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Many pediatric anesthesiologists divide acetaminophen suppositories to achieve an approximate dose. In this three-part study we first surveyed pediatric anesthesiologists regarding their attitudes and frequency of this clinical practice. Second, acetaminophen suppositories were divided for analysis of acetaminophen content. Finally, the accuracy of pediatric anesthesiologists in dividing suppositories was assessed. The survey indicated 50% of anesthesiologists believed acetaminophen was nonuniform and 62% believed the alteration of suppositories was inaccurate. The laboratory investigation revealed uniform distribution of acetaminophen but poor accuracy in achieving the target dose. The findings suggest using only intact suppositories for improved accuracy.

We describe a novel UV-curable mold that is stiff enough for replicating dense sub-100-nm features even with a high aspect ratio. It also allows for flexibility when the mold is prepared on a flexible support such that large area replication can be accomplished. The composite material of the mold is inert to chemicals and solvents. The surface energy is made low with a small amount of releasing agent such that the mold can be removed easily and cleanly after patterning. In addition, the material allows self-replication of the mold. These unique features of the mold material should make the mold quite useful for various patterning purposes.

The anesthetic management of renal transplant recipients requires the maintenance of an adequate perfusion pressure to ensure viability of the donated kidney. A common finding among patients with end-stage renal disease is chronic hypertension. We report a case involving a 2-year-old child with an age-adjusted blood pressure below normal, undergoing transplantation of an adult cadaveric kidney, during which high-dose vasopressor medications were used to sustain the child's blood pressure at above-normal levels to help ensure perfusion of the adult allograft.

We aimed to verify the prognostic factors of stage II rectal cancer and the effect of radiation therapy on the survival and local recurrence rate.This study was undertaken in 202 patients who underwent curative resection of rectal cancer and confirmed to be stage II between July 1989 and December 1996. Univariate and multivariate (Cox's model) analyses of survival were employed to identify prognostic factors. Statistical significance was assigned by p value of0.05.Overall recurrence occurred in 32 patients. Four patterns of recurrence were observed: hematogenous recurrence in 17 patients, local recurrence in 11, peritoneal seeding in two and simultaneous hematogenous and local recurrence in two cases. Overall 5-year survival rate was 85.6% and 5 year disease free survival rate was 82.8%. There was no significant difference in local recurrence rate and survival according to radiation therapy or location of cancer. In multivariate analysis, the number of harvested lymph node was only a prognostic factor.The number of harvested lymph nodes has prognostic value in stage II rectal cancer. Postoperative radiation therapy should be considered for stage II rectal cancer with poor prognostic factors although radiation did not decrease local recurrence rate in present study.

A 3-yr-old female with cryptogenic cirrhosis presented for a liver transplant. After the induction and intubation, we performed a supplemental caudal block with a 22-gauge B-bevel needle in the usual sterile fashion, and 0.6 mg of Duramorph was injected without complications. Initially, the 14.9-kg child received a total of 110 microg of fentanyl in the first 2 h of the 6-h operation and was maintained on air-oxygen-isoflurane. The child was easily tracheally extubated and remained hemodynamically stable. In the pediatric intensive care unit, she was weaned off oxygen, out of bed, and required minimal pain control in the first 18 h.

We have analyzed low density lipoproteins (LDL) apolipoprotein (apop) B structure by direct sequence analysis of LDL apo B-100 tryptic peptides. Native LDL were digested with trypsin, and the products were fractionated on a Sephadex G-50 column. The partially digested apo B-100 still associated with lipids was recovered in the void volume (designated trypsin-nonreleasable, TN, peptides). The released peptides (designated trypsin-releasable, TR, peptides) in subsequent peaks were repurified on two successive high-performance liquid chromatography (HPLC) columns. The TN peak was delipidated and redigested with trypsin, and the resulting peptides were purified on two successive HPLC columns. Using this approach, we sequenced over 88% of LDL apo B-100, extending and refining our previous study (Nature 1986;323:738-742) which covered 52% of the protein. TN peptides made up 31%, and the TR peptides, 34% of the apo B-100 sequence; 23.7% were found under both TN and TR categories. Based on its differential trypsin releasability, apo B-100 can be divided into five domains: 1) residues 1----1000, largely TR; 2) residues 1001----1700, alternating TR and TN; 3) residues 1701----3070, largely TN; 4) residues 3071----4100, mainly TR and mixed; and 5) residues 4101----4536, almost exclusively TN. Domain 1 contained 14 of the 25 Cys residues in apo B. Domain 4 encompassed seven N-glycosylation sites, and contained the putative receptor binding domains. All 19 potential N-glycosylation sites were directly sequenced: 16 were found to be glycosylated and three were not. Three pairs of disulfide bridges were also mapped. Finally, a combination of cDNA sequencing, direct mRNA sequencing, and comparison of published apo B-100 sequences allowed us to identify specific amino acid residues within apo B-100 that seem to represent bona fide allelic variations. Our study provides information on LDL apo B-100 structure that will be important to our understanding of its conformation and metabolism.

The complete amino acid sequence of proapolipoprotein (proapo) A-I of chicken high density lipoproteins was determined by sequencing overlapping peptides produced by trypsin, S. aureus V8 protease, and cyanogen bromide cleavage. There are 240 amino acid residues in mature chicken apoA-I. By direct sequence analysis of a cyanogen bromide peptide, we also determined the sequence of a 6-amino-acid prosegment which is present at approx. 10% the molar amount of the mature peptide in chicken plasma. Sequence comparison among apoA-I from chicken, human, rabbit, dog and rat, and secondary structure analysis indicate that while the degree of sequence homology is only moderate ( < 50% between chicken and man), there is good conservation of apoA-I secondary structure, especially in the N-terminal two-thirds of the protein in these widely separated species.

Apolipoprotein B-100 (apo B-100) contains putative lipid-associating regions that are, in part, responsible for its overall structure in human plasma low-density lipoproteins. Some of these regions have been identified by reassembly of the total tryptic peptides of apo B-100 with bovine brain sphingomyelin, 1-palmitoyl-2-oleoyl phosphatidylcholine (POPC) and dimyristoylphosphatidylcholine (DPMC). Although more than 500 tryptic peptides are predicted from the known number of arginines and lysines in apo B-100, significant amounts of only 13 peptides spontaneously associate with all three phospholipids. These peptides share some structural characteristics, as predicted by several algorithms, that distinguish them from the water-soluble apolipoproteins. Most apolipoproteins associate with lipids via amphipathic helices and are highly helical in native and reassembled lipoproteins. Analysis of all apo B-100 lipophilic peptides by circular dichroism and by use of a predictive algorithm reveals no evidence of amphipathic helices. Although the predictive algorithm suggested that the lipophilic peptides of apo B-100 contain the sequence determinants for beta-sheet, no spectroscopic evidence for this structure was found. We conclude that the lipophilic regions of apo B-100 liberated by trypsinolysis are highly hydrophobic, although their secondary structures do not fit any simple model.