The Jackson Rees technique has become increasingly popular in pediatric anesthesia. This article presents an original Jackson Rees technique that we have used on 1235 cases for the past 7 years, and which is known as Pentothal-Curare-Hyperventilation technique or the Liverpool technique because of its origin and agents used. Technique 1) Atropine and demerol generally are given as premedication but atropine is only given in the newborn baby. 2) Patients are given pentothal 4mg/kg to sleep. 3) A dose of curare 0.6mg/kg is administered to paralyse and the patient is intubated with an appropriate size tube. 4) The patient is hyperventilated with three times the minute volume of N2O/O2 in a 1:2 ratio using a Jackson Rees modification unit. 5) At the end of surgery N2O is discontinued and curare is reversed with prostigmine 0.1mg/kg and atropine 0.03mg/kg. As a result of our experience this technique has been considered to be a very satisfactory technique in all fields of pediatric andsthesia. The advantages and controverses are discussed.
Anesthesia* ; Atropine ; Curare ; Humans ; Infant, Newborn ; Meperidine ; Neostigmine ; Premedication ; Thiopental

The technique of radial artery cannulation and its complications are well documented. However, serious complications are rare. This is a report of one case of finger necrosis developed from the arterial cannulation in a patient who had open heart surgery. This 33 year old female underwent mitral valve replacement surgery with Carpentier Edward porcine prosthesis during a cardiopulmonary bypass. Right radial artery cannulation was carried out percutaneously using an 18 gauge angiocath after the Allen's test appeared to be positive. It was intermittently flushed by heparinized solution. Cardiac arrest occured and the patient was resusciated 3 hours postoperatively. After that her blood pressure was maintained around 60/40 by dopamin drips. On the second postoperative day, her right hand became cold and dusky purple so that the catheter was removed, and a right stellate ganglion blcok was carried our. However, necrotic change on right thumb, index finger and little finger became worse and the whole palm became blue and edematous. She died of cardiac arrest on the 4th postoperative day.
Adult ; Blood Pressure ; Cardiopulmonary Bypass ; Catheterization* ; Catheters ; Female ; Fingers* ; Hand ; Heart Arrest ; Heparin ; Humans ; Mitral Valve ; Necrosis* ; Prostheses and Implants ; Radial Artery* ; Stellate Ganglion ; Thoracic Surgery ; Thumb

Glycogen synthase kinase-3β (GSK-3β) is an important serine/threonine kinase that implicates in multiple cellular processes and links with the neurodegenerative diseases including Alzheimer’s disease (AD). In this study, structure-based virtual screening was performed to search database for compounds targeting GSK-3β from Enamine’s screening collection. Of the top-ranked compounds, 7 primary hits underwent a luminescent kinase assay and a cell assay using human neuroblastoma SH-SY5Y cells expressing Tau repeat domain (TauRD) with pro-aggregant mutation ΔK280. In the kinase assay for these 7 compounds, residual GSK-3β activities ranged from 36.1% to 90.0% were detected at the IC50 of SB-216763. In the cell assay, only compounds VB-030 and VB-037 reduced Tau aggregation in SH-SY5Y cells expressing ΔK280 TauRD-DsRed folding reporter. In SH-SY5Y cells expressing ΔK280 TauRD, neither VB-030 nor VB-037 increased expression of GSK-3α Ser21 or GSK-3β Ser9. Among extracellular signal-regulated kinase (ERK), AKT serine/threonine kinase 1 (AKT), mitogen-activated protein kinase 14 (P38) and mitogenactivated protein kinase 8 (JNK) which modulate Tau phosphorylation, VB-037 attenuated active phosphorylation of P38 Thr180/ Tyr182, whereas VB-030 had no effect on the phosphorylation status of ERK, AKT, P38 or JNK. However, both VB-030 and VB-037 reduced endogenous Tau phosphorylation at Ser202, Thr231, Ser396 and Ser404 in neuronally differentiated SH-SY5Y expressing ΔK280 TauRD. In addition, VB-030 and VB-037 further improved neuronal survival and/or neurite length and branch in mouse hippocampal primary culture under Tau cytotoxicity. Overall, through inhibiting GSK-3β kinase activity and/or p-P38 (Thr180/Tyr182), both compounds may serve as promising candidates to reduce Tau aggregation/cytotoxicity for AD treatment.