Actual temperature during and thermal response after whole-body cryotherapy in cryo-cabin

Whole-body cryotherapy (WBC) involves exposing minimally dressed participants to very cold air (injecting liquid nitrogen with temperature −195 °C), either in a specially designed chamber (cryo-chamber) or cabin (cryo-cabin), for a short period of time. The aim of this study was to examine the actual temperature of the air in the cryo-cabin at different locations throughout the cabin by using human subjects and a manikin. Additionally, we monitored skin temperature before and for 60 min after the cryo-cabin session. Twelve subjects completed one 3 min cryo-cabin session. Temperature next to the skin was assessed during the session, while the skin temperature was monitored before, 3 min after and every 10 min for 60 min after completing the session. There was a statistically significant interaction (time×position) for temperature among the different body parts during the WBC, and for skin temperature among different body parts after the cryo-cabin session. Statistically significant time effects during and following cryo-cabin session were present for all body parts. We showed that actual temperature in the cryo-cabin is substantially different from the one reported by the manufacturer. Thermal response after cryo-cabin session is similar to response observed after cryo-chamber cold exposure reported in previously published studies. This could be of great practical value as cryo-cabins are less expensive and easier to use compared to cryo-chambers.     

Fallot's tetralogy in a European brown bear (Ursus arctos)

A congenital heart malformation was diagnosed in a free-ranging adult female European brown bear (Ursus arctos) found dead due to intraspecific violence. At necropsy, the heart had all four features of Fallot's tetralogy. No further malformations were identified in the animal, which was of normal size and weight for its age, in normal body condition, and had probably borne young. The heart condition was considered to have contributed to death during an attack by another bear.     

妊娠期糖尿病对子代主要先天畸形风险的影响

目的:探讨孕妇妊娠期糖尿病对子代先天畸形风险的影响,为优生优育提供参考。方法:对我院妇产科收治的124例糖尿病孕妇的临床资料进行前瞻性分析,同时选取150正常孕妇作为对照组,运用产前超声对糖尿病孕妇和正常孕妇的胎儿的先天畸形进行对比分析。结果:妊娠期糖尿病孕妇子代的先天畸形的风险明显高于正常孕妇(RR=2.24,95%CI=0.85-5.88)。结论:孕妇妊娠期糖尿病可对子代的各系统先天畸形造成较大影响,对孕早期进血糖监测是必要的。     

Unusual muscle abnormalities associated with thalidomide treatment in a rhesus monkey: a case report.

Unusual musculotendinous abnormalities were observed in the forelimbs of a rhesus monkey treated prenatally with thalidomide (10 mg/kg maternal body weight, gestation days 33, 34, and 35). Although the hindlimbs exhibited malformations typical of thalidomide dysmelia, the forelimbs appeared relatively normal externally. However, dissection revealed totally anomalous insertions of preaxial muscles of both forearms. Extensor muscles inserted on flexor surfaces even though normal sites of insertion were present and unoccupied. Radiographs revealed only minor ossification deficiencies in the carpus and distal radius. These observations suggest that thalidomide, given at the appropriate time, can disrupt condensation and splitting of pre-muscle masses without greatly disturbing condensation of corresponding preskeletal elements. These types of musculoskeletal relationships are unusual findings in congenital malformations of the limbs and have not been widely associated with thalidomide teratogenesis.     

After plastic surgery: adolescent-reported appearance ratings and appearance-related burdens in patient and general population groups.

The aim of this study was to determine the effects of appearance-related surgery on psychosocial functioning during adolescence. To this end, changes in bodily attitudes and appearance-related burdens in adolescents undergoing corrective (for aesthetic deformities) and reconstructive (for congenital or acquired deformities) surgery were compared with those in a general population sample.A group of 184 adolescent plastic surgery patients (corrective, n = 100; reconstructive, n = 84), and a comparison group of 83 adolescents at random selected from three municipalities (corrective, n = 67; reconstructive, n = 16), aged 12 to 22 years, were studied at two time points with a 6-month interval. The plastic surgical patients were studied presurgically and postsurgically. Using fully structured telephone interviews and postal questionnaires, adolescents' ratings of their appearance, bodily satisfaction and attitudes, and appearance-related burdens were obtained.All patients reported a significant decrease in burdens after surgery compared with the comparison group, indicating a much more prominent improvement in the patient sample compared with the developmental changes that may be expected to occur in adolescence. The corrective patient group reported least burdens after the operation. More specifically, the "breasts" group benefited most from the operation, indicating that breast corrections are rewarding interventions.The findings of this study imply that adolescents can be regarded as good candidates for plastic surgery. They gain bodily satisfaction, and they are relieved of many appearance-related burdens. Physical, social, and psychological burdens related to appearance satisfaction improve considerably in both corrective and reconstructive adolescent patients.     

Associated malformations in cases with congenital diaphragmatic hernia

The etiology of congenital diaphragmatic hernia (CDH) is unclear and its pathogenesis is controversial. Because previous reports have inconsistently noted the type and frequency of malformations associated with CDH, we assessed these associated malformations ascertained between 1979 and 2003 in 334,262 consecutive births. Of the 115 patients with the most common type of CDH, the posterolateral, or Bochdalek-type hernia, 70 (60.8%) had associated malformations. These included: chromosomal abnormalities (n = 21, 30.0%); non-chromosomal syndromes (Fryns syndrome, fetal alcohol syndrome, De Lange syndrome, CHARGE syndrome, Fraser syndrome, Goldenhar syndrome, Smith-Lemli-Opitz syndrome, multiple pterygium syndrome, Noonan syndrome, and spondylocostal dysostosis); malformation sequences (laterality sequence, ectopia cordis); malformation complexes (limb body wall complex) and non syndromic multiple congenital anomalies (MCA) (n = 30, 42.9%). Malformations of the cardiovascular system (n = 42, 27.5%), urogenital system (n = 27, 17.7%), musculoskeletal system (n = 24, 15.7%), and central nervous system (n = 15, 9.8%) were the most common other congenital malformations. We observed specific patterns of malformations associated with CDH which emphasizes the need to evaluate all patients with CDH for possible associated malformations. Geneticists and pediatricians should be aware that the malformations associated with CDH can often be classified into a recognizable malformation syndrome or pattern (57.1%).     

Surgical correction of facial asymmetry]

It is not possible to group the facial asymmetries in one single nosological entity. However, whatever the origin of these malformations, their surgical treatment is governed by the same principles. In this article, the author attempts to define certain aetiologies:genetic, congenital and developmental, of the minor assymmetries of the face. He then reviews the different techniques in current use, in plastic and reconstructive surgery:autogenic or homogenic tissue grafts (bone, cartilage, derm, fascia, etc.), implants of plastic material, osteotomies. He stresses the use of simple techniques which cause little mutilation, as well as the simultaneous correction of the profile which greatly enhances the aesthetic appearance and the psychological well-being of these patients.     

A polymorphic DNA marker genetically linked to congenital malformations

Unusual restriction fragments were detected by DNA blot hybridization with PCNA (DNA polymerase-delta auxiliary protein) probe in one of seven cases of congenital malformations. Chromosomal in situ hybridization localized PCNA gene to region q31-35 of human chromosome 2. To discover the locus more closely associated with congenital malformations, a cloned DNA segment which has been mapped to chromosomal region 2q33-36 was tested for restriction fragment length polymorphisms (RFLPs) in these patients. The 2q33-36 probe hybridized with 2.1-kb, 1.9-kb and 1.7-kb fragments in ten normal control samples. In seven cases of congenital malformations examined, however, the band of 2.1 kb is absent in six cases and the band of 1.7 kb in one case. These results indicate that the locus closely linked to congenital malformations is present in the proximity of PCNA locus.     

Preserved Tissue Allografts in Reconstructive Surgery

Results of treatment with three various kinds of allografts: lyophilized bone, deep frozen bone and cartilage preserved in physiological solution, all of them radiation-sterilized are presented. We believe that this presentation may be helpful in estimating the tissue bank's allografts and in establishing indications and contraindications in the application of allografts in surgery. The ‘indices of coincidence’ were compared in a group of 1014 patients after bone (lyophilized and radiation-sterilized) transplantation. It seems that such a variable as ‘rebuilding of graft’ may be of prognostic value in analysing the results of treatment in this group. The application of frozen and radiation-sterilized allogenic bone grafts for reconstructions is also described. An analysis of the results of treatment in 1125 patients reveals that the use of preserved bone reduces the extent and duration of surgery. Almost total substitution of grafts may be seen in 3–8 months after surgery. Allogenic, preserved cartilage is often used in facial reconstructions of face. Human costal cartilage, preserved in 0.9% NaCl and radiation-sterilized, was used for reconstruction. The patients were examined 24–190 months after surgery (in several clinical units) and results were collected in a special questionnaire by the team that performed surgery. In an analysed group of 437 patients after cartilage transplantation, 42.2% were operated because of posttraumatical changes, 29.0% because of congenital malformations and in 16.7% non-specific inflammations were the cause of reconstructive operations. Malformations were located mainly in the nose (59%), the ear concha (16.5%) and 10.9% were mandible. The results of treatment were compared with ages of patients, diagnosis and the locations of the changes. Very good results were achieved in 33.5% of the patients, and satisfactory in 41.8% of the patients. However, in 19.9% of the patients the result of treatment was unsatisfactory. Correlation between some clinical and biological characteristics and the result of treatment is under discussion. This revised version was published online in July 2006 with corrections to the Cover Date.     

In vitro fertilization (IVF) in Sweden: risk for congenital malformations after different IVF methods

BACKGROUND: The possible excess of congenital malformations in infants born after in vitro fertilization (IVF) has been much discussed in the literature, with controversial conclusions. This population based study is aimed at analyzing the presence of congenital malformations in a large group of infants born after IVF and to compare malformation risk both with that of all infants born and according to IVF method used. METHODS: Infants born after IVF during the period 1982-2001 were ascertained from all IVF clinics in Sweden. The presence of congenital malformations was identified from three national health registers: the Swedish Medical Birth Register, the Swedish Registry of Congenital Malformations, and the Swedish Hospital Discharge Register. The IVF children were compared with all children born in Sweden during the same period and recorded in the Swedish Medical Birth Register. RESULTS: Among 16,280 IVF children (30% conceived after intracytoplasmatic sperm injection [ICSI]) a 42% excess of any congenital malformation was found, explainable by parental characteristics and in some cases by the high rate of multiple births. Among these children, 8% had a congenital malformation, and 5% had a relatively severe condition. For neural tube defects, choanal atresia, and alimentary tract atresia, an additional risk increase was seen. There was no difference in malformation rate according to IVF method except for an excess of hypospadias after ICSI. CONCLUSIONS: An increased risk for congenital malformations occurs after IVF, similar for the different IVF techniques used, and mainly a consequence of parental characteristics. A few specific conditions show an extra increase in risk.     

Induction of congenital malformations in the offspring of male mice treated with X-rays at pre-meiotic and post-meiotic stages

The induction of congenital malformations among the offspring of male mice treated with X-rays at pre-meiotic and post-meiotic stages has been studied in two experiments. Firstly, animals were exposed to varying doses (108–504 cGy) of X-rays and mated at various time intervals (1–7, 8–14, 15–21 and 64–80 days post-irradiation), so as to sample spermatozoa, spermatids and spermatogonial stem cells. In the second experiment, only treated spermatogonial stem cells were sampled. One group of males was given a single 500-cGy dose, a second group a fractionated dose (500 + 500 cGy, 24 h apart) and a third group was left unexposed.In the first experiment, induced post-implantation dominant lethality increased with dose, and was highest in week 3, in line with the known greater radiosensitivity of the early spermatid stage. Preimplantation loss also increased with dose and was highest in week 3. There was no clear induction of either pre-implantation or post-implantation loss at spermatogonial stem cell stages.There was a clear induction of congenital malformations at post-meiotic stages, the overall incidence being 2.0 ± 0.32% in the irradiated series and 0.24 ± 0.17% among the controls. The induction was statistically significant at each dose. At the two highest doses the early spermatids (15–21 days) appeared more sensitive than spermatozoa, and at this stage the incidence of malformations increased with dose. The data from Expt. 1 on the induction of malformations by irradiation of spermatogonial stages were equivocal. In contrast, Expt. 2 showed a statistically significant induction of malformations at both dose levels (2.2 ± 0.46% after 500 cGy and 3.1 ± 0.57% after 500 + 500 cGy). The relative sensitivities of male stem cells, post-neiotic stages and mature oocytes to the induction of congenital malformations were reasonably similar to their sensitivities for specific-locus mutations, except that the expected enhancing effect of the fractionation regime used was not seen.Dwarfism and exencephaly were the two most commonly observed malformations in all series.     

Behavioral and autonomic responses to acute restraint stress are segregated within the lateral septal area of rats

Background

The Lateral Septal Area (LSA) is involved with autonomic and behavior responses associated to stress. In rats, acute restraint (RS) is an unavoidable stress situation that causes autonomic (body temperature, mean arterial pressure (MAP) and heart rate (HR) increases) and behavioral (increased anxiety-like behavior) changes in rats. The LSA is one of several brain regions that have been involved in stress responses. The aim of the present study was to investigate if the neurotransmission blockade in the LSA would interfere in the autonomic and behavioral changes induced by RS.

Methodology/Principal Findings

Male Wistar rats with bilateral cannulae aimed at the LSA, an intra-abdominal datalogger (for recording internal body temperature), and an implanted catheter into the femoral artery (for recording and cardiovascular parameters) were used. They received bilateral microinjections of the non-selective synapse blocker cobalt chloride (CoCl₂, 1 mM/ 100 nL) or vehicle 10 min before RS session. The tail temperature was measured by an infrared thermal imager during the session. Twenty-four h after the RS session the rats were tested in the elevated plus maze (EPM).

Conclusions/Significance

Inhibition of LSA neurotransmission reduced the MAP and HR increases observed during RS. However, no changes were observed in the decrease in skin temperature and increase in internal body temperature observed during this period. Also, LSA inhibition did not change the anxiogenic effect induced by RS observed 24 h later in the EPM. The present results suggest that LSA neurotransmission is involved in the cardiovascular but not the temperature and behavioral changes induced by restraint stress.     

De novo monosomy 4q32.1 leads to 4qter in a newborn with multiple malformations (author's transl)]

In a newborn with multiple malformations, deletion 4q32.1 leads to 4qter was observed after BrdU incorporation and staining with acridine orange. The patient's phenotype and that of five children monosomic for 4qter reported in the literature define a syndrome with a high rate of mortality due to major respiratory difficulties, laryngeal hypotonia and oedema, and complex congenital heart malformations.     

An experimental study on the effect of rigid fixation on the developing craniofacial skeleton

Rigid fixation of the craniofacial skeleton has proven of great value in adult orthognathic and traumatic reconstructive surgical procedures. This technique has gained increased acceptance in the surgical treatment of infants and young children with congenital malformations, despite the fact that its effects on subsequent craniofacial growth are unknown. To examine this question, an experimental model using 25 young kittens was developed to compare rigid fixation with conventional wire fixation, with and without osteotomy. Our findings demonstrate a regional restriction of growth in the developing craniofacial skeleton when both wire and plate and screw fixation are utilized in concert with osteotomy. Further, a compensatory growth was observed in individual animals when plate fixation was utilized that was not seen in the wire-treated group. This suggests that there is a dynamic growth interaction between restriction and compensation in this setting.     

Bendectin and human congenital malformations

The relationship between Bendectin exposure during the first trimester of pregnancy and the occurrence of congenital malformations was prospectively studied in 31,564 newborns registered in the Northern California Kaiser Permanente Birth Defects Study. The odds ratio for any major malformation and Bendectin use was 1.0 (95% confidence interval 0.8-1.4). There were 58 categories of congenital malformations; three of them were statistically associated with Bendectin exposure (microcephaly--odds ratio = 5.3, 95% confidence interval = 1.8-15.6; congenital cataract--odds ratio = 5.3, 95% confidence interval = 1.2-24.3; lung malformations (ICD-8 codes 484.4-484.8)--odds ratio = 4.6, 95% confidence interval = 1.9-10.9). This is exactly the number of associations that would be expected by chance. An independent study (the Collaborative Perinatal Project) was used to determine whether vomiting during pregnancy in the absence of Bendectin use was associated with these three malformations. Two of the three (microcephaly and cataract) had strong positive associations with vomiting in the absence of Bendectin use. We conclude that there is no increase in the overall rate of major malformations after exposure to Bendectin and that the three associations found between Bendectin and individual malformations are unlikely to be causal.     

The expanded transposition flap: shifting paradigms based on experience gained from two decades of pediatric tissue expansion

The authors present their experience with the design of expanded skin flaps gained over the past two decades in a large series of 995 expanded flap reconstructions performed in 626 operations in 430 patients. The indications for tissue expansion were giant congenital pigmented nevi (72.7 percent), scar contractures (11.2 percent), and a remainder for a variety of congenital and acquired deformities. Surgical strategies were reviewed retrospectively to determine the location in the body where the tissue expansion was performed, the number of procedures required to accomplish the reconstructive goal, and the design of the expanded flap that was used to reconstruct the involved area. Specific points that were noticed included contour deformities (such as webbing, dog-ears, or decreased limb circumference) following flap reconstruction, anatomic distortions (such as distortion of the eyebrow or the distance from the brow to hairline) following reconstruction, final position of the scars in relation to anatomic landmarks, borders of aesthetic units, and relaxed skin tension lines, and the potential for later scar contracture. Careful examination of reconstruction by region of involvement demonstrated significant advantages in the use of expanded transposition flaps over pure advancement. These advantages and the modifications in the design of expanded flaps for each body region are discussed in a series of representative cases. They emphasize the ability of transposition flaps to dissipate tension away from the flap apex and distribute it more proximally, thus redirecting the tension lines so there is less likelihood of anatomic distortion in the reconstructed area. Also, flaps designed in this manner allow improved contour by avoiding webbing, tenting across concavities, and bunching of skin laterally. The authors conclude that restricting the expanded flap design to advancement alone to minimize potential scarring severely limits the reconstructive capabilities of the added tissue and distracts from the surgeon's ability to accomplish the initial reconstructive goal. The cost of additional incisions is worthwhile to achieve better final contour of the reconstructed part, lesser risk of anatomic distortion, better position of the scars, and lowered risk of scar contracture.     

Fatty acids composition in erythrocyte membranes of athletes after one and after a series of whole body cryostimulation sessions

Whole body cryotherapy (WBC) is a treatment often used by athletes as part of biological renewal. Despite the large interest in this form therapy there is still a lack of information on the effects of WBC on the concentration of fatty acids in erythrocyte membranes. Our study aimed at comparing the fatty acids (FA) composition of erythrocyte membranes of athletes after one session and after a series of sessions of whole body cryostimulation. In our study small changes in the level of total cholesterol (decrease) were observed 24 h after a single session. After the twelfth session of whole body cryostimulation, the level of saturated fatty acids (SFA), mainly palmitic acid (C16:0) and n-3 fatty acid eicosapentaenoic (EPA, C20:5n-3) increased almost two-times fold in the red blood cell membranes. The level of n-6 polyunsaturated fatty acids (PUFA n-6), mainly gamma-linolenic acid (C18:3n-6) as well as trans fatty acids (elaidic acid) decreased in the erythrocyte membranes from men after a series of session in a cryochamber, when compared to the control sample. The n-3/n-6 FA ratio in the erythrocyte membranes was higher after twelfth session in a cryochamber in comparison to the control sample.The data obtained during our study will be important for further research regarding the biochemistry of lipids in men after sessions of whole body cryostimulation.     

CHARGE Association in newborns: a registry-based study

The CHARGE Association is a nonrandom occurrence of congenital malformations that has been described in clinical series. Reported patients have been selected on the basis of certain prior criteria. In this article, we try to identify a congenital malformation pattern corresponding to the CHARGE Association, using statistical methods and analyzing 5,260 infants with multiple malformations collected from four large registries of congenital malformations. Care was taken to identify a number of confounding characteristics that can influence the ascertainment and registration of specific congenital malformations. We have identified a cluster of malformations that generally agreed with the current clinical definition of the CHARGE Association and have added some further malformations (e.g., facial clefts). We demonstrate that others (e.g. , esophageal atresia) are probably not part of the pattern. Heart defects (H in the acronym) seems to be less helpful in identifying infants with the association. We suggest a method to select infants who probably represent the CHARGE Association for analyses of possible risk factors.     

Congenital malformations associated with anencephaly in liveborn and stillborn infants

Records from the population-based British Columbia Health Surveillance Registry were examined, and a total of 456 infants with anencephaly (181 liveborns, 275 stillborns) were identified. Registry records list up to four congenital malformations per individual, and the records of the study cohort were reviewed for the presence of additional malformations. A total of 12.7% of infants (14.4% liveborns, 11.6% stillborns) had congenital malformations in addition to anencephaly. The frequencies of specific congenital malformations (e.g., talipes, cleft lip and/or palate, omphalocele) in infants with anencephaly were compared with the frequencies of these malformations in the general population of liveborns. In addition, the types of additional congenital malformations in liveborn anencephalics compared to stillborns were looked at. The similarity suggests that it is not just the presence of these additional congenital malformations that leads to death in utero. The data provide further evidence for etiological heterogeneity in neural tube defects.