Comparison of bispectral index values and depth of sedation during deep sedation using sevoflurane anesthesia in healthy children versus children with cerebral palsy.

BACKGROUND: Patients with cerebral palsy (CP) are at significant risk by means of periodontal disease and tooth decay. Pharmacological techniques that require intensive care such as sedation and general anesthesia are generally used for dental treatment of this patient group. AIM: The purpose of this retrospective study was to compare bispectral index (BIS) values and depth of sedation recorded during deep sedation protocols performed for healthy children and children with CP in the Department of Pediatric Dentistry, Faculty of Dentistry, Gazi University. MATERIALS AND METHODS: The measurements of BIS and hemodynamic variables recorded during treatment of 26 healthy children and 26 children with CP between 3 and 10 years of age who were treated under sevoflurane and 50% N2O-50% O2 mixture deep sedation method were investigated retrospectively. RESULTS: The mean BIS values in the CP group was statistically lower at all the time points when compared with the control group (P < 0.001). While there was no statistically significant difference between groups in terms of duration of treatment (P = 0.657), the median recovery time in the CP group was significantly longer than that recorded in the control group (P < 0.001). Significant correlation was found between modified Ramsay Sedation Scale (mRSS) scores and BIS levels at 5th, 10th, and 20th min in the control group (P < 0.001). Similar correlation was found in the CP group at 15th and 20th min. CONCLUSION: We concluded that it is necessary to consider the dosage and effect mechanisms of drugs used in children with CP to prevent overuse of anesthetics and emergence of anesthesia-related complications.

Comparison of three different ketofol proportions in children undergoing dental treatment.

AIM AND BACKGROUND: Sedation is gaining popularity among dental procedures in children. Ketamine and propofol mixture, known as ketofol, is one of the promising choices in sedation protocols; however, there is no consensus on the exact ratio of ketamine plus propofol especially in dental practice. The aim of present study was to compare perioperative side effect profiles, recovery profiles, and satisfaction rates of both parents' and dentists' following three different ratio of ketofol mixtures in children undergoing dental treatment. Materials and. METHODS: Three study groups each containing 30 children scheduled for dental treatment were created. Following anesthesia induction with 5% sevoflurane, 50% nitrous oxide mixture in 50% oxygen, 1 mg/kg bolus ketofol dose was administered. Patients in Group 1 received ketofol as a 1:1 mixture, patients in Group 2 received 1:2 ketofol while in Group 3; 1:4 ketofol was administered at a constant dose of 100 µg/kg/min. Additional doses of the ketofol solution at the same concentration with infused solutions in groups (0.5 mg/kg from either 1:1, 1:2, or 1:4 proportions) were administered if required. Perioperative vital signs, side effects, postoperative side effects, recovery durations, parents' and dentists' satisfaction levels were compared between groups. RESULTS: There were no significant differences between groups in terms of perioperative vital signs and side effects. Depth of sedation, dentists' satisfaction levels and postoperative side effects -myoclonus, hypersalivation and tachycardia were significantly higher in Group 1. Parents' satisfaction was highest in Group 3, however, necessity of additional doses and dissatisfaction of dentists' were found highest in this group. Mean duration of recovery recorded in Group 3 was shortest compared with other groups. CONCLUSION: Decreased ketamine doses in ketofol mixture was related with decreased side effect profile, high parents' satisfaction with fast recovery, however, dentists' satisfaction was lower. In this context, results of present study indicated that ketofol mixture of 1:2 ratio was more reliable choice than others when all investigated parameters evaluated simultaneously.

Circulating microRNAs and prediction of asthma exacerbation in childhood asthma.

BACKGROUND: Circulating microRNAs have shown promise as non-invasive biomarkers and predictors of disease activity. Prior asthma studies using clinical, biochemical and genomic data have not shown excellent prediction of exacerbation. We hypothesized that a panel of circulating microRNAs in a pediatric asthma cohort combined with an exacerbation clinical score might predict exacerbation better than the latter alone. METHODS: Serum samples from 153 children at randomization in the Childhood Asthma Management Program were profiled for 754 microRNAs. Data dichotomized for asthma exacerbation one year after randomization to inhaled corticosteroid treatment were used for binary logistic regression with miRNA expressions and exacerbation clinical score. RESULTS: 12 of 125 well-detected circulating microRNAs had significant odd ratios for exacerbation with miR-206 being most significant. Each doubling of expression of the 12 microRNA corresponded to a 25-67% increase in exacerbation risk. Stepwise logistic regression yielded a 3-microRNA model (miR-146b, miR-206 and miR-720) that, combined with the exacerbation clinical score, had excellent predictive power with a 0.81 AUROC. These 3 microRNAs were involved in NF-kß and GSK3/AKT pathways. CONCLUSIONS: This combined circulating microRNA-clinical score model predicted exacerbation in asthmatic subjects on inhaled corticosteroids better than each constituent feature alone. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00000575 .

Circulating microRNAs and association with methacholine PC20 in the Childhood Asthma Management Program (CAMP) cohort.

INTRODUCTION: Circulating microRNAs (miRNA) are promising biomarkers for human diseases. Our study hypothesizes that circulating miRNA would reveal candidate biomarkers related to airway hyperresponsiveness (AHR) and provide biologic insights into asthma epigenetic influences. METHODS: Serum samples obtained at randomization for 160 children in the Childhood Asthma Management Program were profiled using a TaqMan miRNA array set. The association of the isolated miRNA with methacholine PC20 was assessed. Network and pathway analyses were performed. Functional validation of two significant miRNAs was performed in human airway smooth muscle cells (HASMs). RESULTS: Of 155 well-detected circulating miRNAs, eight were significantly associated with PC20 with the strongest association with miR-296-5p. Pathway analysis revealed miR-16-5p as a network hub, and involvement of multiple miRNAs interacting with genes in the FoxO and Hippo signaling pathways by KEGG analysis. Functional validation of two miRNA in HASM showed effects on cell growth and diameter. CONCLUSION: Reduced circulatory miRNA expression at baseline is associated with an increase in PC20. These miRNA provide biologic insights into, and may serve as biomarkers of, asthma severity. miR-16-5p and -30d-5p regulate airway smooth muscle phenotypes critically involved in asthma pathogenesis, supporting a mechanistic link to these findings. Functional ASM phenotypes may be directly relevant to AHR.

Effect of levosimendan on erythrocyte deformability during myocardial ischaemia-reperfusion injury.

UNLABELLED: Diabetes mellitus (DM) is a chronic metabolic disorder accompanied by an increase in oxidative stress. Ischaemia-reperfusion (IR) injury is a cascade of events initiated by tissue ischaemia. The cellular damage produced by reperfusion leads to an active inflammatory response. Erythrocyte deformability and plasma viscosity are of crucial importance for the perfusion of tissues and organs. The aim of this study was to evaluate the effect of levosimendan on erythrocyte deformability during IR myocardial injury in diabetic rats. METHODS: Twenty-four Wistar albino rats were included in the study after streptozocin (55 mg/kg) treatment for 4 weeks to observe the existence of diabetes. The animals were randomly assigned to one of four experimental groups. In Group C and DC (sham-control group), the coronary artery was not occluded or reperfused in the control rats. Myocardial IR was induced by ligation of the left anterior descending coronary artery for 30 min, followed by 2 h of reperfusion in the diabetes-IR (DIR) and diabetes-IR-levosimendan (DIRL) group. Deformability measurements were performed in erythrocyte suspensions containing Htc 5 % in a phosphate-buffered saline (PBS) buffer. RESULTS: The deformability index was significantly increased in the diabetic rats. It was similar in Group DC and DIRL It was significantly increased in the DIR group compared to Group C, DIRL and DC. The relative resistance was increased in the IR models. CONCLUSION: Erythrocyte deformability was decreased in rats with diabetes and IR injury. This injury might lead to further problems in microcirculation. Levosimendan may be useful in enhancing the adverse effects of this type of injury (Fig. 2, Ref. 41). KEYWORDS: erythrocyte deformability, myocardial ischaemia reperfusion, experimental diabetes, levosimendan, rat.

The effects of low and high doses of sugammadex on kidney tissue in streptozotocin-induced diabetic rats.

BACKGROUND: Sugammadex is primarily excreted via renal route. We investigated effects of low and high doses of sugammadex (16 mg/kg versus 96 mg/kg) on renal tissue samples of streptozotocin-induced diabetic rats. MATERIAL AND METHODS: Twenty-four Wistar albino rats were divided into 4 groups. Group C (control - 0.9 % NaCl), Group DC (diabetes control; 55 mg/kg streptozotocin, IP, only), Group DR-16S (diabetes-rocuronium - 16 mg sugammadex, IV.) and Group DR-96S (diabetes- rocuronium - 96 mg sugammadex, IV). Renal tissue histopathological evaluation and antioxidant status (measurements of MDA levels and NO activities) were studied. RESULTS: Significantly higher levels of all inflammation parameters (inflammation, degeneration/necrosis, tubular dilatation, tubular cell degeneration, dilatation in Bowman's space, tubular hyaline casts, and lymphocyte infiltration) were found in the 96 mg/kg sugammadex group. Higher MDA tissue levels and lower NO activity were found in the 96 mg/kg sugammadex group. DISCUSSION: We can conclude that high-dose (96 mg/kg) sugammadex administration resulted in significant renal tissue damage in diabetic rats. As a consequence, low doses of sugammadex have to be preferred in diabetic patients (Tab. 2, Fig. 4, Ref. 26).

Effect of dexmedetomidine on erythrocyte deformability during ischaemia-reperfusion injury of heart in diabetic rats.

UNLABELLED: The aim of this study is to evaluate the effect of dexmedetomidine on erythrocyte deformability during IR heart injury in diabetic rats. METHODS: Eighteen Wistar Albino rats were included in the study after streptozocin (55 mg/kg) treatment for four weeks. In the Group C and DC (sham-control group), the coronary artery was not occluded or reperfused in the control rats. In the Group DIR, a branch of the left coronary artery was occluded for 30 minutes followed by two hours of reperfusion to produce IR. In the Group DIRD, a branch of the left coronary artery was occluded for 30 minutes followed by two hours of reperfusion to produce IR, and dexmedetomidine was administrated via 100 µg/kg IP route 30 minutes before ligating the left coronary artery. Deformability measurements were performed in erythrocyte suspensions containing Htc 5 % in a PBS buffer. RESULTS: The deformability index was significantly increased in diabetic rats; however, it was similar in the Group DC and DIRD. It was significantly increased in the Group DIR when compared to the Group C, DIRD and DC. The relative resistance was increased in IR models. CONCLUSION: Erythrocyte deformability was decreased in rats having diabetes and IR injury. This injury might lead to further problems in microcirculation. It was shown that dexmedetomidine might be useful in enhancing the adverse effects of this type of injury (Fig. 1, Ref. 39).

Diversity and distribution of white-tailed deer mtDNA lineages in chronic wasting disease (CWD) outbreak areas in southern Wisconsin, USA.

Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy affecting North American cervids. Because it is uniformly fatal, the disease is a major concern in the management of white-tailed deer populations. Management programs to control CWD require improved knowledge of deer interaction, movement, and population connectivity that could influence disease transmission and spread. Genetic methods were employed to evaluate connectivity among populations in the CWD management zone of southern Wisconsin. A 576-base-pair region of the mitochondrial DNA of 359 white-tailed deer from 12 sample populations was analyzed. Fifty-eight variable sites were detected within the sequence, defining 43 haplotypes. While most sample populations displayed similar levels of haplotype diversity, individual haplotypes were clustered on the landscape. Spatial clusters of different haplotypes were apparent in distinct ecoregions surrounding CWD outbreak areas. The spatial distribution of mtDNA haplotypes suggests that clustering of the deer matrilineal groups and population connectivity are associated with broad-scale geographic landscape features. These landscape characteristics may also influence the contact rates between groups and therefore the potential spread of CWD; this may be especially true of local disease spread between female social groups. Our results suggest that optimal CWD management needs to be tailored to fit gender-specific dispersal behaviors and regional differences in deer population connectivity. This information will help wildlife managers design surveillance and monitoring efforts based on population interactions and potential deer movement among CWD-affected and unaffected areas.

Expression levels of barley Cbf genes at the Frost resistance-H2 locus are dependent upon alleles at Fr-H1 and Fr-H2.

Genetic analyses have identified two loci in wheat and barley that mediate the capacity to overwinter in temperate climates. One locus co-segregates with VRN-1, which affects the vernalization requirement. This locus is known as Frost resistance-1 (Fr-1). The second locus, Fr-2, is coincident with a cluster of more than 12 Cbf genes. Cbf homologs in Arabidopsis thaliana play a key regulatory role in cold acclimatization and the acquisition of freezing tolerance. Here we report that the Hordeum vulgare (barley) locus VRN-H1/Fr-H1 affects expression of multiple barley Cbf genes at Fr-H2. RNA blot analyses, conducted on a 'Nure'x'Tremois' barley mapping population segregating for VRN-H1/Fr-H1 and Fr-H2, revealed that transcript levels of all cold-induced Cbf genes at Fr-H2 were significantly higher in recombinants harboring the vrn-H1 winter allele than in recombinants harboring the Vrn-H1 spring allele. Steady-state Cbf2 and Cbf4 levels were also significantly higher in recombinants harboring the Nure allele at Fr-H2. Additional experiments indicated that, in vrn-H1 genotypes requiring vernalization, Cbf expression levels were dampened after plants were vernalized, and dampened Cbf expression was accompanied by robust expression of Vrn-1. Cbf levels were also significantly higher in plants grown under short days than under long days. Experiments in wheat and rye indicated that similar regulatory mechanisms occurred in these plants. These results suggest that VRN-H1/Fr-H1 acts in part to repress or attenuate expression of the Cbf at Fr-H2; and that the greater level of low temperature tolerance attributable to the Nure Fr-H2 allele may be due to the greater accumulation of Cbf2 and Cbf4 transcripts during normal growth and development.

[Qualitative and quantitative studies on the lateral geniculate body in an ontogenic series of male Tupaia belangeri]. / Qualitative und quantitative Untersuchungen des Corpus geniculatum laterale an einer ontogenetischen Reihe von männlichen Tupaia belangeri.

The cyto-, fibrillo- and myeloarchitectonics of the dorsal and ventral lateral geniculate body are described in an ontogenetic series of male Tupaia belangeri using light microscopy. The qualitative maturational changes show a heterochronical development. The ventral nucleus is developing earlier than the dorsal nucleus. A quantitative analysis of the fresh volume growth of the two brain regions also shows a heterochronical development. Two different kinds of growth curves were found. The dorsal lateral geniculate body has an overshooting growth which is approximated by the 6-parametric growth function: formula: (see text), The ventral lateral geniculate body shows a monotonously increasing s-shaped growth curve which is approximated by the generalized logistic growth function: formula: (see text), An analysis of the fresh volume growth of the six layers of the dorsal lateral geniculate body demonstrates all layers to take part in the overshooting growth type.