equally effective, even at lower doses (5 mg/kg), to CsA 15 mg/kg and FK 1 mg/kg. In the control of ongoing established late rejection, 20 mg/kg LEF proved to be superior to 10 mg/kg LEF and 15 mg/kg CsA, and was as effective as FK 1 mg/kg. However, when higher doses of CsA (25 mg/kg) and FK (2 mg/kg) were tested against 20 mg/kg LEF in this mode of rescue, LEF proved as effective as CsA and superior to FK. In the assessment of drug toxicity using body weight as a parameter, 20 mg/kg LEF proved safer than any other LEF dose tested, and safer than 15 mg/kg CsA and 1 mg/kg FK in both short- and long term administration. We conclude that LEF is a relatively safe and potent immunosuppressant with promising clinical potential.     

A combined surgical and orthodontic treatment of class III furcations

Abstract Oral hygiene in furcation defects of upper molars is difficult to achieve. In this case report, a combined surgical and orthodontic treatment procedure is presented to facilitate access and plaque control in furcation areas of upper molars with class-III furcation defects. After endodontic treatment and root resection in an upper 1st molar, the remaining mesiobuccal and palatal roots were separated and aligned orthodontically within the dental arch, as one-rooted teeth. The new morphological position of the roots greatly facilitated oral hygiene and may offer a better long-term prognosis.     

The human lck cDNA clone YT16 is a transforming oncogene.

The lck gene belongs to the src gene family and it is implicated in processes of lymphomagenesis. A full-:length lck-encoding cDNA clone, termed YT16 was isolated from a subtractive cDNA library, which was specific for expressed genes of the human Jurkat T-cell lymphoma. Sequence analysis of this molecular clone revealed major structural alterations compared to other tyrosine kinases classified as src-related genes. Firstly, a region within thw YT16 sequence surrounding the conserved ATP-binding site was modified by several short frameshift mutations. Secondly, the regulatory important tyrosine-505 residue was substituted by a threonine at this aligned position. The latter mutation was expected to result in a constitutional hypophosphorylated and thus permanently activated protein tyrosine kinase. These significant genetic alterations within the coding region of YT16 prompted us to investigate its biological relevance in vivo. To this end, we expressed YT16-specific sequences in NIH 3T3 fibroblasts and looked for morphological transformation of transfected cells. Here we report, that transformation of NIH 3T3 cells is obtained, provided that inhibitory untranslated sequences are removed from the YT16 cDNA clone. These results lend support to the notion, that structurally altered lck genes, in this study represented by the YT16 clone, may contribute to neoplastic processes in lymphoid cells.