Setting standards for donor family care.

The number of cadaveric organs made available for transplantation will never meet the demand. Whilst measures such as "opting in", "opting out", have been offered as solutions, could extra support and care to potential donor families increase and make a difference? It may make the donor's gift seem more valued. This in turn should enhance a more positive view of organ donation among their relatives, friends and neighbours. It may be that by paying more attention to current donor families, we may increase the potential donor pool in years to come.

Pharmacological activity and safety profile of P10358, a novel, orally active acetylcholinesterase inhibitor for Alzheimer's disease.

1-[(3-Fluoro-4-pyridinyl)amino]-3-methyl-1(H)-indol-5-yl methyl carbamate (P10358) is a potent, reversible acetylcholinesterase inhibitor that produces central cholinergic stimulation after oral and parental administration in rats and mice. P10358 is a 2.5 times more potent acetylcholinesterase inhibitor than THA in vitro (IC50 = 0.10 +/- 0.02 microM vs. IC50 = 0.25 +/- 0.03 microM). It also inhibits butyrylcholinesterase activity as potently as THA (IC50 = 0.08 +/- 0.05 microM vs. IC50 = 0.07 +/- 0.01 microM). Ex vivo, P10358 (0.2 - 20 mg/kg, p.o.) produced dose-dependent inhibition of brain acetylcholinesterase activity. At 10 and 20 mg/ kg, it produced profound and long-lasting hypothermia in mice. P10358 enhanced performance in rats in a step-down passive avoidance task (0.62 and 1.25 mg/kg) and in a social recognition paradigm (0.32, 0.64 and 1.25 mg/kg) in mice. It reversed scopolamine-induced deficits in the Morris Water maze in rats (1.25 and 2.5 mg/kg) and a higher dose elevated striatal homovanillic acid levels. These behavioral and biochemical effects are consistent with central cholinergic stimulation. Hemodynamic studies in the rat demonstrated a 16-fold separation between behaviorally active doses (1.25 mg/kg) and those that elevated arterial pressure (20 mg/kg). Lethality in rats occurred at an oral dose of 80 mg/kg, but not at lower doses. Chemically, P10358 is an N-aminoindole and may not have the hepatotoxic liability associated with aminoacridine structure of tacrine. P10358 had weak affinity (>10 microM) at a variety of aminergic and peptidergic receptors and uptake carriers. These properties suggest that P10358 may be a safe and promising symptomatic treatment for Alzheimer's disease.

Rapid culture for influenza virus, types A and B, in 96-well plates.

BACKGROUND: Rapid diagnosis and typing of influenza virus are important for patient treatment and management during seasonal outbreaks. Centrifugation-enhanced rapid culture has been reported to be useful as an adjunct to traditional tube culture for rapid diagnosis of influenza virus. OBJECTIVES: We compared rapid culture in 96-well plates against standard tube culture for recovery of influenza virus, types A and B. We also tested two different cell types, MDCK and RMK, to determine if the use of multiple cell lines increases the sensitivity of rapid culture. STUDY DESIGN: The rapid method was initially evaluated by retrospective culture of previously positive frozen specimens. It was then compared to standard culture for recovery of influenza virus by parallel testing of fresh respiratory specimens. RESULTS: Of 32 previously positive frozen specimens, 28 were positive upon repeat culture. Rapid culture recovered 25 (89.3%) and standard culture recovered 23 (82.1%). All positives were type A. Of 722 fresh specimens cultured in parallel, 76 (10.5%) were positive for influenza virus: 43 for type A and 33 for type B. For type A, rapid culture recovered 42 of 43 (97.7%) and tube culture recovered 39 (90.7%). For type B, rapid culture recovered 33 of 33 (100%) and tube culture recovered 24 (72.7%). In the rapid system, the MDCK cell line was positive for 40 of 42 type A positives (95.2%) and the RMK was positive for 41 (97.6%). The MDCK line was positive for 32 of the 33 type B isolates (97.0%) and the RMK cells were positive for all 33 (100%). CONCLUSIONS: Rapid culture substantially reduced total test time and was more sensitive than tube culture. Duplicate cell lines did not significantly increase test sensitivity.

Microsurgical techniques in experimental lymphedema of the rabbit ear.

One of the main obstacles to the study of changes occurring in lymphedema and the effects of various therapeutic modalities has been the lack of a reproducible inexpensive experimental model. We believe that the rabbit ear model satisfies this requirement permitting both evaluation of changes which lead to development of lymphedema as well as evaluation of the efficacy of microsurgical techniques.

Sensory skin flaps for coverage of pressure sores in paraplegic patients. A preliminary report.

Sensory skin flaps represent a possible solution for the paraplegic who has the problem of recurrent pressure sores. An intercostal neurovascular island flap has been used in 3 cases to provide coverage for sacral ulcers. Sensation was retained to a variable degree in both adults and children. An attempt at coverage of an ischial ulcer with an intercostal neurovascular free flap is also reported. The practical and theoretical aspects of these procedures are discussed.

The deltopectoral flap: an anatomical and hemodynamic approach.

An anatomical and hemodynamic study of the deltopectoral flap in cadaver dissections and clinical cases is described. Anatomically, the deltopectoral flap represents a fusion of 3 vascular regions supplied by 3 different sets of vessels. Hemodynamically, the flap consists of a lateral cutaneous flap nourished by a medial arterial pedicle. The method of choice for delay of a deltopectoral flap is discussed.