Biomedical subjects
B McNulty
Publications and source records attributed to B McNulty.
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Neuromuscular and cardiovascular effects of doxacurium in children anaesthetized with halothane.
The neuromuscular and cardiovascular effects of doxacurium chloride (BW A938U) were evaluated in 27 children (2-12 yr) anaesthetized with 1% halothane and nitrous oxide in oxygen. In nine children the incremental technique was used to establish a cumulative dose-response curve by train-of-four stimulation. The remaining children received either 30 or 50 micrograms kg-1 of the drug as a single bolus. The median ED50 and ED95 of doxacurium in children were 19 and 32 micrograms kg-1, respectively. No clinically significant change in heart rate or arterial pressure occurred. Following doxacurium 30 micrograms kg-1 and 50 micrograms kg-1, recovery to 25% of control occurred in 25 (SEM 6) and 44 (3) min, respectively. The recovery index (25-75% of control) was 27 (2) min. The duration of action of doxacurium is similar to that of tubocurarine and dimethyl-tubocurarine in children. Compared with adults, children seem to require more doxacurium (microgram kg-1) to achieve a comparable degree of neuromuscular depression, and they recover more rapidly.
Dose-response relationships of doxacurium chloride in humans during anesthesia with nitrous oxide and fentanyl, enflurane, isoflurane, or halothane.
In a two-part study, the dose-response relationships of doxacurium chloride (BW A938U) were evaluated during general anesthesia maintained with commonly used anesthetic techniques. In part 1, cumulative dose-response methodology was used to establish the ED95 of doxacurium in 36 patients receiving 70% nitrous oxide and fentanyl, or 50% nitrous oxide and either 1.26% enflurane, 0.84% isoflurane, or 0.57% halothane anesthesia. Mechanomyographic response to train-of-four stimulation was used to monitor neuromuscular blockade. The peak effect of doxacurium following each 5 micrograms/kg incremental dose was noted and a log-probit dose-response curve was constructed for each individual patient. The median ED50s were 11 micrograms/kg, 6 micrograms/kg, 8 micrograms/kg, and 8 micrograms/kg for patients receiving fentanyl, enflurane, isoflurane, or halothane anesthesia, respectively. The median ED95s were 24 micrograms/kg, 14 micrograms/kg, 16 micrograms/kg, and 19 micrograms/kg for patients receiving fentanyl, enflurane, isoflurane, and halothane anesthesia, respectively. In part 2, 72 additional patients received a rapid single injection of the ED95 (n = 36) or 2 X ED95 (n = 36) of doxacurium appropriate for the administered anesthetic as estimated from part one of the study. Peak effects of the ED95 given as single injections correlated well with the results in part 1.(ABSTRACT TRUNCATED AT 250 WORDS)
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The effects of succinylcholine on doxacurium-induced neuromuscular blockade.
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Practice management. Making the right choice.
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Elective cesarean hysterectomy versus vaginal hysterectomy for the treatment of cervical intraepithelial neoplasia.
We retrospectively compared elective cesarean hysterectomy and vaginal hysterectomy for cervical intraepithelial neoplasia. Sixteen patients had cesarean hysterectomy and 53 had vaginal hysterectomy. There were no deaths in either group and no neonatal complications in the cesarean hysterectomy group. Major and minor complications were comparable in the two groups except that urinary tract infection was statistically more common in the cesarean hysterectomy group. The mean hospital stay for the two groups was comparable. The estimated blood loss and transfusion rate were higher in the cesarean hysterectomy group. The transfusion rate was probably artificially increased because of overzealous intraoperative transfusion. Elective cesarean hysterectomy does not cause unacceptably high morbidity, and it is an acceptable alternative to interval vaginal hysterectomy for cervical intraepithelial neoplasia in poorly compliant patients.
In vitro growth inhibition of human malignant melanoma cells by glucocorticoids.
The human malignant melanoma cell line, NEL, was found to contain glucocorticoid receptors. When the binding data were analyzed according to the method of Scatchard, results indicated a ligand binding capacity of 247 fmol/mg protein and a Kd of 1 X 10(-9) M. Additional studies show that the continuous incubation of NEL cells with triamcinolone acetonide (TA) for 72 hr results in a 30% inhibition in cell growth. To ascertain the mechanism by which glucocorticoids inhibit the growth of NEL cells, uptake and incorporation studies were carried out using various 3H precursors. Results indicate that, after 4 hr of TA treatment, a modest inhibition in [3H]thymidine uptake was observed, while stimulation of [3H]thymidine incorporation was noted at all steroid concentrations tested. However, cells incubated for 18 hr with TA (concentration, greater than or equal to 10(-8) M) showed a 30% decrease in the amount of [3H]thymidine incorporated into DNA. TA had no effect on [3H]leucine or [3H]glucose uptake after 4 hr of treatment but did inhibit [3H]glucose (42%) uptake after 18 hr of treatment. A slight stimulation (9%) in [3H]leucine incorporation was observed at this time point. When NEL cells were incubated with TA and the antiglucocorticoid, progesterone, the inhibition in [3H]thymidine incorporation was negated. These findings indicate that glucocorticoids exert some influence on the growth of human melanoma cells, and this effect is mediated through the glucocorticoid receptor.