A latent serotonin-1A receptor-gated spinal afferent pathway inhibiting breathing

Spinal afferents such as nociceptive afferents and group III–IV muscle afferents are known to exert an acute excitatory effect on breathing when activated. Here, we report the surprising existence of latent spinal afferents which exerted tonic inhibitory influence on breathing subliminally in anesthetized rats, an effect which was reversed upon activation of serotonin-1A receptors (5-HT[subscript 1A]Rs) in lumbar spinal cord, lesion of pontine lateral parabrachial nucleus or suppression of the adjacent Kölliker-Fuse nucleus with NMDA receptor blockade. Small-interfering RNA knockdown of 5-HT[subscript 1A]Rs in lumbar spinal cord unequivocally localized the site of 5-HT[subscript 1A]R-mediated gating of these respiratory-inhibiting interoceptive afferents to relay neurons in the spinal superficial dorsal horn at the lumbar level and not cervical spinal or supraspinal levels. Our results reveal a novel somatosensory/viscerosensory mechanism which exerts tonic inhibitory influence on homeostatic regulation of breathing independent from the classical chemoreflex excitatory pathways, and suggest a hitherto unrecognized therapeutic target in spinal dorsal horn for 5-HT[subscript 1A]R-based treatment of a variety of respiratory abnormalities.National Institutes of Health (U.S.) (Grants HL093225 and HL067966

Investigation of grain-boundary effect on hydrogen behaviors in single- and poly- crystalline medium-entropy CrCoNi alloy

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N′-(5-Bromo-2-methoxy­benzyl­idene)-3,4-methyl­enedioxy­benzohydrazide

In the title mol­ecule, C16H13BrN2O4, the two benzene rings form a dihedral angle of 74.9 (2)°. In the crystal, mol­ecules are linked via inter­molecular N—H⋯O hydrogen bonds into chains propagating along the c axis

N′-(5-Bromo-2-methoxy­benzyl­idene)-2-methoxy­benzohydrazide

The title hydrazone compound, C16H15BrN2O3, adopts an E configuration about the C=N double bond. The mol­ecule is twisted, the dihedral angle between the two substituted benzene rings being 22.0 (2)°. In the crystal structure, mol­ecules are linked through inter­molecular N—H⋯O hydrogen bonds, forming chains along the c axis

N′-(5-Bromo-2-methoxy­benzyl­idene)-4-hydroxy­benzohydrazide methanol solvate

In the title hydrazone compound, C15H13BrN2O3·CH3OH, the methanol solvate is linked to the benzohydrazide molecule through O—H⋯N and O—H⋯O hydrogen bonds. The benzohydrazide mol­ecule adopts an E configuration about the C=N double bond. The mol­ecule is twisted, with a dihedral angle between the two substituted benzene rings of 35.7 (2)°. In the crystal structure, mol­ecules are linked through inter­molecular N—H⋯O and O—H⋯O hydrogen bonds, forming layers parallel to the ac plane

Intraoperative blood loss during different stages of scoliosis surgery: A prospective study

<p>Abstract</p> <p>Background</p> <p>There are a number of reasons for intraoperative blood loss during scoliosis surgery based on the type of approach, type of disease, osteopenia, and patient blood profile. However, no studies have investigated bleeding patterns according to the stage of the operation. The objective of this prospective study was to identify intraoperative bleeding patterns in different stages of scoliosis surgery.</p> <p>Methods</p> <p>We prospectively analyzed the estimated blood loss (EBL) and operation time over four stages of scoliosis surgery in 44 patients. The patients were divided into three groups: adolescent idiopathic (group 1), spastic neuromuscular (group 2) and paralytic neuromuscular (group 3). The per-level EBL and operation times of the groups were compared on a stage-by-stage basis. The bone marrow density (BMD) of each patient was also obtained, and the relationship between per-level EBL and BMD was compared using regression analysis.</p> <p>Results</p> <p>Per-level operation time was similar across all groups during surgical stage (p > 0.05). Per-level EBL was also similar during the dissection and bone-grafting states (p > 0.05). However, during the screw insertion stage, the per-level EBL was significantly higher in groups 2 and 3 compared to group 1 (p < 0.05). In the correction stage, per-level EBL was highest in group 3 (followed in order by groups 2 and 1) (p < 0.05). Preoperative BMD indicated that group 3 had the lowest bone quality, followed by groups 2 and 1 (in order), but the preoperative blood indices were similar in all groups. The differences in bleeding patterns in the screw insertion and correction stages were attributed to the poor bone quality of groups 2 and 3. Group 3 had the lowest bone quality, which caused loosening of the bone-screw interface during the correction stage and led to more bleeding. Patients with a T-score less than -2.5 showed a risk for high per-level EBL that was nine times higher than those with scores greater than -2.5 (p = 0.003).</p> <p>Conclusions</p> <p>We investigated the blood loss patterns during different stages of scoliosis surgery. Patients with poor BMD showed a risk of blood loss nine times higher than those with good BMD.</p

Juvenile Angiodysplasia of Gut

Angiodysplasia or arteriovenous malformation of the gastrointestinal tract in younger patients is different from "classic" angiodysplasia in older patients, by age of onset, clinical presentation, location of the lesion and diverse histologic features, We report two cases of juvenile angiodysplasia of the gut. The diagnosis was suspected by radionuclide blood pool scan and was confirmed by resection and pathological examination, Both cases were girls of 5 years and 12 years of age, and the lesions were in the jejunum and ileum, Grossly, one case showed multiple petechiae and another case showed a hemorrhagic polypoid mass, Microscopically, the lesions were composed of irregularly dilated vascular channels in mucosa and submucosa with abnormal proliferation of arteries and veins in submucosa, Both cases are free of recurrence after local resection