Effects of cerebral perfusion pressure and increased fraction of inspired oxygen on brain tissue oxygen, lactate and glucose in patients with severe head injury

OBJECTIVE: The purpose of the study was to measure the effects of increased inspired oxygen on patients suffering severe head injury and consequent influences on the correlations between CPP and brain tissue oxygen (PtiO2) and the effects on brain microdialysate glucose and lactate. METHODS: In a prospective, observational study 20 patients suffering severe head injury (GCS< or =8) were studied between January 2000 and December 2001. Each patient received an intraparenchymal ICP device and an oxygen sensor and, in 17 patients brain microdialysis was performed at the cortical-subcortical junction. A 6 h 100% oxygen challenge (F IO2 1.0) ( Period A) was performed as early as possible in the first 24 hours after injury and compared with a similar 6 hour period following the challenge ( Period B). Statistics were performed using the linear correlation analysis, one sample t-test, as well as the Lorentzian peak correlation analysis. RESULTS: F IO2 was positively correlated with PtiO2 (p < 0.0001) over the whole study period. PtiO2 was significantly higher (p < 0.001) during Period A compared to Period B. CPP was positively correlated with PtiO2 (p < 0.001) during the whole study. PtiO2 peaked at a CPP value of 78 mmHg performing a Lorentzian peak correlation analysis of all patients over the whole study. During Period A the brain microdialysate lactate was significantly lower (p = 0.015) compared with Period B. However the brain microdialysate glucose remained unchanged. CONCLUSION: PtiO2 is significantly positively correlated with F IO2, meaning that PtiO2 can be improved by the simple manipulation of increasing F IO2 and ABGAO2. PtiO2 is positively correlated with CPP, peaking at a CPP value of 78 mmHg. Brain microdialysate lactate can be lowered by increasing PtiO2 values, as observed during the oxygen challenge, whereas microdialysate glucose is unchanged during this procedure. Extension of the oxygen challenge time and measurement of the intermediate energy metabolite pyruvate may clarify the metabolic effects of the intervention. Prospective comparative studies, including analysis of outcome on a larger multicenter basis, are necessary to assess the long term clinical benefits of this procedure.

Comparisons between OMI SO2 data and ground-based SO2 measurements at Turrialba volcano

Turrialba is one of the largest and most active stratovolcanoes in the Central Cordillera of Costa Rica and an excellent target for validation of satellite data using ground based measurements due to its high elevation, relative ease of access, and persistent elevated SO2 degassing. The Ozone Monitoring Instrument (OMI) aboard the Aura satellite makes daily global observations of atmospheric trace gases and it is used in this investigation to obtain volcanic SO2 retrievals in the Turrialba volcanic plume. We present and evaluate the relative accuracy of two OMI SO2 data analysis procedures, the automatic Band Residual Index (BRI) technique and the manual Normalized Cloud-mass (NCM) method. We find a linear correlation and good quantitative agreement between SO2 burdens derived from the BRI and NCM techniques, with an improved correlation when wet season data are excluded. We also present the first comparisons between volcanic SO2 emission rates obtained from ground-based mini-DOAS measurements at Turrialba and three new OMI SO2 data analysis techniques: the MODIS smoke estimation, OMI SO2 lifetime, and OMI SO2 transect techniques. A robust validation of OMI SO2 retrievals was made, with both qualitative and quantitative agreements under specific atmospheric conditions, proving the utility of satellite measurements for estimating accurate SO2 emission rates and monitoring passively degassing volcanoes.

Delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) of hip joint cartilage in femoroacetabular impingement (FAI): Are pre- and postcontrast imaging both necessary?

The purpose of this study was to assess if delayed gadolinium MRI of cartilage using postcontrast T(1) (T(1Gd)) is sufficient for evaluating cartilage damage in femoroacetabular impingement without using noncontrast values (T(10)). T(1Gd) and DeltaR(1) (1/T(1Gd) - 1/T(10)) that include noncontrast T(1) measurements were studied in two grades of osteoarthritis and in a control group of asymptomatic young-adult volunteers. Differences between T(1Gd) and DeltaR(1) values for femoroacetabular impingement patients and volunteers were compared. There was a very high correlation between T(1Gd) and DeltaR(1) in all study groups. In the study cohort with Tonnis grade 0, correlation (r) was -0.95 and -0.89 with Tonnis grade 1 and -0.88 in asymptomatic volunteers, being statistically significant (P < 0.001) for all groups. For both T(1Gd) and DeltaR(1), a statistically significant difference was noted between patients and control group. Significant difference was also noted for both T(1Gd) and DeltaR(1) between the patients with Tonnis grade 0 osteoarthritis and those with grade 1 changes. Our results prove a linear correlation between T(1Gd) and DeltaR(1), suggesting that T(1Gd) assessment is sufficient for the clinical utility of delayed gadolinium MRI of cartilage in this setting and additional time-consuming T(10) evaluation may not be needed.

Quantitative sequence analysis of FBN1 premature termination codons provides evidence for incomplete NMD in leukocytes

We improved, evaluated, and used Sanger sequencing for quantification of single nucleotide polymorphism (SNP) variants in transcripts and gDNA samples. This improved assay resulted in highly reproducible relative allele frequencies (e.g., for a heterozygous gDNA 50.0+/-1.4%, and for a missense mutation-bearing transcript 46.9+/-3.7%) with a lower detection limit of 3-9%. It provided excellent accuracy and linear correlation between expected and observed relative allele frequencies. This sequencing assay, which can also be used for the quantification of copy number variations (CNVs), methylations, mosaicisms, and DNA pools, enabled us to analyze transcripts of the FBN1 gene in fibroblasts and blood samples of patients with suspected Marfan syndrome not only qualitatively but also quantitatively. We report a total of 18 novel and 19 known FBN1 sequence variants leading to a premature termination codon (PTC), 26 of which we analyzed by quantitative sequencing both at gDNA and cDNA levels. The relative amounts of PTC-containing FBN1 transcripts in fresh and PAXgene-stabilized blood samples were significantly higher (33.0+/-3.9% to 80.0+/-7.2%) than those detected in affected fibroblasts with inhibition of nonsense-mediated mRNA decay (NMD) (11.0+/-2.1% to 25.0+/-1.8%), whereas in fibroblasts without NMD inhibition no mutant alleles could be detected. These results provide evidence for incomplete NMD in leukocytes and have particular importance for RNA-based analyses not only in FBN1 but also in other genes.

Calibration of cosmogenic noble gas production in ordinary chondrites based on 36 Cl- 36 Ar ages. Part 1: Refined produced rates for cosmogenic 21 Ne and 38 Ar

We measured the concentrations and isotopic compositions of He, Ne, and Ar in bulk samples and metal separates of 14 ordinary chondrite falls with long exposure ages and high metamorphic grades. In addition, we measured concentrations of the cosmogenic radionuclides 10Be, 26Al, and 36Cl in metal separates and in the nonmagnetic fractions of the selected meteorites. Using cosmogenic 36Cl and 36Ar measured in the metal separates, we determined 36Cl-36Ar cosmic-ray exposure (CRE) ages, which are shielding-independent and therefore particularly reliable. Using the cosmogenic noble gases and radionuclides, we are able to decipher the CRE history for the studied objects. Based on the correlation 3He/21Ne versus 22Ne/21Ne, we demonstrate that, among the meteorites studied, only one suffered significant diffusive losses (about 35%). The data confirm that the linear correlation 3He/21Ne versus 22Ne/21Ne breaks down at high shielding. Using 36Cl-36Ar exposure ages and measured noble gas concentrations, we determine 21Ne and 38Ar production rates as a function of 22Ne/21Ne. The new data agree with recent model calculations for the relationship between 21Ne and 38Ar production rates and the 22Ne/21Ne ratio, which does not always provide unique shielding information. Based on the model calculations, we determine a new correlation line for 21Ne and 38Ar production rates as a function of the shielding indicator 22Ne/21Ne for H, L, and LL chondrites with preatmospheric radii less than about 65 cm. We also calculated the 10Be/21Ne and 26Al/21Ne production rate ratios for the investigated samples, which show good agreement with recent model calculations.

Intracellular phosphorylation of ornithine decarboxylase: Regulation of enzyme activity

Ornithine decarboxylase (ODC), the rate-limiting enzyme in polyamine biosynthesis exists as two major and one minor ionic form in the macrophage cell line, RAW 264. The forms have the same molecular weight, 55,000, but differ in their isoelectric points, 5.2, 5.1, and 4.9-5.0. The hypothesis that phosphorylation accounts for the differences in the two major ionic forms and that phosphorylation is involved in the regulation of enzyme activity was investigated. Metabolic-radiolabeling of cells with $\sp{32}$P-orthophosphate indicated that only one of the major forms of the protein can be explained by phosphorylation: treatment of purified ODC with alkaline phosphatase resulted in the loss of the phosphorylated form of the protein, pl 5.1, with a concomitant increase in the unphosphorylated, pl 5.2, form of the protein. Characterization of the phosphorylation sites showed that serine was the present. Tryptic digests of $\sp{32}$P-labeled ODC, analyzed by either two dimensional tryptic peptide mapping or reverse-phase HPLC, contained only one major radiolabeled peptide.^ The role phosphorylation plays in the regulation of enzyme activity was also investigated. Treatment of purified ODC with alkaline phosphatase resulted in the loss of enzyme activity. A positive linear correlation exists between enzyme activity and the amount of phosphorylated form of the protein present.^ To ascertain if the two major forms of the protein were also found in animal cells, ODC was immunoprecipitated from various rat tissues, fractionated by isoelectric focusing, and detected by immunoblotting. ODC was present in rat tissues in a single major form, which comigrated with the pl 5.1, phosphorylated form of ODC present in RAW 264 cell.^ This study concludes that ODC exists as a phosphorylated form, pl 5.1, and an unphosphorylated form, pl 5.2 in RAW 264 cells. The amount of the phosphorylated form of ODC correlates well with the enzyme activity. ^

PREMATURE CONDENSATION OF SPERMATOGENIC CELL CHROMOSOMES

The technique of premature chromosome condensation (PCC) has been used primarily to study interphase chromosomes of somatic cells. In this study, mitotic cells were fused to cells from the mouse testes to examine the chromosomes of germ cells. The testes contain various types of cells, both germinal and nongerminal. In these initial studies, four types of PCC morphologies were observed. Chromosome morphology of the PCC and labeling experiments demonstrated the mouse cell origin of various PCC. Attempts were next made to determine the cell types producing the PCC. Spermatogonia, diplotene spermatocytes, secondary spermatocytes and round spermatids are proposed to be the origin of the PCC morphologies. Some PCC could be banded by G and C banding techniques and the mouse chromosomes identified.^ Studies were subsequently undertaken to evaluate this technique as a method of evaluating damage to germ cells. Testicular cells from irradiated mice were fused to mitotic cells and the PCC examined. Both round spermatids and secondary spermatocytes exhibited chromosome damage in the form of chromatid breaks. A linear correlation was found between the dose of irradiation and the number of breaks per cell. This technique may develop into a useful method for evaluating the clastogenic effect of agents on the germ cells. ^

A 200 Year Sulfate Record from Sixteen Antarctic Ice Cores and Associations With Southern Ocean Sea-Ice Extent

Chemistry data from 16, 50-115 m deep, sub-annually dated ice cores are used to investigate spatial and temporal concentration variability of sea-salt (ss) SO42- and excess (xs) SO42- over West Antarctica and the South Pole for the last 200 years. Low-elevation ice-core sites in western West Antarctica contain higher concentrations Of SO42- as a result of cyclogenesis over the Ross Ice Shelf and proximity to the Ross Sea Polynya. Linear correlation analysis of 15 West Antarctic ice-core SO42- time series demonstrates that at several sites concentrations Of ssSO(4)(2-) are higher when sea-ice (SIE) extent is greater, and the inverse for XSS04. Concentrations Of XSS04 from the South Pole site (East Antarctica) are associated with SIE from the Weddell region, and West Antarctic XSSO42- concentrations are associated with SIE from the Bellingshausen-Amundsen-Ross region. The only notable rise of the last 200 years in xsSO(4)(2-), around 1940, is not related to SIE fluctuations and is most likely a result of increased xsSO(4)(2-) production in the mid-low latitudes and/or an increase in transport efficiency from the mid-low latitudes to central West Antarctica. These high-resolution records show that the source types and source areas Of ssSO(4)(2-) and xsSO(4)(2-) delivered to eastern and western West Antarctica and the South Pole differ from site to site but can best be resolved using records from spatial ice-core arrays such as the International Trans-Antarctic Scientific Expedition (ITASE).

An Ice-Core Proxy for Antarctic Circumpolar Zonal Wind Intensity

Using US National Centers for Environmental Prediction/US National Center for Atmospheric Research re-analysis data, we investigate the relationships between crustal ion (nssCa(2+)) concentrations from three West Antarctic ice cores, namely, Siple Dome (SD), ITASE00-1 (IT001) and ITASE01-5 (IT015), and primary components of the climate system, namely, air pressure/geopotential height, zonal (u) and meridional (v) wind strength. Linear correlation analyses between nssCa(2+) concentrations and both air-pressure and wind fields for the period of overlap between records indicate that the SD nssCa(2+) variation is positively correlated with spring circumpolar zonal wind, while IT001 nssCa(2+) has a positive correlation with circumpolar zonal wind throughout the year (r > 0.3, p < 0.01). Intensified Southern Westerlies circulation is conducive to transport of more crustal aerosols to both sites. Further correlation analyses between nssCa(2+) concentrations from SD and IT001 and atmospheric circulation suggest that the high inland plateau (represented by core IT001) is largely influenced by transport from the upper troposphere. IT015 nssCa(2+) is negatively correlated with westerly wind in October and November, suggesting that stronger westerly circulation may weaken the transport of crustal species to IT015. Correlations of nssCa(2+) from the three ice cores with the Antarctic Oscillation index are consistent with results developed from the wind-field investigation. In addition, calibration between nssCa(2+) concentration and the multivariate El Nino-Southern Oscillation (ENSO) index shows that crustal species transport to IT001 is enhanced during strong ENSO events.

Chemical Composition of Fresh Snow from Glaciar Marinelli, Tierra Del Fuego, Chile

A fresh-snow sampling campaign was conducted during the late austral summer of 2006 in the accumulation zone of Glaciar Marinelli, located in the Cordillera Darwin, Tierra del Fuego, Chile. Snow samples were analyzed for stable isotopes (delta(18)O, major soluble ions (Na', K', Ca, Mg, a NO(3)(-), SO(4)(2-), MS(-)) and major and trace elements (Na, Mg, Al, Fe, Ca, Sr, Cd, Cs, Ba, La, Ce, Pr, Dy, Ho, Er, Bi, U, As, Ti, V, Cr, Mn). The dominance of marine chemistry resembles that in studies from Patagonian glaciers. Snow chemistry was dominantly loaded by marine species (Cl(-), Na(+) and ssSO(4)(2-)), while contributions of crustal species (e.g. Al and Fe) were very low. Empirical orthogonal function analysis suggests two possible dust sources, one represented by Al and Fe and the other by La, Ce and Pr. Enrichment-factor calculations suggest the majority of elements are within average upper-crustal ratios, but major enrichments of Bi and Cd (hundreds of times) suggest possible anthropogenic sources. Linear correlation of delta(18)O and barometric pressure (r = 0.60, p < 0.007) suggests a potential 'amount effect' relationship between depleted delta(18)O ratios and stronger storm conditions (e.g. greater precipitation). The snow-chemistry records from Glaciar Marinelli are the first measured in Tierra del Fuego, the southernmost glaciated region outside Antarctica.

Diurnal variations in middle-atmospheric water vapor by ground-based microwave radiometry

Abstract. In this paper, we compare the diurnal variations in middle-atmospheric water vapor as measured by two ground-based microwave radiometers in the Alpine region near Bern, Switzerland. The observational data set is also compared to data from the chemistry–climate model WACCM. Due to the small diurnal variations of usually less than 1%, averages over extended time periods are required. Therefore, two time periods of five months each, December to April and June to October, were taken for the comparison. The diurnal variations from the observational data agree well with each other in amplitude and phase. The linear correlation coefficients range from 0.8 in the upper stratosphere to 0.5 in the upper mesosphere. The observed diurnal variability is significant at all pressure levels within the sensitivity of the instruments. Comparing our observations with WACCM, we find that the agreement of the phase of the diurnal cycle between observations and model is better from December to April than from June to October. The amplitudes of the diurnal variations for both time periods increase with altitude in WACCM, but remain approximately constant at 0.05 ppm in the observations. The WACCM data are used to separate the processes that lead to diurnal variations in middle-atmospheric water vapor above Bern. The dominating processes were found to be meridional advection below 0.1 hPa, vertical advection between 0.1 and 0.02 hPa and (photo-)chemistry above 0.02 hPa. The contribution of zonal advection is small. The highest diurnal variations in water vapor as seen in the WACCM data are found in the mesopause region during the time period from June to October with diurnal amplitudes of 0.2 ppm (approximately 5% in relative units).

Axial suspension test to assess pre-operative spinal flexibility in patients with adolescent idiopathic scoliosis.

INTRODUCTION An accurate description of the biomechanical behavior of the spine is crucial for the planning of scoliotic surgical correction as well as for the understanding of degenerative spine disorders. The current clinical assessments of spinal mechanics such as side-bending or fulcrum-bending tests rely on the displacement of the spine observed during motion of the patient. Since these tests focused solely on the spinal kinematics without considering mechanical loads, no quantification of the mechanical flexibility of the spine can be provided. METHODS A spinal suspension test (SST) has been developed to simultaneously monitor the force applied on the spine and the induced vertebral displacements. The system relies on cervical elevation of the patient and orthogonal radiographic images are used to measure the position of the vertebras. The system has been used to quantify the spinal flexibility on five AIS patients. RESULTS Based on the SST, the overall spinal flexibility varied between 0.3 °/Nm for the patient with the stiffer curve and 2 °/Nm for the less rigid curve. A linear correlation was observed between the overall spinal flexibility and the change in Cobb angle. In addition, the segmental flexibility calculated for five segments around the apex was 0.13 ± 0.07 °/Nm, which is similar to intra-operative stiffness measurements previously published. CONCLUSIONS In summary, the SST seems suitable to provide pre-operative information on the complex functional behavior and stiffness of spinal segments under physiological loading conditions. Such tools will become increasingly important in the future due to the ever-increasing complexity of the surgical instrumentation and procedures.

Cardiac lipid levels show diurnal changes and long-term variations in healthy human subjects

(1) H-MRS is regularly applied to determine lipid content in ectopic tissue - mostly skeletal muscle and liver - to investigate physiological and/or pathologic conditions, e.g. insulin resistance. Technical developments also allow non-invasive in vivo assessment of cardiac lipids; however, basic data about methodological reliability (repeatability) and physiological variations are scarce. The aim of the presented work was to determine potential diurnal changes of cardiac lipid stores in humans, and to put the results in relation to methodological repeatability and normal physiological day-to-day variations. Optimized cardiac- and respiratory-gated (1) H-MRS was used for non-invasive quantification of intracardiomyocellular lipids (ICCL), creatine, trimethyl-ammonium compounds (TMA), and taurine in nine healthy young men at three time points per day on two days separated by one week. This design allowed determination of (a) diurnal changes, (b) physiological variation over one week and (c) methodological repeatability of the ICCL levels. Comparison of fasted morning to post-absorptive evening measurements revealed a significant 37 ± 19% decrease of ICCL during the day (p = 0.0001). There was a significant linear correlation between ICCL levels in the morning and their decrease during the day (p = 0.015). Methodological repeatability for the ICCL/creatine ratio was excellent, with a coefficient of variance of ~5%, whereas physiological variation was found to be considerably higher (22%) in spite of a standardized physiological preparation protocol. In contrast, TMA levels remained stable over this time period. The proposed (1) H-MRS technique provides a robust way to investigate relevant physiological changes in cardiac metabolites, in particular ICCL. The present results suggest that ICCL reveal a diurnal course, with higher levels in the morning as compared to evening. In addition, a considerable long-term variation of ICCL levels, in both the morning and evening, was documented. Given the high methodological repeatability, these effects should be taken into account in studies investigating the metabolic role of ICCL.

Evaluation of chocolate as a source of dietary copper

Chocolate has frequently been proposed to be a valuable source of dietary copper, but data on the copper content of major contemporary chocolate brands are scarce. The copper content of 22 brands of chocolate, many of which are sold worldwide, is thus presented here. A reliable hot ashing procedure to determine the copper content of chocolate by inductively coupled plasma atomic emission spectroscopy is also described. It was found that the copper contents of the chocolates analyzed here varied in the range of 1.85 ± 0.10 to 16.50 ± 1.29 μg/g. There was a linear correlation of the copper content of chocolate to its cocoa content with a correlation coefficient R2 of 0.89, showing that the copper was largely contributed to the chocolate by the cocoa. The value of chocolate as a source of dietary copper is discussed.

Deep Into the Fibers! Postmortem Diffusion Tensor Imaging in Forensic Radiology.

PURPOSE In traumatic brain injury, diffusion-weighted and diffusion tensor imaging of the brain are essential techniques for determining the pathology sustained and the outcome. Postmortem cross-sectional imaging is an established adjunct to forensic autopsy in death investigation. The purpose of this prospective study was to evaluate postmortem diffusion tensor imaging in forensics for its feasibility, influencing factors and correlation to the cause of death compared with autopsy. METHODS Postmortem computed tomography, magnetic resonance imaging, and diffusion tensor imaging with fiber tracking were performed in 10 deceased subjects. The Likert scale grading of colored fractional anisotropy maps was correlated to the body temperature and intracranial pathology to assess the diagnostic feasibility of postmortem diffusion tensor imaging and fiber tracking. RESULTS Optimal fiber tracking (>15,000 fiber tracts) was achieved with a body temperature at 10°C. Likert scale grading showed no linear correlation (P > 0.7) to fiber tract counts. No statistically significant correlation between total fiber count and postmortem interval could be observed (P = 0.122). Postmortem diffusion tensor imaging and fiber tracking allowed for radiological diagnosis in cases with shearing injuries but was impaired in cases with pneumencephalon and intracerebral mass hemorrhage. CONCLUSIONS Postmortem diffusion tensor imaging with fiber tracking provides an exceptional in situ insight "deep into the fibers" of the brain with diagnostic benefit in traumatic brain injury and axonal injuries in the assessment of the underlying cause of death, considering influencing factors for optimal imaging technique.