bluuebunny/crossref_metadata_2025 huggingface dataset:
Inhibitory and promotive allelopathy in rice (Oryza sativa L.)
Authors: Takeuchi, Yasutomo , Kawaguchi Shun , Yoneyama Koichi
Published: March 2003

Studies on allelopathic rice, which inhibits the germination and development of weeds such as barnyardgrass (Echinochloa spp.) and ducksalad [Heteranthera limosa (Sw.) Wild.], have been strongly conducted in the USA, the Philippines, Japan, Korea, and other countries since the 1980s. Weed‐suppressing rice plants can compete with weeds for light and mineral nutrients by their rapid and thick growth characteristics, and probably also by their allelopathic effects. It was suggested that allelopathic properties were inherited from parents. Different screening methods for finding allelopathic rice simply and rapidly have been proposed. In contrast, stimulative allelopathy in rice, which promotes germination of the dormant and dormancy‐awakened seeds of Monochoria vaginalis (Burm. f.) Kunth var. vaginalis, has been investigated by the authors since the 1990s. Rice seeds promoted the germination in the dark and in light under submerged conditions. Our experiments suggested that rice seeds, hulls, plants and straw contain stimulative substance(s) that promote seed germination of M. vaginalis.
Measuring cysteine biosynthesis activity from serine in extracts from sorghum, corn and grass weeds, and their metolachlor susceptibility
Authors: HIRASE KANGETSU , MOLIN WILLIAM T.
Published: March 2003

In vitro assay procedures for measuring the activity of cysteine biosynthesis

from serine (CBS), which is a coupled reaction catalyzed by serine acetyltransferase

and cysteine synthase, were developed using crude extracts from sorghum shoots. Cysteine

biosynthesis from serine activity was dependent on acetyl‐CoA concentrations (up

to 1.5 mmol L−1), serine (at least up to 20 mmol L−1)

and sulfide (up to 0.25 mmol L−1), respectively, and was proportional

to the protein concentration in the reaction mixture below 0.4 mg mL−1.

The reaction rate was 6.6 nmol min−1 per mg of protein during the

first 5 min, but increased to 45.6 nmol min−1 per mg of protein

between 30 and 45 min after reaction initiation. Sorghum had the highest CBS total

activity (222.4 nmol min−1 per g of fresh weight), and large crabgrass

had the lowest CBS total activity (4.7 nmol min−1 per g of fresh

weight) when CBS activity in shoots was extracted from sorghum, corn, johnsongrass,

barnyardgrass, goosegrass, green foxtail and large crabgrass. Similar results were

obtained for CBS specific activity (nmol min−1 per mg of protein).

There was no correlation between total CBS activity and susceptibility to metolachlor;

however, when corn was excluded, a correlation of R2 = 0.690 was found. Flurazole seed treatment (1.25 g per kg of seed) conferred metolachlor resistance by sorghum, and enhanced total CBS activity and non‐protein thiol content by 27 and 61%, respectively. The increase in thiol content presumably contributed to metolachlor tolerance in sorghum. From these results, the difference in CBS activity partially contributes to the selectivity to metolachlor among certain grass species, and to the safening action of flurazole by increasing thiol content.
Allelopathic effect of Pluchea lanceolata on growth and yield components of mustard (Brassica juncea) and its influence on selected soil properties†
Authors: INDERJIT
Published: March 2003

Pluchea lanceolata (DC.) C.B. Clarke (Asteraceae) is a rapidly spreading perennial weed in semiarid areas of north‐west India. While preparing fields for cultivation, farmers incorporate Pluchea plant debris into the soil. In the present study, mustard grown in plots with soil‐incorporated Pluchea had significantly reduced shoot height (61 ± 8.8 cm), number of pods per plant (7 ± 3.2), number of seeds per pod (4.1 ± 3.9) and weight per seed (0.08 ± 0.03 g) of mustard compared to mustard growing in Pluchea‐free soils. Pluchea‐infested and Pluchea‐free soils were analyzed for pH, electrical conductivity, organic matter, soluble chloride, exchangeable phosphate, copper, zinc, sodium, potassium, magnesium, calcium and water‐soluble phenolics. Pluchea‐infested soils had different values for electrical conductivity, Cl, K and total phenolics when compared to Pluchea‐free soils. Data on yield reduction of mustard due to soil‐incorporated Pluchea leaves have been reported for the first time. The reduced mustard growth and yield is proposed to be partly due to water‐soluble phenolic compounds contributed by Pluchea leaves into soil.
Intraoperative QRS‐interval changes caused by hyperkalaemia in an infant with Arima syndrome
Authors: KOIZUKA SHIRO , NISHIKAWA KOH‐ICHI , NEMOTO HIDENORI , SUDO MAKOTO , YOSHIKAWA DAISUKE , MORITA TOSHIHIRO , GOTO FUMIO
Published: March 2003

A one‐year‐and‐ten‐months‐old male infant with Arima syndrome, a very rare genetic disorder, underwent urgent insertion of a catheter for continuous ambulatory peritoneal dialysis (CAPD) under general anaesthesia. During the procedure he showed QRS‐interval changes caused by hyperkalaemia which was successfully treated with calcium gluconate. The management and intraoperative complications of this syndrome are reported and available literature reviewed.
Children who withdraw consent for elective surgery
Authors: STOKES M. , DRAKE‐LEE A.
Published: March 2003

Parents and legal guardians have authority to consent to medical treatment on behalf of minors. Recently, the concept of emerging competence has been popularized, whereby a child may achieve sufficient understanding and maturity to enable him/her to make a wise choice in his/her own interests. Although there are undoubted merits in involving children in their medical treatment, the ultimate legal authority for consent rests with parents and guardians acting on the advice of doctors and in the child's best interests. We describe two cases in which children withdrew their consent to elective surgery, despite the help and encouragement of their parents and doctors. Surgery was cancelled rather than use force to induce anaesthesia. In practice, it seems that a child must demonstrate a greater maturity and understanding to refuse medical treatment than to agree to it. Some advice is given to clinicians facing similar situations.
The anaesthetic management of a case of Kawasaki's disease (mucocutaneous lymph node syndrome) and Beckwith‐Weidemann syndrome presenting with a bleeding tongue
Authors: Thomas  , McEwan
Published: March 2003

An unusual case of a 13‐month‐old child with Kawasaki's disease and the Beckwith‐Weidemann syndrome is presented. The child, while anticoagulated with warfarin and aspirin to prevent extension of a coronary artery thrombus, fell and lacerated the tongue resulting in haemorrhage and significant swelling. The ongoing haemorrhage, combined with difficulty in securing venous access resulted in the child becoming shocked. Surgical intervention was required to stem the haemorrhage. The anaesthetic management of a shocked child with a coronary artery aneurysm and thrombosis, a potentially difficult airway and a full stomach is described.
Severe hyponatraemia after plastic surgery in a girl with cleft palate, medial facial hypoplasia and growth retardation
Authors: GOMOLA ALEXANDRA , CABROL SYLVIE , MURAT ISABELLE
Published: March 2003

A ten‐year‐old girl with middle face hypoplasia, cleft lip and palate developed severe hyponatraemia on the first day following surgery. Final diagnosis was inappropriate secretion of antidiuretic hormone (ADH) and complete hormonal investigation revealed partial deficit in growth hormone secretion. The incidence of hormonal deficiency associated to midline facial malformations is discussed.
Anaesthetic management of a patient with Freeman Sheldon syndrome
Authors: VAS LAKSHMI , NAREGAL PHALGUNI
Published: March 2003

We present a case of Freeman Sheldon (Whistling Face) syndrome. The anaesthetic management of an additional cervical kyphoscoliosis is discussed.
Anaesthetic management of a patient with Plott's syndrome
Authors: McDONALD DUNCAN
Published: March 2003

There are only seven reported cases of Plott's syndrome and no anaesthetic descriptions of this rare syndrome which is characterized by vocal cord paralysis, psychomotor retardation and sixth nerve palsy. The major anaesthetic implication is postoperative upper airway control. We describe the anaesthetic management of a(r)15‐year‐old boy who presented for magnetic resonance imaging [MRI] of his brain.
Recurrent intraoperative lobar collapse
Authors: LENG C. P. , LALWANI KIRK
Published: March 2003

We present a case report of an asymptomatic 12‐year‐old girl who was incidentally noted to have a collapsed upper lobe of her right lung during anaesthesia for angiography. After initial success at reexpansion using manual ventilation and suctioning, the lobe collapsed again some 15 min later. Physiological parameters remained stable throughout. Consent was obtained for fibreoptic bronchoscopy which was performed uneventfully and resulted in reexpansion of the lobe. We discuss the difficulty in identifying patients at risk of this complication, the need for therapeutic intervention and the issue of consent.
Antley‐Bixler syndrome: a case report and discussion
Authors: LeBARD SCOTT , THIEMANN LISA
Published: March 2003

Antley‐Bixler Syndrome (ABS) is an autosomal recessive trait disorder characterized by multiple bone and cartilaginous abnormalities. Primary features include significant craniosynostosis, midface hypoplasia with choanal stenosis or atresia, femoral bowing, radiohumeral synostosis, and multiple joint contractures. Cardiac, renal, and gastrointestinal malformations have also been described. This report describes the management of a four‐month‐old male who underwent cranial vault remodeling to relieve craniosynostosis and discusses the potential concerns of the anaesthetist during care of children with Antley‐Bixler Syndrome.
Anaesthesia and mitochondrial disease
Authors: WALLACE J. J. , PERNDT H. , SKINNER M.
Published: March 2003

Mitochondrial diseases, or encephalomyopathies, are an uncommon, heterogeneous group of disorders with variable clinical course and presentation. Many of these patients present for surgery, or undergo anaesthesia in the course of investigation of their illness. Unfortunately, little information exists on their management in anaesthetic texts and the literature. We report on the anaesthetic management of a paediatric patient with mitochondrial disease, and briefly discuss the pathophysiology and anaesthetic implications of these disorders.
A modified technique of tubeless anaesthesia for microlaryngoscopy and bronchoscopy in young children with stridor
Authors: THAUNG M. K. , BALAKRISHNAN A.
Published: March 2003

Sixty children including neonates and infants, with stridor undergoing investigations under general anaesthesia, were studied retrospectively. General anaesthesia was induced using an inhalational technique with halothane and was maintained with propofol infusion without the use of tracheal intubation. The ages ranged from three days to two years and five months. In most of the cases after propofol infusion, there was a slight drop in blood pressure without change in heart rate. This modified technique was found to be satisfactory in most of the cases.
The effect of circuit compliance on delivered ventilation with use of an adult circle system for time cycled volume controlled ventilation using an infant lung model
Authors: STEVENSON G. , TOBIN MICHAEL , HORN BABETTE , SAUTEL MICHAEL , CHEN EDWIN , HALL STEVEN , COTÉ CHARLES
Published: March 2003

This in vitro study examined the effect of circuit compliance on delivered ventilation (VE) using a time‐cycled, volume controlled circle system in an infant lung model. A Bio‐Tek ventilator tester set to simulate normal and abnormal lung compliance measured VE delivered by the Narkomed 2B system. Circle circuits of varied compliance (2.75, 1.22 and 0.73 μl·cm H2O−1) were tested. Tidal volume was adjusted to peak inflation pressures (PIP) of 20, 30, 40, and 50 cm H2O with three circuits, two lung compliances, and four different size tracheal tubes (TT) (2.5, 3.5, 4, 4.5 mm ID). Data were analysed using the multiple regression technique. Delivered VE was directly related to PIP and lung compliance. Delivered VE was not affected by the choice of circuit. TT size had minimal effects on VE when lung compliance was low; TT size was a more important factor when test lung compliance was normal. Extrapolating this data to the clinical setting, adequate ventilation of infants can be achieved with an adult circle system if an appropriate PIP is chosen, regardless of the compliance of the circuit used. Infants with poor lung compliance may require very high PIP for adequate ventilation.
Unexpected difficult intubation in the patient with Morning Glory syndrome
Authors: Shevchenko Yuri , Rehman Mohamed , Dorsey Alfred T. , Schwartz Roy E. , Moseley Ralph
Published: March 2003

Morning Glory syndrome is an uncommon congenital optic disc anomaly with occasional systemic associations. A case of unsuspected difficult intubation in a three‐year old patient is described in this case report.
Accidental hypothermia in a child
Authors: Balagna Roberto , Abbo Delia , Ferrero Federica , Valori Andrea , Peruzzi Licia
Published: March 2003

We report a case of severe accidental hypothermia (24.8°C) in a seven‐year‐old child due to prolonged exposure to low temperatures and temporary contact with river water. When the patient was seen in hospital, bradycardia (30·min−1), bradypnoea (5·min−1), scarcely reacting pupils, and Glasgow Coma Scale=3 were noted. For rewarming minimally invasive techniques (humidified warmed gases and intravenous solutions at 40°C) were employed with a very successful outcome.
Another complication of ribavirin therapy in a mechanically ventilated neonate
Authors: Dimond John
Published: March 2003

A critical incident is reported in which ribavirin administered from a small particle aerosol generator (SPAG) into a ventilator circuit became deposited around the humidifier temperature probe with the consequence that it became thermally insulated. This caused overheating of the humidifier and the potential for thermal injury to the respiratory tract. The circuit for aerosolized ribavirin administration is described and modifications suggested to avoid crystal precipitation within the circuit.
High‐frequency jet ventilation using a helium–oxygen mixture
Authors: Tobias Joseph D. , Grueber Ryan E.
Published: March 2003

The physiological basis for the use of helium relates to the relationship described by Poiseuille. During turbulent gas flow, the factors determining the resistance to flow include the density of gas as well as the length and the radius of a tube. While it may not be possible to readily change the latter two, altering the density of the gas is possible by using helium instead of nitrogen. A helium–oxygen combination has been used most commonly to improve air exchange in patients with upper airway obstruction. Anecdotal reports also suggest the beneficial effects of helium during mechanical ventilation in patients with status asthmaticus, hyaline membrane disease, and other pulmonary parenchymal disorders. To date, the clinical reports have utilized helium only with conventional mechanical ventilation. We present a child whose progressive respiratory failure was treated by using high‐frequency jet ventilation with a combination of helium and oxygen. The techniques for the delivery of helium and oxygen through the jet ventilator are discussed.
Novel use of neonatal cuffed tracheal tube to occlude tracheo‐oesophageal fistula
Authors: Greemberg Lev , Fisher Allan , Katz Ana
Published: March 2003

The use of a cuffed tracheal tube is described to occlude the leak through a tracheo‐oesophageal fistula (TOF) in a neonate and prevent gastric dilatation during positive‐pressure lung ventilation.
Anaesthetic management of a patient with adrenocortical tumour
Authors: Vas Lakshmi , Pangam Shilpa Y. , Sanzgiri Savita M.
Published: March 2003

Adrenocortical tumours in children are rare. They produce many changes in haemodynamics and blood chemistry due to hormones of the adrenal cortex. The details of perioperative management and the need for perioperative steroid supplementation are discussed.
Central venous catheter placement in children: evaluation of electrocardiography using J‐wire
Authors: Simon L. , Teboul A. , Gwinner N. , Boulay G. , Cerceau‐Delaporte S. , Hamza J.
Published: March 2003

Misplacement of a central venous catheter may lead to myocardial perforation and dysrhythmia. Atrial electrocardiography (ECG) through a saline column is an effective but complex method to determine the accurate location of catheters. We evaluated a simplified variant of this technique using the guidewire as an internal electrode in 23 children (5–16 years old) undergoing spinal surgery. Catheters were placed using a Seldinger technique after jugular or subclavian venous puncture. Each time the operator recognized the atrial signal, the catheter was found to be correctly placed on the chest radiograph (20/23). In three patients, the atrial signal was not obtained. A technical error was responsible in one case whereas the two others were related to aberrant migrations of the catheter either into a subclavian vein or into the pleura. In this latter case, the complication was unrecognized on the first radiograph despite malposition having been predicted by atrial ECG. We conclude that a method using atrial ECG guidance is sensitive and specific, and may be an alternative to the classical chest radiograph to detect accurate placement of central venous catheters in children.
Duration of action of atracurium when given by infusion to critically ill children
Authors: Playfor S.D. , Thomas David A. , Choonara Imti
Published: March 2003

The aim of the study was to investigate the offset time of atracurium when given by continuous infusion on a paediatric intensive care unit and to look for evidence of tolerance. Over a period of 8 months, 20 mechanically ventilated children had a steady‐state infusion of atracurium discontinued to enable the assessment of their level of sedation. The offset time of atracurium was assessed by train‐of‐four (TOF) stimulation of the ulnar nerve. The initial TOF reading was documented as was the time taken to reach a TOF ratio of 0.9. Thirty‐five assessments were carried out. The mean offset time of atracurium was 28.7 min (SEM 1.76 min, range 8–56 min). There was no correlation between the dose of atracurium at discontinuation and the offset time of the infusion. The duration of infusion was negatively correlated with the offset time of atracurium, and this effect was most prominent in children who had received infusions for longer than 48 h. When given by continuous infusion, the offset time of atracurium is very variable between individual patients. Infusions administered for longer than 48 h are associated with a significant reduction in the offset time as a result of increasing tolerance.
Pharmacokinetics of ropivacaine following caudal analgesia in children
Authors: Habre Walid , Bergesio Riccardo , Johnson Chris , Hackett Peter , Joyce David , Sims Craig
Published: March 2003

Ropivacaine has a favourable toxicity profile for epidural anaesthesia in adults, so it may also be an appropriate agent for epidural analgesia in children. We therefore designed this study to determine the pharmacokinetic variables of ropivacaine relevant to the risk of toxicity, after caudal administration in children. We studied nine healthy children, aged 1–6 years who received 1 ml.kg−1 of ropivacaine 0.25% for caudal analgesia. Venous blood samples were collected at intervals for 12 h after injection. Total plasma concentration of ropivacaine was assayed by high performance liquid chromatography, and pharmacokinetic descriptors were estimated from the plasma concentration‐time data. The median peak venous plasma concentration was 799 μg·l−1[interquartile range (IQR) 707–1044 μg·l−1], and was reached at a median time of 1.5 h (IQR 0.5–2 h). The mean elimination half‐life was 3.9 h (95% CI 2.7–5.0 h), and the mean apparent clearance and volume of distribution were 7.6±1.6 ml·min−1·kg−1 (95% CI 6.1–9.1 ml·min−1·kg−1) and 2.4±0.6 l·kg−1 (95% CI 1.9–3.0 l.kg−1), respectively. Analgesia was satisfactory in all cases and no systemic ropivacaine toxicity was observed. Caudal administration of weight‐adjusted doses of ropivacaine to children resulted in systemic exposure similar to that reported for adults. No systemic toxicity was observed. The findings strengthen predictions that the relative systemic safety of epidural ropivacaine in adults will apply to children. However, the pharmacokinetics and safety of epidural ropivacaine need to be studied further in children with circumstances that affect drug disposition and systemic tolerance.
High frequency oscillatory ventilation during repair of neonatal congenital diaphragmatic hernia
Authors: Bouchut Jean‐Christophe , Dubois Remi , Moussa Martine , Godard Jean , Picaud Jean‐Charles , Di Maio Massimo , Claris Olivier , Bouletreau Paul
Published: March 2003

We evaluated the use of high frequency oscillatory ventilation (HFOV) during congenital diaphragmatic hernia repair. After preoperative stabilization, 22 newborn infants were ventilated with HFOV during surgery. Ventilatory settings, blood gas values and oxygenation index were recorded before, during and after surgical repair. No differences were noted for these variables. No complications related to ventilation were recorded. According to the surgeon, diaphragmatic repair during HFOV is facilitated. This study confirms that CDH can be safely repaired using HFOV during anaesthesia.
Anaesthetic management of children with congenital insensitivity to pain with anhidrosis
Authors: Okuda Koji , Arai Toshimi , Miwa Takaaki , Hiroki Koichi
Published: March 2003

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare sensory neuropathy, which affects patients’ pain sensation and thermoregulation. There are several issues to consider when planning anaesthesia for those with this congenital disorder. Over a 20‐year period, six patients with CIPA underwent 20 surgical procedures under general anaesthesia in our institution. We analysed our experience with these patients retrospectively. We conclude that patients with CIPA are able to undergo surgical procedures under general anaesthesia without major problems.
A randomized controlled trial of the antiemetic effect of three doses of ondansetron after strabismus surgery in children
Authors: Bowhay A.R. , May H.A. , Rudnicka A.R. , Booker P.D.
Published: March 2003

Methods: One hundred and thirty‐one healthy children, aged 31–152 months, undergoing strabismus surgery under general anaesthesia, were randomly allocated to one of four groups: group A received 0.04 mg·kg−1(≡ 1 mg·m−2) of ondansetron, group B 0.1 mg·kg−1(≡ 2.5 mg·m−2), group C 0.2 mg·kg−1(≡ 5 mg·m−2) and group D placebo, given intravenously following induction of anaesthesia. Morphine 0.15 mg·kg−1was given intravenously, intraoperatively, to provide postoperative analgesia. Hourly records of emetic episodes were made for 24 h.

Results: A considerably higher proportion of children suffered emesis in the placebo group compared to the active treatment groups taken together, during the first 8 h of postoperative care (76% vs. 45%,P=0.002). During the first 8 h, only 25% of those in treatment group C suffered emesis, the number‐needed‐to‐treat was 3. There was a statistically significant decrease in the chance of vomiting with increasing dose of ondansetron (P=0.03). By 24 h, the difference in the rate of emesis was less marked but still statistically significant (90% vs. 69%,P=0.03).

Conclusions: Overall, children given ondansetron had less than one‐half the risk of vomiting compared to those given placebo (hazard ratio 0.46, 95% confidence interval 0.29–0.74). The mean number of emetic episodes declined from 2.73 in the placebo group to 1.92 in treatment group C. There was no difference in the incidence of side‐effects between groups.
Complications of anaesthesia and surgery for laryngotracheo‐oesophageal cleft
Authors: Vas Lakshmi , Patil Bharati , Ragavendra Shreekrishna , Hosalkar Hetal , Pratibha G
Published: March 2003

Laryngotracheo‐oesophageal cleft presents great difficulty in airway management. Tracheostomy and/or bilateral endobronchial intubation to secure the airway and a feeding gastrostomy are essential to sustain life until major definitive surgery can be planned. We describe the anaesthesia for these emergency life saving procedures in a 1.1‐kg, 2‐day‐old neonate of 29 weeks gestation with apnoeic spells. Endoscopy to diagnose the extent of cleft, probable tracheostomy and gastrostomy were planned. Oesophagoscopy and bronchoscopy revealed a grade 3–4 cleft. Inadequate spontaneous ventilation during these procedures necessitated positive pressure ventilation. This resulted in a gaseous distension of an intact stomach which could be decompressed into the oesophagus. After the bronchoscopy, the use of a 3‐mm tracheal tube without a Murphy’s eye minimized the distension during gastrostomy. There was an accidental extubation after gastrostomy. Emergency reintubation with a 4‐mm tracheal tube with a Murphy’s eye resulted in gastric distension which led to tension pneumoperitoneum with a disappearance of PECO2. Misdiagnosis of this as loss of airway led to repeated intubations and extubation until the pneumoperitoneum was suspected and decompressed. After this setback, the baby’s condition deteriorated over the next few hours ending fatally. The problems and suggestions to avoid these complications are discussed.
Unlicensed and off label analgesic use in paediatric pain management
Authors: Conroy Sharon , Peden Vanessa
Published: March 2003

Background: The management of pain in children has advanced enormously in recent years. Pharmacological treatment of pain is complicated however, by the widespread use of unlicensed and off label medicines in the paediatric population, leading to everyday practical problems. This study aimed to document the incidence and nature of unlicensed and off label analgesic agents in children.

Methods: Data regarding analgesic use were collected prospectively over a 4‐week period from two wards. The data were analysed to determine whether the drug use was licensed, unlicensed or off label.

Results: Seven hundred and fifteen prescription episodes were analysed. Some 480 of these (67%) were licensed; 235 were licensed medicines used in an off label manner (33%). No medicines were unlicensed. Paracetamol was the most common analgesic used.

Conclusions: Issues regarding the use of off label drugs in children at risk of pain are discussed. Suggestions are made regarding the way forward for the future.
Severe head trauma in children: cranial computer tomography and clinical consequences
Authors: HIRSCH WOLFGANG , SCHOBEß AXEL , EICHLER GERBURG , ZUMKELLER WALTHER , TEICHLER HEIKE , SCHLÜTER ANDREAS
Published: March 2003

Background: We investigated the prognostic and therapeutic implications of cranial computerized tomography (CCT) examinations after severe head trauma in children.

Materials and methods: The CCT scans from 248 children (aged 0.1–14 years) during the course of treatment after severe head trauma were assessed. The initial CCT findings, the frequency of CCT examinations and the schedule as well as duration of treatment were registered. The neurological outcome was examined both 1 month and 1 year after the trauma.

Results: Approximately one‐third (29%) of the children who suffered from severe head trauma showed no changes in the CCT. Furthermore, 40.3% of the children showed a singular finding in the CCT, whereas 30.6% of all children had a combined injury pattern. One year after trauma, we found no impairment of consciousness in children without pathological CCT findings, as well as in cases with isolated epidural and subdural haemorrhage. Children with massive generalized brain oedema had the poorest prognosis (37% died, 25% had impairment of consciousness). The outcome of children with parenchymal and ventricular bleeding was also unfavourable (23.1% and 33.3% neurological findings). Patients with focal oedema likewise had impairment of consciousness. An average number of 3.0 CCT per child was performed but numbers in single cases varied greatly (1–13 scans per individual).

Conclusions: The initial CCT was of importance regarding further therapy, especially for children in need of surgical treatment. In the other cases, there was no direct impact from CCT findings on treatment procedures in the paediatric intensive care unit. The initial CCT was related to the prognosis, which can be poor even if there are only minimal changes in CCT, such as focal oedema or isolated ventricular bleeding.
Perioperative management of tetralogy of Fallot with absent pulmonary valve
Authors: Stayer Stephen A. , Shetty Shakunthala , Andropoulos Dean B.
Published: March 2003

Summary Background: Tetralogy of Fallot with absent pulmonary valve is a rare form of congenital heart disease. The records of patients with this lesion were reviewed over a 6½ year period, and the perioperative management of 13 patients is described.

Methods: We found that our patients could be divided into two groups by age. The younger group failed medical management and was referred for surgery at less than 1 year of age. This group of patients had considerable respiratory disease at the time of surgery, greater ventilatory problems during surgery and prolonged recovery. Most patients in this group have residual respiratory disease.

Results: There were significant differences in postoperative outcome between younger versus older patients: days of ventilation 37 ± 41 versus 1 ± 0.6 days, length of ICU stay 28 ± 31 versus 3 ± 1 days and length of hospital stay 64 ± 48 versus 9 ± 5 days.
Anaesthesia with sevoflurane in children: nitrous oxide does not increase postoperative vomiting
Authors: Bortone Luciano , Picetti Edoardo , Mergoni Mario
Published: March 2003

Summary Background: Nitrous oxide (N2O) has been associated with postoperative nausea and vomiting (PONV), but some studies show conflicting data. The aim of this study was to assess whether the combination of N2O/sevoflurane, in paediatric general anaesthesia, increases the incidence of vomiting in the 24 h following surgery compared with sevoflurane alone.

Methods: One hundred and fourteen children, aged 1–10 years, who underwent testicle and inguinal hernia surgery, were randomized to receive one of the following two anaesthetic regimens: sevoflurane with 70% N2O (group A) or sevoflurane alone (group B).

Results: No significant differences were observed in the incidence of postoperative vomiting between the two groups. The overall incidence of postoperative vomiting was 14.9%; 14.3% in group A and 15.5% in group B (P=0.9).

Conclusions: Nitrous oxide used in combination with sevoflurane is not associated with an increase in the incidence of emesis in children who undergo testicle and inguinal hernia procedures.
Intravenous anaesthesia for laser surgery of the airway in children with recurrent laryngeal papillomatosis.
Authors: Kailey J. , Cranston A. , Moriarty A.
Published: March 2003

Juvenile laryngeal papillomatosis is a recurrent condition that presents a number of challenges to the anaesthetist: varying degrees of airway obstruction, the child's airway is shared and safe use of a laser is required. As well as the usual considerations of laser use, the child's larynx should move as little as possible.

At present the treatment of choice is laser vapourisation of the papillomata. Several anaesthetic techniques have been described, including jet ventilation, intermittent intubation, apnoeic techniques and insufflation of volatile gases with or without spontaneous ventilation (1). Endotracheal intubation has been associated with seeding of the papillomata into the distal airway.

The technique at the Birmingham Children's Hospital for the past 5 years is described; it is based upon deep intravenous anaesthesia with spontaneous ventilation, supplemented by topical lignocaine. Children with significant stridor at rest are induced with volatile/oxygen mixture, otherwise the method of induction is determined by child and anaesthetist. Once the child is deeply anaesthetised the larynx of the child is sprayed with lignocaine (4 mg·kg−1). The volatile agent is then discontinued and anaesthesia is provided by an intravenous infusion of propofol and alfentanil running at 10–20 mg·kg−1·hr−1 and 20–30 mcg·kg−1·hr−1 respectively. Oxygen enriched air is delivered into the pharynx via a nasopharyngeal airway. The oxygen saturation of the child is maintained at 95–97% in order to reduce the risk of ignition of the inspired oxygen by the laser. The larynx of the child is placed in suspension to produce an open airway. Depth of anaesthesia is determined primarily by the child's ventilatory pattern (adrenaline is used topically by the surgeon for haemostasis and interferes with the child's heart rate and blood pressure). End tidal CO2 concentration was measured intermittently for the first few cases, but was always found to be in the normal range. After completion of surgery (usually 15–90 min) the child is placed in the recovery position and allowed to recover.

Over the past 5 years at our hospital 11 children have undergone 112 procedures. There have been no airway complications. Recovery is not prolonged (time to spontaneous eye opening about 10–15 min). This simple technique allows excellent surgical operating conditions with unimpeded visualisation of the barely mobile larynx. There is no pollution of the operating theatre or surgeon by volatile agents. The technique is now routinely used for all microlaryngeal surgery.
Preservation of canine and feline corneoscleral tissue in Optisol® GS
Authors: Arndt Carmen , Reese Sven , Köstlin Roberto
Published: March 2003

Objective The objective of the research was to determine whether preservation of corneal tissue of dogs and cats in Optisol® GS (OGS, Bausch & Lomb Surgical, Irvine, CA, USA) is feasible for subsequent use in penetrating keratoplasty.

Animals The study subjects were 33 dogs and 31 cats with no gross corneal pathology, which had been euthanised by pentobarbital overdose for reasons unrelated to this project.

Procedure One cornea of each pair was evaluated immediately and the other was evaluated after storage in Optisol® GS for either 5, 10, 15 or 20 days. The most important criterion was the preservation of the endothelial cell layer.

Results Corneoscleral tissue of cats survived longer, when preserved in Optisol® GS at 4 °C, than that of dogs. Light and scanning electron microscopy revealed good preservation of the endothelial cell layer for up to 10 days in dogs and up to 15 days in cats.
Excitotoxicity can be mediated through an interaction within the optic nerve; activation of cell body NMDA receptors is not required
Authors: Vorwerk Christian K. , Naskar Rita , Schuettauf Frank , Zurakowski David , McDermott Luann M. , Quinto Kristine M. , Dreyer Evan B.
Published: March 2003

Axonal trauma leads to a series of pathologic events that can culminate in neuronal death. Although the precise mechanisms of retinal ganglion cell death after optic nerve crush in the rat model have not been elucidated, glutamate antagonists can protect retinal ganglion cells after optic nerve axotomy. We therefore explored whether a glutamate congener was toxic if applied directly within the optic nerve, or if toxicity depended upon an interaction at the cell body level. NMDA reduced retinal ganglion cell survival when applied directly into the rat optic nerve. Glutamate can be toxic if administered within the optic nerve; a direct effect at the cell body is not necessary. Future work will help to additionally unravel the steps by which axotomy induces excitotoxic damage to ganglion cells, and perhaps indicate protective interventions.
Postnatal development of corneal curvature and thickness in the cat
Authors: Moodie K. L. , Hashizume N. , Houston D. L. , Hoopes P. J. , Demidenko E. , Trembly B. S. , Davidson M. G.
Published: March 2003

Objective To evaluate the postnatal development of central corneal curvature and thickness in the domestic cat.

Animals studied Six Domestic Short‐haired (DSH) kittens starting at 9 weeks of age and 6 adult cats.

Procedures Kittens were evaluated biweekly to monthly for a 12‐month period, starting at age 9 weeks. Corneal development was monitored by hand‐held keratometry and ultrasound biomicroscopy. Standard regression analysis using a nonlinear least squares method was used to generate a formula that would predict corneal curvature as a function of age.

Results Mean keratometry (K) values for the 9‐week‐old cats were 54.51 (±1.02) diopters (D) and these values steeply declined over the next 3 months to 44.95 (±0.90) D. Thereafter, K‐values gradually decreased to reach a plateau by 12–15 months of age of 39.90 (±0.42) D. Because K‐values still appeared to be slightly diminishing at this point, six other > 2‐year‐old cats were evaluated by keratometry and were found to have K‐values of 38.99 (±0.81). Two to four diopters of astigmatism was common in young kittens whereas adult cats had a low mean degree of astigmatism (< 1 D). A formula that predicted keratometry values in diopters (K) as a function of age in weeks (w) was established as follows: K = 39.83 + 26.87 exp(−0.074 w). The central cornea increased in thickness primarily during the first 4 months of life with 9 week‐old kittens having values of 0.379 (±0.012) mm; 16‐week‐old kittens, 0.548 (±0.021) mm and 67 week‐old cats, 0.567 (±0.012) mm.

Conclusions The maturation process of the feline cornea proceeds over the first 1–2 years of life to attain an adult status that is characterized by a roughly spherical state of approximately 39 D corneal curvature, substantially flatter than the human cornea, and a central thickness similar to the human cornea. Research studies of the refractive or optical properties of the cornea in which cats are used as experimental animals should be conducted on animals greater than 18 months of age.
The relationship of cataract maturity to intraocular pressure in dogs
Authors: Leasure Jennifer , Gelatt Kirk N. , MacKay Edward O.
Published: March 2003

Objective To determine the distribution of intraocular pressure, as measured by applanation tonometry, in dogs with cataracts, and compare these tonometric results to the different stages of cataract formation (incipient, immature, mature, and hypermature).

Animals studied Retrospection study of canine clinical patients (86 dogs).

Procedures All records of dogs presented from 1991 to 1996 to the university veterinary medical teaching hospital for diagnosis of cataracts and evaluation for cataract surgery were reviewed. The tonometric measurements from the initial ophthalmic examination were selected in cataractous and nonglaucomatous eyes either receiving no topical or no systemic medications. The stage of cataracts was based on the degree of opacification, tapetal reflection, clinical vision, and visibility of the ocular fundus by indirect ophthalmoscopy. The distribution of tonometric results were grouped by the cataract maturity, and compared byanovaand Tukey’s general linear tests.

Results Intraocular pressure with incipient cataracts ranged from 9 to 17 mmHg (mean 12.7 ± 1.2 mmHg). Intraocular pressure with immature cataracts ranged from 3 to 27 mmHg (mean 13.6 ± 0.6 mmHg). For the mature cataracts, IOP ranged from 5 to 22 mmHg (mean 11.9 ± 0.7 mmHg). For the hypermature cataract group, IOP ranged from 4 to 23 mmHg (mean 10.8 ± 0.6 mmHg). Comparison of the tonometric results among the different stages of cataract formation indicated a significant difference (P = 0.0086) between only the immature and hypermature groups.

Conclusions Intraocular pressure in lens‐induced uveitis (LIU) is lowered but the relationship to the stage of cataract maturity is less clear. Significant tonometric differences were present between the immature and hypermature cataract groups, but these differences are too small to be clinically useful. Decreased intraocular pressure of dogs with all stages of cataract formation suggests concurrent LIU during all stages of cataract formation, especially with the mature and hypermature stages. The average tonometric measurements in dogs with these cataracts were about two standard deviations below the mean IOP reported in normal dogs.
Effect of topical atropine on intraocular pressure and pupil diameter in the normal horse eye
Authors: Mughannam Albert J. , Buyukmihci Nedim C. , Kass Philip H.
Published: March 2003

The objective was to determine whether topically administered 1% atropine would alter intraocular pressure. The animals studied were four healthy adult horses. Intraocular pressure and pupil diameter were measured prior to and during a 2‐day period of treatment with 1% atropine sulfate. No significant changes in intraocular pressure occurred as a result of the treatment with atropine. Pupil diameter increased significantly after atropine was applied. Available information on the outflow of aqueous humor from the horse eye suggests that atropine might reduce intraocular pressure in the horse by increasing uveoscleral outflow. This could prove beneficial in the treatment of equine glaucoma. We could not confirm a significant pressure‐lowering effect of atropine. It is possible, however, that a longer treatment period may be required or that atropine may have a more profound effect on glaucomatous globes.
Evaluation of intraocular and partial CO2pressure in dogs anesthetized with propofol
Authors: Batista C.M. , Laus J.L. , Nunes N. , Patto dos Santos P.S. , Costa J.L.O.
Published: March 2003

The effects of propofol on intraocular pressure (IOP) and end tidal CO2(ETCO2) were studied because an elevation in the latter may alter IOP. Twenty dogs were divided into two groups (G1 and G2). G1 dogs were induced with 10 mg/kg (IV) of propofol followed by a 0.4 mg/kg/min continuous infusion of the same agent diluted in a 0.2% dextrose solution for 1 h. G(CAPS) 2 dogs served as the control group, where only dextrose solution was administered, under the same time intervals as in G1. Applanation tonometry (Tono‐Pen) was used to determine IOP and ETCO2as a method to determine partial CO2pressure. Measurements were taken every 15 min for 1 h, with M1 occurring immediately before IV administration. IOP and ETCO2were not statistically significant in either groups. Based on the results, it may be concluded that propofol does not alter IOP and ETCO2.
Changes in intraocular pressure associated with topical dorzolamide and oral methazolamide in glaucomatous dogs
Authors: Gelatt Kirk N. , MacKay Edward O.
Published: March 2003

ObjectiveTo compare the reduction in intraocular pressure (IOP) by topical 2% dorzolamide to oral methazolamide (5 mg/kg) in dogs, and determine if the combination of both drugs would reduce IOP more than either drug administered alone.

Animals studiedThirteen glaucomatous beagles.

ProceduresMeasurements, including applanation tonometry, pupil size and heart rate, were obtained at 8 am, 12 noon, and 5 pm on days 1, 3 and 5. The 5‐day drug studies included placebo (0.5% methylcellulose); 2% dorzolamide administered in one eye twice daily (8 am and 5 pm), and repeated again in one eye three times (8 am, 12 noon and 5 pm) daily; methazolamide (5 mg/kg per os administered at 8 am and 5 pm); 2% dorzolamide instilled twice daily (5 days) combined with oral methazolamide on the last 3 days, and methazolamide (5 days) combined with 2% dorzolamide on the last 3 days and instilled twice daily. Statistical comparisons between drug groups included control (nondrug) eye and treated (placebo/drug) eyes for days 1, day 3 and 5.

ResultsTopical 2% dorzolamide, administered twice and three times daily, significantly decreased IOP (mean ± SEM) in glaucomatous dogs on the first day (twice daily 7.6 ± 2.4 mmHg, and three times daily 16.4 ± 3.6 mmHg) that was even greater by day 5 (twice daily 10.4 ± 2.0 mmHg, and three times daily 13.9 ± 2.7). Oral methazolamide also significantly lowered IOP in both eyes. Oral methazolamide (administered from day 1 through to day 5) combined with 2% topical dorzolamide (instilled in the drug eye for day 3 through to day 5) also significantly lowered IOP of both eyes for all days, and for day 5 the mean ± SEM IOP was decreased by 7.9 ± 1.7 mmHg (methazolamide plus dorzolamide) and 7.5 ± 2.6 mmHg (methazolamide only). Topical dorzolamide (instilled in the drug eye for day 1 through to day 5) combined with oral methazolamide (administered from day 3 through to day 5) significantly lowered IOP in the drug eye on day 1 (5 pm: 9.6 ± 1.9 mmHg), for day 3 (11 am and 5 pm) and for all of day 5 for both eyes (5 pm: control eye 9.5 ± 1.8 mmHg; drug eye 9.2 ± 1.9 mmHg). Topical dorzolamide (2%) instilled three times daily produces similar IOP declines compared to the combination of oral methazolamide and 2% dorzolamide administered twice daily.

ConclusionsDorzolamide (2%) instilled twice or three times daily causes significant decreases in IOP in glaucomatous dogs. Twice daily instillations caused progressive declines in IOP from day 1 to day 5. Dorzolamide (2%) combined with oral methazolamide (5 mg/kg per os twice daily) produces similar but not additional declines in IOP.
Feline leukemia virus detection in corneal tissues of cats by polymerase chain reaction and immunohistochemistry
Authors: Herring Ian P. , Troy Gregory C. , Toth Thomas E. , Champagne Erin S. , Pickett J. Phillip , Haines Deborah M.
Published: March 2003

ObjectivesTo determine the presence of feline leukemia virus (FeLV) in the corneas of FeLV‐infected cats.

Animals studied

Thirty‐four random source cats.

Procedures

Seventeen cats were found positive for FeLV serum p27 antigen by enzyme‐linked immunosorbent assay (ELISA). Twelve ELISA positive cats were also positive on peripheral blood samples by immunofluorescent antibody (IFA) testing. Seventeen ELISA negative cats served as negative controls. Full thickness corneal specimens were collected from the left cornea of all cats and analyzed for FeLV proviral DNA and gp70 antigen by polymerase chain reaction (PCR) and immunohistochemical (IHC) testing, respectively.

Results

Eleven (64.7%) positive corneal PCR results were obtained from 17 ELISA positive cats. Of 12 cats that were both ELISA and IFA positive on peripheral blood, 10 (83.3%) had positive corneal PCR results. All corneal tissues from ELISA negative cats were PCR negative. IHC staining of corneal sections revealed the presence of FeLV gp70 in corneal tissues of nine (52.9%) ELISA positive cats. Of the 12 cats that were both ELISA and IFA positive on peripheral blood, eight (66.7%) had positive corneal IHC results. Positive IHC staining was localized to the corneal epithelium. Corneal tissues of all ELISA negative cats and all IFA negative cats were negative on IHC testing.

Conclusions

FeLV antigens and proviral DNA are present in corneal tissues of some FeLV‐infected cats. Screening corneal donors for FeLV infection is warranted.
Congenital cataracts and persistent hyaloid vasculature in a llama (Lama glama)
Authors: Gionfriddo Juliet R. , Blair Michael
Published: March 2003

A 9‐month‐old llama was evaluated for apparent blindness. Bilateral cataracts were diagnosed and cataract surgery was performed on the right eye. At the time of surgery persistent hyperplastic primary vitreous, persistent hyperplastic tunica vasculosa lentis, and a persistent hyaloid artery were observed. Prior to surgery Power Doppler ultrasound revealed a patent tunica vasculosa lentis OS. Despite reports of a poor success rate for llama cataract surgery, through use of careful tissue handling, phacoemulsification, viscoelastic endothelial protectants, anti‐inflammatories, and BSS‐Plus irrigating solution, vision was successfully restored in both eyes of the llama.