Pharmacokinetics and pharmacodynamics of epidural and intrathecal morphine

Spinal opiate analgesia has opened an exciting new field of research and has also rapidly gained widespread clinical acceptance. This mode of administration has obvious and definite advantages over conventional pain therapy; however, the field is still at an early stage of development. More research is clearly needed to provide methods for coping with some of the drawbacks of this method of pain relief. Important areas for future research include (1) the CSF kinetics of opiates; (2) the physiological mechanisms underlying the rostral spread of drugs within the CSF compartment; (3) a search for safer and more selective drugs; and (4) an evaluation of the extent to which pain-modulating systems at different levels in the CNS can be regulated by opiates and drugs interfering with other neurotransmitters. In this context it is essential to emphasize the importance of simultaneous study of the pharmacokinetics and the pharmacodynamic/clinical effects in providing a rational basis for a better understanding of the mechanisms of actions underlying spinal opiate analgesia.     

Functional development of the visual system in normal and protein-deprived rats. IX. Visual evoked response in young rats

Changes in latencies of the visual evoked response (VER) during early post-natal development were examined in protein-deprived (PD) rats. The evoked response to light-flash stimulation was recorded in the dorsal lateral geniculate nucleus (dLGN) and on the surface of the visual cortex. In control rats, latencies of the cortical VER decreased rapidly up to 20 days and slowly thereafter. In PD rats, the latencies of the cortical VER were increased by 10-15 ms at 17 days; the developmental decrease was delayed by approximately 3 days. After 20 days, PD rats also went into a phase with slow decrease of the latencies, and the onset latency of the cortical VER was still increased by some 10 ms at 26/27 days. At this age, PD rats showed an increase in the latencies of the VER in the dLGN which was of similar magnitude to that in the cortical VER, indicating that alterations were more marked in the peripheral parts of the visual system at this stage of development. The findings are in agreement with previous studies indicating that there is a delay of visual system development in PD rats before 20 days. A maturational event which turns rapid into slow development at approximately 20 days in both C and PD rats turns this delay into a distortion of development. The delays and distortions of visual system development may be one causative factor for the functional deficit present in the visual cortex of adult PD rats.     

Functional development of the visual system in normal and protein-deprived rats. IV. Latencies in the specific visual pathway of adult rats

It was recently shown that an increase in latency of the cortical visual evoked response (VER) seen in young malnourished animals persists in adult rats given a low protein diet. In the present paper the VER latencies of the specific visual pathway were measured in order to establish the level at which the latency increase occurs in protein-deprived rats. The VER in the dorsal lateral geniculate nucleus (dLGN) showed no significant differences to onset or peak latencies between control (C) and the protein-deprived (PD) rats. The dLGN activity was higher in C rats than in PD rats. Late components differed in median values between the two groups, but the individual variations were large. Generally, the VER of the dLGN in PD rats was more stereotype compared with the C rats. Intracortical VER at a depth of 0.4-0.5 mm showed a small negative component of short onset latency in both C and PD rats. This component preceded the onset of the initial positivity recorded from the cortical surface by 1-2 ms in C rats and by 3-6 ms in PD rats. Following electrical stimulation of the dLGN, no differences in onset latency of the first cortical activity (monosynaptic response) were recorded between C and PD rats, whereas later activity was significantly delayed in PD compared with C rats. The laminar potential pattern was less distinct in PD compared with C rats, and the late components of the evoked response from deep cortical layers were markedly attenuated or lacking.(ABSTRACT TRUNCATED AT 250 WORDS)     

Contribution of sensitivity, volume and tone to visceral perception in the upper gastrointestinal tract in man: emphasis on testing

Abstract  Upper gastrointestinal (GI) symptoms occur frequently in the general population, making them among the most common indications responsible for patients consulting the healthcare system. Consequently, understanding and characterization of the upper GI symptoms is important for the diagnosis and assessment of organ dysfunction. In practice, assessment of clinical symptoms is difficult and it is still to a large extent unclear how sensitivity, volume and tone contribute to visceral perception in the upper GI tract. The goal of advanced research in upper GI symptoms is to obtain a better understanding of the mechanisms involved in transduction, transmission, and perception under normal and pathophysiological conditions. An important step towards this goal is understanding the information provided by and the inherent limitations of the currently available measuring techniques. This article focuses on the sensory testing of the oesophagus, and methods and concepts used to assess the relation between gastric volumes or tone and upper GI symptoms. It also summarizes the contributions of these techniques towards identifying the components responsible for the generation of upper GI symptoms.     

Treatment of horizontal root‐fractured maxillary incisors – a case report

Abstract – Traumatic dental injuries often occur to the teeth and their supporting tissues and they are the main reasons for emergency visit to a dental clinic. Management of a fracture depends on its position and the extent of root involvement. Horizontal root fractures are not seen frequently and the treatment consists of reduction and long‐term rigid fixation of the coronal segment. The present case demonstrates the successful management of two horizontally fractured maxillary central incisors with a follow‐up period of 9 months.     

Comparison of the effects of three different combinations of general anesthetics on the electroretinogram of dogs

The objective of this study is to compare the effects of three different anesthetic combinations on the electroretinogram in the same animals under similar laboratory conditions. Thiopental–isoflurane (TI), medetomidine–ketamine (MK), and xylazine–ketamine (XK) were used on each of 12 healthy miniature schnauzer dogs (MS) with a period of at least 3 weeks in between subsequent anesthesia protocols, using the Dog Standard Protocol. The scotopic ERGs consisted of scotopic low stimulus strength (S) responses designated S1, S2, S3, S4, and S5, at 1, 5, 10, 15, and 20 min after dark adaptation, respectively, and scotopic standard stimulus strength (S-ST) responses. The photopic ERGs consisted of a photopic single flash (P) response and 31 Hz flicker (P-FL) responses. For S-ST (2.5 cd s/m²), the amplitude of the a-wave using TI was significantly lower than that using MK (adjusted P = 0.05) and XK (adjusted P = 0.03), and the implicit time of the a-wave was significantly shorter than that using MK (adjusted P = 0.04). For P (2.5 cd s/m²), the amplitude of the b-wave using XK was significantly higher than that using MK (adjusted P = 0.01). The implicit times of the b-wave using TI was significantly longer and shorter than that of MK for S1, S2 and P-FL and for S4 and S-ST, respectively, and than that of XK for S2 and P-FL and for S5 and S-ST, respectively. The results of the present study showed that TI affected both the amplitude and the implicit time of the a-wave for S-ST and the implicit time of the b-wave relatively more so than was the case when using XK or MK. Therefore, it appears that either XK or MK could be advantageous to use rather than TI for clinical studies.     

Rotavirus serology and breast-feeding in young children in rural Guinea-Bissau

One hundred and forty-four children aged 9-20 months living in 14 villages in a rural area of Guinea-Bissau were examined for circulating rotavirus antibodies twice in a 15-month period. An immunofluorescence technique was used. About 3/4 of the children seroconverted, independent of age on entering the study. The age-specific proportion of seropositivity increased from 4/40 (10%) at 9-11 months to 26/29 (90%) at 33-35 months of age. All the initially seropositive children retained detectable antibodies to rotavirus. The relative risk of seroconversion was 1.4 times (95% confidence interval 1.0-2.0) more common among children living in villages by the mainroad as compared to those living off the road. Contact rate is probably dependent on population density and mobility but not on age. Breast-feeding, decreasing sharply through the age interval covered by the follow-up (9-35 months), had no apparent influence on seroconversion at the ages concerned.     

Tobacco smoking: a major risk factor for loss of teeth in three 70-year-old cohorts

Oral health was examined in a random sample of 1377 people in three 70-year-old cohorts studied within 5-yr intervals. During the studied period 1971-1983 the prevalence of toothlessness decreased from 52 to 34%. Toothlessness in men was more common in smokers, 48%, and ex-smokers, 32%, than in non-smokers, 20%. Eichner's index was used as a measurement of dental invalidity. This index showed a worse dental state among smokers and ex-smokers compared to non-smokers. Multivariate analyses indicated that tobacco smoking was a major independent risk factor for tooth loss in elderly men.