Assessment of postoperative pain after laryngeal surgery for cancer

OBJECTIVES: To assess the intensity of postoperative pain after laryngeal surgery for cancer and the efficacy of analgesic injections at fixed hours. DESIGN: A prospective clinical study performed during the 3 days following laryngeal cancer surgery. SETTING: A university medical center. PATIENTS: Fifteen men (age range, 38-74 years) having just undergone a partial or total laryngectomy for epidermoid carcinoma. INTERVENTIONS: The analgesic treatment consisted of intravenous administrations at fixed hours (propacetamol or nalbuphine hydrochloride), with the possibility of rescue doses on demand. Pain and anxiety were assessed by means of visual analog scales (graduated from 0-10) every 3 hours on postoperative day 1, then every 6 hours on postoperative days 2 and 3. Objective criteria, ie, heart and respiratory rates and mean blood pressure, were measured with the same schedule. MAIN OUTCOME MEASURES: Postoperative pain and anxiety intensities and their variations were analyzed. Correlations between postoperative pain and other criteria were researched. RESULTS: Postoperative pain had a high initial level (maximum median, 7), then decreased and reached a score of 3 at the 30th hour. Unpredictable individual peaks of pain were reported. Anxiety was never high (maximum median, 4). No individual correlation was found between pain and objective parameters. CONCLUSIONS: After laryngeal surgery for cancer, pain can reach high levels, particularly in the first hours following recovery. Analgesic administrations at fixed hours are not effective enough. Postoperative analgesic treatment should aim to prevent the high initial pain and be individually adapted.     

Effects of etomidate, propofol and thiopental anaesthesia on arteriolar tone in the rat diaphragm

We have assessed, by intravital microscopy in rats, the effects of different anaesthetics on diaphragmatic arteriolar diameter. Rats were anaesthetized with etomidate, propofol or thiopental (groups E, P and T, respectively) and the diameters of the arterioles were measured sequentially at baseline and after topical application of either mefenamic acid (MA, 20 mumol litre-1) or N omega-nitro-L-arginine (NNA, 300 mumol litre-1), inhibitors of prostaglandins and nitric oxide, respectively. In group E, baseline arteriolar diameters were significantly higher than those in the two other groups (P < 0.01). MA and NNA induced significant constriction in the three groups (P < 0.001). However, whereas constriction induced by NNA was similar in the three groups, constriction induced by MA was significantly higher in group E compared with groups P and T (P < 0.05). We conclude that diaphragmatic arteriolar diameters in rats were greater during etomidate than during thiopental or propofol anaesthesia. This phenomenon may be mediated by prostaglandins.     

Gelatinisation Characteristics and Enzyme Susceptibility of Different Types of Barley Starch in the Temperature Range 48–72°C1

The gelatinisation temperatures, pasting characteristics and enzymic susceptibilities in the temperature range 48–72°C of normal, high amylose, low amylose and zero amylose barley starches were determined. Normal starches had the lowest gelatinisation temperatures, but low and zero amylose starches had the lowest pasting temperatures. Normal starches were the most readily soluble in water at 48–60°C in the presence of a mixture of α‐amylase, β‐amylase and limit dextrinase and were most readily broken down to reducing sugars by these enzymes. High amylose starch was the most resistant to enzymic hydrolysis in the temperature range 48–72°C and, hence, produced the lowest level of reducing sugars.     

A TIME-DISCRETE APPROACH TO THE MODELLING OF GRINDING MILL MIXING PROPERTIES

When a grinding mill is not operated in open circuit, residence time distributions (RTD) cannot be directly deduced from tracer concentration measurements at the mill discharge using a conventional tracer impulse experiment. Two methods are proposed for RTD determination from an arbitrary set of input and output tracer concentration/time measurements. The first one provides directly the discretized RTD by a direct deconvolution approach. The second one assumes that the RTD is the impulse response of an autoregressive-moving average model (ARMA). The use of each method is demonstrated using industrial data and a comparison to alternative methods is given.     

Radiologic aspects of infarction of the appendix epiploica

Clinical, US, CT and MR findings were reviewed in 5 patients with primary epiploic appendagitis (3 men, 2 women, mean age 38 years, age range 29-62 years) seen between December 1994 and December 1997. Diagnosis was reached in all cases with CT, with US in 3 and with MR in 1. Follow-up CT was performed in 2 cases and clinical follow-up in 4. One patient underwent surgery. Initial US, CT or MR examinations revealed a fatty oval-shaped nodule located anteriorly or anterolaterally to the left colon. The greater diameter ranged from 20 to 30 mm. Perinodular lesions with strands of periappendicular fat and thickened parietal peritoneum were visualized in all cases without any other inflammatory process in the abdomen. Symptoms resolved within 4 days in all patients. Signs of fatty inflammatory processes resolved in the 2 patients who had follow-up CTs. Primary epiploic appendagitis has characteristic US, CT and MR features which help guide medical treatment.     

Instrumental and clinical studies of the facial skin tone and pigmentation of Shanghaiese women. Changes induced by age and a cosmetic whitening product

The pigmentation patterns of facial skin of 354 healthy Chinese women aged 18–80 years were investigated clinically and instrumentally. Chromasphere^® was used to acquire pictures from the cheeks of subjects. Facial skin tone was described by L* parameter from the L,a,b system as well as Individual Typology Angle (ITA). Results show that skin tone becomes significantly darker along the life span. Both size of hyper‐pigmented spots and their contrast with surrounding skin were found increased with age. As additional study, 40 women from these 354 subjects were asked to apply daily a whitening cosmetic product for a 2‐month period. Such application led to a significantly lighter skin tone, although this study was not vehicle controlled and we cannot exclude that the increase in L* observed was in some part because of cumulative effects of previously used whitening products, there was an association with lighter skin tone as assessed through both instrumental measurements and self‐perception by most subjects.