Response to article by Foote et al.
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Biomedical subjects
Publications and source records attributed to N Syed.
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The anesthetic risks during placement of tympanotomy tubes were prospectively studied in 510 children. Complications were analyzed according to patient risk factors, anesthesia regimen, and surgical variables. No complications were seen in 423 (82.9%) children. Minor degrees of upper airway obstruction (treated with jaw thrust, oral airway, or positive pressure ventilation) were encountered in 61 patients (12.0%), 1 patient had minor obstruction and bradycardia, and 7 patients (1.4%) experienced more severe airway obstruction. Vomiting occurred intraoperatively in 2 patients (0.4%) and postoperatively in 9 patients (1.8%). Twelve patients (2.4%) experienced other complications, including cardiac dysrhythmias, transient hyperthermia, fall from the transport stretcher, and transient agitation. Four patients experienced multiple complications. Patient age, history of anesthesia, and level of experience of the anesthetist were all related to the type and frequency of complications. Anesthesia given for placement of ventilation tubes into tympanic membranes is relatively safe; however, these data are applicable to patients treated by pediatric anesthesiologists in the setting of a children's hospital.
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BACKGROUND: A promising strategy for delaying death of photoreceptor cells in retinal degenerative disease is to support survival of these cells through intraocular delivery of growth/neurotrophic factors. One factor that has received great attention is basic fibroblast growth factor (bFGF; fgf-2), a known stimulator of angiogenesis. We evaluated the potential for neovascularization induced by adenovirus-mediated intravitreal delivery of bFGF. METHODS: Recombinant adenoviruses carrying the low molecular weight (18 kD) or the high molecular weight (22, 23 and 24 kD) forms of human bFGF, driven by the cytomegalovirus (CMV) promoter/enhancer, were prepared. Viruses were delivered to eyes of different strains of mice and rats through intravitreal injection. Contralateral eyes were injected with control virus carrying a reporter gene [green fluorescent protein (GFP) or lacZ]. Transgene expression was assessed by Western analysis and by immunohistochemistry. Neovascularization was evaluated in vivo and histologically at termination of the experiment. RESULTS: Adenovirus-mediated delivery of the 18 kD form of bFGF resulted in anterior segment neovascularization in a strain-dependent fashion. Generation of new blood vessels was not observed after injection of the higher molecular weight forms of bFGF or of control solutions. CONCLUSION: The low molecular weight form (18 kD) (but not the high molecular weight forms) of bFGF drives angiogenic response in the anterior segment of specific strains of mice. Genetic modifiers may contribute to and/or prevent neovascularization induced by bFGF.
Aerial respiration of the pond snail, Lymnaea stagnalis, can be operantly conditioned; however, the parameters necessary to produce long-term (LTM) or intermediate term memory (ITM) have not previously been investigated. We conducted training using procedures that varied in the duration of the training session, the number of training sessions per day or the amount of time between subsequent training sessions (SI). We found that by varying the duration and frequency of the training session learning could be differentially produced. Furthermore, the ability to form LTM was dependent not only on the duration of the training session was also the interval between training sessions, the SI. Thus it was possible to produce ITM, which persists for up to 3 hr, and not form LTM, which persists at least 18 hr. Learning, ITM, and LTM can be differentially produced by altering the SI, the duration of the training session, or the number of training sessions per day. These findings may allow us to begin to elucidate the underlying neural mechanisms of learning, ITM, and LTM.
A continuous infusion of 2-chloroprocaine (Group C) was compared with intermittent bolus injections of bupivacaine (Group B) or 2-chloroprocaine (Group N) for epidural anesthesia in cesarean delivery. Sixty-six patients scheduled for elective cesarean delivery were studied retrospectively during a three-month period. Maternal and neonatal demographics; cord pH; Apgar scores; duration of surgery, including times from induction, incision and end of the case; fluid requirements in the operating room and recovery room; amount of ephedrine used; blood pressures; duration of analgesia, and meperidine use via patient-controlled analgesia (PCA) up to 48 hours postpartum were recorded. Group B experienced a significantly longer time from loading dose to incision and a longer duration of analgesia, but twice the duration of recovery room care than either of the 2-chloroprocaine (2CP) groups. In the first six hours after surgery, Group N patients required significantly more PCA injections than patients in either Group B or Group C. Although statistically significant changes were detected in blood pressure values at three intervals, no clinical importance was appreciated. Fluid requirements were also greater for patients in Group B, both intraoperatively and in the post-anesthesia care unit. Epidural anesthesia using continuous 2CP infusion appears to combine the beneficial effects of bolus injections of both bupivacaine and 2CP by reducing recovery room stay and PCA requirements without troublesome side effects.