The doubly labeled water method is the first method that accurately measures total daily energy expenditure in free-living subjects over periods of days to weeks. Validations have indicated that the method can be performed with a coefficient of variation of between 3% and 5%. This precision, however, is dependent on the quality of the Isotopic analyses. A recent interlaboratory comparison has indicated that there is a wide variation in the accuracy and preci· sion with which deuterium and 18o enrichments are measured. This reduces the accuracy and precision with which a laboratory will perform the doubly labeled water method and in some cases may limit the application of this technique. Herein we review the analytical requirements for optimal use of the method and some of the potential sources of error in the stable isotope analysis.
Octopus bimaculoides and O. bimaculatus can drill holes in the shells of their molluscan prey, through which they appear to inject a paralyzing venom.
Extracts prepared from the venomous dorsal spines of lionfish ( Pterois volitans) were investigated in mice and rabbits. Intravenous injection into mice produced death in from less than a minute up to about one-half hour. The primary action in rabbits was a fall in blood pressure, accompanied by increase in respiratory rate; with larger doses there was evidence of myocardial ischemia or injury. After injection of fatal doses a variety of electrocardiographic changes occurred and the blood pressure fell to zero; respiratory arrest occurred terminally, but artificial respiration did not prolong the life of the animal. The active material was nondialyzable and the extracts contained considerable amounts of protein. Extracts retained substantial activity after lyophilization or addition of glycerol when stored for over a year at –20°C. The mean ld50 following intravenous injection into mice was about 1 mg of protein/kg.
Key wordsComplications; myotonia dystrophica.Myotonic dystrophy is a multisystem disease requiring the skill and knowledge of the anaesthetist in dealing with organ dysfunction and unique drug responses. Intraoperative problems have received considerable attention in the literature; however, the postoperative period is also hazardous and the care during this time has been under-emphasised. An illustrative case is presented to demonstrate the need for the involvement of the anaesthetist during the preand postoperative periods. Case historyThe patient, a 32-year-old white male, presented for evaluation of a mediastinal mass.He had myotonic dystrophy from the age of 17 and at admission he presented with the classical features ( Fig. 1): frontal baldness, ptosis, lenticular opacities, expressionless face, wasted sternocleidomastoids, peripheral muscle weakness, areflexia of the limbs, testicular atrophy and dysphagia. His father and one brother also have myotonic dystrophy. He had smoked 20 cigarettes a day for 15 years but denied frequent respiratory infections or chronic bronchitis. The patient had an uneventful tonsillectomy under general anaesthesia in childhood, and recently had viral pericarditis complicated by a pericardial effusion and dysrhythmias.On examination his weight was 66 kg, blood pressure 134/70 mmHg, pulse 68 and regular.
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