Lidocaine 10% in the endotracheal tube cuff: blood concentrations, haemodynamic and clinical effects

The purpose of this study was to evaluate the effects (common haemodynamic variables, peak cuff pressures, the incidence of reaction ('bucking') during extubation and the incidence of sore throat after operation) of lidocaine 10% instilled into the endotracheal tube cuff in intubated patients. Plasma concentrations of lidocaine were assayed. Seventy ASA class I-II patients scheduled for plastic surgery were studied. Patients were randomly divided in two groups: the cuff of the endotracheal tube was inflated with either lidocaine 10% (group L) or with saline (group S) immediately after endotracheal intubation. In group L patients, the haemodynamic changes were less (P < 0.05), and the peak cuff pressure was lower (P < 0.01) than for group S. At extubation, more patients reacted ('bucked') in group S (70.5% vs. 19.4%, P < 0.01). The incidence and severity of sore throat were significantly lower in group L 1 and 24-h after extubation. Plasma lidocaine concentrations did not reach toxic values. Lidocaine 10%, compared with saline, in the endotracheal tube cuff was associated with less disturbance of haemodynamic responses and less incidence of bucking during tracheal extubation. Lidocaine was also effective in reducing of incidence and severity of sore throat after operation.     

Urogenital injuries in childhood: A strong association of bladder trauma to bowel injuries

We analysed the inter-relationships of the cause and the type of trauma, the presence of pelvic fracture, the associated intraabdominal organ injuries,and the morbidity and mortality rates in 154 patients presenting and being treated for UGT between 1983 and 1997.The cause of injury was blunt in 77% of cases and penetrating in 13%. The most frequently injured organs were kidney followed by urethra and bladder. Bowels, liver and spleen were the most frequently associated injured organs. Moreover, bladder injuries were strongly associated with bowel injuries (p < 0.0001). Hemodynamically normal 49 children with minor or major kidney injuries were managed conservatively. Hemodynamically non-stable 11 patients were explored.The majority of urogenital injuries can be managed conservatively evenwhen associated with intraabdominal organ injuries. Solid genitourinary organ injuries may accompany more frequently to intraperitoneal solidorgan injury. Whereas, non-solid genitourinary organ injuries may more frequently associated with injuries of intraperitoneal hollow viscus. This revised version was published online in August 2006 with corrections to the Cover Date.     

A new simply and effective fractionation method for cylindrospermopsin analyses.

A new simply and effective fractionation method for cylindrospermopsin (CYN) analyses was developed. The extract from cells of Cylindrospermopsis raciborskii was resuspended with 0.1 M carbonate buffer at pH 10.5, and pass through the double-cartridges column which was consisted of a styrene polymer cartridge and an anion exchange cartridge. CYN and deoxy-CYN were adsorbed with the anion exchange cartridge. After separation of the anion exchange cartridge, adsorbed compounds were eluted from the cartridge with 50% methanol containing 1% formic acid solution. CYN and deoxy-CYN were selectively condensed in the eluted solution. When CYN was analyzed by LC-photodiode array or LC/MS, only two peaks of CYN and deoxy-CYN were detected quantitatively. The results suggest that the fractionation method is a useful method for CYN analyses and must be utilized for CYN purification.     

Identification of RAD51–BRCA2 Inhibitors Using N-Acylhydrazone-Based Dynamic Combinatorial Chemistry

RAD51 is an ATP-dependent recombinase, recruited by BRCA2 to mediate DNA double-strand breaks repair through homologous recombination and represents an attractive cancer drug target. Herein, we applied for the first-time protein-templated dynamic combinatorial chemistry on RAD51 as a hit identification strategy. Upon design of N-acylhydrazone-based dynamic combinatorial libraries, RAD51 showed a clear templating effect, amplifying 19 N-acylhydrazones. Screening against the RAD51–BRCA2 protein–protein interaction via ELISA assay afforded 10 inhibitors in the micromolar range. Further ¹⁹F NMR experiments revealed that 7 could bind RAD51 and be displaced by BRC4, suggesting an interaction in the same binding pocket of BRCA2. These results proved not only that ptDCC could be successfully applied on full-length oligomeric RAD51, but also that it could address the need of alternative strategies toward the identification of small-molecule PPI inhibitors.     

Extracorporeal shock-wave lithotripsy for treatment of ureteral calculi in paediatric patients

Our objective was to determine the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of paediatric ureteral calculous disease. We reviewed the records of 41 (23 boys, 18 girls) paediatric patients admitted to our clinic for the treatment of ureteral calculi between between 1989-2001. Patients' age varied between 4-16 years. The majority of the patients, 38 (92.7%) cases were treated initially with ESWL whereas 3 (7.3%) cases were subjected to ureterolithotomy. The mean age of the patients was found as 12.8+/-3.86 (4-16) years. Most calculi were located at either upper or lower ureter. The mean stone burden was 45.16+/-30.65 mm2 and the mean shock wave number per session and power as 2826.72+/-605.18 and 17.69+/-1.11 kV respectively. Minor complications included skin ecchymosis at the site of entry of shock waves in all cases and renal colic that responded to analgesics and emetics in 3 (7.9%) patients. The overall stone-free rate after ESWL was found to be 81.6%. Two (5.3%) cases have residual fragments that escaped to lower calices after lithotripsy for upper ureteral calculi and are still followed. There were 5 (13.2%) failures who were treated with ureterolitotomy for 1 upper and 1 lower ureteral calculi and with ureteroscopy for the rest. It appears that ESWL is still a good option for the initial treatment of most ureteral calculi in children as it is less invasive than ureteroscopy and has a high success rate as a first-line therapy.     

Comment on “The effect of omalizumab on hematological and inflammatory parameters in patients with chronic spontaneous urticarial”: reply from authors

Abstract

We read Cosansu’s commentary entitled “Effectiveness of the new inflammatory parameters in patients with chronic spontaneous urticarial” to our study with great interest. The author remarked that a limited number of patients had C-reactive protein levels and it was not specified whether there were any other drugs used by the patients and no information was given about the severity of the disease in our study.     

Antibacterial activity of triclosan chitosan coated graft on hernia graft infection model

The use of mesh in hernia repair has become common, because of lower recurrence rate and simple application. Data from the meta-analysis and the multi-central studies support the use of meshes in hernia repair. One of the complications due to the hernia repair with mesh is the infection. The incidence range is between 1 and 10%. Triclosan embedded commercial absorbable suture materials are used to reduce surgical site infection rate. This study was planned on mesh infection model, because of the low incidence rate. The agent isolated from mesh infections was mostly Staphylococcus aureus and thus it was used as the infecting agent in this research. To achieve a better therapeutic efficacy, triclosan was formulated in chitosan gels. Chitosan is an attractive biopolymer because of its biocompatible, biodegradable, bioadhesive properties. Gel formulations using chitosans (low, medium and high molecular weight) were prepared in 1% (v/v) acetic acid solution and in vitro release profiles were evaluated. Gel formulations showed release profile extended up to 7 days and high molecular weight chitosan gel formulation was released higher quantity drug than other formulations. Meshes coated with triclosan loaded chitosan gel were used to reduce bacterial count and to prevent mesh infection in the study. 24 h and simultaneous bacteria inoculation was used to model mesh infection. The rats were observed for 8 days by means of surgical site infection. On the eighth day, the animals were sacrificed and the grafts were removed. Tissue squeezers were used to liberate bacterias from removed grafts. The isolated suspensions were cultured on blood agar plates and colony-forming units were counted overnight. Grafts coated with triclosan loaded chitosan gel presented satisfactory preventive effect against graft infection.