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Oliphant K, Ali M, D’Souza M, Hughes PD, Sulakhe D, Wang AZ, Xie B, Yeasin R, Msall ME, Andrews B, Claud EC. Bacteroidota and Lachnospiraceae integration into the gut microbiome at key time points in early life are linked to infant neurodevelopment. Gut Microbes 2021; 13:1997560. [PMID: 34839801 PMCID: PMC8632288 DOI: 10.1080/19490976.2021.1997560] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/28/2021] [Accepted: 10/19/2021] [Indexed: 02/07/2023] Open
Abstract
The early life microbiome plays critical roles in host development, shaping long-term outcomes including brain functioning. It is not known which initial infant colonizers elicit optimal neurodevelopment; thus, this study investigated the association between gut microbiome succession from the first week of life and head circumference growth (HCG), the earliest validated marker for neurodevelopment. Fecal samples were collected weekly from a preterm infant cohort during their neonatal intensive care unit stay and subjected to 16S rRNA gene sequencing for evaluating gut microbiome composition, in conjunction with clinical data and head circumference measurements. Preterm infants with suboptimal HCG trajectories had a depletion in the abundance/prevalence of Bacteroidota and Lachnospiraceae, independent of morbidity and caloric restriction. The severity of gut microbiome depletion matched the timing of significant HCG pattern separation between study groups at 30-week postmenstrual age demonstrating a potential mediating relationship resultant from clinical practices. Consideration of the clinical variables indicated that optimal infant microbiome succession is primarily driven by dispersal limitation (i.e., delivery mode) and secondarily by habitat filtering (i.e., antibiotics and enteral feeding). Bacteroidota and Lachnospiraceae are known core taxa of the adult microbiome, with roles in dietary glycan foraging, beneficial metabolite production and immunity, and our work provides evidence that their integration into the gut microbiome needs to occur early for optimal neurodevelopment.
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Affiliation(s)
- Kaitlyn Oliphant
- Department of Pediatrics, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Mehneez Ali
- Department of Pediatrics, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Mark D’Souza
- Center for Research Informatics, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Patrick D. Hughes
- Department of Pediatrics, Biological Sciences Division, University of Chicago, Chicago, IL, USA
- Department of Pediatrics, Division of Neonatology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Dinanath Sulakhe
- Center for Research Informatics, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Annie Z. Wang
- Department of Pediatrics, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Bingqing Xie
- Department of Medicine, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Rummanu Yeasin
- Department of Pediatrics, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Michael E. Msall
- Department of Pediatrics, Biological Sciences Division, University of Chicago, Chicago, IL, USA
- Kennedy Research Center on Intellectual and Developmental Disabilities, University of Chicago, Chicago, IL, USA
| | - Bree Andrews
- Department of Pediatrics, Biological Sciences Division, University of Chicago, Chicago, IL, USA
| | - Erika C. Claud
- Department of Pediatrics, Biological Sciences Division, University of Chicago, Chicago, IL, USA
- Department of Medicine, Biological Sciences Division, University of Chicago, Chicago, IL, USA
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Affiliation(s)
- A Khan
- Department of Respiratory and General Medicine, Derriford Hospital, Plymouth PL6 8DH, UK.
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Hughes PD, Wilson WR, Leslie SW. Effect of gestational ethanol exposure on the NMDA receptor complex in rat forebrain: from gene transcription to cell surface. Brain Res Dev Brain Res 2001; 129:135-45. [PMID: 11506858 DOI: 10.1016/s0165-3806(01)00192-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Effects of gestational ethanol exposure on the trafficking of the NMDA receptor complex were investigated. Studies focused on three distinct processes in NMDA receptor translocation: (1) the level of gene transcription (2) nascent NMDA receptor subunits (NR) associated with the endoplasmic reticulum bound chaperone protein calnexin and (3) NMDA receptors associated with the cell surface anchoring protein PSD-95. Forebrain mRNA and membrane proteins were isolated from postnatal day 1 rat pups from prenatally ethanol exposed, pair-fed and ad libitum experimental groups. Ribonuclease protection assays were carried out to determine the levels of NR2A, NR2B, and NR2C mRNA within the treatment groups determined. Results indicated that gestational ethanol exposure did not affect the gene transcription of the NR2 subunits. Immunoprecipitation experiments were conducted with an anti-calnexin antibody or an anti-PSD-95 antibody and the immunoprecipitates probed for NR1 and NR2 subunits. Within the anti-calnexin immunoprecipitates, no NR2A, NR2B or NR2C subunits were detectable, but a significant pool of NR1 subunits was identified. These findings suggest that NR1 subunits but not NR2 subunits are associated with calnexin within the endoplasmic reticulum. Further, gestational ethanol exposure significantly increased the NR1 polypeptide levels in the anti-calnexin immunoprecipitate. Anti-PSD-95 immunoprecipitates revealed an abundance of NR1 and NR2B subunits, and these complexes were unaffected by gestational ethanol exposure. No NR2A or NR2C subunits were detected. These results suggest that gestational ethanol exposure significantly affects the assembly and transport of NMDA receptors. Gestational ethanol exposure may not alter the composition of the PSD-95 associated NMDA receptor complex.
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Affiliation(s)
- P D Hughes
- Division of Pharmacology and Toxicology, College of Pharmacy and the Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, 78712, USA.
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Watson AC, Hughes PD, Louise Harris M, Hart N, Ware RJ, Wendon J, Green M, Moxham J. Measurement of twitch transdiaphragmatic, esophageal, and endotracheal tube pressure with bilateral anterolateral magnetic phrenic nerve stimulation in patients in the intensive care unit. Crit Care Med 2001; 29:1325-31. [PMID: 11445679 DOI: 10.1097/00003246-200107000-00005] [Citation(s) in RCA: 160] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE In the critically ill, respiratory muscle strength usually has been assessed by measuring maximum inspiratory pressure. The maneuver is volitional, and results can be unreliable. The nonvolitional technique of bilateral anterolateral magnetic stimulation of the phrenic nerves, producing twitch transdiaphragmatic pressure, has been successful in normal subjects and ambulatory patients. In this study we used the technique in the intensive care unit and explored the measurement of twitch endotracheal tube pressure as a less invasive technique to assess diaphragmatic contractility. DESIGN Clinical study to quantify diaphragm strength in the intensive care unit. SETTING Patients from three London teaching hospital intensive care units and high-dependency units. PATIENTS Forty-one intensive care patients were recruited. Of these, 33 (20 men, 13 women) were studied. INTERVENTIONS Esophageal and gastric balloon catheters were passed through the anaesthetized nose, and an endotracheal tube occlusion device was placed in the ventilation circuit, next to the endotracheal tube. Two 43-mm magnetic coils were placed anteriorly on the patient's neck, and the phrenic nerves were stimulated magnetically. MEASUREMENTS AND MAIN RESULTS On phrenic nerve stimulation, twitch gastric pressure, twitch esophageal pressure, twitch transdiaphragmatic pressure, and twitch endotracheal tube pressure were measured. Forty-one consecutive patients consented to take part in the study, and twitch pressure data were obtained in 33 of these. Mean transdiaphragmatic pressure was 10.7 cm H2O, mean twitch esophageal pressure was 6.7 cm H2O, and mean twitch endotracheal tube pressure was 6.7 cm H2O. The mean difference between twitch esophageal pressure and twitch endotracheal tube pressure was 0.02 cm H2O. Correlation of the means of twitch endotracheal tube pressure to twitch esophageal pressure was 0.93, and that for twitch endotracheal tube pressure to transdiaphragmatic pressure was 0.78. CONCLUSIONS Transdiaphragmatic pressure can be measured in the critically ill to give a nonvolitional assessment of diaphragm contractility, but not all patients can be studied. At present, the relationship of twitch endotracheal tube pressure to transdiaphragmatic pressure is too variable to reliably represent a less invasive measure of diaphragm strength.
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Hughes PD, Hart N, Hamnegård CH, Green M, Coats AJ, Moxham J, Polkey MI. Inspiratory Muscle Relaxation Rate Slows during Exhaustive Treadmill Walking in Patients with Chronic Heart Failure. Am J Respir Crit Care Med 2001; 163:1400-3. [PMID: 11371408 DOI: 10.1164/ajrccm.163.6.2003082] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Exercise intolerance is a feature of chronic heart failure (CHF). We hypothesized that excessive loading of the respiratory muscle pump might contribute to exertional breathlessness. One marker of excessive muscle-loading is slowing of maximum relaxation rate (MRR) and, therefore, to test our hypothesis, we investigated the effect of exhaustive treadmill walking on inspiratory muscle MRR in patients with CHF. We studied eight stable patients with mild-moderate CHF walking on a treadmill until termination because of severe dyspnea. Inspiratory muscle MRR was determined from esophageal pressure (Pes) change during submaximal sniffs (Sn) before and immediately after exercise to a mean (SD) minute ventilation of 77 () L/min. For comparison, nine healthy subjects performed a similar protocol; exercise was terminated either by severe dyspnea or when minute ventilation reached 100 L/min. There were no significant differences in terms of heart rate, respiratory rate, tidal volume, or inspiratory duty cycle at cessation of exercise. The mean slowing of Sn Pes MRR in the first minute after termination of exercise in the CHF group was 22.4% and in the normal control group it was 2.8% (p < 0.01). Our data show that slowing of inspiratory muscle relaxation rate occurs in patients with CHF walking to severe breathlessness. We conclude that severe loading of the inspiratory muscles is a feature of exertional dyspnea in CHF.
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Affiliation(s)
- P D Hughes
- Respiratory Muscle Laboratory, Royal Brompton Hospital, Fulham Rd., London SW3 6NP, United Kingdom
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Hughes PD. Patients need greater access to autologous blood. Med J Aust 2001; 174:308. [PMID: 11297123 DOI: 10.5694/j.1326-5377.2001.tb143281.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lewis AL, Hughes PD, Kirkwood LC, Leppard SW, Redman RP, Tolhurst LA, Stratford PW. Synthesis and characterisation of phosphorylcholine-based polymers useful for coating blood filtration devices. Biomaterials 2000; 21:1847-59. [PMID: 10919688 DOI: 10.1016/s0142-9612(00)00055-7] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Copolymers of 2-methacryloyloxyethylphosphorylcholine (MPC) and lauryl methacrylate (LMA) of molar ratios MPC: LMAX where x = 1, 2 or 4, have been synthesised by two different free-radical polymerisation techniques. The solubility characteristics of the resulting materials were investigated in a variety of water: alcohol solvent mixtures and found to be influenced not only by the molar ratio of MPC: LMA, but also the method of synthesis. A window of solubility was observed for certain copolymers and the alcohol used in the solvent mixture was also found to have a profound influence on the solubility profile of the polymers. These materials were soluble in a wider range of aqueous methanol mixtures compared to aqueous mixtures of higher aliphatic alcohols, such as ethanol or isopropyl alcohol, which was rationalised in terms of the affinity of the phosphorylcholine headgroup for the various alcohols relative to water. 1H nuclear magnetic resonance spectroscopy was used to further examine the solution properties of the copolymers in various solvents. The copolymer MPC: LMA2 was coated onto a variety of substrates from both alcohol-only and water: alcohol solvent systems and the surface properties of the films compared by static and dynamic contact angle, atomic force microscopy (AFM) and attenuated internal reflectance Fourier transform infrared spectroscopy (ATR-IR). The coating formed from the water: alcohol solvent was found to be hydrophilic in nature, possessing spontaneous wettability, whereas films formed from alcohol-only solvents were hydrophobic, and only on conditioning with water were more wettable surfaces attained. This phenomenon was applied in the coating of leukocyte filtration material, where the aqueous-based systems demonstrated lower critical wetting surface tension (CWST) and shorter wetting times relative to both uncoated filters and those coated from alcohol-only systems. The haemocompatibility of the coated filters was equivalent for both coating solvent systems. employed, and far superior when compared to the uncoated control.
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Affiliation(s)
- A L Lewis
- Biomaterials Research Group, Biocompatibles Ltd, Farnham Business Park, Farnham, Surrey, UK.
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Polkey MI, Duguet A, Luo Y, Hughes PD, Hart N, Hamnegård CH, Green M, Similowski T, Moxham J. Anterior magnetic phrenic nerve stimulation: laboratory and clinical evaluation. Intensive Care Med 2000; 26:1065-75. [PMID: 11030162 DOI: 10.1007/s001340051319] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Anterior magnetic stimulation (aMS) of the phrenic nerves is a new method for the assessment of diaphragm contractility that might have particular applications for the clinical assessment of critically ill patients who are commonly supine. DESIGN We compared aMS with existing techniques for measurement of diaphragm weakness and fatigue in 10 normal subjects, 27 ambulant patients with suspected diaphragm weakness and 10 critically ill patients. SETTING Laboratory and intensive care unit of two university hospitals. RESULTS Although aMS was not demonstrably supramaximal in normal subjects, the mean value of twitch transdiaphragmatic pressure (Tw Pdi) obtained at 100% of stimulator output, 23.7 cmH2O, did not differ significantly from that obtained with bilateral supramaximal electrical stimulation (ES), 24.9 cmH2O, or bilateral anterior magnetic phrenic nerve stimulation (BAMPS), 27.3 cmH2O. A fatiguing protocol produced a 20 % fall in aMS-Tw Pdi and a 19% fall in BAMPS-Tw Pdi; the fall in aMS-Tw Pdi correlated with the fall in BAMPS-Tw Pdi (r2 = 0.84, p = 0.03) indicating that aMS can detect diaphragm fatigue. In ambulant patients aMS agreed closely with existing measures of diaphragm strength. The maximal sniff Pdi correlated with both the aMS-Tw Pdi (r2 = 0.60, p < 0.0001) and the BAMPS-Tw Pdi (r2 = 0.65, p < 0.0001) and the aMS-Tw Pdi was a mean (SD) 2.2 (4.3) cmH2O less than BAMPS-Tw Pdi. In addition, aMS correctly identified diaphragm dysfunction in patients studied on the ICU. CONCLUSIONS We conclude that aMS is of clinical value for the investigation of suspected diaphragm weakness.
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Affiliation(s)
- M I Polkey
- Respiratory Muscle Laboratory, Royal Brompton Hospital, London, UK.
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Hughes PD. Re: A technique of transrectal ultrasound guided transperineal random prostate biopsy in patients with ulcerative colitis and an ileal pouch. J Urol 2000; 164:130. [PMID: 10840470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Hughes PD. Prostate cancer in Victoria in 1993: patterns of reported management. Med J Aust 2000; 172:565-6. [PMID: 10920760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Abstract
BACKGROUND Since 1988 the author has used only endoscopic injection of Teflon (polytetrafluoroethylene) paste in the correction of ureteric reflux, in adults and children. METHODS The present paper reports a series of 32 patients, 18 children and 14 adults, with 45 refluxing ureters so treated. Intra-operative cystogram was carried out and a second Teflon paste injection was given under the same anaesthetic where persistent reflux was demonstrated after the initial Teflon injection, to reduce the number of anaesthetics given. RESULTS In those patients who consented to a delayed cystogram after the first injection of Teflon, there was a cure rate of 83.3% in children and 70% in adults from that first injection. CONCLUSION Endoscopic retro-ureteric injection of Teflon paste is done as a day case under general anaesthesia and causes the patient no pain postoperatively. It gives a high cure rate and is an option that should be offered to every patient where a decision has been made to correct ureteric reflux.
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Affiliation(s)
- P D Hughes
- John James Memorial Hospital, Canberra, Australian Capital Territory, Australia.
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Abstract
Reduced respiratory muscle strength has been reported in chronic heart failure (CHF) in several studies. The data supporting this conclusion come almost exclusively from static inspiratory and expiratory mouth pressure maneuvers (MIP, MEP), which many subjects find difficult to perform. We therefore performed a study using measurements that are less dependent on patient aptitude and also provide specific data on diaphragm strength. In 20 male patients and 15 control subjects we measured MIP and MEP as well as esophageal and transdiaphragmatic pressure during maximal sniffs (Sn Pes, Sn Pdi) and cervical magnetic phrenic nerve stimulation (Tw Pdi). In a subgroup the response to paired phrenic nerve stimulation (pTw Pdi) at interpulse intervals from 10 to 200 ms (5 to 100 Hz) was also determined. As expected, MIP was significantly reduced in the CHF group (CHF, 69.5 cm H(2)O; control, 96.7 cm H(2)O; p = 0.01), but differences were much less marked for Sn Pes (CHF, 95.2 cm H(2)O; control, 104.8 cm H(2)O; p = 0.20) and MEP (CHF, 109.1 cm H(2)O; control, 135.7 cm H(2)O; p = 0.09). Diaphragm strength was significantly reduced (Sn Pdi: CHF, 123.8 cm H(2)O; control 143.5 cm H(2)O; p = 0.04. Tw Pdi: CHF, 21.4 cm H(2)O; control, 28.5 cm H(2)O; p = 0.0005). Paired phrenic nerve stimulation suggested a trend to increased twitch summation at 5 to 20 Hz in CHF, although this did not reach significance. We conclude that mild reduction in diaphragm strength occurs in CHF, possibly because of an increased proportion of slow fibers, but overall strength of the respiratory muscles remains well preserved.
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Affiliation(s)
- P D Hughes
- Department of Cardiology and Respiratory Muscle Laboratory, Royal Brompton Hospital and National Heart and Lung Institute, London, UK
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Abstract
Diaphragm paralysis is a recognized complication of neuralgic amyotrophy that causes severe dyspnoea. Although recovery of strength in the arm muscles, when affected, is common, there are little data on recovery of diaphragm function. This study, therefore, re-assessed diaphragm strength in cases of bilateral diaphragm paralysis due to neuralgic amyotrophy that had previously been diagnosed at the authors institutions. Fourteen patients were recalled between 2 and 11 yrs after the original diagnosis. Respiratory muscle and diaphragm strength were measured by volitional manoeuvres as maximal inspiratory pressure and sniff transdiaphragmatic pressure. Cervical magnetic phrenic nerve stimulation was used to give a nonvolitional measure of diaphragm strength: twitch transdiaphragmatic pressure. Only two patients remained severely breathless. Ten of the 14 patients had evidence of some recovery of diaphragm strength, in seven cases to within 50% of the lower limit of normal. The rate of recovery was variable: one patient had some recovery after 2 yrs, and the rest took 3 yrs or more. In conclusion, in most patients with diaphragm paralysis due to neuralgic amyotrophy, some recovery of the diaphragm strength occurs, but the rate of recovery may be slow.
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Affiliation(s)
- P D Hughes
- Respiratory Muscle Laboratory, Royal Brompton Hospital, London, UK
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Polkey MI, Hamnegård CH, Hughes PD, Rafferty GF, Green M, Moxham J. Influence of acute lung volume change on contractile properties of human diaphragm. J Appl Physiol (1985) 1998; 85:1322-8. [PMID: 9760323 DOI: 10.1152/jappl.1998.85.4.1322] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The effect of stimulus frequency on the in vivo pressure generating capacity of the human diaphragm is unknown at lung volumes other than functional residual capacity. The transdiaphragmatic pressure (Pdi) produced by a pair of phrenic nerve stimuli may be viewed as the sum of the Pdi elicited by the first (T1 Pdi) and second (T2 Pdi) stimuli. We used bilateral anterior supramaximal magnetic phrenic nerve stimulation and a digital subtraction technique to obtain the T2 Pdi at interstimulus intervals of 999, 100, 50, 33, and 10 ms in eight normal subjects at lung volumes between residual volume and total lung capacity. The reduction in T2 Pdi that we observed as lung volume increased was greatest at long interstimulus intervals, whereas the T2 Pdi obtained with short interstimulus intervals remained relatively stable over the 50% of vital capacity around functional residual capacity. For all interstimulus intervals, the total pressure produced by the pair decreased as a function of increasing lung volume. These data demonstrate that, in the human diaphragm, hyperinflation has a disproportionately severe effect on the summation of pressure responses elicited by low-frequency stimulations; this effect is distinct from and additional to the known length-tension relationship.
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Affiliation(s)
- M I Polkey
- Respiratory Muscle Laboratory, King's College School of Medicine and Dentistry, London SE5 9PJ, United Kingdom.
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Hughes PD, Kim YN, Randall PK, Leslie SW. Effect of prenatal ethanol exposure on the developmental profile of the NMDA receptor subunits in rat forebrain and hippocampus. Alcohol Clin Exp Res 1998; 22:1255-61. [PMID: 9756040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The effects of prenatal ethanol exposure on the NMDAR1 protein expression (postnatal days 1 and 7) and on the developmental profile of the NMDAR2A and NMDAR2B subunits in rat forebrain and hippocampus were investigated. Forebrain and hippocampal membrane proteins were isolated from pups of various ages (postnatal days 1 to 21) from prenatally ethanol exposed, pair-fed and ad libitum control groups. A semiquantitative immunoblot procedure was used with antibodies raised against the NMDAR1, NMDAR2A, and the NMDAR2B subunits to assess the NMDA subunit protein expression in the samples. NMDAR1 protein expression was unaffected by prenatal ethanol exposure at postnatal day 1 or 7 in both the forebrain and hippocampus. NMDAR2A protein expression levels rose rapidly in both forebrain and hippocampus during the time frame of study. Prenatal ethanol exposure caused a significant reduction in protein expression levels of the NMDAR2A in forebrain through postnatal day 14. NMDAR2B protein expression levels were high throughout the study in both forebrain and hippocampus. Prenatal ethanol exposure significantly reduced protein expression of the NMDAR2B in the forebrain (through postnatal day 14) and hippocampus (up to day 7). The results suggest that there may be a link between the depressed expression of the NMDAR2 subunits and the neurodevelopmental disorders associated with fetal ethanol exposure.
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Affiliation(s)
- P D Hughes
- Division of Pharmacology and Toxicology, College of Pharmacy and Institute for Neuroscience, The University of Texas at Austin, 78712-1074, USA
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Hughes PD. The value of surgical practice guidelines: comment. Aust N Z J Surg 1998; 68:538-9. [PMID: 9669371 DOI: 10.1111/j.1445-2197.1998.tb04821.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hughes PD. Adductor myonecrosis following prostate biopsy: comment. Aust N Z J Surg 1998; 68:456. [PMID: 9623467 DOI: 10.1111/j.1445-2197.1998.tb04799.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Affiliation(s)
- P D Hughes
- Department of Urology, John James Memorial Hospital, Canberra, Australian Capital Territory
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Abstract
BACKGROUND Inspiratory muscle weakness is a recognised cause of unexplained dyspnoea. It may be suggested by the finding of a low static inspiratory mouth pressure (MIP), but MIP is a difficult test to perform, with a wide normal range; a low MIP may also occur if the patient has not properly performed the manoeuvre. Further investigation conventionally requires balloon catheters to obtain oesophageal (Poes) and transdiaphragmatic pressure (Pdi) during sniffs or phrenic nerve stimulation. Two non-invasive tests of inspiratory muscle strength have recently been described--nasal pressure during a maximal sniff (Sn Pnas) and mouth pressure during magnetic stimulation of the phrenic nerves (Tw Pmo). The use of these two tests in combination might identify patients without inspiratory muscle weakness who are unable to produce a satisfactory MIP< therefore avoiding the need for investigation with balloon catheters. METHODS Thirty consecutive patients with clinically suspected inspiratory muscle weakness and a low MIP underwent both conventional (Sn Poes and Tw Pdi) and non-invasive testing (Sn Pnas and Tw Pmo). Weakness was considered to be excluded by a Sn Poes of > or = 80 cm H20 or a Tw Pdi of > or = 20 cm H20. The limit values used to test the hypothesis were Sn Pnas > or = 70 cm H20 or Tw Pmo > or = 12 cm H20. RESULTS Inspiratory muscle weakness was excluded in 17 of the 30 patients. Fifteen of these would have been identified using Sn Pnas and Tw Pmo, with better results when the two tests were combined. The cut off values selected for Sn Pnas and Tw Pmo were shown by ROC plots to indicate normal strength conservatively, avoiding failure to detect mild degrees of weakness. No patient with global weakness was considered normal by Sn Pnas or Tw Pmo. CONCLUSIONS In most patients with normal inspiratory strength and a low MIP, Tw Pmo and Sn Pnas used in combination can reliably exclude global inspiratory muscle weakness, reducing the number of patients who need testing with balloon catheters.
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Affiliation(s)
- P D Hughes
- Respiratory Muscle Laboratory, National Heart and Lung Institute, Royal Brompton Hospital, London, UK
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Kyroussis D, Polkey MI, Mills GH, Hughes PD, Moxham J, Green M. Simulation of cough in man by magnetic stimulation of the thoracic nerve roots. Am J Respir Crit Care Med 1997; 156:1696-9. [PMID: 9372696 DOI: 10.1164/ajrccm.156.5.9702008] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Normal cough requires abdominal muscle contraction. We have previously reported contraction of the abdominal muscles elicited by a single percutaneous magnetic stimulation of the thoracic nerve roots. We hypothesized that paired magnetic twitches could generate sufficient tension in the abdominal muscles to simulate cough. Therefore, six normal subjects were stimulated at the T10 intervertebral level in the seated position. We measured the gastric pressure elicited by paired magnetic stimuli (pTw Pga) with interstimulus intervals in the range of 10 ms (100 Hz) to 999 ms (1 Hz). In the second part of the study we evaluated paired stimuli (at the frequency found to produce the greatest response) using a valve to simulate the function of the glottis; the valve was arranged such that it opened once mouth pressure exceeded a predetermined threshold. Mean pTw Pga during stimulation for the 6 subjects was 74 cm H2O (range, 30-109), and mean peak flow was 209 L/min (range, 128-345 L/min). These values were increased if the subject took a prior inspiration or had previously made a vigorous expiratory effort. Comparable values for a maximal natural cough were 212 cm H2O and 649 L/min. We conclude that paired magnetic thoracic nerve root stimulation produces gastric pressure and expiratory flow of an order of magnitude comparable to a natural cough.
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Affiliation(s)
- D Kyroussis
- Department of Thoracic Medicine, King's College School of Medicine, London, United Kingdom
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Polkey MI, Kyroussis D, Hamnegard CH, Hughes PD, Rafferty GF, Moxham J, Green M. Paired phrenic nerve stimuli for the detection of diaphragm fatigue in humans. Eur Respir J 1997; 10:1859-64. [PMID: 9272931 DOI: 10.1183/09031936.97.10081859] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The transdiaphragmatic pressure (Pdi) elicited by paired bilateral phrenic nerve stimulation may be viewed as the sum of the Pdi values produced by the first (t1) and second (t2) stimulus. The Pdi at t2 (P[di,t2]) is a function of the interstimulus interval. A reduction in the ratio obtained by dividing Pdi,t2 at 10 Hz (P[di,t2,10]) by Pdi at 100 Hz (P[di,t2,100]) (t2(10:100)) has been proposed as a test of low frequency diaphragm fatigue. The aim of the present study was to establish whether this change could also be detected using paired cervical magnetic nerve stimulation (pCMS), and whether t2(10:100) was influenced by lung volume. We studied healthy subjects at functional residual capacity (FRC), at 0.5 and 1.0 L below FRC, and at 0.5, 1.0 and 1.5 L above FRC. The subjects were then subjected to a fatiguing protocol (2 min of maximal isocapnic ventilation (MIV)). Studies were repeated at FRC 20 and 60 min after MIV and between these times at 1.0 L below and 1.5 L above FRC. In the unfatigued state, t2(10:100) had a negative relationship with increasing lung volume (r2=0.98, p=0.002). After MIV there was a fall in the Pdi elicited by a single stimulus (mean fall at 20 min 17.9% and at 60 min 14.6%, p<0.03 for both). t2(10:100) fell by a mean 28.1% after 20 min and mean 22.9% at 60 min (p<0.03 for both). This change was mainly mediated by a fall in the P[di,t2,10]. The t2(10:100) was not able to distinguish between fatigue and acute hyperinflation. We conclude that paired cervical magnetic nerve stimulation may be used to detect low frequency diaphragm fatigue but that it remains important to control for lung volume.
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Affiliation(s)
- M I Polkey
- Respiratory muscle laboratory at Kings College Hospital, London, UK
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Polkey MI, Harris ML, Hughes PD, Hamnegärd CH, Lyons D, Green M, Moxham J. The contractile properties of the elderly human diaphragm. Am J Respir Crit Care Med 1997; 155:1560-4. [PMID: 9154857 DOI: 10.1164/ajrccm.155.5.9154857] [Citation(s) in RCA: 146] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
It has previously been reported that aging is associated with a substantial decrease in diaphragm strength. To test this hypothesis we studied 15 (10 male, 5 female) subjects with a mean age of 29 (range 21 to 40) and 15 elderly (10 male, 5 female) subjects, mean age 73 (range 67 to 81). We measured transdiaphragmatic pressure (Pdi) during a maximal sniff (Sniff Pdi) and during bilateral cervical magnetic stimulation (CMS) of the phrenic nerve roots (Tw Pdi). Additionally in 17 subjects (9 elderly and 8 young) the Pdi elicited by paired CMS (pTw Pdi) was obtained at interstimulus intervals ranging from 10 to 999 ms (1 to 100 Hz). There was considerable overlap between groups. Mean Sniff Pdi in the elderly was 119 cm H2O compared with 136 cm H2O for the young subjects; this represented a median reduction of 18 cm H2O or 13% (p = 0.05, 95% Cl of difference 0 to 33 cm H2O). Mean Twitch Pdi in the elderly was 26.8 cm H2O compared with 35.2 cm H2O, a median reduction of 8 cm H2O or 23% (p = 0.004, 95% Cl 3 to 13 cm H2O). At 10 Hz the elderly tended to generate a higher fraction of the Pdi obtained at 100 Hz than the young, but this trend did not achieve statistical significance (p = 0.11). We conclude that aging is associated with a reduction in diaphragm strength. However the magnitude of the reduction is small and may be offset by a leftward shift of the force-frequency relationship.
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Affiliation(s)
- M I Polkey
- Respiratory Muscle Laboratory, King's College School of Medicine and Dentistry, London, United Kingdom
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Polkey MI, Kyroussis D, Hamnegard CH, Mills GH, Hughes PD, Green M, Moxham J. Diaphragm performance during maximal voluntary ventilation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1997; 155:642-8. [PMID: 9032207 DOI: 10.1164/ajrccm.155.2.9032207] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
In normal subjects 2 min of maximal voluntary hyperventilation results in failure of tension generation and low-frequency fatigue of the diaphragm. Patients with severe chronic obstructive pulmonary disease (COPD) do not develop diaphragm fatigue during exhaustive treadmill exercise despite excessive inspiratory muscle loading and we hypothesized that they might be relatively resistant to the development of diaphragm fatigue during maximal ventilation. In six patients with severe COPD (mean FEV1 0.671) we therefore loaded the diaphragm using 2 min of maximal isocapnic ventilation (MIV). Initial mean ventilation was 28.6 L/min and diaphragm pressure-time product (PTPdi) 602 cm H2O x s/min; these values were sustained throughout MIV without significant decline. Mean twitch transdiaphragmatic pressure (Tw Pdi) was 19.7 cm H2O 25 min after a control run and 20.5 cm H2O at the same time after MIV [corrected]. Compared with normal subjects previously studied in our laboratory (Hamnegard, C.-H., et al. Eur. Respir. J. 1996;9:241-247) the reduction in PTPdi was disproportionately greater than the reduction in Tw Pdi. We conclude that, unlike normal subjects, 2 min of MIV causes neither failure of diaphragm performance nor low-frequency diaphragm fatigue in patients with severe COPD. It is likely that the diaphragm makes a relatively limited contribution to the generation of maximal levels of ventilation in severe COPD.
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Affiliation(s)
- M I Polkey
- Respiratory Muscle Laboratory, Kings College Hospital, London, United Kingdom
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Hughes PD. Correlation of the endoscopic appearance with clinical outcome for submucous Polytef paste injection in vesico-ureteric reflux. Aust N Z J Surg 1996; 66:120. [PMID: 8602809 DOI: 10.1111/j.1445-2197.1996.tb01130.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Hughes PD, McDonald PJ, Rhodes NP, Rockliffe JW, Smith EG, Wills J. A Stray Field Magnetic Resonance Imaging Study of the Drying of Sodium Silicate Films. J Colloid Interface Sci 1996; 177:208-213. [PMID: 10479433 DOI: 10.1006/jcis.1996.0022] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Stray field magnetic resonance imaging (STRAFI) is shown to be highly suited to the study of drying processes in thin films. Sodium silicate films have been chosen as a model system exhibiting many of the properties of film drying in general. Films have been dried, as a function of temperature in the range 22 to 62 degrees C, down to water contents of order 28% by weight, at which stage the film is glassy. The experimental results have been quantitatively analyzed by treating the drying film as a colloidal solution. The results suggest that the localized hydrogen spin-spin relaxation time, and hence the mobility of the water in the films is independent of the drying regime and depends primarily on the local water concentration.
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Affiliation(s)
- PD Hughes
- Department of Physics, University of Surrey, Guildford, Surrey, GU2 5XH, United Kingdom
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Kaura S, Bradford HF, Young AM, Croucher MJ, Hughes PD. Effect of amygdaloid kindling on the content and release of amino acids from the amygdaloid complex: in vivo and in vitro studies. J Neurochem 1995; 65:1240-9. [PMID: 7643103 DOI: 10.1046/j.1471-4159.1995.65031240.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The tissue content and the interstitial fluid levels of glutamate, aspartate, GABA, glutamine, glycine, and serine were studied in amygdaloid-kindled rat brain. Interstitial levels were studied in vivo before and during stage 5 full limbic seizures using microdialysis. Slices of amygdala from kindled and sham-operated animals were used to study baseline and KCl-evoked release in vitro. The contents of these amino acids were measured in slices of amygdala, hippocampus, and cerebral cortex from kindled and sham-operated animals. Kindled brains showed two- to threefold higher levels of glutamate, aspartate, and GABA and 12-fold higher levels of glutamine than sham-operated controls. Correlating with this, interstitial fluid levels of glutamate were two- to threefold higher from kindled amygdala than from control both in vivo (microdialysis) and in vitro (superfusion). GABA levels in interstitial fluid from kindled amygdala were reduced by 67% compared with control amygdala.
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Affiliation(s)
- S Kaura
- Department of Biochemistry, Imperial College of Science, London, England, UK
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Hughes PD, Gillespie MJ, Downes KE, Done M, Major J, Bailey G. Autologous blood donation in total hip replacement. Aust N Z J Surg 1995; 65:449. [PMID: 7786270 DOI: 10.1111/j.1445-2197.1995.tb01776.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Hughes PD, McDonald PJ, Halse MR, Leone B, Smith EG. Water diffusion in zeolite 4A beds measured by broad-line magnetic resonance imaging. Phys Rev B Condens Matter 1995; 51:11332-11338. [PMID: 9977860 DOI: 10.1103/physrevb.51.11332] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Hughes PD. The use of poorly validated and expensive technology. Med J Aust 1994; 161:726. [PMID: 7830656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Hughes PD. Carcinoma of the prostate. Med J Aust 1994; 160:47. [PMID: 8271995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Hughes PD, Foley P, Bradford HF, Ghatei M, Khandanian N, Bloom SR, Wu JY. The differential release of amino acids and neuropeptides from purified subpopulations of mammalian GABAergic and cholinergic cerebrocortical synaptosomes. Neurochem Res 1993; 18:393-400. [PMID: 8097290 DOI: 10.1007/bf00967242] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
GABAergic and cholinergic synaptosome populations were isolated by immunomagnetophoresis. Analysis of 8 amino acids showed that the GABAergic population was enriched in GABA (3 fold). The cholinergic population was enriched in citrulline (5 fold). CCK was found in both populations, but was enriched in the GABAergic. No monoamines were found in either subpopulation. Stimulated release (veratridine 50 microns), measured using a superfusion system, showed that glutamate was only released from the cholinergic subpopulation, as was VIP. In the GABAergic population, stimulated SRIF release was slow and prolonged, and the CCK release was delayed and rapid. GABA release was rapid, only occurring during application of the stimulus and only from the GABAergic synaptosomes. The GABAergic release could be modified by GABAA and GABAB targeted drugs. The cholinergic subpopulation exhibited late release of both VIP and CCK, each showing the same time pattern of release. All release was calcium and tetrodotoxin dependent.
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Affiliation(s)
- P D Hughes
- Department of Biochemistry, Imperial College of Science, Technology and Medicine, South Kensington, London, United Kingdom
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Hughes PD. Radiological investigation of the urinary tract in children. Med J Aust 1993; 158:215. [PMID: 8383797 DOI: 10.5694/j.1326-5377.1993.tb121725.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Foley P, Hughes PD, Bradford HF, Ghatei MA, Khandanian N, Bloom SR. The presence of neuropeptides in GABAergic and cholinergic rat cerebrocortical synaptosome sub-populations. Neuropeptides 1992; 23:67-72. [PMID: 1454155 DOI: 10.1016/0143-4179(92)90080-g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
GABAergic and cholinergic synaptosomes from rat cerebral cortex were isolated by a magnetic immunoaffinity technique, i.e. immunomagnetophoresis. These subpopulations were extracted and subjected to radioimmunoassay for four neuropeptides: Neuropeptide Y (NPY); vasoactive intestinal peptide (VIP); substance P (SP); and somatostatin (SRIF). In each of the sub-populations three of the four peptides were enriched in the sorted fraction compared with the mother fraction with respect to the cytosolic marker lactate dehydrogenase (LDH). In the GABAergic sub-population the order was SP > SRIF > NPY > or = VIP whilst in the cholinergic sub-population they were enriched in the order VIP > or = NPY > SP > SRIF. The presence of NPY has not previously been reported in cortical cholinergic neurons.
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Affiliation(s)
- P Foley
- Department of Biochemistry, Imperial College of Science, Technology & Medicine, South Kensington, London, UK
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Hughes PD. The Papanicolaou smear histories of 237 patients with cervical cancer. Med J Aust 1992. [DOI: 10.5694/j.1326-5377.1992.tb137219.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- P D Hughes
- Urologist, John James Memorial Hospital, Canberra, ACT 2600
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Hughes PD. Teflon injection for ureteric reflux. Med J Aust 1989; 150:608. [PMID: 2716577 DOI: 10.5694/j.1326-5377.1989.tb136717.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Abstract
This paper presents 14 personal patients with transitional cell carcinoma of the kidney who were managed over a period of 13 years. Emphasis is placed on the diagnostic features, the great variety of radiological appearances of this neoplasm and the value of preoperative cytological examination of urine. In three patients the tumour started in the mucosa of peripheral calyces, and did not involve the surgical renal pelvis; this added to the diagnostic difficulty, and led to delay in diagnosis and treatment in one patient. The possibility that this tumour may be more common in Australia because of the high incidence of analgesic nephropathy is raised.
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Hughes PD. The bed--who pays? AUST HEALTH REV 1980; 3:27-30. [PMID: 10251239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Heap GJ, Hughes PD. Bi-vision modification of the Braasch cystoscope. J Urol 1969; 102:353-4. [PMID: 5808892 DOI: 10.1016/s0022-5347(17)62146-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Hughes PD. Correction of vesico-vaginal fistula in a child aged four years. Med J Aust 1968; 2:843-5. [PMID: 5728212 DOI: 10.5694/j.1326-5377.1968.tb83234.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Hughes PD, Wiles HB. Adrenal haematoma in a new-born infant simulating renal tumour. Med J Aust 1965; 2:370-1. [PMID: 5825473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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