Erratum

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Flow increases with an enlarging intravenous catheter.

STUDY OBJECTIVE: To determine the increase in flow of a hydratable enlarging intravenous (IV) catheter in anesthetized patients. DESIGN: A randomized, nonblinded study, with standard Teflon IV catheters used as controls. SETTING: Operating room at a university medical center. PATIENTS: Thiry adult patients receiving general anesthesia for lower extremity surgery. INTERVENTIONS: An IV catheter was placed in the upper extremity, and flow measurements were made by measuring the time for infusion of 250 ml of normal saline within 1 minute after placement and at 1 hour after placement. MEASUREMENTS AND MAIN RESULTS: The enlarging catheters had a statistically significant average flow increase of 26% after 1 hour indwelling time. The standard Teflon catheters had no statistically significant change in flow after 1 hour. The percentage increase in flow for the enlarging catheters was not as great as previously seen in vitro. CONCLUSIONS: Flow through enlarging IV catheters placed in anesthetized patients increases after 1 hour. The percentage increase in flow is not as great as previously seen in vitro and may be due to skin, vein, and subcutaneous tissues preventing complete expansion.     

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Pleiotropic effects of CXC chemokines in gastric carcinoma: differences in CXCL8 and CXCL1 expression between diffuse and intestinal types of gastric carcinoma

CXC chemokines modulate host immunity, neovascularization, growth and invasive behaviour of tumours. Despite their relevance in tumour biology, chemokine expression in intestinal- and diffuse-type gastric carcinoma, which exhibit a completely different growth pattern, has not been investigated in detail. In this study, expression of the CXC chemokines CXCL8 [interleukin (IL)-8], CXCL1 [growth-related oncogene alpha (Gro alpha)], CXCL9 [monokine induced by interferon (IFN)-gamma] and CXCL10 [IFN-gamma-inducible protein-10 (IP-10)] and the corresponding chemokine receptors CXCR1-3 was investigated by immunohistochemistry in intestinal- and diffuse-type gastric carcinoma. Tumour cells of all patients expressed CXCL8. CXCL8 expression was significantly stronger in tumour cells of diffuse- rather than intestinal-type gastric carcinoma (P < 0.01) as determined by a semiquantitative score. CXCL1 was expressed almost exclusively by diffuse- but not intestinal-type carcinoma cells. The corresponding chemokine receptors, CXCR1 and CXCR2, were found on carcinoma cells. Furthermore, CXCL8 expression correlated with number of tumour vessels (P < 0.01), suggesting an angiogenetic function in gastric carcinoma not only in vitro but also in vivo. CXCL10 and CXCL9, attractants for T cells, were expressed by peritumorous macrophages in close proximity to IFN-gamma-producing CXCR3-positive T cells in both tumour types. These chemokines may attract gastric carcinoma-infiltrating T cells via an IFN-gamma-mediated pathway and enhance host immunity against the tumour. In gastric carcinoma a complex interplay between CXC-chemokine signals derived from both tumour cells and tumour-infiltrating immune cells may exhibit pleiotropic effects in tumour biology that go far beyond their originally described functions as leucocyte chemoattractants. Because CXCL8 and CXCL1, which are known to increase growth and invasive behaviour of malignant tumours, are significantly stronger expressed in diffuse- than intestinal-type gastric carcinoma, one may speculate that these chemokines influence the different growth pattern of gastric carcinoma types.     

Caspase inhibitors induce a switch from apoptotic to proinflammatory signaling in CD95-stimulated T lymphocytes

CD95 is a major apoptosis receptor that induces caspase activation and programmed cell death in susceptible cells. CD95-induced apoptosis can be blocked by peptidic caspase inhibitors such as benzyloxycarbonyl-Val-Ala-Asp-fluoromethyl ketone or Ile-Glu-Thr-Asp-fluoromethyl ketone. Here we show that stimulation of CD95 in the presence of these inhibitors induces necrosis and expression of various proinflammatory cytokines in primary T lymphocytes, such as TNF-alpha, IFN-gamma and granulocyte/macrophage colony-stimulating factor. In the absence of caspase inhibition CD95 stimulation did not result in cytokine expression, indicating that this proinflammatory signaling pathway is suppressed by active caspases. Further analysis with A3.01 T cells revealed that the proinflammatory signaling activity of CD95 was mediated by MEK/ERK, p38 and NF-kappaB signaling pathways. These findings point to a pivotal role of caspases not only as mediators of apoptosis but also as enzymes that prevent proinflammatory signaling during CD95-induced apoptosis. Moreover, our findings may be useful for the development of novel pharmacological strategies.     

Simulator trials to determine the wear of the combination aluminium oxide ceramic-carbon fibre reinforced plastic (CFRP) used as an insert in a hip socket

Hip simulator trials were conducted to determine the initial wear between alumina femoral heads and carbon fibre reinforced plastic (CFRP, CAPROMAN) insert in a titanium socket. A force of 2500 N and a frequency of 0.857 H were applied. Using surface and sphericity measurement techniques, the amount of wear was determined. After 500,000 cycles, the centre of the head had moved by 10 μm into the insert, and the average radius increased by 2 μm. After 1 million cycles, the additional changes were less than 1 μm. Based on an examination of retrieved implants (wear rate: 6.1 μm/year) and based on the simulator results, the combination alumina-CFRP inserts could be approved for total hip replacement. Received: 5 March 1998     

Die Wirkung unterschiedlicher Primingdosierungen auf die Pharmakodynamik von Cisatracurium

OBJECTIVE: The aim of the study was to evaluate the effect of two different priming regimen on the onset time of 100 micrograms/kg cisatracurium, when compared to bolus administration. METHODS: 51 patients were randomly assigned and received either a bolus of 100 micrograms/kg cisatracurium, or a priming dose of 10 micrograms/kg cisatracurium followed after 4 min by 90 micrograms/kg cisatracurium, or a priming dose of 15 micrograms/kg cisatracurium followed after 4 min by 85 micrograms/kg cisatracurium. The neuromuscular monitoring was performed using a mechanomyograph (Groningen II Monitor). Anaesthesia was induced with propofol and fentanyl and maintained by continuous infusion of propofol. RESULTS: The priming combination of 15 micrograms/kg cisatracurium followed after 4 min by 85 micrograms/kg cisatracurium produced a statistically significant reduction in the onset time (95% block) (180 +/- 60 s) and time to complete block (210 +/- 48 s), when compared to the bolus group (240 +/- 60 s and 288 +/- 66 s) (p < 0.05). CONCLUSION: Our data indicate that the "priming principle" is an appropriate technique to shorten the onset time of cisatracurium. To achieve a maximum effect the priming combination of 15 micrograms/kg cisatracurium followed after 4 min by 85 micrograms/kg cisatracurium is recommended.