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Background-The left ventricle (LV) adapts to chronic hypoxia by expressing protective angiogenic, metabolic, and antioxidant genes to improve O 2 delivery and energy production, and to minimize reoxygenation injury. The ability of the right ventricle (RV) to adapt to hypoxia in children with tetralogy of Fallot (TOF) is unknown. Methods and Results-Gene expression using real-time polymerase chain reaction was measured in RV myocardium obtained during surgical repair of TOF from 23 patients: 13 cyanotic and 10 acyanotic. Results were compared between the 2 groups and correlated with age at surgery, severity of cyanosis, and early postoperative course. The cyanotic patients were younger at surgery compared with acyanotic (5Ϯ3 versus 9Ϯ4 months; Pϭ0.01), had higher hematocrit (43Ϯ4 versus 38Ϯ3 grams/dL; Pϭ0.004), and lower O 2 saturations (84Ϯ4% versus 98Ϯ2%; (PϽ0.001). Cyanotic patients had a significantly lower expression of vascular endothelial growth factor (VEGF), glycolytic enzymes, and glutathione peroxidase (GPX) (PϽ0.05), and a higher expression of collagen (PϽ0.01) compared with acyanotic patients. Gene expression correlated inversely with severity of cyanosis ie, preoperative hematocrit (PϽ0.01) and positively with preoperative saturation (PϽ0.05). The relationship between gene expression and cyanosis was independent of age at surgery. Ca 2ϩ handling genes did not correlate with the severity of hypoxia. Lower angiogenic, glycolytic, and antioxidant gene expression correlated with increasing postoperative lactate (PϽ0.05). Conclusions-The

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IntroductionEven though the use of nerve monitoring during parotid gland surgery is not the gold standard to prevent damage to the nerve, it surely offers some advantages over the traditional approach. Different from thyroid surgery, where a series of steps in intraoperative nerve monitoring have been described in order to con rm not only the integrity but -most importantly -the function of the recurrent laryngeal nerve, in parotid gland surgery, a formal guideline to follow while dissecting the facial nerve has yet to be described. MethodsA ve-year retrospective study was done reviewing the intraoperative records of patients who underwent parotid gland surgery under neural monitoring. The operative ndings regarding the neuromonitoring process, particularly in regard to the amplitude of two main branches, were revised. A literature search was done in order to search for guidelines to follow when a facial nerve loss of signal is encountered. ResultsFifty-six patients were operated on using the Nim 3 Nerve Monitoring System (Medtronic, Jacksonville, FL USA); thirty-three were female patients, 46 patients had benign lesions. Minimum changes were observed in the amplitude records after a comparison was made between the rst and the last stimulation. There were only three articles discussing the term loss of signal during parotid gland surgery. ConclusionToday, no su cient attention has been given to facial nerve monitoring process during parotidectomy.This study proposes and discusses a formal guideline to follow during this procedure in order to develop a uniform technique of facial nerve stimulation.

Red-tail coral snake (Micrurus mipartitus) is a long and thin bicolor coral snake widely distributed in Colombia and is the coral that causes the majority of accidents in the Andean region, so it is important to keep this species in captivity for anti-venom production and research. However, maintaining this species in captivity is very difficult because it refuses to feed, in addition to the high mortality rate due to maladaptation syndrome. In this study a force feeding diet, diverse substrates for maintenance and a milking technique were evaluated. Additionally, individual variability of the venom was determined by High Performance Liquid Chromatography (HPLC), Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis (SDS-PAGE) and Coagulant, Anticoagulant and Hemolytic activities. The results of this study demonstrate that it was possible to increase the survival rate of this species in captivity and to determine some of the important factors in the maintenance. As to the individual variability of the venom, we found differences in number and intensity of peaks recovered by chromatography and also displayed variations in some of its biological activities.Keywords: antivenom, force-feeding, mortality. RESUMENLa coral "rabo de ají" es una coral bicolor larga y delgada. Esta especie está ampliamente distribuida en Colombia y es la coral que causa el mayor número de accidentes en la región Andina, por esto es importante mantener esta especie en cautiverio con fines de producción de antivenenos e investigación. No obstante, el mantenimiento de esta especie en cautiverio es difícil, debido a que se rehúsan a alimentarse voluntariamente y a que presentan alta mortalidad por el denominado síndrome de mal adaptación. En este estudio se evaluaron varios sustratos para el mantenimiento, además de una dieta forzada y una técnica de ordeño. Adicionalmente, se evaluó la variabilidad individual del veneno a través de cromatografía liquida de alta eficiencia (HPLC), electroforesis (SDS-PAGE) y las actividades coagulante, anticoagulante y hemolítica indirecta. Los resultados de este estudio demostraron que fue posible incrementar la sobrevivencia de esta especie en cautiverio, así como determinar algunos factores importantes en su mantenimiento. A partir de la evaluación del veneno se encontraron diferencias en el número y en la intensidad de picos en la cromatografía, así como en algunas de sus actividades biológicas.Palabras clave: alimentación forzada, antiveneno, mortalidad.