CXCL8 and CXCL11 chemokine secretion in dermal fibroblasts is differentially modulated by vanadium pentoxide.

An increase in skin rashes or atopic dermatitis has been observed in individuals working with vanadium. However, to the best of our knowledge no in vivo or in vitro studies have evaluated the effect of exposure to vanadium in dermal fibroblasts. Cells viability and proliferation were assessed by WST­1 assay, cells were treated with increasing concentrations of V2O5 (1, 10 and 100 nM). CXCL8 and CXCL11 concentrations were measured in the supernatants using an ELISA assay. V2O5 was not observed as having a significant effect on dermal fibroblast's viability and proliferation. However, it was revealed that V2O5 was able to induce the secretion of CXCL8 and CXCL11 chemokines into dermal fibroblasts. V2O5 synergistically increased the effect of interferon (IFN)γ on CXCL11 secretion. In addition, V2O5 synergistically increased the effect of the tumor necrosis factor α on CXCL8 secretion and abolished the inhibitory effect of IFNγ. V2O5 induction of CXCL8 and CXCL11 chemokines may lead to the appearance and perpetuation of an inflammatory reaction into the dermal tissue. Further studies are required to evaluate dermal integrity and manifestations in subjects occupationally exposed, or living in polluted areas.

Induction of Th1 chemokine secretion in dermal fibroblasts by vanadium pentoxide.

Vanadium is a soft, silvery­grey metal with a number of different oxidation states. The most common commercial form of vanadium is vanadium pentoxide (V2O5). All vanadium compounds are considered toxic. An increase in skin rashes has been observed in certain vanadium workers, including the development of atopic dermatitis. However, to the best of our knowledge, no prior in vivo or in vitro studies have evaluated the effect of vanadium exposure in human dermal fibroblasts. The present study evaluated the effect of V2O5 on proliferation and chemokine secretion in dermal fibroblasts. The results revealed that V2O5 had no significant effect on the viability or proliferation of fibroblasts, however it was able to induce the secretion of T­helper (Th)1 chemokines from dermal fibroblasts, synergistically increasing the effect of important Th1 cytokines, including interferon­Î³ and tumor necrosis factor­α. Through these processes, V2O5 may lead to the induction and perpetuation of an inflammatory reaction in dermal tissue. The induction and perpetuation of inflammation in the dermis and the variety of involved candidate genes may be at the base of V2O5­induced effects following occupational and environmental exposures. Further studies are necessary to evaluate dermal integrity and manifestations in subjects who are occupationally exposed, or living in polluted areas.

Vanadium pentoxide induces the secretion of CXCL9 and CXCL10 chemokines in thyroid cells.

Vanadium is a grey metal, existing in different states of oxidation, whose most common form in commercial products is vanadium pentoxide (V2O5). All vanadium compounds have been considered toxic. A carcinogenic role of vanadium on the thyroid has recently been proposed. However no in vivo or in vitro studies have evaluated thyroid disruption in humans and/or animals after exposure to vanadium. In the present study we evaluate the effect of V2O5 on proliferation, and chemokine secretion in normal thyrocytes. Our study demonstrated that V2O5 has no effect on thyroid follicular cell viability or proliferation, but it is able to induce the secretion of T-helper (Th)1 chemokines into the thyroid, synergistically increasing the effect of important Th1 cytokines such as interferon (IFN)γ and tumor necrosis factor (TNF)α. Through this process, V2O5 promotes the induction and perpetuation of an inflammatory reaction in the thyroid. Further studies are necessary to evaluate thyroid function, and nodules, in subjects occupationally exposed, or living in polluted areas.

Alpha subunit-dependent glycine receptor clustering and regulation of synaptic receptor numbers.

Accumulation of glycine receptors at synapses requires the interaction between the beta subunit of the receptor and the scaffold protein gephyrin. Here, we questioned whether different alpha subunits could modulate the receptors' diffusion and propensity to cluster at spinal cord synapses. Using quantitative photoactivated localisation microscopy we found that alpha-1 and alpha-3 containing glycine receptors display the same α3:ß2 stoichiometry and gephyrin binding. Despite these similarities, alpha-3 containing receptors are less mobile and cluster at higher density compared to alpha-1, with 1500 versus 1100 complexes µm-2, respectively. Furthermore, we identified a subunit-specific regulation of glycine receptor copy numbers at synapses: when challenged with interleukin 1ß, the synaptic occupancy of alpha-1 but not alpha-3 receptors was reduced. This mechanism may play a role in the cell-type dependent regulation of glycinergic currents in response to interleukin 1ß and highlights the capacity of the alpha subunits to affect receptor-gephyrin binding at synapses.

[Laryngeal mask perforation: complication of jugular vein cannulation in a newborn]. / Perforation des Luftkissenrings einer Säuglings-Larynxmaske bei der Punktion der V. jugularis interna.

This case report describes the perforation of a laryngeal mask during central venous cannulation of the internal jugular vein in a 2000 g, formerly preterm infant. The procedure was undertaken with the patient under general anaesthesia with a laryngeal mask and spontaneous breathing. As a result of the infant's clinical status, multiple needle insertions were required to obtain venous access. The needle was inadvertently advanced to the retropharynx and perforated the air-filled part of the laryngeal mask. Ventilation parameters remained stable. The laryngeal mask causes anatomical alterations of cervical structures in the newborn and therefore its use for the airway management during jugular vein cannulation appears to be limited.

[The use of laryngeal mask airway in esophagogastroduodenoscopy in children]. / L'impiego della maschera laringea nelle esofagogastroduodenoscopie in età pediatrica.

BACKGROUND: The use of laryngeal mask airway (LMA) for inducing and maintaining sedation during EGDS has never been reported in the literature but for a brief letter written by Gajraj in 1996. This study proposes the use of sevoflurane administered through LMA. METHODS: At the Pediatric Clinic of the University of Rome "La Sapienza" 80 children un-derwent EGDS. After premedication, immediate 8% sevoflurane and 60/40% N2O/O2 induction was delivered. Concentration of sevoflurane was reduced to 1% for maintaining general anesthesia. Heart rate (HR), systemic blood pressure (SBP), respiratory rate (RR), EtCO2 and SpO2 were not invasively monitored. Time for induction, time for emergence as well as complications, if any, were also evaluated. RESULTS: The monitored parameters did not show any significant changes. The time for loss of eyelash reflex and the time for end of induction were of 121+/-15 sec. 3.5+/-1.3 min respectively. The time for emergence was 3.4+/-1.8 min. Only minor complications were reported. CONCLUSIONS: The results obtained show that the use of LMA associated to sevoflurane as single inhaling agent can be a valid technique for EGDS in pediatric patients.

[The use of alfentanil for short duration surgery in pediatric anesthesia]. / L'impiego dell'alfentanil per interventi di breve durata in anestesia pediatrica.

BACKGROUND: In the present paper, the effectiveness of the alfentanyl-propofol combination versus fentanyl-propofol association in pediatric anesthesia during short surgical procedures was investigated. EXPERIMENTAL DESIGN: randomized study. SETTING: This study was carried out at the Surgical-Division of the Pediatric Clinic of the University "La Sapienza", Rome. PATIENT: 100 children (age 4.95 +/- 0.26 yr, body weight 21.13 +/- 0.86 kg) undergone to short anesthesia (50 +/- 0.01 min), were examined. PATIENTs were divided randomly into two groups, A and B, each composed of 50 children. PATIENTs in group A received an alfentanyl bolus dose of 50 micrograms.kg-1 and a continuous infusion of 0.50 microgram.kg-1.min-1, whereas patients in group B received a fentanyl bolus dose of 5 micrograms.kg-1 and a continuous infusion of 0.16 microgram.kg-1.min-1. In all patients, propofol was given in the same dose (bolus dose 1 mg.kg-1; continuous infusion 0.1 mg.kg-1.min-1) in association with opioid analgesic. MEASUREMENTS: non-invasive arterial pressure, EKG, heart rate, rectal temperature, oxygen saturation, capnography; during the postoperative course, we evaluated the motor activity response, the degree of weakfulness and consciousness. RESULTS: No significant differences between two groups in the systolic, diastolic and mean arterial pressure were pointed out whereas a decrease in heart rate in the group B and a better and more rapid restoration of breathing in group A was observed. Children of group A, after awakening, were more quiet and answered more readily to simple orders (64%). In group B 50% of children showed psychomotor unrest and 10% of them cried. The group that received alfentanyl answered more readily than group B (42% versus 26%). CONCLUSIONS: The present study shows that alfentanyl allows a better control of the surgical analgesia and it assures a good analgesic cover for all short surgical procedures without risk of early respiratory depression in postoperative period. Furthermore alfentanyl assures an early postoperative recovery due to the minimal pool, minimal undesired effects, and a cardiocirculatory stability.

[Use of the laryngeal mask for airway control in difficult intubations in children]. / L'impiego della maschera laringea per il controllo delle vie aeree e le intubazioni difficili in pediatria.

LMA was introduced in clinical practice by Arthur Brain in 1983 as a valuable substitute of tracheal tube in adult who underwent general anaesthesia; since then its applications have been extensively studied. LMA is a relatively new non-invasive ventilatory device which has allowed a radical change in the management of modern general anaesthesia. In this study, the application of LMA is assessed during induction and maintenance of general anaesthesia in children affected by severe facial deformities that could render the placement of the tracheal tube difficult. Three patients were affected by complex malformative syndromes involving the maxillo-facial skeleton and one patient presented a massive teratoma, originating from the orbit. In all these cases, LMA provided a patient airway and a satisfactory ventilation during both induction and the repeated attempts of inserting the tracheal tube; in one case, since the orotracheal intubation failed, LMA has proved to be as effective as the tracheal tube during the maintenance of general anaesthesia. Therefore, LMA is recommended as an essential ventilatory device in the hands of paediatric anaesthesiologists.

[Laryngeal mask as alternative to facial mask in the newborn]. / La maschera laringea in alternativa alla maschera facciale nel neonato.

OBJECTIVE: The present study demonstrates that the use of laryngeal mask airway (LMA) is an alternative to face-mask (FM) during induction of general anesthesia with halothane. In all patient the induction of general anesthesia is carried out by halotane and N2O/O2 50%, using only the LMA, preceding topical anesthesia of pharynx. EXPERIMENTAL DESIGN: prospective study. SETTING: this study was carried out at the surgical-division of the Pediatric Clinic, of University "La Sapienza", Rome. PATIENTS: a total of 80 newborns, average age 14.8 +/- 2.4 days and average body weight 2280 +/- 110 g were examined. INTERVENTIONS: newborns were submitted to surgery for congenital malformations, diagnostic research and positioning of a central venous catheter (CVC). MEASUREMENTS: Heart rate, non-invasive arterial pressure through cardiomonitor Hewlett Packard 78352A, oxygen saturation through Nellcor N3000, time of induction of general anesthesia and respiratory rate were assessed. RESULTS: Blood pressure and heart rate were increased during the positioning of LMA; oxygen saturation remained > or = 94% and respiratory rate was constant during the whole observation. Muscular relaxing, as an index of anesthesia, was observed after 33 +/- 1.5 sec after positioning of LMA. CONCLUSIONS: In the light of the results obtained, the use of the LMA for airway ventilation during the induction period of pediatric anesthesia is suggested.