Nitrogen purging of oxygen pipelines: an unusual cause of intraoperative hypoxia.

Intraoperative hypoxia occurred in two patients during the maintenance of the medical gas system. Engineers were purging oxygen pipelines with nitrogen to remove particulate debris but were unaware of a connection to operating room pipelines. This case illustrates the importance of communication between anesthesia providers and engineers servicing the gas system.

Continuous regional analgesia by intraneural block: effect on postoperative opioid requirements and phantom limb pain following amputation.

The objective of this study was to assess the effectiveness of a previously described technique of regional analgesia (continuous infusion of local anesthetic through a catheter placed at the time of amputation within the exposed sciatic or posterior tibial nerve) on relieving the postoperative pain in a heterogeneous group of patients who underwent lower extremity amputations. A second objective was to determine the effect of such treatment on the incidence and characteristics of phantom limb pain 6 months or more after surgery in the same patients. The study design was retrospective, unblinded, controlled (postoperative pain), and unblinded questionnaire and interview (phantom pain) were utilized. Subjects were inpatients at Harborview Medical Center, University of Washington, Seattle, WA. Nineteen bupivacaine-treated and 40 nonbupivacaine-treated patients who underwent lower extremity amputation subsequent to trauma, infection, long-standing injury (poor or no function), congenital deformity, or burns were evaluated in the postoperative pain management assessment. Nine treated and 12 untreated patients were interviewed in the phantom pain assessment. Bupivacaine 0.5% 2-6 ml/h was infused through a polyamide 20-gauge catheter inserted into the sciatic or posterior tibial nerve sheath under direct vision at the time of surgery. All patients, treated and control, received opioid analgesics systemically during the 72-hour period of study. The postoperative opioid analgesic requirement of treated patients was compared with that of control patients who received opioid analgesics alone. A questionnaire was administered to assess presence, severity, and character of phantom pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Characterization of a gene coamplified with Ki-ras in Y1 murine adrenal carcinoma cells that codes for a putative membrane protein.

We report the sequence and genomic organization of a gene linked to Ki-ras in the mouse and coamplified in Y1 murine adrenal carcinoma cells. The entire 4.4-kb cDNA sequence as well as promoter and splice sites for each of the three exons was determined. The gene, designated KRAG (Ki-ras-associated gene) has a CG-rich first exon and promoter region and a long 3' untranslated region and encodes 216 amino acids. The putative 23.9-kDa protein has four potential transmembrane hydrophobic domains. The hydropathy plot resembles that of certain tumor-associated antigens, including CO-029 and ME491. A potential human homologue, EST05985, was identified and provisionally mapped to human chromosome 12, a chromosome syntenic to mouse chromosome 6, the previously mapped location of KRAG.