GS Group Research Articles

Hyperbilirubinemia Reduces the Streptozotocin-Induced Pancreatic Damage through Attenuating the Oxidative Stress in the Gunn Rat

Oxidative stress is an important pathogenic factor in diabetes. Bilirubin may serve a cytoprotective function as an anti-oxidant. The Gunn rat lacks the enzyme uridine-diphosphate glucuronosyltransferase that is responsible for conjugation of bilirubin, exhibiting elevation of plasma bilirubin. We examined the effect of hyperbilirubinemia on the pancreatic damage caused by streptozotocin (STZ) in the Gunn rat. Male Wistar rats and male Gunn rats were treated with STZ (WS and GS groups, respectively) or vehicle (WC and GC groups, respectively). All 5 rats in the WS group developed diabetes, defined as fasting blood glucose 300 mg/dL or more, at 3 days, whereas only 2 of the 5 GS rats became diabetic at 7 days after STZ injection. Without insulin supplement at 7 days after STZ injection, the WS group displayed higher levels of fasting blood glucose (510.3 ± 50.3 vs. 236.4 ± 42.5 mg/dL, p = 0.003) and HbA1c (5.0 ± 0.1 vs. 3.9 ± 0.1, p = 0.001), compared to those of GS group. In Wistar rats, STZ induced apoptosis of the pancreatic islet cells, accompanied with activation of NADPH oxidase and increased production of reactive oxygen species and nitric oxide, but not in Gunn rats. Moreover, in a rat insulinoma cell line (RIN-m5F), pre-treatment with bilirubin (0.1 mg/dL) decreased cell death and apoptosis caused by STZ, and also reduced H₂O₂ production. Considering the protective effect of hyperbilirubinemia against STZ-induced injury, we postulate that bilirubin could be a potential therapeutic modality for oxidative stress of pancreas islets.

Pattern electroretinogram optimized for glaucoma screening (PERGLA) and retinal nerve fiber thickness in suspected glaucoma and ocular hypertension

The purpose of this study is to evaluate pattern electroretinogram optimized for glaucoma screening (PERGLA) and retinal nerve fiber layer (RNFL) at spectral optical coherence tomography (OCT) in eyes with suspected glaucoma (GS) and in eyes with ocular hypertension (OHT). This is a cross-sectional, observational study. Twenty-four patients with GS (BCVA 20/20, normal visual field, intraocular pressure, IOP, less than 21 mmHg, and glaucomatous optic neuropathy, GON) and 14 patients with OHT (BCVA 20/20, intraocular pressure 25 mmHg, absence of glaucomatous optic neuropathy and normal visual field) were considered in this study. GON was intended as vertical cup-disk ratio of 0.5 or more; asymmetry of greater than 0.2, disk notching, disk splinter hemorrhages. PERGLA amplitude and phase were measured, while thickness of the RNFL was obtained with spectral OCT. A control group of 50 age-matched healthy patients was added. In the GS group, 16 eyes (66.7%) showed normal average RNFL analysis and normal PERGLA, 3 eyes (12.5%) showed abnormal average RNFL analysis and abnormal PERGLA, 5 eyes (20.8%) presented with normal average RNFL analysis and abnormal PERGLA. In the OHT group, 11 eyes (78.6%) showed an average normal RNFL and normal PERGLA, while 3 eyes (21.4%) presented with an average normal RNFL and abnormal PERGLA. PERGLA is a non-invasive, fast, and fully automatic version of the pattern ERG. In eyes with OHT and in eyes with GS, PERGLA abnormalities in presence of a normal RNFL could suggest an early functional damage of viable retinal ganglion cells.

Clinical Significance of Granulocytic Sarcoma in Patients with Acute Myeloid Leukemia.

Abstract 3105Poster Board III-42 BackgroundGranulocytic sarcoma (GS) are extramedullary tumors composed of malignant granulocytic precursor cells and is rare, accounting for 3-9%. Its prognostic impact in adults has been controversially discussed. The objectives of this study were to describe the frequency, presenting characteristics, and the survival in AML patients with GS. Patients and MethodsBetween January, 1990 and April, 2008 434 patients (median age 57 (15-86), male/female; 260/174) diagnosed as AML were included. Pretreatment factors were investigated in all 434 patients. Treatment outcomes were investigated in 248 eligible patients who were received intensive chemotherapy on Japan Adult Leukemia Study Group protocols AML92, AML95, AML97, or AML201, excluded patients with acute promyelocytic leukemia and dead within 30 days of the diagnosis. The χ2-test was used for the binary variable comparison. The Mann-Whitney U test was used for the continuous variable comparison. Overall survival (OS) and disease free survival (DFS) were estimated by the Kaplan-Meier method, and compared using the log-rank test. The Cox proportional hazards regression model was used for the multivariate analysis of prognostic factors. P < 0.05 was considered to indicate a statistical significance. Results1. Pretreatment factors zIn all 434 patients 45 patients (10.4%) were with GS at diagnosis (GS group) and 389 patients without GS (non-GS group). Patients in GS group were significantly younger than non-GS group (44.2±18.3 vs 54.2±17.0; p<0.001), and presented with higher white blood cell counts (p=0.03). No significant differences in sex and lactate dehydrogenase levels demonstrated. Patients in GS group had higher frequency of French-American-British M4 (p=0.001) and M5 (p=0.045) morphology. No significant difference in the expression of any surface marker, the distribution of cytogenetic risk groups, and the frequency of each cytogenetic change including t(8;21), 11q23, inv(16), and the complex karyotype demonstrated. Results 2. Treatment outcomes zIn 248 eligible patients (median age 51 (15-69), male/female; 155/93), 41 patients were with GS and 207 patients without GS. Patients in each group did not differ significantly in distribution of age, sex, and undergoing allogenic hematopoietic stem cell transplantation. CR rates within two courses of induction therapy did not differ significantly (75.6% vs 84.1%; p=0.192) between GS group and non-GS group, however GS group had significantly higher relapse rates compared to non-GS group (74.2% vs 54.7%; p=0.042). 5-year OS did not differ significantly (41% vs 39%; p=0.342), however GS group had a significantly shorter 5-year DFS compared to non-GS group (12% vs 27%; p=0.022). Multivariate analysis of OS showed an independent prognostic significance of only age and cytogenetic risk groups, not GS. Thus that of DFS showed an independent prognostic significance of GS besides age and cytogenetic risk groups. ConclusionsThis study shows that adult AML patients with GS are associated with younger age, higher WBC counts, and monocytic differentiation of leukemia cells. GS adversely affects relapse rate and DFS. Recognition of GS may be a useful tool to identify a subset of adult AML patients with higher risk disease. DisclosuresNo relevant conflicts of interest to declare.

The impact of iatrogenic gastroschisis on pulmonary maturation in the fetal rabbit models of congenital diaphragmatic hernia

The aim of this study was to analyze the effect of iatrogenic gastroschisis on pulmonary hypoplasia in fetal rabbits with congenital diaphragmatic hernia (CDH). A total of 30 pregnant rabbits received fetal surgery on gestational day 23. A left diaphragmatic hernia was created in one end fetus (DH group) of each rabbit, and the other end fetus of the same rabbit received sham thoracotomy as control (CR group). Another 19 pregnant rabbits underwent partial resection of the diaphragm in both end fetuses on gestational day 23, and then artificial gastroschisis was performed on one end fetus (GS group) on gestational day 26, while the other end remained as control (CGS group). The fetuses were harvested on gestational day 30. The histological and morphometric evaluation of lungs and livers of the end fetuses in each group was conducted. In the DH group, the lungs were hypoplastic with a decrease in the total lung weight to body weight ratio, and remarkable thickening in alveolar septa. The lung vessels showed significantly thicker arterial walls when compared with those from control fetuses. The pathological finding in the CGS group was similar to that of the DH group. The thickness of the alveolar septa and of the pulmonary arterial walls showed no significant difference among the GS group, DH group and the CGS group. The ratio of liver weight to body weight increased notably in the GS group, DH group and CGS group compared with that in the CR group. In the fetal rabbit models of CDH, pulmonary hypoplasia is the most significant pathological feature. Iatrogenic gastroschisis does not improve pulmonary maturation due to the active growth of the liver that herniates into the thoracic cavity.

Protective effects of nigella sativa against gentamicin-induced nephrotoxicity in rats

The aim of this study was focused on investigating the possible protective effect of NS against GS-induced nephrotoxicity. Twenty four Wistar-albino rats were divided into four equal groups as follows: control group, GS group (100 mg/kg intraperitoneal – i.p.), NSL+GS group (0.2 ml/kg+100 mg/kg i.p.) and NSH+GS group (0.4 ml/kg+100 mg/kg i.p.). Plasma creatinine and urea levels significantly increased as a result of nephrotoxicity in the GS group. Also, creatinine and urea levels significantly decreased in NSL+GS and NSH+GS groups. In the GS group, plasma MDA and NO levels increased significantly ( p<0.05) and erythrocyte SOD and GSH-Px activities decreased significantly ( p<0.05) when compared with control group. NS administration with GS injection resulted in significantly decreased MDA and NO generation and increased SOD and GSH-Px activities when compared with GS group. Proximal tubular necrosis, vacuolation, desquamation and degeneration in epithelial cells of the proximal tubules, hyaline casts in tubular lumen, mononuclear cell infiltration, glomerular and basement membrane alterations were histopathologically detected in the kidneys of the GS group. Co-treatments with NS (low and high dose) considerably decreased the renal damage when compared with the GS group. In conclusion, NS acts in the kidney as a potent scavenger of free radicals to prevent the toxic effects of GS both in the biochemical and histopathological parameters.

Spontaneous K-complexes in chronic psychophysiological insomnia

Objective Spontaneous K-complexes are electroencephalographic features unique to non-rapid eye movement sleep. It has been suggested that this phasic event is a sleep-protective mechanism. Because insomnia sufferers report poor sleep quantity and quality, the objective of this study was to document the occurrence of spontaneous K-complexes in Stage 2 sleep of individuals with chronic insomnia. Specifically, the number and density of spontaneous K-complexes were studied in psychophysiological insomnia sufferers. Setting This study took place in a sleep and event-related potentials laboratory. Design Spontaneous K-complexes were scored during Stage 2 sleep on the second and third nights of a four-consecutive-nights protocol of polysomnographic recordings. Participants The sample included 14 participants suffering from psychophysiological insomnia (INS group; mean age=44.1 years) and 14 good sleepers (mean age=38.1 years). Participants underwent sleep and psychological evaluations. INS group participants met the diagnostic criteria for primary psychophysiological insomnia (mean duration of insomnia=9.6 years). Intervention Not applicable. Results The total number of spontaneous K-complexes and the density according to the total time spent in Stage 2 sleep (spontaneous K-complexes per minute) were compiled. Repeated-measures analyses of variance showed no significant difference in the number and density of spontaneous K-complexes between the INS group (313.98 and 2.66) and the GS group (361.10 and 2.88), respectively. Conclusion These results suggest no deficiency in the sleep-protective mechanism of psychophysiological insomnia sufferers in comparison with good sleepers, as measured by the spontaneous K-complexes' number and density.

GlideScope® video laryngoscope: a randomized clinical trial in 203 paediatric patients

BackgroundThe GlideScope® intubating device has been reported to provide a comparable or superior laryngoscopic view compared with direct laryngoscopy in adults. This study compared the use of the GlideScope® with direct laryngoscopy for the laryngoscopic view and intubation time in children. MethodsThe laryngoscopic view in 203 children was scored using both the Macintosh laryngoscope and the GlideScope® using Cormack and Lehane (C&L) grades. After scoring each laryngoscopic view with and without BURP, the patients were randomly allocated to two groups. The trachea was intubated using direct laryngoscopy (Group DL, n=100) or the GlideScope® (Group GS, n=103). We compared C&L grades for the two views in the same patient, and also the time to intubate for each group. ResultsThe GlideScope® improved the view without BURP in the patients with C&L grade 2 (16/26, P<0.01) and with C&L grades 3 and 4 (7/11, P<0.05). The view with BURP was also improved by the GlideScope® in C&L grade 2 (4/9, P<0.05) and with C&L grades 3 and 4 (4/5, P=0.059). The mean time for tracheal intubation was 36.0 (17.9) s in the GS group and 23.8 (13.9) s in the DL group (P<0.001). ConclusionsIn children, the GlideScope® provided a laryngoscopic view equal to or better than that of direct laryngoscopy but required a longer time for intubation.

Relationships between central corneal thickness and optic disc topography in eyes with glaucoma, suspicion of glaucoma, or ocular hypertension

To identify relationships between central corneal thickness (CCT) and optic disc topography, as determined by scanning laser ophthalmoscopy (SLO), for patients seen in a specialist glaucoma service. 272 eyes of 144 patients with primary open angle glaucoma (POAG; n = 71), normal tension glaucoma (NTG; n = 50), ocular hypertension (OH; n = 48) and those considered to be suspicious for glaucoma (GS; n = 103) underwent ultrasonic pachymetry and optic disc topography by SLO. Correlations between CCT and SLO parameter values were identified. A Bonferroni correction for multiple comparisons was performed and a p value of <0.0042 was considered significant. Mean CCT values were 533 mum (POAG), 530 mum (NTG), 550 mum (GS), and 565 mum (OH). As a group the GS and OH eyes had significantly thicker CCT values than eyes with POAG. In addition, the NTG eyes had significantly thinner CCT values than GS and OH eyes. Overall multiple SLO parameters correlated with CCT even after accounting for co-variance with age, refraction and inclusion of both eyes. Sub-group analysis indicated that 'optic disc rim area' positively correlated with CCT (r = 0.378) and 'cup to disc area ratio' negatively correlated with CCT (r = -0.370) in the POAG group. In the GS group the parameter 'area below reference' (a measure of cup volume) and 'mean cup depth' had negative correlations with CCT (r = -0.297 and -0.323) indicating that eyes with thinner than average corneal thickness measurements had larger and deeper cups. Thinner corneas appear to be associated with larger and deeper optic disc cups in the eyes of patients seen in a specialist glaucoma service.

Sleep spindles in chronic psychophysiological insomnia

Objective A sleep spindle is an electroencephalographic feature that is unique to sleep. It has been suggested that this phasic event has a sleep-protective function. The objective of the present study was to document one aspect of sleep protection in chronic insomnia sufferers: the number and density of sleep spindles in Stage 2 sleep. Methods Sleep spindles were scored during Stage 2 sleep on the second and third nights of a protocol of polysomnographic recordings that lasted for four consecutive nights. The sample included 16 participants suffering from insomnia (INS group; mean age=43.4 years) and 14 good sleepers (GS group; mean age=38.1 years). Participants underwent sleep and psychological evaluations. The INS group participants met the diagnostic criteria for primary psychophysiological insomnia (mean duration of insomnia=9.6 years). Results The total number of sleep spindles in Stage 2 sleep and the density (sleep spindles per minute) according to the total time spent in Stage 2 sleep were compiled. Repeated-measures analyses of variance showed no significant difference in the number and in the density of sleep spindles between the INS group (68.46 and 0.60, respectively) and the GS group (56.28 and 0.46, respectively). Conclusion These results suggest no deficiency in the sleep-protection mechanism of psychophysiological insomnia sufferers in comparison with good sleeper controls, as measured by the number and density of sleep spindles.

Ｇｏｏｄ ＳｌｅｅｐｅｒおよびＰｏｏｒ Ｓｌｅｅｐｅｒにおける睡眠経過の検討

In this study, we investigated sleep profiles in good sleeper and poor sleeper classified by subjective report of daily sleep state. Auditory evoked potentials (AEP), N300 and N550, were measured in order to clarify the relationship between modulation of arousal level and attentional system during sleep. Six healthy undergraduate students participated in this experiment. Based on a questionnaire of sleep latency, three subjects with easy sleep initiation (good sleeper: GS, > 20 minutes) and another three subjects with difficult sleep initiation (poor sleeper: PS, < 30 minutes) were selected. We conducted three nights' experiments after one night sleep for habituating to experimental environment: the first night is control condition, the second night is the first stimulation condition, and the third night is the second stimulation condition. The stimulus used in this study was pure tone (60dB, 1000Hz) lasting 0.1 sec at 10 sec SOA. The sleep polygraph was recorded in all condition, and AEP was also recorded in two stimulation conditions. The data until the end of the first sleep cycle were analyzed. As the result, we observed that sleep latency was shorter and the appearance rate of deep sleep was lower in GS group compared to PS group. In addition, greater N550 amplitude in GS group suggests that subjects in GS group strongly pay attention to stimulus from outwards. Therefore we revealed the possibility that GS group has difficulty to maintain deep sleep by hyperactivity of attentional system, although the sleep latencies of GS group subjects were short.

The effect analysis and comparison between gastroschisis and tracheal ligation on experimental diaphragmatic hernia in fetal rabbits

The authors analyzed and compared the effects of experimentally induced gastroschisis and tracheal ligation on pulmonary hypoplasia in fetal rabbits with congenital diaphragmatic hernia. Twenty-three pregnant rabbits underwent fetal surgery on gestational day 24 through 27. Left diaphragmatic hernia was created in 1 fetus (DH group) from each rabbit, and a left diaphragmatic hernia with gastroschisis (GS group) or tracheal ligation (TL group) was created in another fetuses. The fetuses were delivered on gestational day 27 through 33. Histologic and morphometric examination of the lungs were performed in each group. In the DH group, the lungs were hypoplastic with a decrease in lung weight to body weight ratio and an increase in pulmonary arterial wall thickness. The alveolar septae were markedly thickened and diminished alveolar air spaces. In GS and TL groups, the alveolar septae were thickened but narrower than those of the DH group, air spaces were increased, and the pulmonary arterial wall was only slightly thickened. Pulmonary hypoplasia seen in newborn rabbits after experimentally induced diaphragmatic hernia is less severe in those rabbits with concurrently made gastroschisis or tracheal ligation. From the histologic viewpoint, the effects of gastroschisis and tracheal ligation on pulmonary hypoplasia in diaphragmatic hernia have no differences.

Effects of nociceptin on the spread and seizure activity in the rat amygdala kindling model: Their correlations with 3H-leucyl-nociceptin binding

The effects with pretreatment with nociceptin (0.03-30nmol, i.c.v.) were evaluated on the threshold for eliciting afterdischarge (ADT), generation and spread of seizure activity and postictal depression in rats with kindling stimulation. Nociceptin produced a decrease in ADT (32-45%) in rats with partial seizures (PS, stage II-III), and an increase (61-92%) in rats with generalized seizures (GS, kindled state). Nociceptin did not modify the behavioral changes, spike frequency and duration of afterdischarge elicited at ADT in both experimental groups. In rats with GS, nociceptin enhanced postictal depression (34-44%) evaluated with a recycling paradigm. Autoradiography experiments revealed enhanced nociceptin opioid receptor (NOP) binding in medial amygdala (22-26%), frontal (21-23%) and entorhinal (27-32%) cortices, and reduced binding in the substantia nigra pars compacta (28%) and medial central gray (29%) of rats with PS. The GS group displayed significant decreased NOP binding (40-70%) in most of the brain areas evaluated. These results suggest that nociceptin facilitates ictal activity in rats with PS, whereas in animals with GS, it induces inhibitory effects on ADT and enhances the postictal period. These effects correlate with significant changes in NOP binding.

Experimental antegrade enema: effects on water, electrolyte and acid-base balances with different solutions

To study the effects on the water, electrolyte, and acid-base balances in rabbits submitted to antegrade enema with different solutions through appendicostomy. Forty male New Zealand rabbits were submitted to appendicostomy, and distributed in 4 groups, according to the antegrade enema solution: PEG group, polyethylene glycol electrolyte solution (n=10); ISS group, isotonic saline solution (n=10); GS group, glycerin solution (n=10); SPS group, sodium phosphate solution (n=10). After being weighed, arterial blood gas analysis, red blood count, creatinine and electrolytes were measured at 4 times: preoperatively (T1); day 6 postop, before enema (T2); 4h after enema (T3); and 24h after T3 (T4). In PEG group occurred Na retention after 4h, causing alkalemia, sustained for 24h with HCO3 retention. In ISS group occurred isotonic water retention and hyperchloremic acidosis after 4h, which was partially compensated in 24h. GS group showed metabolic acidosis after 4h, compensated in 24h. In SPS group occurred hypernatremic dehydration, metabolic acidosis in 4h, and hypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis with partially compensated dehydration in 24h. All solutions used in this study caused minor alterations on water, electrolyte or acid-base balances. The most intense ones were caused by hypertonic sodium phosphate solution (SPS) and isotonic saline solution (ISS) and the least by polyethyleneglycol electrolyte solution (PEG) and glycerin solution 12% (GS).

Análise histológica e morfométrica da área cruenta tratada com membrana de silicone: estudo em ratos

This study evaluated the effects of a silicone membrane on the treatment of the raw flesh area in wounds. The experimental study was carried out with 30 male Wistar rats divided into three groups: in the GG group, the raw area was treated with gauze, in the GH group with homograft, and in the GS group with a silicone membrane. Animals were sacrificed at fourteen days of postoperative. The studied attributes were body mass variation, histological study quantified by morphometric analysis evaluating the number of neovessels, fibroblasts, collagen fibers, leucocytes, monocytes; and using a micrometric ruler measurement of the raw area's thickness. Data were then submitted to statistical analysis. There was no significant difference between the animals' mass (p=0.0685). Predominance of neovessels (p<0.01), fibroblasts (p<0.001) and thickness of the raw flesh were observed in G S animals. There was predominance of leucocytes (p<0.021) and monocytes (p<0.0001) in G H animals. Also, no significant difference between the groups as for collagen fibers (p=0.0536) was observed. The silicone membrane promoted granulation tissue with a large number of neovessels, fibroblasts and greater thickness.

Safety of Epidural Administration of Osteogenic Protein-1 (OP-1/BMP-7)

To assess the safety of epidural administration of Osteogenic Protein-1 (OP-1). To examine if epidural administration of OP-1 or administration into the nucleus pulposus (NP) resulted in ectopic bone formation and/or pain-related behavior. OP-1 has the potential for treatment of degenerative disc disease. However, OP-1's safety, when it is applied into the epidural space or herniated nucleus pulposus, is not well established. Forty rats were divided into 5 groups. Sham group: Left L4 and L5 nerve roots were exposed. NP group: The NP obtained from the tail was relocated onto the exposed nerve roots. NP+OP group: The NP obtained from the tail and injected with 0.2 microg of OP-1 in 1 microL of 5% lactose-buffered solution was placed on the nerve roots. GS group: A gelatin sponge was applied on the nerve roots. GS+OP group: A gelatin sponge soaked with 0.2 microg of OP-1 in 1 microL of 5% lactose-buffered solution was placed onto the nerve roots. Motor function and reflex responses to mechanical noxious stimuli were measured in all rats up to 3 weeks after surgery. Three weeks after surgery, all rats were killed for analysis of ectopic bone formation and magnitude of neural compression. Motor paresis was not observed in any groups. Only rats in the NP group showed evidence of irreversible mechanical hyperalgesia after surgery. There were no differences in the mechanical stimuli response among all groups except the NP group. Macroscopic examination revealed no ectopic bone formation or differences in neural compression among the groups. OP-1 application in the epidural space is safe based on behavioral measures and macroscopic observation on ectopic bone formation at 21 days after surgery.

Population Pharmacokinetics of Mycophenolic Acid in Senile Chinese Kidney Transplant Recipients

To explore the pharmacokinetic characteristics of mycophenolic acid (MPA) among elderly Chinese kidney transplant recipients, we enrolled 24 patients over 60 years old (65.6 ± 3.6) as the (Gs) group and 24 patients of 39.6 ± 14.3 years old as a control group (Ga). Venous blood samples were taken at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, and 12 hours after the morning dose of mycophenolate mofetil at 10 to 12 weeks posttransplant. Plasma MPA concentrations were measured by a validated high-performance liquid chromatography method. Within 6-month posttransplant follow-up, there had not been an acute rejection episode when five elderly and one other adult experienced severe adverse events (SAEs), such as pneumonia and leukocytopenia. MPA area under the curve (AUC) in Gs was significantly lower than that among Ga ( P < .05), while there was no significant difference in predose, peak concentrations, or peak times ( P > .05). The concentration-time curve of Gs showed a bipeak pattern in five patients (20.8%) during the early stage (2 to 4 hours postdose). AUC in the subgroup of Gs with SAEs ( n = 5) was significantly higher than that of elderly subjects without SAEs ( n = 19) ( P = .042). When Gs were subdivided at a cutting AUC point of 25 μg/mL, the SAE incidence was significantly higher in the subgroup with a higher AUC than than those with the lower AUC ( P = .047). Through multiple stepwise regression, we obtained a minimal model to estimate MPA AUC of elderly recipients: AUC = 3.0410 + 9.8588 × C 0 + 0.5963 × C 0.5 + 2.5612 × C 3 ( R 2 = .893).

Efficacy and Safety of Voriconazole as an Additive in Optisol GS

To assess the endothelial toxicity and the microbiological efficacy of voriconazole (100 microg/mL) as an antimicrobial additive to Optisol GS. A total of 533 donor rims were studied. One half of each donor rim was placed in standard Optisol GS and the other half rim in Optisol GS fortified with voriconazole (100 microg/mL). All rims were refrigerated for 24 hours at 3 degrees C and placed in thioglycolate broth and incubated at 37 degrees C for 7 days. A pair of donor buttons not used in transplantation was stored for 2 days in each solution and examined for endothelial changes with electron microscopy (EM). A second pair of cornea buttons was examined for toxicity by endothelial staining with 0.3% trypan blue and 0.2% alizarin red. Seven of 533 corneal rim cultures were positive for fungal organisms in the Optisol GS group. No rims were positive for fungal growth in the voriconazole-fortified Optisol GS medium. The difference was statistically significant (P = 0.015; Fisher exact test). There was no difference in the cellular morphology of the button stored in voriconazole fortified Optisol GS compared with Optisol GS using EM. In the bioassay, the percentage of nonviable cells in the voriconazole-fortified medium compared with the control medium was nonsignificant (P < 0.05, Student t test). Voriconazole seems to be safe as a fortifying agent for cornea storage medium. It significantly reduces the rate of positive fungal rim cultures and shows no signs of endothelial cytotoxicity as viewed by EM and by a bioassay of trypan blue and alizarin red.

Clinical comparisons between GlideScope® video laryngoscope and Trachlight® in simulated cervical spine instability

Study Objective To compare the time taken for tracheal intubation, hemodynamic changes, and perioperative morbidities between the GlideScope® (GS) video laryngoscope and the Trachlight® (TL) with manual inline stabilization. Design Prospective, controlled, randomized study. Setting Operating room. Patients 60 ASA physical status I and II patients scheduled for elective surgery with general anesthesia. Interventions Patients were randomly assigned to the GS group or TL group (n = 30 for each group). Measurements Noninvasive blood pressure and heart rate at preinduction; preintubation and one, three, and 5 minutes after successful intubation; grade of face mask ventilation; number of intubation attempts; intubation time; apnea duration; mucosal trauma; lip or dental injury; and presence of hypoxia, were all recorded. Main Results The intubation attempts and perioperative safety data were comparable between the two groups. Intubation time and apnea duration were significantly shorter in the TL group than the GS group. All variables one minute after intubation were greater than baseline values except systolic blood pressure (SBP) in TL group. Both systolic blood pressure (SBP) and the degree of change of SBP from the baseline value one minute after intubation in TL group were significantly less than those of the GS group. Conclusions Trachlight® offers a faster intubation and a milder hemodynamic response than GS.

The GlideScope® Video Laryngoscope: randomized clinical trial in 200 patients

The GlideScope Video Laryngoscope is a new intubating device. It was designed to provide a view of the glottis without alignment of the oral, pharyngeal and tracheal axes. The aim of the study was to describe the use of the GlideScope in comparison with direct laryngoscopy for elective surgical patients requiring tracheal intubation. Two hundred patients were randomly assigned to intubation by direct laryngoscopy using a Macintosh size 3 blade (DL, n=100) or intubation using the GlideScope (GS, n=100). Prior to intubation all patients were given a Cormack and Lehane (C&L) grade by a separate anaesthetist using a Macintosh size 3 blade. The patient was then intubated, using direct laryngoscopy or the GlideScope, by a different anaesthetist during which the larynx was inspected and given a laryngoscopy score. Time to intubate was measured. In the GS group, laryngoscopy grade was improved in the majority (28/41) of patients with C&L grade >1 and in all but one of patients who were grade 3 laryngoscopy (P<0.001). The overall mean time to intubate was 30 (95% CI 28-33) s in the DL group and 46 (95% CI 43-49) s in the GS group. The time to intubate for C&L grade 3 was similar in both groups, being 47 s for the DL group and 50 s for the GS group respectively. In most patients, the GlideScope provided a laryngoscopic view equal to or better than that of direct laryngoscopy, but it took an additional 16 s (average) for tracheal intubation. It has potential advantages over standard direct laryngoscopy for difficult intubations.

The effect of gastroschisis on experimental diaphragmatic hernia in fetal rabbits

Purpose In this study, the authors analyzed the effect of experimentally induced gastroschisis on pulmonary hypoplasia in fetal rabbits with congenital diaphragmatic hernia (CDH). Methods Twenty-three pregnant rabbits underwent fetal surgery on gestational day 24 through 27. A left diaphragmatic hernia was created in 1 fetus (DH group) from each rabbit, and a left diaphragmatic hernia with gastroschisis was created in another fetus (GS group). The fetuses were delivered on gestational day 27 through 33. Histologic and morphometric examination of the lungs in each group was done. Results In the DH group, the lungs were hypoplastic with a decrease in lung weight to body weight ratio and an increase pulmonary arterial medial wall thickness. The alveolar septae were markedly thickened with increased interstitial tissue and diminished alveolar air spaces. In the GS group, the alveolar septae were thickened but narrower than those of DH group, and air spaces were increased. The pulmonary arterial wall was markedly thickened in the DH group but only slightly thickened in the GS group. Conclusions Pulmonary hypoplasia seen in newborn rabbits after experimentally induced diaphragmatic hernia is less severe in those rabbits with both gastroschisis and DH.