Femoral vein stasis during laparoscopic cholecystectomy: effects of graded elastic compression leg bandages in preventing thrombus formation

Venous stasis of the legs during laparoscopic cholecystectomy was compared between patients without graded compression leg bandages (Group 1; n = 12) and patients with such bandages (Group 2; n = 12) by measuring mean blood flow velocity and cross-sectional area of the femoral vein using a color Doppler ultrasonography. In Group 1, when velocity and area were measured in the supine position, a significant decrease in velocity (p < .05) and a significant increase in area (p < .05) occurred after abdominal insufflation to 10 mm Hg. These changes were greater during abdominal insufflation in the reverse Trendelenburg position than during abdominal insufflation in the supine position. In Group 2, flow velocity was significantly higher (p < .05) before abdominal insufflation as compared with Group 1. After abdominal insufflation to 10 mm Hg and a postural change, velocity significantly decreased (p < .05) and area significantly increased (p < .05) in Group 2, similar to the results in Group 1. During abdominal insufflation at 5 mm Hg or lower, the use of the graded compression bandage was found to be useful for preventing femoral vein stasis. During abdominal insufflation at 10 mm Hg or in the reverse Trendelenburg position, the bandage did not prevent femoral vein stasis.     

Nonnecessary conditions or useful procedures in desensitization: A reply to Wilkins.

Discusses W. Wilkins's (see record 1972-06967-001) claim that the 3 procedures defining M. Wolpe's systematic desensitization-muscle relaxation, a graded hierarchy of fear-relevant scenes, and imagination of these scenes concommitant to muscle relaxation-are unnecessary. It is proposed that these claims follow from a somewhat prejudiced review of largely analog studies and may be misleading to the practicing behavior therapist. It is suggested that (a) explanations of the success of densitization in terms of cognitive and social variables have no more support or utility than Wolpe's original theoretical formulations and (b) it is premature to discard the defining procedures of desensitization as unnecessary when they are quite useful and perhaps necessary for success in treating highly fearful patients. (17 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discriminative shock-avoidance learning of an autonomic response under curare.

Assigned 16 curarized, artificially respirated male Sprague-Dawley albino rats to 2 groups of 8 Ss each, rewarded for intestinal contraction (C) or relaxation (R), respectively. Each S received a predetermined series of CS+, CS-, and blank (B) trials, the latter involving no stimulation. On CS+ trials, Ss in Group C received a noxious electric shock to the tail for episodes of intestinal relaxation, while those in Group R received the shock for episodes of intestinal contraction. Results indicate that both groups spent significantly greater amounts of time, both toward the end of acquisition and during extinction, in the intestinal state for which they were rewarded, manifesting stimulus-specific escape and avoidance learning. In Exp. II with 4 curarized Ss, no consistent unconditioned effects on intestinal motility were observed as a result of shock application or shock offset. (16 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of demand characteristics on the outcome of systematic desensitization analogue studies.

48 female undergraduates with high scores on the Snake-Fear Questionnaire participated in either systematic desensitization, sleep therapy, partial systematic desensitization, or no treatment. Sleep therapy and partial systematic desensitization had all of the components of systematic desensitization except pairing the hierarchy and relaxation. However, sleep therapy Ss took the posttreatment fear assessments thinking that relaxation and the hierarchy had been paired while they slept, whereas Ss in partial systematic desensitization took the posttherapy fear assessments with the expectation of subsequently having relaxation paired with the hierarchy. Results indicate that comparable fear reductions were produced by sleep therapy and systematic desensitization. Sleep therapy, however, resulted in more reduction of the Ss' fear responses than partial systematic desensitization. These findings demonstrate that pairing relaxation with the hierarchy was not necessary to achieve reduction of Ss' fear responses, and that operations other than the components of systematic desensitization could influence the outcome of systematic desensitization analog research. Findings support the contention that in analog research a significant amount of the behavior change achieved by systematic desensitization is attributable to the treatment's demand characteristics. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of the strain and the intraocular amount of herpes simplex virus types 1 and 2 in the induction of anterior-chamber-associated immune deviation

The effects of optical isomers of ephedrine and methylephedrine on the guinea pig tracheal smooth muscle were studied. l-Ephedrine markedly caused a graded relaxation of the guinea pig trachea where the tone had been raised spontaneously. A rightward shift of the l-ephedrine concentration-response curve was observed for propranolol and butoxamine, and the pA2 values for propranolol and butoxamine were 8.55 and 6.38, respectively. d-Methylephedrine markedly caused a graded relaxation of the guinea pig trachea contracted with histamine. Propranolol and bupranolol did not affect the relaxant response to d-methylephedrine. d-Methylephedrine competitively antagonized the contractile responses to histamine, and the pA2 value for d-methylephedrine was 5.12. These results suggest that l-ephedrine-induced relaxation of the guinea pig trachea is mediated through beta 2-adrenoceptors, whereas d-methylephedrine relaxes the guinea pig trachea by blocking histamine receptors.     

Importance of hierarchy content in the self-control of anxiety.

Used speech anxiety as the target behavior in a study which compared 2 self-control desensitization procedures: one with a hierarchy relevant to speech anxiety and the other with a hierarchy totally unrelated to public speaking situations. A 3rd treatment condition involved the prolonged exposure of the hierarchy relevant to speech anxiety in the absence of relaxation. 42 speech-anxious community residents volunteered to participate in the program and were seen in groups for 7 therapy sessions. Using a variety of different outcome measures, consistent anxiety reduction was found after each of the 2 desensitization treatments. These were equally effective, indicating that the generally accepted procedure of using hierarchies reflecting target behavior may be an unimportant component of desensitization, at least as presented within a self-control framework. Although the 2 desensitization procedures were somewhat superior to the prolonged exposure, the latter also resulted in anxiety reduction. (1 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exposure and anxiety management in the treatment of social phobia.

Divided 45 18–65 yr old social phobia outpatients into 3 groups of 15 Ss each: Group 1 received exposure with anxiety management. Group 2 received exposure with a nonspecific "filler" treatment instead of anxiety management. Group 3 served as a waiting-list control. Results show that Groups 1 and 2 improved more than Group 3 and the improvement was maintained for 6 mo. At the end of treatment, Group 1 had lower scores than Group 2 on 2 cognitive measures of social anxiety. Six months later, Group 1 had lower scores on 4 additional measures. No S in Group 1 requested additional treatment within a year, while 40% of Group 2 did so. It is suggested that anxiety management increases the effect of exposure treatment because it helps Ss adapt to unpredictable situations, relaxation and distraction are useful techniques, and emphasis on self-help and rationale are important. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A pharmacological evaluation of the pull-up test for muscle relaxation in rats

The pull-up test for muscle relaxation is described and validated. At testing, rats were evaluated for their ability to recover ('pull-up') from a fully inverted head-down position. Control animals rapidly regained position (median: 1 s). Known muscle relaxants increased latency to pull-up compared to controls. The test proved sensitive to the effects of barbiturates and benzodiazepines which produced graded dose-response functions. In general, results in the pull-up test corresponded with known potencies, with weaker muscle relaxants such as clobazam and oxazepam being less active. The test was relatively insensitive to non-benzodiazepine compounds (e.g., haloperidol, etomidate, morphine, fentanyl and risperidone) producing cataleptic, catatonic, neuroleptic, analgesic, sedative or hypnotic effects. In terms of ED50 values for barbiturates and benzodiazepines, the pull-up test correlated significantly with ED50s from the rotarod test, the antipentylenetetrazol test, ataxia in rats and muscle relaxation in cats. It was concluded that the pull-up test was relatively specific for muscle relaxation and provided a simple alternative to more time-consuming or equipment-intensive tests.     

Role of expectancy manipulation in systematic desensitization.

Manipulated expectancy, relaxation, and hierarchy content in a 2 * 2 design with 2 additional control groups. Ss were 76 spider-phobic undergraduates. It was hypothesized that a major portion of therapeutic change following desensitization could be accounted for by the Ss' responses to positive feedback inherent in the paradigm. Ss saw either photographs of spiders or blank slides that they believed to be tachistoscopically-presented pictures of spiders. One-half of the Ss believed their progress through the hierarchy to be contingent on autonomic responses; the others believed rate of progress to be random. Findings did not support the hypothesis that expectancy is the only factor in desensitization, but they did clarify the role of expectancy vis-a-vis the counterconditioning elements typically discussed in the literature. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical meaning of ventricular ectopic beats in the diagnosis of HIV-related myocarditis: a retrospective analysis of Holter electrocardiographic recordings, echocardiographic parameters, histopathological and virologic findings

Clinical-pathological studies have demonstrated that in 46-51% of AIDS patients a lymphocytic interstitial myocarditis can be found at autopsy. In > 80% of these patients no specific etiologic factor for myocarditis was found. This pathological finding is believed to be related to a specific pathogenetic action of HIV on myocardial tissue and it is called HIV-related myocarditis (HRM). In 15-30% of patients with lymphocytic interstitial myocarditis ventricular arrhythmias have been described. In order to assess the prevalence and the predictive value of ventricular ectopic beats (VEB) in the diagnosis of HRM, we performed a retrospective analysis of 24-hour Holter recordings, M-mode and two-dimensional echocardiographic and Doppler parameters and post-mortem myocardial histopathological and virologic findings on a selected sample of 35 NYHA functional class II patients died of AIDS. The patients were divided into two groups according to post-mortem histopathological findings of myocardium specimens: Group 1 (n = 19) including patients with histopathological findings consistent with diagnosis of HRM; Group 2 (n = 16), including patients without histopathological findings of myocarditis. Group 2 patients represented the control group. The retrospective analysis demonstrated a greater prevalence of VEB class IV and subclass IVb in Group 1 compared to Group 2 (p = 0.009 and p = 0.004, respectively). The other classes of VEB did not present a statistically significant difference between groups. VEB class IV presented a 81.2% diagnostic predictive value (subclass IVa: 50%; subclass IVb: 90.9%). Ejection fraction, kinetic score and Doppler E/A ratio, Ei Area, Ai Area and Ai Area/total Area ratio and isovolumetric relaxation time were significantly correlated to Lown's classes of VEB (p < 0.001) and to the values of CD+ cells (p < 0.001); on the other hand, VEB classes correlated significantly with the values of CD+ cells (p < 0.001). Syncytial cells and HIV p24 antigen in cultured myocytes were detected in 17 Group 1 patients (89.4%) and in 2 Group 2 patients (12.5%; p < 0.001). These results have demonstrated that in selected cases of AIDS patients specific classes of VEB may represent a simple and sensitive electrocardiographic marker of HRM. VEB classes correlate significantly with systolic and diastolic echocardiographic parameters and to the values of CD4+ cells. Furthermore, in patients with HRM a direct pathogenetic action of HIV may be assumed.     

Systematic desensitization: Expectancy change or counterconditioning?

Exposed 44 snake and spider phobic undergraduates to either (1) a form of systematic desensitization treatment; (2) a technique, called T-scope therapy, which embodies most of the expectancy-manipulating features of desensitization, but does not contain the technical elements of the procedure, i.e., relaxation, visualization, and the construction of an anxiety hierarchy, (3) T-scope therapy, presented as an "incomplete" and probably ineffective form of treatment; or (4) no treatment. There was no significant differences (on self-rating, runway, or interview measures) between the effects of the systematic desensitization procedure and T-scope therapy, although Ss receiving either of these treatments improved significantly more than those who received no treatment or T-scope therapy administered under the "low-expectancy" condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of atopic dermatitis: A comparison of psychological and dermatological approaches to relapse prevention.

Compared the effectiveness of 4 group treatments for atopic dermatitis, a chronic skin disorder characterized by severe itching and eczema: dermatological educational program (DE), autogenic training as a form of relaxation therapy (AT), cognitive-behavioral treatment (BT), and the combined DE and BT treatments (DEBT). BT comprised relaxation, self-control of scratching, and stress management. Group treatments were also compared with standard medical care (SMC). Assessments at 1-year follow-up showed that the psychological treatments (AT, BT, and DEBT) led to significantly larger improvement in skin condition than intensive (DE) or standard (SMC) dermatological treatment, accompanied by significant reductions in topical steroids used. Results corroborate preliminary reports that psychological interventions are useful adjuncts to dermatological treatment in atopic dermatitis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Modulation of bone mass and turnover in growing rats by voluntary weight-bearing exercise and glucose supplementation

Female Sprague-Dawley rats, 9 weeks of age, were assigned to four groups: Group 0 (n = 8) was dissected for base-line control, and the other three groups were fed for 3 mo: Group 1 (n = 9), sedentary controls; Group 2 (n = 6), running rats housed in a cage with a treadmill and pair-fed with Group 1; and Group 3 (n = 7), running rats, pair-fed and allowed free access to additional glucose. The distances of voluntary running did not significantly differ between Groups 2 and 3. Menstrual cycles in these rats were apparently maintained as observed from daily running distances. The amount of glucose taken by rats in Group 3 was 3.5 +/- 0.4 (mean and SE) g/d. Body weight (BW) at the end of the experiment for Groups 1, 2, and 3 were 295.0 +/- 7.9, 211.7 +/- 5.4 (p < 0.001 vs. Group 1), and 259.0 +/- 3.5 g (p < 0.01 vs. Group 2), respectively. The parameters of bone mass such as ash weights of the femur and bone mineral content of the lumbar spine and the tibia in Groups 1 and 2 did not differ, but the values were significantly greater in Group 3 than in Group 2. However, these parameter values corrected for BW were significantly greater in Group 2 than in Group 1 and did not significantly differ between Groups 2 and 3. The parameters of bone formation, such as serum bone alkaline phosphatase activity levels and trabecular bone formation rates corrected for BW, were significantly greater in Group 2 than in Group 1 but did not differ between Group 2 and 3. However, the parameters of bone resorption, such as serum tartrate resistant acid-phosphatase levels, were significantly less in Group 3 than in Group 2. These results suggest that voluntary running augments the age-dependent increase in bone mass by modulating the bone turnover when an adequate energy source is supplied under conditions of normal menstruation, and an adequate supply of energy could be necessary to enhance the age-dependent increase in bone mass.     

Clinical utility of Lens culinaris agglutinin-reactive alpha-fetoprotein in small hepatocellular carcinoma: special reference to imaging diagnosis

We sought to determine whether insulin/insulin-like growth factor-1 (IGF-1) and an insulin-sensitizing agent, troglitazone, have additive vasodilatory effects and the possible involvement of intracellular Ca2+ ([Ca2+]i) and/or glucose utilization in these effects. Contractile responses to norepinephrine (NE) and potassium chloride (KCl), as well as relaxation to endothelium-dependent (acetylcholine [Ach]) and -independent (sodium nitroprusside [NaNP]) agents, were examined in rat tail artery rings in the presence of insulin/IGF-1 and/or troglitazone. Endothelium-intact tail artery rings stretched to 1 g tension were preincubated with troglitazone (3 micromol/L) and/or insulin/IGF-1 (100 nmol/L) prior to addition of graded doses of NE and KCI. A 90-minute exposure to troglitazone attenuated the maximal contraction to graded doses of NE and KCI (P<.0001). Incubation in glucose-free medium decreased the responses only to NE; troglitazone further attenuated the NE-induced contraction (P = .001). In submaximally precontracted endothelium-intact rings, troglitazone increased the relaxation both to NaNP (P<.0001) and to Ach (P = .001). Contraction experiments in depolarizing KCI (25 mmol/L) or Ca2+ -free buffer showed that troglitazone and insulin have a similar Ca2+ dependency. In conclusion, troglitazone, like insulin/IGF-1, attenuates responses to vasoactive agonists through a Ca2+ -dependent mechanism that may require the presence of glucose but is independent of insulin action and nitric oxide (NO) production.     

Autoimmune thyroiditis complicated with reversible changes of thyroid function

The purpose of this study was to determine whether warm ischemia (WIT) and cold storage preservation (CSP) impair endothelium-dependent vascular relaxation in the kidney. Twenty-four canine kidneys were harvested, preserved with CSP for 24 or 48 hours, and then perfused with canine blood at 37 C for the determination of glomerular filtration rate (GFR), perfusion flow rate, and renal vascular resistance (RVR). There were four experimental groups: Group I--no WIT followed by 24 hours CSP, Group II--30 minutes WIT followed by 24 hours CSP, Group III--no WIT followed by 48 hours CSP, Group IV--30 minutes WIT followed by 48 hours CSP. Endothelial function in each group was evaluated using acetylcholine (ACh, 1 mg. bolus) as an endothelial dependent vasodilator, and sodium nitroprusside (NP, 10 mg. bolus) as an endothelial independent vasodilator. Glomerular filtration rate was significantly less (P < .05) and RVR was significantly greater (P < .05) for kidneys from Groups II, III and IV compared to group I. The highest RVR was observed in kidneys from Groups II and IV. Nitroprusside administration caused an equivalent reduction in RVR among all four study groups. ACh administration caused a similar reduction in RVR in Groups I and III; however, the change in RVR was significantly less in Groups II and IV (P < .05). We hypothesize that the more severe ischemic insult in the latter groups led to vascular endothelial damage with a consequent loss of ability to secrete endothelium-derived relaxing factor in response to ACh administration.     

Interleukin 10 reduces the severity of acute pancreatitis in rats

BACKGROUND & AIMS: Previous studies have documented the effectiveness of interleukin (IL)-10 if given before the onset of experimental acute pancreatitis. This study examined whether IL-10, a cytokine that inhibits macrophage release of inflammatory mediators, would alter the severity of acute pancreatitis if given before or after the induction of disease. METHODS: Eighty-four Sprague-Dawley rats were divided into four groups. Group 1 received intravenous saline, and groups 2, 3, and 4 received intravenous cerulein (8.5 microg x kg(-1) x h(-1)). Group 3 was also given 150,000 U of intraperitoneal IL-10 1 hour before cerulein infusion and every 3 hours thereafter. Group 4 received 150,000 U intraperitoneal IL-10 2 hours after cerulein infusion and every 3 hours thereafter. Serum amylase and tumor necrosis factor (TNF)-alpha levels were measured before and 3, 9, or 15 hours after induction of pancreatitis. Animals were killed at these time points. Pancreata were analyzed for edema and TNF-alpha mRNA and TNF-alpha protein concentrations and were graded histologically. RESULTS: Serum amylase, TNF-alpha mRNA, and TNF-alpha protein levels, pancreatic edema, and histological score were significantly reduced when IL-10 was administered either before or after induction of pancreatitis. Serum TNF-alpha levels were undetectable. CONCLUSIONS: IL-10 attenuated the severity of experimental acute pancreatitis if given either before or after the induction of the disease. These results are consistent with the hypothesis that the macrophage is important in determining the severity of acute pancreatitis in this model.     

Acute cytotoxicity testing with cultured human lung and dermal cells

STUDY OBJECTIVE: To determine if 450 micrograms/kg (1.5 times the ED95) of rocuronium would result in a comparable onset with a shorter duration of action when compared with 600 micrograms/kg (2 times the ED95). DESIGN: Randomized, single-blind study. SETTING: Teaching hospital. PATIENTS: 85 ASA physical status I and II children ages 2 through 12, undergoing elective surgery with an inhalation induction using halothane. INTERVENTIONS: Group 1 received 600 micrograms/kg rocuronium, and Group 2 received 450 micrograms/kg rocuronium. MEASUREMENTS AND MAIN RESULTS: The two groups were compared using a Student's t-test, with p < 0.05 significant. The time of onset, or time to 95% suppression of neuromuscular twitch with standard errors, was 140 +/- 13 seconds (range 46 to 365 sec) in Group 1 and 148 +/- 13 seconds (range 82 to 345 sec) in Group 2 (NS = not significant). The times to 25% return of twitch from baseline (T25) in Groups 1 and 2 were 28 +/- 1.5 minutes (range 14 to 45 min) and 26 +/- 1.6 minutes (range 10 to 55 min), respectively (NS). The differences between these two doses in onset of, and recovery from, block were not found to be statistically significant. The results, however, excluded 5% of the higher dose group and 31% of the lower dose group who did not achieve 95% suppression of twitch. Time to maximal suppression of neuromuscular blockade, however, was not statistically significant for the 85 patients with a time of 270 +/- 28 seconds (range 91 to 605 sec) with a mean maximal suppression of 98.7% in Group 1 and 313 +/- 25 seconds (range 91 to 899 sec) with a mean maximal suppression of 93.1% in Group 2. CONCLUSION: The two doses of rocuronium did not differ statistically in onset or duration. Rocuronium at 600 micrograms/kg offers more reliability than 450 micrograms/kg in achieving adequate muscle relaxation, and the lower dose may result in a significantly large number of patients who may have inadequate intubating conditions.     

Effect of concurrent use of ondansetron hydrochloride and dexamethasone against nausea and vomiting in lung cancer patients receiving cisplatin

We examined the efficacy of concurrent use of ondansetron hydrochloride and dexamethasone, and the effective dose of dexamethasone against nausea and vomiting in lung cancer patients receiving chemotherapy including single high dose cisplatin. The study was carried out on total of 44 courses of chemotherapy in either initial onset or recurrence of lung cancer. The patients were given 4 mg of ondansetron injection on the day of cisplatin injection (Day 1), and 4 mg/day of ondansetron tablet for Days 2 to 4. These patients were randomly allocated into 2 groups, i.e., those who, on Day 2, concomitantly received 10 mg of dexamethasone (D10 Group, 22 courses) or 20 mg (D20 Group, 22 courses), for comparing the antiemetic effects in a different concomitant dose of dexamethasone. An efficacy rate of 70% or more was achieved in each group for acute emesis on Day 1. The efficacy rate was 80% or above for emesis on Day 2 when dexamethasone was concurrently administered, and Days 3 and 4 in both groups. No significant difference was observed between the groups. A higher complete suppression rate against nausea was seen in D20 Group even though the difference from D10 Group was not significant. Furthermore, food intake rate on Day 2 was significantly better in D20 Group. However, in the cases that were graded effective or markedly effective for acute emesis on Day 1, the efficacy rate was also high in both groups through Days 2-4. It was notable that the efficacy rate of Days 2-4 was 100% in D2 Group. The high efficacy rate was shown in male patients regardless of which dose of dexamethasone was used. However, control of emesis was unfavorable in female patients on Day 1 and was still unfavorable even though dexamethasone was combined from Day 2. We considered from the above results that 10 mg/day of concurrent dexamethasone is sufficient in suppression of delayed emesis on Day 2. However, in order to improve nausea or food intake, or to suppress emesis in patients who are highly likely to show unfavorable control for Day 2 and onward, 20 mg/day should also be effective.     

Economic considerations of the use of new anesthetics: a comparison of propofol, sevoflurane, desflurane, and isoflurane

Cost control in anesthesia is no longer an option; it is a necessity. New anesthetics have entered the market, but economic differences in comparison to standard anesthetic regimens are not exactly known. Eighty patients undergoing either subtotal thyroidectomy or laparoscopic cholecystectomy were randomly divided into four groups, with 20 patients in each group. Group 1 received propofol 1%/sufentanil, Group 2 received desflurane/sufentanil, Group 3 received sevoflurane/sufentanil, and Group 4 received isoflurane/sufentanil (standard anesthesia) for anesthesia. A fresh gas flow of 1.5-2 L/min and 60% N2O in oxygen was used for maintenance of anesthesia, and atracurium was given for muscle relaxation. Concentrations of volatile anesthetics, propofol, and sufentanil were varied according to the patient's perceived need. Isoflurane, desflurane, and sevoflurane consumption was measured by weighing the vaporizers with a precision weighing machine. Biometric data, time of surgery, and time of anesthesia were similar in the four groups. Times for extubation and stay in the postanesthesia care unit (PACU) were significantly longer in the isoflurane group. Use of sufentanil and atracurium did not differ among the groups. Propofol patients required fewer additional drugs in the PACU (e.g., antiemetics), and thus showed the lowest additional costs in the PACU. Total (intra- and postoperative) costs were significantly higher in the propofol group ($30.73 per patient; $0.24 per minute of anesthesia). The costs among the inhalational groups did not differ significantly (approximately $0.15 per minute of anesthesia). We conclude that in today's climate of cost savings, a comprehensive pharmacoeconomic approach is needed. Although propofol-based anesthesia was associated with the highest cost, it is doubtful whether the choice of anesthetic regimen will lower the costs of an anesthesia department. IMPLICATIONS: Cost analysis of anesthetic techniques is necessary in today's economic climate. Consumption of the new inhaled drugs sevoflurane and desflurane was measured in comparison to a standard anesthetic regimen using isoflurane and an IV technique using propofol. Propofol-based anesthesia was associated with the highest costs, whereas the costs of the new inhaled anesthetics sevoflurane and desflurane did not differ from those of a standard, isoflurane-based anesthesia regimen.     

Supraventricular tachycardias: therapeutic attitude in 1998

Nitric oxide (NO) is believed to be identical to endothelium-dependent-relaxing-factor, a potent vasodilator. In addition, NO has been founded to play a critical role in the maintenance of vascular permeability through its attenuation of polymorphonuclear neutrophils (PMN) and platelets. In the present study, we have evaluated the effects of inhaled NO at reperfusion in canine left single-lung allotransplantation from a non-heart-beating donor. Twelve weight-matched pairs of adult mongrel dogs were used. The donor dogs were sacrificed by an intravenous injection of potassium chloride without heparinization. They were left at room temperature for 3 hours. Then, the recipient dogs received a left single-lung allotransplantation. After implantation, the right bronchus and pulmonary artery were ligated. In Group 1 (n = 6), NO gas was administered continuously at a concentration of 40 parts per million throughout a 6-hour assessment period. In Group 2 (n = 6), nitrogen gas was administered in the same manner as NO, for control. The survival time in Group 1 was significantly longer than that in Group 2. The arterial oxygen tension in Group 1 was significantly higher than that in Group 2. The pulmonary vascular resistance was significantly lower in Group 1 than in Group 2. The aortic pressure and the cardiac output each did not differ significantly between the two groups. Myeloperoxidase activity was significantly lower in Group 1 than in Group 2. Inhaled NO at reperfusion is beneficial in lung transplantation from non-heart-beating donors because it attenuates ischemia-reperfusion injury by inhibiting PMN activation and vasodilating pulmonary vasculature.