A method for monitoring intracerebral temperature in neurosurgical patients

Current interest in brain temperature and selective brain cooling makes a method allowing for continuous monitoring of intracerebral temperature in humans desirable. The authors describe a safe, simple, and reliable technique using a thermocouple of copper and constantan in combination with intraventricular monitoring of intracranial pressure for measurement of brain temperature in neurosurgical patients.     

Bone Mass in Female Volleyball Players: A Comparison of Total and Regional Bone Mass in Female Volleyball Players and Nonactive Females

The purpose of this cross-sectional study was to evaluate bone mass in female athletes participating in an impact loading sport (volleyball), and especially to investigate whether any changes in bone mass might be related to the type and magnitude of weightbearing loading and muscle strength. The volleyball group consisted of 13 first division players (age 20.9 ± 3.7 years) training for about 8 hours/week, and the reference group consisted of 13 nonactive females (age 25.0 ± 2.4 years) not participating in any kind of regular or organized sport activity. The groups were matched according to weight and height. Areal bone mineral density (BMD) was measured in total body, head, lumbar spine, femoral neck, Ward's triangle, trochanter, the whole femur, and humerus using dual-energy-X-ray absorptiometry. Isokinetic concentric peak torque of the quadricep and hamstring muscles was measured using an isokinetic dynamometer. Compared with the controls, the volleyball players had a significantly (P < 0.05–0.01) higher BMD of the total body (6.1%), lumbar spine (13.2%), femoral neck (15.8%), Ward's triangle (17.9%), trochanter (18.8%), nondominant femur (8.2%), and humerus (dominant 9.5%, nondominant 10.0%), but not of the head and the dominant whole femur. The dominant humerus showed significantly higher BMD than the nondominant humerus in both the volleyball and nonactive group (P < 0.05). There was no significant difference in muscle strength of the thigh between the two groups. In the nonactive group, muscle strength in the quadriceps, and especially hamstrings, was correlated to BMD of the adjacent bones (whole femur, hip sites) and also to distant sites (humerus). However, in the volleyball group there were no correlations between muscle strength and BMD of the adjacent bones, but quadricep strength correlated to BMD of the humerus. These results clearly show that young female volleyball players have a high bone mass. The demonstrated high bone mass seems to be related to the type of loading subjected to each BMD site. Muscle strength of the thigh seems to have little impact on BMD in female volleyball players. Received: 18 June 1996 / Accepted: 31 October 1996     

Local status of the urinary stoma--the relation to peristomal skin complications

Sixty-six patients with uretero-ileostomy were investigated with special regards to local status of the urinary stoma, i.e. stomal site, length, size/shape, and peristomal skin. Each variable was defined. In reports from other centres there has been a lack of definitions making it difficult to compare results from different studies. One fifth of our patients had inadequately located stomas and 85% had stomas shorter than 1 cm. The peristomal skin status was assessed according to CPS, Classification of Peristomal Skin. Eight per cent of the patients exhibited severe erythematous/erosive lesions and one fifth pseudoverrucose lesions. The relation between skin lesions and local status of the urinary stoma was analyzed. Patients with inadequately located stomas were more likely to show severe erythematous/erosive lesions and there was a tendency towards patients with stomas shorter than 1 cm, more frequently exhibiting pseudoverrucose lesions.     

Prenatal diagnosis and carrier detection in fragile X.

Prenatal diagnosis was performed in 81 cases at risk for the fragile X syndrome. There were 12 fra(X)-positive cases, two of which showed low expression in cultured amniotic fluid cells. FUdR and high thymidine were used for induction of fra(X) (q27.3) expression in all cases. In 21 cases linkage studies were performed, 7 with probes for the loci DXS52, DXS98 and DXS105, 13 with probes for DXS369 and DXS296, DXS304 or DXS374 and one with the probe Do33 for DXS465. In 11 of these cases linkage analysis gave risk figures higher than 95% or lower than 5%, all in concordance with the cytogenetic findings. Discordance was found in three cases studied earlier, the two cases with low expression mentioned above and one cytogenetically normal case, which were now restudied with the new probes. RFLP-studies and linkage analysis was also performed for 24 cytogenetically fra(X)-negative females having a 50%, 25% or 12.5% risk of being carriers according to pedigree data. In 15 cases the risk dropped to 1% or less. Six of these women were pregnant and had asked for prenatal diagnosis but after genetic counseling prenatal diagnosis was avoided.     

Cardiovascular and respiratory mechanisms in anaphylactic and anaphylactoid shock reactions

Summary Different mediators such as histamine, leukotrienes, prostaglandins and bradykinin are involved in different reaction mechanisms such as cytotropic anaphylaxis (CA), immune complex anaphylaxis (ICA), reactions due to direct histamine liberation or activation of the complement system or hyperosmolarity induced anaphylactoid reactions.In the monkey CA induces systemic vasodilatation, a transient pulmonary hypertension and increase of cardiac output followed by peripheral blood pooling and depression of cardiac output. ICA induces peripheral vasoconstriction, a severe increase in pulmonary vascular resistance and decreased cardiac output, the latter possibly being partially due to decreased cardiac contractility.In hypersensitivity reactions in man cutaneous vasodilatation as well as vasoconstriction may occur alternatively. Peripheral blood pooling and increased vascular permeability are the cause of severe relative and absolute hypovolemia, respectively. Pulmonary vasoconstriction seems to occur in connection with serious bronchospasm. Decreased venous return, myocardial ischemia and hypoxemia can contribute to a reduction of cardiac performance. The most frequent changes in the ECG are sinus tachycardia, sinus bradycardia, extrasystoles, conduction disturbances as A-V block and bundle branch block; lethal or sublethal shock is often associated with malign arrhythmias or cardiac arrest.Almost normal blood gas values are seen in anaphylactic shock without clinical signs of respiratory obstruction. The very few documented cases of anaphylactic shock with respiratory obstruction indicate that increased airway resistance and reduced lung compliance may be present as well as mild to moderate hypoxemia with normal or subnormal CO₂ values.     

VIP-sensitive adenylate cyclase, guanylate cyclase, muscarinic receptors, choline acetyltransferase and acetylcholinesterase, in brain tissue afflicted by Alzheimer's disease/senile dementia of the Alzheimer type

Biochemical parameters were determined in autopsy material from several brain regions of thirteen patients with Alzheimer's disease/senile dementia of Alzheimer type (AD/SDAT) (mean age 75 years) and from brains of ten age-matched controls (mean age 76 years). Choline acetyltransferase specific activity was significantly lower in the nucleus caudatus, putamen, left thalamus, hippocampus and the cortex from gyrus hippocampus and the temporal lobe in AD/SDAT, acetylcholinesterase specific activity was significantly lower in the hippocampus, parietal and left frontal lobe in AD/SDAT samples than in corresponding samples from aged-matched controls. A compensatory increase of muscarinic receptors was found in the nucleus caudatus and left frontal lobe samples in AD/SDAT. Guanylate cyclase activity was not significantly altered in AD/SDAT in the brain regions examined. The basal, non-stimulated activity of adenylate cyclase was significantly (p less than 0.05) elevated in hippocampus samples from AD/SDAT patients and the enzyme activity stimulated by the vasoactive intestinal polypeptide VIP (2 microM) or forskolin (10 microM) was also elevated in AD/SDAT although not significantly.     

DNA microarray technique for detection and identification of seven flaviviruses pathogenic for man

A flavivirus microarray was developed for detection and identification of yellow fever (YF), West Nile, Japanese encephalitis (JE), and the dengue 1-4 viruses, which are causing severe human disease all over the world. The microarray was based on 500-nucleotide probe fragments from five different parts of the seven viral genomes. A low-stringent amplification method targeting the corresponding regions of the viral genomic RNA was developed and combined with hybridization to the microarray for detection and identification. For distinction of the generated virus-specific fluorescence-patterns a fitting analysis procedure was adapted. The method was verified as functional for all seven flaviviruses and the strategy for the amplification, combined with the long probes, provided a high tolerance for smaller genetic variability, most suitable for these rapidly changing RNA viruses. A potentially high detection and identification capacity was proven on diverged strains of West Nile and dengue viruses. The lower limit for detection was equivalent, or better, when compared to routinely used RT-PCR methods. The performance of the method was verified on human patient samples containing dengue viruses, or normal human serum spiked with YF or JE viruses. The results demonstrated the ability of the flavivirus microarray to screen simultaneously a sample for several viruses in parallel, in combination with a good lower limit of detection.