Evaluation of a novel in-line point-of-care blood gas analyser.

Point-of-care testing is becoming increasingly relevant to the practice of anaesthesia and critical care medicine, especially in terms of minimisation of sample volumes and decreased time to decision making. We performed a prospective observational study to evaluate a novel, in-line blood gas analysis device against a conventional benchtop model, and assessed it while placing the enrolled patients under extreme physiological conditions, specifically deep hypothermic circulatory arrest. Eight patients were studied, and had between seven and 11 samples analysed for seven variables (pH, pCO2 , pO2 , HCO3 (-) , base excess [BE], K(+) and haematocrit [Hct]), using the device during the process of cooling to 20 °C on cardiopulmonary bypass, and subsequent rewarming to normothermia. After Passing-Bablok analysis, the variables were evaluated for bias, limits of agreement and percentage error at above and below 30 °C. Of the measured variables, only pH (percentage error 2.4%) and potassium (19.8%) demonstrated acceptable (< 30%) percentage error over the full range of temperatures measured. Carbon dioxide, when stratified by temperature, was acceptable (< 30 °C percentage error 24.6%, > 30 °C percentage error 9.9%), but the overall percentage error of the dataset (45.8%) was excessively high. Bicarbonate and haematocrit both had an acceptable percentage error above 30 °C (25.2% and 18.5%, respectively), but similar to carbon dioxide, percentage error for the full range of temperatures exceeded 30%. These data differ from previous work examining this device, and highlights the difference between derived measures using different apparatuses when exposed to extreme physiological conditions.

Effect of life in industrialized societies on hearing in natives of Easter Island.

In an effort to determine whether life in industrialized societies can have an effect on hearing, 90 natives from Easter Island over 45 years old were evaluated. They underwent complete clinical and audiological assessment and were divided into groups according to those having lived only on the island or those having lived in modern civilization. With all factors being equal, except exposure to modern civilization, our results showed that living in civilized societies has a significant negative effect on hearing; the severity is directly proportional to the years of exposure. The median hearing thresholds of natives always living on the island (men and women combined) was found to be similar to those of female citizens of the United States; there was no significant difference in hearing thresholds between men and women among these natives. These results suggest that there are no significant inherent racial differences nor significant inherent differences between males and females in the sensitivity of hearing. A relationship between aging and hearing was noted and interpreted as true or intrinsic presbycusis. There were no cases of otosclerosis, Meniere's disease, or exostoses of the external ear canal among natives who had always lived on the island. Pure natives were found not to be prone to otitis media in spite of having an extremely high incidence of severe upper respiratory tract allergies.

Permeability of the human round-window membrane to cationic ferritin.

An ultrastructural study was done in three sequential steps to determine if the human round-window membrane was permeable to macromolecules. Cationic ferritin was first placed for one hour in the round-window niche of two live rhesus monkeys. The same tracer was then placed in the same manner in two rhesus monkeys that had been dead for one hour. In both groups, cationic ferritin was observed to traverse the round-window membrane through pinocytotic vesicles into the scala tympani. After establishing that the transport capabilities of the round-window membrane of the monkey remained present one hour after death, cationic ferritin was placed for one hour in the round-window niche of two humans who had been dead for 30 minutes and one hour. The tracer was observed to traverse the round-window membrane through pinocytotic vesicles into the scala tympani in both humans. This report may be the first to document morphologically the permeability of human round-window membranes to macromolecules.

Congenital absence of the nose and nasal fossae.

We describe a case of complete nasal agenesis and absence of the nasal fossae, without alterations in the central nervous system. The physical and intellectual development of the infant to date has been absolutely normal. Opening of the nasal respiratory passage was not required in our patient as he did not show respiratory problems during deglutition. - Microphthalmia in the right eye with iridoretinal coloboma and right cryptorchidism were also noted. When the child was 9 months old a right orbital asymmetry became evident due to a growth deficit of the microphthalmic eye. This improved after placement of an expandable prosthesis in the orbit to stimulate its growth. - When the child is 4 years old, he will start to use a nasal prosthesis supported by implantology. Final reconstruction of the nasal pyramid will take place after he is 15 years of age.