Transfontanellar duplex brain ultrasonography resistive indices as a prognostic tool in neonatal hypoxic-ischemic encephalopathy before and after treatment with therapeutic hypothermia.

OBJECTIVE: Prior to therapeutic hypothermia (that is, cooling), transfontanellar duplex brain sonography resistive indices (RI) were studied as a bedside non-invasive measures of cerebral hemodynamics in neonates who suffered from hypoxic-ischemic encephalopathy (HIE). We compared pre- and post-cooling RI values and examined the relationships between RI values and specific long-term neurodevelopmental outcomes. STUDY DESIGN: Transfontanellar duplex brain sonography, including RI, were obtained for 28 neonates prior to cooling and for 20 neonates following cooling. All RI values were sampled in the anterior cerebral artery at the beginning of each ultrasound study. Neurodevelopmental assessment was conducted between ages 20-32 months with the Mullen Scale of Early Learning. The relationships between pre- and post-cooling RI and cognitive and motor outcomes were studied. RESULT: Neonates with RI values <0.60 prior to and following cooling were more likely to die or have severe neurodevelopmental disability by ages 20-32 months than those with RI>0.60. Lower RI values were associated with specific neurodevelopmental deficits in motor skill attainment. CONCLUSION: Pre- and post-cooling transfontanellar duplex brain sonography RI values may be a useful prognostic tool, in conjunction with other clinical information, for neonates diagnosed with HIE. The results of this study suggest that further study of the prognostic value of RI values for short- and long-term outcomes is warranted.

Removal of rotavirus and adenovirus from artificial ground water using hydrochar derived from sewage sludge.

AIMS: To determine the pathogenic virus removal performance of an adsorbent produced from hydrothermal carbonization of sewage sludge. METHODS AND RESULTS: The removal of human pathogenic rotavirus and adenovirus was investigated with columns of 10 cm saturated sand with and without amendments of 1·5% (w/w) hydrochar. Virus concentrations were determined with reverse transcription (RT) quantitative polymerase chain reaction (qPCR). The experiments with sand showed 1 log removal, while the columns with 1·5% (w/w) hydrochar amendment showed 2 to >3 log removal for both viruses. Deionized (DI) water flushing into the virus-retaining columns revealed that the secondary energy minimum played a larger role in the attachment of rotavirus onto hydrochar surfaces than adenovirus. Improved virus removal may be attributed to the introduction of hydrophobic and/or meso-macro surface structures of the hydrochar providing favourable attachment sites for viruses. CONCLUSIONS: Hydrochar amended sand beds showed improved virus removal efficiencies exceeding 99·6% corresponding to 2·4 log removal. The addition of humic acid in the influent did not hinder the adsorptive removal of viruses. SIGNIFICANCE AND IMPACT OF THE STUDY: This study suggests that hydrochar derived from sewage sludge can be used as an adsorbent for virus removal in water treatment.

Transpapillary miniscopy and mini-biopsy of the pancreatic duct.

This paper reports on the new combined examination of peroral transpapillary fine-caliber endoscopy (miniscope 0.5 mm in diameter) with mini-biopsy of the pancreatic duct in 10 patients and 19 surgical pancreas resection preparations. With this technique, endoscopic-retrograde inspection of the whole length of the pancreatic duct is possible without the need for papillotomy. In the case of pancreatic duct changes due to carcinoma of the pancreas, and chronic pancreatitis, the ductal lesions can be inspected. Furthermore, with the aid of a new mini-biopsy forceps (1.5 mm in diameter), material for histological evaluation can be much more efficiently obtained than was normally possible with conventional biopsy forceps (2.2 mm). This new endoscopic-bioptic technique promises to improve the diagnostic reliability in pancreatic duct lesions requiring clarification.

Antibacterial activity of BCG-induced, interferon-containing sera.

Sera from mice which have been vaccinated with BCG and challenged with old tuberculin contain gamma interferon. These same sera also express antibacterial activity. Using Staphylococcus aureus we demonstrated that its growth was inhibited at dilutions of sera as high as 1:320. A 4% concentration of sera reduced the growth rate of the S. aureus from 1.6 to 0.6 doubling times per hour. The activity was stable at 56 degrees C but destroyed by 80 degrees C. It was nondialysable and destroyed by acid conditions (pH 2.0) and by the proteolytic enzymes trypsin and chymotrypsin. Antibodies to gamma interferon neutralized the antiviral activity but not the antibacterial activity. Mitogen-induced and virus-induced interferons did not have activity. We subsequently demonstrated that the factor could be induced in mice using BCG without the secondary old tuberculin challenge. No gamma interferon was found in the sera of mice given BCG without old tuberculin. These findings indicate that the antibacterial activity of these sera is not dependent on the presence of gamma interferon. We will continue to work to characterize and identify the antibacterial component in these sera.