Haemodynamic responses to antagonism of bocurarine block with atropine-neostigmine mixture in children

Following antagonism of tubocurarine block with a mixture of atropine 20 microgram/kg and neostigmine 50 microgram/kg in 20 children, heart rate decreased from a control value of 110.4 beat/min to 90.1 at 5 min and 89.2 at 6 min (P less than 0.02). Stroke volume index did not change during the first 5 min from a control value of 36.3 ml. beat--1.m--2 but a significant increase to 48 ml. beat--1. m--2 was observed at the 6th and 7th mins following the injection of the mixture (P less than 0.05). Cardiac index and mean arterial pressure remained unaltered throughout the period of observation. Normal sinus rhythm was maintained in all patients. It was concluded that antagonism of tubocurarine with an atropine-neostigmine mixture does not produce any important haemodynamic change in children.

Premedicant drugs and gastric juice pH and volume in pediatric patients

The effects of premedication on gastric juice volume and pH were evaluated in five groups of 206 pediatric patients undergoing elective surgical procedures: Group 1 (Control) received no premedication; Group 2 was given morphine sulfate and pentobarbital as premedicants. The other groups received, in addition to morphine and pentobarbital, atropine (Group 3), scopolamine (Group 4), or glycopyrrolate (Group 5). After endotracheal intubation, gastric aspirates were examined for volume, pH and color. Neither premedication with morphine and pentobarbital nor addition of atropine or scopolamine to the premedication significantly altered volume. In patients treated with glycopyrrolate, volume was reduced to less than a third of that of patients in Group 1 (P less than 0.001), and the percentage of pH's higher than 2.5 was significantly greater than in other groups. The incidences of unobtainable samples and samples with pH's higher than 2.5 were greatest with atropine (32.0 per cent, P less than 0.05) and glycopyrrolate (58.1 per cent, P less than 0.01). In 60 per cent of the bile-stained specimens, pH's were below 2.5. It is concluded that because of its selective inhibitory effect on gastric acid secretions, glycopyrrolate appears superior to other anticholinergic drugs. The reduction of gastric juice volume and acidity produced by glycopyrrolate would have important clinical implications in case of accidental aspiration. It is also concluded that bile staining of gastric contents is not a reliable indicator of gastric juice pH.

A huge villous tumor of rectum: a case report

Villous tumor of the large intestine was first identified and named by Holmes in 1858. It is said to account for 1.4 to 2.5 per cent of all tumors of the large intestine, but only sporadic cases have been reported in Japan. Although considerably large villous tumors are known to exist, reports refering to them, home and abroad, show that there are no more than 50 known cases which had diameters exceeding 10 cm1). This paper presents one of our recent experience of the tumor whose diameter reached 20 cm.

Effects of hexamethonium and other ganglionic blocking agents on electrical activity of the esophagus induced by vagal stimulation in the dog

Electrical activity of the dog's esophagus was evoked by electrical stimulation of the vagus nerve and recorded by using a suction electrode placed on the serosal surface of the esophagus. Neuromuscular blocking agents (d-tubocurarine and succinylcholine) blocked this activity, while atropine had no effect. Hexamethonium (in doses which did not effect neuromuscular transmission in the diaphragm) and high doses of nicotine significantly depressed the evoked esophageal electrical activity, while lower doses of nicotine facilitated the response. The results suggest that a certain proportion of the striated muscle of the esophagus is innervated by processes from the intermediate ganglion cells in the Auerbach plexus.

Photochemical air pollution: its effects on respiratory function of elementary school children

The effects of photochemical air pollution on respiratory function of Tokyo elementary school children were investigated. Nine types of environmental factors were continuously recorded. Seven categories of respiratory function tests were performed on 20 normal 11-year-old children once a week from June to December 1972, as a general rule. The correlation coefficients between respiratory function measurements and each of the environmental factors were calculated. The maximum expiratory flow rate (V max) showed high correlation with the largest number of environmental factors. Among environmental factors, temperature highly affected various respiratory function tests. The O3 was significantly associated with airway resistance (Raw) or specific airway conductance (Gaw/Vtg), NO or NO2 with V max, and temperature with Raw, Gaw/Vtg, and V max. Two subjects among all subjects were considered as the reactors to the environmental factors.

Effects of ozone and brief exercise on specific airway conductance in man

Four normal male subjects were exposed to 0.9 ppm ozone with exercise for five minutes. Specific airway conductance (Gaw/Vtg) was increased by exercise and decreased by inhalation of ozone in most subjects, but these effects were small. Ozone inhalation with exercise resulted in a highly significant decrease of Gaw/Vtg. It would seem that a peak concentration of 0.9 ppm of ozone for five minutes produces adverse effects when the subject undertakes exxercise in it.