Succinylcholine as a predictor in strabismus surgery

Succinylcholine was injected intraoperatively in 20 patients with congenital esotropia, before and after the surgical procedure. Regression analysis was performed to investigate the relationship between the awake pre- and postoperative alignment and the drug-induced ocular positions, under anesthesia. The postoperative succinylcholine-induced ocular position was found to be a highly significant predictor of the one week postoperative alignment (r = 0.98, p less than 0.0001). Further investigation may lead to an ability to predict the postoperative alignment intraoperatively.     

Evidence for inhibition of monoamine oxidase in vivo in rat brain by 7,8-dichloro-1,2,3,4-tetrahydroisoquinoline

7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline (DCTQ) (50 mg/kg i.p.) antagonized the inactivation of MAO by pargyline as measured by direct enzyme assays in brain homogenates and by accumulation of hypothalamic catecholamines. These findings lend credence to the earlier interpretation that changes in brain concentrations of biogenic amines and their metabolites in DCTQ-treated rats were due at least in part to MAO inhibition.     

Gravity is an important but secondary determinant of regional pulmonary blood flow in upright primates

Original studies leading to the gravitational model of pulmonary blood flow and contemporary studies showing gravity-independent perfusion differ in the recent use of laboratory animals instead of humans. We explored the distribution of pulmonary blood flow in baboons because their anatomy, serial distribution of vascular resistances, and hemodynamic responses to hypoxia are similar to those of humans. Four baboons were anesthetized with ketamine, intubated, and mechanically ventilated. Different colors of fluorescent microspheres were given intravenously while the animals were in the supine, prone, upright (repeated), and head-down (repeated) postures. The animals were killed, and their lungs were excised, dried, and diced into approximately 2-cm3 pieces with the spatial coordinates recorded for each piece. Regional blood flow was determined for each posture from the fluorescent signals of each piece. Perfusion heterogeneity was greatest in the upright posture and least when prone. Using multiple-stepwise regression, we estimate that 7, 5, and 25% of perfusion heterogeneity is due to gravity in the supine, prone, and upright postures, respectively. Although important, gravity is not the predominant determinant of pulmonary perfusion heterogeneity in upright primates. Because of anatomic similarities, the same may be true for humans.     

Endovascular interventions training and credentialing for vascular surgeons

This article reviews issues concerning the training and credentialing of vascular surgeons in the use of endovascular techniques in the peripheral vascular system. These guidelines update a prior document that was published in 1993. They have been rewritten to accommodate the rapid evolution that has occurred in the field and to provide the appropriate requirements that a vascular surgeon should fulfill to be competent in the basic skills needed to safely and effectively perform all presently accepted diagnostic and therapeutic endovascular procedures.