Attenuated adult biphasic shocks compared with weight-based monophasic shocks in a swine model of prolonged pediatric ventricular fibrillation.

Aim: To compare the safety and efficacy of attenuated adult biphasic shocks with standard monophasic weight-based shocks in a piglet model of prolonged prehospital ventricular fibrillation (VF).

Background: If attenuated adult shocks are safe and effective for prehospital pediatric VF, automated external defibrillators (AEDs) can be easily adapted for pediatric use.

Methods: After 7 min of untreated VF, piglets were randomized to treatment with attenuated adult biphasic shocks or weight-based monophasic shocks.

Hyponatremic hypertensive syndrome (HHS) in an 18-month old-child presenting as malignant hypertension: a case report.

Background: The combination of hyponatremia and renovascular hypertension is called hyponatremic hypertensive syndrome (HHS). Malignant hypertension as a presentation has been reported in adults with HHS but is rare in children.

Case Presentation: An eighteen month-old male presented with drowsiness, sudden onset status epilepticus and blood pressure of 210/160.

Imatinib mesylate effectively combines with chaperone-rich cell lysate-loaded dendritic cells to treat bcr-abl+ murine leukemia.

Imatinib mesylate has become an effective agent for the treatment of chronic myeloid leukemia (CML). However, the development of drug resistance has led to examination of combination therapies. In this study, we investigated the effects of combining imatinib with immunotherapy against a murine bcr-abl(+) leukemia, 12B1.

Nasal dyspnea: the place of rhinomanometry in its objective assessment.

Background: "Nasal dyspnea" describes the common symptom of nasal airway obstruction, which usually is assessed subjectively. Objective, quantitative methods are needed to assess the nasal airway adequately.

Methods: Rhinomanometry, in use for >30 years, was reviewed.

A bitter pill: attempting change in a pediatric morning report.

Objective: To assess and address participants' dissatisfaction with departmental morning report (MR).

Methods: Three consecutive MR sessions were observed, and those data, in combination with findings from the literature, were used to guide creation of a quantitative survey. The survey was administered to all faculty and housestaff.

Successful thrombolysis of acute left atrial thrombi in two pediatric patients following interventional cardiac catheterization.

Acute left atrial intracardiac thrombi require aggressive therapy due to the risk of embolization and cerebrovascular accidents. Current treatment includes the use of high-dose recombinant tissue plasminogen activator (rTPA), which is associated with significant bleeding complications. We report the successful treatment of two pediatric patients with acute left atrial thrombi following interventional cardiac catheterizations using low-dose rTPA.

Gender differences in organ density in a rat simulated microgravity model.

Research investigating the physiological effects of microgravity on the human body has demonstrated a shift of body fluids in actual spaceflight and in simulated Earth-based microgravity models in both males and females, possibly causing many deleterious physiological effects. Twenty-five anatomically normal female (NF) and 20 ovariectomized (OE) Fischer 344 rats were randomly selected to be in an experimental (1 h of 45 degrees head-down tilt, 45HDT) or control (1 h of prone position) group. At the end of the hour experimental period, the density of the brain, lungs, heart, liver, and left and right kidneys were measured using spiral computed tomography (SCT) while the rats remained in their experimental positions.

Hormone-refractory breast cancer remains sensitive to the antitumor activity of heat shock protein 90 inhibitors.

Purpose: The antiestrogen tamoxifen (Tam) has been used as therapy against estrogen receptor (ER)-positive breast cancer for decades. Most tumors respond initially, but resistance frequently develops. The ER exists in a multiprotein complex containing the molecular chaperone heat shock protein (Hsp) 90, which is known to regulate the stability and activity of this receptor.

Forkhead genes and human disease.

Forkhead, or Fox-box genes, code for winged helix transcription factors that make up a multi-gene family. Two human genetic diseases have recently been associated with loss of function of one allele of different Fox-box genes: Axenfeld-Rieger anomaly of the anterior eye chamber associated with haploinsufficiency of FOXC1 and lymphedema-distichiasis associated with haploinsufficiency of FOXC2. Earlier, both genes had been studied intensively for their transcription patterns and for the phenotypes of knockouts.

Does chromosome 22 have anything to do with sex determination: further studies on a 46,XX,22q11.2 del male.

Several years ago, we presented a patient with true hermaphroditism and partial duplication of chromosome 22 and no evidence of SRY (Aleck et al. [1999: Am J Med Genet 85:2-4]). Recently a 46,XX male with velocardiofacial syndrome and a deletion of 22q11.

The stress response: implications for the clinical development of hsp90 inhibitors.

In their role as molecular chaperones, heat shock proteins serve as central integrators of protein homeostasis within cells. As part of this function, they guide the folding, assembly, intracellular disposition and proteolytic turnover of many key regulators of cell growth, differentiation and survival. Not surprisingly then, heat shock proteins are over expressed in many types of cancer, and induction of the stress response may actually be required for cells to tolerate the genetic disarray characteristic of malignant transformation.

A pilot study of the use of guided imagery for the treatment of recurrent abdominal pain in children.

Few effective therapies are available for children with recurrent abdominal pain (RAP). Relaxation and guided imagery have been shown to impact the autonomic nervous system, which is altered in patients with functional gastrointestinal disorders. Ten children with RAP were enrolled in the study after evaluation by a pediatric gastroenterologist.

Regulation of intestinal NaPi-IIb cotransporter gene expression by estrogen.

The current experiments were designed to study the effect of beta-estradiol on type IIb sodium-coupled phosphate (NaPi-IIb) cotransporter gene expression. Uptake studies with intestinal brush-border membrane vesicles (BBMV) showed that estrogen treatment increased sodium-dependent phosphate absorption by approximately 45% in rat intestine. Northern blot analysis indicated that NaPi-IIb mRNA expression was increased by approximately 50% after estrogen treatment.

Expression of a unique drug-resistant Hsp90 ortholog by the nematode Caenorhabditis elegans.

In all species studied to date, the function of heat shock protein 90 (Hsp90), a ubiquitous and evolutionarily conserved molecular chaperone, is inhibited selectively by the natural product drugs geldanamycin (GA) and radicicol. Crystal structures of the N-terminal region of yeast and human Hsp90 have revealed that these compounds interact with the chaperone in a Bergerat-type adenine nucleotide-binding fold shared throughout the gyrase, Hsp90, histidine kinase mutL (GHKL) superfamily of adenosine triphosphatases. To better understand the consequences of disrupting Hsp90 function in a genetically tractable multicellular organism, we exposed the soil-dwelling nematode Caenorhabditis elegans to GA under a variety of conditions designed to optimize drug uptake.

Acute myelo-monocytic infiltrate of the lower esophagus in a 4-year-old renal transplant recipient.

Background: Acute myeloid leukemia after solid organ transplantation is a rare phenomenon. Few achieve remission; most succumb to relapse and infection.

Methods: A 4-year-old male renal transplant recipient on triple immunosuppression had culture-negative high spiking fever, persistent leukopenia, anemia and severe gastritis.

The SLC20 family of proteins: dual functions as sodium-phosphate cotransporters and viral receptors.

The SLC20 family transport proteins were originally identified as retroviral receptors (called Glvr-1 and Ram-1). Since then, they have been shown to function as sodium-phosphate (Na/P(i)) cotransporters, and have subsequently been classified as type III Na/P(i) cotransporters (now called Pit-1 and Pit-2). The Pit cotransporters share approximately 60% sequence homology, they have a high affinity for P(i), they are electrogenic with a coupling stoichiometry of >1 Na(+) per P(i) ion cotransported, and are inhibited by alkaline pH and phosphonoformic acid (PFA).

Pediatricians' evaluations of their residency curriculum in emergency medicine.

Objective: To describe residency graduates' perceptions of their preparation for providing pediatric emergency medical care.

Methods: The design was a cross-sectional survey set in a university-affiliated pediatric residency program. Twenty residency graduates from 1994 and 1995 who did not have an emergency department (ED) rotation (pre-ED group) and 24 graduates from 1998 and 1999 who had an ED rotation (post-ED group) participated in the study.

Tumor-derived chaperone-rich cell lysates are effective therapeutic vaccines against a variety of cancers.

With the clinical use of purified, tumor-derived chaperone proteins as anti-cancer vaccines already in clinical trial stages, we have focused our attention on the utility of chaperone-rich cell lysates (CRCL) in cancer immunotherapy. CRCL, as prepared from tumor lysates via a free solution-isoelectric focusing (FS-IEF) technique, is a high-yield vaccine enriched for numerous chaperone proteins. We have compared the efficacy of CRCL vaccines to that of individual chaperone protein vaccines in in vivo settings, including ELISPOT assays, tumor-growth assays and survival assays.

Maternal milk reduces severity of necrotizing enterocolitis and increases intestinal IL-10 in a neonatal rat model.

Necrotizing enterocolitis (NEC) is a devastating intestinal disease of premature infants. Maternal milk has been suggested to be partially protective against NEC; however, the mechanisms of this protection are not defined. The aim of this study was to examine the effect(s) of artificial feeding of rat milk (RM)-versus cow milk-based rat milk substitute (RMS) on the development of NEC in a neonatal rat model and elucidate the role of inflammatory cytokines in NEC pathogenesis.

Femoral central venous catheter-associated deep venous thrombosis in children with diabetic ketoacidosis.

Objective: To describe the incidence of clinical deep venous thrombosis associated with femoral central venous catheters (CVC-DVT) in children with diabetic ketoacidosis (DKA).

Design: Retrospective case-matched control series.

Setting: Pediatric intensive care units of two university-affiliated hospitals.

Hepatic inflammatory mediators contribute to intestinal damage in necrotizing enterocolitis.

Necrotizing enterocolitis (NEC) is a common and devastating gastrointestinal disease of premature infants. Along with pathological effects in the ileum, severe NEC is often accompanied by multisystem organ failure, including liver failure. The aim of this study was to determine the changes in hepatic cytokines and inflammatory mediators in experimental NEC.