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Patient No. 1 3 4 Pain Before Procedure + + + After Procedure NA NA + Pain NA NA NA Clinical Change Tooth-to-Tooth Gap + + + tained perpendicular to the condyle coronal ; through the region of the TMJ. All images were obtained using a head coil with the patient's mouth closed. Preprocedure clinical assessment was performed before sedation or general anesthesia. Routine laboratory testing was not required. Most patients had undergone recent complete blood cell counts and basic metabolic panel screens for routine analysis of the toxicity of antiinflammatory therapy. All but one of the 17 treatments sessions were performed with deep IV sedation. This sedation consisted of IV fentanyl citrate Sublimaze, Janssen ; 13 g kg, pentobarbital sodium Nembutal, Abbott ; 25 mg kg, and midazolam hydrochloride Versed, Hoffman-LaRoche ; 0.10.3 mg kg in combination. One treatment was performed with general anesthesia because injections were administered to other joints the same day. Continuous cardiorespiratory monitoring was performed during all treatments. The procedures were performed by experienced pediatric interventional radiologists. The child was placed supine on the CT table, and the child's head was rotated 45 away from the joint to be injected. Axial CT was performed through the area of interest as a continuous acquisition with 1-mm collimation. A suitable access site was localized just anterior to the tragus, a radiopaque marker was placed, and an appropriate entry site was confirmed. The site was prepared with povidoneiodine and alcohol and draped in standard surgical manner. The access site was locally anesthetized with 1% lidocaine buffered with sodium bicarbonate 8: 2 mixture ; through a 30-gauge needle. Needle access Fig. 2 ; for injection of the joint was obtained either with a tandem needle technique with a 30-gauge needle as the guide or with a single 18- or 21-gauge needle. Satisfactory needle position within the mandibular fossa was confirmed with CT in all cases. Through the access needle, a volume of 1 mL mg ; of triamcinolone acetonide Kenalog-40, Bristol-Myers Squibb ; , a longacting steroid, was injected into the joint with a 1mL syringe, and the needle was withdrawn. The child was discharged from the postsedation recovery area when discharge criteria were met.
Experiments were conducted with approval from the local animal care and use advisory committee. The methods were the same as in our previous studies Carstens 1997; Jinks and Carstens 1998a ; and are summarized here. Single-unit recordings were made in 44 adult male Sprague-Dawley rats anesthetized with pentobarbital sodium induction: 65 mg kg iv, maintenance: 10 20 mg kg 1 h 1 via the jugular vein ; . Anesthesia was sufficient if animals were areflexic and did not exhibit tachycardia monitored by electrocardiogram ; in response to noxious stimulation. The lumbar spinal cord was exposed by laminectomy and stabilized in a frame, and the dura was opened to allow extracellular single-unit recordings with a tungsten microelectrode. Units were searched using innocuous mechanical stimulation of the ipsilateral hind paw, and only those that additionally responded to noxious skin heating 48 or 50C for 5 s ; were tested with chemical stimulation. Unit receptive fields were mapped using von Frey monofilaments with three different bending forces 0.7, 1.5, and 4 g ; see Jinks and Carstens 1998.
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Heparin fragments ranging in size from di- to oligosaccharides 14, 15 ; . Heparinase cleavage of radiolabeled heparin results in a product distribution identical to that obtained with unlabeled heparin, as described elsewhere 16 ; . Animals. For the 5-hr experiments, male Sprague-Dawley rats 300-350 g ; were anesthetized by intraperitoneal injection of sodium pentobarbital Nembutal, 50 mg kg ; . The right jugular vein was cannulated according to the method of Weeks and Davis 17 ; for blood collection. Urine was collected by bladder cannulation with polyethylene tubing PE-50; o.d., 0.038 inch ; , as described 16 ; . For the longer experiments, the jugular vein was cannulated and the animals were allowed at least 3 days to recover from the surgery. After administration of heparin, the animals were placed in Nalgene metabolic cages. All animals were fasted overnight prior to the experiments. Heparin Administration and Sample Collection. Anesthetized rats received 0.5 ml of heparin solution containing unlabeled heparin and either [35S]heparin 75 uCi ml ; or [3H]heparin 210 uCi ml ; at a total dose of 100 mg kg via a number 5 French pediatric feeding tube Argyle ; introduced into the stomach through the mouth. The solution was allowed to drain by gravity into the stomach. The residual content of the tube was emptied by injection of 0.1 ml of air followed by immediate tube removal. Nine rats were used in the 5-hr studies with [35S]- or [3H]heparin, while two groups of three rats each were used for the long-term studies. An additional group of six rats received the same amount of unlabeled heparin for the anticoagulation studies. As a control against aspiration of the solutions, anesthetized animals received 0.5 ml of 0.4% trypan blue solution GIBCO ; via an orogastric tube in the same manner as the heparin solutions were given. No blue staining of the tracheobronchial tree was noted in dissected specimens up to 5 after dye administration. The bowel was stained blue in these specimens, including the colon, showing that bowel peristalsis remained intact under anesthesia. Blood and urine samples were collected as described 16 ; and stored on ice until conclusion of the experimental period. At the end of the 5-hr experiments, the animals were bled by cardiac puncture. For the long-term experiments, blood and urine samples were collected at various time intervals, approximately every 6-12 hr, for up to 3 days. Blood samples were taken hourly for 12 hr in the group studied for anticoagulant activity. Radioactive Material in Blood and Urine. Plasma was prepared by centrifugation of citrated whole blood at 3400 x g, for 15 min at 4C. The radioactivity present in plasma and urine was determined by scintillation spectrometry. In all cases, duplicate determinations of two different aliquot sizes were made to ensure counting accuracy. Anticoagulant Activity. The anticoagulant activity was determined by a factor Xa chromogenic assay Kabi Diagnostica, Stockholm, Sweden ; . The procedure followed was that recommended by the manufacturer. In this assay, the decrease in absorption at 405 nm is linear in the range of 0-5 , ug of heparin per ml of plasma. The detection limit is -0.05 unit of heparin 0.3 , tg ; per ml. The plasma was also assayed for anticoagulant activity by the activated partial thromboplastin time aPTT ; assay Ortho Diagnostics ; . The procedure was essentially as recommended by the manufacturer except that the test plasma was assayed directly without dilution, and the mixture of plasma and activated Thrombofax reagent was incubated at 37C for 15 min rather than for 5 min. This results in increased coagulation times and better reproducibility of the aPTT values. Since base-level aPTT values are quite variable in rats 18 ; , a standard curve was prepared for each rat using plasma collected prior to the experiment. In the aPTT assay, the time for clot formation is linear with the heparin concentration in the range of 0-4 , ug of heparin per ml of plasma. The detection limit is 0.1 unit.
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Orthotopically onto the right eyes of anesthetized CB6F1 H-2b d ; mice using a procedure previously described by She et al20 and modified by He et al.21 Mice were anesthetized with an intraperitoneal injection of sodium pentobarbital 1 to 2 mg mouse; Abbott Laboratories, Chicago, IL ; . Proparacaine was used as a topical anesthetic Alcon Laboratories, Fort Worth, TX ; . Both the donor graft and the recipient graft bed were scored with 2.5-mm and 2.0-mm diameter trephines, respectively Storz Instruments, St. Louis, MO ; before removal of the corneal button using vannas scissors Storz ; . The donor graft was sewn into place using 12 interrupted 11-0 nylon sutures and a 50- zm diameter needle 2881G; Ethicon, Somerville, NJ ; . Sutures were removed 7 to 8 days later. Topical antibiotic Ocumycin; Bausch & Lomb, Tampa, FL ; was applied after surgery. No immunosuppressive drugs were used. Clinical Observations Grafted eyes were examined with a slit lamp biomicroscope at least twice a week throughout the entire study period. Graft opacity, edema, and neovascularization were scored as minimal, moderate, or severe, as previously described.22 If all three parameters became moderate or severe more than 7 days after transplantation, the graft was recorded as rejected on that day. Any host that developed complications such as cataract, anterior chamber loss, iris synechiae, or infection, was excluded from the study. Results are expressed as mean survival time standard deviation of the mean. The Mann-Whitney test was used to determine the statistical significance of the results. Heterotopic Corneal Transplants Heterotopic transplantation of LC-containing grafts is an effective method for inducing allospecific CTL and DTH responses.19 Moreover, heterotopically grafted hosts reject subsequent orthotopic corneal grafts in an accelerated fashion.23 Two LC-containing NZB limbus grafts 3.0-mm diameter ; were implanted into subcutaneous pockets in CB6F1 mice. The incisions were closed with stainless steel staples. Staples were removed 3 weeks later, and the mice were challenged with orthotopic NZB grafts. Anterior Chamber Priming The technique for transplanting alloantigenic cells into the anterior chamber of the mouse eye has been described elsewhere.18 A Hamilton Whittier, CA ; automatic dispensing apparatus was used to dispense 5 A of cell suspensions into the AC of anesthetized mice. Anterior chamber inocula consisting of either 1 X 105 nonadherent or adherent NZB or C3H spleen cells were injected into the left eyes of CB6F1 mice. In other experiments, 1 X 105 NZB corneal epithelial or.
Methods: lewis lung carcinoma llc ; cells and cardiomyoblasts were treated for 2 h with a 100 mol l concentration of xylazine, ketamine, xylazine plus ketamine xy ke ; , or pentobarbital and were measured for sup 18 f- fdg uptake
Times in seconds ; from the beginning of drug administration to lateral recumbency were as follows: ketamine, 83.7 8.7; ketaminediazepam, 61.2 4.1; tiletaminezolazepam, 55.7 4.0; and guaifenesinthiopental, 72.3 4.8. Times in minutes ; to the resumption of sternal recumbency were as follows: ketamine, 25.2 6.3; ketaminediazepam, 40.4 6.3; tiletaminezolazepam, 50.4 6.2; and guaifenesinthiopental, 63.4 8.6. Times in minutes ; to standing were as follows: ketamine, 29.2 8.4; ketaminediazepam, 46.2 7.9; tiletamine zolazepam, 53.1 6.8; and guaifenesinthiopental, 67.8 7.8. The quality of induction and the quality of anesthesia were inadequate with ketamine alone but good to excellent with the other techniques. The quality of recovery was best with ketamine diazepam, followed by guaifenesinthiopental, tiletaminezolazepam, and ketamine. The percentage of horses standing on the first attempt were as follows: ketamine, 50%; ketaminediazepam, 83%; tiletaminezolazepam, 50%; and guaifenesinthiopental, 66%. Cardiorespiratory changes were similar for all techniques, with the exception of arterial blood pressures, which were significantly lower in the guiafenesinthiopental group and pentostatin.
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Cardiorespiratory effects of anaesthesia with morphine or fentanyl in chronic renal failure and cerebral toxicity after morphine. Br. J. Anaesth. 43: 1053-1059 1971.
The identification of novel microbicidal compounds is one of the most rapidly expanding areas of HIV prevention research. In 1994, only a dozen compounds were in preclinical stages of development, with just eight ready for Phase I safety trials and none in later stages of clinical testing. Today, according to the Alliance for Microbicide Development, 38 biotech companies, 28 not-for-profit groups, and seven public-sector agencies are investigating microbicides. An estimated total of 56 products are currently in the pipeline: 34 are in preclinical stages of development, 15 are in Phase I safety trials, four are in Phase II expanded safety and preliminary effectiveness trials Savvy cream, Emmelle gel, Lactobacillus crispatus suppository, and Praneem Polyherbal suppository ; , and three are about to enter Phase II III BufferGel and Pro-2000 gel ; or Phase III Carraguard gel ; effectiveness trials. Microbicidal candidates fall into four categories--or a combination of categories--based on their mechanism of action: 1 ; products that kill or inactivate infectious pathogens; 2 ; products that block fusion, i.e., attachment of pathogens to the mucosal surface of target cells; 3 ; products that inhibit postfusion activity; and 4 ; products that enhance naturally occurring vaginal defense mechanisms. Approximately 35 of the products currently in the pipeline are contraceptive as well as microbicidal, and 21 are noncontraceptive and peppermint.
These medicines are available only with your doctor's prescription, in the following dosage forms: oral ergotamine sublingual tablets ; ergotamine and caffeine tablets and canada ; ergotamine, caffeine, and dimenhydrinate capsules canada ; ergotamine, caffeine, and diphenhydramine capsules canada ; parenteral dihydroergotamine injection and canada ; rectal ergotamine and caffeine suppositories and canada ; ergotamine, caffeine, belladonna alkaloids, and pentobarbital suppositories ; haemophilus b conjugate hem-off-fil-us bee kon-ja-gat ; vaccine is an active immunizing agent used to prevent infection by haemophilus influenza type b hib ; bacteria.
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STUDIES BY Yatsu, 1 Smith, 2 and HofP have demonstrated that pre-insult administration of pentobarbital is protective in the experimental stroke model, significantly reducing the degree of infarction and or the eventual neurological deficit. Some studies show that the protective effect can be conferred by one injection of methohexital, 1 others indicate that continued barbiturate administration produces this effect. * Shapiro has shown recently that with patients there can be a useful clinical effect gained by the administration of pentobarbital to head injuries and this effect is associated with and presumably at least in part due to the lowering of intercranial pressure.8 The pressure reduction is more marked when the intracranial pressure is raised then when it is normal. That administration after stroke onset could have a protective effect was suggested by a previous study.8 Dose dependency of a suspected pharmacological effect is a criterion for its acceptance as such. The current study was undertaken to examine the possibility of dose dependency of this post-insult protective effect. Methods Eighteen mongrel dogs weighing between 15-22 kg received preoperative atropine sulfate 0.6 mg intramuscularly. Anesthesia was induced by mask with nitrous oxide-oxygen-halothane sufficient to place an orotracheal cannula and maintained similarly at inspired concentration of 7O%-28.5%-1.5% respectively. Ventilation was controlled by a piston respirator set at a calculated minute volume of 250 ml kg. In a majority of the dogs a direct mean femoral arterial pressure was measured and varied between 75-90 torr. A peripheral venous line infused normal saline at 5 ml hr. Under sterile conditions a right temporal craniectomy was performed wide enough to allow easy elevation of the temporal lobe exposing the carotid bifurcation when the dura was opened. The right internal carotid and middle cerebral arteries were clipped in a tandem fashion by a procedure described previously.6 After closure of the muscle flap and skin, the anesthetic was discontinued and the dogs regained consciousness promptly. One hour after the clipFrom the University of California, Davis, CA 95616. Mr. Corkill is professor and Dr. Sivalingam is instructor, Dept. of Neurosurgery; Dr. Reitan is an associate professor, Dept. of Anesthesiology, School of Medicine. Drs. Gilroy and Helphrey are anesthesia residents, School of Veterinary Medicine and percodan.
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Index that was 4.0 was antagonistic, a FIC index that fell between 0.5 and 4.0 was additive or indifferent, and a FIC index that was 0.5 was indicative of synergy. Checkerboard test results represented the average of duplicate testing for each isolate. Growth curve assays were performed in 50 ml cationadjusted Mueller-Hinton broth inoculated with the test organisms at a starting concentration of 5 105 CFU ml as described previously 4 ; . Test organisms included CTS 41 lysostaphin MIC, 16 g ml; oxacillin MIC, 32 g ml ; and Butler 920 lysostaphin MIC, 1 g ml; oxacillin MIC, 32 g ml ; . Synergy was defined as suppression of growth at 24 h the presence of both antibiotics. The rabbit model of aortic valve endocarditis, as previously described 21 ; , was used to evaluate the antibiotic treatment regimens. Seventy-two hours after transcarotid placement of a polyethylene catheter across the aortic valve, 1 ml of an overnight culture containing approximately 109 CFU of the test organism Butler 920; ORSE ; ml was injected intravenously through the marginal ear vein of the rabbits. Butler 920 has previously been used in the rabbit model of endocarditis 2 ; . After 24 h, blood cultures were obtained and the rabbits were randomly assigned to one of the following treatment groups: i ; lysostaphin, 1 mg kg of body weight intravenously i.v. ; twice a day BID ; , ii ; nafcillin, 200 mg kg intramuscularly i.m. ; BID, iii ; lysostaphin, 1 mg kg intravenously BID; and nafcillin, 200 mg kg i.m. BID, iv ; vancomycin, 30 mg kg i.v. BID, or v ; no treatment control group ; . After 3 days of antibiotic treatment, surviving rabbits were sacrificed with intravenous pentobarbital and the heart and kidneys were aseptically harvested from each rabbit for quantitative counts. Tissue homogenates were also plated onto Mueller-Hinton agar containing lysostaphin 16 g ml ; order to screen for resistant subpopulations. Isolates recovered from aortic valve tissue homogenates also underwent antimicrobial susceptibility testing by the microdilution method to check for small changes in susceptibility to lysostaphin. For the final analysis, animals that fulfilled the following criteria were included: i ; positive blood culture at 24 h, ii ; survival for at least 24 h of antibiotic treatment; iii ; proper placement of the catheter across the aortic valve at necropsy with macroscopic evidence of aortic valve endocarditis visible vegetations and iv ; aortic valve vegetation and kidney tissue yielding pure cultures of the test organism. The mean number of bacteria per gram of vegetation and kidney tissue in all treatment groups was compared by the analysis of variance. The Student-Newman-Keuls test was used to adjust for multiple comparisons. A P of 0.05 was considered statistically significant. Forty-one ORSE isolates underwent testing of antimicrobial susceptibility to lysostaphin. Lysostaphin MICs ranged from 0.125 to 64 g ml, with a MIC at which 50% of the isolates tested are inhibited MIC50 ; of 4 g and a MIC at which 90% of the isolates tested are inhibited of 64 g ml. For comparison, previous work has indicated that typical lysostaphin MICs for S. aureus range from 0.007 to 0.125 g ml 7 ; order to test the hypothesis that combinations of -lactam antibiotics given with lysostaphin could improve its activity, we performed broth microdilution checkerboard testing with lysostaphin and oxacillin against 10 ORSE isolates with reduced.
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IGF-IR structure IGF-IR is composed of two extracellular -subunits that contain a ligand-binding domain and two transmembrane -subunits that possess tyrosine kinase activity, connected by disulfide bonds LeRoith, Werner et al. 1995 ; . The - and -subunits contain 706 and 627 amino acids, respectively and their molecular weights are 135kDa for and 90 kDa for Ullrich, Gray et al. 1986 ; . The ligand pockets of IGFIR are formed by the -subunits and possibly by some extracellular part of the subunits. The -subunits span the cell membrane and its intracellular part is essential for the receptor activity. It consists of a juxtamembranous tyrosine kinase part and a C-terminal domain. The structure of IGF-IR tyrosine kinase catalytic domain displays similarities with the insulin receptor, sharing sequence homology of 70% overall, 84% within the tyrosine catalytic domains and 100% within the ATP binding site, a highly conserved region of the IGF-IR Ullrich, Gray et al. 1986 ; . The structures of the IGFIR and insulin receptor catalytic domains display the typical two-lobed protein kinase fold Hubbard 1997; Favelyukis, Till et al. 2001 ; and the ATP binding and catalysis 12 and pergolide.
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Ten mongrel dogs, weighing 17 to 24 mean weight, 20.1 3.1 kg ; , were anesthetized with pentobarbital sodium 26 mg kg intravenously ; , intubated, and ventilated with a volume ventilator. Arterial blood pressure was monitored with highfidelity catheter micromanometers Millar instruments, Houston ; and the electrocardiogram was continuously monitored. A left fifth interspace thoracotomy was performed and the ITA grafts were harvested bilaterally from the chest wall with a wide pedicle. The dissection was continued proximally to the origin of the ITA and distally to the level of eighth costal interspace. The pericardium was then incised and the left atrial appendage was ligated at its tips and gently retracted with this suture to expose and perphenazine.
Iv therapy should continue for 24hrs after improvement then can switch to oral doxycycline 100mg bd plus metronidazole 400mg bd and pentobarbital.
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Barbiturates are central nervous system depressants and used as hypnotic sedatives. Overdose and extended usage of barbiturates may lead to severe and or permanent damage to the human nervous system. Barbiturates are classified as 1 ; ultra-short, 2 ; short-intermediate, and 3 ; long-acting. The duration range of the ultra shortacting compounds, secobarbital, pentobarbital etc. is from fifteen 15 ; minutes to six 6 ; hours. The duration range of the intermediate acting compounds, amobarbital, etc. is from three 3 ; to twenty-four 24 ; hours. The duration range of the long-acting compounds, phenobarbital etc. is from fifteen 15 ; to forty-eight 48 ; hours. The most commonly abused barbiturates are short- and intermediate-acting agents. The long-acting agents are rarely subject to abuse. Barbiturate derivatives are excreted into urine in varying amounts of unchanged drug and metabolites. Longacting barbiturates are excreted with a higher percentage of unchanged drugs in the urine, while shorter-acting barbiturates, secobarbital and amobarbital, are extensively metabolized and excreted in the urine with a smaller percentage of unchanged drugs
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