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Cognitive frailty was notable target for the prevention of adverse health outcomes in future. The goal of this study was to use a population-based survey to investigate cognitive frailty phenotypes and potentially sociodemographic factors in elderly Chinese individuals. Cross-sectional study. General community. A total of 5328 elderly adults (aged 60 years or older, mean age 71.36 years) enrolled in the Shanghai study of health promotion for elderly individuals with frailty. The 5-item FRAIL scale and the 3-item Rapid Cognitive Screen tools were used to assess physical frailty and cognitive impairment, including dementia or mild cognitive impairment (MCI). Physical frailty was diagnosed by limitations in 3 or more of the FRAIL scale domains and pre-physical frailty by 1–2 limitations. Subjective cognitive decline (SCD) and pre-MCI SCD, was diagnosed with two self-report measures based on memory and other cognitive domains in elderly adults. Of the participating individuals, 97.17% (n= 5177, female 53.4%) were eligible. Notably, 9.67%, 41.61% and 35.20% of participants were MCI, SCD and pre-MCI SCD; 35.86% and 4.41% exhibited physical pre-frailty and frailty; and 19.86% and 6.30% exhibited reversible and potential reversible cognitive frailty. Logistic regression analyses indicated that physical frailty phenotypes were significantly associated with MCI with SCD, and pre-MCI with SCD. Older single females with a high education level were more likely to exhibit the reversible cognitive frailty; and younger elderly individuals with a middle education level were at lower risk for potentially reversible cognitive frailty. The prevalence of pre-physical and reversible cognitive frailty was high in elderly individuals and age was the most significant risk factor for all types of frailty phenotypes. To promote the rapid screening protocol of cognitive frailty in community-dwelling elderly is important to find high-risk population, implement effective intervention, and decrease adverse prognosis.

Objective The objective of this study was to implement a strategy for critical congenital heart disease (CCHD) newborn screening in the neonatal intensive care unit (NICU). Design A NICU-specific curriculum, screening algorithm, slide presentations, and templates of orders, policies, and procedures were developed into a toolkit for training NICU personnel. Screening was conducted on first and second screen pre- and postductal oxygen saturations (SpO2) on newborns admitted or transferred to the NICU. Results We trained 347 NICU personnel in 13 Texas hospitals, representing rural, suburban, and metropolitan settings. Key hospital staff submitted deidentified, case-based screening data. Of 4,621 NICU admissions, 80% received a first screen. Second screening rates were substantially lower in all gestational age groups. Screening rates on first and second screens were lowest among infants born Conclusion CCHD screening in the NICU is challenging, given the complexities of the NICU population. A modified screening protocol that recognizes special circumstances of neonatal intensive care could facilitate a more efficient system.

Purpose To compare infant and retinopathy of prematurity (ROP) characteristics from 3 clinical studies conducted over a 27-year period in the United States. Design Secondary analysis of results of 3 clinical studies. Participants Infants with birth weight (BW) Methods Analysis of data from the Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) and Early Treatment for Retinopathy of Prematurity (ETROP) trials and the primary data from the Telemedicine Approaches for the Evaluation of Acute-Phase Retinopathy of Prematurity (e-ROP) study. Main Outcome Measures Infant characteristics and onset, severity, and time course of ROP. Results Across the 3 studies, mean (standard deviation) BW and mean gestational age (GA) decreased over time from CRYO-ROP (954 g [185 g], 27.9 weeks [2.2 weeks]) to ETROP (907 g [205 g], 27.4 weeks [2.2 weeks]) to e-ROP (864 g [212 g], 27.0 weeks [2.2 weeks]), with an increase in the percentage of infants enrolled weighing P P = 0.003). Moderately severe ROP (defined as prethreshold or referral warranted) varied (17.8% CRYO, 12.3% ETROP, 19.4% e-ROP; P Conclusions The BW and GA of infants enrolled in ROP studies in the United States have decreased over the past 27 years, whereas ROP prevalence and onset of disease are stable.

Background The American Thyroid Association published revised guidelines in 2015 on the management of differentiated thyroid cancer in adults. One of the key changes introduced in the revision proposes that diagnostic biopsy be based on ultrasound findings (i.e. size and nodule characteristics). The overall effect of these changes results in fewer nodules requiring biopsy. This study was conducted to determine if the changes to the guidelines will result in overlooked thyroid cancers, specifically malignancies with aggressive characteristics measuring between 1 and 1.49 cm. Methods Patients (n = 2083) with thyroid nodules who underwent total or subtotal/hemi thyroidectomy with or without neck dissection by a single surgeon between 2006 and 2016 were retrospectively enrolled. Demographic information and nodule characteristics were collected for all patients. Ultrasonography and final pathology reports were reviewed for patients with thyroid nodules between the sizes of 1–1.49 cm (n = 155). Results 45% (n = 70) of patients with nodules between 1 and 1.49 cm were “low suspicion” nodules according to ultrasound. 47 of these nodules contained malignancies on final histopathological examination, 100% of which were of the papillary subtype. 21% (n = 10) of these malignant nodules demonstrated extrathyroidal extension and 34% (n = 16) were associated with regional metastases. Conclusions Reliance on sonographic patterns alone could result in missed cancer diagnoses in patients with thyroid nodules measuring between 1 and 1.49 cm. Moreover, a portion of these malignancies may be associated with aggressive features. The effect of this finding on long-term outcomes is unclear.

The aim of the study was to determine the acute and long-term outcomes of preterm infants treated with an intravenous fish oil-based lipid emulsion (FishLE) for parenteral nutrition-associated liver disease (PNALD).Preterm infants 14 days to 24 months of age with anatomic short gut or severe intestinal dysmotility, serum direct bilirubin ≥4 mg/dL, and requiring60% calories from parenteral nutrition were eligible. Enrolled infants received 1 g · kg · day of FishLE until resolution of direct hyperbilirubinemia or return of enteral nutrition. Acute clinical effects and biochemical markers of liver function were monitored. Growth and developmental scores at 6 and 12 months postmenstrual age (PMA) were assessed and compared with controls matched by gestational age (GA).Thirteen patients with mean GA of 28 ± 4 weeks were treated and compared with 119 GA-matched controls. Their mean direct bilirubin was 9.8 ± 6.4 mg/dL at enrollment. All infants had resolution of cholestasis after study completion. There were no acute adverse events, deaths, or liver/intestinal transplants. Weight and head circumference were similar between FishLE-treated patients and controls at 6- and 12-month PMA. Cognitive and motor scores were decreased at 6 and 12 months PMA in FishLE-treated infants. Logistic regression analysis showed that prolonged hospitalization was detrimental to cognitive and motor development, whereas treatment was not.The use of intravenous FishLEs in premature infants appears to be safe and reverses PNALD despite significant liver disease and intestinal failure. This therapy should be used in preterm infants with PNALD and followed long term to evaluate development.

Objective Critical congenital heart disease (CCHD) is a leading cause of death in infants. Newborn screening (NBS) by pulse oximetry allows early identification of CCHD in asymptomatic newborns. To improve readiness of hospital neonatal birthing facilities for mandatory screening in Texas, an educational and quality improvement (QI) project was piloted to identify an implementation strategy for CCHD NBS in a range of birthing hospitals. Study Design Thirteen Texas hospitals implemented standardized CCHD screening by pulse oximetry. An educational program was devised and a tool kit was created to facilitate education and implementation. Newborn nursery nurses' knowledge was assessed using a pre- and posttest instrument. Results The nurses' knowledge assessment improved from 71 to 92.5% (p Conclusion Our educational program, including a tool kit, QI processes, and standardized pulse oximetry CCHD NBS, is applicable for a range of hospital birthing facilities and may facilitate wide-scale implementation, thereby improving newborn health.

Introduction: Cadmium-induced neurotoxic effects are mediated through adverse oxidative stress and calcium signaling. Genistein, a phytoestrogen is a potent antioxidant and exhibits property to cross blood-brain barrier. Methods: Experimental model of cadmium-induced neurotoxic effects were induced by treatment with cadmium (5 mg/kg) for 28 days in wistar rats. For determining the protective effect, genistein was administered at a dose of (10 mg/kg) for 7 days followed by cadmium treatment for 28 days. Serum and tissues were analyzed for various oxidative stress markers such as total antioxidant capacity, total oxidant levels, non-enzymic antioxidants, enzymic antioxidants, lipid peroxide levels and protein carbonyl content. Results: The results showed significant increase in the oxidative stress markers during cadmium treatment was attenuated in rats treated with genistein followed by cadmium treatment. In addition, cadmium induced alterations and activities of ATPase were significantly restored by genistein treatment. Conclusion: The present study observations show promising results of genistein against cadmium-induced neurotoxic effects in wistar rats. Thus its potent antioxidant and cytoprotective effects could act as potent therapeutic agent against various neuro-degenerative diseases involving oxidative stress as primary mechanism.

Importance Most premature infants will not develop retinopathy of prematurity (ROP) of clinical relevance, yet screening evaluations often continue beyond hospital discharge, even for those infants without ROP. Objectives To identify the characteristics of infants at low risk for ROP, for whom further postdischarge screening may be of limited value. Design, setting, and participants This study took place in North American neonatal intensive care units where clinicians had expertise in ROP. Infants with birth weight less than 1251 g who were born at or transferred into an Telemedicine Approaches to Evaluating Acute-Phase ROP (e-ROP) study center were enrolled. The study included post hoc analysis of prospectively collected in-hospital ROP examination results among infants enrolled in the e-ROP study. We characterized infants without ROP and performed logistic regression on the subset of infants who were 27 to 33 weeks' gestational age to determine characteristics associated with the absence of ROP during all in-hospital examinations. Main outcomes and measures The main measure was the absence of ROP prior to hospital discharge; the main outcome was treatment for ROP. Results A total of 1257 infants born at 22 to 35 weeks' gestation (median [interquartile range (IQR)], 26 [25-28] weeks) with birth weights less than 1251 g (median [IQR], 860 [690-1040] g) underwent 4113 ROP examinations between 31 and 47 weeks' postmenstrual age. Overall, 1153 examinations (38%) showed no ROP, and 456 infants (36%) did not have ROP prior to study center discharge or study end point. Among infants without ROP during examinations at 32 and 33 weeks' postmenstrual age, 16 (9.4%) and 14 (5.3%) subsequently underwent ROP treatment, respectively. At hospital discharge, there was no ROP in 59% of infants of 27 to 33 weeks' gestational age, compared with 15% of those who were less than 27 weeks' gestational age (difference, 44% [95% CI, 38.5%-48.1%]; P ≤ .001). With more than 85% follow-up among infants without ROP by 37 weeks' postmenstrual age, none (95% CI, 0%-0.98%) were treated for ROP. In multivariate analysis of infants born at 27 to 33 weeks' gestation, larger birth weight (OR, 4.1 [95% CI, 1.6-10.3]) and higher gestational age (OR, 4.0 [95% CI, 1.5-10.8]) were significantly associated with absence of ROP. Conclusions and relevance These findings suggest that, for infants of 27 weeks' gestational age or greater and birth weights larger than 750 g, if no ROP has been detected by discharge at near-term postmenstrual age, then further ROP surveillance has limited value. Studies of all infants at risk are needed to develop more specific, objective criteria for termination of ROP surveillance and focus resources on infants at higher risk of ROP. Trial registration ClinicalTrials.gov Identifier: NCT01264276.

Objectives: Schwann cell (SC) transplantation is a promising therapy for peripheral nerve transaction, however, clinical use of SCs is limited due to their very limited availability. Adipose-derived stem cells (ADSCs) have been identified as an alternative source of adult stem cells in recent years. The aim of this study was to evaluate the feasibility of using ADSCs as a source of stem cells for differentiation into Schwann-like cells by an indirect co-culture approach, in vitro. Materials and methods: Multilineage differentiation potential of the obtained ADSCs was assayed by testing their ability to differentiate into osteoblasts and adipocytes. The ADSCs were co-cultured with SCs to be induced into Schwann-like cells through proximity, using a Millicell system. Expression of typical SC markers S-100, GFAP and P75NTR of the treated ADSCs was determined by immunocytochemical staining, western blotting and RT-PCR. Myelination capacity of the differentiated ADSCs (dADSCs) was evaluated in dADSC/dorsal root ganglia neuron (DRGN) co-cultures. Results: The treated ADSCs adopted a spindle shaped-like morphology after co-cultured with SCs for 6 days. All results of immunocytochemical staining, western blotting and RT-PCR showed that the treated cells expressed S-100, GFAP and P75NTR, indications of differentiation. dADSCs could form Schwann-like cell myelin in co-culture with DRGNs. Undifferentiated ADSCs (uADSCs) did not form myelin compared to DRGNs cultured alone, but could produce neurite extension. Conclusions: These results demonstrate that this indirect co-culture microenvironment could induce ADSCs to differentiate into Schwann-like cells in vitro, which may be beneficial for treatment of peripheral nerve injuries in the near future.

Importance Measurable competence derived from comprehensive and advanced training in grading digital images is critical in studies using a reading center to evaluate retinal fundus images from infants at risk for retinopathy of prematurity (ROP). Details of certification for nonphysician trained readers (TRs) have not yet been described. Objective To describe a centralized system for grading ROP digital images by TRs in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study. Design, Setting, and Participants Multicenter observational cohort study conducted from July 1, 2010, to June 30, 2014. The TRs were trained by experienced ROP specialists and certified to detect ROP morphology in digital retinal images under supervision of an ophthalmologist reading center director. An ROP reading center was developed with standard hardware, secure Internet access, and customized image viewing software with an electronic grading form. A detailed protocol for grading was developed. Based on results of TR gradings, a computerized algorithm determined whether referral-warranted ROP (RW-ROP; defined as presence of plus disease, zone I ROP, and stage 3 or worse ROP) was present in digital images from infants with birth weight less than 1251 g enrolled from May 25, 2011, through October 31, 2013. Independent double grading was done by the TRs with adjudication of discrepant fields performed by the reading center director. Exposure Digital retinal images. Main Outcomes and Measures Intragrader and intergrader variability and monitoring for temporal drift. Results Four TRs underwent rigorous training and certification. A total of 5520 image sets were double graded, with 24.5% requiring adjudication for at least 1 component of RW-ROP. For individual RW-ROP components, the adjudication rate was 3.9% for plus disease, 12.4% for zone I ROP, and 16.9% for stage 3 or worse ROP. The weighted κ for intergrader agreement (n = 80 image sets) was 0.72 (95% CI, 0.52-0.93) for RW-ROP, 0.57 (95% CI, 0.37-0.77) for plus disease, 0.43 (95% CI, 0.24-0.63) for zone I ROP, and 0.67 (95% CI, 0.47-0.88) for stage 3 or worse ROP. The weighted κ for grade-regrade agreement was 0.77 (95% CI, 0.57-0.97) for RW-ROP, 0.87 (95% CI, 0.67-1.00) for plus disease, 0.70 (95% CI, 0.51-0.90) for zone I ROP, and 0.77 (95% CI, 0.57-0.97) for stage 3 or worse ROP. Conclusions and Relevance These data suggest that the e-ROP system for training and certifying nonphysicians to grade ROP images under the supervision of a reading center director reliably detects potentially serious ROP with good intragrader and intergrader consistency and minimal temporal drift.

This study describes the incidence, correlates and subsequent morbidities of hyperglycemia, a highly prevalent condition in extremely low birth weight (ELBW) infants. A retrospective chart review of 169 infants with birth weight (BW)

BACKGROUND: Conventional methods for measuring the total bilirubin concentration in blood require the use of serum or plasma, but physically separating red blood cells from plasma by centrifugation is a time-consuming and potentially dangerous process that does not lend itself to rapid, near-patient testing. Therefore, we have sought to determine whether spectrophotometric measurements of total bilirubin concentration are feasible in unaltered whole blood. METHODS: We modified an Hb-Quick hemoglobinometer (Avox Systems, Inc., San Antonio, TX), a relatively new, portable, battery-powered instrument that uses disposable cuvettes and a reagentless system to measure total hemoglobin in nonhemolyzed, whole blood. The prototype consisted of an Hb-Quick equipped with light-emitting diodes with emissions at five different wavelengths to measure total bilirubin and total hemoglobin. Using blood samples from neonates with suspected hyperbilirubinemia, we made measurements on plasma from centrifuged samples and on hemolyzed and nonhemolyzed aliquots of the same blood samples. RESULTS: In the first series of experiments, we compared the Unistat bilirubinometer's readings with the prototype's measurements of bilirubin in plasma. There was a close linear correlation between the prototype's measurements and those of the reference instrument (slope=1.01, r2=0.991). Subsequently, we used the prototype's measurements on plasma as the reference method and compared them with readings on hemolyzed and nonhemolyzed aliquots of each sample. Readings on hemolyzed and nonhemolyzed aliquots were significantly correlated with the measurements in plasma, but the regression lines did not have a slope of 1. However, when the measurements on hemolyzed and nonhemolyzed blood were scaled appropriately to compensate for the fact that red cells “dilute” the bilirubin in plasma, the correlation coefficients improved, and there was then a 1:1 relationship between the measurements in whole blood and plasma. CONCLUSIONS: These preliminary findings demonstrate the feasibility of developing a portable instrument to measure total bilirubin in unaltered whole blood. The advantages of this method are speed, elimination of centrifugation or other sample preparation, and instrument portability. The disadvantage is that the concentration units are unconventional, i.e., milligrams of bilirubin per volume of whole blood. However, the instrument can be programmed to display the total bilirubin concentration in traditional units, e.g., milligrams of bilirubin per volume of plasma.

During a recent comparison of two portable hemoglobinometers designed for near-patient testing, we noted disparate readings on a quality-control material derived from human hemoglobin (Level 1, Multi-4® CO-Oximeter Controls; Instrumentation Laboratory). The insert sheet listed an acceptable range of total hemoglobin readings of 159–185 g/L (15.9–18.5 g/dL) for the OSM3 co-oximeter (Radiometer A/S). Our results on the OSM3 were at the midpoint of this range, as were results with one of the hemoglobinometers, the Hb-Quick® hemoglobinometer from Avox Systems [mean (SD), 175 (0.5) g/L; n = 5]. By contrast, readings on a HemoCue hemoglobinometer (HemoCue AB) were 16 g/L higher than the mid-range value and averaged 188 ± 1.5 g/L. Both hemoglobinometers had recently been calibrated by factory-trained employees of the respective companies. Because Level 1 controls contained ∼60% carboxyhemoglobin, we made additional measurements on fresh whole blood from a nonsmoking donor and on …

Rats exposed to 0.1-600 cGy x-rays developed significantly prolonged increases (1.9-11%) of normoblasts (red cell precursors) in the bone marrow as well as a subpopulation of transferrin receptor marked erythrocytes (E-Tr, 1.9-20%) in the blood. Several characteristics are shared in common by these two progenies of the hematopoietic stem cell (HSC): a heretofore unrecognized dose-response curve extending from 0.1-600 cGy composed of logarithmic and quadratic dose response segments, the joining of the segments at approximately 150 cGy, and an identical 29-wk period for one-half repair of the quantified cell damage. This suggests that both of these cells could be surrogates for assessing radiation injury. Preliminary findings suggest that this phenomenon is identifiable in humans.

Objective. The Hb-Quick® is a new portable hemoglobinometer that uses disposable cuvettes to measure the total hemoglobin concentration of capillary, venous, or arterial blood. Therefore, the objectives of this study were 1) to evaluate the performance of this compact, battery-powered hemoglobinometer by assessing its precision, accuracy, and linearity, 2) to determine whether its measurements suffer from interference by hemolysis, bilirubin, fetal hemoglobin, or hemodilution, and 3) to establish whether it can easily be used by clinical personnel with little or no laboratory training. Methods. The precision of the test instrument was assessed by making repeated measurements on blood samples. Its accuracy and linearity were evaluated by comparing its measurements with the internationally accepted cyanmethemoglobin method. Samples of whole blood with and without bilirubin, fetal hemoglobin, hemolysis, and hemodilution were also analyzed to determine if any interference occurred when these disturbances were present, and it was placed in physicians’ offices to evaluate its use by non-laboratory personnel. Results. Repeated measurements on blood samples with a wide range of hemoglobin concentrations were consistent with the precision specification (0.25 g/dl). The bias of the new hemoglobinometer was calculated as the mean difference between its readings and measurements with the cyanmethemoglobin method, and its accuracy as the standard deviation of the differences between the two methods. As assessed in this manner, the new hemoglobinometer had a bias of −0.04 g/dl and an accuracy of 0.40 g/dl. The linearity was checked over a hemoglobin concentration range from 0 to nearly 30 g/dl. There was a highly significant linear relationship between its readings and measurements with the cyanmethemoglobin method (slope = 0.997, y-intercept = 0.005, r = 0.999). Complete hemolysis of the sample increased the readings on average by only 0.22 g/dl. Bilirubin (17.5 mg/dl) increased the reading by an average of 0.29 g/dl, and fetal hemoglobin (76.5% HbF) reduced the readings by an average of only 0.035 g/dl. Diluting blood samples with saline also did not appreciably affect its accuracy. Conclusions. The new hemoglobinometer is fast and easy to operate. No sample preparation or pipetting is required. To operate the instrument, the user simply allows a drop of blood to fill the disposable cuvette by capillary action and inserts the cuvette into the instrument. The instrument analyzes the 10 µl sample and displays the results in less than 10 seconds. The interference caused by hemolysis, hemodilution with saline, fetal hemoglobin, and bilirubin were too small to be of any clinical importance. Tests in physician’s offices indicated that clinical personnel with little or no formal laboratory training could successfully use this device. The observed precision, accuracy, linearity, and freedom from interference indicate that this hemoglobinometer is suitable for near-patient testing in a wide range of clinical settings including physicians’ offices.

A multicenter, randomized, double-blind, placebo-controlled trial of synthetic surfactant therapy for premature infants with respiratory distress syndrome (RDS) and birth weights of 700 to 1350 gm demonstrated a reduction in severity of RDS, morbidity, and neonatal and 1-year mortality. Of the 419 infants who were entered in the study, 80% of the surviving infants in both the air placebo group (122) and the synthetic surfactant group (138) returned for the follow-up evaluation at 1-year adjusted age. The only significant difference observed at follow-up was a reduction in the incidence of mild cerebral palsy in the synthetic surfactant group (air placebo group, 8 of 122 (7%); synthetic surfactant group, 3 of 138 (2%); relative risk 0.306; 95% confidence interval 0.094, 0.999). No differences were observed between the air placebo and synthetic surfactant treatment groups with respect to health status of the infants, including the incidence of retinopathy of prematurity and neurodevelopmental delays. The difference in the overall incidence of impairment among the 1-year survivors in the air placebo group (43 of 122 (35%)) and in the synthetic surfactant group (40 of 138 (29%)) was not statistically significant. The results of this 1-year follow-up study show that rescue treatment with synthetic surfactant in infants weighing 700 to 1300 gm is not associated with adverse developmental consequences despite the improvement in survival.

OBJECTIVES a) To evaluate the performance of a compact, new instrument that uses disposable cuvettes to measure total hemoglobin concentration, oxygen content, and the relative concentrations of oxy- and methemoglobin in 50-microL blood samples; b) to determine whether the instrument can be used for near-patient assessment of methemoglobinemia; and c) to ascertain whether problems commonly encountered in neonatal blood samples affect the instrument's performance. DESIGN Prospective study, in which the test instrument was compared with a standard method. Samples of whole blood with and without bilirubin, fetal hemoglobin, and hemolysis were analyzed on the new (test) instrument and on a widely used cooximeter (OSM3 hemoximeter, Radiometer; reference instrument). SETTING In vitro analyses of blood samples in clinical and university laboratories. MEASUREMENTS AND MAIN RESULTS There was a close linear correlation between the methomoglobin measurements of the test instrument and those measurements of the reference instrument (slope = 0.989; r2 = .989). The average difference in mean assay values between the reference instrument and the test instrument was -0.59%, i.e., < 1% methemoglobin. Repeated measurements indicated the precision was 0.5% methemoglobin. Complete hemolysis of the sample reduced the methemoglobin reading by only 0.40%. Adding bilirubin (10 to 11 mg/dL [171 to 188.1 mumol/L]), increased the methemoglobin reading by 0.23%, increased the oxyhemoglobin reading by 0.45%, and increased total hemoglobin by 0.21 g/dL. Fetal hemoglobin also had minimal effects on the readings. CONCLUSIONS The test instrument is fast and easy to operate. No sample preparation or pipetting is required. To operate the instrument, the user simply connects a syringe containing the blood sample to one of the disposable cuvettes, injects 50 microL of blood into the cuvette, and inserts the cuvette into the instrument. The test instrument automatically detects the presence of the cuvette, analyzes the sample, and displays the results in < 10 secs. The findings in this study indicate that the test instrument has sufficient accuracy for near-patient testing in intensive care units. The errors introduced by hemolysis, fetal hemoglobin, and bilirubin were too small to be of clinical importance. Thus, the test instrument is essentially unaffected by complications commonly encountered in neonatal blood. The capacity of the test instrument to measure methemoglobin makes it particularly useful if inhaled nitric oxide therapy becomes a standard clinical practice.

The objectives of this study were to provide an economic assessment as well as a calculated projection of the costs that typical U.S. tertiary-care hospitals would incur through policy reconfiguration and implementation to achieve the UNICEF/World Health Organization Baby-Friendly® Hospital designation and to examine the associated challenges and benefits of becoming a Baby-Friendly Hospital. We analyzed hospital resource utilization, focusing on formula use and staffing profiles at one U.S. urban tertiary-care teaching hospital, as well as conducted an online survey and telephone interviews with a selection of Baby-Friendly Hospitals to obtain their perspective on costs, challenges, and benefits. Findings indicate that added costs for a new Baby-Friendly Hospital will approximate $148 per birth, but these costs sharply decrease over time as breastfeeding rates increase in a Baby-Friendly environment.

Quality of life (QoL) is a ubiquitous yet poorly defined concept; the precise determinants of QoL are rarely identified. We used pilot data from the GapS Questionnaire to investigate the most important determinants of QoL in children with chronic somatic illness.We enrolled 92 participants including 60 parents and 32 of their children. The sample comprised rheumatology, diabetes, epilepsy, gastroenterology, cystic fibrosis, and day unit patients. Trained interviewers administered the GapS Questionnaire to parents, and to children if ≥ 10 years. We determined the relative importance of different items for QoL.Child participants had a mean age of 14.7 years. Children identified "having good friendships", "being happy most days", and "getting along with parents" as most important. Parents ranked most highly "being allowed to do all the things you like doing", "getting told you have done a good job at something", and "being physically able to do everything you enjoy doing".Physical health items were not as important as social and psychological determinants of QoL in our pilot sample.

OBJECTIVE The aim of the present study was to examine the effects of early and high intravenous (IV) amino acid (AA) supplementation on growth, health, and neurodevelopment of extremely-low-birth-weight (ELBW) infants throughout their first 2 years of life. METHODS Infants were prospectively randomized in a double-masked fashion and treated for 7 days with either IV AA starting at 0.5 g · kg (-1) · day(-1) and increased by 0.5 g · kg(-1) every day to 3 g · kg(-1)· day(-) or starting at 2 g · kg (-1) · day(-1) of IV AA and advanced by 1 g · kg(-1) every day to 4 g · kg (-1) · day(-1). Plasma AA concentrations were determined by reverse-phase high-performance liquid chromatography. Survivors were longitudinally assessed with Bayley II Scales of Infant Development and physical, social, and global health. RESULTS Forty-three of 51 survivors were studied. Mental Developmental Index (MDI) and Psychomotor Developmental Index were similar between groups; however, the early and high AA group had a lower MDI at 18 months. This difference disappeared at 2 years of age. The early and high AA group z score means for weight, length, and head circumferences were significantly lower than the standard AA group at most visits. Cumulative and single plasma AA concentrations correlated negatively with MDI and postnatal growth. CONCLUSIONS ELBW infants who received early and high IV AA during the first week of life were associated with poor overall growth at 2 years.

This study reports the synthesis of the mercapto-hapten (S)-N-(2-(mercaptoethyl)-6-(3-(2-(methylamino)propyl)phenoxy)hexanamide [3, (+)-METH HSMO9] and its use to prepare METH-conjugated vaccines (MCV) from maleimide-activated proteins. MALDI-TOF mass spectrometry analysis of the MCV synthesized using 3 showed there was a high and controllable epitope density on two different carrier proteins. In addition, the MCV produced a substantially greater immunological response in mice than previous METH haptens, and a monoclonal antibody generated from this MCV in mice showed a very high affinity for (+)-METH (K(D) = 6.8 nM). The efficient covalent coupling of (+)-METH HSMO9 to the activated carrier proteins suggests that this approach could be cost-effective for large-scale production of MCV. In addition, the general methods described for the synthesis of (+)-METH HSMO9 (3) and its use to synthesize MCV will be applicable for conjugated vaccines of small molecules and other substances of abuse such as morphine, nicotine, and cocaine.

In a multicenter, double-blind, placebo-controlled trial conducted at 23 hospitals in the United States, a single prophylactic 5 ml/kg dose of a synthetic surfactant (Exosurf Neonatal) or air placebo was administered shortly after birth to 215 infants with birth weights of 500 to 699 gm. Despite stratification at entry by birth weight and gender, by chance female infants predominated in the air placebo group and male infants predominated in the surfactant group. Among infants receiving synthetic surfactant, improvements in oxygen requirements were significant at 2 hours after birth ( p =0.014) and persisted for 3 days ( p =0.001); improvements in the alveolar-arterial partial pressure of oxygen gradient were significant at 6 hours after birth ( p =0.01) and persisted for 3 days ( p =0.008). Improvements in mean airway pressure were not significant at 2 or at 6 hours after birth ( p =0.622 and 0.083, respectively), but became significant thereafter and persisted for 3 days ( p =0.002). Pneumothorax was reduced by slightly more than half (25 vs 11; p =0.014); death from respiratory distress syndrome (RDS) was also reduced (26 vs 15; p =0.046). Overall neonatal mortality, however, was not significantly reduced (58 vs 46; p =0.102). Other complications of RDS and prematurity were not altered, except that pulmonary hemorrhage occurred significantly more frequently in infants receiving synthetic surfactant (2 vs 12; p =0.006). These findings indicate that a single prophylactic dose of synthetic surfactant in infants weighing 500 to 699 gm at birth improves lung function, incidence of air leak, and death from RDS but not overall mortality. The only safety problem identified was an increase in pulmonary hemorrhage.

In addition to addiction, the repeated use of (+)-methamphetamine [(+)-METH], (+)-amphetamine [(+)-AMP], or (+/-)-3,4-methylenedioxymethamphetamine ((+/-)-MDMA, commonly called ecstasy) can lead to life-threatening medical problems including cardiovascular injury, severe depression, and psychosis. Currently, there are no specific pharmacotherapies to treat these medical problems. In this study, we report the design and synthesis of two haptens, (S)-(+)-3-(9-carboxynonyloxy)methamphetamine (3a, (+)-METH MO10) and (S)-(+)-3-(5-carboxypentyloxy)methamphetamine (3b, (+)-METH MO6), and their use in generating high affinity (low K(D) value) monoclonal antibodies (mAbs) against (+)-METH, (+)-AMP, and/or (+)-MDMA. On the basis of results from the determination of mAb K(D) values and ligand specificity, the mAbs generated from hapten 3a showed the greatest promise for generating active and passive immunotherapies for treating overdose or addiction from (+)-METH-like stimulants.

We studied the hemodynamic effects of using natural surfactant in premature baboons with hyaline membrane disease (HMD). Study animals (n = 5) received a single dose of surfactant immediately after delivery and control animals (n = 8) did not. Using microspheres at 3, 8, and 23 h we found no significant differences in left ventricular output, effective systemic flow, systemic-to-pulmonary patent ductus arteriosus (PDA) shunting, or in cerebral or renal organ blood flow. However, both groups had large PDA shunts (fraction of LVO to lungs > 0.40–0.55 at 3 and 8 h) resulting in low systemic perfusion (< 80 ml/min/kg). Single dose surfactant did not improve the myocardial dysfunction and low cerebral and renal blood flow which occur during treatment for HMD.

Synthetic methods were developed for the synthesis of the 3beta-(4-substituted phenyl)-2 beta-[5-(substituted phenyl)thiazol-2-yl]tropanes (4a-s). The compounds were evaluated for their monoamine transporter binding and monoamine uptake inhibition properties using both rat brain tissue and cloned transporter assays. In general, the compounds showed higher dopamine transporter (DAT) affinity relative to the serotonin and norepinephrine transporters (SERT and NET, respectively) and greater [3H]dopamine uptake inhibition potency relative to [3H]serotonin and [3H]norepinephrine uptake inhibition. Several compounds were DAT selective relative to the SERT and NET in the monoamine transporter binding assays. The most potent and selective analog in the functional monoamine uptake inhibition test was 3beta-(4-methylphenyl-2 beta-[5-(3-nitrophenyl)thiazol-2-yl]tropane (4p).

Peanut allergy is transient in some children but it is not clear whether quantitating peanut-specific IgE by Skin Prick Test (SPT) adds additional information to fluorescent-enzyme immunoassay (FEIA) in discriminating between allergic and tolerant children. To investigate whether SPT with a commercial extract or fresh foods adds additional predictive information for peanut challenge in children with a low FEIA (10 k UA/L) who were previously sensitized, or allergic to peanuts. Children from a hospital-based allergy service who were previously sensitized or allergic to peanuts were invited to undergo a peanut challenge unless they had a serum peanut-specific IgE10 k UA/L, a previous severe reaction, or a recent reaction to peanuts (within two years). SPT with a commercial extract, raw and roasted saline soaked peanuts was performed immediately prior to open challenge in hospital with increasing quantity of peanuts until total of 26.7 g of peanut was consumed. A positive challenge consisted of an objective IgE mediated reaction occurring during the observation period. 54 children (median age of 6.3 years) were admitted for a challenge. Nineteen challenges were positive, 27 negative, five were indeterminate and three did not proceed after SPT. Commercial and fresh food extracts provided similar diagnostic information. A wheal diameter ofor=7 mm of the commercial extract predicted an allergic outcome with specificity 97%, positive predictive value 93% and sensitivity 83%. There was a tendency for an increase in SPT wheal since initial diagnosis in children who remained allergic to peanuts while it decreased in those with a negative challenge. The outcome of a peanut challenge in peanut sensitized or previously allergic children with a low FEIA can be predicted by SPT. In this cohort, not challenging children with a SPT wheal ofor=7 mm would have avoided 15 of 18 positive challenges and denied a challenge to one out of 27 tolerant children.

An experimental animal model was used to assess spinal cord injury following lateral hemitransection at thoracic spinal cord level.To determine whether extract of Ginkgo biloba (EGb) could have a neuroprotective effect in spinal cord injury (SCI) in rats.Department of Biological Sciences and Biotechnology, Tsinghua University, China.A total of 72 adult rats were divided randomly into three groups: the EGb group, normal saline (NS) group, and sham operation group (sham group). After thoracic spinal cord hemitransection was performed at the level of the 9th thoracic vertebra (T9), rats in the EGb group were given 100 mg/kg EGb 761 daily, while rats in the NS group received NS. The rats in the sham group only underwent laminectomy without spinal cord hemitransection. At various time points after surgery, thoracic spinal cords were sampled and sliced for histochemistry, immunohistochemistry of inducible nitric oxide synthase (iNOS), and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) of apoptotic cells.Myelin staining showed that the area of cavities was small and the demyelinated zones were limited at and around the injury site of the spinal cord in the EGb group, while the area of cavities was large and the demyelinated zones were serious in the NS group. Nissl staining showed that the ratio of bilateral ventral horn neurons (transection side/uninjured side) in the EGb group was higher than that in the NS group (P0.05). The apoptotic index and the percentage of iNOS-positive cells were lower in the EGb group than in the NS group. Furthermore, the percentage of iNOS-positive cells positively correlated with the apoptotic index (r( 2)=0.729, P0.01) after SCI.This study demonstrated that EGb 761 could inhibit iNOS expression and have neuroprotective effect by preventing nerve cells from apoptosis after SCI in rats.

Background Hyperglycemia (HG) has been reported in up to 70% of extremely low birth weight (ELBW) infants (birth weight Objective To describe the incidence of HG in ELBW infants, risk factors, and related morbidities. Design/Methods: Retrospective chart review of live-born ELBW infants admitted to University Hospital, San Antonio, Texas, from 1998-2001. 230 charts were reviewed; 45 were excluded due to previable status. HG was defined as serum glucose level $ 150 mg/dL during the first 2 weeks of life. Logistic regression, multivariate analysis, and Fisher exact test were performed using SPSS and SAS. Results 185 patients were eligible for the analysis. The mean gestational age (GA) and mean birth weight (BW) were 25.9 6 2.1 weeks and 760 6 138 g, respectively. Seventy-two percent of the infants were Hispanic and 55% were male. The incidence of HG was 88%. The mean serum glucose level for the HG group was 249 mg/dL 6 83 compared to 128 mg/dL 6 16 for the normoglycemic group; both groups peaked on day of life 6 (1-15 d). On average, the number of days with hyperglycemia was 3.7 days. There were no differences in race, gender, prenatal steroid use, sepsis, and chorioamnionitis between the groups. Using a multivariate analysis, higher GA had a protective effect for HG (OR 0.16, CI 0.04-0.53), whereas BW, small for gestational age (SGA), sepsis, and postnatal steroids had no effect. ROP was significantly associated with HG after adjusting for GA, BW, and postnatal steroid use (OR 4.6, CI 1.12-18.9). Laser treatment was required in 15/66 patients with ROP in the HG group, and 0/3 with ROP in the normoglycemic group (p .37). Bronchopulmonary dysplasia (BPD), IVH, length of stay, and death were not associated with HG. Conclusions In our predominantly Hispanic population, the incidence of HG is higher than previously reported. However, race was not identified as a risk factor. HG infants tend to be more immature by GA at birth, independent of BW and SGA status. HG was associated with the development of ROP even after correction for GA, BW, and postnatal steroid use. This association may be due to an expression of severity of illness, although no differences in death, length of stay, IVH, or BPD were demonstrated. Further studies need to be done to determine if this association is causal.

Osteoclast development and growth were studied by determining the number of labelled nuclei in osteoclasts of different sizes (based on the number of nuclei per osteoclast, N/O) and the number of osteoclasts with labelled nuclei at various intervals after tritiated thymidine ([3H]TdR) injection in young rats. The osteoclast smears were made from the cellular periosteum of the proximal tibia. The frequency distribution of the N/O osteoclasts types in the smears had profiles similar to that of in situ osteoclasts in whole mounts of proximal tibia, which indicates that the osteoclast population of the smears was representative of that on the bone surface. A vast majority of the osteoclasts had a 1–6 N/O, and a number of the cells had as many as 26 or more nuclei. Furthermore, profiles of N/O frequency distributions were similar over the course of the study. Nuclei with [3H]TdR label were initially observed in osteoclasts between 4 and 12 hr after isotope injection. However, fusion of labelled nuclei to osteoclasts continued for at least 150 hr. In general, the labelled osteoclasts exhibited a significantly larger number of nuclei than the unlabelled osteoclasts. The probability of an osteoclast incorporating one or more labelled nuclei increased with time after injection and with an increase in N/O. Labelling intensity decreased with time post injection and with an increase in N/O. The data suggest that turnover of nuclei is more rapid in osteoclasts with high N/O values.

Osteoblasts and osteoclasts are known to adhere tenaciously to bone surfaces even when the fibrous periosteal covering is removed. Brush-smear isolates and in situ, whole bone mounts of the osteogenic periosteum on the inner and outer calvarial tables of young adult rats were examined at the light microscopic level after exposing the cells by removing the fibrous periosteum. Based on staining, enzymatic activity, and overall morphology, most of the cells could be classified as osteogenic in nature. However, detailed analysis revealed that some cells exhibited certain unique morphologic appearances that suggested the existence of subpopulations or variant forms of the conventional or prototypic osteoblast. Three variant forms were the large nucleate, small nucleate, and multinucleate osteoblast-like cells, the latter with nuclear numbers ranging from 2-10. The finding of all such forms in smears, short-term cell cultures, and in situ specimens greatly lessened the probability that the unusual forms were artifactual. Phase contrast microscopic studies and sectioning of cellular isolates for study at both the light and electron microscopic levels provided additional support for the existence of the multinucleate osteoblast-like cell. The small size of these osteoblast-like subpopulations and the orientation of the cells to the commonly used plane of section of most histologic bone specimens, particularly with the multinucleate type, could explain why they had escaped earlier detection.

Adult female Sprague-Dawley rats were exposed (200 kvp X-rays) to whole body doses of 22-1320 mrad and examined for changes in the level of red blood cell precursors (RBCp) in the marrow at 5-30 weeks post-irradiation, under nonbled and phlebotomy-induced anemic stress conditions. Increases in the RBCp %, RBCp/mg marrow, and RBCp/skeleton under nonbled conditions, and a suppressed erythroid response to an induced anemia, were found after acute doses in the range of at least 70 mrad. Dosages of 22 or 44 mrad that induced no measurable changes when applied only once were found to be effective when they were employed 4 or 2 times/week, respectively. The results suggested the presence of a linear-quadratic dose-response relationship in which the quadratic function exists between 88 and 981 mrad, and the linear dependency, below 88 mrad.

Rats were irradiated with one tibia shielded (95% marrow exposure), total body exposed (TBI, 100%), and only one tibia exposed (5%), or they were sham irradiated (SI, 0%). Plasma Fe-59 clearance time (T 1/2) and Fe-59 content ratio in the right and left tibia (RT/LT) were assayed to determine the erythroid activity of the overall marrow of the animals and the relative marrow activity in the exposed and shielded tibias, respectively. When a major fraction of the overall marrow was shielded or irradiated, the overall erythroid activity levels were identical to those of the SI and TBI animals, respectively. Interestingly, enhanced normoblastosis was observed in the marrow of the exposed tibia of individual animals exhibiting normal erythroid activity in 95% of the marrow. Conversely, localized marrow with normal erythroid activity was found in a shielded tibia of individual rats, demonstrating an enhanced erythroid activity in a major fraction of the total body. It was concluded that 88 mrad can alter marrow functions in a small isolated skeletal region as effectively as in the whole body, and tandem assays of the Fe-59T 1/2 and Fe-59 RT/LT can facilitate ultra-low-dose X-ray studies involved with partial body exposures.

Clinical trials are underway that use pulmonary surfactant replacement therapy in an attempt to prevent respiratory distress syndrome (RDS) in premature infants. This study was undertaken to determine the relationship between the clinical course of infants receiving prophylactic "first-breath" endotracheal surfactant and their initial posttreatment radiographs. The study population consisted of 80 premature infants of 24-32 weeks gestational age. All received 3 ml of calf-lung surfactant extract via endotracheal tube at birth. Anteroposterior chest radiographs taken within 1 hr of treatment were reviewed and correlated with gestational age, birth weight, days of endotracheal intubation, mean airway pressure, and days of oxygen requirement greater than 30%. Three distinct patterns of radiographic abnormality were encountered: typical RDS with hypoinflation, diffuse granularity, and air bronchograms (30%); central clearing of RDS (14%); and disproportionate clearing of RDS in the right lung (8%). No significant differences in ventilator requirements or clinical course were seen among these three groups. A fourth group (49%), whose posttreatment radiographs showed no evidence of RDS, required significantly less ventilatory support. Prophylactic first-breath surfactant treatment of premature infants occasionally results in radiographic patterns that are atypical for RDS. Familiarity with these patterns and their clinical significance will be important if surfactant augmentation becomes prevalent.

Osteoclasts residing on rims and walls of bony concavities on remodeling proximal tibia from growing rats were examined by light microscopy following stripping of the periosteal connective tissue layer. Comparison of these cells in situ and after transfer to glass slides revealed the presence of numerous mononucleate osteoclasts, as well as typical multinucleate forms, all exhibiting a ruffled border and acid phosphatase and succinic dehydrogenase activity. Macrophage-like cells were situated adjacent to osteoclasts in situ. Osteoblasts were relatively inconspicuous. The possibility that the basic functional osteoclast unit is a mononucleate cell is discussed.

Summary1. The effect of chemical agents ethylene diamine tetra-acetic acid (EDTA) and zirconium citrate on skeletal content and excretion of injected radiostrontium was studied in rats. BAL was also administered in combination with EDTA in an effort to increase the excretion of injected strontium. 2. Administration of salts of EDTA under the most favorable conditions for its action had no effect on skeletal distribution of injected carrier-free Sr89. Zirconium citrate administrated prior to injection of Sr89 resulted in a level of Sr89 in the skeleton at 5 days 40% lower than that found in controls. A corresponding increase in Sr89 excretion was also noted. Combined administration of EDTA with zirconium citrate and with BAL are without effect on skeletal distribution of injected Sr89. Possible explanations for the effect of the various chemical agents employed are discussed.

Ninety-six percent of mice that were bled of 50 percent of their blood volume when they were 9 weeks old succumbed to myelogenous leukemia by 15 months after phlebotomy, the majority of them dying between 7 and 10 months after this treatment. These results suggest that (i) anemia is an effective stress for triggering myelogenous leukemia in animals that are predisposed to the disease, (ii) the RF mouse is "naturally" prone to the development of myelogenous leukemia, and (iii) the concept of two-step de novo induction of myelogenous leukemia appears to be applicable in this animal.

Cord serum samples treated with staphylococcus protein A and an immune affinity column to remove immunoglobulin G were used to establish a seronegative range for herpes simplex virus and cytomegalovirus. No seroconversions or increased heterologous antibody levels to herpes simplex virus or cytomegalovirus were found in live varicella vaccine recipients.

Circulating erythrocytes from rats were examined up to 30 weeks post whole-body exposures of 1.0 R for alterations in the expression of net negative surface charge as measured by whole-cell microelectrophoresis in saline sorbitol. Erythrocyte electrophoretic mobility was determined in an apparatus composed of a horizontal transilluminated cylindrical chamber, equipped with a reversible, blacked platinum electrode, immersed in a water bath maintained at 25.0 +/- 1.0 degree C (Rank Brothers). In two separate experiments, recurrent decreases in the expression of net negative surface charge occurred at 10, 17, and 30 weeks post-irradiation. At these times distributional analyses of recorded erythrocyte electrophoretic mobility (EEPM) values revealed a skewing of the normally distributed EEPM population values to lower EEPM. Total sialic acid content released from hydrolyzed erythrocyte membrane preparations revealed no significant differences between erythrocytes from sham and irradiated animals. In vivo post-irradiation labeling of erythrocytes with diisopropyl-[32P] phosphorofluoridate at 4 and 33 weeks (separate experiments) indicated only a minor abbreviated erythrocyte life span at 33 weeks. Therefore, effects from low dose (1.0 R) whole-body irradiation would appear to include a recurrent defect in the expression of the net negative surface charge.

Skeletons of altitude-acclimatized, altitude-deacclimatized, and sea-level control dogs were completely analyzed for water, fat, and nonfatty organic and inorganic fractions. The total skeletal and marrow volumes as well as their contents were calculated and compared. Neither the marrow volume nor the bone (trabecular and cortical) volume was affected by the altitude changes. The relative distribution of marrow and bone in the various parts of the skeleton was also unchanged. Marrow fat in the whole skeleton as well as in the individual parts of the skeleton was lowered on acclimatization and increased on deacclimatization. Of the fat lost, one-third was from the flat bones while one-half of the fat deposited on deacclimatization occurred in flat bones. The marrow water as well as the functional marrow (fat-free, by definition) in either the whole or the various parts of the skeleton was increased on acclimatization and decreased on deacclimatization.

All of the 128 Sprague-Dawley female rats bled two-thirds of the blood volume at 1, 2, or 3 months after irradiation (50, 170, or 350 roentgens) succumbed to leukemia by 16 months after bleeding. Some nonbled irradiated rats developed leukemia possibly as a result of triggering by a radiation-induced anemia. The threshold leukemogenic x-ray dose is probably below 25 roentgens. Elevated levels of basophils, neutrophils containing the "pseudo-Pelger" type nuclear anomaly, and myeloblasts exhibiting Auer rods seen in these animals were generally not found in earlier models of rat myelogenous leukemia.

A technique was devised for obtaining marrow-free trabecular bone so that the trabecular and cortical bone composition of dog, steer, monkey and man could be studied. Vertebral body was cut in the frontal plane into slices 2 mm thick with an electric band saw. The cortical bone encrircling each slice was trimmed off with a cleaver, leaving intact a lacy slice of trabecular bone. The marrow substance was washed away by fine and powerful jets of tap water obtained from an adjustable nozzle. Marrow washing was discontinued when no trace of red color was visible on holding the slice in front of a strong light source. The quantities of water, volatile inorganic, organic and ash fractions in cortical bone was alike for all species. Likewise, the trabecular bone fractions of each was quantitatively similar. In general, density and amount of ash in cortical bone was higher than that in trabecular bone. The water and ash:organic ratio were higher in trabecular than in cortical bones. Ratios of trabecular to cortical ash for the bones in an entire dog skeleton were also determined. Based on this, volume or mass of the various bone fraction may be estimated when the weight of the ash for any particular bone is known.

Five adult monkeys (Macaca mulatta) having an average weight of 3.4 kg were analyzed for the overall skeletal contents of water, fat, nonfatty organic fraction, volatile inorganic fraction and ash. Volumes of bone and marrow for each skeletal region were calculated according to an earlier method used in the study of the dog and rabbit (Gong and Arnold, '65; Gong and Reis, 1970). A shortcut method for calculating marrow volume and fresh volumes of trabecu-lar and cortical bone using only two variables, the ash volume (or mass) and the fresh volume of the skeletal region, was also shown. It was found that the marrow constituted approximately 50.7% of the overall skeletal volume. Comparison of the composition of the marrow in the long bone and flat bone regions of the skeleton showed that the general distribution of the various components in these regions was similar to those found in the dog and rabbit; namely, a relatively high fat content in the long bone marrow and relatively high nonfatty organic and water contents in the flat bone marrow.