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Notes: Experimental data are presented for the scattering of electrons by CF2Cl2 and CF3Cl for both integral and backward scattering, from 2 eV (for CF2Cl2) and 0.65 eV (for CF3Cl) down to energies of 10 meV to 20 meV, with an energy resolution ranging from 0.75 meV to 1.5 meV (full width at half maximum) in the electron beam. Both molecules have dipole moments of ∼0.5 D and are expected to show very similar rotationally inelastic scattering cross sections. Cross sections for CF2Cl2 are, however, much larger at low energy than for CF3Cl, attributed to short-lived attachment of electrons to CF2Cl2. CF3Cl displays powerful suppression of rotational excitation in the forward direction, most strongly around 70 meV impact energy. This is ascribed to interference between a direct channel of rotational excitation and indirect excitation via a short-lived negative ion state. © 2001 American Institute of Physics.

Notes: (Pb1−x−ySrxBay)(Zr0.976−zTizNb0.024)O3 solid solutions have been investigated to understand the relationship between structural changes caused by isovalent strontium and barium substitution on the A-site and dielectric and piezoelectric properties. As strontium and barium were substituted for lead, the zirconium:titanium (Zr:Ti) ratio was modified so that all compositions had an optimized piezoelectric coefficient (d33). The value of d33 was at a maximum in the tetragonal phase near, but not at, the morphotropic-phase boundary (MPB). The real MPB was taken as the Zr:Ti ratio at which X-ray diffraction patterns appeared either pseudocubic or a mixture of rhombohedral and tetragonal. As strontium content increased, optimized d33 also increased from 410 pC/N (x= 0) to 640 pC/N (x= 0.12), commensurate with a decrease in the paraelectric-to-ferroelectric phase transition temperature (TC) from 350°C (x= 0) to 175°C (x= 0.12). However, for ceramics where x 〉 0.12, optimized d33 decreased even though the phase-transition temperature was ∼150°C. Low strontium concentration ceramics (x= 0–0.08) contained 80 nm ferrroelectric domains typical of PZT, but high strontium concentration ceramics (x= 0.12–0.16) contained fine-scale domains (20 nm) in some regions of the microstructure. In addition, [110] pseudocubic electron diffraction patterns revealed superlattice reflections at 1/2{hkl} positions associated with rotations of the octahedra in antiphase. Co-doping ceramics with strontium (x= 0.06) and barium (y= 0.06) resulted in the disappearance of the 1/2{hkl} reflections. Optimized d33 (∼520 pC/N, TC∼ 205°C) for this composition was similar to that of ceramics where x= 0.08, y= 0, which had a TC of ∼250°C.

Notes: Summary A postal survey was sent to all anaesthetic departments in the UK to identify current practice and gain insight into anaesthetists' attitudes regarding the use of anaesthetic rooms for induction of general anaesthesia. Replies were received from 247 (88%) departments. Of these, 10 (4%) departments routinely anaesthetise all patients in theatre. The main reason for change was patient safety. Of those who routinely use the anaesthetic room for induction of anaesthesia, only 5% have made provision to change to in-theatre induction. An estimated £30 million has been spent on equipping anaesthetic rooms since 1994; with the result that 91% of departments where anaesthetic room induction occurs, now have monitoring that complies with the current Association of Anaesthetists of Great Britain and Ireland guidelines. The majority of the respondents who use anaesthetic rooms perceived induction in theatre to result in reduced efficiency, increased patient anxiety, a worse teaching environment and no improvement in patient safety. This was in contrast to the attitudes of respondents from hospitals where in-theatre induction occurs. Only 9.7% of all respondents believed that clinical governance would necessitate a change to anaesthetizing all patients in theatre compared to 25% who believed that the increasing costs of monitoring equipment would lead to a change. Overall 79% of respondents prefer to use the anaesthetic room, 16% prefer in-theatre induction and 5% expressed no preference. However, of those who routinely anaesthetise in theatre, 70% thought it to be preferable.

Notes: The acquired immune deficiency syndrome has reached pandemic proportions. Anaesthetists should be aware of the implications of dealing with increasing numbers of both diagnosed and undiagnosed, symptomatic and asymptomatic, human immunodeficiency virus-infected patients in the fields of intensive therapy, operating theatre anaesthesia, obstetrics and pain management. With recent advances, important insights have been gained into the pathogenesis of human immunodeficiency virus. Molecular techniques allow quantification of viral burden, and together with CD4 T-lymphocyte count, prognosis and response to therapy can be evaluated. New drugs and therapeutic regimens have improved prognosis for those who are infected with the virus and vertical transmission of infection from mother to infant can be minimised. Should accidental occupational exposure to the virus occur, a prophylactic regimen of antiretroviral drugs can be administered in an attempt to prevent subsequent human immunodeficiency virus infection.

Notes: Background:  Allergic rhinitis is characterized by selective expansion of T cell subsets with a CD4+ phenotype. Recently, we identified a subpopulation of nonallergic rhinitis subjects with increased epithelial mast cell and eosinophil populations, suggestive of local mucosal allergy. Previously, T cell subsets have not been characterized in this subselection of nonallergic subjects and furthermore, their relationship to mast cell and basophil effector cells remain unidentified.Objective:  To determine if a subpopulation of nonallergic subjects with idiopathic rhinitis (IR) have localized allergy confined to their nasal mucosa by comparing the T cell subsets and major histocompatibility complex (MHC) II expressing cells to persistent allergic rhinitis (PAR). Furthermore, the relationship between T cell subsets and mast cells/basophils was investigated.Methods:  None of the symptomatic patients in this study were clinically allergen-challenged. Nasal turbinate mucosa was removed from patients with PAR, IR and normal controls. Morphometry was performed on immunostained sections for T cell subset populations including CD3+, CD4+, CD8+, CD25+, CD45RA+, CD45RO+, human leucocyte antigen (HLA)-DRα (MHC class II), mast cell tryptase and for basophils.Results:  Subjects with persistent allergic rhinitis differed to normal controls in showing significantly increased numbers of total (CD3+), activated (CD25+) and allergen-naïve (CD45RA+) T lymphocytes in their nasal mucosa (P 〈 0.025). The naïve CD45RA+ memory T cells correlated to mucosal mast cells in PAR (P = 0.03). IR patients differ to allergic subjects in showing significantly reduced numbers of epithelial HLA-DRα+ cells (P = 0.007), but increased numbers of CD8+ lymphocytes (P = 0.02). The CD8+ T cells correlated with mucosal mast cell numbers (P = 0.02). In both rhinitis groups, basophils were present in very low numbers obviating the need for statistical analysis.Conclusion:  PAR is characterized by increased numbers of CD3+, CD25+ and CD45RA+ T lymphocytes compared with normal mucosa. Allergic and nonallergic rhinitis groups can be separated by significant differences in the number of epithelial antigen presenting cells (APCs) (HLA-DRα+) and sub-epithelial activated (CD25+) T cells. Moreover, IR patients do not significantly differ to their allergic counterparts with respect to total (CD3+) and naïve (CD45RA+) T cell numbers, or numbers of epithelial activated (CD25+) lymphocytes. IR subjects show significantly increased numbers of CD8+ lymphocytes compared with control mucosa and although our findings suggest that the initiating inflammatory events may differ, both rhinitis groups show a similarity in pathology involving mucosal mast cells with an association to infiltrating T cells.

Notes: Background The pathophysiology of idiopathic rhinitis is unknown although evidence is accumulating to suggest that many patients may have a localized form of allergic rhinitis in the absence of other atopic symptoms and markers. This study compares detailed nasal challenge results obtained from patients with idiopathic rhinitis to those of atopic and normal controls.Methods Patients with idiopathic rhinitis (n = 23), perennial allergic rhinitis (n = 8) and normal controls (n = 8) underwent a normal saline challenge to exclude hyper-reactivity and then bilateral nasal allergen challenges. Nasal patency was assessed by anterior active rhinomanometry.Results All of the patients with atopic rhinitis demonstrated positive bilateral allergen challenges. All normal control subjects had bilateral negative challenges. Two patients in the idiopathic group tested positively to saline and were excluded from further study with 62% of the remainder testing positive to allergens. Of the idiopathic patients testing positive, 85% were sensitive to house dust mite.Conclusion A significant proportion of patients with idiopathic rhinitis have positive nasal challenges, the vast majority to house dust mite allergen. These findings add to the weight of evidence that suggests ‘localized allergy’ may exist in the absence of systemic atopic markers.

Notes: Summary In a prospective, double-blind, randomised, placebo-controlled trial, we have compared the effects of midazolam co-induction with propofol predosing on the induction dose requirements of propofol in elderly patients. We enrolled 60 patients aged 〉 70 years, attending for urological surgery. The patients were allocated randomly to one of three groups, to receive either midazolam 0.02 mg.kg−1, propofol 0.25 mg.kg−1, or normal saline 2 ml (placebo) 2 min prior to induction of anaesthesia using propofol 1% infusion at 300 ml.h−1. The propofol dose requirements for induction were recorded for two end-points (loss of verbal contact and insertion of an oropharyngeal airway). Cardiovascular parameters were recorded at 1-min intervals for each patient until induction was complete. The midazolam group showed a significant reduction in propofol dose requirements for induction (p = 0.05) compared to the placebo group. The propofol group did not show a significant dose reduction compared to placebo. There were no demonstrable differences in terms of improved cardiovascular stability between groups. We conclude that propofol predosing does not significantly reduce the induction dose of propofol required in the elderly, and there were no cardiovascular benefits to either midazolam co-induction or propofol predosing in the elderly.

Notes: Summary Whilst conducting a randomised controlled trial into the effects of combination anti-emetics, we endeavoured to confirm that our patient groups were matched using the predictive scoring systems for postoperative nausea and vomiting (PONV) and postoperative vomiting (POV) reported in the literature. One hundred and seventy-seven female patients attending for day case gynaecological surgery were studied and their individual risks of PONV and POV were calculated using four predictive models for PONV and two predictive models for POV. The scoring systems were then evaluated to see if agreement existed between them using the method described by Bland and Altman. Bias and 95% limits of agreement were calculated for each combination. Agreement between scoring systems was poor. As the scoring systems gave widely divergent predictions, we concluded that the predictive risk for PONV or POV would be dependent upon the scoring system chosen, thus limiting their usefulness in this role.