A computer linked Doppler system was used to make continuous measurements of cerebral blood flow velocity (CBFV) from the middle cerebral artery, mean arterial blood pressure (MAP) from the umbilical artery, and heart rate before, during, and for 20 minutes after the endotracheal administration of 200 mg/kg of porcine surfactant in 10 preterm infants with respiratory distress syndrome. Within two minutes of surfactant administration, there was a median fall of 6 mm Hg (15%) fall in MAP and 36% in CBFV. There was a change in the Doppler spectra with almost complete loss of diastolic velocities. A rapid reduction in pulmonary vascular resistance with consequent left to right ductal shunting is one possible cause. These acute changes in MAP and CBFV after bolus surfactant administration may increase the risk of intraventricular haemorrhage.

This study used anthropometric data in the form of Farkas' proportion indices in order to quantify facial attractiveness, and to relate measured change through surgery, to clinical judgement. Standardized photographs of 15 orthognathic patients were used in album form and rated by 10 experienced clinicians: album 1 for facial attractiveness (before surgery) and album 2 for improvement in facial attractiveness (before and after surgery). Twenty-five proportion indices were selected and linear measurements recorded from the pre- and post-surgical photographs. The corresponding change in indices and in clinicians' scores were compared. The clinicians' assessment of the degree of improvement in facial appearance achieved through surgery, related closely to the scores produced by the change in proportion indices (r = 0.698, P = 0.004). Clinical assessment demonstrated a clear inverse relationship between initial attractiveness rating and the degree of improvement achieved through orthognathic surgery (r = –0.781, P = 0.001). The results showed good repeatability in terms of clinical assessment, photography and digitization. The method would appear to have potential for further development, possibly into a ‘facial attractiveness index’ for the objectives of quantification of improvement achieved through treatment.

The prognostic value of early neonatal continuous electroencephalographic recordings in hypoxic ischaemic encephalopathy was evaluated. Thirty seven full term infants with hypoxic ischaemic encephalopathy were studied. The electroencephalogram (EEG) was recorded using four or eight channel Oxford Medilog recorders and was started as soon as possible after birth. The recordings were initially visually analysed and divided into four categories: three in relation to the grade of discontinuity of the background activity (continuous, discontinuous, and maximum depression) and an additional fourth category to include status epilepticus. The EEGs with discontinuous activity were then analysed by computer to obtain a more objective assessment of discontinuity. The results were related to neurological outcome. Continuous background activity was associated with a normal outcome in all but the three infants who had continuous, but asymmetrical EEGs and who developed contralateral hemiplegia. In the eight infants with discontinuous activity, the outcome appeared to be related to the grade of continuity and the presence of clear convulsions on the EEG. The 10 infants with maximum depression and status epilepticus had severe impairment. These preliminary results suggest that continuous recording of EEGs could be used routinely in term infants with hypoxic ischaemic encephalopathy. Computer analysis can improve the value of this technique, allowing the identification of infants who might benefit from early therapeutic intervention.

This paper reviews past, current and likely future research on the fish haemogregarine, Haemogregarina bigemina Laveran et Mesnil, 1901. Recorded from 96 species of fishes, across 70 genera and 34 families, this broad distribution for H. bigemina is questioned. In its type hosts and other fishes, the parasite undergoes intraerythrocytic binary fission, finally forming mature paired gamonts. An intraleukocytic phase is also reported, but not from the type hosts. This paper asks whether stages from the white cell series are truly H. bigemina. A future aim should be to compare the molecular constitution of so-called H. bigemina from a number of locations to determine whether all represent the same species. The transmission of H. bigemina between fishes is also considered. Past studies show that young fish acquire the haemogregarine when close to metamorphosis, but vertical and faecal-oral transmission seem unlikely. Some fish haemogregarines are leech-transmitted, but where fish populations with H. bigemina have been studied, these annelids are largely absent. However, haematophagous larval gnathiid isopods occur on such fishes and may be readily eaten by them. Sequential squashes of gnathiids from fishes with H. bigemina have demonstrated development of the haemogregarine in these isopods. Examination of histological sections through gnathiids is now underway to determine the precise development sites of the haemogregarine, particularly whether merozoites finally invade the salivary glands. To assist in this procedure and to clarify the internal anatomy of gnathiids, 3D visualisation of stacked, serial histological sections is being undertaken. Biological transmission experiments should follow these processes.