GABA is a modulator, rather than a classical transmitter, in the medial nucleus of the trapezoid body-lateral superior olive sound localization circuit.

Key Points: The lateral superior olive (LSO), a brainstem hub involved in sound localization, integrates excitatory and inhibitory inputs from the ipsilateral and the contralateral ear, respectively. In gerbils and rats, inhibition to the LSO reportedly shifts from GABAergic to glycinergic within the first three postnatal weeks. Surprisingly, we found no evidence for synaptic GABA signalling during this time window in mouse LSO principal neurons.

Impaired Glycine Receptor Trafficking in Neurological Diseases.

Ionotropic glycine receptors (GlyRs) enable fast synaptic neurotransmission in the adult spinal cord and brainstem. The inhibitory GlyR is a transmembrane glycine-gated chloride channel. The immature GlyR protein undergoes various processing steps, e.

PKA and PKC Modulators Affect Ion Channel Function and Internalization of Recombinant Alpha1 and Alpha1-Beta Glycine Receptors.

Glycine receptors (GlyRs) are important mediators of fast inhibitory neurotransmission in the mammalian central nervous system. Their function is controlled by multiple cellular mechanisms, including intracellular regulatory processes. Modulation of GlyR function by protein kinases has been reported for many cell types, involving different techniques, and often yielding contradictory results.

The factor time in fetal heart rate monitoring and the detection of acidosis using the WAS score.

Background: Using the naked eye evaluation of fetal heart rate (fhr) patterns remains difficult and is not complete. Computer-aided analysis of the fhr offers the opportunity to analyze fhr patterns completely and to detect all changes due to hypoxia and acidosis. It was the goal of this study to analyze the factor time in fetal monitoring and to evaluate the association between the fhr and the actual pH values in arterial umbilical blood.

Fetal heart rate patterns during delivery complicated by hypoxia and acidosis - a computer-aided analysis.

Background: Using the naked eye, evaluation of fetal heart-rate (FHR) patterns remains difficult and is not complete. Computer-aided analysis of the FHR offers the opportunity to analyse FHR patterns completely and to detect all changes possibly due to hypoxia and acidosis. It was the goal of this study to make these hypoxic changes of the FHR visible and to compare them directly with normal tracings.

Basic principles of the foetal heart rate during delivery without hypoxia and acidosis.

Background: Using naked-eye evaluation of foetal heart rate (FHR) patterns remains difficult and is not complete. Computer-aided analysis of the FHR offers the opportunity to analyse the FHR completely and to detect all changes due to hypoxia and acidosis. In order to better understand these changes FHR patterns in non-acidotic foetuses should be studied by first separating FHR into (i) basal FHR (baseline) and (ii) all decelerations.

The clinical significance of base excess (BEB) and base excess in the extracellular fluid compartment (BEEcf) with and without correction to real oxygen saturation of haemoglobin.

Background: Besides actual pH, base excess [ctH (+)(B) (mmol/l)] is of major importance since it is meant to reflect lactate acidosis due to foetal hypoxia; In vivo BE (B) is not independent from pCO (2). Independence is achieved by using the extended extracellular fluid (Ecf) for dilution of haemoglobin (cHb (B)) thus reducing cHb (B) to cHb (B)/3 (in the foetus to cHb (B)/4). Correction of ctH (+)(B) from the normally low foetal oxygen saturation by reoxygenation of Hb increases ctH (+)(B), resulting in 4 different variables: ctH (+)(B,act) (=BE (B)), ctH (+)(Ecf,act) (standard BE), ctH (+)(B,ox.

[How to define a non-reassuring FHR tracing online].

Background: Sub partu foetal heart-rate (FHR) patterns are difficult to evaluate. Until now we have no numerical criteria to reliably define what is a non-reassuring or even a 'pathological' FHR tracing. Computer-aided FHR analysis using the new WAS score offers the unique opportunity to assess numerical boundaries for these definitions.

Sensitivity, specificity, receiver-operating characteristic (ROC) curves and likelihood ratios for electronic foetal heart rate monitoring using new evaluation techniques.

Objective: Hypoxia and acidosis adversely influence many foetal organ functions. We wanted to know how foetal heart rate (FHR) patterns are mirrored by the fetal acid-base status and if they could serve for predicting the actual pH in umbilical artery (UA) blood. For this purpose we condensed the FHR phenomena into one figure which was to be used as a testing variable and to analyse the performance of the new testing procedure.

[A new approach to quantitative electronic foetal heart-rate analysis].

Background: Recently it was found that a significant correlation exists between the variables of the foetal acid-base balance (ABB) and the parameters of the foetal heart rate (FHR). This dependency can be used for diagnostic purposes. Until now FHR could be evaluated off- and online by computer using scoring procedures, i.

Outcome measures in perinatal medicine - pH or BE. The thresholds of these parameters in term infants.

Background: Hypoxia and severe foetal acidosis may lead to cerebral injuries and multi-organ failure. Base excess (BE) and actual pH determined in umbilical artery (UA) blood are valid parameters to measure (metabolic) acidosis. Until now there is no consensus worldwide as to which of the two parameters should preferably be used and which thresholds should be applied: the thresholds 7.

How to determine and use base excess (BE) in perinatal medicine.

Background: Foetal hypoxia may lead to multi-organ failure and cerebral injury. Usually this process is accompanied by severe metabolic acidosis. The base excess (BE) determined in umbilical artery (UA) blood is the most appropriate parameter to evaluate metabolic acidosis.

[Quantitative Cardiotocography--what does it look like and what can we expect].

Background: [corrected] Cardiotocography (CTG) seems to be a non-reliable, expensive but nevertheless practical method for fetal surveillance. Moreover, its diagnostic value is dependent on a long-standing experience of the obstetrician (midwife). It is difficult to define exact diagnostic criteria since nearly all CTG phenomena are lacking precise qualification by the naked eye.

[Outcome measures in perinatal medicine--pO2 and SO2. With remarks on pulse oximetry].

Background: Due to the outstanding pioneer work of Ronald E. Myers (Bethesda, Maryland) using term rhesus monkey fetuses we know for sure that hypoxia is the leading cause for brain damage and death when exposure occurs perinatally. He defined threshold values for oxygen content and time variables leading to death or cerebral injury.

[Measured quantities in perinatal medicine--the pCO(2)].

Background: For many years the interest of the obstetrician and neonatologist was focused on the base excess (BE) in umbilical artery (UA) blood. Otherwise, the pCO (2) (mmHg) value which is necessary to compute BE values played only a marginal role in our diagnostic evaluation of the fetus/newborn. This is especially true for pCO (2) values determined in umbilical venous (UV) blood and the feto-matemal interrelations of blood gases and the variables of the acid-base balance (ABB) in the fetus and the mother.

[Measured quantities in perinatal medicine--the base excess].

Background: There are convincing data from neonatal studies that the base excess (BE, mmol/L) measured in capillary or cord blood offers special diagnostic and prognostic power in the new-born compromised by hypoxia. For computation of BE the hemoglobin concentration (Hb, %), the oxygen saturation (%) and the distribution of the fetal fluid compartments are necessary. Until now these three factors, which differ in the fetus when compared with adults, have not been taken into account using automatic blood gas equipment.

[Comments on a report by the BQS on obstetric quality indicators].

When re-evaluating an epidemiologically oriented BQS expertise concerning the quality indicators in obstetrics, we examined three essential methods in obstetrics to verify their scientific evidence and their clinical relevance. In doing so we ascertained that recording the fetal heart rate sub part, analysing fetal blood and determining the blood gas of the umbilical blood are entirely appropriate quality indicators during delivery from a clinical and medical point of view -- although to varying extents. Above all, these three indicators prove to be essentially better evidence-based than described in the BQS expertise.

[CTG: microfluctuation].

Objective: Microfluctuation (MF) of fetal heart rate (FHR) is regarded as the most sensitive parameter for diagnosing the condition of the fetus. The MF can only be crudely quantified with the naked eye. Therefore the following questions arise: 1) How can MF be exactly measured numerically? 2) What interrelationships are there between the MF determined electronically, the basal FHR, the oscillation amplitude (OA) of the FHR and the beat-to-beat variability (beat-to-beat var.

[Quantitative CTG appraisal sub partu with a new CTG score: diagnostic significance of the parameters of the acid-base balance in umbilical blood?].

Background: As a role, the severity of "CTG pathology" in acute or chronic fetal hypoxia could only be registered but not quantified exactly by visual examination. For this reason, the term "CTG pathology" has not been unequivocally defined. The objective of the present study was to describe the dependence of fetal heart rate phenomena on the parameters of the acid-base balance quantitatively and to subject the latter to statistical analysis.

[Can subpartal fetal acidosis be avoided? Investigations on the complex causes of intrauterine asphyxia].

Objective: The extent to which faulty medical treatment and defective apparatus are concomitant causes for the development of subpartal acidosis was investigated in a retrospective study. At the same time, the incidence of acidosis in the Lippe-Detmold Hospital, Department of Gynaecology and Obstetrics, its morbidity and mortality were analysed.

Methods: Data from all case histories of neonates with acidosis (pH in the umbilical artery < 7.

[Computer-assisted analysis of intrapartum cardiotocodynagraphs].

Objective: To develop a numerical index by quantifying characteristic cardiotocography parameters in order to determine the intrauterine state of the fetus sub partu with sufficient accuracy to improve the diagnostic potential of cardiotocography. This score is then computerized for offline and online analysis.

Methods: The last 120 minutes of 406 directly recorded intrapartal cardiotocograms (CTG) were evaluated with a magnifying glass on the basis of conventional criteria.

[The cardiotocographic score of Hammacher in computer analysis].

Objective: After the quantitative, fully computerized evaluation of cardiotocography (CTG) after G.S. Dawes had yielded reliable results, an investigation was to be carried out to see whether a semiquantitative CTG analysis together with a CTG score (K.

[Initial results of the Erfurt Prevention of Prematurity Campaign].

Objectives: Genital infection particularly bacterial vaginosis (BV) increases the relative risk of prematurity. Detection of disturbances of vaginal milieu at an early stage and the use of suitable countermeasures such as intervention with antimicrobial substances, e.g.