Interaction of magnesium sulphate with vecuronium-induced neuromuscular blockt

We have investigated the interaction between magnesium sulphate 40 mg kg−1 i.v. and vecuronium. First, we determined the effect of pretreatment with magnesium on the potency of vecuronium using a single bolus dose-response technique. In addition, we compared the time course of vecuronium-induced neuromuscular block (vecuronium 100 μg kg−1) with and without magnesium pretreatment. For both parts, neuromuscular block was assessed by electromyography. In addition, the effect of magnesium pretreatment on vecuronium-induced neuromuscular block was investigated in the context of rapid sequence induction of anaesthesia. We found that the neuromuscular potency of vecuronium was increased by pretreatment with magnesium sul phate. The ED50 and ED90 of vecuronium with MgSO4 were 25% lower than without MgSO4 (ED50 21.3 vs 26.9 μg kg−1 ED90 34.2 vs 45.7 μg kg−1 P < 0.05 for both). Mean onset time was 147.3 (SD 22.2) s in the MgSO4 group vs 297.3 (122) s for controls (P < 0.05). Clinical duration was prolonged (MgSO4-vecuronium 43.3 (9) min vs 25.2 (5.1) min for controls; P < 0.05). This was also true for the recovery index (20.1 (6.6) mm vs 10.6 (3.4) min; P < 0.05) and duration to 75% recovery (63.4 (9.9) min vs 35.8 (6.9) min; < 0.05). In the context of rapid sequence induction, pretreatment with MgSO4 improved the intubating score of vecuronium compared with vecuronium without MgSO4 reach ing the same quality as that with suxamethonium 1 mg kg−1. We conclude that magnesium pretreat ment increased the neuromuscular potency of vecuronium, in addition to modifying the time course of its neuromuscular bloc

Solving clinical challenges in prostate cancer using the single-port robot system

Objective: Patients who desire or require surgical management for prostate cancer, but are poor candidates for multi-port robotic surgery, can present a clinical challenge. Use of single port (SP) robotic technology may help overcome these challenges. We present our initial experience with robotic-assisted radical prostatectomy (RARP) using the da Vinci SP robot for prostate cancer in patients who would otherwise not be good surgical candidates for conventional multi-port transabdominal robotic surgery. Patients and surgical procedure: Fourteen of 41 patients who underwent SP-RARP from November 2020 to February 2022 for biopsy confirmed, organ-confined prostate adenocarcinoma at a single tertiary care institution qualified for inclusion in our study due to specific considerations posing challenges for conventional multiport transperitoneal RARP. Perioperative metrics, pathologic findings and functional outcomes were collected prospectively. The accompanying video shows two cases demonstrating our transvesical and extraperitoneal approaches to SP-RARP. Results: All patients underwent successful procedures without need to convert to multi-port robotic or open approach. Most patients had prior abdominal surgery (13/14, 93%) including aborted multi-port RARP (2), hernia repairs (5), bowel diversions (3), and peritoneal dialysis catheters (2) among others. Most underwent extraperitoneal (9/14, 64%) followed by transvesical (5/14, 36%) approach. There were no intraoperative complications and one Clavien III post-operative complication. Positive margin rate was 29%, most of which were microscopic (≤3 mm, 3/4, 75%). Eighty-five percent of patients had undetectable nadir PSA. Conclusions: Our initial experience using the SP robot suggests that this technology can facilitate surgery for prostate cancer patients who might otherwise not be considered surgical candidates. Operative outcomes are not compromised despite a smaller incision and working space. We have found the SP system to be a valuable tool for carefully selected patients

Aerodynamic flight evaluation analysis and data base update

Research was conducted to determine the feasibility of replacing the Solid Rocket Boosters on the existing Space Shuttle Launch Vehicle (SSLV) with Liquid Rocket Boosters (LRB). As a part of the LRB selection process, a series of wind tunnel tests were conducted along with aero studies to determine the effects of different LRB configurations on the SSLV. Final results were tabulated into increments and added to the existing SSLV data base. The research conducted in this study was taken from a series of wind tunnel tests conducted at Marshall's 14-inch Trisonic Wind Tunnel. The effects on the axial force (CAF), normal force (CNF), pitching moment (CMF), side force (CY), wing shear force (CSR), wing torque moment (CTR), and wing bending moment (CBR) coefficients were investigated for a number of candidate LRB configurations. The aero effects due to LRB protuberances, ET/LRB separation distance, and aft skirts were also gathered from the tests. Analysis was also conducted to investigate the base pressure and plume effects due to the new booster geometries. The test results found in Phases 1 and 2 of wind tunnel testing are discussed and compared. Preliminary LRB lateral/directional data results and trends are given. The protuberance and gap/skirt effects are discussed. The base pressure/plume effects study is discussed and results are given

Heart rate changes during partial seizures: A study amongst Singaporean patients

INTRODUCTION: Studies in Europe and America showed that tachycardia, less often bradycardia, frequently accompanied partial seizures in Caucasian patients. We determine frequency, magnitude and type of ictal heart rate changes during partial seizures in non-Caucasian patients in Singapore. METHODS: Partial seizures recorded during routine EEGs performed in a tertiary hospital between 1995 and 1999 were retrospectively reviewed. All routine EEGs had simultaneous ECG recording. Heart rate before and during seizures was determined and correlated with epileptogenic focus. Differences in heart rate before and during seizures were grouped into 4 types: (1) >10% decrease; (2) -10 to +20% change; (3) 20–50% increase; (3) >50% increase. RESULTS: Of the total of 37 partial seizures, 18 were left hemisphere (LH), 13 were right hemisphere (RH) and 6 were bilateral (BL) in onset. 51% of all seizures showed no significant change in heart rate (type 2), 22% had moderate sinus tachycardia (type 3), 11% showed severe sinus tachycardia (type 4), while 16% had sinus bradycardia (type 1). Asystole was recorded in one seizure. Apart from having more tachycardia in bilateral onset seizures, there was no correlation between side of ictal discharge and heart rate response. Compared to Caucasian patients, sinus tachycardia was considerably less frequent. Frequency of bradycardia was similar to those recorded in the literature. CONCLUSIONS: Significant heart rate changes during partial seizures were seen in half of Singaporean patients. Although sinus tachycardia was the most common heart rate change, the frequency was considerably lower compared to Caucasian patients. This might be due to methodological and ethnic differences. Rates of bradycardia are similar to those recorded in the literature

Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections among the General Population

Governments are preparing for a potential influenza pandemic. Therefore they need data to assess the possible impact of interventions. Face-masks worn by the general population could be an accessible and affordable intervention, if effective when worn under routine circumstances.We assessed transmission reduction potential provided by personal respirators, surgical masks and home-made masks when worn during a variety of activities by healthy volunteers and a simulated patient.All types of masks reduced aerosol exposure, relatively stable over time, unaffected by duration of wear or type of activity, but with a high degree of individual variation. Personal respirators were more efficient than surgical masks, which were more efficient than home-made masks. Regardless of mask type, children were less well protected. Outward protection (mask wearing by a mechanical head) was less effective than inward protection (mask wearing by healthy volunteers).Any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence, personal respirators providing most protection. Masks worn by patients may not offer as great a degree of protection against aerosol transmission

Reduction of biological activity of murine recombinant interleukin-1β by selective deamidation at asparagine-149

AbstractA biologically active preparation of murine recombinant interleukin-1β (mIL-1β) fromEscherichia coli cell lysates contained two forms of mIL-1β with pI 8.7 and pI 8.1, respectively. Treatment with 0.1 M Tris, pH 8.5, at 37°C for 35 h converted the pI 8.7 form to the pI 8.1 form by the selective deamidation of an asparagine residue (Asn149) in the mIL-1β molecule. Deamidated mIL-1β had 3- to 5-fold lower co-mitogenic activity and receptor affinity than the unmodified form

Observations of whistler mode waves with nonlinear parallel electric fields near the dayside magnetic reconnection separatrix by the Magnetospheric Multiscale mission

We show observations from the Magnetospheric Multiscale (MMS) mission of whistler mode waves in the Earth's low-latitude boundary layer (LLBL) during a magnetic reconnection event. The waves propagated obliquely to the magnetic field toward the X line and were confined to the edge of a southward jet in the LLBL. Bipolar parallel electric fields interpreted as electrostatic solitary waves (ESW) are observed intermittently and appear to be in phase with the parallel component of the whistler oscillations. The polarity of the ESWs suggests that if they propagate with the waves, they are electron enhancements as opposed to electron holes. The reduced electron distribution shows a shoulder in the distribution for parallel velocities between 17,000 and 22,000 km/s, which persisted during the interval when ESWs were observed, and is near the phase velocity of the whistlers. This shoulder can drive Langmuir waves, which were observed in the high-frequency parallel electric field data

Functional annotations of diabetes nephropathy susceptibility loci through analysis of genome-wide renal gene expression in rat models of diabetes mellitus

<p>Abstract</p> <p>Background</p> <p>Hyperglycaemia in diabetes mellitus (DM) alters gene expression regulation in various organs and contributes to long term vascular and renal complications. We aimed to generate novel renal genome-wide gene transcription data in rat models of diabetes in order to test the responsiveness to hyperglycaemia and renal structural changes of positional candidate genes at selected diabetic nephropathy (DN) susceptibility loci.</p> <p>Methods</p> <p>Both Affymetrix and Illumina technologies were used to identify significant quantitative changes in the abundance of over 15,000 transcripts in kidney of models of spontaneous (genetically determined) mild hyperglycaemia and insulin resistance (Goto-Kakizaki-GK) and experimentally induced severe hyperglycaemia (Wistar-Kyoto-WKY rats injected with streptozotocin [STZ]).</p> <p>Results</p> <p>Different patterns of transcription regulation in the two rat models of diabetes likely underlie the roles of genetic variants and hyperglycaemia severity. The impact of prolonged hyperglycaemia on gene expression changes was more profound in STZ-WKY rats than in GK rats and involved largely different sets of genes. These included genes already tested in genetic studies of DN and a large number of protein coding sequences of unknown function which can be considered as functional and, when they map to DN loci, positional candidates for DN. Further expression analysis of rat orthologs of human DN positional candidate genes provided functional annotations of known and novel genes that are responsive to hyperglycaemia and may contribute to renal functional and/or structural alterations.</p> <p>Conclusion</p> <p>Combining transcriptomics in animal models and comparative genomics provides important information to improve functional annotations of disease susceptibility loci in humans and experimental support for testing candidate genes in human genetics.</p