Hospital ambulatory pediatric surgery

Since 1990, we have been conducting ambulatory pediatric surgery in an unit established solely for this purpose, supported by a team of kindergarten teachers, pediatric nurses, anesthesiologists and pediatric surgeons. This prospective investigation includes all ambulatory pediatric operations performed in our department from 1990 to 1995. In this time 3665 infants and children between the ages of 6 weeks and 18 years underwent an ambulatory operation. The ratio male to female was 4.1 to 1. The series consists of 1400 inguinal hernias, 722 inguinal testes, 191 hydroceles/funiculoceles, 75 umbilical hernias, 667 phimoses, 70 meatotomies, 59 hemangiomas, 217 endoscopies and 264 other surgical procedures. Postoperative complications defined as secondary hemorrhage, fever, obvious vomiting, urine retention and laryngospasm upon terminating anesthesia accompanied by subsequent vomiting occurred in 59 (1.6%) of all infants and children. Wound infections were seen in 0.48% (17/3517) of all patients. The recurrence rate for inguinal hernias were 0.79% and 1.12% for inguinal testes. Our experience enables us to summarize that a variety of pediatric operations can be performed today as ambulatory procedures. Nevertheless one must be prepared for the occurrence of complications and always have capacities free for inpatient care where adequate observation and treatment are available. Further improvement is necessary in quality management. In the last 20 years only a few data have been published about recurrence rates after pediatric ambulatory operations for inguinal hernias and inguinal testes. Therefore we started a prospective long- term study.     

Dopamine and intestinal mucosal tissue oxygenation in a porcine model of haemorrhage

Haemorrhage is associated with intestinal mucosal hypoxia and impaired gut barrier function. Dopamine increases oxygen delivery to the intestinal mucosa and may thus counteract haemorrhage-induced mucosal hypoxia. Jejunal mucosal tissue oxygen tension (mucosal PO2) and jejunal oxygen saturation of mucosal microvascular haemoglobin (mucosal HbO2) were measured in 14 anaesthetized pigs. Seven animals served as controls (group C) and seven received continuous infusion of dopamine 16 micrograms kg-1 min-1 (group D) while 45% of blood volume was removed in three equal increments. Resuscitation was performed using shed blood and fluid. Mean arterial pressure and systemic oxygen delivery decreasing significantly during haemorrhage and returned to baseline after resuscitation in both groups. Mucosal PO2 decreased from 4.4 to 1.7 kPa after haemorrhage (P < 0.01) and further to 1.5 kPa after resuscitation (P < 0.01) in group C whereas group D showed an increase from 3.9 to 5.9 kPa after the start of the dopamine infusion (P < 0.05), but no significant difference from baseline after haemorrhage (2.3 kPa) (ns) or resuscitation (3.1 kPa) (ns). Mucosal HbO2 decreased from 52 to 32% after haemorrhage (P < 0.05) and increased to near baseline (37%) (ns) after resuscitation in group C whereas group D showed no significant changes from baseline (54%) throughout the experiment. Comparison between groups showed higher mucosal PO2 and HbO2 values for group D animals after the start of the dopamine infusion (P < 0.05 each), after the first two steps of haemorrhage (P < 0.01 each) and after resuscitation (P < 0.05 each). We conclude that i.v. dopamine 16 micrograms kg-1 min-1 improved tissue oxygenation of the small intestinal mucosa during moderate haemorrhage and subsequent resuscitation.     

Effects of ketotifen on human lymphocytes in vitro and in vivo

The effects of the antiasthmatic drug ketotifen (CAS 34580-13-7) on human mononuclear leukocytes were studied in vitro and in vivo. In vitro ketotifen concentration-dependently inhibited mitogen-stimulated lymphocyte proliferation. High ketotifen concentrations also inhibited T-lymphocyte mitogen- and adenosine triphosphate stimulated increases in intracellular Ca2+ in lymphocytes and the U937 human monocyte precursor cell line, respectively; this involved inhibition of both Ca2+ influx and intracellular mobilization. In in vivo experiments, treatment of healthy volunteers with 1 mg ketotifen b.i.d. for 7 d did not alter the number or subset composition of circulating lymphocytes. Moreover, the mitogen-stimulated in vitro proliferation of lymphocytes obtained before and after ketotifen treatment in vivo was similar. It is concluded that high ketotifen concentrations can inhibit the activation of resting lymphocytes in vitro but standard ketotifen treatment does not notably affect the number of function of circulating lymphocytes in vivo.     

Extraction of penicillin G from simulated media by an emulsion liquid membrane process

The extraction of penicillin G from simulated media was performed by water/oil/water (w/o/w) emulsion liquid membranes (ELMs) and studied under various operational conditions in a batch system. The degree of extraction achieved was between 80% and 95% under specific conditions. A concentration of greater than nine times the initial concentration of penicillin G in the external phase was obtained in the internal phase. The pH of the internal aqueous solution, containing a basic salt, was theoretically calculated on the basis of the amount of penicillin G transported into the internal phase. The calculated results agreed with the experimental data well and were used to select a suitable type and concentration of a basic salt in the internal phase to give a pH within the range 5 to 8 where penicillin G was stable after the termination of extraction. The extraction of penicillin G was successfully performed by the ELM process with sodium carbonate in the internal phase.     

The neurotrophic analogue of ACTH(4-9) reduces the perineuronal microglial reaction after rat facial nerve crush

Rats bled to a severe condition of volume-controlled hemorrhagic shock were randomly assigned to one of the following treatments: (1) saline, 1 ml/kg i.v.; (2) saline, 0.2 ml/kg per min i.v. for 10 min; (3) ACTH-(1-24), 160 micrograms/kg i.v.; 4) methylprednisolone, 40 mg/kg i.v.; (5) methylprednisolone, 80 mg/kg i.v.; (6) aprotinin, 10,000 KIU/kg i.v.; (7) norepinephrine, 5 micrograms/kg per min i.v. for 10 min; (8) norepinephrine, 10 micrograms/kg per min i.v. for 10 min. All rats treated with saline or with either of the two doses of methylprednisolone, and half of the rats treated with aprotinin, died within the subsequent 2 h. On the other hand, rats treated with norepinephrine, at either dose, or with ACTH-(1-24) were all still alive 2 h later, a similar improvement in cardiovascular and respiratory parameters being obtained with the two treatments. The effect of ACTH on mean arterial pressure was however more sustained throughout the observation period. These results further support the potential usefulness of ACTH-(1-24) as first-aid treatment in cases of severe blood losses.     

Cat sera neutralize rotaviruses of serotype G3

Group A rotaviruses play an important role for the induction of gastroenteritis. Seroepidemiological studies evaluating the situation in humans have been performed previously. In this study data concerning the importance of group A rotavirus infections and the contribution of the most important serotypes are given for the domestic cat. 91% of the observed sera showed antibodies neutralizing serotype G 3. Antibodies with neutralizing properties directed against other important human serotypes could not be detected. The results obtained are discussed with respect to the formation of reassortant rotaviruses.     

Microstructural investigation of long-term degradation mechanisms in GFRP dowel bars for jointed concrete pavement

Steel dowel bar is used to transfer loads in concrete pavement slab. However, once the steel dowel bar corrodes, it may cause faults, such as joint freezing in concrete pavement, level differences resulting from spalling or decreased efficiency of load transfer, etc., which are the same problems experienced by typical reinforcing steel. This study evaluated the applicability of glass fiber-reinforced polymer (GFRP) dowel bar as a substitute for steel dowel bar. A microstructural analysis was conducted to examine the decrease in durability of GFRP dowel bar exposed to deterioration environments. To analyze the deterioration mechanism of GFRP dowel bar, scanning electron microscopy was employed and the porosity was measured by the gas absorption method. It was concluded that the longer the GFRP dowel bar was exposed to deterioration environments, the more the interlaminar shear stress decreased. This result was validated by the microstructural analysis. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008     

Preparation of monodisperse poly(vinyl alcohol) microspheres by heterogeneous surface saponification and iodine complex formation

Monodisperse poly(vinyl acetate) (PVAc) microspheres with high molecular weight obtained by suspension polymerization of vinyl acetate were saponified in alkaline aqueous solution to keep their spherical structure. The saponification was restricted on the surface of the PVAc microspheres and obtained particles had skin/core structure. Various poly(vinyl alcohol) (PVA) microspheres with different diameters and degrees of saponification (DSs) were obtained. The conversion of PVAc to PVA during the heterogeneous surface saponification time were examined by nuclear magnetic resonance spectroscopy and after 72 h hydrogel type PVA microspheres completely saponified were obtained. The crystal melting temperatures of the microspheres obtained by the saponification were measured a constant value of 238°C irrespective of varying DS, and the peaks became enlarged as reaction time. Iodine complexes were formed in saponified microspheres with DS of 41% and 99% by immersing them in I₂/KI aqueous solution and decomposed by the reduction of I₂ in the complexes to 2I^? using sodium sulfite to confirm whether the skin formed through the saponification was composed of PVA with high VA content. Obviously, characteristic blue color developments owing to I₅^?‐PVA complexes were observed in both saponified regions and a red in the PVAc core. Consequently, it was concluded that the PVA skins formed by heterogeneous surface saponification had high DSs. Such complexes endowed polymeric microspheres a good radiopacity which would be useful in clinical treatment of vascular diseases and were examined by X‐ray irradiation image. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2008