Measurements of Strong-Interaction Effects in Kaonic-Helium Isotopes at Sub-eV Precision with X-Ray Microcalorimeters.

We have measured the 3d→2p transition x rays of kaonic ^{3}He and ^{4}He atoms using superconducting transition-edge-sensor microcalorimeters with an energy resolution better than 6 eV (FWHM). We determined the energies to be 6224.5±0.4(stat)±0.2(syst) eV and 6463.7±0.3(stat)±0.1(syst) eV, and widths to be 2.5±1.0(stat)±0.4(syst) eV and 1.0±0.6(stat)±0.3(stat) eV, for kaonic ^{3}He and ^{4}He, respectively. These values are nearly 10 times more precise than in previous measurements. Our results exclude the large strong-interaction shifts and widths that are suggested by a coupled-channel approach and agree with calculations based on optical-potential models.

Drug administration errors: a prospective survey from three South African teaching hospitals.

This prospective study was undertaken to determine the incidence of drug administration errors by anaesthetists at three tertiary South African hospitals. Hospitals A and C treat adults predominantly, whereas Hospital B is a paediatric hospital. Anaesthetists completed an anonymous study form for every anaesthetic performed over a six-month period. They were asked to indicate whether or not an error or near-miss had occurred and if so, the details thereof. A total of 30,412 anaesthetics were administered during the study period. The response rate and combined incidence of errors and near-misses was as follows: Hospital A 48.8% (1:320), B 81.3% (1:252) and C 48.1% (1:250). The overall response rate was 53% and the combined incidence was 1:274. Neither the experience of the anaesthetist nor emergency surgery influenced whether an error occurred or not. Most errors occurred during the maintenance phase of anaesthesia. The most common errors were those of substitution. At the paediatric hospital, incorrect dose was as frequent an error as substitution. Of all errors, 36.9% were due to drug ampoule misidentification; of these the majority (64.4%) were due to similar looking ampoules. Another 21.3% were due to syringe identification errors. No major complication attributable to a drug administration error was reported. Despite an increasing awareness of the problem together with suggestions in the literature to reduce the incidence, drug administration errors remain fairly common in South Africa. Failure to institute suggested solutions will continue to compromise patient safety.

Anaesthesia for burns in children: a review of procedures practised at Red Cross War Memorial Children's Hospital, Cape Town.

Burns anaesthesia for children is a potentially hazardous procedure. We describe our technique developed over a number of years which allows a relatively large number of patients to be dealt with safety in limited theatre time. The technique involves an oral premedication with atropine (0.02 mg/kg), trimeprazine (3 mg/kg) and droperidol (0.2 mg/kg). Intramuscular ketamine (10 mg/kg) is used after an initial halothane induction and anaesthesia is maintained with intravenous ketamine, and a nitrous oxide/oxygen mixture given via nasal prongs. The advantages of the technique together with precautions and monitoring employed are discussed.

Molecular details of tomato extensin and glycine-rich protein gene expression.

In a recent publication (Plant Molecular Biology 16: 547-565 (1991)), Showalter et al. described the isolation and initial characterization of fifteen extensin and extensin-like tomato cDNAs. These cDNAs were determined to fall into five distinct classes; class I and II clones encoded extensins, class III and V clones encoded glycine-rich proteins (GRPs), and class IV clones encoded a portion of a GRP sequence on one DNA strand and a portion of an extensin sequence on the other DNA strand. In this publication, a more detailed analysis of the expression of these cDNA classes was performed with respect to wounding in various tomato organs, development, kinetics and systemic extent of the wound response, ethylene treatment, abscisic acid (ABA) treatment, and drought stress by using RNA gel blot hybridizations. In general, extensin gene expression was readily detected in stems and roots, but not in leaves. With both class I and II extensin cDNA probes, wound-induced accumulation of mRNA in stems was first detected between 4 and 8 h after wounding with maximal accumulation occurring after 12 h. Moreover, these extensin wound responses were detected locally at the wound site but not systemically. Expression of the class III GRP was largely limited to wounded stem tissue. Initial detection and maximal accumulation of the class III GRP mRNA was similar to the extensins mRNAs; however, this GRP wound response occurred both locally and systemically. Additionally, abscisic acid treatment and drought stress resulted in the marked accumulation of the class III GRP mRNA in tomato stems, but did not alter the expression of the other cDNA classes. In contrast, expression of the class V GRP occurred in stems and roots and to a lesser extent in leaves and decreased in response to wounding over a 24 h time period. The class V GRP wound response was further characterized by an early, transient accumulation of mRNA occurring 2-4 h after wounding in stems and by its local nature.

Acyl carrier protein is conjugated to glutathione in spinach seed.

Acyl carrier protein (ACP) contains an essential sulfhydryl group in its phosphopantetheine prosthetic group. We have investigated the state of this sulfhydryl in developing and mature spinach seed (Spinacia oleracea). Seed extracts were separated on sodium dodecyl sulfate or native polyacrylamide gels, blotted to nitrocellulose, and probed with antibodies raised against spinach ACP-I. In extracts of mature seeds prepared with reducing agents, ACP-II migrated as a single major band, whereas extracts prepared without reducing agents gave two major bands. The additional band was identified as a conjugate of ACP-II to glutathione (ACP-S-S-G) on the basis of its sensitivity to reducing agents and its comigration with standards in both native and sodium dodecyl sulfate gel electrophoresis. In developing spinach seeds ACP-II exists primarily in its free sulfhydryl form or as acyl derivatives, with essentially no ACP-S-S-G present. During later stages of seed development, as seed water content declines, ACP-S-S-G accumulates to approximately 50% of the total ACP. Seed imbibition results in a rapid decline in ACP-S-S-G levels. The ACP-S-S-G:ACP-SH ratio of seeds during storage was found to be a function of seed water content and this could be manipulated by controlling the relative humidity under which the seeds were stored. We speculate that conjugation of ACP to glutathione protects the ACP from sulfhydryl oxidative damage in dry seeds.

Cardiovascular and respiratory effects of oral premedication with trimeprazine and droperidol in children.

The systolic blood pressure, pulse rate and respiratory rate were assessed in 112 children before and after receiving premedication consisting of trimeprazine (3 mg/kg) and droperidol (0.2 mg/kg) by mouth. A mild (10%) drop in blood pressure was shown, but no statistical difference was found in the other parameters measured. The premedication is highly efficacious, 70% of patients being asleep in the preanaesthetic room; 27% were calm and only 3% were distressed or crying.

Recovery time after ultrabrief anaesthesia. A comparison of four techniques.

Recovery time after ultrabrief anaesthesia for minor gynaecological procedures was shown to be significantly and appreciably longer after thiopentone induction than after Althesin (alphaxalone and alphadolone), etomidate or propanidid. Suitable anaesthesia was provided by all techniques, but propanidid is associated with a 51% rise in pulse rate and etomidate with an 18% slowing. Twenty-seven per cent of patients anaesthetized with propanidid or etomidate were nauseous or vomited immediately postoperatively. Oxytocin 5 U given as an intravenous bolus for uterine contraction markedly increased heart rate (+ 29%). Althesin is now excluded on the basis of occasional adverse reactions; none of the techniques used is entirely satisfactory.

Hypo-osmolar intravascular volume overload during anaesthesia for transurethral prostatectomy. A report of 2 cases.

Two cases are reported in which absorption of surgical irrigant into the vascular system during transurethral resection of the prostate gland (TUR) resulted in life-threatening complications due to hypo-osmolar volume overload (also known as water intoxication or the TUR syndrome). Manifestations common to both cases were haemolysis of red cells, cardiac arrhythmias, a drop in the serum sodium level, and an elevated central venous pressure. In addition, one patient developed acute pulmonary oedema and the other hypokalaemia, confusion and visual disturbances due to cerebral oedema. Water as an irrigant for TUR should be superseded by glycine 1,5%, which is safer.

Anaesthetic hazards in undiagnosed myotonia dystrophica. A case report.

Respiratory and cardiovascular complications in a patient in the immediate postoperative period led to the ultimate diagnosis of myotonic dystrophy. The features and anaesthetic-related hazards of the myotonic syndromes are discussed.

Comparison of methohexitone and etomidate for general anaesthesia in unpremedicated outpatients.

This study compares methohexitone (Brietal; Eli Lilly) and etomidate (Hypnomidate; Janssen) as hypnotic agents for the induction and maintenance of general anaesthesia in outpatients given fentanyl and nitrous oxide for analgesia but no premedication. While both agents provided suitable anaesthesia with a minimal incidence of side-effects, 66% of the patients who received methohexitone were noticeably drowsy 2 hours after the operation, whereas all but 3% of the patients who received etomidate were wide awake.