Pulmonary hemorrhage in neonatal respiratory distress syndrome: Radiographic evolution, course, complications and long-term clinical outcomes

BACKGROUND

Pulmonary hemorrhage (PH) is occasionally seen in premature infants after surfactant treatment for respiratory distress syndrome (RDS). These infants receive frequent chest radiographs (CXR) during and after hospitalization enabling long-term radiographic-clinical correlation.

OBJECTIVE

To chart the natural evolution of CXR findings of PH in RDS and correlate radiographic patterns to supplemental oxygen requirement.

MATERIALS AND METHODS

Retrospective review of clinical notes for gestational age (GA), birth weight (BW), intraventricular hemorrhage (IVH) and oxygen requirement were performed. CXRs were reviewed at 4 time-points; during PH, 28 days postnatal age, 36 weeks and at farthest available clinical follow-up.

RESULTS

18 infants born (2003-2016), GA (24-30 weeks); BW (482-1590 grams) were included. Mean onset of PH was 1.94 (0-5) days. 9/18 (50%) had IVH. 3 died during PH; all had IVH. During PH, CXR showed whiteout 9/18 (50%); patchy opacities 5/18 (27%); diffuse haziness 1/18 (6%) and no change 3/18 (17%). At 28 days postnatal age, CXR showed fine-interstitial (FI) markings 14/15 (93%) and whiteout 1/15 (7%). At 36 weeks,12/14 (85%) had FI and 2/14 (15%) developed cystic-interstitial changes. At farthest follow-up, FI 3/13 (23%); coarse-interstitial 4/13 (30%); peri-bronchial cuffing 5/13 (38%); normal 1/13 (9%) and the majority had hyperinflation 9/13 (69%). At discharge, 9/14 (64%) required home-oxygen and 5/14 (36%) were on room-air. At farthest follow-up, 6/14 (42%) required home-oxygen and 8/14 (58%) were on room-air.

CONCLUSION

Premature infants that survive PH may later develop chronic lung disease of prematurity with an evolving interstitial pattern on CXR that clears overtime as they outgrow the need for supplemental oxygen.

Probing the size- and constituent-mediated mechanical properties and deformation behavior in crystalline/amorphous nanolaminates

Two kinds of crystalline/amorphous nanolaminates (C/ANLs), i.e., Ag/Cu-Zr and Mo/Cu-Zr, with a wide range of modulation ratios η (thickness ratio of the amorphous layer to the crystalline layer) from 0.1 up to 9.0 were, respectively, prepared using magnetron sputtering. The hardness and the strain rate sensitivity m were measured for comparison through nanoindentation testing. The mechanical properties displayed a strong η-dependence, which was tuned by the crystalline phases. With the increase of η, the hardness increased in the Ag/Cu-Zr nanolaminates while it decreased in the Mo/Cu-Zr ones. However, the two C/ANLs showed similar variations in m that was reduced gradually from positive values at small η to negative values at large η. Microstructural examination demonstrated that the amorphous Cu-Zr layers in both the C/ANLs showed a deformation-induced crystallization (DIC) phenomenon within the nanoindentation deformation zone. The DIC was highly dependent on η and became more intense in the Mo/Cu-Zr than in the Ag/Cu-Zr C/ANLs. The η- and constituent-dependent DIC behaviors were rationalized in light of the stress field applied on the amorphous layers that is sensitive to both the amorphous layer thickness and the crystalline constituents. This DIC-induced negative m in amorphous layers competed with the positive m in crystalline layers, leading to a negative-to-positive change in m on reducing η. The underlying deformation mechanism was revealed to be the cooperation between dislocation activities in the crystalline layers and shear transformation zone motions in the amorphous layers. Furthermore, a modified mechanistic model was utilized to quantitatively describe the η-dependent hardness at different crystalline constituents.

[Germline gene testing of the RET, VHL, SDHD and SDHB genes in patients with pheochromocytoma/paraganglioma]

OBJECTIVE

To analyze the germline variations of genes RET, VHL, SDHD and SDHB in patients with pheochromocytoma and/or paraganglioma and to evaluate variations of these genes in Chinese patients.

METHODS

Patients who were treated in Peking University First Hospital from September 2012 to March 2014 and diagnosed with pheochromocytoma and/or paraganglioma by pathologists were included in this study. Twelve patients were included in total, of whom 11 had pheochromocytoma, and 1 had paraganglioma. Deoxyribonucleic acid (DNA) was extracted from the leukocytes of peripheral blood of the patients. The exons 10, 11, 13-16 of the RET gene, and all exons of VHL, SDHB and SDHD genes and their nearby introns (±20 bp) were amplified with polymerase chain reactions, and the products were sent to a biotechnology company for sequencing. The sequencing results were compared with wildtype sequences of these genes to identify variations. One of the patients was diagnosed with multiple endocrine neoplasia type 2A. A family analysis was performed in his kindred, and his family members received genetic tests for the related variations.

RESULTS

Three patients were found to have germline gene variations. A c.136C>T (p.R46X) variation of the SDHB gene was found in a patient with malignant pheochromocytoma. A c.1901G>A (C634Y) variation, as well as c.2071G>A (p.G691S) and c.2712C>G (p.S904S) variations of the RET gene were found in a patient with multiple endocrine neoplasia type 2A. After a family analysis, five family members of this patient were found to have the same variations. c.2071G>A (p.G691S) and c.2712C>G (p.S904S) variations of the RET gene were also found in a clinical sporadic patient without evidence of malignancy. A patient with congenital single ventricle malformation and pheochromocytoma was included in this study, and no variation with clinical significance was found in the four genes of this patient.

CONCLUSION

25% (3/12) patients with pheochromocytoma or paraganglioma were found to have missense or nonsense germline gene variations in this study, including the c.136C>T (p.R46X) variation of the SDHB gene, the c.1901G>A (C634Y) variation of the RET gene, and c.2071G>A (p.G691S) and c.2712C>G (p.S904S) variations of the RET gene. The former two variations have already been confirmed to be pathogenic. The existence of these variations in Chinese patients with pheochromocytoma and/or paraganglioma was validated in this study, which supports the conclusion that genetic testing is necessary to be generally performed in patients with pheochromocytoma and/or paraganglioma.

Unraveling the discrepancies in size dependence of hardness and thermal stability in crystalline/amorphous nanostructured multilayers: Cu/Cu-Ti vs. Cu/HfO2

Crystalline/amorphous interfaces (CAIs) confer outstanding mechanical properties on crystalline/amorphous nanostructured multilayers (C/ANMs), which are widely used in micro/nanodevices, because their unique interfacial structure possesses high strain compatibility. In this study, Cu/X (X = Cu-Ti, HfO2) C/ANMs with equal layer thicknesses (h) were comparatively investigated in terms of size-dependent hardness (H) and thermal stability to uncover the fundamental difference(s) between Cu/Cu-Ti and Cu/HfO2. It was found that both as-deposited Cu/Cu-Ti and Cu/HfO2 C/ANMs exhibited a maximum hardness at a critical thickness of h ∼30 nm, which was caused by a transition from confined dislocation gliding to dislocation transmission across the interface. Specifically, the Cu/Cu-Ti C/ANMs exhibited annealing hardening, whereas the Cu/HfO2 C/ANMs exhibited annealing softening associated with a minimum softening at h ∼ 30 nm, which was closely correlated with their thermal stability. In comparison with monolithic amorphous X thin films, the glassy X nanolayers in the present Cu/X C/ANMs exhibited reduced thermal stability and a trend that smaller sizes led to higher stability. The underlying mechanism of the size-dependent crystallization behavior of X nanolayers is discussed in terms of the constraining effects of the interface. These findings provide deep insights into the design of Cu/metallic-glass and Cu/ceramic-glass C/ANMs with optimal performance.

[Associations of obesity and physical activity with cognition in people aged 50 and above in Shanghai]

Objective: To investigate the associations of obesity and physical activity with cognition in the elderly. Methods: A cross-sectional survey was conducted from October 2009 to June 2010 among people aged ≥50 years selected through multistage random cluster sampling in Shanghai. The subjects' body weight, body height, waist circumference and hip circumference were measured to calculate body mass index (BMI) and waist-hip ratio (WHR), and the data on self-reported physical activity level were collected through questionnaire survey. A comprehensive battery of cognitive tests was conducted to assess subjects' cognitive functions, including verbal recall, forward digit span (FDS), backward digit span (BDS), and verbal fluency (VF). General linear model was used to examine the associations of BMI, WHR and physical activity with cognition. Results: A total of 7 913 participants were included, with a median age of 60 years. Age, sex, education level, income level, BMI, WHR and physical activity level were significantly associated with cognitive scores in univariate analysis. After adjusted for age, sex, education level and income level, BMI was no longer significantly associated with cognitive scores in all cognitive functions (all P>0.01). WHR was significantly associated with VF score (P<0.01). Abdominally obese participants had lower VF score than non-abdominally obese participants (P<0.01). Physical activity level was significantly associated with all cognitive functions (P<0.01). Compared with participants with moderate physical activity level, participants with low physical activity level had lower scores in all cognitive functions (P<0.01). Conclusion: Abdominal obesity and low physical activity level were negatively associated with cognition level in the elderly, suggesting that waist circumference control and physical activity might help maintain cognition in the elderly.

The W alloying effect on thermal stability and hardening of nanostructured Cu-W alloyed thin films

In order to achieve desired mechanical properties of alloys by manipulating grain boundaries (GBs) via solute decoration, it is of great significance to understand the underlying mechanisms of microstructural evolution and plastic deformation. In this work, nanocrystalline (NC) Cu-W alloyed films with W concentrations spanning from 0 to 40 at% were prepared by using magnetron sputtering. Thermal stability (within the temperature range of 200 °C-600 °C) and hardness of the films were investigated by using the x-ray diffraction, transmission electron microscope (TEM) and nanoindentation, respectively. The NC pure Cu film exhibited substantial grain growth upon all annealing temperatures. The Cu-W alloyed films, however, displayed distinct microstructural evolution that depended not only on the W concentration but also on the annealing temperature. At a low temperature of 200 °C, all the Cu-W alloyed films were highly stable, with unconspicuous change in grain sizes. At high temperatures of 400 °C and 600 °C, the microstructural evolution was greatly controlled by the W concentrations. The Cu-W films with low W concentration manifested abnormal grain growth (AGG), while the ones with high W concentrations showed phase separation. TEM observations unveiled that the AGG in the Cu-W alloyed thin films was rationalized by GB migration. Nanoindentation results showed that, although the hardness of both the as-deposited and annealed Cu-W alloyed thin films monotonically increased with W concentrations, a transition from annealing hardening to annealing softening was interestingly observed at the critical W addition of ∼25 at%. It was further revealed that an enhanced GB segregation associated with detwinning was responsible for the annealing hardening, while a reduced solid solution hardening for the annealing softening.

A preliminary study on topical ozonated oil in the therapeutic management of atopic dermatitis in murine

OBJECTIVE

To explore whether ozonated oil recovery atopic dermatitis (AD) via immunoregulation.

METHODS

Mice were repeatedly challenged with the triplex allergens of staphylococcal enterotoxin B, ovalbumin and calcipotriol ointment on the back to develop AD lesions, and were treated with ozonated oil. The lesional skins were scanned by reflectance confocal microscopy to measure the thickness of epidermis. The skin tissues were stained. Th1-type and Th2-type cytokines in serum and in tissues were detected by ELISA and real-time PCR, respectively.

RESULTS

Ozonated oil significantly inhibited inflammation and healed the lesions in 7 d. Ozonated oil inhibited NGF expression as compared to the groups treated with vehicle or PBS (p < .01).The serum proteins and lesional transcripts of Th2 cytokines including IL-4 and IL-31 were lower in the ozonated oil treated group than the groups treated with vehicle or PBS (p < .05). The IL-10 level was increased with treatment of ozonated oil (p < .01). On the other hand, the expressions of Th1 cytokines including IL-2, TNF-α, and IFN-γ in the serum were not regulated by ozonated oil.

CONCLUSIONS

Our results showed that ozonated oil could suppress inflammation in an AD murine via decreasing Th2-dominant cytokines response and increasing IL-10 expression. These suggest that ozonated oil may be a potential remedy for AD.

Continuous low temperature synthesis of MAPbX3 perovskite nanocrystals in a flow reactor

Perovskite nanocrystals prepared at room temperature using a simple flow reactor.

Stacking fault-mediated ultrastrong nanocrystalline Ti thin films

In this work, we prepared nanocrystalline (NC) Ti thin films with abundant stacking faults (SFs), which were created via partial dislocations emitted from grain boundaries and which were insensitive to grain sizes. By employing the nanoindentation test, we investigated the effects of SFs and grain sizes on the strength of NC Ti films at room temperature. The high density of SFs significantly strengthens NC Ti films, via dislocation-SF interactions associated with the reported highest Hall-Petch slope of ∼20 GPa  nm^1/2, to an ultrahigh strength of ∼4.4 GPa, approaching ∼50% of its ideal strength.