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This paper focuses on the spurious noise of the Ffowcs Williams and Hawkings equation with a permeable integral surface, which is now commonly used in far-field noise prediction for computational aeroacoustics methodologies. Spurious noise arises in the surface integral terms as an adverse effect of truncating a computational domain resolved for the quadrupole sources so that hydrodynamic fluctuations pass through the integral surface with mean flow. First, the quadrupole contribution is reformulated in the form of surface integrals for additive correction by introducing a frozen turbulence assumption for uniform mean flow. The math formulation is verified for simple convecting vortices. The derived formulation is then extended to nonuniform convection for locally subsonic flow. By adding the correction to the conventional Ffowcs Williams and Hawkings surface integrals, spurious noise is suppressed in two-dimensional wake flow. In a three-dimensional turbulent jet-noise simulation, the proposed correction, extended to nonuniform convection, is demonstrated to reduce the dependence of the prediction on the streamwise end-cap location of the integral surface. The present method requires no tunable parameters, with only a minimal additional cost compared to the conventional permeable-surface integrals in the far-field noise computation. [ABSTRACT FROM AUTHOR]

Aerodynamics of cambered airfoils are investigated numerically, using a NACA four-digit series of 6 % thickness at low Reynolds number Re = 10,000 and moderate Mach number M = 0.2, by focusing on the relation of aeroacoustic effects and hydrodynamic flow unsteadiness. Two-dimensional numerical simulations show that the onset of an acoustic feedback loop leads to an abrupt increase in lift force. Associated with the feedback process, the evolution of two-dimensional vortices in the suction-side boundary layer shifts a separation bubble toward the leading edge, which causes a relatively steep pressure recovery near the trailing edge. Through a parametric study on airfoil shape, the aerodynamically favorable feature of aft camber is further enhanced with the presence of an acoustic feedback loop. In addition, the aft camber airfoil successfully forms a laminar separation bubble in three-dimensional calculations at the present Reynolds number, developing transitional behavior on the suction side, supposedly prompted by the airfoil tones. Although the boundary layer shows three-dimensional complexity, still the formation of an acoustic feedback loop is strongly suggested, via the comparison of spanwise correlations. [ABSTRACT FROM AUTHOR]

Objective Effect of free radical scavenger, 3-methyl-lphenyl2pyrazolin-5 one (MCI-186), on perinatal hypoxic-ishchemic brain injury was studied. Methods Seven-day-old Wistar rats (n = 48) were subjected to modified Levine's procedure (left carotid artery ligation with 2 hr 8% hypoxia), then given either vehicle or MCI-186 at the dosage of 9 mg/kg intraperitonealy. Thiobarbituric Acid Reactive substances (TBARS) was used as an index of lipid peroxidation. Brain hemispheres were homogenized. TBARS was measured at 2 (n = 12), 5 (n = 12), 24 (n = 12) and 48 (n = 12) hr after injection by spectroflurometry. Data are presented as mean ± SEM. Results The TBARS level (µmol/mg brain tissue) of the ligated side (vehicle vs. MCI-186) was 55.3 ± 14.1 vs. 35.4 ± 5.2 at 2 h (ns, unpaired t test), 227.7±67.2 vs. 20.3 ± 8.4 at 5 hr (P < 0.001), 238.4 ± 75.4 vs. 55.0 ± 9.8 at 24 hr (P < 0.001), and 103.8 ± 23.8 vs. 97.8 ± 12.1 at 48 hr (ns). Thus, MCI-186 significantly reduced TBARS levels at 5 and 24 hr after injection. Conclusion This result shows that MCI-186 has a free radical scavenging effect on hypoxic-ischemic brain damage in neonatal rat model. [ABSTRACT FROM AUTHOR]

Aim Noninvasive blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) has recently been used to evaluate placental oxygenation. However, this method still has unresolved problems, such as long testing times and lack of normal values set. In the present study, we used a shorter protocol in BOLD-MRI and established normal values for placental oxygenation in late pregnancy. Methods We recruited 18 healthy singleton pregnant women (>32 weeks of gestation) who had a normal body size before pregnancy and a normal course of pregnancy. They underwent BOLD-MRI with three consecutive 4-min periods of different oxygenation: normoxia (21% O2), hyperoxia (10 L O2/min), and then normoxia. Placental time–activity curves were presented as signal intensity change relative to baseline (ΔR2*). The time from starting maternal oxygen administration to peak ΔR2*. To assess the relationship between peak ΔR2* values and placenta-related parameters and fetal development, the correlation between peak ΔR2*, placental weight, and neonatal birth weight was evaluated using Spearman’s rank correlation test. Results In all cases, the BOLD signal was elevated by maternal oxygen administration, with the peak resolving within 4 min after the end of oxygen administration. Peak ΔR2* and time to peak ΔR2* during oxygenation were 7.99 ± 2.58, and 458.1 ± 73.9 s, respectively. There was a significant correlation between peak ΔR2* and neonatal birth weight (percentile) (r = 0.537, p = .022), and between placental weight and neonatal birth weight (r = 0.769, p < .01). Conclusions In all cases, the BOLD signal increased with maternal hyperoxia using this protocol. So, 4 min observation following maternal oxygen administration is sufficient for peak ΔR2* evaluation. These reference values set in this study may be one of the indicators of BOLD signal changes in normal pregnancies after 32 weeks of gestation. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to measure the blood levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) before and after tadalafil treatment in patients with fetal growth restriction. Materials and methods Maternal blood was collected from 13 women before and 2 weeks after tadalafil administration in the TADAFER II trial. The tadalafil treatment was conducted in addition to the conventional FGR treatment. As a control, maternal blood was also collected from 11 women before and 2 weeks after conventional treatment for fetal growth restriction. Blood sFlt-1 and PlGF were measured and the sFlt-1/PlGF ratio was calculated. Student’s t-test was used to statistically analyze differences in the sFlt-1 and PlGF levels, and in the sFlt-1/PlGF ratios. Results In both treatment groups, the levels of sFlt-1 and PlGF before and after treatment were not significantly different from each other. The sFlt-1/PlGF ratio was 2.0 ± 1.0 before and 17.6 ± 11.3 after treatment in the control group (p=.04). The sFlt-1/PlGF ratio was 2.2 ± 1.1 before and 22.2 ± 10.6 after tadalafil treatment in the tadalafil group (p=.06). The sFlt-1/PlGF ratios before and after tadalafil treatment were significantly increased in the control group. In both treatment groups, the sFlt-1/PlGF ratios before and after treatment were less than 38. Conclusions We conclude that the levels of sFlt-1 and PlGF were not significantly different as a result of tadalafil treatment. Further studies are needed to understand the mechanism of action of tadalafil in the treatment of fetal growth restriction. [ABSTRACT FROM AUTHOR]

Background To clarify whether the use of balloons for cervical ripening is associated with the incidence of umbilical cord prolapse. Methods A postal questionnaire survey was distributed in Japan. Cases of umbilical cord prolapse occurring during labor in association with the use of balloons for cervical ripening between 2007 and 2011 in Japan were analyzed. Results Answers from 942 institutions were obtained. The subjects included 369 patients with forelying or prolapse of the umbilical cord among a total of 2,037,460 deliveries. Among the singleton vertex cases, fore-lying or prolapse of the umbilical cord during labor were observed in 88 (0.005%) of 1,891,189 deliveries not associated with the use of balloons for cervical ripening and in 93 (0.064%) of 146,271 deliveries associated with the use of balloons for cervical ripening (Odds ratio 13.67, 95% confidence interval 10.21, 18.30). All types of balloons were significantly associated with the occurrence of fore-lying or prolapse of the umbilical cord. A total of 39% of cases of umbilical cord prolapse occurred during manual or spontaneous balloon removal, while 53% of cases occurred after a while not directly associated with balloon removal. Conclusion The risk of umbilical cord prolapse was significantly increased during the use of balloons for cervical ripening, especially in cases involving the use of disk-type and ball-type balloons filled with large amounts of water. [ABSTRACT FROM AUTHOR]

Objective: We conducted a retrospective study in which we evaluated the feasibility and effectiveness of total vaginectomy for isolated vaginal recurrence of cervical cancer that had been treated surgically. Such recurrence is uncommon, and there is no consensus regarding the treatment strategy. Methods: Included in our study were 6 patients who, between January 2012 and December 2019, had undergone laparoscopic vaginectomy for vaginal recurrence of cervical cancer or high-grade squamous intraepithelial lesion that had been treated by hysterectomy. Results: The patients ranged in age from 49 to 78 years (median, 68 years). Vaginectomy time ranged from 128 to 385 minutes (median, 176.5 minutes), and estimated blood loss ranged from 40 to 310 mL (median, 105 mL). Patients' hospital stay ranged from 7 to 29 days (median, 14 days). Two intraoperative complications occurred: a grade 1 small bowel injury in 1 patient and a grade 1 bladder injury in another. An abdominal abscess developed postoperatively in 1 patient. Conclusions: Local control was achieved in 5 of the 6 patients. Our data support both the feasibility and effectiveness of laparoscopic total vaginectomy for isolated vaginal recurrence of cervical cancer or high-grade squamous intraepithelial lesion after hysterectomy. [ABSTRACT FROM AUTHOR]

Fetal heart rate variability (FHRV) is a key index of antenatal and intrapartum fetal well-being. FHRV is well established to be mediated by both arms of the autonomic nervous system, but it remains unknown whether higher centers in the forebrain contribute to FHRV. We tested the hypothesis that selective forebrain ischemia would impair the generation of FHRV. Sixteen chronically instrumented near-term fetal sheep were subjected to either forebrain ischemia induced by bilateral carotid occlusion or sham-ischemia for 30 min. Time, frequency, and nonlinear measures of FHRV were assessed during and for seven days after ischemia. Ischemia was associated with profound suppression of electroencephalographic (EEG) power, which remained suppressed throughout the recovery period (P < 0.001). During the first 5 min of ischemia, multiple time and frequency domain measures were increased (all P < 0.05) before returning back to sham levels. A delayed increase in sample entropy was observed during ischemia (P < 0.05). For the first 3 h after ischemia, there was moderate suppression of two measures of FHRV (very-low frequency power and the standard deviation of RR-intervals, both P < 0.05) and increased sample entropy (P < 0.05). Thereafter, all measures of FHRV returned to control levels. In conclusion, profound forebrain ischemia sufficient to lead to severe neural injury had only transient effect on multiple measures of FHRV. These findings suggest that the forebrain makes a limited contribution to FHRV. FHRV therefore primarily originates in the hindbrain and is unlikely to provide meaningful information on forebrain neurodevelopment or metabolism. [ABSTRACT FROM AUTHOR]

Asafinalconsiderationontheautonomicoriginsofmeasures of FHRV, if intrapartum FHRV is solely mediated by parasympathetic activity (7, 8), then all measures of FHRV appliedtolabormustdefactobecomemeasuresofparasympathetic-mediated FHRV once decelerations of fetal heart rate are present. Lear CA, Galinsky R, Wassink G, Mitchell CJ, Davidson JO, Westgate JA, Bennet L, Gunn AJ. Lear CA, Westgate JA, Kasai M, Beacom MJ, Maeda Y, Magawa S, MiyagiE,IkedaT,BennetL,GunnAJ. Lear CA, Kasai M, Drury PP, Davidson JO, Miyagi E, Bennet L, GunnAJ. [Extracted from the article]

Background: Pelvic lymphadenectomy should be considered the standard of care for endometrial cancer patients with intermediate-risk. In such cases, lymph node assessment may be performed via a minimally invasive approach. Situs inversus totalis is a congenital condition wherein the major visceral organs are reversed or mirrored from their normal anatomical positions. Reports state that performing surgery on patients with this condition is difficult due to the anatomical abnormality. However, few clinical studies have been conducted to evaluate the efficacy of robotic surgery for endometrial cancer patients with situs inversus totalis because it is technically challenging. Case presentation: A 69-year-old woman with situs inversus totalis (gravida 2 para 2) was brought to our hospital due to a uterine tumor. Endometrial biopsy showed grade 1 endometrioid carcinoma. Using 3 dimensional -computed tomography reconstruction, her common iliac arteries and veins were found to be reversed or mirrored from their normal positions. She underwent hysterectomy with pelvic lymphadenectomy using the multi-articulated arms or 3 dimensional high-definite vision of the da Vinci® surgical system, and 19 lymph nodes were harvested. She was followed up for 24 months without signs of recurrence. Conclusion: The multi-articulated arms or 3 dimensional high-definite vision of the da Vinci® surgical system may be a feasible and safe approach for performing a pelvic lymphadenectomy on patients with situs inversus totalis using 3 dimensional computed tomography analysis. [ABSTRACT FROM AUTHOR]

Antenatal glucocorticoids improve outcomes among premature infants but are associated with hyperglycemia, which can exacerbate hypoxic-ischemic injury. It is still unclear how antenatal glucocorticoids or hyperglycemia modulate fetal cardiovascular adaptations to severe asphyxia. In this study, preterm fetal sheep received either saline or 12 mg im maternal dexamethasone, followed 4 h later by complete umbilical cord occlusion (UCO) for 25 min. An additional cohort of fetuses received titrated glucose infusions followed 4 h later by UCO to control for the possibility that hyperglycemia contributed to the cardiovascular effects of dexamethasone. Fetuses were studied for 7 days after UCO. Maternal dexamethasone was associated with fetal hyperglycemia (P < 0.001), increased arterial pressure (P < 0.001), and reduced femoral (P < 0.005) and carotid (P < 0.05) vascular conductance before UCO. UCO was associated with bradycardia, femoral vasoconstriction, and transient hypertension. For the first 5 min of UCO, fetal blood pressure in the dexamethasone- asphyxia group was greater than saline-asphyxia (P < 0.001). However, the relative increase in arterial pressure was not different from saline-asphyxia. Fetal heart rate and femoral vascular conductance fell to similar nadirs in both saline and dexamethasoneasphyxia groups. Dexamethasone did not affect the progressive decline in femoral vascular tone or arterial pressure during continuing UCO. By contrast, there were no effects of glucose infusions on the response to UCO. In summary, maternal dexamethasone but not fetal hyperglycemia increased fetal arterial pressure before and for the first 5 min of prolonged UCO but did not augment the cardiovascular adaptations to acute asphyxia. [ABSTRACT FROM AUTHOR]

Fetal heart rate variability (FHRV) is a widely used index of intrapartum well being. Both arms of the autonomic system regulate FHRV under normoxic conditions in the antenatal period. However, autonomic control of FHRV during labor when the fetus is exposed to repeated, brief hypoxemia during uterine contractions is poorly understood. We have previously shown that the sympathetic nervous system (SNS) does not regulate FHRV during labor-like hypoxia. We therefore investigated the hypothesis that the parasympathetic system is the main mediator of intrapartum FHRV. Twenty-six chronically instrumented fetal sheep at 0.85 of gestation received either bilateral cervical vagotomy (n = 7), atropine sulfate (n = 7), or sham treatment (control, n = 12), followed by three 1-min complete umbilical cord occlusions (UCOs) separated by 4-min reperfusion periods. Parasympathetic blockade reduced three measures of FHRV before UCOs (all P < 0.01). Between UCOs, atropine and vagotomy were associated with marked tachycardia (both P < 0.005), suppressed measures of FHRV (all P < 0.01), and abolished FHRV on visual inspection compared with the control group. Tachycardia in the atropine and vagotomy groups resolved over the first 10 min after the final UCO, in association with evidence that the SNS contribution to FHRV progressively returned during this time. Our findings support that SNS control of FHRV is acutely suppressed for at least 4 min after a deep intrapartum deceleration and takes 5-10 min to recover. The parasympathetic system is therefore likely to be the key mediator of FHRV once frequent FHR decelerations are established during labor. [ABSTRACT FROM AUTHOR]

Fetal heart rate (FHR) variability (FHRV) and ST segment morphology are potential clinical indices of fetal well-being during labor. -Adrenergic stimulation by circulating catecholamines has been hypothesized to contribute to both FHRV and ST segment morphology during labor, but this has not been tested during brief repeated fetal hypoxemia that is characteristic of labor. Near-term fetal sheep (0.85 gestation) received propranolol (-adrenergic blockade; n =10) or saline (n= 7) 30 min before being exposed to three 2-min complete umbilical cord occlusions (UCOs) separated by 3-min reperfusions. T/QRS ratio was calculated throughout UCOs and reperfusion periods, and measures of FHRV (RMSSD, SDNN, and STV) were calculated between UCOs. During the baseline period, before the start of UCOs, propranolol was associated with reduced FHR, SDNN, and STV but did not affect RMSSD or T/QRS ratio. UCOs were associated with rapid FHR decelerations and increased T/QRS ratio; propranolol significantly reduced FHR during UCOs and was associated with a slower rise in T/QRS ratio during the first UCOs, without affecting the maximal rise or T/QRS ratio during the second and third UCO. Between UCOs propranolol reduced FHR and T/QRS ratio but did not affect any measure of FHRV. These data demonstrate that circulating catecholamines do not contribute to FHRV during labor-like hypoxemia. Furthermore, circulating catecholamines did not contribute to the major rise in T/QRS ratio during labor-like hypoxemia but may regulate T/QRS ratio between brief hypoxemia. [ABSTRACT FROM AUTHOR]

Background: Severe early-onset fetal growth restriction occurs in 0.4 % of all pregnancies, and the prognoses of these patients are dismal. Severely growth-restricted fetuses (far below 500 g) are thought to be nonviable. Since there have not been effective treatments for such fetal patients, obstetricians have simply tried to identify the optimal timing for their delivery. There are a few reports suggesting that the phosphodiesterase type 5 inhibitor sildenafil has some limited beneficial effects on fetal growth, but there are no such reports on tadalafil, another derivative phosphodiesterase type 5 inhibitor which has a much longer half-life than sildenafil. Here we present a case in which the administration of tadalafil to the mother revived the arrested growth and severe oligohydramnios of the very prematurely growth-restricted fetus. Case presentation: We describe a case of early-onset fetal growth restriction with oligohydramnios in a 41-year-old primigravida Japanese woman who was treated with tadalafil (20-mg tablet daily) from 22 weeks' gestational age. Ten days after the initiation of the tadalafil therapy, the amniotic fluid level rose and the weight of the fetus began to increase. A 1024-g baby boy was delivered by cesarean at 32 weeks' gestation. The z-score for fetal head circumference had increased from -2.2 to -1.2, whereas the z-score of the femur legth was decreased to -4.3, indicating that tadalafil preferentially increased the blood flow to important organs. Conclusions: We achieved two positive results by administering tadalafil to the mother carrying a severely growth-restricted fetus with oligohydramnios. First, the z-scores of head circumference and abdominal circumference had at first declined but started to rise after the tadalafil administration. Second, the amniotic fluid, which was emptied before the tadalafil treatment, recovered to normal range with this treatment. Tadalafil administration to mothers could be a promising therapy to reverse severe fetal growth restriction and oligohydramnios. [ABSTRACT FROM AUTHOR]

Reports of pregnancy following treatment for vulvar carcinoma are extremely uncommon, as the main problem of subsequent pregnancy is vulvar scarring following radical surgery. We herein report the case of a patient who was diagnosed with stage I squamous cell carcinoma of the vulva at the age of 17 years and was treated with multimodal therapy, including neoadjuvant chemotherapy, wide local excision with bilateral inguinal lymph node dissection and adjuvant radiotherapy. The patient became pregnant spontaneously 9 years after her initial diagnosis and the antenatal course was good, except for mild acute pyelonephritis at 25 weeks of gestation. An elective caesarean section was performed at 38 weeks of gestation due to vulvar scarring following multimodal therapy, particularly radiotherapy. The patient remains alive and well, without signs of recurrence or metastasis 12 years after her diagnosis and treatment. Radical vulvectomy as well as multimodal therapy for vulvar carcinoma, particularly radiotherapy, may cause extensive skin scarring. The presence of vulvar scarring following multimodal therapy for vulvar carcinoma may increase the incidence of caesarean delivery. [ABSTRACT FROM AUTHOR]

Objectives: Amniotic fluid embolism exhibits activation of the complement system and the kallikrein-kinin and coagulofibrinolytic systems. C1 esterase inhibitor is a major inhibitor of C1 esterase and can inhibit plasma kallikrein and also factors XIIa and XIa. Its activity has been shown to be significantly lower in pregnancy and labor than in the nonpregnant state. The purpose of this study was to determine CI esterase inhibitor activity levels in amniotic fluid embolism. Design: Retrospective study. Setting: A single university-based center. Patients: One hundred six cases with amniotic fluid embolism in a total of 194 singleton pregnant women between January 2010 and December 2011. Interventions: None. Measurements and Main Results: One hundred six cases of amniotic fluid embolism had applied to the Japan amniotic fluid embolism registration center in Hamamatsu University School of Medicine between January 2010 and December 2011. In amniotic fluid embolism cases, 85 cases were nonfatal and 21 cases were fatal. Eighty-eight women who delivered without amniotic fluid embolism were regarded as a control. C1 esterase inhibitor activity levels were significantly lower in amniotic fluid embolism patients (30.0% ± 1.8%) than in control women (62.0% ± 2.0%) (p < 0.0001 ). C1 esterase inhibitor activity levels in fatal amniotic fluid embolism cases (22.5% ± 3.4%) were significantly lower than those in nonfatal amniotic fluid embolism cases (32.0% ± 2.1%) (p< 0.05). Conclusions: These results demonstrated that low C1 esterase inhibitor activity levels were closely associated with the pathogenesis of amniotic fluid embolism suggesting that C1 esterase inhibitor activity levels have potential as a prognosis factor of amniotic fluid embolism. [ABSTRACT FROM AUTHOR]

Species distribution and antifungal susceptibility of Candida isolates at one institution were evaluated. Detection rates of fungi were examined for 5 years between 2007 and 2011. Sensitivities of fungi to amphotericin B, flucytosine, fluconazole, micafungin, itraconazole, and voriconazole were evaluated in blood culture-positive patients. A total of 3,832 fungal isolates were detected, including Candida albicans 66.5%, Candida glabrata 20.3%, Candida parapsilosis 6.2%, Candida tropicalis 5.5%, and others 1.5%. Candidemia was diagnosed in 131 patients, and C. albicans, C. parapsilosis, C. glabrata, C. tropicalis, and others were present in 42.0%, 27.5%, 16.0%, 8.4%, and 6.1% of these patients, respectively. Voriconazole had the lowest MIC90S against C. albicans and C. parapsilosis (0.015 and 0.25). Micafungin had a low MIC90 against C. glabrata and C. tropicalis. C. albicans was the most common fungus in patients with candidemia. Voriconazole and micafungin were effective against C. albicans. Amphotericin B was effective for C. parapsilosis, and micafungin showed good efficacy against C. glabrata and C. tropicalis. [ABSTRACT FROM AUTHOR]

Mesenchymal stem cells (MSC) have been reported to be an attractive therapeutic cell source for the treatment of renal diseases. Recently, we reported that transplantation of allogenic fetal membrane-derived MSC (FM-MSC), which are available noninvasively in large amounts, had a therapeutic effect on a hindlimb ischemia model (Ishikane S, Ohnishi S, Yamahara K, Sada M, Harada K, Mishima K, Iwasaki K, Fujiwara M, Kitamura S, Nagaya N, Ikeda T. Stem Cells 26: 2625-2633, 2008). Here, we investigated whether allogenic FM-MSC administration could ameliorate renal injury in experimental glomerulonephritis. Lewis rats with anti-Thy1 nephritis intravenously received FM-MSC obtained from major histocompatibility complex-mismatched ACI rats (FM-MSC group) or a PBS (PBS group). Nephritic rats exhibited an increased urinary protein excretion in the PBS group, whereas the FM-MSC group rats had a significantly lower level of increase (P 0.05 vs. PBS group). FM-MSC transplantation significantly reduced activated mesangial cell (MC) proliferation, glomerular monocyte/ macrophage infiltration, mesangial matrix accumulation, as well as the glomerular expression of inflammatory or extracellular matrixrelated genes including TNF-α, monocyte chemoattractant protein 1 (MCP-1), type I collagen, TGF-β, type 1 plasminogen activator inhibitor (PAI-1) (P < 0.05 vs. PBS group). In vitro, FM-MSCderived conditioned medium significantly attenuated the expression of TNF-α and MCP-1 in rat MC through a prostaglandin E2-dependent mechanism. These data suggest that transplanted FM-MSC contributed to the healing process in injured kidney tissue by producing paracrine factors. Our results indicate that allogenic FM-MSC transplantation is a potent therapeutic strategy for the treatment of acute glomerulonephritis. [ABSTRACT FROM AUTHOR]

Objective We investigated the effects of lipopolysaccharide (LPS) on neonatal rat brain damage after intermittent hypoxia Methods On postnatal day 7, Wistar rats were separated into 3 groups: (1) LPS administration with hypoxia-ischemia (i. p. 1 mg/kg, n = 46, LPS/HI) G2) sahne administration with hypoxia-ischemia (n = 42, saline/HI) and (3) LPS administration alone (n = 16, LPS alone). At 4 h after injection rats from LPS/HI and saline/HI group were exposed to unilateral carotid artery ligation followed by repeating a 10 minutes of experimental period (2min of hypoxia and 8min of recovery) for 10 times at 33°C. All rats were sacrificed after 7 days and the brains were histologically studied by HE staining Results Mortality rate during the experiment was not different among the groups. Neuronal loss was detected in the cerebral cortex and the hippocampus. Animals with neuronal loss were significantly increased in LPS/HI group (21%), compared with saline/HI group (0%, P < 0.003) Conclusion LPS administration worsened hypoxic-ischemic brain damage in the newborn rats exposed to intermittent hypoxia. It may give some clinical relevances that repetitive uterine contractions would affect neonatal neurological outcomes with intrauterine infection. [ABSTRACT FROM AUTHOR]

AbstractCase report??We report a complicated extremely low-birth-weight (ELBW) infant with posthemorrhagic hydrocephalus after intraventricular hemorrhage and preceding stoma creation after bowel perforation who was treated with staged operations, including shunting and external ventricular drainage. The first operation was a temporary valveless ventriculoperitoneal (VP) shunt placement until the time of the stoma closure. The stoma was successfully closed 3?months after the first operation when the peritoneal tube was drawn out from the chest wall and the VP shunt system was temporarily used as an external drainage with a long subcutaneous tunnel. One month after the second operation, final VP shunt placement was performed after good healing of bowel anastomosis was surely confirmed. The previous peritoneal shunt tube was cut behind the ear, removed, and replaced with a valve-regulated VP shunt system.Conclusion??This staged strategy is a safe and feasible option for complicated ELBW infants with preceding stoma and hydrocephalus. [ABSTRACT FROM AUTHOR]