WorldWideScience

Sample records for grafting employing cardiopulmonary

  1. Ketamine has no effect on oxygenation indices following elective coronary artery bypass grafting under cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Parthasarathi Gayatri

    2011-01-01

    Full Text Available Cardiopulmonary bypass is known to elicit systemic inflammatory response syndrome and organ dysfunction. This can result in pulmonary dysfunction and deterioration of oxygenation after cardiac surgery and cardiopulmonary bypass. Previous studies have reported varying results on anti-inflammatory strategies and oxygenation after cardiopulmonary bypass. Ketamine administered as a single dose at induction has been shown to reduce the pro-inflammatory serum markers in patients undergoing cardiopulmonary bypass. Therefore we investigated if ketamine can result in better oxygenation in these patients. This was a prospective randomized blinded study. Eighty consecutive adult patients undergoing elective coronary artery bypass grafting under cardiopulmonary bypass were included in the study. Patients were divided into two groups. Patients in ketamine group received 1mg/kg of ketamine intravenously at induction of anesthesia. Control group patients received an equal volume of saline. All patients received standard anesthesia, operative and postoperative care.Paired t test and independent sample t test were used to compare the inter-group and between group oxygenation indices respectively. Oxygenation index and duration of ventilation were analyzed. Deterioration of oxygenation index was noted in both the groups after cardiopulmonary bypass. However, there was no significant difference in the oxygenation index at various time points after cardiopulmonary bypass or the duration of ventilation between the two groups. This study shows that the administered as a single dose at induction does not result in better oxygenation after cardiopulmonary bypass.

  2. [The correlation between flow pattern during cardiopulmonary bypass and patency of the coronary artery bypass grafts].

    Science.gov (United States)

    Hagiwara, H; Shirakawa, M; Nakayama, T; Asai, T; Nakayama, M; Ito, T; Yano, Y

    2005-07-01

    Recently the availability of transit time flow measurement (TTFM) is reported especially in off-pump coronary artery bypass grafting (CABG). But little is known about TTFM findings in on-pump CABG. We examined the correlation between the TTFM flow pattern and the angiography findings in on-pump CABG. The subjects consisted of 52 patients who underwent on-pump CABG and angiography early after operation. In these patients, 55 internal thoracic artery (ITA), 17 gastroepiploic artery (GEA), 13 saphenous vein graft (SVG) and 41 radial artery (RA) were tested with TTFM during cardiopulmonary bypass (CPB). TTFM demonstrated a diastolic filling pattern in 53 ITA, 16 GEA, 13 SVG and 36 RA. The angiography revealed that all these grafts were perfectly patent with the exception of a GEA with a flow competition pattern. TTFM revealed an abnormal flow pattern in 2 ITA (these 2 grafts were revised during CPB and the angiography demonstrated their perfect patency), 1 GEA (to and fro pattern), 0 SVG and 5 RA (the abnormal pattern was due to graft spasm in 3 of 5, and the angiography revealed their perfect patency, however, the angiography detected stenosis in the remaining 2 grafts). The present study found that the TTFM flow pattern during CPB correlated well with the angiography findings. TTFM during CPB was useful to detect graft failure, and grafts were revised safely during CPB. PMID:16004331

  3. Cytokines and troponin-I in cardiac dysfunction after coronary artery grafting with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Savaris Neverton

    2001-01-01

    Full Text Available OBJECTIVE: The association between cytokines and troponin-I with cardiac function after cardiac surgery with cardiopulmonary bypass remains a topic of continued investigation. METHODS: Serial measurements, within 24h following surgery, of tumor necrosis factor-alpha, its soluble receptors, and troponin-I were performed in patients with normal ejection fraction undergoing coronary artery bypass grafting. Ejection fraction was measured by radioisotopic ventriculography preoperatively, at 24h and at day 7 postoperatively. RESULTS: Of 19 patients studied (59±8.5 years, 10 (group 1 showed no changes in ejection fraction, 53±8% to 55±7%, and 9 (group 2 had a decrease in ejection fraction, 60±11% to 47±11% (p=0.015 before and 24h after coronary artery bypass grafting, respectively. All immunological variables, except tumor necrosis factor-alpha soluble receptor I at 3h postoperation (5.5± 0.5 in group 1 versus 5.9±0.2 pg/ml in group 2; p=0.048, were similar between groups. Postoperative troponin-I had an inverse correlation with ejection fraction at 24h (r= -0.44. CONCLUSIONS: Inflammatory activity, assessed based on tumor necrosis factor-alpha and its receptors, appears to play a minor role in cardiac dysfunction after cardiac surgery. Troponin I levels are inversely associated with early postoperative ejection fraction.

  4. Cytokines and troponin-I in cardiac dysfunction after coronary artery grafting with cardiopulmonary bypass

    Scientific Electronic Library Online (English)

    Neverton, Savaris; Carisi, Polanczyk; Nadine, Clausell.

    2001-08-01

    Full Text Available OBJECTIVE: The association between cytokines and troponin-I with cardiac function after cardiac surgery with cardiopulmonary bypass remains a topic of continued investigation. METHODS: Serial measurements, within 24h following surgery, of tumor necrosis factor-alpha, its soluble receptors, and tropo [...] nin-I were performed in patients with normal ejection fraction undergoing coronary artery bypass grafting. Ejection fraction was measured by radioisotopic ventriculography preoperatively, at 24h and at day 7 postoperatively. RESULTS: Of 19 patients studied (59±8.5 years), 10 (group 1) showed no changes in ejection fraction, 53±8% to 55±7%, and 9 (group 2) had a decrease in ejection fraction, 60±11% to 47±11% (p=0.015) before and 24h after coronary artery bypass grafting, respectively. All immunological variables, except tumor necrosis factor-alpha soluble receptor I at 3h postoperation (5.5± 0.5 in group 1 versus 5.9±0.2 pg/ml in group 2; p=0.048), were similar between groups. Postoperative troponin-I had an inverse correlation with ejection fraction at 24h (r= -0.44). CONCLUSIONS: Inflammatory activity, assessed based on tumor necrosis factor-alpha and its receptors, appears to play a minor role in cardiac dysfunction after cardiac surgery. Troponin I levels are inversely associated with early postoperative ejection fraction.

  5. The Effects of Etomidate and Propofol Induction on Hemodynamic and Endocrine Response in Patients Undergoing Coronary Artery Bypass Graft Surgery on Cardiopulmonary Bypass

    OpenAIRE

    Pandey, Anil K.; Neeti Makhija; Sandeep Chauhan; Sambhunath Das; Usha Kiran; A. K. Bisoi; Lakshmy, R

    2012-01-01

    Aim: To compare the effects of propofol and etomidate induction on hemodynamic parameters and serum cortisol levels in patients with normal left ventricular function undergoing elective coronary artery bypass graft surgery on cardiopulmonary bypass. Material and Method: After approval from the Institute Ethics committee hundred American Society of Anesthesiologists (ASA) grade II or III patients undergoing scheduled coronary artery bypass surgery on cardiopulmonary bypass were enrolled in the...

  6. Clinical and economic outcomes associated with blood transfusions among elderly Americans following coronary artery bypass graft surgery requiring cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Ganz, Michael Lee; Wu, Ning

    2014-01-01

    BACKGROUND: Blood transfusion occurring during hospitalisation for heart surgery has been shown to be associated with increased morbidity and mortality and with increased time spent in hospital, use of healthcare services, and costs. The objective of this study was to assess how perioperative blood transfusion among adults 65 years and older who underwent coronary artery bypass graft surgery requiring cardiopulmonary bypass in the United States is associated with immediate and longer term clinical and economic outcomes. MATERIALS AND METHODS: Using data from a 5% random sample of Medicare patients who underwent their first (within 2 years) coronary artery bypass graft requiring cardiopulmonary bypass procedure in 2005 or 2006, this study estimated associations (hazard ratios and regression coefficients) between transfusion status (received or not) and complications after surgery, serious adverse events, death, and costs using Cox proportional hazard and generalised linear models adjusting for patients' demographic and clinical characteristics. RESULTS: Adjusted hazard ratios were statistically significant (P<0.05) for risks of complications (1.20), serious adverse events (1.58), and death (1.49). There was also a statistically significantly (P?0.01) and strong relationship between receiving transfused blood and Medicare payments over the subsequent 45 months following discharge ($5,778 per calendar quarter for those receiving transfusion vs $5,197; all costs are measured in 2011 USD). CONCLUSION: Blood transfusion during hospitalisation for coronary artery bypass graft requiring cardiopulmonary bypass was significantly associated with increased long-term post-operative morbidity, mortality, and overall healthcare costs. This study contributes to the evidence demonstrating an association between transfusion and adverse clinical and economic outcomes by using a nationally representative longitudinal cost and utilisation database.

  7. 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.

  8. 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)

    Science.gov (United States)

    Ahmed, Imdad; House, Chad M; Nelson, William B

    2009-01-01

    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. PMID:19519919

  9. The Effects of Etomidate and Propofol Induction on Hemodynamic and Endocrine Response in Patients Undergoing Coronary Artery Bypass Graft Surgery on Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Anil K Pandey

    2012-09-01

    Full Text Available Aim: To compare the effects of propofol and etomidate induction on hemodynamic parameters and serum cortisol levels in patients with normal left ventricular function undergoing elective coronary artery bypass graft surgery on cardiopulmonary bypass. Material and Method: After approval from the Institute Ethics committee hundred American Society of Anesthesiologists (ASA grade II or III patients undergoing scheduled coronary artery bypass surgery on cardiopulmonary bypass were enrolled in the study. Patients were allocated randomly to receive either propofol or etomidate for anesthesia induction. Anesthesia was maintained in both groups with sevoflurane, vecuronium bromide for muscle relaxation (0.1 mg/kg, boluses and fentanyl up to a total dose of 20 mcg/kg. Result: The baseline serum cortisol values were within normal limits in both the groups. The serum cortisol levels in the propofol group increased more than two fold, whereas the values in the etomidate group decreased by close to fifty percent on weaning from cardiopulmonary bypass (CPB. There was no significant difference in serum cortisol levels in the two groups at twenty-four hours after induction, although the values were close to double the baseline levels. Hemodynamically, etomidate group was more stable than propofol group following induction of anesthesia (P < 0.05. Conclusion: The surge in serum cortisol levels on the initiation of CPB seen after the use of propofol is prevented by the use of etomidate. Serum cortisol levels in both groups are well above the baseline at twenty-four hours without any untoward effects. Etomidate provides more stable hemodynamic parameters when used for induction of anesthesia as compared to propofol.

  10. A patent ductus arteriosus complicating cardiopulmonary bypass for combined coronary artery bypass grafting and aortic valve replacement only discovered by computed tomography 3D reconstruction.

    Science.gov (United States)

    van Middendorp, Lars B; Maessen, Jos G; Sardari Nia, Peyman

    2014-12-01

    We describe the case of a 59-year old male patient undergoing combined coronary artery bypass grafting and aortic valve replacement. Manipulation of the heart during cardiopulmonary bypass significantly decreased venous return. Several measures were necessary to improve venous return to a level at which continuation of the procedure was safe. Based on the initial troubles with venous return, we decided to selectively cross-clamp the aorta. This resulted in a large amount of backflow of oxygenated blood from the left ventricle, necessitating additional vents in the pulmonary artery and directly in the left ventricle. The procedure was continued uneventfully, and postoperative recovery was without significant complications. Postoperative 2D computed tomography did not show any signs of a shunt, but 3D reconstruction showed a small patent ductus arteriosus. PMID:25164136

  11. Hereditary spherocytosis in a patient undergoing coronary artery bypass grafting with cardiopulmonary bypass--a case report.

    Science.gov (United States)

    Spegar, J; Riha, H; Kotulak, T; Vanek, T

    2015-01-01

    Hereditary spherocytosis is a genetically determined abnormality of red blood cells. It is the most common cause of inherited haemolysis in Europe and North America within the Caucasian population. We document a patient who underwent an aortocoronary bypass procedure on cardiopulmonary bypass. In view of the uncertain tolerance of the abnormal red cells in hereditary spherocytosis to cardiopulmonary bypass, we reviewed the patient's chart and analyzed recorded values of these parameters: free plasma haemoglobin, renal parameters, cystatin C, bilirubin, liver tests, urine samples. From the results, we can see that slight haemolysis-elevated bilirubin in the blood sample and elevated bilirubin and urobilinogen in the urine sample occurred on the first postoperative day. The levels of these parameters slowly decreased during the next postoperative days. There was no real clinical effect of this haemolysis on renal functions. PMID:24714521

  12. Comparison of Bleeding and Transfusion in Patients who Undergo Coronary Artery Bypass Grafting with and without Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    M Abbaszadeh

    2011-10-01

    Full Text Available Background and Aim: Excessive Bleeding continues to play a key role and an important cause of morbidity and mortality after cardiopulmonary bypass (CPB. The goal of this study was to determine the differences in bleeding and transfusion between OPCAB and on -pump CABG patients.Materials and Methods: In a randomized, double blinded prospective study 300 patient's undergoing coronary revascularization surgery were enrolled, 150 CABG patients were compared with 150 OPCAB patients. The patients were assessed during the first 72 hours to determine the postoperative side effects. The 2 groups were compared using the chi-square test or fisher's exact test and the rank sum test.Results: CABG patients received more intraoperative red blood cells (P<0.0001, more albumin and more fresh- frozen plasma (P<0.0001. Postoperatively, CABG patients were more likely to receive more platelets (29.3% ? 70.7 %, P<0.007. During the operative and the initial 4-hour postoperative period OPCAB patients exhibited greater blood loss (P<0.0001; however, at 12,24and 72 hours postoperatively, CABG patients exhibited greater blood loss. There were4 death in CABG patients (P<0.05Conclusion: Despite not reversing the heparin at the end of the OPCAB surgery, OPCAB surgery was associated with an overall reduction in platelets, fresh- frozen plasma, Albumin and transfusion requirements.

  13. Bivalirudin Anticoagulation for Cardiopulmonary Bypass: An Unusual Case

    OpenAIRE

    Nikolaidis, Nicolas; Velissaris, Theodore; Ohri, Sunil K.

    2007-01-01

    The standard agent used for systemic anticoagulation during cardiopulmonary bypass is heparin. Alternative methods of anticoagulation are required for patients with heparin hypersensitivity. We present the case of a patient with heparin hypersensitivity who was anticoagulated with bivalirudin during cardiopulmonary bypass for coronary artery bypass grafting. This presented unusual challenges surrounding the monitoring of anticoagulation and the method of myocardial protection.

  14. 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)

    OpenAIRE

    Nelson William B; House Chad M; Ahmed Imdad

    2009-01-01

    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 inc...

  15. Revascularização cirúrgica do miocárdio sem utilização do circuito extracorpóreo em pacientes com infarto agudo do miocárdio tratados previamente com estreptoquinase intravenosa / Coronary artery bypass grafting without cardiopulmonary bypass in patients with myocardial infarction innitially treated with intravenous streptokinase

    Scientific Electronic Library Online (English)

    Hermínio, Vega; Luiz Eduardo V, Leão; José Honório de Almeida Palma da, Fonseca; Walter José, Gomes; Lélio Alves, Silva; João Nelson Rodrigues, Branco; Miguel Angel, Maluf; Expedito E, Ribeiro; Ênio, Buffolo.

    1991-12-01

    Full Text Available A utilização de agentes trombolíticos nas primeiras horas do infarto agudo do miocárdio tem sido aceita como um dos principais métodos de limitar-se a extensão do infarto. Entretanto, a persistência de estenose residual necessita de método complementar de revascularização. Em nosso Serviço, temos re [...] alizado a revascularização cirúrgica do miocárdio sem a utilização do circuito extracorpóreo de modo eletivo, com bons resultados. Utilizamos o método em 25 pacientes com diagnóstico de infarto agudo do miocárdio tratados dentro de seis horas do início dos sintomas com estreptoquinase intravenosa e um a 21 dias após (média de oito dias) a revascularização cirúrgica sem a utilização do circuito extracorpóreo. A média de idade do grupo foi de 53,8 anos, sendo a média da fração de ejeção medida pelo método de Dodge de 60%; dez pacientees eram uniarteriais, 14 biarteriais e um triarterial, em 15 pacientes, o infarto localizava-se em parede anterior e em dez em parede posterior. Oito pacientes receberam uma ponte e 17, duas pontes. Em 15 casos utilizou-se a artéria torácica interna. A mortalidade hospitalar foi 0% e em nenhum caso houve necessidade de reoperação por sangramento. A revascularização cirúrgica do miocárdio sem a utilização do circuito extracorpóreo é, pois, uma opção tática que pode ser utilizada em alguns pacientes com esse tipo de doença, com excelentes resultados em termos de morbidade e mortalidade hospitalares. Abstract in english The authors have performed coronary artery bypass grafting without cardiopulmonary bypass in 25 patients with myocardial infarction treated innitially with intravenous streptokinase. Our goal is to offer a tatic option to this kind of patients. Our satisfactory results authorize us to continue to pe [...] rform this procedure, particulary in patients who need one or two bypass graftings.

  16. Prevalence and intensity of hyperglycemia in non-diabetic patients undergoing coronary artery bypass graft surgery with and without cardiopulmonary bypass.

    OpenAIRE

    Rasoul Azarfarin2,; Azin Alizadeh Asl

    2008-01-01

    OBJECTIVES To study the prevalence and severity of hyperglycemia in nondiabetic patients undergoing cardiac operation. METHODS In an observational prospective study, 282 non-diabetic patients underwent elective off-pump (n=101) or on-pump (n=181) coronary artery bypass grafting (CABG) surgery from March 2006 to July 2007 in Madani Heart Hospital, Tabriz, Iran. Blood glucose (BG) levels were measured during and 24 hours after operation. Frequencies of hyperglycemia (BG>or=126 mg/dl...

  17. Anesthesia for coronary artery bypass grafting with hypothermic cardiopulmonary bypass in a patient with a A2B negative Blood Group

    OpenAIRE

    M. Toufan; F Sepasi; Alizadeh, A. (PhD); R Azarfarin

    2008-01-01

    A2B negative is one of rare subgroups of ABO blood group system. Herein, we report a 59-year-old male patientwho was candidate for coronary artery bypass grafting surgery (CABG) due to coronary artery stenosis. The patient`s blood group was reported as AB negative in routine laboratory, and because of doubtful result, a complementary test confirmed his blood group as A2B negative. The consultant hematologist recommended reserving either negative A2B packed red blood cell (PRBC) or if unavaila...

  18. A case report and brief review of the literature on bilateral retinal infarction following cardiopulmonary bypass for coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Trethowan Brian A

    2011-11-01

    Full Text Available Abstract Postoperative visual loss is a devastating perioperative complication. The commonest aetiologies are anterior ischaemic optic neuropathy (AION, posterior ischaemic optic neuropathy (PION, and central retinal artery occlusion (CRAO. These appear to be related to certain types of operation, most commonly spinal and cardiac bypass procedures; with the rest divided between: major trauma causing excessive blood loss; head/neck and nasal or sinus surgery; major vascular procedures (aortic aneurysm repair, aorto-bifemoral bypass; general surgery; urology; gynaecology; liposuction; liver transplantation and duration of surgery. The non-surgical risk factors are multifactorial: advanced age, prolonged postoperative anaemia, positioning (supine v prone, alteration of venous drainage of the retina, hypertension, smoking, atherosclerosis, hyperlipidaemia, diabetes, hypercoagulability, hypotension, blood loss and large volume resuscitation. Other important cardiac causes are septic emboli from bacterial endocarditis and emboli caused by atrial myxomata. The majority of AION cases occur during CPB followed by head/neck surgery and prone spine surgery. CPB is used to allow coronary artery bypass grafting on a motionless heart. It has many side-effects and complications associated with its use and we report here a case of bilateral retinal infarction during routine coronary artery bypass grafting in a young male patient with multiple risk factors for developing this complication despite steps to minimise its occurrence.

  19. Prevalence and intensity of hyperglycemia in non-diabetic patients undergoing coronary artery bypass graft surgery with and without cardiopulmonary bypass

    International Nuclear Information System (INIS)

    Objective was to study the prevalence and severity of hyperglycemia in nondiabetic patients undergoing cardiac operation. In an observational prospective study, 282 non-diabetic patients underwent elective off-pump (n=101) or non on-pump (n=181) coronary artery bypass grafting (CABG) surgery from March 2006 to July 2007 in Madani Heart Hospital, Tabriz, Iran. Blood glucose (BG) levels were measured during and 24 hours after operation. Frequencies of hyperglycemia (BG>-126 mg/dl) and severe hyperglycemia (BG>-180 mg/dl) and postoperative complications were compared in the 2 study groups. Prevalence of at least one episode of severe hyperglycemia was 54.6% (154/282) in our patients during and 24 hours after operation. Intra-operative hyperglycemia was slightly higher in on-pumping group. Frequency of post-operative hyperglycemia was higher, although not significantly different between the two groups. The 2 study groups were not significantly different in frequency of severe hyperglycemia during operation, although were different within 24 hours postoperative period. Prevalence of hyperglycemia especially severe hyperglycemia was high during, and after operation in both off-pump and on-pump CABG in non-diabetic patients. There was a borderline difference in blood glucose level between on-pump and off-pump CABG patients. It may be prudent to consider glycemic control protocols in these patients especially in early post-operative period. (author)eriod. (author)

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

    OpenAIRE

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

    2010-01-01

    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 g...

  1. 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.

  2. 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

  3. Cardiopulmonary Exercise Testing

    OpenAIRE

    Donnell, Denis E. O.; Alberto Neder, J.; Johnson, Bruce D.; Marciniuk, Darcy D.

    2013-01-01

    Cardiopulmonary exercise testing (CPET) is a noninvasive procedure that provides diagnostic and prognostic information and evaluates an individual’s capacity for dynamic exercise. CPET is an investigation of the respiratory, cardiovascular and cellular response to the exercise that can be done under controlled metabolic conditions. It provides assessment of the integrative exercise responses involving not only the pulmonary and cardiovascular systems but also skeletal muscle system, which a...

  4. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Science.gov (United States)

    2010-04-01

    ...false Cardiopulmonary bypass heat exchanger. 870.4240 Section 870...4240 Cardiopulmonary bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting...

  5. 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.

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

    Scientific Electronic Library Online (English)

    Ricardo Antonio G., Barbosa; Silvia Regina C. Jorge, Santos; Paul F., White; Valéria A., Pereira; Carlos R., Silva Filho; Luiz M. S., Malbouisson; Maria José C., Carmona.

    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 pharmacok [...] inetics 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

  7. 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.

  8. 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...

  9. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Science.gov (United States)

    2010-04-01

    ...Cardiopulmonary bypass pulsatile flow generator. 870.4320 Section 870.4320...Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and...

  10. The place of cardiopulmonary resuscitation.

    OpenAIRE

    Tombleson, P.

    1990-01-01

    Following the report of a working party of the Royal College of Physicians in July 1987, a decision was taken to make the skill of cardiopulmonary resuscitation mandatory for entrants to the College. The options for introducing this criterion are discussed, including the ultimate decision reached by the Examination Board to accept presentation of a certificate of competence by candidates on application to take the examination.

  11. 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

  12. Aortic valve replacement after previous coronary artery bypass grafting: a case report.

    Science.gov (United States)

    Suzuki, Shigemitsu; Nakamura, Katsuhiko; Takagi, Kazumi; Kashikie, Hideyuki; Akaiwa, Keiichi

    2013-01-01

    We experienced a case of aortic valve replacement after previous coronary artery bypass grafting with patent bypass grafts. Based on the retrosternal anatomy assessed by preoperative angiography and thoracic computed tomography, aortic valve replacement was performed through a median resternotomy. After careful dissection of the right side of the heart and the ascending aorta, cardiopulmonary bypass was established with cannulation of the ascending aorta and bicaval venous cannulation. The patent bypass grafts were dissected only as required for clamping and were clamped during cardiac arrest. After aortic valve replacement, the patient was uneventfully weaned from cardiopulmonary bypass and had a good postoperative recovery. It is important that surgeons have a meticulous strategy for reducing the risks associated with operating on patients with patent bypass grafts. We report on the surgical management of patients undergoing aortic valve replacement after previous coronary artery bypass grafting, including careful planning during the first operation. PMID:23877203

  13. The history of cardiopulmonary resuscitation.

    Science.gov (United States)

    DeBard, M L

    1980-05-01

    The development of modern cardiopulmonary resuscitation (CPR) is an exciting and surprising history to modern health professionals who rarely are aware of how new CPR really is. Artificial respiration began in the 16th century with Vesalius's work on living animals; progressed with the rise and fall of mouth-to-mouth, manual, and positive pressure ventilation methods of the 18th and 19th centuries; and culminated in 1958 with demonstration of the superiority of the mouth-to-mouth technique. Cardiac massage began in 1874, with the open chest method gaining ascendancy until the 1960 demonstration of the equality and greater ease of closed chest cardiac massage. Electrical defibrillation may have begun in 1775, but was not proven successful in animals internally until 1899. The technique was applied to man internally in 1947 and externally in 1956. The simultaneous use of all these modern CPR methods dates back only 20 years. PMID:6989296

  14. Amitriptyline Intoxication Responded to Cardiopulmonary Resuscitation

    OpenAIRE

    Güldem Turan; Özcan Pi?kin; Gül?en Bulut

    2012-01-01

    The most severe effects in amitriptiline intoxications are related with central nervous system and cardiovascular system. Amitriptiline intoxication especially with high doses has severe cardiac effects and can result in cardiac arrest. Most favorable responses can be achieved with efficient and prolonged cardiopulmonary resuscitation. We wanted to present a case ingested high dose of amitriptiline for attempt to suicide and responded to prolonged cardiopulmonary resuscitation.

  15. Current Approaches to Cardiopulmonary Resuscitation.

    Science.gov (United States)

    Truong, Huu Tam; Low, Li Shien; Kern, Karl B

    2015-07-01

    Real progress has been made in improving long-term outcome after out-of-hospital cardiac arrest in the past 10 years. Many communities have doubled their survival-to-hospital-discharge rate during this period. Common features of such successful programs include the following: (1) 911 dispatcher-assisted cardiopulmonary resuscitation (CPR) instruction, (2) bystander chest compression-only CPR program, (3) public access defibrillation, including targeted automated external defibrillator programs, (4) renewed emphasis on minimally interrupted chest compressions by emergency medical services responders, and (5) aggressive postresuscitation care, including targeted temperature management and early coronary angiography and intervention. An important lesson from these successful community efforts is that multiple, simultaneous changes to the local cardiac arrest response system are necessary to improve survival. The next exciting step in this quest appears to be the treatment of refractory cardiac arrest with the combination of mechanical CPR, intra-arrest hypothermia, extracorporeal CPR with mechanical circulatory support devices, and early coronary intervention. PMID:26071014

  16. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Science.gov (United States)

    2010-04-01

    ...870.4250 Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a...

  17. 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.

  18. [Valve surgery in patients with prior coronary artery bypass grafting].

    Science.gov (United States)

    Fujita, Tomoyuki; Kobayashi, Junjiro

    2013-07-01

    Valve surgery in patients with prior coronary artery bypass grafting (CABG) is challenging procedure. If the patent graft was injured during resternotomy or dissection of the graft, operative mortality and morbidity was significantly increased. To avoid the injury, left internal mammary artery( LIMA)should be passed through under the left lung and right internal mammary artery (RIMA) should be avoided if valve surgery is anticipated in the future. We invented "internal mammary artery (IMA)-non-touch procedure" which included systemic hyperkalemia and mild hypothermia during cardiopulmonary bypass without touching IMA. With this technique, cardiac arrest can be achieved without myocardial injury avoiding IMA injury. Available transcatheter aortic valve replacement (TAVR) is awaited in Japan. Patent graft is no longer a risk for TAVR, although long term results have not been obtained. Therefore, once TAVR becomes available, TAVR can be the standard therapy for aortic valve replacement( AVR) in patients with prior CABG. PMID:23917176

  19. Brain microvascular function during cardiopulmonary bypass

    International Nuclear Information System (INIS)

    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 capillary diffusion capacity for hydrophilic tracers of low permeability. Capillary diffusion capacity, cerebral blood flow, and cerebral metabolic rate for glucose were measured simultaneously by the integral method, different tracers being used with different circulation times. In eight animals subjected to normothermic cardiopulmonary bypass, and seven subjected to hypothermic bypass, cerebral blood flow, cerebral metabolic rate for glucose, and capillary diffusion capacity decreased significantly: cerebral blood flow from 63 to 43 ml/100 gm/min in normothermia and to 34 ml/100 gm/min in hypothermia and cerebral metabolic rate for glucose from 43.0 to 23.0 mumol/100 gm/min in normothermia and to 14.1 mumol/100 gm/min in hypothermia. The capillary diffusion capacity declined markedly from 0.15 to 0.03 ml/100 gm/min in normothermia but only to 0.08 ml/100 gm/min in hypothermia. We conclude that the decrease of cerebral metabolic rate for glucose during normothermic cardiopulmonary ucose during normothermic cardiopulmonary bypass is caused by interruption of blood flow through a part of the capillary bed, possibly by microemboli, and that cerebral blood flow is an inadequate indicator of capillary blood flow. Further studies must clarify why normal microvascular function appears to be preserved during hypothermic cardiopulmonary bypass

  20. Pathophysiology of cardiopulmonary bypass: current issues.

    Science.gov (United States)

    Utley, J R

    1990-09-01

    Much of the research related to cardiopulmonary bypass in recent years has been directed toward defining the changes in plasma and blood cells during bypass. In this review, recent information is reexamined for six areas of current interest. These areas are complement activation, immune response, anaphylactic reactions, coagulation, and cerebral dysfunction. Complement may be activated by either the classical or alternate pathway during cardiopulmonary bypass and protamine administration. Membrane oxygenators appear to diminish the degree of complement activation. Complement is a major factor in the whole body inflammatory response; which often accompanies cardiopulmonary bypass. A product of complement activation, C5a- desArg, causes activation and aggregation of granulocytes. Other products of complement activation lead to lysis of blood cells including granulocytes and red cells. Bubble oxygenators appear to have a distinct disadvantage compared to membrane oxygenators regarding infection. Airborne microorganisms are more likely to be entrained into circulating blood with bubble oxygenators than with membrane oxygenators. Bubble oxygenators cause a greater decrease in leukocyte number and function than membrane oxygenators. Anaphylactic reactions have been associated with use of antibiotics, blood products, protamine, and volume expanders during cardiopulmonary bypass. Protamine reactions may be on an immunological basis or due to direct toxicity of the drug. Free radicals including superoxide, hydrogen peroxide, and the hydroxyl radical may be generated during cardiopulmonary bypass and reperfusion. Free radical scavengers including; vitamin E, coenzyme Q, vitamin C, mannitol, and glutathione have been studied. The avoidance of blood transfusion because of risk of transmitted infection including AIDS has become a major goal in cardiac surgery. Factors that correlate with increased transfusion requirement include low hematocrit, female gender, increased age, small body size, low ejection fraction, reoperation, and emergency operation. Heparin resistance due to antithrombin III deficiency is being recognized more commonly. Antithrombin III deficiency may be corrected with fresh frozen plasma. Patients with heparin induced thrombocytopenia may be difficult to manage. Several management protocols are suggested. The most straightforward appears to be the use of aspirin preoperatively and platelet transfusions postoperatively. The incidence of cerebral dysfunction after cardiopulmonary bypass depends on the sensitivity of the test or indicator used. Perioperative stroke is associated with intrinsic cerebrovascular disease and atherosclerosis of the ascending aorta. Retinal angiograms during cardiopulmonary bypass show that microemboli are very common. Cerebroplegia has been shown to extend the period of safe circulatory arrest in animals. Much of the new knowledge concerning cardiopulmonary bypass is the result of close collaboration between cardiac surgeons and nonsurgical scientists. PMID:2133841

  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.

    1105-11-01

    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 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. 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.

  3. 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.

  4. Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is ... bypass multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of ...

  5. Stimulation of the cardiopulmonary baroreflex enhances ventricular contractility in awake dogs: a mathematical analysis study.

    Science.gov (United States)

    Sala-Mercado, Javier A; Moslehpour, Mohsen; Hammond, Robert L; Ichinose, Masashi; Chen, Xiaoxiao; Evan, Sell; O'Leary, Donal S; Mukkamala, Ramakrishna

    2014-08-15

    The cardiopulmonary baroreflex responds to an increase in central venous pressure (CVP) by decreasing total peripheral resistance and increasing heart rate (HR) in dogs. However, the direction of ventricular contractility change is not well understood. The aim was to elucidate the cardiopulmonary baroreflex control of ventricular contractility during normal physiological conditions via a mathematical analysis. Spontaneous beat-to-beat fluctuations in maximal ventricular elastance (Emax), which is perhaps the best available index of ventricular contractility, CVP, arterial blood pressure (ABP), and HR were measured from awake dogs at rest before and after ?-adrenergic receptor blockade. An autoregressive exogenous input model was employed to jointly identify the three causal transfer functions relating beat-to-beat fluctuations in CVP to Emax (CVP ? Emax), which characterizes the cardiopulmonary baroreflex control of ventricular contractility, ABP to Emax, which characterizes the arterial baroreflex control of ventricular contractility, and HR to Emax, which characterizes the force-frequency relation. The CVP ? Emax transfer function showed a static gain of 0.037 ± 0.010 ml(-1) (different from zero; P < 0.05) and an overall time constant of 3.2 ± 1.2 s. Hence, Emax would increase and reach steady state in ?16 s in response to a step increase in CVP, without any change to ABP or HR, due to the cardiopulmonary baroreflex. Following ?-adrenergic receptor blockade, the CVP ? Emax transfer function showed a static gain of 0.0007 ± 0.0113 ml(-1) (different from control; P < 0.10). Hence, Emax would change little in steady state in response to a step increase in CVP. Stimulation of the cardiopulmonary baroreflex increases ventricular contractility through ?-adrenergic receptor system mediation. PMID:24944253

  6. 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.

  7. Feasibility of Temporary Biventricular Pacing after Off-Pump Coronary Artery Bypass Grafting in Patients with Reduced Left Ventricular Function

    OpenAIRE

    Wang, Daniel Y.; Kelly, Lauren A.; Richmond, Marc E.; Quinn, T. Alexander; Cheng, Bin; Spotnitz, Michelle D.; Cabreriza, Santos E.; Naka, Yoshifumi; Stewart, Allan S.; Smith, Craig R.; Spotnitz, Henry M.

    2013-01-01

    In selected patients undergoing cardiac surgery, our research group previously showed that optimized temporary biventricular pacing can increase cardiac output one hour after weaning from cardiopulmonary bypass. Whether pacing is effective after beating-heart surgery is unknown. Accordingly, in this study we examined the feasibility of temporary biventricular pacing after off-pump coronary artery bypass grafting.

  8. 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 patientsemperature 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

  9. Textile sensing interfaces for cardiopulmonary signs monitoring.

    Science.gov (United States)

    Loriga, G; Taccini, N; De Rossi, D; Paradiso, R

    2005-01-01

    A wearable system able to monitor cardiopulmonary vital signs is presented. The innovative technological core of the system is based on the use of a textile conformable sensing cloth, where conducting and piezoresistive materials are integrated in form of fibres and yarns, giving rise to fabric sensors, electrodes and connections. Electrocardiogram and impedance pneumography signals are acquired through the same textile electrodes, while to discriminate between abdominal and thoracic activity, two piezoresistive fabric sensors are placed below the lower end of the sternum and at the level of the navel for recording the thorax and the abdominal pattern of breathing. The use of impedance pneumography methodology reduces the artefacts due to the movement, phonation and rib cage expansions disjointed from respiratory mechanics. All the signals are acquired simultaneously allowing a comparative control of the cardiopulmonary activity and artefacts rejection. PMID:17281978

  10. Graft copolimerization of hydrophilic monomers onto irradiated polypropylene fibers

    International Nuclear Information System (INIS)

    A method of graft copolymerization of hydrophilic monomers, such as 1-vinyl-2-pyrrolidone, acrylonitrile, acrylic acid, and acrylamide, onto irradiated polypropylene fibers has been studied. ? ray as well as electron beam were employed for the irradiation processes. Graft-copolymerization kinetics and the properties of grafted fibers have been investigated. Moisture regain, dyes absorption, and melting point of the grafted fibers were found to increase with the increasing of the degree of grafting. Polypropylene for 1-vinyl-2-pyrrolidone grafted fibers showed excellent dye absorption for almost all kinds of dyes such as direct, basic, acid, reactive, disper, and naphthol dyes. However, for polypropylene acrylic acid grafted fibers, the colorfastness to washing was found to be unsatisfactory. The colorfastness to washing for polypropylene 1-vinyl-2-pyrrolidone grafted fibers was found to be fairly good for certain types of dyes such as vat and naphthol dyes. (author)

  11. 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 the...

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

    Science.gov (United States)

    2010-04-01

    ...Nonroller-type cardiopulmonary bypass blood pump. 870.4360 Section 870.4360 Food...Nonroller-type cardiopulmonary bypass blood pump. (a) Identification. A nonroller-type cardiopulmonary bypass blood pump is a device that uses a method other...

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

    Science.gov (United States)

    2010-04-01

    ...Roller-type cardiopulmonary bypass blood pump. 870.4370 Section 870.4370...Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass blood pump is a device that uses a revolving...

  14. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Science.gov (United States)

    2010-04-01

    ...false Cardiopulmonary bypass vascular catheter, cannula, or tubing. 870.4210...4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing. (a) Identification... A cardiopulmonary bypass vascular catheter, cannula, or tubing is a...

  15. Haemodialysis and haemofiltration on cardiopulmonary bypass.

    OpenAIRE

    Hakim, M.; Wheeldon, D.; Bethune, D. W.; Milstein, B. B.; English, T. A.; Wallwork, J.

    1985-01-01

    Over a three year period we have used haemodialysis and haemofiltration in parallel with cardiopulmonary bypass in 26 patients. Impaired renal function and excessive fluid retention have been the main indications. Patients on haemodialysis programmes for end stage renal failure did not require further dialysis until at least the third postoperative day, when they could tolerate the haemodynamic disturbance of dialysis. In the other patients these techniques proved valuable in reversing the ef...

  16. Thromboxane Mediation of Cardiopulmonary Effects of Embolism

    OpenAIRE

    Utsunomiya, Takayoshi; Krausz, Michael M.; Levine, Lawrence; Shepro, David; Hechtman, Herbert B.

    1982-01-01

    Humoral factors released from platelets during pulmonary embolism may be the cause of several attendant cardiopulmonary abnormalities. This study examines the role of thromboxanes (Tx) after experimental embolism induced with 0.5 g/kg autologous clot in four groups of five dogs: (a) untreated embolized controls; (b) pretreatment with the Tx synthetase inhibitor, imidazole 25 mg/kg · h i.v., starting 30 min before embolization; (c) pretreatment with the cyclooxygenase inhibitor indomethacin, ...

  17. Cardiopulmonary arrest in the pregnant woman

    OpenAIRE

    Heyns, T.; de Kock, J

    2008-01-01

    It is not common for a woman to suffer a cardiac arrest during pregnancy, but when it occurs it can be devastating for both mother and fetus. To improve the likelihood of a positive outcome for the mother and the fetus, the midwife should be skilled in cardiopulmonary resuscitation (CPR). This includes early recognition, early basic life support and early defibrillation until appropriately qualified healthcare professionals can start with advanced life support (ALS). Although CPR dur...

  18. 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...

  19. 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 th...

  20. Artificial neural network cardiopulmonary modeling and diagnosis

    Science.gov (United States)

    Kangas, L.J.; Keller, P.E.

    1997-10-28

    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. 12 figs.

  1. Cardiopulmonary resuscitation: update, controversies and new advances

    Scientific Electronic Library Online (English)

    Alexandre C., Zago; Cristine E., Nunes; Viviane R. da, Cunha; Euler, Manenti; Luís Carlos, Bodanese.

    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. Cardio [...] pulmonary 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.

  2. Prophylactic amrinone for weaning from cardiopulmonary bypass.

    Science.gov (United States)

    Lewis, K P; Appadurai, I R; Pierce, E T; Halpern, E F; Bode, R H

    2000-07-01

    This prospective, randomised, double-blind, controlled clinical study was performed at a single tertiary referral centre to test the hypothesis that the prophylactic administration of amrinone before separation of a patient from cardiopulmonary bypass decreases the incidence of failure to wean, and to identify those patients who could be predicted to benefit from such pre-emptive management. Two hundred and thirty-four patients, scheduled to undergo elective cardiac surgery, were randomly allocated to receive either a bolus dose of 1.5 mg x kg(-1) amrinone over 15 min, followed by an infusion of 10 microg x kg(-1) x min(-1), or a bolus of placebo of equal volume followed by an infusion of placebo. Treatment with amrinone or placebo was initiated upon release of the aortic cross-clamp, before weaning from cardiopulmonary bypass. Anaesthetic technique, monitoring and myocardial preservation methods were standardised for both groups. Significantly fewer patients failed to wean in the group that received prophylactic amrinone than in the control group (7 vs. 21%, p = 0.002). Amrinone improved weaning success regardless of left ventricular ejection fraction, although this benefit was statistically significant only in the group with left ventricular ejection fractions > 55%. Of the 32 patients who failed to wean from cardiopulmonary bypass, 14 had normal pre-operative left ventricular ejection fractions. PMID:10919416

  3. Anesthetic management of a patient with deteriorated cardiac function following cardiopulmonary resuscitation.

    Science.gov (United States)

    Nagata, Tamaki; Mishima, Yasunori; Ito, Takahiko; Sawada, Maiko; Hiraki, Teruyuki; Hamada, Nobuya; Miyawaki, Nao; Ito, Asuka; Watanabe, Seiji; Ushijima, Kazuo

    2010-01-01

    A 73-year-old woman suffering from an abdominal aortic aneurysm (AAA), unstable angina, and low cardiac function (32% of ejection fraction) was scheduled for abdominal aortic replacement and coronary artery bypass grafting. However, before the scheduled operation the patient fell into cardiopulmonary arrest with ventricular fibrillation due to rupture of the AAA. Immediate cardiopulmonary resuscitation (CPR) using epinephrine and electrical defibrillation restored the spontaneous circulation. Following CPR, a continuous high-dose dopamine infusion (15 µg/kg/min) was initiated and emergent abdominal aortic replacement was performed. On arrival at the operating room, the patient showed serious hypotension, atrial fibrillation with multifocal ventricular premature contractions, and metabolic acidosis. Transesophageal echocardiography (TEE) suggested that the circulatory collapse might have resulted from diastolic dysfunction and deteriorated compliance of the left ventricular (LV) wall, possibly due to myocardial stunning induced by myocardial ischemia, and tachycardia induced by hypovolemia, both of which are influenced by high doses of catecholamine. We accordingly transfused adequate amounts of blood products and gradually decreased the infusion rate of dopamine to 4 µg/kg/min, while carefully monitoring blood pressure, central venous pressure, and TEE. By the end of surgery hemodynamic parameters had recovered to near normal levels. In post-resuscitated and hypovolemic patients, caution should be taken when administering high levels of exogenous catecholamines, which can induce myocardial stunning and circulatory collapse. PMID:21186343

  4. Evaluation of Flow Characteristics of the Left Internal Thoracic Artery Graft: Perioperative Color Doppler Ultrasonography versus Intraoperative Free-Bleeding Technique

    OpenAIRE

    Cagli, Kerim; Emir, Mustafa; Kunt, Aysegul; Ergun, Kumral; Tola, Muharrem; Topbas, Murat; Vural, Kerem; Sener, Erol

    2004-01-01

    From October 2000 through April 2001, we prospectively evaluated the flow characteristics of the left internal thoracic artery (LITA) graft in a homogenous group of 44 men with isolated severe proximal left anterior descending coronary artery stenosis who underwent elective coronary artery bypass grafting with cardiopulmonary bypass. We performed transthoracic color Doppler ultrasonography preoperatively and repeated this examination in each patient between the 5th and 7th postoperative days,...

  5. 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

  6. 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.

  7. 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.

  8. Radiation-induced grafting of acrylic acid onto polyethylene filaments

    International Nuclear Information System (INIS)

    Radiation-induced grafting of acrylic acid onto high density polyethylene (PE) filaments was carried out in order to raise softening temperature and impart flame retardance and hydrophilic properties. Mutual ?-irradiation method was employed for the grafting in a mixture of acrylic acid (AA), ethylene dichloride and water containing a small amount of ferrous ammonium sulfate. The rate of grafting was very low at room temperature. On the other hand, large percent grafts were obtained when the grafting was performed at an elevated temperature. Activation energy for the initial rate of grafting was found to be 17 kcal/mol between 20 and 600C and 10 kcal/ mol between 60 and 800C. Original PE filament begins to shrink at 700C, shows maximum shrinkage of 50% at 1300C and then breaks off at 1360C. When a 34% AA graft is converted to metallic salt the graft filament retains its filament form even above 3000C and gives maximum shrinkage of 15%. Burning tests by a wire-netting basket method indicate that graft filaments and their metallic salts do not form melting drops upon burning and are self-extinguishing. Original PE filament shows no moisture absorption; however, that of AA-grafted PE increases with increasing graft percent. (author)

  9. Strategies for cardiopulmonary exercise testing of pectus excavatum patients

    Directory of Open Access Journals (Sweden)

    Moh H. Malek

    2008-01-01

    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.

  10. 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.

  11. Transient Diabetes InsipidusFollowing Cardiopulmonary Bypass.

    Science.gov (United States)

    Ekim, Meral; Ekim, Hasan; Yilmaz, Yunus Keser; Bolat, Ali

    2015-04-01

    Diabetes insipidus(DI) results from inadequate output of Antidiuretic Hormone (ADH) from the pituitary gland (central DI) or the inability of the kidney tubules to respond to ADH (nephrogenic DI). ADH is an octapeptide produced in the supraoptic and paraventricular nuclei of the hypothalamus and stored in the posterior lobe of the pituitary gland. Cardiopulmonary Bypass (CPB) has been shown to cause a six-fold increased circulating ADH levels 12 hours after surgery. However, in some cases, ADH release may be transiently suppressed due to cardioplegia (cardiac standstill) or CPB leading to DI. We present the postoperative course of a 60-year-old man who developed transient DI after CPB. He was successfully treated by applying nasal desmopressin therapy. Relevant biochemical parameters should be monitored closely in patients who produce excessive urine after open heart surgery. PMID:25933447

  12. 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.

  13. Intraoperative grafts assessment.

    Science.gov (United States)

    Leacche, Marzia; Balaguer, Jorge M; Byrne, John G

    2009-01-01

    Graft patency strongly influences early and late outcomes after coronary artery bypass grafting (CABG) surgery. The current standard of care in CABG surgery does not require intraoperative imaging. Because coronary angiography is rarely available in the operating room (OR), other techniques have been developed to assess graft integrity intraoperatively. The 2 most commonly used are the transit time flow measurement (TTFM) and the intraoperative fluorescence imaging (IFI). The TTFM is a quantitative volume flow technique, whereas the IFI is based on the fluorescent properties of indocyanine green. TTFM cannot define the degree of graft stenosis nor discriminate between the influence of the graft conduit and the coronary arteriolar bed on the mean graft flow. IFI provides a "semiquantitative" assessment of the graft patency with images that provide some details about the quality of coronary anastomoses. Both methods are valuable in identifying only at the extremes, that is, either patent or occluded grafts, and can confirm very good grafts; however, neither method is sensitive or specific enough in identifying more subtle abnormalities. These abnormal grafts most likely have poor long-term patency and are predestined to fail. The hybrid suite has the capability of serving both as a complete surgical OR and as a catheterization laboratory. It allows for routine completion angiogram following CABG surgery and identifies abnormal grafts, providing the opportunity to revise them with percutaneous coronary intervention or surgery before leaving the OR. PMID:19942118

  14. 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...

  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. 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.

  17. Thoracic stent-graft

    Directory of Open Access Journals (Sweden)

    Hyodoh H.

    2007-01-01

    Full Text Available The stent-graft is a device constructed from a stent and vascular graft and is inserted by means of an interventional procedure under imaging guidance. In 1986, Balko et al.1 reported the first stentgraft experiment, in which a Z stent covered with polyurethane was inserted into an animal aorta. In the early 1990s, Parodi et al.2 reported clinical introduction of the stent-graft for abdominal aortic aneurysm. In comparison to the abdominal aortic stent-graft, the thoracic stent-graft has several disadvantages, including difficulties associated with the aortic arch curvature and the relatively large caliber of the stent-graft, and the risk of central nervous system or spinal complication. However, the thoracic stentgraft is advantageous because of minimal procedural invasiveness in comparison to surgical graft replacement. In 1994, Dake et al.3 reported transluminal placement of an endovascular stent-graft for thoracic aortic aneurysm, and Kato et al.4 reported use of a stent-graft for aortic dissection and suggested that the stent-graft could be considered an alternative to surgical treatment.

  18. Accelerated intimal hyperplasia in aortocoronary internal mammary vein grafts in minipigs

    Directory of Open Access Journals (Sweden)

    Seipelt Ralf

    2008-04-01

    Full Text Available Abstract Background More than 50% of aortocoronary saphenous vein grafts are occluded 10 years after surgery. Intimal hyperplasia is the initial critical step in the progression toward occlusion. Internal mammary veins, which are physiologically prone to less hydrostatic pressure, may undergo an accelerated progression to intimal hyperplasia and thus be suitable for investigation of the mechanisms of aortocoronary vein graft disease. Methods Six minipigs underwent aortocoronary bypass grafting using standard cardiopulmonary bypass and cardioplegic arrest. Mammary vein were grafted in a reversed manner from ascending aorta to left anterior descending coronary artery (LAD. The proximal LAD was ligated, rendering the anterior left ventricle vein graft-dependent. Minipigs were killed after 4 weeks, and vein grafts were harvested. Histological and immunohistological investigation were performed with respect to morphometric analysis, endothelial damage/dysfunction (v-Willebrand-factor (vWF, smooth muscle cells (?-smooth actin and proliferation rate (proliferation marker Ki 67. Results Mean intimal area of vein grafts was increased compared to ungrafted mammary veins. Intimal hyperplasia in vein grafts was characterized by massive accumulation of smooth muscle cells with a high proliferation rate and endothelial perturbation. Significant (p = 0.001 intimal hyperplasia of the grafted mammary vein compared to the ungrafted mammary vein was found. These changes were absent in ungrafted mammary veins. Conclusion The present study demonstrates a pig model of aortocoronary vein graft intimal hyperplasia which is characterized by an accelerated progression within internal mammary veins. The model is suitable to investigate the pathophysiology of aortocoronary vein graft intimal hyperplasia as well as therapeutic approaches.

  19. 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 survivg 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)

  20. Cardiopulmonary consequences of obstructive sleep apnea.

    Science.gov (United States)

    Shepard, J W

    1990-09-01

    During sleep, oxygen consumption and systemic blood pressure decrease in normal subjects; during rapid eye movement sleep, irregular ventilation can be accompanied by brief periods of apnea. In patients with obstructive sleep apnea, alveolar ventilation during an apneic episode is immediately reduced to zero, and the metabolic demands for oxygen must be met from oxygen stores within the body. As the stores of oxygen within the lung are diminished, the rate of arterial oxyhemoglobin desaturation increases. The development of alveolar hypoventilation during wakefulness seems to be based on a balance between central ventilatory drives to breathe and mechanical loads placed on the respiratory system. Coexistent cardiopulmonary or neuromuscular disease in patients with obstructive sleep apnea contributes to the development of alveolar hypoventilation. During apneic episodes, the systemic blood pressure increases while the heart rate and cardiac output decrease. Both bradycardias and increased ventricular ectopic activity have been associated with these disordered breathing episodes. Because of the possibility of apnea-associated arrhythmias, patients with obstructive sleep apnea may be at increased risk for cardiovascular mortality. The influence of these recurrent nocturnal episodes of asphyxia on cardiovascular longevity needs further investigation. PMID:2205763

  1. 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.

  2. Cardiopulmonary Exercise Testing in Heart Failure.

    Science.gov (United States)

    Myers, Jonathan; Arena, Ross; Cahalin, Lawarence P; Labate, Valentina; Guazzi, Marco

    2015-08-01

    A growing body of literature has underscored the value of ventilatory gas exchange techniques during exercise testing (commonly termed cardiopulmonary exercise testing, or CPX) and their applications in the management of patients with heart failure (HF). The added precision provided by this technology is useful in terms of understanding the physiology and mechanisms underlying exercise intolerance in HF, quantifying the response to therapy, evaluating disability, making activity recommendations, and quantifying the response to exercise training. Importantly, a wealth of data has been published in recent years on the prognostic utility of CPX in patients with HF. These studies have highlighted the concept that indices of ventilatory inefficiency, such as the VE/VCO2 slope and oscillatory breathing, are particularly powerful in stratifying risk in HF. This article provides an overview of the clinical utility of CPX in patients with HF, including the applications of ventilatory inefficiency during exercise, the role of the pulmonary system in HF, respiratory muscle performance (RMP), and the application of CPX as part of a comprehensive clinical and exercise test evaluation. PMID:26096801

  3. 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.

  4. Calcar bone graft

    International Nuclear Information System (INIS)

    A canine model was developed to investigate the use of an autogeneic iliac bone graft to treat the calcar deficiency commonly found at the time of revision surgery for femoral component loosening. Five large male mixed-breed dogs had bilateral total hip arthroplasty staged at three-month intervals, and were sacrificed at six months. Prior to cementing the femoral component, an experimental calcar defect was made, and a bicortical iliac bone graft was fashioned to fill the defect. Serial roentgenograms showed the grafts had united with no resorption. Technetium-99 bone scans showed more uptake at three months than at six months in the graft region. Disulfine blue injection indicated all grafts were perfused at both three and six months. Thin section histology, fluorochromes, and microradiographs confirmed graft viability in all dogs. Semiquantitative grading of the fluorochromes indicated new bone deposition in 20%-50% of each graft at three months and 50%-80% at six months. Although the calcar bone graft was uniformly successful in this canine study, the clinical application of this technique should be evaluated by long-term results in humans

  5. 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.

  6. Gravity and Development of Cardiopulmonary Reflex

    Science.gov (United States)

    Nagaoka, Shunji; Eno, Yuko; Ohira, Yoshinobu

    Cardio-pulmonary reflex, which our cardiac activity is synchronized to the respiration by autonomic nervous system regulation, is called as "respiratory sinus arrhythmia" and commonly found in adult. The physiological function of the espiratory sinus arrhythmia is considered to maximize the gas exchange during respiration cycle. This respiration induced heart rate variability (RHRV) is only found in mammals and avian showing a remarkable postnatal development, whereas no RHRV in aquatic species such as fish or amphibian. To elucidate our hypothesis that gravity exposure may plays a key role in the postnatal development of RHRV as well as its evolutional origin in these ground animals, we have studied effects of hypergravity (2G) on the postnatal development of RHRV using rat. Pregnant Wister rats were kept in centrifugal cages system for 38 days from 6th days of pregnant mother to have neonates until 23 days old. Electrocardiograph was recorded from the neonates in 2 to 23 days old in 2G group with simultaneous control (1G) group. The RHRV analysis was performed by calculating a component of Fourier power spectral coincide with the respiration frequency. In both groups, averaged resting heart rate gradually increase from 2 to 23 days old. When comparing the heart rate between the two groups, the 2G group indicated significantly lower (240± 8 bpm) than 1G control (326±21 bpm, p¡0.001) in 2 days old, where as no significance in 23 days old. The RHRV of 2 days old neonates in both groups indicated very small magnitude but significantly lower in 2G group than 1G control (p¡0.01). The RHRV gradually increase during the first 2 weeks and then rapid increased to reached 45 fold of magnitude in 1G control, whereas 69 fold in 2G group. The results strongly suggested that the postnatal innervation from respiration to cardiovascular centers was gravity dependent.

  7. 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

  8. An integrative review: instructional strategies to improve nurses' retention of cardiopulmonary resuscitation priorities.

    Science.gov (United States)

    Sullivan, Nancy

    2015-01-01

    Recognizing and responding to a cardiac arrest in the hospital setting is a high stress, high anxiety event for all healthcare providers. It requires the performance of several basic, but extremely important cardiopulmonary resuscitation (CPR) skills and response priorities. If not executed correctly and in a timely manner, a bad outcome may result. Poor retention of cardiopulmonary resuscitation skills and priorities is well documented in the literature. An integrative review of the evidence was conducted to answer the question, "Is there a more effective training method to improve nurses' retention of CPR priorities during an in hospital cardiac arrest as compared to traditional American Heart Association training? "This review evaluated high fidelity and low fidelity simulation training, online or computer-based training and video instruction as potential teaching strategies focusing on CPR priorities. The role of deliberate practice is discussed. The strongest evidence suggests that a teaching plan employing brief, frequent, repetitive or deliberate practice used in collaboration with low fidelity or high fidelity simulation may be a potential strategy to improve nurses' retention of CPR priorities over time. PMID:25830906

  9. 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.

  10. 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.

  11. End-Grafted Polymer Chains onto Inorganic Nano-Objects

    Directory of Open Access Journals (Sweden)

    Demetra S. Achilleos

    2010-03-01

    Full Text Available Organic/inorganic nanohybrid materials have attracted particular scientific and technological interest because they combine the properties of the organic and the inorganic component. Inorganic nanoparticles exhibit interesting electrical, optical, magnetic and/or catalytic properties, which are related with their nano-scale dimensions. However, their high surface-to-volume ratio often induces agglomeration and leads to the loss of their attractive properties. Surface modification of the inorganic nano-objects with physically or chemically end-tethered polymer chains has been employed to overcome this problem. Covalent tethered polymer chains are realized by three different approaches: the “grafting to”, the “grafting from” and the “grafting through” method. This article reviews the synthesis of end-grafted polymer chains onto inorganic nanoparticles using “controlled/living” polymerization techniques, which allow control over the polymer characteristics and the grafting density of the end-tethered polymer chains.

  12. 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. ected, 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)

  13. Family presence during cardiopulmonary resuscitation and invasive procedures in children

    Science.gov (United States)

    Ferreira, Cristiana Araújo G.; Balbino, Flávia Simphronio; Balieiro, Maria Magda F. G.; Mandetta, Myriam Aparecida

    2014-01-01

    Objective: To identify literature evidences related to actions to promote family's presence during cardiopulmonary resuscitation and invasive procedures in children hospitalized in pediatric and neonatal critical care units. Data sources : Integrative literature review in PubMed, SciELO and Lilacs databases, from 2002 to 2012, with the following inclusion criteria: research article in Medicine, or Nursing, published in Portuguese, English or Spanish, using the keywords "family", "invasive procedures", "cardiopulmonary resuscitation", "health staff", and "Pediatrics". Articles that did not refer to the presence of the family in cardiopulmonary resuscitation and invasive procedures were excluded. Therefore, 15 articles were analyzed. Data synthesis : Most articles were published in the United States (80%), in Medicine and Nursing (46%), and were surveys (72%) with healthcare team members (67%) as participants. From the critical analysis, four themes related to the actions to promote family's presence in invasive procedures and cardiopulmonary resuscitation were obtained: a) to develop a sensitizing program for healthcare team; b) to educate the healthcare team to include the family in these circumstances; c) to develop a written institutional policy; d) to ensure the attendance of family's needs. Conclusions: Researches on these issues must be encouraged in order to help healthcare team to modify their practice, implementing the principles of the Patient and Family Centered Care model, especially during critical episodes. PMID:24676198

  14. Necessity of immediate cardiopulmonary resuscitation in trauma emergency

    Directory of Open Access Journals (Sweden)

    Luciano Baitello

    2010-08-01

    Full Text Available Abstract The ability to respond quickly and effectively to a cardiac arrest situation rests on nurses being competent in the emergency life-saving procedure of cardiopulmonary resuscitation. The objective of the current study was to evaluate the types of trauma and survival of patients that require immediate cardiopulmonary resuscitation in trauma emergencies. A total of 13301 patients treated as accident victims between July 2004 and December 2006 were evaluated in a prospective study. Patients requiring immediate cardiopulmonary resuscitation at admission were identified. The type of injury and the survival of these patients were evaluated. Of the 65 patients included in the study, 30% had suffered from gunshot wounds, 19% had been run over, 18% had been involved in car crashes, 13% in motor cycle accidents, 9% stabbings, 1% by cycle accidents and 10% other types of accidents including burns, hangings and falls. In only 12 of these patients, immediate resuscitation was successful and procedure such as chest drainage, exploratory laparotomy and interventions in the surgical center were performed. However all patients evolved to death; eight within 24 hours, two between 24 and 48 hours and the other 2 after 48 hours. Immediate cardiopulmonary resuscitation after accidents is a sign of high mortality requiring further studies to review indication and the ethical aspects involved.

  15. Diagnosing and managing cardiopulmonary diseases in small animals

    OpenAIRE

    Schoeman, Johan P.

    2013-01-01

    How to cite this book review: Schoeman, J.P., 2013, ‘Diagnosing and managing cardiopulmonary diseases in small animals’, Journal of the South African Veterinary Association 84(1), Art. #954, 1 page. http://dx.doi. org/10.4102/jsava.v84i1.954

  16. 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…

  17. Left ventricular assist device outflow graft: alternative sites

    OpenAIRE

    El-Sayed Ahmed, Magdy M.; Aftab, Muhammad; Steve K. Singh; 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 ...

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

    International Nuclear Information System (INIS)

    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 patients (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 2/FiO2 ratio or shunt fraction at ub>2 ratio or shunt fraction at 24 h postoperatively and postoperative lung alterations. The data show that lung structure is profoundly modified after CABG with CPB. Taken together, multiple changes occurring in the lungs contribute to postoperative hypoxemia rather than atelectasis alone. (author)

  19. 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

  20. The Effect of Low Tidal Volume Ventilation during Cardiopulmonary Bypass on Postoperative Pulmonary Function

    Directory of Open Access Journals (Sweden)

    Gholamreza Safarpour

    2010-08-01

    Full Text Available Background: Postoperative pulmonary dysfunction is one of the most frequent complications after cardiac surgery and it is believed to result from the use of cardiopulmonary bypass (CPB. In this study, we investigated the effect of low tidal volume ventilation during CPB on postoperative gas exchange and lung mechanics.Methods: This prospective randomized study included 100 patients undergoing elective coronary artery bypass grafting. In 50 patients, low tidal volume ventilation [tidal volume (TV = 3 ml/kg, respiratory rate (RR = 12/min, fraction of inspiratory oxygen (FIO2= 1.0, positive end expiratory pressure (PEEP = 5 cmH2O] was applied during CPB (group I; and in the other 50 patients (group II, the lungs were open to the atmosphere without ventilation. Measurements were taken preoperatively,after CPB, and before discharge.Results: Post-bypass PaO2 (just after CPB 85 versus75 was higher significantly in group I (P value < 0.05. Decrease in postoperative forced expiratory volume in 1 second (25% versus 30% and forced vital capacity (32% versus 35% was less significant in group I. Also, time to extubation (5 hrs versus 5.5 hrs was shorter in group I.Conclusion: Continued low tidal volume ventilation during CPB improved post-bypass oxygenation and lung mechanics.

  1. Radiation graft-copolymerization kinetics of poly(ethylene terephthalate) fibres

    International Nuclear Information System (INIS)

    A theoretical analysis of radiation grafting kinetics has been made in terms of the quantitative interrelationship between the degree of grafting (Gsub(f)), the grafting periods (t) grafting temperature (T) and the monomer content in the polymeric system (M). Poly(ethylene terephthalate) fibres and a number of hydrophilic monomers have been employed for these experiments. The grafting reactions were initiated by trapped radicals produced by irradiation of the polymeric system under vacuum at room temperature. Experimental results showed that the monomer content in the fibres obeyed the Arrhenius relationship. The overall activation energy of the grafting reaction has been calculated. Grafting reactions can proceed only if ?Esub(t) > ?Esub(p) + ?Esub(M). This termination activation energy ?Esub(t) is a function of the state of polymeric system. (author)

  2. On Pump Coronary Artery Bypass Graft Surgery Versus Off Pump Coronary Artery Bypass Graft Surgery: A Review

    Directory of Open Access Journals (Sweden)

    Muhammad Shahzeb Khan

    2014-01-01

    Full Text Available There are two basic ways of performing coronary artery bypass graft surgery (CABG: on pump CABG and off pump CABG. Off pump CABG is relatively a newer procedure to on-pump CABG and does not require the use of the cardiopulmonary bypass machine. On pump CABG is the more traditional method of performing bypass surgery. However its resultant inflammatory effects cause renal dysfunction, gastrointestinal distress and cardiac abnormalities which have forced the surgeons to look for alternatives to the procedure. An extensive literature search revealed that on pump CABG causes better revascularization as compared to off pump CABG while off pump CABG has a much lower post operative morbidity and mortality especially in high risk patients. We suggest that the technique used should depend on the ease of the surgeon doing the operation as both the methods seem almost equally efficient according to the review.

  3. 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.

  4. Skin grafting in severely contracted socket with the use of ?Compo?

    Directory of Open Access Journals (Sweden)

    Betharia S

    1990-01-01

    Full Text Available The results of split thickness autologous skin grafting along with the use of a dental impression material (Compo, a thermoplastic substance are presented in a series of 11 patients of acquired, severely contracted, anophthalmic sockets. Only the fornix fixation sutures and the central tarsorrhaphy were employed for the proper placement of graft without the use of retention devices. Artificial eyes were successfully fitted and retained subsequently after 6 weeks of grafting.

  5. 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 ...

  6. 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

  7. Estimation of cerebral blood flow during cardiopulmonary resuscitation in humans.

    DEFF Research Database (Denmark)

    Christensen, S F; Stadeager, Carsten Preben

    1990-01-01

    Cerebral blood flow (CBF) and cardiac output (CO) were measured during cardiopulmonary resuscitation in patients who were unsuccessfully resuscitated by use of C14-iodoantipyrine injected into the left ventricle. CO varied between 1.3 and 2.2 l/min with mean 1.8 +/- 0.6 l/min (+/- SD) (28 ml/kg/min). The cortical CBF was found between 14 and 211 ml 100 g-1.min-1 with mean 42 ml 100 g-1.min-1 and mean white matter CBF equal to 27 ml 100 g-1.min-1. It is suggested that the external cardiac massage in humans may be of poor efficacy in terms of brain revival. Cortical CBF after long-lasting cardiopulmonary resuscitation showed signs of maldistribution suggestive of a patchy and incomplete perfusion.

  8. Role of cardiopulmonary mechanoreceptors in the postural regulation of renin

    International Nuclear Information System (INIS)

    To change the stretch on cardiopulmonary mechanoreceptors, large shifts of blood in the capacity space were elicited by tilting and by exerting positive lower body pressure in the tilted position. Twelve volunteers underwent invasive hemodynamic studies and in 10 other subjects cardiac size was determined by radionuclide cardiography. In all 22 subjects tilting caused the expected increase of renin, which was abolished by lower body compression. Decompression caused renin to increase again. Right atrial pressure in invasive studies and end-systolic and end-diastolic counts in noninvasive studies showed a significant and strong negative correlation with renin and norepinephrine levels. Thus, the degree of stretch of the cardiopulmonary mechanoreceptors is a major determinant of reflex regulation of renin release in humans

  9. A Novel Rotary Pulsatile Flow Pump for Cardiopulmonary Bypass

    OpenAIRE

    Teman, Nicholas R.; Mazur, Daniel E; Toomasian, John; Jahangir, Emilia; Alghanem, Fares; Goudie, Marcus; Rojas-Peña, Alvaro; Haft, Jonathan W.

    2014-01-01

    It has been suggested that pulsatile blood flow is superior to continuous flow in cardiopulmonary bypass (CPB). However, adoption of pulsatile flow (PF) technology has been limited due to practically and complexity of creating a consistent physiologic pulse. A pediatric pulsatile rotary ventricular pump (PRVP) was designed to address this problem. We evaluated the PRVP in an animal model, and determined its ability to generate PF during CPB.

  10. 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...

  11. Management of patients with carotid bruit undergoing cardiopulmonary bypass.

    Science.gov (United States)

    Ivey, T D; Strandness, E; Williams, D B; Langlois, Y; Misbach, G A; Kruse, A P

    1984-02-01

    During a 31 month period, 1,433 consecutive patients undergoing cardiac procedures were screened for carotid bruit. A total of 94 patients with carotid bruit were identified who had ultrasonic carotid duplex scans. Nine patients had a history of transient ischemic attack, carotid bruit, and reduction in internal carotid artery diameter by greater than or equal to 50% according to ultrasonic carotid duplex scanning. All nine patients underwent carotid angiography followed by thromboendarterectomy prior to or simultaneous with cardiopulmonary bypass. There was one neurological complication leading to death in this subset. Sixteen patients with asymptomatic carotid bruit had ultrasonic carotid duplex scanning revealing an internal carotid artery lesion of greater than or equal to 50% but did not undergo arteriography or thromboendarterectomy prior to the cardiac procedure. Perfusion pressure was maintained at greater than or equal to 70 mm Hg during bypass. There were no focal neurological events in this subset. Sixty-six patients with internal carotid artery stenosis of less than 50% diameter reduction and asymptomatic bruits had no further work-up or modification in perfusion technique, and there were no focal neurological events in this group. Thus there were no focal neurological events in any of the 82 patients with asymptomatic carotid bruit. An additional group of three patients with a previous stroke and internal carotid artery occlusion by ultrasonic carotid duplex scanning had transient exacerbation of neurological symptoms after cardiopulmonary bypass. The remaining 1,339 patients without carotid bruit had nine (0.7%) focal neurological events postoperatively. We believe that asymptomatic patients with or without hemodynamically significant stenosis can safely undergo cardiopulmonary bypass procedures without carotid thromboendarterectomy. Patients with asymptomatic bruits can be safely screened with ultrasonic carotid duplex scanning and do not require arteriography prior to cardiopulmonary bypass. PMID:6694409

  12. Use of the impedance threshold device in cardiopulmonary resuscitation

    OpenAIRE

    Demestiha, Theano D.; Pantazopoulos, Ioannis N.; Xanthos, Theodoros T.

    2010-01-01

    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, impr...

  13. Gravity and the Evolution of Cardiopulmonary Morphology in Snakes

    OpenAIRE

    Lillywhite, Harvey B.; Albert, James S.; Sheehy, Coleman M.; Seymour, Roger S

    2011-01-01

    Physiological investigations of snakes have established the importance of heart position and pulmonary structure in contexts of gravity effects on blood circulation. Here we investigate morphological correlates of cardiopulmonary physiology in contexts related to ecology, behavior and evolution. We analyze data for heart position and length of vascular lung in 154 species of snakes that exhibit a broad range of characteristic behaviors and habitat associations. We construct a composite phylog...

  14. Cardiopulmonary resuscitation in the elderly: patients' and relatives' views.

    OpenAIRE

    Mead, G. E.; Turnbull, C. J.

    1995-01-01

    One hundred inpatients on an acute hospital elderly care unit and 43 of their relatives were interviewed shortly before hospital discharge. Eighty per cent of elderly patients and their relatives were aware of cardiopulmonary resuscitation (CPR). Television drama was their main source of information. Patients and relatives overestimated the effectiveness of CPR. Eighty-six per cent of patients were willing to be routinely consulted by doctors about their own CPR status, but relatives were les...

  15. Effect of Dextrose-Crystalloid Priming Solution on Fluid Requirements and Urine Output During Cardiopulmonary Bypass

    OpenAIRE

    Metz, Samuel; Hacker, Jerriann

    1986-01-01

    We examined the influence of the addition of dextrose to crystalloid cardiopulmonary bypass priming solution. Ten patients received only lactated Ringer's solution during the perioperative period and as their cardiopulmonary bypass priming solution, while ten others, managed identically in all other respects, received only 5% dextrose in lactated Ringer's solution (D 5LR). During cardiopulmonary bypass, patients who did not receive glucose required more supplementary fluid (20.0 vs 2.2 ml Kg?...

  16. Effect of hormone replacement on exercise cardiopulmonary reserve and recovery performance in subclinical hypothyroidism

    OpenAIRE

    Mainenti, M.R.M.; P.F.S. Teixeira; Oliveira, F.P.; Vaisman, M.

    2010-01-01

    Subclinical hypothyroidism (SH) patients present cardiopulmonary, vascular and muscle dysfunction, but there is no consensus about the benefits of levothyroxine (L-T4) intervention on cardiopulmonary performance during exercise. The aim of the present study was to investigate the effects of L-T4 on cardiopulmonary exercise reserve and recovery in SH patients. Twenty-three SH women, 44 (40-50) years old, were submitted to two ergospirometry tests, with an interval of 6 months of normalization ...

  17. 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.

  18. 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 radiologyminder. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    O' Neill, John M.; McBride, Kieran D

    2001-04-01

    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.

  20. Interventional bronchoscopy for benign tracheobronchial diseases under cardiopulmonary bypass support: case reports and literature review.

    Science.gov (United States)

    Adwan, Hussamuddin; Wigfield, Christopher H; Clark, Stephen; Barnard, Sion

    2008-01-01

    The use of cardiopulmonary bypass as an adjunct to airway surgery for non-malignant diseases in adults is not well established in the UK. We are reporting two cases which demonstrate the additional benefits of using cardiopulmonary bypass during difficult bronchoscopy and complex airway stenting. The first case presents an emergency indication for cardiopulmonary bypass in a life-threatening but benign condition. The second case presented, utilises cardiopulmonary bypass standby as adjunct to a potentially life threatening procedure. A review of the literature is also provided. PMID:18462499

  1. Interventional bronchoscopy for benign tracheobronchial diseases under cardiopulmonary bypass support: case reports and literature review

    Directory of Open Access Journals (Sweden)

    Clark Stephen

    2008-05-01

    Full Text Available Abstract The use of cardiopulmonary bypass as an adjunct to airway surgery for non-malignant diseases in adults is not well established in the UK. We are reporting two cases which demonstrate the additional benefits of using cardiopulmonary bypass during difficult bronchoscopy and complex airway stenting. The first case presents an emergency indication for cardiopulmonary bypass in a life-threatening but benign condition. The second case presented, utilises cardiopulmonary bypass standby as adjunct to a potentially life threatening procedure. A review of the literature is also provided.

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

    Directory of Open Access Journals (Sweden)

    Bartholomay Eduardo

    2003-01-01

    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. Spontaneous 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.

  3. Acrylonitrile grafted to PVDF

    Energy Technology Data Exchange (ETDEWEB)

    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.

  4. Immobilization of enzymes and antibodies to radiation grafted polymers for therapeutic and diagnostic applications

    International Nuclear Information System (INIS)

    Pre-irradiation and mutual radiation grafting were employed to produce poly(methacrylic acid) (MAAc) hydrogels on polypropylene/polyethylene (PP/PE) copolymer films, and porous PP fibers of a plasma filter. A diphenyl picryl hydrazyl (DPPH) assay was developed to measure the surface peroxide concentration of the pre-irradiated PP/PE films prior to grafting. Mutually grafted porous PP fibers were used for subsequent immobilization of L-asparaginase while the mutually grafted PP/PE films were used to immobilize a schistosoma monoclonal antibody. (author)

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

    Directory of Open Access Journals (Sweden)

    Fernando A Atik

    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 eram 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%, POBJECTIVES: 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 approached 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<0.0001 than in patients with other indications, which follow their preoperative plan. Cardiopulmonary bypass (deep hypothermic circulatory arrest in 55% and conventional in the remaining was uneventfully conducted in all patients but one (success rate 98% due to undiagnosed inominate artery stenosis. Local complication was lymphatic drainage in three (6.2% patients. CONCLUSIONS: Axillary artery is an alternative cannulation site in patients unsuitable to aortic cannulation. The type of indication may determine intraoperative changes in surgical planning

  6. 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 question of whether alpha-stat or pH-stat is the most physiological way to regulate the acid-base balance during hypothermic CPB

  7. Kinetics and sites of sequestration of indium 111-labeled human platelets during cardiopulmonary bypass

    International Nuclear Information System (INIS)

    A new approach for the study of the kinetics and quantification of the in vivo and ex vivo sites of sequestration of platelets during cardiopulmonary bypass (CPB) is described. Autologous platelets of four patients were labeled with 111In-oxine and reinfused on the day prior to CPB for coronary artery bypass grafting. Changes in blood 111In-labeled platelet radioactivity and blood platelet counts were monitored during the operation. In vivo 111In-labeled platelet redistribution was quantified with a scintillation camera and a computer-assisted imaging system before and after CPB. Sequestration of 111In-labeled platelets in the bubble oxygenator was measured. 111In-labeled platelet activity in the blood decreased by 46% +/- 5% within 5 minutes of CPB, but this decrease was mostly due to hemodilution; the true loss of platelets from the circulation was 13% +/- 4%. Intraoperatively, whole body 111In activity decreased by oxygenator 10.8% +/- 1.3% of administered platelets were sequestered, especially in the innermost active layers of the defoaming mesh of the bubble oxygenator. Mean survival time of circulating platelets was 58 +/- 8 hours and fitted an exponential function best. The bleeding time increased to 40 minutes during operation and returned to normal within 24 hours. During operation 111In-labeled platelets accumulated somewhat in the liver (10.7%) but not in the spleen, thorax, or hea.7%) but not in the spleen, thorax, or head. In the 48 hours after operation, platelets were sequestered mainly in the liver. The scintillation camera with computer-assisted imaging allows in vivo quantitative studies of platelet kinetics of a type which has not been possible with previous techniques

  8. 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 transe 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

  9. 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.

  10. A Review of Post--Cardiopulmonary Bypass Bleeding, Aminocaproic Acid, Tranexamic Acid, and Aprotinin.

    Science.gov (United States)

    Barrons, Robert W.; Jahr, Jonathan S.

    1996-12-01

    OBJECTIVE: To review the mechanism and cause of hemostatic defects following cardiopulmonary bypass (CPB) and determine the safety and efficacy of antifibrinolytic agents for use in cardiac surgery and patients likely to benefit. DATA SOURCES: A MEDLINE search (1966 to present) of the English-language literature pertaining to aminocaproic acid (ACA), tranexamic acid (TA), and aprotinin was performed. Additional literature was obtained from reference citations of pertinent articles identified through the search. STUDY SELECTION AND DATA EXTRACTION: While all articles of relevance were considered for inclusion, this review evaluates only clinical trials with emphasis on prospective, randomized, controlled studies. DATA SYNTHESIS: In reported trials, ACA and TA each reduce mediastinal blood losses by about one-third, while transfusion needs remain unchanged. ACA and TA dosing inconsistencies, omission of transfusion criteria, and unidentified surgical risk factors prevent optimal findings. Thromboembolic complications could not be ascribed to either ACA or TA in more than 950 patients studied. Aprotinin decreased mean mediastinal blood losses by 42%, 67% and 48% in primary coronary artery bypass grafting (CABG), reoperative CABG, and in CABG patients receiving aspirin, respectively. Transfusion needs were reduced 42% in primary CABG patients and 55% to 88% in high-risk patients. Patients at high risk of bleeding (i.e., reoperative CABG and patients on aspirin) demonstrated greater transfusion needs and blood loss than primary CABG patients. As blood conservation measures may eliminate the need for transfusions among primary CABG patients, patients at higher risk may benefit most from the addition of antifibrinolytic prophylaxis. CONCLUSION: The efficacy of all antifibrinolytic agents in cardiac surgery has been established, but comparative data is inconclusive to suggest an agent of choice. Thromboembolic complications have been rare and difficult to ascribe to antifibrinolytic agents. Future trials comparing efficacy of agents in high risk patients and rigorously evaluating thromboembolic events will allow unconditional recommendations. PMID:11862245

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

    Directory of Open Access Journals (Sweden)

    R.R. Rodrigues

    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 patients (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 < 0.001 while tissue volume increased by 19% (P < 0.001. Non-aerated lung increased by 253 ± 97 g (P < 0.001, from 3 to 27%, after surgery and poorly aerated lung by 72 ± 68 g (P < 0.001, from 24 to 27%, while normally aerated lung was reduced by 147 ± 119 g (P < 0.001, from 72 to 46%. No correlations (Pearson were observed between PaO2/FiO2 ratio or shunt fraction at 24 h postoperatively and postoperative lung alterations. The data show that lung structure is profoundly modified after CABG with CPB. Taken together, multiple changes occurring in the lungs contribute to postoperative hypoxemia rather than atelectasis alone.

  12. 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.

  13. Lepirudin as an alternative to "heparin allergy" during cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Parissis Haralabos

    2011-04-01

    Full Text Available Abstract A treatment strategy of a difficult and unusual problem is presented. We are reporting a case of a patient who had a documented allergy to heparin and required Cardiac surgery for an ASD closure. The anticoagulation regime used during cardiopulmonary bypass was lepirudin based. This report indicates that r-hirudin provides effective anticoagulation, however unless ECT is monitoring, post operative hemorrhage is encountered. Therefore this case is unique not only because of its rarity but also by the fact that it presents the caveats encountered when ECT is not available.

  14. [New recommendations in European cardiopulmonary resuscitation guidelines (Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care 2000: an International Consensus on Science].

    Science.gov (United States)

    Jakubaszko, Juliusz; Smereka, Jacek; Sehn, Marek

    2002-01-01

    The article presents most important changes in international guidelines for adult cardiopulmonary resuscitation. In this article guideline changes in basic and advanced life support published in Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care--a Consensus on Science are discussed. Major changes in guidelines presented in this article include: pulse check, ventilation technique for rescue breathing, compression technique, abdominal thrust recommendations, precordial thump, universal algorithm changes. PMID:12715725

  15. Employment Dynamics

    OpenAIRE

    Stadin, Karolina

    2014-01-01

    The main focus of this thesis is the employment decisions of firms. The thesis consists of three self-contained but closely related essays, all enlightening employment dynamics in different ways. The thesis is mainly empirical but there are also some theoretical developments when existing theory is insufficient to explain the empirical findings. The impact on employment of product market conditions and labor market conditions facing firms are investigated. The results suggest that product dem...

  16. EMPLOYMENT GUARANTEE”

    OpenAIRE

    DILIP KHANDERAO PATIL

    2013-01-01

    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 ...

  17. Systolic compression of bypass grafts.

    Science.gov (United States)

    Aqel, Raed; Gupta, Ritesh; Zoghbi, Gilbert

    2006-05-01

    Myocardial bridging, systolic compression of an intramyocardial segment of an epicardial coronary artery, is well known to involve native coronary arteries. Systolic compression of bypass grafts has been rarely described. We present two cases of dynamic systolic compression of bypass grafts to native coronary arteries: one of a vein graft to the right coronary artery, and another of a left internal mammary artery to the left anterior descending artery. PMID:16670459

  18. 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.

  19. Lipid peroxidation and nitric oxide metabolites in sedentary subjects and sportsmen before and after a cardiopulmonary test.

    Science.gov (United States)

    Lo Presti, Rosalia; Canino, Baldassare; Montana, Maria; Caimi, Gregorio

    2013-01-01

    Our aim was to investigate the effects of an exercise test on some indices of oxidative status and endothelial function, in trained and untrained subjects. We examined lipid peroxidation, nitric oxide metabolites (NOx) and their ratio before and after a cardiopulmonary test, using a cycloergometer. We enrolled 60 male subjects who practiced sport unprofessionally, subdivided in two groups (A and B) according to the values of VO2max. Group A included sportsmen with poor or fair aerobic fitness (VO2max 39 ml/Kg/min). The control group included 19 male sedentary subjects. Lipid peroxidation was evaluated by detection of the thiobarbituric acid-reactive substances (TBARS); the NOx were evaluated employing the Griess reagent. At rest, in comparison with sedentary controls, an increase in TBARS, NOx and TBARS/NOx ratio was found in all sportsmen and partially in the two groups. After the cardiopulmonary test, the increase of TBARS and TBARS/NOx ratio was significantly more evident in sedentary controls than in sportsmen. No variation was observed for NOx in any group. These data suggest that sportsmen are protected against the acute oxidative stress induced by an exercise test, and that protection is not strictly dependent on the aerobic fitness. PMID:22710809

  20. 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)

  1. Fluxometria da artéria torácica interna esquerda na revascularização da artéria descendente anterior com e sem circulação extracorpórea Flowmetry of left internal thoracic artery graft to left anterior descending artery: comparison between on-pump and off-pump surgery

    Directory of Open Access Journals (Sweden)

    Filinto Marques de Cerqueira Neto

    2012-06-01

    Full Text Available INTRODUÇÃO: A cirurgia de revascularização do miocárdio (RM sem circulação extracorpórea (CEC é uma técnica amplamente utilizada. A fluxometria coronariana é a técnica mais usada para avaliação dos enxertos, porém, poucos estudos comparam os dados fluxométricos na RM com e sem CEC. O objetivo deste estudo foi comparar as variáveis fluxométricas dos enxertos de artéria torácica interna esquerda para a artéria descendente anterior em pacientes submetidos à RM com e sem CEC. MÉTODOS: Entre março e setembro de 2010, foram analisados retrospectivamente 35 pacientes consecutivos, não randomizados, submetidos à RM. Foram alocados 10 pacientes no grupo A (com CEC e 25 no grupo B (sem CEC. O fluxo médio do enxerto (FME, o índice pulsátil (PI e a porcentagem de enchimento diastólico (ED foram obtidos por meio da fluxometria por tempo de trânsito. Foi utilizado o teste exato de Fisher e Mann-Whitney, sendo considerado estatisticamente significante PBACKGROUND: Off-pump coronary bypass grafting (OPCAB has become a widely used technique. Coronary flowmetry is the most common method employed to assess graft patency, nevertheless, few studies compare flow patterns between ONCAB and OPCAB surgery. The objective of this study was to compare flowmetry data in left internal mammary artery grafts bypasses to the left anterior descendent artery. METHODS: From March to September of 2010, thirtyfive consecutive, non-randomized patients underwent CABG and were retrospectively evaluated. Ten patients were located on group A (On Pump, and twenty-five on group B (Off Pump. The mean graft flow (MGF, pulsatile index (PI and diastolic filling (DF were obtained using Transit Time Flowmetry (TTFM. The Fisher exact test, and Mann Whitney test were used, and a P value of < 0.05 was considered to indicate statistical significance. RESULTS: There were no deaths, AMI, re-interventions or PTCA in a 30-day period. The number of bypasses performed per patient was 2.3 ± 0.8 in the OPCAB group, and 2.2 ± 0.6 in the ONCAB group, with no significant difference (P=0.10. The median of mean flow was 23 ml/min on group A, and 25 ml/min on group B (P=0.34. Diastolic filling percentage was 56% on group A, and 56.9% on group B (P=0.86. Pulsatile Index was 2.3 on group A, and 2.2 on group B (P=0.82. CONCLUSIONS: There was no difference between TTFM values (MF, PI and DF in patients operated with or without cardiopulmonary bypass.

  2. 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…

  3. ICT Employment

    Science.gov (United States)

    This page, from the Mid-Pacific Information and Communications Technology Center, provides some information on careers and employment in the Information and Communications Technology (ICT) industries. The three types of individuals using information and communications technologies include ICT users, enablers and creators. The webpage also includes employment data from a few different agencies including the United States Bureau of Labor Statistics.

  4. Employment Law

    Science.gov (United States)

    Runkel, Ross, 1939-

    Ross Runkel is a retired professor of law, and given his long experience with employment and labor law, it seems quite natural that he would be the founder of the Employment Law website. Along with a team of other equally qualified professionals, he has created this site to serve as a clearinghouse of material about the world of employment law and its many facets. First time visitors may wish to check out his employment law or arbitration blogs, then move on to such popular features such as the list of recent and pending cases in the field that have been heard before the US Supreme Court. Additionally, the �Articles� area contains pieces authored by Runkel and others, including a piece on how to find an employment lawyer and several timely pieces on the National Labor Relations Board.

  5. Saphenous vein graft vs. radial artery graft searching for the best second coronary artery bypass graft

    OpenAIRE

    Al-sabti, Hilal Ali; Al Kindi, Adil; Al-rasadi, Khalid; Banerjee, Yajnavalka; Al-hashmi, Khamis; Al-hinai, Ali

    2013-01-01

    Coronary artery bypass grafting (CABG) was first used in the late 1960s. This revolutionary procedure created hope among ischemic heart disease patients. Multiple conduits are used and the golden standard is the left internal mammary artery to the left anterior descending artery. Although all approaches were advocated by doctors, the use of saphenous vein grafts became the leading approach used by the majority of cardiac surgeons in the 1970s. The radial artery graft was introduced at the sam...

  6. Ocular, bulbar, limb, and cardiopulmonary involvement in oculopharyngeal muscular dystrophy

    DEFF Research Database (Denmark)

    Witting, N; Mensah, A

    2014-01-01

    OBJECTIVES: To assess skeletal muscle weakness and progression as well as the cardiopulmonary involvement in oculopharyngeal muscular dystrophy (OPMD). MATERIALS AND METHODS: Cross-sectional study including symptomatic patients with genetically confirmed OPMD. Patients were assessed by medical history, ptosis, ophthalmoplegia, facial and limb strength, and swallowing capability. Cardiopulmonary function was evaluated using forced expiratory capacity in 1 s (FEV1), electrocardiogram (ECG), Holter monitoring, and echocardiography. RESULTS: We included 13 symptomatic patients (six males, mean age; 64 years (41-80) from 8 families. Ptosis was the first symptom in 8/13 patients followed by limb weakness in the remaining 5 patients Dysphagia was never the presenting symptom. At the time of examination, all affected patients had ptosis or had previously been operated for ptosis, while ophthalmoplegia was found in 9 patients. Dysphagia, tested by cold-water swallowing test, was abnormal in 9 patients (17-116 s, ref<8 s). Six patients could not climb stairs of whom two were wheelchair bound and one used a rollator. Six patients had reduced FEV1 (range 23%-59%). No cardiac involvement was identified. CONCLUSIONS: Limiting limb weakness is common in OPMD and can even be the presenting symptom of the disease. In contrast, dysphagia was not the initial symptom in any of our patients, although it was obligatory for diagnosing OPMD before genetic testing became available. Mild respiratory dysfunction, but no cardiac involvement, was detected.

  7. 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.

  8. Complement activation before, during and after cardiopulmonary bypass.

    Science.gov (United States)

    Bonser, R S; Dave, J R; John, L; Gademsetty, M K; Carter, P G; Davies, E; Taylor, P; Gaya, H; Lennox, S C; Vergani, D

    1990-01-01

    Plasma levels of the complement parent molecules C3, C4, and factor B and their split products, C3d, C4d, and Ba were measured in 12 patients undergoing cardiopulmonary bypass for coronary artery surgery. Alternative and common complement pathway activation, demonstrated by statistically significant rising levels of Ba (P less than 0.05), and C3d (P less than 0.05) and by elevated Ba:B (P less than 0.05) and C3d:C3 (P less than 0.05) ratios were found before the institution of cardiopulmonary bypass but following heparin administration suggesting that heparin may itself initiate alternative pathway activation. In addition, significant depletion of parent complement components and elevation of split product concentrations was seen during bypass suggesting classical and alternate pathway activation (P less than 0.01). This study clarifies the pathways of complement activation during bypass and presents evidence that heparin administration may initially activate the complement cascade. PMID:2361017

  9. Evaluation of cardiopulmonary circulation time with functional images

    International Nuclear Information System (INIS)

    Functional images of circulation time, peak time image and half time image, were generated using a scintillation camera with a minicomputer system. Peak time image represents the progression of a bolus through heart, lungs and great vessels. Half time image is considered to reflect the regional clearance of the tracer. Normal values of peak time and half time were determined from subjects without evidence of cardiopulmonary disease. Normal values (n = 20) of peak time were: superior vena cava (SVC), always designated to 1 sec; right ventricle (RV), 2.0 +- 0.3 (SD) sec; lungs 4.5 +- 0.5 sec; left ventricle (LV), 7.6 +- 0.7 sec and that of half time were: RV, 2.0 +- 0.6 (SD) sec; right lung, 3.2 +- 0.5 sec; left lung, 3.3 +- 0.6 sec; LV, 3.8 +- 0.9 sec. In case of ischemic heart disease, these parameters were significantly delayed and supposed to be useful for the evaluations of cardiopulmonary hemodynamics. (author)

  10. 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.

  11. Coronary Artery Bypass Graft

    Science.gov (United States)

    Patient Education Institute

    This patient education program explains the benefits and risks of coronary artery bypass graft surgery for the treatment of coronary arteriosclerosis. This is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: The tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary

  12. 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)

  13. Radiation-induced graft polymerization of polyacrylamide onto polyethylene nonwoven fabric (PE NWF) for phenol adsorption

    International Nuclear Information System (INIS)

    Polyethylene nonwoven fabric was functionalized using radiation-induced graft polymerization of acrylonitrile by ?-rays from 60Co source. The simultaneous grafting technique was employed wherein the polyethylene fibers were irradiated in nitrogen atmosphere in the presence of acrylonitrile dissolved in 1:1 water/methanol solvent. The effects of different grafting parameters to the grafting yield were evaluated. The optimum values of dose rate, absorbed dose and concentration of monomer were found to be 6kGy h-1, 25kGy and 10% w/w acrylonitrile, respectively. Using the optimum conditions, the degree of grafting of approximately 14% is achieved. The grafted polyethylene fibers were reacted with hydroxylamine to introduce amidoxime functional groups on the nonwoven fabric. The unmodified, grafted and functionalized fibers were characterized using Attenuated Total Reflectance - Fourier Transformed Infrared Spectroscopy (FTIR - ATR) and Scanning Electron Microscopy (SEM). The results of these tests confirmed the successful grafting of acrylonitrile and functionalization to amidoxime functional groups. The ability of the amidoximated grafted polyethylene to remove phenol from aqueous solutions was investigated. The results from Gas Chromatography - Flame Ionization Detection (GC - FID) indicated that approximately 58% of the phenol was removed. (author)

  14. 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.

  15. 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

  16. 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.

  17. Successful resuscitation from cardiopulmonary arrest following deliberate inhalation of Freon refrigerant gas.

    Science.gov (United States)

    Brilliant, L C; Grillo, A

    1993-06-01

    Presented is a case of successful resuscitation of cardiopulmonary arrest following inhalation of a fluorinated hydrocarbon. Fluorinated hydrocarbons have a direct cardiotoxic effect. We found no previous reports describing resuscitation with good neurologic outcome of a patient in cardiopulmonary arrest subsequent to inhalation of a fluorinated hydrocarbon. Early bystander cardiopulmonary resuscitation and ACLS provider intervention help to contribute to improved patient survival. We present a case illustrating the utility of basic life support and early advanced life support, followed by a review of the pertinent literature. PMID:8339849

  18. 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.

  19. Cardiopulmonary resuscitation: a historical perspective leading up to the end of the 19th century.

    Science.gov (United States)

    Ekmektzoglou, Konstantinos A; Johnson, Elizabeth O; Syros, Periklis; Chalkias, Athanasios; Kalambalikis, Lazaros; Xanthos, Theodoros

    2012-01-01

    Social laws and religious beliefs throughout history underscore the leaps and bounds that the science of resuscitation has achieved from ancient times until today. The effort to resuscitate victims goes back to ancient history, where death was considered a special form of sleep or an act of God. Biblical accounts of resuscitation attempts are numerous. Resuscitation in the Middle Ages was forbidden, but later during Renaissance, any prohibition against performing cardiopulmonary resuscitation (CPR) was challenged, which finally led to the Enlightenment, where scholars attempted to scientifically solve the problem of sudden death. It was then that the various components of CPR (ventilation, circulation, electricity, and organization of emergency medical services) began to take shape. The 19th century gave way to hallmarks both in the ventilatory support (intubation innovations and the artificial respirator) and the open-and closed chest circulatory support. Meanwhile, novel defibrillation techniques had been employed and ventricular fibrillation described. The groundbreaking discoveries of the 20th century finally led to the scientific framework of CPR. In 1960, mouth-to-mouth resuscitation was eventually combined with chest compression and defibrillation to become CPR as we now know it. This review presents the scientific milestones behind one of medicine's most widely used fields. PMID:23094842

  20. Comparison of Alloderm and mucosal graft in mandibular vestibuloplasty

    Directory of Open Access Journals (Sweden)

    Mahmoodhashemi H.

    2009-12-01

    Full Text Available "nBackground and Aim: The usage of free gingival grafts for vestibuloplasty is a routine procedure. The free gingival procedure requires harvesting the graft from a donor site which increases morbidity and the risk of surgical complications. In addition, adequate amount of donor tissue may not be available. Acceptable results of Alloderm application as a substitute for autogenous soft tissue grafts are: Not exposing the patient to an additional surgery, no donor site morbidity, unlimited availability, decreasing the bleeding during the surgery, decreasing the surgical complications, and better color match. The aim of this study was to evaluate the maintenance of the vestibular depth in vestibuloplasty with mucosal graft and Alloderm."nMaterials and Methods: Both methods of anterior mandibular vestibuloplasty by Clark, utilizing Alloderm and mucosal grafts, were employed in ten clinical cases. During the surgeries, half the prepared recipient sites received Alloderm, while the remaining half received autografts in a randomized fashion. Immediately, 1, 3, and 6 months postoperatively, the variables of graft rejection, depth of vestibule and the degree of relapse were evaluated. SPSS software was used for analysis of the data and the methods used for "statistical tests" were as follows: Friedman Method, Paired sample t-test, Smirnov-kolmogrove Method. (The statistical significance level was established at P-value<0.05."nResults: The mean difference of the relapse measurements in both methods throughout the survey did not have significant predictive value (P>0.05. Similar results were achieved for the mean difference of depth of the vestibule."nConclusion: In patients undergoing Vestibuloplasty, Alloderm could be material of choice to be utilized as autogenic soft tissue grafts in pre-prosthesis procedures.

  1. 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)

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

    Science.gov (United States)

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

  3. 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.

  4. Cardiopulmonary exercise testing – the gold standard in physical performance assesment

    Directory of Open Access Journals (Sweden)

    Claudiu Avram

    2008-12-01

    Full Text Available Background: Cardiopulmonary exercise testing (CPX is a modern procedure that allows us to evaluate the global performanceof a subject. Because CPX devices are expensive and less popular due to a less amount of specialists in this field, many oflaboratories uses the more common ECG stress tests for physical performance assessment. Aim: to demonstrate theimportance and accuracy of cardiopulmonary exercise testing comparing with traditional maximal electrocardiographic (ECGstress test without gas exchange analysis. Methods: 18th elite soccer players (age 22.7±6 years, body mass 74.6±9.5 kg,height 175.4±9.8 cm participated in the study. The subjects accomplished two treadmill effort tests with and without gasanalyses, in 2 consecutive days interval. Results: At the end of the study we noticed a highly significant statistical difference(p<0.0001 between the investigated testing methods. In gas exchange testing method we found a decreased level of all theparameters evaluated comparing to stress ECG: VO2 peak (ml*kg-1*min-1 = 55.4±5.2 vs. 67.8±5.7; AT (ml*kg-1*min-1 =41.2±7.6 vs. 47.4±6.9; VO2/HR (ml = 23.8±2.5 vs. 23.8±2.5. Conclusions: Asessment of exercise performance based solelyon a maximal stress ECG without gas analyzing is inaccurate. Furthermore, estimation of peak exercise responses based uponcalculation of VO2 peak from peak work rate are inappropriate in sportsman. The study demonstrate once again that CPXremain the most accurate and reliable test for detection of AT and for a comprehensive physical performance assessment andcannot be replace by other surrogate laboratory exercise tests like stress ECG.

  5. 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 ow 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

  6. Sequestration of fentanyl by the cardiopulmonary bypass (CPBP).

    Science.gov (United States)

    Koren, G; Crean, P; Klein, J; Goresky, G; Villamater, J; MacLeod, S M

    1984-01-01

    Immediately following the connection of pediatric patients to cardiopulmonary bypass we have consistently observed a steep decrease in fentanyl plasma concentration (74 +/- 8.7%) (mean +/- SD), much greater than would have been expected from hemodilution alone (50.6% +/- 12.0%) (p less than 0.0001). Priming of the pump with 20 ng/ml of fentanyl before connection to the patients did not prevent this phenomenon. In order to study the possibility that fentanyl is sequestered by the bypass, levels of the primed drug in the bypass were assessed before connecting the pump to the children and a steep fall from 20 ng/ml to zero was shown before initiation of bypass. Pharmacokinetic assessment of fentanyl in a closed pump circuit showed that levels of 120 ng/ml fall to 2 ng/ml within 3 min and remain stable at the lower concentration for at least 30 min. Further studies have identified the membrane oxygenator as the major site of fentanyl sequestration. Concentrations across the membrane fall from 120 ng/ml to 10 ng/ml. The attached siliconized tubing is associated with a minor binding effect sufficient to reduce concentrations from 110 to 84 ng/ml. The pvc tubing, aluminium heat exchanger and plastic reservoir had no binding effect on fentanyl. The possibility that a decrease in fentanyl protein binding caused the fall in serum concentration was checked in 5 patients undergoing open heart surgery. After initiation of the cardiopulmonary bypass, there was a significant decrease in albumin serum concentrations from 32.0 +/- 2.3 mM to 15.0 +/- 1.6 mM (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6489427

  7. 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)

  8. Future Perspectives of Fat Grafting.

    Science.gov (United States)

    Pu, Lee L Q; Yoshimura, Kotaro; Coleman, Sydney R

    2015-07-01

    Autologous fat grafting is an exciting part of plastic and reconstructive surgery. Fat serves as a filler and its role in tissue regeneration will likely play a more important role in our specialty. As we learn more about the basic science of fat grafting and the standardized techniques and instruments used for fat grafting, this procedure alone or in conjunction with invasive procedures may be able to replace many operations that we perform currently. Its minimally invasive nature will benefit greatly our cosmetic and reconstructive patients, and may even achieve better clinical outcomes. PMID:26116945

  9. 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.

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

    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...

  11. 21 CFR 870.4340 - Cardiopulmonary bypass level sensing monitor and/or control.

    Science.gov (United States)

    2010-04-01

    ...bypass level sensing monitor and/or control. 870.4340 Section 870.4340 Food and Drugs FOOD AND DRUG ADMINISTRATION...DEVICES Cardiovascular Surgical Devices § 870.4340 Cardiopulmonary bypass level sensing monitor...

  12. 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.

  13. Employability Skills

    Science.gov (United States)

    This module from the Florida Advanced Technological Education (FL-ATE) Center will help students understand and develop their own set of personal employability skills, such as communication and teamwork. The activity aims to help students understand the importance of communication and teamwork in a business setting. The lesson should require one class period to complete.

  14. Pressure and time dependence of the cardiopulmonary reflex response in patients with hypertensive cardiomyopathy

    OpenAIRE

    Otto, M. E. B.; Consolim-colombo, F. M.; Rodrigues Sobrinho, C. R. M.; Krieger, E. M.

    2004-01-01

    The first minutes of the time course of cardiopulmonary reflex control evoked by lower body negative pressure (LBNP) in patients with hypertensive cardiomyopathy have not been investigated in detail. We studied 15 hypertensive patients with left ventricular dysfunction (LVD) and 15 matched normal controls to observe the time course response of the forearm vascular resistance (FVR) during 3 min of LBNP at -10, -15, and -40 mmHg in unloading the cardiopulmonary receptors. Analysis of the averag...

  15. Graft Failure after Allogeneic Hematopoietic Cell Transplantation

    OpenAIRE

    Mattsson, Jonas; Ringdén, Olle; Storb, Rainer

    2008-01-01

    Graft failure is a significant complication following allogeneic hematopoietic cell transplantation (AHCT). It may be due to rejection caused by recipient T-cells, NK-cells or antibodies. It is increased in HLA-mismatched grafts, unrelated grafts, T-cell replete transplants, sensitized patients and in patients treated with reduced intensity conditioning (RIC). In recipients of unrelated grafts, graft failure is increased in patients receiving major AB0 blood group mismatched transplants (p=0....

  16. Saphenous vein graft vs. radial artery graft searching for the best second coronary artery bypass graft.

    Science.gov (United States)

    Al-Sabti, Hilal Ali; Al Kindi, Adil; Al-Rasadi, Khalid; Banerjee, Yajnavalka; Al-Hashmi, Khamis; Al-Hinai, Ali

    2013-10-01

    Coronary artery bypass grafting (CABG) was first used in the late 1960s. This revolutionary procedure created hope among ischemic heart disease patients. Multiple conduits are used and the golden standard is the left internal mammary artery to the left anterior descending artery. Although all approaches were advocated by doctors, the use of saphenous vein grafts became the leading approach used by the majority of cardiac surgeons in the 1970s. The radial artery graft was introduced at the same time but was not as prevalent due to complications. It was reintroduced into clinical practice in 1989. The procedure was not well received initially but it has since shown superiority in patency as well as long-term survival after CABG. This review provides a summary of characteristics, technical features and patency rates of the radial artery graft in comparison with venous conduits. Current studies and research into radial artery grafts and saphenous vein grafts for CABG are explored. However, more studies are required to verify the various findings of the positive effects of coronary artery bypass grafting with the help of radial arteries on mortality and long-lasting patency. PMID:24198449

  17. The efficacies of modified mechanical post conditioning on myocardial protection for patients undergoing coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Durdu Serkan

    2012-08-01

    Full Text Available Abstract Background Coronary artery bypass grafting (CABG with cardioplegic cardiac arrest and cardiopulmonary bypass (CPB is associated with myocardial injury. The aim of this study was to investigate whether a modified mechanical post-conditioning (MMPOC technique has a myocardial protective effect by enhancing early metabolic recovery of the heart following revascularization. Methods A prospective, randomized trial was conducted at a single-center university hospital performing adult cardiac surgery. Seventy-nine adult patients undergoing first-time elective isolated multivessel coronary artery bypass grafting were prospectively randomized to MMPOC or control group. Anesthetic, cardiopulmonary bypass, myocardial protection, and surgical techniques were standardized. The post reperfusion cardiac indices, inotrope use and biochemical-electrocardiographic evidence of myocardial injury were recorded. The incidence of postoperative complications was recorded prospectively. Results Operative characteristics, including CPB and aortic cross-clamp time, were similar between the two groups (p>0.05. The MMPOC group had lower troponin I and other cardiac biomarkers level post CPB and postoperatively, with greater improvement in cardiac indices (p Conclusions MMPOC technique promotes early metabolic recovery of the heart during elective CABG, leading to better myocardial protection and functional recovery.

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

    Science.gov (United States)

    Mirmohammad-Sadeghi, Mohsen; Etesampour, Ali; Gharipour, Mojgan; Shariat, Zeinab; Nilforoush, Peyman; Saeidi, Mahmoud; Mackie, Mahsa; Sadeghi, Fatemeh Mirmohamad

    2009-01-01

    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. PMID:22666720

  19. Effect of Cardiopulmonary Bypass Duration on Thyroid Function Tests after Open Heart Surgery in Children

    Directory of Open Access Journals (Sweden)

    A. Jafari Javid

    2011-01-01

    Full Text Available This study was designed to evaluate the effect of cardiopulmonary bypass duration on thyroid function in children undergoing open heart surgery. One hundred and five children with congenital heart disease in-need of open heart surgery with cardiopulmonary bypass were enrolled during a 12-month period. Patients categorized into two groups: Short-time cardiopulmonary bypass (0.05. The mean serum level of T3, T4 and TSH was not significantly different between the two groups. In each groups, serum TSH and thyroid hormones were decreased until 2 h and 2 days after post-operation, respectively, with gradual increase afterward. Decline of serum thyroid hormones was more longstanding in the long-time cardiopulmonary bypass group. Two weeks after operation, repeating the same laboratory tests in patients with defective results yielded normal consequences. According to our results, there is a transient laboratory abnormality in thyroid function tests in children undergoing cardiopulmonary bypass. This abnormality persists longer in patients with long-time cardiopulmonary bypass.

  20. Correlation of femoral artery vs radial artery pressures with central pressure after cardiopulmonary bypass in children

    International Nuclear Information System (INIS)

    To assess the effectiveness of femoral and radial arterial lines on the correlation of peripheral and central mean arterial blood pressure in children after discontinuation of cardiopulmonary bypass. Fifty children scheduled for cardiac surgery with cardiopulmonary bypass were included in the study. After approval from the hospital ethics committee and informed consent. 50 children undergoing cardiac surgical procedures with cardiopulmonary bypass were randomly assigned to two different groups. In Group- A (RAP, n-2) a radial arterial line and in Group-B (FAP, n-25) a femoral arterial line was used to monitor the blood pressure. Simultaneous mean peripheral arterial pressure and mean central aortic pressure were recorded before cardiopulmonary bypass and 5 mins after separation from the cardiopulmonary bypass. The correlation of mean peripheral arterial pressure (radial and femoral) versus mean aortic pressure were compared. The data was recorded as Mean +- SD and P-value. The ages of children ranged from 4-12 years and their weight from 14.1-28.5 kg. In all of them following cardiopulmonary bypass, aortic pressure correlates better with femoral arterial pressure (p<0.001). The radial arterial line readings under estimated central aortic pressure when compared to femoral arterial line readings. Aortic pressure readings correlate better with femoral arterial pressure than radial arterial pressure in children. (author)

  1. Study on remodelling of bone grafts

    International Nuclear Information System (INIS)

    The remodelling of bone grafts depends to a large extent upon the type of graft and the condition of the recipient site. We applied sup(99m)Tc-phosphate scintigraphy in a follow-up study on cases treated by bone grafting, and quantitative analysis of the scintigram by computer to make clear the difference of remodelling time or the process of acceptance between a cancellous and a cortical bone grafting or due to various graft and conditions. The result revealed that the grafted bones which were smoothly adapted for subsequent growths or functions could restore normal accumulation ratios by 36 months after the grafting. When the cancellous bone was grafted to grafting beds with good conditions such as osteotomy site in the cases with coxarthrosis deformans or congenital dislocation of the hip, it could attain the quickest recovery of the normal accumulation ratio. The next quickest recovery of accumulation ratio was attained by grafting the cancellous bone to the grafting beds with poor conditions such as osteomyelitis, pseudoarthrosis, and bone tumor. The third best accumulation ratio could be attained when the cortical bone was grafted to grafting beds with good conditions, while the slowest recovery to normal accumulation ratio was noted when the cortical bone was grafted to grafting beds with poor conditions. (author)

  2. Bone Grafts (Periodontal Regenerative Surgery)

    Science.gov (United States)

    Bone Grafts (Periodontal Regenerative Surgery) What Is It? What It's Used For Preparation How It's Done Follow-Up Risks When To ... Before your surgery, you need to have basic periodontal treatment called scaling and root planing. You also ...

  3. 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.

  4. 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

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

    OpenAIRE

    O?zcan, O?zden Beste; Karakoyun, Onur; Kodal, Mehmet; O?zkoc?, Gu?ralp

    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...

  6. Platlet Rich Plasma (PRP) Improves Fat Grafting Outcomes.

    Science.gov (United States)

    Modarressi, Ali

    2013-01-01

    Autologous fat transfer offers many qualities of a ideal soft tissue filler. Main advantages of fat grafting ensue from the fact that the lipoaspirate tissue is an abundant source of regenerative pluripotential cells. However, the reported rates of fat cell survival vary greatly in the medical literature (10-90%). Different techniques of harvesting, processing, and reinjecting the fat cells are so claimed to be responsible for these differences, without any agreement concerning the best way to process. To address this important disadvantage, we propose the addition of autologous platelet rich plasma (PRP) which is known as a natural reservoir of growth factors stimulating tissue repair and regeneration. This approach is completely autologous and immediately employed without any type of preconditioning. Platelets rich plasma (PRP) preparation included bleeding of 8 ml of blood from patient's peripheral vein in Regen Lab© tubes containing sodium citrate anticoagulant. The whole blood was centrifugated at 1500 g during 3 min. As Regen-tubes contained a special gel separator, 99 % of red blood cells were discarded from the plasma at the bottom of the gel, and >90% of platelets were harvested in 4 ml of plasma on the top of the gel, called the platelet-rich plasma (PRP). The purified fat prepared by Coleman technique was mixed with different amount of PRP for in vitro, in vivo (mice) and clinical experiments: >50% of PRP for skin rejuvenation, superficial scars correction, infraorbital region, ..., and for 20% of PRP with 80% of purified fat for deep filler indication (nasolabial folds, lips, or soft tissue defect). In vitro studies demonstrated that PRP increased fat cells survival rate and stem cells differentiation. Animal models showed that fat graft survival rate was significantly increased by addition of PRP. Several clinical cases confirmed the improvement of wound healing and fat grafting survival in facial reconstruction and aesthetic cases by association of fat grafting with PRP. The addition of PRP to fat grafts represented many advantages with a simple, cost-effective and safe method. In addition to its booster effect on fat grafts, PRP had a rejuvenation capacity per se. It is also used on nappage technique, on mask and as a temporary regenerative filler in combination with thrombin. So we consider the addition of 20% PRP to fat grafts offers a better fat grafting survival, a less bruising and inflammation reaction, and easier application of fat grafts due to liquefaction effect of PRP. PMID:25489498

  7. FAS grafted superhydrophobic ceramic membrane

    International Nuclear Information System (INIS)

    The hydrophobic properties of ?-Al2O3 membrane have been obtained by grafting fluoroalkylsilane (FAS) on the surface of the membrane. The following grafting parameters were studied: the eroding time of the original membrane, the grafting time, the concentration of FAS solution and the multiplicity of grafting. Hydrophobicity of the membranes was characterized by contact angle (CA) measurement. The thermogravimetric analysis (TGA) was used to investigate the weight loss process (25-800 deg. C) of the fluoroalkylsilane grafted on Al2O3 powders under different grafting conditions. The morphologies of the membranes modified under different parameters were examined by field emission scanning electron microscopy (FE-SEM) and the surface roughness (Ra) was measured using white light interferometers. A needle-like structure was observed on the membrane surface after modification, which causes the change of Ra. On the results above, we speculated a model to describe the reaction between FAS and ?-Al2O3 membrane surface as well as the formed surface morphology.

  8. Effect of bystander initiated cardiopulmonary resuscitation on ventricular fibrillation and survival after witnessed cardiac arrest outside hospital.

    OpenAIRE

    Herlitz, J.; Ekstro?m, L.; Wennerblom, B.; Axelsson, A.; Ba?ng, A.; Holmberg, S.

    1994-01-01

    OBJECTIVE--To describe the proportion of patients who were discharged from hospital after witnessed cardiac arrest outside hospital in relation to whether a bystander initiated cardiopulmonary resuscitation. PATIENTS--All patients with witnessed cardiac arrest outside hospital before arrival of the ambulance and in whom cardiopulmonary resuscitation was attempted by the emergency medical service in Gothenburg during 1980-92. RESULTS--Cardiopulmonary resuscitation was initiated by a bystander ...

  9. 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

  10. 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.

  11. 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.

  12. Surface-grafted polymers from electrodeposited macroprecursors

    Science.gov (United States)

    Rellamas Tria, Maria Celeste

    The use of electrochemically deposited macroprecursors for tethering polymers onto conducting surfaces is presented. Specifically, anodic electropolymerization was used as a tool to electrodeposit the precursors on electrodes that mediated the grafting of polymers onto surfaces. With this approach, patterning of surface-grafted polymers was also made possible through selective electrodeposition of the conjugated polymer network of the macroprecursors. This approach was used to fabricate protein and cell-resistant poly(poly(ethylene glycol) methyl ether methacrylate) (PPEGMEMA) brushes on Au surfaces. A chain transfer agent (CTA) was electrodeposited on the Au surface that served as the macroprecursor for the subsequent surface-initiated reversible addition-fragmentation chain transfer (SI-RAFT) polymerization of poly(ethylene glycol) methyl ether methacrylate (PEGMEMA). X-ray photoelectron spectroscopy (XPS) results showed the stability of the electrogenerated CTA under anodic conditions while successful brush growth was confirmed by surface techniques including XPS, ellipsometry, atomic force microscopy (AFM), and contact angle measurements. The PPEGMEMA-coated substrate exhibited protein and cell-repellant properties comparable to other reported PEG-functionalized surfaces. The proposed approach also yielded polymer-patterned surfaces as discussed in Chapters 3 and 4. An electroactive photocrosslinker was employed to facilitate the dual mode patterning of polystyrene (PS) on the surface by either electropatterning or photopatteming route. An electrodeposited CTA was also utilized to selectively grow surface-grafted PS on conducting regions of the substrate. Subsequent backfilling of nonconducting areas with a silane atom transfer radical polymerization (ATRP) initiator directed the growth of poly-N-isopropylacrylamide (PNIPAM) that produced a patterned binary polymer system. The patterns were successfully characterized by AFM and IR-imaging. Surface-grafted poly(N-vinyl carbazole) (PVK) film on indium tin oxide (ITO) was fabricated using this technique. This surface was used as a hole transporting layer (HTL) for a photovoltaic device as a possible replacement for existing poly(3,4-ethylene dioxythiophene) : poly(styrene sulfonate) (PEDOT:PSS). Device testing showed a comparable performance between the tethered PVK HTL and PEDOT:PSS as HTLs.

  13. Inhibition of neutrophil activity improves cardiac function after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Grünwald Frank

    2007-10-01

    Full Text Available Abstract Background The arterial in line application of the leukocyte inhibition module (LIM in the cardiopulmonary bypass (CPB limits overshooting leukocyte activity during cardiac surgery. We studied in a porcine model whether LIM may have beneficial effects on cardiac function after CPB. Methods German landrace pigs underwent CPB (60 min myocardial ischemia; 30 min reperfusion without (group I; n = 6 or with LIM (group II; n = 6. The cardiac indices (CI and cardiac function were analyzed pre and post CPB with a Swan-Ganz catheter and the cardiac function analyzer. Neutrophil labeling with technetium, scintigraphy, and histological analyses were done to track activated neutrophils within the organs. Results LIM prevented CPB-associated increase of neutrophil counts in peripheral blood. In group I, the CI significantly declined post CPB (post: 3.26 ± 0.31; pre: 4.05 ± 0.45 l/min/m2; p 2; p = 0.23. Post CPB, the intergroup difference showed significantly higher CI values in the LIM group (p Conclusion Our data provides strong evidence that LIM improves perioperative hemodynamics and cardiac function after CPB by limiting neutrophil activity and inducing accelerated sequestration of neutrophils in the spleen.

  14. Cardiopulmonary resuscitation--time for a change in the paradigm?

    Science.gov (United States)

    Levinson, Michele; Mills, Amber

    2014-08-01

    Cardiopulmonary resuscitation (CPR) is the default treatment in hospital unless there is a decision to the contrary and this is documented in the patient record. The outcome of CPR in older chronically ill patients is very poor and discharge home is unlikely. Fewer not-for-resuscitation (NFR) orders are written than there are patients who would not benefit from CPR. NFR orders appear to be a marker of death, rather than the result of informed discussion about end-of-life care. There is a legal and ethical framework for the consideration of the suitability of CPR. Discussions about CPR are challenging, and uncertainty is introduced because of the lack of consensus around futility, the emotionally charged nature of the topic, misconceptions about the success of CPR and the failure to recognise that not offering CPR will allow a peaceful and supported death. Discussion around CPR can be misconstrued as a need for consent. A focus on patient and family involvement may result in an expectation that CPR is an entitlement. As part of evidence-based patient-centred care, CPR should only be offered to those for whom it is beneficial. CPR should no longer be the universal default. We propose an opt-in model, which will drive discussion and evaluation of the efficacy and suitability of CPR for the individual. A CPR discussion should occur on admission for all elderly hospital inpatients. PMID:25128949

  15. Multisite Near Infrared Spectroscopy During Cardiopulmonary Bypass in Pediatric Patients.

    Science.gov (United States)

    Ricci, Zaccaria; Haiberger, Roberta; Tofani, Lorenzo; Romagnoli, Stefano; Favia, Isabella; Cogo, Paola

    2015-07-01

    Multisite near infrared spectroscopy (NIRS) monitoring during pediatric cardiopulmonary bypass (CPB) has not been extensively validated. Although it might be rational to explore regional tissue saturation at different body sites (namely brain, kidney, upper body, lower body), conflicting results are currently provided by experience in children. The aim of our study was to evaluate absolute values of multisite NIRS saturation during CPB in a cohort of infants undergoing pediatric cardiac surgery to describe average differences between cerebral, renal, upper body (arm), and lower body (thigh) regional saturation. Furthermore, the correlation between cerebral NIRS and cardiac index (CI) at CPB weaning was evaluated. Twenty-five infants were enrolled: their median weight, age, and body surface area were 3.9 (3.3-6) kg, 111 (47-203) days, and 0.24 (0.22-0.33) m(2) , respectively. Median Aristotle score was 8 (6-10), and vasoactive inotropic score at CPB weaning was 16 (14-25). A total of 17?430 data points were recorded by each sensor: two-way ANOVA showed that time (P?saturation changes over time showed that, at all sites, average NIRS values increased after CPB start, even if the increase of cerebral saturation was less intense than other sites (P?saturations, regardless of their position. Based on these results, positioning of noncerebral NIRS sensors during CPB without CA may be questioned. PMID:25788341

  16. Tendencias en resucitación cardiopulmonar / Trends in cardiopulmonary resuscitation

    Scientific Electronic Library Online (English)

    Raúl-Jaime, Gazmuri; Jesús-Andrés, Álvarez-Fernández.

    2009-02-01

    Full Text Available Menos del 10% de las personas que sufren una parada cardíaca son resucitados con éxito y regresan a sus hogares para vivir vidas productivas. Nuevos enfoques de la resucitación podrían modificar de forma sustancial este resultado tan triste. Cuatro tendencias en resucitación cardiopulmonar (RCP) par [...] ecen tener el mayor potencial para mejorar el pronóstico: los sistemas para la prevención de la parada cardíaca mediante reconocimiento precoz de los signos de alarma e intervención oportuna; el cambio hacia una resucitación orientada hacia el flujo sanguíneo, enfatizando la realización ininterrumpida de una RCP de alta calidad con un papel limitado de la ventilación; la importancia creciente de la tecnología guiando las intervenciones en resucitación, mejorando el proceso humano de toma de decisiones, y el empleo de la hipotermia. Abstract in english Less than 10% of those individuals who suffer an episode of sudden cardiac arrest are successfully resuscitated and return home to live productive lives. New approaches to cardiac resuscitation could substantially improve such dismal outcome. Four current trends in cardiopulmonary resuscitation (CPR [...] ) have the greatest potential for improving outcome: the development of systems that can prevent cardiac arrests through recognition of early warning signs and timely intervention; a shift towards a flow-based resuscitation emphasizing the delivery of high-quality uninterrupted CPR limiting the role of ventilation; the growing role of technology in driving resuscitation interventions, incrementally enhancing the human decision-making process, and the use of hypothermia.

  17. Tendencias en resucitación cardiopulmonar Trends in cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Raúl-Jaime Gazmuri

    2009-02-01

    Full Text Available Menos del 10% de las personas que sufren una parada cardíaca son resucitados con éxito y regresan a sus hogares para vivir vidas productivas. Nuevos enfoques de la resucitación podrían modificar de forma sustancial este resultado tan triste. Cuatro tendencias en resucitación cardiopulmonar (RCP parecen tener el mayor potencial para mejorar el pronóstico: los sistemas para la prevención de la parada cardíaca mediante reconocimiento precoz de los signos de alarma e intervención oportuna; el cambio hacia una resucitación orientada hacia el flujo sanguíneo, enfatizando la realización ininterrumpida de una RCP de alta calidad con un papel limitado de la ventilación; la importancia creciente de la tecnología guiando las intervenciones en resucitación, mejorando el proceso humano de toma de decisiones, y el empleo de la hipotermia.Less than 10% of those individuals who suffer an episode of sudden cardiac arrest are successfully resuscitated and return home to live productive lives. New approaches to cardiac resuscitation could substantially improve such dismal outcome. Four current trends in cardiopulmonary resuscitation (CPR have the greatest potential for improving outcome: the development of systems that can prevent cardiac arrests through recognition of early warning signs and timely intervention; a shift towards a flow-based resuscitation emphasizing the delivery of high-quality uninterrupted CPR limiting the role of ventilation; the growing role of technology in driving resuscitation interventions, incrementally enhancing the human decision-making process, and the use of hypothermia.

  18. [From interpretation of cardiopulmonary exercise testing to medical decision].

    Science.gov (United States)

    Aguilaniu, B; Wallaert, B

    2013-06-01

    Exercise is a situation that involves cardiovascular, respiratory and metabolic responses simultaneously. Thus, interpretating the results of the cardiopulmonary exercise testing (CPET) requires an integrated understanding of the pathophysiology of exercise intolerance which may result from lung, heart, pulmonary or peripheral circulation, muscles disturbances, or a combination of these functional disorders. In this paper, we offer a systematic method to assist clinicians in developing a pathophysiological reasoning from the functional competency of each component measured during incremental exercise. We propose to go through four steps: descriptive analysis, prioritization of the functional disorders, mechanistic proposals and diagnostic and/or therapeutic suggestions. The descriptive analysis step should answer seven key physiological questions, the prioritization step is based on the magnitude of the functional disorders and their relevance to the primary symptoms causing exercise intolerance, the mechanistic proposals step aims at suggesting different mechanisms and etiologies compatible with the scale of observed functional abnormalities, which will finally be tested by exploring specific diagnostic or therapeutic suggestions. PMID:23835322

  19. 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.

  20. 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.

  1. 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 conducting films, 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-diazonium 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 the film 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 the film growth has its origin in electron transfer processes occurring through the layer mediated by the redox moieties embedded in the organic film.

  2. Vascularized osseous graft for scaphoid

    International Nuclear Information System (INIS)

    The most commonly used technique for treatment of pseudo-arthrosis of the scaphoid is osteo-synthesis with Kirschnet wires and cortical sponge grafts. Results reported by different teams using this procedure show no more than 90% osseous consolidation, especially in cases where vascularisation of the proximal fragment of the scaphoid is compromised. Here we present a series of ten cases of pseudo-arthrosis of the scaphoid, treated using a new surgical technique involving a vascularized osseous graft of the distal radius. Using this procedure we obtained 100% consolidation, with no complications either during the procedure or immediately post-operatively. Patients returned to work in week 15 on average. In 4 cases we observed discomfort in the area of the scar, which was successfully treated using local cortisone injection. The results obtained are very similar to those seen in the literature on the different techniques for vascularized osseous grafts for pseudo-arthrosis of the scaphoid

  3. Plant grafting: new mechanisms, evolutionary implications

    OpenAIRE

    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 t...

  4. Gamma radiation-induced grafting of glycidyl methacrylate (GMA) onto water hyacinth fibers

    Science.gov (United States)

    Madrid, Jordan F.; Nuesca, Guillermo M.; Abad, Lucille V.

    2013-04-01

    Water hyacinth fibers (Eichhornia crassipes) were functionalized using radiation-induced graft polymerization of glycidyl methacrylate by ?-rays from 60Co source. The simultaneous grafting technique was employed wherein the water hyacinth fibers were irradiated in nitrogen atmosphere in the presence of glycidyl methacrylate dissolved in water/methanol solvent. The effects of different grafting parameters to the grafting yield were evaluated. The optimal values of solvent, absorbed dose, dose rate, and concentration of monomer were found to be 1:3 (volume/volume) water-methanol solvent, 10 kGy, 8 kGy h-1 dose rate and 5% volume/volume glycidyl methacrylate, respectively. Using the optimum conditions, degree of grafting of approximately 58% was achieved. The grafted water hyacinth fibers were characterized using Attenuated Total Reflectance-Fourier Transformed Infrared Spectroscopy (ATR-FTIR), Thermogravimetric Analysis (TGA), Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectroscopy (EDX). The results of these tests confirmed the successful grafting of glycidyl methacrylate onto water hyacinth fibers.

  5. 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.

  6. [Radioindication of bone graft healing].

    Science.gov (United States)

    Kuznetsova, L B; Pavlova, L P; Kondrat'ev, V G; Khmelev, O N

    1977-01-01

    To control the state of transplanted bone in different terms following the plastic procedure a radioisotope study by strontium-85 was performed in 29 patients. The results of scannography (in 31 cases) and radiometry (in 42 cases) were analysed. The determination of the character of strontium-85 distribution and the intensity of its accumulation in the operated extremity makes it possible to assess the graft condition and the intensity of osteogenesis a greater precision and earlier than does roentgenography. Radioisotope investigation conducted dynamically enable the prognostication of the course of the graft healing process. PMID:333749

  7. Organosiloxane-grafted natural polymer coatings

    Science.gov (United States)

    Sugama, Toshifumi (Wading River, NY)

    1998-01-01

    A new family of polysaccharide graft polymers are provided as corrosion resistant coatings having antimicrobial properties which are useful on light metals such as aluminum, magnesium, zinc, steel and their alloys. Methods of making the polysaccharide graft polymers are also included. The methods of making the polysaccharide graft polymers involve reacting a polysaccharide source with an antimicrobial agent under conditions of hydrolysis-condensation.

  8. 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...

  9. Retrospective Study of the Survival of Patients who Underwent Cardiopulmonary Resuscitation in an Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Moreira Daniel Martins

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate clinical and evolutive characteristics of patients admitted in an intensive care unit after cardiopulmonary resuscitation, identifying prognostic survival factors.METHODS: A retrospective study of 136 patients admitted between 1995 and 1999 to an intensive care unit, evaluating clinical conditions, mechanisms and causes of cardiopulmonary arrest, and their relation to hospital mortality.RESULTS: A 76% mortality rate independent of age and sex was observed. Asystole was the most frequent mechanism of death, and seen in isolation pulmonary arrest was the least frequent. Cardiac failure, need for mechanical ventilation, cirrhosis and previous stroke were clinically significant (p<0.01 death factors.CONCLUSION: Prognostic factors supplement the doctor's decision as to whether or not a patient will benefit from cardiopulmonary resuscitation.

  10. Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest.

    Science.gov (United States)

    Cameron, D E; Reitz, B A; Carson, B S; Long, D M; Dufresne, C R; Vander Kolk, C A; Maxwell, L G; Tilghman, D M; Nichols, D G; Wetzel, R C

    1989-11-01

    Occipitally joined craniopagus Siamese twins were separated with the use of cardiopulmonary bypass and hypothermic circulatory arrest. The 7-month-old infants shared a large sagittal venous sinus that precluded conventional neurosurgical approach because of risk of exsanguination and air embolism. After craniotomy and preliminary exposure of the sinus, each twin underwent sternotomy and total cardiopulmonary bypass with deep hypothermia. Hypothermic circulatory arrest allowed safe division and subsequent reconstruction of the sinus remnants. Several unusual problems were encountered, including transfusion of a large blood volume from one extracorporeal circuit to the other through the common venous sinus, deleterious warming of the exposed brain during circulatory arrest, and thrombosis of both pump oxygenators. Both infants survived, although recovery was complicated in each by neurologic injury, cranial wound infection, and hydrocephalus. This case demonstrates the valuable supportive role of cardiopulmonary bypass and hypothermic circulatory arrest in the management of complex surgical problems of otherwise inoperable patients. PMID:2682024

  11. 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. 

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

    DEFF Research Database (Denmark)

    Isbye, Dan L; HØiby, Pernilla

    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 CPR performance a scoring system based on the Cardiff test was used. Groups were compared with a Mann Whitney rank sum test. RESULTS: There was no statistically significant difference between the two groups when considering change in overall CPR performance score from before training to 3 months after training (P=0.12). However, the IF group performed significantly better than the VAM group in the total score, both immediately after (P=0.0008) and 3 months after training (P=0.02). This difference was primarily related to the BVM skills. CONCLUSION: Skill retention in CPR using a bag-valve-mask was better after 3 months when training with an instructor than with an automated voice advisory manikin Udgivelsesdato: 2008/10

  13. Cardiopulmonary Responses to Supine Cycling during Short-Arm Centrifugation

    Science.gov (United States)

    Vener, J. M.; Simonson, S. R.; Stocks, J.; Evettes, S.; Bailey, K.; Biagini, H.; Jackson, C. G. R.; Greenleaf, J. E.; Dalton, Bonnie P. (Technical Monitor)

    2001-01-01

    The purpose of this study was to investigate cardiopulmonary responses to supine cycling with concomitant +G(sub z) acceleration using the NASA/Ames Human Powered Short-Arm Centrifuge (HPC). Subjects were eight consenting males (32+/-5 yrs, 178+/-5 cm, 86.1+/- 6.2 kg). All subjects completed two maximal exercise tests on the HPC (with and without acceleration) within a three-day period. A two tailed t-test with statistical significance set at p less than or equal to 0.05 was used to compare treatments. Peak acceleration was 3.4+/-0.1 G(sub z), (head to foot acceleration). Peak oxygen uptake (VO2(sub peak) was not different between treatment groups (3.1+/-0.1 Lmin(exp -1) vs. 3.2+/-0.1 Lmin(exp -1) for stationary and acceleration trials, respectively). Peak HR and pulmonary minute ventilation (V(sub E(sub BTPS))) were significantly elevated (p less than or equal to 0.05) for the acceleration trial (182+/-3 BPM (Beats per Minute); 132.0+/-9.0 Lmin(exp -1)) when compared to the stationary trial (175+/-3 BPM; 115.5+/-8.5 Lmin(exp -1)). Ventilatory threshold expressed as a percent of VO2(sub peak) was not different for acceleration and stationary trials (72+/-2% vs. 68+/-2% respectively). Results suggest that 3.4 G(sub z) acceleration does not alter VO2(sub peak) response to supine cycling. However, peak HR and V(sub E(sub BTPS)) response may be increased while ventilatory threshold response expressed as a function of percent VO2(sub peak) is relatively unaffected. Thus, traditional exercise prescription based on VO2 response would be appropriate for this mode of exercise. Prescriptions based on HR response may require modification.

  14. 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

  15. [Cardiopulmonary exercise testing in patients with pectus excavatum].

    Science.gov (United States)

    Cavestri, B; Wurtz, A; Bart, F; Nevière, R; Aguilaniu, B; Wallaert, B

    2010-09-01

    The functional consequences of physiologic impairments due to pectus excavatum (PE) are not known. This study was conducted to determine the exercise performance in patients with this condition. This prospective study included all patients presenting for PE during a 5-year period. Patients had a chest CT scan to measure the PE severity index, resting pulmonary function tests, cardiopulmonary exercise testing (CPET) with gas exchange analysis and echocardiography. Thirty-two patients were included, with a mean age of 25.9 years. The mean PE severity index was 3.72 ± 0.87. The maximal oxygen uptake (VO(2-max)) was 78.6 ± 22.1% predicted. Only four out of the 32 patients had a normal CPET. In the remaining patients, we observed three main patterns of limitation: 18 patients had a marked limitation in increasing their tidal volume (41 ± 5% of FVC at VO(2-max) versus 51 ± 7.5%); five patients had abnormal gas exchange with increased P(A-a)O(2) at VO(2-max) (47 ± 23 mmHg versus 20 ± 7.5 mmHg) associated with a patent foramen ovale without elevation of right pressure. The five last patients had cardiovascular impairment with a decreased oxygen pulse at VO(2-max) (57 ± 9% versus 90 ± 20%). They exhibited the most severe limitation (VO(2-max) = 55 ± 10%; P = 0.003). CPET abnormalities were predicted by neither PE index severity nor the results of resting pulmonary function tests. PE is associated with abnormal CPET, including impairments in ventilatory, cardiovascular responses and/or gas exchange, which may be of importance in disease management. PMID:20863972

  16. Pressure and time dependence of the cardiopulmonary reflex response in patients with hypertensive cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Otto M.E.B.

    2004-01-01

    Full Text Available The first minutes of the time course of cardiopulmonary reflex control evoked by lower body negative pressure (LBNP in patients with hypertensive cardiomyopathy have not been investigated in detail. We studied 15 hypertensive patients with left ventricular dysfunction (LVD and 15 matched normal controls to observe the time course response of the forearm vascular resistance (FVR during 3 min of LBNP at -10, -15, and -40 mmHg in unloading the cardiopulmonary receptors. Analysis of the average of 3-min intervals of FVR showed a blunted response of the LVD patients at -10 mmHg (P = 0.03, but a similar response in both groups at -15 and -40 mmHg. However, using a minute-to-minute analysis of the FVR at -15 and -40 mmHg, we observed a similar response in both groups at the 1st min, but a marked decrease of FVR in the LVD group at the 3rd min of LBNP at -15 mmHg (P = 0.017, and -40 mmHg (P = 0.004. Plasma norepinephrine levels were analyzed as another neurohumoral measurement of cardiopulmonary receptor response to LBNP, and showed a blunted response in the LVD group at -10 (P = 0.013, -15 (P = 0.032 and -40 mmHg (P = 0.004. We concluded that the cardiopulmonary reflex response in patients with hypertensive cardiomyopathy is blunted at lower levels of LBNP. However, at higher levels, the cardiopulmonary reflex has a normal initial response that decreases progressively with time. As a consequence of the time-dependent response, the cardiopulmonary reflex response should be measured over small intervals of time in clinical studies.

  17. Pressure and time dependence of the cardiopulmonary reflex response in patients with hypertensive cardiomyopathy

    Scientific Electronic Library Online (English)

    M.E.B., Otto; F.M., Consolim-Colombo; C.R.M., Rodrigues Sobrinho; E.M., Krieger.

    1615-16-01

    Full Text Available The first minutes of the time course of cardiopulmonary reflex control evoked by lower body negative pressure (LBNP) in patients with hypertensive cardiomyopathy have not been investigated in detail. We studied 15 hypertensive patients with left ventricular dysfunction (LVD) and 15 matched normal co [...] ntrols to observe the time course response of the forearm vascular resistance (FVR) during 3 min of LBNP at -10, -15, and -40 mmHg in unloading the cardiopulmonary receptors. Analysis of the average of 3-min intervals of FVR showed a blunted response of the LVD patients at -10 mmHg (P = 0.03), but a similar response in both groups at -15 and -40 mmHg. However, using a minute-to-minute analysis of the FVR at -15 and -40 mmHg, we observed a similar response in both groups at the 1st min, but a marked decrease of FVR in the LVD group at the 3rd min of LBNP at -15 mmHg (P = 0.017), and -40 mmHg (P = 0.004). Plasma norepinephrine levels were analyzed as another neurohumoral measurement of cardiopulmonary receptor response to LBNP, and showed a blunted response in the LVD group at -10 (P = 0.013), -15 (P = 0.032) and -40 mmHg (P = 0.004). We concluded that the cardiopulmonary reflex response in patients with hypertensive cardiomyopathy is blunted at lower levels of LBNP. However, at higher levels, the cardiopulmonary reflex has a normal initial response that decreases progressively with time. As a consequence of the time-dependent response, the cardiopulmonary reflex response should be measured over small intervals of time in clinical studies.

  18. Markers of primary graft dysfunction

    DEFF Research Database (Denmark)

    Hagedorn, Peter Technical University of Denmark,

    The present invention relates to methods for diagnosing transplant rejection, or a condition associated with transplant rejection, such as, primary graft dysfunction in a subject, to antigen probe arrays for performing such a diagnosis, and to antigen probe sets for generating such arrays.

  19. 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)

  20. 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.)

  1. Combined Psoas Compartment-Sciatic Block in a Pediatric Patient with High-Risk Cardiopulmonary

    Directory of Open Access Journals (Sweden)

    Levent Þahin

    2013-03-01

    Full Text Available There is high potential for complications in cardiopulmonary high-risk patients with valvular heart disease at perioperative period. The operation was planned due to pathological fracture of the femoral shaft of a nine year old male patient weighing 26 kilograms. He had 3o tricuspid insufficiency, 3o mitral insufficiency and pulmonary hypertension in preoperative evaluation. Sciatic nerve block and psoas compartment block was performed to patient for anesthesia and analgesia. In conclusion we think that combined psoas compartment-sciatic nerve block may be a good alternative to other methods of anesthesia in high-risk pediatric patients with cardiopulmonary perspective in lower-extremity surgery.

  2. Histoplasma infection of aortofemoral bypass graft.

    Science.gov (United States)

    Patel, Nishit; Bronze, Michael S

    2014-05-01

    Histoplasma infection of vascular grafts is extremely rare. To our knowledge, there are only 4 cases reported with Histoplasma capsulatum infection of the aortic graft. All had previous disseminated histoplasmosis and atherosclerotic peripheral vascular disease. They were treated surgically with explantation of the infected graft and reimplantation of new graft in extra-anatomic uninfected site. The authors present a new case of H capsulatum infection of aortofemoral bypass graft, but unlike the other cases, this case was managed without surgical intervention. PMID:23928546

  3. Predictive value of rotational thromboelastometry during cardiopulmonary bypass for thrombocytopenia and hypofibrinogenemia after weaning of cardiopulmonary bypass

    Science.gov (United States)

    Ji, Sung-Mi; Kim, Sung-Hoon; Nam, Jae-Sik; Yun, Hye-Joo; Choi, Jeong-Hyun; Choi, In-Cheol

    2015-01-01

    Background The early detection of coagulopathy helps guide decisions regarding optimal transfusion management during cardiac surgery. This study aimed to determine whether rotational thromboelastometry (ROTEM) analysis during cardiopulmonary bypass (CPB) could predict thrombocytopenia and hypofibrinogenemia after CPB. Methods We analyzed 138 cardiac surgical patients for whom ROTEM tests and conventional laboratory tests were performed simultaneously both during and after CPB. An extrinsically activated ROTEM test (EXTEM), a fibrin-specific ROTEM test (FIBTEM) and PLTEM calculated by subtracting FIBTEM from EXTEM were evaluated. Correlations between clot amplitude at 10 min (A10), maximal clot firmness, platelet count, and fibrinogen concentrations at each time point were calculated. A receiver operating characteristic analysis with area under the curve (AUC) was used to assess the thresholds of EXTEM, PLTEM and FIBTEM parameters during CPB and for predicting thrombocytopenia and hypofibrinogenemia after weaning of CPB. Results The A10 on EXTEM, PLTEM, and FIBTEM during CPB showed a good correlation with platelet counts (r = 0.622 on EXTEM and r = 0.637 on PLTEM; P < 0.0001 for each value) and fibrinogen levels (r = 0.780; P < 0.0001) after CPB. A10 on a FIBTEM threshold of 8 mm during the CPB predicted a fibrinogen concentration < 150 mg/dl (AUC = 0.853) after CPB. Additionally, the threshold level of A10 on EXTEM during CPB for predicting platelet counts < 100,000 /µl after CPB was 42 mm (AUC = 0.768). Conclusions EXTEM, PLTEM, and FIBTEM parameters during CPB may be useful for predicting thrombocytopenia and hypofibrinogenemia after weaning of CPB.

  4. Posterior repair with perforated porcine dermal graft

    Scientific Electronic Library Online (English)

    G. Bernard, Taylor; Robert D., Moore; John R., Miklos; T. Fleming, Mattox.

    2008-02-01

    Full Text Available OBJECTIVE: To compare postoperative vaginal incision separation and healing in patients undergoing posterior repair with perforated porcine dermal grafts with those that received grafts without perforations. Secondarily, the tensile properties of the perforated and non-perforated grafts were measure [...] d and compared. MATERIALS AND METHODS: This was a non-randomized retrospective cohort analysis of women with stage II or greater rectoceles who underwent posterior repair with perforated and non-perforated porcine dermal grafts (PelvicolTM CR Bard Covington, GA USA). The incidence of postoperative vaginal incision separation (dehiscence) was compared. A secondary analysis to assess graft tensile strength, suture pull out strength, and flexibility after perforation was performed using standard test method TM 0133 and ASTM bending and resistance protocols. RESULTS: Seventeen percent of patients (21/127) who received grafts without perforations developed vaginal incision dehiscence compared to 7% (5/71) of patients who received perforated grafts (p = 0.078). Four patients with vaginal incision dehiscence with non-perforated grafts required surgical revision to facilitate healing. Neither tensile strength or suture pull out strength were significantly different between perforated and non-perforated grafts (p = 0.81, p = 0.29, respectively). There was no difference in the flexibility of the two grafts (p = 0.20). CONCLUSION: Perforated porcine dermal grafts retain their tensile properties and are associated with fewer vaginal incision dehiscences.

  5. 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.

  6. Guías de Reanimación Cardiopulmonar / Guides for Cardiopulmonary Resuscitation

    Scientific Electronic Library Online (English)

    Raffo, Escalante-Kanashiro.

    2010-10-01

    Full Text Available El presente artículo busca como objetivo primordial, una aproximación a las Guías 2010 y principales cambios; estamos convencidos que el entrenamiento y aprendizaje de ella se basa en los conceptos de metodología activa y simulación clínica, no podemos tener un conocimiento de la ciencia y protocolo [...] s de reanimación cardiopulmonar sin antes no haber experimentado la discusión de temas y desarrollo de casos escenarios vivenciales, para cada uno de los tópicos descritos a continuación. Una de las estrategias más importantes es la diseminación de los conceptos contenidos en las Guías ILCOR de Reanimación Cardiopulmonar que se han consensuado en la ERC y AHA. Ello ha permitido que el personal de salud trate a los pacientes victimas de paro cardiaco o emergencias cardiacas con mayor eficiencia. Las guías actuales fundamentan todos sus aspectos en investigación y recomendaciones, los cambios se iniciaron con una variación sustantiva de la cadena de supervivencia incorporando conceptos de integración de cuidados postparo1,2. Las Guías de Reanimación Cardiopulmonar fueron publicadas y puestas on-line (Resuscitation y American Heart Association) en Octubre 18, 20109,10. Abstract in english The objective of the present article is the approach of 2010 ECC & CPR Guidelines and their principal modifications. Guidelines are the result of scientific evidence and clinical research that support statements and new recommendations. Some important changes in 2010 present in the Chain of Survival [...] which includes aspects of Postresuscitation Care1,2. CPR Guidelines were published and uploaded on-line (Resuscitation and Circulation publication) in October 18th, 20109,10. One of the most important training and learning strategies is the dissemination of concepts from ILCOR CPR and ECC Guidelines which had extended into ERC and AHA. This has allowed the medical personnel to treat patients victims of cardiac arrest or cardiac emergency efficiently. We are convinced that interactive methodology and clinical simulation are essential for training and learning. We cannot know cardiopulmonary resuscitation without discussion of science and performance of lively clinical scenery cases for each of the main topics in CPR and ECC.

  7. 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.

  8. 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.

  9. Determining the degree of grafting for poly (vinylidene fluoride) graft-copolymers using fluorine elemental analysis

    International Nuclear Information System (INIS)

    Acrylic acid (AAc) and styrene (St) were grafted onto poly (vinylidene fluoride) (PVDF) powder or membrane samples by pre-irradiation graft copolymerization. The grafted chains were proved by FT-IR spectroscopy analysis. The degree of grafting (DG) of the grafted PVDF was determined by fluorine elemental analysis (FEA) method, and was compared with the DGs determined by weighing method, acid-base back titration method and quantitative FT-IR method. The results show that the FEA method is accurate, convenient and universal, especially for the grafted polymer powders. (authors)

  10. Enzyme-functionalized vascular grafts catalyze in-situ release of nitric oxide from exogenous NO prodrug.

    Science.gov (United States)

    Wang, Zhihong; Lu, Yaxin; Qin, Kang; Wu, Yifan; Tian, Yingping; Wang, Jianing; Zhang, Jimin; Hou, Jingli; Cui, Yun; Wang, Kai; Shen, Jie; Xu, Qingbo; Kong, Deling; Zhao, Qiang

    2015-07-28

    Nitric oxide (NO) is an important signaling molecule in cardiovascular system, and the sustained release of NO by endothelial cells plays a vital role in maintaining patency and homeostasis. In contrast, lack of endogenous NO in artificial blood vessel is believed to be the main cause of thrombus formation. In this study, enzyme prodrug therapy (EPT) technique was employed to construct a functional vascular graft by immobilization of galactosidase on the graft surface. The enzyme-functionalized grafts exhibited excellent catalytic property in decomposition of the exogenously administrated NO prodrug. Localized and on-demand release of NO was demonstrated by in vitro release assay and fluorescent probe tracing in an ex vivo model. The immobilized enzyme retained catalytic property even after subcutaneous implantation of the grafts for one month. The functional vascular grafts were implanted into the rat abdominal aorta with a 1-month monitoring period. Results showed effective inhibition of thrombus formation in vivo and enhancement of vascular tissue regeneration and remodeling on the grafts. Thus, we create an enzyme-functionalized vascular graft that can catalyze prodrug to release NO locally and sustainably, indicating that this approach may be useful to develop new cell-free vascular grafts for treatment of vascular diseases. PMID:26004323

  11. Cardiopulmonary resuscitation on Flemish television: challenges to the television effects hypothesis

    OpenAIRE

    Den Bulck, J.; Damiaans, K.

    2004-01-01

    Background: People who watch a lot of medical fiction overestimate the success rate of cardiopulmonary resuscitation (CPR). It has been suggested that this is because CPR is usually shown to be successful on television. This study analysed a popular Flemish medical drama series. Previous research showed that heavy viewing of this series was related to overestimation of CPR success.

  12. 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.

  13. Increased concentrations of L-lactate in the rectal lumen in patients undergoing cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Perner, A; JØrgensen, V L

    2005-01-01

    Gut ischaemia may contribute to morbidity in patients after cardiopulmonary bypass (CPB), but little is known about the metabolic state of the large bowel in such patients. Therefore we estimated the concentrations of L-lactate and Pco(2) in rectal mucosa in patients undergoing cardiac surgery with or without the use of CPB.

  14. Cardiopulmonary resuscitation should continue as long as shockable cardiac rhythms persist

    DEFF Research Database (Denmark)

    Adelborg, Kasper; LØfgren, Bo

    2012-01-01

    Initiation of cardiopulmonary resuscitation or termination of a resuscitation attempt may be challenging. We report a case with a 41-year-old man who was successfully resuscitated without significant neurological deficits despite more than 45 minutes of cardiac arrest with shockable cardiac rhythms. This case demonstrates that treatment should continue as long as shockable cardiac rhythms persist.

  15. AGONIST-MEDIATED AIRWAY CHALLENGE: CARDIOPULMONARY INTERACTIONS MODULATE GAS EXCHANGE AND RECOVERY

    Science.gov (United States)

    ABSTRACT To better understand the early phase response (0-60 minutes) to airway challenge, we examined cardiopulmonary reactions during ovalbumin (OVA), histamine, and methacholine aerosol challenge tests in guinea pigs. Propranolol and 100% O2 were used to modify the reacti...

  16. Transapical arterial cannulation for salvage cardiopulmonary bypass in transcatheter aortic valve replacement.

    Science.gov (United States)

    Brinster, Derek R; Patel, Jay A; McCarthy, Harry L; Aron, Ty M; Gertz, Zachary M

    2014-10-01

    Hemodynamic instability during transcatheter aortic valve replacement procedures may require transient cardiopulmonary bypass for support. In patients with severe atherosclerosis, peripheral cannulation may not be possible. This method of direct left ventricle cannulation during transapical TAVR is a facile means to provide arterial inflow. PMID:25282226

  17. Extradural hematoma following double valve replacement under cardiopulmonary bypass: a rare complication.

    Science.gov (United States)

    Kumar, Bhupesh; Bhagat, Hemant; Raj, Ravi; Jayant, Aveek

    2013-01-01

    The primary mechanisms responsible for acute neurological deterioration following cardiopulmonary bypass (CPB) include cerebral embolism, cerebral hypoperfusion and/or inflammatory process triggered by CPB. Extradural hematoma (EDH) following CPB is rare but associated with significant mortality and morbidity. We present a case of EDH following double valve replacement in an adolescent boy. PMID:23287089

  18. Cardiopulmonary Resuscitation in Resource-limited Health Systems-Considerations for Training and Delivery.

    Science.gov (United States)

    Friesen, Jason; Patterson, Dean; Munjal, Kevin

    2015-02-01

    In the past 50 years, cardiopulmonary resuscitation (CPR) has gained widespread recognition as a life-saving skill that can be taught successfully to the general public. Cardiopulmonary resuscitation can be considered a cost-effective intervention that requires minimal classroom training and low-cost equipment and supplies; it is commonly taught throughout much of the developed world. But, the simplicity of CPR training and its access for the general public may be misleading, as outcomes for patients in cardiopulmonary arrest are poor and survival is dependent upon a comprehensive "chain-of-survival," which is something not achieved easily in resource-limited health care settings. In addition to the significant financial and physical resources needed to both train and develop basic CPR capabilities within a community, there is a range of ethical questions that should also be considered. This report describes some of the financial and ethical challenges that might result from CPR training in low- and middle-income countries (LMICs). It is determined that for many health care systems, CPR training may have financial and ethically-deleterious, unintended consequences. Evidence shows Basic Life Support (BLS) skills training in a community is an effective intervention to improve public health. But, health care systems with limited resources should include CPR training only after considering the full implications of that intervention. Friesen J , Patterson D , Munjal K . Cardiopulmonary resuscitation in resource-limited health systems-considerations for training and delivery. Prehosp Disaster Med. 2015;30(1):1-5 . PMID:25407562

  19. Cardiopulmonary data acquisition system. Version 2.0, volume 2: Detailed software/hardware documentation

    Science.gov (United States)

    1980-01-01

    Detailed software and hardware documentation for the Cardiopulmonary Data Acquisition System is presented. General wiring and timing diagrams are given including those for the LSI-11 computer control panel and interface cables. Flowcharts and complete listings of system programs are provided along with the format of the floppy disk file.

  20. Cationic membrane obtained by radiation grafting method

    International Nuclear Information System (INIS)

    A study has been made for the preparation of ion-containing reverse osmosis membranes by the radiation grafting of aqueous acrylic acid onto low density polyethylene films followed by alkaline treatment to confer ionic character in the prepared membranes. The appropriate reaction conditions were selected under which the graft polymerization was carried out successfully. In this grafting system ammonium ferrous sulphate (Mohr's salt) was used as inhibitor to minimize the homopolymerization of AAc, and a suitable concentration of the inhibitor to be added to the reaction medium was found to be 2.5 wt%. The effect of aqueous monomer concentration on the rate and degree of grafting was studied. The dependence of the grafting rate on the monomer concentration was found to be 0.8 order, i.e. almost first order dependence. It was also found that the irradiation atmosphere (air and nitrogen gas) had no significant effect on the grafting yield at given reaction conditions. The prepared graft copolymer films showed good thermal and chemical stability. Gel determination in the grafted films was also investigated and the results indicated that a crosslinked network structure may be formed. The extent of the gelled part in the graft copolymer increased as the degree of grafting increased. (author)

  1. Employers' Guide to the Employment Equity Act

    Directory of Open Access Journals (Sweden)

    Lesley-Anne Katz

    2001-02-01

    Full Text Available 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.

  2. 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.

  3. 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

  4. Plasma Levels of Receptor for Advanced Glycation End Products, Blood Transfusion, and Risk of Primary Graft Dysfunction

    Science.gov (United States)

    Christie, Jason D.; Shah, Chirag V.; Kawut, Steven M.; Mangalmurti, Nilam; Lederer, David J.; Sonett, Joshua R.; Ahya, Vivek N.; Palmer, Scott M.; Wille, Keith; Lama, Vibha; Shah, Pali D.; Shah, Ashish; Weinacker, Ann; Deutschman, Clifford S.; Kohl, Benjamin A.; Demissie, Ejigayehu; Bellamy, Scarlett; Ware, Lorraine B.

    2009-01-01

    Rationale: The receptor for advanced glycation end products (RAGE) is an important marker of lung epithelial injury and may be associated with impaired alveolar fluid clearance. We hypothesized that patients with primary graft dysfunction (PGD) after lung transplantation would have higher RAGE levels in plasma than patients without PGD. Objectives: To test the association of soluble RAGE (sRAGE) levels with PGD in a prospective, multicenter cohort study. Methods: We measured plasma levels of sRAGE at 6 and 24 hours after allograft reperfusion in 317 lung transplant recipients at seven centers. The primary outcome was grade 3 PGD (PaO2/FiO2 < 200 with alveolar infiltrates) within the first 72 hours after transplantation. Measurements and Main Results: Patients who developed PGD had higher levels of sRAGE than patients without PGD at both 6 hours (median 9.3 ng/ml vs. 7.5 ng/ml, respectively; P = 0.028) and at 24 hours post-transplantation (median 4.3 ng/ml vs. 1.9 ng/ml, respectively; P < 0.001). Multivariable logistic regression analyses indicated that the relationship between levels of sRAGE and PGD was attenuated by elevated right heart pressures and by the use of cardiopulmonary bypass. Median sRAGE levels were higher in subjects with cardiopulmonary bypass at both 6 hours (P = 0.003) and 24 hours (P < 0.001). sRAGE levels at 6 hours were significantly associated with intraoperative red cell transfusion (Spearman's ? = 0.39, P = 0.002 in those with PGD), and in multivariable linear regression analyses this association was independent of confounding variables (P = 0.02). Conclusions: Elevated plasma levels of sRAGE are associated with PGD after lung transplantation. Furthermore, plasma sRAGE levels are associated with blood product transfusion and use of cardiopulmonary bypass. PMID:19661249

  5. 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. [Orthopedics. 2015; 38(6):e473-e476.]. PMID:26091219

  6. Employment Consequences of Employment Protection Legislation

    OpenAIRE

    Skedinger, Per

    2011-01-01

    This article surveys the literature and adds to the evidence on the impact of employment protection legislation on employment. While stringent employment protection contributes to less turnover and job reallocation, the effects on aggregate employment and unemployment over the business cycle are more uncertain. Exploitation of partial reforms and the use of micro data in recent research appear not to have affected results regarding employment and unemployment in any systematic way. Labour mar...

  7. 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.

  8. As seen on TV: observational study of cardiopulmonary resuscitation in British television medical dramas

    Science.gov (United States)

    Gordon, P N; Williamson, S; Lawler, P G

    1998-01-01

    Objective: To determine the frequency and accuracy with which cardiopulmonary resuscitation is portrayed in British television medical dramas. Design: Observational study. Subjects: 64 episodes of three major British television medical dramas: Casualty, Cardiac Arrest, and Medics. Main outcome measures: Frequency of cardiopulmonary resuscitation shown on television; age, sex, and diagnosis of the patients undergoing resuscitation; rate of survival through resuscitation. Results: Overall 52 patients had a cardiorespiratory arrest on screen and 3 had a respiratory arrest alone, all the arrests occurring in 40 of the 64 episodes. Of the 52 patients having cardiorespiratory arrest, 32 (62%) underwent an attempt at cardiopulmonary resuscitation; 8 attempts were successful. All 3 of the patients having respiratory arrests alone received ventilatory support and survived. On 48% of occasions, victims of cardiac arrest seemed to be less than 35 years old. Conclusions: Cardiorespiratory resuscitation is often depicted in British television medical dramas. Patients portrayed receiving resuscitation are likely to be in a younger age group than in real life. Though the reasons for resuscitation are more varied and more often associated with trauma than in reality, the overall success rate is nevertheless realistic. Widespread overoptimism of patients for survival after resuscitation cannot necessarily be blamed on British television medical dramas. Key messagesA quarter of patients in British television medical dramas who received cardiopulmonary resuscitation on screen seemed to surviveThis figure is comparable to initial survival rates in a series of patients in real lifePatients on television are more likely to suffer cardiac arrest as a result of trauma than in real life, and patients undergoing resuscitation are likely to be younger than patients in real lifeThe overall survival rate of patients after cardiopulmonary resuscitation in British television medical drama seems to be more realistic than in American medical dramas PMID:9740563

  9. Effect of hormone replacement on exercise cardiopulmonary reserve and recovery performance in subclinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    M.R.M. Mainenti

    2010-11-01

    Full Text Available Subclinical hypothyroidism (SH patients present cardiopulmonary, vascular and muscle dysfunction, but there is no consensus about the benefits of levothyroxine (L-T4 intervention on cardiopulmonary performance during exercise. The aim of the present study was to investigate the effects of L-T4 on cardiopulmonary exercise reserve and recovery in SH patients. Twenty-three SH women, 44 (40-50 years old, were submitted to two ergospirometry tests, with an interval of 6 months of normalization of thyroid-stimulating hormone (TSH levels (L-T4 replacement group or simple observation (TSH = 6.90 ?IU/mL; L-T4 = 1.02 ng/dL. Patients with TSH >10 ?IU/mL were excluded from the study to assure that they would receive treatment in this later stage of SH. Twenty 30- to 57-year-old women with no thyroid dysfunction (TSH = 1.38 ?IU/mL; L-T4 = 1.18 ng/dL were also evaluated. At baseline, lower values of gas exchange ratio reserve (0.24 vs 0.30; P < 0.05 were found for SH patients. The treated group presented greater variation than the untreated group for pulmonary ventilation reserve (20.45 to 21.60 L/min; median variation = 5.2 vs 25.09 to 22.45 L/min; median variation = -4.75, respectively and for gas exchange ratio reserve (0.19 to 0.27; median variation = 0.06 vs 0.28 to 0.18; median variation = -0.08, respectively. There were no relevant differences in cardiopulmonary recovery for either group at baseline or after follow-up. In the sample studied, L-T4 replacement improved exercise cardiopulmonary reserve, but no modification was found in recovery performance after exercise during this period of analysis.

  10. 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.

  11. Interventions in infrainguinal bypass grafts

    International Nuclear Information System (INIS)

    The long-term success of infrainguinal bypass grafts depends on meticulous surgical technique and a periodic program of postoperative surveillance. Duplex scanning is the method of choice for the detection of stenotic lesions that threaten graft patency. As an alternative to surgery, PTA is gaining increasing acceptance for the treatment of non-recurrent, short, and single stenotic lesions, despite somewhat controversial opinions. The initial technical success rates for PTA were reported to be up to 100%, and a 5-year primary assisted patency rate of up to 65% has been achieved. Some authors favorize intra-arterial infusion of fibrinolytic agents for the treatment of bypass graft occlusion with technical success rates of up to 92%. In addition to a reduced trauma compared to surgical thrombectomy, of the venous wall the advantage of thrombolytic therapy is clot lysis in run-off vessels, and uncovering of the stenotic lesions. This stenosis may then be treated by an endovascular or surgical approach. (orig.)

  12. 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.

  13. 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.

  14. Radiation grafting of hydrophilic monomers onto poly (4-methylpentene-1) grafting of acrylic acid

    International Nuclear Information System (INIS)

    Radiation grafting of acrylic acid (AAc) on poly (4-methylpentene-1) (TPX with different crystallinity has been invertigated under various conditions. Free radicals formed by pre-irradiation of radiation of TPX in vaccum were more stoble than those in the presence of air and might initiate the grafting reaction when came in contact with the AAc. Grafting yields increased with increasing pre-irradiation doses, grafting temperature, and concentration of AAc. Lower crystallinity TPX (24%) showed higher initial grafting rate compared with higher crystallinity one. The distribution of grafting was observed by X-ray micro analyzer. The grafting reaction proceeded gradually with time from the surface of the film to the inner part. In high crystallinity TPX (34%) grafting distribution in the final stage depended on the film thickness, while in the lower crystalline was homogeneous regardless the film thickness. (authors). 10 refs, 9 figs

  15. Aortic Replacement with Sutureless Intraluminal Grafts

    OpenAIRE

    Lemole, Gerald M.

    1991-01-01

    To avoid the anastomotic complications and long cross-clamp times associated with standard suture repair of aortic lesions, we have implanted sutureless intraluminal grafts in 122 patients since 1976. Forty-nine patients had disorders of the ascending aorta, aortic arch, or both: their operative mortality was 14% (7 patients), and the group's 5-year actuarial survival rate has been 64%. There have been no instances of graft dislodgment, graft infection, aortic bleeding, or pseudoaneurysm form...

  16. Radiation graft-copolymerization onto polyethylene film

    International Nuclear Information System (INIS)

    The grafting of acrylic and methacrylic acids and N-vinylpyrrolidone onto polyethylene film is described. Under the action of gamma radiation the radicals were formed with a spectrum identical to that of radicals formed by electrons, but their efficiency as initiators of graft copolymerization was lower. The film irradiated by gamma radiation can be used in grafting with the utilization of the after-effect. Electrons are an effective agent in the initiation of the grafting reaction of monomers directly in the irradiation field. An advantage of the using of after-effect comparing with direct initiation is a limitation of the monomer homopolymerization. (A.S.)

  17. 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)

  18. 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.

  19. Graft polymerization on magnesium oxide surface

    International Nuclear Information System (INIS)

    Radiation-induced graft polymerization of methyl methacrylate on magnesium oxide surface has been studied in the paper. IR spectroscopy and solvent extraction proved the presence of the graft chain polymethyl methacrylate on magnesium oxide surface. Based on the data in the paper, the graft polymerizations are simultaneously initiated by both free radical and anion mechanism. It is suggested that Odminus anion free radical species trapped at an oxide ion vacancy on the solid surface is the active species initiating graft polymerization by the high energy radiation

  20. Induced-pluripotent stem cells seeded acellular peripheral nerve graft as “autologous nerve graft

    OpenAIRE

    Ti-Fei Yuan; Guo-Dong Gao; Jiang Li

    2010-01-01

    The hypothesis is that induced pluripotent stem cells (iPSC) derived Schwann cells and/or macrophages can be transplanted into acellular nerve graft in repairing injured nervous system. The efficiency of iPSC seeded acellular nerve graft may mimic the autologous peripheral nerve graft.

  1. Does Homeostasis Model Assessment of Insulin Resistance have a predictive value for post-coronary artery bypass grafting surgery outcomes?

    Science.gov (United States)

    Aydin, Ebuzer; Ozkokeli, Mehmet

    2014-01-01

    Objective This study aims to investigate whether pre-operative Homeostasis Model Assessment Insulin Resistance (HOMA-IR) value is a predictor in non-diabetic coronary artery bypass grafting patients in combination with hemoglobin A1c, fasting blood glucose and insulin levels. Methods Eighty one patients who were admitted to Cardiovascular Surgery Clinic at our hospital between August 2012 and January 2013 with a coronary artery bypass grafting indication were included. Patients were non-diabetic with insulin resistance (HOMA-IRinsulin resistance (HOMA-IR>2.5, Group B; n=40), respectively. Pre-operative fasting blood glucose and insulin were measured and serum chemistry tests were performed. The Homeostasis Model Assessment Insulin Resistance values were calculated. Statistical analysis was performed. Results There was a statistically significant difference in fasting blood glucose and HOMA-IR values between the groups. Cross-clamping time, and cardiopulmonary bypass time were longer in Group B, compared to Group A (P=0.043 and P=0.031, respectively). Logistic regression analysis revealed that hemoglobin A1c was not a reliable determinant factor alone for pre-operative glucometabolic evaluation of non-diabetic patients. The risk factors of fasting blood glucose and cardiopulmonary bypass time were more associated with high Homeostasis Model Assessment Insulin Resistance levels. Conclusion Our study results suggest that preoperative screening of non-diabetic patients with Homeostasis Model Assessment Insulin Resistance may improve both follow-up visit schedule and short-term outcomes, and may be useful in risk stratification of the high-risk population for impending health problems. PMID:25372910

  2. 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

  3. CARDIOPULMONARY GENE EXPRESSION PROFILES IN NORMO- AND SPONTANEOUSLY HYPERSENSITIVE (SH) RATS: IMPACT OF PARTICULATE MATTER (PM) EXPOSURE

    Science.gov (United States)

    CARDIOPULMONARY GENE EXPRESSION PROFILES IN NORMO- AND SPONTANEOUSLY HYPERTENSIVE (SH) RATS: IMPACT OF PARTICULATE MATTER (PM) EXPOSURE. SS Nadadur UP Kodavanti, Pulmonary Toxicology Branch, ETD, ORD, NHEERL, US Environmental Protection Agency, Research Triangle Park, NC 27711....

  4. Dynamic, Nondestructive Imaging of a Bioengineered Vascular Graft Endothelium

    OpenAIRE

    WHITED, BRYCE M.; Hofmann, Matthias C.; Lu, Peng; XU, YONG; Rylander, Christopher G.; WANG, GE; Sapoznik, Etai; Criswell, Tracy; Lee, Sang Jin; Soker, Shay; Rylander, Marissa Nichole

    2013-01-01

    Bioengineering of vascular grafts holds great potential to address the shortcomings associated with autologous and conventional synthetic vascular grafts used for small diameter grafting procedures. Lumen endothelialization of bioengineered vascular grafts is essential to provide an antithrombogenic graft surface to ensure long-term patency after implantation. Conventional methods used to assess endothelialization in vitro typically involve periodic harvesting of the graft for histological se...

  5. 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.

  6. 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.

  7. 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)

  8. Nanotribological study of grafted polymer

    Science.gov (United States)

    Bouhacina, T.; Aimé, J. P.; Attias, A. J.

    1998-06-01

    The frictional forces between grafted layers, organosilanes and polymer, on silica and a nanotip have been investigated as a function of the tip velocity. From the interpretation of these results and one gets a step forward for more quantitative information. Les forces de friction entre des couches greffées sur silice et une nanopointe ont été étudiées en fonction de la vitesse de la pointe. À partir de l'interprétation de ces résultats on s'avance vers plus d'infor mations quantitatives.

  9. Mouse models for graft arteriosclerosis.

    Science.gov (United States)

    Qin, Lingfeng; Yu, Luyang; Min, Wang

    2013-01-01

    Graft arteriosclerois (GA), also called allograft vasculopathy, is a pathologic lesion that develops over months to years in transplanted organs characterized by diffuse, circumferential stenosis of the entire graft vascular tree. The most critical component of GA pathogenesis is the proliferation of smooth muscle-like cells within the intima. When a human coronary artery segment is interposed into the infra-renal aortae of immunodeficient mice, the intimas could be expand in response to adoptively transferred human T cells allogeneic to the artery donor or exogenous human IFN-? in the absence of human T cells. Interposition of a mouse aorta from one strain into another mouse strain recipient is limited as a model for chronic rejection in humans because the acute cell-mediated rejection response in this mouse model completely eliminates all donor-derived vascular cells from the graft within two-three weeks. We have recently developed two new mouse models to circumvent these problems. The first model involves interposition of a vessel segment from a male mouse into a female recipient of the same inbred strain (C57BL/6J). Graft rejection in this case is directed only against minor histocompatibility antigens encoded by the Y chromosome (present in the male but not the female) and the rejection response that ensues is sufficiently indolent to preserve donor-derived smooth muscle cells for several weeks. The second model involves interposing an artery segment from a wild type C57BL/6J mouse donor into a host mouse of the same strain and gender that lacks the receptor for IFN-? followed by administration of mouse IFN-? (delivered via infection of the mouse liver with an adenoviral vector. There is no rejection in this case as both donor and recipient mice are of the same strain and gender but donor smooth muscle cells proliferate in response to the cytokine while host-derived cells, lacking receptor for this cytokine, are unresponsive. By backcrossing additional genetic changes into the vessel donor, both models can be used to assess the effect of specific genes on GA progression. Here, we describe detailed protocols for our mouse GA models. PMID:23712086

  10. Lymphoid Tissue Grafts in Man

    International Nuclear Information System (INIS)

    Grafts of lymphoid tissue or of lymphoid stem cells may be appropriate in the treatment of some congenital immune deficiency disorders. The reasons for preferring tissues of foetal origin are discussed and the evidence for foetal immunocompetence is briefly summarized. Methods of storing foetal liver cells and cells or fragments of thymus are mentioned, and the organization of the Foetal Tissue Bank of the Royal Marsden Hospital is described. Clinical data from transplantation of lymphoid cells in various immune deficiency disorders are briefly presented. (author)

  11. Graft polymerization of glycidylmethacrylate onto coralline hydroxyapatite.

    Science.gov (United States)

    Murugan, R; Panduranga Rao, K

    2003-01-01

    Graft polymerization of glycidylmethacrylate (GMA) onto coralline hydroxyapatite (CHA) was carried out using potassium persulfate (K2S2O8) and sodium metabisulfite (Na2S2O5) as initiators in aqueous medium. To optimize the reaction conditions for getting maximum grafting yield, the concentrations of backbone, monomer, initiator, temperature and time were varied. The percent grafting was found to increase initially and then gradually decrease with respect to reaction parameters. The results obtained imply that the optimum temperature and time was 60 degrees C and 180 min, respectively, to obtain higher grafting yield. The grafting results have been discussed and a mechanism involved in the grafting of GMA onto CHA is described. The grafted materials were analyzed with Fourier transform infrared (FT-IR) spectroscopy and X-ray diffraction (XRD) measurements. The results of FT-IR confirmed the presence of epoxy group on the grafted CHA. The XRD pattern showed that there was no secondary phase in the apatite lattice due to chemical modification. PMID:12807147

  12. 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.

  13. Emerging concepts in liver graft preservation.

    Science.gov (United States)

    Bejaoui, Mohamed; Pantazi, Eirini; Folch-Puy, Emma; Baptista, Pedro M; García-Gil, Agustín; Adam, René; Roselló-Catafau, Joan

    2015-01-14

    The urgent need to expand the donor pool in order to attend to the growing demand for liver transplantation has obliged physicians to consider the use of suboptimal liver grafts and also to redefine the preservation strategies. This review examines the different methods of liver graft preservation, focusing on the latest advances in both static cold storage and machine perfusion (MP). The new strategies for static cold storage are mainly designed to increase the fatty liver graft preservation via the supplementation of commercial organ preservation solutions with additives. In this paper we stress the importance of carrying out effective graft washout after static cold preservation, and present a detailed discussion of the future perspectives for dynamic graft preservation using MP at different temperatures (hypothermia at 4?°C, normothermia at 37?°C and subnormothermia at 20?°C-25?°C). Finally, we highlight some emerging applications of regenerative medicine in liver graft preservation. In conclusion, this review discusses the "state of the art" and future perspectives in static and dynamic liver graft preservation in order to improve graft viability. PMID:25593455

  14. Emerging concepts in liver graft preservation

    Science.gov (United States)

    Bejaoui, Mohamed; Pantazi, Eirini; Folch-Puy, Emma; Baptista, Pedro M; García-Gil, Agustín; Adam, René; Roselló-Catafau, Joan

    2015-01-01

    The urgent need to expand the donor pool in order to attend to the growing demand for liver transplantation has obliged physicians to consider the use of suboptimal liver grafts and also to redefine the preservation strategies. This review examines the different methods of liver graft preservation, focusing on the latest advances in both static cold storage and machine perfusion (MP). The new strategies for static cold storage are mainly designed to increase the fatty liver graft preservation via the supplementation of commercial organ preservation solutions with additives. In this paper we stress the importance of carrying out effective graft washout after static cold preservation, and present a detailed discussion of the future perspectives for dynamic graft preservation using MP at different temperatures (hypothermia at 4?°C, normothermia at 37?°C and subnormothermia at 20?°C-25?°C). Finally, we highlight some emerging applications of regenerative medicine in liver graft preservation. In conclusion, this review discusses the “state of the art” and future perspectives in static and dynamic liver graft preservation in order to improve graft viability. PMID:25593455

  15. Grafting of styrene onto fluoropolymers films

    Energy Technology Data Exchange (ETDEWEB)

    Geraldes, Adriana N.; Zen, Heloisa A.; Parra, Duclerc F.; Lugao, Ademar B.; Linardi, Marcelo [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil). Centro de Quimica e Meio Ambiente], E-mail: angeral@ipen.br

    2007-07-01

    Grafting of styrene onto poly(vinylidenefluoride) (PVDF) and poly(tetrafluoroethylene) (PTFE) films was studied for the synthesis of ion exchange membranes. Radiation-induced grafting of styrene onto PVDF and PTFE films was investigated by simultaneous method using a Co{sup 60} source. The films of PVDF and PTFE were irradiated at total dose of 20 to 120 kGy and chemical changes were monitored after contact with styrene. Films of PTFE and PVDF were immersed in styrene/toluene 1:1 and were submitted to gamma radiation. After irradiation the samples were evaluated at periods of 0, 7, 14, 21 and 28 days, at room temperature in order to measure the grafting degree. Results of infrared spectroscopic analysis (FTIR), differential scanning calorimetry (DSC), thermogravimetry analysis (TGA) and the degree of grafting (DOG) were evaluated. The characterization techniques showed that irradiated PVDF and PTFE films exhibited a much higher grafting degree at 120 kGy. (author)

  16. Grafting of styrene onto fluoropolymers films

    International Nuclear Information System (INIS)

    Grafting of styrene onto poly(vinylidenefluoride) (PVDF) and poly(tetrafluoroethylene) (PTFE) films was studied for the synthesis of ion exchange membranes. Radiation-induced grafting of styrene onto PVDF and PTFE films was investigated by simultaneous method using a Co60 source. The films of PVDF and PTFE were irradiated at total dose of 20 to 120 kGy and chemical changes were monitored after contact with styrene. Films of PTFE and PVDF were immersed in styrene/toluene 1:1 and were submitted to gamma radiation. After irradiation the samples were evaluated at periods of 0, 7, 14, 21 and 28 days, at room temperature in order to measure the grafting degree. Results of infrared spectroscopic analysis (FTIR), differential scanning calorimetry (DSC), thermogravimetry analysis (TGA) and the degree of grafting (DOG) were evaluated. The characterization techniques showed that irradiated PVDF and PTFE films exhibited a much higher grafting degree at 120 kGy. (author)

  17. Pathogenesis of cardiac graft failure in children

    Directory of Open Access Journals (Sweden)

    Jenny Lin

    2012-12-01

    Full Text Available For many critical cardiac conditions such as cardio-myopathy, congenital heart defects, or arrhythmogenic disorders, cardiac transplantation is often an accepted treatment with optimistic one- and five-year survival rates of 90% and 75% in the pediatric patient population, respectively. However, poor long-term survival is a cause for concern, with cardiac graft failure being the leading cause in late mortality transplant recipients. Cardiac graft failure occurs through several mechanisms. However, the most common causes include cardiac allograft vasculopathy, myocardial fibrosis, and fibrofatty changes. Risk factors exacerbate these mechanisms through rejection, immunosuppressive drug side effects, hypertension, diabetes mellitus, renal dysfunction, and viral infection to increase the chance of cardiac graft failure. Changes in expression levels of various genes offer diagnostic potential for the future of cardiac transplantation. Through a comprehensive review of how multiple factors can lead a cardiac graft into failure, we hope to contribute to the longevity of cardiac grafts and pediatric heart transplant recipients.

  18. Graft healing in anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Chen Chih-Hwa

    2009-09-01

    Full Text Available Abstract Successful anterior cruciate ligament reconstruction with a tendon graft necessitates solid healing of the tendon graft in the bone tunnel. Improvement of graft healing to bone is crucial for facilitating an early and aggressive rehabilitation and ensuring rapid return to pre-injury levels activity. Tendon graft healing in a bone tunnel requires bone ingrowth into the tendon. Indirect Sharpey fiber formation and direct fibrocartilage fixation confer different anchorage strength and interface properties at the tendon-bone interface. For enhancing tendon graft-to-bone healing, we introduce a strategy that includes the use of periosteum, hydrogel supplemented with periosteal progenitor cells and bone morphogenetic protein-2, and a periosteal progenitor cell sheet. Future studies include the use of cytokines, gene therapy, stem cells, platelet-rich plasma, and mechanical stress for tendon-to-bone healing. These strategies are currently under investigation, and will be applied in the clinical setting in the near future.

  19. Graft transformation in tobacco (Nicotiana tabacum)

    International Nuclear Information System (INIS)

    Full text: We have obtained various graft-induced changes and clarified the genetic nature mainly in solanaceous plants, such as red pepper, eggplant, tomato and in soybean. From the similarity of genetic behaviour of the graft-induced changes with that of DNA-mediated transformation in higher organisms, we speculate transformational matter as a probable mechanism of the graft-induced change. In order to check the relationship between transformation and graft-induced change, a graft experiment was performed, in which the transgenic tobacco plant having bacterial KmR gene closely linked with Nos gene was used as stock plant. The genetic behaviour and fate of the bacterial genes derived from the stock plant were pursued in the progenies from the scion capsules of normal tobacco. (author)

  20. 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...

  1. Temporary epicardial left ventricular and biventricular pacing improves cardiac output after cardiopulmonary bypass

    OpenAIRE

    García-Bengochea Jose B; Fernández Angel L; Calvelo Daniel; Escudero Julian; Gude Francisco; Juanatey José R

    2012-01-01

    Abstract Background To evaluate, with different pacing modes, acute changes in left ventricular systolic function, obtained by continuous cardiac output thermodilution in various subsets of patients undergoing cardiopulmonary bypass surgery. Increments of mean arterial pressure and cardiac output were considered the end point. Methods Fifty cases electively submitted to cardiac surgery were analyzed. Isolated valve surgery 62%, coronary revascularization 30% and 8% mixed disease. Left ventric...

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

    OpenAIRE

    Carlos Serrano; Silva, Mauricio Rocha E.

    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....

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

    OpenAIRE

    Poswal P; Mehta Y; Juneja R; Khanna S; Meharwal Zile; Trehan N

    2004-01-01

    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 ...

  4. Recent Advances in the Cardiopulmonary Rehabilitation in Spinal Cord Injury- Education

    OpenAIRE

    Ye?im Kurtai?

    2010-01-01

    Cardiac and pulmonary disorders are the leading causes of mortality and morbidity in spinal cord injury (SCI). As the life expectancy increased for patients with SCI, the prevalence of these disorders increased as well. The rate of yearly hospitalization due to cardiopulmonary problems is around 25-40% within 5-20 years after the injury. Sympathetic denervation associated with autonomic dysfunction leads to many cardiac and pulmonary problems. Furthermore, secondary conditions such as muscle ...

  5. When is it futile for ambulance personnel to initiate cardiopulmonary resuscitation?

    OpenAIRE

    Marsden, A. K.; Ng, G. A.; Dalziel, K.; Cobbe, S. M.

    1995-01-01

    OBJECTIVE--To determine whether patients with unexpected prehospital cardiac arrest could be identified in whom ambulance resuscitation attempts would be futile. DESIGN--Review of ambulance and hospital records; detailed review of automated external defibrillator rhythm strips of patients in whom no shock was advised. SETTING--Scottish Ambulance Service; all cardiopulmonary resuscitation attempts after cardiorespiratory arrest during 1988-94 included in the Heartstart Scotland database. SUBJE...

  6. Chronic and Acute Effects of Coal Tar Pitch Exposure and Cardiopulmonary Mortality Among Aluminum Smelter Workers

    OpenAIRE

    Melissa C. Friesen; Paul A. Demers; Spinelli, John J; Eisen, Ellen A; Lorenzi, Maria F.; Le, Nhu D.

    2010-01-01

    Air pollution causes several adverse cardiovascular and respiratory effects. In occupational studies, where levels of particulate matter and polycyclic aromatic hydrocarbons (PAHs) are higher, the evidence is inconsistent. The effects of acute and chronic PAH exposure on cardiopulmonary mortality were examined within a Kitimat, Canada, aluminum smelter cohort (n = 7,026) linked to a national mortality database (1957–1999). No standardized mortality ratio was significantly elevated compared ...

  7. [Thrombolytic therapy during cardiopulmonary resuscitation for acute massive pulmonary embolism. A case report].

    Science.gov (United States)

    Greco, F; Misuraca, G; Serafini, O; Guzzo, D; Plastina, F

    2001-12-01

    Massive pulmonary embolism associated with cardiac arrest has an extremely high mortality in spite of cardiopulmonary resuscitation maneuvers. An early diagnosis of pulmonary embolism as cause of cardiac arrest and a rapid specific therapy able to obtain a restoration of pulmonary flow can improve the prognosis. The authors report a case of cardiac arrest for massive pulmonary embolism promptly diagnosed by echocardiography and treated by thrombolytic therapy with an initial favourable outcome. PMID:11733741

  8. 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...

  9. Resection of Intrapericardial Schwannoma Co-Existing with Thymic Follicular Hyperplasia through Sternotomy without Cardiopulmonary Bypass

    OpenAIRE

    Chung, Jae Ho; Jung, Jae Seung; Lee, Sung Ho; Kim, Kwang Taik; Lee, Kanghoon; Lee, Seung Hun

    2014-01-01

    A 35-year-old man was admitted to Korea University Anam Hospital for evaluation of intermittent chest pain. Computed tomography of the chest showed enlargement of a previously identified anterior mediastinal mass and also a well-defined, circumscribed mass in the subcarinal area, surrounded by the roof of the left atrium, right pulmonary artery, and the carina. Complete resection of the intrapericardial tumor was performed through median sternotomy without cardiopulmonary bypass. Pathologic e...

  10. The clinical utility of cardiopulmonary exercise testing: results of a university hospital

    OpenAIRE

    Tajana Jalusic-Gluncic

    2012-01-01

    Objective: To determine the main reasons for cardiopulmonary exercise test (CPET) referrals in our hospital over the last two years; to evaluate clinical usefulness of CPET. Methods: We included 207 patients between 17 and 76 years of age. For every patient, we measured electrocardigraphy (ECG), arterial blood gases, spirometry, maximal voluntary ventilation (MVV) and diffusing capacity. CPET was then performed; using a treadmill, according to the modified Bruce protocol; then spirometry and ...

  11. 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 pressur...

  12. Cardio-pulmonary resuscitation challenges in selected Botswana hospitals: Nurse managers’ views

    OpenAIRE

    Lakshmi Rajeswaran; Ehlers, Valerie J.

    2013-01-01

    Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR) with functional equipment and adequate resources.The objectives of the study were to identify unit managers’ perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used t...

  13. 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.

  14. Cardiopulmonary response to dynamic exercise after heart and combined heart-lung transplantation.

    OpenAIRE

    Banner, N. R.; Lloyd, M. H.; Hamilton, R. D.; Innes, J. A.; Guz, A.; Yacoub, M. H.

    1989-01-01

    The exercise capacity and cardiopulmonary response to progressive dynamic exercise of eight healthy recipients of heart-lung transplants were compared with those of matched recipients of orthotopic cardiac transplants and normal controls. In both transplant groups the maximum workloads were lower than that in the normal group. The transplant recipients had higher pre-exercise heart rates and lower maximum heart rates than the normal controls. Ventilation during submaximal exercise was similar...

  15. Bioavailable transition metals in particulate matter mediate cardiopulmonary injury in healthy and compromised animal models.

    OpenAIRE

    Costa, D L; Dreher, K. L.

    1997-01-01

    Many epidemiologic reports associate ambient levels of particulate matter (PM) with human mortality and morbidity, particularly in people with preexisting cardiopulmonary disease (e.g., chronic obstructive pulmonary disease, infection, asthma). Because much ambient PM is derived from combustion sources, we tested the hypothesis that the health effects of PM arise from anthropogenic PM that contains bioavailable transition metals. The PM samples studied derived from three emission sources (two...

  16. Comparison of cephalothin and ceforanide prophylaxis in cardiac surgery with cardiopulmonary bypass.

    OpenAIRE

    Karney, W; Correa-Coronas, R; Zajtchuk, R; Schwartz, J.; Smith, L. P.; Tramont, E

    1983-01-01

    Eighty-five patients undergoing cardiac surgery with cardiopulmonary bypass were given either cephalothin or ceforanide perioperatively in randomized, blinded fashion. The incidence of surgically related, postoperative infections was 23% for the cephalothin- and 26% for the ceforanide-treated groups. There were no statistically significant differences that could be identified between patients who became infected and those who remained free of infections, although the time spent in the operati...

  17. Diffusion of Cardiopulmonary Resuscitation Training to Chinese Immigrants with Limited English Proficiency

    OpenAIRE

    Mei Po Yip; Brandon Ong; Shin Ping Tu; Devora Chavez; Brooke Ike; Ian Painter; Ida Lam; Steven M. Bradley; Gloria D. Coronado; Meischke, Hendrika W.

    2011-01-01

    Cardiopulmonary resuscitation (CPR) is an effective intervention for prehospital cardiac arrest. Despite all available training opportunities for CPR, disparities exist in participation in CPR training, CPR knowledge, and receipt of bystander CPR for certain ethnic groups. We conducted five focus groups with Chinese immigrants who self-reported limited English proficiency (LEP). A bilingual facilitator conducted all the sessions. All discussions were taped, recorded, translated, and trans...

  18. Bystander initiated and dispatcher assisted cardiopulmonary resuscitation in out-of-hospital cardiac arrest

    OpenAIRE

    Bohm, Katarina

    2009-01-01

    Cardiac arrest (CA) is a common cause of death. In Sweden approximately 6 000- 10 000 people annually suffer a CA outside hospital. Cardiopulmonary resuscitation (CPR) can save lives in an out-of-hospital cardiac arrest (OHCA). The aim of this thesis was to describe various aspects of CPR and the emergency medical dispatcher (EMD) organisation to find approaches for enhancing bystander intervention in OHCA. Methods and results: In Study I, 315 consecutive cases of OHCA duri...

  19. Witnessed arrest, but not delayed bystander cardiopulmonary resuscitation improves prehospital cardiac arrest survivial

    OpenAIRE

    Vukmir, R

    2004-01-01

    Methods: This prospective, randomised, double blinded clinical intervention trial enrolled 874 prehospital cardiopulmonary arrest patients encountered in a prehospital urban, suburban, and rural regional emergency medical service (EMS) area. This group underwent conventional advanced cardiac life support intervention followed by empiric early administration of sodium bicarbonate (1 mEq/l), monitoring conventional resuscitation parameters. Survival was measured as presence of vital signs on em...

  20. Knowledge of cardiopulmonary resuscitation of clinicians at a South African tertiary hospital

    OpenAIRE

    Botha, Liesl; Geyser, M.M.; Engelbrecht, Andreas

    2012-01-01

    OBJECTIVES : The objectives of this study were to assess clinicians' knowledge about evaluating possible cardiac arrest patients and recognising cardiac arrest, to assess clinicians' knowledge about appropriate decisions and actions during cardiopulmonary resuscitation (CPR), and to determine which advanced life support courses had been undertaken and whether they were still valid. DESIGN : This was a descriptive, cross-sectional survey. SETTING AND SUBJECT : The subjects were doctors who wor...

  1. Postconditioning improvement effects of ulinastatin on brain injury following cardiopulmonary resuscitation

    OpenAIRE

    SUI, BO; LI, YONGWANG; Li MA

    2014-01-01

    The aim of the present study was to determine the effects of ulinastatin (UTI) on brain injury in rats subjected to cardiopulmonary resuscitation (CPR) following asphyxial cardiac arrest (CA) and identify the underlying mechanisms. In total, 100 healthy male Wistar rats were randomly divided into control and treatment groups (n=50). After 4 min of asphyxial CA, all the rats were immediately subjected to CPR. The treatment group animals were administered 15 mg/kg UTI at the onset of resuscitat...

  2. The influence of the media on COPD patients’ knowledge regarding cardiopulmonary resuscitation

    OpenAIRE

    Stefano Nava; Carmen Santoro; Mario Grassi; Nicholas Hill

    2008-01-01

    Stefano Nava1, Carmen Santoro1, Mario Grassi2, Nicholas Hill31Respiratory Unit, Fondazione S Maugeri, I R C C S Istituto Scientifico di Pavia, Pavia, Italy; 2Department of Health Sciences, Section of Medical Statistics and Epidemiology, University of Pavia, Pavia, Italy; 3Pulmonary and Critical Care Division, Tufts University, New England Medical Center, Boston, MA, USABackground: The decision whether or not to undertake cardiopulmonary resuscitation (CPR) is a major ethical challenge. Patien...

  3. ASSESSMENT OF KNOWLEDGE & ATTITUDE OF THE PEDIATRIC RESIDENT ABOUT NEONATAL & PEDIATRIC CARDIOPULMONARY RESUSCITATION

    Directory of Open Access Journals (Sweden)

    M KADIAVAR

    2003-09-01

    Full Text Available Introduction: A high leve of skill & knowledge is required in circumstances of cardiopulmonary resucitation which represents the most urgent clinical situations. The difficulties for pediatric residents who are fronted with the most cases of pediatric & neonatal resucitation are due to different causes of cardiorespiratory arrest in camparison to adults. This study aimed to assess the knowledge & their personal attitude toward the neonatal & pediatric cardiopulmonary resuscitatin. Methods: By cross - sectional multicenter study between the pediatric residents who were studied in the teaching hospitals in Tehran (1378-90. Data were gathered among 140 residents by self-completed questionnaires which were included three parts as. demographic information assessment of their attitude by summation of score via ranking list questions and total score from assessment to their knowledge by different scenarios which were formatted in the multiple choice questions. Results: 35.7% of the residents studied in the first year of residency 35.0% in the second year and the remainder (29/3% in the third year More than 90% of them considered their knowledge about neonatal and pediatric cardiopulmonary resuscitation low & less than average. Net only 80% of the residents self - assessed their actual ability about this issue low but also declaired the insufficient education during the medical training. The total score of knowledge assessment was 14.7 + 1_0.54 from 30 without any significant relations among the residents in different hospitals or various levels of pediatric residency. (P value= 0.1 , 0.7 There was not significant correlation between the total score from their attitude & their knowledge. Conclusion: Pediatric residents as the key personnel in the management of cardiopulmonary resuscitation of the neonates and children should have enough knowledge and skills about this topic. This survey demonstrates a low level of the pediatric & neonatal resuscitation knowledge among the residents pediatrics. The effectiveness of regular training improving the situation of pediatric resusciton should considered in the of the medical education.

  4. Smaller self-inflating bags produce greater guideline consistent ventilation in simulated cardiopulmonary resuscitation

    OpenAIRE

    Boyle Malcolm J; Nehme Ziad

    2009-01-01

    Abstract Background Suboptimal bag ventilation in cardiopulmonary resuscitation (CPR) has demonstrated detrimental physiological outcomes for cardiac arrest patients. In light of recent guideline changes for resuscitation, there is a need to identify the efficacy of bag ventilation by prehospital care providers. The objective of this study was to evaluate bag ventilation in relation to operator ability to achieve guideline consistent ventilation rate, tidal volume and minute volume when using...

  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. Effects of cardiopulmonary bypass on tight junction protein expressions in intestinal mucosa of rats

    OpenAIRE

    Ying-jie Sun, Wei-min Chen

    2008-01-01

    AIM: To investigate the tight junction protein expressions of intestinal mucosa in an experimental model of cardiopulmonary bypass (CPB) in rats.METHODS: Thirty anesthetized rats were randomly divided into two groups: Group S (n = 10) served as sham operation and group C (n = 20) served as CPB which underwent CPB for 1 h. Expression of occludin and zonula occludens-1 (ZO-1) were determined by Western blotting and immunocytochemistry, respectively. Plasma levels of diamine oxidase (DAO) and d-...

  7. Processos de proteção dos garfos na enxertia da mangueira / Grafting processes for mango tree protection

    Scientific Electronic Library Online (English)

    Angelo Pedro, Jacomino; Keigo, Minami; João Alexio, Scarpare Filho; Ricardo Alfredo, Kluge.

    2000-03-01

    Full Text Available Diferentes processos de proteção dos garfos foram pesquisados na produção de mudas por enxertia, da mangueira ‘Tommy Atkins’. Os tratamentos utilizados foram os seguintes: saquinho de polietileno (testemunha), filme de PVC, parafilme, cera de abelha, parafina e parafina + vaselina. Verificou-se que [...] o filme de PVC e o parafilme proporcionaram pegamentos de enxertia semelhantes à testemunha (40,60%, 56,62% e 48,33%, respectivamente), enquanto que para os demais tratamentos, os percentuais de pegamento foram muito baixos ( Abstract in english Different processes of graft protection were evaluated in the process of grafting ‘Tommy Atkins’ mango trees. The treatments employed were the following: polyethylene bag (control), PVC film, parafilm, bee wax, paraffin and paraffin + vaseline. It was verified that both PVC film and parafilm present [...] ed successful grafting in relation to the control (40.60%, 56.62% and 48.33%, respectively), while the other treatments presented low success rate (

  8. Surface Modification of Colloidal Silica Nanoparticles: Controlling the size and Grafting Process

    International Nuclear Information System (INIS)

    Surface modification of colloidal silica nanoparticles without disrupting the electric double layer of nanoparticles is a major challenge. In the work, silane was employed to modify colloidal silica nanoparticles without inducing bridge flocculation obviously. The effect of pH value of the silica sol, the amount of silane in feed, and reaction temperature on the graft amount and the final size of modified particles was investigated. The increased weight loss by TG and the appearance of T2 and T3 except for Q2 and Q3 signals by CP/MAS 29Si NMR of the modified samples verified the successful grafting of silane. The graft amount reached 0.57 mmol/g, which was slightly lower than theory value, and the particle size remained nearly the same as unmodified particles for acidic silica sol at the optimum condition. For alkaline silica sol after modification, aggregates composed of several nanoparticles connected together with silane moleculars as the bridge appeared

  9. Recent Advances in the Cardiopulmonary Rehabilitation in Spinal Cord Injury- Education

    Directory of Open Access Journals (Sweden)

    Ye?im Kurtai?

    2010-12-01

    Full Text Available Cardiac and pulmonary disorders are the leading causes of mortality and morbidity in spinal cord injury (SCI. As the life expectancy increased for patients with SCI, the prevalence of these disorders increased as well. The rate of yearly hospitalization due to cardiopulmonary problems is around 25-40% within 5-20 years after the injury. Sympathetic denervation associated with autonomic dysfunction leads to many cardiac and pulmonary problems. Furthermore, secondary conditions such as muscle denervation, immobility, obesity contribute to the morbidity related to cardiopulmonary problems. The prevalence of atherosclerotic heart diseases in patients with SCI is 30-50%, whereas it is 5-10% in healthy individuals; this implies a 5-6 fold increased risk in this population. Atherosclerotic heart disease appears at a younger age in cases of SCI and correlates with the level and completeness of the lesion. These data demonstrate the importance of awareness about cardiopulmonary problems and their complications. In this review, rehabilitation approches to these problems will be discussed and recent advances will be emphasized. Turk J Phys Med Rehab 2010; 56 Suppl 2: 67-74

  10. Fate of 111In-labeled platelets during cardiopulmonary bypass performed with membrane and bubble oxygenators

    International Nuclear Information System (INIS)

    To elucidate the effects of bubble and membrane oxygenators on platelet integrity, we developed a quantitative method of determining platelet lysis during cardiopulmonary bypass. Two groups of dogs whose platelets had been labeled with 111In were subjected to 1 hour of cardiopulmonary bypass. In Group A (bubble oxygenator), platelet lysis as measured by free plasma 111In levels increased from 6% +/- 1% to 33% +/- 7% during bypass. In Group B (membrane oxygenator), plasma 111In levels increased from 5% +/- 2% to 10% +/- 6% during bypass (p less than 0.01). After 1 hour of bypass, the ratio of 111In-labeled platelets to prebypass levels was 36% +/- 8% in Group A and 67% +/- 9% in Group B. Platelet deposition on the oxygenator was greater in bubble oxygenators (19% +/- 4% of total injected 111In) than in membrane oxygenators (12% +/- 3% of total injected 111In). These data indicated that membrane oxygenators maintain a higher circulating platelet count both intraoperatively and postoperatively and result in less platelet destruction than bubble oxygenators following 1 hour of cardiopulmonary bypass in dogs

  11. Bioavailable transition metals in particulate matter mediate cardiopulmonary injury in healthy and compromised animal models

    Energy Technology Data Exchange (ETDEWEB)

    Costa, D.L.; Dreher, K.L. [US Environmental Protection Agency, Research Triangle Park, NC (United States). National Health and Environmental Effects Research Lab.

    1997-09-01

    Many epidemiologic reports associate ambient levels of particulate matter (PM) with human mortality and morbidity, particularly in people with preexisting cardiopulmonary disease (e.g., chronic obstructive pulmonary disease, infection, asthma). Because much ambient PM is derived from combustion sources, the hypothesis that the health effects of PM arise from anthropogenic PM that contains bioavailable transition metals was tested. The PM samples studied derived from three emission sources (two oil and one coal fly ash) and four ambient airsheds (St. Louis, MO, USA; Washington, DC (USA); Duesseldorf, Germany; and Ottawa, Canada). PM was administered to rats by intratracheal instillation in equimass or equimetal doses to address directly the influence of PM mass versus metal content on actual lung injury and inflammation. Results indicated that the lung dose of bioavailable transition metal, not instilled PM mass, was the primary determinant of the acute inflammatory response for both the combustion source and ambient PM samples. Residual oil fly ash, a combustion PM rich in bioavailable metal, and evaluated in rat model of cardiopulmonary disease (pulmonary vasculitis/hypertension) to ascertain whether the disease state augmented sensitivity to that PM. It is proposed that soluble metals from PM mediate the array of PM-associated injuries to the cardiopulmonary system of the healthy and at-risk compromised host.

  12. Effect of hormone replacement on exercise cardiopulmonary reserve and recovery performance in subclinical hypothyroidism

    Scientific Electronic Library Online (English)

    M.R.M., Mainenti; P.F.S., Teixeira; F.P., Oliveira; M., Vaisman.

    2010-11-01

    Full Text Available Subclinical hypothyroidism (SH) patients present cardiopulmonary, vascular and muscle dysfunction, but there is no consensus about the benefits of levothyroxine (L-T4) intervention on cardiopulmonary performance during exercise. The aim of the present study was to investigate the effects of L-T4 on [...] cardiopulmonary exercise reserve and recovery in SH patients. Twenty-three SH women, 44 (40-50) years old, were submitted to two ergospirometry tests, with an interval of 6 months of normalization of thyroid-stimulating hormone (TSH) levels (L-T4 replacement group) or simple observation (TSH = 6.90 ?IU/mL; L-T4 = 1.02 ng/dL). Patients with TSH >10 ?IU/mL were excluded from the study to assure that they would receive treatment in this later stage of SH. Twenty 30- to 57-year-old women with no thyroid dysfunction (TSH = 1.38 ?IU/mL; L-T4 = 1.18 ng/dL) were also evaluated. At baseline, lower values of gas exchange ratio reserve (0.24 vs 0.30; P

  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. Retrenchment in Malaysia: Employer’s Right?

    Directory of Open Access Journals (Sweden)

    Hamidah Marsono

    2008-11-01

    Full Text Available 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 redundancy.

  15. Revascularização do miocárdio sem circulação extracorpórea: resultados imediatos / Miocardial revascularization without cardiopulmonary bypass; early results

    Scientific Electronic Library Online (English)

    Ricardo de Carvalho, Lima; Mozart, Escobar; José, Wanderley Neto; Luís Daniel, Torres; Décio O, Elias; José Teles de, Mendonça; Ricardo, Lagreca; Renato, Dellassanta; Luis Gonzaga, Granja; Mônica, Farias; Hemerson, Gama.

    1993-09-01

    Full Text Available A cirurgia de revascularização do miocárdio sem uso de circulação extracorpórea (CEC) foi realizada por TRAPP & BISARYA14, na década de 70. Coube, entretanto, a BUFFOLO et alii2, 3 em nosso meio, e a BENETTI et alii¹, na Argentina, o seu uso sistemático, a sua padronização e recomendação, como uma a [...] lternativa válida e segura. Com o objetivo de avaliar a reprodutibilidade da técnica, morbidade e mortalidade, as dificuldades técnicas e as possibilidades de incorporá-las à rotina, os autores apresentam os resultados obtidos em 182 pacientes submetidos a revascularização do miocárdio com pontes de veia safena e/ou torácica interna sem a utilização do sistema de circulação extracorpórea. Foram operados por esta técnica 182 pacientes; 128/182 (70,3%) do sexo masculino e 54/128 (29,7%) do feminino, cujas idades variaram de 40 a 79 anos (m=58,8 anos), com lesões das artérias coronárias: interventricular anterior (IA), direita (CD), diagonal (DI) e marginal (MG). Foram revascularizadas 277 artérias: a IA 159/277 (57,4%), a CD 62/277 (22,4%), a DI 44/277 (15,9%) e a MG 12/277 (4,3%). A artéria torácica interna esquerda foi utilizada em 60 (21,7%) vezes e a veia safena 217/277 (78,3%). O tempo de isquemia variou de 5 a 33 minutos, com média de 14 minutos. Como complicações na série estudada foram observadas: espasmo coronário em 6/182 (3,3%), infarto agudo do miocárdio em 3/182 (1,6%), sangramento em 2/182 (1,1 %), embolia pulmonar em 2/182 (1,1%) e mediastinite em 1/182 (0,6%). Cinco/182 (2,7%) pacientes foram a óbito no período de pósoperatório imediato, sem relação com a técnica utilizada. Os autores concluem que a técnica pode ser realizada em casos selecionados, com segurança e bons resultados pela maioria dos cirurgiões. A técnica reduz os custos da operação e, em alguns subgrupos (idosos, portadores de doenças sistêmicas), pode ser a melhor alternativa. Abstract in english Myocardial revascularization surgery without the use of cardiopulmonary bypass was performed by Trapp and Ankeney in the 1970's. However it fell to Buffolo in Brazil and Benetti in Argentina to introduce its systematic use, standardization and recommendation as a valid and safe alternative modality [...] of treatment. With the aim of evaluating the technique's reproducibility, morbidity and mortality, its technical difficulties and the possibilities of incorporating it into routine practice, the authors present the results obtained in 182 patients submitted to myocardial revascularization with saphenous and/or thoracic internal bypass without the use of cardiopulmonary bypass. One hundred and eighty-two patients were operated on using this technique: 128 (70.3%) males and 54 (29.7%) females, whose ages ranged from 40 to 79 years (mean = 58.8 years), with lesions of coronary arteries: interventricular anterior (IA); right coronary (RD); diagonal artery (DI) and marginal artery (MG). Two hundred and seventy-seven arteries were revasculahsed: 159/277 IA's (57.4%), 62/277 CD's (22.4%), 44/277 DI's (15.9%) and 12/277 MG's (4.3%). The left thoracic internal artery was used on 60/277 (21.7%) occasions and the saphenous vein on 217/277 (78.3%). The duration of the ischemia ranged from 5 to 33 minutes with a mean of 14 minutes. The following conditions were noted in the study as complications: coronary spasm in 6/182 cases (3.3%), acute myocardial infarct in 3/182 (0.6%), bleeding in 2/182 (1.1%), pulmonary embolism in 1/182 (0.6%) and mediastinitis in 1/182 (0.6%). Five/182 patients (2.7%) died in the immediate postoperative period from causes unrelated to the technique employed. The authors conclude that the technique may be safely carried out by most surgeons in selected cases with good results. The technique reduces the costs of surgery and in some subgroups, such as the elderly and those suffering from systemic disease, it may be the best alternative.

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

    Science.gov (United States)

    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. Data Sources MEDLINE, MEDLINE in-Process & Other non-Indexed Citations, EMBASE, Cochrane database of systematic reviews and Cochrane central register of trials, Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment database, along with reference lists of relevant systematic reviews and included articles. Study Eligibility Criteria Prospective cohort studies which derive or validate a clinical prediction model of outcome following cardiopulmonary arrest. Participants and Interventions Children or young people (aged 0 – 18 years) who had cardiopulmonary arrest and received an attempt at resuscitation, excluding resuscitation at birth. Study Appraisal and Synthesis Methods Risk of bias assessment developed the Hayden system for non-randomised studies and QUADAS2 for decision rules. Synthesis undertaken by narrative, and random effects meta-analysis with the DerSimonian-Laird estimator. Results More than 18,000 episodes in 16 data sets were reported. Meta-analysis was possible for survival and one neurological outcome; others were reported too inconsistently. In-hospital patients (average survival 37.2% (95% CI 23.7 to 53.0%)) have a better chance of survival following cardiopulmonary arrest than out-of-hospital arrests (5.8% (95% CI 3.9% to 8.6%)). Better neurological outcome was also seen, but data were too scarce for meta-analysis (17% to 71% ‘good’ outcomes, compared with 2.8% to 3.2%). Limitation Lack of consistent outcome reporting and short-term neurological outcome measures limited the strength of conclusions that can be drawn from this review. Conclusions and Implications of Key Findings There is a need to collaboratively, prospectively, collect potentially predictive data on these rare events to understand more clearly the predictors of survival and long-term neurological outcome. Systematic Review Registration Number PROSPERO 2013:CRD42013005102 PMID:26107958

  17. Aneurysm formation in arteriovenous grafts: associations and clinical significance.

    Science.gov (United States)

    Siedlecki, Andrew; Barker, Jill; Allon, Michael

    2007-01-01

    Aneurysms are a common complication of arteriovenous grafts in hemodialysis patients, resulting from repetitive needle sticks in the graft material. Although aneurysms are thought to contribute to graft failure, there are no prospective studies evaluating their risk factors or impact on graft survival. The present study evaluated aneurysms in 117 hemodialysis outpatients with upper extremity grafts at a university-affiliated dialysis center. An arterial aneurysm was defined as a cannulation site defect diameter (difference between arterial cannulation site diameter and normal graft diameter) above the median value for the study population (0.63 cm). Subsequent graft outcomes were determined by retrospective analysis of a prospective vascular access database. Thrombosis-free graft survival was compared among patient subgroups using Cox proportional hazards models. Patients with an arterial aneurysm had significantly longer median graft age, when compared with those not having a aneurysm (888 vs. 588 days, p = 0.01). However, the two groups did not differ in patient age, sex, diabetes, body mass index, or graft location. The hazard ratio for graft thrombosis was 0.45 (95% confidence interval, 0.25-0.82, p = 0.009) for grafts with an arterial aneurysm, when compared with those without a defect (1-year graft survival of 71 vs. 50%). Graft age was not associated with the likelihood of graft thrombosis (p = 0.12). In contrast to the prevailing wisdom, arterial aneurysms are associated with improved graft survival. PMID:17244126

  18. Radiation grafting of hydrophilic monomers onto ethylene-propylene rubber

    International Nuclear Information System (INIS)

    Graft copolymerization of hydrophilic monomers onto thin plates of ethylene-propylene rubber by the direct irradiation method was carried out. Experimental conditions ensuring a surface grafting reaction were ascertained. Slices of the grafted samples were analyzed by IR absorption spectroscopy and the distribution of the grafted chains across the plate thickness was evaluated. (author)

  19. Radiation grafting of hydrophilic monomers onto ethylene-propylene rubber

    International Nuclear Information System (INIS)

    Graft copolymerization of hydrophilic monomers onto thin plates of ethylene-propylene rubber by direct irradiation method was carried out. Experimental conditions ensuring a surface grafting reaction were ascertained. Slices of the grafted samples were analyzed by IR absorption spectroscopy and the distribution of the grafted chains across the plate thickness was evaluated. (Author)

  20. Assistência circulatória com bomba centrífuga no choque cardiogênico após cirurgia com extracorpórea / Assisted circulation for cardiogenic shock following cardiopulmonary bypass with a centrifugal pump

    Scientific Electronic Library Online (English)

    Paulo M, Pêgo-Fernandes; Luiz Felipe P, Moreira; Noedir A. G, Stolf; Sérgio Almeida de, Oliveira; Álvaro V, Moraes; José Otávio C, Auler Júnior; Adib D, Jatene.

    1991-08-01

    Full Text Available No período de abril a dezembro de 1990, quatro pacientes foram submetidos a utilização de bomba centrífuga, para suporte circulatório. Em todos, foi colocado previamente balão intra-aórtico e feito uso maciço de drogas vasoativas. A primeira paciente apresentava aneurisma de ventrículo esquerdo, com [...] fração de ejeção de 16% no pré-operatório. Após correção do aneurisma, não se conseguiu retirá-la de extracorpórea pelos métodos convencionais. Optou-se, então, pelo uso de assistência ventricular esquerda, que foi mantida por 48 horas. Teve boa evolução, estando, atualmente, no 11º mês de pós-operatório em classe funcional II. O segundo caso foi de paciente submetido a revascularização do miocárdio e troca valvar mitral. No 2? dia de pós-operatório, apresentou oclusão de ponte de safena para descendente anterior, com infarto e parada cardíaca. Massageado, reaberto e recolocado em circulação extracorpórea, não saiu de "bomba". O ventrículo esquerdo apresentava infarto anterior extenso, sendo colocado em assistência ventricular esquerd como "ponte" para transplante. Após cinco dias de assistência, sem se conseguir doador, apresentou óbito por embolia pulmonar. O terceiro caso foi de paciente com má função ventricular esquerda, submetido a revascularização do miocárdio. Também não se conseguiu retirar de circulação extracorpórea. Foi colocado em assistência ventricular esquerda por 32 horas, quando se conseguiu retirar a bomba centrífuga. Esse paciente apresentou distúrbios severos de coagulação. Apesar de estável hemodinamicamente, houve piora progressiva da função pulmonar, com óbito no 4º dia de pós-operatório. O quarto caso foi de paciente submetido a correção de aneurisma de ventrículo esquerdo e revascularização do miocárdio. Não se conseguiu retirar de circulação extracorpórea, e optado por assistência ventricular esquerda com bomba centrífuga. Apresentou melhora progressiva de função ventricular, sendo possível a retirada da bomba centrífuga após 60 horas. O paciente faleceu no 35º dia de pós-operatório por complicações respiratórias. Acreditamos que a utilização com maior freqüência e mais precocemente de assistência circulatória, permitirá uma redução da mortalidade global. O uso de ecocardiograma intra-esofágico nos nossos quatro pacientes foi útil na avaliação da evolução da função ventricular, fornecendo subsídios para retirada ou não da assistência. Abstract in english From April to December 1990, four patients were submitted to left ventricular assistance with centrifugal pump, because they presented cardiogenic shock after cardiac surgery, not responsive to intraortic balloon pump and drugs. The first patient had an aneurysm of anterior wall of the left ventricl [...] e with ejection fraction of 16% in the pre-operative period. The cardiac surgery was technically successful, but the patient could not be weaned from cardiopulmonary bypass with maximal pharmacological therapy and intra-aortic balloon pump. Then we used Biomedicus centrifugal pump for left ventricular assistance. The patient was assisted for 48 hours. Nowadays, she is in NYHA class II at eleventh post-operative month. The second case was a patient submitted to coronary bypass and mitral valve replacement. At second post-operative day the graft to LAD was occluded, resulting in cardiac arrest. The patient was put again in cardiopulmonary bypass, and could not be weaned. The left ventricle had a myocardial infarction, and the assisted circulation was used as a bridge to cardiac transplantation. After five days, without heart donor, he died due to a large embolus at lung. The third case was a patient with bad left ventricular function, submitted to coronary bypass. The patient could not be weaned of cardiopulmonary bypass. He was put in left assisted circulation for 32 hours. This patient had bleeding diathesis. He died in the fourth post-operative day due to respiratory failure. The fourth, case was a patient submi

  1. 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.

  2. Multi-stage grafting and simultaneous co-grafting of acrylic acid and vinyl pyrrolidone onto polyethylene induced by ?-ray irradiation

    International Nuclear Information System (INIS)

    Studies on multi-stage grafting or simultaneous co-grafting of acrylic acid and vinyl pyrrolidone onto polyethylene have been carried out in an attempt to introduce different functional groups into polymers in some ordered states. In the multi-stage grafting, time conversion curves of grafting and graft percent of the second stage depend on the order of monomer to be grafted, and on graft percent of the first-stage grafting. In simultaneous co-grafting, time conversion curves of grafting reaction and graft percent of each monomer depend on monomer ratio in the solution. Effect of graft percent on electric resistance across the grafted film was also found to depend on the mode of multi-stage grafting or simultaneous co-grafting. Results of some trial experiments to establish the grafting conditions are also described. (author)

  3. 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.

  4. Regenerative Approach to Scleroderma with Fat Grafting.

    Science.gov (United States)

    Magalon, Guy; Daumas, Aurélie; Sautereau, Nolwenn; Magalon, Jérémy; Sabatier, Florence; Granel, Brigitte

    2015-07-01

    Grafted fat has many qualities of ideal filler; it is autologous, easily available, and naturally integrated into the host tissues. From a lipoaspirate, the adipose-tissue-derived stromal vascular fraction can be isolated, which is an excellent source of stem/stromal cells, endothelial progenitors, and immune cells. Fat grafting is being increasingly applied in autoimmune diseases, and this article focuses on systemic sclerosis, a rare autoimmune disease characterized by skin fibrosis and microvascular damage. The authors' approach of using fat graft in the face and adipose-tissue-derived stromal vascular fraction for hands is presented as innovative and promising therapy for patients with systemic sclerosis. PMID:26116941

  5. Graft failure versus graft fixation in ACL reconstruction: histological and immunohistochemical studies in rabbits.

    Science.gov (United States)

    Hsu, Shan-Ling; Wang, Ching-Jen

    2013-09-01

    The causes of graft failure after anterior cruciate ligament (ACL) reconstruction are multifactorial including the methods of graft fixation. The purpose of this study was to examine the ACL graft failure in three different methods of graft fixations including interference screw fixation, suture-post fixation and combined interference screw and suture-post fixation. We hypothesized that the fixation method after ACL reconstruction can affect the graft healing in tibial tunnel. Eighteen New Zealand white rabbits were categorized into three groups according to the method of fixation in unilateral ACL reconstruction with long digital extensor autograft. Histological examination demonstrated that the combined fixation and suture-post fixation groups showed significantly better integration between tendon and bone (P = 0.04). In immunohistochemical analysis, the combined fixation and suture-post fixation groups showed significantly higher BMP-2 and VEGF expressions than interference screw (P micromotion and improved the graft healing in tibial tunnel. PMID:23793478

  6. Processos de proteção dos garfos na enxertia da mangueira Grafting processes for mango tree protection

    Directory of Open Access Journals (Sweden)

    Angelo Pedro Jacomino

    2000-03-01

    Full Text Available Diferentes processos de proteção dos garfos foram pesquisados na produção de mudas por enxertia, da mangueira ‘Tommy Atkins’. Os tratamentos utilizados foram os seguintes: saquinho de polietileno (testemunha, filme de PVC, parafilme, cera de abelha, parafina e parafina + vaselina. Verificou-se que o filme de PVC e o parafilme proporcionaram pegamentos de enxertia semelhantes à testemunha (40,60%, 56,62% e 48,33%, respectivamente, enquanto que para os demais tratamentos, os percentuais de pegamento foram muito baixos (Different processes of graft protection were evaluated in the process of grafting ‘Tommy Atkins’ mango trees. The treatments employed were the following: polyethylene bag (control, PVC film, parafilm, bee wax, paraffin and paraffin + vaseline. It was verified that both PVC film and parafilm presented successful grafting in relation to the control (40.60%, 56.62% and 48.33%, respectively, while the other treatments presented low success rate (<10%. It was concluded that the PVC film or parafilm can be employed optionally as a replacement of the plastic bag for protection of mango grafting.

  7. Immobilization and controlled release of ?-galactosidase from chitosan-grafted hydrogels.

    Science.gov (United States)

    Facin, Bruno R; Moret, Bruna; Baretta, Dilmar; Belfiore, Laurence A; Paulino, Alexandre T

    2015-07-15

    Chitosan-grafted hydrogels were employed for immobilization and controlled released of ?-galactosidase. These hydrogels containing immobilized enzymes were employed to simulate the production of lactose-free food and controlled release of ?-galactosidase into lactose-intolerant individuals. The degree of swelling, efficiency of immobilization (i.e., fractional uptake of enzyme), and controlled release were studied as a function of pH and temperature. The degrees of swelling decreased in acidic media: 49.4 g absorbed water per g hydrogel at pH 7.0, and 8.4 g absorbed water per g hydrogel at pH 3.5. The immobilization efficiency was 19%, indicating that chitosan-grafted hydrogels are promising matrices for enzyme adsorption and immobilization. Cyclic experiments reveal that chitosan-grafted hydrogels containing immobilized enzymes can be reused several times without introducing additional enzyme prior to each cycle. There is no significant decrease in the activity of the immobilized enzyme during reutilization studies. All results were conducted in triplicate by considering t-tests at a 95% significance level. Analysis of ?-galactosidase activity and controlled release reveals that chitosan-grafted hydrogels containing immobilized enzymes are useful for the production of lactose-free food and controlled enzyme release with high performance. PMID:25722137

  8. Preparation of poly(vinylbenzyl chloride)-grafted PFA film by a simultaneous irradiation grafting method

    International Nuclear Information System (INIS)

    In this study, PFA-g-PVBC films were prepared by a radiation grafting of vinylbenzyl chloride (VBC) monomer onto poly(tetrafluoroethylene-co-perfluoro propyl vinyl ether) (PFA) films by simultaneous irradiation method. IR, TGA, and SEM-EDX instruments were utilized to confirm the successful preparation of the grafted film. The effects of several irradiation conditions, including the dose, VBC concentration, and film thickness on the degree of grafting of PFA-g-PVBC film were investigated

  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. 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. 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

  13. 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

  14. Levosimendan usage in patients with left ventricle dysfunction in coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Habib Cakir

    2012-10-01

    Full Text Available Introduction: In this study we explicated early results of patients (the patients in whom levosimendan was used who underwent coronary artery bypass graft surgery with ejection fraction 35% or less. We compared this group with the patients in whom levo-simendan was not used. Material and Methods: 97 patients who have 35% ejection fraction or less taken to isolated coronary artery bypass surgery between January 2009 and December 2011 in our clinic are chosen for this study retrospectively. We compared the patients in whom levosimendan was used with the patients in whom levosimendan was not used. Levo- simendan (Simdax, Abbott has been used according to surgeon’s decision in patients. Results: The mean age of group 1 was 62.3 ± 7.6, and the mean age of group 2 was 59.3 ± 10.5 (p > 0.05. It was detected that the average ejection fraction was less in group 1 (p < 0.05. There were no statistically significant difference between the two groups in terms of demand for inotropics, demand for intraaortic balloon pump, revision (because of bleeding, atrial fibrillation, discharging intervals, intensive care unit time, cross clamp and cardiopulmonary bypass time (p > 0.05. It was found that need for blood transfusion were less in group 1 than group 2 (p < 0.05. There were no statistically significant difference between the two groups in terms of mortality (p > 0.05. Conclusion: We consider levosimendan reduces need for blood transfusion in coronary artery bypass graft surgery. This results may change with increasing number of patients so we consider that multicenter larger study is needed.

  15. 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

  16. Biotin grafting on boron-doped diamond.

    Science.gov (United States)

    Delabouglise, Didier; Marcus, Bernadette; Mermoux, Michel; Bouvier, Pierre; Chane-Tune, Jérôme; Petit, Jean-Pierre; Mailley, Pascal; Livache, Thierry

    2003-11-01

    Grafting of biotin on top of a polycrystalline boron-doped diamond layer was achieved by surface oxidation followed by an esterification reaction and revealed by fluorescently labelled streptavidin. PMID:14649817

  17. 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

  18. Polystyrene grafted multi-walled carbon nanotubes.

    Science.gov (United States)

    Shaffer, M S P; Koziol, K

    2002-09-21

    Oxidised, multi-walled, carbon nanotubes can be grafted with polystyrene molecules using an situ radical polymerisation reaction, thereby dramatically modifying their solubility and their suitability for nanocomposite applications. PMID:12357785

  19. Grafting of a LLDPE using gamma irradiation

    International Nuclear Information System (INIS)

    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 st00 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

  20. Pathogenesis of cardiac graft failure in children

    OpenAIRE

    Jenny Lin; Shehata, Bahig M.

    2012-01-01

    For many critical cardiac conditions such as cardio-myopathy, congenital heart defects, or arrhythmogenic disorders, cardiac transplantation is often an accepted treatment with optimistic one- and five-year survival rates of 90% and 75% in the pediatric patient population, respectively. However, poor long-term survival is a cause for concern, with cardiac graft failure being the leading cause in late mortality transplant recipients. Cardiac graft failure occurs through several mechanisms. How...

  1. DNA nanosensor surface grafting and salt dependence

    Science.gov (United States)

    Carvalho, B. G.; Fagundes, J.; Martin, A. A.; Raniero, L.; Favero, P. P.

    2013-02-01

    In this paper we investigated the Paracoccidoides brasiliensis fungus nanosensor by simulations of simple strand DNA grafting on gold nanoparticle. In order to improve the knowledge of nanoparticle environment, the addiction of salt solution was studied at the models proposed by us. Nanoparticle and DNA are represented by economic models validated by us in this paper. In addition, the DNA grafting and salt influences are evaluated by adsorption and bond energies calculations. This theoretical evaluation gives support to experimental diagnostics techniques of diseases.

  2. Management of Peyronie's Disease by Dermal Grafting

    OpenAIRE

    Hamid Reza Nasseh; Hooman Jaladat; GH Pourmand; Abdolrasoul Mehrsai; Mohammad Reza Nikoobakht

    2004-01-01

    Purpose: To evaluate the results of plaque excision and dermal grafting in Peyronie’s disease.Materials and Methods: Twenty seven patients were scheduled to undergo plaque excision and dermal grafting for Peyronie’s disease. Potency, bending of erected penis, and having painful erection were evaluated in patients before and after operation. To evaluate erectile dysfunction, we used International Index of Erectile Function (IIEF) by interviewing the patients and filling questionnaires by their...

  3. 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)

  4. 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.

  5. High voltage supercapacitors based on carbon-grafted NiO nanowires interfaced with an aprotic ionic liquid.

    Science.gov (United States)

    Paravannoor, Anjali; Nair, Shantikumar V; Pattathil, Praveen; Manca, Michele; Balakrishnan, Avinash

    2015-04-11

    The report provides a preliminary assessment of the charge storage prerogatives of an asymmetric electrochemical capacitor employing a carbon-grafted NiO electrode interfaced with 1-ethyl-3-methyl imidazoliumdicyanamide as an ionic liquid electrolyte. This configuration has been demonstrated to be potentially exploited for developing hybrid supercapacitors providing as high energy density as 21 W h Kg(-1). PMID:25742721

  6. 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 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.

  7. Time for new concepts about measurement of complement activation by cardiopulmonary bypass?

    Science.gov (United States)

    Videm, V; Fosse, E; Mollnes, T E; Garred, P; Svennevig, J L

    1992-10-01

    Fifty-one patients admitted for routine coronary bypass operations were randomized to cardiopulmonary bypass with a membrane oxygenator (Capiox) or a bubbler (Polystan or William Harvey). Complement activation was measured using enzyme immunoassays for concentrations of C3 activation products and the terminal complement complex. From 5.8 to 8.1 arbitrary units (AU)/mL (medians), the plasma concentrations of C3 activation products increased by 119.9 AU/mL (Capiox), 124.6 AU/mL (Polystan), and 79.5 AU/mL (William Harvey) to a peak at closure of the sternum (not significant when related to baseline concentrations). The increase in C3 activation products and baseline C3 activation were linearly correlated (R2 = 0.30; p less than 0.0001). From 5.5 to 6.1 AU/mL, the plasma terminal complement complex concentrations increased by 45.2 AU/mL (Capiox), 15.4 AU/mL (Polystan), and 17.4 AU/mL (William Harvey) to a peak before termination of cardiopulmonary bypass. Maximal terminal (C5-C9) activation was significantly higher in the membrane oxygenator group (p less than 0.0001) and showed no relationship to C3 activation. Measurement of C3 activation only gives no information about C5-C9 activation. At present, terminal complement complex quantitation is probably the best index of C5-C9 activation during cardiopulmonary bypass. PMID:1417231

  8. Quantitative blood flow measurements in the small animal cardiopulmonary system using digital subtraction angiography

    Science.gov (United States)

    Lin, MingDe; Marshall, Craig T.; Qi, Yi; Johnston, Samuel M.; Badea, Cristian T.; Piantadosi, Claude A.; Johnson, G. Allan

    2009-01-01

    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 (100×100 ?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 18.90×CODSA=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. PMID:19994543

  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. New guidelines for cardiopulmonary resuscitation / Novas diretrizes da ressuscitação cardiopulmonar / Nuevas directrices para la resucitación cardiopulmonar

    Scientific Electronic Library Online (English)

    Maria Celia Barcellos, Dalri; Izilda Esmenia Muglia, Araújo; Renata Cristina de Campos Pereira, Silveira; Silvia Rita Marin da Silva, Canini; Regilene Molina Zacareli, Cyrillo.

    1060-10-01

    Full Text Available 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. Abstract in spanish 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 internacionale [...] s 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. Abstract in english 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 th [...] e 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.

  11. 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.

  12. 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.

  13. 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

  14. National Employment Matrix

    Science.gov (United States)

    The US Bureau of Labor Statistics offers the National Industry-Occupation Employment Matrix. This fascinating searchable and browsable database allows users to track the employment distribution of an occupation among industries. Users can search or browse by industry or occupation. Results can be sorted by employment or projected (percent or numeric) change in employment. Data are available for over 500 occupations within 240 industries.

  15. Economic Analysis of Employment

    OpenAIRE

    Oana Camelia Iacob; Ana-Maria Volintiru; Daniela Tudorache; Serban Taranu

    2013-01-01

    In social policy, a distinct field is the employment policies. Their aim is to maintain and increase employment through direct or indirect actions. These actions are intended to provide jobs for young people entering the labor market, for the unemployed and others who want to hire as employees. This paper aims to achieve a perspective on labor market and employment policies with its typologies, causes, effects, generated by these policies on the individuals and society. The employment impact ...

  16. Partial atrial resection in advanced lung carcinoma with and without cardiopulmonary bypass.

    OpenAIRE

    Shirakusa, T.; Kimura, M.

    1991-01-01

    Combined pneumonectomy and partial resection of the left atrium was performed in 12 patients with advanced lung carcinoma (T3 and T4 in the new UICC classification). In the eight patients with a T3 lung carcinoma intrapericardial atrial resection with vascular clamping was carried out; four of the patients died within a year. The remaining four patients had a T4 tumour and underwent removal of the right lung and part of the left atrium under total cardiopulmonary bypass. One patient died shor...

  17. Resection of Intrapericardial Schwannoma Co-Existing with Thymic Follicular Hyperplasia through Sternotomy without Cardiopulmonary Bypass.

    Science.gov (United States)

    Chung, Jae Ho; Jung, Jae Seung; Lee, Sung Ho; Kim, Kwang Taik; Lee, Kanghoon; Lee, Seung Hun

    2014-06-01

    A 35-year-old man was admitted to Korea University Anam Hospital for evaluation of intermittent chest pain. Computed tomography of the chest showed enlargement of a previously identified anterior mediastinal mass and also a well-defined, circumscribed mass in the subcarinal area, surrounded by the roof of the left atrium, right pulmonary artery, and the carina. Complete resection of the intrapericardial tumor was performed through median sternotomy without cardiopulmonary bypass. Pathologic examination identified the tumor as schwannoma, of an ancient type, diffusely positive for the S-100 antigen. Unlike other reported cases, grossly, the tumor did not seem to be involved with any nerve. PMID:25207232

  18. 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.

  19. Cardiopulmonary bypass in anesthetic management of resection. Its use for severe tracheal stenosis.

    Science.gov (United States)

    Bricker, D L; Parker, T M; Dalton, M L

    1979-07-01

    On initial evaluation, two patients were found to be in severe respiratory distress from tracheal obstruction. One patient had late obstruction after a crushing injury to the chest, whereas the other had subtotal tracheal obstruction from a carcinoid adenoma. In each case, the state of the patient seemed to preclude safe anesthetic induction with an endotracheal tube as the sole means of oxygenating the patient. Partial cardiopulmonary bypass provided an adjunct to ensure adequate oxygenation for tracheal resection. Consideration for the use of this technique is recommended in similar circumstances. PMID:454179

  20. Extracorporeal cardiopulmonary support may be an efficient rescue of patients after massive pulmonary embolism. An experimental porcine study

    DEFF Research Database (Denmark)

    Kjærgaard, Benedict; Rasmussen, Bodil Steen

    2012-01-01

    INTRODUCTION: Treatment of massive pulmonary embolism leading to cardiac arrest is controversial but restitution of circulation within a shorter time is crucial. Cardiopulmonary support and therapeutic hypothermia is an option for cardiac arrest and could be used to treat massive PE. However, hypothermia may influence the effect of the ongoing intrinsic fibrinolysis. OBJECTIVES: To establish a porcine model of massive pulmonary embolism, to show that cardiopulmonary support can rescue pigs with massive pulmonary embolism and to examine the effect of hypothermia on fibrinolysis. METHODS: Pigs ~80kg were anesthetised and prepared for cardiopulmonary support. Repetitive injections of preformed blood thrombi into the right atrium were done until cardiac arrest. Cardiopulmonary support was established and eighteen pigs were randomised into 3 groups: Normothermia (38-39°C); hypothermia (33-34°C); or medication with recombinant tissue plasminogen activator. After three hours the pigs were weaned from cardiopulmonarysupport, and after 15minutes with spontaneous circulation assassinated and autopsied. Remaining thrombi in the lungs were weighed. RESULTS: The development of fatal pulmonary embolism was highly reproducible. All 18 pigs could be weaned from cardiopulmonary support and survived more than 15minutes. The amount of remaining thromboemboli was substantial in all groups and not significantly different between groups. Normothermic group 20.0±2.2g, Hypothermic group 17.0±3.7g, and rt-PA group 14.3±3.2g. CONCLUSIONS: Cardiopulmonary support could rescue pigs with massive pulmonary embolism. Hypothermia did not reduce the emboli but may for other reasons be beneficial. The optimal additional treatment is still unknown but treatment modalities can be tested in this model.

  1. Graduate Identity and Employability

    Science.gov (United States)

    Hinchliffe, Geoffrey William; Jolly, Adrienne

    2011-01-01

    This paper develops the concept of graduate identity as a way of deepening the understanding of graduate employability. It does this through presenting research in which over 100 employers in East Anglia were asked to record their perceptions of graduates in respect of their employability. The findings suggest a composite and complex graduate…

  2. Toddlers with Employed Mothers.

    Science.gov (United States)

    Schachter, Frances Fuchs

    1981-01-01

    Compares a group of 32 toddlers with employed mothers with a matched group of 38 toddlers with nonemployed mothers in order to examine the effect of maternal employment on the development of the child. While no differences were found between the two groups in language development and emotional adjustment, children of employed mothers were more…

  3. Employment in Agribusiness.

    Science.gov (United States)

    Hilgenberg, Gene; Huston, Jane

    This curriculum guide is intended to assist persons teaching a course in employment in agribusiness. Addressed in the individual units of instruction are the following topics: employment information (training plans/agreements and wages, taxes, and fringe benefits); human relations (employer/employee/customer relations and communication skills);…

  4. Coronary artery bypass grafting and sensorineural hearing loss, a cohort study

    Directory of Open Access Journals (Sweden)

    Ashraf Omer

    2005-12-01

    Full Text Available Abstract Background Sudden sensorineural hearing loss is routinely encountered by the otologist. The etiology is varied and often identifiable. One of the relatively less frequent causes is surgery. Apart from being an established entity with otological surgeries, sensorineural hearing loss has also been known to occur after non-otological procedures under general anesthesia. Commonest amongst these procedures is cardiopulmonary bypass, an association that has long been recognized. However, despite the proposition of diverse hypotheses in the past, the pathophysiology remains unclear. Methods The study is a prospective matched cohort study that will be carried out in Aga Khan University Hospital, Karachi, Pakistan. Participants among exposed would include all those patients who would be undergoing coronary artery bypass surgery in the hospital who fall under the criteria for inclusion. Unexposed group would comprise of patients undergoing a non-bypass procedure of similar duration under the same type of anesthesia who meet the selection criteria. Both these groups will undergo audiometric testing at our hospital on three different occasions during the course of this study. Initially before the procedure to test the baseline hearing capacity; then one week after the procedure to assess any changes in hearing ability following the surgery; and finally a third audiogram at six weeks follow-up to assess further changes in any hearing deficits noted during the second phase of testing. Certain variables including the subjects' demographics and those concerning the procedure itself will be noted and used later for risk factors analysis. A detailed past medical and surgical history will also be obtained. Data analysis would include calculation of relative risk and significance of the results, by running the chi-square test. Other statistical tests like Fisher exact test may then be employed to facilitate data interpretation. Continuous scale may then be employed and multivariate linear regression used. Discussion This study is planned to obtain a better understanding of the correlation between sudden sensorineural hearing loss and cardiopulmonary bypass. Being the first major cohort trial in this line of investigation, the project is designed to identify the existence of any significant relationship between cardiopulmonary bypass and sensorineural hearing deficit.

  5. Improving coronary artery bypass graft durability: use of the external saphenous vein graft support.

    Science.gov (United States)

    Ferrari, Enrico; von Segesser, Ludwig; Berdajs, Denis

    2015-01-01

    Coronary bypass grafting remains the best option for patients suffering from multivessel coronary artery disease, and the saphenous vein is used as an additional conduit for multiple complete revascularizations. However, the long-term vein graft durability is poor, with almost 75% of occluded grafts after 10 years. To improve the durability, the concept of an external supportive structure was successfully developed during the last years: the eSVS Mesh device (Kips Bay Medical) is an external support for vein graft made of weft-knitted nitinol wire into a tubular form with an approximate length of 24?cm and available in three diameters (3.5, 4.0 and 4.5?mm). The device is placed over the outer wall of the vein and carefully deployed to cover the full length of the graft. The mesh is flexible for full adaptability to the heart anatomy and is intended to prevent kinking and dilatation of the vein in addition to suppressing the intima hyperplasia induced by the systemic blood pressure. The device is designed to reduce the vein diameter of about 15-20% at most to prevent the vein radial expansion induced by the arterial blood pressure, and the intima hyperplasia leading to the graft failure. We describe the surgical technique for preparing the vein graft with the external saphenous vein graft support (eSVS Mesh) and we share our preliminary clinical results. PMID:25976117

  6. 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

  7. Radiation-induced graft copolymerization to polyester, 19

    International Nuclear Information System (INIS)

    Resistivity of polyethylene terephthalate (PET) fibers grafted with various hydrophilic monomers to alkaline media was tested by treating the graft fibers in boiling 1% aqueous sodium carbonate for 4 hr. The higher the percent weight loss of the fiber by the treatment the lower the resistivity. The results are as follows: (a) Two types of fibers which have been grafted with acrylic acid are compared; one is grafted rather homogeneously and thoroughly (by microscopic observation of cross section of the dyed fiber) and the other is grafted only peripherally (showing coloured ring in cross section). It is noteworthy that the two fibers show practically no difference in the alkali-resistivity. When the percent apparent graft is 5%, the weight loss exceeds 30%. (b) Neither cross linking of polyacrylic acid grafted on PET by irradiation with ?-rays nor additional grafting with hydrophobic monomers improved the alkali-sensitivity of the graft fibers. (c) PET fiber grafted with methacrylic acid shows almost the same low resistivity as fiber grafted with acrylic acid. Behaviour of vinylpyrrolidone is not far different from that of acrylic or methacrylic acid. (d) The decrease of the alkali-sensitivity of PET fiber by grafting of 4-vinyl pyridine is very small. The graft fibers may be regarded to be alkali-insensitive. (e) PET fibers grafted with monomethacrylates of ethylene- and polyethylene-glycos show higher alkali-resistivity than fibers grafted with acrylic acid. (f) PET fibers grafted with diacrylates and dimethacrylates of polyethylene glycols show good resistivity to alkaline media. Due to large molecular size of these monomers and crosslinking during the reaction, the apparent grafting takes place only on the surface of the fibers. Taking into account the experimental results of Schamberg, it may be concluded that the decrease in the alkali-resistivity of PET grafted with acidic monomers is attributed to such a structure change of PET matrix that alkali can easily penetrate into the matrix to hydrolyse PET. (author)

  8. Gamma radiation-induced grafting of glycidyl methacrylate to water hyacinth fibers: functionalization and metal ion uptake kinetics

    International Nuclear Information System (INIS)

    Water hyacinth fibers (WHF) were functionalized using gamma radiation-induced graft polymerization of glycidyl methacrylate (GMA) to obtain fibers with oxirane groups for chemical modification. The simultaneous grafting technique was employed wherein the WHF were irradiated in nitrogen atmosphere in the presence of GMA dissolved in water/methanol solvent. The effects of different grafting parameters to the grafting yield were evaluated. The optimal values of solvent, radiation absorbed dose, dose rate, concentration of monomer were found to be 1:3 (volume/volume) water-methanol solvent, 10 kGy, 8 kGy hour -1 dose rate and 5% (volume/volume) GMA, respectively. Using the optimum conditions, grafting yield approximately 58% was achieved. The GMA grafted WHF were subsequently modified with ethylenediamine and sodium sulfite. The resulting amine and sulfonic acid functionalized WHF, together with the grafted WHF, were characterized using Attenuated Total Reflectance-Fourier Transformed Infrared Spectroscopy (ATR-FTIR). Thermogravimetric Analysis (TGA), Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectroscopy (EDX). The sorption of Cu2+, Cr3+ and Pb2+ ions on the amine functionalized WHF was studied. The initial concentration of the metal ions and pH of the solution were found to have important effect on the adsorption of the metal ions onto the amine functionalized WHF. The kinetics of adsorption was observed t The kinetics of adsorption was observed to follow Lagergren first order equation. Results of ion sorption studies indicate that radiation induced grafting and subsequent chemical modification improved the ion sorption behavior of WHF. (author)

  9. 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)

  10. Synthesis of grafted phosphorylcholine polymer layers as specific recognition ligands for C-reactive protein focused on grafting density and thickness to achieve highly sensitive detection.

    Science.gov (United States)

    Kamon, Yuri; Kitayama, Yukiya; Itakura, Akiko N; Fukazawa, Kyoko; Ishihara, Kazuhiko; Takeuchi, Toshifumi

    2015-04-21

    We studied the effects of layer thickness and grafting density of poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) thin layers as specific ligands for the highly sensitive binding of C-reactive protein (CRP). PMPC layer thickness was controlled by surface-initiated activators generated by electron transfer for atom transfer radical polymerization (AGET ATRP). PMPC grafting density was controlled by utilizing mixed self-assembled monolayers with different incorporation ratios of the bis[2-(2-bromoisobutyryloxy)undecyl] disulfide ATRP initiator, as modulated by altering the feed molar ratio with (11-mercaptoundecyl)tetra(ethylene glycol). X-ray photoelectron spectroscopy and ellipsometry measurements were used to characterize the modified surfaces. PMPC grafting densities were estimated from polymer thickness and the molecular weight obtained from sacrificial initiator during surface-initiated AGET ATRP. The effects of thickness and grafting density of the obtained PMPC layers on CRP binding performance were investigated using surface plasmon resonance employing a 10 mM Tris-HCl running buffer containing 140 mM NaCl and 2 mM CaCl2 (pH 7.4). Furthermore, the non-specific binding properties of the obtained layers were investigated using human serum albumin (HSA) as a reference protein. The PMPC layer which has 4.6 nm of thickness and 1.27 chains per nm(2) of grafting density showed highly sensitive CRP detection (limit of detection: 4.4 ng mL(-1)) with low non-specific HSA adsorption, which was improved 10 times than our previous report of 50 ng mL(-1). PMID:25783194

  11. 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.

  12. Education for Employment: Realizing Arab Youth Employment

    Science.gov (United States)

    The Arab world is "overwhelmingly young", and the human potential throughout the area is tremendous. Recent events across the region have "amplified the social and economic disconnect between skills, jobs, and opportunity." To address this situation, a group of organizations (including the Islamic Development Bank), started the Education for Employment (e4e) initiative. The basic goal of the initiative is to position "education as a major priority to drive improved employment prospects." On their website, visitors can look over a brief summary of their work, and also look over their report from April 2011. The report is based on 200 in-depth interviews and surveys of over 1500 employers and 1500 youth throughout the region. Visitors can download the 150 page report, or view the executive summary here in Arabic or English. The report's chapters include "Perspectives of e4e Stakeholders" and "The e4e Challenge in the Arab World".

  13. 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...

  14. Growth and Yield of Watermelon as Influenced by Grafting

    OpenAIRE

    Salam, M. A.; Masum, A. S. M. H.; Chowdhury, S. S.; Monoranjan Dhar; Saddeque, M. A.; Islam, M. R.

    2002-01-01

    The study was conducted to determine the effect of grafting on the growth, yield and control of wilt disease of watermelon. Grafting of watermelon on bottle gourd root stock significantly reduced the wilt disease in the field. Grafting also produced higher number of fruits per plant (5.25) and larger fruit (30.30 cm) which ultimately produced higher yield (56.92 t/ha?1) than non grafted plants. The grafts produced 3.5 times higher yield than non grafts.

  15. 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

  16. Novel block, graft and random copolymers for biomedical applications

    DEFF Research Database (Denmark)

    Javakhishvili, Irakli; Jankova Atanasova, Katja

    Despite the simple structure, poly(2-methoxyethyl acrylate) (PMEA) shows excellent blood compatibility [1]. Both the freezing-bound water (intermediate water: preventing the biocomponents from directly contacting the polymer surface) and non-freezing water on the polymer surface play important roles for this [2]. An artificial lung (oxygenator), already in use, is coated with high MW PMEA prepared by radical polymerization with AIBN [2]. To broaden the possibilities for designing biomedical devices [3] and inspired from these findings we first prepared homo polymers of MEA and their block copolymers with MMA [4] utilizing ATRP. Here we present other block, graft and random copolymers of MEA intended for biomedical applications. These macromolecular architectures have been constructed by employing controlled radical polymerization methods such as RAFT and ATRP.

  17. Molecular Dynamics in grafted layers of poly(dimethylsiloxane) (PDMS)

    CERN Document Server

    Hartmann, L; Leger, L; Kremer, F

    2002-01-01

    Dielectric relaxation spectroscopy 10^-1 Hz to 10^6 Hz) is employed to study the molecular dynamics of poly(dimethylsiloxane) (PDMS, Mw=1.7 10^5 g/mol and Mw=9.6 10^4 g/mol as grafted films with thicknesses d below and above the radius of gyration Rg. For d smaller than Rg the molecular dynamics becomes faster by up to three orders of magnitude with respect to the bulk resulting in a pronounced decrease of the Vogel temperature T0 and hence the calorimetric glass transition temperature Tg. For d larger than Rg the molecular dynamics is comparable to that of the bulk melt. The results are interpreted in terms of a chain confinement effect and compared with the findings for low molecular eight glass forming liquids contained in nanoporous glasses and zeolites. Crystallization effects - well known for PDMS - are observed for films of thicknesses above and below Rg.

  18. 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.

  19. Grafting onto polyester fibers. II. Kinetics of grafting of acrylic acid, acrylonitrile, and vinyl acetate onto polyester fibers

    International Nuclear Information System (INIS)

    The kinetics of grafting of acrylonitrile, acrylic acid, and vinyl acetate onto polyester fiber by catalytic initiation and radiation were studied. The energy of activation determined for acrylic acid grafting by the catalytic method was 10.7 kcal/mole and that for vinyl acetate grafting by the radiation method, 11.7 kcal/mole. In the case of acrylonitrile grafting by the catalytic method, the rate of grafting decreased with increase in temperature of grafting, showing the differential behavior of the precipitating type of polymer from that of homogeneous polymerization. 5 figures

  20. Oversized vein grafts develop advanced atherosclerosis in hypercholesterolemic minipigs

    DEFF Research Database (Denmark)

    Thim, Troels; Hagensen, Mette Kallestrup

    2012-01-01

    ABSTRACT: BACKGROUND: Accelerated atherosclerosis is the main cause of late aortocoronary vein graft failure. We aimed to develop a large animal model for the study of pathogenesis and treatment of vein graft atherosclerosis. METHODS: An autologous reversed jugular vein graft was inserted end-to-end into the transected common carotid artery of ten hypercholesteroemic minipigs. The vein grafts were investigated 12-14 weeks later with ultrasound and angiograpy in vivo and microscopy post mortem. RESULTS: One minipig died during follow up (patent vein graft at autopsy), and one vein graft thrombosed early. In the remaining eight patent vein grafts, the mean (standard deviation) intima-media thickness was 712 mum (276 mum) versus 204 mum (74 mum) in the contralateral control internal jugular veins (P diameter of artery). No plaques were found in four non-oversized vein grafts (P <.05). CONCLUSIONS: Our model of jugular vein graft in the common carotid artery of hypercholesterolemic minipigs displayed the components of human vein graft disease, i.e. thrombosis, intimal hyperplasia, and atherosclerosis. Advanced atherosclerosis, the main cause of late failure of human aortocoronary vein grafts was only seen in oversized grafts. This finding suggests that oversized vein grafts may have detrimental effects on patient outcome.

  1. 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.

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

    Scientific Electronic Library Online (English)

    S., BAGCHI; S. B., DESHPANDE.

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

    Directory of Open Access Journals (Sweden)

    Carlos Serrano

    2010-01-01

    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.

  4. 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.

  5. 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)

  6. Haemoconcentration of residual cardiopulmonary bypass blood using Hemosep(®) : a randomised controlled trial.

    Science.gov (United States)

    Hogan, M; Needham, A; Ortmann, E; Bottrill, F; Collier, T J; Besser, M W; Klein, A A

    2015-05-01

    Cardiac surgery and cardiopulmonary bypass are associated with haemodilution, activation of haemostasis and blood transfusion. We undertook a randomised controlled trial that included 53 patients in order to compare autotransfusion of residual cardiopulmonary bypass blood with residual blood concentrated using the novel Hemosep(®) device. There was no difference in patients' mean (SD) haemoglobin concentration after autotransfusion of unprocessed blood compared with Hemosep; 103.5 (10.2) g.l(-1) vs 106.2 (12.4) g.l(-1) , respectively, p = 0.40. The mean (SD) change in haemoglobin concentration after autotransfusion was 5.9 (5.3) g.l(-1) in the control group compared with 4.9 (6.3) g.l(-1) in the Hemosep group, p = 0.545. Adjusted for baseline haemoglobin concentrations, the estimated mean (95% CI) difference in change in haemoglobin concentration (control vs Hemosep) was 0.57 (-2.65 to 3.79) g.l(-1) , p = 0.72. This was despite Hemosep's reducing the weight of the blood from a mean (SD) of 778.7 (243.0) g to 607.3 (248.2) g, p blood increased from a mean (SD) of 87.0 (15.1) g.l(-1) to 103.7 (17.4) g.l(-1) , p blood, but that this is insufficient to increase patient haemoglobin. PMID:25692545

  7. Effect of Prior Cardiopulmonary Resuscitation Knowledge on Compression Performance by Hospital Providers

    Directory of Open Access Journals (Sweden)

    Joshua N. Burkhardt

    2014-07-01

    Full Text Available Introduction: The purpose of this study was to determine cardiopulmonary resuscitation (CPR knowledge of hospital providers and whether knowledge affects performance of effective compressions during a simulated cardiac arrest. Methods: This cross-sectional study evaluated the CPR knowledge and performance of medical students and ED personnel with current CPR certification. We collected data regarding compression rate, hand placement, depth, and recoil via a questionnaire to determine knowledge, and then we assessed performance using 60 seconds of compressions on a simulation mannequin. Results: Data from 200 enrollments were analyzed by evaluators blinded to subject knowledge. Regarding knowledge, 94% of participants correctly identified parameters for rate, 58% for hand placement, 74% for depth, and 94% for recoil. Participants identifying an effective rate of ?100 performed compressions at a significantly higher rate than participants identifying <100 (µ=117 vs. 94, p<0.001. Participants identifying correct hand placement performed significantly more compressions adherent to guidelines than those identifying incorrect placement (µ=86% vs. 72%, p<0.01. No significant differences were found in depth or recoil performance based on knowledge of guidelines. Conclusion: Knowledge of guidelines was variable; however, CPR knowledge significantly impacted certain aspects of performance, namely rate and hand placement, whereas depth and recoil were not affected. Depth of compressions was poor regardless of prior knowledge, and knowledge did not correlate with recoil performance. Overall performance was suboptimal and additional training may be needed to ensure consistent, effective performance and therefore better outcomes after cardiopulmonary arrest.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. Prediction of coronary artery bypass graft flow

    International Nuclear Information System (INIS)

    To predict the coronary artery bypass graft (CABG) flow based on the time density curve (TDC) obtained from the digital subtraction aortograms (DSA), we developed a pulsatile CABG model (perfusion pressure 60,130 mmHg, pulse rate 53,126/min, cardiac output 3-7 l/min, diameter of the graft 2.1?6.0 mm). After positioning the regions of interest (ROI), we injected contrast medium(5?40 ml/sec, 5?40 ml) into the outlet conduit. Concerning the TDCs, we calculated appearance time (Ta), peak densities (Dp), peak time (Tp), disappearance time (Td), integral of TDC, ?Tp (difference of Tp between two ROI) and ?Ta (difference of Ta between two ROI). Perfusion pressure, graft flow and output curve were similar to those of patients with CABG. Ta, Tp, Td, and ?Tp were affected by both the injection rate and the volume of the contrast medium; while Dp and the TDC integral were only affected by the latter parameter. Under the same conditions of contrast medium injection, the TDC depended strongly on graft flow, diameter of the graft, output and pulse rate. 21.6+0.92?·d2/4·?1/?Tp·60 provided the most accurate estimation of CABG flow (r=0.865, p<0.01). We conclude that densitometric analysis of DSA may be useful in the prediction of CABG flow. (author)

  13. Radiographic analysis of pasteurized autologous bone graft

    International Nuclear Information System (INIS)

    Local malignant bone tumor excision followed by pasteurization and subsequent reimplantation is a unique technique for reconstruction after resection of primary bone sarcomas. The purpose of this investigation was to assess the normal and abnormal long-term radiographic findings of intercalary and osteo-chondral pasteurized bone graft/implant composite. The long-term radiographic findings of pasteurized bone grafts used in reconstruction after resection of bone and soft tissue sarcomas in relation to patients' clinical data were reviewed retrospectively. Thirty-one patients (18 females, 13 males; age range 7-77 years, mean 30 years) who underwent surgery between April 1990 and January 1997 at the authors' institute constituted the material of this study. They were followed up for at least 3 years or until the patient's death (mean 69 months). The International Society of Limb Salvage graft evaluation method that assesses the fusion, resorption, fracture, graft shortening, fixation, subluxation, joint narrowing and subchondral bone was used for evaluation of the radiographs. Twenty-one patients (68%) showed complete incorporation of graft and eight patients (26%) had partial incorporation. The overall radiographic evaluation rate was 81%. Fracture (10%) and infection (16%) were the main complications. No local recurrence was detected. These results indicate that pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors. (orig resection of malignant bone tumors. (orig.)

  14. Radiation graft modification of EPDM rubber

    International Nuclear Information System (INIS)

    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 behaviour have been investigated. The inhibitory effect upon homopolymerization of various salts has also been evaluated for the three monomers. 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. (author)

  15. Aqueous dispersions of oligomer-grafted carbon nanomaterials with controlled surface charge and minimal framework damage.

    Science.gov (United States)

    Hu, Sheng; Chen, Shu; Menzel, Robert; Goode, Angela D; Ryan, Mary P; Porter, Alexandra E; Shaffer, Milo S P

    2014-01-01

    Functionalised carbon nanomaterials (CNMs), with an undamaged carbon framework and controlled physiochemical properties, are desirable for a wide range of scientific studies and commercial applications. The use of a thermochemical grafting approach provides a versatile means to functionalise both multi-walled carbon nanotubes (MWCNTs) and carbon black (CB) nanoparticles without altering their inherent structures. The functionalisation process was investigated by employing various types of grafting monomers; to improve water solubility, reagents were chosen that introduced an ionic character either intrinsically or after further chemical reactions. The degree of grafting for both MWCNTs and CB ranged from 3-27 wt%, as established by thermal gravimetric analysis (TGA). Raman spectroscopy confirmed that the structural framework of the MWCNTs was unaffected by the thermochemical treatment. The effectiveness of the surface modification was demonstrated by significantly improved dispersibility and stability in water, and further quantified by zeta-potential analysis. The concentration of stable, individualised and grafted MWCNTs in water ranged from ?30 to 80 ?g mL(-1) after centrifugation at 10?000 g for 15 min, whereas functionalised CB in water showed improved dispersibility up to ?460 ?g mL(-1). The successful preparation of structurally identical but differently functionalised nanoparticle panels, with high water compatibility and minimal framework damage, is useful for controlled experiments. For example, they can be used to explore the relationship between toxicological effects and specific physiochemical properties, such as surface charge and geometry. PMID:25254653

  16. Water transport and clustering behavior in homopolymer and graft copolymer polylactide

    Energy Technology Data Exchange (ETDEWEB)

    Du, An; Koo, Donghun; Theryo, Grayce; Hillmyer, Marc A.; Cairncross, Richard A. (Drexel); (UMM)

    2015-02-19

    Polylactide is a bio-based and biodegradable polymer well-known for its renewable origins. Water sorption and clustering behavior in both a homopolymer polylactide and a graft copolymer of polylactide was studied using the quartz crystal microbalance/heat conduction calorimetry (QCM/HCC) technique. The graft copolymer, poly(1,5-cyclooctadiene-co-5-norbornene-2-methanol-graft-D,L-lactide), contained polylactide chains (95 wt.%) grafted onto a hydrophobic rubbery backbone (5 wt.%). Clustering is an important phenomenon in the study of water transport properties in polymers since the presence of water clusters can affect the water diffusivity. The HCC method using the thermal power signals and Van't Hoff's law were both employed to estimate the water sorption enthalpy. Sorption enthalpy of water in both polymers was determined to be approximately -40 kJ/mol for all water activity levels. Zimm-Lundberg analysis showed that water clusters start to form at a water activity of 0.4. The engaged species induced clustering (ENSIC) model was used to curve fit sorption isotherms and showed that the affinity among water molecules is higher than that between water molecules and polymer chains. All the methods used indicate that clustering of water molecules exists in both polymers.

  17. Nitroxide mediated and atom transfer radical graft polymerization of atactic polymers onto syndiotactic polystyrene

    Scientific Electronic Library Online (English)

    M., Abbasian; S. Esmaeily, Shoja.

    2012-06-01

    Full Text Available 'Living' radical graft polymerization was employed to prepare graft copolymers with nitroxide-mediated arylated syndiotactic polystyrene as the backbone and polystyrene (PS), poly(p-methylstyrene) (PMS) and poly(methylmethacrylate) (PMMA) as branches. A two-stage process has been developed to synthe [...] size the macroinitiator. First, syndiotactic polystyrene (sPS) was modified by the Friedel-Crafts reaction to introduce chlorine; second, the chlorine groups were converted to nitroxide mediated groups by coupling with 1-hydroxy-2,2,6,6-tetramethyl-1-piperidinyloxy (TEMPO-OH). The resulting macroinitiator (sPS-TEMPO) for 'living' free radical polymerization was then heated in the presence of styrene and p-methylstyrene to form graft and block copolymers. We used the obtained copolymer and N-bromosuccinimide as brominating agent to achieve polymers with bromine groups. This brominated copolymer was used as a macroinitiator for polymerizing methyl methacrylate in the presence of the CuBr/bpy catalyst system. The formation of the graft and block copolymers was confirmed by DSC, ¹H NMR and FTIR spectroscopy. This approach using macroinitiators is an effective method for the preparation of new materials.

  18. University-Employer Cooperation

    Directory of Open Access Journals (Sweden)

    Erol Šehu

    2014-12-01

    Full Text Available University-employer cooperation is one of the most important forms of cooperation in the economy, needed for economic development and sustainable growth and has become a key emphasis in higher education policy in recent years. The main goal is to achieve an equal partnership between universities and employers aimed at strengthening of economic development at the national, regional and local level. This goal can be achieved through active support (in information and knowledge of local businesses and entrepreneurship in developing and realization of their ideas, and by linking students with their future employers, through various employer-seeking students associations and employers associations. Authors will analyze the university-employer cooperation in Poland, United Kingdom and Croatia and try to give an answer if the current cooperation is satisfying, and if is not, how it can be enhanced.

  19. Platelet--arterial synthetic graft interaction and its modification

    Energy Technology Data Exchange (ETDEWEB)

    Callow, A.D.; Connolly, R.; O' Donnell, T.F. Jr.; Gembarowicz, R.; Keough, E.; Ramberg-Laskaris, K.; Valeri, C.R.

    1982-11-01

    We compared the in vivo platelet reactivity of two commonly used clinical grafts, Dacron and expanded polytetrafluoroethylene (PTFE), with that of a control autogenous artery graft and assessed whether platelet reactivity was modified by the platelet-antiaggregating agent prostacyclin (PGI2) (epoprostenol). Grafts were randomly placed into the carotid arteries of 21 baboons. Platelets labeled with /sup 111/In were infused within one hour after implantation graft for gamma camera scanning of platelet uptake. The accumulation of platelets on Dacron grafts began almost immediately after injection and reached a peak after one to two hours. The PTFE and control autogenous artery grafts accumulated comparable small amounts of platelets. Prostacyclin was then infused in a second series of baboons with Dacron grafts, at a rate of 150 to 200 ng/kg/min. It prevented the usual platelet uptake when administered concomitant with graft implantation and reduced previously established platelet activity.

  20. Platelet--arterial synthetic graft interaction and its modification

    International Nuclear Information System (INIS)

    We compared the in vivo platelet reactivity of two commonly used clinical grafts, Dacron and expanded polytetrafluoroethylene (PTFE), with that of a control autogenous artery graft and assessed whether platelet reactivity was modified by the platelet-antiaggregating agent prostacyclin (PGI2) (epoprostenol). Grafts were randomly placed into the carotid arteries of 21 baboons. Platelets labeled with 111In were infused within one hour after implantation graft for gamma camera scanning of platelet uptake. The accumulation of platelets on Dacron grafts began almost immediately after injection and reached a peak after one to two hours. The PTFE and control autogenous artery grafts accumulated comparable small amounts of platelets. Prostacyclin was then infused in a second series of baboons with Dacron grafts, at a rate of 150 to 200 ng/kg/min. It prevented the usual platelet uptake when administered concomitant with graft implantation and reduced previously established platelet activity

  1. 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

  2. Manufacturing employment cycle

    OpenAIRE

    Claro, Sebastián

    2002-01-01

    The paper demonstrates that two relatively unknown features of the employment cycle in U.S. manufacturing industries can provide a clue to understanding the role of sectorial shocks in the evolution of aggregate employment. First, interindustry wage differentials rise in expansions and fall in contractions. Second, periods of increasing aggregate employment are associated with relatively good price and productivity shocks to capital-intensive sectors. The paper presents a simple general-equil...

  3. Grafting of 2-butenyl acrylate onto starch

    International Nuclear Information System (INIS)

    The monomer 2-butenyl acrylate was reacted with starch by exposure to either 60Co irradiation or ceric ion initiation. Monomer conversion in the presence of starch is greater than in the absence of starch, indicating that a starch initiating mechanism takes place for 60Co irradiated samples. Acetone extraction indicates little or no soluble homopolymer in the grafts. Portions of the samples soluble in dimethyl sulfoxide (DMSO) appear to be low-level 2-butenyl acrylate-grafted starch by infrared analysis. DMSO-insoluble portions (usually more than 50% of each sample) are somewhat more soluble in 1N NaOH at room temperature. This indicates that the 2-butenyl acrylate acts as an easily hydrolyzed crosslink for starch in samples containing as low as 5 wt% grafted poly

  4. Autologous miniature punch grafting in stable vitiligo

    Directory of Open Access Journals (Sweden)

    Rajagopal R

    2005-01-01

    Full Text Available Autologous miniature punch grafting with certain modifications was taken up in 54 sites in 30 patients with stable vitiligo for 6 months or more. The modifications were: (a use of same sized disposable punches for both donor and recipient areas except over convex body surfaces, (b use of Castraviejo?s scissors for harvesting donor grafts, (c use of medial side of thigh as donor site and (d not removing the primary dressing of the recipient site till 8 postoperaive day. The patients were given systemic PUVASOL after the procedure for a period of three months and mean pigment spread was noted at each site. Results showed that the extent of repigmentation varied among the recipient sites, the maximum being over upper eyelids, axillae and umbilicus. The modifications in the standard procedure were found to produce less complications, like cobblestoning, graft rejection.

  5. Meshed split skin graft for extensive vitiligo

    Directory of Open Access Journals (Sweden)

    Srinivas C

    2004-05-01

    Full Text Available A 30 year old female presented with generalized stable vitiligo involving large areas of the body. Since large areas were to be treated it was decided to do meshed split skin graft. A phototoxic blister over recipient site was induced by applying 8 MOP solution followed by exposure to UVA. The split skin graft was harvested from donor area by Padgett dermatome which was meshed by an ampligreffe to increase the size of the graft by 4 times. Significant pigmentation of the depigmented skin was seen after 5 months. This procedure helps to cover large recipient areas, when pigmented donor skin is limited with minimal risk of scarring. Phototoxic blister enables easy separation of epidermis thus saving time required for dermabrasion from recipient site.

  6. Functionalisation of PAA radiation grafted PVDF

    International Nuclear Information System (INIS)

    The covalent bonding of amino-terminated molecules was performed onto acrylic acid radiation induced grafting poly(vinylidene fluoride) (PVDF). The polymer was irradiated with different ionizing radiation: swift heavy ions or electrons. The polymerization of acrylic acid was then performed to confer to PVDF carboxyl groups suitable for condensation with the amino groups of the other molecule. Acrylic acid swelling of PVDF films was investigated as a function of temperature and monomer concentration in order to anticipate the best grafting conditions. Grafted and functionalized films were characterized using infrared spectroscopy (transmission and ATR), and weighing measurements. The PVDF-g-PAA films exhibit different structures depending on the monomer concentration. Immobilization of an amino-terminated molecule and a peptide onto PVDF was achieved using water soluble carbodiimide

  7. Revascularização miocárdica com artéria radial: influência da anastomose proximal na oclusão a médio e longo prazo / Coronary artery bypass grafting using the radial artery: influence of proximal anastomosis site in mid-term and long-term graft patency

    Scientific Electronic Library Online (English)

    Luciano Jannuzzi, Carneiro; Fernando, Platania; Luís Augusto Palma, Dallan; Luís Alberto Oliveira, Dallan; Noedir Antonio Groppo, Stolf.

    2009-03-01

    Full Text Available OBJETIVO: Determinar se o local da anastomose proximal apresenta influência ou não na perviedade a médio e longo prazo destes enxertos. MÉTODOS: Foram reestudados 123 pacientes, de um total de 481 operados com artéria radial (AR). A média de idade era de 58,8 + 10,4 anos. Noventa e seis (78,05%) pac [...] ientes foram operados com circulação extracorpórea (CEC). Considerando-se todos os enxertos, foram revascularizados 382 ramos coronários, média de 3,1 + 0,8 artérias por paciente. Desse total, 150 artérias foram revascularizadas com AR, sendo os ramos marginais esquerdos (ME) os mais prevalentes (48,67%). A anastomose proximal foi realizada na aorta em 50 pacientes (40,65%) e em "Y" com a artéria torácica interna esquerda (ATIE) ou direita (ATID) nos demais 73 (59,35%). No pós-operatório, os reestudos angiográficos tiveram período médio de 5,36 + 3,21 anos. Os dados foram divididos em duas categorias: anastomose proximal (aorta/"Y") e perviedade (enxerto ocluído/pérvio). Foi utilizado teste qui-quadrado para duas proporções, com intervalo de confiança (IC) de 95%. RESULTADOS: Dos 50 enxertos com anastomose na aorta, 42 (84%) apresentaram-se pérvios, contra oito (16%) ocluídos. Dos 73 enxertos em "Y", 59 (80,82%) apresentaram-se pérvios, contra 14 (19,18%) ocluídos. Comparando-se enxertos ocluídos e pérvios de ambas as técnicas, observou-se não haver diferença estatisticamente significativa entre as proporções (P=0,651, IC=95%). CONCLUSÃO: Conclui-se que, na utilização da AR como enxerto coronário, o local da anastomose proximal não interfere na obstrução e no fluxo do enxerto, a médio e longo prazo. Abstract in english OBJECTIVE: To determine whether the proximal anastomosis interferes or not in mid- and long-term patency of these grafts. METHODS: One hundred twenty-three out of 481 patients who had undergone surgery using radial artery (RA) were restudied. The mean age was 58.8 + 10.4 years. In 96 (78.05%) patien [...] ts the cardiopulmonary bypass (CPB) was used. Considering all surgical grafts, 382 coronary branches were grafted (mean, 3.1 + 0.8 arteries per patient). 150 of them used radial artery (RA), and the left marginal branches (LOM) were the most prevalent (48.67%). The proximal anastomosis was performed in the aorta in 50 (40.65%) patients and as an artificial "Y" composite graft with the left or right internal thoracic artery (LIMA/RITA) in 73 (59.35%). Postoperatively, coronary angiography studies were performed within a mean period of 5.36 + 3.21 years. The obtained data was divided into two categories: proximal anastomosis (aorta/composite) and patency (occluded/patent). A chi-square test was used to compare both proportions, within a 95% confidence interval (CI). RESULTS: From the 50 aorta-anastomosed grafts, 42 (84%) were patent and eight (16%) occluded. Regarding the 73 "Y" composite grafts, 59 (80.82%) were patent and 14 (19.18%) occluded. Comparing these proportions in both techniques, there was no statistically significant difference between them (P=0.651, CI=95%). CONCLUSION: The site of proximal anastomosis of the RA coronary grafts does not interfere in mid- and long-term graft occlusion and patency.

  8. High-Dose Intravenous Methylprednisolone for Hantavirus Cardiopulmonary Syndrome in Chile: A Double-Blind, Randomized Controlled Clinical Trial

    OpenAIRE

    Vial, Pablo A.; Valdivieso, Francisca; Ferres, Marcela; Riquelme, Raul; Rioseco, M. Luisa; Calvo, Mario; Castillo, Constanza; Di?az, Ricardo; Scholz, Luis; Cuiza, Analia; Belmar, Edith; Hernandez, Carla; Martinez, Jessica; Lee, Sang-joon; Mertz, Gregory J.

    2013-01-01

    We conducted a double-blind, placebo-controlled clinical trial to evaluate the efficacy of intravenous methylprednisolone for hantavirus cardiopulmonary syndrome in Chile between 2003 and 2010. Sixty of 66 enrollees had hantavirus confirmed. We observed no significant difference in primary efficacy or safety outcomes between the groups.

  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. Transfusion-Free Cardiac Reoperation in an 11-kg Jehovah's Witness Child by Use of a Minimized Cardiopulmonary Bypass Circuit

    OpenAIRE

    Huebler, Michael; Boettcher, Wolfgang; Koster, Andreas; Stiller, Brigitte; Kuppe, Hermann; Hetzer, Roland

    2007-01-01

    Herein, we describe the design of a perfusion system for a complex cardiovascular reoperation in an 11-kg Jehovah's Witness patient. The goal of safe, transfusion-free surgery was achieved chiefly by minimizing the priming volume of the cardiopulmonary bypass circuit to 200 mL while providing adequate flow and standard safety features.

  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. Prophylactic antibiotics prevent bacterial biofilm graft infection.

    Science.gov (United States)

    Bergamini, T M; Peyton, J C; Cheadle, W G

    1992-02-01

    Bacterial biofilm graft infection is due to prostheses colonization by Staphylococcus epidermidis, a pathogen frequently recovered from perigraft tissues of man during vascular procedures despite the use of asepsis and prophylactic antibiotics. The effect of preoperative intraperitoneal cefazolin, administered at a standard (15 or 30 mg/kg) and high (120 mg/kg) dose, on the prevention of bacterial biofilm infection was studied in a rat model. Seventy-four Dacron grafts, colonized in vitro with S. epidermidis to produce an adherent biofilm (3.19 +/- 0.71 x 10(7) colony-forming units/cm2 graft), were implanted in the dorsal subcutaneous tissue at 0.5, 2, and 4 hr after antibiotic administration. The study strain was a slime-producing clinical isolate with minimum inhibitory concentration (MIC) of 15-30 micrograms/ml to cefazolin. Subcutaneous tissue antibiotic levels were determined at each time interval. One week after implantation, the concentration of bacteria in the surface biofilm by quantitative agar culture was significantly decreased (P less than 0.05) only for grafts implanted when antibiotic tissue levels were greater than or equal to the MIC of the study strain. The result of no growth by biofilm broth culture was significantly achieved (P less than 0.01) only for grafts implanted 0.5 hr after high dose cefazolin, in which the tissue antibiotic level was above the MIC of the study strain. Antibiotics can markedly reduce the bacteria concentration of a prosthetic surface biofilm. The effectiveness of prophylactic antibiotics on the prevention of graft infection is dependent upon maintaining an adequate antibiotic level in the perigraft tissues for the duration of the procedure. PMID:1346815

  14. Synthesis and Modification of Polypropylene by Radiation-induced Grafting

    OpenAIRE

    Feng Yuan; Junfu Wei; En-qi Tang; Kong-yin Zhao; Yang Xue

    2009-01-01

    Polypropylene fiber (PP) was radiation-induced graft polymerization of lauryl acrylate (LA) and butyl acrylate (BA)using a 60Co gamma radiation source. Then the grafted polypropylene fiber was characterized by a Fourier transforminfrared (FT-IR) spectrometer, Scanning Electron Microscopy (SEM), differential scanning calorimetry (DSC) andthermogravimetry (TG), which indicated that LA and BA have been grafted onto PP. The article focused on somefactors that influenced on the graft degree, such ...

  15. Side Grafting and Various Scion Parts Interaction in Guava

    OpenAIRE

    Samiullah; Syed Asghar Hussain; Abdur Rab; Haji Mohammad

    2004-01-01

    A research project "Side grafting and various scion parts interaction in guava" was carried out at Government Fruit Nursery Farm, Jabban, Dargai Malakand Agency during 2002-2003. Three scion parts i.e. Apical, Middle, Basal and two grafting methods i.e. side veneer and side T. grafting were studied. The experiment was laid out according to Randomized Complete Block design with two factorial arrangement. Maximum graft take success (77.5%), survival percentage (27.9) and percent saleable plants...

  16. Plasma Induced Grafting of PMMA onto Titanium Dioxide Powder

    Science.gov (United States)

    Zhong, Shaofeng; Meng, Yuedong; Ou, Qiongrong; Xu, Xu

    2005-08-01

    Grafting of polymer of methyl methacrylate (PMMA) onto titanium dioxide powder is investigated in this paper. The graft polymerization reaction is induced by dielectric-barrier-discharge produced N2 plasma treatment of titanium dioxide surfaces. IR, XPS and TGA results show that PMMA is grafted onto the surfaces of titanium dioxide powder. And crystal structure of the titanium dioxide powder observed with XRD spectra is unchanged after plasma graft polymerization.

  17. Simultaneous angioplasty and intraluminal grafting with the Palmaz expandable intraluminal graft

    International Nuclear Information System (INIS)

    The authors describe their experience with the Palmaz expandable intraluminal graft (EIG) in a Flemish giant rabbit model of atherosclerosis. Rabbits were rendered atherosclerotic by means of a combination of desiccation endothelial injury of the femoral arteries and atherogenic diet (2% cholesterol, 6% peanut oil). Via carotic cutdown, EIGs mounted on small-vessel angioplasty balloons (? 3.5 mm in diameter) were placed in stenotic femoral arteries. The feasibility of simultaneous percutaneous transluminal angioplasty and intraluminal grafting was assessed. Angiograms revealed dramatic improvement in vessel diameters. Angiographic and pathologic findings are presented, and the concept of intraluminal grafting with the Palmaz EIG is reviewed

  18. Employment Inequality, Employment Regulation, and Social Welfare

    OpenAIRE

    Borooah, Vani

    2002-01-01

    This paper develops a model which explains the unequal employment outcomes of two groups - defined as their, respective, likelihoods of successfully filling job vacancies - in terms of disparities in their access to job networks. This disparity arises because a proportion of vacancies are filled using informal methods so that, as a first step, information about vacancies only becomes available through word-of-mouth; as a second step, appointments are based on the recommendations of existing e...

  19. Cell subpopulations in failed human corneal grafts

    Science.gov (United States)

    Kuffova, L.; Lumsden, L.; Forrester, J.; Filipec, M.

    1999-01-01

    BACKGROUND/AIMS—Inflammatory cells and antigen presenting cells (APC) are not present under normal circumstances in the centre of the healthy cornea. The purpose of this study was to investigate and phenotype the inflammatory cell populations, particularly with reference to T cell subpopulations and macrophages, and to localise dendritic cells (DC) and other MHC class II positive cells in three groups of grafted corneas: rejected non-inflamed, rejected inflamed grafts, and control dystrophic explants.?METHODS—15 corneal buttons removed during keratoplasty from non-inflamed "quiet" previously grafted corneas, five inflamed corneas requiring urgent regrafting for "graft melting" (in "high risk" corneas), and 10 control dystrophic opaque corneas explanted during their first graft procedure were examined. Cryosections of corneas were immunostained with a panel of monoclonal antibodies (mAb) against CD3, CD4, CD8, CD14, CD25, CD68, HLA-DP, and HLA-DR molecules using the StreptABC method. DC were detected by dual immunostaining as CD1a+ and MHC class II+ and CD19?. Cell densities in immunostained tissue sections were evaluated using a scale from 0 to +4.?RESULTS—Immunostaining in control dystrophic corneas was negative for all antibodies. A moderate to high density of CD8+, CD14+, and CD68+ cells was observed in the majority of rejected non-inflamed as well as in rejected inflamed corneal buttons. Strong positivity for HLA-DP and HLA-DR molecules in the epithelium, stroma, and endothelium was also demonstrated. Weak positivity for CD4 and CD25 was observed in six of 15 and 11 of 15 rejected corneas, respectively. The presence of dendritic cells in the basal layer of the epithelium and in the stroma was observed in 50% of the grafts.?CONCLUSIONS—A high frequency of macrophages, the presence of DC in the explants, and strong expression of HLA-DP and HLA-DR molecules on resident cells are characteristics of rejected corneal allografts, whether actively inflamed or not. The presence of DC in the stroma of the grafted cornea suggests that they may be mainly responsible for T cell activation and graft rejection since DC are known to be a 100-fold more potent than macrophages as APC.?? PMID:10574815

  20. Radiation grafting of acrylic acid onto fluorine-containing polymers. I. Kinetic study of preirradiation grafting onto poly(tetrafluoroethylene)

    International Nuclear Information System (INIS)

    Preirradiation grafting of acrylic acid onto poly(tetrafluoroethylene) film was studied. The trapped radicals formed upon irradiation are able to induce graft polymerization under appropriate conditions. The influence of the grafting conditions were analyzed kinetically. The grafting reaction begins close to the film surface and proceeds into the center with progressive monomer diffusion through the grafted layer. The dependences of the grafting rate on preirradiation dose and monomer concentration were found to be 0.2 and 1.1 order, respectively. The overall activation energies for this grafting were calculated to be 15.2 and 4.8 kcal/mol below and above 350C, respectively. The relationship between the grafting rate and film and film thickness gave negative first-order dependence

  1. Immobilization of urease on grafted starch by radiation method

    International Nuclear Information System (INIS)

    The acrylamide was grafted by radiation onto starch which is a kind polymeric biomaterial. The urease was immobilized on the grafted starch. Some experiments to observe the quantitative relationships between the percent graft and the activity of immobilized enzyme were determined. The enzyme activity was maintained by more than seven batch enzyme reactions. (Author)

  2. Immobilization of urease on grafted starch by radiation method

    International Nuclear Information System (INIS)

    The acrylamide was grafted by radiation onto starch which is a kind of polymeric biomaterial. The urease was immobilized on the grafted starch. Some experiments to observe the quantitative relationships between the percent graft and the activity of immobilized enzyme were determined. The enzyme activity was maintained by more than seven batch enzyme reactions. (author)

  3. Polymers grafted by ionizing radiations. Regulated desorption of fertilizers

    International Nuclear Information System (INIS)

    Study and development of copolymers for progressive liberation of fertilizers in the soil through a membrane. These copolymers are obtained by grafting a hydrophilic acrylic monomer on a hydrophobic polymer (polyolefine). Desorption of a fertilizer through a membrane of graft polymer as a function of time and grafting ratio was tested both in the laboratory and by plant growing

  4. Revascularisation of fresh compared with demineralised bone grafts in rats

    DEFF Research Database (Denmark)

    Solheim, E; Pinholt, E M

    2001-01-01

    Revascularisation of bone grafts is influenced by both the anatomical origin and the pre-implantation processing of the graft. We investigated the revascularisation by entrapment of 141Ce (cerium)-labelled microspheres in large, fresh and demineralised syngeneic grafts of predominantly cancellous (iliac bone) or cortical (tibial diaphysis) bone three weeks after heterotopic implantation in rats. The mean (SD) 141Ce deposition index (counts per minute (cpm) of mg recovered implant/cpm of mg host iliac bone) was higher in fresh iliac bone grafts, 0.98 (0.46) compared to that of demineralised iliac bone, 0.32 (0.20), p <0.001, and fresh tibial bone grafts, 0.51 (0.27), p = 0.007. We found no significant difference in the mean 141Ce deposition index between fresh tibial bone grafts and demineralised tibial bone grafts, 0.35 (0.42), p = 0.4, or between demineralised tibial grafts and demineralised iliac bone grafts, p = 0.8. The results suggest that whereas fresh cancellous grafts are revascularised more completely than fresh cortical grafts, there is no difference in the revascularisation of demineralised cancellous and cortical grafts. In addition, fresh cancellous bone is revascularised more completely than demineralised cancellous bone, whereas there is no difference between fresh and demineralised cortical bone.

  5. The Ultimate Goal: Employment.

    Science.gov (United States)

    Ross, Nancy; Ierullo, Teresa

    1993-01-01

    Describes a program designed to help prepare learners for entry into the Canadian workplace. The article delineates an "English and Employment" class developed as a result of a concern expressed by 25 male students urgently needing employment. The curriculum included a self-awareness component, resume writing, job search strategies, and interview…

  6. Employment Retention Policy

    OpenAIRE

    Fox, E; Stafford, B.

    2007-01-01

    This Report investigates the potential for a statutory model of employment retention leave. A Private Members Bill (HC Bill 2006-07) [79] currently in progress through Parliament would, if enacted, offer disabled employees the right to paid leave for employment assessment, rehabilitation or re-training.

  7. Homosexual Discrimination in Employment

    Science.gov (United States)

    Siniscalco, Gary R.

    1976-01-01

    Recent developments in homosexual activism regarding employment problems in both the public and private sector are analyzed. Focus is on the law governing private employment, where homosexuals are afforded the least legal protection against discrimination. Available from: the University of Santa Clara, Santa Clara, California 95053. (LBH)

  8. Employment Characteristics of Families

    Science.gov (United States)

    The Bureau of Labor Statistics site offers data on the employment characteristics of American families. The statistics include data on employment and unemployment in families by race, relationship, sex, marital status, presence of children in the family, and presence of children under three, among others. The data can be accessed from a table of contents or reviewed in an extensive news release.

  9. Does transfusion of residual cardiopulmonary bypass circuit blood increase postoperative bleeding? A prospective randomized study in patients undergoing on pump cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Duara Rajnish

    2008-01-01

    Full Text Available Objective: Homologous blood transfusion after open heart surgery puts a tremendous load on the blood banks. This prospective randomized study evaluates the efficacy of infusing back residual cardiopulmonary bypass (CPB circuit i.e., pump blood as a means to reduce homologous transfusion after coronary artery bypass surgery (CABG and whether its use increases postoperative drainage. Materials and Methods: Sixty-seven consecutive patients who underwent elective CABGs under CPB were randomized into 2 groups: (1 cases where residual pump blood was used and (2 controls where residual pump blood was not used. Patients were monitored for hourly drainage on the day of surgery and the 1 st postoperative day and the requirements of homologous blood and its products. Data were matched regarding change in Hemoglobin, Packed Cell Volume and coagulation parameters till 1st postoperative day. All cases were followed up for three years. Results: There was a marginal reduction in bleeding pattern in the early postoperative period in the cases compared to controls. The requirement of homologous blood and its products were also reduced in the cases. Conclusions: The use of CPB circuit blood is safe in the immediate postoperative period. The requirement of homologous blood transfusion can come down if strict transfusion criteria are maintained.

  10. Effect of age on cerebral blood flow during hypothermic cardiopulmonary bypass

    International Nuclear Information System (INIS)

    Cerebral blood flow was measured in 20 patients by xenon 133 clearance methodology during nonpulsatile hypothermic cardiopulmonary bypass to determine the effect of age on regional cerebral blood flow during these conditions. Measurements of cerebral blood flow at varying perfusion pressures were made in patients arbitrarily divided into two age groups at nearly identical nasopharyngeal temperature, hematocrit value, and carbon dioxide tension and with equal cardiopulmonary bypass flows of 1.6 L/min/m2. The range of mean arterial pressure was 30 to 110 mm Hg for group I (less than or equal to 50 years of age) and 20 to 90 mm Hg for group II (greater than or equal to 65 years of age). There was no significant difference (p = 0.32) between the mean arterial pressure in group I (54 +/- 28 mm Hg) and that in group II (43 +/- 21 mm Hg). The range of cerebral blood flow was 14.8 to 29.2 ml/100 gm/min for group I and 13.8 to 37.5 ml/100 gm/min for group II. There was no significant difference (p = 0.37) between the mean cerebral blood flow in group I (21.5 +/- 4.6 ml/100 gm/min) and group II (24.3 +/- 8.1 ml/100 gm/min). There was a poor correlation between mean arterial pressure and cerebral blood flow in both groups: group I, r = 0.16 (p = 0.67); group II, r = 0.5 (p = 0.12). In 12 patients, a second cerebral blood flow measurements was taken to determine the effect of mean arterial pressure on cerebral blood flow in the individual patient. Changes in mean arterial pressur patient. Changes in mean arterial pressure did not correlate with changes in cerebral blood flow (p less than 0.90). We conclude that age does not alter cerebral blood flow and that cerebral blood flow autoregulation is preserved in elderly patients during nonpulsatile hypothermic cardiopulmonary bypass

  11. Aortic reconstruction with bovine pericardial grafts Reconstrução aórtica com condutos de pericárdio bovino

    Directory of Open Access Journals (Sweden)

    Lindemberg Mota Silveira

    2003-10-01

    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.INTRODUÇÃO: Os condutos de pericárdio bovino corrugado, processados em glutaraldeído, têm sido cada vez mais utilizados em cirurgia cardíaca para reconstrução da aorta. Têm constituído alternativa ao uso de outros materiais, com custo aceitável e com grande disponibilidade de formas e tamanhos. OBJETIVO: Analisar os resultados obtidos com o uso destes condutos de pericárdio bovino em operações de reconstrução aórtica, especialmente em relação a complicações tardias. MÉTODO: Estudo retrospectivo com 57 pacientes operados entre Janeiro de 1995 e Janeiro de 2002 submetidos aa reconstrução aórtica com uso de condutos de pericárdio bovino. Destes, 29 (50,8% foram operados em condições de urgência ou emergência (predominantemente dissecções agudas de aorta Stanford A e 28 em situações eletivas. Cinqüenta e quatro pacientes foram submetidos a esternotomia e circulação extracorpórea com abordagem da aorta ascendente com parada circulatória total e hipotermia profunda nas dissecções agudas e nos aneurismas de arco aórtico. Em três pacientes foi realizada toracotomia, para troca da aorta descendente (dois pacientes e aortoplastia com "patch" (um paciente. RESULTADOS: A mortalidade hospitalar foi de 17,5%, sendo 7% nos eletivos e 27,5% nas urgências. O tempo de seguimento foi de 24,09 meses (intervalo de confiança 18,5:29,8 meses e a sobrevida livre de complicações relacionadas aos condutos foi de 92,3% (EP±10,6 meses. Dois pacientes evoluíram com aneurisma tóraco-abdominal extenso secundário à dissecção de aorta que se esxtendia até as artérias ilíacas e um faleceu por endocardite na evolução tardia. Um paciente submetido a aortoplastia em aorta descendente evoluiu 42 meses após com dilatação local, sendo reoperado. Todos os demais pacientes encontram-se assintomáticos e reavaliados periodicamente por métodos de imagem, sem apresentarem alterações. CONCLUSÕES: O resultado pós-operatório foi adequado com índices de sobrevida adequados e compatíveis com a literatura. O uso de condutos de pericárdio bovino em operações de reconstrução aórtica se mostrou exeqüível e seguro, face ao baixo índice de complicações relacionadas ao material.

  12. Aortic reconstruction with bovine pericardial grafts / Reconstrução aórtica com condutos de pericárdio bovino

    Scientific Electronic Library Online (English)

    Lindemberg Mota, Silveira; Orlando, Petrucci Jr; Pedro Paulo Martins de, Oliveira; Reinaldo Wilson, Vieira; Domingo Marcolino, Braile.

    2003-10-01

    Full Text Available INTRODUÇÃO: Os condutos de pericárdio bovino corrugado, processados em glutaraldeído, têm sido cada vez mais utilizados em cirurgia cardíaca para reconstrução da aorta. Têm constituído alternativa ao uso de outros materiais, com custo aceitável e com grande disponibilidade de formas e tamanhos. OBJE [...] TIVO: Analisar os resultados obtidos com o uso destes condutos de pericárdio bovino em operações de reconstrução aórtica, especialmente em relação a complicações tardias. MÉTODO: Estudo retrospectivo com 57 pacientes operados entre Janeiro de 1995 e Janeiro de 2002 submetidos aa reconstrução aórtica com uso de condutos de pericárdio bovino. Destes, 29 (50,8%) foram operados em condições de urgência ou emergência (predominantemente dissecções agudas de aorta Stanford A) e 28 em situações eletivas. Cinqüenta e quatro pacientes foram submetidos a esternotomia e circulação extracorpórea com abordagem da aorta ascendente com parada circulatória total e hipotermia profunda nas dissecções agudas e nos aneurismas de arco aórtico. Em três pacientes foi realizada toracotomia, para troca da aorta descendente (dois pacientes) e aortoplastia com "patch" (um paciente). RESULTADOS: A mortalidade hospitalar foi de 17,5%, sendo 7% nos eletivos e 27,5% nas urgências. O tempo de seguimento foi de 24,09 meses (intervalo de confiança 18,5:29,8 meses) e a sobrevida livre de complicações relacionadas aos condutos foi de 92,3% (EP±10,6 meses). Dois pacientes evoluíram com aneurisma tóraco-abdominal extenso secundário à dissecção de aorta que se esxtendia até as artérias ilíacas e um faleceu por endocardite na evolução tardia. Um paciente submetido a aortoplastia em aorta descendente evoluiu 42 meses após com dilatação local, sendo reoperado. Todos os demais pacientes encontram-se assintomáticos e reavaliados periodicamente por métodos de imagem, sem apresentarem alterações. CONCLUSÕES: O resultado pós-operatório foi adequado com índices de sobrevida adequados e compatíveis com a literatura. O uso de condutos de pericárdio bovino em operações de reconstrução aórtica se mostrou exeqüível e seguro, face ao baixo índice de complicações relacionadas ao material. Abstract in english 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 pericardi [...] al 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.

  13. Long-term results after vascularised bone graft as treatment of Kienböck disease

    DEFF Research Database (Denmark)

    Kirkeby, Lone; von Varfalva Palffy, Lena

    2013-01-01

    Abstract The aim of this study was to present the long-term results in a small series of patients with Kienböck disease treated with a pedicled vascularised bone graft from the 4/5 extensor compartment of the distal radius as the only surgical treatment. In the period 2002-2006, five patients, three men and two women, mean age 41 years (22-54) were operated on using a pedicled vascularised bone graft from the 4/5 extensor compartment of the distal radius as described by Sheetz et al. Four patients were staged as Lichtman stage 2 and one as Lichtman stage 3. At the follow-up examination with radiographs and clinical examination at a mean of 7.4 years (5-9) after the operation, they all stated that they were satisfied with the operation. None of the patients had any further surgery in the observation period. Four patients were fully employed, and only one had changed employment due to his hand. The last patient was on a medical pension due to other medical causes. In all patients, no sign of progression was found of the radiological changes in the lunate and in all patients the arches of Gilula were unchanged without signs of carpal collapse. So, in this small series, a pedicled vascularised bone graft from the 4/5 extensor compartment of the distal radius as the only surgical treatment provided good long-term results in patients with stage 2 and 3 Kienböck disease.

  14. MICELLIZATION BEHAVIOR COMPARISION OF POLYPEPTIDE GRAFT COPOLYMER AND BLOCK-GRAFT COPOLYMER IN ETHANOL

    Scientific Electronic Library Online (English)

    GUO-QUAN, ZHU.

    2010-06-01

    Full Text Available Poly(ethylene glycol)-block-poly(?-benzyl L-glutamate)-graft-poly(ethylene glycol) (PEG-b-PBLG-g-PEG) copolymer and poly(?-benzyl L-glutamate)-graft-poly(ethylene glycol) (PBLG-graft-PEG) copolymer were synthesized by the ester exchange reaction of PEG chain with PBLG-block-PEG copolymer and PBLG ho [...] mopolymer, respectively. The micellization behaviors of PEG-b-PBLG-g-PEG and PBLG-graft-PEG in ethanol were investigated by transmission electron microscopy (TEM) and viscometry. Effects of both the introduction of PBLG homopolymer and the change of testing temperature on the critical aggregation concentration (CAC) of the two polypeptide copolymers in ethanol were mainly studied. Nuclear magnetic resonance (NMR) spectroscopy and fourier transform infrared spectroscopy (FTIR) were used to research the chain conformations of polypeptide segments of the two polypeptide copolymers in solvent and in the solid state, respectively.

  15. Labial fat pad grafts (modified Martius graft) in complex perianal fistulas.

    OpenAIRE

    Pinedo, G.; PHILLIPS, R

    1998-01-01

    Complex perianal fistulas may at times be very difficult to treat. New vascularised tissue can reach the perineum from leg muscles and the omentum. A less well-known source is the labial fat tissue (modified Martius graft) which has a robust posterolateral pedicle and which can be useful as an adjunctive technique for high anterior anal and rectovaginal fistulas. Between November 1993 and July 1997, eight women (age range 18-55 years) underwent modified Martius grafting, six of the eight havi...

  16. Graft-versus-host disease and graft-versus-tumor effects after allogeneic hematopoietic cell transplantation

    DEFF Research Database (Denmark)

    Storb, Rainer; Gyurkocza, Boglarka

    2013-01-01

    We designed a minimal-intensity conditioning regimen for allogeneic hematopoietic cell transplantation (HCT) in patients with advanced hematologic malignancies unable to tolerate high-intensity regimens because of age, serious comorbidities, or previous high-dose HCT. The regimen allows the purest assessment of graft-versus-tumor (GVT) effects apart from conditioning and graft-versus-host disease (GVHD) not augmented by regimen-related toxicities.

  17. Synthesis of Polymer Grafted Magnetite Nanoparticle with the Highest Grafting Density via Controlled Radical Polymerization

    OpenAIRE

    Babu Kothandapani; Dhamodharan Raghavachari

    2009-01-01

    Abstract The surface-initiated ATRP of benzyl methacrylate, methyl methacrylate, and styrene from magnetite nanoparticle is investigated, without the use of sacrificial (free) initiator in solution. It is observed that the grafting density obtained is related to the polymerization kinetics, being higher for faster polymerizing monomer. The grafting density was found to be nearly 2 chains/nm2for the rapidly polymerizing benzyl methacrylate. In contrast, for the less rapidly polymerizing styren...

  18. Correction of Short Nose Deformity Using a Septal Extension Graft Combined with a Derotation Graft

    OpenAIRE

    Paik, Moo Hyun; Chu, Lo Shui

    2014-01-01

    In patients having a short nose with a short septal length and/or severe columellar retraction, a septal extension graft is a good solution, as it allows the dome to move caudally and pushes down the columellar base. Fixing the medial crura of the alar cartilages to a septal extension graft leads to an uncomfortably rigid nasal tip and columella, and results in unnatural facial animation. Further, because of the relatively small and weak septal cartilage in the East Asian population, undercor...

  19. Photoactivated surface grafting from PVDF surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Berthelot, Thomas, E-mail: thomas.berthelot@cea.fr [Chemistry of Surfaces and Interfaces, CEA Saclay, DSM/IRAMIS/SPCSI, F-91191, Gif-sur-Yvette Cedex (France); Le, Xuan Tuan; Jegou, Pascale; Viel, Pascal [Chemistry of Surfaces and Interfaces, CEA Saclay, DSM/IRAMIS/SPCSI, F-91191, Gif-sur-Yvette Cedex (France); Boizot, Bruno [Laboratory of Irradiated Solids UMR 7642 CEA/CNRS/Ecole Polytechnique, CEA-DSM/IRAMIS LSI, Ecole Polytechnique, F-91128, Palaiseau Cedex (France); Baudin, Cecile; Palacin, Serge [Chemistry of Surfaces and Interfaces, CEA Saclay, DSM/IRAMIS/SPCSI, F-91191, Gif-sur-Yvette Cedex (France)

    2011-09-01

    Economic and easy methods to tune surface properties of polymers as Poly(vinylidene fluoride) (PVDF) without altering bulk properties are of major interest for different applications as biotechnological devices, medical implant device... UV irradiation appears as one of the simplest, easy and safe method to modify surface properties. In the case of self-initiated grafting, it is generally assumed that the pre-treatment of the PVDF surface with UV irradiation can yield alkyl and per-oxy radicals originating from breaking bonds and capable of initiating the subsequent surface grafting polymerizations. Surprisingly, the present work shows that it is possible to obtain polymer grafting using low energetic UV-A irradiation (3.1-3.9 eV) without breaking PVDF bonds. An EPR study has been performed in order to investigate the nature of involved species. The ability of the activated PVDF surface to graft different kinds of hydrophilic monomers using the initiated surface polymerization method has been tested and discussed on the basis of ATR FT-IR, XPS and NMR HRMAS results.

  20. Management of Peyronie's Disease by Dermal Grafting

    Directory of Open Access Journals (Sweden)

    Hamid Reza Nasseh

    2004-06-01

    Full Text Available Purpose: To evaluate the results of plaque excision and dermal grafting in Peyronie’s disease.Materials and Methods: Twenty seven patients were scheduled to undergo plaque excision and dermal grafting for Peyronie’s disease. Potency, bending of erected penis, and having painful erection were evaluated in patients before and after operation. To evaluate erectile dysfunction, we used International Index of Erectile Function (IIEF by interviewing the patients and filling questionnaires by their partners. Doppler ultrasonography was used to determine the vascular competence of penis before and after operation in 15 patients. Results: The disease was more prevalent between the ages of 40 and 60 years. Plaques were located as follows: dorsal in 18, right lateral in 6 and left lateral in 3. Mean plaque size was 11 (range 5 to 18 mm. After plaque excision and dermal grafting, penile deformity, erectile dysfunction, and painful erection had remained yet in 4 (15% out of 27, 3 (16% out of 19, and 3 (14% out of 22, respectively. Doppler ultrasonographic study in 15 patients revealed improvement in peak systolic velocity (P Conclusion: This procedure showed significant improvement in penile deformity (85% of cases, erectile dysfunction (84% of cases and painful erection (86% of cases. We recommend plaque excision and dermal grafting as an effective procedure in treating Peyronie’s disease.

  1. [Modified endothelial cells in graft vasculopathy].

    Science.gov (United States)

    Haverich, A; Kallenbach, K

    2001-12-01

    Occlusion of venous bypass grafts after coronary revascularization grafting represents the main reason for re-do operations. Arterial pressure as well as mechanical injury of the venous wall lead to endothelial dysfunction, causing intimal hyperplasia with luminal stenosis and eventually occlusion. In the transplanted heart, coronary artery disease limits the long-term success of cardiac transplantation. The disease is characterized by the interaction of activated immunologic cells and donor epicardical and microvascular endothelium. The ex vivo modification of endothelial cells may offer a therapeutic option to overcome both kinds of graft vasculopathy. Seeding of human endothelial cells on artificial and bioartificial acellularized vessel matrices has proven possible. The use of xenogenic matrices initially acellularized and recellularized with autologic endothelial cells and myofibroblasts may help to overcome the lack of vascular and valvular grafts with long durability. In addition, gene therapeutic methods to modify the function of such endothelial cells may offer a new therapeutic strategy, such as over-expression of nitric monoxide or inhibition of matrix metalloprotinases. First results of large animal studies show promising results and may lead to the first clinical trials in the near future. PMID:11826835

  2. Plant grafting: making the right connections.

    Science.gov (United States)

    Kümpers, Britta M C; Bishopp, Anthony

    2015-05-18

    The cultivation of many crops relies on the formation of chimeric plants, where roots from one variety are grafted onto the shoot of another. A new study uncovers how two plants connect and demonstrates that the root and shoot do not contribute equally to the union. PMID:25989079

  3. Cellular grafts in management of leucoderma

    Directory of Open Access Journals (Sweden)

    Mysore Venkataram

    2009-01-01

    Full Text Available Cellular grafting methods constitute important advances in the surgical management of leucoderma. Different methods such as noncultured epidermal suspensions, melanocyte cultures, and melanocyte-keratinocyte cultures have all been shown to be effective. This article reviews these methods.

  4. Photoactivated surface grafting from PVDF surfaces

    International Nuclear Information System (INIS)

    Economic and easy methods to tune surface properties of polymers as Poly(vinylidene fluoride) (PVDF) without altering bulk properties are of major interest for different applications as biotechnological devices, medical implant device... UV irradiation appears as one of the simplest, easy and safe method to modify surface properties. In the case of self-initiated grafting, it is generally assumed that the pre-treatment of the PVDF surface with UV irradiation can yield alkyl and per-oxy radicals originating from breaking bonds and capable of initiating the subsequent surface grafting polymerizations. Surprisingly, the present work shows that it is possible to obtain polymer grafting using low energetic UV-A irradiation (3.1-3.9 eV) without breaking PVDF bonds. An EPR study has been performed in order to investigate the nature of involved species. The ability of the activated PVDF surface to graft different kinds of hydrophilic monomers using the initiated surface polymerization method has been tested and discussed on the basis of ATR FT-IR, XPS and NMR HRMAS results.

  5. Interposition Grafting of Large Extracranial Carotid Aneurysm

    OpenAIRE

    Huyzer, Marlous; Reijnen, Michel M. P. J.; Sybrandy, Johannes E. M.; Buth, Jacob; Zeebregts, Clark J.

    2011-01-01

    Extracranial carotid aneurysms are a rare entity and carry an inherent risk of thromboembolic complications. Treatment options consist of endovascular and conventional surgical techniques. We describe the cases of 3 patients who were treated with an interposition graft for a large extracranial carotid aneurysm.

  6. Fatal Saccharomyces Cerevisiae Aortic Graft Infection

    Science.gov (United States)

    Meyer, Michael (Technical Monitor); Smith, Davey; Metzgar, David; Wills, Christopher; Fierer, Joshua

    2002-01-01

    Saccharomyces cerevisiae is a yeast commonly used in baking and a frequent colonizer of human mucosal surfaces. It is considered relatively nonpathogenic in immunocompetent adults. We present a case of S. cerevisiae fungemia and aortic graft infection in an immunocompetent adult. This is the first reported case of S. cerevisiue fungemia where the identity of the pathogen was confirmed by rRNA sequencing.

  7. Stretch Polytetrafluoroethylene Grafts for Hemodialysis Angioaccess: Three-year Experience

    Directory of Open Access Journals (Sweden)

    Al Dayel Adel

    2001-01-01

    Full Text Available We report the results of 90 stretch polytetrafluoroethylene (PTFE grafts in 78 chronic renal failure patients over a 3-year period from 1995-1998. The grafts were used as primary access in 15% of the patients. The cumulative patency was 63.3% and there were no complications in 48.8% of the cases. Infection was encountered in 15.5% and thrombosis in 31.1% of the grafts. Intimal hyperplasia, venous anastomotic stenosis, improper puncture technique and subclavian vein stenosis were the major causes of failure of grafts. We conclude that stretch PTFE grafts as angioaccesses may provide good patency and durability.

  8. Use of Trellis thrombectomy system in acute aortofemoral graft occlusion.

    Science.gov (United States)

    Hanna, Elias B; Gupta, Raghav; Hennebry, Thomas A

    2010-05-01

    Acute aortofemoral graft occlusion is often effectively treated with endovascular therapy but a substantial proportion of patients experience failure or complications of this therapy, and most of them require definitive surgery for the underlying inflow, outflow, or graft disease. We describe a case of an aortofemoral graft occlusion that was successfully treated with the Trellis thrombectomy-thrombolysis system (Covidien, Dublin, Ireland). Subsequent stenting of the graft obviated the need for a definitive graft revision surgery. The Trellis system combines mechanical and local pharmacologic lysis of the thrombus, with more rapid and more effective thrombus dissolution and theoretically less risk of systemic dispersion of the thrombolytic agent and less bleeding. PMID:20155799

  9. Dynamics of graft formation in fruit trees: a review.

    Directory of Open Access Journals (Sweden)

    GK Mahunu

    2013-05-01

    Full Text Available This review paper comprehensively discussed the dynamics of graft union formation in fruit trees. Histological studies confirmed graft union is a continuous process and reliable indicators of graft-compatibility are not visible. Although initiation of scion bud development is signs of graftformation processesbut early callus formation determines subsequent survival of scion prior to cambial and vascular connectivity. Process of graft union formation is similar in most plants with few variations in days to completion. Factors attributed to graft-incompatibility or otherwise have been mentioned whiles research should also target specific tropical plants.

  10. Arterial repair of the lower limbs: prevention of prosthetic grafts occlusion by LMW-heparin.

    Science.gov (United States)

    Benedetti-Valentini, F; Irace, L; Gattuso, R; Ciocca, F; Aracu, A; Intrieri, F; Marini, P; Massa, R; Gossetti, B

    1988-01-01

    The postoperative thrombosis of prosthetic grafts may be due to many factors: technical errors, poor run-off, prosthetic material, graft length, trauma by subcutaneous tunnellization or repeated microtrauma across the joint areas, evolution of atherosclerotic lesions, emorheological changes. In 50 patients submitted to surgical arterial repair of the lower limbs, we have employed 8,000 I.U. AXa/daily of LMW-Heparin, injected subcutaneously for 6 months after the operations to prevent immediate and late thrombosis. During the follow-up, one patient died, four stopped any treatment and in two the medication was changed. Hence our results are based on 43 cases: 10 patients operated upon by aorto-femoral bypass, 19 femoro-popliteal and 14 extra-anatomical procedures. During the follow-up all the patients were investigated by ultrasounds (pressure measurement, waveform analysis and duplex scanning echotomography); moreover 13/43 (30%) were studied by angioscintigraphy and 11/43 (25.5%) by a conventional or digital subtraction angiography. Thrombosis of the grafts at one year term occurred in none aorto-femoral, in one femoro-popliteal (5.2%) and in one extra-anatomical bypass (7.1%). This figure compares favourably with the results obtained in our experience in the patients treated by a variety of drugs. In such group the incidence of occlusion is 3.9% in aorto-femoral, 9.3% in femoro-popliteal and 11% in extra-anatomical grafts. Those results emphasize the possibility to improve the patency of the grafts in the arterial repair of the lower limbs by LMW-Heparin overall in femoro-popliteal and extra-anatomical areas. PMID:2850324

  11. In vivo applications of electrospun tissue-engineered vascular grafts: a review.

    Science.gov (United States)

    Rocco, Kevin A; Maxfield, Mark W; Best, Cameron A; Dean, Ethan W; Breuer, Christopher K

    2014-12-01

    There is great clinical demand for synthetic vascular grafts with improved long-term efficacy. The ideal vascular conduit is easily implanted, nonthrombogenic, biocompatible, resists aneurysmal dilatation, and ultimately degrades or is assimilated as the patient remodels the graft into tissue resembling native vessel. The field of vascular tissue engineering offers an opportunity to design the ideal synthetic graft, and researchers have evaluated a variety of methods and materials for use in graft construction. Electrospinning is one method that has received considerable attention within tissue engineering for constructing so-called tissue scaffolds. Tissue scaffolds are temporary, porous structures which are commonly composed of bioresorbable polymers that promote native tissue ingrowth and have degradation kinetics compatible with a patient's rate of extracellular matrix production in order to successfully transit from synthetic conduits into neovessels. In this review, we summarize the history of tissue-engineered vascular grafts (TEVG), focusing on scaffolds generated by the electrospinning process, and discuss in vivo applications. We review the materials commonly employed in this approach and the preliminary results after implantation in animal models in order to gauge clinical viability of the electrospinning process for TEVG construction. Scientists have studied electrospinning technology for decades, but only recently has it been orthotopically evaluated in animal models such as TEVG. Advantages of electrospun TEVG include ease of construction, favorable cellular interactions, control of scaffold features such as fiber diameter and pore size, and the ability to choose from a variety of polymers possessing a range of mechanical and chemical properties and degradation kinetics. Given its advantages, electrospinning technology merits investigation for use in TEVG, but an emphasis on long-term in vivo evaluation is required before its role in clinical vascular tissue engineering can be realized. PMID:24786567

  12. Tissue engineered small-diameter vascular grafts.

    Science.gov (United States)

    Schmedlen, Rachael H; Elbjeirami, Wafa M; Gobin, Andrea S; West, Jennifer L

    2003-10-01

    Arterial occlusive disease remains the leading cause of death in western countries and often requires vascular reconstructive surgery. The limited supply of suitable small-diameter vascular grafts has led to the development of tissue engineered blood vessel substitutes. Many different approaches have been examined, including natural scaffolds containing one or more ECM proteins and degradable polymeric scaffolds. For optimal graft development, many efforts have modified the culture environment to enhance ECM synthesis and organization using bioreactors under physiologic conditions and biochemical supplements. In the past couple of decades, a great deal of progress on TEVGs has been made. Many challenges remain and are being addressed, particularly with regard to the prevention of thrombosis and the improvement of graft mechanical properties. To develop a patent TEVG that grossly resembles native tissue, required culture times in most studies exceed 8 weeks. Even with further advances in the field, TEVGs will likely not be used in emergency situations because of the time necessary to allow for cell expansion, ECM production and organization, and attainment of desired mechanical strength. Furthermore, TEVGs will probably require the use of autologous tissue to prevent an immunogenic response, unless advances in immune acceptance render allogenic and xenogenic tissue use feasible. TEVGs have not yet been subjected to clinical trials, which will determine the efficacy of such grafts in the long term. Finally, off-the-shelf availability and cost will become the biggest hurdles in the development of a feasible TEVG product. Although many obstacles exist in the effort to develop a small-diameter TEVG, the potential benefits of such an achievement are exciting. In the near future, a nonthrombogenic TEVG with sufficient mechanical strength may be developed for clinical trials. Such a graft will have the minimum characteristics of biological tissue necessary to remain patent over a period comparable to current vein graft therapies. As science and technology advance, TEVGs may evolve into complex blood vessel substitutes. TEVGs may become living grafts, capable of growing, remodeling, and responding to mechanical and biochemical stimuli in the surrounding environment. These blood vessel substitutes will closely resemble native vessels in almost every way, including structure, composition, mechanical properties, and function. They will possess vasoactive properties and be able to dilate and constrict in response to stimuli. Close mimicry of native blood vessels may aid in the engineering of other tissues dependent upon vasculature to sustain function. With further understanding of the factors involved in cardiovascular development and function combined with the foundation of knowledge already in place, the development of TEVGs should one day lead to improved quality of life for those with vascular disease and other life-threatening conditions. PMID:14621299

  13. Synthesis of Polymer Grafted Magnetite Nanoparticle with the Highest Grafting Density via Controlled Radical Polymerization

    Directory of Open Access Journals (Sweden)

    Babu Kothandapani

    2009-01-01

    Full Text Available Abstract The surface-initiated ATRP of benzyl methacrylate, methyl methacrylate, and styrene from magnetite nanoparticle is investigated, without the use of sacrificial (free initiator in solution. It is observed that the grafting density obtained is related to the polymerization kinetics, being higher for faster polymerizing monomer. The grafting density was found to be nearly 2 chains/nm2for the rapidly polymerizing benzyl methacrylate. In contrast, for the less rapidly polymerizing styrene, the grafting density was found to be nearly 0.7 chain/nm2. It is hypothesized that this could be due to the relative rates of surface-initiated polymerization versus conformational mobility of polymer chains anchored by one end to the surface. An amphiphilic diblock polymer based on 2-hydroxylethyl methacrylate is synthesized from the polystyrene monolayer. The homopolymer and block copolymer grafted MNs form stable dispersions in various solvents. In order to evaluate molecular weight of the polymer that was grafted on to the surface of the nanoparticles, it was degrafted suitably and subjected to gel permeation chromatography analysis. Thermogravimetric analysis, transmission electron microscopy, and Fourier transform infrared spectroscopy were used to confirm the grafting reaction.

  14. [Research on optimization of lower limb parameters of cardiopulmonary resuscitation simulation model based on genetic algorithm].

    Science.gov (United States)

    Xu, Lin

    2014-10-01

    Sudden cardiac arrest is one of the critical clinical syndromes in emergency situations. A cardiopulmonary resuscitation (CPR) is a necessary curing means for those patients with sudden cardiac arrest. In order to simulate effectively the hemodynamic effects of human under AEI-CPR, which is active compression-decompression CPR coupled with enhanced external counter-pulsation and inspiratory impedance threshold valve, and research physiological parameters of each part of lower limbs in more detail, a CPR simulation model established by Babbs was refined. The part of lower limbs was divided into iliac, thigh and calf, which had 15 physiological parameters. Then, these 15 physiological parameters based on genetic algorithm were optimized, and ideal simulation results were obtained finally. PMID:25764738

  15. Detection and significance of S-100 protein and NSE during mild hypothermia cardiopulmonary bypass

    International Nuclear Information System (INIS)

    To observe dynamic changes of S-100 protein and NSE during mild hypothermia cardiopulmonary bypass (CPB), the venous blood samples of 25 patients with elective cardiac surgery were obtained simultaneously from the left artery and left jugular bulb before CPB(A), hypothermia period (32-35 degree C) (B) and rewarming to 36 degree C (C) during CPB, 30 minutes (D), 4-6 hours (E) and 24 hours (F) after CPB. Plasma S-100 protein concentration was determined by chemiluminescence immunoassay, and NSE level was determined by radioimmunoassay. The results showed that the levels of S-100 protein and NSE increased significantly during CPB, and NSE peaked at 30 minutes (D) after CPB. It suggested the central nervous system dysfunctions. The S-100 protein and NSE concentrations decreased gradually and retuned to normal nearly (F) after mild hypothermia CPB. It suggested that there were not obvious central nervous system dysfunctions

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

    Directory of Open Access Journals (Sweden)

    Pedro Miguel Garcez Sardo

    2007-09-01

    Full Text Available 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 Environment for Nursing Graduation. The research attends to the ethical principles recommended by Resolution 196/96. The instruments used for data bank are: (1 Virtual Learning Environment with its resources, activities and tools; (2 Form based on Standard ISO/IEC 9126 with three extra opened questions to evaluate the PBL methodology. We hope that the use of PBL methodology will improve the nurses’ abilities and skills to solve real-life problems, when compared with traditional education.

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

    Directory of Open Access Journals (Sweden)

    Pedro Miguel Garcez Sardo

    2007-12-01

    Full Text Available 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 Environment for Nursing Graduation. The research attends to the ethical principles recommended by Resolution 196/96. The instruments used for data bank are: (1 Virtual Learning Environment with its resources, activities and tools; (2 Form based on Standard ISO/IEC 9126 with three extra opened questions to evaluate the PBL methodology. We hope that the use of PBL methodology will improve the nurses’ abilities and skills to solve real-life problems, when compared with traditional education.

  18. A Novel Use of a Metronome in Dispatcher-assisted Cardiopulmonary Resuscitation.

    Science.gov (United States)

    Ateyyah, Khalid A; Cady, Charles E; Poltrock, James T; Pirrallo, Ronald G

    2015-01-01

    Abstract Early, high-quality cardiopulmonary resuscitation (CPR) is the key to increasing the likelihood of successful resuscitation in cardiac arrest. The use of dispatch-assisted (DA) CPR can increase the likelihood of bystander CPR. We describe a case in which a metronome was introduced to guide DA-CPR. The wife of a 52-year-old male activated 9-1-1 after her husband suffered a cardiac arrest. During her 9-1-1 call she received CPR instructions and heard a metronome over the phone while following the instructions. Return of spontaneous circulation of the patient occurred during paramedic on scene care. The patient was transported to hospital and discharged 6 days later with no neurological deficit. This case supports the use of a metronome by emergency medical dispatchers during the provision of DA-CPR to improve bystander CPR. PMID:25420016

  19. Exposure of patients to ethylene oxide during cardiopulmonary bypass using gas-sterilized pump components.

    Science.gov (United States)

    Lindop, C R; Willcox, T W; McKegg, P M; Harris, E A

    1980-06-01

    We have shown that ethylene oxide (EO), absorbed by polyvinyl chloride (PVC) and rubber components of the cardiopulmonary bypass (CPB) circuit during sterilization, is subsequently eluted by the circulating blood-prime mixture and enters the patient. The amount of EO available for elution is diminished by increasing the airing period of the tubing after sterilization, but it is still appreciable after 72 hours' airing. When tubing is used after 24 hours' airing, the amount of EO which enters the patient during 90 minutes of CPB is probably at least 70 mg. During the first few hours after CPB, the amount of EO recoverable from the patient's blood rapidly diminishes, probably because of the binding of EO in irreversible chemical combination. PMID:7374200

  20. La reanimación cerebro cardiopulmonar: estado del arte / Brain cardiopulmonary reanimation: state of the art

    Scientific Electronic Library Online (English)

    Laura Catalina, Leal-Forero; Luz Catherine, Martínez-Malo; José Ricardo, Navarro-Vargas.

    2014-01-01

    Full Text Available Las maniobras de reanimación cerebro- cardiopulmonares son efectivas a largo plazo cuando se preserva la función del cerebro. La comunidad ha progresado en el conocimiento de la cadena de sobrevida o supervivencia, sin embargo, hace falta mayor conocimiento de la preservación de la función cerebral [...] y la protección sistémica para que el síndrome isquemia-reperfusión (que se presenta después del paro o cuando el corazón ha recuperado su circulación de manera espontánea), no limite los esfuerzos de una reanimación aparentemente exitosa. Abstract in english Brain cardiopulmonary resuscitation maneuvers are effective in long term only when there is a brain function preserved. The community has made progress in the knowledge of the survival chain, yet need greater awareness about of preserving brain function and systemic protection due to ischemia-reperf [...] usion syndrome, which occurs after of the Cardiac Arrest or when the heart circulation has recovered spontaneously, without to limit efforts of an apparently successful resuscitation.

  1. Hantavirus cardiopulmonary syndrome: a report of two cases / Síndrome cardiopulmonar por hantavírus: relato de dois casos

    Scientific Electronic Library Online (English)

    Marcos Lazaro, Moreli; Vivaldo Gomes da, Costa; Daiane Pereira da Silva, Novaes; Enia Cristina, Flor; Juliana Freitas, Silva; Keila Rejane Guimarães, Vilela; Cácia Régia de, Paula.

    2013-10-01

    Full Text Available A infecção por hantavírus, família Bunyaviridae, provoca a síndrome cardiopulmonar por hantavírus (SCPH) nos países da América. Ela é uma antropozoonose, de elevada letalidade, que tem acometido preferencialmente indivíduos em contato com o meio rural, sendo transmitida por aerossóis a partir das ex [...] cretas dos roedores silvestres infectados. O objetivo deste estudo foi relatar a ocorrência, quase que simultânea, de dois casos de SCPH ocorridos no município de Jataí, Estado de Goiás, Brasil. Abstract in english Infection with hantavirus, from the family Bunyaviridae, causes hantavirus cardiopulmonary syndrome (HCPS) in the Americas. This highly lethal anthropozoonosis afflicts preferentially individuals in rural areas and is transmitted by aerosol of excreta from infected wild rodents. The aim of this stud [...] y is to report the almost simultaneous occurrence of two cases of HCPS in the municipality of Jataí, state of Goiás, Brazil.

  2. Differences in displayed pump flow compared to measured flow under varying conditions during simulated cardiopulmonary bypass.

    LENUS (Irish Health Repository)

    Hargrove, M

    2008-07-01

    Errors in blood flow delivery due to shunting have been reported to reduce flow by, potentially, up to 40-83% during cardiopulmonary bypass. The standard roller-pump measures revolutions per minute and a calibration factor for different tubing sizes calculates and displays flow accordingly. We compared displayed roller-pump flow with ultrasonically measured flow to ascertain if measured flow correlated with the heart-lung pump flow reading. Comparison of flows was measured under varying conditions of pump run duration, temperature, viscosity, varying arterial\\/venous loops, occlusiveness, outlet pressure, use of silicone or polyvinyl chloride (PVC) in the roller race, different tubing diameters, and use of a venous vacuum-drainage device.

  3. Psychophysiologic effects of Hatha Yoga on musculoskeletal and cardiopulmonary function: a literature review.

    Science.gov (United States)

    Raub, James A

    2002-12-01

    Yoga has become increasingly popular in Western cultures as a means of exercise and fitness training; however, it is still depicted as trendy as evidenced by an April 2001 Time magazine cover story on "The Power of Yoga." There is a need to have yoga better recognized by the health care community as a complement to conventional medical care. Over the last 10 years, a growing number of research studies have shown that the practice of Hatha Yoga can improve strength and flexibility, and may help control such physiological variables as blood pressure, respiration and heart rate, and metabolic rate to improve overall exercise capacity. This review presents a summary of medically substantiated information about the health benefits of yoga for healthy people and for people compromised by musculoskeletal and cardiopulmonary disease. PMID:12614533

  4. Cardiopulmonary exercise testing variables as predictors of long-term outcome in thoracic sarcoidosis

    Scientific Electronic Library Online (English)

    A.J., Lopes; S.L.S., Menezes; C.M., Dias; J.F., Oliveira; M.R.M., Mainenti; F.S., Guimarães.

    2012-03-01

    Full Text Available Cardiopulmonary exercise testing (CPET) plays an important role in the assessment of functional capacity in patients with interstitial lung disease. The aim of this study was to identify CPET measures that might be helpful in predicting the vital capacity and diffusion capacity outcomes of patients [...] with thoracic sarcoidosis. A longitudinal study was conducted on 42 nonsmoking patients with thoracic sarcoidosis (median age = 46.5 years, 22 females). At the first evaluation, spirometry, the measurement of single-breath carbon monoxide diffusing capacity (D LCOsb) and CPET were performed. Five years later, the patients underwent a second evaluation consisting of spirometry and D LCOsb measurement. After 5 years, forced vital capacity (FVC)% and D LCOsb% had decreased significantly [95.5 (82-105) vs 87.5 (58-103) and 93.5 (79-103) vs 84.5 (44-102), respectively; P

  5. Does pharmacotherapy influence the inflammatory responses during cardiopulmonary bypass in children?

    Science.gov (United States)

    Kapitein, Berber; van Saet, Anne-Wil; Golab, Hanna D; de Hoog, Matthijs; de Wildt, Saskia; Tibboel, Dick; Bogers, Ad J J C

    2014-08-01

    Cardiopulmonary bypass (CPB) induces a systemic inflammatory response syndrome (SIRS) by factors such as contact of the blood with the foreign surface of the extracorporeal circuit, hypothermia, reduction of pulmonary blood flow during CPB and endotoxemia. SIRS is maintained in the postoperative phase, co-occurring with a counter anti-inflammatory response syndrome. Research on the effects of drugs administered before the surgery, especially in the induction phase of anesthesia, as well as drugs used during extracorporeal circulation, has revealed that they greatly influence these postoperative inflammatory responses. A better understanding of these processes may not only improve postoperative recovery but also enable tailor-made pharmacotherapy, with both health and economic benefits. In this review, we describe the pathophysiology of SIRS and counter anti-inflammatory response syndrome in the light of CPB in children and the influence of drugs used on these syndromes. PMID:24949583

  6. Specific requirements for bloodless cardiopulmonary bypass in neonates and infants; a review.

    Science.gov (United States)

    Golab, Hanna D; Takkenberg, Johanna Jm; Bogers, Ad J J C

    2010-07-01

    A miniaturized cardiopulmonary bypass circuit enables the safe performance, in selected pediatric patients, of bloodless open heart surgery. As the latest survival rates in neonatal and infant cardiac surgery have become satisfactory, investigators have concentrated upon the improvement of existing procedures. Institutional guidelines and multidisciplinary efforts undertaken in the pre- and postoperative periods are of great importance, concerning bloodless CPB and should be seriously pursued by all involved caregivers. This review reflects upon the selective, most relevant requirements for success of asanguinous neonatal and infant CPB: acceptable level of hemodilution during the CPB, patient preoperative hematocrit value and volume of CPB circuit. We present an assessment of practical measures that were also adapted in our institution to achieve an asanguinous CPB for neonatal and infant patients. PMID:20576727

  7. Urinary trypsin inhibitor attenuated inflammatory response of patients undergoing cardiopulmonary bypass by inducing activated Treg cells.

    Science.gov (United States)

    Hao, Xing; Han, Junyan; Xing, Zhichen; Hao, Yu; Jiang, Chunjing; Zhang, Jianping; Yang, Jing; Hou, Xiaotong

    2013-12-01

    The urinary trypsin inhibitor (ulinastatin) is used in the clinic to prevent inflammatory responses in patients undergoing cardiopulmonary bypass (CPB); however, the anti-inflammatory mechanism is unclear. In the current study, we recruited 40 patients undergoing selective cardiac valve replacement surgery; and these patients were randomly divided into two groups (ulinastatin group [UG] and control group [CG]). We collected peripheral blood preoperatively, at the end of CPB, and postoperative days 1 and 3 and analyzed the kinetic changes in regulatory T (Treg) cell subsets. There was no statistically significant difference in the number of CD4(+) T cells between the two groups. The number of CD4(+)CD25(+) Treg cells, especially the suppressive activated Treg (aTreg) subset, was higher in the UG than the CG 1 and 3 days postoperatively. Thus, ulinastatin alleviated the inflammatory response during CPB by inducing the expansion of aTreg cells. PMID:23765601

  8. Canine and feline cardiopulmonary parasitic nematodes in Europe: emerging and underestimated

    Directory of Open Access Journals (Sweden)

    Conboy Gary

    2010-07-01

    Full Text Available Abstract Cardiopulmonary nematodes of dogs and cats cause parasitic diseases of central relevance in current veterinary practice. In the recent past the distribution of canine and feline heartworms and lungworms has increased in various geographical areas, including Europe. This is true especially for the metastrongyloids Aelurostrongylus abstrusus, Angiostrongylus vasorum and Crenosoma vulpis, the filarioid Dirofilaria immitis and the trichuroid Eucoleus aerophilus (syn. Capillaria aerophila. The reasons of this emergence are little known but many drivers such as global warming, changes in vector epidemiology and movements in animal populations, may be taken into account. The purpose of this article is to review the knowledge of the most important heartworm and lungworm infections of dogs and cats in Europe. In particular recent advances in epidemiology, clinical and control are described and discussed.

  9. Academic Employment Network

    Science.gov (United States)

    The Academic Employment Network provides educators with an opportunity to browse current educational employment opportunities across the United States. Users select the state they are interested in, and receive a listing of jobs arranged by district or institution and job title. Information on each position is provided, as well as instructions for contacting the employer. Administrators seeking to hire educators may place advertisements (for a fee) by email, telephone, or mail; advertisements run for 30 days. Additional information provided on the site includes certification requirements for most states, as well as links to relocation services such as school district profiles and cost-of-living comparisons.

  10. Vascularized bone graft in scaphoid fractures. Anatomical details and clinical indications. A cases series

    International Nuclear Information System (INIS)

    The fracture of scaphoid continues being a challenge for orthopedist and hand surgeons. Objective. To show the anatomical details of the bony strip from the second metacarpal in corpses injected with green latex and the results of the surgical technique in a series of patients with scaphoid pseudarthrosis. Materials and methods. We carry out an initial anatomical analysis before employing the surgical technique in clinical setting, and then we did a descriptive study of patients with pseudarthrosis of scaphoid,treated with vascularized bony graft by the first metacarpal artery. Results. All patients consolidated and improved in the pain scale, they did not have mobility deterioration or residual carpus instability, after ten years of observations. Conclusions. The vascularized graft is a useful option in the management of the pseudarthrosis of the scaphoid.

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

    DEFF Research Database (Denmark)

    Daugaard, Anders Egede; Jankova Atanasova, Katja

    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 dependent loading of polymers as a function of time (up to 38 wt% for both acrylates), and showed a plateau in loading after 12 h of polymerization. The modified nanomaterials were melt mixed into polypropylene composites with very low filler loading (0.3 wt%), whereafter both the thermal and electrical properties were investigated by DSC and dielectric resonance spectroscopy. The electrical properties were found to be substantially improved, where poly(lauryl acrylate) was found to be the superior surface modification, resulting in a conductive composite.

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

    DEFF Research Database (Denmark)

    SØrensen, Marie Maagaard; Jensen, Mariann Tang

    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 exercise capacity were measured using a photoacoustic gas-rebreathing technique during rest and exercise. RESULTS: Forty-four patients and 26 controls completed 3 years follow-up. Preoperatively, patients had lower maximum cardiac index, mean ±SD, 6.6 ± 1.2 l·min(-1)·m(-2) compared with controls 8.1 ± 1.0 l·min(-1)·m(-2) during exercise (p = 0.0001). One year and 3 years postoperatively, patients' maximum cardiac index had increased significantly and after 3 years there was no difference between patients and controls (8.1 ± 1.2 l·min(-1)·m(-2) and 8.3 ± 1.6 l·min(-1)·m(-2), respectively [p = 0.572]). The maximum oxygen consumption was unchanged. Left ventricular dimensions increased in patients over 3 years; however, no difference was seen between the 2 groups. Preoperatively, patients had lower forced expiratory volume in the first second of expiration (FEV1; 86% ± 13%) as compared with controls (94% ± 10%), p = 0.009. Postoperatively, no difference was found in FEV1 between the 2 groups. CONCLUSIONS: Before operation, FEV1 and maximum cardiac index were lower in patients compared with healthy, age-matched controls. One year after, both parameters had increased, although only FEV1 had normalized. After 3 years and bar removal, cardiopulmonary function in patients during exercise had normalized.

  13. Effect of exercise training on cardiopulmonary baroreflex control of forearm vascular resistance in humans

    Science.gov (United States)

    Mack, G. W.; Convertino, V. A.; Nadel, E. R.

    1993-01-01

    We studied the stimulus-response characteristics of cardiopulmonary baroreflex control of forearm vascular resistance (FVR) in four groups of male volunteer subjects: i) unfit, ii) physically fit, iii) before and after 10 wk of endurance training (chronic blood volume expansion), and iv) before and after acute blood volume expansion. We assessed the relationship between reflex stimulus, i.e., changes in central venous pressure and response, i.e., FVR, during unloading of cardiopulmonary mechanoreceptors with lower body negative pressure (LBNP, 0 to -20 mm Hg). The slope of the linear relationship between FVR and CVP, the index of the responsiveness of this baroreflex, was significantly diminished (> 50%) in the fit subjects compared with the unfit. The slope of the FVR-CVP relationship was inversely correlated with the subject's total blood volume, suggesting that blood volume expansion was related to the attenuated CP baroreflex. In the exercise training study, maximal oxygen consumption and blood volume increased following 10 wk of endurance training (N = 14) but were unchanged in the time control group (N = 7). The slope of the FVR-CVP relationship was significantly reduced (32%) following 10 wk of training but was unchanged in the time control group. The reduction in slope of the FVR-CVP relationship was inversely related to the increase in blood volume associated with exercise training. Acute blood volume expansion 8 ml.kg-1 body weight with 5% human serum albumin solution) significantly reduced the slope of the FVR-CVP relationship. These data support the hypothesis that the attenuated forearm vascular reflex in physically fit individuals is related to a training-induced hypervolemia.(ABSTRACT TRUNCATED AT 250 WORDS).

  14. Soft tissue grafting to improve implant esthetics

    Directory of Open Access Journals (Sweden)

    Moawia M Kassab

    2010-09-01

    Full Text Available Moawia M KassabDivision of Periodontics, Marquette University, School of Dentistry, Milwaukee, WI, USAAbstract: Dental implants are becoming the treatment of choice to replace missing teeth, especially if the adjacent teeth are free of restorations. When minimal bone width is present, implant placement becomes a challenge and often resulting in recession and dehiscence around the implant that leads to subsequent gingival recession. To correct such defect, the author turned to soft tissue autografting and allografting to correct a buccal dehiscence around tooth #24 after a malpositioned implant placed by a different surgeon. A 25-year-old woman presented with the chief complaint of gingival recession and exposure of implant threads around tooth #24. The patient received three soft tissue grafting procedures to augment the gingival tissue. The first surgery included a connective tissue graft to increase the width of the keratinized gingival tissue. The second surgery included the use of autografting (connective tissue graft to coronally position the soft tissue and achieve implant coverage. The third and final surgery included the use of allografting material Alloderm to increase and mask the implant from showing through the gingiva. Healing period was uneventful for the patient. After three surgical procedures, it appears that soft tissue grafting has increased the width and height of the gingiva surrounding the implant. The accomplished thickness of gingival tissue appeared to mask the showing of implant threads through the gingival tissue and allowed for achieving the desired esthetic that the patient desired. The aim of the study is to present a clinical case with soft tissue grafting procedures.Keywords: case report, connective tissue, dental implants, allograft, coronally positioned flap

  15. Free and microvascular bone grafting in the irradiated dog mandible

    International Nuclear Information System (INIS)

    Microvascular and free rib grafts were placed in 4.5 cm defects in an edentate mandibular body defect 18 to 28 days after completion of 50 Gy of irradiation from a 60Co source. The animals were sacrificed from two to forty weeks postoperatively and evaluated clinically, radiographically, and histologically. There was a marked difference in the alveolar mucosal viability with the two grafts. Mucosal dehiscence was not observed over any of the microvascular grafts, but was present in seven-eighths of the free grafts. Union of the microvascular bone graft to the host bone occurred within six weeks. In contrast, after six weeks the free graft was sequestered in all the animals. An unexpected finding with both types of graft was the marked subperiosteal bone formation. This bone appeared to be derived from the host bed, stabilizing and bridging the defects bilaterally. The results suggest that radiated periosteum may play an important role in osteogenesis

  16. ESR spectroscopic investigations of the radiation-grafting of fluoropolymers

    Energy Technology Data Exchange (ETDEWEB)

    Huebner, G.; Roduner, E. [University of Stuttgart (Germany); Brack, H.P.; Scherer, G.G. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1999-08-01

    ESR spectroscopic investigations have clarified the influence of several preparative parameters on the reaction rates and yields obtained in the radiation-grafting method used at PSI to prepare proton-conducting polymer membranes. At a given irradiation dose, a higher concentration of reactive radical sites was detected in ETFE films than in FEP films. This higher concentration explains the higher grafting levels and rates of the ETFE films found in our previous grafting experiments. Taken together, the in-situ ESR experiments and grafting experiments show that the rates of disappearance of radical species and grafting rates and final grafting levels depend strongly on the reaction temperature and the oxygen content of the system. Average grafted chain lengths were calculated to contain about 1,000 monomer units. (author) 2 figs., 4 refs.

  17. Optimal use of negative pressure wound therapy for skin grafts.

    Science.gov (United States)

    Gupta, Subhas

    2012-08-01

    Skin grafting is a technique used for transplanting human skin (i.e. epidermal and some dermal layers) from a harvest site to a recipient site. However, advancements in bioengineered matrices have also introduced alternatives to skin grafts. The method used to secure the graft, whether skin or biomatrix, is critical in reducing graft failure. During the past several years, negative pressure wound therapy using reticulated open-cell foam (NPWT/ROCF; V.A.C.® Therapy, KCI USA, Inc., San Antonio, TX) has become a well-established method for bolstering grafts to recipient beds and is being used more frequently over biomatrices to help improve graft outcomes. This review will combine expert opinion with scientific evidence for the use of NPWT/ROCF over grafts. PMID:22727139

  18. Design and optimization of a tissue-engineered bone graft substitute

    Science.gov (United States)

    Shimko, Daniel Andrew

    2004-12-01

    In 2000, 3.1 million surgical procedures on the musculoskeletal system were reported in the United States. For many of these cases, bone grafting was essential for successful fracture stabilization. Current techniques use intact bone obtained either from the patient (autograft) or a cadaver (allograft) to repair large defects, however, neither source is optimal. Allografts suffer integration problems, and for autografts, the tissue supply is limited. Because of these shortcomings, and the high demand for graft tissues, alternatives are being explored. To successfully engineer a bone graft replacement, one must employ a three pronged research approach, addressing (1) the cells that will inhabit the new tissue, (2) the culture environment that these cells will be exposed to, and (3) the scaffold in which these cells will reside. The work herein examines each of these three aspects in great detail. Both adult and embryonic stem cells (ESCs) were considered for the tissue-engineered bone graft. Both exhibited desirable qualities, however, neither were optimal in all categories examined. In the end, the possibility of teratoma formation and ethical issues surrounding ESCs, made the use of adult marrow-derived stem cells in the remaining experiments obligatory. In subsequent experiments, the adult stem cells' ability to form bone was optimized. Basic fibroblast growth factor, fetal bovine serum, and extracellular calcium supplementation studies were all performed. Ultimately, adult stem cells cultured in alpha-MEM supplemented with 10% fetal bovine serum, 10mM beta-glycerophosphate, 10nM dexamethasone, 50mug/ml ascorbic acid, 1%(v/v) antibiotic/antimycotic, and 10.4mM CaCl2 performed the best, producing nearly four times more mineral than any other medium formulation. Several scaffolds were then investigated including those fabricated from poly(alpha-hydroxy esters), tantalum, and poly-methylmethacrylate. In the final study, the most appealing cell type, medium formulation, and scaffold material from all preceding studies were combined and a tissue-engineered bone graft was fabricated. The graft was exposed to long-term in vitro culture, and then mechanically evaluated to determine its clinical potential. The studies contained herein constitute the first steps in the conception and development of a viable tissue-engineered bone graft substitute and establish a solid scientific foundation for future in vivo experimentation utilizing this design.

  19. Medicaid: Employment Initiatives

    Science.gov (United States)

    ... person's employability and potential contributions to the labor market. In conjunction with the administration's initiative to promote ... the Act. It may be offered to any target group for whom the provision of these services ...

  20. Radiation grafting of acrylonitrile on ethylene-propylene diene terpolymer rubber. Optimization of grafting parameters and oil resistance properties

    International Nuclear Information System (INIS)

    Radiation induced grafting of acrylonitrile (ACN) on ethylene-propene diene terpolymer (EPDM) rubber film was investigated by mutual radiation grafting technique. Effect of experimental variables viz. radiation dose, dose rate, type of solvent and monomer content on extent of grafting was studied. From the kinetic studies a mathematical relation Rg?[M]0.7D0.68 showing non-linear relationship for rate of grafting with monomer concentration and dose was deduced. The grafted samples showed increased hardness and oil resistance. (author)

  1. Effect of moderate and high intensity training sessions on cardiopulmonary chemosensitivity and time-based characteristics of response in high performance rowers

    Directory of Open Access Journals (Sweden)

    Tomiak Tomasz

    2014-10-01

    Full Text Available Background: The present study was performed to clarify fatigue-induced effects of a strenuous and moderate intensity endurance training session on temporary changes of cardiopulmonary (CP chemosensitivity and fast kinetics response.

  2. 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.

  3. Chemical hydrogels based on a hyaluronic acid-graft-?-elastin derivative as potential scaffolds for tissue engineering

    Energy Technology Data Exchange (ETDEWEB)

    Palumbo, Fabio Salvatore [Dipartimento di Scienze e Tecnologie Molecolari e Biomolecolari, Sezione di Chimica e Tecnologie Farmaceutiche, Università degli Studi di Palermo, Via Archirafi 32, 90123, Palermo (Italy); Pitarresi, Giovanna, E-mail: giovanna.pitarresi@unipa.it [Dipartimento di Scienze e Tecnologie Molecolari e Biomolecolari, Sezione di Chimica e Tecnologie Farmaceutiche, Università degli Studi di Palermo, Via Archirafi 32, 90123, Palermo (Italy); Institute of Biophysics at Palermo, Italian National Research Council, Via Ugo La Malfa 153, 90146 Palermo (Italy); Fiorica, Calogero [Dipartimento di Scienze e Tecnologie Molecolari e Biomolecolari, Sezione di Chimica e Tecnologie Farmaceutiche, Università degli Studi di Palermo, Via Archirafi 32, 90123, Palermo (Italy); Rigogliuso, Salvatrice; Ghersi, Giulio [Dipartimento di Scienze e Tecnologie Molecolari e Biomolecolari, Sezione di Biologia Cellulare, Università degli Studi di Palermo, Viale delle Scienze ed. 16, 90128, Palermo (Italy); Giammona, Gaetano [Dipartimento di Scienze e Tecnologie Molecolari e Biomolecolari, Sezione di Chimica e Tecnologie Farmaceutiche, Università degli Studi di Palermo, Via Archirafi 32, 90123, Palermo (Italy); IBIM-CNR, Via Ugo La Malfa 153, 90146 Palermo (Italy)

    2013-07-01

    In this work hyaluronic acid (HA) functionalized with ethylenediamine (EDA) has been employed to graft ?-elastin. In particular a HA-EDA derivative bearing 50 mol% of pendant amino groups has been successfully employed to produce the copolymer HA-EDA-g-?-elastin containing 32% w/w of protein. After grafting with ?-elastin, remaining free amino groups reacted with ethylene glycol diglycidyl ether (EGDGE) for producing chemical hydrogels, proposed as scaffolds for tissue engineering. Swelling degree, resistance to chemical and enzymatic hydrolysis, as well as preliminary biological properties of HA-EDA-g-?-elastin/EGDGE scaffold have been evaluated and compared with a HA-EDA/EGDGE scaffold. The presence of ?-elastin grafted to HA-EDA improves attachment, viability and proliferation of primary rat dermal fibroblasts and human umbilical artery smooth muscle cells. Biological performance of HA-EDA-g-?-elastin/EGDGE scaffold resulted comparable to that of a commercial collagen type I sponge (Antema®), chosen as a positive control. - Highlights: ? Hyaluronic acid (HA) has been functionalized with ethylenediamine (EDA). ? Amino groups of HA-EDA allow the reaction with ?-elastin and ethylene glycol diglycidyl ether (EGDGE). ? Chemical scaffolds of HA-EDA-graft-?-elastin/EGDGE have been characterized. ? The presence of ?-elastin affects porosity, swelling and enzymatic degradation of scaffolds. ? The presence of ?-elastin improves attachment, viability and proliferation of fibroblasts and smooth muscle cells.

  4. Chemical hydrogels based on a hyaluronic acid-graft-?-elastin derivative as potential scaffolds for tissue engineering

    International Nuclear Information System (INIS)

    In this work hyaluronic acid (HA) functionalized with ethylenediamine (EDA) has been employed to graft ?-elastin. In particular a HA-EDA derivative bearing 50 mol% of pendant amino groups has been successfully employed to produce the copolymer HA-EDA-g-?-elastin containing 32% w/w of protein. After grafting with ?-elastin, remaining free amino groups reacted with ethylene glycol diglycidyl ether (EGDGE) for producing chemical hydrogels, proposed as scaffolds for tissue engineering. Swelling degree, resistance to chemical and enzymatic hydrolysis, as well as preliminary biological properties of HA-EDA-g-?-elastin/EGDGE scaffold have been evaluated and compared with a HA-EDA/EGDGE scaffold. The presence of ?-elastin grafted to HA-EDA improves attachment, viability and proliferation of primary rat dermal fibroblasts and human umbilical artery smooth muscle cells. Biological performance of HA-EDA-g-?-elastin/EGDGE scaffold resulted comparable to that of a commercial collagen type I sponge (Antema®), chosen as a positive control. - Highlights: ? Hyaluronic acid (HA) has been functionalized with ethylenediamine (EDA). ? Amino groups of HA-EDA allow the reaction with ?-elastin and ethylene glycol diglycidyl ether (EGDGE). ? Chemical scaffolds of HA-EDA-graft-?-elastin/EGDGE have been characterized. ? The presence of ?-elastin affects porosity, swelling and enzymatic degradation of scaffolds. ? The presence of ?-elastin improves attachment, viability and proliferation of fibroblasts and smooth muscle cells

  5. A study on the morphology of polystyrene-grafted poly(ethylene-alt-tetrafluoroethylene) (ETFE) films prepared using a simultaneous radiation grafting method

    International Nuclear Information System (INIS)

    The morphology of polystyrene-grafted poly(ethylene-alt-tetrafluoroethylene) (ETFE) films prepared using a simultaneous radiation grafting method was investigated using DMA, DSC, XRD, and SAXS instruments. The DMA study indicates that the ETFE amorphous phase and PS amorphous phase are mixed well in the PS-grafted ETFE films while the ETFE crystalline phase and the PS amorphous phase are separated, suggesting that the PS chains are grafted mainly on the ETFE amorphous regions. The DSC and XRD data showed that the natural crystalline structures of ETFE in the grafted ETFE films are not affected by the degree of grafting. The SAXS profiles displayed that the inter-crystalline distance of the ETFE films increases with an increasing degree of grafting, which further implies that the PS graft chains formed by the simultaneous irradiation has a significant impact on the amorphous morphology of the resulting grafted ETFE film. Thus, these results indicate that the styrene monomers are mainly grafted on the ETFE amorphous regions during the simultaneous radiation grafting process. - Highlights: • PS-grafted ETFE films were prepared by a simultaneous radiation grafting method was investigated. • The natural crystalline structures of grafted ETFE films are not affect by the degree of grafting. • The inter-crystalline distance of the ETFE films increase with increasing degree of grafting. • The styrene monomers are mainly grafted on the ETFE amorphous regions during a simultaneous radiation grafting using gamma-ray

  6. Graft copolymers of polypropylene films. 1. radiation induced grafting of mixed monomers. Vol. 3

    International Nuclear Information System (INIS)

    Radiation graft copolymerization of co monomer mixtures of acrylic acid (AAC), and styrene (S) onto polypropylene (PP) film by mutual method has been investigated. The effects of different factors that may affect the grafting yield such as inhibitor concentration (Mohr's salt), solvent composition (MeOH and H2 O), radiation dose and dose rate were considered. It was found that the role of Mohr's salt is very effective when the ratio of AAC in the co monomer mixtures was at lower values. However, the addition of 1.25 Wt% of Mohr's salt reduced the homo polymer formation and enhances the grafting process. Graft copolymerization in presence of solvent mixture composed of methanol and water was found to afford higher grafting than in pure methanol regardless of the composition of the co monomer mixture used. However, the highest degree of grafting was obtained at a solvent composition of 20% H2 O:80%MeOH and a co monomer mixture of 20%AAC:80%sty. An attempt was made to determine each PAAC and PS fractions in the total graft yield obtained. Two methods of analysis based on using the reactivity ratios reported in literature, elemental analysis and IR spectroscopy. The determination of poly (acrylic acid) and polystyrene fractions by elemental analysis is believed more accurate than these by reactivity ratio. The precise results obtained by elemental analysis with respect to the chemical structure of known polymer prepared under identical conditions. The results obtained by IR measurements go well with that obtained with the reactivity ratio methods. 5 figs., 3 tabs

  7. 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 wasly 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

  8. The effect of cardiopulmonary bypass in coronary artery bypass surgeries (on-pump versus off-pump) on erectile function and endothelium-derived nitric oxide levels

    Scientific Electronic Library Online (English)

    Onder, Canguven; Selami, Albayrak; Ahmet, Selimoglu; Muhsin, Balaban; Ahmet, Sasmazel; Ayse, Baysal.

    2011-12-01

    Full Text Available PURPOSE: To investigate the effects of on-pump and off-pump coronary artery bypass grafting (CABG) on the erectile function and endothelium-derived nitric oxide (eNO) levels. MATERIALS AND METHODS: Twenty-eight consecutive patients were randomized into two groups depending on use of cardiopulmonary [...] bypass in CABG surgery. The erectile function was evaluated by using the IIEF-5 questionnaire. The plasma eNO levels were determined at baseline and after reactive hyperemia before and after surgery. Blood was collected in one minute after cuff deflation from the radial artery on the same side. RESULTS: After CABG surgery the mean IIEF-5 score increased insignificantly over baseline from 14.8 to 15.8 (p = 0.29) and 12.4 to 14.3 (p = 0.11) after on-pump and off-pump CABG surgeries, respectively. The baseline plasma NO levels before surgery were 18.16 ± 7.63 nmol/L in on-pump and 21.76 ± 11.08 nmol/L in off-pump CABG. After reactive hyperemia the plasma NO levels were 22.14 ± 10.52 nmol/L in on-pump and 21.49 ± 9.13 nmol/L in off-pump CABG before the surgery. The difference in the plasma NO levels before surgery was not significant (p = 0.51). Two hours after surgery, the difference of the plasma NO levels at baseline (24.44 ± 12.31on-pump and 20.58 ± 6.74 nmol/L off-pump CABG) and after reactive hyperemia (35.55 ± 23.54 nmol/L on-pump and 23.00 ± 15.40 nmol/L off-pump CABG) were not significantly different from each other (p = 0.11). CONCLUSIONS: Patients who had on-pump or off-pump CABG surgeries had higher IIEF-5 scores. Nevertheless, the improvement was insignificant in both groups. Meanwhile, on-pump or off-pump CABG surgeries did not have significant effect on plasma eNO levels.

  9. Modification of polyetherurethane for biomedical application by radiation-induced grafting. I. Grafting procedure, determination of mechanical properties, and chemical modification of grafted films

    International Nuclear Information System (INIS)

    Radiation grafting of monomers onto suitable trunk polymers is a useful tool for tailoring new polymers for special purposes. This technique has been used in the past for the development of biocompatible materials, e.g., by grafting hydrogels onto mechanically stable polymers. In this first part of our work, the radiation grafting of hydrophilic or reactive monomers onto a polyetherurethane film using the pre-swelling technique is described. Following this technique the trunk polymer was swollen in the monomer before irradiation. As monomers 2-hydroxyethyl methacrylate (HEMA), 2,3-epoxypropyl methacrylate (GMA), 2,3-dihydroxypropyl methacrylate (GOMA), and acrylamide (AAm) were used. The kinetics of the grafting reactions were examined, and the distribution of the graft component inside the trunk polymer was investigated by means of infrared (IR) spectroscopy. Surface-grafted as well as bulk- and surface-grafted products could be obtained. The mechanical behavior of the grafted films--especially in the water-swollen state--was examined and compared with that of the pure trunk polymer. In nearly all cases it was found that the tensile strength sigma B and the elongation at break epsilon R decreases as the grafting yield increases. Modification of GMA- and AAm-grafted films via chemical reactions was performed to create new functional groups of biomedical interest. In this manner a diol structure, a carboxylic acid structure, and a sulfonic acid group could be introduced a sulfonic acid group could be introduced in the grafted polymer. The water uptake of such modified films is increased markedly when compared with that of the unmodified samples

  10. Fatores de risco para mortalidade de pacientes submetidos à revascularização miocárdica / Risk factors for mortality of patients undergoing coronary artery bypass graft surgery

    Scientific Electronic Library Online (English)

    Carlos Alberto dos, Santos; Marcos Aurélio Barboza de, Oliveira; Antônio Carlos, Brandi; Paulo Henrique Husseini, Botelho; Josélia de Cássia Menin, Brandi; Marcio Antônio dos, Santos; Moacir Fernandes de, Godoy; Domingo Marcolino, Braile.

    2014-12-01

    Full Text Available Introdução: Cirurgia de revascularização do miocárdio é um procedimento seguro realizado em todo o mundo com taxas baixas de mortalidade e morbidade na população geral. Objetivo: Estudar fatores de risco para mortalidade de pacientes submetidos à revascularização miocárdica com circulação extracorp [...] órea. Métodos: Foram estudados retrospectivamente e de forma consecutiva 1.628 pacientes submetidos à revascularização com circulação extracorpórea no período de dezembro de 1999 a fevereiro de 2012. A análise de dados foi efetuada por meio dos testes t de Student não pareado, Mann-Whitney e exato de Fisher para dados categóricos. Regressão logística, Odds Ratio e IC95% foram utilizados para definição de fatores de risco para mortalidade. Resultados: Do total de 1.628 pacientes submetidos à cirurgia de revascularização do miocárdio com circulação extracorpórea, 141 (8,7%) foram a óbito. Após regressão logística, foram identificados como fatores de risco para mortalidade as variáveis diálise (OR=7,61; IC 95% 3,58-16,20), lesão neurológica tipo I (OR = 4,42; IC 95% 2,48-7,81), uso de BIA (OR=3,38; IC 95% 1,98-5,79), tempo de CEC (OR = 3,09; IC 95% 2,04-4,68), creatinina pico - admissão > 0,4 mg/dL (OR=2,67; IC 95% 1,79-4,00), idade > 65 anos (OR=2,31; IC 95% 1,55-3,44) e tempo entre admissão hospitalar e procedimento cirúrgico (OR = 1,53; IC 95% 1,03-2,27). Conclusão: Diálise, lesão neurológica tipo I, uso de balão intra- aórtico, tempo de circulação extracorpórea (> 115 minutos), creatinina pico-admissão > 0,4 mg/dL, idade > 65 anos e tempo entre admissão hospitalar e procedimento cirúrgico foram considerados como fatores de risco para mortalidade em pacientes submetidos à cirurgia de revascularização do miocárdio com circulação extracorpórea. Abstract in english Introduction: Coronary artery bypass grafting is a safe procedure performed worldwide with low rates of mortality and morbidity in general population. Objective: To investigate risk factors for mortality of patients undergoing coronary artery bypass grafting coronary artery bypass grafting surgery. [...] Methods: A total of 1,628 consecutive patients undergoing on-pump coronary artery bypass grafting were retrospectively studied from December 1999 to February 2012. Data analysis involved paired Student t test, Mann-Whitney test and Fisher’s exact test for the categorical data. Logistic regression, Odds Ratio and 95%CI were used for definition of risk factors for mortality. Results: Of a total of 1,628 patients undergoing on-pump coronary artery bypass grafting, 141 (8.7%) died. The following risk factors for mortality were identified after logistic regression: dialysis (OR=7.61; 95%CI 3.58-16.20), neurologic dysfunction type I (OR=4.42; 95%CI 2.48-7.81), use of IABP (OR=3.38; 95%CI 1.98-5.79), cardiopulmonary bypass time (OR=3.09; 95%CI 2.04-4.68), serum creatinine on admission and peak values > 0.4mg/dL (OR=2.67; 95%CI 1.79-4.00), age > 65 years (OR=2.31; 95%CI 1.55-3.44), and time between hospital admission and and surgical procedure (OR=1.53; 95%CI 1.03-2.27). Conclusion: Dialysis, type I neurologic dysfunction, use of IABP, cardiopulmonary bypass time (> 115 minutes), serum creatinine on admission and peak values>0.4mg/dL, age > 65 years and time between hospital admission and surgical procedure were considered as risk factors for mortality in patients undergoing on-pump coronary artery bypass grafting surgery.

  11. Nursing diagnosis activity intolerance and inefficient cardiopulmonary tissue perfusion: evaluation in patients undergoing gene therapy ? preview note

    Directory of Open Access Journals (Sweden)

    Clarissa Garcia Rodrigues, Maria Antonieta Moraes, Emiliane Nogueira de Souza, Jaquelini Messer Sauer, Andréia Orjana Ribeiro Coutinho, Renato Abdala Karam Kalil

    2009-10-01

    Full Text Available Objective: to evaluate and compare the frequency of nursing diagnosis activity intolerance and ineffective cardiopulmonary tissue perfusion in advanced ischemic heart disease patients before and after gene therapy for myocardial revascularization. Methods: cohort study, in which 20 patients developed ischemic heart disease treated with gene therapy are undergoing clinical evaluation of two nurses with experience of minimum three years in cardiology, to identify the presence or absence of the nursing diagnosis activity intolerance and ineffective cardiopulmonary tissue perfusion. These evaluations will be done before gene therapy and three and six months afterwards. The data will be tabulated for later analysis of absolute and relative frequency as well as comparison between the three moments. Will be used for the coefficient of Kappa analysis of agreement between the assessments of nursing. To compare the dichotomous variables will be used for the Cochran Q-test and for ordinal variables will be used the Friedman test.

  12. Bilateral Mooren's ulcer - Customised corneal graft with additional amniotic membrane graft.

    Science.gov (United States)

    Bhandari, Vipul; Siddharthan, K S

    2015-01-01

    Mooren's ulcer (MU) is a rare and painful peripheral corneal ulceration which occurs in the absence of any associated scleritis, and any detectable systemic disease. A 60-year-old male patient was referred to us with bilateral peripheral corneal ulceration. Best corrected visual acuity (BCVA) in both eyes was counting finger at one metre. The right eye showed a 180° thinning with perforation at 8 o'clock position. The left eye showed a 360° thinning with central contact lens type cornea. After complete blood analysis we started the patient on cyclophosphamide orally along with high doses of oral steroids. A crescentic excision of the thinned cornea and crescentic customised corneal graft with additional amniotic membrane graft (AMG) was done first for the right eye and a 360° peripheral lamellar corneal graft with additional AMG for the left eye. The BCVA of RE was 1/60 improving to 6/36 with plus ten aphakic glasses and LE was 3/60. Hand fashioned full thickness crescentic customised corneal graft with additional AMG and a peripheral 360° lamellar corneal graft with additional AMG in these cases are a novel approach to Mooren's ulcer with gratifying results. PMID:26155087

  13. Operative and early results of coronary artery bypass grafting in female patients in different body mass indexes

    Directory of Open Access Journals (Sweden)

    Tokmakoglu Hilmi

    2010-11-01

    Full Text Available Abstract Background Female gender has been reported to be an independent risk factor for coronary artery bypass grafting (CABG in European System for Cardiac Risk Evaluation. The effect of the body size on the CABG outcome is less clear. There is ongoing debate about obesity as a risk factor for adverse outcomes after cardiovascular procedures. The goal of this retrospective study is to evaluate the in hospital and early postoperative outcomes in severe obese, obese and normal-slightly obese female patients after CABG. Methods In a four year period a total of 427 female patients underwent isolated CABG under cardiopulmonary bypass. The patients were allocated into three groups according to the Body Mass Index (BMI as follows; group 1: severe obese patients; BMI > 35, group 2: obese patients; 30?BMI?35, group 3: normal-slightly obese patients; BMI Results The patients in group 3 were older than the group1 and group 2 (65,6 ± 8,3 year vs 63,01 ± 8,0 and 63,57 ± 8,4 year p Conclusion This study may give an aspect for evaluations of the inhospital-early mortality and morbidity after CABG in female patients in different BMI. Severe obesity is not a risk factor in-hospital mortality in female patients. However, severe obese female patients appear to have more wound problems and re-hospitalization rate after CABG compared to obese and normal-slightly obese patients.

  14. Luxembourg Employment Study

    Science.gov (United States)

    Funded, in part, by the Human Capital and Mobility Programme of the European Commission and the Norwegian Research Council, the Luxembourg Employment Study (LES) is a searchable databank consisting of information mostly collected in the early 1990s by the Labour Force Surveys. Countries in North America and Europe with different labor market strategies were surveyed about areas of information including "job search, employment characteristics, comparable occupations, investment in education, migration, etc." Users may search the databank by country name, as well as by an extensive list of standardized variables. LES has also included detailed user instructions, working papers, a newsletter, and links to statistical information from the countries surveyed.

  15. 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

  16. Surface modification of cellulose by PCL grafts

    International Nuclear Information System (INIS)

    Two cellulosic substrates (microcrystalline cellulose, MCC, and bleached kraft softwood pulps, BSK) were grafted by polycaprolactone (PCL) chains with different molecular weights, following a three-step procedure using non-swelling conditions in order to limit the reaction to their surface. First, one of the two OH PCL ends was blocked by phenyl isocyanate and the reaction product (adduct 1) was subsequently reacted with 2,4-toluene diisocyanate (adduct 2) to provide it with an NCO function, capable of reacting with cellulose. The ensuing PCL-grafted cellulosic materials were characterized by weight gain, elemental analysis, contact angle measurements, attenuated total reflexion-Fourier transform infrared (ATR-FTIR), X-ray photoelectron spectroscopy (XPS) and biodegradation tests. The modification was proven to occur by the presence of nitrogen atoms in the elemental analysis tests and XPS spectra of modified and soxhlet-extracted cellulose. The contact angle measurements have also shown that the surface became as hydrophobic as PCL itself. The polar component of the surface energy of cellulosic substrates before treatment was found to be about 32 and 10 mJ m-2, for MCC and BSK, respectively. This value vanished to practically zero after grafting with different PCLs. The strategy proposed in the present work is original since, to the best of our knowledge, this paper reports for the first time the chemical 'grafting onto' of the cellulose surface by PCL mac onto' of the cellulose surface by PCL macromolecular structures, with the aim of obtaining fibre-matrix co-continuous fully sustainable and biodegradable composite materials.

  17. Mechanics of laser cut stent grafts.

    Czech Academy of Sciences Publication Activity Database

    Major, Št?pán; Kocour, Vladimír; Hubálovský, Š.

    Prague : Institute of theoretical and applied mechanics, Academy of Sciences of the Czech Republic, v.v.i, 2015 - (Náprstek, J.; Fischer, C.). s. 186-187 ISBN 978-80-86246-42-0. ISSN 1805-8248. [Engineering mechanics 2015 /21./. 11.05.2015-14.05.2015, Svratka] Institutional support: RVO:68378297 Keywords : stent-grafts * nitinol * finite element analysis * fatigue * fracture Subject RIV: JJ - Other Materials

  18. Graft selection in anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Miller, Suzanne L; Gladstone, James N

    2002-10-01

    Selecting the appropriate graft for ACL reconstruction depends on numerous factors including surgeon philosophy and experience, tissue availability (affected by anatomical anomalies or prior injury or surgery), and patient activity level and desires. Although the patella tendon autograft has the widest experience in the literature, and is probably the most commonly used graft source, this must be tempered with the higher reported incidences of potential morbidity and pitfalls associated with its use. The hamstring tendons are gaining increasing popularity, mostly due to reduced harvest morbidity and improved soft tissue fixation techniques, and many recent studies in the literature report equal results to BTB ACL reconstruction with respect to functional outcome and patient satisfaction. On the other hand, many of these studies report higher degrees of instrument (KT-100) tested laxity for hamstring reconstruction, and some have reported lower returns to preinjury levels of activity. One question that remains to be addressed is how closely objectively measured laxity tests correlate with subjectively assessed outcomes and ability to return to high levels of competitive sports. Allograft use, which decreased in popularity during the 1990s, appears to be undergoing a resurgence, with better sterilization processes and new graft sources (tibialis tendons), leading to increased availability and improved fixation techniques. The benefits of decreased surgical morbidity and easier rehabilitation must be weighed against the potential for greater failure of biologic incorporation, infection, and possibly slower return to activities. In our practice, for high-demand individuals (those playing cutting, pivoting, or jumping sports and skiing) BTB tends to be the graft of choice. For lower demand or older individuals, hamstring reconstructions will be performed. Allograft tissue will be used in older individuals (generally over 45 years old), those with signs of arthritis (and compelling evidence of instability), or those individuals who understand the pros and cons of allograft use fully and do not want their own tissue used. PMID:12528909

  19. LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS

    Directory of Open Access Journals (Sweden)

    E.S. Stolyarevich

    2014-05-01

    Full Text Available Rejection has always been one of the most important cause of late renal graft dysfunction. Aim of the study was to analyze the prevalence of different clinico-pathological variants of rejection that cause late graft dysfunction, and evaluate their impact on long-term outcome. Materials and methods. This is a retrospective study that analyzed 294 needle core biopsy specimens from 265 renal transplant recipients with late (48,8 ± 46,1 months after transplantation allograft dysfunction caused by late acute rejection (LAR, n = 193 or chronic rejection (CR, n = 78 or both (n = 23. C4d staining was performed by immunofl uorescence (IF on frozen sections using a standard protocol. Results. Peritubular capillary C4d deposition was identifi ed in 36% samples with acute rejection and in 62% cases of chronic rejection (including 67% cases of transplant glomerulopathy, and 50% – of isolated chronic vasculopathy. 5-year graft survival for LAR vs CR vs their combination was 47, 13 and 25%, respectively. The outcome of C4d– LAR was (p < 0,01 better than of C4d+ acute rejection: at 60 months graft survival for diffuse C4d+ vs C4d? was 33% vs 53%, respectively. In cases of chronic rejection C4d+ vs C4d– it was not statistically signifi cant (34% vs 36%. Conclusion. In long-term allograft biopsy C4d positivity is more haracteristic for chronic rejection than for acute rejection. Only diffuse C4d staining affects the outcome. C4d– positivity is associated with worse allograft survival in cases of late acute rejection, but not in cases of chronic rejection. 

  20. Photoactivated surface grafting from PVDF surfaces

    OpenAIRE

    Berthelot, Thomas; Le, Xuan Tuan; Jégou, Pascale; Viel, Pascal; Boizot, Bruno; Baudin, Cécile; Palacin, Serge

    2011-01-01

    Economic and easy methods to tune surface properties of polymers as Poly(vinylidene fluoride) (PVDF) without altering bulk properties are of major interest for different applications as biotechnological devices, medical implant device. . . UV irradiation appears as one of the simplest, easy and safe method to modify surface properties. In the case of self-initiated grafting, it is generally assumed that the pretreatment of the PVDF surface with UV irradiation can yield alkyl and per-oxy radic...