OPTIMAL DOSE OF LIGNOCAINE FOR PREVENTING PAIN ON INJECTION OF PROPOFOL

The purpose of this study was to define the optimum dose oflignocaine required to reduce pain on injection of propofol.We conducted a prospective, randomized, double-blind trial on310 patients undergoing anaesthesia. Patients were allocatedto four groups according to the lignocaine dosage: group A (control),no lignocaine; group B, lignocaine 0.1 mg kg^–1; groupC, lignocaine 0.2mgkg^–1; group D, lignocaine 0.4mg kg^–1.Our results showed that a dose of lignocaine 0.1 mg kg^–1significantly reduced the incidence of pain and that there wasno improvement when the dose was increased.     

Central Nervous System Involvement in Burkitt's Lymphoma

Thirty-five of 77 patients (46%) withBurkitt’s lymphoma presented or developed evidence of central nervous system involvement by tumor. Neurologic abnormalities included paraplegia, cranial neuropathy, altered levels ofconsciousness and malignant pleocytosis.An analysis of this series disclosed thefollowing: Paraplegia is a common presenting feature of Burkitt’s lymphomaand is responsive to systemic chemotherapy. The association of cranial neuropathy and malignant pleocytosis withfacial tumors points to direct tumor extension to intracranial structures (duraarachnoid) as the pathogenesis of theselesions. Intrathecal chemotherapy temporarily reverses malignant pleocytosisbut systemic chemotherapy is requiredto treat cranial neuropathy. A poor prognosis follows presentation or developmentof malignant pleocytosis. The limitationsof the current forms of therapy for CNSinvolvement are discussed.

Submitted on April 20, 1970 Revised on June 9, 1970 Accepted on June 10, 1970     

A social enquiry with leukaemic patients

Summary. A study of 15 patients who were being treated for leukaemia is described. A psychosocial enquiry into problems encountered by them included an investigation into how they coped with their disease and treatment, and their response to the hospital and medical staff. The issues discussed indicate the areas where a social worker might contribute to the care of the families concerned, and the sources of the distress which clinicians are likely to observe.     

Chronic Toxicity Studies of 5-(2-Pyrazinyl)-4-methyl-l,2-dithiole-3-thione, a Potential Chemopreventive Agent

The synthetic compound Oltipraz, 5-(2-pyraziny1)-4-methyl-1,2-dithiole-3-thione, is related to the 1,2-dithiolthiones naturallyfound in cruciferous vegetables, the consumption of which hasbeen epidemiologically associated with reduced frequency ofcolorectal cancers. Oltipraz has shown chemopreventive efficacyin numerous laboratory epithelial cancer models and is a potentialchemopreventive, antimutagenic compound that specifically inducesPhase II enzymes. Thirteen-week and 1-year toxicity studiesin rats and dogs were performed to characterize the toxicitiesof the compound at high dosages and to support potential furtherdevelopment as a chemopreventive agent in clinical trials. Administrationto rats by gavage for 13 weeks at dosages of 5 and 50 mg/kg/dayand for 52 weeks at dosages of 10, 30, and 60 mg/kg/ day producedeffects on the liver and on clinical chemistry and hematologyparameters. Absolute and relative liver weight increases correlatedwith diffuse hypertrophy in the mid- and highdose males andcentrilobular hypertrophy in the high-dose females. Granularityof hepatocyte cytoplasm was also observed. These anatomicalfindings were associated with dose-associated slight increasesin albumin, total protein, and cholesterol in the males anda moderate increase in cholesterol only in the females. In addition,slight decreases in erythrocyte count, hemoglobin, and hematocritand reticulocyte elevations occurred. The no effect dose wasconsidered 10 mg/kg/day. Administration by capsule to dogs atdosages of 10 and 100 mg/kg/day for 13 weeks and of 5, 15, and60 mg/kg/day for 52 weeks also produced effects on the sameendpoints noted in the rodent studies. In the 13-week study,precipitate was observed in the bile canaliculi, and gonadalatrophy and increased pituitary weights occurred in the males.Cholesterol and alkaline phosphatase activity were slightlyelevated in both studies. Decreased hematology parameters inthe 13-week study also occurred. The no effect dose was consideredto be 5 mg/kg/ day. Oltipraz is being carefully evaluated inclinical trials as a potential antimutagenic compound.     

Human blood dendritic cells: binding to vascular endothelium and expression of adhesion molecules

To investigate the binding properties of dendritic cells (DC) to vascular endothelium, a comparative analysis was undertaken of DC, monocytes and lymphocytes isolated from the blood of 25 healthy subjects using monolayers of human umbilical vein endothelial cells as the adherence substrate. More blood DC (mean 24% adherence) were adherent to endothelial monolayers than monocytes (mean 18%; P < 0.001) and lymphocytes (mean 12%; P < 0.001). When the monolayers were pretreated with tumour necrosis factor-alpha (TNF-α) all leucocyte populations exhibited an increased attachment, but there was still greater binding of DC (mean 37% adherence) in comparison with monocytes (mean 23%; P < 0.001) and lymphocytes (mean 18%; P < 0.001). Flow cytometric analysis revealed that in relation to monocytes and lymphocytes the DC had a higher surface expression of the adhesion molecules CD11a (P < 0.05), CD11c (P < 0.05) and CD54 (P < 0.05) but a lower prevalence of cells bearing CD49d (mean 38%; P < 0.05) and the homing receptor CD62L (mean 14%; P < 0.001). CD1a was present on 22% of DC and virtually absent from the surface of monocytes and lymphocytes. The intensity of expression of the β₁-integrins, CD49c, CD49d and CD49e was greater on DC than lymphocytes and monocytes (P < 0.05). Antibody blocking studies demonstrated that DC binding to untreated and TNF-α-treated endothelium was dependent upon the expression of CD11a, CD18 and CD49d, and the simultaneous application of anti-CD18 and anti-CD49d antibodies produced an approximate 70% inhibition of adhesion (P < 0.001). Thus, the expression of both β₁- and β₂-integrins contributes to the adhesive interaction between DC and endothelium.     

Mixture analysis of smooth pursuit eye movements in schizophrenia

The goal of this study was to replicate and extend previous findings indicating that the eye movement data of schizophrenic patients is best represented by the mixture of two groups, one of which has distinctly poor performance. Forty-nine schizophrenic patients and 32 normal controls had their smooth pursuit eye movements quantified by calculating the root mean square (RMS) deviation between the target and eye waveforms. Based on the finding of mixture in the distribution of RMS error, the patients were divided in to low (better tracking) and high (worse tracking) RMS error subgroups. The high RMS error patient had abnormally decreased gain. Both patient subgroups had abnormally increased frequency of catch-up saccades and increased phase lag. Distinguishing between these two subgroups may be useful in clarifying the pathophysiology of abnormal pursuit and its relationship to heterogeneity in schizophrenia.     

Dental attendance in preschool children – a prospective study

International Journal of Paediatric Dentistry 2013; 23: 84–93 Background. At present, our understanding of the use of dental care services is incomplete, certainly where preschool children are concerned. Objectives. To investigate what proportion of 3‐ and 5‐year‐olds living in Flanders (Belgium) have already visited the dentist, to describe parents’ experience about their child’s dental visit, and to explore factors that may have an impact on children’s early dental visit. Design. Data were collected from 1057 children; validated questionnaires were completed, and children were examined by trained dentist at ages 3 and 5. Logistic regression analyses were performed to explain dental attendance. Results. At the age of 3, 62% and by 5 years, 21% had never visited the dentist. The first dental visit was considered a pleasant experience for the majority of children. Multivariable regression analyses revealed that children who were not first born, whose mothers had a higher educational level and whose parents had recently visited the dentist, had significantly higher odds for having visited the dentist at young age. Conclusions. Parents of young children need to be informed about and motivated for an early dental visit. Promotion campaigns should focus on firstborn children, children from less educated parents, and parents who do not regularly see a dentist.