bluuebunny/crossref_metadata_2025_split huggingface dataset:
Voltage‐gated Ca2+ channel subtypes mediating GABAergic transmission in the rat supraoptic nucleus
Authors: Bhaukaurally Khaleel , Panatier Aude , Poulain Dominique A. , Oliet Stéphane H. R. 
Published: May 2005

AbstractThe supraoptic nucleus receives an abundant γ‐aminobutyric acid (GABA)ergic input which is inhibited by activation of various presynaptic metabotropic receptors. We here analysed the subtypes of voltage‐gated Ca2+ channels intervening in the control of transmitter release at these synapses. To address this issue, we tested various specific inhibitors of Ca2+ channels on evoked inhibitory postsynaptic currents (IPSCs). Blocking N‐ and P‐type voltage‐gated Ca2+ channels with 1 µmω‐conotoxin‐GVIA and 20 nmω‐agatoxin‐IVA, respectively, dramatically reduced IPSC amplitude. Q‐ and l‐type Ca2+ channels also contributed to GABAergic transmission, although to a lesser extent, as revealed by applications of 200 nmω‐agatoxin‐IVA and of the dihydropyridines nifedipine (10 µm) and nimodipine (10 µm). Evoked IPSCs were insensitive to SNX‐482 (300 nm), a blocker of some R‐type Ca2+ channels. Analysis of selective blockade by the various antagonists suggested that multiple types of Ca2+ channels synergistically interact to trigger exocytosis at some individual GABA release sites. We next investigated whether inhibition of GABA release in response to the activation of metabotropic glutamate, GABA and adenosine receptors involved the modulation of these presynaptic Ca2+ channels. This was not the case, as the inhibitory actions of selective agonists of these receptors were unaffected by the presence of the different Ca2+ channel antagonists. This finding suggests that these metabotropic receptors modulate GABAergic transmission through a different mechanism, downstream of Ca2+ entry in the terminals, or upstream through the activation of K+ channels.
Perioperative management of face‐to‐face craniopagus twins separation
Authors: PIETRINI D. , VALENTI M. , PUSATERI A. , SCORZONI M. , TOSI F. , FORTE E. , BARBI S. , CARESTA E. , CALDARELLI M. , DI ROCCO C. , PIASTRA M. 
Published: May 2005

SummaryCraniopagus conjoining represents a complex and challenging issue for neurosurgeons as well as for anesthesiologists. A rare face‐to‐face case of conjoined twins underwent surgical separation and presented peculiar differences compared with those already reported in the literature. Even in cases lacking large cerebrovascular sinus connections, the impending risk of large blood loss and hemorrhagic shock in the infant requires a high level of surveillance and the institution of invasive monitoring.
Caudal anesthesia for minor pediatric surgery: a prospective randomized comparison of ropivacaine 0.2% vs levobupivacaine 0.2%
Authors: IVANI G. , DE NEGRI P. , LONNQVIST P.A. , L'ERARIO M. , MOSSETTI V. , DIFILIPPO A. , ROSSO F. 
Published: May 2005

SummaryBackground : Previous published data comparing ropivacaine 0.2% with levobupivacaine 0.25% have suggested that ropivacaine might be associated with less early postoperative motor blockade compared with levobupivacaine. The aim of the present study was to further investigate this issue comparing equal concentrations (0.2%) of ropivacaine and levobupivacaine in children undergoing minor subumbilical surgery.Methods : Following induction of a standardized anesthetic, patients (1–7 years) were randomized in a double‐blind manner to receive a caudal block with either ropivacaine 0.2% (group R, n = 30) or levobupivacaine 0.2% (group L, n = 30), total volume 1 ml·kg−1. Motor blockade (modified Bromage scale; primary end‐point) and analgesia [Children and Infants Postoperative Pain Scale (CHIPPS) score] were assessed at predetermined time points during the first 24‐postoperative hours.Results : Motor blockade was only registered during the first postoperative hour with no significant differences between the groups (group R n = 5, group L n = 8). Postoperative CHIPPS scores were almost identical in both groups with only seven and six patients requiring supplemental analgesia (CHIPPS score ≥4) in the R and L groups, respectively.Conclusions : A 0.2% concentrations of ropivacaine or levobupivacaine are clinically very similar with regard to postoperative analgesia and unwanted postoperative motor blockade in children undergoing minor subumbilical surgery.
Anesthetic management of a neonate with vein of Galen aneurysmal malformations and severe pulmonary hypertension
Authors: ASHIDA YUKI , MIYAHARA HIROMI , SAWADA HIROHUMI , MITANI YOSHIHIDE , MARUYAMA KAZUO 
Published: May 2005

SummaryVein of Galen aneurysmal malformations (VGAMs) are rare congenital vascular malformations and excessive arteriovenous shunt causes intractable congestive high‐output heart failure in the neonate. We report a case of successful staged transcatheter embolizations for a neonate with congestive heart failure and pulmonary hypertension (PH). Heart failure was dramatically relieved as the staged procedure progressed. Although transcatheter embolizations is essential for the treatment, inhaled nitric oxide (iNO) was helpful as a bridge treatment to reduce right‐to‐left shunt before the initial emergency embolization. Endovascular embolization is a less invasive therapy than open cranial surgery and allows hemodynamic stability. Perioperative iNO can be used to manage PH in VGAMs.
Anesthesia for a neonate with persistent buccopharyngeal membrane and unilateral choanal atresia
Authors: LIM EVANGELINE H. , TAN SHANI , LIM SUAN‐LING 
Published: May 2005

SummaryWe report our anesthetic management of a neonate who presented with complete persistent buccopharyngeal membrane and unilateral choanal atresia, and underwent examination under anesthesia. Maintaining airway patency and spontaneous respiration were our priority. Intravenous propofol was used to maintain adequate anesthetic depth for flexible laryngotracheoscopy and nasotracheal intubation through the only patent passage. We encountered problems of bradycardia and hypotension. Tracheostomy was performed. Definitive management of the persistent buccopharyngeal membrane was carried out on day 14.
Intraoperative low‐dose S‐ketamine has no preventive effects on postoperative pain and morphine consumption after major urological surgery in children
Authors: BECKE KARIN , ALBRECHT SVEN , SCHMITZ BERND , RECH DORIT , KOPPERT WOLFGANG , SCHÜTTLER JÜRGEN , HERING WERNER 
Published: May 2005

SummaryBackground : Clinical studies suggest low‐dose ketamine may have preemptive effects on postoperative pain in adults. The objective of this study was to determine whether intraoperative low‐dose S‐ketamine reduces postoperative pain and morphine consumption in children undergoing major urological surgery.Materials : Thirty children scheduled for major urological surgery were included in this prospective study. Anesthesia was performed as total intravenous anesthesia (TIVA) with alfentanil and propofol. Fifteen patients additionally received an intravenous bolus of S‐ketamine (0.2 mg·kg−1) followed by a continuous infusion of 5 μg·kg−1·min−1, which was stopped immediately after skin closure (Ketamine Group). Another 15 patients received an infusion of saline (Control group). After transfer to the PACU, pain intensity was evaluated using a numeric rating scale (NRS). First patient controlled analgesia (PCA) request, cumulative morphine consumption and pain intensities within the first 72 h were compared.Results : Morphine consumption was not significantly different during the first 72 h (Control: 0.4 mg·kg−1, 0.24–0.51 mg·kg−1, Ketamine: 0.32 mg·kg−1, 0.19–0.61 mg·kg−1; median, 25–75% percentile; n.s.). However, differences were found in pain intensity during the first postoperative hour (Control: 4.0, 3.2–4.6, Ketamine: 2.5, 1.3–3.5; median, 25–75% percentile; P < 0.05) and in the time to first PCA use (Control: 37, 28–46 min, Ketamine: 62, 38–68 min; median, 25–75% percentile; P < 0.05).Conclusions : Intraoperative low‐dose S‐ketamine had no effect on morphine consumption during the first 72 h after surgery. The differences in pain intensity and time to first PCA use probably reflect additional sedation and antinociceptive effects of S‐ketamine rather than a true ‘prevention’ of pain.
The addition of clonidine 2 μg·kg−1 does not enhance the postoperative analgesia of a caudal block using 0.125% bupivacaine and epinephrine 1 : 200 000 in children: a prospective, double‐blind, randomized study1
Authors: WHEELER MELISSA , PATEL ARTI , SURESH SANTHANAM , ROTH ANDREW G. , BIRMINGHAM PATRICK K. , HEFFNER CORRI L. , COTÉ CHARLES J. 
Published: May 2005

SummaryBackground : In this prospective, randomized, double‐blind study, we compared the efficacy of 0.125% bupivacaine and epinephrine 1 : 200 000 with and without clonidine 2 μg·kg−1 for ‘single shot’ pediatric caudal analgesia.Methods : Thirty ASA I and II children, ages 2–8 years, undergoing outpatient surgical procedures below the umbilicus received 1 ml·kg−1 0.125% bupivacaine with fresh epinephrine 1 : 200 000 and clonidine 2 μg·kg−1 (group‐C) or 1 ml·kg−1 0.125 % bupivacaine with epinephrine 1 : 200 000 (group‐NC). All patients received a standardized general anesthetic (induction with 67% N2O in O2 and sevoflurane followed by isoflurane maintenance). Primary outcome measures were time to first rescue analgesic and number of patients requiring rescue analgesic at 4, 6, 8, 12, and 24 h after caudal placement. Secondary outcome measures included: extubation times, Objective Pain Scale (OPS) scores, sedation scores, time in postanesthesia care unit (PACU), discharge time, number of analgesic doses given in 24 h following caudal blockade, and adverse effects (vomiting, hypotension, and bradycardia).Results : There were no differences in demographics, investigated parameters, or adverse effects between groups.Conclusions : We found that the addition of clonidine 2 μg·kg−1 to 0.125% bupivacaine with fresh epinephrine 1 : 200 000 for caudal analgesia did not significantly delay the time to first rescue analgesic or decrease the overall need for rescue analgesics in children 2–8 years undergoing surgical procedures below the umbilicus.
Severe hemoptysis in a child after the Fontan procedure
Authors: DEISENBERG MARKUS , STAYER STEPHEN A. 
Published: May 2005

SummaryThere is an increased incidence of pulmonary hemorrhage and hemoptysis among patients with congenital heart disease (CHD). The pathophysiology of pulmonary hemorrhage in CHD includes pulmonary hypertension, pulmonary venous congestion, aorto‐pulmonary collaterals, pulmonary arteriovenous malformations, and dilated bronchial arteries. We present the case of a 6‐year old boy who required treatment for massive hemoptysis after staged palliation for hypoplastic left heart syndrome (HLHS). Effective management of this life threatening entity is described as well as the anesthetic implications of performing rigid bronchoscopy in a patient with the Fontan circulation and massive hemoptysis.
Herbal and homeopathic medication use in pediatric surgical patients
Authors: EVERETT LUCINDA L. , BIRMINGHAM PATRICK K. , WILLIAMS GLYN D. , RANDALL BRENN B. , SHAPIRO JAY H. 
Published: May 2005

SummaryBackground : Patients who present for surgery may be using herbal or homeopathic preparations; adverse effects of some of these substances include bleeding, cardiovascular changes, and liver dysfunction. Little information is available on the frequency of use in the pediatric surgical population.Methods : With institutional approval, a survey was conducted to assess the use of vitamins, nutritional supplements, or herbal or homeopathic preparations in children presenting for surgery in five geographically diverse centers in the USA.Results : A total of 894 completed surveys showed that overall, 3.5% of pediatric surgical patients had been given herbal or homeopathic medications in the 2 weeks prior to surgery. Most substances were prescribed by parents. The use of these medications did not differ between children with coexisting diseases and those without; use was also not different among ethnic groups or by residence setting (city, suburban, rural). There was a significant difference between the west coast centers in the study compared with the rest of the country (7.5% of patients in Palo Alto, CA; 5.5% of patients in Seattle, WA; 1.5% of patients in Chicago, IL; and 1.9% in Virginia and Delaware used herbal or homeopathic remedies). The most prevalent substance given to children presenting for elective surgery was Echinacea.Conclusions : Herbal and homeopathic medications are used by a small percentage of pediatric patients presenting for elective pediatric surgery patients. Use of these substances should be addressed in the preoperative history.
A noninvasive estimation of mixed venous oxygen saturation using near‐infrared spectroscopy by cerebral oximetry in pediatric cardiac surgery patients
Authors: TORTORIELLO TIA A. , STAYER STEPHEN A. , MOTT ANTONIO R. , DEAN McKENZIE E. , FRASER CHARLES D. , ANDROPOULOS DEAN B. , CHANG ANTHONY C. 
Published: May 2005

SummaryBackground : Near‐infrared spectroscopy (NIRS) is a noninvasive optical monitor of regional cerebral oxygen saturation (rSO2). The aim of this study was to validate the use of NIRS by cerebral oximetry in estimating invasively measured mixed venous oxygen saturation (SvO2) in pediatric postoperative cardiac surgery patients.Methods : Twenty patients were enrolled following cardiac surgery with intraoperative placement of a pulmonary artery (PA) or superior vena cava (SVC) catheter. Five patients underwent complete biventricular repair – complete atrioventricular canal (n = 3) and other (n = 2). Fifteen patients with functional single ventricle underwent palliative procedures – bidirectional Glenn (n = 11) and Fontan (n = 4). Cerebral rSO2 was monitored via NIRS (INVOS 5100) during cardiac surgery and 6 h postoperatively. SvO2 was measured from blood samples obtained via an indwelling PA or SVC catheter and simultaneously correlated with rSO2 by NIRS at five time periods: in the operating room after weaning from cardiopulmonary bypass, after sternal closure, and in the CICU at 2, 4, and 6 h after admission.Results : Each patient had five measurements (total = 100 comparisons). SvO2 obtained via an indwelling PA or SVC catheter for all patients correlated with rSO2 obtained via NIRS: Pearson's correlation coefficient of 0.67 (P < 0.0001) and linear regression of r2 = 0.45 (P < 0.0001). Separate linear regression of the complete biventricular repairs demonstrated an r = 0.71, r2 = 0.50 (P < 0.0001). Bland–Altman analysis showed a bias of +3.3% with a precision of 16.6% for rSO2 as a predictor of SvO2 for all patients. Cerebral rSO2 was a more accurate predictor of SvO2 in the biventricular repair patients (bias −0.3, precision 11.8%), compared with the bidirectional Glenn and Fontan patients.Conclusions : Regional cerebral oximetry via NIRS correlates with SvO2 obtained via invasive monitoring. However, the wide limits of agreement suggest that it may not be possible to predict absolute values of SvO2 for any given patient based solely on the noninvasive measurement of rSO2. Near‐infrared spectroscopy, using the INVOS 5100 cerebral oximeter, could potentially be used to indicate trends in SVO2, but more studies needs to be performed under varying clinical conditions.
Psoas compartment block (PCB) in children: Part II – generation of an institutional learning curve with a new technique1
Authors: SCHUEPFER GUIDO , JÖHR MARTIN 
Published: May 2005

SummaryBackground : Literature concerning institutional learning processes for anesthesia procedures in pediatric anesthesia is rare. Until recently only small series of psoas compartment blocks (PCB) in children have been reported. We report on a series of 100 consecutive blocks using new landmarks and the institutional learning process.Methods : In 100 consecutive children (5.9–106 kg) PCB was performed using a nerve stimulator. In the lateral position, the needle was inserted between the medial 2/3 and the lateral 1/3 on a line from the spinous process of L4 to the posterior superior iliac spine. Residents unfamiliar with PCB were instructed by one single staff member without manual intervention. Failure was defined as a bloody tap, more than one skin perforation with the needle or relinquishing the procedure to senior staff. To evaluate the institutional learning process the cumulative sum (CUSUM) statistical technique was used. CUSUM analysis was performed using an acceptable failure rate of 10%. A learning curve using a bootstrap technique and a least square fit model was also used.Results : Although all blocks were clinically successful, only in 64% was a single attempt sufficient. In 16% vascular puncture occurred. Surprisingly the CUSUM analysis showed a clear institutional learning phenomenon. Applying a strict definition for a successful block, more than 100 PCB in an institution may be necessary. Using the generated learning curve, for a success rate of 70% a case load of at least 55 attempts is required.Conclusions : Although the described new technique had a very high success rate with a low complication rate, PCB in children is not easily implemented into clinical practice when strict criteria of success were used, despite a well‐controlled environment. Training programs could use CUSUM to track the progress of their institutional learning in order to guarantee adequate experience.
Analysis of prevalence of presumed inherited eye diseases in Entlebucher Mountain Dogs
Authors: Heitmann M. , Hamann H. , Brahm R. , Grußendorf H. , Rosenhagen C. U. , Distl O. 
Published: May 2005

AbstractWe analyzed the prevalence of the presumed inherited eye diseases (PIED) noncongenital cataract and progressive retinal atrophy in the Entlebucher Mountain Dog for systematic environmental influences and the additive genetic variation. Multivariate linear animal models using residual maximum likelihood methods and multivariate threshold animal models using Gibbs sampling in Bayesian analyses were used to estimate variance and covariance components. Data were obtained from the kennel club for Swiss Mountain Dog breeds in Germany. PIED were recorded using the standardized protocols of the Dortmunder Kreis, the German panel of the European Eye Scheme for Diagnosis of Inherited Eye Diseases in Animals (DOK). The material included 515 Entlebucher Mountain Dogs from 344 litters at 77 different kennels. Veterinary diagnoses for PIED were from the years 1981–2001. Pedigree information was available for up to nine generations. The multivariate animal model regarded the fixed effects of sex, birth year, experience of the veterinary ophthalmologist, litter size, percentage of examined dogs per litter, inbreeding coefficient and age at examination. The common environment of the litter and the additive genetic effect of the animal were taken into account as randomly distributed effects. The heritability estimates for PIED in the Entlebucher Mountain Dog were h2 = 0.15 ± 0.06 (noncongenital cataract), and h2 = 0.34 ± 0.08 (progressive retinal atrophy) in the linear model and h2 = 0.32 ± 0.05 (noncongenital cataract) and h2 = 0.59 ± 0.03 (progessive retinal atrophy) in the threshold model. The additive genetic correlation between noncongenital cataract and progressive retinal atrophy was moderately positive (rg = 0.54 ± 0.08) in the threshold model. The number of examinations performed by the veterinary ophthalmologists was associated with slightly higher heritabilities for noncongenital cataract and considerably higher heritabilities for progressive retinal atrophy. The investigated PIED in the Entlebucher Mountain Dog are genetically influenced and the size of the genetic parameters estimated may be sensitive to the accuracy of the diagnosis and how the data were collected.
Feline periocular peripheral nerve sheath tumor: a case series
Authors: Hoffman Allison , Blocker Tiffany , Dubielzig Richard , Ehrhart E. J. 
Published: May 2005

AbstractThe objective of this retrospective study was to describe signalment, clinical presentation, surgical treatment, outcome, histopathologic, and immunohistochemical characteristics of periocular peripheral nerve sheath tumor in a series of cats. Six cats with a histologic diagnosis of peripheral nerve sheath tumor of the eyelid and/or conjunctiva were identified from 3997 feline ocular histopathologic submissions to the Comparative Ocular Pathology Laboratory of Wisconsin between 1976 and 2002. Medical records were reviewed and data were collected for signalment, eye affected, location, duration, and history of tumor recurrence. Ancillary diagnostic tests, surgical approach, and histopathology were also described. Special stains and immunohistochemistry panels were performed on the tissue. Follow‐up information was obtained through telecommunications with the owner and local veterinarian. The mean age of the cats was 8 years (range: 5–15 years). There was an equal distribution of males and females. Breeds represented were two Domestic Long‐haired (DLH) cats, three Domestic Short‐haired (DSH) cats, and one Manx. The right eye was affected in four cats and the left eye in two cats. The superior eyelid was affected in four cats, the superior conjunctiva in two cats, and the inferior eyelid in one cat. All of the cats that underwent surgical excision, cryoablation, or laser ablation had an average of three recurrences of the tumor. Four of six cats undergoing wide excision with enucleation, exenteration or rhomboid flap had no recurrence of the tumor. Histomorphologically, all of the tumors were of spindle cell type with five of six tumors showing histologic features of Antoni type B tissue. All six tumors stained positive for vimentin. Five of six tumors stained positive for S‐100 and laminin. All six tumors were negative for smooth muscle actin. Definitive histologic diagnoses of spindle cell tumors can be difficult. The presence of Antoni A and B histologic patterns as well as immunohistochemical reactivity for vimentin, S‐100, and laminin suggest a diagnosis of peripheral nerve sheath tumor. Our findings suggest that local aggressive recurrence is common and that wide surgical excision combined with enucleation or exenteration may be indicated.