Four applications of the anesthetic cut-off effect.

This article presents and analyses several cases in which the use of the cut-off effect is useful. It starts from the fact that an anesthetic effect of homologous agents is always expressible as a function of their chain lengths and that the cut-off point is a point at which the function vanishes. We then investigate four categories of results: (i) whole body effects.

Fiberoptic bronchoscopy in children using the laryngeal mask airway.

We describe our experience using the laryngeal mask airway (LMA) in children to facilitate diagnostic procedures in fiberoptic bronchoscopy (FOB). Two cases of stridor, two cases of protracted pneumonia, and one case of laryngotracheomalacia were studied. Intravenous atropine (0.

IL-17 regulates gene expression and protein synthesis of the complement system, C3 and factor B, in skin fibroblasts.

Human IL-17 is a cytokine secreted by CD4+-activated memory T cells with the profile of effects of a Th1 cytokine. The effects of IL-17 on many cellular constituents of joints suggest that it may participate in inflammatory joint diseases. Proteins of the complement system are known to be regulated by pro- and anti-inflammatory cytokines.

Pectoralis major muscle flap for deep sternal wound infection in neonates.

Background: Deep sternotomy wound infections during the neonatal period, their management utilizing the pectoralis major muscle flap (PMF), and their follow-up are reported.

Methods: Seven hundred-twenty consecutive pediatric cardiac operations performed from 1995 to mid 1998 in 108 neonates and 612 infants are reviewed. Nine children (1.

Decrease in asthma mortality rate in Israel from 1991-1995: is it related to increased use of inhaled corticosteroids?

Background: Asthma mortality rates (AMRs) during the last several decades increased in many countries with developed medical services, including Israel. The reasons for this trend were never established. Recent data suggested that this trend is changing.

Complement factor H gene mutation associated with autosomal recessive atypical hemolytic uremic syndrome.

Atypical hemolytic uremic syndrome (HUS) presents with the clinical features of hypertension, microangiopathic hemolytic anemia, and acute renal failure. Both dominant and recessive modes of inheritance have been reported. This study describes the genetic and functional analysis of a large Bedouin kindred with autosomal recessive HUS.

Midazolam/ketamine sedative combination compared with fentanyl/propofol/isoflurane anaesthesia for oocyte retrieval.

Assisted reproduction may be associated with repeated occasions of surgical intervention. Propofol, which is frequently used for induction of anaesthesia in such procedures, has been suspected of damaging oocytes. We compared in a randomized prospective design the use of general anaesthesia with fentanyl 0.

Distinction between processing of normal and mutant complement C3 within human skin fibroblasts.

Inherited C3 deficiency may result from mutations in the C3 gene affecting transcription or translation (type I deficiency). We described a type II C3 deficiency caused by a mutation yielding an abnormal non-secreted C3. The post-translational processing of mutant and normal C3 was analyzed in fibroblasts grown from skin biopsies.

Indoor survey of moulds and prevalence of mould atopy in Israel.

Background: Moulds are ubiquitous indoor as well as outdoor allergens and therefore potential candidates for indoor environmental control measures. However, very few studies have been performed to examine the significance of indoor moulds in allergic diseases and the effectiveness of measures to reduce the quantity of indoor moulds has not been established.

Objective: To determine the significance and the contribution of moulds to allergic manifestations.

'Respiratory epilepsy'--does it exist?

Past literature suggests a possible relationship between two recurrent illnesses: bronchial asthma and epilepsy. Only one preliminary study, performed 30 years ago, demonstrated epileptiform EEG activity in patients with bronchial asthma who were treated successfully for their asthma with antiepileptic drugs. We demonstrated epileptiform activity in six out of 24 (25%) children with bronchial asthma who had no history of neurological illnesses or epilepsy, compared to one out of 24 (4.

Hypocomplementemic autosomal recessive hemolytic uremic syndrome with decreased factor H.

We describe the clinical course, complement components, and pathological findings of 10 infants with autosomal recessive hemolytic uremic syndrome (HUS). All patients were members of one extended highly inbred Bedouin kindred. The median age of presentation was 2 weeks (range 1-20 weeks).

Fluticasone propionate 50 micrograms BID versus 100 micrograms BID in the treatment of children with persistent asthma. Fluticasone Propionate Study Group.

The aim of this multicenter, double-masked study was to compare the efficacy and safety of two different doses of inhaled fluticasone propionate dry powder--50 micrograms and 100 micrograms--administered BID via a multidose powder inhaler with those of placebo in the treatment of children with persistent asthma. After a 2-week run-in period, 263 patients were randomized to treatment with twice-daily placebo (n = 92), fluticasone 50 micrograms (n = 85), or fluticasone 100 micrograms (n = 86) for 12 weeks. One hundred sixty-six (63%) patients were male, and 224 (85%) were white, with a mean age of 8 years.

A comparison between arterial- and venous-sampled activated clotting time measurements.

In order to compare activated clotting time (ACT) sampled from an arterial (heparin-flushed) line with the control, a venous (heparin-free) line, arterial and venous ACT values were assessed before and after cardiopulmonary bypass in 150 patients while undergoing open-heart surgery. ACT was measured by Hemochron 801 automatic analyzer. Baseline arterial ACT was significantly higher than baseline venous ACT (14%; p < 0.

[Analgesia in breast surgery with interpleural bupivacaine].

A control group of 15 patients undergoing breast surgery was given general anesthesia. In 15 other patients an interpleural block with 0.4 ml/kg bupivacaine, 0.

Interleukin-1beta levels in serum and cerebrospinal fluid of children with febrile seizures.

We compared interleukin-1beta (IL-1beta) levels in peripheral blood and cerebrospinal fluid (CSF) of children with febrile seizures with those of children with febrile illnesses without seizures (control). Twenty patients were included in the study, 10 with febrile seizures and 10 with febrile illness not complicated by seizures (control). Blood and CSF were obtained after the patients' admission to the hospital.

[Separation of conjoined twins: the anesthesiologist's perspective].

Managing anesthesia care for separation of conjoined twins poses a special challenge for the anesthesia team. Early preparation, thorough understanding of the anatomical and the physiological consequences of this complex anomaly, as well as careful coordination with the teams of surgeons, nurses and operating room personnel are mandatory to assure successful separation of the conjoined twins. It is recommended that the mother be transferred to and the babies be delivered at a tertiary care medical center, like the Children's Hospital.

Pain-evoked potentials: what do they really measure?

Cerebral evoked potentials (EPs) in response to painful stimuli have been recorded since the 1970s. Based on the apparent relationship of the response amplitude to intensity of stimulation, these potentials are conventionally interpreted as reflecting the sensory-discriminative aspects of pain. As such, pain-EPs provide an objective measure for sensation of pain.

[Correlation between exposure to allergenic pollens and allergic manifestations].

Due to increase in allergic morbidity, better understanding of the relationships between environmental parameters and clinical responses of patients is needed. Serious analysis of such correlations requires examination of an entire population. So far there has been no study in Israel that examined an entire population in order to establish the distribution of inhalant allergens, the prevalence of skin hypersensitivity and allergic clinical morbidity.