Monitoring depth of anesthesia using combination of EEG measure and hemodynamic variables

Monitoring depth of anesthesia (DOA) via vital signs is a major ongoing challenge for anesthetists. A number of electroencephalogram (EEG)-based monitors such as the Bispectral (BIS) index have been proposed. However, anesthesia is related to central and autonomic nervous system functions whereas the EEG signal originates only from the central nervous system. This paper proposes an automated DOA detection system which consists of three steps. Initially, we introduce multiscale modified permutation entropy index which is robust in the characterization of the burst suppression pattern and combine multiscale information. This index quantifies the amount of complexity in EEG data and is computationally efficient, conceptually simple and artifact resistant. Then, autonomic nervous system activity is quantified with heart rate and mean arterial pressure which are easily acquired using routine monitoring machine. Finally, the extracted features are used as input to a linear discriminate analyzer (LDA). The method is validated with data obtained from 25 patients during the cardiac surgery requiring cardiopulmonary bypass. The experimental results indicate that an overall accuracy of 89.4 % can be obtained using combination of EEG measure and hemodynamic variables, together with LDA to classify the vital sign into awake, light, surgical and deep anesthetised states. The results demonstrate that the proposed method can estimate DOA more effectively than the commercial BIS index with a stronger artifact-resistance.     

Behavioral and electrophysiological analysis of general anesthesia in 3 background strains of Drosophila melanogaster

General anesthetics achieve behavioral unresponsiveness via a mechanism that is incompletely understood. The study of genetic model systems such as the fruit fly Drosophila melanogaster is crucial to advancing our understanding of how anesthetic drugs render animals unresponsive. Previous studies have shown that wild-type control strains differ significantly in their sensitivity to general anesthetics, which potentially introduces confounding factors for comparing genetic mutations placed on these wild-type backgrounds. Here, we examined a variety of behavioral and electrophysiological endpoints in Drosophila, in both adult and larval animals. We characterized these endpoints in 3 commonly used fly strains: wild-type Canton Special (CS), and 2 commonly used white-eyed strains, isoCJ1 and w¹¹¹⁸. We found that CS and isoCJ1 show remarkably similar sensitivity to isoflurane across a variety of behavioral and electrophysiological endpoints. In contrast, w¹¹¹⁸ is resistant to isoflurane compared to the other 2 strains at both the adult and larval stages. This resistance is however not reflected at the level of neurotransmitter release at the larval neuromuscular junction (NMJ). This suggests that the w¹¹¹⁸ strain harbors another mutation that produces isoflurane resistance, by acting on an arousal pathway that is most likely preserved between larval and adult brains. This mutation probably also affects sleep, as marked differences between isoCJ1 and w¹¹¹⁸ have also recently been found for behavioral responsiveness and sleep intensity measures.     

Anesthetic effects on the structure and dynamics of the second transmembrane domains of nAChR α4β2

Channel functions of the neuronal α4β2 nicotinic acetylcholine receptor (nAChR), one of the most widely expressed subtypes in the brain, can be inhibited by volatile anesthetics. Our Na⁺ flux experiments confirmed that the second transmembrane domains (TM2) of α4 and β2 in 2:3 stoichiometry, (α4)₂(β2)₃, could form pentameric channels, whereas the α4 TM2 alone could not. The structure, topology, and dynamics of the α4 TM2 and (α4)₂(β2)₃ TM2 in magnetically aligned phospholipid bicelles were investigated using solid-state NMR spectroscopy in the absence and presence of halothane and isoflurane, two clinically used volatile anesthetics. ²H NMR demonstrated that anesthetics increased lipid conformational heterogeneity. Such anesthetic effects on lipids became more profound in the presence of transmembrane proteins. PISEMA experiments on the selectively ¹⁵N-labeled α4 TM2 showed that the TM2 formed transmembrane helices with tilt angles of 12° ± 1° and 16° ± 1° relative to the bicelle normal for the α4 and (α4)₂(β2)₃ samples, respectively. Anesthetics changed the tilt angle of the α4 TM2 from 12° ± 1° to 14° ± 1°, but had only a subtle effect on the tilt angle of the (α4)₂(β2)₃ TM2. A small degree of wobbling motion of the helix axis occurred in the (α4)₂(β2)₃ TM2. In addition, a subset of the (α4)₂(β2)₃ TM2 exhibited counterclockwise rotational motion around the helix axis on a time scale slower than 10^- 4 s in the presence of anesthetics. Both helical tilting and rotational motions have been identified computationally as critical elements for ion channel functions. This study suggested that anesthetics could alter these motions to modulate channel functions.     

交感神经阻滞对糖尿病心腔扩张顽固心衰的疗效

目的:探讨交感神经阻滞对有糖尿病、心腔扩张的顽固心衰患者心脏收缩功能和心腔大小的影响。方法:经胸3～胸4棘突间隙穿刺至硬膜外腔,留置硬膜外导管,0.5%利多卡因3～5ml每2h推注一次,持续4w,适当辅以常规治疗。测定并比较TEB治疗前及后4w射血分数(EF)、左室内径(LVED)和左房内径(LAED)等指标的变化。结果:治疗后左室射血分数(EF)由治疗前的(31.53±9.29)%升为(44.75±8.32)%(P0.05);左室内径(LVED)由治疗前的(70.59±6.25)mm缩减到(63.59±7.05)mm(P0.05);左房内径(LAED)由治疗前的(46.16±7.19)mm缩减到(39.05±7.23)mm(P0.05)。结论:心区交感神经阻滞结合常规用药对有糖尿病、心腔扩张的顽固心衰患者的心脏功能有明显改善作用,并使其扩大的心脏明显缩小。     

USE OF MIDAZOLAM/PETHIDINE AND TILETAMINE/ZOLAZEPAM COMBINATIONS FOR THE CHEMICAL RESTRAINT OF LEOPARD SEALS (HYDRURGA LEPTONYX)

We immobilized 200–550-kg leopard seals ( Hydrurga leptonyx ) on sea ice in Prydz Bay, Antarctica (68°25'S, 77°10'E) between November 1997 and February 2000. Midazolam (0.18–0.27 mg/kg)/ pethidine (1.0–1.5 mg/kg) was administered by dart to 16 leopard seals. Unpredictable immobilization, poor airway maintenance, and our inability to fully assess the suitability of flumazenil (0.003–0.01 mg/kg), naloxone (0.01–0.013 mg/kg), and naltrexone (0.05–0.12 mg/kg) as reversal agents limited suitability of midazolam/pethidine. Tiletamine/zolazepam 1:1 (0.5–1.5 mg/kg) was, therefore, administered to 19 leopard seals. It produced faster induction (19 ± 3 min), more effective and reliable response to dose (rank correlation: r _s= 0.88, n = 18), and better pulmonary ventilation and faster return of cognitive function upon recovery, in comparison to midazolam/pethidine. Best results were achieved with tiletamine/zolazepam (1.2–1.4 mg/kg) which safely immobilized seven of nine seals for 20–30 min. Entry to the water upon darting was minimized, but not eliminated, by the use of lightweight air-pressurized darts and a thorough knowledge of leopard seal behavior.     

Social Eavesdropping: A Game-Theoretic Analysis

Here we extend the classic Hawk-Dove model of animal conflict to allow for continuous variation in fighting strengths. Whereas the winner of a fight is chosen at random in the discrete game, in our continuous game, the winner of any fight is the stronger individual, and costs are higher for more evenly matched opponents. We identify the evolutionary stable strength threshold beyond which an animal should be prepared to engage in aggressive behaviour and show that this threshold increases with variance in fighting strength when the costs of aggression are insensitive to the level of strength asymmetry, but decreases with variance when the costs are sensitive to the level of asymmetry. In contrast to the classic discrete game, population-wide aggressive behaviour occurs only when the costs of fighting are zero. It is now known that animals can eavesdrop on the outcome of contests between neighbours and modify their behaviour towards observed winners and losers. We therefore further extend our model to allow for social eavesdropping within networks comprising three individuals. Whereas earlier work showed that eavesdropping increases the frequency of mutually aggressive contests in the discrete game by enhancing the value of victory, here we show that aggression thresholds in the continuous game are always higher with eavesdropping than without it: for sufficiently weak animals, avoiding the costs of challenging an observed winner over-rides the potential benefit of winning, so that eavesdropping reduces the frequency of aggressive encounters. Thus, even though strength is not directly observable, information is extracted from the variation in fighting ability that the classic Hawk-Dove game ignores.     

Kinetic studies of constitutive human granulocyte-macrophage colony stimulating factor (hGM-CSF) expression in continuous culture of <Emphasis Type="Italic">Pichia pastoris</Emphasis>

Extracellular human granulocyte-macrophage colony stimulating factor (hGM-CSF) expression was studied under the control of the GAP promoter in recombinant Pichia pastoris in a series of continuous culture runs (dilution rates from 0.025 to 0.2 h⁻¹). The inlet feed concentration was also varied and the steady state biomass concentration increased proportionally demonstrating efficient substrate utilization and constancy of the biomass yield coefficient (Y_x/s) for a given dilution rate. The specific product formation rate (q_P) showed a strong correlation with dilution rates demonstrating growth associated product formation of hGM-CSF. The volumetric product concentration achieved at the highest feed concentration (4×) and a dilution rate of 0.2 h⁻¹ was 82 mg l⁻¹ which was 5-fold higher compared to the continuous culture run with 1× feed concentration at the lowest dilution rate thus translating to a 40 fold increase in the volumetric productivity. The specific product yield (Y_P/X) increased slightly from 2 to 2.5 mg g⁻¹, with increasing dilution rates, while it remained fairly invariant, for all feed concentrations demonstrating negligible product degradation or feed back inhibition. The robust nature of this expression system would make it easily amenable to scale up for industrial production.     

Preparation of a monolithic capillary column with immobilized alpha-mannose for affinity chromatography of lectins

A simple method for the preparation of an affinity monolithic (also called continuous bed) capillary column for alpha-mannose-specific lectins is described. 2-Hydroxyethyl methacrylate in combination with (+)-N,N -diallyltartardiamide (DATD) and piperazine diacrylamide (PDA, 1,4-bisacryloyl-piperazine) as crosslinkers, were used as monomers for the monolith. After oxidation of DATD with periodate, alpha-mannose with spacer was bound to the aldehyde groups of the polymeric skeleton via reductive amination to form an affinity column for the separation, enrichment or binding studies of mannose-specific lectins. The permeability of the column was excellent. The porosity of the monolith was investigated by scanning electron microscope (SEM) and inverse size exclusion chromatography (ISEC). The affinity of the monolith was evaluated by frontal analysis (FA) and fluorescence microscopy (FM) using fluorescently labeled concanavalin (Con A). Frontal affinity chromatography showed a specific interaction of two different lectins with the alpha-mannose-modified monolith. According to FM the affinity sites were evenly distributed over the monolithic bed.     

Enantioseparation by ligand-exchange using particle-loaded monoliths: capillary-LC versus capillary electrochromatography

Particle-loaded monoliths containing a polymethacrylamide backbone were prepared by suspending a silica-based chiral phase in the mixture of the monomers followed by in-situ polymerization in the capillary. As chiral selector l-4-hydroxyproline chemically bonded to 3 microm silica particles was used following the separation principle of ligand-exchange. Electrolytes containing Cu(II) ions were used. Amino acid enantiomers were separated by capillary-LC and CEC, whereby the latter showed the better resolution properties. For the chiral separation of alpha-hydroxy acids the EOF was reversed by copolymerizing diallyldimethylammonium chloride instead of vinylsulfonic acid as charge providing agent. Short columns of 6 cm were found to be sufficient in the case of CEC for baseline separations of amino acids with alpha values up to 5.     

A long-wavelength fluorescent substrate for continuous fluorometric determination of cellulase activity: resorufin-beta-D-cellobioside

A simple and reliable continuous assay procedure for measurement of cellulase activity from several species using the new substrate resorufin-beta-D-cellobioside (Res-CB) has been developed. The product of enzyme reaction, resorufin, exhibits fluorescence emission at 585 nm with excitation at 571 nm and has a pK(a) of 5.8, which allows continuous measurement of fluorescence turnover at or near physiological pH values. The assay performed using purified cellulase from the microscopic fungus Trichoderma reesei has been shown to give the kinetic parameters K(m) of 112 microM and V(max) of 0.000673 micromol/mL/min. Methods for performing the assay using cellulases isolated from both live Arabidopsis thaliana plant and Aspergillus niger fungal species are presented.