Effect of theophylline-ethylenediamine in Cheyne-Stokes respiration

Localisation of the respiratory centre:- The respiratory centre, which is constituted by the integration of many neurons, has been localised . in e relatively extensive area between the upper border of the pons and the lower third or so of the medulla oblongata. It has been demonstrated by V. E. Henderson and Craigie, by Gesell, Bricker and Magee that these neurons are scattered at different levels through the formatio reticularis of the se parts of the brain stern. The centre is bilateral and each half contains inspiratory and expiratory components that control muscles of inspiration and expiration respectively.The nervous structures controlling respiration has been localised by Markwald. The fact that powerful and prolonged tonic inspiratory movements supervened after bilateral section of the vagus nerves and division of the brain stem immediately behind the posterior colliculi, made him conclude that a centre inhibitory to respiration was located in the posterior colliculi.Tine vagi however also has an inhibitory action, consequently these inspiratory movements, or "cramps", as he termed them, appeared only after their influence had been abolished as well. In recent years Lumsden found that prolonged inspiratory movements occurred only if the section passed through the pons e few millimetres behind its anterior border, and occurred whether the vági were divided or not, and . that these respiratory movements were dependent upon an apneustic or inspiratory centre situated at the level of the striae accousticae, which was dominated normally by an inhibitory or pneumotoxic centre situated 'i.n the upper part of the pons. On account of the inhibitory influence of the latter, the apneustic n-ovements were transformed into the rhythmical movements characteristic of normal respiration, as shown by the fact that rythmic action currents are registered by leads from the medulla. Section of the brain stem behind the atriae accousticae brought about a series of gasps occurring at relatively long intervals

The use of ultrasound-guided transversus abdominis plane blocks for total abdominal hysterectomy: A double-blind, controlled trial

Objectives: This study investigated the postoperative analgesic efficacy of bilateral ultrasound-guided transversus abdominis plane (TAP) blocks, in patients undergoing total abdominal hysterectomy.Design, setting and subjects: This was a prospective, randomised, double-blind, controlled study. Thirty patients were allocated to two groups; a TAP block group (n = 15) and a placebo group (n = 15). The TAP blocks were performed with 0.25% bupivacaine. The placebo group received sham blocks with normal saline, post induction of anaesthesia. Postoperatively,patients received patient-controlled intravenous morphine for analgesia.Outcome measures: The primary outcome was morphine consumption during the first 24 hours postoperatively. Secondary outcomes were  adequacy of pain relief, as assessed by pain scores at 0, 6 and 24 hours postoperatively, and side-effects.Results: Our study showed a significant between-group difference in morphine requirements (5.2 ± 3.9 vs. 9.7 ± 4.3 mg, p = 0.007, and 12.9 ± 8.9 mg vs. 25 ± 12.1 mg, p = 0.006) for the TAP group, compared with the placebo group at six and 24 hours, respectively. There were no significant between-group differences in pain scores. There were no complicationswith any of the blocks.Conclusion: Bilateral ultrasound-guided TAP blocks significantly reduced postoperative morphine consumption in a multimodal postoperative analgesia regimen for abdominal hysterectomy

Model-based segmentation of CT Images

This paper presents preliminary work on the segmentation of Computed Tomography data using a model-based approach. Conventional image processing of CT data is aimed at the production of simple iso-surfaces for surgical planning or diagnosis — such methods are not suitable for the automated detection of fractures, which is the ultimate application of our work. To address these deficiencies a surface-based technique with appropriate constraints is introduced. The output of the segmentation phase is a triangulated surface representing the bone or bones of interest. We illustrate the method applied to low resolution CT test data and discuss its robustness and performance

Sensitivity to grid resolution in the ability of a chemical transport model to simulate observed oxidant chemistry under high-isoprene conditions

Formation of ozone and organic aerosol in continental atmospheres depends on whether isoprene emitted by vegetation is oxidized by the high-NOx pathway (where peroxy radicals react with NO) or by low-NOx pathways (where peroxy radicals react by alternate channels, mostly with HO2). We used mixed layer observations from the SEAC4RS aircraft campaign over the Southeast US to test the ability of the GEOS-Chem chemical transport model at different grid resolutions (0.25°  ×  0.3125°, 2°  ×  2.5°, 4°  ×  5°) to simulate this chemistry under high-isoprene, variable-NOx conditions. Observations of isoprene and NOx over the Southeast US show a negative correlation, reflecting the spatial segregation of emissions; this negative correlation is captured in the model at 0.25°  ×  0.3125° resolution but not at coarser resolutions. As a result, less isoprene oxidation takes place by the high-NOx pathway in the model at 0.25°  ×  0.3125° resolution (54 %) than at coarser resolution (59 %). The cumulative probability distribution functions (CDFs) of NOx, isoprene, and ozone concentrations show little difference across model resolutions and good agreement with observations, while formaldehyde is overestimated at coarse resolution because excessive isoprene oxidation takes place by the high-NOx pathway with high formaldehyde yield. The good agreement of simulated and observed concentration variances implies that smaller-scale non-linearities (urban and power plant plumes) are not important on the regional scale. Correlations of simulated vs. observed concentrations do not improve with grid resolution because finer modes of variability are intrinsically more difficult to capture. Higher model resolution leads to decreased conversion of NOx to organic nitrates and increased conversion to nitric acid, with total reactive nitrogen oxides (NOy) changing little across model resolutions. Model concentrations in the lower free troposphere are also insensitive to grid resolution. The overall low sensitivity of modeled concentrations to grid resolution implies that coarse resolution is adequate when modeling continental boundary layer chemistry for global applications

Why highly expressed proteins evolve slowly

Much recent work has explored molecular and population-genetic constraints on the rate of protein sequence evolution. The best predictor of evolutionary rate is expression level, for reasons which have remained unexplained. Here, we hypothesize that selection to reduce the burden of protein misfolding will favor protein sequences with increased robustness to translational missense errors. Pressure for translational robustness increases with expression level and constrains sequence evolution. Using several sequenced yeast genomes, global expression and protein abundance data, and sets of paralogs traceable to an ancient whole-genome duplication in yeast, we rule out several confounding effects and show that expression level explains roughly half the variation in Saccharomyces cerevisiae protein evolutionary rates. We examine causes for expression's dominant role and find that genome-wide tests favor the translational robustness explanation over existing hypotheses that invoke constraints on function or translational efficiency. Our results suggest that proteins evolve at rates largely unrelated to their functions, and can explain why highly expressed proteins evolve slowly across the tree of life.Comment: 40 pages, 3 figures, with supporting informatio

Why do models overestimate surface ozone in the Southeast United States

Ozone pollution in the Southeast US involves complex chemistry driven by emissions of anthropogenic nitrogen oxide radicals (NOx  ≡  NO + NO2) and biogenic isoprene. Model estimates of surface ozone concentrations tend to be biased high in the region and this is of concern for designing effective emission control strategies to meet air quality standards. We use detailed chemical observations from the SEAC4RS aircraft campaign in August and September 2013, interpreted with the GEOS-Chem chemical transport model at 0.25°  ×  0.3125° horizontal resolution, to better understand the factors controlling surface ozone in the Southeast US. We find that the National Emission Inventory (NEI) for NOx from the US Environmental Protection Agency (EPA) is too high. This finding is based on SEAC4RS observations of NOx and its oxidation products, surface network observations of nitrate wet deposition fluxes, and OMI satellite observations of tropospheric NO2 columns. Our results indicate that NEI NOx emissions from mobile and industrial sources must be reduced by 30–60 %, dependent on the assumption of the contribution by soil NOx emissions. Upper-tropospheric NO2 from lightning makes a large contribution to satellite observations of tropospheric NO2 that must be accounted for when using these data to estimate surface NOx emissions. We find that only half of isoprene oxidation proceeds by the high-NOx pathway to produce ozone; this fraction is only moderately sensitive to changes in NOx emissions because isoprene and NOx emissions are spatially segregated. GEOS-Chem with reduced NOx emissions provides an unbiased simulation of ozone observations from the aircraft and reproduces the observed ozone production efficiency in the boundary layer as derived from a regression of ozone and NOx oxidation products. However, the model is still biased high by 6 ± 14 ppb relative to observed surface ozone in the Southeast US. Ozonesondes launched during midday hours show a 7 ppb ozone decrease from 1.5 km to the surface that GEOS-Chem does not capture. This bias may reflect a combination of excessive vertical mixing and net ozone production in the model boundary layer

Clinical presentation and outcome of Tuberculosis in Human Immunodeficiency Virus infected children on anti-retroviral therapy

<p>Abstract</p> <p>Background</p> <p>The tuberculosis (TB) and human immunodeficiency virus (HIV) epidemics are poorly controlled in sub-Saharan Africa, where highly active antiretroviral treatment (HAART) has become more freely available. Little is known about the clinical presentation and outcome of TB in HIV-infected children on HAART.</p> <p>Methods</p> <p>We performed a comprehensive file review of all children who commenced HAART at Tygerberg Children's Hospital from January 2003 through December 2005.</p> <p>Results</p> <p>Data from 290 children were analyzed; 137 TB episodes were recorded in 136 children; 116 episodes occurred before and 21 after HAART initiation; 10 episodes were probably related to immune reconstitution inflammatory syndrome (IRIS). The number of TB cases per 100 patient years were 53.3 during the 9 months prior to HAART initiation, and 6.4 during post HAART follow-up [odds ratio (OR) 16.6; 95% confidence interval (CI) 12.5–22.4]. A positive outcome was achieved in 97/137 (71%) episodes, 6 (4%) cases experienced no improvement, 16 (12%) died and the outcome could not be established in 18 (13%). Mortality was less in children on HAART (1/21; 4.8%) compared to those not on HAART (15/116; 12.9%).</p> <p>Conclusion</p> <p>We recorded an extremely high incidence of TB among HIV-infected children, especially prior to HAART initiation. Starting HAART at an earlier stage is likely to reduce morbidity and mortality related to TB, particularly in TB-endemic areas. Management frequently deviated from standard guidelines, but outcomes in general were good.</p

Study of mechanical properties, microstructures and corrosion behavior of al 7075 t651 alloy with varying strain rate

Compression test of Al 7075 T651 was carried out at high strain rates (1138-2534 s-1) using Split Hopkinson Pressure Bar and at slow strain rate (10-4s-1) in 100KN Universal Testing machine to understand the improvement in mechanical properties and associated changes in microstructures. Cylindrical specimens of 6 mm height and 6 mm diameter were compressed dynamically. The influence of strain rates on mechanical properties, microstructure evolution and corrosion behavior after immersion test in 3.5% NaCl solution was also investigated. Strain rate, withdrawal stress and yield stress were observed to increase with impact velocity in high strain rate tests, while in slow strain rate tests, n value was observed to increase with increasing total strain. Microstructural observations revealed that after high strain rate test, grains of Al matrix were elongated. It was observed that corrosion resistance decreased with increase in impact velocity

Natural variation in immune responses to neonatal mycobacterium bovis bacillus calmette-guerin (BCG) vaccination in a cohort of Gambian infants

Background There is a need for new vaccines for tuberculosis (TB) that protect against adult pulmonary disease in regions where BCG is not effective. However, BCG could remain integral to TB control programmes because neonatal BCG protects against disseminated forms of childhood TB and many new vaccines rely on BCG to prime immunity or are recombinant strains of BCG. Interferon-gamma (IFN-) is required for immunity to mycobacteria and used as a marker of immunity when new vaccines are tested. Although BCG is widely given to neonates IFN- responses to BCG in this age group are poorly described. Characterisation of IFN- responses to BCG is required for interpretation of vaccine immunogenicity study data where BCG is part of the vaccination strategy. Methodology/Principal Findings 236 healthy Gambian babies were vaccinated with M. bovis BCG at birth. IFN-, interleukin (IL)-5 and IL-13 responses to purified protein derivative (PPD), killed Mycobacterium tuberculosis (KMTB), M. tuberculosis short term culture filtrate (STCF) and M. bovis BCG antigen 85 complex (Ag85) were measured in a whole blood assay two months after vaccination. Cytokine responses varied up to 10 log-fold within this population. The majority of infants (89-98% depending on the antigen) made IFN- responses and there was significant correlation between IFN- responses to the different mycobacterial antigens (Spearman’s coefficient ranged from 0.340 to 0.675, p=10-6-10-22). IL-13 and IL-5 responses were generally low and there were more non-responders (33-75%) for these cytokines. Nonetheless, significant correlations were observed for IL-13 and IL-5 responses to different mycobacterial antigens Conclusions/Significance Cytokine responses to mycobacterial antigens in BCG-vaccinated infants are heterogeneous and there is significant inter-individual variation. Further studies in large populations of infants are required to identify the factors that determine variation in IFN- responses