bluuebunny/crossref_metadata_2025 huggingface dataset:
Malignant Hyperthermia in a Family: A Clinical and Serological Investigation of 139 Members
Authors: Kelstrup J. , Reske‐Nielsen E. , Haase J. , Jørni J.
Published: December 2008

In a family of 147 members, two have died from malignant hyperthermia induced by general anaesthesia, and six from other causes. The remaining 139 family members have all been examined clinically and serologically. Forty per cent of the family members had musculoskeletal disorders and 30% had elevated values of creatine phosphokinase in serum.

The mode of inheritance is shown not to be autosomal dominant. Doubt is expressed concerning the value of the determination of creatinine phosphokinase (CPK) in serum. It is concluded that it is uncertain whether such determination can predict the risk of the individual patient for developing malignant hyperthermia. Emphasis is laid upon prophylaxis by issuing cards to members of families at risk, by questioning all patients preoperatively about anaesthesiological complications among family members, and by temperature monitoring. It is suggested that any case of malignant hyperthermia give rise to investigation of the family.
Trauma: Hormonal Factors with Special Reference to Diabetes Mellitus
Authors: Efendic S. , Cerasi E. , Luft R.
Published: December 2008

Three aspects of the role of hormones in stress will be reviewed: 1) changes in hormone secretion during stress, 2) metabolic alterations as a consequence of these changes in hormone production, and 3) the significance of hormones as permissive factors in stress reactions. It is emphasized that body tissues in general ‐ except for the central nervous system ‐ can make use of free fatty acids as a source of energy. In order to provide the central nervous system with its requirement for glucose, the glucose uptake in other tissues is restrained by two hormonally controlled mechanisms: 1) depression of insulin secretion and 2) increase in the concentration of free fatty acids in plasma (which by direct means depresses glucose uptake). Thus, these hormonal interactions provide large amounts of metabolic fuel and distribute them in an effective manner, so that the body can meet stress.

In diabetics, an increased secretion of stress hormones in connection with trauma is observed. The metabolic and therapeutic implications of this finding are discussed.
Therapy with Fat Emulsion
Authors: Hallberg D.
Published: December 2008

Fat emulsions for paranteral nutrition are indicated to maintain a physiological nutrition during impaired function of the gastrointestinal tract. Modern fat emulsions seem to metabolize in the same way as chylomicrons.

It is usually possible to infuse a dose of fat up to 3–4 g/kg b.w./24 h. Fat emulsions as such have no osmolal effects and are therefore also indicated during treatment of hyperosmolal fluid balance disturbances.
High‐Frequency Positive‐Pressure Ventilation (HFPPV) Applied for Small Lung Ventilation and Compared with Spontaneous Respiration and Continuous Positive Airway Pressure (CPAP)
Authors: Jonzon A. , Sedin G. , Sjöstrand U.
Published: December 2008

The respiratory and circulatory conditions in high‐frequency positive‐pressure ventilation (HFPPV) in the dog and during routine surgery in man have been investigated previously. From this previous experimental and clinical experience, the insufflation‐expiratory systems could be modified for small lung ventilation (HFPPV‐infant), and the insufflation frequency‐insufflation time systems could be combined into one function. This modified HFPPV system works without any separate insufflation catheter. The respiratory and circulatory conditions during ventilation with this modified system were investigated in a series of healthy cats anaesthetized with pentobarbital.

The present version of HFPPV utilizes humidified, warmed, compressed air (gas mixture) which is obtained by means of a slightly modified pneumatic part of a commercially available incubator system. By means of intermittent opening of an electronically controlled valve, this gas mixture gives an intermittent positive pressure ventilation at high frequency.

It is possible to regulate alveolar ventilation during HFPPV both by means of driving‐pressure and expiratory‐resistance adjustments, as well as by regulation of the insufflation frequency and insufflation time. In the cat with normal‐compliant lungs, HFPPV gives adequate alveolar ventilation at continuous positive and low intratracheal pressures. As it has been shown that methods with continuous positive airway pressure increase arterial oxygenation and prevent airway closure, HFPPV was compared with yet another positive airway technique, continuous positive airway pressure (CPAP). The experimental studies on HFPPV and CPAP in the cat with normal‐compliant lungs revealed that HFPPV ‐ in contrast to CPAP ‐ gives adequate alveolar ventilation without circulatory interference.

The electronically coupled function of insufflation frequency and time (“respirator setting”) in HFPPV was also tested, and it was shown that the arterial Po2 is mainly influenced by the respirator driving pressure but that the arterial Pco2 and pH are additionally influenced by the respirator setting.
Miscarriages Among Operating Theatre Staff
Authors: Rosenberg P. , Kirves A.
Published: December 2008

Altogether 300 married Finnish women working as anaesthesia, scrub, casualty and intensive care unit nurses were interviewed about the fate of their pregnancies since 1965. The scrub nurses had the highest frequency of miscarriages; 21.5% of the pregnancies ended in spontaneous abortion. Intensive care unit nurses had a miscarriage rate of 16.7%, anaesthesia nurses 15.0% and casualty department nurses 8.3% of the pregnancies, respectively. The difference between the rate of the combined number of miscarriages of operating room nurses (anaesthesia and scrub) and that of the others was statistically significant.

Scrub nurses seemed to have the earliest miscarriages (mean 9.3 weeks), and intensive care unit nurses also had earlier mean time of miscarriages (10.4 weeks) than anaesthesia nurses (11.1 weeks). Gross abnormalities were not observed in the children, but two cases of foetal death in the third trimester of pregnancy (anaesthesia and intensive care unit nurses) and two cases of mental retardation (scrub and intensive care unit nurses) were registered.

The results do not indicate foetal lethality of anaesthetic gases in operating room but rather an increased rate of spontaneous miscarriages due to stress.
Comparative Nitrogen Balance Studies with an Amino‐Acid Solution Based on Nutritional Studies Against Two Protein‐Based Solutions
Authors: Vinnars E. , Bergström J. , Fürst P.
Published: December 2008

This trial presents the results of a cross‐over study in which the nitrogen balance was assessed in a non‐catabolic patient using the amino‐acid solution Intramin forter̀, based on studies of human requirements, and a second amino‐acid solution based on the amino‐acid pattern of egg protein.

A second study reports on the nitrogen balance findings in five postoperative, catabolic patients to whom Intramin forte was given. The results are compared to previously published findings in a group of similar, probably less surgically traumatized, patients treated with a hydrolysate of casein.

Significant differences regarding the nitrogen balance when comparing the effect of these solutions were not obtained.
Positive End‐Expiratory Pressure Ventilation After Open‐Heart Surgery
Authors: Drugge U. , Norlander O. , Olsson P. , Rådegran K.
Published: December 2008

Thirty‐seven patients were studied after open‐heart surgery in relation to the effect of positive end‐expiratory pressure ventilation (PEEP) as compared to routine intermittent positive pressure ventilation (IPPV) with the Engström Respirator. The patients were divided in two groups with 21 patients receiving PEEP and 16 IPPV. Arterial oxygen tensions and inspiratory oxygen fractions were determined 1 h after surgery and 1 day later. During the first postoperative night, the respirator settings were not changed. Inspired oxygen fractions were kept constant. PEEP between + 5 to + 10 cmH2O was used. In 11 patients, functional residual capacity (FRC) was measured preoperatively and on the first postoperative day. Statistical analyses showed no significant changes in arterial oxygen tension or in the alveolar‐arterial oxygen differences between the two groups. FRC was slightly disminished, but no correlation was found in relation to changes in arterial oxygen tensions. It is concluded that after uneventful open‐heart surgery, when careful attention is paid to maintenance of circulation and avoidance of overhydration, PEEP does not have any advantage over IPPV with a volume controlled ventilator. PEEP should, therefore, be reserved for patients with interstitial pulmonary oedema with alveolar “oxygen‐block” or those in whom measures to improve pulmonary perfusion have not succeeded.
Carbon Dioxide Elimination from Circle Systems
Authors: Jørgensen B. , Jørgensen S.
Published: December 2008

Ten various circle systems were studied in model experiments. All the experiments were performed using a Waters cannister containing 675–685 g of Durasorbr̀. 300 ml of carbon dioxide were supplied to the system per min. The efficacy of these systems was expressed as the time taken to demonstrate a concentration of 0.6% carbon dioxide in the gas mixture supplied to the patient connection during each respiratory cycle. The carbon dioxide elimination was studied at a gas flow of 2, 4 and 6 1 per min. All the systems showed an effective carbon dioxide elimination for 6 h or more at a flow of 2 1. An increasing efficacy was found with increasing flow, but to a varying extent.

A circle system where all the components, including the cannister and directional valves, can be replaced after use is recommended owing to the risk of cross contamination. A soda‐lime charge of 600–700 g is advantageous. For anesthetic procedures of less than 1 h, other techniques should be employed as they are more economical.
Some Physiological Changes During Minor Surgery Under Hypnotic Analgesia
Authors: Finer B. , Jonzon A. , Sedin G. , Sjöstrand U.
Published: December 2008

During an operation for varicose veins with stripping under hypnotic analgesia, there were no signs of sympathetic stimulation during the phases of the operation usually considered to be the most painful. These findings support the “gate theory” of pain.
The Influence of Acid‐Base Changes on Central Nervous System Toxicity of Local Anaesthetic Agents I: An Experimental Study in Cats
Authors: Englesson S.
Published: December 2008

A method is described of stabilising the metabolic and respiratory acid‐base status of 90 cats in which 127 local anaesthetic toxicity studies were performed. Nine different local anaesthetic agents were studied. These agents were infused intravenously at a constant rate until the appearance of generalised seizure activity in the EEG from the cortex and amygdala via implanted electrodes. A fall in Paco2, or hydrogen ion activity (aH+) was found to decrease local anaesthetic toxicity, such that a linear correlation was found between the log of the toxic dose and Paco2 and aH+. No correlation was found to the metabolic variable chosen (“non‐respiratory” hydrogen activity, aH+NR). The conclusion was that both hydrogen ion activity and Paco2 are of importance in modifying the CNS toxic threshold dose of local anaesthetic agents.

Es wird eine Methode der Stabilisation des metabolischen und respiratorischen Säure‐Basen‐Status bei 90 Katzen beschrieben, bei welchen 127 Toxizitätsuntersuchungen mit Lokalanaesthetika durchgeführt wurden. Neun verschiedene Lokalanaesthetika, die untersucht wurden, wurden mit gleichbleibender Geschwindigkeit so lange i.v. infundiert, bis im EEG des Cortex und der Mandelkerne‐via implantierter Elektroden registriert‐generalisierte Krampfpotentiale auftraten. Dabei zeigte sich, daß ein Abfallen des Paco2 oder der Wasserstoffionen‐Aktivität (aH+) die Toxizität der Lokalanaesthetika reduzierte und zwar so, daß eine lineare Korrelation zwischen dem Logarithmus der toxischen Dosis und dem PaCo2 bzw. aH+ festgestellt werden konnte. Zu der gewählten metabolischen Variablen (“nicht‐respiratorische” Wasserstoffionen‐Aktivität, aH+NR) konnte keine Korrelation gefunden werden. Die Schlußfolgerung war, daß sowohl die Wasserstoffionen‐Aktivität als auch das PaCO2 von Bedeutung fur die Modifizierung der toxischen Schwellendosen von Lokalanaesthetika im ZNS sind.
Cerebral Metabolic Changes in Arterial Hypocapnia of Short Duration
Authors: Carlsson C. , Nilsson L. , Siesjö B. K.
Published: December 2008

In order to study the energy metabolism of the brain in pronounced hypocapnia, lightly anaesthetized rats were hyperventilated to arterial CO2 tensions of minimally 10 mmHg during 2, 5 and 45 min, respectively. There were marked increases in the tissue concentrations of lactate (and pyruvate) already at 2 min, but no changes in phosphocreatine, ATP, ADP or AMP at 2 or 5 min. It is concluded that the lactic acidosis observed in the tissue during hyperventilation is unrelated to a derangement of the energy state of the tissue. Measurement of other glycolytic substrates seems to indicate an activation of phosphofructokinase, but the possibility that the accumulation of lactate (and pyruvate) at the present degree of hypocapnia is secondary to an activation of other enzymatic steps cannot be ruled out.

Um den Energiestoffwechsel des Gehirns unter ausgeprägter Hypokapnie zu studieren, wurden oberflächlich narkotisierte Ratten auf arterielle CO2‐Spannungen von minimal 10 mm Hg während 2, 5 bzw. 45 Minuten hyperventiliert. Schon nach zwei Minuten zeigten sich deutliche Anstiege der Gewebekonzentrationen von Laktat (und Pyruvat), aber keine Veränderungen des Phosphor‐Kreatins, der ATP, ADP oder AMP nach 2 bzw. 5 Minuten. Es wird daraus geschlossen, daß die in den Geweben während der Hyperventilation beobachtete Laktatazidose in keiner Beziehung zu einer Stöning des Energiezustandes der Gewebe steht. Messungen anderer glykolytischer Substrate scheinen auf eine Aktivation der Phosphofruktokinase hinzuweisen, aber die Möglichkeit, daß die Anhäufung von Laktat (und Pyruvat) bei den gegenständlichen Werten der Hypokapnie die Folge einer Aktivation anderer enzymatischer Schritte sein könnte, ist nicht auszuschließen.
Uterine Blood Flow in Dogs During Various Depths of Halothane Anesthesia Measured by Local Injection of Xenon
Authors: Einer‐Jensen N. , Juhl B.
Published: December 2008

The correlated values of cardiac output (measured by Cardio‐Greenr̀) and uterine blood flow (measured with 133xenon) were determined on eight dogs. This was done both under basis anesthesia with O2‐N2O‐barbiturate‐gallamonium with controlled ventilation and during the addition of 0.5% and 1.0% halothane to the inspiratory air. A fall in cardiac output and uterine blood flow was demonstrated during the addition of halothane. With 0.5% halothane, the fall was on an average 30% and 17% of the initial values respectively and with 1.0% halothane, it was 49% and 42% of the initial values. The uterine blood flow varied considerably from animal to animal, and these values were not correlated to the Paco2 changes carried out within the range of Paco2, from 25 to 66 mmHg.

Bei 8 Hunden wurden die Korrelationswerte des Herzminutenvolumens (HMV) (gemessen mit Cardio‐Green®) und der Uterusdurchblutung (gemessen mit 133Xenon) bestimmt. Dies wurde sowohl unter Basisnarkose mit O2‐N2O‐Barbiturat‐Gallamin‐Basisnarkose mit kontrollierter Beatmung als auch während eines Zusatzes von 0.5–1.0% Halothan im Inspirationsgemisch durchgeführt. Unter Halothan zeigte sich ein Abfall des HMV und der Uterusdurchblutung. Bei 0.5% Halothan betrug der Abfall 30 bzw. 17% der Ausgangswerte und bei 1.0% Halothan 49 bzw. 42%. Die Uterusdurchblutung schwankte beträchtlich von Tier zu Tier, doch standen diese Werte nicht in Korrelation zu PaCo2‐Veränderungen, die in einem Bereich von 25‐66 mm Hg variiert wurden.
The Effect of Operative Stress on Plasma Catecholamine Levels in Chronic Alcoholics
Authors: Takki S. , Tammisto T.
Published: December 2008

The goal of the study was to determine if the increased tolerance to anaesthetics in alcoholics is associated with a sympathetic overactivity during anaesthesia and operative stress. Plasma catecholamines were measured in six chronic alcoholics at five stages during “balanced anaesthesia” given for upper abdominal surgery. Six non‐alcoholics, matched for age, weight and operative procedure served as controls. Plasma catecholamines were determined by the method of Vendsalu (1960).

Before skin incision, blood pressure, heart rate and plasma noradrenaline were slightly above preanaesthetic levels in alcoholics but not in controls. Operative stress seemed to be associated with a higher incidence of signs of inadequate depth of anaesthesia in alcoholics. During operative stress, before abolition of the pressor response with fentanyl and tubocurarine, the increase in blood pressure, heart rate and total catecholamines was similar in both groups. After abolition of the pressor response, heart rate and catecholamines returned to preanaesthetic levels in non‐alcoholics, whereas in alcoholics plasma noradrenaline was about 100%, total catecholamines about 70% and heart rate about 20% above the preanaesthetic level at this stage. The results suggest that, in alcoholics, the increased tolerance to anaesthetics is reflected in a more marked sympathetic activity during operative stress.

Ziel dieser Untersuchung war es festzustellen, ob die erhöhte Narkosetoleranz von Alkoholikern mit einer vermehrten Sympathikusaktivität während der Narkose und des Operationsstresses vergesellschaftet ist. Plasmakatecholamine wurden bei sechs chronischen Alkoholikern zu fünf Zeitpunkten während Kombinationsnarkosen fur Oberbauchoperationen bestimmt. Sechs Nichtalkoholiker vergleichbaren Alters, Gewichtes und unter gleichen Operationsbedingungen dienten als Kontrollen. Die Plasmakatecholamine wurden nach der Methode von Vendsalu 1960) bestimmt.

Vor dem Hautschnitt waren Blutdruck, Herzfrequenz und Plasma‐Noradrenalin bei den Alkoholikern gegenüber den pränarkotischen Werten leicht erhöht, nicht aber bei den Kontrollpersonen. Der Operationsstress schien bei den Alkoholikern mit einem höheren Prozentsatz von Anzeichen ungenügender Narkosetiefe verbunden zu sein. Während des Operationsstresses, vor der Unterdrückung der pressorischen Wirkung durch Fentanyl und Tubocurarin, war der Anstieg des Blutdrucks, der Herzfrequenz und der Gesamtkatecholamine in beiden Gruppen ähnlich. Nach Unterdrückung der pressorischen Wirkung kehrten bei den Nichtalkoholikern die Herzfrequenz und die Katecholamine zu den pranarkotischen Aus‐gangswerten zurück, während bei den Alkoholikern in diesem Stadium das Plasma‐Noradrenalin urn etwa 100%, die Gesamtkatecholamine um ca. 70% und die Herzfrequenz um etwa 20%über den pränarkotischen Werten lagen. Die Resultate deuten darauf hin, daß sich die erhöhte Narkosetoleranz bei Alkoholikern in einer deutlichen Sympathikusaktivitätssteigerung während des operativen Stresses wiederspiegelt.
Pulmonary Microembolism During Intramedullary Orthopaedic Trauma
Authors: Modig J. , Busch C. , Olerud S. , Saldeen T.
Published: December 2008

Patients undergoing prosthetic hip surgery by the Charnley method were given 51Cr labelled platelets and 125I labelled fibrinogen the day before the operation. External monitoring of both kinds of radioactivity over the right lung was performed during the surgical procedure. A transient accumulation of 51Cr radioactivity over the lung was noted during broaching of the femoral bone marrow and after impaction of the femoral prosthetic stem. Transient trapping of 125I radioactivity was also recorded during the latter period. Arterial oxygen tension (Pao2) dropped significantly after impaction of the femoral prosthesis. The correlation coefficient was ‐0.97 between deposition of 125I radioactivity in the lung and the Pao2 reduction occurring after insertion of the femoral prosthesis. These results might indicate a pulmonary microembolism occurring during this stage of the operation, with concomitant pulmonary dysfunction.

Patienten, die für prothetische Hüftoperationen nach der Methode nach Charnley vorgesehen waren, erhielten am Tag vor dem Eingriff 51Cr‐markierte Thrombozyten und 125I‐markiertes Fibrinogen. Wahrend des chirurgischen Eingriffes wurden beide Arten der Radioaktivät über der rechten Lunge extern registriert. Eine vorübergehende Anhäufung der 51Cr‐Aktivität über der Lunge wurde während des Ausraumens des Knochenmarks aus dem Femur und nach dem Einsetzen der Femurstammprothese beo‐bachtet. Wahrend dieser zweiten Phase wurde auch eine vorubergehende Haufung der 125I‐Radio‐aktivitat registriert. Nach dem Einsetzen der Femurprothese fiel die arterielle Sauerstoffspannung (PaO2) significant ab. Der Korrelationskoeffizient war—0,97 zwischen dem vermehrten Auftreten der 125I‐Radioaktivität in der Lunge und der nach dem Einsetzen der Femurprothese auftretenden PaO2‐Reduktion. Diese Resultate könnten als Anzeichen von Mikroembolis‐ationen in die Lunge in diesem Operationsstadium interpretiert werden bei gleichzeitiger pulmonaler Dysfunktion.
Methoxyflurane and Lipid and Carbohydrate Metabolism in Rats
Authors: Mäkeläinen A.
Published: December 2008

The mechanism of methoxyflurane‐induced changes in lipid and carbohydrate metabolisms were studied in vivo and in vitro in rats. Methoxyflurane caused a clear elevation of plasma free fatty acids (FFA) during and after anesthesia, while on the other hand, the plasma glycerol level rose only during the recovery period. The changes during anesthceia seem to be due to indirect actions of the sympathetic nervous system and can be abolished by beta‐blocking agents or by sympathectomy together with prevention of hypothermia. These pretreatments only slightly reduced the changes during the recovery period. Methoxyflurane caused no alterations in lipolysis in vitro.

The present results indicate that after methoxyflurane anesthesia there must exist some lipolytic mechanisms other than those caused by the methoxyflurane itself. The slight changes in plasma glucose observed in the present study can be explained by catecholamine release or by changes in the peripheral utilization of carbohydrate during and after methoxyflurane anesthesia.

Der Mechanismus von Methoxyfluran‐induzierten Veränderungen im Fett‐ und Kohlehydratstoffwechsel wurde an Ratten in vivo und in vitro untersucht. Methoxyfluran führt zu einer deutlichen Erhöhung der freien Fettsäuren im Plasma während und nach der Narkose, der Plasmaglyzerolspiegel stieg jedoch nur während der Erholungsperiode an. Die Veränderungen während der Narkose scheinen durch indirekte Wirkungen des sympathischen Nerven‐systems bedingt zu sein und können durch Beta‐Blocker oder durch Sympathektomie unter gleichzeitiger Verhütung einer Hypothermie verhindert werden. Diese Vorbehand‐lungsmethoden reduzieren jedoch die Veränderungen während der Erholungsperiode nur in geringem Maße. In vitro verursachte Methoxyfluran keine Störungen der Lipolyse. Die gegenwartigen Befunde weisen darauf hin, daß nach Methoxyfluran‐Narkose ein anderer lipolytischer Mechanismus vorliegen muß, als der durch Methoxyfluran selbst.

Die geringen Veränderungen der Plasmaglukose, die während der vorliegenden Untersuchungen beobachtet wurden, können durch Katecholaminfreisetzung oder durch Änderungen in der peripheren Ausnützung der Kohlehydrate während und nach Methoxyfluran‐Narkosen erklärt werden.
Influence of Simultaneous and Equal Increase in External Dead Space and Tidal Volume on Arterial Blood Gases in Artificially Ventilated Patients
Authors: Molnar I. , Refsum H. E.
Published: December 2008

In 13 patients undergoing artificial ventilation, arterial blood gases, respiratory frequency and pulmonary ventilation were measured before, during and after a simultaneous and equal increase of the respiratory dead space and tidal volume. The patients were ventilated with a time cycled, constant volume respirator, using 50% O2—50% N2 or atmospheric air. Prior to the addition of the dead space, the average arterial blood gases were: Pao2= 95.4 mmHg, Paco2= 37.4 mmHg and pH = 7.442. Following ventilation for 20 min with an added dead space of 200 ml and a correspondingly increased tidal volume, Pao2 rose to 113.7 mmHg (P< 0.001), whereas Paco2 and pH remained essentially unchanged. Twenty minutes after removal of the extra dead space and restoration of the ventilation to the original level, Pao2 was reduced to 107.1 mmHg, a level still clearly higher than the initial (P< 0.001). The observations demonstrate that simultaneous increase of dead space and tidal volume during artificial ventilation improves ventilation/perfusion disturbances and oxygenation of the arterial blood. This effect persists to a varying extent even after the dead space ventilation.

Bei 13 Patienten unter künstlicher Beatmung wurden die arteriellen Blutgase, die Atemfrequenz und die Lungenventilation vor, während und nach einer gleichzeitigen und gleich hohen Vergrößerung des Totraumes und des Atemvolumens gemessen. Die Patienten wurden mit einem zeitgesteuerten, volumenkonstanten Respirator unter Verwendung von 50% O2 und 50% N2 oder Luft beatmet. Vor der Zuschaltung des Totraumes waren die durchschnittlichen Blutgase: Pao2= 95,4 mm Hg, Paco2= 37,4 mm Hg und pH = 7,442. Nach 20‐minütiger Ventilation mit einem zusätzlichen Totraum von 200 ml und einer gleich hohen Vergrößerung des AV stieg das Pao2 auf 113,7 mm Hg (P < 0,001), während Paco2 und pH praktisch unverändert blieben. Zwanzig Minuten nach Entfernung des Zusatztotraumes und Wiederherstellung der ursprünglichen Ventilationsgrößen war das Pao2 zwar auf 107,1 mm Hg abgesunken, aber immer noch deutlich über dem Ausgangswert (P < 0,001). Diese Beobachtungen zeigen, daß die gleichzeitige Erhöhung des Totraumes und des Atemvolumens während einer künstlichen Beatmung Ventilations‐Perfusions‐Störungen und die O2‐Anreicherung des Blutes verbessern kann. Diese Wirkung hält in variablem Ausmaß noch über die Totraum‐Ventilation hinaus an.
Preliminary Clinical Evaluation of Etidocaine (Duranest®): A New Long‐Acting Local Anesthetic Agent
Authors: Bridenbaugh P. O. , Tucker G. T. , Moore D. C. , Bridenbaugh L. D. , Thompson G. E.
Published: December 2008

Etidocaine represents a new anilide‐type local anesthetic structurally related to lidocaine. In pre‐clinical tests, the anesthetic potency was four times that of lidocaine, and the duration of action in equipotent concentrations was two times longer than lidocaine.

Thirty‐one patients received intercostal nerve block anesthesia with 30–60 ml of etidocaine in concentrations of 0.25% and 0.5% with 1:200,000 epinephrine added. Sensory anesthesia was complete in 6–9 min and lasted approximately 790 min. Fifty patients received lumbar epidural anesthesia with 20 ml of etidocaine in progressive concentrations from 0.25% to 1.5% with 1:200,000 epinephrine added. In all concentrations, anesthesia was complete in less than 20 min and lasted from 384 to 655 min. Interestingly, the 1.5% concentration provided a shorter duration than did the 1% dose.

Up to and at the 300 mg dose of etidocaine with 1:200,000 epinephrine, no signs of local or systemic toxicity, cardiovascular disturbance, or organ function abnormalities were observed.

Etidocaine ist ein neues Lokalanaesthetikum vom Typus der Anilide, strukturell dem Lidocain verwandt. Bei vorklinischen Tests zeigte es eine vierfache Wirkungsstärke gegenüber dem Lidocain und in wirkungsgleichen Konzentrationen war seine Wirkungsdauer doppelt so lang als die des Lidocain. Bei 31 Patienten wurden Intercostalblockaden mit 30–60 ml Etidocaine in Konzentrationen von 0,25 und 0,5% unter Zusatz von 1:200.000 Adrenalin durchgeführt. Innerhalb von 6–9 Minuten trat komplette sensorische Anaesthesie auf und dauerte ungefähr 790 Minuten. 50 Patienten erhielten eine lumbale Epiduralanaesthesie mit 20 ml Etidocaine in steigenden Konzentrationen von 0,25%–1,5% unter Zusatz von Adrenalin 1:200.000. Bei alien Konzentrationen war die Anaesthesie in weniger als 20 Minuten komplett und dauerte zwischen 384 und 655 Minuten. Interessanterweise zeigte die l,5%ige Lösung eine kürzere Wirkungsdauer als die 1%ige. Bis zu einschließlich 300 mg Etidocaine mit Adrenalin 1:200.000 wurden keine Zeichen von lokaler oder systemischer Toxizität, kardiovaskulären Störungen oder abnorme Organfunktionen beobachtet.
Etidocaine (Duranest®): A Clinical and Laboratory Evaluation
Authors: Lund P. C. , Cwik J. C. , Gannon R. T.
Published: December 2008

The results of a clinical and laboratory evaluation of the new local anesthetic etidocaine for conduction anesthesia in a series exceeding 2200 cases are reported in detail. It has a high frequency, rapid onset of action, slow regression as well as a prolonged duration of sensory and motor blockade exceeding that of bupivacaine. The peak venous blood plasma concentration curves following peridural anesthesia are lower than those of an equipotent concentration of bupivacaine. Reference is also made to pharmacokinetic studies which suggest that this agent has a lower systemic toxicity or therapeutic index than other local anesthetic agents. Appropriate concentrations for various conduction anesthesia procedures vary from 0.5 to 1.5%. It is indicated that the low systemic toxicity and prolonged duration of action of etidocaine is related to its high plasma protein binding capacity and enhanced lipid solubility. The structural formula and chemical properties of this stable amide are quite similar to those of lidocaine.

Es wird über die Ergebnisse einer klinischen und Laboratoriumsauswertung des neuen Lokalanaesthetikums Etidocain zur Leitungsanaesthesie in einer Serie von über 2200 Fällen im Detail berichtet. Seine Wirkungsfrequenz ist hoch, der Wirkungseintritt rasch, der Wirkungsverlust langsam. Die Dauer der sensorischen und motorischen Blockade übertrifft die des Bupivacains. Die Spitzenwerte der venösen Blutplasmakonzentrationen nach Periduralanaesthesien sind niedriger als nach wirkungsgleichen Mengen von Bupivacain. Es wird auf pharmakokinetische Untersuchungen verwiesen, die ergaben, daß dieses Agens eine niedrigere systemische Toxizität, bzw. therapeutischen Index hat als andere Lokalanaesthetika. Gecignete Konzentrationen für verschiedene Methoden der Leitungsanaesthesie liegen zwischen 0,5 und 1,5%. Es wird betont, daß die geringe systemische Toxizität und längere Wirksamkeit von Etidocain auf seiner hohen Plasmaprotein‐Bindungskapazität und vermehrten Lipoidlöslichkeit beruht. Die Strukturformel und die chemischen Eigenschaften dieses stabilen Amids sind ganz ähnlich denen des Lidocains.
The Effect of Halothane on the Limb Arteries in Dog
Authors: Ahlgren I. , Trägårdh B.
Published: December 2008

The effect of halothane on the limb arteries in dog was studied angiographically and with a flowmeter. After preparatory sedation with barbiturate, animals were anaesthetized with 1.5% halothane in 5 1 of oxygen in a non‐rebreathing system. Selective angiography was performed prior to administration of halothane, 30 min after halothane anaesthesia and after mild hyperventilation with the same concentration of halothane‐oxygen. Arterial hypotension invariably occurred as well as respiratory acidosis, which was eliminated by hyperventilation. Vessels consistently demonstrated constriction under halothane administration. Flowmeter measurements were in accordance with these findings. It seems reasonable to assume that this vasoconstriction is not related to variation in blood gases and that it is a direct or indirect effect of halothane.

Wir untersuchten die Wirkung von Halothan auf die Beinarterien des Hundes mit Hilfe der Angiographie und eines Strömungsmessers. Nach vorbereitender Sedierung mit einem Barbiturat wurden die Tiere mit 1,5% Halothan in 5 1 Sauerstoff in einem Nicht Rückatmungssystem narkotisiert. Selektive Angiographien wurden durchgeführt vor der Anwendung von Halothan, nach 30‐minütiger Halothannarkose und nach mäßiger Hyperventilation mit der gleichen Halothankonzentration in Sauerstoff. Es kam in jedem Fall zu einer arteriellen Hypotension ebenso wie zu einer respiratorschen Azidose, welch letztere durch Hyperventilation ausgeglichen werden konnte. Während der Halothan‐Verabreichung kam es stets zu einer Konstriktion der Gefäße. Die Strömungsmessungen zeigten Übereinstimmung mit diesen Befunden. Man darf daraus wohl mit Recht den Schluß ziehen, daß die Vasokonstriktion nicht mit Blutgasveränderungen in Zusammenhang steht, sondern eine direkte oder indirekte Halothanwirkung darstellt.
A Mobile Emergency Care Unit: Two Years of Experience
Authors: Palm T. , Elkjær P.
Published: December 2008

During recent years, attempts have been made in various countries to provide optimum treatment of patients suffering from acute life‐threatening conditions outside hospitals.

A system with medically staffed ambulances provided with the requisite equipment for observation and treatment is reported. The object is to apply life‐saving measures to all such patients ‐ not only to those in need of emergency coronary care, as has been the object of some previously reported systems.

The experience gained within a 2‐year period is presented, and the fundamental differences between various mobile emergency care systems are discussed.

Während der letzten Jahre wurden in einigen händern Versuche unternommen, Patienten mit akuten lebensbedrohlichen Krankheitszuständen auch außerhalb der Krankenhäuser optimale Behandlungsbedingungen zu bieten.

Es wird über ein Notarztwagensystem mit entsprechenden Beobachtungs‐ und Behandlungseinrichtungen berichtet. Es wurde dabei bezweckt, die lebensrettenden Maßnahmen bei allen derartigen Patienten zur Anwendung zu bringen, nicht nur ‐ wie dies bei einigen früher publizierten Systemen der Fall war ‐ für Herzinfarktpatienten.

Die während einer Periode von zwei Jahren gewonnenen Erfahrungen werden dargelegt und die grundlegenden Unterschiede zwischen verschiedenen Notarztwagensystemen erörtert.
Variations in Serum Potassium and Serum Cholinesterase Activity After Induction with Althesin®‐Suxamethonium and Thiopentone‐Suxamethonium
Authors: Wisborg K. , Hanel H. K. , Viby‐Mogensen J.
Published: December 2008

The changes in serum potassium and serum cholinesterase during induction of anaesthesia by thiopentone or Althesin® followed by suxamethonium were studied. We found a significant fall in serum potassium after induction of anaesthesia and a significant increase after suxamethonium with both agents, but there were no significant differences between the two agents.

The activity of serum cholinesterase did not show any significant variation from normal during the time of observation.

Wir untersuchten die Veränderungen des Serum‐K und der Serumcholinesterase, die im Gefolge einer Suxamethoniumgabe nach Narkoseeinleitung mit Thiopental oder Althesin® auftreten. Dabei fanden wir einen signifikanten Abfall des K‐Spiegels nach Narkoseeinleitung mit beiden Agentien und einen deutlichen Anstieg des K nach Suxamethonium, aber keinen signifikanten Unterschied zwischen den beiden Agentien.

Die Aktivität der Serumcholinesterase zeigte keinerlei bemerkemwerte Abweichungen von der Norm während des Beobachtungszeitraumes.
Pulmonary Venoconstriction by Induced Platelet Aggregation
Authors: Rådegran K. , Drugge U. , Olsson P.
Published: December 2008

Fourteen mongrel dogs were subjected to intravenous infusions of thrombin or protamine chloride in order to induce in vivo platelet aggregation. As a result, the platelet count of blood decreased acutely to 20–30% of the preinfusion value. Together with the fall in the platelet count, there was observed in the thrombin experiments a rise in the pulmonary artery pressure (PA) from 192 (s.d.) to 41 13 mmHg. Simultaneously, the pressure in a small intrapulmonary vein (SPV) increased from 10 3 to 22 10 mmHg. Similar results were obtained in the protamine experiments where the PA increased from 20 5 to 37 8 mmHg and the SPV from 10 3 to 23 6 mmHg. The airways were also affected, as evidenced by a rise in tracheal insufflation pressure by 36 32 and 71 53%, respectively. The rise in tracheal pressure was not the cause of the rise in SPV since apnea did not prevent it. It is suggested that vasoconstriction rather than intravascular obstruction caused the rise in SPV.

Um eine “in‐vivo”‐Thrombozytenaggregation einzuleiten, erhielten 14 Bastardhunde intravenöse Infusionen von entweder Thrombin oder Protaminchlorid. Als Resultat davon fiel die Thrombozytenzahl akut auf 20–30% des Vor‐Infusions‐Wertes. Gleichzeitig mit dem Thrombozytensturz wurde bei den Thrombinexperimenten ein Anstieg des Pulmonalarteriendruckes (P̄PA) von 19±2 (x̄± s.d.) auf 41 ± 13 mmHg beobachtet. Gleichzeitig stieg der Druck in einer kleinen intrapulmonalen Vene (P̄SPV) von 10 ± 3 auf 22 ± 10 mmHg an. Ähnliche Resultate ergaben sich bei den Protamin‐Versuchen, bei denen der P̄PA von 20 ± 5 auf 37±8 mmHg und der P̄SPV von 10±3 auf 23±6 mmHg anstiegen. Als Zeichen einer gleichzeitigen Beeinträchtigung der Atemwege ergab sich eine Erhöhung des trachealen Insufflationsdruckes um 36±32 bzw. 71±53 %. Die Erhöhung des Intratrachealdruckes war jedoch nicht die Ursache des Anstieges des P̄SPV denn dieser zeigte sich auch bei Apnoe. Es wird angenommen, daß der erhöhte P̄SPV eher durch Vasokonstriktion als durch eine intravaskuläre Obstruktion zustande kommt.
Influence of methoprene and protein on survival, maturation and sexual performance of male Ceratitis capitata (Diptera: Tephritidae)
Authors: Faria M. J. , Pereira R. , Dellinger T. , Teal P. E. A.
Published: December 2008

The Mediterranean fruit fly (medfly), Ceratitis capitata (Wied.), like many other polyphagous tephritids (Diptera: Tephritidae), preforms a lek as mating system. The sterile insect technique (SIT) requires released males to survive in the field, and to compete with wild males in attracting, courting and mating with wild females. The effects of the juvenile hormone analogue, methoprene, and the incorporation of hydrolyzed yeast protein into the adult diet, on survival, sexual maturation and sexual performance of male C. capitata were evaluated for the four possible combinations of methoprene‐treated or untreated, and protein‐fed or deprived flies. The incorporation of protein had a positive impact on laboratory survival and accelerates the sexual maturation of mass‐reared males. In addition, in the laboratory, male sexual performance was significantly higher in treatments with methoprene. However, field cage tests with mature and protein‐fed wild males and females failed to show any effects of either factor on male sexual performance. The increased survival and the earlier sexual maturation of sterile males due to the addition of protein to the adult diet can positively influence the efficacy of SIT application against C. capitata.
Nassarius corniculus (Olivi, 1792) (Caenogastropoda: Nassariidae): a model of environmental complexity of Italian brackish and marine habitats
Authors: Iannotta Maria Alessandra , Toscano Francesco , Patti Francesco Paolo
Published: December 2008

Strong environmental selection may give rise to complex species and/or camouflage the presence of sibling species in brackish waters. The prosobranch gastropod Nassarius corniculus (Olivi, 1792) is a common scavenger widely distributed in Mediterranean brackish and marine areas. We examined the morphological and molecular features of N. corniculus populations and related these features to the environmental complexity of brackish habitats. Morphological data revealed differences in radular features between specimens collected from two Mediterranean lagoons (Lake Faro, Messina, Sicily and Lake Fusaro, Gulf of Gaeta). Analysis of with the mitochondrial marker mt 16S rRNA revealed genetic variability within the Lake Faro population but did not show the different geographic structure between the two lagoons indicated by morphological data. We also predicted the gene flow of N. corniculus by comparing populations of two marine areas (Faro Sea and Ischia).
Bilateral Testicular Haemorrhage in a Bleu du Maine Ram: Clinical, Ultrasonographic and Histologic Features
Authors: Smith K , Brown P , Barr F
Published: December 2008

Contents

Bilateral testicular haemorrhage was detected in a 5‐year‐old Bleu du Maine ram in an abattoir survey of male reproductive tracts in sheep; the ultrasonographic and histologic features of the lesions are described.
Offspring from Heterotopic Transplantation of Newborn Mice Ovaries
Authors: Li S , Qin B‐L , Li F , Li W‐L , Shi Z‐D , Tian Y‐B , Chen X‐J
Published: December 2008

Contents

This study is aimed at investigating the developmental potential of the primordial follicles from ovaries of newborn mice after cryopreservation in liquid nitrogen for long‐term storage, thawing, and heterografting into the kidney capsules of ovariectomized adult female mice. After stimulation of recipient mice with pregnant mare serum gonadotropin on day‐19 after heterografting, the primordial follicles of the transplanted ovaries could develop into antral follicles. When the oocyte‐cumulus cell complexes were retrieved from these antral follicles, they could mature after in vitro culture for 16–17 h. After in vitro fertilization, the rates of embryos derived from these oocytes that developed into the two‐cell stage and the blastocyst stage after 16–17 h and after day‐4, respectively, in the culture medium were 55.40% (55/107) and 9.09% (5/55), respectively. In the ovarian transplantation groups, no pups were derived from the 410 embryos that were transferred into 10 pseudopregnant mothers at the pronuclear stage. However, of the 10 surrogate mothers in whom 570 embryos were transferred at the two‐cell stage, four achieved pregnancy and gave birth to 20 live offspring. These results demonstrated that primordial follicles in newborn mice ovaries were capable of sustaining their developmental potential after freezing and thawing. Once transplanted into the kidney capsules of ovariectomized adult female mice, these primordial follicles could develop and respond to gonadotropin stimulation and reach the antral stage; further, live offspring could be derived from these follicles.
Pre‐breeding Ovaro–Uterine Ultrasonography and its Relationship with First Service Pregnancy Rate in Seasonal‐Calving Dairy Herds
Authors: Mee JF , Buckley F , Ryan D , Dillon P
Published: December 2008

Contents

The objectives of the study were to characterize an ultrasound reproductive tract scoring (URTS) system to assess suitability for breeding in dairy cows, to describe the prevalence of these scores in commercial dairy herds and to examine their relationship with subsequent fertility. Ultrasound examinations (7797) were performed on 5751 Holstein–Friesian cows prior to breeding in 62 seasonally calving herds over 2 years. Data recorded from images of both ovaries and the uterus were combined into a six point scoring system and the prevalence of cows with cystic ovarian follicles and uterine abscesses and adhesions was recorded separately. The prevalence of ovulatory cows which had completed uterine involution (score 1), or had mild (2) or moderate endometritis (3) was 62.5%, 21.7% and 2.2%, respectively. The prevalence of anovulatory cows with moderate endometritis (4), ovulatory cows with pyometra (5) and anovulatory cows which had completed uterine involution (6) was 3.3%, 2.2% and 8.1%, respectively. The interval between calving and examination differed between cows with each of the scores 1, 2, 5 and 6 (61, 46, 53 and 50 days, respectively, p < 0.05) but not between cows with scores 3 and 4 (37 and 35 days, respectively). Ovulatory cows which had completed uterine involution (score 1) had a higher likelihood of pregnancy to first service than ovulatory or anovulatory cows which had not completed uterine involution (p ≤ 0.10). The prevalence of cows with cystic ovarian follicles or abscesses or adhesions of the reproductive tract was 3.9% and 1.2%, respectively. In conclusion, 29% and 11% of cows in seasonally calving and breeding dairy herds had not completed uterine involution or were anovulatory prior to the mating start date, respectively. Both conditions, detected using a URTS system, significantly reduced first service pregnancy rate in these pasture‐based dairy herds.
hCG‐Induced Ovulation in Thoroughbred Mares Does Not AffectCorpus luteumDevelopment and Function During Early Pregnancy
Authors: Urquieta B , Durán MC , Coloma I , Parraguez VH
Published: December 2008

Contents

Our aim was to compareCorpus luteum(CL) development and blood plasma concentration of progesterone ([P4]) in thoroughbred mares after spontaneous (Control: C) or human chorionic gonadotrophin (hCG)‐induced ovulation. Lactating mares (C = 12; hCG = 21) were daily teased and mated during second oestruspost‐partum. Treated mares received 2500 IU hCG i.v. at first day of behavioural oestrus when dominant follicular size was >35, ≤42 mm and mated 12–24 h after. Control mares in oestrus were mated with dominant follicular size ≥45 mm. Dominant follicle before ovulation, CL and gestational sac were measured by ultrasound and [P4] by radioimmunoassay (RIA). Blood sampling and ultrasound CL exams were done at days 1, 2, 3, 4, 8, 12, 16, 20, 25, 30, 35, 40, 45, 60 and 90 after ovulation and gestational sac from day 12 after ovulation in pregnant (P) mares; non‐pregnant (NP) were followed until oestrus returned. Data analyses considered four subgroups: hCG‐P, hCG‐NP, C‐P and C‐NP. Preovulatory follicular size was smaller in hCG mares than in C: 39.2 ± 2.7 mm vs 51.0 ± 1.8 mm (p < 0.0001). All hCG mares ovulated 24–48 h after treatment and presented similar oestrus duration as controls.C. luteumsize in P mares showed the same pattern of development through days 4–35, presenting erratic differences during initial establishment. Thus, on days 1 and 3, CL was smaller in hCG‐P (p < 0.05); while in hCG‐NP, CL size was greater than in C‐NP on day three (p = 0.03).Corpus luteumsize remained stable until day 90 in hCG‐P mares, while in C‐P a transient and apparently not functional increase was detected on days 40 and 45 (p < 0.05) and the decrease from day 60 onwards, made this difference to disappear. No differences were observed in [P4] pattern between P, or between NP subgroups, respectively. So, hCG‐induced ovulation does not affect CL development, neither [P4] during early pregnancy. One cycle pregnancy rate tended to be lower in hCG mares while season pregnancy rates were similar to controls.
In Vivo and In Vitro Sperm Interaction with Oviductal Epithelial Cells of Llama
Authors: Apichela S , Jiménez‐Díaz MA , Roldan‐Olarte M , Valz‐Gianinet JN , Miceli DC
Published: December 2008

Contents

Sperm reservoirs in South American Camelids would be crucial for successful fertilization. Since ovulation occurs approximately 36 h after mating, the maintenance of the sperm viability in the oviduct waiting for the ovum is a critical reproductive event. Our study aimed at determining whether the isthmus or the utero tubal junction (UTJ) could function as a sperm reservoir in llama by means of in vivo and in vitro experiments. For the in vivo experiments, the oviducts of adult females with a dominant follicle bigger than 7 mm were examined for the presence of sperm at 6, 18, 24, 28 and 35 h after mating. The results using scanning and transmission electron microscopy showed ultrastructural differences between isthmus and UTJ with respect to (1) predominance of secretory cells in the UTJ and ciliated cells in the isthmus epithelium and (2) cytoplasmic bulbous projection of the secretory cells in the UTJ. Sperm adhered by a mucus‐like substance were seen only in the UTJ at 6, 18, 24 and 28 h post‐mating. Lack of sperm adhered to oviductal mucosa was observed around ovulation (35 h). In vitro experiments demonstrated higher ability of UTJ epithelial cell explants with respect to isthmus explants to bind sperm in a co‐cultured system. The anatomical features and the presence of a sperm bonding agent in the UTJ together with the in vitro differential binding of sperm to UTJ explants strongly suggest that both may be feasible mechanisms that facilitate sperm storage in this oviductal region in llama.