Search Results - (Author, Cooperation:J. E. Smith)

2013-05-10

Nature Publishing Group (NPG)

0028-0836

1476-4687

Biology

Chemistry and Pharmacology

Medicine

Natural Sciences in General

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Animals ; CD8-Positive T-Lymphocytes/cytology/immunology ; Chemokine CXCL9/administration & dosage/immunology ; *Chemotaxis, Leukocyte ; Female ; Herpesvirus 2, Human/immunology ; Immunity, Innate/*immunology ; Immunity, Mucosal/*immunology ; Immunologic Memory/*immunology ; Interferon-gamma/immunology ; Lymph Nodes/immunology ; Mice ; Vaccines/immunology ; Vagina/immunology

2014-10-04

Nature Publishing Group (NPG)

0028-0836

1476-4687

Biology

Chemistry and Pharmacology

Medicine

Natural Sciences in General

Physics

Animals ; Enzyme Inhibitors/*pharmacology ; Humans ; Jumonji Domain-Containing Histone Demethylases/*antagonists & inhibitors ; Macrophages/*drug effects/*immunology

2012-07-31

Nature Publishing Group (NPG)

0028-0836

1476-4687

Biology

Chemistry and Pharmacology

Medicine

Natural Sciences in General

Physics

Amino Acid Sequence ; Animals ; Biocatalysis/drug effects ; Catalytic Domain ; Cells, Cultured ; Enzyme Inhibitors/metabolism/*pharmacology ; Evolution, Molecular ; Histones/chemistry/metabolism ; Humans ; Inhibitory Concentration 50 ; Jumonji Domain-Containing Histone Demethylases/*antagonists & ; inhibitors/chemistry/classification/metabolism ; Lysine/metabolism ; Macrophages/*drug effects/enzymology/*immunology/metabolism ; Methylation/drug effects ; Mice ; Models, Molecular ; Substrate Specificity ; Tumor Necrosis Factor-alpha/biosynthesis

1471-4159

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Abstract— Pigeons working on a multiple fixed ratio 50, fixed interval 10 schedule for food reinforcement were killed at 0, 50, 90, 150 and 240 min after an i.m. injection of 300mg/kg l-tryptophan. The levels of tryptophan, 5-hydroxytryptophan, 5-hydroxytryptamine, 5-hydroxyindole acetic acid, tyrosine, dopamine and norepinephrine were concurrently measured in crude nerve ending fractions (P2) isolated from the telencephalon, diencephalon plus mesencephalon and pons plus medulla-oblongata of each pigeon. Increases in 5-hydroxytryptamine levels in the nerve ending fraction from the telencephalon were correlated with the onset of the decreased response rates, whereas a return to baseline responding was correlated with a return to normal serotonin levels in this fraction. Changes in dopamine or norepinephrine were not related to the onset of or recovery from the decreased response rate. One group of pigeons were found which did not display any behavioral disruption even though each had received an injection of l-tryptophan; the content of 5-hydroxytryptophan, 5-hydroxytryptamine and 5-hydroxyindoleacetic acid in the nerve ending fraction isolated from the telencephalon of these birds did not differ from control values.

Electronic Resource

1471-4159

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Abstract— Pigeons working on a multiple lixed-ratio 50, fixed interval 10 schedule of food reinforcement were injected with l-tryptophan (300mg/kg; I.M.) and killed at various times before, during and after the period of behavioural depression following the administration of this amino acid (0, 25, 50, 90, 170 and 230 min). The levels of tryptophan, 5-hydroxytryptophan, 5-hydroxytryptamine, 5-hydroxyindoleacetic acid, tyrosine, dopamine and norepinephrine were concurrently measured in 4 specific areas of the brain (telencephalon, diencephalon plus mesencephalon, pons plus medulla-oblongata and cerebellum). The course of the increases in the level of 5-hydroxytryptamine in the telencephalon, and subsequent return to pre-injection levels, was temporally related to the onset of the decreased responding and gradual return to normal rates of responding. Changes in dopamine and norepinephrine were not correlated with the onset of and recovery from the decreased response rates. The data in this paper are discussed in terms of (a) the previously reported work with 5-hydroxytryptophan and (b) the importance of the telencephalic serotonergic system in certain types of behavioural depression.

Electronic Resource

1471-4159

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

—Preparations of crude synaptosome fractions (P2) from the telencephalon and from the diencephalon plus optic lobes of the pigeon and from the telencephalon of the rat were used to study the effects of l-tryptophan on (a) the levels of serotonin (5-HT), norepinephrinc (NE) and dopamine in nerve endings and (b) the release of radioactive 5-HT, NE and dopamine from nerve endings. The level of 5-HT was significantly higher (P 〈 0–05) in the P2 fraction isolated from the telencephalon of pigeons given intramuscular injections of 300mg/kg of l-tryptophan in comparison to control values (1.11 ± 0.09 vs 0.74 ± 0.13 nmol/g original tissue wt). A smaller but not statistically significant increase in 5-HT was noted in the P2 fractions isolated from the diencephalon plus optic lobes of pigeons given injections of l-tryptophan. In vitro studies using preparations of synaptosomes (from both pigeon and rat) labelled with [3H]5–HT demonstrated that 1.0 mm-l-tryptophan caused a 30% increase (P 〈 0.05) in the release of [3H]5-HT over control values. This effect by l-tryptophan was blocked when a decarboxylase inhibitor was added to the medium. Tryptophan had no effect on the levels of NE or dopamine in these nerve endings nor did it have any effect on the release of these two amines from these preparations of synaptosomes. The results are discussed in terms of the role of serotonin in producing depression in pigeons working on a certain learned behavioural task.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Two cases are described in which congestion of the arm occurred during intravenous regional analgesia. One case exhibited signs of serious local anaesthetic toxicity, while a significant plasma bupivacaine level was demonstrated in the other. In a study in a volunteer, leakage of contrast medium past the cuff was demonstrated radiologically only when congestion of the arm was produced. The Hoyle double cuff apparatus has narrow runs producing less tissue compression than a standard blood pressure cuff inflated to the same pressure. It may sometimes not occlude the brachial artery when inflated to a pressure based on the systolic arterial pressure measured with a standard cuff and congestion of the arm may then result. Increases in arterial blood pressure occurring during the procedure can also lead to congestion of the arm. Congestion may increase the risk of local anaesthetic agent leaking past the tourniquet into the systemic circulation. Recommendations are made about the choice of cuff gauge pressure and the prevention of arm congestion occurring during intravenous regional analgesia.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

We have studied the extent to which learning fibreoptic nasotracheal endoscopy first helped anaesthetists to learn fibreoptic orotracheal endoscopy later, and vice versa. After preliminary training on a bronchial tree model, 30 anaesthetic trainees were randomly allocated to the nasal first/oral second group, who performed 10 nasal intubations followed by 10 oral intubations, or the oral first/nasal second group, who performed 10 oral intubations followed by 10 nasal intubations, in anaesthetised, ASA group I or II patients undergoing elective oral or general surgery. Each type of endoscopy was taught in a standard manner, with the aid of an endoscopic video-camera system, under the supervision of experienced instructors. Performing nasal endoscopy second (average 70.8 s) took significantly less time than performing it first (average 84.4 s) and performing oral endoscopy second (average 35.2 s) took significantly less time than performing it first (average 48.5 s). The mean (SD) total endoscopy time for all the endoscopies (both nasal and oral) in the nasal first/oral second group [1196 (162) s] was not significantly different from that for all the endoscopies in the oral first/nasal second group [1193 (188) s]. Because there is no advantage or disadvantage to be gained in starting to learn either type of endoscopy first, graduated training programmes can be planned according to the availability of suitable patients for fibreoptic intubation, without instructors needing to consider whether trainees make better progress if they learn one technique before the other.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

The effectiveness of fentanyl in attenuating the pressor and heart rate response to orotracheal fibreoptic intubation under general anaesthesia was assessed in 60 healthy patients undergoing elective surgery. Patients were randomly assigned to receive either fibreoptic intubation with or without fentanyl 6μg.kg−1 or traditional Macintosh intubation with fentanyl 6μg.kg−1. A standardised general anaesthetic was administered which included temazepam premedication, thiopentone, atracurium, oxygen, nitrous oxide and isoflurane. The pressor response to fibreoptic intubation was suppressed in those patients who received fentanyl and was similar to that seen in the Macintosh-fentanyl group of patients. The heart rate response to fibreoptic intubation was also significantly reduced in the patients who received fentanyl, but, in contrast, was still significantly greater than that in the Macintosh-fentanyi group. Fentanyl 6μg.kg−1 appears to have a useful place in attenuating the cardiovascular effects of fibreoptic intubation under general anaesthesia.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

We have studied the reliability of two simple pre-induction tests used to select the more patent nostril for nasotracheal intubation by comparing their results with those obtained from fibreoptic examination of the nostrils, in 75 maxillo-facial patients requiring nasotracheal intubation under general anaesthesia, who had no history of nasal obstruction. The tests comprised (1) estimation of the rate of airflow through each nostril during expiration by palpating the passage of air when the contralateral nostril was occluded, and (2) asking for the patient's assessment of airflow through the nostrils, following the administration of a vasoconstrictor. After each test, noses were classified as left or right nostril clearer or nostrils equally clear. After the induction of general anaesthesia, bilateral nasendoscopies were performed and videotape recordings of these were later analysed by an otolaryngologist who had no knowledge of the test results. Intranasal abnormalities were identified and noses were again classified as left or right nostril clearer or nostrils equally clear. There was no significant difference between the overall diagnostic success rates of the two tests (44% and 47%, respectively). In patients with intranasal abnormalities, the numbers of correct diagnoses made by the two tests were not significantly different and were also not significantly different from the number of correct selections made if only the right nostril or only the left nostril had been used for the intubation. In view of the relatively high diagnostic failure rates, anaesthetists should not rely on the two tests investigated when selecting the best nostril for nasotracheal intubation.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

We have investigated the extent to which the laryngeal mask airway, when used as an aid to fibreoptic nasotracheal video-endoscopy training, could reduce endoscopy apnoeic time in anaesthetised, paralysed oral surgery patients. Twenty anaesthetic trainees were randomly allocated to the laryngeal mask airway or control group. Laryngeal mask airway group endoscopies were performed in three stages following insertion of the laryngeal mask airway: stage 1: nasendoscopy, with the lungs ventilated automatically through the laryngeal mask airway; stage 2: removal of the laryngeal mask airway; stage 3: pharyngoscopy, larygoscopy and tracheoscopy. Control group endoscopies were performed conventionally, in one stage. Each trainee performed five nasotracheal intubations. Though total endoscopy time in the laryngeal mask airway group (stage 1 + stage 2 + stage 3 times) was significantly longer (average 136 s vs. 108 s), apnoeic time (stage 2 + stage 3 times) was significantly shorter (average 59 s vs. 108 s) than endoscopy time in the control group. This application of the laryngeal mask airway may have a useful role to play in ensuring patient safety during early fibreoptic training.

Electronic Resource

1365-3180

Blackwell Publishing Journal Backfiles 1879-2005

Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

We have followed the progress of 12 anaesthetic trainees as they learnt how to perform fibreoptic nasotracheal intubation with the aid of an endoscopic video camera system. Each trainee had a structured teaching session on a bronchial tree model, viewed an instructional videotape and then performed 20 nasotracheal intubations on anaesthetised oral surgery patients. Trainees were required to perform the endoscopies under full visual control and to demonstrate airway anatomy as they advanced the fibrescope. They were allowed up to two 2½ min periods to complete nasotracheal endoscopy. All 240 endoscopies were completed within the time limit: 228 were completed within 2½ min and 12 (5%) were completed during the second 2½ min period. We constructed a group learning curve from the pooled data. The half-life of the curve was nine endoscopies. The best fit value for the first endoscopy time was 132 s, and after the 18th (two half-lives) it was 49 s. We analysed the theoretical basis for deriving a learning curve from raw data. This information could form a rational basis for the design of fibreoptic training programmes using video imaging systems.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

We have assessed the effectiveness of three tracheal tube rotational movements in assisting nasotracheal tube placement over the fibreoptic laryngoscope. Ninety ASA grade 1 or 2 oral surgery patients undergoing fibreoptic nasotracheal intubation under general anaesthesia were studied. After the fibrescope had been positioned in the trachea, patients were randomly allocated to one of three groups. In group 1, no rotation was used and the tube was advanced towards the trachea in the neutral position. In group 2, the tube was rotated by 90° anticlockwise. In group 3, the tube was rotated by 180° anticlockwise, then rotated back to 90° anticlockwise (overcorrected rotation). If resistance to the advance was encountered, up to two more attempts were allowed, after further rotational manoeuvres had been made, in accordance with a standard, graduated sequence. There were significantly more successful tube placements at the first attempt in groups 2 and 3 (93% and 100% respectively) than in group I (63%). It is therefore recommended that 90° anticlockwise or overcorrected 90° anticlockwise tube rotation is used to facilitate nasotracheal tube placement during fibreoptic intubation.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

We have compared the progress of anaesthetists taught fibreoptic techniques on awake patients in ear, nose and throat clinics with that of anaesthetists taught by traditional methods. Twelve anaesthetists participated in the study and were randomly allocated to the ear, nose and throat group or to the traditional training group. Each individual in the ear, nose and throat group attended the outpatient clinic and performed ten nasendoscopies on awake patients, whose upper airway had been anaesthetised with cocaine, under the supervision of an ear, nose and throat surgeon. Each individual in the traditional group performed ten nasendoscopies on anaesthetised oral surgery inpatients under the supervision of an anaesthetist. To assess the effectiveness of the two training methods, each anaesthetist in each group then attempted ten fibreoptic nasotracheal intubations on anaesthetised oral surgery patients. There was no significant difference between either the success rates or mean successful tracheoscopy times between the two groups. Nasendoscopy training in the ear, nose and throat clinic appears to be a good way of learning fibreoptic skills, which can then be readily applied to fibreoptic tracheal intubation in anaesthetic practice.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

The cardiovascular responses to fibreoptic orotracheal intubation under general anaesthesia were compared with those in a control group in whom tracheal intubation was effected with a Macintosh laryngoscope. The patients received a standard anaesthetic and were allocated randomly to either group immediately before intubation. Fibreoptic intubation took significantly longer to perform. There were significant increases in heart rate and arterial pressure in both groups compared with pre-induction values. The tachycardia in the fibreoptic group was significantly greater than that in the control group during the second minute after intubation, and the increase in systolic pressure was sustained for a longer period in the fibreoptic group. The maximum increases in systolic and diastolic pressures above pre-intubation values were significantly greater in the fibreoptic group. The cardiovascular responses associated with fibreoptic intubation under general anaesthesia appear to be more severe than those which follow intubation effected with a Macintosh laryngoscope.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Intubation time, arterial pressure, heart rate and arterial oxygen saturation during nasotracheal intubation effected with the Macintosh laryngoscope blade were compared with those during orotracheal intubation. The 60 patients studied received a standardised general anaesthetic and were randomly allocated to one of two groups immediately before tracheal intubation. The mean nasal intubation time (33.2 seconds) was significantly greater than mean oral intubation time (14.8 seconds). The mean arterial pressure changes in the nasal group were significantly greater and more prolonged than in the oral group. The mean heart rate in the nasal group was significantly lower than in the oral group during the first minute after intubation, after which heart rates were similar. There were no significant differences between the two groups with regard to arterial oxygen saturation levels at any stage.

Electronic Resource

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

The cardiovascular effects of fibrescope-guided nasotracheal intubation were compared to those of a control group of patients who were intubated using the Macintosh laryngoscope. The 60 patients studied received a standard anaesthetic technique which included a muscle relaxant and were allocated randomly to one of two groups immediately before tracheal intubation. Systolic and diastolic arterial pressures in the fibreoptic group were significantly lower than in the control group during the first minute after intubation. The maximum increase in diastolic pressure was significantly lower in the fibreoptic group. The heart rate in the fibreoptic group was significantly higher than in the control group during all five minutes after intubation. The maximum increase in hearl rate was significantly higher in the fibreoptic group. The cardiovascular responses to fibreoptic nasotracheal intubation under general anaesthesia should not cause undue concern in fit patients, but appropriate measures should be taken to prevent excessive tachycardia in compromised patients.

Electronic Resource

1095-8649

Blackwell Publishing Journal Backfiles 1879-2005

Biology

Principal components analysis revealed two main groups among 163 Vibrio anguillarum cultures from diseased fish from Norwegian waters. Nearly all isolates from farmed salmonids fell in group I (arabinose positive) but those from wild fish, particularly saithe Gadus virens, more commonly appeared in group II (arabinose negative).

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