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Obesity influences propranolol pharmacokinetics in patients undergoing coronary artery bypass grafting employing cardiopulmonary bypass / Influência da obesidade na farmacocinética do propranolol em pacientes submetidos à revascularização do miocárdio com circulação extracorpórea  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese As concentrações plasmáticas e a disposição cinética do propranolol podem ser alteradas pela circulação extracorpórea (CEC). Investigou-se a influência da obesidade na farmacocinética do propranolol em pacientes submetidos à revascularização do miocárdio empregando a CEC. Investigaram-se quinze paci [...] entes, recebendo cronicamente propranolol no pré- (10-40 mg, 2 a 3 vezes ao dia PO) e no pós-operatório (10 mg, 1 vez ao dia) sendo os mesmos distribuídos em dois grupos: obesos (n = 9, média 29,4) kg/m²; e não-obesos (n = 6, média 24,8 kg/m²). Colheram-se amostras seriadas de sangue nos períodos pré- e pós-operatório (Ä); determinaram-se as concentrações plasmáticas do propranolol através da cromatografia líquida de alta eficiência. Aplicou-se o software PK Solutions 2.0 para estimativa dos parâmetros cinéticos. Não se registrou alteração na farmacocinética do propranolol avaliada através dos parâmetros meia-vida biológica (t1/2), volume de distribuição aparente (Vd/F) e depuração plasmática (CL T/F) no grupo de pacientes não-obesos, enquanto prolongamento relevante da t1/2 (3,2 para 11,2 h, p Abstract in english Propranolol plasma levels and kinetic disposition may be altered by hypothermic cardiopulmonary bypass (CPB-H). We investigated the potential influence of obesity on propranolol pharmacokinetics in patients undergoing coronary artery bypass grafting employing CPB-H. Fifteen patients, receiving propr [...] anolol perorally pre- (10-40 mg, 2-3 times a day) and post-operatively (10 mg, once a day) were distributed in two groups, based on body mass index (BMI), in obese (n = 9, BMI: mean 29.4 kg/m²) and non-obese (n=6, BMI: mean 24.8 kg/m²). A serial of blood samples was collected at the pre- and post-operative periods at time dosing interval (Ä); propranolol plasma levels were measured one day before and after surgery using a high performance liquid chromatographic procedure described previously. PK Solutions software 2.0 was applied to obtain pharmacokinetic parameters. No changes on kinetic parameters as biological half-life (t1/2, p = 0.0625, NS), volume of distribution (Vd/F, p=0.8438, NS) and plasma clearance (CL T/F, p = 0.1563, NS) were obtained for the non-obese patients, while a prolongation of t1/2 (3.2 to 11.2 h, p

Valéria Adriana, Pereira; Maria José Carvalho, Carmona; Célia Etsuco Kobayashi, Omosako; José Otávio Costa, Auler Júnior; Silvia Regina Cavani Jorge, Santos.

2003-12-01

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

Science.gov (United States)

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

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

2005-07-01

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Assessment of the hospital result in coronary artery bypass graft with and without cardiopulmonary bypass  

International Nuclear Information System (INIS)

To assess the hospital results in coronary artery bypass graft (CABG) with or without cardiopulmonary bypass (CPB). This study was performed in Shahid Madani Hospital in Tabriz, Iran during the year 2003- 2006. The patients who had CABGs with or without CPB were studied. The data was collected by a questionnaire and was analyzed by the t-test and chi-square program. In this study 416 patients had CABG without CPB (group I) and 578 with CPB (group II). Number of grafts in group I were 2.12+-0.73 and 2.92+-0.82 in group II. The rate of complications in 2 groups was not significant. EF is improved in group I, and use of Inotrops and IABP was less than in group II. In group I hospitalization (ICU, hospital) was less than in comparison with group I. CABG without CPB was a safe method in our series. (author)

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

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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.

Neverton Savaris

2001-08-01

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

DEFF Research Database (Denmark)

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.

Ganz, Michael Lee; Wu, Ning

2014-01-01

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

Science.gov (United States)

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

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

2015-01-01

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Perioperative risk factors for prolonged mechanical ventilation and tracheostomy in women undergoing coronary artery bypass graft with cardiopulmonary bypass  

Science.gov (United States)

Background: Prolonged mechanical ventilation is an important recognized complication occurring during cardiovascular surgery procedures. This study was done to assess the perioperative risk factors related to postoperative pulmonary complications and tracheostomy in women undergoing coronary artery bypass graft with cardiopulmonary bypass. Methods: It was a retrospective study on 5,497 patients, including 31 patients with prolonged ventilatory support and 5,466 patients without it; from the latter group, 350 patients with normal condition (extubated in 6-8 hours without any complication) were selected randomly. Possible perioperative risk factors were compared between the two groups using a binary logistic regression model. Results: Among the 5,497 women undergoing coronary artery bypass graft (CABG), 31 women needed prolonged mechanical ventilation (PMV), and 15 underwent tracheostomy. After logistic regression, 7 factors were determined as being independent perioperative risk factors for PMV. Discussion: Age ?70 years old, left ventricular ejection fraction (LVEF) ?30%, preexisting respiratory or renal disease, emergency or re-do operation and use of preoperative inotropic agents are the main risk factors determined in this study on women undergoing CABG. PMID:21804797

Faritous, Zahra S.; Aghdaie, Nahid; Yazdanian, Forouzan; Azarfarin, Rasoul; Dabbagh, Ali

2011-01-01

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A pilot study of cerebral tissue oxygenation and postoperative cognitive dysfunction among patients undergoing coronary artery bypass grafting randomised to surgery with or without cardiopulmonary bypass*.  

Science.gov (United States)

Coronary artery bypass surgery, performed with or without cardiopulmonary bypass, is frequently followed by postoperative cognitive decline. Near-infrared spectroscopy is commonly used to assess cerebral tissue oxygenation, especially during cardiac surgery. Recent studies have suggested an association between cerebral desaturation and postoperative cognitive dysfunction. We therefore studied cerebral oxygen desaturation, defined as area under the cerebral oxygenation curve 10 min.%, with respect to cognitive performance at 4 days (early) and 3 months (late) postoperatively, compared with baseline, using a computerised cognitive test battery. We included 60 patients, of mean (SD) age 62.8 (9.4) years, scheduled for elective coronary artery bypass grafting, who were randomly allocated to surgery with or without cardiopulmonary bypass. Cerebral desaturation occurred in only three patients and there was no difference in cerebral oxygenation between the two groups at any time. Among patients who received cardiopulmonary bypass, 18 (62%) had early cognitive decline, compared with 16 (53%) in the group without cardiopulmonary bypass (p = 0.50). Three months after surgery, 11 patients (39%) in the cardiopulmonary bypass group displayed cognitive dysfunction, compared with four (14%) in the non-cardiopulmonary bypass group (p = 0.03). The use of cardiopulmonary bypass was identified as an independent risk factor for the development of late cognitive dysfunction (OR 6.4 (95% CI 1.2-33.0) p = 0.027. In conclusion, although cerebral oxygen desaturation was rare in our population, postoperative cognitive decline was common in both groups, suggesting that factors other than hypoxic neuronal injury are responsible. PMID:24750013

Kok, W F; van Harten, A E; Koene, B M J A; Mariani, M A; Koerts, J; Tucha, O; Absalom, A R; Scheeren, T W L

2014-06-01

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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  

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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.

Nelson William B

2009-06-01

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

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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.

Anil K Pandey

2012-09-01

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

OpenAIRE

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 ...

Abbaszadeh, M.; Boloorian, A.; Mehrani, F.; Jazayeri Gharehbagh, E.

2011-01-01

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

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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.

M Abbaszadeh

2011-10-01

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Acute Effect of Intravenous Administration of Magnesium Sulfate on Serum Levels of Interleukin-6 and Tumor Necrosis Factor-? in Patients Undergoing Elective Coronary Bypass Graft With Cardiopulmonary Bypass  

Science.gov (United States)

Background: Cardiovascular problems are among the most common health issues. A considerable number of cardiac patients undergo cardiac surgery, and coronary artery disease patients constitute about two-thirds of all these surgeries. The application of cardiopulmonary bypass (CBP) usually results in some untoward effects. Objectives: Studies have suggested magnesium sulfate (MgSO4) as an anti-inflammatory agent in a coronary artery bypass graft (CABG). This study aimed to assess the effect of an IV MgSO4 infusion during elective CABG (with CBP) on the blood levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-?). Materials and Methods: During a 12 month period, after review board approval and based on inclusion and exclusion criteria, 90 patients were selected and entered randomly into one of the two study groups (MgSO4 or placebo). Anesthesia, surgery and CBP were performed in exactly the same way, except for the use of MgSO4 or a placebo. Both preoperative and postoperative plasma levels of IL-6 and TNF-? were checked and compared between the two groups using an ELISA. Results: There was no difference found between the two groups with regard to; gender, basic variables, Ejection Fraction (EF), CBP time and aortic cross-clamp time. The preoperative levels of IL-6 and TNF-? were not different; however, their postoperative levels were significantly higher in the placebo group (P value = 0.01 for IL-6 and 0.005 for TNF-?). Conclusions: This study showed that MgSO4 infusion could suppress part of the inflammatory response after CABG with CBP. This was demonstrated by decreased levels of interleukin-6 and TNF-? in postoperative serum levels in elective CABG with CBP. PMID:25237633

Aryana, Parastou; Rajaei, Samira; Bagheri, Abdolhamid; Karimi, Forouzan; Dabbagh, Ali

2014-01-01

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Basics of cardiopulmonary bypass: normal and abnormal postoperative CT appearances.  

Science.gov (United States)

Cardiothoracic surgical procedures with and without cardiopulmonary bypass are becoming more commonly performed as surgical techniques improve and the population ages. Changes related to cardiopulmonary bypass are often depicted at routine postoperative computed tomographic (CT) studies performed for various reasons. The purpose of this article is to present knowledge critical to the accurate postoperative evaluation of the patient who has undergone cardiopulmonary bypass. This article will review the surgical technique for cardiopulmonary bypass, as well as the associated normal and abnormal postoperative imaging findings. Common cannulation sites used for cardiopulmonary bypass include the ascending aorta, axillary artery, right atrium, superior vena cava, and inferior vena cava. Normal postoperative findings related to cardiopulmonary bypass include (a) felt pledgets, which are used to reinforce cannulation sites; (b) oversewn side grafts; and (c) oversewn graft side branches. These normal postoperative findings can be mistaken for abnormalities. Abnormal postoperative findings related to cardiopulmonary bypass include pseudoaneurysm formation at cannulation sites, aortic dissection, and seroma formation. An awareness of normal and abnormal postoperative CT findings related to cardiopulmonary bypass is critical for all radiologists who interpret chest CT studies, to help prevent unnecessary further evaluation and to help direct prompt treatment when warranted. PMID:23322827

El-Sherief, Ahmed H; Wu, Carol C; Schoenhagen, Paul; Little, Brent P; Cheng, Allen; Abbara, Suhny; Roselli, Eric E

2013-01-01

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

Science.gov (United States)

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. PMID:22104114

Trethowan, Brian A; Gilliland, Helen; Popov, Aron F; Varadarajan, Barathi; Phillips, Sally-Anne; McWhirter, Louise; Ghent, Robert

2011-01-01

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

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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.

Trethowan Brian A

2011-11-01

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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)

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Cardiopulmonary Collapse during Labour  

OpenAIRE

Cardiopulmonary collapse during labour is a catastrophic event caused by various medical, surgical and obstetrical conditions. It is an emergency that threatens the life of the mother and her unborn child. We present a case of a pregnant woman who suffered from preeclampsia and underwent induction of labour. Severe lung edema occurred early in labour that caused cardiopulmonary collapse. Advanced heart-lung resuscitation was established immediately and continued until an emergency cesarean se...

Kristina Larsby; Claus Klingenberg; Lasse Raatiniemi; Vasilis Sitras

2010-01-01

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A Modified Branched Graft Inversion Technique Employing a Syringe Inserter in Ascending Aortic Replacement for Type A Aortic Dissection  

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Full Text Available Purpose: To achieve good outcomes during aortic surgery with circulatory arrest, a secure and non-bleeding anastomosis must be achieved rapidly to ensure brain protection. We report our initial experiences with a modified Branched Graft Inverting (BGI technique using an inserter under mild hypothermia. We aimed to reduce the surgical duration and to prevent unnecessary damage to the fragile aorta. Methods: We retrospectively reviewed patients with type A acute aortic dissection (AAD who underwent distal anastomosis via the modified BGI technique using an inserter between January 2012 and March 2013. Open distal anastomosis was performed under mild hypothermia with right hemisphere perfusion from the right axillary artery. Results: Eight patients were enrolled. There was no mortality. Circulatory arrest time was reproducibly 20.3 ± 1.9 min, which was sufficient to complete non-bleeding distal anastomoses. The average rectal temperature during circulatory arrest was 26.5? ± 1.9?. All patients were extubated the day after the operation without any neurological deficit. Conclusion: The modified BGI technique employing an inserter and mild hypothermia offered easy, secure, and reproducible distal anastomosis for ascending aortic replacement for type A acute aortic dissection. Our outcomes were favorable and support further development of this technique.

Masashi Kawabori

2014-07-01

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

Science.gov (United States)

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. PMID:25136407

Hillerup, Soren; Elberg, Jens Jorgen; Thorn, Jens Jorgen; Andersen, Mikael

2014-09-01

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Fluid distribution kinetics during cardiopulmonary bypass  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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

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

2014-08-01

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Employment  

SCPinfonet

... Fariba Di Benedetto: fdibenedetto-achtari@iisd.org. Electronic applications are preferred; there is no need to provide hard copies. The deadline for applications is March 31, 2014 IISD is an equal opportunities employer and welcomes applications regardless of ethnicity, age, gender or disability. ...

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Effect of cardiopulmonary bypass on the pharmacokinetics of propranolol and atenolol  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english The pharmacokinetics of some ?-blockers are altered by cardiopulmonary bypass (CPB). The objective of this study was to compare the effect of coronary artery bypass graft (CABG) surgery employing CPB on the pharmacokinetics of propranolol and atenolol. We studied patients receiving oral propranolol [...] with doses ranging from 80 to 240 mg (N = 11) or atenolol with doses ranging from 25 to 100 mg (N = 8) in the pre- and postoperative period of CABG with moderately hypothermic CPB (32°C). On the day before and on the first day after surgery, blood samples were collected before ?-blocker administration and every 2 h thereafter. Plasma levels were determined using high-performance liquid chromatography and data were treated by pharmacokinetics-modelling. Statistical analysis was performed using ANOVA or the Friedman test, as appropriate, and P

M.J.C., Carmona; V.A., Pereira; L.M.S., Malbouisson; J.O.C., Auler Jr.; S.R.C.J., Santos.

2009-06-01

24

Bone grafting: An overview  

Directory of Open Access Journals (Sweden)

Full Text Available Bone grafting is the process by which bone is transferred from a source (donor to site (recipient. Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of the surgeon. A search for ideal bone graft is on and may continue till time to time. [Vet World 2010; 3(4.000: 198-200

D. O. Joshi

2010-08-01

25

21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.  

Science.gov (United States)

...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...

2010-04-01

26

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

Directory of Open Access Journals (Sweden)

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

Ricardo de Carvalho Lima

2003-09-01

27

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

Scientific Electronic Library Online (English)

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

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

2003-09-01

28

Novel system for percutaneous cardiopulmonary bypass.  

Science.gov (United States)

Percutaneous cardiopulmonary bypass (PCPB) has recently come to the forefront of medicine as a technique for resuscitating and supporting patients in various clinical situations. Current systems utilize small-diameter cannulas to aspirate blood under high suction into the cardiopulmonary bypass circuit. Aspiration-based systems have several disadvantages including risk of air embolism, blood hemolysis, and cavitation. Additionally, they are suboptimal for use during open-heart surgical procedures. A system with a venous cannula that employs gravity drainage has been evaluated. Once advanced into position over a guide-wire, the stylet is removed, causing the basket near the end of the cannula to expand. Blood flows into the cannula from side holes and the basket region, which prevents the vessel wall or atrium from collapsing around the catheter and impeding venous drainage. Hemodynamic, hematologic, and histologic examinations were performed on eight anesthetized mongrel dogs during 2 h of PCPB. All animals exhibited adequate tissue perfusion and right and left heart decompression. All animals were successfully weaned from PCPB and after 30 min exhibited normal myocardial function. No ischemic changes were observed in the heart, lung, kidney, or liver by light and electron microscopy. We conclude that full PCPB can be satisfactorily achieved by using a novel percutaneous venous cannula and gravity drainage. PMID:2069931

Laub, G W; Muralidharan, S; Gu, J; Pollock, S B; Perritt, A; Daloisio, C; Adkins, M; McGrath, L B

1991-01-01

29

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

OpenAIRE

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...

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

2011-01-01

30

21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.  

Science.gov (United States)

...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...

2010-04-01

31

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

Directory of Open Access Journals (Sweden)

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.

Ricardo Antonio G. Barbosa

2009-03-01

32

A reappraisal of saphenous vein grafting  

OpenAIRE

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

Yuan Shi-Min; Jing Hua

2011-01-01

33

Refractory Vascular Spasm Associated with Coronary Bypass Grafting  

OpenAIRE

Diffuse refractory vascular spasms associated with coronary bypass artery grafting (CABG) are rare but devastating. A 42-year-old male patient with a past history of stent insertion was referred for the surgical treatment of a recurrent left main coronary artery disease. A hemodynamic derangement developed during graft harvesting, necessitating a hurried initiation of cardiopulmonary bypass (CPB). Although CABG was carried out as planned, the patient could not be weaned from the bypass. An em...

Kim, Young Sam; Yoon, Yong Han; Kim, Jeoung Taek; Shinn, Helen Ki; Woo, Seong Ill; Baek, Wan Ki

2014-01-01

34

Embolic activity during in vivo cardiopulmonary bypass.  

Science.gov (United States)

Neurologic injury after cardiac surgery is principally associated with emboli. Although much work has focused on surgical sources of emboli, less attention has been focused on emboli associated with the heart-lung machine. We tested whether emboli are associated with discrete processes during cardiopulmonary bypass (CPB). One hundred patients undergoing cardiothoracic surgery were enrolled between April 2008 and May 2011 at a single medical center. During each surgical procedure, emboli were counted in three CPB locations: the venous side (Channel 1), before the arterial line filter (Channel 2), and after the arterial line filter (Channel 3). We used prespecified event markers to identify perfusionist interventions. Identical circuits were used on all patients. Of the 100 patients enrolled, 62 underwent isolated coronary artery bypass grafting (CABG), 17 underwent isolated valve operations, and 21 underwent CABG plus valve. Median counts across Channels 1, 2, and 3 were 69,853, 3,017, and 1,251, respectively. The greatest contributor to emboli in Channels 1, 2, and 3, respectively, were achieving the calculated CPB flow, opening of the electronic arterial line clamp, and introducing a hemofilter. The circuit technology was efficient in reducing total emboli counts from Channels 1-2 irrespective of the size of the emboli. Nearly 71% of all emboli 30-100 microm in size were removed from the circuit between Channels 2 and 3. No significant association was found between emboli counts and S100B release. Emboli occur frequently during CPB and are predominantly associated with the initiation of bypass, operation of the electronic arterial line clamp, and the initiation of a hemofilter. Continued work to reduce the occurrence of emboli is warranted. PMID:25208432

DeFoe, Gordon R; Dame, Norman A; Farrell, Mark S; Ross, Cathy S; Langner, Craig W; Likosky, Donald S

2014-06-01

35

Triiodothyronine supplementation in patients undergoing cardiopulmonary bypass.  

Science.gov (United States)

Patients undergoing cardiopulmonary bypass may develop clinically significant physiologic alterations in the perioperative period, including alteration of thyroid hormone concentrations. Alterations in the concentration of thyroid hormones are of concern due to the effects of these hormones on cardiac function. Hypothyroidism is associated with a decrease in cardiac performance; therefore, supplementation with the active thyroid hormone triiodothyronine (T3) in patients undergoing cardiopulmonary bypass has been investigated to improve outcomes. In addition, T3 has been studied as an agent to reduce the frequency of atrial fibrillation after cardiopulmonary bypass. PMID:11714210

Reichert, M G; Verzino, K C

2001-11-01

36

Rationale, design and methodology for a Prospective Randomized Study of graft patency in Off-pump and On-pump MultI-Vessel coronary artery bypasS Surgery (PROMISS) using multidetector computed tomography  

OpenAIRE

Abstract Background Off-pump coronary artery bypass grafting has been accused of possibly compromising graft patency. Sixteen slice computed tomography has shown good diagnostic accuracy in the assessment of coronary bypass graft patency when compared with conventional coronary artery angiography and is less invasive. The study hypothesis is that coronary artery bypass grafting (CABG) performed without cardiopulmonary bypass (Off-Pump) has equivalent early graft patency as if...

Magalhães Manuel; Cavaco Sara; Matias Fernando; Uva Miguel

2008-01-01

37

Respiratory variation and cardiopulmonary interactions.  

Science.gov (United States)

It is often unclear whether or not a patient's stroke volume will increase following a fluid bolus. Volume responsiveness is defined by an increase in stroke volume following a fluid bolus. For patients being mechanically ventilated, the cardiopulmonary interactions associated with positive pressure ventilation create pulse pressure and stroke volume variation in the arterial pressure waveform that can be used to assess fluid responsiveness, so-called dynamic preload assessment. However, lung-protective ventilation is increasingly being used to avoid the adverse outcomes of higher tidal volume ventilation, and pulse pressure and stroke volume variation do not effectively predict volume responsiveness in the setting of lung-protective ventilation without using special techniques. Dynamic preload assessment is more effective at determining whether a patient will be fluid responsive than static measures of preload, but further studies are needed to more conclusively show that outcomes are improved with this approach to fluid management. PMID:25480770

Roberson, Russell S

2014-12-01

38

Smoking cessation in patients with cardiopulmonary diseases  

OpenAIRE

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 ...

Zeynep P?nar Önen; Elif ?en; Banu Eri? Gülbay; Ayperi Öztürk; Öznur Akkoca Y?ld?z; Turan Ac?can; Sevgi Saryal; Gülseren Karab?y?ko?lu

2011-01-01

39

Skin Graft  

OpenAIRE

Skin graft is one of the most indispensable techniques in plastic surgery and dermatology. Skin grafts are used in a variety of clinical situations, such as traumatic wounds, defects after oncologic resection, burn reconstruction, scar contracture release, congenital skin deficiencies, hair restoration, vitiligo, and nipple-areola reconstruction. Skin grafts are generally avoided in the management of more complex wounds. Conditions with deep spaces and exposed bones normally require the use o...

Ruka Shimizu; Kazuo Kishi

2012-01-01

40

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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

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

41

[Cardiopulmonary bypass in cardiac surgery].  

Science.gov (United States)

Cardiopulmonary bypass (CPB) is a standard procedure in cardiac surgery; however, apart from its therapeutic options a CPB might also initiate systemic and organ-specific complications, such as heart failure, renal and pulmonary dysfunction, impaired coagulation as well as neurological and cognitive dysfunction. The immunological response to the extracorporeal circulation generates systemic inflammation which often meets the definition of systemic inflammatory response syndrome (SIRS). The main inducers of SIRS are contact of blood with the artificial surfaces of the CPB, mechanical stress which affects the blood components and the extensive surgical trauma. Hence, a number of technical and surgical developments aim at reduction of the inflammatory response caused by the CPB. By reason of surgical demands, the majority of cardiothoracic procedures still depend on the use of CPB; however, there is an on-going development of new techniques trying to reduce the surgical trauma and the negative consequences of CPB. Here, minimized systems with biocompatible surfaces have been shown to be effective in attenuating the inflammatory response to CPB. Alternative procedures such as off-pump surgery may help to avoid CPB-associated complications but due to specific limitations will not replace conventional bypass surgery. PMID:22971923

Baehner, T; Boehm, O; Probst, C; Poetzsch, B; Hoeft, A; Baumgarten, G; Knuefermann, P

2012-10-01

42

Smoking cessation in patients with cardiopulmonary diseases  

Directory of Open Access Journals (Sweden)

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.

Zeynep P?nar Önen

2011-05-01

43

Should family members witness cardiopulmonary resuscitation?  

Science.gov (United States)

Clinical questionWhat is the effect of family presence during cardiopulmonary resuscitation on family members and the medical team?Article chosenJabre P, Belpomme V, Azoulay E, et al. Family presence during cardiopulmonary resuscitation. N Engl J Med 2013;368:1008-18.ObjectiveThe authors sought to determine whether systematically offering relatives the option to be present during cardiopulmonary resuscitation increases the proportion of relatives with posttraumatic stress disorder-related symptoms after 90 days. Secondary outcomes included the presence of anxiety and depression symptoms in relatives, the effect of family presence on medical efforts at resuscitation, the well-being of the medical team, and the occurrence of medicolegal claims. PMID:25358283

Mottillo, Salvatore; Delaney, J Scott

2014-11-01

44

Pancreas grafts  

International Nuclear Information System (INIS)

Perfusion studies with sup(99m)Tc-DTPA, which has hitherto been used routinely to investigate renal grafts, have also proved useful for monitoring the perfusion of pancreas grafts. A total perfusion failure is equally reliably demonstrable as in renal grafts. Quantitatively smaller perfusion alterations can be demonstrated by monitoring the course. It seems possible to differentiate the salivary edema of a rejection reaction, well known from animal experiments, with the help of other paramters (e.g. creatinine). Further clinical studies are however necessary to confirm these results. (orig.)

45

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

Directory of Open Access Journals (Sweden)

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

Sh Shahbazi

2011-03-01

46

Tracheal grafts  

International Nuclear Information System (INIS)

To learn when transplanted trachea becomes established and is suitable for experimentation, a serial sacrifice study was performed on rats. After transplant to a subcutaneous site, tracheal grafts survived by diffusion until the fourth day when the blood supply was reestablished. Further improvement occurred in the mucosal epithelium, so that by the seventh day after transplanting, the graft was again lined by tall columnar ciliated cells and scattered secretory cells. The mucosal epithelium remained separated from the submucosal elastic layer, however, until 14 days after transplanting, when the established grafts resembled untransplanted tracheas histologically. When exposed to 7,12-dimethyl(a)benzanthracene, the mucosa underwent squamous metaplasia that progressed to squamous carcinoma as early as 3 months after treatment. A major advantage of the tracheal graft as a research tool is that neoplasia can be induced in a respiratory tissue without interfering with respiration

47

Management of Cardiopulmonary Complications of Cirrhosis  

OpenAIRE

Advanced portal hypertension accompanying end-stage liver disease results in an altered milieu due to inadequate detoxification of blood from splanchnic circulation by the failing liver. The portosystemic shunts with hepatic dysfunction result in an increased absorption and impaired neutralisation of the gastrointestinal bacteria and endotoxins leads to altered homeostasis with multiorgan dysfunction. The important cardiopulmonary complications are cirrhotic cardiomyopathy, hepatopulmonary sy...

Sawant, Prabha; Vashishtha, C.; Nasa, M.

2011-01-01

48

Postoperative abdominal complications after cardiopulmonary bypass  

OpenAIRE

Abstract Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB). Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medi...

Dong Guohua; Liu Canhui; Xu Biao; Jing Hua; Li Demin; Wu Haiwei

2012-01-01

49

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

OpenAIRE

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 alternative...

Muhammad Shahzeb Khan; Mohammad Yousuf-ul Islam; Muhammad Umer Ahmed; Faizan Imran Bawany; Asadullah Khan; Mohammad Hussham Arshad

2014-01-01

50

Aortic reconstruction with bovine pericardial grafts  

Directory of Open Access Journals (Sweden)

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.

Silveira Lindemberg Mota

2003-01-01

51

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

1105-11-01

52

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

Directory of Open Access Journals (Sweden)

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.

Flavia Baggio Nerbass

2010-01-01

53

History of the evolution of cardiopulmonary resuscitation  

Directory of Open Access Journals (Sweden)

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.

George Karlis

2013-04-01

54

Management of cardiopulmonary complications of cirrhosis.  

Science.gov (United States)

Advanced portal hypertension accompanying end-stage liver disease results in an altered milieu due to inadequate detoxification of blood from splanchnic circulation by the failing liver. The portosystemic shunts with hepatic dysfunction result in an increased absorption and impaired neutralisation of the gastrointestinal bacteria and endotoxins leads to altered homeostasis with multiorgan dysfunction. The important cardiopulmonary complications are cirrhotic cardiomyopathy, hepatopulmonary syndrome, portopulmonary hypertension, and right-sided hydrothorax. PMID:21994850

Sawant, Prabha; Vashishtha, C; Nasa, M

2011-01-01

55

Assessing Exercise Limitation Using Cardiopulmonary Exercise Testing  

OpenAIRE

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...

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

2012-01-01

56

Artificial neural network cardiopulmonary modeling and diagnosis  

Science.gov (United States)

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.

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

1997-01-01

57

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

Science.gov (United States)

...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...

2010-04-01

58

21 CFR 870.4330 - Cardiopulmonary bypass on-line blood gas monitor.  

Science.gov (United States)

... Cardiopulmonary bypass on-line blood gas monitor. 870.4330 Section... Cardiopulmonary bypass on-line blood gas monitor. (a) Identification. A cardiopulmonary bypass on-line blood gas monitor is a device used in...

2010-04-01

59

A marked increase in gastric fluid volume during cardiopulmonary bypass  

OpenAIRE

Major physiological stress occurs during cardiac surgery with cardiopulmonary bypass. This is related to hypothermia and artificial organ perfusion. Thus, serious gastrointestinal complications, particularly upper gastrointestinal bleeding, sometimes follow cardiac surgery. We have compared the antisecretory effects of a preanesthetic H2 antagonist (roxatidine, cardiopulmonary bypass-H2 group, n = 15) and a proton pump inhibitor (rabeprazole, cardiopulmonary bypass-PPI group, n = 15) in p...

Hirota, Kazuyoshi; Kudo, Mihoko; Hashimoto, Hiroshi; Kushikata, Tetsuya

2011-01-01

60

Transit time flowmetry in coronary surgery--an important tool in graft verification.  

Science.gov (United States)

The aim of this study was to analyze the Transit time flow measurement (TTFM) experience in the first 1000 CABG operations. First 1000 patients had coronary artery bypass grafting (CABG) performed in Cardiovascular Clinic, University Clinical Centre Tuzla, Bosnia and Herzegovina, between September, 1998 and September, 2003. CABG without use of cardiopulmonary bypass (CPB)-(OPCAB) was used as the preferential surgical method both because this method is reported to have equal or better results than CABG with use of CPB (ONCAB), and because of the significant cost savings realized. TTFM was routinely used in all grafts as a quality assurance measure. Criteria for a poor functioning graft were: low mean flow (MF), pulsatility index (PI) above 5 and a poor diastolic flow pattern. When no reversible cause of poor TTFM results were identified the graft was revised. A total of 1394 grafts in OPCAB group and 1478 in ONCAB group were performed. A total of 38 grafts (2,72%) in 37 patients (7,07%) were revised in OPCAB group, and 26 grafts (1,75%) in 26 patients (5,45%) in ONCAB group. 1 patient in OPCAB group needed 2 graft revisions. Graft revisions were more common in OPCAB, but with no significant difference (p=0,1035). The most frequently revised graft was LAD graft in both groups. Although the percentage of grafts revised are relatively low, it is still very important to record TTFM. More than 5% of patients in both groups needed graft revision. Although TTFM does not guarantee that grafts will stay open for a prolonged period of time we certainly believe that grafts that are occluded at the time of surgery will continue to stay occluded. TTFM is especially critical in OPCAB surgery where the technical challenge of grafting is higher then in ONCAB. PMID:17848157

Mujanovi?, Emir; Kabil, Emir; Bergsland, Jacob

2007-08-01

61

Role of coronary graft flow measurement during reoperations for early graft failure after off-pump coronary revascularization.  

Science.gov (United States)

Doppler-based techniques of coronary graft flow measurement are frequently used, especially during coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB), to exclude graft dysfunction resulting from technical errors. Nevertheless, early graft failure in the immediate postoperative period continues to affect a small percentage of patients who may require emergent reoperation as a result of severe hemodynamic deterioration. In this setting, in which coronary angiography is infrequently an option, expeditious intraoperative assessment of previously constructed coronary grafts may be performed by using the Doppler-based technique Transit Time Flow Measurement (TTFM). As a result, the hemodynamic values obtained during reoperations may guide the operative strategy. In this study we report on eight patients who underwent "off-pump" CABG and necessitated early reintervention as a result of presumed graft dysfunction. In these patients, graft dysfunction was confirmed or excluded by using intraoperatively the TTFM technique, comparing newly obtained flow hemodynamic variables with those recorded as a baseline during primary operations. PMID:10875587

Ricci, M; Karamanoukian, H L; Salerno, T A; Dancona, G; Bergsland, J

1999-01-01

62

Polystyrene modified by grafting  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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.

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

1997-06-01

63

Strategies for cardiopulmonary exercise testing of pectus excavatum patients  

OpenAIRE

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

Malek, Moh H.; Coburn, Jared W.

2008-01-01

64

[Should we avoid cardiopulmonary bypass with diabetic patients?].  

Science.gov (United States)

In the peri-operative and post-operative course of coronary bypass operations, the diabetic patient is susceptible to complications that cause morbidity and mortality. Morbidity might best be conceptualized as the cumulative effect of the diabetic patient chronically at risk and a variety of surgically related insults, including surgical stress, anaesthesia, hypo- and hypertension, anaemia, dysrhythmias, de- or hyperhydration and cardiopulmonary bypass (CPB) that exceed the compensatory capacities of the patient. Because all these factors for adverse outcome coexist, it becomes difficult to determine which ones are most important. However, it is reasonable that, in the presence of generalized atherosclerosis affecting the aorta ascendens, carotids and the cerebral arteries, the interaction of CPB-associated embolization, hypoperfusion and inflammation may cause neurologic morbidity. Many physiologic alterations (such as non-pulsatile perfusion and hemodilution) occur during CPB and may worsen renal dysfunction in patients with diabetic nephropathy. Pulmonary dysfunctions, associated with diabetic microangiopathy, could be unmasked by atelectasis, capillary leak and other pathophysiological conditions developing after the use of extracorporeal circulation. Actually, there is evidence that with the avoidance of CBP and the use of adequate OPCAB (Off Pump Coronary Artery Bypass) techniques, by experienced teams, the incidences of neurological, renal and pulmonary complications decrease, in high-risk patients, e. g. diabetics, as well as in unselected cohorts. Because it is not possible to identify confidently those patients who are at risk for CPB-associated complications, we use a strategy where all CABG (Coronary Artery Bypass Grafting) are performed in OPCAB technique. The total OPCAB approach will in addition ascertain the development of organizational OPCAB routines and expertise. The process of re-engineering the unit towards total OPCAB needs systematic training and re-training of cardiac surgeons by surgeons, experienced in both, OPCAB surgery and knowledge transfer, according to the principles of continuing medical education (CME). Thus, the chances of the OPCAB technique improving the outcome of diabetic patients can be fully realized. PMID:16598547

Albert, A; Ennker, J; Sergeant, P

2006-01-01

65

Refractory vascular spasm associated with coronary bypass grafting.  

Science.gov (United States)

Diffuse refractory vascular spasms associated with coronary bypass artery grafting (CABG) are rare but devastating. A 42-year-old male patient with a past history of stent insertion was referred for the surgical treatment of a recurrent left main coronary artery disease. A hemodynamic derangement developed during graft harvesting, necessitating a hurried initiation of cardiopulmonary bypass (CPB). Although CABG was carried out as planned, the patient could not be weaned from the bypass. An emergency coronary angiography demonstrated a diffuse spasm of both native coronary arteries and grafts. CPB was switched to the femorofemoral extracorporeal membrane oxygenator (ECMO). Although he managed to recover from heart failure, his discharge was delayed due to the ischemic injury of the lower limb secondary to cannulation for ECMO. We reviewed the case and literature, placing emphasis on the predisposing factors and appropriate management. PMID:25346903

Kim, Young Sam; Yoon, Yong Han; Kim, Jeoung Taek; Shinn, Helen Ki; Woo, Seong Ill; Baek, Wan Ki

2014-10-01

66

Refractory Vascular Spasm Associated with Coronary Bypass Grafting  

Science.gov (United States)

Diffuse refractory vascular spasms associated with coronary bypass artery grafting (CABG) are rare but devastating. A 42-year-old male patient with a past history of stent insertion was referred for the surgical treatment of a recurrent left main coronary artery disease. A hemodynamic derangement developed during graft harvesting, necessitating a hurried initiation of cardiopulmonary bypass (CPB). Although CABG was carried out as planned, the patient could not be weaned from the bypass. An emergency coronary angiography demonstrated a diffuse spasm of both native coronary arteries and grafts. CPB was switched to the femorofemoral extracorporeal membrane oxygenator (ECMO). Although he managed to recover from heart failure, his discharge was delayed due to the ischemic injury of the lower limb secondary to cannulation for ECMO. We reviewed the case and literature, placing emphasis on the predisposing factors and appropriate management. PMID:25346903

Kim, Young Sam; Yoon, Yong Han; Kim, Jeoung Taek; Shinn, Helen Ki; Woo, Seong Ill; Baek, Wan Ki

2014-01-01

67

Bone Graft Alternatives  

Science.gov (United States)

... deformity or during a surgical procedure such as spinal fusion. What Types of Bone Grafts are There? Bone ... of bone grafts in spine surgery is during spinal fusion. The use of autogenous bone grafts for spinal ...

68

Proximal Tibial Bone Graft  

Science.gov (United States)

... Treatments of the Smaller Toes AOFAS / FootCareMD / Treatments Proximal Tibial Bone Graft Page Content What is a ... bone from the proximal tibia. What is a proximal tibial bone graft? Proximal tibial bone graft (PTBG) ...

69

Influence of tranexamic acid in postoperative bleeding of cardiac surgery with cardiopulmonary bypass  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: To analyze the influence of tranexamic acid in postoperative bleeding of cardiac surgery with cardiopulmonary bypass. METHOD: 51 patients who underwent heart surgery with cardiopulmonary bypass were randomly divided in 2 groups: Group I - control, with 12 coronary artery disease patients and 14 valve disease patients. Group II - Tranexamic acid, with 14 coronary artery disease patients and 11 valve disease patients. The Group I after venous access, received 250 ml of 0.9% normal saline solution as a placebo, Group II received 100 milligram per kilogram of body weight of tranexamic acid diluted in 250 ml of 0.9% normal saline solution. Blood samples were taken and examined at entry to Intensive care unit and after 12, 24 and 36 hours in the postoperative period. The groups were compared concerning factors which might influence the postoperative bleeding and transfusion required: age, gender, creatinine, duration of Cardiopulmonary bypass, hematocrit, platelets and fibrinogen variations, number of saphenous vein grafts performed, mammary artery used and valve replacement or repair. The postoperative bleeding was evaluated from the 1st to 4th hours and the total. Data were analyzed by appropriate statistic methods (Student T-test, X² test and Fischer's test; a p-value of less than 0.05 was the accepted level of significance. RESULTS: Concerning the postoperative bleeding and transfusion required, there was a statistically significant reduction in its average in valve disease patients in Group II. In coronary disease patients there was only a slight tendency. There was no significant statistical difference as far as the thromboembolic or renal complications were concerned. CONCLUSION: In valve disease patients, there was a reduction in bleeding and the need of transfusions of red blood cells, both of which had statistical differences. In coronary disease patients there was only a reduced tendency. The use of tranexamic acid was not related to further thromboembolic complications or renal insufficiency in the assessed groups.

Gonçalves Flávio Donizete

2002-01-01

70

Prospective, Open-Label Investigation of the Pharmacokinetics of Daptomycin during Cardiopulmonary Bypass Surgery?  

Science.gov (United States)

As methicillin-resistant Staphylococcus aureus (MRSA) becomes more prevalent, vancomycin is becoming increasingly used as a prophylaxis against surgical-site infections for cardiothoracic surgeries. However, vancomycin administration can be challenging, and the pharmacokinetics of alternative antibiotics in this setting are poorly understood. The primary objective of this investigation was to describe the pharmacokinetics of daptomycin in patients undergoing coronary artery bypass graft surgery. We enrolled 15 patients undergoing coronary artery bypass surgery requiring cardiopulmonary bypass. Each subject was administered a single open-label dose of daptomycin (8 mg/kg of body weight) for surgical prophylaxis. Fourteen daptomycin plasma samples were collected. Safety outcomes between subjects who received daptomycin and 15 control subjects who received the standard-of-care antibiotic were compared. The mean maximal concentration of daptomycin (Cmax) was 84.4 ± 27.1 ?g/ml; the mean daptomycin concentration during the cardiopulmonary bypass procedure was 33.2 ± 11.4 ?g/ml and was 30.9 ± 12.7 ?g/ml at sternum closure. Mean daptomycin concentrations at 12, 18, 24, and 48 h were 22.7 ± 9.7, 16.2 ± 8.2, 12.0 ± 4.7, and 3.5 ± 2.3 ?g/ml, respectively. Mean daptomycin concentrations were consistently above the MIC at which 90% of the tested isolates are inhibited (MIC90) for S. aureus and S. epidermidis during the cardiopulmonary bypass procedure. Daptomycin was not associated with surgical-site infections or differences in adverse events compared to findings for control subjects. We found that a single dose of daptomycin at 8 mg/kg was well tolerated and achieved adequate plasma concentrations against common pathogens associated with surgical-site infections after cardiothoracic surgery. Daptomycin may be considered an alternative surgical prophylaxis antibiotic for patients undergoing cardiothoracic bypass surgery who are unable to receive vancomycin. PMID:21444695

Nguyen, Megan H.; Eells, Samantha J.; Tan, Jennifer; Sheth, Corinne T.; Omari, Bassam; Flores, Margarita; Wang, Jeffrey; Miller, Loren G.

2011-01-01

71

Pulsatile flow during cardiopulmonary bypass preserves postoperative microcirculatory perfusion irrespective of systemic hemodynamics.  

Science.gov (United States)

The onset of nonpulsatile cardiopulmonary bypass is known to deteriorate microcirculatory perfusion, but it has never been investigated whether this may be prevented by restoration of pulsatility during extracorporeal circulation. We therefore investigated the distinct effects of nonpulsatile and pulsatile flow on microcirculatory perfusion during on-pump cardiac surgery. Patients undergoing coronary artery bypass graft surgery were randomized into a nonpulsatile (n = 17) or pulsatile (n = 16) cardiopulmonary bypass group. Sublingual mucosal microvascular perfusion was measured at distinct perioperative time intervals using sidestream dark field imaging, and quantified as the level of perfused small vessel density and microvascular flow index (vessel diameter < 20 ?m). Microcirculation measurements were paralleled by hemodynamic and free hemoglobin analyses. The pulse wave during pulsatile bypass estimated 58 ± 17% of the baseline blood pressure waveform. The observed reduction in perfused vessel density during aorta cross-clamping was only restored in the pulsatile flow group and increased from 15.5 ± 2.4 to 20.3 ± 3.7 mm/mm(2) upon intensive care admission (P < 0.01). The median postoperative microvascular flow index was higher in the pulsatile group [2.6 (2.5-2.9)] than in the nonpulsatile group [2.1 (1.7-2.5); P = 0.001]. Pulsatile flow was not associated with augmentation of free hemoglobin production and was paralleled by improved oxygen consumption from 70 ± 14 to 82 ± 16 ml·min(-1)·m(-2) (P = 0.01) at the end of aortic cross-clamping. In conclusion, pulsatile cardiopulmonary bypass preserves microcirculatory perfusion throughout the early postoperative period, irrespective of systemic hemodynamics. This observation is paralleled by an increase in oxygen consumption during pulsatile flow, which may hint toward decreased microcirculatory heterogeneity during extracorporeal circulation and preservation of microcirculatory perfusion throughout the perioperative period. PMID:22403352

Koning, Nick J; Vonk, Alexander B A; van Barneveld, Lerau J; Beishuizen, Albertus; Atasever, Bektas; van den Brom, Charissa E; Boer, Christa

2012-05-01

72

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

Science.gov (United States)

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

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

2010-01-01

73

Graft irradiation abrogates graft-versus-host disease in combined pancreas-spleen transplantation  

International Nuclear Information System (INIS)

A model of combined pancreas-spleen transplantation (PST) was studied in LBN F1 recipients of Lewis grafts in order to evaluate the efficacy of pretransplant graft irradiation in preventing lethal graft-versus-host disease (GVHD). Recipients of unmodified PST uniformly developed severe GVHD and died (MST = 16.7 +/- 3.8 days). Whole body donor irradiation with either 500 or 250 rad prevented lethal GVHD. Similarly, ex vivo graft irradiation with either 1000 or 500 rad also resulted in normal weight gain, graft function, and host survival for the 6-week study period. Conversely, delay of graft irradiation until 3 days after transplantation failed to prevent this complication (MST = 15.8 +/- 3.7 days). Recipients of irradiated grafts displayed glucose tolerance tests that were identical to those in the control group indicating that the doses of radiation employed in these experiments were not deleterious to islet function. Irradiated spleen grafts appeared histologically normal at 6 weeks after transplantation. Cells derived from these grafts failed to stimulate lymph node enlargement in a popliteal lymph node assay for GVHD, suggesting that these spleens may have become repopulated with host cells. These experiments confirm that PST has the potential to cause lethal GVHD and suggest that pretransplant graft irradiation may be used to prevent its occurrence

74

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish 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.

Hermes, Ilarraza-Lomelí.

2012-06-01

75

Strategies for cardiopulmonary exercise testing of pectus excavatum patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

76

Strategies for cardiopulmonary exercise testing of pectus excavatum patients  

Directory of Open Access Journals (Sweden)

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.

Moh H. Malek

2008-01-01

77

The teaching of cardiopulmonary resuscitation in schools in Hampshire.  

Science.gov (United States)

In order to maximise the number of potential providers of cardiopulmonary resuscitation (CPR) in the community, it has been suggested that a programme of basic life support (BLS) training should be included within the school curriculum. Using a questionnaire sent to 275 schools in south east Hampshire (representing 71,716 pupils), we discovered that BLS was taught at only 26% of schools which replied. The age at which teaching commenced ranged from 7-16 years (mode = 10 years). We estimated that almost 5000 children might currently be trained annually in these schools. Consequently, each year approximately 40% of children in south east Hampshire schools might be exposed to BLS training. On average, schools offering BLS tuition were larger, had more teaching staff and employed a higher proportion of staff who were themselves BLS providers. The majority of BLS teaching was undertaken by school staff (50.9% of schools) and members of the Red Cross, The St. John Ambulance Brigade or statutory ambulance service (30.9%). One school utilised members of the local fire brigade. Only one school offering BLS training to its pupils did not have a staff member trained in CPR. PMID:9259057

Lewis, R M; Fulstow, R; Smith, G B

1997-08-01

78

The role of Levosimendan in cardiopulmonary resuscitation.  

Science.gov (United States)

Although initial resuscitation from cardiac arrest (CA) has increased over the past years, long term survival rates remain dismal. Epinephrine is the vasopressor of choice in the treatment of CA. However, its efficacy has been questioned, as it has no apparent bene?ts for long-term survival or favorable neurologic outcome. Levosimendan is an inodilator with cardioprotective and neuroprotective effects. Several studies suggest that it is associated with increased rates of return of spontaneous circulation as well as improved post-resuscitation myocardial function and neurological outcome. The purpose of this article is to review the properties of Levosimendan during cardiopulmonary resuscitation (CPR) and also to summarize existing evidence regarding the use of Levosimendan in the treatment of CA. PMID:24972240

Varvarousi, Giolanda; Stefaniotou, Antonia; Varvaroussis, Dimitrios; Aroni, Filippia; Xanthos, Theodoros

2014-10-01

79

Impact of cardiopulmonary resuscitation training on resuscitation.  

Science.gov (United States)

Restoration of adequate spontaneous circulation after "arrest" and cardiopulmonary resuscitation (CPR) of 546 patients before and 460 patients after initiation of a CPR training course in a 500-bed city hospital is reported. Between January 1972 and June 1976, adequate circulation after CPR was present in 38.6% of patients before and 50.4% after training ICU nurses and house physicians in modern resuscitation techniques. Factors crucial to resumption of adequate circulation are: (1) CPR training of all hospital personnel so that effective CPR can be started immediately after recognition of an arrest situation, (2) production of a palpable pulse with closed chest cardiac massage, and (3) prompt effective therapy so that the time interval between arrest and resumption of adequate spontaneous circulation is short. PMID:446057

Bernhard, W N; Turndorf, H; Cottrell, J E; Vea, F; Basak, A

1979-06-01

80

Activation of hemostasis after off-pump coronary artery bypass graft surgery  

OpenAIRE

The aim of this thesis was to study the activation of hemostasis and inflammation, in patients undergoing off-pump (OPCAB) and on-pump coronary artery bypass graft (CABG) surgery and the relationship of coagulation and inflammation to clinical outcome. We hypothesized that activation of hemostasis and C-reactive protein (CRP) would be more pronounced in patients undergoing CABG using cardiopulmonary bypass (CPB) and that this would be associated with increased morbidity. In particular, neuroc...

Lo, B.

2007-01-01

81

Effect of Surgery and Cardiopulmonary Bypass on Indocyanine Green Pharmacokinetics  

OpenAIRE

The pharmacokinetics of indocyanine green (ICG), a marker for hepatic blood flow (HBF), were studied at selected times during the initial 24-hour postoperative period in patients undergoing cardiac surgery with (n = 33) and without (n = 13) cardiopulmonary bypass. Cardiopulmonary bypass (CPB) caused a depression in ICG clearance and, by implication, HBF, reaching 48% of the pre-anesthetic and 60% of the pre-bypass values 2 hours post-CPB, returning to control values between 8 and 12 hours pos...

Kramer, William G.; Romagnoli, Alexander

1986-01-01

82

Cardiopulmonary disease in the geriatric dog and cat.  

Science.gov (United States)

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. PMID:2646821

Miller, M S; Tilley, L P; Smith, F W

1989-01-01

83

The radiation-induced grafting of polybutadiene onto silica  

International Nuclear Information System (INIS)

The ?-ray-induced grafting of polybutadiene oligomers onto precipitated silica was investigated in the dose range up to 200 kGy by THA, FTIR, CP/MAS NMR, TEM microscopy, inverse gas chromatography (IGC), with determination of the grafting yields and the characterization of the modified silica with respect to surface energy, SiO2-oligomer interaction and morphology. The matrix EPR spectroscopy was employed for investigating the nature of the intermediate radicals in the grafting mechanism.

84

The radiation-induced grafting of polybutadiene onto silica  

Science.gov (United States)

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

Dondi, D.; Buttafava, A.; Stagnaro, P.; Turturro, A.; Priola, A.; Bracco, S.; Galinetto, P.; Faucitano, A.

2009-07-01

85

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)

86

Transfusion associated graft versus host disease in an immunocompetent individual following coronary artery bypass grafting  

Directory of Open Access Journals (Sweden)

Full Text Available Transfusion associated graft versus host disease (TA-GVHD is a rare but commonly fatal complication of transfusion of cellular blood products, which usually occurs in immunosuppressed individuals following transfusion and subsequent engraftment of viable T lymphocytes. Very rarely it may arise in apparently immunocompetent individuals. The clinical syndrome consists of fever, skin rash, diarrhoea, hepatic dysfunction, and bone marrow aplasia. The outcome is nearly always fatal. We present here a case report of fatal TA-GVHD in a "presumed" immunocompetent patient, post coronary artery bypass grafting surgery after transfusion of blood products. The patient died 24 days after transfusion. There is a perceived increased risk of TA-GVHD following bypass grafting and other surgical procedures where cardiopulmonary bypass is required. TA-GVHD is probably underreported and the incidence is felt to be too low to warrant routine irradiation of cellular products for this group of patients. Clinicians, pathologists, and transfusion centers should be aware of this rare but devastating complication of blood transfusion after cardiac surgery.

Nagendra Girish

2008-01-01

87

Coronary Artery Bypass Graft  

Science.gov (United States)

Coronary Artery Bypass Graft Introduction Sometimes people have serious problems with their heart and the arteries that go into it. Coronary artery bypass graft surgery, or CABG, bypasses clogged arteries in the ...

88

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available Coronary Artery Bypass Graft Introduction Sometimes people have serious problems with their heart and the arteries that go into it. Coronary artery bypass graft surgery, or CABG, bypasses clogged arteries in the ...

89

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

90

Effect of surface texture of grafted films on antithrombogenicity  

International Nuclear Information System (INIS)

The relation between grafting conditions and antithrombogenicity has been examined from the purpose of clearing the necessity of controlling grafting conditions to enhance blood compatibility. The grafting systems employed here were N,N-dimethylacrylamide (DMAA) - poly(tetrafluoroethylene) (PTFE) and DMAA - poly(ethylene-co-tetrafluoroethylene) (AFLON) and grafting parameters were dose rate, monomer concentration and total dose (irradiation time). Grafting DMAA on to the substrates was carried out by using simultaneous irradiation method of gamma rays from a 60Co source. After evaluation of blood compatibility of the grafted films by using in vitro tests, it has been clear that control of grafting conditions is important. Especially, in both grafting systems, dose rate control has found to be very important for blood compatibility. When higher dose rate of 1.0 x 105 to 3.0 x 105 rad/hr was used for grafting DMAA on to PTFE or AFLON, blood compatibility of the substrates was not enhanced, whereas it was improved when the grafting was carried out at lower dose rate of 0.97 x 104 rad/hr. The correlation between dose rate and antithrombogenicity has been interpreted in terms of surface-roughness of the grafted films. By scanning electron microscope (SEM) - observation, it has been observed that higher dose rate makes the surface rough, whereas lower dose rate makes it smooth. (author)

91

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)

92

Hantaviruses and cardiopulmonary syndrome in South America.  

Science.gov (United States)

Hantavirus (Bunyaviridae) cardiopulmonary syndrome (HCPS) is an emerging health problem in South America due to urban growth and to the expansion of agriculture and cattle-raising areas into ecosystems containing most of the species of Sigmodontinae rodents that act as hantavirus reservoirs. About 4000 HCPS cases have been reported in South America up to 2013, associated with the following hantaviruses: Andes, Anajatuba, Araraquara (ARQV), Paranoá, Bermejo, Castelo dos Sonhos, Juquitiba, Araucária, Laguna Negra, Lechiguanas, Maripa, Oran, Rio Mamore and Tunari. The transmission of hantavirus to man occurs by contact with or through aerosols of excreta and secretions of infected rodents. Person-to-person transmission of hantavirus has also been reported in Argentina and Chile. HCPS courses with a capillary leaking syndrome produced by the hantavirus infecting lung endothelial cells and mostly with a severe inflammatory process associated with a cytokine storm. HCPS starts as a dengue-like acute febrile illness but after about 3 days progresses to respiratory failure and cardiogenic shock, leading to a high fatality rate that reaches 50% for patients infected with ARQV. PMID:24508343

Figueiredo, Luiz Tadeu Moraes; Souza, William Marciel de; Ferrés, Marcela; Enria, Delia Alcira

2014-07-17

93

Postoperative abdominal complications after cardiopulmonary bypass  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB. Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed. Results Of all the patients, 33(1.4% developed abdominal complications postoperatively, including 11(33.3% cases of paralytic ileus, 9(27.3% of gastrointestinal haemorrhage, 2(6.1% of gastroduodenal ulcer perforation, 2(6.1% of acute calculus cholecystitis, 3(9.1% of acute acalculus cholecystitis, 4(12.1% of hepatic dysfunction and 2(6.1% of ischemia bowel diseases. Of the 33 patients, 26 (78.8% accepted medical treatment and 7 (21.2% underwent subsequent surgical intervention. There were 5(15.2% deaths in this series, which was significantly higher than the overall mortality (2.7%. Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications. Conclusions Abdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients.

Dong Guohua

2012-10-01

94

Role of corticosteroids during cardiopulmonary bypass.  

Science.gov (United States)

Corticosteroids are commonly used in the peri-operative setting for patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The inflammatory response to CPB is associated with organ dysfunction and increased mortality. Corticosteroids reduce biochemical inflammatory markers associated with CPB, however the impact on clinical outcomes is mixed. The purpose of this article is to evaluate the evidence of changes in clinical outcomes associated with the peri-operative administration of corticosteroids in patients undergoing cardiac surgery with CPB. Randomized, placebo-controlled trials and meta-analyses were reviewed for evidence evaluating the impact of corticosteroids on clinical outcomes including mortality, myocardial infarction, atrial fibrillation (AF), duration of intubation, length of intensive care unit (ICU) or hospital stay, hyperglycemia, and gastrointestinal complications. Most of the relevant studies are underpowered to assess major clinical outcomes. Although corticosteroids likely reduce the risk of AF, this needs to be evaluated when used in addition to or in lieu of other anti-arrhythmic agents. Evidence does not equivocally support the use of corticosteroids to improve clinical outcomes in cardiac surgery patients. PMID:24715740

Kristeller, Judith L; Jankowski, Arthur; Reinaker, Travis

2014-03-01

95

Conflicting perspectives compromising discussions on cardiopulmonary resuscitation.  

LENUS (Irish Health Repository)

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.

Groarke, J

2010-09-01

96

21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.  

Science.gov (United States)

...Cardiopulmonary bypass arterial line blood filter. (a) Identification...cardiopulmonary bypass arterial line blood filter is a device used as part of a gas exchange (oxygenator) system...nonbiologic particles and emboli (blood clots or pieces of...

2010-04-01

97

Historical development of the cardiopulmonary ressuscitation: review study  

Directory of Open Access Journals (Sweden)

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.

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

2009-07-01

98

Radial artery jump graft from anterior to posterior descending coronary artery.  

OpenAIRE

A novel technique to achieve total arterial grafting, using a radial artery jump graft from the anterior descending coronary artery to the posterior descending artery, was employed in a preliminary series of 10 patients. All radial artery grafts were patent. This was confirmed using the SPY intraoperative fluorescence imaging system. There were no postoperative complications in any patient, and all were discharged uneventfully.

Taggart, Dp; Balacumaraswami, L.; Venkatapathy, A.

2009-01-01

99

A reappraisal of saphenous vein grafting  

Directory of Open Access Journals (Sweden)

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.

Yuan Shi-Min

2011-01-01

100

Septal graft in laryngeal reconstruction  

International Nuclear Information System (INIS)

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

101

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

Science.gov (United States)

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

Docters, E. H.; Smolko, E. E.; Suarez, C. E.

102

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

Energy Technology Data Exchange (ETDEWEB)

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

Docters, E.H.; Smolko, E.E. (Comision Nacional de Energia Atomica, Buenos Aires (Argentina). Direccion de Radioisotopos y Radiaciones); Suarez, C.E. (Instituto Nacional de Tecnologia Agropecuaria, Castelar (Argentina))

1990-01-01

103

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

International Nuclear Information System (INIS)

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

104

Intraoperative grafts assessment.  

Science.gov (United States)

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

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

2009-01-01

105

DC information preservation for cardiopulmonary monitor utilizing CW Doppler radar.  

Science.gov (United States)

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

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

2008-01-01

106

Sliding grafted polymer layers  

OpenAIRE

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 as cyclodextrins. 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 br...

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

2004-01-01

107

Non-contact cardiopulmonary sensing with a baby monitor.  

Science.gov (United States)

Cardiopulmonary signals can be detected at a distance using simple Doppler radars operating in CW mode. Tests with and without audio modulation show the feasibility of measurements with this hardware, providing a maximum measured difference to the reference of just 1.6bpm for heart rate. Tests show good correspondence of heart/respiration rate with the reference data. PMID:18002451

Hafner, Noah; Mostafanezhad, Isar; Lubecke, Victor M; Boric-Lubecke, Olga; Host-Madsen, Anders

2007-01-01

108

Retention of Cardiopulmonary Resuscitation Skills by Medical Students.  

Science.gov (United States)

A study of preclinical medical students' cardiopulmonary resuscitation (CPR) skills showed students had a very recent CPR course had a significantly lower failure rate than those with courses one or two years previously. The most frequent errors were in chest compression rate and inability to adhere to the single-rescuer compression-to-ventilation…

Fossel, Michael; And Others

1983-01-01

109

Predicting postoperative cardiopulmonary complications by a test of stair climbing  

International Nuclear Information System (INIS)

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

110

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

International Nuclear Information System (INIS)

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

111

Osseous scintigraphy and auxiliary graft  

International Nuclear Information System (INIS)

The scintigraphy could be a good way to survey the osseous graft: three cases are studied in which were recognized the presence of a graft, surinfection, graft lysis, pseudo-arthrosis, algodystrophy. 8 refs., 5 figs

112

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)

113

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

Scientific Electronic Library Online (English)

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

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

2005-05-01

114

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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

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

115

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available ... arteries, forming “plaques” that narrow the arteries. Narrowed arteries do not let enough blood go through. This causes blood flow to decrease, ... of the body and grafting them to coronary arteries. These grafts bypass clogged blood vessels and allow increased blood flow to the ...

116

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available ... CABG surgery includes taking blood vessels from other parts of the body and grafting them to coronary arteries. These grafts bypass clogged blood vessels and allow increased blood flow to the heart muscles. Make sure to contact your doctor in case of any new symptoms, ...

117

Coronary Artery Bypass Grafting  

Science.gov (United States)

... no benefit Routinely adding mitral valve repair to coronary artery bypass graft surgery for heart attack patients may not be warranted in patients with moderate mitral valve damage, according to an NIH-funded study. View ... Coronary Artery Bypass Grafting Press Releases Know the Facts and Act ...

118

Effect of surface texture of grafted films on antithrombogenicity  

International Nuclear Information System (INIS)

The relation between grafting conditions and antithrombogenicity has been examined from the purpose of clearing the necessity of controlling grafting conditions to enhance blood compatibility. The grafting systems employed here were N,N-dimethylacrylamide (DMAA) - poly(tetrafluoroethylene) (PTFE) and DMAApoly(ethylene-co-tetrafluoroethylene) (AFLON) and grafting parameters were dose rate, monomer concentration and total dose (irradiation time). Grafting DMAA onto the substrates was carried out by using simultaneous irradiation method of gamma rays from a 60Co source. After evaluation of blood compatibility of the grafted films by using in vitro tests, it has been clear that control of grafting conditions is important. Especially, in both grafting systems, dose rate control has found to be very important for blood compatibility. When higher dose rate of 1.0 x 105 to 3.0 x 105 rad/hr was used for grafting DMAA onto PTFE or AFLON, blood compatibility of the substrates was not enhanced, whereas it was improved when the grafting was carried out at lower dose rate of 0.97 x 104 rad/hr. The correlation between dose rate and antithrombogenicity has been interpretated in terms of surfaceroughness of the grafted films. By scanning electron microscope (SEM) observation, it has been observed that higher dose rate makes the surface rough, whereas lower dose rate does it smooth. In the grafting systems used here, therefore, dose rate is tstems used here, therefore, dose rate is the most important factor to control the roughness of surface which gives a profound effect on antithrombogenicity

119

Sliding grafted polymer layers  

CERN Document Server

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.

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

2005-01-01

120

End-Grafted Polymer Chains onto Inorganic Nano-Objects  

Directory of Open Access Journals (Sweden)

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.

Demetra S. Achilleos

2010-03-01

121

Study on radiation grafting reaction of MMA onto hydroxyapatite  

International Nuclear Information System (INIS)

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

122

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

International Nuclear Information System (INIS)

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

123

Lethal systemic Degos disease with prominent cardio-pulmonary involvement  

International Nuclear Information System (INIS)

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

124

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

125

A small scale oxygenator for cardiopulmonary bypass in rats.  

Science.gov (United States)

Cardiopulmonary bypass (CPB) devices replace transiently the function of both heart and lungs, allowing the investigator to work safely on a stopped heart. Although this technology has greatly improved since its first applications in the early 1950's there is still no definitive rat CPB model, various experiments reporting drawbacks like pulmonary edema, large priming volumes,etc. We present a new oxygenator that can be used in cardiopulmonary bypass experiments in rats, simple in design and efficient in function,in which the process of blood oxygenation takes place in a vertical cylinder filled up with air or oxygen, with blood being spread onto the wall and then trickling down in a thin layer that facilitates the oxygen transfer. The oxygenation is efficient, the pO2 reaches levels of almost 150 mmHg (physiological level is around 100 mmHg) in conditions of oxygen saturation of over 99% (normal levels 95%-98%). PMID:16969752

Ordodi, V L; Paunescu, V; Mic, A A; Ionac, M; Sandesc, D; Mic, F A

2006-08-01

126

Does tranexamic acid decrease bleeding in patients undergoing cardiopulmonary bypass?  

OpenAIRE

We reviewed the records of 66 patients who underwent cardiopulmonary bypass; half of these patients received the plasmin inhibitor, tranexamic acid. The demographics were not different between the group who received tranexamic acid and the group who did not (control group). There was no difference in the heparin or protamine requirements between the two groups. There was a significantly greater amount of 12-hr chest tube bleeding in the control group (495 +/- 484 vs. 863 +/- 655 in the contro...

Connelly, N. R.; Kiessling, B. M.; Brull, S. J.

1994-01-01

127

Cardiopulmonary Resuscitation : Pharmacological Interventions for Augmentation of Cerebral Blood Flow  

OpenAIRE

Cardiac arrest results in immediate interruption of blood flow. The primary goal of cardiopulmonary resuscitation (CPR) is to re-establish blood flow and hence oxygen delivery to the vital organs. This thesis describes different pharmacological interventions aimed at increasing cerebral blood flow during CPR and after restoration of spontaneous circulation (ROSC). In a porcine model of cardiac arrest, continuous infusion of adrenaline generated higher cortical cerebral blood flow during CPR a...

Johansson, Jakob

2004-01-01

128

Serial Cardiopulmonary Exercise Testing in Patients with Previous Fontan Surgery  

OpenAIRE

Patients with previous Fontan surgery have reduced peak oxygen consumption (VO2), and data regarding progression of exercise intolerance is limited. The purpose of this study was to assess the evolution of exercise tolerance in patients with previous Fontan surgery. We performed a retrospective cohort study of patients with previous Fontan surgery who underwent cardiopulmonary exercise testing between November 2002 and January 2009. Patients were required to have completed at least two tests,...

Fernandes, Susan M.; Mcelhinney, Doff B.; Khairy, Paul; Graham, Dionne A.; Landzberg, Michael J.; Rhodes, Jonathan

2010-01-01

129

Removal of Cardiopulmonary Resuscitation Artifacts in the Human Electrocardiogram  

OpenAIRE

Death from heart diseases is the most common type of mortality in western countries and the survival rate of cardiac arrest is dismally low. In the treatment of cardiac arrest, two therapeutic methods are most important: cardiopulmonary resuscitation (CPR; chest compressions and ventilations) and defibrillation (electrical shocks to restart a fibrillating heart). An automated external defibrillator is commonly used for such shocks, and records and performs signal analysis on the electrocardi...

Eilevstjønn, Joar

2004-01-01

130

Cardiopulmonary signal sensing from subject wearing body armor.  

Science.gov (United States)

Continuous wave (CW) Doppler motion sensing radar can detect human physiological signal such as respiration or heart signals at a distance and through barriers. It has been shown that heart rate can be extracted with good accuracy for normally clothed subjects. Such technique could potentially be used to search for survivors in battlefield triage applications. To assess the feasibility of such applications, we investigated Doppler radar of cardiopulmonary signal sensing from subjects wearing body armor vests. This paper presents measurement results of heart signals obtained using CW Doppler radar from a subject wearing body armor vest. Since armor plate reflects most of the RF signal, received signal after reflected from a subject is phase modulated with motion of an armor plate induced by chest motion, rather than directly with chest motion due to cardiopulmonary motion. Two different cases, including supine and seated positions, are chosen for this study, and good sensitivity was obtained in both cases. To the best of author's knowledge, this is the first published result of cardiopulmonary signal detection from a subject wearing a body armor vest. PMID:18001966

Park, Byung-Kwon; Lubecke, Victor; Boric-Lubecke, Olga; Host-Madsen, Anders

2007-01-01

131

Cardiopulmonary Resuscitation Training in Sport Universities: An Italian Survey  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Physical activity is associated to an increased risk of sudden cardiac death (SCD. Together with primary prevention, prompt recognition and early management of SCD are crucial in order to improve survival rate. During their duty, sport trainers and teachers can play a key role in secondary prevention of cardiac arrest provided they have received an appropriate training in Cardiopulmonary Resuscitation (CPR during their curricular study. This is usually achieved through a Basic life Support and Defibrillation (BLS-D Course which in Italy formally enables to Automated External Defibrillator (AED use. Objective: To investigate the presence, the type and the diffusion of cardiopulmonary resuscitation training in Sport and Exercise Sciences Universities in Italy. Design: Descriptive survey research design was adopted for the study. Setting: The study sample consisted of 32 Italian Universities with Bachelor and Master-Level Degrees in Sport and Exercise Sciences. Methods: Teaching secretary or directly deans/ course presidents were contacted by email or telephone in order to collect information on the availability of BLS-D courses for Sport and Exercise Sciences students during the academic year 2010-2011. Results: The compliance to the survey has been >93%. Only a reduced number of the contacted Universities offered dedicated courses of Cardiopulmonary Resuscitation with license to Defibrillation according to current local regulation. Conclusion: The described situation shows a limit in the generation of a sport trainers’ category highly specialized in cardiac and respiratory emergencies: only 6 Universities organize BLS-D training with official certification.

Andrea Scapigliati

2013-08-01

132

Cardiopulmonary Exercise Capacity and Preoperative Markers of Inflammation  

Science.gov (United States)

Explanatory mechanisms for the association between poor exercise capacity and infections following surgery are underexplored. We hypothesized that aerobic fitness—assessed by cardiopulmonary exercise testing (CPET)—would be associated with circulating inflammatory markers, as quantified by the neutrophil-lymphocyte ratio (NLR) and monocyte subsets. The association between cardiopulmonary reserve and inflammation was tested by multivariable regression analysis with covariates including anaerobic threshold (AT) and malignancy. In a first cohort of 240 colorectal patients, AT was identified as the sole factor associated with higher NLR (P = 0.03) and absolute and relative lymphopenia (P = 0.01). Preoperative leukocyte subsets and monocyte CD14+ expression (downregulated by endotoxin and indicative of chronic inflammation) were also assessed in two further cohorts of age-matched elective gastrointestinal and orthopaedic surgical patients. Monocyte CD14+ expression was lower in gastrointestinal patients (n = 43) compared to age-matched orthopaedic patients (n = 31). The circulating CD14+CD16? monocyte subset was reduced in patients with low cardiopulmonary reserve. Poor exercise capacity in patients without a diagnosis of heart failure is independently associated with markers of inflammation. These observations suggest that preoperative inflammation associated with impaired cardiorespiratory performance may contribute to the pathophysiology of postoperative outcome. PMID:25061264

Sultan, Pervez; Edwards, Mark R.; Gutierrez del Arroyo, Ana; Cain, David; Sneyd, J. Robert; Struthers, Richard; Minto, Gary; Ackland, Gareth L.

2014-01-01

133

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.

2011-08-02

134

Industry Employment  

Science.gov (United States)

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…

Occupational Outlook Quarterly, 2012

2012-01-01

135

Employer Branding  

DEFF Research Database (Denmark)

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

Frimann, SØren; MØnsted, Bolette Rye

2012-01-01

136

Employment Law  

Science.gov (United States)

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 site, Employment Law. 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 one of the most popular features, a list of recent and pending cases in the field that have been heard before the US Supreme Court. Additionally, the â??Articlesâ? 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.

Runkel, Ross, 1939-

137

Left ventricular assist device outflow graft: alternative sites  

OpenAIRE

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 ...

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

2014-01-01

138

Vein graft failure.  

Science.gov (United States)

After the creation of an autogenous lower extremity bypass graft, the vein must undergo a series of dynamic structural changes to stabilize the arterial hemodynamic forces. These changes, which are commonly referred to as remodeling, include an inflammatory response, the development of a neointima, matrix turnover, and cellular proliferation and apoptosis. The sum total of these processes results in dramatic alterations in the physical and biomechanical attributes of the arterialized vein. The most clinically obvious and easily measured of these is lumen remodeling of the graft. However, although somewhat less precise, wall thickness, matrix composition, and endothelial changes can be measured in vivo within the healing vein graft. Recent translational work has demonstrated the clinical relevance of remodeling as it relates to vein graft patency and the systemic factors influencing it. By correlating histologic and molecular changes in the vein, insights into potential therapeutic strategies to prevent bypass failure and areas for future investigation are explored. PMID:24095042

Owens, Christopher D; Gasper, Warren J; Rahman, Amreen S; Conte, Michael S

2015-01-01

139

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available ... An incentive spirometer is a device that you hold against your mouth when you breathe in. It ... beats. Coronary artery bypass graft surgery is relatively safe. Risks and complications are rare but possible. Knowing ...

140

Grafting in rhinoplasty.  

Science.gov (United States)

Advances in grafting techniques have provided the basis for a paradigm shift in rhinoplasty in which purely reductive techniques have been largely supplanted by structurally sound framework surgery. Proficiency with autologous cartilage grafting allows the rhinoplasty surgeon to achieve superior nasal definition and durable aesthetic outcomes by building a stable nasal framework that resists the contractile forces of healing responsible for delayed nasal airway compromise and aesthetic distortion. Cartilage grafts may be used to reposition, augment, or reconstitute nasal structure after cartilaginous resection and recontouring. The authors present various grafting techniques that are reliably used to sculpt the nasal framework in rhinoplasty, with emphasis on the relevant anatomy, nomenclature, and clinical indications for each approach. Judicious use of these methods results in predictable rhinoplasty outcomes with enhanced aesthetics and function. PMID:19181282

Brenner, Michael J; Hilger, Peter A

2009-02-01

141

[Cartilaginous graft in rhinoplasty].  

Science.gov (United States)

Nowadays, cartilage grafts are widely used in secondary as well as primary rhinoplasty. Even if their fixation is often easier and more precise using an open approach, most of them can also be positioned with a close approach. In this article, the authors describe various cartilage donor sites. For each of them, they describe benefits, inconveniences, harvesting techniques and preferred indications. Cartilage can be harvested on the septum, ear and ribs. For the authors, septal cartilage is often the best material but can be insufficient or totally missing (especially in secondary rhinoplasty). In such cases, concha cartilage is a good material for tip and alar grafts because of its pliability and convexity whereas rib cartilage, which is stiffer and thicker, will provide good supporting grafts. Described more recently, diced cartilage wrapped in fascia (DCF) can be a very good option for dorsal onlay graft, avoiding irregularities of conchal cartilage and risk of rib cartilage's twisting. PMID:25213491

Duron, J-B; Aiach, G

2014-12-01

142

Vascular graft infections  

OpenAIRE

Vascular procedures are rarely complicated by infection, but if prosthetic vascular graft infection (PVGI) occurs, morbidity and mortality are high. Several patient-related, surgery-related and postoperative risk factors are reported, but they are not well validated. PVGI is due to bacterial colonisation of the wound and the underlying prosthetic graft, generally as a result of direct contamination during the operative procedure, mainly from the patient's skin or adjacent bowel. There is no c...

Hasse, Barbara; Husmann, Lars; Zinkernagel, Annelies; Weber, Rainer; Lachat, Mario; Mayer, Dieter

2013-01-01

143

Transfusion-associated graft versus host disease in the immunocompetent patient: an ongoing problem.  

Science.gov (United States)

Transfusion associated-graft versus host disease (TA-GVHD) is a rare complication of blood transfusion. It carries a very high mortality rate. Although the phenomenon has been well described in immunocompromised patients, this review focuses on the immunocompetent host. Cases of TA-GVHD continue to be reported following a variety of surgical procedures, especially cardiac procedures requiring cardiopulmonary bypass. Additional risk factors for TA-GVHD include blood component transfusion in populations with limited genetic diversity, the use of directed donations from family members, and the transfusion of fresh blood. As there is no effective treatment, the focus is on prevention. PMID:23792801

Jawa, Randeep S; Young, David H; Stothert, Joseph C; Kulaylat, Mahmoud N; Landmark, James D

2015-03-01

144

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

International Nuclear Information System (INIS)

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

145

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

Directory of Open Access Journals (Sweden)

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.

Muhammad Shahzeb Khan

2014-01-01

146

A comparative study of release of interleukin-6 and tumour necrosis factor during normothermic and hypothermic cardiopulmonary bypass.  

OpenAIRE

The institution of cardiopulmonary bypass generates many pro-inflammatory cytokines and several clinical variables, including temperature, have been shown to influence cytokine release during and after cardiopulmonary bypass. The release of tumour necrosis factor and interleukin-6 are the best predictors of post-cardiopulmonary bypass related morbidity. Their release during normothermic and hypothermic cardiopulmonary bypass and the correlation with clinical parameters of organ injury was stu...

Naresh Sandur; Kapoor Mukul; Ramchandran Trichur; Kale Shailaja

2002-01-01

147

Radial artery jump graft from anterior to posterior descending coronary artery.  

Science.gov (United States)

A novel technique to achieve total arterial grafting, using a radial artery jump graft from the anterior descending coronary artery to the posterior descending artery, was employed in a preliminary series of 10 patients. All radial artery grafts were patent. This was confirmed using the SPY intraoperative fluorescence imaging system. There were no postoperative complications in any patient, and all were discharged uneventfully. PMID:19592543

Taggart, David P; Balacumaraswami, Lognathen; Venkatapathy, Ajit

2009-04-01

148

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

Directory of Open Access Journals (Sweden)

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.

Betharia S

1990-01-01

149

Axillobifemoral bypass grafting  

Directory of Open Access Journals (Sweden)

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.

Davidovi? Lazar B.

2004-01-01

150

Cerebral hemodynamics during coronary artery bypass graft surgery: the effect of carotid stenosis.  

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Carotid stenosis is a frequent coexisting condition in patients undergoing coronary artery bypass graft (CABG) surgery. The impact of carotid stenosis on cerebral perfusion is not fully understood. The purpose of this study was to determine the impact of carotid stenosis on cerebral blood flow velocity in patients undergoing CABG. Seventy-three patients undergoing CABG were prospectively recruited and underwent preoperative Duplex carotid ultrasound to evaluate the degree of carotid stenosis. Intraoperatively, transcranial Doppler ultrasound was used to record the mean flow velocity (MFV) within the bilateral middle cerebral arteries. In addition, during the period of cardiopulmonary bypass, regulators of cerebral hemodynamics such as hematocrit, partial pressure of carbon dioxide and temperature were recorded. The ipsilateral middle cerebral artery mean flow velocity was compared in arteries with and without carotid stenosis using a repeated measures analysis. Seventy-three patients underwent intraoperative monitoring during CABG and 30% (n=22) had carotid stenosis. Overall, MFV rose throughout the duration of CABG including when the patient was on cardiopulmonary bypass. However, there was no significant MFV difference between those arteries with and without stenosis (F=1.2, p=.21). Further analysis during cardiopulmonary bypass, demonstrated that hemodilution and partial pressure of carbon dioxide may play a role in cerebral autoregulation during CABG. Carotid stenosis did not impact mean cerebral blood flow velocity during CABG. The cerebrovascular regulatory process appears to be largely intact during CABG. PMID:19540657

Rudolph, James L; Sorond, Farzaneh A; Pochay, Val E; Haime, Miguel; Treanor, Patrick; Crittenden, Michael D; Babikian, Viken L

2009-08-01

151

Jugular bulb oxygen saturation and middle cerebral blood flow velocity during cardiopulmonary bypass.  

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This study investigates changes of jugular bulb oxygen saturation (SjO2) measured by fiberoptic jugular bulb oximetry and changes of intracranial hemodynamics using transcranial Doppler sonography (TCD) during cardiopulmonary bypass (CPB) for coronary artery bypass graft (CABG) in 17 ASA III patients. Anesthesia was maintained with fentanyl, midazolam, and continuous infusion of etomidate. Hypothermic CPB (27 degrees C) was managed according to alpha-stat conditions. SjO2 (%) was measured by a fiberoptic catheter (Opticath F 5.5; Abbott Critical Care Systems) placed in the right jugular bulb via the right internal jugular vein. Mean blood flow velocity (Vmean, cm/s) was measured in the middle cerebral artery using a bidirectional 2-MHz TCD system (Transpect, Medasonics). Data were recorded continuously from the beginning to the end of the CPB. During cooling and hypothermia (27 degrees C); SjO2 and Vmean did not change compared with values at the start of CPB. However, with the beginning of rewarming, Vmean was increased 65% compared with stable hypothermia (27 degrees C). This increase in Vmean was associated with a 25% decrease in SjO2. Maximum desaturation occurred at a 36 degrees C jugular bulb temperature. During cooling and stable hypothermia, global oxygen balance and intracerebral perfusion seemed to be maintained. However, a major alteration in the balance of the cerebral oxygen supply and demand may occur in response to rewarming despite increases in Vmean. Findings suggest inadequate increases in CBF to meet cerebral metabolic demand. Further investigations need to validate these findings with biochemical techniques and neuropsychological tests. PMID:9100181

von Knobelsdorff, G; Hänel, F; Werner, C; Schulte am Esch, J

1997-04-01

152

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

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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.

R.R. Rodrigues

2011-06-01

153

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

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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 PaO{sub 2}/FiO{sub 2} 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 PaO{sub 2}/FiO{sub 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)

Rodrigues, R.R.; Sawada, A.Y.; Fukuda, M.J.; Neves, F.H.; Carmona, M.J.; Auler, J.O.; Malbouisson, L.M.S., E-mail: malbouisson@hcnet.usp.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Hospital das Clinicas; Pelosi, P. [Universita' degli Studi dell' Insubria, Varese (Italy). Dipt. Ambiente, Salute e Sicurezza; Rouby, J.-J. [University Pierre and Marie Curie, Paris (France). La Pitie Salpetriere Hospital. Dept. of Anesthesiology and Critical Care and Medicine

2011-06-15

154

Leukocyte-Aprotinin Atrial Fibrillation Study (LAFFS: Impact of Aprotinin and Leukofiltration on Atrial Fibrillation, Renal Insufficiency and Encephalopathy Post-Cardiopulmonary Bypass  

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Full Text Available Abstract Purpose:  Atrial fibrillation remains the leading postoperative complication following cardiopulmonary bypass.  A randomized trial was undertaken to evaluate the effectiveness of leukocyte filtration and aprotinin, applied separately and in combination, on the incidence of post-operative atrial fibrillation.   A secondary component of the study was the impact of these adjunct interventions on post-surgical renal and neurological dysfunction. Methods:  A total of 1,220 patients undergoing primary isolated coronary artery bypass grafting were randomly assigned to one of four treatment groups.  The control group (305 patients received standard cardiopulmonary bypass with moderately hypothermic (34ºC cardioplegic arrest.  In the filtration group (310 patients leukocyte reducing filters were incorporated into the bypass circuit.  The aprotinin group (285 patients received full Hammersmith dose aprotinin.  The combination therapy group (320 patients received both aprotinin and leukocyte filtration. Results:  The incidences of atrial fibrillation were 25% in the control group, 16% in the filtration group, 19% in the aprotinin group and 10% in the combination therapy group (P < 0.001.  Renal dysfunction was detected in 3% of the control group, 2% of the filtration group, 8% of the aprotinin group, and 5% of the combination group (P < 0.005.  Neurological dysfunction occurred in 2% of the control group, 2% of the filtration group, 1% of the aprotinin group, and 2% of the combination group (P = n.s.. Conclusions: Combination therapy with aprotinin and leukocyte filtration markedly reduced atrial fibrillation post-cardiopulmonary bypass, and was more effective than the individual treatments.  Aprotinin treatment increased the incidence of renal dysfunction, and the addition of leukocyte filtration partially mitigated this detrimental effect of aprotinin.

Robert T. Mallet

2008-12-01

155

Delayed stenosis of the small intestine after cardiopulmonary arrest.  

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A man in his 70s experienced cardiopulmonary arrest (CPA) due to acute myocardial infarction. He was resuscitated and treated with a multimodal approach, and he fortunately survived CPA without neurological damage. However, abdominal pain and vomiting occurred 45 days after the CPA. Small intestinal endoscopy showed pinhole-like stenosis of the ileum. Although balloon dilation was performed through the scope, his symptoms did not improve. Partial small bowel resection was eventually performed 139 days after the CPA. Pathological findings revealed ischemic changes in the mucosa at two spots. We speculate that an ischemic event occurred in the small bowel during CPA. PMID:25482908

Adachi, Seiji; Okuno, Mitsuru; Horibe, Yohei; Ono, Tomohiko; Goto, Naoe; Nakamura, Noriaki; Iwama, Midori; Yamauchi, Osamu; Saito, Koshiro

2014-12-01

156

Cardiopulmonary resuscitation skills of hospital medical and nursing staff members.  

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The cardiopulmonary resuscitation skills of 160 staff members at a large metropolitan teaching hospital were assessed by a multiple choice questionnaire and a practical test of basic life support skills on a manikin. Medical staff members performed significantly better than did nurses in the multiple choice test, but significantly worse in the practical test; 48 (60%) of 80 nurses and only 26 (32.5%) of 80 doctors passed the practical test. Training in resuscitation by the St John Ambulance Association as a medical student may have improved the basic life support skills of doctors but there is clearly a need for continued revision and assessment of resuscitation skills. PMID:3773804

Goucke, C R; Dobb, G J

1986-11-17

157

Employer Responsibilities  

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... Form 300 ). On February 1, and for three months, covered employers must post the summary of the OSHA log of injuries ... or for three working days, whichever is longer. Post abatement ... universal interventions that can substantially reduce the number and severity ...

158

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

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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

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

2013-01-01

159

Punch grafting in vitiligo  

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Full Text Available Thirty three patients of 15-35 years age having various types of stable vitilligo from 1-15 years duration were selected for punch grafting. Vitiligo lesions in all these patients were relatively refractory to systemic PUVA therapy tried for a period of 1 to 8 years. The technique of punch grafting was modified from the method described by Falabella and Behl. Complete responses was observed in 10 patients, still under follow up for 1 year and partial response in rest 23 patients who are under observation.

Jha Anil

1992-01-01

160

Water-soluble graft copolymers of starch-acrylamide and uses therefor  

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Graft copolymers having starch as the central chain with grafted side chains of acrylamide or acrylamide-acrylic acid, and a process for preparation of such copolymers in the presence of Ce.sup.+4 or other redox initiators. These copolymers are employed in preparing highly viscous aqueous solutions that are particularly useful in oil recovery from subterranean wells.

Butler, George B. (Gainesville, FL); Hogen-Esch, Thieo E. (Gainesville, FL); Meister, John J. (Dallas, TX); Pledger, Jr., Huey (Gainesville, FL)

1983-08-23

161

New membranes obtained by grafted irradiated PVDF foils  

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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.

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

162

Do Radiologists Want/Need Training in Cardiopulmonary Resuscitation?  

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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.

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

2003-03-01

163

Do Radiologists Want/Need Training in Cardiopulmonary Resuscitation?  

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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

164

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

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

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

2014-08-01

165

Early graft function.  

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1. The average serum creatinine level during the first 20 days after transplantation was lower in HLA-identical siblings than in parental donor transplants, suggesting an early effect of histocompatibility. 2. In rather small numbers of patients, the daily average serum creatinine values were not different with HLA-DR mismatching and HLA-B,DR mismatching, but were lower in the better matched transplants for the HLA-A,B loci and the HLA-A,B,DR loci. 3. The average serum creatinine values in the first 20 days after transplantation were correlated with the one-year graft survival rates. Those patients with serum creatinine levels less than 2.4 mg/dl had one-year graft survival rates of over 80% compared with those with serum creatinine levels above 7.5 mg/dl after the first week who had one-year graft survival rates about 30% less. Intermediate serum creatinine values yielded intermediate one-year graft survival rates. 4. The cyclosporine dosage in the first month after transplantation varied considerably among the four centers studied here. These values were not directly correlated with the one-year graft survival rate, average serum creatinine levels or cumulative rejection rates in this preliminary examination. 5. Patients who rejected transplants 11 to 60 days posttransplant had been given lower cyclosporine dosages than those who rejected early or who had no rejections. 6. Although firm conclusions cannot be drawn from the small numbers of patients encompassed in this study, we hope the potential value of this type of analysis will be realized. PMID:3154426

Toyotome, A; Terasaki, P I; Takiff, H; Kahan, B; Starzl, T; Salvatierra, O; Berne, T; Najarian, J

1986-01-01

166

Limiting inflammatory response to cardiopulmonary bypass: pharmaceutical strategies.  

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A significant inflammatory response and subsequent organ dysfunction is known to be associated with the use of CPB. Pharmaceutical interventions, such as corticosteroids, statins and ACE-Is can attenuate the post-CPB inflammatory and immune response, by so doing, either directly or indirectly, reduce incidence of postoperative complications. Apart from its effects on lipids, statins have been found to reduce postoperative oxidative stress that may partly contribute towards improved graft patency. In addition, certain ACE-inhibitors can promote a pro-fibrinolytic environment, whose role on maintaining graft patency and clinical outcomes warrant further investigation. There is increasing evidence to support the use of combined clopidogrel with aspirin following CABG to improve graft patency, although its impact on reducing postoperative adverse events remains unclear. Factors such as drug bioavailability and individual variability in drug responses and metabolism of these antiplatelet agents can significantly influence clinical outcomes. PMID:22305683

Ng, Calvin S H; Wan, Song

2012-04-01

167

Cardiopulmonary malformations in the inv/inv mouse.  

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The inv/inv mouse carries an insertional mutation in the inversin gene, (inv, for inversion of embryonic turning). Previously it had been reported that almost 100% of the homozygous offspring (inv/inv) were characterized by situs inversus totalis. In this report we identify the spectrum of cardiopulmonary anatomical abnormalities in inv/inv mice surviving to birth to determine whether the abnormalities seen are of the categories classically associated with human situs abnormalities. Stillborn mice, offspring that died unexpectedly (within 48 hr after birth), and neonates with phenotypic characteristics of situs inversus (right-sided stomachs, growth failure or jaundice) were processed for standard histological examination. Of 173 offspring, 34 (20%) neonates (11 stillborn, 9 unexpected deaths, and 14 mice with situs inversus phenotype) were examined, 27 of which were genotyped to be inv/inv. Interestingly, three inv/inv mice (11%) were found to have situs solitus. Twenty-four had situs inversus with normal, mirror-image cardiac anatomy (dextrocardia with atrioventricular concordance, ventriculoarterial concordance and a right aortic arch). The overall incidence of cardiovascular anomalies observed was 10 out of 27 (37%). The most frequent severe malformation, identified in 3 out of 27 animals, was a complex consisting of pulmonary infundibular stenosis/atresia with absence of pulmonary valve tissue and a ventricular septal defect. The pulmonary phenotype in inv/inv mice was situs inversus with occasional minor lobar abnormalities. We conclude that 1) cardiopulmonary malformations in inv/inv mice are not rare (37%), 2) the cardiopulmonary malformations observed in inv/inv specimens are not of the spectrum typically associated with human heterotaxia. In particular, inv/inv mice have a propensity for defects in the development of the right ventricular outflow tract and the interventricular septum, and 3) approximately one out of ten inv/inv mice is born with situs solitus and shows cardiac anomalies that correspond to those observed in inv/inv specimens with situs inversus. Our data therefore suggest that inversin, the product of the inv locus, may have specific roles in cardiac morphogenesis independent of its role in situs determination. PMID:11331972

McQuinn, T C; Miga, D E; Mjaatvedt, C H; Phelps, A L; Wessels, A

2001-05-01

168

Rationale, design and methodology for a Prospective Randomized Study of graft patency in Off-pump and On-pump MultI-Vessel coronary artery bypasS Surgery (PROMISS using multidetector computed tomography  

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Full Text Available Abstract Background Off-pump coronary artery bypass grafting has been accused of possibly compromising graft patency. Sixteen slice computed tomography has shown good diagnostic accuracy in the assessment of coronary bypass graft patency when compared with conventional coronary artery angiography and is less invasive. The study hypothesis is that coronary artery bypass grafting (CABG performed without cardiopulmonary bypass (Off-Pump has equivalent early graft patency as if performed with cardiopulmonary bypass (On-Pump and may have reduced complication rate. Methods/Design The Prospective Randomized Comparison of Off-Pump and On-Pump MultI-vessel Coronary Artery BypasS Surgery (PROMISS is a controlled, single blinded, single centre clinical trial, comparing early graft patency using 16-slice computed tomography in patients with multi-vessel coronary artery disease operated either without or with extracorporeal circulation. Inclusion criteria are multivessel disease with an indication for first time, isolated, non emergent coronary artery bypass grafting with a minimum of three distal anastomoses. Secondary end points are peri-operative mortality, combined morbidity, length of stay, neuro-cognitive testing at 6 weeks and adverse events, stress test and quality of life at 6 months and one year. The sample size of one hundred and fifty patients was calculated in order to enable the detection of a 5% difference in graft patency, with 80% power, considering a minimum of 3 distal anastomoses per patient. Enrolment started in April 2005 and ended July 2007 with study closure in July 2008. Conclusion The PROMISS trial aims to shed new light on the effect of Off-Pump as compared to On-Pump coronary artery bypass surgery on graft patency, assessed by multidetector computed tomography, in unselected patients with multivessel coronary artery disease. Trial Registration Current Controlled Trials ISRCTN58800729

Magalhães Manuel

2008-07-01

169

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

International Nuclear Information System (INIS)

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

170

Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs  

Directory of Open Access Journals (Sweden)

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.

Wohlfart Björn

2010-10-01

171

Stenting an aortopulmonary conduit with peripheral cardiopulmonary bypass support.  

Science.gov (United States)

Although surgically created aortopulmonary (AP) shunts are uncommon in the adult congenital heart disease population, they are often used in patients with pulmonary atresia. For these patients, the shunt is a vital supply of pulmonary blood flow and thus obstruction of the shunt may lead to pulmonary hypoperfusion and hypoxia thereby increasing morbidity and mortality. This report describes a safe and effective method of stenting the conduit with the hemodynamic support of peripheral cardiopulmonary bypass (PCB). Prior to the procedure, a multimodality assessment of a stenosis in a kinked AP conduit using computed tomography, angiography, intravascular ultrasound (IVUS), and pressure wire assessment (PWA) was utilized. While PCB, IVUS, and PWA have all been used to great effect in various clinical scenarios, the combined use of these techniques has not been previously been described in the setting of intervention in adult congenital heart disease. PMID:23592486

Incani, Alexander; Lee, Joseph C; Nicolae, Mugur J; Walters, Darren L

2014-01-01

172

Severe hyperkalemia during cardiopulmonary bypass: etiology and effective therapy.  

Science.gov (United States)

Hyperkalemia is considered a medical emergency as it can result in severe disturbances in cardiac rhythm and death. Although many causes of hyperkalemia exist, exogenous red blood cell transfusions are being recognized as the primary perioperative etiology. The authors report a case of severe intraoperative hyperkalemia associated with the use of allogeneic blood products (packed red blood cells), during a surgical mission to a developing country. The patient was undergoing repeat mitral valve replacement with cardiopulmonary bypass (CPB) and developed significant hyperkalemia with a serum potassium value of 9.9 mEq/L. Successful intraoperative therapies were instituted with a gradual reduction in the serum potassium value to 4.8 mEq, which allowed the patient to be weaned from CPB. The authors review the etiology of hyperkalemia in children including its relationship with allogeneic red blood cell transfusions and treatment modalities including specific therapies which can be instituted during CPB. PMID:23799735

Martin, David P; Gomez, Daniel; Tobias, Joseph D; Schechter, William; Cusi, Carlos; Michler, Robert

2013-04-01

173

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  

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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.

Filinto Marques de Cerqueira Neto

2012-06-01

174

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

175

Siloxane-grafted membranes  

Science.gov (United States)

Composite cellulosic semipermeable membranes are disclosed which are the covalently bonded reaction product of an asymmetric cellulosic semipermeable membrane and a polysiloxane containing reactive functional group. The two reactants chemically bond by ether, ester, amide or acrylate linkages to form a siloxane-grafted cellulosic membrane having superior selectivity and flux stability. Selectivity may be enhanced by wetting the surface with a swelling agent such as water.

Friesen, D.T.; Obligin, A.S.

1989-10-31

176

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

LENUS (Irish Health Repository)

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.

Cotter, P E

2009-03-01

177

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

LENUS (Irish Health Repository)

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.

Marshall, C

2012-02-03

178

Are the additional grafts necessary?  

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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.

?ur?i? A.

2010-01-01

179

Pilot Canine Investigation of the Cardiopulmonary Baroreflex Control of Ventricular Contractility  

OpenAIRE

We performed a pilot investigation of the cardiopulmonary baroreflex control of ventricular contractility in two conscious dogs. We specifically measured spontaneous beat-to-beat hemodynamic variability before and after the administration of propranolol. We then identified the transfer function relating beat-to-beat fluctuations in central venous pressure (CVP) to maximal ventricular elastance (Emax) to characterize the cardiopulmonary baroreflex control of ventricular contractility, while ac...

Sala-mercado, Javier A.; Chen, Xiaoxiao; Hammond, Robert L.; Kim, Jong-kyung; Mcdonald, Phillip J.; Stephenson, Larry W.; O’leary, Donal S.; Mukkamala, Ramakrishna

2009-01-01

180

Validating HeartSmart® against the Cardiopulmonary Bypass Machine  

OpenAIRE

Purpose: To assess the utility of HeartSmart®, a new method that uses empirical physiological formulae to estimate hemodynamic variables, in estimating cardiac index during open heart surgery when compared with the cardiopulmonary bypass machine. Methods: This was a prospective, blinded study of patients undergoing elective cardiac bypass surgery. We monitored and compared the flow rates provided by the cardiopulmonary bypass machine (roller pump) with estimates derive...

Warring-davies, Kenneth J.; Bland, Martin J.

2012-01-01

181

Occupational affiliation does not influence practical skills in cardiopulmonary resuscitation for in-hospital healthcare professionals  

OpenAIRE

Abstract Background D-CPR (Defibrillator Cardiopulmonary Resuscitation) is a technique for optimal basic life support during cardiopulmonary resuscitation (CPR). Guidelines recommend that healthcare professionals can perform CPR with competence. How CPR training and provision is organized varies between hospitals, and it is our impression that in Sweden this has generally improved during the last 15-20 years. However, some hospitals still do not have any AED (Automated Extern...

Thoren Ann-Britt; Berglund Anders; Källestedt Marie-Louise; Herlitz Johan; Enlund Mats

2011-01-01

182

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)

183

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

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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.

A. Jafari Javid

2011-01-01

184

Techniques for diced cartilage with deep temporalis fascia graft.  

Science.gov (United States)

Diced cartilage with deep temporalis fascia (DC-F) graft has become a popular technique for reconstruction of the nasal dorsum. Cartilage can be obtained from the septum, ear, or costal cartilage when employing the DC-F technique. The complications seen with DC-F grafts tend to occur early in the surgeon's implementation of this technique. Management of the complications varies depending on the severity of the problem. This article gives an overview of both the technique and the complications commonly encountered. PMID:25430929

Calvert, Jay; Kwon, Edwin

2015-02-01

185

[The effect of pump flow on cerebral oxygen metabolism during cardiopulmonary bypass].  

Science.gov (United States)

We evaluated effects of pump flow on cerebral metabolism using transcranial Doppler (TCD) during cardiopulmonary bypass (CPB) in 22 adult patients undergoing coronary artery bypass grafting. All the patients were anesthetized with high dose fentanyl. The pump flow was controlled with non-pulsatile roller pump at 2.2-2.5 L/min/m2 in group L and 2.7-3.0 L/min/m2 in group H under alpha-stat acid-base regulation. Pharyngeal temperature was kept at 31 degrees C in steady CPB state. Mean velocity of middle cerebral artery (MCAV) was monitored with TCD fixed on the temple continuously. Cerebral oxygen consumption was estimated by relating the difference in oxygen content between arterial and venous (jugular bulb) blood (AVDO2) to flow velocity. In group L, blood oxygen saturation of jugular bulb (SjO2) was stable during hypothermic period, but decreased significantly during rewarming period. In group H, SjO2 was significantly increased with cooling, but went down to preoperative level during rewarming period. Significant difference of SjO2 between two groups was noticed in rewarming period (52.9 +/- 10.0% in group L and 65.6 +/- 11.8% in group H, p = 0.0133). MCAV tended to decrease with cooling and increase with rewarming, but which was not significant change respectively. Relative cerebral metabolic rate for oxygen (rCMRO2) was defined as the percent change of the product AVDO2 and MCAV. In each group, rCMRO2 was decreased with cooling and increased with rewarming significantly. Especially, rCMRO2 right after CPB discontinued was increased 1.7 times in L group and 2.0 times in group H as much as that of steady state of CPB. It is suggested that cerebral metabolism should be decreased during cooling to 31 degrees C of pharyngeal temperature, 2.2-2.5 l/min/m2 of pump flow was adequate to keep SjO2 stable. On the other hand, it is necessary to increase pump flow to 2.7-3.0 l/min/m2 during rewarming period as cerebral oxygen metabolic demand becomes greater. PMID:9513520

Sakahashi, H

1998-01-01

186

Cerebral Hemodynamics during Coronary Artery Bypass Graft surgery: The effect of carotid stenosis Running Head: Carotid stenosis and cerebral regulation  

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Carotid stenosis is a frequent coexisting condition in patients undergoing coronary artery bypass graft (CABG) surgery. The impact of carotid stenosis on cerebral perfusion is not fully understood. The purpose of this study was to determine the impact of carotid stenosis on cerebral blood flow velocity in patients undergoing CABG. Seventy-three patients undergoing CABG were prospectively recruited and underwent preoperative Duplex carotid ultrasound to evaluate the degree of carotid stenosis. Intraoperatively, transcranial Doppler ultrasound was used to record of the mean flow velocity within the bilateral middle cerebral arteries. Additionally, during the period of cardiopulmonary bypass, regulators of cerebral hemodynamics such as hematocrit, partial pressure of carbon dioxide, and temperature were recorded. The ipsilateral middle cerebral artery mean flow velocity was compared in arteries with and without carotid stenosis using a repeated measures analysis. Seventy-three patients underwent intraoperative monitoring during CABG and 30% (n=22) had carotid stenosis. Overall, MFV rose throughout the duration of CABG including when the patient was on cardiopulmonary bypass. However, there was no significant MFV difference between those arteries with and without stenosis (F=1.2, p=.21). Further analysis during cardiopulmonary bypass, demonstrated that hemodilution and partial pressure of carbon dioxide may play a role in cerebral autoregulation during CABG. Carotid stenosis did not impact mean cerebral blood flow velocity during CABG. The cerebrovascular regulatory process appears to be largely intact during CABG. PMID:19540657

Rudolph, James L.; Sorond, Farzaneh A.; Pochay, Val E.; Haime, Miguel; Treanor, Patrick; Crittenden, Michael D.; Babikian, Viken L.

2009-01-01

187

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

LENUS (Irish Health Repository)

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.

Coleman, E T

2012-02-03

188

Alar cartilage grafts.  

Science.gov (United States)

The alar cartilages provide the contour and structural support of the nasal tip. Current rhinoplasty concepts support preservation of alar structure with suture techniques or judicious cephalic trim indicated for tip deformities. In many primary cases and some revisions, adequate alar structure exists to achieve the desired aesthetic and functional results with conservative surgical methods. In some primary and most revision cases, however, the existing tip structure is inadequate to create a structurally sound and aesthetically pleasing nasal tip without adding structure. In these cases, alar cartilage grafting techniques are indicated to recapitulate nasal tip contour and structure. PMID:20206743

Weber, Stephen M; Baker, Shan R

2010-04-01

189

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)

190

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)

191

Thermal stability of grafted fibers  

International Nuclear Information System (INIS)

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

192

Does off-pump total arterial grafting increase the incidence of intraoperative graft failure?  

OpenAIRE

BACKGROUND: Early graft failure is a common cause of cardiac mortality and morbidity after coronary artery bypass grafting, but there is little information on its natural incidence. Furthermore, there is particular concern about graft patency in off-pump coronary artery bypass grafting and total arterial grafting. METHODS: We performed a prospective observational study to assess intraoperative graft patency in patients undergoing off-pump and on-pump coronary artery bypass grafting, who also ...

Balacumaraswami, L.; Abu-omar, Y.; Anastasiadis, K.; Choudhary, B.; Pigott, D.; Yeong, Sk; Taggart, Dp

2004-01-01

193

ACL Reconstruction: Choosing the Graft.  

Science.gov (United States)

Rupture of the anterior cruciate ligament is one of the most common ligament injuries in sports traumatology. The need for surgical anterior cruciate ligament reconstruction is justified by its anatomical characteristics. Key considerations when choosing a graft include the potential for bone integration and the risk of failure. Bone sclerosis around the tunnel affects the integration of the graft. For this reason, one aspect upon which orthopedic surgeons should focus is the biology of the bone-graft interface. Although the BPTB graft is still used, hamstrings and synthetic grafts have become increasingly widespread and popular over the years. An allograft certainly requires more long-term follow-up to validate its use in response to functional, clinical and biological requirements. PMID:25606507

Cerulli, Giuliano; Placella, Giacomo; Sebastiani, Enrico; Tei, Matteo Maria; Speziali, Andrea; Manfreda, Francesco

2013-03-01

194

Coxiella burnetii vascular graft infection  

Directory of Open Access Journals (Sweden)

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.

Von Segesser Ludwig

2005-12-01

195

ACL Reconstruction: Choosing the Graft  

Science.gov (United States)

Summary Rupture of the anterior cruciate ligament is one of the most common ligament injuries in sports traumatology. The need for surgical anterior cruciate ligament reconstruction is justified by its anatomical characteristics. Key considerations when choosing a graft include the potential for bone integration and the risk of failure. Bone sclerosis around the tunnel affects the integration of the graft. For this reason, one aspect upon which orthopedic surgeons should focus is the biology of the bone-graft interface. Although the BPTB graft is still used, hamstrings and synthetic grafts have become increasingly widespread and popular over the years. An allograft certainly requires more long-term follow-up to validate its use in response to functional, clinical and biological requirements.

Cerulli, Giuliano; Placella, Giacomo; Sebastiani, Enrico; Tei, Matteo Maria; Speziali, Andrea; Manfreda, Francesco

2013-01-01

196

Radiation grafting on natural films  

Science.gov (United States)

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.

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

2014-01-01

197

Comparison of Alloderm and mucosal graft in mandibular vestibuloplasty  

Directory of Open Access Journals (Sweden)

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.

Mahmoodhashemi H.

2009-12-01

198

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

Science.gov (United States)

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

Levinson, Michele; Mills, Amber

2014-08-01

199

[Cardiopulmonary resuscitation already in Egypt 5,000 years ago?].  

Science.gov (United States)

In light of the medically relevant features of the ancient Egyptian mouth-opening ceremony, the question of the effectiveness of medical practices in Egypt thousands of years ago is examined, whereby the religious and cultural framework also plays a significant role. In the Land on the Nile myth and reality clearly generated special conditions which favoured the systematic treatment of questions of resuscitation. Numerous examples show that this had practical consequences in the area of everyday medicine. In addition, rebirth and resurrection were central elements of the cult of the dead which had exact medical equivalents. These equivalents may demonstrate the advanced state of resuscitation practices in Egypt at that time. In this context, a reconstruction of an ancient Egyptian mouth-opening instrument is presented. In the cult of the dead, this instrument played a role which can be compared to the function of a modern laryngoscope. It appears possible that at the time of the pyramids the Egyptians already had an understanding of the technology required to perform instrument-aided artificial respiration. Whether or not they actually possessed a fundamental knowledge of the principles of cardio-pulmonary resuscitation remains unclear. Nevertheless, the astonishingly functional characteristics of the reconstructed mouth-opening instrument suggest that it was developed for more than purely symbolic purposes. PMID:9281230

Ocklitz, A

1997-06-01

200

Accuracy of continuous jugular bulb venous oximetry during cardiopulmonary bypass.  

Science.gov (United States)

We evaluated the accuracy of fiberoptic catheter oximetry in the jugular bulb during conditions of normothermia, hemodilution, and hypothermia in 11 patients who underwent cardiac surgery with cardiopulmonary bypass (CPB). An oximetry catheter was inserted into the right jugular bulb under general anesthesia, calibrated by the in vitro (n = 7) or in vivo (n = 4) mode. Jugular bulb oxygen saturation (SjO2) with the catheter oximeter was compared with a concurrent laboratory CO-oximeter value from a blood sample during surgery. Nasopharyngeal temperature (NPT) and hemoglobin concentration (Hb) were also measured. The oximetric catheter SjO2 correlated closely with the CO-oximeter determinations in both calibration modes (in vitro, r2 = 0.88; in vivo; r2 = 0.96). Data in the in vitro calibrated group were grouped into three conditions; 1) normothermia and no hemodilution, 2) normothermia and hemodilution, and 3) hypothermia and hemodilution, and showed good correlations between SjO2 values measured by the two methods (r2 = 0.90, r2 = 0.81, r2 = 0.79, respectively). The difference in SjO2 values by the two methods was not significantly affected by changes in NPT and Hb during CPB. In conclusion, the continuous SjO2 monitoring with catheter oximetry during CPB would be accurate and reliable under either calibration mode. Moderate hypothermia and hemodilution during CPB did not significantly influence the accuracy. PMID:8250299

Nakajima, T; Ohsumi, H; Kuro, M

1993-12-01

201

Tendencias en resucitación cardiopulmonar / Trends in cardiopulmonary resuscitation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish 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.

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

2009-02-01

202

Use of the impedance threshold device in cardiopulmonary resuscitation  

Directory of Open Access Journals (Sweden)

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

Theano D Demestiha

2010-02-01

203

New insights onto cardiopulmonary nematodes of dogs in Sardinia, Italy.  

Science.gov (United States)

Dog heartworms Angiostrongylus vasorum and Dirofilaria immitis cause severe parasitological diseases; the importance of these parasitosis is growing due to their health impact on animals, the possible zoonotic implications and the recent spreading across several European countries and previously non-endemic areas. The aim of this study is to update the epidemiological scenario of cardiopulmonary nematodes A. vasorum and D. immitis in dogs of Sardinia island and to perform a morphological identification of larvae by the use of the Baermann and Knott techniques respectively and the molecular characterization of the mitochondrial cytochrome c oxidase subunit I (cox1) and the second ribosomal transcribed spacer region (ITS-2) of larvae L1 of A. vasorum. In the present study, 3.4% (5/146) of dogs resulted positive at Baermann technique for A. vasorum while 8.9% (61/684) to D. immitis. If on one side A. vasorum can be considered an emerging parasite in Sardinia, the parasitic pressure and the risk of infection for D. immitis in the island seems to be increased compared with the recent past. PMID:24525757

Pipia, A P; Varcasia, A; Tosciri, G; Seu, S; Manunta, M L; Mura, M C; Sanna, G; Tamponi, C; Brianti, E; Scala, A

2014-04-01

204

Inhibition of neutrophil activity improves cardiac function after cardiopulmonary bypass  

Directory of Open Access Journals (Sweden)

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.

Grünwald Frank

2007-10-01

205

Development of a hemodynamically optimized outflow cannula for cardiopulmonary bypass.  

Science.gov (United States)

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

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

2014-11-01

206

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)

207

Graft copolymerisation of methyl-methacrylate on to natural rubber latex  

International Nuclear Information System (INIS)

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

208

Radiation grafting of hydroxyethyl methacrylate on low density polyethylene and electric capacity of grafting copolymer  

International Nuclear Information System (INIS)

Grafting polymerization of hydroxyethyl methacrylate on low density polyethylene film has been studied by direct method. An effect of radiation dose, dose rate, concentration of cupric ion and polar monomer on grafting rate of polyethylene has been discussed. The grafted product was characterized by infrared spectrum. It was found that the electric capacity of grafting copolymer increase with the increasing of grafting rate

209

Evaluating Employability Skills: Employer and Student Perceptions  

Science.gov (United States)

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

Saunders, Venetia; Zuzel, Katherine

2010-01-01

210

Predicting complications after pulmonary resection. Preoperative exercise testing vs a multifactorial cardiopulmonary risk index.  

Science.gov (United States)

Recent studies have used preoperative cardiopulmonary exercise testing to improve risk assessment of pulmonary resection for lung cancer. These studies have demonstrated inconsistent correlation between peak oxygen uptake (VO2) and postoperative complications but have not systematically examined other methods of risk stratification. We analyzed the findings in 42 patients who had cardiopulmonary exercise testing prior to lung cancer resection. Preoperative clinical data combining pulmonary factors (obesity, productive cough, wheezing, tobacco use, ratio of the forced expiratory volume in 1 s over the forced vital capacity [FEV1/FVC] 45 mm Hg), and an established cardiac risk index were used to generate a cardiopulmonary risk index (CPRI). When analyzed using the risk index, the incidence of postoperative complications increased with higher CPRI scores. Those with a CPRI of 4 or greater were 22 times more likely to develop a complication, compared to a CPRI of less than 4 (p CPRI of 4 or greater was associated with significant reductions in peak VO2. We conclude that both the peak VO2 during cardiopulmonary exercise testing and a multifactorial CPRI are highly predictive of complications after lung resection. Adding the peak VO2 did not enhance the risk estimation generated by the CPRI. The association between postoperative complications and peak VO2 may be explained by the correlation between identifiable cardiopulmonary disease (CPRI) and reduced oxygen uptake with exercise. PMID:8365278

Epstein, S K; Faling, L J; Daly, B D; Celli, B R

1993-09-01

211

Left ventricular assist device outflow graft: alternative sites.  

Science.gov (United States)

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

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

2014-09-01

212

Preirradiation grafting VBTAC onto HDPE films  

International Nuclear Information System (INIS)

HDPE films irradiated to 200 kGy in N2 were grafted with vinyl benzyltrimethylammonium chloride (VBTAC) to synthesize a strong base anion-exchange membrane. Comonomer grafting technique was used owing to the difficulty of direct graft polymerization of VBTAC onto polyethylene. Dimethylaminoethyl methacrylate (DMAEMA), a relative weak acid monomer, was selected as a co-monomer to promote graft polymerization of VBTAC. The grafting conditions, as well as the compositions of grafted films were investigated. The distribution of grafted basic group in polymer substrate was measured by an X-ray microanalyzer. (authors)

213

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)

214

Anionic resin by radiation grafting  

International Nuclear Information System (INIS)

Anion-exchange resin has been prepared by grafting of 4-Vinyl Pyridine on PVC by simultaneous irradiation in the presence of air in multipurpose gamma irradiator (RAVI). Grafting was studied at two different dose rate, cumulative dose up to 26 kGy and by pre-irradiation of the Trunk polymer. A marked increase in the grafting percentage from 98 to 145 was observed when the trunk polymer was pre-irradiated and an ion-exchange capacity of 7.3 m eq/gm (dry) resin was achieved. Other properties like bulk density, particle size etc. has also been studied. (author)

215

Unusual costochondral bone graft complication.  

Science.gov (United States)

In hemifacial microsomia, patients with severely hypoplastic mandibles (Pruzansky type III) require replacement of the ramus and condyle unit. Common complications of this procedure include graft fracture and overgrowth of the graft. An uncommon case of osteolysis of the costochondral graft with osteitis of the middle cranial fossa is reported herein. To our knowledge, no such case has been reported in the literature previously. The aim of this report is to present the only known case and to discuss the contributing factors. PMID:23972557

Tabchouri, Nathalie; Kadlub, Natacha; Diner, Patrick A; Picard, Arnaud

2013-11-01

216

Arterial grafts: clinical classification and pharmacological management  

OpenAIRE

In comparison with standard saphenous vein grafts, use of the internal mammary artery (IMA) as a coronary artery bypass graft has achieved superior long-term results. This is related to the differences in the biological characteristics between the venous and arterial grafts. However, even arterial grafts are not uniform in their biological characteristics. The variation in the perioperative behavior of the grafts and in their long-term patency may be related to different characteristics. Thes...

He, Guo-wei

2013-01-01

217

Fabrication of glycosylated surface on polymer membrane by UV-induced graft polymerization for lectin recognition.  

Science.gov (United States)

Increasingly, carbohydrate-protein interactions are viewed as important mechanisms for many biological processes such as blood coagulation, immune response, viral infection, inflammation, embryogenesis, and cellular signal transfer. However, the weak affinity of the interactions and the structural complexity of carbohydrates have hindered efforts to develop a comprehensive understanding of carbohydrate functions. Fortunately, synthetic polyvalent glycoligands give us a chance to reveal the nature of these biological processes. In this work a sugar-containing monomer (alpha-D-allyl glucoside (AG)) was grafted onto polypropylene microporous membrane (PPMM) by UV-induced graft polymerization to generate a glycosylated porous surface for the first time. Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, and scanning electron microscopy were employed to confirm the glycosylation. Water contact angle measurement was used to evaluate the hydrophilicity change of the surfaces before and after the graft polymerization of AG. It was found that the grafting density increased reasonably with the increase of AG monomer concentration, and then this increase slowed when the AG concentration exceeded 80 g/L. At the same time a 20-25 min UV irradiation was enough for the grafting polymerization. The photoinitiator concentration also influenced the grafting density obviously, and there was an optimal concentration of the photoinitiator for the grafting process. The water contact angle of the polyAG-tethered membrane surface decreased from 149 degrees to 80 degrees with the increase of grafting density from 0 to 187.76 microg/cm2, which indicated a hydrophilic variation of the membrane surface by the grafting of AG. Results also indicated that the surface-grafted polyAG chains showed weak interaction with Con A when the grafting density was low. However, when the sugar density exceeded 90 microg/cm2, the binding affinity increased dramatically which was the due to the "glycoside cluster effect". PMID:17042552

Yang, Qian; Hu, Meng-Xin; Dai, Zheng-Wei; Tian, Jing; Xu, Zhi-Kang

2006-10-24

218

Forces of Interaction between DNA-Grafted Colloids: An Optical Tweezer Measurement  

Science.gov (United States)

Optical tweezers are employed to measure the forces of interaction between single DNA-grafted colloids. Parameters to be varied are the length of the DNA, the grafting density, and the ion concentration of the surrounding medium. From the measured force-separation dependence an interaction length at a given force is deduced. It shows in the mushroom regime a scaling with the grafting density which levels off for brushes. For the latter the transition from an osmotic to a salted brush can be traced in detail by varying the ion concentration in accordance with mean field theories.

Kegler, K.; Salomo, M.; Kremer, F.

2007-02-01

219

Evidence of systemic cytokine release in patients undergoing cardiopulmonary bypass.  

Science.gov (United States)

Cardiopulmonary bypass (CPB) causes a systemic inflammatory response syndrome (SIRS), which can progress to an acute lung inflammation known as postperfusion syndrome. We developed a two-phase hypothesis: first, that SIRS, as indicated by elevated cytokines post-CPB, would be correlated with postoperative pulmonary dysfunction (Phase I), and second, that the cytokine interleukin-6 (IL-6) is predominantly released from the heart in CPB patients (Phase II). Blood samples were collected from patients undergoing CPB for elective cardiac surgery. In seven patients (Phase I), arterial samples were drawn before, during (5 minutes and 60 minutes), and after CPB. In 14 patients (Phase II), samples were collected from the coronary sinus, superior vena cava, and a systemic artery at the times indicated previously. Samples were analyzed with enzyme-linked immunosorbent assay: IL-1, IL-6, IL-8, IL-10, and tumor necrosis factor-alpha were assessed in Phase I and IL-6 assessed in Phase II. In Phase I, IL-6, IL-8, and IL-10 were elevated after CPB, but only IL-6 concentrations correlated with lung function. In summary, Phase I data demonstrate that increased IL-6 levels at the end of CPB correlate with reduced lung function postoperatively. In Phase II, IL-6 elevation was similar at all sample sites suggesting that the heart is not the major source of IL-6 production. We suggest that IL-6 be implemented as a prognostic measure in patient care, and that patients with elevated IL-6 after CPB be targeted for more aggressive anti-inflammatory therapy to protect lung function. PMID:16350379

Halter, Jeffrey; Steinberg, Jay; Fink, Gregory; Lutz, Charles; Picone, Anthony; Maybury, Rubie; Fedors, Nathan; DiRocco, Joseph; Lee, Hsi-Ming; Nieman, Gary

2005-09-01

220

Repletion of factor XIII following cardiopulmonary bypass using a recombinant A-subunit homodimer. A preliminary report.  

Science.gov (United States)

Bleeding following cardiac surgery involving cardiopulmonary bypass (CPB) remains a major concern. Coagulation factor XIII (FXIII) functions as a clot-stabilising factor by cross-linking fibrin. Low post-operative levels of FXIII correlate with increased post-operative blood loss. To evaluate preliminary safety and pharmacokinetics of recombinant FXIII (rFXIII-A(2)) in cardiac surgery, patients scheduled for coronary artery bypass grafting were randomised to receive a single dose of either rFXIII-A(2) (11.9, 25, 35 or 50 IU/kg) or placebo in a 4:1 ratio. Study drug was given post-CPB within 10 to 20 minutes after first protamine dose. Patients were evaluated until day 7 or discharge, with a follow-up visit at weeks 5-7. The primary end-point was incidence and severity of adverse events. Thirty-five patients were randomised to rFXIII-A(2) and eight to placebo. Eighteen serious adverse events were reported. These were all complications well recognised during cardiac surgery. Although one patient required an implantable defibrillator, all recovered without sequelae. One myocardial infarction in a patient receiving 35 IU/kg rFXIII-A(2) was identified by the Data Monitoring Committee after reviewing ECGs and cardiac enzymes. No other thromboembolic events were seen. Dosing with 25-50 IU/kg rFXIII-A(2) restored levels of FXIII to pre-operative levels, with a tendency towards an overshoot in receiving 50 IU/kg. rFXIII-A(2), in doses from 11.9 IU/kg up to 50 IU/kg, was well tolerated. For post-operative FXIII replenishment, 35 IU/kg of rFXIII-A(2) may be the most appropriate dose. PMID:19806264

Levy, Jerrold H; Gill, Ravi; Nussmeier, Nancy A; Olsen, Peter Skov; Andersen, Henning F; Booth, Frank V McL; Jespersen, Christian M

2009-10-01

221

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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

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

222

Medicaid: Employment Initiatives  

Science.gov (United States)

... ended in September, 2009 Medicaid Services that Support Employment Personal Assistance Services. Personal Assistance services are a ... to develop policies and programs that support employment. Employment and HCBS States can provide specific employment supports ...

223

Cardiopulmonary bypass/extracorporeal membrane oxygenation/left heart bypass: indications, techniques, and complications.  

Science.gov (United States)

Cardiopulmonary bypass has revolutionized the ability to provide cardiorespiratory support and has advanced the field of cardiac surgery. This invention has given surgeons the ability to perform many procedures that were not possible previously. The concept and development of cardiopulmonary bypass has been pioneered by numerous legendary surgeons. Cardiopulmonary bypass, extracorporeal membrane oxygenation, and left heart bypass have revolutionized our ability to operate on the heart, great vessels, and aorta in addition to providing means of short-term support for reversible causes of cardiac and/or respiratory failure. The success of these approaches is dependent upon excellent communication between the surgeon, perfusionist, and anesthesiologist as well as constant vigilance and troubleshooting by the caregivers. PMID:19782837

Ailawadi, Gorav; Zacour, Richard K

2009-08-01

224

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)

225

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 ...

226

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

Directory of Open Access Journals (Sweden)

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.

Otto M.E.B.

2004-01-01

227

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

1615-16-01

228

Glial grafting for demyelinating disease  

OpenAIRE

Remyelination of demyelinated central nervous system (CNS) axons is considered as a potential treatment for multiple sclerosis, and it has been achieved in experimental models of demyelination by transplantation of pro-myelinating cells. However, the experiments undertaken have not addressed the need for tissue-type matching in order to achieve graft-mediated remyelination since they were performed in conditions in which the chance for graft rejection was minimized. This article focuses on th...

Tepavc?evic?, V.; Blakemore, W. F.

2005-01-01

229

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

OpenAIRE

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

Lubowitz, James H.

2012-01-01

230

Surgical treatment for chronic pulmonary thromboembolism under cardiopulmonary bypass with selective cerebral perfusion.  

Science.gov (United States)

The median sternotomy approach for the treatment of chronic pulmonary thromboembolism was recently improved by Daily, Jamieson, and coworkers who adopted it for use under cardiopulmonary bypass with intermittent circulatory arrest; however, we have sometimes found that the circulatory arrest time was too short to complete thromboendarterectomy. Therefore, we attempted to perform a selective cerebral perfusion technique to extend the endarterectomy time. Although we noted slight back-bleeding from the bronchial arteries, we were able to extend the endarterectomy time without causing any postoperative delirium. We conclude that the median sternotomy approach using cardiopulmonary bypass with selective cerebral perfusion may be the best option for extending the thromboendarterectomy time. PMID:11291702

Masuda, M; Mogi, K; Nakaya, M; Pearce, Y; Imamaki, M; Shimura, H; Okada, Y; Nishimura, K; Nakajima, N

2001-01-01

231

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.)

232

A comparative study of release of interleukin-6 and tumour necrosis factor during normothermic and hypothermic cardiopulmonary bypass.  

Directory of Open Access Journals (Sweden)

Full Text Available The institution of cardiopulmonary bypass generates many pro-inflammatory cytokines and several clinical variables, including temperature, have been shown to influence cytokine release during and after cardiopulmonary bypass. The release of tumour necrosis factor and interleukin-6 are the best predictors of post-cardiopulmonary bypass related morbidity. Their release during normothermic and hypothermic cardiopulmonary bypass and the correlation with clinical parameters of organ injury was studied. This prospective study was carried out in 52 adult patients, scheduled for cardiac surgery, exposed to normothermic and 27 to hypothermic cardiopulmonary bypass. Samples for estimation of tumour necrosis factor and interleukin-6 were collected preoperatively, 1 hour and 24 hours post cardiopulmonary bypass and analysed by ELISA. Haemodynamic parameters and respiratory parameters were noted and lung injury scores calculated. Interleukin-6 levels were raised in both the groups at 1 hour and 24 hours post cardiopulmonary bypass and the response was higher in the normothermic group. Tumour necrosis factor response was, however, similar in both the groups, with a rise at 1 hour returning back to baseline by 24 hours post cardiopulmonary bypass. The normothermic group had a better respiratory index in the postoperative period, early extubation was possible, had better clinical haemodynamics, a shorter cardiopulmonary bypass time and had reduced requirement of defibrillation after the release of aortic cross clamp. We conclude that the release of interleukin-6 was thermo-dependant but did not correlate with the clinical signs of organ injury. Tumour necrosis factor levels were significantly raised after the cardiopulmonary bypass but the rise was not thermo-dependant.

Naresh Sandur

2002-01-01

233

Arthroscopically assisted anatomical coracoclavicular ligament reconstruction using tendon graft  

OpenAIRE

We describe a method of arthroscopically assisted, mini-open, anatomical reconstruction of the coracoclavicular ligament. This method restores both components of the native ligament with the aim of achieving maximum stability with minimal disruption of the normal anatomy. Using the same principles of ligament reconstruction that are employed in other joints, transosseous tunnels are created following the native footprints of the conoid and trapezoid ligaments and an autologous graft is fixed ...

Yoo, Yon-sik; Seo, Young-jin; Noh, Kyu-cheol; Patro, Bishu Prasad; Kim, Do-young

2010-01-01

234

Retrenchment in Malaysia: Employer’s Right?  

OpenAIRE

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 applica...

Hamidah Marsono; Hj.Kamaruzaman Jusoff

2008-01-01

235

Surface-grafted polymers from electrodeposited macroprecursors  

Science.gov (United States)

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.

Rellamas Tria, Maria Celeste

236

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

LENUS (Irish Health Repository)

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.

Flynn, Michael J

2012-02-03

237

Neonatal aortic arch hemodynamics and perfusion during cardiopulmonary bypass.  

Science.gov (United States)

The objective of this study is to quantify the detailed three-dimensional (3D) pulsatile hemodynamics, mechanical loading, and perfusion characteristics of a patient-specific neonatal aortic arch during cardiopulmonary bypass (CPB). The 3D cardiac magnetic resonance imaging (MRI) reconstruction of a pediatric patient with a normal aortic arch is modified based on clinical literature to represent the neonatal morphology and flow conditions. The anatomical dimensions are verified from several literature sources. The CPB is created virtually in the computer by clamping the ascending aorta and inserting the computer-aided design model of the 10 Fr tapered generic cannula. Pulsatile (130 bpm) 3D blood flow velocities and pressures are computed using the commercial computational fluid dynamics (CFD) software. Second order accurate CFD settings are validated against particle image velocimetry experiments in an earlier study with a complex cardiovascular unsteady benchmark. CFD results in this manuscript are further compared with the in vivo physiological CPB pressure waveforms and demonstrated excellent agreement. Cannula inlet flow waveforms are measured from in vivo PC-MRI and 3 kg piglet neonatal animal model physiological experiments, distributed equally between the head-neck vessels and the descending aorta. Neonatal 3D aortic hemodynamics is also compared with that of the pediatric and fetal aortic stages. Detailed 3D flow fields, blood damage, wall shear stress (WSS), pressure drop, perfusion, and hemodynamic parameters describing the pulsatile energetics are calculated for both the physiological neonatal aorta and for the CPB aorta assembly. The primary flow structure is the high-speed canulla jet flow (approximately 3.0 m/s at peak flow), which eventually stagnates at the anterior aortic arch wall and low velocity flow in the cross-clamp pouch. These structures contributed to the reduced flow pulsatility (85%), increased WSS (50%), power loss (28%), and blood damage (288%), compared with normal neonatal aortic physiology. These drastic hemodynamic differences and associated intense biophysical loading of the pathological CPB configuration necessitate urgent bioengineering improvements--in hardware design, perfusion flow waveform, and configuration. This study serves to document the baseline condition, while the methodology presented can be utilized in preliminary CPB cannula design and in optimization studies reducing animal experiments. Coupled to a lumped-parameter model the 3D hemodynamic characteristics will aid the surgical decision making process of the perfusion strategies in complex congenital heart surgeries. PMID:19045541

Pekkan, Kerem; Dur, Onur; Sundareswaran, Kartik; Kanter, Kirk; Fogel, Mark; Yoganathan, Ajit; Undar, Akif

2008-12-01

238

Novel electronic refreshers for cardiopulmonary resuscitation: a randomized controlled trial  

Directory of Open Access Journals (Sweden)

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

Magura Stephen

2012-11-01

239

Guías de Reanimación Cardiopulmonar / Guides for Cardiopulmonary Resuscitation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish 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.

Raffo, Escalante-Kanashiro.

2010-10-01

240

Nurses’ attitude in out-of-hospital cardiopulmonary resuscitation  

Directory of Open Access Journals (Sweden)

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.

Maria Meidani

2008-10-01

241

Plant grafting: new mechanisms, evolutionary implications  

Science.gov (United States)

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

Goldschmidt, Eliezer E.

2014-01-01

242

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

OpenAIRE

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 ...

Conboy Gary; Di Cesare Angela; Traversa Donato

2010-01-01

243

Esmolol and percutaneous cardiopulmonary bypass enhance myocardial salvage during ischemia in a dog model.  

Science.gov (United States)

Despite recent advances in techniques of reperfusion for acute myocardial ischemia, myocardial salvage remains suboptimal. Beta-blockers have been shown to limit infarct size during acute ischemia, but their negative inotropic properties have limited their use. Cardiopulmonary bypass is an attractive technique for cardiac resuscitation because it can stabilize a hemodynamically compromised patient and potentially reduce myocardial oxygen consumption. In an attempt to maximize myocardial salvage in the setting of acute ischemia, the combination of esmolol, an ultrashort-acting beta-blocker, with percutaneous cardiopulmonary bypass was evaluated. Four groups of instrumented dogs underwent 2 hours of myocardial ischemia induced by occlusion of the proximal left anterior descending coronary artery, followed by 1 hour of reperfusion. Throughout the period of ischemia and reperfusion, esmolol plus percutaneous cardiopulmonary bypass was compared with esmolol alone, percutaneous cardiopulmonary bypass alone, and control conditions. After the reperfusion period, the extent of infarction of the left ventricle at risk was determined. Four animals had intractable arrhythmias: one in the esmolol plus bypass group, one in the esmolol group, and two in the control group. The extent of infarction of the left ventricle at risk was significantly reduced in the esmolol plus bypass group (30%) compared with bypass alone (52%), with esmolol alone (54%), and with the control groups (59%; p < 0.05). We conclude that in this experimental model the combination of esmolol with bypass improves myocardial salvage after ischemia and reperfusion. PMID:8622306

Laub, G W; Muralidharan, S; Reibman, J; Fernandez, J; Anderson, W A; Gu, J; Daloisio, C; McGrath, L B; Mulligan, L J

1996-05-01

244

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

Science.gov (United States)

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

Friesen, Jason; Patterson, Dean; Munjal, Kevin

2015-02-01

245

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

Science.gov (United States)

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

246

Risk Factors for Pulmonary Complications Following Cardiac Surgery with Cardiopulmonary Bypass  

OpenAIRE

Background: Pulmonary complications following cardiac surgery with cardiopulmonary bypass (CPB) are often associated with significant morbidity and mortality. However, few reports have focused on evaluating intra- and post-operative independent risk factors for pulmonary complications following cardiac surgery with CPB. This study aimed to evaluate peri-operative independent risk factors for postoperative pulmonary complications through investigating and analyzing 2056 adult patients undergoi...

Ji, Qiang; Mei, Yunqing; Wang, Xisheng; Feng, Jing; Cai, Jianzhi; Ding, Wenjun

2013-01-01

247

CARDIOPULMONARY EFFECTS IN AWAKE RATS FOUR AND SIX MONTHS AFTER EXPOSURE TO METHYL ISOCYANATE  

Science.gov (United States)

Cardiopulmonary function was assessed four and six months after Fischer-344 rats were exposed for 2 hr to 0, 3, or 10 ppm methyl isocyanate (MIC). Minute ventilation (VE) during CO2 challenge was increased in MIC-treated rats compared to controls suggesting a ventilation/perfusio...

248

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

Science.gov (United States)

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

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

1999-01-01

249

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

OpenAIRE

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...

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

2012-01-01

250

Decellularized grafts with axially aligned channels for peripheral nerve regeneration.  

Science.gov (United States)

At least 2 million people worldwide suffer annually from peripheral nerve injuries (PNI), with estimated costs of $7 billion incurred due to paralysis alone. The current "gold" standard for treatment of PNI is the autograft, which poses disadvantages such as high fiscal cost, possible loss of sensation at donor site and the requirement of two surgeries. Allografts are viable alternatives; however, intensive immunosuppressive treatments are often necessary to prevent host rejection. For this reason, significant efforts have been made to remove cellular material from allografts. These decellularized nerve grafts perform better than other clinically available grafts but not as well as autografts; therefore, current research on these grafts includes the incorporation of additional components such as growth factors and cells to provide chemical guidance to regenerating axons. However, effective cellular and axonal penetration is not achieved due to the small pore size (5-10?m) of the decellularized grafts. The overall objective of this study was to induce axially aligned channels in decellularized nerve grafts to facilitate enhanced cell penetration. The specific aims of this study were to optimize a decellularization method to enhance cellular removal, to induce axially aligned pore formation in decellularized grafts through a novel unidirectional freeze drying method, to study the bulk mechanical properties of these modified decellularized grafts and to assess cell penetration into these grafts. To this end we modified an existing decellularization protocol to improve cellular removal while preserving matrix structure in rat sciatic nerve sections. Standard freeze drying and unidirectional freeze drying were employed to impart the necessary pore architecture, and our results suggest that unidirectional freezing is a pertinent modification to the freeze drying process to obtain axially aligned channels. These highly porous scaffolds obtained using unidirectional freeze-drying possessed similar tensile properties to native nerve tissue and exhibited enhanced cellular penetration after 14 days of culture when compared to non-freeze dried and standard freeze-dried scaffolds. The results of this study not only highlight the importance of aligned pores of diameters ~20-60?m on cellular infiltration, but also presents unidirectional freeze drying as a viable technique for producing this required architecture in decellularized nerves. To the best of our knowledge, this study represents the first attempt to manipulate the physical structure of decellularized nerves to enhance cell penetration which may serve as a basis for future peripheral nerve regenerative strategies using decellularized allografts. PMID:25460409

Sridharan, Rukmani; Reilly, Richard B; Buckley, Conor T

2014-10-14

251

Vascularized bone grafts to the upper extremity. Indications and technique.  

Science.gov (United States)

Massive autogenous bone grafts with an intact vascular pedicle decrease the time to bony union and immobilization required for treatment of segmental bony defects. These techniques have been shown to be effective in treatment of segmental defects of more than 6 cm after trauma or tumor resection in relatively avascular beds. Additionally, in the upper extremity, the free vascularized bone graft is in the developmental phase for employment in the reconstruction of epiphyseal arrest and congenital radial club hand. There are disadvantages to free vascularized bone transfers compared with conventional techniques. For example, a free vascularized fibular transfer requires a team skilled in microvascular technique, a long operative time (6 to 10 hours), and the sacrifice of a major vessel to the lower extremity. If the anastomosis fails, however, the free vascularized fibula will act as a conventional bone graft, thereby minimizing adverse effects. We think that by proper patient selection, appropriate evaluation and preparation of the bony defect, meticulous microvascular anastomosis, and correct fixation and immobilization of the graft a good outcome can be achieved in those patients with large bony defects that defy the use of conventional methods. PMID:1400603

Gerwin, M; Weiland, A J

1992-08-01

252

Inhibition of carcinoma formation and of vascular invasion in grafts of radiation-initiated thyroid clonogens by unirradiated thyroid cells  

International Nuclear Information System (INIS)

Quantitative transplantation techniques have been employed to study radiogenic cancer initiation frequency and cell interactions during promotion/progression in grafted clonogenic rat thyroid epithelial cells. The graft recipients were surgically thyroidectomized. Radiogenic initiation is a common cellular event; one of ? 32 surviving 5-Gy-irradiated thyroid clonogens gave rise to cancer in grafts initially containing ? 11 clonogens per transplantation site. The efficiency of promotion/progression is inversely related to grafted irradiated cell number. As the number of transplanted surviving irradiated clonogens was increased progressively from ? 11 to ? 720 clonogens per graft site, the carcinoma frequency per grafted clonogen progressively decreased to one per ? 920. Addition of unirradiated thyroid cells to the transplant inocula further suppressed promotion/progression of radiation-initiated thyroid clonogens. Furthermore, the probability of vascular invasion, a reflection of metastatic potential in carcinomas which arose from irradiated grafted thyroid clonogens, was reduced by addition of unirradiated thyroid cells to the transplant inocula. Assays of thyroid stimulating hormone (TSH) titers in the sera of thyroidectomized rats 44 weeks after transplantation of clonogenic thyroid cells indicate that the suppression of neoplastic promotion/progression observed with increased numbers of cells per graft site is due at least in part to feed-back inhibition in part to feed-back inhibition of TSH production by thyroid hormone of graft origin. (author)

253

POST CORONARY ARTERY BYPASS GRAFT STUDY (CABG)  

Science.gov (United States)

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

254

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

Science.gov (United States)

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

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

1998-01-01

255

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)

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.

Diego Felipe Gaia

2003-09-01

256

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)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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

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

2003-09-01

257

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

Directory of Open Access Journals (Sweden)

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

Dawn T. Gulick

2002-09-01

258

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

Science.gov (United States)

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.

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

2013-04-01

259

Grafted glycopolymer-based receptor mimics on polymer support for selective adhesion of bacteria.  

Science.gov (United States)

A sugar-containing monomer (2-lactobionamidoethyl methacrylate, LAMA) was grafted on a polypropylene (PP) microfiltration membrane surface by UV-induced graft copolymerization. The degree of grafting can be controlled by variation of monomer concentration, UV irradiation time, and photoinitiator concentration. Fourier transform infrared spectroscopy and scanning electron microscopy were employed to confirm the surface modification on the membranes. The water contact angle was used to evaluate the hydrophilicity change of the membrane surface before and after modification. Bacteria capture experiments showed that the membrane could selectively bind E. faecalis while adhesion of S. maltophilia was not influenced by the functionalization of PP with grafted poly(LAMA). The adhesion of E. faecalis onto poly(LAMA) grafted membrane could be inhibited by 200 mM galactose solution; however, glucose solution showed no inhibition effect. Moreover, occupying sugar residues on the membrane surface primarily by a galactose targeting lectin, peanut agglutinin, could significantly suppress the following adhesion of E. faecalis. All these results clearly demonstrate that this poly(LAMA) grafted PP membrane can selectively capture E. faecalis and that this selection is based on the interaction between galactose side groups on grafted flexible functional polymer chains on the membrane surface and galactose binding protein on the E. faecalis cell membrane. PMID:21090578

Yang, Qian; Strathmann, Martin; Rumpf, Anna; Schaule, Gabriela; Ulbricht, Mathias

2010-12-01

260

Grafting rays fellow travel Teichmuller geodesics  

OpenAIRE

Given a measured geodesic lamination on a hyperbolic surface, grafting the surface along multiples of the lamination defines a path in Teichmuller space, called the grafting ray. We show that every grafting ray, after reparametrization, is a Teichmuller quasi-geodesic and stays in a bounded neighborhood of a Teichmuller geodesic. As part of our approach, we show that grafting rays have controlled dependence on the starting point. That is, for any measured geodesic laminati...

Choi, Young-eun; Dumas, David; Rafi, Kasra

2010-01-01

261

Mouse Model of Venous Bypass Graft Arteriosclerosis  

OpenAIRE

Saphenous vein grafts are widely used for treatment of severe atherosclerosis via aortocoronary bypass surgery, a procedure often complicated by later occlusion of the graft vessel. Because the molecular mechanisms of this process remain largely unknown, quantitative models of venous bypass graft arteriosclerosis in transgenic mice could be useful to study this process at the genetic level. We describe herein a new model of vein grafts in the mouse that allows us to take advantage of transgen...

Zou, Yiping; Dietrich, Hermann; Hu, Yanhua; Metzler, Bernhard; Wick, Georg; Xu, Qingbo

1998-01-01

262

Successful rescue from cardiac arrest in a patient with postinfarction left ventricular blow-out rupture: "extra-pericardial aortic cannulation" for establishment total cardiopulmonary bypass.  

Science.gov (United States)

We report a quick and simple technique to establish cardiopulmonary bypass (CPB) in a left ventricular (LV) blow-out rupture. A 74-year-old woman with a diagnosis of acute myocardial infarction suddenly collapsed and lost consciousness. A venous-arterial extracorporeal membrane oxygenation (ECMO) device was inserted by femoral cannulation. Emergent median sternotomy was performed. The pericardium was not opened first, and the thymus was divided to expose the ascending aorta just above the pericardial reflection. After placing two purse-string sutures on the distal ascending aorta, a 7-mm aortic cannula (Terumo, Tokyo, Japan) was inserted. The pericardium was then incised. A large volume of blood was expelled from the pericardial space, and CPB was initiated with suction drainage. A two-stage venous drainage cannula was then inserted from the right atrial appendage without hemodynamic collapse. After cardiac arrest, closure of ruptured LV wall and concomitant coronary artery bypass grafting were performed. The patient was weaned from CPB with an intra-aortic balloon pump (IABP) and the previously inserted venous-arterial ECMO. Extra-pericardial aortic cannulation is an effective and reproducible method to prepare for CPB in emergent cases of LV rupture. PMID:25179976

Ohira, Suguru; Yaku, Hitoshi; Nakajima, Shunsuke; Takahashi, Akihiko

2014-08-01

263

Industrial applications of radiation grafting  

International Nuclear Information System (INIS)

Radiation grafting can introduce the aiming function to the trunk polymer. This technique gave the separator membrane for a button-shaped battery and the gas adsorbent for fabrication facility as commercial products. This commercialization was realized by the excellent properties which were imparted by graft polymerization into the trunk polymer. As ongoing R and D, the fibrous adsorbent has been synthesized by using fibrous trunk polymer. The metal ion adsorbent is promising materials for removal of toxic metals and the recovery of significant metals from the point of environmental preservation view. (author)

264

New variant for whole pancreas grafting  

International Nuclear Information System (INIS)

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

265

Multisaccular Aneurysm in a Coronary Vein Graft  

OpenAIRE

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

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

1988-01-01

266

Graft inserter for anterior cervical fusion.  

Science.gov (United States)

The authors have developed a simple instrument for graft insertion in anterior cervical fusion. This device obviates the need for screw distraction of the adjacent vertebrae or the use of an impactor for insertion. This device simplifies graft insertion where the disc space is narrow, particularly in multilevel fusions, and reduces the risk of over-penetration of the graft. PMID:24974192

Hitchon, Patrick W; Kumar, Rajinder; Viljoen, Stephanus; Dahdaleh, Nader S

2014-11-01

267

New variant for whole pancreas grafting  

Energy Technology Data Exchange (ETDEWEB)

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

Kootstra, G.; van Hooff, J.P.; Joerning, P.J.L.; Leunissen, K.M.; van der Linden, C.J.; Beukers, E.; Buurman, W.A.

1987-02-01

268

A Case of Pituitary Hemorrhage Following Cardiopulmonary Bypass Surgery  

Directory of Open Access Journals (Sweden)

Full Text Available A 68-year-old female patient with previous history of transsphenoidal hypophysectomy operation underwent three-vessel coronary artery bypass graft (CABG surgery for extensive coronary artery disease. Preoperative neurological examination revealed sequelae visual loss at right temporal visual field. Follow-up Magnetic Resonance Imaging studies showed a residual hypophyseal tumor tissue extending to suprasellar area. No additional pathology was detected in the early postoperative cranial control CT, but aggravation of visual field defect was determined. Coincidently, cranial magnetic resonance imaging (MRI showed hemorrhage into the tumor tissue. We decided to follow-up the patient who exhibited no additional symptoms and was discharged well on the fifth day due to the signs of resolution of hemorrhage. Follow-up controls of the patient at sixth and twelfth months demonstrated normal hormone levels without any additional clinical complaints. We present preoperative assessment, perioperative anesthesia management, and postoperative clinical follow-up of a patient with a residual hypophyseal tumor.

Ayda Turkoz

2011-05-01

269

Employing Discourse: Universities and Graduate "Employability"  

Science.gov (United States)

What constitutes graduate employability is discursively framed. In this paper we argue that whilst universities in the UK have long had an involvement in producing useful and productive citizens, the ongoing neoliberalisation of higher education has engendered a discursive shift in definitions of employability. Traditionally, universities regarded…

Boden, Rebecca; Nedeva, Maria

2010-01-01

270

Osteochondral Grafting: Effect of Graft Alignment, Material Properties, and Articular Geometry  

OpenAIRE

Osteochondral grafting for cartilage lesions is an attractive surgical procedure; however, the clinical results have not always been successful. Surgical recommendations differ with respect to donor site and graft placement technique. No clear biomechanical analysis of these surgical options has been reported. We hypothesized that differences in graft placement, graft biomechanical properties, and graft topography affect cartilage stresses and strains. A finite element model of articular cart...

D D’lima, Darryl; C Chen, Peter; W Colwell Jr, Clifford

2009-01-01

271

Learning, Labour and Employability  

Science.gov (United States)

Public policy in the UK has adopted employability to define the relationship of globalisation, work and learning. This article claims that employability serves the interests of capital. It helps capital to exercise its domination/hegemony over labour and employs a redefined vision of learning as its principal vehicle. Employability is a term that…

Ball, Malcolm J.

2009-01-01

272

Vascularization of the area between free grafts and irradiated graft beds in the neck in rats.  

Science.gov (United States)

Inflammatory lesions of the vascular endothelium after preoperative radiotherapy often cause healing-delayed healing of free flaps in the irradiated graft bed. We investigated changes in neovascularization in the transition area between grafted tissues and irradiated tissues of the graft bed. We irradiated the neck(30 and 50 Gy total dose) in 102 Wistar rats and then grafted a free myocutaneous gracilis flap to the irradiated region of the neck 4 weeks later. We examined histologically the tissues of the graft, the transition area between the graft and the irradiated graft bed, and the graft bed. In contrast to control rats, the tissues in the irradiated animals showed a qualitatively reduced and a more irregular capillary distribution, with substantial fibrosis in the irradiated graft bed. We also found significant differences in vascularization and mean capillary lumen in the transitional zone between graft and graft bed in the irradiated rats compared with controls (P = 0.004 and P < 0.001, respectively). Both number and diameter of capillaries were reduced in the irradiated graft bed tissue. The graft failed to improve vascularization in the transitional zone between graft and irradiated tissue, so we conclude that it is the vascularization status of the bed tissue rather than that of the transplant tissue that is the limiting factor for graft healing. PMID:11883968

Schultze-Mosgau, S; Rödel, F; Radespiel-Tröger, M; Wörl, J; Grabenbauer, G G; Neukam, F W

2002-02-01

273

Markers of primary graft dysfunction  

DEFF Research Database (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.

Hagedorn, Peter Technical University of Denmark,

274

Homogeneous cation exchange membrane by radiation grafting  

International Nuclear Information System (INIS)

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

275

Validating HeartSmart<sup>®</sup> against the Cardiopulmonary Bypass Machine  

OpenAIRE

Purpose: To assess the utility of HeartSmart®, a new method that uses empirical physiological formulae to estimate hemodynamic variables, in estimating cardiac index during open heart surgery when compared with the cardiopulmonary bypass machine. Methods: This was a prospective, blinded study of patients undergoing elective cardiac bypass surgery. We monitored and compared the flow rates provided by the cardiopulmonary bypass machine (roller pump) with estimates derive...

Warring-davies, Kenneth J.; Bland, Martin J.

2012-01-01

276

Renal graft irradiation in acute rejection  

International Nuclear Information System (INIS)

To evaluate the effect of graft irradiation in the treatment of acute rejection of renal transplants, a randomized study was conducted from 1978 to 1981. Patients with acute rejection were given standard medical management in the form of intravenous methylprednisolone, and were chosen randomly to receive either graft irradiation (175 rads every other day, to a total of 525 rads) or simulated (sham) irradiation. Eighty-three rejections occurring in 64 grafts were randomized to the protocol. Rejection reversal was recorded in 84.5% of control grafts and 75% of the irradiated grafts. Recurrent rejections were more frequent and graft survival was significantly lower in the irradiated group (22%) than in the control group (54%). Graft irradiation does not appear to be beneficial in the treatment of acute rejection of renal transplants when used in conjunction with high-dose steroids

277

Renal graft irradiation in acute rejection  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the effect of graft irradiation in the treatment of acute rejection of renal transplants, a randomized study was conducted from 1978 to 1981. Patients with acute rejection were given standard medical management in the form of intravenous methylprednisolone, and were chosen randomly to receive either graft irradiation (175 rads every other day, to a total of 525 rads) or simulated (sham) irradiation. Eighty-three rejections occurring in 64 grafts were randomized to the protocol. Rejection reversal was recorded in 84.5% of control grafts and 75% of the irradiated grafts. Recurrent rejections were more frequent and graft survival was significantly lower in the irradiated group (22%) than in the control group (54%). Graft irradiation does not appear to be beneficial in the treatment of acute rejection of renal transplants when used in conjunction with high-dose steroids.

Pilepich, M.V.; Sicard, G.A.; Breaux, S.R.; Etheredge, E.E.; Blum, J.; Anderson, C.B.

1983-03-01

278

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

International Nuclear Information System (INIS)

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

279

“Employability-miles” and worker employability awareness  

OpenAIRE

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

Gerards, Ruud; Grip, Andries; Witlox, Maaike

2012-01-01

280

Assessment of aorto-coronary bypass graft patency and graft flow by contrast enhanced computed tomography  

International Nuclear Information System (INIS)

Recent advances in computed tomography have led to clinically useful imaging of the cardiovascular structures with remarkable resolution. In 44 patients with 66 aorto-coronary bypass grafts, the efficacy of contrast enhanced computed tomography to determine graft patency and estimate graft flow was studied. After the proper scanning level was selected by scout scans, sequential scans with a 5 seconds scanning time and a 5 seconds interscan period were performed during the rapid injection of a 30 ml bolus of contrast medium into an antecubital vein. Patency of grafts was determined by a characteristic enhancement with contrast medium that coincides with appearance of contrast in the aorta. Comparing CECT with conventional graft angiography, our results gave a 91% sensitivity for CECT detection of graft patency, a 91% specificity and a 91% accuracy. Variables, such as follows, were measured by plotting the time-density curve of dynamic scans. ?CT = increasing rate of CT number, Max CT = peak CT number - ?CT = clearance rate of CT number. The mean graft flow was measured intraoperatively by using an electromagnetic flowmeter. To determine if CECT can quantitate graft flow, correlation between the mean graft flow and variables was studied. There was significant correlation between the mean graft flow and -?CT of graft/ -?CT of Ao. (p<0.001). These findings indicates that CECT has promise as a safe and relatively noninvasive technique for determining bypass graft patenque for determining bypass graft patency and estimating graft flow. (author)

281

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)

282

Effect of Cardiopulmonary Bypass on Regional Antibiotic Penetration into Lung Tissue  

OpenAIRE

The use of cardiopulmonary bypass (CPB) during cardiac surgery causes regional ventilation-perfusion mismatch, contributing to regional disturbances in antibiotic penetration into lung tissue. Ventilation-perfusion mismatch is associated with postoperative pneumonia, a frequent and devastating complication after cardiac surgery. In this prospective clinical animal study, we performed in vivo microdialysis to determine the effect of CPB on regional penetration of levofloxacin (LVX) into lung t...

Hutschala, D.; Skhirtladze, K.; Kinstner, C.; Zeitlinger, M.; Wisser, W.; Jaeger, W.; Hoeferl, M.; Mu?ller, M.; Tschernko, E.

2013-01-01

283

The Hemobag: the modern ultrafiltration system for patients undergoing cardiopulmonary by pass  

OpenAIRE

Abstract Background The return of extracorporeal circuit blood at the termination of cardiopulmonary bypass (CPB) is an important feature of blood conservation during cardiac surgery procedures globally. We report our initial clinical evaluation of the Hemobag system a blood-salvaging device designed for whole blood recovery of residual post-CPB volume. Methods Residual whole blood is hemoconcetrated through the multipass “recovery loop” circuit separ...

Colli Andrea; Balduzzi Sara; Ruyra Xavier

2012-01-01

284

Testosterone Exacerbates Neuronal Damage Following Cardiac Arrest and Cardiopulmonary Resuscitation in Mouse  

OpenAIRE

Male animals exhibit greater neuronal damage following focal cerebral ischemic injury in many experimental injury models, however the mechanism of this is unknown. This study used cardiac arrest and cardiopulmonary resuscitation (CA/CPR) in male mice exposed to physiological vs. pharmacological doses of testosterone and tested the hypothesis that testosterone increases damage following global cerebral ischemia. Analysis of histological damage 72 hrs after resuscitation revealed a complex dose...

Nakano, Takaaki; Hurn, Patricia D.; Herson, Paco S.; Traystman, Richard J.

2010-01-01

285

One thousand heart attacks in Grampian: the place of cardiopulmonary resuscitation in general practice.  

OpenAIRE

The outcome of 1011 heart attacks in patients under the care of general practitioners who practised cardiopulmonary resuscitation and were equipped with defibrillators is reported. The 28 day mortality was 36% (367 patients), and 59% of deaths occurred outside hospital. The general practitioner was the first medical contact in 92% of heart attacks and was equipped with a defibrillator in 80% of such calls. Fifty six patients had a cardiac arrest in the presence of a general practitioner, and ...

Pai, G. R.; Haites, N. E.; Rawles, J. M.

1987-01-01

286

Application of Percutaneous Cardiopulmonary Support for Cardiac Tamponade Following Blunt Chest Trauma: Two Case Reports  

OpenAIRE

Since the advent of percutaneous cardiopulmonary support (PCPS), its application has been extended to massively injured patient. Cardiac injury following blunt chest trauma brings out high mortality and morbidity. In our cases, patients had high injury severity score by blunt trauma and presented sudden hemodynamic collapse in emergency room. We quickly detected cardiac tamponade by focused assessment with sonography for trauma and implemented PCPS. As PCPS established, their vital sign resto...

Kim, Seon Hee; Song, Seunghwan; Kim, Yeong Dae; Cho, Jeong Su; Lee, Chung Won; Lee, Jong Geun

2012-01-01

287

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

Directory of Open Access Journals (Sweden)

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.

M KADIAVAR

2003-09-01

288

The additive prognostic value of the cardiopulmonary exercise test in elderly patients with heart failure  

OpenAIRE

Abstract Objectives: The role of the cardiopulmonary exercise test (CPET) for risk stratification in elderly HF patients with depressed or preserved ventricular function has not yet been evaluated. We analysed whether CPET is useful in predicting outcome in this population. Methods and Results: 220 NYHA class I-III HF patients ? 70 years performed maximal CPET (peak expiratory exchange ratio > 1.00). Median age was 75 years, 23% had NYHA class III; 59% had preserved ventr...

Scardovi, Angela Beatrice; Maria, Renata; Celestini, Andrea; Perna, Silvia; Coletta, Claudio; Feola, Mauro; Aspromonte, Nadia; Rosso, Gianluca; Carunchio, Alessandro; Ferraironi, Alessandro; Pimpinella, Alessandro; Ricci, Roberto

2009-01-01

289

Cardiopulmonary effects of a ketamine hydrochloride/acepromazine combination in healthy cats.  

OpenAIRE

The effect of a ketamine hydrochloride/acepromazine combination on the cardiopulmonary function of 11 healthy cats was studied. Test parameters included cardiac output, measured by thermodilution, heart rate, respiratory rate, arterial blood pressure (systolic, diastolic and mean) and arterial blood gas analysis. Values for systemic vascular resistance, cardiac index and stroke volume were calculated. The cardiac output, cardiac index, stroke volume, arterial blood pressure and arterial blood...

Ingwersen, W.; Allen, D. G.; Dyson, D. H.; Pascoe, P. J.; O Grady, M. R.

1988-01-01

290

Diagnostic imaging of cardiopulmonary structures in normal dogs and dogs with mitral regurgitation  

OpenAIRE

The general aim of this thesis was to evaluate two different imaging techniques used to evaluate the heart of dogs with mitral regurgitation, one for measurements of left atrial size and one for general cardiac size and to compare cardiopulmonary imaging with plasma levels of natriuretic peptides. A more specific aim was to study the variability in objective measurements of left atrial and cardiac size and subjective evaluation of general cardiomegaly, left atrial enlargement and radiologic s...

Hansson, Kerstin

2004-01-01

291

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

Science.gov (United States)

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

292

Neutralizing Antibodies and Sin Nombre Virus RNA after Recovery from Hantavirus Cardiopulmonary Syndrome  

OpenAIRE

Patients who later have a mild course of hantavirus cardiopulmonary syndrome (HCPS) are more likely to exhibit a high titer of neutralizing antibodies against Sin Nombre virus (SNV), the etiologic agent of HCPS, at the time of hospital admission. Because administering plasma from patients who have recovered from HCPS to those in the early stages of disease may be an advantageous form of passive immunotherapy, we examined the neutralizing antibody titers of 21 patients who had recovered from S...

Ye, Chunyan; Prescott, Joseph; Nofchissey, Robert; Goade, Diane; Hjelle, Brian

2004-01-01

293

Elevated Generation of Reactive Oxygen/Nitrogen Species in Hantavirus Cardiopulmonary Syndrome  

OpenAIRE

Hantavirus cardiopulmonary syndrome (HCPS) is a life-threatening respiratory disease characterized by profound pulmonary edema and myocardial depression. Most cases of HCPS in North America are caused by Sin Nombre virus (SNV), which is carried asymptomatically by deer mice (Peromyscus maniculatus). The underlying pathophysiology of HCPS is poorly understood. We hypothesized that pathogenic SNV infection results in increased generation of reactive oxygen/nitrogen species (RONS), which contrib...

Davis, Ian C.; Zajac, Allan J.; Nolte, Kurt B.; Botten, Jason; Hjelle, Brian; Matalon, Sadis

2002-01-01

294

Cardiopulmonary Exercise Testing as Predictors for Lung Resection ?in Patients with Lung Cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Cardiopulmonary exercise testing (CPET has become an important clinical tool to evaluate exercise capacity and predict outcome for patients with lung cancer being considered for lung resection. CPET can help in stratifying the surgical risk and identify those high-risk patients with lung resection. Preoperative screening using CPET allow the selection of appropriate therapeutic approach to decrease surgical complications and mortality.

Chunting TAN

2011-07-01

295

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

OpenAIRE

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 ...

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

2004-01-01

296

Cardiopulmonary effects of a ketamine/acepromazine combination in hypovolemic cats.  

OpenAIRE

The cardiopulmonary effects of a ketamine/ acepromazine combination was studied in ten cats subjected to a 25% whole blood volume loss. Test parameters included cardiac output, measured via thermodilution, heart rate, respiratory rate, arterial blood pressure (systolic, diastolic and mean) and blood gas analysis. Values for cardiac index, stroke volume and systemic vascular resistance were calculated from these data. Posthemorrhage, cardiac output, cardiac index, stroke volume, heart rate and...

Ingwersen, W.; Allen, D. G.; Dyson, D. H.; Black, W. D.; Goldberg, M. T.; Valliant, A. E.

1988-01-01

297

Knowledge and attitudes towards cardiopulmonary resuscitation and defibrillation amongst Asian primary health care physicians  

OpenAIRE

Marcus Eh Ong1, Susan Yap1, Kim P Chan1, Papia Sultana2, Venkataraman Anantharaman11Department of Emergency Medicine, 2Department of Clinical Research, Singapore General Hospital, SingaporeObjective: To assess the knowledge and attitudes of local primary health care physicians in relation to cardiopulmonary resuscitation (CPR) and defibrillation.Methods: We conducted a survey on general practitioners in Singapore by using a self-administered questionnaire that comprised 29 questions.Results: ...

Marcus Eh Ong; Susan Yap; Chan, Kim P.; et al.

2009-01-01

298

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

OpenAIRE

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

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

2013-01-01

299

Cardiac arrest and cardiopulmonary resuscitation knowledge of nursing staff in a pediatric emergency service  

OpenAIRE

Objective: to characterize the nursing team who works at the pediatric clinic of a university hospital (UH); reveal the knowledge of the nursing staff of the pediatric clinic of a UH, the episode about the cardiopulmonary arrest and resuscitation (CPA/CPR), to discuss the implications of such knowledge about the advent of CPA/CPR assistance to the child and implement a training program in service from the results identified. Method: descriptive exploratory study with a quantitative approach. ...

Helen Conceic?a?o Pereira Vendas Rodrigues, Tathiana Silva Souza Martins

2010-01-01

300

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

OpenAIRE

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 ...

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

2010-01-01

301

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

OpenAIRE

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...

Bohm, Katarina

2009-01-01

302

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

Directory of Open Access Journals (Sweden)

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

Suat Zengin

2012-06-01

303

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

OpenAIRE

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 p...

Iglézias José Carlos Rossini; Lourenção Jr. Artur; Dallan Luís Alberto de Oliveira; Puig Luiz Boro; Oliveira Sérgio Almeida

2003-01-01

304

Cardiopulmonary Profile in Streptozotocin-Induced Type 1 Diabetic Rats during Systemic Endotoxemia  

OpenAIRE

This study was designed to determine the severity of cardiopulmonary dysfunction during systemic endotoxemia in type 1 diabetes. Thirty-two adult male Wistar rats were randomly assigned to a control group or to a group treated with streptozotocin (STZ) to create an animal model of type 1 diabetes. Survival time and cardiovascular parameters were continually monitored in urethane anaesthetized animals receiving intravenous infusion of endotoxin (lipopolysaccharide (LPS)) or saline. We also det...

Hung, Ching-hsia; Chang, Che-ning; Chen, Yu-wen; Chen, Yu-chung; Tzeng, Jann-inn; Wang, Jhi-joung

2013-01-01

305

Cardiopulmonary resuscitation in the elderly: analysis of the events in the emergency department  

OpenAIRE

With the increasing number of old people in all western countries and increasing life expectancy at birth, many seniors spend the last period of their life with various afflictions that may lead to cardiac arrest. Bystander cardiopulmonary resuscitation (CPR) increases survival rates. Octogenarians are the fastest growing segment of the population and despite empirical evidence that CPR is of questionable effectiveness in seniors with comorbidities, it is still the only treatment among life-s...

Luigi Zulli; Augusto Tricerri; Lorenzo Palleschi

2013-01-01

306

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

OpenAIRE

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...

Lakshmi Rajeswaran; Ehlers, Valerie J.

2013-01-01

307

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.

308

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

Directory of Open Access Journals (Sweden)

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.

Mirkhani S. H

2002-07-01

309

Outcome of Coronary Artery Bypass Grafts: Comparison between on Pump and off Pump  

Directory of Open Access Journals (Sweden)

Full Text Available The present study was undertaken to compare the in hospital results of coronary artery bypass graft (CABG with (on pump or without (off pump cardiopulmonary bypass (CPB. Data were collected on all first-time isolated CABGs with saphenous vein and/or artery grafts at Shahid Madani Hospital in Tabriz-Iran, between 2006 and 2009. Age and clinical profile were marched between on pump and off pump group patients. Patients with concomitant cardiac operations or beating pump technique were excluded from the study. The study included 994 patients; CABG with CPB (ONCABG was done in 578 (58% and CABG without CPB (OPCABG in 416 (42%. For pump and off pump group respectively, mortality rate was 2/3%, and 0.2%, the number of grafts was2/92 ± 0.82 and 2/12 ±o.73 and the use of intra aortic balloon-pump (IABP was1.5% and5.4%. Post operative ejection fraction (EF was improved in off pump group (47.9±0.6 versus on pump group (44.53±1.5 and the latter group had more post operative atrial fibrillation, Stroke, acute renal failure, bleeding rate and blood products transfusion, prolonged intubation time but was not statistically significance. Meanwhile Hospitalization time and use of inotrops was less in comparison with former patients group. Off pump CABG was a safe method in our series. Patients with comparable risk profiles have similar prevalence's of selected complications after ONCABG and OPCABG, though some clinical and hemodynamic results are better with off pump technique.

Rasoul Ibrahim Abdulrahman

2010-05-01

310

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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

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

1095-11-01

311

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

312

Cardiopulmonary exercise capacity and ventilation effectiveness in patients after clinical cure of acute irritant gas poisoning.  

Science.gov (United States)

The aim of this study is to assess the medium to long-term effect of acute irritant gas poisoning on cardiopulmonary exercise function in patients after clinical cure. Fourteen patients after an average of 18.5 months of clinical cure of acute irritant gas poisoning were recruited, and 14 healthy individuals were selected as control. All subjects were examined by resting pulmonary function testing (RPFT), cardiopulmonary exercise testing (CPET), and arterial blood gas (ABG) analysis. No statistically significant differences were found between poisoning and control groups for baseline parameters (age, height, and weight) or ABG values (pH, PaO2, PaCO2, and SaO2) (P > 0.05). For most RPFT parameters, including FEV1/FVC, FEV1, FEV1%pred, RV/TLC, DLCO%, and FVC%, no statistically significant differences were observed between poisoning and control groups (P > 0.05). However, MVV% was significantly lower in poisoning group compared with healthy individuals (P  0.05). Compared with controls, patients with acute irritant gas poisoning had decreased cardiopulmonary exercise capacity and ventilation effectiveness after clinical cure. PMID:25480428

Yan, Rong; Yang, Wenlan; Liu, Jinming; Gao, Beilan; Guo, Kongrong; Sun, Daoyuan

2015-03-01

313

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)

314

Graduate Identity and Employability  

Science.gov (United States)

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…

Hinchliffe, Geoffrey William; Jolly, Adrienne

2011-01-01

315

Post-surgical complications of symphyseal block graft with and without soft tissue grafting  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: To determine whether soft tissue augmentation prior to block grafting will minimize post-block grafting soft tissue complications. Methods: This longitudinal controlled pilot study was conducted at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia from October 2010 to January 2013. Fourteen sites requiring block grafting were divided into 2 groups: Group A - 7 sites in 6 patients were subjected to monocortical block graft (control; and Group B - 7 sites in 6 patients were subjected to soft tissue graft through new tunnel technique, followed by monocortical block graft (test. Results: In Group A, 2 patients had wound dehiscence and graft exposure. The first that had an exposure of 3x4 mm resulted in 45% resorption of the graft. The second had an exposure of 4x5 mm followed by infection, which resulted in 75% resorption of the graft. In the other 5 cases, sites healed with no complications and minimal resorption (0-15%. In Group B - there were generalized 1-2 mm increases in the thickness of soft tissue following soft tissue graft. Recipient sites healed with no complications or infection following block grafting. Block graft resorption ranged from 0-15%. Conclusion: More complications were seen in those patients who did not receive soft tissue augmentation, thus demonstrating the importance of soft tissue preparation prior to block grafting, especially in patients having thin soft tissue. 

Ali S. AlGhamdi

2013-06-01

316

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".

317

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

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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.

Ponzoni Deise

2009-01-01

318

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

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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.

Raissi Kamal

2009-12-01

319

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

320

Ocular Graft Versus Host Disease  

OpenAIRE

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

Elif Erdem; Meltem Yagmur

2014-01-01

321

Intestinal graft versus host disease.  

OpenAIRE

An ileocolectomy specimen was examined from a patient with graft versus host disease (GvHD). In addition to the characteristic histological features of this condition, both the small and the large intestine showed extensive destruction of mucosal tissue with survival of clusters of enterochromaffin cells. This appearance has previously been described only in the large bowel. Endocrine cells seem to be less vulnerable to the effects of GvHD than epithelial cells, resulting in their being spare...

Bryan, R. L.; Antonakopoulos, G. N.; Newman, J.; Milligan, D. W.

1991-01-01

322

Elastic properties of grafted microtubules  

OpenAIRE

We use single-particle tracking to study the elastic properties of single microtubules grafted to a substrate. Thermal fluctuations of the free microtubule's end are recorded, in order to measure position distribution functions from which we calculate the persistence length of microtubules with contour lengths between 2.6 and 48 micrometers. We find the persistence length to vary by more than a factor of 20 over the total range of contour lengths. Our results support the hyp...

Pampaloni, Francesco; Lattanzi, Gianluca; Jona?s, Alexandr; Surrey, Thomas; Frey, Erwin; Florin, Ernst-ludwig

2005-01-01

323

Transverse fluctuations of grafted polymers  

OpenAIRE

We study the statistical mechanics of grafted polymers of arbitrary stiffness in a two-dimensional embedding space with Monte Carlo simulations. The probability distribution function of the free end is found to be highly anisotropic and non-Gaussian for typical semiflexible polymers. The reduced distribution in the transverse direction, a Gaussian in the stiff and flexible limits, shows a double peak structure at intermediate stiffnesses. We also explore the response to a tr...

Lattanzi, Gianluca; Munk, Tobias; Frey, Erwin

2003-01-01

324

The Effects Of Tranexamic Acid On Postoperative Bleeding In Coronary Artery Bypass Graft Surgery  

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Full Text Available Background: Perioperative administration of tranexamic acid (TA, decreases bleeding and the need for transfusion after cardiac procedures. Hence, the results may vary in different clinical settings and the most appropriate timing to get the best results is unclear. The primary objectives of the present study were to determine the efficacy of TA in decreasing chest tube drainage, the need for perioperative allogeneic transfusions and the best timing for TA administration following primary, elective, coronary artery bypass grafting (CABG in patients with a low baseline risk of postoperative bleeding. Methods: In this double-blind, prospective, placebo-controlled clinical trial in Seiedoshohada Hospital during 2011-2012, we evaluated 150 patients scheduled for elective, primary coronary revascularization. They were randomly divided into three groups. Group B received tranexamic 10 mg/kg prior to, Group A received tranexamic acid 10 mg/kg after cardiopulmonary bypass and group C received an equivalent volume of saline solution. Blood requirement and postoperative chest tube drainage were recorded. Results: The placebo group (group C had a greater postoperative blood loss 12 h after surgery (501±288 vs. 395±184 in group B and 353±181 mL in group A, P=0.004. The placebo group also had greater postoperative total blood loss (800±347 vs. 614±276 in group B and 577±228 mL in group A, P=0.001. There was a significant increase in allogeneic blood requirement in the placebo group (P=0.001. Conclusion: For elective, first time coronary artery bypass surgery, a single dose of tranexamic acid before or after cardiopulmonary bypass is equally effective.

H Noroozinia

2012-06-01

325

Thrombolytic treatment (alteplase; rt-PA in acute massive pulmonary embolism and cardiopulmonary arrest  

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Full Text Available Adem Dirican,1 Sevket Ozkaya,2 Ali Ekber Atas,3 Esra Kayahan Ulu,4 Ilknur Kitapci,5 Ferah Ece21Department of Pulmonary Medicine, Medical Park Samsun Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Bahçesehir University, Istanbul, Turkey; 3Department of Cardiology, Medical Park Samsun Hospital, Samsun, Turkey; 4Department of Radiology, Medical Park Samsun Hospital, Samsun, Turkey; 5Department of Intensive Care Unit, Medical Park Samsun Hospital, Samsun, TurkeyAbstract: Patients with pulmonary thromboembolism (PE often decompensate suddenly, and once hemodynamic compromise has developed, mortality is extremely high. Currently, thrombolytic therapy for PE is still controversial. We retrospectively evaluated 34 patients with PE between January 2010 and December 2013 in the Department of Pulmonary Medicine, Medical Park Samsun Hospital, Samsun, Turkey. The demographic and disease characteristics of patients who received thrombolytic treatment were retrospectively analyzed. The female to male ratio was 19/15 and the mean age was 63.1±13.2 years. PE diagnosis was made using echocardiography (64.7% or contrast-enhanced thorax computed tomography with echocardiography (32.4%. Twenty-two (64.7% patients went into the cardiopulmonary arrest due to massive PE and 17 (50% patients recovered without sequelae. Eleven (32.4% patients were diagnosed with massive PE during cardiopulmonary arrest with clinical and echocardiographic findings. Alteplase (recombinant tissue plasminogen activator [rt-PA] was administered during cardiopulmonary resuscitation (CPR and four (36.3% patients responded and survived without sequelae. The complications of rt-PA treatment were hemorrhage in five (14.7% patients and allergic reactions in two (5.9% patients. There was no mortality due to rt-PA treatment complications. In conclusion, mortality due to massive PE is much more than estimated and alteplase can be used safely in patients with massive PE. This thrombolytic treatment was not associated with any fatal hemorrhage complication. If there is any sign of acute PE, echocardiography should be used during cardiopulmonary arrest/instability. Alteplase should be given to patients with suspected massive PE.Keywords: massive pulmonary embolism, thrombolytic treatment, rt-PA, cardiopulmonary arrest, resuscitation, mortality, hemorrhage

Dirican A

2014-06-01

326

Motion Calculations on Stent Grafts in AAA  

OpenAIRE

Endovascular aortic repair (EVAR) is a technique which uses stent grafts to treat aortic aneurysms in patients at risk of aneurysm rupture. Although this technique has been shown to be very successful on the short term, the long term results are less optimistic due to failure of the stent graft. The pulsating blood flow applies stresses and forces to the stent graft, which can cause problems such as breakage, leakage, and migration. Therefore it is of importance to gain more insight into the ...

Klein, Almar; Renema, W. Klaas Jan; Vliet, J. Adam; Oostveen, Luuk J.; Hoogeveen, Yvonne; Schultze Kool, Leo J.; Slump, Cornelis H.

2011-01-01

327

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)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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.

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

2002-12-01

328

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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

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

329

Characterization of radiation-induced grafting reactions  

International Nuclear Information System (INIS)

Various methods for characterization the initiators and products of grafting reactions (ESR spectroscopy, tracer technique, voltammetry, and polarography) are described. Recent developments and analytical techniques are considered. (author)

330

Tensioning of the anterior cruciate ligament graft.  

Science.gov (United States)

A great deal in variability exists in the protocols for graft tensioning. Biologic studies have not been conclusive about the optimum tension for revascularization while minimizing stress relaxation. Clinically, the risk of undertensioning the graft, and thereby not correcting the laxity, must be balanced with the risk of overconstraining the knee, which may lead to pathologic stresses on the joint cartilage, graft failure, or infrapatellar contracture syndrome . Amis and Jakob reported at the European Society of Sports Traumatology Knee Surgery and Arthroscopy scientific workshop in 1998 that most surgeons chose to impose a graft tension of 20 N to 80 N at an average of 11 degrees flexion. Preloading in full or nearly full extension limits the risk of pathologic stresses that can occur at full extension when the graft is tensioned at 30 degrees, but increases the risk of laxity at that angle. For our flexion parameters, we recommend tensioning the graft at 20 degrees to 30 degrees unless the graft tightens or shortens 5 mm or more with knee extension. If shortening occurs, tensioning should be performed in extension. The magnitude of graft tensioning should be tissue specific. For bone-patellar tendon-bone autograft or allograft, 5 pounds of tension should be applied. For hamstring graft, we apply 15 pounds of tension with each bundle tensioned individually. PMID:12528911

Heis, Forest T; Paulos, Leon E

2002-10-01

331

Membrane rigidity induced by grafted polymer brush.  

Science.gov (United States)

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

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

2015-02-01

332

The autologus graft of epithelial tissue culture  

Directory of Open Access Journals (Sweden)

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.

Minaee B

1999-08-01

333

Local complications after arterial bypass grafting.  

OpenAIRE

We have documented prospectively the problems occurring after 496 arterial bypass grafts (149 aortoiliac, 238 femorodistal, 65 extra-anatomic, and 44 others) implanted during the period 1987 to 1991 in a district general hospital. Postoperative bleeding occurred early in 14 (2.8%), and later (because of infection) in 3 (0.6%). Early graft occlusion (< 30 days) was seen in 2.9% aortofemoral, 10.4% femoropopliteal, and 25.3% femorotibial grafts, and amputation was required after 6.9% grafts. Wo...

Campbell, W. B.; Tambeur, L. J.; Geens, V. R.

1994-01-01

334

Radiation induced graft copolymerization of jute fibre  

International Nuclear Information System (INIS)

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

335

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)

336

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

337

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

Scientific Electronic Library Online (English)

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

Ana M. Rocha, Pinto; Marcelo, Pochini; Itagiba, Marinelli; Valquíria P, Campagnucci; Sílvio M. A, Gandra; Luiz Antônio, Rivetti.

1996-09-01

338

Economic Analysis of Employment  

Directory of Open Access Journals (Sweden)

Full Text Available 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 on the population identifies and examines various indicators of the labor market

Oana Camelia Iacob

2013-12-01

339

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

Science.gov (United States)

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

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

2007-06-01

340

Robotically-Assisted Coronary Artery Bypass Grafting  

OpenAIRE

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

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

2010-01-01

341

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.

342

Homosexual Discrimination in Employment  

Science.gov (United States)

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)

Siniscalco, Gary R.

1976-01-01

343

Ocular Graft Versus Host Disease  

Directory of Open Access Journals (Sweden)

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

Elif Erdem

2014-06-01

344

All-inside anterior cruciate ligament graft link: graft preparation technique.  

Science.gov (United States)

The anatomic single-bundle, all-inside anterior cruciate ligament graft-link technique requires meticulous graft preparation. The graft choice is no-incision allograft or gracilis-sparing, posterior semitendinosus autograft. The graft is linked, like a chain, to femoral and tibial TightRope cortical suspensory fixation devices with adjustable-length graft loops (Arthrex, Naples, FL) in the following manner: the graft is quadrupled, and the free ends are first whip-stitched and then sutured with a buried-knot technique, 4 times through each strand in a loop. The graft is placed on a tensioning station under approximately 20 lb of tension during arthroscopic preparation of the knee and then removed from the tensioner and inserted into all-inside femoral and tibial sockets through the anteromedial arthroscopic portal. PMID:23766990

Lubowitz, James H

2012-12-01

345

Use of high-frequency ventilation to wean off cardiopulmonary bypass in a patient with pulmonary hemorrhage after failure of conventional ventilation.  

Science.gov (United States)

The management of an infant who underwent corrective surgery for a supracardiac total anomalous pulmonary venous drainage, which was complicated by the development of pulmonary hemorrhage while separating from cardiopulmonary bypass, is presented. Initiation of high-frequency oscillatory ventilation was effective in weaning the patient off cardiopulmonary bypass. PMID:25468581

John, Jiju; Bhaskar, Pradeep; Lone, Reyaz A; Riyas, Mohammed K; Bhat, Akhlaque N; Sallehuddin, Ahmed

2014-12-01

346

Numerical study of weak polybase brushes grafted on neutral or charged spherical surface by the self-consistent field theory.  

Science.gov (United States)

The self-consistent field theory (SCFT) is employed to numerically study the response of weak polybase type polymer chains grafted on a sphere to electric fields generated by the uniform positive or negative charges on the grafting substrate in the planar polyelectrolyte brush limit. Also the effect of curvature of the grafting sphere on the brush height of weak polybase brushes in the absence of surface charges is investigated. The numerical study reveals interesting and nontrivial dependence of the brush height on the radius of the grafting substrate. Consistent with experimental results, in the parameter range of the surface charge density examined, the brush height is found to be independent of the applied electric field at intermediate and high grafting densities. At relatively low grafting density, the applied negative surface charge which is termed as negative bias in this study results in a reduction of the brush height. At rather low grafting density, the positive bias corresponding to applied positive surface charges can lead to a slight increase in the brush height. The underlining mechanism governing the response of weak polybase brushes to the applied electric field is elucidated. PMID:25459349

Tong, Chaohui

2014-12-23

347

Addressing thrombogenicity in vascular graft construction.  

Science.gov (United States)

Thrombosis is a major cause of poor patency in synthetic vascular grafts for small diameter vessel (endothelialisation in humans have lead to the investigation of pre-implantation in vitro endothelial cell seeding. These approaches ultimately aim to result in novel synthetic grafts which are anti-thrombogenic and hence suitable for coronary and distal infrainguinal bypass. PMID:17078085

Sarkar, Sandip; Sales, Kevin M; Hamilton, George; Seifalian, Alexander M

2007-07-01

348

Who Needs Coronary Artery Bypass Grafting?  

Science.gov (United States)

... no benefit Routinely adding mitral valve repair to coronary artery bypass graft surgery for heart attack patients may not be warranted in patients with moderate mitral valve damage, according to an NIH-funded study. View ... Coronary Artery Bypass Grafting Press Releases Know the Facts and Act ...

349

Types of Coronary Artery Bypass Grafting  

Science.gov (United States)

... no benefit Routinely adding mitral valve repair to coronary artery bypass graft surgery for heart attack patients may not be warranted in patients with moderate mitral valve damage, according to an NIH-funded study. View ... Coronary Artery Bypass Grafting Press Releases Know the Facts and Act ...

350

Aortoesophageal fistula after thoracic stent grafting.  

Science.gov (United States)

Aortoesophageal fistula after thoracic stent grafting is rare and usually fatal. A 66-year-old woman developed an aortoesophageal fistula 1 month after endovascular stent grafting of the thoracic aorta for a complicated type B dissection. She had a fatal episode of massive bleeding before she could be treated. The limited treatment options are discussed. PMID:22100932

Albors, José; Bahamonde, José Ángel; Sanchis, Juan Manuel; Boix, Ricardo; Palmero, Julio

2011-10-01

351

Effect of carotid and aortic baroreceptors on cardiopulmonary reflex: the role of autonomic function  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english We determined the sympathetic and parasympathetic control of heart rate (HR) and the sensitivity of the cardiopulmonary receptors after selective carotid and aortic denervation. We also investigated the participation of the autonomic nervous system in the Bezold-Jarish reflex after selective removal [...] of aortic and carotid baroreceptors. Male Wistar rats (220-270 g) were divided into three groups: control (CG, N = 8), aortic denervation (AG, N = 5) and carotid denervation (CAG, N = 9). AG animals presented increased arterial pressure (12%) and HR (11%) compared with CG, while CAG animals presented a reduction in arterial pressure (16%) and unchanged HR compared with CG. The sequential blockade of autonomic effects by atropine and propranolol indicated a reduction in vagal function in CAG (a 50 and 62% reduction in vagal effect and tonus, respectively) while AG showed an increase of more than 100% in sympathetic control of HR. The Bezold-Jarish reflex was evaluated using serotonin, which induced increased bradycardia and hypotension in AG and CAG, suggesting that the sensitivity of the cardiopulmonary reflex is augmented after selective denervation. Atropine administration abolished the bradycardic responses induced by serotonin in all groups; however, the hypotensive response was still increased in AG. Although the responses after atropine were lower than the responses before the drug, indicating a reduction in vagal outflow after selective denervation, our data suggest that both denervation procedures are associated with an increase in sympathetic modulation of the vessels, indicating that the sensitivity of the cardiopulmonary receptors was modulated by baroreceptor fibers.

T.L., Fernandes; A.C., Piratello; V., Farah; P., Fiorino; E.D., Moreira; M.C., Irigoyen; E.M., Krieger.

2010-07-01

352

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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.

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

353

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

Directory of Open Access Journals (Sweden)

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.

Maria Celia Barcellos Dalri

2008-12-01

354

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

355

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.

356

Pathogenesis of cardiac graft failure in children  

Directory of Open Access Journals (Sweden)

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.

Jenny Lin

2012-12-01

357

MR angiography of coronary artery bypass grafts  

International Nuclear Information System (INIS)

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

358

Grafting of styrene onto fluoropolymers films  

Energy Technology Data Exchange (ETDEWEB)

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)

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

359

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)

360

Dermis fat graft in eviscerated sockets.  

Science.gov (United States)

Following evisceration, three patients who experienced extrusion of synthetic orbital implant underwent socket reconstruction using an autogenous dermis fat graft. An incision into the fundus of the existing sclera was necessary to provide for an adequate vascular bed for a composite fat graft, although the anterior ring of existing sclera with extraocular muscle attachments was not disturbed. Conjunctival reepithelialization of the dermal surface and enhancement of orbital volume occurred in each case. Furthermore, the autogenous fat graft retained the original excellent globe motility that was present before the socket reconstruction. After an average follow-up of 18 months, the volume restoration, integrity of conjunctival epithelium and fornices, and the graft viability have remained unchanged. As with alloplastic orbital implant extrusions in enucleated sockets, autogeneous dermis fat grafts can be useful in managing extrusions in previously eviscerated sockets. PMID:2487209

Borodic, G E; Townsend, D J; Beyer-Machule, C K

1989-01-01

361

Electrical failure during cardiopulmonary bypass: an evaluation of incidence, causes, management and guidelines for preventative measures.  

LENUS (Irish Health Repository)

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.

Hargrove, M

2012-02-03

362

Diclofenac plasma protein binding: PK-PD modelling in cardiac patients submitted to cardiopulmonary bypass  

OpenAIRE

Twenty-four surgical patients of both sexes without cardiac, hepatic, renal or endocrine dysfunctions were divided into two groups: 10 cardiac surgical patients submitted to myocardial revascularization and cardiopulmonary bypass (CPB), 3 females and 7 males aged 65 ± 11 years, 74 ± 16 kg body weight, 166 ± 9 cm height and 1.80 ± 0.21 m2 body surface area (BSA), and control, 14 surgical patients not submitted to CPB, 11 female and 3 males aged 41 ± 14 years, 66 ± 14 kg body weight, 159 ...

Auler Jr, J. O.; Espada, E. B.; Crivelli, E.; Quintavalle, T. B. G.; Kurata, A.; Stolf, N. A. G.; Issy, A. M.; Paschoa, O. E. D.; Danhof, M.; Breimer, D. D.; Chamone, D. A. F.; Santos, S. R. C. J.

1997-01-01

363

Sex differences in the effort indicators during cardiopulmonary resuscitation manoeuvres on manikins.  

Science.gov (United States)

The aims of this study were to examine sex differences in college students while they performed cardiopulmonary resuscitation (CPR) on a manikin for 20?min in (a) objective and subjective effort indicators and (b) to analyse the influence of potential confounders (age, BMI and cardiorespiratory fitness) on these sex differences. Sixty-three participants were recruited. Participants performed 20?min of CPR on a manikin. During the CPR trial, percentages of maximal heart rate levels were higher in women than in men (Pwomen scored higher than men (Phigher in women than in men, but these sex differences are because of BMI and differences in physical fitness conditions. PMID:25046656

López-González, Ángel; Sánchez-López, Mairena; Rovira-Gil, Elías; González-García, Alberto; Ferrer-López, Vicente; Martínez-Vizcaíno, Vicente

2015-02-01

364

Life-threatening hemothorax due to azygos vein rupture after chest compression during cardiopulmonary resuscitation.  

Science.gov (United States)

Hemothorax is not an uncommon cardiopulmonary resuscitation(CPR)–related complication. But hemothorax related to azygos vein injury (AVI) is a rare condition following blunt chest trauma, with no report of CPR-related AVI in the literature. We present a case of azygosve in rupture in a middle-aged woman after repeated chest compression during 1 hour of CPR. She eventually presented with massive hemothorax due to azygos vein rupture diagnosed by computed tomography (CT). When faced with a patient with massive hemothorax after chest compression, azygos vein rupture should be considered as a complication. PMID:24881516

Yang, Euiseok; Jeong, WonJoon; Lee, JunWan; Kim, SeungWhan

2014-11-01

365

NHE-1 Inhibitors and Erythropoietin for Maintaining Myocardial Function during Cardiopulmonary Resuscitation  

Directory of Open Access Journals (Sweden)

Full Text Available Efforts to successfully restore life in cardiac arrest victims are formidably challenging. They require not only that cardiac activity be initially reestablished but that injury to vital organs be prevented or minimized. In this article, we discuss the effects that cardiac arrest and resuscitation have on the myocardium, describing first the functional myocardial abnormalities that occur during cardiac resuscitation, which may limit the ability to reestablish cardiac activity. We then discuss strategies for minimizing myocardial injury and examine novel therapies aimed at minimizing ischemia and reperfusion injury. Finally, we discuss sodium-hydrogen exchanger isoform-1(NHE-1 inhibitors and erythropoietin for maintaining myocardial function during cardiopulmonary resuscitation.

Raul J.Gazmuri

2010-10-01

366

Cardiopulmonary Bypass induced Fever and Systemic inflammatory response syndrome in Paediatric patients: Management Strategy  

Directory of Open Access Journals (Sweden)

Full Text Available Cardiopulmonary bypass is considered to be the common culprit for the occurrence of fever in the immediate post-operative period i.e, within 24 hours in pediatric patients. Other common causes contributing to fever are anaesthetic drugs, blood transfusions & pain. This early fever usually manifests as tachy-arrthymias in recovery room requiring interventions. This review intends to know the pathophysiology of fever and systemic inflammatory response syndrome after bypass (SIRAB onset, preventive aspects and better management of the fever in the post-operative period. 

Ravi Ghatnatti

2013-05-01

367

A numerical analysis of the aortic blood flow pattern during pulsed cardiopulmonary bypass.  

Science.gov (United States)

In the modern era, stroke remains a main cause of morbidity after cardiac surgery despite continuing improvements in the cardiopulmonary bypass (CPB) techniques. The aim of the current work was to numerically investigate the blood flow in aorta and epiaortic vessels during standard and pulsed CPB, obtained with the intra-aortic balloon pump (IABP). A multi-scale model, realized coupling a 3D computational fluid dynamics study with a 0D model, was developed and validated with in vivo data. The presence of IABP improved the flow pattern directed towards the epiaortic vessels with a mean flow increase of 6.3% and reduced flow vorticity. PMID:24962383

Gramigna, V; Caruso, M V; Rossi, M; Serraino, G F; Renzulli, A; Fragomeni, G

2015-11-01

368

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

369

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

International Nuclear Information System (INIS)

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

370

Tumescent Anethesia : A Useful Technique For Harvesting Split- Thickness Skin Graft  

Directory of Open Access Journals (Sweden)

Full Text Available Tumescent anesthesia is a now an established technique for regional anesthesia of the skin and the subcutaneous fatty tissue. The unsurpassed simplicity and safely of this procedure have opened up the gates for newer indications. We have employed this technique for harvesting split-thickness grafts in various conditions. We have found that this technique is extremely simple in which large areas can be anesthetized for harvesting split-thickness skin grafts safely. The good passive resistance achieved facilitates easy harvesting of split-thickness grafts along with minimal bleeding and long lasting pain relief. We found this to be an inexpensive, safe and simple technique with elimination of risks and expenses of general anesthesia.

Saraf Sanjay

2004-01-01

371

Physical self-concept and its link to cardiopulmonary exercise tolerance among adolescents with mild congenital heart disease.  

Science.gov (United States)

Background:Due to medical advances, most children with congenital heart disease (CHD) are expected to survive into adulthood. Establishing adequate physical self-concept and cardiopulmonary tolerance during the adolescent period can primarily enhance overall well-being.Aim:The purpose of this study was to undertake a gender-specific evaluation of the domain of physical self-concept among adolescents with mild CHD, and to examine the relationships between physical self-concept and cardiopulmonary exercise tolerance among adolescents with mild CHD.Methods:Four hundred and thirteen adolescents 12-20 years of age, whose cardiologists had not recommended any limitation of exercise, completed Physical Self-Description Questionnaires and three-minute step tests in two outpatient cardiology departments.Results:The male participants had significantly greater scores in measures of overall physical self-concept, competence in sports, physical appearance, body fat, physical activity, endurance, and strength than did the female participants. More than 80% of the participants had at least an average cardiopulmonary exercise tolerance index. The perception of not being 'too fat' and being more physically active were significant correlates of better cardiopulmonary exercise tolerance for adolescents with mild CHD.Conclusions:The results provided evidence for gender-specific evaluation of domains of physical self-concept among adolescents with mild CHD. The three-minute step test to measure cardiopulmonary exercise tolerance in adolescents with mild CHD may be an appropriate objective measure for use in future research. Continued efforts are needed in early intervention to promote cardiopulmonary exercise tolerance. PMID:24500873

Chen, Chi-Wen; Su, Wen-Jen; Wang, Jou-Kou; Yang, Hsiao-Ling; Chiang, Yueh-Tao; Moons, Philip

2014-02-01

372

Ionic polymer-metal composite actuators obtained from radiation-grafted cation- and anion-exchange membranes.  

Science.gov (United States)

Two series of ionic polymer-metal composites (IPMCs), one cationic and one anionic, are designed and prepared from radiation-grafted ion-exchange membranes. Through examination of the properties of the membranes synthesized from the two grafting monomers and the two base polymers, acrylic acid-grafted poly(vinylidene fluoride-co-hexafluoropropylene) and quarternized 4-vinylpyridine-grafted poly(ethylene-co-tetrafluoroethylene) with the appropriate amount of ionic groups are employed for the fabrication of cation and anion IPMCs, respectively. The bending displacement of the cation IPMC is comparable to Nafion-based IPMC under direct- and alternating-current voltage, but back-relaxation is not observed. The actuation performance of the anion IPMC is highly improved over those reported earlier in the literature for the other anion IPMCs. PMID:25420910

Park, Jong Hyuk; Han, Man Jae; Song, Dae Seock; Jho, Jae Young

2014-12-24

373

Plasma-grafted alkaline anion-exchange membranes based on polyvinyl chloride for potential application in direct alcohol fuel cell  

Science.gov (United States)

Plasma grafting is employed to prepare alkaline anion-exchange membranes in this study. The attenuated total reflection Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy and thermo gravimetric analysis demonstrate that the benzyltrimethylammonium cationic groups are successfully introduced into the polyvinyl chloride matrix via plasma grafting, quaternization and alkalization. The plasma-grafted alkaline anion-exchange membrane exhibits a satisfactory ionic exchange capacity (1.01 mmol g-1), thermal stability, mechanical property, ionic conductivity (0.0145 S cm-1) and methanol permeability (9.59 × 10-12 m2 s-1), suggesting a great potential for application in direct alcohol fuel cells. The open circuit voltage of air-breathing ADAFC using plasma-grafted alkaline anion-exchange membrane is 0.796 V with 1 M EtOH solution at ambient temperature.

Hu, Jue; Zhang, Chengxu; Cong, Jie; Toyoda, Hirotaka; Nagatsu, Masaaki; Meng, Yuedong

2011-05-01

374

Percutaneous Transluminal Angioplasty of Contralateral Iliac and Superficial Femoral Arteries via Graft Vessel in a Patient with FemoroFemoral Bypass Graft  

OpenAIRE

Peripheral arterial disease represents a significant problem, particularly among the elderly population. There has been great progress made in the treatment of peripheral arterial disease in recent years. Percutaneous transluminal angioplasty (PTA) has been employed as a method of treatment for patients with a variety of peripheral arterial disease. We report our experience with PTA of contralateral common iliac and superficial femoral arteries via graft vessel in a patient with femorofemoral...

Chung, Jin Wook; Nah, Deuk Young; Bae, Jun Ho

2013-01-01

375

Views of the employers  

International Nuclear Information System (INIS)

The aim of this paper is to present an employer's view of the recent trends in occupational radiation exposure and discuss their implications as to the effectiveness of the existing system of radiation protection. Future needs are considered from the perspective of those employers operating in a global context. The general conclusions do not support major changes, but a change in emphasis and presentation to give greater clarity for the benefit of all stakeholders. The views presented are derived from discussions within industry, but do not represent the views of any particular employer

376

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.

377

Feasibility of temporary biventricular pacing after off-pump coronary artery bypass grafting in patients with reduced left ventricular function.  

Science.gov (United States)

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. The effects of optimized pacing on cardiac output were measured with an electromagnetic aortic flow probe at the conclusion of surgery in 5 patients with a preoperative mean left ventricular ejection fraction of 0.26 (range, 0.15-0.35). Atrioventricular (7) and interventricular (9) delay settings were optimized in randomized order. Cardiac output with optimized biventricular pacing was 4.2 ± 0.7 L/min; in sinus rhythm, it was 3.8 ± 0.5 L/min. Atrial pacing at a matched heart rate resulted in cardiac output intermediate to that of sinus rhythm and biventricular pacing (4 ± 0.6 L/min). Optimization of atrioventricular and interventricular delay, in comparison with nominal settings, trended toward increased flow. This study shows that temporary biventricular pacing is feasible in patients with preoperative left ventricular dysfunction who are undergoing off-pump coronary artery bypass grafting. Further study of the possible clinical benefits of this intervention is warranted. PMID:24082369

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

378

The Effect of Low-Dose of Ketamine Infusion on Stress Responses in Coronary Artery Bypass Graft Surgery  

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Full Text Available Background: Open heart surgery is associated with acute perioperative changes in plasma levels of neurohormonal stress factors,cortisol,interleukin-6 and C-reactive protein. Human studies involving cardiopulmonary bypass have shown that very low doses of ketamine can attenuate the markers of inflammation without adverse effects. The aim of this study was to investigate whether, low dose infusion of ketamine when administered during 48 hours after induction , have anti-inflammatory effect and attenuate stress factors, in on-pump coronary artery bypass graft surgery.Methods: In this prospective randomized-controlled trial, 50 patients undergoing on-pump coronary artery bypass graft were randomly assigned to receive either 1.25mcg/kg/min of ketamine (Ketamine group, n=25 or normal saline (Control group, n=25 infusion during and for 48 hours after surgery. Inflammatory and stress response markers including C-reactive protein, cortisol, White blood cell count and differential , glucose and lactate level were measured ,before induction (T1, 4 hours after surgery (T2, and on the first and the second days after surgery (T3 and T4.Results: The level of lactate were higher in ketamine compared with control group four hours after operation (P< 0.05 without any significant differences detected in other measurements. Conclusion: Low dose ketamine did not cause any change in C-reactive protein, cortisol, White blood cell count and glucose level, however lactate level was higher compared to control group.

S Azemati

2010-03-01

379

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)

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.

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

380

The concept of employability  

OpenAIRE

The concept of ‘employability’ plays a crucial role in informing labour market policy in the UK, the EU and beyond. This paper analyses current and previous applications of the term and discusses its value as an exploratory concept and a framework for policy analysis. It then traces the development of the concept, discusses its role in current labour market and training strategies (with particular reference to the UK) and seeks to identify an approach to defining employability that can be...

Mcquaid, Ronald W.; Lindsay, Colin Dale

2005-01-01

381

Enhancement of surface graft density of MPEG on alginate/chitosan hydrogel microcapsules for protein repellency.  

Science.gov (United States)

Alginate/chitosan/alginate (ACA) hydrogel microcapsules were modified with methoxy poly(ethylene glycol) (MPEG) to improve protein repellency and biocompatibility. Increased MPEG surface graft density (n(S)) on hydrogel microcapsules was achieved by controlling the grafting parameters including the buffer layer substrate, membrane thickness, and grafting method. X-ray photoelectron spectroscopy (XPS) model was employed to quantitatively analyze n(S) on this three-dimensional (3D) hydrogel network structure. Our results indicated that neutralizing with alginate, increasing membrane thickness, and in situ covalent grafting could increase n(S) effectively. ACAC(PEG) was more promising than ACC(PEG) in protein repellency because alginate supplied more -COO(-) negative binding sites and prevented MPEG from diffusing. The n(S) increased with membrane thickness, showing better protein repellency. Moreover, the in situ covalent grafting provided an effective way to enhance n(S), and 1.00 ± 0.03 chains/nm(2) was achieved, exhibiting almost complete immunity to protein adsorption. This antifouling hydrogel biomaterial is expected to be useful in transplantation in vivo. PMID:22921144

Zheng, Jiani; Xie, Hongguo; Yu, Weiting; Tan, Mingqian; Gong, Faquan; Liu, Xiudong; Wang, Feng; Lv, Guojun; Liu, Wanfa; Zheng, Guoshuang; Yang, Yan; Xie, Weiyang; Ma, Xiaojun

2012-09-18

382

Deficiency of employability capacity  

Directory of Open Access Journals (Sweden)

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.

Pelse I.

2012-10-01

383

A coprological investigation of gastrointestinal and cardiopulmonary parasites in hunting dogs in Denmark  

DEFF Research Database (Denmark)

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.

Al-Sabi, Mohammad Nafi Solaiman; Kapel, Christian Moliin Outzen

2013-01-01

384

Biotechnological traps for the reduction of inflammation due to cardiopulmonary bypass operations.  

Science.gov (United States)

Cardiopulmonary bypass induces a systemic inflammatory response (SIR), characterized by the activation of cellular and humoral elements, with concomitant release of neutrophil elastase and matrix-metallo proteinases. In the present study, the protease release during extracorporeal circulation in 28 patients undergoing cardiac surgical operations was monitored using casein zymography. A peak in protease activity was found in all patients at the end of cardiopulmonary bypass. Plasma samples of patients were allowed to interact with different traps obtained by immobilizing different protease inhibitors on specific carriers. alpha1-Antitrypsin, Bovine Pancreatic Trypsin Inhibitor, Elastatinal or Leupeptin were used as inhibitors and were covalently immobilized by diazotization or by condensation. A reduction in the proteolytic activity of the plasma samples was observed after interaction with the different traps. The most efficient traps, i.e. the ones displaying greatest power to inhibit protease activity, were those obtained by immobilizing Bovine Pancreatic Trypsin Inhibitor and Leupeptin. The biocompatibility of traps was also tested. Results show that protease activity in blood can be decreased by our protease traps. PMID:16533521

Grano, Valentina; Salamino, Franca; Melloni, Edon; Minafra, Roberto; Regola, Eliana; Diano, Nadia; Nicolucci, Carla; Attanasio, Angelina; Nappi, Gianantonio; Cotrufo, Maurizio; Maresca, Lucio; De Santo, Natale Gaspare; Mita, Damiano Gustavo

2006-07-01

385

Noncontact accurate measurement of cardiopulmonary activity using a compact quadrature Doppler radar sensor.  

Science.gov (United States)

The designed sensor enables accurate reconstruction of chest-wall movement caused by cardiopulmonary activities, and the algorithm enables estimation of respiration, heartbeat rate, and some indicators of heart rate variability (HRV). In particular, quadrature receiver and arctangent demodulation with calibration are introduced for high linearity representation of chest displacement; 24-bit ADCs with oversampling are adopted for radar baseband acquisition to achieve a high signal resolution; continuous-wavelet filter and ensemble empirical mode decomposition (EEMD) based algorithm are applied for cardio/pulmonary signal recovery and separation so that accurate beat-to-beat interval can be acquired in time domain for HRV analysis. In addition, the wireless sensor is realized and integrated on a printed circuit board compactly. The developed sensor system is successfully tested on both simulated target and human subjects. In simulated target experiments, the baseband signal-to-noise ratio (SNR) is 73.27 dB, high enough for heartbeat detection. The demodulated signal has 0.35% mean squared error, indicating high demodulation linearity. In human subject experiments, the relative error of extracted beat-to-beat intervals ranges from 2.53% to 4.83% compared with electrocardiography (ECG) R-R peak intervals. The sensor provides an accurate analysis for heart rate with the accuracy of 100% for p = 2% and higher than 97% for p = 1%. PMID:24235293

Hu, Wei; Zhao, Zhangyan; Wang, Yunfeng; Zhang, Haiying; Lin, Fujiang

2014-03-01

386

[Positional paper of the German working group "cardiopulmonary exercise testing" to ventilatory and metabolic (lactate) thresholds].  

Science.gov (United States)

Thresholds in cardiopulmonary exercise testing are necessary for the evaluation of motivation and cooperation in exercise, for training programs, in transplant medicine, preoperative evaluation and medical assessments. There is a hardly comprehensible number of terminologies concerning these thresholds and their definitions. This hampers the comparison of protocols and studies and leads to incertainties in terminologies and interpretations of cardiopulmonary exercise tests. Based on literature a definition of thresholds was undertaken. Thresholds should be regarded from a conceptional and an operational (methodological) point of view. The conceptional model means, that there are two ventilatory thresholds (VT1 and VT2) and two metabolic thresholds (lactate threshold [LT] 1 and 2 ). These thresholds are pathophysiologically based. Both threshold concepts determinate the beginning and the end of the aerobic-anaerobic transition. The lactate thresholds determine the metabolic changes, whereas the ventilator thresholds 1 and 2 represent the ventilatory response to the metabolic changes. VT1 represents the subsequent increase of ventilation and CO2-output relative to oxygen uptake as a consequence of an increase of lactate and a necessary lactate buffering. VT2 is characterized by an exceeding of lactate-steady-state, resulting in excess lactate, metabolic acidosis and overproportional rise of ventilation. The operational concept describes the method, which is used for determination of the different lactate and ventilatory thresholds. In a further step this can be completed by indicating the exercise protocol which was applied. PMID:23361352

Westhoff, M; Rühle, K H; Greiwing, A; Schomaker, R; Eschenbacher, H; Siepmann, M; Lehnigk, B

2013-02-01

387

Edema pulmonar não cardiogênico após circulação extracorpórea / Non-cardiogenic pulmonary edema after cardiopulmonary bypass  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O edema pulmonar não cardiogênico é uma complicação grave, de conhecimento recente, que se segue a cirurgias cardíacas com circulação extracorpórea. O quadro clínico é de instalação rápida, caracterizando-se, principalmente, por broncoespasmo, secreção sero-hemorrágica pelas vias aéreas e hipotensão [...] arterial. O diagnóstico diferencial com insuficiência ventricular esquerda é realizado pela constatação de pressões normais, ou baixas, em território pulmonar e átrio esquerdo, sugerindo mecanismo de aumento súbito da permeabilidade capilar. Os autores relatam a ocorrência desta síndrome em 6 pacientes submetidos a operações cardíacas com circulação extracorpórea, tecendo considerações sobre os mecanismos fisiopatológicos aventados, meios de diagnóstico, terapêutica adotada, bem como os achados histopatológicos dos pacientes com má evolução. Abstract in english Non-cardiogenic pulmonary edema is a recently described serious complication which follows heart surgery under cardiopulmonary bypass. The onset of symptoms is rapid, with bronchospasm, sero-hemorrhagic secretion through the airways, and arterial hypotension. Differential diagnosis with left ventric [...] ular failure is obtained from the normal or low pressures in the pulmonary circulation. This points out to an increased vascular permeability as the main ethiological agent. The authors report the occurrence of this syndrome in six patients submitted to heart operations under cardiopulmonary bypass and discuss physiopathology, diagnosis, therapy and histopathological findings in patients with lethal evolution.

José Otávio C, Auler Júnior; Jorge Maurício Stibich, Pascual; José Luís, Santello; Pablo M. A, Pomerantzeff; Roberto, Falzoni; Ruy Vaz Gomide do, Amaral; Geraldo, Verginelli; Adib D, Jatene.

1986-12-01

388

Edema pulmonar não cardiogênico após circulação extracorpórea Non-cardiogenic pulmonary edema after cardiopulmonary bypass  

Directory of Open Access Journals (Sweden)

Full Text Available O edema pulmonar não cardiogênico é uma complicação grave, de conhecimento recente, que se segue a cirurgias cardíacas com circulação extracorpórea. O quadro clínico é de instalação rápida, caracterizando-se, principalmente, por broncoespasmo, secreção sero-hemorrágica pelas vias aéreas e hipotensão arterial. O diagnóstico diferencial com insuficiência ventricular esquerda é realizado pela constatação de pressões normais, ou baixas, em território pulmonar e átrio esquerdo, sugerindo mecanismo de aumento súbito da permeabilidade capilar. Os autores relatam a ocorrência desta síndrome em 6 pacientes submetidos a operações cardíacas com circulação extracorpórea, tecendo considerações sobre os mecanismos fisiopatológicos aventados, meios de diagnóstico, terapêutica adotada, bem como os achados histopatológicos dos pacientes com má evolução.Non-cardiogenic pulmonary edema is a recently described serious complication which follows heart surgery under cardiopulmonary bypass. The onset of symptoms is rapid, with bronchospasm, sero-hemorrhagic secretion through the airways, and arterial hypotension. Differential diagnosis with left ventricular failure is obtained from the normal or low pressures in the pulmonary circulation. This points out to an increased vascular permeability as the main ethiological agent. The authors report the occurrence of this syndrome in six patients submitted to heart operations under cardiopulmonary bypass and discuss physiopathology, diagnosis, therapy and histopathological findings in patients with lethal evolution.

José Otávio C Auler Júnior

1986-12-01

389

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

Carlos, Serrano; Mauricio Rocha e, Silva.

390

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

Directory of Open Access Journals (Sweden)

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.

Joshua N. Burkhardt

2014-07-01

391

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)

392

Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea.  

Science.gov (United States)

Information regarding the safety of maximal cardiopulmonary exercise testing (CPET) or the mechanisms of exercise limitation in obstructive sleep apnea (OSA) patients is fairly limited. In the present study, we addressed the problem of exercise capacity in moderate-to-severe OSA patients. Nineteen non-consecutive patients (three female, 16 male) with moderate-to-severe OSA and 11 age and body mass index matched control subjects (four female, seven male) underwent respiratory function tests during pre-exercise resting period and volitionally limited cardiopulmonary exercise testing on an electronically braked cycle ergometer. All participants completed CPET without any complication. Control subjects were exercise limited due to deconditioning. None of the patients revealed mechanical ventilatory limitation to exercise or had evidence of cardiac ischaemia. Five patients had no limitation to exercise. Six patients had low VO2peak, low anaerobic treshold (AT), and low peak O2 pulse, a pattern consistent with ventricular dysfunction. Six patients had low VO2peak, low AT, and peak heart rate less than 85% predicted. This pattern is consistent with exercise limitation due to peripheral vascular disease. Two patients had low VO2peak, low AT without peak oxygen pulse and peak heart rate abnormalities consistent with deconditioning. We concluded that moderate-to-severe OSA patients have impaired exercise capacity. Exercise limitation seems to originate from cardiovascular reasons namely left ventricular dysfunction and/or peripheral vascular impairment; and finally, maximal CPET can be tolerated by these patient group without serious complications. PMID:15765282

Oztürk, Levent Mukadder; Metin, Gökhan; Cuhadaro?lu, Ca?lar; Utkusava?, Ayfer; Tutluo?lu, Bülent

2005-01-01

393

Occupational affiliation does not influence practical skills in cardiopulmonary resuscitation for in-hospital healthcare professionals  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background D-CPR (Defibrillator Cardiopulmonary Resuscitation is a technique for optimal basic life support during cardiopulmonary resuscitation (CPR. Guidelines recommend that healthcare professionals can perform CPR with competence. How CPR training and provision is organized varies between hospitals, and it is our impression that in Sweden this has generally improved during the last 15-20 years. However, some hospitals still do not have any AED (Automated External Defibrillators. The aim was to investigate potential differences in practical skills between different healthcare professions before and after training in D-CPR. Methods Seventy-four healthcare professionals were video recorded and evaluated for adherence to a modified Cardiff Score. A Laerdal Resusci Anne manikin in connection to PC Skill reporting System was used to evaluate CPR quality. A simulated CPR situation was accomplished during a 5-10 min scenario of ventricular fibrillation. Paired and unpaired statistical methods were used to examine differences within and between occupations with respect to the intervention. Results There were no differences in skills among the different healthcare professions, except for compressions per minute. In total, the number of compression per minute and depth improved for all groups (P P Conclusion Nearly all healthcare professionals learned to use the AED. There were no differences in CPR skill performances among the different healthcare professionals.

Thoren Ann-Britt

2011-01-01

394

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

395

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

Directory of Open Access Journals (Sweden)

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.

S. BAGCHI

2001-01-01

396

Noninvasive measurement of cardiopulmonary blood volume: evaluation of the centroid method  

International Nuclear Information System (INIS)

Cardiopulmonary blood volume (CPV) and mean pulmonary transit time (MTT) determined by radionuclide measurements (Tc-99m HSA) were compared with values obtained from simultaneous dye-dilution (DD) studies (indocyanine green). The mean transit time was obtained from radionuclide curves by two methods: the peak-to-peak time and the interval between the two centroids determined from the right and left-ventricular time-concentration curves. Correlation of dye-dilution MTT and peak-to-peak time was significant (r = 0.79, p < 0.001), but its correlation with centroid-derived values was better (r = 0.86, p < 0.001). CPV values (using the centroid method for radionuclide technique) correlated significantly with values derived from dye-dilution curves (r = 0.74, p < 0.001). Discrepancies between the two were greater the more rapid the circulation (r = 0.61, p < 0.01), suggesting that minor inaccuracies of dye-dilution methods, due to positioning or delay of the system, can become magnified in hyperkinetic conditions. The radionuclide method is simple, repeatable, and noninvasive, and it provides simultaneous evaluation of pulmonary and systemic hemodynamics. Further, calculation of the ratio of cardiopulmonary to total blood volume can be used as an index of overall venous distensibility and relocation of intravascular blood volume

397

Adaptive significance of root grafting in trees  

Energy Technology Data Exchange (ETDEWEB)

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

Loehle, C.; Jones, R.

1988-12-31

398

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

Directory of Open Access Journals (Sweden)

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.

Angelo Pedro Jacomino

2000-03-01

399

Sepsis after autologous fat grafting.  

Science.gov (United States)

Autologous fat grafting is an increasingly popular technique, with numerous examples of excellent results. Adherence to key principles, including sterile technique and low-volume injection throughout layers of tissue, appears to be critical to obtaining good results. Reports of adverse outcomes are infrequent, but several case reports document both infectious and aesthetic complications. This case report represents an extreme complication, including abscess formation, life-threatening sepsis, and residual deformity. It serves as yet another reminder that early adoption of surgical procedures by those without a sound understanding of the underlying principles and techniques can have disastrous consequences. Furthermore, physicians operating on any patient must understand the potential for complications and be able to manage these appropriately when they occur. PMID:20885205

Talbot, Simon G; Parrett, Brian M; Yaremchuk, Michael J

2010-10-01

400

Modification of natural rubber by different grafting techniques  

International Nuclear Information System (INIS)

An attempt has been made to graft a hydrophylic monomer of N,N-dimethyl acrylamide (DMAA) onto natural rubber (NR) tube by simultaneous, pre-oxidation and preirradiation grafting techniques. It was found that the grafting by simultaneous grafting technique results in a maximum 29 wt% degree of grafting and by peroxidation and preirradiation techniques, results the maximum 42 wt% and 13 wt% degree of grafting, respectively. It was concluded that the peroxidation technique is the most appropriate to obtain a high degree of grafting in radiation copolymerization of DMAA onto NR. (author)

401

Acrylique acid grafted polyolefines. Thermoadhesive applications  

International Nuclear Information System (INIS)

Radiochemical grafting of polyolefines by peroxidation has been industrialized in France for about 10 years by irradiation of these polymers with an electron accelerator and then treated by acrylic acid. Products obtained show a high adhesivity on metallic surfaces above their melting point. The main application of acrylic acid grafted high density polyethylene is composite film with aluminum foil for thermosealing of plastic bottle caps of sterilized milk. Acrylic acid grafted polypropylene is used in suspension in a volatile liquid for aluminum foil coating satisfying food packaging regulations

402

Employability Skills Indicator as Perceived by Manufacturing Employers  

OpenAIRE

Research on employability skills were conducted nationally and internationally, found that many technical graduates lacked employability skills. This article reports on the study of employability skills that technical students should acquire to be employed and sustained in manufacturing industries. The study investigates the importance of employability skills as perceived by 107 employers from manufacturing industries. The findings of the study revealed employers place great importance on int...

Mohamad Sattar Rasul; Azlin Norhaini Mansor

2013-01-01

403

Endoluminal stent-graft relining of visceral artery bypass grafts to treat perigraft seroma  

OpenAIRE

PURPOSE: To describe the endovascular treatment of intra-abdominal perigraft seromas associated with small-caliber expanded polytetrafluoroethylene (ePTFE) grafts. CASE REPORTS: Two patients who underwent hybrid repair of thoracoabdominal aortic aneurysms in which renovisceral bypass grafts were implanted presented with large, symptomatic perigraft seromas. The 5- to 8-mm-diameter ePTFE bypass grafts believed to be involved in the seromas were successfully relined with self-expanding Viaba...

Lachat, Mario; Romero Toledo, Maricarmen; Glenck, Michael; Veith, Frank J.; Schmidt, Christian A.; Pecoraro, Felice

2013-01-01

404

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

International Nuclear Information System (INIS)

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

405

Role of Bone Graft in Reconstruction of Skull Base Defect: Is a Bone Graft Necessary  

OpenAIRE

Ten patients underwent reconstruction of skull base defects between 1989 and 1992. In this series, the maximum size of the skull base defect was 6 × 5 cm. Three patients underwent bone grafts to reinforce the skull base. The postoperative course of seven patients without bone grafts was uneventful. There was no cerebrospinal fluid leakage, meningitis, extradural abscess, on brain herniation. On the other hand, two of the three patients with bone grafts developed extradural abseesses requirin...

Yamamoto, Yuhei; Minakawa, Hidehiko; Yoshida, Tetsunori; Igawa, Hiroharu; Sugihara, Tsuneki; Ohura, Takehiko; Nohira, Kunihiko

1993-01-01

406

Frequency of myocardial indium-111 antimyosin uptake after uncomplicated coronary artery bypass grafting  

International Nuclear Information System (INIS)

The reported incidence of myocardial damage after coronary artery bypass grafting (CABG) is highly related to the methods used. Since indium-111 monoclonal antimyosin antibody scintigraphy has been shown to be highly specific and sensitive for myocardial necrosis, even in small lesions, uptake of this radiotracer was evaluated after CABG. In 23 consecutive patients without previous myocardial infarction who underwent CABG for stable angina, 80 MBq indium-111 antimyosin was injected on the third postoperative day. Planar images were obtained 48 hours later and analyzed for myocardial uptake of indium-111 antimyosin. Scintigraphic results were related to creatine kinase MB levels, duration of both aortic cross-clamping and cardiopulmonary bypass, and electrocardiographic changes. In all patients surgical procedure and postoperative course was uncomplicated. Indium-111 antimyosin uptake was present in 19 of 23 patients (82%). It was diffused in 7 patients and localized in 12. No pathologic Q waves occurred postoperatively. Fourteen patients exhibited ST-segment changes. No good relation was found among indium-111 antimyosin uptake and creatine kinase MB levels, duration of cross-clamping or bypass, and ST-T changes. It is concluded that some degree of myocardial damage, though silent, is common after CABG

407

Polypropylene grafted with glycidyl methacrylate using supercritical CO2 medium  

OpenAIRE

Films of polypropylene (PP) were grafted with glycidil methacrylate (GMA) using supercritical CO2 as swelling agent and solvent. Different pressures and temperatures were used to study their effects on the soaking and grafting process. FTIR results showed signals at 1726 and 1640 cm-1, assigned to C=O and C=C (after the soaking process), and a decreased signal at 1640 cm-1 (after the grafting procedure), suggesting the effective grafting of GMA. For the grafted material immersed in ethylenedi...

Kunita, M. H.; Girotto, E. M.; Muniz, E. C.; Rubira, A. F.

2006-01-01

408

The 5-strand hamstring graft in anterior cruciate ligament reconstruction.  

Science.gov (United States)

The use of anterior cruciate ligament reconstruction in the pediatric and adolescent population has been increasing in recent years. Autograft hamstring graft is favored in this population, but these patients often have smaller hamstring tendons that yield smaller final graft constructs. These smaller grafts are associated with an increased need for revision surgery. We describe a technique for obtaining a larger-diameter anterior cruciate ligament graft construct from autologous hamstring graft without allograft supplementation. PMID:25473619

Lee, Rushyuan Jay; Ganley, Theodore J

2014-10-01

409

Muscle graft as a substitute for peripheral nerve graft in rats Enxerto de músculo como substituto de nervo periférico em ratos  

Directory of Open Access Journals (Sweden)

Full Text Available PURPOSE: To evaluate the applicability of the use of autogenous muscle treated in various ways, as a substitute of the nerve grafts. METHODS: Rats were divided into seven groups that received, as a treatment for a standard nerve injury, the following types of grafts: fresh muscle, muscle fixed with 10% formaldehyde, muscle frozen in a freezer, muscle frozen in refrigerator, nerveless muscle, peripheral nerve and a group was without any treatment. It assessed the histological appearance of the nerve fibers in the segment repaired. RESULTS: The evaluation of the segment nervous repaired showed nerve fibers through the graft in almost all groups, but the methodology employed has not adequately characterized the differences between the groups. CONCLUSION: This study showed the migration of nerves fibers through all grafts used.OBJETIVO: Avaliar a aplicabilidade do uso de músculo autógeno, tratado de diversas maneiras, em substituição aos enxertos de nervo. MÉTODOS: Os ratos foram separados em sete grupos que receberam, como tratamento a uma lesão nervosa padronizada, os seguintes tipos de enxertos: músculo fresco, músculo fixado com formol 10%, músculo congelado em freezer, músculo congelado em refrigerador, músculo denervado, nervo periférico e um grupo ficou sem qualquer tratamento. Foi avaliado o aspecto histológico das fibras nervosas no segmento reparado. RESULTADOS: A avaliação do segmento nervoso reparado mostrou que existiam axônios em quase todos os grupos, mas a metodologia empregada não possibilitou caracterizar adequadamente as diferenças entre os grupos. CONCLUSÃO: Este estudo mostrou a migração de axônios por meio de todos os enxertos utilizados.

Aristides Palhares

2009-06-01

410

Grafting-responsive miRNAs in cucumber and pumpkin seedlings identified by high-throughput sequencing at whole genome level.  

Science.gov (United States)

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

Li, Chaohan; Li, Yansu; Bai, Longqiang; Zhang, Tieyao; He, Chaoxing; Yan, Yan; Yu, Xianchang

2014-08-01

411

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

OpenAIRE

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.

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

412

Positive end-expiratory pressure improves survival in a rodent model of cardiopulmonary resuscitation using high-dose epinephrine.  

LENUS (Irish Health Repository)

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.

McCaul, Conán

2009-10-01

413

Cardiopulmonary exercise testing reveals onset of disease and response to treatment in a case of heritable pulmonary arterial hypertension  

OpenAIRE

Patients affected by pulmonary arterial hypertension (PAH) show a typical pattern of abnormalities on cardiopulmonary exercise testing (CPET). However, CPET is not routinely used as a screening method. We discuss a patient with hereditary PAH in whom CPET revealed onset of disease. Furthermore, we show that the abnormalities observed can improve in part by PAH-specific treatment.

Trip, P.; Vonk Noordegraaf, A.; Bogaard, H. J.

2012-01-01

414

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...

415

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

Directory of Open Access Journals (Sweden)

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.

Ashraf Omer

2005-12-01

416

Graft Rejection and Graft Failure After Penetrating Keratoplasty or Posterior Lamellar Keratoplasty for Fuchs Endothelial Dystrophy  

DEFF Research Database (Denmark)

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.

Hjortdal, Jesper; Pedersen, Iben B

2013-01-01

417

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.

418

Employment certificates on HRT  

CERN Multimedia

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

HR Department

2008-01-01

419

Enxerto composto de artéria torácica interna esquerda e veia safena magna: estudo angiográfico após oito anos / Left internal thoracic artery and saphenous vein as a composite graft: 8-year angiographic follow-up study  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O uso de enxerto composto de artéria torácica interna esquerda (ATIE) com segmentos arteriais ou segmentos de veia safena magna (VSM) pode permitir a revascularização completa do sistema coronariano esquerdo (SCE) sem circulação extracorpórea (CEC) e sem manuseio da aorta ascendente (MAA), como form [...] a de tentar reduzir alguns riscos e complicações no pós-operatório imediato. Neste trabalho, relatamos os resultados angiográficos, após oito anos, de dois pacientes submetidos à cirurgia de revascularização do SCE com enxerto composto de ATIE e VSM, sem CEC e sem MAA. Abstract in english The use of a composite graft with left internal thoracic artery (LITA) and arterial or saphenous vein (SV) grafts can allow the complete revascularization of the left coronary system (LCS) without cardiopulmonary bypass (CPB) and without ascending aorta manipulation (AAM), in order to reduce some co [...] mplications in the immediate postoperative. This study shows 8-year angiographic follow-up results of two patients underwent no-touch aorta off-pump coronary artery bypass grafting (CABG) using LITA and SV as a composite graft to supply LCS.

José Glauco, Lobo Filho; Heraldo Guedis, Lobo Filho; Francisco José Cabral, Mesquita; Jaime Paula Pessoa, Linhares Filho.

2010-03-01

420

Thiersch skin grafting in otologic surgery.  

Science.gov (United States)

Thiersch skin grafting is an old but highly effective surgical technique in otology. We frequently place a Thiersch graft after otologic procedures that either create a mastoid cavity or result in reduced skin coverage of a portion of the external auditory canal. The purpose of this article is to introduce this surgical technique to a new generation of otologists. We discuss its indications, the surgical technique, tips for a successful outcome, and postoperative care. A key to successful skin grafting is to perform the procedure about 10 days after the primary procedure to allow sufficient time for the formation of an adequate vascular bed at the recipient site. The goal in all cases is to achieve a safe, dry ear that is covered with keratinizing squamous epithelium. Thiersch grafting accomplishes this very well. PMID:23975487

Xu, Helen; Pollak, Natasha; Paparella, Michael M

2013-08-01

421

What Is Coronary Artery Bypass Grafting (CABG)?  

Science.gov (United States)

... Coronary artery bypass grafting or "CABG" (often pronounced "cabbage") is the most commonly performed "open heart" operation ... infarction . In some cases, particularly in individuals with diabetes mellitus , angina may be absent or infarctions "silent." ...

422

Experimental tendon grafting within intact tendon sheath.  

Science.gov (United States)

A chicken toe experimental model was used to study the fate of flexor tendon grafts, introduced into intact tendon sheaths. After perfusion of the limb by India Ink, the vascular pattern of the graft and the synovial sheath could be identified. The grafts</