bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Younger Generation: The Labour Party and the 1959 Youth Commission
Authors: Ellis Catherine 
Published: February 2004

In 1956, Martha Gellhorn spent an evening exploring the uncharted territory of London's espresso bars. Her impressions were recorded in an article on “the younger generation”: “Full of expectations and ignorance, I made the long sight-seeing trip through the Espresso-bar country of London, stared at the young natives, and came gladly home at last with many pictures in my mind but little understanding …. The youthful Espresso-ites remained hopelessly strangers, in their strange, small, chosen land; I can only report what I have seen.” Gellhorn's account was punctuated by references to the “strangeness” of her experience. The decor of the bars invoked “distant places” with “bull-fight posters, bamboo, tropical plants, an occasional shell or Mexican mask.” As she traveled through this “strange country,” the sight of a tortilla was “terrifying,” the customers' clothing was breathtakingly exotic, and their skin tones suggested amalgams such as “Chinese-Javanese-Siamese” or “Spanish-Arab-Cuban.” At times, Gellhorn heard French and Italian spoken freely among the espresso bars' young patrons.The foreign topography of youth culture described by Gellhorn was not unusual among accounts of young people in the 1950s, yet until recently this period has been characterized principally as a time of social peace and political apathy, “an age of prosperity and achievement” shaped by “consensus” and a return to normality after the disruption and sacrifices of the Second World War. Following an extended period of austerity, the welfare state and the managed economy seemed to have ensured full employment and an unprecedented standard of living, while the election of successive Conservative governments in 1951, 1955, and 1959 has been explained as the political reflection of rising personal prosperity and security.
“There'll Always Be an England”: Representations of Colonial Wars and Immigration, 1948–1968
Authors: Webster Wendy 
Published: February 2004

“In Malaya,” theDaily Mailnoted in 1953, “three and a half years of danger have given the planters time to convert their previously pleasant homes into miniature fortresses, with sandbag parapets, wire entanglements, and searchlights.” The image of the home as fortress and a juxtaposition of the domestic with menace and terror were central to British media representations of colonial wars in Malaya and Kenya in the 1950s. The repertoire of imagery deployed in theDaily Mailfor the “miniature fortress” in Malaya was extended to Kenya, where the newspaper noted wire over domestic windows, guns beside wine glasses, the charming hostess in her black silk dress with “an automatic pistol hanging at her hip.” Such images of English domesticity threatened by an alien other were also central to immigration discourse in the 1950s and 1960s. In the context of the decline of British colonial rule after 1945, representations of the empire and its legacy—resistance to colonial rule in empire and “immigrants” in the metropolis—increasingly converged on a common theme: the violation of domestic sanctuaries.Colonial wars of the late 1940s and 1950s have received little attention in literatures on national identity in early postwar Britain, but the articulation of racial difference through immigration discourse, and its significance in redefining the postimperial British national community has been widely recognized. As Chris Waters has suggested in his work on discourses of race and nation between 1947 and 1963, these years saw questions of race become central to questions of national belonging.
Altered brain exposure of morphine in experimental meningitis studied with microdialysis
Authors: Tunblad K. , Ederoth P. , Gärdenfors A. , Hammarlund‐Udenaes M. , Nordström C.‐H. 
Published: February 2004

Background:  During pathologic conditions such as meningitis and traumatic brain injury the function of the blood–brain barrier (BBB) is disturbed. In the present study we examined the cerebral pharmacokinetic pattern of morphine in the intact brain and during experimentally induced meningitis using a pig model. Secondly, the use of intracerebral microdialysis as a potential tool for monitoring damage in the BBB by studying the pharmacokinetics of morphine is addressed.Methods:  Six pigs were studied under general anaesthesia. One occipital and two frontal microdialysis probes and one pressure transducer were inserted into the brain tissue. Another probe was placed into the jugularis interna. Morphine 1 mg kg−1 was administered as a 10‐min infusion, and morphine concentrations were then measured for 3 h. Meningitis was subsequently induced by injecting lipopoly‐saccharide into the cisterna magna. When meningitis was established, the morphine experiment was repeated.Results:  The unbound area under the concentration‐time curve (AUCu) ratio of morphine in brain to blood was 0.47 (0.19) during the control period, and 0.95 (0.20) (P < 0.001) during meningitis. The increase in the brain/blood AUCu ratio during meningitis implies decreased active efflux and increased passive diffusion of morphine over the BBB. The half‐life of morphine in brain was longer than in blood during both periods, and was unaffected by meningitis.Conclusion:  This study demonstrates that the morphine exposure to the brain is significantly increased during meningitis as compared with the control situation.
The validity of the static‐charge‐sensitive bed in the detection of fentanyl‐induced respiratory depression
Authors: Nikkola E. M. , Leino K. A. , Takala R. S. K. , Kirvelä O. A. , Salonen M. A. O. 
Published: February 2004

Background:  Only a few methods for the measurement of breathing are non‐invasive and do not interfere with measured parameters. The static‐charge‐sensitive bed (SCSB) could be such a monitor. The aim of this study was to evaluate the validity of the SCSB compared with the respiratory inductive plethysmograph (RIP) using a fentanyl‐induced respiratory depression model.Methods:  Eight healthy male volunteers were infused with intravenous (i.v.) fentanyl (15 µg/kg/h) until a decrease in SpO2 below 90% for 1 min emerged. Breathing was continuously and simultaneously measured with SCSB and RIP. Oxygenation, hemodynamics, arterial blood gas analysis, and subjective opioid‐related effects were monitored. Fentanyl concentration was measured from an arterial blood sample. The respiratory rate data of the SCSB (automated analysis and manual calculation) were compared with the corresponding RIP data, using analysis of variance for repeated measures. The validity of the SCSB compared with RIP was evaluated using an intra‐class correlation coefficient.Results:  Mean fentanyl dose was 629 µg. A statistically significant association was found between the RIP and SCSB data in the manual SCSB analysis (P < 0.0001), but not in the automated SCSB analysis (P = 0.91). After adjusting for the effect of time and the SCSB method, an intra‐class correlation coefficient between the manually calculated SCSB values and the RIP values was 0.66.Conclusion:  Clinically significant changes in respiratory rate were detected with the SCSB, but the results had to be analyzed manually. The SCSB best suits situations, where comprehensive data are needed. It is not suitable for on‐line respiratory monitoring, as the automated analysis did not calculate the respiratory rate correctly.
Evaluation of a recruitment maneuver with positive inspiratory pressure and high PEEP in patients with severe ARDS
Authors: Póvoa P. , Almeida E. , Fernandes A. , Mealha R. , Moreira P. , Sabino H. 
Published: February 2004

Background: To evaluate the effect of a recruitment maneuver (RM) with constant positive inspiratory pressure and high positive end‐expiratory pressure (PEEP) on oxygenation and static compliance (Cs) in patients with severe acute respiratory distress syndrome (ARDS).Methods: Eight patients with ARDS ventilated with lung‐protective strategy and an arterial partial pressure of oxygen to inspired oxygen fraction ratio (PaO2/FIO2) ≤100 mmHg regardless of PEEP were prospectively studied. The RM was performed in pressure‐controlled ventilation at FIO2of 1.0 until PaO2reached 250 mmHg or a maximal plateau pressure/PEEP of 60/45 cmH2O was achieved. The RM was performed with stepwise increases of 5 cmH2O of PEEP every 2 min and thereafter with stepwise decreases of 2 cmH2O of PEEP every 2 min until a drop in PaO2>10% below the recruitment PEEP level. Data was collected before (preRM), during and after 30 min (posRM).Results: The PaO2/FIO2increased from 83 ± 22 mmHg preRM to 118 ± 32 mmHg posRM (P = 0.001). The Cs increased from 28 ± 10 ml cmH2O−1preRM to 35 ± 12 ml cmH2O−1posRM (P = 0.025). The PEEP was 12 ± 3 cmH2O preRM and was set at 15 ± 4 cmH2O posRM (P = 0.025). The PEEP of recruitment was 36 ± 9 cmH2O and the collapsing PEEP was 13 ± 4 cmH2O. The PaO2of recruitment was 225 ± 105 mmHg, with five patients reaching a PaO2  ≥ 250 mmHg. The FIO2decreased from 0.76 ± 0.16 preRM to 0.63 ± 0.15 posRM (P = 0.001). No major complications were detected.Conclusions: Recruitment maneuver was safe and useful to improve oxygenation and Cs in patients with severe ARDS ventilated with lung‐protective strategy.
Ketamine suppresses endotoxin‐induced NF‐κB activation and cytokines production in the intestine
Authors: Sun J. , Wang X. D. , Liu H. , Xu J. G. 
Published: February 2004

Background:  Ketamine has been advocated for anesthesia in endotoxemic and other severely ill patients because it is a cardiovascular stimulant. However, ketamine also suppresses serum levels of endotoxin‐induced tumor necrosis factor‐alpha, and reduces mortality in mice in endotoxin shock. Our study was designed to investigate the protective effect of ketamine on the endotoxin‐induced proinflammatory cytokines and nuclear factor kappa B (NF‐κB) activation in vivo.Methods:  Adult male Wistar rats were randomly divided into six groups: saline controls; rats challenged with endotoxin (5 mg kg−1) and treated with saline; challenged with endotoxin (5 mg kg−1) and treated with ketamine (0.5 mg kg−1); challenged with endotoxin (5 mg kg−1) and treated with ketamine (5 mg kg−1); challenged with endotoxin (5 mg kg−1) and treated with ketamine (50 mg kg−1); and saline injected and treated with ketamine (50 mg kg−1). TNF‐α, IL‐6 and NF‐κB were investigated in the tissues of the intestine (jejunum) after 1, 4 and 6 h.Results:  Endotoxin caused transient production of TNF‐α and IL‐6 and activation of NF‐κB in the intestine at peak times of 1, 4 and 1 h, respectively. Ketamine 0.5 mg kg−1 suppressed endotoxin‐induced TNF‐α elevation and inhibited NF‐κB activation in the intestine; a dose of 5 mg kg−1 was required to inhibit IL‐6.Conclusion:  Ketamine suppresses the production of proinflammatory cytokines such as TNF‐α and IL‐6 in the intestine, possibly via inhibition of NF‐κB.
Pressure‐volume relationships in acute lung injury: methodological and clinical implications
Authors: Nunes S. , Uusaro A. , Takala J. 
Published: February 2004

Background:  Pressure‐volume relationships (PV curves) are the only available method for bedside monitoring of respiratory mechanics. Alveolar recruitment modifies the results obtained from the PV curves. We hypothesized that method‐related differences may influence PV‐curve guided ventilatory management.Methods:  Twelve acute lung injury (ALI) patients [PaO2/FiO2 13.0 ± 1.5 kPa (97.6 ± 11.3 mmHg), bilateral pulmonary infiltrates] were studied. Two PV curves [one at variable, and another at constant level of positive end‐expiratory pressure (PEEP)] were obtained from each patient using constant inspiratory flow and end‐inspiratory and ‐expiratory occlusions. Upper and lower inflection points (UIP, LIP) were estimated. Recruitment due to PEEP and during inflation was assessed by respiratory inductive plethysmography (RIP).Results:  (1) Pressure‐volume curves at constant PEEP tended to provide higher LIP values compared with curves at variable PEEP (mean difference  ± SEM 5.1 ± 1.9 cmH2O); and (2) recruitment occurred throughout the PV curve with no relationship with LIP or UIP.Conclusion:  Pressure‐volume curves obtained using variable PEEP translate a different physiological reality and seem to be clinically more relevant than curves constructed at constant PEEP. If curves constructed at constant PEEP are used to set the ventilator, unnecessarily high PEEP levels may be used. Respiratory inductive plethysmography technology may be used for monitoring of recruitment at the bedside.
Accuracy in estimating the correct intervertebral space level during lumbar, thoracic and cervical epidural anaesthesia
Authors: Lirk P. , Messner H. , Deibl M. , Mitterschiffthaler G. , Colvin J. , Steger B. , Rieder J. , Keller C. 
Published: February 2004

Background:  Even in the absence of factors concealing anatomical landmarks, high failure rates in correctly determining a given lumbar interspace have been reported.Methods:  Therefore, it was the aim of the present study to compare the assessed and factual level (determined by computed tomography) of epidural puncture in attending a regional anaesthesia cadaver workshop. Eighty‐two anaesthetists performed 117 punctures.Results:  Vertebral interspaces between T8–L4 were correctly identified more often than those between C3–T5 (P <  0.05). Identification of an arbitrarily chosen vertebral interspace was excellent in both the cervical/high thoracic and thoracic/lumbar regions.Conclusion:  As previously conjectured only for the lumbar region, we could confirm the tendency of anaesthetists to perform neuraxial puncture more cranially than expected also for the thoracic and cervical regions. The large majority of punctures (93.7%) was performed within one interspace of the predicted level.
Application of a mandibular nerve block using an indwelling catheter for intractable cancer pain
Authors: Kohase H. , Umino M. , Shibaji T. , Suzuki N. 
Published: February 2004

We report a case in which a mandibular nerve block using an indwelling catheter was employed for pain management in a terminal case of orofacial cancer.The patient was a 74‐year‐old female weighing 27 kg. She had a 27‐month history of mouth floor and tongue cancer. The cancer recurred and spread to bilateral face and neck. The severest pain mainly originated from the right mandibular region. Two steps of pain relief were performed for the patient. First, pain control using 1% lidocaine or 0.25% bupivacaine administered intermittently or continuously through an indwelling catheter in the mandibular nerve was performed for 1 week to estimate the amount of pain relief thereby obtained. Second, a neurolytic block was applied to the mandibular nerve through the catheter. After the neurolytic block, the total dosage of morphine and diclofenac remained unchanged for 2 months. We conclude from the present case that this technique is an excellent means of obtaining long‐term pain control in patients with intractable orofacial cancer pain.
Desflurane–remifentanil–nitrous oxide anaesthesia for abdominal surgery: optimal concentrations and recovery features
Authors: Billard V. , Servin F. , Guignard B. , Junke E. , Bouverne M. N. , Hédouin M. , Chauvin M. 
Published: February 2004

Background:  Intraoperative combinations of volatile and opioid agents are used to achieve unconsciousness, hypnotic sparing, haemodynamic stability and uneventful recovery. This study describes the influence of different remifentanil concentrations on these variables when combined with desflurane during abdominal surgery.Methods:  Sixty‐one healthy adult patients were randomly allocated to one of five predefined remifentanil target concentrations (3, 5, 7, 10 or 15 ng ml−1). Anaesthesia was titrated to maintain mean blood pressure (MBP), heart rate (HR) and BIS™ within predetermined values by adjusting desflurane delivery. Postoperative analgesia using propacetamol and morphine was initiated 30–45 min before skin closure, and continued using morphine PCA.Results:  Desflurane requirements adjusted to both BIS and haemodynamics were not significantly modified by the remifentanil concentration (median FetDES 2.7% before incision, 2.5% intraoperatively, and 2.2% during closure), resulting in a calculated drug consumption of 0.22–0.25 ml min−1 (with 1.5 l min−1 fresh gas flow). High remifentanil concentration decreased MBP and HR, and reduced the duration of tachycardia, but increased the duration of hypotension. The optimal balance was obtained with a remifentanil concentration of 5–7 ng ml−1 for intubation, 3 ng ml−1 until incision, 10 ng ml−1 during intra‐abdominal surgery and 5–7 ng ml−1 during closure. Post‐operative morphine requirements were not significantly modified by intraoperative remifentanil concentrations (median 30 mg/24 h, range [2–88]).Conclusion:  Remifentanil target concentrations from 3 to 15 ng ml−1 had little influence on desflurane requirements or postoperative morphine consumption, but markedly modified intraoperative haemodynamic stability, suggesting that the target concentration should closely follow the successive noxious stimulations.
Analgesic effect of dextromethorphan in neuropathic pain
Authors: Carlsson K. C. , Hoem N. O. , Moberg E. R. , Mathisen L. C. 
Published: February 2004

Background:  Dextromethorphan, a clinically available N‐methyl‐D‐aspartic acid (NMDA) receptor antagonist, has an analgesic effect in patients with diabetic neuropathy. The aim of this study was to evaluate the analgesic and adverse effects of a single high dose of dextromethorphan on spontaneous pain in patients suffering long‐term neuropathic pain of traumatic origin.Methods:  Fifteen patients with post‐traumatic neuropathic pain participated in this placebo‐controlled, double‐blind, randomized crossover study. On two separate occasions, the participants received 270 mg of dextromethorphan hydrobromide or placebo. Pain intensity, adverse effects and serum concentrations of dextromethorphan and metabolites were registered.Results:  Dextromethorphan had a statistically significant analgesic effect compared with placebo, but the effect varied markedly among the patients. Light‐headedness was the most important adverse effect reported. Extensive metabolizers of dextromethorphan had an apparently better analgesic effect than poor metabolizers.Conclusion:  This report indicates that a single high dose of dextromethorphan has an analgesic effect in patients with neuropathic pain of traumatic origin. The main metabolite dextrorphan seems to be important for the analgesic effect. At the relatively high dose studied, the clinical usefulness of dextromethorphan is limited to that portion of the patient population experiencing analgesia without an unacceptable level of adverse effects.
Predictive value of mechanomyography and accelerometry for pulmonary function in partially paralyzed volunteers
Authors: Eikermann M. , Groeben H. , Hüsing J. , Peters J. 
Published: February 2004

Background:  Accelerometry (ACM) of adductor pollicis muscle has been used for monitoring of neuromuscular blockade but its validity compared with the gold standard, mechanomyography (MMG), has been questioned. During neuromuscular blockade we compared these methods and we assessed pulmonary function.Methods:  In awake partially paralyzed volunteers we spirometrically assessed pulmonary function every 5 min until recovery. Rocuronium (0.01 mg kg−1 + 2–10 µg kg−1 min−1) was administered to maintain train‐of‐four (TOF)‐ratios (assessed every 15 s) of approximately 0.5 and 0.8 over a period of more than 5 min. The TOF‐ratio associated with ‘acceptable’ pulmonary recovery [forced vital capacity (FVC) and forced inspiratory volume in 1 s (FIV1) of ≥90% of baseline] was calculated using a linear regression model. During 5‐min periods of repetitive nerve stimulation we compared the squared residuals of the FVC and FIV1 estimates from TOFACM vs. TOFMMG, and compared variance of values derived from ACM and MMG using Wilcoxon's test.Results:  Limits of agreement of TOF‐ratio derived from ACM and MMG were wide [0.15±0.016 (SD)], and variability of TOFACM exceeded that of TOFMMG[variance: 77±105 vs. 51±55% (P<0.01)]. Calculated TOFACM and TOFMMG ratios of 0.56 (0.22–0.71) [mean (95%CI) and 0.6 (0.28–0.74)], respectively, predict ‘acceptable’ (90%) recovery of FVC while FIV1 remains impaired until TOF‐ratios of 0.91 (0.82–1.07) and 0.95 (0.82–1.18), respectively. In turn, TOFMMG (TOFACM) of unity predicted ‘acceptable’ recovery of FVC and FIV1 in 94 (93) % and 68 (73) % of measurements, respectively.Conclusions:  Accelerometry predicts effects of relaxation on pulmonary function as valid as the gold standard mechanomyography. We recommend that recovery of TOF ratio to 0.9–1.0 should be used as an indication of sufficient neuromuscular recovery in daily practice.
Continuous popliteal sciatic nerve block for outpatient foot surgery – a randomized, controlled trial
Authors: Zaric D. , Boysen K. , Christiansen J. , Haastrup U. , Kofoed H. , Rawal N. 
Published: February 2004

Background:  A major problem in outpatient foot surgery is severe postoperative pain that is not sufficiently treated by peroral analgesics.Methods:  Sixty‐three patients underwent foot surgery under spinal anesthesia. Immediately on conclusion of the operation, sciatic and saphenous nerve blocks were performed. The sciatic nerve was blocked in the popliteal fossa with 30 ml of ropivacaine 5 mg ml−1 and a perineural catheter was passed through the cannula. The patients were randomized to receive either ropivacaine 2 mg ml−1 (n=30) or saline (n=30) in the catheter through a disposable elastomeric pump with a fixed infusion rate of 5 ml h−1 for 55 h.Results:  Analgesia was excellent until 23 h 44 min (14 h 34 min) in the treatment group and 18 h 16 min (7 h) in the placebo group [mean (SD), P=0.07]. Thereafter, pain was significantly less in the treatment group on the first and second postoperative days (P=0.001). Sleep disturbances because of the pain in the foot were experienced by 25% of the treatment group on the first night at home and by 50% of the control group (P=0.29). There were no differences between the groups in their need for rescue opioid medication. None of the patients had any major problem with the catheter or pump, and none had any toxic effect referable to the technique.Conclusion:  This randomized, double‐blind study shows that continuous blockade of the sciatic nerve in the popliteal fossa reduces postoperative pain and has no untoward effects in a patient group known to experience severe pain after ambulatory surgery.