[Severe airway distress following cervical spine operation: retrospective breakdown of the chain of errors]

A 71-year-old female patient received a prothesis due to a cervical disc prolapsed and bleeding into the collar soft tissues occurred postoperatively. Following a computed tomography examination severe peracute respiratory decompensation occurred while administering topical anesthesia to the pharynx in order to perform fiber optic intubation. Endotracheal intubation using conventional laryngoscopy was unsuccessful and the patient required immediate cricothyroidotomy. As an on-site cricothyrotomy set to establish a secure airway was not available the decision was taken to perform surgical cricothyroidotomy. As a conclusion to this life-threatening event in the case of symptoms, such as dyspnea, dysphonia and dysphagia after operations of the cervical spine the airway has to be secured early and according to the local algorithm.

Persistent left fifth aortic arch with pentalogy of Fallot

Congenital double-lumen aortic arch resulting from persistence of the fifth aortic arterial arch (PFAA) is a rare congenital anomaly. It appears as a vascular structure running inferior and parallel to the "real" aortic arch from the innominate artery to the left subclavian artery. We report a case of persistent fifth aortic arch (systemic-to-systemic arterial connection) with pentalogy of Fallot in a patient who underwent successful intracardiac repair with a transannular patch with very proximal aortic cannulation for cardiopulmonary bypass (CPB).

Production of type II collagen specific monoclonal antibodies

Immunoassays are used for the specific measurement of type II collagen, a major cartilage protein, which is lost in osteoarthritic joints. Poor immunogenicity and species dependent immune response to type II collagen make it difficult to obtain specific antibodies required for immunoassay development. In addition, type II collagen antibodies exhibit reactivity to structurally dissimilar antigens such as actin, myoglobin, thyroglobulin and ssDNA, complicating the isolation of specific antibodies. It is therefore necessary to characterize the antibody reactivity against both noncollagenous antigens and different collagen types. In this study, immune response to type II collagen was improved by conjugation to carrier proteins, KLH and BSA. Hybridomas were generated by fusions of lymphocytes derived from lymph nodes or spleens with X63-653-Ag8 myeloma cells. Compared to spleens, the utilization of lymph nodes as a source of lymphocytes resulted in a 23% higher number of hybridomas secreting type II collagen antibodies. Hybridomas secreting polyreactive antibodies were identified based on their reactivity to thyroglobulin and eliminated. Extensive testing of the remaining monoclonal antibodies with other structurally dissimilar antigens and various types of collagen for reactivity, allowed us to isolate specific monoclonal antibodies to type II collagen. We emphasize the importance of characterization of the reactivity of type II collagen monoclonal antibodies before employing them for immunoassays.

Plant regeneration from mesophyll protoplasts of Centaurea cyanus, Senecio x hybridus and Callistephus chinensis

Protoplasts were isolated from leaves of glasshouse-grown plants of Centaurea cyanus and axenic shoot cultures of Senecio x hybridus. Upon culture, using modified MS-based media, protoplasts of both systems entered division to produce callus, followed by plant regeneration. Leaf protoplasts of Callistephus chinensis entered sustained division only following the preconditioning for 24h of peeled leaf tissues on agar-solidified MS-based medium. Protoplasts were also isolated from cell suspensions of C. chinensis and divided in MS-based or KM media. However, only leaf mesophyll protoplasts of Callistephus produced callus, which developed shoots.The establishment of protoplast-to-plant protocols for these ornamental species has provided a basis for broadening their gene pools through somatic hybridisation.

Family Walk-In Centre--Eaton Socon: evaluation of a project on preventive intervention based in the community

The Family Walk-In Centre opened November 1978 as a pilot project at Eaton Socon in Cambridgeshire with the aims: to encourage parents to visit the centre on "their terms," including parents who have abused or who fear they will abuse or neglect their child who may be difficult or handicapped, or because of chronic or acute family problems; further to mobilize "Self Help" groups and offer professional support. "Help" offered to the families included informal and formal group work, family casework and education in social and physical skills. Volunteer and professional support was given at the Centre and at home. Close liaison with specialist agencies was maintained to enable families to receive appropriate help. Periodic reviews and visits were made to maintain contact. An analysis of 50 families who attended the Centre between October 1979 and May 1980 was made to assess: the attendance and reattendance rate which indicated their acceptance of help offered and their motivation to use the Centre; the types of problems presented to the Centre, the types of action taken, the progress made when reviewed after three months and the degree of involvement by the volunteers. A final analysis will comprise 100 families. A preliminary summary found: significant reduction in the registration of new cases of child abuse; self-referrals exceeded significantly other modes of referral; loneliness and parenting difficulties formed the major proportion of families seeking help; 48% of families continued to attend for 3 months or more; work done centered upon discussion of parenting problems in 30% of the cases and involvement in activities with other families in 28%; 18% were assessed as showing improved child care after 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Haloperidol in the treatment of children with severe behaviour disorders

Since Janssen's (1959) introduction of haloperidol, numerous clinical trials have been published showing its usefulness in the treatment of mania and hypomanic states. Davies (1962) found it an effective drug in the treatment of adult patients showing aggressive behaviour resulting from various causes, and in the management of mania. Gerle (1963), in his review, showed the effectiveness of this drug in the control of disturbed behaviour in mentally sub-normal patients. He also showed (1962) that patients taking this drug are remarkably free from toxic reactions such as jaundice, agranulocytosis and allergic dermatitis. Haloperidol has been used in our unit (Rogers, 1955, 1965a) over the past three years. The impression has been gained that it controls aggressive, overactive and destructive behaviour in severely disturbed children, without impairing their ability to participate normally in the therapeutic activities of the unit (Rogers, 1965b).