ACADEMIC EMERGENCY MEDICINE, Issue 4 2010
Robert F. McCormack MD
Abstract Objectives:, The primary goal of evaluation for acute-onset headache is to exclude aneurysmal subarachnoid hemorrhage (SAH). Noncontrast cranial computed tomography (CT), followed by lumbar puncture (LP) if the CT is negative, is the current standard of care. Computed tomography angiography (CTA) of the brain has become more available and more sensitive for the detection of cerebral aneurysms. This study addresses the role of CT/CTA versus CT/LP in the diagnostic workup of acute-onset headache. Methods:, This article reviews the recent literature for the prevalence of SAH in emergency department (ED) headache patients, the sensitivity of CT for diagnosing acute SAH, and the sensitivity and specificity of CTA for cerebral aneurysms. An equivalence study comparing CT/LP and CT/CTA would require 3,000 + subjects. As an alternative, the authors constructed a mathematical probability model to determine the posttest probability of excluding aneurysmal or arterial venous malformation (AVM) SAH with a CT/CTA strategy. Results:, SAH prevalence in ED headache patients was conservatively estimated at 15%. Representative studies reported CT sensitivity for SAH to be 91% (95% confidence interval [CI] = 82% to 97%) and sensitivity of CTA for aneurysm to be 97.9% (95% CI = 88.9% to 99.9%). Based on these data, the posttest probability of excluding aneurysmal SAH after a negative CT/CTA was 99.43% (95% CI = 98.86% to 99.81%). Conclusions:, CT followed by CTA can exclude SAH with a greater than 99% posttest probability. In ED patients complaining of acute-onset headache without significant SAH risk factors, CT/CTA may offer a less invasive and more specific diagnostic paradigm. If one chooses to offer LP after CT/CTA, informed consent for LP should put the pretest risk of a missed aneurysmal SAH at less than 1%. ACADEMIC EMERGENCY MEDICINE 2010; 17:444,451 © 2010 by the Society for Academic Emergency Medicine [source]

The impact of nutrient density in terms of energy and/or protein on live performance, metabolism and carcass composition of female and male broiler chickens of two commercial broiler strains

JOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 4 2010
E. Delezie
Summary The objective of this study was to investigate the effects of diet composition on performance, slaughter yield and plasma metabolites, as different modern broiler strains show different responses to feed intake. Broilers of two commercial strains and of both sexes received one of three diets being different in energy and/or protein level [control diet, low energy/low protein diet (LM/LP) and low protein diet (LP)]. Low energy/low protein diet chickens were characterized by significantly lower body weights and feed intake compared with their LP and control counterparts. Broilers of the Cobb strain or broilers that were fed the control diet were most efficient in converting energy to body weight. No significant differences in plasma metabolites were detected due to diet composition or genotype. The diet with the lower energy and crude protein levels reached the lowest slaughter yield but the highest drumstick and wing percentages. The lowest mortality percentages were observed for broilers fed the LM/LP diet, and Cobb birds appeared to be more sensitive for metabolic disorders resulting in death. It is obvious from this study that different genotypes respond differently to changes in diet composition and therefore have adjusted nutritional requirements. [source]

A Randomized, Double-Blind Comparison of Two Topical Anesthesic Formulations Prior to Electrodesiccation of Dermatosis Papulosa Nigra

DERMATOLOGIC SURGERY, Issue 1 2006
ERIC L. CARTER MD
BACKGROUND Liposomal lidocaine 4% (L.M.X.4 cream, Ferndale Laboratories Inc., Ferndale, MI, USA) has been proposed as a more rapidly acting topical anesthetic than the eutectic mixture of lidocaine 2.5% and prilocaine 2.5% (EMLA cream, AstraZeneca LP, Wilmington, DE, USA) for venipuncture and laser procedures. However, their anesthetic efficacy has not been previously compared for electrosurgical destruction of superficial skin lesions. OBJECTIVE To test the hypothesis that L.M.X.4 and EMLA differ in anesthetic efficacy when applied under occlusion for 30 minutes prior to electrodesiccation of papules of dermatosis papulosa nigra. METHODS Forty adults were randomly assigned to treatment with either agent for 30 minutes under Tegaderm. The study drug was administered for an additional 30 minutes if the electrodesiccation of the first few papules was too painful. RESULTS One subject treated with EMLA versus none treated with L.M.X.4 experienced complete anesthesia after a single 30-minute application. Nineteen of 20 (95%) subjects treated with EMLA versus 18 of 20 (90%) subjects treated with L.M.X.4 required only a single application (p=.49). Pain scores after the initial 30-minute application (scale: 0=none to 10=very severe) were EMLA 3.3±2.2 (mean±SD) versus L.M.X. 4 2.9±2.0 (p=.46). CONCLUSION EMLA and L.M.X.4 provide comparable levels of anesthesia after a single 30-minute application under occlusion prior to electrodesiccation of superficial skin lesions. [source]

A 75% insulin lispro/25% NPL mixture provides a longer duration of insulin activity compared with insulin lispro alone in patients with Type 1 diabetes

DIABETIC MEDICINE, Issue 11 2003
P. Roach
Abstract Aims To compare a new insulin formulation, high mix (HM) [75% lispro (LP) and 25% neutral protamine lispro (NPL)], to regular human insulin (HR) and LP with respect to glucose response and pharmacokinetics following a test meal in patients with Type 1 diabetes. Methods After fasting overnight, patients received an intravenous insulin infusion to standardize blood glucose (BG) to 7.5 mmol/l (135 mg/dl). In a randomised, three-way crossover study, HR was injected 30 min before, and LP or HM was injected immediately before the test meal on three separate occasions. For each patient, LP and HR were administered at identical doses; the HM dose was one and one third times that of HR and LP to maintain the same dose of short or rapid-acting insulin. The insulin infusion was stopped 15 min after the insulin injection. Free insulin and BG concentrations were measured frequently for 7 h following the test meal. Results HM and LP resulted in better glycaemic control than HR during the observation period. BG concentrations during the first 4,5 h did not differ between HM and LP. However, HM exhibited prolonged insulin activity relative to LP beyond 5 h, extending the duration of action by approximately 1 h, and resulting in lower overall BG concentrations when the 0,6- and 0,7-h intervals were considered. Conclusions Compared with LP, HM provided similar glycaemic control for up to 5 h and superior glycaemic control from 5 to 7 h following a standard test meal [source]

On the development of low-level auditory discrimination and deficits in dyslexia

DYSLEXIA, Issue 2 2004
Burkhart Fischer
Abstract Absolute auditory thresholds, frequency resolution and temporal resolution develop with age. It is still discussed whether low-level auditory performance is of clinical significance,specifically, for delayed maturation of central auditory processing. Recently, five new auditory tasks were used to study the development of low-level auditory discrimination. It was found that the development lasts up to the age of 16,18 years (on an average). Very similar tasks were now used with 432 controls and 250 dyslexic subjects in the age range of 7,22 years. For both groups the performance in one of the tasks was not related to the performance in another task indicating that the five tasks challenge independent subfunctions of auditory processing. Surprisingly high numbers of subjects were classified as low performers (LP), because they could not perform one or the other task at its easiest level and no threshold value could be assigned. For the dyslexics the incidence of LP was considerably increased in all tasks and age groups as compared with the age matched controls. The development of dynamic visual and optomotor functions and the corresponding deficits in dyslexia are discussed in relation to the auditory data presented here. Copyright © 2004 John Wiley & Sons, Ltd. [source]

Competence of New Emergency Medicine Residents in the Performance of Lumbar Punctures

ACADEMIC EMERGENCY MEDICINE, Issue 7 2005
Richard L. Lammers MD
Abstract Background: Medical students are taught some procedural skills during medical school, but there is no uniform set of procedures that all students learn before residency. Objective: To determine the level of competence in the performance of a lumbar puncture (LP) by new postgraduate year 1 (PGY1) emergency medicine (EM) residents. Methods: An observational study was conducted at three EM residencies with 42 PGY1 residents who recently graduated from 26 various medical schools. The LP procedure was divided into 26 major and 44 minor steps to create a scoring protocol. The model, procedure, and scoring protocol were validated by experienced emergency physicians. Subjects performed the procedure without interruption or feedback on an LP training model using a standard LP kit. A step was scored as "performed correctly" if two of the three evaluators concurred. Pre- and poststudy questionnaires assessed subjects' prior instruction and clinical experience with LP, self-confidence, sense of relevance, motivation, and fatigue. Results: Subjects completed an average of 14.8 (57%; 95% confidence interval [95% CI] = 53% to 61%) of the major steps (range: 4,26) and 19.1 (43%; 95% CI = 42% to 45%) of the minor steps (range: 7,28) in 14.3 minutes (range: 3,22). Sixty-nine percent failed to obtain cerebrospinal fluid from the model. Subjects' levels of confidence changed slightly on a five-point scale from 2.8 ("little-to-some") before the test to 2.5 after the test. Eighty-three percent of the subjects previously performed LPs on patients during medical school (average attempts = 2.2; range: 0,10), but only 40% of those who did so were supervised by an attending during their first attempt. Conclusions: In the cohort studied, new PGY1 EM residents had not attained competence in performing LPs from training in medical school. Most new PGY1 residents probably require training, practice, and close, direct supervision of this procedure by attending physicians until the residents demonstrate competent performance. [source]

Phosphorus availability mediates plasticity in life-history traits and predator,prey interactions in Daphnia

ECOLOGY LETTERS, Issue 10 2005
Punidan D. Jeyasingh
Abstract We analysed growth plasticity of two Daphnia pulex clones under low-phosphorus (LP) and high phosphorus (HP) conditions, in the presence of Chaoborus kairomones to examine how food quality (P-availability) might impact life-history responses and vulnerability to predation. Overall, clone 1 grew faster, and was larger at maturity. Under HP, both clones responded to kairomones by increasing growth, age and size at maturity, and decreasing fecundity. Under LP, both clones suffered reduced growth, and fecundity. However, the magnitude of response to kairomones depended on a clone by P-availability interaction. Chaoborus presented a 1 : 1 clonal mixture under HP or LP, consumed more individuals under LP. Moreover, fewer clone 1 individuals were consumed. Studying the effects of P-availability on life histories, and predator,prey interactions may help us understand the mechanisms generating and maintaining plasticity, as well as influencing genotypic diversity and microevolutionary processes in natural populations. [source]

Antiepileptic drugs combined with high-frequency electrical stimulation in the ventral hippocampus modify pilocarpine-induced status epilepticus in rats

EPILEPSIA, Issue 3 2010
Manola Cuellar-Herrera
Summary Purpose:, To evaluate the effects of high-frequency electrical stimulation (HFS) in both ventral hippocampi, alone and combined with a subeffective dose of antiepileptic drugs, during the status epilepticus (SE) induced by lithium-pilocarpine (LP). Methods:, Male Wistar rats, stereotactically implanted in both ventral hippocampi, were injected with pilocarpine (30 mg/kg, i.p.) 24 h after lithium (3 mEq/kg) administration. One minute following pilocarpine injection, HFS (pulses of 60 ,s width at 130 Hz at subthreshold intensities and applied during 3 h) was applied alone or combined with subeffective doses of antiepileptic drugs. Results:, HFS alone reduced the incidence of severe generalized seizures. This effect was not evident when HFS was combined with phenytoin (33.3 mg/kg, i.p.). HFS combined with diazepam (0.41 mg/kg, i.p.) or phenobarbital (10 mg/kg, i.p.) reduced the incidence of severe generalized seizures and mortality rate, and augmented the latency to first forelimb clonus, generalized seizure, and status epilepticus (SE). When combined with gabapentin (46 mg/kg, i.p.), HFS reduced the incidence of severe generalized seizures, enhanced latency to SE, and decreased mortality rate. Discussion:, Subeffective doses of antiepileptic drugs that increase the ,-aminobutyric acid (GABA)ergic neurotransmission may represent a therapeutic tool to augment the HFS-induced anticonvulsant effects. [source]

Incidence of Traumatic Lumbar Puncture

ACADEMIC EMERGENCY MEDICINE, Issue 2 2003
Kaushal H. Shah MD
Abstract Objective: To determine the incidence of traumatic lumbar puncture (LP). Methods: A retrospective study was conducted at an urban, university tertiary care referral center with 50,000 annual emergency department (ED) visits. The study population included all patients who had cerebrospinal fluid (CSF) samples sent to the laboratory between August 15, 2000, and August 14, 2001. The numbers of red blood cells (RBCs) recorded in the first and last CSF tubes, the location where the LP was performed, and the discharge summary and the discharge diagnoses from the particular visit were obtained. All patients with intracranial pathology and CSF obtained via neurosurgical procedure or fluoroscopic guidance were excluded from the study group. Given no clear definition of traumatic LP in the literature, the incidence of traumatic LP was calculated using a cutoff of greater than 400 RBCs (visual threshold for bloody fluid) and 1,000 RBCs (arbitrary threshold selected by other authors) in CSF tube 1. Proportions were compared using chi-square statistics. Results: Seven hundred eighty-six CSF samples were recorded over one year. Twenty-four samples were obtained from patients with intracranial pathology or were obtained via a neurosurgical procedure. Of the remaining 762 CSF samples in the study population, 119 (15.6%) were traumatic using a cutoff of 400 RBCs, and 80 (10.5%) were traumatic, using a cutoff of 1,000 RBCs in tube 1. Five hundred three LPs were done in the ED and 259 were attributed to all other locations in the hospital. Using a cutoff of 400 RBCs, the incidence of traumatic LP in the ED was 13.3%, compared with 20% in the rest of the hospital (p < 0.025). Similarly, using a cutoff of 1,000 RBCs, the incidence of traumatic LP in the ED was 8.9%, compared with 13.5% in the rest of the hospital (p = 0.1). The incidence of "champagne taps" (defined as zero RBCs in the first and last tubes) in the ED was 34.4%, compared with 24.3% in the rest of the hospital (p < 0.01). Conclusions: The incidence of traumatic lumbar puncture is approximately 15% using a cutoff of 400 RBCs and 10% using a cutoff of 1,000 RBCs. In this study, the rate of traumatic lumbar puncture was significantly less (with a cutoff of 400 RBCs) and the rate of champagne tap was significantly greater for LPs done in the ED compared with the rest of the hospital. [source]

Long-term survey of laryngoplasty and ventriculocordectomy in an older, mixed-breed population of 200 horses.

EQUINE VETERINARY JOURNAL, Issue 4 2003
Part 1: Maintenance of surgical arytenoid abduction, complications of surgery
Summary Reasons for performing study: Laryngoplasty (LP) is currently the most common surgical treatment for equine laryngeal paralysis, however, there have been no reports quantifying the degree of retention of arytenoid abduction following L P. ADitionally, the complications of LP have been poorly documented. Objectives: To record the degree of arytenoid abduction retention following LP and to accurately document all complications of surgery. Methods: A study (1986,1998) of 200 horses of mixed breed and workload, median age 6 years (prospective 136 cases and retrospective 64 cases) undergoing LP (using 2 stainless steel wires) and combined ventriculocordectomy was undertaken; 198 owners completed questionnaires, a median of 19 months following surgery. The degree of arytenoid abduction achieved was endoscopically, semi-quantitatively evaluated using a 5-grade system, at 1 day, 7 days, and 6 weeks after surgery. Results: On the day following LP, 62% of horses had good (median grade 2) arytenoid abduction, 10% had excessive (grade 1), and 5% had minimal (grade 4) abduction (overall - median grade 2). Due to progressive loss of abduction, moderate (median grade 3, range 1,5) abduction was present overall at 1 and 6 weeks after LP. Further surgery was required to re-tighten prostheses in 10% of cases with excessive loss of abduction, or to loosen prostheses in 7% of horses which had continuing high levels of LP abduction and significant post operative dysphagia. LP wound problems (mainly seromas and suture abscesses) were reported to last <2 weeks in 9% of cases, <4 weeks in 4% and >4 weeks in 4%. The (partially sutured) laryngotomy wounds discharged post operatively for <2 weeks in 22% of cases, <4 weeks in 7% and for >4 weeks in 2%. Coughing occurred at some stage post operatively in 43% of cases and its presence correlated significantly with the degree of surgical arytenoid abduction. This coughing occurred during eating in 24% of cases and was not associated with eating (or dysphagia) in the other 19% of cases. Chronic (>6 months duration) coughing occurred in 14% of cases, but appeared to be due to intercurrent pulmonary disease in half of these horses. Conclusions: Suturing the cricotracheal membrane allows most laryngotomy wounds to heal quickly. Laryngoplasty wound problems were of little long-term consequence when stainless steel wire prostheses were used. Potential relevance: A significant loss of LP abduction occurs in most horses in the 6 weeks following surgery and efforts should be made to find ways to prevent such loss. However, excessive LP abduction is associated with post operative dysphagia and coughing. [source]

Site-specific expression of CD11b and SIRP, (CD172a) on dendritic cells: implications for their migration patterns in the gut immune system

EUROPEAN JOURNAL OF IMMUNOLOGY, Issue 5 2005
Diane Bimczok
Abstract Dendritic cells (DC) in the intestinal tract play a major role in directing the mucosal immune system towards tolerance or immunity. We analyzed whether different mucosal DC subsets in pigs have specific functions, localizations, or migration patterns in vivo. Therefore, we collected physiologically migrating DC by pseudo-afferent cannulation of the intestinal duct in eight Göttingen minipigs. Lymph DC were phenotypically and functionally characterized and compared to DC found on histological sections of porcine small intestine and mesenteric lymph nodes (MLN). Four different DC subpopulations were detected. Lamina propria (LP) DC were mainly CD11b+ signal regulatory protein,, (SIRP,)+, DC in Peyer's patches were mainly CD11b,/SIRP,+ in subepithelial domes and CD11b,/SIRP,, in interfollicular regions, whereas MLN DC were largely CD11b+/SIRP,,. Of these four subsets, only the CD11b+/SIRP,+ DC and the CD11b+/SIRP,, DC were present in lymph. This suggests that DC migration to MLN largely originates from the LP. Lymph DC expressed high levels of MHC class,II and costimulatory molecules and had a low capacity for FITC-dextran uptake, indicating a mature phenotype. However, lymph DC did not induce PBMC proliferation in MLR, and migration was not significantly influenced by mucosal antigen application. [source]

Viral meningoencephalitis: a review of diagnostic methods and guidelines for management

EUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2010
I. Steiner
Background:, Viral encephalitis is a medical emergency. The prognosis depends mainly on the pathogen and host immunologic state. Correct immediate diagnosis and introduction of symptomatic and specific therapy has a dramatic influence upon survival and reduces the extent of permanent brain injury. Methods:, We searched the literature from 1966 to 2009. Recommendations were reached by consensus. Where there was lack of evidence but consensus was clear, we have stated our opinion as good practice points. Recommendations:, Diagnosis should be based on medical history and examination followed by CSF analysis for protein and glucose levels, cellular analysis, and identification of the pathogen by polymerase chain reaction amplification (recommendation level A) and serology (level B). Neuroimaging, preferably by MRI, is essential (level B). Lumbar puncture can follow neuroimaging when immediately available, but if this cannot be performed immediately, LP should be delayed only under unusual circumstances. Brain biopsy should be reserved only for unusual and diagnostically difficult cases. Patients must be hospitalized with easy access to intensive care units. Specific, evidence-based, antiviral therapy, acyclovir, is available for herpes encephalitis (level A) and may also be effective for varicella-zoster virus encephalitis. Ganciclovir and foscarnet can be given to treat cytomegalovirus encephalitis, and pleconaril for enterovirus encephalitis (IV class evidence). Corticosteroids as an adjunct treatment for acute viral encephalitis are not generally considered to be effective, and their use is controversial, but this important issue is currently being evaluated in a large clinical trial. Surgical decompression is indicated for impending uncal herniation or increased intracranial pressure refractory to medical management. [source]

Excitatory actions of substance P in the rat lateral posterior nucleus

EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 1 2010
Kush Paul
Abstract The lateral posterior nucleus (LP) receives inputs from both neocortex and superior colliculus (SC), and is involved with integration and processing of higher-level visual information. Relay neurons in LP contain tachykinin receptors and are innervated by substance P (SP)-containing SC neurons and by layer V neurons of the visual cortex. In this study, we investigated the actions of SP on LP relay neurons using whole-cell recording techniques. SP produced a graded depolarizing response in LP neurons along the rostro-caudal extent of the lateral subdivision of LP nuclei (LPl), with a significantly larger response in rostral LPl neurons compared with caudal LPl neurons. In rostral LPl, SP (5,2000 nm) depolarized nearly all relay neurons tested (> 98%) in a concentration-dependent manner. Voltage-clamp experiments revealed that SP produced an inward current associated with a decreased conductance. The inward current was mediated primarily by neurokinin receptor (NK)1 tachykinin receptors, although significantly smaller inward currents were produced by specific NK2 and NK3 receptor agonists. The selective NK1 receptor antagonist RP67580 attenuated the SP-mediated response by 71.5% and was significantly larger than the attenuation of the SP response obtained by NK2 and NK3 receptor antagonists, GR159897 and SB222200, respectively. The SP-mediated response showed voltage characteristics consistent with a K+ conductance, and was attenuated by Cs+, a K+ channel blocker. Our data suggest that SP may modulate visual information that is being processed and integrated in the LPl with inputs from collicular sources. [source]

Elevated levels of collagen cross-link residues in gingival tissues and crevicular fluid of teeth with periodontal disease

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 3 2003
Søren Jepsen
Lysylpyridinoline (LP) and hydroxylysylpyridinoline (HP) are collagen cross-link residues. Lysylpyridinoline is present in most tissues, whereas LP is present mainly in mineralized tissue. Both are elevated in tissue with increased collagen resorption. The purpose of this investigation was to assess if the concentrations of LP and HP are elevated in gingiva and gingival crevicular fluid (GCF) of teeth with advanced periodontitis (AP). We investigated human gingival biopsies of healthy teeth (n = 19) and teeth with AP (n = 43) in 49 individuals. Samples of GCF from 54 teeth with AP were collected in seven patients and compared with samples from 11 patients with experimentally induced gingivitis. Levels of LP and HP were measured by HPLC and fluorescence detection. Gingival concentrations of HP but not LP around teeth with advanced periodontitis were significantly elevated compared with teeth with healthy periodontium. While significant amounts of HP and LP were measurable in the GCF of teeth with AP, no HP and LP was identified 3 months following non-surgical periodontal therapy of the teeth or in fluid from teeth subjected to experimentally induced gingivitis. Elevated concentrations of HP and LP in GCF may serve as indicators of ongoing destruction of periodontal tissues and alveolar bone in advanced periodontitis. [source]

Fatigue life expenditure assessment and countermeasure for turbine blades due to harmonic excitations of slip energy recovery drives

EUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 8 2009
Jong-Ian Tsai
Abstract The long-term effect of noncharacteristic harmonic currents arising from a slip energy recovery drive (SERD) on the fatigue life expenditure in turbine-generator blades is presented in this paper. Since the SERD converter can be rated at a fraction of a motor due to its static converter cascade with the wound-rotor and with high efficiency characteristics, still the feedwater pumps (FPs) in a few power plants are driven by such an induction motor (IM) drive. However, because the frequencies of the three main harmonic terms of the recovery currents are subsynchronous and offer a probability distribution due to the adjustable speed operation, a systematic fatigue estimation approach was devised by the author to investigate the long-term impact for the low-pressure (LP) turbine blades. From the simulation results, it was found that such a long-term harmonic excitation becomes a cause of turbine blade failure for single generator connected to the SERD system, even though the amplitude of these harmonic currents is normal. By the effect analysis of uncertainty, the countermeasure for the turbine integrity was then found. Copyright © 2008 John Wiley & Sons, Ltd. [source]

An efficient methodology for security assessment of power systems based on distributed optimal power flow

EUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 3 2003
D. Hur
This paper presents an algorithm for the parallel solution of the security constrained optimal power flow (SCOPF) problem in a decentralized framework, consisting of regions, using a price-based mechanism that models each region as an economic unit. We first solve the distributed optimal power flow (OPF) problem to determine the maximum secure simultaneous transfer capability of each tie-line between adjacent regions by taking only the security constraints imposed on the tie-lines into account. In this paper, the line outage distribution factors (LODF) calculated at the current state are used to formulate the appended constraints. Once the secure transfer capability of each tie-line is determined, the intra-regional SCOPF is performed using the conventional linear programming (LP) approach. A description on the inclusion of security constraints with distributed OPF algorithm will be given, followed by the case study for Korea Electric Power System. [source]

Magnesium sulphate treatment decreases blood,brain barrier permeability during acute hypertension in pregnant rats

EXPERIMENTAL PHYSIOLOGY, Issue 2 2008
Anna G. Euser
Eclampsia is associated with increased blood,brain barrier (BBB) permeability and formation of cerebral oedema. Magnesium sulphate is used to treat eclampsia despite an unclear mechanism of action. This study was to determine the effect of magnesium sulphate on in vivo BBB permeability and formation of cerebral oedema during acute hypertension and on brain aquaporin-4 (AQP4) protein expression. An in vivo model of hypertensive encephalopathy was used in late-pregnant (LP) rats following magnesium sulphate treatment, 270 mg kg,1i.p. injection every 4 h for 24 h. Permeability of the BBB was determined by in situ brain perfusion of Evan's Blue (EB) and sodium fluorescein (NaFl), and dye clearance determined by fluorescence spectrophotometry. Cerebral oedema was determined following acute hypertension by measuring brain water content. The effect of magnesium treatment on AQP4 expression was determined by Western blot analysis. Acute hypertension with autoregulatory breakthrough increased BBB permeability to EB in both brain regions studied (P < 0.05). Magnesium attenuated BBB permeability to EB during acute hypertension by 41% in the posterior cerebrum (P < 0.05) but had no effect in the anterior cerebrum (P > 0.05). Treatment with magnesium did not change NaFl permeability, cerebral oedema formation or AQP4 expression. In summary, BBB permeability to Evan's Blue was increased by acute hypertension in LP rats, and this was attenuated by treatment with magnesium sulphate. The greatest effect on BBB permeability to EB was in the posterior cerebrum, an area particularly susceptible to oedema formation during eclampsia. [source]

Calcium balance in Daphnia grown on diets differing in food quantity, phosphorus and calcium

FRESHWATER BIOLOGY, Issue 11 2009
XUE-JIA HE
Summary 1.,The influences of dietary phosphorus (P) and food concentration on the calcium (Ca) balance in Daphnia magna were examined in this study at two different ambient Ca concentrations (0.5 and 10 mg Ca L,1). Daphnia were grown by feeding the young adults differentially under contrasting dietary P conditions [molar C : P ratio = c. 900 and c. 90 as low P (LP) and high P (HP), respectively], ambient Ca concentrations [0.5 mg and 10 mg Ca L,1 as low Ca (LCa) or high Ca (HCa), respectively] and food levels [0.15 or 1.5 mg C L,1 as low food (LF) or high food (HF), respectively] for 5 days. 2.,The specific Ca contents of daphniids (1.9,6.5% of dry weight,1) increased with increasing Ca concentration, food level and dietary P content, although the food level did not affect the Ca content in the HPHCa treatment. A radioactive tracer method showed that the food level did not affect the influx of Ca from the water under LP conditions, but the Ca influx under HP conditions doubled with a HF level. A LP condition also led to a decrease in Ca influx with a HF level. 3.,During the 3 days of efflux, generally only a small proportion of Ca (2.6,3.3%) was retained by the daphniids, but this retention increased (14,23%) under low ambient Ca concentrations and under P-limitation. Excretion was the most important pathway for Ca loss (accounting for 50,60% of body Ca), followed by moulting (20,47%), but the relative contribution of these two pathways (excretion and moulting) did not vary among all the different treatments. The absolute loss of Ca through excretion and moulting, on the contrary, differed with different ambient Ca concentrations and dietary P conditions. A HF level led to an increase in the loss rates in most cases. 4.,Our study strongly suggested that there is an interaction between an essential metal (Ca) and macronutrients (C and P) in freshwater crustaceans with HCa and P contents. The results imply that variation in environmental nutrient conditions may change the Ca budget in crustaceans and may affect the dynamics of Ca in the epilimnion of freshwaters. [source]

Relationship uncertainty linkage statistics (RULS): affected relative pair statistics that model relationship uncertainty

GENETIC EPIDEMIOLOGY, Issue 4 2008
Amrita Ray
Abstract Linkage analysis programs invariably assume that the stated familial relationships are correct. Thus, it is common practice to resolve relationship errors by either discarding individuals with erroneous relationships or using an inferred alternative pedigree structure. These approaches are less than ideal because discarding data is wasteful and using inferred data can be statistically unsound. We have developed two linkage statistics that model relationship uncertainty by weighting over the possible true relationships. Simulations of data containing relationship errors were used to assess our statistics and compare them to the maximum-likelihood statistic (MLS) and the Sall non-parametric LOD score using true and discarded (where problematic individuals with erroneous relationships are discarded from the pedigree) structures. We simulated both small pedigree (SP) and large pedigree (LP) data sets typed genome-wide. Both data sets have several underlying true relationships; SP has one apparent relationship,full sibling,and LP has several different apparent relationship types. The results show that for both SP and LP, our relationship uncertainty linkage statistics (RULS) have power nearly as high as the MLS and Sall using the true structure. Also, the RULS have greater power to detect linkage than the MLS and Sall using the discarded structure. For example, for the SP data set and a dominant disease model, both the RULS had power of about 93%, while Sall and MLS have 90% and 83% power on the discarded structure. Thus, our RULS provide a statistically sound and powerful approach to the commonly encountered problem of relationship errors. Genet. Epidemiol. © 2008 Wiley-Liss, Inc. [source]

Prevalence of Herniation and Intracranial Shift on Cranial Tomography in Patients With Subarachnoid Hemorrhage and a Normal Neurologic Examination

ACADEMIC EMERGENCY MEDICINE, Issue 4 2010
Larry J. Baraff MD
Abstract Objectives:, Patients frequently present to the emergency department (ED) with headache. Those with sudden severe headache are often evaluated for spontaneous subarachnoid hemorrhage (SAH) with noncontrast cranial computed tomography (CT) followed by lumbar puncture (LP). The authors postulated that in patients without neurologic symptoms or signs, physicians could forgo noncontrast cranial CT and proceed directly to LP. The authors sought to define the safety of this option by having senior neuroradiologists rereview all cranial CTs in a group of such patients for evidence of brain herniation or midline shift. Methods:, This was a retrospective study that included all patients with a normal neurologic examination and nontraumatic SAH diagnosed by CT presenting to a tertiary care medical center from August 1, 2001, to December 31, 2004. Two neuroradiologists, blinded to clinical information and outcomes, rereviewed the initial ED head CT for evidence of herniation or midline shift. Results:, Of the 172 patients who presented to the ED with spontaneous SAH diagnoses by cranial CT, 78 had normal neurologic examinations. Of these, 73 had initial ED CTs available for review. Four of the 73 (5%; 95% confidence interval [CI] = 2% to 13%) had evidence of brain herniation or midline shift, including three (4%; 95% CI = 1% to 12%) with herniation. In only one of these patients was herniation or shift noted on the initial radiology report. Conclusions:, Awake and alert patients with a normal neurologic examination and SAH may have brain herniation and/or midline shift. Therefore, cranial CT should be obtained before LP in all patients with suspected SAH. ACADEMIC EMERGENCY MEDICINE 2010; 17:423,428 © 2010 by the Society for Academic Emergency Medicine [source]

Genotype,phenotype correlations in hereditary familial retinoblastoma,

HUMAN MUTATION, Issue 3 2007
Melissa Taylor
Abstract We studied 50 unrelated pedigrees with a family history of retinoblastoma (Rb) (165 carriers of a RB1 mutation) to delineate the spectrum of RB1 germline mutations in familial Rb and to identify genotype,phenotype correlations as well as putative modifiers. Patients were followed at Institut Curie and they were examined by an ophthalmologist, a pediatrician, and a geneticist. All cases of familial Rb were determined via genetic counseling. Clinical features included disease status, laterality, age at diagnosis, mutation type, follow-up, and disease,eye ratio (DER). To eliminate mosaic cases, first-generation carriers displaying low-penetrance (LP) Rb were excluded from the analysis. Complete penetrance was the rule for nonsense and frameshift mutations (25 families) and high penetrance was observed for large rearrangements (eight families). Promoter (two families) and missense (two families) mutations displayed heterogeneous phenotypes and LP. Variable penetrance was observed for splice abnormalities (13 families) and was explained by in/out of frame mutations or respect of functional domains. Surprisingly, two families with the LP g.45867G>T/IVS6+1G>T mutation presented data that conflicted with the data reported in previous publications, as unaffected carriers had paternally inherited mutant alleles. Moreover, RNA analyses suggested that the lack of penetrance in unaffected carriers could be explained by an increase in expression levels of the wild-type allele. This observation prompted us to define a new class "3" of LP alleles. We believe this is the first large-scale study of familial Rb with a high level of homogeneity in the clinical and genetic analysis of patients and their relatives, thereby allowing for reliable intrafamilial genotype,phenotype correlations. Our analysis suggests in some cases the influence of modifier factors probably involved in mRNA level regulation and/or pRB pathway regulation. Hum Mutat 28(3), 284,293, 2007. © 2006 Wiley-Liss, Inc. [source]

Steady- and unsteady-state lumped parameter modelling of tritium and chlorofluorocarbons transport: hypothetical analyses and application to an alpine karst aquifer

HYDROLOGICAL PROCESSES, Issue 17 2005
N. Nur Ozyurt
Abstract Determination of a groundwater's mean residence time with the aid of environmental tracers is common in hydrogeology. Many of the lumped parameter (LP) applications used for this purpose have been based on steady-state models. However, the results may be misleading if a steady LP model is used to simulate the environmental tracer transport in an unsteady aquifer. To test this hypothesis, the results of steady and unsteady versions of several LP models were evaluated theoretically and in an alpine karst aquifer case by using tritium, oxygen-18 and chlorofluorocarbons (CFCs). The results reveal that the mean residence times obtained may be significantly different between the steady and unsteady versions of the same model. For the karst aquifer investigated, a serially connected exponential and a plug flow model were run under unsteady conditions. It is shown that outflux calibration with an unsteady model provides a firm basis in evaluating the results of models. An outflux-calibrated unsteady model predicted reasonably the observed series of water isotopes. The calibrated model's CFCs output overpredicts the observed concentrations, probably because of the time lag in the unsaturated zone of the alpine karst aquifer. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Can Computed Tomography Angiography of the Brain Replace Lumbar Puncture in the Evaluation of Acute-onset Headache After a Negative Noncontrast Cranial Computed Tomography Scan?

Lymphoid microenvironment in the gut for immunoglobulin A and inflammation

IMMUNOLOGICAL REVIEWS, Issue 1 2003
Robert Chin
Summary:, Signaling through lymphotoxin , receptor (LT,R) initiates the unfolding of a host of developmental programs ranging from the organogenesis of lymph nodes and Peyer's patches (PPs) to the coordination of splenic microarchitecture. While investigating an alternative pathway to immunoglobulin A (IgA) production, it was uncovered that LT,R signaling in the lamina propria (LP) stroma orchestrates the coordinated expression of key chemokines and adhesion molecules, creation of a cytokine milieu, and stroma development that facilitates robust IgA production independent of secondary lymphoid structures. Simultaneously, this same infrastructure can be commandeered by autoreactive T cells to organize both the acute destruction of the intestinal mucosa and chronic intestinal inflammation via the ligands for LT,R. The ability to modulate LT,R signaling may alternatively permit the suppression of autoimmune responses and augmentation of gut defenses. [source]

CXCL12 Is a constitutive and inflammatory chemokine in the intestinal immune system

INFLAMMATORY BOWEL DISEASES, Issue 4 2010
Iris Dotan MD
Abstract Background: Inflammatory bowel disease (IBD) is characterized by increased lymphocytic infiltrate to the lamina propria (LP) and upregulation of inflammatory chemokines and receptors. CXCL12 is a constitutive chemokine involved in lung, brain, and joint inflammation. We hypothesized that CXCL12 and its receptor, CXCR4, would have a constitutive and inflammatory role in the gut. Methods: Intestinal epithelial cells (IECs) and T lymphocytes were isolated from intestinal mucosa of IBD and control patients undergoing bowel resection. Autologous T cells were isolated from peripheral blood (PB). CXCL12 and CXCR4 expression by IECs was assessed by polymerase chain reaction and immunohistochemistry, lymphocyte phenotype by flow cytometry, and migration by Transwells. Results: IECs expressed CXCL12 and expression was increased and more diffuse in IBD compared to normal crypts (ulcerative colitis [UC] > Crohn's disease [CD], inflamed > noninflamed). CXCR4 was expressed by IECs, LP T cells (LPTs), and PB T cells (PBTs), and CXCR4+ cells were increased in IBD LP in situ. PBTs and LPTs from all patients had a high and comparable migration toward CXCL12 (P < 0.0001 and P < 0.05 vs. medium, respectively). Migration toward IBD-IEC-derived supernatant was significantly higher compared to normal. Antibodies against CXCR4 and CXCL12 blocked migration. Conclusions: CXCL12 is expressed by normal IECs and upregulated and differentially distributed in IBD IECs. CXCR4 is expressed by IECs and LPTs, and CXCR4+ cells are significantly increased in IBD LP. CXCL12 is chemotactic for both PBTs and LPTs. Thus, CXCL12 and CXCR4 have a constitutive and inflammatory role in the intestinal mucosa and their selective therapeutic manipulation may be considered in IBD management. (Inflamm Bowel Dis 2009;) [source]

Expression and functional characterization of FOXP3+CD4+ regulatory T cells in ulcerative colitis,

INFLAMMATORY BOWEL DISEASES, Issue 2 2007
Qi T. Yu BS
Abstract Background: CD4+CD25+ regulatory T cells (TR) can prevent or treat experimental murine colitis but little is known about their potential role in human inflammatory bowel disease (IBD). FOXP3 is a transcription factor that plays a critical role in the development and function of CD4+CD25+ TR. The aim of this study was to examine the presence and functional characteristics of TR cells in colonic lymphoid tissues in patients with ulcerative colitis (UC). Methods: FOXP3 expression was assessed by flow cytometry, immunohistochemistry, and reverse-transcriptase polymerase chain reaction (RT-PCR). Functional characterization of CD4+CD25+ cells was analyzed by suppression of proliferation and secretion of cytokines by cocultured effector CD4+CD25, T cells. Results: FOXP3+CD4+ T cells are increased in the lamina propria (LP) of inflamed and noninflamed areas of UC colon compared to normal colon. CD4+CD25+ T cells in UC mesenteric lymph nodes (MLN) express FOXP3 mRNA and protein and suppress the proliferation of autologous MLN CD4+CD25, T cells. The suppressor activity of MLN CD4+CD25+ T cells is cell contact-dependent but cytokine-independent. In addition, CD4+CD25+ T cells potently suppress the production of both Th1 (IFN-,, IL-2) and Th2 (IL-5, IL-13) cytokines by cocultured CD4+CD25, T cells. FOXP3+ cells localized in the T-cell-rich areas of MLN and occasionally present in the follicles. Conclusions: There is an expansion of FOXP3+CD4+ T cells in mucosal lymphoid tissues in UC. CD4+CD25+ isolated from UC MLN express FOXP3 and display features of TR cells in spite of active mucosal inflammation. These data suggest that their suppressor activity may be abrogated in vivo or they are unable to counterbalance the chronic mucosal inflammation in UC. (Inflamm Bowel Dis 2007) [source]

Chemokine receptor CXCR3 expression in inflammatory bowel disease

INFLAMMATORY BOWEL DISEASES, Issue 4 2001
Yu-Hong Yuan
Abstract CD4+ T lymphocytes in the lamina propria (LP) of the gut play a central role in the immune response in inflammatory bowel disease (IBD). CXCR3 is a chemokine receptor expressed on activated T lymphocytes, and a key component for the recruitment of T helper (Th1) effector cells to the site of inflammation. To determine if CXCR3 is involved in localization of T cells to the gut in IBD patients, we investigated the expression of CXCR3 on CD4+ T lymphocytes in the LP and in the submucosa of resection specimens from 51 IBD patients and 15 control patients. Positive cells were microscopically scored using a semiquantitative analysis on a five-point scale. We found that CD4+ T cells, CXCR3+ cells, and CD4+CXCR3+ T cells in the LP were slightly increased in both IBD groups compared with control non-IBD specimens. In addition, CD4+ and CXCR3+ cells in the submucosa were significant increased in the CD group compared with the control group. CD4+ and CXCR3+ expression was not statistically different between CD and UC. Flow cytometry was used to analyze the percentage of CXCR3+ cells within the CD4+ T-cell population isolated from biopsy specimens and peripheral blood from IBD patients and control patients. There was no difference in the percentage of CD4+CXCR3+ cells between the different groups in the gut as well as in the circulation. These results suggest that CD4+CXCR3+ T cells migrate to the normal and inflamed intestinal mucosa, indicating a role in maintaining normal gut homeostasis. The selective expression of CXCR3+ cells in the submucosa of CD patients might also indicate that these cells play a role in inflammation. [source]

Rigid-plastic/rigid-viscoplastic FE simulation using linear programming for metal forming

INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 4 2003
Weili Xu
Abstract For rigid-plastic/rigid-viscoplastic (RP/RVP) FE simulation in metal forming processes, the linear programming (LP) approach has many remarkable advantages, compared with a normal iterative solver. This approach is free from convergence problems and is convenient for dealing with contact surfaces, rigid zones, and friction forces. In this paper, a numerical model for axisymmetrical and plane-strain analysis using RP/RVP and LP is proposed and applied to industrial metal forming. Numerical examples are provided to validate the accuracy and efficiency of the proposed method. Copyright © 2002 John Wiley & Sons, Ltd. [source]

A DC stabilized log-domain nth-order multifunction filter based on the decomposition of nth-order HP filter function to FLF topology

INTERNATIONAL JOURNAL OF CIRCUIT THEORY AND APPLICATIONS, Issue 10 2009
N. A. Shah
Abstract The design of high-order log-domain filters can be easily accomplished by transposing already known linear-domain Gm -C filter topologies to their counterparts in the log-domain through the employment of a set of complementary operators. To achieve the Gm -C filter topologies, the multiple feedback approach is widely used due to its accrued advantages. In this paper a synthesis approach for the development of an nth-order multifunction log-domain filter comprising lowpass (LP), highpass (HP) and bandpass (BP) filter functions is proposed. The approach is based on the decomposition of nth-order HP filter function to follow-the-leader-feedback (FLF) topology. The design is simple and simultaneously achieves nearly all of the chief advantages. The design offers superior performance factors vis-à-vis the ones recently reported. To verify the high-order behavior of the topology, a 5th-order multifunction filter was designed and the achieved simulated results verify the theory. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Blocking performance of fixed-paths least-congestion routing in multifibre WDM networks

INTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 2-3 2002
Ling Li
Abstract Wavelength-routed all-optical networks have been receiving significant attention for high-capacity transport applications. Good routing and wavelength assignment (RWA) algorithms are critically important in order to improve the performance of wavelength-routed WDM networks. Multifibre WDM networks, in which each link consists of multiple fibres and each fibre carries information on multiple wavelengths, offer the advantage of reducing the effect of the wavelength continuity constraint without using wavelength converters. A wavelength that cannot continue on the next hop on the same fibre can be switched to another fibre using an optical cross-connect (OXC) if the same wavelength is free on one of the other fibres. However, the cost of a multifibre network is likely to be higher than a single-fibre network with the same capacity, because more amplifiers and multiplexers/demultiplexers may be required. The design goal of a multifibre network is to achieve a high network performance with the minimum number of fibres. In this paper, we study the blocking performance of fixed-paths least-congestion (FPLC) routing in multifibre WDM networks. A new analytical model with the consideration of link-load correlation is developed to evaluate the blocking performance of the FPLC routing. The analytical model is a generalized model that can be used in both regular (e.g. mesh-torus) and irregular (e.g. NSFnet) networks. It is shown that the analytical results closely match the simulation results, which indicate that the model is adequate in analytically predicting the performance of the FPLC routing in different networks. Two FPLC routing algorithms, wavelength trunk (WT)-based FPLC and lightpath (LP)-based FPLC, are developed and studied. Our analytical and simulation results show that the LP-based FPLC routing algorithm can use multiple fibres more efficiently than the WT-based FPLC and the alternate path routing. In both the mesh-torus and NSFnet networks, limited number of fibres is sufficient to guarantee high network performance. Copyright © 2002 John Wiley & Sons, Ltd. [source]