A unique (lethal-cardiotoxic-hemorrhagic) protein toxin (Toxin CM55) was isolated and purified from Indian King Cobra (Ophiophagus hannah) venom by CM-sephadex ion exchange chromatography and reverse phase HPLC. The purified toxin had an SDS-molecular weight of 22 +/- 0.5 kD. UV absorption spectra of Toxin CM55 showed a peak at 280 nm, whereas when excited at 280 nm fluorescence, Toxin CM55 showed an E(max) at 333.4 nm. Toxin CM55 had an LD(50) of 28.28 microg/20 g (i. v.) in albino mice. The cardiotoxic action of the toxin was established on isolated guinea pig/rabbit heart and guinea pig auricle. In rats, Toxin CM55 caused ECG abnormalities including widened QRS complex and monomorphic ventricular tachycardia suggesting that the possible site of action of Toxin CM55 was the ventricle. Toxin CM55 produced significant vasoconstriction on peripheral blood vessels. It produced significant contraction of isolated guinea pig ileum, rat fundus and rat uterus, which was completely antagonised by methysergide. The toxin was found to release a significant amount of serotonin from rabbit platelets. Toxin CM55 produced cutaneous hemorrhage in albino mice, which was also produced in reserpine and p-chloro phenylalanine pretreated animals. Rabbit antiserum was raised against Toxin CM55, which gave prominent bands in immunogel diffusion and immunoelectrophoresis. The antiserum provided 2 LD(50) protection against Toxin CM55-induced lethality in mice and also neutralised 3 MHD hemorrhagic dose of the toxin.

Animals↗

PubMedDate not supplied

Sinusitis and asthma: how do they interrelate in sinus surgery?

Sinusitis has been suspected to be etiopathogenically linked to bronchial asthma. Asthma, on the other hand, has been reported to affect negatively the outcome of sinus surgery. The purpose of this study is to elucidate how sinusitis and asthma clinically interrelate, in a group of asthmatic subjects undergoing surgical interventions on the sinuses. A total of 43 asthmatic patients, selected for functional endoscopic sinus surgery, preoperatively had their sinus disease staged and their lung function tested, and were evaluated for allergy and aspirin sensitivity. One year after surgery the surgical results were analyzed, lung function was re-assessed, and patients' clinical status addressed through a questionnaire; and 93 nonasthmatic patients, whose functional endoscopic sinus surgery was contemporaneous, were used as a control group for the surgical results. Asthma was a critical factor negatively affecting the outcome of sinus surgery. On the other hand, sinus disease extension did not correlate with asthma severity at any stage. Sinus surgery, despite being capable of improving asthma, ultimately failed to produce significant change in lung function scores. Furthermore, consistent good surgical results on the nose did not come across as a critical issue for postoperative asthma improvement. We concluded that, if the surgical intervention on the sinuses was found to be able clinically to benefit asthma evolution, other evidence does not seem to support a causative relationship between sinusitis and asthma. Instead, since asthma was shown to affect sinus disease severity significantly, their association apparently reflects a systemic inflammatory process of the respiratory mucosa.

Adolescent↗

PubMedDate not supplied

The effects of adenoid hypertrophy and subsequent adenoidectomy on pediatric nasal airway resistance.

To investigate how adenoid hypertrophy and subsequent adenoidectomy affect pediatric airway resistance, we developed a prospective controlled study. Fifty children, aged 3 to 12 years, diagnosed with adenoid hypertrophy and selected for adenoidectomy, preoperatively had their nasal airway resistance assessed by active anterior rhinomanometry. Twenty-five of these children were subsequently followed up postoperatively, undergoing nasal resistance evaluations at 1 month, 3 months, 6 months, and 12 months. Another 25 children, without chronic upper airway obstruction symptoms, were enrolled as a control group, and their airway resistance was assessed in the same fashion. We concluded that the children selected for adenoidectomy, compared to the control group and before surgery, had mean resistance values up to two- to threefold higher, in both untreated and decongested nose states. Surgery was found to dramatically reduce airway resistance, but only in children under the age of seven. However, the postoperative values still tended to remain higher than the control subjects results. If in a significant number of children the operation failed in completely resolving their complaints, no pre-operative rhinomanometric pattern could be found to specifically relate to a complete surgical success.

Adenoidectomy↗

PubMedDate not supplied

[Pheochromocytoma--apropos a clinical case].

A case of a 43-year-old woman with severe sustained hypertension resistant to many antihypertensive drugs, frequent hypertensive crisis and symptoms suggestive of pheochromocytoma (symptomatic triad) is presented. Three of the four determinations of the urinary catecholamines metabolites have been normal as it was the only determination of plasmatic catecholamines. Abdominal sonography and CT scan detected a left adrenal mass, that have been histologically confirmed, after surgery, to be a pheochromocytoma. After adrenalectomy, the patient symptoms disappeared but she maintained mild hypertension easily controlled with drugs. The finding of normal plasmatic and urinary catecholamines values in a patient with sustained hypertension may suggest that we are handling with a case of essential hypertension and a superimposed pheochromocytoma with paroxysmal secretion. Some considerations are made essentially about specificity and sensitivity of diagnostic tests.

Adrenal Gland Neoplasms↗

PubMedDate not supplied

[A comparison of 4 pregnancy assessment scales (CRIB, SNAP, SNAP-PE, NTISS) in premature newborns. Clinical Risk Index for Babies. Score for Neonatal Acute Physiology. Score for Neonatal Acute Physiology-Perinatal Extension. Neonatal Therapeutic Intervention Scoring System].

In recent years a number of neonatal risk scores have been developed in order to assure a more accurate evaluation of results obtained by different NICU's. It is noteworthy that throughout the years an effort has been made to adapt the scores to the specific neonatal problems and to make them easier to use. We felt that it would be important to compare various scores (CRIB, SNAP, SNAP-PE, NTISS) in a population of premature infants. This was the main objective in this study. Between January 1992 and February 1995 a total of 186 infants with birthweight under 1500 grams and/or gestational age under 32 weeks were admitted to our Unit. There were 40 deaths (21.5%). It was possible to use the four above mentioned scores retrospectively. The area under the ROC curve (for predicting in-hospital mortality) in each score was: CRIB 0.90; SNAP 0.88; SNAP-PE 0.88; NTISS 0.85. The CRIB score was easier to perform (only 5 minutes, in contrast to 20-30 minutes for the other scores). From this study CRIB score is apparently a suitable and accurate method easily performed in clinical practice.

Evaluation Studies as Topic↗