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Sample records for grafting employing cardiopulmonary

  1. Cardiac Compression of Lung Lower Lobes after Coronary Artery Bypass Graft with Cardiopulmonary Bypass

    Science.gov (United States)

    Neves, Flávio H.; Carmona, Maria J.; Auler, José O. C.; Rodrigues, Roseny R.; Rouby, Jean Jacques; Malbouisson, Luiz M. S.

    2013-01-01

    Background Atelectasis is a major cause of hypoxemia after coronary artery bypass grafting (CABG) and is commonly ascribed to general anesthesia, high inspiratory oxygen concentration and cardiopulmonary bypass (CPB). The objective of this study was to evaluate the role of heart-induced pulmonary compression after CABG with CPB. Methods Seventeen patients without pre-operative cardiac failure who were scheduled for coronary artery bypass graft underwent pre- and postoperative thoracic computed tomography. The cardiac mass, the pressure exerted on the lungs by the right and left heart and the fraction of collapsed lower lobe segments below and outside of the heart limits were evaluated on a computed tomography section 1 cm above the diaphragmatic cupola. Results In the postoperative period, cardiac mass increased by 32% (117±31 g versus 155±35 g, p<0.001), leading to an increase in the pressure that was exerted on the lungs by the right (2.2±0.6 g.cm?2 versus 3.2±1.2 g.cm?2, p<0.05) and left heart (2.4±0.7 g.cm?2 versus 4.2±1.8 g.cm?2, p<0.001). The proportion of collapsed lung segments beneath the heart markedly increased [from 6.7% to 32.9% on the right side (p<0.001) and from 6.2% to 29% on the left side (p<0.001)], whereas the proportion of collapsed lung segments outside of the heart limits slightly increased [from 0.7% to 10.8% on the right side (p<0.001) and from 1.5% to 12.6% on the left side (p<0.001)]. Conclusion The pressure that is exerted by the heart on the lungs increased postoperatively and contributed to the collapse of subjacent pulmonary segments. PMID:24244331

  2. Predictors of inotrope use in patients undergoing concomitant coronary artery bypass graft (CABG and aortic valve replacement (AVR surgeries at separation from cardiopulmonary bypass (CPB

    Directory of Open Access Journals (Sweden)

    Nelson William B

    2009-06-01

    Full Text Available Abstract Background Left ventricular dysfunction is common after coronary artery bypass graft and valve replacement surgeries and is often treated with inotropic drugs to maintain adequate hemodynamic status. In this study, we aimed to identify the demographic, clinical, laboratory, echocardiographic and hemodynamic factors that are associated with use of inotropic drugs in patients undergoing concomitant coronary artery bypass graft and aortic valve replacement surgery. Methods The study included 97 patients who had undergone concomitant coronary artery bypass graft and aortic valve replacement at Regions Hospital, University of Minnesota Medical School from January 2006 to December 2008. All data were collected retrospectively after reviewing electronic medical records. Inotropic support was defined as the use of dopamine [greater than or equal to] 5 ug/kg/min; any dose of epinephrine, norepinephrine, dobutamine, and milrinone at the separation from cardiopulmonary bypass. Results Inotropic support was used in a total of 50 patients (52% at the separation from cardiopulmonary bypass. Average age of the patients requiring inotropic support was 72.2 +/- 8.8 years. The study identified four significant, independent predictors of inotrope use: (1 Cardiac index [less than or equal to]2.5 L/min/m2, (2 LVEDP [greater than or equal to] 20 mm Hg, (3 LVEF [less than or equal to]40%, and (4 CKD stage 3 to 5. Conclusion We identified four independent risk factors for postoperative use of inotropic support in patients undergoing concomitant coronary artery bypass graft and arotic valve replacement surgery at the separation from cardiopulmonary bypass. The study results will be helpful to prospectively identify patients who will likely to require inotropic support at the separation from cardiopulmonary bypass.

  3. Reconstruction of irradiated mandible after segmental resection of osteoradionecrosis-a technique employing a microvascular latissimus dorsi flap and subsequent particulate iliac bone grafting

    DEFF Research Database (Denmark)

    Hillerup, Soren; Elberg, Jens Jorgen

    2014-01-01

    The fibula osteocutaneous flap has revolutionized the options of mandibular segmental defect bridging in osteoradionecrosis (ORN). In selected cases, however, the fibula flap is not an option because of atherosclerosis or other features that compromise the vascularity of the lower leg and foot. The aim of this study is to present an alternative method of mandibular segmental reconstruction employing a latissimus dorsi (LD) flap and subsequent particulate iliac free bone graft reconstruction. In 15 patients with ORN, a mandibular segmental defect was bridged with a reconstruction plate, and the defect site was primed with a LD musculocutaneous flap wrapped around the reconstruction plate to bring in vascularized tissue and optimize healing conditions for a subsequent particulate iliac free bone graft reconstruction. The management of defect closure was successful in all 15 patients. Twelve patients had a subsequent bone grafting from the posterior ileum for repair of defects up to 14 cm length. Three patients had no bone graft for various reasons. In three patients dental rehabilitation was achieved with implant supported prosthodontic appliances. Ten patients met the success criteria of uneventful graft healing with restitution of osseous continuity, mandibular height, symmetry and function, and avoidance of reconstruction plate fracture.

  4. Off-pump versus on-pump coronary artery bypass grafting for ischaemic heart disease

    DEFF Research Database (Denmark)

    Møller, Christian H; Penninga, Luit; Wetterslev, Jørn; Steinbrüchel, Daniel A; Gluud, Christian

    2012-01-01

    Coronary artery bypass grafting (CABG) is performed both without and with cardiopulmonary bypass, referred to as off-pump and on-pump CABG respectively. However, the preferable technique is unclear.......Coronary artery bypass grafting (CABG) is performed both without and with cardiopulmonary bypass, referred to as off-pump and on-pump CABG respectively. However, the preferable technique is unclear....

  5. Fluid distribution kinetics during cardiopulmonary bypass

    Scientific Electronic Library Online (English)

    Mattias, Törnudd; Robert G., Hahn; Joachim H., Zdolsek.

    2014-08-01

    Full Text Available OBJECTIVE: The purpose of this study was to examine the isovolumetric distribution kinetics of crystalloid fluid during cardiopulmonary bypass. METHODS: Ten patients undergoing coronary artery bypass grafting participated in this prospective observational study. The blood hemoglobin and the serum [...] albumin and sodium concentrations were measured repeatedly during the distribution of priming solution (Ringer's acetate 1470 ml and mannitol 15% 200 ml) and initial cardioplegia. The rate of crystalloid fluid distribution was calculated based on 3-min Hb changes. The preoperative blood volume was extrapolated from the marked hemodilution occurring during the onset of cardiopulmonary bypass. Clinicaltrials.gov: NCT01115166. RESULTS: The distribution half-time of Ringer's acetate averaged 8 minutes, corresponding to a transcapillary escape rate of 0.38 ml/kg/min. The intravascular albumin mass increased by 5.4% according to mass balance calculations. The preoperative blood volume, as extrapolated from the drop in hemoglobin concentration by 32% (mean) at the beginning of cardiopulmonary bypass, was 0.6-1.2 L less than that estimated by anthropometric methods (p

  6. Cardiopulmonary discipline science plan

    Science.gov (United States)

    1991-01-01

    Life sciences research in the cardiopulmonary discipline must identify possible consequences of space flight on the cardiopulmonary system, understand the mechanisms of these effects, and develop effective and operationally practical countermeasures to protect crewmembers inflight and upon return to a gravitational environment. The long-range goal of the NASA Cardiopulmonary Discipline Research Program is to foster research to better understand the acute and long-term cardiovascular and pulmonary adaptation to space and to develop physiological countermeasures to ensure crew health in space and on return to Earth. The purpose of this Discipline Plan is to provide a conceptual strategy for NASA's Life Sciences Division research and development activities in the comprehensive area of cardiopulmonary sciences. It covers the significant research areas critical to NASA's programmatic requirements for the Extended-Duration Orbiter, Space Station Freedom, and exploration mission science activities. These science activities include ground-based and flight; basic, applied, and operational; and animal and human research and development. This document summarizes the current status of the program, outlines available knowledge, establishes goals and objectives, identifies science priorities, and defines critical questions in the subdiscipline areas of both cardiovascular and pulmonary function. It contains a general plan that will be used by both NASA Headquarters Program Offices and the field centers to review and plan basic, applied, and operational (intramural and extramural) research and development activities in this area.

  7. Complications of cardiopulmonary resuscitation

    OpenAIRE

    Özer, Erdal; ?am, Bülent; Tokdemir, Murat Bülent; Çetin, Gürsel

    2010-01-01

    AbstractAim. In 1960, Kouwenhoven observed that forceful chest compressions can produce arterial pulses. At following years cardiopulmonary resuscitation (CPR) continually advanced. Right now experts at the International Guidelines 2000 Conference strongly recommended development of in-school CPR programs as a primary educational strategy to ensure wide-spread learning of CPR. Rib and sternum fractures are frequent complications of CPR in adults. Fractures frequently occur at ribs, number 3-8...

  8. Cardiopulmonary bypass in pregnancy

    Directory of Open Access Journals (Sweden)

    Mukul Chandra Kapoor

    2014-01-01

    Full Text Available Cardiac surgery carried out on cardiopulmonary bypass (CPB in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women. Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB. The CPB is associated with utero-placental hypoperfusion due to a number of factors, which may translate into low fetal cardiac output, hypoxia and even death. Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status, use of perioperative fetal monitoring, optimization of CPB, delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

  9. Free graft anoplasty

    OpenAIRE

    Fucini C; Caminati F; Basiricò F; Bartolini N.; Mirasolo VM

    2012-01-01

    Aim Reconstruction of a stenotic anal canal and repair of a stenotic perineal colostomy using a free graft foreskin. Method The use of free graft foreskin anoplasty was described by Freeman for the treatment of mucosal prolapse in pediatric patients. The original surgical technique was modified and employed in two adult patients for the reconstruction of the anal region. Results The graft, in both cases, took well with a satisfactory functional and morphological recovery of the anal canal. Co...

  10. Implantation of transcatheter aortic valve prosthesis through the ascending aorta concomitant with coronary artery bypass grafting without cardiopulmonary bypass / Implante de prótese valvar aórtica transcateter através da aorta ascendente concomitante com revascularização do miocárdio sem circulação extracorpórea

    Scientific Electronic Library Online (English)

    João Carlos Ferreira, Leal; Luis Ernesto, Avanci; Achilles, Abelaira Filho; Thiago Faria, Almeida; Domingo Marcolino, Braile.

    2014-12-01

    Full Text Available Introdução: implante de prótese aórtica transcateter no tratamento da estenose aórtica sintomática de alto risco vem aumentando de número a cada ano no mundo. A curva de aprendizado para implante da prótese aórtica transcateter melhorou os resultados ao longo dos últimos 12 anos, o que permitiu o s [...] urgimento de outras vias de acesso como alternativas. Objetivo: Este trabalho refere-se ao implante de prótese aórtica transcateter pela via transaórtica associada à revascularização do miocárdio sem em paciente do sexo masculino de 67 anos com doença pulmonar obstrutiva crônica, hipertensão arterial sistêmica e transplante de rim. Métodos: A revascularização miocárdica e o implante da prótese aórtica transcateter foram realizados com sucesso sem o auxílio da circulação extracorpórea. Resultados: No intra e pós-operatório não houve complicações, a redução do gradiente transvalvar, o aumento do orifício efetivo e ausência de regurgitação paravalvar foram observados pelo ecocardiograma transesofágico. Conclusão: O implante da prótese aórtica transcateter pela aorta ascendente associado com revascularização do miocárdio sem circulação extracorpórea é uma nova alternativa para pacientes de alto rico. Abstract in english Introdution: The transcatheter aortic valve implantation in the treatment of high-risk symptomatic aortic stenosis has increased the number of implants every year. The learning curve for transcatheter aortic valve implantation has improved since the last 12 years, allowing access alternatives. Obje [...] ctive: The aim of this study is to approach the implantation of transcatheter aortic valve through transaortic via associated with off-pump cardiopulmonary bypass surgery in a 67-year-old man, with chronic obstructive pulmonary disease, arterial hypertension and kidney transplant. Methods: Off-pump coronary artery bypass surgery was performed and the valve in the aortic position was released successfully. Results: There were no complications in the intraoperative and postoperative period. Gradient reduction, effective orifice increasing of the prosthesis and absence of valvular regurgitation after implantation were observed by transesophageal echocardiography. Conclusion: Procedural success demonstrates that implantation of transcatheter aortic valve through the ascending aorta associated with coronary artery bypass surgery without CPB is a new option for these patients.

  11. Surgical results of coronary artery bypass grafting without cardiopulmonary bypass: analysis of 3,410 patients Resultados cirúrgicos na revascularização do miocárdio sem circulação extracorpórea: análise de 3.410 pacientes

    Directory of Open Access Journals (Sweden)

    Ricardo de Carvalho Lima

    2003-09-01

    Full Text Available OBJECTIVES: Over the past few years, great strides have been made in off-pump coronary surgery. This progress is due to a combination of the advances in surgical techniques and the development of instruments that make it possible to perform this procedure in the most varied situations. This is a retrospective study, the purpose of which is to assess our experience with this procedure over the last eleven and a half years. The authors underscore the rapid progress of the method in recent years and report on its indications, contraindications and results. METHODS: In the period from August 1991 to December 2003, 3,410 consecutively patients suffering from angina pectoris were submitted to off-pump coronary surgery. Ages ranged from 13 to 93 years, with a mean of 63 ± 12.0 years. Males accounted for 58% of the cases. The angina was rated according to the criteria of the Canadian Cardiovascular Society, 6.1% of the patients being in Class I, 6.8% in Class II, 46.3% in Class III and 40.8% in Class IV. RESULTS: Intraoperative mortality was low (0.4%. Hospital mortality (30 postoperative days was 2.5%. Mortality and morbidity among the octogenarian patients were extremely low compared with patients operated on with cardiopulmonary bypass (CPB (2.2% versus 12.6% (pOBJETIVO: Nos últimos anos, tem-se observado um grande avanço na cirurgia de revascularização miocárdica sem circulação extracorpórea (RMSCEC. Esse desenvolvimento deveu-se à combinação dos avanços da técnica cirúrgica e ao desenvolvimento de instrumentos que possibilitam a realização deste procedimento nas mais variadas situações. Este é um estudo retrospectivo, que visa avaliar nossa experiência com este procedimento nos últimos 11,5 anos. Os autores enfatizam o rápido progresso do método nos últimos anos, suas indicações, contra-indicações e resultados. MÉTODO: No período de agosto de 1991 e dezembro de 2002, 3.410 pacientes consecutivos, portadores de angina do peito, foram submetidos a cirurgia de revascularização miocárdica sem circulação extracorpórea. A idade variou de 13 a 93 anos (63 12,0 anos, sendo 58% dos pacientes do sexo masculino. A angina foi classificada segundo a Canadian Cardiovascular Society, sendo 6,1% na classe I, 6,8% na classe II, 46,3% na classe III e 40,8% na classe IV. RESULTADOS: A mortalidade intra-operatória foi baixa (0,4%. A mortalidade hospitalar (trinta dias de pós-operatório foi de 2,58%. A mortalidade e morbidade, no grupo dos pacientes octogenários, foram extremamente baixas em relação aos pacientes operados com circulação extracorpórea (2,2% x 12,6% (p<0,001. As complicações pós-operatórias que não resultaram em óbito foram de 7,6%. No último ano, não observamos diferença entre o número de condutos nos pacientes operados com e sem CEC [com CEC 2,81,2 e sem CEC 2,80,8 (NS]. Infarto agudo do miocárdio foi a complicação não fatal mais freqüente, observada em 2,8% dos pacientes. O tempo médio de permanência na UTI foi de 22,3 horas. CONCLUSÕES: A RMSCEC, usada como técnica de revascularização em pacientes multiarteriais, é um procedimento reproduzível e apresenta resultados semelhantes aos obtidos com a operação convencional com CEC. Nesta série foi possível revascularizar o miocárdio sem circulação extracorpórea em mais de 95% dos pacientes, tornando assim, a princípio, todos os pacientes, com indicação de revascularização miocárdica, potenciais candidatos à operação de RMSCEC.

  12. Surgical results of coronary artery bypass grafting without cardiopulmonary bypass: analysis of 3,410 patients / Resultados cirúrgicos na revascularização do miocárdio sem circulação extracorpórea: análise de 3.410 pacientes

    Scientific Electronic Library Online (English)

    Ricardo de Carvalho, Lima; Mozart Augusto Soares, Escobar; José Glauco, Lobo Filho; Roberto, Diniz; Antonio, Saraiva; Antonio, Césio; Mário, Gesteira; Frederico, Vasconcelos.

    2003-09-01

    Full Text Available OBJETIVO: Nos últimos anos, tem-se observado um grande avanço na cirurgia de revascularização miocárdica sem circulação extracorpórea (RMSCEC). Esse desenvolvimento deveu-se à combinação dos avanços da técnica cirúrgica e ao desenvolvimento de instrumentos que possibilitam a realização deste procedi [...] mento nas mais variadas situações. Este é um estudo retrospectivo, que visa avaliar nossa experiência com este procedimento nos últimos 11,5 anos. Os autores enfatizam o rápido progresso do método nos últimos anos, suas indicações, contra-indicações e resultados. MÉTODO: No período de agosto de 1991 e dezembro de 2002, 3.410 pacientes consecutivos, portadores de angina do peito, foram submetidos a cirurgia de revascularização miocárdica sem circulação extracorpórea. A idade variou de 13 a 93 anos (63 12,0 anos), sendo 58% dos pacientes do sexo masculino. A angina foi classificada segundo a Canadian Cardiovascular Society, sendo 6,1% na classe I, 6,8% na classe II, 46,3% na classe III e 40,8% na classe IV. RESULTADOS: A mortalidade intra-operatória foi baixa (0,4%). A mortalidade hospitalar (trinta dias de pós-operatório) foi de 2,58%. A mortalidade e morbidade, no grupo dos pacientes octogenários, foram extremamente baixas em relação aos pacientes operados com circulação extracorpórea (2,2% x 12,6%) (p Abstract in english OBJECTIVES: Over the past few years, great strides have been made in off-pump coronary surgery. This progress is due to a combination of the advances in surgical techniques and the development of instruments that make it possible to perform this procedure in the most varied situations. This is a ret [...] rospective study, the purpose of which is to assess our experience with this procedure over the last eleven and a half years. The authors underscore the rapid progress of the method in recent years and report on its indications, contraindications and results. METHODS: In the period from August 1991 to December 2003, 3,410 consecutively patients suffering from angina pectoris were submitted to off-pump coronary surgery. Ages ranged from 13 to 93 years, with a mean of 63 ± 12.0 years. Males accounted for 58% of the cases. The angina was rated according to the criteria of the Canadian Cardiovascular Society, 6.1% of the patients being in Class I, 6.8% in Class II, 46.3% in Class III and 40.8% in Class IV. RESULTS: Intraoperative mortality was low (0.4%). Hospital mortality (30 postoperative days) was 2.5%. Mortality and morbidity among the octogenarian patients were extremely low compared with patients operated on with cardiopulmonary bypass (CPB) (2.2% versus 12.6%) (p

  13. A Reappraisal of Saphenous Vein Grafting

    OpenAIRE

    Yuan Shi-Min; Jing Hua

    2011-01-01

    Autologous saphenous vein grafting has been broadly used as a bypass conduit, interposition graft, and patch graft in a variety of operations in cardiac, thoracic, neurovascular, general vascular, vascular access, and urology surgeries, since they are superior to prosthetic veins. Modified saphenous vein grafts (SVG), including spiral and cylindrical grafts, and vein cuffs or patches, are employed in vascular revascularization to satisfy the large size of the receipt vessels or to obtain a be...

  14. Palliative care in cardiopulmonary transplantation.

    Science.gov (United States)

    McKenna, Maria; Clark, Stephen C

    2015-12-01

    Cardiopulmonary transplantation is a life-prolonging therapy available to a select population of patients with cardiac or respiratory failure. Transplantation is associated with significant morbidity, mortality and unmet palliative care need. Despite recommendations that palliative care should be a core component of the heart and lung transplant process, collaboration within clinical practice is extremely rare. A key reason for this is the misperception among patients, their families and transplant clinicians, that palliative care is analogous with end of life care. Other challenges include prognostication, communication, and the balance of hope and reality. We suggest a change in clinical practice within cardiopulmonary transplantation, whereby palliative care takes place alongside active management. Greater partnership working will demonstrate clinical credibility and highlight the impact of palliative care interventions. Education is required to address current misperceptions and further research should explore the effect of initiatives to improve palliative care provision for this patient group. PMID:25812577

  15. MRI Catheterization in Cardiopulmonary Disease

    OpenAIRE

    Rogers, Toby; Ratnayaka, Kanishka; Lederman, Robert J

    2014-01-01

    Diagnosis and prognostication in patients with complex cardiopulmonary disease can be a clinical challenge. A new procedure, MRI catheterization, involves invasive right-sided heart catheterization performed inside the MRI scanner using MRI instead of traditional radiographic fluoroscopic guidance. MRI catheterization combines simultaneous invasive hemodynamic and MRI functional assessment in a single radiation-free procedure. By combining both modalities, the many individual limitations of i...

  16. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Cardiopulmonary prebypass filter. 870.4280 Section 870.4280 ...870.4280 Cardiopulmonary prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming...

  17. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Science.gov (United States)

    2010-04-01

    ...false Cardiopulmonary bypass blood reservoir. 870.4400 Section 870.4400...4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  18. Effects of cardiopulmonary bypass on propofol pharmacokinetics and bispectral index during coronary surgery

    Directory of Open Access Journals (Sweden)

    Ricardo Antonio G. Barbosa

    2009-03-01

    Full Text Available PURPOSE: Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacokinetics increase hypnotic effects after cardiopulmonary bypass. METHODS: Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10 or off-pump coronary artery bypass graft (group, n=10 coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 µg/mL. Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p<0.05 as significant. RESULTS: After cardiopulmonary bypass, despite similar plasma propofol concentrations in both groups, bispectral index values were lower in the on-pump coronary artery bypass graft group. Time to extubation after the end of propofol infusion was greater in the on-pump coronary artery bypass graft group (334 ± 117 vs. 216 ± 85 min, p = 0.04. Patients undergoing cardiopulmonary bypass had shorter biological (1.82 ± 0.5 vs. 3.67 ± 1.15h, p < 0.01 and terminal elimination (6.27 ± 1.29 vs. 10.5h ± 2.18, p < 0.01 half-life values, as well as higher total plasma clearance (28.36 ± 11.40 vs.18.29 ± 7.67 mL/kg/min, p = 0.03, compared to patients in the off-pump coronary artery bypass graft group. CONCLUSION: Aside from the increased sensitivity of the brain to anesthetics after cardiopulmonary bypass, changes in propofol pharmacokinetics may contribute to its central nervous system effects.

  19. Regional cerebral oxygenation during cardiopulmonary bypass.

    Science.gov (United States)

    Baris, R R; Israel, A L; Amory, D W; Benni, P

    1995-07-01

    A significant number of patients suffer transient neuropsychological dysfunction after coronary artery bypass graft (CABG) surgery. Recent studies have implicated reduced levels of O2 supply/demand ratio during the rewarming phase of cardiopulmonary bypass (CPB). Using a near infrared spectroscopy (NIRS) system that permits continuous noninvasive monitoring of regional cerebral O2 saturation (rSO2), we investigated rSO2 during CPB. Following Institution Review Board approval and informed consent, 10 patients undergoing elective CABG were studied. Nonpulsatile CPB with a membrane oxygenator, haemodilution and alpha-state pH management was used. The NIRS system consisting of two low-power laser diode sources (780 nm and 810 nm) with a photodetector placed on the frontal cortex was used to measure continuously haemoglobin, oxyhaemoglobin and cerebral blood volume. Continuous rSO2 measurements were obtained before, during moderate hypothermia, and during the rewarming phase of CPB. A rSO2 < 50% was defined as abnormal. Onset of rSO2 < 50% was at 32 degrees C, and the highest incidence occurred during the late stages of rewarming (35-37 degrees C). On rewarming from hypothermic CPB, 70% of our patients sustained a rSO2 < 50% for an average total duration of 9.3 minutes, primarily at the end of the rewarming period. This suggests a transient global imbalance in cerebral O2 supply and demand in a large percentage of patients during the rewarming phase of CPB. However, it has not been determined how long a rSO2 < 50% can be permitted before neuropsychological dysfunction is induced. Additional studies correlating psychometric testing with rSO2 measurements should prove useful in detecting episodes of impaired cerebral oxygenation, and help define rewarming protocols. PMID:7488770

  20. Plant grafting.

    Science.gov (United States)

    Melnyk, Charles W; Meyerowitz, Elliot M

    2015-03-01

    Since ancient times, people have cut and joined together plants of different varieties or species so they would grow as a single plant - a process known as grafting (Figures 1 and 2). References to grafting appear in the Bible, ancient Greek and ancient Chinese texts, indicating that grafting was practised in Europe, the Middle East and Asia by at least the 5(th) century BCE. It is unknown where or how grafting was first discovered, but it is likely that natural grafting, the process by which two plants touch and fuse limbs or roots in the absence of human interference (Figure 3), influenced people's thinking. Such natural grafts are generally uncommon, but are seen in certain species, including English ivy. Parasitic plants, such as mistletoe, that grow and feed on often unrelated species may have also contributed to the development of grafting as a technique, as people would have observed mistletoe growing on trees such as apples or poplars. PMID:25734263

  1. [Plaque surgery for Peyronie's disease: heterologous grafts].

    Science.gov (United States)

    Paradiso, Matteo; Sedigh, Omid; Milan, Gian Luca

    2003-06-01

    Surgical treatment of Induratio Penis Plastica includes conservative procedures (phalloplasty), substitutive procedures (prosthesis) and combined procedures (phalloplasty plus prosthesis). Our policy for conservative treatment is based on radical removal of the plaque and replacement with biological patches. During a 15 year experience we employed lyophilized dura mater, autologous dermal graft, preputial skin, cadaveric dermal graft (AlloDerm), venous graft and porcine SIS (Small Intestine Submucosa) graft. Our experience confirms the superiority of venous grafts, but preliminary results with SIS grafts are encouraging. PMID:12868152

  2. Off-Pump Versus On-Pump Coronary Artery Bypass Grafting

    DEFF Research Database (Denmark)

    Møller, Christian H; Steinbrüchel, Daniel A

    2014-01-01

    Coronary artery bypass grafting (CABG) remains the preferred treatment in patients with complex coronary artery disease. However, whether the procedure should be performed with or without the use of cardiopulmonary bypass, referred to as off-pump and on-pump CABG, is still up for debate. Intuitively, avoidance of cardiopulmonary bypass seems beneficial as the systemic inflammatory response from extracorporeal circulation is omitted, but no single randomized trial has been able to prove off-pump ...

  3. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  4. Pulmonary complications of cardiopulmonary bypass.

    Science.gov (United States)

    Huffmyer, Julie L; Groves, Danja S

    2015-06-01

    Pulmonary complications after the use of extracorporeal circulation are common, and they range from transient hypoxemia with altered gas exchange to acute respiratory distress syndrome (ARDS), with variable severity. Similar to other end-organ dysfunction after cardiac surgery with extracorporeal circulation, pulmonary complications are attributed to the inflammatory response, ischemia-reperfusion injury, and reactive oxygen species liberated as a result of cardiopulmonary bypass. Several factors common in cardiac surgery with extracorporeal circulation may worsen the risk of pulmonary complications including atelectasis, transfusion requirement, older age, heart failure, emergency surgery, and prolonged duration of bypass. There is no magic bullet to prevent or treat pulmonary complications, but supportive care with protective ventilation is important. Targets for the prevention of pulmonary complications include mechanical, surgical, and anesthetic interventions that aim to reduce the contact activation, systemic inflammatory response, leukocyte sequestration, and hemodilution associated with extracorporeal circulation. PMID:26060028

  5. Cardiopulmonary loading in motocross riding.

    Science.gov (United States)

    Konttinen, Tomi; Häkkinen, Keijo; Kyröläinen, Heikki

    2007-07-01

    The present study was designed to examine physiological responses during motocross riding. Nine Finnish A-level motocross riders performed a 15-min ride at a motocross track and a test of maximal oxygen uptake (VO2max) in the laboratory. Cardiopulmonary strain was measured continuously during the ride as well as in the VO2max test. During the ride, mean VO2 was 32 ml x kg(-1) x min(-1) (s = 4), which was 71% (s = 12) of maximum, while ventilation (V(E)) was 73% (s = 15) of its maximum. The relative VO2 and V(E) values during the riding correlated with successful riding performance (r = 0.80, P motocross causes riders great physical stress. Both aerobic and anaerobic metabolism is required for the isometric and dynamic muscle actions experienced during a ride. PMID:17497401

  6. Cardiopulmonary helminths in foxes from the Pyrenees.

    Science.gov (United States)

    Garrido-Castañé, Ignasi; Ortuño, Anna; Marco, Ignasi; Castellà, Joaquim

    2015-12-01

    The present survey was carried out to investigate the prevalence of cardiopulmonary helminths in red foxes in Pyrenees area and to evaluate the role of foxes in the eco-epidemiology of these nematodes. Hearts and entire respiratory tracts were obtained from 87 foxes from Vall d'Aran region, Pyrenees, Catalonia, north-eastern Spain. The cardiopulmonary tracts were dissected, flushed and examined for nematodes using sedimented flushing water. Of the 87 examined foxes, 53 (61%) were positive for cardiopulmonary helminths. The identified nematodes were Crenosoma vulpis (44.8%), Eucoleus aerophilus (29.9%) and Angiostrongylus vasorum (3.4%). Statistical differences were observed only on comparing age and C.vulpis prevalence, with young foxes being more infected than adults. The high prevalence of cardiopulmonary nematodes suggested that red foxes may play an important role in their transmission and maintenance in the studied area. PMID:26408595

  7. Unsuspected cardiopulmonary abnormalities complicating bronchopulmonary dysplasia.

    OpenAIRE

    Abman, S H; Accurso, F J; Bowman, C M

    1984-01-01

    Bronchopulmonary dysplasia is a serious chronic lung disease of infancy but despite numerous problems such as poor growth, recurrent lower respiratory tract infections, and cor pulmonale, steady improvement and recovery may generally be expected. We report four infants with bronchopulmonary dysplasia in whom the cardiopulmonary course did not show the usual steady improvement. Each infant was found to have an unsuspected cardiopulmonary lesion in addition to lung disease: two had congenital h...

  8. Brain microvascular function during cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Sørensen, Henrik Toft; Husum, B; Waaben, J; Andersen, K; Andersen, L I; Gefke, K; Kaarsen, A L; Gjedde, A

    1987-01-01

    Emboli in the brain microvasculature may inhibit brain activity during cardiopulmonary bypass. Such hypothetical blockade, if confirmed, may be responsible for the reduction of cerebral metabolic rate for glucose observed in animals subjected to cardiopulmonary bypass. In previous studies of cerebral blood flow during bypass, brain microcirculation was not evaluated. In the present study in animals (pigs), reduction of the number of perfused capillaries was estimated by measurements of the capil...

  9. Arterial pressure during cardiopulmonary bypass is not associated with acute kidney injury

    DEFF Research Database (Denmark)

    Kandler, K; Jensen, M E; Nilsson, J C; Møller, C H; Steinbrüchel, D A

    2015-01-01

    BACKGROUND: Acute kidney injury (AKI) after cardiac surgery is common and is associated with increased mortality. We wanted to investigate if the arterial pressure or the use of norepinephrine during cardiopulmonary bypass were associated with AKI. METHODS: A retrospective analysis of patients who...... underwent coronary artery bypass grafting with or without concomitant procedures was conducted. AKI was defined using the RIFLE criteria. Data on arterial pressure and use of norepinephrine during cardiopulmonary bypass were entered in a binary logistic regression model to control for possible perioperative...... confounders. RESULTS: A total of 623 patients were included. Mean age was 68.3?±?9.7 years and 81% were males. AKI was observed in 198 patients (32%). Mean arterial pressure was 47?±?6?mmHg and 45?±?6?mmHg (P?=?0.008) in the AKI and no-AKI group, respectively. Norepinephrine was used more frequently and in...

  10. Interaction of the carotid baroreflex, the muscle chemoreflex and the cardiopulmonary baroreflex in man during exercise

    Science.gov (United States)

    Eiken, O.; Convertino, V. A.; Doerr, D. F.; Dudley, G. A.; Morariu, G.; Mekjavic, I. B.

    1991-01-01

    The interaction of the muscle chemoreflex and the cardiopulmonary baroreflex with the carotid baroreflex in humans performing exercise was investigated in healthy subjects using specially designed exercise regimen and apparatus. Stimulation of the muscle chemoreflex was achieved by restricting blood flow in the exercising muscles by means of applying a pressure of 50 mm Hg, whereas cardiopulmonary baroreceptors were unloaded by employing LBNP of -20 mm Hg. The carotid baroreceptors were unloaded and stimulated by neck-pressure maneuvers (Sprenkle et al., 1986). Results showed that the cardiodecelerating capacity of the carotid baroreflex remains active during exercise, and may even be sensitized by the chemoreflex-induced increase in arterial pressure; but it is not affected by the cardiopulmonary baroreceptor activity.

  11. Cardiopulmonary resuscitation: a new perspective

    Directory of Open Access Journals (Sweden)

    V. A. Sulimov

    2012-01-01

    Full Text Available At the present there are principles of cardiopulmonary resuscitation (CPR which are reflected in the recommendations of the AHA and ESC of 2010. They include strict rules on well-timed and proper closed-chest cardiac massage. According to these rules chest compressions should be repeated at least 100 times per minute at a depth of not less than 5 cm. To comply with the standards is not easy even for skilled staff, operator tiredness quickly leads to decrease in CPR quality. Various mechanical devices for closed-chest cardiac massage are used nowadays. One of them is LUCAS system.In some studies LUCAS system showed an efficacy and safety comparable with manual closed-chest cardiac massage. Design features of the LUCAS device do not disturb other life maintaining activities — defibrillation, mechanical ventilation. The device permeability for X-rays makes possible the use of LUCAS in cath labs, if CPR is needed during the intervention procedure. LUCAS system can serve as an alternative tool for CPR. It can be used in intensive care units, as well as be at the disposal of special emergency teams.

  12. Smoking cessation in patients with cardiopulmonary diseases

    Directory of Open Access Journals (Sweden)

    Zeynep P?nar Önen

    2011-05-01

    Full Text Available Objective: To determine the smoking cessation rates of outpatients with cardiopulmonary disease and the differences between non-cardiopulmonary diseases.Methods: Two hundred and two active smokers with comorbid diseases were prospectively evaluated between September 2004 and January 2008 in this observational study. All of the patients answered Fagerstrom test for nicotine dependence with a regular questionnaire of general characteristics. Behavioral counseling therapies were administered to all of the subjects. Nicotine replacement therapy, bupropion or combination therapies were the pharmacological therapies after running the baseline spirometry and carbon monoxide oximetry tests. Subjects were classified as patients with cardiopulmonary disease (124 and non-cardiopulmonary diseases (78, based on medical history. Student t and Chi-square tests were used for statistical analyses. Results: The age of smoking was similar but total amount of smoked tobacco was higher (p0.05. Conclusion: Results of this analysis confirm that, tobacco dependence is still a severe but necessary condition for the patients with cardiopulmonary diseases. Additionally neither of the treatment protocols was superior to the others.

  13. The Best Bypass Surgery Trial : rationale and design of a randomized clinical trial with blinded outcome assessment of conventional versus off-pump coronary artery bypass grafting

    DEFF Research Database (Denmark)

    MØller, Christian H; Jensen, Birte Østergaard

    2007-01-01

    Recent trials suggest that off-pump coronary artery bypass grafting (OPCAB) reduces the risk of mortality and morbidity compared with conventional coronary artery bypass grafting (CCAB) using cardiopulmonary bypass. Patients with a moderate- to high-risk of complications after CCAB may have additional benefit from OPCAB.

  14. Cardiopulmonary fitness is related to disease severity in multiple sclerosis

    DEFF Research Database (Denmark)

    Heine, Martin; Wens, Inez; Christensen, Martin Langeskov; Verschuren, Olaf; Eijnde, Bert O; Kwakkel, Gert; Dalgas, Ulrik

    2015-01-01

    cardiopulmonary fitness. METHODS: Data from cardiopulmonary exercise tests, previously conducted in three different countries, were pooled. The association between disease severity (Expanded Disability Status Scale (EDSS)) and cardiopulmonary fitness (peak oxygen uptake (VO2peak)) was adjusted for age, sex and...... associated with physical inactivity, suggest a progressive increase in risk of secondary health conditions in pwMS....

  15. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow....

  16. Cost Performance and Efficacy of Off-pump Coronary Artery Bypass Grafting

    OpenAIRE

    Nomura, Fumikazu; Mukai, Shogo; Tamura, Kentaro; Shimazutsu, Kazufumi; Okuma, Kazuhide; Ihara, Katsuhiko

    2006-01-01

    Off-pump coronary artery bypass grafting (Off-Pump CABG) may provide an alternative form of surgical revascularization by avoiding the unwanted complications of cardiopulmonary bypass, particularly in high-risk patients. To clarify the efficacy and cost performance of Off- Pump CABG, we studied the postoperative course of Off-Pump CABG and compared it to On- pump coronary artery bypass grafting (On-Pump CABG). From Aug. 1998 to Feb. 2002, twenty-eight patients who had preoperative complicatio...

  17. Aortic reconstruction with bovine pericardial grafts

    Directory of Open Access Journals (Sweden)

    Silveira Lindemberg Mota

    2003-01-01

    Full Text Available INTRODUCTION: Glutaraldehyde-treated crimped bovine pericardial grafts are currently used in aortic graft surgery. These conduits have become good options for these operations, available in different sizes and shapes and at a low cost. OBJECTIVE:To evaluate the results obtained with bovine pericardial grafts for aortic reconstruction, specially concerning late complications. METHOD: Between January 1995 and January 2002, 57 patients underwent different types of aortic reconstruction operations using bovine pericardial grafts. A total of 29 (50.8% were operated on an urgent basis (mostly acute Stanford A dissection and 28 electively. Thoracotomy was performed in three patients for descending aortic replacement (two patients and aortoplasty with a patch in one. All remaining 54 underwent sternotomy, cardiopulmonary bypass and aortic resection. Deep hypothermia and total circulatory arrest was used in acute dissections and arch operations. RESULTS: Hospital mortality was 17.5%. Follow-up was 24.09 months (18.5 to 29.8 months confidence interval and complication-free actuarial survival curve was 92.3% (standard deviation ± 10.6. Two patients lately developed thoracoabdominal aneurysms following previous DeBakey II dissection and one died from endocarditis. One "patch" aortoplasty patient developed local descending aortic pseudoaneurysm 42 months after surgery. All other patients are asymptomatic and currently clinically evaluated with echocardiography and CT scans, showing no complications. CONCLUSION: Use of bovine pericardial grafts in aortic reconstruction surgery is adequate and safe, with few complications related to the conduits.

  18. Effect of Colloid versus Crystalloid Administration of Cardiopulmonary Bypass Prime Solution on Tissue and Organ Perfusion

    Directory of Open Access Journals (Sweden)

    Sh Shahbazi

    2011-03-01

    Full Text Available Background: We evaluated the effects of tissue and organ perfusionduring and after coronary artery bypass graft surgery with either colloid(Voluven or crystalloid (Lactated ringer’s as prime solution.Methods: In this prospective randomized-controlled trial study, 70patients undergoing on-pump coronary artery bypass graft surgery were randomlyassigned to receive either colloid (Voluven or crystalloid (Lactated ringer’sas prime solution, for initiation of cardiopulmonary bypass machine procedure.Tissue and organ perfusion markers including lactate, troponin I, liver andrenal function tests and electrolytes were measured sequentially, beforeinduction (T1 to second days after surgery (T5.Results: With exception of chloride and potassium levels no significantdifferences detected in other measurements, and the laboratory results wereentirely identical in both procedures.Conclusion: There was no significant difference between Voluven® (hydroxyethyl starch, HES 130/0.4 and crystalloid (Lactated ringer’s as primingsolution on the basis of organ and tissue perfusion tests assessment.

  19. Cardiopulmonary resuscitation: update, controversies and new advances

    Directory of Open Access Journals (Sweden)

    Alexandre C. Zago

    1999-03-01

    Full Text Available Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardiopulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of life chain, cardio-pulmonary resuscitation courses for professionals who work in emergency medical services, the automated external defibrillator, the implantable cardioverter-defibrillator, and mobile intensive care units, among others. New concepts, strategies and structures motivated by new advances have also modified the treatment and improved the results of cardiopulmonary resuscitation in the hospital setting. Among them, we can cite the concept of cerebral resuscitation, the application of the life chain, the creation of the universal life support algorithm, the adjustment of drug doses, new techniques - measure of the end-tidal carbon dioxide levels and of the coronary perfusion pressure - and new drugs under research.

  20. Effects of massage therapy on sleep quality after coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Flavia Baggio Nerbass

    2010-01-01

    Full Text Available INTRODUCTION: Having poor sleep quality is common among patients following cardiopulmonary artery bypass graft surgery. Pain, stress, anxiety and poor sleep quality may be improved by massage therapy. OBJECTIVE: This study evaluated whether massage therapy is an effective technique for improving sleep quality in patients following cardiopulmonary artery bypass graft surgery. METHOD: Participants included cardiopulmonary artery bypass graft surgery patients who were randomized into a control group and a massage therapy group following discharge from the intensive care unit (Day 0, during the postoperative period. The control group and the massage therapy group comprised participants who were subjected to three nights without massage and three nights with massage therapy, respectively. The patients were evaluated on the following mornings (i.e., Day 1 to Day 3 using a visual analogue scale for pain in the chest, back and shoulders, in addition to fatigue and sleep. Participants kept a sleep diary during the study period. RESULTS: Fifty-seven cardiopulmonary artery bypass graft surgery patients were enrolled in the study during the preoperative period, 17 of whom were excluded due to postoperative complications. The remaining 40 participants (male: 67.5%, age: 61.9 years ± 8.9 years, body mass index: 27.2 kg/m² ± 3.7 kg/m² were randomized into control (n = 20 and massage therapy (n = 20 groups. Pain in the chest, shoulders, and back decreased significantly in both groups from Day 1 to Day 3. The participants in the massage therapy group had fewer complaints of fatigue on Day 1 (p=0.006 and Day 2 (p=0.028 in addition, they reported a more effective sleep during all three days (p=0.019 when compared with the participants in the control group. CONCLUSION: Massage therapy is an effective technique for improving patient recovery from cardiopulmonary artery bypass graft surgery because it reduces fatigue and improves sleep.

  1. Effects of massage therapy on sleep quality after coronary artery bypass graft surgery

    Scientific Electronic Library Online (English)

    Flavia Baggio, Nerbass; Maria Ignez Zanetti, Feltrim; Silvia Alves de, Souza; Daisy Satomi, Ykeda; Geraldo, Lorenzi-Filho.

    Full Text Available INTRODUCTION: Having poor sleep quality is common among patients following cardiopulmonary artery bypass graft surgery. Pain, stress, anxiety and poor sleep quality may be improved by massage therapy. OBJECTIVE: This study evaluated whether massage therapy is an effective technique for improving sle [...] ep quality in patients following cardiopulmonary artery bypass graft surgery. METHOD: Participants included cardiopulmonary artery bypass graft surgery patients who were randomized into a control group and a massage therapy group following discharge from the intensive care unit (Day 0), during the postoperative period. The control group and the massage therapy group comprised participants who were subjected to three nights without massage and three nights with massage therapy, respectively. The patients were evaluated on the following mornings (i.e., Day 1 to Day 3) using a visual analogue scale for pain in the chest, back and shoulders, in addition to fatigue and sleep. Participants kept a sleep diary during the study period. RESULTS: Fifty-seven cardiopulmonary artery bypass graft surgery patients were enrolled in the study during the preoperative period, 17 of whom were excluded due to postoperative complications. The remaining 40 participants (male: 67.5%, age: 61.9 years ± 8.9 years, body mass index: 27.2 kg/m² ± 3.7 kg/m²) were randomized into control (n = 20) and massage therapy (n = 20) groups. Pain in the chest, shoulders, and back decreased significantly in both groups from Day 1 to Day 3. The participants in the massage therapy group had fewer complaints of fatigue on Day 1 (p=0.006) and Day 2 (p=0.028) in addition, they reported a more effective sleep during all three days (p=0.019) when compared with the participants in the control group. CONCLUSION: Massage therapy is an effective technique for improving patient recovery from cardiopulmonary artery bypass graft surgery because it reduces fatigue and improves sleep.

  2. Stent graft placement for dysfunctional arteriovenous grafts

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Gyeong Sik [Dept. of Radiology, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam (Korea, Republic of); Shin, Byung Seok; Ohm, Joon Young; Ahn, Moon Sang [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2015-07-15

    This study aimed to evaluate the usefulness and outcomes of stent graft use in dysfunctional arteriovenous grafts. Eleven patients who underwent stent graft placement for a dysfunctional hemodialysis graft were included in this retrospective study. Expanded polytetrafluoroethylene covered stent grafts were placed at the venous anastomosis site in case of pseudoaneurysm, venous laceration, elastic recoil or residual restenosis despite the repeated angioplasty. The patency of the arteriovenous graft was evaluated using Kaplan-Meier analysis. Primary and secondary mean patency was 363 days and 741 days. Primary patency at 3, 6, and 12 months was 82%, 73%, and 32%, respectively. Secondary patency at the 3, 6, 12, 24, and 36 months was improved to 91%, 82%, 82%, 50%, and 25%, respectively. Fractures of the stent graft were observed in 2 patients, but had no effect on the patency. Stent graft placement in dysfunctional arteriovenous graft is useful and effective in prolonging graft patency.

  3. Stent graft placement for dysfunctional arteriovenous grafts

    International Nuclear Information System (INIS)

    This study aimed to evaluate the usefulness and outcomes of stent graft use in dysfunctional arteriovenous grafts. Eleven patients who underwent stent graft placement for a dysfunctional hemodialysis graft were included in this retrospective study. Expanded polytetrafluoroethylene covered stent grafts were placed at the venous anastomosis site in case of pseudoaneurysm, venous laceration, elastic recoil or residual restenosis despite the repeated angioplasty. The patency of the arteriovenous graft was evaluated using Kaplan-Meier analysis. Primary and secondary mean patency was 363 days and 741 days. Primary patency at 3, 6, and 12 months was 82%, 73%, and 32%, respectively. Secondary patency at the 3, 6, 12, 24, and 36 months was improved to 91%, 82%, 82%, 50%, and 25%, respectively. Fractures of the stent graft were observed in 2 patients, but had no effect on the patency. Stent graft placement in dysfunctional arteriovenous graft is useful and effective in prolonging graft patency

  4. History of the evolution of cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    George Karlis

    2013-04-01

    Full Text Available Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references on CPR go back to the era of Ancient Egypt (3100 B.C.. Although the technique for mouth to mouth ventilation was known in ancient times, its efficacy was demonstrated just in 1958. The ease and efficacy of chest compressions were demonstrated in 1960. Electrical defibrillation may have begun in 1775, but it was applied to a victim of cardiac arrest in the 1950s. Conclusion: CPR is currently a rapidly evolving field of medical science. According to latest data, there is evidence that high quality chest compressions, prompt defibrillation if applicable and treatment of reversible causes improve Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references on CPR go back to the era of Ancient Egypt (3100 B.C.. Although the technique for mouth to mouth ventilation was known in ancient times, its efficacy was demonstrated just in 1958. The ease and efficacy of chest compressions were demonstrated in 1960. Electrical defibrillation may have begun in 1775, but it was applied to a victim of cardiac arrest in the 1950s. Conclusion: CPR is currently a rapidly evolving field of medical science. According to latest data, there is evidence that high quality chest compressions, prompt defibrillation if applicable and treatment of reversible causes improve neurologically intact long term survival of cardiac arrest victims.

  5. Emergent cardiopulmonary bypass during pectus excavatum repair

    Directory of Open Access Journals (Sweden)

    Ryan Craner

    2013-01-01

    Full Text Available Pectus excavatum is a chest wall deformity that produces significant cardiopulmonary disability and is typically seen in younger patients. Minimally invasive repair of pectus excavatum or Nuss procedure has become a widely accepted technique for adult and pediatric patients. Although it is carried out through a thoracoscopic approach, the procedure is associated with a number of potential intraoperative and post-operative complications. We present a case of cardiac perforation requiring emergent cardiopulmonary bypass in a 29-year-old male with Marfan syndrome and previous mitral valve repair undergoing a Nuss procedure for pectus excavatum. This case illustrates the importance of vigilance and preparation by the surgeons, anesthesia providers as well as the institution to be prepared with resources to handle the possible complications. This includes available cardiac surgical backup, perfusionist support and adequate blood product availability.

  6. Artificial neural network cardiopulmonary modeling and diagnosis

    Science.gov (United States)

    Kangas, Lars J. (Richland, WA); Keller, Paul E. (Richland, WA)

    1997-01-01

    The present invention is a method of diagnosing a cardiopulmonary condition in an individual by comparing data from a progressive multi-stage test for the individual to a non-linear multi-variate model, preferably a recurrent artificial neural network having sensor fusion. The present invention relies on a cardiovascular model developed from physiological measurements of an individual. Any differences between the modeled parameters and the parameters of an individual at a given time are used for diagnosis.

  7. Cardiopulmonary exercise testing and its application

    OpenAIRE

    Albouaini, K.; EGRED, M; Alahmar, A

    2007-01-01

    Cardiopulmonary exercise testing (CPET) has become an important clinical tool to evaluate exercise capacity and predict outcome in patients with heart failure and other cardiac conditions. It provides assessment of the integrative exercise responses involving the pulmonary, cardiovascular and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system function. CPET is being used increasingly in a wide spectrum of clinical applications for ev...

  8. Assessing Exercise Limitation Using Cardiopulmonary Exercise Testing

    OpenAIRE

    Stickland, Michael K.; Butcher, Scott J.; Marciniuk, Darcy D.; Mohit Bhutani

    2012-01-01

    The cardiopulmonary exercise test (CPET) is an important physiological investigation that can aid clinicians in their evaluation of exercise intolerance and dyspnea. Maximal oxygen consumption (V?O2max) is the gold-standard measure of aerobic fitness and is determined by the variables that define oxygen delivery in the Fick equation (V?O2 = cardiac output × arterial-venous O2 content difference). In healthy subjects, of the variables involved in oxygen delivery, it is the limitations of the c...

  9. Polystyrene modified by grafting

    Scientific Electronic Library Online (English)

    Avani Maria C, Rocha; Laura Hecker de, Carvalho; Antonio Gouveia de, Souza.

    1997-06-01

    Full Text Available Diversos tipos de poliestireno modificados foram obtidos através da polimerização por enxertia (graft polymerization) de estireno na presença dos seguintes modificadores: copolímero de etileno-acetato de vinila (EVA); polietileno de baixa densidade (PE) e polibutadieno (PB). Os modificadores foram u [...] tilizados em separado e combinados. Em todos os casos, manteve-se a concentração de modificador fixa em 8% em peso e foram avaliadas as propriedades dos produtos obtidos em função da sua composição. A técnica de polimerização empregada foi a de massa/suspensão. Os melhores resultados foram obtidos para os sistemas PS/modificadores mistos. Os resultados obtidos para estes sistemas comprovam que a copolimerização por enxertia gera produtos com melhores propriedades de impacto do que as obtidas, a partir de misturas mecânicas dos componentes individuais, em sistemas semelhantes. Abstract in english Several grades of modified polystyrene were obtained through the graft polymerization of styrene in the presence of modifiers such as ethylene-vinyl acetate (EVA), low density polyethylene (PE), and polybutadiene (PB). These modifiers were used by themselves and in combination. In all cases, the mod [...] ifier concentration was kept constant at 8% w/w, and the product properties were determined as a function of composition. The polymerization technique employed was that of mass/suspension. The best results were obtained for the PS/mixed modifiers systems. The results confirm that graft copolymers present better impact properties than those of mechanical blends of similar composition.

  10. Diabetic patients have abnormal cerebral autoregulation during cardiopulmonary bypass

    International Nuclear Information System (INIS)

    We tested the hypothesis that insulin-dependent diabetic patients with coronary artery bypass graft surgery experience altered coupling of cerebral blood flow and oxygen consumption. In a study of 23 patients (11 diabetics and 12 age-matched controls), cerebral blood flow was measured using 133Xe clearance during nonpulsatile, alpha-stat blood gas managed cardiopulmonary bypass at the conditions of hypothermia and normothermia. In diabetic patients, the cerebral blood flow at 26.6 +/- 2.42 degrees C was 25.3 +/- 14.34 ml/100 g/min and at 36.9 +/- 0.58 degrees C it was 27.3 +/- 7.40 ml/100 g/min (p = NS). The control patients increased cerebral blood flow from 20.7 +/- 6.78 ml/100 g/min at 28.4 +/- 2.81 degrees C to 37.6 +/- 8.81 ml/100 g/min at 36.5 +/- 0.45 degrees C (p less than or equal to 0.005). The oxygen consumption was calculated from jugular bulb effluent and increased from hypothermic values of 0.52 +/- 0.20 ml/100 g/min in diabetics to 1.26 +/- 0.28 ml/100 g/min (p = 0.001) at normothermia and rose from 0.60 +/- 0.27 to 1.49 +/- 0.35 ml/100 g/min (p = 0.0005) in the controls. Thus, despite temperature-mediated changes in oxygen consumption, diabetic patients did not increase cerebral blood flow as metabolism increased. Arteriovenous oxygen saturation gradients and oxygen extraction across the brain were calculated from arterial and jugular bulb blood samples. The increase in arteriovenous oxygen difference between temperature conditions in diabetic patients and controls was significantly different (p = 0.01). These data reveal that diabetic patients lose cerebral autoregulation during cardiopulmonary bypass and compensate for an imbalance in adequate oxygen delivery by increasing oxygen extraction

  11. Cardiopulmonary fitness is related to disease severity in multiple sclerosis

    DEFF Research Database (Denmark)

    Heine, Martin; Wens, Inez; Christensen, Martin Langeskov; Verschuren, Olaf; Eijnde, Bert O; Kwakkel, Gert; Dalgas, Ulrik

    2015-01-01

    BACKGROUND: In persons with MS (pwMS), a lower cardiopulmonary fitness has been associated with a higher risk for secondary disorders, decreased functional capacity, symptom worsening and reduced health-related quality of life. OBJECTIVE: To investigate the association between disease severity and cardiopulmonary fitness. METHODS: Data from cardiopulmonary exercise tests, previously conducted in three different countries, were pooled. The association between disease severity (Expanded Disability...

  12. Active decompression improves the haemodynamic state during cardiopulmonary resuscitation.

    OpenAIRE

    Guly, U. M.; Robertson, C. E.

    1995-01-01

    OBJECTIVE--To examine whether use of the active compression-decompression device improves the haemodynamics of cardiopulmonary resuscitation compared with those of conventional cardiopulmonary resuscitation. DESIGN--Prospective crossover study. SETTING--The accident and emergency department of a university teaching hospital. PATIENTS--36 adult patients with non-traumatic, normothermic, out of hospital cardiac arrest. INTERVENTIONS--Cardiopulmonary resuscitation was performed during resuscitat...

  13. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Science.gov (United States)

    2010-04-01

    ...Cardiopulmonary bypass arterial line blood filter. 870.4260 Section 870.4260...Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part of a...

  14. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Science.gov (United States)

    2010-04-01

    ...Cardiopulmonary bypass cardiotomy suction line blood filter. 870.4270 Section 870.4270 ...Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas...

  15. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Science.gov (United States)

    2010-04-01

    ...Cardiopulmonary bypass in-line blood gas sensor. 870.4410 Section 870.4410...Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures...

  16. Modification of microcrystalline cellulose by gamma radiation-induced grafting

    Science.gov (United States)

    Madrid, Jordan F.; Abad, Lucille V.

    2015-10-01

    Modified microcrystalline cellulose (MCC) was prepared through gamma radiation-induced graft polymerization of glycidyl methacrylate (GMA). Simultaneous grafting was employed wherein MCC with GMA in methanol was irradiated with gamma radiation in nitrogen atmosphere. The effects of different experimental factors such as monomer concentration, type of solvent and absorbed dose on the degree of grafting, Dg, were studied. The amount of grafted GMA, expressed as Dg, was determined gravimetrically. Information from grafted samples subjected to Fourier transformed infrared spectroscopy (FTIR) in attenuated total reflectance (ATR) mode showed peaks corresponding to GMA which indicates successful grafting. The X-ray diffraction (XRD) analysis revealed that the crystalline region of MCC was not adversely affected after grafting with GMA. The thermogravimetric analysis (TGA) data showed that the decomposition of grafted MCC occurred at higher temperature compared to the base MCC polymer.

  17. ACE inhibition attenuates radiation-induced cardiopulmonary damage

    International Nuclear Information System (INIS)

    Background and purpose: In thoracic irradiation, the maximum radiation dose is restricted by the risk of radiation-induced cardiopulmonary damage and dysfunction limiting tumor control. We showed that radiation-induced sub-clinical cardiac damage and lung damage in rats mutually interact and that combined irradiation intensifies cardiopulmonary toxicity. Unfortunately, current clinical practice does not include preventative measures to attenuate radiation-induced lung or cardiac toxicity. Here, we investigate the effects of the ACE inhibitor captopril on radiation-induced cardiopulmonary damage. Material and methods: After local irradiation of rat heart and/or lungs captopril was administered orally. Cardiopulmonary performance was assessed using biweekly breathing rate measurements. At 8 weeks post-irradiation, cardiac hemodynamics were measured, CT scans and histopathology were analyzed. Results: Captopril significantly improved breathing rate and cardiopulmonary density/structure, but only when the heart was included in the radiation field. Consistently, captopril reduced radiation-induced pleural and pericardial effusion and cardiac fibrosis, resulting in an improved left ventricular end-diastolic pressure only in the heart-irradiated groups. Conclusion: Captopril improves cardiopulmonary morphology and function by reducing acute cardiac damage, a risk factor in the development of radiation-induced cardiopulmonary toxicity. ACE inhibition should be evaluated as a strategy to reduce cardiopulmonary complications induced by radiotherapy to the thoracic area

  18. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

  19. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Science.gov (United States)

    2010-04-01

    ... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood or... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass heat exchanger....

  20. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass defoamer. 870.4230 Section... bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction... entitled “Guidance for Extracorporeal Blood Circuit Defoamer 510(k) Submissions.”...

  1. Strategies for cardiopulmonary exercise testing of pectus excavatum patients

    OpenAIRE

    Moh H. Malek; Coburn, Jared W.

    2008-01-01

    The purpose of this paper is to provide strategies for cardiopulmonary exercise testing of pectus excavatum patients. Currently, there are no standardized methods for assessing cardiovascular and pulmonary responses in this population; therefore, making comparisons across studies is difficult if not impossible. These strategies are intended for physicians, pulmonary technicians, exercise physiologists, and other healthcare professionals who conduct cardiopulmonary exercise testing on pectus e...

  2. 21 CFR 870.4280 - Cardiopulmonary prebypass filter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary prebypass filter. 870.4280 Section... prebypass filter. (a) Identification. A cardiopulmonary prebypass filter is a device used during priming of... bypass. The device is not used to filter blood. (b) Classification. Class II (performance standards)....

  3. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass vascular catheter, cannula... Devices § 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing. (a) Identification. A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery...

  4. Prueba de ejercicio con análisis de gases espirados / Cardiopulmonary exercise testing

    Scientific Electronic Library Online (English)

    Hermes, Ilarraza-Lomelí.

    2012-06-01

    Full Text Available La prueba de ejercicio con análisis de gases espirados (PEAGE) es una herramienta útil tanto en el proceso diagnóstico como pronóstico de pacientes con enfermedades cardiovasculares, pulmonares, neuromusculares e incluso metabólicas. El análisis de la composición del gas espirado y las característic [...] as de la dinámica ventilatoria, nos dejan ver la manera en que la energía es transformada incluso a nivel celular (crestas mitocondriales), a través de diferentes procesos metabólicos. Mediante la PEAGE, el médico podrá discernir entre las diversas causas de disnea con origen indeterminado. Por otro lado, esta prueba representa un importante apoyo para indicar la realización de un trasplante (cardiaco, pulmonar o ambos) en pacientes con cardiopatía o neumopatía graves. La utilidad de una prueba cardiopulmonar, ha sido también comprobada en deportistas de alto rendimiento y en pacientes con cardiopatías congénitas. En el pasado, el acceso que tenían tanto el médico como el paciente a la realización de una PEAGE era restringido, debido principalmente a la complejidad y altos costos de los equipos. Sin embargo, hoy en día la tecnología se ha simplificado y los costos han disminuido, lo que ha hecho de la PEAGE una alternativa real en el trabajo cotidiano. Abstract in english Cardiopulmonary exercise test is a useful tool in the diagnosis and prognosis of patients with cardiovascular, pulmonary, neuromuscular and even metabolic disorders. The composition and the analysis of expired gas, and the characteristics of ventilatory dynamics, let us see how energy is transformed [...] , within the cells (mitochondrial cristae), through several metabolic processes. Using the cardiopulmonary exercise testing, physicians can distinguish among several causes of dyspnea with undetermined origin. On the other hand, this test represents an important support to indicate the indication of a graft-transplant (heart, lung or both) in patients with severe heart disease, lung disease or both. Cardiopulmonary test has also been used to evaluate high performance athletes and patients with congenital heart disease. In the past, physicians and patients had a restricted access to the performance of a cardiopulmonary exercise testing, mainly due to the complexity and high costs of this technology. Nowadays, this kind of equipment has been simplified and the costs lowered, in consequence this test became a real alternative in daily work.

  5. Strategies for cardiopulmonary exercise testing of pectus excavatum patients

    Scientific Electronic Library Online (English)

    Moh H., Malek; Jared W., Coburn.

    Full Text Available The purpose of this paper is to provide strategies for cardiopulmonary exercise testing of pectus excavatum patients. Currently, there are no standardized methods for assessing cardiovascular and pulmonary responses in this population; therefore, making comparisons across studies is difficult if not [...] impossible. These strategies are intended for physicians, pulmonary technicians, exercise physiologists, and other healthcare professionals who conduct cardiopulmonary exercise testing on pectus excavatum patients. By using the strategies outlined in this report, comparisons across studies can be made, and the effects of pectus excavatum on cardiopulmonary function can be assessed with greater detail.

  6. Bone Graft Alternatives

    Science.gov (United States)

    ... spinal deformity, or who have some types of disc herniations. In certain types of spinal fusion, bone grafts or bone graft alternatives are used to replace the cushioning disc material that lies between the vertebrae. When the ...

  7. Grafting and curing

    International Nuclear Information System (INIS)

    Progress in radiation grafting and curing is briefly reviewed. The two processes are shown to be mechanistically related. The parameters influencing yields are examined particularly for grafting. For ionising radiation grafting systems (EB and gamma ray) these include solvents, substrate and monomer structure, dose and dose-rate, temperature and more recently role of additives. In addition, for UV grafting, the significance of photoinitiators is discussed. Current applications of radiation grafting and curing are outlined. The recent development of photoinitiator free grafting and curing is examined as well as the potential for the new excimer laser sources. The future application of both grafting and curing is considered, especially the significance of the occurrence of concurrent grafting during cure and its relevance in environmental considerations

  8. Endovascular stent-graft management of thoracic aortic diseases

    International Nuclear Information System (INIS)

    The traditional standard therapy for descending thoracic aortic aneurysm (TAA) is open operative repair with graft replacement of the diseased aortic segment. Despite important advances in surgical techniques, anesthetic management, and post-operative care over the last 30 years, the mortality and morbidity of surgery remains considerable, especially in patients at high risk for thoracotomy because of coexisting severe cardiopulmonary abnormalities or other medical diseases. The advent of endovascular stent-graft technology provides an alternative to open surgery for selected patients with TAA. The initial experience suggests that stent-graft therapy potentially may reduce the operative risk, hospital stay and procedural expenses of TAA repair. These potential benefits are especially attractive for patients at high risk for open TAA repair. Current results of endovascular TAA therapy document operative mortalities of between 0 and 4%, aneurysm thrombosis in 90 and 100% of cases, and paraplegia as a complication in 0 and 1.6% of patients. The early success of stent-graft repair of TAA has fostered the application of these devices for the management of a wide variety of thoracic aortic pathologies, including acute and chronic dissection, intramural hematoma, penetrating ulcer, traumatic injuries, and other diseases. The results of prospective controlled trials that compare the outcomes of stent-graft therapy with those of surgical treatment in patients with specific types of aortic disease are anxiously awaited before recommendations regarding the general use of these new devices can be made with confidence

  9. Endovascular stent-graft management of thoracic aortic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Dake, Michael D. E-mail: mddake@stanford.edu

    2001-07-01

    The traditional standard therapy for descending thoracic aortic aneurysm (TAA) is open operative repair with graft replacement of the diseased aortic segment. Despite important advances in surgical techniques, anesthetic management, and post-operative care over the last 30 years, the mortality and morbidity of surgery remains considerable, especially in patients at high risk for thoracotomy because of coexisting severe cardiopulmonary abnormalities or other medical diseases. The advent of endovascular stent-graft technology provides an alternative to open surgery for selected patients with TAA. The initial experience suggests that stent-graft therapy potentially may reduce the operative risk, hospital stay and procedural expenses of TAA repair. These potential benefits are especially attractive for patients at high risk for open TAA repair. Current results of endovascular TAA therapy document operative mortalities of between 0 and 4%, aneurysm thrombosis in 90 and 100% of cases, and paraplegia as a complication in 0 and 1.6% of patients. The early success of stent-graft repair of TAA has fostered the application of these devices for the management of a wide variety of thoracic aortic pathologies, including acute and chronic dissection, intramural hematoma, penetrating ulcer, traumatic injuries, and other diseases. The results of prospective controlled trials that compare the outcomes of stent-graft therapy with those of surgical treatment in patients with specific types of aortic disease are anxiously awaited before recommendations regarding the general use of these new devices can be made with confidence.

  10. Composite graft tympanoplasty

    OpenAIRE

    S. Mukherjee; Chamyal, P. C.

    1997-01-01

    Seventy six ears with chronic suppurative otitis media and fit for tympanoplasty were subjected to grafting with combination of perichondrium and cartilage (composite graft) for restoration of sound conducting apparatus and reconstruction of canal wall. A comparison with temporal fascia grafting has been done. Composite graft procedure gave better functional improvement, helped in reconstruction of canal wall and was also useful in elimination of retraction pockets.

  11. Bone grafts in dentistry

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar

    2013-01-01

    Full Text Available Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation.

  12. Aortic luminal thrombus and intramural hematoma after cardiopulmonary resuscitation.

    Science.gov (United States)

    Fagnoul, David; Herpain, Antoine; Vincent, Jean-Louis; De Backer, Daniel

    2013-01-01

    We describe the case of a patient with an intramural hematoma and floating thrombus after cardiopulmonary resuscitation. The 92-year old man had a cardiac arrest due to ventricular fibrillation and witnesses immediately initiated manual cardiopulmonary resuscitation. Transesophageal echocardiography was performed immediately on hospital admission because the patient was in cardiogenic shock. In addition to an akinetic anterior wall, examination of the descending thoracic aorta demonstrated an intramural hematoma and a floating intra-aortic thrombus at a distance of 40cm from the dental arch. There was no aortic dissection. The thrombus was attributed to aortic compression during cardiopulmonary resuscitation. Although the aortic thrombus and intramural hematoma were not associated with any complications in this patient, insertion of an intra-aortic balloon may have led to aortic rupture or embolic events. Transesophageal echocardiography should be performed, when available, prior to insertion of an intra-aortic balloon for counterpulsation in patients who have undergone cardiopulmonary resuscitation. PMID:24553517

  13. The radiation-induced grafting of polybutadiene onto silica

    Energy Technology Data Exchange (ETDEWEB)

    Dondi, D.; Buttafava, A. [Department of General Chemistry, University of Pavia, V.le Taramellli 12, 27100 Pavia (Italy); Stagnaro, P. [ISMAC-CNR Genova, Genova (Italy); Turturro, A. [Chemistry and Industrial Chemistry Department, University of Genova, Genova (Italy); Priola, A. [Department of Material Science and Chemical Engineering, Polytecnic of Turin, Turin (Italy); Bracco, S. [Department of Material Science, University of Milano-Bicocca, Milano (Italy); Galinetto, P. [Department of Physics, University of Pavia, Pavia (Italy); Faucitano, A. [Department of General Chemistry, University of Pavia, V.le Taramellli 12, 27100 Pavia (Italy)], E-mail: antonio.faucitano@unipv.it

    2009-07-15

    The {gamma}-ray-induced grafting of polybutadiene oligomers onto precipitated silica was investigated in the dose range up to 200 kGy by THA, FTIR, CP/MAS NMR, TEM microscopy, inverse gas chromatography (IGC), with determination of the grafting yields and the characterization of the modified silica with respect to surface energy, SiO{sub 2}-oligomer interaction and morphology. The matrix EPR spectroscopy was employed for investigating the nature of the intermediate radicals in the grafting mechanism.

  14. Long-term graft outcome of pediatric liver transplantation in Copenhagen

    DEFF Research Database (Denmark)

    Yamauchi, Yasushi; Yamashita, Yuichi; Wettergren, Andre; Larsen, Peter N; Rasmussen, Allan; Mikami, Koji; Shirakusa, Takayuki; Kirkegaard, Preben

    BACKGROUND: Graft loss after liver transplantation remains a significant problem, especially in pediatric patients. The aim of this study was to assess our initial series of pediatric liver transplantation and to identify the risk factors that influence graft outcome. METHODS: The first 51...... status of the recipients (hospitalization or intensive care unit care before surgery), a retransplanted graft, and a reduced-size graft were independent risk factors for graft failure. With experience, overall graft survival has improved significantly and the differences in graft survival between graft...... types have disappeared. CONCLUSIONS: To improve graft survival after pediatric liver transplantation, the timely referral of potential recipients to the transplant team and employing a meticulous technique during the operation, particularly for the technical-variant graft, are required....

  15. Cardiopulmonary disease in the geriatric dog and cat

    International Nuclear Information System (INIS)

    The incidence of cardiopulmonary disease increases with age. Degenerative valvular disease, chronic obstructive pulmonary disease, and arrhythmias are common in the geriatric dog. Chronic bronchial disease, pulmonary neoplasia, and arrhythmias occur in the geriatric cat. Systemic diseases in both species often show cardiopulmonary manifestations. Medical management to treat the underlying disease and to control clinical signs is complicated by altered absorption, metabolism, and elimination of drugs

  16. Incidence and aetiology of a raised hemidiaphragm after cardiopulmonary bypass.

    OpenAIRE

    Large, S. R.; Heywood, L J; Flower, C D; Cory-Pearce, R.; Wallwork, J.; English, T A

    1985-01-01

    A raised hemidiaphragm has been reported as an uncommon complication of cardiopulmonary bypass, possibly resulting from cold injury to the phrenic nerve. At Papworth Hospital myocardial protection during cardiac arrest relies in part on irrigation of the pericardial cavity with large volumes of Hartmann's solution at 4 degrees C. Retrospective review of the chest radiographs of 100 consecutive patients undergoing cardiopulmonary bypass showed that 31 had a raised left hemidiaphragm soon after...

  17. Cardiopulmonary fitness is related to disease severity in multiple sclerosis

    DEFF Research Database (Denmark)

    Heine, Martin; Wens, Inez

    2015-01-01

    BACKGROUND: In persons with MS (pwMS), a lower cardiopulmonary fitness has been associated with a higher risk for secondary disorders, decreased functional capacity, symptom worsening and reduced health-related quality of life. OBJECTIVE: To investigate the association between disease severity and cardiopulmonary fitness. METHODS: Data from cardiopulmonary exercise tests, previously conducted in three different countries, were pooled. The association between disease severity (Expanded Disability Status Scale (EDSS)) and cardiopulmonary fitness (peak oxygen uptake (VO2peak)) was adjusted for age, sex and the country of origin. RESULTS: The combined sample comprised 116 ambulant pwMS having a mean (± SD) EDSS score of 2.7 ± 1.3. There was a significant correlation (r = -0.418, p < .01) between VO2peak and EDSS. A multiple regression model (R(2) = 0.520, p < .01) was constructed to describe VO2peak (mL?kg(-1)?min(-1)); VO2peak = 36.622 - 5.433 (Sex (1=men)) - 0.124 (Age) - 2.082 (EDSS) + 2.737 (Belgium) + 8.674 (Denmark). CONCLUSION: There was a significant association between disease severity and cardiopulmonary fitness. The close relation between cardiopulmonary fitness and chronic conditions associated with physical inactivity, suggest a progressive increase in risk of secondary health conditions in pwMS.

  18. Long-term graft outcome of pediatric liver transplantation in Copenhagen : analysis of the first 51 cases

    DEFF Research Database (Denmark)

    Yamauchi, Yasushi; Yamashita, Yuichi

    2006-01-01

    BACKGROUND: Graft loss after liver transplantation remains a significant problem, especially in pediatric patients. The aim of this study was to assess our initial series of pediatric liver transplantation and to identify the risk factors that influence graft outcome. METHODS: The first 51 transplantations were analyzed retrospectively. All transplantations were stratified into three groups according to graft type (full-size, reduced-size, and living-related-donor graft). Survival data of the grafts were stratified and multivariate analysis conducted with respect to preoperative and surgical factors. RESULTS: Seventeen of all the transplants were full-size grafts and 34 technical-variant grafts (27 reduced-size grafts from cadavers and 7 living-related-donor grafts). The overall graft survival rates were 65, 62 and 53% at 1, 3 and 5 years, respectively. Twenty-three of 51 grafts (45%) were lost. Poor status of the recipients (hospitalization or intensive care unit care before surgery), a retransplanted graft, and a reduced-size graft were independent risk factors for graft failure. With experience, overall graft survival has improved significantly and the differences in graft survival between graft types have disappeared. CONCLUSIONS: To improve graft survival after pediatric liver transplantation, the timely referral of potential recipients to the transplant team and employing a meticulous technique during the operation, particularly for the technical-variant graft, are required.

  19. Septal graft in laryngeal reconstruction

    International Nuclear Information System (INIS)

    A 62-year-old woman presented with symptoms of dyspnea. Ultrasonography and computed tomography examinations revealed mass extending from the cricoid cartilage to the left lobe of thyroid gland and thyroid cartilage. Cytology revealed possibility of cartilaginous origin, which was proven to be chondrosarcoma (Grade 1) from the biopsy specimen obtained during panendosopy. She underwent one stage radical resection and immediate reconstruction of laryngeal skeleton defect by mucocartilaginous graft from the nasal septum. Her postoperative course was optimal with preservation of the laryngeal functions. Twenty-eight months postoperatively, she had to undergo total laryngectomy as a salvage procedure for the advanced local recurrence. We report on the relatively easy technique for functional reconstruction of the large laryngeal defect with the employment cartilage graft from the nasal septum. (author)

  20. Outcome of cardiopulmonary resuscitation - predictors of survival

    International Nuclear Information System (INIS)

    To assess the outcomes of patients undergoing cardiopulmonary resuscitation (CPR). Data were collected retrospectively of all adult patients who underwent CPR. Clinical outcomes of interest were survival at the end of CPR and survival at discharge from hospital. Factors associated with survival were evaluated using logistic regression analysis. Of the 159 patients included, 55 (35%) were alive at the end of CPR and 17 (11%) were discharged alive from the hospital. At the end of CPR, univariate logistic regression analysis found the following factors associated with survival: cardiac arrest within hospital as compared to outside the hospital (odds ratio = 2.8, 95% CI = 1.27-6.20, p-value = 0.01), both cardiac and pulmonary arrest as compared to either cardiac or pulmonary arrest (odds ratio = 0.37, 95% CI = 0.19- 0.73, p-value = 0.004), asystole as cardiac rhythm at presentation (odds ratio = 0.47, 95% CI = 0.24-0.93, p-value = 0.03), and total atropine dose given during CPR (odds ratio = 0.78, 95% CI = 0.62-0.97, p-value = 0.02). In multivariate logistic regression, cardiac arrest within hospital (odds ratio = 2.52, 95% CI = 1.06-5.99, p-value = 0.04) and both cardiac and pulmonary arrest as compared to cardiac or pulmonary arrest (odds ratio = 0.44, 95% CI = 0.21-0.91, p-value = 0.03) were associated with survival at the end of CPR. At the time of discharge from hospital, univariate logistic regression analysis found following factors that were associated with survival: cardiac arrest within hospital (odds ratio = 8.4, 95% CI = 1.09-65.64, p-value = 0.04), duration of CPR (odds ratio = 0.91, 95% CI = 0.85-0.96, p-value = 0.001), and total atropine dose given during CPR (odds ratio = 0.68, 95% CI = 0.47-0.99, p-value = 0.05). In multivariate logistic regression analysis cardiac arrest within hospital (odds ratio 8.69, 95% CI = 1.01-74.6, p-value = 0.05) and duration of CPR (odds ratio 0.92, 95% CI = 0.87-0.98, p-value = 0.01) were associated with survival at discharge from hospital. In-hospital cardiopulmonary arrest was associated with better clinical outcomes as compared to outside hospital arrest. Public education is needed to improve clinical outcomes in patients who need CPR outside hospital. (author)

  1. A reappraisal of saphenous vein grafting

    Directory of Open Access Journals (Sweden)

    Yuan Shi-Min

    2011-01-01

    Full Text Available Autologous saphenous vein grafting has been broadly used as a bypass conduit, interposition graft, and patch graft in a variety of operations in cardiac, thoracic, neurovascular, general vascular, vascular access, and urology surgeries, since they are superior to prosthetic veins. Modified saphenous vein grafts (SVG, including spiral and cylindrical grafts, and vein cuffs or patches, are employed in vascular revascularization to satisfy the large size of the receipt vessels or to obtain a better patency. A loop SVG helps flap survival in a muscle flap transfer in plastic and reconstructive surgery. For dialysis or transfusion purposes, a straight or loop arteriovenous fistula created in the forearm or the thigh with an SVG has acceptable patency. The saphenous vein has even been used as a stent cover to minimize the potential complications of standard angioplasty technique. However, the use of saphenous vein grafting is now largely diminished in treating cerebrovascular disorders, superior vena cava syndrome, and visceral revascularization due to the introduction of angioplasty and stenting techniques. The SVG remains the preferable biomaterial in coronary artery bypass, coronary ostioplasty, free flap transfer, and surgical treatment of Peyronie disease. Implications associated with saphenous vein grafting in vascular access surgery for the purpose of dialysis and chemotherapy are considerable. Vascular cuffs and patches have been developed as an important and effective means of enhancing the patency rates of the grafts by linking the synthetic material to the receipt vessel. In addition, saphenous veins can be a cell source for tissue engineering. We review the versatile roles that saphenous vein grafting has played as well as its current status in therapy.

  2. Comparative effects of propofol and nitroglycerine on efficacy of rewarming in patients undergoing on-pump coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Bhupesh Kumar

    2015-01-01

    Full Text Available Objectives: To compare the effects of propofol and nitroglycerine (NTG on the efficacy of rewarming, extra volume added during cardiopulmonary bypass and extravascular lung water (EVLW in patients undergoing on-pump coronary artery bypass grafting. Materials and Methods: A prospective, randomized, blinded trial, twenty adult patients were randomly assigned to receive either NTG infusion (NTG group or propofol infusion (propofol group during rewarming. Results: After drop in temperature at the end of surgery and till 24 h were significantly less in propofol group compare to NTG group (P < 0.025. Extra volume added during cardiopulmonary bypass and net crystalloid balance till 24 h was less in the propofol group (P < 0.003. There was no difference in EVLW and postoperative outcome. Conclusions: Propofol use during moderate hypothermic cardiopulmonary bypass is associated with less after drop in temperature and less requirement of extra fluid during the perioperative period.

  3. Review and Outcome of Prolonged Cardiopulmonary Resuscitation

    Science.gov (United States)

    Youness, Houssein; Al Halabi, Tarek; Hussein, Hussein; Awab, Ahmed; Jones, Kellie; Keddissi, Jean

    2016-01-01

    The maximal duration of cardiopulmonary resuscitation (CPR) is unknown. We report a case of prolonged CPR. We have then reviewed all published cases with CPR duration equal to or more than 20 minutes. The objective was to determine the survival rate, the neurological outcome, and the characteristics of the survivors. Measurements and Main Results. The CPR data for 82 patients was reviewed. The median duration of CPR was 75 minutes. Patients mean age was 43 ± 21 years with no significant comorbidities. The main causes of the cardiac arrests were myocardial infarction (29%), hypothermia (21%), and pulmonary emboli (12%). 74% of the arrests were witnessed, with a mean latency to CPR of 2 ± 6 minutes and good quality chest compression provided in 96% of the cases. Adjunct therapy included extracorporeal membrane oxygenation (18%), thrombolysis (15.8%), and rewarming for hypothermia (19.5%). 83% were alive at 1 year, with full neurological recovery reported in 63 patients. Conclusion. Patients undergoing prolonged CPR can survive with good outcome. Young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts. PMID:26885387

  4. Change of platelet functions during cardiopulmonary bypass

    International Nuclear Information System (INIS)

    For observing the activation degree of platelets during various stages of cardiopulmonary bypass (CPB), a monoclonal antibody SZ-51 specific for an ?-granule membrane protein (GMP-140) on the surface of activated human platelets was used. The number of platelets fell significantly during CPB and went to minimum at the end of CPB. The GMP-140 molecules on the platelet surface remarkably increased at the start of CPB, then reached to maximum between the ending of CPB and administration of protamine, and returned to normal 2 hours post-operation. However, after ending of CPB the concentration of GMP-140 in plasma began to increase, 2 hours post-operation reached to peak and 24 to 48 hours after ending CPB returned to normal. The TxB2 in plasma reached the first peak after heparinization and start of CPB, the second peak was in the end of CPB and after administration of protamine, and returned to normal 2 hours post-operation. But the 6-keto-PGF1? did not change very much. The concentration of PF4 increased at the start of CPB reached to peak at the end of CPB and became normal 24 hours post-operation. The vWF increased at the start of CPB and reached to peak at the ending of CPB, then returned to normal 24 hours post-operation. These results could explain the activation degree of platelets during CPB

  5. Conflicting perspectives compromising discussions on cardiopulmonary resuscitation.

    LENUS (Irish Health Repository)

    Groarke, J

    2010-09-01

    Healthcare professionals, patients and their relatives are expected to discuss resuscitation together. This study aims to identify the differences in the knowledge base and understanding of these parties. Questionnaires examining knowledge and opinion on resuscitation matters were completed during interviews of randomly selected doctors, nurses and the general public. 70% doctors, 24% nurses and 0% of a public group correctly estimated survival to discharge following in-hospital resuscitation attempts. Deficiencies were identified in doctor and nurse knowledge of ethics governing resuscitation decisions. Public opinion often conflicts with ethical guidelines. Public understanding of the nature of cardiopulmonary arrests and resuscitation attempts; and of the implications of a \\'Do Not Attempt Resuscitation (DNAR)\\' order is poor. Television medical dramas are the primary source of resuscitation knowledge. Deficiencies in healthcare professionals\\' knowledge of resuscitation ethics and outcomes may compromise resuscitation decisions. Educational initiatives to address deficiencies are necessary. Parties involved in discussion on resuscitation do not share the same knowledge base reducing the likelihood of meaningful discussion. Public misapprehensions surrounding resuscitation must be identified and corrected during discussion.

  6. Gamma radiation grafted polymers for immobilization of Brucella antigen in diagnostic test studies

    International Nuclear Information System (INIS)

    The radiation grafting process has a wide field of industrial applications, and in the recent years the immobilization of biocomponents in grafted polymeric materials obtained by means of ionizing radiations is a new and important contribution to biotechnology. In the present work, gamma preirradiation grafting method was employed to produce acrylics hydrogels onto polyethylene (PE), polyvinyl chloride (PVC) and polystyrene (PS). Two monomers were used to graft the previously mentioned polymers: methacrylic acid (MAAc) and acrylamide (AAm), and several working conditions were considered as influencing the degree of grafting. All these grafted polymers were used to study the possibility of a subsequent immobilization of Brucella antigen (BAg) in diagnostic test studies (ELISA). (author)

  7. Cardiopulmonary bypass without preoperative exchange transfusion in sicklers.

    Science.gov (United States)

    Maddali, Madan M; Rajakumar, Muthukkumar C; Fahr, Jutta; Albahrani, Maher J; Amna, Mohamed A

    2006-02-01

    The effect of hypothermic cardiopulmonary bypass techniques on the sickling process was evaluated in patients with sickle cell hemoglobin. It was presumed that intraoperative hemolysis, as identified by hemoglobinuria, reflected increased sickling. Data of 43 patients with sickle cell traits and 2 with sickle cell disease, who were operated on under cardiopulmonary bypass and cold cardioplegic arrest in a tertiary center from the beginning of 1995 to the end of 2004, were retrospectively analyzed. A mean nasal temperature of 30.8 degrees C +/- 2.1 degrees C was achieved. Three patients with sickle cell trait developed intraoperative hemoglobinuria, albeit with normal surrogate values for hemolysis. However, they had significantly lower mean hemoglobin levels during cardiopulmonary bypass compared to those sickle cell patients who did not exhibit hemoglobinuria (hemoglobin, 6.0 +/- 0.2 vs. 7.4 +/- 0.9 g x dL(-1), p < 0.01). Total drainage and blood transfusion requirements in patients with normal and sickle cell hemoglobin were similar. It was concluded that hypothermic cardiopulmonary bypass with cold cardioplegia is safe in sickle cell patients. Maintenance of adequate hemoglobin levels during cardiopulmonary bypass may be important to avoid triggering a sickling process. PMID:16432120

  8. Historical development of the cardiopulmonary ressuscitation: review study

    Directory of Open Access Journals (Sweden)

    Érika de Azevedo Leitão Mássimo, Daclé Vilma Carvalho, Talline Arêdes Hang Costa, Danilo Ulisses Oliveira

    2009-07-01

    Full Text Available Objective: this review aimed to describe the historical development of cardiopulmonary resuscitation, following the history of this therapeutic modality. Methods: the methodology consists of a review of the databases Medline and Lilacs looking for articles published in the last 20 years about the history and establishment of cardiopulmonary resuscitation as a therapeutic option for reversal of cardiorespiratory arrest. Results: there are historical antecedents of cardiopulmonary resuscitation from the Biblical era until the establishment of the committee of the American Heart Association. As this committee, currently, a reference in teaching and research in cardiopulmonary resuscitation in the world, its investment allowed from 2000, the development of a global consensus of resuscitation guidelines that generated international attention only on the cardiopulmonary resuscitation. Conclusion: it was noted that over the years the techniques of PCR produced an impact on modern society to the point of generating new expectations facing life and death, revealing is essential that the healthcare professional who understands your technical and scientific competence for a parade heart can make a difference between life and death of a patient.

  9. Ca(2+)-independent nitric oxide synthase activity in human lung after cardiopulmonary bypass.

    OpenAIRE

    Delgado, R; A. Rojas; Glaría, L. A.; Torres, M.; Duarte, F.; Shill, R.; Nafeh, M.; E. Santin; González, N.; Palacios, M

    1995-01-01

    BACKGROUND--Because surgery involving cardiopulmonary bypass induces a systemic inflammatory response, the effect of cardiopulmonary bypass on nitric oxide (NO) generation was investigated in human lung tissue. METHODS--Nitric oxide synthase (NOS) activity was measured by the conversion of 14C-L-arginine to 14C-L-citrulline in tissue biopsy samples obtained before and after cardiopulmonary bypass. RESULTS--The Ca(2+)-independent production of NO found before cardiopulmonary bypass was extreme...

  10. Cartilage grafting in facial reconstruction with special consideration of irradiated grafts

    International Nuclear Information System (INIS)

    The search for the perfect facial implant for reconstruction of the face continues. Cartilage, once thought to be an undesirable graft material because of its propensity for absorption, has regained popularity in the past decade. Various preparation techniques have been employed to ensure graft sterility and diminished absorption. An improved understanding of cartilage structure and physiology has shed considerable light on the host-graft relationship. Gamma irradiation is a time-honored method of preservation. An experiment was undertaken to investigate the physiology of irradiated cartilage grafts following prolonged implantation on the facial skeleton of sheep and dog. Merthiolate preserved grafts were used as controls. Direct observation, histochemical techniques, autoradiography, and transmission electron micrography were used to determine chondrocyte viability and matrix composition. It was surprising to note that following implantation of 16 to 72 months, complete resorption was seen in 87.7% of the irradiated grafts and in 43.8% of the Merthiolate stored controls. Many of the grafts acquired chondrocytes from the host and produced new proteoglycan matrix as well as undergoing some degree of ossification. A comparison to the clinical situation in humans is made. 98 references

  11. Dirofilaria immitis infection in dogs: cardiopulmonary biomarker levels.

    Science.gov (United States)

    Carretón, E; Corbera, J A; Juste, M C; Morchón, R; Simón, F; Montoya-Alonso, J A

    2011-03-22

    Cardiopulmonary biomarkers are biological parameters that can be objectively measured and quantified as indicators of pathogenic processes (heartworm disease) or as indicators of response to therapeutic intervention. To determine levels of cardiopulmonary biomarkers in canine dirofilariasis, measurements of cardiac troponin T, cardiac troponin I, myoglobin, and D-dimer concentrations were performed for dogs with and without evidence of adult heartworm infection. The results showed that levels of cardiac troponin T were undetectable in all dogs studied while levels of cardiac troponin I were higher in dogs infected with Dirofilaria immitis. In healthy dogs, levels of myoglobin and D-dimer were below detection limits of the instrument and were significantly higher in heartworm-infected dogs, notably in microfilaremic dogs. The results suggest the possibility of using troponin I and myoglobin as markers for cardiac damage and the D-dimer as a supportive tool for a diagnosis of pulmonary thromboembolism in dogs with cardiopulmonary dirofilariasis. PMID:21310535

  12. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonroller-type cardiopulmonary bypass blood pump... Nonroller-type cardiopulmonary bypass blood pump. (a) Identification. A nonroller-type cardiopulmonary bypass blood pump is a device that uses a method other than revolving rollers to pump the blood...

  13. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Roller-type cardiopulmonary bypass blood pump. 870... Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass blood pump is a device that uses a revolving roller mechanism to pump the blood through...

  14. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass arterial line blood filter... Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line blood filter is a device used as part of a gas exchange (oxygenator) system to filter...

  15. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass in-line blood gas sensor... Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the level of gases in the blood. (b) Classification. Class...

  16. The effect of the metabolic syndrome on the risk and outcome of coronary artery bypass graft surgery

    OpenAIRE

    Swart, Marius J; De Jager, Wihan H; Kemp, Johann T; Nel, Paul J; Van Staden, Sarel L; Joubert, Gina

    2012-01-01

    Background The individual components of the metabolic syndrome are risk factors for coronary artery disease. The underlying pathophysiology of a low-grade inflammatory process postulates that the metabolic syndrome could compromise a procedure such as coronary artery bypass graft surgery (CABG) done on cardiopulmonary bypass (CPB). Methods From a single institution, 370 patients with the metabolic syndrome (IDF and ATP III criteria) and 503 patients without the metabolic syndrome were identif...

  17. DC information preservation for cardiopulmonary monitor utilizing CW Doppler radar.

    Science.gov (United States)

    Vergara, Alexander M; Boric-Lubecke, Olga; Lubecke, Victor M

    2008-01-01

    Direct conversion RF receivers introduce large DC offsets, reducing the dynamic range of the baseband signal. Coupled with the relatively small time varying signals in human vital sign monitoring using CW Doppler radar, extraction of cardio-pulmonary information becomes difficult. Previous DC offset compensation techniques utilizing AC coupling have proven detrimental to the performance of the system and the integrity of the low-frequency cardiopulmonary signals. A proposed system utilizing digitally controlled voltage feedback and center finding preserves the important DC information for optimal extraction of phase information in the quadrature system. PMID:19162892

  18. Effect of cardiopulmonary bypass on gastrointestinal perfusion and function.

    Science.gov (United States)

    Gaer, J A; Shaw, A D; Wild, R; Swift, R I; Munsch, C M; Smith, P L; Taylor, K M

    1994-02-01

    Gastric mucosal tonometry was used to determine the adequacy of gastrointestinal perfusion in 10 patients undergoing elective myocardial revascularization. Patients were prospectively randomized to receive either pulsatile or nonpulsatile flow during cardiopulmonary bypass. All patients showed a reduction in gastric mucosal perfusion during bypass, manifested by a reduction in the gastric mucosal pH, which occurred independently of variations in the arterial pH. In the group of patients receiving nonpulsatile flow, this reduction was significantly greater (p < 0.05). Cardiopulmonary bypass using nonpulsatile flow is associated with the development of a gastric mucosal acidosis, which may have implications for the development of postoperative complications. PMID:8311598

  19. Synchronization and Cardio-pulmonary feedback in Sleep Apnea

    Science.gov (United States)

    Xu, Limei; Ivanov, Plamen Ch.; Chen, Zhi; Hu, Kun; Paydarfar, David; Stanley, H. Eugene

    2004-03-01

    Findings indicate a dynamical coupling between respiratory and cardiac function. However, the nature of this nonlinear interaction remains not well understood. We investigate transient patterns in the cardio-pulmonary interaction under healthy conditions by means of cross-correlation and nonlinear synchronization techniques, and we compare how these patterns change under pathologic conditions such as obstructive sleep apnea --- a periodic cessation of breathing during sleep. We find that during apnea episodes the nonlinear features of cardio-pulmonary interaction change intermittently, and can exhibit variations characterized by different time delays in the phase synchronization between breathing and heartbeat dynamics.

  20. Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... location of the heart. Figure B shows how vein and artery bypass grafts are attached to the heart. Overview CABG is ... if blockages form in the grafted arteries or veins or in arteries that weren't blocked before. Taking medicines and making ... NEXT >> Updated: February ...

  1. Complications of bystander cardiopulmonary resuscitation for unconscious patients without cardiopulmonary arrest

    Directory of Open Access Journals (Sweden)

    Yoshihiro Moriwaki

    2012-01-01

    Full Text Available Background: Insufficient knowledge of the risks and complications of cardiopulmonary resuscitation (CPR may be an obstructive factor for CPR, however, particularly for patients who are not clearly suffering out of hospital cardiopulmonary arrest (OH-CPA. The object of this study was to clarify the potential complication, the safety of bystander CPR in such cases. Materials and Methods: This study was a population-based observational case series. To be enrolled, patients had to have undergone CPR with chest compressions performed by lay persons, had to be confirmed not to have suffered OHCPA. Complications of bystander CPR were identified from the patients? medical records and included rib fracture, lung injury, abdominal organ injury, and chest and/or abdominal pain requiring analgesics. In our emergency department, one doctor gathered information while others performed X-ray and blood examinations, electrocardiograms, and chest and abdominal ultrasonography. Results: A total of 26 cases were the subjects. The mean duration of bystander CPR was 6.5 minutes (ranging from 1 to 26. Nine patients died of a causative pathological condition and pneumonia, and the remaining 17 survived to discharge. Three patients suffered from complications (tracheal bleeding, minor gastric mucosal laceration, and chest pain, all of which were minimal and easily treated. No case required special examination or treatment for the complication itself. Conclusion: The risk and frequency of complications due to bystander CPR is thought to be very low. It is reasonable to perform immediate CPR for unconscious victims with inadequate respiration, and to help bystanders perform CPR using the T-CPR system.

  2. Gamma ray-induced graft copolymerization of acrylamide and acrylic acid to nylon 6 fabric

    International Nuclear Information System (INIS)

    Kinetics of radiation-induced grafting of acrylamide (Aam) and acrylic acid (Aa) to nylon 6 fabric were investigated employing a mutual radiation technique. Copper sulfate was used as the radical scavenger to reduce homopolymer formation. Formic acid was used for swelling, and its effect on grafting was studied. Maximum amount of grafting was doubled when formic acid was used for swelling nylon prior to, but not during, irradiation. The rate of grafting was not significantly affected if it was carried out in an atmosphere of air instead of nitrogen. The effect of monomer concentration, dose rate, and total dose on grafting has been studied. Rate of grafting was significantly higher when lower dose rates and monomer concentrations were used. Saturation grafting was proportional to monomer concentration up to 2.1M. Initial rate of grafting was proportional to monomer concentration. The rate of grafting of Aam was proportional to the dose rate to the power 0.25 - 1.0. A synergestic effect was noticed during grafting with mixtures of Aam and Aa (80:20; 20:80). Grafted fabrics showed considerable increase in moisture regain. Dyeability and tensile properties of the grafted fabrics were not significantly affected by grafting. Aa-grafted fabrics did not melt up to 3200C, whereas untreated nylon melts at 2150C. (U.S.)

  3. Sliding grafted polymer layers

    CERN Document Server

    Baulin, V A; Marques, C M; Baulin, Vladimir A.; Johner, Albert; Marques, Carlos M.

    2005-01-01

    We study theoretically the structure of sliding grafted polymer layers or SGP layers. These interfacial structures are built by attaching each polymer to the substrate with a ring-like molecule. Such a topological grafting mode allows the chains to freely slide along the attachment point. Escape from the sliding link is prevented by bulky capping groups. We show that grafts in the mushroom regime adopt mainly symmetric configurations (with comparable branch sizes) while grafts in dense layers are highly dissymmetric so that only one branch per graft participates in the layer. Sliding layers on small colloids or star-like sliding micelles exhibit an intermediate behavior where the number of longer branches participating in the corona is independent of the total number of branches. This regime also exists for sliding surface-micelles comprising less chains but it is narrower.

  4. Predicting postoperative cardiopulmonary complications by a test of stair climbing

    International Nuclear Information System (INIS)

    Objective: To assess whether a test of stair climbing ability could be used to predict the risk of developing postoperative cardiopulmonary complications in patients undergoing general anesthesia. Design: Cohort study Place and Duration of Study: The Aga Khan University Hospital, Karachi. The duration of the study was from December 2003 to December 2004. Patients and Methods: This study was carried out on consecutive, adult patients presenting for elective thoracic or abdominal surgery under general anesthesia. Pre-operatively, patients were asked to climb a standard staircase. Number of steps climbed was recorded. Those unable to climb stairs due to debilitation cardiac, pulmonary or rheumatologic disease were categorized as 0 stairs climbed. Outcome variables were postoperative cardiopulmonary complications for mortality. Period of follow-up was until hospital discharge. Results: Seventy-eight patients were enrolled; 59 (75.6%) climbed > 1 flight of stairs, 19 (24.3%) climbed 1 flight and 40% in those patients who climbed < 1 flight. The group that climbed < 1 flight tended to have complications associated with poor reserves of the cardiopulmonary systems; i.e. pulmonary edema, exacerbation of underlying lung disease. The relative risk of developing complications, if unable to climb at least 1 flight of stairs, was calculated to be 1.8 (95% CI 0.7 - 4.6). Conclusion: Stair climbing can be a useful pre-operative tool to predict the risk of postoperative cardiopulmonary complications. (author)

  5. Cardiopulmonary resuscitation: biomedical and biophysical analysis (Chapter XXX)

    DEFF Research Database (Denmark)

    Noordergraaf, G.J; Ottesen, Johnny T.; Scheffer, G.J.; Schilders, W.H.A.; Noordergraaf, A.

    2004-01-01

    The evolution of the human in caring for others is reflected in the development of cardiopulmonary resuscitation (CPR). Superstition, divine intervention and finally science have contributed to the development of a technique which may allow any person to save another’s life. Fully 50% of the firs...

  6. Rupture of a left internal mammary artery during cardiopulmonary resuscitation

    OpenAIRE

    Patel, Chhaya; Metting, Austin; Curtis, Brydan; Mixon, Timothy

    2016-01-01

    We present a rare case of a left internal mammary artery rupture during cardiopulmonary resuscitation (CPR). This case demonstrates that intrinsic cardiac/vascular injuries can occur even with manual CPR, and each patient should be monitored closely, considering the very subtle signs that can clue the physicians into the diagnosis.

  7. Cardiopulmonary Fitness and Endurance in Children with Developmental Coordination Disorder

    Science.gov (United States)

    Wu, Sheng K.; Lin, Hsiao-Hui; Li, Yao-Chuen; Tsai, Chia-Liang; Cairney, John

    2010-01-01

    The purpose of this study was to compare cardiopulmonary fitness and endurance in 9-11-year-old children with DCD against a group of typically developing children in Taiwan. The Movement ABC test was used to evaluate the motor abilities of children. Forty-one participants (20 children with DCD and 21 children without DCD) were recruited for this…

  8. Off-Pump Versus On-Pump Coronary Artery Bypass Grafting

    DEFF Research Database (Denmark)

    Møller, Christian H; Steinbrüchel, Daniel A

    2014-01-01

    Coronary artery bypass grafting (CABG) remains the preferred treatment in patients with complex coronary artery disease. However, whether the procedure should be performed with or without the use of cardiopulmonary bypass, referred to as off-pump and on-pump CABG, is still up for debate....... Intuitively, avoidance of cardiopulmonary bypass seems beneficial as the systemic inflammatory response from extracorporeal circulation is omitted, but no single randomized trial has been able to prove off-pump CABG superior to on-pump CABG as regards the hard outcomes death, stroke or myocardial infarction....... In contrast, off-pump CABG is technically more challenging and may be associated with increased risk of incomplete revascularization. The purpose of the review is to summarize the current literature comparing outcomes of off-pump versus on-pump coronary artery bypass surgery....

  9. N- acetyl-beta-d-glucosaminidase and inflammatory response after cardiopulmonary bypass

    International Nuclear Information System (INIS)

    To determine the changes in activity of plasma N-acetyl-beta-D-glucosaminidase, a marker for inflammation as well as renal, pulmonary and cardiac damage and proinflammatory cytokines in patients undergoing coronary artery bypass grafting and find out the relationship between their plasma levels with clinical outcome of patients. N-Acetyl-beta-D-glucosaminidase (NAG) activity and concentrations of tumor necrosis factor-alpha of (TNF alpha), interleukin 6 (IL-6), interleukin 8 (IL8) and granulocyte-macrophage colony stimulating factor (GM-CSF) were monitored in plasma samples of 12 angina patients undergoing coronary artery bypass grafting (CABG), before, immediately after and 5 days post-surgical procedure. Serum glucose concentrations were also monitored in those patients. Patient's clinical condition was monitored during this time period. No significant increase was observed in plasma NAG activity (a marker of inflammation) or in plasma levels of TNF alpha IL-6, IL-8 and GM-CSF immediately after surgery, indicating that cardiopulmonary bypass itself does not produce any significant amount of inflammation immediately after CABG. However, 5 days post surgery, there was a significant increase in plasma NAG activity (p=0.001), TNF alpha (p=0.047) and GM-CSF (p=0.045). There was no relationship between plasma NAG activity and clinical outcome because various parameters of renal, cardiac and pulmonary functions, though slightly affected, remained within the normal limits. Increased levels of NAG and TNF alpha did not affect clinical outcome. However, data suggest that NAG can be a potential marker for inflammation and end organ damage following CABG. An increase in GM-CSF on day 5 following CABG indicates enhanced body's defense mechanism against infection. (author)

  10. Modified T-Graft for Extracorporeal Membrane Oxygenation in a Patient with Small-Caliber Femoral Arteries

    Science.gov (United States)

    Calderon, Daniel; El-Banayosy, Aly; Koerner, Michael M.; Reed, Amy B.

    2015-01-01

    Extracorporeal membrane oxygenation (ECMO) is generally used as a last resort to provide cardiopulmonary support in patients whose advanced cardiac or respiratory failure does not respond to less invasive treatments. Lower-limb ischemia secondary to the large diameter of the arterial cannula is one of ECMO's major limitations: in patients who have small-caliber arteries, the cannulas can reduce native blood flow. The creation of a T-graft—a well-described technique to avoid limb ischemia—enables flow into the ECMO cannula without jeopardizing blood flow to the limb. However, leaving the graft exposed through an open groin wound can result in dislodgment, and it increases the risk of infection. We describe our modification of a conventional T-graft in an 18-year-old woman who had systolic heart failure, acute respiratory distress syndrome, and small-caliber femoral vessels. We tunneled a polytetrafluoroethylene graft inside a Dacron graft, then ran the combined graft through a subcutaneous tunnel similar to that created for a peripheral bypass. Thus, the graft was protected from environmental exposure and the risk of infection. Our technique seems safer and more secure than the original T-graft technique, and we recommend its consideration during ECMO cannulation. PMID:26664305

  11. Atrial Fibrillation, Neurocognitive Decline and Gene Expression After Cardiopulmonary Bypass

    Science.gov (United States)

    Dalal, Rahul S.; Sabe, Ashraf A.; Elmadhun, Nassrene Y.; Ramlawi, Basel; Sellke, Frank W.

    2015-01-01

    OBJECTIVE Atrial fibrillation and neurocognitive decline are common complications after cardiopulmonary bypass. By utilizing genomic microarrays we investigate whether gene expression is associated with postoperative atrial fibrillation and neurocognitive decline. METHODS Twenty one cardiac surgery patients were prospectively matched and underwent neurocognitive assessments pre-operatively and four days postoperatively. The whole blood collected in the pre-cardiopulmonary bypass, 6 hours after-cardiopulmonary bypass, and on the 4th postoperative day was hybridized to Affymetrix Gene Chip U133 Plus 2.0 Microarrays. Gene expression in patients who developed postoperative atrial fibrillation and neurocognitive decline (n=6; POAF+NCD) was compared with gene expression in patients with postoperative atrial fibrillation and normal cognitive function (n=5; POAF+NORM) and patients with sinus rhythm and normal cognitive function (n=10; SR+NORM). Regulated genes were identified using JMP Genomics 4.0 with a false discovery rate of 0.05 and fold change of >1.5 or <-1.5. RESULTS Eleven patients developed postoperative atrial fibrillation. Six of these also developed neurocognitive decline. Of the 12 patients with sinus rhythm, only 2 developed neurocognitive decline. POAF+NCD patients had unique regulation of 17 named genes preoperatively, 60 named genes six hours after cardiopulmonary bypass, and 34 named genes four days postoperatively (P<0.05) compared with normal patients. Pathway analysis demonstrated that these genes are involved in cell death, inflammation, cardiac remodeling and nervous system function. CONCLUSION Patients who developed postoperative atrial fibrillation and neurocognitive decline after cardiopulmonary bypass may have differential genomic responses compared to normal patients and patients with only postoperative atrial fibrillation, suggesting common pathophysiology for these conditions. Further exploration of these genes may provide insight into the etiology and improvements of these morbid outcomes.

  12. Employment Outlook

    Science.gov (United States)

    Henderson, Bonnie C.

    1973-01-01

    Interviews were conducted with some key figures among nonacademic employers of geoscientists in order to present their best guesses about opportunities for the rest of the decade and their best advice to students concerning employment. (DF)

  13. Cardiopulmonary bypass alters the pharmacokinetics of propranolol in patients undergoing cardiac surgery

    Scientific Electronic Library Online (English)

    M.J.C., Carmona; L.M.S., Malbouisson; V.A., Pereira; M.A., Bertoline; C.E.K., Omosako; K.B., Le Bihan; J.O.C., Auler Jr.; S.R.C.J., Santos.

    2005-05-01

    Full Text Available The pharmacokinetics of propranolol may be altered by hypothermic cardiopulmonary bypass (CPB), resulting in unpredictable postoperative hemodynamic responses to usual doses. The objective of the present study was to investigate the pharmacokinetics of propranolol in patients undergoing coronary art [...] ery bypass grafting (CABG) by CPB under moderate hypothermia. We evaluated 11 patients, 4 women and 7 men (mean age 57 ± 8 years, mean weight 75.4 ± 11.9 kg and mean body surface area 1.83 ± 0.19 m²), receiving propranolol before surgery (80-240 mg a day) and postoperatively (10 mg a day). Plasma propranolol levels were measured before and after CPB by high-performance liquid chromatography. Pharmacokinetic Solutions 2.0 software was used to estimate the pharmacokinetic parameters after administration of the drug pre- and postoperatively. There was an increase of biological half-life from 4.5 (95% CI = 3.9-6.9) to 10.6 h (95% CI = 8.2-14.7; P

  14. Cerebral vasoreactivity to carbon dioxide during cardiopulmonary perfusion at normothermia and hypothermia

    International Nuclear Information System (INIS)

    With the pH-stat acid-base regulation strategy during hypothermic cardiopulmonary bypass (CPB), carbon dioxide (CO2) is generally administered to maintain the partial pressure of arterial CO2 at a higher level than with the alpha-stat method. With preserved CO2 vasoreactivity during CPB, this induction of respiratory acidosis can lead to a much higher cerebral blood flow level than is motivated metabolically. To evaluate CO2 vasoreactivity, cerebral blood flow was measured using a xenon 133 washout technique before, during, and after CPB at different CO2 levels in patients who were undergoing coronary artery bypass grafting with perfusion at either hypothermia or normothermia. The overall CO2 reactivity was 1.2 mL/100 g/min/mm Hg. There was no difference between the groups. The CO2 reactivity was not affected by temperature or CPB. The induced hemodilution resulted in higher cerebral blood flow levels during CPB, although this was counteracted by the temperature-dependent decrease in the hypothermia group. After CPB, a transient increase in cerebral blood flow was noted in the hypothermia group, the reason for which remains unclear. The study shows that manipulation of the CO2 level at different temperatures results in similar changes in cerebral blood flow irrespective of the estimated metabolic demand. This finding further elucidates the question of whether alpha-stat or pH-stat is the most physiological way to regulate the acid-base balance during hypothermic CPB

  15. Computed tomography assessment of lung structure in patients undergoing cardiac surgery with cardiopulmonary bypass

    Scientific Electronic Library Online (English)

    R.R., Rodrigues; A.Y., Sawada; J.-J., Rouby; M.J., Fukuda; F.H., Neves; M.J., Carmona; P., Pelosi; J.O., Auler; L.M.S., Malbouisson.

    2011-06-01

    Full Text Available Hypoxemia is a frequent complication after coronary artery bypass graft (CABG) with cardiopulmonary bypass (CPB), usually attributed to atelectasis. Using computed tomography (CT), we investigated postoperative pulmonary alterations and their impact on blood oxygenation. Eighteen non-hypoxemic patie [...] nts (15 men and 3 women) with normal cardiac function scheduled for CABG under CPB were studied. Hemodynamic measurements and blood samples were obtained before surgery, after intubation, after CPB, at admission to the intensive care unit, and 12, 24, and 48 h after surgery. Pre- and postoperative volumetric thoracic CT scans were acquired under apnea conditions after a spontaneous expiration. Data were analyzed by the paired Student t-test and one-way repeated measures analysis of variance. Mean age was 63 ± 9 years. The PaO2/FiO2 ratio was significantly reduced after anesthesia induction, reaching its nadir after CPB and partially improving 12 h after surgery. Compared to preoperative CT, there was a 31% postoperative reduction in pulmonary gas volume (P

  16. Carbon nanotube grafted with polyalcohol and its influence on the thermal conductivity of phase change material

    International Nuclear Information System (INIS)

    Highlights: • CNTs are grafted with polyhydric alcohols. • The grafted CNTs are well dispersed. • The graft ratio of CNTs-C8, CNTs-C14 and CNTs-C18 is 11%, 32% and 38%. • The thermal conductivities of CNTs/paraffin are increased through graft treatment. • The carbon number of polyalcohol has influence on thermal conductivity. - Abstract: Carbon nanotubes (CNTs) were grafted with polyhydric alcohols (octanol, tetradecyl alchohol and stearyl alcohol) after acidification. The composite phase change materials (PCMs) were prepared with grafted CNTs and paraffin. The grafted CNTs were characterized with Transmission Electron Micrograph (TEM), X-ray Diffractometer (XRD), Fourier Transform Infrared Spectroscopy (FTIR) and Thermogravimetric analyzer (TG). Hot disk method was employed to measure the thermal conductivity of composite PCMs. The results showed that polyhydric alcohols were grafted onto CNTs. The graft ratio was 38% for the CNTs grafted with stearyl alcohol. The grafted CNTs were shorter than CNTs and the dispersibility of grafted CNTs was better than that of CNTs. The thermal conductivity of grafted CNTs/paraffin composite PCMs was higher than that of pristine CNTs/paraffin composite PCMs

  17. Study on radiation grafting reaction of MMA onto hydroxyapatite

    International Nuclear Information System (INIS)

    The grafting reaction of MMA onto hydroxyapatite has been studied with the pre-irradiation method in air. The effects of radiation dose, monomer concentration, reaction temperature and inorganic acid on the system are observed. The grafting copolymerization is found to be controlled by the kinetics. If proper kinetic conditions are selected, a better grafting yield can be obtained. Employing weight method, burning method as well as SeM and IR analysis, it has been proved that MMA is definitely grafted onto hydroxyapatite by chemical bonds, which shows that it is possible to improve the interface of inorganic-organic composite materials and to make bioactive ceramics by using radiation induced-grafting copolymerization

  18. Radiation grafting studies of acrylic acid onto cellulose triacetate membranes

    International Nuclear Information System (INIS)

    Polymer surface modifications were obtained by the application of radiation treatments, etching and grafting of acrylic acid monomers on different membranes of cellulose triacetate materials. Cellulose triacetate foils from pellet dissolution and commercial cellulose triacetate solid state nuclear track detector membranes were assayed. Irradiation with fission fragments from Cf-252 source to obtain a porous structure, 25 MeV proton beam and Co-60 γ-source to produce peroxides were employed in the experiments. The present work gives the grafting yield of AAc monomer onto CTA membranes as a function of diverse variables including irradiation parameters (γ-dose, Cf-252 ff irradiation time, proton fluency and electronic energy loss (dE/dx)e), structural parameters (pore diameter and pore density, etching time and etching temperature) and grafting parameters (monomer and Mohr salt concentration, grafting time and grafting temperature)

  19. Thermal stability of radiation induced acrylic acid grafted nylon-6 fabric

    International Nuclear Information System (INIS)

    Acrylic acid was graft copolymerized onto nylon-6 fabric employing the ?-ray irradiation technique. The effect of heat treatment at constant length in the temperature range 200deg-300deg C on the mechanical properties of grafting nylon has been studied. The tenstile properties of grafted samples have been found to be unaffected by heat treatment up to 300deg C, suggesting significantly improved thermal stability of nylon-6 as a consequence of radiation grafting. Heat treatment at constant length does not significantly affect the initial modulus as well as the yield stress of the grafted nylon. (auth.)

  20. Sizing of crimped Dacron grafts.

    Science.gov (United States)

    Reid, J D; Sladen, J G

    1992-05-01

    The aim of this study was to correlate the stated size of Dacron grafts (Microvel) with their actual internal diameter and to compare this with measurements by ultrasound in the early postoperative period. Grafts of stated diameters of 7, 8, 9, and 10 mm were studied. Grafts were measured by graded probes and by measuring the width of the longitudinally opened graft and calculating the diameter. Each graft accepted a probe 1 mm larger than its stated size very easily and 2 mm greater when stretched. By open measurement, the grafts were 1.3 to 1.8 mm greater than their stated diameter without stretching. Twenty grafts were studied by duplex ultrasound for diameter and peak systolic velocity within 3 months of implantation. The grafts were 12% larger than their stated graft size. Some of the larger grafts showed low velocity and wall thrombus. We conclude that Microvel grafts are larger than their stated diameter. The same size discrepancy was seen in in vitro measurements of Vascutek (Dacron) grafts but not in polytetrafluoroethylene (Gortex) grafts. Since flow velocity is related to the diameter of the graft, this information should be useful when choosing the diameter of a prosthetic vascular graft. PMID:1533494

  1. Rib grafts in septorhinoplasty

    OpenAIRE

    Moretti, A.; Sciuto, S.

    2013-01-01

    Autogenous cartilage has generally been considered the gold standard grafting material in reconstructive septorhinoplasty for volume filling and structural support. In the restructuring of the nasal skeleton, autogenous cartilage can be harvested from the nasal septum, the auricle or the rib, but costal cartilage is considered the best graft material in patients requiring major reconstruction. Rib cartilage is an outstanding material in reconstructive septorhinoplasty, especially in revision ...

  2. Graft pancreatitis: literature review.

    Science.gov (United States)

    Labruzzo, Cinzia; El Tayar, Adil R; Hakim, Nadey S

    2006-01-01

    Graft pancreatitis is an inflammatory disease leading to autodigestion of the gland. The failure of the pancreatic graft can be attributed to immunological or nonimmunological causes. It consists of a premature activation of pancreatic proenzymes. When complications such as bleeding or leaks have already occurred, surgical correction should be considered. The aim of this review is to draw the attention of surgeons to the complications that can easily be avoided. PMID:16774182

  3. The impact of avoiding cardiopulmonary by-pass during coronary artery bypass surgery in elderly patients: the Danish On-pump Off-pump Randomisation Study (DOORS

    Directory of Open Access Journals (Sweden)

    Schmidt Thomas

    2009-07-01

    Full Text Available Abstract Background Coronary Artery Bypass Graft operation for ischemic heart disease provides improved quality of life and, in some patients, prolonged survival. Concern has, however, been raised about complications that may be related to the use of cardiopulmonary by-pass (CPB and aortic cross-clamping. It has been hypothesized that when coronary artery by-pass grafting is performed without the use of CPB, the rate of serious complications is reduced. Methods/Design The trial is designed as an open, randomized, controlled, clinical trial with blinded assessment of end-points. Patients at or above 70 years of age, referred for surgical myocardial revascularisation, are included and randomised to receive coronary artery by-pass grafting either with or without the use of CPB and aortic cross-clamping. Follow-up is performed by clinical, biochemical, electrocardiographic, and angiographic data that are evaluated by independent committees that are blinded with respect to the result of the randomisation. End points include mortality, stroke, myocardial infarction, graft patency, quality of life, and cost-effectiveness. The trial is performed in four different Danish, cardiac surgery centres. Trial registration ClinicalTrials.gov NCT00123981

  4. The impact of avoiding cardiopulmonary by-pass during coronary artery bypass surgery in elderly patients: the Danish On-pump Off-pump Randomisation Study (DOORS)

    Science.gov (United States)

    Houlind, Kim; Kjeldsen, Bo Juul; Madsen, Susanne Nørgaard; Rasmussen, Bodil Steen; Holme, Susanne Juel; Schmidt, Thomas Andersen; Haahr, Poul Erik; Mortensen, Poul Erik

    2009-01-01

    Background Coronary Artery Bypass Graft operation for ischemic heart disease provides improved quality of life and, in some patients, prolonged survival. Concern has, however, been raised about complications that may be related to the use of cardiopulmonary by-pass (CPB) and aortic cross-clamping. It has been hypothesized that when coronary artery by-pass grafting is performed without the use of CPB, the rate of serious complications is reduced. Methods/Design The trial is designed as an open, randomized, controlled, clinical trial with blinded assessment of end-points. Patients at or above 70 years of age, referred for surgical myocardial revascularisation, are included and randomised to receive coronary artery by-pass grafting either with or without the use of CPB and aortic cross-clamping. Follow-up is performed by clinical, biochemical, electrocardiographic, and angiographic data that are evaluated by independent committees that are blinded with respect to the result of the randomisation. End points include mortality, stroke, myocardial infarction, graft patency, quality of life, and cost-effectiveness. The trial is performed in four different Danish, cardiac surgery centres. Trial registration ClinicalTrials.gov NCT00123981 PMID:19575814

  5. Synthesis of polymer-polymer nanocomposites using radiation grafting techniques

    International Nuclear Information System (INIS)

    Fabrication of polymer-polymer nanocomposites based on sub-micron electrospun fibers imbedded in a distinct matrix is dependent on being able to control the wetting behavior of the electrospun fibrous mats. In this work the use of radiation grafting to modify electrospun polysulfone fiber surfaces with acrylamide is presented. Pre-irradiation grafting using electron beam (EB) and plasma treatments have been evaluated. The grafted fibrous mats were characterized using contact angle measurements, XPS, ATR-FTIR, and ESEM. It was found that 3 MeV EB can be used to obtain controlled degrees of grafting by varying total dose and that such grafting is uniform throughout the thickness of the fiber mat. In contrast, plasma grafting resulted in a concentration gradient of grafted acrylamide through the thickness with highest grafting yield on the surface of the mat exposed directly to the plasma. Procedures based on these techniques can be employed to generate polymer-polymer nanocomposites of dissimilar materials with geometric characteristics derived from the templating material

  6. Synthesis of polymer-polymer nanocomposites using radiation grafting techniques

    Energy Technology Data Exchange (ETDEWEB)

    Robinette, E.J. [Department of Chemical Engineering, Drexel University, Philadelphia, PA 19104 (United States); Palmese, G.R. [Department of Chemical Engineering, Drexel University, Philadelphia, PA 19104 (United States)]. E-mail: palmese@coe.drexel.edu

    2005-07-01

    Fabrication of polymer-polymer nanocomposites based on sub-micron electrospun fibers imbedded in a distinct matrix is dependent on being able to control the wetting behavior of the electrospun fibrous mats. In this work the use of radiation grafting to modify electrospun polysulfone fiber surfaces with acrylamide is presented. Pre-irradiation grafting using electron beam (EB) and plasma treatments have been evaluated. The grafted fibrous mats were characterized using contact angle measurements, XPS, ATR-FTIR, and ESEM. It was found that 3 MeV EB can be used to obtain controlled degrees of grafting by varying total dose and that such grafting is uniform throughout the thickness of the fiber mat. In contrast, plasma grafting resulted in a concentration gradient of grafted acrylamide through the thickness with highest grafting yield on the surface of the mat exposed directly to the plasma. Procedures based on these techniques can be employed to generate polymer-polymer nanocomposites of dissimilar materials with geometric characteristics derived from the templating material.

  7. Left ventricular assist device outflow graft: alternative sites

    OpenAIRE

    El-Sayed Ahmed, Magdy M.; Aftab, Muhammad; Singh, Steve K.; Mallidi, Hari R.; Frazier, Oscar H.

    2014-01-01

    We describe three alternative approaches for the left ventricular assist device (LVAD) outflow graft during implantation of the LVAD. The supraceliac abdominal aorta, innominate artery and left axillary artery were employed as alternative sites for the LVAD outflow graft in the setting of a heavily calcified ascending aorta or a hostile chest wall and mediastinum. The first approach involved the use of the supraceliac abdominal aorta. Given that the patient had a history of multiple previous ...

  8. Determination of grafting conversion degree in PS/PS-graft-POSS/POSS hybrid nanocomposites obtained through reactive processing

    International Nuclear Information System (INIS)

    Hybrid nanocomposites of polystyrene (PS) and polyhedral oligomeric silsesquioxanes (POSS) - PS/PS-graft-POSS/POSS - with different grafting degrees were prepared by reactive melt processing using dicumyl peroxide (DCP) as initiator in the presence or absence of styrene monomer as radical transfer agent. Gel permeation chromatography (GPC) using triple-detector and proton nuclear magnetic resonance (NMR 1H) analyses were used together to determine the conversion degree of PS-graft-POSS as a function of the reactive processing conditions adopted. GPC was employed to evaluate the effects of grafting (PS-graft-POSS) and PS chains degradation (? scission) that occur simultaneously during processing on the variation of average molecular masses and distributions for each PS/POSS sample. PS/POSS systems processed with styrene showed higher weight average molecular weights (Mw) and lower polydispersity indexes (Mw/Mn), as a result of higher grafting (PS-graft-POSS) conversion (28-40%) and lower PS chain degradation level, as compared to PS/POSS systems processed without styrene in which the degree of grafting conversion was around 25-28%. (author)

  9. Lethal systemic Degos disease with prominent cardio-pulmonary involvement

    International Nuclear Information System (INIS)

    Degos disease (DD) is a rare obstructive vasculopathy characterized by distinctive skin lesions. Involvement of the soles, palms and genitalia is rare. In most cases disease has an unfavorable course and involves gastrointestinal tract, central nervous system and occasionally other organs. Pleural and pericardial involvements are usually minor manifestations with prolonged course. Death occurs in approximately 50% of the patients usually due to intestinal perforation or central nervous system bleeding. We describe a 48-year-old man of lethal systemic DD. Widespread skin lesions with involvement of palm plantar surfaces, genitalia and scalp were ignored for 3 years, whereas the disease revealed its own malignant nature. The disorder progressed to nervous, gastrointestinal and cardiopulmonary system that led to death after 5 months from onset of systemic involvement as severe restrictive cardio-pulmonary insufficiency. Autopsy showed diffuse fibrotic changes in serial membranes and internal organs. (author)

  10. Climate change. A global threat to cardiopulmonary health.

    Science.gov (United States)

    Rice, Mary B; Thurston, George D; Balmes, John R; Pinkerton, Kent E

    2014-03-01

    Recent changes in the global climate system have resulted in excess mortality and morbidity, particularly among susceptible individuals with preexisting cardiopulmonary disease. These weather patterns are projected to continue and intensify as a result of rising CO2 levels, according to the most recent projections by climate scientists. In this Pulmonary Perspective, motivated by the American Thoracic Society Committees on Environmental Health Policy and International Health, we review the global human health consequences of projected changes in climate for which there is a high level of confidence and scientific evidence of health effects, with a focus on cardiopulmonary health. We discuss how many of the climate-related health effects will disproportionally affect people from economically disadvantaged parts of the world, who contribute relatively little to CO2 emissions. Last, we discuss the financial implications of climate change solutions from a public health perspective and argue for a harmonized approach to clean air and climate change policies. PMID:24400619

  11. Lethal systemic degos disease with prominent cardio-pulmonary involvement

    Directory of Open Access Journals (Sweden)

    Yaghoobi Notash Ali

    2011-01-01

    Full Text Available A 48-year-old man presented with acute abdominal pain underwent laparotomy that revealed two perforated ulcers in jejunum. He had skin lesions with porcelain white atrophic scar which were ignored for 3 years, whereas the disease revealed own malignant nature and progressed to nervous, gastrointestinal, and cardiopulmonary systems. The diagnosis of Degos disease was established on the basis of clinical and histopathological features. He expired due to cardio-pulmonary insufficiency after 5 months from the onset of systemic involvement. Autopsy showed diffuse fibrotic changes in serosal membranes and internal organs. Distribution of skin lesions that involved palmoplantar surfaces, genitalia and scalp and, furthermore, course of disease as rapid progressive cardio-polmunary involvement are remarkable point in this patient. On the other hand, this case highlights importance of clinicopathologic correlation, specially in the dermatologic field.

  12. Cardiopulmonary exercise testing in the assessment of exertional dyspnea

    Directory of Open Access Journals (Sweden)

    Debapriya Datta

    2015-01-01

    Full Text Available Dyspnea on exertion is a commonly encountered problem in clinical practice. It is usually investigated by resting tests such as pulmonary function tests and echocardiogram, which may at times can be non-diagnostic. Cardiopulmonary exercise testing (CPET measures physiologic parameters during exercise which can enable accurate identification of the cause of dyspnea. Though CPET has been around for decades and provides valuable and pertinent physiologic information on the integrated cardiopulmonary responses to exercise, it remains underutilized. The objective of this review is to provide a comprehensible overview of the underlying principles of exercise physiology, indications and contraindications of CPET, methodology and interpretative strategies involved and thereby increase the understanding of the insights that can be gained from the use of CPET.

  13. Industry Employment

    Science.gov (United States)

    Occupational Outlook Quarterly, 2012

    2012-01-01

    This article illustrates projected employment change by industry and industry sector over 2010-20 decade. Workers are grouped into an industry according to the type of good produced or service provided by the establishment for which they work. Industry employment projections are shown in terms of numeric change (growth or decline in the total…

  14. Axillobifemoral bypass grafting

    Directory of Open Access Journals (Sweden)

    Davidovi? Lazar B.

    2004-01-01

    Full Text Available INTRODUCTION Axillo-femoral bypass (AxF means connecting the axillar and femoral artery with the graft that is placed subcutaneously [1]. Usually, this graft is connected with contralateral femoral artery via one accessory subcutaneous graft, and this connection is known as axillobifemoral bypass (AxFF. This extra-anatomic procedure is an alternative method to the standard reconstruction of aortoiliac region when there are contraindications for general or local reasons. OBJECTIVE The objective of this paper is to show early and late results of AxFF bypass grafting as well as to show the indications for AxFF bypass. METHODS The sample consisted of 37 patients. The procedure was performed in 28 patients who suffered from aortoiliac occlusive disease and who were at high risk due to the comorbidity- in one patient with the rupture of juxtarenal aneurysm of abdominal aorta; in five patients with aortoenteric fistula, in two patients with iatrogenic lesion of abdominal aorta and in one female patient with anus preternaturalis definitivus who was treated for rectovaginal fistula. Donor's right axillary artery was used in 26 cases (70.3%, and donor's left axillary artery was used in 9 cases (29.7%. Dacron graft was used in 34 patients and Polytetrafluo-roethlylene graft was used in three patients. Simultaneously, profundo-plastic was done in four patients and femoro-popliteal bypass was performed in three patients. In five patients who suffered from aortoenteric fistula, simultaneous intervention of gastrointerstinal system has been done, x2 test was used for statistical evaluation and life table method was used for verification of late graft patency. RESULTS The rate of early postoperative mortality was 13.5%. The causes of death were: sepsis -1, MOFS - 3, and infarct myocardium -1. The mean follow up period was 40.1 months, ranging from six months to 17 years. During the follow up period, an early graft thrombosis was identified in two and late graft occlusion was reported in four patients. As the cause of occlusion, the progression of occlusive disease of receptive artery was identified in three patients, while anastomotic neointimae hyperplasia of recipient artery was identified in one patient. Three patients died during the follow up period. As the cause of death, CVI was reported in two patients and malignancy of the urinary tract was fpund in one patient. The other complications were - artery angulation on the level of proximal anastomosis in one patient (Figure 1, false aneurysm in one patient, perigraft seroma in one patient and graft infection in three patients. Life table method has shown that cumulative rate of late graft patency is 80.39% after five years (Graph 1. DISCUSSION Our results were analyzed and compared with the results of the study on 283 patients who had undergone aortobifemoral bypass (AFF operation due to the aortoiliac occlusive disease. This study was completed in 1995 (18. The results showed that there was no statistically significant differences between AxFF and AFF group (p>0.05, considering early mortality rate and late graft patency (Graph 2. The review of mortality and late patency rate after AxFF bypass grafting in a world well known studies has shown the similar results (Table 1. CONCLUSION The authors suggest that axilobifemoral bypass is indicated when there are contraindications or difficulties to perform anatomic reconstruction due to the abdomen condition (infection, adhesion, comorbidity as well as in high risk patients with low life expectancy.

  15. Cardiopulmonary Resuscitation Training in Sport Universities: An Italian Survey

    OpenAIRE

    Andrea Scapigliati; Saverio Giampaoli; Alessia Marsili; Federica Valeriani; Vincenzo Romano Spica

    2013-01-01

    Background: Physical activity is associated to an increased risk of sudden cardiac death (SCD). Together with primary prevention, prompt recognition and early management of SCD are crucial in order to improve survival rate. During their duty, sport trainers and teachers can play a key role in secondary prevention of cardiac arrest provided they have received an appropriate training in Cardiopulmonary Resuscitation (CPR) during their curricular study. This is usually achieved through a Basic ...

  16. Measurements of Cardiac and Cardiopulmonary Activities Using Contactless Doppler Radar

    OpenAIRE

    El-Samad, Sarah; Obeid, Dany; Zaharia, Gheorghe; Sadek, Sawsan; El Zein, Ghais

    2015-01-01

    This paper presents a wireless measurement system for cardiopulmonary activity. This system generates a continuous wave signal at 2.4 GHz toward the target and then measures the reflected signal. The target is the person's chest set at a distance of 1 m. The radar system contains a vector network analyzer, which measures the phase of S 21. The phase variation of S 21 contains information about heart and respiration activity. Measurements are performed with two different conditions, while the ...

  17. Survey of junior hospital doctors' attitudes to cardiopulmonary resuscitation

    OpenAIRE

    Morgan, R; Westmoreland, C

    2002-01-01

    Most cardiac arrest teams are made up of junior doctors. The stressful effect of cardiopulmonary resuscitation (CPR) on doctors has not previously been established. A questionnaire was sent to all 52 junior doctors who participated in the cardiac arrest team at a district general hospital. Forty one questionnaires were returned by 22 junior house officers, 12 senior house officers, and seven specialist registrars. The questionnaire was anonymous so non-responders could not be recontacted. Sev...

  18. Novel electronic refreshers for cardiopulmonary resuscitation: a randomized controlled trial

    OpenAIRE

    Magura Stephen; Miller Michael G; Michael Timothy; Bensley Robert; Burkhardt Jason T; Puente Anne Cullen; Sullins Carolyn

    2012-01-01

    Abstract Background Currently the American Red Cross requires that individuals renew their cardiopulmonary resuscitation (CPR) certification annually; this often requires a 4- to 8-hour refresher course. Those trained in CPR often show a decrease in essential knowledge and skills within just a few months after training. New electronic means of communication have expanded the possibilities for delivering CPR refreshers to members of the general public who receive CPR training. The study’s purp...

  19. Effects of inosine on reperfusion injury after cardiopulmonary bypass

    OpenAIRE

    Horkay Ferenc; Seres Leila; Radovits Tamás; Veres Gábor; Karck Matthias; Szabó Gábor

    2010-01-01

    Abstract Objective Inosine, a break-down product of adenosine has been recently shown to exert inodilatory and anti-inflammatory properties. Furthermore inosine might be a key substrate of pharmacological post-conditioning. In the present pre-clinical study, we investigated the effects of inosine on cardiac function during reperfusion in an experimental model of cardioplegic arrest and extracorporal circulation. Methods Twelve anesthetized dogs underwent hypothermic cardiopulmonary bypass. Af...

  20. Induced hypothermia after cardiopulmonary resuscitation: possible adverse effects

    OpenAIRE

    Milanovic, Rudlof; Husedzinovic, Sanja; Bradic, Nikola

    2007-01-01

    The last several years have seen an increased interest in the use of induced hypothermia after witnessed cardiopulmonary resuscitation (CPR). The main reason for its use is protection of the brain and hence, better neurological outcome in these patients. Therefore, induced hypothermia after CPR has become a part of standard recommendations in the 2005 Resuscitation Guidelines. At the same time, hypothermia can have many adverse effects. In the event of pre-hospital and/or in-hospital inductio...

  1. Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs

    OpenAIRE

    Wohlfart Björn; Paskevicius Audrius; Sjöberg Trygve; Liao Qiuming; Steen Stig

    2010-01-01

    Abstract Background Optimal manual closed chest compressions are difficult to give. A mechanical compression/decompression device, named LUCAS, is programmed to give compression according to the latest international guidelines (2005) for cardiopulmonary resuscitation (CPR). The aim of the present study was to compare manual CPR with LUCAS-CPR. Methods 30 kg pigs were anesthetized and intubated. After a base-line period and five minutes of ventricular fibrillation, manual CPR (n = 8) or LUCAS-...

  2. The ethics of cardiopulmonary resuscitation. I. Background to decision making.

    OpenAIRE

    Davies, J. M.; Reynolds, B M

    1992-01-01

    Futile cardiopulmonary resuscitation (CPR) may prevent humane care of the dying child and deprive parents of the opportunity to express their love, grief, and dedication at a critical moment, while appropriate and successful CPR may restore intact their child. Attempted resuscitation of corpses or children with terminal illness indicates inadequate knowledge, discrimination, and decision making. CPR is a medical procedure applicable to certain medical problems; weighing up the risks and benef...

  3. Cardiopulmonary responses to exercise in patients with hypertrophic cardiomyopathy

    OpenAIRE

    Jones, S.; ELLIOTT, P; S Sharma; McKenna, W; Whipp, B

    1998-01-01

    Objective—To examine the submaximal and maximal indices of the exercise response of patients with hypertrophic cardiomyopathy.?Design and setting—Prospective examination of cardiopulmonary responses to ramp exercise test of a consecutive group of patients with hypertrophic cardiomyopathy attending a cardiomyopathy outpatient clinic.?Methods—50 patients aged 12 to 76 years (mean (SD) 35 (14)) with diagnosis of hypertrophic cardiomyopathy performed incremental cycle ergometry; 22 sedentary volu...

  4. VentSim: a simulation model of cardiopulmonary physiology.

    OpenAIRE

    Rutledge, G. W.

    1994-01-01

    VentSim is a quantitative model that predicts the effects of alternative ventilator settings on the cardiopulmonary physiology of critically ill patients. VentSim is an expanded version of the physiologic model in VentPlan, an application that provides ventilator-setting recommendations for patients in the intensive care unit. VentSim includes a ventilator component, an airway component, and a circulation component. The ventilator component predicts the pressures and airflows that are generat...

  5. Tomographic ventilation-perfusion lung scintigraphy in cardiopulmonary disease

    OpenAIRE

    Jögi, Jonas

    2011-01-01

    Respiration relies, among other things, on the balance between regional ventilation and perfusion in the lungs. There are many cardiopulmonary diseases, such as pulmonary embolism (PE), chronic obstructive pulmonary disease (COPD) and left heart failure (LHF), which can affect respiration negatively. The diagnosis of PE, COPD and LHF follows separate diagnostic pathways. However, the symptoms that cause the patient to seek medical care are overlapping. This results in a diagnostic dilemma tha...

  6. Implementation of cardiopulmonary resuscitation workshop in first MBBS

    OpenAIRE

    Saiyad, Shaista M; Saiyad, Mubassir; Pandya, Charu J

    2015-01-01

    Context: Students should be exposed to early clinical scenario so that they start developing competency-based learning right from their MBBS 1st year. Medical Council of India has recognized this need and has suggested early clinical exposure of MBBS 1st year students in their document Vision 2015. Medical education in India needs change for achieving desired competencies. It has been concluded that Indian medical undergraduates have inadequate knowledge in cardiopulmonary resuscitation (CPR)...

  7. Cardiopulmonary exercise testing in the assessment of exertional dyspnea

    OpenAIRE

    Debapriya Datta; Edward Normandin; Richard ZuWallack

    2015-01-01

    Dyspnea on exertion is a commonly encountered problem in clinical practice. It is usually investigated by resting tests such as pulmonary function tests and echocardiogram, which may at times can be non-diagnostic. Cardiopulmonary exercise testing (CPET) measures physiologic parameters during exercise which can enable accurate identification of the cause of dyspnea. Though CPET has been around for decades and provides valuable and pertinent physiologic information on the integrated cardiopulm...

  8. Cardiopulmonary resuscitation and contrast media reactions in a radiology department

    International Nuclear Information System (INIS)

    AIM: To assess current knowledge and training in the management of contrast media reactions and cardiopulmonary resuscitation within a radiology department. MATERIALS AND METHODS: The standard of knowledge about the management of contrast media reactions and cardiopulmonary resuscitation among radiologists, radiographers and nurses were audited using a two-section questionnaire. Our results were compared against nationally accepted standards. Repeat audits were undertaken over a 28-month period. Three full audit cycles were completed. RESULTS: The initial audit confirmed that although a voluntary training programme was in place, knowledge of cardiopulmonary resuscitation techniques were below acceptable levels (set at 70%) for all staff members. The mean score for radiologists was 50%. Immediate changes instituted included retraining courses, the distribution of standard guidelines and the composition and distribution of two separate information handouts. Initial improvements were complemented by new wallcharts, which were distributed throughout the department, a series of lectures on management of contrast reactions and regular reviews with feedback to staff. In the third and final audit all staff groups had surpassed the required standard. CONCLUSION: Knowledge of contrast media reactions and resuscitation needs constant updating. Revision of skills requires a prescriptive programme; visual display of advice is a constant reminder. It is our contention all radiology departmental staff should consider it a personal duty to maintain their resuscitation skills at appropriate standards. O'Neill, J.M., McBride, K.D.(2001). Clinical Radiology 00, 000-000

  9. Medication Errors in Cardiopulmonary Arrest and Code-Related Situations.

    Science.gov (United States)

    Flannery, Alexander H; Parli, Sara E

    2016-01-01

    PubMed/MEDLINE (1966-November 2014) was searched to identify relevant published studies on the overall frequency, types, and examples of medication errors during medical emergencies involving cardiopulmonary resuscitation and related situations, and the breakdown by type of error. The overall frequency of medication errors during medical emergencies, specifically situations related to resuscitation, is highly variable. Medication errors during such emergencies, particularly cardiopulmonary resuscitation and surrounding events, are not well characterized in the literature but may be more frequent than previously thought. Depending on whether research methods included database mining, simulation, or prospective observation of clinical practice, reported occurrence of medication errors during cardiopulmonary resuscitation and surrounding events has ranged from less than 1% to 50%. Because of the chaos of the resuscitation environment, errors in prescribing, dosing, preparing, labeling, and administering drugs are prone to occur. System-based strategies, such as infusion pump policies and code cart management, as well as personal strategies exist to minimize medication errors during emergency situations. PMID:26724288

  10. Effect of chronic cardiopulmonary disease on survival after resection for stage Ia lung cancer.

    OpenAIRE

    U. Pastorino; Valente, M; Bedini, V; Pagnoni, A; Ravasi, G

    1982-01-01

    The role of chronic cardiopulmonary disease as a risk factor for immediate and late mortality was evaluated retrospectively in a consecutive series of 116 patients who had had resections for stage Ia non-oat-cell lung cancers. The presence of chronic cardiopulmonary disease was diagnosed on the clinical history and preoperative assessment of lung and heart function by traditional means. Patients with chronic cardiopulmonary disease showed a lower five-year survival rate than controls--35% ver...

  11. Crosslinked grafted PVC obtained by direct radiation grafting

    International Nuclear Information System (INIS)

    Direct radiation-induced grafting of 4-vinylpyridine onto both pure and plasticized poly(vinyl chloride) has been studied. The effect of grafting conditions such as solvent, monomer concentration, irradiation dose, and inhibitor concentration on the grafting yield was investigated. The grafting process was enhanced by using distilled water as diluent and higher degrees of grafting were obtained as compared with other solvents used (benzene, methanol, and a mixture of methanol and water). The homopolymerization of 4-vinylpyridine was reduced to a minimum using ammonium ferrous sulfate and the suitable optimum concentration of the inhibitor was found to be 0.25 wt%. It was observed that the degrees of grafting onto plasticized PVC were higher than those onto pure one, at constant grafting conditions. The diffusibility of the monomer solution through the trunk polymers enhanced at higher monomer concentrations. The higher the monomer concentration the higher the degrees of grafting obtained. The dependence of the grafting rate on monomer concentration was found to be 0.15 and 0.4 order for the grafting onto pure and plasticized PVC films, respectively. The gel content in both grafted extracted pure and plasticized PVC films increased with the degree of grafting to reach certain limiting values. (author)

  12. A comparison of urinary neutrophil gelatinase-associated lipocalin in patients undergoing on- versus off-pump coronary artery bypass graft surgery

    DEFF Research Database (Denmark)

    Wagener, Gebhard; Gubitosa, Gina; Wang, Shuang; Borregaard, Niels; Kim, Mihwa; Lee, H Thomas

    2009-01-01

    OBJECTIVE: The purpose of this study was to compare urinary neutrophil gelatinase-associated lipocalin (NGAL) levels in off-pump and on-pump coronary artery bypass graft (CABG) surgery. DESIGN: A matched cohort study. SETTING: A tertiary university hospital. PARTICIPANTS: Thirty adult patients undergoing CABG surgery without cardiopulmonary bypass (off-pump) matched to 30 patients with on-pump CABG surgery by age, preoperative serum creatinine, Parsonnet score, ejection fraction, body mass index...

  13. Alveolar bone grafting

    Directory of Open Access Journals (Sweden)

    Lilja Jan

    2009-10-01

    Full Text Available In patients with cleft lip and palate, bone grafting in the mixed dentition in the residual alveolar cleft has become a well-established procedure. The main advantages can be summarised as follows: stabilisation of the maxillary arch; facilitation of eruption of the canine and sometimes facilitation of the lateral incisor eruption; providing bony support to the teeth adjacent to the cleft; raising the alar base of the nose; facilitation of closure of an oro-nasal fistula; making it possible to insert a titanium fixture in the grafted site and to obtain favourable periodontal conditions of the teeth within and adjacent to the cleft. The timing of the ABG surgery take into consideration not only eruption of the canine but also that of the lateral incisor, if present. The best time for bone grafting surgery is when a thin shell of bone still covers the soon erupting lateral incisor or canine tooth close to the cleft.

  14. Impact of cerebral cardiopulmonary resuscitation maneuvers in a general hospital: prognostic factors and outcomes

    Scientific Electronic Library Online (English)

    Eduardo, Bartholomay; Fernando Suparregui, Dias; Fábio Alves, Torres; Pedro, Jacobson; Afonso, Mariante; Rodrigo, Wainstein; Renato, Silva; Luiz Carlos, Bodanese.

    2003-08-01

    Full Text Available OBJECTIVE: To assess survival of patients undergoing cerebral cardiopulmonary resuscitation maneuvers and to identify prognostic factors for short-term survival. METHODS: Prospective study with patients undergoing cardiopulmonary resuscitation maneuvers. RESULTS: The study included 150 patients. Spo [...] ntaneous circulation was re-established in 88 (58%) patients, and 42 (28%) were discharged from the hospital. The necessary number of patients treated to save 1 life in 12 months was 3.4. The presence of ventricular fibrillation or tachycardia (VF/VT) as the initial rhythm, shorter times of cardiopulmonary resuscitation maneuvers and cardiopulmonary arrest, and greater values of mean blood pressure (BP) prior to cardiopulmonary arrest were independent variables for re-establishment of spontaneous circulation and hospital discharge. The odds ratios for hospital discharge were as follows: 6.1 (95% confidence interval [CI] = 2.7-13.6), when the initial rhythm was VF/VT; 9.4 (95% CI = 4.1-21.3), when the time of cerebral cardiopulmonary resuscitation was 70 mmHg. CONCLUSION: The presence of VF/VT as the initial rhythm, shorter times of cerebral cardiopulmonary resuscitation and of cardiopulmonary arrest, and a greater value of BP prior to cardiopulmonary arrest were independent variables of better prognosis.

  15. Spinal bone graft - series (image)

    Science.gov (United States)

    ... is made over the bone defect, and the bone graft is shaped around and inserted into the defect. The graft is held in place with pins, plates, or screws. The incisions are stitched (sutured) closed. A splint ...

  16. Epoxy and Silicone Optical Nanocomposites Filled with Grafted Nanoparticles

    Science.gov (United States)

    Tao, Peng

    Polymer nanocomposites, as a technologically important class of materials, exhibit diverse functional properties, and are used for applications ranging from structural and biomedical to electronic and optical. The properties of polymer nanocomposites are determined, in part, by the chemical composition of the polymer matrix and the nanofillers. Their properties are also sensitive to the geometry and size of the nanofillers, and to spatial distribution of the fillers. Control of the nanoparticle size and dispersion within a given polymer provides opportunities to tailor and optimize the properties of nanocomposites for specific application. For optical applications such as encapsulation of light emitting diodes (LEDs), polymer nanocomposites filled with homogeneously dispersed nanoparticles would endow the polymer encapsulant with new functionality without sacrificing optical transparency. To this end, this thesis focuses on developing a simple and versatile approach towards the fabrication of epoxy and silicone transparent nanocomposites using matrix compatible chain-grafted nanoparticles as fillers, and studying the optical properties of the nanocomposites. The surface chemistry and grafted polymer chain design have been shown to play an important role in determining the dispersion state of the grafted nanoparticles and hence the final optical properties of the nanocomposites. To prepare transparent epoxy nanocomposites, poly (glycidyl methacrylate) (PGMA) chains were grafted onto the optical nanoparticle surfaces via a combined phosphate ligand exchange process and azide-alkyne "click" chemistry. The dispersion behavior of PGMA-grafted nanoparticles within the epoxy matrix was investigated by systematically varying the grafting density and grafted chain length. It was found that within the small molecular weight epoxy resins, the dispersion states are more sensitive to the grafting density than the molecular weight of grafted chains. With high grafting densities, the grafted PGMA brushes effectively screen the van der Waals attraction between the particles, and homogenous nanoparticle dispersions of grafted nanoparticles were obtained. Transparent high refractive index TiO2/epoxy thin film and bulk nancomposites were obtained by dispersing PGMA brushes-grafted TiO2 nanoparticles into a commercial epoxy matrix. The refractive index of the nanocomposites showed a linear dependence on the volume fraction of TiO2 nanoparticles and the optical transparency could be generally described by the Rayleigh scattering model. This powerful dispersing technique was further employed to make visibly transparent, UV/IR blocking ITO/epoxy nanocomposites which can be easily applied onto glass and plastic substrates as energy saving optical coating materials. To produce transparent silicone nanocomposites, we directly coupled phosphate-terminated PDMS chains onto the optical nanoparticle surface. It was observed that the mono-modal PDMS-grafted particles usually formed agglomerates within silicone matrices, whereas the bimodal PDMS-grafted particles were able to be individually dispersed even within high molecular weight matrices. Transparent high refractive index bulk TiO2/silicone nanocomposites were successfully prepared by filling with bimodal PDMS-grafted TiO2 nanoparticles. Furthermore, we used the PDMS-grafted TiO2/silicone nanocomposite as a model system to create a methodology to predict and control the dispersion behavior of grafted nanoparticles. The good agreement between experimental observation of dispersion of mono-modal and bimodal grafted particles and theoretical prediction would better guide future experiments and lead to predictability in polymer composite design. Finally, the bimodal grafted chain design was implemented in the preparation of transparent and luminescent CdSe/silicone nanocomposites with potential application as non-scattering light conversion materials for LEDs. The homogeneous dispersion of bimodal PDMS-grafted CdSe quantum dots not only minimizes the transparency loss due to scattering, but also benefits the uniformity and long-term stability of photoluminescence of the nanocomposites.

  17. Supported Employment

    OpenAIRE

    Jordán de Urríes, Francisco de Borja

    2010-01-01

    In this article we will try to show an overview of what is Supported Employment. We will provide a general vision of this tool for integration into open employment for people with disabilities and other social disadvantage groups. For this proposal the origin and definitions will be reviewed, after which the characteristics and philosophy, and the evolution of the model will be discussed. Although practices may differ among disability groups or countries, some core practices are clearly de...

  18. The surface of the corneal graft: in vivo color specular microscopic study in the human.

    OpenAIRE

    Lemp, M A

    1989-01-01

    An in vivo microscopic study of the cellular morphology of the corneal graft surface, employing CSM, has been presented. The following epithelial cellular abnormalities have been noted on the graft surface: a high prevalence (70%) of central vortex keratopathy in the postoperative graft; a redirection of cells in a palisading pattern around sutures; a piling up of cells at the wound junction, with redirection parallel to the wound; cellular evidence of filaments and coarse mucus plaques near ...

  19. Acrylonitrile grafted to PVDF

    Science.gov (United States)

    Yang, Jin; Eitouni, Hany Basam

    2015-03-31

    PVDF-g-PAN has been synthesized by grafting polyacrylonitrile onto polyvinylidene fluoride using an ATRP/AGET method. The novel polymer is ionically conducive and has much more flexibility than PVDF alone, making it especially useful either as a binder in battery cell electrodes or as a polymer electrolyte in a battery cell.

  20. Employer Branding

    DEFF Research Database (Denmark)

    Frimann, Søren; Mønsted, Bolette Rye

    Employer branding er både for den private og den offentlige sektor blevet en måde, de kan imødekomme ændrede arbejdsmarkedsvilkår og organisatoriske udfordringer i en postmoderne og globaliseret verden. Den aktuelle finanskrise har skabt nye udfordringer for organisationer i deres bestræbelser på...... at tiltrække- og fastholde attraktive medarbejdere. Men hvilken betydning har det, når Grundfos siger ”Mennesket er i fokus”, og hvad siger ”mangfoldighed” om Københavns Kommune som arbejdsplads i relation til employer branding? Er der egentlig sammenhæng mellem tankerne bag employer branding og de...... eksternt kommunikerede employer brandprodukter. Eller bliver det unikke ved arbejdspladserne ersattet af buzzwords uden substans og inddragelse af ansatte og interessenter? Artiklen har til formål at vurdere disse spørgsmål på baggrund af analyser af to cases med employer branding....

  1. New membranes obtained by grafted irradiated PVDF foils

    International Nuclear Information System (INIS)

    The present work describes a new method to produce membranes of poly(Acrylic-acid-Xmonomer) using the grafting procedure. PVDF foils irradiated with Ar+ beam with energies between 30 and 150 keV were employed as substratum. Different combinations of monomers in water solutions were used: acrylic acid (AAc); acrylic acid–glycidyl methacrylate (AAc–GMA); acrylic acid–styrene (AAc–S), acrylic acid-N-isopropyl acrylamide (AAc–NIPAAm) and acrylic acid-N-isopropyl acrylamide–glycidyl methacrylate (AAc-NIPAAm–GMA). A large percentage of grafting results for specific values of: ion fluence and energy, AAc and sulfuric acid concentration, and different substrata PVDF polymorphous (alpha or beta). At a particular time of the grafting process, the poly(AAc-Xmonomer) membranes detach from the substratum and continue their grafting in the solution. This method is useful to produce increased replicated membranes of the irradiated original surface.

  2. New membranes obtained by grafted irradiated PVDF foils

    Energy Technology Data Exchange (ETDEWEB)

    Mazzei, R. [Unidad de Actividades Tecnologicas y Agropecuarias, Laboratorio de Polimeros, Comision Nacional de Energia Atomica, Buenos Aires (Argentina); Universidad Tecnologica Nacional Facultad Regional, Buenos Aires (Argentina); Garcia Bermudez, G. [Gerencia de Investigacion y Aplicaciones, Laboratorio Tandar, Comision Nacional de Energia Atomica, Buenos Aires (Argentina); Escuela de Ciencia y Tecnologia, Universidad Nacional de General San Martin, Buenos Aires (Argentina); Consejo Nacional de Investigaciones Cientificas y Tecnicas, Buenos Aires (Argentina); Camporotondi, D.E., E-mail: camporotondi@cae.cnea.gov.ar [Unidad de Actividades Tecnologicas y Agropecuarias, Laboratorio de Polimeros, Comision Nacional de Energia Atomica, Buenos Aires (Argentina); Arbeitman, C. [Gerencia de Investigacion y Aplicaciones, Laboratorio Tandar, Comision Nacional de Energia Atomica, Buenos Aires (Argentina); Consejo Nacional de Investigaciones Cientificas y Tecnicas, Buenos Aires (Argentina); and others

    2012-09-15

    The present work describes a new method to produce membranes of poly(Acrylic-acid-Xmonomer) using the grafting procedure. PVDF foils irradiated with Ar{sup +} beam with energies between 30 and 150 keV were employed as substratum. Different combinations of monomers in water solutions were used: acrylic acid (AAc); acrylic acid-glycidyl methacrylate (AAc-GMA); acrylic acid-styrene (AAc-S), acrylic acid-N-isopropyl acrylamide (AAc-NIPAAm) and acrylic acid-N-isopropyl acrylamide-glycidyl methacrylate (AAc-NIPAAm-GMA). A large percentage of grafting results for specific values of: ion fluence and energy, AAc and sulfuric acid concentration, and different substrata PVDF polymorphous (alpha or beta). At a particular time of the grafting process, the poly(AAc-Xmonomer) membranes detach from the substratum and continue their grafting in the solution. This method is useful to produce increased replicated membranes of the irradiated original surface.

  3. New membranes obtained by grafted irradiated PVDF foils

    Science.gov (United States)

    Mazzei, R.; García Bermúdez, G.; Camporotondi, D. E.; Arbeitman, C.; del Grosso, M. F.; Behar, M.

    2012-09-01

    The present work describes a new method to produce membranes of poly(Acrylic-acid-Xmonomer) using the grafting procedure. PVDF foils irradiated with Ar+ beam with energies between 30 and 150 keV were employed as substratum. Different combinations of monomers in water solutions were used: acrylic acid (AAc); acrylic acid-glycidyl methacrylate (AAc-GMA); acrylic acid-styrene (AAc-S), acrylic acid-N-isopropyl acrylamide (AAc-NIPAAm) and acrylic acid-N-isopropyl acrylamide-glycidyl methacrylate (AAc-NIPAAm-GMA). A large percentage of grafting results for specific values of: ion fluence and energy, AAc and sulfuric acid concentration, and different substrata PVDF polymorphous (alpha or beta). At a particular time of the grafting process, the poly(AAc-Xmonomer) membranes detach from the substratum and continue their grafting in the solution. This method is useful to produce increased replicated membranes of the irradiated original surface.

  4. Myocardial revascularization in the elderly patient: with or without cardiopulmonary bypass?

    Directory of Open Access Journals (Sweden)

    Iglézias José Carlos Rossini

    2003-01-01

    Full Text Available OBJECTIVE: To verify if there is advantage in myocardial revascularization the elderly without cardiopulmonary bypass (CPB in relation to the use of the same, being considered the viability of complete myocardial revascularization (MR and the hospital morbidity and mortality. METHOD: We prospectively studied a hundred consecutive, no randomized patients, with age > or = 70 years, submitted to the primary and isolated myocardial revascularization between January and December of 2000. The patients were divided in two groups, G1 - 50 patients operated with CPB and G2 - 50 patients operated without CPB. Univariate testing of variables was performed with chi-squared analysis in the SPSS 10.0 Program and a p value less than 0.005 was considered significant. RESULTS: There was no renal failure or myocardial infarction (MI in both groups; the incidence of respiratory failure was identical in the two groups (4%; two patient of G1 they had Strokes, and 12 presented low output syndrome, occurrences not registered in G2. The need of ventilatory support > 24 hs was not significant between groups. Medium time of hospital stay was 21.8 and 11.7 days respectively (NS and the survival after 30 days were similar in the two groups. The patients' of G1 eighty percent had more than two approached arteries, against only 48% of G2 (p < 0.0001. CONCLUSION: Because the largest number of grafts in the patients of G1, we can affirm that the use of CPB can provide a larger probability of complete RM.

  5. Factors associated with excessive bleeding in cardiopulmonary bypass patients: a nested case-control study

    Directory of Open Access Journals (Sweden)

    Barrios Ysamar

    2007-04-01

    Full Text Available Abstract Introduction Excessive bleeding (EB after cardiopulmonary bypass (CPB may lead to increased mortality, morbidity, transfusion requirements and re-intervention. Less than 50% of patients undergoing re-intervention exhibit surgical sources of bleeding. We studied clinical and genetic factors associated with EB. Methods We performed a nested case-control study of 26 patients who did not receive antifibrinolytic prophylaxis. Variables were collected preoperatively, at intensive care unit (ICU admission, at 4 and 24 hours post-CPB. EB was defined as 24-hour blood loss of >1 l post-CPB. Associations of EB with genetic, demographic, and clinical factors were analyzed, using SPSS-12.2 for statistical purposes. Results EB incidence was 50%, associated with body mass index (BMI2, (P = 0.03, lower preoperative levels of plasminogen activator inhibitor-1 (PAI-1 (P = 0.01, lower body temperature during CPB (P = 0.037 and at ICU admission (P = 0.029, and internal mammary artery graft (P = 0.03 in bypass surgery. We found a significant association between EB and 5G homozygotes for PAI-1, after adjusting for BMI (F = 6.07; P = 0.02 and temperature during CPB (F = 8.84; P = 0.007. EB patients showed higher consumption of complement, coagulation, fibrinolysis and hemoderivatives, with significantly lower leptin levels at all postoperative time points (P = 0.01, P P Conclusion Excessive postoperative bleeding in CPB patients was associated with demographics, particularly less pronounced BMI, and surgical factors together with serine protease activation.

  6. Cardiopulmonary bypass alters the pharmacokinetics of propranolol in patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    M.J.C. Carmona

    2005-05-01

    Full Text Available The pharmacokinetics of propranolol may be altered by hypothermic cardiopulmonary bypass (CPB, resulting in unpredictable postoperative hemodynamic responses to usual doses. The objective of the present study was to investigate the pharmacokinetics of propranolol in patients undergoing coronary artery bypass grafting (CABG by CPB under moderate hypothermia. We evaluated 11 patients, 4 women and 7 men (mean age 57 ± 8 years, mean weight 75.4 ± 11.9 kg and mean body surface area 1.83 ± 0.19 m², receiving propranolol before surgery (80-240 mg a day and postoperatively (10 mg a day. Plasma propranolol levels were measured before and after CPB by high-performance liquid chromatography. Pharmacokinetic Solutions 2.0 software was used to estimate the pharmacokinetic parameters after administration of the drug pre- and postoperatively. There was an increase of biological half-life from 4.5 (95% CI = 3.9-6.9 to 10.6 h (95% CI = 8.2-14.7; P < 0.01 and an increase in volume of distribution from 4.9 (95% CI = 3.2-14.3 to 8.3 l/kg (95% CI = 6.5-32.1; P < 0.05, while total clearance remained unchanged 9.2 (95% CI = 7.7-24.6 vs 10.7 ml min-1 kg-1 (95% CI = 7.7-26.6; NS after surgery. In conclusion, increases in drug distribution could be explained in part by hemodilution during CPB. On the other hand, the increase of biological half-life can be attributed to changes in hepatic metabolism induced by CPB under moderate hypothermia. These alterations in the pharmacokinetics of propranolol after CABG with hypothermic CPB might induce a greater myocardial depression in response to propranolol than would be expected with an equivalent dose during the postoperative period.

  7. Cerebral vasoreactivity to carbon dioxide during cardiopulmonary perfusion at normothermia and hypothermia

    Energy Technology Data Exchange (ETDEWEB)

    Johnsson, P.; Messeter, K.; Ryding, E.; Kugelberg, J.; Stahl, E. (University Hospital, Lund (Sweden))

    1989-12-01

    With the pH-stat acid-base regulation strategy during hypothermic cardiopulmonary bypass (CPB), carbon dioxide (CO{sub 2}) is generally administered to maintain the partial pressure of arterial CO{sub 2} at a higher level than with the alpha-stat method. With preserved CO{sub 2} vasoreactivity during CPB, this induction of respiratory acidosis can lead to a much higher cerebral blood flow level than is motivated metabolically. To evaluate CO{sub 2} vasoreactivity, cerebral blood flow was measured using a xenon 133 washout technique before, during, and after CPB at different CO{sub 2} levels in patients who were undergoing coronary artery bypass grafting with perfusion at either hypothermia or normothermia. The overall CO{sub 2} reactivity was 1.2 mL/100 g/min/mm Hg. There was no difference between the groups. The CO{sub 2} reactivity was not affected by temperature or CPB. The induced hemodilution resulted in higher cerebral blood flow levels during CPB, although this was counteracted by the temperature-dependent decrease in the hypothermia group. After CPB, a transient increase in cerebral blood flow was noted in the hypothermia group, the reason for which remains unclear. The study shows that manipulation of the CO{sub 2} level at different temperatures results in similar changes in cerebral blood flow irrespective of the estimated metabolic demand. This finding further elucidates the question of whether alpha-stat or pH-stat is the most physiological way to regulate the acid-base balance during hypothermic CPB.

  8. Comparative study of pulsatile and nonpulsatile flow during cardio-pulmonary bypass.

    Directory of Open Access Journals (Sweden)

    Poswal P

    2004-01-01

    Full Text Available The use of nonpulsatile flow during extracorporeal circulation remains popular despite theoretical advantages of pulsatile cardiopulmonary bypass (CPB. Pulsatile CPB is considered to be more physiological than nonpulsatile flow as the pulsatile energy ensures the patency of the vascular bed and mechanical motion of tissue fluid around the cell membrane, improves microcirculation and enhances diffusion. The purpose of this study was to compare the effect of pulsatile and nonpulsatile flow on the coagulation profile, liver and kidney function and also on the haemodynamics in patients undergoing coronary artery bypass grafting on CPB. One hundred patients between 35 and 65 years of age with normal left ventricular function were randomly divided into two equal groups: Pulsatile (P and nonpulsatile (NP. Haematological parameters, clotting profile, renal parameters, hepatic function tests and haemodynamic variables were measured preoperatively and postoperatively at specific intervals. Surgical, anaesthetic and CPB regimen was standard in all cases. There was a decrease in platelet count during and after CPB in both groups. Coagulation profile and renal function parameters remained similar in both groups except that creatinine clearance was better in group P on the first postoperative day. Urine output was also better in group P. There was no change in liver function tests in both groups. The haemodynamic variables were comparable in both groups. The systemic vascular resistance was higher in group NP postoperatively and oxygen consumption was higher in group P post CPB. In conclusion we did not find any significant difference between pulsatile and nonpulsatile flow during CPB except the creatinine clearance and urine output were better in pulsatile group.

  9. Improved red blood cell survival after cardiac operations with administration of urea during cardiopulmonary bypass

    International Nuclear Information System (INIS)

    The plasma hemoglobin and red blood cell survival (half-life of 51Cr) was studied in 48 patients undergoing single valve replacement or coronary artery bypass graft. Urea or placebo was administered during cardiopulmonary bypass in a prospective, randomized, double-blind manner to test the potential effect on mechanical hemolysis. The mean plasma hemoglobin level at the end of extracorporeal circulation was significantly lower in the urea-treated groups (coronary artery bypass 342 mg/L; valve replacement 364 mg/L) than in the control groups (coronary artery bypass 635 mg/L, valve replacement 518 mg/L. The half-life of 51Cr was significantly longer in the urea-treated patients (coronary artery bypass 18 days; valve replacement 16 days) than in the control groups (coronary artery bypass 12.4 days; valve replacement 12.7 days) but still below the normal reference value (29 +/- 4 days). The plasma hemoglobin returned to near normal values (50 mg/L) the day after operation (day 1) and remained low with no differences between control and urea-treated groups. The total blood hemoglobin was followed for 2 weeks after operation and showed significantly less anemia in the urea-treated group. The lowest mean blood hemoglobin level was noted between days 5 and 9-114 (coronary artery bypass) and 107 (valve replacement) gm/L in the urea-treated patients compared to 92.3 gm/L in the control subjects. The reduction in the severity of the anemia led to less transfusion in the urea-treated patients (approximately 0.5 unit/patient) than in the control subjects (approximately 1 unit/patient) between days 3 and 14

  10. Dexmedetomidine decreases the inflammatory response to myocardial surgery under mini-cardiopulmonary bypass.

    Science.gov (United States)

    Bulow, N M H; Colpo, E; Pereira, R P; Correa, E F M; Waczuk, E P; Duarte, M F; Rocha, J B T

    2016-01-01

    Cardiopulmonary bypass (CPB) with extracorporeal circulation produces changes in the immune system accompanied by an increase in proinflammatory cytokines and a decrease in anti-inflammatory cytokines. We hypothesize that dexmedetomidine (DEX) as an anesthetic adjuvant modulates the inflammatory response after coronary artery bypass graft surgery with mini-CPB. In a prospective, randomized, blind study, 12 patients (4 females and 8 males, age range 42-72) were assigned to DEX group and compared with a conventional total intravenous anesthesia (TIVA) group of 11 patients (4 females and 7 males). The endpoints used to assess inflammatory and biochemical responses to mini-CPB were plasma interleukin (IL)-1, IL-6, IL-10, interferon (INF)-γ, tumor necrosis factor (TNF)-α, C-reactive protein, creatine phosphokinase, creatine phosphokinase-MB, cardiac troponin I, cortisol, and glucose levels. These variables were determined before anesthesia, 90 min after beginning CPB, 5 h after beginning CPB, and 24 h after the end of surgery. Endpoints of oxidative stress, including thiobarbituric acid reactive species and delta-aminolevulinate dehydratase activity in erythrocytes were also determined. DEX+TIVA use was associated with a significant reduction in IL-1, IL-6, TNF-α, and INF-γ (P<0.0001) levels compared with TIVA (two-way ANOVA). In contrast, the surgery-induced increase in thiobarbituric acid reactive species was higher in the DEX+TIVA group than in the TIVA group (P<0.01; two-way ANOVA). Delta-aminolevulinate dehydratase activity was decreased after CPB (P<0.001), but there was no difference between the two groups. DEX as an adjuvant in anesthesia reduced circulating IL-1, IL-6, TNF-α, and INF-γ levels after mini-CPB. These findings indicate an interesting anti-inflammatory effect of DEX, which should be studied in different types of surgical interventions. PMID:26909786

  11. Contrast MR of the brain after high-perfusion cardiopulmonary bypass

    Energy Technology Data Exchange (ETDEWEB)

    Simonson, T.M.; Yuh, W.T.C.; Hindman, B.J.; Embrey, R.P.; Halloran, J.I.; Behrendt, D.M. (Univ. of Iowa College of Medicine, Iowa City, IA (United States))

    1994-01-01

    To study the efficacy of contrast MR imaging in the evaluation of central nervous system complications in the cardiopulmonary bypass patient and attempt to explain their pathophysiology based on the MR appearance and the cardiopulmonary bypass protocol. Nineteen patients were prospectively studied with contrast MR examinations the day before and 3 to 7 days after cardiopulmonary bypass, to determine the nature, extent, and number of new postoperative MR abnormalities. Cardiopulmonary bypass parameters used in our institution included: membrane oxygenation, arterial filtration with a pore size of 25 [mu]m, and a relatively high perfusion rate to produce a cardiac index of 2.0 to 2.5 L min per m[sup 2]. The preoperative noncontrast MR examination showed age-related changes and/or signs of ischemia in 60% of patients on the day before surgery. However, there was no abnormal enhancement or new T2 abnormalities on any postoperative MR examination to suggest hypoperfusion or emboli. None of the 19 patients developed overt neurologic deficits postoperatively. Review of the cardiopulmonary bypass protocol used indicated significant variations in technique at different institutions. Contrast MR imaging demonstrated no new abnormalities in patients after cardiopulmonary bypass performed with strict in-line arterial filtration and relatively high perfusion. MR imaging is feasible in the early postoperative period after cardiopulmonary bypass and may offer a convenient method for evaluation of the neurologic impact of technical factors associated with cardiopulmonary bypass. 17 refs.

  12. Does Cardiopulmonary Resuscitation Cause Rib Fractures in Children? A Systematic Review

    Science.gov (United States)

    Maguire, Sabine; Mann, Mala; John, Nia; Ellaway, Bev; Sibert, Jo R.; Kemp, Alison M.

    2006-01-01

    Background: There is a diagnostic dilemma when a child presents with rib fractures after cardiopulmonary resuscitation (CPR) where child abuse is suspected as the cause of collapse. We have performed a systematic review to establish the evidence base for the following questions: (i) Does cardiopulmonary resuscitation cause rib fractures in…

  13. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Science.gov (United States)

    2010-04-01

    ... blood filter. 870.4270 Section 870.4270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange...

  14. Off-pump coronary artery bypass grafting: the Zurich experience.

    Science.gov (United States)

    Tavakoli, R; Reuthebuch, O; Hofer, C; Grünenfelder, J; Genoni, M

    2005-01-01

    Coronary artery bypass grafting (CABG) is the surgical procedure of choice for treatment of multi-vessel coronary artery disease. The rising risk profile of the patients requiring isolated CABG and the economic pressure have prompted us to devise new operative strategies to treat these patients. Elimination of the cardiopulmonary bypass is one possible answer to the dilemma of maintaining the quality of care and reducing the exploding costs of our health system. Therefore, we developed the off-pump coronary artery bypass grafting (OPCAB) for patients requiring isolated CABG. In our experience the key to successful OPCAB relies on the order of revascularization of the myocardial walls (anterior, inferior, lateral), use of intracoronary shunt, no-touch technique for the proximal aortic anastomosis with heart string â (Guidant, IN, USA), close collaboration with the anesthesiologists, early and aggressive administration of anti-platelet therapy, endoscopic vein harvest by perfusionists, and improved body temperature control. Following these concepts, we have been able to offer the OPCAB procedure to over 90% of our patients and to reduce perioperative morbidity and global costs. PMID:16112937

  15. Case report on effective cardiopulmonary resuscitation in a pregnant woman

    Science.gov (United States)

    Sharan, Radhe; Madan, Anita; Makkar, Vega; Attri, Joginder Pal

    2016-01-01

    The management of cardiac arrest in pregnancy is an important task for the emergency physicians. Some reasons for cardiac arrest are reversible and should be recognized and managed promptly. Cardiopulmonary resuscitation follows general advanced cardiac life support guidelines with several modifications for pregnant women, taking into account the lives of both mother and fetus. Here, we present the case of 23-year-old pregnant patient who came to Guru Nanak Dev Hospital, Amritsar; in shock, had a cardiac arrest, successfully resuscitated in Intensive Care Unit (ICU), delivered by emergency cesarean section and was discharged from ICU on 9th day in healthy state.

  16. Cardiopulmonary effects of xylazine and yohimbine in laterally recumbent sheep.

    OpenAIRE

    Doherty, T J; Pascoe, P J; W.N. McDonell; Monteith, G

    1986-01-01

    The effects of yohimbine (0.125 mg/kg) on cardiopulmonary parameters in six adult, xylazine treated (0.15 mg/kg), laterally recumbent sheep were studied. Following collection of baseline data, xylazine was administered intravenously and data were collected five and fifteen minutes later. At twenty minutes post-xylazine either yohimbine (0.125 mg/kg) or saline was given and further collection of data occurred at 25, 30, 40 and 50 minutes. Xylazine administration resulted in significant (P less...

  17. Sedative and cardiopulmonary effects of buprenorphine and xylazine in horses

    OpenAIRE

    Cruz, Fernando S.F.; Carregaro, Adriano B.; Machado, Melissa; Antonow, Rômulo R.

    2011-01-01

    This study investigated the sedative, cardiopulmonary, and gastrointestinal effects produced by buprenorphine and xylazine given in combination to horses. Six healthy adult horses underwent 4 randomized treatments, with an interval of 1 wk between treatments. A control group was given a saline solution intravenously (IV) and the experimental groups received buprenorphine [10 ?g/kg bodyweight (BW)] in combination with 1 of 3 different doses of xylazine: 0.25 mg/kg BW (BX25), 0.50 mg/kg BW (BX5...

  18. A method of automatic control procedures cardiopulmonary resuscitation

    Science.gov (United States)

    Bureev, A. Sh.; Zhdanov, D. S.; Kiseleva, E. Yu.; Kutsov, M. S.; Trifonov, A. Yu.

    2015-11-01

    The study is to present the results of works on creation of methods of automatic control procedures of cardiopulmonary resuscitation (CPR). A method of automatic control procedure of CPR by evaluating the acoustic data of the dynamics of blood flow in the bifurcation of carotid arteries and the dynamics of air flow in a trachea according to the current guidelines for CPR is presented. Evaluation of the patient is carried out by analyzing the respiratory noise and blood flow in the interspaces between the chest compressions and artificial pulmonary ventilation. The device operation algorithm of automatic control procedures of CPR and its block diagram has been developed.

  19. Northern employment

    International Nuclear Information System (INIS)

    Hiring practices and policies and employment opportunities that were available in the Beaufort Sea and MacKenzie Delta project for local residents and for people from southern Canada were dealt with in this chapter. Depending on the source, Northern hiring was a mere token, or a genuine and successful effort on the part of the companies to involve the native population and to share with them the benefits of the project. The fact remains that opening up job opportunities for Northerners was not easily attained, and would never have been realized without the involvement of government and community organizations. Government also played a major role in developing policies and training regimes. By the end of exploration operations, the hiring of Northern residents in the oil and gas industry had become a requirement of drilling applications. Training programs were also created to ensure that Northern residents received the means necessary to take advantage of Northern employment opportunities

  20. Do Radiologists Want/Need Training in Cardiopulmonary Resuscitation?

    International Nuclear Information System (INIS)

    Purpose: Prompt and effective cardiopulmonary resuscitation (CPR) decreases morbidity and mortality following cardiopulmonary arrest. Radiologists are frequently confronted with severely ill patients, who may deteriorate at any time. Furthermore, they have to be aware of life-threatening reactions towards contrast media. This study was designed to assess experience and self-estimation of German-speaking radiologists in CPR and cardiac defibrillation (CD). Material and Methods: 650 German-speaking radiologists were audited by a specially designed questionnaire, which was sent via e-mail. The answers were expected to be re-mailed within a 2-month period. Results: The response rate was 12.6%. 72.8% of the responders had performed at least 1 CPR (range 9.5 ± 13.1) and 37% at least 1 CD. 67.9% had had opportunities to attend training courses, which had been utilized by 41.8% of them. The last training of the responders was more than 2 years ago in 69.2% and more than 5 years ago in 37%. Of all responders 75.6% expressed the need for further education. Conclusion: The small response rate indicates the small importance of CPR in the subpopulation surveyed. The vast majority of the responders, however, showed interest in basic and advanced life support and advocated regular updates. It seems reasonable that radiological Dept. themselves should organize courses in order to cope with their specific situations

  1. Effects of inosine on reperfusion injury after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Horkay Ferenc

    2010-11-01

    Full Text Available Abstract Objective Inosine, a break-down product of adenosine has been recently shown to exert inodilatory and anti-inflammatory properties. Furthermore inosine might be a key substrate of pharmacological post-conditioning. In the present pre-clinical study, we investigated the effects of inosine on cardiac function during reperfusion in an experimental model of cardioplegic arrest and extracorporal circulation. Methods Twelve anesthetized dogs underwent hypothermic cardiopulmonary bypass. After 60 minutes of hypothermic cardiac arrest, reperfusion was started after application of either saline vehicle (control, n = 6, or inosine (100 mg/kg, n = 6. Left ventricular end-systolic pressure volume relationship (ESPVR was measured by a combined pressure-volume-conductance catheter at baseline and after 60 minutes of reperfusion. Left anterior descendent coronary blood flow (CBF, endothelium-dependent vasodilatation to acetylcholine (ACh and endothelium-independent vasodilatation to sodium nitroprusside (SNP were also determined. Results The administration of inosine led to a significantly better recovery (given as percent of baseline of ESPVR 90 ± 9% vs. 46 ± 6%, p Conclusions Application of inosine improves myocardial and endothelial function after cardiopulmonary bypass with hypothermic cardiac arrest.

  2. Do Radiologists Want/Need Training in Cardiopulmonary Resuscitation?

    Energy Technology Data Exchange (ETDEWEB)

    Schellhammer, F. [St. Katharinen Hospital, Frechen (Germany). Dept. of Radiology

    2003-03-01

    Purpose: Prompt and effective cardiopulmonary resuscitation (CPR) decreases morbidity and mortality following cardiopulmonary arrest. Radiologists are frequently confronted with severely ill patients, who may deteriorate at any time. Furthermore, they have to be aware of life-threatening reactions towards contrast media. This study was designed to assess experience and self-estimation of German-speaking radiologists in CPR and cardiac defibrillation (CD). Material and Methods: 650 German-speaking radiologists were audited by a specially designed questionnaire, which was sent via e-mail. The answers were expected to be re-mailed within a 2-month period. Results: The response rate was 12.6%. 72.8% of the responders had performed at least 1 CPR (range 9.5 {+-} 13.1) and 37% at least 1 CD. 67.9% had had opportunities to attend training courses, which had been utilized by 41.8% of them. The last training of the responders was more than 2 years ago in 69.2% and more than 5 years ago in 37%. Of all responders 75.6% expressed the need for further education. Conclusion: The small response rate indicates the small importance of CPR in the subpopulation surveyed. The vast majority of the responders, however, showed interest in basic and advanced life support and advocated regular updates. It seems reasonable that radiological Dept. themselves should organize courses in order to cope with their specific situations.

  3. “EMPLOYMENT GUARANTEE”

    Directory of Open Access Journals (Sweden)

    DILIP KHANDERAO PATIL

    2013-06-01

    Full Text Available Guarantee for one hundred days of employment in every financial year to adult members of any rural household willing to do public work-related unskilled manual work at the statutory minimum wage of Rs.100 per day. The Mahatma Gandhi National Rural Employment Guarantee Act (MNREGA is an Indian job guarantee scheme, enacted by legislation on August 25, 2005. The scheme provides a legal guarantee for one hundred days of employment in every financial year to adult members of any rural household willing to do public work-related unskilled manual work at the statutory minimum wage of 100 (US$2.17 per day. The Central government outlay for scheme is 40,000 crore (US$8.68 billion in FY 2010-11. The scheme commenced on February 2, 2006 in 200 districts, was expanded to cover another 130 districts in 2007-2008 and eventually covered all 593 districts in India by April 1, 2008. The outlay was Rs. 110 billion in 2006-2007, and rose steeply to Rs. 391 billion (140% increase in amount with respect to previous 2008-2009 budget in 2009-2010. Many criticisms have been leveled at the programme, which has been argued to be no more effective than other poverty reduction programmes in India, with key exceptions such as Rajasthan.The first criticism is financial. The MGNREGAis one of the largest initiatives of its kind in the world. The national budget for the financial year 2006-2007 was Rs 113 billion (about US$2.5bn and almost 0.3% of GDP and now fully operational, it costs Rs. 391 billion in financial year 2009-2010.

  4. Comparison of two technics of cardiopulmonary bypass (conventional and mini CPB in the trans-and postoperative periods of cardiac surgery

    Directory of Open Access Journals (Sweden)

    Sergio Nunes Pereira

    2015-08-01

    Full Text Available Abstract Objective: This study aimed to compare the effects of two different perfusion techniques: conventional cardiopulmonary bypass and miniature cardiopulmonary bypass in patients undergoing cardiac surgery at the University Hospital of Santa Maria - RS. Methods: We perform a retrospective, cross-sectional study, based on data collected from the patients operated between 2010 and 2013. We analyzed the records of 242 patients divided into two groups: Group I: 149 patients undergoing cardiopulmonary bypass and Group II - 93 patients undergoing the miniature cardiopulmonary bypass. Results: The clinical profile of patients in the preoperative period was similar in the cardiopulmonary bypass and miniature cardiopulmonary bypass groups without significant differences, except in age, which was greater in the miniature cardiopulmonary bypass group. The perioperative data were significant of blood collected for autotransfusion, which were higher in the group with miniature cardiopulmonary bypass than the cardiopulmonary bypass and in transfusion of packed red blood cells, which was higher in cardiopulmonary bypass than in miniature cardiopulmonary bypass. In the immediate, first and second postoperative period the values of hematocrit and hemoglobin were higher and significant in miniature cardiopulmonary bypass than in the cardiopulmonary bypass, although the bleeding in the first and second postoperative days was higher and significant in miniature cardiopulmonary bypass than in the cardiopulmonary bypass. Conclusion: The present results suggest that the miniature cardiopulmonary bypass was beneficial in reducing the red blood cell transfusion during surgery and showed slight but significant increase in hematocrit and hemoglobin in the postoperative period.

  5. Are the additional grafts necessary?

    Directory of Open Access Journals (Sweden)

    ?ur?i? A.

    2010-01-01

    Full Text Available The goals of surgery for spinal deformity are to correct or improve the deformity to get a stable, balanced and fused spine. The long-term success of any procedure for scoliosis depends on a solid arthrodesis. Getting fusion of the instrumented segment with the aid of copious autogenous iliac graft has been the most important goal of treatment. However, harvesting copious graft from teenage iliac bone has its limitation in the quantity of graft, surgical time, and other complications of graft sites. Bone substitute is a promising concept, but there is not ideal bone substitute with all the characteristics of an autogenous bone graft. Several alternative graft materials like tricalcium phosphate, hydroxyapatite, and demineralized bone matrix have osteoinductive properties. Bone morphogenic protein has osteoconductive properties. The limitations with bone substitutes are osteoinduction and osteoconduction properties, sterilization, chances of transmitting infective disease and cost. We consider that the introduction of segmental spinal instrumentation which enables strong and firm correction and fixation of the scoliotic deformity has enabled getting fusion with less graft. We can obtain that quantity of graft after laminae and spinous process decortication. This retrospective study has been done in our hospital from January 2002 to December 2004. A total of 188 patients underwent posterior corrections for adolescent idiopathic scoliosis using segmental fixation by Moss-Miami. No autogenous iliac crest graft was taken or graft substitutes. After meticulous decortication and destruction of facet joints, we used local graft taken from spinous process and laminae. All patients had minimum thirty months follow- up. We have excellent results. Out of these 188 patients, 177 patients have fused spine, no implant failure, no pain, no infection and no loss of correction. Eleven (5.8% patients underwent re-operation; four among them because of infection, three for symptomatic implants and four due to pseudarthrosis. We consider that the use of local harvesting graft is enough for getting good spondylodesis.

  6. Coxiella burnetii vascular graft infection

    OpenAIRE

    Von Segesser Ludwig; Moulin Alexandre; Raoult Didier; Franciolli Mario; Senn Laurence; Calandra Thierry; Greub Gilbert

    2005-01-01

    Abstract Background Coxiella burnetii, the causative agent of Q fever, may cause culture-negative vascular graft infections. Very few cases of C. burnetii infection of a vascular graft have been reported. All were diagnosed by serology. Case presentation We report the first case of Coxiella burnetii vascular graft infection diagnosed by broad-range PCR and discuss the diagnostic approaches and treatment strategies of chronic C. burnetii infection. Conclusion C. burnetii should be considered a...

  7. Impact of the initial classic section during a simulated cross-country skiing skiathlon on the cardiopulmonary responses during the subsequent period of skate skiing.

    Science.gov (United States)

    Mourot, Laurent; Fabre, Nicolas; Andersson, Erik; Willis, Sarah J; Hébert-Losier, Kim; Holmberg, Hans-Christer

    2014-08-01

    The aim of this study was to assess potential changes in the performance and cardiorespiratory responses of elite cross-country skiers following transition from the classic (CL) to the skating (SK) technique during a simulated skiathlon. Eight elite male skiers performed two 6 km (2 × 3 km) roller-skiing time trials on a treadmill at racing speed: one starting with the classic and switching to the skating technique (CL1-SK2) and another employing the skating technique throughout (SK1-SK2), with continuous monitoring of gas exchanges, heart rates, and kinematics (video). The overall performance times in the CL1-SK2 (21:12 ± 1:24) and SK1-SK2 (20:48 ± 2:00) trials were similar, and during the second section of each performance times and overall cardiopulmonary responses were also comparable. However, in comparison with SK1-SK2, the CL1-SK2 trial involved significantly higher increases in minute ventilation (V?E, 89.8 ± 26.8 vs. 106.8 ± 17.6 L·min(-1)) and oxygen uptake (V?O2; 3.1 ± 0.8 vs 3.5 ± 0.5 L·min(-1)) 2 min after the transition as well as longer time constants for V?E, V?O2, and heart rate during the first 3 min after the transition. This higher cardiopulmonary exertion was associated with ?3% faster cycle rates. In conclusion, overall performance during the 2 time trials did not differ. The similar performance times during the second sections were achieved with comparable mean cardiopulmonary responses. However, the observation that during the initial 3-min post-transition following classic skiing cardiopulmonary responses and cycle rates were slightly higher supports the conclusion that an initial section of classic skiing exerts an impact on performance during a subsequent section of skate skiing. PMID:24857293

  8. Environmental application of radiation grafting

    International Nuclear Information System (INIS)

    Adsorbent having high selectivity against a certain metal ion was synthesized by means of radiation-induced graft polymerization for the purpose of environmental application. The resulting adsorbents were utilized for the removal of toxic metal from scallop waste and the collection of uranium from seawater. As a novel application of grafting, the biodegradability of poly-hydroxybutylate was controlled by grafting. The biodegradability could be depressed by the graft chain and then recovered by external stimuli such as thermal and chemical treatments. (author)

  9. Suction blister grafting - Modifications for easy harvesting and grafting

    Directory of Open Access Journals (Sweden)

    2012-01-01

    Full Text Available Suction blister grafting is a simple modality of treatment of patients with resistant and stable vitiligo. But raising the blisters may be time consuming and transferring to the recipient site may be difficult as the graft is ultrathin. By doing some modifications we can make the technique simpler and easier. We can decrease the blister induction time by intradermal injection of saline, exposure to Wood?s lamp, intrablister injection of saline. By these methods we can decrease the blister induction time from 2-3 hrs to 45-90 minutes. After harvesting the graft, it can be transferred to the recipient area by taking the graft on a sterile glass slide, on the gloved finger, rolling the graft over a sterile syringe and then spreading on the recipient area, or taking on the sterile wrapper of paraffin dressing and then placing over the recipient area.

  10. Reconstruction of large upper eyelid defects with a free tarsal plate graft and a myocutaneous pedicle flap plus a free skin graft

    DEFF Research Database (Denmark)

    Toft, Peter B

    2016-01-01

    PURPOSE: To review and present the results of a one-step method employing a free tarsal plate graft and a myocutaneous pedicle flap plus a free skin graft for reconstruction of large upper eyelid defects after tumour surgery. METHODS: This was a retrospective case-series of 8 patients who underwent...... skin graft. RESULTS: All patients healed without necrosis, did not suffer from lagophthalmos, achieved reasonable cosmesis, and did not need lubricants. In one patient, a contact lens was necessary for three weeks because of corneal erosion. One patient still needs a contact lens 3 months after...... excision to avoid eye discomfort. CONCLUSION: Large upper eyelid defects can be reconstructed with a free tarsal plate graft and a laterally based myocutaneous pedicle flap in combination with a free skin graft. Two-step procedures can probably be avoided in most cases....

  11. Artéria axilar na instalação de circulação extracorpórea: indicações e resultados / Axillary artery in cardiopulmonary bypass: indications and results

    Scientific Electronic Library Online (English)

    Fernando A, Atik; Cristiano N, Faber; Ricardo B, Corso; Mateus de Souza, Santos; Karina Pereira, Michelette; Maria Regina, Barros; Luiz Fernando, Caneo.

    2009-09-01

    Full Text Available OBJETIVO: Estudar as indicações e os resultados da artéria axilar na instalação de circulação extracorpórea. MÉTODOS: Entre janeiro de 2005 e dezembro de 2008, a artéria axilar foi utilizada em 48 pacientes submetidos a cirurgia cardiovascular. A idade média foi 62 ± 11 anos e 33 (69%) pacientes era [...] m do sexo masculino. A artéria axilar foi abordada por incisão infraclavicular e a cânula introduzida no tubo de Dacron de 8 milímetros suturado nos bordos da artéria. RESULTADOS: As indicações foram calcificação da aorta (N=18, 38%), dissecção da aorta (N=15, 31%), aneurisma da aorta ascendente e/ou arco aórtico (N=11, 23%) e prévio a reesternotomia (N=4, 8%). A presença de calcificação da aorta levou mais frequentemente à mudança de tática intra-operatória do que as outras indicações (100% versus 10%, P Abstract in english OBJECTIVES: To determine indications and results of axillary artery cannulation for cardiopulmonary bypass. METHODS: From January 2005 through December 2008, axillary artery cannulation was used in 48 patients. Mean age was 62 ± 11 years and 33 (69%) patients were males. Axillary artery was approach [...] ed by infraclavicular incision and the cannula introduced in a 8 millimeter Dacron side graft. RESULTS: Indications were calcified aorta (N=18, 38%), aortic dissection (N=15, 31%), ascending and/or aortic arch aneurysm (N=11, 23%) and prior to reoperative median sternotomy (N=4, 8%). Changes in intraoperative planning occurred most often in patients with calcified aorta (100% versus 10%, P

  12. Induced hypothermia after cardiopulmonary resuscitation: possible adverse effects

    Directory of Open Access Journals (Sweden)

    Milanovic, Rudlof

    2007-04-01

    Full Text Available The last several years have seen an increased interest in the use of induced hypothermia after witnessed cardiopulmonary resuscitation (CPR. The main reason for its use is protection of the brain and hence, better neurological outcome in these patients. Therefore, induced hypothermia after CPR has become a part of standard recommendations in the 2005 Resuscitation Guidelines. At the same time, hypothermia can have many adverse effects. In the event of pre-hospital and/or in-hospital induction of hypothermia, without adequate monitoring and controlled cooling, hypothermia can cause serious complications, without beneficial effects on the brain. This article explains the most frequent adverse effects of hypothermia and possible hazardous outcomes for patients.

  13. Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs

    Directory of Open Access Journals (Sweden)

    Wohlfart Björn

    2010-10-01

    Full Text Available Abstract Background Optimal manual closed chest compressions are difficult to give. A mechanical compression/decompression device, named LUCAS, is programmed to give compression according to the latest international guidelines (2005 for cardiopulmonary resuscitation (CPR. The aim of the present study was to compare manual CPR with LUCAS-CPR. Methods 30 kg pigs were anesthetized and intubated. After a base-line period and five minutes of ventricular fibrillation, manual CPR (n = 8 or LUCAS-CPR (n = 8 was started and run for 20 minutes. Professional paramedics gave manual chest compression's alternating in 2-minute periods. Ventilation, one breath for each 10 compressions, was given to all animals. Defibrillation and, if needed, adrenaline were given to obtain a return of spontaneous circulation (ROSC. Results The mean coronary perfusion pressure was significantly (p Conclusions LUCAS-CPR gave significantly higher coronary perfusion pressure and significantly fewer rib fractures than manual CPR in this porcine model.

  14. Krypton-81m in the evaluation of cardiopulmonary disease

    International Nuclear Information System (INIS)

    The authors have been studying the clinical application of krypton-81m for cardiopulmonary disease. They have found its physical properties to be an asset for ventilation studies in a respiratory gated V/Q (ventilation-to-perfusion ratio) matching computer procedure for diagnosis of pulmonary embolism. Such a method has shown promise of separating pulmonary embolism from other diseases. They have also used first-pass intravenous krypton for evaluation of right ventricular ejection fraction. They found it to be an excellent, rapidly repeatable procedure with good agreement with traditional first-pass technetium-99m pertechnetate. They have also calculated tables of dosimetry for these methods and have found that they compare very favorably with current methods in nuclear medicine

  15. Voice advisory manikin versus instructor facilitated training in cardiopulmonary resuscitation

    DEFF Research Database (Denmark)

    Isbye, Dan L; Høiby, Pernilla; Rasmussen, Maria B; Sommer, Jesper; Lippert, Freddy; Ringsted, Charlotte; Rasmussen, Lars S

    2008-01-01

    BACKGROUND: Training of healthcare staff in cardiopulmonary resuscitation (CPR) is time-consuming and costly. It has been suggested to replace instructor facilitated (IF) training with an automated voice advisory manikin (VAM), which increases skill level by continuous verbal feedback during...... individual training. AIMS: To compare a VAM (ResusciAnne CPR skills station, Laerdal Medical A/S, Norway) with IF training in CPR using a bag-valve-mask (BVM) in terms of skills retention after 3 months. METHODS: Forty-three second year medical students were included and CPR performance (ERC Guidelines for...... Resuscitation 2005) was assessed in a 2 min test before randomisation to either IF training in groups of 8 or individual VAM training. Immediately after training and after 3 months, CPR performance was assessed in identical 2 min tests. Laerdal PC Skill Reporting System 2.0 was used to collect data. To quantify...

  16. Vacuum-assisted drainage in cardiopulmonary bypass: advantages and disadvantages.

    Science.gov (United States)

    Carvalho Filho, Elio Barreto de; Marson, Fernando Augusto de Lima; Costa, Loredana Nilkenes Gomes da; Antunes, Nilson

    2014-01-01

    Systematic review of vacuum assisted drainage in cardiopulmonary bypass, demonstrating its advantages and disadvantages, by case reports and evidence about its effects on microcirculation. We conducted a systematic search on the period 1997-2012, in the databases PubMed, Medline, Lilacs and SciELO. Of the 70 selected articles, 26 were included in the review. Although the vacuum assisted drainage has significant potential for complications and requires appropriate technology and professionalism, prevailed in literature reviewed the concept that vacuum assisted drainage contributed in reducing the rate of transfusions, hemodilutions, better operative field, no significant increase in hemolysis, reduced complications surgical, use of lower prime and of smaller diameter cannulas. PMID:25140478

  17. Assessment of Knowledge of Medical Staff about Cardiopulmonary Ressucitation (CPR

    Directory of Open Access Journals (Sweden)

    M. PGoranaraki

    1998-04-01

    Full Text Available This survey, evaluated the level of awareness and knowledge among the medical staff about conditions and methods of performing cardiopulmonary ressucitation. The study sampling comprised 497 subjects including 208 residents and 262 interns of ten university hospitals in Tehran. In regard to the basic principles, this has been 43.54% (SD = 13.36%, in drug and fluid therapy 31.22% (GD = 13.22%, in electroshock 43.6% (SD=21.12%, in appropriate approach to the problem 34.73% (SD=13.42% and in complications of CPR 17.7% (SD = 15.25%. Considering the results of the project, the medical staff have insufficient knowledge of CPR "md it does not improve significantly during internship and residency period. Therefore, there is a great necessity for the medical students to attend basic and advanced CPR courses during their study

  18. Thermal stability of grafted fibers

    International Nuclear Information System (INIS)

    Presented the experimental results on the study of thermal stability of grafted fibers, i.e., polypropylene-, polyester-, and rayon-grafted fibers. These fibers were obtained by radiation grafting processes using hydrophylic monomers such as 1-vinyl 2-pyrolidone, acrylic acid, N-methylol acrylamide, and acrylonitrile. The thermal stability of the fibers was studied using a Shimadzu Thermal Analyzer DT-30. The thermal stability of the fibers, which can be indicated by the value of the activation energy for thermal degradation, was not improved by radiation grafting. The degree of improvement depends on the thermal stability of the monomers used for grafting. The thermal stability of a polypropylene fiber, either a grafted or an ungrafted one, was found to be inferior compared to the polyester of a rayon fiber, which may be due to the lack of C=O and C=C bonds in the polypropylene molecules. The thermal stability of a fiber grafted with acrylonitrile monomer was found to be better than that of an ungrafted one. However, no improvement was detected in the fibers grafted with 1-vinyl 2-pyrrolidone monomer, which may be due to the lower thermal stability of poly(1-vinyl-2-pyrrolidone), compared to the polypropylene or polyester fibers. 17 figures, 3 tables

  19. Asymptotic behavior of grafting rays

    CERN Document Server

    Diaz, Raquel

    2007-01-01

    In this paper we study the convergence behavior of grafting rays to the Thurston boundary of Teichmuller space. When the grafting is done along a weighted system of simple closed curves or along a maximal uniquely ergodic lamination this behavior is the same as for Teichmuller geodesics and lines of minima. We also show that these rays are at bounded distance from Teichmuller geodesics.

  20. Coronary blood flow during cardiopulmonary resuscitation in swine

    International Nuclear Information System (INIS)

    Recent papers have raised doubt as to the magnitude of coronary blood flow during closed-chest cardiopulmonary resuscitation. We will describe experiments that concern the methods of coronary flow measurement during cardiopulmonary resuscitation. Nine anesthetized swine were instrumented to allow simultaneous measurements of coronary blood flow by both electromagnetic cuff flow probes and by the radiomicrosphere technique. Cardiac arrest was caused by electrical fibrillation and closed-chest massage was performed by a Thumper (Dixie Medical Inc., Houston). The chest was compressed transversely at a rate of 66 strokes/min. Compression occupied one-half of the massage cycle. Three different Thumper piston strokes were studied: 1.5, 2, and 2.5 inches. Mean aortic pressure and total systemic blood flow measured by the radiomicrosphere technique increased as Thumper piston stroke was lengthened (mean +/- SD): 1.5 inch stroke, 23 +/- 4 mm Hg, 525 +/- 195 ml/min; 2 inch stroke, 33 +/- 5 mm Hg, 692 +/- 202 ml/min; 2.5 inch stroke, 40 +/- 6 mm Hg, 817 +/- 321 ml/min. Both methods of coronary flow measurement (electromagnetic [EMF] and radiomicrosphere [RMS]) gave similar results in technically successful preparations (data expressed as percent prearrest flow mean +/- 1 SD): 1.5 inch stroke, EMF 12 +/- 5%, RMS 16 +/- 5%; 2 inch stroke, EMF 30 +/- 6%, RMS 26 +/- 11%; 2.5 inch stroke, EMF 50 +/- 12%, RMS 40 +/- 20%. The phasic coronary flow signal during closed-chest compression indicated that all perfusion occurred during the relaxation phase of the massage cycle. We concluded that coronary blood flow is demonstrable during closed-chest massage, but that the magnitude is unlikely to be more than a fraction of normal

  1. System identification of dynamic closed-loop control of total peripheral resistance by arterial and cardiopulmonary baroreceptors

    Science.gov (United States)

    Aljuri, A. N.; Bursac, N.; Marini, R.; Cohen, R. J.

    2001-01-01

    Prolonged exposure to microgravity in space flight missions (days) impairs the mechanisms responsible for defense of arterial blood pressure (ABP) and cardiac output (CO) against orthostatic stress in the post-flight period. The mechanisms responsible for the observed orthostatic intolerance are not yet completely understood. Additionally, effective counter measures to attenuate this pathophysiological response are not available. The aim of this study was to investigate the ability of our proposed system identification method to predict closed-loop dynamic changes in TPR induced by changes in mean arterial pressure (MAP) and right atrial pressure (RAP). For this purpose we designed and employed a novel experimental animal model for the examination of arterial and cardiopulmonary baroreceptors in the dynamic closed-loop control of total peripheral resistance (TPR), and applied system identification to the analysis of beat-to-beat fluctuations in the measured signals. Grant numbers: NAG5-4989. c 2001. Elsevier Science Ltd. All rights reserved.

  2. Awareness of cardiopulmonary resuscitation in medical-students and doctors in Rawalpindi-Islamabad, Pakistan

    International Nuclear Information System (INIS)

    Objective: To assess the level of awareness regarding basic and practical knowledge of cardiopulmonary resuscitation and its importance in the eyes of medical/dental students and doctors. Methods: The cross-sectional study was conducted in medical and dental colleges as well as hospitals of Rawalpindi and Islamabad, Pakistan, from June to September 2011. Non-probability convenience sampling was used and structured questionnaires on basic and practical knowledge of the procedure were distributed. The questionnaire had 26 items related to basic and advanced knowledge of the required skills. Doctors were divided into two groups based on their years of service and practice. Those with less than 5 years' experience were grouped as junior doctors, while rest as senior doctors. Descriptive statistics were employed to analyse the data using SPPS version 17 and Microsoft Excel. Percentages were worked out and the results were interpreted. Result: Of the 1000 questionnaires distributed, 646 (64.6%) were received duly filled and represented the study sample. Of the 646 participants, 34 (5.26%) were dentists, 424 (65.63%) were medical students, 92 (14.24%) were doctors and 96 (14.86%) were dental students. Basic knowledge of doctors was found to be better than that of dentists (n=96; 50% vs. n=8; 23%). Similarly, the advance knowledge of doctors was better than the dentists (n=53; 58% vs. n=11; 31%). The basic knowledge of junior doctors was found to be almost equal to the senior doctors (n=26; 44.75% vs. n=15; 45.5%). The advance knowledge of junior doctors was found to be better than the senior doctors (n=27; 45.37% vs. n=10; 29.48%). Among the students, 157 (37%) of the medical students had basic knowledge of CPR, while 36 (38%) dental students had basic knowledge of the topic. Medical students had more advanced knowledge (n=157; 37%) than dental students (n=34; 35%). Conclusion: The awareness of basic and advance knowledge of cardiopulmonary resuscitation skills in medical/dental students and doctors in Rawalpindi and Islamabad was inadequate. (author)

  3. Coxiella burnetii vascular graft infection

    Directory of Open Access Journals (Sweden)

    Von Segesser Ludwig

    2005-12-01

    Full Text Available Abstract Background Coxiella burnetii, the causative agent of Q fever, may cause culture-negative vascular graft infections. Very few cases of C. burnetii infection of a vascular graft have been reported. All were diagnosed by serology. Case presentation We report the first case of Coxiella burnetii vascular graft infection diagnosed by broad-range PCR and discuss the diagnostic approaches and treatment strategies of chronic C. burnetii infection. Conclusion C. burnetii should be considered as etiological agent in patients with a vascular graft and fever, abdominal pain, and laboratory signs of inflammation, with or without exposure history. Broad-range PCR should be performed on culture-negative surgical samples in patients with suspected infection of vascular graft.

  4. Radiation grafting on natural films

    Science.gov (United States)

    Lacroix, M.; Khan, R.; Senna, M.; Sharmin, N.; Salmieri, S.; Safrany, A.

    2014-01-01

    Different methods of polymer grafting using gamma irradiation are reported in the present study for the preparation of newly functionalized biodegradable films, and some important properties related to their mechanical and barrier properties are described. Biodegradable films composed of zein and poly(vinyl alcohol) (PVA) were gamma-irradiated in presence of different ratios of acrylic acid (AAc) monomer for compatibilization purpose. Resulting grafted films (zein/PVA-g-AAc) had their puncture strength (PS=37-40 N mm-1) and puncture deformation (PD=6.5-9.8 mm) improved for 30% and 50% PVA in blend, with 5% AAc under 20 kGy. Methylcellulose (MC)-based films were irradiated in the presence of 2-hydroxyethyl methacrylate (HEMA) or silane, in order to determine the effect of monomer grafting on the mechanical properties of films. It was found that grafted films (MC-g-HEMA and MC-g-silane) using 35% monomer performed higher mechanical properties with PS values of 282-296 N mm-1 and PD of 5.0-5.5 mm under 10 kGy. Compatibilized polycaprolactone (PCL)/chitosan composites were developed via grafting silane in chitosan films. Resulting trilayer grafted composite film (PCL/chitosan-g-silane/PCL) presented superior tensile strength (TS=22 MPa) via possible improvement of interfacial adhesion (PCL/chitosan) when using 25% silane under 10 kGy. Finally, MC-based films containing crystalline nanocellulose (CNC) as a filling agent were prepared and irradiated in presence of trimethylolpropane trimethacrylate (TMPTMA) as a grafted plasticizer. Grafted films (MC-g-TMPTMA) presented superior mechanical properties with a TS of 47.9 MPa and a tensile modulus (TM) of 1792 MPa, possibly due to high yield formation of radicals to promote TMPTMA grafting during irradiation. The addition of CNC led to an additional improvement of the barrier properties, with a significant 25% reduction of water vapor permeability (WVP) of grafted films.

  5. Wireless System for Continuous Cardiopulmonary Monitoring in a Space Environment Project

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose to develop the NJM Sense-It system based on small sensor tags, which include a cardiopulmonary MEMS sensor for measuring heartbeat and breath rates...

  6. Wireless System for Continuous Cardiopulmonary Monitoring in a Space Environment Project

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose to develop the NJM Sense-It system based on small sensor tags, which include a cardiopulmonary MEMS sensor for measuring heartbeat and breath rates...

  7. Utilising cardiopulmonary bypass for cancer surgery. Malignancy-induced protein C deficiency and thrombophilia.

    LENUS (Irish Health Repository)

    Marshall, C

    2012-02-03

    Cardiopulmonary bypass has evolved over the last 30 years. It is an important tool for the cardiac surgeon today and also has applications in non-cardiac operations such as surgery to extract tumours. Such patients undergoing surgery for cancer may be at an increased risk of a thromboembolic event post surgery, due to disturbances in the normal clotting pathway leading to hypercoagulability. One such disturbance is malignancy-induced Protein C deficiency. A deficiency of Protein C can cause hypercoagulabitity. Recent studies have examined cardiopulmonary bypass and inherited Protein C deficiency. However, surgery for cancer patients with a malignancy-induced Protein C deficiency involving cardiopulmonary bypass has not been reported. Surgery using CPB in these patients may result in increased morbidity and mortality. The objective of this article is to review the literature in order to discuss the occurrence, the aetiology and possible management of cancer patients with malignancy-induced Protein C deficiencies that require cardiopulmonary bypass for their surgery.

  8. Changing attitudes to cardiopulmonary resuscitation in older people: a 15-year follow-up study.

    LENUS (Irish Health Repository)

    Cotter, P E

    2009-03-01

    while it is well established that individual patient preferences regarding cardiopulmonary resuscitation (CPR) may change with time, the stability of population preferences, especially during periods of social and economic change, has received little attention.

  9. Electron beam-induced graft copolymerization of vinyl monomers on to polyester fibre

    International Nuclear Information System (INIS)

    Electron beam-induced graft copolymerization of acrylic acid on to multifilament PET fibre was carried out by simultaneous method. The fibre was impregnated with acrylic acid at room temperature and the impregnated fibre was irradiated with electron beams in air. The effects of impregnation time, swelling agent, monomer composition, dose, dose rate and grafting temperature have been investigated. Four hour impregnation time was found to be sufficient to obtain the maximum weight percentage of grafting for this system. Among the swelling agents employed, formic acid was found to be the most effective. Some properties of several percentage of grafting have been studied by means of Optical Microscope, X-rays Microanalyzer and Differential Scanning Calorimeter. Optical microscopic observations show that the diameter of graft fibres increases with the increasing percentage of grafting. X-rays microscope analysis shows that the distribution of grafts across the PET cross-sections is more intense at the surface in comparison to the core of the fibres. It is learned from DSC measurements that the melting point of graft fibres decreases slightly as the weight percentage of grafting increases. (author)

  10. Systematic Review and Meta-Analysis of Outcomes after Cardiopulmonary Arrest in Childhood

    OpenAIRE

    Phillips, Robert S.; Scott, Bryonnie; Carter, Simon J.; Taylor, Matthew; Peirce, Eleanor; Davies, Patrick; Maconochie, Ian K.

    2015-01-01

    Background Cardiopulmonary arrest in children is an uncommon event, and often fatal. Resuscitation is often attempted, but at what point, and under what circumstances do continued attempts to re-establish circulation become futile? The uncertainty around these questions can lead to unintended distress to the family and to the resuscitation team. Objectives To define the likely outcomes of cardiopulmonary resuscitation in children, within different patient groups, related to clinical features....

  11. Exercise and NO production: relevance and implications in the cardiopulmonary system

    OpenAIRE

    Nosarev, Alexei V.; Smagliy, Lyudmila V.; Anfinogenova, Yana; Popov, Sergey V; Kapilevich, Leonid V.

    2015-01-01

    This article reviews the existing knowledge about the effects of physical exercise on nitric oxide (NO) production in the cardiopulmonary system. The authors review the sources of NO in the cardiopulmonary system; involvement of three forms of NO synthases (eNOS, nNOS, and iNOS) in exercise physiology; exercise-induced modulation of NO and/or NOS in physiological and pathophysiological conditions in human subjects and animal models in the absence and presence of pharmacological modulators; an...

  12. Partial pressure of end-tidal carbon dioxide predicts successful cardiopulmonary resuscitation in the field

    OpenAIRE

    Weil, Max Harry

    2008-01-01

    Kolar and colleagues contribute an additional and important incentive for rescuers to utilize end-tidal carbon dioxide tensions as a routine monitor to guide management and decision-making during cardiopulmonary resuscitation. They conclude that below-threshold levels of 14 mmHg (1.5 kPa) measured after 20 minutes of cardiopulmonary resuscitation reliably predict that spontaneous circulation cannot be restored.

  13. Computational Modeling of Neonatal Cardiopulmonary Bypass Hemodynamics With Full Circle of Willis Anatomy.

    Science.gov (United States)

    Piskin, Senol; Ündar, Akif; Pekkan, Kerem

    2015-10-01

    Cardiopulmonary bypass (CPB) procedure is employed to repair most congenital heart defects (CHD). Cannulation is a critical component of this procedure where the location and diameter of cannula controls the hemodynamic performance. State-of-the-art computational studies of neonatal CPB employed an isolated aortic arch region by truncating the three-dimensional (3D) patient-specific cerebral system. The present work expanded these studies where the 3D patient-specific MRI reconstruction of the cerebral system, including the Circle of Willis (CoW), is integrated with a hypoplastic neonatal aortic arch. The inlet of the arterial cannula is assigned a steady velocity boundary condition of the CPB pump, while all outlets are modeled as resistance boundary conditions, thus allowing acute comparisons between different cannula configurations. Three-dimensional (3D) flow simulations in the aortic arch model are performed at a Reynolds number of 2150 using an experimentally validated commercial solver. Results demonstrate that the inclusion of 3D CoW is essential to predict the accurate head-neck blood perfusion and therefore critical in deciding the neonatal aortic cannulation strategy preoperatively. Using this integrated model two CPB configurations are studied, where the cannulas were placed at innominate artery (IA) (IA-cannula configuration) and ductus arteriosus (DA) (DA-cannula configuration). Configuration change produced significant differences in flow splits and local hemodynamics of blood flow throughout the whole aortic arch, neck and cerebral arteries. Percent flow rate differences between the IA- and DA-cannula configurations are computed to be: 19%, for descending aorta, 198% for ascending aorta (perfusing coronary arteries), 91% for right anterior cerebral artery, and 68% for left anterior cerebral artery. Another important finding is the retrograde flow at vertebral arteries for IA-cannula configuration, but not for DA-cannula. These results may help to translate better neonatal arterial cannulae design for minimizing cerebral complications during CPB procedures. PMID:25940836

  14. Gaseous micro-emboli activity during cardiopulmonary bypass in adults: pulsatile flow versus nonpulsatile flow.

    Science.gov (United States)

    Dodonov, Mikhail; Milano, Aldo; Onorati, Francesco; Dal Corso, Bruno; Menon, Tiziano; Ferrarini, Daniele; Tessari, Maddalena; Faggian, Giuseppe; Mazzucco, Alessandro

    2013-04-01

    Cardiopulmonary bypass (CPB) has a risk of cerebral injury, with an important role of gaseous micro-emboli (GME) coming from the CPB circuit. Pulsatile perfusion is supposed to perform specific conditions for supplementary GME activity. We aimed to determine whether pulsatile CPB augments production and delivery of GME and evaluate the role of different events in GME activity during either type of perfusion. Twenty-four patients who underwent on-pump coronary artery bypass grafting surgery at the University of Verona were divided equally into two groups-pulsatile perfusion (PP) group and nonpulsatile perfusion (NP) group. The circuit included a JostraHL-20 roller pump set in pulsatile or nonpulsatile mode, an open Sorin Synthesis membrane oxygenator with integrated screen-type arterial filter, and phosphorylcholine-coated tubes. Hemodynamic flow evaluation was performed in terms of energy equivalent pressure and surplus hemodynamic energy (SHE). GME were counted by means of a GAMPT BCC200 bubble counter (GAMPT, Zappendorf, Germany) with two probes placed at postpump and postarterial filter positions. Results were evaluated in terms of GME number, GME volume, number of over-ranged GME from both probes, and series of filtering indexes. In PP mode, the pump produced and delivered along the circuit significantly higher amounts of SHE than in NP mode. At the venous postpump site, GME number was significantly higher during PP but no difference was found in terms of GME volume or number of over-ranged bubbles. No significant difference in GME number, GME volume, or number of over-ranges was found at the postarterial filter site. Filtering indexes were similar between the two groups. Neither type of perfusion was shown to contribute to excessive GME production during the most important perfusionist manipulation. Pulsatility leads to GME increment by splitting and size diminishing of the existing bubbles but not by additional gas production. PP augmented GME number at the venous postpump site, while mean volume remained comparable with NP. Sorin Synthesis oxygenator showed high efficacy in GME removal during either type of perfusion. Supplementary GME production and delivery during typical perfusionist manipulations did not depend on perfusion type. PMID:23489040

  15. Percutaneous Intervention of Sequential Coronary Venous Graft

    OpenAIRE

    Dogan, Zeki; Karabulut, Ahmet; Uzunlar, Bulent

    2014-01-01

    We present a case with coronary bypass grafts in which venous graft was anastomosed to obtuse marginal (OM) 1 and OM2 branches sequentially. We performed percutaneous intervention to the proximal circumflex (CX), OM1, and bridging segment of the venous graft. Finally, bridging segment of the venous graft began to function as a CX body extending between the OM1 and OM2.

  16. Modification of synthetic fibers by radiation-induced grafting

    International Nuclear Information System (INIS)

    The present report describes studies to modify properties of synthetic fibers by radiation-induced grafting technique. This technique was employed since it is considered to be generally applicable to the grafting of a radically polymerizable monomer onto fiber. Three synthetic fibers were used mainly in the present studies; (1) polyester fiber which is ranked as the first in the amount of production in the synthetic fibers at present and is expected to increase in its importance in the future, (2) poly (vinyl chloride) fiber which is inexpensive and fire-retardant, and (3) polyethylene fiber which is not yet used in apparel at present. In order to perform the grafting, the following two methods were studied; one is to graft monomer uniformly in the fiber preventing homopolymerization of the monomer outside of the fiber, and the other to graft monomer only on the fiber surface. Using these methods, the following experiments were carried out and fairly good results as expected were obtained. (1) In the case of polyester fiber it was intended to make this more hydrophilic and fire-retardant. (2) Concerning to poly(vinyl chloride) fiber experiments were carried out to make the fiber more hydrophilic and simultaneously more heat-resistant. (3) In the case of polyethylene fiber, target was fire-retardance and heat-resistance. (author)

  17. Radiation grafting of styrene into PVDF powder

    International Nuclear Information System (INIS)

    Polyvinylidene fluoride PVDF powder was chosen as the base material, and grafted with styrene monomer under pre-irradiation graft polymerization method. The styrene grafted PVDF (PVDF-g-PS) powder was characterized by FTIR spectroscopy, DSC, TGA and element analysis. The FTIR spectra demonstrate that the poly-styrene is successfully grafted into PVDF powder. The crystallinity of grafted PVDF powder decreases with the increasing in the degree of grafting according to the DSC curves. The TGA curves of PVDF-g-PS change remarkably with respect to the original PVDF. It further proves the polystyrene is successfully grafted into PVDF powder. (authors)

  18. Sharma's clamp for sequential coronary artery grafting.

    Science.gov (United States)

    Sharma, Ashok Kumar; Siddiqi, Mohammad Salman; Sabti, Hilal Al

    2015-10-01

    Sequential coronary artery grafting is a common procedure. Holding the graft in the correct alignment and orientation in a limited pericardial space and taking a suture at the correct place on the graft is difficult. Graft slippage from the assistant can be distracting to the surgeon, unnecessarily increasing the anastomosis time and also affecting graft patency due to improperly placed sutures. We describe a simple device (Sharma's clamp) for graft holding and stabilization for sequential bypass grafting in coronary artery bypass surgery. PMID:25931571

  19. The effects of venous cannulation technique and cardioplegia type on plasma potassium concentration and arterial blood pressure during cardiopulmonary bypass.

    LENUS (Irish Health Repository)

    Coleman, E T

    2012-02-03

    The cannulation method and cardioplegia solution used during cardiopulmonary bypass (CPB) may both influence plasma potassium concentrations ([K+]) and mean arterial blood pressure (MAP). Bi-caval or right atrial cannulation methods are routinely used in conjunction with crystalloid or blood cardioplegia. We investigated the influence of cannulation method and cardioplegia solutions on plasma [K+] and MAP during cardiopulmonary bypass. Sixty consecutive patients undergoing elective coronary artery bypass grafting (CABG) using CPB were studied. They were randomly divided into three groups of 20 patients. Patients in Group A underwent bi-caval venous cannulation and received crystalloid cardioplegia. Group B patients underwent right atrial cannulation and received crystalloid cardioplegia. Group C patients underwent right atrial cannulation and received blood cardioplegia. In each case. cardioplegia was administered antegrade via the aortic root. Plasma [K+], MAP. and hemoglobin concentration (Hb) were measured over an 8-min period following cardioplegia administration (pilot studies indicated pressure changes occuring post cardioplegia administration up to this time). The combination of bi-caval cannulation and crystalloid cardioplegia (Group A) was associated with the least increase in plasma [K+] and no decrease in MAP. The maximum [K+] for this Group was 4.2 mmol\\/L (4.6% increase). The minimum mean pressure was 57 mmHg (13.6% increase). Both right atrial cannulation groups (B and C) showed a large rise in plasma [K+] and a decrease in MAP. Group B maximum [K+] was 5.2 mmol\\/L (27.5% increase). Group C was also 5.2 mmol\\/L (26.0% increase). Group C showed the largest pressure decrease, the minimum mean pressure was 45 mmHg (21.3% decrease). The Group B minimum mean pressure was 45 mmHg (8.7% decrease). Our results show that patients undergoing CPB operations who are deemed to be at increased risk of suffering adverse effects from hypotensive episodes may benefit from bicaval cannulation and caval snaring, in preference to right atrial cannulation. Crystalloid cardioplegia may be preferable to blood cardioplegia in these cases to maintain the MAP.

  20. Quantification of cardiopulmonary blood volume turnover using dynamic PET

    DEFF Research Database (Denmark)

    Harms, Hans; Tolbod, Lars Poulsen

    Background: Dynamic 15O-water PET is used to quantify myocardial blood flow. For clinical use however, additional information regarding left ventricular performance is often required but is not obtained from standard tracer kinetic modelling. The aim of this study was to explore the use of a novel index, the central circulatory turnover (CCT) which represents the fractional exchange of blood per stroke within the cardiopulmonary blood pool and can be measured from any dynamic PET scan. Methods: Data from 111 clinical patients were analysed retrospectively. Patients underwent a 6-min 15O-water scan during rest and adenosine-induced stress. Patients were categorized into 4 groups based on stress myocardial blood flow (MBF, in mL/g/min): all segments >2.3 (group 1, n=53), one vessel <2.3 (group 2, n=18), global <2.3 (group 3, n=25) or global <1.3 (group 4, n=15). Using automated software, LV and RV time-activity curves were extracted after which their first-pass peaks were isolated and the centroid of each peakwas obtained. Mean pulmonary transit time (MPTT, min) was defined as the difference between the LV centroid and the RV centroid and CCT was defined as 1/(MPTT*heart rate). Results: MPTT progressively increased with disease severity during stress (mean MPTT±SD of 0.142±0.051 min, 0.176±0.042 min, 0.186±0.040 min and 0.248±0.077 min for groups 1 to 4, ANOVA p<0.001). Similar results were obtained during rest (MPTT of 0.175±0.035 min, 0.205±0.043 min, 0.201±0.033min and 0.237±0.059 min for groups 1 to 4, ANOVA p<0.001). CCT decreased with increasing disease severity both during stress (CCT of 0.082±0.028, 0.077±0.027, 0.075±0.015 and 0.056±0.014 for groups 1 to 4, ANOVA p<0.001) and rest (CCT of 0.089±0.014, 0.076±0.025, 0.081±0.014 and 0.061±0.017 for groups 1 to 4, ANOVA p<0.001). Decrease of CCT was especially pronounced in severely ischemic patients already at rest Conclusion: Pulmonary transit times and central circulatory turnover can be measured automatically using dynamic PET. Since both are correlated with severity of myocardial ischemia already at rest, they appear to reflect manifest adverse cardiopulmonary remodelling. Both measures add information to standard tracer kinetic approaches and may play a future role in diagnosing and evaluating heart failure.

  1. Graft copolymerisation of methyl-methacrylate on to natural rubber latex

    International Nuclear Information System (INIS)

    In MG latex (natural rubber latex grafted with polymethyl methacrylate) preparations, the percentage of graftings were found to be influenced by the monomer concentrations. And the percentage of methyl metharylate grafted on natural rubber latex was improved by prior latex treatment with urea. Tensile strengths and elongation at breaks of the MG lattices were found to decrease with the increased in the percentage of the monomer grafted on the latex. Whereas, their moduli increased with the increased in the percentage of graftings. The irradiation dose employed in the MG latex preparations produces moderately vulcanized MG latex. These were exhibited by the low tensile readings. However, the tensile properties were improved by vulcanization process. It could be carried out either when the MG lattices were in the latex form or cast films form

  2. Coronary vein graft disease: Pathogenesis and prevention

    OpenAIRE

    Parang, Pirouz; Arora, Rohit

    2009-01-01

    Not long after coronary artery bypass grafting surgery was described, several reports presented follow-up angiographic data on large cohorts of patients, demonstrating that approximately one-half of saphenous vein grafts fail within 10 to 15 years of surgery and that graft failure is associated with worse clinical outcomes. Three processes are responsible for vein graft failure. Thrombosis, intimal hyperplasia and accelerated atherosclerosis contribute to graft failure in the acute, subacute ...

  3. Early chest tube removal after coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Mohsen Mirmohammad-Sadeghi

    2009-01-01

    Full Text Available Background: There is no clear data about the optimum time for chest tube removal after coronary artery bypass surgery. Aim: The aim of this study was to assess the impact of the chest tube removal time following coronary artery bypass grafting surgery on the clinical outcome of the patients. Material and Methods: An analysis of data from 307 patients was performed. The patients were randomized into two groups: in group 1 (N=107 chest tubes were removed within the first 24 hours after surgery, whereas in group 2 (N=200, chest tubes were removed in the second 24 hours after surgery. Demographics, lactate and pH at the beginning, during and after the operation, creatinine, left ventricular ejection fraction, inotropic drugs administration, length of ICU stay, and mortality data were collected. Respiratory rate and pain level was assessed. Results: In these surgeries, the mean± standard deviation for the aortic clamping time was 49.18±17.59 minutes and cardiopulmonary bypass time was 78.39±25.12 minutes. The amount of heparin consumed by the second group was higher (P <0.001 which could be considered as an important factor in increasing the drainage time after the surgery (P =0.047. The pain level evaluated 24 hours post-operation was lower in the first group, and the difference in the pain level between the 2 groups evaluated 30 hours post-operation was significant (P=0.016. The mean time of intensive care unit stay was longer in the second group but it was not statistically significant. Conclusion: Early extracting of chest tubes after coronary artery bypass graft surgery when there is no significant drainage can lead to pain reduction and consuming oxygen is an effective measure after surgery toward healing; it doesn?t increase the risk of creation of plural effusion and pericardial effusion.

  4. Controlled grafting of cellulose diacetate.

    Czech Academy of Sciences Publication Activity Database

    Vl?ek, Petr; Janata, Miroslav; Látalová, Petra; K?íž, Jaroslav; ?adová, Eva; Toman, Lud?k

    Gargnano : European Polymer Federation, 2006. s. 1. [European Polymer Conference EUPOC. Branched Macromolecular Structures. 07.05.2006-12.05.2006, Gargnano] R&D Projects: GA AV ?R IAA410820601 Keywords : cellulose diacetate * grafting Subject RIV: CD - Macromolecular Chemistry

  5. Coronary arteries bypass grafting stenosis

    Directory of Open Access Journals (Sweden)

    Mahmoud Ebrahimi

    2014-12-01

    Full Text Available Coronary artery disease (CAD is a major global problem. In addition, it is higher risk of mortality for women more than men are when develop in female gender Atherosclerotic plaques consist of deposits of fatty material in the tunica intima. The role of inflammatory process in CAD has been known from 1980’s. Several studies investigated the innate immunity and adaptive immunity roles in atherosclerosis and they concluded that it plays a key role in atherosclerosis. Coronary artery bypass grafting (CABG is a widely used method for the treatment of CAD. Based on the literature, CABG is the most common surgical operation done worldwide. In During the first 10 years after CABG, up to 50% of saphenous grafts will occlude. Graft restenosis is beginning with acute thrombosis, intima hyperplasia, and plaque formation. In this review, some molecular pathways of graft failure and restenosis such as apoptosis and nuclear factor kappa B (NF-?B are described.

  6. Left ventricular assist device outflow graft: alternative sites.

    Science.gov (United States)

    El-Sayed Ahmed, Magdy M; Aftab, Muhammad; Singh, Steve K; Mallidi, Hari R; Frazier, Oscar H

    2014-09-01

    We describe three alternative approaches for the left ventricular assist device (LVAD) outflow graft during implantation of the LVAD. The supraceliac abdominal aorta, innominate artery and left axillary artery were employed as alternative sites for the LVAD outflow graft in the setting of a heavily calcified ascending aorta or a hostile chest wall and mediastinum. The first approach involved the use of the supraceliac abdominal aorta. Given that the patient had a history of multiple previous breast surgeries and chest wall radiation for breast cancer treatment, a left subcostal incision was employed as a sternotomy-sparing approach. The second approach was the use of the innominate artery in a patient with a porcelain ascending aorta. The patient underwent pulmonary valve replacement, right ventricle outflow tract reconstruction and tricuspid valve annuloplasty in addition to the LVAD implantation. The third approach was the use of the left axillary artery. This patient had a history of LVAD implantation and subsequently developed infection with pseudoaneurysm formation at the aortic anastomosis of the outflow graft. We conclude that the supraceliac abdominal aorta, the innominate artery and the left axillary artery are potential alternative routes for the LVAD outflow graft in the settings of heavily calcified ascending aorta or a hostile chest wall and mediastinum. Although the described alternative approaches are safe and viable options, we highly recommend utilizing these approaches only in selected patients with significantly higher risks and hazards to the standard surgical approach. PMID:25452918

  7. ACL Reconstruction: Choosing the Graft

    OpenAIRE

    CERULLI, GIULIANO; PLACELLA, GIACOMO; Sebastiani, Enrico; Tei, Matteo Maria; Speziali, Andrea; Manfreda, Francesco

    2013-01-01

    Rupture of the anterior cruciate ligament is one of the most common ligament injuries in sports traumatology. The need for surgical anterior cruciate ligament reconstruction is justified by its anatomical characteristics. Key considerations when choosing a graft include the potential for bone integration and the risk of failure. Bone sclerosis around the tunnel affects the integration of the graft. For this reason, one aspect upon which orthopedic surgeons should focus is the biology of the b...

  8. Vascular graft infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Skov Jensen, J; Prag, J; Eiberg, J; Jørgensen, J; Schroeder, T V

    1995-01-01

    Vascular graft infection is one of the most serious complications in vascular surgery. It is associated with mortality rates ranging from 25% to 75% and with morbidity in the form of amputation in approximately 30% of patients. Staphylococcus aureus is the leading pathogen. With conventional laboratory techniques, the percentage of culture-negative yet grossly infected vascular grafts seems to be increasing and is not adequately explained by the prior use of antibiotics. We have recently reporte...

  9. Interventions in Infrainguinal Bypass Grafts

    International Nuclear Information System (INIS)

    The interventional radiologist plays an important role in the detection and prevention of infrainguinal bypass failure. Early detection and evaluation of flow-limiting lesions effectively preserve graft (venous bypass and polyester or expanded polytetrafluoroethylene bypass) patency by identifying stenoses before occlusion occurs. Delay in treatment of the at-risk graft may result in graft failure and a reduced chance of successful revascularization. For this reason, surveillance protocols form an important part of follow-up after infrainguinal bypass surgery. As well as having an understanding of the application of imaging techniques including ultrasound, MR angiography, CT angiography and digital subtraction angiography, the interventional radiologist should have detailed knowledge of the minimally invasive therapeutic options. Percutaneous transluminal angioplasty (PTA), or alternatively cutting balloon angioplasty, is the interventional treatment of choice in prevention of graft failure and occlusion. Further alternatives include metallic stent placement, fibrinolysis, and mechanical thrombectomy. Primary assisted patency rates following PTA can be up to 65% at 5 years. When the endovascular approach is unsuccessful, these therapeutic options are complemented by surgical procedures including vein patch revision, jump grafting, or placement of a new graft

  10. CARDIAC OUTPUT AFTER REVASCULARIZATION OF MYOCARDIUM WITHOUT THE USE OF CARDIOPULMONARY BYPASS

    Directory of Open Access Journals (Sweden)

    Jasmin Caluk

    2008-06-01

    Full Text Available Introduction: Cardiac output is the amount of blood pumped out from left ventricle into systemic circulation within one minute, i.e. product of stroke volume and heart rate. Coronary artery disease occurs as a consequence of reduced blood flow to heart muscle due to partial or total coronary artery obstruction by atherosclerosis or coronary thrombosis. Surgical revascularization of myocardium is performed with or without the use of cardiopulmonary bypass. Goal: to find the values of cardiac output, cardiac index, stroke volume, and heart rate before and after surgical revascularization of myocardium. Patients and methods: research was conducted as a retrospective study in Cardiovascular Clinic of University Clinical Centre in Tuzla on a sample of 60 patients subjected to surgical revascularization of myocardium. The first group consisted of 30 patients in which the revascularization was performed without the use of cardiopulmonary bypass, and the second group consisted of 30 patients in which the revascularization was performed witht the use of cardiopulmonary bypass. Haemodynamic parametres were measured and analyzed in all patients before and after the revascularization procedure. Results and Discussion: cardiac output after revascularization of myocardium without the use of cardiopulmonary bypass was increased by 13.62% (p< .05, cardiac index was increased by 13.64% (p< .05, and stroke volume was increased by 8.24% (p< .05 compared to preoperative values. Heart rate was increased by 5.2% (p< .05. After revascularization of myocardium with the use of cardiopulmonary bypass, cardiac output was decreased by 9.3% (p> .05, and cardiac index was decreased by 9.25% (p> .05 compared to preoperative values. Conclusion: values of haemodynamic parametres after revascularization of myocardium without the use of cardiopulmonary bypass are significantly better compared to the ones after revascularization of myocardium with the use of cardiopulmonary bypass.

  11. Capnography during cardiopulmonary resuscitation: Current evidence and future directions

    Directory of Open Access Journals (Sweden)

    Bhavani Shankar Kodali

    2014-01-01

    Full Text Available Capnography continues to be an important tool in measuring expired carbon dioxide (CO 2 . Most recent Advanced Cardiac Life Support (ACLS guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR. Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO 2 (PETCO 2 and cardiac output that can indicate the return of spontaneous circulation (ROSC. Additional evidence favoring the use of capnography during CPR includes definitive proof of correct placement of the endotracheal tube and possible prediction of patient survival following cardiac arrest, although the latter will require further investigations. There is emerging evidence that PETCO 2 values can guide the initiation of extracorporeal life support (ECLS in refractory cardiac arrest (RCA. There is also increasing recognition of the value of capnography in intensive care settings in intubated patients. Future directions include determining the outcomes based on capnography waveforms PETCO 2 values and determining a reasonable duration of CPR. In the future, given increasing use of capnography during CPR large databases can be analyzed to predict outcomes.

  12. Clinical benefit of steroid use in patients undergoing cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Whitlock, Richard P; Chan, Simon; Devereaux, P J; Sun, Jack; Rubens, Fraser D; Thorlund, Kristian; Teoh, Kevin H T

    2008-01-01

    We sought to establish the efficacy and safety of prophylactic steroids in adult patients undergoing cardiopulmonary bypass (CPB). We performed a meta-analysis of randomized trials reporting the effects of prophylactic steroids on clinical outcomes after CPB. Outcomes examined were mortality...... randomizing 3205 patients. Steroids reduced new onset atrial fibrillation [relative risk (RR) 0.71, 95% confidence interval (CI) 0.59 to 0.87], postoperative bleeding [weighted mean difference (WMD) -99.6 mL, 95% CI -149.8 to -49.3], and duration of ICU stay (WMD -0.23 days, 95% CI -0.40 to -0.07). Length of...... hospital stay was also reduced (WMD -0.59 days, 95% CI -1.17 to -0.02), but this result was less robust. A trend towards reduction in mortality was observed (RR 0.73, 95% CI 0.45 to 1.18). Randomized trials suggest that perioperative steroids have significant clinical benefit in CPB patients by decreasing...

  13. Evidence-based clinical practice manual: Cardiopulmonary-cerebral resuscitation

    Directory of Open Access Journals (Sweden)

    José Ricardo Navarro Vargas

    2015-01-01

    Full Text Available Cardio respiratory arrest in adults arises as a consequence of coronary artery disease inmore than 60% of cases. At present, it is considered a public health problem. It is important to keep in mind that prevention, through the adoption of healthy habits, isthe principle contributor to the reduction of morbimortality. Nevertheless, when a malignarrhythmia that leads to cardiac arrest presents itself, the outcomes are directly related tothe speed and quality with which cardiopulmonary resuscitation maneuvers are put intoeffect, and to the integral management of the clinical condition that is post-cardiac arrestsyndrome.These clinical practice handbook aim to provide sufficient information in order to guarantee appropriate medical attention in these cases. It is based on international norms ofthe lex artis in terms of the understanding and management of cardiac arrest. What's more, criteria for determining brain death, and the organization of the advancedresuscitation team, which goes by various names around the world, emergency medicalsystem, code blue, mega code, advanced resuscitation code, are included here.

  14. Cardiopulmonary resuscitation knowledge and skills of registered nurses in Botswana

    Scientific Electronic Library Online (English)

    Lakshmi, Rajeswaran; Valerie J., Ehlers.

    2014-01-01

    Full Text Available BACKGROUND: In Botswana nurses provide most health care in the primary, secondary and tertiary level clinics and hospitals. Trauma and medical emergencies are on the increase, and nurses should have cardiopulmonary resuscitation (CPR) knowledge and skills in order to be able to implement effective i [...] nterventions in cardiac arrest situations. OBJECTIVE: The objective of this descriptive study was to assess registered nurses' CPR knowledge and skills. METHOD: A pre-test, intervention and re-test time-series research design was adopted, and data were collected from 102 nurses from the 2 referral hospitals in Botswana. A multiple-choice questionnaire and checklist were used to collect data. RESULTS: All nurses failed the pre-test. Their knowledge and skills improved after training, but deteriorated over the three months until the post-test was conducted. CONCLUSION: The significantly low levels of registered nurses' CPR skills in Botswana should be addressed by instituting country-wide CPR training and regular refresher courses.

  15. Brain computed tomographic findings in post-cardiopulmonary resuscitation patients

    International Nuclear Information System (INIS)

    We retrospectively assessed the brain computed tomographic (CT) findings in 22 post-cardiopulmonary resuscitation (CPR) patients excluding neonatal cases. On the basis of the CT findings, the patients were divided into two groups. Eight patients (36.4 %) had bilateral abnormal lowdensity areas in the basal ganglia (Group I). The remaining 14 patients (63.6 %) had no abnormalities in that area (Group II). In Group I, the incidence of primary cardiac arrest and duration of advanced life support (ALS) was significantly different (p < 0.05) from Group II. Sex, age, duration of basic life support (BLS), time elapsed from initiation of BLS to initial CT and from initiation of ALS to initial CT was not significantly different between the two groups. Outcome was very poor in both groups and no significant difference was noted between them. We conclude that primary cardiac arrest and long duration of ALS were predictors of abnormal bilateral low-density areas in the basal ganglia in post-CPR patients. However, their appearance was not related to outcome. (author)

  16. Use of the impedance threshold device in cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Theano D Demestiha

    2010-02-01

    Full Text Available Although approximately one million sudden cardiac deaths occur yearly in the US and Europe, cardiac arrest (CA remains a clinical condition still characterized by a poor prognosis. In an effort to improve the cardiopulmonary resuscitation (CPR technique, the 2005 American Heart Association (AHA Guidelines for CPR gave the impedance threshold device (ITD a Class IIa recommendation. The AHA recommendation means that there is strong evidence to demonstrate that ITD enhances circulation, improves hemodynamics and increases the likelihood of resuscitation in patients in CA. During standard CPR, venous blood return to the heart relies on the natural elastic recoil of the chest which creates a transient decrease in intrathoracic pressure. The ITD further decreases intrathoracic pressure by preventing respiratory gases from entering the lungs during the decompression phase of CPR. Thus, although ITD is placed into the respiratory circuit it works as a circulatory enhancer device that provides its therapeutic benefit with each chest decompression. The ease of use of this device, its ability to be incorporated into a mask and other airway devices, the absence of device-related adverse effects and few requirements in additional training, suggest that ITD may be a favorable new device for improving CPR efficiency. Since the literature is short of studies with clinically meaningful outcomes such as neurological outcome and long term survival, further evidence is still needed.

  17. DOES MEAN PERFUSION PRESSURE DURING CARDIOPULMONARY BYPASS AFFECT RENAL FUNCTION?

    Directory of Open Access Journals (Sweden)

    Ramesh

    2015-10-01

    Full Text Available BACKGROUND: After cardiac surgery acute kidney injury (AKI is a common and serious condition carrying significant costs and is independently associated with increased morbidity and mortality. During cardiopulmonary bypass (CPB surgery, modifiable factors may contri bute to post - operative AKI. Their prevention might be a potential target for nephroprotection and any other morbidity after cardiac surgery. METHODS AND MATERIAL : The objective of the present study was to identify and determine whether intraoperative hypot ension or any other cofactor are independent risk factors for postoperative AKI defined by the RIFLE (renal Risk, Injury, Failure, Loss of renal function and End - stage renal disease. On basis of this patients were divided into two groups according to rise in serum creatinine >0.3 mg/dl till 72 hrs postoperatively. Group B patients have developed AKI (n=34 and the remaining patients were in Group A. RESULT : In our study we have found that mean arterial pressure during CPB were less in group B patients compare to group A patients which was statistically significant (p<0.001. And in this group ICU stay and mortality rate were also high compare to group A pati ent who had not developed AKI. CONCLUSION: Lower MAP during CPB is associated with development of postoperative renal derangement, leads to increase ICU stay and mortality. Larger studies are required to further support the evidence

  18. Acute mesenteric ischemia after cardio-pulmonary bypass surgery

    Directory of Open Access Journals (Sweden)

    Bassam Abboud, Ronald Daher, Joe Boujaoude

    2008-09-01

    Full Text Available Acute mesenteric ischemia (AMI is a highly-lethal surgical emergency. Several pathophysiologic events (arterial obstruction, venous thrombosis and diffuse vasospasm lead to a sudden decrease in mesenteric blood flow. Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities, leading to multi-organ failure and death. Early diagnosis is difficult because the clinical presentation is subtle, and the biological and radiological diagnostic tools lack sensitivity and specificity. Therapeutic options vary from conservative resuscitation, medical treatment, endovascular techniques and surgical resection and revascularization. A high index of suspicion is required for diagnosis, and prompt treatment is the only hope of reducing the mortality rate. Studies are in progress to provide more accurate diagnostic tools for early diagnosis. AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB. Several factors contribute to the systemic hypo-perfusion state, which is the most frequent pathophysiologic event. In this particular setting, the clinical presentation of AMI can be misleading, while the laboratory and radiological diagnostic tests often produce inconclusive results. The management strategies are controversial, but early treatment is critical for saving lives. Based on the experience of our team, we consider prompt exploratory laparotomy, irrespective of the results of the diagnostic tests, is the only way to provide objective assessment and adequate treatment, leading to dramatic reduction in the mortality rate.

  19. Development of a hemodynamically optimized outflow cannula for cardiopulmonary bypass.

    Science.gov (United States)

    Kaufmann, Tim A S; Schlanstein, Peter; Moritz, Anton; Steinseifer, Ulrich

    2014-11-01

    The jet of the outflow cannula is a potential risk for patients undergoing cardiopulmonary bypass (CPB), because increased jet velocities lead to altered flow conditions and might furthermore mobilize atherosclerotic plaques from calcified aortas. The cannula jet is therefore among the main reasons for cerebral hypoxia and stroke in CPB patients. In the past, we developed a validated computational fluid dynamics (CFD) model to analyze flow conditions during CPB as dependent on cannulation and support modalities. This model is now applied to develop a novel CPB outflow cannula to reduce the jet effect and increase cerebral blood flow. The Multi-Module Cannula (MMC) is based on a generic elbow cannula that was iteratively improved. It features an inner wall to smoothly guide the blood as well as an elliptically shaped outlet diffuser. During standard CPB conditions of 5 L/min, the pressure drop over the MMC is 61 mm Hg, compared with 68 mm Hg with a standard cannula. The maximum velocities are decreased from 3.7 m/s to 3.3 m/s. In the cannula jet of the MMC, the velocities are reduced further, down to 1.6 m/s. The cerebral blood flow is typically reduced during CPB. Using the MMC, however, it reaches almost physiological values at 715 mL/min. These results suggest that the MMC outperforms standard CPB cannulas. Further design improvements and improved insertion techniques are under consideration. PMID:24533575

  20. Venous obstruction and cerebral perfusion during experimental cardiopulmonary bypass.

    Science.gov (United States)

    Tovedal, Thomas; Jonsson, Ove; Zemgulis, Vitas; Myrdal, Gunnar; Thelin, Stefan; Lennmyr, Fredrik

    2010-11-01

    To investigate the effects on cerebral perfusion by experimental venous congestion of the superior vena cava (SVC) during bicaval cardiopulmonary bypass (CPB) at 34 °C, pigs were subjected to SVC obstruction at levels of 75%, 50%, 25% and 0% of baseline SVC flow at two arterial flow levels (low, LQ, high, HQ). The cerebral perfusion was examined with near-infrared spectroscopy (NIRS), cerebral microdialysis and blood gas analysis. SVC obstruction caused significant decreases in the NIRS tissue oxygenation index (TOI) and in SVC oxygen saturations (P<0.05, both groups), while the mixed venous saturation was decreased only in the LQ group. Sagittal sinus venous saturations were measured in the HQ group and found significantly reduced in response to venous congestion (P<0.05). No microdialysis changes were seen at the group level, however, individual ischemic patterns in terms of concomitant venous desaturation, decreased TOI and increased lactate/pyruvate occurred in both groups. The total venous drainage remained stabile throughout the experiment, indicating increased flow in the inferior vena cava cannula. The results indicate that SVC congestion may impair cerebral perfusion especially in the case of compromised arterial flow during CPB. Reduced SVC cannula flow may pass undetected during bicaval CPB, if SVC flow is not specifically monitored. PMID:20696750

  1. All-Inside Anterior Cruciate Ligament Graft Link: Graft Preparation Technique

    OpenAIRE

    Lubowitz, James H.

    2012-01-01

    The anatomic single-bundle, all-inside anterior cruciate ligament graft-link technique requires meticulous graft preparation. The graft choice is no-incision allograft or gracilis-sparing, posterior semitendinosus autograft. The graft is linked, like a chain, to femoral and tibial TightRope cortical suspensory fixation devices with adjustable-length graft loops (Arthrex, Naples, FL) in the following manner: the graft is quadrupled, and the free ends are first whip-stitched and then sutured wi...

  2. Radiation grafting on natural films

    International Nuclear Information System (INIS)

    Different methods of polymer grafting using gamma irradiation are reported in the present study for the preparation of newly functionalized biodegradable films, and some important properties related to their mechanical and barrier properties are described. Biodegradable films composed of zein and poly(vinyl alcohol) (PVA) were gamma-irradiated in presence of different ratios of acrylic acid (AAc) monomer for compatibilization purpose. Resulting grafted films (zein/PVA-g-AAc) had their puncture strength (PS=37–40 N mm?1) and puncture deformation (PD=6.5–9.8 mm) improved for 30% and 50% PVA in blend, with 5% AAc under 20 kGy. Methylcellulose (MC)-based films were irradiated in the presence of 2-hydroxyethyl methacrylate (HEMA) or silane, in order to determine the effect of monomer grafting on the mechanical properties of films. It was found that grafted films (MC-g-HEMA and MC-g-silane) using 35% monomer performed higher mechanical properties with PS values of 282–296 N mm?1 and PD of 5.0–5.5 mm under 10 kGy. Compatibilized polycaprolactone (PCL)/chitosan composites were developed via grafting silane in chitosan films. Resulting trilayer grafted composite film (PCL/chitosan-g-silane/PCL) presented superior tensile strength (TS=22 MPa) via possible improvement of interfacial adhesion (PCL/chitosan) when using 25% silane under 10 kGy. Finally, MC-based films containing crystalline nanocellulose (CNC) as a filling agent were prepared and irradiated in presence of trimethylolpropane trimethacrylate (TMPTMA) as a grafted plasticizer. Grafted films (MC-g-TMPTMA) presented superior mechanical properties with a TS of 47.9 MPa and a tensile modulus (TM) of 1792 MPa, possibly due to high yield formation of radicals to promote TMPTMA grafting during irradiation. The addition of CNC led to an additional improvement of the barrier properties, with a significant 25% reduction of water vapor permeability (WVP) of grafted films. - Highlights: • Irradiation of zein/PVA/acrylic acid improved the mechanical properties of films. • Irradiation of Methylcellulose/NCC/TMPTMA improved the barrier properties of films. • Irradiation of chitosane/Methylcellulose/HEMA/silane improved the strength of films

  3. Radiation grafting of methyl methacrylate on radiation crosslinked natural rubber film. Part 1. Grafting conditions and grafting yield

    International Nuclear Information System (INIS)

    Grafting of methyl methacrylate (MMA) on radiation crosslinked natural rubber (NR) film has been investigated by mutual radiation grafting. The effect of experimental parameters like radiation dose, dose-rate, additives like acids and inorganic salts, solvents, monomer concentration, cross-linking density of the natural rubber film on the grafting extent has been studied.From the kinetic studies, a kinetic equation showing almost parabolic and linear dependence of grafting on concentration and dose rate, respectively, was deduced.Preliminary thermal stability studies of grafted films indicated that grafting of MMA does not enhance the thermal stability of NR. (author)

  4. Grafting of Polystyrene into Poly(hedral oligomeric silsesquioxane) (POSS) Molecules

    OpenAIRE

    Özcan, Özden Beste; Karakoyun, Onur; Kodal, Mehmet; Özkoç, Güralp

    2014-01-01

    In this study, we aimed to improve the thermal properties, its stability, and the distribution of POSS, namely octavinylpoly(hedral oligomeric silsesquioxane), molecules in the polymeric matrix by grafting polystyrene. Being compatible with the selected POSS molecule, the initiator was AIBN and the solvent was toluene. The experimental method employed was solution polymerization. To characterize the grafting of polystyrene into POSS molecules, Fourier-Transform Infrared Spectroscopy (FTIR), d...

  5. Poly(lauryl acrylate) and poly(stearyl acrylate) grafted multiwalled carbon nanotubes for polypropylene composites

    DEFF Research Database (Denmark)

    Daugaard, Anders Egede; Jankova Atanasova, Katja; Hvilsted, Søren

    2014-01-01

    Two new polymer grafts on an industrial grade multiwalled carbon nanotube (MWCNT) were prepared through a non-oxidative pathway employing controlled free radical polymerization for surface initiated polymer grafting. After photochemical introduction of an ATRP initiator onto the MWCNT, polymerizations of lauryl or stearyl acrylate were performed, resulting in two novel polymer modifications on the MWCNT (poly(lauryl acrylate) or poly(stearyl acrylate)). The method was found to give time dependen...

  6. Employers' Guide to the Employment Equity Act

    OpenAIRE

    Lesley-Anne Katz

    2001-01-01

    Employers' Guide to the Employment Equity Act is aimed, according to the author, at assisting those in the labour arena (employers, managers, labour relations practitioners, union officials, and students) to develop a practical understanding of the Employment Equity Act (hereafter, the Act).

  7. Evaluating Employability Skills: Employer and Student Perceptions

    Science.gov (United States)

    Saunders, Venetia; Zuzel, Katherine

    2010-01-01

    Graduate employability is a key issue for Higher Education. In this two-part study student employability skills have been evaluated from the perspective of sandwich students and graduates in biomolecular science, and their employers. A strong correlation was found between employer and sandwich student/graduate perceptions of the relative…

  8. Effect of chronic cardiopulmonary disease on survival after resection for stage Ia lung cancer.

    Science.gov (United States)

    Pastorino, U; Valente, M; Bedini, V; Pagnoni, A; Ravasi, G

    1982-01-01

    The role of chronic cardiopulmonary disease as a risk factor for immediate and late mortality was evaluated retrospectively in a consecutive series of 116 patients who had had resections for stage Ia non-oat-cell lung cancers. The presence of chronic cardiopulmonary disease was diagnosed on the clinical history and preoperative assessment of lung and heart function by traditional means. Patients with chronic cardiopulmonary disease showed a lower five-year survival rate than controls--35% versus 53% (p less than 0.08). The difference increased and became significant if besides having cardiopulmonary disease the patient was over 60 years of age or had had a pneumonectomy--30% versus 52% (p less than 0.025). A higher operative mortality was the main reason for the lower observed survival. Nevertheless, survival of patients at risk exceeded 30% in each subgroup, being 33% for patients over 60 undergoing pneumonectomy. In our series the benefits of resection of lung cancer in patients with impaired cardiopulmonary function were greater than the risks of perioperative and later death even in the groups with a poorer prognosis. PMID:7157222

  9. Saphenous vein forearm grafts and gortex thigh grafts as alternative forms of vascular access.

    Science.gov (United States)

    Bhandari, S; Wilkinson, A; Sellars, L

    1995-11-01

    To compare the survival and complication rates of saphenous vein forearm grafts and gortex thigh grafts. Retrospective study over a twelve-year period with review of case-notes. Saphenous vein forearm grafts were constructed in 17 males and 12 females, mean age 61 years and gortex thigh grafts in 24 males and 22 females (49 grafts), mean age 49 years. Grafts were the primary form of access in 9 patients in each group. Follow-up was 45.6 and 135.2 patient years on dialysis for forearm grafts and thigh grafts respectively. One-year total survival was 89.4% (89.4% at 2 years and 71.5% at 3 years) and 84.9% (82.3% at 2 years and 70.4% at 3 years) for saphenous vein forearm grafts and gortex thigh grafts respectively. The overall complication rates were 0.22 and 0.61 per patient year on dialysis for saphenous vein forearm grafts and gortex thigh grafts respectively. Thrombosis occurred in 10% and 52%, infection in 0% and 35% and no complications in 62% and 24% of saphenous vein forearm grafts and gortex thigh grafts respectively. Both saphenous vein forearm grafts and gortex thigh grafts can provide satisfactory vascular access. The survival is similar at one year but gortex thigh grafts have a higher complication rate. PMID:8605714

  10. Kinetics of vein graft hyperplasia

    International Nuclear Information System (INIS)

    Human aortocoronary vein grafts fail due to accelerated occlusive disease. The possibility that this is related to cellular hyperplasia was investigated in a rabbit model where kinetics of vein graft thickening, endothelial (EC) repair, and smooth muscle cell (SMC) proliferation were measured from 2 days to 24 weeks after implanting jugular vein segments in the carotid artery. Immediately after graft placement focal EC denudation was observed. These defects were repaired within 1 week and did not recur. By 4 weeks intimal area had increased 30 fold from 0.028 +/- 0.004 to 0.705 +/- 0.021 mm2, and a 24 weeks was 0.93 +/- 0.21 mm2. This response did not produce a reduction in graft lumen area. EC and SMC thymidine-labeling index were measured by en face and cross-section autoradiography after injection of 3H-thymidine and perfusion fixation. Despite rapid EC surface repair EC labeling index remained elevated and only returned to normal levels at 12 weeks; SMC labeling was 10 fold greater than baseline even at 24 weeks (0.22% vs 0.02%). SMC mass demonstrated morphometrically increased between 2 and 12 weeks. Intimal thickening in vein grafts is due to SMC proliferation and develops after the EC layer has been restored. In contrast, intimal SMC proliferate in damaged arteries when the EC layer is absent and cease when the EC layer is regenerated

  11. Strategies to prevent intraoperative lung injury during cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Siminelakis Stavros N

    2010-01-01

    Full Text Available Abstract During open heart surgery the influence of a series of factors such as cardiopulmonary bypass (CPB, hypothermia, operation and anaesthesia, as well as medication and transfusion can cause a diffuse trauma in the lungs. This injury leads mostly to a postoperative interstitial pulmonary oedema and abnormal gas exchange. Substantial improvements in all of the above mentioned factors may lead to a better lung function postoperatively. By avoiding CPB, reducing its time, or by minimizing the extracorporeal surface area with the use of miniaturized circuits of CPB, beneficial effects on lung function are reported. In addition, replacement of circuit surface with biocompatible surfaces like heparin-coated, and material-independent sources of blood activation, a better postoperative lung function is observed. Meticulous myocardial protection by using hypothermia and cardioplegia methods during ischemia and reperfusion remain one of the cornerstones of postoperative lung function. The partial restoration of pulmonary artery perfusion during CPB possibly contributes to prevent pulmonary ischemia and lung dysfunction. Using medication such as corticosteroids and aprotinin, which protect the lungs during CPB, and leukocyte depletion filters for operations expected to exceed 90 minutes in CPB-time appear to be protective against the toxic impact of CPB in the lungs. The newer methods of ultrafiltration used to scavenge pro-inflammatory factors seem to be protective for the lung function. In a similar way, reducing the use of cardiotomy suction device, as well as the contact-time between free blood and pericardium, it is expected that the postoperative lung function will be improved.

  12. Anesthetic management during cardiopulmonary bypass: a systematic review.

    Science.gov (United States)

    Barry, Aaron E; Chaney, Mark A; London, Martin J

    2015-04-01

    Cardiopulmonary bypass (CPB) required for cardiac surgery presents unique challenges to the cardiac anesthesiologist responsible for providing the 3 most basic facets of any anesthetic: amnesia, analgesia, and muscle relaxation. Unique pathophysiologic changes during CPB result in pharmacokinetic alterations that impact the serum and tissue concentrations of IV and volatile anesthetics. Similarly, CPB causes pharmacodynamic alterations that impact anesthetic efficacy. The clinical significance of these alterations represents a "moving target" as practice evolves and the technology of CPB circuitry advances. In addition, perfusionists choose, modify, and maintain the CPB circuitry and membrane oxygenator. Thus, their significance may not be fully appreciated by the anesthesiologist. These issues have a profound impact on the anesthetic state of the patient. The delivery and maintenance of anesthesia during CPB present unique challenges. The perfusionist may be directly responsible for the delivery of anesthetic during CPB, a situation unique to the cardiac suite. In addition, monitors of anesthetic depth-assessment of clinical signs, hemodynamic indicators, the bispectral index monitor, end-tidal anesthetic concentration, or twitch monitoring-are often absent, unreliable, or directly impacted by the unique pathophysiology associated with CPB. The magnitude of these challenges is reflected in the higher incidence of intraoperative awareness during cardiac surgery. Further complicating matters are the lack of specific clinical guidelines and varying international policies regarding medical device specifications that add further layers of complexity and introduce practice variability both within institutions and among nations. We performed a systematic survey of the literature to identify where anesthetic practice during CPB is evidence based (or not), identify gaps in the literature to guide future investigations, and explore the implications of evolving surgical practice, perfusion techniques, and national policies that impact amnesia, analgesia, and muscle relaxation during CPB. PMID:25790208

  13. Hydrogen sulfide improves neural function in rats following cardiopulmonary resuscitation

    Science.gov (United States)

    LIN, JI-YAN; ZHANG, MIN-WEI; WANG, JIN-GAO; LI, HUI; WEI, HONG-YAN; LIU, RONG; DAI, GANG; LIAO, XIAO-XING

    2016-01-01

    The alleviation of brain injury is a key issue following cardiopulmonary resuscitation (CPR). Hydrogen sulfide (H2S) is hypothesized to be involved in the pathophysiological process of ischemia-reperfusion injury, and exerts a protective effect on neurons. The aim of the present study was to investigate the effects of H2S on neural functions following cardiac arrest (CA) in rats. A total of 60 rats were allocated at random into three groups. CA was induced to establish the model and CPR was performed after 6 min. Subsequently, sodium hydrosulfide (NaHS), hydroxylamine or saline was administered to the rats. Serum levels of H2S, neuron-specific enolase (NSE) and S100? were determined following CPR. In addition, neurological deficit scoring (NDS), the beam walking test (BWT), prehensile traction test and Morris water maze experiment were conducted. Neuronal apoptosis rates were detected in the hippocampal region following sacrifice. After CPR, as the H2S levels increased or decreased, the serum NSE and S100? concentrations decreased or increased, respectively (P<0.0w. The NDS results of the NaHS group were improved compared with those of the hydroxylamine group at 24 h after CPR (P<0.05). In the Morris water maze experiment, BWT and prehensile traction test the animals in the NaHS group performed best and rats in the hydroxylamine group performed worst. At day 7, the apoptotic index and the expression of caspase-3 were reduced in the hippocampal CA1 region, while the expression of Bcl-2 increased in the NaHS group; and results of the hydroxylamine group were in contrast. Therefore, the results of the present study indicate that H2S is able to improve neural function in rats following CPR.

  14. Plant grafting: new mechanisms, evolutionary implications.

    Science.gov (United States)

    Goldschmidt, Eliezer E

    2014-01-01

    Grafting, an old plant propagation practice, is still widely used with fruit trees and in recent decades also with vegetables. Taxonomic proximity is a general prerequisite for successful graft-take and long-term survival of the grafted, composite plant. However, the mechanisms underlying interspecific graft incompatibility are as yet insufficiently understood. Hormonal signals, auxin in particular, are believed to play an important role in the wound healing and vascular regeneration within the graft union zone. Incomplete and convoluted vascular connections impede the vital upward and downward whole plant transfer routes. Long-distance protein, mRNA and small RNA graft-transmissible signals currently emerge as novel mechanisms which regulate nutritional and developmental root/top relations and may play a pivotal role in grafting physiology. Grafting also has significant pathogenic projections. On one hand, stock to scion mechanical contact enables the spread of diseases, even without a complete graft union. But, on the other hand, grafting onto resistant rootstocks serves as a principal tool in the management of fruit tree plagues and vegetable soil-borne diseases. The 'graft hybrid' historic controversy has not yet been resolved. Recent evidence suggests that epigenetic modification of DNA-methylation patterns may account for certain graft-transformation phenomena. Root grafting is a wide spread natural phenomenon; both intraspecific and interspecific root grafts have been recorded. Root grafts have an evolutionary role in the survival of storm-hit forest stands as well as in the spread of devastating diseases. A more fundamental evolutionary role is hinted by recent findings that demonstrate plastid and nuclear genome transfer between distinct Nicotiana species in the graft union zone, within a tissue culture system. This has led to the formation of alloploid cells that, under laboratory conditions, gave rise to a novel, alloploid Nicotiana species, indicating that natural grafts may play a role in plant speciation, under certain circumstances. PMID:25566298

  15. Causes of corneal graft failure in India

    Directory of Open Access Journals (Sweden)

    Dandona Lalit

    1998-01-01

    Full Text Available The success of corneal grafting in visual rehabilitation of the corneal blind in India depends on survival of the grafts. Understanding the causes of graft failure may help reduce the risk of failure. We studied these causes in a series of 638 graft failures at our institution. Multivariate logistic regression analysis was used to evaluate the association of particular causes of graft failure with indications for grafting, socioeconomic status, age, sex, host corneal vascularization, donor corneal quality, and experience of surgeon. The major causes of graft failure were allograft rejection (29.2%, increased intraocular pressure (16.9%, infection excluding endophthalmitis (15.4%, and surface problems (12.7%. The odds of infection causing graft failure were significantly higher in patients of lower socioeconomic status (odds ratio 2.45, 95% CI 1.45-4.15. Surface problems as a cause of graft failure was significantly associated with grafts done for corneal scarring or for regrafts (odds ratio 3.36, 95% CI 1.80-6.30. Increased intraocular pressure as a cause of graft failure had significant association with grafts done for aphakic or pseudophakic bullous keratopathy, congenital conditions or glaucoma, or regrafts (odds ratio 2.19, 95% CI 1.25-3.84. Corneal dystrophy was the indication for grafting in 12 of the 13 cases of graft failure due to recurrence of host disease. Surface problems, increased intraocular pressure, and infection are modifiable risk factors that are more likely to cause graft failure in certain categories of patients in India. Knowledge about these associations can be helpful in looking for and aggressively treating these modifiable risk factors in the at-risk categories of corneal graft patients. This can possibly reduce the chance of graft failure.

  16. What to Expect during Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... For surgeries with several bypasses, both artery and vein grafts are commonly used. Artery grafts. These grafts are much less likely than vein grafts to become blocked over time. The left internal ...

  17. Dopexamine increases internal mammary artery blood flow following coronary artery bypass grafting.

    LENUS (Irish Health Repository)

    Flynn, Michael J

    2012-02-03

    OBJECTIVE: Vasoactive agents and inotropes influence conduit-coronary blood flow following coronary artery bypass grafting (CABG). It was hypothesized that dopexamine hydrochloride, a dopamine A-1 (DA-1) and beta(2) agonist would increase conduit-coronary blood flow. A prospective randomized double blind clinical trial was carried out to test this hypothesis. DA-1 receptors have previously been localized to human left ventricle. METHODS: Twenty-six American Society of Anaesthesiology class 2-3 elective coronary artery bypass graft patients who did not require inotropic support on separation from cardiopulmonary bypass (CPB) were studied. According to a randomized allocation patients received either dopexamine (1 microg\\/kg per min) or placebo (saline) by intravenous infusion for 15 min. Immediately prior to and at 5,10 and 15 min of infusion, blood flow through the internal mammary and vein grafts (Transit time flow probes, Transonic Ltd.), heart rate, cardiac index, mean arterial pressure and pulmonary haemodynamics were noted. The data were analysed using multivariate analysis of variance. RESULTS: Low-dose dopexamine (1 microg\\/kg per min) caused a significant increase in mammary graft blood flow compared to placebo at 15 min of infusion (P=0.028, dopexamine group left internal mammary artery (LIMA) flow of 43.3+\\/-14.2 ml\\/min, placebo group LIMA flow at 26.1+\\/-16.3 ml\\/min). Dopexamine recipients demonstrated a non-significant trend to increased saphenous vein graft flow (P=0.059). Increased heart rate was the only haemodynamic change induced by dopexamine (P=0.004, dopexamine group at 85.2+\\/-9.6 beats\\/min and placebo group at 71.1+\\/-7.6 beats\\/min after 15 min of infusion). CONCLUSION: This study demonstrates that administration of dopexamine (1 microg\\/kg per min) was associated with a significant increase in internal mammary artery graft blood flow with mild increase in heart rate being the only haemodynamic change. Low-dose dopexamine may improve graft flow in the early post CABG period with minimal haemodynamic changes.

  18. The risk of performing cardiopulmonary bypass in malaria patients: a small case series.

    Science.gov (United States)

    Moutaouekkil, El Mehdi; Drissi, Mohamed; Houssa, Mahdi Ait; Boulahya, Abdelletif; El Kirat, Abdelmajid

    2010-01-01

    The effects of cardiopulmonary bypass on patients who have active or dormant malaria are unknown. What is known is that malaria-induced hemolysis can be exacerbated by cardiopulmonary bypass. We report 3 cases in which patients with active or dormant malaria underwent open-heart surgery. Two of them received quinine prophylaxis, and the 3rd patient (who presented with an active infection) received longer-term preoperative treatment with quinine. In all 3 cases, the surgery was performed uneventfully. We suggest preoperative quinine prophylaxis for patients with a history of malaria whose blood smears are negative for parasites, and we advocate more radical preoperative treatment with quinine for patients whose blood smears are positive at presentation. These measures appear to prevent hemolysis and fever during both the preoperative and postoperative periods. However, there is need of a multicenter study to ascertain the actual effects of cardiopulmonary bypass on patients with malaria. PMID:20401297

  19. THE BASIC LAWS AND FEATURES OF CYTOKINE DYNAMICS IN PROCESS AND EARLY TERMS AFTER CARDIOPULMONARY BYPASS

    Directory of Open Access Journals (Sweden)

    S. I. Suskov

    2011-06-01

    Full Text Available The basic variants of cytokines reactions defining type of organ dysfunctions are revealed in the course of car- diopulmonary bypass and in the early postoperative period. Their character and expression, depends on gravity preoperative an immunodeficiency and initial degree of heart insufficiency. Diphasic dynamics of development of system inflammatory reaction is confirmed after cardiopulmonary bypass: increase of levels proinflammatory cytokines is in the first phase and anti-inflammatory cytokines with development immunodepression and cellular anergy in is the second phase. Also, key role IL-1Ra is revealed in restraint of hyperactivation of system inflam- matory reaction. Blood whey levels IL-6, IL-8, G-CSF, TNF-? and IL-1Ra should be defined to cardiopulmonary bypass, in 10–12 hours, 24 hours and 3 days after cardiopulmonary bypass and may be used as prognostic criteria of development of postoperative complications. 

  20. THE BASIC LAWS AND FEATURES OF CYTOKINE DYNAMICS IN PROCESS AND EARLY TERMS AFTER CARDIOPULMONARY BYPASS

    Directory of Open Access Journals (Sweden)

    S. I. Suskov

    2011-06-01

    Full Text Available The basic variants of cytokines reactions defining type of organ dysfunctions are revealed in the course of car- diopulmonary bypass and in the early postoperative period. Their character and expression, depends on gravity preoperative an immunodeficiency and initial degree of heart insufficiency. Diphasic dynamics of development of system inflammatory reaction is confirmed after cardiopulmonary bypass: increase of levels proinflammatory cytokines is in the first phase and anti-inflammatory cytokines with development immunodepression and cellular anergy in is the second phase. Also, key role IL-1Ra is revealed in restraint of hyperactivation of system inflam- matory reaction. Blood whey levels IL-6, IL-8, G-CSF, TNF-α and IL-1Ra should be defined to cardiopulmonary bypass, in 10–12 hours, 24 hours and 3 days after cardiopulmonary bypass and may be used as prognostic criteria of development of postoperative complications. 

  1. Radiation grafting of acrylamide onto polystyrene beads

    International Nuclear Information System (INIS)

    The radiation grafting of acrylamide onto polystyrene beads by peroxide has been studied and the ability for binding immunoglobulin onto chemically-treated grafted beads has been determined. The results show that the grafting reaction basically completes in three hours. At about 60 deg C of grafting reaction temperature the grafting level is the highest. The grafing level is higher in low dose rate than in high dose rate when the total dose is the same. The grafting level is increased with the increasing of irradiation dose and monomer contcentration. The half-life of the peroxide produced on polystyrene beads is about 50 hours under ambient temperature. It is found that the ability for binding immunoglobulin by chemically-treated grafted beads is higher than untreated beads and the ability is increased with the increasing of grafting level

  2. POST CORONARY ARTERY BYPASS GRAFT STUDY (CABG)

    Science.gov (United States)

    Relative effectiveness of moderate versus more aggressive lipid lowering, and of low dose anticoagulation versus placebo, in delaying saphenous vein coronary bypass graft atherosclerosis and preventing occlusion of saphenous grafts of patients with saphenous vein coronary bypass ...

  3. Occlusion of a Rapidly Expanding Hemodialysis Graft Pseudoaneurysm with Placement of a Stent Graft

    OpenAIRE

    Moszkowicz, Arie; Behrens, George; Gueyikian, Sebouh; Patel, Nilesh H.; Ferral, Hector

    2007-01-01

    We describe a 44-year-old man with end-stage renal disease who underwent insertion of a stent graft to repair a hemodialysis graft pseudoaneurysm. The indication for stent graft placement was an acute and rapidly enlarging intragraft pseudoaneurysm. The patient experienced no complications following the procedure, but he presented with two graft occlusions within the 2 months following the procedure.

  4. Prevention of primary vascular graft infection with silver-coated polyester graft in a porcine model

    DEFF Research Database (Denmark)

    Gao, H; Sandermann, J; Prag, J; Lund, L; Lindholt, Jes S.

    2010-01-01

    To evaluate the efficacy of a silver-coated vascular polyester graft in the prevention of graft infection after inoculation with Staphylococcus aureus in a porcine model.......To evaluate the efficacy of a silver-coated vascular polyester graft in the prevention of graft infection after inoculation with Staphylococcus aureus in a porcine model....

  5. Scoring System for Predicting Saphenous Vein Graft Patency in Coronary Artery Bypass Grafting

    OpenAIRE

    Sarzaeem, Mahmood Reza; Mandegar, Mohammad Hossein; Roshanali, Farideh; Vedadian, Ali; Saidi, Bahare; ALAEDDINI, Farshid; Tabarestani, Nardin

    2010-01-01

    The initial and long-term benefits of coronary artery bypass grafting depend upon maintaining the coronary blood flow supplied by the graft. In order to devise a scoring system for predicting graft patency, we evaluated presumptive correlations between saphenous vein graft patency and the characteristics of saphenous veins that were used as conduits in coronary revascularization.

  6. Recanalization of an Occluded Infrainguinal Vein Graft Complicated by Graft Aneurysm

    International Nuclear Information System (INIS)

    The technique of subintimal angioplasty has been described for the recanalisation of native vessels after occlusion of infrainguinal vascular bypass grafts. We report a case in which an attempt at such treatment resulted in inadvertent but successful recanalisation of the occluded vein graft instead. This was complicated by graft perforation and subsequent graft aneurysm which was successfully treated with a covered stent

  7. Global and regional changes of cardiopulmonary blood volume under continuous work load

    International Nuclear Information System (INIS)

    The present study describes a method for the continuous determination of global and regional stress-induced alterations of cardiopulmonary blood volumes in normals, trained athletes and patients with latent cardiac insufficiency. In contrast to normals and athletes there is an increase of the total cardiac blood volume in the cardiac patients. There are also significant differences in blood volume changes of the left lung between normals and athletes on the one hand and the cardiac patients on the other. The method is simple and non-hazardous; it permits the observation of the obviously different adaptation of the cardiopulmonary system during exercise in normals, athletes and cardiac patients. (orig.)

  8. Costal Cartilage Grafts in Rhinoplasty.

    Science.gov (United States)

    Fedok, Fred G

    2016-01-01

    Cartilage grafts are regularly used in rhinoplasty. Septal and auricular donor sites are commonly used. Many situations compel the surgeon to use other alternative donor sites, including revision rhinoplasty and trauma. Many patients have a small amount of native septal cartilage and are unable to provide adequate septal cartilage to be used for frequently performed rhinoplasty maneuvers. The rib cage provides an enormous reserve of costal cartilage that can be carved into a variety of necessary grafts. A description of the technique of harvesting costal cartilage, a review of complications and management, and illustrative cases examples are included. PMID:26616708

  9. EMPLOYERS EXPECTATIONS AND STUDENTS EMPLOYABILITY SKILLS

    OpenAIRE

    G.SUDHA

    2013-01-01

    As a result of the increased competition and rapid changing economy, entry and survival of graduates in industries is tougher than ever before. The employers' expectations are changing day by day and graduates have to obtain new skills for their sustainability. Mere academic skill alone will not help the graduates for better employment. Due to lack of employability skills graduates are not employable even though there are opportunities. In this study an attempt is made to find out the organiz...

  10. Elucidation of the Mechanism of Redox Grafting of Diazotated Anthraquinone

    DEFF Research Database (Denmark)

    Chernyy, Sergey; Bousquet, Antoine

    2012-01-01

    Redox grafting of aryldiazonium salts containing redox units may be used to form exceptionally thick covalently attached conductingfilms, even in the micrometers range, in a controlled manner on glassy carbon and gold substrates. With the objective to investigate the mechanism of this process in detail, 1-anthraquinone (AQ) redox units were immobilized on these substrates by electroreduction of 9,10-dioxo-9,10-dihydroanthracene-1-diazo-nium tetrafluoroborate. Electrochemical quartz crystal microbalance was employed to follow the grafting process during a cyclic voltammetric sweep by recording the frequency change. The redox grafting is shown to have two mass gain regions/phases: an irreversible one due to the addition of AQ units to the substrate/film and a reversible one due to the association of cations from the supporting electrolyte with the AQ radical anions formed during the sweeping process. Scanning electrochemical microscopy was used to study the relationship between the conductivity of thefilm and the charging level of the AQ redox units in the grafted film. For that purpose, approach curves were recorded at a platinum ultramicroelectrode for AQ-containing films on gold and glassy carbon surfaces using the ferro/ferricyanide redox system as redox probe. It is concluded that thefilm growth has its origin in electron transfer processes occurring through the layer mediated by the redox moieties embedded in the organic film

  11. Primary Breast Augmentation with Fat Grafting.

    Science.gov (United States)

    Coleman, Sydney R; Saboeiro, Alesia P

    2015-07-01

    The controversy over fat grafting to the breasts has now been settled. In 2009, the American Society of Plastic Surgeons Fat Graft Task Force stated that "Fat grafting may be considered for breast augmentation and correction of defects associated with medical conditions and previous breast surgeries; however, results are dependent on technique and surgeon expertise." This article discusses the history, indications, planning, complications, and present technique of fat grafting to the breast using the Coleman technique. PMID:26116935

  12. An alternative method of skin grafting: the scalp microdermis graft.

    Science.gov (United States)

    Lin, T W

    1995-08-01

    Although microskin grafting has been used successfully to treat major burns, when the donor skin areas are inadequate, it is still not in popular use because of the difficulties of mincing and floating procedures. Floating is expected to produce more microskin patches with the dermal side upwards than with the epidermal side upwards. Another problem is that many microskin patches will be lost in the container during floating. This problem may be solved by preparing the microskin from the second layer scalp skin. This will be a graft of hair follicle cells, which can be sowed on the wound no matter which side is upwards. Grafting was carried out on well-prepared granulation beds, or on the fat surface after tangential excision, or on the bed after fascial excision of the burn. Allograft and Biobrane were used as cover dressings. The combination of fascial excision and allograft overlay gave an acceptable result. This can be an alternative method of skin grafting for burns with very limited donor skin areas when the scalp skin is not burned. PMID:7546262

  13. Revascularização do miocárdio sem circulação extracorpórea com derivação intraluminal temporária (DILT na emergência pós angioplastia transluminal coronária (ATC Myocardial revascularization without cardiopulmonary bypass with temporary intraluminal shunt: emergential approach after transluminal coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Ana M. Rocha Pinto

    1996-09-01

    Full Text Available No período de novembro 1989 a dezembro 1995, 18 doentes foram submetidos a cirurgia de emergência para revascularização do miocárdio sem circulação extracorpórea (CEC, devido a insucesso de angioplastia transluminal percutânea (ATC. Todos os pacientes apresentavam lesões do ramo interventricular anterior (RIA, coronária direita (CD ou coronária diagonal (Dg, passíveis de abordagem sem CEC. Em todos utilizamos derivação intraluminal temporária (DITL para manter o fluxo coronariano e minimizar a isquemia. Três (16,66% doentes foram operados na vigência de infarto agudo do miocárdio e 4 (22,22% doentes com importante corrente de lesão ao ECG. O choque cardiogênico estava presente em 3 (16,66% doentes. Não houve mortalidade. Realizamos estudo estatístico para comparação da mortalidade referida por diversos autores utilizando revascularização com CEC.From November 1989 through December 1995, eighteen patients underwent emergency coronary artery bypass grafting without cardiopulmonary bypass following percutaneous transluminal coronary angioplasty (PTCA. All patients had lesions in the left anterior descending coronary artery, diagonal coronary artery or right coronary artery, when we could reach without using cardiopulmonary bypass. In all cases we used a temporary intraluminal shunt in order to allow perfusion through the coronary artery and prevent ischemic effects. Three (16.66% patients had myocardial infarction before going to emergency surgery and 4 (22.22% patients had important ST segment elevation. The cardiogenic shock was present in 3 (16.66% patients. The in-hospital mortality was zero. We compared the several authors mortality rates and ours by a statistic analysis.

  14. Spontaneous rupture of a saphenous vein graft

    OpenAIRE

    Davey, P.; Gwilt, D; Forfar, C

    1999-01-01

    We present a case of spontaneous rupture of a right coronary bypass vein graft in a 57-year-old woman 10 years after coronary by-pass surgery. Although rare, this diagnosis should be considered in such patients presenting with appropriate symptoms.???Keywords: coronary artery bypass graft; false aneurysm; saphenous vein graft

  15. Multisaccular Aneurysm in a Coronary Vein Graft

    OpenAIRE

    Pintar, Karl; Barboriak, Joseph J.; Moreno, Miguel

    1988-01-01

    This report describes an unusual multisaccular vein graft aneurysm that developed in a patient who had undergone aortocoronary bypass with a saphenous vein graft. The aneurysm was a complication of an atherosclerotic lesion. This case supports the belief that aortocoronary vein grafts have an increased susceptibility to aneurysm formation. (Texas Heart Institute Journal 1988;15:59-60)

  16. Radiation induced grafting of TMPM onto polypropylene

    International Nuclear Information System (INIS)

    The gamma radiation induced graft copolymerization of 2,2,6,6-tetramethyl-4-piperidinyl-methacrylate (TMPM), a very effective hindered amine light stabilizer (HALS), onto polypropylene was investigated by simultaneous-irradiation technique. the effects of various synthesis conditions on the graft content were studied. It was shown that percent grafting in benzene, CCl4 and petroleum ether were higher than that in other solvents. The percent grafting was higher when graft copolymerization was carried out in argon atmosphere than that in air. For the grafting copolymerization carried out in benzene, percent grafting increased linearly from 10 to 60 kGy and beyond 60 kGy a tendency to level off was appeared. In CCl4, percent grafting increased linearly from 10 to 50 kGy and beyond 50 kGy a tendency to level off was appeared. Percent grafting also increased continuously with increasing monomer concentration up to 2.85 mol/L, but significant increase was observed only up to 1.14 mol/L. the percent grafting decreased when inhibitor was used, the difference of percent grafting between the samples with and without inhibitor became smaller with the increase of irradiation dose. The stabilizing effectiveness of grafted TMPM on the radiation resistance of Polypropylene was found to be better than that of TMPM monomer

  17. New variant for whole pancreas grafting

    International Nuclear Information System (INIS)

    A new variant for whole pancreas grafting is described in which a segment of the duodenum and the spleen is included in the graft. The graft is placed extraperitoneally as in kidney transplantation. The exocrine drainage is with side-to-side anastomosis between duodenum and bladder. The spleen is irradiated to prevent the occurrence of GVHD, as is reported in splenic transplantation

  18. Sodium and chloride exclusion and retention by non-grafted and grafted melon and Cucurbita plants

    OpenAIRE

    Edelstein, M.; Plaut, Z.; M. Ben-Hur

    2010-01-01

    The effects of grafting on Na and Cl– uptake and distribution in plant tissues were quantified in a greenhouse experiment using six combinations of melon (Cucumis melo L. cv. Arava) and pumpkin (Cucurbita maxima Duchesne×Cucurbita moschata Duchesne cv. TZ-148): non-grafted, self-grafted, melons grafted on pumpkins, and pumpkins grafted on melons. Total Na concentration in shoots of plants with pumpkin or melon rootstocks was 400?mmol kg?1, respectively, regardless of the scion. In contrast, s...

  19. Cardiopulmonary resuscitation: biomedical and biophysical analysis (Chapter XXX)

    DEFF Research Database (Denmark)

    Noordergraaf, G.J; Ottesen, Johnny T.

    2004-01-01

    The evolution of the human in caring for others is reflected in the development of cardiopulmonary resuscitation (CPR). Superstition, divine intervention and finally science have contributed to the development of a technique which may allow any person to save another?s life. Fully 50% of the first presentation of coronary artery disease is sudden death, typically in (western) men. [Anonymous, 2000, ID-469] However, achieving a clear understanding of why CPR saves some lives remains shrouded in mist; mist made even thicker by contradictory reports, different school of thought and persistently low survival rates. Despite the suggestion that much remains unclear, CPR is not new. An early report, in an 18 year old woman, of CPR as performed today, initially known as closed-chest cardiac resuscitation (CCCR), dates from 1858 [Husveti, ID-649]. Following airway obstruction and hypoxia, cardiac arrest occurred. Artificial respiration and compressions on the anterior chest wall for six minutes resolved the incidentsuccessfully. Surprisingly little seems to have changed in CCCR since that early report. Even though CPR has been researched extensively, the number of survivors remains disappointingly small. Survival rates as low as a few percent and extending upwards to 30%, (most frequently ±10%) survival for ?out-of-hospital? resuscitation have been reported, without a clear understanding of why some patients do and others do not survive when given the same care. CPR is a technique taught to tens of thousands each year. This chapter will address functional aspects of CPR required for a working understanding of the biomedical aspects of CPR. It does not purport to be a CPR course, although practical aspects relevant to understanding will be addressed, but not exhaustively. The development in CPR and the contributions of science to this development will be presented, with emphasis on the cardiovascular system and only on the artificial respiratory aspects when needed. Schools of thought, chronologically organized, withthe effects of physical and experimental models on their development and validity will allow the reader to analyze strengths and weaknesses.

  20. Nurses’ attitude in out-of-hospital cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Maria Meidani

    2008-10-01

    Full Text Available Sudden cardiac arrest is one of the leading causes of death in Europe. Bystanders’ early Cardio-Pulmonary Resuscitation (CPR may double or triple survival rates of out-of-hospital cardiac arrest victims.Aim: To investigate nurses’ attitude, in starting or not CPR and also the most frequent reasons that deter them from engaging in.Materials and Methods: The study had a sample of 177 nurses and assistant nurses that were working in nine hospitals of Athens. Nurses filled out the same, predetermined questionnaire, voluntarily and anonymously. The collected answers were analyzed with the help of the statistical program SPSS v.16, using x2 and Kendall’s Tau-B methods.Results: From 177 participants, 78% (137 were women and 22% (40 men with mean age 31 years (±7. According to their education, 16% (28 were Assistant Nurses, 79% (140 Registered Nurses (ATEI, AEI and 5% (9 Nurses had an MSc diploma. Nurses that had been recently trained in certified BLS courses felt more confident and were more willing to start CPR in a known victim (p=0.004 and in an unknown victim (p=0.02 comparing to nurses that had been trained a long time ago or never. Most frequent reasons nurses reported that deter them from starting CPR are the fear of a possible lawsuit (43%, the fear of harming instead of helping (30% and the fear of infectious transmission from victim to rescuer (15%. The fear of harming correlates considerably with lower ages (the younger the nurse the more is afraid, p=0.04 and also correlates substantially with the training in a certified CPR course (the more a nurse is trained, the less is afraid, p<0.001. Accordingly, the fear of infection diminishes as long as the CPR training is repeated (p=0.03.Conclusions: According to the results, there is a necessity of continuous education and re-education of nurses, in certified Basic Life Support programs. With frequent and specialized training, nurses will show more willingness to engage in an out-of-hospital arrest situation, in a familiar or unknown victim and, moreover, fears that deter them from starting CPR are remarkably reduced.

  1. 2010 Survey on cell phone use while performing cardiopulmonary bypass.

    Science.gov (United States)

    Smith, T; Darling, E; Searles, B

    2011-09-01

    Cell phone use in the U.S. has increased dramatically over the past decade and text messaging among adults is now mainstream. In professions such as perfusion, where clinical vigilance is essential to patient care, the potential distraction of cell phones may be especially problematic. However, the extent of this as an issue is currently unknown. Therefore, the purpose of this study was to (1) determine the frequency of cell phone use in the perfusion community, and (2) to identify concerns and opinions among perfusionists regarding cell phone use. In October 2010, a link to a 19-question survey (surveymonkey.com) was posted on the AmSECT (PerfList) and Perfusion.com (PerfMail) forums. There were 439 respondents. Demographic distribution is as follows; Chief Perfusionist (30.5%), Staff Perfusionist (62.0%), and Other (7.5%), with age ranges of 20-30 years (14.2%), 30-40 years (26.5%), 40-50 years (26.7%), 50-60 years (26.7%), >60 years (5.9%). The use of a cell phone during the performance of cardiopulmonary bypass (CPB) was reported by 55.6% of perfusionists. Sending text messages while performing CPB was acknowledged by 49.2%, with clear generational differences detected when cross-referenced with age groups. For smart phone features, perfusionists report having accessed e-mail (21%), used the internet (15.1%), or have checked/posted on social networking sites (3.1%) while performing CPB. Safety concerns were expressed by 78.3% who believe that cell phones can introduce a potentially significant safety risk to patients. Speaking on a cell phone and text messaging during CPB are regarded as "always an unsafe practice" by 42.3% and 51.7% of respondents, respectively. Personal distraction by cell phone use that negatively affected performance was admitted by 7.3%, whereas witnessing another perfusionist distracted with phone/text while on CPB was acknowledged by 33.7% of respondents. This survey suggests that the majority of perfusionists believe cell phones raise significant safety issues while operating the heart-lung machine. However, the majority also have used a cell phone while performing this activity. There are clear generational differences in opinions on the role and/or appropriateness of cell phones during bypass. There is a need to further study this issue and, perhaps, to establish consensus on the use of various communication modes within the perfusion community. PMID:21593081

  2. Novel electronic refreshers for cardiopulmonary resuscitation: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Magura Stephen

    2012-11-01

    Full Text Available Abstract Background Currently the American Red Cross requires that individuals renew their cardiopulmonary resuscitation (CPR certification annually; this often requires a 4- to 8-hour refresher course. Those trained in CPR often show a decrease in essential knowledge and skills within just a few months after training. New electronic means of communication have expanded the possibilities for delivering CPR refreshers to members of the general public who receive CPR training. The study’s purpose was to determine the efficacy of three novel CPR refreshers - online website, e-mail and text messaging – for improving three outcomes of CPR training - skill retention, confidence for using CPR and intention to use CPR. These three refreshers may be considered “novel” in that they are not typically used to refresh CPR knowledge and skills. Methods The study conducted two randomized clinical trials of the novel CPR refreshers. A mailed brochure was a traditional, passive refresher format and served as the control condition. In Trial 1, the refreshers were delivered in a single episode at 6 months after initial CPR training. In Trial 2, the refreshers were delivered twice, at 6 and 9 months after initial CPR training, to test the effect of a repeated delivery. Outcomes for the three novel refreshers vs. the mailed brochure were determined at 12 months after initial CPR training. Results Assignment to any of three novel refreshers did not improve outcomes of CPR training one year later in comparison with receiving a mailed brochure. Comparing outcomes for subjects who actually reviewed some of the novel refreshers vs. those who did not indicated a significant positive effect for one outcome, confidence for performing CPR. The website refresher was associated with increased behavioral intent to perform CPR. Stated satisfaction with the refreshers was relatively high. The number of episodes of refreshers (one vs. two did not have a significant effect on any outcomes. Conclusions There was no consistent evidence for the superiority of novel refreshers as compared with a traditional mailed brochure, but the low degree of actual exposure to the materials does not allow a definitive conclusion. An online web-based approach seems to have the most promise for future research on electronic CPR refreshers.

  3. Experimental Study of a Novel Method of Cardiopulmonary Resuscitation Using a Combination of Percutaneous Cardiopulmonary Support and Liposome-encapsulated Hemoglobin (TRM645

    Directory of Open Access Journals (Sweden)

    Ogata,Yoshitaka

    2008-08-01

    Full Text Available Percutaneous cardiopulmonary support (PCPS has been applied for cardiopulmonary arrest (CPA. We have developed a novel method of cardiopulmonary resuscitation using PCPS combined with liposome-encapsulated hemoglobin (TRM645 to improve oxygen delivery to vital organs. Ventricular fibrillation was electrically induced to an adult goat for 10 min. Next, PCPS (30 ml/kg/min, V/Q: 1 was performed for 20 min. Then, external defibrillation was attempted and observed for 120 min. The TRM group (n5 was filled with 300 mL of TRM645 for the PCPS circuit. The control group (n5 was filled with the same volume of saline. The delivery of oxygen (DO2 and oxygen consumption (VO2 decreased markedly by PCPS after CPA, compared to the preoperative values. DO2 was kept at a constant level during PCPS in both groups, but VO2 slowly decreased at 5, 10, and 15 min of PCPS in the control groups, demonstrating that systemic oxygen metabolism decreased with time. In contrast, the decreases in VO2 were small in the TRM group at 5, 10, and 15 min of PCPS, demonstrating that TRM645 continuously maintained systemic oxygen consumption even at a low flow rate. AST and LDH in the TRM group were lower than the control. There were significant differences at 120 min after the restoration of spontaneous circulation (p<0.05.

  4. Anterior cruciate ligament reconstruction: clinical outcomes of patella tendon and hamstring tendon grafts.

    Science.gov (United States)

    Gulick, Dawn T; Yoder, Heather N

    2002-09-01

    An injury to the ACL can result in significant functional impairment. It has been estimated that more than 100,000 new ACL injuries occur each year. Surgeons employ numerous techniques for reconstruction of the ACL. Of critical importance is the source of the graft to replace the damaged ACL. The graft choices include autografts (the patient's own tissue), allografts (donor tendon), and synthetic/prosthetic ligaments. Tissue harvest sites for autografting include the middle third of the patella tendon, the quadriceps tendon, semitendinosus tendon, gracilis tendon, iliotibial band, tensor fascia lata, and the Achilles tendon. Selection of the type of graft material is predicated upon the tissue's ability to tolerate high levels of stress. Likewise, the clinical presentation and functional outcome is related to the graft material selected. This manuscript specifically examined the patella tendon and hamstring tendon grafts. Numerous manuscripts that studied the outcomes of these graft materials were compiled to help the clinician appreciate the advantages and disadvantages of each of the graft materials. Outcome measures such as thigh circumference, knee range of motion, isokinetic strength, knee stability, pain, and vertical jump/1-leg hop were incorporated. The purpose of this manuscript was to compare and contrast the clinical presentation of patients who underwent an ACL reconstruction using the patella tendon versus the hamstring tendons. This information can be valuable to the clinician when considering the rehabilitation protocol after ACL reconstruction. PMID:24701126

  5. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: CLINICAL OUTCOMES OF PATELLA TENDON AND HAMSTRING TENDON GRAFTS

    Directory of Open Access Journals (Sweden)

    Dawn T. Gulick

    2002-09-01

    Full Text Available An injury to the ACL can result in significant functional impairment. It has been estimated that more than 100,000 new ACL injuries occur each year. Surgeons employ numerous techniques for reconstruction of the ACL. Of critical importance is the source of the graft to replace the damaged ACL. The graft choices include autografts (the patient's own tissue, allografts (donor tendon, and synthetic/prosthetic ligaments. Tissue harvest sites for autografting include the middle third of the patella tendon, the quadriceps tendon, semitendinosus tendon, gracilis tendon, iliotibial band, tensor fascia lata, and the Achilles tendon. Selection of the type of graft material is predicated upon the tissue's ability to tolerate high levels of stress. Likewise, the clinical presentation and functional outcome is related to the graft material selected. This manuscript specifically examined the patella tendon and hamstring tendon grafts. Numerous manuscripts that studied the outcomes of these graft materials were compiled to help the clinician appreciate the advantages and disadvantages of each of the graft materials. Outcome measures such as thigh circumference, knee range of motion, isokinetic strength, knee stability, pain, and vertical jump/1-leg hop were incorporated. The purpose of this manuscript was to compare and contrast the clinical presentation of patients who underwent an ACL reconstruction using the patella tendon versus the hamstring tendons. This information can be valuable to the clinician when considering the rehabilitation protocol after ACL reconstruction

  6. Modification of nylon-6 fibres by radiation-induced graft polymerisation of vinylbenzyl chloride

    Science.gov (United States)

    Ting, T. M.; Nasef, Mohamed Mahmoud; Hashim, Kamaruddin

    2015-04-01

    Modification of nylon-6 fibres by radiation-induced graft copolymerisation (RIGP) of vinylbenzyl chloride (VBC) using the preirradiation method was investigated. A number of grafting parameters such as type of solvent, total dose, monomer concentrations, reaction temperature and reaction time were studied to obtain desired degree of grafting (DG). The DG was found to be a function of reaction parameters and achieved a maximum value of 130 wt% at 20 vol% VBC concentration in methanol, 300 kGy dose, 30 °C temperature and 3 h reaction time. Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and X-ray diffraction (XRD) were employed to evaluate the chemical, morphological and structural changes that occurred in the grafted fibres, respectively. Thermogravimetric analysis (TGA) was also applied to determine the thermal stability, whereas differential scanning calorimeter (DSC) and universal mechanical tester were used to analyse respective thermal and mechanical properties of the grafted fibres. The results of these analyses provide strong evidence for successful grafting of VBC onto nylon-6, and the variation in the properties of the grafted fibres depends on DG.

  7. Blood compatibility of chitosan/heparin complex surface modified ePTFE vascular graft

    Science.gov (United States)

    Zhu, A. P.; Ming, Zhang; Jian, Shen

    2005-03-01

    Vascular grafts made of expanded polytetrafluoroethylene (ePTFE) are widely employed in vascular reconstructive surgery. While they are successful as replacements for large-diameter blood vessels, ePTFE vascular grafts are unsuitable for small-diameter ones because when the internal diameters of the graft are less than 6 mm, they are found to fail without exception due to blood clot formation. To reduce platelets adhesion onto the ePTFE vascular graft, a novel method of binding of chitosan/heparin (CS/Hp) complex to the surface of vascular graft was developed. The binding of chitosan was achieved by irradiating with ultraviolet light the azide modified chitosan that was coated on the ePTFE surface. By forming complex with this coating of chitosan, heparin was then bonded to the ePTFE surface. In vitro blood compatibility experiments showed that CS/Hp surface-modified ePTFE vascular grafts exhibited markedly reduced platelets adhesion. The outstanding performance of these grafts was further demonstrated by the in vivo experiments, in which they were found to be still unclogged two weeks post-implantation into dog veins.

  8. Endovascular stent grafting: a review

    International Nuclear Information System (INIS)

    Endovascular stent grafts are intravascular devices composed of surgical graft material and a metallic frame, (Fig. 1). Their main application has been to treat aneurysms, but they have been used in vascular trauma and are being investigated for use in occlusive disease. Their advantage in treating aneurysms over conventional surgical treatment is that they are loaded into relatively small delivery systems (Fig. 2) and can be introduced to the area of interest from a remote site - usually the femoral artery. This avoids the morbidity of surgical exposure in difficult sites, such as the thoracic aorta, and lessens the cardiovascular stress to patients by eliminating the need to surgically cross-clamp the vessel being treated. The first description of abdominal aortic aneurysm exclusion by an endovascular stent graft was provided by Parodi and colleagues in 1991. Much of the early clinical experience in endovascular stent grafting was obtained from centres in Australia and Europe, and they are now reporting midterm follow-up data. There are now many centres in Canada and the United States involved in endovascular research and practice. (author)

  9. Homogeneous cation exchange membrane by radiation grafting

    International Nuclear Information System (INIS)

    Preparation of a strong cation exchange membrane by radiation grafting of styrene on to polyethylene (LDPE) film by mutual irradiation technique in the presence of air followed by sulfonation is described. The grafting has been carried out in the presence of air and without any additive. Low dose rate has been seen to facilitate the grafting. Further higher the grafting percentage more is the exchange capacity. The addition of a swelling agent during the sulfonation helped in achieving the high exchange capacity. The TGA-MASS analysis confirmed the grafting and the sulfonation. (author)

  10. Perioperative Intravenous Acetaminophen Attenuates Lipid Peroxidation in Adults Undergoing Cardiopulmonary Bypass: A Randomized Clinical Trial

    OpenAIRE

    Billings IV, Frederic T.; Petracek, Michael R.; Roberts II, L. Jackson; Pretorius, Mias

    2015-01-01

    Background Cardiopulmonary bypass (CPB) lyses erythrocytes and induces lipid peroxidation, indicated by increasing plasma concentrations of free hemoglobin, F2-isoprostanes, and isofurans. Acetaminophen attenuates hemeprotein-mediated lipid peroxidation, reduces plasma and urine concentrations of F2-isoprostanes, and preserves kidney function in an animal model of rhabdomyolysis. Acetaminophen also attenuates plasma concentrations of isofurans in children undergoing CPB. The effect of acetami...

  11. Unexpected Fatal Hypernatremia after Successful Cardiopulmonary Resuscitation with Therapeutic Hypothermia: A Case Report

    OpenAIRE

    Choi, Sang-Sik; Kim, Won Young; Kim, Won; Lim, Kyung-Su

    2012-01-01

    Central diabetes insipidus (DI), characterized by unexpected fatal hypernatremia, is a rare complication after successful cardiopulmonary resuscitation with therapeutic hypothermia, but may be potentially fatal if recognition is delayed. We describe here a patient who experienced cardiac arrest due to a pulmonary embolism, followed by successful resuscitation after induction of therapeutic hypothermia. The patient, however, suddenly developed unexpected hypernatremia with increased urine outp...

  12. Comparative cardiopulmonary toxicity of soy biofuel and diesel exhaust in healthy and hypertensive rats

    Science.gov (United States)

    Increased use of renewable energy sources raise concerns about health effects of emissions from such sources. We conducted a comprehensive analysis of relative cardiopulmonary health effects of exhausts from 1) 100% soy biofuel (B100), 2) 20% soy biofuel + 80% low sulfur petroleu...

  13. Anaesthetic Considerations for Noncoronary Surgery on a Perfused Beating Heart under Cardiopulmonary Bypass.

    Directory of Open Access Journals (Sweden)

    Tomar Akhlesh

    2002-01-01

    Full Text Available Myocardial revascularisation on a beating heart with or without cardiopulmonary bypass has significantly reduced the incidence of cardioplegic myocardial injury. With this advantage in view, noncoronary open heart surgery was performed on a beating heart under cardiopulmonary bypass. We discuss the anaesthetic management of such cases. Thirty-three patients aged 14-56 years underwent open heart surgery on a perfused beating heart. Eleven of them underwent open mitral valvotomy, eighteen underwent mitral valve replacement, repair of atrial septal defect was performed in 3 patients and one had removal of left atrial myxoma. Cardiopulmonary bypass was instituted with aortic and bicaval cannulation. At normothermia, aorta was cross-clamped and continuous coronary perfusion was maintained through an aortic root needle at a rate of 4-6 mL/Kg/minute facilitating a beating heart. Trans-oesophageal echocardiography was routinely deployed. Anaesthetic considerations were focused towards the maintenance of the beating state of the heart, that included, strict control of electrolyte balance, maintenance of adequate perfusion pressure and ST segment monitoring. All the patients could be weaned off cardiopulmonary bypass without defibrillation or significant inotropic support. There was no operative mortality. Open heart surgery on a beating heart for non-coronary cardiac conditions appears to be a good and reproducible option to protect the myocardium from deleterious effects of cardioplegic arrest.

  14. [Transport with ongoing cardiopulmonary resuscitation - when does is it make sense?].

    Science.gov (United States)

    Diepenseifen, Christian Jens; Heister, Ulrich; Schewe, Jens-Christian

    2011-06-01

    The currently valid guidelines for resuscitation of the European Resuscitation Council (ERC) do not give any unambiguous recommendations for "transport with ongoing cardiopulmonary resuscitation". Furthermore, up to now there are no generally accepted criteria for terminating cardiopulmonary resuscitation, apart from certain signs of death. In spite of the generally poor outcome of patients being transported with ongoing cardiopulmonary resuscitation, there are a number of positive case reports and undisputable indications (e.g., in cases with a potentially reversible cause of cardiac arrest). The increase observed over the past few years in the number of patients being transported under cardiopulmonary resuscitation has as yet not been reflected in an improved prognosis for these patients. The use of mechanical chest compression devices with a better quality of chest compression, also under transport conditions, may have an influence on the number transports but this has not yet been evaluated sufficiently with regard to patient outcome. However, the decision to transport a patient resides with the responsible emergency physician who has to evaluate the prognosis for the patient on an individual basis. PMID:21688229

  15. A Comparative Analysis of Student Learning with a Collaborative Computer Simulation of the Cardiopulmonary System

    Science.gov (United States)

    Keyser, Diane

    2010-01-01

    To design a series of assessments that could be used to compare the learning gains of high school students studying the cardiopulmonary system using traditional methods to those who used a collaborative computer simulation, called "Mr. Vetro". Five teachers and 264 HS biology students participated in the study. The students were in regular…

  16. Studies on radiation-induced graft polymerization

    International Nuclear Information System (INIS)

    Radiation-induced graft polymerization is used extensively to improve physical properties of polymers, but few processes are now commercialized. The reason for this is partly inadequate basic research on the reaction and partly the difficulty in developing the grafting process with large radiation source. Firstly, new techniques are proposed of studying kinetics of the graft polymerization in heterogeneous system. Based on the grafting yield, the molecular weight of graft chains, and the amount of radicals given by ESR and activation analysis, kinetic parameters are obtained and the reaction mechanism of grafting process is discussed. Secondly, the development of grafting process of poly (vinyl chloride)-butadiene is described. By study of the reaction, process design, construction and operation of the pilot plant, and economic analysis of the process, this process with 60Co gamma ray sources is shown to be industrially promising. (author)

  17. Evaluation of the graft flow reserve after coronary artery bypass grafting by stress {sup 201}Tl myocardial SPECT. Comparison between arterial grafts and venous grafts

    Energy Technology Data Exchange (ETDEWEB)

    Ichikawa, Akihiro; Taki, Junichi; Nakajima, Kenichi; Kawasuji, Michio; Tonami, Norihisa [Kanazawa Univ. (Japan). School of Medicine

    1997-01-01

    We performed stress {sup 201}Tl myocardial SPECT to evaluate ischemia and perfusion reserve after coronary artery bypass grafting (CABG). A total of 103 patients was performed stress {sup 201}Tl myocardial SPECT one month after CABG. Each patient`s myocardium was divided into 9 segments and visually evaluated using five grade scoring system (0=defect, 1=severe decrease, 2=moderate decrease, 3=mild decrease, 4=normal uptake). Eleven of 133 (8.27%) segments covered by patent venous grafts showed reversible {sup 201}Tl defect, however, 36 of 117 (30.8%) segments which covered by patent arterial grafts showed reversible {sup 201}Tl defect. This finding was observed more significantly in arterial grafts than in venous grafts (p<0.001). These finding suggests that arterial grafts have lower flow capacity than venous grafts at peak exercise. (author)

  18. Employment Polarization and Immigrant Employment Opportunities

    OpenAIRE

    Wielandt, Hanna

    2015-01-01

    Building on the task-based approach of technological change, this paper discusses the interaction between occupational polarization (e.g. a gradual increase of native employment in the lowest and highest-paying jobs) and employment opportunities of immigrant workers. Using high quality administrative data for Germany, I first show that technological change is positively related to employment growth of natives in low-paying occupations that are also typically held by immigrant workers. In...

  19. PAI-1 and t-PA/PAI-1 complex potential markers of fibrinolytic bleeding after cardiac surgery employing cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Ozolina Agnese

    2012-10-01

    Full Text Available Abstract Background Enhanced bleeding remains a serious problem after cardiac surgery, and fibrinolysis is often involved. We speculate that lower plasma concentrations of plasminogen activator inhibitor – 1 (PAI-1 preoperatively and tissue plasminogen activator/PAI-1 (t-PA/PAI-1 complex postoperatively might predispose for enhanced fibrinolysis and increased postoperative bleeding. Methods Totally 88 adult patients (mean age 66?±?10 years scheduled for cardiac surgery, were enrolled into a prospective study. Blood samples were collected pre-operatively, on admission to the recovery and at 6 and 24 hours postoperatively. Patients with a surgical bleeding that was diagnosed during reoperation were discarded from the study. The patients were allocated to two groups depending on the 24-hour postoperative chest tube drainage (CTD: Group I > 500ml, Group II ? 500ml. Associations between CTD, PAI-1, t-PA/PAI-1 complex and D-dimer were analyzed with SPSS. Results Nine patients were excluded because of surgical bleeding. Of the 79 remaining patients, 38 were allocated to Group I and 41 to Group II. The CTD volumes correlated with the preoperative plasma levels of PAI-1 (r = ? 0.3, P = 0.009. Plasma concentrations of preoperative PAI-1 and postoperative t-PA/PAI-1 complex differed significantly between the groups (P Conclusions Lower plasma concentrations of PAI-1 preoperatively and t-PA/PAI-1 complex postoperatively leads to higher plasma levels of D-dimer in association with more postoperative bleeding after cardiac surgery.

  20. Retrenchment in Malaysia: Employer’s Right?

    OpenAIRE

    Hamidah Marsono; Hj. Kamaruzaman Jusoff

    2008-01-01

    There are several ways to put a contract of employment to an end. One of them is by way of retrenchment.  Termination of employment by way of retrenchment may be relevant when the employer restructures his business. The focus of this article is to evaluate the application of the principle Last in First Out (LIFO) in the case of retrenchment in Malaysia. This article will also assess to what extent the courts defend the prerogative of the employer to retrench his employee in the case of redund...

  1. EMPLOYERS EXPECTATIONS AND STUDENTS EMPLOYABILITY SKILLS

    Directory of Open Access Journals (Sweden)

    G. SUDHA

    2013-05-01

    Full Text Available As a result of the increased competition and rapid changing economy, entry and survival of graduates in industries is tougher than ever before. The employers' expectations are changing day by day and graduates have to obtain new skills for their sustainability. Mere academic skill alone will not help the graduates for better employment. Due to lack of employability skills graduates are not employable even though there are opportunities. In this study an attempt is made to find out the organizations needs and the skills the engineering students actually possess. From the results it is very clear that students are far behind in their needed skill set.

  2. PNIPAM grafting on the surface of zirconium phosphate

    Science.gov (United States)

    Li, Hai; Wang, Xuezhen; Cheng, Zhengdong; Cheng's Group Team, Dr.

    2015-03-01

    We are reporting for the first time the grafting of the thermoresponsive polymer PNIPAM (poly n-isoproprylacrylamide) on the surface of inorganic nanoplates zirconium phosphate. Particularly, the grafting on inorganic nanoplates using gamma rays has never scarcely been reported and yet proved to be successful in our synthesis. We proved that by gamma ray irradiation, the peroxide groups has been produced on the ZrP particles since that peroxide groups, on the surface of the hexagonal nanoplates, which upon heating initiated the free radical polymerization and subsequent attachment of PNIPAM. The presence of covalent band between ZrP and PNIPAM were observed and characterized by TGA, FTIR and solid state NMR respectively. The attachment of a thermoresponsive polymer to ZrP nanocrystals brings thus remarkable possibilities for their employment in the fields of medicine, oil industry, as well as physics.

  3. Stability of Grafted Polymer Nanoscale Films toward Gamma Irradiation.

    Science.gov (United States)

    Borodinov, Nikolay; Giammarco, James; Patel, Neil; Agarwal, Anuradha; O'Donnell, Katie R; Kucera, Courtney J; Jacobsohn, Luiz G; Luzinov, Igor

    2015-09-01

    The present article focuses on the influence of gamma irradiation on nanoscale polymer grafted films and explores avenues for improvements in their stability toward the ionizing radiation. In terms of applications, we concentrate on enrichment polymer layers (EPLs), which are polymer thin films employed in sensor devices for the detection of chemical and biological substances. Specifically, we have studied the influence of gamma irradiation on nanoscale poly(glycidyl methacrylate) (PGMA) grafted EPL films. First, it was determined that a significant level of cross-linking was caused by irradiation in pure PGMA films. The cross-linking is accompanied by the formation of conjugated ester, carbon double bonds, hydroxyl groups, ketone carbonyls, and the elimination of epoxy groups as determined by FTIR. Polystyrene, 4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl, dimethylphenylsilanol, BaF2, and gold nanoparticles were incorporated into the films and were found to mitigate different aspects of the radiation damage. PMID:26259102

  4. Postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation: a prospective observational pilot study

    Directory of Open Access Journals (Sweden)

    Meybohm Patrick

    2011-03-01

    Full Text Available Abstract Background Neurologic deficits after cardiac surgery are common complications. Aim of this prospective observational pilot study was to investigate the incidence of postoperative cognitive deficit (POCD after cardiac surgery, provided that relevant decrease of cerebral oxygen saturation (cSO2 is avoided during cardiopulmonary bypass. Methods cSO2 was measured by near infrared spectroscopy in 35 patients during cardiopulmonary bypass. cSO2 was kept above 80% of baseline and above 55% during anesthesia including cardiopulmonary bypass. POCD was tested by trail making test, digit symbol substitution test, Ray's auditorial verbal learning test, digit span test and verbal fluency test the day before and 5 days after surgery. POCD was defined as a decline in test performance that exceeded - 20% from baseline in two tests or more. Correlation of POCD with lowest cSO2 and cSO2 - threshold were determined explorative. Results POCD was observed in 43% of patients. Lowest cSO2 during cardiopulmonary bypass was significantly correlated with POCD (p = 0.015, r2 = 0.44, without Bonferroni correction. A threshold of 65% for cSO2 was able to predict POCD with a sensitivity of 86.7% and a specificity of 65.0% (p = 0.03, without Bonferroni correction. Conclusions Despite a relevant decrease of cerebral oxygen saturation was avoided in our pilot study during cardiopulmonary bypass, incidence of POCD was comparable to that reported in patients without monitoring. A higher threshold for cSO2 may be needed to reduce the incidence of POCD.

  5. Flow-induced vein-wall vibration in an arteriovenous graft

    Science.gov (United States)

    Lee, S.-W.; Fischer, P. F.; Loth, F.; Royston, T. J.; Grogan, J. K.; Bassiouny, H. S.

    2005-08-01

    The hemodynamic environment of an arteriovenous (AV) graft differs from that of arterial grafts because mean flow rates are typically 10 times greater. This increased flow rate can create a weakly turbulent state, which alters the biomechanical environment greatly and may play a role in AV graft failure. A canine animal study was conducted to simulate the hemodynamic environment of a human AV graft. In vivo measurements were obtained for vein-wall vibration (VWV), graft geometry, and blood flow rate. In order to investigate the complex flow structure at the venous anastomosis of an AV graft, which is thought to induce these vibrations, a computational fluid dynamics study was conducted by direct numerical simulation under pulsatile flow and geometry conditions based on the animal study. The simulation technique employs the spectral element method, which is a high-order discretization ideally suited to the simulation of transitional flows in complex domains. The minimum and maximum Reynolds numbers entering the graft, based on average velocities, were 875 and 1235, respectively. While velocity and pressure fluctuations are clearly present in the numerical simulations, their magnitude and frequency do not correlate well with the in vivo VWV measurements. Potential reasons for this discrepancy are threefold. First, a quiescent inflow condition was used in the present computations; a more realistic inflow condition might alter the velocity fluctuations significantly. Second, simulations were conducted with a rigid geometry; compliance may play an important role in flow stability within an AV graft. Third, the flow split between the graft and vein inlet may also play an important role in the stability of the flow structures.

  6. Cardiac muscle apoptosis: a comparison of myocardium revascularization with and without cardiopulmonary bypass Apoptose no músculo cardíaco: comparação na revascularização do miocárdio com e sem circulação extracorpórea

    Directory of Open Access Journals (Sweden)

    Diego Felipe Gaia

    2003-09-01

    Full Text Available OBJECTIVE: Inflammatory response and metabolic disturbances in coronary artery bypass grafting (CABG with cardiopulmonary bypass (CPB and without (OFF-PUMP have been researched. Apoptosis in ischemic reperfusion and chronic disease models has been shown in recent studies. The objective of this study is to compare the apoptosis intensity detected in cardiac myocytes before and after CABG with and without cardiopulmonary bypass. METHOD: Eighteen patients undergoing elective CABG were divided in two groups: the first group underwent cardiopulmonary bypasses and the second group did not. Auricle myocardial samples were obtained at the beginning and at the end of the surgery. Specimens were examined for apoptosis using the TUNEL method. RESULTS: There was no significant difference between the two groups in the surgical, demographic and postoperative data. The number of grafts was statistically different. There was no significant difference between the numbers of cells undergoing apoptosis in the two groups at the beginning of the procedure. There was no significant difference in the number of cells undergoing apoptosis from the beginning to the end of CABG in the OFF-PUMP group. There was a significant difference between the number of cells undergoing apoptosis at the beginning and the end of the CABG in the CPB group (pINTRODUÇÃO: A resposta inflamatória e os distúrbios metabólicos nas cirurgias de revascularização do miocárdio (RM com e sem circulação extracorpórea (CEC têm sido pesquisados. A apoptose vem sendo estudada em modelos de isquemia, reperfusão e processos crônicos. O objetivo deste trabalho é comparar o grau de apoptose detectada em cardiomiócitos, antes e após a RM com e sem CEC. MÉTODO: Dezoito indivíduos com indicação de RM, divididos em dois grupos (CEC e OFF-PUMP, sendo o primeiro (CEC com o emprego da CEC e o segundo sem o auxílio desta (OFF-PUMP, tiveram coletadas biópsias da aurícula direita, ao início e ao término da operação. Os fragmentos foram submetidos à marcação imunohistoquímica pelo método de TUNEL e à contagem das células em apoptose. RESULTADOS: Não houve diferença entre os grupos nos dados cirúrgicos, demográficos e pós-operatórios. O número de pontes foi estatisticamente diferente. Não houve diferença entre o número de células em apoptose nos grupos CEC e OFF-PUMP, ao início do procedimento. O número de células em apoptose não apresentou diferença significante entre o início e o término do procedimento no grupo OFF-PUMP. O número de células em apoptose, ao início e ao término da operação, no grupo CEC apresentou diferença significante. CONCLUSÃO: O menor número de células em apoptose encontrado no grupo OFF-PUMP condiz com dados da literatura que sugerem que a CEC é uma agressão à homeostase e capaz de gerar lesão celular. Deste modo, mais um argumento favorável pode ser agregado para a maior indicação de RM sem o uso de CEC.

  7. Cardiac muscle apoptosis: a comparison of myocardium revascularization with and without cardiopulmonary bypass / Apoptose no músculo cardíaco: comparação na revascularização do miocárdio com e sem circulação extracorpórea

    Scientific Electronic Library Online (English)

    Diego Felipe, Gaia; Rafael Saviolo, Moreira; Magaly, Arrais; Nivia Cristina Tot, Vinhola; Enio, Buffolo; Ricardo Luiz, Smith.

    2003-09-01

    Full Text Available INTRODUÇÃO: A resposta inflamatória e os distúrbios metabólicos nas cirurgias de revascularização do miocárdio (RM) com e sem circulação extracorpórea (CEC) têm sido pesquisados. A apoptose vem sendo estudada em modelos de isquemia, reperfusão e processos crônicos. O objetivo deste trabalho é compar [...] ar o grau de apoptose detectada em cardiomiócitos, antes e após a RM com e sem CEC. MÉTODO: Dezoito indivíduos com indicação de RM, divididos em dois grupos (CEC e OFF-PUMP), sendo o primeiro (CEC) com o emprego da CEC e o segundo sem o auxílio desta (OFF-PUMP), tiveram coletadas biópsias da aurícula direita, ao início e ao término da operação. Os fragmentos foram submetidos à marcação imunohistoquímica pelo método de TUNEL e à contagem das células em apoptose. RESULTADOS: Não houve diferença entre os grupos nos dados cirúrgicos, demográficos e pós-operatórios. O número de pontes foi estatisticamente diferente. Não houve diferença entre o número de células em apoptose nos grupos CEC e OFF-PUMP, ao início do procedimento. O número de células em apoptose não apresentou diferença significante entre o início e o término do procedimento no grupo OFF-PUMP. O número de células em apoptose, ao início e ao término da operação, no grupo CEC apresentou diferença significante. CONCLUSÃO: O menor número de células em apoptose encontrado no grupo OFF-PUMP condiz com dados da literatura que sugerem que a CEC é uma agressão à homeostase e capaz de gerar lesão celular. Deste modo, mais um argumento favorável pode ser agregado para a maior indicação de RM sem o uso de CEC. Abstract in english OBJECTIVE: Inflammatory response and metabolic disturbances in coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) and without (OFF-PUMP) have been researched. Apoptosis in ischemic reperfusion and chronic disease models has been shown in recent studies. The objective of this st [...] udy is to compare the apoptosis intensity detected in cardiac myocytes before and after CABG with and without cardiopulmonary bypass. METHOD: Eighteen patients undergoing elective CABG were divided in two groups: the first group underwent cardiopulmonary bypasses and the second group did not. Auricle myocardial samples were obtained at the beginning and at the end of the surgery. Specimens were examined for apoptosis using the TUNEL method. RESULTS: There was no significant difference between the two groups in the surgical, demographic and postoperative data. The number of grafts was statistically different. There was no significant difference between the numbers of cells undergoing apoptosis in the two groups at the beginning of the procedure. There was no significant difference in the number of cells undergoing apoptosis from the beginning to the end of CABG in the OFF-PUMP group. There was a significant difference between the number of cells undergoing apoptosis at the beginning and the end of the CABG in the CPB group (p

  8. Effects of sevoflurane vs. propofol on mitochondrial functional activity after ischemia-reperfusion injury and the influence on clinical parameters in patients undergoing CABG surgery with cardiopulmonary bypass.

    Science.gov (United States)

    Sirvinskas, E; Kinderyte, A; Trumbeckaite, S; Lenkutis, T; Raliene, L; Giedraitis, S; Macas, A; Borutaite, V

    2015-10-01

    The aim of the study was to evaluate the effects of sevoflurane and propofol on the activity of mitochondrial function related to ischemia-reperfusion injury, myocardial damage biomarkers release and clinical parameters in the postoperative period. Seventy-two patients scheduled for elective coronary artery bypass graft surgery with cardiopulmonary bypass were randomized into two groups: 36 patients received sevoflurane during anesthesia (Group S) and 36 patients received propofol (Group P). To investigate the functional activity of mitochondria, we used skinned fibers prepared from biopsies of right atrial tissue before cardioplegia and after the aorta cross-clamp removal (within 10-15 minutes after reperfusion). Patients' clinical data (length of stay in ICU, hemodynamic parameters, duration of mechanical ventilation (MV) and the amount of lactate and troponin I in the blood serum) were evaluated postoperatively. The results showed that, before cardioplegia and after reperfusion, there was no significant difference in the mitochondrial routine and State 3 respiration rates between the groups. The effect of cytochrome c was higher in Group P. Troponin I concentration at the 12(th) hour after the surgery was 2.2 ± 0.8 ng/mL in Group S and 3.5 ± 1.1 ng/mL in Group P (psevoflurane slightly protects the mitochondrial outer membrane from ischemia-reperfusion injury and the loss of cytochrome c, yet has the similar effect on clinical parameters in the postoperative period when compared to propofol. PMID:25686857

  9. Impact of body mass index on outcome in patients undergoing coronary artery bypass grafting and/or valve replacement surgery

    Science.gov (United States)

    Costa, Vinícius Eduardo Araújo; Ferolla, Silvia Marinho; dos Reis, Tâmara Oliveira; Rabello, Renato Rocha; Rocha, Eduardo Augusto Victor; Couto, Célia Maria Ferreira; Couto, José Carlos Ferreira; Bento, Alduir

    2015-01-01

    Objective This study aimed to analyze the impact of body mass index on outcomes of 101 patients undergoing coronary artery bypass grafting, valve replacement, or combined valve/ coronary artery bypass grafting surgery in a private hospital in Belo Horizonte, Brazil. Methods This was a prospective cross-sectional study of patients undergoing cardiac surgery from May 2009 to December 2012. All patients were followed up from the first day of admission until discharge or death. Patients were divided into three groups according to BMI: normal weight, overweight, and obese. The main outcome measure was the association between BMI and postoperative morbidities and mortality. Results Multivariate analysis identified obesity as an independent predictor of increased risk of surgical reintervention (odds ratio [OR] 13.6; 95%CI 1.1 - 162.9; P=0.046) and reduced risk of bleeding (OR 0.05; 95% CI 0.09 - 0.69; P=0.025). Univariate analysis showed that obesity was associated with increased frequency of wound dehiscence (P=0.021). There was no association between BMI and other complications or mortality in univariate analysis. There was also no association between body mass index and duration of cardiopulmonary bypass, aortic clamping, mechanical ventilation, and intensive care unit or hospital stay. Conclusion Obese individuals undergoing coronary artery bypass grafting, valve replacement, or combined surgery have a higher postoperative risk of surgical reintervention and lower chances of bleeding. PMID:26313724

  10. Radiation sterilization of tissue grafts

    International Nuclear Information System (INIS)

    The Tissue Bank at the Tata Memorial Hospital was started in 1989 in collaboration with the Department of Atomic Energy, Government of India, as part of an IAEA project to promote the use of nuclear technology for peaceful purposes. The Bank produces freeze dried, gamma irradiated allografts such as skin, amniotic membrane, dura mater, fascia lata, bone blocks/chips/dust, iliac crest, femoral heads and ribs. Tissues are harvested from cadavers or obtained secondary to surgical procedures. After processing, the grafts are exposed to 25 kGy of gamma radiation. The grafts have found use in a variety of clinical conditions like burns, non-union fractures, periodontal osseous defects and surgical reconstructions. (author)

  11. Ocular Graft Versus Host Disease

    OpenAIRE

    ERDEM, Elif; Yagmur, Meltem

    2014-01-01

    Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an important therapeutic procedure for the treatment of hematologic malignancies. Graft-versus-host disease (GVHD) is a common cause of morbidity and mortality after allo-HSCT. Severe systemic form of GVHD may become life threatening. Ocular involvement of GVHD remains the most common cause of long-term morbidity.In this review article, the etiology, pathophysiology, clinical features, and treatment modalities of ocular GVHD a...

  12. Hybrid Graft Anterior Cruciate Ligament Reconstruction: A Predictable Graft for Knee Stabilization.

    Science.gov (United States)

    Alvarez-Pinzon, Andres M; Barksdale, Leticia; Krill, Michael K; Leo, Brian M

    2015-06-01

    Trauma to the anterior cruciate ligament (ACL) is a season-ending injury and involves months of activity modification and rehabilitation. The annual incidence of ACL tears in the United States is approximately 200,000, which allows for a broad range of individualized treatment options. Various surgical techniques, including transtibial and independent tunnel drilling, allograft and autograft tissue, and various implants, have been described in the literature. This article describes the indications and technique for a hybrid soft tissue graft for ACL reconstruction. Autologous grafts eliminate the risk of disease transmission and have recently been shown to have a lower rerupture rate, particularly in younger, active patients; however, the harvesting of autologous hamstring grafts carries a risk of donor-site morbidity, iatrogenic injury of the graft, and inadequate graft size. In contrast to a traditional autologous soft tissue graft, the hybrid graft allows for graft size customization for a desired reconstruction, especially in cases where autograft hamstrings may be iatrogenically damaged or of inadequate size when harvested. The goal of a hybrid graft ACL reconstruction is to provide a favorable-sized graft with clinical outcomes comparable with autologous soft tissue grafts. In contrast to a traditional autologous soft tissue graft, this technique provides another option in the event of unforeseen deficiencies or complications associated with harvesting and preparation of the autologous gracilis and semitendinosis soft tissue graft. PMID:26091219

  13. Evaluation of early coronary graft patency after coronary artery bypass graft surgery using multislice computed tomography angiography

    Directory of Open Access Journals (Sweden)

    Raissi Kamal

    2009-12-01

    Full Text Available Abstract Background Coronary artery bypass graft (CABG surgery is the standard of care in the treatment of advanced coronary artery disease, and its long-term results are affected by the failure of bypass grafts. The aim of the present study was to evaluate the early patency rate in coronary bypass grafts. Methods A total of 107 consecutive patients who underwent CABG were included in this study. Early graft patency was evaluated via computed tomography (CT angiography in the first week after surgery. Results There were a total of 366 grafts, comprised of 250 venous grafts and 116 arterial grafts. Multi-slice CT detected acute graft occlusions in 32 (8.7% of all the grafts, including 26 (10% of the 250 venous grafts and 6 (5% of the 116 arterial grafts. The patency rates obtained were 97.3% for the left internal mammary (IMA grafts, 50% for the radial artery grafts, and 50% for the right IMA grafts. Additionally, 107 (96.4% grafts to the left anterior descending artery (LAD were classified as patent, whereas 1 (30% of the 3 grafts in the left circumflex (LCX region and 1 (50% of the 2 grafts in the right coronary artery (RCA territory were found to be occluded. In the venous category, 8 (13.7% of the 58 grafts to LAD were found to be occluded. In the LCX region, 9 (8.5% of the 106 grafts were classified as occluded, while the remaining 97 (91.5% grafts were patent. The venous grafts to RCA were occluded in 9 (10.4% of the 86 grafts. Amongst the multiple preoperative, intraoperative, and postoperative factors, pump time was significantly longer in the patients with occluded grafts than in those with patent grafts (P = 0.04. Conclusion The IMA grafts had the highest early patency rate amongst the coronary bypass grafts. However, the other arterial grafts were associated with a high rate of acute occlusions.

  14. Detection of patent coronary bypass grafts by digital subtraction angiography

    International Nuclear Information System (INIS)

    Nine aortocoronary bypass graft patients were evaluated by a digital subtraction angiography (DSA) with intravenously administered contrast media to determine graft patency. DSA correctly identified 14 of 15 patent grafts and all of 3 occluded grafts. We conclude that DSA is a new promising relatively noninvasive method for determining patency of aortocoronary bypass graft. (author)

  15. Cardioprotective effects of carnitine in extensive aortocoronary bypass grafting: a double-blind, randomized, placebo-controlled clinical trial.

    Science.gov (United States)

    Demeyere, R; Lormans, P; Weidler, B; Minten, J; Van Aken, H; Flameng, W

    1990-11-01

    The cardioprotective effects of carnitine were tested in patients undergoing multiple aortocoronary bypass grafting. Intermittent aortic cross-clamping at 28 degrees C was used. Mean total cross-clamping time was 30 +/- 11 min. Patients were randomized into three groups: a control group receiving placebo (group 1), a group pretreated with 3 g carnitine intravenously before cardiopulmonary bypass (CPB) (group 2), and a group pretreated with 6 g carnitine intravenously (group 3). The markers of myocardial ischemia included levels of adenosine triphosphate, its catabolites, and creatine phosphate in transmural left ventricular biopsy specimens taken at the beginning and end of CPB, as well as hemodynamic recovery during weaning from CPB and for the next 24 h. The intravenous infusion of carnitine (3 or 6 g) had no hemodynamic effect. At the end of CPB myocardial tissue levels of adenosine triphosphate and creatine phosphate did not differ significantly among the groups (P greater than 0.05). Recovery of cardiac function during weaning from CPB and for the following 24 h was similar in all three groups (P greater than 0.05). It is concluded that pretreatment with carnitine neither facilitates weaning from cardiopulmonary bypass in patients undergoing aortocoronary bypass surgery nor favorably affects hemodynamic function during the next 24 h. PMID:2221413

  16. Radiation grafting of styrene onto polyethylene

    Science.gov (United States)

    Izumi, Yoshinobu; Nagaike, Hiroshi; Tabuse, Shigehiko; Yoshida, Yoichi; Tagawa, Seiichi

    2001-07-01

    In order to improve the radiation stability of aliphatic polymers, radiation-induced graft polymerization of styrene onto low-density polyethylene (LDPE) has been studied. Two methods, namely, simultaneous irradiation and pre-irradiation method, were treated. In the case of simultaneous irradiation, it was indicated from the dependency of percent graft on monomer concentration and absorbed dose that grafting efficiency was reduced by the increase in the homo-polymerization of styrene. On the other hand, more highly grafting polymer could be prepared by the pre-irradiation method. Depth-profile of grafted phenyl ring was also analyzed by means of micro-FT-IR spectroscopy. Recently, radiation stability of the obtained graft polymer was tested.

  17. Study of coronary grafts by MR imaging

    International Nuclear Information System (INIS)

    Thirty-one patients with 64 coronary grafts were examined by MR imaging and angiography in a comparative prospective study aimed at evaluating graft patency. The MR imaging examinations were performed using a 0.5-T unit, electrocardiographic gating, a surface coil, 5-mm-thick contiguous transverse sections, and spin-echo pulses (TE = 28, 56 msec,TR < RR interval). Analysis criteria are discussed. MR imaging can be used to establish the patency of coronary grafts, whatever the surgical technique used (mammary or saphenous vein grafting), with 95% accuracy and 97% specificity. Because only a few patients were studied, the diagnostic value of MR imaging cannot be definitively established from the results. Nevertheless, MR imaging was of value in the depiction of graft stenosis, based on slow flow phenomena, and for clear identification of occluded grafts

  18. Off - Pump Coronary Artery Bypass Graft Surgery: A Safe Method For Complete Revascularization

    Directory of Open Access Journals (Sweden)

    Mirkhani S. H

    2002-07-01

    Full Text Available In recent years off-pump coronary artery bypass surgery (OPCAB has emerged as preferred method for revascularization of coronary arteries in relatively selected group of patients. Considering patients receiving incomplete revascularization need significantly higher postoperative catheterization and re-intervention (PTCA or CABG, we performed this study to identify safety and feasibility of this technique for total revascularization in nearly all patients requiring coronary artery graft surgery."nMaterials and Methods: In this study, 150 consecutive patients underwent OPCAB by one surgeon. Octopus device used for regional wall stabilization. Vascular control achieved by ethibond loops, occluder, and shunts. Situations such as cardiomegaly, poor ventricular function, advanced age, hemodynamic instability, and small coronary arteries were not considered contraindications to OPCAB."nResults: Of 150 OPCAB cases, 146 (97.3 percent were completely off-pump. The mean number of grafts per patient was 4.1 (range, 2 to 6. Total 595 distal grafts anastomosed to LAD (140 diagonals (140, right coronary artery (145, left circumflex (164. Thirty-day mortality and myocardial infarction were 0.6 percent and 3.3 percent respectively OPCAB patient experienced lesser postoperative bleeding had shorter stay at surgical intensive care unit and extubated earlier. Conduits used were left internal mammary artery, radial artery and greater saphenous vein."nConclusion: OPCAB is a safe method for complete revascularization in nearly all patients. The OPCAB patients experience less complications, have shorter hospital stay, absolute contraindication for OPCAB other than severe, diffuse coronary artery disease with poor run-off which is better treated by cardiopulmonary bypass.

  19. Fixation of tibial plateau fractures with synthetic bone graft versus natural bone graft: a comparison study.

    LENUS (Irish Health Repository)

    Ong, J C Y

    2012-06-01

    The goal of this study was to determine differences in fracture stability and functional outcome between synthetic bone graft and natural bone graft with internal fixation of tibia plateau metaphyseal defects.

  20. Study on polyethylene films grafted with vinyl acetate and ethyl methacrylate by radiation grafting

    International Nuclear Information System (INIS)

    Low density polyethylene (LDPE) films were grafted with a vinyl acetate (VAc) and ethyl methacrylate (EMA) commoner mixture by radiation using a 60Co gamma source. IR spectra and x-ray diffraction (XRD) for the original PE matrix and for the graft copolymers were studied. Electrical conductivity and thermal properties of the prepared grafted materials were also measured. XRD results showed that poly(vinyl acetate/ethyl methacrylate) P(VAc/EMA) graft chains cause a decrease in the crystallinity of the PE polymer substrate. The changes in thermal parameters such as melting (Tm) and crystallization (Tc) temperatures and heats of melting (?Hm) and crystallization (?Hc) of the graft copolymers were followed by differential scanning calorimetry (DSC) and for thermal stability by TGA. These thermal parameters of PE were influenced by grafting, with VAc and EMA and depended on the percent grafting, which reflected the change in crystallinity due to formation of branches via the grafted chains. (author)

  1. "Employability-miles" and worker employability awareness

    OpenAIRE

    Gerards, Ruud; De Grip, Andries; Witlox, Maaike

    2012-01-01

    This article studies the use and impact of a firm-sponsored training (Employability-miles) voucher scheme that aims to stimulate employees to develop a more active attitude toward their own employability. Using data from two surveys of the firm's workforce, we find that voucher use is related to various personality traits and personal characteristics. In particular, a worker's ambition, goal setting, and education level are positively related to voucher use. In addition, women and those with ...

  2. Synthesis of Graft Copolymers Based on Poly(2?Methoxyethyl Acrylate) and Investigation of the Associated Water Structure

    DEFF Research Database (Denmark)

    Javakhishvili, Irakli; Tanaka, Masaru; Ogura, Keiko; Jankova Atanasova, Katja; Hvilsted, Søren

    2012-01-01

    Graft copolymers composed of poly(2?methoxyethyl acrylate) are prepared employing controlled radical polymerization techniques. Linear backbones bearing atom transfer radical polymerization (ATRP) initiating sites are obtained by reversible addition–fragmentation chain transfer copolymerization of 2?methoxyethyl acrylate (MEA) and 2?(bromoisobutyryloxy)ethyl methacrylate (BriBuEMA) as well as 2?hydroxyethyl methacrylate and BriBuEMA in a controlled manner . MEA is then grafted from the linear ma...

  3. Intravascular heat exchange technology successfully treats a patient after ultra-long cardiopulmonary resuscitation: a case report

    OpenAIRE

    Zou, Xiuli; Wu, Tiejun; Zhang, Lina; Zhang, Xihong; Tian, Hui

    2015-01-01

    Objective: To investigate the effect of intravascular heat exchange in saving the lives of patients after cardiopulmonary resuscitation. Methods: The clinical data of a female patient who was given cardiopulmonary resuscitation for 1.67 h in July 2014 in our hospital was retrospectively analyzed. An intravascular heat exchange procedure was performed on the patient to control her body temperature. Comprehensive treatment measures also included mechanical ventilation, vasoactive agents, and os...

  4. Low-dose heparin versus full-dose heparin with high-dose aprotinin during cardiopulmonary bypass. A preliminary report.

    OpenAIRE

    von Segesser, L K; Garcia, E.; Turina, M I

    1993-01-01

    Perfusion during cardiopulmonary bypass with low-dose heparin (activated clotting time, > 180 sec) versus full-dose heparin (activated clotting time, > 480 sec) combined with high-dose aprotinin was evaluated prospectively. Fifteen patients undergoing elective myocardial revascularization were randomly assigned to 1 of 2 groups. No significant differences between the groups were found for age, sex, body surface area, preoperative hematocrit level, duration of cardiopulmonary bypass, aortic cr...

  5. Bone grafting in total hip replacement

    International Nuclear Information System (INIS)

    MRI of ten hip joints in nine patients with total hip replacement and reconstruction of the acetabulum with autologous bone grafts, were reviewed. The viability of inserted bone grafts was clearly documented by MRI. Characteristic differences in signal intensity between autologous and homologous bone grafts are discussed. Despite extended metallic artifacts in the operated region, sufficient diagnostic information was available in most cases. No side effects were reported. (orig.)

  6. Electrokinetic properties of commercial vascular grafts

    OpenAIRE

    Indest, Tea; Strnad, Simona; Stana-Kleinschek, Karin; Ribitsch, Volker; Fras, Lidija

    2012-01-01

    The surface morphology and chemical composition (the presence or absence of surface functional groups) of commercial vascular grafts? surfaces are significant for their interaction abilities with components of polar liquids. This can also be assumed as correct for grafts-blood interactions. In this paper we studied the adsorption characteristics of different grafts? surfaces using an electrokinetic measurement technique. A comparative study was performed on woven, knitted polyethylene terepht...

  7. Simple technique of securing intraoral skin grafts.

    Science.gov (United States)

    Qureshi, Sajid S; Chaukar, Devendra; Dcruz, Anil K

    2005-02-01

    Small defects following intraoral resection are often resurfaced by skin grafts. Skin grafting has the advantage of ease of harvest with minimal additional operating time and post-operative hospital stay, an acceptable functional cosmetic result, and the ability to survive post-operative radiation 1. In addition to adequate vascularity of the recipient area, the most important aspect for graft survival is immobilization and adherence of the graft to the defect. However, in the oral cavity due to the uneven wound bed and constant mobility of the cheek, the graft is not completely immobilized. In addition, the salivary secretions tend to accumulate beneath the graft, separating the graft from the bed. Graft-failure can be prevented by immobilizing the graft and closing up any potential dead space that might lead to separation 2. A variety of methods have been described for immobilization and bolstering the graft to the wound. Many types of stents have been used varying from the simple cotton balls, resin molds, and foam pads, to complex stents like metal, plastic, and dental liner 34. The traditional tie over bolster technique described by Schramm and Myers involves fixation of the skin graft to the raw area, followed by placement of non-absorbable silk sutures from the adjacent mucosa, which are then tied over the bolster 1. However, the placement of this tie over sutures requires adjacent normal mucosa for anchorage, which may not be sufficient especially in the gingivo-buccal sulcus. Although external fixation of the stents to the cheek has been described, this results in ugly scarring of the cheek 2. We describe a simple technique of fixation of the skin graft in the oral cavity, which avoids the placement of additional tie over sutures and in our opinion results in better anchorage. PMID:15660369

  8. Saphenous vein graft aneurysm: an incidental finding

    OpenAIRE

    Rana, Omar; Greaves, Kim; Shepherd, David; Parvin, Simon; Swallow, Rosie

    2009-01-01

    Saphenous vein graft aneurysm (SVGA) is an uncommon complication of coronary artery bypass graft surgery (CABG). An 82-year-old man underwent contrast-enhanced computed tomography to investigate aorto-iliac disease. He was coincidentally noted to have an aneurysm of the saphenous vein graft to his right coronary artery. This was visualised on transthoracic echocardiography, computed tomography and coronary angiography. In the absence of symptoms and in view of high surgical risk, conservative...

  9. Coronary steal or large collateral? Three cases of graft failure in sequential and composite grafts.

    Science.gov (United States)

    Morakhia, Jwalit; Ramachandran, Padmakumar; Sanjeeva, Naveen Chandra Ganiga; Thakkar, Ashok

    2014-01-01

    Coronary bypass grafting using conduits with multiple distal anastomoses continues to demand scrutiny. While on one hand these techniques allow the surgeon to avoid or minimise aortic manipulation, the unique flow and pressure characteristics lead to complex forms of graft failure if the anatomy of the target vascular bed is not carefully taken into consideration. We report three cases of graft failure in patients with coronary bypass grafting performed using multiple distal anastomoses, and percutaneous revascularisation in one patient. PMID:25395430

  10. The effect of total arterial grafting on medium-term outcomes following coronary artery bypass grafting

    OpenAIRE

    Buth Karen J; Hassan Ansar; Légaré Jean-Francois; Sullivan John A

    2007-01-01

    Abstract Background While it is believed that total arterial grafting (TAG) for coronary artery bypass grafting (CABG) confers improved long-term outcomes when compared to conventional grafting with left internal mammary artery and saphenous vein grafts (LIMA+SVG), to date, this has not become the standard of care. In this study, we assessed the impact of TAG on medium-term outcomes after CABG. Methods Peri-operative data was prospectively collected on consecutive first-time, isolated CABG pa...

  11. [Replacement of the aortic root with woven and knitted Dacron composite graft].

    Science.gov (United States)

    Mashiko, K; Ishii, S; Naganuma, H; Yoshida, S; Seo, A; Sakamoto, H; Mikawa, H; Okuyama, H

    1997-07-01

    Some of the patients with annuloaortic ectasia or Stanford type A require aortic root replacement. If conventional Bentall procedure is employed in such cases, aortic root will become a cylindrical shape totally lacking sinus of Valsalva because the procedure utilizes a straight tube. The sinuses of Valsalva support an important role in opening and closing the valvar leaflets, and opening of the coronary arteries, together with the interleaflet triangles and the sinutubular junction. In this study, we performed aortic root replacement with composite graft which consisted of two types of graft including 30 mm Knitted Dacron Graft (Gelsoft) with different dilation rates and 30 mm Woven Dacron Graft (Hemashield) as well as bioprosthesis (27 mm Carpentier-Edwards), in order to reconstruct sinus of Valsalva. Post-operative angiography revealed an excellent diastolic coronary flow, as evidenced by proximal Knitted graft of 37 mm in diameter, distal Woven graft of 30.3 mm in diameter and Doppler flow DSVR (Diastolic/Systolic Velocity Ration) of 2.2 measured at the left coronary orifice. Since it is difficult to obtain homograft at present, this procedure would be worth trying during aortic root replacement. PMID:9223857

  12. Histological evaluation of the influence of magnetic field application in autogenous bone grafts in rats

    Directory of Open Access Journals (Sweden)

    Ponzoni Deise

    2009-01-01

    Full Text Available Abstract Background Bone grafts are widely used in oral and maxillofacial reconstruction. The influence of electromagnetic fields and magnets on the endogenous stimulation of target tissues has been investigated. This work aimed to assess the quality of bone healing in surgical cavities filled with autogenous bone grafts, under the influence of a permanent magnetic field produced by in vivo buried devices. Methods Metal devices consisting of commercially pure martensitic stainless steel washers and titanium screws were employed. Thirty male Wistar rats were divided into 3 experimental and 3 control groups. A surgical bone cavity was produced on the right femur, and a bone graft was collected and placed in each hole. Two metallic washers, magnetized in the experimental group but not in the control group, were attached on the borders of the cavity. Results The animals were sacrificed on postoperative days 15, 45 and 60. The histological analysis of control and experimental samples showed adequate integration of the bone grafts, with intense bone neoformation. On days 45 and 60, a continued influence of the magnetic field on the surgical cavity and on the bone graft was observed in samples from the experimental group. Conclusion The results showed intense bone neoformation in the experimental group as compared to control animals. The intense extra-cortical bone neoformation observed suggests that the osteoconductor condition of the graft may be more susceptible to stimulation, when submitted to a magnetic field.

  13. Nuclear accidents and bone marrow graft

    International Nuclear Information System (INIS)

    In case of serious contamination, the only efficacious treatment is the bone marrow grafts. The graft types and conditions have been explained. To restrict the nuclear accidents consequences, it is recommended to: - take osseous medulla of the personnel exposed to radiations and preserve it , that permits to carry out rapidly the auto-graft in case of accidents; - determine, beforehand, the HLA group of the personnel; - to register the voluntary donors names and addresses, and their HLA group, that permits to find easily a compatible donar in case of allo-graft. (author)

  14. Membrane rigidity induced by grafted polymer brush.

    Science.gov (United States)

    Lei, Zhen; Yang, Shuang; Chen, Er-Qiang

    2015-02-01

    The contribution of neutral polymer brush to the curvature elasticity of the grafting surface is investigated theoretically. Using self-consistent field theory, we accurately evaluate the dependence of bending modulus on parameters including chain length, Flory-Huggins parameter and grafting density and reveal the importance of solvent. The results show that the brush-induced bending modulus follows a complex dependence on grafting density and Flory-Huggins parameter, while it obeys a simple power law with chain length as N(3). The method is further applied to calculate the polymer brush's contribution to the elastic properties of PEG-grafted lipid monolayers. PMID:25575082

  15. Radiation induced graft copolymerization of jute fibre

    International Nuclear Information System (INIS)

    Graft copolymerized jute fibres (GCJF) were prepared by ?-ray induced graft copolymerization of various monomers onto bleached and de-waxed jute samples. The effect of ?-ray dose on the tendency of various monomers to form graft co-polymer was studied. It was found that the tendency decreases as follows: methylmethacrylate (MMA)>acrylonitrile (AN)>styrene (STY)>vinylacetate (VA). When the effect of monomer concentration on the formation of graft co-polymer was studied, it was found that a mixture of AN and STY gave a higher amount of grafting than what was observed for STY or AN alone, when used at a comparable concentration. A study on the effect of concentration of methyl alcohol (a swelling agent for jute) on the tendency of the monomers to form graft co-polymer showed that although there is no effect when only AN is used, an appreciable effect is observed if AN is mixed with STY. In the later case the tendency of graft co-polymerization increases with the increase of CH3OH concentration. It was further observed that the increase of CH3OH also has a positive influence on MMA to form graft co-polymer in the range of 40-90% CH3OH. The affinity of GCJF towards moisture has been found to decrease with the increase of polymer loading onto jute. The presence of swelling agents during graft copolymer formation was also found to decrease the affinity of GCJF towards moisture. (author)

  16. The autologus graft of epithelial tissue culture

    Directory of Open Access Journals (Sweden)

    Minaee B

    1999-08-01

    Full Text Available With the intention of research about culture and autologus graft of epithelial tissue we used 4 french Albino Rabbits with an average age of 2 months. After reproduction on the support in EMEM (Eagle's Minimum Essential Medium we used this for graft after 4 weeks. This region which grafted total replaced. After fixation of this sample and passing them through various process, histological sections were prepared. These sections were stained with H & E and masson's trichrome and studied by light microscope. We succeeded in graft. We hope in the near future by using the method of epithelium tissue culture improving to treat burned patients.

  17. Synthesis of electroactive tetraaniline grafted polyethylenimine for tissue engineering

    Science.gov (United States)

    Dong, Shilei; Han, Lu; Cai, Muhang; Li, Luhai; Wei, Yan

    2015-07-01

    Tetraaniline grafted polyethylenimine (AT-PEI) was successfully synthesized in this study. Proton Nuclear Magnetic Resonance (1H NMR) Spectroscopy was used to determine the structure of carboxyl-capped aniline tetramer (AT-COOH) and AT-PEI. UV-Vis spectroscopy and Fourier transform infrared (FT-IR) spectroscopy were employed to characterize the absorption spectrum of the obtained AT-PEI samples. The morphology of AT-PEI copolymers in aqueous solution was determined by Scanning electron microscope (SEM). Moreover, AT-PEI copolymers demonstrated excellent solubility in aqueous solution and possessed electroactivity by cyclic voltammogram (CV) curves, which showed its potential application in the field of tissue engineering.

  18. Computational fluid dynamics evaluation of the cross-limb stent graft configuration for endovascular aneurysm repair.

    Science.gov (United States)

    Shek, Tina L T; Tse, Leonard W; Nabovati, Aydin; Amon, Cristina H

    2012-12-01

    The technique of crossing the limbs of bifurcated modular stent grafts for endovascular aneurysm repair (EVAR) is often employed in the face of splayed aortic bifurcations to facilitate cannulation and prevent device kinking. However, little has been reported about the implications of cross-limb EVAR, especially in comparison to conventional EVAR. Previous computational fluid dynamics studies of conventional EVAR grafts have mostly utilized simplified planar stent graft geometries. We herein examined the differences between conventional and cross-limb EVAR by comparing their hemodynamic flow fields (i.e., in the "direct" and "cross" configurations, respectively). We also added a "planar" configuration, which is commonly found in the literature, to identify how well this configuration compares to out-of-plane stent graft configurations from a hemodynamic perspective. A representative patient's cross-limb stent graft geometry was segmented using computed tomography imaging in Mimics software. The cross-limb graft geometry was used to build its direct and planar counterparts in SolidWorks. Physiologic velocity and mass flow boundary conditions and blood properties were implemented for steady-state and pulsatile transient simulations in ANSYS CFX. Displacement forces, wall shear stress (WSS), and oscillatory shear index (OSI) were all comparable between the direct and cross configurations, whereas the planar geometry yielded very different predictions of hemodynamics compared to the out-of-plane stent graft configurations, particularly for displacement forces. This single-patient study suggests that the short-term hemodynamics involved in crossing the limbs is as safe as conventional EVAR. Higher helicity and improved WSS distribution of the cross-limb configuration suggest improved flow-related thrombosis resistance in the short term. However, there may be long-term fatigue implications to stent graft use in the cross configuration when compared to the direct configuration. PMID:23363204

  19. Industrial application of electron beams for grafting and vulcanization

    International Nuclear Information System (INIS)

    The topics discussed are radiation graft polymerization; industrial application of radiation grafting - ion exchange membrane for a battery separator, ammonia adsorbent, non-flammable PE (polyethylene) foam; R and D on radiation grafting, radiation vulcanization of natural rubber

  20. Use of Cardiopulmonary Bypass for Thrombectomy in Acute Superior Vena Cava Syndrome

    OpenAIRE

    Calhoun, Thomas R.; Wright, Robert M.; Cimo, Philip L.; Pai, Arvind; Windham, Pamela A.; Kitten, Clifford M.

    1983-01-01

    An increasing incidence of nonmalignant, indwelling catheter cases has been reported in relation to superior vena cava syndrome. Such cases may be life-threatening, with rapid development of facial and neck edema and the production of respiratory distress. This is the first reported case of atrial and superior vena caval thrombectomy requiring cardiopulmonary bypass; it is only the second case reported in which operative thrombectomy has been used. Because of the problems associated with an i...

  1. Histophilus somni biofilm formation in cardiopulmonary tissue of the bovine host following respiratory challenge

    DEFF Research Database (Denmark)

    Sandal, Indra; Shao, Jian Q.; Annadata, Satish; Apicella, Michael A.; Boye, Mette; Jensen, Tim Kåre; Saunders, Geoffrey K.; Inzana, Thomas J.

    2009-01-01

    Biofilms form in a variety of host sites following infection with many bacterial species. However, the study of biofilms in a host is hindered due to the lack of protocols for the proper experimental investigation of biofilms in vivo. Histophilus somni is an agent of respiratory and systemic diseases in bovines, and readily forms biofilms in vitro. In the present study the capability of H. somni to form biofilms in cardiopulmonary tissue following experimental respiratory infection in the bovine...

  2. Oxygenator Exhaust Capnography for Prediction of Arterial Carbon Dioxide Tension During Hypothermic Cardiopulmonary Bypass

    OpenAIRE

    Baraka, Anis; El-Khatib, Mohamad; Muallem, Eva; Jamal, Salim; Haroun-Bizri, Sania; Aouad, Marie

    2005-01-01

    Continuous monitoring and control of arterial carbon dioxide tension (PaCO2) during cardiopulmonary bypass (CPB) is essential. A reliable, accurate, and inexpensive system is not currently available. This study was undertaken to assess whether the continuous monitoring of oxygenator exhaust carbon dioxide tension (PexCO2) can be used to reflect PaCO2 during CPB. A total of 33 patients undergoing CPB for cardiac surgery were included in the study. During normothermia (37°C) and stable hypother...

  3. Surgical risk tests related to cardiopulmonary postoperative complications: comparison between upper abdominal and thoracic surgery

    OpenAIRE

    Karine Aparecida Arruda; Daniele Cristina Cataneo; Antonio José Maria Cataneo

    2013-01-01

    PURPOSE: To investigate if tests used in the preoperative period of upper abdominal or thoracic surgeries are able to differentiate the patients that presented cardiopulmonary postoperative complications. METHODS: Seventy eight patients, 30 submitted to upper abdominal surgery and 48 to thoracic surgery were evaluated. Spirometry, respirometry, manovacuometry, six-minute walk test and stair-climbing test were performed. Complications from immediate postoperative to discharge from hospital wer...

  4. Median sternotomy for double lung transplantation with cardiopulmonary bypass in seven consecutive patients

    DEFF Research Database (Denmark)

    Kohno, Mitsutomo; Steinbrüchel, Daniel A

    2012-01-01

    We describe our technique of using median sternotomy to perform double lung transplantations with cardiopulmonary bypass. By sparing the respiratory muscles, median sternotomy is probably less invasive and preserves lung function. Furthermore, it causes less long-term discomfort than intercostal thoracotomy. Although exposure of the pleural space is less optimal, abundant pleural adhesions can be dissected, particularly in the left posterior pleural cavity, using pericardial traction stitches, exposing the retrocardiac pleura with minimal manipulation of the heart.

  5. Problem-based learning in cardiopulmonary resuscitation on a virtual learning environment – methodological research

    OpenAIRE

    Pedro Miguel Garcez Sardo; Grace Teresinha Marcon Dal Sasso

    2007-01-01

    Sudden cardiac arrest is one of the leading causes of death in the world, however some nurses face several difficulties to perform Basic and Advanced Life Support. We believe that active methodologies, such as Problem-Based Learning (PBL) may be a good option to improve the learning process in Nursing. This is a methodological research and technological production of quantitative nature that aims to develop Problem-Based Learning in Cardiopulmonary Resuscitation on a Virtual Learning Env...

  6. Arterial line filtration protects brain microcirculation during cardiopulmonary bypass in the pig

    DEFF Research Database (Denmark)

    Waaben, J; Sørensen, H R; Andersen, U L; Gefke, K; Lund, J; Aggestrup, S; Husum, B; Laursen, H; Gjedde, A

    1994-01-01

    Microemboli in the brain may inhibit brain function during cardiopulmonary bypass, and in a previous study in pigs of normothermic nonpulsatile bypass we reported a significant decrease in cerebral glucose consumption secondary to interruption of the capillary flow, possibly caused by microemboli. In the present study we measured the regional cerebral glucose consumption and the regional capillary diffusion capacity (that is, the number of perfused capillaries) in 10 different brain regions in t...

  7. Modulation of cardiopulmonary depressor reflex in nucleus ambiguus by electroacupuncture: roles of opioids and ?-aminobutyric acid

    OpenAIRE

    Tjen-A-Looi, Stephanie C.; Li, De Peng; Li, Min; Longhurst, John C

    2011-01-01

    Stimulation of cardiopulmonary receptors with phenylbiguanide (PBG) elicits depressor cardiovascular reflex responses, including decreases in blood pressure and heart rate mediated in part by the brain stem parasympathetic cardiac neurons in the nucleus ambiguus (NAmb). The present study examined NAmb neurotransmitter mechanisms underlying the influence of electroacupuncture (EA) on the PBG-induced hypotension and bradycardia. We hypothesized that somatic stimulation during EA modulates PBG r...

  8. GABA in nucleus tractus solitarius participates in electroacupuncture modulation of cardiopulmonary bradycardia reflex

    OpenAIRE

    Tjen-A-Looi, Stephanie C.; Guo, Zhi-Ling; Longhurst, John C

    2014-01-01

    Phenylbiguanide (PBG) stimulates cardiopulmonary receptors and cardiovascular reflex responses, including decreases in blood pressure and heart rate mediated by the brain stem parasympathetic cardiac neurons in the nucleus ambiguus and nucleus tractus solitarius (NTS). Electroacupuncture (EA) at P5–6 stimulates sensory fibers in the median nerve and modulates these reflex responses. Stimulation of median nerves reverses bradycardia through action of ?-aminobutyric acid (GABA) in the nucleus a...

  9. Scorpion (Buthus tamulus) venom toxicity on cardiopulmonary reflexes involves kinins via 5-HT3 receptor subtypes

    OpenAIRE

    Bagchi, S; Deshpande, S. B.

    2001-01-01

    The mechanisms underlying the action of Indian red scorpion Buthus tamulus (BT) venom-induced augmentation of cardiopulmonary reflexes elicited by intravenous injection of 5-HT were examined in urethane anaesthetized rats. The 5-HT produced a concentration-dependent increase in time-response area of bradycardiac response, with the responses at submaximal concentrations shifted to the left after exposure to BT venom (20 µg/kg, IV). Aprotinin (6000 kallikrein inactivating unit, IV) as such had ...

  10. Cardiopulmonary baroreceptor control of muscle sympathetic nerve activity in heat-stressed humans

    Science.gov (United States)

    Crandall, C. G.; Etzel, R. A.; Farr, D. B.

    1999-01-01

    Whole body heating decreases central venous pressure (CVP) while increasing muscle sympathetic nerve activity (MSNA). In normothermia, similar decreases in CVP elevate MSNA, presumably via cardiopulmonary baroreceptor unloading. The purpose of this project was to identify whether increases in MSNA during whole body heating could be attributed to cardiopulmonary baroreceptor unloading coincident with the thermal challenge. Seven subjects were exposed to whole body heating while sublingual temperature, skin blood flow, heart rate, arterial blood pressure, and MSNA were monitored. During the heat stress, 15 ml/kg warmed saline was infused intravenously over 7-10 min to increase CVP and load the cardiopulmonary baroreceptors. We reported previously that this amount of saline was sufficient to return CVP to pre-heat stress levels. Whole body heating increased MSNA from 25 +/- 3 to 39 +/- 3 bursts/min (P Central blood volume expansion via rapid saline infusion did not significantly decrease MSNA (44 +/- 4 bursts/min, P > 0.05 relative to heat stress period) and did not alter mean arterial blood pressure (MAP) or pulse pressure. To identify whether arterial baroreceptor loading decreases MSNA during heat stress, in a separate protocol MAP was elevated via steady-state infusion of phenylephrine during whole body heating. Increasing MAP from 82 +/- 3 to 93 +/- 4 mmHg (P < 0.05) caused MSNA to decrease from 36 +/- 3 to 15 +/- 4 bursts/min (P < 0.05). These data suggest that cardiopulmonary baroreceptor unloading during passive heating is not the primary mechanism resulting in elevations in MSNA. Moreover, arterial baroreceptors remain capable of modulating MSNA during heat stress.

  11. ELEMENTAL ANALYSIS OF RESPIRABLE TIRE PARTICLES AND ASSESSMENT OF CARDIO-PULMONARY TOXICITY IN RATS

    Science.gov (United States)

    Elemental Analysis of Respirable Tire Particles and Assessment of Cardio-pulmonary Toxicity in RatsR.R. Gottipolu, PhD1, E. Landa, PhD2, J.K. McGee, MS1, M.C. Schladweiler, BS1, J.G. Wallenborn, MS3, A.D. Ledbetter, BS1, J.E. Richards, MS1 and U.P. Kodavanti, PhD1. 1NHEER...

  12. The Effectiveness of Ultrasound in Patients with Non-Traumatic Cardiopulmonary Arrest

    Directory of Open Access Journals (Sweden)

    Suat Zengin

    2012-06-01

    Full Text Available Objective: The purpose of this study was to evaluate the effectiveness of using cardiac ultrasound in emergency departments to direct resuscitation after cardiopulmonary arrest. Material and Methods: The study was performed prospectively on 73 patients who underwent cardiopulmonary resuscitation in the emergency department at Gaziantep University Faculty of Medicine between January and December 2010. Two senior doctors, who had received emergency cardiac ultrasonography training, performed the cardiac ultrasound, which was done from the apical and subxiphoid windows. SonoSite Titan was used as the sonography device. Ultrasound evaluation and pulse controls were performed spontaneously. SPSS 18.0 was used for statistical analysis. Results: The cases included 38 males and 35 females. 57.5% of the cardiopulmonary arrest incidents occurred out of the hospital. Only 8.2% of patients had a femoral pulse during the initial evaluation; 91.8% showed no femoral pulse. Although 31.5% of patients had a regular rhythm, 54.8% did not, and ventricular fibrillation was present in 13.7% of patients. Ultrasound inspection detected a heart rate in 13.7% of patients and ventricular fibrillation in 9.6%. In 76.7% of the cases, no heart rate was observed. There were 42 patients with asystole, two with a normal rate and 14 with valvular motion. Ventricular fibrillation was detected in seven cases, and following the evaluation performed simultaneously with ultrasound, pericardial tamponade was found in two and right ventricular enlargement in four cases. Global hypokinesia was detected in one patient and hypovolemia in one patient. Conclusion: Doctors trained in emergency cardiac ultrasonography can use cardiac ultrasound as a supplementary method for managing cardiopulmonary resuscitation and making appropriate decisions.

  13. Resetting of the cardiopulmonary baroreflex 10 years after surgical repair of coarctation of the aorta

    OpenAIRE

    Johnson, D.; Perrault, H; Vobecky, S.; Trudeau, F; Delvin, E; Fournier, A; Davignon, A

    2001-01-01

    OBJECTIVE—To characterise cardiopulmonary baroreflex responses and examine the effects of a 45 minute cycling bout late after successful repair of coarctation of the aorta.?SUBJECTS—10 young adults (mean (SEM) age 18.1 (2.6 years)) operated on for coarctation of the aorta 12.7 (3.5) years earlier, and 10 healthy controls.?DESIGN—Forearm blood flow (venous occlusion plethysmography) and vascular resistance, left ventricular internal diastolic diameter, and central venous pressure estimated fro...

  14. Assessment of cardiopulmonary circulation in schistosomiasis using radionuclide first-pass technique

    International Nuclear Information System (INIS)

    Forty four cases with schistosomiasis, as well as normal control were studied for assessment of cardiopulmonary circulation using radionuclide minimal transient times (MTTs). Twenty five to thirty percent of schistosomiasis patients have prolongation of cardiac and total MTTs with concomitant reduction of verticular ejections. The MTTs are directly related to the degree of advancement in clinical stage of disease and inversely related to eosinophilia.5 fig.,1 tab

  15. Cardiac Arrest/Cardiopulmonary Resuscitation Increases Anxiety-Like Behavior and Decreases Social Interaction

    OpenAIRE

    Neigh, Gretchen N; Kofler, Julia; Meyers, Jessica L.; Bergdall, Valerie; La Perle, Krista M.D.; Traystman, Richard J.; DeVries, A. Courtney

    2004-01-01

    Advances in medical technology have increased the number of individuals who survive cardiac arrest/cardiopulmonary resuscitation (CPR). This increased incidence of survival has created a population of patients with behavioral and physiologic impairments. We used temperature manipulations to characterize the contribution of central nervous system damage to behavioral deficits elicited by 8 minutes of cardiac arrest/CPR in a mouse model. Once sensorimotor deficits were resolved, we examined anx...

  16. Cardiopulmonary effects of using carbon dioxide for laparoscopic surgery in cats

    OpenAIRE

    Beazley, Shannon G.; Cosford, Kevin; Duke-Novakovski, Tanya

    2011-01-01

    The cardiopulmonary effects of capnoperitoneum were investigated in 8 spontaneously breathing, young adult female cats undergoing laparoscopic pancreatic biopsy (intra-abdominal pressure 12 mmHg). Cats were premedicated with acepromazine and hydromorphone, induced with ketamine and diazepam, and maintained using an end-tidal isoflurane concentration of 1.13% in 100% oxygen. Direct systemic arterial blood pressure, heart and respiratory rates, end-tidal carbon dioxide (CO2), and isoflurane wer...

  17. Locked-in Syndrome and Blue Toe Syndrome Caused by Cardiopulmonary Bypass

    OpenAIRE

    Sabzi, Feridoun; Moloudi, Abdolrasoul

    2010-01-01

    Severe inflammation after cardiopulmonary bypass with the vasculitis of the acral extremity and vertebro-basilar arterial system leads to the locked-in syndrome and blue toe syndrome. In broad terms, systemic, idiopathic, and environmental factors provoke syndromes that present with digital discoloration or the blue toe syndrome. Painful digital discoloration, accompanied by ulceration, suggests vasculitis, involving small blood vessels. Definitive diagnosis usually requires histological docu...

  18. Effects of Cardiopulmonary Bypass Surgery on Auditory Function: A Preliminary Study

    OpenAIRE

    Sanjay Kumar Munjal; Parul Malik; Anuradha Sharma; Naresh Kumar Panda; Shyam K. Singh Thingnum

    2013-01-01

    Hearing loss has been reported as a complication following cardiac surgery with extracorporeal circulation. Preoperative hearing testing is not commonly done in these procedures, so preoperative and postoperative hearing loss, if any, may occur unnoticed. 30 subjects in the age range of 50–70 with a mean age of 60.16 years with myocardial infarction and scheduled to undergo cardiopulmonary bypass surgery underwent detailed audiological assessment comprising of pure tone audiometry with extend...

  19. Disseminating cardiopulmonary resuscitation training by distributing 35,000 personal manikins among school children

    DEFF Research Database (Denmark)

    Isbye, Dan L; Rasmussen, Lars S; Ringsted, Charlotte; Lippert, Freddy K

    2007-01-01

    BACKGROUND: Because most cardiac arrests occur at home, widespread training is needed to increase the incidence of cardiopulmonary resuscitation (CPR) by lay persons. The aim of this study was to evaluate the effect of mass distribution of CPR instructional materials among schoolchildren. METHODS AND RESULTS: We distributed 35,002 resuscitation manikins to pupils (12 to 14 years of age) at 806 primary schools. Using the enclosed 24-minute instructional DVD, they trained in CPR and subsequently u...

  20. Endogenous Gas Formation—An In Vitro Study with Relevance to Gas Microemboli during Cardiopulmonary Bypass

    OpenAIRE

    Lindholm, Lena; Engström, Karl Gunnar

    2012-01-01

    Gas embolismis an identified problemduring cardiopulmonary bypass (CPB). Our aim was to analyze the potential influence from gas solubility based on simple physical laws, here called endogenous gas embolism. Gas solubility decreases at higher temperature and gas bubbles are presumably formed at CPB warming. An experimental model to measure gas release was designed. Medium (water or blood retrieved from mediastinal drains, 14.6 mL) was incubated and equilibrated with gas (air, 100% oxygen, or ...

  1. A review of cardiopulmonary research in Brazilian medical journals: clinical, surgical and epidemiological data

    OpenAIRE

    Carlos Serrano; Mauricio Rocha e Silva

    2010-01-01

    Research in the field of cardiopulmonary disease in Brazil has been very active in recent decades. The combination of PUBMED, SCieLO, open access and online searching has provided a significant increase in the visibility of Brazilian journals. This newly acquired international visibility has in turn resulted in the appearance of more original research reports in the Brazilian scientific press. This review is intended to highlight part of this work for the benefit of the readers of "Clinics." ...

  2. Median sternotomy for double lung transplantation with cardiopulmonary bypass in seven consecutive patients

    DEFF Research Database (Denmark)

    Kohno, Mitsutomo; Steinbrüchel, Daniel A

    2012-01-01

    We describe our technique of using median sternotomy to perform double lung transplantations with cardiopulmonary bypass. By sparing the respiratory muscles, median sternotomy is probably less invasive and preserves lung function. Furthermore, it causes less long-term discomfort than intercostal...... thoracotomy. Although exposure of the pleural space is less optimal, abundant pleural adhesions can be dissected, particularly in the left posterior pleural cavity, using pericardial traction stitches, exposing the retrocardiac pleura with minimal manipulation of the heart....

  3. Normalized Cardiopulmonary Exercise Function in Patients With Pectus Excavatum Three Years After Operation

    DEFF Research Database (Denmark)

    Sørensen, Marie Maagaard; Jensen, Mariann Tang; Ringgaard, Steffen; Nielsen, Hans Henrik M; Frøkiær, Jørgen; Haubuf, Maj; Pilegaard, Hans K; Hjortdal, Vibeke E

    2013-01-01

    BACKGROUND: During exercise cardiac function is often limited in patients with pectus excavatum. Therefore, we hypothesized that cardiopulmonary exercise function would improve after the Nuss procedure. METHODS: Seventy-five teenagers (49 patients, 26 controls) were investigated at rest and during bicycle exercise before surgery, and 1 year and 3 years postoperatively (after pectus-bar removal). Echocardiography and lung spirometry were performed at rest. Cardiac output, heart rate, and aerobic ...

  4. Observations on some cardiopulmonary effects of midazolam, xylazine and a midazolam / ketamine combination in the goat

    OpenAIRE

    G.F. Stegmann

    2012-01-01

    Xylazine, midazolam and a midazolam / ketamine combination were administered to 6 goats in a randomised 3-way block design. All goats received all treatments with at least a 7-day interval between treatments. Statistically significant (P < 0.05) changes were observed in some of the measured cardiopulmonary variables for xylazine and midazolam/ ketamine. Xylazine administration resulted in statistically significant decreases in minute volume, arterial partial pressure of oxygen, heart r...

  5. Cardiac arrest and cardiopulmonary resuscitation dysregulates the hypothalamic–pituitary–adrenal axis

    OpenAIRE

    Neigh, Gretchen N; Karelina, Kate; Zhang, Ning; Glasper, Erica R.; Owens, Michael J.; Plotsky, Paul M; Nemeroff, Charles B.; DeVries, A. Courtney

    2009-01-01

    Cardiac arrest and cardiopulmonary resuscitation (CA/CPR) increase the risk for affective disorders in human survivors. Postischemic anxiety- and depressive-like behaviors have been documented in animal models of CA/CPR; however, the stability of post-CA/CPR anxiety-like behavior over time and the underlying physiologic mechanisms remain unknown. The hypothalamic–pituitary–adrenal (HPA) axis and the corticotropin releasing factor (CRF) system may mediate the pathophysiology of anxiety and dep...

  6. Cardiopulmonary resuscitation in undiagnosed situs inversus totalis in emergency department: An intensivist challenge

    OpenAIRE

    Samanta, Sukhen; Samanta, Sujay; Ghatak, Tanmoy

    2013-01-01

    Situs inversus totalis is a rare congenital condition. A 34-year-old woman with undiagnosed situs inversus was referred to our emergency department with cardiac arrested state. She underwent cardiopulmonary resuscitation (CPR) and defibrillation with a modified approach. We faced different challenging aspects during intensive care management. Ultrasonography in CPR in our patient was very helpful. We restricted our discussion on special aspect of SIT in emergency and intensive care unit.

  7. A tradable employment quota

    OpenAIRE

    Akyol, Metin; Neugart, Michael; Pichler, Stefan

    2015-01-01

    Discrimination of women in the labor market requires appropriate policy interventions. Affirmative action policies typically advocate the introduction of an employment quota uniformly applied to all firms. In a heterogeneous labor market such a policy may yield avoidable welfare losses. We propose a tradable employment quota showing its effects on wages, employment, and welfare in a labor market with search frictions and taste discrimination. A tradable employment quota appears to be a viable...

  8. Wage-Employment Contracts

    OpenAIRE

    Kahn, Charles M.; Green, Jerry

    1983-01-01

    This paper studies the efficient agreements about the dependence of workers' earnings on employment, when the employment level is controlled by firms. The firms' superior information about profitability conditions is responsible for this form of contract governance. Under plausible assumptions, such agreements will cause employment to diverge from efficiency as a byproduct of their attempt to mitigate risk. It is shown that, if leisure is a normal good and firms are risk-neutral, employment i...

  9. Graft-versus-host disease versus graft-versus-leukemia.

    Science.gov (United States)

    Negrin, Robert S

    2015-12-01

    Graft-versus-host disease (GVHD) is a significant clinical problem after allogenic hematopoietic cell transplantation (HCT) associated with substantial morbidity and mortality that limits the potential utility of transplantation. Associated with GVHD is the well-recognized phenomenon of the graft-versus-leukemia (GVL) effect that results in reduced risk of disease relapse. GVL effects have been observed after treatment for a broad range of hematological malignancies. Both GVHD and GVL are the results of T cell-effector functions that frames a major question in the field of how linked are these two phenomena. A major goal of basic science and translational research has been to develop strategies to reduce the risk of GVHD while maintaining or enhancing GVL. In this review, a number of different strategies developed from preclinical animal models will be explored with a focus on those approaches that have been extended to the clinic in an attempt to achieve this goal. Needless to say, there is no proven strategy; however, with the use of modern technology and clinical translation, there has been substantial progress toward this goal of reducing the risks of GVHD while promoting and enhancing GVL responses. PMID:26637726

  10. Design and development of multilayer vascular graft

    Science.gov (United States)

    Madhavan, Krishna

    2011-07-01

    Vascular graft is a widely-used medical device for the treatment of vascular diseases such as atherosclerosis and aneurysm as well as for the use of vascular access and pediatric shunt, which are major causes of mortality and morbidity in this world. Dysfunction of vascular grafts often occurs, particularly for grafts with diameter less than 6mm, and is associated with the design of graft materials. Mechanical strength, compliance, permeability, endothelialization and availability are issues of most concern for vascular graft materials. To address these issues, we have designed a biodegradable, compliant graft made of hybrid multilayer by combining an intimal equivalent, electrospun heparin-impregnated poly-epsilon-caprolactone nanofibers, with a medial equivalent, a crosslinked collagen-chitosan-based gel scaffold. The intimal equivalent is designed to build mechanical strength and stability suitable for in vivo grafting and to prevent thrombosis. The medial equivalent is designed to serve as a scaffold for the activity of the smooth muscle cells important for vascular healing and regeneration. Our results have shown that genipin is a biocompatible crosslinker to enhance the mechanical properties of collagen-chitosan based scaffolds, and the degradation time and the activity of smooth muscle cells in the scaffold can be modulated by the crosslinking degree. For vascular grafting and regeneration in vivo, an important design parameter of the hybrid multilayer is the interface adhesion between the intimal and medial equivalents. With diametrically opposite affinities to water, delamination of the two layers occurs. Physical or chemical modification techniques were thus used to enhance the adhesion. Microscopic examination and graft-relevant functional characterizations have been performed to evaluate these techniques. Results from characterization of microstructure and functional properties, including burst strength, compliance, water permeability and suture strength, showed that the multilayer graft possessed properties mimicking those of native vessels. Achieving these FDA-required functional properties is essential because they play critical roles in graft performances in vivo such as thrombus formation, occlusion, healing, and bleeding. In addition, cell studies and animal studies have been performed on the multilayer graft. Our results show that the multilayer graft support mimetic vascular culture of cells and the acellular graft serves as an artery equivalent in vivo to sustain the physiological conditions and promote appropriate cellular activity. In conclusion, the newly-developed hybrid multilayer graft provides a proper balance of biomechanical and biochemical properties and demonstrates the potential for the use of vascular tissue engineering and regeneration.

  11. Improvement of polymer stability by radiation grafting

    International Nuclear Information System (INIS)

    Losses of the stabilizer due to extractability or volatility immediately affect ultimate performance of polymer product. A new approach to increase the persistence of the stabilizer in the final product is to chemically bind it to the polymer backbone. Radiation grafting or crosslinking could be an efficient method for this, when the stabilizer is polymerizable. By a mutual gamma irradiation method, photoprotector 2-hydroxy-4-(3-methacryloxy-2- hydroxy-propoxy) benzophenone (HMB) has been readily grafted to low density polyethylene (LDPE) in benzene, tetrahydrofuran and methanol solution, respectively. Surface grafting occurs in a methanol solution of stabilizer, while in benzene and tetrahydrofuran solutions of stabilizer, grafting proceeds more or less in the inner parts of the polymeric film as well. The grafted LDPE film in methanol and tetrahydrofuran (containing 1 w/w % of grafted HMB), 1 w/w % blended HMB with LDPE and nongrafted LDPE film, were all exposed to accelerated aging and natural weathering and their spectral changes, expressed by the carbonyl index, were then compared. The change of elongation at break and tensile strength were measured in the course of aging. UV stability tests on aged films and change in mechanical properties indicate a pronounced protective effect achieved by grafted stabilizer. Grafting in methanol solution appears to be an efficient photostabilization treatment and the most economical with respect to the consumption of monomer, the grafting yield being less than 0.5%. Surface grafting is an efficient photostabilization method since grafted stabilizer is chemically bound to a polymeric surface and in this way the problem of evaporation of blended stabilizers during the prolonged use of polymeric materials is eliminated. (author)

  12. Ocular Graft Versus Host Disease

    Directory of Open Access Journals (Sweden)

    Elif Erdem

    2014-06-01

    Full Text Available Allogeneic hematopoietic stem cell transplantation (allo-HSCT is an important therapeutic procedure for the treatment of hematologic malignancies. Graft-versus-host disease (GVHD is a common cause of morbidity and mortality after allo-HSCT. Severe systemic form of GVHD may become life threatening. Ocular involvement of GVHD remains the most common cause of long-term morbidity.In this review article, the etiology, pathophysiology, clinical features, and treatment modalities of ocular GVHD are presented. [Archives Medical Review Journal 2014; 23(3.000: 484-491

  13. Onlay Bone Grafts in Head and Neck Reconstruction

    OpenAIRE

    Yazar, Sukru

    2010-01-01

    Bone grafts are used in a variety of clinical situations and can be divided into two categories: treatment of bone gaps (inlay bone grafting) and bone projection (onlay bone grafting). Cortical grafts are useful in situations requiring immediate mechanical strength. These grafts can survive with or without complete revascularization or resorption and are primarily used by plastic surgeons in the treatment of bone volume deficiency. Cancellous grafts, in contrast, have no mechanical strength a...

  14. Mechanistic factors and innate immune components in vein graft disease

    OpenAIRE

    Vries, Margreet Renate de

    2014-01-01

    Vein graft surgery to treat occlusive arterial disease is a common applied procedure. Each year more than two million vein graft surgeries are performed worldwide. The major drawback of vein grafting is that within 10 years after vein graft surgery 50-60 % of the vein grafts suffer from patency loss due to thrombosis, intimal hyperplasia formation, accelerated atherosclerosis and rupture. Endogenous factors orchestrate the development and failure of vein grafts. Investigating the role of end...

  15. Influence of ischemia before vein grafting on early hyperplasia of the graft and the dynamic changes of the intima after grafting

    Directory of Open Access Journals (Sweden)

    Zou RongJiang

    2012-09-01

    Full Text Available Abstract Background To investigate both the influence of ischemia before grafting on early hyperplasia of the vein grafts, and the dynamic changes of the intima after grafting in a rabbit model of vein graft disease. Methods We performed paired vein graft experiments under different ischemic conditions (15 vs. 60 min; 15 vs. 90 min in the neck of the rabbits and compared the differences between the grafts. Clopidogrel, an anti-platelet agent, was administered before and after surgery. Twenty-eight days after the grafting procedure, the veins were evaluated microscopically. The dynamic changes of the intima after grafting were evaluated by scanning electron microscopy over time. Results The vein grafts subjected to 60- or 90-min ischemia exhibited no differences compared to those subjected to 15-min ischemia in terms of the mean thickness of the intimal, medial, and adventitial layers of the graft. Similarly, there was no difference in the Ki-67 labeling index (proliferation marker between the vein grafts. Vein grafts with 15-min ischemia lost endothelial cells (ECs but healed by 3 days post graft, whereas vein grafts with 90-min ischemia suffered serious EC loss, which was restored with new ECs during days 2 to 14 post graft. Conclusions Ninety-minute ischemia before vein grafting can cause serious EC loss, but does not increase early intimal hyperplasia when clopidogrel is administered. Protecting the vein from ischemia and reperfusion injury preserves ECs.

  16. Biodegradability of poly(3-hydroxybutyrate) film grafted with vinyl acetate: Effect of grafting and saponification

    Science.gov (United States)

    Wada, Yuki; Seko, Noriaki; Nagasawa, Naotsugu; Tamada, Masao; Kasuya, Ken-ichi; Mitomo, Hiroshi

    2007-06-01

    Radiation-induced graft polymerization of vinyl acetate (VAc) onto poly(3-hydroxybutyrate) (PHB) film was carried out. At a degree of grafting higher than 5%, the grafted films (PHB-g-VAc) completely lost the enzymatic degradability that is characteristic of PHB due to the grafted VAc covering the surface of the PHB film. However, the biodegradability of the PHB-g-VAc films was recovered when the films were saponified in alkali solution under optimum conditions. Graft chains of the PHB-g-VAc film reacted selectively to become biodegradable polyvinyl alcohol (PVA). The biodegradability of the saponified PHB-g-VAc film increased rapidly with time.

  17. Biodegradability of poly(3-hydroxybutyrate) film grafted with vinyl acetate: Effect of grafting and saponification

    Energy Technology Data Exchange (ETDEWEB)

    Wada, Yuki [Department of Biological and Chemical Engineering, Faculty of Engineering, Gunma University, 1-5-1 Tenjin-cho, Kiryu, Gunma 376-8515 (Japan)]. E-mail: wada.yuki@jaea.go.jp; Seko, Noriaki [Environment and Industrial Materials Research Division, Quantum Beam Science Directorate, Japan Atomic Energy Agency, 1233 Watanuki-machi, Takasaki, Gunma 370-1292 (Japan); Nagasawa, Naotsugu [Environment and Industrial Materials Research Division, Quantum Beam Science Directorate, Japan Atomic Energy Agency, 1233 Watanuki-machi, Takasaki, Gunma 370-1292 (Japan); Tamada, Masao [Environment and Industrial Materials Research Division, Quantum Beam Science Directorate, Japan Atomic Energy Agency, 1233 Watanuki-machi, Takasaki, Gunma 370-1292 (Japan); Kasuya, Ken-ichi [Department of Biological and Chemical Engineering, Faculty of Engineering, Gunma University, 1-5-1 Tenjin-cho, Kiryu, Gunma 376-8515 (Japan); Mitomo, Hiroshi [Department of Biological and Chemical Engineering, Faculty of Engineering, Gunma University, 1-5-1 Tenjin-cho, Kiryu, Gunma 376-8515 (Japan)

    2007-06-15

    Radiation-induced graft polymerization of vinyl acetate (VAc) onto poly(3-hydroxybutyrate) (PHB) film was carried out. At a degree of grafting higher than 5%, the grafted films (PHB-g-VAc) completely lost the enzymatic degradability that is characteristic of PHB due to the grafted VAc covering the surface of the PHB film. However, the biodegradability of the PHB-g-VAc films was recovered when the films were saponified in alkali solution under optimum conditions. Graft chains of the PHB-g-VAc film reacted selectively to become biodegradable polyvinyl alcohol (PVA). The biodegradability of the saponified PHB-g-VAc film increased rapidly with time.

  18. End tidal CO2 versus arterial CO2 monitoring in patients undergoing coronary artery bypass graft

    Directory of Open Access Journals (Sweden)

    Hassani E

    2009-12-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Measuring end tidal carbon dioxide (ETCo2 is one of the methods used for estimating arterial carbon dioxide (PaCo2 during general anesthesia. ETCo2 measurements maybe obviate the need for repeating arterial puncture for determination of arterial PaCo2. This study performed to determine the accuracy of ETCo2 levels as a measure of PaCo2 levels in patients undergoing coronary artery bypass graft and also to evaluate variation of the gradient between PaCo2 and ETCo2, peri- cardiopulmonary bypass operation."n"nMethods: In a prospective, cross-sectional study, a total of 40 patients with age 57±11 (35-73 years old undergoing coronary artery bypass graft were enrolled. ETCo2 levels (mmHg were recorded using side stream capnography at the time of arterial blood gas sampling, before (T0 and after (T1 cardiopulmonary bypass."n"nResults: Mean P(a-ETCo2 at T0 was 4.3±4.4mmHg, with the mean PaCo2, 33±6mmHg and mean ETCo2, 29±5mmHg and these values at T1 were 4.5±4.1mmHg, 33±5mmHg and 29±2mmHg respectively. There was no variation of the mean gradient (PaCo2-PETCo2 during, before and after cardiopulmonary bypass (p>0.870. Significant correlation was found between ETCo2 and PaCo2 at T0 and T1 (r=0.754 and 0.685 respectively and p=0.001."n"nConclusion: Capnography is a non- invasive and a safe technique for determining arterial PCo2 and for measurements of ETCo2 that correlate well with PaCo2 values in healthy patients undergoing coronary artery bypass graft. ETCo2 measurements maybe sufficient measures of PaCo2 in selected patients and obviate the need for repeating arterial blood gas determination. Further study is warranted.

  19. Economics of grafted vs conventional watermelon plants

    Science.gov (United States)

    Grafting of watermelons has been used in many countries to provide control of, or resistance to, certain soil borne diseases such as Fusarium wilt. The impact of grafting on postharvest quality has not been thoroughly examined. This report deals with the comparison of the costs of production betwe...

  20. Small parietal thrombi in artificial bypass grafts

    International Nuclear Information System (INIS)

    During the last five years, 51 femoro-popliteal polytrafluoroethylene grafts were implanted in patients in the Second Surgical University Clinic, Vienna. In four of these patients an angiogram performed shortly after operation showed numerous small parietal thrombi on the artificial graft, a review of the literature has not shown any similar reports. The clinical importance and consequences of this observation are discussed. (orig.)

  1. Radiation graft modification of EPDM rubber

    Science.gov (United States)

    Katbab, A. A.; Burford, R. P.; Garnett, J. L.

    N-Vinyl pyrrolidone (NVP), 2-hydroxyethylmethacrylate (HEMA) and acrylamide (AAm) have been grafted to the surface of rubber vulcanizates based on ethylene-propylene-terpolymer (EPDM) using the simultaneous radiation method to alter surface properties such as wettability and therefore biocompatibility. The effect of monomer concentration, solvent and EPDM structural factors on the grafting behavior have been investigated. The inhibitory effect upon homopolymerization of various salts has also been evaluated for the three monomers. NVP and HEMA could be grafted onto EPDM rubber in the presence of aqueous solutions of cupric nitrate at 0.005 M and 1.0 M concentrations respectively. Aqueous solutions of Mohr's salt (ammonium ferrous sulphate) at 0.05 M not only suppressed the homopolymerization of AAm but also increased grafting yield. The percentage grafting also increased with increasing AAm concentration. A mechanism has been proposed to explain the behaviour of these monomers. The inclusion of multifunctional acrylates in additive amounts (1.0 vol%) enhanced the graft degree. Modified samples were able to be efficiently stained, allowing the depth of the graft copolymerization to be determined by light microscopy. Water was found to have an accelerating effect on the polymerization of these monomers, but methanol prevented their polymerization completely. The effect of EPDM structural factors upon degree of grafting was found to vary, depending upon the monomer type.

  2. DSA and duplex ultrasonography in aorta grafts

    International Nuclear Information System (INIS)

    In 95 patients with aorta grafts, DSA was compared with duplex ultrasonography. In 4 patients the graft was better visualized by means of angiography. Kinking, coiling, dilations, pseudoaneurysms, stenoses, and occlusions could be sufficiently diagnosed with both methods. Marginal thrombosis and periprosthetic pathologies could only be found with ultrasonographic and angiographic examination techniques are described and, the limitations of both methods discussed. (orig.)

  3. Robotically-Assisted Coronary Artery Bypass Grafting

    OpenAIRE

    Thierry A. Folliguet; Alain Dibie; François Philippe; Fabrice Larrazet; Slama, Michel S.; François Laborde

    2010-01-01

    Objectives. Robotic surgery enables to perform coronary surgery totally endoscopically. This report describes our experience using the da Vinci system for coronary artery bypass surgery. Methods. Patients requiring single-or-double vessel revascularization were eligible. The procedure was performed without cardiopulmonary bypass on a beating heart. Results. From April 2004 to May 2008, fifty-six patients were enrolled in the study. Twenty-four patients underwent robotic harvesting of ...

  4. Strategic sequences in fat graft survival.

    Science.gov (United States)

    Guo, Jimmy; Widgerow, Alan D; Banyard, Derek; Toranto, Jason; Wirth, Garrett A; Paydar, Keyianoosh; Tussardi, Ilaria Tocco; Evans, Gregory R D

    2015-03-01

    Although lipotransfer, or fat grafting, is a commonly used procedure in aesthetic and reconstructive surgery, there is still variability in graft survival and neoadipogenesis from one procedure to the next. A better understanding of the sequential molecular events occurring with grafting would allow us to strategize methods to improve the regenerative potency of the grafted tissue. These steps begin with an autophagic process, followed by the inclusion of stromal vascular fraction and matrix components. By tailoring and modifying each of these steps for a particular type of aesthetic or reconstructive procedure, strategic sequencing represents a dynamic approach to lipotransfer with the aim of maximizing adipocyte viability and growth. In the implementation of the strategic sequence, it remains important to consider the clinical viability of each step and its compliance with the US Food and Drug Administration regulations. This review highlights the basic science behind clinically translatable approaches to supplementing various fat grafting procedures. PMID:25643185

  5. MR angiography of coronary artery bypass grafts

    Energy Technology Data Exchange (ETDEWEB)

    Yoshioka, Kunihiro; Kamata, Hiroyuki; Hirose, Atsuo [Iwate Medical Univ., Morioka (Japan)

    1997-03-01

    The purpose of this study is to assess the value of MR angiography in the evaluation of the patency of coronary artery bypass grafts (CABGs). Fifty consecutive patients with a total of 108 CABGs underwent breath-hold MR angiography and conventional arteriography. Fifty-seven of the CABGs were internal mammary artery grafts (IMAGs), and 51 were saphenous vein grafts (SVGs). With conventional arteriography used as the standard of reference, MR angiography was found to depict patency in all 53 IMAGs (sensitivity 100%) and 4 occluded IMAGs (specificity 100%), in 37 of 39 SVGs (sensitivity 95%) and occluded 10 of 12 SVGs (specificity 83%). The overall graft patency was 98% sensitivity and 88% specificity. Graft stenoses were also clearly demonstrated in 5 cases. This study suggests that MR angiography is a useful, noninvasive technique to evaluate the patency of CABGs. (author)

  6. Influence of tranexamic acid in postoperative bleeding of cardiac surgery with cardiopulmonary bypass / Influência do ácido tranexâmico no sangramento pós-operatório de cirurgias cardíacas com circulação extracorpórea

    Scientific Electronic Library Online (English)

    Flávio Donizete, Gonçalves; Fernando Rotatori, Novaes; Marcelo Alves, Maia.

    2002-12-01

    Full Text Available OBJETIVO: Analisar a influência do ácido tranexâmico no sangramento pós-operatório de cirurgia cardíaca com circulação extracorpórea (CEC). MÉTODO: Foram randomizados, em 2 grupos, 51 pacientes submetidos a cirurgia cardíaca com auxílio de CEC. Grupos: Grupo I - controle, com 26 pacientes, sendo 12 [...] com doença coronariana obstrutiva e 14 com lesões valvulares; Grupo II - ácido tranexâmico, com 25 pacientes, sendo 14 com doença coronariana obstrutiva e 11 com lesões valvulares. No grupo I foram infundidos 250ml de solução fisiológica (SF) 0,9%, após acesso venoso; o grupo II recebeu 100mg/kg de peso corpóreo de ácido tranexâmico diluído em 250ml de SF 0,9%, após acesso venoso. Foram colhidas amostras de sangue para exames na admissão ao CTI, após 12, 24 e 36 horas de pós-operatório. Os grupos foram comparados com relação a fatores que pudessem influir no sangramento pós-operatório e na necessidade de hemotransfusão: idade, sexo, creatinina, tempo de CEC, variação no hematócrito, plaquetas, fibrinogênio, número de pontes safenas, uso da artéria torácica interna, troca ou reconstrução valvar. Foram avaliados o sangramento no pós-operatório da 1a a 4a horas e o total. O método estatístico empregado foi o teste t de Student, com correção de Welch, dependendo do caso, para os dados contínuos. Os dados categóricos (sexo, troca valvar, etc.) foram analisados pelo teste não paramétrico do X². Em algumas situações foi usado teste exato de Fisher. Em todos os casos foi utilizado índice de significância p Abstract in english OBJECTIVE: To analyze the influence of tranexamic acid in postoperative bleeding of cardiac surgery with cardiopulmonary bypass. METHOD: 51 patients who underwent heart surgery with cardiopulmonary bypass were randomly divided in 2 groups: Group I - control, with 12 coronary artery disease patients [...] and 14 valve disease patients. Group II - Tranexamic acid, with 14 coronary artery disease patients and 11 valve disease patients. The Group I after venous access, received 250 ml of 0.9% normal saline solution as a placebo, Group II received 100 milligram per kilogram of body weight of tranexamic acid diluted in 250 ml of 0.9% normal saline solution. Blood samples were taken and examined at entry to Intensive care unit and after 12, 24 and 36 hours in the postoperative period. The groups were compared concerning factors which might influence the postoperative bleeding and transfusion required: age, gender, creatinine, duration of Cardiopulmonary bypass, hematocrit, platelets and fibrinogen variations, number of saphenous vein grafts performed, mammary artery used and valve replacement or repair. The postoperative bleeding was evaluated from the 1st to 4th hours and the total. Data were analyzed by appropriate statistic methods (Student T-test, X² test and Fischer's test); a p-value of less than 0.05 was the accepted level of significance. RESULTS: Concerning the postoperative bleeding and transfusion required, there was a statistically significant reduction in its average in valve disease patients in Group II. In coronary disease patients there was only a slight tendency. There was no significant statistical difference as far as the thromboembolic or renal complications were concerned. CONCLUSION: In valve disease patients, there was a reduction in bleeding and the need of transfusions of red blood cells, both of which had statistical differences. In coronary disease patients there was only a reduced tendency. The use of tranexamic acid was not related to further thromboembolic complications or renal insufficiency in the assessed groups.

  7. Influence of tranexamic acid in postoperative bleeding of cardiac surgery with cardiopulmonary bypass Influência do ácido tranexâmico no sangramento pós-operatório de cirurgias cardíacas com circulação extracorpórea

    Directory of Open Access Journals (Sweden)

    Flávio Donizete Gonçalves

    2002-12-01

    Full Text Available OBJECTIVE: To analyze the influence of tranexamic acid in postoperative bleeding of cardiac surgery with cardiopulmonary bypass. METHOD: 51 patients who underwent heart surgery with cardiopulmonary bypass were randomly divided in 2 groups: Group I - control, with 12 coronary artery disease patients and 14 valve disease patients. Group II - Tranexamic acid, with 14 coronary artery disease patients and 11 valve disease patients. The Group I after venous access, received 250 ml of 0.9% normal saline solution as a placebo, Group II received 100 milligram per kilogram of body weight of tranexamic acid diluted in 250 ml of 0.9% normal saline solution. Blood samples were taken and examined at entry to Intensive care unit and after 12, 24 and 36 hours in the postoperative period. The groups were compared concerning factors which might influence the postoperative bleeding and transfusion required: age, gender, creatinine, duration of Cardiopulmonary bypass, hematocrit, platelets and fibrinogen variations, number of saphenous vein grafts performed, mammary artery used and valve replacement or repair. The postoperative bleeding was evaluated from the 1st to 4th hours and the total. Data were analyzed by appropriate statistic methods (Student T-test, X² test and Fischer's test; a p-value of less than 0.05 was the accepted level of significance. RESULTS: Concerning the postoperative bleeding and transfusion required, there was a statistically significant reduction in its average in valve disease patients in Group II. In coronary disease patients there was only a slight tendency. There was no significant statistical difference as far as the thromboembolic or renal complications were concerned. CONCLUSION: In valve disease patients, there was a reduction in bleeding and the need of transfusions of red blood cells, both of which had statistical differences. In coronary disease patients there was only a reduced tendency. The use of tranexamic acid was not related to further thromboembolic complications or renal insufficiency in the assessed groups.OBJETIVO: Analisar a influência do ácido tranexâmico no sangramento pós-operatório de cirurgia cardíaca com circulação extracorpórea (CEC. MÉTODO: Foram randomizados, em 2 grupos, 51 pacientes submetidos a cirurgia cardíaca com auxílio de CEC. Grupos: Grupo I - controle, com 26 pacientes, sendo 12 com doença coronariana obstrutiva e 14 com lesões valvulares; Grupo II - ácido tranexâmico, com 25 pacientes, sendo 14 com doença coronariana obstrutiva e 11 com lesões valvulares. No grupo I foram infundidos 250ml de solução fisiológica (SF 0,9%, após acesso venoso; o grupo II recebeu 100mg/kg de peso corpóreo de ácido tranexâmico diluído em 250ml de SF 0,9%, após acesso venoso. Foram colhidas amostras de sangue para exames na admissão ao CTI, após 12, 24 e 36 horas de pós-operatório. Os grupos foram comparados com relação a fatores que pudessem influir no sangramento pós-operatório e na necessidade de hemotransfusão: idade, sexo, creatinina, tempo de CEC, variação no hematócrito, plaquetas, fibrinogênio, número de pontes safenas, uso da artéria torácica interna, troca ou reconstrução valvar. Foram avaliados o sangramento no pós-operatório da 1a a 4a horas e o total. O método estatístico empregado foi o teste t de Student, com correção de Welch, dependendo do caso, para os dados contínuos. Os dados categóricos (sexo, troca valvar, etc. foram analisados pelo teste não paramétrico do X². Em algumas situações foi usado teste exato de Fisher. Em todos os casos foi utilizado índice de significância p < 0,05. RESULTADOS: Com relação ao sangramento pós-operatório e a utilização de hemoderivados, houve redução da média dos mesmos nos pacientes com lesões valvulares no Grupo II, com diferença estatística. Com relação às complicações tromboembólicas ou renais, não houve diferença estatística entre os grupos. CONCLUSÃO: Nos pacientes com lesões valvulares, ocorreu redução do sangramento e da necessidade de

  8. Employment Protection and Migration

    OpenAIRE

    Bazillier, Rémi; Moullan, Yasser

    2012-01-01

    We argue in this paper that labor market institutions, and more particularly employment protection (EPL), are an important determinant of migration. Using a bilateral migration database, we empirically show that the employment protection di fferential has a negative impact on bilateral ows. Contrary to pop- ular wisdom which assumes that migrants look for a more protected market, we show that migrants tend to move to countries where employment protection is close to that of their country of o...

  9. Why employment relations matter

    OpenAIRE

    Sisson, Keith

    2010-01-01

    This paper has its origins in an on-going project labeled Employment Relations Matters. The title captures the double intention: to demonstrate the ways in which employment relations matters and to bring people up to date with the matters that the subject deals with. It is one of three in IRRU's Warwick Papers in Industrial Relations series covering the project's main themes. The two already published deal respectively with the nature of the employment relationship and the significance of ins...

  10. Assessing employment in Malta

    OpenAIRE

    Grech, Aaron George

    2003-01-01

    In this paper the total number of employed and the full-time equivalent employment in Malta are estimated for the last three decades. These series give a new picture of the historical development of employment and productivity in Malta. The estimated full-time equivalent time series, in spite of its limitations, is a first step on the way towards a comprehensive statistical measure of labour input in Malta

  11. Authenticity in Employment Relations

    DEFF Research Database (Denmark)

    Tackney, Charles Thomas

    , it becomes possible to specify employment relations parameters between the indirect and direct employer and employees in a manner that will ensure working conditions consistent with these traditions, substantially enhancing the prospect of authenticity in employment relations. This theology of the...... workplace analysis should complement and support corporate social responsibility, management spirituality, authentic leadership / authentic follower, and other secular research by offering a research methods bridge between empirically grounded theology and secular studies, with the common goal of improving...

  12. Imaging features of anterior cruciate ligament reconstruction graft insufficiency

    International Nuclear Information System (INIS)

    Objective: To investigate the imaging features of anterior cruciate ligament (ACL) graft insufficiency. Methods: X-Ray and MR imaging examinations in 24 consecutive patients who had ACL reconstructive graft insufficiency were retrospectively evaluated for tunnel position, osteoarthrosis and its related complications. Follow-up arthroscopy showed 16 graft tears and 8 graft laxities. Fisher exact test was used to compare tunnel malpositions, the proportion of graft tear on MRI and osteoarthrosis between graft tear group and graft laxity group. Results: Two malpositions of tibial tunnel and 3 malpositions of femoral tunnel were seen in graft tear group. Three-malpositions of tibial tunnel and 4 malpositions of femoral tunnel were seen in graft laxity group. The proportion of tibial or femoral malposition showed no significant difference between the two groups (P=0.289, P=0.167). In graft tear group, 15 complete graft tears were diagnosed correctly, 1 partial tear was misdiagnosed as normal on MRI. In graft laxity group, 4 grafts were diagnosed as normal and 4 were considered as graft tear on MRI. A significant difference was seen between the two groups (P=0.028) in the proportion of graft tear diagnosed on MRI. Fourteen osteoarthrosis were seen in graft tear group and 5 in graft laxity group. No significant difference was seen between the two groups (P= 0.289) in the proportion of osteoarthrosis. Conclusion: The proportions of tunnel malposition and osteoarthrosis showed no significant difference between the graft tear group and graft Laxity group. Most graft tears can be diagnosed accurately on MRI, but some cases of graft laxity may be misdiagnosed for graft tear. (authors)

  13. Inflorescence stem grafting made easy in Arabidopsis

    Directory of Open Access Journals (Sweden)

    Nisar Nazia

    2012-12-01

    Full Text Available Abstract Background Plant grafting techniques have deepened our understanding of the signals facilitating communication between the root and shoot, as well as between shoot and reproductive organs. Transmissible signalling molecules can include hormones, peptides, proteins and metabolites: some of which travel long distances to communicate stress, nutrient status, disease and developmental events. While hypocotyl micrografting techniques have been successfully established for Arabidopsis to explore root to shoot communications, inflorescence grafting in Arabidopsis has not been exploited to the same extent. Two different strategies (horizontal and wedge-style inflorescence grafting have been developed to explore long distance signalling between the shoot and reproductive organs. We developed a robust wedge-cleft grafting method, with success rates greater than 87%, by developing better tissue contact between the stems from the inflorescence scion and rootstock. We describe how to perform a successful inflorescence stem graft that allows for reproducible translocation experiments into the physiological, developmental and molecular aspects of long distance signalling events that promote reproduction. Results Wedge grafts of the Arabidopsis inflorescence stem were supported with silicone tubing and further sealed with parafilm to maintain the vascular flow of nutrients to the shoot and reproductive tissues. Nearly all (87% grafted plants formed a strong union between the scion and rootstock. The success of grafting was scored using an inflorescence growth assay based upon the growth of primary stem. Repeated pruning produced new cauline tissues, healthy flowers and reproductive siliques, which indicates a healthy flow of nutrients from the rootstock. Removal of the silicone tubing showed a tightly fused wedge graft junction with callus proliferation. Histological staining of sections through the graft junction demonstrated the differentiation of newly formed vascular connections, parenchyma tissue and lignin accumulation, supporting the presumed success of the graft union between two sections of the primary inflorescence stem. Conclusions We describe a simple and reliable method for grafting sections of an Arabidopsis inflorescence stem. This step-by-step protocol facilitates laboratories without grafting experience to further explore the molecular and chemical signalling which coordinates communications between the shoot and reproductive tissues.

  14. The influence of platelet-graft interaction on platelet survival in patients with aortobifemoral Dacron grafts

    International Nuclear Information System (INIS)

    In patients with arterial grafts, platelet consumption may be due to platelet interaction with the graft, and/or concomitant platelet consumption in the rest of the arterial tree. This hypothesis was tested by quantifying the kinetics and platelet-graft interaction of indium-111-labelled platelets with double velour Dacron grafts in 13 patients with arterial insufficiency ascribed to atherosclerosis. Mean platelet lifespan (MPLS), 149±46 hours, was significantly shorter than normal. Labelled platelets were transiently deposited onto the graft surfaces. Peak 111In deposition on the grafts, 1,33±1,02% of injected labelled platelets, was reached at 70±33 hours. Thereafter the graft-platelet radioactivity decreased in parallel with platelet radioactivity in the circulation. There was no statistical correlation between MPLS and the factors known to be associated with graft platelet deposition. It is therefore concluded that in patients with arterial disease requiring graft implantation, the observed increased platelet consumption cannot only be ascribed to the interaction of platelets with the graft. 27 refs., 3 tabs., 2 figs

  15. Binary mixed homopolymer brushes grafted on nanorod particles: A self-consistent field theory study

    Science.gov (United States)

    Ma, Xin; Yang, Yingzi; Zhu, Lei; Zhao, Bin; Tang, Ping; Qiu, Feng

    2013-12-01

    We employ the self-consistent field theory to study phase structures of brush-rod systems composed of two chemically distinct linear homopolymers. The polymer chains are uniformly grafted on the surface of a nanorod particle of finite length and comparable radius to the polymer radius of gyration. A "masking" technique treating the cylindrical boundary is introduced to solve the modified diffusion equations with an efficient and high-order accurate pseudospectral method involving fast Fourier transform on an orthorhombic cell. A rich variety of structures for the phase separated brushes is predicted. Phase diagrams involving a series of system parameters, such as the aspect ratio of the nanorod, the grafting density, and the chain length are constructed. The results indicate that the phase structure of the mixed brush-rod system can be tailored by varying the grafted chain length and/or the aspect ratio of the rod to benefit the fabrication of polymeric nanocomposites.

  16. Adaptive significance of root grafting in trees

    Energy Technology Data Exchange (ETDEWEB)

    Loehle, C.; Jones, R.

    1988-12-31

    Root grafting has long been observed in forest trees but the adaptive significance of this trait has not been fully explained. Various authors have proposed that root grafting between trees contributes to mechanical support by linking adjacent root systems. Keeley proposes that this trait would be of greatest advantage in swamps where soils provide poor mechanical support. He provides as evidence a greenhouse study of Nyssa sylvatica Marsh in which seedlings of swamp provenance formed between-individual root grafts more frequently than upland provenance seedlings. In agreement with this within-species study, Keeley observed that arid zone species rarely exhibit grafts. Keeley also demonstrated that vines graft less commonly than trees, and herbs never do. Since the need for mechanical support coincides with this trend, these data seem to support his model. In this paper, the authors explore the mechanisms and ecological significance of root grafting, leading to predictions of root grafting incidence. Some observations support and some contradict the mechanical support hypothesis.

  17. Employment Policy and Territories.

    Science.gov (United States)

    Berthet, Thierry; Cuntigh, Philippe; Guitton, Christophe

    2002-01-01

    France's employment policy has historically been governed by a strategy of interventions aimed at specific categories of individuals, including victims of industrial restructuring, entry workers, the long-term unemployed, and the disabled. Since the 1980s, France has had the following main lines of employment policy: (1) assistance to victims of…

  18. Employment Discrimination: A Survey.

    Science.gov (United States)

    Caplan, Gerald A.

    Chapter 4 in a book on school law provides a general overview of the various federal statutes directed toward discrimination in employment and considers some of the recent developments under these statutes. The first section is a survey of the employment discrimination laws and their interrelationships. The second section analyzes more closely…

  19. Radiation-induced graft copolymerization to polyester, 18

    International Nuclear Information System (INIS)

    Properties of polyester (polyethylene terephthalate) fibers grafted with acrylic acid (AA) and methacrylic acid were measured not only in the form of free acid but also in the form of sodium and calcium salts. Nearly the same moisture regain as that of cotton was obtained in the cases of sodium acrylate graft (AA-Na) and methacrylate graft (MAA-Na) at 14 and 18% graft respectively. Although the rate of water droplet absorption by the wicking test revealed that the rate increased with grafting, it is generally lower than that of cotton. Only AA-Na graft showed similar rate as that of cotton at 5% graft. All other grafts i.e. AA, AA-Ca, MAA and MAA-Na grafts showed lower rate than cotton even at higher percent graft. Results of frictional electricity test were similar, AA-Na graft showed satisfactory low static charge, whereas the effect of the grafting was insufficient in the cases of AA, MAA and MAA-Na grafts. Polyester fibers above 10% AA graft were dyed homogeneously to deep color with cationic and disperse dyes. AA, AA-Na and AA-Ca grafts showed almost the same dyeability. In the case of MAA grafts, only MAA-Na graft showed good dyeability. Fibers dyed with cationic dyes showed poor light fastness. Nor or very little change in tensile properties of polyester fibers were observed upon grafting of acrylic acid. However, strength and modulus of grafts decrease when AA grafts above 15% graft were converted to AA-Na by treatment in aqueous sodium bicarbonate solution. (auth.)

  20. Incentives for nurse employment.

    Science.gov (United States)

    Deets, C; Froebe, D J

    1984-01-01

    This study was designed to discover perceived incentives for employment in terms of similarities in how employed and nonemployed nurses ranked employment inducements, and if the two groups could be differentiated on the basis of their rankings. March and Simon's (1958) theory was the basis for identifying inducements/incentives. A 47-item instrument was distributed randomly to a 5% sample of registered nurses (RNs) from a midwestern state. Similarities in incentives existed in the factor structure for both the employed and nonemployed. The factor structure for the part-employed approximated both groups depending on items considered. Little variance was accounted for by the instrument, indicating other variables need to be identified. Data indicate that the area of professionalism would be valuable in developing more items related to inducements/incentives. PMID:6564528

  1. Revascularized periosteal grafts--a new method to produce functional new bone without bone grafting.

    Science.gov (United States)

    Finley, J M; Acland, R D; Wood, M B

    1978-01-01

    Rib periosteum was transplanted to the groins of 9 dogs. In half of the periosteal grafts, no microvascular anastomoses were done (free grafts); at 6 weeks after grafting they had become resorbed. The other periosteal grafts were revascularized by microvascular anastomoses of the intercostal vessels to local muscular vessels; at 6 weeks those with confirmed vascular patency had all formed substantial amounts of new bone. Five cm, full-thickness defects were created in the tibias of 10 dogs. The control animals (without grafting) did not heal in two months. However, the experimental dogs, with vascularized periosteal grafts in the defects regenerated their tibias with healthy new bone by 6 weeks--and were walking on them then. PMID:619374

  2. The Effects of Atorvastatin on Cardiopulmonary Bypass Induced Inflammatory Response of Early Period and Intensive Care Unit Length of Stay After Coronary Artery Bypass Surgery

    Directory of Open Access Journals (Sweden)

    Co?kun Araz

    2011-04-01

    Full Text Available Objective: To evaluate the effects of preoperative using of atorvastatin on cardiopulmonary bypass induced early inflammatory response in coronary artery bypass grafting surgery. Materials and Methods: After obtaining Instutitional Ethics Committee approval and patients’ written informed consent, 20 patients who were atorvastatin users and 20 matched controls were included in this prospective observational cohort study. All patients underwent CABG with CPB using standard anesthetic and surgical techniques. Blood samples were collected for measurement of serum interleukin-1 (IL-1, IL-6, tumor necrosis factor-alpha (TNF-alpha and p-selectin levels at the beginning of the operation (T1, 5 minutes after the removing of the cross clamp (T2, 10 minutes after the end of the CPB (T3 and 6 hours of the operation (T4. Results: The groups were comparable regarding demographic features; preoperative characteristics; duration of CPB, aortic cross clamping, and anesthesia; intra- and postoperative hemodynamicparameters; inotrope and vasopressor needs; blood products and fluid requirements; and extubation times (p>0.05 for all. Compared to baseline values, in both groups serum IL-1, IL-6, TNF-alpha and p-selectin levels increased significantly at the 5 minutes after the opening of the cross clamp, termination of CPB and 6 hours after surgery (p0.05 for all. Patients in atorvastatin group had a significantly shorter intensive care unit (ICU length of stay than the control group (56.7±19.5 hours vs 72.5±26.6 hours, P=0.008. Conclusion: Pretreatment with atorvastatin did not decrease CPB induced inflammatory response in our CABG patients. The shorter length of ICU stay in our atorvastatin users needs to be further evaluated. (Journal of the Turkish Society of Intensive Care 2011; 9: 1-7

  3. Study on radiation graft copolymerization of MMA onto SBS. Pt.1: Liquid phase radiation graft copolymerization

    International Nuclear Information System (INIS)

    This paper introduces mainly experimental results of graft copolymerization of styrene-butadiene-styrene (SBS) with methyl methacrylate (MMA) in solution by ?-ray irradiation. Effects of irradiation dose and monomer concentration on mass increment and graft yield onto two types of SBS have been discussed. FTIR characterization of the irradiated samples showed that the monomer had been grated to the SBS molecular chains, while thermal performance of the graft products, SBS-g-MMA, was measured by DSC. (authors)

  4. Complications in skin grafts when continuing antithrombotic therapy prior to cutaneous surgery requiring skin grafting

    DEFF Research Database (Denmark)

    Jarjis, Reem Dina; Jørgensen, Lone; Finnerup, Kenneth; Birk-Sørensen, Lene

    2015-01-01

    Abstract The risk of postoperative bleeding and wound healing complications in skin grafts among anticoagulated patients undergoing cutaneous surgery has not been firmly established. The objective was to examine the literature and assess the risk of postoperative bleeding or wound healing complications in skin grafts among anticoagulated patients, compared with patients who discontinue or patients who are not receiving antithrombotic therapy prior to cutaneous surgery requiring skin grafting. A ...

  5. Hybrid Repair of Complex Thoracic Aortic Arch Pathology: Long-Term Outcomes of Extra-anatomic Bypass Grafting of the Supra-aortic Trunk

    International Nuclear Information System (INIS)

    Hybrid repair constitutes supra-aortic debranching before thoracic endovascular aortic repair (TEVAR). It offers improved short-term outcome compared with open surgery; however, longer-term studies are required to assess patient outcomes and patency of the extra-anatomic bypass grafts. A prospectively maintained database of 380 elective and urgent patients who had undergone TEVAR (1997–2011) was analyzed retrospectively. Fifty-one patients (34 males; 17 females) underwent hybrid repair. Median age was 71 (range, 18–90) years with mean follow-up of 15 (range, 0–61) months. Perioperative complications included death: 10 % (5/51), stroke: 12 % (6/51), paraplegia: 6 % (3/51), endoleak: 16 % (8/51), rupture: 4 % (2/51), upper-limb ischemia: 2 % (1/51), bypass graft occlusion: 4 % (2/51), and cardiopulmonary complications in 14 % (7/51). Three patients (6 %) required emergency intervention for retrograde dissection: (2 aortic root repairs; 2 innominate stents). Early reintervention was performed for type 1 endoleak in two patients (2 proximal cuff extensions). One patient underwent innominate stenting and revision of their bypass for symptomatic restenosis. At 48 months, survival was 73 %. Endoleak was detected in three (6 %) patients (type 1 = 2; type 2 = 1) requiring debranching with proximal stent graft (n = 2) and proximal extension cuff (n = 1). One patient had a fatal rupture of a mycotic aneurysm and two arch aneurysms expanded. No bypass graft occluded after the perioperative period. Hybrid operations to treat aortic arch disease can be performed with results comparable to open surgery. The longer-term outcomes demonstrate low rates of reintervention and high rates of graft patency.

  6. Hybrid Repair of Complex Thoracic Aortic Arch Pathology: Long-Term Outcomes of Extra-anatomic Bypass Grafting of the Supra-aortic Trunk

    Energy Technology Data Exchange (ETDEWEB)

    Lotfi, S., E-mail: shamim.lotfi@kcl.ac.uk; Clough, R. E.; Ali, T. [Guy' s and St. Thomas' NHS Trust, Vascular Surgery (United Kingdom); Salter, R. [Guy' s and St. Thomas' NHS Trust, Interventional Radiology (United Kingdom); Young, C. P. [Guy' s and St. Thomas' NHS Trust, Cardiac Surgery (United Kingdom); Bell, R.; Modarai, B.; Taylor, P., E-mail: peter.taylor@gstt.nhs.uk [Guy' s and St. Thomas' NHS Trust, Vascular Surgery (United Kingdom)

    2013-02-15

    Hybrid repair constitutes supra-aortic debranching before thoracic endovascular aortic repair (TEVAR). It offers improved short-term outcome compared with open surgery; however, longer-term studies are required to assess patient outcomes and patency of the extra-anatomic bypass grafts. A prospectively maintained database of 380 elective and urgent patients who had undergone TEVAR (1997-2011) was analyzed retrospectively. Fifty-one patients (34 males; 17 females) underwent hybrid repair. Median age was 71 (range, 18-90) years with mean follow-up of 15 (range, 0-61) months. Perioperative complications included death: 10 % (5/51), stroke: 12 % (6/51), paraplegia: 6 % (3/51), endoleak: 16 % (8/51), rupture: 4 % (2/51), upper-limb ischemia: 2 % (1/51), bypass graft occlusion: 4 % (2/51), and cardiopulmonary complications in 14 % (7/51). Three patients (6 %) required emergency intervention for retrograde dissection: (2 aortic root repairs; 2 innominate stents). Early reintervention was performed for type 1 endoleak in two patients (2 proximal cuff extensions). One patient underwent innominate stenting and revision of their bypass for symptomatic restenosis. At 48 months, survival was 73 %. Endoleak was detected in three (6 %) patients (type 1 = 2; type 2 = 1) requiring debranching with proximal stent graft (n = 2) and proximal extension cuff (n = 1). One patient had a fatal rupture of a mycotic aneurysm and two arch aneurysms expanded. No bypass graft occluded after the perioperative period. Hybrid operations to treat aortic arch disease can be performed with results comparable to open surgery. The longer-term outcomes demonstrate low rates of reintervention and high rates of graft patency.

  7. New guidelines for cardiopulmonary resuscitation Nuevas directrices para la resucitación cardiopulmonar Novas diretrizes da ressuscitação cardiopulmonar

    Directory of Open Access Journals (Sweden)

    Maria Celia Barcellos Dalri

    2008-12-01

    Full Text Available Cardiopulmonary arrest (CPA poses a severe threat to life; cardiopulmonary resuscitation (CPR represents a challenge for research and assessment by nurses and their team. This study presents the most recent international recommendations for care in case of cardiopulmonary heart arrest, based on the 2005 Guidelines by the American Heart Association (AHA. These CPR guidelines are based on a large-scale review process, organized by the International Liaison Committee on Resuscitation (ILCOR. High-quality basic and advanced CPR maneuvers can save lives.La parada cardiorrespiratoria (PCR es una ocurrencia que presenta una grave amenaza a la vida; la resucitación cardiopulmonar (RCP representa un desafío para la investigación y la evaluación por parte del enfermero y su equipo. Este estudio presenta las más recientes recomendaciones internacionales sobre la atención a la parada cardiorrespiratoria, basada en las Directrices de 2005 de la American Heart Asociation (AHA. Esas directrices sobre RCP se fundamentan en un proceso de revisión extenso, organizado por el International Liasion Committee on Resuscitation (ILCOR. Las maniobras básicas y avanzadas de RCP ofrecidas con calidad pueden salvar vidas.A parada cardiorrespiratória (PCR é intercorrência de grave ameaça à vida; a ressuscitação cardiopulmonar (RCP representa desafio para a investigação e a avaliação por parte do enfermeiro e sua equipe. Esse estudo apresenta as mais recentes recomendações internacionais sobre atendimento da parada cardiorrespiratória, baseado nas Diretrizes de 2005 da American Heart Association (AHA. Essas diretrizes sobre RCP fundamentam-se num processo de revisão extenso, organizado pelo International Liasion Committee on Resuscitation (ILCOR. As manobras básicas e avançadas de RCP com qualidade podem salvar vidas.

  8. Quantitative blood flow measurements in the small animal cardiopulmonary system using digital subtraction angiography

    International Nuclear Information System (INIS)

    Purpose: The use of preclinical rodent models of disease continues to grow because these models help elucidate pathogenic mechanisms and provide robust test beds for drug development. Among the major anatomic and physiologic indicators of disease progression and genetic or drug modification of responses are measurements of blood vessel caliber and flow. Moreover, cardiopulmonary blood flow is a critical indicator of gas exchange. Current methods of measuring cardiopulmonary blood flow suffer from some or all of the following limitations--they produce relative values, are limited to global measurements, do not provide vasculature visualization, are not able to measure acute changes, are invasive, or require euthanasia. Methods: In this study, high-spatial and high-temporal resolution x-ray digital subtraction angiography (DSA) was used to obtain vasculature visualization, quantitative blood flow in absolute metrics (ml/min instead of arbitrary units or velocity), and relative blood volume dynamics from discrete regions of interest on a pixel-by-pixel basis (100x100 ?m2). Results: A series of calibrations linked the DSA flow measurements to standard physiological measurement using thermodilution and Fick's method for cardiac output (CO), which in eight anesthetized Fischer-344 rats was found to be 37.0±5.1 ml/min. Phantom experiments were conducted to calibrate the radiographic density to vessel thickness, allowing a link of DSA cardiac output measurements to cardiopulmonary blood flow measurements in discrete regions of interest. The scaling factor linking relative DSA cardiac output measurements to the Fick's absolute measurements was found to be 18.90xCODSA=COFick. Conclusions: This calibrated DSA approach allows repeated simultaneous visualization of vasculature and measurement of blood flow dynamics on a regional level in the living rat.

  9. Quantitative blood flow measurements in the small animal cardiopulmonary system using digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lin Mingde; Marshall, Craig T.; Qi, Yi; Johnston, Samuel M.; Badea, Cristian T.; Piantadosi, Claude A.; Johnson, G. Allan [Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States)

    2009-11-15

    Purpose: The use of preclinical rodent models of disease continues to grow because these models help elucidate pathogenic mechanisms and provide robust test beds for drug development. Among the major anatomic and physiologic indicators of disease progression and genetic or drug modification of responses are measurements of blood vessel caliber and flow. Moreover, cardiopulmonary blood flow is a critical indicator of gas exchange. Current methods of measuring cardiopulmonary blood flow suffer from some or all of the following limitations--they produce relative values, are limited to global measurements, do not provide vasculature visualization, are not able to measure acute changes, are invasive, or require euthanasia. Methods: In this study, high-spatial and high-temporal resolution x-ray digital subtraction angiography (DSA) was used to obtain vasculature visualization, quantitative blood flow in absolute metrics (ml/min instead of arbitrary units or velocity), and relative blood volume dynamics from discrete regions of interest on a pixel-by-pixel basis (100x100 {mu}m{sup 2}). Results: A series of calibrations linked the DSA flow measurements to standard physiological measurement using thermodilution and Fick's method for cardiac output (CO), which in eight anesthetized Fischer-344 rats was found to be 37.0{+-}5.1 ml/min. Phantom experiments were conducted to calibrate the radiographic density to vessel thickness, allowing a link of DSA cardiac output measurements to cardiopulmonary blood flow measurements in discrete regions of interest. The scaling factor linking relative DSA cardiac output measurements to the Fick's absolute measurements was found to be 18.90xCO{sub DSA}=CO{sub Fick}. Conclusions: This calibrated DSA approach allows repeated simultaneous visualization of vasculature and measurement of blood flow dynamics on a regional level in the living rat.

  10. Graft Rejection and Graft Failure After Penetrating Keratoplasty or Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy

    DEFF Research Database (Denmark)

    Hjortdal, Jesper; Pedersen, Iben B

    2013-01-01

    PURPOSE:: To compare the frequency of rejection episodes and graft failure because of surgical complications or rejection after Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK) for Fuchs endothelial dystrophy. METHODS:: A total of 201 eyes of 201 consecutive patients with Fuchs endothelial dystrophy undergoing keratoplasty were included. One hundred two patients underwent DSAEK and 99 PK in the period January 1, 2000, to December 31, 2010. Postoperative topical steroid treatment was similar in the 2 groups. Most patients in the PK group received a short course of oral prednisolone, which was not prescribed for patients undergoing DSAEK. Patient records were retrospectively reviewed; rejection episodes and causes of graft failures were recorded, and Kaplan-Meier survival curves up to 5 years after surgery were computed and compared. RESULTS:: All rejection episodes and most graft failures occurred during the first 2 years after surgery. In this period, rejection episodes were noted in 16% of PK and in 5% of DSAEK-treated eyes (P = 0.03). During the first 5 years, significantly more DSAEK grafts than PK grafts had failed (P = 0.04) but only 2 PK-treated and no DSAEK-treated grafts failed because of rejection. CONCLUSION:: The frequency of graft rejection episodes is higher after PK than DSAEK for primary endothelial disease, despite the use of oral prednisolone in the PK group. Early graft failure is more common after DSAEK than after PK, whereas graft failure because of previous rejection episodes is uncommon after DSAEK and PK.

  11. Effect of monomer concentration on the degree of grafting and mechanical properties of grafted rubber film

    International Nuclear Information System (INIS)

    The effect of concentration of monomer on the properties of grafted rubber film was studied. =rays obtained from Co-60 source were used as initiator for grafting. For this purpose latex concentration was kept constant. The mechanical properties of grafted rubber films like tensile strength, modulus, tear strength and elongation at break were determined. Tensile strength attains maximum at 50 phr (parts per hundred rubber) concentration of monomer and after this concentration it remains almost unchanged. On the other hand tear strength and modulus increase with increase in concentration of monomer but elongation at break decreases. The conversion of monomer to polymers and degree of grafting were also determined. (author)

  12. Kinetic and mechanism of radiation-induced graft copolymerization for two grafting systems

    International Nuclear Information System (INIS)

    The graft copolymerization of glycidyl methacrylate (GMA) and vinylbenzyl chloride (VBC) onto nylon fiber was investigated by the pre-irradiation method using electron beam. The effects of grafting parameters, such as monomer concentration, absorbed dose and reaction temperature were investigated. The empirical kinetic rate equations: dG0/ dt = k(Mg0)1.14(Ag)0.52 and dG0/dt = k(Mv0)0.86(Av)1.06, were used to describe grafting of GMA and VBC, respectively. The overall activation energy for graft copolymerization of GMA and VBC were found to be 5.4 and 22.6 kJ/mol, respectively. The results revealed that the grafting kinetics in the two grafting systems were both controlled by the amounts of trapped radicals and monomer molecules. The grafting of GMA onto nylon-6 fibers was found to exhibit higher dependency on the quantity of monomer molecules available, whereas the VBC grafting system was found to exhibit higher dependency on the quantity of trapped radicals. Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM) were used to provide evidence for the formation of graft copolymers. (author)

  13. Non-contact cardiopulmonary monitoring algorithm for a 24 GHz Doppler radar.

    Science.gov (United States)

    Birsan, Nicusor; Munteanu, Doru-Petru

    2012-01-01

    The paper presents the particularities of using a Doppler radar in the 24 GHz band for non-contact cardiopulmonary monitoring. To separate heart beat from respiration we looked for a pattern in time-frequency domain instead of trying to extract directly the distance from phase observation in the baseband signal. By selecting the proper components from the Gabor transform prior expansion we obtained good accuracy for heart beat and respiration rates. Also, with minor correction in frequency, the algorithm leads to usable heartbeat waveform, opening new doors for further information extraction. PMID:23366613

  14. Touch-less Heartbeat Detection and Measurement-based Cardiopulmonary Modeling

    OpenAIRE

    Obeid, Dany; Sadek, Sawsan; Zaharia, Gheorghe; El Zein, Ghais

    2010-01-01

    This paper presents a system for touch-less heartbeat detection and a cardiopulmonary signal modeling approach. Using a vector network analyzer, a microwave system is tested in detecting the heartbeat signal at a distance of 1-m from a person. The proposed system shows the ability of detecting the heartbeat signals with the possibility of tuning both frequency and power; measurements are performed at 2.4, 5.8, 10, 16, and 60 GHz, as well as at different power levels between 0 and -27 dBm. Bas...

  15. Cardiopulmonary Bypass and Extracorporeal Life Support for Emergent Intraoperative Thoracic Situations.

    Science.gov (United States)

    Machuca, Tiago N; Cypel, Marcelo; Keshavjee, Shaf

    2015-08-01

    Intraoperative thoracic surgical catastrophes may require extracorporeal circulation modes to support the patient while the appropriate repair is made. Teamwork is key and, given the evidence supporting better performance with the use of simulation and surgical-crisis checklists, their use should be encouraged. Anticipation is another important factor because the results of intrathoracic malignancy resection are clearly superior in the setting of planned cardiopulmonary support. In addition, familiarity with the different modes of support that are currently available can direct the decision-making process toward the best option to facilitate resolution of the intraoperative catastrophe with the least related morbidity. PMID:26210928

  16. Measurement of end-tidal carbon dioxide concentration during cardiopulmonary resuscitation.

    OpenAIRE

    Steedman, D J; Robertson, C. E.

    1990-01-01

    End-tidal carbon dioxide concentrations were measured prospectively in 12 cardiac arrest patients undergoing cardiopulmonary resuscitation (CPR) in an accident and emergency department. The end-tidal carbon dioxide (CO2) concentration decreased from a mean (+/- SD) of 4.55 +/- 0.88% 1 min after chest compression and ventilation was established, to values ranging from 2.29 +/- 0.84% at 2 min to 1.56 +/- 0.66% following 8 min of CPR. Spontaneous circulation was restored in five patients. This w...

  17. Publications of the Space Physiology and Countermeasures Program, Cardiopulmonary Discipline: 1980-1990

    Science.gov (United States)

    Powers, Janet V.; Wallace-Robinson, Janice; Dickson, Katherine J.; Hess, Elizabeth

    1992-01-01

    A 10-year cumulative bibliography of publications resulting from research supported by the Cardiopulmonary Discipline of the Space Physiology and Countermeasures Program of NASA's Life Sciences Division is provided. Primary subjects included in this bibliography are Fluid Shifts, Cardiovascular Fitness, Cardiovascular Physiology, and Pulmonary Physiology. General physiology references are also included. Principal investigators whose research tasks resulted in publication are identified. Publications are identified by a record number corresponding with their entry in the Life Sciences Bibliographic Database, maintained at the George Washington University.

  18. Modelling ventricular fibrillation coarseness during cardiopulmonary resuscitation by mixed effects stochastic differential equations.

    Science.gov (United States)

    Gundersen, Kenneth; Kvaløy, Jan Terje; Eftestøl, Trygve; Kramer-Johansen, Jo

    2015-10-15

    For patients undergoing cardiopulmonary resuscitation (CPR) and being in a shockable rhythm, the coarseness of the electrocardiogram (ECG) signal is an indicator of the state of the patient. In the current work, we show how mixed effects stochastic differential equations (SDE) models, commonly used in pharmacokinetic and pharmacodynamic modelling, can be used to model the relationship between CPR quality measurements and ECG coarseness. This is a novel application of mixed effects SDE models to a setting quite different from previous applications of such models and where using such models nicely solves many of the challenges involved in analysing the available data. PMID:26013575

  19. Emergency management of heat exchanger leak on cardiopulmonary bypass with hypothermia.

    Science.gov (United States)

    Gukop, P; Tiezzi, A; Mattam, K; Sarsam, M

    2015-11-01

    Heat exchanger leak on cardiopulmonary bypass is very rare, but serious. The exact incidence is not known. It is an emergency associated with the potential risk of blood contamination, air embolism and haemolysis, difficulty with re-warming, acidosis, subsequent septic shock, multi-organ failure and death. We present a prompt, highly co-ordinated algorithm for the successful management of this important rare complication. There is need for further research to look for safety devices that detect leaks and techniques to reduce bacterial load. It is essential that teams practice oxygenator change-out routines and have a well-established change-out protocol. PMID:25870370

  20. Cardiopulmonary Function, Exercise Capacity, and Echocardiography Finding of Pediatric Patients With Kawasaki Disease

    OpenAIRE

    Tuan, Sheng-Hui; Li, Min-Hui; Hsu, Miao-Ju; Tsai, Yun-Jeng; Chen, Yin-Han; Liao, Tin-Yun; Lin, Ko-Long

    2016-01-01

    Abstract Coronary artery (CA) abnormalities influence exercise capacity (EC) of patients with Kawasaki disease (KD), and Z-score of CA is a well established method for detecting CA aneurysm. We studied the influence of KD on cardiopulmonary function and EC; meanwhile we analyzed echocardiographic findings of KD patients. We also assessed the correlation between CA Z-score and EC of KD patients to see if CA Z-score of KD patients could reflect EC during exercise. Sixty-three KD patients were r...

  1. Should blood flow during cardiopulmonary bypass be individualized more than to body surface area?

    DEFF Research Database (Denmark)

    Thomassen, Sisse Anette; Larsson, A; Andreasen, Jan Jesper; Bundgaard, W; Bøgsted, M; Rasmussen, Bodil Steen

    2011-01-01

    Blood flow during cardiopulmonary bypass (CPB) is calculated on body surface area (BSA). Increasing comorbidity, age and weight of today's cardiac patients question this calculation as it may not reflect individual metabolic requirement. The hypothesis was that a measured cardiac index (CI) prior to normothermic CPB is a better estimate. A cross-over study, with random allocation to CPB blood flow for 20 minutes based on either a calculation (2.4 L/min/m(2)) or on CI, with a switch to the opposi...

  2. Expression of adhesion and activation molecules on lymphocytes during open-heart surgery with cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Toft, P; Tønnesen, Else Kirstine; Zülow, I; Nielsen, C H; Hokland, Marianne

    1997-01-01

    Open-heart surgery with cardiopulmonary bypass (CPB) and abdominal surgery are associated with lymphocytopenia. We measured a panel of adhesion and activation molecules on lymphocytes to clarify possible association of CPB with increased expression of these molecules. Eight patients undergoing open-heart surgery and eight with abdominal surgery were studied. The adhesion molecules CD11a/CD18 (LFA-1_, CD11c/CD18 and CD44 and the activation molecules CD25, CD69, CD71 and MHCII were measured, using...

  3. Surgical removal of an embolized patent ductus arteriosus coil from pulmonary artery without cardiopulmonary bypass.

    Science.gov (United States)

    Aydin, Hakan; Ozisik, Kanat

    2009-06-01

    We report the case of a 4-month-old girl who underwent patent ductus arteriosus (PDA) coil embolization. The coil had migrated into the left pulmonary artery and attempts to retrieve it with interventional techniques were unsuccessful. To prevent late effects of a foreign object in pulmonary artery, the patient was referred to surgery. The operation was done without cardiopulmonary bypass (CPB) and with the aid of a Fogarty catheter. Recovery was uneventful after the procedure. As far as we know this is the first patient in whom CPB was not used for coil removal. PMID:19324917

  4. Electrical failure during cardiopulmonary bypass: an evaluation of incidence, causes, management and guidelines for preventative measures.

    LENUS (Irish Health Repository)

    Hargrove, M

    2012-02-03

    The incidence of electrical failure during cardiopulmonary bypass (CPB) has been reported to occur in approximately 1 per 1000 cases. While the resultant morbidity and mortality is low, electrical failure is a life-threatening scenario. We report three major electrical failures during CPB in a patient population of 3500 over a 15-year period. These cases involved mains failure and generator shut down, mains failure and generator power surge, and failure of the uninterruptable power supply (UPS), which caused protected sockets to shut down. Protocols for preventative maintenance, necessary equipment, battery backup and guidelines for the successful management of such accidents during CPB are discussed.

  5. Should blood flow during cardiopulmonary bypass be individualized more than to body surface area?

    DEFF Research Database (Denmark)

    Thomassen, Sisse Anette; Larsson, A; Andreasen, Jan Jesper; Bundgaard, W; Rasmussen, Bodil Steen

    Blood flow during cardiopulmonary bypass (CPB) is calculated on body surface area (BSA). Increasing comorbidity, age and weight of today's cardiac patients question this calculation as it may not reflect individual metabolic requirement. The hypothesis was that a measured cardiac index (CI) prior...... normal ventricular function were included. Effect parameters were cerebral oxygenation, mixed venous saturation and arterial lactate. CI varied from 1.9 to 3.1 L/min/m(2) (median 2.4 L/min/m(2)). No differences in effect parameters were seen. In conclusion, a CPB blood flow based on an individual...

  6. Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players

    OpenAIRE

    R.R. Perim; G.R. Signorelli; Araújo, C.G.S.

    2011-01-01

    During cardiopulmonary exercise testing (CPET), stroke volume can be indirectly assessed by O2 pulse profile. However, for a valid interpretation, the stability of this variable over time should be known. The objective was to analyze the stability of the O2 pulse curve relative to body mass in elite athletes. VO2, heart rate (HR), and relative O2 pulse were compared at every 10% of the running time in two maximal CPETs, from 2005 to 2010, of 49 soccer players. Maximal values of VO2 (63.4 ± 0....

  7. Effect of short-acting beta blocker on the cardiac recovery after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Qian Yanning

    2011-08-01

    Full Text Available Abstract The objective of this study was to investigate the effect of beta blocker on cardiac recovery and rhythm during cardiac surgeries. Sixty surgical rheumatic heart disease patients were received esmolol 1 mg/kg or the same volume of saline prior to removal of the aortic clamp. The incidence of cardiac automatic re-beat, ventricular fibrillation after reperfusion, the heart rate after steady re-beat, vasoactive drug use during weaning from bypass, the posterior parallel time and total bypass time were decreased by esmolol treatment. In conclusion: Esmolol has a positive effect on the cardiac recovery in cardiopulmonary bypass surgeries.

  8. The 5-strand hamstring graft in anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Lee, Rushyuan Jay; Ganley, Theodore J

    2014-10-01

    The use of anterior cruciate ligament reconstruction in the pediatric and adolescent population has been increasing in recent years. Autograft hamstring graft is favored in this population, but these patients often have smaller hamstring tendons that yield smaller final graft constructs. These smaller grafts are associated with an increased need for revision surgery. We describe a technique for obtaining a larger-diameter anterior cruciate ligament graft construct from autologous hamstring graft without allograft supplementation. PMID:25473619

  9. Graft copolymerization of acrylonitrile onto polypropylene membrane by preirradiation

    International Nuclear Information System (INIS)

    A porous, graft copolymer and amidoxime group containing membrane were prepared by radiation graft copolymerization of acrylonitrile onto porous polypropylene. In order to calculate the grafting and amidoxime ratios of porous polypropylene-acrylonitrile graft copolymer. We have done CHN elemental analysis. It is obtained the result that grafting rate is increased to linear and value was about 75 percent at 20 Mrad dose rate. (Author)

  10. Fabrication of Custom-Shaped Grafts for Cartilage Regeneration

    OpenAIRE

    Koo, Seungbum; Hargreaves, Brian A; GOLD, GARRY E.; Dragoo, Jason L

    2010-01-01

    Transplantation of engineered cartilage grafts is a promising method to treat diseased articular cartilage. The interfacial areas between the graft and the native tissues play an important role in the successful integration of the graft to adjacent native tissues. The purposes of the study were to create a custom shaped graft through 3D tissue shape reconstruction and rapid-prototype molding methods using MRI data, and to test the accuracy of the custom shaped graft against the original anato...

  11. Aneurysms and pseudoaneurysms of saphenous vein coronary artery bypass grafts

    OpenAIRE

    Le Breton, H; Pavin, D; Langanay, T; Roland, Y; Leclercq, C; Beliard, J; Bedossa, M; Rioux, C.; Pony, J

    1998-01-01

    Aneurysms of saphenous vein grafts to coronary arteries are unusual complications of coronary artery bypass graft (CABG) surgery. Three patients (men aged 47, 62, and 68 years) are presented with spontaneous chest pains 10, 21, and 17 years after CABG surgery. In one case, the saphenous vein graft had eroded into the right atrium and had established a fistula between the graft and the right atrium. Diagnosis of saphenous vein graft aneurysms was confirmed by echocardiography, computed tomogra...

  12. Policies for full employment

    OpenAIRE

    Koning, Jaap de; Layard, Richard; Nickel, Stephen; Westergård-Nielsen, Niels Chr.

    2008-01-01

    European unemployment is too high, and employment is too low. Over 7½ per cent of Europe's workforce is unemployed, and only two thirds of people aged 15-64 are in work. At the Lisbon summit two years ago the heads of government set the target that by 2010 the employment rate should rise from 64 per cent to at least 70 per cent. And for older workers between 55 and 64 the employment rate should rise from 38 per cent to at least one half. These are ambitious targets. They will require two big ...

  13. Radiation-induced grafting onto wool

    International Nuclear Information System (INIS)

    Radiation-induced grafting tests were done on single wool fibres. Different vinyl monomers were used for this purpose and they were grafted in twenty different solvents which were selected for their swelling effiency and solvent parameters. The tests were done once with and once without the addition of water. The presence of water causes the polymer uptake to increase considerably. Formic acid/methanol and methanol were found to be the most suitable solvent systems, as they have the highest hydrogen-bond interaction effiency. The moisture uptake of wool depends on the hydrophily and hydrophoby of the grafted polymers. The single-fibre tests serve as a basis for analogous grafting tests on wool fabrics. The permanent- press was improved by graftng with hydrophoric polymers and polymers with a high glass-transition temperature

  14. Mechanical Bench Grafting for Apple Propagation

    OpenAIRE

    Muhammad Ashraf Sumrah; Allah Bakhsh; Zahid Hussain; Shafique Ahmad

    2002-01-01

    Mechanically and manually prepared stock and scion for bench grafting were adopted in four phases for apple propagation i.e., mechanically made stock and manually prepared scion, second phase was vice versa while in third stage both the stock and scion were prepared mechanically. In fourth operation all the grafting process was performed by hand made scion and stock. Maximum sprouting and success percentage of 93.2 and 83.2 respectively was recorded in the mechanically prepared scion and stoc...

  15. Biomaterials in Maxillofacial Surgery: Membranes and Grafts

    OpenAIRE

    Rodella, Luigi F.; Favero, Gaia; Labanca, Mauro

    2011-01-01

    Today, significant differences in the use of biomaterials (membranes and grafts) of animal or synthetic origin have yet to be reported. Nevertheless, some evidences suggest that synthetic materials have a lower risk of disease transmission. This review aims to assess the available informations on regenerative bone technique using reasorbable membranes and bone grafts. In particular, biocompatibility, immunological response, tissue reaction, reabsorption time and histological features of mater...

  16. Seeking for the ideal stent graft

    OpenAIRE

    Isa Cristina Teixeira Santos; Luís Rocha; João Manuel Ribeiro da Silva Tavares

    2010-01-01

    Aortic aneurysms are localized dilatations of the aorta that if not treated may lead to death. One of the current treatments is endovascular repair, a minimal invasive procedure in which a stent graft is placed transluminally to prevent wall rupture shielding the aneurysm from blood pressure. Stent grafts are classified as class III medical devices. They are composed of a metallic scaffold covered by a polymeric membrane. While early devices were custom designed by the operating surgeon, n...

  17. Free vascularised fibular grafts in orthopaedics

    OpenAIRE

    Bumbasirevic, Marko; Stevanovic, Milan; Bumbasirevic, Vesna; Lesic, Aleksandar; Atkinson, Henry D. E.

    2014-01-01

    Bony defects caused by trauma, tumors, infection or congenital anomalies can present a significant surgical challenge. Free vascularised fibular bone grafts (FVFGs) have proven to be extremely effective in managing larger defects (longer than 6 cm) where other conventional grafts have failed. FVFGs also have a role in the treatment of avascular necrosis (AVN) of the femoral head, failed spinal fusions and complex arthrodeses. Due to the fact that they have their own blood supply, FVFGs are ef...

  18. Grafting of a LLDPE using gamma irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Catari, E. [Centro de Quimica, Laboratorio de Polimeros Instituto Venezolano de Investigaciones Cientificas (IVIC) (Venezuela); Albano, C. [Centro de Quimica, Laboratorio de Polimeros Instituto Venezolano de Investigaciones Cientificas (IVIC) (Venezuela) and Universidad Central de Venezuela, Facultad de Ingenieria, Escuela de Ingenieria Quimica (Venezuela)]. E-mail: calbano@ivic.ve; Karam, A. [Centro de Quimica, Laboratorio de Polimeros Instituto Venezolano de Investigaciones Cientificas (IVIC) (Venezuela)]. E-mail: akaram@quimica.ivic.ve; Perera, R. [Departamento de Mecanica, Universidad Simon Bolivar (Venezuela); Silva, P. [Centro de Fisica, Laboratorio de Fisica de la Materia Condensada, Instituto Venezolano de Investigaciones Cientificas (IVIC), Caracas (Venezuela); Gonzalez, J. [Departamento de Mecanica, Universidad Simon Bolivar (Venezuela)

    2005-07-01

    In this investigation, the grafting of a commercial linear low-density polyethylene (LLDPE) with different concentrations of diethyl maleate (DEM, 5 and 15 wt.%) was carried out at different absorbed doses from a cobalt-60 source of gamma rays (0, 15, 30, 50, 100, 200 kGy). This process was performed in a decalin solution at 10% w/v to obtain a homogeneous dispersion of the monomer into the polyethylene matrix. The grafting degree was estimated by means of FTIR using a calibration curve reported in literature. Thermal properties of the functional polymers were studied by thermogravimetric analysis (TGA). Melt flow index (MFI) values were also taken. The results found indicate that the grafting degree increases as the concentration of DEM in the reaction mixture and the absorbed doses are increased upto 100 kGy, as expected. However, the behavior at higher doses is attributed to secondary reactions such as long-chain branching and/or crosslinking, which are faster than radical reactions responsible for the grafting of the DEM onto the polymeric chain. This fact was ascertained by the decrease of the MFI values as the applied irradiation was increased, irrespective of the quantity of DEM used in the grafting reaction. Therefore, in order to obtain a high grafting degree, the absorbed dose should be estimated carefully. Initial degradation temperatures of the grafted PEs decreased when the gamma irradiation dose was higher than 100 kGy. This indicates that the thermal stability decreases as higher doses are applied to the material, which is associated to branching and crosslinking. The grafting degree never exceeded 0.3 mol%, which demonstrates the low efficiency of the functionalization procedure here presented.

  19. Youth Employment and Unemployment

    Science.gov (United States)

    OECD Observer, 1977

    1977-01-01

    Discusses youth employment and unemployment in Canada, France, Germany, Italy, Japan, United Kingdom, and the United States; the trends, causes, consequences, policy goals, and specific measures needed to resolve problems. (SL)

  20. Globalisation, growth and employment

    OpenAIRE

    Michie , Jonathan; Oughton, Christine; Zanfei, Antonello

    2002-01-01

    The full-text of this article is not available in ORA at this time. Citation: Michie, J., Oughton, C. & Zanfei, A. (2002). 'Globalisation, growth and employment', Journal of Interdisciplinary Economics, 13(1-3), 1-12.

  1. Effect of different grafting methods for absorption, translocation and distribution of 59Fe in apple trees

    International Nuclear Information System (INIS)

    The test result with 59Fe demonstrate that the iron content in leaves by belly grafting is higher than that by cleft grafting and cutting grafting, and the content of chlorophyll in leaves and height and diameter of apple seedling by belly grafting is larger than cleft grafting and cutting grafting too. It is important to replace cleft grafting and cutting grafting with belly grafting as a method of top-working to correct chlorosis and improve growth of new cultivar

  2. Development aid and employment

    OpenAIRE

    Hoeven, R.E. van der

    2012-01-01

    Abstract. Globalization has led to a precarization of labour, which especially manifests in the unstable working conditions, a lower labour share in national income as well as in a growing income inequality, with the exception of some countries with high initial income inequality. The neglect of concern for employment and inequality in the formulation of the Millennium Development Goals (MDGs) in 2000 is noted; the addition of a goal for full employment in a reformulation of th...

  3. Technology, Employment and Wages

    OpenAIRE

    Addison, John T.; Teixeira, Paulino

    2001-01-01

    This paper examines the contribution of technological change to changes in the structure of relative employment and wages. Even if the nature of demand-side forces is fairly clear – international trade being of secondary importance because of the modest size of the between-industry employment shifts – the identification of the fundamental causes of skill-biased technological change, the techniques involved, and the manner of their adoption by firms is not transparent. Accordingly the skill-bi...

  4. Development Aid and Employment

    OpenAIRE

    van der Hoeven, Rolph

    2012-01-01

    Abstract. Globalization has led to a precarization of labour, which especially manifests in the unstable working conditions, a lower labour share in national income as well as in a growing income inequality, with the exception of some countries with high initial income inequality. The neglect of concern for employment and inequality in the formulation of the Millennium Development Goals (MDGs) in 2000 is noted; the addition of a goal for full employment in a reformulation of the MDGs in 2005 ...

  5. Synthesis and characterization of nanoscale polymer films grafted to metal surfaces

    Science.gov (United States)

    Galabura, Yuriy

    Anchoring thin polymer films to metal surfaces allows us to alter, tune, and control their biocompatibility, lubrication, friction, wettability, and adhesion, while the unique properties of the underlying metallic substrates, such as magnetism and electrical conductivity, remain unaltered. This polymer/metal synergy creates significant opportunities to develop new hybrid platforms for a number of devices, actuators, and sensors. This present work focused on the synthesis and characterization of polymer layers grafted to the surface of metal objects. We report the development of a novel method for surface functionalization of arrays of high aspect ratio nickel nanowires/micronails. The polymer "grafting to" technique offers the possibility to functionalize different segments of the nickel nanowires/micronails with polymer layers that possess antagonistic (hydrophobic/hydrophilic) properties. This method results in the synthesis of arrays of Ni nanowires and micronails, where the tips modified with hydrophobic layer (polystyrene) and the bottom portions with a hydrophilic layer (polyacrylic acid). The developed modification platform will enable the fabrication of switchable field-controlled devices (actuators). Specifically, the application of an external magnetic field and the bending deformation of the nickel nanowires and micronails will make initially hydrophobic surface more hydrophilic by exposing different segments of the bent nanowires/micronails. We also investigate the grafting of thin polymer films to gold objects. The developed grafting technique is employed for the surface modification of Si/SiO2/Au microprinted electrodes. When electronic devices are scaled down to submicron sizes, it becomes critical to obtain uniform and robust insulating nanoscale polymer films. Therefore, we address the electrical properties of polymer layers of poly(glycidyl methacrylate) (PGMA), polyacrylic acid (PAA), poly(2-vinylpyridine) (P2VP), and polystyrene (PS) grafted to the Si/SiO2/Au microprinted electrodes. The polymer layers insulated under normal ambient conditions can display a significant increase in conductivity as the environment changes. Namely, we demonstrate that the in-plane electrical conductivity of the grafted polymer layers grafted to Au and SiO2 surfaces can be changed by at least two orders of magnitude upon exposure to water or organic solvent vapors. The conductive properties of all the grafted polymer films under study are also significantly enhanced with temperature increase. The observed phenomenon makes possible the chemical design of polymer nanoscale layers with reduced or enhanced sensitivity to anticipated changes in environmental conditions. Finally, we show that the observed effects can be used in a micron-sized conductometric-transducing scheme for the detection of volatile organic solvents. This research also includes the study of nanoscale-level actuation with grafted polymer films and polymer/gold nanoparticles systems-grafted composites. First, we investigate the nanoscale-level actuation with polymer films. To this end, we use "grafting to" approach to synthesize PGMA thin polymer film (80-200 nm). Then, film is swollen in a good solvent and freeze-dried until the solvent is sublimated, thereby creating grafted polymer nanofoam that exhibits shape memory properties. We demonstrate nanoscale actuation using the developed system. In addition, we show that the modification of the PGMA nanofoam with low molecular weight polystyrene allows response tuning of the porous polymer film. Furthermore, we incorporate gold nanoparticles (5 nm) into a thin PGMA layer (80 nm) to fabricate a PGMA/gold nanoparticles grafted composite film. The PGMA/gold nanoparticles grafted nanofoam is synthesized following the same procedure developed for the fabrication of the PGMA nanofoam. We demonstrate the shape-memory properties and nanoscale-level actuation of the developed system. Moreover, we investigate the change in the optical signal of the developed system as a function of temperature arisi

  6. Polypeptide Grafted Hyaluronan: Synthesis and Characterization

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xiaojun [ORNL; Messman, Jamie M [ORNL; Mays, Jimmy [ORNL; Baskaran, Durairaj [University of Tennessee, Knoxville (UTK)

    2010-01-01

    Poly(L-leucine) grafted hyaluronan (HA-g-PLeu) has been synthesized via a Michael addition reaction between primary amine terminated poly(L-leucine) and acrylate-functionalized HA (TBAHA-acrylate). The precursor hyaluronan was first functionalized with acrylate groups by reaction with acryloyl chloride in the presence of triethylamine in N,N-dimethylformamide. 1H NMR analysis of the resulting product indicated that an increase in the concentration of acryloylchoride with respect to hydroxyl groups on HA has only a moderate effect on functionalization efficiency, f. A precise control of stoichiometry was not achieved, which could be attributed to partial solubility of intermolecular aggregates and the hygroscopic nature of HA. Michael addition at high [PLeu- NH2]/[acrylate]TBAHA ratios gave a molar grafting ratio of only 0.20 with respect to the repeat unit of HA, indicating grafting limitation due to insolubility of the grafted HA-g-PLeu. Soluble HA-g-PLeu graft copolymers were obtained for low grafting ratios (<0.039) with <8.6% by mass of PLeu and were characterized thoroughly using light scattering, 1H NMR, FT-IR, and AFM techniques. Light scattering experiments showed a strong hydrophobic interaction between PLeu chains, resulting in aggregates with segregated nongrafted HA segments. This yields local networks of aggregates, as demonstrated by atomic force microscopy. Circular dichroism spectroscopy showed a -sheet conformation for aggregates of poly(L-leucine).

  7. Graft-copolymerization onto carbon black

    International Nuclear Information System (INIS)

    Radiation-induced graft copolymerization of vinyl monomer onto carbon black was performed. During the ?-ray- and electron beam-induced polymerization (In-source), or the electron beam post-polymerization, the graft-copolymerization behavior was affected by the kinds of both carbon blacks and monomers, i.e. the smaller the size of carbon black particles, the higher the apparent grafted fraction. Homopolymer in the grafted carbon black samples was washed out by the solvent of the polymer, and the extracted polymer seemed to be dimer or trimer of the used monomer. In the case of the post-polymerization with the pre-irradiation doses of 50 Mrad, homopolymer was hardly observed. The polymer sheets of plastics or rubbers with grafted carbon black had an electrical conductivity unalterable considerably by the heating cycles. The particles of grafted carbon black in the sheet might be kept much more at the surface layer within 100 nm depth than at the inner layer. (author)

  8. Deficiency of employability capacity

    Directory of Open Access Journals (Sweden)

    Pelse I.

    2012-10-01

    Full Text Available Young unemployed people have comprised one of the significantly largest groups of the unemployed people in Latvia in recent years. One of the reasons why young people have difficulty integrating into the labour market is the “expectation gap” that exists in the relations between employers and the new generation of workers. Employers focus on capacity-building for employability such individual factors as strength, patience, self-discipline, self-reliance, self-motivation, etc., which having a nature of habit and are developed in a long-term work socialization process, which begins even before the formal education and will continue throughout the life cycle. However, when the socialization is lost, these habits are depreciated faster than they can be restored. Currently a new generation is entering the labour market, which is missing the succession of work socialization. Factors, such as rising unemployment and poverty in the background over the past twenty years in Latvia have created a very unfavourable employability background of “personal circumstances” and “external factors”, which seriously have impaired formation of the skills and attitudes in a real work environment. The study reveals another paradox – the paradox of poverty. Common sense would want to argue that poverty can be overcome by the job. However, the real state of affairs shows that unfavourable coincidence of the individual, personal circumstances and external factors leads to deficit of employability capacity and possibility of marked social and employment deprivation.

  9. Evaluation of Factors Influencing Liver Function Test in On-Pump Coronary Artery Bypass Graft Surgery

    Directory of Open Access Journals (Sweden)

    Shahrbano Shahbazi

    2013-12-01

    Full Text Available Background: Liver dysfunction during on-pump coronary artery bypass graft surgery (CABG is a rare complication but is associated with significant morbidity and mortality. The ability to identify high-risk patients may be helpful in planning appropriate management strategies. We aimed to evaluate the factors influencing liver function tests during on-pump CABG. Methods: In 146 patients scheduled for on-pump CABG, the liver function test was done preoperatively and on the first postoperative day. Some preoperative and intraoperative risk factors were checked and then the postoperative liver function tests were compared with the preoperative ones. Probable relationships between these changes and the preoperative and intraoperative risk factors were studied. Results: A medical history of diabetes had a significant relationship with the changes in direct bilirubin. Preoperative central venous pressure had a significant relationship with the changes in aspartate aminotransferase and alanine aminotransferase. Use of intra-aortic balloon pump and duration of aortic cross-clamp were significantly related to the changes in the liver function tests except for alanine aminotransferase and alkaline phosphatase. Conclusion: It seems that the techniques for the reduction of cardiopulmonary bypass and aortic cross-clamp duration may be useful to protect liver function. We recommend that a larger population of patients be studied to confirm these findings.

  10. Bloodless off pump coronary artery bypass grafting treatment of choice for Jehova's witness patients.

    Science.gov (United States)

    Mujanovic, Emir; Bergsland, Jacob; Jahic, Mirza; Djedovic, Samed; Behrem, Adnan; Stanimirovic-Mujanovic, Sanja; Kabil, Emir

    2012-01-01

    Jehovah's witnesses (JW) belong to a religious group refusing to accept blood transfusion Surgical treatment remains a challenge in this subset of patients. From 1945, JW introduced a ban on accepting blood transfusions, even in life-threatening situations while autologous blood must also be refused if it is predeposited-thus excluding preoperative autodonation. However, autologous blood is acceptable if it is not separated from the patients' circulation at any time. The invasive nature of coronary artery bypass grafting (CABG), the associated decrease of body temperature and the use of cardiopulmonary bypass (CPB) are major reasons for increased blood loss and high incidence for blood transfusions during and after this procedures. Allogenic blood transfusions are often given and considered necessary in such operations, in spite of increased mortality, morbidity and major adverse outcomes resulting from transfusion. Reduction in the use of blood products should therefore be a general desire for every patient due to the associated risk factors. The evolution of less invasive cardiac surgical approaches, such as CABG without CPB (OPCAB) may contribute to a further reduction of blood transfusion and although these minimally invasive techniques may benefit every patient, they might be particularly valuable for JW. In this report, we present our initial experience in JW patient undergoing OPCAB and the way to use patient blood management for improved surgical outcome in such patient. PMID:22486150

  11. Grafting-responsive miRNAs in cucumber and pumpkin seedlings identified by high-throughput sequencing at whole genome level.

    Science.gov (United States)

    Li, Chaohan; Li, Yansu; Bai, Longqiang; Zhang, Tieyao; He, Chaoxing; Yan, Yan; Yu, Xianchang

    2014-08-01

    Grafting is an important agricultural technique widely used for improving growth, yields and tolerance of crops to abiotic and biotic stresses. As one type of endogenous, non-coding small RNAs, microRNAs (miRNAs) regulate development and responsiveness to biotic and abiotic stresses by negatively mediating expression of target genes at the post-transcriptional level. However, there have been few detailed studies to evaluate the role of miRNAs in mediation of grafting-induced physiological processes in plants. Cucumis sativus and Cucurbita moschata are important vegetables worldwide. We constructed eight small RNA libraries from leaves and roots of seedlings that were grafted in the following four ways: (1) hetero-grafting, using cucumber as scion and pumpkin as rootstock; (2) hetero-grafting, with pumpkin as scion and cucumber as rootstock; (3) auto-grafting of cucumbers and (4) auto-grafting of pumpkins. High-throughput sequencing was employed, and more than 120 million raw reads were obtained. We annotated 112 known miRNAs belonging to 40 miRNA families and identified 48 new miRNAs in the eight libraries, and the targets of these known and novel miRNAs were predicted by bioinformatics. Grafting led to changes in expression of most miRNAs and their predicted target genes, suggesting that miRNAs may play significant roles in mediating physiological processes of grafted seedlings by regulating the expression of target genes. The potential role of the grafting-responsive miRNAs in seedling growth and long-distance transport of miRNA was discussed. These results are useful for functional characterization of miRNAs in mediation of grafting-dependent physiological processes. PMID:24279842

  12. Complication after arterial bypass grafting.

    Science.gov (United States)

    Dizon, M; Wallach, P; Matfin, G; Adelman, H M

    1998-10-15

    A 57-year-old man experienced sudden onset of pleuritic chest pain and respiratory distress 10 days after undergoing four-vessel coronary artery bypass grafting (CABG). The surgery was performed after cardiac catheterization had shown right coronary artery dominance and the presence of lesions occluding 40% of the mid right coronary artery, 20% of the left main coronary artery, and 99% of the lower left anterior descending artery and its first diagonal branch. The patient had initially presented with acute dyspnea following an episode of crushing, nonradiating pain in the left chest and was diagnosed as having a non-Q-wave myocardial infarction after cardiac enzyme testing. His hospital course before and immediately after CABG was uneventful. The first sign of difficulty was detected one week after surgery, on day 17. An echocardiogram showed a small pericardial effusion, moderate to severe concentric thickening of the left ventricle, a left ventricular ejection fraction of 0.60 (normal, 0.67 +/- 0.08), normal valves, and normal segmental wall motion. The pleural chest pains began two days later, on day 19. PMID:9793541

  13. Isotopic scintigraphy in kidney grafting

    International Nuclear Information System (INIS)

    Isotopic explorations of kidney transplants were performed on sixty-six patients. Three scintigraphic techniques were used: labelled ferrous ascorbate scintigraphy, sequential 99m technetium DTPA scintigraphy and the 131I hippuran nephrogram. The aim of this study is to analyse the results obtained under different pathological circumstances affecting the transplant, to discuss the advantages of the techniques and to propose a working procedure. The most reliable and accurate technique is the 131I hippuran nephrogram combined with sequential 99mTc DTPA, by which renal vascularisation may be judged labelled ferrous ascorbate on the other hand is too insensitive. Although the information supplied is mostly contained in the scintigraphic images, the nephrographic curves and the blood radioactivity decay time and rad V/rad R ratio measurements are very helpful in the early diagnosis and differential diagnosis of complications affecting the transplant. The proper use of isotopic scintigraphy in kidney grafting should provide optimum conditions for better survival of the transplant at minimum risk to the patient

  14. Employers' Gas Association (ZPZ)

    International Nuclear Information System (INIS)

    Employers' Gas Association (ZPZ) is the institution which main task is to maintain the optimum conditions for dynamic development of its members' activities, their business activities and to maintain the common or individual interests o fits members. To meet this objective, the association: - maintains the interests of association members during discussions with representative authorities, central state administration bodies and the trade unions regarding the economic and social policy and the questions which are to be the subject matter of collective bargaining, conclusion of contracts and the collective agreements of higher force; - is the member of enterprising, negotiating and advisory authorities; - coordinates the procedure and promotes the common interests of its members in relation to the representative authorities and the central state administration bodies, central trade union authorities and in relation to the international organisation of employers and the International Labour Organisation; maintains the commercial and business activities of the members of association; submits the proposals, filling with the courts and makes interventions regarding the preparation of economic and political decisions on the national and international level; engages with the legal entities in the Slovak Republic and enters the foreign international organisations. ZPZ, originally Gas Association (PZ), was founded by the General Assembly on 27th January 1995. It was registered in compliance with the Act No. 83/1990 Coll. on Association of Citizens as amended by the act No. 300/90 Coll., as the organisation of employers with the legal personality. The Employer's Gas Association was a member of the Employers' Associations in Slovak Republic till 31st March 2004, after this date it is represented by the Republican Union of Employers in SR (RUZ SR), which was established to maintain employer's associations interests on more qualitative level. The list of members, representatives of members and officials as well as their activities are presented

  15. Cardiopulmonary assessment of medetomidine, ketamine, and butorphanol anesthesia in captive Thomson's gazelles (Gazella thomsoni).

    Science.gov (United States)

    Chittick, E; Horne, W; Wolfe, B; Sladky, K; Loomis, M

    2001-06-01

    This investigation evaluated the cardiopulmonary effects of medetomidine, ketamine, and butorphanol anesthesia in captive juvenile Thomson's gazelles (Gazella thomsoni). Butorphanol was incorporated to reduce the dose of medetomidine necessary for immobilization and minimize medetomidine-induced adverse cardiovascular side effects. Medetomidine 40.1 +/- 3.6 microg/kg, ketamine 4.9 +/- 0.6 mg/kg, and butorphanol 0.40 +/- 0.04 mg/kg were administered intramuscularly by hand injection to nine gazelles. Times to initial effect and recumbency were within 8 min postinjection. Cardiopulmonary status was monitored every 5 min by measuring heart rate, respiratory rate, indirect blood pressure, end-tidal CO2, and indirect oxygen-hemoglobin saturation by pulse oximetry. Venous blood gases were collected every 15 min postinjection. Oxygen saturations less than 90% in three gazelles suggested hypoxemia. Subsequent immobilized gazelles were supplemented with intranasal oxygen throughout the anesthetic period. Sustained bradycardia (ketamine, and butorphanol can be used to safely anesthetize Thomson's gazelles for routine, noninvasive procedures. More invasive procedures, such as castration, can be readily performed with the additional use of local anesthetics. PMID:12790416

  16. Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection

    Directory of Open Access Journals (Sweden)

    Kambiz Alizadeh

    2014-02-01

    Full Text Available Cold agglutinins are of unique relevance in cardiac surgerybecause of the use of hypothermic cardiopulmonary bypass (CPB. Cold autoimmune diseases are defined by the presence of abnormal circulating proteins (usually IgM or IgA antibodies that agglutinate in response to a decrease in body temperature. These disorders include cryoglobulinemia and cold hemagglutinin disease.Immunoglobulin M autoantibodies to red blood cells, which activateat varying levels of hypothermia, can cause catastrophic hemagglutination,microvascular thrombosis, or hemolysis. Management of anesthesia in these patients includes strict maintenance of normothermia. Patients scheduled for the surgery requiring cardiopulmonary bypass present significant challenges. Use of systemic hypothermia may be contraindicated, and cold cardioplegia solutions may precipitate intracoronary hemagglutination with consequent thrombosis, ischemia, or infarction. Management of CPB andmyocardial protection requires individualized planning. We describea case of MV repair and CABG in a patient with high titercold agglutinins and high thermal amplitude for antibody activation.Normothermic CPB and continuous warm blood cardioplegia weresuccessfully used.

  17. Sport climbing with pre-existing cardio-pulmonary medical conditions.

    Science.gov (United States)

    Kuepper, T; Morrison, A; Gieseler, U; Schoeffl, V

    2009-06-01

    Over the past 25 years sport climbing has developed from an elite extreme sport subculture pursued by few into a mainstream recreational sport enjoyed globally by climbers of all ages, climbing abilities, and with pre-existing health conditions. As the demands and grades of climbing difficulty have increased over this period, most scientific literature on sport climbing focused on acute injuries and overuse syndromes, or performance physiology in healthy adult males. The physiological response to sport climbing is more similar to that of resistance training (i.e., body building) rather than a predominantly aerobic sport (i.e., running, cycling), so that heart rate and blood pressure during a climb will be disproportionately high relative to the 'exercise' of climbing, and breathing may be irregular. Therefore this review sought evidence-based recommendations for recreational sport climbing participation by those individuals with pre-existing cardiopulmonary medical conditions including coronary heart disease, chronic heart failure, cardiac dysrhythmia, pulmonary diseases (i.e., asthma) or hypertension. This review defines the criteria that must be fulfilled for safe sport climbing by those with pre-existing cardiopulmonary conditions or those with hypertension. PMID:19199210

  18. Noncontact accurate measurement of cardiopulmonary activity using a compact quadrature Doppler radar sensor.

    Science.gov (United States)

    Hu, Wei; Zhao, Zhangyan; Wang, Yunfeng; Zhang, Haiying; Lin, Fujiang

    2014-03-01

    The designed sensor enables accurate reconstruction of chest-wall movement caused by cardiopulmonary activities, and the algorithm enables estimation of respiration, heartbeat rate, and some indicators of heart rate variability (HRV). In particular, quadrature receiver and arctangent demodulation with calibration are introduced for high linearity representation of chest displacement; 24-bit ADCs with oversampling are adopted for radar baseband acquisition to achieve a high signal resolution; continuous-wavelet filter and ensemble empirical mode decomposition (EEMD) based algorithm are applied for cardio/pulmonary signal recovery and separation so that accurate beat-to-beat interval can be acquired in time domain for HRV analysis. In addition, the wireless sensor is realized and integrated on a printed circuit board compactly. The developed sensor system is successfully tested on both simulated target and human subjects. In simulated target experiments, the baseband signal-to-noise ratio (SNR) is 73.27 dB, high enough for heartbeat detection. The demodulated signal has 0.35% mean squared error, indicating high demodulation linearity. In human subject experiments, the relative error of extracted beat-to-beat intervals ranges from 2.53% to 4.83% compared with electrocardiography (ECG) R-R peak intervals. The sensor provides an accurate analysis for heart rate with the accuracy of 100% for p = 2% and higher than 97% for p = 1%. PMID:24235293

  19. A review of cardiopulmonary research in brazilian medical journals: clinical, surgical and epidemiological data

    Scientific Electronic Library Online (English)

    Carlos, Serrano; Mauricio Rocha e, Silva.

    Full Text Available Research in the field of cardiopulmonary disease in Brazil has been very active in recent decades. The combination of PUBMED, SCieLO, open access and online searching has provided a significant increase in the visibility of Brazilian journals. This newly acquired international visibility has in turn [...] resulted in the appearance of more original research reports in the Brazilian scientific press. This review is intended to highlight part of this work for the benefit of the readers of "Clinics." We searched through PUBMED for noteworthy articles published in Brazilian medical journals included in the Journal of Citation Reports of the Institute of Scientific Information to better expose them to our readership. The following journals were examined: "Arquivos Brasileiros de Cardiologia," "Arquivos Brasileiros de Endocrinologia e Metabologia," "Brazilian Journal of Medical and Biological Reviews," "Jornal Brasileiro de Pneumologia," "Jornal de Pediatria," "Revista Brasileira de Cirurgia Cardiovascular," "Revista da Associação Médica Brasileira," Revista da Escola de Enfermagem U.S.P." and "São Paulo Medical Journal." These journals publish original investigations in the field of cardiopulmonary disease. The search produced 71 references, which are briefly examined.

  20. Use of the cardiopulmonary flow index to evaluate cardiac function in thoroughbred horses

    International Nuclear Information System (INIS)

    The ratio of the cardiopulmonary blood volume to stroke volume is called the cardiopulmonary flow index (CPFI). The CPFI can be determined indirectly from the simultaneous recording of a radiocardiogram and an electrocardiogram. The CPFI and cardiac output were measured simultaneously in horses that were diagnosed as having cardiac disease. The results obtained from these subjects were compared with those from control animals and significant differences were found between the mean CPFI of the control horses and those with macroscopically visible myocardial fibrosis on post mortem examination. No significant differences were found between the means of the cardiac output measured in either of the groups of horses. The effect of pharmacological acceleration of the heart rate on the CPFI was also studied. Significant differences were found between the mean CPFI and the slopes of the regression lines of CPFI on heart rate of the control and principal groups of horses. These differences were greatest at heart rates near to the resting heart rates of the individuals. The CPFI was found to be a more sensitive measure of cardiac function than cardiac output, in the horses. 16 refs., 2 figs., 2 tabs

  1. Cardiopulmonary resuscitation beyond the technique / Reanimación cardiopulmonar más allá de la técnica

    Scientific Electronic Library Online (English)

    Fritz E, Gempeler R.

    2015-04-01

    Full Text Available En este artículo de reflexión se presenta el estado actual de la reanimación cardiopulmonar (RCP) y su revisión bioética. Se parte de la poca efectividad de RCP y las razones por las cuales hoy en día es un procedimiento de aplicación universal, en ocasiones sin tener en cuenta el estado o deseos de [...] l paciente. Se presentan posibles caminos de acción para el mejoramiento continuo de la reanimación cardiopulmonar especialmente desde el punto de vista humanístico. Se incita a una mayor participación de los pacientes y sus familiares en las decisiones medicas, especialmente en la planeación del manejo medico mas que en el momento agudo de la enfermedad, como es el caso de la RCP. Abstract in english This reflective article presents the current state of cardiopulmonary resuscitation (CPR) and reviews it from a bioethical standpoint. It starts with the ineffectiveness of CPR and the reasons why today it is a universally applied procedure, sometimes without taking into consideration the wishes or [...] condition of the patient. Possible courses of action for the continuous improvement of cardiopulmonary resuscitation are proposed, especially from the humanistic point of view. Greater involvement of patients and their families in medical decisions, particularly in the planning of medical management rather than in the acute phase of the disease-as is the case for CPR-is encouraged.

  2. Scorpion (Buthus tamulus venom toxicity on cardiopulmonary reflexes involves kinins via 5-HT3 receptor subtypes

    Directory of Open Access Journals (Sweden)

    S. BAGCHI

    2001-01-01

    Full Text Available The mechanisms underlying the action of Indian red scorpion Buthus tamulus (BT venom-induced augmentation of cardiopulmonary reflexes elicited by intravenous injection of 5-HT were examined in urethane anaesthetized rats. The 5-HT produced a concentration-dependent increase in time-response area of bradycardiac response, with the responses at submaximal concentrations shifted to the left after exposure to BT venom (20 µg/kg, IV. Aprotinin (6000 kallikrein inactivating unit, IV as such had no effect on 5-HT reflex responses (bradycardia, hypotension, and apnea, but blocked the venom-induced reflex augmentation. While ondansetron (10 µg/kg, IV completely blocked the 5-HT reflex responses, these reappeared partially after venom exposure (20 µg/kg. Exposure to bradykinin (50 µg/kg, IV for 30 min also augmented the 5-HT-induced reflex responses similar to venom. The bradykinin-induced augmentation was also blocked by ondansetron. Results indicate that the venom-induced augmentation of cardiopulmonary reflexes is mediated through kinins sensitizing 5-HT3 receptor subtypes.

  3. Cardiac magnetic resonance imaging in a patient with amniotic fluid embolism associated with severe cardiopulmonary complications.

    Science.gov (United States)

    Hosoya, Yumiko; Watanabe, Masafumi; Terashima, Masahiro; Amiya, Eisuke; Nakao, Tomoko; Hasegawa, Akiko; Hyodo, Hironobu; Ando, Jiro; Fujii, Tomoyuki; Nagai, Ryozo; Komuro, Issei

    2013-01-01

    Amniotic fluid embolism (AFE) is a rare but devastating complication of pregnancy. Acute circulatory failure and obstetric disseminated intravascular coagulopathy are often associated with AFE and lead to poor prognosis of this syndrome. Although many reports of AFE and its cardiopulmonary complications exist, their etiology remains unknown. Classically, it was believed that the fatal cardiopulmonary complication in AFE is due to acute and severe pulmonary hypertension caused by critical obstruction of the pulmonary vessels by embolized amniotic fluid. However, recent hypotheses are suggesting that anaphylactic reaction or a cytokine effect induced by amniotic fluid is the main pathophysiological mechanism. We report a case in which cardiac magnetic resonance imaging was performed at the chronic stage of AFE. Late gadolinium enhancement (LGE) was detected at the mid-wall of the left ventricle with no evidence of pulmonary hypertension. This finding suggests that the pathophysiological mechanism of severe cardiac complications in AFE may include direct left ventricular myocardial injury through an immune reaction or cytokine release, rather than pulmonary embolism. PMID:23676374

  4. 113Insup(m) radiocardiographic measurements of cardiopulmonary parameters in healthy subjects and in cardiac patients

    International Nuclear Information System (INIS)

    Single detector arrangements are used to measure heart radioactivity curves in healthy subjects and in patients with various heart failures. A method is developed from a modified gamma function to determine the cardiopulmonary parameters from the radiocardiograms: systemic flow, pulmonary flow, right to left shunting flow, left to right shunting flow, regurgitant fractions, stroke volume, atrial blood volumes, ventricular end-diastolic volumes, pulmonary blood volume and ejection fractions. The method is well suited to clinical routine and requires only a desk calculator or a mini-computer for data handling. The cardiopulmonary parameters were measured from 70 healthy subjects with following results: cardiac index 3.46+-0.72 l/min/m2, stroke index 49+-9 ml/b/m2, right atrial blood volume 35+-13 ml/m2, right ventricular end-diastolic volume 76+-15 ml/m2, pulmonary blood volume 250+-51 ml/m2, left atrial blood volume 41+-15 ml/m2, left ventricular end-diastolic volume 75+-15 ml/m2, right heart ejection fraction 0.64+-0.11, left heart ejection fraction 0.66+-0.12. These values agree closely with the data accumulated from more elaborate methods. (author)

  5. A coprological investigation of gastrointestinal and cardiopulmonary parasites in hunting dogs in Denmark

    DEFF Research Database (Denmark)

    Al-Sabi, Mohammad Nafi Solaiman; Kapel, Christian Moliin Outzen

    2013-01-01

    A coprological survey was conducted to investigate the prevalence of parasites infect-ing hunting dogs with no history of recent anthelmintic treatments and with no overtclinical manifestations of cardiopulmonary or gastrointestinal illness. The hunting dogswere recruited from four different areas in Denmark, and fecal samples were obtainedin October and November, 2007. For detecting gastrointestinal parasites, samples (N = 178)were examined by a commercial flotation kit (Fecalyzer®EVSCO, USA). For detection of car-diopulmonary parasites, samples (N = 181) were collected on three consecutive days andexamined using the Baermann method. Parasites were recovered from 22.1% of the huntingdogs: Angiostrongylus vasorum (2.2%), Toxocara canis (12.4%), Uncinaria stenocephala (7.3%),Taenia spp. (1.7%), Toxascaris leonina (0.6%), Coccidia (0.6%) and unidentified trematode eggs(1.1%). Infection with only one species of parasite was more common (89.5%) than infectionwith two species (10.5%). A multiple logistic regression model showed that prevalence ofintestinal parasites was not influenced by age, gender or breed in adult dogs. There was asignificantly higher prevalence of intestinal parasites in the densely populated area of theisland Zealand compared with the less populated regions of the peninsular Jutland. Thepresent study reports the first case of A. vasorum in a dog from Jutland. The dog had beenvisiting the endemic area of western Zealand, suggesting that translocation of sub-clinicallyinfected dogs may contribute to introduction of A. vasorum into non-endemic areas.

  6. Esophageal gastric tube airway vs endotracheal tube in prehospital cardiopulmonary arrest.

    Science.gov (United States)

    Goldenberg, I F; Campion, B C; Siebold, C M; McBride, J W; Long, L A

    1986-07-01

    We evaluated the efficacy of the esophageal airway (EA) by prospectively randomizing 175 prehospital cardiopulmonary arrest patients to receive either an esophageal gastric tube airway (EGTA) or an endotracheal tube (ET). If attempts with the initial airway failed, the alternate airway was attempted. The cost of training paramedics in EA use was considerably less than the ET ($80 vs $1,000). Survival to the emergency room, to hospitalization and to discharge in ET and EGTA groups were 64.4 percent, 25.6 percent, 11.1 percent, and 54.1 percent, 27.1 percent, 12.9 percent, respectively--differences not statistically significant. The incidence of neurologic residual (ET 50 percent, EGTA 36.4 percent) and congestive heart failure (ET 40 percent, EGTA 45.5 percent) in surviving ET and EGTA patients did not differ (NS). An additional 125 consecutive patients with only the opportunity to receive an EA were also evaluated and did not differ in mortality, neurologic residual, or congestive heart failure from ET patients. We conclude that the EA is a satisfactory alternative to the ET for short-term prehospital use in cardiopulmonary arrest patients. PMID:3720391

  7. Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection

    Directory of Open Access Journals (Sweden)

    Kambiz Alizadeh

    2014-02-01

    Full Text Available Cold agglutinins are of unique relevance in cardiac surgerybecause of the use of hypothermic cardiopulmonary bypass (CPB. Cold autoimmune diseases are defined by the presence of abnormal circulating proteins (usually IgM or IgA antibodies that agglutinate in response to a decrease in body temperature. These disorders include cryoglobulinemia and cold hemagglutinin disease.Immunoglobulin M autoantibodies to red blood cells, which activateat varying levels of hypothermia, can cause catastrophic hemagglutination,microvascular thrombosis, or hemolysis. Management of anesthesia in these patients includes strict maintenance of normothermia. Patients scheduled for the surgery requiring cardiopulmonary bypass present significant challenges. Use of systemic hypothermia may be contraindicated, and cold cardioplegia solutions may precipitate intracoronary hemagglutination with consequent thrombosis, ischemia, or infarction. Management of CPB andmyocardial protection requires individualized planning. We describea case of MV repair and CABG in a patient with high titercold agglutinins and high thermal amplitude for antibody activation.Normothermic CPB and continuous warm blood cardioplegia weresuccessfully used.

  8. Occupational affiliation does not influence practical skills in cardiopulmonary resuscitation for in-hospital healthcare professionals

    Directory of Open Access Journals (Sweden)

    Thoren Ann-Britt

    2011-01-01

    Full Text Available Abstract Background D-CPR (Defibrillator Cardiopulmonary Resuscitation is a technique for optimal basic life support during cardiopulmonary resuscitation (CPR. Guidelines recommend that healthcare professionals can perform CPR with competence. How CPR training and provision is organized varies between hospitals, and it is our impression that in Sweden this has generally improved during the last 15-20 years. However, some hospitals still do not have any AED (Automated External Defibrillators. The aim was to investigate potential differences in practical skills between different healthcare professions before and after training in D-CPR. Methods Seventy-four healthcare professionals were video recorded and evaluated for adherence to a modified Cardiff Score. A Laerdal Resusci Anne manikin in connection to PC Skill reporting System was used to evaluate CPR quality. A simulated CPR situation was accomplished during a 5-10 min scenario of ventricular fibrillation. Paired and unpaired statistical methods were used to examine differences within and between occupations with respect to the intervention. Results There were no differences in skills among the different healthcare professions, except for compressions per minute. In total, the number of compression per minute and depth improved for all groups (P P Conclusion Nearly all healthcare professionals learned to use the AED. There were no differences in CPR skill performances among the different healthcare professionals.

  9. Observations on some cardiopulmonary effects of midazolam, xylazine and a midazolam / ketamine combination in the goat

    Directory of Open Access Journals (Sweden)

    G.F. Stegmann

    1999-07-01

    Full Text Available Xylazine, midazolam and a midazolam / ketamine combination were administered to 6 goats in a randomised 3-way block design. All goats received all treatments with at least a 7-day interval between treatments. Statistically significant (P < 0.05 changes were observed in some of the measured cardiopulmonary variables for xylazine and midazolam/ ketamine. Xylazine administration resulted in statistically significant decreases in minute volume, arterial partial pressure of oxygen, heart rate andmeanarterial blood pressure. The increase in arterial partial pressure of carbon dioxide was not statistically significant. For the midazolam / ketamine combination, the decrease in tidal volume was statistically significant, but not the decrease in minute volume and increase in arterial partial pressure of carbon dioxide. The decrease in the arterial partial pressure of oxygen was also statistically significant. The mean arterial blood pressure for the combination was statistically significantly higher compared to xylazine. The changes in cardiopulmonary variables after midazolam administration were not statistically significant, such as tidal and minute volume, arterial partial pressure of oxygen and carbon dioxide. However, clinically significant effects such as hypoventilation and hypoxia were observed after its administration. The change in mean arterial blood pressure was minimal.

  10. Nontraumatic postmortem computed tomographic demonstration of cerebral gas embolism following cardiopulmonary resuscitation

    International Nuclear Information System (INIS)

    The aim of this study was to investigate cerebral gas embolism (GE) on nontraumatic postmortem CT (PMCT), regarding its frequency, location (arterial or venous), and causes. Our subjects were 404 nontraumatically deceased patients who had been in a state of cardiopulmonary arrest on arrival at our emergency room. PMCT was performed within 2 h of the confirmation of death. Cardiopulmonary resuscitation (CPR) was performed on 387 of the 404 subjects; and of these, cerebral GE was detected in 29 (7.5%) subjects (3 arterial, 25 venous, 1 undeterminable). Cerebral GE was not noted in the other 17 of the 404 subjects who did not undergo CPR. However, there was no significant difference in the incidence of cerebral GE between the subjects who underwent CPR and those who did not. The mechanism of cerebral arterial GE was presumed due to pulmonary barotrauma and/or paradoxical embolism, while the thoracic pump theory was suggested to explain the cerebral venous GE. Cerebral arterial/venous GE is found in CPR cases on nontraumatic PMCT. (author)

  11. Prosthetic graft interposition of the brachiocephalic veins or superior vena cava combined with resection of malignant tumours: graft patency and risk factors for graft occlusion

    Science.gov (United States)

    Lee, Geun Dong; Choi, Se Hoon; Kim, Yong-Hee; Kim, Dong Kwan; Park, Seung-Il

    2016-01-01

    Background We aimed to assess graft patency in patients undergoing prosthetic graft interposition of the brachiocephalic veins (BCVs) or the superior vena cava (SVC) combined with resection of malignant tumours. Methods A retrospective analysis was conducted on 16 patients who underwent prosthetic graft interposition of the BCVs or the SVC between 1998 and 2012. Results Among a total of 20 grafts in 16 patients (unilateral graft interposition in 12, bilateral graft interposition in 4), 8 grafts were occluded in 8 patients. Overall graft patency rate was 64.6%, 42.4% at the 2- and 5-year follow-up. Graft patency rate of the left BCV was significantly lower than that of the right BCV or the SVC (2-year patency, 38.1% vs. 81.8%, P=0.024). In univariate analysis, the superior anastomosis site [left BCV vs. right BCV; hazard ratio (HR) =2.312; 95% confidence interval (CI), 1.015–5.265; P=0.046], the inferior anastomosis site (right atrial appendage vs. SVC; HR =2.409; 95% CI, 1.124–5.161; P=0.024), and interruption of warfarin (HR =5.015; 95% CI, 1.106–22.734; P=0.037) were significant risk factors for graft occlusion. Graft occlusive symptoms were identified in 4 patients who underwent unilateral graft interposition. Conclusions Prosthetic graft interposition between the left BCV and the right atrial appendage resulted in a significant rate of graft occlusion. Prosthetic graft interposition of the bilateral BCVs and long-term warfarin therapy may be necessary to prevent graft occlusive symptoms.

  12. Physical properties of agave cellulose graft polymethyl methacrylate

    International Nuclear Information System (INIS)

    The grafting polymerization of methyl methacrylate and Agave cellulose was prepared and their structural analysis and morphology were investigated. The grafting reaction was carried out in an aqueous medium using ceric ammonium nitrate as an initiator. The structural analysis of the graft copolymers was carried out by Fourier transform infrared and X-ray diffraction. The graft copolymers were also characterized by field emission scanning electron microscopy (FESEM). An additional peak at 1732 cm?1 which was attributed to the C=O of ester stretching vibration of poly(methyl methacrylate), appeared in the spectrum of grafted Agave cellulose. A slight decrease of crystallinity index upon grafting was found from 0.74 to 0.68 for cellulose and grafted Agave cellulose, respectively. Another evidence of grafting showed in the FESEM observation, where the surface of the grafted cellulose was found to be roughed than the raw one

  13. Physical properties of agave cellulose graft polymethyl methacrylate

    Energy Technology Data Exchange (ETDEWEB)

    Rosli, Noor Afizah; Ahmad, Ishak; Abdullah, Ibrahim; Anuar, Farah Hannan [Polymer Research Centre (PORCE), School of Chemical Sciences and Food Technology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 Bangi Selangor (Malaysia)

    2013-11-27

    The grafting polymerization of methyl methacrylate and Agave cellulose was prepared and their structural analysis and morphology were investigated. The grafting reaction was carried out in an aqueous medium using ceric ammonium nitrate as an initiator. The structural analysis of the graft copolymers was carried out by Fourier transform infrared and X-ray diffraction. The graft copolymers were also characterized by field emission scanning electron microscopy (FESEM). An additional peak at 1732 cm{sup ?1} which was attributed to the C=O of ester stretching vibration of poly(methyl methacrylate), appeared in the spectrum of grafted Agave cellulose. A slight decrease of crystallinity index upon grafting was found from 0.74 to 0.68 for cellulose and grafted Agave cellulose, respectively. Another evidence of grafting showed in the FESEM observation, where the surface of the grafted cellulose was found to be roughed than the raw one.

  14. Anesthetic management of a patient with polycythemia vera undergoing emergency repair of a type-A aortic dissection and concomitant coronary artery bypass grafting: a case report

    Science.gov (United States)

    Im, Hyeongwoo; Yang, Jaeyoung; Lee, Sangmin Maria; Lee, Jong Hwan

    2015-01-01

    Polycythemia vera is a chronic progressive myeloproliferative disease characterized by increased circulating red blood cells, and the hyperviscosity of the blood can lead to an increased risk of arterial thrombosis. In a previous survey regarding postoperative outcomes in polycythemia vera patients, an increased risk of both vascular occlusive and hemorrhagic complications have been reported. Aortic surgery involving cardiopulmonary bypass may be associated with the development of a coagulopathy, and as a result, the occurrence of thrombotic complications should be avoided after coronary anastomosis. Thus, optimizing the hemostatic balance is an important concern for anesthesiologists. However, only a few cases of anesthetic management in polycythemia vera patients undergoing concomitant aorta and coronary arterial bypass surgery have ever been reported. Here, we experience a polycythemia vera patient who underwent an emergency repair of a type-A aortic dissection and concomitant coronary artery bypass grafting, and report this case with a review of the relevant literature. PMID:26634086

  15. Anesthetic management of a patient with polycythemia vera undergoing emergency repair of a type-A aortic dissection and concomitant coronary artery bypass grafting: a case report.

    Science.gov (United States)

    Im, Hyeongwoo; Min, Jeong Jin; Yang, Jaeyoung; Lee, Sangmin Maria; Lee, Jong Hwan

    2015-12-01

    Polycythemia vera is a chronic progressive myeloproliferative disease characterized by increased circulating red blood cells, and the hyperviscosity of the blood can lead to an increased risk of arterial thrombosis. In a previous survey regarding postoperative outcomes in polycythemia vera patients, an increased risk of both vascular occlusive and hemorrhagic complications have been reported. Aortic surgery involving cardiopulmonary bypass may be associated with the development of a coagulopathy, and as a result, the occurrence of thrombotic complications should be avoided after coronary anastomosis. Thus, optimizing the hemostatic balance is an important concern for anesthesiologists. However, only a few cases of anesthetic management in polycythemia vera patients undergoing concomitant aorta and coronary arterial bypass surgery have ever been reported. Here, we experience a polycythemia vera patient who underwent an emergency repair of a type-A aortic dissection and concomitant coronary artery bypass grafting, and report this case with a review of the relevant literature. PMID:26634086

  16. Enxerto composto de artéria torácica interna esquerda e veia safena magna: estudo angiográfico após oito anos / Left internal thoracic artery and saphenous vein as a composite graft: 8-year angiographic follow-up study

    Scientific Electronic Library Online (English)

    José Glauco, Lobo Filho; Heraldo Guedis, Lobo Filho; Francisco José Cabral, Mesquita; Jaime Paula Pessoa, Linhares Filho.

    2010-03-01

    Full Text Available O uso de enxerto composto de artéria torácica interna esquerda (ATIE) com segmentos arteriais ou segmentos de veia safena magna (VSM) pode permitir a revascularização completa do sistema coronariano esquerdo (SCE) sem circulação extracorpórea (CEC) e sem manuseio da aorta ascendente (MAA), como form [...] a de tentar reduzir alguns riscos e complicações no pós-operatório imediato. Neste trabalho, relatamos os resultados angiográficos, após oito anos, de dois pacientes submetidos à cirurgia de revascularização do SCE com enxerto composto de ATIE e VSM, sem CEC e sem MAA. Abstract in english The use of a composite graft with left internal thoracic artery (LITA) and arterial or saphenous vein (SV) grafts can allow the complete revascularization of the left coronary system (LCS) without cardiopulmonary bypass (CPB) and without ascending aorta manipulation (AAM), in order to reduce some co [...] mplications in the immediate postoperative. This study shows 8-year angiographic follow-up results of two patients underwent no-touch aorta off-pump coronary artery bypass grafting (CABG) using LITA and SV as a composite graft to supply LCS.

  17. Implementing public employment policy

    DEFF Research Database (Denmark)

    Larsen, Flemming; Bredgaard, Thomas

    . But there is an interesting question to investigate here: whether and if so how, NPM-inspired reforms are related to changes in employment policy towards a work-first approach? Are changes in public management systems created as deliberate policy changes, or do they bring about more indirect and......Like most other areas within welfare policy, the employment and social policy areas are undergoing far-reaching changes in many countries. Partly in the shape of new forms of governance inspired by New Public Management (NPM), partly through new policies oriented towards activation and stronger...... disciplining of the unemployed (work first) (cf.Bredgaard & Larsen, 2005; Sol & Westerweld, 2005). It is, however, remarkable that in the research field there seems to be a division of labour so that changes in public administration and changes in the substance of employment policies are dealt with separately...

  18. Effect of acid additives on grafting efficiency and water absorption of hydrolyzed cassava starch grafted polymers

    International Nuclear Information System (INIS)

    Gelatinized cassava starch was radiation graft copolymerized with acrylamide, acrylic acid or their mixture in the presence of sulphuric acid or maleic acid. Various acid concentrations were used from 0.001 to 0.1 M of sulphuric acid while the maleic acid concentrations were varied from 1 to 3% (by weight). The optimum total dose and dose rate were investigated. The saponification temperature and time had the marked effects on grafting characteristics and water absorption capacity. We found that the effect of maleic acid addition gave a profound effect on water absorption. The CHNS/O analyses indicated significant changes in the nitrogen content in the hydrolyzed starch grafted polyacrylamide with 2% maleic acid. The article explains the possible causes for the enhancement influence of mineral acid and maleic acid on grafting behavior and water absorption of the saponified cassava starch grafted polyacrylamide super absorbent polymer. (author)

  19. Study on grafting glycidyl methacrylate onto HDPE membranes by pre-irradiation graft copolymerization

    International Nuclear Information System (INIS)

    Glycidyl methacrylate (GMA) was grafted onto HDPE membranes by pre-irradiation method with 1.8 MeV E-beam and a kind of membranes having reactive epoxy groups was successfully synthesized. Effects of monomer concentration, reaction temperature and time and irradiation dose on the grafting yield were studied. Composition, thermo-property and surface morphology of the grafted membranes were studied by FTIR, DSC and Tapping-mode AFM, respectively. The FTIR measurements proved the synthesized copolymer is HDPE-g-GMA. The DSC results indicated the grafted HDPE's melting temperature (Tm) and heat of fusion (?Hf(HDPE)) which was reduced with increasing grafting yield. The AFM images indicated that surface of the HDPE-g-GMA membranes was rougher than the virgin HDPE. (authors)

  20. Multifunctional network-structured film coating for woven and knitted polyethylene terephthalate against cardiovascular graft-associated infections.

    Science.gov (United States)

    Al Meslmani, Bassam M; Mahmoud, Gihan F; Sommer, Frank O; Lohoff, Michael D; Bakowsky, Udo

    2015-05-15

    Multifunctional network-structured polymeric coat for woven and knitted forms of crimped polyethylene terephthalate PET graft was developed to limit graft-associated infections. A newly synthesized antibacterial sulfadimethoxine polyhexylene adipate-b-methoxy polyethylene oxide (SD-PHA-b-MPEO) di-block copolymer was employed. Our figures of merit revealed that the formed coat showed a porous topographic architecture which manifested paramount properties, mostly bacterial anti-adhesion efficiency and biocompatibility with host cells. Compared to untreated grafts, the coat presented marked reduction of adhered Gram-positive Staphylococcus epidermidis previously isolated from a patient's vein catheter by 2.6 and 2.3 folds for woven and knitted grafts, respectively. Similarly, bacterial anti-adhesion effect was observed for Staphylococcus aureus by 2.3 and 2.4 folds, and by 2.9 and 2.7 folds for Gram-negative Escherichia coli for woven and knitted grafts, respectively. Additionally, adhesion and growth characteristics of L929 cells on the modified grafts revealed no significant effect on the biocompatibility. In conclusion, coating of PET with (SD-PHA-b-MPEO) is a versatile approach offers the desired bacterial anti-adhesion effect and host biocompatibility. PMID:25796119

  1. Self-deploying shape memory polymer scaffolds for grafting and stabilizing complex bone defects: A mouse femoral segmental defect study.

    Science.gov (United States)

    Baker, Richard M; Tseng, Ling-Fang; Iannolo, Maria T; Oest, Megan E; Henderson, James H

    2016-01-01

    Treatment of complex bone defects places a significant burden on the US health care system. Current strategies for treatment include grafting and stabilization using internal metal plates/screws, intramedullary rods, or external fixators. Here, we introduce the use of shape memory polymer (SMP) materials for grafting and adjunct stabilization of segmental defects. Self-deploying SMP grafts and SMP sleeves capable of expanding and contracting, respectively, under intraoperative conditions were developed and evaluated in a mouse segmental defect model in vivo. Integration between grafts/sleeves and native bone was assessed using x-ray radiography, microcomputed tomography, and torsional mechanical testing. We found that SMP grafts were able to integrate with the native bone after 12 weeks, maintain defect stability, and provide torsional mechanical properties comparable to an allograft alone treatment; however no gross de novo bone formation was observed. SMP sleeves did not inhibit bony bridging at the margins, and limbs treated with a sleeve/allograft combination had torsional mechanical properties comparable to limbs treated with an allograft alone. In vitro torsional and bending tests suggest sleeves may provide additional torsional stability to defects. Incorporation of shape memory into synthetic bone graft substitutes and adjunct stabilization devices is anticipated to enhance functionality of synthetic materials employed in both applications. PMID:26561935

  2. Employability Skills Indicator as Perceived by Manufacturing Employers

    OpenAIRE

    Mohamad Sattar Rasul; Azlin Norhaini Mansor

    2013-01-01

    Research on employability skills were conducted nationally and internationally, found that many technical graduates lacked employability skills. This article reports on the study of employability skills that technical students should acquire to be employed and sustained in manufacturing industries. The study investigates the importance of employability skills as perceived by 107 employers from manufacturing industries. The findings of the study revealed employers place great importance on int...

  3. Employment certificates on HRT

    CERN Multimedia

    HR Department

    2008-01-01

    As part of the ongoing drive to simplify and streamline administrative procedures and processes, the IT and HR Departments have made employment certificates available on a self-service basis on the HRT application, in the main menu under "My self services". All members of the personnel can thus obtain a certificate of employment or association, in French or in English, for the present or past contractual period. The HR Department’s Records Office remains responsible for issuing any special certificates that might be required. IT-AIS (Administrative Information Services) HR-SPS (Services, Procedures & Social) Records Office – Tel. 73700

  4. Free Gingival Grafting; Epiglu VS. Silk Thread Suturing: A Comparative Study

    OpenAIRE

    M. Paknejad; Y. Soleymani Shayesteh; A. Esmaielieh

    2004-01-01

    Statement of the Problem: The routine procedure for immobilization of free gingival graft (FGG) is suturing. Due to the successful application of tissue adhesives their employment has also become the subject of interest.Purpose: The aim of present clinical trial was to compare using Epiglu (E.g) versus silk thread suturing in FGG.Materials and Methods: This study was a split mouth clinical trial. The study group comprised of 12 patients with symmetrical loss of attached gingiva whom were refe...

  5. Adolescent External Iliac Artery Trauma: Recurrent Aneurysmal Dilatation of an Iliofemoral Saphenous Vein Graft Treated by Stent-Grafting

    International Nuclear Information System (INIS)

    An adolescent male sustained a severe penetrating injury to the external iliac artery. Emergency surgical revascularization was with a reversed long saphenous vein interposition graft. The primary graft and the subsequent revision graft both became aneurysmal. The second graft aneurysm was successfully excluded by endovascular stent-grafts with medium-term primary patency. A venous graft was used initially rather than a synthetic graft to reduce the risk of infection and the potential problems from future growth. Aneurysmal dilatation of venous grafts in children and adolescents is a rare but recognized complication. To the best of our knowledge, exclusion of these aneurysms with stent-grafts has not been previously reported in the adolescent population.

  6. Synthesis of Graft Copolymers by Small Doses of Irradiation

    International Nuclear Information System (INIS)

    In addition to grafting, there is often an undesirable alteration in the properties of the original polymer when polymer monomer mixtures are irradiated. As a result of irradiation, grafting occurs not only on the original polymeric backbone, but also on the already grafted side-chains. The result is an acceleration of grafting. The effect is especially pronounced in the case of preformed polymers, if irradiation is carried out intermittently. The grafting of styrene can be accelerated by the addition of some solvents which suppress the protective effect of the styrene on the polymer. Grafting can be accelerated by other additives. The swelling properties of the irradiated films were investigated. (author)

  7. Atherosclerosis of coronary artery bypass grafts and smoking.

    OpenAIRE

    FitzGibbon, G M; Leach, A J; Kafka, H P

    1987-01-01

    Follow-up angiography was performed at selected intervals on 340 men who had undergone coronary artery bypass surgery. There were 1160 grafts, but 112 were excluded from study because they occluded shortly after the operation. After 5 years 115 patients were smokers and 225 were nonsmokers. The mean number of grafts per patient was similar in the two groups. We classified each graft according to irregularities in graft outlines and graft patency and found disease-free grafts in 39% of the smo...

  8. Characterization and Some Properties of Functionalized Graft Copolymer

    International Nuclear Information System (INIS)

    The study involved the investigation and characterization of membranes prepared by graft copolymerization of acrylonitrile (AN) and vinyl acetate (VAc) binary monomers onto low density polyethylene (LDPE) and isotactic polypropylene (IPP). The mutual gamma-irradiation method was used as a grafting technique. The effects of grafting and chemical treatments on the thermal properties and crystallinity of prepared graft copolymer have been investigated using DSC, TGA and XRD. IR spectra recorded before and after grafting and also for the chemically treated membranes to elucidate the structural changes occurred due to grafting and chemical treatments

  9. Positive end-expiratory pressure improves survival in a rodent model of cardiopulmonary resuscitation using high-dose epinephrine.

    LENUS (Irish Health Repository)

    McCaul, Conán

    2009-10-01

    Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pulmonary vascular resistance, and potentially improve cardiac output, its use during CPR would increase survival.

  10. Acute and Subacute Effects of Urban Air Pollution on Cardiopulmonary Emergencies and Mortality: Time Series Studies in Austrian Cities

    Directory of Open Access Journals (Sweden)

    Daniel Rabczenko

    2013-10-01

    Full Text Available Daily pollution data (collected in Graz over 16 years and in the Linz over 18 years were used for time series studies (GAM and case-crossover on the relationship with daily mortality (overall and specific causes of death. Diagnoses of patients who had been transported to hospitals in Linz were also available on a daily basis from eight years for time series analyses of cardiopulmonary emergencies. Increases in air pollutant levels over several days were followed by increases in mortality and the observed effects increased with the length of the exposure window considered, up to a maximum of 15 days. These mortality changes in Graz and Linz showed similar patterns like the ones found before in Vienna. A significant association of mortality could be demonstrated with NO2, PM2.5 and PM10 even in summer, when concentrations are lower and mainly related to motor traffic. Cardiorespiratory ambulance transports increased with NO2/PM2.5/PM10 by 2.0/6.1/1.7% per 10 µg/m³ on the same day. Monitoring of NO2 (related to motor traffic and fine particulates at urban background stations predicts acute effects on cardiopulmonary emergencies and extended effects on cardiopulmonary mortality. Both components of urban air pollution are indicators of acute cardiopulmonary health risks, which need to be monitored and reduced, even below current standards.

  11. Comparative Cardiopulmonary Toxicity of exhausts from Soy-Based Biofuels and Diesel in Healthy and Hypertensive Rats

    Science.gov (United States)

    Increased use of renewable energy sources raise concerns about health effects of new emissions. We analyzed relative cardiopulmonary health effects of exhausts from (1) 100% soy biofuel (B100), (2) 20% soy biofuel + 80% low sulfur petroleum diesel (B20), and (3) 100% petroleum di...

  12. EFFECTS OF INHALATION OF SOLUBLE METALLIC CONSTITUENTS OF PARTICULATE MATTER ON CARDIOPULMONARY, THERMOREGULATORY, AND BIOCHEMICAL PARAMETERS IN GUINEA PIGS

    Science.gov (United States)

    EFFECTS OF INHALATION OF SOLUBLE METALLIC CONSTITUENTS OF PARTICULATE MATTER ON CARDIOPULMONARY, THERMOREGULATORY, AND BIOCHEMICAL PARAMETERS IN GUINEA PIGS. JP Nolan1, LB Wichers2, J Stanek3, UP Kodavanti1, MCJ Schladweiler1, PA Evansky1, ER Lappi1, DL Costa1, and WP Watkinson1...

  13. Cardiopulmonary exercise testing reveals onset of disease and response to treatment in a case of heritable pulmonary arterial hypertension

    Science.gov (United States)

    Trip, Pia; Vonk-Noordegraaf, Anton; Bogaard, Harm Jan

    2012-01-01

    Patients affected by pulmonary arterial hypertension (PAH) show a typical pattern of abnormalities on cardiopulmonary exercise testing (CPET). However, CPET is not routinely used as a screening method. We discuss a patient with hereditary PAH in whom CPET revealed onset of disease. Furthermore, we show that the abnormalities observed can improve in part by PAH-specific treatment. PMID:23130108

  14. Cardiopulmonary exercise testing reveals onset of disease and response to treatment in a case of heritable pulmonary arterial hypertension

    OpenAIRE

    Trip, Pia; Vonk-Noordegraaf, Anton; Bogaard, Harm Jan

    2012-01-01

    Patients affected by pulmonary arterial hypertension (PAH) show a typical pattern of abnormalities on cardiopulmonary exercise testing (CPET). However, CPET is not routinely used as a screening method. We discuss a patient with hereditary PAH in whom CPET revealed onset of disease. Furthermore, we show that the abnormalities observed can improve in part by PAH-specific treatment.

  15. Corneal Graft Rejection: Incidence and Risk Factors

    Directory of Open Access Journals (Sweden)

    Alireza Baradaran-Rafii

    2008-12-01

    Full Text Available

    PURPOSE: To determine the incidence and risk factors of late corneal graft rejection after penetrating keratoplasty (PKP. METHODS: Records of all patients who had undergone PKP from 2002 to 2004 without immunosuppressive therapy other than systemic steroids and with at least one year of follow up were reviewed. The role of possible risk factors such as demographic factors, other host factors, donor factors, indications for PKP as well as type of rejection were evaluated. RESULTS: During the study period, 295 PKPs were performed on 286 patients (176 male, 110 female. Mean age at the time of keratoplasty was 38±20 (range, 40 days to 90 years and mean follow up period was 20±10 (range 12-43 months. Graft rejection occurred in 94 eyes (31.8% at an average of 7.3±6 months (range, 20 days to 39 months after PKP. The most common type of rejection was endothelial (20.7%. Corneal vascularization, regrafting, anterior synechiae, irritating sutures, active inflammation, additional anterior segment procedures, history of trauma, uncontrolled glaucoma, prior graft rejection, recurrence of herpetic infection and eccentric grafting increased the rate of rejection. Patient age, donor size and bilateral transplantation had no significant influence on graft rejection. CONCLUSION: Significant risk factors for corneal graft rejection include corneal vascularization, anterior synechiae, irritating sutures, active inflammation, regrafting, additional surgery, trauma, uncontrolled intraocular pressure, history of graft rejection, recurrent herpetic infection, eccentric grafting and corneal scarring. Recipient age and donor cornea size do not seem to be risk factors for corneal graft rejection.

  16. Employer Engagement in Education

    Science.gov (United States)

    Mann, Anthony; Dawkins, James

    2014-01-01

    The subject of this paper is employer engagement in education as it supports the learning and progression of young people through activities including work experience, job shadowing, workplace visits, career talks, mock interviews, CV workshops, business mentoring, enterprise competitions and the provision of learning resources. Interest has grown…

  17. Disability Employment 101

    Science.gov (United States)

    US Department of Education, 2007

    2007-01-01

    Business is about productivity and maintaining a competitive advantage. To do this, business needs qualified workers. Hiring people with disabilities adds value to a business and will attract new customers. Disability is not inability. Employers can make sound business decisions and gain a competitive advantage by using this guide to increase the…

  18. Policies for full employment

    DEFF Research Database (Denmark)

    de Koning, Jaap; Layard, Richard; Nickel, Stephen; Westergård-Nielsen, Niels Chr.

    European unemployment is too high, and employment is too low. Over 7½ per cent of Europe's workforce is unemployed, and only two thirds of people aged 15-64 are in work. At the Lisbon summit two years ago the heads of government set the target that by 2010 the employment rate should rise from 64....... So we need higher participation, and (for full employment) we need a much lower unemployment rate. Can it be done? A mere glance at the experience of different European countries shows that it can. As Table 1 shows, four E.U. countries already exceed the overall target for 2010 (Britain, Denmark, the...... per cent to at least 70 per cent. And for older workers between 55 and 64 the employment rate should rise from 38 per cent to at least one half. These are ambitious targets. They will require two big changes: more people must seek work, and among those seeking work a higher proportion must get a job...

  19. Westchester County Employers Survey.

    Science.gov (United States)

    Lee, Marcia M.

    The Westchester County Employers Survey was done in May 2003 in order learn more about employee training needs, how they accomplished these needs, and how it would be possible for the Westchester Community College to fulfill these needs. Out of the 639 surveys sent, 145 were returned in a satisfactory format, which produces a 22.6% return rate.…

  20. Employment-Socialization Project.

    Science.gov (United States)

    Washburn, Richard W.

    An employment socialization project was developed to reduce the re-hospitalization of patients by assisting them in their re-entry into the world of work. The project was established by ex-psychiatric patients who took major responsibility for planning and implementing the project's activities with the clinic staff serving in an advisory capacity.…