Use of long catheters for multipatient anesthetic monitoring at high respiratory frequencies

Anesthetic gases from several patients can be monitored simultaneously with a centrally located mass spectrometer. Such monitoring requires catheters from patient to spectrometer that are several meters long. Scamman (J Clin Monit 1988;4:227–229) found that when the respiratory frequency is high, as with infants, the CO₂ signal from the patient is unacceptably distorted during passage down the catheter. This is due to Taylor dispersion of the input signal. An outline of the theory of Taylor dispersion is given. The equations describe the interaction between the velocity distribution (which, in laminar flow, is parabolic) and the radial diffusion of CO₂. This interaction keeps a tracer signal together in a pulse, as it moves down the tube with themean velocity, spreading somewhat as it proceeds. How much does an initially sharp signal become blurred? The spread of such a signal when it reaches the detector, measured in time, can be expressed in various ways. Measurement is complicated, however, by the fact that the gas pressure may fall by as much as a factor of 10 along the line. The resultant expansion and acceleration of the gas cannot be ignored. A full treatment of this complication is given elsewhere, but the following simple equation is described: {ie237-1} Typically, the spread time is up to a quarter of a second for catheters of 50 m, such as used by Scamman. This is comparable with the period of CO₂ rise and fall for infants and explains the serious distortion in wave form that Scamman found. Some distortion can be eliminated by reducing R to 0.1 or less, but the extent of this improvement is small. Ideally, for fast-breathing patients, the catheter length should be reduced to 20 m or less, if possible.     

A short C-terminal sequence is necessary and sufficient for the targeting of chitinases to the plant vacuole.

Tobacco contains different isoforms of chitinase (EC 3.2.1.14), a hydrolase thought to be involved in the defense against pathogens. Deduced amino acid sequences for putatively vacuolar, basic chitinases differ from the homologous extracellular, acidic isoforms by the presence of a C-terminal extension. To examine the role of this C-terminal extension in protein sorting, Nicotiana silvestris plants were stably transformed with chimeric genes coding for tobacco basic chitinase A with and without the seven C-terminal amino acids. In plants expressing unmodified chitinase A, the enzyme activity was low in the intercellular wash fluid but high in protoplasts and isolated vacuoles. In contrast, in plants expressing mutant chitinase lacking the C terminus, the activity was high in the intercellular wash fluid but low in protoplasts. N. silvestris plants were also transformed with similar constructions coding for a structurally unrelated, extracellular cucumber chitinase. In plants expressing unmodified cucumber chitinase, its activity was present in the intercellular wash fluid and absent from protoplasts. In plants expressing cucumber chitinase with the C-terminal extension from tobacco chitinase A, activity was low in intercellular wash fluids but high in protoplasts and vacuoles. These results demonstrate that the C-terminal extension of tobacco chitinase A is necessary and sufficient for the vacuolar localization of chitinases and, therefore, that it comprises a targeting signal for plant vacuoles.     

Loss of endogenous androgen receptor protein accelerates motor neuron degeneration and accentuates androgen insensitivity in a mouse model of X-linked spinal and bulbar muscular atrophy

Human Molecular     

Differences in triage thresholds for patients presenting with possible acute coronary syndromes: more than meets the eye.

BACKGROUND: Many studies have shown differences in cardiac care by racial/ethnic groups without accounting for institutional factors at the location of care. OBJECTIVE: Exploratory analysis of the effect of hospital funding status (public vs private) on emergency department (ED) triage decision making for patients with symptoms suggestive of acute coronary syndromes (ACSs) and on the likelihood of ED discharge for patients with confirmed ACS. STUDY DESIGN AND SETTING: Secondary analysis of data from a randomized controlled trial of 10,659 ED patients with possible ACS in five urban academic public and five private hospitals. The main outcome measures were the sensitivity and specificity of hospital admission for the presence of ACS at public and private hospitals and the adjusted odds of a patient with ACS not being hospitalized at public versus private hospitals. RESULTS: Of 10,659 ED patients, 1,856 had confirmed ACS. For patients with suspected ACS, triage decisions at private hospitals were considerably more sensitive (99 vs 96%; p<.001) but less specific (30 vs 48%; p<.001) than at public hospitals. The difference between hospital types persisted after adjustment for multiple patient-level and hospital-level characteristics. CONCLUSION: Significant differences in triage for patients with suspected ACS exist between public and private hospital EDs, even after adjustment for multiple patient demographic, clinical, and institutional factors. Further studies are needed to clarify the causes of the differences.     

Polymer Reaction Engineering VI Halifax,Canada May 21–26, 2006

Conference Reports: This section contains reports on topical conferences. Reports are usually written at the request of the editorial office, but unsolicited contributions are also welcome. Suggestions should be sent to the editorial office of the Macromolecular journals, preferably by E‐mail to macromol@wiley‐vch.de.