Non-invasive measurement of renal perfusion and oxygen metabolism to predict postoperative acute kidney injury in neonates and infants after cardiopulmonary bypass surgery.

BACKGROUND: The pathophysiology of acute kidney injury (AKI) after cardiopulmonary bypass surgery for congenital heart disease is not completely understood. The aim of this study was to carry out a prospective analysis of the diagnostic value of non-invasive monitoring of renal oxygenation and microcirculation by combining laser Doppler flowmetry and tissue spectrometry. METHODS: In 50 neonates and infants who underwent repair (n = 31) or neonatal palliation (n = 19) of congenital heart disease with cardiopulmonary bypass, renal oxygenation, and microcirculatory flow, the approximate renal metabolic rate of oxygen and Doppler-based renal resistive index were determined after surgery. Correlations between these parameters and the occurrence of AKI according to the Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease criteria were investigated. RESULTS: Acute kidney injury occurred in 45% of patients after repair and in 32% after palliation. Renal oxygenation was significantly lower and the approximate renal metabolic rate of oxygen significantly higher in patients with AKI (P < 0.05). The microcirculatory flow was significantly higher in patients with AKI after neonatal palliation (P < 0.05), whereas renal resistive index was significantly higher in patients with AKI after repair (P < 0.05). The sensitivity of renal oxygenation, metabolic rate of oxygen, microcirculation, and resistive index in predicting AKI was 78-80, 73-78, 64-83, and 71-74%, respectively, with a specificity of 63-65, 54-75, 64-78, and 46-74% (area under the curve: 0.73-0.75, 0.68-0.83, 0.52-0.68, and 0.60-0.75), respectively. CONCLUSIONS: Monitoring of renal oxygen metabolism allows early prediction of AKI in infants after cardiac surgery. In contrast, renal resistive index does not allow prediction of AKI after neonatal palliation with aortopulmonary shunt establishment.

Temperature gradient driven lasing and stimulated cooling.

A laser can be understood as a thermodynamic engine converting heat to a coherent single mode field close to Carnot efficiency. To achieve lasing, spectral shaping of the excitation light is used to generate a higher effective temperature on the pump than on the gain transition. Here, using a toy model of a quantum well structure with two suitably designed tunnel-coupled wells kept at different temperatures, we predict that lasing can also occur on an actual spatial temperature gradient between the pump and gain regions. Gain and narrow band laser emission require a sufficiently large temperature gradient and resonator quality. Lasing appears concurrent with amplified heat flow between the reservoirs and points to a new form of stimulated solid state cooling. In addition, such a mechanism could reduce intrinsic heating and thus extend the operating regime of quantum cascade lasers by substituting phonon emission driven injection by a phonon absorption step.

Cavity QED with magnetically coupled collective spin states.

We report strong coupling between an ensemble of nitrogen-vacancy center electron spins in diamond and a superconducting microwave coplanar waveguide resonator. The characteristic scaling of the collective coupling strength with the square root of the number of emitters is observed directly. Additionally, we measure hyperfine coupling to (13)C nuclear spins, which is a first step towards a nuclear ensemble quantum memory. Using the dispersive shift of the cavity resonance frequency, we measure the relaxation time of the NV center at millikelvin temperatures in a nondestructive way.

[The influence of food-supply to the concentration of blood ammonia (author's transl)]. / Der Einfluss der Nahrungsaufnahme auf die Blutammoniakkonzentration.

It has been determined of 70 liver-healthy probands the ammonia concentration of capillary blood after poor on protein respectively rich on proteine food in 30 minutes distances. It comes in both groups to a spontaneous ascent the concentration of ammonia. The highest ammonia concentration depends on the content of protein which has been taken through food and the descent also variable quick. For it amount to the waiting period of food on the determination of blood ammonia after in frontly poor on protein food 90 minutes and after in frontly rich on protein food three hours. The statements have been secured statisticaly by means of U-test.

[Induction of standardized burns in animal experiments]. / Die Erzeugung standardisierter Verbrennungsverletzungen im Tierexperiment

A burn stamp is described that was designed in cooperation with the Institute for Biophysics. It is capable to induce standardized reproduceable burns in experiments on guinea-pigs.