Vecuronium titration for muscle relaxation in myotonic dystrophy

A 14-year-old boy with pronounced myotonic dystrophy and cardiac malformation had a normal ED₉₅ (53 μg·kg^?1) of vecuronium, whereas the recovery index (25-75% twitch recovery) was three times as long as in the absence of neuromuscular disease. We conclude that in young patients with dystrophic muscle disease individual titration of the muscle relaxant with the aid of a nerve stimulator does not preclude a considerable delay in the recovery of neuromuscular transmission.     

The preparedness to share injecting equipment: an analysis using vignettes

This paper reports on the use of vignettes to study drug injectors’preparedness to share injecting equipment. Separate vignettes referring to borrowing and passing on injecting equipment have been submitted to 505 injecting drug users in Glasgow. Injectors were asked to identify their own likely response in each of the situations described within the vignettes. It was shown that even among those injectors not reporting any actual sharing in the last 6 months a significant proportion would still be prepared to share injecting equipment within certain situations. The preparedness to share injecting equipment was seen to be influenced by such factors as social distance, sex and length of time injecting. It is suggested that even in situations where drug injectors may have modified their behaviour in the direction of lower levels of reported sharing, a propensity to share may remain. This suggests the continuing need to provide injectors with easy access to sterile injecting equipment; in addition, services working with injecting drug users may need to focus not only upon actual sharing behaviour but also upon what we have described here as the preparedness to share. Indeed, the latter dimension should stand as a warning to services of the potential for sharing injecting equipment to increase in the future.     

Response to suxamethonium in a myasthenic patient during remission

A cumulative dose followed by an infusion was used to determine the dose response to suxamethonium in a patient with diagnosed myasthenia gravis who was in true remission (asymptomatic while receiving no therapy). The ED50 and ED90 values for suxamethonium were 0.08 mg/kg and 0.20 mg/kg, and an infusion rate of 3.2 mg/kg/hour was required to maintain a 90-95% depression of the single twitch response as monitored by integrated electromyography. These values are within the range for normal patients, and we conclude that myasthenic patients during a true remission may not demonstrate resistance to suxamethonium.     

WAS THE FETAL ALCOHOL SYNDROME RECOGNIZED IN THE ANCIENT NEAR EAST?

One of the most frequently cited examples of ancient prescienceconcerning the potential dangers of drinking during pregnancyis the story of Samson in the Biblical Book of Judges. The presentarticle examines the relevant passages from this and other relatedBiblical texts for indications that the ancient Hebrews wereindeed aware of alcohol's potential to harm the fetus. Thisexamination was then broadened to include a survey of laterTalmudic literature relating to drinking during pregnancy, andliterature from Sumerian, Hittite, and Egyptian cultures contemporarywith those found in the Bible. No evidence was found for concernin the ancient Near East about any possible harm.     

Synthesis and characterization of indolicidin,a tryptophan-rich antimicrobial peptide from bovine neutrophils *

Indolicidin, a novel tryptophan-rich microbicidal tridecapeptide amide isolated originally from granules of bovine neutrophils, has been prepared by optimized manual and automated protocols of stepwise solid-phase synthesis with N^α-9-fluorenylmethyloxycarbonyl (Fmoc) amino acid derivatives. Both standard polystyrene (PS) and polyethylene glycol-polystyrene (PEG-PS) graft supports were used in combination with handles that provide C-terminal peptide amides: 5-(4-Fmoc-aminomethyl-3,5-dimethoxyphenoxy)valeric acid (PAL) or 5-(9-Fmoc-aminoxanthen-2-oxy)valeric acid (XAL). Final deprotection/cleavage was carried out with reagent K, trifluoroacetic acid–phenol–water–thioanisole–1,2-ethanedithiol (82.5:5:5:5:2.5), or reagent B, trifluoroacetic acid–phenol–water–tri(isopropyl)silane (88:5:5:2), and related cocktails. Initial purities as high as 93% were obtained immediately following cleavage. In the largest-scale synthesis carried out, 0.8 g of HPLC-purified indolicidin (> 99% pure) was obtained, representing a 39% overall yield based on C-terminal Arg(Pmc) anchored to PAL-PS-resin. The main synthetic product, and some by-products, were characterized by analytical high-performance liquid chromatography (HPLC), sequencing, and fast atom bombardment mass spectrometry (FABMS). The antimicrobial potencies of natural and synthetic indolicidin, as determined by in vitro antibacterial and antifungal assays, were identical. Further, the reactivities of natural and synthetic peptides with anti-indolicidin antibody were indistinguishable. © Munksgaard 1995.     

The mitotic index in psoriatic plaques and their response to PUVA therapy

The mitotic index of pretreatment plaques of chronic psoriasis was determined before treatment with PUVA. There was a wide variation in mitotic indices in different patients. Treatment was given with UV-A 2 h after oral ingestion of 8-methoxypsoralen (8-MOP) two or three times per week, with increasing doses of UV-A. Patients were considered cleared if there was 95% clearing of all psoriatic plaques. There was no correlation between the mitotic index and the response to treatment, as measured by either the number of joules administered or the number of treatments until the lesions cleared. This suggests that the action of PUVA in psoriasis is not dependent on the amount of increase in epidermal proliferation.