bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phenotypic and genetic analysis of the cerebellar mutant tmgc26, a new ENU‐induced ROR‐alpha allele
Authors: Swanson Douglas J. , Steshina Ekaterina Y. , Wakenight Paul , Aldinger Kimberly A. , Goldowitz Dan , Millen Kathleen J. , Chizhikov Victor V. 
Published: August 2010

AbstractROR‐alpha is an orphan nuclear receptor, inactivation of which cell‐autonomously blocks differentiation of cerebellar Purkinje cells with a secondary loss of granule neurons. As part of our ENU mutagenesis screen we isolated the recessive tmgc26 mouse mutant, characterized by early‐onset progressive ataxia, cerebellar degeneration and juvenile lethality. Detailed analysis of the tmgc26−/− cerebella revealed Purkinje cell and granule cell abnormalities, and defects in molecular layer interneurons and radial glia. Chimera studies suggested a cell‐autonomous effect of the tmgc26 mutation in Purkinje cells and molecular layer interneurons, and a non‐cell‐autonomous effect in granule cells. The mutation was mapped to a 13‐Mb interval on chromosome 9, a region that contains the ROR‐alpha gene. Sequencing of genomic DNA revealed a T‐to‐A transition in exon 5 of the ROR‐alpha gene, resulting in a nonsense mutation C257X and severe truncation of the ROR‐alpha protein. Together, our data identify new roles for ROR‐alpha in molecular layer interneurons and radial glia development and suggest tmgc26 as a novel ROR‐alpha allele that may be used to further delineate the molecular mechanisms of ROR‐alpha action.
Impairment of CaMKII activation and attenuation of neuropathic pain in mice lacking NR2B phosphorylated at Tyr1472
Authors: Matsumura Shinji , Kunori Shunji , Mabuchi Tamaki , Katano Tayo , Nakazawa Takanobu , Abe Tetsuya , Watanabe Masahiko , Yamamoto Tadashi , Okuda‐Ashitaka Emiko , Ito Seiji 
Published: August 2010

AbstractCa2+/calmodulin‐dependent protein kinase II (CaMKII) is a key mediator of long‐term potentiation (LTP), which can be triggered by N‐methyl‐d‐aspartate (NMDA) receptor‐mediated Ca2+ influx. We previously demonstrated that Fyn kinase‐mediated phosphorylation of NR2B subunits of NMDA receptors at Tyr1472 in the dorsal horn was involved in a neuropathic pain state even 1 week after nerve injury. Here we show that Y1472F‐KI mice with a knock‐in mutation of the Tyr1472 site to phenylalanine did not exhibit neuropathic pain induced by L5 spinal nerve transection, whereas they did retain normal nociceptive responses and induction of inflammatory pain. Phosphorylation of NR2B at Tyr1472 was only impaired in the spinal cord of Y1472F‐KI mice among the major phosphorylation sites. There was no difference in the Ca2+ response to glutamate and sensitivity to NMDA receptor antagonists between naive wild‐type and Y1472F‐KI mice, and the Ca2+ response to glutamate was attenuated in the Y1472F‐KI mice after nerve injury. Autophosphorylation of CaMKII at Thr286 was markedly impaired in Y1472F‐KI mice after nerve injury, but there was no difference in phosphorylation of CaMKII at Thr305 or protein kinase Cγ at Thr674, and activation of neuronal nitric oxide synthase and microglia in the superficial layer of spinal cord between wild‐type and Y1472F‐KI mice after the operation. These results demonstrate that the attenuation of neuropathic pain is caused by the impaired NMDA receptor‐mediated CaMKII signaling in Y1472F‐KI mice, and suggest that autophosphorylation of CaMKII at Thr286 plays a central part not only in LTP, but also in persistent neuropathic pain.
Differential participation of temporal structures in the consolidation and reconsolidation of taste aversion extinction
Authors: Garcia‐delaTorre Paola , Rodríguez‐Ortiz Carlos J. , Balderas Israela , Bermúdez‐Rattoni Federico 
Published: August 2010

AbstractThe extinction process has been described as the decline in the frequency or intensity of the conditioned response following the withdrawal of reinforcement. Hence, experimental extinction does not reflect loss of the original memory, but rather reflects new learning, which in turn requires consolidation in order to be maintained in the long term. During extinction of conditioned taste aversion (CTA), a taste previously associated with aversive consequences acquires a safe status through continuous presentations of the flavor with no aversive consequence. In addition, reconsolidation has been defined as the labile state of a consolidated memory after its reactivation by the presentation of relevant information. In this study, we analyzed structures from the temporal lobe that could be involved in consolidation and reconsolidation of extinction of CTA by means of new protein synthesis. Our results showed that protein synthesis in the hippocampus (HC), the perirhinal cortex (PR) and the insular cortex (IC) of rats participate in extinction consolidation, whereas the basolateral amygdala plays no part in this phenomenon. Furthermore, we found that inhibition of protein synthesis in the IC in a third extinction trial had an effect on reconsolidation of extinction. The participation of the HC in taste memory has been described as a downmodulator for CTA consolidation, and has been related to a context–taste association. Altogether, these data suggest that extinction of aversive taste memories are subserved by the IC, HC and PR, and that extinction can undergo reconsolidation, a process depending only on the IC.
Time course of allocation of spatial attention by acoustic cues in non‐human primates
Authors: Populin Luis C. , Rajala Abigail Z. 
Published: August 2010

AbstractSpatial attention mediates the selection of information from different parts of space. When a brief cue is presented shortly before a target [cue to target onset asynchrony (CTOA)] in the same location, behavioral responses are facilitated, a process called attention capture. At longer CTOAs, responses to targets presented in the same location are inhibited; this is called inhibition of return (IOR). In the visual modality, these processes have been demonstrated in both humans and non‐human primates, the latter allowing for the study of the underlying neural mechanisms. In audition, the effects of attention have only been shown in humans when the experimental task requires sound localization. Studies in monkeys with the use of similar cues but without a sound localization requirement have produced negative results. We have studied the effects of predictive acoustic cues on the latency of gaze shifts to visual and auditory targets in monkeys experienced in localizing sound sources in the laboratory with the head unrestrained. Both attention capture and IOR were demonstrated with acoustic cues, although with a faster time course than with visual cues. Additionally, the effect was observed across sensory modalities (acoustic cue to visual target), suggesting that the underlying neural mechanisms of these effects may be mediated within the superior colliculus, a center where inputs from both vision and audition converge.
Recommended use of morphine in neonates, infants and children based on a literature review: Part 2–Clinical use
Authors: KART TRINE , CHRISTRUP LONA L. , RASMUSSEN METTE 
Published: August 2010

SummaryThe indication for morphine use is primarily pain, but also a combined analgesic and sedative effect may be the rationale behind morphine administration. Paediatric morphine regimens have been reported for children with postoperative pain, pain related to cancer, sickle cell crisis pain, burns and AIDS. No dose response curve for morphine in neonates, infants or children has been established, and different levels for the minimum effective plasma concentration have been estimated. The side effects observed in neonates, infants, and children are similar to those observed in adults, and neonates do not seem to be more susceptible to respiratory depression than older children. Despite shortcomings in the knowledge of the pharmacodynamics of morphine, it can be considered safe to administer morphine to neonates, infants or children. Initial regimens has been calculated from the pharmacokinetic parameters of morphine, but treatment must be adjusted according to analgesic effect and incidence of side effects.
Psoas compartment block in children: Part I – description of the technique*
Authors: SCHUEPFER GUIDO , JÖHR MARTIN 
Published: August 2010

SummaryBackground : Until recently only small series of psoas compartment blocks (PCB) in children have been reported. A high incidence of epidural spread as an important side effect was noted. A series of 100 consecutive blocks using new standardized landmarks is reported.Methods : In 100 consecutive children (5.9–106 kg) PCB was performed using a nerve stimulator. In the lateral position, the needle was inserted between the medial 2/3 and the lateral 1/3 on a line from the spinous process of L4 to the posterior superior iliac spine. The blocks were performed by residents in training under supervision of one specific designated pediatric anesthetist.Results : All blocks were clinically successful. In 64% only one attempt was necessary, in 26 patients two attempts were necessary and in 10 patients more than two attempts were necessary. In 16% a vascular puncture occurred. In one patient with a dense unilateral block a partial epidural spread occurred. No serious complications were observed during the perioperative period.Conclusions : The described new technique has a very high success rate with no relevant side effects. Although only one case of epidural spread occurred, PCB remains an invasive technique with the potential for serious complications.
Perioperative management of a child with short‐chain acyl‐CoA dehydrogenase deficiency
Authors: TURPIN BRIAN , TOBIAS JOSEPH D. 
Published: August 2010

SummaryShort‐chain acyl‐CoA dehydrogenase (SCAD) is a mitochondrial enzyme that catalyzes the dehydrogenation of short chain fatty acids (4 to 6 carbons in length) thereby initiating the cycle of β‐oxidation. This process generates acetyl‐CoA, the key substrate for hepatic ketogenesis or ATP production by the Kreb's cycle. A deficiency of SCAD results in the build‐up of potentially cytotoxic metabolites including ethylmalonic acid, methylsuccinyl CoA and butyryl‐carnitine. The end‐organ involvement is heterogeneous, but most commonly includes hypotonia with possible lipid myopathy and developmental delay. Other reported complications include dysmorphic craniofacial features, hypoglycemia, seizures, scoliosis, hypertonia and hyperreflexia, cyclic vomiting and myocardial dysfunction. We present a 23‐month‐old girl with SCAD deficiency, who required posterior fossa decompression for type 1 Chiari malformation. The potential perioperative implications of SCAD deficiency are reviewed.
Intraoperative pediatric blood transfusion therapy: a review of common issues. Part I: hematologic and physiologic differences from adults; metabolic and infectious risks
Authors: BARCELONA SANDRA L. , THOMPSON ALEXIS A. , COTÉ CHARLES J. 
Published: August 2010

SummaryPediatric intraoperative transfusion therapy, particularly the approach to massive blood transfusion (blood loss ≥one blood volume) can be quite complex because of the unique relationship between the patient's blood volume and the volume of the individual blood product transfused. This paper is divided into two parts: part 1 presents an overview of the physiologic and hematologic differences between children and adults as well as an overview of the metabolic consequences of blood transfusions, risks of disease transmission, and blood compatibility issues.
The temperature and humidity of inspired gases in infants using a pediatric circle system: effects of high and low‐flow anesthesia
Authors: HUNTER TED , LERMAN JERROLD , BISSONNETTE BRUNO 
Published: August 2010

SummaryBackground:  The effects of low‐flow anesthesia on the temperature and humidity of the inspired gas in infants during mechanical ventilation is unknown. This study was designed to evaluate the temperature and humidity of the inspired gas in infants using a pediatric circle absorber system with high and low fresh gas flow (HFGF and LFGF) anesthesia.Methods:  Twenty infants participated in this observational, sequential, cross‐over study. Each infant was mechanically ventilated with a Kion Anesthesia Workstation, using a pediatric anesthesia circle circuit with both HFGF (6 l·min−1) and LFGF (0.6 l·min−1) technique. Airway temperature was recorded continuously at 16 sites throughout the breathing circuit. The relative humidity of the inspired gas was measured at the elbow connector adjacent to the CO2 sampling line.Results:  The mean airway temperatures of the inspired gas and the changes in mean airway temperatures throughout the breathing circuit during HFGF and LFGF did not differ significantly. The mean relative humidity of the inspired gas at steady state using a LFGF technique, 33.7 ± 3.6%, was approximately threefold greater than it was with a HFGF technique, 11.9 ± 5.1% (P < 0.05).Conclusions:  Low‐flow anesthesia with a pediatric circle system in infants neither increases the temperature of the inspired gas, nor achieves the minimum humidity of 50% reported to prevent ciliary damage, although the humidity during LFGF did increase threefold compared with HFGF. To maintain the temperature and humidity of the inspired gas during mechanical ventilation in infants, passive or active gas humidification should be used.
Moyamoya disease and anesthesia
Authors: BAYKAN NIGAR , ÖZGEN SERDAR , SERPIL USTALAR Z. , DAǦÇINAR ADNAN , MEMET ÖZEK M. 
Published: August 2010

SummaryMoyamoya disease is a condition that results from bilateral stenosis or obstruction of the intracranial arteries at the base of the brain. Patients exhibit ischemic symptoms, and vascular reconstruction is the therapy of choice. Surgical treatment for Moyamoya disease is often complicated by cerebral ischemia, so the goal in perioperative management is to maintain the balance between oxygen supply and demand in the brain. This report presents three cases of Moyamoya disease in patients under 3 years of age, and discusses anesthesia management issues for pediatric patients with this condition.
A 10‐year‐old child with status asthmaticus, hypercapnia and a unilateral dilated pupil
Authors: UDY ANDREW 
Published: August 2010

SummaryThis article reports the case of a 10‐year‐old child with an exacerbation of asthma requiring mechanical ventilation. His immediate course was complicated by significantly elevated arterial CO2 tensions and a unilateral dilated pupil. A computed tomography scan of his brain failed to demonstrate any evidence of intracranial hypertension or cerebral edema, and he went on to make an uncomplicated recovery, with no evidence of neurological sequelae. The most likely diagnosis appeared to be local contamination with ipratropium when he was receiving frequent nebulizers prior to mechanical ventilation. Similar cases reported in the literature are reviewed, with a discussion of clinical management, implications of permissive hypercapnia and neurological complications in ventilating asthmatic patients and the importance of safe drug handling by staff members.
Does dexmedetomidine prevent emergence delirium in children after sevoflurane‐based general anesthesia?
Authors: SHUKRY MOHANAD , CLYDE MATHISON C. , KALARICKAL PHILIP L , RAMADHYANI USHA 
Published: August 2010

SummaryBackground : Emergence agitation or delirium (ED) is a frequent phenomenon in children recovering from general anesthesia (GA). Dexmedetomidine, an alpha2 receptor agonist, has analgesic and sedative properties that might be helpful in the management of ED. We studied the effects of a continuous perioperative infusion of 0.2 μg·kg−1·h−1 dexmedetomidine on the incidence of ED in 50 children aged 1–10 years scheduled for sevoflurane‐based GA.Methods : Following inhalation induction of GA, the children were randomly assigned into dexmedetomidine or placebo Groups D and S, respectively. The infusion of 0.2 μg·kg−1·h−1 dexmedetomidine or equal volume of saline was started after securing the airway. Depth of anesthesia was maintained by adjusting the concentration of sevoflurane to achieve a Bispectral Index Score of 40–60. Intraoperative hemodynamics were recorded every 5 min and the trachea was extubated at the end of the procedure. Perioperative pain management was determined by the blinded anesthesia team, and the study drug infusion was maintained for 15 min following the postanesthesia care unit (PACU) admission. ED and pain scores were evaluated by a blinded observer.Results : The incidence of ED was statistically significantly different between the two groups, 26% in Group D Vs 60.8% in Group S (P = 0.036). Additionally, the number of episodes of ED was lower in Group D (P < 0.017). Pain scores and the times to extubate and discharge from PACU were the same.Conclusions : The perioperative infusion of 0.2 μg·kg−1·h−1 dexmedetomidine decreases the incidence and frequency of ED in children after sevoflurane‐based GA without prolonging the time to extubate or discharge.
Intraoperative hyperthermia in a child with neuroblastoma
Authors: MAYHEW JAMES F. 
Published: August 2010

SummaryThe development of intraoperative hyperthermia has been reported in association with blood malignancies. This is case report of hyperthermia in a child with neuroblastoma, which was not an episode of malignant hyperthermia as determined by arterial blood cases and physiologic vital signs.
Improving processes of care in patient‐controlled analgesia: the impact of computerized order sets and acute pain service patient management
Authors: WRONA SHARON , CHISOLM DEENA J. , POWERS MICHAEL , MILER VERONICA 
Published: August 2010

SummaryBackground:  In an effort to combat opioid induced side effects within the first 24 h of patient‐controlled analgesia (PCA) induction, it has been recommended that care be provided by an Acute Pain Treatment Service (APS) and that computerized PCA order sets with patient monitoring requirements be implemented. To date, there are few published studies on the role of computerized order sets or APS in improving the quality and safety of pediatric PCA use. This retrospective analysis sought to determine if the implementation of computerized order sets would increase appropriate monitoring and problem recognition.Methods:  Analysis included 536 patients prescribed PCA in one of three ways: an anesthesia order set with APS support (n = 285), a general PCA order set (n = 95), or no order set (n = 156). We analyzed the use of order sets by unit; the incidence of appropriate monitoring (≥12 recordings within 24 h) of respiratory rate, oxygen saturation, and sedation level and the recognition of low respiration rate and low oxygen saturation between the types of PCA order.Results:  We found a significant difference in type of PCA order used by unit. Appropriate documentation of respiratory rate and oxygen saturation occurred significantly more often if the order set with APS was used. Low respiration rate was also recognized significantly more frequently (P ≤ 05) in the APS order set group.Conclusions:  These findings show that use of a computerized PCA order set with monitoring requirements and an APS can increase monitoring and documentation of important vital signs and increase identification of potential negative events.
Bilateral inguinal hernia repair in a child with hyperekplexia
Authors: EPPRIGHT BRIAN , MAYHEW JAMES F 
Published: August 2010

SummaryThis is a case report of anesthesia for a child with a rare congenital disease marked by hyperreactivity of the neuromuscular system; hyperekplexia. Unlike other reports, she experienced no untoward effects from general anesthesia using sevoflurane, rocuronium and a caudal block.
Addition of morphine to local anesthetic infiltration does not improve analgesia after pediatric dental extractions
Authors: BHANANKER SANJAY M. , AZAVEDO LAWRENCE F. , SPLINTER WILLIAM M. 
Published: August 2010

SummaryBackground:  Opioid receptors have been noted in the peripheral nerve endings of afferent neurons. Blockade of these receptors with peripherally administered opioids is believed to result in analgesia.Methods:  In a prospective, randomized, double‐blind study, we studied the analgesic effects of adding a subsystemic dose of morphine to local anesthetic infiltration (lidocaine hydrochloride) during pediatric dental extractions. Forty‐two subjects, aged 2–7 years of ASA physical status I–II, were randomized to receive submucous infiltration with either morphine 25 μg·kg−1 in 2% lidocaine hydrochloride with 1 : 1 00 000 epinephrine (morphine group) or 2% lidocaine hydrochloride with 1 : 1 00 000 epinephrine (control group) at the end of surgery.Results:  There was no difference in postoperative analgesic requirements within the first 24 h. In‐hospital acetaminophen consumption was 85% in the morphine group compared with 81% in the control group.Conclusion:  We conclude that there is no benefit of adding a subsystemic analgesic dose of morphine to local anesthetics for analgesia after dental extractions in children.
The Shikani Optical Stylet: a useful adjunct to airway management in a neonate with popliteal pterygium syndrome
Authors: JANSEN ANDREA H. , JOHNSTON GRAHAM 
Published: August 2010

SummaryThe craniofacial abnormalities of popliteal pterygium syndrome present unique challenges to the pediatric anesthetist. Congenital fibrous bands between the maxilla and mandible limit mouth opening and the tongue may be fused to the palate. We describe the use of the Shikani Optical Stylet, a novel fiberoptic endoscope, in the airway management of a neonate with popliteal pterygium syndrome and syngnathia.
Clinical adaptation of a pharmacokinetic model of Propofol plasma concentrations in children
Authors: ENGELHARDT THOMAS , McCHEYNE ALAN J , MORTON NEIL , KARSLI CENGIZ , LUGINBUEHL IGOR , ADELI KHOSROW , WALSH WARREN , BISSONNETTE BRUNO 
Published: August 2010

SummaryBackground:  A previously published pharmacokinetic simulation suggested a simple manual infusion regimen to achieve propofol plasma concentrations of 3 μg·ml−1. This study investigated if a simple variation in propofol infusion rates is able to achieve distinct propofol plasma concentrations and whether these are close to the propofol plasma concentrations predicted by the Kataria model.Methods:  With Research Ethics Board approval and written parental consent, a total of 17 healthy children requiring general anaesthesia were enrolled. Following inhalational induction of anaesthesia, a propofol bolus of 5 mg·kg−1 was given and anaesthesia maintained using an adaptation of the McFarlan continuous propofol infusion regimen to achieve three distinct depths of propofol anaesthesia. Weight and propofol infusion data were used to calculate simulated propofol concentrations using the Kataria dataset and the tiva® simulation program. The performance of the infusion regimen was assessed by calculating the median performance error, median absolute performance error, wobble, and divergence.Results:  Measured propofol concentrations were (mean ± sd) 7.15 ± 1.4, 4.3 ± 0.85, and 2.85 ± 0.53 μg·ml−1 against simulation values of 6.6, 4.1, and 2.8 μg·ml−1, respectively, at 30, 50, and 70 min using the Kataria dataset. These differences were not significant. Formal assessment of the infusion regimen’s performance was acceptable.Conclusion:  The manual propofol infusion regimen achieved three distinct depths of propofol anaesthesia. The manual infusion regimen produced higher plasma propofol concentrations than predicted during the early part of the infusion period but was more accurate for later time points.