bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of caudal morphine and tramadol for postoperative pain control in children undergoing inguinal herniorrhaphy
Authors: Ozcengiz D. , Gunduz M. , Ozbek H. , Isik G.
Published: March 2003

Objectives: We compared the quality and duration of analgesia, the effect on perioperative sevoflurane requirement after a single, presurgical caudal block with either tramadol or morphine in children undergoing inguinal herniorrhaphy. Our study was also designed to evaluate the preemptive analgesic efficacy of morphine administered caudally in children.

Methods: Patients were randomly divided into three groups to receive 2 mg·kg–1 tramadol (group T, preemptive group) or morphine sulphate 0.03 mg·kg–1 (group M, preemptive group). The patients in control group (group C, postincisional group) received morphine sulphate 0.03 mg·kg–1 at the end of surgery, caudally. Cardiorespiratory data, sedation and pain were recorded for 24 h following recovery from anaesthesia.

Results: There were no differences between the three groups in baseline blood pressure or heart rate; or duration of anaesthesia, surgery. The inhaled sevoflurane concentration was significantly lower in group M and group T than in the control group. The quality and duration of postoperative pain relief did not differ between the three groups. There were no intergroup differences in postoperative nausea, vomiting, or other complications.

Conclusions: Caudal tramadol (2 mg·kg–1) provided reliable postoperative analgesia similar to caudal morphine (0.03 mg·kg–1) in quality and duration of pain relief in our study children who were undergoing herniorrhaphy. We also concluded that presurgical caudal morphine or tramadol reduced perioperative sevoflurane requirements and either presurgical or postsurgical caudal morphine did not make any difference to postoperative analgesia.
Review of ethics in paediatric anaesthesia: consent issues
Authors: Edgar J , Morton N S , Pace N A
Published: March 2003

The concepts of law and ethics as related to medical practice have always been of paramount importance to the medical profession. This series of three reviews, examines the changes in the law in the last 10 years in relation to ethics and the practice of paediatric anaesthesia. The reviews cover, in a practical question and answer format, the topics of consent, research, intensive care and organ donation issues in children.
Use of rapacuronium in a child with spinal muscular atrophy
Authors: Stucke Astrid G. , Stuth Eckehard A.E.
Published: March 2003

We report the case of an 18‐month‐old girl with spinal muscular atrophy (SMA) that received 1 mg·kg–1 rapacuronium for laryngospasm during induction of anaesthesia. Within 15 min, we observed some diaphragmatic recovery and, after emergence from anaesthesia, the child demonstrated adequate respiratory efforts. However, the child showed diminished strength of the upper extremity muscles. Since the preoperative workup had revealed bulbar symptoms and laryngeal function could not be easily assessed, the patient was kept intubated until upper extremity strength had returned to preoperative levels. Small doses of midazolam had been given to reduce the patient’s anxiety but the patient was extubated within 5 h without any complications. Train of four (TOF) monitoring of the right adductor pollicis muscle, performed during anaesthetic recovery, was equivocal. In SMA, muscle groups are differentially affected so that TOF responses may be inconclusive and not reflect the state of the upper airway muscles. To our knowledge, this is the first report of use of a nondepolarizing neuromuscular blocking agent in a child with SMA.
Comparison of rocuronium and suxamethonium for rapid tracheal intubation in children
Authors: CHENG CLAUDIA A.Y. , AUN CINDY S.T. , GIN TONY
Published: March 2003

Background: The purpose of our study was to determine whether a smaller dose of rocuronium than previously reported could provide similar intubating conditions to suxamethonium during rapid‐sequence induction of anaesthesia in children.

Methods: One hundred and twenty ASA I, unpremedicated children, aged 1–10 years, who were undergoing elective surgery, were randomized into three groups to receive rocuronium 0.6 mg·kg–1, rocuronium 0.9 mg·kg–1 or suxamethonium 1.5 mg·kg–1. The study was double‐blinded, anaesthesia and timing of injection was standardized to alfentanil 10 μg·kg–1, thiopentone 5 mg·kg–1 and the study drug. Intubation was attempted at 30 s after injection of neuromuscular relaxant and intubating conditions graded as excellent, good, poor or impossible.

Results: All 120 children were successfully intubated within 60 s without need for a second attempt after administration of neuromuscular relaxant. Differences between suxamethonium and rocuronium 0.6 mg·kg–1 and between the two doses of rocuronium were statistically significant (P=0.016 and 0.007, respectively).

Conclusions: Rocuronium 0.9 mg·kg–1 provides similar intubating conditions to suxamethonium 1.5 mg·kg–1 during modified rapid‐sequence induction using alfentanil and thiopentone in children (P=0.671). Rocuronium 0.6 mg·kg–1 was inadequate.
Childhood obesity: a challenge for the anaesthetist?
Authors: SMITH H.L. , MELDRUM D.J. , BRENNAN L.J.
Published: March 2003

The definition of childhood obesity has not been standardized in the past, making studies difficult to compare. In spite of this, the increase in the incidence of childhood obesity is evident and has now reached epidemic proportions. Obese children experience few of the medical complications seen in obese adults. Respiratory physiology appears to be most affected, the degree of which is determined by the level of obesity. Although there is a considerable amount of information on the anaesthetic management of the obese adult, very little has been written concerning the obese child. There is less pathology in the obese child when compared with the adult but some evidence shows a higher likelihood of a critical incident occurring when anaesthetizing such children. This shows that we need to be as worried about anaesthetizing the obese child as we are for the obese adult. This concern should increase with increasing body mass index.
Sevoflurane versus halothane: effect of oxycodone premedication on emergence behaviour in children
Authors: MURRAY DAVID J. , COLE JENNIFER W. , SHROCK CHARLES D. , SNIDER REBECCA J. , MARTINI JOHN A.
Published: March 2003

Background: Clinical studies have provided conflicting conclusions about whether the frequency of emergence agitation is increased in children following sevoflurane anaesthesia. The purpose of the study was to determine a frequency and duration of agitation with halothane and sevoflurane anaesthesia and whether oxycodone premedication affected the incidence of emergence agitation in children.

Methods: We measured and compared halothane and sevoflurane recovery in 130 patients using a 5‐point scale measuring emergence behaviour every 10 min during the first 60 min of recovery or until discharge.

Results: We used this 5‐point scale to assess the presence or absence of emergence agitation and found a frequency of emergence agitation of more than 40% in children who received halothane and sevoflurane anaesthesia.

Conclusions: Oxycodone reduced the frequency of agitation in children who received halothane, but not in the children who received sevoflurane anaesthesia.
Is haemostasis biological screening always useful before performing a neuraxial blockade in children?
Authors: ROUX CORINNE LE , LEJUS CORINNE , SURBLEB MARIELLE , RENAUDIN MARIETTE , GUILLAUD CHRISTIAN , WINDT ARIANE DE , LASNIER BETTY , PINAUD MICHEL
Published: March 2003

Background: Because of the lack of controlled studies, there is no consensus of opinion about the practice of routine haemostasis tests before neuraxial blockade in children. The purpose of this study was to compare the influence of two different strategies of coagulation evaluation on the incidence of diagnosed coagulopathies leading to a modification of the preoperative or anaesthetic management in children who were scheduled for caudal, epidural or intrathecal block.

Methods: For a 24‐month period (period 1, retrospective study, n=751), haemostasis screening was undertaken only after family and personal history and physical examination in all patients. For the following 24 months (period 2, prospective study, n=958), a standardized questionnaire was used. In addition, routine tests (prothrombin, partial thromboplastin time, platelet count) were performed in children who where not yet walking. In older children, coagulation tests were undertaken as in period 1.

Results: Overall, 26 significant abnormalities were diagnosed. Coagulation tests were performed in 16.2% (period 1) and 78.2% (period 2) of the children, who were not yet walking. Routine tests did not improve the diagnosis of haemostasis abnormalities justifying a modification of the preoperative and anaesthetic management (2.2% from 406 children in period 1 vs 4.1% from 266 children in period 2). The predictive positive value of routine tests (period 2) was 19%, vs 45% for specific tests (period 1) (P < 0.001). In older children, the use of a standardized form increased the number of haemostasis screenings without improvement of diagnosis leading to modified preoperative management (0.3% from 315 children in period 1 vs 0.5% from 628 children in period 2).

Conclusions: When routine testing is performed in nonwalking children, the screening number increases without leading to a higher number of anaesthetic management changes, suggesting that routine testing does not seem to provide much extra information in the absence of a positive history.
Myotonia dystrophica and spinal surgery
Authors: COLOVIC V. , WALKER R.W.M.
Published: March 2003

Two cases of patients suffering from the congenital form of myotonia dystrophica under going spinal surgery are presented. Both patients had major complications, including cardiac arrhythmias, postoperative wound infection and more minor complications, such as sedation and opioid sensitivity. However, the most notable complication resulting in long‐term morbidity was the deterioration of bulbar muscular function in one of the patients. This resulted in recurrent aspiration pneumonia and the need for a tracheostomy. This serious complication has not previously been reported following surgery.
Complicated negative pressure pulmonary oedema in a child with cerebral palsy
Authors: TAHA SAMAR , BARTELMAOS TONINE , KASSAS CHADI , KHATIB MOHAMAD , BARAKA ANIS
Published: March 2003

A 3‐year‐old child with cerebral palsy developed postextubation upper airway obstruction secondary to laryngospasm and/or masseteric spasm,which may have been triggerred by the muscular spasticity and the slow recovery from inhalational anaesthesia associated with cerebral palsy. This upper airway obstruction was followed by negative pressure pulmonary oedema. The patient improved on mechanical ventilation; however, his condition was complicated with the occurrence of bilateral pneumothoraces. After release of the pneumothoraces and reexpansion of the lungs, the child developed reexpansion pulmonary oedema, culminating in acute lung injury.
Anaesthetic management of a patient with microvillus inclusion disease for intestinal transplantation
Authors: Goldman Luis J. , Santamaría Manuel López , Gámez Manuel
Published: March 2003

We report the anaesthetic management of a 3‐year‐old‐child with microvillus inclusion disease undergoing isolated small bowel transplantation. He required long‐term total parenteral nutrition which was complicated with numerous episodes of catheter related sepsis. This resulted in thrombosis of the major blood vessels which critically restricted vascular access available for intravenous nutrition, becoming a life‐threatening condition for the patient. Haemodynamic, respiratory parameters and urinary output were well preserved throughout the procedure. Besides a transitory increase in potassium following graft revascularization, biochemical changes were small. Anaesthetic management included comprehensive preoperative assessment, central venous angiography to depict accessibility of central and peripheral veins, assurance of additional vascular access through the intraoperative catheterization of the left renal vein, perioperative epidural analgesia and preservation of splanchnic perfusion to ensure implant viability.
The effect of baricity of intrathecal morphine in children receiving tetracaine spinal anaesthesia for cardiac surgery: a preliminary report
Authors: FINKEL JULIA C. , BOLTZ M. GAIL , CONRAN AISLING M.
Published: March 2003

Background: This prospective, randomized study examined the effect of baricity of intrathecal preservative‐free morphine on the duration of postoperative analgesia and incidence of side‐effects in infants and children receiving high spinal anaesthesia with hyperbaric tetracaine in combination with a light general anaesthetic.

Methods: Fourteen infants and children, aged 7–91 months, undergoing repair of either uncomplicated atrial or ventricular septal defects, were randomized to receive either 10 μg·kg–1 of intrathecal morphine in combination with 0.5% tetracaine D10 (hyperbaric morphine group) or intrathecal morphine mixed with saline and injected sequentially after the administration of 0.5% tetracaine D10 (hypobaric morphine group). After spinal injection, patients were positioned in 30° of Trendelenburg for a minimum of 10 min. Postoperatively, patients were monitored for a minimum of 12 h. Pain scores and the incidence and severity of side‐effects were recorded every 1 h.

Results: All patients were extubated at the conclusion of surgery without any incidence of respiratory depression. There was a decreased incidence of vomiting in the hypobaric morphine group and no significant difference in the duration of analgesia.

Conclusions: When intrathecal morphine is administered in conjunction with a hyperbaric tetracaine spinal to paediatric cardiac patients in the head down position, sequential administration of the hypobaric solution may mitigate side‐effects.
The reliability of endtidal CO2 in spontaneously breathing children during anaesthesia with Laryngeal Mask AirwayTM, low flow, sevoflurane and caudal epidural
Authors: AASHEIM Per , FASTING SIGURD , MOSTAD Ulf , AADAHL PETTER
Published: March 2003

Background: Noninvasive devices for monitoring endtidal CO2 (PECO2) are in common use in paediatric anaesthesia. Questions have been raised concerning the reliability of these devices in spontaneous breathing children during surgery. Our anaesthetic technique for elective infraumbilical surgery consists of spontaneous breathing through a Laryngeal Mask Airway (LMATM), low fresh gas flow, sevoflurane and a caudal epidural. We wanted to compare PECO2 and arterial CO2 (PaCO2) during surgery.

Methods: Twenty children, aged 1–6 years, scheduled for infraumbilical surgery, were studied and one arterial sample was taken 45 min after induction of anaesthesia. PECO2, inspiratory PCO2, oxygen saturation, heart rate, respiratory rate, mean arterial blood pressure and expiratory sevoflurane concentration were measured every 5 min. The respiratory and circulatory parameters were stable during surgery.

Results: The mean PaCO2 – PECO2 difference was 0.15 (0.16) kPa [1.1 (1.2 mmHg)].

Conclusions: PECO2 is a good indicator of PaCO2 in our anaesthetic setting.
Premedication with midazolam in young children: a comparison of four routes of administration
Authors: Kogan Alexander , Katz Jacob , Efrat Rachel , Eidelman Leonid A.
Published: March 2003

Summary Background: We undertook a study to determine the effects of four routes of administation on the efficacy of midazolam for premedication.

Methods: In a randomized double‐blind study, 119 unmedicated children, ASA I–II, aged 1.5–5 years, who were scheduled for minor elective surgery and who had been planned to received midazolam as a premedicant drug, were randomly assigned to one of four groups. Group I received intranasal midazolam 0.3 mg·kg−1; group II, oral midazolam 0.5 mg·kg−1; group III, rectal midazolam 0.5 mg·kg−1; and group IV, sublingual midazolam 0.3 mg·kg−1. A blinded observer assessed the children for sedation and anxiolysis every 5 min prior to surgery. Quality of mask acceptance for induction, postanaesthesia care unit behaviour and parents' satisfaction were evaluated. Thirty patients were enrolled in each of groups I, III and IV. Twenty‐nine patients were enrolled in group II.

Results: There were no significant differences in sedation and anxiety levels among the four groups. Average sedation and anxiolysis increased with time, achieving a maximum at 20 min in group I and at 30 min in groups II–IV. Patient mask acceptance was good for more than 75% of the children. Although the intranasal route provides a faster effect, it causes significant nasal irritation. Seventy‐seven percent of the children from this group cried after drug administration. Most parents in all groups (67–73%) were satisfied with the premedication.

Conclusions: Intranasal, oral, rectal and sublingual midazolam produces good levels of sedation and anxiolysis. Mask acceptance for inhalation induction was easy in the majority of children, irrespective of the route of drug administration.
Is there a role of a small dose of propofol in the treatment of laryngeal spasm?
Authors: Afshan Gauhar , Chohan Ursula , Qamar‐Ul‐Hoda Mohammad , Kamal Rehana S.
Published: March 2003

Summary Background: Propofol has been found to depress the laryngeal reflexes. We studied whether this property could be utilized to relieve laryngeal spasm.

Methods: This study was conducted over a period of 3 years, and included children aged 3–10 years, ASA status I and II. Most of the children were undergoing minor surgical procedures, under general anaesthesia with Laryngeal Mask Airway (LMA™) and caudal epidural analgesia.

Results: During this period, 20 patients developed laryngeal spasm on removal of the LMA at the end of surgery. Initially, they all were treated with 100% O2, with gentle positive pressure ventilation. Out of 20 patients, seven responded well with 100% O2 and gentle positive pressure ventilation. The remaining 13 were treated with a small dose of propofol (0.8 mg·kg−1 body weight). Laryngeal spasm was relieved successfully in 10 patients and three patients required intubation to improve their oxygenation.

Conclusions: Propofol in a small dose (0.8 mg·kg−1 body weight) was a useful drug to relieve laryngeal spasm in most children (76.9%) following the removal of the LMA. Because it was not found to be effective in all patients, succinylcholine still has a role to play in critical conditions. However, we recommend propofol as a suitable alternative for relieving laryngeal spasm in situations where succinylcholine is contraindicated.
Preemptive diclofenac reduces morphine use after remifentanil‐based anaesthesia for tonsillectomy
Authors: Öztekin Sermin , Hepağuşlar Hasan , Kar Aysun Afi̇fe , Özzeybek Deni̇z , Artikaslan Oya , Elar Zahi̇de
Published: March 2003

Summary Background: We investigated the effect of preincisional rectal diclofenac on pain scores and postoperative morphine requirements of children undergoing tonsillectomy after remifentanil‐propofol anaesthesia in a randomized clinical trial.

Methods: Induction and maintenance of anaesthesia were with remifentanil and propofol. Forty children were randomly assigned into two groups before incision. The diclofenac group (n=20) received diclofenac suppositories (approximately 1 mg·kg−1) and the control group (n=20) received no treatment. Following discontinuation of remifentanil, patient‐controlled analgesia (PCA) with morphine (a loading dose 50 µg·kg−1, a background infusion 4 µg·kg−1·h−1 and a demand dose 20 µg·kg−1 with 5‐min intervals) was started. We assessed pain score [verbal analogue scales (VAS), 0–10] and sedation level at 5‐min intervals and recorded the total morphine consumption of the first hour in the PACU. Patients were discharged to the ward with a new PCA morphine programme (a demand dose 20 µg·kg−1 with a lockout time of 30 min, for 4 h), and total morphine consumption was recorded.

Results: The mean VAS score of the diclofenac group was significantly lower than the control group on arrival in the PACU (2.85 ± 0.77, 7.60 ± 0.83, respectively, P < 0.01) and it remained significantly lower in the PACU stay of the children. The mean total morphine consumption of the diclofenac group was less than the control group in the PACU (130.33 ± 11.26 and 169.92 ± 9.22, respectively, P=0.012) and the ward (50.80 ± 11.38 and 87.77 ± 10.55, respectively, P=0.021).

Conclusions: Preemptive diclofenac given rectally reduced pain intensity and morphine requirements of children anaesthetized with remifentanil for tonsillectomy.
A 3:1 volume admixture of 1% propofol and 2.5% thiopentone reduces pain on induction in paediatric anaesthesia
Authors: Pollard R.C. , Makky S. , Mcfadzean J. , Ainsworth L. , Goobie S.M. , Montgomery C.J.
Published: March 2003

Introduction  The incidence of pain on injection with 1% propofol in adult and paediatric patients ranges from 50 to 100% (1). In paediatric practice, the addition of lignocaine 1 mg·kg−1 to propofol reduces the incidence of pain. The incidence of pain with this technique in a pilot study in our institution was 20%. Thiopentone mixed with propofol may also reduce injection pain (2). The purpose of this study was to evaluate the incidence of pain on injection during intravenous induction using a 3:1 volume admixture of 1% propofol and 2.5% thiopentone (P/T) compared to a 10:1 volume admixture of 1% propofol and 2% lignocaine (P/L).

Methods  After ethics committee approval and informed written parental consent, 127 children, aged 1–10 years and weighing < 40 kg were randomised into two groups; group P/L received 5 mg·kg−1 of 1% propofol and 1 mg·kg−1 of lignocaine, group P/T received 3 mg·kg−1 of 1% propofol and 3 mg·kg−1 of 2.5% thiopentone in a standardised fashion. Any subject who was not calm and cooperative immediately prior to induction after establishment of intravenous access was excluded from further study. A single, blinded observer scored pain behavior defined as any one of. a motor response of the arm, a verbal complaint of pain, cry and/or one of three standardised facial expressions of pain.

Results  The incidence of pain on injection was higher in the P/L group where 34% subjects experienced pain compared with 14% in the P/T group (χ2 = 7.5, P = 0.006). Motor response was the most frequent pain response in the P/L group (68%).

Discussion  The hemodynamic effects, immediate in‐hospital or late recovery profile and incidence of postoperative nausea and vomiting of these admixtures were not evaluated in this study. Our clinical impression is that using either the P/L or P/T combination allowed rapid IV induction, and therefore rapid ventilation and LMA insertion without obvious hypotension. The P/T admixture may be less painful to inject simply because propofol is diluted. The optimum ratio of dilution of propofol with thiopentone may not be 3:1 and requires a dose‐finding study evaluating in detail the efficacy and side effects of other ratios of admixtures.

Conclusion  The use of a 3:1 volume admixture of 1% propofol and 2.5% thiopentone compared to a 10:1 volume admixture of 1% propofol and 2% lignocaine reduces pain on injection at induction of anaesthesia in paediatric patients from 34% to 14%, and is a practical solution for pain on injection in pediatric patients.
Diode laser transscleral cyclophotocoagulation for the treatment of primary glaucoma in 18 dogs: a retrospective study
Authors: Hardman Chloe , Stanley Robin G.
Published: March 2003

Objective

To evaluate a higher total energy protocol for diode laser transscleral cyclophotocoagulation (TSCP) for the treatment of primary glaucoma in dogs.

Procedures

Diode laser TSCP was performed on 24 eyes of 18 dogs (six dogs were treated bilaterally). A glaucoma probe with a spot size of 600 microns was applied in 25 sites 3–4 mm posterior to the limbus for dogs. A power of 1000 milliwatts (mW) for a duration of 5000 milliseconds (ms) to deliver an average 125 J of energy per eye, which is higher energy delivery than previously reported for the diode laser for the treatment of canine glaucoma. Anterior chamber needle paracentesis was performed using a 30‐gauge needle until intraocular pressure (IOP) was measured to be less than 15 mmHg by applanation tonometry. Subconjunctival corticosteroids were administered in all cases and a temporary tarsorrhaphy was applied in 13 of the 24 treated eyes. Postoperative topical and systemic corticosteroids, and carbonic anhydrase inhibitors were administered as required to maintain an IOP of less than 25 mmHg. Intraocular pressure was measured at approximately 3 h postoperatively then at 1, 2, 3, 7, 14, 28, 60, 120, and 180 days. Adequate control of IOP was considered to be less than 25 mmHg on re‐examination.

Results

Intraocular pressure was successfully maintained within the normal range in 22/24 eyes (92%). Three eyes required a second diode laser treatment within the first week postoperatively. Two eyes developed recurrence of glaucoma at 8 and 32 weeks postoperatively. Follow‐up ranged from 8 to 21 months. Fourteen eyes were assessed by clinical examination and history to be potentially visual. Of these, seven eyes (50%) regained useful visual function. Mean IOP at 6 months was 11.0 ± 7.6 mmHg and at 12 months was 11.0 ± 8 mmHg. Postoperative complications included cataracts (six cases), corneal ulceration (three cases), and keratitis (three cases). Of 13 cases that were treated postoperatively with a temporary tarsorrhaphy, only one case (8%) developed corneal disease. Of the remaining 11 cases that were not treated with a temporary tarsorrhaphy, there were three cases of corneal ulceration and two cases of vascular keratitis (45% incidence of corneal disease). This was found to be statistically significant (P < 0.05). Postoperative complications of hyphema and phthisis bulbi were not seen in this series.

Conclusion

Low energy, higher power laser cyclophotocoagulation was effective in the treatment of canine primary glaucoma, with 50% of potentially visual eyes regaining vision, but may cause an increased incidence of secondary cataracts.
Screening and controlling canine inherited ocular diseases in Finland: epidemiological, economical and health promotional aspect
Authors: Leppänen  , Saloniemi
Published: March 2003

Official eye examination records of 18 146 dogs in 17 breeds were analyzed in order to evaluate the Finnish Kennel Club’s eye examination scheme. The most common inherited ocular diseases were the Collie eye anomaly (CEA) in the Rough Collie and the persistent hyperplastic tunica vasculosa lentis (PHTVL) in the Doberman. In both diseases the prevalence has also increased during the study period 1988–1997. The most likely reason for the increase is the change in examination routines that now makes it easier to find milder disease forms that were previously classified as normal. The prevalences of other inherited diseases are so low that no conclusions about the trends can be made. Also, the data have some defects that can cause biased estimations of prevalences. The costs of screening programs are very high and no direct economical benefits can be shown. Methods of improving the screening and effectiveness of the program are also presented.
Comparative retinal ganglion cell and optic nerve morphology
Authors: Brooks  , Komàromy  , Källberg
Published: March 2003

The optic nerve is divided in four regions: intraocular, intraorbital, intracanalicular, and intracranial. The vertebrate retinal ganglion cells are classified by morphology, physiology and soma size. Species differences and similarities occur with retinal ganglion cells. Alpha retinal ganglion cells have large somata, large dendritic fields, large‐diameter axons, and are most dense in the peripheral retina. Beta retinal ganglion cells have smaller diameter somata, smaller dendritic fields, small diameter axons, and predominate in the central retina. Gamma retinal ganglion cells are a heterogenous class of cells and have small diameter axons, and slow axon conduction velocities. The spatial distribution and organization of the retinal ganglion cells extends retinotopically through the nerve fiber layer, optic nerve, optic chiasm, optic tract, lateral geniculate nucleus, and visual cortex. The retinal nerve fiber layer thickness decreases from the optic disk toward the periphery of the retina. The retrobulbar optic nerve axon counts and axon density vary by species, with larger nerves having higher axon counts. Decussation of the optic nerve axons at the optic chiasm varies with 100% decussation in most birds and fish, 65% in cats, 75% in dogs, 80–90% in large animals, and 50% in primates. Centrifugal axons also occur in the optic nerve and may represent a method by which the brain can influence retinal activity.
Schwalbe line’s cell in the normal and glaucomatous dog
Authors: Samuelson Don , Plummer Caryn , Lewis Patricia , Gelatt Kirk
Published: March 2003

Objective The canine iridocorneal angle contains an operculum, which is similar to that in nonhuman primates and consists of a peripheral extension of the inner cornea that overlies the anterior‐most portion of the corneoscleral trabecular meshwork. This region contains cells, the Schwalbe line’s (SL) cells, that have been found to have secretory and epithelial characteristics. This region of the iridocorneal angle represents the nonfiltering portion and becomes altered early during spontaneous glaucoma in the Beagle. The present study describes the SL cell for the first time in the dog and changes associated with canine primary open angle glaucoma.

Procedures The iridocorneal angles from 18 Beagles with inherited glaucoma (3 months–8 years old) and 17 normal, age‐matched Beagles were placed in 10% buffered formalin for light microscopic evaluation, or 2.5% glutaraldehyde for ultrastructural evaluation. Using at least three fields from each region of the iridocorneal angle (opercular, corneoscleral, and uveal) at ×1000 magnification, trabecular cell nuclei were counted.

Results The operculum in the canine iridocorneal angle consisted of the peripheral extension of the corneal endothelium and underlying anterior‐most corneoscleral meshwork, having no direct contact with the angular aqueous plexus. The SL cells associated with operculum‐retained epithelial morphology (polyhedral in shape with rER, Golgi apparatus, and secretory vesicles) in both normal, pre‐and early glaucomatous dogs. In animals with moderate and advanced stages the SL cells often became less epithelial and secretory in appearance. The number of SL cells in normal dogs declined by approximately one‐third by the end of their first year with gradual loss thereafter. In the glaucoma group the decline was more substantial and continuous through the first three years.

Conclusions The SL cell is morphologically a distinct cell type within the canine iridocorneal angle that is specifically associated with the nonfiltering portion of the corneoscleral trabecular meshwork. Changes in the SL cells of the glaucomatous dog occurred with regard to age and progression of the disease.
Systematics and phylogeny of the cheilostome bryozoan Doryporella
Authors: Grischenko Andrei V. , Shunsuke F. Mawatari , Paul D. Taylor
Published: March 2003

The four nominal species of the Arctic‐Boreal anascan bryozoan Doryporella Norman are revised. Colonies of Doryporella are small, typically encrust shells and pebbles, and have autozooids with frontal walls bearing a distinctive reticulate pattern of polygonal ridges. High resolution SEM shows the frontal wall to be an interior wall (cryptocyst), contrary to previous studies which have regarded it as an exterior wall (gymnocyst). The inter‐relationships between the species assigned to Doryporella are assessed cladistically using skeletal characters. The type species (D. spathulifera) and two other species (D. alcicornis and D. armata) form a well‐supported clade, but the fourth species (D. reticulata) is more closely‐related to certain other calloporid genera. Therefore, the reticulate frontal wall is inferred to have evolved twice and D. reticulata is removed to Doryporellina gen. n. Biogeographical distributions of the four species are reviewed.
Phylogeny and revision of the leech genus Helobdella (Glossiphoniidae) based on mitochondrial gene sequences and morphological data and a special consideration of the triserialis complex
Authors: Siddall Mark E. , Borda Elizabeth
Published: March 2003

The relationships, as well as identification of species, within Helobdella (Glossiphoniidae) were explored through phylogenetic analysis and through an overview of the historical systematics of the genus. The phylogeny was determined using morphological data and the mitochondrial gene sequences of cytochrome c oxidase subunit I and nicotinamide adenine dinucleotide dehydrogenase subunit I. A broad representation of 15 ingroup species was sampled, including 10 individuals from South America. Outgroup taxa included five species of Haementeria. Cladistic analysis of all available data resulted in one most parsimonious tree. Results shed light on genetic divergence of members classified as the same species, including those that are not monophyletic. Historically, external morphological characters have played a significant role in contributing to the confusion in the classification of H. triserialis, H. papillata, H. lineata and H. fusca in North America. Re‐evaluation of Verril's Clepsine papillifera var. b and var. d in a phylogenetic context provides a solution. Additionally, the genera Adaetobdella, Acritobdella, Dacnobdella and Gloiobdella created by Ringuelet are returned to Helobdella based on overlapping morphological characters.
Middle Miocene elasmotheriine Rhinocerotidae from China and Mongolia: taxonomic revision and phylogenetic relationships
Authors: Antoine Pierre‐Olivier
Published: March 2003

Eight elasmotheriine rhinocerotid species have been described from the Middle Miocene of China and Mongolia. In this paper a revised taxonomy is presented based on direct observation and comparison of the available material. A phylogenetic analysis based on 282 morphological characters has led to the reappraisal of Procoelodonta Matthew, 1931, Caementodon Heissig, 1972 and Huaqingtherium Huang & Yan, 1983. The genus Procoelodonta is split into three subgenera: P. (Procoelodonta) Matthew, 1931, P. (Begertherium) Beliaeva, 1971, and P. (Pasalarhinus subg. n). The genus Caementodon is split into two subgenera: C. (Caementodon) Heissig, 1972 and C. (Beliajevina) Heissig, 1974. Four species are assumed to have occurred in the Middle Miocene within the area studied: Procoelodonta (Procoelodonta) mongoliense (Osborn, 1924), ‘P.’ (Begertherium) borissiaki (Beliaeva, 1971), ‘Caementodon’ (Beliajevina) fangxianense (Yan, 1979) and Huaqingtherium lintungense (Zhai, 1978) (=‘Caementodon tongxinensis’ Guan, 1988 =‘Huaqingtherium qiui’ Guan, 1993 =‘Hispanotherium tungurense’ Cerdeño, 1996). Shennongtherium hypsodontus Huang & Yan, 1983 is removed from the Elasmotheriina, owing to dental characters which suggest that it is a teleoceratine. The distribution of the main characters later seen in Elasmotherium is briefly discussed. The persistence and diversity of the Elasmotheriina throughout the Middle Miocene help explain how minute brachyodont animals gave rise to the mammoth‐sized hypsodont Elasmotherium.
Pathogenicity genes of phytopathogenic fungi
Authors: Idnurm Alexander , Howlett Barbara J.
Published: March 2003

Recently many fungal genes have been identified that, when disrupted, result in strains with a reduction or total loss of disease symptoms. Such pathogenicity genes are the subject of this review. The large number of pathogenicity genes identified is due to the application of tagged mutagenesis techniques (random or targeted). Genes have been identified with roles in the formation of infection structures, cell wall degradation, overcoming or avoiding plant defences, responding to the host environment, production of toxins, and in signal cascades. Additionally, genes with no database matches and with ‘novel’ functions have also been found. Improved technologies for mutation analysis and for sequencing and analysing fungal genomes hold promise for identifying many more pathogenicity genes.
Analysis of the distribution and structure of integrated Banana streak virus DNA in a range of Musa cultivars
Authors: Geering Andrew D. W. , Olszewski Neil E. , Dahal Ganesh , Thomas John E. , Lockhart Benham E. L.
Published: March 2003

Banana streak virus strain OL (BSV‐OL) commonly infects new Musa hybrids, and this infection is thought to arise de novo from integrated virus sequences present in the nuclear genome of the plant. Integrated DNA (Musa6+8 sequence) containing the whole genome of the virus has previously been cloned from cv. Obino l’Ewai (Musa AAB group), a parent of many of the hybrids. Using a Southern blot hybridization assay, we have examined the distribution and structure of integrated BSV‐OL sequences in a range of Musa cultivars. For cv. Obino l’Ewai, almost every restriction fragment hybridizing to BSV‐OL was predicted from the Musa6+8 sequence, suggesting that this is the predominant type of BSV‐OL integrant in the genome. Furthermore, since only two junction fragments of Musa/BSV sequence were detected, and the Musa6+8 sequence is believed to be integrated as multiple copies in a tandem array, then the internal Musa spacer sequences must be highly conserved. Similarly sized restriction fragments were detected in four BB group cultivars, but not in six AA or AAA group cultivars, suggesting that the BSV‐OL sequences are linked to the B‐genome of Musa. We also provide evidence that cv. Williams (Musa AAA group) contains a distinct badnavirus integrant that is closely related to the ‘dead’ virus integrant previously characterized from Calcutta 4 (Musa acuminata ssp. burmannicoides). Our results suggest that the virus integrant from cv. Williams is linked to the A‐genome, and the complexity of the hybridization patterns suggest multiple sites of integration and/or variation in sequence and structure of the integrants.
Congruence of terms between lists of problems and the ICNP®– Alpha Version
Authors: Cruz D. M. , Gutierrez B. A. O. , López A. L. , De Souza T. T. , Assami S.
Published: March 2003

Abstract

The International Classification for Nursing Practice (ICNP®) – Alpha Version, is the first rendition of the International Council of Nurses (ICN) efforts to develop a standardized international nursing language system. This system has three principal components: nursing phenomena; nursing actions; and nursing outcomes. This article describes a study of agreements between terms used by nurses of the intensive care unit at the Hospital of the University of Sao Paulo, to designate patients’ nursing problems and the terms proposed by the ICNP®– Alpha Version. The records of 59 interned patients, admitted to the intensive therapy unit, were analysed for nursing problems. Of 336 problem categories listed by the nurses, 153 (45.5%) corresponded to the ICNP® terms. The 183 categories of problems that did not correspond to the ICNP® terms were categorized by the authors as the following: medical diagnoses (37.2%); signs (28.4%); interventions (26.2%); and historical data (8.2%). These results show that there may be no agreement between the concept of nursing phenomena for the ICNP® and of nursing problems for the nurses whose records were analysed. Considering that medical diagnoses, intervention and historical data could not be accepted as nursing phenomena for the ICNP®, the agreement is potentially higher than 45.5%.

Readers can access the entire text of the ICNP® Beta Version by visiting http://www.icn.ch/icnpupdate.htm. Other information about the ICNP® and its development can be found at
http://www.icn.ch/icnp.htm.
The development of advanced practice roles: implications in the international nursing community
Authors: Ketefian S. , Redman R. W. , Hanucharurnkul S. , Masterson A. , Neves E. P.
Published: March 2003

This article examined the critical elements that have been identified in the development of advanced practice roles of nurses in four countries: Brazil, Thailand, the United Kingdom and the United States of America. Several socio‐political and professional forces were examined for possible insights and ways in which they may have shaped the development and evolution of the roles of advanced practice nurses (APNs). These forces were: the socio‐political environment; the health needs of society; the health workforce supply and demand; governmental policy and support; intra‐ and interprofessional collaboration; the development of nursing education; and documentation of effectiveness of the advanced role. The development of APN roles in the four social systems was reviewed to illustrate how socio‐political and professional forces may have shaped nursing roles in each health care delivery system. Commonalities and distinguishing features across the four health and social systems were analysed to assess the predictive forces that may be identified as advanced roles in nursing have evolved in the global community.
Cross‐mapping the ICNP with NANDA, HHCC, Omaha System and NIC for unified nursing language system development
Authors: Hyun S. , Park H.A.
Published: March 2003

Nursing language plays an important role in describing and defining nursing phenomena and nursing actions. There are numerous vocabularies describing nursing diagnoses, interventions and outcomes in nursing. However, the lack of a standardized unified nursing language is considered a problem for further development of the discipline of nursing. In an effort to unify the nursing languages, the International Council of Nurses (ICN) has proposed the International Classification for Nursing Practice (ICNP) as a unified nursing language system. The purpose of this study was to evaluate the inclusiveness and expressiveness of the ICNP terms by cross‐mapping them with the existing nursing terminologies, specifically the North American Nursing Diagnosis Association (NANDA) taxonomy I, the Omaha System, the Home Health Care Classification (HHCC) and the Nursing Interventions Classification (NIC). Nine hundred and seventy‐four terms from these four classifications were cross‐mapped with the ICNP terms. This was performed in accordance with the Guidelines for Composing a Nursing Diagnosis and Guidelines for Composing a Nursing Intervention, which were suggested by the ICNP development team. An expert group verified the results. The ICNP Phenomena Classification described 87.5% of the NANDA diagnoses, 89.7% of the HHCC diagnoses and 72.7% of the Omaha System problem classification scheme. The ICNP Action Classification described 79.4% of the NIC interventions, 80.6% of the HHCC interventions and 71.4% of the Omaha System intervention scheme. The results of this study suggest that the ICNP has a sound starting structure for a unified nursing language system and can be used to describe most of the existing terminologies. Recommendations for the addition of terms to the ICNP are provided.
International field test results of the Observable Indicators of Nursing Home Care Quality instrument
Authors: Rantz M. , Jensdóttir A. B. , Hjaltadóttir I. , Gudmundsdòttir H. , Sigurveig Gudjónsdóttir J. , Brunton B. , Rook M.
Published: March 2003

Researchers at the University of Missouri‐Columbia developed the Observable Indicators of Nursing Home Care Quality instrument to measure the dimensions of nursing home care quality during a brief on‐site visit to a nursing home. The instrument has been translated for use in Iceland and used in Canada. Results of the validity and reliability studies using the instrument in 12 nursing homes in Reykjavik, in a large Veterans Home in Ontario with 14 units tested separately, and in 20 nursing homes in Missouri, are promising. High‐content validity was observed in all countries, together with excellent inter‐rater reliability and coefficient alpha. Test–retest reliabilities in Iceland and Missouri were good. Results of the international field test of the Observable Indicators of Nursing Home Care Quality instrument points to the usefulness of such an instrument in measuring nursing home care quality following a quick on‐site observation in a nursing facility. The instrument should be used as a facility‐wide assessment of quality, rather than for individual units within a facility. We strongly recommend its use by practising nurses in nursing homes to assess quality of care and guide efforts to improve care. We recommend its use by researchers and consumers and further testing of the use of the instrument with regulators.
A physical method for preservation of cosmetic products
Authors: LINTNER K. , GENET V.
Published: March 2003

To date, the microbiological stability of cosmetics products is assured by means of chemical preservatives, with well‐known possible side effects such as irritation or cutaneous allergic events. This paper describes a new concept to protect all types of cosmetic formulae from microbiological contamination: the osmotic effect of a particular form of glycerylpolyacrylate gels. The latter allows the formulator to conceive numerous preservative‐free formulae. The basis of its activity lies in the strong osmotic properties of the hydrogel: it absorbs water from its surroundings, thus depriving germs of the vital aqueous environment needed for survival. Challenge tests on various microorganisms, repeat insult challenges and time‐stability tests performed on these hydrogels in cosmetic formulas were carried out. At the same time, the hydrogel exhibited high skin moisturizing power. The hydrogel is non‐toxic and non‐irritant as the Primary Cutaneous Irritation Index observed after 48 h of occlusive patches in 10 adult volunteers is only of 0.10.

Jusqu'à l'heure actuelle, malgré les risques connus d'observer des effets secondaires comme, par exemple, des cas d'irritation locale ou d'allergie cutanée, la pérennité de l'asepsie des produits cosmétiques était assurée par l'ajout de conservateurs de nature chiminique. Pour remédier à ces inconvénients, nous avons développé un nouveau concept: l'effet osmotique qui est apporté par une forme particulière de gels de nature polyacrylate de glycérine. Cet hydrogel autorise la réalisation par l'homme de l'art, de nombreux types de formulations cosmétiques sans aucun conservateur ou, s'il le désire, d'en diminuer considérablement les quantités utilisées. Le mécanisme d'action qui explique l'efficacité de cet hydrogel dans le maintien de l'asepsie initiale réside dans sa capacité d'absorption de l'eau du milieu environnant et donc de priver les germes de l'eau nécessaire à leur survie. Cet effet est démontré par les résultats des études réalisées avec de nombreux micro‐organismes ainsi que par des tests de stabilité dans le temps réalisés sur des compositions cosmetiques en présence ou en l'absence de cet hydrogel. De plus, cet hydrogel démontre un pouvoir hydratant très puissant qu'il est toujours intéressant d'apporter dans les préparations cosmétiques. Cet hydrogel est non toxique et non irritant puisque l'index d'Irritation Primaire Cutané obtenu après un patch occlusif de 48 heures chez 10 voluntaires adultes est égal à seulement 0,10. © Rapid Science Ltd. 1998