Anesthesiological support, postoperative care and the results of the surgical treatment of patients with tumors of the base of the posterior cranial fossa

Problems of anesthesiological maintenance, measures of the postoperative management and results of surgical treatment of 76 patients with an oncological process on the base of the posterior cranial fossa are discussed. An analysis of informative-regulatory and adaptational reactions of organism is made on the basis of the intervalogram in the course of operative interventions near by the cerebral trunk. The results are estimated.     

A molecular redox switch on p21(ras). Structural basis for the nitric oxide-p21(ras) interaction

We have identified the site of molecular interaction between nitric oxide (NO) and p21(ras) responsible for initiation of signal transduction. We found that p21(ras) was singly S-nitrosylated and localized this modification to a fragment of p21(ras) containing Cys118. A mutant form of p21(ras), in which Cys118 was changed to a serine residue and termed p21(ras)C118S, was not S-nitrosylated. NO-related species stimulated guanine nucleotide exchange on wild-type p21(ras), resulting in an active form, but not on p21(ras)C118S. Furthermore, in contrast to parental Jurkat T cells, NO-related species did not stimulate mitogen-activated protein kinase activity in cells transfected with p21(ras)C118S. These data indicate that Cys118 is a critical site of redox regulation of p21(ras), and S-nitrosylation of this residue triggers guanine nucleotide exchange and downstream signaling.     

Divergence between biochemical and cytogenetic differences in three species of the Callicebus moloch group

Four viruses were compared for their ability to induce an intestinal antibody response in piglets. Antibodies were not detected in response to oral vaccination with either fowlpox virus or a baculovirus (BV). Simultaneous oral dosing and parenteral inoculation with high concentrations of BV in an oil emulsion adjuvant induced high levels of circulating virus neutralising (VN) antibodies, and also low levels of intestinal antibodies when booster doses of virus were given. In response to oral vaccination with swinepox virus (SPV), low levels of circulating and intestinal VN antibodies, and higher titres of antibodies reactive in an enzyme immunoassay, including intestinal antibodies of the IgA class, were detected. Oral vaccination with porcine adenovirus type 3 (PAV-3) stimulated both circulating and intestinal VN antibodies, and IgA antibodies were demonstrated in the intestinal contents. It was concluded that SPV and PAV-3 might be suitable vectors for the expression of genes encoding the protective antigens of porcine enteric viruses.     

Psychologists collaborating with clergy.

If a patient adheres to religious values and practices, should the treating psychologist get input from a clergyperson? How frequent is clergy–psychologist collaboration? What obstacles impede such collaboration? An exploratory survey questionnaire was sent to 200 clergy, 200 psychologists interested in religious issues, and 200 psychologists selected without regard to religious interests or values. Four themes were assessed: types of collaborative activities, frequency of collaboration, obstacles to collaboration, and ways to enhance collaboration. Strategies for promoting clergy–psychologist collaboration include challenging unidirectional referral assumptions, building trust through proximity and familiarity, and considering the importance of shared values and beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient maintained alfentanil target-controlled infusion for analgesia during extracorporeal shock wave lithotripsy

PURPOSE: The purpose of this study was to determine whether alfentanil given by a pharmacokinetic-based target controlled infusion (TCI) system under patient control is a suitable analgesic technique for extracorporeal shock wave lithotripsy (ESWL). METHODS: The design was an open, unblinded, noncomparative, prospective study. Forty outpatients undergoing ESWL were given patient maintained alfentanil TCI. Pain, nausea and sedation were assessed every 300 shocks. Vital signs were recorded every three minutes, pulse oximetry and electrocardiography being monitored continuously. Blood alfentanil concentration was measured for comparison with the predicted value. RESULTS: Alfentanil consumption (median 1.34 mg, range 0.8-3.6) and measured levels following treatment (median 60 ng.ml-1, range 15.6-134.3) varied widely. The precision of the TCI system and the median prediction error (bias) were both 49%. The median of pain scores recorded during treatment was 4 (range 0-8). The median respiration rate was 15 bpm (range 10-23), three patients required oxygen (SaO2 < 92%) cardiovascular measurements were stable and there was no excessive sedation. The incidence of nausea was 15%. All patients were ready for hospital discharge within one hour following treatment. CONCLUSIONS: Patient maintained alfentanil TCI provides good analgesia for ESWL in the majority of patients with little sedation. Respiratory depression is uncommon but supplementary oxygen should be given prophylactically. There is considerable interindividual variation in demand for alfentanil indicating the usefulness of the patient control method. The TCI system underestimated alfentanil blood concentrations but this did not affect its clinical usefulness.     

Error probabilities on fading channels with intersymbolinterference and noise

Sums of infinite sequences of weighted binary random variables arise in communications problems involving signal-dependent interferences. In many cases of practical importance, the distribution functions of these sums are singular and often of Cantor type; they are continuous but do not have a density function. For this reason, special methods of calculating expectations are needed. Results of this type are derived. The method is used to compute error probabilities for differential detection of minimum shift keying, and for noncoherent detection of frequency shift keying. In each case the model assumed is a Rician fading channel     

Aging and heparin-related bleeding

BACKGROUND: Many studies have suggested that elderly patients are at increased risk of bleeding during heparin therapy. OBJECTIVE: To establish whether the risk of bleeding in the elderly results from concomitant risk factors or is associated with the aging process itself. METHODS: One hundred ninety-nine patients who presented with proximal deep vein thrombosis were treated with a standard intravenous heparin protocol in a double-blind, randomized, prospective study. Bleeding complications were monitored. Activated partial thromboplastin times and heparin levels were assessed 4 to 6 hours after a standard intravenous heparin bolus and infusion. Heparin doses and heparin levels were also assessed after stable therapeutic heparin infusion rates were established. RESULTS: There was an increase in total and major bleeding complications with aging (P < .05) that was not accounted for by standard risk factors for bleeding. Aging was associated with an increase in heparin levels (r = .239, P = .003) and a tendency for an increase in activated partial thromboplastin time (r = .134, P = .07) after standard heparin doses. Aging was also associated with lower heparin dose requirements (r = .267, P = .003) after therapeutic activated partial thromboplastin times were achieved. CONCLUSION: Aging is a risk for heparin-related bleeding that may be explicable by age-related changes in the pharmacologic characteristics of heparin.