bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of patient‐controlled analgesia with and without a background infusion after appendicectomy in children
Authors: Yildiz Karamehmet , Tercan Elvan , Dogru Kudret , Ozkan Ugur , Boyaci Adem 
Published: June 2003

SummaryBackground: There have been many studies using patient‐controlled analgesia (PCA) and opioids for postoperative analgesia in children. In this study, we investigated the efficacy, usefulness and analgesic consumption of two different PCA programmes [bolus dose alone (BD) or bolus dose with background infusion (BD + BI)] to evaluate postoperative analgesia for children after emergency appendicectomy.Methods: Forty children, aged between 6 and 15 years and ASA class I or II, undergoing emergency appendicectomy were randomly allocated into two groups. The children were given a loading dose of pethidine 0.3 mg·kg−1 and 150 μg·kg−1 bolus intravenously in group BD (n = 20) and pethidine 0.3 mg·kg−1 loading dose, 75 μg·kg−1 bolus and 15 μg·kg−1·h−1 background infusion in group BD + BI (n = 20). The lockout interval was 20 min in both groups.Results: There were no significant differences in pain, sedation and nausea scores during the 24‐h postoperative period between the groups (P > 0.05). Pethidine consumption was significantly lower in group BD + BI than that in group BD for the first 24‐h period (P < 0.05).Conclusions: We demonstrated that both these PCA programmes were effective and reliable for postoperative pain relief in children. We believe that giving information about PCA to the children and their parents is useful during the preoperative period. However, the background infusion with lower bolus dose in PCA did not increase pethidine consumption.
Comparison of 0.2% ropivacaine and 0.25% bupivacaine for axillary brachial plexus blocks in paediatric hand surgery
Authors: Thornton K.L. , Sacks M.D. , Hall R. , Bingham R. 
Published: June 2003

SummaryBackground:  The purpose of this study was to compare the use of ropivacaine 0.2% with bupivacaine 0.25% for axillary brachial plexus block in children undergoing hand surgery.Methods:  In a double‐blind, randomized study, 35 children undergoing hand surgery received axillary brachial plexus blocks with 0.5 ml·kg−1 of either 0.2% ropivacaine or 0.25% bupivacaine. Pain scores were noted at 0, 3, 6, 12 and 24 h after surgery. The time to first dose of codeine phosphate and the total doses of all analgesics given were recorded.Results:  There was no significant difference between the two groups in pain scores, the time to first dose of codeine phosphate or in analgesic requirements in the first 24 h.Conclusions:  Ropivacaine 0.2% is as effective as bupivacaine 0.25% for axillary brachial plexus blocks in children undergoing hand surgery.
The dose of caudal epidural analgesia and duration of postoperative analgesia
Authors: Schrock Charles R. , Jones Matthew Barry 
Published: June 2003

SummaryBackground: Single dose caudal epidural is commonly utilized for postoperative analgesia in children. Previous studies have determined the optimal concentration of local anaesthetic, and the minimal volume to produce a desired dermatomal distribution. However, none has sought the optimal volume to administer. The specific aim of this study was to determine whether the volume of caudal epidural local anaesthetic influenced the duration of postoperative analgesia.Methods: Fifty‐four children aged 1–6 years and ASAPS I‐II scheduled for elective inguinal herniorraphy were enrolled in this randomized and blinded clinical trial. They received a standardized general anaesthetic with one of three possible doses of caudal epidural analgesic: 0.7, 1.0, or 1.3 ml·kg−1 of 0.175% bupivacaine with 1 : 200 000 epinephrine. The patients were assessed by blinded observers during in‐hospital recovery and by parents at home.Results: The principal outcome measure of time until first postoperative analgesic requirement was similar between the groups (4.2, 3.6, and 4.8 h respectively). Other effects which might be altered by epidural analgesia, including time until first void, ambulation, and discharge readiness did not differ between groups.Conclusions: Increasing local anaesthetic dose and volume do not increase the duration of postoperative analgesia of caudal epidural in children undergoing inguinal herniorraphy.
Comparison between instillation of bupivacaine versus caudal analgesia for postoperative analgesia following inguinal herniotomy in children
Authors: Machotta Andreas , Risse Anna , Bercker Sven , Streich Rita , Pappert Dirk 
Published: June 2003

SummaryBackground: In this study we compare the postoperative pain relief for inguinal herniotomy in children provided by instillation of bupivacaine into the wound with that provided by a caudal block.Methods: Fifty‐eight children aged 0–5 years having elective unilateral hernia repair were studied in this prospective, randomized, single‐blind study. Anaesthesia was induced and maintained with oxygen, nitrous oxide, sevoflurane and propofol. Patients were randomly assigned to receive caudal analgesia with 1.0 ml·kg−1 body weight (BW) bupivacaine 0.25% or wound instillation with 0.2 ml·kg−1 BW bupivacaine 0.5% at the end of surgery. Pain was assessed over 24 h using a modified 10‐point objective pain scale. During the first postoperative hour in the postanaesthesia care unit (PACU), intravenous (i.v.) piritramide (0.05 mg·kg−1) was administered to any child scoring 5 or more points on the pain scale. On the ward, rectal acetaminophen was administered by a staff nurse when considered necessary.Results: Thirty children in the caudal group and 28 children in the wound instillation group were studied. There were no statistically significant differences between the groups regarding need for i.v. opioids, discharge time from the PACU and administration of acetaminophen. No statistically significant differences in postoperative pain score were observed in 16 of a total of 17 postoperative observations. No complications and no adverse effects were observed.Conclusion: Instillation of bupivacaine into a wound provides postoperative pain relief following hernia repair, which is as effective as that provided by a postoperative caudal block.
Double‐blind randomized placebo‐controlled trial of the effect of ketamine on postoperative morphine consumption in children following appendicectomy
Authors: Dix P. , Martindale S. , Stoddart P.A. 
Published: June 2003

SummaryBackground: Ketamine has an opioid sparing effect following surgery in adults. This study investigated whether a similar effect is seen following appendicectomy in paediatric patients.Methods: Seventy‐five ASA 1 or 2 children aged 7–16 years were recruited, and randomly allocated to one of three groups. Following a standard anaesthetic for appendicectomy, all were prescribed patient controlled analgesia (PCA) morphine with paracetamol and nonsteroidal anti‐inflammatory drugs (NSAIDS) as required for postoperative analgesia. In addition the control group received a saline infusion postoperatively, the ketamine bolus group received 500 μg·kg−1 intravenous (i.v.) ketamine preincision and a saline infusion postoperatively, and the ketamine infusion group received 500 μg·kg−1 i.v. ketamine preincision and a ketamine infusion at 4 μg·kg−1 min−1 postoperatively. Morphine consumption, rescue analgesia requirement and side‐effects were recorded postoperatively.Results: There was no difference in morphine consumption between the groups. The ketamine infusion group required more doses of rescue analgesia and reported more side‐effects than the control group. Five patients, all in the ketamine infusion group, reported hallucinations.Conclusions: In this paediatric population intravenous ketamine did not have a morphine sparing effect. The increased incidence of side‐effects, especially hallucinations, reported by patients given a ketamine infusion may limit the further use of postoperative ketamine in children.
Erythropoietin therapy and acute preoperative normovolaemic haemodilution in infants undergoing craniosynostosis surgery
Authors: Meneghini Luisa , Zadra Nicola , Aneloni Vittorio , Metrangolo Salvatore , Faggin Roberto , Giusti Franca 
Published: June 2003

SummaryBackground: A retrospective study was performed to evaluate whether pretreatment with erythropoietin and iron combined with acute preoperative normovolaemic haemodilution (APNH) could decrease homologous blood transfusion in craniosynostosis (CS) surgery. A treated group was compared with a historical group of infants who underwent surgery with no pretreatment.Methods: The charts of 25 healthy infants who underwent CS surgery were reviewed. Nine of them underwent surgery with no treatment beforehand. Sixteen infants were given erythropoietin at a dosage of 300 U·kg −1 two times per week and iron (elemental iron 10 mg·kg−1·day−1) for 3 weeks before surgery. On the day of surgery APNH was performed after induction of general anaesthesia; a precalculated amount of autologous blood was withdrawn and replaced by hydroxyethyl starch 6%.Results: Eleven of the 16 infants of the study group received only autologous blood. Five of 16 received homologous blood transfusion vs seven of nine infants in the control group.Conclusions: APNH combined with erythropoietin was effective in reducing homologous blood requirements during CS surgery. Further studies are necessary on a larger scale to assess the role of this technique in avoiding homologous blood transfusion and to evaluate how infants can benefit from this combined approach.
Measurement of cerebral oxygenation state in anaesthetized children using the INVOS 5100 cerebral oximeter
Authors: Dullenkopf Alexander , Frey Bernhard , Baenziger Oskar , Gerber Andreas , Weiss Markus 
Published: June 2003

Summary Background: Near‐infrared spectroscopy is a developing technique for monitoring cerebral oxygenation during anaesthesia. The aim of this study was to evaluate absolute values of cerebral oxygenation during stable anaesthesia conditions in otherwise healthy children using the recently introduced INVOS 5100 cerebral oximeter with a paediatric and adult sensor and to compare them with values obtained from the NIRO 300 oximeter. Methods: Thirty paediatric surgical patients (aged 0.23–15.97 years) were studied during general anaesthesia with tracheal intubation and controlled ventilation. Comparative measurements of cerebral oxygenation were performed on the forehead with two probes within 10 min under stable cardiorespiratory and anaesthesia conditions. Cerebral oxygenation values (rSO2) obtained from the paediatric and adult INVOS 5100 sensors were compared with the tissue oxygenation index (TOI) obtained from the NIRO 300 cerebral oximeter using 4‐ and 5‐cm emitter‐detector separation. Results: Cerebral rSO2 values and the TOI values both showed a large range of cerebral oxygenation in the children studied (rSO2: 59–95%, TOI: 48–85%). Cerebral rSO2 values measured by the INVOS 5100, particularly with the paediatric sensor, were significantly higher than the TOI values obtained from the NIRO 300 (P < 0.0001). Agreement between the INVOS and NIRO oximeter was poor. Conclusion: The large range and the poor agreement of cerebral oxygenation values between the two oximeters makes it difficult to define a normal value. Cerebral oxygenation readings by these monitors, based on one single point measurement during anaesthesia, should be viewed with caution. Actually, there may be little indication for routine use of such monitoring during general anaesthesia.
Morphogenesis and growth of the soft tissue and cartilage of the vomeronasal organ in pigs
Authors: Salazar Ignacio , Lombardero Matilde , Cifuentes José M. , Quinteiro Pablo Sánchez , Alemañ Nuria 
Published: June 2003

AbstractThe morphology of the soft tissue and supporting cartilage of the vomeronasal organ of the fetal pig was studied from early stages to term. Specimens obtained from an abattoir were aged by crown‐to‐rump distance. Series of transverse sections show that some time before birth all structures – cartilage, connective tissue, blood vessels, nerves, glands and epithelia – are well developed and very similar in appearance to those of the adult. Furthermore, in transmission electron microscopy photomicrographs obtained at this stage the vomeronasal glands exhibit secretory activity.
Physical indicators of cartilage health: the relevance of compliance, thickness, swelling and fibrillar texture
Authors: Broom Neil D. , Flachsmann René 
Published: June 2003

AbstractThis study uses a bovine patella model to compare the relative merits of on‐bone compliance and thickness measurements, free‐swelling behaviour, and structural imaging with differential interference contrast (DIC) light microscopy to assess the biomechanical normality of the cartilage matrix. The results demonstrate that across a spectrum of cartilage tissues from immature, mature, through to mildly degenerate, and all with intact articular surfaces, there is a consistent pattern of increased free swelling of the isolated general matrix with age and degeneration. High swelling was always associated with major structural alterations of the general matrix that were readily imaged using DIC light microscopy. Conversely, for all tissue groups, no relationship was observed between thickness vs. compliance and compliance vs. general matrix swelling. Only in the proximal aspects of the normal mature and degenerate tissues was there a correlation between thickness and general matrix swelling. Free‐swelling measurements combined with fibrillar texture imaging using DIC light microscopy are therefore recommended as providing a reliable and quick method of assessing the biomechanical condition of the cartilage general matrix.
The distribution of Notch receptors and their ligands during articular cartilage development
Authors: Hayes A. J. , Dowthwaite G. P. , Webster S. V. , Archer C. W. 
Published: June 2003

AbstractWe examined the distribution of Notch family members and their ligands during the development of articular cartilage and the growth plate. Notch 1 was expressed by the chondrocytes of the developing articular surface but became increasingly restricted to the deeper layers after birth whilst expression of this family member was restricted to hypertrophic chondrocytes in the growth plate. Notch 2 and 4, Delta and Jagged 2 showed a broadly similar distribution, being present throughout the articular cartilage during development and becoming increasingly restricted to deeper layers with age. Hypertrophic chondrocytes within the growth plate also expressed Notch 2 and 4, Delta and Jagged 2 (which was also expressed in prehypertrophs). Notch 3 and Jagged 1 were absent from developing articular cartilage but were present in deeper layers at later time points (> 1 month) and both receptor and ligand were expressed in hypertrophic chondrocytes at all ages examined. These results highlight the complex Notch signalling interactions that result in the formation of the heterogeneous articular cartilage and allow for the co‐ordinated ossification and elongation of the growth plate. Mechanisms by which these processes are controlled are discussed in light of recent advances in the understanding of Notch signalling pathways.
A topographical study of mechanical and electrical properties of single myocytes isolated from normal guinea‐pig ventricular muscle
Authors: Wan X. , Bryant S. M. , Hart G. 
Published: June 2003

AbstractMajor regional differences in the electrical properties of myocytes from ventricular muscle have been described previously, on the basis of samples taken from a maximum of three regions in each heart. In order to define the topographical basis for such differences, we studied the electrical and mechanical properties of single myocytes isolated from 20 regions throughout the ventricles in the normal guinea‐pig heart. Single myocytes were isolated using an enzymatic dispersion method, and were studied under conditions that were close to physiological. Cell capacitance and action potentials were recorded using the switch‐clamp technique, and cell length and evoked shortening were measured using a photodiode array system. In the left ventricular free wall, mid‐myocardial cells were longer and had greater capacitative surface area than surface myocytes. There were transmural but not longitudinal differences in APD90 (action potential duration to 90% repolarization), with the longest APD90 in subendocardial and the shortest in subepicardial myocytes. We found a septum – left ventricular free wall – right ventricular free wall gradient, with the longest APD90 in the septum and the shortest in the right ventricular free wall. The regional distribution of APD90 was closely mirrored by relaxation time. Peak cell shortening was greater in subendocardial myocytes than in subepicardial myocytes in the left ventricular free wall, and in myocytes from the left side of the septum compared with the right. We concluded that the regional distribution of APD is closely and inversely related to the sequence of ventricular depolarization, and that the regional variations in cell shortening amplitude are related principally to reported regional variations in wall stress.
The cellular structure and lipid/protein composition of adipose tissue surrounding chronically stimulated lymph nodes in rats
Authors: Mattacks Christine A. , Sadler Dawn , Pond Caroline M. 
Published: June 2003

AbstractTo test the hypothesis that chronic immune stimulation of a peripheral lymph node induces the formation of additional mature adipocytes in adjacent adipose tissue, one popliteal lymph node of large male rats was stimulated by local injection of 10 µg or 20 µg lipopolysaccharide three times a week for 6 weeks. Adipocyte volumes in sites defined by their anatomical relations to the stimulated and homologous unstimulated popliteal lymph nodes were measured, plus adipocyte complement of the popliteal depot, and the lipid and protein content of adipocytes and adipose stroma. The higher dose of lipopolysaccharide doubled the mass of the locally stimulated lymph node and the surrounding adipose tissue enlarged by the appearance of additional mature adipocytes. Similar but smaller changes were observed in the popliteal adipose depot of the unstimulated leg and in a nodeless depot. The lipid content of the adipocytes decreased and that of the stroma increased dose‐dependently in all samples measured but the changes were consistently greater in the depot surrounding the stimulated lymph node. The protein content of both adipocytes and stroma increased in samples surrounding the stimulated node. We conclude that chronic immune stimulation of lymphoid tissues induces the formation of more adipocytes in the adjacent adipose tissue. These findings suggest a mechanism for the selective hypertrophy of lymphoid‐containing adipose depots in the HIV‐associated adipose redistribution syndrome.
Polyploid cells in the mouse ovary
Authors: Keighren Margaret A. , Macfadyen Leah P. , Hill Alan S. , Patek Charles E. , Telfer Evelyn E. , West John D. 
Published: June 2003

AbstractCell ploidy in the ovarian follicle and corpus luteum was investigated by DNA in situ hybridization to a reiterated, chromosome 3 transgene in mice that were hemizygous for the transgene. This approach was first validated by analysis of mouse kidney, pancreas and liver control tissues, which contain different frequencies of polyploid nuclei. Polyploid nuclei (with multiple hybridization signals) were seen in histological sections of both ovarian follicles and corpora lutea. The frequency of polyploid nuclei in follicles showed no consistent relationship with age (between 6 weeks and 10 months) but polyploid nuclei were significantly more abundant in corpora lutea than follicles (6.3% vs. 2.5%). This implies that production of polyploid cells is more closely associated with differentiation of ovarian follicles into corpora lutea than with the age of the female. Polyploidy tended to be more frequent in corpora lutea of mice that had mated even if they did not become pregnant. This study has highlighted the presence of polyploid cells in the mouse ovarian follicle and corpus luteum and has identified mating as a possible trigger for polyploidy in the corpus luteum. Further work is required to determine the physiological role of polyploid ovarian cells in reproduction.
Immunohistochemistry of the canine vomeronasal organ
Authors: Dennis J. C. , Allgier J. G. , Desouza L. S. , Eward W. C. , Morrison E. E. 
Published: June 2003

AbstractThe canine's olfactory acuity is legendary, but neither its main olfactory system nor its vomeronasal system has been described in much detail. We used immunohistochemistry on paraffin‐embedded sections of male and female adult dog vomeronasal organ (VNO) to characterize the expression of proteins known to be expressed in the VNO of several other mammals. Basal cell bodies were more apparent in each section than in rodent VNO and expressed immunoreactivity to anticytokeratin and antiepidermal growth factor receptor antibodies. The thin layer of neurone cell bodies in the sensory epithelium and axon fascicles in the lamina propria expressed immunoreactivity to neurone cell adhesion molecule, neurone‐specific beta tubulin and protein gene product 9.5. Some neurones expressed growth‐associated protein 43 (GAP43): and a number of those also expressed neurone‐specific beta tubulin‐immunoreactivity. Some axon fascicles were double labelled for those two proteins. The G‐protein alpha subunits Gi and Go, involved in the signal transduction pathway, showed immunoreactivity in the sensory cell layer. Our results demonstrate that the canine vomeronasal organ contains a population of cells that expresses several neuronal markers. Furthermore, GAP43 immunoreactivity suggests that the sensory epithelium is neurogenic in adult dogs.
Immunohistochemical localization of carbonic anhydrase isozymes in the rat carotid body
Authors: Yamamoto Yoshio , Fujimura Minako , Nishita Toshiho , Nishijima Kazutoshi , Atoji Yasuro , Suzuki Yoshitaka 
Published: June 2003

AbstractThe rat carotid body was immunohistochemically stained for carbonic anhydrase I, II and III (CA‐I, CA‐II and CA‐III). Immunoreactivity for CA‐I was distributed in type I cells, type II cells and nerve bundles. Smooth muscle cells and endothelial cells of blood vessels were also strongly stained for CA‐I. CA‐II immunoreactivity was distinctly positive in type I cells and nerve bundles. Vascular smooth muscle cells were weakly positive, and type II cells were negative for CA‐II. CA‐III immunoreactivity was identified in type I cells and vascular smooth muscle cells. Our results suggest that carbonic anhydrase isozymes in type I cells play an important role in chemoreception for hypercapnia. Immunoreactivities for CA‐I and CA‐II in the nerve fibres may participate in the synergic action of carotid sinus nerve between hypoxic and hypercapnic stimuli.