Olfaction in the Anthropocene: NO3 negatively affects floral scent and nocturnal pollination

There is growing concern about sensory pollutants affecting ecological communities. Anthropogenically enhanced oxidants [ozone (O3) and nitrate radicals (NO3)] rapidly degrade floral scents, potentially reducing pollinator attraction to flowers. However, the physiological and behavioral impacts on pollinators and plant fitness are unknown. Using a nocturnal flower-moth system, we found that atmospherically relevant concentrations of NO3 eliminate flower visitation by moths, and the reaction of NO3 with a subset of monoterpenes is what reduces the scent's attractiveness. Global atmospheric models of floral scent oxidation reveal that pollinators in certain urban areas may have a reduced ability to perceive and navigate to flowers. These results illustrate the impact of anthropogenic pollutants on an animal's olfactory ability and indicate that such pollutants may be critical regulators of global pollination.

Anthropogenic control over wintertime oxidation of atmospheric pollutants

During winter in the mid-latitudes, photochemical oxidation is significantly slower than in summer and the main radical oxidants driving formation of secondary pollutants, such as fine particulate matter and ozone, remain uncertain, owing to a lack of observations in this season. Using airborne observations, we quantify the contribution of various oxidants on a regional basis during winter, enabling improved chemical descriptions of wintertime air pollution transformations. We show that 25-60% of NO_x is converted to N₂O₅ via multiphase reactions between gas-phase nitrogen oxide reservoirs and aerosol particles, with ~93% reacting in the marine boundary layer to form >2.5 ppbv ClNO₂. This results in >70% of the oxidizing capacity of polluted air during winter being controlled, not by typical photochemical reactions, but from these multiphase reactions and emissions of volatile organic compounds, such as HCHO, highlighting the control local anthropogenic emissions have on the oxidizing capacity of the polluted wintertime atmosphere.

Formaldehyde production from isoprene oxidation across NOx regimes

The chemical link between isoprene and formaldehyde (HCHO) is a strong, non-linear function of NOx (= NO + NO2). This relationship is a linchpin for top-down isoprene emission inventory verification from orbital HCHO column observations. It is also a benchmark for overall photochemical mechanism performance with regard to VOC oxidation. Using a comprehensive suite of airborne in situ observations over the Southeast U.S., we quantify HCHO production across the urban-rural spectrum. Analysis of isoprene and its major first-generation oxidation products allows us to define both a "prompt" yield of HCHO (molecules of HCHO produced per molecule of freshly-emitted isoprene) and the background HCHO mixing ratio (from oxidation of longer-lived hydrocarbons). Over the range of observed NOx values (roughly 0.1 - 2 ppbv), the prompt yield increases by a factor of 3 (from 0.3 to 0.9 ppbv ppbv-1), while background HCHO increases by a factor of 2 (from 1.6 to 3.3 ppbv). We apply the same method to evaluate the performance of both a global chemical transport model (AM3) and a measurement-constrained 0-D steady state box model. Both models reproduce the NOx dependence of the prompt HCHO yield, illustrating that models with updated isoprene oxidation mechanisms can adequately capture the link between HCHO and recent isoprene emissions. On the other hand, both models under-estimate background HCHO mixing ratios, suggesting missing HCHO precursors, inadequate representation of later-generation isoprene degradation and/or under-estimated hydroxyl radical concentrations. Detailed process rates from the box model simulation demonstrate a 3-fold increase in HCHO production across the range of observed NOx values, driven by a 100% increase in OH and a 40% increase in branching of organic peroxy radical reactions to produce HCHO.

Molecular Composition and Volatility of Organic Aerosol in the Southeastern U.S.: Implications for IEPOX Derived SOA

We present measurements as part of the Southern Oxidant and Aerosol Study (SOAS) during which atmospheric aerosol particles were comprehensively characterized. We present results utilizing a Filter Inlet for Gases and AEROsol coupled to a chemical ionization mass spectrometer (CIMS). We focus on the volatility and composition of isoprene derived organic aerosol tracers and of the bulk organic aerosol. By utilizing the online volatility and molecular composition information provided by the FIGAERO-CIMS, we show that the vast majority of commonly reported molecular tracers of isoprene epoxydiol (IEPOX) derived secondary organic aerosol (SOA) is derived from thermal decomposition of accretion products or other low volatility organics having effective saturation vapor concentrations <10(-3) μg m(-3). In addition, while accounting for up to 30% of total submicrometer organic aerosol mass, the IEPOX-derived SOA has a higher volatility than the remaining bulk. That IEPOX-SOA, and more generally bulk organic aerosol in the Southeastern U.S. is comprised of effectively nonvolatile material has important implications for modeling SOA derived from isoprene, and for mechanistic interpretations of molecular tracer measurements. Our results show that partitioning theory performs well for 2-methyltetrols, once accretion product decomposition is taken into account. No significant partitioning delays due to aerosol phase or viscosity are observed, and no partitioning to particle-phase water or other unexplained mechanisms are needed to explain our results.

Formaldehyde production from isoprene oxidation across NOx regimes

The chemical link between isoprene and formaldehyde (HCHO) is a strong, non-linear function of NO_x (= NO + NO₂). This relationship is a linchpin for top-down isoprene emission inventory verification from orbital HCHO column observations. It is also a benchmark for overall photochemical mechanism performance with regard to VOC oxidation. Using a comprehensive suite of airborne in situ observations over the Southeast U.S., we quantify HCHO production across the urban-rural spectrum. Analysis of isoprene and its major first-generation oxidation products allows us to define both a "prompt" yield of HCHO (molecules of HCHO produced per molecule of freshly-emitted isoprene) and the background HCHO mixing ratio (from oxidation of longer-lived hydrocarbons). Over the range of observed NO_x values (roughly 0.1 - 2 ppbv), the prompt yield increases by a factor of 3 (from 0.3 to 0.9 ppbv ppbv^-1), while background HCHO increases by a factor of 2 (from 1.6 to 3.3 ppbv). We apply the same method to evaluate the performance of both a global chemical transport model (AM3) and a measurement-constrained 0-D steady state box model. Both models reproduce the NO_x dependence of the prompt HCHO yield, illustrating that models with updated isoprene oxidation mechanisms can adequately capture the link between HCHO and recent isoprene emissions. On the other hand, both models under-estimate background HCHO mixing ratios, suggesting missing HCHO precursors, inadequate representation of later-generation isoprene degradation and/or under-estimated hydroxyl radical concentrations. Detailed process rates from the box model simulation demonstrate a 3-fold increase in HCHO production across the range of observed NO_x values, driven by a 100% increase in OH and a 40% increase in branching of organic peroxy radical reactions to produce HCHO.

Instrumentation and Measurement Strategy for the NOAA SENEX Aircraft Campaign as Part of the Southeast Atmosphere Study 2013

Natural emissions of ozone-and-aerosol-precursor gases such as isoprene and monoterpenes are high in the southeast of the US. In addition, anthropogenic emissions are significant in the Southeast US and summertime photochemistry is rapid. The NOAA-led SENEX (Southeast Nexus) aircraft campaign was one of the major components of the Southeast Atmosphere Study (SAS) and was focused on studying the interactions between biogenic and anthropogenic emissions to form secondary pollutants. During SENEX, the NOAA WP-3D aircraft conducted 20 research flights between 27 May and 10 July 2013 based out of Smyrna, TN. Here we describe the experimental approach, the science goals and early results of the NOAA SENEX campaign. The aircraft, its capabilities and standard measurements are described. The instrument payload is summarized including detection limits, accuracy, precision and time resolutions for all gas-and-aerosol phase instruments. The inter-comparisons of compounds measured with multiple instruments on the NOAA WP-3D are presented and were all within the stated uncertainties, except two of the three NO₂ measurements. The SENEX flights included day- and nighttime flights in the Southeast as well as flights over areas with intense shale gas extraction (Marcellus, Fayetteville and Haynesville shale). We present one example flight on 16 June 2013, which was a daytime flight over the Atlanta region, where several crosswind transects of plumes from the city and nearby point sources, such as power plants, paper mills and landfills, were flown. The area around Atlanta has large biogenic isoprene emissions, which provided an excellent case for studying the interactions between biogenic and anthropogenic emissions. In this example flight, chemistry in and outside the Atlanta plumes was observed for several hours after emission. The analysis of this flight showcases the strategies implemented to answer some of the main SENEX science questions.

Instrumentation and Measurement Strategy for the NOAA SENEX Aircraft Campaign as Part of the Southeast Atmosphere Study 2013

Natural emissions of ozone-and-aerosol-precursor gases such as isoprene and monoterpenes are high in the southeast of the US. In addition, anthropogenic emissions are significant in the Southeast US and summertime photochemistry is rapid. The NOAA-led SENEX (Southeast Nexus) aircraft campaign was one of the major components of the Southeast Atmosphere Study (SAS) and was focused on studying the interactions between biogenic and anthropogenic emissions to form secondary pollutants. During SENEX, the NOAA WP-3D aircraft conducted 20 research flights between 27 May and 10 July 2013 based out of Smyrna, TN. Here we describe the experimental approach, the science goals and early results of the NOAA SENEX campaign. The aircraft, its capabilities and standard measurements are described. The instrument payload is summarized including detection limits, accuracy, precision and time resolutions for all gas-and-aerosol phase instruments. The inter-comparisons of compounds measured with multiple instruments on the NOAA WP-3D are presented and were all within the stated uncertainties, except two of the three NO₂ measurements. The SENEX flights included day- and nighttime flights in the Southeast as well as flights over areas with intense shale gas extraction (Marcellus, Fayetteville and Haynesville shale). We present one example flight on 16 June 2013, which was a daytime flight over the Atlanta region, where several crosswind transects of plumes from the city and nearby point sources, such as power plants, paper mills and landfills, were flown. The area around Atlanta has large biogenic isoprene emissions, which provided an excellent case for studying the interactions between biogenic and anthropogenic emissions. In this example flight, chemistry in and outside the Atlanta plumes was observed for several hours after emission. The analysis of this flight showcases the strategies implemented to answer some of the main SENEX science questions.

Ozone production chemistry in the presence of urban plumes

Ozone pollution affects human health, especially in urban areas on hot sunny days. Its basic photochemistry has been known for decades and yet it is still not possible to correctly predict the high ozone levels that are the greatest threat. The CalNex_SJV study in Bakersfield CA in May/June 2010 provided an opportunity to examine ozone photochemistry in an urban area surrounded by agriculture. The measurement suite included hydroxyl (OH), hydroperoxyl (HO₂), and OH reactivity, which are compared with the output of a photochemical box model. While the agreement is generally within combined uncertainties, measured HO₂ far exceeds modeled HO₂ in NO_x-rich plumes. OH production and loss do not balance as they should in the morning, and the ozone production calculated with measured HO₂ is a decade greater than that calculated with modeled HO₂ when NO levels are high. Calculated ozone production using measured HO₂ is twice that using modeled HO₂, but this difference in calculated ozone production has minimal impact on the assessment of NO_x-sensitivity or VOC-sensitivity for midday ozone production. Evidence from this study indicates that this important discrepancy is not due to the HO₂ measurement or to the sampling of transported plumes but instead to either emissions of unknown organic species that accompany the NO emissions or unknown photochemistry involving nitrogen oxides and hydrogen oxides, possibly the hypothesized reaction OH + NO + O₂ → HO₂ + NO₂.

Growth of High-Resistivity Wurtzite and Zincblende Structure Single Crystal Gan by Reactive-Ion Molecular Beam Epitaxy

Epitaxial GaN films have been grown at temperatures between 600 and 900 °C by reactive-ion molecular-beam epitaxy. Ga was provided by evaporation from an effusion cell while nitrogen was supplied from a low-energy, single-grid, ion source. The average energy per accelerated N incident at the growing film surface was ≈ 19 eV. Films deposited on Al2O3(0112) and MgO(100)l×l substrates had wurtzite (a-GaN) and metastable zincblende (α-GaN) structures, respectively. The lattice constants were a = 0.3192 nm and c = 0.5196 nm for α;-GaN and a = 0.4531 nm for β -GaN. The room-temperature optical bandgap Eg of zincblende GaN, 3.30 eV, was found to be 0.11 eV lower than that of the hexagonal polymorph α-GaN. All films were n-type with electron carrier concentrations which decreased from 4×1018 to 8×1013 cm−3 with increasing incident N2+/Ga flux ratios between 0.63 and 3.9. Resistivities <106Ω-cm were achieved.

The influence of associability changes in negative patterning and other discriminations

Normal rats showed faster learning of a serial negative patterning (NP) discrimination (X+, A+, X-->A-) than of a comparable feature negative (FN) discrimination (A+, X-->A-). This advantage was absent in rats with lesions of the amygdala central nucleus. Earlier data indicated that this brain lesion interferes with surprise-induced increases in attention specified by the Pearce-Hall model (J. M. Pearce & G. Hall, 1980). In the NP task, but not the FN task, omission of the reinforcer after X on X-->A- trials was surprising. A variation of the NP task (NPX), in which X was reinforced on both X+ and X-->A- trials, was learned more rapidly than the NP task. Lesioned rats were unimpaired in learning the NPX task. Evaluation of the lesion effects and the results of posttraining transfer tests suggested that the NP advantage involved attentional processes, whereas the NPX advantage was based on the acquisition of inhibitory control by aspects of excitation conditioned to X.

Testing and analytical procedures for laboratory studies involving nonresponders during a limited observation period: an illustration using male sexual behavior in rats

In many laboratory studies, a subpopulation of subjects fails to exhibit the response under investigation during the period of observation. For example, within any population of male rats, there is significant variation in the expression of sexual behavior in the presence of a receptive female. Some males may never display the full sequence of behaviors leading to ejaculation within the typical time frame of the testing session, with the resulting lack of behavioral response presenting problems in the analysis of the data. Conventional strategies range from screening such males from the study or dropping them from the analysis to constructing new variables based on estimates from existing parameters or increasing the length of the test session to capture sexual responses in a greater portion of males. Herein, we present an alternative strategy for analyzing data where outcomes are absent due to the limited observation period. Survival regression analysis enables inclusion of all subjects in the analysis whether or not they have shown the behavior of interest. Use of such a strategy not only has potential to reveal new results but also guards against bias from excluding nonresponders from the study or dropping more males from one experimental condition than another. Furthermore, this procedure can be helpful in generating the conditional probability (increase, decrease, or constant) of the response with the passage of time based on the hazard function and in estimating parameters for establishing an optimal behavioral test length for future studies.

The influence of associability changes in negative patterning and other discriminations

Normal rats showed faster learning of a serial negative patterning (NP) discrimination (X+, A+, X-->A-) than of a comparable feature negative (FN) discrimination (A+, X-->A-). This advantage was absent in rats with lesions of the amygdala central nucleus. Earlier data indicated that this brain lesion interferes with surprise-induced increases in attention specified by the Pearce-Hall model (J. M. Pearce & G. Hall, 1980). In the NP task, but not the FN task, omission of the reinforcer after X on X-->A- trials was surprising. A variation of the NP task (NPX), in which X was reinforced on both X+ and X-->A- trials, was learned more rapidly than the NP task. Lesioned rats were unimpaired in learning the NPX task. Evaluation of the lesion effects and the results of posttraining transfer tests suggested that the NP advantage involved attentional processes, whereas the NPX advantage was based on the acquisition of inhibitory control by aspects of excitation conditioned to X.

Rhinal cortex ablations fail to disrupt reinforcer devaluation effects in rhesus monkeys (Macaca mulatta)

Studies have shown that excitotoxic lesions of the amygdala attenuate reinforcer devaluation effects in monkeys and rats. Because the rhinal (i.e., entorhinal and perirhinal) cortex has prominent reciprocal connections with the amygdala and has been suggested to store knowledge about objects, it is possible that it too composes part of the critical circuitry subserving learning about objects and their associated reinforcement value. To test this possibility, rhesus monkeys with rhinal cortex removals as well as unoperated controls were tested using a reinforcer devaluation procedure. Monkeys with rhinal cortex removals and controls, unlike those with amygdala lesions, tended to avoid displacing objects overlying a devalued food. These results indicate that the rhinal cortex is not a critical part of the neural circuitry mediating the effects of reinforcer devaluation.

Selective hippocampal lesions yield nonspatial memory impairments in rhesus monkeys

Monkeys with removals of medial temporal lobe (MTL) structures are widely recognized as valid models of human global anterograde amnesia, a syndrome that arises consequent to damage to a finite set of brain structures situated in the medial temporal lobe and/or medial diencephalon. However, a comparison of memory deficits in human and nonhuman primates with MTL damage has presented a long-standing puzzle. Whereas amnesic patients are impaired in learning object discrimination problems, monkeys with MTL damage are typically not. One possible explanation for this difference is that object discrimination tasks for humans and monkeys differ in that the former but not the latter requires the use of contextual information. If this analysis is correct, monkeys with MTL damage might be disadvantaged in learning to discriminate similar objects presented in different contexts. To test this possibility, we evaluated the effects of excitotoxic lesions of one of the MTL structures, the hippocampus, on the rate of learning of discrimination problems embedded within unique contexts. Monkeys with hippocampal lesions were impaired relative to controls in learning object discrimination problems of this type. These findings strongly support the idea that the difference in the effect on object memory of MTL damage in human and nonhuman primates is due to a difference in the opportunity to employ contextual cues rather than to a difference in the organization of memory.

Rhinal cortex ablations fail to disrupt reinforcer devaluation effects in rhesus monkeys (Macaca mulatta)

Studies have shown that excitotoxic lesions of the amygdala attenuate reinforcer devaluation effects in monkeys and rats. Because the rhinal (i.e., entorhinal and perirhinal) cortex has prominent reciprocal connections with the amygdala and has been suggested to store knowledge about objects, it is possible that it too composes part of the critical circuitry subserving learning about objects and their associated reinforcement value. To test this possibility, rhesus monkeys with rhinal cortex removals as well as unoperated controls were tested using a reinforcer devaluation procedure. Monkeys with rhinal cortex removals and controls, unlike those with amygdala lesions, tended to avoid displacing objects overlying a devalued food. These results indicate that the rhinal cortex is not a critical part of the neural circuitry mediating the effects of reinforcer devaluation.

Rhinal cortex removal produces amnesia for preoperatively learned discrimination problems but fails to disrupt postoperative acquisition and retention in rhesus monkeys

To test whether the rhinal cortex (i.e., entorhinal and perirhinal cortex) plays a time-limited role in information storage, eight rhesus monkeys were trained to criterion on two sets of 60 object discrimination problems, one set at each of two different time periods separated by 15 weeks. After the monkeys had learned both sets, two groups balanced for preoperative acquisition rates were formed. One group received bilateral ablation of the rhinal cortex (n = 4), and the other was retained as an unoperated control group (n = 4). After a 2 week rest period, monkeys were assessed for retention of the object discrimination problems. Retention was significantly poorer in monkeys with removals of the rhinal cortex relative to the controls (68 vs 91%). Although both groups showed slightly better retention of problems from the more recently learned set, there was no evidence of a differential effect of the cortical removal across sets (i.e., no temporal gradient). In addition, the monkeys with rhinal cortex lesions subsequently learned three new sets of 10 object discrimination problems as quickly as the controls did, thus ruling out the possibility of a gross impairment in visual perception or discrimination abilities. Furthermore, they retained these postoperatively learned object discriminations as well as the controls did. The findings indicate that the rhinal cortex is critical for the storage and/or retrieval of object discrimination problems that were learned up to 16 weeks before rhinal cortex ablation; however, in the absence of the rhinal cortex, efficient learning and retention of new discrimination problems can still occur.

Using a Regression Approach to Study the Influence of Male Fetuses on the Genital Morphology of Neonatal Female Rats

Among newborn female rats considerable variability is found in genital morphology (e.g., anogenital distance, AGD). Presumably, such differences are related to prenatal androgen exposure, with greater exposure resulting in larger AGD's and thus in a trend toward masculinization. The source of prenatal androgen in female fetuses is unclear, but a role for male uterine mates has been implicated. The present study investigated the effect of a number of prenatal factors related to number and position of males in utero on female AGD in two strains of rats. Because such prenatal factors often show systematic covariance, a methodology was used that enabled statistical control over variables that could not be /experimentally controlled. Results confirmed the importance of caudal males to Female AGD,and identified two additional intra-uterine variables salient to female genital masculinization, namely the distance of the female fetus from the nearest caudal male, and the overall number of males sharing the same uterine horn. An increase in number of adjacent males was, contrary to previous reports, associated with a decrease in AGD, but this effect was limited to one strain. There was considerable variation in AGD across the two strains, and, more importantly, across litters, suggesting the importance of factors impacting the litter as a whole rather than specific individuals within the litter.

A comparison of alfentanil requirements in European and Asian patients during general anaesthesia

Alfentanil requirements were compared in thirty-six Asian and forty-three European patients during general anaesthesia with muscle relaxants. Alfentanil infusion at 5 micrograms/kg/min was started immediately after induction with thiopentone and alcuronium. The infusion rate was reduced to 0.5 microgram/kg/min after ten minutes. An incremental dose of 5 micrograms/kg/min for five minutes was given on each occasion when anaesthesia was clinically judged to be inadequate. Recovery parameters were recorded. Pharmacokinetics were also studied in five Europeans, four Chinese and four Nepalese. The dosage of alfentanil required was comparable in both Asian and European patients, but recovery was slower in the Asian patients. The elimination half-life in the Chinese and the Nepalese were both significantly shorter than that of the Europeans (P less than 0.05), but at the time of recovery of spontaneous ventilation, the mean plasma concentrations were not significantly different.

Ventilatory effects of isoflurane: a comparison with halothane in a draw-over system

Halothane and isoflurane were studied using a draw-over anaesthetic system in two groups each of 25 patients to compare the ventilatory effects of the two agents in field anaesthesia. Respiratory variables were measured and it was confirmed that isoflurane is a more potent respiratory depressant than halothane, but satisfactory anaesthesia for short procedures was possible.

Midazolam in conservative dentistry. A cross-over trial

In a double-blind trial, 50 patients were randomly allocated to receive up to 0.29 mg/kg diazepam (Valium 5 mg/ml) or 0.14 mg/kg of midazolam (midazolam hydrochloride 5 mg/ml) intravenously at a first session of conservative dentistry, the alternative being administered at the second session. Good operating conditions were reported under each sedative and no important physiological differences were observed. Most patients failed to return to 'street fitness' 30 minutes after either session of treatment. Previous reports of reduced incidence of venous thrombophlebitis with midazolam were not convincingly confirmed in this trial, but data quality was poor. For about half the patients, the amnesic effect was stronger following midazolam.

Midazolam--does it cause resedation?

The objective of this double blind study was to compare the sedation following the intravenous injections of midazolam in three dose levels (0.07, 0.10 and 0.15 mg/kg), and to assess the time taken after each dose to return to street fitness. Recovery was monitored by measurement of reaction time. The mean results for each dose were compared against placebo and each other using the Student's t-test. All doses gave a significant (p less than 0.05) lengthening of reaction time compared to placebo. The two highest doses gave similar results when compared to 0.07 mg/kg, but not when compared to each other. Reaction times always returned to control values within 3 hours of injection. The Deletion of Ps test was also employed. A significant correlation was found between the results of reaction time testing and the Deletion of Ps test.

Evaluation of a new range of air drawover vaporizers. The 'PAC' series--laboratory and 'field' studies

The 'Ether Pac' and 'Fluo Pac' temperature compensated vaporizers have been evaluated in the laboratory and the 'field'. Rigorous testing has demonstrated that these vaporizers are robust and reliable. Shaking, tilting and overturning do not significantly affect their performance. Both vaporizers deliver lower concentrations of the vapour than the setting on the vaporizers at low tidal volumes (100 ml). The 'Ether Pac' vaporizer output declines progressively with ambient temperatures below 23 degrees C and a similar result occurs with the 'Fluo Pac' at temperatures below 20 degrees C. Clinical trials in Nepal, Kenya, Burma and the UK have demonstrated that, when halothane is used, oxygen enrichment is necessary during spontaneous and controlled ventilation. When ether is used with controlled ventilation oxygen enrichment is probably not necessary even with ambient pressures as low as 619 mmHg.

Total intravenous anaesthesia with etomidate-fentanyl. Use in general and gynaecological surgery

A total intravenous anaesthetic technique using etomidate, fentanyl and neuromuscular blocking drugs with artificial ventilation of the lungs has been used in 90 patients undergoing elective general and gynaecological surgery. A two-step schedule was used, based on a pharmacokinetic model for rapidly eliminated, intravenously administered drugs. Etomidate 100 micrograms/kg/minute with fentanyl 1 microgram/kg/minute were given for 10 minutes, followed by a maintenance dose at a rate of one-tenth this amount. Concurrent evaluation of the technique led to variations in the adjuvant drugs used (atropine, droperidol and neuromuscular blocking agent). The basic dose schedule provided adequate surgical anaesthesia for 76% of patients (although dose adjustments were used in the remainder), with recovery times of 10 minutes or less in 57% of patients. No further opiate analgesia was needed in 40% of patients postoperatively. Those patients given atropine intravenously prior to induction had a significantly lower incidence of nausea and vomiting postoperatively.

Immunological and non-immunological mechanisms involved in adverse reactions to drugs

This communication reviews the mechanisms involved in anaphylactic and anaphylactoid reactions to intravenous drugs used in anaesthesia. Although the mechanisms involved are pertinent to other drugs and substances used in clinical practice, the use of the intravenous route makes this a particularly worrying problem in anaesthetic practice. Despite the similarity of the clinical manifestations to those expected from immediate immunological hypersensitivity (anaphylaxis), relatively few reactions involve antibodies. Instead, a variety of mechanisms occur where activation of the blood inflammatory response systems, particularly complement, may be either primary or secondary to activation of the coagulation or fibrinolytic cascades of the blood clotting mechanisms. Immediate anaphylactoid reactions, manifest in the release of vasoactive substances such as histamine, may therefore pose very minor problems compared with coagulation problems arising in the peri- and post-operative period. It is important to discover the mechanism of all adverse reactions not only if these are to be avoided in the reactants in the future but also because of the necessity for devising suitable prophylactic and therapeutic measures for general use. The practical problems of such investigations are explored with particular reference to the laboratory investigation of subclinical reactions in terms of plasma histamine release and changes in blood leucocyte distribution.

Continuous thoracic epidural fentanyl. A comparison of epidural fentanyl with intramuscular papaveretum for postoperative pain

A prospective open trial was conducted to compare the analgesic and side-effects of continuously infused fentanyl into the thoracic epidural space with those of intramuscular papaveretum given 4 hourly as required. It was demonstrated that during the first 24 hours after upper abdominal surgery thoracic epidural fentanyl produced better analgesia with less sedation than intramuscular papaveretum. However, the epidural group suffered more nausea. Likewise, postoperative respiratory function tests were statistically significantly better in those patients who received epidural fentanyl. Despite a significantly greater volume of nasogastric aspirate during the period of study, the epidural fentanyl group also had a significantly greater urine output than did the patients receiving papaveretum. Hypotension and respiratory depression were not problems, but pruritus occurred in two patients given fentanyl. It is concluded that epidural fentanyl delivered by continuous infusion offers significant advantages over a conventional intramuscular narcotic regime.

Supernumerary senior house offices in anaesthesia: a review of a regional training scheme, 1962-1972

The Sheffield Regional Hospital Board, which became the Trent Regional Health Authority in 1974, initiated a scheme for training of Senior House Officers in anaesthesia in 1962; between 1962 and 1972, 73 graduates passed through the scheme of whom 29 (40%)* held consultant posts at the time of the review (mid 1979), another 8 (11%)* were senior registrars and on the way to consultant status. None of the 16 overseas graduates had achieved consultant status although one was a senior registrar. Twenty-six (35-6%)* of the 73 doctors (15(20-5%)* United Kingdom or Republic of Ireland graduates and 11 (15-1%)* from overseas) are thought to have left the practice of anaesthesia although some of these were not traced and may indeed be practising, and some of the females have indicated an intention to return to the specialty when their children are older.

Comparative studies of a new commercial kit for the estimation of vitamin B12 in serum

A commercial kit method (Technia Diagnostics) for the estimation of serum vitamin B12 claiming certain practical advantages was examined. Analytical and clinical performance were compared with a non-commercial radioisotope B12 method, previously compared to other commercial radioisotope B12 methods. The kit's analytical performance in our hands was satisfactory, although the within-batch precision and recovery of added cyanocobalamin were disappointing. Clinical performance was comparable with the non-commercial B12 method. Establishment of suitable reference ranges as a prerequisite to diagnostic use is apparent.

I.v. flunitrazepam and i.v. diazepam in conservative dentistry. A cross-over trial

In a randomized cross-over trial in 82 outpatients aged 15-45 yr undergoing conservative dentistry, a solution of flunitrazepam 0.25 mg ml-1 i.v. (average dose 0.014 mg kg-1) was compared with a solution of diazepam 5 mg ml-1 i.v. (0.29 mg kg-1). Cardiovascular changes, operating conditions and side-effects were similar. Forty minutes after the start of injection, about 85% of all patients could not remember the local anaesthetic injection. Thirty minutes after the end of treatment, only 25% of all patients had recovered. One week later, most patients receiving each drug had only vague memories of their treatment; they had felt more relaxed immediately after the i.v. injection than before. Drowsiness was equally common after flunitrazepam and diazepam. Ataxia was more prolonged with flunitrazepam but arm pain and venous thrombophlebitis were less frequent.

An evaluation of commercial radioisotope methods for the determination of folate and vitamin B12

Five commercial kits for the determination of folate and six kits for the determination of vitamin B12 were investigated. Their performance has been compared with microbiological methods for the two vitamins and with a non-commercial radioisotopic method for B12. The results show the importance of the determination of the reference range for an individual laboratory for each method. The precision of the kits varied appreciably, as did their performance using specimens from patients with different haematological disorders. In particular, certain kits failed to detect all patients with pernicious anaemia. The relative accuracy of the kits was assessed. Various factors which should be taken into account in the final selection of a satisfactory kit are discussed.