Rapid intubation with fazadinium and suxamethonium

Fazadinium at two dose levels (1 mg/kg and 1.5 mg/kg) and suxamethonium at three dose levels (50 mg, 75 mg and 100 mg) were investigated in 106 adult patients to determine the time interval from injection to tracheal intubation. The intubating conditions were graded according to the scheme described by Lund and Stovner. Suxamethonium 100 mg gave the shortest time interval between the end of injection and intubation. There was no significant difference between the intubation time when smaller doses of suxamethonium (50 mg and 75 mg were used and those when AH8165 (1 mg and 1.5 mg/kg) were given. Suxamethonium 100 mg also produced a significantly higher incidence of excellent intubating conditions. The clinical implications of the findings are discussed.

Activation of the classical complement pathway by Fc fragment of human IgA

Intact Fcalpha fragments from five human IgA myeloma proteins were produced by two different methods, high temperature trypsinolysis and IgA protease digestion. Three of the Fcalpha fragments activated the classical pathway as determined by the titers of the individual complement components. Two other fragments did not fix complement by either pathway.

Terminal gas-exhaust valve for a passive disposal system

A one-way gas-exhaust valve for use in passive disposal systems is described. The valve is explosion-proof and it does not offer any resistance at gas flow rates of up to 30 litres/minute. The design of the valve minimises the influence of wind velocities on pressure fluctuation in the disposal system.

Longitudinal analysis of growth of the soft palate and nasopharynx from six months to six years

Between the ages of six months and six years, longitudinal lateral headfilms were taken on 54 patients with palatal clefts or with unilateral and bilateral clefts of the lip and palate. They were measured and were compared to data on both normals and subjects with clefts of the lip only. The objectives of the study were: 1. To sutdy the effects of palatal surgery on the growth of the soft palate. 2. To compare the growth of the soft palate and nasopharynx among the patients with various types of clefts and normals. 3. To study the growth acceleration or so-called catch-up growth after palatal surgery at various ages. (Anterior palatal surgery at 14 months +/- 2 months. Posterior palatal surgery at 16 months +/- 2 months.) 4. To evaluate the relationship between velopharyngeal growth in cleft groups and voice quality.

Split-hand and split-foot deformity inherited as an autosomal recessive trait

A intermarried consanguineous family with split-hand and -foot deformity occurring in two sibship is presented. Both the sibship resulted from marriage between first cousins. This report, together with those of Ray (1960) and Freire-Maia (1971), further demonstrates that split-hand and -foot deformity can be inherited as an autosomal recessive trait.

Chloramphenicol metabolism in children with protein-calorie malnutrition

The plasma levels and urinary excretion of chloramphenicol was studied in ten malnourished children and four normal children after oral administration of a single dose of 25 mg/kg body weight. Plasma peak levels were achieved 2-4 hours later and were 1.5 or 2 times higher in malnourished children compared to the normal. They also took much longer to clear the drug from the plasma, 30 hours or more in malnourished children compared with 12 hours in the normal. These observations point to a slower rate of biotransformation in the liver. The excretion pattern of the drug and its metabolite lends support to this hypothesis. 75-85% of the drug excreted was in the form of conjugated fraction in the normal while only 35-55% was conjugated in malnourished children. In two children the liver biopsy tissue was subjected to assay of bilirubin-UDP transferase and low levels were detected. This observation also points to an alteration in the rate of biosynthesis of chloramphenicol.

Effects of althesin anaesthesia and surgery on carbohydrate and fat metabolism in man

The effects of Althesin anaesthesia alone, and associated with surgery, on carbohydrate and fet metabolism were studied in 36 patients by determining the plasma concentrations of cortisol, human growth hormone, insulin, free fatty acids, and blood sugar. The differences between the mean blood sugar and plasma cortisol concentrations before induction and during anaesthesia alone were not statistically significant. Blood sugar concentrations increased slightly during minor surgery and increased significantly during body surface and abdominal surgery. The plasma cortisol concentrations increased slightly during minor and body surface surgery but increased significantly during abdominal surgery. Plasma insulin and human growth hormone concentrations did not change appreciably during anesthesia and surgery. During Althesin anaesthesia alone and during minor surgery, a significant increase in plasma FFA concentration was observed at 15 min. The hyperglycaemia response in diabetic patients did not differ significantly from that in nondiabetic subjects. The clinical significance of the results is discussed.

Craniofacial serial dimensions related to age, sex, and cleft-type from six months of age to two years

The first two postnatal years are a time of rapid craniofacial growth. We selected 30 cleft lip/palate children, each seen at 6, 12, 18, 24 months, at which time lateral X-ray headfilms were taken. There were five boys, five girls, in each of three cleft-types: cleft palate only (CP), unilateral cleft lip/palate (UCLP), and bilateral cleft lip/palate (BCLP). Three dimensions were selected: 1) anterior cranial base (S-N); 2) upper face height (N-Pt.A); 3) maxillary depth (Pt.A-Ptm). All were in the midsagittal plane. This is a repeated measures study on the factor patient age, so that for each combination of sex and cleft-type the same subject was measured at the four levels of patient age. The multiple comparison technique utilized was the Newman-Keuls Procedure. There is no significant joint effect in the 6-24 months period. The factors seem to operate singly. There is no main effect due to the factor sex. Dimensions N-Pt.A. and Pt.A-Ptm show a significant main effect due to the factor cleft-type. There is a highly significant main effect due to the patient age factor.

Operating room air pollution: influence of anaesthetic circuit, vapour concentration, gas flow and ventilation

Atmospheric halothane was sampled from three selected operating theatres and anaesthetic rooms during the middle of operating sessions. Two of the operating theatres studied were ventilated with total air exchange once every six minutes; the third operating theatre had no ventilation. End-tidal samples were obtained from anaesthetists. Halothane vapour concentrations were analysed by gas-liquid chromatography. The effect of commonly used anaesthetic circuits on the level of contamination in the ambient atmosphere was studied. Concentrations of halothane vapour in the theatre atmosphere were found to vary with sampling site, anaesthetic circuit used, total gas flow and vapour concentration, the scavenging system employed and the efficiency of ventilation system. Although the ventilation system considerably reduced the level of halothane in the operating room atmosphere, it did not totally eliminate the contaminating vapour. A significant reduction in operating-room pollution was obtained by use of simple scavenging equipment. Scavenging of anaesthetic vapours outside the operating room led to 97.3 per cent reduction of overall mean concentration of halothane in the operating room atmosphere and reduction of 72 per cent in end-tidal samples of anaesthetists, with the Magill semiclosed circuit. The implications of these findings are discussed.

Adrenocortical function related to Althesin anaesthesia and surgery in man

Althesin anaesthesia alone had no significant effect on plasma cortisol concentration. When Althesin induction was followed by maintenance with N2O and halothane there was a statistically insignificant fall, but with N2O, pancuronium and I.P.P.V there was a tendency for plasma cortisol concentrations to rise. This, too, was statistically not significant. A significant elevation in the mean plasma cortisol concentration was only found in patients during abdominal surgery.