A time series transcriptome analysis of cassava (Manihot esculenta Crantz) varieties challenged with Ugandan cassava brown streak virus

A time-course transcriptome analysis of two cassava varieties that are either resistant or susceptible to cassava brown streak disease (CBSD) was conducted using RNASeq, after graft inoculation with Ugandan cassava brown streak virus (UCBSV). From approximately 1.92 billion short reads, the largest number of differentially expressed genes (DEGs) was obtained in the resistant (Namikonga) variety at 2 days after grafting (dag) (3887 DEGs) and 5 dag (4911 DEGs). At the same time points, several defense response genes (encoding LRR-containing, NBARC-containing, pathogenesis-related, late embryogenesis abundant, selected transcription factors, chaperones, and heat shock proteins) were highly expressed in Namikonga. Also, defense-related GO terms of 'translational elongation', 'translation factor activity', 'ribosomal subunit' and 'phosphorelay signal transduction', were overrepresented in Namikonga at these time points. More reads corresponding to UCBSV sequences were recovered from the susceptible variety (Albert) (733 and 1660 read counts per million (cpm)) at 45 dag and 54 dag compared to Namikonga (10 and 117 cpm respectively). These findings suggest that Namikonga's resistance involves restriction of multiplication of UCBSV within the host. These findings can be used with other sources of evidence to identify candidate genes and biomarkers that would contribute substantially to knowledge-based resistance breeding.

Distribution of oxytocin in the brain of a eusocial rodent

Naked mole-rats are highly social rodents that live in large colonies characterized by a rigid social and reproductive hierarchy. Only one female, the queen, breeds. Most colony members are non-reproductive subordinates that work cooperatively to rear the young and maintain an underground burrow system. Little is known about the neurobiological basis of the complex sociality exhibited by this species. The neuropeptide oxytocin (Oxt) modulates social bonding and other social behaviors in many vertebrates. Here we examined the distribution of Oxt immunoreactivity in the brains of male and female naked mole-rats. As in other species, the majority of Oxt-immunoreactive (Oxt-ir) cells were found in the paraventricular and supraoptic nuclei, with additional labeled cells scattered throughout the preoptic and anterior hypothalamic areas. Oxt-ir fibers were found traveling toward and through the median eminence, as well as in the tenia tecta, septum, and nucleus of the diagonal band of Broca. A moderate network of fibers covered the bed nucleus of the stria terminalis and preoptic area, and a particularly dense fiber innervation of the nucleus accumbens and substantia innominata was observed. In the brainstem, Oxt-ir fibers were found in the periaqueductal gray, locus coeruleus, parabrachial nucleus, nucleus of the solitary tract, and nucleus ambiguus. The high levels of Oxt immunoreactivity in the nucleus accumbens and preoptic area are intriguing, given the link in other rodents between Oxt signaling in these regions and maternal behavior. Although only the queen gives birth or nurses pups in a naked mole-rat colony, most individuals actively participate in pup care.

Shoot meristem: an ideal explant for Zea mays L. transformation

We report on a rapid high-frequency somatic embryogenesis and plant regeneration protocol for Zea mays. Maize plants were regenerated from complete shoot meristem (3-4 mm) explants via organogenesis and somatic embryogenesis. In organogenesis, the shoot meristems were directly cultured on a high-cytokinin medium comprising 5-10 mg x L(-1) 6-benzylaminopurine (BAP). The number of multiple shoots produced per meristem varied from six to eight Plantlet regeneration through organogenesis resulted in just four weeks. Callus was induced in five days of incubation on an auxin-modified Murashige and Skoog (MS) medium. Prolific callus, with numerous somatic embryos, developed within 3-4 weeks when cultured on an auxin medium containing 5 mg 2,4-dichlorophenoxyacetic acid x L(-1). The number of multiple shoots varied from three to six per callus. Using R23 (Pioneer, Hi-Bred, Johnston, Iowa), the frequency of callus induction was consistently in excess of 80% and plant regeneration ranged between 47 and 64%. All regenerated plantlets survived in the greenhouse and produced normal plants. Each transgenic plant produced leaves, glumes, and anthers that uniformly expressed green fluorescent protein (GFP). The GFP gene segregated in the pollen. Based on this data it is concluded that the transgenics arose from single-cell somatic embryos. The rate of transfer DNA (T-DNA) transfer to complete shoot meristems of Zea mays was high on the auxin medium and was independent of using super-virulent strains of Agrobacterium.

Apomixis in Tripsacum: comparative mapping of a multigene phenomenon

A relationship has been established between the expression of apomixis in natural polyploids of Tripsacum dactyloides and fertility as measured by percent seed set. Thus, fertility may be reliably used as a defining phenotype for apomixis when scoring the progeny from diploid (2n = 2x = 36) x tetraploid (2n = 4x = 72) crosses in Tripsacum. By exploiting the relationship between apomixis and fertility, as defined by seed set, analyses were performed on a set of related second-generation triploid populations segregating for apomixis. These populations were derived from sexual (diploid) x apomictic (tetraploid) crosses. Six out of 25 genome-dispersed restriction fragment length polymorphism (RFLP) markers co-segregate with fertility. Five of these markers were previously reported and include: php20855, tda48, tda53, umc62, and umc83, and are linked to Tripsacum genetic linkage groups F, I, H, L, and A, respectively. Significantly, we report here the syntenic relationships of the maize chromosome intervals to Tripsacum that segregate for numerous meiosis-specific and fertility-associated genes. Utilizing RFLP locus comparative mapping based on conservation of chromosome (genic) regions between related species, it may be concluded that the genes controlling fertility have been preserved in both Tripsacum and maize. A sixth marker, umc166, has also been shown to co-segregate with fertility and is conserved in both grass species. Specifically, umc166 is linked to Tripsacum linkage group D and, by syntenic comparison, to the short arm of maize chromosome 5. Encoded within this marked interval is the gene Ameiotic1 (Am1) whose function is required for the initiation of meiosis in both micro- and megaspore mother cells and whose absence of expression in the female is, in all likelihood, a prerequisite for the expression of apomixis.

Genetic and environmental influences on short-day responsiveness in Siberian hamsters (Phodopus sungorus)

Siberian hamsters are photoperiodic rodents that typically exhibit several physiological changes when exposed to a short-day photoperiod. However, development of the winter phenotype in short days is largely conditional on prior photoperiod history: Hamsters that have been reared in an exceptionally long day length (18 L) do not usually exhibit the winter phenotype after transfer to short days, whereas animals reared under "moderately" long days (16 L) are more variable in responsiveness to subsequent short-day exposure, with 20% to 30% generally failing to exhibit winter-type responses. Hamsters reared exclusively in an "intermediate" day length (14 L) are almost uniformly responsive to short photoperiod. In the present study, the authors examine the influence of photoperiod history on short-day responsiveness in a breeding line of hamsters that has been subjected to artificial selection for resistance to the effects of short days. The results demonstrate that photoperiod history is an important determinant of short-day responsiveness in both random-bred (UNS) hamsters and animals artificially selected and bred for nonresponsiveness to short photoperiod (PNR). The PNR hamsters have a reduced requirement for long-day exposure to evoke a state of unresponsiveness to short days. The results are discussed in relation to possible significance for the origin of population and species differences in photoperiod responsiveness.

Factors influencing metabolic rate in naked mole-rats (Heterocephalus glaber)

Naked mole-rats (Heterocephalus glaber) are fossorial, eusocial mammals that live in colonies averaging about 70 individuals. Metabolic regulation is of particular interest in this species because it is one of only two naturally occurring small mammals that are hairless. Further, relative to other small mammals, naked mole-rats exhibit low body temperature (Tb) and weak capacity to maintain Tb above the ambient temperature (Ta). The present study examined effects of Ta, norepinephrine (NE), and chronic food restriction on O2 consumption (as a measure of metabolism) in naked mole-rats. Studies were performed in both awake and anesthetized animals. Metabolic rate decreased with increasing T. over the range of 23-34 degrees C in awake mole-rats, whereas in anesthetized animals rates of O2 consumption were very low over this entire range of Ta and tended to increase with increasing Ta. Injections of NE led to rapid increases in metabolic rate at all Tas in anesthetized subjects and also at Ta = 34 degrees C in awake mole-rats. However, at Tas of 29 and 23 degrees C, awake subjects given NE showed little stimulation of O2 consumption beyond the already elevated baseline rates observed at these Tas. During chronic restriction of food to 60-70% of their normal daily consumption mole-rats exhibited decreased rates of metabolism; metabolic rate was not altered following several hours of acute food deprivation. Food consumption remained somewhat decreased after a period of chronic food restriction, even when animals were returned to ad lib conditions. However, body weights returned to prerestriction values, despite the continued reduction in ad lib food intake. These observations suggest that mole-rats may be capable of long-lasting metabolic adaptations as a means to cope with restricted food supply. These findings are discussed in relation to adaptation of this fossorial species to a habitat where food has a patchy distribution. Naked mole-rats, with their several unusual thermoregulatory and behavioral features, provide an intriguing model for studies of mammalian metabolic regulation.

Bronchodilator delivered by metered dose inhaler and spacer improves respiratory system compliance more than nebulizer-delivered bronchodilator in ventilated premature infants

We compared the change in passive respiratory system compliance (Crs) and resistance (Rrs) after albuterol aerosol treatment administered by either low-flow nebulizer (NEB) or a metered dose inhaler (MDI) and spacer into a ventilator circuit. We hypothesized that albuterol delivered to ventilated infants older than 7 days of life by an MDI and a spacer would improve Crs more than albuterol delivered by a low-flow nebulizer. The treatments were administered 6 hr apart to premature infants with Crs < or = 0.8 mL/cm H2O per kg, requiring ventilation after 7 days of age. Patients served as their own controls and treatment order was randomized. Eighteen studies were performed in eight infants before and 1 and 3 hr after treatment. Differences between methods were compared by analyses of variance. Mean (range) birth weight and study age were 888 (619-1,283) g and 12 (7-29) days, respectively. Mean respiratory system compliance increased by 34% with MDI and by 11% with NEB at 1 hr after treatment (P < 0.02). By 3 hr after treatment, Crs returned to baseline with both methods of aerosol delivery. There was no significant difference in Rrs between the two methods at 1 and 3 hr after treatment. We conclude that albuterol delivered by MDI improves Crs more than low-flow NEB in ventilated premature infants.

Circadian patterns of locomotor activity and body temperature in blind mole-rats, Spalax ehrenbergi

A wide variety of organisms exhibit circadian rhythms, regulated by internal clocks that are entrained primarily by the alternating cycle of light and darkness. There have been few studies of circadian rhythms in fossorial species that inhabit a microenvironment where day-night variations in most environmental parameters are minimized and where exposure to light occurs only infrequently. In this study, daily patterns of locomotor activity and body temperature (Tb) were examined in adult blind mole-rats (Spalax ehrenbergi). These fossorial rodents lack external eyes but possess rudimentary ocular structures that are embedded in the Harderian glands and covered by skin and fur. Most individual mole-rats exhibited circadian rhythms of locomotor activity, but some animals were arrhythmic. Individuals that did exhibit robust rhythms of locomotor activity also showed rhythms of Tb. In most cases, Tb was highest during the phase of intense locomotor activity. Locomotor activity rhythms could be entrained to light:dark cycles, and several mole-rats exhibited entrainment to non-24-h light cycles (T-cycles) with period lengths ranging from T = 23 h to T = 25 h. Some individuals also showed entrainment to daily cycles of ambient temperature. There was considerable interindividual variation in the daily patterns of locomotor activity among mole-rats in virtually all the conditions of environmental lighting and temperature employed in this study. Thus, whereas it appears likely that photic cues have a significant role in the entrainment of circadian rhythms in mole-rats, the amount of variability in rhythm patterns among individuals appears to be much greater than for most species that have been studied.

Beliefs about mood moderate the relationship of stress to illness and symptom reporting

The current prospective study examined how characteristic beliefs about mood affect illness and symptom reporting. Using the Trait Meta-Mood Scale, 134 undergraduate (76 females and 58 males) reported their beliefs about attention to, clarity, and reparability of mood. Self-reported stress, illness, and symptoms were collected at three times following assessment of trait meta-mood, during times of general stress, and immediately prior to a class examination. Results indicate that, at increasing levels of distress, those who believe in greater attention to mood were more likely to report physical symptoms. In addition, those individuals who said that they generally make efforts to maintain positive mood were less likely to report illness than those less likely to engage in mood repair. The findings suggest that a person's general manner of evaluating or appraising mood is an important moderator of the relation between distress and symptom and illness reporting.

Comparisons among aerodynamic, electroglottographic, and acoustic spectral measures of female voice

This study examines measures of the glottal airflow waveform, the electroglottographic signal (EGG), amplitude differences between peaks in the acoustic spectrum, and observations of the spectral energy content of the third formant (F3), in terms of how they relate to one another. Twenty females with normal voices served as subjects. Both group and individual data were studied. Measurements were made for the vowel in two speech tasks: strings of the syllable /pae/and sustained phonation of /ae/, which were produced at two levels of vocal effort: comfortable and loud voice. The main results were: 1. Significant differences in parameter values between /pae/and/ae/were related to significant differences in the sound pressure level (SPL). 2. An "adduction quotient," measured from the glottal waveform at a 30% criterion, was sensitive enough to differentiate between waveforms reflecting abrupt versus gradual vocal fold closing movements. 3. DC flow showed weak or nonsignificant relationships with acoustic measures. 4. The spectral content in the third formant (F3) in comfortable loudness typically consisted of a mix of noise and harmonic energy. In loud voice, the F3 spectral content typically consisted of harmonic energy. 5. Significant differences were found in all measures between tokens with F3 harmonic energy and tokens with F3 noise, independent of loudness condition. 6. Strong relationships between flow- and EGG-adduction quotients suggested that these signals can be used to complement each other. 7. The amplitude difference between spectral peaks of the first and third formant (F1-F3) was found to add information about abruptness of airflow decrease (flow declination) that may be lost in the glottal waveform signal due to low-pass filtering. The results are discussed in terms of how an integrated use of these measures can contribute to a better understanding of the normal vocal mechanism and help to improve methods for evaluating vocal function.

The impact of parental trait anxiety on the utilization of health care services in infancy: a prospective study

Used a prospective approach to examine the relation of prenatal parental anxiety to pediatric utilization in the first year. 31 firstborn children and their parents participated in the study. These families were primarily Caucasian, college-educated, middle-class couples who had been married an average of 4.3 years at the prenatal time period. They were first seen in their home during the second trimester of pregnancy. At that time, each parent independently completed the Life Events Survey and the Speilberger Trait Anxiety Inventory. At 12 months, each parent completed the Marital Relationship Inventory. Data on pediatric services utilization were derived from complete medical records when the child reached 12 months of age. Frequency counts for unscheduled acute care and well baby care visits were used as the primary dependent variables. As expected, prenatal reports of high maternal anxiety predicted an increased incidence of unscheduled acute care visits in the infancy period. The findings implicate physiological mechanisms and extend earlier work on psychosocial influences of pediatric services utilization to the infancy period, a time when children experience their greatest incidence of illness and patterns of medical care use become established.

Measurement error masks bipolarity in affect ratings

For years, affect researchers have debated about the true dimensionality of mood. Some have argued that positive and negative moods are largely independent and can be experienced simultaneously. Others claim that mood is bipolar, that joy and sorrow represent opposite ends of a single dimension. The 3 studies presented in this article suggest that the evidence that purportedly shows the independence of seemingly opposite mood states, that is, low correlations between positive and negative moods, may be the result of failures to consider biases due to random and nonrandom response error. When these sources of error are taken into account using multiple methods of mood assessment, a largely bipolar structure for affect emerges. The data herein speak to the importance of a multi-method approach to the measurement of mood.

Measurement error masks bipolarity in affect ratings

For years, affect researchers have debated about the true dimensionality of mood. Some have argued that positive and negative moods are largely independent and can be experienced simultaneously. Others claim that mood is bipolar, that joy and sorrow represent opposite ends of a single dimension. The 3 studies presented in this article suggest that the evidence that purportedly shows the independence of seemingly opposite mood states, that is, low correlations between positive and negative moods, may be the result of failures to consider biases due to random and nonrandom response error. When these sources of error are taken into account using multiple methods of mood assessment, a largely bipolar structure for affect emerges. The data herein speak to the importance of a multi-method approach to the measurement of mood.

Pulmonary mechanics in premature infants one month after treatment with synthetic surfactant

During the double-blind, multicenter trials of the synthetic surfactant Exosurf Neonatal, we measured pulmonary mechanics at 28 days of age in 30 surfactant- or placebo-treated infants. In the 20 surfactant-treated and 10 air-treated infants studied, there were no differences in lung compliance or resistance at 28 days of age. These observations suggest that improvements in pulmonary function reported early in the neonatal course after the administration of exogenous surfactant are not detectable at 28 days of age.

Children's representations of "everyday" aspects of health and illness

Moving beyond a focus on children's conceptions of causation, the study sought to (a) identify and evaluate additional dimensions along which young children's conceptions of illness might be organized and (b) to discover how young children also understand health concepts related to nutrition and routine preventive medical examination. 27 healthy preschool children, ages 4-6 were interviewed about their conceptions of common illness, knowledge of basic nutrition, and understanding of medical procedures and instruments associated with a standard pediatric examination. The findings demonstrated that children understand five characteristics of illness representations, which have also been identified in adults. They include causation, identity, consequence, time line, and cure. Associations among illness dimensions, concepts of nutrition, and knowledge about routine medical examinations were also found and are discussed in terms of their implications for future research.

Inspiratory time and pulmonary function in mechanically ventilated babies with chronic lung disease

To learn if increasing inspiratory time would improve pulmonary function in mechanically ventilated babies with chronic lung disease, we measured lung mechanics and alveolar ventilation at three inspiratory times: 0.4, 0.6, and 0.8 s. Nine babies were studied. Their mean birth weight was 875 g (range, 570-1,100 g), gestational age 27 (24-34) weeks, and age 7 (4-12) weeks. Their mean oxygen requirement was 40% (29-53), ventilator rate 33/min (20-40), and mean airway pressure 8 (5-10) cmH2O. Ventilator rate was kept constant; therefore expiratory time decreased and mean airway pressure and I:E ratio increased at longer inspiratory times. At 0.6 s and 0.8 s, when compared to 0.4 s, significant increases occurred in tidal volume (10.4, 10.1, and 8.4 mL/kg, respectively), dynamic lung compliance (0.68, 0.68, and 0.53 mL/cmH2O/kg, respectively), and alveolar ventilation (6.0, 6.3, and 4.7 mL/kg/breath, respectively). Airway resistance, anatomical dead space to tidal volume ratio, and functional residual capacity were similar at the three inspiratory times. Our findings suggest that an inspiratory time greater than or equal to 0.6 s (compared to 0.4 s) increases the effectiveness of mechanical ventilation for babies with chronic lung disease.

Scanning electron microscope studies of Agrobacterium tumefaciens attachment to Zea mays, Gladiolus sp., and Triticum aestivum

Scanning electron microscope studies demonstrated that cells of Agrobacterium tumefaciens strains attach to cells on the cut surfaces of corn and wheat seedlings and to gladiolus disks. Bacterial cells attached to these monocots in the same manner as they attached to the dicots tested. Of the strains tested, A66 and T37 covered more of the cut surfaces of these monocots in a nonrandom fashion than did cells of other isolates. These bacteria attached to cells of intact monocotyledonous plants and had the greatest affinity for tissues located within the vascular bundles. They attached in large numbers to cells in these areas in all three monocots tested.

Circulating erythroid progenitors in the anemia of prematurity

We studied erythropoiesis in infants with the anemia of prematurity by counting the number of colonies derived from erythroid burst-forming units (BFU-E) in the blood of 11 premature infants before they received transfusions. Colony growth in blood from the infants was compared with growth in blood from adults and umbilical-cord blood from term infants, in the presence of erythropoietin, 0 to 2000 mU per milliliter. Addition of increasing concentrations of erythropoietin resulted in a stepwise increase in the number of colonies derived from BFU-E (P less than 0.0005) of all three groups of subjects. Cultures stimulated with 2000 mU of erythropoietin yielded 28.1 +/- 7.6, 88.0 +/- 19.4, and 121.0 +/- 22.5 bursts (mean +/- SE) per 10(5) cells plated in blood from adults, blood from premature infants, and cord blood, respectively. Although more BFU-E-derived colonies appeared when 200 or 2000 mU were present per milliliter in cultures of the infants' blood and cord blood, the intrinsic responsiveness of BFU-E to erythropoietin was similar in all groups. Although the mean hematocrit was 26 percent, mean serum erythropoietin concentrations (+/- SD) in the infants (20.7 +/- 10.0 mU per milliliter) were not significantly different from those in the adult controls (24.0 +/- 6.5). We conclude that progenitor cells committed to erythroid differentiation are present during the anemia of prematurity, and that the intrinsic responsiveness of the circulating BFU-E pool to erythropoietin is normal. These results implicate inadequate production of erythropoietin as the cause of the anemia of prematurity and suggest that recombinant erythropoietin might provide a therapeutic alternative to transfusion for symptomatic babies with this condition.

Agrobacterium tumefaciens-mediated transformation of the monocot genus Gladiolus: detection of expression of T-DNA-encoded genes

Agrobacterium tumefaciens was capable of directing the transformation of Gladiolus sp., a monocot genus belonging to the family Iridaceae. Only strains capable of transferring T-DNA formed tumors, sections of which could be cultured in phytohormone-free media. Opine synthase activities were also observed in homogenates made from these tumors.

A new evaluation method for instructors of advanced cardiac life support

This study evaluated the ability of a specific educational program to teach instructors of advanced cardiac life support (ACLS) how to identify errors committed by team leaders of cardiac arrest simulations. The design compared experimental and control groups for differences in identification of critical performance errors, grade assignments and errors specifically emphasized in the educational program. The group receiving the educational program documented more critical performance errors (1.70 vs. 1.10, P = 0.006), made more correct grade assignments (2.35 vs. 2.0, P = 0.026), and identified more errors that were emphasized in the educational program (3.61 vs. 2.25, P = 0.0001) than the control group. The data strongly suggests that the educational program accounted for the observed differences.

Evaluation of assessment methods of cardiac arrest simulations

Evaluation of advanced cardiac life support performance requires a consistent assessment process. This study compares a new objective method of evaluation to the currently used method to determine if this objective method improves evaluator concordance on critical errors and whether or not this method is reasonable when compared to the current evaluation method. The design compared two experienced evaluator groups consisting of two evaluators in each group, with one group utilizing written guidelines and the other without these guidelines. Each evaluator independently reviewed student performances on 36 videotaped simulations. Results indicate that evaluators with the written guidelines identified critical errors more often than evaluators without these guidelines (30 versus 20 of 36 cases). When the critical errors observed by the no guideline evaluators were compared to the written guidelines, the critical errors were consistent with the written guidelines in 32 of 36 cases. These results suggest that written guidelines improve evaluator identification of critical errors observed and are reasonable when compared to two experienced evaluators without these guidelines.

The transformation of Zea mays seedlings with Agrobacterium tumefaciens

Virulent strains of the soil bacterium Agrobacterium tumefaciens infect dicotyledonous plants and elicit a profound neoplastic response which results in crown gall formation (18). The inciting agent has been shown to be a high molecular weight plasmid (Ti) a section of which, the T-DNA, integrates into the host plant's genome (4, 28, 30). Although transformation of this kind was presumed to be limited to dicots, the detection of enzyme activities linked to the expression of T-DNA has been demonstrated in monocots from the families Liliaceae and Amaryllidaceae (10, 11).In this communication, we present evidence that a member of the commercially important Gramineae also is subject to A. tumefaciens directed transformation. This conclusion is based on two observations. First, seedlings of Zea mays that have had the bacteria introduced into wound sites defined by a region which includes the scutellar node and mesocotyl express the activity of enzymes whose synthesis is associated with the translation of T-DNA transcripts. Specifically, strain specific lysopine dehydrogenase activity has been detected in B6 infected material, whereas nopaline dehydrogenase activity is reported only in those plants inoculated with C58N. Second, the detection of either of these activities in extracts made from infected maize plants requires that the assaulting bacterial strain be competent with respect to the transfer of T-DNA. The vir (-) strains, JK195 and 238MX, are not, and transformation does not seem to occur. In this connection, the corresponding opine synthase activities are not observed.

Jaundice meter: evaluation of new guidelines

The correlation of transcutaneous bilirubin measurements with serum bilirubin concentrations is not good enough to allow for accurate prediction of the serum values. To impose the jaundice meter's potential clinical usefulness, we evaluated 344 paired jaundice meter-serum bilirubin measurements in 125 infants, using new guidelines from the marketing company which were designed to identify which infants require serum bilirubin determinations rather than to predict the actual bilirubin values. Use of the new guidelines correctly assessed the need for serum determinations in most infants, but false positives and, more importantly, false negatives (missed high serum values) did occur.

Detection of seizure activity in the paralyzed neonate using continuous monitoring

In experimental animals neurologic damage may occur during seizure activity whether the seizure is accompanied by motor activity and hypoxemia or whether the animal is paralyzed and normoxemic. These findings suggest that it may be important to detect seizure activity in the paralyzed neonate. Nine infants who were mechanically ventilated and paralyzed with pancuronium had their condition diagnosed as seizure activity. Vital signs were continuously monitored and six infants had either oxygen saturation or transcutaneous oxygen measured during seizure activity. For the group as a whole, rhythmic fluctuations in vital signs, cardiac rhythm, and oxygenation occurred every four minutes (range one to seven minutes) and lasted two minutes (range one to four minutes). In seven patients whose seizures were not accompanied by cardiac arrhythmias the following mean increases were noted: systolic arterial blood pressure, 15 mm Hg (range 7 to 36 mm Hg); heart rate, ten beats per minute (-11 to 30/min); oxygen saturation, 12% (range 4% to 20%); and transcutaneous oxygen, 31 mm Hg (range 14 to 45 mm Hg). Seizures in the two patients with cardiac arrhythmias were accompanied by a decrease in systolic arterial blood pressure of 27 mm Hg (range 15 to 40 mm Hg) and in oxygen saturation of 24% (range 20% to 28%). The presence of rhythmic fluctuation in vital signs and oxygenation should alert the physician to the possibility of seizure activity in the paralyzed neonate.

Hospital based cardiopulmonary resuscitation: it could be better

The frequency and duration of interruptions of cardiopulmonary resuscitation (CPR) were evaluated in a hospital to determine whether or not CRP was being performed properly according to American Heart Association (AHA) standards. The frequency of interruptions were 0.41 per min. Interruptions of greater than 20 s duration occurred in 17.12% of all interruptions. Eighty percent of these interruptions of greater than 20 s duration were of unjustified duration. CPR education should reflect these unjustified deviations and their reasons in an attempt to limit such interruptions in future patient CPR.

Attenuated response to insulin in very low birthweight infants

Four hyperglycemia very low birthweight (VLBW) infants were given a constant infusion of insulin with parenteral alimentation in order to improve glucose tolerance. After an initial 45% decrease in serum glucose, intolerance recurred within hours to days despite delivery of as much as 16 units/kg/hour or regular insulin. Resulting serum insulin levels were as high as 72,000 microU/ml. It is suggested that insulin "resistance", instead of insulin deficiency, may be responsible for glucose intolerance in some infants.

Increased work of breathing associated with nasal prongs

To see if continuous distending pressure (CPD) given by nasal prongs increases work of breathing, we measured the mechanics of breathing, minute ventilation, and blood gases in nine infants with both nasal prong and face mask CDP. Minute ventilation was 16% larger (P less than .02), work of breathing was 94% higher (P less than .01), and the mean PaO2 was 8 mm Hg lower (P less than .03) with the nasal prongs. There was no difference in pH or PaCO2. We speculate that CDP given by nasal prongs may increase the risk of respiratory failure in the premature infant already compromised with hyaline membrane disease.

Hyperglycemic hyperosmolar coma in a 9-month-old child

Hyperglycemic hyperosmolar coma is a life-threatening emergency with a mortality much higher than that of other forms of hyperosmolarity such as hypernatremia or diabetic ketoacidosis. Despite the differences in the three conditions, present evidence suggests that correction of hyperosmolarity should proceed slowly to avoid the seizures that may occur in all three conditions. This report describes a 9-month-old diabetic child who initially had hyperglycemic hyperosmolar coma and who is one of the youngest survivors of this syndrome in the American literature. This case report points out the limited understanding of the pathophysiology of this syndrome and the consequent problems of therapy.

Protein-calorie malnutrition in patients with colorectal cancer

Protein-calorie malnutrition, as determined by anthropometric measures and laboratory tests, was assessed in 17 preoperative patients with colorectal cancer and 47 control patients. The cancer patients had significant deficits in visceral protein and skeletal muscle and no deficit in fat stores. Greater attention should be given to preoperative nutritional assessment and to the correction of protein deficits.

Apnea, hypoxemia, and aborted sudden infant death syndrome

To find out whether there is any relationship between the ventilatory response to hypoxia and the sudden infant death syndrome (SIDS), we studied the effects of mild induced hypoxia (PIO2, 120 mm Hg = 17% oxygen) in 16 infants aged 2 weeks to 6 months. Eight had recurrent apneic spells (apnea group) (five had aborted SIDS and three had recurrent apnea in the intensive care nursery) and eight were "well" preterm infants about to fly in a pressurized airplane (PIO2, 120 mm Hg) (control group). Mean birth weights were 2,245 and 1,400 gm and mean gestational ages were 35 and 30 weeks. Postconceptual ages (41.8 and 41.3 weeks) were almost identical. Heart rate was obtained from an ECG, and respiratory rate and pattern were obtained from a pneumogram. In addition, end-tidal PCO2 and PN2 or PO2 were obtained with a nasal catheter and gas analyzers. In the apnea group with inhalation of 17% oxygen, we observed an increase in periodic breathing and an increase in both rate and total duration of respiratory pauses. In the control group there were no significant changes. Heart rate and PCO2 did not change in either group. Our findings suggest that infants prone to apnea may have unique respiratory responses to mild induced hypoxia.

An unusual complication of the teflon-sling repair of rectal prolapse: report of a case

A previously unreported late complication of the Teflon-sling repair for rectal prolapse is described. Two years after operation the Teflon had eroded into the lumen of the bowel. Avulsion of the sling was effected by gentle traction. There has been no further complication or recurrence of the prolapse.

Diagnosis of asbestosis by transbronchial biopsy. A method to facilitate demonstration of ferruginous bodies

The diagnosis of asbestos-associated pulmonary fibrosis was established in 3 patients by finding ferruginous bodies in transbronchial lung biopsies. Ferruginous bodies may be difficult to identify in histologic preparations when they are not oriented parallel to the plane of tissue section or when camouflaged by anthracotic pigment. We describe a simple method to enhance diagnostic sensitivity by digesting biopsy tissue and examining the filtered residue for ferruginous bodies.