Abstract  Rectal methohexital has been used for nearly 30 yr in pediatric anesthesia. Despite this long and increasingly varied use, no large prospective series has been published detailing safety and efficacy. This study prospectively evaluated the efficacy, safety, and side effects of this medication in a series of 648 cases. On 553 of 648 occasions (85%), the child fell asleep after a single 30-mg/kg dose of 10% methohexital. Sleep was less likely in patients with myelomeningocele or who were receiving oral phenobarbital or phenytoin. When sleep occurred, the average time to onset of sleep was 6 min. Most patients who remained awake 15 min after drug were sedated. Defecation (10%) and hiccups (13%) were common but benign side effects. Partial airway obstruction and/or desaturation to Spo2 < or = 93% occurred in 26 patients (4%), but was resolved with blow-by oxygen and/or jaw-thrust in all but two cases. These two patients (0.3% of total) required aggressive airway intervention by the supervising anesthesiologist. Apnea did not occur in any patient. Methohexital has a high efficacy rate for sleep (85%) or sedation (96%), and has a relatively rapid onset. Significant respiratory side effects occur infrequently, but can be life threatening if not properly managed.

Abstract  In experimental infections in mice, the therapeutic efficacies of rectal administration of ceftizoxime (CZX) were compared with those of subcutaneous administration. The efficacies of rectal administration were equivalent to those of subcutaneous administration against intraperitoneal infections due to Streptococcus pneumoniae and Escherichia coli. Against Staphylococcus aureus, Streptococcus pyogenes, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Morganella morganii and Serratia marcescens, the efficacies of rectal administration were inferior to those of subcutaneous administration. Against urinary tract and respiratory tract infections, the efficacies of rectal administration were slightly inferior to those of subcutaneous administration. Serum concentrations of CZX for rectal administration were less than those of subcutaneous administration.

Abstract  The pattern of asthmatic response after inhalation of atropine and methacholine was studied in six adult asthmatics. After pretreatment with atropine, the provocation concentration of methacholine to cause a fall in FEV1 of 20% was increased from 0.66 +/- 2.09 to 94.90 +/- 1.78 mg/ml. In the subsequent 7 hr, four subjects developed prolonged asthmatic responses. These occurred after concentrations of methacholine higher than those used clinically but did not directly relate to the dose of methacholine or to the increase in dose after atropine. In one subject the prolonged response was not accompanied by increased methacholine responsiveness and was not prevented by pretreatment with cromolyn sodium (40 mg). These results show that high doses of methacholine inhaled after pretreatment with atropine can induce prolonged asthmatic responses but the mechanism is unclear.

Abstract  A young infant with vomiting associated with a gastric polyp is presented. The polyp proved to be focal foveolar hyperplasia. These non-neoplastic polyps of unknown etiology are usually found in adults.

Abstract  We used positron emission tomography (PET) with 18F-2-deoxyglucose (FDG) and 15O water in 20 patients with complex partial seizures to compare glucose metabolism and blood flow in temporal lobe epileptic foci identified by ictal scalp-sphenoidal video-EEG telemetry. Glucose metabolism was measured 20 minutes after blood flow without moving the patient from the scanner. We also studied 11 patients with 99mTc-HMPAO single-photon emission computed tomography (SPECT). Both local cerebral metabolic rate of glucose (LCMRGlc) and regional cerebral blood flow (rCBF) were significantly decreased in temporal cortex ipsilateral to the EEG focus. However, LCMRGlc was reduced by 11.2% in inferior lateral and 11.1% in inferior mesial temporal cortex and rCBF by only 3.2% and 6.1%. The ratio of LCMRGlc to rCBF was significantly reduced in inferior lateral temporal cortex ipsilateral to the ictal focus (p < 0.009). Moreover, using standardized criteria, blinded raters found that 16 of 20 patients had focal FDG-PET hypometabolism, all in the epileptogenic region; 10 of 20 had focal 15O water PET hypoperfusion, but it was falsely lateralized in two of these 10; and five of 11 had focal 99mTc-HMPAO SPECT hypoperfusion, but it was falsely lateralized in two of these five. Our data suggest that interictal glucose metabolism and blood flow may be uncoupled in epileptogenic cortex.

Abstract  Prenatal RDS-prevention is currently done by two substances: Corticosteroids and Bromhexine Metabolit VIII. The influence on fibrinolytic activity of these drugs in the fetal rat-lung was tested in vivo. The inhibitory effect against tissue-fibrinogen-activator of Beta-methason was greater than this of Bromhexine Metabolit VIII.

Abstract  The influence of monaural acoustic deprivation on the size of dendrites in n. laminaris in the chick was examined. Chicks were raised in a controlled acoustic environment with one ear occluded from 2 days prior to hatching until 25 days after hatching by an earplug which provided a conductive hearing loss of approximately 40 dB across the audible frequency range. Each n. laminaris cell receives spatially segregated binaural excitatory innervation; one dendritic field received input from the plugged ear while the other received input from the normal ear. This arrangement allowed comparison of the size (length) of the "deprived" dendrites and the "nondeprived" dendrites for each cell. The tonotopic organization of n. laminaris allowed these comparisons to be made as a function of the frequency organization of the nucleus. We observed systematic changes in dendritic size which differed as a function of the tonotopic position of the neurons. In high-frequency regions the dendrites receiving information from the deprived ear were shorter than those receiving input from the normal ear. Unexpectedly, cells responsive to low frequencies showed the opposite result; the dendrites innervated from the deprived ear were longer than those responsive to the nondeprived ear. These results suggests that a relatively flat conductive hearing loss may cause nonuniform changes in activity impinging on high- and low-frequency areas of the auditory system.

Abstract  Here we compared the features of apoptosis induced by DNA-damaging agent, etoposide, and by withdrawal of the growth factors in NB 2a neuroblastoma cells. We showed that serum deprivation and etoposide induced a distinct pattern of regulation of c-Fos, c-Jun and p53 protein levels, as well as the differential changes in DNA-binding activity of AP-1 and NF-kappaB transcription factors. The late phase of apoptesis induced by serum withdrawal was associated with disintegration of nuclear DNA both into high molecular weight (HMW) and oligonucleosomal DNA fragments, whereas etoposide induced the formation of HMW-DNA fragments without internucleosomal DNA cleavage. Incubation of etoposide-treated cells without serum resulted in an additive effect on the pattern of DNA fragmentation. Differences in DNA fragmentation profiles induced by serum withdrawal and etoposide in NB 2a cells were reproducible in nonproliferating cerebellar granule cells and also in a cell free system assay after treatment of isolated normal nuclei with cytosolic extracts prepared from serum-deprived or etoposide-treated cells. Both HMW and oligonucleosomal DNA fragmentation in serum-deprived cells was inhibited by aurintricarboxylic acid and was completely abrogated by cycloheximide. In contrast, DNA fragmentation in etoposide-treated cells was insensitive to the inhibitory effect of aurintricarboxylic acid, and was not prevented by cycloheximide. Our results indicate that in NB 2a neuroblastoma cells etoposide and serum withdrawal induce a distinct mode of apoptosis which is associated with a distinct pattern of regulation of immediately early response genes in the early phase, and with recruitment of different mechanisms for DNA disintegration in the late phase of apoptosis.

Abstract  The association between EBV and nasopharyngeal carcinoma (NPC) has been well documented although the precise role of the virus in the genesis of the tumour is not understood. We undertook this study to examine the prevalence of EBV infection in nasopharyngeal tissue obtained from 33 healthy individuals not considered to be at risk of developing NPC. Using polymerase chain amplification (PCR) and in situ hybridization we have identified EBV DNA in 70% (23/33) of the tissues examined. Our data demonstrate that EBV is present at the site of tumour development in the low-risk population and by inference that the virus is also present before the onset of disease in the high-risk group. This survey supports the concept of NPC pathogenesis as a multifactorial process.

Abstract  The inhibitory effects of TNFalpha on adipocyte differentiation are well described, however, the mechanisms are poorly understood. Early during hormonally-induced 3T3-L1 preadipocyte differentiation there is a requisite mitotic clonal expansion phase that is associated with significant regulation in p130 and p107 protein levels, two members of the retinoblastoma protein family that regulate cell cycle events through interactions with the E2F transcription factors. This regulation occurs within the first 24 hours of differentiation (Day 1) and is characterized by a transient increase in p107 protein and mRNA levels as well as a transient decrease in p130 protein levels. Here we describe that TNFalpha disrupts the normal pattern of expression of both p130 and p107 proteins, leading to a complete block in mitotic clonal expansion. Interestingly, TNFalpha-treated cells enter S-phase as determined by 5-bromo-2'-deoxyuridine uptake experiments, but rather than completing cell cycle, they are stimulated to undergo apoptosis.