Active warming, not passive heat retention, maintains normothermia during combined epidural-general anesthesia for hip and knee arthroplasty.

Study Objective: to compare passive heat retention by low-flow anesthesia, alone and with additional thermal insulation by reflective blankets, with forced-air warming preventing intraoperative hypothermia during combined epidural-general anesthesia.

Design: Randomized, controlled study.

Setting: Inpatient anesthesia at a university department of orthopedic surgery.

[Perioperative thermal homeostasis. A duty of the anesthesiologist].

Anaesthesia, surgical procedures and operating room temperature can deeply alter the human thermoregulatory system. Unexpected and sometimes serious perioperative complications can occur. Many studies have been carried out in order to describe and evaluate the detrimental effects produced by different anaesthesia procedures (whether by general, regional or integrated anaesthesia) on thermic homeostasis.

Arterial to end-tidal carbon dioxide gradient and physiological dead space monitoring during general anaesthesia: effects of patients' position.

Methods: One hundred and five ASA I-II patients, scheduled for elective surgical procedures were studied in order to evaluate the effect of different surgical postures on physiological pulmonary dead space (VDphys/ VT) and arterial to end-tidal carbon dioxide gradient [P(a-Et)CO2]. Patients were divided into four groups according to their position on the operating table: supine position (acting as control group, n = 33), 20 degree Trendelenburg position (n = 24), lateral position (n = 24) and prone position with convex saddle frame (n = 24). Physiologic dead space was measured using Enghoff modification of Bohr equation.

Cardiac performance during unilateral lumbar spinal block after crystalloid preload.

Purpose: The haemodynamic effects of crystalloid preload were evaluated in a randomised blind study in 20 ASA status I-II, 50-80 yr-old patients, undergoing unilateral spinal anaesthesia for leg surgery produced with low doses of hyperbaric bupivacaine.

Methods: Baseline non-invasive blood pressure (oscillometry), heart rate, stroke volume and cardiac index (transthoracic electrical bioimpedance) were recorded. Then, patients were randomly allocated to receive 10 ml.

Motional properties of E. coli polysaccharide K5 in aqueous solution analyzed by NMR relaxation measurements.

13C NMR relaxation measurements at three different magnetic field strengths have been used to analyse the motional properties of a low molecular weight K5 polysaccharide (delta UA-[-->4)-beta-D-GlcNAc(1-->4)-beta-D-GlcA(1-->]n-GlcNAcred) from E. coli. Two-dimensional double INEPT spectra with suppression of cross-correlation effects between dipolar and chemical shift anisotropy relaxation mechanisms were collected in order to determine carbon longitudinal and transverse relaxation times.

[Interaction of soda lime and halogenated anesthetics].

The increased use of soda lime for low flow anaesthesia leads to some problems related to the interaction with halogenated agents. These agents may be absorbed by soda lime or degradated according to their water content. Halothane and enflurane, in contact with soda lime, produce some metabolites, but their concentration is low when compared to their own lethal concentration.

Haemodynamic monitoring during alkalinized lignocaine epidural block: a comparison with subarachnoid anaesthesia.

Cardiovascular responses after epidural alkalinized lignocaine and subarachnoid hyperbaric bupivacaine administration were studied using a non-invasive cardiac output measurement in 32 ASA Grade I-II patients undergoing orthopaedic leg surgery (hip hemi-arthroplasty or Ender nailing). All patients achieved adequate surgical anaesthesia. The block onset time was faster (P = 0.

Eleven X chromosome breakpoints associated with premature ovarian failure (POF) map to a 15-Mb YAC contig spanning Xq21.

Eleven balanced X-autosome translocations associated with premature ovarian failure (POF) were mapped to a YAC contig spanning most of Xq21 and constructed between the DXS223 and DXS1171 loci. The contig corresponds to a genomic region of about 15 Mb and contains the whole X-Y homologous region. The most proximal and most distal breakpoints associated with POF were mapped 15 Mb apart.

Synthesis and biological effects of N-alkylamine-labeled low-molecular-mass dermatan sulfate.

Dermatan sulfate (DS) is a component of connective tissue and catalyzes the heparin cofactor II-mediated inhibition of thrombin. Low-molecular-mass dermatan sulfates (LMMDS) are produced to prolong the antithrombotic activity of this substance. Cleavage of DS by nitrous acid leads to an LMMDS with a terminal 2,5-anhydrotalose (At) group at the reducing end which can react with primary amines.

Cardiorespiratory changes during gynaecological laparoscopy by abdominal wall elevation: comparison with carbon dioxide pneumoperitoneum.

We have studied the cardiorespiratory changes produced by abdominal wall elevation (AWE) or carbon dioxide pneumoperitoneum (PN) in 20 women undergoing gynaecological laparoscopy. Arterial pressure, heart rate, lung/chest complicance and blood-gas tensions were measured 10 min after induction of general anaesthesia (T0), 10 min after abdominal distension in the supine position (T1) and 10 min after the Trendelenburg position was assumed (T2). Visual analogue scores for pain were recorded 1 and 6 h after the end of surgery.

1H and 13C NMR spectral assignments of the major sequences of twelve systematically modified heparin derivatives.

The complete 1H and 13C NMR spectral assignments are described for the most prevalent patterns of sulfation and acetylation which can be found in polymeric heparin or can be obtained by standard chemical modifications. These include a number of novel structures containing unsubstituted or acetylated amino groups and the first complete NMR assignments of many of the other derivatives. Beef lung heparin was chosen as a model system and studies were carried out using conditions to control the influences on the chemical shift positions in heparin samples of divalent cations and variations in pH and temperature.

HPLC of structural isomers with cyclodextrin-poly(vinylamine)-coated silica columns, Part I: Synthesis and characterization of cyclodextrin-bonded stationary phases by NMR solid state.

Different supports for high-performance liquid chromatography are prepared by using the coating technology. These supports are based on silica beads coated with a beta-cyclodextrin-containing poly(vinylamine). Surface area, pore size distribution, and solid-state nuclear magnetic resonance are used for the characterization of these supports.

Results of the representative Italian national survey on radon indoors.

A representative national survey on population exposure to radon in Italian dwellings was carried out from 1989 to 1994, with the co-operation of the National Health Service. The measurements were performed by 19 Regional Laboratories, all using the same techniques and protocols. A stratified, two-stage sampling procedure was used to sample families.

Hyperacute pneumonitis in a patient with overwhelming Strongyloides stercoralis infection.

The case of a 64-year-old man who was admitted to hospital with fever, general deterioration and anorexia is reported. For the past 4 years, the patient had been receiving corticosteroid therapy for a chronic inflammatory demyelinating polyradiculoneuropathy. Soon after admission the patient developed respiratory insufficiency as a result of a massive pneumonitis, with severe hypoxia, acute anaemia, acute renal failure and a systemic inflammatory response syndrome (SIRS) requiring admission to the Intensive Care Unit (ICU).

Comparison between hemodynamic changes after single-dose and incremental subarachnoid anesthesia.

Background And Objectives: The depressant activity on sympathetic tone of subarachnoid anesthetic block is well known. The aim of this study was to compare cardiovascular response to an incremental dose of subarachnoid anesthesia administered through a small-bore microcatheter with the response to single-dose spinal anesthesia.

Methods: The 26 ASA I or II patients, 45-65 years old, who were undergoing elective gynecologic, urologic, or orthopaedic surgery, were randomized into two groups of 13 each: the first group (SSA) underwent single-shot spinal anesthesia with 1% hyperbaric bupivacaine (0.

Characterization of sulfation patterns of beef and pig mucosal heparins by nuclear magnetic resonance spectroscopy.

Though differing only slightly in their degrees of sulfation, heparin preparations from pig mucosa and those from beef mucosa have consistently different 13C- and 1H-NMR spectra, which provide useful fingerprints for distinguishing the two types of heparin. Integrated areas of NMR signals associated with minor, undersulfated sequences (assigned by comparison with mono-dimensional spectra of selectively desulfated heparins and by analysis of two-dimensional spectra of heparins prepared from pig and beef mucosa) permit quantitation of differences in sulfation patterns. Undersulfation of pig mucosal heparins at position 6 of the hexosamine units, determined by 13C-NMR and expressed as percent glucosamines nonsulfated at C6 referred to total glucosamines, is substantially lower for pig mucosal heparins than for beef mucosal heparins (16.

Optimization and comparison of three different methods for the determination of Rn-222 in water.

Three different systems for the determination of radon in water have been examined: liquid scintillation counting (LSC), degassification followed by Lucas cell counting (LCC) and gamma counting (GC). Particular care has been devoted to the sampling methodologies of the water. Comparative results for several environmental samples are given.

Conformational analysis of heparin epoxide in aqueous solution. An NMR relaxation study.

1H and 13C NMR relaxation measurements at various magnetic fields have been used to characterize the nature of overall and internal motions in heparin epoxide in aqueous solution. A two-dimensional homonuclear NOESY experiment showed a considerable number of cross-relaxing protons in the molecule. The inter-proton distances calculated from NOE data were compared with those obtained by molecular mechanics calculations.

Magnetic bead protamine-linked microtiter assay for detection of heparin using iodinated low-molecular-mass heparin-tyramine.

We have developed a competitive heparin binding assay employing protamine-coated magnetic beads for detection and measurement of heparin. The assay utilizes 125-iodine specifically bound to newly synthesized low-molecular-mass (LMM) heparin-tyramine. The tracer was stable over a period of 3 weeks, as demonstrated by gel filtration chromatography.

Regional cerebral metabolism of glucose in comatose and vegetative state patients.

Regional cerebral metabolism of glucose (rCMRglu) was evaluated in patients who were in a coma and vegetative state to determine the level of brain function during these conditions. rCMRglu was measured in 17 discrete brain regions with (/-) [18F] -fluoro-2-deoxy-D-glucose (FDG) and positrn emission tomography (PET) in 15 patients with ;brain pathology subsequent to cardiorespiratory arrest (CA), head trauma (HT), or brain ischemia (BI) resulting from cerebrovascular accident or brain surgery. Five comatose patients (Coma group, n = 5), and 10 vegetative state patients (VS, patients awake but not aware) were studied.

Dynamics in aqueous solutions of the pentasaccharide corresponding to the binding site of heparin for antithrombin III studied by NMR relaxation measurements.

1H NMR and 13C NMR relaxation measurements at different magnetic field strengths were used to study the nature of overall and internal motions, in aqueous solution, of the synthetic pentasaccharide (A-G-A*-I-AM) corresponding to the binding site of heparin for antithrombin III. Two-dimensional double INEPT spectra were recorded at 11.7 T with and without suppression of cross-correlation effects between dipolar and chemical shift anisotropy relaxation mechanisms in measurements of spin-lattice and spin-spin relaxation times.

Metabolic and bone effects after administration of ipriflavone and salmon calcitonin in postmenopausal osteoporosis.

Forty postmenopausal women with bone mineral density (BMD) > 2 standard deviations below the mean value for healthy age matched controls were enrolled into an open controlled study to evaluate the metabolic and bone effects of ipriflavone (IP) versus salmon calcitonin (sCT) over a 12 month period. Both treatments significantly increased BMD after 6 and 12 months. A 4.

Pharmacologic profile of a low-molecular-weight heparin depolymerized by gamma-irradiation.

Low molecular weight heparins (LMWHs) are considered to be the agent of choice for the prophylaxis of DVT in medical and surgical patients. Conventionally, these agents have been produced by fractionation of or by chemical or enzymatic depolymerization of native heparin. The fractionated heparin retains many of its biological properties such as AT III affinity and sulfate content gamma-irradiation (60Co) has been used to depolymerize GAGs (De Ambrosi et al.