Cerebellar injury in preterm infants less than 28 weeks gestational age.

BACKGROUND: Cerebellar injury is one of the perinatal complications in preterm infants. Recent studies have highlighted the effect of perinatal complications on neurological morbidity. We investigated the perinatal risk factors and morbidity for cerebellar injury in extremely premature infants. METHODS: This retrospective cohort study included 285 infants born between April 2009 and December 2020 at gestational age <28 weeks at our institution. The infants were divided into two groups based on magnetic resonance imaging findings: those with and without cerebellar injury. We performed a statistical analysis of the perinatal background and short-term morbidity of the two groups. RESULTS: Significant differences (p < 0.05) were observed between the groups with respect to the perinatal background, especially gestational weeks, birthweight, and hemoglobin values at birth. In the short-term morbidity, significant differences (p < 0.05) were observed in the incidence of respiratory distress syndrome, chronic lung disease, hydrocephalus, severe intraventricular hemorrhage (IVH), and cerebellar hemorrhage. Extensive cerebellar lesions, such as cerebellar agenesis or global cerebellar hypoplasia, accounted for 11 of the 22 cases of cerebellar injury; seven of the 11 cases had severe IVH in addition to cerebellar hemorrhage. CONCLUSIONS: Gestational age was significantly lower in the cerebellar injury group. The combination of severe IVH and cerebellar hemorrhage may promote cerebellar injury.

Lipiodol remnants misinterpreted as a metal device on postoperative abdominal X-ray images.

We experienced a case of pregnancy after hysterosalpingogram and residual lipiodol in the extraperitoneal space. Initially, we suspected a metallic remnant; however, analysis by mass spectrometer confirmed that it was a remnant of lipiodol.

Video-Rate Identification of High-Capacity Low-Cost Tags in the Terahertz Domain.

In this article, we report on video-rate identification of very low-cost tags in the terahertz (THz) domain. Contrary to barcodes, Radio Frequency Identification (RFID) tags, or even chipless RFID tags, operate in the Ultra-Wide Band (UWB). These THz labels are not based on a planar surface pattern but are instead embedded, thus hidden, in the volume of the product to identify. The tag is entirely made of dielectric materials and is based on a 1D photonic bandgap structure, made of a quasi-periodic stack of two different polyethylene-based materials presenting different refractive indices. The thickness of each layer is of the order of the THz wavelength, leading to an overall tag thickness in the millimetre range. More particularly, we show in this article that the binary information coded within these tags can be rapidly and reliably identified using a commercial terahertz Time Domain Spectroscopy (THz-TDS) system as a reader. More precisely, a bit error rate smaller than 1% is experimentally reached for a reading duration as short as a few tens of milliseconds on an 8 bits (~40 bits/cm2) THID tag. The performance limits of such a tag structure are explored in terms of both dielectric material properties (losses) and angular acceptance. Finally, realistic coding capacities of about 60 bits (~300 bits/cm2) can be envisaged with such tags.

Respiratory Distress Syndrome in Infants Delivered via Cesarean from Mothers with Preterm Premature Rupture of Membranes: A Propensity Score Analysis.

OBJECTIVE: This study aimed to clarify the effects of cesarean delivery on neonatal respiratory morbidity when women had preterm premature rupture of membranes. METHODS: This retrospective study included women with preterm premature rupture of membranes who delivered from 23 weeks to 33 weeks of gestation between January 2009 and December 2014. Neonatal outcomes were compared between infants delivered by cesarean section and those delivered vaginally. The primary outcome was respiratory distress syndrome (RDS). Neonatal intubation and mechanical ventilation periods were secondary outcomes. Propensity score matching was used to compare outcomes between cesarean and vaginal delivery cases. RESULTS: There were 101 cesarean deliveries and 89 vaginal deliveries. A comparison of the presence or absence of neonatal complications based on the delivery type indicated a higher occurrence of RDS with cesarean deliveries (P = 0.025). The intubation and mechanical ventilation periods were not significantly longer in neonates delivered via cesarean section. CONCLUSIONS: Cesarean delivery is a risk factor for neonatal RDS in women with preterm premature rupture of membranes. Trials identifying long-term neonatal prognoses are needed to further develop optimal management strategies in such cases.

Maternal risk score for the prediction of fetal inflammatory response syndrome after preterm premature rupture of membranes.

AIM: Preterm premature rupture of membranes (PPROM) is common in preterm births. Fetal inflammatory response syndrome (FIRS) is present in nearly 50% of PPROM cases. We created a risk score to predict FIRS using maternal factors after PPROM. METHODS: We conducted a retrospective study of singleton pregnancies complicated by PPROM that resulted in delivery at 23-35 weeks of gestation. Antepartum maternal factors and umbilical cord blood interleukin-6 (IL-6) data were analyzed. FIRS was defined as IL-6 > 11 pg/mL. RESULTS: Umbilical cord blood IL-6 and maternal blood data within 24 h before parturition were available for 158 cases; 66 were diagnosed with FIRS (41.8%; median IL-6, 57.55 pg/mL). We created a risk score (FIRS score) comprising expected delivery weeks (≤30 weeks), maternal C-reactive protein (≥1.2 mg/dL), maternal white blood cell count (≥13 000/µL), corticosteroid use (none) and PROM latency period (≥3 days) from the multivariate logistic regression model predicting FIRS. Receiver operating characteristic curve analysis of the score produced the following results: area under the curve, 0.82; 95% CI, 0.76-0.89; cut-off value, 7.5; sensitivity, 89%; specificity, 63%; positive predictive value, 63% and negative predictive value, 89%. The probability of FIRS according to the categories of the FIRS score was 11% for those with a score of 0-7, 50% for a score of 8-15, and 88% for a score of 16-22. CONCLUSION: The devised maternal risk score could predict FIRS and be helpful to decide the delivery timing for the cases of PPROM.

Terahertz Time of Flight Spectroscopy as a Coating Thickness Reference Method for Partial Least Squares Near Infrared Spectroscopy Models.

Near infrared spectroscopy (NIRS) is often used during the tablet coating process to assess coating thickness. As the coating process proceeds, the increase and decrease in NIRS signal from both the coating formulation and tablet core has been related to coating thickness. Partial least-squares models are often generated relating NIRS spectra to reference coating thickness measurements for in-line and/or at-line monitoring of the coating process. This study investigated the effect of the reference coating thickness measurements on the accuracy of the model. The two primary reference techniques used were weight gain-based coating thickness and terahertz-based coating thickness. Most NIRS coating thickness models currently use weight gain-based reference values; however, terahertz-time-of-flight spectroscopy (THz-TOF) offers a more direct reference coating thickness measurement. Results showed that the accuracy of the NIRS coating thickness model significantly improved when terahertz-based coating thickness measurements were used as reference when compared to weight gain-based coating thickness measurements. Therefore, the application of THz-TOF as a reference method is further demonstrated.

Determining the effect of photodegradation on film coated nifedipine tablets with terahertz based coating thickness measurements.

Film coating of nifedipine tablets is commonly performed to reduce photo-degradation. The coating thickness of these tablets is a primary dictating factor of photo-stability. Terahertz spectroscopy enables accurate measurement of coating thickness. This study identifies a method to determine an end-point of a photo-protective coating process by using coating thickness measurements from terahertz time of flight spectroscopy (THz-TOF). For this method, nifedipine tablets, at different coating thicknesses, were placed in a photostability chamber. The illumination conditions of the coated tablets were adjusted based on the time duration of these tablets inside the chamber. A multiple linear regression model was developed with the coating thickness estimates from THz-TOF and illumination conditions information to predict the amount of drug remaining after photo-degradation (percent label claim). The prediction error of this model was 1.03% label claim in the range of 88.4-100.6% label claim. According to this model, acceptable levels of photo-protection in illumination conditions of up to approximately 700,000 lx hours was achieved at the end of the coating process (approximately 50 µm coating thickness) performed in this study. These results suggest THz-TOF as a viable process analytical technology tool for process understanding and end-point determination of a photo-protective coating process.

Refractive Index Measurement of Pharmaceutical Solids: A Review of Measurement Methods and Pharmaceutical Applications.

Refractive index is an important optical parameter that can be used to characterize the physicochemical properties of pharmaceutical solids. The complexity of most drugs and solid oral dosage systems introduces challenges for refractive index measurement methods. These challenges are highlighted, and different types of measurement methods are discussed in this review article. These measurements provide pharmaceutical scientists the opportunity to improve the drug-development process and enhance product quality. Pharmaceutical applications range from identification and quantification of drug crystallinity and polymorphism to mechanical strength assessment of tablets. This review article surveys the literature and evaluates the current and potential future characterization of pharmaceutical solids using refractive index measurements.

An Acquired Form of Dandy-Walker Malformation with Enveloping Hemosiderin Deposits.

Dandy-Walker malformation (DWM) is a posterior fossa anomaly characterized by hypoplasia and upward rotation of the cerebellar vermis and cystic dilation of the fourth ventricle. The cyst of DWM rarely extends posteriorly to almost completely fill the entire posterior fossa, which mimics primary cerebellar agenesis, a cerebellar porencephalic cyst, and an arachnoid cyst due to the lack of clarity of the thin cystic wall. A 10-month-old female born at 23 weeks' gestation with cerebellar hemorrhage in the neonatal period was admitted to our hospital with dysphagia and side-to-side head bobbing. The detection of hemosiderin deposits enveloping the cyst wall by T2 star-weighted angiography (SWAN) was useful for the differential diagnosis of an acquired form of DWM from primary cerebellar agenesis. Cyst fenestration successfully improved dysphagia and head bobbing. A pathological specimen of the perforated cyst consisted of collagen fibers with hemosiderin deposits but lacked congenital cyst components. In infants with posterior fossa cysts, SWAN will be useful for a differential diagnosis between DWM and primary cerebellar agenesis.

A titanium surface with nano-ordered spikes and pores enhances human dermal fibroblastic extracellular matrix production and integration of collagen fibers.

The acquisition of substantial dermal sealing determines the prognosis of percutaneous titanium-based medical devices or prostheses. A nano-topographic titanium surface with ordered nano-spikes and pores has been shown to induce periodontal-like connective tissue attachment and activate gingival fibroblastic functions. This in vitro study aimed to determine whether an alkali-heat (AH) treatment-created nano-topographic titanium surface could enhance human dermal fibroblastic functions and binding strength to the deposited collagen on the titanium surface. The surface topographies of commercially pure titanium machined discs exposed to two different AH treatments were evaluated. Human dermal fibroblastic cultures grown on the discs were evaluated in terms of cellular morphology, proliferation, extracellular matrix (ECM) and proinflammatory cytokine synthesis, and physicochemical binding strength of surface-deposited collagen. An isotropically-patterned, shaggy nano-topography with a sponge-like inner network and numerous well-organized, anisotropically-patterned fine nano-spikes and pores were observed on each nano-topographic surface type via scanning electron microscopy. In contrast to the typical spindle-shaped cells on the machined surfaces, the isotropically- and anisotropically-patterned nano-topographic titanium surfaces had small circular/angular cells containing contractile ring-like structures and elongated, multi-shaped cells with a developed cytoskeletal network and multiple filopodia and lamellipodia, respectively. These nano-topographic surfaces enhanced dermal-related ECM synthesis at both the protein and gene levels, without proinflammatory cytokine synthesis or reduced proliferative activity. Deposited collagen fibers were included in these surfaces and sufficiently bound to the nano-topographies to resist the physical, enzymatic and chemical detachment treatments, in contrast to machined surfaces. Well-organized, isotropically-/anisotropically-patterned, nano-topographic titanium surfaces with AH treatment-created nano-spikes and pores enhanced human dermal fibroblastic ECM synthesis and established sufficient mechanical integration between the surfaces and ECM to resist various detachment treatments used to experimentally mimic overloading and inflammation.

Effects of infant flow Bi-NCPAP on apnea of prematurity.

BACKGROUND: Infant flow biphasic nasal continuous positive airway pressure (Bi-NCPAP) and regular NCPAP (Re-NCPAP) are equally useful with respect to the rate of successful weaning from mechanical ventilation. It remains unclear, however, whether Bi-NCPAP or Re-NCPAP is more effective for reducing apnea of prematurity (AOP). METHODS: A multicenter randomized controlled study was conducted of 66 infants assigned to receive Bi-NCPAP and 66 assigned to receive Re-NCPAP for respiratory support after extubation. Primary outcome was the number of AOP events during the 48 h observation period after successful extubation, defined as no reintubation and no adverse events associated with the use of NCPAP during the observation period. The secondary outcome was successful extubation. Reintubation was at the discretion of the attending physician. RESULTS: Baseline characteristics were similar between the two groups. The number of AOP events during the 48 h observation period was significantly lower in infants with Bi-NCPAP than in those with Re-NCPAP (5.2 ± 6.5 vs 10.3 ± 10.9 per infant, respectively; P = 0.002). The rate of successful extubation tended to be greater in those with Bi-NCPAP than in those with Re-NCPAP (92.4%, 61/66 vs 80.3%, 53/66, respectively; P = 0.074). Adverse events occurred in only one of 132 infants: erosive dermatitis developed on the nose after application of Re-NCPAP. The risk of reintubation did not differ significantly between the two groups (7.6%, 5/66 for Bi-NCPAP vs 18.2%, 12/66 for Re-NCPAP; P = 0.117). CONCLUSIONS: Bi-NCPAP was superior to Re-NCPAP for reduction of AOP following extubation.

Rotavirus gastroenteritis-associated urinary ammonium acid urate crystals.

Although ammonium acid urate (AAU) calculi are extremely rare renal stone components, it was recently found that many urinary tract calculi that cause post-renal renal failure in rotavirus (RV) gastroenteritis are AAU calculi. The mechanism of AAU calculi development in RV gastroenteritis has not been fully elucidated. We analyzed data from eight RV gastroenteritis patients who transiently had AAU crystals in their urinary sediment. In these patients, formation of AAU crystals occurred earlier than the formation of AAU calculi. No difference was observed in serum and urine uric acid levels between RV gastroenteritis patients with or without AAU crystals. Interestingly, fractional excretion of sodium was extremely low among patients with AAU crystals. These results suggest that the formation of AAU crystals might not be due to excretion of uric acid, but excretion of sodium.

Periodontal-like gingival connective tissue attachment on titanium surface with nano-ordered spikes and pores created by alkali-heat treatment.

OBJECTIVES: Establishment of periodontal-like connective tissue attachment is one of the outstanding issues in implant dentistry. Organized nanotopographic titanium surface may acquire periodontal-like connective tissue attachment with activation of fibroblastic function. This study aimed to evaluate gingival fibroblastic function and connective tissue attachment on two types of nanotopographic titanium surface created by alkali-heat (AH) treatment. METHODS: Commercially pure titanium turned discs with or without acid-etching or two types of AH treatment, underwent scanning electron microscopic evaluation in surface topography. Rat gingival fibroblasts cultured on the discs evaluated in terms of cellular adhesion, collagen synthesis and physicochemical binding strength of deposited collagen on the surfaces. Turned or the AH-treated pure titanium mini-implants were placed on the hard palatal plate of rabbits and underwent histological evaluation at 8 weeks postoperatively. RESULTS: Both AH-treated surfaces were characterized by numerous well-organized fine nanospikes with crevasses and nanoholes, and uniform shaggy-like nanotopography with a sponge-like inner network, respectively. These nanotopographic surfaces enhanced cellular adhesion and collagen synthesis and toughened binding strength of deposited collagen sufficiently to resist against experimental overloading and inflammatory conditions by inclusion of collagen fibers into the surface, as compared with turned or acid-etched surfaces. The AH-treated mini-implants yielded inclusion of gingival connective tissue into the nanotopographic surface structure, with collagen fiber directions mimicking periodontal tissue in the transmucosal area. These features were not seen on turned surface implants. SIGNIFICANCE: The well-organized nanotopographic titanium surface with nanospikes and pores by the AH treatment enhanced gingival fibroblastic collagen synthesis and acquired periodontal-like connective tissue attachment with substantial detachment resistance.

Calcium concentration in hypoxic-ischemic encephalopathy during hypothermia.

BACKGROUND: The aim of this study was to investigate the relationship between prognosis and the changes in serum-ionized calcium concentration in neonates with hypoxic-ischemic encephalopathy (HIE) before and during brain hypothermia (BHT). METHODS: Serum samples were obtained from 16 HIE neonates who underwent BHT. All patients underwent developmental testing at 18 months of age. RESULTS: Mean serum-ionized calcium concentration in the poor outcome group (developmental quotient [DQ], <80; nine infants) was significantly lower than in the good outcome group (DQ >80; seven infants), both immediately before and after 6 h of BHT. Mean serum-ionized calcium concentration significantly decreased in both groups for 6 h, and the lowest adjusted serum-ionized calcium during 6 h of BHT was <1.05 mmol/L, known as the cut-off value for poor outcome, in 57.1% of the good outcome group. CONCLUSION: The influx of calcium into cells continues regardless of neurological prognosis during the early phase of BHT, but BHT might protect some high-risk patients against neurological damage at low adjusted serum-ionized calcium concentration.

Retrospective clinical outcome of nanopolymorphic crystalline hydroxyapatite-coated and anodic oxidized titanium implants for 10 years.

PURPOSE: Nanopolymorphic crystalline Hydroxyapatite (HA)-coated implants were different in surface property from conventional HA-coated implants subjected to previous clinical studies. The purposes of the present study were to retrospectively evaluate 10-years clinical outcome of the HA-coated implants (HA implants) with a comparison to the same system implants with anodic oxidized titanium surface (Ti implants). METHODS: Cumulative survival rate (CSR) of HA or Ti implants placed in 183 patients (55±12.4 years old) over two decades was calculated with life table analysis. Differences in CSR at each interval year, sex, age, frequency of number of implant placement according to implant location and diameter were compared between both types of implants. RESULTS: Total 455 HA implants and 255 Ti implants were included. CSR at upper molar site was consistently higher in HA implants than Ti implants until 8 years after placement. The values after 10 years was 89.9% or 77.7% in HA or Ti implants, respectively. There were no significant differences in overall CSR at any interval year. HA implants were more distributed at upper molar site but less at lower molar site than Ti implants. Diameter of HA implants tended to be wider than Ti implants. CONCLUSIONS: Under limitation of this retrospective study, the nanopolymorphic crystalline HA-coated implants were more survived at upper molar site than anodic oxidized implants until 8 years after placement. This clinical outcome might attribute to differences in topographical and physicochemical characteristics between both types of implants.

Rapid scanning terahertz time-domain magnetospectroscopy with a table-top repetitive pulsed magnet.

We have performed terahertz time-domain magnetospectroscopy by combining a rapid scanning terahertz time-domain spectrometer based on the electronically controlled optical sampling method with a table-top minicoil pulsed magnet capable of producing magnetic fields up to 30 T. We demonstrate the capability of this system by measuring coherent cyclotron resonance oscillations in a high-mobility two-dimensional electron gas in GaAs and interference-induced terahertz transmittance modifications in a magnetoplasma in lightly doped n-InSb.

Superradiant decay of cyclotron resonance of two-dimensional electron gases.

We report on the observation of collective radiative decay, or superradiance, of cyclotron resonance (CR) in high-mobility two-dimensional electron gases in GaAs quantum wells using time-domain terahertz magnetospectroscopy. The decay rate of coherent CR oscillations increases linearly with the electron density in a wide range, which is a hallmark of superradiant damping. Our fully quantum mechanical theory provides a universal formula for the decay rate, which reproduces our experimental data without any adjustable parameter. These results firmly establish the many-body nature of CR decoherence in this system, despite the fact that the CR frequency is immune to electron-electron interactions due to Kohn's theorem.

Biodegradation property of beta-tricalcium phosphate-collagen composite in accordance with bone formation: a comparative study with Bio-Oss Collagen® in a rat critical-size defect model.

PURPOSE: The objective of this study was to compare osteoconductivity and biodegradation properties of an in-house fabricated beta-tricalcium phosphate (b-TCP)-collagen composite with those of Bio-Oss Collagen® (Osteohealth, Shirley, NY, USA) using a rat calvarial critical-size defect model. MATERIALS AND METHODS: b-TCP-collagen composite material was fabricated by mixing b-TCP granules having a particle size of 0.15 to 0.8 mm and 75% porosity, with bovine dermis-derived soluble collagen sponge. The dry weight ratio of b-TCP granules-to-collagen ratios was 4:1. Bio-Oss Collagen or the b-TCP-collagen composite was used to fill a 5.0 mm-diameter calvarial defect in rats. The defects were evaluated by histological and histomorphological analyses of decalcified histological sections with hematoxylin and eosin staining 6 and 10 weeks, respectively, after surgery. RESULTS: The defect implanted with the b-TCP composite contained immature bone structures with dense connective tissue in contrast to the abundant fibrous tissue, but no trabecular structure was observed within the defect implanted with Bio-Oss Collagen at 6 weeks postoperatively. Eventually, the defect filled with the b-TCP composite was covered with dense, continuous, mature bone tissue with complete replacement of the graft material. However, in defects filled with Bio-Oss Collagen, only dense connective tissue, containing limited amounts of immature trabecular bone and abundant remnant Bio-Oss particles, was observed. Histomorphological analysis revealed that the b-TCP composite caused greater tissue augmentation with a larger volume of bone tissue observed in the defect and greater bioabsorption of remnant material than Bio-Oss Collagen. CONCLUSION: These results indicated that the b-TCP composite has greater osteoconductivity and better biodegradation properties than Bio-Oss Collagen; these properties of the b-TCP-collagen composite complimented bone formation and remodeling.

Agranulocytosis after infectious mononucleosis.

We report the case of a 5-year-old boy with agranulocytosis after infectious mononucleosis (IM). Antibodies against anti-human neutrophil-specific antigens (HNA)-1 were detected in his serum. A literature review on agranulocytosis after IM and our case suggest that anti-HNA-1 antibodies play important roles in agranulocytosis associated with IM.