Primary osteosarcoma of the thoracic spine: report of an unusual elderly patient with autopsy findings.

STUDY DESIGN: A case report of primary osteosarcoma of the spine in an elderly patient. OBJECTIVE: The histopathological features of osteosarcoma vary widely, often leading to diagnostic difficulties particularly when there is little evidence of osteoid formation. The report describes the difficulty in the diagnosis of osteosarcoma of the thoracic vertebra. SETTING: Department of Orthopaedics and Rehabilitation Medicine, Fukui University Faculty of Medicine, Fukui, Japan. METHOD: A 78-year-old man presented with paraparesis and underwent urgent anterior excision of a primary spinal tumor emanating from the T10 vertebra followed by artificial vertebral replacement. The patient eventually died of disseminated disease of vertebral osteosarcoma. RESULTS: Samples from the T10 vertebral tumor showed neoplastic growth of atypical spindle-shaped cells, with foci of storiform-like proliferation. The tissue also demonstrated positive immunohistochemical staining for vimentin and alpha-smooth muscle actin and a tentative diagnosis of leiomyosarcoma was made. However, a metastatic nodule of the chest wall at autopsy showed focal osteoid formation, a finding not seen in the primary tumor. CONCLUSION: Early detection and accurate diagnosis is important for improving not only patient prognosis but also the quality of life. We should always consider this rare entity, particularly in elderly patients who present with back pain and vertebral collapse.

"Deep-forehead" temperature correlates well with blood temperature.

PURPOSE: To evaluate the accuracy and precision of "deep-forehead" temperature with rectal, esophageal, and tympanic membrane temperatures, compared with blood temperature. METHODS: We studied 41 ASA physical status 1 or 2 patients undergoing abdominal and thoracic surgery scheduled to require at least three hours. "Deep-forehead" temperature was measured using a Coretemp thermometer (Terumo, Tokyo, Japan). Blood temperature was measured with a thermistor of a pulmonary artery. Rectal, tympanic membrane, and distal esophageal temperatures were measured with thermocouples. All temperatures were recorded at 20 min intervals after the induction of anesthesia. We considered blood temperature as the reference value. Temperatures at the other four sites were compared with blood temperature using correlation, regression, and Bland and Altman analyses. We determined accuracy (mean difference between reference and test temperatures) and precision (standard deviation of the difference) of 0.5 degrees C to be clinically acceptable. RESULTS: "Deep-forehead" temperature correlated well with blood temperature as well as other temperatures, the determination coefficients (r2) being 0.85 in each case. The bias for the "deep-forehead" temperature was 0.0 degrees C, which was the same as tympanic membrane temperature and was smaller than rectal and esophageal temperatures. The standard deviation of the differences for the "deep-forehead" temperature was 0.3 degrees C, which was the same as rectal temperature. CONCLUSIONS: We have demonstrated that the "deep-forehead" temperature has excellent accuracy and clinically sufficient precision as well as other three core temperatures, compared with blood temperature.

The bilateral effect of stellate ganglion block on the facial skin blood flow.

BACKGROUND AND OBJECTIVES: It is our hypothesis that stellate ganglion block increases regional blood flow on the blocked side, but does not change cardiac output, suggesting that the corresponding regional blood flow on the contralateral side may decrease, which would be disadvantageous for patients with bilateral sympathetically-maintained pain. The aim of this study is to examine the effect of stellate ganglion block on facial skin blood flow. METHODS: Skin blood flow on the right and left forehead was measured by a laser blood flowmeter before stellate ganglion block and 15 minutes after the block. The block was performed for 8 outpatients with acute or chronic pain in the head or neck using a 24-gauge needle, 5 mL of 1% mepivacaine, and a paratracheal approach at the C6 transverse process. Time control without the block was obtained with 9 healthy volunteers. RESULTS: All the patients developed the Horner's syndrome on the blocked side, but not on the contralateral side. The facial skin blood flow increased from 7.5 +/- 1.1 mL/min/100 g to 14.5 +/- 1.4 mL/min/100 g on the blocked side (P < .01) and from 8.8 +/- 1.2 mL/min/100 g to 12.8 +/- 1.7 mL/min/100 g on the contralateral side (P < .05). The healthy volunteers without the block showed no significant change (from 10.1 +/- 0.8 mL/min/100 g to 10.3 +/- 0.7 mL/min/100 g). CONCLUSIONS: Our study suggests that stellate ganglion block may increase the contralateral regional skin blood flow.

Comparative contractile effects of halothane and sevoflurane in rat aorta.

BACKGROUND: Volatile anesthetic agents have been shown to have contractile effects in vascular tissues during specific conditions. This study compared contractile effects of halothane and sevoflurane in rat aorta treated with verapamil. This study also tried to elucidate the mechanism of the contraction. METHODS: Endothelium-denuded rat thoracic aorta was used for recording of isometric tension and measurement of influx of 45Ca2+. All experiments were performed in the presence of verapamil. In recording of tension, rings were precontracted with a submaximum dose of phenylephrine, followed by exposure to halothane or sevoflurane. For measurement of influx of 45Ca2+, rat aortic strips were exposed to phenylephrine and then to additional halothane or sevoflurane. Influx of Ca2+ was estimated by incubating the strips in 45Ca2+-labeled solution for 2 min. RESULTS: Halothane (0.5-4.0%) induced contraction in a dose-dependent manner, whereas sevoflurane (1-4%) had no effect on tension. Influx of 45Ca2+ was strongly enhanced by halothane at 1% and 2%, but only slightly at 4%, and was not affected by 1-4% sevoflurane. SK&F 96365, a blocker of voltage-independent Ca2+ channels, abolished contraction and influx of 45Ca2+ by 1% halothane. Depletion of Ca2+ from the sarcoplasmic reticulum with ryanodine or thapsigargin reduced the contraction induced by halothane at 4% but not that at 1% and 2%. CONCLUSION: Halothane is suggested to cause contraction by enhancing influx of Ca2+ via voltage-independent Ca2+ channels at concentrations up to 2% and by inducing release of Ca2+ at 4%. Sevoflurane (1-4%) is devoid of these contractile effects.

Halothane decreases calcium sensitivity of rat aortic smooth muscle.

PURPOSE: To examine the effect of halothane on the cytosolic Ca2+ concentration ([Ca2+]i)-tension relationship of rat aortic smooth muscle. METHODS: Rat aortic rings without endothelia were loaded with the fluorescent Ca2+ indicator, Fura PE3-AM, and then mounted in organ baths. The changes in isometric tension and [Ca2+]i were measured simultaneously. In one series ionomycin (10 nM-3 microM) was added to normal Krebs' solution cumulatively in the absence and presence of halothane (1.5%, 3%). In the other series, CaCl2 (0.3-3 mM) was added to Ca2+-free Krebs' solution including high KCl (50 mM), phenylephrine (100 nM) or prostaglandin F2alpha (PGF2alpha, 1-3 microM) in the absence and presence of halothane (1.5%, 3%). The linear part of [Ca2+]i-tension relationship was analyzed by a linear regression. RESULTS: Halothane, 1.5%, had no effect on the normal [Ca2+]i-tension relationship obtained with the calcium ionophore, ionomycin (10 nM-3 microM), but halothane 3% decreased the slope of the relationship (0.239 +/- 0.037 for control and 0.110 +/- 0.010 for halothane 3%, P < 0.05). Halothane, 1.5% and 3%, did not change the [Ca2+]i-tension relationship obtained with CaCl2 (0.3-3 mM) in the presence of high KCl (50 mM) or phenylephrine (100 nM). In contrast, halothane, 3%, inhibited the intercept of [Ca2+]i-tension relationship obtained with CaCl2 (0.3-3 mM) in the presence of prostaglandin F2alpha (PGF2alpha, 1-3 microM) (45.708 +/- 4.233 for control and 26.997 +/- 2.522 for halothane 3%, P < 0.01). CONCLUSION: Halothane decreases the Ca2+ sensitivity and that in the presence of PGF2.

Cholinergic contraction is altered in nNOS knockouts. Cooperative modulation of neural bronchoconstriction by nNOS and COX.

Endogenous nitric oxide (NO) is a bronchodilator but its physiologic role in small airways is not clear. In this study, we investigated the role of endogenous NO in the regulation of bronchiolar tone in the small airways of wild type and NO synthase (NOS) isoform (eNOS and nNOS)-knockout mice. Pretreatment with the cyclooxygenase inhibitor indomethacin significantly enhanced electrical field stimulation (EFS)-induced contraction in the airways from all types of mice by approximately 60 to 170% (n = 8 in each case), whereas pretreatment with the NOS inhibitor, N(G)-nitro-L-arginine methyl ester (L-NAME) did not (n = 8). Combined pretreatment with L-NAME and indomethacin enhanced airway contraction of wild-type and eNOS-knockout mice to a significantly greater extent (i.e., by 140 to 290%) than did indomethacin alone (n = 8 for each). This potentiation by L-NAME was not seen in nNOS knockout mice (n = 8). Neither indomethacin nor L-NAME alone affected carbachol (CCh) potency or maximal efficacy in the airways of wild-type mice, whereas the combined pretreatment slightly enhanced the maximal response without altering the potency of CCh (n = 6). Our results show that both NO and prostaglandins modulate neuronal contraction of murine small airways. NO is produced by nNOS, which may be located in nerves, and its overall effects are tonically inhibited by cyclooxygenase products.

Endothelium-dependent sensory NANC vasodilatation: involvement of ATP, CGRP and a possible NO store.

1 Non-adrenergic non-cholinergic (NANC) vasodilator nerves regulate tone in certain vascular beds. We have investigated the mechanisms of the NANC dilator response in the isolated small mesenteric artery of the rabbit by use of the tension myograph. 2 Small second or third order (150-300 microm in diameter) arteries of the rabbit mesenteric bed were mounted in a Mulvany tension myograph. Responses to electrical field stimulation (EFS) and exogenous vasodilators were investigated. 3 EFS (0.5-16 Hz, 10 V, 0.3 ms for 5 s), in the presence of guanethidine (5 microM) and atropine (1 microM) produced frequency-dependent relaxation of small arteries. Pretreatment with tetrodotoxin (1 microM) abolished the relaxation and desensitization with capsaicin (10 microM) strongly inhibited the relaxation. 4 Pretreatment with a P2Y-purinoceptor antagonist, basilen blue (3 microM) or a human calcitonin gene-related peptide (hCGRP) receptor antagonist, hCGRP8-37 (1 microM) suppressed the NANC relaxation by approximately 40-60 % in each case and combined pretreatment almost abolished the relaxation. 5 The EFS-induced relaxation was suppressed by endothelium-removal, pretreatment with the soluble guanylyl cyclase inhibitor ODQ (1 microM) and the NO scavenger oxyhaemoglobin (OxyHb; 20 microM) but not by NO synthase inhibitors NG-nitro-L-arginine methyl ester (L-NAME; 300 microM) or NG-nitro-L-arginine (L-NOARG; 300 microM). Combined pretreatment with ODQ and CGRP8-37 almost abolished the relaxation. 6 A P2Y-purinoceptor agonist, 2-methylthio ATP, produced endothelium-dependent relaxation which was inhibited by L-NAME and ODQ (1 microM), whilst hCGRP produced endothelium-independent and ODQ-insensitive relaxation. 7 Ultraviolet light (320 nm, 5 shots over 20 s) produced relaxation that was blocked by both OxyHb and ODQ but not by NG-monomethyl-L-arginine (L-NMMA, 300 microM). 8 The present study suggests that EFS-induced NANC relaxation of the mesenteric small artery of the rabbit is mediated mainly by capsaicin-sensitive sensory C-fibres and that both ATP and CGRP are involved. The action of ATP released by EFS appears to be endothelium-dependent and involve activation of soluble guanylyl cyclase, but is resistant to inhibitors of NO synthase. The response to CGRP is endothelium-independent. These results show that ATP and CGRP account fully for the NANC relaxation of this vessel type and that the endothelium is involved in NANC-induced relaxation. The endothelium-dependent part of the response is consistent with the release of NO, either from NO synthase, incompletely inhibited by the NO synthase inhibitors, or by some preformed stores.

Different effects of halothane, isoflurane and sevoflurane on sarcoplasmic reticulum of vascular smooth muscle in dog mesenteric artery.

BACKGROUND: The direct effect of halothane on vascular smooth muscle is mediated in part via its effects on the sarcoplasmic reticulum (SR). Little information is available concerning the effects of other volatile anesthetics including isoflurane and sevoflurane, whose vascular effects differ from those of halothane. The aim of the present study was to compare the effects of halothane, isoflurane and sevoflurane on the SR by testing the contraction induced by caffeine in vascular smooth muscle. METHODS: Rings without endothelium from isolated canine mesenteric artery were mounted in physiological saline solution (PSS) for isometric tension recording. After complete depletion of Ca2+ from the SR by adding 35 mM caffeine, the rings were exposed to normal Ca2+ containing PSS (Ca2+ loading), to Ca(2+)-free PSS for 10 min, and then to 15 mM caffeine to induce contraction. Anesthetics were administered during Ca2+ loading, the Ca(2+)-free phase and simultaneously with caffeine administration. RESULTS: Halothane (0.5-2%) attenuated the caffeine-induced contraction of canine mesenteric artery when administered during Ca2+ loading in the SR (P < 0.001), whereas isoflurane and sevoflurane (1-4%) failed to affect the contraction. When given simultaneously with caffeine, halothane (1-2%) potentiated the caffeine-induced contraction (P < 0.05), but isoflurane and sevoflurane had no effect. When given before caffeine administration, halothane (0.5-2%), isoflurane (2-4%) and sevoflurane (4%) all potentiated the caffeine-induced contraction (P < 0.05). CONCLUSION: It has been shown that halothane not only potentiates caffeine-induced Ca2+ release from the SR, but also induces contraction by releasing Ca2+ from the SR. We conclude that halothane decreases Ca2+ accumulation in the SR while exerting facilitative and additive effects on caffeine-induced Ca2+ release from the SR when applied before caffeine administration and simultaneously with caffeine, respectively, whereas isoflurane and sevoflurane lack both the ability to decrease Ca2+ accumulation and an additive effect on caffeine-induced Ca2+ release from the SR, but are able to facilitate Ca2+ release by caffeine.

Thiobarbiturates suppress depolarization-induced contraction of vascular smooth muscle without suppression of calcium influx.

We have studied the effects of barbiturates on vascular smooth muscle tension and cytosolic calcium concentrations ([Ca2+]i) in endothelium-denuded rat aortic rings, preloaded with fluo-3. Changes in [Ca2+]i were estimated by the fluorescence intensity of the calcium-bound form of fluo-3. In aortic rings under basal conditions, thiobarbiturates (thiopentone and thiamylal 100-300 mumol litre-1) increased [Ca2+]i, concomitantly with an increase in tension, although oxybarbiturates (pentobarbitone and secobarbitone up to 300 mumol litre-1) had no effect. Thiopentone (300 mumol litre-1)-induced increases in tension and fluorescence intensity were mean 25.1 (SD 3.2)% and 55.0 (6.0)%, respectively, of those induced by KCl 30 mmol litre-1 (n = 8, each). In KCl (30 mmol litre-1)-precontracted aortic rings, thiopentone decreased tension without reduction of [Ca2+]i, whereas pentobarbitone decreased tension and [Ca2+]i, KCl (30 mmol litre-1)-induced contraction was suppressed by pretreatment with all barbiturates (100-300 mumol litre-1); thiopentone 300 mumol litre-1 suppressed contraction to 64.8 (2.5)% (n = 6) and pentobarbitone 300 mumol litre-1 to 57.5 (2.2)% (n = 9). However, the increase in [Ca2+]i was suppressed by oxybarbiturates (pentobarbitone 300 mumol litre-1 to 77.9 (5.2) %; n = 9), but not altered by thiobarbiturates. These results suggest that thiobarbiturates and oxybarbiturates affect vascular smooth muscle differently and that the affected site in thiobarbiturate-induced vasodilatation is distal to regulation of [Ca2+]i.

Modification of endothelium-dependent relaxation by propofol, ketamine, and midazolam.

Since volatile anesthetics, barbiturates, and local anesthetics have been reported to inhibit endothelium-dependent relaxation, we hypothesized that any drug with anesthetic action would suppress this relaxation. In the present study, using rat thoracic aortae, we attempted to determine whether nonbarbiturate intravenous anesthetics, including midazolam, propofol, and ketamine, suppress endothelium-dependent relaxation, and to clarify the mechanism(s) involved. Acetylcholine-induced, endothelium-dependent relaxation was significantly attenuated by propofol and ketamine, but was unaffected by midazolam. Sodium nitroprusside (SNP)-induced relaxation was attenuated by propofol, but not by midazolam or ketamine. The acetylcholine-stimulated 3',5'-cyclic guanosine monophosphate (cGMP) level was reduced by pretreatment with propofol and ketamine but not by midazolam, and that stimulated by SNP was reduced by propofol but not by ketamine or midazolam. We conclude that propofol and ketamine suppress endothelium-dependent relaxation, whereas midazolam has no influence. Moreover, the suppressive effect of ketamine on endothelium-dependent relaxation is mediated by suppression of nitrous oxide (NO) formation, whereas that of propofol may be mediated at least partly by suppression of NO function.

Vasodilative effect of adrenomedullin in isolated arteries of the dog.

Adrenomedullin is known to induce profound hypotension in vivo, but the direct effect of this peptide on isolated arteries has not been demonstrated. This study estimated the vasodilative effects of adrenomedullin in comparison with those of calcitonin gene-related peptide (CGRP) in basilar, mesenteric, coronary, renal and femoral arteries isolated from the dog. Adrenomedullin (3 to 100 nM) and CGRP (1 to 30 nM) induced concentration-dependent relaxation of these arteries with and without endothelium, and the relaxing effects were slightly greater in endothelium-intact arteries than in denuded ones. The vasodilative potency of adrenomedullin relative to CGRP was smaller in the femoral artery than in basilar, mesenteric, coronary and renal arteries.

Inhibitory effects of anesthetics on cyclic guanosine monophosphate (cGMP) accumulation in rat cerebellar slices.

General anesthetics, including halothane, isoflurane, and barbiturates, suppress endothelium-dependent formation of 3',5'-cyclic guanosine monophosphate (cGMP) in the systemic and cerebral vasculature. The present study was conducted to determine whether these anesthetics have similar effects on the nitric oxide (NO)-cGMP system in the brain, and to elucidate the mechanism responsible. In rat cerebellar slices, formation of cGMP was suppressed by halothane after stimulation by N-methyl-D-aspartate (NMDA, 0.1 mM) and D-aspartate (1.0 mM) but not after stimulation by sodium nitroprusside (SNP, 0.3 mM). Isoflurane (2%) suppressed NMDA (0.1 mM)-stimulated, but not D-aspartate (1.0 mM)- and nitroprusside (0.3 mM)-stimulated formation of cGMP. In contrast, thiopental (0.1-1.0 mM) suppressed NMDA (0.1 mM)-, D-aspartate (1.0 mM)-, and nitroprusside (0.3 mM)-stimulated formation of cGMP. Treatment with aminophylline (0.1 mM), a phosphodiesterase inhibitor, did not influence the effect of thiopental, suggesting that the effect of thiopental was not mediated by activation of phosphodiesterase. D-Aspartate increases intracellular calcium, which in turn activates NO synthase, and nitroprusside generates NO without activation of NO synthase. Therefore, the present findings strongly suggest that halothane inactivates NO synthase (or related cofactors) without marked interaction with the NMDA receptor, that isoflurane may interact with the NMDA receptor, receptor-coupled G-protein, or calcium channels, and that thiopental suppresses guanylate cyclase activity.

Halothane and isoflurane preferentially inhibit prostanoid-induced vasoconstriction of rat aorta.

In a previous study, we demonstrated that halothane and isoflurane inhibit binding of thromboxane A2 to its receptors on human platelets and thus inhibit prostanoid-induced aggregation strongly. The aim of this study was to determine whether volatile anaesthetics inhibit prostanoid-induced vasoconstriction preferentially. Rat isolated aortic rings were mounted in organ baths and their isometric tension was measured. They were contracted with STA2 (a stable thromboxane A2 analogue), prostaglandin F2 alpha (PGF2 alpha), phenylephrine, and 20 mM KCl, and then exposed to halothane (0.5-3%), isoflurane (0.5-3%), and sodium nitroprusside (SNP, 10(-9)-3 x 10(-7) M). Halothane (2-3%) and isoflurane (2-3%) induced greater relaxation of aortic rings precontracted with STA2 and PGF2 alpha than of those precontracted with phenylephrine (P < 0.01). Halothane induced greater relaxation of rings precontracted with KCl than phenylephrine only at 3%, whereas isoflurance relaxed rings precontracted with KCl more than those with phenylephrine at 0.5, 2 and 3% (P < 0.05). In contrast, SNP relaxed rings precontracted with PGF2 alpha. KCl and phenylephrine equally, but induced smaller relaxations of those precontracted with STA2 (P < 0.05). We conclude that halothane and isoflurane inhibit prostanoid-induced vasoconstriction preferentially, possibly by interacting with prostanoid receptors.

Halothane and enflurane constrict canine mesenteric arteries by releasing Ca2+ from intracellular Ca2+ stores.

BACKGROUND: Recent studies suggest that volatile anesthetics cause not only vasodilation but also vasoconstriction, depending on the experimental conditions. However, the mechanism of the constrictive effect of volatile anesthetics has not been clarified. The aim of this study was to evaluate the vasoconstrictor effects of halothane, enflurane, and isoflurane and to elucidate the underlying mechanism. METHODS: Vascular rings of canine mesenteric arteries were mounted in organ baths, and isometric tension changes were recorded. Changes in intracellular free Ca2+ concentration of vascular smooth muscle were examined by using the fluorescent Ca2+ indicator fura 2 and a dual-wavelength fluorometer. RESULTS: Halothane (0.75-2.3%) and enflurane (1.7-3.4%), but not isoflurane (1.2-3.5%), induced a concentration-dependent transient contraction, followed by a slight, sustained contraction. Halothane (1.5%)- and enflurane (3.4%)-induced contractions were reduced by endothelial denudation and enhanced by indomethacin (10(-5) M) treatment but were not affected by L-NG-nitroarginine (10(-5) M) or nifedipine (2 x 10(-7) M) treatment. Ryanodine (2 x 10(-5) M) treatment completely abolished the transient increases in tension and Ca2+ concentration. Even in ryanodine-treated arteries, however, both anesthetics induced a slowly developing sustained contraction, and the sustained contraction induced by enflurane (3.4%) was not accompanied by a significant increase in Ca2+ concentration. CONCLUSIONS: Halothane and enflurane, but not isoflurane, induce vasoconstriction by releasing Ca2+ from intracellular stores. Release of a vasodilating prostanoid and endothelium-derived constricting factor may also be involved in the vasoconstrictor effect. Furthermore, increased Ca2+ sensitivity of contractile machinery may be involved in the effect of enflurane.

Barbiturates inhibit endothelium-dependent and independent relaxations mediated by cyclic GMP.

The inhibitory effects of volatile and local, but not intravenous, anesthetics on endothelium-dependent relaxations of blood vessels have been demonstrated in vitro by several investigators. The aim of this study was to determine the effects of barbiturates on endothelium-dependent arterial relaxation and elucidate the mechanism(s) responsible. Canine mesenteric arteries and rat aortae were isolated, and tension changes in helical strips were recorded. Endothelium-dependent relaxations elicited by acetylcholine and bradykinin in canine mesenteric arteries, and those by acetylcholine in rat aortae, were significantly attenuated by thiopental (3 x 10(-4) M) pretreatment. Sodium nitroprusside (SNP)-induced, endothelium-independent relaxations were significantly attenuated by thiopental (10(-4)-3 x 10(-4) M). The effects of pentobarbital were less marked than those of thiopental. Acetylcholine (10(-5) M)-stimulated levels of 3',5'-cyclic guanosine monophosphate (cGMP) in rat aortae were reduced significantly by thiopental and pentobarbital (both 10(-3) M), and SNP (3 x 10(-7) M)-stimulated levels were reduced by thiopental (3 x 10(-4)-10(-3) M) and pentobarbital (10(-3) M). We conclude that barbiturates inhibit cGMP-mediated endothelium-dependent and independent arterial relaxations. Inhibition of endothelium-dependent relaxation by barbiturates may be mediated by their effects on vascular smooth muscle itself and not on endothelium.

Mechanisms of inhibition of endothelium-dependent relaxation by halothane, isoflurane, and sevoflurane.

Volatile anaesthetics inhibit endothelium-dependent relaxation, but the underlying mechanism(s) have not been clarified. In an attempt to elucidate the mechanism(s), we determined the effects of halothane, isoflurane and sevoflurane on relaxation induced by acetylcholine and sodium nitroprusside (SNP) and the cGMP formation elicited by exogenous nitric oxide (NO) and SNP in rat aortas. Acetylcholine (10(-7)-10(-5) M)-induced relaxation was attenuated by halothane (2%), isoflurane (2%) and sevoflurane (4%). SNP (10(-8) M)-induced relaxation was reduced by halothane (2%), but not by isoflurane (2%) or sevoflurane (4%). The cGMP level of NO-stimulated aorta was reduced by halothane (2%) and sevoflurane (4%), but not by isoflurane (2%). The cGMP level of SNP (10(-7) M)-stimulated aorta was reduced by halothane (2%), but not by isoflurane (2%) and sevoflurane (4%). We conclude that the mechanisms responsible for the inhibition of endothelium-dependent relaxation differ among anaesthetics. Isoflurane inhibits the relaxation mainly by inhibiting the formation of NO in the endothelium. In contrast, the effect of halothane on endothelium-dependent relaxation may be largely due to the inhibition of action of NO in the vascular smooth muscle and the effect of sevoflurane may be to inactivate NO or to inhibit the action of NO.

[Relative accuracy and precision of two non-invasive thermometry systems].

The relative accuracy and precision of the two non-invasive thermometry systems, FirstTemp (Intelligent Medical Systems, USA), an infrared tympanic thermometer, and CTM-205 (Terumo, Japan), a newly developed deep body thermometry system, were evaluated in 32 patients undergoing various surgeries under general anesthesia using esophageal temperature as the reference value. The "limits of agreement (mean difference +/- 2SD)" of the "core" temperature measured by FirstTemp and esophageal temperature was 0.4 +/- 0.5 degrees C, and was larger (P < 0.01) than those between rectal temperature and esophageal temperature (0.2 +/- 0.7 degrees C), between tympanic membrane temperature and esophageal temperature (-0.1 +/- 0.4 degrees C), and between "forehead deep body temperature" measured by CTM-205 and esophageal temperature (-0.2 +/- 0.7 degrees C). The "limits of agreement" between "forehead deep body temperature" and esophageal temperature did not differ from that between tympanic membrane temperature and esophageal temperature. The repeatability of the measurement by FirstTemp was good; the difference between paired measurement values was 0 +/- 0.2 degrees C (mean +/- 2SD). We conclude that the relative accuracy and precision of the two systems are still not sufficient for monitoring body temperature during general anesthesia.

Direct vascular effect of ropivacaine in femoral artery and vein of the dog.

A study was conducted to examine the direct vascular effect of ropivacaine, in comparison with the effect of bupivacaine and lidocaine. Changes in tension induced by ropivacaine (10(-5)-3 x 10(-3) mol l-1) and lidocaine (10(-5)-10(-2) mol l-1) were examined cumulatively in vascular rings of dog femoral artery and vein under basal tension, or in those which had been precontracted with phenylephrine submaximally in Krebs' bicarbonate solution at 37 degrees C aerated with 95% O2 and 5% CO2 (pH 7.4). The change in tension induced by 10(-2) mol l-1 ropivacaine was tested under basal tension in vascular rings bathed in HEPES buffer (pH 6.8). Ropivacaine induced greater constriction than bupivacaine at concentrations over 10(-3) mol l-1 in vascular rings under basal tension (P < 0.01). The maximal contraction was induced by ropivacaine at 10(-3) mol l-1, averaging 51.5 +/- 2.8% (n = 11) and 27.0 +/- 3.7% (n = 12) of the maximal contraction induced by epinephrine in the artery and vein, respectively, and the contractions induced by ropivacaine at 10(-2) mol l-1 were 16.3 +/- 2.0% (n = 11) and 5.5 +/- 1.1% (n = 9), respectively. Phenylephrine (10(-6) mol l-1)-precontracted artery was contracted significantly by ropivacaine at 3 x 10(-4) mol l-1 and 10(-3) mol l-1, and by bupivacaine at 3 x 10(-4) mol l-1, whereas the phenylephrine (10(-6) mol l-1)-precontracted vein was relaxed by these anesthetics. Lidocaine did not exert constricting effects.(ABSTRACT TRUNCATED AT 250 WORDS)