The utility of Amies charcoal bacteriology swabs for storage of canine urine prior to culture.

OBJECTIVE: To determine the usefulness of bacteriology swabs as a storage method of canine urine samples and the effect on quantitative bacterial culture. MATERIALS AND METHODS: Two hundred fourteen canine urine samples were collected by cystocentesis. The reference aliquot was placed in a sterile tube and processed for quantitative bacterial culture within 6 hours. A bacteriology swab was then immersed in the urine for 5 seconds and returned to the charcoal Amies media container. The urine samples in the sterile tube and bacteriology swab were stored at room temperature for 48 hours and processed for quantitative bacterial culture. RESULTS: Thirty-seven of the samples were positive on reference culture with a total of 42 bacterial isolates. Samples stored in sterile tube and bacteriology swab had identical sensitivity and specificity for detection of bacteriuria (94.7% and 100%, respectively) with very good agreement (κ = 0.92; 95% CI 0.81 to 1.00). Agreement between the bacterial species of the reference sample and the bacteriology swab was higher (κ = 0.85; 95% CI 0.71 to 0.99) than compared to the sterile tube (κ = 0.78; 95% CI 0.62 to 0.94), but the overlapping confidence intervals mean improved agreement cannot be inferred. CLINICAL SIGNIFICANCE: Bacteriology swabs stored in Amies charcoal transport media should be considered an alternative method to preserve canine urine sample when immediate processing for quantitative bacterial culture is not possible. The sensitivity of culturing plain urine, stored for 48 hours in a sterile tube, for detection of bacteriuria, was higher than previously reported.

Targeting myelin lipid metabolism as a potential therapeutic strategy in a model of CMT1A neuropathy.

In patients with Charcot-Marie-Tooth disease 1A (CMT1A), peripheral nerves display aberrant myelination during postnatal development, followed by slowly progressive demyelination and axonal loss during adult life. Here, we show that myelinating Schwann cells in a rat model of CMT1A exhibit a developmental defect that includes reduced transcription of genes required for myelin lipid biosynthesis. Consequently, lipid incorporation into myelin is reduced, leading to an overall distorted stoichiometry of myelin proteins and lipids with ultrastructural changes of the myelin sheath. Substitution of phosphatidylcholine and phosphatidylethanolamine in the diet is sufficient to overcome the myelination deficit of affected Schwann cells in vivo. This treatment rescues the number of myelinated axons in the peripheral nerves of the CMT rats and leads to a marked amelioration of neuropathic symptoms. We propose that lipid supplementation is an easily translatable potential therapeutic approach in CMT1A and possibly other dysmyelinating neuropathies.

Geo-environmental zoning using physiographic compartmentalization: a proposal for supporting sustainable decision-making

ABSTRACT The geo-environmental zoning represents an important strategy in the territorial management. However, it requires a logical and structured procedure. Therefore, an approach using physiographic compartmentalization is proposed and applied as case study in a region covered by the topographic maps of São José dos Campos and Jacareí, Brazil. This region has great geological and geomorphological peculiarities, beyond being a place with large human interventions because of its quickly economic growth. The methodology is based on photointerpretation techniques and remote sensing in GIS environment. As a result, seven geo-environmental zones were obtained from a weighted integration by multicriteria analysis of physiographic units with land-use classes. In conclusion, taking into account potentialities and limitations, the proposed approach can be considered able to support sustainable decision-making, being applicable in other regions.

Geo-environmental zoning using physiographic compartmentalization: a proposal for supporting sustainable decision-making.

The geo-environmental zoning represents an important strategy in the territorial management. However, it requires a logical and structured procedure. Therefore, an approach using physiographic compartmentalization is proposed and applied as case study in a region covered by the topographic maps of São José dos Campos and Jacareí, Brazil. This region has great geological and geomorphological peculiarities, beyond being a place with large human interventions because of its quickly economic growth. The methodology is based on photointerpretation techniques and remote sensing in GIS environment. As a result, seven geo-environmental zones were obtained from a weighted integration by multicriteria analysis of physiographic units with land-use classes. In conclusion, taking into account potentialities and limitations, the proposed approach can be considered able to support sustainable decision-making, being applicable in other regions.

Neonatal paracetamol treatment reduces long-term nociceptive behaviour after neonatal procedural pain in rats.

BACKGROUND: Pain from skin penetrating procedures (procedural pain) during infancy in the neonatal intensive care unit (NICU) may result in changes of nociceptive sensitivity in later life. This supports the need for pain management during such vulnerable periods in life. This study, therefore, analyses the short- and long-term consequences of neonatal paracetamol (acetaminophen) treatment on pain behaviour in an experimental rat model of neonatal procedural pain. METHODS: A repetitive needle-prick model was used, in which neonatal rats received four needle pricks into the left hind paw per day from postnatal day 0 to day 7 (P0-P7). Paracetamol (50 mg/kg/day s.c.) was administered daily (P0-P7), and sensitivity to mechanical stimuli was compared with a needle-prick/saline-treated group and to a tactile control group. At 8 weeks of age, all animals underwent an ipsilateral paw-incision, modelling postoperative pain, and the duration of hypersensitivity was assessed. RESULTS: Neonatal paracetamol administration had no effect upon short-term mechanical hypersensitivity during the first postnatal week or upon long-term baseline sensitivity from 3 to 8 weeks. However, neonatal paracetamol administration significantly reduced the postoperative mechanical hypersensitivity in young adults, caused by repetitive needle pricking. CONCLUSION: Paracetamol administration during neonatal procedural pain does not alter short-term or long-term effects on mechanical sensitivity, but does reduce the duration of increased postoperative mechanical hypersensitivity in a clinically relevant neonatal procedural pain model. WHAT DOES THIS STUDY ADD: Paracetamol can be used safely in neonatal rats. Neonatal paracetamol treatment had no effect upon short-term mechanical hypersensitivity during the first postnatal week, nor upon long-term baseline sensitivity from 3 to 8 weeks. Paracetamol treatment during the first postnatal week significantly reduced the postoperative mechanical hypersensitivity in young adult rats.

Stimulus Dependence of Gamma Oscillations in Human Visual Cortex.

A striking feature of some field potential recordings in visual cortex is a rhythmic oscillation within the gamma band (30-80 Hz). These oscillations have been proposed to underlie computations in perception, attention, and information transmission. Recent studies of cortical field potentials, including human electrocorticography (ECoG), have emphasized another signal within the gamma band, a nonoscillatory, broadband signal, spanning 80-200 Hz. It remains unclear under what conditions gamma oscillations are elicited in visual cortex, whether they are necessary and ubiquitous in visual encoding, and what relationship they have to nonoscillatory, broadband field potentials. We demonstrate that ECoG responses in human visual cortex (V1/V2/V3) can include robust narrowband gamma oscillations, and that these oscillations are reliably elicited by some spatial contrast patterns (luminance gratings) but not by others (noise patterns and many natural images). The gamma oscillations can be conspicuous and robust, but because they are absent for many stimuli, which observers can see and recognize, the oscillations are not necessary for seeing. In contrast, all visual stimuli induced broadband spectral changes in ECoG responses. Asynchronous neural signals in visual cortex, reflected in the broadband ECoG response, can support transmission of information for perception and recognition in the absence of pronounced gamma oscillations.

Task-free electrocorticography frequency mapping of the motor cortex.

OBJECTIVE: Electrocortical stimulation mapping (ESM) is the current gold standard for functional mapping of the eloquent cortex prior to epilepsy surgery. The procedure is, however, time-consuming and quite demanding for patients. Electrocorticography frequency mapping (ECoG mapping) has been suggested as an adjunct method. Here, we investigated whether it is possible to perform mapping of motor regions using ECoG data of spontaneous movements. METHODS: Using the video registration of seven epilepsy patients who underwent electrocorticography and ESM, we selected periods of spontaneous hand and arm movements and periods of rest. Frequency analysis was performed, and electrodes showing a significant change in power (4-7, 8-14, 15-25, 26-45 or 65-95 Hz) were compared with those being identified as relevant for hand and/or arm movement by ESM. RESULTS: All frequency bands showed a high specificity (>0.80), and the 65-95 Hz frequency band additionally had a high sensitivity (0.82) for identifying ESM positive electrodes. CONCLUSIONS: Our data show a good match between ECoG mapping of spontaneous movements and ESM data. SIGNIFICANCE: The accurate match suggests that ECoG mapping of the motor cortex using spontaneous movements may be a valuable complement to ESM, especially when other options requiring patient cooperation fail.

The effects of blood vessels on electrocorticography.

Electrocorticography, primarily used in a clinical context, is becoming increasingly important for fundamental neuroscientific research, as well as for brain-computer interfaces. Recordings from these implanted electrodes have a number of advantages over non-invasive recordings in terms of band width, spatial resolution, smaller vulnerability to artifacts and overall signal quality. However, an unresolved issue is that signals vary greatly across electrodes. Here, we examine the effect of blood vessels lying between an electrode and the cortex on signals recorded from subdural grid electrodes. Blood vessels of different sizes cover extensive parts of the cortex causing variations in the electrode-cortex connection across grids. The power spectral density of electrodes located on the cortex and electrodes located on blood vessels obtained from eight epilepsy patients is compared. We find that blood vessels affect the power spectral density of the recorded signal in a frequency-band-specific way, in that frequencies between 30 and 70 Hz are attenuated the most. Here, the signal is attenuated on average by 30-40% compared to electrodes directly on the cortex. For lower frequencies this attenuation effect is less pronounced. We conclude that blood vessels influence the signal properties in a non-uniform manner.

Functional MRI-based identification of brain areas involved in motor imagery for implantable brain-computer interfaces.

For the development of minimally invasive brain-computer interfaces (BCIs), it is important to accurately localize the area of implantation. Using fMRI, we investigated which brain areas are involved in motor imagery. Twelve healthy subjects performed a motor execution and imagery task during separate fMRI and EEG measurements. fMRI results showed that during imagery, premotor and parietal areas were most robustly activated in individual subjects, but surprisingly, no activation was found in the primary motor cortex. EEG results showed that spectral power decreases in contralateral sensorimotor rhythms (8-24 Hz) during both movement and imagery. To further verify the involvement of the motor imagery areas found with fMRI, one epilepsy patient performed the same task during both fMRI and ECoG recordings. Significant ECoG low (8-24 Hz) and high (65-95 Hz) frequency power changes were observed selectively on premotor cortex and these co-localized with fMRI. During a subsequent BCI task, excellent performance (91%) was obtained based on ECoG power changes from the localized premotor area. These results indicate that other areas than the primary motor area may be more reliably activated during motor imagery. Specifically, the premotor cortex may be a better area to implant an invasive BCI.

[Odontogenic tumors in childhood - case report and review of literature]. / Odontogene Tumoren im Kindesalter - Fallbeschreibung und Literaturübersicht.

BACKGROUND: Odontogenic tumors are a heterogenic group of neoplasias of the oral cavity, whose biological behaviour reaches from true hamartomas to highly malignant tumors. PATIENT: We describe the case of a 4 year old caucasian girl presenting with eruption disturbance of a primary tooth and corresponding maxillary tumor. After surgical removal of the mass, histological examination classified the tumor as ameloblastic fibroodontoma. This very rare neoplasm is of odontogenic origin. DISCUSSION: Following our case report, the variety of odontogenic tumors regarding tumor biology, clinical symptoms and therapeutic options in childhood are discussed. CONCLUSION: In case of complaints or clinical symptoms paediatricians should take the possibility of such neoplasias into consideration.

Focussing cellular function. Metabolic monitoring in perioperative and Intensive Care Medicine.

In the clinical field microdialysis today is a routine technique for monitoring the chemistry of tissues and organs in physiological and pharmacological research on animals. In more than 10.000 papers on microdialysis research it is used to uncover physiological mechanisms and the influence of drugs in almost every organ of the body. Since the first papers describing microdialysis in the human brain microdialysis has become a technique for routine monitoring of energy metabolism especially in neurointensive care. This paper gives an account of the microdialysis technique describing its practical use and interpretation in monitoring energy metabolism and ischemia in different organs with respect to the field of perioperative and intensive care medicine. This article gives an overview over current results of clinical studies using microdialysis in critical care medicine and tries to focus on possible indications for clinical biochemical monitoring. However, despite numerous publications available microdialysis has not been shown to improve outcome of the patients yet.

Directional flow induced by synchronized longitudinal and zeta-potential controlling AC-electrical fields.

Electroosmotic flow (EOF) in a microchannel can be controlled by electronic control of the surface charge using an electrode embedded in the wall of the channel. By setting a voltage to the electrode, the zeta-potential at the wall can be changed locally. Thus, the electrode acts as a "gate" for liquid flow, in analogy with a gate in a field-effect transistor. In this paper we will show three aspects of a Field Effect Flow Control (FEFC) structure. We demonstrate the induction of directional flow by the synchronized switching of the gate potential with the channel axial potential. The advantage of this procedure is that potential gas formation by electrolysis at the electrodes that provide the axial electric field is suppressed at sufficiently large switching frequencies, while the direction and magnitude of the EOF can be maintained. Furthermore we will give an analysis of the time constants involved in the charging of the insulator, and thus the switching of the zeta potential, in order to predict the maximum operating frequency. For this purpose an equivalent electrical circuit is presented and analyzed. It is shown that in order to accurately describe the charging dynamics and pH dependency the traditionally used three capacitor model should be expanded with an element describing the buffer capacitance of the silica wall surface.

The value of FDG-PET and bone scintigraphy with SPECT in the primary diagnosis and follow-up of patients with chronic osteomyelitis of the mandible.

OBJECTIVE: To appraise the value of FDG-PET and bone scintigraphy using SPECT in the primary diagnosis and follow-up of patients with chronic osteomyelitis of the mandible (COM). METHODS: In a prospective study the pattern of tracer uptake was investigated using 2 diagnostic methods in 42 patients. Results were compared with histology and radiographs as well as clinical and laboratory parameters. RESULTS: The use of FDG-PET in the primary diagnosis of COM resulted in a sensitivity of 64% and a specificity of 77.7%. The sensitivity of SPECT was 84% and the specificity 33.3%. During the follow-up period of these patients the sensitivity of SPECT increased to 93.7%, while the specificity decreased (6.6%). The sensitivity and specificity of FDG-PET for this follow-up group were 62.5 and 80%, respectively. CONCLUSION: Because of its high sensitivity, SPECT is vastly superior to other diagnostic methods in initiating treatment. In the follow-up period it might be replaced by FDG-PET, which reflects the disease course better and indicates the time of clinical remission.

Exposure of implants using a modified multiple-flap transposition vestibuloplasty.

AIM: To introduce a minimally invasive operation to improve the condition of the soft tissues around the implants in an atrophied mandible, at the same time, as uncovering the implants. PATIENTS AND METHOD: A multiple-flap transposition vestibuloplasty was done in 11 patients after the insertion of four implants in the interforaminal region of an atrophied mandible. Improvement in soft tissues and successful exposure of implants and attached gingiva were evaluated during a follow-up period of 55 months. All the patients were operated on local anaesthesia as outpatients. RESULTS: Adequate exposure of implants and an area of attached gingiva 4-9 mm wide were attained. There was no bleeding on probing or local infection. CONCLUSION: The transposition multiple-flap vestibuloplasty is a simple and minimally invasive method of improving the condition of soft tissue after insertion of implants. It does not limit the patients' routine activities and avoids staged operations.

Strongly accelerated and humidity-independent drying of nanochannels induced by sharp corners.

Measurements are shown indicating that the drying rate of nanochannels can be enhanced by up to 3 orders of magnitude relative to drying by vapor diffusion, and that the drying rate is independent of the relative humidity of the environment up to a relative humidity of more than 90%. Micromachined Pyrex glass nanochannels of 72 nm height and with sharp corners (corner angles 7 degrees) were used. Available theory shows that the sharp corners function as a low-resistance pathway for liquid water, siphoning (wicking) the water to a location close to the channel exit before it evaporates. The described phenomena are of importance for the understanding of drying processes in industry and agriculture. The introduction of sharp corners or grooves can furthermore be beneficial for the functioning of microheat pipes and capillary-pumped loops.

[Incorporation of multiple foreign bodies due to borderline personality disorder]. / Inkorporation multipler Fremdkörper bei Borderlinepersönlichkeitsstörung. Literaturübersicht und Fallbeschreibung.

BACKGROUND: Autoaggressive behaviour is one of the pathognomonic characteristics in patients with borderline personality disorder. Clinical symptoms of such behaviour can be the self-induced incorporation of foreign bodies. In the head and neck area, this form of autoaggressivity causes primary or secondary infectious complications with different clinical manifestations. Below follows a description of diagnosis, therapy and follow-up of such a case, comparing our own findings with the corresponding literature. CASE REPORT: A 24-year-old woman with manifest borderline personality disorder was referred to the Department of Maxillofacial Surgery after developing a swelling in the infra-auricular region. After antibiotic therapy failed to reduce inflammatory symptoms, local revision was performed including excision of two metallic foreign bodies. Comprehensive radiological evaluation identified multiple foreign bodies in the head and neck region and lower arms. A total of 76 metallic foreign bodies was removed surgically. During early surgical follow-up and subsequent psychiatric treatment, the patient incorporated new foreign bodies. DISCUSSION: The case reported represents a pattern of foreign body incorporation which is unusual based on review of the literature but characteristic for patients with borderline personality disorder. Diagnostics and therapy require an individual concept which only can be implemented in close co-operation with psychiatrists. Secondary clinical benefit derived from surgical diagnostics and therapy as well as the possibility of autoaggressive relapse have to be taken into consideration.

[Perioperative use of medical hypnosis. Therapy options for anaesthetists and surgeons]. / Perioperativer Einsatz von medizinischer Hypnose. Therapieoption für Anästhesisten und Chirurgen.

BACKGROUND: Surgical treatment of patients under local anaesthesia is quite commonly restricted by limited compliance from the patient. An alternative to treatment under pharmacological sedation or general anaesthesia could be the application of medical hypnosis. With this method, both suggestive and autosuggestive procedures are used for anxiolysis, relaxation, sedation and analgesia of the patient. PATIENTS AND METHODS: During a 1-year period of first clinical application, a total of 207 surgical procedures on a non-selected collective of 174 patients were carried out under combined local anaesthesia and medical hypnosis. RESULTS: Medical hypnosis proved to be a standardisable and reliable method by which remarkable improvements in treatment conditions for both patient and surgeons were achievable. CONCLUSION: Medical hypnosis is not considered to be a substitute for conscious sedation or general anaesthesia but a therapeutic option equally interesting for anaesthesists and surgeons.

[Evaluation of intraoperative standardized hypnosis with the State-Trait Anxiety Inventory]. / Evaluation des intraoperativen Einsatzes standardisierter Hypnose mit State-Trait-Angst-Inventar.

BACKGROUND: Surgical treatment under local anesthesia is commonly restricted by limited compliance of patients. Hypnosis may represent an alternative to sedation or general anesthesia. As the procedure demonstrated promising prospects during 1-year experience, the observed hypnosis-induced effects are now being evaluated in clinical studies. PATIENTS AND METHOD: The prospective study included 50 patients scheduled for dental surgery. All procedures were performed under standardized surgical conditions. The experimental group (n=25) received supplementary standardized tape hypnosis, whereas the control group received standard treatment (only local anesthesia). Individual and situative anxiety levels were determined by the State-Trait Anxiety Inventory (STAI). RESULTS: After simultaneous increase of preoperative state anxiety, anxiety levels in the hypnosis group showed a significant intraoperative reduction to baseline level, whereas intraoperative anxiety of the control group (n=25) remained unchanged. CONCLUSIONS: Hypnosis reduces intraoperative anxiety of oral and maxillofacial patients significantly. Further clinical studies on the use of hypnosis are considered useful.