WorldWideScience
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Interleukin-2 as a predictor of early postoperative atrial fibrillation after cardiopulmonary bypass graft (CABG).  

OpenAIRE

Recently, inflammation has been considered as a risk factor of postoperative atrial fibrillation (PAF). The main purpose of this study was to estimate the connections between occurrence of PAF and cytokine release. Thirty-three patients who qualified for cardiopulmonary bypass graft (CABG) were included in the study. Blood was taken from all of them before CABG, then 3 h, 24 h, and 72 h afterwards. Cytokine (IL-6, IL-2, IL-4, IL-10, IFN-gamma, TNF-alpha) concentration was measured at every ti...

Hak, ?.; Mys?liwska, J.; Wieckiewicz, J.; Szyndler, K.; Siebert, J.; Rogowski, J.

2009-01-01

2

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

3

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

Directory of Open Access Journals (Sweden)

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

4

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

Science.gov (United States)

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

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

2014-12-01

5

A comparison of low vs conventional-dose heparin for minimal cardiopulmonary bypass in coronary artery bypass grafting surgery.  

Science.gov (United States)

The biocompatibility of minimal extracorporeal circuits has improved; however, anticoagulation is still required. We compared standard high-dose anticoagulation with a low-dose heparin regimen in a retrospective study of patients who underwent coronary bypass surgery using minimal cardiopulmonary bypass. One hundred patients who received 300 IU.kg(-1) heparin were compared with 68 patients who received heparin according to an individually adjusted activated coagulation time target of 300 s, resulting in a mean (SD) heparin dose of 145 (30) IU.kg(-1) . There were no thromboembolic events in either group; however, patients in the low-dose group had lower 24-hour mean (SD) postoperative blood loss than the conventional group (545 (61) vs 680 (88) ml, p=0.001) and a reduced rate of transfusion of allogeneic blood (15% patients transfused vs 32%, p=0.01). An individually tailored low-dose heparin regimen for minimal cardiopulmonary bypass is safe and may be associated with reduced bleeding and lower transfusion requirements. PMID:21501130

Fromes, Y; Daghildjian, K; Caumartin, L; Fischer, M; Rouquette, I; Deleuze, P; Bical, O M

2011-06-01

6

17?-estradiol effects on human coronaries and grafts employed in myocardial revascularization: a preliminary study  

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Full Text Available Abstract Background This study was undertaken to compare the in vitro effects of 17?-estradiol on human epicardial coronary arteries, resistance coronary arteries and on arterial vessels usually employed as grafts in surgical myocardial revascularization. Methods Coronary artery rings (descending coronary artery, right coronary artery, circumflex coronary artery, first septal branch and arterial graft rings (internal thoracic artery, gastro-epiploic artery obtained from human heart donors with heart not suitable to cardiac transplantation were connected to force transducer for isometric force recording. Precontracted specimens with and without endothelium were exposed to increasing concentration of 17?-estradiol (3–30–300–3000 nmol/l and to vehicle (0.1% v/v ethanol. We also evaluated the effects of 17?-estradiol on vessels before and 20 minutes after exposure to L-monomethyl-arginine and indomethacin. Results 17?-estradiol induced a significant relaxation in all precontracted vessels (mean maximum effect: 78,6% ± 8,5. This effect was not different among the different rings and was not related to the presence of endothelium. N-monomethyl-L-arginine and indomethacin did not modify 17?-estradiol relaxant effect. Conclusion The vasodilator action of the 17?-estradiol is similar on coronary arteries, resistance coronary arteries and arterial vessels usually employed as grafts in myocardial revascularization.

Penza Eleonora

2006-12-01

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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)  

OpenAIRE

Abstract Background Left ventricular dysfunction is common after coronary artery bypass graft and valve replacement surgeries and is often treated with inotropic drugs to maintain adequate hemodynamic status. In this study, we aimed to identify the demographic, clinical, laboratory, echocardiographic and hemodynamic factors that are associated with use of inotropic drugs in patients undergoing concomitant coronary artery bypass graft and aortic valve replacement surgery. Methods The study inc...

Nelson William B; House Chad M; Ahmed Imdad

2009-01-01

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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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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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A marked increase in gastric fluid volume during cardiopulmonary bypass  

Science.gov (United States)

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 patients undergoing cardiac surgery with cardiopulmonary bypass, and also compared in patients undergoing a off-pump coronary artery bypass graft surgery (off-pump cardiopulmonary bypass-H2 group, n = 15). Gastric pH (5.14 ± 0.61) and gastric fluid volume (13.2 ± 2.4 mL) at the end of surgery in off-pump cardiopulmonary bypass-H2 groups was significantly lower and higher than those in both cardiopulmonary bypass-H2 (6.25 ± 0.54, 51.3 ± 8.0 mL) and cardiopulmonary bypass-PPI (7.29 ± 0.13, 63.5 ± 14.8 mL) groups, respectively although those variables did not differ between groups after the induction of anesthesia. Plasma gastrin (142 ± 7 pg/mL) at the end of surgery and maximal blood lactate levels (1.50 ± 0.61 mM) in off-pump cardiopulmonary bypass-H2 group were also significantly lower than those in both cardiopulmonary bypass-H2 (455 ± 96 pg/mL, 3.97 ± 0.80 mM) and cardiopulmonary bypass-PPI (525 ± 27 pg/mL, 3.15 ± 0.44 mM) groups, respectively. In addition, there was a significant correlation between gastric fluid volume and maximal blood lactate (r = 0.596). In conclusion, cardiopulmonary bypass may cause an increase in gastric fluid volume which neither H2 antagonist nor PPI suppresses. A significant correlation between gastric fluid volume and maximal blood lactate suggests that gastric fluid volume may predict degree of gastrointestinal tract hypoperfusion. PMID:21765601

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

2011-01-01

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Effect of cardiopulmonary bypass on the pharmacokinetics of propranolol and atenolol  

Scientific Electronic Library Online (English)

Full Text Available 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

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Bone grafting: An overview  

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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

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PRODUCTION OF INDIAN CITRUS RINGSPOT VIRUS FREE PLANTS OF KINNOW EMPLOYING CHEMOTHERAPY COUPLED WITH SHOOT TIP GRAFTING  

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Full Text Available Indian citrus ringspot virus (ICRSV is known to cause serious problem in Kinnow (Citrus nobilis Lour × C. deliciosa Tenora. This paper reports the elimination of ICRSV from Kinnow by chemotherapy coupled with shoot tip grafting under in vitro conditions. Nodal segments from infected mother plant (indexed by indirect ELISA and RT-PCR were cultured on MS medium containing 2-iP (1mg/l and malt extract (800 mg/l along with different concentrations of five antiviral chemicals acycloguanosine, azidothymidine, 2,4-dioxohexahydro-1, 2,5-triazine (DHT, ribavirin and 2- thiouracil. Shoot tips of size 0.7 mm were excised from the sprouts of these nodal segments and grafted on to rough lemon (Citrus jambhiri under aseptic conditions. The plantlets obtained from chemotherapy coupled with in vitro micrografting were indexed by indirect ELISA and RT-PCR after acclimatization. Maximum effect (37% virus elimination was seen for ribavirin at 25 mg/l followed by 2-thiouracil at 25 mg/l (21.4% and acyclguanosine at 25 mg/l (20.8%. Azidothymidine and DHT at the tested doses could not eliminate ICRSV. In the present study only those plants/plantlets were considered virus free, which showed negative reaction both with indirect ELISA and RT-PCR.

Sharma SANJEEV

2007-11-01

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21 CFR 870.4430 - Cardiopulmonary bypass intracardiac suction control.  

Science.gov (United States)

...Cardiopulmonary bypass intracardiac suction control. 870.4430 Section 870...Cardiopulmonary bypass intracardiac suction control. (a) Identification. A cardiopulmonary bypass intracardiac suction control is a device which...

2010-04-01

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Platelet preservation during cardiopulmonary bypas  

OpenAIRE

The purpose of this thesis was to find an answer to the following problem: does treatment with platelet function inhibiting drugs during cardiopulmonary bypass (CPB) preserve platelet number of function? ... Zie: Summary

Dungen, Johannes Josephus Antonius Maria Den

1983-01-01

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

Scientific Electronic Library Online (English)

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

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

2014-12-01

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

Scientific Electronic Library Online (English)

Full Text Available PURPOSE: Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacok [...] inetics increase hypnotic effects after cardiopulmonary bypass. METHODS: Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10) or off-pump coronary artery bypass graft (group, n=10) coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 µg/mL). Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p

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

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Effects of saffan on cardiopulmonary function in healthy cats.  

OpenAIRE

The effects of saffan on cardiopulmonary function were evaluated in eight healthy adult cats. Measured values were cardiac output by thermodilution, heart rate by electrocardiogram, arterial blood gases, respiratory rate and systolic, diastolic and mean arterial blood pressures by arterial catheterization. Calculated values included cardiac index, stroke volume and systemic vascular resistance. Statistical analysis employed paired t-tests comparing pre saffan anesthetic induction and post saf...

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

1987-01-01

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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

21

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

22

21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.  

Science.gov (United States)

... Cardiopulmonary bypass pump speed control. (a) Identification...A cardiopulmonary bypass pump speed control is a device used...and is used to control the speed of blood pumps used in cardiopulmonary... (b) Classification. Class II (performance...

2010-04-01

23

21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.  

Science.gov (United States)

...2010-04-01 false Cardiopulmonary bypass bubble detector. 870.4205 Section 870... § 870.4205 Cardiopulmonary bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used to...

2010-04-01

24

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

25

MRI Catheterization in Cardiopulmonary Disease  

OpenAIRE

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

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

2014-01-01

26

Effects of saffan on cardiopulmonary function in healthy cats.  

Science.gov (United States)

The effects of saffan on cardiopulmonary function were evaluated in eight healthy adult cats. Measured values were cardiac output by thermodilution, heart rate by electrocardiogram, arterial blood gases, respiratory rate and systolic, diastolic and mean arterial blood pressures by arterial catheterization. Calculated values included cardiac index, stroke volume and systemic vascular resistance. Statistical analysis employed paired t-tests comparing pre saffan anesthetic induction and post saffan anesthetic parameters over a 120 minute time sequence. Thirty min after saffan induction, significant depression in cardiac output was evident while stroke volume was significantly depressed at 45 and 60 min, systolic blood pressure at 15 min and respiratory rate at 5, 10 and 15 min. No significant changes occurred in cardiac index, heart rate, arterial blood gases, diastolic and mean arterial blood pressure or systemic vascular resistance. It was concluded that saffan causes significant depression of cardiopulmonary function in normal adult cats. PMID:3111675

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

1987-01-01

27

Cardiopulmonary involvement in Puumala hantavirus infection  

OpenAIRE

BACKGROUND: Hantavirus infections cause potentially life-threatening disease in humans world-wide. Infections with American hantaviruses may lead to hantavirus pulmonary syndrome characterised by severe cardiopulmonary distress with high mortality. Pulmonary involvement in European Puumala hantavirus (PUUV) infection has been reported, whereas knowledge of potential cardiac manifestations is limited. We aimed to comprehensively investigate cardiopulmonary involvement in patients with PUUV-inf...

Rasmuson, Johan; Lindqvist, Per; So?rensen, Karen; Hedstro?m, Magnus; Blomberg, Anders; Ahlm, Clas

2013-01-01

28

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

29

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

Science.gov (United States)

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

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

2003-06-01

30

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

31

Skin grafts.  

Science.gov (United States)

In this article, we have reviewed important issues regarding skin graft reconstruction of cutaneous and mucosal defects in the head and neck. Careful attention to surgical technique and immobilization of the grafts during healing lead to more successful reconstructions. Partial-thickness skin grafts lack epidermal appendages. When used for cutaneous reconstruction, they must be protected from desiccation and excessive trauma. Donor site morbidity can be reduced by protection against environmental trauma and excessive sunlight. PMID:8159425

Petruzzelli, G J; Johnson, J T

1994-02-01

32

Cardiopulmonary resuscitation following profound immersion hypothermia.  

OpenAIRE

A case is presented in which prolonged resuscitation and rewarming was performed following post-rescue cardiopulmonary arrest in severe immersion hypothermia. The rescue and resuscitation techniques necessary to optimise outcome in such cases are described.

Steedman, D. J.; Rainer, T.; Campanella, C.

1997-01-01

33

Evaluation of lay skills in cardiopulmonary resuscitation.  

OpenAIRE

The theoretical knowledge and practical performance of 166 lay people attending a short cardiopulmonary resuscitation course were evaluated according to the American Heart Association standards. Before tt course no participant was able to perform even a bad attempt at cardiopulmonary resuscitation. Theoretical knowledge was good at the end of the course and at the refresher course six months later. At the end of the initial course 65% (57/88) of the participants examined could adequately comp...

Kalmthout, P. M.; Speth, P. A.; Rutten, J. R.; Vonk, J. T.

1985-01-01

34

Pathways to complement activation during cardiopulmonary bypass  

OpenAIRE

Complement activation was assessed in 34 patients undergoing cardiopulmonary bypass. Arterial concentrations of complement fragments Ba and C3d rose in all patients, the increase in Ba preceding that of C3d. At the same time as complement fragments were being generated the arterial neutrophil count fell. These findings suggest (a) that complement activation is initiated by the alternative pathway during cardiopulmonary bypass and (b) that complement activation mediates loss of neutrophils dur...

Collett, B.; Alhaq, A.; Abdullah, N. B.; Korjtsas, L.; Ware, R. J.; Dodd, N. J.; Alimo, E.; Ponte, J.; Vergani, D.

1985-01-01

35

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

Science.gov (United States)

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

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

2014-08-15

36

Predictive value of coagulation testing in cardiopulmonary bypass surgery.  

Science.gov (United States)

Severe postoperative bleeding in cardiopulmonary bypass surgery is still a major problem. One hundred and seven patients undergoing uncomplicated coronary artery bypass grafting (CABG) were studied. Two groups were formed according to the patients' 24 hours postoperative mediastinal blood loss. Patients in group I (n = 70) had blood loss less than 1000 ml and patients in group II (n = 33) had blood loss over 1000 ml. Between the two groups, there were no differences in age, male-female ratio, number of grafts, by pass-time or heparin-protamine dose. Coagulation testing: APTT (Activated Partial Thromboplastin Time), PT (Prothrombin Time), fibrinogen, D-dim. (D-dimers), bleeding time, MPV (mean platelet volume) and platelet count, was done preoperatively (T0), immediately postoperatively (T1), 6 hours postoperatively (T2). We were especially interested in the predictive value of hemostatic parameters at T0 and T1. We found a slight but statistically negative correlation between the platelet count (T0 and T1) and the postoperative blood loss. PMID:1796727

Fassin, W; Himpe, D; Alexander, J P; Borms, S; Theunissen, W; Muylaert, P; Van Cauwelaert, P

1991-01-01

37

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.)

38

Cardiopulmonary resuscitation: a new perspective  

Directory of Open Access Journals (Sweden)

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

V. A. Sulimov

2012-01-01

39

Are We Successful in Cardiopulmonary Resuscitation?  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: In this study, we aimed to determine the success rate of cardiopulmonary resuscitation performed in the patients with diagnosis of cardiac arrest, and demographic characteristics of these patients. Material and Methods: The patients admitted to Adana Numune Education and Research Hospital, Department of Emergency Medicine between 01.01.2011 and 31.12.2012, and who underwent cardiopulmonary resuscitation were included to this study planned as retrospectively. The age, gender, status of judicial cases, causes and time of cardiac arrest, first observed arrest rhythm, the diseases prior to the arrest, means of arrival to emergency department, duration of cardiopulmonary resuscitation, results of cardiopulmonary resuscitation, the name of the hospitalised clinic, the existence of the operation, and outcome of the patients who underwent cardiopulmonary resuscitation in accordance with current advanced life support protocols were recorded in standard data entry form. Results: A total of 290 patients with completely accessible data were included to the study. Most of these patients were men (65.2%. The mean ages were 61 ± 19 years for men, 67 ± 14 years for women (p = 0.018. The most common diagnosis were ischemic heart disease and heart failure according to the analysis of the patient's medical history. 92 patients (31.7% were brought to the emergency department after death, and all of these patients were unsuccessful following to cardiopulmonary resuscitation. 198 patients (68.3% had cardiac arrest in the emergency department, and we determined that cardiopulmonary resuscitation application of 102 patients were successful. The most common causes of cardiac arrest were myocardial infarction and heart failure. Mostly first observed rhythm in the monitor was asystole. The response rate of cardiopulmonary resuscitation in patients with ventricular fibrillation and ventricular tachycardia was higher. Most patients were hospitalised to the coronary intensive care unit, and 11 of the 21 patients who underwent percutaneous coronary intervention were discharged from hospital in good health. Total 15 (5% of all patients included to the study were discharged in good health. Conclusion: The lower rate of success in cardiopulmonary resuscitation showed the presence of defects in all stages of the chain of life, and suggests that some actions should be performed to correct them. [Cukurova Med J 2013; 38(4.000: 601-609

Nalan Kozaci

2013-08-01

40

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

41

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

OpenAIRE

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

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

2006-01-01

42

Off-pump coronary artery bypass grafting: Misperceptions and misconceptions  

OpenAIRE

Coronary artery bypass grafting (CABG) continues to be one of the most commonly performed cardiac surgical procedures worldwide. Conventional CABG performed on cardiopulmonary bypass termed on-pump CABG is regarded as the gold standard. However, on-pump CABG results in several physiologic derangements including but not limited to thrombocytopenia, activation of complement factors, immune suppression, and inflammatory responses leading to organ dysfunction. Furthermore, manipulating an atheros...

Raja, Shahzad G.; Benedetto, Umberto

2014-01-01

43

Brain microvascular function during cardiopulmonary bypass  

International Nuclear Information System (INIS)

Emboli in the brain microvasculature may inhibit brain activity during cardiopulmonary bypass. Such hypothetical blockade, if confirmed, may be responsible for the reduction of cerebral metabolic rate for glucose observed in animals subjected to cardiopulmonary bypass. In previous studies of cerebral blood flow during bypass, brain microcirculation was not evaluated. In the present study in animals (pigs), reduction of the number of perfused capillaries was estimated by measurements of the capillary diffusion capacity for hydrophilic tracers of low permeability. Capillary diffusion capacity, cerebral blood flow, and cerebral metabolic rate for glucose were measured simultaneously by the integral method, different tracers being used with different circulation times. In eight animals subjected to normothermic cardiopulmonary bypass, and seven subjected to hypothermic bypass, cerebral blood flow, cerebral metabolic rate for glucose, and capillary diffusion capacity decreased significantly: cerebral blood flow from 63 to 43 ml/100 gm/min in normothermia and to 34 ml/100 gm/min in hypothermia and cerebral metabolic rate for glucose from 43.0 to 23.0 mumol/100 gm/min in normothermia and to 14.1 mumol/100 gm/min in hypothermia. The capillary diffusion capacity declined markedly from 0.15 to 0.03 ml/100 gm/min in normothermia but only to 0.08 ml/100 gm/min in hypothermia. We conclude that the decrease of cerebral metabolic rate for glucose during normothermic cardiopulmonary ucose during normothermic cardiopulmonary bypass is caused by interruption of blood flow through a part of the capillary bed, possibly by microemboli, and that cerebral blood flow is an inadequate indicator of capillary blood flow. Further studies must clarify why normal microvascular function appears to be preserved during hypothermic cardiopulmonary bypass

44

Discussing cardiopulmonary resuscitation with patients and relatives.  

OpenAIRE

This paper aims to give clear guidance for doctors working in the UK about their responsibilities when discussing cardiopulmonary resuscitation with patients and their relatives. The ethical and legal framework for making decisions is outlined and the commonly encountered dilemmas are discussed.

Stewart, K.

1995-01-01

45

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

46

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

Scientific Electronic Library Online (English)

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

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

1105-11-01

47

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

48

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

49

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

OpenAIRE

PURPOSE: To investigate the effects of on-pump and off-pump coronary artery bypass grafting (CABG) on the erectile function and endothelium-derived nitric oxide (eNO) levels. MATERIALS AND METHODS: Twenty-eight consecutive patients were randomized into two groups depending on use of cardiopulmonary bypass in CABG surgery. The erectile function was evaluated by using the IIEF-5 questionnaire. The plasma eNO levels were determined at baseline and after reactive hyperemia before and after surger...

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

2011-01-01

50

Myocardial Revascularization for the Elderly: Current Options, Role of Off-pump Coronary Artery Bypass Grafting and Outcomes  

OpenAIRE

The increase in life expectancy has confronted cardiac surgery with a rapidly growing population of elderly patients requiring surgical myocardial revascularization. Recent advances in surgical and anesthetic techniques and improvements in postoperative care have made coronary artery bypass grafting an established therapeutic option for the treatment of coronary artery disease in this group of patients. However, conventional coronary artery bypass grafting on cardiopulmonary bypass is associa...

Raja, Shahzad G.

2012-01-01

51

Percutaneous cardiopulmonary bypass for cardiac emergencies.  

Science.gov (United States)

Percutaneous cardiopulmonary support systems (PCPS) are compact, battery-powered, portable heart-lung machines that can be implemented rapidly in any area of the hospital using thin-walled cannulae inserted via the femoral vessels. PCPS provides temporary circulatory support by actively aspirating blood from the patient's venous system using a centrifugal pump and hollow fiber membrane oxygenator for gas exchange. A review of clinical reports has delineated several indications for emergent applications, with the most frequent being cardiac arrest (CA) or cardiogenic shock (CS). Survival is more likely in patients with CS (40%) compared to CA (21%). Implementation of PCPS after unwitnessed CA or cardiopulmonary resuscitation > 30 min yields a patient survival rate of membrane oxygenation or a ventricular assist device is recommended. PMID:12139384

Kurusz, Mark; Zwischenberger, Joseph B

2002-07-01

52

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

Science.gov (United States)

...false Cardiopulmonary bypass cardiotomy suction line blood filter. 870.4270 Section...4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device...

2010-04-01

53

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

Science.gov (United States)

...2010-04-01 2010-04-01 false Roller-type cardiopulmonary bypass blood...Cardiovascular Surgical Devices § 870.4370 Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass...

2010-04-01

54

Polystyrene modified by grafting  

Scientific Electronic Library Online (English)

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

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

1997-06-01

55

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

56

Graft copolimerization of hydrophilic monomers onto irradiated polypropylene fibers  

International Nuclear Information System (INIS)

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

57

Hydroxyethyl starch versus Ringer solution in cardiopulmonary bypass prime solutions (a randomized controlled trial  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background In our study we compared the Ringer solution, which is the standard prime solution of our department, with the HES (Hydroxyethyl starch 130-0.4 solution, which can be a potential alternative prime solution with an indispensable material for the cardio-pulmonary bypass applications. Methods 140 patients undergoing to CABG (Coronary Artery Bypass Graft surgery were electively enrolled to the study. 1500 ml Ringer solution + 200 ml mannitol + 60 ml sodium bicarbonate + 150 U/kg heparin was used as a prime solution to start cardiopulmonary by-pass in 70 patients which was defined as group 1. On the other hand, 1500 ml HES 130 - 0.4 + 200 ml mannitol + 60 ml sodium bicarbonate + 150 U/kg heparin was used as a prime solution in 70 patients in group 2. Results INR (International Normalized Ratio, urea levels and blood platelet counts were significantly different between the groups. INR level was higher in group 1, while blood urea and creatinine levels and platelet count were higher in group 2 at the end of the 12th and 24nd hours postoperatively (p = 0.001. In this study, it was shown that the usage of HES 130-0.4 as a prime solution did not have negative effect on postoperative INR level, platelet count, the need for transfusion and the amount of drainage, despite the negative opinions that similar solutions caused coagulation disorders. Another interesting result of the study was that blood platelet count at 24th hour was statistically significantly higher in group 2 (p = 0.001. Conclusion HES 130-0.4 solution is an alternative colloidal solution which can be used as the prime solution or as a mixture with the crystalloids in cardio-pulmonary bypass applications.

Ozyaz?c?oglu Ahmet

2008-07-01

58

Does flow character of cardiopulmonary bypass make a difference?  

Science.gov (United States)

The influence of pulsatile bypass flow on the performance of the cardiovascular system, fluids and blood balance, acid-base equilibrium, and splanchnic function was investigated. One hundred patients scheduled for elective coronary artery bypass grafting were randomly divided into a group of standard perfusion (NP) and a group of pulsatile perfusion (PP). At the end of the operation, similar cardiac performance developed in both groups that was higher than before bypass: left ventricular stroke work index after bypass, 56.8 +/- 2.7 gm/beat per square meter in the NP group and 56.7 +/- 2.6 gm/beat per square meter in the PP group (not significant). Further determinations did not differ among the groups. After discontinuation of cardiopulmonary bypass, bypass grafts flow measured using an electromagnetic probe did not differ among the groups. During the postbypass period, mean arterial pressure and systemic vascular resistance were similar (mean arterial pressure 86.8 +/- 1.6 mm Hg in the NP group and 88.5 +/- 1.7 in the PP group; systemic vascular resistance 817 +/- 33 dyne.sec/cm5 in the NP group and 881 +/- 34.5 in the PP group), as were further determinations. However, severe hypotension requiring the administration of vasoconstrictors was observed more frequently in PP group of patients (20 versus 6%; p < 0.05). Fluid balance determined at the second postoperative day was similar among the groups (+1307 +/- 239 ml in the NP group and +1535 +/- 266 ml in the PP group). Blood loss was 1122 +/- 120 ml in the NP group and 1263 +/- 119 ml in the PP group during the first postoperative day (p = 0.407). Urine output during bypass was lower in the PP group (261 +/- 25 versus 341 +/- 26 ml/hr; p = 0.028). The creatinine clearance was 96.4 +/- 10.3 ml/min in the NP group and 92.6 +/- 7.0 ml/min in the PP group (not significant); amylase and lipase clearance did not differ among the groups. Finally, no significant difference was detected in arterial lactic acid determinations and acid-base balance assessment between the groups postoperatively. Thus equivalent cardiovascular hemodynamics, a good control of fluids and blood balance, acid-base equilibrium, and a satisfactory protection of the function of kidneys and pancreas were obtained with both types of perfusion. PMID:1453728

Louagie, Y A; Gonzalez, M; Collard, E; Mayné, A; Gruslin, A; Jamart, J; Buche, M; Schoevaerdts, J C

1992-12-01

59

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

60

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

OpenAIRE

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

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

2004-01-01

61

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

62

Preeclampsia induced cardiopulmonary arrest in pregnant: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available There are several medical, and obstetrical conditions that can lead to cardiopulmonary arrest during pregnancy. Preeclampsia is an important cause of cardiopulmonary arrest in pregnant woman. In case of pregnant with cardiopulmonary arrest, intensive effort is necessary to rescue the mother and baby. We report a case of a 35-years-old pregnant woman who had a severe pulmonary edema and cardiac arrest due to preeclampsia. According to recent guidelines of resuscitation, modified advanced cardiac life support was performed in the emergency department and then at 32-week gestation healthy baby was delivered by cesarean section at the 10th minutes of the resuscitation

Mehmet Tahir Gökdemir

2013-03-01

63

Off-pump or on-pump coronary-artery bypass grafting at 30 days.  

OpenAIRE

BACKGROUND: The relative benefits and risks of performing coronary-artery bypass grafting (CABG) with a beating-heart technique (off-pump CABG), as compared with cardiopulmonary bypass (on-pump CABG), are not clearly established. METHODS: At 79 centers in 19 countries, we randomly assigned 4752 patients in whom CABG was planned to undergo the procedure off-pump or on-pump. The first coprimary outcome was a composite of death, nonfatal stroke, nonfatal myocardial infarction, or new renal failu...

Lamy, A.; Devereaux, Pj; Prabhakaran, D.; Taggart, Dp; Hu, S.; Paolasso, E.; Straka, Z.; Piegas, Ls; Akar, Ar; Jain, Ar; Noiseux, N.; Padmanabhan, C.; Bahamondes, Jc; Novick, Rj; Vaijyanath, P.

2012-01-01

64

Off-pump coronary artery bypass graft surgery is standard of care: Where do you stand?  

OpenAIRE

The cardiopulmonary bypass (CPB) has allowed the establishment of coronary artery bypass graft surgery (CABG) to be a safe and effective treatment for patients with ischemic heart disease. However, the concern that CPB may be responsible for CABG-related morbidity has been raised, and it has been suggested that CABG itself would be safer without CPB. The development of commercially available cardiac stabilization devices resulted in several large, nonrandomized retrospective case series. The ...

Le?gare?, Jean-francois; Hirsch, Gregory

2006-01-01

65

Is it worth placing ventricular pacing wires in all patients post-coronary artery bypass grafting?  

OpenAIRE

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether ventricular pacing wires should be placed routinely in all patients undergoing coronary artery bypass grafting (CABG) regardless of immediate post-cardiopulmonary bypass (CPB) rhythm status. Using the reported search, 142 papers were found, from which 10 papers represented the best evidence on the subject. The author, date and country of 10 publications, study type, pati...

Khorsandi, Maziar; Muhammad, Ishaq; Shaikhrezai, Kasra; Pessotto, Renzo

2012-01-01

66

Merit of Anisodamine Combined with Opioid -Receptor Activation in the Protection against Myocardial Injury during Cardiopulmonary Bypass  

OpenAIRE

Myocardial ischemia/reperfusion (MIR) injury easily occurrs during cardiopulmonary bypass surgery in elderly patients. In an attempt to develop an effective strategy, we employed a pig model of MIR injury to investigate the maximum rate of change of left ventricular pressure, left ventricular enddiastolic pressure, and left intraventricular pressure. Coronary sinus cardiac troponin T (TnT) and adenosine-triphosphate (ATP) content in myocardium were measured. The ultrastructures for MIR injury...

Xuan Hong; Huimin Fan; Rong Lu; Paul Chan; Zhongmin Liu

2013-01-01

67

Endovascular stent-graft management of thoracic aortic diseases  

International Nuclear Information System (INIS)

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

68

Endovascular stent-graft management of thoracic aortic diseases  

Energy Technology Data Exchange (ETDEWEB)

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

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

2001-07-01

69

Clinical experience of percutaneous cardiopulmonary support.  

Science.gov (United States)

Recently, percutaneous cardiopulmonary support (PCPS) combined with femoro-femoral bypass without reservoir has become valued because of its quick and easy application. We developed a fully preconnected compact integrated cardiopulmonary bypass (CPB) unit (priming volume of 250 ml) with a blind pore membrane oxygenator (Kuraray Menox) for PCPS. From 1990 to 1995, PCPS was performed in 49 patients of whom 26 were weaned from support. In most cases, we applied this CICU in patients with no active bleeding (22 patients); in patients with active bleeding (n = 13), we used Medtronic's heparin-bonded close chest support pack (CCSP). Of these, PCPS was performed uneventfully for 2 h (median) in 8 elective cases; all of these patients were weaned or were switched to a left ventricular assist system (LVAS). In 8 urgent cases, such as those with low cardiac output syndrome, PCPS was performed for 4 days (median), 1 was weaned, and 2 CICU were cases switched to other procedures. In 32 cases of shock, 5 CICU patients were weaned, and 3 of them survived. Eight patients including 5 CICU patients and 1 CCSP patient were switched to operation or LVAS, and 2 CICU patients remain alive. From these data, PCPS has been shown to support the patient's circulation in the acute phase and earn time to switch to operation or LVAS; the quick and easy set-up of the CICU can improve the clinical results. The use of the Medtronic device broadened the indication for PCPS. The CCSP enlarged the indication of PCPS but could not improve the results. To improve the results, a heparin-bonded surface is desired. PMID:8817989

Sasako, Y; Nakatani, T; Nonogi, H; Miyazaki, S; Kito, Y; Takano, H; Kawashima, Y

1996-06-01

70

Coronary Artery Bypass Grafting  

Science.gov (United States)

... Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart ...

71

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

72

Unaccounted blood loss in operations using cardiopulmonary bypass.  

OpenAIRE

Typically, blood loss after operations requiring cardiopulmonary bypass is estimated from the sum of blood on sponges and drapes, in the suction system reservoir, and in chest drainage bottles. Prime of the extracorporeal circuit is usually returned to the patient, but no accounting is made of blood remaining in the circuit. In 50 patients, we examined 25 bubble and 25 membrane oxygenator circuits after completion of cardiopulmonary bypass and after return of all prime to the patients. Saline...

Romagnoli, A.; Stafford, T. B.; Keats, A. S.

1997-01-01

73

A Correlation Study of Cardiopulmonary Arrests, Cholesterol and Pressures  

OpenAIRE

This study consisted of cardiopulmonary arrests occurring between January 1990 and December 1991 in a Midwestern City in Kansas, U.S.A., with a population of 300,000. Admission cholesterol levels and hourly barometric pressures were obtained to show if there exists a relationship between cardiopulmonary arrests, cholesterol levels and barometric pressures. Statistical analysis was performed using Pearson-Moment Correlation Coefficient. Scattergrams amongst the dependent variables such as time...

Rider, S. E.; Taher, S. M.

2003-01-01

74

Prognostic evaluation of bispectral index in patients following cardiopulmonary resuscitation  

OpenAIRE

The aim of this study was to evaluate the prognosis of patients following cardiopulmonary resuscitation in an intensive care unit (ICU) using bispectral index (BIS) monitoring. The study was a prospective comparative study performed at the academic department of an ICU. A total of 33 adults who received cardiopulmonary resuscitation were enrolled and divided into the surviving and non-surviving groups according to their 7-day survival status. During their stay in the ICU, the BIS and arterial...

Liu, Han; Liu, Ying; Xu, Ying; Xue, Yan

2013-01-01

75

Cardiopulmonary disease in the geriatric dog and cat  

International Nuclear Information System (INIS)

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

76

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)

77

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)

78

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

79

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

80

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

81

Iron overload in paediatrics undergoing cardiopulmonary bypass.  

Science.gov (United States)

Pathological changes in iron status are known to occur during bypass and will be superimposed upon physiological abnormalities in iron distribution, characteristic of the neonatal period. We have sought to define the severity of iron overload in these patients. Plasma samples from 65 paediatric patients undergoing cardiopulmonary bypass (CPB) were analysed for non-haem iron, total iron binding capacity, transferrin and bleomycin-detectable iron. Patients were divided into four age groups for analysis. Within each age group, patients who were in iron overload at any time point were statistically compared to those who were not. The most significant changes in iron chemistry were seen in the plasma of neonates, with 25% in a state of plasma iron overload. 18.5% of infants and 14.3% of children at 1-5 years were also in iron overload at some time point during CPB. No children over 5 years, however, went into iron overload. Increased iron saturation of transferrin eliminates its ability to bind reactive forms of iron and to act as an antioxidant. When transferrin is fully saturated with iron, reactive forms of iron are present in the plasma which can stimulate iron-driven oxidative reactions. Our data suggest that paediatric patients are at greater risk of iron overload during CPB, and that some form of iron chelation therapy may be advantageous to decrease oxidative stress. PMID:10699376

Mumby, S; Chaturvedi, R R; Brierley, J; Lincoln, C; Petros, A; Redington, A N; Gutteridge, J M

2000-03-17

82

Thoracic stent-graft  

Directory of Open Access Journals (Sweden)

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

Hyodoh H.

2007-01-01

83

[Operative Results of Total Arch Replacement with Arch First Technique using a Trifurcated Graft].  

Science.gov (United States)

In aortic arch surgery, we reconstruct branches before opening the arch to avoid cerebral embolism of the debris derived from the aortic wall. We made a trifurcated graft for branch reconstruction using 10 mm and 8 mm polyester grafts. Cardiopulmonary bypass started under right axillary perfusion and venous drainage through the right atrium. While cooling, the left subclavian artery was clamped andanastomosed to the end of the trifurcated graft. Then the ascending aorta was cross-clamped and cardioplegic solution was infused. At 25 degrees centigrade of the tympanic temperature, the left carotid artery is clamped and anastomosed to the branch of the trifurcated graft with or without perfusion into the left carotid artery. Subsequently the brachiocephalic artery was reconstructed in the same manner. After antegrade cerebral perfusion was established through the trifurcated graft via right axillary perfusion, distal anastomosis of the aortic arch was done with the open distal technique. Graft-graft anasto mosis was followed to reperfuse the lower half of the body. Finally proximal anastomosis was performed to complete total arch replacement. Forty-four patients underwent total arch replacement in this technique. In-hospital mortality was 4.5%. Cerebral infarction occurred in 4.5% of the patients probably due to embolization of the debris derived from the branches of the aortic arch. PMID:25743547

Nishimori, Hideaki; Yamamoto, Masaki; Fukutomi, Takashi; Handa, Takemi; Kondo, Nobuo; Tashiro, Miwa; Orihashi, Kazumasa; Wariishi, Seiichiro; Sasaguri, Shiro

2015-03-01

84

Effects of off-pump and on-pump coronary-artery bypass grafting at 1 year.  

OpenAIRE

BACKGROUND: Previously, we reported that there was no significant difference at 30 days in the rate of a primary composite outcome of death, myocardial infarction, stroke, or new renal failure requiring dialysis between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report results on quality of life and cognitive function and on clinical outco...

Lamy, A.; Devereaux, Pj; Prabhakaran, D.; Taggart, Dp; Hu, S.; Paolasso, E.; Straka, Z.; Piegas, Ls; Akar, Ar; Jain, Ar; Noiseux, N.; Padmanabhan, C.; Bahamondes, Jc; Novick, Rj; Vaijyanath, P.

2013-01-01

85

Acute posthypoxic myoclonus after cardiopulmonary resuscitation  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Acute posthypoxic myoclonus (PHM can occur in patients admitted after cardiopulmonary resuscitation (CPR and is considered to have a poor prognosis. The origin can be cortical and/or subcortical and this might be an important determinant for treatment options and prognosis. The aim of the study was to investigate whether acute PHM originates from cortical or subcortical structures, using somatosensory evoked potential (SEP and electroencephalogram (EEG. Methods Patients with acute PHM (focal myoclonus or status myoclonus within 72 hours after CPR were retrospectively selected from a multicenter cohort study. All patients were treated with hypothermia. Criteria for cortical origin of the myoclonus were: giant SEP potentials; or epileptic activity, status epilepticus, or generalized periodic discharges on the EEG (no back-averaging was used. Good outcome was defined as good recovery or moderate disability after 6?months. Results Acute PHM was reported in 79/391 patients (20%. SEPs were available in 51/79 patients and in 27 of them (53% N20 potentials were present. Giant potentials were seen in 3 patients. EEGs were available in 36/79 patients with 23/36 (64% patients fulfilling criteria for a cortical origin. Nine patients (12% had a good outcome. A broad variety of drugs was used for treatment. Conclusions The results of this study show that acute PHM originates from subcortical, as well as cortical structures. Outcome of patients admitted after CPR who develop acute PHM in this cohort was better than previously reported in literature. The broad variety of drugs used for treatment shows the existing uncertainty about optimal treatment.

Bouwes Aline

2012-08-01

86

Synchronization and Cardio-pulmonary feedback in Sleep Apnea  

Science.gov (United States)

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

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

2004-03-01

87

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

Science.gov (United States)

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

Sullivan, Nancy

2015-01-01

88

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

89

Cardiopulmonary Fitness and Endurance in Children with Developmental Coordination Disorder  

Science.gov (United States)

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

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

2010-01-01

90

Necessity of immediate cardiopulmonary resuscitation in trauma emergency  

Directory of Open Access Journals (Sweden)

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

Luciano Baitello

2010-08-01

91

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)

92

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

International Nuclear Information System (INIS)

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

93

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

Scientific Electronic Library Online (English)

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

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

94

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)

95

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

Scientific Electronic Library Online (English)

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

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

96

Prediction of post-cardiopulmonary bypass cardiac output by venous oximetry.  

Science.gov (United States)

The present study evaluates two equations for predicting the post-cardiopulmonary bypass cardiac output (CO) in 10 patients undergoing coronary artery bypass grafting. One equation is based on the relationship of CO with mixed venous oxygen saturation (SVO 2), while the second equation is based on the relationship with oxygen extraction (1 - SVO 2). Each patient served as his own control. During bypass, when the patients were normothermic and perfused with a pump flow of 2.4 L/min/m 2, the SVO 2 was monitored by an in-line Bentley oxystat Meter. Just before termination of bypass, the pump flow was decreased to 0.4 L/min/m 2 and the left atrial pressure was increased to 10-15 mmHg; the resulting SVO 2 was recorded. The post-bypass CO was predicted in every patient by the two equations. Immediately after weaning from bypass, the cardiac output was measured by thermodilution. The thermodilutional CO measurement was correlated with the CO predicted by the two equations. Correlation analysis suggests that CO prediction is more accurate and approaches the 1:1 ratio when the calculation of predicted CO is based on the relationship between cardiac output and oxygen extraction. PMID:10148071

Baraka, A; Baroody, M; Haroun, S; Nawfal, M; Dabbous, A; El-Khatib, R; Taha, S; Meshefedjian, G; Baraka, H

1992-01-01

97

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

98

Radiation grafting studies of acrylic acid onto cellulose triacetate membranes  

International Nuclear Information System (INIS)

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

99

Polytrimethylsylylpropyne gas separation membranes modified by radiochemical grafting of divinylbenzene  

International Nuclear Information System (INIS)

A radiochemical method was employed to obtain poly(1-trimethylsilyl-1-propyne)(PTMSP)-divinylbenzene (DVB) grafted films. DVB monomer vapors were absorbed by the PTMSP, and the grafting reaction was thereafter accomplished by 60Co ?-irradiation in a nitrogen atmosphere. The films so obtained were tested for nitrogen-oxygen separation. The performances of the membranes were studied as functions of time and percent of grafting. The DVB-grafted membranes show an increased selectivity factor and stability with time. The experimental data and some SEM observations confirm the presence of large voids in the PTMSP matrix. These voids are responsible for permeability changes during operation and disappear after the grafting procedure. 8 refs., 5 figs

100

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.)

101

Calcific stenotic jump graft.  

Science.gov (United States)

A young lady with post-subclavian coarctation and cranial hypertension is discussed. She had a jump graft from left subclavian artery to descending aorta, and presented 18 years later with hypertension, calcification of the graft with a gradient of 40 mmHg across it. In the meantime, she also developed moderate aortic regurgitation on a bicuspid aortic valve. Management strategies including trans-catheter options are discussed. We present our reservations on trans-catheter options in an occluded dacron graft. PMID:16749963

Padmakumar, R.; Krishnamoorthy, K. M.; Tharakan, J. A.

2004-01-01

102

Gum Graft Surgery  

Science.gov (United States)

... reduce tooth sensitivity and improve esthetics of your smile. Whether you have a gum graft to improve ... receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, ...

103

Fenestrated Aortic Stent Grafts  

OpenAIRE

Fenestrated stent grafts have been developed to offer an endovascular treatment option to those patients with abdominal aortic aneurysms whose infrarenal necks are anatomically unsuitable for endovascular repair with standard infrarenal devices. The ability to have customized fenestrations that will preserve flow to essential visceral arteries allows proximal seal and fixation to be achieved at and above the renal level. This article discusses patient selection, stent-graft design, and the im...

Scurr, James R. H.; Mcwilliams, Richard G.

2007-01-01

104

Calcific stenotic jump graft.  

OpenAIRE

A young lady with post-subclavian coarctation and cranial hypertension is discussed. She had a jump graft from left subclavian artery to descending aorta, and presented 18 years later with hypertension, calcification of the graft with a gradient of 40 mmHg across it. In the meantime, she also developed moderate aortic regurgitation on a bicuspid aortic valve. Management strategies including trans-catheter options are discussed. We present our reservations on trans-catheter options in an occlu...

Padmakumar, R.; Krishnamoorthy, K. M.; Tharakan, J. A.

2004-01-01

105

Bone grafting: An overview  

OpenAIRE

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...

Joshi, D. O.; Tank, P. H.; Mahida, H. K.; Dhami, M. A.; Vedpathak, H. S.; Karle, A. S.

2010-01-01

106

Factor XI deficiency: incidental diagnosis post coronary artery bypass graft.  

Science.gov (United States)

Severe Factor XI (FXI) deficiency is defined when the activated partial thromboplastin time is prolonged and its activation is UdL(-1) in plasma. It is inherited as an autosomal recessive trait but can be acquired. In severe deficiency the bleeding diathesis is normally injury related. This particularly occurs during surgical procedures and trauma involving tissues rich in fibrinolytic activators. Cardiopulmonary bypass induces transient abnormalities in haemostasis which can cause a postoperative bleeding diathesis. Once treated, it does not appear to be a contraindication to cardiac procedures. Conversely, acquired deficiencies are more insidious being incidentally diagnosed during routine laboratory investigations and might be triggered by an inhibitory agent. We present a case of an uncomplicated 12-month delayed diagnosis of Factor XI deficiency following coronary artery bypass grafting and sternal rewiring. The potential risks if undiagnosed and the uncharacteristic clinical history of our case are discussed. PMID:24419230

Lammy, Simon; Pessotto, Renzo

2014-02-01

107

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)

108

Coronary artery bypass grafting in a patient with pituitary adenoma: can alertness prevent tragedy?  

Science.gov (United States)

Pituitary apoplexy is a rare, life-threatening complication that may occur after coronary artery bypass graft surgery for patients with pituitary adenomas. The dynamics of cardiopulmonary bypass may contribute to a sudden expansion of silent pituitary adenomas and result in the compression of surrounding structures. A range of clinical features have been described, and the condition requires prompt diagnosis and treatment to prevent further complications. Herein, we present an uncomplicated case highlighting the importance of diagnosing pituitary apoplexy, ensuring high alertness to the condition, so as to prevent life-threatening tragedy due to missed diagnosis. PMID:25273945

Shah, Shitalkumar; Hrabovsky, Derek

2014-09-01

109

Cardiopulmonary exercise testing (CPET) as preoperative test before lung resection.  

Science.gov (United States)

Lung resection is still the only potentially curative therapy for patients with localized non-small lung cancer (NSCLC). However, the presence of cardiovascular comorbidities and underlying lung disease increases the risk of postoperative complications. Various studies have evaluated the use of different preoperative tests in order to identify patients with an increased risk for postoperative complications, associated with prolonged hospital stay and increased morbidity and mortality. In this topic review, we discuss the role of cardiopulmonary exercise testing (CPET) as one of the preoperative tests suggested for lung cancer patients scheduled for lung resection. We describe different types of exercise testing techniques and present algorithms of preoperative evaluation in lung cancer patients. Overall, patients with maximal oxygen consumption (VO2max) DLCO<40% predicted, are at high risk for perioperative death and postoperative cardiopulmonary complications, and thus should be offered an alternative medical treatment option. PMID:25398794

Kallianos, Anastasios; Rapti, Aggeliki; Tsimpoukis, Sotirios; Charpidou, Andriani; Dannos, Ioannis; Kainis, Elias; Syrigos, Konstantinos

2014-01-01

110

Estimation of cerebral blood flow during cardiopulmonary resuscitation in humans.  

DEFF Research Database (Denmark)

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

Christensen, S F; Stadeager, Carsten Preben

1990-01-01

111

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

112

Climate change. A global threat to cardiopulmonary health.  

Science.gov (United States)

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

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

2014-03-01

113

The Role of Cardiopulmonary Exercise Test in IPF Prognosis  

OpenAIRE

Background. In IPF, defects in lung mechanics and gas exchange manifest with exercise limitation due to dyspnea, the most prominent and disabling symptom. Aim. To evaluate the role of exercise testing through the 6MWT (6-minute walk test) and CPET (cardiopulmonary exercise testing) in the survival of patients with IPF. Methods. This is a prospective, observational study evaluating in 25 patients the relationship between exercise variables through both the 6MWT and CPET and survival. Results. ...

Anna Karakatsani; Manos Alchanatis; Anastasia Kotanidou; Konstantinos Vougas; Sotirios Gyftopoulos; Konstantinos Kagouridis; Likourgos Kolilekas; Panagiotis Lyberopoulos; Effrosyni Manali; Christina Triantafillidou; Papiris, Spyros A.

2013-01-01

114

Intracranial gas on CT after Cardiopulmonary resuscitation: 4 cases  

International Nuclear Information System (INIS)

We report four patients in whom gas was seen in the head on CT shortly after cardiopulmonary resuscitation. The gas was in the posterior cranial fossa, presumably within veins, or in the cavernous sinus. The cause of the cardiac arrest was myocardial infarction in three patients and hanging in one. All had peripheral or central venous lines. The mechanism by which gas appeared in the intracranial veins is discussed. (orig.)

115

Intracranial gas on CT after Cardiopulmonary resuscitation: 4 cases  

Energy Technology Data Exchange (ETDEWEB)

We report four patients in whom gas was seen in the head on CT shortly after cardiopulmonary resuscitation. The gas was in the posterior cranial fossa, presumably within veins, or in the cavernous sinus. The cause of the cardiac arrest was myocardial infarction in three patients and hanging in one. All had peripheral or central venous lines. The mechanism by which gas appeared in the intracranial veins is discussed. (orig.) With 5 figs., 14 refs.

Imanishi, M.; Nishimura, A.; Tabuse, H.; Miyamoto, S. [Department of Emergency and Critical Care Medicine, Nara Medical University, Shijo-cho, Kashihara (Japan); Sakaki, T. [Department of Neurosurgery, Nara Medical University, Nara (Japan); Iwasaki, S. [Department of Radiology, Nara Medical University, Nara (Japan)

1998-03-01

116

How Much Do We Know About Cardiopulmonary Resuscitation?  

OpenAIRE

study, we aimed to investigate how much the physicians knew about resuscitation and the current guidelines were applied during the resuscitation. Materials and Methods: A total of 134 physicians working in the training and research hospitals, the university hospitals and 112 emergency medical services. A survey including questions about the participants’ resuscitation knowledge, age, specialty, the university graduated from and the number of cardiopulmonary resuscitations (CPR)carried out i...

Nazire Belgin Ak?ll?; Ba?ar Cander; Ramazan Köylü; Zerrin Defne Dündar; Murat Ayan

2012-01-01

117

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

118

Cardiopulmonary Exercise Testing in Lung Transplantation: A Review  

OpenAIRE

There has been an increase in lung transplantation in the USA. Lung allocation is guided by the lung allocation score (LAS), which takes into account one measure of exercise capacity, the 6-minute walk test (6MWT). There is a paucity of data regarding the role and value of cardiopulmonary stress test (CPET) in the evaluation of lung transplant recipients while on the transplant waiting list and after lung transplantation. While clearly there is a need for further prospective investigation, th...

Dudley, Katherine A.; Souheil El-Chemaly

2012-01-01

119

Cardiopulmonary Resuscitation Training in Sport Universities: An Italian Survey  

OpenAIRE

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 ...

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

2013-01-01

120

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

OpenAIRE

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

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

1995-01-01

121

Capnography during cardiopulmonary resuscitation: Current evidence and future directions  

OpenAIRE

Capnography continues to be an important tool in measuring expired carbon dioxide (CO2). Most recent Advanced Cardiac Life Support (ACLS) guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR). Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlatio...

Kodali, Bhavani Shankar; Urman, Richard D.

2014-01-01

122

Cardiopulmonary Physical Therapy Practice in the Paediatric Intensive Care Unit  

OpenAIRE

Purpose: Physical therapists play an important role in the pediatric intensive care setting. The purpose of this study was to describe current cardiopulmonary physical therapy (CPT) practices in a pediatric cardiac critical care unit (CCCU) and a pediatric intensive care unit (PICU), as well as to determine the feasibility of obtaining clinically relevant outcome measures in this setting. Methods: We obtained reasons for admission, CPT treatment patterns, and availability of chest X-rays inte...

Mccord, Jennifer; Krull, Nelin; Kraiker, Jennifer; Ryan, Rachelle; Duczeminski, Erica; Hassall, Alison; Lati, Jamil; Mathur, Sunita

2013-01-01

123

Gravity and the Evolution of Cardiopulmonary Morphology in Snakes  

OpenAIRE

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

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

2011-01-01

124

Cardiopulmonary bypass via common carotid artery cannulation in redo sternotomy  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract There are certain situations in redo cardiac surgery in adults where it may not be possible to use alternate arterial cannulation sites like the common femoral artery and axillary artery. We report a case where we established safe cardiopulmonary bypass with common carotid artery cannulation in an adult patient. The patient underwent aortic valve replacement for severe aortic regurgitation 8 months after repair of type A aortic dissection plus aortic valve resuspension.

Hassan Asif

2007-07-01

125

Cardiopulmonary resuscitation and contrast media reactions in a radiology department  

International Nuclear Information System (INIS)

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

126

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

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

Bartholomay Eduardo

2003-01-01

127

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

Scientific Electronic Library Online (English)

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

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

2003-08-01

128

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

129

Radiation grafted adhesive primers  

International Nuclear Information System (INIS)

Electron-beam and UV radiation can induce covalent attachment of unsaturated monomers onto a variety of polymer surfaces. The surface characteristics of a polymeric material can therefore be precisely manipulated by grafting the proper combination of monomers onto the surface. Radiation-grafted, sterically nonhindered tertiary acrylamides behave surprisingly well as primers for acidic pressure-sensitive adhesives. Physical and spectroscopic analyses of grafted acrylamides indicate that this unusual behavior is due to hydrogen bonding between the amide functionality in the primer and the acid functionality in the adhesive. Primary and secondary acrylamides are postulated to be less effective because they have the tendency to form hydrogen bonded dimers within the primer rather than interacting with the adhesive. (author)

130

Radiation grafted adhesive primers  

International Nuclear Information System (INIS)

Electron-beam and UV radiation can induce covalent attachment of unsaturated monomers onto a variety of polymer surfaces. The surface characteristics of a polymeric material can therefore be precisely manipulated by grafting the proper combination of monomers onto the surface. Radiation-grafted, sterically nonhindered tertiary acrylamides behave surprisingly well as primers for acidic pressure-sensitive adhesives. Physical and spectroscopic analyses of grafted acrylamides indicate that this unusual behavior is due to hydrogen bonding between the amide functionality in the primer and the acid functionality in the adhesive. Primary and secondary acrylamides are postulated to be less effective because they have the tendency to form hydrogen bonded dimers within the primer rather than interacting with the adhesive

131

Effect of skin graft preparation and graft survival on the secondary contraction of full-thickness skin grafts in dogs.  

Science.gov (United States)

The effects of 4 skin grafting techniques and graft survival on the secondary contraction of full-thickness skin grafts were evaluated. A total of 48 skin grafts were done on 12 dogs, with 2 skin grafts placed on both sides of the thorax of each dog. The grafting techniques included the sheet graft, sheet graft with continuous low-level suction provided by a butterfly catheter and evacuated glass tube, pie-crust graft, and nonexpanded mesh graft. Graft viability was assessed by visual inspection 10 days after surgical operation. Thirty skin grafts (64%) had a viability of 90% or greater. The final area of these grafts ranged from 73% to 119% of the original area. The secondary graft contraction followed a similar pattern for all graft types. During the first 10 days after surgical operation, the grafts contracted to 83% of their original area. Enlargement of the grafts began between 10 and 21 days after surgical operation. By 12 weeks, the grafts had attained a mean value of 96% of the original area. A significant difference in final area was not observed among graft types. Grafts with a high percentage of viability generally contracted less than those with larger areas of necrosis, but statistical relationship between viability and degree of contraction could not be proven. The results of the present study indicate that full-thickness skin grafts may be successfully done in dogs and that the grafts can be expected to undergo minimal postoperative contraction when graft survival is nearly complete. PMID:3909864

Pope, E R

1985-12-01

132

New membranes obtained by grafted irradiated PVDF foils  

Energy Technology Data Exchange (ETDEWEB)

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

133

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

134

Acrylonitrile grafted to PVDF  

Energy Technology Data Exchange (ETDEWEB)

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

Yang, Jin; Eitouni, Hany Basam

2015-03-31

135

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

Energy Technology Data Exchange (ETDEWEB)

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

136

Influence of different intravascular volume therapies on platelet function in patients undergoing cardiopulmonary bypass.  

Science.gov (United States)

The influence of four different kinds of intravascular volume replacement on platelet function was investigated in 60 patients undergoing elective aortocoronary bypass grafting using cardiopulmonary bypass (CPB). In a randomized sequence, high-molecular weight hydroxyethyl starch solution (HMW-HES, mean molecular weight [Mw] 450,000 d), low-molecular weight HES (LMW-HES, Mw 200,000 d), 3.5% gelatin or 5% albumin were infused preoperatively to double reduced filling pressure (pulmonary capillary wedge pressure [PCWP] Platelet function was assessed by aggregometry using turbidometric technique (inductors: ADP, epinephrine, collagen). Maximum aggregation, maximum gradient of aggregation, and platelet volume were measured before, during, and after CPB until the first postoperative day. HMW-HES 840 +/- 90 mL, LMW 850 +/- 100 mL, gelatin 950 +/- 110 mL, and albumin 810 +/- 100 mL were given preoperatively. Maximum platelet aggregation (ranging from -23% to -44% relative from baseline value) and maximum gradient of platelet aggregation (ranging from -26% to -45% relative from baseline values) were reduced only in the HMW-HES patients. After CPB, aggregometry also was impaired most markedly in these patients. The other volume groups showed less reduction in platelet aggregation and were similar to the untreated control. On the first postoperative day, aggregation variables had returned almost to baseline in all patients. Platelet volume was the same among the groups within the investigation period. Postbypass blood loss was highest in the HMW-HES group (890 +/- 180 mL). There was significant (P platelet aggregation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7684579

Boldt, J; Knothe, C; Zickmann, B; Andres, P; Dapper, F; Hempelmann, G

1993-06-01

137

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

International Nuclear Information System (INIS)

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

138

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

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

Iglézias José Carlos Rossini

2003-01-01

139

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

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

Poswal P

2004-01-01

140

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

International Nuclear Information System (INIS)

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

141

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

International Nuclear Information System (INIS)

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

142

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

Energy Technology Data Exchange (ETDEWEB)

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

Hope, A.F.; Heyns, A.D.; Loetter, M.G.; van Reenen, O.R.; de Kock, F.; Badenhorst, P.N.; Pieters, H.; Kotze, H.; Meyer, J.M.; Minnaar, P.C.

1981-06-01

143

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

Directory of Open Access Journals (Sweden)

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

M.J.C. Carmona

2005-05-01

144

Prognostic evaluation of bispectral index in patients following cardiopulmonary resuscitation.  

Science.gov (United States)

The aim of this study was to evaluate the prognosis of patients following cardiopulmonary resuscitation in an intensive care unit (ICU) using bispectral index (BIS) monitoring. The study was a prospective comparative study performed at the academic department of an ICU. A total of 33 adults who received cardiopulmonary resuscitation were enrolled and divided into the surviving and non-surviving groups according to their 7-day survival status. During their stay in the ICU, the BIS and arterial oxygen saturation (SaO(2)) levels of all the patients were continuously monitored. The neurological condition of the patients was measured according to the Glasgow coma scale (GCS). Acute physiological and chronic diseases were measured according to the acute physiology and chronic health evaluation II (APACHE II). SaO(2) was monitored in all patients. The jugular bulb venous oxygen saturation (SjO(2)) levels were continuously monitored in 23 patients and the difference between the SaO(2) and SjO(2) values was used to indicate oxygen metabolism in the brain. The variables in the present study were compared between the 2 groups. The correlations between BIS values and GCS or APACHE II scores were analyzed. The BIS values were significantly higher in the surviving group than in the non-surviving group (P<0.01). The difference between the SaO(2) and SjO(2) was significant (P<0.01). There was a positive correlation between BIS values and GCS scores (r=0.821, P<0.01) and between BIS values and APACHE II scores (r=0.434, P<0.05). BIS values may be used to predict the post-resuscitative outcome of patients following cardiopulmonary resuscitation. PMID:23407546

Liu, Han; Liu, Ying; Xu, Ying; Xue, Yan

2013-03-01

145

Cardiopulmonary effects of xylazine and yohimbine in laterally recumbent sheep.  

OpenAIRE

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

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

1986-01-01

146

Digital subtraction cardiopulmonary angiography using FCR (Fuji computed radiography)  

International Nuclear Information System (INIS)

Digital subtraction cardiopulmonary angiography using FCR was performed on 46 patients including lung cancer, mediastinal tumor, giant bullous formation and others. The images of digital subtraction for pulmonary artery, pulmonary vein and thoracic aorta were studied by comparing to the conventional pulmonary angiogram. Good images of pulmonary artery due to digital subtraction were obtained in 80 % of the 45 cases. This method needed only half volume of contrast media compared to the conventional for obtaining good images and thus reduced side effect. Therefore this method seems to be an usefull pre-operative examination in various chest diseases, especially in case of lung cancer. (author)

147

Delayed stenosis of the small intestine after cardiopulmonary arrest.  

Science.gov (United States)

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

148

Employment Dynamics  

OpenAIRE

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

Stadin, Karolina

2014-01-01

149

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

Science.gov (United States)

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 sportsmen with average to excellent 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

150

[Characteristic of the complement system in patients with ischemic heart disease with moderate and marked hemolysis after operations with cardiopulmonary bypass].  

Science.gov (United States)

A study of the complement system in cardiosurgical patients with moderate (40 patients) and marked (18 patients) hemolysis after coronary artery bypass grafting in conditions of cardiopulmonary bypass was carried out. Before and after operation the content of D35+-, D55+-erythrocytes and reticulocytes in blood, free hemoglobin in blood plasma, indicators of the functional state of classical, lectin and alternative pathways of complement activation as well as concentration of its terminal complex in blood serum were analyzed. It was established that development of marked hemolysis was associated with higher (compared with moderate hemolysis) content of terminal complement complex and reticulocytes in blood before operation as well as deficiency of D55+- erythrocytes and low activity of alternative pathway. PMID:23548384

Chumakova, S P; Urazova, O I; Novitski?, V V; Shipulin, V M; Khokhlov, O A; Emel'ianova, T V; Mikha?lova, M A

2013-01-01

151

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.

152

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

153

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

Science.gov (United States)

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

154

Evaluation of cardiopulmonary circulation time with functional images  

International Nuclear Information System (INIS)

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

155

Effects of inosine on reperfusion injury after cardiopulmonary bypass  

Directory of Open Access Journals (Sweden)

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

Horkay Ferenc

2010-11-01

156

Comparative physiology of postnatal developments of cardiopulmonary reflex.  

Science.gov (United States)

We analyzed and compared the frequency components of the heart rate variability in human neonate, rat, white chicken, turtle, and frog during the developments. Frequency analysis with autocorrelation-FFT method was applied to the heart rate and respiration waves to calculate the respiration induced frequency component in the power spectra. The comparative analysis of the cardiopulmonary reflex in human and rat neonates resulted in a similar developmental progress. In case of human immature neonate, respiration induced frequency component in the heart rate variability was negligible at day-old 0, and significantly increased at postnatal 1 month. The rat neonates also showed no or negligible respiration induced components until days 8 and it became significant approximately postnatal 1 month. The white chicken also indicated negligible respiration induced component before and a few days after hatching, and became significant after 38 days-old (17 days post hatching). However the frog and the turtle indicated no clear response in entire periods of the development even in adult. The results strongly suggested that gravity may be a possible essential factor of the appearance of the post natal development of the cardiopulmonary reflex. PMID:14676409

Nagaoka, Shunji; Bito, Yukiko; Sakuma, Rie; Nomura, Hiroko; Hata, Tadayoshi; Nishiyama, Junpei; Hirata, Yutaka

2003-10-01

157

How Much Do We Know About Cardiopulmonary Resuscitation?  

Directory of Open Access Journals (Sweden)

Full Text Available study, we aimed to investigate how much the physicians knew about resuscitation and the current guidelines were applied during the resuscitation. Materials and Methods: A total of 134 physicians working in the training and research hospitals, the university hospitals and 112 emergency medical services. A survey including questions about the participants’ resuscitation knowledge, age, specialty, the university graduated from and the number of cardiopulmonary resuscitations (CPRcarried out in a month was performed. The level of knowledge of the physicians working in the training and research hospitals, the university hospitals and 112 emergency medical services were compared. Results: We determined that, while 24.6% (n=33 of the participants applied the ILCOR protocols correctly, 38.8% (n=52 of them applied the protocols incorrectly or incompletely and 24.6% (n=33 of them did not know the protocols. The evaluation was performed according to the physician’s work place and the best results were obtained from the university hospital physicians, but the success rate was achieved in only around 50%. This rate was even lower in the training and research hospital and 112 emergency medical services groups. Conclusion: By reviewing the cardiopulmonary resuscitation training system in Turkey, implementation of resuscitation protocols with more current information should be provided. We believe that it is necessary to establish the in-service training programs, including the emergency medical system, as a part of training for using current information in daily practice.

Nazire Belgin Ak?ll?

2012-06-01

158

Postgraduate Education for Physical Therapists at Cardiopulmonary Area in Colombia  

Directory of Open Access Journals (Sweden)

Full Text Available This paper presents the supply of postdegreeprograms in the cardiopulmonary area in Colombiain orden to show its state and sufficiency.Plans of formation, objectives, curricular approach,methodology and profile of performanceare analyzed in terms of costs, duration,supply, location and research capabilities.Our results show problems in regard to supplyas well as unanimous criteria and strategic alliances.There are no Gremial associations thatfavor both discussion and analysis about epidemiologistaspects of respiratory and cardiovasculardiseases in Colombia there is necessityof professionals in this area with experience.Knowledge and appropiated skills in management,administration, laws, agreements andpublic policies that cover the affected population.Also, it is exposed that the Universities whitthis programs require support and pursuit forprofessionals positioning both in national andinternational context.MethodologyA descriptive study was carried out with a datacollection made in a period between April-Decemberof 2006. Cards were done and they allowedto review different aspects such as costs,occupational profile, duration, modality, methodology,practical component and evaluation inthe offering universities of programs of postdegreein the cardiopulmonary area for physiotherapists.Later an analysis was made oncurriculum, profiles, objectives, contents, professionalcompetitions the areas of research.

Diana Durán Palomino

2007-09-01

159

Percutaneous Extracorporeal Membrane Oxygenation for Graft Dysfunction after Heart Transplantation  

Science.gov (United States)

Background We evaluated the safety and efficacy of percutaneous extracorporeal membrane oxygenation (ECMO) in patients with primary graft dysfunction after heart transplantation. Methods Of 65 patients (44 males and 21 females) who underwent heart transplantation from January 2006 to December 2012, 13 patients (group I) needed peripheral ECMO support due to difficulty in weaning from cardiopulmonary bypass (CPB) and 52 patients (group II) were weaned from CPB without mechanical support. The mean age of the patients at the time of operation was 54.4±13.6 years. There were no differences in the preoperative characteristics of the two groups. Multivariable analysis was performed to identify the risk factors for ECMO therapy. Results All group I patients were successfully weaned from ECMO after 53±9 hours of circulatory support. Early mortality occurred in four patients (1 [7.7%] in group I and 3 [5.8%] in group II, p>0.999). There were no differences in the postoperative complications between the two groups, with the exception of reoperation for bleeding. A greater number of group I patients underwent reoperation for bleeding (5 [38.5%] in group I vs. 6 [11.5%] in group II, p=0.035). In multivariable analysis, preoperative mechanical support (ECMO and intra-aortic balloon pump) and longer CPB time were the risk factors of ECMO therapy for graft dysfunction (odds ratio, 6.377; 95% confidence interval, 1.519 to 26.77; p=0.011 and odds ratio, 1.010; 95% confidence interval, 1.001 to 1.019; p=0.033). Conclusion Percutaneous ECMO support could be a viable option for rescuing patients when graft dysfunction refractory to medical management develops after heart transplantation. PMID:24782957

Lim, Jae Hong; Hwang, Ho Young; Yeom, Sang Yoon; Cho, Hyun-Jai; Lee, Hae-Young

2014-01-01

160

Are the additional grafts necessary?  

Directory of Open Access Journals (Sweden)

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

161

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)

162

Effects of preoperative calcium channel and beta-adrenergic blockade on the vascular response to adrenergic agonists during cardiopulmonary bypass.  

Science.gov (United States)

The present report compares the effects of isoproterenol (ISO), norepinephrine (NE), and phenylephrine (PH) on the mean arterial pressure (MAP) and reservoir volume (RV) during cardiopulmonary (CPB) in 16 patients undergoing coronary artery bypass grafting (CABG) who were treated preoperatively with oral nifedipine (10 to 40 mg, three times a day) and propranolol (40 to 60 mg, three times a day). The changes of RV and MAP were used as indices of the changes in venous capacitance and arterial resistance, respectively, produced by the adrenergic agonists. ISO, a beta-adrenergic agonist, decreased both MAP and RV. NE, which activates both alpha 1- and alpha 2- adrenoceptors, increased both MAP and RV, while PH, a selective alpha 1-adrenergic agonist, increased only MAP with no significant change in RV. The changes are qualitatively similar to those previously achieved in patients undergoing valve replacement who did not receive any blocker preoperatively. However, the decrease of MAP by ISO and its increase by NE were significantly less in the CABG group. It is concluded that preoperative preparation of patients undergoing CABG with beta-adrenergic blockers and calcium channel blockers can modify the effect of ISO and NE on the peripheral resistance, but they have no significant effect on the action of PH at the doses selected in this study. PMID:2519946

Baraka, A; Baroody, M; Haroun, S; Nawfal, M; Sibai, A

1989-04-01

163

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)

164

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

165

Cardiopulmonary resuscitation knowledge among nurses working in Bahrain.  

Science.gov (United States)

There is a public expectation that registered nurses are competent in their skills. Nurses need to know cardiopulmonary resuscitation (CPR) to enable them to safely and effectively provide appropriate CPR measures. The objectives of this descriptive study were (i) to investigate nurses' knowledge regarding CPR; and (ii) to identify barriers to appropriate CPR evaluation. One hundred questionnaires were distributed to nurses working in a public government hospital in Bahrain; 82 of these were returned. The results indicated that cognitive knowledge was not adequately retained. Fifty-eight per cent of respondents perceived recalling CPR information as easy or extremely easy. Only 7% of respondents passed the knowledge test. In general, those who had less education and experience did not recall essential CPR knowledge. This study identified a significant problem with the knowledge surrounding CPR. More concerning was the lack of professional responsibility in dealing with this inadequacy. PMID:19703046

Marzooq, Hussain; Lyneham, Joy

2009-08-01

166

Microfluctuations of steady-state accommodation and the cardiopulmonary system.  

Science.gov (United States)

The relationship between variations in steady-state accommodation (microfluctuations) and rhythmic cycles in cardiopulmonary system was investigated. As previously reported, vascular pulse frequency was consistently correlated with the high frequency component of steady-state accommodation microfluctuations. In a new finding, respiration rate and an associated cycle in the instantaneous pulse rate also showed a correlation with a low frequency component of the accommodation power spectra. This apparent coherence between respiration frequency and an accommodation low frequency component was maintained during rapid breathing and was evident at the expected frequency during regulated breathing patterns. This association may reflect the direct influence of the autonomic nervous system upon the ciliary muscle or may be caused by the modulation of intraocular pulse by the autonomic nervous system. PMID:8594816

Collins, M; Davis, B; Wood, J

1995-09-01

167

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

168

Gastroenterology case report of mesalazine-induced cardiopulmonary hypersensitivity.  

Science.gov (United States)

Mesalazine is a 5-aminosalicylic acid derivative that has been widely used to treat patients with inflammatory bowel disease. Accumulating evidence indicates that mesalazine has a very low rate of adverse drug reactions and is well tolerated by patients. However, a few cases of pulmonary and cardiac disease related to mesalazine have been reported in the past, though infrequently, preventing clinicians from diagnosing the conditions early. We describe the case of a 32-year-old man with ulcerative colitis who was admitted with a two-month history of persistent fever following mesalazine treatment initiated 14 mo earlier. At the time of admission, mesalazine dose was increased from 1.5 to 3.0 g/d, and antibiotic therapy was started with no improvement. Three weeks after admission, the patient developed dyspnea, non-productive cough, and chest pain. Severe eosinophilia was detected in laboratory tests, and a computed tomography scan revealed interstitial infiltrates in both lungs, as well as a large pericardial effusion. The bronchoalveolar lavage reported a CD4/CD8 ratio of 0.5, and an increased eosinophil count. Transbronchial biopsy examination showed a severe eosinophilic infiltrate of the lung tissue. Mesalazine-induced cardiopulmonary hypersensitivity was suspected after excluding other possible etiologies. Consequently, mesalazine treatment was suspended, and corticosteroid therapy was initiated, resulting in resolution of symptoms and radiologic abnormalities. We conclude that mesalazine-induced pulmonary and cardiac hypersensitivity should always be considered in the differential diagnosis of unexplained cardiopulmonary symptoms and radiographic abnormalities in patients with inflammatory bowel disease. PMID:25852295

Ferrusquía, José; Pérez-Martínez, Isabel; Gómez de la Torre, Ricardo; Fernández-Almira, María Luisa; de Francisco, Ruth; Rodrigo, Luis; Riestra, Sabino

2015-04-01

169

Femoral impaction grafting  

Directory of Open Access Journals (Sweden)

Full Text Available Femoral impaction grafting is a reconstruction option applicable to both simple and complex femoral component revisions. It is one of the preferred techniques for reconstructing large femoral defects when the isthmus is non-supportive. The available level of evidence is primarily derived from case series, which shows a mean survivorship of 90.5%, with revision or re-operation as the end-point, with an average follow-up of 11 years. The rate of femoral fracture requiring re-operation or revision of the component varies between several large case series, ranging from 2.5% to 9%, with an average of 5.4%.

John A Scanelli

2013-01-01

170

Collapse of grafted polyelectrolyte layer  

OpenAIRE

The theory describing chain conformation in a planar layer of grafted polyelectrolyte (polyampholyte) molecules and the conformational transition related to the collapse of this layer caused by the decrease in solvent strenght is developed. Depending on the values of the layer parameters (grafting and charge densities) this transition may occur as a continuous (cooperative) or as a first order phase transition.

Borisov, O.; Birshtein, T.; Zhulina, E.

1991-01-01

171

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)

172

A Comparison of Interposition and Femoropopliteal Bypass Grafts in the Management of Popliteal Artery Trauma  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Peripheral vascular injury associated with lower limb trauma is a well-known emergency. The experience for the management of popliteal artery trauma have mainly come from managing the traumas of military personnels during Iran-Iraq war. The present study compared the effects of two currently-used surgical techniques in the management of popliteal trauma, namley femoropopliteal bypass graft and interposition vein graft on limb salvage. Methods: A retrospective review of 40 patients with popliteal artery trauma admitted to the trauma unit of a university teaching hospital during 2003 to 2008. The patients had undergone femoropopliteal bypass graft (n=26 or interposition vein graft (n=14 for the management of popliteal trauma. Results: The amputation rate among patients managed by femoropopliteal bypass or interposition vein graft was 35.7% and 61.5%, respectively. Knee stability among patients managed by interposition graft group was 57.7% and in those managed by femoropopliteal bypass graft was 85.7%. Conclusion: The rates of knee stability achieved by the employed techniques indicate that femoropopliteal bypass vein graft is superior, and therefore, preferable to the interposition vein graft in the management of popliteal artery trauma

Mohammad Ali Mohammadzade

2011-03-01

173

Employability Skills  

Science.gov (United States)

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

174

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

175

A Systematic Review of Intensive Cardiopulmonary Management after Spinal Cord Injury  

OpenAIRE

Intensive cardiopulmonary management is frequently undertaken in patients with spinal cord injury (SCI), particularly due to the occurrence of neurogenic shock and ventilatory insufficiency and in an attempt to reduce secondary injury. We undertook a systematic review of the literature to examine the evidence that intensive care management improves outcome after SCI and to attempt to define key parameters for cardiopulmonary support/resuscitation. We review the literature in five areas: manag...

Casha, Steven; Christie, Sean

2011-01-01

176

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

OpenAIRE

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 ...

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

2009-01-01

177

Acid base changes in arterial and central venous blood during cardiopulmonary resuscitation.  

OpenAIRE

Twenty-seven patients in cardiopulmonary arrest had simultaneous measurements of arterial and central venous blood gases during cardiopulmonary resuscitation (CPR) with a pneumatic chest comparison and ventilation device. Mean central venous and arterial hydrogen ion concentrations, PCO2 and calculated bicarbonate concentrations were significantly different (P less than 0.01) at all sampling times (0, 10 and 20 min). Central venous blood samples predominantly showed a respiratory acidosis in ...

Steedman, D. J.; Robertson, C. E.

1992-01-01

178

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

179

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

180

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

181

Comparison of Alloderm and mucosal graft in mandibular vestibuloplasty  

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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

182

Modified two-dimensional computational model for electrostrictive graft elastomer  

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A modified two-dimensional computational model is developed to calculate the electromechanical properties of the electrostrictive graft elastomer. The electrostrictive graft elastomer, recently developed by NASA, is a type of electro-active polymer. In a previous paper, the authors calculated electrostrictive graft elastomer electromechanical properties using a 2-D atomic force field. For this 2-D polymer structure, a much higher electric field was required to produce strain compared with that required in experiments. Two reasons could explain the higher electric field strength: (1) Polymer chain movement is restricted to a 2-D plane rather than to a 3-D plane. Out-plane dihedral torsional angle change would thus not be modeled. For this reason, 2-D polymer chains are less flexible than actual 3-D polymer chains. (2) Boundary effect of the computational model. In the original model, a unit cell consisting of a single graft unit was developed to simulate the deformation of the electrostrictive graft elastomer. The boundary of the unit cell would restrict the rotation of the graft unit. In this paper, a modified 2-D computational model is established to overcome the above problems. Firstly, three-dimensional deformations, induced by both bending angle and dihedral torsional angle changes, are projected onto a two-dimensional plane. Using both theoretical and numerical analyses, the projected 2-D equilibrium bending angle is shown to have the same value as the 3-D equilibrium bending angle. The 2-D equivalent bending stiffness is derived using a series model based upon the fact that both bending and dihedral torsion produce configuration change. The equivalent stiffness is justified by the characteristics of the polymer chain and end-to-end distance. Secondly, a self-consistent scheme is developed to eliminate the boundary effect. Eight images of the unit cell are created peripherally, with the original unit cell in the center. Thus the boundary can only affect the rotation of the eight images, not the central unit cell. The modified 2-D computational model is employed to determine the electromechanical properties of the electrostrictive graft elastomer. Relations between electric field induced strain and electric field strength is calculated. The effect of molecular scale factors, such as free volume fraction, graft weight percentage, and graft orientation are also discussed. The results should enable molecular scale design of the electrostrictive graft elastomer.

Sun, Changjie; Wang, Youqi; Su, Ji

2004-07-01

183

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

184

Epidemiology of coronary artery bypass grafting at the Hospital Beneficência Portuguesa, São Paulo  

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Introduction The knowledge of the prevalence of risk factors and comorbidities, as well as the evolution and complications in patients undergoing coronary artery bypass graft allows comparison between institutions and evidence of changes in the profile of patients and postoperative evolution over time. Objective To profile (risk factors and comorbidities) and clinical outcome (complications) in patients undergoing coronary artery bypass graft in a national institution of great surgical volume. Methods A retrospective cohort study of patients undergoing coronary artery bypass graft in the hospital Beneficência Portuguesa de São Paulo, from July 2009 to July 2010. Results We included 3,010 patients, mean age of 62.2 years and 69.9% male. 83.8% of patients were hypertensive, 36.6% diabetic, 44.5% had dyslipidemia, 15.3% were smokers, 65.7% were overweight/obese, 29.3% had a family history of coronary heart disease. The expected mortality calculated by logistic EuroSCORE was 2.7%. The isolated CABG occurred in 89.3% and 11.9% surgery was performed without cardiopulmonary bypass. The most common complication was cardiac arrhythmia (18.7%), especially acute atrial fibrillation (14.3%). Pneumonia occurred in 6.2% of patients, acute renal failure in 4.4%, mediastinites in 2.1%, stroke in 1.8% and AMI in 1.2%. The in-hospital mortality was 5.4% and in isolated coronary artery bypass graft was 3.5%. The average hospital stay was 11 days with a median of eight days (3-244 days). Conclusion The profile of patients undergoing coronary artery bypass graft surgery in this study is similar to other published studies. PMID:25859865

de Sousa, Alexandre Gonçalves; Fichino, Maria Zenaide Soares; da Silva, Gilmara Silveira; Bastos, Flávia Cortez Colosimo; Piotto, Raquel Ferrari

2015-01-01

185

Evaluation of graft patency by intravenous digital subtraction angiography after vascular reconstruction  

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Intravenous digital subtraction angiography (IVDSA) was employed to evaluate graft patency after reconstructive vascular surgery in 45 cases with various vascular diseases. IVDSA offered equally valuable information about the patency of the graft, compared with conventional arteriography. In the peripheral vascular disease, IVDSA readily demonstrated patency or occlusion of the graft, even in the complex one, and the result of evaluation by IVDSA correlated well with that inferred by postoperative change in ankle pressure index measured by Doppler ultrasound technique. In the aortic disease, IVDSA was effective to rule out stenosis or leakage at the anastomotic site of the graft, and was also useful in the detection of the patency of the reconstructed inferior mesenteric artery after surgery for abdominal aortic aneurysm. The procedure in IVDSA is simple and safe, and it can be performed on an outpatient basis. IVDSA is a reliable and valuable approach in the evaluation of the graft patency after reconstructive vascular surgery. (author).

Kuribayashi, Sachio; Ootaki, Makoto; Watabe, Tsuneya; Matsuyama, Seiya

1985-01-01

186

Evaluation of graft patency by intravenous digital subtraction angiography after vascular reconstruction  

International Nuclear Information System (INIS)

Intravenous digital subtraction angiography (IVDSA) was employed to evaluate graft patency after reconstructive vascular surgery in 45 cases with various vascular diseases. IVDSA offered equally valuable information about the patency of the graft, compared with conventional arteriography. In the peripheral vascular disease, IVDSA readily demonstrated patency or occlusion of the graft, even in the complex one, and the result of evaluation by IVDSA correlated well with that inferred by postoperative change in ankle pressure index measured by Doppler ultrasound technique. In the aortic disease, IVDSA was effective to rule out stenosis or leakage at the anastomotic site of the graft, and was also useful in the detection of the patency of the reconstructed inferior mesenteric artery after surgery for abdominal aortic aneurysm. The procedure in IVDSA is simple and safe, and it can be performed on an outpatient basis. IVDSA is a reliable and valuable approach in the evaluation of the graft patency after reconstructive vascular surgery. (author)

187

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)

188

EMPLOYMENT GUARANTEE”  

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

DILIP KHANDERAO PATIL

2013-06-01

189

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

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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

190

Tendencias en resucitación cardiopulmonar / Trends in cardiopulmonary resuscitation  

Scientific Electronic Library Online (English)

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

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

2009-02-01

191

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

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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

192

Therapeutical hypothermia after cardiopulmonary resuscitation: evidences and practical issues.  

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Cardiac arrest survivors frequently suffer from ischemic brain injury associated with poor neurological outcome and death. Therapeutic hypothermia improves outcomes in comatose survivors after resuscitation from out-of-hospital cardiac arrest. Considering its formal recommendation as a therapy, post-return of spontaneous circulation after cardiac arrest, the objective of this study was to review the clinical aspects of therapeutic hypothermia. Non-systematic review of articles using the keywords "cardiac arrest, cardiopulmonary resuscitation, cooling, hypothermia, post resuscitation syndrome" in the Med-Line database was performed. References of these articles were also reviewed. Unconscious adult patients with spontaneous circulation after out-of-hospital ventricular fibrillation or pulseless ventricular tachycardia should be cooled. Moreover, for any other rhythm or in the intra-hospital scenario, such cooling may also be beneficial. There are different ways of promoting hypothermia. The cooling system should be adjusted as soon as possible to the target temperature. Mild therapeutic hypothermia should be administered under close control, using neuromuscular blocking drugs to avoid shivering. The rewarming process should be slow, and reach 36º C, usually in no less then 8 hours. When temperature increases to more than 35º C, sedation, analgesia, and paralysis could be discontinued. The expected complications of hypothermia may be pneumonia, sepsis, cardiac arrhythmias, and coagulopathy. In spite of potential complications which require rigorous control, only six patients need to be treated to save one life. PMID:25303131

Feitosa-Filho, Gilson Soares; Sena, Joberto Pinheiro; Guimarães, Hélio Penna; Lopes, Renato Delascio

2009-03-01

193

Priming solutions for cardiopulmonary bypass: comparison of three colloids.  

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The present study was designed to compare the differences in the clinical effects of three colloidal solutions, albumin, urea-linked gelatin, and succinyl-linked gelatin, when used as priming fluids for cardiopulmonary bypass (CPB) under alpha-stat conditions. A consecutive series of 105 patients scheduled for cardiac surgery were randomized into three identically managed groups, except for the CPB prime. Variables relating to acid-base status, oncotic activity, metabolism, coagulation, and postoperative evaluation were measured. Marked differences in acid-base status, colloid osmotic pressure, additional prime requirements, blood lactate, urine output, and the need for buffer solutions occurred among groups, with the succinyl-linked gelatin group having better results than the other groups. Changes in hemodynamics, oxygen consumption, and blood-glucose levels during CPB did not vary among groups. There were also no important intergroup differences in hematologic and clotting variables or postoperative parameters such as blood loss or use of blood products. Electrolyte changes were similar except for a significant increase in ionized calcium that occurred in the urea-linked gelatin group after bypass. The results indicate that succinyl-linked gelatin is an adequate and safe alternative to human albumin for use as a colloid during CPB under alpha-stat conditions. PMID:1932651

Himpe, D; Van Cauwelaert, P; Neels, H; Stinkens, D; Van den Fonteyne, F; Theunissen, W; Muylaert, P; Hermans, C; Goossens, G; Moeskops, J

1991-10-01

194

Apolipoprotein E levels in pediatric patients undergoing cardiopulmonary bypass.  

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Apolipoprotein E (apoE) may play a critical role in modulating the response to neurological injury after cardiopulmonary bypass (CPB) in children. Plasma samples were collected from 38 pediatric patients. Half of the patients received nonpulsatile flow and the other half underwent pulsatile flow during CPB. Plasma samples were collected at three time points: at baseline prior to incision (T1), 1?h after CPB (T2), and 24?h after CPB (T3). The study included 38 pediatric patients undergoing heart surgery (mean age 2.5?±?2.1 years). Baseline apoE levels were low (0.464, P?=?0.045) at 24?h following CPB for the nonpulsatile group but not for the pulsatile group. In this cohort of young children with congenital heart disease, baseline apoE levels were low in the majority of patients prior to surgery. ApoE levels decreased further at 1?h after CPB, and then significantly increased by 24?h. The mode of perfusion and the duration of pump time and clamp time influence the apoE levels after CPB. An improved understanding of these mechanisms may translate into the development of new techniques to improve the clinical outcomes after pediatric CPB. PMID:25626577

A?irba?li, Mehmet; Song, Jianxun; Lei, Fengyang; Wang, Shigang; Kunselman, Allen R; Clark, Joseph B; Myers, John L; Ündar, Akif

2015-01-01

195

A reliable method for rhythm analysis during cardiopulmonary resuscitation.  

Science.gov (United States)

Interruptions in cardiopulmonary resuscitation (CPR) compromise defibrillation success. However, CPR must be interrupted to analyze the rhythm because although current methods for rhythm analysis during CPR have high sensitivity for shockable rhythms, the specificity for nonshockable rhythms is still too low. This paper introduces a new approach to rhythm analysis during CPR that combines two strategies: a state-of-the-art CPR artifact suppression filter and a shock advice algorithm (SAA) designed to optimally classify the filtered signal. Emphasis is on designing an algorithm with high specificity. The SAA includes a detector for low electrical activity rhythms to increase the specificity, and a shock/no-shock decision algorithm based on a support vector machine classifier using slope and frequency features. For this study, 1185 shockable and 6482 nonshockable 9-s segments corrupted by CPR artifacts were obtained from 247 patients suffering out-of-hospital cardiac arrest. The segments were split into a training and a test set. For the test set, the sensitivity and specificity for rhythm analysis during CPR were 91.0% and 96.6%, respectively. This new approach shows an important increase in specificity without compromising the sensitivity when compared to previous studies. PMID:24895621

Ayala, U; Irusta, U; Ruiz, J; Eftestøl, T; Kramer-Johansen, J; Alonso-Atienza, F; Alonso, E; González-Otero, D

2014-01-01

196

Capnography during cardiopulmonary resuscitation: Current evidence and future directions.  

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Capnography continues to be an important tool in measuring expired carbon dioxide (CO2). Most recent Advanced Cardiac Life Support (ACLS) guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR). Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO2 (PETCO2) and cardiac output that can indicate the return of spontaneous circulation (ROSC). Additional evidence favoring the use of capnography during CPR includes definitive proof of correct placement of the endotracheal tube and possible prediction of patient survival following cardiac arrest, although the latter will require further investigations. There is emerging evidence that PETCO2 values can guide the initiation of extracorporeal life support (ECLS) in refractory cardiac arrest (RCA). There is also increasing recognition of the value of capnography in intensive care settings in intubated patients. Future directions include determining the outcomes based on capnography waveforms PETCO2 values and determining a reasonable duration of CPR. In the future, given increasing use of capnography during CPR large databases can be analyzed to predict outcomes. PMID:25400399

Kodali, Bhavani Shankar; Urman, Richard D

2014-10-01

197

Inhibition of neutrophil activity improves cardiac function after cardiopulmonary bypass  

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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

198

Cardiopulmonary Physical Therapy Practice in the Paediatric Intensive Care Unit  

Science.gov (United States)

ABSTRACT Purpose: Physical therapists play an important role in the pediatric intensive care setting. The purpose of this study was to describe current cardiopulmonary physical therapy (CPT) practices in a pediatric cardiac critical care unit (CCCU) and a pediatric intensive care unit (PICU), as well as to determine the feasibility of obtaining clinically relevant outcome measures in this setting. Methods: We obtained reasons for admission, CPT treatment patterns, and availability of chest X-rays interpretation via a retrospective chart review of children who received CPT while in the PICU and CCCU (n=111). Results: Congenital cardiac conditions (34.2%) and primary respiratory deterioration (27.9%) were the most common reasons for admission; 50% of the children had associated diagnoses (e.g., developmental delay). Manual hyperinflation with expiratory vibration was the most common CPT treatment. Chest X-ray interpretation was available in 72% of the charts. Conclusions: Manual hyperinflation with expiratory vibration was used across diagnostic groups in the CCCU and PICU; its effectiveness therefore requires further study. Chest X-ray is an important clinical outcome and therefore needs to be recorded in a standardized manner to be useful for future clinical research studies. PMID:24396167

McCord, Jennifer; Krull, Nelin; Kraiker, Jennifer; Ryan, Rachelle; Duczeminski, Erica; Hassall, Alison; Lati, Jamil

2013-01-01

199

Cardiocerebral protection by emulsified isoflurane during cardiopulmonary resuscitation.  

Science.gov (United States)

Although improvement in cardiopulmonary resuscitation (CPR) performance and the increasing success at achieving return of spontaneous circulation (ROSC) have been possible in recent years, the survival and discharge rates of post-cardiac arrest (CA) patients remain disappointing. The high mortality rate is attributed to whole-body ischemia/reperfusion (I/R) induced multi-organ dysfunction that is well known as post-cardiac arrest syndrome. Post-cardiac arrest myocardial dysfunction and brain injury are the main clinical features of this complex pathophysiological process. Previous evidences have shown that volatile anesthetics, such as isoflurane, trigger a powerful and highly integrated cell survival response during I/R period in multiple organs, including heart and brain, which reduces I/R injury. This effect that called anesthetic-induced postconditioning can be shown when volatile anesthetics are administered after the onset of ischemia and at the time of reperfusion. Emulsified isoflurane (EIso) is a new anesthetic for intravenous administration, which is conveniently feasible outside operating room. Therefore, we hypothesize that EIso postconditioning could provide the cardiocerebral protection, and combined with therapeutic hypothermia as sedative agent could produce enhanced cardiocerebral protection, which can result in significant improvement of neurologically intact post-cardiac arrest survival. We consider that it would become a feasible, safe and efficient cardiocerebral protective intervention in the prevention and alleviation of post-cardiac arrest syndrome, which would also improve the outcomes after CA. PMID:25466299

Zhang, Ya-Jie; Wu, Meng-Jun; Li, Yi; Yu, Hai

2015-01-01

200

The cardiopulmonary capacities of young hockey players: age 10.  

Science.gov (United States)

The cardiopulmonary capacities of 15 selected 10 year old ice hockey players were determined during a discontinuous steady-state bicycle ergometer test. During the test, heart rates, minute ventilation and oxygen uptake were monitored and the peak values at maximal capacity were recorded. Blood was collected from the median cubital vein after each maximal exercise for lactate analysis. These boys represented a select group of highly successful young hockey players. They had been involved in organized hockey for a mean of 4.4 years, 2.9 of which had been spent in a competitive league. The team has ranked 3rd in the Ontario Championships. The maximal oxygen uptake was 56.6 ml/kg-min, a value much higher than reported for healthy inactive boys and close to values reported for young athletes in other sports. Mean maximal minute ventilation reached 64.5 l/min (1.84 l/kg-min). The tests on these athletes were carried out on two separate occasions, 48 hours apart. The test-retest correlations for VO2 max was high (r = 0.81). Only the reliability of the lactate determinations was low (r = 0.24). None of the differences between the mean values for the measurements made at the first and second exercise tests were significant. PMID:1272001

Cunningham, D A; Telford, P; Swart, G T

1976-01-01

201

Effect of alpha-stat versus pH-stat strategy on oxyhemoglobin dissociation and whole-body oxygen consumption during hypothermic cardiopulmonary bypass.  

Science.gov (United States)

To determine whether alpha-stat or pH-stat strategy should be used, 20 patients undergoing coronary artery bypass grafting during moderate hypothermic hemodilutional cardiopulmonary bypass were studied. The carbon dioxide management during bypass was randomly done according to alpha-stat strategy in 10 patients (i.e., temperature-uncorrected PaCO2 was kept near 40 mm Hg and uncorrected pHa was kept at about 7.4) and according to pH-stat strategy in the other 10 patients (i.e., temperature-corrected PaCO2 was kept near 40 mm Hg and uncorrected pHa was kept at about 7.4). In both groups, when the central venous temperature was stable at 26.5 +/- 2.5 degrees C, the perfusion flow was altered sequentially from 2.4 to 1.8 and 1.2 L.min-1.m-2. The mixed venous oxyhemoglobin saturation at the different perfusion flows was monitored by the Oxy-Stat meter and was correlated with the corresponding mixed venous oxygen tension to construct an oxyhemoglobin dissociation curve. Also, the whole-body oxygen consumption at the different perfusion flows was computed. The whole-body oxygen consumption and the oxyhemoglobin dissociation were not significantly different between the alpha-stat and the pH-stat groups. In both groups, the dissociation curve is shifted to the left, but the oxygen consumption per unit time does not significantly change despite decreasing the perfusion flow from 2.4 to 1.2 L.min-1.m-2. The results suggest that oxygen delivery is not impaired during moderate hypothermic cardiopulmonary bypass independent of whether alpha-stat or pH-stat strategy is used. PMID:1734795

Baraka, A S; Baroody, M A; Haroun, S T; Sibai, A A; Nawfal, M F; Dabbous, A S; Taha, S K; el-Khatib, R A

1992-01-01

202

Radiation grafting on natural films  

International Nuclear Information System (INIS)

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

203

[Graft or CVC? A prosthetic graft is the better choice].  

Science.gov (United States)

For more than 30 years, research and industry have attempted to introduce into clinical practice solutions and products that could remedy the impossibility to use native veins. Vascular grafts of various types have been created that would approach the ideal characteristics as closely as possible with low antigenic power, high resistance to infections, low risk of thrombosis, and easy pierceability but high resistance to puncturing. For this purpose various materials, either totally synthetic such as PTFE, biological homologous or heterologous, or biosynthetic with mixed components have been created. In addition, different configurations to improve the hemodynamic outline of synthetic grafts have been studied: grafts of varying caliber, conical or equipped with cuffs, and various systems of wall reinforcement to increase the resistance to punctures. But each of these types favors one aspect over another: biological grafts show better compliance with the native vein but offer less resistance to punctures and ectatic processes; synthetic grafts, instead, tend to be more vulnerable to intimal hyperplasia at the venous anastomosis, which is the Achilles' heel of grafts. In recent years, the use of tunneled central venous catheters (CVCs) has grown exponentially. This has offered a new, important solution to the vascular access problem, but the extensive use of CVCs is not always justified. In comparison with grafts, CVCs have various disadvantages including insertion-related complications, possible malfunctioning, risk of infections and thrombosis, but above all a high risk of steno-occlusion of central veins. Also in this field, research and industry are offering more and more reliable and secure products. More resistant, flexible, tolerable and less thrombogenic materials are being used and various configurations which would offer the best performance with the least insertion-related risks have been introduced: double-lumen CVCs with input and output staggered in oval and circular sections, separate-lumen CVCs, split CVCs, and so on. Also the radiological and ultrasound techniques of insertion have improved, thereby reducing risks and disadvantages. The choice of graft system or CVC is often determined not by clinical factors but by the preference or experience of the operator, the presence of a vascular surgeon, or a radiological staff experienced in vascular accesses. The probability of steno-occlusion of central veins, which may occur as early as 2 weeks after the procedure, could affect any other ''traditional'' vascular access in the corresponding limb owing to the high risk of arm edema. In the surgical timing, the preparation of a graft access should therefore precede the placement of a CVC. The refinement of endovascular procedures has allowed to increase the secondary patency considerably, permitting excellent survival of graft accesses. Statistical studies performed on large samples of patients have reported a marked increase in the mortality connected to CVC access, not only as a result of infection. There are, however, according to my surgical experience, some conditions in which the use of the CVC is a priority, namely in patients with severe cardiopathy and reduced ejection fraction in whom volume overload caused by a graft access increases the risk of cardiac failure; in pediatric patients weighing less than 20 kg, in whom a graft vascular access could cause notable, even insuperable, difficulties of construction and management, as well as negative psychological implications for the small patient; in very elderly patients in poor clinical condition with a short life expectancy or suffering from cancer, in whom a CVC could be used also for the infusion of chemotherapeutic drugs; and in patients with peripheral arteriopathy in whom the alternative is a graft in a lower limb, because of the high risk of ischemia. PMID:19382069

Cifarelli, M

2009-01-01

204

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 | Languages: English, 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

205

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

206

Anesthetic management during cardiopulmonary bypass: a systematic review.  

Science.gov (United States)

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

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

2015-04-01

207

Hitos sobre el test cardiopulmonar de ejercicio Cardiopulmonary exercise test  

Directory of Open Access Journals (Sweden)

Full Text Available El test cardiopulmonar de ejercicio TCPE (CPET en la literatura anglosajona evalúa aspectos dinámicos de la la fisiología cardiorespiratoria, en contraste, las pruebas funcionales estáticas no reproducen la condición activa de un individuo. No obstante su complejo montaje e interpretación, en el último decenio ha habido un creciente interés en aplicarlo en la detección de mecanismos de disnea. Al respecto, la curva flujo/volumen dinámica permite demostrar limitación de flujos e hiperinflación dinámica, también esta prueba permite profundizar en el análisis del intercambio gaseoso en ejercicio. La utilidad de estas pruebas en la evaluación funcional pre-operatoria compleja es destacada. Dada su alta reproducibilidad, el TCPE continúa siendo un alto referente en pruebas cardíacas de esfuerzo. Publicaciones cardiológicas enfatizan su valor pronóstico como indicador de sobrevida, seguimiento de terapias y enlistado para trasplante en insuficiencia cardíaca congestiva, utilizando parámetros máximos y submáximos. Entre los primeros el consumo cumbre o punta de oxígeno, y en los submáximos el equivalente ventilatorio de anhídrido carbónico y el consumo de oxígeno en el umbral lácticoCardiopulmonary exercise test (CPET evaluates cardiorespiratory function in dynamic conditions, in contrast to static pulmonary function tests which can not reproduce the dynamic situation of an individual. Despite its complex implementation there has been growing interest in CPET in evaluating the mechanisms of dyspnoea With this respect dynamic flow/volume curve is useful in identifying expiratory airflow limitation and dynamic hyperinflation. Besides gas exchange analysis during exercise deepens the quality of information in that subject. Its utility for decision making in complex perioperative evaluation can not be overemphasized. Considering its high reproducibility, this method is a highly valuable tool in cardiac stress testing. Several publications in Cardiology emphasize its value in diagnosis, follow up, prognosis and enlisting for transplant in congestive heart failure. Remarkably useful are maximal and submaximal indices obtained during exercise, such as peak oxygen consumption among the maximals, and carbon dioxide equivalent and oxygen consumption at lactic threshold, among the submaximal indicators

RODRIGO SOTO F

2008-01-01

208

Merit of anisodamine combined with opioid ?-receptor activation in the protection against myocardial injury during cardiopulmonary bypass.  

Science.gov (United States)

Myocardial ischemia/reperfusion (MIR) injury easily occurrs during cardiopulmonary bypass surgery in elderly patients. In an attempt to develop an effective strategy, we employed a pig model of MIR injury to investigate the maximum rate of change of left ventricular pressure, left ventricular enddiastolic pressure, and left intraventricular pressure. Coronary sinus cardiac troponin T (TnT) and adenosine-triphosphate (ATP) content in myocardium were measured. The ultrastructures for MIR injury were visualized by transmission electron microscopy (TEM). The role of ?-opioid receptor activation using D-Ala2, D-Leu5-enkephalin (DADLE) in both early (D1) and late (D2) phases of cardioprotection was identified. Also, the merit of cardioprotection by DADLE in combination with anisodamine, the muscarinic receptor antagonist (D+M), was evaluated. Glibenclamide was employed at the dose sufficient to block ATP-sensitive potassium channels. Significant higher cardiac indicators, reduced TnT and increased ATP contents, were observed in D1, D2, and D+M groups compared with the control group. DADLE induced protection was better in later phase of ischemia that was attenuated by glibenclamide. DADLE after the ischemia showed no benefit, but combined treatment with anisodamine showed a marked postischemic cardioprotection. Thus, anisodamine is helpful in combination with DADLE for postischemic cardioprotection. PMID:24386635

Hong, Xuan; Fan, Huimin; Lu, Rong; Chan, Paul; Liu, Zhongmin

2013-01-01

209

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

Scientific Electronic Library Online (English)

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

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

1615-16-01

210

Upper limb grafts for hemodialysis access.  

Science.gov (United States)

Arteriovenous (AV) grafts are required for hemodialysis access when options for native fistulas have been fully exhausted, where they continue to play an important role in hemodialysis patients, offering a better alternative to central vein catheters. When planning autogenous accesses using Doppler ultrasound, adequate arterial inflow and venous outflow must be consciously preserved for future access creation with grafts. Efforts to improve graft patency include changing graft configuration, graft biology and hemodynamics. Industry offers early cannulation grafts to reduce central catheter use and a bioengineered graft is undergoing clinical studies. Although the outcome of AV grafts is inferior to fistulas, grafts can provide long-term hemodialysis access that is a better alternative to central venous catheters. AV grafts have significant drawbacks, mainly poor patency, infection and cost but also have some advantages: early maturation, ease of creation and needling and widespread availability. The outcome of AV graft surgery is variable from center to center. The primary patency rate for AV grafts is 58% at 6 months and the secondary patency rate is 76% at 6 months and 55% at 18 months. There are centers of excellence that report a 1 year secondary patency rate of up to 91%. In this review of the use of AV grafts for hemodialysis access in the upper extremities, technical issues involved in planning the access and performing the surgery in its different configurations are discussed and the role of surveillance and maintenance with their attendant surgical and radiological interventions is described. PMID:25751548

Shemesh, David; Goldin, Ilya; Verstandig, Anthony; Berelowitz, Daniel; Zaghal, Ibrahim; Olsha, Oded

2015-03-01

211

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

212

Anesthetic potency and cardiopulmonary effects of sevoflurane in goats: comparison with isoflurane and halothane.  

OpenAIRE

The anesthetic potency and cardiopulmonary effects of sevoflurane were compared with those of isoflurane and halothane in goats. The (mean +/- SD) minimal alveolar concentration (MAC) was 0.96 +/- 0.12% for halothane, 1.29 +/- 0.11% for isoflurane, and 2.33 +/- 0.15% for sevoflurane. Cardiopulmonary effects of sevoflurane, halothane and isoflurane were examined at end-tidal concentrations equivalent to 1, 1.5 and 2 MAC during either spontaneous or controlled ventilation (SV or CV). During SV,...

Hikasa, Y.; Okuyama, K.; Kakuta, T.; Takase, K.; Ogasawara, S.

1998-01-01

213

Grafted megaporous materials as ion-exchangers for bioproduct adsorption.  

Science.gov (United States)

Megaporous chromatographic materials were manufactured by a three-step procedure, including backbone synthesis, chemical grafting, and introduction of ion-exchange functionality. The backbone of the adsorbent cylindrical bodies was prepared by polymerization of methacrylic acid and poly(ethylene glycol) diacrylate at sub-zero temperatures. Grafting was performed employing glycidyl methacrylate and a chemical initiator, cerium ammonium nitrate. The degree of grafting was adjusted by modifying the concentration of the initiator in the reaction mixture to a range of values (23, 39, 62, 89, and 105%). Further, the pendant epoxy-groups generated by the previous step were reacted to cation- and anion-exchanging moieties utilizing known chemical routes. Infrared spectroscopy studies confirmed the incorporation of epoxy and ion-exchanger groups to the backbone material. Optimized materials were tested for chromatography applications with model proteins; the dynamic binding capacity, as recorded at 10% breakthrough and 2.0 × 10(-4) m/s superficial velocity, were 350 and 58 mg/g for the cation-exchanger and the anion-exchanger material, respectively. These results may indicate that long tentacle-type polymer brushes were formed during grafting therefore increasing the ability of the megaporous body to efficiently capture macromolecules. PMID:23401432

Bibi, Noor Shad; Fernández-Lahore, Marcelo

2013-01-01

214

Elucidation of the Mechanism of Redox Grafting of Diazotated Anthraquinone  

DEFF Research Database (Denmark)

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

Chernyy, Sergey; Bousquet, Antoine

2012-01-01

215

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

216

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 ...

217

Who Needs Coronary Artery Bypass Grafting?  

Science.gov (United States)

... Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is used to treat people who have severe ... CHD) that could lead to a heart attack . CABG also might be used during or after a ...

218

Ultrasonography of the LIMA graft  

OpenAIRE

Coronary artery bypass grafting (CABG) is a surgical procedure that has been in existence since 1967 [1]. Over the years, the use of the left internal mammary artery (LIMA), has been shown to be the conduit of choice for single or sequential bypass grafting to the anterior wall of the heart because of its long-term patency [2-10]. The LIMA originates from the stem of the concave side of the subclavian artery opposite the vertebral artery. It runs behind the cartilage of the fir...

Hartman, J. M.

2009-01-01

219

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

220

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

221

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

222

Guías de Reanimación Cardiopulmonar / Guides for Cardiopulmonary Resuscitation  

Scientific Electronic Library Online (English)

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

Raffo, Escalante-Kanashiro.

2010-10-01

223

Cardiopulmonary resuscitation: biomedical and biophysical analysis (Chapter XXX)  

DEFF Research Database (Denmark)

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

Noordergraaf, G.J; Ottesen, Johnny T.

2004-01-01

224

Hitos sobre el test cardiopulmonar de ejercicio / Cardiopulmonary exercise test  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish El test cardiopulmonar de ejercicio TCPE (CPET en la literatura anglosajona) evalúa aspectos dinámicos de la la fisiología cardiorespiratoria, en contraste, las pruebas funcionales estáticas no reproducen la condición activa de un individuo. No obstante su complejo montaje e interpretación, en el úl [...] timo decenio ha habido un creciente interés en aplicarlo en la detección de mecanismos de disnea. Al respecto, la curva flujo/volumen dinámica permite demostrar limitación de flujos e hiperinflación dinámica, también esta prueba permite profundizar en el análisis del intercambio gaseoso en ejercicio. La utilidad de estas pruebas en la evaluación funcional pre-operatoria compleja es destacada. Dada su alta reproducibilidad, el TCPE continúa siendo un alto referente en pruebas cardíacas de esfuerzo. Publicaciones cardiológicas enfatizan su valor pronóstico como indicador de sobrevida, seguimiento de terapias y enlistado para trasplante en insuficiencia cardíaca congestiva, utilizando parámetros máximos y submáximos. Entre los primeros el consumo cumbre o punta de oxígeno, y en los submáximos el equivalente ventilatorio de anhídrido carbónico y el consumo de oxígeno en el umbral láctico Abstract in english Cardiopulmonary exercise test (CPET) evaluates cardiorespiratory function in dynamic conditions, in contrast to static pulmonary function tests which can not reproduce the dynamic situation of an individual. Despite its complex implementation there has been growing interest in CPET in evaluating the [...] mechanisms of dyspnoea With this respect dynamic flow/volume curve is useful in identifying expiratory airflow limitation and dynamic hyperinflation. Besides gas exchange analysis during exercise deepens the quality of information in that subject. Its utility for decision making in complex perioperative evaluation can not be overemphasized. Considering its high reproducibility, this method is a highly valuable tool in cardiac stress testing. Several publications in Cardiology emphasize its value in diagnosis, follow up, prognosis and enlisting for transplant in congestive heart failure. Remarkably useful are maximal and submaximal indices obtained during exercise, such as peak oxygen consumption among the maximals, and carbon dioxide equivalent and oxygen consumption at lactic threshold, among the submaximal indicators

RODRIGO, SOTO F; IVAN, CAVIEDES S.

225

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

226

2010 Survey on cell phone use while performing cardiopulmonary bypass.  

Science.gov (United States)

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

Smith, T; Darling, E; Searles, B

2011-09-01

227

The Effect of Aerobic Exercise on Cardiopulmonary System in Children  

Directory of Open Access Journals (Sweden)

Full Text Available AIM: The purpose of this study is to investigate the changes in cardiopulmonary system stimulated by aerobic exercise in different age group of children and to find out in which age group aerobic exercise is more effective. METHOD: Totally, 76 children participated in this study. Ages of the participants ranged between 11?17, and mean age was 14.08±0.65. Participants were divided into three groups according to their age range. There were 23 in the first and second and 30 participants in the third group, (15?17, (13?14 and 30 (11?12 respectively. Each of the groups then was divided into two parts one of which was experimental and the other was control group. During 8 weeks, a training programme based on doing aerobic exercise lasting one hour 3 days a week was performed in the experimental groups. Before and after training, EKG, spirometer, blood pressure, heart rate, PWC 170 test of the participants, which was the data collection method, were recorded. The results obtained were compared through t test method of SPSS. RESULTS: The results revealed a decrease in the systolic blood pressure and in the heart rate of those who did exercise as opposed to those who did not do exercise in Group I. In addition, R wave height in V6 of exercise group showed a statistically significant increase. As for second group, it was determined that the R/S, at V1 derivation obtained from the participants who did exercise showed a statistically decrease as compared to those of the participants who did not do exercise. In the third group, no changes were observed in the systolic blood pressure the heart rate, R wave height in V6 and R/S although the measures of PWC 170 test, VC and FVC obtained from all training groups made a significant increase when compared to those of control groups. CONCLUSION: The results of this study revealed that of the three groups the 15?17 age group was affected mostly by the aerobic exercise on kardiyopulmoner sytem. The results suggest that the exercises performed with this group affected the participants positively, which should be taken into consideration for further research. [TAF Prev Med Bull 2009; 8(2.000: 125-130

Dilek Sevimli

2009-04-01

228

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

OpenAIRE

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

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

2010-01-01

229

Anticoagulation and Temporary Graft Occlusion to Determine the Need for Revascularization Following Vascular Graft Infection  

OpenAIRE

The patient with a patent, infected vascular graft presents a dilemma to the surgeon, who must decide whether revascularization is necessary in addition to removal of the infected graft. When a graft infection points superficially or requires drainage, the graft may be well enough exposed to provide easy access. A technique to determine preoperatively the need for revascularization in two patients with patent, exposed grafts is discussed. Following therapeutic anticoagulation, the exposed gra...

Lawrence, Peter F.

1982-01-01

230

Preimplantation-stage stem cells induce long-term allogeneic graft acceptance without supplementary host conditioning.  

Science.gov (United States)

Hematopoietic stem cells have been successfully employed for tolerance induction in a variety of rodent and large animal studies. However, clinical transplantation of fully allogeneic bone marrow or blood-borne stem cells is still associated with major obstacles, such as graft-versus-host disease or cytoreductive conditioning-related toxicity. Here we show that when rat embryonic stem cell-like cells of WKY origin are injected intraportally into fully MHC-mismatched DA rats, they engraft permanently (>150 days) without supplementary host conditioning. This deviation of a potentially alloreactive immune response sets the basis for long-term graft acceptance of second-set transplanted WKY cardiac allografts. Graft survival was strictly correlated with a state of mixed chimerism, which required functional thymic host competence. Our results provide a rationale for using preimplantation-stage stem cells as vehicles in gene therapy and for the induction of long-term graft acceptance. PMID:11821902

Fändrich, Fred; Lin, Xiongbin; Chai, Gui X; Schulze, Maren; Ganten, Detlev; Bader, Michael; Holle, Julia; Huang, Dong-Sheng; Parwaresch, Reza; Zavazava, Nicholaus; Binas, Bert

2002-02-01

231

Relative adrenal insufficiency and hemodynamic status in cardiopulmonary bypass surgery patients. A prospective cohort study  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The objectives of this study were to determine the risk factors for relative adrenal insufficiency in cardiopulmonary bypass patients and the impact on postoperative vasopressor requirements. Methods Prospective cohort study on cardiopulmonary bypass patients who received etomidate or not during anesthetic induction. Relative adrenal insufficiency was defined as a rise in serum cortisol ? 9 ?g/dl after the administration of 250 ?g of consyntropin. Plasma cortisol levels were measured preoperatively, immediately before, 30, 60, and 90 minutes after the administration of cosyntropin, and at 24 hours after surgery. Results 120 elective cardiopulmonary bypass patients were included. Relative adrenal insufficiency (?cortisol ?9 ?g/dl incidence was 77.5%. 78 patients received etomidate and 69 (88% of them developed relative adrenal insufficiency, (P P P = 0.04, and at 4 hours after surgery (P = 0.01. Pre and post-test plasma cortisol levels were inversely associated with maximum norepinephrine dose (? = -0.22, P = 0.02; ? = -0.18, P = 0.05; ? = -0.21, P = 0.02; and ? = -0.22, P = 0.02, respectively. Conclusions Relative adrenal insufficiency in elective cardiopulmonary bypass patients may induce postoperative vasopressor dependency. Use of etomidate in these patients is a modifiable risk factor for the development of relative adrenal insufficiency that should be avoided.

Mora María L

2010-04-01

232

EFFECTS OF INSTILLED AND INHALED PARTICULATE MATTER ON CARDIOPULMONARY PARAMETERS IN RATS  

Science.gov (United States)

EFFECTS OF INSTILLED AND INHALED PARTICULATE MATTER ON CARDIOPULMONARY PARAMETERS IN RATS LB Wichers (UNC - Chapel Hill; Chapel Hill, NC USA), MJ Campen (LRRI; Albuquerque, NM USA), JP Nolan, WH Rowan, AD Ledbetter, DW Winsett, UP Kodavanti, MCJ Schladweiler, DL Costa, and...

233

Pig model in the study on apoptotic DNA fragmentation during cardiopulmonary bypass.  

Czech Academy of Sciences Publication Activity Database

Ro?. 12, - (2002), s. 154-158. ISSN 1407-0944 R&D Projects: GA ?R GA304/01/0850; GA AV ?R KSK6005114 Keywords : pig model * apoptosis * cardiopulmonary bypass Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

Matalová, Eva; Španová, A.; Ková??, F.

2002-01-01

234

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

Directory of Open Access Journals (Sweden)

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

Tomar Akhlesh

2002-01-01

235

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 Eucoleus aerophilus (syn. Capillaria aerophila...

Conboy Gary; Di Cesare Angela; Traversa Donato

2010-01-01

236

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

237

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,

238

Vascular grafting strategies in coronary intervention  

Science.gov (United States)

With the growing need for coronary revascularizations globally, several strategies to restore blood flow to the heart have been explored. Bypassing the atherosclerotic coronary arteries with autologous grafts, synthetic prostheses and tissue-engineered vascular grafts continue to be evaluated in search of a readily available vascular graft with clinically acceptable outcomes. The development of such a vascular graft including tissue engineering approaches both in situ and in vitro is herein reviewed, facilitating a detailed comparison on the role of seeded cells in vascular graft patency.

Knight, Darryl; Gillies, Elizabeth; Mequanint, Kibret

2014-06-01

239

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

240

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

241

The radial forearm skin graft-fascial flap.  

Science.gov (United States)

The radial forearm flap has become a versatile flap for upper extremity reconstruction. The use of the forearm flap for hand reconstruction in the patient with previously burned forearms has not been widely appreciated. In those patients whose forearms have been previously split-thickness skin-grafted on fascia, we have employed the reverse radial forearm flap as a skin graft-fascial flap for hand reconstruction and have obtained excellent functional results. Three patients at various intervals postburn are presented to demonstrate use of this flap for wrist contracture release, coverage of arthroplasties, first web space contracture release, and acute salvage of phalanges and tendons. Assessment of the hand's vascular anatomy and careful treatment of the donor area have contributed to no added morbidity and an excellent aesthetic result at the donor site. PMID:2349295

Cherup, L L; Zachary, L S; Gottlieb, L J; Petti, C A

1990-06-01

242

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)

243

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

Energy Technology Data Exchange (ETDEWEB)

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

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

1997-01-01

244

Studies on radiation-induced graft polymerization  

International Nuclear Information System (INIS)

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

245

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

246

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

OpenAIRE

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

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

2012-01-01

247

Analysis of Risk Factors for Acute Kidney Injury after Ascending Aortic Replacement Combined with Open Placement of Triple-Branched Stent Graft in Type A Aortic Dissection: A New Technique versus the Traditional Method in a Single Chinese Center  

Science.gov (United States)

Background We aimed to analyze the risk factors and prognosis of acute kidney injury (AKI) after aortic arch repair in type A aortic dissection. Material/Methods We included 155 patients undergoing arch repair surgery for type A aortic dissection from January 2009 to January 2014 in our hospital. Ninety-three patients underwent ascending aortic replacement combined with open placement of triple-branched stent graft and 62 underwent arch replacement with 4-branched Dacron graft combined with stented elephant trunk implantation into the descending aorta. Univariate analysis and multiple logistic regression were performed to evaluate possible parameters associated with AKI according to the AKI Network (AKIN). Results Postoperative AKI occurred in 56 patients, with a morbidity of 36.13%. Advanced age (OR=2.32 per decade, 95% CI; range, 1.47–3.67); aortic arch replacement with 4-branched Dacron graft combined with stented elephant trunk implantation (OR=3.29, 95% CI; range, 1.12–9.67); cardiopulmonary bypass time >180 min (OR=3.91, 95% CI; range, 1.35–11.35) and packed red blood cells >10 U (OR=4.88, 95% CI; range, 2.03–11.76) were independent risk factors. Conclusions AKI is a complication after arch repair in type A aortic dissection. Advanced age; aortic arch replacement with 4-branched Dacron graft combined with stented elephant trunk implantation; cardiopulmonary bypass time >180 min; and packed red blood cells >10 U were independent risk factors for AKI. Ascending aortic replacement combined with open triple-branched stent graft placement could reduce the occurrence of AKI and protect renal function. PMID:25737240

Qiu, Zhihuang; Chen, Liangwan; Cao, Hua; Zhang, Guican; Xu, Fan; Chen, Qiang

2015-01-01

248

Radiation sterilization of tissue grafts  

International Nuclear Information System (INIS)

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

249

Immediate non-traumatic postmortem computed tomographic demonstration of myocardial intravascular gas of the left ventricle: effects from cardiopulmonary resuscitation  

OpenAIRE

An 87-year-old man was found in a state of cardiopulmonary arrest. Despite cardiopulmonary resuscitation (CPR) for over 1 hour by emergency technicians and physicians, the patient died. Immediate postmortem computed tomography showed cardiovascular gas in the right atrium, right ventricle, and left ventricle. Cardiovascular gas in the left ventricle was located in the myocardium and appeared as linear or branch-shaped suggesting the presence of myocardial intravascular gas. This is the first ...

Okuda, Takahisa; Shiotani, Seiji; Kobayashi, Tomoya; Kohno, Mototsugu; Hayakawa, Hideyuki; Kikuchi, Kazunori; Suwa, Kunio

2013-01-01

250

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

251

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

Directory of Open Access Journals (Sweden)

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

252

Interventions in infrainguinal bypass grafts  

International Nuclear Information System (INIS)

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

253

Grafting zwitterionic polymer onto cryogel surface enhances protein retention in steric exclusion chromatography on cryogel monolith.  

Science.gov (United States)

Cryogel monoliths with interconnected macropores (10-100?m) and hydrophilic surfaces can be employed as chromatography media for protein retention in steric exclusion chromatography (SXC). SXC is based on the principle that the exclusion of polyethylene glycol (PEG) on both a hydrophilic chromatography surface and a protein favors their association, leading to the protein retention on the chromatography surface. Elution of the retained protein can be achieved by reducing PEG concentration. In this work, the surface of polyacrylamide-based cryogel monolith was modified by grafting zwitterionic poly(carboxybetaine methacrylate) (pCBMA), leading the increase in the surface hydrophilicity. Observation by scanning electron microscopy revealed the presence of the grafted pCBMA chain clusters on the cryogel surface, but pCBMA grafting did not result in the changes of the physical properties of the monolith column, and the columns maintained good recyclability in SXC. The effect of the surface grafting on the SXC behavior of ?-globulin was investigated in a wide flow rate range (0.6-12cm/min). It was found that the dynamic retention capacity increased 1.4-1.8 times by the zwitterionic polymer grafting in the flow rate range of 1.5-12cm/min. The mechanism of enhanced protein retention on the zwitterionic polymer-grafted surface was proposed. The research proved that zwitterionic polymer modification was promising for the development of new materials for SXC applications. PMID:25757821

Tao, Shi-Peng; Zheng, Jie; Sun, Yan

2015-04-10

254

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

Directory of Open Access Journals (Sweden)

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

255

Synthesis and characterization of water-soluble chitosan grafted with hydrophilic aliphatic polyester.  

Science.gov (United States)

Traditionally, hydrophobic aliphatic polyester has been employed to modify chitosan and organic soluble or swellable graft copolymers have been obtained. In this work, linear poly(butylene tartrate) (PBT) with hydrophilic pendant hydroxyl groups, which was synthesized by direct polycondensation of tartaric acid and butanediol under mild condition, was chosen to modify chitosan and synthesize PBT grafted chitosan (CS-g-PBT) with the mediation of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide in aqueous solution of an ionic liquid. The chain length of the grafted PBT could be facilely controlled by varying the molecular weight of PBT. The chemical structures of CS-g-PBT were systematically characterized by (1)H NMR, attenuated total reflectance Fourier transform infrared and wide-angle X-ray diffraction. The thermal properties were investigated by thermogravimetric analysis and differential scanning calorimetry. The water solubility of chitosan has been effectively improved after grafting with PBT and a water-soluble chitosan derivative has been synthesized. Meanwhile, the water solubility of grafts varies regularly with chain length of grafted PBT. PMID:25576746

Chen, Jiajia; Zheng, Liuchun; Chen, Xiaonong; Wang, Zhaodong; Li, Chuncheng; Xiao, Yaonan; Guan, Guohu; Zhu, Wenxiang

2015-03-01

256

Pancreatic Stone Protein Predicts Postoperative Infection in Cardiac Surgery Patients Irrespective of Cardiopulmonary Bypass or Surgical Technique  

Science.gov (United States)

Introduction We investigated the role of pancreatic stone protein (PSP) in predicting the occurrence of infection in the postoperative course of cardiac surgery patients. Several biomarkers indicating the presence of inflammation and infection are available in the clinical routine; yet, their utility in the postoperative course of patients following cardiac surgery remains uncertain. Moreover, cardiopulmonary bypass, also referred to as “on-pump surgery”, increases the susceptibility to an exaggerated inflammatory state. However, the impact of such extracorporeal circulation on circulating PSP levels remains poorly understood. Methods In a prospective cohort of unselected patients undergoing cardiac surgery, we set out to elucidate the diagnostic accuracy of serum PSP levels as opposed to canonical biomarkers (CRP, WBC) of inflammation to discriminate between the presence of infection and surgical trauma,. In addition, we investigated whether the biomarkers were influenced by the surgical technique employed, i.e. on-pump vs. off-pump and minimally invasive surgery vs. sternotomy. Levels of circulating PSP and routine inflammatory biomarkers (CRP, WBC) were measured in samples taken from 120 patients at baseline as well as at postoperative day 1–3. Results Univariate analysis showed that among the biomarkers investigated, only PSP levels had discriminatory power to differentiate infection from surgical trauma in the postoperative course of the entire cohort of patients following cardiac surgery. With regard to cardiac surgical interventions, there was no significant association between the absence or presence of extracorporeal circulation and PSP levels. However, there was a significant difference in the slope of the rise of postoperative PSP between minimally invasive surgery as opposed to patients subjected to sternotomy. Conclusion In an unselected population of cardiac surgery patients, post-operative serum PSP levels were significantly associated with the presence of infection in both the on-pump and off-pump setting. Of note, the surgical technique employed (sternotomy vs. minimally invasive approach) had a significant impact on postoperative PSP levels. PMID:25793700

Falk, Volkmar; Slankamenac, Ksenija; Rudiger, Alain; Schönrath, Felix; Rodriguez Cetina Biefer, Hector; Starck, Christoph T.; Graf, Rolf

2015-01-01

257

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

International Nuclear Information System (INIS)

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

258

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

LENUS (Irish Health Repository)

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

Ong, J C Y

2012-06-01

259

Grafting rays fellow travel Teichmuller geodesics  

CERN Document Server

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 lamination Lambda, the map of Teichmuller space which is defined by grafting along Lambda is L-Lipschitz with respect to the Teichmuller metric, where L is a universal constant. This Lipschitz property follows from an extension of grafting to an open neighborhood of Teichmuller space in the space of quasi-Fuchsian groups.

Choi, Young-Eun; Rafi, Kasra

2010-01-01

260

Gamma-radiation-induced grafting onto wool  

International Nuclear Information System (INIS)

On the basis of radiation-induced grafting treatments carried out on single wool fibres, as described in Part I, analogous treatments were carried out on wool fabrics. Some textile properties such as the permanent-press behaviour, area shrinkage, abrasion resistance and dry crease-recovery angle can be improved by grafting hydrophobic polymers onto the textile. In the case of bending length, relaxation shrinkage and felting shrinkage, the results in general show deterioration after grafting, compared with untreated material. (author)

261

Bone grafting in total hip replacement  

International Nuclear Information System (INIS)

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

262

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

Science.gov (United States)

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

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

2012-12-01

263

Radiation graft-copolymerization onto polyethylene film  

International Nuclear Information System (INIS)

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

264

Graft polymerization on magnesium oxide surface  

International Nuclear Information System (INIS)

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

265

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)

266

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

267

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

Directory of Open Access Journals (Sweden)

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

Ti-Fei Yuan

2010-01-01

268

Ozone is associated with cardiopulmonary and stroke emergency hospital visits in Reykjavik, Iceland 2003--2009  

OpenAIRE

BACKGROUND: Air pollution exposure is associated with hospital admissions and emergency room visits for cardiopulmonary disease and stroke. Iceland's capital area, Reykjavik, has generally low air pollution levels, but traffic and natural sources contribute to pollution levels. The objective of this study was to investigate temporal associations between emergency hospital visits and air pollutants ozone (O3), nitrogen dioxide (NO2), and particulate matter (PM10) in the Icelandic capital area....

Carlsen, Hanne Krage; Forsberg, Bertil; Meister, Kadri; Gi?slason, Thorarinn; Oudin, Anna

2013-01-01

269

Cardiopulmonary exercise testing in congenital heart disease: equipment and test protocols  

OpenAIRE

Cardiopulmonary exercise testing (CPET) in paediatric cardiology differs in many aspects from the tests as performed in adult cardiology. Children's cardiovascular responses during exercise testing present different characteristics, particularly oxygen uptake, heart rate and blood pressure response, which are essential in interpreting haemodynamic data. Diseases that are associated with myocardial ischaemia are very rare in children. The main indications for CPET in children are evaluation of...

Takken, T.; Blank, A. C.; Hulzebos, E. H.; Brussel, M.; Groen, W. G.; Helders, P. J.

2009-01-01

270

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

OpenAIRE

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

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

1989-01-01

271

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

DEFF Research Database (Denmark)

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

Kohno, Mitsutomo; Steinbrüchel, Daniel A

2012-01-01

272

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

273

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

274

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

275

Cardiopulmonary effects of a halothane/oxygen combination in healthy cats.  

OpenAIRE

The effects of a halothane/oxygen combination on the cardiopulmonary function of 11 healthy cats were studied. Test parameters included cardiac output, measured via thermo-dilution, heart rate, respiratory rate, arterial blood pressure (systolic, diastolic and mean) and blood gas analysis. Values for systemic vascular resistance, cardiac index and stroke volume were calculated from these data. Cardiac output, cardiac index, heart rate, stroke volume, arterial blood pressure (systolic, diastol...

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

1988-01-01

276

Cardiopulmonary effects of a halothane/oxygen combination in hypovolemic cats.  

OpenAIRE

The cardiopulmonary effects of a halothane/oxygen combination were studied in eight 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 and measurements of ...

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

1988-01-01

277

The Utility of Cardiopulmonary Exercise Testing in the Assessment of Suspected Microvascular Ischemia  

OpenAIRE

Evidence demonstrating the potential value of cardiopulmonary exercise testing (CPET) to accurately detect myocardial ischemia secondary to macro-vascular disease is beginning to emerge. Despite distinct mechanisms mediating ischemia in micro-vascular and macrovascular coronary artery disease (CAD), the net physiologic effect of exercise-induced left ventricular (LV) dysfunction is common to both. The abnormal physiologic response to CPET may, therefore, be similar in patients with macro- and...

Chaudhry, Sundeep; Arena, Ross; Wasserman, Karlman; Hansen, James E.; Lewis, Gregory D.; Myers, Jonathan; Belardinelli, Romualdo; Labudde, Brian; Menasco, Nicholas; Boden, William E.

2009-01-01

278

Andes Virus Antigens Are Shed in Urine of Patients with Acute Hantavirus Cardiopulmonary Syndrome? ‡  

OpenAIRE

Hantavirus cardiopulmonary syndrome (HCPS) is a highly pathogenic emerging disease (40% case fatality rate) caused by New World hantaviruses. Hantavirus infections are transmitted to humans mainly by inhalation of virus-contaminated aerosol particles of rodent excreta and secretions. At present, there are no antiviral drugs or immunotherapeutic agents available for the treatment of hantaviral infection, and the survival rates for infected patients hinge largely on early virus recognition and ...

Godoy, Paula; Marsac, Delphine; Stefas, Elias; Ferrer, Pablo; Tischler, Nicole D.; Pino, Karla; Ramdohr, Pablo; Vial, Pablo; Valenzuela, Pablo D. T.; Ferre?s, Marcela; Veas, Francisco; Lo?pez-lastra, Marcelo

2009-01-01

279

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

OpenAIRE

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

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

2013-01-01

280

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

Science.gov (United States)

Situs inversus totalis is a rare congenital condition. A 34-year-old woman with undiagnosed situs inversus was referred to our emergency department with cardiac arrested state. She underwent cardiopulmonary resuscitation (CPR) and defibrillation with a modified approach. We faced different challenging aspects during intensive care management. Ultrasonography in CPR in our patient was very helpful. We restricted our discussion on special aspect of SIT in emergency and intensive care unit. PMID:24015144

Samanta, Sukhen; Samanta, Sujay; Ghatak, Tanmoy

2013-01-01

281

OUTCOMES OF THE FIFTH INTERNATIONAL CONFERENCE ON PEDIATRIC MECHANICAL CIRCULATORY SUPPORT SYSTEMS AND PEDIATRIC CARDIOPULMONARY PERFUSION  

OpenAIRE

The overall objective of the Conference was to bring together internationally know clinicians, bioengineers, and basic scientists involved in research on pediatric mechanical cardiac support systems and pediatric cardiopulmonary bypass procedures. The primary focus was to explicitly describe the problems with current pediatric mechanical circulatory support systems, methods, and techniques during acute and chronic support. The organizers were able to bring together respected international sch...

U?ndar, Akif

2009-01-01

282

Validating HeartSmart® against the Cardiopulmonary Bypass Machine  

Directory of Open Access Journals (Sweden)

Full Text Available 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 derived from the empirical physiological formulae embedded in the HeartSmart® monitor in 32 patients. Cardiac index values were compared at the start of cardiopulmonary bypass, during re-warming, and at the end of cardiopulmonary bypass. Results: A total of 256 paired sets of measurements were suitable for comparison. The mean of the differences or bias (95% limits of agreement was 0.09 l/min/m2 and the limits of agreement –0.86 to 1.05 l/min/m2. The mean difference of the sets of 256 measurements was 585.5 l/min/m for the pump and 575.0 l/min/m2 for the empirical physiological formulae—a difference of 5% l/min/m2. The range of flow rates for the pump was 1.2 to 2.85 l/min/m2; for the empirical physiological formulae, the range was 1.2 to 3.0 l/min/m2. Conclusion: The cardiac index estimates derived from the empirical physiological formulae in the HeartSmart® software are in good agreement with pump cardiac output rates. These results suggest that HeartSmart® measurements are sufficiently accurate for assessing hemodynamic variables in many groups of patients.

Kenneth J. Warring-Davies

2012-01-01

283

The ethics of cardiopulmonary resuscitation. II. Medical logistics and the potential for good response.  

OpenAIRE

Mismatches between provision of paediatric cardiopulmonary resuscitation (CPR) and potential to benefit are examined. Deficiencies are most likely to occur in peripheral maternity units but futile CPR is more common in emergency departments where the child is unknown. Decision making in individual cases is best retained by the medical profession for the sake of the child and family. American style intervention by the legislature is likely to dissipate scarce resources and perhaps harm infants...

Davies, J. M.; Reynolds, B. M.

1992-01-01

284

Diagnosis and management after life threatening events in infants and young children who received cardiopulmonary resuscitation.  

OpenAIRE

OBJECTIVE--To determine the mechanisms and thereby appropriate management for apparent life threatening events treated with cardiopulmonary resuscitation in infants and young children. DESIGN--Prospective clinical and physiological study. SETTING--Royal Brompton Hospital or in patients' homes, or both. SUBJECTS--157 Patients referred at median age 2.8 months (range 1 week to 96 months), 111 (71%) had recurrent events, 44 were born preterm, 19 were siblings of infants who had died suddenly and...

Samuels, M. P.; Poets, C. F.; Noyes, J. P.; Hartmann, H.; Hewertson, J.; Southall, D. P.

1993-01-01

285

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

OpenAIRE

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...

Bagchi, S.; Deshpande, S. B.

2001-01-01

286

Year in review 2010: Critical Care - cardiac arrest and cardiopulmonary resuscitation  

OpenAIRE

This review will summarize some of the data published in 2010 and focus on papers published in Critical Care in regard to cardiac arrest and cardiopulmonary resuscitation. In particular, we discuss the latest research in therapeutic hypothermia after cardiac arrest, including methods of inducing hypothermia, potential protective mechanisms, spontaneous hypothermia versus therapeutic hypothermia, and several predictors of outcome. Furthermore, we will discuss the effects of bystander-initiated...

Metzger, Jeffery C.; Eastman, Alexander L.; Pepe, Paul E.

2011-01-01

287

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

288

Cardiac examination and the effect of dual-processing instruction in a cardiopulmonary simulator  

OpenAIRE

Use of dual-processing has been widely touted as a strategy to reduce diagnostic error in clinical medicine. However, this strategy has not been tested among medical trainees with complex diagnostic problems. We sought to determine whether dual-processing instruction could reduce diagnostic error across a spectrum of experience with trainees undertaking cardiac physical exam. Three experiments were conducted using a similar design to teach cardiac physical exam using a cardiopulmonary simulat...

Sibbald, Matt; Mckinney, James; Cavalcanti, Rodrigo B.; Yu, Eric; Wood, David A.; Nair, Parvathy; Eva, Kevin W.; Hatala, Rose

2012-01-01

289

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

OpenAIRE

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

Pedro Miguel Garcez Sardo; Grace Teresinha Marcon Dal Sasso

2007-01-01

290

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

OpenAIRE

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

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

1983-01-01

291

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

OpenAIRE

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 kno...

Burkhardt, Joshua N.; Glick, Joshua E.; Terndrup, Thomas E.

2014-01-01

292

Optimizing patient selection for cardiac resynchronization therapy: the role of cardiopulmonary exercise testing  

OpenAIRE

Background: Cardiac resynchronization therapy (CRT) is an established treatment modality for moderate to severe heart failure (HF) but 30–40% of patients treated with CRT do not experience clinical improvement. Purpose: the aim of this study was to identify predictors of response to CRT, in two different definitions of responders, by using the cardiopulmonary exercise testing (CPET) before CRT implantation. In definition A, responders were defined as ?15% improvement in left ventricular e...

Pinto, Maria Rita Da Silva Alexandre

2012-01-01

293

Estradiol after cardiac arrest and cardiopulmonary resuscitation is neuroprotective and mediated through estrogen receptor-?  

OpenAIRE

We evaluated long-term administration of estrogen after cardiac arrest and cardiopulmonary resuscitation (CA/CPR) on neurohistopathological and behavioral outcome. We also examined the effect of estrogen receptor (ER) stimulation using ER-? agonist propyl pyrazole triol (PPT) and ER-? agonist diarylpropionitrile (DPN) on neuronal survival after CA/CPR to determine whether possible neuroprotective effects of estrogen are ER-mediated. Male C57Bl/6 mice underwent 10 mins of CA/CPR and 3-day su...

Noppens, Ruediger R.; Kofler, Julia; Grafe, Marjorie R.; Hurn, Patricia D.; Traystman, Richard J.

2008-01-01

294

Circadian Affective, Cardiopulmonary, and Cortisol Variability in Depressed and Nondepressed Individuals at Risk for Cardiovascular Disease  

OpenAIRE

Depression is a risk factor for cardiovascular disease (CVD) perhaps mediated by hypothalamic-pituitary-adrenal (HPA) axis or vagal dysregulation. We investigated circadian mood variation and HPA-axis and autonomic function in older (?55 years) depressed and nondepressed volunteers at risk for CVD by assessing diurnal positive and negative affect (PA, NA), cortisol, and cardiopulmonary variables in 46 moderately depressed and 19 nondepressed volunteers with elevated CVD risk. Participants s...

Conrad, Ansgar; Wilhelm, Frank H.; Roth, Walton T.; Spiegel, David; Taylor, C. Barr

2007-01-01

295

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

296

Experimental cardiopulmonary cerebral resuscitation : A study of cerebral perfusion with special reference to the postresuscitation disturbances  

OpenAIRE

Ischemic neuronal injury continues to be a major delimiting factor in achieving successful clinical outcomesafter resuscitation from cardiac arrest. In this thesis, a pig model of cardiopulmonary resuscitation (CPR) wasused to address the effects of different interventions on cerebral blood flow and oxygenation during CPR and theinitial postresuscitation period. A novel technique is presented to quantify the reperfusion oxidative injury. Maximization of cerebral blood flow during CPR by open-...

Nozari, Ala

2000-01-01

297

Echocardiographic Predictors of Mortality in Patients with Pulmonary Hypertension and Cardiopulmonary Comorbidities  

Science.gov (United States)

Objective We aimed to identify the echocardiographic measures associated with survival in a patient population with a high prevalence of co-morbid cardiovascular and pulmonary disease that have significantly elevated estimated pulmonary artery systolic pressures (ePASP). Background Pulmonary hypertension (PH) is a clinical feature of several cardiopulmonary diseases that are prevalent among elderly. While certain echocardiographic parameters have been shown to be important in the prognosis in specific PH groups, the prognostic relevance of echocardiographic characteristics in a cohort with multiple cardiopulmonary comorbidities is unclear. Methods We retrospectively identified 152 patients with ePASP > 60 mmHg by echocardiography over a five year period (6/2006–11/2011) and followed until 4/2013. Candidate clinical and echocardiographic characteristics suggestive of PH severity were compared between deceased and surviving subpopulations. Cox proportional hazard modeling was used to identify echocardiographic predictors of death adjusted for age and clinical characteristics. Results This was a predominantly elderly (age 78.8 ± 10.2 years), male (98.7%) cohort with several cardiopulmonary comorbidities. Overall mortality was high (69.7%, median survival 129 days). After adjusting for age and clinical characteristics, decreased right ventricular (RV) systolic function assessed by tricuspid annular plane systolic excursion (HR 0.56, 95% CI 0.33–0.96, p = 0.034) and increased RV thickness (HR: 4.34, 95% CI: 1.49–12.59, p = 0.007) were independently associated with mortality. In contrast, left ventricular systolic function, left ventricular diastolic parameters, ePASP, or echo-derived pulmonary vascular resistance (PVR) were not associated with increased mortality. Conclusion In a cohort of patients with PH and high prevalence of cardio-pulmonary comorbidities, RV systolic function and hypertrophy are associated with mortality and may be the most relevant echocardiographic markers for prognosis. PMID:25774911

Steiner, Johannes; Wu, Wen-Chih; Jankowich, Matthew; Maron, Bradley A.; Sharma, Satish; Choudhary, Gaurav

2015-01-01

298

Cardiopulmonary arrest caused by acute abdominal aortic thrombosis: a case report  

OpenAIRE

Acute abdominal aortic thrombosis is a rare but potentially fatal condition. The patient was a 56-year-old man who developed lower back pain and arrived at our emergency room in a state of shock. He was alert, but could not move his legs. Cardiac echo revealed abnormal movement of the heart, and acute myocardial ischaemia was suspected as a differential diagnosis. Emergency coronary angiography and aortography together with percutaneous cardiopulmonary support were attempted. Both femoral art...

Matsuoka, Yoshinori; Hashizume, Makoto

2009-01-01

299

Synthesis and characterization of macromolecular layers grafted to polymer surfaces  

Science.gov (United States)

The composition and behavior of surfaces and interfaces play a pivotal role in dictating the overall efficiency of the majority of polymeric materials and devices. Surface properties of the materials can be altered using surface modification techniques. It is necessary to highlight that successful methods of surface modification should affect only the upper layer of the polymer material without changing bulk properties. The processes must introduce new functionalities to the surface, optimize surface roughness, lubrication, hydrophobicity, hydrophilicity, adhesion, conductivity, and/or biocompatibility. Research presented in this dissertation is dedicated to the synthesis, characterization, and application of thin macromolecular layers anchored to polymer substrates. Specifically, attachment of functional polymers via a "grafting to" approach has been extensively studied using PET and nylon model substrates. First, poly(glycidyl methacrylate) was used to introduce permanent functionalities to the model substrates by anchoring it to model films. Then, three different functional polymers were grafted on top of the previous layer. As one part of this study, the temperature and time dependence of grafting functional layers were studied. The surface coverage by hydrophobic polymer was determined from experimental data and predicted by a model. In general, the model has a high degree of predictive capability. Next, surface modification of polymeric fibers and membranes is presented as an important application of the polymer thin layers targeted in the study. Specifically, the procedures developed for surface modification of model substrates was employed for modification of PET, nylon, and cotton fabrics as well as PET track-etched membranes. Since epoxy groups are highly reactive in various chemical reactions, the approach becomes virtually universal, allowing both various surfaces and end-functionalized macromolecules to be used in the grafted layer synthesis. PET membranes modified with a reactive anchoring layer can be successfully used to build membrane assemblies by incorporating silica, aluminum, or titanium oxide microparticles as spacers. It is expected that the proposed approaches for the surface modification of the membranes and for the generation of multilayered membrane assemblies can be employed straightforwardly to provide an efficient platform for fabrication of breathable protective materials. Characterization of modified membranes with a cantilever-based method, which can be used for prediction of properties and behavior of thin grafted films, is reported. This technique can be used as a method for fast screening of modified membranes. The method is very robust and capable of detecting very small quantities of substance adsorbed; kinetics of the process can be tracked, as well. This approach can be further developed as a handheld sensor for early warning of the presence of chemical vapors and nerve agents.

Burtovyy, Oleksandr

300

Withholding or termination of resuscitation in pediatric out-of-hospital traumatic cardiopulmonary arrest.  

Science.gov (United States)

This multiorganizational literature review was undertaken to provide an evidence base for determining whether or not recommendations for out-of-hospital termination of resuscitation could be made for children who are victims of traumatic cardiopulmonary arrest. Although there is increasing acceptance of out-of-hospital termination of resuscitation for adult traumatic cardiopulmonary arrest when there is no expectation of a good outcome, children are routinely excluded from state termination-of-resuscitation protocols. The decision to withhold resuscitative efforts in a child under specific circumstances (decapitation or dependent lividity, rigor mortis, etc) is reasonable. If there is any doubt as to the circumstances or timing of the traumatic cardiopulmonary arrest, under the current status of limiting termination of resuscitation in the field to persons older than 18 years in most states, resuscitation should be initiated and continued until arrival to the appropriate facility. If the patient has arrested, resuscitation has already exceeded 30 minutes, and the nearest facility is more than 30 minutes away, involvement of parents and family of these children in the decision-making process with assistance and guidance from medical professionals should be considered as part of an emphasis on family-centered care, because the evidence suggests that either death or a poor outcome is inevitable. PMID:24655460

Fallat, Mary E

2014-04-01

301

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

302

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

Directory of Open Access Journals (Sweden)

Full Text Available 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

2010-07-01

303

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

Scientific Electronic Library Online (English)

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

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

1095-11-01

304

Normal cardiopulmonary responses during incremental exercise in 20- to 70-yr-old men.  

Science.gov (United States)

Healthy men (N = 1424, age 20-70 yr) underwent a progressive incremental treadmill exercise test to volitional maximum. Cardiopulmonary variables were measured breath-by-breath. The aerobic power (VO2max) declined at an average yearly rate of 0.33 ml.kg.-1min-1, HRmax declined 0.685 beats.min-1.yr-1, and max O2 pulse declined at an annual rate of 0.115 ml.beat-1.kg-1*100. Gas exchange threshold (GET) expressed as percentage of VO2max was 58% and 69% in the youngest (20-30 yr) and oldest (61-70 yr) decades, respectively. The average decline in VE, Vt, f, and PETCO2 over the entire age range was 29%, 10%, 21%, and 7%, respectively. There were increases in VE/VO2, and VE/VECO2, from age 20-70 yr of 13% and 14%, respectively, but no changes across 5 decades in PETO2. Physical (height and weight) as well as life-style characteristics (leisure time activity, place of residency, smoking), were found to be potent predictors in most of the cardiopulmonary values at maximal exercise and therefore should be incorporated in the predictive equations for such variables. Normal response patterns of most cardiopulmonary variables throughout the range of exercise intensities were shown to be age-affected and thus should be standardized for age decades. PMID:8007799

Inbar, O; Oren, A; Scheinowitz, M; Rotstein, A; Dlin, R; Casaburi, R

1994-05-01

305

Effect of bidispersity in grafted chain length on grafted chain conformations and potential of mean force between polymer grafted nanoparticles in a homopolymer matrix.  

Science.gov (United States)

In efforts to produce polymeric materials with tailored physical properties, significant interest has grown around the ability to control the spatial organization of nanoparticles in polymer nanocomposites. One way to achieve controlled particle arrangement is by grafting the nanoparticle surface with polymers that are compatible with the matrix, thus manipulating the interfacial interactions between the nanoparticles and the polymer matrix. Previous work has shown that the molecular weight of the grafted polymer, both at high grafting density and low grafting density, plays a key role in dictating the effective inter-particle interactions in a polymer matrix. At high grafting density nanoparticles disperse (aggregate) if the graft molecular weight is higher (lower) than the matrix molecular weight. At low grafting density the longer grafts can better shield the nanoparticle surface from direct particle-particle contacts than the shorter grafts and lead to the dispersion of the grafted particles in the matrix. Despite the importance of graft molecular weight, and evidence of non-trivial effects of polydispersity of chains grafted on flat surfaces, most theoretical work on polymer grafted nanoparticles has only focused on monodisperse grafted chains. In this paper, we focus on how bidispersity in grafted chain lengths affects the grafted chain conformations and inter-particle interactions in an implicit solvent and in a dense homopolymer polymer matrix. We first present the effects of bidispersity on grafted chain conformations in a single polymer grafted particle using purely Monte Carlo (MC) simulations. This is followed by calculations of the potential of mean force (PMF) between two grafted particles in a polymer matrix using a self-consistent Polymer Reference Interaction Site Model theory-Monte Carlo simulation approach. Monte Carlo simulations of a single polymer grafted particle in an implicit solvent show that in the bidisperse polymer grafted particles with an equal number of short and long grafts at low to medium grafting density, the short grafts are in a more coiled up conformation (lower radius of gyration) than their monodisperse counterparts to provide a larger free volume to the longer grafts so they can gain conformational entropy. The longer grafts do not show much difference in conformation from their monodisperse counterparts at low grafting density, but at medium grafting density the longer grafts exhibit less stretched conformations (lower radius of gyration) as compared to their monodisperse counterparts. In the presence of an explicit homopolymer matrix, the longer grafts are more compressed by the matrix homopolymer chains than the short grafts. We observe that the potential of mean force between bidisperse grafted particles has features of the PMF of monodisperse grafted particles with short grafts and monodisperse grafted particles with long grafts. The value of the PMF at contact is governed by the short grafts and values at large inter-particle distances are governed by the longer grafts. Further comparison of the PMF for bidisperse and monodisperse polymer grafted particles in a homopolymer matrix at varying parameters shows that the effects of matrix chain length, matrix packing fraction, grafting density, and particle curvature on the PMF between bidisperse polymer grafted particles are similar to those seen between monodisperse polymer grafted particles. PMID:21599087

Nair, Nitish; Wentzel, Nathaniel; Jayaraman, Arthi

2011-05-21

306

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

Directory of Open Access Journals (Sweden)

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

Hassani E

2009-12-01

307

Onlay Bone Grafts in Head and Neck Reconstruction  

OpenAIRE

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

Yazar, Sukru

2010-01-01

308

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 application of the principle Last in First Out (LIFO) in the case of retrenchment in Malaysia. This article will also assess to what extent the courts defend the prerogative of the employer to retrench his employee in the case of redun...

Hamidah Marsono; Hj. Kamaruzaman Jusoff

2008-01-01

309

Retrenchment in Malaysia: Employer’s Right?  

Directory of Open Access Journals (Sweden)

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

Hamidah Marsono

2008-11-01

310

Design and development of multilayer vascular graft  

Science.gov (United States)

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

Madhavan, Krishna

2011-07-01

311

Improvement of polymer stability by radiation grafting  

International Nuclear Information System (INIS)

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

312

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

Directory of Open Access Journals (Sweden)

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

Zou RongJiang

2012-09-01

313

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

International Nuclear Information System (INIS)

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

314

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

Energy Technology Data Exchange (ETDEWEB)

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

2007-06-15

315

Nanotribological study of grafted polymer  

Science.gov (United States)

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

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

1998-06-01

316

Can the Cardiopulmonary 6-Minute Walk Test Reproduce the Usual Activities of Patients with Heart Failure?  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: The 6-minute walk test is an way of assessing exercise capacity and predicting survival in heart failure. The 6-minute walk test was suggested to be similar to that of daily activities. We investigated the effect of motivation during the 6-minute walk test in heart failure. METHODS: We studied 12 males, age 45±12 years, ejection fraction 23±7%, and functional class III. Patients underwent the following tests: maximal cardiopulmonary exercise test on the treadmill (max, cardiopulmonary 6-minute walk test with the walking rhythm maintained between relatively easy and slightly tiring (levels 11 and 13 on the Borg scale (6EB, and cardiopulmonary 6-minute walk test using the usual recommendations (6RU. The 6EB and 6RU tests were performed on a treadmill with zero inclination and control of the velocity by the patient. RESULTS: The values obtained in the max, 6EB, and 6RU tests were, respectively, as follows: O2 consumption (ml.kg-1.min-1 15.4±1.8, 9.8±1.9 (60±10%, and 13.3±2.2 (90±10%; heart rate (bpm 142±12, 110±13 (77±9%, and 126±11 (89±7%; distance walked (m 733±147, 332±66, and 470±48; and respiratory exchange ratio (R 1.13±0.06, 0.9±0.06, and 1.06±0.12. Significant differences were observed in the values of the variables cited between the max and 6EB tests, the max and 6RU tests, and the 6EB and 6RU tests (p<0.05. CONCLUSION: Patients, who undergo the cardiopulmonary 6-minute walk test and are motivated to walk as much as they possibly can, usually walk almost to their maximum capacity, which may not correspond to that of their daily activities. The use of the Borg scale during the cardiopulmonary 6-minute walk test seems to better correspond to the metabolic demand of the usual activities in this group of patients.

Guimarães Guilherme Veiga

2002-01-01

317

A comparison between the HeRO graft and conventional arteriovenous grafts in hemodialysis patients.  

Science.gov (United States)

Venous stenosis and occlusion are a major cause of vascular access dysfunction and failure. The HeRO Graft bypasses occlusion and traverses stenosis with outflow directly into the central venous circulation. A randomized, multicenter study was conducted to evaluate the efficacy and safety of the HeRO Graft relative to conventional AV grafts. The design was to enroll 143 patients in a 2:1 randomization ratio between HeRO and conventional AV control groups. Data on 72 subjects (52 HeRO Graft and 20 AV graft controls) were obtained. The HeRO Graft and control cohorts were comparable in baseline characteristics. Adequacy of dialysis, bacteremia rates, and adverse events were consistent between groups. Twelve month Kaplan-Meier estimates for primary and secondary patency rates were 34.8% and 67.6% in the HeRO Graft cohort, and 30.6% and 58.4% in the control cohort. There was no statistical difference in terms of patency between groups. The rates of intervention were 2.2/year for HeRO Graft and 1.6/year for the control (p = 0.100). Median days to loss of secondary patency was 238 for HeRO Graft versus 102 for the control (p = 0.032). The HeRO Graft appears to provide similar patency, adequacy of dialysis, and bacteremia rates to those of conventional AV grafts. PMID:24428351

Nassar, George M; Glickman, Marc H; McLafferty, Robert B; Croston, J Kevin; Zarge, Joseph I; Katzman, Howard E; Peden, Eric K; Lawson, Jeffrey H; Martinez, Jeffrey M; Thackeray, Lisa

2014-01-01

318

Emerging concepts in liver graft preservation  

Science.gov (United States)

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

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

2015-01-01

319

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

320

Strategic sequences in fat graft survival.  

Science.gov (United States)

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

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

2015-03-01

321

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

322

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)

323

Coronary artery grafting in infants  

Science.gov (United States)

Background Coronary artery bypass grafting (CABG) with cardiac vale repair is an uncommon surgery in infants. CABG is technically demanding in infants due to the small size not only of the coronary arteries but also the potential graft arteries. The short and long-term outcome of surgery is not known and thus has largely been avoided. Results We report the case histories of two infants in whom CABG was undertaken successfully as a life-saving measure. Case 1: This infant needed an arterial switch operation after which the right coronary artery (RCA) was stenosed resulting in low cardiac output. After the right internal mammary artery (RIMA) was used to anastamose the RCA, the hemodynamic status improved drastically. Case 2: This infant underwent surgical correction for Anomalous Left Coronary Artery from Pulmonary Artery (ALCAPA). Postoperatively, she was in low cardiac output. She was found to have an occluded left coronary artery and mitral regurgitation (MR). After she underwent left internal mammary artery (LIMA) to Left Anterior Descending (LAD) anastamosis and mitral valve repair, the clinical condition improved dramatically. Conclusion CABG is an uncommon operation in infants. This surgery is technically difficult. The long term results are not known and there are very few reports for the same. Though such an operation is best avoided, it can be used as a desperate life saving measure. PMID:22368554

Gopal, MR; Maskari, S; Zacharias, S; Valliathu, J

2009-01-01

324

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

325

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

Scientific Electronic Library Online (English)

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

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

2000-03-01

326

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

327

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

328

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

International Nuclear Information System (INIS)

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

329

The employer’s perspective on retirement  

OpenAIRE

In this chapter we discuss the literature with respect to the role of employers in retirement processes of older workers and provide suggestions for future research. In the first part of this chapter we will review existing theoretical insights regarding the employers’ actions and attitudes toward older workers and retirement. In the next section we will discuss empirical findings with regard to age related stereotypes in the workplace and age norms with respect to retirement and present so...

Henkens, C. J. I. M.; Dalen, H. P.

2011-01-01

330

Radiation induced graft copolymerization for preparation of cation exchange membranes: a review  

International Nuclear Information System (INIS)

Cation exchange membranes are regarded as the ideal solid polymer electrolyte materials for the development of various electrochemical energy conversion applications where significant improvements in the current density are required. Such membranes require special polymers and preparation techniques to maintain high chemical , mechanical and thermal stability in addition to high ionic conductivity and low resistance. A lot of different techniques have been proposed in the past to prepare such membranes. Radiation-induced graft copolymerization provides an attractive ft method for modification of chemical and physical properties of polymeric materials and is of particular interest in achieving specially desired cation exchange membranes as well as excellent membrane properties. This is due to the ability to control the membrane compositions as well as properties by proper selection of grafting conditions. Therefore numerous parameters have to be investigated to properly select the right polymeric materials, radiation grafting technique and the grafting conditions to be employed. In this paper a state-of-the-art of radiation-induced graft copolymerization for preparation of cation exchange membranes and their applications are briefly reviewed. (Author)

331

Surface grafting density analysis of high anti-clotting PU-Si-g-P(MPC) films  

Energy Technology Data Exchange (ETDEWEB)

Well-defined zwitterionic polymer brushes with good blood compatibility were studied, grafted from polyurethane (PU) substrate (PU-Si-g-P(MPC)) by surface-initiated reverse atom transfer radical polymerization (SI-RATRP). We found that the structure of polymer brushes and hence their properties greatly depend on the grafting density. To solve the problems of the normal method for grafting density measurement, i.e., more requirements for qualified and proficient instrument operator, we established an effective and feasible way instead of the conventional method of spectroscopic ellipsometer combined with gel permeation chromatograph (ELM/GPC) to calculate the grafting density of PU-Si-g-P(MPC) films by using a software named ImageJ 1.44e in combination with scanning electronic microscope (SEM) or atomic microscope (AFM). X-ray photoelectron spectroscopy (XPS), SEM and AFM were employed to analyze the surface topography and changes of elements before and after graft modification of the synthetic PU-Si-g-P(MPC) biofilms.

Lu Chunyan [Jiangsu Key Laboratory of Biofunctional Materials, College of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210097 (China); Jiangsu Engineering Research Center for Biomedical Function Materials, Nanjing Normal University, Nanjing 210097 (China); Zhou Ninglin, E-mail: ninglinzhou@yahoo.com [Jiangsu Key Laboratory of Biofunctional Materials, College of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210097 (China); Jiangsu Engineering Research Center for Biomedical Function Materials, Nanjing Normal University, Nanjing 210097 (China); Jiangsu Technological Research Center for Interfacial Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093 (China); Xiao Yinghong; Tang Yida; Jin Suxing; Wu Yue [Jiangsu Key Laboratory of Biofunctional Materials, College of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210097 (China); Jiangsu Engineering Research Center for Biomedical Function Materials, Nanjing Normal University, Nanjing 210097 (China); Zhang Jun; Shen Jian [Jiangsu Key Laboratory of Biofunctional Materials, College of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210097 (China); Jiangsu Engineering Research Center for Biomedical Function Materials, Nanjing Normal University, Nanjing 210097 (China); Jiangsu Technological Research Center for Interfacial Chemistry and Chemical Engineering, Nanjing University, Nanjing 210093 (China)

2012-02-01

332

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

Directory of Open Access Journals (Sweden)

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

333

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

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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

334

Cistatina C e taxa de filtração glomerular em cirurgia cardíaca com circulação extracorpórea / Cystatin C and glomerular filtration rate in the cardiac surgery with cardiopulmonary bypass  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese OBJETIVO: Avaliar a cistatina C como marcador de função renal em pacientes submetidos à cirurgia de cardíaca com circulação extracorpórea, comparando com a dosagem sérica de creatinina. MÉTODOS: Foram analisados 50 pacientes consecutivos submetidos à cirurgia de revascularização do miocárdio. A funç [...] ão renal foi avaliada com a dosagem sérica de cistatina C e de creatinina no pré-operatório, no primeiro e no quinto dia de pós-operatório. Foram utilizadas as fórmulas de Cockcroft-Gault (CG) e Modification of Diet in Renal Disease (MDRD) para calcular a taxa de filtração glomerular estimada (TFG) através da creatinina, e a fórmula de Larsson para a TFG estimada através da cistatina C (TFG-Cis). RESULTADOS: A creatinina e o TFG através das fórmulas de CG e MDRD não mostraram diferença significativa nos momentos estudados. Após a agressão renal pela cirurgia, houve um aumento da cistatina C no 1º e 5º pós-operatório, sendo que no 5º pós-operatório com diferença estatisticamente significativa (P Abstract in english OBJECTIVE: The aim of this study was to compare cystatin C versus creatinine as a marker for acute kidney injury in patients submitted to cardiac surgery with cardiopulmonary bypass. METHODS: Fifty consecutive patients submitted to coronary artery bypass grafting were studied. Renal function was eva [...] luated by serum cystatin C and creatinine. Blood samples were obtained from each patient at three time points: before operation, and on the first and fifth postoperative days. Glomerular filtration rate (GFR) was calculated by Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Larsson (Cys-GFR) formulas. RESULTS: Creatinine and GFR by CG and MDRD formulas did not show statistical difference between study times. After renal injury from surgery, there was an increase in cystatin C on the 1st and 5th day after surgery, being significantly different on the 5th postoperative (P

Marcello Laneza, Felicio; Rubens Ramos de, Andrade; Yara Marcondes Machado, Castiglia; Marcos Augusto de Moraes, Silva; Pedro Thadeu Galvão, Vianna; Antonio Sergio, Martins.

2009-09-01

335

Radiation-induced graft copolymerization to polyester, 18  

International Nuclear Information System (INIS)

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

336

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

Scientific Electronic Library Online (English)

Full Text Available A parada cardiorrespiratória (PCR) é intercorrência de grave ameaça à vida; a ressuscitação cardiopulmonar (RCP) representa desafio para a investigação e a avaliação por parte do enfermeiro e sua equipe. Esse estudo apresenta as mais recentes recomendações internacionais sobre atendimento da parada [...] cardiorrespiratória, baseado nas Diretrizes de 2005 da American Heart Association (AHA). Essas diretrizes sobre RCP fundamentam-se num processo de revisão extenso, organizado pelo International Liasion Committee on Resuscitation (ILCOR). As manobras básicas e avançadas de RCP com qualidade podem salvar vidas. Abstract in spanish La parada cardiorrespiratoria (PCR) es una ocurrencia que presenta una grave amenaza a la vida; la resucitación cardiopulmonar (RCP) representa un desafío para la investigación y la evaluación por parte del enfermero y su equipo. Este estudio presenta las más recientes recomendaciones internacionale [...] s sobre la atención a la parada cardiorrespiratoria, basada en las Directrices de 2005 de la American Heart Asociation (AHA). Esas directrices sobre RCP se fundamentan en un proceso de revisión extenso, organizado por el International Liasion Committee on Resuscitation (ILCOR). Las maniobras básicas y avanzadas de RCP ofrecidas con calidad pueden salvar vidas. Abstract in english Cardiopulmonary arrest (CPA) poses a severe threat to life; cardiopulmonary resuscitation (CPR) represents a challenge for research and assessment by nurses and their team. This study presents the most recent international recommendations for care in case of cardiopulmonary heart arrest, based on th [...] e 2005 Guidelines by the American Heart Association (AHA). These CPR guidelines are based on a large-scale review process, organized by the International Liaison Committee on Resuscitation (ILCOR). High-quality basic and advanced CPR maneuvers can save lives.

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

337

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

338

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.

339

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

340

Sedative and cardiopulmonary effects of medetomidine and reversal with atipamezole in desert tortoises (Gopherus agassizii).  

Science.gov (United States)

Ten desert tortoises (Gopherus agassizii) were given i.m. injections of 150 microg/kg of medetomidine. Sedation was achieved in all tortoises by 20 min postinjection and was accompanied by a significant decrease in mean heart and respiratory rates, systolic, diastolic, and mean ventricular pressures, and mean ventricular partial pressure of oxygen (PO2). There was no change in mean blood pH, HCO3, Na+, K+, ionized calcium values, and mean ventricular partial pressure of carbon dioxide (PCO2). There were statistically significant but clinically insignificant changes in mean base excess and pH-corrected ionized calcium values. Atipamezole given to five of the tortoises at 0.75 mg/kg i.m. significantly reversed the sedative effects of the medetomidine, with all tortoises returning to a normal state by 30 min after administration of the reversal agent. In comparison, the other five tortoises given an equal volume of physiologic saline in place of atipamezole (control group) remained significantly sedated for the duration of the study. In addition, the heart rate and ventricular PO2 returned to baseline, but the respiratory rate and ventricular blood pressures were not significantly altered by the atipamezole as compared with those of the control group. These cardiopulmonary and physiologic effects are similar to those seen in some domestic mammals. Medetomidine can be used to safely induce sedation in desert tortoises. For procedures lasting greater than 120 min, supplemental oxygen should be provided. Atipamezole will reverse the sedation but not all of the cardiopulmonary effects, thus necessitating continued monitoring after reversal. Future studies should address the anesthetic and cardiopulmonary effects of medetomidine in combination with other agents such as ketamine and/or butorphanol. PMID:10884120

Sleeman, J M; Gaynor, J

2000-03-01

341

Can the Cardiopulmonary 6-Minute Walk Test Reproduce the Usual Activities of Patients with Heart Failure?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: The 6-minute walk test is an way of assessing exercise capacity and predicting survival in heart failure. The 6-minute walk test was suggested to be similar to that of daily activities. We investigated the effect of motivation during the 6-minute walk test in heart failure. METHODS: We st [...] udied 12 males, age 45±12 years, ejection fraction 23±7%, and functional class III. Patients underwent the following tests: maximal cardiopulmonary exercise test on the treadmill (max), cardiopulmonary 6-minute walk test with the walking rhythm maintained between relatively easy and slightly tiring (levels 11 and 13 on the Borg scale) (6EB), and cardiopulmonary 6-minute walk test using the usual recommendations (6RU). The 6EB and 6RU tests were performed on a treadmill with zero inclination and control of the velocity by the patient. RESULTS: The values obtained in the max, 6EB, and 6RU tests were, respectively, as follows: O2 consumption (ml.kg-1.min-1) 15.4±1.8, 9.8±1.9 (60±10%), and 13.3±2.2 (90±10%); heart rate (bpm) 142±12, 110±13 (77±9%), and 126±11 (89±7%); distance walked (m) 733±147, 332±66, and 470±48; and respiratory exchange ratio (R) 1.13±0.06, 0.9±0.06, and 1.06±0.12. Significant differences were observed in the values of the variables cited between the max and 6EB tests, the max and 6RU tests, and the 6EB and 6RU tests (p

Guilherme Veiga, Guimarães; Giovanni, Bellotti; Fernando, Bacal; Amilcar, Mocelin; Edimar Alcides, Bocchi.

2002-06-01

342

Free graft techniques in skull base reconstruction.  

Science.gov (United States)

Over the last 20-30 years, the management of anterior skull base defects, CSF leaks and encephaloceles has shifted towards endoscopic, minimally invasive approaches. Whether their etiology is spontaneous or traumatic, the large majority of these lesions can be repaired with free mucosal grafts. Such grafts may be readily harvested from the nasal septum or turbinates and applied as either a single layer reconstruction for small leaks or as a multilayer reconstruction for larger defects. The accessibility, ease of placement, and high take rate associated with free mucosal grafts makes them a wise and popular choice for reconstruction of many skull base defects. PMID:23257550

Ting, Jonathan Y; Metson, Ralph

2013-01-01

343

Graft polymerization produced by ionizing radiation  

International Nuclear Information System (INIS)

Radiation-induced graft polymerization has developed as an independent discipline with its own methodology to deal with a wide range of practical tasks relating to the general problem of producing materials with given combinations of properties. The various aspects of this discipline are the grafting techniques, the regularities and mechanisms involved, the structures and properties of the materials, and aspects of implementing radiation grafting under engineering conditions. This paper characterizes the general history of this line and the current state of the art; only the key aspects are considered

344

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.

345

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

346

Effect of short-acting beta blocker on the cardiac recovery after cardiopulmonary bypass  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract The objective of this study was to investigate the effect of beta blocker on cardiac recovery and rhythm during cardiac surgeries. Sixty surgical rheumatic heart disease patients were received esmolol 1 mg/kg or the same volume of saline prior to removal of the aortic clamp. The incidence of cardiac automatic re-beat, ventricular fibrillation after reperfusion, the heart rate after steady re-beat, vasoactive drug use during weaning from bypass, the posterior parallel time and total bypass time were decreased by esmolol treatment. In conclusion: Esmolol has a positive effect on the cardiac recovery in cardiopulmonary bypass surgeries.

Qian Yanning

2011-08-01

347

First notification in Italy of cardiopulmonary filariosis (heartworm disease) in a wolf (Canis lupus).  

Science.gov (United States)

The authors report on the first notification of filariosis (heartworm disease) caused by Dirofilaria immitis in a wolf (Canis lupus) in Italy. On account of this exceptional finding, the parasite was typed not only using traditional methods, such as stereomicroscopic examination, but also using highly innovative diagnostic methods, such as scanning electron microscope and molecular identification with the application of various recently developed methods (polymerase chain reaction and sequencing). Certain aspects regarding the epidemiology of the disease are discussed in the light of this first case in Italy that occurred in an area in which cardiopulmonary filiariasis had not previously been reported in wild or domestic carnivores. PMID:20422563

Pascucci, Ilaria; Fico, Rosario; D'Angelo, Anna Rita; Serini, Sabrina; Cammà, Cesare

2007-01-01

348

Plasma macrophage colony-stimulating factor levels during cardiopulmonary bypass with extracorporeal circulation  

OpenAIRE

Leukocytosis and thrombocytopenia occur during cardiopulmonary bypass (CPB) with extracorporeal circulation (ECC). Elevated circulating concentrations of macrophage colony-stimulating factor (M-CSF) are reported during thrombocytopenia and leukopenia of different origins. We have assessed M-CSF concentrations in 40 patients undergoing CPB with ECC. Plasma M-CSF concentrations were stable during ECC and increased at the 6th (7.3 ± 0.7 IU/?g protein) and 24th (8.6 ± 0.8 IU/?g protein) posto...

Denizot, Y.; Fixe, P.; Cornu, E.; Nathan, N.

1996-01-01

349

Cardiopulmonary arrest following administration of Cyclomydril eyedrops for outpatient retinopathy of prematurity screening.  

Science.gov (United States)

Eyedrops used for mydriasis and cycloplegia can be systemically absorbed, causing serious side effects, including oxygen desaturation, apnea, bradycardia, transient hypertension, delayed gastric emptying, and transient paralytic ileus. These effects can be more serious in infants because of their lower body mass and immature cardiovascular and nervous systems. We report a case of a 27-week-old infant who suffered a cardiopulmonary arrest after the administration of only Cyclomydril eyedrops (Alcon Laboratories, Fort Worth, TX) during an outpatient retinopathy of prematurity examination. PMID:24698618

Lee, Jung M; Kodsi, Sylvia R; Gaffar, Majida A; Rubin, Steven E

2014-04-01

350

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

351

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

352

Cardiopulmonary effects in awake rats four and six months after exposure to methyl isocyanate.  

OpenAIRE

Cardiopulmonary function was assessed four and six months after Fischer 344 rats were exposed to 2 hr to 0, 3, or 10 ppm methyl isocyanate (MIC). During assessment, the rats were challenged with 4 and 8% carbon dioxide (CO2) to stimulate ventilatory drive. Minute ventilation (VE) during CO2 challenge was increased in MIC-treated rats compared to controls when examined 4 months after exposure to 10 ppm MIC, suggesting a ventilation/perfusion inequality. An increase in maximum expiratory flow a...

Tepper, J. S.; Wiester, M. J.; Costa, D. L.; Watkinson, W. P.; Weber, M. F.

1987-01-01

353

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

DEFF Research Database (Denmark)

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

Kjærgaard, Benedict; Rasmussen, Bodil Steen

2012-01-01

354

Coronary Artery Bypass Grafting Combined with Total Occlusion of Internal Carotid Artery  

Directory of Open Access Journals (Sweden)

Full Text Available Background: The presence of significant carotid stenosis in coronary artery bypass grafting (CABG patients increases the risk of either transient ischemic attack or stroke. However, there is a dearth of data on the risk for patients with unilateral total occlusion of the carotid artery. We herein report our results of cardiac surgery in patients with unilateral total occlusion of the carotid artery. Methods: We examined 10,000 patients who underwent carotid artery duplex scanning before CABG or other cardiac procedures between January 2001 and September 2006 at Tehran Heart Center. The occlusions were detected via carotid Doppler screening and were confirmed through conventional or MR angiography. Among these patients, 15 (0.15% patients had unilateral total occlusion of the internal carotid artery, and all of them underwent elective cardiac surgery. During cardiopulmonary bypass, the mean arterial pressure was maintained at above 60 mmHg with vasopressure drugs and increasing flow pump.Results: There were 4 patients with left and 11 patients with right carotid occlusions. Four patients had a history of cerebrovascular accident. The mean cross-clamp time (min and perfusion time (min was 50.7±17.3 and 94.2±26.7, respectively. The mean graft number was 4.1±0.9. One of these patients expired intraoperatively because of low cardiac output. In one (6.66% patient, postoperative cerebrovascular accident occurred on the contralateral side of the totally occluded region. All the patients recovered uneventfully. Conclusion: Our results suggest that CABG can be performed in patients with unilateral total occlusion of the internal carotid artery without ipsilateral stroke using our strategies.

Seyed Hesameddin Abbasi

2008-08-01

355

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

Directory of Open Access Journals (Sweden)

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

Habib Cakir

2012-10-01

356

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

Science.gov (United States)

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

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

2015-07-15

357

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

358

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

359

Overview of supported employment.  

OpenAIRE

This article traces the emergence of supported employment as a result of philosophical changes in expectations for persons with disabilities, based on scientific developments that challenged traditional service-delivery models. Supported employment program characteristics also are reviewed, and the influence of applied behavior analysis is outlined. Finally, areas for future research in supported employment are discussed.

Rusch, F. R.; Hughes, C.

1989-01-01

360

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

361

Pinch grafting for chronic venous leg ulcers in general practice  

OpenAIRE

Twenty-five patients with chronic venous leg ulcers were treated in general practice by pinch grafting. Fifteen of the ulcers (60%) were completely healed one year after grafting. Prior to grafting 19 patients (76%) complained of daily pain in the ulcer. These patients experienced complete relief from pain after grafting. Pinch grafting is a simple, safe and effective therapy when applied in a domiciliary environment.

Steele, Keith

1985-01-01

362

Effect of monomer concentration on the degree of grafting and mechanical properties of grafted rubber film  

International Nuclear Information System (INIS)

The effect of concentration of monomer on the properties of grafted rubber film was studied. =rays obtained from Co-60 source were used as initiator for grafting. For this purpose latex concentration was kept constant. The mechanical properties of grafted rubber films like tensile strength, modulus, tear strength and elongation at break were determined. Tensile strength attains maximum at 50 phr (parts per hundred rubber) concentration of monomer and after this concentration it remains almost unchanged. On the other hand tear strength and modulus increase with increase in concentration of monomer but elongation at break decreases. The conversion of monomer to polymers and degree of grafting were also determined. (author)

363

Synthesis and characterization of nanoscale polymer films grafted to metal surfaces  

Science.gov (United States)

Anchoring thin polymer films to metal surfaces allows us to alter, tune, and control their biocompatibility, lubrication, friction, wettability, and adhesion, while the unique properties of the underlying metallic substrates, such as magnetism and electrical conductivity, remain unaltered. This polymer/metal synergy creates significant opportunities to develop new hybrid platforms for a number of devices, actuators, and sensors. This present work focused on the synthesis and characterization of polymer layers grafted to the surface of metal objects. We report the development of a novel method for surface functionalization of arrays of high aspect ratio nickel nanowires/micronails. The polymer "grafting to" technique offers the possibility to functionalize different segments of the nickel nanowires/micronails with polymer layers that possess antagonistic (hydrophobic/hydrophilic) properties. This method results in the synthesis of arrays of Ni nanowires and micronails, where the tips modified with hydrophobic layer (polystyrene) and the bottom portions with a hydrophilic layer (polyacrylic acid). The developed modification platform will enable the fabrication of switchable field-controlled devices (actuators). Specifically, the application of an external magnetic field and the bending deformation of the nickel nanowires and micronails will make initially hydrophobic surface more hydrophilic by exposing different segments of the bent nanowires/micronails. We also investigate the grafting of thin polymer films to gold objects. The developed grafting technique is employed for the surface modification of Si/SiO2/Au microprinted electrodes. When electronic devices are scaled down to submicron sizes, it becomes critical to obtain uniform and robust insulating nanoscale polymer films. Therefore, we address the electrical properties of polymer layers of poly(glycidyl methacrylate) (PGMA), polyacrylic acid (PAA), poly(2-vinylpyridine) (P2VP), and polystyrene (PS) grafted to the Si/SiO2/Au microprinted electrodes. The polymer layers insulated under normal ambient conditions can display a significant increase in conductivity as the environment changes. Namely, we demonstrate that the in-plane electrical conductivity of the grafted polymer layers grafted to Au and SiO2 surfaces can be changed by at least two orders of magnitude upon exposure to water or organic solvent vapors. The conductive properties of all the grafted polymer films under study are also significantly enhanced with temperature increase. The observed phenomenon makes possible the chemical design of polymer nanoscale layers with reduced or enhanced sensitivity to anticipated changes in environmental conditions. Finally, we show that the observed effects can be used in a micron-sized conductometric-transducing scheme for the detection of volatile organic solvents. This research also includes the study of nanoscale-level actuation with grafted polymer films and polymer/gold nanoparticles systems-grafted composites. First, we investigate the nanoscale-level actuation with polymer films. To this end, we use "grafting to" approach to synthesize PGMA thin polymer film (80-200 nm). Then, film is swollen in a good solvent and freeze-dried until the solvent is sublimated, thereby creating grafted polymer nanofoam that exhibits shape memory properties. We demonstrate nanoscale actuation using the developed system. In addition, we show that the modification of the PGMA nanofoam with low molecular weight polystyrene allows response tuning of the porous polymer film. Furthermore, we incorporate gold nanoparticles (5 nm) into a thin PGMA layer (80 nm) to fabricate a PGMA/gold nanoparticles grafted composite film. The PGMA/gold nanoparticles grafted nanofoam is synthesized following the same procedure developed for the fabrication of the PGMA nanofoam. We demonstrate the shape-memory properties and nanoscale-level actuation of the developed system. Moreover, we investigate the change in the optical signal of the developed system as a function of temperature arisi

Galabura, Yuriy

364

Effect of different grafting methods for absorption, translocation and distribution of 59Fe in apple trees  

International Nuclear Information System (INIS)

The test result with 59Fe demonstrate that the iron content in leaves by belly grafting is higher than that by cleft grafting and cutting grafting, and the content of chlorophyll in leaves and height and diameter of apple seedling by belly grafting is larger than cleft grafting and cutting grafting too. It is important to replace cleft grafting and cutting grafting with belly grafting as a method of top-working to correct chlorosis and improve growth of new cultivar

365

Influence of triflusal on platelet activation after coronary artery bypass graft.  

Science.gov (United States)

The aim of the study was to investigate the effects of the antiplatelet agent triflusal on the changes in platelet function in patients who underwent a cardiopulmonary bypass for coronary arteries (CABG). In 20 surgical patients, blood was sampled before and at the conclusion of surgery, 48 h later (in the intensive care unit), and after 10 days of treatment with 600 mg/day triflusal (triflusal was administered from the first day after surgery). Adenosine diphosphate (ADP) and collagen-induced platelet aggregation in whole blood, granular release of beta-thromboglobulin and platelet release of thromboxane B2 were measured. Basal values were compared with results in a group of ten healthy volunteers. All platelet determinations of activation were higher in coronary patients than in healthy volunteers. Immediately after CABG, the platelet reactivity to ADP and collagen were significantly lower, and release of beta-thromboglobulin and thromboxane B2 were higher, than in the pre-CABG samples. During the patient's stay in the intensive care unit, all values tend to return to pre-CABG values. Triflusal inhibits both platelet beta-thromboglobulin (63% with respect to the post-CABG value) and thromboxane B2 (91% with respect to the post-CABG value) release. Platelet aggregation after 10 days of triflusal treatment tended to return to the pre-CABG values. In conclusion, Triflusal reduces platelet activation caused by the coronary artery bypass graft surgery. PMID:10759013

Prieto, M A; De La Cruz, J P; Del Prado, M F; Sánchez de la Cuesta, F

2000-03-01

366

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

367

What Is Coronary Artery Bypass Grafting (CABG)?  

Science.gov (United States)

... Rhead, MA What is Coronary Artery Bypass Grafting (CABG)? What Can Happen When Blockages Occur in the ... Risks or Potential Complications to Consider Prior to CABG? What are the Risks of Surgery? What are ...

368

CT diagnosis of aortic graft infections  

International Nuclear Information System (INIS)

Two cases of aortic graft infections diagnosed by computed tomography (CT) are presented. CT scans demonstrated a zone of low attenuation in the perigraft area, in one case with a rim enhancement. The diagnoses were verfied by operation. (orig.)

369

Radiation-induced grafting onto wool  

International Nuclear Information System (INIS)

Radiation-induced grafting tests were done on single wool fibres. Different vinyl monomers were used for this purpose and they were grafted in twenty different solvents which were selected for their swelling effiency and solvent parameters. The tests were done once with and once without the addition of water. The presence of water causes the polymer uptake to increase considerably. Formic acid/methanol and methanol were found to be the most suitable solvent systems, as they have the highest hydrogen-bond interaction effiency. The moisture uptake of wool depends on the hydrophily and hydrophoby of the grafted polymers. The single-fibre tests serve as a basis for analogous grafting tests on wool fabrics. The permanent- press was improved by graftng with hydrophoric polymers and polymers with a high glass-transition temperature

370

Subepithelial connective tissue graft: a case report  

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Full Text Available Introduction and objective: Marginal tissue recession represents a common condition in Periodontology. Miller’s Classes I and II recessions, in which the etiological factors are well diagnosed and eliminated, show great predictability of total coverage when the technique of subepithelial connective tissue graft is used. This technique success has been mainly attributed to the double blood supply for graft’s nutrition, originating from the connective tissue of both the periosteum and flap. Case report and conclusion: The authors reported a clinical case in which a Miller’s Class I recession was treated by the surgical technique of subepithelial connective tissue graft, obtaining total coverage, eliminating the aesthetic deficiency and the dentin hypersensitivity complained by patient.

Juliana Alcarás Saraiva

2011-07-01

371

Management of Peyronie's Disease by Dermal Grafting  

OpenAIRE

Purpose: To evaluate the results of plaque excision and dermal grafting in Peyronie’s disease.Materials and Methods: Twenty seven patients were scheduled to undergo plaque excision and dermal grafting for Peyronie’s disease. Potency, bending of erected penis, and having painful erection were evaluated in patients before and after operation. To evaluate erectile dysfunction, we used International Index of Erectile Function (IIEF) by interviewing the patients and filling questionnaires by t...

Hamid Reza Nasseh; Hooman Jaladat; Gh, Pourmand; Abdolrasoul Mehrsai; Mohammad Reza Nikoobakht

2004-01-01

372

Grafting of a LLDPE using gamma irradiation  

Energy Technology Data Exchange (ETDEWEB)

In this investigation, the grafting of a commercial linear low-density polyethylene (LLDPE) with different concentrations of diethyl maleate (DEM, 5 and 15 wt.%) was carried out at different absorbed doses from a cobalt-60 source of gamma rays (0, 15, 30, 50, 100, 200 kGy). This process was performed in a decalin solution at 10% w/v to obtain a homogeneous dispersion of the monomer into the polyethylene matrix. The grafting degree was estimated by means of FTIR using a calibration curve reported in literature. Thermal properties of the functional polymers were studied by thermogravimetric analysis (TGA). Melt flow index (MFI) values were also taken. The results found indicate that the grafting degree increases as the concentration of DEM in the reaction mixture and the absorbed doses are increased upto 100 kGy, as expected. However, the behavior at higher doses is attributed to secondary reactions such as long-chain branching and/or crosslinking, which are faster than radical reactions responsible for the grafting of the DEM onto the polymeric chain. This fact was ascertained by the decrease of the MFI values as the applied irradiation was increased, irrespective of the quantity of DEM used in the grafting reaction. Therefore, in order to obtain a high grafting degree, the absorbed dose should be estimated carefully. Initial degradation temperatures of the grafted PEs decreased when the gamma irradiation dose was higher than 100 kGy. This indicates that the thermal stability decreases as higher doses are applied to the material, which is associated to branching and crosslinking. The grafting degree never exceeded 0.3 mol%, which demonstrates the low efficiency of the functionalization procedure here presented.

Catari, E. [Centro de Quimica, Laboratorio de Polimeros Instituto Venezolano de Investigaciones Cientificas (IVIC) (Venezuela); Albano, C. [Centro de Quimica, Laboratorio de Polimeros Instituto Venezolano de Investigaciones Cientificas (IVIC) (Venezuela) and Universidad Central de Venezuela, Facultad de Ingenieria, Escuela de Ingenieria Quimica (Venezuela)]. E-mail: calbano@ivic.ve; Karam, A. [Centro de Quimica, Laboratorio de Polimeros Instituto Venezolano de Investigaciones Cientificas (IVIC) (Venezuela)]. E-mail: akaram@quimica.ivic.ve; Perera, R. [Departamento de Mecanica, Universidad Simon Bolivar (Venezuela); Silva, P. [Centro de Fisica, Laboratorio de Fisica de la Materia Condensada, Instituto Venezolano de Investigaciones Cientificas (IVIC), Caracas (Venezuela); Gonzalez, J. [Departamento de Mecanica, Universidad Simon Bolivar (Venezuela)

2005-07-01

373

Fusarium incarnatum/equiseti hemodialysis graft infection  

Directory of Open Access Journals (Sweden)

Full Text Available Hemodialysis graft infections typically occur as a result of contamination by skin flora at the time of insertion or become secondarily infected after high-grade bacteremia. Infection of implanted vascular devices with filamentous fungi is rare. We report a case of infection of an implanted polytetrafluoroethylene dialysis graft with Fusarium incarnatum/equiseti that did not grow in cultures of tissue but was identified by molecular means.

Jeffery D. Punch

2010-08-01

374

Fusarium incarnatum/equiseti hemodialysis graft infection.  

Science.gov (United States)

Hemodialysis graft infections typically occur as a result of contamination by skin flora at the time of insertion or become secondarily infected after high-grade bacteremia. Infection of implanted vascular devices with filamentous fungi is rare. We report a case of infection of an implanted polytetrafluoroethylene dialysis graft with Fusarium incarnatum/equiseti that did not grow in cultures of tissue but was identified by molecular means. PMID:24470894

Riddell, James; Woodside, Kenneth J; Leavitt, Matthew A; Newton, Duane W; Punch, Jeffery D

2010-08-01

375

Fusarium incarnatum/equiseti hemodialysis graft infection  

OpenAIRE

Hemodialysis graft infections typically occur as a result of contamination by skin flora at the time of insertion or become secondarily infected after high-grade bacteremia. Infection of implanted vascular devices with filamentous fungi is rare. We report a case of infection of an implanted polytetrafluoroethylene dialysis graft with Fusarium incarnatum/equiseti that did not grow in cultures of tissue but was identified by molecular means.

Punch, Jeffery D.; Newton, Duane W.; Leavitt, Matthew A.; Woodside, Kenneth J.; James Riddell

2010-01-01

376

Dermis fat grafting in contracted socket  

OpenAIRE

5 cases of severely contracted sockets were recon-structed with the use of dermis-fat graft. This type of graft is extremely useful as it is more viable and is a suitable replacement for soft tissue deficiency as in case of contracted socket. Excellent results were obtained and this method seems to be the method of choice in the manage-ment of such cases.

Betharia S; Patil N

1988-01-01

377

Local graft irradiation in renal transplant rejection  

Energy Technology Data Exchange (ETDEWEB)

From 1977 to 1988, of 142 renal transplantations, seven recipients (4.9%) received local graft irradiation following rejective reaction refractory to antirejection medical managements. Concurrent with the administration of pulsed high dose methylprednisolone and other antirejection medical managements, the graft was irradiated with a total dose of 6.0 Gy-150 cGy per fraction every other day at the midplane of the graft using two opposing portals of 4MX Linac. The fields were defined by palpation and echography. All patients had improvements in serum creatinine on the 10th day after beginning the irradiation. Four patients with peripheral lymphocytosis during the irradiation combined with pulsed high dose methylprednisolone improved in renal functions. On the other hand, out of 3 patients with lymphcytopenic changes, in two the transplanted graft was removed due to deteriorations, and the other patient is currently suffering from chronic rejection. Local graft irradiation can be useful in maintaining a rejective graft and reversing its functions in some patients whose rejective reaction failed to respond to the antirejection medical managements. (author).

Kawamura, Masashi; Kataoka, Masaaki; Itoh, Hisao (Ehime Univ., Matsuyama (Japan). School of Medicine)

1990-04-01

378

Polypeptide Grafted Hyaluronan: Synthesis and Characterization  

Energy Technology Data Exchange (ETDEWEB)

Poly(L-leucine) grafted hyaluronan (HA-g-PLeu) has been synthesized via a Michael addition reaction between primary amine terminated poly(L-leucine) and acrylate-functionalized HA (TBAHA-acrylate). The precursor hyaluronan was first functionalized with acrylate groups by reaction with acryloyl chloride in the presence of triethylamine in N,N-dimethylformamide. 1H NMR analysis of the resulting product indicated that an increase in the concentration of acryloylchoride with respect to hydroxyl groups on HA has only a moderate effect on functionalization efficiency, f. A precise control of stoichiometry was not achieved, which could be attributed to partial solubility of intermolecular aggregates and the hygroscopic nature of HA. Michael addition at high [PLeu- NH2]/[acrylate]TBAHA ratios gave a molar grafting ratio of only 0.20 with respect to the repeat unit of HA, indicating grafting limitation due to insolubility of the grafted HA-g-PLeu. Soluble HA-g-PLeu graft copolymers were obtained for low grafting ratios (<0.039) with <8.6% by mass of PLeu and were characterized thoroughly using light scattering, 1H NMR, FT-IR, and AFM techniques. Light scattering experiments showed a strong hydrophobic interaction between PLeu chains, resulting in aggregates with segregated nongrafted HA segments. This yields local networks of aggregates, as demonstrated by atomic force microscopy. Circular dichroism spectroscopy showed a -sheet conformation for aggregates of poly(L-leucine).

Wang, Xiaojun [ORNL; Messman, Jamie M [ORNL; Mays, Jimmy [ORNL; Baskaran, Durairaj [University of Tennessee, Knoxville (UTK)

2010-01-01

379

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

380

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

381

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.

382

Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection  

Directory of Open Access Journals (Sweden)

Full Text Available Cold agglutinins are of unique relevance in cardiac surgerybecause of the use of hypothermic cardiopulmonary bypass (CPB. Cold autoimmune diseases are defined by the presence of abnormal circulating proteins (usually IgM or IgA antibodies that agglutinate in response to a decrease in body temperature. These disorders include cryoglobulinemia and cold hemagglutinin disease.Immunoglobulin M autoantibodies to red blood cells, which activateat varying levels of hypothermia, can cause catastrophic hemagglutination,microvascular thrombosis, or hemolysis. Management of anesthesia in these patients includes strict maintenance of normothermia. Patients scheduled for the surgery requiring cardiopulmonary bypass present significant challenges. Use of systemic hypothermia may be contraindicated, and cold cardioplegia solutions may precipitate intracoronary hemagglutination with consequent thrombosis, ischemia, or infarction. Management of CPB andmyocardial protection requires individualized planning. We describea case of MV repair and CABG in a patient with high titercold agglutinins and high thermal amplitude for antibody activation.Normothermic CPB and continuous warm blood cardioplegia weresuccessfully used.

Kambiz Alizadeh

2014-02-01

383

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

Science.gov (United States)

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. PMID:20454503

Serrano, Carlos; Rocha e Silva, Mauricio

2010-04-01

384

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

385

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

Energy Technology Data Exchange (ETDEWEB)

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.

Fouad, F.M.; MacIntyre, W.J.; Tarazi, R.C.

1981-03-01

386

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

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

The hemodynamic effects of methylene blue when administered at the onset of cardiopulmonary bypass.  

Science.gov (United States)

Hypotension occurs during cardiopulmonary bypass (CPB), in part because of induction of the inflammatory response, for which nitric oxide and guanylate cyclase play a central role. In this study we examined the hemodynamic effects of methylene blue (MB), an inhibitor of guanylate cyclase, administered during cardiopulmonary bypass (CPB) to patients taking angiotensin-converting enzyme inhibitors. Thirty patients undergoing cardiac surgery were randomized to receive either MB (3 mg/kg) or saline (S) after institution of CPB and cardioplegic arrest. CPB was managed similarly for all study patients. Hemodynamic data were assessed before, during, and after CPB. The use of vasopressors was recorded. All study patients experienced a similar reduction in mean arterial blood pressure (MAP) and systemic vascular resistance (SVR) with the onset of CPB and cardioplegic arrest. MB increased MAP and SVR and this effect lasted for 40 minutes. The saline group demonstrated a persistently reduced MAP and SVR throughout CPB. The saline group received phenylephrine more frequently during CPB, and more norepinephrine after CPB to maintain a desirable MAP. The MB group recorded significantly lower serum lactate levels despite equal or greater MAP and SVR. In conclusion, administration of MB after institution of CPB for patients taking angiotensin-converting enzyme inhibitors increased MAP and SVR and reduced the need for vasopressors. Furthermore, serum lactate levels were lower in MB patients, suggesting more favorable tissue perfusion. PMID:16790616

Maslow, Andrew D; Stearns, Gary; Butala, Parag; Batula, Parag; Schwartz, Carl S; Gough, Jeffrey; Singh, Arun K

2006-07-01

389

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)

390

Use of the cardiopulmonary flow index to evaluate cardiac function in thoroughbred horses  

International Nuclear Information System (INIS)

The ratio of the cardiopulmonary blood volume to stroke volume is called the cardiopulmonary flow index (CPFI). The CPFI can be determined indirectly from the simultaneous recording of a radiocardiogram and an electrocardiogram. The CPFI and cardiac output were measured simultaneously in horses that were diagnosed as having cardiac disease. The results obtained from these subjects were compared with those from control animals and significant differences were found between the mean CPFI of the control horses and those with macroscopically visible myocardial fibrosis on post mortem examination. No significant differences were found between the means of the cardiac output measured in either of the groups of horses. The effect of pharmacological acceleration of the heart rate on the CPFI was also studied. Significant differences were found between the mean CPFI and the slopes of the regression lines of CPFI on heart rate of the control and principal groups of horses. These differences were greatest at heart rates near to the resting heart rates of the individuals. The CPFI was found to be a more sensitive measure of cardiac function than cardiac output, in the horses. 16 refs., 2 figs., 2 tabs

391

Report of the National Consensus Conference on Family Presence During Pediatric Cardiopulmonary Resuscitation and Procedures.  

Science.gov (United States)

Representatives from 18 national organizations were convened for a conference to develop recommendations regarding family presence (FP) during pediatric procedures and cardiopulmonary resuscitation. Before the conference, invitees were given a questionnaire and provided with current literature regarding FP. A modified Delphi process was used to develop consensus, including use of multiple questionnaires and breakouts for discussion of specific issues. Participants were encouraged to develop consensus recommendations based on the literature and discussions. Changes in attitude were tracked with repeat questionnaires. Results of the conference were circulated to participants for review and revision. Consensus recommendations include (1) consider FP as an option for families during pediatric procedures and cardiopulmonary resuscitation, (2) offer FP as an option after assessing factors that could adversely affect the interaction, (3) if family is not offered the option for FP, document the reasons why, (4) always consider the safety of the health care team, (5) develop in-hospital transport and transfer policies and procedures for FP, such as family member definition, preparation of the family, handling disagreements, and providing support for the staff, (6) obtain legal review of policies, (7) include education in FP in all core curricula and orientation for health care providers, (8) promote research into best methods for education; effects of FP on patients, family, and staff; best practices for FP; and legal issues regarding FP, among others. These recommendations were approved in concept by the American Academy of Pediatrics and the Ambulatory Pediatrics Association. PMID:16439283

Henderson, Deborah Parkman; Knapp, Jane F

2006-02-01

392

Graft and Patient Survival in Kidney Transplant Recipients Selected for de novo Steroid-Free Maintenance Immunosuppression  

OpenAIRE

Steroid-free regimen is increasingly employed in kidney transplant recipients across transplant centers. However, concern remains because of unknown impact of such approach on long-term graft and patient survival. We studied outcomes of steroid-free immunosuppression in a population-based U.S. cohort of kidney transplant recipients.

Luan, Fu L.; Steffick, Diane E.; Gadegbeku, Crystal; Norman, Silas P.; Wolfe, Robert; Ojo, Akinlolu O.

2008-01-01

393

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

Science.gov (United States)

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

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

2015-03-24

394

Temperature-dependent conformational changes of PNIPAM grafted chains in water : effects of molecular weight and grafting density.  

Energy Technology Data Exchange (ETDEWEB)

Poly(N-isopropyl acrylamide) (PNIPAM) is perhaps the most well known member of the class of responsive polymers. Free PNIPAM chains have a lower critical solution temperature in water at {approx}31 C. This very sharp transition ({approx}5 C) is attributed to alterations in the hydrogen bonding interactions of the amide group. Grafted chains of PNIPAM have shown promise for creating responsive surfaces. Examples include controlling the adsorption of proteins or bacteria, regulating the flow of liquids in narrow filaments or mesoporous materials, control of enzymatic activity, and releasing the contents of liposomes. Conformational changes of the polymer are likely to play a role in some of these applications, in addition to changes in local interactions. In this work we investigated the T-dependent conformational changes of grafted PNIPAM chains in D2O using neutron reflection and AFM. The molecular weight (M) and surface density of the PNIPAM brushes were controlled using atom-transfer radical polymerization. We discovered a strong effect of surface density. At lower surface densities, in the range typically achieved with grafting-to methods, we observed very little conformational change. At higher surface densities, significant changes with T were observed. The results will be compared with numerical SCF calculations employing an effective (conc.-dependent) Flory-Huggins chi parameter extracted from the solution phase diagram. For the case of high M and high surface density, a non-monotonic change in profile shape with T was observed. This will be discussed in the context of vertical phase separation predicted for brushes of water-soluble polymers within two-state models.

Satija, Sushil K. (National Institute of Standards and Technology, Gaithersburg, MD); Mendez, Sergio (University of New Mexico, Albuquerque, NM); Kent, Michael Stuart; Yim, Hyun; Lopez, Gabriel P. (University of New Mexico, Albuquerque, NM)

2005-03-01

395

Multifunctional network-structured film coating for woven and knitted polyethylene terephthalate against cardiovascular graft-associated infections.  

Science.gov (United States)

Multifunctional network-structured polymeric coat for woven and knitted forms of crimped polyethylene terephthalate PET graft was developed to limit graft-associated infections. A newly synthesized antibacterial sulfadimethoxine polyhexylene adipate-b-methoxy polyethylene oxide (SD-PHA-b-MPEO) di-block copolymer was employed. Our figures of merit revealed that the formed coat showed a porous topographic architecture which manifested paramount properties, mostly bacterial anti-adhesion efficiency and biocompatibility with host cells. Compared to untreated grafts, the coat presented marked reduction of adhered Gram-positive Staphylococcus epidermidis previously isolated from a patient's vein catheter by 2.6 and 2.3 folds for woven and knitted grafts, respectively. Similarly, bacterial anti-adhesion effect was observed for Staphylococcus aureus by 2.3 and 2.4 folds, and by 2.9 and 2.7 folds for Gram-negative Escherichia coli for woven and knitted grafts, respectively. Additionally, adhesion and growth characteristics of L929 cells on the modified grafts revealed no significant effect on the biocompatibility. In conclusion, coating of PET with (SD-PHA-b-MPEO) is a versatile approach offers the desired bacterial anti-adhesion effect and host biocompatibility. PMID:25796119

Al Meslmani, Bassam M; Mahmoud, Gihan F; Sommer, Frank O; Lohoff, Michael D; Bakowsky, Udo

2015-05-15

396

Intraoperative graft assessment during coronary artery bypass surgery.  

Science.gov (United States)

Coronary artery bypass grafting (CABG) is an established revascularization method for treating multivessel coronary artery disease. The goal of CABG is to achieve complete revascularization with a durable, patent graft without reintervention. However, early graft failure, including that associated with technical errors, has been reported. This makes intraoperative verification of graft patency one of the most important ways in which surgeons can reduce the rate of early graft failure. Conventional angiography is considered the gold standard for graft assessment. However, because it is invasive and inconvenient, several alternatives to intraoperative graft assessment have become available that help reduce early graft failure by allowing revision of the anastomosis intraoperatively. The aim of this article is to review the advantages and disadvantages of several intraoperative graft assessment methods for CABG. PMID:25556862

Fukui, Toshihiro

2015-03-01

397

Physical properties of agave cellulose graft polymethyl methacrylate  

Energy Technology Data Exchange (ETDEWEB)

The grafting polymerization of methyl methacrylate and Agave cellulose was prepared and their structural analysis and morphology were investigated. The grafting reaction was carried out in an aqueous medium using ceric ammonium nitrate as an initiator. The structural analysis of the graft copolymers was carried out by Fourier transform infrared and X-ray diffraction. The graft copolymers were also characterized by field emission scanning electron microscopy (FESEM). An additional peak at 1732 cm{sup ?1} which was attributed to the C=O of ester stretching vibration of poly(methyl methacrylate), appeared in the spectrum of grafted Agave cellulose. A slight decrease of crystallinity index upon grafting was found from 0.74 to 0.68 for cellulose and grafted Agave cellulose, respectively. Another evidence of grafting showed in the FESEM observation, where the surface of the grafted cellulose was found to be roughed than the raw one.

Rosli, Noor Afizah; Ahmad, Ishak; Abdullah, Ibrahim; Anuar, Farah Hannan [Polymer Research Centre (PORCE), School of Chemical Sciences and Food Technology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 Bangi Selangor (Malaysia)

2013-11-27

398

Radiation grafting of maleic anhydride onto polypropylene in suspension system  

Science.gov (United States)

This paper studies the grafting of maleic anhydride (MAH) onto polypropylene (PP) performed in suspension through co-irradiation in the absence of an initiator. The effect of radiation dose and MAH concentration on the graft degree of MAH onto PP was investigated. The graft degree and relative viscosity of grafted MAH were investigated by means of chemical titration and viscosity measurements. The results show that the co-irradiation in suspension systems can obviously cause the increase of the amount of grafted MAH, implying that the grafting reaction consists of chain scission and the grafting reaction of the produced macroradicals with MAH. The percentage of grafting of the product amounts to 4.82%. The molecular structures of the prepared grafted MAH were characterized by Fourier-transform infrared spectroscopy (FT-IR). Differential scanning calorimetry (DSC) and wide-angle X-ray diffraction (WXRD) were used to determine the degree of crystallinity and crystalline structure.

Tan, Xiumin; Xu, Yongshen

399

Mandible reconstruction with vascularized bone grafts. A histologic evaluation.  

Science.gov (United States)

To our knowledge, a histologic evaluation of bone healing after mandible reconstruction with vascularized human bone grafts has not been previously reported. Serial sections through both the decalcified graft and the junction between mandible and graft were evaluated in four patients who required surgical removal of their reconstructed mandibles. A failed scapular bone graft that had been wrapped within a pectoralis major myocutaneous flap for salvage following pedicle thrombosis showed markedly resorbed but viable bone with a fibrous union to the native mandible. Viable vascularized grafts without evidence of ongoing resorption characterized an iliac osteocutaneous bone graft and two scapula osteocutaneous grafts that healed with continuity of healthy bone between graft and mandible. Observations from the evaluation of these specimens are made regarding bone circulation, bone union, and bone graft survival as they occur clinically. Implications regarding the techniques of bone plating and indications for use of vascularized bone in mandible reconstruction are discussed. PMID:1892626

Hoffman, H T; Harrison, N; Sullivan, M J; Robbins, K T; Ridley, M; Baker, S R

1991-08-01

400

Physical properties of agave cellulose graft polymethyl methacrylate  

International Nuclear Information System (INIS)

The grafting polymerization of methyl methacrylate and Agave cellulose was prepared and their structural analysis and morphology were investigated. The grafting reaction was carried out in an aqueous medium using ceric ammonium nitrate as an initiator. The structural analysis of the graft copolymers was carried out by Fourier transform infrared and X-ray diffraction. The graft copolymers were also characterized by field emission scanning electron microscopy (FESEM). An additional peak at 1732 cm?1 which was attributed to the C=O of ester stretching vibration of poly(methyl methacrylate), appeared in the spectrum of grafted Agave cellulose. A slight decrease of crystallinity index upon grafting was found from 0.74 to 0.68 for cellulose and grafted Agave cellulose, respectively. Another evidence of grafting showed in the FESEM observation, where the surface of the grafted cellulose was found to be roughed than the raw one

401

[Preoperative magnetic resonance angiography findings and postoperative neurological complications in 93 cases of CABG with cardiopulmonary bypass].  

Science.gov (United States)

Between February 1994 and January 1997, 102 of the 146 patients treated by coronary artery bypass grafting (CABG) had undergone magnetic resonance angiography (MRA) of the brain and neck before the operation, and arterial stenosis or occlusion had been detected in 38 (36.9%) of them. Two of these patients had complicating severe calcification of the ascending aorta, and CABG was performed without cardiopulmonary bypass (CPB). Seven patients without stenotic lesions on MRA were also treated by CABG without CPB for other complications. In addition to the 102 patients one patient had been found to have occlusion of the left common carotid artery and poor enhancement of the distal portion, and as a result we switched from CABG to percutaneous transluminal angioplasty (PTCA). We enrolled 93 patients in this study excluding these 10 patients. The patients were distributed into the three groups according to the MRA findings. Group C = no stenotic lesions (58 patients). Group S = stenosis of or = 70% (9 patients). Enhancement distal to the stenotic or occlusive lesions was good in all patients in group S and SS. We then examined them for the incidence of postoperative neurological complications. There were no significant differences among the three groups in regard to age, male/female ratio, or incidence of hypertension and hyperlipidemia. In Group S, the incidence of diabetes was significantly higher than in the other Groups. The incidence of prior stroke was significantly higher and the number of coronary arteries affected was significantly larger in group SS than the other groups. There were no significant differences among the three groups with regard to intraoperative variables. The lowest mean arterial pressure on CPB was 44.3 +/- 7.4 mmHg, 48.0 +/- 8.8 mmHg, 46.3 +/- 7.8 mmHg in Group C, S, and SS, respectively, In all groups the lowest mean arterial pressure on CPB was below 50 mmHg. There were no significant differences among the three groups with regard to time to awaken and time to extubation. Two patients experienced transient conciousness disturbance after CABG, one in Group C, the other in Group SS, but no new lesions were detected by brain CT. Only one patient, in Group C. suffered a stroke and had a new lesion on brain CT a month after the operation. No strokes occurred in the perioperative period. In nine patients with good enhancement distal to the severe stenotic or occlusive lesion on MRA of the brain and neck the lowest mean arterial pressure on CPB was below 50 mmHg, but there was no postoperative neurological complications due to the low perfusion pressure on CPB. The results of this study suggested that CABG with CPB can be performed safely in patients with good enhancement distal to the stenotic or occlusive lesions on MRA of the brain and neck. PMID:10037831

Koyama, T; Mochizuki, T; Mitsui, N; Marui, A

1998-12-01

402

Deficiency of employability capacity  

OpenAIRE

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 havin...

Pelse I.; Vilka L.

2012-01-01

403

Treatment of venous aortorenal bypass graft aneurysm using a stent-graft.  

Science.gov (United States)

We present the case of a 77-year-old male patient who had undergone a bilateral venous aortorenal bypass graft 30 years previously. Thirteen years previously, the patient was shown to have a decrease in renal function, with mild shrinking of both kidneys; additionally, a stenosis was found in the left proximal anastomosis. At the most recent follow-up visit (1 year previously), ultrasound revealed an aneurysm (42 mm in diameter) of the left renal bypass graft