Dose-response and time-course of the effect of rocuronium bromide during sevoflurane anaesthesia

To evaluate the influence of sevoflurane on the dose-response relationship and on the time-course of the effect of rocuronium, 60 adult patients undergoing elective plastic surgery were randomly allocated to either the control or the sevoflurane group. Anaesthesia was maintained with 60% nitrous oxide in oxygen and thiopentone in the control group and with 60% nitrous oxide in oxygen and an end-tidal concentration of 1.75% sevoflurane in the sevoflurane group. Neuromuscular function was assessed mechanomyographically with train-of-four stimulation at the wrist every 12s and the percentage depression of the first twitch of the train-of-four was used as the study parameter. The dose-response relationship of rocuronium in the two groups was determined by the cumulative dose-response technique. The dose-response curve of rocuronium in the sevoflurane group was shifted to the left compared to the control group, indicating a potentiation of rocuronium-induced neuromuscular block. The effective doses of rocuronium required to produce 50%, 90% and 95% twitch depression in the sevoflurane group were decreased by 30.5%, 26.7% and 25.2%, respectively, compared to the control group. Following the administration of a total dose of rocuronium of 400 micrograms.kg-1, the duration of action of, and the recovery from, rocuronium were both significantly prolonged by sevoflurane. There were significant differences in the duration of peak effect, clinical duration, recovery index and the total duration of action between the control and the sevoflurane groups.

[Study on T lymphocyte recognition of tumor antigens on autologous CML cells]

OBJECTIVE

To investigate the existence of cytotoxic precursor cells in previously untreated or remissive chronic myelogenous leukemia(CML) patients,and identify their phenotypical and functional characteristics.

METHODS

Bone marrow or peripheral blood mononuclear cells from CML patients were stimulated with autologous CML cells by using mixed lymphocyte tumor cell coculture.

RESULTS

A kind of cytotoxic T lymphocytes could be generated from bone marrow or peripheral blood of CML patients. These T cells showed differential cytotoxicities against autologous and allogeneic CML cells and no activity to autologous and allogeneic normal bone marrow cells. They also exhibited no inhibitive effect on CFU-GM yields. LAK cells had no effect on autologous CML cells, but showed intensive cytotoxic activity to allogeneic CML cells. The T lymphocytes obtained were CD3+ CD56+ non-MHC restricted or CD3+ CD56- MHC restricted. HLA-DR and CD25 were expressed in a significantly larger proportion of T lymphocytes stimulated with autologous CML cells than those not stimulated. The T lymphocytes showed low proliferative response to autologous CML cell stimulation and no or least response to allogeneic CML cells, they showed also no response to EB virus-transformed autologous B cells(obtained in remission) pulsed with peptides corresponding to the BCR-ABL joining region.

CONCLUSION

There is probably a common tumor antigen among CMLs, this leukemia-specific antigen can be recognized by T cells,and it shows no indication to be a p210 fusion sequence.

Pharmacokinetics of vecuronium during acute isovolaemic haemodilution

To evaluate the effect of acute isovolaemic haemodilution on the pharmacokinetics of vecuronium, we studied 13 patients undergoing haemodilution during surgery and 13 control patients. General anaesthesia was induced with thiopentone 4-6 mg kg-1 and fentanyl 2-4 micrograms kg-1, and maintained with enflurane and 60% nitrous oxide in oxygen. The haemodilution patients underwent major elective plastic surgery with an anticipated surgical loss of more than 600 ml. Haemodilution was achieved by drainage of venous blood and i.v. infusion of lactated Ringer's solution and 6% dextran, during which the packed cell volume and haemoglobin concentration decreased from 45% to 28.1% and from 14.7 g dl-1 to 9.1 g dl-1, respectively. After administration of a bolus of vecuronium 100 micrograms kg-1, an improved fluorimetric assay was used to measure the plasma concentrations of vecuronium for 5 h. The results showed that the disposition kinetics of vecuronium were best described mathematically by a three-compartment open model in the two groups. The mean volume of the central compartment and volume of distribution at steady state were 42.3 (SD 11.8) ml kg-1 and 168.4 (31.5) ml kg-1, respectively, in control patients, and significantly greater (55.2 (13.4) ml kg-1 and 225.9 (53.3) ml kg-1) in the haemodilution patients (P < 0.05). The elimination half-life was 50.3 (11.5) min in control patients and significantly greater (68.2 (15.1) min) in the haemodilution patients (P < 0.05). The half-lives of fast distribution and distribution, mean residual time, area under the plasma concentration curve and plasma clearance were unchanged in patients who underwent haemodilution compared with the control group.

Evidence that the DNA binding specificity of winged helix proteins is mediated by a structural change in the amino acid sequence adjacent to the principal DNA binding helix

We present the first structural evidence supporting the hypothesis that the binding specificity of the winged helix DNA binding motif is mediated by residues adjacent to the alpha-helix (H3), the moiety which is primarily involved in the interaction with DNA. Using NMR to determine secondary structural elements of a winged helix family member, Genesis (formerly HFH-2), and comparing these with those found in the X-ray crystal structure of the HNF-3gamma/DNA complex [Clark, K. L., Halay, E. D., Lai, E., & Burley, S. K. (1993) Nature 364, 412-420], we show that the major differences observed occur for H3 and the region immediately prior to this. H3 in Genesis is slightly shorter than in HNF-3gamma and, in addition, we observe an extra small helix (H4) in the region between H2 and H3 which is not found in the HNF-3gamma/DNA complex. This is significant as it has been shown previously [Overdier, D. G., Porcella, A., & Costa R. H. (1994) Mol. Cell. Biol. 14, 2755-2766] that the DNA-binding specificity is influenced by amino acid residues in this region.

Dose-response and time course of effect of rocuronium in male and female anesthetized patients

To determine differences from dose-response and time-course of rocuronium between male and female patients, 60 adult patients (30 male and 30 female), ASA grade I, aged 17-52 yr, undergoing elective plastic surgery were studied. Anesthesia was maintained with 60% nitrous oxide in oxygen, thiopental, and incremental doses of fentanyl as required. Neuromuscular function was assessed mechanomyographically with train-of-four (TOF) stimulation at the wrist every 12 s, and the percentage depression of the T1 response was used as the study variable. The dose-response relationship of rocuronium was determined by a cumulative dose-response technique. The results showed that the dose-response curve of rocuronium in the men was shifted to the right, indicating a decrease in the sensitivity to rocuronium-induced neuromuscular block versus the women. The 50%, 90%, and 95% effective doses of rocuronium were 178.4 +/- 53.7, 358.7 +/- 101.3, and 386.2 +/- 113.4 microg/kg, respectively, in male patients, and 128.8 +/- 42.5, 252.8 +/- 51.7, and 274.4 +/- 59.4 microg/kg in female patients. After an intravenous administration of total dose of 400 microg/kg rocuronium, neuromuscular block was significantly longer in the men than in the women. The duration of peak effect, clinical duration, and total duration were 6.5 +/- 3.0, 12.5 +/- 4.9, and 33.6 +/- 8.7 min, respectively, in male patients, and 11.8 +/- 2.7, 18.5 +/- 5.3, and 46.8 +/- 9.6 min in female patients. We conclude that women were approximately 30% more sensitive to rocuronium compared with men.

IMPLICATIONS

The authors found that women were 30% more sensitive to rocuronium than men. This suggests that the routine dose of rocuronium should be reduced in women compared with men.

Different DNA contact schemes are used by two winged helix proteins to recognize a DNA binding sequence

The hepatocyte nuclear factor 3 (HNF-3)/fork head (fkh) family contains a large number of transcription factors which recognize divergent DNA sequences via a winged-helix binding motif. In this report we present studies on the DNA binding properties of winged-helix HNF-3/fkh homologues 1 (HFH-1) and 2 (HFH-2) which recognize a shared DNA binding site with different affinities. To explore how HFH-1 and HFH-2 proteins recognize this DNA binding sequence, the binding affinities of these two HFH proteins toward a series of DNA sites containing a single strand trimer loop insertion at different positions were studied. This insertion induces a bend of approximately 80 degrees in the DNA binding site (prebending). HFH-1 and HFH-2 were shown to recognize DNA sites prebent at many nucleotide positions on both strands of the DNA sequence. Both HFH-1 and HFH-2 were more sensitive to mismatch insertions on the sense strand of the DNA binding site, especially within the AAAATAAC sequence. Our data suggest that the recognition helix (helix 3) recognizes the AAAATAAC sequence and that the helix 3/DNA interaction results in bending of the DNA which narrows the major groove in the AAAATAAC sequence. Furthermore, the binding affinities of HFH-1 and HFH-2 toward DNA binding sites with base-pair reversion in the AAAATAAC sequence was also investigated. Different patterns of response from HFH-1 and HFH-2 to both prebent and base-pair reverted binding sites was observed. Our results demonstrate that even two highly conserved members of the winged-helix family may contact the same DNA sequence differently.

Susceptibility to beta-lactam antibiotics of Pseudomonas aeruginosa overproducing penicillin-binding protein 3

By using a broad-host-range vector, pUCP27, the Pseudomonas aeruginosa and Escherichia coli pbpB genes, which encode penicillin-binding protein 3 (PBP3), were separately overexpressed in a P. aeruginosa strain, PAO4089, that is deficient in producing chromosomal beta-lactamase. Susceptibility studies indicated that overproduction of the P. aeruginosa PBP3 in PAO4089 resulted in twofold-increased resistance to aztreonam, fourfold-increased resistance to cefepime and cefsulodin, and eightfold-increased resistance to ceftazidime, whereas overproduction of the P. aeruginosa PBP3 in PAO4089 did not affect susceptibility to PBP1-targeted cephaloridine or PBP2-targeted imipenem. Similar results were obtained with PAO4089 overproducing E. coli PBP3, with the exception that there was no influence on the MICs or minimal bactericidal concentrations of cefsulodin and cefepime, which have very low affinities for E. coli PBP3. These data are consistent with the conclusion that PBP3 has to achieve a certain level of saturation, with beta-lactams targeted to this protein, to result in cell inhibition or death.

Proviral integrations at the Evi5 locus disrupt a novel 90 kDa protein with homology to the Tre2 oncogene and cell-cycle regulatory proteins

Evi5 is a common site of retroviral integration in T-cell lymphomas of AKXD mice. Mapping studies have localized Evi5 to a region approximately 18 kb upstream of another common viral integration site, Gfi1, on mouse chromosome 5 (Liao X, Jenkins NA and Copeland NG, (1995a). J. Virol., 69, 7132-7137). Gfi1 encodes a zinc finger transcription factor involved in interleukin-2 signaling. To determine if Evi5 encodes a gene separate from Gfi1 that might also be involved in T-cell disease, we have searched within the Evi5 locus for novel transcripts. A 6.0 kb transcript was identified in these studies that spans the Evi5 locus and is disrupted by viral integration at Evi5. This transcript is expressed in all embryonic and adult mouse tissues examined. While blast searches indicated that Evi5 is a novel gene, homologies were detected between Evi5 and a known oncogene, Tre2, as well as mammalian and yeast cell cycle regulatory proteins. Evi5 thus encodes a gene separate from Gfi1 that may also be involved in T-cell disease.

Identification of a penicillin-binding protein 3 homolog, PBP3x, in Pseudomonas aeruginosa: gene cloning and growth phase-dependent expression

A homolog of Pseudomonas aeruginosa penicillin-binding protein 3 (PBP3), named PBP3x in this study, was identified by using degenerate primers based on conserved amino acid motifs in the high-molecular-weight PBPs. Analysis of the translated sequence of the pbpC gene encoding this PBP3x revealed that 41 and 48% of its amino acids were identical to those of Escherichia coli and P. aeruginosa PBP3s, respectively. The downstream sequence of pbpC encoded convergently transcribed homologs of the E. coli soxR gene and the Mycobacterium bovis adh gene. The pbpC gene product was expressed from the T7 promoter in E. coli and was exported to the cytoplasmic membrane of E. coli cells and could bind [3H] penicillin. By using a broad-host-range vector, pUCP27, the pbpC gene was expressed in P. aeruginosa PAO4089. [3H]penicillin-binding competition assays indicated that the pbpC gene product had lower affinities for several PBP3-targeted beta-lactam antibiotics than P. aeruginosa PBP3 did, and overexpression of the pbpC gene product had no effect on the susceptibility to the PBP3-targeted antibiotics tested. By gene replacement, a PBP3x-defective interposon mutant (strain HC132) was obtained and confirmed by Southern blot analysis. Inactivation of PBP3x caused no changes in the cell morphology or growth rate of exponentially growing cells, suggesting that pbpC was not required for cell viability under normal laboratory growth conditions. However, the upstream sequence of pbpC contained a potential sigma(s) recognition site, and pbpC gene expression appeared to be growth rate regulated. [3H]penicillin-binding assays indicated that PBP3 was mainly produced during exponential growth whereas PBP3x was produced in the stationary phase of growth.

Isolation and characterization of the platelet-derived growth factor beta receptor promoter

The PDGFbeta r gene has been implicated in many physiological processes including development and wound healing. Aberrant expression of the receptor is seen in many pathological conditions such as atherosclerosis and inflammatory diseases. To study the mechanisms of PDGFbeta r regulation, we identified the regulatory regions of the gene. We have cloned and characterized the promoter region of the platelet-derived growth factor beta receptor (PDGFbeta r). We isolated a 4.5 Kb genomic fragment which confers PDGFbeta r tissue-specific promoter activity. This fragment can direct transcription of a luciferase reporter gene in a cell-specific manner which correlates well with the known pattern of expression of the PDGFbeta r. The specificity of this clone was demonstrated by its high activity in NIH 3T3 fibroblasts and lack of activity in N-MUNG epithelial cells, a pattern that parallels the expression of the endogenous PDGFbeta r. We have defined a 614 bp region encompassing the 5' untranslated region of the gene which includes the basal promoter region. We generated transgenic mice that carry the chloramphenicol acetyltransferase (CAT) reporter gene under the control of the 4.5 Kb promoter. The expression pattern of the reporter gene was compared to that of the endogenous PDGFbeta r gene. The promoter was able to direct reporter gene expression with the same temporal and spatial pattern as the endogenous PDGFbeta r. The most prominent expression was in condensing mesenchyme of developing blood vessels, bone and tissues adjacent to epithelium. We conclude that this clone contains the regulatory regions sufficient to direct expression of the PDGFbeta r. The further analysis of this promoter will help elucidate the transcriptional regulation of expression of the PDGFbeta r, and provide a useful tool for directing expression of heterologous genes.

Monocyte chemoattractant protein-1 is sufficient for the chemotaxis of monocytes and lymphocytes in transgenic mice but requires an additional stimulus for inflammatory activation

Monocyte chemoattractant protein-1 (MCP-1), a chemotactic cytokine, acts in vitro as a chemotactic and activating factor for multiple types of leukocytes. To determine the chemotactic and activating effects of MCP-1 in vivo, we constructed transgenic mice that express human MCP-1 in type II alveolar epithelial cells and secrete it into the bronchoalveolar space. We found that MCP-1 overexpression led to a marked increase in the numbers of both monocytes and lymphocytes that could be recovered by bronchoalveolar lavage. This accumulation of mononuclear leukocytes could be reversed by the administration of an MCP-1-blocking Ab. In spite of its chemotactic effect, MCP-1 expression did not cause the inflammatory activation of accumulated leukocytes. Lungs of MCP-1 transgenic mice also showed no morphologic evidence of inflammation. However, MCP-1 mice had an increased sensitivity to other inflammatory stimuli. MCP-1 mice treated with either i.p. LPS or i.v. yeast wall glucan developed consolidated pulmonary infiltrates consisting predominantly of macrophages. Nontransgenic mice developed no such infiltrates. These results demonstrate that MCP-1 is chemotactic for monocytes and lymphocytes in vivo and that MCP-1 expression alone does not cause inflammatory activation of cells, but leads to an enhanced inflammatory response upon treatment with other stimuli.

Monocyte chemoattractant protein-1 is sufficient for the chemotaxis of monocytes and lymphocytes in transgenic mice but requires an additional stimulus for inflammatory activation

Monocyte chemoattractant protein-1 (MCP-1), a chemotactic cytokine, acts in vitro as a chemotactic and activating factor for multiple types of leukocytes. To determine the chemotactic and activating effects of MCP-1 in vivo, we constructed transgenic mice that express human MCP-1 in type II alveolar epithelial cells and secrete it into the bronchoalveolar space. We found that MCP-1 overexpression led to a marked increase in the numbers of both monocytes and lymphocytes that could be recovered by bronchoalveolar lavage. This accumulation of mononuclear leukocytes could be reversed by the administration of an MCP-1-blocking Ab. In spite of its chemotactic effect, MCP-1 expression did not cause the inflammatory activation of accumulated leukocytes. Lungs of MCP-1 transgenic mice also showed no morphologic evidence of inflammation. However, MCP-1 mice had an increased sensitivity to other inflammatory stimuli. MCP-1 mice treated with either i.p. LPS or i.v. yeast wall glucan developed consolidated pulmonary infiltrates consisting predominantly of macrophages. Nontransgenic mice developed no such infiltrates. These results demonstrate that MCP-1 is chemotactic for monocytes and lymphocytes in vivo and that MCP-1 expression alone does not cause inflammatory activation of cells, but leads to an enhanced inflammatory response upon treatment with other stimuli.

Upregulation of Gfi-1, a gene involved in IL-2-independent growth of T cells, in a murine retrovirus-induced immunodeficiency syndrome

BACKGROUND

A prominent feature of retrovirus-induced immunodeficiency in mice (MAIDS) is early polyclonal activation of CD4+ T cells followed by the appearance of monoclonal lymphomas marked by clonal proviral integrations. These events appear to occur independent of interleukin-2 (IL-2), suggesting the activity of an alternative growth-promoting pathway. We studied the possible contributions to T cell expansion of a gene, Gfi-1, previously shown to confer IL-2 independence to rat T cell lymphomas.

MATERIALS, RESULTS, CONCLUSIONS

We studied 17 mice with MAIDS that had clonal populations of T cells. Proviral integrations at Gfi-1 were detected in two animals. These integrations were associated with enhanced transcription of Gfi-1. Unexpectedly, elevated levels of Gfi-1 transcripts were also observed in four T cell lymphomas without detectable integrations at this locus. This suggests that IL-2-independent T cell growth in MAIDS may be driven by transcriptional activation of Gfi-1 by proviral insertion or transactivation.

Effect of epidural block on the lag time of pulse oximeter response

Thirty-six healthy patients, ASA 1, aged 16-41 years, scheduled for elective plastic surgery were studied to determine if thoracocervical or lumbar epidural blocks affected the lag time of the pulse oximeter response. Patients were allocated to receive thoracocervical epidural block (n = 20) (group 1) (lignocaine 1%) or lumbar epidural block (n = 16) (group 2) (lignocaine 1.5%). Epidural block was performed with a 17-gauge Tuohy needle inserted in the midline between C7-T2 vertebrae in group 1 and between L1-S1 in group 2 and an epidural catheter was introduced. Arterial oxygen saturation (SpO2) was measured continuously using a Datex pulse oximeter. The lag time of the pulse oximeter response was measured while breathing oxygen (100%) after breath-holding. Values were obtained 10 min before and 5, 10, 15, 20, 30, and 40 min after epidural injection of a test dose. There was a progressive decrease in the lag time of the pulse oximeter response so that by 30 min after epidural injection the mean (SD) value had decreased from 29 (6.1) to 14 (3.4) in Group 1 and 41 (12.8) to 23 (7.9) s in group 2 (p < 0.01).

Study of the safe threshold of apneic period in children during anesthesia induction

STUDY OBJECTIVES

(1) To investigate changes in arterial oxygen saturation via pulse oximeter (SpO2) during apnea and after reinstitution of manual ventilation at SpO2 of 95% or 90% following rapid sequence induction of anesthesia in children after 2-minute preoxygenation; (2) to determine whether the setting of a safe threshold of apneic period to an SpO2 of 95% is appropriate in children during anesthetic induction; and (3) to evaluate the influences of age, body weight, and height on the time from the start of apnea to SpO2 of 95%.

DESIGN

A clinical study of random design and comparison among groups.

SETTING

Operating room of a plastic surgery hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College.

PATIENTS

152 infants and children, ASA physical status 1, aged 3 months to 12 years, scheduled for elective plastic surgery.

INTERVENTIONS

Patients were divided into three age groups: Group 1-infants 3 months to 1 year (n = 39); Group 2 children 1 to 3 years (n = 41); and Group 3-children 3 to 12 years (n = 72). Patients in each age group were randomly allocated again to Subgroups A and B. After a 2-minute preoxygenation, anesthesia was induced with thiopental 5 mg/kg, fentanyl 5 micrograms/kg and suxamethonium 1.5 mg/kg. Patients were manually ventilated when SpO2 decreased to 90% in Subgroups A and 95% in Subgroups B, respectively, during apnea.

MEASUREMENTS AND MAIN RESULTS

SpO2 was measured continuously with a Datex pulse oximeter applied to the right index finger. During apnea, the times for SpO2 to decrease to 09% (T99) and 95% (T99) in all children, and 90% (T90) in Subgroups A were recorded. The time for SpO2 to decrease from 95% to 90% (T95-90) in Subgroups A was also measured. After reinstitution of manual ventilation, the time when SpO2 continued to decrease (T1) and the time from the end of apnea to recovery of SpO2 baseline (T2) were determined. In addition, the lowest value of SpO2 after apnea was also recorded. The results showed that younger children were more susceptible than older children to the risk of hypoxemia during apnea. There were significant differences in T99, T95, T90, and T95-90 between the three age groups T1 and T2 were significantly longer in Group 3 than in Groups 1 and 2. There were significant differences in the lowest values of SpO2 following apnea among the three Subgroups A and between Subgroups A and B of each age group. During apnea, heart rate decreased gradually as SpO2 decreased, showing a significant decrease at SpO2 of 95%. Bradycardia was found in three children in Subgroups A. The apnea time to SpO2 of 95% correlated well with age, weight, and height by linear regression analysis.

CONCLUSIONS

The safe threshold of an apneic period setting to an SpO2 of 95% was appropriate in children during anesthesia induction. Despite the same duration of preoxygenation, younger children were more susceptible than elder ones to the risk of hypoxemia during apnea. The apnea time to SpO2 of 95% correlated with age, body weight, and height using linear regression analysis.

Molecular cloning and primary characterization of a single-chain antibody against human sarcoma-associated antigen p200

BACKGROUND

Monoclonal Antibody (MAb) 29-13 reacts with the human sarcoma-associated antigen (SAA) p200. We report here engineering and primary characterization of a single chain antibody (scFV2913).

MATERIALS AND METHODS

The scFV2913 recombinant gene, consisting of VH-linker-VK, was constructed with RT-PCR. This gene was cloned and expressed in E. coli. The renatured scFV2913 was used in the immunostaining study.

RESULTS

Consistent with its parent MAb 29-13, purified and renatured scFV2913 showed affinity and specificity to the SAA p200 according to the immuno-histochemical staining study of 99 specimens of human sarcomas and other tissues.

CONCLUSIONS

Due to its retained specificity and affinity, scFV2913 may be useful in immunodiagnosis and immunotherapy for sarcoma patients.

A comparative study of early postoperative hypoxemia in infants, children, and adults undergoing elective plastic surgery

To determine the influence of age on postoperative hypoxemia, we studied postoperative hypoxemia in 1152 patients, from infants to adults, ASA physical status I, undergoing elective plastic surgery. Subjects were divided into four groups on the basis of age: Group 1, infants aged 1 yr or less (n = 108); Group 2, children aged 1-3 yr (n = 240); Group 3, children aged 3-14 yr (n = 482); and Group 4, adults aged 14-58 yr (n = 322). Arterial oxygen saturation (Spo2) levels were recorded while patients were breathing room air in the postanesthesia recovery room shortly after arrival (0 min), and 5, 10, 15, 20, 30, 40, 50, 60, 120, and 180 min thereafter. Younger patients showed lower Spo2 levels and a higher incidence of hypoxemia during the early postoperative period. The incidences of hypoxemia (Spo2 = 86%-90%) and severe hypoxemia (Spo2 < or = 85%) in the recovery room were 30.6% and 16.7%, respectively, in Group 1, 20.0% and 10.0% in Group 2, 14.1% and 3.3% in Group 3, and 7.8% and 0.6% in Group 4. Hypoxemia occurred most commonly within 1 h after anesthesia, particularly during the first 40 min in infants and during the first 15 min in older children and adults. A significant correlation was found by linear regression analysis between low Spo2 levels on admission to the recovery room and children's age. Thereafter, Spo2 levels and the incidence of hypoxemia during the early postoperative period were related only to infants' recovery scores.

[Early postoperative hypoxemia in infants, children and adults undergoing elective plastic surgery]

Seven hundred ASA-class-1 patients undergoing elective plastic surgery were selected to study the effect of age on early postoperative hypoxemia with a pulse eximeter for continuous monitoring of arterial oxygen saturation (SpO2) in the postanesthesia recovery room. The patients were divided into four groups: group 1, 72 infants aged less than one year; group 2, 120 children aged from one to three years; group 3, 364 children aged over three years; and group 4, 144 adults aged from 18 to 58 years. The results showed that the younger the patients, the lower the SpO3 and the higher the incidence of hypoxemia in the early postoperative period. The incidences of early postoperative hypoxemia in the postanesthesia recovery room were 44.4% in group 1, 31.7% in group 2, 17.3% in group 3 and 8.3% in group 4. Early postoperative hypoxemia occurred most commonly within 40 min. in infants and within 15 min. in children aged over one year and adults.

Viability of transgenic mice expressing a platelet derived growth factor (PDGF) antagonist in plasma

BACKGROUND

Many studies have implicated PDGF in the development of diseases such as atherosclerosis. Previously, we showed in tissue culture that the soluble extracellular domain of the PDGF beta-receptor is capable of binding BB-PDGF with high affinity; therefore antagonizing the ability of BB-PDGF to stimulate cell growth.

METHODS

This work describes the efforts of expressing the soluble extracellular domain of the PDGF beta-receptor in transgenic mice. Driven by the albumin promoter, which is activated relatively late during embryonic development, the secreted form of the PDGF receptor protein was detected in plasma of the homozygous mice at a high concentration (approximately 60 micrograms/microL or approximately 545 nm).

RESULTS

Plasma from these transgenic mice was capable of blocking PDGF-induced receptor autophosphorylation in tissue culture. The mice appeared to be healthy, demonstrating that full PDGF beta-receptor function is not required for viability.

CONCLUSION

By expressing a high level of a soluble form of the extracellular domain of the PDGF receptor in transgenic mice, we have established a novel animal model that will allow us to gain insight into the role of the PDGF receptor in vascular diseases and other diseases involving PDGF stimulated cell proliferation.

Observation of early postoperative hypoxaemia in children undergoing elective plastic surgery

The incidence, severity and duration of early postoperative hypoxaemia were determined in 420 healthy infants and children undergoing elective plastic surgery. Mean value of preoperative SpO2 was 98.3 +/- 0.87%. However, it decreased significantly to 92.7 +/- 4.01% immediately following anaesthesia in the postanaesthesia recovery room (PAR) when children breathed room air. Then SpO2 gradually increased to 93.8 +/- 4.25% at 10 min, 95.4 +/- 3.14% at 30 min, 96.6 +/- 2.25% at 60 min, 96.9 +/- 1.69% at 120 min, and 97.4 +/- 1.55% at 180 min, respectively. The incidence of hypoxaemia and severe hypoxaemia, which were 14.8% and 6.2% respectively on arrival in the PAR, decreased significantly to 6.6% and 1.9%, 30 min later. The hypoxaemia occurred most commonly within 1 h, particularly the first 30 min following anaesthesia. The hypoxaemia was more common and more severe in children undergoing cleft palate repair than other kinds of plastic surgery. A significant correlation was found between low SpO2 levels on admission to the PAR and children's age, fentanyl doses, and the infants' recovery score.

Evi-5, a common site of retroviral integration in AKXD T-cell lymphomas, maps near Gfi-1 on mouse chromosome 5

We have identified a novel common site of retroviral integration, Evi-5, in AKXD T-cell lymphomas. All proviruses located at Evi-5 are clustered within a 7-kb genomic region and, where determined, are oriented in the same transcriptional direction. Interspecific backcross analysis localized Evi-5 to mouse chromosome 5, where it cosegregated with another common viral integration site, Gfi-1. Gfi-1 encodes a novel zinc finger transcription factor whose expression is thought to be important for interleukin-2 signaling. Physical mapping studies showed that Evi-5 is located approximately 18 kb upstream of Gfi-1, and Southern analysis showed that Gfi-1, like Evi-5, is a common integration site in AKXD T-cell tumors. With one exception, Evi-5 and Gfi-1 integrations were mutually exclusive. Ten of the tumors with Evi-5 or Gfi-1 integrations also harbored viral integrations at other common integration sites causally associated with T-cell disease. These results are consistent with the hypothesis that T-cell lymphomagenesis is a multistep disease and that viral integration at Evi-5 or Gfi-1 is causally associated with this disease process.