Comparison of Near-Infrared Spectroscopy-Based Cerebral Autoregulatory Indices in Extremely Low Birth Weight Infants

BACKGROUND

Premature infants are born with immature cerebral autoregulation function and are vulnerable to pressure passive cerebral circulation and subsequent brain injury. Measurements derived from near-infrared spectroscopy (NIRS) have enabled continuous assessment of cerebral vasoreactivity. Although NIRS has enabled a growing field of research, the lack of clear standardization in the field remains problematic. A major limitation of current literature is the absence of a comparative analysis of the different methodologies.

OBJECTIVES

To determine the relationship between NIRS-derived continuous indices of cerebral autoregulation in a cohort of extremely low birth weight (ELBW) infants.

METHODS

Premature infants of birth weight 401-1000 g were studied during the first 72 h of life. The cerebral oximetry index (COx), hemoglobin volume index (HVx), and tissue oxygenation heart rate reactivity index (TOHRx) were simultaneously calculated. The relationship between each of the indices was assessed with Pearson correlation.

RESULTS

Fifty-eight infants with a median gestational age of 25.8 weeks and a median birth weight of 738 g were included. Intraventricular hemorrhage (IVH) was detected in 33% of individuals. COx and HVx demonstrated the highest degree of correlation, although the relationship was moderate at best (r = 0.543, p < 0.001). No correlation was found either between COx and TOHRx (r = 0.318, p < 0.015) or between HVx and TOHRx (r = 0.287, p < 0.029). No significant differences in these relationships were found with respect to IVH and no IVH in subgroup analysis.

CONCLUSIONS

COx, HVx, and TOHRx are not numerically equivalent. Caution must be applied when interpreting or comparing results based on different methodologies for measuring cerebral autoregulation. Uniformity regarding data acquisition and analytical methodology are needed to firmly establish a gold standard for neonatal cerebral autoregulation monitoring.

The Effect of Contingent Singing on Infants with Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit

A significant component of care for infants with bronchopulmonary dysplasia (BPD) is providing an optimal environment for supporting neurodevelopment and growth. Interventions that support the behavioral and physiologic stability of this population may play an important role in improving overall outcomes. Contingent singing is a music intervention that allows the caregiver to tailor certain musical elements, such as rhythm and tempo, to match behavioral and physiologic cues and support the infant in achieving optimal stabilization. A randomized crossover design was used to study the effect of contingent singing on the behavioral state and physiologic measures compared to standard care practices in the neonatal intensive care unit (NICU). Data were collected on a sample of 37 infants diagnosed with BPD. There were no significant differences in the physiologic measures or behavioral states of infants in the contingent singing sessions compared to control sessions. Parents and staff reported favorable views of music therapy in the NICU, and there were no adverse responses from infants during contingent singing. Further research is needed to determine the effectiveness of this intervention on the physiologic stability of infants with BPD.

Probiotic effects of mixture of Groenewaldozyma salmanticensis and Gluconacetobacter liquefaciens on growth and immune responses in Paralichthys olivaceus

This study was performed to evaluate the effects of dietary probiotics on growth, non-specific immune responses and disease resistance in olive flounder, Paralichthys olivaceus. During 8 weeks, the fish were fed the five experimental diets such as a basal commercial diet (CON), oxytetracycline (OTC) and three basal diets containing Bacillus subtilis (BS), a commercial microbial product (CES) and a mixture of yeast and bacterium (PI), respectively. Fish fed all the probiotics diets and OTC showed a significantly higher growth than fish-fed CON (P < 0·05). Fish-fed PI had a significantly higher nitroblue tetrazolium activity, whereas fish-fed CES showed a higher lysozyme level (P < 0·05). A 7-day challenge test also showed that fish-fed PI had a cumulative survival rate equivalent to that of fish-fed OTC (P < 0·05). Moreover, the diet (PI) appeared to increase the diversity of microbial community in the fish. All these results suggest that the probiotics diet could function as a potential antibiotic replacer in the olive flounder. SIGNIFICANCE AND IMPACT OF THE STUDY: This study is unique in revealing that a diet mixture of yeast, Groenewaldozyma salmanticensis and bacterium Gluconacetobacter liquefaciens can enhance growth, innate immunity and diversity of microbial community including dominant species in the olive flounder. All these indicate that the diet mixture could function as a potential antibiotic replacer in one of the most commercially important fisheries in South Korea.

The Upper Limit of Cerebral Blood Flow Autoregulation Is Decreased with Elevations in Intracranial Pressure

BACKGROUND

The upper limit of cerebrovascular pressure autoregulation (ULA) is inadequately characterized. We sought to delineate the ULA in a neonatal swine model.

METHODS

Neonatal piglets with sham surgery (n = 9), interventricular fluid infusion (INF; n = 10), controlled cortical impact (CCI; n = 10), or impact + infusion (CCI + INF; n = 11) had intracranial pressure monitoring and bilateral cortical laser-Doppler flux recordings during arterial hypertension until lethality. An increase in red cell flux as a function of cerebral perfusion pressure was determined by piecewise linear regression and static rates of autoregulation (SRoRs) were determined above and below this inflection.

RESULTS

When identified, the ULA (median [interquartile range]) was as follows: sham group: 102 mmHg (97-109), INF group: 75 mmHg (52-84), CCI group: 81 mmHg (69-101), and CCI + INF group: 61 mmHg (52-57; p = 0.01). Both groups with interventricular infusion had significantly lower ULA compared with the sham group.

CONCLUSION

Neonatal piglets without intracranial pathological conditions tolerated acute hypertension, with minimal perturbation of cerebral blood flow. Piglets with acutely elevated intracranial pressure, with or without trauma, demonstrated loss of autoregulation when subjected to arterial hypertension.

Effects of short-term citicoline treatment on acute cocaine intoxication and cardiovascular effects

RATIONALE

The majority of pharmacotherapies proposed for cocaine dependence have been marginally effective and frequently have undesirable side effects. We recently demonstrated that short-term treatment with citicoline decreased self-reported desire to use cocaine in crack cocaine users.

OBJECTIVE

The present study was conducted to assess the safety of citicoline in combination with cocaine by investigating whether cocaine-induced cardiovascular and behavioral effects and cocaine plasma levels are altered by citicoline pretreatment.

METHODS

Eight healthy male and female volunteers who used cocaine on an occasional basis participated in this randomized, placebo-controlled, three-visit study. During all three visits, subjects received an acute intranasal dose of cocaine (0.9 mg/kg) and were continuously monitored for the ensuing 3.5 h. The first visit involved no pretreatment, and visits 2 and 3 were preceded by a 4-day pretreatment period of either citicoline (1 g/day) or placebo.

RESULTS

Citicoline pretreatment did not alter the cardiovascular, physiologic, or subjective effects of acute cocaine.

CONCLUSIONS

Although citicoline did not block the acute subjective effects of cocaine in a laboratory environment, the combined use of citicoline and a moderate dose of intranasal cocaine presented no added risk of cardiovascular effects. Further study is necessary to determine whether this medication (which is currently used to treat strokes) will be a useful adjunct to treat cocaine dependence.

Angiogenesis effects of nerve growth factor (NGF) on rat corneas

This study was performed to evaluate the effects of nerve growth factor (NGF) upon angiogenesis in the rat cornea, to examine its possible application as an alternative angiogenic inducer and to provide basic data for further studies. Angiogenesis was induced by cornea micropocket assay, as previously described. Eight of thirty two eyes of Sprague-Dawley rats were randomly assigned to one of four groups, namely, a non-NGF group (Group 0), a 0.5 ng of NGF group (Group 0.5), a 1.0 ng of NGF group (Group 1.0) and a 5.0 ng of NGF group (Group 5.0). Pellets made of poly-2-hydroxylethylmethacrylate and sucralfate were implanted into the corneal stroma no closer than 1 mm from the limbus. After the implantation, the number of new vessels, vessel length and circumferential neovascularization were examined daily under the surgical microscope over a period of 7 days. The area of neovascularization was determined using a mathematical formula. Although new vessels in Group 0 and Group 0.5 were first observed at day 5, those of Groups 1.0 and 5.0 were first noted on days 4 and 3, respectively. However, the growth rates of new vessels in Groups 1.0 and 5.0 were higher than those of Groups 0 and 0.5 with the passage of time. The number, length, circumferential neovascularization and areas covered by the vessels in Groups 1.0 and 5.0 were significantly more than in Group 0 and Group 0.5 (p<0.05). This study showed that NGF had a dose-dependent angiogenic effects on the rat cornea and that the minimal effective dose of NGF was 1.0 ng per cornea. Also, it showed that NGF would be useful in angiogenic studies as an alternative angiogenic inducer.

Formulation and in vivo evaluation of omeprazole buccal adhesive tablet

For the development of omeprazole buccal adhesive tablets, we studied the release and bioavailability of omeprazole delivered by buccal adhesive tablets composed of sodium alginate, hydroxypropylmethylcellulose (HPMC), magnesium oxide and croscarmellose sodium. Croscarmellose sodium enhanced the release of omeprazole from the tablets. The analysis of the release mechanism showed that croscarmellose sodium changed the release profile of omeprazole from first- to zero-order release kinetics by forming porous channels in the tablet matrix. However, it decreased the bioadhesive forces and stability of omeprazole tablets in human saliva. The tablet is composed of omeprazole-sodium alginate-HPMC-magnesium oxide-croscarmellose sodium (20:24:6:50:10 mg). It may be attached to the human cheek without collapse and it enhanced the stability of omeprazole in human saliva for at least 4 h, giving a fast release of omeprazole. The plasma concentration of omeprazole in hamsters increased to reach a maximum of 370 ng/ml at 45 min after buccal administration and remained at the high level of 146-366 ng/ml for 6 h. The buccal bioavailability of omeprazole in hamsters was 13.7+/-3.2%. These results demonstrate that the omeprazole buccal adhesive tablet would be useful to deliver omeprazole which degrades very rapidly in acidic aqueous medium and undergoes hepatic first-pass metabolism after oral administration.

Middle mediastinal lesions: imaging findings and pathologic correlation

Lesions primarily involving the middle mediastinum are uncommon and include lymph node diseases, cystic lesions, neurogenic tumors, mesenchymal tumors, tumors of mediastinal organ, amd other benign processes. In this article, we illustrate imaging findings of a variety of middle mediastinal lesions with pathologic correlation.

Modifications of the Lejour vertical mammaplasty: analysis of results in 100 consecutive patients

The technique of vertical mammaplasty described by Madeline LeJour nearly ten years ago has been slow to gain wide acceptance in the United States. This is perhaps due to the misconception by many that this technique is more technically demanding or harder to reproduce and teach on a consistent basis. This paper describes several modifications to Madam LeJour's procedure, including the use of a template, a controlled excision, and a tension free nipple areola complex closure. When applied routinely, these modifications to the LeJour mammaplasty have produced predictable, reliable and extremely satisfying results.

Cross-generational attributions concerning locus of control beliefs

Age differences and attributions of age differences in locus of control orientation were examined for college students and older adults. Self-ratings and ratings of the other group by sixty college students and ninety-seven older adults were measured using Rotter's locus of control items in a Likert format. Findings showed that both age groups misattributed levels of control orientation to the other group when compared to that group's self-ratings. Older adults endorsed more internal beliefs than did college students. College students viewed older adults as more external than older adults viewed themselves, while older adults viewed college students as more internal than students' self-ratings indicated. The common perception in gerontological literature that older adults are particularly external in their locus of control beliefs may represent an erroneous attribution rather than self-reported beliefs.

Fabry-Perot wavemeter for shot-by-shot analysis of pulsed lasers

A Fabry-Perot wavemeter for analyzing a pulsed laser operating in a single longitudinal mode with an injection-seeding technique has been constructed with an array detector. This wavemeter permits the real-time measurement of both the wavelength and the spectral effectiveness of the laser pulse produced at 10 Hz. The performance of the wavemeter is checked with a frequency-stabilized He-Ne laser and a double Nd:YAG laser that operates in the single longitudinal mode. The precision of the wavemeter is found to be < 10 MHz. Also, we calculated the uncertainties in determining the wave number by processing a Fabry-Perot fringe pattern imaged on a linear-array detector. The calculation is done by changing the number of pixels of the array detector, the finesse of the Fabry-Perot étalon, the waist of the incident laser beam, and the magnitude of random noise.

Interpersonal relations and helping norms among university students of Japan, Taiwan, and Korea

This study investigated the effects of interpersonal relations on some aspects of moral judgment among 68 Japanese, 70 Chinese, and 92 Korean university students. The subjects were asked to judge agents' acts in stories about varied helping situations which formed a factorial design: familiarity and kinship between subjects and the agent, those between the agent and the victim, and actions. Analysis showed that the two relationships between the agent and the victim significantly affected judgments in three cultures. The magnitudes of the effects of kinship between agent and victim varied across the cultures.

Reward dominance and passive avoidance learning in adolescent psychopaths

This study tests predictions that adolescent psychopaths are hyperresponsive to rewards (Quay, 1988) and deficient in passive avoidance learning (Newman & Kosson, 1986). Forty male adolescent juvenile offenders were divided into psychopaths and nonpsychopaths using cluster analysis. Subjects were administered a passive avoidance learning task which required learning when to respond to cards associated with either reward or punishment. Results showed a greater responsivity to reward in psychopaths, with no group differences in passive avoidance errors. Results lend support to the view that psychopaths tend to focus on the prospect of reward under conditions of mixed incentives and, when sufficiently motivated, are capable of improved performance. Together with findings of recent psychophysiological studies, these results suggest that adolescent psychopaths may have latent abilities which could have treatment implications.

Reference wavelength method for a two-color pyrometer

The reference wavelength method is used for a two-color pyrometer and, with the reference wavelength method, an analytical formula of the ratio temperature for the two-color pyrometer is derived. For one channel of the two-color pyrometer, with a triangular spectral response of 0.1-micro m FWHM and 2.0-micro m peak wavelength, the effective wavelength and the correction factors with several reference wavelengths are determined. By fitting the curves of the effective wavelength and the correction factor to simple functional forms of temperature, the radiance errors for both cases are calculated. Also, it is found that the correction factor determined in a single-color pyrometer can be used directly in one channel of the two-color pyrometer without additional calculation.

Delayed consequences of endothelial removal from rabbit aortae

One year after de-endothelialization of rabbit aorta by a balloon catheter, the damaged areas show arteriosclerotic thickening. In the study described here, aortae from six rabbits were examined 2 years after the single injury. Three had advanced atherosclerotic lesions. All the animals had been fed standard rabbit chow, and the five tested did not have hypercholesterolemia when they were sacrificed. Apparently vascular injury alone is sufficient basis for development of atherosclerotic disease in the rabbit.

Anthraquinone pigments from Phoma foveata Foister

1. Suitable conditions have been determined for growing the fungus Phoma foveata in culture for optimum production of pigments. 2. The pigments have been extracted and fractionated according to their solubility in aqueous bicarbonate, carbonate and alkali. 3. The carbonate- and alkali-soluble pigments have been further separated by chromatography and shown to consist of anthraquinone derivatives. 4. The alkali-soluble fraction, which comprised the bulk of the pigment, consists of pachybasin (1-hydroxy-3-methylanthraquinone; II) and chrysophanol (1,8-dihydroxy-3-methylanthraquinone; III) by comparison with authentic samples. 5. The carbonate-soluble fraction contains emodin (1,6,8-trihydroxy-3-methylanthraquinone; V) and a hitherto unrecorded pigment for which the name phomarin and the structure 1,6-dihydroxy-3-methylanthraquinone (IV) are put forward. 6. The identification of emodin and the structural determination of phomarin are based largely on their ultraviolet, visible, infrared, nuclear-magnetic-resonance and mass spectra.