Summary
We present a case of a 29 months old previously healthy child who experienced apnea resulting in brain injury following a dose of acetaminophen and codeine 2 days after an uneventful ...anesthetic for tonsillectomy. A genetic polymorphism leading to ultra‐rapid metabolism of codeine into morphine resulted in narcosis and apnea. This paper discusses the use of codeine for pain relief, obstructive sleep apnea, the alteration of the CYP2D6 gene and the resulting effect on drug metabolism.
Let c be a proper edge coloring of a graph G=(V,E) with integers 1,2,…,k. Then k≥Δ(G), while Vizing's theorem guarantees that we can take k≤Δ(G)+1. On the course of investigating irregularities in ...graphs, it has been conjectured that with only slightly larger k, that is, k=Δ(G)+2, we could enforce an additional strong feature of c, namely that it attributes distinct sums of incident colors to adjacent vertices in G if only this graph has no isolated edges and is not isomorphic to C5. We prove the conjecture is valid for planar graphs of sufficiently large maximum degree. In fact an even stronger statement holds, as the necessary number of colors stemming from the result of Vizing is proved to be sufficient for this family of graphs. Specifically, our main result states that every planar graph G of maximum degree at least 28, which contains no isolated edges admits a proper edge coloring c:E→{1,2,…,Δ(G)+1} such that ∑e∋uc(e)≠∑e∋vc(e) for every edge uv of G.
A locally irregular graph is a graph whose adjacent vertices have distinct degrees. We say that a graph G can be decomposed into k locally irregular subgraphs if its edge set may be partitioned into ...k subsets each of which induces a locally irregular subgraph in G. We characterize all connected graphs which cannot be decomposed into locally irregular subgraphs. These are all of odd size and include paths, cycles and a special class of graphs of maximum degree 3. Moreover we conjecture that apart from these exceptions all other connected graphs can be decomposed into 3 locally irregular subgraphs. Using a combination of a probabilistic approach and some known theorems on degree constrained subgraphs of a given graph, we prove this statement to hold for all regular graphs of degree at least 107. We also support this conjecture by showing that decompositions into three or two such subgraphs might be indicated e.g. for some bipartite graphs (including trees), complete graphs and cartesian products of graphs with this property (hypercubes for instance). We also investigate a total version of this problem, where in some sense also the vertices are being prescribed to particular subgraphs of a decomposition. Both the concepts are closely related to the known 1-2-3 Conjecture and 1-2 Conjecture, respectively, and other similar problems concerning edge colourings. In particular, we improve the result of Addario-Berry et al. (2005) in the case of regular graphs.
A proper edge
k
-colouring of a graph
G
=
(
V
,
E
)
is an assignment
c
:
E
→
{
1
,
2
,
…
,
k
}
of colours to the edges of the graph such that no two adjacent edges are associated with the same ...colour. A neighbour sum distinguishing edge
k
-colouring, or nsd
k
-colouring for short, is a proper edge
k
-colouring such that
∑
e
∋
u
c
(
e
)
≠
∑
e
∋
v
c
(
e
)
for every edge
uv
of
G
. We denote by
χ
Σ
′
(
G
)
the neighbour sum distinguishing index of
G
, which is the least integer
k
such that an nsd
k
-colouring of
G
exists. By definition at least maximum degree,
Δ
(
G
)
colours are needed for this goal. In this paper we prove that
χ
Σ
′
(
G
)
≤
Δ
(
G
)
+
1
for any graph
G
without isolated edges, with
mad
(
G
)
<
3
and
Δ
(
G
)
≥
6
.
Consider a graph G=(V,E) of minimum degree δ and order n. Its total vertex irregularity strength is the smallest integer k for which one can find a weighting w:E∪V→{1,2,...,k} such that ...∑e∋uw(e)+w(u)≠∑e∋vw(e)+w(v) for every pair u,v of vertices of G. We prove that the total vertex irregularity strength of graphs with δ≥n0.5lnn is bounded from above by (2+o(1))nδ+4. One of the cornerstones of the proof is a random ordering of the vertices generated by order statistics.
Variations in urothelial carcinoma (UC) response to platinum chemotherapy are common and frequently attributed to genetic and epigenetic variations of somatic DNA. We hypothesized that variations in ...germline DNA may contribute to UC chemosensitivity.
DNA from 210 UC patients treated with platinum-based chemotherapy was genotyped for 80 single nucleotide polymorphisms (SNPs). Logistic regression was used to examine the association between SNPs and response, and a multivariable predictive model was created. Significant SNPs were combined to form a SNP score predicting response. Eleven UC cell lines were genotyped as validation.
Six SNPs were significantly associated with 101 complete or partial responses (48%). Four SNPs retained independence association and were incorporated into a response prediction model. Each additional risk allele was associated with a nearly 50% decrease in odds of response odds ratio (OR) = 0.51, 95% confidence interval 0.39–0.65, P = 1.05 × 10-7). The bootstrap-adjusted area under the curves of this model was greater than clinical prognostic factors alone (0.78 versus 0.64). The SNP score showed a positive trend with chemosensitivity in cell lines (P = 0.115).
Genetic variants associated with response of UC to platinum-based therapy were identified in germline DNA. A model using these genetic variants may predict response to chemotherapy better than clinical factors alone.
For an assignment of numbers to the vertices of a graph, let Su be the sum of the labels of all the vertices in the closed neighborhood of u, for a vertex u. Such an assignment is called closed ...distinguishing if Su≠Sv for any two adjacent vertices u and v unless the closed neighborhoods of u and v coincide. In this note we investigate disG, the smallest integer k such that there is a closed distinguishing labeling of G using labels from {1,…,k}. We prove that disG≤Δ2−Δ+1, where Δ is the maximum degree of G. This result is sharp. We also consider a list-version of the function disG and give a number of related results.
Summary
We report the case of a teenager who developed a postanesthesia acute psychosis (delusions, paranoia, and hallucinations) caused by a reaction to antibiotic therapy (amoxicillin and ...clarithromycin), so called ‘Hoigne's syndrome’ or ‘antibiomania.’ The differential diagnosis and a review of literature are presented. Our patient illustrates the importance of adding antibiomania as part of the differential diagnosis when altered postanesthesia behavior is observed in pediatric patients.
A proper total
k
-colouring of a graph
G
=
(
V
,
E
)
is an assignment
c
:
V
∪
E
→
{
1
,
2
,
…
,
k
}
of colours to the edges and the vertices of
G
such that no two adjacent edges or vertices and no ...edge and its end-vertices are associated with the same colour. A total neighbour sum distinguishing
k
-colouring, or tnsd
k
-colouring for short, is a proper total
k
-colouring such that
∑
e
∋
u
c
(
e
)
+
c
(
u
)
≠
∑
e
∋
v
c
(
e
)
+
c
(
v
)
for every edge
uv
of
G
. We denote by
χ
Σ
′
′
(
G
)
the total neighbour sum distinguishing index of
G
, which is the least integer
k
such that a tnsd
k
-colouring of
G
exists. It has been conjectured that
χ
Σ
′
′
(
G
)
≤
Δ
(
G
)
+
3
for every graph
G
. In this paper we confirm this conjecture for any graph
G
with
mad
(
G
)
<
14
3
and
Δ
(
G
)
≥
8
.
Summary
Background : Anesthesia induction in children is commonly accomplished by introducing volatile agents by mask. Occasionally a child describes an excessive fear of the anesthesia facemask. ...Little is known of the cause of the fear or of the quality or magnitude of the feelings the child is experiencing. The purpose of this study was to allow children who have established mask fear as demonstrated by volunteering the presence of fear and requesting no mask be placed on the face during the induction of anesthesia and their parents to describe and compare the distress from the mask to the alternative intravenous anesthesia induction.
Methods : Eight children describing mask fear on the preanesthetic examination were studied. An Anesthesia Mask Fear questionnaire developed by the investigators was answered by the children and their parents.
Results : Six children and their parents completed the study. The age at presentation of mask fear ranged from 1.4 to 14 years. There were one to 16 anesthetic exposures prior to reporting mask fear. One child described an aversion to the odor of the mask. Another boy developed mask fear after a single anesthetic exposure. He was subsequently diagnosed with a generalized anxiety disorder. Four female children developed mask fear after repeated anesthetic exposures. These children rated mask fear with the greatest discomfort possible while venous cannulation was scored at half or less that of the mask discomfort.
Conclusions : Care must be taken when developing a plan for anesthesia induction in children requiring multiple procedures. Children may develop an aversion to the odor or feel of the mask, or have a true phobia (irrational fear) of the mask. Those children with a phobia might also have other underlying anxieties.
PDF
