Effectiveness of individualized neurodevelopmental care in the newborn intensive care unit (NICU)

The individual infant's neurodevelopmental process provides an integrative framework for the delivery of medical care needed to assure the infant's survival and quality of outcome. The infant's neurobehavioral functioning and expression provides an opportunity for caregivers to estimate the individual infant's current strengths, vulnerabilities and threshold to disorganization, as well as to identify the infant's strategies in collaborating in his or her best progression. This perspective supports caregivers in seeing themselves in a relationship with the infant, and in considering opportunities to enhance the infant's strengths and reduce apparent stressors in collaboration with the infant and the family. The results of several randomized studies supporting the effectiveness of such a neuro developmental approach to NICU care will be presented, and suggest implications for staff education and nursery-wide implementation.     

Phosphodiesterase activity of the lower urinary tract

Cyclic AMP is believed to mediate the physiologic response of beta-receptor stimulation in the lower urinary tract. A possible novel therapy for specific dysfunctions might be via pharmacologic modification of cyclic AMP through regulation of phosphodiesterase, the enzyme responsible for metabolizing cyclic AMP. The present study characterizes the phosphodiesterase activity present in various sections of the lower urinary tract and determines the effect of calmodulin and the potency of a series of phosphodiesterase inhibitors. The results can be summarized as follows: the phosphodiesterase activity of all smooth muscle sections of the lower urinary tract were similar. They showed nonlinear kinetics with Vmax between 1.0 and 2.4 nmol./mg. protein/minute and apparent Km's around 100 microM. The external sphincter (skeletal muscle) displayed linear kinetics with a Vmax of 0.2 nmol./mg. protein/minute and a Km of 9 microM. Of the drugs tested, papaverine was the most potent inhibitor and theophylline was one of the weakest inhibitors. These studies also indicate that the major form of cyclic AMP phosphodiesterase is not sensitive to calmodulin.     

Application of magnetic resonance (MR) imaging for the development and validation of computational fluid dynamic (CFD) models of the rat respiratory system

Computational fluid dynamic (CFD) models of the respiratory system provide a quantitative basis for extrapolating the localized dose of inhaled materials and improving human health risk assessments based upon inhalation studies conducted in animals. Nevertheless, model development and validation have historically been tedious and time-consuming tasks. In recognition of this, we previously reported on the use of proton (1H) magnetic resonance (MR) imaging for visualizing nasal-sinus passages in the rat, and for speeding computational mesh generation. Here, the generation and refinement of meshes for rat nasal airways are described in more detail and simulated airflows are presented. To extend the CFD models to the complete respiratory tract, three-dimensional (3D) 1H MR imaging of rat pulmonary casts was also utilized to construct pulmonary airway meshes using procedures developed for the nasal airways. Furthermore, the feasibility of validating CFD predictions with MR was tested by imaging hyperpolarized 3He gas at physiological flow rates in a straight pipe with a diameter comparable to the rat trachea. Results from these diverse studies highlight the potential utility of MR imaging not only for speeding CFD development but also possibly for model validation.