Premedication with flunitrazepam in gastro-intestinal endoscopy

Administration of 2 mg flunitrazepam (Rohypnol; Roche) to patients before gastro-intestinal endoscopy caused significantly less anxiety and achieved significantly greater sedation than diazepam (Vallium; Roche). No differences were found between any of the trial groups with respect to ease of intubation, tolerance of the procedure, gastric peristalsis, and the state of the pylorus. Memory of the procedure was significantly less vivid in the groups who received 2 mg flunitrazepam, than in the other groups. The patients who received 2 mg flunitrazepam showed a significantly greater willingness to undergo a repeat procedure, both when asked immediately after the procedure, and when asked on the next visit. Pulse rate increased in all groups during the procedure. No change in respiratory rate or in systolic and diastolic blood pressure occurred in any group.

The effect of hyoscine and atropine on the lower oesophageal sphincter

The effects of intravenous hyoscine 0-4 mg and atropine 0-6 mg on lower oesophageal sphincter tone were studied in normal human subjects. Hyoscine and atropine both decreased the lower oesophageal sphincter (L.O.S) pressure by approximately 11 cm H2O (p less than 0-01). There was also an increased incidence of reflux as seen by an indwelling pH electrode in the lower oesophagus. These findings are relevant to the preoperative preparation of patients presenting for emergency obstetrical anaesthesia; since gastro-oesophagus reflux and pulmonary aspiration of acid gastric content continues to be a significant cause of morbidity and mortality.

A phase II study of triazinate (NSC 139105) in advanced colorectal carcinoma

Triazinate (Baker's Antifol, NSC 139105) was given to 28 patients as a single agent in the chemotherapy of advanced colerectal carcinoma. The dosage utilized was 250 mg/m2 intravenously, administered daily in three consecutive days. Patients were evaluated at three weeks, six weeks, and then monthly until progression was evident. Various immunologic determinants (i.e., DNCB sensitization, immunoglobulins, recall skin tests, lymphocyte blastogenesis, and circulating lymphocytes, T-cells and B-cells) were obtained prior to treatment and at each re-evaluation. The principal side effects were dermatitis, stomatitis, diarrhea, nausea, somnolence, and leukopenia. There was no discernable effect of Triazinate on the immunologic determinants tested. There was one complete response, and four partial responses, for an objective regression rate of 18%. This study suggests that Triazinate has a definite, though limited, effect on advanced colorectal carcinoma.

Chronic peritoneal dialysis in the management of diabetics with terminal renal failure

Twelve diabetics with terminal renal failure were maintained on chronic peritoneal dialysis (PD) for 2-28 months (average 10 months). 7/12 survived more than 1 year. Blood glucose levels were well controlled by the use of supplemental, intradialysis, intraperitoneal insulin. The incidence of dialysis-related complications, including peritonitis was not significantly higher than in controls. Neurophysiological studies revealed a high incidence of neuropathy initially with progression in most patients. Radiological studies revealed initial vascular calcifications in 7 out of 12 patients with progression in 4. Retinopathy did not progress significantly. PD is a suitable alternative to hemodialysis in the management of end-stage diabetic nephropathy.

The administration of metoclopramide with atropine. A drug interaction effect on the gastro-oesophageal sphincter in man

The effects of intravenous atropine 0-6 mg alone, metoclopramide (Maxolon) 10mg alone and atropine 0-6 mg and metoclopramide 10 mg in combination, on the lower oesophageal sphincter (LOS) were studied in three groups of normal human volunteers. Atropine decreased the LOS pressure by an average of 8 cm H2O (P less than 0-001), whereas metoclopramide increased the LOS pressure by a mean of 29 cmH2O compared to basal values (P less than 0-001). In contrast, no change in sphincter tone was noted following injection of atropine-metaclopramide mixture. These findings are relevant to the pre-operative preparation of patients presenting for emergency anaesthesia, since gasgro-oesophageal reflux and pulmonary aspiration of acid gastric content continues to be a significant cause of morbidity and mortality.

The signal from fruiting body and conus tips of Dictyostelium discoideum

Tips from fruiting bodies and conuses were transplanted into interphase fields of Dictyostelium discoideum amoebae. Progressively increasing concentrations of beef-heart phosphodiesterase added to the fields significantly decreased the chemotactic range of the responding amoebae. The findings suggest that the tip secretes c-AMP. We also find that the chemotactic range is independent of the size of the tip implying that the tip may produce a regulating gradient.

Laryngeal incompetence during neuroleptanalgesia in combination with diazepam

In eight patients, following carotid angiography under neuroleptanalgesia, a radiopaque dye was instilled into the pharynx. The chest was x-rayed 15 min later. All eight patients were observed to have aspirated the dye. The technique of neuroleptanalgesia described should not be used without safeguarding the airway in patients liable to regurgitate and inhale gastric contents.

Atomic coordinates and molecular conformation of yeast phenylalanyl tRNA. An independent investigation

The atomic coordinates of yeast tRNA(Phe) in the monoclinic crystal form have been determined by an independent analysis from a model built into a 3 A MIR map. The overall molecular structure is found to be in agreement with those reported for the same crystal form by Ladner et al. (1975) and for the orthorhombic form by Quigley et al. (1975) and Kim et al. (1975). However, significant differences between any two of the four models are found in certain local regions of the molecule. The structure is analyzed in terms of the nucleotide stereochemistry and internucleotide phosphodiesters. A striking observation is that the majority of the nucleotide moieties occur in the conformation preferred by the constituent mononucleotides themselves. The internucleotide P-O bonds afford the primary source of flexibility for the folding of the polynucleotide backbone while the sugar pucker and C(4')-C(5') torsions provide the secondary source of flexibility.

Management of peritonitis and bowel perforation during chronic peritoneal dialysis

Peritonitis and bowel perforation are the most serious conditions of peritoneal dialysis. This paper reports our experience with these two complications among 87 patients who were admitted to our porgram during a 3.5-year period and were treated with chronic peritoneal dialysis for periods up to 38 months (average 9 months). Approximately 6,000 dialyses were performed. Peritonitis occurred seven times in six patients (0.1%) and five patients had six episodes of bowel perforation (0.1%). All patients were successfully managed with conservative treatment, consisting of continuous peritoneal dialysis and intraperitoneal and systemic antibiotics. Careful aseptic technique seems to be the only necessary factor in prevention of peritonitis.

The tip of the Dictyostelium discoideum pseudoplasmodium as an organizer

We have extended Raper's original work on the organizing ability of the tip of the Dictyostelium discoideum slug. Our new results are that tips from all multicellular (pseudoplasmodial) stages act as organizers; that the structure organized by a tip depends on the developmental stage of the cells responding to the tip's signal; that tips from all stages release a qualitatively similar signal which is continuous, most probably a gradient of c-AMP; and that the signal from fruiting-body tips appears stronger than that from conus tips. We discuss these results with reference to the control of morphogenetic movement and patterned differentiation and point out that the D. discoideum tip is analagous to a classical organizer, whose signal is interpreted according to the state of determination of cells in its field of influence.

Crystal structure of a naturally occurring dinucleoside monophosphate: uridylyl (3',5') adenosine hemihydrate

The crystal structure of uridylyl (3',5') adenosine hemihydrate has been analyzed by x-ray diffraction. The two independent molecules found in the asymmetric unit exhibit conformations that differ significantly from those found in double-helical RNA. The conformational information obtained from this analysis provides considerable insight into the possible conformations of nonhelical "loop" regions of transfer RNA, as well as single-stranded regions of nucleic acids in general.