Experimental constraints on left-right symmetric models from muon decay.

The TWIST Collaboration has completed a new measurement of the energy-angle spectrum of positrons from the decay of highly polarized muons. A simultaneous measurement of the muon decay parameters ρ, δ, and P(µ)(π)ξ tests the standard model in a purely leptonic process and provides improved limits for relevant extensions to the standard model. Specifically, for the generalized left-right symmetric model |(g(R)/g(L))ζ|<0.020 and (g(L)/g(R))m(2)>578 GeV/c(2), both 90% C.L.

Measurement of the Michel parameter rho in muon decay.

The TWIST Collaboration has measured the Michel parameter rho in normal muon decay, mu(+)--> e(+)nu(e)nu (mu). In the standard model, rho = 3/4. Deviations from this value imply mixing of left- and right-handed muon and electron couplings. We find rho=0.750 80+/-0.000 32(stat) +/- 0.000 97(syst) +/- 0.000 23, where the last uncertainty represents the dependence of rho on the Michel parameter eta. This result sets new limits on the W(L)-W(R) mixing angle in left-right symmetric models.

Accuracy of text entries within a manually compiled anaesthetic record.

We have examined the accuracy of text entries within a manually compiled anaesthetic record by comparing the record of the anaesthetist with that of an observer, present throughout the procedure but whose sole purpose was the documentation of perioperative events. Eighty-six items of information were analysed for accuracy from 197 records. The mean proportion of omissions was 35% and the mean proportion of incorrect entries was 3.4%. Where no entry should have been made, the mean proportion of unwarranted entries was 1%. Accuracy varied according to the information contained; however, omissions were common for preoperative status, fluids, tourniquet use, aspects of monitoring, local anaesthesia and intraoperative problems. The most consistently accurate information was the description of the patient and that relating to intraoperative i.v. drug use. Inaccuracy was common for the majority of sites on the record, irrespective of their reflecting on the anaesthetist's performance. We suggest, therefore, that the reason for this inaccuracy of data was not related principally to anaesthetists' defensiveness, but may reflect their attitudes to the record's value and response to inadequacies in its design. The observed deficiencies in recording accuracy may affect patient safety during future anaesthesia and has relevance to medico-legal and epidemiological research.

The anaesthetic record: a confidential survey on data omission or modification.

A confidential survey was conducted among medical practitioners in New Zealand with a stated interest in anaesthesia to ascertain the proportion of those currently engaged in anaesthetic practice (thought to be approximately 325), who knowingly omit or alter undesirable physiological parameters from the anaesthetic record. Two hundred and forty-five replies were received from currently active anaesthetists. The reported frequency of occasional data omission or falsification was 55%. Those anaesthetists who intentionally manipulated data were more likely to be dissatisfied with their current anaesthetic record form, to view the record as an intraoperative distraction and less likely to perceive the record as being important for the use of future anaesthetists. There was no correlation between data manipulation and concerns over the medicolegal uses of the record.

Pituitary and cerebellum of nude mice.

The anterior pituitary of athymic homozygous "nude" (nu nu) mice shows signs of reduced activity of the acidophilic cells, nuclear volumes of which lag significantly behind normal values. Also there is a significant deficiency in the number of basophilic cells. A similar deficiency is found in the numbers of Purkinje cells of the cerebellum, which in addition also show a reduction in size, as part of an overall reduction of cerebellum size.

Pituitary fossa injection with alcohol for widespread cancer pain.

Trans-sphenoidal injection of 95 percent dehydrated alcohol into the pituitary fossa was attempted in 10 patients to control pain associated with widely disseminated metastatic cancer. Significant pain relief was obtained in eight patients, some of whom had tumours not recognised as being hormone sensitive. Effects of pituitary destruction were easily managed, and there were few complications. There was no mortality directly attributable to the injection.

The elimination of pollution by a non inhalational technique.

A method is described whereby major surgery can be accomplished without inhalational anaesthtic agents, thus completely eliminating operating room pollution. The method is based on the balanced use of three intravenous agents--morphine, alcuronium and gamma-hydroxybutyrate (GHB). In the dose chosen for GHB, reliable unconsciousness can be produced for surgery of any length, and using physostigmine as an antidote, patients can be wakened within ten minutes. The advantages are convenience, simplicity of equipment, low cost, absence of pollution and good patient acceptance. The disadvantages are a certain incidence of hypertension and in this series, a small failure rate with the antidote.

Endogenous opiates-a progress report.

The "opiate receptor" has become a well-accepted entity, stimulating the search for an endogenous agonist. This has successfully revealed several different endogenous peptide opiates whose physiological role is under intense investigation, contributing to our understanding of pain and of opiate tolerance and dependence. A review of the current literature is presented.

Reversal of the anaesthetic action of sodium gamma-hydroxybutyrate.

Physostigmine was administered intravenously to 25 patients, anaesthetised with sodium gamma-hydroxybutyrate (GHB), and their emergence from anesthesia was studied. Physostigmine (2 mg) brought about rapid, safe, reliable and sustained awakening after a "latent period" varying from 2-10 minutes (mean 6-2 minutes+/-S.D. 2-2) in 24 patients. In the one patient not awake at 10 minutes, a second dose of physostigmine produced awakening in an additional 8 minutes. No serious side effects were attributable to the physostigmine. This finding may warrant a reconsideration of the place of GHB in anaesthetic practice.