Immunomodulatory and clinical effects of Viscum album (Iscador M and Iscador P) in children with recurrent respiratory infections as a result of the Chernobyl nuclear accident.

Ninety-two children 5 to 14 years of age living in areas exposed to the radioactive fallout from Chernobyl with recurrent respiratory infections (RRIs) were treated after randomization with either Viscum album praeparatum mali or pini (Iscador M or P). The dosage was two subcutaneous injections a week for 5 weeks with individual doses of 0.001 mg to 1.0 mg. Both Viscum album preparations were effective in significantly reducing clinical symptoms. One year after a single treatment course, the frequency of RRI relapses decreased by 78% and 73%, respectively. Immunomodulatory effects were assessed by investigation of lymphocyte subsets, natural killer (NK) cell activity, phagocytic and oxidative activity of polymorphonuclear leukocytes, and antiviral activity of serum before and 1 week after treatment. Viscum album therapy resulted in normalization of initial immune indices either below or above the normal ranges. High levels of antiviral activity before treatment were significantly decreased by Viscum album mali. Viscum album treatment should be studied further in children with RRI.

Transcranial Doppler sonography during isoflurane/N2O anaesthesia and surgery: flow velocity, "vessel area" and "volume flow".

Transcranial Doppler sonography (TCD) constitutes an advance in noninvasive monitoring of the cerebral circulation. However, as long as the diameter and cross-sectional area of the insonated middle cerebral artery (MCA) remain unknown, the derived flow velocities (v) are not informative. It is not known how the human MCA is influenced by anaesthetic agents. However, a TCD-modification allows noninvasive determination of "vessel area" (VA) and "volume flow" (VF) in MCA by analysing the backscattered Doppler power. This investigation evaluates the effects of isoflurane (in combination with N2O and surgery) on v, VA and VF. In 14 patients (ASA I) scheduled for minor surgical or gynaecological operations, anaesthesia was induced with droperidol, alfentanil, thiopentone and vecuronium. After intubation ventilation with N2O:O2 = 3:2 was adjusted, to maintain endexpiratory carbon dioxide (FECO2) constant between 4 and 5%. Baseline values of heart rate (HR), oscillometric mean arterial pressure (MAP), and TCD variables (v, VA VF) were measured before adding 2.4% isoflurane to the inspiratory mixture. Further measurements-were made 3, 6, 10, and 20 min after starting isoflurane. Surgery commenced between the sixth and tenth minute after isoflurane application. The MAP, FECO2, and v showed only minor alterations; HR increased after 6, 10 and 20 min. Transcranial "vessel area" and "volume flow" showed increases after isoflurane inhalation. The increase of "vessel area" supports the assumption that isoflurane greater than 1 MAC dilates large human cerebral arteries, so that if flow velocities are considered alone, alterations of cerebral blood flow may easily be underestimated.

Transcranial Doppler monitoring during induction of anesthesia: effects of propofol, thiopental, and hyperventilation in patients with large malignant brain tumors.

Disturbed autoregulation and CO2 reactivity have been reported in patients with brain tumors. Therefore, we decided to monitor the cerebrovascular effects of anesthetic drugs and hyperventilation. Transcranial Doppler sonography (TCD) can measure noninvasively alterations of flow velocities (v) and cross-sectional vessel area (VA) in large brain arteries. Twenty-eight patients with large malignant brain tumors in the territory of the middle cerebral artery (MCA) randomly received propofol or thiopental for induction and maintenance of anesthesia. Mean arterial pressure (MAP), heart rate (HR), and TCD parameters (vMCA and VA of the tumor or nontumor side) were determined at six data points (DP). The first measurements (MAP, HR, and TCD of the nontumor side) were performed before (DP I) and 60 s after (DP II) induction of anesthesia with either 2 mg/kg propofol or 4 mg/kg thiopental. After intubation and normoventilation (50% O2 in air), 0.05-0.1 mg/kg midazolam and an alfentanil infusion (100 micrograms/kg x h) were initiated. Then MAP, HR, vMCA, and VA of the tumor side were analyzed before (DP III) and 60 s after (DP IV) either propofol (1 mg/kg) or thiopental (2 mg/kg) were given. Finally, the effects of hyperventilation on HR, MAP, vMCA, and VA (tumor side) were determined (DP V and VI). Mean +/- SD, thiopental or propofol reactivity (non-tumor and tumor side) and CO2 reactivity (tumor side) were calculated; statistical comparison between DP I and II, III and IV, and V and VI was performed by paired t tests (p < 0.05). Unpaired t tests were used to evaluate differences between groups.(ABSTRACT TRUNCATED AT 250 WORDS)