Treatment of infants with posthemorrhagic hydrocephalus by diversion of CSF is frequently complicated by bacterial ventriculitis. We report the CSF values before and during bacterial ventriculitis of four very low birth weight infants with progressive posthemorrhagic ventricular dilatation. Extremely high CSF IL-6 concentrations of between 8,000 and 61,000 pg/ml were observed and compared with values reported in the literature. IL-6 seems to be a useful marker for bacterial ventriculitis in preterm infants. The role of IL-6 monitoring in the CSF of preterm infants with posthemorrhagic hydrocephalus for early diagnosis of bacterial ventriculitis prior to clinical manifestation should be clarified by further studies.

Biomarkers↗

PubMedDate not supplied

CSF interleukin-6 in neonatal Citrobacter ventriculitis after meningitis.

An infant with neonatal severe Citrobacter koseri (formerly Citrobacter diversus) meningoencephalitis developed necrosis with multicystic regression of both hemispheres. The ventriculitis persisted over months in spite of antibiotic therapy. The treatment succeeded with cefotaxime in a high dose (300 mg/kg/day) without surgical intervention. The infant had been previously treated with cefotaxime (200 mg/kg/day) over 5 weeks. High levels of CSF interleukin-6 (IL-6) permitted to attribute persisting CSF pleocytosis in spite of sterile CSF cultures to chronic infection and not to reminiscence of brain necrosis. This report reveals two main points. On the one hand, the importance of therapy monitoring with IL-6 in CSF for the consequent treatment of Citrobacter meningitis and on the other hand, high-dose cefotaxime (300 mg/kg/day) treatment of Citrobacter ventriculitis, which succeeded without surgical intervention.

Biomarkers↗

PubMedDate not supplied

Computer simulation of concentrated fluid-particle suspension flows in axisymmetric geometries.

To investigate the particle migration effects and fluid-particle interaction occurring in the flow of highly concentrated fluid-particle suspensions, a numerical method has been developed for effective computer simulation in arbitrary axisymmetric geometries. In the mathematical flow model the suspension is treated as a generalized Newtonian fluid where the effective flow properties of the suspension (density and viscosity) are determined by the local volume fraction of the particles. The description of the particle motion is governed by a modified transport equation with diffusion coefficients accounting for the effects of shear-induced particle migrations. The strongly coupled system of flow and transport equations is solved by applying the Galerkin finite element method and a velocity-pressure projection scheme. The numerical results in tube flow demonstrate strong particle migration towards the center of the tube and an increasing blunting of the velocity profiles which is in good agreement with an available analytical solution. In the case of flow through a stenosed tube model, particle concentration is lowest at the site of maximum constriction whereas a strong accumulation of particles can be seen in the recirculation zone downstream of the stenosis.

Computer Simulation↗

PubMedDate not supplied

Glucan as stimulator of hematopoiesis in normal and gamma-irradiated mice. A survey of the authors' results.

Glucan, a beta-1,3-linked polyglucose derived from the yeast Saccharomyces cerevisiae, is a broad spectrum enhancer of host defense mechanisms stimulating humoral and cell-mediated immunity. On the basis of these features, glucan has been tested by the authors' research group in experiments on gamma-irradiated mice. Two glucan forms, particulate and soluble, have been studied. Attention has been focused on various application regimens in relation to the time of irradiation (pre- or postirradiation application), the possibilities of using glucan in various radiation regimens (single or repeated irradiation), combined pharmacological therapy (joint administration of glucan with cystamine or inhibitors of prostaglandin synthesis), and on the negative side effects of therapy with glucan. Some studies included also experiments on unirradiated mice. The results have demonstrated the ability of glucan to influence positively the course of the acute radiation disease. Stimulation of hematopoiesis has been found to be the most important mechanism of glucan's radioprotective effects. In this communication, the results of 11 full-length articles are summarized and discussed.

Adjuvants, Immunologic↗

PubMedDate not supplied

Stimulation of haemopoiesis and protection of mice against radiation injury by synthetic analogues of muramyldipeptide incorporated in liposomes.

Protection from undesirable effects of radiotherapy or chemotherapy, primarily from myelosuppression, remains still a crucial problem to be studied. Attention has been therefore paid to various immunomodulatory agents that through the monocyte/macrophage system induced production of cytokines, which can induce and operate restoration of haemopoiesis and thus act radioprotectively. Some synthetic analogues of MDP free of undesirable side-effects, were synthesized in the Czech Republic. Lipophilic beta-D-GlcNstearoyl-(1- > 4)-norMurNAc-L-Abu-D-isoGln (DDD-St) was designed to be easily entrapped into liposomes and this liposomal DDD-St protected efficiently mice against irradiation, when administered i.p., i.v. or s.c. 24 h prior to lethal irradiation (survival rate in the range of 30-80% compared with 0% in control). Especially the subcutaneous application of liposomal DDD-St was very efficient. The parameters characteristic of recovery of haemopoiesis in bone marrow on day 10 after 6.5 Gy irradiation were significantly improved in comparison with the controls. Very high radioprotective effect of s.c. administered liposomal DDD-St can be explained (together with induction of haemopoiesis) by an effective and long-lasting activation of nonspecific immunity, which is able to withhold an onset of septicemia in early days after irradiation. In conclusion, the liposomal DDD-St should be therapeutically beneficial in moderating the haemopoietic damage, which is an undesirable effect of radiotherapy or chemotherapy.

Acetylmuramyl-Alanyl-Isoglutamine↗

PubMedDate not supplied

Quantification of carotid blood flow velocity using MR phase mapping.

OBJECTIVE: The purpose of this study was to determine the feasibility of a two-dimensional phase-sensitive MR technique [phase mapping (PM)] for the quantification of carotid blood flow velocity (CBFV) and pulsatility in normal subjects and patients with extracranial carotid disease. MATERIALS AND METHODS: Using PM, we measured the systolic peak, minimum diastolic, and mean CBFV and the pulsatility index in both common carotid arteries (CCAs) of 22 normal subjects and 32 patients. In addition, the CBFV was quantified in the internal carotid arteries (ICAs) of 25 patients. These data were compared with independent measurements based on pulsed-wave Doppler ultrasonography. RESULTS: Correlations between PM and pulsed-wave Doppler were strong for systolic peak CBFV in both the CCA (r = 0.91) and the ICA (r > or = 0.82). Slightly lower correlations were obtained for mean CBFV (r > or = 0.79) and minimum diastolic CBFV (r > or = 0.75), both measured in the CCA. Velocity waveform comparison revealed high between-method correlations for the CCA (r = 0.90 for normals; r > or = 0.88 for patients) and slightly lower correlations for the ICA (r > or = 0.75). Agreement was lower (r = 0.63) for measurements in the ICA distal to high grade stenosis. CONCLUSION: Phase mapping compared well with Doppler ultrasonography in quantifying CBFV and pulsatility in patients with extracranial carotid artery disease. Except for poststenotic measurements in high grade obstructive lesions, PM is capable of providing quantitative hemodynamic information on the severity of ICA stenosis.

Adult↗

PubMedDate not supplied

Factors influencing flow-induced signal loss in MR angiography: an in vitro study.

OBJECTIVE: Signal loss due to poststenotic turbulence is one remaining limitation in the clinical use of MRA. The objective of this study was to determine the factors influencing poststenotic signal loss (PSL) in a stenotic tube system. MATERIALS AND METHODS: With use of a two-dimensional gradient echo sequence (FLASH), the influence of (a) the degree of stenosis (50, 75, and 91% cross-sectional area reduction), (b) flow velocity (12, 47, 71, and 94 cm/s), (c) TE (3, 6, 13, and 20 ms), and (d) flip angle (5, 10, 20, ... , 90 degrees) on the length of PSL was measured in a nonpulsatile stenotic tube system. To quantify the effect of first-order gradient motion refocusing (GMR), the signal intensity ratio from flow-compensated and -uncompensated images was calculated. For statistical analysis, multiple regression analysis and unpaired Student t test were used. RESULTS: In the flow model used, the length of PSL increased significantly with the degree of stenosis (beta ST' = 0.483 mm/%, beta ST" = 0.447 mm/%, p < 0.0001), flow velocity (beta v' = 0.297 s, beta v" = 0.213 s, p < 0.0001), and TE (beta TE = 1.88 mm/ms, p < 0.0001), respectively, whereas no correlation emerged for varying flip angles (beta alpha = 0.0214, p = 0.29). First-order GMR reduced significantly PSL in through-plane measurements (p < 0.0001). Maximal signal-enhancing effects of first-order GMR were observed 1-3 cm distal to the stenosis. CONCLUSION: Flow model parameters (i.e., degree of stenosis, flow velocity) markedly influenced the length of PSL that could be compensate for by use orf shortened TEs and first-order GMR. Varying flip angles had no significant influence on PSL.

Acrylic Resins↗

PubMedDate not supplied

Cerebral blood volume maps with dynamic contrast-enhanced T1-weighted FLASH imaging: normal values and preliminary clinical results.

PURPOSE: In this article we investigate the application of a method that uses the relaxation effect of bolus-like injected Gd-DTPA to quantify regional cerebral blood volume (rCBV). The aim of the study was to determine if the method provides correct rCBV values in healthy subjects as well as to obtain additional diagnostic information for patients with a glioma or stroke. METHOD: Twenty healthy subjects, 12 patients with brain infarctions, and 18 patients with gliomas were examined. A series of 64 sequential images of one slice was recorded during bolus transit with a FLASH sequence. The measured signal intensity-time curves were converted pixel-wise to concentration-time curves from which the rCBV images were calculated applying the indicator dilution method. RESULTS: An average value for gray and white matter of 4.4 +/- 1.6 vol% was obtained for the group of healthy subjects. The grading of the tumors could be classified according to the differences of their corresponding rCBV values. Fifty percent of the infarct patients had to be excluded from the analysis in the acute phase due to mispositioning of the slice and data degradation by gross motion artifact. Different rCBV values were found for areas that develop later into gliotic scars or cystic necrosis. CONCLUSION: The proposed method is easy to apply in clinical routine MR investigations and provides valuable information for noninvasive, preoperative assessment of tumor grading. It can also provide additional criteria for estimating the histological outcome and with it the degree of ischemia in stroke patients.

Adolescent↗

PubMedDate not supplied

Behavioral and physiologic effects of littermate removal on the remaining single pup and mother during the pre-weaning period in rats.

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Age Factors↗