The milk-alkali syndrome caused by betelnuts in oyster shell paste

We report anesthetic management of 6 cases (5 patients) with dilated cardiomyopathy for noncardiac surgery. The severity of their cardiomyopathy evaluated by left ventricular ejection fraction (LVEF) utilizing echocardiography was different in each case. The management of anesthesia was divided into 3 steps according to the LVEF. In cases with LVEF over 0.45, it was possible to perform regular anesthetic management by carefully selecting and controlling anesthetic agents. In 2 cases with LVEF from 0.2 to 0.4, anesthetic management was difficult. Some vasoactive drugs (e.g. dopamine) and intensive monitoring devices (e.g. pulmonary artery catheter) were needed to optimize anesthetic course. In one case with LVEF less than 0.2, we discussed much about surgical indication. Because of the malignant nature of the tumor, we agreed to proceed. IABP was inserted preoperatively and this proved to be life-saving during the procedure. It is important to have an inter-departmental discussion on these severely compromised cases.     

Raetrad model extensions for radon entry into multi-level buildings with basements or crawl spaces

The RAETRAD model was generalized to characterize radon generation and movement from soils and building materials into multi-level buildings with basements or crawl spaces. With the generalization, the model retains its original simplicity and ease of use. The model calculates radon entry rates that are consistent with measurements published for basement test structures at Colorado State University, confirming approximately equal contributions from diffusion and pressure-driven air flow at indoor-outdoor air pressure differences of deltaP(i-o) = -3.5 Pa. About one-fourth of the diffusive radon entry comes from concrete slabs and three-fourths comes from the surrounding soils. Calculated radon entry rates with and without a barrier over floor-wall shrinkage cracks generally agree with Colorado State University measurements when a sustained pressure of deltaP(i-o) = -2 Pa is used to represent calm wind (<1 m s(-1)) conditions. Calculated radon distributions in a 2-level house also are consistent with published measurements and equations.     

Cryosurgical ablation of the normal ventral prostate plus adjuvant does not protect Copenhagen rats from Dunning prostatic adenocarcinoma challenge

PURPOSE: We wished to determine if cryosurgical ablation of the normal ventral prostate of Copenhagen rats confers protective immunity against a subsequent challenge with Dunning R3327 MatLyLu prostatic adenocarcinoma. In human melanoma, tumor antigens have been characterized as normal cellular proteins. We reasoned that cryosurgical ablation of the normal prostate along with immunostimulatory adjuvants might release prostatic antigens to the immune system engendering an immune response and rendering rats immune to prostatic cancer cells. MATERIALS AND METHODS: On day 0, Copenhagen rats underwent cryosurgical ablation of the normal ventral prostate, cryosurgery and intraprostatic injection of Complete Freund's Adjuvant (CFA), CFA injection alone, or laparotomy alone. On day 21, animals received a subcutaneous challenge of MatLyLu tumor cells. Tumor dimensions were recorded at regular intervals by a single blinded investigator. RESULTS: Animals receiving cryosurgical ablation of the normal ventral prostate or intraprostatic CFA developed tumors more frequently than animals receiving laparotomy alone and the effect was statistically significant if animals received both cryosurgical ablation of the prostate and intraprostatic CFA (3 experiments, 1 x 10(4) MatLyLu cells), total number with tumors/total number challenged: laparotomy alone 3/17, cryosurgical ablation 7/17, cryosurgery plus CFA 10/16 (p = 0.013 versus laparotomy, Fisher's exact test), CFA alone 9/17. CONCLUSIONS: Cryosurgical ablation of the normal rat ventral prostate and intraprostatic CFA does not protect against and can enhance the tumorigenicity of MatLyLu prostatic cancer cells at distant sites. This could be occurring through specific immunologic effects or non-specific mechanisms induced by cryosurgery and CFA.