The relation between given volume and heart rate during newborn resuscitation.

BACKGROUND: During delivery room resuscitation of depressed newborns, provision of appropriate tidal volume (TV) with establishment of functional residual capacity (FRC) is essential for circulatory recovery. Effective positive pressure ventilation (PPV) is associated with a rapid increase in heart rate (HR). The relationship between delivery of TV and HR responses remains unclear. OBJECTIVES: The study objectives were to determine (1) the relationship between a given TV during initial PPV and HR responses of depressed newborns, and (2) the optimal delivered TV associated with a rapid increase in HR. METHODS: In a Tanzanian rural hospital, ventilation and ECG signals were recorded during neonatal resuscitation and stored in Neonatal Resuscitation Monitors. Resuscitators without positive end-expiratory pressure were used for PPV. No oxygen was used. Perinatal events were observed and recorded by research assistants. RESULTS: 215 newborns of gestational age 37.3±1.9 weeks and birth weight 3115±579g were included. There was a non-linear relationship between delivered TV and HR increase. TV of 9.3ml/kg produced the largest increase in HR during PPV. Frequent interruptions of PPV sequences to provide stimulation/suctioning occurred in all cases and were associated with further HR increases, especially for newborns with initial HR<100 beats/minute. CONCLUSIONS: There was a consistent positive relationship between HR increase and delivered TV. The unanticipated finding of a further increase in HR with PPV pauses to provide stimulation/suctioning suggests that most newborns were in primary rather than secondary apnea.

[Sant'Ippazio (St. Hypatius of Gangra): A southern Italian cult of virility and red carrots]. / Sant'Ippazio (St. Hypatius von Gangra) : Ein süditalienischer Kult um Potenz und Pastinaken.

Sant'Ippazio (St. Hypatius of Gangra) is a saint, martyr, and advocate in cases of impotency, inguinal hernia, and other abdominal disorders. In Tiggiano, a small town at the southernmost point of Italy, Sant'Ippazio, bishop of Gangra, is venerated as a patron saint. According to legend, during an excited dispute on the question of the Arian heresy at the synod of Nicaea (325 AD), Bishop Ippazio was kicked in the lower abdominal region by an Arian presbyter, which caused an inguinal hernia. Therefore, his help is sought for relief and cure of hernia or impotency. Every January 19th, the day of the parish fair, particular carrots (the "pastinache") which have a reddish to violet color are sold. They are said to be similar to the saint's penis after the kick. Also described in this article are other pagan fertility rituals which have been christianized by the veneration of a saint and which are still kept alive among local populations.

[Effects of physical stimulation of spontaneous arteriolar vasomotion on microcirculation and the immune system in diabetes and impaired wound healing]. / Wirkungen einer physikalischen Stimulierung der spontanen arteriolären Vasomotion auf Mikrozirkulation und Immunsystem bei Diabetes und Wundheilungsstörungen.

BACKGROUND: Whether and to what extent the complementary use of a biorhythm-defined physical stimulation of insufficient spontaneous arteriolar vasomotion contributes to increasing the therapeutic success of established treatment concepts were examined. MATERIALS AND METHODS: In a placebo-controlled study on a biometrically defined sample of older diabetes patients with impaired wound healing, measurements of representative features of the functional status of the microcirculation and the immune system were investigated using high-resolution methods (intravital microscopy, reflective spectrometry, white light spectroscopy combined with laser Doppler microflow measurements). The stimulation signal corresponding to physiological spontaneous arteriolar vasomotion was transmitted using an electromagnetic alternating field of low magnetic flux density. RESULTS: During the 27-day treatment and observation period, a complementary treatment effect of the applied biorhythm-defined physical vasomotion stimulation could be detected.

Effects of deep brain stimulation of the cerebellothalamic pathways on the sense of smell.

The cerebellum and the motor thalamus, connected by cerebellothalamic pathways, are traditionally considered part of the motor-control system. Yet, functional imaging studies and clinical studies including patients with cerebellar disease suggest an involvement of the cerebellum in olfaction. Additionally, there are anecdotal clinical reports of olfactory disturbances elicited by electrical stimulation of the motor thalamus and its neighbouring subthalamic region. Deep brain stimulation (DBS) targeting the cerebellothalamic pathways is an effective treatment for essential tremor (ET), which also offers the possibility to explore the involvement of cerebellothalamic pathways in the sense of smell. This may be important for patient care given the increased use of DBS for the treatment of tremor disorders. Therefore, 21 none-medicated patients with ET treated with DBS (13 bilateral, 8 unilateral) were examined with "Sniffin' Sticks," an established and reliable method for olfactory testing. Patients were studied either with DBS switched on and then off or in reversed order. DBS impaired odor threshold and, to a lesser extent, odor discrimination. These effects were sub-clinical as none of the patients reported changes in olfactory function. The findings, however, demonstrate that olfaction can be modulated in a circumscribed area of the posterior (sub-) thalamic region. We propose that the impairment of the odor threshold with DBS is related to effects on an olfacto-motor loop, while disturbed odor discrimination may be related to effects of DBS on short-term memory.

[Failure of milk ejection reflex in primiparous cows from the differential diagnostic and therapeutic aspects]. / Störungen des Milchejektionsreflexes bei Erstkalbinnen aus differentialdiagnostischer und therapeutischer Sicht.

A particular failure of the milk-ejection reflex in dairy cows is described on the base of own experiences in farms and reports from literature. Four cases are reported more in detail. Quantity and fat content of cisternal, alveolar and residual milk fractions, oxytocin content in blood serum, milk-ejection after manual teat stimulation, after massage of the clitoris or rectal stimulation of the vagina and cervix were investigated. This failure of the milk-ejection is observed mostly in primiparous cows and always at the begin of the lactation period. It is complete and permanent unless successfully treated, and seems to be based on an central inhibition of the oxytocin release. Treatment consists of thorough udder stimulation and milking followed by an i.v. application of oxytocin in order to remove the residual milk portion. The condition has a good prognosis, if the treatment is carried out regularly for some days and even weeks. Acute Mastitis is the main differential diagnosis.

Systemic administration of rotenone produces selective damage in the striatum and globus pallidus, but not in the substantia nigra.

Complex I dysfunction has been implicated in the pathogenesis of Parkinson's disease and in the neurotoxicity of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), which produces a Parkinsonian syndrome in experimental animals and humans. Rotenone is an insecticide which is a specific inhibitor of complex I. We examined the pattern of central nervous system damage produced by i.v. systemic administration of rotenone in rats. Rotenone produced selective damage in the striatum and the globus pallidus, but the substantia nigra was spared. These results are consistent with prior reports suggesting that the selective vulnerability of the substantia nigra to MPTP involves both uptake by the dopamine transporter as well as complex I inhibition, and they show that rotenone produces a unique pattern of central nervous system damage.

[Tissue regeneration processes in the bovine mammary gland]. / Zu den im Rindereuter ablaufenden Regenerationsprozessen.

Tissue regeneration within the udder after mastitis is part of the healing process and may lead to restoration of the affected quarter. These in most cases multiple processes differ considerably in shape and size according to the duration and the type of the disease. They are distinct from the more uniform regenerative processes within the lobuli of the gland during colostrogenesis of the dry period.

Respiratory syncytial virus infection: its role in aeroallergen sensitization during the first two years of life.

Our aim was to study the influence of infection with the respiratory syncytial virus (RSV) in non-hospitalized infants on sensitization to aeroallergens and the early manifestation of atopy. Six hundred and nine infants from the prospective German Multicenter Cohort Study on Atopy were included, 38% of whom had an elevated atopic risk. RSV IgG and IgM antibodies were tested by ELISA with gradient purified RSV antigen. Specific IgE against mites, cat dandruff, birch and grass pollens and relevant nutritional antigens were tested with CAP-RAST-FEIA (Pharmacia, Sweden). Of the cord sera 99% were positive for RSV-IgG, 44.7% at one year and 64.2% (n = 265) at two years of age. The positivity rate after 12 months varied with the season of birth, the number of siblings and the degree of exposure to tobacco smoke; and correlated closely with attacks of wheezing during infancy. Twenty (2.8%) children were found to be sensitized against at least one aeroallergen at one year, and 28 (10.5%) at two years. By the first birthday, mite sensitization (n = 3) could only be seen in the RSV-infected children; grass pollen sensitization (n = 9) was associated with RSV seropositivity (logistic regression model including the confounders mentioned above: with RSV IgG < p = 0.048 > and IgM < p = 0.0006 >), as was birch sensitization (n = 5) with RSV IgM (p = 0.009). No such differences could be detected at two years. No correlation of RSV seropositivity to any allergic manifestation could be found. We conclude, that it is only in the first year of life, that RSV infection plays a significant role in promoting sensitization against aeroallergens, which do not at this time produce allergic symptoms.

The value of nifedipine in the treatment of hypertension, coronary heart disease and myocardial infarction (post-infarction therapy).

Calcium antagonists are among the drugs most often prescribed in the treatment of cardiovascular diseases. Among the 2000 preparations most often prescribed in Germany in 1994, there were 48 calcium antagonists which presented a prescription rate of 1268 million defined daily doses. Calcium antagonists of the nifedipine type are by far the most often prescribed preparations of this group. They are targeted mainly against hypertension and coronary heart disease, with post-infarction angina pectoris also featuring among their indications. Recent publications have, in consideration of indications on possible risks associated with nifedipine medication, fanned discussions on the pros and cons of nifedipine medication and thus the value of calcium antagonists in treating hypertension and CHD as well as post-infarction patients. The purpose of this report is to analyze the current situation and to draw conclusions for the practical use of calcium antagonists.

[Metaphylaxis of puerperal disorders in cattle]. / Zur Metaphylaxe von Puerperalstörungen beim Rind.

The effects of metaphylactic measures in cattle herds with the aim of diminishing puerperal disturbances and ensurement of high reproductive performance were studied. About 5000 cows in more than 30 groups (experimental and controls) were included into the clinical investigations. Dietary supplementation by sodium propionic acid over a period of 4 weeks, oxytocin or parasympathomimetics administered during the first 3 days post partum had a certain metaphylactic effect, only when the therapeutic principle met the prevalent cause of the given puerperal disturbance. In herds with high incidence of noninfectious retention of fetal membranes the metaphylactic application of Se and Vitamin E (10 days ante partum) can be taken into account. Stimulation of the ovarian activity by GnRH is recommended in animals which fail to have developed follicular activity by the 12th-15th day post partum.

The properties of skeletal muscle.

The authors review the musculoskeletal system and the controversy that surrounds methods for improving and strengthening it. Disorders brought on by over utilization, deficient working habits, lack of appropriate maintenance care and intercurrent stress and fatigue from repetitious daily tasks and poor sleeping habits are recognized and discussed. Also discussed are muscle structure and its relation to the contractive state, muscle energy requirements, motor control, source of muscle strength and factors modulating it, training adaptations in skeletal muscle, methods of strength training, erogenic aids including anabolic steroids and electrical stimulation and the pathologic states in muscles.

In vivo immunomodulating properties of two synthetic agents: azimexon and tuftsin.

Mice were submitted to various immunologic tests at different times after a single intravenous (IV) injection of azimexon or tuftsin in order to determine the mode of action of these chemically defined immunomodulators. Azimexon, (BM 12,531) an aziridine derivative, potentiated antibody responses to both thymus-dependent (TNP-KLH) and thymus-independent (TNP-LPS) antigens and DTH reaction to oxazolone when injected at least 1 day before the antigen. It activated macrophages, rendering them cytostatic for tumor cells, but depressed ADCC activity of spleen cells directed against antibody-coated CRBC. Tuftsin, a basic tetrapeptide, potentiated antibody response to TNP-KLH when injected at least 3 days before the antigen. The response to TNP-LPS was stimulated on days 1 and 3, but was slightly depressed on day 7. It rendered macrophages highly cytostatic for tumor cells but, as observed with azimexon, the activation process required 7 days to develop. ADCC was enhanced throughout the period of observation.